Physical disability, life stress, and psychosocial adjustment in multiple sclerosis.

PubMed

Zeldow, P B; Pavlou, M

1984-02-01

Eighty-one outpatients with diagnosed multiple sclerosis were studied in an effort to examine the relative contributions of physical health status, life stress, duration of illness, age, sex, marital status, and social class on various aspects of personal and interpersonal functioning. Stepwise multiple regression analyses were performed to identify the most significant discriminators of the seven psychosocial measures. Physical health status exerted the broadest influence, affecting personal efficiency and well-being, capacity for independent thought and action, self-confidence, self-reliance, and number of meaningful social contacts. Life stress was associated with lowered personal efficiency and sense of well-being. Duration of illness and the demographic variables had few or no effects on psychosocial adjustment. Discussion contrasts the present findings with others in the rehabilitation literature and specifies certain limitations of the study's design.

Non-cereal food consumption, food insecurity and nutritional status of children and mothers: a case study in Bangladesh.

PubMed

Rabiul, Islam G M; Jahangir, Alam M; Buysse, J

2012-04-01

The aim of this study is to investigate the effects of food insecurity derived from non-cereal food consumption on nutritional status of children and mothers in a poverty-prone region in Bangladesh. Data from the Bangladesh Nutritional Surveillance Project, 2005 of Helen Keller International were used to relate non-cereal food consumption and household food insecurity to nutritional status of children and their mothers. Multiple regressions were used to determine the association between the nutritional outcomes and the explanatory variables. In the case of binary and multi-level outcomes, logistic regressions were used as well. Non-cereal dietary diversity was found to have little predictive power on BMI and MUAC of mothers and on the nutritional status of the children. Maternal education is strongly associated with mothers' and children's nutritional status. Dietary diversity based on non-cereal food consumption can be a useful tool to investigate the nutritional status of poor households, but more studies are needed to verify these findings.

Contributions of sociodemographic factors to criminal behavior

PubMed Central

Mundia, Lawrence; Matzin, Rohani; Mahalle, Salwa; Hamid, Malai Hayati; Osman, Ratna Suriani

2016-01-01

We explored the extent to which prisoner sociodemographic variables (age, education, marital status, employment, and whether their parents were married or not) influenced offending in 64 randomly selected Brunei inmates, comprising both sexes. A quantitative field survey design ideal for the type of participants used in a prison context was employed to investigate the problem. Hierarchical multiple regression analysis with backward elimination identified prisoner marital status and age groups as significantly related to offending. Furthermore, hierarchical multinomial logistic regression analysis with backward elimination indicated that prisoners’ age, primary level education, marital status, employment status, and parental marital status as significantly related to stealing offenses with high odds ratios. All 29 nonrecidivists were false negatives and predicted to reoffend upon release. Similarly, all 33 recidivists were projected to reoffend after release. Hierarchical binary logistic regression analysis revealed age groups (24–29 years and 30–35 years), employed prisoner, and primary level education as variables with high likelihood trends for reoffending. The results suggested that prisoner interventions (educational, counseling, and psychotherapy) in Brunei should treat not only antisocial personality, psychopathy, and mental health problems but also sociodemographic factors. The study generated offending patterns, trends, and norms that may inform subsequent investigations on Brunei prisoners. PMID:27382342

Pre-fracture nutritional status is predictive of functional status at discharge during the acute phase with hip fracture patients: A multicenter prospective cohort study.

PubMed

Inoue, Tatsuro; Misu, Syogo; Tanaka, Toshiaki; Sakamoto, Hiroki; Iwata, Kentaro; Chuman, Yuki; Ono, Rei

2017-10-01

Malnutrition is common in patients with hip fractures, and elderly patients with hip fractures lose functional independence and often fail to recover previous functional status. The aim of this study was to determine whether pre-fracture nutritional status predicts functional status of patients with hip fracture at discharge from acute hospitals. In the present multicenter prospective cohort study, pre-fracture nutritional status was assessed using the Mini Nutritional Assessment Short-Form (MNA-SF). At discharge from acute hospitals, functional status was evaluated using a functional independent measurement instrument (FIM). Subsequently, multiple regression analyses were performed using FIM as the dependent variable and MNA-SF as the independent variable. Among the 204 patients analyzed in the present study, the mean length of hospital stay was 26.2 ± 12.6 days, and according to MNA-SF assessments, 51 (25.0%) patients were malnourished, 98 (48.0%) were at risk of malnutrition, and 55 (27.0%) were well-nourished before fracture. At discharge, FIM scores were higher in patients who were well-nourished than in those who were malnourished or were at risk of malnutrition (p < 0.01). After adjustment for confounding factors, multiple regression analyses showed that MNA-SF was a significant independent predictor for FIM at discharge (well-nourished vs. malnourished, β = -0.86, p < 0.01). Pre-fracture nutritional status was a significant independent predictor for functional status at discharge during the acute phase, warranting early assessment of nutritional status and early intervention for successful postoperative rehabilitation. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

The relationship between turbidity of mouth-rinsed water and oral health status.

PubMed

Takeuchi, Susumu; Ueno, Masayuki; Takehara, Sachiko; Pham, Thuy Anh Vu; Hakuta, Chiyoko; Morishima, Seiji; Shinada, Kayoko; Kawaguchi, Yoko

2013-01-01

The purpose of this study was to examine the relationship between turbidity of mouth rinsed water and oral health status such as dental and periodontal conditions, oral hygiene status, flow rate of saliva and oral bacteria. Subjects were 165 patients who visited the Dental Hospital, Tokyo Medical and Dental University. Oral health status, including dental and periodontal conditions, oral hygiene status and flow rate of saliva, was clinically examined. The turbidity was measured with a turbidimeter. Quantification of Fusobacterium spp, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola and total bacteria levels was performed using real-time PCR. The Pearson correlation and multiple regression analysis were used to explore the associations between the turbidity and oral health parameters. The turbidity showed significant correlations with the number of decayed teeth and deep pockets, the plaque index, extent of tongue coating and Fusobacterium spp, P. gingivalis, T. forsythia, T. denticola and total bacteria levels. In a multiple regression model, the turbidity was negatively associated with the flow rate of saliva and positively associated with the total number of bacteria (p < 0.001). Current findings suggested that turbidity of mouth rinsed water could be used as an indicator to evaluate oral health condition and the amount of bacteria in the oral cavity. In addition, the turbiditimeter appeared as a simple and objective device for screening abnormality of oral health condition at chair side as well as community-based research.

Step-rate cut-points for physical activity intensity in patients with multiple sclerosis: The effect of disability status.

PubMed

Agiovlasitis, Stamatis; Sandroff, Brian M; Motl, Robert W

2016-02-15

Evaluating the relationship between step-rate and rate of oxygen uptake (VO2) may allow for practical physical activity assessment in patients with multiple sclerosis (MS) of differing disability levels. To examine whether the VO2 to step-rate relationship during over-ground walking differs across varying disability levels among patients with MS and to develop step-rate thresholds for moderate- and vigorous-intensity physical activity. Adults with MS (N=58; age: 51 ± 9 years; 48 women) completed one over-ground walking trial at comfortable speed, one at 0.22 m · s(-1) slower, and one at 0.22 m · s(-1) faster. Each trial lasted 6 min. VO2 was measured with portable spirometry and steps with hand-tally. Disability status was classified as mild, moderate, or severe based on Expanded Disability Status Scale scores. Multi-level regression indicated that step-rate, disability status, and height significantly predicted VO2 (p<0.05). Based on this model, we developed step-rate thresholds for activity intensity that vary by disability status and height. A separate regression without height allowed for development of step-rate thresholds that vary only by disability status. The VO2 during over-ground walking differs among ambulatory patients with MS based on disability level and height, yielding different step-rate thresholds for physical activity intensity. Copyright © 2015 Elsevier B.V. All rights reserved.

The effects of sleep quality, physical activity, and environmental quality on the risk of falls in dementia.

PubMed

Eshkoor, Sima Ataollahi; Hamid, Tengku Aizan; Nudin, Siti Sa'adiah Hassan; Mun, Chan Yoke

2013-06-01

This study aimed to identify the effects of sleep quality, physical activity, environmental quality, age, ethnicity, sex differences, marital status, and educational level on the risk of falls in the elderly individuals with dementia. Data were derived from a group of 1210 Malaysian elderly individuals who were noninstitutionalized and demented. The multiple logistic regression model was applied to estimate the risk of falls in respondents. Approximately the prevalence of falls was 17% among the individuals. The results of multiple logistic regression analysis revealed that age (odds ratio [OR] = 1.03), ethnicity (OR = 1.76), sleep quality (OR = 1.46), and environmental quality (OR = 0.62) significantly affected the risk of falls in individuals (P < .05). Furthermore, sex differences, marital status, educational level, and physical activity were not significant predictors of falls in samples (P > .05). It was found that age, ethnic non-Malay, and sleep disruption increased the risk of falls in respondents, but high environmental quality reduced the risk of falls.

Assessing risk factors for periodontitis using regression

NASA Astrophysics Data System (ADS)

Lobo Pereira, J. A.; Ferreira, Maria Cristina; Oliveira, Teresa

2013-10-01

Multivariate statistical analysis is indispensable to assess the associations and interactions between different factors and the risk of periodontitis. Among others, regression analysis is a statistical technique widely used in healthcare to investigate and model the relationship between variables. In our work we study the impact of socio-demographic, medical and behavioral factors on periodontal health. Using regression, linear and logistic models, we can assess the relevance, as risk factors for periodontitis disease, of the following independent variables (IVs): Age, Gender, Diabetic Status, Education, Smoking status and Plaque Index. The multiple linear regression analysis model was built to evaluate the influence of IVs on mean Attachment Loss (AL). Thus, the regression coefficients along with respective p-values will be obtained as well as the respective p-values from the significance tests. The classification of a case (individual) adopted in the logistic model was the extent of the destruction of periodontal tissues defined by an Attachment Loss greater than or equal to 4 mm in 25% (AL≥4mm/≥25%) of sites surveyed. The association measures include the Odds Ratios together with the correspondent 95% confidence intervals.

Refractive Status at Birth: Its Relation to Newborn Physical Parameters at Birth and Gestational Age

PubMed Central

Varghese, Raji Mathew; Sreenivas, Vishnubhatla; Puliyel, Jacob Mammen; Varughese, Sara

2009-01-01

Background Refractive status at birth is related to gestational age. Preterm babies have myopia which decreases as gestational age increases and term babies are known to be hypermetropic. This study looked at the correlation of refractive status with birth weight in term and preterm babies, and with physical indicators of intra-uterine growth such as the head circumference and length of the baby at birth. Methods All babies delivered at St. Stephens Hospital and admitted in the nursery were eligible for the study. Refraction was performed within the first week of life. 0.8% tropicamide with 0.5% phenylephrine was used to achieve cycloplegia and paralysis of accommodation. 599 newborn babies participated in the study. Data pertaining to the right eye is utilized for all the analyses except that for anisometropia where the two eyes were compared. Growth parameters were measured soon after birth. Simple linear regression analysis was performed to see the association of refractive status, (mean spherical equivalent (MSE), astigmatism and anisometropia) with each of the study variables, namely gestation, length, weight and head circumference. Subsequently, multiple linear regression was carried out to identify the independent predictors for each of the outcome parameters. Results Simple linear regression showed a significant relation between all 4 study variables and refractive error but in multiple regression only gestational age and weight were related to refractive error. The partial correlation of weight with MSE adjusted for gestation was 0.28 and that of gestation with MSE adjusted for weight was 0.10. Birth weight had a higher correlation to MSE than gestational age. Conclusion This is the first study to look at refractive error against all these growth parameters, in preterm and term babies at birth. It would appear from this study that birth weight rather than gestation should be used as criteria for screening for refractive error, especially in developing countries where the incidence of intrauterine malnutrition is higher. PMID:19214228

Correlates of Successful Aging: Are They Universal?

ERIC Educational Resources Information Center

Litwin, Howard

2005-01-01

The analysis compared differing correlates of life satisfaction among three diverse population groups in Israel, examining background and health status variables, social environment factors, and activity indicators. Multiple regression analysis revealed that veteran Jewish-Israelis (n = 2,043) had the largest set of predictors, the strongest of…

Influence of Family Structure on Health among Youths with Diabetes.

ERIC Educational Resources Information Center

Thompson, Sanna J.; Auslander, Wendy F.; White, Neil H.

2001-01-01

Discusses the extent to which family structure is significantly associated with health in youth with Type 1 diabetes. Multiple regression analyses demonstrated that family structure remains a significant predictor of youth's health when statistically controlling for race, child's age, family socioeconomic status, and adherence. (BF)

Food Group Intakes as Determinants of Iodine Status among US Adult Population.

PubMed

Lee, Kyung Won; Shin, Dayeon; Cho, Mi Sook; Song, Won O

2016-05-26

Adequate intake of iodine is essential for proper thyroid function. Although dietary reference intakes for iodine have been established, iodine intake cannot be estimated due to the lack of data on iodine contents in foods. We aimed to determine if food group intakes can predict iodine status assessed by urinary iodine concentration (UIC) from spot urine samples of 5967 US adults in the National Health and Nutrition Examination Survey (NHANES) 2007-2012. From an in-person 24-h dietary recall, all foods consumed were aggregated into 12 main food groups using the individual food code of the US Department of Agriculture (USDA); dairy products, meat/poultry, fish/seaweed, eggs, legumes/nuts/seeds, breads, other grain products, fruits, vegetables, fats/oils, sugars/sweets, and beverages. Chi-square test, Spearman correlation, and multiple linear regression analyses were conducted to investigate the predictability of food group intakes in iodine status assessed by UIC. From the multiple linear regressions, the consumption of dairy products, eggs, and breads, and iodine-containing supplement use were positively associated with UIC, whereas beverage consumption was negatively associated with UIC. Among various food group intakes, dairy product intake was the most important determinant of iodine status in both US men and women. Subpopulation groups with a high risk of iodine deficiency may need nutritional education regarding the consumption of dairy products, eggs, and breads to maintain an adequate iodine status. Efforts toward a better understanding of iodine content in each food and a continued monitoring of iodine status within US adults are both warranted.

Identification determinant factors on willingness to pay for health services in Iran.

PubMed

Javan-Noughabi, Javad; Kavosi, Zahra; Faramarzi, Ahmad; Khammarnia, Mohammad

2017-11-21

A common method used to examine the relationship between internal preferences and caring externalities is willingness to pay (WTP) approach. We aimed to estimate WTP for health status with different severity level and identify determinant factors on WTP. For determining main factors in WTP, a cross-sectional study was conducted in Shiraz in the southeast of Iran, in March to April 2015. The open-ended method was used to estimate monthly WTP in private and altruistic section. Multivariate regression analyses using ordinary least squares were applied to examine the effect of Scio-demographic factors on WTP using SPSS software 21. Participants were willing to pay an average amount of $ 295 in health status 1 and an average amount of $ 596 in health status 6 (worst status) for internal preferences. Altruistic WTP for health status 1 was $ 294 and participants were willing to pay an average amount of $ 416 in health status 6. Multiple regression analysis identified monthly income as the key determinant of WTP for internal preferences and caring externalities (P < 0.01). With an increase of 1% in income, private WTP increase 1.38% in health status 1. The finding indicates that the mean of WTP increases at severe health status; therefore, health policy maker should allocate resources toward severe health status.

Changing physiological status predicts severe injury and need for specialized trauma center resources.

PubMed

Talbert, Steven

2009-01-01

This study evaluated the association between changing physiological status (delta data) with severe injury (SI) or need for trauma center resources (TCR). Prehospital and emergency department arrival weighted RTS (RTSw) were computed for patients with complete records entered into the registry from 2002 to 2004 (n = 23,753). Physiological change was classified as unchanged, deteriorated, or improved (PreRTSw vs EDRTSw). Performance of delta data was evaluated using standard epidemiological approaches and multiple logistic regression. Deterioration status predicted SI (operating room [OR] = 1.38) and TCR (OR = 2.09). Improved status predicted TCR (OR = 1.27). Delta data independently predicted both SI and TCR.

Subjective economic status, sex role attitudes, fertility, and mother's work.

PubMed

Moon, C

1987-07-01

Data were drawn from the General Social Survey conducted by the National Opinion Research Center (NORC) in 1985 to observe the effect of subjective economic status and sex role attitude on fertility and mother's work, controlling for major influential variables such as household resources, individual characteristics, and place of residence. A multiple regression method was used to examine factors affecting the employment status of currently married mothers. The study objective was to develop the household resources model by adding the subjective economic status, i.e., economic status as perceived by a mother, and to observe how a wife's work as a coping strategy varies with the current number of children and sex role attitudes, when controlling for other explanatory variables -- including the subjective economic status. The 274 study subjects were currently married women with 1 or more children and ranging in age from 18-55 years. The effect of age on women's employment was not "so" significant, i.e., there were conflicting findings on the curvilinear effect of age. The effect of wives' education was not significant at a 95% confidence level in all regression equations. Race was negatively correlated to the probability of married women. The effect of race on women's employment was not significant at .05 level for all regressions. Region had no effect on women's entry into gainful employment. The effect of current number of children was significant at a 95% confidence level before controlling for subjective economic status and sex role attitude, but its effect on women's employment was insignificant when 2 types of additional explanatory variables were introduced independently or together. The regression analysis revealed a neutral effect of husbands' occupational prestige on employment status. The observed regression coefficient revealed that the possibility of women's employment will increase by 2% when the annual family income from other sources decreases by $1000. The analysis provides evidence in support of the household resources model and Oppenheimer's economic squeezes model. The inclusion of sex role attitude in the regression model did not affect the magnitude of impact of subjective economic status on mother's employment. Financial status had a significant influence on women's working status. The influence of sex role attitude on mother's working was not significant at a 95% confidence level, but the deletion of subjective economic status variables did increase a confidence level of significance from 0.82 to 0.89, indicating the feasible interaction between sex role attitude and economic squeezes.

Does the utilization of dental services associate with masticatory performance in a Japanese urban population?: the Suita study

PubMed Central

Kikui, Miki; Kida, Momoyo; Kosaka, Takayuki; Yamamoto, Masaaki; Yoshimuta, Yoko; Yasui, Sakae; Nokubi, Takashi; Maeda, Yoshinobu; Kokubo, Yoshihiro; Watanabe, Makoto; Miyamoto, Yoshihiro

2015-01-01

Abstract There are numerous reports on the relationship between regular utilization of dental care services and oral health, but most are based on questionnaires and subjective evaluation. Few have objectively evaluated masticatory performance and its relationship to utilization of dental care services. The purpose of this study was to identify the effect of regular utilization of dental services on masticatory performance. The subjects consisted of 1804 general residents of Suita City, Osaka Prefecture (760 men and 1044 women, mean age 66.5 ± 7.9 years). Regular utilization of dental services and oral hygiene habits (frequency of toothbrushing and use of interdental aids) was surveyed, and periodontal status, occlusal support, and masticatory performance were measured. Masticatory performance was evaluated by a chewing test using gummy jelly. The correlation between age, sex, regular dental utilization, oral hygiene habits, periodontal status or occlusal support, and masticatory performance was analyzed using Spearman's correlation test and t‐test. In addition, multiple linear regression analysis was carried out to investigate the relationship of regular dental utilization with masticatory performance after controlling for other factors. Masticatory performance was significantly correlated to age when using Spearman's correlation test, and to regular dental utilization, periodontal status, or occlusal support with t‐test. Multiple linear regression analysis showed that regular utilization of dental services was significantly related to masticatory performance even after adjusting for age, sex, oral hygiene habits, periodontal status, and occlusal support (standardized partial regression coefficient β = 0.055). These findings suggested that the regular utilization of dental care services is an important factor influencing masticatory performance in a Japanese urban population. PMID:29744141

Does the utilization of dental services associate with masticatory performance in a Japanese urban population?: the Suita study.

PubMed

Kikui, Miki; Ono, Takahiro; Kida, Momoyo; Kosaka, Takayuki; Yamamoto, Masaaki; Yoshimuta, Yoko; Yasui, Sakae; Nokubi, Takashi; Maeda, Yoshinobu; Kokubo, Yoshihiro; Watanabe, Makoto; Miyamoto, Yoshihiro

2015-12-01

There are numerous reports on the relationship between regular utilization of dental care services and oral health, but most are based on questionnaires and subjective evaluation. Few have objectively evaluated masticatory performance and its relationship to utilization of dental care services. The purpose of this study was to identify the effect of regular utilization of dental services on masticatory performance. The subjects consisted of 1804 general residents of Suita City, Osaka Prefecture (760 men and 1044 women, mean age 66.5 ± 7.9 years). Regular utilization of dental services and oral hygiene habits (frequency of toothbrushing and use of interdental aids) was surveyed, and periodontal status, occlusal support, and masticatory performance were measured. Masticatory performance was evaluated by a chewing test using gummy jelly. The correlation between age, sex, regular dental utilization, oral hygiene habits, periodontal status or occlusal support, and masticatory performance was analyzed using Spearman's correlation test and t -test. In addition, multiple linear regression analysis was carried out to investigate the relationship of regular dental utilization with masticatory performance after controlling for other factors. Masticatory performance was significantly correlated to age when using Spearman's correlation test, and to regular dental utilization, periodontal status, or occlusal support with t -test. Multiple linear regression analysis showed that regular utilization of dental services was significantly related to masticatory performance even after adjusting for age, sex, oral hygiene habits, periodontal status, and occlusal support (standardized partial regression coefficient β  = 0.055). These findings suggested that the regular utilization of dental care services is an important factor influencing masticatory performance in a Japanese urban population.

Parental employment status and adolescents' health: the role of financial situation, parent-adolescent relationship and adolescents' resilience.

PubMed

Bacikova-Sleskova, Maria; Benka, Jozef; Orosova, Olga

2015-01-01

The paper deals with parental employment status and its relationship to adolescents' self-reported health. It studies the role of the financial situation, parent-adolescent relationship and adolescent resilience in the relationship between parental employment status and adolescents' self-rated health, vitality and mental health. Multiple regression analyses were used to analyse questionnaire data obtained from 2799 adolescents (mean age 14.3) in 2006. The results show a negative association of the father's, but not mother's unemployment or non-employment with adolescents' health. Regression analyses showed that neither financial strain nor a poor parent-adolescent relationship or a low score in resilience accounted for the relationship between the father's unemployment or non-employment and poorer adolescent health. Furthermore, resilience did not work as a buffer against the negative impact of fathers' unemployment on adolescents' health.

Overweight dogs exercise less frequently and for shorter periods: results of a large online survey of dog owners from the UK.

PubMed

German, Alexander J; Blackwell, Emily; Evans, Mark; Westgarth, Carri

2017-01-01

Canine obesity is now the number one health concern in dogs worldwide. Regular physical activity can improve health, and owners are advised to exercise their dogs on a regular basis. However, limited information exists about associations between overweight status of dogs and walking activity. An online survey was conducted between June and August in 2014, coinciding with the broadcast of a national UK television programme, exploring dog behaviour. Information gathered included signalment, overweight status, and owner-reported information on duration and frequency of dog walking. The University of Liverpool Ethics Committee approved the project, and owners consented to data use. Simple and multiple logistic regression analyses were used to determine associations between overweight status and dog walking activity. Data were available from 11 154 adult dogs, and 1801 (16·1 %) of these were reported as overweight by their owners. Dogs reported to be overweight dogs were more likely to be neutered ( P  < 0·0001) and older ( P  < 0·0001). Various breeds were over-represented including beagle, Cavalier King Charles spaniel, golden retriever, Labrador retriever and pug ( P  < 0·0001 for all). Both frequency and duration of walking were negatively associated with overweight status ( P  < 0·0001 for both). On multiple regression analysis, duration and frequency were independently and negatively associated with the odds of being overweight, along with a range of other factors including age, neuter status and breed. This study has identified associations between overweight status and exercise. In the future, studies should determine the reason for this association, and whether changes in walking activity can influence weight status.

In-State Tuition Policies for Undocumented Youth

ERIC Educational Resources Information Center

Vargas, Edward D.

2011-01-01

This article is an investigation into why U.S. states have enacted, banned, or continued with the status quo regarding in-state tuition policies for unauthorized youth. Using data from multiple government and nonprofit sources, a series of multinomial logistic regressions are estimated to explain the determinants of state behavior across the…

A cross-sectional study examining multiple mobility device use and fall status among middle-aged and older adults with multiple sclerosis.

PubMed

Finlayson, Marcia L; Peterson, Elizabeth W; Asano, Miho

2014-01-01

To document the prevalence of multiple mobility device use among adults with multiple sclerosis (MS) (≥ 55 years) and examine the association between falls status (faller/non-faller) and the number of mobility devices used. Cross-sectional data generated through telephone interviews with 353 participants was used for this secondary analysis. Descriptive statistics were used to address the first study purpose. Multiple device use was measured by the number of devices used, which ranged from 0 (never use a cane, walker, manual wheelchair, or power wheelchair/scooter) to 4 (use all four mobility devices at least some of the time). Logistic regression analysis was used to address the second purpose, with fall status used as the dependent variable (non-fallers [<1 per year] versus fallers [≥ 1 per year]). Just under 60% of participants reported the use of at least two mobility devices. For each additional mobility device used, the odds of being a faller increased by 1.47 times (95% CI = 1.14-1.90). Multiple mobility device use was common and the greater number of devices used, the greater the likelihood of being a faller. To prevent falls, this association requires further research to determine directionality.

Eating habits, health status, and concern about health: a study among 1641 employees in the German metal industry.

PubMed

Reime, B; Novak, P; Born, J; Hagel, E; Wanek, V

2000-04-01

Nutrition has been found to be associated with sociodemographic characteristics and concern about health. There is limited knowledge, however, of associations between blue-collar worker's diet, morbidity, and health care utilization. We conducted a survey on eating habits, physical symptoms, health care utilization, health status, and concern about health in two German metal companies. A self-administered questionnaire was mailed to employees of whom 1641 participated in the study (response rate 54. 7%). Most employees were characterized by a combination of healthy and unhealthy eating elements. Using linear regression analyses adjusted for age, gender, and occupational status, healthy eating was negatively associated with stomach aches and headaches, but not with cardiovascular disease. Restricted activity days and days in hospital were associated with healthy eating, but self-assessed health status and physician consultations were not. Using stepwise multiple regression analysis, age, gender, and concern about health were strongly and morbidity was weakly related to diet. Occupational status, marital status, and number of children were not associated with nutrition. Health promotion programs should motivate younger and male employees to participate in and aim toward increasing concern about health. Copyright 2000 American Health Foundation and Academic Press.

[Multiple roles and health among Korean women].

PubMed

Cho, Su-Jin; Jang, Soong-Nang; Cho, Sung-Il

2008-09-01

Most studies about multiple roles and women's health suggested that combining with paid job, being married and having children was more likely to improve health status than in case of single or traditional roles. We investigated whether there was better health outcome in multiple roles among Korean women coinciding with previous studies of other nations. Data were from the 2005 Korea National Health & Nutritional Examination Survey, a subsample of women aged 25-59 years (N=2,943). Health status was assessed for self-rated poor health, perceived stress and depression, respectively based on one questionnaire item. The age-standardized prevalence of all health outcomes were calculated by role categories and socioeconomic status. Multiple logistic regression was used to assess the association of self rated health, perceived stress, and depression with multiple roles adjusted for age, education, household income, number of children and age of children. Having multiple roles with working role was not associated with better health and psychological wellbeing. Compared to those with traditional roles, employed women more frequently experienced perceived stress, with marital and/or parental roles. Non-working single mothers suffered depression more often than women with traditional roles or other role occupancy. Socioeconomic status indicators were potent independent correlates of self-rated health and perceived stress. Employment of women with other roles did not confer additional health benefit to traditional family responsibility. Juggling of work and family responsibility appeared more stressful than traditional unemployed parental and marital role in Korean women.

[Associations of the Employment Status during the First 2 Years Following Medical Rehabilitation and Long Term Occupational Trajectories: Implications for Outcome Measurement].

PubMed

Holstiege, J; Kaluscha, R; Jankowiak, S; Krischak, G

2017-02-01

Study Objectives: The aim was to investigate the predictive value of the employment status measured in the 6 th , 12 th , 18 th and 24 th month after medical rehabilitation for long-term employment trajectories during 4 years. Methods: A retrospective study was conducted based on a 20%-sample of all patients receiving inpatient rehabilitation funded by the German pension fund. Patients aged <62 years who were treated due to musculoskeletal, cardiovascular or psychosomatic disorders during the years 2002-2005 were included and followed for 4 consecutive years. The predictive value of the employment status in 4 predefined months after discharge (6 th , 12 th , 18 th and 24 th month), for the total number of months in employment in 4 years following rehabilitative treatment was analyzed using multiple linear regression. Per time point, separate regression analyses were conducted, including the employment status (employed vs. unemployed) at the respective point in time as explanatory variable, besides a standard set of additional prognostic variables. Results: A total of 252 591 patients were eligible for study inclusion. The level of explained variance of the regression models increased with the point in time used to measure the employment status, included as explanatory variable. Overall the R²-measure increased by 30% from the regression model that included the employment status in the 6 th month (R²=0.60) to the model that included the work status in the 24 th month (R²=0.78). Conclusion: The degree of accuracy in the prognosis of long-term employment biographies increases with the point in time used to measure employment in the first 2 years following rehabilitation. These findings should be taken into consideration for the predefinition of time points used to measure the employment status in future studies. © Georg Thieme Verlag KG Stuttgart · New York.

Relationship of cariogenic bacteria levels with periodontal status and root surface caries in elderly Japanese.

PubMed

Saotome, Yasuhiko; Tada, Akio; Hanada, Nobuhiro; Yoshihara, Akihiro; Uematsu, Hiroshi; Miyazaki, Hideo; Senpuku, Hidenobu

2006-12-01

The relationship of the levels of cariogenic bacterial species with periodontal status and decayed root surfaces was investigated in elderly Japanese subjects. Three hundred and sixty-eight individuals (each 75 years old) were examined for periodontal status (pocket depth, attachment loss), root surface caries and salivary levels of mutans streptococci (MS) and lactobacilli (LB). Values >4 mm of attachment loss (rAL4) and for average attachment loss (aAL) of sites measured were significantly higher in subjects with LB than those without. Multiple regression analysis also showed a correlation between aAL and rAL4 values with the presence of LB (aAL p = 0.003; rAL4 p = 0.002). Further, multiple regression analysis of interacting factors regarding decayed root surfaces showed that LB carriers had a greater incidence of decayed root surface caries (p = 0.003), while MS and LB levels were correlated to the number of decayed root surfaces (LB p = 0.010; MS p = 0.026). Our results indicate that considerable attachment loss elevates the possibility of having LB, thus increasing the risk of root surface caries. It was also found that LB and MS measurements may be useful indicators of decayed root surfaces in elderly individuals with attachment loss.

Parent’s Socioeconomic Status, Adolescents’ Disposable Income, and Adolescents’ Smoking Status in Massachusetts

PubMed Central

Soteriades, Elpidoforos S.; DiFranza, Joseph R.

2003-01-01

Objectives. This study examined the association between parental socioeconomic status (SES) and adolescent smoking. Methods. We conducted telephone interviews with a probability sample of 1308 Massachusetts adolescents aged 12 to 17 years. We used multiple-variable-adjusted logistic regression models. Results. The risk of adolescent smoking increased by 28% with each step down in parental education and increased by 30% for each step down in parental household income. These associations persisted after adjustment for age, sex, race/ethnicity, and adolescent disposable income. Parental smoking status was a mediator of these associations. Conclusions. Parental SES is inversely associated with adolescent smoking. Parental smoking is a mediator but does not fully explain the association. PMID:12835202

Preference-based Health status in a German outpatient cohort with multiple sclerosis

PubMed Central

2013-01-01

Background To prospectively determine health status and health utility and its predictors in patients with multiple sclerosis (MS). Methods A total of 144 MS patients (mean age: 41.0 ±11.3y) with different subtypes (patterns of progression) and severities of MS were recruited in an outpatient university clinic in Germany. Patients completed a questionnaire at baseline (n = 144), 6 months (n = 65) and 12 months (n = 55). Health utilities were assessed using the EuroQol instrument (EQ-5D, EQ VAS). Health status was assessed by several scales (Expanded Disability Severity Scale (EDSS), Modified Fatigue Impact Scale (M-FIS), Functional Assessment of MS (FAMS), Beck Depression Inventory (BDI-II) and Multiple Sclerosis Functional Composite (MSFC)). Additionally, demographic and socioeconomic parameters were assessed. Multivariate linear and logistic regressions were applied to reveal independent predictors of health status. Results Health status is substantially diminished in MS patients and the EQ VAS was considerably lower than that of the general German population. No significant change in health-status parameters was observed over a 12-months period. Multivariate analyses revealed M-FIS, BDI-II, MSFC, and EDSS to be significant predictors of reduced health status. Socioeconomic and socio-demographic parameters such as working status, family status, number of household inhabitants, age, and gender did not prove significant in multivariate analyses. Conclusion MS considerably impairs patients’ health status. Guidelines aiming to improve self-reported health status should include treatment options for depression and fatigue. Physicians should be aware of depression and fatigue as co-morbidities. Future studies should consider the minimal clinical difference when health status is a primary outcome. PMID:24089999

Prevalence of vitamin D deficiency and associated factors in women and newborns in the immediate postpartum period

PubMed Central

do Prado, Mara Rúbia Maciel Cardoso; Oliveira, Fabiana de Cássia Carvalho; Assis, Karine Franklin; Ribeiro, Sarah Aparecida Vieira; do Prado, Pedro Paulo; Sant'Ana, Luciana Ferreira da Rocha; Priore, Silvia Eloiza; Franceschini, Sylvia do Carmo Castro

2015-01-01

Abstract Objective: To assess the prevalence of vitamin D deficiency and its associated factors in women and their newborns in the postpartum period. Methods: This cross-sectional study evaluated vitamin D deficiency/insufficiency in 226 women and their newborns in Viçosa (Minas Gerais, BR) between December 2011 and November 2012. Cord blood and venous maternal blood were collected to evaluate the following biochemical parameters: vitamin D, alkaline phosphatase, calcium, phosphorus and parathyroid hormone. Poisson regression analysis, with a confidence interval of 95%, was applied to assess vitamin D deficiency and its associated factors. Multiple linear regression analysis was performed to identify factors associated with 25(OH)D deficiency in the newborns and women from the study. The criteria for variable inclusion in the multiple linear regression model was the association with the dependent variable in the simple linear regression analysis, considering p<0.20. Significance level was α <5%. Results: From 226 women included, 200 (88.5%) were 20-44 years old; the median age was 28 years. Deficient/insufficient levels of vitamin D were found in 192 (85%) women and in 182 (80.5%) neonates. The maternal 25(OH)D and alkaline phosphatase levels were independently associated with vitamin D deficiency in infants. Conclusions: This study identified a high prevalence of vitamin D deficiency and insufficiency in women and newborns and the association between maternal nutritional status of vitamin D and their infants' vitamin D status. PMID:26100593

Factors predictive of immediate breast reconstruction following mastectomy for invasive breast cancer in Australia.

PubMed

Roder, D; Zorbas, H; Kollias, J; Pyke, C; Walters, D; Campbell, I; Taylor, C; Webster, F

2013-12-01

To investigate person, cancer and treatment determinants of immediate breast reconstruction (IBR) in Australia. Bi-variable and multi-variable analyses of the Quality Audit database. Of 12,707 invasive cancers treated by mastectomy circa 1998-2010, 8% had IBR. This proportion increased over time and reduced from 29% in women below 30 years to approximately 1% in those aged 70 years or more. Multiple regression indicated that other IBR predictors included: high socio-economic status; private health insurance; being asymptomatic; a metropolitan rather than inner regional treatment centre; higher surgeon case load; small tumour size; negative nodal status, positive progesterone receptor status; more cancer foci; multiple affected breast quadrants; synchronous bilateral cancer; not having neo-adjuvant chemotherapy, adjuvant radiotherapy or adjuvant hormone therapy; and receiving ovarian ablation. Variations in access to specialty services and other possible causes of variations in IBR rates need further investigation. Copyright © 2013 Elsevier Ltd. All rights reserved.

Depoliticizing Minority Admissions through Predicted Graduation Equations. AIR Forum 1982 Paper.

ERIC Educational Resources Information Center

Sanford, Timothy R.

The way that the University of North Carolina, Chapel Hill, has tried to depoliticize minority admissions through the use of predicted graduation equations that are race specific is examined. Multiple regression and discriminant analyses were used with nine independent variables (primarily academic) to predict graduation status of 1974 entering…

Factors Related to Play Therapists' Social Justice Advocacy Attitudes

ERIC Educational Resources Information Center

Parikh, Sejal B.; Ceballos, Peggy; Post, Phyllis

2013-01-01

The authors used a correlational research design to examine how belief in a just world, political ideology, socioeconomic status of family of origin, and percentage of racial minority clients were related to social justice advocacy attitudes among play therapists. A multiple regression was used to analyze the data. Results indicated that belief in…

Too Latino and Not Latino Enough: The Role of Ethnicity-Related Stressors on Latino College Students' Life Satisfaction

ERIC Educational Resources Information Center

Ojeda, Lizette; Navarro, Rachel L.; Meza, Rocio Rosales; Arbona, Consuelo

2012-01-01

The relationship between demographics (generation status, age, gender, education level) and ethnicity-related stressors, namely, perceived discrimination, stereotype confirmation concern, and own-group conformity pressure, and the life satisfaction of 115 Latino college students was examined. A hierarchical multiple regression analysis indicated…

Academic Advising and First-Generation College Students: A Quantitative Study on Student Retention

ERIC Educational Resources Information Center

Swecker, Hadyn K.; Fifolt, Matthew; Searby, Linda

2014-01-01

For this quantitative study, we used a multiple logistic regression technique to investigate the relationship between the number of meetings with an academic advisor and retention of first-generation students, as represented by enrollment status and academic standing at a large, public research institution in the Southeast. Consistent with…

Impact of night-shift work on the prevalence of erosive esophagitis in shipyard male workers.

PubMed

Chung, Tae Heum; Lee, Jiho; Kim, Moon Chan

2016-08-01

Whether night-shift work is a risk factor for gastroesophageal reflux disease is controversial. The aim of this study was to investigate the association between night-shift work and other factors, and erosive esophagitis. A cross-sectional study with 6040 male shipyard workers was performed. Esophagogastroduodenoscopic examination and a survey about night-shift work status, lifestyle, medical history, educational status, and marital status were conducted in all workers. The odds ratios of erosive esophagitis according to night-shift work status were calculated by using the logistic regression model. The prevalence of erosive esophagitis increased in the night-shift workers [odds ratio, 95 % confidence interval: 1.41 (1.03-1.94)]. According to multiple logistic regression models, night-shift work, obesity, smoking, and alcohol consumption of ≥140 g/week were significant risk factors for erosive esophagitis. By contrast, Helicobacter pylori infection was negatively associated with erosive esophagitis. Night-shift work is suggested to be a risk factor for erosive esophagitis. Avoidance of night-shift work and lifestyle modification should be considered for prevention and management of gastroesophageal reflux disease.

How Possibly Do Leisure and Social Activities Impact Mental Health of Middle-Aged Adults in Japan?: An Evidence from a National Longitudinal Survey.

PubMed

Takeda, Fumi; Noguchi, Haruko; Monma, Takafumi; Tamiya, Nanako

2015-01-01

This study aimed to investigate longitudinal relations between leisure and social activities and mental health status, considering the presence or absence of other persons in the activity as an additional variable, among middle-aged adults in Japan. This study used nationally representative data in Japan with a five-year follow-up period. This study focused on 16,642 middle-aged adults, age 50-59 at baseline, from a population-based, six-year panel survey conducted by the Japanese Ministry of Health, Labour and Welfare. To investigate the relations between two leisure activities ('hobbies or cultural activities' and 'exercise or sports') and four social activities ('community events', 'support for children', 'support for elderly individuals' and 'other social activities') at baseline and mental health status at follow-up, multiple logistic regression analysis was used. We also used multiple logistic regression analysis to investigate the association between ways of participating in these activities ('by oneself', 'with others', or 'both' (both 'by oneself' and 'with others')) at baseline and mental health status at follow-up. Involvement in both leisure activity categories, but not in social activities, was significantly and positively related to mental health status in both men and women. Furthermore, in men, both 'hobbies or cultural activities' and 'exercise or sports' were significantly related to mental health status only when conducted 'with others'. In women, the effects of 'hobbies or cultural activities' on mental health status were no differences regardless of the ways of participating, while the result of 'exercise or sports' was same as that in men. Leisure activities appear to benefit mental health status among this age group, whereas specific social activities do not. Moreover, participation in leisure activities would be effective especially if others are present. These findings should be useful for preventing the deterioration of mental health status in middle-aged adults in Japan.

Brain enlargement is associated with regression in preschool-age boys with autism spectrum disorders

PubMed Central

Nordahl, Christine Wu; Lange, Nicholas; Li, Deana D.; Barnett, Lou Ann; Lee, Aaron; Buonocore, Michael H.; Simon, Tony J.; Rogers, Sally; Ozonoff, Sally; Amaral, David G.

2011-01-01

Autism is a heterogeneous disorder with multiple behavioral and biological phenotypes. Accelerated brain growth during early childhood is a well-established biological feature of autism. Onset pattern, i.e., early onset or regressive, is an intensely studied behavioral phenotype of autism. There is currently little known, however, about whether, or how, onset status maps onto the abnormal brain growth. We examined the relationship between total brain volume and onset status in a large sample of 2- to 4-y-old boys and girls with autism spectrum disorder (ASD) [n = 53, no regression (nREG); n = 61, regression (REG)] and a comparison group of age-matched typically developing controls (n = 66). We also examined retrospective head circumference measurements from birth through 18 mo of age. We found that abnormal brain enlargement was most commonly found in boys with regressive autism. Brain size in boys without regression did not differ from controls. Retrospective head circumference measurements indicate that head circumference in boys with regressive autism is normal at birth but diverges from the other groups around 4–6 mo of age. There were no differences in brain size in girls with autism (n = 22, ASD; n = 24, controls). These results suggest that there may be distinct neural phenotypes associated with different onsets of autism. For boys with regressive autism, divergence in brain size occurs well before loss of skills is commonly reported. Thus, rapid head growth may be a risk factor for regressive autism. PMID:22123952

A population-based study on the association between rheumatoid arthritis and voice problems.

PubMed

Hah, J Hun; An, Soo-Youn; Sim, Songyong; Kim, So Young; Oh, Dong Jun; Park, Bumjung; Kim, Sung-Gyun; Choi, Hyo Geun

2016-07-01

The objective of this study was to investigate whether rheumatoid arthritis increases the frequency of organic laryngeal lesions and the subjective voice complaint rate in those with no organic laryngeal lesion. We performed a cross-sectional study using the data from 19,368 participants (418 rheumatoid arthritis patients and 18,950 controls) of the 2008-2011 Korea National Health and Nutrition Examination Survey. The associations between rheumatoid arthritis and organic laryngeal lesions/subjective voice complaints were analyzed using simple/multiple logistic regression analysis with complex sample adjusting for confounding factors, including age, sex, smoking status, stress level, and body mass index, which could provoke voice problems. Vocal nodules, vocal polyp, and vocal palsy were not associated with rheumatoid arthritis in a multiple regression analysis, and only laryngitis showed a positive association (adjusted odds ratio, 1.59; 95 % confidence interval, 1.01-2.52; P = 0.047). Rheumatoid arthritis was associated with subjective voice discomfort in a simple regression analysis, but not in a multiple regression analysis. Participants with rheumatoid arthritis were older, more often female, and had higher stress levels than those without rheumatoid arthritis. These factors were associated with subjective voice complaints in both simple and multiple regression analyses. Rheumatoid arthritis was not associated with organic laryngeal diseases except laryngitis. Rheumatoid arthritis did not increase the odds ratio for subjective voice complaints. Voice problems in participants with rheumatoid arthritis originated from the characteristics of the rheumatoid arthritis group (higher mean age, female sex, and stress level) rather than rheumatoid arthritis itself.

Employee Health Behaviors, Self-Reported Health Status, and Association With Absenteeism: Comparison With the General Population.

PubMed

Yun, Young Ho; Sim, Jin Ah; Park, Eun-Gee; Park, June Dong; Noh, Dong-Young

2016-09-01

To perform a comparison between health behaviors and health status of employees with those of the general population, to evaluate the association between employee health behaviors, health status, and absenteeism. Cross-sectional study enrolled 2433 employees from 16 Korean companies in 2014, and recruited 1000 general population randomly in 2012. The distribution of employee health behaviors, health status, and association with absenteeism were assessed. Employees had significantly worse health status and low rates of health behaviors maintenance compared with the general population. Multiple logistic regression model revealed that regular exercise, smoking cessation, work life balance, proactive living, religious practice, and good physical health status were associated with lower absenteeism. Maintaining health behaviors and having good health status were associated with less absenteeism. This study suggests investment of multidimensional health approach in workplace health and wellness (WHW) programs.

Relationship between a Belief in a Just World and Social Justice Advocacy Attitudes of School Counselors

ERIC Educational Resources Information Center

Parikh, Sejal B.; Post, Phyllis; Flowers, Claudia

2011-01-01

The purpose of this study was to examine how belief in a just world (BJW), political ideology, religious ideology, socioeconomic status of origin, and race relate to social justice advocacy attitudes among school counseling professionals. A sequential multiple regression indicated that political ideology and BJW were statistically significant…

Analyzing the Gender Gap in Math Achievement: Evidence from a Large-Scale US Sample

ERIC Educational Resources Information Center

Cheema, Jehanzeb R.; Galluzzo, Gary

2013-01-01

The US portion of the Program for International Student Assessment (PISA) 2003 student questionnaire comprising of 4,733 observations was used in a multiple regression framework to predict math achievement from demographic variables, such as gender, race, and socioeconomic status, and two student-specific measures of perception, math anxiety and…

Cobalamin and folate status predicts mental development scores in North Indian children 12-18 mo of age.

PubMed

Strand, Tor A; Taneja, Sunita; Ueland, Per M; Refsum, Helga; Bahl, Rajiv; Schneede, Joern; Sommerfelt, Halvor; Bhandari, Nita

2013-02-01

Micronutrient deficiencies can affect cognitive function. Many young children in low- and middle-income countries have inadequate cobalamin (vitamin B-12) status. The objective was to measure the association of plasma concentrations of folate, cobalamin, total homocysteine, and methylmalonic acid with cognitive performance at 2 occasions, 4 mo apart, in North Indian children aged 12-18 mo. Bayley Scales of Infant Development II were used to assess cognition. In multiple regression models adjusted for several potential confounders, we measured the association between biomarkers for folate and cobalamin status and psychomotor or mental development scores on the day of blood sampling and 4 mo thereafter. Each 2-fold increment in plasma cobalamin concentration was associated with a significant increment in the mental development index score of 1.3 (95% CI: 0.2, 2.4; P = 0.021). Furthermore, each 2-fold increment in homocysteine or methylmalonic acid concentration was associated with a decrement in mental development index score of 2.0 (95% CI: 0.5, 3.4; P = 0.007) or 1.1 (95% CI: 0.3, 1.8; P = 0.004) points, respectively. Plasma folate concentration was significantly and independently associated with mental development index scores only when children with poor cobalamin status were excluded, ie, in those who had cobalamin concentrations below the 25th percentile. None of these markers was associated with psychomotor scores in the multiple regression models. Cobalamin and folate status showed a statistically significant association with cognitive performance. Given the high prevalence of deficiencies in these nutrients, folate and cobalamin supplementation trials are required to measure any beneficial effect on cognition.

Relationship between dental caries status, nutritional status, snack foods, and sugar-sweetened beverages consumption among primary schoolchildren grade 4-6 in Nongbua Khamsaen school, Na Klang district, Nongbua Lampoo Province, Thailand.

PubMed

Lueangpiansamut, Juthamas; Chatrchaiwiwatana, Supaporn; Muktabhant, Benja; Inthalohit, Warangkana

2012-08-01

To evaluate relationship between dental caries status, nutritional status, snack foods, and sugar-sweetened beverages consumption among primary schoolchildren grade 4-6 in Na Klang district, Nongbua Lampoo province, Thailand in 2011. The subjects included 111 children (57 boys and 54 girls), aged 11 and 12 years, who were studying in grades 4 to 6 in the year 2011. The data were collected through questionnaires, interview, and oral examination. Results were obtained by means of descriptive, bivariate, and multiple logistic regression analyses. Prevalence of dental caries in the children was 82.9% with the mean DMFT of 2.28. The dental caries prevalence in permanent and primary dentitions was 69.4% and 34.2%, respectively. About 10.2% of the children were underweight, 13.0% were obese, and 7.5% were stunting. Findings from the final multiple logistic regression models showed that weight-for-age malnutrition as well as eating sweets before bedtime were significantly related to dental caries in primary dentition, with the adjusted odds ratio (95% CI) being 6.68 (1.57, 28.41) and 5.34 (1.60, 17.77), respectively. Family income was significantly related to permanent dental caries with the odds ratio (95% CI) being 9.60 (1.89, 48.59). Nutritional status is associated with dental caries among these elementary schoolchildren. Larger studies extending to cover other elementary schools in Na Klang district should be conducted so that the results will be representative of all elementary schools in Na Klang district, Nongbua Lampoo province.

Intimate Partner Violence Associated with Postpartum Depression, Regardless of Socioeconomic Status.

PubMed

Kothari, Catherine L; Liepman, Michael R; Shama Tareen, R; Florian, Phyllis; Charoth, Remitha M; Haas, Suzanne S; McKean, Joseph W; Moe, Angela; Wiley, James; Curtis, Amy

2016-06-01

Objective This study examined whether socioeconomic status moderated the association between intimate partner violence (IPV) and postpartum depression among a community-based sample of women. Defining the role of poverty in the risk of postpartum depression for IPV victims enables prioritization of health promotion efforts to maximize the effectiveness of existing maternal-infant resources. Methods This cross-sectional telephone-survey study interviewed 301 postpartum women 2 months after delivery, screening them for IPV and depression [using Edinburgh Postnatal Depression Scale (EPDS)]. Socioeconomic status was defined by insurance (Medicaid-paid-delivery or not). This analysis controlled for the following covariates, collected through interview and medical-record review: demographics, obstetric history, prenatal health and additional psychosocial risk factors. After adjusting for significant covariates, multiple linear regression was conducted to test whether socioeconomic status confounded or moderated IPV's relationship with EPDS-score. Results Ten percent of participants screened positive for postpartum depression, 21.3 % screened positive for current or previous adult emotional or physical abuse by a partner, and 32.2 % met poverty criteria. IPV and poverty were positively associated with each other (χ(2) (1) = 11.76, p < .001) and with EPDS score (IPV: beta 3.2 (CI 2.0, 4.5) p < .001, poverty: beta 1.3 (CI 0.2, 2.4) p = .017). In the multiple linear regression, IPV remained significantly associated, but poverty did not (IPV: adjusted beta 3.1 (CI 1.8, 4.3) p < .001, poverty: adjusted beta 0.8 (CI -0.3, 1.9) p = .141), and no statistically significant interaction between IPV and poverty was found. Conclusions Study findings illustrated that IPV was strongly associated with postpartum depression, outweighing the influence of socioeconomic status upon depression for postpartum women.

Marital status, social capital and health locus of control: a population-based study.

PubMed

Lindström, M; Rosvall, M

2012-09-01

To investigate the association between marital status and lack of internal health locus of control (HLC), taking economic stress and trust into account. Cross-sectional study. The public health survey Skåne 2008 is a postal questionnaire study (55% participation rate). A random sample was invited to participate, and 28,198 individuals aged 18-80 years agreed. Logistic regression models were used to discern associations between marital status and lack of internal HLC. The multiple regression analyses included age, country of birth, education, economic stress and 'horizontal' trust. In total, 33.7% of the men and 31.8% of the women lacked internal HLC. After age-adjustments, the unmarried and divorced men and the widowed women displayed significantly higher odds ratios of lack of internal HLC. The significantly higher odds ratios only remained for unmarried men throughout the multiple analyses. In contrast, divorced women had significantly lower odds ratios of lack of internal HLC than married women after adjustments for economic stress. Health promotion regarding HLC and related behaviours should consider men and women who are not cohabiting. Health promotion should particularly consider unmarried men due to their higher propensity to lack internal HLC. The economic conditions and exposure to economic stress among widowed and divorced women should also be highlighted. Copyright © 2012 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

[Effect of TNF-alpha gene polymorphism on outcome of thalidomide-based regimens for multiple myeloma].

PubMed

DU, Juan; Yuan, Zhen-Gang; Zhang, Chun-Yang; Fu, Wei-Jun; Jiang, Hua; Chen, Bao-An; Hou, Jian

2009-10-01

To evaluate the effect of polymorphism at the -238 and -308 position of the TNF-alpha promotor region on the clinical outcome of thalidomide (Thal)-based regimens for the treatment of multiple myeloma (MM). The polymorphism at the -238 and -308 position of the TNF-alpha promotor region of 168 MM patients treated with Thal-based regimens were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Genotypes were tested for association with overall response by logistic regression, and survival was evaluated by univariate and multivariate analysis. In TNF-alpha -238 position, 11 (6.5%) patients had GA genotype and 1 (0.6%) AA genotype. In TNF-alpha -308 position, 19 (11.3%) had GA genotype and 1 (0.6%) AA genotype. In univariate analysis, the TNF-alpha -238 GA + AA genotypes were associated with a significantly prolonged progression free survival (PFS) (P = 0.017), and a better overall survival (OS) (P = 0.150). Multivariate COX regression analysis showed that TNF-alpha -238 polymorphic status was an independent prognostic factor for prolonged PFS (P = 0.049). The TNF-alpha -238 polymorphic status is associated with a favorable clinical outcome in MM patients treated with thalidomide-based regimen. The polymorphism status of TNF-alpha gene might be of promise for developing a more informative stratification system for MM.

Psychological impact of sports activity in spinal cord injury patients.

PubMed

Gioia, M C; Cerasa, A; Di Lucente, L; Brunelli, S; Castellano, V; Traballesi, M

2006-12-01

To investigate whether sports activity is associated with better psychological profiles in patients with spinal cord injury (SCI) and to evaluate the effect of demographic factors on psychological benefits. The State-Trait Anxiety Inventory, Form X2 (STAI-X2), the Eysenck Personality Questionnaire for extraversion (EPQ-R (E)) and the questionnaire for depression (QD) were administered in a cross-sectional study of 137 males with spinal cord injury including 52 tetraplegics and 85 paraplegics. The subjects were divided into two groups according to sports activity participation (high frequency vs no sports participation). Moreover, multiple regression analysis was adopted to investigate the influence of demographic variables, such as age, educational level, occupational status and marital status, on psychological variables. Analysis of variance revealed significant differences among the groups for anxiety (STAI-X2), extraversion (EPQ-R (E)) and depression (QD). In particular, SCI patients who did not practice sports showed higher anxiety and depression scores and lower extraversion scores than sports participants. In addition, with respect to the paraplegics, the tetraplegic group showed the lowest depression scores. Following multiple regression analysis, only the sports activity factor remained as an independent factor of anxiety scores. These findings demonstrate that sports activity is associated with better psychological status in SCI patients, irrespective of tetraplegia and paraplegia, and that psychological benefits are not emphasized by demographic factors.

Vasomotor and physical menopausal symptoms are associated with sleep quality.

PubMed

Kim, Min-Ju; Yim, Gyeyoon; Park, Hyun-Young

2018-01-01

Sleep disturbance is one of the common complaints in menopause. This study investigated the relationship between menopausal symptoms and sleep quality in middle-aged women. This cross-sectional observational study involved 634 women aged 44-56 years attending a healthcare center at Kangbuk Samsung Hospitals. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI).Multiple linear regression analysis was performed to assess the associations between Menopause-specific Quality of Life (MENQOL) scores and PSQI scores and Menopause-specific Quality of Life (MENQOL)scores. The mean PSQI score was 3.6±2.3, and the rates of poor sleep quality(PSQI score > 5) in premenopausal, perimenopausal, and postmenopausal women were 14.4%, 18.2%, and 30.2%, respectively. Total PSQI score, specifically the sleep latency, habitual sleep efficiency and sleep disturbances scores, were significantly increased in postmenopausal women. Multiple linear regression analysis adjusted for age, BMI, hypertension, diabetes, smoking, marital status, family income, education, employment status, parity, physical activity, depression symptoms, perceived stress and menopausal status showed that higher PSQI score was positively correlated with higher vasomotor(ß = 0.240, P = 0.020)and physical(ß = 0.572, P<0.001) scores. Vasomotor and physical menopause symptoms was related to poor sleep quality. Effective management strategies aimed at reducing menopausal symptoms may improve sleep quality among women around the time of menopause.

Resting heart rate, physiological stress and disadvantage in Aboriginal and Torres Strait Islander Australians: analysis from a cross-sectional study.

PubMed

Zhang, Alice; Hughes, Jaquelyne T; Brown, Alex; Lawton, Paul D; Cass, Alan; Hoy, Wendy; O'Dea, Kerin; Maple-Brown, Louise J

2016-02-11

Lower socioeconomic status has been linked to long-term stress, which can manifest in individuals as physiological stress. The aim was to explore the relationship between low socioeconomic status and physiological stress in Aboriginal and Torres Strait Islander Australians. Using data from the eGFR Study (a cross-sectional study of 634 Indigenous Australians in urban and remote areas of northern and central Australia), we examined associations between resting heart rate and demographic, socioeconomic, and biomedical factors. An elevated resting heart rate has been proposed as a measure of sustained stress activation and was used as a marker of physiological stress. Relationships were assessed between heart rate and the above variables using univariate and multiple regression analyses. We reported a mean resting heart rate of 74 beats/min in the cohort (mean age 45 years). On multiple regression analysis, higher heart rate was found to be independently associated with Aboriginal ethnicity, being a current smoker, having only primary level schooling, higher HbA1c and higher diastolic blood pressure (model R(2) 0.25). Elevated resting heart rate was associated with lower socioeconomic status and poorer health profile in Aboriginal and Torres Strait Islander Australians. Higher resting heart rate may be an indicator of stress and disadvantage in this population at high risk of chronic diseases.

Factors associated with abdominal obesity in children

PubMed Central

Melzer, Matheus Ribeiro Theodósio Fernandes; Magrini, Isabella Mastrangi; Domene, Semíramis Martins Álvares; Martins, Paula Andrea

2015-01-01

Objective: To identify the association of dietary, socioeconomic factors, sedentary behaviors and maternal nutritional status with abdominal obesity in children. Methods: A cross-sectional study with household-based survey, in 36 randomly selected census tracts in the city of Santos, SP. 357 families were interviewed and questionnaires and anthropometric measurements were applied in mothers and their 3-10 years-old children. Assessment of abdominal obesity was made by maternal and child's waist circumference measurement; for classification used cut-off points proposed by World Health Organization (1998) and Taylor et al. (2000) were applied. The association between variables was performed by multiple logistic regression analysis. Results: 30.5% of children had abdominal obesity. Associations with children's and maternal nutritional status and high socioeconomic status were shown in the univariate analysis. In the regression model, children's body mass index for age (OR=93.7; 95%CI 39.3-223.3), female gender (OR=4.1; 95%CI 1.8-9.3) and maternal abdominal obesity (OR=2.7; 95%CI 1.2-6.0) were significantly associated with children's abdominal obesity, regardless of the socioeconomic status. Conclusions: Abdominal obesity in children seems to be associated with maternal nutritional status, other indicators of their own nutritional status and female gender. Intervention programs for control of childhood obesity and prevention of metabolic syndrome should consider the interaction of the nutritional status of mothers and their children. PMID:26298655

[Prevalence of vitamin D deficiency and associated factors in women and newborns in the immediate postpartum period].

PubMed

do Prado, Mara Rúbia Maciel Cardoso; Oliveira, Fabiana de Cássia Carvalho; Assis, Karine Franklin; Ribeiro, Sarah Aparecida Vieira; do Prado Junior, Pedro Paulo; Sant'Ana, Luciana Ferreira da Rocha; Priore, Silvia Eloiza; Franceschini, Sylvia do Carmo Castro

2015-01-01

To assess the prevalence of vitamin D deficiency and its associated factors in women and their newborns in the postpartum period. This cross-sectional study evaluated vitamin D deficiency/insufficiency in 226 women and their newborns in Viçosa (Minas Gerais, BR) between December 2011 and November 2012. Cord blood and venous maternal blood were collected to evaluate the following biochemical parameters: vitamin D, alkaline phosphatase, calcium, phosphorus and parathyroid hormone. Poisson regression analysis, with a confidence interval of 95% was applied to assess vitamin D deficiency and its associated factors. Multiple linear regression analysis was performed to identify factors associated with 25(OH)D deficiency in the newborns and women from the study. The criteria for variable inclusion in the multiple linear regression model was the association with the dependent variable in the simple linear regression analysis, considering p<0.20. Significance level was α<5%. From 226 women included, 200 (88.5%) were 20 to 44 years old; the median age was 28 years. Deficient/insufficient levels of vitamin D were found in 192 (85%) women and in 182 (80.5%) neonates. The maternal 25(OH)D and alkaline phosphatase levels were independently associated with vitamin D deficiency in infants. This study identified a high prevalence of vitamin D deficiency and insufficiency in women and newborns and the association between maternal nutritional status of vitamin D and their infants' vitamin D status. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

Change in bone mineral density and its determinants in pre- and perimenopausal Chinese women: the Hong Kong Perimenopausal Women Osteoporosis Study.

PubMed

Ho, S C; Chan, S G; Yip, Y B; Chan, C S Y; Woo, J L F; Sham, A

2008-12-01

This 30-month study investigating bone change and its determinants in 438 perimenopausal Chinese women revealed that the fastest bone loss occurred in women undergoing menopausal transition but maintenance of body weight and physical fitness were beneficial for bone health. Soy protein intake also seemed to exert a protective effect. This 30-month follow-up study aims to investigate change in bone mineral density and its determinants in Hong Kong Chinese perimenopausal women. Four hundred and thirty-eight women aged 45 to 55 years were recruited through random telephone dialing and primary care clinic. Bone mass, body composition, lifestyle measurements were obtained at baseline and at 9-, 18- and 30-month follow-ups. Univariate and stepwise multiple regression analyses were performed with the regression coefficients of BMD/C (derived from baseline and follow-up measurements) as the outcome variables. Menopausal status was classified as pre- or postmenopausal or transitional. Menopausal status was the strongest determinant of bone changes. An annual bone loss of about 0.5% was observed among premenopausal, 2% to 2.5% among transitional, and about 1.5% in postmenopausal women. Multiple regression analyses, revealed that a positive regression slope of body weight was protective for follow-up bone loss at all sites. Number of pregnancy, soy protein intake and walking were protective for total body BMC. Higher baseline LM was also protective for neck of femur BMD. Maintenance of body weight and physical fitness were observed to have a protective effect on for bone loss in Chinese perimenopausal women.

Coastal climate is associated with elevated solar irradiance and higher 25(OH)D level.

PubMed

Cherrie, M P C; Wheeler, B W; White, M P; Sarran, C E; Osborne, N J

2015-04-01

There is evidence that populations living close to the coast have improved health and wellbeing. Coastal environments are linked to promotion of physical activity through provision of safe, opportune, aesthetic and accessible spaces for recreation. Exposure to coastal environments may also reduce stress and induce positive mood. We hypothesised that coastal climate may influence the vitamin D status of residents and thus partly explain benefits to health. Ecological and cross-sectional analyses were designed to elucidate the connection between coastal residence and vitamin D status. We divided residential data, from developed land use areas and the Lower Super Output Areas or Data Zones (Scotland) of the 1958 Birth Cohort participants, into the following coastal bands: <1 km, 1-5 km, 5-20 km, 20-50 km and over 50 km. In the ecological analysis we used a multiple regression model to describe the relationship between UV vitd and coastal proximity adjusted for latitude. Subsequently, using the residential information of the participants of the 1958 Birth Cohort we developed a multiple regression model to understand the relationship between serum 25(OH)D (a marker of vitamin D status) and coastal proximity adjusted for several factors related to vitamin D status (e.g. diet, outdoor activity). We found that coastal proximity was associated with solar irradiance; on average a 99.6 (96.1-103.3)J/m(2)/day regression coefficient was recorded for settlements <1 km from the coast compared with those at >50 km. This relationship was modified by latitude with settlements at a lower latitude exhibiting a greater effect. Individuals living closer to the coast in England had higher vitamin D levels than those inland, particularly in autumn. Geographic location may influence biochemistry and health outcomes due to environmental factors. This can provide benefits in terms of vitamin D status but may also pose a risk due to higher skin cancer risk. We provide further evidence in support of the claim that coastal environments can provide opportunities for health and wellbeing. Copyright © 2015 Elsevier Ltd. All rights reserved.

Relationships Between Meibomian Gland Loss and Age, Sex, and Dry Eye.

PubMed

Pult, Heiko

2018-02-12

This study evaluated relationships between meibomian gland loss (MGL) and age, sex, and dry eye. Dry eye and MGL of the lower eyelid was evaluated from 112 randomly selected subjects (66 women; mean age 62.8; SD ±15.7; and age range: 19-89 years) from Horst Riede GmbH, Weinheim, Germany. In addition, subjects were grouped into dry eye and non-dry eye by the Ocular Surface Disease Index (OSDI) score, lid-parallel conjunctival folds and non-invasive break-up time. Symptoms were evaluated by the OSDI. Meibography of the lower eyelid was performed using a Cobra camera (bon Optic, Lübeck, Germany), and images were analyzed by its digital grading tool. Data were analyzed by backward, multiple regression analyses and Pearson correlation. Analyzing all subjects, multiple regression analyses detected that age and dry eye status (dry eye diagnosis or OSDI) but not sex were significantly related to MGL. In both, non-dry eye (n=66) and dry eye subjects (n=46), dry eye status (OSDI) but not age or sex was significantly related to MGL. Ocular Surface Disease Index scores were significantly correlated with MGL, but this correlation was stronger among all subjects (Pearson correlation; r=0.536, P<0.001) and dry eye group subjects (r=0.520, P<0.001) than in non-dry eye group subjects (r=0.275, P=0.014). Dry eye group subjects showed significantly increased MGL of the lower eyelid. Age and dry eye status were related to MGL of the lower eyelid, but sex was not; dry eye status was the dominant factor.

[Factors Influencing Quality of Life of Alcoholics Anonymous Members in Korea].

PubMed

Yoo, Jae Soon; Lee, Jongeun; Park, Woo Young

2016-04-01

The purpose of this study was to determine quality of life (QOL) related factors in Alcoholics Anonymous (AA) members based on PRECEDE Model. A cross sectional survey was conducted with participants (N =203) from AA meeting in 11 alcohol counsel centers all over South Korea. Data were collected using a specially designed questionnaire based on the PRECEDE model and including QOL, epidemiological factors (including depression and perceived health status), behavioral factors (continuous abstinence and physical health status and practice), predisposing factors (abstinence self-efficacy and self-esteem), reinforcing factors (social capital and family functioning), and enabling factors. Data were analyzed using t-test, one way ANOVA, Tukey HSD test and hierarchical multiple regression analysis with SPSS (ver. 21.0). Of the educational diagnostic variables, self-esteem (β=.23), family functioning (β=.12), abstinence self-efficacy (β=.12) and social capital (β=.11) were strong influential factors in AA members' QOL. In addition, epidemiological diagnostic variables such as depression (β=-.44) and perceived health status (β=.35) were the main factors in QOL. Also, physical health status and practice (β=.106), one of behavioral diagnostic variables was a beneficial factor in QOL. Hierarchical multiple regression analysis showed the determinant variables accounted for 44.0% of the variation in QOL (F=25.76, p<.001). The finding of the study can be used as a framework for planning interventions in order to promote the quality of life of AA members. It is necessary to develop nursing intervention strategies for strengthening educational and epidemiological diagnostic variables in order to improve AA members' QOL.

Human papillomavirus in oropharyngeal cancer in Canada: analysis of 5 comprehensive cancer centres using multiple imputation

PubMed Central

Habbous, Steven; Chu, Karen P.; Lau, Harold; Schorr, Melissa; Belayneh, Mathieos; Ha, Michael N.; Murray, Scott; O’Sullivan, Brian; Huang, Shao Hui; Snow, Stephanie; Parliament, Matthew; Hao, Desiree; Cheung, Winson Y.; Xu, Wei; Liu, Geoffrey

2017-01-01

BACKGROUND: The incidence of oropharyngeal cancer has risen over the past 2 decades. This rise has been attributed to human papillomavirus (HPV), but information on temporal trends in incidence of HPV-associated cancers across Canada is limited. METHODS: We collected social, clinical and demographic characteristics and p16 protein status (p16-positive or p16-negative, using this immunohistochemistry variable as a surrogate marker of HPV status) for 3643 patients with oropharyngeal cancer diagnosed between 2000 and 2012 at comprehensive cancer centres in British Columbia (6 centres), Edmonton, Calgary, Toronto and Halifax. We used receiver operating characteristic curves and multiple imputation to estimate the p16 status for missing values. We chose a best-imputation probability cut point on the basis of accuracy in samples with known p16 status and through an independent relation between p16 status and overall survival. We used logistic and Cox proportional hazard regression. RESULTS: We found no temporal changes in p16-positive status initially, but there was significant selection bias, with p16 testing significantly more likely to be performed in males, lifetime never-smokers, patients with tonsillar or base-of-tongue tumours and those with nodal involvement (p < 0.05 for each variable). We used the following variables associated with p16-positive status for multiple imputation: male sex, tonsillar or base-of-tongue tumours, smaller tumours, nodal involvement, less smoking and lower alcohol consumption (p < 0.05 for each variable). Using sensitivity analyses, we showed that different imputation probability cut points for p16-positive status each identified a rise from 2000 to 2012, with the best-probability cut point identifying an increase from 47.3% in 2000 to 73.7% in 2012 (p < 0.001). INTERPRETATION: Across multiple centres in Canada, there was a steady rise in the proportion of oropharyngeal cancers attributable to HPV from 2000 to 2012. PMID:28808115

Impact of clinical status and salivary conditions on xerostomia and oral health-related quality of life of adolescents with type 1 diabetes mellitus.

PubMed

Busato, Ivana Maria Saes; Ignácio, Sérgio Aparecido; Brancher, João Armando; Moysés, Simone Tetu; Azevedo-Alanis, Luciana Reis

2012-02-01

To investigate the influence of clinical status and salivary conditions on the presence of xerostomia on adolescents with and without type 1 diabetes mellitus (DM1), and further to investigate the influence of clinical status, salivary conditions and xerostomia on oral health-related quality of life (OHQoL) of those with DM1. A cross-sectional study was performed on 102 adolescents, 51 with DM1 and 51 nondiabetics. Xerostomia was detected by asking a question about the sensation of having 'dry mouth', and Oral Health Impact Profile-14 was used to measure the impact of xerostomia on OHQoL. The clinical status was assessed by using decayed, missing or filled and Community Periodontal indices, and by evaluating oral manifestations; and the following salivary conditions were evaluated: stimulated salivary flow, pH, buffer capacity, total protein, amylase, urea, calcium, and glucose salivary concentrations. Multiple logistic regression analysis was used to evaluate the influence of clinical status and salivary conditions on xerostomia and the impact of xerostomia on the OHQoL of adolescents with DM1. Clinical status and salivary conditions was shown to have no influence on the presence of xerostomia. Bivariate (P = 0.00) and logistic regression (P = 0.01) analysis showed a significant association between DM1 and xerostomia. Logistic regression analysis showed association between xerostomia (P = 0.00) and OHQoL, and caries experience (P = 0.03) and OHQoL. DM1 showed to be predictive of a high prevalence of xerostomia in adolescents. Caries experience and xerostomia showed to have a negative impact on the OHQoL of adolescents with DM1. © 2011 John Wiley & Sons A/S.

Total energy expenditure in adults with cerebral palsy as assessed by doubly labeled water.

PubMed

Johnson, R K; Hildreth, H G; Contompasis, S H; Goran, M I

1997-09-01

To characterize total energy expenditure (TEE) in free-living adults with cerebral palsy (CP) using the doubly labeled water technique, and to determine those physiologic variables and characteristics of CP that were markers of TEE in adults with CP. TEE was measured using the doubly labeled water technique in 30 free-living adults with CP (12 women, 18 men). To determine the best markers of TEE, the following factors were examined: CP status, resting metabolic rate (RMR), anthropometric characteristics and body composition by means of dual-energy x-ray absorptiometry (DXA) and skinfold thickness measurements, energy cost of leisure-time activities, and oral-motor impairment. Means +/- standard deviations, t tests, Pearson product-moment correlation coefficients, Spearman rank correlation coefficients, chi 2, stepwise multiple-correlation regression analysis, and analysis of covariance were used to examine the relationships among variables of interest. TEE was highly variable in the sample (mean = 2,455 +/- 622 kcal/day for men and 1,986 +/- 363 kcal/day for women). Stepwise regression analysis showed that TEE was best predicted in the sample by RMR, percentage body fat determined by DXA, ambulation status, and sex (multiple R = .68, P = .003). When practical, easily measured variables were used, TEE was best predicted by height, ambulation status, percentage body fat by skinfold thickness measurements, and sex (multiple R = .61, P. = 018). The contribution of energy expended in physical activity to TEE was significantly higher in the ambulatory subjects than the nonambulatory subjects (25% vs 16%, respectively; P = .009). The high degree of variability in TEE, largely attributable to high interindividual variation in energy expended in physical activity, makes it difficult to provide general guidelines for energy requirements for adults with CP. Because ambulation status was an important predictor of TEE, it must be accounted for in estimating energy requirements in this population.

Resilience in women with autoimmune rheumatic diseases.

PubMed

Rojas, Manuel; Rodriguez, Yhojan; Pacheco, Yovana; Zapata, Elizabeth; Monsalve, Diana M; Mantilla, Rubén D; Rodríguez-Jimenez, Monica; Ramírez-Santana, Carolina; Molano-González, Nicolás; Anaya, Juan-Manuel

2017-12-28

To evaluate the relationship between resilience and clinical outcomes in patients with autoimmune rheumatic diseases. Focus groups, individual interviews, and chart reviews were done to collect data on 188 women with autoimmune rheumatic diseases, namely rheumatoid arthritis (n=51), systemic lupus erythematosus (n=70), systemic sclerosis (n=35), and Sjögren's syndrome (n=32). Demographic, clinical, and laboratory variables were assessed including disease activity by patient reported outcomes. Resilience was evaluated by using the Brief Resilience Scale. Bivariate, multiple linear regression, and classification and regression trees were used to analyse data. Resilience was influenced by age, duration of disease, and socioeconomic status. Lower resilience scores were observed in younger patients (<48years) with systemic lupus erythematosus, rheumatoid arthritis, and systemic sclerosis who had low socioeconomic status, whereas older patients (>50years) had higher resilience scores regardless of socioeconomic status. There was no influence of disease activity on resilience. A particular behaviour was observed in systemic sclerosis in which patients with high socioeconomic status and regular physical activity had higher resilience scores. Resilience in patients with autoimmune rheumatic diseases is a continuum process influenced by age and socioeconomic status. The ways in which these variables along with exercise influence resilience deserve further investigation. Copyright © 2017 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

Does marital status predict the odds of suicidal death in taiwan? A seven-year population-based study.

PubMed

Yeh, Jui-Yuan; Xirasagar, Sudha; Liu, Tsai-Ching; Li, Chong-Yi; Lin, Herng-Ching

2008-06-01

Using nationwide, 7-year population-based data for 1997-2003, we examined marital status to see if it predicted suicide among the ethnic Chinese population of Taiwan. Using cause of death data, with a case-control design, two groups-total adult suicide deaths, n = 17,850, the study group, and adult deaths other than suicide, n = 71,400 (randomly selected from age, sex, and geographic region matched controls, four per suicide)-were studied. Using multiple logistic regression analysis including age-marital status interaction, adjusted estimates show divorced status to be the most detrimental for suicide propensity, with males showing stronger effect size. Females never married, aged below 35 and 65-plus, and widowed 65-plus had lower suicide odds.

Multiple regression analysis of factors influencing dominant hand grip strength in an adult Malaysian population.

PubMed

Hossain, M G; Zyroul, R; Pereira, B P; Kamarul, T

2012-01-01

Grip strength is an important measure used to monitor the progression of a condition, and to evaluate outcomes of treatment. We assessed how various physical and social factors predict normal grip strength in an adult Malaysian population of mixed Asian ethnicity (254 men, 246 women). Grip strength was recorded using the Jamar dynamometer. The mean grip strength for the dominant hand was 29.8 kg for men and 17.6 kg for women. Multiple regression analysis demonstrated that the dominant hand grip strength was positively associated with height and body mass index, and negatively associated with age for both sexes. Dominant hand grip strength was related to work status for men (p < 0.05) but not for women. However, there was no difference in grip strength among ethnic groups.

Patterns of Drug Use, Risky Behavior, and Health Status Among Persons Who Inject Drugs Living in San Diego, California: A Latent Class Analysis

PubMed Central

Roth, Alexis M.; Armenta, Richard A.; Wagner, Karla D.; Roesch, Scott C.; Bluthenthal, Ricky N.; Cuevas-Mota, Jazmine; Garfein, Richard S.

2015-01-01

Background Among persons who inject drugs (PWID), polydrug use (the practice of mixing multiple drugs/alcohol sequentially or simultaneously) increases risk for HIV transmission and unintentional overdose deaths. Research has shown local drug markets influence drug use practices. However, little is known about the impact of drug mixing in markets dominated by black tar heroin and methamphetamine, such as the western United States. Methods Data were collected through an ongoing longitudinal study examining drug use, risk behavior, and health status among PWID. Latent class analysis (LCA) was used to identify patterns of substance use (heroin, methamphetamine, prescription drugs, alcohol, and marijuana) via multiple administration routes (injecting, smoking, and swallowing). Logistic regression was used to identify behaviors and health indicators associated with drug use class. Results The sample included 511 mostly white (51.5%) males (73.8%), with mean age of 43.5 years. Two distinct classes of drug users predominated: methamphetamine by multiple routes (51%) and heroin by injection (49%). In multivariable logistic regression, class membership was associated with age, race, and housing status. PWID who were HIV-seropositive and reported prior sexually transmitted infections had increased odds of belonging to the methamphetamine class. Those who were HCV positive and reported previous opioid overdose had an increased odds of being in the primarily heroin injection class (all P-values < .05). Conclusion Risk behaviors and health outcomes differed between PWID who primarily inject heroin vs. those who use methamphetamine. The findings suggest that in a region where PWID mainly use black tar heroin or methamphetamine, interventions tailored to sub-populations of PWID could improve effectiveness. PMID:25313832

Factors Influencing Amount of Weekly Exercise Time in Colorectal Cancer Survivors.

PubMed

Chou, Yun-Jen; Lai, Yeur-Hur; Lin, Been-Ren; Liang, Jin-Tung; Shun, Shiow-Ching

Performing regular exercise of at least 150 minutes weekly has benefits for colorectal cancer survivors. However, barriers inhibit these survivors from performing regular exercise. The aim of this study was to explore exercise behaviors and significant factors influencing weekly exercise time of more than 150 minutes in colorectal cancer survivors. A cross-sectional study design was used to recruit participants in Taiwan. Guided by the ecological model of health behavior, exercise barriers were assessed including intrapersonal, interpersonal, and environment-related barriers. A multiple logistic regression was used to explore the factors associated with the amount of weekly exercise. Among 321 survivors, 57.0% of them had weekly exercise times of more than 150 minutes. The results identified multiple levels of significant factors related to weekly exercise times including intrapersonal factors (occupational status, functional status, pain, interest in exercise, and beliefs about the importance of exercise) and exercise barriers related to environmental factors (lack of time and bad weather). No interpersonal factors were found to be significant. Colorectal cancer survivors experienced low levels of physical and psychological distress. Multiple levels of significant factors related to exercise time including intrapersonal factors as well as exercise barriers related to environmental factors should be considered. Healthcare providers should discuss with their patients how to perform exercise programs; the discussion should address multiple levels of the ecological model such as any pain problems, functional status, employment status, and time limitations, as well as community environment.

Multiple Traumatic Events and Psychological Distress : The South Africa Stress and Health Study

PubMed Central

Williams, Stacey L.; Williams, David R.; Stein, Dan J.; Seedat, Soraya; Jackson, Pamela B.; Moomal, Hashim

2011-01-01

Using nationally representative data from South Africa, we examine lifetime prevalence of traumas and multiple traumas (number of events). Employing multiple regression analysis, we study sociodemographic risk of trauma, and the association between trauma and distress. Results indicate most South Africans experience at least one traumatic event during their lives, with the majority reporting multiple. Consistent variation in risk is evident for gender and marital status but not other sociodemographics. Trauma is positively related to high distress, and findings also support a cumulative effect of trauma exposure. Individuals with the most traumas (6+) appear at five- times greater risk of high distress. This study highlights the importance of considering traumatic events in the context of other traumas in South Africa. PMID:17955545

Multiple traumatic events and psychological distress: the South Africa stress and health study.

PubMed

Williams, Stacey L; Williams, David R; Stein, Dan J; Seedat, Soraya; Jackson, Pamela B; Moomal, Hashim

2007-10-01

Using nationally representative data from South Africa, we examine lifetime prevalence of traumas and multiple traumas (number of events). Employing multiple regression analysis, the authors study the sociodemographic risk of trauma, and the association between trauma and distress. Results indicate most South Africans experience at least one traumatic event during their lives, with the majority reporting multiple. Consistent variation in risk is evident for gender and marital status, but not other sociodemographics. Trauma is positively related to high distress, and findings also support a cumulative effect of trauma exposure. Individuals with the most traumas (6+) appear at 5 times greater risk of high distress. This study highlights the importance of considering traumatic events in the context of other traumas in South Africa.

Disclosure of HIV Status and Social Support Among People Living With HIV

PubMed Central

Jorjoran Shushtari, Zahra; Sajjadi, Homeira; Forouzan, Ameneh Setareh; Salimi, Yahya; Dejman, Masoumeh

2014-01-01

Background: Disclosure of HIV is important for improving self-care behaviors, psychological well-being, commitment to the treatment, and reducing risk of transmission. One of the major benefits of disclosure is social support, which is an essential resource for effective coping with HIV infection. However, receiving any social support requires disclosing of HIV status. Objectives: This study aimed to determine the disclosure of HIV status and its related factors such as social support in addition to demographic and disease characteristics among people living with HIV in Iran. Patients and Methods: This cross-sectional study, using simple random sampling, was carried out on 175 people with HIV/AIDS who referred to Behavioral Counseling Centers. The self-administrated, Norbeck Social Support Questionnaire was used to measure social support. Disclosure of HIV status was assessed with an investigator-designed questions. Multiple logistic regression analysis with backward Likelihood Ratio method was applied to identify the adjusted odds ratio between disclosure as dependent variable and demographic variables, social support as independent variables. Results: Participants were often disclosed their HIV status to family members. But there were differences about disclosure of HIV status within the context of the family. Family members were perceived as more supportive. Multiple logistic regression analysis demonstrates that the gender (adjusted OR = 0.181; 95% CI .068-0.479), CD4 cell count (adjusted OR = 0.997; 95% CI 0.994-0.999), route of transmission (injection-drug user [adjusted OR = 9.366; 95% CI 3.358-26.123] and other routes [tattooing, mother to child, dental services, etc.], [adjusted OR = 3.752; 95% CI 1.157-12.167]), and functional support variable (adjusted OR = 1.007; 95% CI 1.001-1.013) remained in the model as significant predictors for disclosure. Conclusions: The results of this study regarding disclosure of HIV status and its relations to social support and some demographic variables can provide an understanding based on the evidence for promotion of knowledge and coping interventions about people living with HIV/AIDS and their perceived social support status. PMID:25389470

How Possibly Do Leisure and Social Activities Impact Mental Health of Middle-Aged Adults in Japan?: An Evidence from a National Longitudinal Survey

PubMed Central

Takeda, Fumi; Noguchi, Haruko; Monma, Takafumi; Tamiya, Nanako

2015-01-01

Objectives This study aimed to investigate longitudinal relations between leisure and social activities and mental health status, considering the presence or absence of other persons in the activity as an additional variable, among middle-aged adults in Japan. This study used nationally representative data in Japan with a five-year follow-up period. Methods This study focused on 16,642 middle-aged adults, age 50–59 at baseline, from a population-based, six-year panel survey conducted by the Japanese Ministry of Health, Labour and Welfare. To investigate the relations between two leisure activities (‘hobbies or cultural activities’ and ‘exercise or sports’) and four social activities (‘community events’, ‘support for children’, ‘support for elderly individuals’ and ‘other social activities’) at baseline and mental health status at follow-up, multiple logistic regression analysis was used. We also used multiple logistic regression analysis to investigate the association between ways of participating in these activities (‘by oneself’, ‘with others’, or ‘both’ (both ‘by oneself’ and ‘with others’)) at baseline and mental health status at follow-up. Results Involvement in both leisure activity categories, but not in social activities, was significantly and positively related to mental health status in both men and women. Furthermore, in men, both ‘hobbies or cultural activities’ and ‘exercise or sports’ were significantly related to mental health status only when conducted ‘with others’. In women, the effects of ‘hobbies or cultural activities’ on mental health status were no differences regardless of the ways of participating, while the result of ‘exercise or sports’ was same as that in men. Conclusions Leisure activities appear to benefit mental health status among this age group, whereas specific social activities do not. Moreover, participation in leisure activities would be effective especially if others are present. These findings should be useful for preventing the deterioration of mental health status in middle-aged adults in Japan. PMID:26431536

Periodontal disease in Chinese patients with systemic lupus erythematosus.

PubMed

Zhang, Qiuxiang; Zhang, Xiaoli; Feng, Guijaun; Fu, Ting; Yin, Rulan; Zhang, Lijuan; Feng, Xingmei; Li, Liren; Gu, Zhifeng

2017-08-01

Disease of systemic lupus erythematosus (SLE) and periodontal disease (PD) shares the common multiple characteristics. The aims of the present study were to evaluate the prevalence and severity of periodontal disease in Chinese SLE patients and to determine the association between SLE features and periodontal parameters. A cross-sectional study of 108 SLE patients together with 108 age- and sex-matched healthy controls was made. Periodontal status was conducted by two dentists independently. Sociodemographic characteristics, lifestyle factors, medication use, and clinical parameters were also assessed. The periodontal status was significantly worse in SLE patients compared to controls. In univariate logistic regression, SLE had a significant 2.78-fold [95% confidence interval (CI) 1.60-4.82] increase in odds of periodontitis compared to healthy controls. Adjusted for potential risk factors, patients with SLE had 13.98-fold (95% CI 5.10-38.33) increased odds against controls. In multiple linear regression model, the independent variable negatively and significantly associated with gingival index was education (P = 0.005); conversely, disease activity (P < 0.001) and plaque index (P = 0.002) were positively associated; Age was the only variable independently associated with periodontitis of SLE in multivariate logistic regression (OR 1.348; 95% CI: 1.183-1.536, P < 0.001). Chinese SLE patients were likely to suffer from higher odds of PD. These findings confirmed the importance of early interventions in combination with medical therapy. It is necessary for a close collaboration between dentists and clinicians when treating those patients.

A national cohort study of parental socioeconomic status and non-fatal suicidal behaviour-the mediating role of school performance

PubMed Central

2012-01-01

Background A link between low parental socioeconomic status and mental health problems in offspring is well established in previous research. The mechanisms that explain this link are largely unknown. The present study investigated whether school performance was a mediating and/or moderating factor in the path between parental socioeconomic status and the risk of hospital admission for non-fatal suicidal behaviour. Methods A national cohort of 447 929 children born during 1973-1977 was followed prospectively in the National Patient Discharge Register from the end of their ninth and final year of compulsory school until 2001. Multivariate Cox proportional hazards and linear regression analyses were performed to test whether the association between parental socioeconomic status and non-fatal suicidal behaviour was mediated or moderated by school performance. Results The results of a series of multiple regression analyses, adjusted for demographic variables, revealed that school performance was as an important mediator in the relationship between parental socioeconomic status and risk of non-fatal suicidal behaviour, accounting for 60% of the variance. The hypothesized moderation of parental socioeconomic status-non-fatal suicidal behaviour relationship by school performance was not supported. Conclusions School performance is an important mediator through which parental socioeconomic status translates into a risk for non-fatal suicidal behaviour. Prevention efforts aimed to reduce socioeconomic inequalities in non-fatal suicidal behaviour among young people will need to consider socioeconomic inequalities in school performance. PMID:22230577

Investigation of nutritional status using the Mini Nutritional Assessment-Short Form and analysis of the relevant factors in patients with head and neck tumour.

PubMed

Yanagi, Ayaka; Murase, Mai; Sumita, Yuka I; Taniguchi, Hisashi

2017-06-01

The aims of this study were to reveal the nutritional status of patients after head and neck tumour treatment by using the Mini Nutritional Assessment-Short Form (MNA-SF) and to analyse the factors affecting nutritional status in patients with head and neck tumour. Elderly patients with loss of teeth and maxillary/mandibular bone due to head and neck tumour treatment could be at high risk of malnutrition. However, there are few reports on the nutritional status of these patients. Forty-six participants (average age 74.7 years) were selected from patients who visited the maxillofacial prosthetics clinic of Tokyo Medical and Dental University Hospital Faculty of Dentistry in Japan. Nutritional status was evaluated using the MNA-SF. Multiple regression analysis was used to identify predictors affecting MNA-SF score. The candidate explanatory variables were age, sex, maxillofacial prosthesis use, number of residual teeth, resection side, neck dissection and treatment option. The results showed that approximately half of the patients were at risk of malnutrition, and a regression equation for MNA-SF score was developed using two predictors: maxillofacial prosthesis use and neck dissection. Use of a maxillofacial prosthesis can improve nutritional status. On the other hand, a medical history of neck dissection can decrease nutritional status. © 2016 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

[Factors associated with abdominal obesity in children].

PubMed

Melzer, Matheus Ribeiro Theodósio Fernandes; Magrini, Isabella Mastrangi; Domene, Semíramis Martins Álvares; Martins, Paula Andrea

2015-12-01

To identify the association of dietary, socioeconomic factors, sedentary behaviors and maternal nutritional status with abdominal obesity in children. A cross-sectional study with household-based survey, in 36 randomly selected census tracts in the city of Santos/SP. 357 families were interviewed and questionnaires and anthropometric measurements were applied in mothers and their 3-0 years-old children. Assessment of abdominal obesity was made by maternal and child's waist circumference measurement; for classification used cut-off points proposed by World Health Organization (1998) and Taylor et al. (2000) were applied. The association between variables was performed by multiple logistic regression analysis. 30.5% of children had abdominal obesity. Associations with children's and maternal nutritional status and high socioeconomic status were shown in the univariate analysis. In the regression model, children's body mass index for age (OR=93.7; 95%CI 39.3-223.3), female gender (OR=4.1; 95%CI 1.8-9.3) and maternal abdominal obesity (OR=2.7; 95%CI 1.2-6.0) were significantly associated with children's abdominal obesity, regardless of the socioeconomic status. Abdominal obesity in children seems to be associated with maternal nutritional status, other indicators of their own nutritional status and female gender. Intervention programs for control of childhood obesity and prevention of metabolic syndrome should consider the interaction of the nutritional status of mothers and their children. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

Estimated maturity status and perceptions of adult autonomy support in youth soccer players.

PubMed

Cumming, Sean P; Battista, Rebecca A; Martyn, Standage; Ewing, Martha E; Malina, Robert M

2006-10-01

In this study, we examined the relations between biological maturity status, body mass index, age, and perceptions of adult autonomy support in the context of youth soccer. A total of 70 female and 43 male soccer players, aged 9 - 15 years, completed three adult-specific versions (i.e. mother, father, coach) of the perceived autonomy support subscale from the Interpersonal Style Scale. The participants' percent predicted adult stature was used as an estimate of biological maturity status. Multiple linear regression analyses revealed that advanced maturity status in male players predicted lower perceptions of autonomy support from the coach. Maturity status was unrelated to perceptions of autonomy support from the coach in female soccer players, and paternal and maternal autonomy support in male and female players. Age and body mass index were unrelated to perceptions of adult (i.e. coach, mother, father) autonomy support in male and female players.

Relationship between betel quid chewing and radiographic alveolar bone loss among Taiwanese aboriginals: a retrospective study.

PubMed

Hsiao, Chun-Nan; Ting, Chun-Chan; Shieh, Tien-Yu; Ko, Edward Chengchuan

2014-11-04

Betel quid chewing is associated with the periodontal status; however, results of epidemiological studies are inconsistent. To the best of our knowledge, no study has reported radiographic alveolar bone loss (RABL) associated with betel quid chewing. This survey was conducted in an aboriginal community in Taiwan because almost all betel quid chewers were city-dwelling cigarette smokers. In total, 114 subjects, aged 30-60 years, were included. Full-mouth intraoral RABL was retrospectively measured and adjusted for age, gender, and plaque index (PI). Multiple regression analysis was used to assess the relationship between RABL and potential risk factors. Age-, gender-, and PI-adjusted mean RABL was significantly higher in chewers with or without cigarette smoking than in controls. Multiple regression analysis showed that the RABL for consumption of 100,000 pieces betel quid for the chewer group was 0.40 mm. Full-mouth plotted curves for adjusted mean RABL in the maxilla were similar between the chewer and control groups, suggesting that chemical effects were not the main factors affecting the association between betel quid chewing and the periodontal status. Betel quid chewing significantly increases RABL. The main contributory factors are age and oral hygiene; however, the major mechanism underlying this process may not be a chemical mechanism. Regular dental visits, maintenance of good oral hygiene, and reduction in the consumption of betel quid, additives, and cigarettes are highly recommended to improve the periodontal status.

Health-promoting lifestyle behaviour for cancer prevention: a survey of Turkish university students.

PubMed

Ay, Semra; Yanikkerem, Emre; Çalim, Selda Ildan; Yazici, Mete

2012-01-01

Health risks associated with unhealthy behaviours in adolescent and university students contribute to the development of health problems in later life. During the past twenty years, there has been a dramatic increase in public, private, and professional interest in preventing disability and death through changes in lifestyle and participation in screening programs. The aim of the study was to evaluate university students' health-promoting lifestyle behaviour for cancer prevention. This study was carried out on university students who had education in sports, health and social areas in Celal Bayar University, Manisa, Turkey. The health-promoting lifestyles of university students were measured with the "health-promoting lifestyle profile (HPLP)" The survey was conducted from March 2011 to July 2011 and the study sample consisted of 1007 university students. T-test, ANOVA and multiple regression analyses were used for statistical analyses. In the univariate analyses, the overall HPLP score was significantly related to students' school, sex, age, school grades, their status of received health education lessons, place of birth, longest place of residence, current place of residence, health insurance, family income, alcohol use, their status in sports, and self-perceived health status. Healthier behaviour was found in those students whose parents had higher secondary degrees, and in students who had no siblings. In the multiple regression model, healthier behaviour was observed in Physical Education and Sports students, fourth-year students, those who exercised regularly, had a good self-perceived health status, who lived with their family, and who had received health education lessons. In general, in order to ensure cancer prevention and a healthy life style, social, cultural and sportive activities should be encouraged and educational programmes supporting these goals should be designed and applied in all stages of life from childhood through adulthood.

[Social support status and related influential factors of patients with acute coronary syndrome].

PubMed

Lei, S; Ding, R J; Wang, L; Xia, K; Zhang, L J; Yao, D K; Hu, D Y

2017-05-24

Objectives: To investigate the social support status, related influential factors and the impact on one year outcome in patients with acute coronary syndrome (ACS), our data might be helpful to provide basis for making new treatment strategy aimed at improving social support for patients with ACS. Methods: From January 2013 to June 2014, a total of 778 hospitalized patients with ACS were enrolled in the study. All patients completed enhancing recovery in coronary heart disease patients social support inventory(ESSI), general anxiety disorder scale(GAD-7), patient health questionnaire(PHQ-9), short-form 12 health survey questionnaire(SF-12), sleep questionnaire and demographic questionnaire within 7 days after admission and at 6 months and one year post discharge. Multiple linear regressions were performed to analyze factors that influenced the social support. Results: The total score of social support was 17.08±3.61, 17.72±3.04, and 17.76±3.05 respectively in patients with ACS at baseline, 6 months and 12 months after discharge. Patients had a higher point of social support at 6 months ( t =-2.69, P <0.01) and 12 months ( t =-2.86, P <0.01) after discharge than at baseline. Multiple regression analysis for baseline data identified five significant predictors of low social support status: workers or farmers ( t =2.82, P <0.01), low family monthly income ( t =2.42, P <0.05), anxiety ( t =-3.66, P <0.01), depression ( t =-3.22, P <0.01) and low quality of life ( t =4.38, P <0.01). Conclusions: Social support of patients with ACS is lower in China, and there are significant relationships between low social support and occupation, economic status, anxiety, depression, quality of life of ACS patients.

An Examination of Postsecondary Faculty and the Extent of Critical Reading Taught in 100-Level Introductory Biology and American History Courses in Publicly Funded Two-Year and Four-Year Pennsylvania Institutions

NASA Astrophysics Data System (ADS)

Sand, Dianna

This research examined the responses of postsecondary faculty on a critical reading inventory. The research is quantitative, non-experimental, and incorporates a multiple regression model in the analyses. Three research questions guided this study: (1) By institution type: To what degree does institution type predict the extent to which postsecondary faculty teach critical reading as measured by the Reading Goals Inventory (Jones, 1996)? (2) By faculty status: To what degree does faculty status predict the extent to which postsecondary faculty teach critical reading as measured by the Reading Goals Inventory (Jones, 1996)? (3) By disciplinary area: To what degree does disciplinary area predict the extent to which postsecondary faculty teach critical reading as measured by the Reading Goals Inventory (Jones, 1996)? Faculty from 28 Pennsylvania postsecondary institutions participated in this study. Faculty respondents taught 100-level introductory biology or American history courses either part-time or full-time at Pennsylvania community colleges or Pennsylvania State System of Higher Education (PASSHE) universities. Fifty-four faculty respondents completed the Reading Goals Inventory (Jones, 1996). The researcher conducted multiple regression analyses using a hierarchical method. Predictor variables included Institution Type, Faculty Status, and Disciplinary Area; criterion or outcome variables included seven sub-scales of the critical reading inventory. In this study, Institution Type and Faculty Status were not significant predictors. Disciplinary Area was a consistent significant predictor of the amount of critical reading taught as measured in the Interpretation, Analysis, Evaluation, and Reflection sub-scales of the Reading Goals Inventory (Jones, 1996).

Weight and skin colour as predictors of vitamin D status: results of an epidemiological investigation using nationally representative data.

PubMed

Rajan, Sonali; Weishaar, Tom; Keller, Bryan

2017-07-01

Current US dietary recommendations for vitamin D vary by age. Recent research suggests that body weight and skin colour are also major determinants of vitamin D status. The objective of the present epidemiological investigation was to clarify the role of age as a predictor of vitamin D status, while accounting for body weight and skin colour, among a nationally representative sample. We calculated the mean serum 25-hydroxyvitamin D levels for the US population by age and weight, as well as by weight and race/ethnicity group. Multiple regression analyses were utilized to evaluate age and weight as predictors of vitamin D status: serum 25-hydroxyvitamin D levels with age alone, age and body weight, and age, body weight and their two-way interaction were modelled for the entire sample and each age subgroup. Graphical data were developed using B-spline non-linear regression. National Health and Nutrition Examination Survey (31 934 unweighted cases). Individuals aged 1 year and older. There were highly significant differences in mean vitamin D status among US residents by weight and skin colour, with those having darker skin colour or higher body weight having worse vitamin D status. Although a significant factor, the impact of age on vitamin D status was notably less than the impact of body weight. Vitamin D status varied predominantly by body weight and skin colour. Recommendations by nutritionists for diet and supplementation needs should take this into account if vitamin D-related health disparities are to be meaningfully reduced across the USA.

Does environmental confounding mask pleiotropic effects of a multiple sclerosis susceptibility variant on vitamin D in psychosis?

PubMed

Iyegbe, Conrad O; Acharya, Anita; Lally, John; Gardner-Sood, Poonam; Smith, Louise S; Smith, Shubulade; Murray, Robin; Howes, Oliver; Gaughran, Fiona

2015-01-01

This work addresses the existing and emerging evidence of overlap within the environmental and genetic profiles of multiple sclerosis (MS) and schizophrenia. To investigate whether a genetic risk factor for MS (rs703842), whose variation is indicative of vitamin D status in the disorder, could also be a determinant of vitamin D status in chronic psychosis patients. A cohort of 224 chronic psychosis cases was phenotyped and biologically profiled. The relationship between rs703842 and physiological vitamin D status in the blood plasma was assessed by logistic regression. Deficiency was defined as a blood plasma concentration below 10 ng/µl. Potential environmental confounders of the vitamin D status were considered as part of the analysis. We report suggestive evidence of an association with vitamin D status in established psychosis (ß standardized=0.51, P=0.04). The logistic model fit significantly benefited from controlling for body mass index, depression and ethnicity (χ (2)=91.7; 2 degrees of freedom (df); P=1.2×10(20)). The results suggest that, in addition to lifestyle changes that accompany the onset of illness, vitamin D dysregulation in psychosis has a genetic component that links into MS. Further, comprehensive studies are needed to evaluate this prospect.

Correction of body-mass index using body-shape perception and socioeconomic status in adolescent self-report surveys.

PubMed

Legleye, Stéphane; Beck, François; Spilka, Stanislas; Chau, Nearkasen

2014-01-01

To propose a simple correction of body-mass index (BMI) based on self-reported weight and height (reported BMI) using gender, body shape perception and socioeconomic status in an adolescent population. 341 boys and girls aged 17-18 years were randomly selected from a representative sample of 2165 French adolescents living in Paris surveyed in 2010. After an anonymous self-administered pen-and-paper questionnaire asking for height, weight, body shape perception (feeling too thin, about the right weight or too fat) and socioeconomic status, subjects were measured and weighed. BMI categories were computed according to Cole's cut-offs. Reported BMIs were corrected using linear regressions and ROC analyses and checked with cross-validation and multiple imputations to handle missing values. Agreement between actual and corrected BMI values was estimated with Kappa indexes and Intraclass correlation coefficients (ICC). On average, BMIs were underreported, especially among girls. Kappa indexes between actual and reported BMI were low, especially for girls: 0.56 95%CI = [0.42-0.70] for boys and 0.45 95%CI = [0.30-0.60] for girls. The regression of reported BMI by gender and body shape perception gave the most balanced results for both genders: the Kappa and ICC obtained were 0.63 95%CI = [0.50-0.76] and 0.67, 95%CI = [0.58-0.74] for boys; 0.65 95%CI = [0.52-0.78] and 0.74, 95%CI = [0.66-0.81] for girls. The regression of reported BMI by gender and socioeconomic status led to similar corrections while the ROC analyses were inaccurate. Using body shape perception, or socioeconomic status and gender is a promising way of correcting BMI in self-administered questionnaires, especially for girls.

Aging, not menopause, is associated with higher prevalence of hyperuricemia among older women.

PubMed

Krishnan, Eswar; Bennett, Mihoko; Chen, Linjun

2014-11-01

This work aims to study the associations, if any, of hyperuricemia, gout, and menopause status in the US population. Using multiyear data from the National Health and Nutrition Examination Survey, we performed unmatched comparisons and one to three age-matched comparisons of women aged 20 to 70 years with and without hyperuricemia (serum urate ≥6 mg/dL). Analyses were performed using survey-weighted multiple logistic regression and conditional logistic regression, respectively. Overall, there were 1,477 women with hyperuricemia. Age and serum urate were significantly correlated. In unmatched analyses (n = 9,573 controls), postmenopausal women were older, were heavier, and had higher prevalence of renal impairment, hypertension, diabetes, and hyperlipidemia. In multivariable regression, after accounting for age, body mass index, glomerular filtration rate, and diuretic use, menopause was associated with hyperuricemia (odds ratio, 1.36; 95% CI, 1.05-1.76; P = 0.002). In corresponding multivariable regression using age-matched data (n = 4,431 controls), the odds ratio for menopause was 0.94 (95% CI, 0.83-1.06). Current use of hormone therapy was not associated with prevalent hyperuricemia in both unmatched and matched analyses. Age is a better statistical explanation for the higher prevalence of hyperuricemia among older women than menopause status.

Oral health status and the epidemiologic paradox within latino immigrant groups

PubMed Central

2012-01-01

Background According to the United States census, there are 28 categories that define “Hispanic/Latinos.” This paper compares differences in oral health status between Mexican immigrants and other Latino immigrant groups. Methods Derived from a community-based sample (N = 240) in Los Angeles, this cross-sectional study uses an interview covering demographic and behavioral measures, and an intraoral examination using NIDCR epidemiologic criteria. Descriptive, bivariate analysis, and multiple regression analysis were conducted to examine the determinants that are associated with the Oral Health Status Index (OHSI). Results Mexican immigrants had a significantly higher OHSI (p < .05) compared to other Latinos. The multilinear regression showed that both age and gender (p < .05), percentage of untreated decayed teeth (p < .001), number of replaced missing teeth (p < .001), and attachment loss (p < .001) were significant. Conclusions Compared with the other Latino immigrants in our sample, Mexican immigrants have significantly better oral health status. This confirms the epidemiologic paradox previously found in comparisons of Mexicans with whites and African Americans. In this case of oral health status the paradox also occurs between Mexicans and other Latinos. Therefore, when conducting oral health studies of Latinos, more consideration needs to be given to differences within Latino subgroups, such as their country of origin and their unique ethnic and cultural characteristics. PMID:22958726

Oral hygiene status in relation to sociodemographic factors of children and adults who are hearing impaired, attending a special school.

PubMed

Kumar, Santhosh; Dagli, Rushabh Jayesh; Mathur, Anmol; Jain, Manish; Duraiswamy, Prabu; Kulkarni, Suhas

2008-01-01

This study examined the oral hygiene levels and periodontal status in a group of children and adults with hearing impairment attending a special school in Udaipur, India. Oral hygiene status was assessed by the Simplified Oral Hygiene Index (OHI-S) of Greene and Vermillion and periodontal status by the Community Periodontal Index. An analysis using a bivariate analysis revealed that all the oral hygiene variables varied significantly with age, economic status, and education of the parents. A multiple regression analysis showed that the education of the mother was the single best predictor for oral hygiene status and explained 92% of the variance. These findings show that children with hearing impairment have poor oral hygiene and high levels of periodontal disease. This may be due to a lack of communication; hence, appropriate oral health education should be tailored to the needs of these students with the support of their teachers and their parents.

Does the relation between volunteering and well-being vary with health and age?

PubMed

Okun, Morris A; Rios, Rebeca; Crawford, Aaron V; Levy, Roy

2011-01-01

Previous studies have established a positive association between organizational volunteering and well-being. In the current study, we examined whether the relations between organizational volunteering and positive affect, negative affect, and resilience are modified by respondents' age and number of chronic health conditions. This study used cross-sectional data from the 2008 Arizona Health Survey of residents 18 years old and older (N = 4,161). Multiple regression analyses provided no support for the hypothesis that age moderates the association between volunteer status and positive affect, negative affect, and resilience. In contrast, there was a significant (p < .05) interaction between volunteer status and chronic health conditions on positive affect and resilience. Consistent with the compensatory hypothesis, as number of chronic health conditions increased, the relations between volunteering and positive affect and resilience scores increased. Implications of these findings for increasing volunteering among adults with multiple chronic health conditions are discussed.

Lifestyle and Genetic Predictors of Stiffness Index in Community-dwelling Elderly Korean Men and Women.

PubMed

Park, Kyung-Ae; Park, Yeon-Hwan; Suh, Min-Hee; Choi-Kwon, Smi

2015-09-01

Differing lifestyle, nutritional, and genetic factors may lead to a differing stiffness index (SI) determined by quantitative ultrasound in elderly men and women. The purpose of this study was to determine SI and the gender-specific factors associated with low SI in a Korean elderly cohort. This was a cross-sectional descriptive study identifying the gender-specific factors related to SI in 252 men and women aged 65 years and greater from local senior centers in Seoul, Korea between January and February 2009. The mean SI of elderly men was significantly higher than that of the women's. A multiple regression analysis reveals that age, nutritional status, and physical activity were predictive factors of lower SI in men, whereas age, alcohol consumption, educational level, and genetic polymorphism were predictive factors for elderly women. Low SI was common in both elderly men and women. We found gender differences in factors linked to low SI. In multiple regression analysis, nutritional status and physical activity were more important factors in men, whereas alcohol consumption, educational level, and genetic polymorphism were significant factors predicting low SI in women. Gender-specific modifiable risk factors associated with low SI should be considered when developing osteoporosis prevention programs for the elderly. Copyright © 2015. Published by Elsevier B.V.

A case of succinic semialdehyde dehydrogenase deficiency with status epilepticus and rapid regression.

PubMed

Horino, Asako; Kawawaki, Hisashi; Fukuoka, Masataka; Tsuji, Hitomi; Hattori, Yuka; Inoue, Takeshi; Nukui, Megumi; Kuki, Ichiro; Okazaki, Shin; Tomiwa, Kiyotaka; Hirose, Shinichi

2016-10-01

Clinical phenotypic expression of SSADH deficiency is highly heterogeneous, and some infants may develop refractory secondary generalized seizures. A 9-month-old boy manifested partial seizures, developing severe status epilepticus, and conventional antiepileptic drugs were ineffective. Use of ketamine contributed to the control of status epilepticus, achieving a reduction in frequency of partial seizures, and improving EEG findings without apparent complications. Diffusion-weighted images showed hyperintensities in the bilateral basal ganglia and fornix, and multiple T2 hyperintensity lesions were detected. (123)I-iomazenil (IMZ) SPECT revealed a decrease in binding of (123)I-iomazenil predominantly in the left temporal region by the 18th day of hospitalization. However, repeated IMZ-SPECT on the 46th day of hospitalization demonstrated almost no accumulation across a broad region, sparing the left temporal region. The patient showed rapid regression, refractory myoclonus, and severe progressive brain atrophy. IMZ-SPECT findings demonstrated reduced benzodiazepine receptor binding and its dynamic changes in an SSADH-deficient patient. Considering the down regulation of the GABAA receptor, ketamine should be included in pharmacotherapeutic strategies for treatment of refractory status epilepticus in SSADH-deficient patients. Copyright © 2016 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Relating Factors for Depression in Korean Working Women: Secondary Analysis of the Fifth Korean National Health and Nutrition Examination Survey (KNHANES V).

PubMed

Lee, Kyung-Jae; Kim, Jeung-Im

2015-09-01

The purpose of this study was to investigate the health behaviors and risk factors for self-reported depression in Korean working women. This study adopted a secondary analysis from the fifth Korean National Health and Nutrition Examination Survey (KNHANES-V) for the Health Examination Survey and Health Behavior Survey, using stratified, multi-stage, cluster-sampling design to obtain a nationally representative sample. Data were gathered on extensive information including sociodemographic, occupational characteristics, health behaviors and depression. Multiple logistic regression analysis was employed to compute the odds ratio (OR) between health behaviors and depression to identify the health behaviors and the risk factors for depression with adjustment for the complex sample design of the survey. The prevalence rate of depression was 15.5% among working women. Depression was more common in older female workers and in those with part-time job. Current smokers were significantly more likely to be depression-positive. In a multiple logistic regression analysis, significant variables of depression were marital status (OR = 2.02; 95% CI [1.05, 3.89]), smoking status (OR = 1.55; 95% CI [1.01, 2.38]), stress (OR = 0.20; 95% CI [0.15, 0.26]), employment condition (OR = 1.77; 95% CI [1.34, 2.33]) and health status (OR = 2.10; 95% CI [1.53, 2.87]). Based on the study, factors leading to depression were marital status, current smoking, stress, employment condition and self-reported health status. Further studies are expected to unravel the characteristics of stress. Health care providers for women need to evaluate underreported depression and change their associated health behaviors. Also it is necessary to establish preventive strategies for female workers to control the negative effect of depression in the workplace. Copyright © 2015. Published by Elsevier B.V.

Work-family conflict, part I: Antecedents of work-family conflict in national collegiate athletic association division I-A certified athletic trainers.

PubMed

Mazerolle, Stephanie M; Bruening, Jennifer E; Casa, Douglas J

2008-01-01

Work-family conflict (WFC) involves discord that arises when the demands of work interfere with the demands of family or home life. Long work hours, minimal control over work schedules, and time spent away from home are antecedents to WFC. To date, few authors have examined work-family conflict within the athletic training profession. To investigate the occurrence of WFC in certified athletic trainers (ATs) and to identify roots and factors leading to quality-of-life issues for ATs working in the National Collegiate Athletic Association Division I-A setting. Survey questionnaire and follow-up, in-depth, in-person interviews. Division I-A universities sponsoring football. A total of 587 ATs (324 men, 263 women) responded to the questionnaire. Twelve ATs (6 men, 6 women) participated in the qualitative portion: 2 head ATs, 4 assistant ATs, 4 graduate assistant ATs, and 2 AT program directors. Multiple regression analysis was performed to determine whether workload and travel predicted levels of WFC. Analyses of variance were calculated to investigate differences among the factors of sex, marital status, and family status. Interviews were transcribed verbatim and then analyzed using computer software as well as member checks and peer debriefing. The triangulation of the data collection and multiple sources of qualitative analysis were utilized to limit potential researcher prejudices. Regression analyses revealed that long work hours and travel directly contributed to WFC. In addition to long hours and travel, inflexible work schedules and staffing patterns were discussed by the interview participants as antecedents to WFC. Regardless of sex (P = .142), marital status (P = .687), family status (P = .055), or age of children (P = .633), WFC affected Division I-A ATs. No matter their marital or family status, ATs employed at the Division I-A level experienced difficulties balancing their work and home lives. Sources of conflict primarily stemmed from the consuming nature of the profession, travel, inflexible work schedules, and lack of full-time staff members.

The relationship between employment and health and health care among working-age adults with and without disabilities in the United States.

PubMed

Reichard, Amanda; Stransky, Michelle; Brucker, Debra; Houtenville, Andrew

2018-05-20

To better understand the relationship between employment and health and health care for people with disabilities in the United States (US). We pooled US Medical Expenditure Panel Survey (2004-2010) data to examine health status, and access to health care among working-age adults, comparing people with physical disabilities or multiple disabilities to people without disabilities, based on their employment status. Logistic regression and least squares regression were conducted, controlling for sociodemographics, health insurance (when not the outcome), multiple chronic conditions, and need for assistance. Employment was inversely related to access to care, insurance, and obesity. Yet, people with disabilities employed in the past year reported better general and mental health than their peers with the same disabilities who were not employed. Those who were employed were more likely to have delayed/forgone necessary care, across disability groups. Part-time employment, especially for people with multiple limitations, was associated with better health and health care outcomes than full-time employment. Findings highlight the importance of addressing employment-related causes of delayed or foregone receipt of necessary care (e.g., flex-time for attending appointments) that exist for all workers, especially those with physical or multiple disabilities. Implications for rehabilitation These findings demonstrate that rehabilitation professionals who are seeking to support employment for persons with physical limitations need to ensure that overall health concerns are adequately addressed, both for those seeking employment and for those who are currently employed. Assisting clients in prioritizing health equally with employment can ensure that both areas receive sufficient attention. Engaging with employers to develop innovative practices to improve health, health behaviors and access to care for employees with disabilities can decrease turnover, increase productivity, and ensure longer job tenure.

Women's health issues with fibromyalgia syndrome.

PubMed

Shaver, Joan L F; Wilbur, Joellen; Robinson, F Patrick; Wang, Edward; Buntin, Mary S

2006-11-01

Fibromyalgia syndrome (FMS) involves multiple sensory, somatic, and cognitive symptoms that are bound to affect or be affected by physical and mental health status and behavioral components of daily life. From a telephone survey of 442 women with and 205 women without FMS as volunteers, data were compared on (1) general health status, (2) reproductive and sleep-related diagnoses, and (3) lifestyle health behaviors. All multiple or logistics regression analyses for group differences were controlled for age, body mass index (BMI), race, employment status, marital status, having a college degree, low household income, and having ever been diagnosed with depression, with a Bonferroni p value correction for multiple indicators. Accordingly, FMS negatively impacted both perceived physical and mental health status, although relatively more so for physical (p < 0.017). Women with FMS were more likely to have had reproductive health or sleep-related diagnoses, including premenstrual syndrome, dysmenorrhea, breast cysts, bladder cystitis, sleep apnea, restless leg syndrome, and abnormal leg movements (p < 0.0125). They were calculated to use less than half as many calories per week as control women (689 +/- 1293 vs. 1499 +/- 1584 kcal/week, p < 0.05) and had more sleep pattern difficulties (p < 0.0125), more negative changes in sexual function (greater odds for 5 of 10 indicators at p < 0.005), and lower alcohol use (odds ratio = 0.39, p < 0.05). Patients with FMS deserve careful assessment for reproductive conditions and sleep-related functional disorders. Besides more research into mechanisms underlying symptoms, intervention testing specifically to alleviate sleep problems, low physical activity levels, and sexual dysfunction should be paramount.

Caring, employment, and quality of life: comparison of employed and nonemployed mothers of adults with intellectual disability.

PubMed

Chou, Yueh-Ching; Pu, Cheng-Yun; Kröger, Teppo; Fu, Li-yeh

2010-09-01

The effects of caregiving on mothers of adults with intellectual disability was examined by determining whether there are differences in quality of life and related factors between mothers with different employment status. Study participants were 302 working-age mothers who had adult children with intellectual disability based on the 2008 census survey on intellectual disability carried out in Hsinchu, City, Taiwan. Results revealed that nonemployed mothers are more likely to have a lower level of health status, including the WHOQOL Physical Health domain, than are mothers employed fulltime. Multiple regression analysis showed that mothers' quality of life was significantly determined by the availability of a person with whom they could share care work, family income, social support, and employment status.

Perceived discrimination, psychological distress, and current smoking status: results from the Behavioral Risk Factor Surveillance System Reactions to Race module, 2004-2008.

PubMed

Purnell, Jason Q; Peppone, Luke J; Alcaraz, Kassandra; McQueen, Amy; Guido, Joseph J; Carroll, Jennifer K; Shacham, Enbal; Morrow, Gary R

2012-05-01

We examined the association between perceived discrimination and smoking status and whether psychological distress mediated this relationship in a large, multiethnic sample. We used 2004 through 2008 data from the Behavioral Risk Factor Surveillance System Reactions to Race module to conduct multivariate logistic regression analyses and tests of mediation examining associations between perceived discrimination in health care and workplace settings, psychological distress, and current smoking status. Regardless of race/ethnicity, perceived discrimination was associated with increased odds of current smoking. Psychological distress was also a significant mediator of the discrimination-smoking association. Our results indicate that individuals who report discriminatory treatment in multiple domains may be more likely to smoke, in part, because of the psychological distress associated with such treatment.

Predictors of life satisfaction among caregivers of individuals with multiple sclerosis.

PubMed

Waldron-Perrine, Brigid; Rapport, Lisa J; Ryan, Kelly A; Harper, Kaja Telmet

2009-04-01

Research on life satisfaction among caregivers of persons with multiple sclerosis (MS) is sparse. This study examined the extent to which MS-specific disease and psychosocial characteristics predict caregiver life satisfaction. Participants were 64 caregivers of patients with MS and the patients for whom they care. Multiple regression analysis indicated that caregiver perception of illness uncertainty and patients' unawareness of deficits have unique value in predicting caregiver life satisfaction, even after accounting for general financial status. Gender and level of social support were also important contributing factors to caregiver life satisfaction. The findings suggest that duration and severity of the patients' illness take a greater toll on life satisfaction of caregivers with low versus high social support, particularly among women caregivers.

Self-transcendence and well-being in homeless adults.

PubMed

Runquist, Jennifer J; Reed, Pamela G

2007-03-01

This study examines the relationships of spiritually and physically related variables to well-being among homeless adults. A convenience sample of 61 sheltered homeless persons completed the Spiritual Perspective Scale, the Self-Transcendence Scale, the Index of Well-Being, and items measuring fatigue and health status. The data were subjected to correlational and multiple regression analysis. Positive, significant correlations were found among spiritual perspective, self-transcendence, health status, and well-being. Fatigue was inversely correlated with health status and well-being. Self-transcendence and health status together explained 59% of the variance in well-being. The findings support Reed's theory of self-transcendence, in which there is the basic assumption that human beings have the potential to integrate difficult life situations. This study contributes to the growing body of evidence that conceptualizes homeless persons as having spiritual, emotional, and physical capacities that can be used by health care professionals to promote well-being in this vulnerable population.

Low urine pH and acid excretion do not predict bone fractures or the loss of bone mineral density: a prospective cohort study.

PubMed

Fenton, Tanis R; Eliasziw, Misha; Tough, Suzanne C; Lyon, Andrew W; Brown, Jacques P; Hanley, David A

2010-05-10

The acid-ash hypothesis, the alkaline diet, and related products are marketed to the general public. Websites, lay literature, and direct mail marketing encourage people to measure their urine pH to assess their health status and their risk of osteoporosis.The objectives of this study were to determine whether 1) low urine pH, or 2) acid excretion in urine [sulfate + chloride + 1.8x phosphate + organic acids] minus [sodium + potassium + 2x calcium + 2x magnesium mEq] in fasting morning urine predict: a) fragility fractures; and b) five-year change of bone mineral density (BMD) in adults. Cohort study: the prospective population-based Canadian Multicentre Osteoporosis Study. Multiple logistic regression was used to examine associations between acid excretion (urine pH and urine acid excretion) in fasting morning with the incidence of fractures (6804 person years). Multiple linear regression was used to examine associations between acid excretion with changes in BMD over 5-years at three sites: lumbar spine, femoral neck, and total hip (n = 651). Potential confounders controlled included: age, gender, family history of osteoporosis, physical activity, smoking, calcium intake, vitamin D status, estrogen status, medications, renal function, urine creatinine, body mass index, and change of body mass index. There were no associations between either urine pH or acid excretion and either the incidence of fractures or change of BMD after adjustment for confounders. Urine pH and urine acid excretion do not predict osteoporosis risk.

[Multiple factors analysis of periodontal status in pregnant women in Shanghai].

PubMed

Chen, Lin; Lu, Hai-xia; Wei, Tian-you; Feng, Xi-ping

2014-08-01

To assess the periodontal health status of pregnant women in Shanghai, and to investigate the factors that may influence the periodontal health status of pregnant women, in order to provide theoretical evidence for the pointed oral health education and public health strategies in future. A cross-sectional study was carried out to recruit pregnant women (0 to 40 weeks) randomly selected from primary Maternal and Child Care Service Centers in Shanghai. The data collection included the questionnaire survey and clinical periodontal examination. Visible plaque index (VPI), bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL) were assessed during the clinical examination. Chi-square test and logistic regression analysis were performed to analyze the data by SPSS 18.0 software package. A total of 561 pregnant women were surveyed. The mean age was (27.5 ± 4.0) years. The mean gestational age was (18.9 ± 8.1) weeks, ranged from 5 to 40 weeks. The prevalence of periodontal disease during pregnancy was 49.6%, of which the prevalence of gingivitis and periodontitis were 42.8% and 6.8%, respectively. The results of multiple logistic regression showed that pregnant women who were in the second and third trimesters, and whose place of residence was rural were significantly more likely to suffer periodontal disease. Gestational age and place of residence are the factors that are associated with the prevalence of periodontal disease among pregnant women in Shanghai. More oral health education and promotion should be targeted on these pregnant women at high-risk.

Determinant of factors associated with child health outcomes and service utilization in Ghana: multiple indicator cluster survey conducted in 2011.

PubMed

Dwumoh, Duah; Essuman, Edward Eyipe; Afagbedzi, Seth Kwaku

2014-01-01

The effects of National Health Insurance Scheme in Ghana and its impact on child health outcome and service utilization cannot be underestimated. Despite the tremendous improvement in child health care in Ghana, there are still some challenges in relation to how National health insurance membership, socioeconomic status and other demographic factors impacts on child health outcomes. The study seeks to determine the association between NHIS membership, socio-economic status, geographic location and other relevant background factors, on child health service utilization and outcomes. Secondary data from the Multiple Indicator Cluster Survey conducted in 2011 was used. Multivariate analysis based on Binary Logistic Regression Models and Multiple linear regression techniques was applied to determine factors associated with child health outcomes and service utilization. Collection of best models was based on Hosmer-Lemeshow Goodness-Of-Fit as one criterion of fit and the Akaike Information Criterion. Controlling for confounding effect of socioeconomic status, age of the child, mothers education level and geographic location, the odds of a child developing anemia for children with National Health Insurance Scheme Membership is 65.2% [95% CI: 52.9-80.2] times less than children without National Health Insurance Scheme Membership. The odds of being fully immunized against common childhood illnesses for children with NHIS membership is 2.3[95% CI: 1.4-3.7] times higher than children without National Health Insurance Scheme Membership. There was no association between National Health Insurance Scheme Membership and stunted growth in children. National Health Insurance Scheme Membership was found to be related to child health service utilization (full immunization) of children under five a child's anemia status. Children with NHIS are more likely to be fully immunized against common childhood diseases and are less likely to develop anemia. Stunted growth of children was not associated with National Health Insurance Scheme Membership. Health Education on the registration and the use of the National Health Insurance should be made a national priority to enable the Ministry of Health achieve routine Immunization targets and to reduce to the bearers minimum prevalence of anemia.

Prevalence and predictors of depression in Iranian patients with multiple sclerosis: a population-based study.

PubMed

Seyed Saadat, Seyed Mohammad; Hosseininezhad, Mozaffar; Bakhshayesh, Babak; Seyed Saadat, Seyedeh Nastaran; Nabizadeh, Seyedeh Parand

2014-05-01

Depression is a frequent symptom in multiple sclerosis (MS) which has a negative impact on quality of life and cognitive status. The purpose of this study was to determine the prevalence and associated factors of depression, and status of antidepressant use in Iranian MS patients. One-hundred and sixty patients with definite MS were included. Demographic and clinical characteristics were recorded. Fatigue and depression were evaluated using the fatigue severity scale and Beck depression inventory-II. Cognitive performance and disability were examined by mini-mental status examination and expanded disability status scale. Multiple logistic regressions were used to determine the associated factors of depression and antidepressant use. The prevalence of depression and severe depression was 59.4 and 18.1 %, respectively. However, only 21.1 % of patients were on antidepressant treatment, while the prevalence of unrecognized/untreated depression was found to be as high as 44.1 %. Multivariable analysis showed that fatigue (P < 0.0001, OR = 5.98, 95 % CI = 2.9-12.3) and older age (P = 0.027, OR = 2.24, 95 % CI = 1.09-4.6) were associated with depression in MS patient. A significant association was found between fatigue and antidepressant use (P = 0.001, OR = 6.81, 95 % CI = 2.26-20.48). Our findings demonstrate that depression is significantly associated with fatigue and older age, regardless of other factors. Moreover, despite the high prevalence of depression in MS, most patients do not receive adequate treatment.

Changes in food insecurity, nutritional status, and physical health status after antiretroviral therapy initiation in rural Uganda.

PubMed

Weiser, Sheri D; Gupta, Reshma; Tsai, Alexander C; Frongillo, Edward A; Grede, Nils; Kumbakumba, Elias; Kawuma, Annet; Hunt, Peter W; Martin, Jeffrey N; Bangsberg, David R

2012-10-01

To investigate whether time on antiretroviral therapy (ART) is associated with improvements in food security and nutritional status, and the extent to which associations are mediated by improved physical health status. The Uganda AIDS Rural Treatment Outcomes study, a prospective cohort of HIV-infected adults newly initiating ART in Mbarara, Uganda. Participants initiating ART underwent quarterly structured interview and blood draws. The primary explanatory variable was time on ART, constructed as a set of binary variables for each 3-month period. Outcomes were food insecurity, nutritional status, and PHS. We fit multiple regression models with cluster-correlated robust estimates of variance to account for within-person dependence of observations over time, and analyses were adjusted for clinical and sociodemographic characteristics. Two hundred twenty-eight ART-naive participants were followed for up to 3 years, and 41% were severely food insecure at baseline. The mean food insecurity score progressively declined (test for linear trend P < 0.0001), beginning with the second quarter (b = -1.6; 95% confidence interval: -2.7 to -0.45) and ending with the final quarter (b = -6.4; 95% confidence interval: -10.3 to -2.5). PHS and nutritional status improved in a linear fashion over study follow-up (P < 0.001). Inclusion of PHS in the regression model attenuated the relationship between ART duration and food security. Among HIV-infected individuals in Uganda, food insecurity decreased and nutritional status and PHS improved over time after initiation of ART. Changes in food insecurity were partially explained by improvements in PHS. These data support early initiation of ART in resource-poor settings before decline in functional status to prevent worsening food insecurity and its detrimental effects on HIV treatment outcomes.

Gender differences in the predictors of physical activity among assisted living residents.

PubMed

Chen, Yuh-Min; Li, Yueh-Ping; Yen, Min-Ling

2015-05-01

To explore gender differences in the predictors of physical activity (PA) among assisted living residents. A cross-sectional design was adopted. A convenience sample of 304 older adults was recruited from four assisted living facilities in Taiwan. Two separate simultaneous multiple regression analyses were conducted to identify the predictors of PA for older men and women. Independent variables entered into the regression models were age, marital status, educational level, past regular exercise participation, number of chronic diseases, functional status, self-rated health, depression, and self-efficacy expectations. In older men, a junior high school or higher educational level, past regular exercise participation, better functional status, better self-rated health, and higher self-efficacy expectations predicted more PA, accounting for 61.3% of the total variance in PA. In older women, better self-rated health, lower depression, and higher self-efficacy expectations predicted more PA, accounting for 50% of the total variance in PA. Predictors of PA differed between the two genders. The results have crucial implications for developing gender-specific PA interventions. Through a clearer understanding of gender-specific predictors, healthcare providers can implement gender-sensitive PA-enhancing interventions to assist older residents in performing sufficient PA. © 2015 Sigma Theta Tau International.

Exploring genetic variants predisposing to diabetes mellitus and their association with indicators of socioeconomic status.

PubMed

Schmidt, Börge; Dragano, Nico; Scherag, André; Pechlivanis, Sonali; Hoffmann, Per; Nöthen, Markus M; Erbel, Raimund; Jöckel, Karl-Heinz; Moebus, Susanne

2014-06-16

The relevance of disease-related genetic variants for the explanation of social inequalities in complex diseases is unclear and empirical analyses are largely missing. The aim of our study was to examine whether genetic variants predisposing to diabetes mellitus are associated with socioeconomic status in a population-based cohort. We genotyped 11 selected diabetes-related single nucleotide polymorphisms in 4655 participants (age 45-75 years) of the Heinz Nixdorf Recall study. Diabetes status was self-reported or defined by blood glucose levels. Education, income and paternal occupation were assessed as indicators of socioeconomic status. Multiple regression analyses were used to examine the association of socioeconomic status and diabetes by estimating sex-specific and age-adjusted prevalence ratios and their corresponding 95%-confidence intervals. To explore the relationship between individual single nucleotide polymorphisms and socioeconomic status sex- and age-adjusted odds ratios were computed. We adjusted the alpha-level for multiple testing of 11 single nucleotide polymorphisms using Bonferroni's method (α(BF) ~ 0.005). In addition, we explored the association of a genetic risk score with socioeconomic status. Social inequalities in diabetes were observed for all indicators of socioeconomic status. However, there were no significant associations between individual diabetes-related risk alleles and socioeconomic status with odds ratios ranging from 0.87 to 1.23. Similarly, the genetic risk score analysis revealed no evidence for an association. Our data provide no evidence for an association between 11 diabetes-related risk alleles and different indicators of socioeconomic status in a population-based cohort, suggesting that the explored genetic variants do not contribute to health inequalities in diabetes.

Poor mental health status and aggression are associated with poor driving behavior among male traffic offenders

PubMed Central

Abdoli, Nasrin; Farnia, Vahid; Delavar, Ali; Esmaeili, Alirez; Dortaj, Fariborz; Farrokhi, Noorali; Karami, Majid; Shakeri, Jalal; Holsboer-Trachsler, Edith; Brand, Serge

2015-01-01

Background In Iran, traffic accidents and deaths from traffic accidents are among the highest in the world, and generally driver behavior rather than either technical failures or environmental conditions are responsible for traffic accidents. In the present study, we explored the extent to which aggressive traits, health status, and sociodemographic variables explain driving behavior among Iranian male traffic offenders. Method A total of 443 male driving offenders (mean age: M =31.40 years, standard deviation =9.56) from Kermanshah (Iran) took part in the study. Participants completed a questionnaire booklet covering sociodemographic variables, traits of aggression, health status, and driving behavior. Results Poor health status, such as symptoms of depression, anxiety, insomnia, and social dysfunction, and also higher levels of trait aggression explained poor driving behavior. Multiple regressions indicated that poor health status, but not aggression, independently predicted poor driving behavior. Conclusion Results suggest that health status concerns are associated with poor driving behavior. Prevention and intervention might therefore focus on drivers reporting poor mental health status. PMID:26316753

Assessment of environmental injustice in Korea using synthetic air quality index and multiple indicators of socioeconomic status: A cross-sectional study.

PubMed

Choi, Giehae; Heo, Seulkee; Lee, Jong-Tae

2016-01-01

Despite the existence of the universal right to a healthy environment, the right is being violated in some populations. The objective of the current study is to verify environmental discrimination associated with socioeconomic status in Korea, using synthetic air quality index and multiple indicators of socioeconomic status. The concentrations of NO₂(nitrogen dioxide), CO (carbon monoxide), SO₂(sulfur dioxide), PM10 (particulate matter with an aerodynamic diameter <10 μm), and O₃(ozone) in ambient air were integrated into a synthetic air quality index. Socioeconomic status was measured at individual level (income, education, number of household members, occupation, and National Basic Livelihood status) and area level (neighborhood index). The neighborhood index was calculated in the finest administrative unit (municipality) by performing standardization and integration of municipality-level data of the following: number of families receiving National Basic Livelihood, proportion of people engaged in an elementary occupation, population density, and number of service industries. Each study participant was assigned a neighborhood index value of the municipality in which they reside. Six regression models were generated to analyze the relationship between socioeconomic status and overall air pollution. All models were adjusted with sex, age, and smoking status. Stratification was conducted by residency (urban/rural). Moran's I was calculated to identify spatial clusters, and adjusted regression analysis was conducted to account for spatial autocorrelation. Results showed that people with higher neighborhood index, people living with smaller number of family members, and people with no education lived in municipalities with better overall air quality. The association differed by residency in some cases, and consideration of spatial autocorrelation altered the association. This study gives strength to the idea that environmental discrimination exists in some socioeconomic groups in Korea, and that residency and spatial autocorrelation must be considered in order to fully understand environmental disparities. This is the first study that provides the possible evidence of the environmental injustice in Korea using air quality index. The findings suggested that air quality index was negatively correlated with several important socioeconomic status measured at either individual or area level. The main implication of this paper, therefore, is to provide another insight to environmental policy makers to consider environmental injustice problem into community intervention for resolving the public health problems by air pollution.

Association of Emotional Labor and Occupational Stressors with Depressive Symptoms among Women Sales Workers at a Clothing Shopping Mall in the Republic of Korea: A Cross-Sectional Study

PubMed Central

Chung, Yuh-Jin; Jung, Woo-Chul

2017-01-01

In the distribution service industry, sales people often experience multiple occupational stressors such as excessive emotional labor, workplace mistreatment, and job insecurity. The present study aimed to explore the associations of these stressors with depressive symptoms among women sales workers at a clothing shopping mall in Korea. A cross sectional study was conducted on 583 women who consist of clothing sales workers and manual workers using a structured questionnaire to assess demographic factors, occupational stressors, and depressive symptoms. Multiple regression analyses were performed to explore the association of these stressors with depressive symptoms. Scores for job stress subscales such as job demand, job control, and job insecurity were higher among sales workers than among manual workers (p < 0.01). The multiple regression analysis revealed the association between occupation and depressive symptoms after controlling for age, educational level, cohabiting status, and occupational stressors (sβ = 0.08, p = 0.04). A significant interaction effect between occupation and social support was also observed in this model (sβ = −0.09, p = 0.02). The multiple regression analysis stratified by occupation showed that job demand, job insecurity, and workplace mistreatment were significantly associated with depressive symptoms in both occupations (p < 0.05), although the strength of statistical associations were slightly different. We found negative associations of social support (sβ = −0.22, p < 0.01) and emotional effort (sβ = −0.17, p < 0.01) with depressive symptoms in another multiple regression model for sales workers. Emotional dissonance (sβ = 0.23, p < 0.01) showed positive association with depressive symptoms in this model. The result of this study indicated that reducing occupational stressors would be effective for women sales workers to prevent depressive symptoms. In particular, promoting social support could be the most effective way to promote women sales workers’ mental health. PMID:29168777

Association of Emotional Labor and Occupational Stressors with Depressive Symptoms among Women Sales Workers at a Clothing Shopping Mall in the Republic of Korea: A Cross-Sectional Study.

PubMed

Chung, Yuh-Jin; Jung, Woo-Chul; Kim, Hyunjoo; Cho, Seong-Sik

2017-11-23

In the distribution service industry, sales people often experience multiple occupational stressors such as excessive emotional labor, workplace mistreatment, and job insecurity. The present study aimed to explore the associations of these stressors with depressive symptoms among women sales workers at a clothing shopping mall in Korea. A cross sectional study was conducted on 583 women who consist of clothing sales workers and manual workers using a structured questionnaire to assess demographic factors, occupational stressors, and depressive symptoms. Multiple regression analyses were performed to explore the association of these stressors with depressive symptoms. Scores for job stress subscales such as job demand, job control, and job insecurity were higher among sales workers than among manual workers ( p < 0.01). The multiple regression analysis revealed the association between occupation and depressive symptoms after controlling for age, educational level, cohabiting status, and occupational stressors (sβ = 0.08, p = 0.04). A significant interaction effect between occupation and social support was also observed in this model (sβ = -0.09, p = 0.02). The multiple regression analysis stratified by occupation showed that job demand, job insecurity, and workplace mistreatment were significantly associated with depressive symptoms in both occupations ( p < 0.05), although the strength of statistical associations were slightly different. We found negative associations of social support (sβ = -0.22, p < 0.01) and emotional effort (sβ = -0.17, p < 0.01) with depressive symptoms in another multiple regression model for sales workers. Emotional dissonance (sβ = 0.23, p < 0.01) showed positive association with depressive symptoms in this model. The result of this study indicated that reducing occupational stressors would be effective for women sales workers to prevent depressive symptoms. In particular, promoting social support could be the most effective way to promote women sales workers' mental health.

Universal Algorithms for Plant Phenotyping: Are we there yet?

NASA Astrophysics Data System (ADS)

Kakani, V. G.; Kambham, R. R.; Zhao, D.; Foster, A. J.; Gowda, P. H.

2017-12-01

Hyperspectral remote sensing offers ability to capture spectral signatures of plant morpho-physio-biochemical traits at multiple scales (leaf to canopy to aerial). Experimental results on plant phenotype from pot, growth chamber and field studies at multiple location were used in this study. Pigment, leaf/plant water status, plant nutrient status, plant height, leaf area, fresh and dry weights of biomass and its components are correlated with hyperspectral reflectance signatures. Leaf reflectance was collected with spectroradiometer having a light source. Canopy hyperspectral reflectance was collected from 1.5 m above the canopy using a spectroradiometer, while multispectral images were acquired from aerial platforms ( 400m). Several statistical methods including simple ratios, principal component analysis, and partial least squares regression were used to identify hyperspectral reflectance bands that were tightly associated with plant phenotypic traits. Leaf level spectra best described the morpho-physio-biochemical traits (R2 = 0.6-0.9), while canopy reflectance best described plant height (R2 = 0.65), leaf area index (R2 = 0.67-0.74) and biomass (R2 = 0.69-0.78), while aerial spectra improved canopy level regression coefficients for plant height (R2 = 0.93) and leaf area index (R2 = 0.89). The comparison of multi-level spectra and resolution, clearly showed the advantage of hyperspectral reflectance data over the multispectral reflectance data, particularly for understanding the basis for spectral reflectance differences among species and traits. In conclusion, high resolution (1-2 cm) spectral imagery can help to bridge the gap across multiple levels of phenotype measurement.

Logistic Regression with Multiple Random Effects: A Simulation Study of Estimation Methods and Statistical Packages.

PubMed

Kim, Yoonsang; Choi, Young-Ku; Emery, Sherry

2013-08-01

Several statistical packages are capable of estimating generalized linear mixed models and these packages provide one or more of three estimation methods: penalized quasi-likelihood, Laplace, and Gauss-Hermite. Many studies have investigated these methods' performance for the mixed-effects logistic regression model. However, the authors focused on models with one or two random effects and assumed a simple covariance structure between them, which may not be realistic. When there are multiple correlated random effects in a model, the computation becomes intensive, and often an algorithm fails to converge. Moreover, in our analysis of smoking status and exposure to anti-tobacco advertisements, we have observed that when a model included multiple random effects, parameter estimates varied considerably from one statistical package to another even when using the same estimation method. This article presents a comprehensive review of the advantages and disadvantages of each estimation method. In addition, we compare the performances of the three methods across statistical packages via simulation, which involves two- and three-level logistic regression models with at least three correlated random effects. We apply our findings to a real dataset. Our results suggest that two packages-SAS GLIMMIX Laplace and SuperMix Gaussian quadrature-perform well in terms of accuracy, precision, convergence rates, and computing speed. We also discuss the strengths and weaknesses of the two packages in regard to sample sizes.

Logistic Regression with Multiple Random Effects: A Simulation Study of Estimation Methods and Statistical Packages

PubMed Central

Kim, Yoonsang; Emery, Sherry

2013-01-01

Several statistical packages are capable of estimating generalized linear mixed models and these packages provide one or more of three estimation methods: penalized quasi-likelihood, Laplace, and Gauss-Hermite. Many studies have investigated these methods’ performance for the mixed-effects logistic regression model. However, the authors focused on models with one or two random effects and assumed a simple covariance structure between them, which may not be realistic. When there are multiple correlated random effects in a model, the computation becomes intensive, and often an algorithm fails to converge. Moreover, in our analysis of smoking status and exposure to anti-tobacco advertisements, we have observed that when a model included multiple random effects, parameter estimates varied considerably from one statistical package to another even when using the same estimation method. This article presents a comprehensive review of the advantages and disadvantages of each estimation method. In addition, we compare the performances of the three methods across statistical packages via simulation, which involves two- and three-level logistic regression models with at least three correlated random effects. We apply our findings to a real dataset. Our results suggest that two packages—SAS GLIMMIX Laplace and SuperMix Gaussian quadrature—perform well in terms of accuracy, precision, convergence rates, and computing speed. We also discuss the strengths and weaknesses of the two packages in regard to sample sizes. PMID:24288415

A twelve-year profile of students' SAT scores, GPAs, and MCAT scores from a small university's premedical program.

PubMed

Montague, J R; Frei, J K

1993-04-01

To determine whether significant correlations existed among quantitative and qualitative predictors of students' academic success and quantitative outcomes of such success over a 12-year period in a small university's premedical program. A database was assembled from information on the 199 graduates who earned BS degrees in biology from Barry University's School of Natural and Health Sciences from 1980 through 1991. The quantitative variables were year of BS degree, total score on the Scholastic Aptitude Test (SAT), various measures of undergraduate grade-point averages (GPAs), and total score on the Medical College Admission Test (MCAT); and the qualitative variables were minority (54% of the students) or majority status and transfer (about one-third of the students) or nontransfer status. The statistical methods were multiple analysis of variance and stepwise multiple regression. Statistically significant positive correlations were found among SAT total scores, final GPAs, biology GPAs versus nonbiology GPAs, and MCAT total scores. These correlations held for transfer versus nontransfer students and for minority versus majority students. Over the 12-year period there were significant fluctuations in mean MCAT scores. The students' SAT scores and GPAs proved to be statistically reliable predictors of MCAT scores, but the minority or majority status and the transfer or nontransfer status of the students were statistically insignificant.

Subjective social status and readiness to quit among homeless smokers.

PubMed

Garey, Lorra; Reitzel, Lorraine R; Bakhshaie, Jafar; Kendzor, Darla E; Zvolensky, Michael J; Businelle, Michael S

2015-03-01

To explore the predictive value of subjective social status (SSS-US and SSS-Community) on readiness to quit among 245 homeless smokers. Hierarchical multiple regression analyses were conducted (stratified by sex). Higher SSS-US (p = .02) and SSS-Community (p < .001) predicted greater readiness to quit in the total sample. These relationships upheld for men (p's <. 01), but only SSS-Community predicted readiness to quit for women (p = .02). Higher SSS is associated with greater readiness to quit among homeless smokers. SSS-Community may be a more relevant index of SSS for women relative to SSS-US. Results suggest SSS may be a factor that contributes to smoking, disease, and health disparities.

Social patterning of stress and coping: Does disadvantaged social status confer more stress and fewer coping resources?

PubMed Central

Meyer, Ilan H.; Schwartz, Sharon; Frost, David M.

2008-01-01

Despite its centrality to social stress theory, research on the social patterning of stress exposure and coping resources has been sparse and existing research shows conflicting results. We interviewed 396 gay, lesbian and bisexual, and 128 heterosexual people in New York City to examine variability in exposure to stress related to sexual orientation, gender, and race/ethnicity. Multiple linear regression showed clear support for the social stress hypothesis with regard to race/ethnic minority status, somewhat mixed support with regard to sexual orientation, and no support with regard to gender. We discuss this lack of parsimony in social stress explanations for health disparities. PMID:18433961

Obesity and hypomagnesemia.

PubMed

Guerrero-Romero, Fernando; Flores-García, Araceli; Saldaña-Guerrero, Stephanie; Simental-Mendía, Luis E; Rodríguez-Morán, Martha

2016-10-01

Whether low serum magnesium is an epiphenomenon related with obesity or, whether obesity per se is cause of hypomagnesemia, remains to be clarified. To examine the relationship between body weight status and hypomagnesemia in apparently healthy subjects. A total of 681 healthy individuals aged 30 to 65years were enrolled in A cross-sectional study. Extreme exercise, chronic diarrhea, alcohol intake, use of diuretics, smoking, oral magnesium supplementation, diabetes, malnutrition, hypertension, liver disease, thyroid disorders, and renal damage were exclusion criteria. Based in the Body Mass Index (BMI), body weight status was defined as follows: normal weight (BMI <25kg/m 2 ); overweight (BMI ≥25<30 BMIkg/m 2 ); and obesity (BMI ≥30kg/m 2 ). Hypomagnesemia was defined by serum magnesium concentration ≤0.74mmol/L. A multiple logistic regression analysis was used to compute the odds ratio (OR) between body weight status (independent variables) and hypomagnesemia (dependent variable). The multivariate logistic regression analysis showed that dietary magnesium intake (OR 2.11; 95%CI 1.4-5.7) but no obesity (OR 1.53; 95%CI 0.9-2.5), overweight (OR 1.40; 95%CI 0.8-2.4), and normal weight (OR 0.78; 95%CI 0.6-2.09) were associated with hypomagnesemia. A subsequent logistic regression analysis adjusted by body mass index, waist circumference, total body fat, systolic and diastolic blood pressure, and triglycerides levels showed that hyperglycemia (2.19; 95%CI 1.1-7.0) and dietary magnesium intake (2.21; 95%CI 1.1-8.9) remained associated with hypomagnesemia. Our results show that body weight status is not associated with hypomagnesemia and that, irrespective of obesity, hyperglycemia is cause of hypomagnesemia in non-diabetic individuals. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Perceived Discrimination, Psychological Distress, and Current Smoking Status: Results From the Behavioral Risk Factor Surveillance System Reactions to Race Module, 2004–2008

PubMed Central

Peppone, Luke J.; Alcaraz, Kassandra; McQueen, Amy; Guido, Joseph J.; Carroll, Jennifer K.; Shacham, Enbal; Morrow, Gary R.

2012-01-01

Objectives. We examined the association between perceived discrimination and smoking status and whether psychological distress mediated this relationship in a large, multiethnic sample. Methods. We used 2004 through 2008 data from the Behavioral Risk Factor Surveillance System Reactions to Race module to conduct multivariate logistic regression analyses and tests of mediation examining associations between perceived discrimination in health care and workplace settings, psychological distress, and current smoking status. Results. Regardless of race/ethnicity, perceived discrimination was associated with increased odds of current smoking. Psychological distress was also a significant mediator of the discrimination–smoking association. Conclusions. Our results indicate that individuals who report discriminatory treatment in multiple domains may be more likely to smoke, in part, because of the psychological distress associated with such treatment. PMID:22420821

Association between Social Activities and Cognitive Function among the Elderly in China: A Cross-Sectional Study.

PubMed

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.

Association between Social Activities and Cognitive Function among the Elderly in China: A Cross-Sectional Study

PubMed Central

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

MMR immunisation status among Dublin paediatric A&E attenders.

PubMed

Murphy, A W; Power, R; Kinlen, D M; Johnson, Z

1994-01-01

The objectives of this study were to establish the need for opportunistic MMR immunisation among paediatric A&E attenders to the three Dublin paediatric hospitals and to examine the relationship between immunisation status and socioeconomic factors. Design was that of a two month cross sectional study. Survey data was then compared with information on the Eastern Health Board (EHB) records system. Small area and multiple regression analysis of socioeconomic factors derived from participants addresses was also performed. Subjects were 337 children who attended these departments and were aged between fifteen months and five years. For 66% of cases there was a history of MMR immunisation, 30% gave a negative history and 4% did not know. Of those giving a negative history, one third said immunisation had been omitted for no specific reason. EHB records suggested that 39% were immunised, 41% were not and 20% were not on file. Eligibility for the GMS was not associated with failure to immunise. Small area and multiple regression analysis showed little association between immunisation uptake and socioeconomic factors. An opportunistic MMR immunisation policy in A&E Departments would make an important contribution to increasing overall uptake figures. Parental knowledge of the implications of measles and the effectiveness of immunisation needs to be improved. Computerised child health systems must have high data quality standards and access to these systems should be made available in A&E departments.

Comparison of risk factors for tooth loss between professional drivers and white-collar workers: an internet survey.

PubMed

Suzuki, Seitaro; Yoshino, Koichi; Takayanagi, Atsushi; Ishizuka, Yoichi; Satou, Ryouichi; Kamijo, Hideyuki; Sugihara, Naoki

2016-06-10

This cross-sectional study was conducted to examine tooth loss and associated factors among professional drivers and white-collar workers. The participants were recruited by applying screening procedures to a pool of Japanese registrants in an online database. The participants were asked to complete a self-reported questionnaire. A total of 592 professional drivers and 328 white-collar workers (male, aged 30 to 69 years) were analyzed. A multiple logistic regression analysis was performed to identify differences between professional drivers and white-collar workers. The results showed that professional drivers had fewer teeth than white-collar workers (odds ratio [OR], 1.74; 95% confidence interval [95% CI], 1.150-2.625). Moreover, a second multiple logistic regression analysis revealed that several factors were associated with the number of teeth among professional drivers: diabetes mellitus (OR, 2.68; 95% CI, 1.388-5.173), duration of brushing teeth (OR, 1.66; 95% CI, 1.066-2.572), frequency of eating breakfast (OR, 2.23; 95% CI, 1.416-3.513), frequency of eating out (OR, 1.70; 95% CI, 1.086-2.671) and smoking status (OR, 2.88; 95% CI, 1.388-5.964). These findings suggest that the lifestyles of professional drivers could be related to not only their general health status, but also tooth loss.

Correlates and Predictors of Psychological Distress Among Older Asian Immigrants in California.

PubMed

Chang, Miya; Moon, Ailee

2016-01-01

Psychological distress occurs frequently in older minority immigrants because many have limited social resources and undergo a difficult process related to immigration and acculturation. Despite a rapid increase in the number of Asian immigrants, relatively little research has focused on subgroup mental health comparisons. This study examines the prevalence of psychological distress, and relationship with socio-demographic factors, and health care utilization among older Asian immigrants. Weighted data from Asian immigrants 65 and older from 5 countries (n = 1,028) who participated in the California Health Interview Survey (CHIS) were analyzed descriptively and in multiple linear regressions. The prevalence of psychological distress varied significantly across the 5 ethnic groups, from Filipinos (4.83%) to Chinese (1.64%). General health status, cognitive and physical impairment, and health care utilization are all associated (p < .05) with psychological distress in multiple linear regressions. These findings are similar to those from previous studies. The findings reinforce the need to develop more culturally effective mental health services and outreach programs.

The Influence of Subjective Social Status on Vulnerability to Postpartum Smoking Among Young Pregnant Women

PubMed Central

Reitzel, Lorraine R.; Vidrine, Jennifer I.; Li, Yisheng; Mullen, Patricia D.; Velasquez, Mary M.; Cinciripini, Paul M.; Cofta-Woerpel, Ludmila; Greisinger, Anthony; Wetter, David W.

2007-01-01

Objectives. Associations between subjective social status, a subjective measure of socioeconomic status, and predictors of risk for postpartum smoking were examined among 123 pregnant women (aged 18–24 years) who stopped smoking because of pregnancy. The goal was to identify how subjective social status might influence the risk for postpartum smoking and to elucidate targets for intervention. Methods. We used multiple regression equations to examine the predictive relations between subjective social status and tobacco dependence, self-rated likelihood of postpartum smoking, confidence, temptations, positive and negative affect, depression, stress, and social support. Adjusted analyses were also conducted with control for race/ethnicity, education, income, and whether participant had a partner or not (partner status). Results. In unadjusted and adjusted analyses, subjective social status predicted tobacco dependence, likelihood of postpartum smoking, confidence, temptations, positive affect, negative affect, and social support. Adjusted analyses predicting depression and stress approached significance. Conclusions. Among young pregnant women who quit smoking because of pregnancy, low subjective social status was associated with a constellation of characteristics indicative of increased vulnerability to postpartum smoking. Subjective social status provided unique information on risk for postpartum smoking over and above the effects of race/ethnicity, objective socioeconomic status, and partner status. PMID:17600249

Disparities in chronic conditions and health status by type of disability

PubMed Central

Horner-Johnson, Willi; Dobbertin, Konrad; Lee, Jae Chul; Andresen, Elena M.

2013-01-01

Background Prior research has established health disparities between people with and without disabilities. However, disparities within the disability population, such as those related to type of disability, have been much less studied. Objective To examine differences in chronic conditions and health status between subgroups of people with different types of disability. Methods We analyzed Medical Expenditure Panel Survey annual data files from 2002-2008. Logistic regression analyses considered disparity from three perspectives: 1) basic differences, unadjusted for other factors; 2) controlling for key demographic and health covariates; and 3) controlling for a larger set of demographic variables and socioeconomic status as well as health and access to healthcare. Results Individuals with vision, physical, cognitive, or multiple disability types fared worse than people with hearing impairment on most health outcomes. This was most consistently true for people with multiple disabilities. Even when all covariates were accounted for, people with multiple types of disability were significantly more likely (p < 0.05) than those with hearing impairment (reference group) to report every poor health outcome with the exception of BMI ≥ 25 and lung disease. Conclusions While many of the differences between disability types were reduced when controlling for other factors, some differences remained significant. This argues for a more individualized approach to understanding and preventing chronic conditions and poor health in specific disability groups. PMID:24060250

Adherence to preferable behavior for lipid control by high-risk dyslipidemic Japanese patients under pravastatin treatment: the APPROACH-J study.

PubMed

Kitagawa, Yasuhisa; Teramoto, Tamio; Daida, Hiroyuki

2012-01-01

We evaluated the impact of adherence to preferable behavior on serum lipid control assessed by a self-reported questionnaire in high-risk patients taking pravastatin for primary prevention of coronary artery disease. High-risk patients taking pravastatin were followed for 2 years. Questionnaire surveys comprising 21 questions, including 18 questions concerning awareness of health, and current status of diet, exercise, and drug therapy, were conducted at baseline and after 1 year. Potential domains were established by factor analysis from the results of questionnaires, and adherence scores were calculated in each domain. The relationship between adherence scores and lipid values during the 1-year treatment period was analyzed by each domain using multiple regression analysis. A total of 5,792 patients taking pravastatin were included in the analysis. Multiple regression analysis showed a significant correlation in terms of "Intake of high fat/cholesterol/sugar foods" (regression coefficient -0.58, p=0.0105) and "Adherence to instructions for drug therapy" (regression coefficient -6.61, p<0.0001). Low-density lipoprotein cholesterol (LDL-C) values were significantly lower in patients who had an increase in the adherence score in the "Awareness of health" domain compared with those with a decreased score. There was a significant correlation between high-density lipoprotein (HDL-C) values and "Awareness of health" (regression coefficient 0.26; p= 0.0037), "Preferable dietary behaviors" (regression coefficient 0.75; p<0.0001), and "Exercise" (regression coefficient 0.73; p= 0.0002). Similar relations were seen with triglycerides. In patients who have a high awareness of their health, a positive attitude toward lipid-lowering treatment including diet, exercise, and high adherence to drug therapy, is related with favorable overall lipid control even in patients under treatment with pravastatin.

Positive correlation of employment and psychological well-being for veterans with major abdominal surgery.

PubMed

Horner, David J; Wendel, Christopher S; Skeps, Raymond; Rawl, Susan M; Grant, Marcia; Schmidt, C Max; Ko, Clifford Y; Krouse, Robert S

2010-11-01

Intestinal stomas (ostomies) have been associated negatively with multiple aspects of health-related quality of life. This article examines the relationship between employment status and psychological well-being (PWB) in veterans who underwent major bowel procedures with or without ostomy. Veterans from 3 Veterans Affairs (VA) medical centers were surveyed using the City of Hope ostomy-specific questionnaire and the Short Form 36 item Veteran's version (SF-36V). Response rate was 48% (511 of 1,063). Employment and PWB relationship was assessed using multiple regression with age, income, SF-36V physical component summary (PCS), and employment status as independent variables. Employed veterans reported higher PWB compared with unemployed veterans (P = .003). Full-time workers also reported higher PWB than part-time or unemployed workers (P = .001). Ostomy was not an independent predictor of PWB. Employment among veterans after major abdominal surgery may have intrinsic value for PWB. Patients should be encouraged to return to work, or do volunteer work after recovery. Published by Elsevier Inc.

The impact of weight misperception on health-related quality of life in Korean adults (KNHANES 2007–2014): a community-based cross-sectional study

PubMed Central

Park, Susan; Lee, Sejin; Hwang, Jinseub; Kwon, Jin-Won

2017-01-01

Background/objectives Weight perception, especially misperception, might affect health-related quality of life (HRQoL); however, related research is scarce and results remain equivocal. We examined the association between HRQoL and weight misperception by comparing obesity level as measured by body mass index (BMI) and weight perception in Korean adults. Methods Study subjects were 43 883 adults aged 19 years or older from cycles IV (2007–2009), V (2010–2012) and VI (2013–2014) of the Korean National Health and Nutrition Examination Survey. Multiple regression analyses comprising both logit and tobit models were conducted to evaluate the independent effect of obesity level as measured by BMI, weight perception and weight misperception on HRQoL after adjusting for demographics, socioeconomic status and number of chronic diseases. We also performed multiple regressions to explore the association between weight misperception and HRQoL stratified by BMI status. Results Obesity level as measured by BMI and weight perception were independently associated with low HRQoL in both separate and combined analyses. Weight misperception, including underestimation and overestimation, had a significantly negative impact on HRQoL. In subgroup analysis, subjects with BMI ranges from normal to overweight who misperceived their weight also had a high risk of low HRQoL. Overestimation of weight among obese subjects associated with low HRQoL, whereas underestimation of weight showed no significant association. Conclusions Both obesity level as measured by BMI and perceiving weight as fat were significant risk factors for low HRQoL. Subjects who incorrectly perceived their weight relative to their BMI status were more likely to report impaired HRQoL, particularly subjects with BMI in the normal to overweight range. Based on these findings, we recommend political and clinical efforts to better inform individuals about healthy weight status and promote accurate weight perception. PMID:28645975

The Effect of Work Characteristics on Dermatologic Symptoms in Hairdressers

PubMed Central

2014-01-01

Objectives Hairdressers in Korea perform various tasks and are exposed to health risk factors such as chemical substances or prolonged duration of wet work. The objective of this study is to provide descriptive statistics on the demographics and work characteristics of hairdressers in Korea and to identify work-related risk factors for dermatologic symptoms in hairdressers. Methods 1,054 hairdressers were selected and analyzed for this study. Independent variables were exposure to chemical substances, the training status of the hairdressers, and the main tasks required of them, and the dependent variable was the incidence of dermatologic symptoms. The relationships between work characteristics and dermatologic symptoms were evaluated by estimating odds ratios using multiple logistic regression analysis. Results Among the 1,054 study subjects, 212 hairdressers (20.1%) complained of dermatologic symptoms, and the symptoms were more prevalent in younger, unmarried or highly educated hairdressers. The main tasks that comprise the majority of the wet work were strictly determined by training status, since 96.5% of staff hairdressers identified washing as their main task, while only 1.5% and 2.0% of master and designer hairdressers, respectively, identified this as their main task. Multiple logistic regressions was performed to estimate odds ratios. While exposure to hairdressing chemicals showed no significant effect on the odds ratio for the incidence of dermatologic symptoms, higher odds ratios of dermatologic symptoms were shown in staff hairdressers (2.70, 95% CI: 1.32 - 5.51) and in hairdressers who perform washing as their main task (2.03, 95% CI: 1.22 - 3.37), after adjusting for general and work characteristics. Conclusions This study showed that the training status and main tasks of hairdressers are closely related to each other and that the training status and main tasks of hairdressers are related to the incidence of dermatologic symptoms. This suggests that in the future, regulations on working conditions and health management guidelines for hairdressers should be established. PMID:25028609

Correction of Body-Mass Index Using Body-Shape Perception and Socioeconomic Status in Adolescent Self-Report Surveys

PubMed Central

Legleye, Stéphane; Beck, François; Spilka, Stanislas; Chau, Nearkasen

2014-01-01

Objectives To propose a simple correction of body-mass index (BMI) based on self-reported weight and height (reported BMI) using gender, body shape perception and socioeconomic status in an adolescent population. Methods 341 boys and girls aged 17–18 years were randomly selected from a representative sample of 2165 French adolescents living in Paris surveyed in 2010. After an anonymous self-administered pen-and-paper questionnaire asking for height, weight, body shape perception (feeling too thin, about the right weight or too fat) and socioeconomic status, subjects were measured and weighed. BMI categories were computed according to Cole’s cut-offs. Reported BMIs were corrected using linear regressions and ROC analyses and checked with cross-validation and multiple imputations to handle missing values. Agreement between actual and corrected BMI values was estimated with Kappa indexes and Intraclass correlation coefficients (ICC). Results On average, BMIs were underreported, especially among girls. Kappa indexes between actual and reported BMI were low, especially for girls: 0.56 95%CI = [0.42–0.70] for boys and 0.45 95%CI = [0.30–0.60] for girls. The regression of reported BMI by gender and body shape perception gave the most balanced results for both genders: the Kappa and ICC obtained were 0.63 95%CI = [0.50–0.76] and 0.67, 95%CI = [0.58–0.74] for boys; 0.65 95%CI = [0.52–0.78] and 0.74, 95%CI = [0.66–0.81] for girls. The regression of reported BMI by gender and socioeconomic status led to similar corrections while the ROC analyses were inaccurate. Conclusions Using body shape perception, or socioeconomic status and gender is a promising way of correcting BMI in self-administered questionnaires, especially for girls. PMID:24844229

Association between Personality Traits and Sleep Quality in Young Korean Women

PubMed Central

Kim, Han-Na; Cho, Juhee; Chang, Yoosoo; Ryu, Seungho

2015-01-01

Personality is a trait that affects behavior and lifestyle, and sleep quality is an important component of a healthy life. We analyzed the association between personality traits and sleep quality in a cross-section of 1,406 young women (from 18 to 40 years of age) who were not reporting clinically meaningful depression symptoms. Surveys were carried out from December 2011 to February 2012, using the Revised NEO Personality Inventory and the Pittsburgh Sleep Quality Index (PSQI). All analyses were adjusted for demographic and behavioral variables. We considered beta weights, structure coefficients, unique effects, and common effects when evaluating the importance of sleep quality predictors in multiple linear regression models. Neuroticism was the most important contributor to PSQI global scores in the multiple regression models. By contrast, despite being strongly correlated with sleep quality, conscientiousness had a near-zero beta weight in linear regression models, because most variance was shared with other personality traits. However, conscientiousness was the most noteworthy predictor of poor sleep quality status (PSQI≥6) in logistic regression models and individuals high in conscientiousness were least likely to have poor sleep quality, which is consistent with an OR of 0.813, with conscientiousness being protective against poor sleep quality. Personality may be a factor in poor sleep quality and should be considered in sleep interventions targeting young women. PMID:26030141

[Associations between dormitory environment/other factors and sleep quality of medical students].

PubMed

Zheng, Bang; Wang, Kailu; Pan, Ziqi; Li, Man; Pan, Yuting; Liu, Ting; Xu, Dan; Lyu, Jun

2016-03-01

To investigate the sleep quality and related factors among medical students in China, understand the association between dormitory environment and sleep quality, and provide evidence and recommendations for sleep hygiene intervention. A total of 555 undergraduate students were selected from a medical school of an university in Beijing through stratified-cluster random-sampling to conduct a questionnaire survey by using Chinese version of Pittsburgh Sleep Quality Index (PSQI) and self-designed questionnaire. Analyses were performed by using multiple logistic regression model as well as multilevel linear regression model. The prevalence of sleep disorder was 29.1%(149/512), and 39.1%(200/512) of the students reported that the sleep quality was influenced by dormitory environment. PSQI score was negatively correlated with self-reported rating of dormitory environment (γs=-0.310, P<0.001). Logistic regression analysis showed the related factors of sleep disorder included grade, sleep regularity, self-rated health status, pressures of school work and employment, as well as dormitory environment. RESULTS of multilevel regression analysis also indicated that perception on dormitory environment (individual level) was associated with sleep quality with the dormitory level random effects under control (b=-0.619, P<0.001). The prevalence of sleep disorder was high in medical students, which was associated with multiple factors. Dormitory environment should be taken into consideration when the interventions are taken to improve the sleep quality of students.

Socioeconomic status, labour market connection, and self-rated psychological health: the role of social capital and economic stress.

PubMed

Lindström, Martin; Ali, Sadiq M; Rosvall, Maria

2012-02-01

To investigate the association between socioeconomic status, unemployment and self-rated psychological health, taking economic stress and horizontal trust into account. The 2008 public health survey in Skåne is a cross-sectional postal questionnaire study with a 55% participation rate. A random sample was invited and 28,198 persons aged 18-80 participated. Logistic regression models were used to investigate associations between socioeconomic status by occupation (SES), labour market connection and self-rated psychological health (GHQ12). The multiple regression analyses included age, country of birth, education, economic stress and generalized (horizontal) trust. 13.8% of the men and 18.2% of the women had poor psychological health. Poor psychological health was more common among the young, among those born abroad, among those with lower education, with economic stress, and low horizontal trust. There were no significant differences between the employed and self-employed groups. However, the people who had retired early, the unemployed and those on long-term sick leave had significantly higher odds ratios of poor psychological health than higher non-manual employees throughout the analyses. There were no differences in psychological health between non-manual employees in higher positions and other employed and self-employed SES groups among men or women. In contrast, the early retired, the unemployed and the category on long-term sick leave had significantly higher odds ratios of poor psychological health among both men and women throughout the multiple analyses. Both economic stress and trust affected this association (i.e., lowered the odds ratios of poor psychological health), but affected by economic stress to a somewhat higher extent.

Serum Vitamin D Status in Iranian Fibromyalgia Patients: according to the Symptom Severity and Illness Invalidation

PubMed Central

Maafi, Alireza Amir; Haghdoost, Afrooz; Aarabi, Yasaman; Hajiabbasi, Asghar; Shenavar Masooleh, Irandokht; Zayeni, Habib; Ghalebaghi, Babak; Hassankhani, Amir; Bidari, Ali

2016-01-01

Background This study was designed to assess serum vitamin D status (25-OHD) in the fibromyalgia (FM) patients and to compare it with a healthy control group. It also aimed to investigate the correlation of serum vitamin D level with FM symptom severity and invalidation experiences. Methods A total of 74 consecutive patients with FM and 68 healthy control participants were enrolled. The eligible FM patients completed the Illness Invalidation Inventory (3*I), the Revised Fibromyalgia Impact Questionnaire (FIQR) and a short-form health survey (SF-12). Venous blood samples were drawn from all participants to evaluate serum 25-OHD levels. Mann-Whitney tests and multiple logistic regression analyses were performed and Spearman's correlations were calculated. Results 88.4% of FM patients had low levels of serum 25-OHD. FM patients had significantly higher level of serum 25-OHD than the control group (17.24 ± 13.50 and 9.91 ± 6.47 respectively, P = 0.0001). There were no significant correlations between serum 25-OHD levels and the clinical measures of disease impact, invalidation dimensions, and health status. Multiple logistic regression analyses revealed that an increased discounting of the disease by the patient's spouse was associated with a 4-fold increased risk for vitamin D deficiency (OR = 4.36; 95% CI, 0.95–19.87, P = 0.05). Conclusions This study showed that although high rates of vitamin D insufficiency or deficiency were seen among FM patients and healthy non-FM participants, but it seems there was no intrinsic association between FM and vitamin D deficiency. Addressing of invalidation experience especially by the patient's spouse is important in management of FM. PMID:27413482

Effect of knee osteoarthritis on the perception of quality of life in Venezuelan patients.

PubMed

Chacón, José G; González, Nancy E; Véliz, Aleida; Losada, Benito R; Paul, Hernando; Santiago, Luís G; Antúnez, Ana; Finol, Yelitza; González, María E; Granados, Isabel; Maldonado, Irama; Maldonado, Teolinda; Marín, Francisco; Zambrano, Gisela; Rodríguez, Martín A

2004-06-15

To measure the perception of quality of life in Venezuelan patients with knee osteoarthritis and to identify those variables that may influence it. A multicenter, cross-sectional study of 126 mestizo patients with knee osteoarthritis recruited from 8 rheumatology centers in Venezuela. We used a Spanish-translated version of the Arthritis Impact Measurement Scales (AIMS), as adapted in Venezuela. One-way analysis of variance was used to compare the AIMS mean total score among subgroups of knee pain, anatomic stage, and socioeconomic status (SES); a post-hoc test was performed to identify significant intragroup differences. Pearson's correlation coefficient was used to examine correlations between age, body mass index (BMI), disease duration, knee pain, and AIMS score. Associations between radiologic stage, SES, and AIMS scores were examined using Spearman's rank correlation. Multiple regression analysis was used to estimate predictor factors of AIMS scores. A significant correlation was found between total AIMS scores and knee pain, age, and socioeconomic status, but not with BMI, disease duration, or anatomic stage. Patients with severe knee pain differed from those with mild and moderate pain, and the highest AIMS mean total score was seen in patients within the severe knee pain subset. Patients in the highest socioeconomic levels differed from those within lowest categories. Patients classified as being at the levels of relative and critical poverty showed the highest AIMS scores. Multiple regression analysis showed that knee pain was the only variable that exerted an independent effect on the quality of life in our patients. The perception of quality of life is negatively affected by increasing levels of joint pain, old age, and low socioeconomic status in Venezuelan patients with knee osteoarthritis. Our study supports the need for an early and vigorous approach to treat pain in this group of patients.

Education and health and well-being: direct and indirect effects with multiple mediators and interactions with multiple imputed data in Stata.

PubMed

Sheikh, Mashhood Ahmed; Abelsen, Birgit; Olsen, Jan Abel

2017-11-01

Previous methods for assessing mediation assume no multiplicative interactions. The inverse odds weighting (IOW) approach has been presented as a method that can be used even when interactions exist. The substantive aim of this study was to assess the indirect effect of education on health and well-being via four indicators of adult socioeconomic status (SES): income, management position, occupational hierarchy position and subjective social status. 8516 men and women from the Tromsø Study (Norway) were followed for 17 years. Education was measured at age 25-74 years, while SES and health and well-being were measured at age 42-91 years. Natural direct and indirect effects (NIE) were estimated using weighted Poisson regression models with IOW. Stata code is provided that makes it easy to assess mediation in any multiple imputed dataset with multiple mediators and interactions. Low education was associated with lower SES. Consequently, low SES was associated with being unhealthy and having a low level of well-being. The effect (NIE) of education on health and well-being is mediated by income, management position, occupational hierarchy position and subjective social status. This study contributes to the literature on mediation analysis, as well as the literature on the importance of education for health-related quality of life and subjective well-being. The influence of education on health and well-being had different pathways in this Norwegian sample. © 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.

Psychological status and quality of life among primary caregivers of individuals with mental illness: a hospital based study.

PubMed

Jeyagurunathan, Anitha; Sagayadevan, Vathsala; Abdin, Edimansyah; Zhang, YunJue; Chang, Sherilyn; Shafie, Saleha; Rahman, Restria Fauziana Abdul; Vaingankar, Janhavi Ajit; Chong, Siow Ann; Subramaniam, Mythily

2017-05-19

This study aimed to explore the psychological status and quality of life among primary caregivers of individuals suffering from various mental illnesses including early psychosis, chronic schizophrenia, depressive disorders, anxiety disorders and dementia. A total of 350 primary caregivers with relatives seeking treatment at a tertiary psychiatric hospital were recruited for this study. Socio-demographic data was obtained and the brief version of the World Health Organisation Quality of Life instrument was used to assess caregiver's quality of life (QOL). Psychological status among primary caregivers was assessed using the General Anxiety Disorder - 7 item (GAD-7) and Patient Health Questionnaire - 9 item (PHQ-9) scales. Family Interview Schedule (FIS) was used to assess the impact of caregiving relating to social problems, interpersonal strain among family members, work related problems and financial difficulties as a result of their relative's illness. The socio-demographic and clinical correlates of QOL, PHQ-9 and GAD-7 were examined using multiple linear and logistic regression analyses. Associations between QOL domains and psychological status was examined using multiple linear regression analyses. The mean age of the primary caregivers was 49.7 years (SD = 13.2), ranging from 21 to 82 years, with a preponderance of females (67.6%), aged 50-64 years old (45.7%). Majority were of Chinese ethnicity (57.5%), had secondary level education (43.1%), were married (65.2%), and employed (64.9%). 18.3% of primary caregivers had symptoms of depression (based on PHQ-9 cut-off point of 10 or greater) while 12.7% had symptoms of anxiety (based on GAD-7 cut-off point of 10 or greater). Multiple linear and logistic regression analyses revealed that primary caregivers aged between 35-49 years and 50-64 years, unemployed, living with others, providing care to those diagnosed with dementia and who had higher FIS scores were significantly more likely to report symptoms of depression whilst those who cared for their son/daughter were less likely to be associated with symptoms of depression. Primary caregivers who had lower education, were living with others, were single or divorced/separated, were unemployed and with higher FIS scores were associated with lower QOL domain scores. Those with symptoms of depression were significantly associated with low QOL across all four domains, whilst those with symptoms of anxiety were significantly associated with low QOL in the social relationships domain. Psychological status of caregivers in the current study was associated with the various domains of QOL. In particular, caregivers' symptoms of depression were significantly associated with lower QOL across all four domains of QOL whereas symptoms of anxiety were associated with lower scores in the social relationships domain. The study suggests a need to provide caregivers with social support and psycho-education to improve the QOL as well as aid in developing healthy coping strategies.

Crop status evaluations and yield predictions

NASA Technical Reports Server (NTRS)

Haun, J. R.

1975-01-01

A model was developed for predicting the day 50 percent of the wheat crop is planted in North Dakota. This model incorporates location as an independent variable. The Julian date when 50 percent of the crop was planted for the nine divisions of North Dakota for seven years was regressed on the 49 variables through the step-down multiple regression procedure. This procedure begins with all of the independent variables and sequentially removes variables that are below a predetermined level of significance after each step. The prediction equation was tested on daily data. The accuracy of the model is considered satisfactory for finding the historic dates on which to initiate yield prediction model. Growth prediction models were also developed for spring wheat.

Low folate status enhances pregnancy changes in plasma betaine and dimethylglycine concentrations and the association between betaine and homocysteine.

PubMed

Fernàndez-Roig, Sílvia; Cavallé-Busquets, Pere; Fernandez-Ballart, Joan D; Ballesteros, Monica; Berrocal-Zaragoza, Maria Isabel; Salat-Batlle, Judith; Ueland, Per M; Murphy, Michelle M

2013-06-01

Folate, choline, and betaine participate in homocysteine metabolism. It is not known whether they interact during pregnancy. The objective was to investigate how folate status affects choline, betaine, and dimethylglycine during pregnancy. Fasting plasma folate, cobalamin, free choline, betaine, dimethylglycine, and total homocysteine (tHcy) were measured longitudinally at <12, 15, 24-27, and 34 gestational weeks (GW); at labor (nonfasting); and in the cord in participants (n = 522) from the Reus-Tarragona Birth Cohort (NUTrició i Creixement Intrauterí Retardat phase). Timing, dose, and duration of folic acid supplement use were recorded. Folate status was classified as below (low) or above (high) median plasma folate at baseline (27.6 nmol/L) and at 24-27 GW (11.4 nmol/L). Associations between folate or betaine with tHcy were investigated by using multiple linear regression analysis. Plasma betaine decreased by 34.8% (1.0%) throughout pregnancy, and dimethylglycine increased by 39.7% (2.7%) between 24-27 GW and labor (all P < 0.001). Compared with high folate status, low status was associated with a higher dimethylglycine/betaine ratio from 15 GW and with lower plasma betaine and higher dimethylglycine from 24 to 27 GW, for the rest of pregnancy. Regression analysis showed that by 24-27 GW, both plasma folate and betaine were inversely associated with tHcy when folate status was low and that the association between betaine and tHcy depended on folate status at 24-27 and 34 GW (interaction terms: P < 0.001 and P < 0.01). Betaine was inversely associated with tHcy at labor regardless of folate status. Low folate status enhances the reduction in betaine and the increase in dimethylglycine during pregnancy and strengthens the association between betaine and tHcy. This trial was registered at clinicaltrials.gov as NCT01778205.

Relationships between Family Levels of Socioeconomic Status and Distribution of Breast Cancer Risk Factors

PubMed Central

Mohaghegh, Pegah; Yavari, Parvin; Akbari, Mohammad Esmaeil; Abadi, Alireza; Ahmadi, Farzaneh; Shormeij, Zeinab

2015-01-01

Background Not only the expand development of knowledge for reducing risk factors, but also the improvement in early diagnosis and treatment of cancer, and socioeconomic inequalities could affect cancer incidence, diagnosis stage, and mortality. The aim of this study was investigation the relationships between family levels of socioeconomic status and distribution of breast cancer risk factors. Methods This descriptive cross-sectional study has conducted on 526 patients who were suffering from breast cancer, and have registered in Cancer Research Center of Shahid Beheshti University of Medical Sciences from March 2008 to December 2013. A reliable and valid questionnaire about family levels of socioeconomic status has filled by interviewing the patients via phone. For analyzing the data, Multinomial logistic regression, Kendal tau-b correlation coefficient and Contingency Coefficient tests have executed by SPSS19. Results The mean age of the patients was 48.30 (SD=11.41). According to the results of this study, there was a significant relationship between family socioeconomic status and patient's age at diagnosis of breast cancer (p value<0.001). Also, the relationships between socioeconomic status and number of pregnancies, and duration of breast feeding were significant (p value> 0.001). In the multiple logistic regressions, the relationship between excellent socioeconomic status and number of abortions was significant (p value> 0.007). Furthermore, the relationships between moderate and good socioeconomic statuses and smoking were significant (p value=0.05 and p value=0.02, respectively). Conclusion The results have indicated that among those patients having better socioeconomic status, age at cancer diagnosis, number of pregnancies and duration of breast feeding was lower, and then number of abortions was more than the others. According to the results of this study, it was really important to focus on family socioeconomic status as a critical and effective variable on breast cancer risk factors among the Iranian women. PMID:25821572

Relationships between Family Levels of Socioeconomic Status and Distribution of Breast Cancer Risk Factors.

PubMed

Mohaghegh, Pegah; Yavari, Parvin; Akbari, Mohammad Esmaeil; Abadi, Alireza; Ahmadi, Farzaneh; Shormeij, Zeinab

2015-01-01

Not only the expand development of knowledge for reducing risk factors, but also the improvement in early diagnosis and treatment of cancer, and socioeconomic inequalities could affect cancer incidence, diagnosis stage, and mortality. The aim of this study was investigation the relationships between family levels of socioeconomic status and distribution of breast cancer risk factors. This descriptive cross-sectional study has conducted on 526 patients who were suffering from breast cancer, and have registered in Cancer Research Center of Shahid Beheshti University of Medical Sciences from March 2008 to December 2013. A reliable and valid questionnaire about family levels of socioeconomic status has filled by interviewing the patients via phone. For analyzing the data, Multinomial logistic regression, Kendal tau-b correlation coefficient and Contingency Coefficient tests have executed by SPSS19. The mean age of the patients was 48.30 (SD=11.41). According to the results of this study, there was a significant relationship between family socioeconomic status and patient's age at diagnosis of breast cancer (p value<0.001). Also, the relationships between socioeconomic status and number of pregnancies, and duration of breast feeding were significant (p value> 0.001). In the multiple logistic regressions, the relationship between excellent socioeconomic status and number of abortions was significant (p value> 0.007). Furthermore, the relationships between moderate and good socioeconomic statuses and smoking were significant (p value=0.05 and p value=0.02, respectively). The results have indicated that among those patients having better socioeconomic status, age at cancer diagnosis, number of pregnancies and duration of breast feeding was lower, and then number of abortions was more than the others. According to the results of this study, it was really important to focus on family socioeconomic status as a critical and effective variable on breast cancer risk factors among the Iranian women.

Ultraviolet B Irradiance and Vitamin D Status are Inversely Associated With Incidence Rates of Pancreatic Cancer Worldwide

DTIC Science & Technology

2010-01-01

exposure of most of the skin to solar irradiance, especially Muslim countries. In these countries, 25(OH)D levels, partic- ularly in women wearing a hijab ...exceptions. Key Words: pancreatic neoplasms, incidence, vitamin D, alcohol, smoking, multiple regression (Pancreas 2010;00: 00Y00) A pproximately...The possibility that vita- min D might play a role in the etiology of pancreatic cancer was raised by studies showing that populations living at

Immigration, stress, and depressive symptoms in a Mexican-American community.

PubMed

Golding, J M; Burnam, M A

1990-03-01

This study assessed levels of depressive symptomatology in a household probability sample of Mexico-born (N = 706) and U.S.-born (N = 538) Mexican Americans. We hypothesized that immigration status differences in acculturation, strain, social resources, and social conflict, as well as differences in the associations of these variables with depression, would account for differences in depression between U.S.-born and Mexico-born respondents. U.S.-born Mexican Americans had higher depression scores than those born in Mexico. When cultural and social psychological variables were controlled in a multiple regression analysis, the immigrant status difference persisted. Tests of interaction terms suggested greater vulnerability to the effects of low acculturation and low educational attainment among the U.S.-born relative to those born in Mexico; however, the immigrant status difference persisted after controlling for these interactions. Unmeasured variables such as selective migration of persons with better coping skills, selective return of depressed immigrants, or generational differences in social comparison processes may account for the immigration status difference.

An analysis of factors that impact secondary science outcomes in Tennessee

NASA Astrophysics Data System (ADS)

South, Suzanne Lawson

The purpose of this study was to analyze school and district characteristics for 2005--2006 through 2007--2008 to determine which factors impacted science achievement for the graduating class of 2008--2009 in Tennessee. School size, socioeconomic status, per pupil instructional expenditures and rurality/urbanicity were predictor variables. Achievement was represented by performance on the science and reasoning portion of the ACT. Correlational studies indicated that socioeconomic status had a significant impact on science achievement while the impact of school size and rurality/urbanicity was observed to be weak. Statistical analyses through multiple linear regression produced a model in which socioeconomic status and rurality/urbanicity explained 65.4% of the variance observed. Schools were segmented into quintiles based on socioeconomic status in an effort to control for poverty and correlational studies were repeated. School size and rurality/urbanicity appeared to have a more significant impact on achievement, particularly for students in the highest and lowest poverty bands.

Role of Sex, Socioeconomic Status, and Emotional Support in Predicting Aging Perception Among Older Adults.

PubMed

Yaghoobzadeh, Ameneh; Sharif Nia, Hamid; Pahlevan Sharif, Saeed; Hosseinigolafshani, Seyedeh Zahra; Mohammadi, Fatemeh; Oveisi, Sonia; Allen, Kelly A

2017-01-01

Self-perception is found to be a central predictive factor in experiencing successful aging. The aim of this study was to explore the role of sex, socioeconomic status, and emotional support in elders' aging perception. A cross-sectional design was used with 300 older aged participants recruited from 23 clinics and health centers in Qazvin, Iran. Data were collected included questions to elicit demographic information and Barker's aging perception questionnaire. Exploratory multiple linear regression showed that the level of emotional support (β: -12.10; 95% CI: [-20.72, -3.48]), socioeconomic status (β: 2.84; 95% CI: [0.25, 5.43]), and women (β: -4.34; 95% CI: [-6.91, -1.77]) were associated with aging perception among elders. Educational level and marital status did not significantly contribute to the variance of AP. Findings revealed that aging perception was related to individual differences as well as social and emotional factors. Researchers, health-care professionals, and elders may benefit from thinking about old age as an inevitable life stage.

The influence of posttraumatic stress disorder numbing and hyperarousal symptom clusters in the prediction of physical health status in veterans with chronic tobacco dependence and posttraumatic stress disorder.

PubMed

Harder, Laura H; Chen, Shuo; Baker, Dewleen G; Chow, Bruce; McFall, Miles; Saxon, Andrew; Smith, Mark W

2011-12-01

Smoking and PTSD are predictors of poor physical health status. This study examined the unique contribution of PTSD symptoms in the prediction of the SF-36 physical health status subscales accounting for cigarette smoking, chronic medical conditions, alcohol and drug use disorders, and depression. This study examined baseline interview and self-report data from a national tobacco cessation randomized, controlled trial (Veterans Affairs Cooperative Study 519) that enrolled tobacco-dependent veterans with chronic PTSD (N = 943). A series of blockwise multiple regression analyses indicated that PTSD numbing and hyperarousal symptom clusters explained a significant proportion of the variance across all physical health domains except for the Physical Functioning subscale, which measures impairments in specific physical activities. Our findings further explain the impact of PTSD on health status by exploring the way PTSD symptom clusters predict self-perceptions of health, role limitations, pain, and vitality.

Poor Health and Experiences of Being Bullied in Adolescents: Self-Perceived Overweight and Frustration with Appearance Matter.

PubMed

Lin, Yi-Ching; Latner, Janet D; Fung, Xavier C C; Lin, Chung-Ying

2018-02-01

To examine the associations between body image (actual and self-perceived weight status; feelings about appearance) and health outcomes (overall health, life satisfaction, and mental health) and between body image and experiences of being bullied. Participants included 8,303 children from 7th to 10th grade in the Health Behavior of School-Aged Children (HBSC) 2009-2010 data set, a large-scale sample in the United States. Several multiple linear regressions (with health outcomes as dependent variables) and multivariate logistic regressions (with being bullied or not as dependent variable) were conducted to investigate the associations between each dependent variable and the following independent variables: relationship with parents, frustration with appearance, and actual and self-perceived weight status. Self-perceived underweight, self-perceived overweight (OW), and frustration with appearance were positively associated with being bullied. Frustration with appearance was a risk factor, while good relationship with parents was a protective factor, especially for psychological health outcomes. Self-perceived OW had a stronger association with the experience of being bullied than actual OW. The relationship between actual OW and being bullied might be attenuated when self-perceived OW is simultaneously considered. Body image may be an important factor in the association between weight status and the experience of being bullied. © 2017 The Obesity Society.

MBS Measurement Tool for Swallow Impairment—MBSImp: Establishing a Standard

PubMed Central

Martin-Harris, Bonnie; Brodsky, Martin B.; Michel, Yvonne; Castell, Donald O.; Schleicher, Melanie; Sandidge, John; Maxwell, Rebekah; Blair, Julie

2014-01-01

The aim of this study was to test reliability, content, construct, and external validity of a new modified barium swallowing study (MBSS) tool (MBSImp) that is used to quantify swallowing impairment. Multiple regression, confirmatory factor, and correlation analyses were used to analyze 300 in- and outpatients with heterogeneous medical and surgical diagnoses who were sequentially referred for MBS exams at a university medical center and private tertiary care community hospital. Main outcome measures were the MBSImp and index scores of aspiration, health status, and quality of life. Inter- and intrarater concordance were 80% or greater for blinded scoring of MBSSs. Regression analysis revealed contributions of eight of nine swallow types to impressions of overall swallowing impairment (p ≤ 0.05). Factor analysis revealed 13 significant components (loadings ≥ 0.5) that formed two impairment groupings (oral and pharyngeal). Significant correlations were found between Oral and Pharyngeal Impairment scores and Penetration-Aspiration Scale scores, and indexes of intake status, nutrition, health status, and quality of life. The MBSImp demonstrated clinical practicality, favorable inter- and intrarater reliability following standardized training, content, and external validity. This study reflects potential for establishment of a new standard for quantification and comparison of oropharyngeal swallowing impairment across patient diagnoses as measured on MBSS. PMID:18855050

Work-Family Conflict, Part I: Antecedents of Work-Family Conflict in National Collegiate Athletic Association Division I-A Certified Athletic Trainers

PubMed Central

Mazerolle, Stephanie M; Bruening, Jennifer E; Casa, Douglas J

2008-01-01

Context: Work-family conflict (WFC) involves discord that arises when the demands of work interfere with the demands of family or home life. Long work hours, minimal control over work schedules, and time spent away from home are antecedents to WFC. To date, few authors have examined work-family conflict within the athletic training profession. Objective: To investigate the occurrence of WFC in certified athletic trainers (ATs) and to identify roots and factors leading to quality-of-life issues for ATs working in the National Collegiate Athletic Association Division I-A setting. Design: Survey questionnaire and follow-up, in-depth, in-person interviews. Setting: Division I-A universities sponsoring football. Patients or Other Participants: A total of 587 ATs (324 men, 263 women) responded to the questionnaire. Twelve ATs (6 men, 6 women) participated in the qualitative portion: 2 head ATs, 4 assistant ATs, 4 graduate assistant ATs, and 2 AT program directors. Data Collection and Analysis: Multiple regression analysis was performed to determine whether workload and travel predicted levels of WFC. Analyses of variance were calculated to investigate differences among the factors of sex, marital status, and family status. Interviews were transcribed verbatim and then analyzed using computer software as well as member checks and peer debriefing. The triangulation of the data collection and multiple sources of qualitative analysis were utilized to limit potential researcher prejudices. Results: Regression analyses revealed that long work hours and travel directly contributed to WFC. In addition to long hours and travel, inflexible work schedules and staffing patterns were discussed by the interview participants as antecedents to WFC. Regardless of sex (P  =  .142), marital status (P  =  .687), family status (P  =  .055), or age of children (P  =  .633), WFC affected Division I-A ATs. Conclusions: No matter their marital or family status, ATs employed at the Division I-A level experienced difficulties balancing their work and home lives. Sources of conflict primarily stemmed from the consuming nature of the profession, travel, inflexible work schedules, and lack of full-time staff members. PMID:18833313

Social support and the self-rated health of older people

PubMed Central

Dai, Yue; Zhang, Chen-Yun; Zhang, Bao-Quan; Li, Zhanzhan; Jiang, Caixiao; Huang, Hui-Ling

2016-01-01

Abstract The lack of social support in elderly populations incurs real societal costs and can lead to their poor health. The aim of this study is to investigate the self-rated health (SRH) and social support among older people as well as its associated factors. We conducted a cross-sectional study among 312 urban community-dwelling elderly aged 65 to 90 years in Tainan Taiwan and Fuzhou Fujian Province from March 2012 to October 2012. A Spearson correlation test, independent t test, a Pearson χ2 test, a linear regression analysis, and a multiple-level model were performed to analyze the results. The participants identified children as the most important source of objective and subjective support, followed by spouse and relatives. Tainan's elderly received more daily life assistance and emotional support, showed stronger awareness of the need to seek help, and maintained a higher frequency of social interactions compared with the elderly in Fuzhou. The mean objective support, subjective support, and support utilization scores as well as the overall social support among Tainan's elderly were significantly high compared with the scores among Fuzhou's elderly. Further, Tainan's elderly rated better SRH than Fuzhou's elderly. Correlation analysis showed that social support was significantly correlated with city, age, living conditions, marital status, and SRH. Multiple linear regression analysis, with social support as a dependent variable, retained the following independent predictors in the final regression model: city (4.792, 95% confidence interval [CI]: 3.068–6.516, P = 0.000), age (−0.805, 95% CI: −1.394 to −0.135, P = 0.013), marital status (−1.260, 95% CI: −1.891 to −0.629, P = 0.000), living conditions (4.069, 95% CI: 3.022–5.116, P = 0.000), and SRH −1.941, 95% CI: −3.194 to −0.688, P = 0.003). The multiple-level model showed that city would impact older people's social support (χ2 = 5.103, P < 0.001). Marital status (−2.133, 95% CI: −2.768 to −1.499, P = 0.000), education (1.697, 95% CI: 0.589–2.805 P = 0.003), living conditions (4.20, 95% CI: 1.762–6.638, P = 0.000), and SRH (−3.144, 95% CI: −4.502 to −1.727, P = 0.000) were the associated factors. Thus, city, age, marital status, education, living conditions, and SRH might be the associated factors for social support among older people. This study presents some feasible implications for social support improvement in China and in other nations worldwide. PMID:27310979

Multiple Types of Memory and Everyday Functional Assessment in Older Adults

PubMed Central

Beaver, Jenna

2017-01-01

Abstract Objective Current proxy measures for assessing everyday functioning (e.g., questionnaires, performance-based measures, and direct observation) show discrepancies in their rating of functional status. The present study investigated the relationship between multiple proxy measures of functional status and content memory (i.e., memory for information), temporal order memory, and prospective memory in an older adult sample. Method A total of 197 community-dwelling older adults who did (n = 45) or did not meet (n = 152) criteria for mild cognitive impairment (MCI), completed six different assessments of functional status (two questionnaires, two performance-based tasks, and two direct observation tasks) as well as experimental measures of content memory, prospective memory, and temporal order memory. Results After controlling for demographics and content memory, the temporal order and prospective memory measures explained a significant amount of variance in all proxy functional status measures. When all variables were entered into the regression analyses, content memory and prospective memory were found to be significant predictors of all measures of functional status, whereas temporal order memory was a significant predictor for the questionnaire and direct observation measures, but not performance-based measures. Conclusion The results suggest that direct observation and questionnaire measures may be able to capture components of everyday functioning that require context and temporal sequencing abilities, such as multi-tasking, that are not as well captured in many current laboratory performance-based measures of functional status. Future research should aim to inform the development and use of maximally effective and valid proxy measures of functional ability. PMID:28334170

Low Prevalence of Vitamin D Insufficiency among Nepalese Infants Despite High Prevalence of Vitamin D Insufficiency among Their Mothers

PubMed Central

Haugen, Johanne; Ulak, Manjeswori; Chandyo, Ram K.; Henjum, Sigrun; Thorne-Lyman, Andrew L.; Ueland, Per Magne; Midtun, Øivind; Shrestha, Prakash S.; Strand, Tor A.

2016-01-01

Background: Describing vitamin D status and its predictors in various populations is important in order to target public health measures. Objectives: To describe the status and predictors of vitamin D status in healthy Nepalese mothers and infants. Methods: 500 randomly selected Nepalese mother and infant pairs were included in a cross-sectional study. Plasma 25(OH)D concentrations were measured by LC-MS/MS and multiple linear regression analyses were used to identify predictors of vitamin D status. Results: Among the infants, the prevalence of vitamin D insufficiency (25(OH)D <50 nmol/L) and deficiency (<30 nmol/L) were 3.6% and 0.6%, respectively, in contrast to 59.8% and 14.0% among their mothers. Infant 25(OH)D concentrations were negatively associated with infant age and positively associated with maternal vitamin D status and body mass index (BMI), explaining 22% of the variability in 25(OH)D concentration. Global solar radiation, maternal age and BMI predicted maternal 25(OH)D concentration, explaining 9.7% of its variability. Conclusion: Age and maternal vitamin D status are the main predictors of vitamin D status in infants in Bhaktapur, Nepal, who have adequate vitamin D status despite poor vitamin D status in their mothers. PMID:28009810

Drinking at College Parties: Examining the Influence of Student Host-Status and Party-Location

PubMed Central

Buettner, Cynthia K.; Khurana, Atika; Slesnick, Natasha

2011-01-01

The present research focuses on the party related drinking behaviors of college students and explores the differences in these behaviors based on students’ host status (i.e. party host vs. party attendee). Furthermore, we examine if the differences in party hosts and attendees’ drinking behaviors vary as a function of the party location (on-campus vs. off-campus). Multiple regression analyses were conducted using data from 3,796 undergraduates at a Midwestern University. Findings revealed a significant interaction between host status and party location, such that student party hosts reported significantly greater drink consumption and related consequences as compared to party attendees, only when the party was organized off-campus. For parties organized on-campus, student hosts reported lower drink consumption as compared to attendees. College-based preventive interventions should target students likely to host off-campus parties due to their high risk for involvement in heavy drinking. PMID:21862229

Does BCG vaccine prevent tuberculous meningitis?

PubMed Central

Thilothammal, N; Krishnamurthy, P V; Runyan, D K; Banu, K

1996-01-01

The reported efficacy of BCG vaccine in preventing pulmonary tuberculosis varies from 0-80%; however, its efficacy in preventing tuberculous meningitis ranges from 52%-84%. A case-control study was conducted to assess the efficacy of BCG in preventing tuberculous meningitis in children. New cases of tuberculous meningitis, confirmed bacteriologically, were registered as cases. Controls were children suffering from febrile convulsions attending the same hospital. A total of 107 cases and 321 controls, block matched for age, were registered. Vaccination status was determined from the history reported by the mother and by BCG scar reading. Data regarding socioeconomic status, crowding, and nutritional status were collected. Using multiple logistic regression analysis the odds ratio obtained for the presence of BCG scar was 0.23 (95% confidence interval (CI) 0.14 to 0.37) and the protective efficacy of BCG vaccine in preventing tuberculous meningitis in children was found to be 77% (95% CI 71 to 83%). PMID:8660078

Trichuriasis and low-iron status in schoolchildren from Northwest Mexico.

PubMed

Quihui-Cota, L; Morales-Figueroa, G G; Esparza-Romero, J; Valencia, M E; Astiazarán-García, H; Méndez, R O; Pacheco-Moreno, B I; Crompton, D W T; Diaz-Camacho, S P

2010-10-01

The aim of this study was to investigate the association between trichuriasis and iron status in rural schoolchildren from Northwest Mexico. A total of 73 schoolchildren (37 boys, 36 girls) between the ages of 6 and 10 years were voluntarily recruited from the public primary school of the rural community of El Higueral in Culiacan, Sinaloa (Northwest Mexico) for a cross-sectional study with a longitudinal follow-up of 5 weeks. Data were collected on socioeconomic status, anthropometry, haematological and biochemical indices of iron status, daily iron intake, and prevalence and intensity of trichuriasis. Multiple regression models, independent t-test and paired t-test were used to analyse the association between trichuriasis and iron status in cross-sectional and longitudinal samples, respectively. Adjusted models were tested for linear regression assumptions using residual plots. The mean age of the Trichuris-free and Trichuris-infected groups was 7.7±1.3 and 7.7±1.5 years respectively (P=0.92). The height for age was significantly higher in the Trichuris-free group than the Trichuris-infected group (P=0.02). No differences were found in the socioeconomic variables between the two groups. At baseline, significantly higher concentrations of haemoglobin, haematocrit, blood cell count (RBC) and serum iron were measured in the Trichuris-free group compared with the Trichuris-infected children (P<0.05). An association was found between trichuriasis and haemoglobin adjusted for socioeconomic variables, age and sex. Haemoglobin, RBC and serum ferritin concentrations were significantly increased in the infected children 5 weeks after treatment (P<0.05). Trichuriasis could be a risk factor for low-iron status in the schoolchildren of Northwest Mexico.

A general practice-based study of the relationship between indicators of mental illness and challenging behaviour among adults with intellectual disabilities.

PubMed

Felce, D; Kerr, M; Hastings, R P

2009-03-01

Existing studies tend to show a positive association between mental illness and challenging behaviour among adults with intellectual disabilities (ID). However, whether the association is direct or artefactual is less clear. The purpose was to explore the association between psychiatric status and level of challenging behaviour, while controlling for adaptive behaviour and occurrence of autistic spectrum disorders. Data were collected on the age, gender, adaptive and challenging behaviour, social impairment and psychiatric status of 312 adults with ID. Participants were divided according to psychiatric status, group equivalence in adaptive behaviour and the presence of autistic spectrum disorders achieved, and differences in challenging behaviour explored. In addition, multiple regression was used to examine the association between psychiatric status and challenging behaviour after controlling for other participant characteristics and to test whether the interaction between psychiatric status and adaptive behaviour added significantly to explanation. Challenging behaviour was higher among participants meeting threshold levels on the psychiatric screen. The regression analysis confirmed the association and demonstrated an interaction between total score on the psychiatric screen and level of adaptive behaviour. This moderated effect showed the relationship between psychiatric status and challenging behaviour to be stronger at lower adaptive behaviour. This study reinforces previous findings that psychiatric morbidity among people with ID is associated with higher levels of challenging behaviour and supports predictions that this association is more pronounced for people with severe ID. The precise nature and causal direction of the association requires further clarification. However, the understanding of how psychiatric problems might contribute to challenging behaviour needs to be part of the clinical appreciation of such behaviour.

Association Between Socioeconomic Status and Participation in Colonoscopy Screening Program in First Degree Relatives of Colorectal Cancer Patients.

PubMed

Chouhdari, Arezoo; Yavari, Parvin; Pourhoseingholi, Mohammad Amin; Sohrabi, Mohammad-Reza

2016-04-01

Approximately 15% to 25% of colorectal cancer (CRC) cases have positive family history for disease. Colonoscopy screening test is the best way for prevention and early diagnosis. Studies have found that first degree relatives (FDRs) with low socioeconomic status are less likely to participate in colonoscopy screening program. The aim of this study is to determine the association between socioeconomic status and participation in colonoscopy screening program in FDRs. This descriptive cross-sectional, study has been conducted on 200 FDRs who were consulted for undergoing colonoscopy screening program between 2007 and 2013 in research institute for gastroenterology and liver disease of Shahid Beheshti University of Medical Sciences, Tehran, Iran. They were interviewed via phone by a valid questionnaire about socioeconomic status. For data analysis, chi-square, exact fisher and multiple logistic regression were executed by SPSS 19. The results indicated 58.5% participants underwent colonoscopy screening test at least once to the time of the interview. There was not an association between participation in colonoscopy screening program and socioeconomic status to the time of the interview in binomial analysis. But statistical significance between intention to participate and educational and income level were found. We found, in logistic regression analysis, that high educational level (Diploma and University degree in this survey) was a predictor to participate in colonoscopy screening program in FDRs. According to this survey low socioeconomic status is an important factor to hinder participation of FDRs in colonoscopy screening program. Therefore, planned interventions for elevation knowledge and attitude in FDRs with low educational level are necessary. Also, reducing colonoscopy test costs should be a major priority for policy makers.

Screening for ketosis using multiple logistic regression based on milk yield and composition.

PubMed

Kayano, Mitsunori; Kataoka, Tomoko

2015-11-01

Multiple logistic regression was applied to milk yield and composition data for 632 records of healthy cows and 61 records of ketotic cows in Hokkaido, Japan. The purpose was to diagnose ketosis based on milk yield and composition, simultaneously. The cows were divided into two groups: (1) multiparous, including 314 healthy cows and 45 ketotic cows and (2) primiparous, including 318 healthy cows and 16 ketotic cows, since nutritional status, milk yield and composition are affected by parity. Multiple logistic regression was applied to these groups separately. For multiparous cows, milk yield (kg/day/cow) and protein-to-fat (P/F) ratio in milk were significant factors (P<0.05) for the diagnosis of ketosis. For primiparous cows, lactose content (%), solid not fat (SNF) content (%) and milk urea nitrogen (MUN) content (mg/dl) were significantly associated with ketosis (P<0.01). A diagnostic rule was constructed for each group of cows: (1) 9.978 × P/F ratio + 0.085 × milk yield <10 and (2) 2.327 × SNF - 2.703 × lactose + 0.225 × MUN <10. The sensitivity, specificity and the area under the curve (AUC) of the diagnostic rules were (1) 0.800, 0.729 and 0.811; (2) 0.813, 0.730 and 0.787, respectively. The P/F ratio, which is a widely used measure of ketosis, provided the sensitivity, specificity and AUC values of (1) 0.711, 0.726 and 0.781; and (2) 0.678, 0.767 and 0.738, respectively.

Socioeconomic factors and home allergen exposure in children with asthma.

PubMed

Ungar, Wendy J; Cope, Shannon F; Kozyrskyj, Anita; Paterson, J Michael

2010-01-01

The objective of this study was to determine the association between sociodemographic factors and the elimination of allergen sources from homes of asthmatic children. In a cross-sectional analysis of data from 845 asthmatic children, multiple linear regression investigated the association between socioeconomic factors and failure to reduce allergen sources (i.e., stuffed toys, pets, carpeting, curtains, and cushions); failure to use linen covers; and not laundering linens weekly in hot water. Logistic regression assessed the relationship between socioeconomic status and exposure to environmental tobacco smoke. Mother's employment status was significantly associated with the quality of the home environment (P = .0002). Homemakers demonstrated fewer poor practices (3.1) compared with full-time or part-time employed mothers (3.6). Children whose mothers reported no post-secondary education were more likely to have environmental tobacco smoke exposure compared with those who had a post-secondary CE education or higher (OR 2.4, 95% CI 1.7, 3.5). Children whose mothers worked at home and were better educated were at reduced risk for exposure to sources of indoor allergens.

Fundamental Movement Skills among Iranian Primary School Children.

PubMed

Aalizadeh, Bahman; Mohamadzadeh, Hassan; Hosseini, Fatemeh Sadat

2014-12-01

To determine the relationship between anthropometric indicators, physical activity (PA) and socioeconomic status (SES) with fundamental movement skills (FMS) among Iranian male students. In this descriptive study, based on SES scores, 241 students (7-10 years) were randomly selected and classified in high, medium and low groups. All children were measured by 8 morphology anthropometric measures. In order to examine a subset of manipulative skills and to measure physical activity and socioeconomic status, Test of Gross Motor Development (TGMD2) and, interviewer-administered questionnaires were used, respectively. The data were analyzed using Pearson correlation and multiple regression. There was a significant positive correlation between SES and body mass index (BMI), while a significant negative correlation existed between PA and BMI. Object control skills were significantly correlated with height, foot length, forearm length, hand length and physical activity. Students with low socioeconomic status were more qualified in movements than other students who were in medium and high socioeconomic status. Therefore, parents need to encourage students to be more active in order to prevent obesity and to facilitate development of object control skills in high socioeconomic status.

Longitudinal patterns and predictors of multiple health risk behaviors among adolescents: The TRAILS study.

PubMed

de Winter, Andrea F; Visser, Leenke; Verhulst, Frank C; Vollebergh, Wilma A M; Reijneveld, Sijmen A

2016-03-01

Most studies on multiple health risk behaviors among adolescents have cross-sectionally studied a limited number of health behaviors or determinants. To examine the prevalence, longitudinal patterns and predictors of individual and multiple health risk behaviors among adolescents. Eight health risk behaviors (no regular consumption of fruit, vegetables or breakfast, overweight or obesity, physical inactivity, smoking, alcohol use and cannabis use) were assessed in a prospective population study (second and third wave). Participants were assessed in three waves between ages 10 and 17 (2001-2008; n=2230). Multiple linear regression was used to assess the influence of gender, self-control, parental health risk behaviors, parental monitoring and socioeconomic factors on the number of health risk behaviors adjusted for preceding multiple health risk behaviors (analysis: 2013-2014). Rates of >5 health risk behaviors were high: 3.6% at age 13.5 and 10.2% at age 16. Smoking at age 13.5 was frequently associated with health risk behaviors at age 16. No regular consumption of fruit, vegetables and breakfast, overweight or obesity, physical inactivity and smoking predicted the co-occurrence of health risk behaviors at follow-up. Significant predictors of the development of multiple health risk behaviors were adolescents' levels of self-control, socioeconomic status and maternal smoking. Multiple health risk behaviors are common among adolescents. Individual and social factors predict changes in multiple health risk behaviors, showing that prevention targeting multiple risk behaviors is needed. Special attention should be paid to adolescents with low self-control and families with low socioeconomic status or a mother who smokes. Copyright © 2015 Elsevier Inc. All rights reserved.

Personality Traits and Mental Symptoms are Associated with Impact of Chronic Obstructive Pulmonary Disease on Patients' Daily Life.

PubMed

Topp, Marie; Vestbo, Jørgen; Mortensen, Erik Lykke

2016-12-01

Previous research has shown that personality traits are associated with self-reported health status in the general population. COPD Assessment Test (CAT) is increasingly used to assess health status such as the impact of chronic obstructive pulmonary disease (COPD) on patients' daily life, but knowledge about the influence of personality traits on CAT score is lacking. The aim of this study was to examine the influence of Big Five personality traits on CAT score and the relation between personality traits and mental symptoms with respect to their influence on CAT score. A sample of 168 patients diagnosed with COPD was consecutively recruited in a secondary care outpatient clinic. All participants completed CAT, NEO Five-Factor Inventory, and Hospital Depression and Anxiety Scale. Multiple linear regression analysis was used to explore the association between personality traits and CAT scores and how this association was influenced by mental symptoms. The personality traits neuroticism, agreeableness and conscientiousness; and the mental symptoms depression and anxiety showed significant influence on CAT score when analysed in separate regression models. Identical R-square (R = 0.24) was found for personality traits and mental symptoms, but combining personality traits and mental symptoms in one regression model showed substantially reduced effect estimates of neuroticism, conscientiousness and anxiety, reflecting the strong correlations between personality traits and mental symptoms. We found that the impact of COPD on daily life measured by CAT was related to personality and mental symptoms, which illustrates the necessity of taking individual differences in personality and mental status into account in the management of COPD.

Correlation of Vitamin D status and orthodontic-induced external apical root resorption.

PubMed

Tehranchi, Azita; Sadighnia, Azin; Younessian, Farnaz; Abdi, Amir H; Shirvani, Armin

2017-01-01

Adequate Vitamin D is essential for dental and skeletal health in children and adult. The purpose of this study was to assess the correlation of serum Vitamin D level with external-induced apical root resorption (EARR) following fixed orthodontic treatment. In this cross-sectional study, the prevalence of Vitamin D deficiency (defined by25-hydroxyvitamin-D) was determined in 34 patients (23.5% male; age range 12-23 years; mean age 16.63 ± 2.84) treated with fixed orthodontic treatment. Root resorption of four maxillary incisors was measured using before and after periapical radiographs (136 measured teeth) by means of a design-to-purpose software to optimize data collection. Teeth with a maximum percentage of root resorption (%EARR) were indicated as representative root resorption for each patient. A multiple linear regression model and Pearson correlation coefficient were used to assess the association of Vitamin D status and observed EARR. P < 0.05 was considered statistically significant. The Pearson coefficient between these two variables was determined about 0.15 ( P = 0.38). Regression analysis revealed that Vitamin D status of the patients demonstrated no significant statistical correlation with EARR, after adjustment of confounding variables using linear regression model ( P > 0.05). This study suggests that Vitamin D level is not among the clinical variables that are potential contributors for EARR. The prevalence of Vitamin D deficiency does not differ in patients with higher EARR. These data suggest the possibility that Vitamin D insufficiency may not contribute to the development of more apical root resorption although this remains to be confirmed by further longitudinal cohort studies.

Characteristics of youth soccer players aged 13–15 years classified by skill level

PubMed Central

Malina, Robert M; Ribeiro, Basil; Aroso, João; Cumming, Sean P

2007-01-01

Objective To evaluate the growth, maturity status and functional capacity of youth soccer players grouped by level of skill. Subjects The sample included 69 male players aged 13.2–15.1 years from clubs that competed in the highest division for their age group. Methods Height and body mass of players were measured and stage of pubic hair (PH) was assessed at clinical examination. Years of experience in football were obtained at interview. Three tests of functional capacity were administered: dash, vertical jump and endurance shuttle run. Performances on six soccer‐specific tests were converted to a composite score which was used to classify players into quintiles of skill. Multiple analysis of covariance, controlling for age, was used to test differences among skill groups in experience, growth status and functional capacity, whereas multiple linear regression analysis was used to estimate the relative contributions of age, years of training in soccer, stage of PH, height, body mass, the height×weight interaction and functional capacities to the composite skill score. Results The skill groups differed significantly in the intermittent endurance run (p<0.05) but not in the other variables. Only the difference between the highest and lowest skill groups in the endurance shuttle run was significant. Most players in the highest (12 of 14) and high (11 of 14) skill groups were in stages PH 4 and PH 5. Pubertal status and height accounted for 21% of the variance in the skill score; adding aerobic resistance to the regression increased the variance in skill accounted for to 29%. In both regressions, the coefficient for height was negative. Conclusion Adolescent soccer players aged 13–15 years classified by skill do not differ in age, experience, body size, speed and power, but differ in aerobic endurance, specifically at the extremes of skill. Stage of puberty and aerobic resistance (positive coefficients) and height (negative coefficient) are significant predictors of soccer skill (29% of the total explained variance), highlighting the inter‐relationship of growth, maturity and functional characteristics of youth soccer players. PMID:17224444

Does an elite education benefit health? Findings from the 1970 British Cohort Study.

PubMed

Bann, David; Hamer, Mark; Parsons, Sam; Ploubidis, George B; Sullivan, Alice

2017-02-01

Attending private school or a higher-status university is thought to benefit future earnings and occupational opportunities. We examined whether these measures were beneficially related to health and selected health-related behaviours in midlife. Data were from up to 9799 participants from the 1970 British birth Cohort Study. The high school attended (private, grammar or state) was ascertained at 16 years, and the university attended reported at 42 years [categorised as either higher (Russell Group) or normal-status institutions]. Self-reported health, limiting illness and body mass index (BMI) were reported at 42 years, along with television viewing, take-away meal consumption, physical inactivity, smoking and high risk alcohol drinking. Associations were examined using multiple regression models, adjusted for gender and childhood socioeconomic, health and cognitive measures. Private school and higher status university attendance were associated with favourable self-rated health and lower BMI, and beneficially associated with health-related-behaviours. For example, private school attendance was associated with 0.56 [95% confidence interval (CI): 0.48, 0.65] odds of lower self-rated health [odds ratio (OR) for higher-status university: 0.32 (0.27, 0.37)]. Associations were largely attenuated by adjustment for potential confounders, except for those of private schooling and higher-status university attendance with lower BMI and television viewing, and less frequent take-away meal consumption. Private school and higher-status university attendance were related to better self-rated health, lower BMI and multiple favourable health behaviours in midlife. Findings suggest that type or status of education may be an important under-researched construct to consider when documenting and understanding socioeconomic inequalities in health. © The Author 2016. Published by Oxford University Press on behalf of the International Epidemiological Association.

Does an elite education benefit health? Findings from the 1970 British Cohort Study

PubMed Central

Bann, David; Hamer, Mark; Parsons, Sam; Ploubidis, George B; Sullivan, Alice

2017-01-01

Abstract Background: Attending private school or a higher-status university is thought to benefit future earnings and occupational opportunities. We examined whether these measures were beneficially related to health and selected health-related behaviours in midlife. Methods: Data were from up to 9799 participants from the 1970 British birth Cohort Study. The high school attended (private, grammar or state) was ascertained at 16 years, and the university attended reported at 42 years [categorised as either higher (Russell Group) or normal-status institutions]. Self-reported health, limiting illness and body mass index (BMI) were reported at 42 years, along with television viewing, take-away meal consumption, physical inactivity, smoking and high risk alcohol drinking. Associations were examined using multiple regression models, adjusted for gender and childhood socioeconomic, health and cognitive measures. Results: Private school and higher status university attendance were associated with favourable self-rated health and lower BMI, and beneficially associated with health-related-behaviours. For example, private school attendance was associated with 0.56 [95% confidence interval (CI): 0.48, 0.65] odds of lower self-rated health [odds ratio (OR) for higher-status university: 0.32 (0.27, 0.37)]. Associations were largely attenuated by adjustment for potential confounders, except for those of private schooling and higher-status university attendance with lower BMI and television viewing, and less frequent take-away meal consumption. Conclusions: Private school and higher-status university attendance were related to better self-rated health, lower BMI and multiple favourable health behaviours in midlife. Findings suggest that type or status of education may be an important under-researched construct to consider when documenting and understanding socioeconomic inequalities in health. PMID:27170767

Combined high-field intraoperative magnetic resonance imaging and endoscopy increase extent of resection and progression-free survival for pituitary adenomas

PubMed Central

Sylvester, Peter T.; Evans, John A.; Zipfel, Gregory J.; Chole, Richard A.; Uppaluri, Ravindra; Haughey, Bruce H.; Getz, Anne E.; Silverstein, Julie; Rich, Keith M.; Kim, Albert H.; Dacey, Ralph G.

2014-01-01

Purpose The clinical benefit of combined intraoperative magnetic resonance imaging (iMRI) and endoscopy for transsphenoidal pituitary adenoma resection has not been completely characterized. This study assessed the impact of microscopy, endoscopy, and/or iMRI on progression-free survival, extent of resection status (gross-, near-, and subtotal resection), and operative complications. Methods Retrospective analyses were performed on 446 transsphenoidal pituitary adenoma surgeries at a single institution between 1998 and 2012. Multivariate analyses were used to control for baseline characteristics, differences during extent of resection status, and progression-free survival analysis. Results Additional surgery was performed after iMRI in 56/156 cases (35.9 %), which led to increased extent of resection status in 15/156 cases (9.6 %). Multivariate ordinal logistic regression revealed no increase in extent of resection status following iMRI or endoscopy alone; however, combining these modalities increased extent of resection status (odds ratio 2.05, 95 % CI 1.21–3.46) compared to conventional transsphenoidal microsurgery. Multivariate Cox regression revealed that reduced extent of resection status shortened progression-free survival for near- versus gross-total resection [hazard ratio (HR) 2.87, 95 % CI 1.24–6.65] and sub- versus near-total resection (HR 2.10; 95 % CI 1.00–4.40). Complication comparisons between microscopy, endoscopy, and iMRI revealed increased perioperative deaths for endoscopy versus microscopy (4/209 and 0/237, respectively), but this difference was non-significant considering multiple post hoc comparisons (Fisher exact, p = 0.24). Conclusions Combined use of endoscopy and iMRI increased pituitary adenoma extent of resection status compared to conventional transsphenoidal microsurgery, and increased extent of resection status was associated with longer progression-free survival. Treatment modality combination did not significantly impact complication rate. PMID:24599833

[High Risk Sex Behaviors and Associated Factors in Young Men in Chengdu].

PubMed

2015-11-01

To determine the prevalence of high risk sex behaviors and associated factors in 18-34 years old men in Chengdu. Methods An anonymous questionnaire survey was conducted in 18-34 years old men selected by multi-stage random sampling in Chengdu. Data of 1536 respondents who reported having sex contacts were analyzed. 23.6% of respondents had multiple sex partners in the past 12 months; 11.8% were involved commercial sex; 9.0% had group sex; 4. 7% had anal sex; 15.6% had never used a condom; 37.7% had sex under the influence of alcohol or drugs. Logistic regression analysis revealed that marital status [married, standardized partial regression coefficient (B) = -0.086, P<0.05] , level of education (bachelor or above, B= -0.063, P<0.05), frequency of exposure to pornography (B=0.058, P<0.05), childhood sexual abuse (B= 0.042, P<0.05), first sexual intercourse at an earlier age (B=0.162, P<0.05), frequency of sex under the influence of alcohol or drugs (B=0.054, P<0.05) were significant predictors of having multiple sexual partners. Sexual orientation, age, smoking, alcohol abuse, drug use, anxiety, depression, childhood physical abuse did not appear to be significant factors associated with having multiple sexual partners. Having multiple sexual partners is the main high risk sex behavior of young men in Chengdu. Childhood sexual abuse and early start of sexual intercourse are the major predictors of having multiple sexual partners.

Systematic genomic identification of colorectal cancer genes delineating advanced from early clinical stage and metastasis

PubMed Central

2013-01-01

Background Colorectal cancer is the third leading cause of cancer deaths in the United States. The initial assessment of colorectal cancer involves clinical staging that takes into account the extent of primary tumor invasion, determining the number of lymph nodes with metastatic cancer and the identification of metastatic sites in other organs. Advanced clinical stage indicates metastatic cancer, either in regional lymph nodes or in distant organs. While the genomic and genetic basis of colorectal cancer has been elucidated to some degree, less is known about the identity of specific cancer genes that are associated with advanced clinical stage and metastasis. Methods We compiled multiple genomic data types (mutations, copy number alterations, gene expression and methylation status) as well as clinical meta-data from The Cancer Genome Atlas (TCGA). We used an elastic-net regularized regression method on the combined genomic data to identify genetic aberrations and their associated cancer genes that are indicators of clinical stage. We ranked candidate genes by their regression coefficient and level of support from multiple assay modalities. Results A fit of the elastic-net regularized regression to 197 samples and integrated analysis of four genomic platforms identified the set of top gene predictors of advanced clinical stage, including: WRN, SYK, DDX5 and ADRA2C. These genetic features were identified robustly in bootstrap resampling analysis. Conclusions We conducted an analysis integrating multiple genomic features including mutations, copy number alterations, gene expression and methylation. This integrated approach in which one considers all of these genomic features performs better than any individual genomic assay. We identified multiple genes that robustly delineate advanced clinical stage, suggesting their possible role in colorectal cancer metastatic progression. PMID:24308539

Factors associated with parental underestimation of child's weight status.

PubMed

Warkentin, Sarah; Mais, Laís A; Latorre, Maria do Rosário D O; Carnell, Susan; Taddei, José Augusto A C

The aim of this study was to examine the prevalence of parental misperception of child weight status, and identify socioeconomic, anthropometric, behavioral and dietary factors associated with underestimation. Cross-sectional study. Data was collected in 14 Brazilian private schools. Parents of children aged 2-8 years (n=976) completed a self-reported questionnaire assessing their perception of their child's weight status, and sociodemographic, anthropometric, behavioral and dietary information. To measure the agreement between parental perception about child weight status and actual child weight status, the Kappa coefficient was estimated, and to investigate associations between parental underestimation and independent variables, chi-squared tests were performed, followed by multiple logistic regression, considering p≤0.05 for statistical significance. Overall, 48.05% of the parents incorrectly classified their child's weight. Specifically, 45.08% underestimated their child's weight status, with just 3% of parents overestimating. Children with higher body mass index (OR=2.03; p<0.001) and boys (OR=1.70; p<0.001) were more likely to have their weight status underestimated by parents. Since awareness of weight problems is essential for prevention and treatment, clinical practitioners should help parents at high risk of misperception to correctly evaluate their child's weight status. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

The Relationship between Structure-Related Food Parenting Practices and Children's Heightened Levels of Self-Regulation in Eating.

PubMed

Frankel, Leslie A; Powell, Elisabeth; Jansen, Elena

Food parenting practices influence children's eating behaviors and weight status. Food parenting practices also influence children's self-regulatory abilities around eating, which has important implications for children's eating behaviors. The purpose of the following study is to examine use of structure-related food parenting practices and the potential impact on children's ability to self-regulate energy intake. Parents (n = 379) of preschool age children (M = 4.10 years, SD = 0.92) were mostly mothers (68.6%), Non-White (54.5%), and overweight/obese (50.1%). Hierarchical Multiple Regression was conducted to predict child self-regulation in eating from structure-related food parenting practices (structured meal setting, structured meal timing, family meal setting), while accounting for child weight status, parent age, gender, BMI, race, and yearly income. Hierarchical Multiple Regression results indicated that structure-related feeding practices (structured meal setting and family meal setting, but not structured meal timing) are associated with children's heightened levels of self-regulation in eating. Models examining the relationship within children who were normal weight and overweight/obese indicated the following: a relationship between structured meal setting and heightened self-regulation in eating for normal-weight children and a relationship between family meal setting and heightened self-regulation in eating for overweight/obese children. Researchers should further investigate these potentially modifiable parent feeding behaviors as a protective parenting technique, which possibly contributes to a healthy weight development by enhancing self-regulation in eating.

White Blood Cells, Neutrophils, and Reactive Oxygen Metabolites among Asymptomatic Subjects.

PubMed

Kotani, Kazuhiko; Sakane, Naoki

2012-06-01

Chronic inflammation and oxidative stress are associated with health and the disease status. The objective of the present study was to investigate the association among white blood cell (WBC) counts, neutrophil counts as a WBC subpopulation, and diacron reactive oxygen metabolites (d-ROMs) levels in an asymptomatic population. The clinical data, including general cardiovascular risk variables and high-sensitivity C-reactive protein (hs-CRP), were collected from 100 female subjects (mean age, 62 years) in outpatient clinics. The correlation of the d-ROMs with hs-CRP, WBC, and neutrophil counts was examined. The mean/median levels were WBC counts 5.9 × 10(9)/L, neutrophil counts 3.6 × 10(9)/L, hs-CRP 0.06 mg/dL, and d-ROMs 359 CURR U. A simple correlation analysis showed a significant positive correlation of the d-ROMs with the WBC counts, neutrophil counts, or hs-CRP levels. The correlation between d-ROMs and neutrophil counts (β = 0.22, P < 0.05), as well as that between d-ROMs and hs-CRP (β = 0.28, P < 0.01), remained significant and independent in a multiple linear regression analysis adjusted for other variables. A multiple linear regression analysis showed that WBC counts had only a positive correlation tendency to the d-ROMs. Neutrophils may be slightly but more involved in the oxidative stress status, as assessed by d-ROMs, in comparison to the overall WBC. Further studies are needed to clarify the biologic mechanism(s) of the observed relationship.

Determinants of child maltreatment in Nepal: Results from the 2014 Nepal multiple indicator cluster survey (the 2014 NMICS).

PubMed

Atteraya, Madhu Sudhan; Ebrahim, Nasser B; Gnawali, Shreejana

2018-02-01

We examined the prevalence of child maltreatment as measured by the level of physical (moderate to severe) and emotional abuse and child labor, and the associated household level determinants of child maltreatment in Nepal. We used a nationally representative data set from the fifth round of the Nepal Multiple Indicator Cluster Survey (the 2014 NMICS). The main independent variables were household level characteristics. Dependent variables included child experience of moderate to severe physical abuse, emotional abuse, and child labor (domestic work and economic activities). Bivariate analyses and logistic regressions were used to examine the associations between independent and dependent variables. The results showed that nearly half of the children (49.8%) had experienced moderate physical abuse, 21.5% experienced severe physical abuse, and 77.3% experienced emotional abuse. About 27% of the children had engaged in domestic work and 46.7% in various economic activities. At bivariate level, educational level of household's head and household wealth status had shown significant statistical association with child maltreatment (p<0.001). Results from multivariate logistic regressions showed that higher education levels and higher household wealth status protected children from moderate to severe physical abuse, emotional abuse and child labor. In general, child maltreatment is a neglected social issue in Nepal and the high rates of child maltreatment calls for mass awareness programs focusing on parents, and involving all stakeholders including governments, local, and international organizations. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Correlational study among anger, perceived stress and mental health status in middle aged women].

PubMed

Lee, Pyoung-Sook

2003-10-01

This study was to identify the relationships of trait anger, mode of anger expression, and perceived stress to mental health status in middle aged women. The subjects were 157 middle aged women from 40s to 60s who lived in Seoul. Data was collected by questionnaire surveys using the convenience sampling. The instruments used for this study were Spielberger's trait anger scale and anger expression scale, Cohen, Kamarck, and Mermelstein's perceived stress and Derogatis's SCL-90-R. The collected data was analyzed using descriptive statistics, Pearson correlation coefficient, and Stepwise multiple regression with SAS/PC. The trait anger of middle aged women indicated a significantly positive correlation to perceived stress(r=.180, p=.023) and mental health status(r.=021, p=.014). Anger-in(r=.237, p<.05), and perceived stress(p=.461, p<.01) showed significantly positive correlation to mental health status. The most significant predictor influencing health status of middle aged women was perceived stress, and anger-in and the variance explained was 27%. These results suggested that middle aged women with high degree of trait anger is likely to be high in stress perception. Perceived stress and anger-in are major factors influencing mental health status.

A multiple-risk interaction model: effects of temperament and divorce on psychiatric disorders in children.

PubMed

Kasen, S; Cohen, P; Brook, J S; Hartmark, C

1996-04-01

Effects of family status on the trajectory of problematic temperament-adjustment at 1 and 10 years of age and associated psychiatric disturbance 8 years later were examined in an epidemiological sample of 648 children. After adjusting for predivorce temperament-adjustment and background factors, logistic regression yielded independent effects of single custodial mother (SCM) family status for increased risk of disruptive and anxiety disorders, and of stepfamily status for increased risk of disruptive disorders. Increased risk of psychiatric disorders was more pervasive for SCM family boys versus intact family boys than for SCM family girls versus intact family girls, however only significantly more so for depression. No significant sex interaction was observed for stepfamily status. When girls and boys were treated independently, patterns of family status and outcomes of internalizing disorders varied. In stepfamilies, an elevated risk of depression and anxiety disorders was observed in girls but not boys, whereas in SCM families an elevated risk of depression was observed in boys but not girls. Within each family status group there was support for an altered risk of later psychiatric disorders given specific problematic predivorce temperament-adjustment characteristics. Implications for future research and treatment are discussed.

Predicting quality of life in multiple sclerosis: accounting for physical disability, fatigue, cognition, mood disorder, personality, and behavior change.

PubMed

Benedict, Ralph H B; Wahlig, Elizabeth; Bakshi, Rohit; Fishman, Inna; Munschauer, Frederick; Zivadinov, Robert; Weinstock-Guttman, Bianca

2005-04-15

Health-related quality of life (HQOL) is poor in multiple sclerosis (MS) but the clinical precipitants of the problem are not well understood. Previous correlative studies demonstrated relationships between various clinical parameters and diminished HQOL in MS. Unfortunately, these studies failed to account for multiple predictors in the same analysis. We endeavored to determine what clinical parameters account for most variance in predicting HQOL, and employability, while accounting for disease course, physical disability, fatigue, cognition, mood disorder, personality, and behavior disorder. In 120 MS patients, we measured HQOL (MS Quality of Life-54) and vocational status (employed vs. disabled) and then conducted detailed clinical testing. Data were analyzed by linear and logistic regression methods. MS patients reported lower HQOL (p<0.001) and were more likely to be disabled (45% of patients vs. 0 controls). Physical HQOL was predicted by fatigue, depression, and physical disability. Mental HQOL was associated with only depression and fatigue. In contrast, vocational status was predicted by three cognitive tests, conscientiousness, and disease duration (p<0.05). Thus, for the first time, we predicted HQOL in MS while accounting for measures from these many clinical domains. We conclude that self-report HQOL indices are most strongly predicted by measures of depression, whereas vocational status is predicted primarily by objective measures of cognitive function. The findings highlight core clinical problems that merit early identification and further research regarding the development of effective treatment.

Poorer General Health Status in Children is Associated with being Overweight or Obese in Hawai‘i: Findings from the 2007 National Survey of Children's Health

PubMed Central

Teranishi, Kristen; Iwaishi, Louise K; Fuddy, Loretta J

2011-01-01

Obesity is a widespread national issue that affects the health and well-being of millions of people; particular attention has been focused on the burden among children. The National Survey of Children's Health data from 2007 was used to examine the relationship of child health status and unhealthy weight (overweight/obese defined as body mass index in ≥85th percentile) among 874 children aged 10 to 17 years of age in Hawai‘i. In particular, the parentally reported child's general health status was assessed comparing those with a poorer health status (defined as “good/fair/poor”) to those with a better one (defined as “excellent/very good”). Descriptive analysis and multiple logistic regression analysis examined risk for overweight/obese with child's general health status, accounting for gender, race, and socioeconomic factors. More children with a poorer health status (46.5%; 95%CI=33.2–60.2) were overweight/obese compared to those of better health status (25.8%; 95%CI=21.9–30.2). Estimates of overweight/obese were high in Native Hawaiian/Pacific Islander (38.6%; 95%CI: 28.9–49.4), multiracial (30.9%; 95%CI=24.2–38.6) children, and children whose parents had less than 12 years education (56.8%; 95%CI=32.8–78.0). Multivariate logistic regression modeling showed a 2.92 (95%CI=1.52–5.61) greater odds for overweight/obese status in children with a poorer health status compared to those of better health status after accounting for age, race, gender, and parental education. Gender, race, and parental education were also significant factors associated with overweight/obese in the final adjusted model. It is important that children that are overweight or obese receive appropriate health screenings including assessments of general health status. Children in high risk socioeconomic groups should be a particular focus of prevention efforts to promote health equity and provide opportunities for children to reach their potential. PMID:21886288

Parameter estimation in Cox models with missing failure indicators and the OPPERA study.

PubMed

Brownstein, Naomi C; Cai, Jianwen; Slade, Gary D; Bair, Eric

2015-12-30

In a prospective cohort study, examining all participants for incidence of the condition of interest may be prohibitively expensive. For example, the "gold standard" for diagnosing temporomandibular disorder (TMD) is a physical examination by a trained clinician. In large studies, examining all participants in this manner is infeasible. Instead, it is common to use questionnaires to screen for incidence of TMD and perform the "gold standard" examination only on participants who screen positively. Unfortunately, some participants may leave the study before receiving the "gold standard" examination. Within the framework of survival analysis, this results in missing failure indicators. Motivated by the Orofacial Pain: Prospective Evaluation and Risk Assessment (OPPERA) study, a large cohort study of TMD, we propose a method for parameter estimation in survival models with missing failure indicators. We estimate the probability of being an incident case for those lacking a "gold standard" examination using logistic regression. These estimated probabilities are used to generate multiple imputations of case status for each missing examination that are combined with observed data in appropriate regression models. The variance introduced by the procedure is estimated using multiple imputation. The method can be used to estimate both regression coefficients in Cox proportional hazard models as well as incidence rates using Poisson regression. We simulate data with missing failure indicators and show that our method performs as well as or better than competing methods. Finally, we apply the proposed method to data from the OPPERA study. Copyright © 2015 John Wiley & Sons, Ltd.

The incremental value of troponin biomarkers in risk stratification of acute coronary syndromes: is the relationship multiplicative?

PubMed

Amin, Amit P; Nathan, Sandeep; Vassallo, Patricia; Calvin, James E

2009-05-20

To emphasize the importance of troponin in the context of a new score for risk stratifying acute coronary syndromes (ACS) patients. Although troponins have powerful prognostic value, current ACS scores do not fully capitalize this prognostic ability. Here, we weigh troponin status in a multiplicative manner to develop the TRACS score from previously published Rush score risk factors (RRF). 2,866 ACS patients (46.7% troponin positive) from 9 centers comprising the TRACS registry, were randomly split into derivation (n=1,422) and validation (n=1,444) cohorts. In the derivation sample, RRF sum was multiplied by 3 if troponins were positive to yield the TRACS score, which was grouped into five categories of 0-2, 3-5, 6-8, 9-11, 12-15 (multiples of 3). Predictive performance of this score to predict hospital death was ascertained in the validation sample. The TRACS score had ROC AUC of 0.71 in the validation cohort. Logistic regression, Kaplan-Meier analysis, likelihood-ratio and Bayesian Information Criterion (BIC) test indicated that weighing troponin status with 3 in the TRACS score improved the prediction of mortality. Hosmer-Lemeshow test indicated sound model fit. We demonstrate that weighing troponin as a multiple of 3 yields robust prognostication of hospital mortality in ACS patients, when used in the context of the TRACS score.

The Incremental Value of Troponin Biomarkers in Risk Stratification of Acute Coronary Syndromes: Is the Relationship Multiplicative?

PubMed Central

Amin, Amit P; Nathan, Sandeep; Vassallo, Patricia; Calvin, James E

2009-01-01

Structured Abstract Objective: To emphasize the importance of troponin in the context of a new score for risk stratifying acute coronary syndromes (ACS) patients. Although troponins have powerful prognostic value, current ACS scores do not fully capitalize this prognostic ability. Here, we weigh troponin status in a multiplicative manner to develop the TRACS score from previously published Rush score risk factors (RRF). Methods: 2,866 ACS patients (46.7% troponin positive) from 9 centers comprising the TRACS registry, were randomly split into derivation (n=1,422) and validation (n=1,444) cohorts. In the derivation sample, RRF sum was multiplied by 3 if troponins were positive to yield the TRACS score, which was grouped into five categories of 0-2, 3-5, 6-8, 9-11, 12-15 (multiples of 3). Predictive performance of this score to predict hospital death was ascertained in the validation sample. Results: The TRACS score had ROC AUC of 0.71 in the validation cohort. Logistic regression, Kaplan-Meier analysis, likelihood-ratio and Bayesian Information Criterion (BIC) test indicated that weighing troponin status with 3 in the TRACS score improved the prediction of mortality. Hosmer-Lemeshow test indicated sound model fit. Conclusions: We demonstrate that weighing troponin as a multiple of 3 yields robust prognostication of hospital mortality in ACS patients, when used in the context of the TRACS score. PMID:19557150

Exposure to Pre- and Perinatal Risk Factors Partially Explains Mean Differences in Self-Regulation between Races.

PubMed

Barnes, J C; Boutwell, Brian B; Miller, J Mitchell; DeShay, Rashaan A; Beaver, Kevin M; White, Norman

2016-01-01

To examine whether differential exposure to pre- and perinatal risk factors explained differences in levels of self-regulation between children of different races (White, Black, Hispanic, Asian, and Other). Multiple regression models based on data from the Early Childhood Longitudinal Study, Birth Cohort (n ≈ 9,850) were used to analyze the impact of pre- and perinatal risk factors on the development of self-regulation at age 2 years. Racial differences in levels of self-regulation were observed. Racial differences were also observed for 9 of the 12 pre-/perinatal risk factors. Multiple regression analyses revealed that a portion of the racial differences in self-regulation was explained by differential exposure to several of the pre-/perinatal risk factors. Specifically, maternal age at childbirth, gestational timing, and the family's socioeconomic status were significantly related to the child's level of self-regulation. These factors accounted for a statistically significant portion of the racial differences observed in self-regulation. The findings indicate racial differences in self-regulation may be, at least partially, explained by racial differences in exposure to pre- and perinatal risk factors.

Vitamin D levels and their associations with survival and major disease outcomes in a large cohort of patients with chronic graft-vs-host disease

PubMed Central

Katić, Mašenjka; Pirsl, Filip; Steinberg, Seth M.; Dobbin, Marnie; Curtis, Lauren M.; Pulanić, Dražen; Desnica, Lana; Titarenko, Irina; Pavletic, Steven Z.

2016-01-01

Aim To identify the factors associated with vitamin D status in patients with chronic graft-vs-host disease (cGVHD) and evaluate the association between serum vitamin D (25(OH)D) levels and cGVHD characteristics and clinical outcomes defined by the National Institutes of Health (NIH) criteria. Methods 310 cGVHD patients enrolled in the NIH cGVHD natural history study (clinicaltrials.gov: NCT00092235) were analyzed. Univariate analysis and multiple logistic regression were used to determine the associations between various parameters and 25(OH)D levels, dichotomized into categorical variables: ≤20 and >20 ng/mL, and as a continuous parameter. Multiple logistic regression was used to develop a predictive model for low vitamin D. Survival analysis and association between cGVHD outcomes and 25(OH)D as a continuous as well as categorical variable: ≤20 and >20 ng/mL; <50 and ≥50 ng/mL, and among three ordered categories: ≤20, 20-50, and ≥50 ng/mL, was performed. PMID:27374829

Combined effect of Hashimoto's thyroiditis and BRAF(V600E) mutation status on aggressiveness in papillary thyroid cancer.

PubMed

Kim, Su-jin; Myong, Jun Pyo; Jee, Hyeon-Gun; Chai, Young Jun; Choi, June Young; Min, Hye Sook; Lee, Kyu Eun; Youn, Yeo-Kyu

2016-01-01

The purpose of this study was to evaluate the association between Hashimoto's thyroiditis and BRAF(V600E) mutation status in patients with papillary thyroid cancer (PTC) and to determine their combined association with tumor aggressiveness in PTC. A total of 1780 patients with PTC who underwent surgery were enrolled in this study. Simple and multiple analyses were performed to determine the association between Hashimoto's thyroiditis and the BRAF(V600E) mutation in PTC. Hashimoto's thyroiditis was present in 11.5% of patients (204/1780) with PTC. Multiple logistic regressions showed that BRAF(V600E) (odds ratio [OR] = 0.493; 95% confidence interval [CI] = 0.360-0.678) and the female sex (OR = 7.146; 95% CI = 3.408-18.347) were independent factors associated with Hashimoto's thyroiditis in PTC. BRAF(V600E) mutation and the Hashimoto's thyroiditis-negative PTC group were associated with aggressive disease (OR = 3.069; 95% CI = 1.654-5.916). Hashimoto's thyroiditis was associated less frequently with BRAF(V600E) , and frequently with the female sex in patients with PTC. Hashimoto's thyroiditis and BRAF(V600E) status may help to predict clinical outcome of PTC. © 2015 Wiley Periodicals, Inc.

Hyperhomocysteinaemia is an independent risk factor of abdominal aortic aneurysm in a Chinese Han population

PubMed Central

Liu, Jie; Wei Zuo, Shang; Li, Yue; Jia, Xin; Jia, Sen Hao; Zhang, Tao; Xiang Song, Yu; Qi Wei, Ying; Xiong, Jiang; Hua Hu, Yong; Guo, Wei

2016-01-01

The associations between hyperhomocysteinaemia (HHcy), methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism, and abdominal aortic aneurysm (AAA) remain controversial, with only few studies focused on these associations within the Chinese population. We performed subgroup and interaction analyses in a Chinese Han population to investigate these associations. In all, 155 AAA patients and 310 control subjects were evaluated for serum total homocysteine levels and MTHFR C677T polymorphisms. Multiple logistic regression models were used to evaluate the aforementioned associations. Interaction and stratified analyses were conducted according to age, sex, smoking status, drinking status, and chronic disease histories. The multiple logistic analyses showed a significant association between HHcy and AAA but no significant association between MTHFR C677T polymorphism and AAA. The interaction analysis showed that age and peripheral arterial disease played an interactive role in the association between HHcy and AAA, while drinking status played an interactive role in the association between MTHFR C677T polymorphism and AAA. In conclusion, HHcy is an independent risk factor of AAA in a Chinese Han population, especially in the elderly and peripheral arterial disease subgroups. Longitudinal studies and clinical trials aimed to reduce homocysteine levels are warranted to assess the causal nature of these relationships PMID:26865327

Multiple role adaptation among women who have children and re-enter nursing school in Taiwan.

PubMed

Lin, Li-Ling

2005-03-01

This study assessed multiple role adaptation within maternal and student roles among female RNs who had children and returned to school for baccalaureate degrees in Taiwan. Using Roy's Adaptation Model as the theoretical framework, relationships were explored among demographic (number of children, age of youngest child, employment status), physical (sleep quality, health perception, activity), and psychosocial factors (self-identity, role expectation, role involvement, social support) and multiple role adaptation (role accumulation). The sample included 118 mother-students who had at least one child younger than age 18 and who were studying in nursing programs in Taiwan. The highest correlation was found between activity and role accumulation followed by significant correlations between sleep quality, health perception, maternal role expectation, and age of youngest child and role accumulation. In regression analyses, the complete model explained 46% of the variance in role accumulation. Implications for education and future research are identified.

Physical Activity and Depressive Symptoms in Four Ethnic Groups of Midlife Women

PubMed Central

Im, Eun-Ok; Ham, Ok Kyung; Chee, Eunice; Chee, Wonshik

2014-01-01

The purpose of this study was to determine the associations between physical activity and depression and the multiple contextual factors influencing these associations in four major ethnic-groups of midlife women in the U.S. This was a secondary analysis of the data from 542 midlife women. The instruments included questions on background characteristics and health and menopausal status; the Depression Index for Midlife Women; and the Kaiser Physical Activity Survey. The data were analyzed using chi-square tests, the ANOVA, twoway ANOVA, correlation analyses, and hierarchical multiple regression analyses. The women's depressive symptoms were negatively correlated with active living and sports/exercise physical activities whereas they were positively correlated with occupational physical activities (p < .01). Family income was the strongest predictor of their depressive symptoms. Increasing physical activity may improve midlife women's depressive symptoms, but the types of physical activity and multiple contextual factors need to be considered in intervention development. PMID:24879749

Sportsmanship in young athletes: the role of competitiveness, motivational orientation, and perceived purposes of sport.

PubMed

Ryska, Todd A

2003-05-01

The purpose of the study was to evaluate measures of competitiveness, motivational orientation, and perceived purposes of participation as predictors of sportsmanship in a sample of 319 young participants in sports. Hierarchical regression analyses indicated that intrinsic reasons for sports participation, such as enhanced self-esteem and task mastery, predicted higher levels on multiple dimensions of sportsmanship, above and beyond the influence of competitiveness, motivational orientation, and various demographic variables. In contrast, extrinsic purposes for participation in sports, such as to obtain social status and a high-status career, contributed to lower levels on 3 of the 4 sportsmanship dimensions. These results are discussed with regard to developing a competitive sport setting that promotes ethical standards of interpersonal behavior for young participants in sports.

Psychological effects of dog ownership: role strain, role enhancement, and depression.

PubMed

Cline, Krista Marie Clark

2010-01-01

The purpose of this study is to examine the link between multiple roles and depression and to attempt to provide a clearer answer to the question of what effect, if any, the role of dog ownership plays. Role strain and role enhancement theories are drawn upon to study this relationship. Ordinary least squares regression is used to examine a national sample of 201 adults in the United States. Findings revealed sex and marital status differences in the relationship between dog ownership and well-being, with women and single adults more likely to benefit from dog ownership. The findings presented here suggest that inattention to variations in marital status and sex may have been one factor in the inconsistency in the literature on pets and well-being.

Differential relationships between social adversity and depressive symptoms by HIV-status and racial/ethnic identity

PubMed Central

Williamson, Timothy J.; Mahmood, Zanjbeel; Kuhn, Taylor P.; Thames, April D.

2016-01-01

Objective Historically marginalized groups are likely to be exposed to social adversity, which predicts important mental health outcomes (e.g., depression). Despite the well-established relationship between adversity and poor health, few studies have examined how adversity differentially predicts mental health among people living with multiple, co-occurring marginalized identities or statuses. The current study fills this gap by examining whether relationships between social adversity and depressive symptoms differed between those living with or without a stigmatized disease (i.e., HIV) and/or marginalized racial/ethnic identity (i.e., African American). Method A community sample of men and women (n = 149) completed questionnaires assessing demographics and depressive symptoms. Additionally, a composite index of social adversity was derived from measures of perceived discrimination, socioeconomic status, financial restriction to receiving medical care, and perceived neighborhood characteristics. Multiple regression was used to test whether relationships between adversity and depressive symptoms differed as a function of HIV-status and racial/ethnic identity. Results A significant three-way interaction between social adversity, HIV-status, and racial/ethnic identity indicated that there was a direct relationship between adversity and depressive symptoms for HIV-positive (HIV+) African Americans but not for HIV-negative (HIV-) African Americans, HIV+ Caucasians, or HIV- Caucasians. Further, HIV+ African Americans evidenced a significantly greater relationship between adversity and depressive symptoms, as compared to HIV- African Americans but not as compared to other groups. Conclusions The findings suggest that HIV+ African Americans may be at risk for higher depressive symptoms amidst adversity, highlighting the importance of evaluating intersectional identities/statuses in the context of mental health. PMID:27929330

Differential relationships between social adversity and depressive symptoms by HIV status and racial/ethnic identity.

PubMed

Williamson, Timothy J; Mahmood, Zanjbeel; Kuhn, Taylor P; Thames, April D

2017-02-01

Historically marginalized groups are likely to be exposed to social adversity, which predicts important mental health outcomes (e.g., depression). Despite the well-established relationship between adversity and poor health, few studies have examined how adversity differentially predicts mental health among people living with multiple, co-occurring marginalized identities or statuses. The current study fills this gap by examining whether relationships between social adversity and depressive symptoms differed between those living with or without a stigmatized disease (i.e., HIV) and/or marginalized racial/ethnic identity (i.e., African American). A community sample of men and women (N = 149) completed questionnaires assessing demographics and depressive symptoms. Additionally, a composite index of social adversity was derived from measures of perceived discrimination, socioeconomic status, financial restriction to receiving medical care, and perceived neighborhood characteristics. Multiple regression was used to test whether relationships between adversity and depressive symptoms differed as a function of HIV status and racial/ethnic identity. A significant 3-way interaction between social adversity, HIV status, and racial/ethnic identity indicated that there was a direct relationship between adversity and depressive symptoms for HIV-positive (HIV+) African Americans but not for HIV-negative (HIV-) African Americans, HIV+ Caucasians, or HIV- Caucasians. Further, HIV+ African Americans evidenced a significantly greater relationship between adversity and depressive symptoms compared with HIV- African Americans, but not compared with other groups. The findings suggest that HIV+ African Americans may be at risk for higher depressive symptoms amid adversity, highlighting the importance of evaluating intersectional identities/statuses in the context of mental health. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Multiple Types of Memory and Everyday Functional Assessment in Older Adults.

PubMed

Beaver, Jenna; Schmitter-Edgecombe, Maureen

2017-06-01

Current proxy measures for assessing everyday functioning (e.g., questionnaires, performance-based measures, and direct observation) show discrepancies in their rating of functional status. The present study investigated the relationship between multiple proxy measures of functional status and content memory (i.e., memory for information), temporal order memory, and prospective memory in an older adult sample. A total of 197 community-dwelling older adults who did (n = 45) or did not meet (n = 152) criteria for mild cognitive impairment (MCI), completed six different assessments of functional status (two questionnaires, two performance-based tasks, and two direct observation tasks) as well as experimental measures of content memory, prospective memory, and temporal order memory. After controlling for demographics and content memory, the temporal order and prospective memory measures explained a significant amount of variance in all proxy functional status measures. When all variables were entered into the regression analyses, content memory and prospective memory were found to be significant predictors of all measures of functional status, whereas temporal order memory was a significant predictor for the questionnaire and direct observation measures, but not performance-based measures. The results suggest that direct observation and questionnaire measures may be able to capture components of everyday functioning that require context and temporal sequencing abilities, such as multi-tasking, that are not as well captured in many current laboratory performance-based measures of functional status. Future research should aim to inform the development and use of maximally effective and valid proxy measures of functional ability. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The relationship between employment status and self-rated health among wage workers in South Korea: the moderating role of household income.

PubMed

Lim, Hyejin; Kimm, Heejin; Song, In Han

2015-02-01

The purpose of the study reported in this article was to investigate the relationship between employment status and self-rated health (SRH) and the moderating effect of household income among wage workers in South Korea. This research analyzed the Korean Labor and Income Panel Study, 2005 to 2008. Of the 10,494 respondents participating in the survey during the period, a total of 1,548 people whose employment status had remained either precarious or nonprecarious were selected. A moderated multiple regression model was used to examine the main effect of employment status on SRH and the moderating effect of total household income on the relationship between employment status and SRH. Among 343 precarious workers and 1,205 nonprecarious workers, after controlling for gender, age, education, smoking, and drinking, employment status was associated with SRH of wage workers, and household income was found to have a moderating effect on SRH in that higher income buffers the link between unstable employment status and low SRH. Unstable employment, combined with low income, was significantly related to precarious wage workers' perceived health. To promote public health, efforts may be needed to secure not only people's employment, but also their income.

The Prevalence of Disclosure of HIV Status to HIV-Infected Children in Western Kenya.

PubMed

Turissini, Matthew L; Nyandiko, Winstone M; Ayaya, Samuel O; Marete, Irene; Mwangi, Ann; Chemboi, Victor; Warui, Lucy; Vreeman, Rachel C

2013-06-01

As antiretroviral therapy (ART) allows the world's 2.3 million human immunodeficiency virus (HIV)-infected children to grow and thrive, these children need to be informed of their HIV status. Neither the prevalence of disclosure to children nor its impact has been evaluated in most resource-limited settings. We conducted a prospective assessment of a random sample of HIV-infected children ages 6-14 years enrolled in HIV care at a large referral clinic in Eldoret, Kenya. Clinicians administered questionnaires to children and caregivers independently at routine clinic visits to assess disclosure status, ART adherence, stigma, and depression. Children's demographic and clinical characteristics were extracted from chart review. We calculated descriptive statistics and performed logistic regression to assess the association between disclosure and other characteristics. Two hundred seventy children-caregiver dyads completed questionnaires. The mean child age was 9.3 years (standard deviation 2.6); 49% were male, and 42% were orphans. 11.1% of children had been informed of their HIV status (N = 30). Of those under 10 years, 3.3% knew their status, whereas 9.2% of 10- to 12-year-olds and 39.5% of 13- to 14-year-olds knew they had HIV. Only age was significantly associated with disclosure status in both bivariate analyses (P < .0001) and multiple logistic regression (odds ratio 1.67, 95% confidence interval 1.36-2.05) when considering social demographics, disease stage variables, adherence, stigma measures, and depression. Rates of informing children in western Kenya of their HIV status are low, even among older children. Guiding families through developmentally appropriate disclosure processes should be a key facet of long-term pediatric HIV management. © The Author 2013. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Expressed emotion displayed by the mothers of inhibited and uninhibited preschool-aged children.

PubMed

Raishevich, Natoshia; Kennedy, Susan J; Rapee, Ronald M

2010-01-01

In the current study, the Five Minute Speech Sample was used to assess the association between parent attitudes and children's behavioral inhibition in mothers of 120 behaviorally inhibited (BI) and 37 behaviorally uninhibited preschool-aged children. Mothers of BI children demonstrated significantly higher levels of emotional over-involvement (EOI) and self-sacrificing/overprotective behavior (SS/OP). However, there was no significant relationship between inhibition status and maternal criticism. Multiple regression also indicated that child temperament, but not maternal anxiety, was a significant predictor of both EOI and SS/OP.

Prevalence and predictors of dysphagia in Iranian patients with multiple sclerosis

PubMed Central

Tarameshlu, Maryam; Azimi, Amir Reza; Ghelichi, Leila; Ansari, Noureddin Nakhostin

2017-01-01

Background: Dysphagia is frequently observed in patients with multiple sclerosis (MS). Dysphagia and its complications are common causes of morbidity and mortality in final stages of MS disease. This study aimed at determining the prevalence of dysphagia in Iranian patients with MS and identifying predictors associated with dysphagia. Methods: A total of 230 MS patients were enrolled in this cross-sectional study. Dysphagia was evaluated using Mann Assessment of Swallowing Ability (MASA). Demographic characteristics (age and gender), duration of the disease, disease course, and Expanded Disability Status Scale (EDSS) were recorded for all participants. Results: In total, dysphagia was found in 85 participants (37%) with mild to severe dysphagia (mild 50.6%; moderate 29.4%; and severe 20%). The logistic regression model demonstrated that disability status in EDSS (OR= 2.1; 95% CI 0.5-1.2) and disease duration (OR= 2.3; 95% CI 0.4-1.1) predicts a high risk for dysphagia in MS patients. Conclusion: Dysphagia is prevalent in Iranian patients with MS. Disability level and disease duration are significant predictors of dysphagia after MS.

Maternal perceptions of their child's weight status: the GENESIS study.

PubMed

Manios, Yannis; Kondaki, Katerina; Kourlaba, Georgia; Vasilopoulou, Emilia; Grammatikaki, Evangelia

2009-08-01

The objective of the present work was to quantify mothers' misclassification of pre-school children's weight status and to determine factors associated with the maternal misperception. A representative sample of 2287 children aged 2-5 years was examined (GENESIS study). Mothers' perceptions of their child's weight status and the children's and mothers' anthropometric and other characteristics (sociodemographic and lifestyle) were recorded. Almost 38 % of mothers underestimated their child's weight status. The frequency of underestimation was much higher among 'at risk of being overweight' and 'overweight' children (88.3 % and 54.5 %, respectively) compared with 'underweight/normal-weight' children (18.0 %, P < 0.001). Multiple logistic regression modelling revealed that the likelihood of mothers' underestimation of their child's weight status was significantly higher in boys, in children engaging in physical activity for less than 3 h/week and in children whose mothers had low education status, compared with their counterparts. Moreover, the higher the BMI-for-age Z-score, the greater the odds that the mother would underestimate her child's weight status. The current study demonstrated that more than one-third of mothers misclassify their children's weight status as being lower than the actual. Given that mother's weight perception might be an important determinant of child's body weight development, clinicians and health professionals should help mothers correctly classify their children's weight status, which could potentially help in the early prevention of overweight and obesity.

Comparison of Neural Network and Linear Regression Models in Statistically Predicting Mental and Physical Health Status of Breast Cancer Survivors

DTIC Science & Technology

2015-07-15

Long-term effects on cancer survivors’ quality of life of physical training versus physical training combined with cognitive-behavioral therapy ...COMPARISON OF NEURAL NETWORK AND LINEAR REGRESSION MODELS IN STATISTICALLY PREDICTING MENTAL AND PHYSICAL HEALTH STATUS OF BREAST...34Comparison of Neural Network and Linear Regression Models in Statistically Predicting Mental and Physical Health Status of Breast Cancer Survivors

Relationship between tinnitus and suicidal behaviour in Korean men and women: a cross-sectional study.

PubMed

Seo, J H; Kang, J M; Hwang, S H; Han, K D; Joo, Y H

2016-06-01

This study investigated the prevalence of suicidal ideation and behaviour in a representative sample of South Koreans with or without tinnitus. A cross-sectional study. Based on data from the 2010 to 2012 Korean National Health and Nutrition Examination Survey (KNHANES). The study included 17 446 Korean individuals. Participants provided demographic, socio-economic and behavioural information, as well as responses to questionnaires assessing the presence and severity of tinnitus, mental health status regarding stress, depression, and suicidal ideation and attempts. In the univariate analysis, the Rao-Scott chi-square test and logistic regression analysis were used to test the association between tinnitus and risk factors. Simple and multiple linear regression analyses were used to examine the association between tinnitus and mental status. A total of 20.9% and 1.2% of participants with tinnitus, and 12.2% and 0.6% of those without, reported suicidal ideation and attempts, respectively (P < 0.0001 and P = 0.001). Participants reporting suicide attempts showed a higher proportion of severe annoying (6.0%) and irritating (11.8%) tinnitus than those with suicidal ideation (1.4% and 10.2%, respectively). Risks for experiencing tinnitus were significantly associated with suicidal ideation and attempts after adjusting for confounding variables. This study has important implications for enhanced screening and evaluation of mental health status and suicidal ideation/behaviour among tinnitus patients. © 2015 John Wiley & Sons Ltd.

Correlates of circulating 25-hydroxyvitamin D: Cohort Consortium Vitamin D Pooling Project of Rarer Cancers.

PubMed

McCullough, Marjorie L; Weinstein, Stephanie J; Freedman, D Michal; Helzlsouer, Kathy; Flanders, W Dana; Koenig, Karen; Kolonel, Laurence; Laden, Francine; Le Marchand, Loic; Purdue, Mark; Snyder, Kirk; Stevens, Victoria L; Stolzenberg-Solomon, Rachael; Virtamo, Jarmo; Yang, Gong; Yu, Kai; Zheng, Wei; Albanes, Demetrius; Ashby, Jason; Bertrand, Kimberly; Cai, Hui; Chen, Yu; Gallicchio, Lisa; Giovannucci, Edward; Jacobs, Eric J; Hankinson, Susan E; Hartge, Patricia; Hartmuller, Virginia; Harvey, Chinonye; Hayes, Richard B; Horst, Ronald L; Shu, Xiao-Ou

2010-07-01

Low vitamin D status is common globally and is associated with multiple disease outcomes. Understanding the correlates of vitamin D status will help guide clinical practice, research, and interpretation of studies. Correlates of circulating 25-hydroxyvitamin D (25(OH)D) concentrations measured in a single laboratory were examined in 4,723 cancer-free men and women from 10 cohorts participating in the Cohort Consortium Vitamin D Pooling Project of Rarer Cancers, which covers a worldwide geographic area. Demographic and lifestyle characteristics were examined in relation to 25(OH)D using stepwise linear regression and polytomous logistic regression. The prevalence of 25(OH)D concentrations less than 25 nmol/L ranged from 3% to 36% across cohorts, and the prevalence of 25(OH)D concentrations less than 50 nmol/L ranged from 29% to 82%. Seasonal differences in circulating 25(OH)D were most marked among whites from northern latitudes. Statistically significant positive correlates of 25(OH)D included male sex, summer blood draw, vigorous physical activity, vitamin D intake, fish intake, multivitamin use, and calcium supplement use. Significant inverse correlates were body mass index, winter and spring blood draw, history of diabetes, sedentary behavior, smoking, and black race/ethnicity. Correlates varied somewhat within season, race/ethnicity, and sex. These findings help identify persons at risk for low vitamin D status for both clinical and research purposes.

Correlates of Circulating 25-Hydroxyvitamin D

PubMed Central

McCullough, Marjorie L.; Weinstein, Stephanie J.; Freedman, D. Michal; Helzlsouer, Kathy; Flanders, W. Dana; Koenig, Karen; Kolonel, Laurence; Laden, Francine; Le Marchand, Loic; Purdue, Mark; Snyder, Kirk; Stevens, Victoria L.; Stolzenberg-Solomon, Rachael; Virtamo, Jarmo; Yang, Gong; Yu, Kai; Zheng, Wei; Albanes, Demetrius; Ashby, Jason; Bertrand, Kimberly; Cai, Hui; Chen, Yu; Gallicchio, Lisa; Giovannucci, Edward; Jacobs, Eric J.; Hankinson, Susan E.; Hartge, Patricia; Hartmuller, Virginia; Harvey, Chinonye; Hayes, Richard B.; Horst, Ronald L.; Shu, Xiao-Ou

2010-01-01

Low vitamin D status is common globally and is associated with multiple disease outcomes. Understanding the correlates of vitamin D status will help guide clinical practice, research, and interpretation of studies. Correlates of circulating 25-hydroxyvitamin D (25(OH)D) concentrations measured in a single laboratory were examined in 4,723 cancer-free men and women from 10 cohorts participating in the Cohort Consortium Vitamin D Pooling Project of Rarer Cancers, which covers a worldwide geographic area. Demographic and lifestyle characteristics were examined in relation to 25(OH)D using stepwise linear regression and polytomous logistic regression. The prevalence of 25(OH)D concentrations less than 25 nmol/L ranged from 3% to 36% across cohorts, and the prevalence of 25(OH)D concentrations less than 50 nmol/L ranged from 29% to 82%. Seasonal differences in circulating 25(OH)D were most marked among whites from northern latitudes. Statistically significant positive correlates of 25(OH)D included male sex, summer blood draw, vigorous physical activity, vitamin D intake, fish intake, multivitamin use, and calcium supplement use. Significant inverse correlates were body mass index, winter and spring blood draw, history of diabetes, sedentary behavior, smoking, and black race/ethnicity. Correlates varied somewhat within season, race/ethnicity, and sex. These findings help identify persons at risk for low vitamin D status for both clinical and research purposes. PMID:20562191

[The Influence of Subjective Health Status, Post-Traumatic Growth, and Social Support on Successful Aging in Middle-Aged Women].

PubMed

Lee, Seung Hee; Jang, Hyung Suk; Yang, Young Hee

2016-10-01

This study was done to investigate factors influencing successful aging in middle-aged women. A convenience sample of 103 middle-aged women was selected from the community. Data were collected using a structured questionnaire and analyzed using descriptive statistics, two-sample t-test, one-way ANOVA, Kruskal Wallis test, Pearson correlations, Spearman correlations and multiple regression analysis with the SPSS/WIN 22.0 program. Results of regression analysis showed that significant factors influencing successful aging were post-traumatic growth and social support. This regression model explained 48% of the variance in successful aging. Findings show that the concept 'post-traumatic growth' is an important factor influencing successful aging in middle-aged women. In addition, social support from friends/co-workers had greater influence on successful aging than social support from family. Thus, we need to consider the positive impact of post-traumatic growth and increase the chances of social participation in a successful aging program for middle-aged women.

Inhibitory saccadic dysfunction is associated with cerebellar injury in multiple sclerosis.

PubMed

Kolbe, Scott C; Kilpatrick, Trevor J; Mitchell, Peter J; White, Owen; Egan, Gary F; Fielding, Joanne

2014-05-01

Cognitive dysfunction is common in patients with multiple sclerosis (MS). Saccadic eye movement paradigms such as antisaccades (AS) can sensitively interrogate cognitive function, in particular, the executive and attentional processes of response selection and inhibition. Although we have previously demonstrated significant deficits in the generation of AS in MS patients, the neuropathological changes underlying these deficits were not elucidated. In this study, 24 patients with relapsing-remitting MS underwent testing using an AS paradigm. Rank correlation and multiple regression analyses were subsequently used to determine whether AS errors in these patients were associated with: (i) neurological and radiological abnormalities, as measured by standard clinical techniques, (ii) cognitive dysfunction, and (iii) regionally specific cerebral white and gray-matter damage. Although AS error rates in MS patients did not correlate with clinical disability (using the Expanded Disability Status Score), T2 lesion load or brain parenchymal fraction, AS error rate did correlate with performance on the Paced Auditory Serial Addition Task and the Symbol Digit Modalities Test, neuropsychological tests commonly used in MS. Further, voxel-wise regression analyses revealed associations between AS errors and reduced fractional anisotropy throughout most of the cerebellum, and increased mean diffusivity in the cerebellar vermis. Region-wise regression analyses confirmed that AS errors also correlated with gray-matter atrophy in the cerebellum right VI subregion. These results support the use of the AS paradigm as a marker for cognitive dysfunction in MS and implicate structural and microstructural changes to the cerebellum as a contributing mechanism for AS deficits in these patients. Copyright © 2013 Wiley Periodicals, Inc.

Screening for ketosis using multiple logistic regression based on milk yield and composition

PubMed Central

KAYANO, Mitsunori; KATAOKA, Tomoko

2015-01-01

Multiple logistic regression was applied to milk yield and composition data for 632 records of healthy cows and 61 records of ketotic cows in Hokkaido, Japan. The purpose was to diagnose ketosis based on milk yield and composition, simultaneously. The cows were divided into two groups: (1) multiparous, including 314 healthy cows and 45 ketotic cows and (2) primiparous, including 318 healthy cows and 16 ketotic cows, since nutritional status, milk yield and composition are affected by parity. Multiple logistic regression was applied to these groups separately. For multiparous cows, milk yield (kg/day/cow) and protein-to-fat (P/F) ratio in milk were significant factors (P<0.05) for the diagnosis of ketosis. For primiparous cows, lactose content (%), solid not fat (SNF) content (%) and milk urea nitrogen (MUN) content (mg/dl) were significantly associated with ketosis (P<0.01). A diagnostic rule was constructed for each group of cows: (1) 9.978 × P/F ratio + 0.085 × milk yield <10 and (2) 2.327 × SNF − 2.703 × lactose + 0.225 × MUN <10. The sensitivity, specificity and the area under the curve (AUC) of the diagnostic rules were (1) 0.800, 0.729 and 0.811; (2) 0.813, 0.730 and 0.787, respectively. The P/F ratio, which is a widely used measure of ketosis, provided the sensitivity, specificity and AUC values of (1) 0.711, 0.726 and 0.781; and (2) 0.678, 0.767 and 0.738, respectively. PMID:26074408

Ethnicity and acculturation: do they predict weight status in a longitudinal study among Asian, Hispanic, and non-Hispanic White early adolescent females?

PubMed Central

Fialkowski, Marie K; Ettienne, Reynolette; Shvetsov, Yurii B; Rivera, Rebecca L; Van Loan, Marta D; Savaiano, Dennis A; Boushey, Carol J

2015-01-01

Background The prevalence of overweight and obesity among adolescents has increased over the past decade. Prevalence rates are disparate among certain racial and ethnic groups. This study sought to longitudinally examine the relationship between overweight status (≥85th percentile according to the Centers for Disease Control and Prevention growth charts) and ethnic group, as well as acculturation (generation and language spoken in the home) in a sample of adolescent females. Methods Asian (n=160), Hispanic (n=217), and non-Hispanic White (n=304) early adolescent girls participating in the multistate calcium intervention study with complete information on weight, ethnicity, and acculturation were included. Multiple methods of assessing longitudinal relationships (binary logistic regression model, linear regression model, Cox proportional-hazards regression analysis, and Kaplan–Meier survival analysis) were used to examine the relationship. Results The total proportion of girls overweight at baseline was 36%. When examining by ethnic group, the proportion varied with Hispanic girls having the highest percentage (46%) in comparison to their Asian (23%) and Non-Hispanic White (35%) counterparts. Although the total proportion of overweight was 36% at 18 months, the variation across the ethnic groups remained with the proportion of Hispanic girls becoming overweight (55%) being greater than their Asian (18%) and non-Hispanic White (34%) counterparts. However, regardless of the statistical approach used, there were no significant associations between overweight status and acculturation over time. Conclusion These unexpected results warrant further exploration into factors associated with overweight, especially among Hispanic girls, and further investigation of acculturation’s role is warranted. Identifying these risk factors will be important for developing targeted obesity prevention initiatives. PMID:25624775

Correlation of Vitamin D status and orthodontic-induced external apical root resorption

PubMed Central

Tehranchi, Azita; Sadighnia, Azin; Younessian, Farnaz; Abdi, Amir H.; Shirvani, Armin

2017-01-01

Background: Adequate Vitamin D is essential for dental and skeletal health in children and adult. The purpose of this study was to assess the correlation of serum Vitamin D level with external-induced apical root resorption (EARR) following fixed orthodontic treatment. Materials and Methods: In this cross-sectional study, the prevalence of Vitamin D deficiency (defined by25-hydroxyvitamin-D) was determined in 34 patients (23.5% male; age range 12–23 years; mean age 16.63 ± 2.84) treated with fixed orthodontic treatment. Root resorption of four maxillary incisors was measured using before and after periapical radiographs (136 measured teeth) by means of a design-to-purpose software to optimize data collection. Teeth with a maximum percentage of root resorption (%EARR) were indicated as representative root resorption for each patient. A multiple linear regression model and Pearson correlation coefficient were used to assess the association of Vitamin D status and observed EARR. P < 0.05 was considered statistically significant. Results: The Pearson coefficient between these two variables was determined about 0.15 (P = 0.38). Regression analysis revealed that Vitamin D status of the patients demonstrated no significant statistical correlation with EARR, after adjustment of confounding variables using linear regression model (P > 0.05). Conclusion: This study suggests that Vitamin D level is not among the clinical variables that are potential contributors for EARR. The prevalence of Vitamin D deficiency does not differ in patients with higher EARR. These data suggest the possibility that Vitamin D insufficiency may not contribute to the development of more apical root resorption although this remains to be confirmed by further longitudinal cohort studies. PMID:29238379

Association between Family and Friend Smoking Status and Adolescent Smoking Behavior and E-Cigarette Use in Korea.

PubMed

Joung, Myoung Jin; Han, Mi Ah; Park, Jong; Ryu, So Yeon

2016-11-25

Smoking is harmful to the health of adolescents because their bodies are still growing. The aim of this study was to analyze the association between the smoking status of Korean adolescents' parents and friends and their own smoking behavior. The study assessed a nationwide sample of 72,060 middle and high students from the 10th Korea Youth Risk Behavior Web-based Survey (2014). Descriptive analysis, chi-square tests, and multiple logistic regression analysis were used to probe the association between family and friend smoking status and adolescent smoking behavior. The current cigarette smoking rates were 13.3% of boys and 4.1% of girls. The corresponding rates for electronic cigarette smoking were 4.1% and 1.5%, respectively. Higher exposure to secondhand smoke, smoking by any family member, more friends smoking, and witnessed smoking at school were associated with current smoking and electronic smoking. The smoking status of family and friends was significantly related to adolescent smoking behavior. These results should be considered in designing programs to control adolescent smoking.

Selected family characteristics are associated with adolescents' subjective health complaints.

PubMed

Petanidou, Dimitra; Mihas, Constantinos; Dimitrakaki, Christine; Kolaitis, Gerasimos; Tountas, Yannis

2014-02-01

This national study of schoolchildren in Greece investigated the association between adolescents' subjective health complaints (SHC) and a number of family characteristics. Questionnaires were completed by a random, school-based sample of children from 12 to 18 years of age, and one of their parents (76.6% mothers), in 2003. Data from 1041 adolescent-parent pairs were analysed. Multiple linear regression analysis was used to assess the associations between the adolescent's SHC and the following characteristics: parent's marital status, parent's physical and mental health status, parent's worries about their child's SHC, the parent-child relationship, family cohesion, family socio-economic status and the adolescent's sex and age. The analysis showed that the adolescents' SHC were independently and significantly correlated with poor parental subjective mental health status, poor quality parent-child relationships and parental worry. There were also associations between levels of SHC and female and older adolescents. Certain family features can be seen as potential contributing factors to SHC in adolescence and should therefore constitute complementary targets for prevention and treatment planning. ©2013 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Association between Family and Friend Smoking Status and Adolescent Smoking Behavior and E-Cigarette Use in Korea

PubMed Central

Joung, Myoung Jin; Han, Mi Ah; Park, Jong; Ryu, So Yeon

2016-01-01

Smoking is harmful to the health of adolescents because their bodies are still growing. The aim of this study was to analyze the association between the smoking status of Korean adolescents’ parents and friends and their own smoking behavior. The study assessed a nationwide sample of 72,060 middle and high students from the 10th Korea Youth Risk Behavior Web-based Survey (2014). Descriptive analysis, chi-square tests, and multiple logistic regression analysis were used to probe the association between family and friend smoking status and adolescent smoking behavior. The current cigarette smoking rates were 13.3% of boys and 4.1% of girls. The corresponding rates for electronic cigarette smoking were 4.1% and 1.5%, respectively. Higher exposure to secondhand smoke, smoking by any family member, more friends smoking, and witnessed smoking at school were associated with current smoking and electronic smoking. The smoking status of family and friends was significantly related to adolescent smoking behavior. These results should be considered in designing programs to control adolescent smoking. PMID:27898019

The big five personality factors as predictors of driving status in older adults.

PubMed

Gadbois, Emily A; Dugan, Elizabeth

2015-02-01

Although factors including cognitive and health status have been associated with driving cessation in older adults, the role of psychosocial variables is not well studied. Previous research on young adult drivers has suggested that personality may be related to driving behavior, but this study is among the first to explore the relationship between driving status and the Big Five Model of personality for older adults. Data are from the Health and Retirement Study (2008 wave, n = 4,028). Descriptive, bivariate, and multiple logistic regression analyses were conducted. Neuroticism (β = -0.4511, p < .001) and agreeableness (β = -0.5058, p < .001) were associated with decreased likelihood of driving; extraversion (β = 0.4588, p < .001), openness (β = 0.5903, p < .001), and conscientiousness (β = 0.4077, p < .001) were associated with increased likelihood of driving, although results were partially mediated by including known risk factors. People who limited their driving to nearby locations were the most different from those who no longer drove. Personality adds a unique contribution to the prediction of late-life driving status. © The Author(s) 2014.

Evaluation of patient characteristics as predictors of health status in knee osteoarthritis patients referred for physical therapy.

PubMed

Gonçalves, Rui Soles; Cabri, Jan; Pinheiro, J P

2011-01-01

The purpose of this cross sectional study was to estimate the contributions of patient characteristics to variation in joint-specific and generic health status in knee osteoarthritis (OA) patients referred for physical therapy. The Portuguese Knee injury and Osteoarthritis Outcome Score (KOOS) and Medical Outcomes Study - 36 item Short Form (SF-36) questionnaires, and a form for the patient characteristics (gender, age, body mass index, profession, professional situation, educational level, marital status, duration of knee OA, involved knee and walking aids) were self-administered to 377 subjects with symptomatic knee OA (282 females, 95 males; age: 67.8 ± 8.2 years). Multiple stepwise regression analyses revealed that patient characteristics explained only 9.4% to 19.7% of the variance in KOOS subscales scores, and only 1.0% to 17.2% of the variance in SF-36 subscales scores. Therefore, it can be concluded that the patient characteristics studied were limited predictors of joint-specific and generic health status in knee OA patients referred for physical therapy.

Association of personality traits with oral health-related quality of life independently of objective oral health status: a study of community-dwelling elderly Japanese.

PubMed

Takeshita, Hajime; Ikebe, Kazunori; Kagawa, Ryosuke; Okada, Tadashi; Gondo, Yasuyuki; Nakagawa, Takeshi; Ishioka, Yoshiko; Inomata, Chisato; Tada, Sayaka; Matsuda, Ken-ichi; Kurushima, Yuko; Enoki, Kaori; Kamide, Kei; Masui, Yukie; Takahashi, Ryutaro; Arai, Yasumichi; Maeda, Yoshinobu

2015-03-01

Oral health-related quality of life (OHRQoL) is being increasingly used in epidemiologic studies of dentistry. However, patient-reported OHRQoL does not always coincide with clinical measures. Previous studies have shown a relationship between OHRQoL and personality, but did not concomitantly investigate oral function. We aimed to examine the association among personality traits, oral function, and OHRQoL using a large sample of community-dwelling Japanese elderly. The participants (n = 938; age, 69-71 years) were drawn from a complete enumeration of an urban area and a rural area of both the Tokyo metropolitan area and Hyogo Prefecture. The self-perceived impact of OHRQoL was measured using the Geriatric Oral Health Assessment Index (GOHAI). The oral status and socioeconomic characteristics were recorded in each participant, and personality traits (neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness) were assessed with the NEO-five-factor inventory. Multiple linear regression analysis was performed to examine the relationships between OHRQoL and other factors, with p < 0.05 considered to be statistically significant. Neuroticism was negatively associated with the GOHAI score in bivariate analyses (Spearman rank-order correlation coefficient (rs )= -0.20), whereas extraversion was positively associated (rs = 0.17). In the regression analyses, neuroticism (standardized partial regression coefficient (β) = -0.179) and extraversion (β=0.094) were significantly associated with the GOHAI scores independently of the number of teeth, maximal occlusal force, and financial status. Personality traits are associated with OHRQoL independently of objective measures of oral health status in community-dwelling elderly Japanese. This study showed personality traits are associated with OHRQoL independently of dental status and oral function in old Japanese people. As elderly patients undergo increasingly complex dental treatments, there is a need to evaluate patient personality traits prior to dental treatment and predict patient expectations and responses to planned treatment. This is advantageous in determining the most appropriate therapy. Copyright © 2015 Elsevier Ltd. All rights reserved.

Psychosocial factors for influencing healthy aging in adults in Korea.

PubMed

Han, KyungHun; Lee, YunJung; Gu, JaSung; Oh, Hee; Han, JongHee; Kim, KwuyBun

2015-03-07

Healthy aging includes physical, psychological, social, and spiritual well-being in later years. The purpose of this study is to identify the psychosocial factors influencing healthy aging and examining their socio-demographic characteristics. Perceived health status, depression, self-esteem, self-achievement, ego-integrity, participation in leisure activities, and loneliness were identified as influential factors in healthy aging. 171 Korean adults aged between 45 and 77 years-old participated in the study. Self-reporting questionnaires were used, followed by descriptive statistics and multiple regressions as inferential statistical analyses. There were significant differences between participants' general characteristics: age, education, religion, housing, hobby, and economic status. The factors related to healthy aging had positive correlation with perceived health status, self-esteem, self-achievements, and leisure activities, and negative correlation with depression and loneliness. The factors influencing healthy aging were depression, leisure activities, perceived health status, ego integrity, and self-achievements. These factors were able to explain 51.9%. According to the results, depression is the factor with the greatest influence on healthy aging. Perceived health status, ego integrity, self-achievement, self-esteem, participation of leisure activities were also influential on healthy aging as beneficial factors.

APOE polymorphism as a potential determinant of functional fitness in the elderly regardless of nutritional status.

PubMed

Snejdrlova, Michaela; Kalvach, Zdenek; Topinkova, Eva; Vrablik, Michal; Prochazkova, Renata; Kvasilova, Marie; Lanska, Vera; Zlatohlavek, Lukas; Prusikova, Martina; Ceska, Richard

2011-01-01

Life expectancy is determined by a combination of genetic predisposition (~25%) and environmental influences (~75%). Nevertheless a stronger genetic influence is anticipated in long-living individuals. Apolipoprotein E (APOE) gene belongs among the most studied candidate genes of longevity. We evaluated the relation of APOE polymorphism and fitness status in the elderly. We examined a total number of 128 subjects, over 80 years of age. Using a battery of functional tests their fitness status was assessed and the subjects were stratified into 5 functional categories according to Spirduso´s classification. Biochemistry analysis was performed by enzymatic method using automated analyzers. APOE gene polymorphism was analysed performed using PCR-RFLP. APOE4 allele carriers had significantly worse fitness status compared to non-carriers (p=0.025). Multiple logistic regression analysis showed the APOE4 carriers had higher risk (p=0.05) of functional unfitness compared to APOE2/E3 individuals. APOE gene polymorphism seems be an important genetic contributor to frailty development in the elderly. While APOE2 carriers tend to remain functionally fit till higher age, the functional status of APOE4 carriers deteriorates more rapidly. © 2011 Neuroendocrinology Letters

Fundamental Movement Skills among Iranian Primary School Children

PubMed Central

Aalizadeh, Bahman; Mohamadzadeh, Hassan; Hosseini, Fatemeh Sadat

2014-01-01

Objective: To determine the relationship between anthropometric indicators, physical activity (PA) and socioeconomic status (SES) with fundamental movement skills (FMS) among Iranian male students. Materials and methods: In this descriptive study, based on SES scores, 241 students (7-10 years) were randomly selected and classified in high, medium and low groups. All children were measured by 8 morphology anthropometric measures. In order to examine a subset of manipulative skills and to measure physical activity and socioeconomic status, Test of Gross Motor Development (TGMD2) and, interviewer-administered questionnaires were used, respectively. The data were analyzed using Pearson correlation and multiple regression. Results: There was a significant positive correlation between SES and body mass index (BMI), while a significant negative correlation existed between PA and BMI. Object control skills were significantly correlated with height, foot length, forearm length, hand length and physical activity. Conclusion: Students with low socioeconomic status were more qualified in movements than other students who were in medium and high socioeconomic status. Therefore, parents need to encourage students to be more active in order to prevent obesity and to facilitate development of object control skills in high socioeconomic status. PMID:25530767

Predictors of caregiving burden: impact of subjective health, negative affect, and loneliness of octogenarians and centenarians.

PubMed

Lee, Kyuho; Martin, Peter; Poon, Leonard W

2017-11-01

This study aimed (1) to determine whether octogenarian and centenarian care recipients' self-report on physical, social, and emotional status are different from caregivers' reports, (2) to assess associations between octogenarian and centenarian care recipients' poor physical, social, and emotional status and caregiver burden, and (3) to determine which report, the care recipients' self-report or caregivers' report, about the participants' physical and emotional status predicted more accurately levels of caregiver burden. Self-ratings and caregiver informant ratings were obtained from 309 participants of the Georgia Centenarian Study. Care recipients' health, negative affect, and loneliness were reported by both the caregivers and care recipients for the analyses. Differences between care recipients' and caregivers' reports were assessed by t-test. Blockwise multiple regression analysis was computed to assess predictors of caregiver burden. Caregivers' reports on the three measures were significantly higher than self-reports. Caregivers' negative affect and loneliness, not physical health, reported by caregivers predicted higher caregiver burden. Care recipients' reports did not predict caregiver burden. Caregivers perceived care recipients' social and emotional status more negatively, and caregivers' negative perceptions on care recipients' well-being status were an important predictor of caregiver burden.

The Silk Road Health Project: How Mobility and Migration Status Influence HIV Risks among Male Migrant Workers in Central Asia.

PubMed

El-Bassel, Nabila; Gilbert, Louisa; Shaw, Stacey A; Mergenova, Gaukhar; Terlikbayeva, Assel; Primbetova, Sholpan; Ma, Xin; Chang, Mingway; Ismayilova, Leyla; Hunt, Tim; West, Brooke; Wu, Elwin; Beyrer, Chris

2016-01-01

We examined whether mobility, migrant status, and risk environments are associated with sexually transmitted infections (STIs) and HIV risk behaviors (e.g. sex trading, multiple partners, and unprotected sex). We used Respondent Driven Sampling (RDS) to recruit external male migrant market vendors from Kyrgyzstan, Uzbekistan, and Tajikistan as well internal migrant and non-migrant market vendors from Kazakhstan. We conducted multivariate logistic regressions to examine the effects of mobility combined with the interaction between mobility and migration status on STIs and sexual risk behaviors, when controlling for risk environment characteristics. Mobility was associated with increased risk for biologically-confirmed STIs, sex trading, and unprotected sex among non-migrants, but not among internal or external migrants. Condom use rates were low among all three groups, particularly external migrants. Risk environment factors of low-income status, debt, homelessness, and limited access to medical care were associated with unprotected sex among external migrants. Study findings underscore the role mobility and risk environments play in shaping HIV/STI risks. They highlight the need to consider mobility in the context of migration status and other risk environment factors in developing effective prevention strategies for this population.

Association of Maternal Vitamin D Status with Glucose Tolerance and Caesarean Section in a Multi-Ethnic Asian Cohort: The Growing Up in Singapore Towards Healthy Outcomes Study

PubMed Central

Loy, See Ling; Lek, Ngee; Yap, Fabian; Soh, Shu E.; Padmapriya, Natarajan; Tan, Kok Hian; Biswas, Arijit; Yeo, George Seow Heong; Kwek, Kenneth; Gluckman, Peter D.; Godfrey, Keith M.; Saw, Seang Mei; Müller-Riemenschneider, Falk; Chong, Yap-Seng; Chong, Mary Foong-Fong; Chan, Jerry Kok Yen

2015-01-01

Objective Epidemiological studies relating maternal 25-hydroxyvitamin D (25OHD) with gestational diabetes mellitus (GDM) and mode of delivery have shown controversial results. We examined if maternal 25OHD status was associated with plasma glucose concentrations, risks of GDM and caesarean section in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study. Methods Plasma 25OHD concentrations, fasting glucose (FG) and 2-hour postprandial glucose (2HPPG) concentrations were measured in 940 women from a Singapore mother-offspring cohort study at 26–28 weeks’ gestation. 25OHD inadequacy and adequacy were defined based on concentrations of 25OHD ≤75nmol/l and >75nmol/l respectively. Mode of delivery was obtained from hospital records. Multiple linear regression was performed to examine the association between 25OHD status and glucose concentrations, while multiple logistic regression was performed to examine the association of 25OHD status with risks of GDM and caesarean section. Results In total, 388 (41.3%) women had 25OHD inadequacy. Of these, 131 (33.8%), 155 (39.9%) and 102 (26.3%) were Chinese, Malay and Indian respectively. After adjustment for confounders, maternal 25OHD inadequacy was associated with higher FG concentrations (β = 0.08mmol/l, 95% Confidence Interval (CI) = 0.01, 0.14), but not 2HPPG concentrations and risk of GDM. A trend between 25OHD inadequacy and higher likelihood of emergency caesarean section (Odds Ratio (OR) = 1.39, 95% CI = 0.95, 2.05) was observed. On stratification by ethnicity, the association with higher FG concentrations was significant in Malay women (β = 0.19mmol/l, 95% CI = 0.04, 0.33), while risk of emergency caesarean section was greater in Chinese (OR = 1.90, 95% CI = 1.06, 3.43) and Indian women (OR = 2.41, 95% CI = 1.01, 5.73). Conclusions 25OHD inadequacy is prevalent in pregnant Singaporean women, particularly among the Malay and Indian women. This is associated with higher FG concentrations in Malay women, and increased risk of emergency caesarean section in Chinese and Indian women. PMID:26571128

Association of Maternal Vitamin D Status with Glucose Tolerance and Caesarean Section in a Multi-Ethnic Asian Cohort: The Growing Up in Singapore Towards Healthy Outcomes Study.

PubMed

Loy, See Ling; Lek, Ngee; Yap, Fabian; Soh, Shu E; Padmapriya, Natarajan; Tan, Kok Hian; Biswas, Arijit; Yeo, George Seow Heong; Kwek, Kenneth; Gluckman, Peter D; Godfrey, Keith M; Saw, Seang Mei; Müller-Riemenschneider, Falk; Chong, Yap-Seng; Chong, Mary Foong-Fong; Chan, Jerry Kok Yen

2015-01-01

Epidemiological studies relating maternal 25-hydroxyvitamin D (25OHD) with gestational diabetes mellitus (GDM) and mode of delivery have shown controversial results. We examined if maternal 25OHD status was associated with plasma glucose concentrations, risks of GDM and caesarean section in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study. Plasma 25OHD concentrations, fasting glucose (FG) and 2-hour postprandial glucose (2HPPG) concentrations were measured in 940 women from a Singapore mother-offspring cohort study at 26-28 weeks' gestation. 25OHD inadequacy and adequacy were defined based on concentrations of 25OHD ≤75nmol/l and >75nmol/l respectively. Mode of delivery was obtained from hospital records. Multiple linear regression was performed to examine the association between 25OHD status and glucose concentrations, while multiple logistic regression was performed to examine the association of 25OHD status with risks of GDM and caesarean section. In total, 388 (41.3%) women had 25OHD inadequacy. Of these, 131 (33.8%), 155 (39.9%) and 102 (26.3%) were Chinese, Malay and Indian respectively. After adjustment for confounders, maternal 25OHD inadequacy was associated with higher FG concentrations (β = 0.08mmol/l, 95% Confidence Interval (CI) = 0.01, 0.14), but not 2HPPG concentrations and risk of GDM. A trend between 25OHD inadequacy and higher likelihood of emergency caesarean section (Odds Ratio (OR) = 1.39, 95% CI = 0.95, 2.05) was observed. On stratification by ethnicity, the association with higher FG concentrations was significant in Malay women (β = 0.19mmol/l, 95% CI = 0.04, 0.33), while risk of emergency caesarean section was greater in Chinese (OR = 1.90, 95% CI = 1.06, 3.43) and Indian women (OR = 2.41, 95% CI = 1.01, 5.73). 25OHD inadequacy is prevalent in pregnant Singaporean women, particularly among the Malay and Indian women. This is associated with higher FG concentrations in Malay women, and increased risk of emergency caesarean section in Chinese and Indian women.

Socio-economic and demographic factors influencing nutritional status among early childbearing young mothers in Bangladesh.

PubMed

Islam, Ashraful; Islam, Nurul; Bharati, Premananda; Aik, Saw; Hossain, Golam

2016-08-26

Early childbearing influences women's health. This study aims to examine the effects of socio-demographic factors on nutritional status of early childbearing mothers in Bangladesh based on Body Mass Index (BMI) as the indicator. Data was extracted from Bangladesh Demographic and Health Survey (BDHS)-2011. The survey was performed on 17,842 married women aged 15-49. We focused on early childbearing mothers (age ≤ 24, and who had delivered their first child ≤ 20). Mothers who were underweight (BMI ≤ 18.5 kg/m(2)) would be further classified into various grades of chronic energy deficiency (CED): mild (17.0 ≤ BMI < 18.5 kg/m(2)), moderate (16.0 ≤ BMI <17.0 kg/m(2)), and severe (BMI < 16.0 kg/m(2)). Multiple logistic regression model was used to examine the effect of socio-demographic factors on nutritional status. Mean age of the mothers was 20.49 ± 2.37 years (ranged 15-24 years). The prevalence of underweight among early childbearing mothers was 32.1 % (urban 25 % and rural 35.1 %). Most of the underweight mothers had mild (62.2 %) CED, while the remaining had either moderate (25.9 %) or severe (11.9 %) CED. Multiple logistic regression analysis demonstrated that young mothers from rural areas, poor families, and those who were illiterate or with low level of education, working, and married to unemployed husband were at higher risk for being underweight. Young mothers who had non-caesarean delivered, delivered at home, or married at early age and had more than two children were also at higher risk for being underweight. The prevalence of underweight among early childbearing mothers in Bangladesh is very high (32.1 %), associated with the still common practice of teenage marriage. Education level, wealth index, occupation, place of residence, age at first marriage and parity were important predictors for their nutritional status. The government and non-government organizations should take initiatives to reduce the prevalence of underweight mothers in Bangladesh.

The socioeconomic within-gender gap in informal caregiving among middle-aged women: Evidence from a Japanese nationwide survey.

PubMed

Tokunaga, Mutsumi; Hashimoto, Hideki

2017-01-01

Caregiving to older people with needs has been mainly dependent on informal care provision by female caregivers. Compared with the care burden gender gap, the within-gender gap in women's socioeconomic status (SES) has attracted less policy attention. We investigated the association between middle-aged women's SES and the likelihood of being a primary caregiver for elderly informal care, focusing on household income, women's marital status, work status, and educational background under the universal and public system of formal long-term care provision in Japan. We used repeated cross-sectional data from nationally representative household surveys conducted between 2010 and 2013 to obtain a sample of 2399 women aged between 40 and 60 years living in the same household as a care recipient. We conducted multiple logistic regression analysis to obtain odds ratios of being a primary caregiver in the household regressed on women's SES variables, adjusting for the characteristics of care recipients and household composition. The results showed that single women with lower education were likely to be primary caregivers when the care recipients had severe levels of care needs, whereas the association was null in the case of care recipients with milder conditions. The results indicated that women's low education and non-married status were related to a higher likelihood of becoming a primary caregiver of severely disabled elderly for reasons other than lower economic power. To emancipate socioeconomically vulnerable women from the care burden, a broader set of social, economic, and welfare policies are needed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Exploring the social determinants of mental health service use using intersectionality theory and CART analysis.

PubMed

Cairney, John; Veldhuizen, Scott; Vigod, Simone; Streiner, David L; Wade, Terrance J; Kurdyak, Paul

2014-02-01

Fewer than half of individuals with a mental disorder seek formal care in a given year. Much research has been conducted on the factors that influence service use in this population, but the methods generally used cannot easily identify the complex interactions that are thought to exist. In this paper, we examine predictors of subsequent service use among respondents to a population health survey who met criteria for a past-year mood, anxiety or substance-related disorder. To determine service use, we use an administrative database including all physician consultations in the period of interest. To identify predictors, we use classification tree (CART) analysis, a data mining technique with the ability to identify unsuspected interactions. We compare results to those from logistic regression models. We identify 1213 individuals with past-year disorder. In the year after the survey, 24% (n=312) of these had a mental health-related physician consultation. Logistic regression revealed that age, sex and marital status predicted service use. CART analysis yielded a set of rules based on age, sex, marital status and income adequacy, with marital status playing a role among men and by income adequacy important among women. CART analysis proved moderately effective overall, with agreement of 60%, sensitivity of 82% and specificity of 53%. Results highlight the potential of data-mining techniques to uncover complex interactions, and offer support to the view that the intersection of multiple statuses influence health and behaviour in ways that are difficult to identify with conventional statistics. The disadvantages of these methods are also discussed.

Lower Circulating B12 Is Associated with Higher Obesity and Insulin Resistance during Pregnancy in a Non-Diabetic White British Population.

PubMed

Knight, Bridget Ann; Shields, Beverley M; Brook, Adam; Hill, Anita; Bhat, Dattatray S; Hattersley, Andrew T; Yajnik, Chittaranjan S

2015-01-01

Vitamin B12 and folate are critical micronutrients needed to support the increased metabolic demands of pregnancy. Recent studies from India have suggested that low vitamin B12 and folate concentrations in pregnancy are associated with increased obesity; however differences in diet, antenatal vitamin supplementation, and socioeconomic status may limit the generalisability of these findings. We aimed to explore the cross-sectional relationship of circulating serum vitamin B12 and folate at 28 weeks' gestation with maternal adiposity and related biochemical markers in a white non diabetic UK obstetric cohort. Anthropometry and biochemistry data was available on 995 women recruited at 28 weeks gestation to the Exeter Family Study of Childhood Health. Associations between B12 and folate with maternal BMI and other obesity-related biochemical factors (HOMA-R, fasting glucose, triglycerides, HDL and AST) were explored using regression analysis, adjusting for potential confounders (socioeconomic status, vegetarian diet, vitamin supplementation, parity, haemodilution (haematocrit)). Higher 28 week BMI was associated with lower circulating vitamin B12 (r = -0.25; P<0.001) and folate (r = -0.15; P<0.001). In multiple regression analysis higher 28 week BMI remained an independent predictor of lower circulating B12 (β (95% CI) = -0.59 (-0.74, -0.44) i.e. for every 1% increase in BMI there was a 0.6% decrease in circulating B12). Other markers of adiposity/body fat metabolism (HOMA-R, triglycerides and AST) were also independently associated with circulating B12. In a similar multiple regression AST was the only independent obesity-related marker associated with serum folate (β (95% CI) = 0.16 (0.21, 0.51)). In conclusion, our study has replicated the previous Indian findings of associations between lower serum B12 and higher obesity and insulin resistance during pregnancy in a non-diabetic White British population. These findings may have important implications for fetal and maternal health in obese pregnancies.

Nutritional status according to Mini Nutritional Assessment is related to functional status in geriatric patients--independent of health status.

PubMed

Schrader, E; Baumgärtel, C; Gueldenzoph, H; Stehle, P; Uter, W; Sieber, C C; Volkert, D

2014-03-01

The aim of this study was to investigate the relationship between nutritional and functional status in acute geriatric patients including mobility and considering health status. Cross-sectional study. Hospital. 205 geriatric patients (median age 82.0 (IQR: 80-86) years, 69.3% women). Nutritional status was determined by Mini Nutritional Assessment (MNA) and patients were categorized as well-nourished (≥ 24 points), at risk of malnutrition (17-23.5 points) or as malnourished (< 17 points). Functional status was determined by Barthel Index (BI) and Timed 'Up and Go' Test (TUG) and related to MNA categories. Using binary multiple logistic regression the impact of nutritional status on functional status was examined, adjusted for health status. 60.3% of the patients were at risk of malnutrition and 29.8% were malnourished. Ability to perform basic activities of daily living (ADL) decreased with declining nutritional status. The proportion of patients unable to perform the TUG increased with worsening of nutritional status (45.0% vs. 50.4% vs. 77.0%, p<0.01). After adjusting for age, gender, number of diagnoses, disease severity and cognitive function, a higher MNA score significantly lowered the risk of being dependent in ADL (OR 0.85, 95 % CI 0.77-0.94) and inability to perform the TUG (OR 0.90, 95 % CI 0.82-0.99). Nutritional status according to MNA was related to ADL as well as to mobility in acute geriatric patients. This association remained after adjusting for health status.

[Prediction of perceived health status on job stress and family stress with middle school teachers].

PubMed

Park, Hyoung Sook; Jeong, Seong Hee; Park, Kyung Yeon

2007-06-01

The purpose of this study was to identify the relationship among job stress, family stress and perceived health status of middle school teachers and to present basic information about promoting health and coping with stress. Participants(N=547) was recruited in B city from November 2005 to December 2005. Data were analyzed with descriptive statistics, t-test, ANOVA, Pearson's correlation and multiple regression. The degree of job stress of the middle school teachers was 54.47 out of a total score of 88; that of family stress was 46.57 out of a total score of 96; and that of perceived health status was 78.59 out of the perfect score 100. There was a significantly negative relationship between job stress and perceived health status (r=-.274, p<.001), and family stress and perceived health status(r=-.408, p<.001). However, there was a positive relationship between job stress and family stress(r=.298, p<.001). Family stress, gender, charging subject, job stress, charging grade and number of family member was 27.1% of the variance in perceived health status of middle school teachers. Family stress has the most important impact on perceived health status with middle school teachers. Based on the finding, we could conclude that both job stress and family stress management should be required to improve perceived health status.

An ecological study on suicide and homicide in Brazil.

PubMed

Bando, Daniel Hideki; Lester, David

2014-04-01

The objective was to evaluate correlations between suicide, homicide and socio-demographic variables by an ecological study. Mortality and socio-demographic data were collected from official records of the Ministry of Health and IBGE (2010), aggregated by state (27). The data were analyzed using correlation techniques, factor analysis, principal component analysis with a varimax rotation and multiple linear regression. Suicide age-adjusted rates for the total population, men and women were 5.0, 8.0, and 2.2 per 100,000 inhabitants respectively. The suicide rates ranged from 2.7 in Pará to 9.1 in Rio Grande do Sul. Homicide for the total population, men and women were 27.2, 50.8, and 4.5 per 100,000, respectively. The homicide rates ranged from 13.0 in Santa Catarina to 68.9 in Alagoas. Suicide and homicide were negatively associated, the significance persisted among men. Unemployment was negatively correlated with suicide and positively with homicide. Different socio-demographic variables were found to correlate with suicide and homicide in the regressions. Suicide showed a pattern suggesting that, in Brazil, it is related to high socioeconomic status. Homicide seemed to follow the pattern found in other countries, associated with lower social and economic status.

A Technique of Fuzzy C-Mean in Multiple Linear Regression Model toward Paddy Yield

NASA Astrophysics Data System (ADS)

Syazwan Wahab, Nur; Saifullah Rusiman, Mohd; Mohamad, Mahathir; Amira Azmi, Nur; Che Him, Norziha; Ghazali Kamardan, M.; Ali, Maselan

2018-04-01

In this paper, we propose a hybrid model which is a combination of multiple linear regression model and fuzzy c-means method. This research involved a relationship between 20 variates of the top soil that are analyzed prior to planting of paddy yields at standard fertilizer rates. Data used were from the multi-location trials for rice carried out by MARDI at major paddy granary in Peninsular Malaysia during the period from 2009 to 2012. Missing observations were estimated using mean estimation techniques. The data were analyzed using multiple linear regression model and a combination of multiple linear regression model and fuzzy c-means method. Analysis of normality and multicollinearity indicate that the data is normally scattered without multicollinearity among independent variables. Analysis of fuzzy c-means cluster the yield of paddy into two clusters before the multiple linear regression model can be used. The comparison between two method indicate that the hybrid of multiple linear regression model and fuzzy c-means method outperform the multiple linear regression model with lower value of mean square error.

Drinking at college parties: examining the influence of student host-status and party-location.

PubMed

Buettner, Cynthia K; Khurana, Atika; Slesnick, Natasha

2011-12-01

The present research focuses on the party related drinking behaviors of college students and explores the differences in these behaviors based on students' host status (i.e. party host vs. party attendee). Furthermore, we examine if the differences in party hosts and attendees' drinking behaviors vary as a function of the party location (on-campus vs. off-campus). Multiple regression analyses were conducted using data from 3796 undergraduates at a Midwestern University. Findings revealed a significant interaction between host status and party location, such that student party hosts reported significantly greater drink consumption and related consequences as compared to party attendees, only when the party was organized off-campus. For parties organized on-campus, student hosts reported lower drink consumption as compared to attendees. College-based preventive interventions should target students likely to host off-campus parties due to their high risk for involvement in heavy drinking. Copyright © 2011 Elsevier Ltd. All rights reserved.

Unfavourable family characteristics and their associations with childhood obesity: a cross-sectional study.

PubMed

Moens, Ellen; Braet, Caroline; Bosmans, Guy; Rosseel, Yves

2009-07-01

This cross-sectional study explores the influence of multiple familial factors on children's weight status and the interaction between parenting stress and unfavourable family characteristics. A total of 197 families with children between 6 and 14 years participated in this study. Of this group, 97 families had a child with normal weight and 100 families had a child with overweight. Parents reported on seven family factors (maternal BMI, number of children, family structure, socioeconomic position, life events, parental psychopathology and parenting stress). Families with overweight children experience more parenting stress. A regression analysis revealed that familial factors explain 27% in the variance in child's weight status. The hypothesis that a combination of familial factors will be more able to explain child's adiposity could not be confirmed. Familial factors have moderate ability to predict children's weight status. There is a need to identify other familial mechanisms taking into account developmental and temporal evolutions over the past decade. 2009 John Wiley & Sons, Ltd and Eating Disorders Association

Maternal distress and intended breastfeeding duration.

PubMed

Rondó, Patricia H C; Souza, Márcia R

2007-03-01

To evaluate the associations between maternal psychological status and intended breastfeeding duration. A total of 852 pregnant women who attended antenatal care between September 1997 and August 2000 in 12 health units and five hospitals in Jundiaí city, Brazil, were included in the study. Psychological measures (stress and distress) were obtained at a gestational age from 30 to 36 weeks, using standardized scales, questionnaires and inventories. Psychological factors specifically related to breastfeeding assessed their worries, concerns, and support when breastfeeding. Multiple linear regression analysis identified the associations between the outcome "intended duration of breastfeeding" and psychological status of the mothers, controlling for toxic exposure, socioeconomic, demographic, obstetric and nutritional factors. There were negative associations between the outcome and distress, "concerned about body's changes", and work outside home, and a positive association between the outcome and marital status (p < or = 0.03). Early identification of distress in pregnant women and a more attentive encouragement to breastfeed is probably one of the steps to improve intended breastfeeding duration.

Mental Health of Children Living in Foster Families in Rural Rwanda: The Role of HIV and the Family Environment.

PubMed

Nduwimana, Estella; Mukunzi, Sylvere; Ng, Lauren C; Kirk, Catherine M; Bizimana, Justin I; Betancourt, Theresa S

2017-06-01

Fostering children is common in sub-Saharan Africa, but few studies examine these children's mental health needs. This study investigated the impact of living in a foster family on the mental health of HIV-positive, HIV-affected and HIV-unaffected children (n = 681 aged 10-17) in rural Rwanda. Regression analyses assessed the impact of living in a foster family on mental health, parenting, and daily hardships; multiple mediation analyses assessed whether family factors mediated the association between foster status and mental health. HIV-positive children were eight times more likely to live in foster families than HIV-unaffected children. Being HIV-affected was predictive of depression and irritability symptoms after controlling for family factors. Controlling for HIV-status, foster children had more symptoms of depression, anxiety, and irritability than non-fostered children. Positive parenting fully mediated the association between foster status and mental health. Mental health and parenting interventions for foster children and HIV-affected children may improve child outcomes.

Tongue thickness relates to nutritional status in the elderly.

PubMed

Tamura, Fumiyo; Kikutani, Takeshi; Tohara, Takashi; Yoshida, Mitsuyoshi; Yaegaki, Ken

2012-12-01

Many elderly people under long-term care suffer from malnutrition caused by dysphagia, frequently leading to sarcopenia. Our hypothesis is that sarcopenia may compromise oral function, resulting in dysphagia. The objectives of this study were to evaluate sarcopenia of the lingual muscles by measuring the tongue thickness, and elucidate its relationship with nutritional status. We examined 104 elderly subjects (mean age = 80.3 ± 7.9 years). Anthropometric data, such as triceps skinfold thickness and midarm muscle area (AMA), were obtained. The tongue thickness of the central part was determined using ultrasonography. Measurement was performed twice and the mean value was obtained. The relationship between tongue thickness and nutritional status was analyzed by Pearson's correlation coefficient and Spearman's rank correlation coefficient. AMA and age were identified by multiple-regression analysis as factors influencing tongue thickness. The results of this study suggest that malnutrition may induce sarcopenia not only in the skeletal muscles but also in the tongue.

Influence of Socioeconomic Factors, Gender and Indigenous Status on Smoking in Taiwan.

PubMed

Tsai, Liang-Ting; Lo, Feng-En; Yang, Chih-Chien; Lo, Wen-Min; Keller, Joseph Jordan; Hwang, Chiou-Wei; Lin, Ching-Feng; Lyu, Shu-Yu; Morisky, Donald E

2016-10-25

The indigenous Austronesian minority of Taiwan is heavily affected by health disparities which may include suffering from a greater burden of the tobacco epidemic. While a lack of representative data has historically precluded an investigation of the differences in smoking between Taiwanese ethnicities, these data have recently become available through an annual population-based telephone survey conducted by the Health Promotion Administration, Ministry of Health and Welfare (previously known as the Bureau of Health Promotion (BHP), Department of Health). We used the BHP monitoring data to observe the prevalence of smoking and environmental tobacco smoke exposure among indigenous and non-indigenous Taiwanese surrounding a tobacco welfare tax increase in 2006, investigate ethnic differences in smoking prevalence and environmental tobacco smoke exposure each year between 2005 and 2008, and perform multiple logistic regression to estimate measures of association between potential risk factors and smoking status. Despite significant ethnic and gender differences in smoking prevalence, smoking status was not found to be significantly associated with ethnicity after controlling for socioeconomic and demographic factors.

Around the Table: Food Insecurity, Socioeconomic Status, and Instrumental Social Support among Women Living in a Rural Kenyan Island Community.

PubMed

Nagata, Jason M; Fiorella, Kathryn J; Salmen, Charles R; Hickey, Matthew D; Mattah, Brian; Magerenge, Richard; Milner, Erin M; Weiser, Sheri D; Bukusi, Elizabeth A; Cohen, Craig R

2015-01-01

The objective of this study was to investigate the relationship among socioeconomic status, social support, and food insecurity in a rural Kenyan island community. A cross-sectional random sample of 111 female heads of households representing 583 household members were surveyed in Mfangano Island, Kenya from August to October 2010 using adaptations of the Household Food Insecurity Access Scale and the Medical Outcomes Study Social Support Survey. In multiple linear regression models, less instrumental social support, defined as concrete direct ways people help others (B = -0.81; 95% confidence interval [CI] -1.45 to -0.17), and decreased ownership scale based on owning material assets (B = -2.93; 95% CI -4.99 to -0.86) were significantly associated with increased food insecurity, controlling for age, education, marital status, and household size. Social support interventions geared at group capacity and resilience may be crucial adjuncts to improve and maintain the long term food security and health of persons living in low-resource regions.

Epidemiology of multiple childhood traumatic events: child abuse, parental psychopathology, and other family-level stressors.

PubMed

Menard, C B; Bandeen-Roche, K J; Chilcoat, H D

2004-11-01

Multiple family-level childhood stressors are common and are correlated. It is unknown if clusters of commonly co-occurring stressors are identifiable. The study was designed to explore family-level stressor clustering in the general population, to estimate the prevalence of exposure classes, and to examine the correlation of sociodemographic characteristics with class prevalence. Data were collected from an epidemiological sample and analyzed using latent class regression. A six-class solution was identified. Classes were characterized by low risk (prevalence=23%), universal high risk (7 %), family conflict (11 %), household substance problems (22 %), non-nuclear family structure (24 %), parent's mental illness (13 %). Class prevalence varied with race and welfare status, not gender. Interventions for childhood stressors are person-focused; the analytic approach may uniquely inform resource allocation.

Correlates of motivation to change in pathological gamblers completing cognitive-behavioral group therapy.

PubMed

Gómez-Peña, Mónica; Penelo, Eva; Granero, Roser; Fernández-Aranda, Fernando; Alvarez-Moya, Eva; Santamaría, Juan José; Moragas, Laura; Neus Aymamí, Maria; Gunnard, Katarina; Menchón, José M; Jimenez-Murcia, Susana

2012-07-01

The present study analyzes the association between the motivation to change and the cognitive-behavioral group intervention, in terms of dropouts and relapses, in a sample of male pathological gamblers. The specific objectives were as follows: (a) to estimate the predictive value of baseline University of Rhode Island Change Assessment scale (URICA) scores (i.e., at the start of the study) as regards the risk of relapse and dropout during treatment and (b) to assess the incremental predictive ability of URICA scores, as regards the mean change produced in the clinical status of patients between the start and finish of treatment. The relationship between the URICA and the response to treatment was analyzed by means of a pre-post design applied to a sample of 191 patients who were consecutively receiving cognitive-behavioral group therapy. The statistical analysis included logistic regression models and hierarchical multiple linear regression models. The discriminative ability of the models including the four URICA scores regarding the likelihood of relapse and dropout was acceptable (area under the receiver operating haracteristic curve: .73 and .71, respectively). No significant predictive ability was found as regards the differences between baseline and posttreatment scores (changes in R(2) below 5% in the multiple regression models). The availability of useful measures of motivation to change would enable treatment outcomes to be optimized through the application of specific therapeutic interventions. © 2012 Wiley Periodicals, Inc.

Estimating Time to Event From Longitudinal Categorical Data: An Analysis of Multiple Sclerosis Progression.

PubMed

Mandel, Micha; Gauthier, Susan A; Guttmann, Charles R G; Weiner, Howard L; Betensky, Rebecca A

2007-12-01

The expanded disability status scale (EDSS) is an ordinal score that measures progression in multiple sclerosis (MS). Progression is defined as reaching EDSS of a certain level (absolute progression) or increasing of one point of EDSS (relative progression). Survival methods for time to progression are not adequate for such data since they do not exploit the EDSS level at the end of follow-up. Instead, we suggest a Markov transitional model applicable for repeated categorical or ordinal data. This approach enables derivation of covariate-specific survival curves, obtained after estimation of the regression coefficients and manipulations of the resulting transition matrix. Large sample theory and resampling methods are employed to derive pointwise confidence intervals, which perform well in simulation. Methods for generating survival curves for time to EDSS of a certain level, time to increase of EDSS of at least one point, and time to two consecutive visits with EDSS greater than three are described explicitly. The regression models described are easily implemented using standard software packages. Survival curves are obtained from the regression results using packages that support simple matrix calculation. We present and demonstrate our method on data collected at the Partners MS center in Boston, MA. We apply our approach to progression defined by time to two consecutive visits with EDSS greater than three, and calculate crude (without covariates) and covariate-specific curves.

Positive effect of human milk feeding during NICU hospitalization on 24 month neurodevelopment of very low birth weight infants: an Italian cohort study.

PubMed

Gibertoni, Dino; Corvaglia, Luigi; Vandini, Silvia; Rucci, Paola; Savini, Silvia; Alessandroni, Rosina; Sansavini, Alessandra; Fantini, Maria Pia; Faldella, Giacomo

2015-01-01

The aim of this study was to determine the effect of human milk feeding during NICU hospitalization on neurodevelopment at 24 months of corrected age in very low birth weight infants. A cohort of 316 very low birth weight newborns (weight ≤ 1500 g) was prospectively enrolled in a follow-up program on admission to the Neonatal Intensive Care Unit of S. Orsola Hospital, Bologna, Italy, from January 2005 to June 2011. Neurodevelopment was evaluated at 24 months corrected age using the Griffiths Mental Development Scale. The effect of human milk nutrition on neurodevelopment was first investigated using a multiple linear regression model, to adjust for the effects of gestational age, small for gestational age, complications at birth and during hospitalization, growth restriction at discharge and socio-economic status. Path analysis was then used to refine the multiple regression model, taking into account the relationships among predictors and their temporal sequence. Human milk feeding during NICU hospitalization and higher socio-economic status were associated with better neurodevelopment at 24 months in both models. In the path analysis model intraventricular hemorrhage-periventricular leukomalacia and growth restriction at discharge proved to be directly and independently associated with poorer neurodevelopment. Gestational age and growth restriction at birth had indirect significant effects on neurodevelopment, which were mediated by complications that occurred at birth and during hospitalization, growth restriction at discharge and type of feeding. In conclusion, our findings suggest that mother's human milk feeding during hospitalization can be encouraged because it may improve neurodevelopment at 24 months corrected age.

Seasonal variations of 25-OH vitamin D serum levels are associated with clinical disease activity in multiple sclerosis patients.

PubMed

Hartl, Christina; Obermeier, Viola; Gerdes, Lisa Ann; Brügel, Mathias; von Kries, Rüdiger; Kümpfel, Tania

2017-04-15

Low 25-hydroxy vitamin D (25-[OH]-D) serum concentrations have been associated with higher disease activity in multiple sclerosis (MS) patients. In a large cross-sectional study we assessed the vitamin D status in MS patients in relation to seasonality and relapse rate. 415 MS-patients (355 relapsing-remitting MS and 60 secondary-progressive, 282 female, mean age 39.1years) of whom 25-(OH)-D serum concentrations were determined at visits between 2010 and 2013 were included in the study. All clinical data including relapse at visit and expanded disability status scale were recorded in a standardized manner by an experienced neurologist. Seasonal variations of 25-(OH)-D serum concentrations were modelled by sinusoidal regression and seasonal variability in the prevalence of relapse by cubic regression. The mean 25-(OH)-D serum concentration was 24.8ng/ml (range 8.3-140ng/ml) with peak levels of 32.2ng/ml in July/August and nadir in January/February (17.2ng/ml). The lowest modelled prevalence of relapse was in September/October (28%) and the highest modelled prevalence in March/April (47%). The nadir of 25-(OH)-D serum concentrations preceded the peak in prevalence of relapses by two months. In summary, seasonal variation of 25-(OH)-D serum levels were inversely associated with clinical disease activity in MS patients. Future studies should investigate whether vitamin D supplementation in MS patients may decrease the seasonal risk for MS relapses. Copyright © 2017 Elsevier B.V. All rights reserved.

Knowledge, attitudes, beliefs, and practices about HIV/AIDS in Kuwait.

PubMed

al-Owaish, R; Moussa, M A; Anwar, S; al-Shoumer, H; Sharma, P

1999-04-01

This survey is aimed at assessing knowledge, attitudes, beliefs and practices in Kuwait regarding AIDS/HIV. Structured face-to-face interviews were conducted during the year 1995 on a sample of 2,219 subjects, aged 18 to 60, health professionals were excluded. The survey instrument included 26 questions on AIDS/HIV knowledge, 6 about attitudes and beliefs, and 6 about behavior and practice. The remaining 22 items dealt with sociodemographic characteristics, role of religion, source of information, and satisfaction about AIDS control programs. Two thirds of subjects had good knowledge about the main modes of HIV/AIDS transmission. Using a multiple regression model, the knowledge score was positively associated with level of education, age, years of hearing about AIDS, and socioeconomic status. The multiple logistic regression showed that subjects tend not to change their behavior related to AIDS if they were less than 40 years old, had low education, were females, single, had a lower socioeconomic status, had heard about AIDS for less than 3 years, and had a low level of knowledge about AIDS. More than half of the participants were satisfied with the government's action for AIDS prevention. The majority of subjects thought that religion was important in dealing with daily life problems. In conclusion, while most of the people in Kuwait were aware of the main modes of AIDS transmission, a gap existed about modes that did not transmit the disease. This was reflected in their attitudes and practice toward AIDS patients. The study calls for a greater role for medical professionals, mass media, and religion in AIDS prevention and control.

Nonmedical Prescription Opioid Use Among Victimized Women On Probation And Parole

PubMed Central

Hall, Martin T.; Golder, Seana; Higgins, George E.; Logan, TK

2015-01-01

Background Nonmedical prescription opioid use (NPOU) is a major public health concern and few studies have described this phenomenon among victimized women involved in the criminal justice system. Objective This study will describe the relationship between victimization, psychological distress, health status and NPOU among the vulnerable population of victimized women on probation and parole. Methods A sample of 406 women on probation and parole responded to items assessing victimization history, self-reported health status, physical pain, psychological distress, and post-traumatic stress disorder. Multiple logistic regression analysis was utilized to differentiate NPOUs versus nonusers. Results Overall, 169 (41.6%) women reported lifetime NPOU, and 20% reported use in the past year. Compared to women who did not report NPOU, NPOUs were more likely to be White, have poorer general health, and more severe psychological distress across nine symptom domains. In multiple logistic regression models, each year of age reduced the odds of NPOU by 4%; White women were twice as likely as women of other races to report NPOU; each unit increase in the measure for physical pain was associated with a 30% increase in the odds of NPOU; and participants who met diagnostic criteria for PTSD were 60% more likely to report NPOU compared to individuals who did not. Conclusion Victimized women on probation and parole report high rates of NPOU and comorbid mental and physical health problems. The criminal justice system should routinely screen for NPOU, as well as untreated or poorly managed physical pain and psychological distress, which may increase risk of NPOU. PMID:26476007

Taste sensitivity, nutritional status and metabolic syndrome: Implication in weight loss dietary interventions

PubMed Central

Bertoli, Simona; Laureati, Monica; Battezzati, Alberto; Bergamaschi, Valentina; Cereda, Emanuele; Spadafranca, Angela; Vignati, Laila; Pagliarini, Ella

2014-01-01

AIM: We investigated the relationship between taste sensitivity, nutritional status and metabolic syndrome and possible implications on weight loss dietary program. METHODS: Sensitivity for bitter, sweet, salty and sour tastes was assessed by the three-Alternative-Forced-Choice method in 41 overweight (OW), 52 obese (OB) patients and 56 normal-weight matched controls. OW and OB were assessed also for body composition (by impedence), resting energy expenditure (by indirect calorimetry) and presence of metabolic syndrome (MetS) and were prescribed a weight loss diet. Compliance to the weight loss dietary program was defined as adherence to control visits and weight loss ≥ 5% in 3 mo. RESULTS: Sex and age-adjusted multiple regression models revealed a significant association between body mass index (BMI) and both sour taste (P < 0.05) and global taste acuity score (GTAS) (P < 0.05), with lower sensitivity with increasing BMI. This trend in sensitivity for sour taste was also confirmed by the model refitted on the OW/OB group while the association with GTAS was marginally significant (P = 0.06). MetS+ subjects presented higher thresholds for salty taste when compared to MetS- patients while no significant difference was detected for the other tastes and GTAS. As assessed by multiple regression model, the association between salty taste and MetS appeared to be independent of sex, age and BMI. Patients continuing the program (n = 37) did not show any difference in baseline taste sensitivity when compared to drop-outs (n = 29). Similarly, no significant difference was detected between patients reporting and not reporting a weight loss ≥ 5% of the initial body weight. No significant difference in taste sensitivity was detected even after dividing patients on the basis of nutritional (OW and OB) or metabolic status (MetS+ and MetS-). CONCLUSION: There is no cause-effect relationship between overweight and metabolic derangements. Taste thresholds assessment is not useful in predicting the outcome of a diet-induced weight loss program. PMID:25317249

Parents' perception of health-related quality of life in children and adolescents with excess weight.

PubMed

Nascimento, Melissa Maria Romero; Melo, Tatiana Rocha; Pinto, Rogério Melo Costa; Morales, Nívea Macedo Oliveira; Mendonça, Tânia Maria Silva; Paro, Helena Borges Martins da Silva; Silva, Carlos Henrique Martins

2016-01-01

To evaluate the perception of parents or caregivers on the health-related quality of life (HRQOL) of children/adolescents with overweight/obesity and possible factors associated with this perception. This was a cross-sectional study involving 297 caregivers of children and adolescents with normal weight (n=170) and with overweight/obesity (n=127), from public and private schools in the study municipality. HRQOL scores obtained through the Child Health Questionnaire - Parent Form 50 (CHQ-PF50) were compared according to the nutritional status and gender of the children/adolescents. Multiple regression analysis was used to determine the predictive value of studied variables for the variation in HRQOL scores. Parents of children/adolescents with overweight/obesity attributed lower HRQOL scores to their children in the following domains: physical functioning (p<0.01; d=0.49), self-esteem (p<0.01; d=0.38), parental impact-emotional (p<0.05; d=0.29), family cohesion (p<0.05; d=0.26), physical summary score (p<0.05; d=0.29), and psychosocial summary score (p<0.05; d=0.25). In the multiple regression models, the variables with the highest contribution to the variation in HRQOL scores were: in the physical functioning domain, parental impact-time (β=0.23; p<0.05); self-esteem, nutritional status (β=-0.18; p≤0.01); emotional impact on parents, impact on parents' time (β=0.31; p<0.05); and in family cohesion, global behavior (β=0.30; p<0.05). A negative impact on HRQOL of children/adolescents with overweight/obesity was observed in the physical and psychosocial aspects. The nutritional status was the variable with the greatest contribution for the assessment the self-esteem of children and adolescents in this study. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Generalized Linear Mixed Model Analysis of Urban-Rural Differences in Social and Behavioral Factors for Colorectal Cancer Screening

PubMed Central

Wang, Ke-Sheng; Liu, Xuefeng; Ategbole, Muyiwa; Xie, Xin; Liu, Ying; Xu, Chun; Xie, Changchun; Sha, Zhanxin

2017-01-01

Objective: Screening for colorectal cancer (CRC) can reduce disease incidence, morbidity, and mortality. However, few studies have investigated the urban-rural differences in social and behavioral factors influencing CRC screening. The objective of the study was to investigate the potential factors across urban-rural groups on the usage of CRC screening. Methods: A total of 38,505 adults (aged ≥40 years) were selected from the 2009 California Health Interview Survey (CHIS) data - the latest CHIS data on CRC screening. The weighted generalized linear mixed-model (WGLIMM) was used to deal with this hierarchical structure data. Weighted simple and multiple mixed logistic regression analyses in SAS ver. 9.4 were used to obtain the odds ratios (ORs) and their 95% confidence intervals (CIs). Results: The overall prevalence of CRC screening was 48.1% while the prevalence in four residence groups - urban, second city, suburban, and town/rural, were 45.8%, 46.9%, 53.7% and 50.1%, respectively. The results of WGLIMM analysis showed that there was residence effect (p<0.0001) and residence groups had significant interactions with gender, age group, education level, and employment status (p<0.05). Multiple logistic regression analysis revealed that age, race, marital status, education level, employment stats, binge drinking, and smoking status were associated with CRC screening (p<0.05). Stratified by residence regions, age and poverty level showed associations with CRC screening in all four residence groups. Education level was positively associated with CRC screening in second city and suburban. Infrequent binge drinking was associated with CRC screening in urban and suburban; while current smoking was a protective factor in urban and town/rural groups. Conclusions: Mixed models are useful to deal with the clustered survey data. Social factors and behavioral factors (binge drinking and smoking) were associated with CRC screening and the associations were affected by living areas such as urban and rural regions. PMID:28952708

Generalized Linear Mixed Model Analysis of Urban-Rural Differences in Social and Behavioral Factors for Colorectal Cancer Screening

PubMed

Wang, Ke-Sheng; Liu, Xuefeng; Ategbole, Muyiwa; Xie, Xin; Liu, Ying; Xu, Chun; Xie, Changchun; Sha, Zhanxin

2017-09-27

Objective: Screening for colorectal cancer (CRC) can reduce disease incidence, morbidity, and mortality. However, few studies have investigated the urban-rural differences in social and behavioral factors influencing CRC screening. The objective of the study was to investigate the potential factors across urban-rural groups on the usage of CRC screening. Methods: A total of 38,505 adults (aged ≥40 years) were selected from the 2009 California Health Interview Survey (CHIS) data - the latest CHIS data on CRC screening. The weighted generalized linear mixed-model (WGLIMM) was used to deal with this hierarchical structure data. Weighted simple and multiple mixed logistic regression analyses in SAS ver. 9.4 were used to obtain the odds ratios (ORs) and their 95% confidence intervals (CIs). Results: The overall prevalence of CRC screening was 48.1% while the prevalence in four residence groups - urban, second city, suburban, and town/rural, were 45.8%, 46.9%, 53.7% and 50.1%, respectively. The results of WGLIMM analysis showed that there was residence effect (p<0.0001) and residence groups had significant interactions with gender, age group, education level, and employment status (p<0.05). Multiple logistic regression analysis revealed that age, race, marital status, education level, employment stats, binge drinking, and smoking status were associated with CRC screening (p<0.05). Stratified by residence regions, age and poverty level showed associations with CRC screening in all four residence groups. Education level was positively associated with CRC screening in second city and suburban. Infrequent binge drinking was associated with CRC screening in urban and suburban; while current smoking was a protective factor in urban and town/rural groups. Conclusions: Mixed models are useful to deal with the clustered survey data. Social factors and behavioral factors (binge drinking and smoking) were associated with CRC screening and the associations were affected by living areas such as urban and rural regions. Creative Commons Attribution License

Menopausal status and physical performance in middle aged women: a cross-sectional community-based study in Northeast Brazil.

PubMed

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.

Psychosocial work environment and its association with socioeconomic status. A comparison of Spain and Denmark.

PubMed

Moncada, Salvador; Pejtersen, Jan Hyld; Navarro, Albert; Llorens, Clara; Burr, Hermann; Hasle, Peter; Bjorner, Jakob Bue

2010-02-01

The purpose of this study was to describe psychosocial work environment inequalities among wage earners in Spain and Denmark. Data came from the Spanish COPSOQ (ISTAS 21) and the Danish COPSOQ II surveys both performed in 2004-05 and based on national representative samples of employees with a 60% response rate. Study population was 3,359 Danish and 6,685 Spanish women and men. Only identical items from both surveys were included to construct 18 psychosocial scales. Socioeconomic status was categorized according to the European Socioeconomic Classification System. Analysis included ordinal logistic regression and multiple correspondence analysis after categorizing all scales. A relationship between socioeconomic status and psychosocial work environment in both Denmark and Spain was observed, with wider social inequalities in Spain for many scales, describing a strong interaction effect between socioeconomic status and country. Socioeconomic status is related to psychosocial work environment and some adverse psychosocial conditions tend to cluster in lower socioeconomic status groups in both Spain and Denmark. This effect could be modified by a country's characteristics, such as economic and labour market structures, normative regulations and industrial relations including work organization. Hence, preventive strategies to reduce social inequalities in working conditions should consider the combination of actions at the macro and micro levels.

Factors Related to Positive Changes in Perceived Health Status of Married Han Chinese and Korean-Chinese Women After Immigration to Korea.

PubMed

Asano, Kana; Ryu, Si Hyun; Chin, Meejung; Yoon, Jihyun

2016-11-01

This study aimed to compare factors related to changes in perceived health status of Han Chinese (traditional Chinese) and Korean-Chinese (Chinese nationals of Korean descent) women after immigration to Korea. During summer 2013, a survey was conducted with 151 Han and 158 Korean-Chinese women married to Korean men. Most of the respondents reported either no changes (82%) or positive changes (18%) in their perceived health status after immigration. The results of the multiple logistic regression analyses indicated healthy dietary behavior was related to positive changes in the perceived health status of both groups (odds ratio [OR] = 7.4 for Han Chinese; OR = 14.6 for Korean-Chinese). Among Han Chinese women, the length of residence in Korea and the change in perceived health status showed a negative relation (OR = 0.2). In contrast, their level of acculturation and health perception were positive (OR = 7.5). However, these results did not apply to the Korean-Chinese women. In conclusion, factors related to changes in perceived health status differed between the 2 groups although they shared healthy dietary behaviors as a common factor. Therefore, policies and programs aimed at promoting immigrant women's health should consider the differences between Han Chinese and Korean-Chinese. © 2016 APJPH.

Assessment of nutritional status and health-related quality of life before and after liver transplantation.

PubMed

García-Rodríguez, María Teresa; Piñón-Villar, María Del Carmen; López-Calviño, Beatriz; Otero-Ferreiro, Alejandra; Suárez-López, Francisco; Gómez-Gutiérrez, Manuel; Pita-Fernández, Salvador

2015-01-22

Patients with chronic liver disease frequently suffer from malnutrition, together with a decline in their health-related quality of life. This study was carried out with the aim of evaluating the nutritional status, complications of medical and surgical care, anxiety, health-related quality of life and dependence level on basic and instrumental activities of daily living in pre- and post-liver transplant patients. A prospective observational study with follow-up of patients on the waiting list for liver transplants who subsequently received a transplant at the University Hospital Complex in A Coruña during the period 2012-2014 (n = 110). All the patients will be followed-up for a maximum of 6 months. For survivors, assessments will be re-evaluated at one, three and six months post- transplant. Informed consent of the patient and ethical review board approval was obtained (Code: 2010/081 and 2010/082). The following variables will be studied: socio-demographic data, reason for the transplant, comorbidity (Charlson Score), analytical parameters, time on transplant waiting list and post-transplant complications. A trained nurse will evaluate the following for each patient: nutritional indices, anthropometric variables and handgrip strength. Validated questionnaires will be used to determine the patients' nutritional status (Subjective Global Assessment), anxiety (STAI questionnaire), Health-Related Quality of Life (LDQoL 1.0 questionnaire), dependence (Barthel Index and Lawton-Brody Scale), nursing diagnoses (NANDA) and post-transplant quality indicators. Multiple linear/logistic regression models will be used to identify variables associated with the events of interest. Changes in nutritional status, quality of life and dependence over time will be analysed with linear mixed-effects regression models. Actuarial survival analysis using Kaplan-Meier curves, Cox regression and competitive risk will be performed Concordance between the different scores that assess nutritional status and interobserver agreement regarding nursing diagnoses will be studied using the statistical Kappa index and Bland Altman method. The risk of malnutrition can be considered as a possible prognostic factor in transplant outcomes, associated with anxiety, health-related quality of life and dependence. For this reason we consider interesting to perform a prospective follow-up study of patients who require a transplant to survive, studying their nutritional status and health-related quality of life.

Ordinal logistic regression analysis on the nutritional status of children in KarangKitri village

NASA Astrophysics Data System (ADS)

Ohyver, Margaretha; Yongharto, Kimmy Octavian

2015-09-01

Ordinal logistic regression is a statistical technique that can be used to describe the relationship between ordinal response variable with one or more independent variables. This method has been used in various fields including in the health field. In this research, ordinal logistic regression is used to describe the relationship between nutritional status of children with age, gender, height, and family status. Nutritional status of children in this research is divided into over nutrition, well nutrition, less nutrition, and malnutrition. The purpose for this research is to describe the characteristics of children in the KarangKitri Village and to determine the factors that influence the nutritional status of children in the KarangKitri village. There are three things that obtained from this research. First, there are still children who are not categorized as well nutritional status. Second, there are children who come from sufficient economic level which include in not normal status. Third, the factors that affect the nutritional level of children are age, family status, and height.

Breast Cancer and Modifiable Lifestyle Factors in Argentinean Women: Addressing Missing Data in a Case-Control Study

PubMed Central

Coquet, Julia Becaria; Tumas, Natalia; Osella, Alberto Ruben; Tanzi, Matteo; Franco, Isabella; Diaz, Maria Del Pilar

2016-01-01

A number of studies have evidenced the effect of modifiable lifestyle factors such as diet, breastfeeding and nutritional status on breast cancer risk. However, none have addressed the missing data problem in nutritional epidemiologic research in South America. Missing data is a frequent problem in breast cancer studies and epidemiological settings in general. Estimates of effect obtained from these studies may be biased, if no appropriate method for handling missing data is applied. We performed Multiple Imputation for missing values on covariates in a breast cancer case-control study of Córdoba (Argentina) to optimize risk estimates. Data was obtained from a breast cancer case control study from 2008 to 2015 (318 cases, 526 controls). Complete case analysis and multiple imputation using chained equations were the methods applied to estimate the effects of a Traditional dietary pattern and other recognized factors associated with breast cancer. Physical activity and socioeconomic status were imputed. Logistic regression models were performed. When complete case analysis was performed only 31% of women were considered. Although a positive association of Traditional dietary pattern and breast cancer was observed from both approaches (complete case analysis OR=1.3, 95%CI=1.0-1.7; multiple imputation OR=1.4, 95%CI=1.2-1.7), effects of other covariates, like BMI and breastfeeding, were only identified when multiple imputation was considered. A Traditional dietary pattern, BMI and breastfeeding are associated with the occurrence of breast cancer in this Argentinean population when multiple imputation is appropriately performed. Multiple Imputation is suggested in Latin America’s epidemiologic studies to optimize effect estimates in the future. PMID:27892664

Family support and other social factors precipitating suicidal ideation.

PubMed

Hirsch, J; Ellis, J B

1995-01-01

To examine the effects of family support and demographics on suicidal behavior, 385 subjects completed a demographic questionnaire and a Suicidal Ideation Questionnaire (SIQ). Sixteen percent described themselves as "serious" ideators, while 59% were seen as ideators, numbers consistent with past suicide research. Multiple regression analyses revealed that the type of caregiver a person reported having while growing up accounted for a significant amount of the variance on ideator status. Serious ideators were more common among single parent households. Although many demographic variables were assessed, only the primary caregiver a person had as a child impacted their status as a suicidal ideator. This suggests that suicidal behaviors may occur due to a complex interaction between social factors and childhood care. The influence of living in a single-parent home may contribute to whether or not a person considers suicide.

Configurations of Adolescents' Peer Experiences: Associations With Parent-Child Relationship Quality and Parental Problem Behavior.

PubMed

Kretschmer, Tina; Sentse, Miranda; Meeus, Wim; Verhulst, Frank C; Veenstra, René; Oldehinkel, Albertine J

2016-09-01

Adolescents' peer experiences embrace behavior, relationship quality, status, and victimization, but studies that account for multiple dimensions are rare. Using latent profile modeling and measures of peer behavior, relationship quality, peer status, and victimization assessed from 1,677 adolescents, four profiles were identified: High Quality, Low Quality, Low Quality Victimized, and Deviant Peers. Multinomial logistic regressions showed that negative parent-child relationships in preadolescence reduced the likelihood of High Quality peer relations in mid-adolescence but only partly differentiated between the other three profiles. Moderation by gender was partly found with girls showing greater sensitivity to parent-child relationship quality with respect to peer experiences. Results underline the multifaceted nature of peer experiences, and practical and theoretical implications are discussed. © 2015 The Authors. Journal of Research on Adolescence © 2015 Society for Research on Adolescence.

Characteristics of foraging sites and protein status in wintering muskoxen: insights from isotopes of nitrogen

USGS Publications Warehouse

Gustine, David D.; Barboza, Perry S.; Lawler, James P.; Arthur, Stephen M.; Shults, Brad S.; Persons, Kate; Adams, Layne G.

2011-01-01

Identifying links between nutritional condition of individuals and population trajectories greatly enhances our understanding of the ecology, conservation, and management of wildlife. For northern ungulates, the potential impacts of a changing climate to populations are predicted to be nutritionally mediated through an increase in the severity and variance in winter conditions. Foraging conditions and the availability of body protein as a store for reproduction in late winter may constrain productivity in northern ungulates, yet the link between characteristics of wintering habitats and protein status has not been established for a wild ungulate. We used a non‐invasive proxy of protein status derived from isotopes of N in excreta to evaluate the influence of winter habitats on the protein status of muskoxen in three populations in Alaska (2005–2008). Multiple regression and an information‐theoretic approach were used to compare models that evaluated the influence of population, year, and characteristics of foraging sites (components of diet and physiography) on protein status for groups of muskoxen. The observed variance in protein status among groups of muskoxen across populations and years was partially explained (45%) by local foraging conditions that affected forage availability. Protein status improved for groups of muskoxen as the amount of graminoids in the diet increased (−0.430 ± 0.31, β± 95% CI) and elevation of foraging sites decreased (0.824 ± 0.67). Resources available for reproduction in muskoxen are highly dependent upon demographic, environmental, and physiographic constraints that affect forage availability in winter. Due to their very sedentary nature in winter, muskoxen are highly susceptible to localized foraging conditions; therefore, the spatial variance in resource availability may exert a strong effect on productivity. Consequently, there is a clear need to account for climate–topography effects in winter at multiple scales when predicting the potential impacts of climatic shifts on population trajectories of muskoxen.

Shift work schedule and night work load: Effects on body mass index - a four-year longitudinal study.

PubMed

Buchvold, Hogne Vikanes; Pallesen, Ståle; Waage, Siri; Bjorvatn, Bjørn

2018-05-01

Objectives The aim of this study was to investigate changes in body mass index (BMI) between different work schedules and different average number of yearly night shifts over a four-year follow-up period. Methods A prospective study of Norwegian nurses (N=2965) with different work schedules was conducted: day only, two-shift rotation (day and evening shifts), three-shift rotation (day, evening and night shifts), night only, those who changed towards night shifts, and those who changed away from schedules containing night shifts. Paired student's t-tests were used to evaluate within subgroup changes in BMI. Multiple linear regression analysis was used to evaluate between groups effects on BMI when adjusting for BMI at baseline, sex, age, marital status, children living at home, and years since graduation. The same regression model was used to evaluate the effect of average number of yearly night shifts on BMI change. Results We found that night workers [mean difference (MD) 1.30 (95% CI 0.70-1.90)], two shift workers [MD 0.48 (95% CI 0.20-0.75)], three shift workers [MD 0.46 (95% CI 0.30-0.62)], and those who changed work schedule away from [MD 0.57 (95% CI 0.17-0.84)] or towards night work [MD 0.63 (95% CI 0.20-1.05)] all had significant BMI gain (P<0.01) during the follow-up period. However, day workers had a non-significant BMI gain. Using adjusted multiple linear regressions, we found that night workers had significantly larger BMI gain compared to day workers [B=0.89 (95% CI 0.06-1.72), P<0.05]. We did not find any significant association between average number of yearly night shifts and BMI change using our multiple linear regression model. Conclusions After adjusting for possible confounders, we found that BMI increased significantly more among night workers compared to day workers.

Reported prevalence of gestational diabetes in Scotland: The relationship with obesity, age, socioeconomic status, smoking and macrosomia, and how many are we missing?

PubMed

Collier, Andrew; Abraham, E Christie; Armstrong, Julie; Godwin, Jon; Monteath, Kirsten; Lindsay, Robert

2017-03-01

Gestational diabetes mellitus (GDM) is defined as 'carbohydrate intolerance of varying degrees of severity with onset or first recognition during pregnancy,' and is associated with increased fetal and maternal risks. The aims of the present study were to investigate the prevalence of GDM in Scotland over 32 years (1981-2012), and using the data from 2012, to assess how GDM related to maternal body mass index, maternal age, parity, smoking, Scottish Index of Multiple Deprivation, infant gender and macrosomia status. GDM prevalence along with anthropometric, obstetric and demographic data were collected on a total of 1,891,097 women with a delivery episode between 1 January 1981 and 31 December 2012 using data extracted from the Scottish Morbidity Record 02. Univariate and multivariate logistic regression analysis was undertaken to investigate their association with GDM. A ninefold increase in GDM prevalence was observed from 1981 to 2012 (P < 0.001). GDM prevalence in 2012 was 1.9%. Maternal body mass index, age, parity status, Scottish index of multiple deprivation and fetal macrosomia were positively associated with GDM. Reported smoking status at booking was inversely associated with GDM. Multivariable analysis showed that fetal macrosomia was not associated with GDM status. The present study confirmed that the reporting of GDM is low in Scotland, and that GDM is associated with maternal body mass index, maternal age, multiparity and social deprivation. GDM was negatively associated with smoking and requires further investigation. The lack of association between GDM and macrosomia (following multivariate analysis) might reflect the screening processes undertaken in Scotland. © 2016 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

Brain MRI lesions and atrophy are associated with employment status in patients with multiple sclerosis.

PubMed

Tauhid, Shahamat; Chu, Renxin; Sasane, Rahul; Glanz, Bonnie I; Neema, Mohit; Miller, Jennifer R; Kim, Gloria; Signorovitch, James E; Healy, Brian C; Chitnis, Tanuja; Weiner, Howard L; Bakshi, Rohit

2015-11-01

Multiple sclerosis (MS) commonly affects occupational function. We investigated the link between brain MRI and employment status. Patients with MS (n = 100) completed a Work Productivity and Activity Impairment (WPAI) (general health version) survey measuring employment status, absenteeism, presenteeism, and overall work and daily activity impairment. Patients "working for pay" were considered employed; "temporarily not working but looking for work," "not working or looking for work due to age," and "not working or looking for work due to disability" were considered not employed. Brain MRI T1 hypointense (T1LV) and T2 hyperintense (T2LV) lesion volumes were quantified. To assess lesional destructive capability, we calculated each subject's ratio of T1LV to T2LV (T1/T2). Normalized brain parenchymal volume (BPV) assessed brain atrophy. The mean (SD) age was 45.5 (9.7) years; disease duration was 12.1 (8.1) years; 75 % were women, 76 % were relapsing-remitting, and 76 % were employed. T1LV, T1/T2, Expanded Disability Status Scale (EDSS) scores, and activity impairment were lower and BPV was higher in the employed vs. not employed group (Wilcoxon tests, p < 0.05). Age, disease duration, MS clinical subtype, and T2LV did not differ between groups (p > 0.05). In multivariable logistic regression modeling, adjusting for age, sex, and disease duration, higher T1LV predicted a lower chance of employment (p < 0.05). Pearson correlations showed that EDSS was associated with activity impairment (p < 0.05). Disease duration, age, and MRI measures were not correlated with activity impairment or other WPAI outcomes (p > 0.05). We report a link between brain atrophy and lesions, particularly lesions with destructive potential, to MS employment status.

Mental health status, aggression, and poor driving distinguish traffic offenders from non-offenders but health status predicts driving behavior in both groups

PubMed Central

Abdoli, Nasrin; Farnia, Vahid; Delavar, Ali; Dortaj, Fariborz; Esmaeili, Alireza; Farrokhi, Noorali; Karami, Majid; Shakeri, Jalal; Holsboer-Trachsler, Edith; Brand, Serge

2015-01-01

Background In Iran, traffic accidents and deaths from traffic accidents are among the highest in the world, and generally, driver behavior rather than technical failures or environmental conditions are responsible for traffic accidents. In a previous study, we showed that among young Iranian male traffic offenders, poor mental health status, along with aggression, predicted poor driving behavior. The aims of the present study were twofold, to determine whether this pattern could be replicated among non-traffic offenders, and to compare the mental health status, aggression, and driving behavior of male traffic offenders and non-offenders. Methods A total of 850 male drivers (mean age =34.25 years, standard deviation =10.44) from Kermanshah (Iran) took part in the study. Of these, 443 were offenders (52.1%) and 407 (47.9%) were non-offenders with lowest driving penalty scores applying for attaining an international driving license. Participants completed a questionnaire booklet covering socio-demographic variables, traits of aggression, health status, and driving behavior. Results Compared to non-offenders, offenders reported higher aggression, poorer mental health status, and worse driving behavior. Among non-offenders, multiple regression indicated that poor health status, but not aggression, independently predicted poor driving behavior. Conclusion Compared to non-offenders, offenders reported higher aggression, poorer health status and driving behavior. Further, the predictive power of poorer mental health status, but not aggression, for driving behavior was replicated for male non-offenders. PMID:26300646

Demographic, medical, and psychiatric factors in work and marital status after mild head injury.

PubMed

Vanderploeg, Rodney D; Curtiss, Glenn; Duchnick, Jennifer J; Luis, Cheryl A

2003-01-01

To explore factors associated with long-term outcomes of work and marital status in individuals who had experienced a mild head injury (MHI), as well as those who had not. Population-based study using logistical regression analyses to investigate the impact of preinjury characteristics on work and marital status. Two groups of Vietnam-era Army veterans: 626 who had experienced a MHI an average of 8 years before examination, and 3,896 who had not. Demographic characteristics, concurrent medical conditions, early life psychiatric problems, loss of consciousness (LOC), and interactions among these variables were used to predict current work and marital status. Multiple variables were associated with work and marital status in the sample with MHI, accounting for approximately 23% and 17% of the variance in these two outcome variables, respectively. In contrast, the same factors accounted for significantly less variance in outcome in the sample without a head injury-13.3% and 9.4% for work and marital status, respectively. These findings suggest a more potent role for and increased vulnerability to the influence of demographic, medical, and psychiatric factors on outcomes after a MHI. That is, MHI itself moderates the influence of preinjury characteristics on work and marital status. In addition, in those who had a MHI, moderator relationships were found between education and LOC for both work and marital status. Similarly, complex moderator relationships among race, region of residence, and LOC were found for both work and marital status outcomes.

Physical activity and physical activity adherence in the elderly based on smoking status.

PubMed

Cooper, Theodore V; Resor, Michelle R; Stoever, Colby J; Dubbert, Patricia M

2007-10-01

This study assessed the impact of current smoking status and lifetime smoking status on physical fitness and physical activity regimen adherence as part of a larger study on walking for exercise in elderly primary care patients at a Veterans Affairs Medical Center. At baseline, 218 participants self-reported smoking status which was verified by carbon monoxide expiration. Former and current smokers responded to questions about length of time quit, average daily cigarette intake, and years a smoker. Smoking measures were re-collected at 6- and 12-month follow-ups if the participants indicated a change in smoking status. Veterans completed multiple measures of physical activity (e.g., 6-min walk, 7-day Physical Activity Recall), and adherence to a physical activity goal was assessed. The Physical Component Summary (PCS) subscale of the Medical Outcomes Study Short Form-36 (MOS SF-36) was used to assess health-related quality of life. Hierarchical regression models indicated smoking status was a predictor of the baseline 6-min walk such that smokers walked significantly shorter distances than nonsmokers. In addition, smoking status was found to be a significant predictor of adherence; however, the overall model that included smoking status as a predictor did not demonstrate a significant effect on adherence. Neither smoking status nor pack years were predictors of baseline self-reported physical activity or changes in physical activity post intervention. Results are consistent with recommendations to use physical exercise as an aid to tobacco cessation, even in aging men with extensive smoking histories.

The impact of social isolation on the health status and health-related quality of life of older people.

PubMed

Hawton, Annie; Green, Colin; Dickens, Andy P; Richards, Suzanne H; Taylor, Rod S; Edwards, Rachel; Greaves, Colin J; Campbell, John L

2011-02-01

To investigate for socially isolated older people, and older people at risk of social isolation: (1) health status and health-related quality of life (HRQL); (2) the relationship between social isolation and health status/HRQL; (3) the relationship between two alternative measures of health status/HRQL. Older people at risk of social isolation (n = 393) completed the EQ-5D and the SF-12. Multiple regression analyses were performed to examine the relationship between levels of social isolation and health status/HRQL, controlling for demographic/clinical characteristics. The agreement between EQ-5D and SF-6D (SF-12) scores was explored using descriptive psychometric techniques. Health status and health state values were much lower than UK general population age-matched norms. After controlling for depression, physical co-morbidities, age, gender, living alone status, employment and accommodation, social isolation was significantly associated, to a degree that was clinically relevant, with EQ-5D DSI, SF-6D (SF-12) and SF-12 MCS scores. The potential for ceiling effects on the EQ-5D with this population was identified. This work highlights the burden that social isolation may have on the health and well-being of older people. The potential HRQL gains from addressing social isolation may be considerable, with those at risk of social isolation also a key target group.

Risk factors for poor work functioning of persons with schizophrenia in rural China.

PubMed

Ran, Mao-Sheng; Chen, Sheying; Chen, Elaina Y; Ran, Bo-Yu; Tang, Cui-Ping; Lin, Fu-Rong; Li, Li; Li, Si-Gan; Mao, Wen-Jun; Hu, Shi-Hui

2011-11-01

The long-term work performance of persons with schizophrenia in the community is unclear. This study examined the status of long-term work functioning and the predictors of poor work status among patients with schizophrenia in a Chinese rural area. A 10-year follow-up investigation (1994-2004) of a cohort (n = 510) of persons with schizophrenia was conducted in Xinjin County, Chengdu, China. Compared with baseline data, work functioning of patients with schizophrenia deteriorated after 10 years. The rates of not working increased significantly from 12.0% in 1994 to 23.0% in 2004. Bivariate analyses showed that the poor work functioning in 2004 was significantly associated with male gender, older age, older age of first onset, higher level of education, longer duration of illness, lower family economic status, lack of caregivers, poor work status in 1994, living in shabby or unstable house, marked symptoms, and higher score on the Social Disability Screening Schedule (SDSS). In multiple logistic regression analyses, higher score of SDSS and poor work status in 1994 were identified as unique predictors of poor work status in 2004. The status of work functioning of persons with schizophrenia decreased over the course of the illness. The risk factors for poor work functioning and specific socio-cultural environment should be considered in planning community mental health services and rehabilitation for these patients.

Multidimensional Predictors of Fatigue among Octogenarians and Centenarians

PubMed Central

Cho, Jinmyoung; Martin, Peter; Margrett, Jennifer; MacDonald, Maurice; Johnson, Mary Ann; Poon, Leonard W.

2012-01-01

Background Fatigue is a common and frequently observed complaint among older adults. However, knowledge about the nature and correlates of fatigue in old age is very limited. Objective: This study examined the relationship of functional indicators, psychological and situational factors and fatigue for 210 octogenarians and centenarians from the Georgia Centenarian Study. Methods Three indicators of functional capacity (self-rated health, instrumental activities of daily living, physical activities of daily living), two indicators of psychological well-being (positive and negative affect), two indicators of situational factors (social network and social support), and a multidimensional fatigue scale were used. Blocked multiple regression analyses were computed to examine significant factors related to fatigue. In addition, multi-group analysis in structural equation modeling was used to investigate residential differences (i.e., long-term care facilities vs. private homes) in the relationship between significant factors and fatigue. Results Blocked multiple regression analyses indicated that two indicators of functional capacity, self-rated health and instrumental activities of daily living, both positive and negative affect, and social support were significant predictors of fatigue among oldest-old adults. The multiple group analysis in structural equation modeling revealed a significant difference among oldest-old adults based on residential status. Conclusion The results suggest that we should not consider fatigue as merely an unpleasant physical symptom, but rather adopt a perspective that different factors such as psychosocial aspects can influence fatigue in advanced later life. PMID:22094445

Multidimensional predictors of fatigue among octogenarians and centenarians.

PubMed

Cho, Jinmyoung; Martin, Peter; Margrett, Jennifer; MacDonald, Maurice; Johnson, Mary Ann; Poon, Leonard W; Jazwinski, S M; Green, R C; Gearing, M; Woodard, J L; Tenover, J S; Siegler, I C; Rott, C; Rodgers, W L; Hausman, D; Arnold, J; Davey, A

2012-01-01

Fatigue is a common and frequently observed complaint among older adults. However, knowledge about the nature and correlates of fatigue in old age is very limited. This study examined the relationship of functional indicators, psychological and situational factors and fatigue for 210 octogenarians and centenarians from the Georgia Centenarian Study. Three indicators of functional capacity (self-rated health, instrumental activities of daily living, physical activities of daily living), two indicators of psychological well-being (positive and negative affect), two indicators of situational factors (social network and social support), and a multidimensional fatigue scale were used. Blocked multiple regression analyses were computed to examine significant factors related to fatigue. In addition, multi-group analysis in structural equation modeling was used to investigate residential differences (i.e., long-term care facilities vs. private homes) in the relationship between significant factors and fatigue. Blocked multiple regression analyses indicated that two indicators of functional capacity, self-rated health and instrumental activities of daily living, both positive and negative affect, and social support were significant predictors of fatigue among oldest-old adults. The multiple group analysis in structural equation modeling revealed a significant difference among oldest-old adults based on residential status. The results suggest that we should not consider fatigue as merely an unpleasant physical symptom, but rather adopt a perspective that different factors such as psychosocial aspects can influence fatigue in advanced later life. Copyright © 2011 S. Karger AG, Basel.

Socio-demographic correlates of breast-feeding in urban slums of Chandigarh.

PubMed

Kumar, Dinesh; Agarwal, Neeraj; Swami, H M

2006-11-01

Whether socio-demographic factors are associated with initiation of breast-feeding in urban slums of Chandigarh. (1) To study the prevailing breast-feeding practices adopted by mothers, (2) To study the socio-demographic factors associated with initiation of breast-feeding. Cross-sectional. Mothers of infants willing to participate in the study in the selected area. A total of 270 respondents. Social and demographic characteristics like age, socioeconomic status, educational level, birth interval, parity, gender preference, natal care practices, etc.; and variables related to various aspects of breast-feeding practices like prelacteal feed, initiation of feeding, colostrum feeding, reasons of discarding colostrum, etc. Chi-square test and odd ratios along with their respective 95% confidence intervals, multiple logistic regression analysis. Out of all 270 respondents, 159 (58.9%) initiated breast-feeding within 6 h of birth, only 43 (15.9%) discarded colostrum and 108 (40.0%) mothers gave prelacteal feed. Illiterate/just literate mothers who delivered at home were found at significantly higher risk of delay in initiation of breast-feeding on the basis of multiple logistic regression analysis. Promotion of institutional deliveries and imparting health education to mothers for protecting and promoting optimal breast-feeding practices are suggested.

Predictors of Dropout by Female Obese Patients Treated with a Group Cognitive Behavioral Therapy to Promote Weight Loss.

PubMed

Sawamoto, Ryoko; Nozaki, Takehiro; Furukawa, Tomokazu; Tanahashi, Tokusei; Morita, Chihiro; Hata, Tomokazu; Komaki, Gen; Sudo, Nobuyuki

2016-01-01

To investigate predictors of dropout from a group cognitive behavioral therapy (CBT) intervention for overweight or obese women. 119 overweight and obese Japanese women aged 25-65 years who attended an outpatient weight loss intervention were followed throughout the 7-month weight loss phase. Somatic characteristics, socioeconomic status, obesity-related diseases, diet and exercise habits, and psychological variables (depression, anxiety, self-esteem, alexithymia, parenting style, perfectionism, and eating attitude) were assessed at baseline. Significant variables, extracted by univariate statistical analysis, were then used as independent variables in a stepwise multiple logistic regression analysis with dropout as the dependent variable. 90 participants completed the weight loss phase, giving a dropout rate of 24.4%. The multiple logistic regression analysis demonstrated that compared to completers the dropouts had significantly stronger body shape concern, tended to not have jobs, perceived their mothers to be less caring, and were more disorganized in temperament. Of all these factors, the best predictor of dropout was shape concern. Shape concern, job condition, parenting care, and organization predicted dropout from the group CBT weight loss intervention for overweight or obese Japanese women. © 2016 S. Karger GmbH, Freiburg.

Dental calculus is associated with death from heart infarction.

PubMed

Söder, Birgitta; Meurman, Jukka H; Söder, Per-Östen

2014-01-01

We studied whether the amount of dental calculus is associated with death from heart infarction in the dental infection-atherosclerosis paradigm. Participants were 1676 healthy young Swedes followed up from 1985 to 2011. At the beginning of the study all subjects underwent oral clinical examination including dental calculus registration scored with calculus index (CI). Outcome measure was cause of death classified according to WHO International Classification of Diseases. Unpaired t-test, Chi-square tests, and multiple logistic regressions were used. Of the 1676 participants, 2.8% had died during follow-up. Women died at a mean age of 61.5 years and men at 61.7 years. The difference in the CI index score between the survivors versus deceased patients was significant by the year 2009 (P < 0.01). In multiple regression analysis of the relationship between death from heart infarction as a dependent variable and CI as independent variable with controlling for age, gender, dental visits, dental plaque, periodontal pockets, education, income, socioeconomic status, and pack-years of smoking, CI score appeared to be associated with 2.3 times the odds ratio for cardiac death. The results confirmed our study hypothesis by showing that dental calculus indeed associated statistically with cardiac death due to infarction.

Predictors of Dropout by Female Obese Patients Treated with a Group Cognitive Behavioral Therapy to Promote Weight Loss

PubMed Central

Sawamoto, Ryoko; Nozaki, Takehiro; Furukawa, Tomokazu; Tanahashi, Tokusei; Morita, Chihiro; Hata, Tomokazu; Komaki, Gen; Sudo, Nobuyuki

2016-01-01

Objective To investigate predictors of dropout from a group cognitive behavioral therapy (CBT) intervention for overweight or obese women. Methods 119 overweight and obese Japanese women aged 25-65 years who attended an outpatient weight loss intervention were followed throughout the 7-month weight loss phase. Somatic characteristics, socioeconomic status, obesity-related diseases, diet and exercise habits, and psychological variables (depression, anxiety, self-esteem, alexithymia, parenting style, perfectionism, and eating attitude) were assessed at baseline. Significant variables, extracted by univariate statistical analysis, were then used as independent variables in a stepwise multiple logistic regression analysis with dropout as the dependent variable. Results 90 participants completed the weight loss phase, giving a dropout rate of 24.4%. The multiple logistic regression analysis demonstrated that compared to completers the dropouts had significantly stronger body shape concern, tended to not have jobs, perceived their mothers to be less caring, and were more disorganized in temperament. Of all these factors, the best predictor of dropout was shape concern. Conclusion Shape concern, job condition, parenting care, and organization predicted dropout from the group CBT weight loss intervention for overweight or obese Japanese women. PMID:26745715

Total bone calcium in normal women: effect of age and menopause status

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gallagher, J.C.; Goldgar, D.; Moy, A.

1987-12-01

Bone density in different regions of the skeleton was measured in 392 normal women aged 20-80 years by dual photon absorpiometry. In premenopausal women, aged 25-50 years, multiple regression analysis of regional bone density on age, height, and weight showed a small significant decrease in total bone density (less than 0.01) but no significant change in other regions of the skeleton. In postmenopausal women there were highly significant decreases in all regions of the skeleton (p less than 0.001), and bone density in these areas decreased as a logarithmic function of years since menopause. Based on multiple regression analyses, themore » decrease in spine density and total bone calcium was 2.5-3.0 times greater in the 25 years after menopause than the 25 years before menopause. The largest change, however, occurred in the first five years after menopause. During this time the estimated annual change in spine density and total bone calcium was about 10 times greater than that in the premenopausal period. These results demonstrate the important effect of the menopause in determining bone mass in later life.« less

Barriers to pelvic floor physical therapy utilization for treatment of female urinary incontinence.

PubMed

Washington, Blair B; Raker, Christina A; Sung, Vivian W

2011-08-01

The purpose of this study was to estimate the effect of insurance status on pelvic floor physical therapy (PFPT) nonparticipation for the treatment of urinary incontinence. A cross-sectional study of women referred to PFPT for urinary incontinence between January 2009 and June 2010 was conducted. A telephone questionnaire was administered. Multiple logistic regression was used to identify risk factors for nonparticipation. Thirty-three percent of women with private insurance and 17% with other insurance were PFPT nonparticipants. On multiple logistic regression, women with Medicare were more likely to participate in PFPT (odds ratio [OR], 0.12; 95% confidence interval [CI], 0.01-0.72). Risk factors for nonparticipation included insurance noncoverage (OR, 103.85; 95% CI, 6.21-infinity) and a negative perception regarding the benefit of PFPT (OR, 5.07; 95% CI, 2.16-12.49). Among women who were referred to PFPT for urinary incontinence, insurance noncoverage and negative patient perception of efficacy were risk factors for nonparticipation, although having Medicare was protective. Improving patient education and insurance coverage for PFPT may increase usage. Copyright © 2011 Mosby, Inc. All rights reserved.

Prevalence of Depressive Symptoms and Related Factors in Korean Employees: The Third Korean Working Conditions Survey (2011).

PubMed

Park, Ji Nam; Han, Mi Ah; Park, Jong; Ryu, So Yeon

2016-04-14

The aim of this study was to analyze the association between general working conditions and depressive symptoms among Korean employees. The target population of the study was native employees nationwide who were at least 15 years old, and 50,032 such individuals were enrolled in the study. Depressive symptoms was assessed using the WHO-5 wellbeing index. Associations between general characteristics, job-related characteristics, work environment, and depressive symptoms were tested using chi-square tests, t-tests, and multiple logistic regression analysis. The prevalence of depressive symptoms was 39% (40.7% in males and 36.5% in females). Multiple regression analysis revealed that male subjects, older subjects, subjects with higher education status, subjects with lower monthly income, current smokers, and frequent drinkers were more likely to have depressive symptoms. In addition, longer weekly work hours, occupation type (skilled, unskilled, operative, or economic sector), shift work, working to tight deadlines, exposure to stress at work, and hazard exposure were associated with depressive symptoms. This representative study will be a guide to help manage depression among Korean employees. We expect that further research will identify additional causal relationships between general or specific working conditions and depression.

Prediction of health levels by remote sensing

NASA Technical Reports Server (NTRS)

Rush, M.; Vernon, S.

1975-01-01

Measures of the environment derived from remote sensing were compared to census population/housing measures in their ability to discriminate among health status areas in two urban communities. Three hypotheses were developed to explore the relationships between environmental and health data. Univariate and multiple step-wise linear regression analyses were performed on data from two sample areas in Houston and Galveston, Texas. Environmental data gathered by remote sensing were found to equal or surpass census data in predicting rates of health outcomes. Remote sensing offers the advantages of data collection for any chosen area or time interval, flexibilities not allowed by the decennial census.

Neurocognition and community outcome in schizophrenia: long-term predictive validity.

PubMed

Fujii, Daryl E; Wylie, A Michael

2003-02-01

The present study examined the predictive validity of neuropsychological measures to functional outcome in 26 schizophrenic patients 15-plus year post-testing. Outcome measures included score on the Resource Associated Functional Level Scale (RAFLS), number of state hospital admissions, and total duration of state hospital inpatient stay. Results of several stepwise multiple regressions revealed that verbal memory significantly predicted RAFLS score, accounting for nearly half of the variance. Trails B significantly predicted duration of state hospital inpatient status. Discussion focused on the utility of these measures for clinicians and system planners. Copyright 2002 Elsevier Science B.V.

Relationships among personality traits, metabolic syndrome, and metabolic syndrome scores: The Kakegawa cohort study.

PubMed

Ohseto, Hisashi; Ishikuro, Mami; Kikuya, Masahiro; Obara, Taku; Igarashi, Yuko; Takahashi, Satomi; Kikuchi, Daisuke; Shigihara, Michiko; Yamanaka, Chizuru; Miyashita, Masako; Mizuno, Satoshi; Nagai, Masato; Matsubara, Hiroko; Sato, Yuki; Metoki, Hirohito; Tachibana, Hirofumi; Maeda-Yamamoto, Mari; Kuriyama, Shinichi

2018-04-01

Metabolic syndrome and the presence of metabolic syndrome components are risk factors for cardiovascular disease (CVD). However, the association between personality traits and metabolic syndrome remains controversial, and few studies have been conducted in East Asian populations. We measured personality traits using the Japanese version of the Eysenck Personality Questionnaire (Revised Short Form) and five metabolic syndrome components-elevated waist circumference, elevated triglycerides, reduced high-density lipoprotein cholesterol, elevated blood pressure, and elevated fasting glucose-in 1322 participants aged 51.1±12.7years old from Kakegawa city, Japan. Metabolic syndrome score (MS score) was defined as the number of metabolic syndrome components present, and metabolic syndrome as having the MS score of 3 or higher. We performed multiple logistic regression analyses to examine the relationship between personality traits and metabolic syndrome components and multiple regression analyses to examine the relationship between personality traits and MS scores adjusted for age, sex, education, income, smoking status, alcohol use, and family history of CVD and diabetes mellitus. We also examine the relationship between personality traits and metabolic syndrome presence by multiple logistic regression analyses. "Extraversion" scores were higher in those with metabolic syndrome components (elevated waist circumference: P=0.001; elevated triglycerides: P=0.01; elevated blood pressure: P=0.004; elevated fasting glucose: P=0.002). "Extraversion" was associated with the MS score (coefficient=0.12, P=0.0003). No personality trait was significantly associated with the presence of metabolic syndrome. Higher "extraversion" scores were related to higher MS scores, but no personality trait was significantly associated with the presence of metabolic syndrome. Copyright © 2018 Elsevier Inc. All rights reserved.

Water quality and herbivory interactively drive coral-reef recovery patterns in American Samoa.

PubMed

Houk, Peter; Musburger, Craig; Wiles, Phil

2010-11-10

Compared with a wealth of information regarding coral-reef recovery patterns following major disturbances, less insight exists to explain the cause(s) of spatial variation in the recovery process. This study quantifies the influence of herbivory and water quality upon coral reef assemblages through space and time in Tutuila, American Samoa, a Pacific high island. Widespread declines in dominant corals (Acropora and Montipora) resulted from cyclone Heta at the end of 2003, shortly after the study began. Four sites that initially had similar coral reef assemblages but differential temporal dynamics four years following the disturbance event were classified by standardized measures of 'recovery status', defined by rates of change in ecological measures that are known to be sensitive to localized stressors. Status was best predicted, interactively, by water quality and herbivory. Expanding upon temporal trends, this study examined if similar dependencies existed through space; building multiple regression models to identify linkages between similar status measures and local stressors for 17 localities around Tutuila. The results highlighted consistent, interactive interdependencies for coral reef assemblages residing upon two unique geological reef types. Finally, the predictive regression models produced at the island scale were graphically interpreted with respect to hypothesized site-specific recovery thresholds. Cumulatively, our study purports that moving away from describing relatively well-known patterns behind recovery, and focusing upon understanding causes, improves our foundation to predict future ecological dynamics, and thus improves coral reef management.

Regression analysis of informative current status data with the additive hazards model.

PubMed

Zhao, Shishun; Hu, Tao; Ma, Ling; Wang, Peijie; Sun, Jianguo

2015-04-01

This paper discusses regression analysis of current status failure time data arising from the additive hazards model in the presence of informative censoring. Many methods have been developed for regression analysis of current status data under various regression models if the censoring is noninformative, and also there exists a large literature on parametric analysis of informative current status data in the context of tumorgenicity experiments. In this paper, a semiparametric maximum likelihood estimation procedure is presented and in the method, the copula model is employed to describe the relationship between the failure time of interest and the censoring time. Furthermore, I-splines are used to approximate the nonparametric functions involved and the asymptotic consistency and normality of the proposed estimators are established. A simulation study is conducted and indicates that the proposed approach works well for practical situations. An illustrative example is also provided.

Multiple Correlation versus Multiple Regression.

ERIC Educational Resources Information Center

Huberty, Carl J.

2003-01-01

Describes differences between multiple correlation analysis (MCA) and multiple regression analysis (MRA), showing how these approaches involve different research questions and study designs, different inferential approaches, different analysis strategies, and different reported information. (SLD)

Interaction between adolescent obesity and HLA risk genes in the etiology of multiple sclerosis

PubMed Central

Lima Bomfim, Izaura; Barcellos, Lisa; Gianfrancesco, Milena; Schaefer, Catherine; Kockum, Ingrid; Olsson, Tomas; Alfredsson, Lars

2014-01-01

Objective: We investigated potential interactions between human leukocyte antigen (HLA) genotype and body mass index (BMI) status in relation to the risk of developing multiple sclerosis (MS). Methods: We used 2 case-control studies, one with incident cases (1,510 cases, 2,017 controls) and one with prevalent cases (937 cases, 609 controls). Subjects with different genotypes and BMI were compared with regard to incidence of MS by calculating odds ratios (ORs) with 95% confidence intervals (CIs) employing logistic regression. Potential interactions between genotypes and BMI were evaluated by calculating the attributable proportion due to interaction. Results: In both cohorts, a significant interaction was observed between HLA-DRB1*15 and obesity, regardless of HLA-A*02 status. Similarly, there was a significant interaction between absence of A*02 and obesity, regardless of DRB1*15 status. In the incident cohort, obese subjects with the most susceptible genotype (carriage of DRB1*15 and absence of A*02) had an OR of 16.2 (95% CI 7.5–35.2) compared to nonobese subjects without the genetic risk factors. The corresponding OR in the prevalent study was 13.8 (95% CI 4.1–46.8). Conclusions: We observed striking interactions between BMI status and HLA genotype with regard to MS risk. Hypothetically, a low-grade inflammatory response inherent to obesity synergizes with the adaptive, HLA molecule–restricted arm of the immune system, causing MS. Prevention of adolescent obesity may thus lower the risk of developing MS, predominantly among people with a genetic susceptibility to the disease. PMID:24500647

Associations of cigarette smoking with rheumatoid arthritis in African Americans

PubMed Central

Mikuls, Ted R.; Sayles, Harlan; Yu, Fang; LeVan, Tricia; Gould, Karen A.; Thiele, Geoffrey M.; Conn, Doyt; Jonas, Beth L.; Callahan, Leigh F.; Smith, Edwin; Brasington, Richard; Moreland, Larry W.; Reynolds, Richard; Bridges, S. Louis

2010-01-01

Objective To examine the associations of cigarette smoking with rheumatoid arthritis (RA) in African Americans and to determine to whether this association is impacted by HLA-DRB1 shared epitope (SE). Methods Smoking status, cumulative smoking exposure, and SE status were measured in African American patients with RA and in healthy controls. Associations of smoking with RA were examined using age- and gender-adjusted logistic regression. Additive and multiplicative SE-smoking interactions were examined. Results After adjusting for age and gender, ever (OR = 1.45; 95% CI 1.07 to 1.97) and current smoking (OR = 1.56; 95% CI 1.07 to 2.26) were more common in African American RA cases (n = 605) than in controls (n = 255). The association of smoking with RA was limited to those with a cumulative exposure exceeding 10 pack-years, associations that were evident in both autoantibody positive and negative disease. There was evidence of a significant additive interaction between SE status and heavy smoking (≥ 10 pack-years) in RA risk (attributable proportion due to interaction [AP] of 0.58, p = 0.007) with an AP of 0.47 (p = 0.006) between SE status and ever smoking. There was no evidence of multiplicative interactions. Conclusion Among African Americans, cigarette smoking is associated not only with the risk of autoantibody positive RA but also with the risk of autoantibody negative disease. RA risk attributable to smoking is limited to African Americans with more than 10 pack-years of exposure and is more pronounced among individuals positive for HLA-DRB1 SE. PMID:20722010

Correlates of smoking with socioeconomic status, leisure time physical activity and alcohol consumption among Polish adults from randomly selected regions.

PubMed

Woitas-Slubowska, Donata; Hurnik, Elzbieta; Skarpańska-Stejnborn, Anna

2010-12-01

To determine the association between smoking status and leisure time physical activity (LTPA), alcohol consumption, and socioeconomic status (SES) among Polish adults. 466 randomly selected men and women (aged 18-66 years) responded to an anonymous questionnaire regarding smoking, alcohol consumption, LTPA, and SES. Multiple logistic regression was used to examine the association of smoking status with six socioeconomic measures, level of LTPA, and frequency and type of alcohol consumed. Smokers were defined as individuals smoking occasionally or daily. The odds of being smoker were 9 times (men) and 27 times (women) higher among respondents who drink alcohol several times/ week or everyday in comparison to non-drinkers (p < 0.0001 and p < 0.0001). Among men with the elementary/vocational level of education the frequency of smoking was four times higher compared to those with the high educational attainment (p = 0.007). Among women we observed that students were the most frequent smokers. Female students were almost three times more likely to smoke than non-professional women, and two times more likely than physical workers (p = 0.018). The findings of this study indicated that among randomly selected Polish man and women aged 18-66 smoking and alcohol consumption tended to cluster. These results imply that intervention strategies need to target multiple risk factors simultaneously. The highest risk of smoking was observed among low educated men, female students, and both men and women drinking alcohol several times a week or every day. Information on subgroups with the high risk of smoking will help in planning future preventive strategies.

The Detection and Interpretation of Interaction Effects between Continuous Variables in Multiple Regression.

ERIC Educational Resources Information Center

Jaccard, James; And Others

1990-01-01

Issues in the detection and interpretation of interaction effects between quantitative variables in multiple regression analysis are discussed. Recent discussions associated with problems of multicollinearity are reviewed in the context of the conditional nature of multiple regression with product terms. (TJH)

Health Status of Older US Workers and Nonworkers, National Health Interview Survey, 1997-2011.

PubMed

Kachan, Diana; Fleming, Lora E; Christ, Sharon; Muennig, Peter; Prado, Guillermo; Tannenbaum, Stacey L; Yang, Xuan; Caban-Martinez, Alberto J; Lee, David J

2015-09-24

Many US workers are increasingly delaying retirement from work, which may be leading to an increase in chronic disease at the workplace. We examined the association of older adults' health status with their employment/occupation and other characteristics. National Health Interview Survey data from 1997 through 2011 were pooled for adults aged 65 or older (n = 83,338; mean age, 74.6 y). Multivariable logistic regression modeling was used to estimate the association of socioeconomic factors and health behaviors with 4 health status measures: 1) self-rated health (fair/poor vs good/very good/excellent); 2) multimorbidity (≤1 vs ≥2 chronic conditions); 3) multiple functional limitations (≤1 vs ≥2); and 4) Health and Activities Limitation Index (HALex) (below vs above 20th percentile). Analyses were stratified by sex and age (young-old vs old-old) where interactions with occupation were significant. Employed older adults had better health outcomes than unemployed older adults. Physically demanding occupations had the lowest risk of poor health outcomes, suggesting a stronger healthy worker effect: service workers were at lowest risk of multiple functional limitations (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.71-0.95); and blue-collar workers were at lowest risk of multimorbidity (OR, 0.84; 95% CI, 0.74-0.97) and multiple functional limitation (OR, 0.84; 95% CI, 0.72-0.98). Hispanics were more likely than non-Hispanic whites to report fair/poor health (OR, 1.62; 95% CI, 1.52-1.73) and lowest HALex quintile (OR, 1.21; 95% CI, 1.13-1.30); however, they were less likely to report multimorbidity (OR, 0.78; 95% CI, 0.73-0.83) or multiple functional limitations (OR, 0.82; 95% CI, 0.77-0.88). A strong association exists between employment and health status in older adults beyond what can be explained by socioeconomic factors (eg, education, income) or health behaviors (eg, smoking). Disability accommodations in the workplace could encourage employment among older adults with limitations.

Fatigue and physical fitness of mildly disabled persons with multiple sclerosis: a cross-sectional study.

PubMed

Valet, Maxime; Lejeune, Thierry; Glibert, Yumiko; Hakizimana, Jean C; Van Pesch, Vincent; El Sankari, Souraya; Detrembleur, Christine; Stoquart, Gaëtan

2017-09-01

Fatigue is frequent and disabling in persons with multiple sclerosis (pwMS) with mild neurological disability. These patients also have impaired physical fitness. Whether mildly disabled pwMS are deconditioned, and this deconditioning is linked to fatigue, remains unknown. Our aim is to determine the physical fitness of mildly disabled patients with multiple sclerosis and study its relationship with perceived fatigue and to link perceived fatigue with other parameters. Twenty patients (14 women; mean age: 45.5 years) with mild disability (Expanded Disability Status Scale 0-4) underwent a 2-min walking test, Timed Up-and-Go test, aerobic capacity testing, and isometric knee extension testing to assess strength and neuromuscular fatigability. They completed questionnaires assessing perceived fatigue, psychological status, and physical activity. Correlation coefficients and multivariate regression were used to analyze the relationships among variables. Seventeen (85%) patients reported a high level of fatigue. Thirteen (65%) patients had subnormal aerobic capacity. Fatigue was weakly to moderately associated with aerobic capacity, mobility, walking capacity, depression, and neuromuscular fatigability. An association of disease duration, aerobic capacity, and the neuromuscular fatigability index explained 65.1% of fatigue. A high proportion of pwMS with mild neurological disability are fatigued and deconditioned. Perceived fatigue is linked to aerobic capacity, neuromuscular fatigability, depression, mobility, and walking capacity. Focusing on these parameters could help in the management of fatigue.

Multitasking in multiple sclerosis: can it inform vocational functioning?

PubMed

Morse, Chelsea L; Schultheis, Maria T; McKeever, Joshua D; Leist, Thomas

2013-12-01

To examine associations between multitasking ability defined by performance on a complex task integrating multiple cognitive domains and vocational functioning in multiple sclerosis (MS). Survey data collection. Laboratory with referrals from an outpatient clinic. Community-dwelling individuals with MS (N=30) referred between October 2011 and June 2012. Not applicable. The modified Six Elements Test (SET) to measure multitasking ability, Fatigue Severity Scale to measure fatigue, several neuropsychological measures of executive functioning, and vocational status. Among the sample, 60% of individuals have reduced their work hours because of MS symptoms (cutback employment group) and 40% had maintained their work hours. Among both groups, SET performance was significantly associated with performance on several measures of neuropsychological functioning. Individuals in the cutback employment group demonstrated significantly worse overall performance on the SET (P=.041). Logistic regression was used to evaluate associations between SET performance and vocational status, while accounting for neuropsychological performance and fatigue. The overall model was significant (χ(2)3=8.65, P=.032), with fatigue [Exp(B)=.83, P=.01] and multitasking ability [Exp(B)=.60, P=.043] retained as significant predictors. Multitasking ability may play an important role in performance at work for individuals with MS. Given that multitasking was associated with vocational functioning, future efforts should assess the usefulness of incorporating multitasking ability into rehabilitation planning. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Job stress, mentoring, psychological empowerment, and job satisfaction among nursing faculty.

PubMed

Chung, Catherine E; Kowalski, Susan

2012-07-01

The National League for Nursing endorses mentoring throughout nursing faculty's careers as the method to recruit nurses into academia and improve retention of nursing faculty within the academy. A nationwide sample of 959 full-time nursing faculty completed a descriptive survey comprising a researcher-created demographic questionnaire plus Dreher's mentoring scale, Gmelch's faculty stress index, Spreitzer's psychological empowerment scale, and the National Survey for Postsecondary Faculty's job satisfaction scale. Results showed that 40% of the sample had a current work mentor. Variables showed significant relationships to job satisfaction (p < 0.01): mentoring quality (0.229), job stress (-0.568), and psychological empowerment (0.482). Multiple regression results indicated job satisfaction was significantly influenced (p < 0.01) by the presence of a mentoring relationship, salary, tenure status, psychological empowerment, and job stress. The regression model explained 47% of the variance in job satisfaction for the sample. Copyright 2012, SLACK Incorporated.

Psychological inflexibility and depressive symptoms among Asian English speakers: A study on Indian, Philippine, and Singaporean samples.

PubMed

Kato, Tsukasa

2016-04-30

Psychological inflexibility is a core concept in Acceptance and Commitment Therapy. The primary aim of this study was to examine psychological inflexibility and depressive symptoms among Asian English speakers. A total of 900 adults in India, the Philippines, and Singapore completed some measures related to psychological inflexibility and depressive symptoms through a Web-based survey. Multiple regression analyses revealed that higher psychological inflexibility was significantly associated with higher levels of depressive symptoms in all the samples, after controlling for the effects of gender, marital status, and interpersonal stress. In addition, the effect sizes of the changes in the R(2) values when only psychological flexibility scores were entered in the regression model were large for all the samples. Moreover, overall, the beta-weight of the psychological flexibility scores obtained by the Philippine sample was the lowest of all three samples. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Sociodemographic predictors of elderly's psychological well-being in Malaysia.

PubMed

Momtaz, Yadollah A; Ibrahim, Rahimah; Hamid, Tengku A; Yahaya, Nurizan

2011-05-01

Psychological well-being as one of the most important indicators of successful aging has received substantial attention in the gerontological literature. Prior studies show that sociodemographic factors influencing elderly's psychological well-being are multiple and differ across cultures. The aim of this study was to identify significant sociodemographic predictors of psychological well-being among Malay elders. The study included 1415 older Malays (60-100 years, 722 women), randomly selected through a multistage stratified random method from Peninsular Malaysia. WHO-Five well-being index was used to measure psychological well-being. Data analysis was conducted using the Statistical Package for Social Sciences (SPSS) version 13.0. Using multiple regression analysis a significant model emerged (F(7, 1407) = 20.14, p ≤ 0.001), where age, sex, marital status, and household income were significant predictor variables of psychological well-being among Malay elders. However, level of education, employment status, and place of residence failed to predict psychological well-being. This study showed that the oldest old, elderly women, unmarried, and the poor elderly people are at risk for experiencing low psychological well-being. Therefore, they need special attention from family, policy makers, and those who work with elderly people.

Predictors of intractable childhood epilepsy.

PubMed

Seker Yilmaz, Berna; Okuyaz, Cetin; Komur, Mustafa

2013-01-01

Our study sought to identify early predictive factors of medically intractable childhood epilepsy. A cohort of epileptic children from the city of Mersin was retrospectively investigated. All patients received care from the same Department of Pediatric Neurology. The epileptic cohort was divided into a drug-responsive epilepsy group and an intractable epilepsy group. Intractable epilepsy is defined as continued seizures in children despite adequate therapy with two or more antiepileptic drugs for more than 18 months. Strong univariate association was observed between intractability and several factors: age of onset, high initial seizure frequency, symptomatic etiology, mixed seizure types, previous history of status epilepticus, febrile and neonatal seizures, mental and motor developmental delay, multiple seizures in 1 day, electroencephalogram abnormalities, magnetic resonance imaging findings, and specific epileptic syndromes. Logistic regression analysis revealed that a previous history of epilepticus status, abnormal electroencephalogram results, and multiple seizures in 1 day comprise independent predictors of medically intractable childhood epilepsy. We suggest that medical intractability in childhood epilepsy can be predicted by monitoring these factors. Along with early prediction, alternative therapies may be designed to provide patients better seizure control and quality of life. Copyright © 2013 Elsevier Inc. All rights reserved.

Quality of life among people with multiple sclerosis: Replication of a three-factor prediction model.

PubMed

Bishop, Malachy; Rumrill, Phillip D; Roessler, Richard T

2015-01-01

This article presents a replication of Rumrill, Roessler, and Fitzgerald's 2004 analysis of a three-factor model of the impact of multiple sclerosis (MS) on quality of life (QOL). The three factors in the original model included illness-related, employment-related, and psychosocial adjustment factors. To test hypothesized relationships between QOL and illness-related, employment-related, and psychosocial variables using data from a survey of the employment concerns of Americans with MS (N = 1,839). An ex post facto, multiple correlational design was employed incorporating correlational and multiple regression analyses. QOL was positively related to educational level, employment status, job satisfaction, and job-match, and negatively related to number of symptoms, severity of symptoms, and perceived stress level. The three-factor model explained approximately 37 percent of the variance in QOL scores. The results of this replication confirm the continuing value of the three-factor model for predicting the QOL of adults with MS, and demonstrate the importance of medical, mental health, and vocational rehabilitation interventions and services in promoting QOL.

Acculturation and self-reported health among Hispanics using a socio-behavioral model: the North Texas Healthy Heart Study.

PubMed

Johnson, Katandria L; Carroll, Joan F; Fulda, Kimberly G; Cardarelli, Kathryn; Cardarelli, Roberto

2010-02-02

Acculturation is a continuous, firsthand contact with other cultures functioning at both group and individual levels and is reflected in our culturally diverse society, calling for a greater understanding of the environmental and cultural impact on health. Self-reported health (SRH), a robust and well validated predictor of future mortality for all racial/ethnic groups, has been differentially reported by Hispanics compared to whites, especially based on their acculturation status. This study investigated the relationship between acculturation and SRH among Hispanics. An adapted Andersen framework was used to develop logistic regression models to assess for an association between acculturation and general health status. Hispanic participants (n = 135), as part of the North Texas Healthy Heart Study, were administered standardized questionnaires on acculturation, psychosocial measures which included sense of control, stress, depression and social support and a single item SRH measure. In addition, physiological measurements and demographic characteristics including age, gender, body mass index, medical history, and socioeconomic status were also obtained. Bivariate analyses found Mexican-oriented participants 3.16 times more likely to report fair/poor SRH compared to Anglo-oriented Hispanics. Acculturation was also associated with SRH in multiple regression models controlling for enabling, need, and predisposing factors together (OR: 3.53, 95% CI: 1.04, 11.97). Acculturation status was associated with SRH after accounting for other underlying factors. Medical and public health professionals should promote the use of acculturation measures in order to better understand its role in Hispanic behaviors, health outcomes and health care use. Such research findings will contribute to the design of culturally sensitive prevention and treatment strategies for diverse and immigrant populations.

Socio-economic inequalities in low-birth weight, full-term babies from singleton pregnancies in Taiwan.

PubMed

Li, C Y; Sung, F C

2008-03-01

This study investigated the chronological trend of low-birth weight in full-term babies (TLBW) in Taiwan in the 1980s and 1990s when the nation experienced a rapid economic advancement, and assessed the association between TLBW and parental education and marital status. Data from liveborn singletons from Taiwan's birth registry, born between 1978 and 1997, were used to calculate overall and socio-economic factor-specific rates of TLBW for every 2-year interval in this 20-year period. Logistic regression models were used to assess the trend of TLBW rates, and the interaction between secular time, selected demographic factors and other predictors. Among 6,159,070 full-term, liveborn singletons, 208,729 were TLBW. The average annual rate of TLBW was 3.39% in the study period. The period-specific TLBW declined monotonically from 4.41% in 1978-1979 to 2.49% in 1996-1997, representing a 43% deduction. Multiple logistic regression demonstrated persistent declining trends irrespective of the educational level or marital status of the parents. However, the decline was slower for populations of lower socio-economic status, such as less-educated parents and unmarried mothers, which enhanced the inequalities of TLBW risk across populations. The TLBW risk ratios of the least-educated mothers to the most-educated mothers increased from 1.43 in 1978-1979 to 2.05 in 1996-1997. Unmarried status was an independent predictor of elevated risk of TLBW. The association between socio-economic inequality and the risk of TLBW infants was sustained over the 1980s and 1990s in Taiwan. Interventions are necessary to promote antenatal care and educational attainment, particularly for lower socio-economic and socially deprived populations in Taiwan.

Only-Child Status in Relation to Perceived Stress and Studying-Related Life Satisfaction among University Students in China: A Comparison with International Students.

PubMed

Chu, Janet Junqing; Khan, Mobarak Hossain; Jahn, Heiko J; Kraemer, Alexander

2015-01-01

University students in general face multiple challenges, which may affect their levels of perceived stress and life satisfaction. Chinese students currently face specific strains due to the One-Child Policy (OCP). The aim of this study was to assess (1) whether the levels of perceived stress and studying-related life satisfaction are associated with only-child (OC) status after controlling for demographic and socio-economic characteristics and (2) whether these associations differ between Chinese and international students. A cross-sectional health survey based on a self-administrated standardised questionnaire was conducted among 1,843 (1,543 Chinese, 300 international) students at two Chinese universities in 2010-2011. Cohen's Perceived Stress Scale (PSS-14) and Stock and Kraemer's Studying-related Life Satisfaction Scale were used to measure perceived stress and studying-related life satisfaction respectively. Multivariable logistic regression analyses were used to examine the associations of OC status with perceived stress and studying-related life satisfaction by sex for Chinese students and international students separately. The Chinese non-only-children (NOCs) were more likely to come from small cities. Multivariable regression models indicate that the Chinese NOCs were more stressed than OCs (OR = 1.39, 1.11-1.74) with a stronger association in men (OR = 1.48, 1.08-2.02) than women (OR = 1.26, 0.89-1.77). NOCs were also more dissatisfied than their OC fellows in the Chinese subsample (OR = 1.37, 1.09-1.73). Among international students, no associations between OC status and perceived stress or studying-related life satisfaction were found. To promote equality between OCs and NOCs at Chinese universities, the causes of more stress and less studying-related life satisfaction among NOCs compared to OCs need further exploration.

Changes in prescription contraceptive use, 1995-2002: the effect of insurance status.

PubMed

Culwell, Kelly R; Feinglass, Joe

2007-12-01

To examine changes in prescription contraception use between 1995 and 2002 by insurance status among women at risk for unintended pregnancy. Data from the National Survey of Family Growth, including 4,767 women at risk of unintended pregnancy in 1995 and 3,569 in 2002, were used to evaluate changes in primary contraception methods by health insurance status and year of survey. Logistic regression models tested differences in the likelihood of prescription contraceptive use among privately insured, publicly insured, and uninsured women in each year, after controlling for age, race and ethnicity, education, income, employment, marital status, number of children, religion, and self reported overall health. Overall prescription contraceptive use increased between 1995 and 2002 by 3% (48.9% to 51.9%, P=.049). Nonuse of contraception also increased (11.6% to 16.1%, P<.001). The change in the likelihood of prescription contraceptive use was greatest and only significant among privately insured women (+5.5%, P=.002). In multiple regression analysis, women in 1995 were 10% less likely to report use of prescription contraceptives compared with women in 2002 (relative risk 0.90, 95% confidence interval 0.82-0.98), and uninsured women were more than 20% less likely to report prescription contraceptive use compared with privately insured women (relative risk 0.78, 95% confidence interval 0.67-0.90). Prescription contraceptive use increased most significantly among privately insured women between 1995 and 2002, potentially reflecting state mandates enacted during that period requiring contraceptive coverage by private insurers. It is important for clinicians to understand these differences and address issues of insurance coverage with patients when discussing contraceptive options. III.

Depressive symptoms, handgrip strength, and weight status in US older adults.

PubMed

Smith, Lee; White, Stephanie; Stubbs, Brendon; Hu, Liang; Veronese, Nicola; Vancampfort, Davy; Hamer, Mark; Gardner, Benjamin; Yang, Lin

2018-06-05

Handgrip strength is a valid indicator of broader physical functioning. Handgrip strength and weight status have been independently associated with depressive symptoms in older adults, but no study has yet investigated the relationships between all three in older US adults. This study investigated the relationship between physical function and depressive symptoms by weight status in older US adults. Cross-sectional data were analysed from the National Health and Nutrition Examination Survey waves 2011 to 2012 and 2013 to 2014. Physical function was assessed using a grip strength dynamometer. Depressive symptoms were assessed using the self-reported Patient Health Questionnaire-9. Weight status was assessed using Body Mass Index (BMI) and participants were categorised as normal weight (< 25 kg/m 2 ), overweight (25 to < 30 kg/m 2 ), and obese (≥ 30.0 kg/m 2 ). Associations between depressive symptoms and hand grip strength were estimated by gender-specific multiple linear regressions and BMI stratified multivariable linear regression. A total of 2,812 adults (54% female, mean age 69.2 years, mean BMI 29.2 kg/m 2 ) were included. Women with moderate to severe depressive symptoms had 1.60 kg (95% CI: 0.91 to 2.30) lower hand grip strength compared to women with minimal or no depressive symptoms. No such association was observed in men. Among those with obesity, men (-3.72 kg, 95% CI: -7.00 to -0.43) and women (-1.83 kg, 95% CI: -2.87 to -0.78) with moderate to severe depressive symptoms both had lower handgrip strength. Among older US adults, women and people who are obese and depressed are at the greatest risk of decline in physical function. Copyright © 2018 Elsevier B.V. All rights reserved.

A global, cross cultural study examining the relationship between employee health risk status and work performance metrics.

PubMed

Howarth, Ana; Quesada, Jose; Mills, Peter R

2017-01-01

Health risk assessments (HRA) are used by many organisations as a basis for developing relevant and targeted employee health and well-being interventions. However, many HRA's have a western-centric focus and therefore it is unclear whether the results can be directly extrapolated to those from non-western countries. More information regarding the differences in the associations between country status and health risks is needed along with a more global perspective of employee health risk factors and well-being overall. Therefore we aimed to i) quantify and compare associations for a number of health risk factors based on country status, and then ii) explore which characteristics can aid better prediction of well-being levels and in turn workplace productivity globally. Online employee HRA data collected from 254 multi-national companies, for the years 2013 through 2016 was analysed (n = 117,274). Multiple linear regression models were fitted, adjusting for age and gender, to quantify associations between country status and health risk factors. Separate regression models were used to assess the prediction of well-being measures related to productivity. On average, the developing countries were comprised of younger individuals with lower obesity rates and markedly higher job satisfaction compared to their developed country counterparts. However, they also reported higher levels of anxiety and depression, a greater number of health risks and lower job effectiveness. Assessment of key factors related to productivity found that region of residency was the biggest predictor of presenteeism and poor pain management was the biggest predictor of absenteeism. Clear differences in health risks exist between employees from developed and developing countries and these should be considered when addressing well-being and productivity in the global workforce.

Gradients in Depressive Symptoms by Socioeconomic Position Among Men Who Have Sex With Men in the EXPLORE Study.

PubMed

Pakula, Basia; Marshall, Brandon D L; Shoveller, Jean A; Chesney, Margaret A; Coates, Thomas J; Koblin, Beryl; Mayer, Kenneth; Mimiaga, Matthew; Operario, Don

2016-08-01

This study examines gradients in depressive symptoms by socioeconomic position (SEP; i.e., income, education, employment) in a sample of men who have sex with men (MSM). Data were used from EXPLORE, a randomized, controlled behavioral HIV prevention trial for HIV-uninfected MSM in six U.S. cities (n = 4,277). Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression scale (short form). Multiple linear regressions were fitted with interaction terms to assess additive and multiplicative relationships between SEP and depressive symptoms. Depressive symptoms were more prevalent among MSM with lower income, lower educational attainment, and those in the unemployed/other employment category. Income, education, and employment made significant contributions in additive models after adjustment. The employment-income interaction was statistically significant, indicating a multiplicative effect. This study revealed gradients in depressive symptoms across SEP of MSM, pointing to income and employment status and, to a lesser extent, education as key factors for understanding heterogeneity of depressive symptoms.

RACE AS LIVED EXPERIENCE

PubMed Central

Garcia, John A.; Sanchez, Gabriel R.; Sanchez-Youngman, Shannon; Vargas, Edward D.; Ybarra, Vickie D.

2015-01-01

A growing body of social science research has sought to conceptualize race as a multidimensional concept in which context, societal relations, and institutional dynamics are key components. Utilizing a specially designed survey, we develop and use multiple measures of race (skin color, ascribed race, and discrimination experiences) to capture race as “lived experience” and assess their impact on Latinos’ self-rated health status. We model these measures of race as a lived experience to test the explanatory power of race, both independently and as an integrated scale with categorical regression, scaling, and dimensional analyses. Our analyses show that our multiple measures of race have significant and negative effects on Latinos’ self-reported health. Skin color is a dominant factor that impacts self-reported health both directly and indirectly. We then advocate for the utilization of multiple measures of race, adding to those used in our analysis, and their application to other health and social outcomes. Our analysis provides important contributions across a wide range of health, illness, social, and political outcomes for communities of color. PMID:26681972

Physical activity and depressive symptoms in four ethnic groups of midlife women.

PubMed

Im, Eun-Ok; Ham, Ok Kyung; Chee, Eunice; Chee, Wonshik

2015-06-01

The purpose of this study was to determine the associations between physical activity and depression and the multiple contextual factors influencing these associations in four major ethnic groups of midlife women in the United States. This was a secondary analysis of the data from 542 midlife women. The instruments included questions on background characteristics and health and menopausal status; the Depression Index for Midlife Women (DIMW); and the Kaiser Physical Activity Survey (KPAS). The data were analyzed using chi-square tests, the ANOVA, two-way ANOVA, correlation analyses, and hierarchical multiple regression analyses. The women's depressive symptoms were negatively correlated with active living and sports/exercise physical activities whereas they were positively correlated with occupational physical activities (p < .01). Family income was the strongest predictor of their depressive symptoms. Increasing physical activity may improve midlife women's depressive symptoms, but the types of physical activity and multiple contextual factors need to be considered in intervention development. © The Author(s) 2014.

Beyond Multiple Regression: Using Commonality Analysis to Better Understand R[superscript 2] Results

ERIC Educational Resources Information Center

Warne, Russell T.

2011-01-01

Multiple regression is one of the most common statistical methods used in quantitative educational research. Despite the versatility and easy interpretability of multiple regression, it has some shortcomings in the detection of suppressor variables and for somewhat arbitrarily assigning values to the structure coefficients of correlated…

Comprehensive assessment of nutritional status and associated factors in the healthy, community-dwelling elderly.

PubMed

Iizaka, Shinji; Tadaka, Etsuko; Sanada, Hiromi

2008-03-01

Malnutrition among the elderly has become a serious problem as their population increases in Japan. To approach the risk of malnutrition in the healthy, community-dwelling elderly is important for early prevention of malnutrition. The nutritional status and mutable associated factors with poor nutritional status specific to the healthy elderly were examined comprehensively. One hundred and thirty healthy elderly people from a senior college in Tokyo, Japan were eligible for this study. Nutritional status was evaluated by Mini-Nutritional Assessment (MNA). The demographic status and potential correlates with poor nutritional status, including the physical factors (mobility, cognitive impairment and oral status) and the psychosocial factors (depression, self-efficacy, attitudes toward health, instrumental activities of daily living, public health service knowledge, and difficulty and dissatisfaction with meal preparation) were investigated. The multiple linear regression analysis using a stepwise procedure adjusted for demographic status was performed to detect independent associated factors. There were 16 participants (12.6%) at risk of malnutrition. The independent associated factors with lower MNA scores were depression (beta = -0.27, P = 0.005), lower self-efficacy (beta = 0.25, P = 0.009), lower attitudes toward health scores (beta = 0.21, P = 0.02) and difficulty with meal preparation (beta = -0.18, P = 0.03). The prevalence of the healthy elderly at the initial risk of malnutrition was relatively high and should not be overlooked. The comprehensive geriatric screening and intervention including mental health, health management and life-situation will be important for the healthy, community-dwelling elderly.

Respiratory muscle weakness and respiratory muscle training in severely disabled multiple sclerosis patients.

PubMed

Gosselink, R; Kovacs, L; Ketelaer, P; Carton, H; Decramer, M

2000-06-01

To evaluate the contribution of respiratory muscle weakness (part 1) and respiratory muscle training (part 2) to pulmonary function, cough efficacy, and functional status in patients with advanced multiple sclerosis (MS). Survey (part 1) and randomized controlled trial (part 2). Rehabilitation center for MS. Twenty-eight bedridden or wheelchair-bound MS patients (part 1); 18 patients were randomly assigned to a training group (n = 9) or a control group (n = 9) (part 2). The training group (part 2) performed three series of 15 contractions against an expiratory resistance (60% maximum expiratory pressure [PEmax]) two times a day, whereas the control group performed breathing exercises to enhance maximal inspirations. Forced vital capacity (FVC), inspiratory, and expiratory muscle strength (PImax and PEmax), neck flexion force (NFF), cough efficacy by means of the Pulmonary Index (PI), and functional status by means of the Extended Disability Status Scale (EDSS). Part 1 revealed a significantly reduced FVC (43% +/- 26% predicted), PEmax (18% +/- 8% predicted), and PImax (27% +/- 11% predicted), whereas NFF was only mildly reduced (93% +/- 26% predicted). The PI (median score, 10) and EDSS (median score, 8.5) were severely reduced. PEmax was significantly correlated to FVC, EDSS, and PI (r = .77, -.79, and -.47, respectively). In stepwise multiple regression analysis. PEmax was the only factor contributing to the explained variance in FVC (R2 = .60), whereas body weight (R2 = .41) was the only factor for the PI. In part 2, changes in PImax and PEmax tended to be higher in the training group (p = .06 and p = .07, respectively). The PI was significantly improved after 3 months of training compared with the control group (p < .05). After 6 months, the PI remained significantly better in the training group. Expiratory muscle strength was significantly reduced and related to FVC, cough efficacy, and functional status. Expiratory muscle training tended to enhance inspiratory and expiratory muscle strength. In addition, subjectively and objectively rated cough efficacy improved significantly and lasted for 3 months after training cessation.

An examination of predictive variables toward graduation of minority students in science at a selected urban university

NASA Astrophysics Data System (ADS)

Hunter, Evelyn M. Irving

1998-12-01

The purpose of this study was to examine the relationship and predictive power of the variables gender, high school GPA, class rank, SAT scores, ACT scores, and socioeconomic status on the graduation rates of minority college students majoring in the sciences at a selected urban university. Data was examined on these variables as they related to minority students majoring in science. The population consisted of 101 minority college students who had majored in the sciences from 1986 to 1996 at an urban university in the southwestern region of Texas. A non-probability sampling procedure was used in this study. The non-probability sampling procedure in this investigation was incidental sampling technique. A profile sheet was developed to record the information regarding the variables. The composite scores from SAT and ACT testing were used in the study. The dichotomous variables gender and socioeconomic status were dummy coded for analysis. For the gender variable, zero (0) indicated male, and one (1) indicated female. Additionally, zero (0) indicated high SES, and one (1) indicated low SES. Two parametric procedures were used to analyze the data in this investigation. They were the multiple correlation and multiple regression procedures. Multiple correlation is a statistical technique that indicates the relationship between one variable and a combination of two other variables. The variables socioeconomic status and GPA were found to contribute significantly to the graduation rates of minority students majoring in all sciences when combined with chemistry (Hypotheses Two and Four). These variables accounted for 7% and 15% of the respective variance in the graduation rates of minority students in the sciences and in chemistry. Hypotheses One and Three, the predictor variables gender, high school GPA, SAT Total Scores, class rank, and socioeconomic status did not contribute significantly to the graduation rates of minority students in biology and pharmacy.

Multiplication factor versus regression analysis in stature estimation from hand and foot dimensions.

PubMed

Krishan, Kewal; Kanchan, Tanuj; Sharma, Abhilasha

2012-05-01

Estimation of stature is an important parameter in identification of human remains in forensic examinations. The present study is aimed to compare the reliability and accuracy of stature estimation and to demonstrate the variability in estimated stature and actual stature using multiplication factor and regression analysis methods. The study is based on a sample of 246 subjects (123 males and 123 females) from North India aged between 17 and 20 years. Four anthropometric measurements; hand length, hand breadth, foot length and foot breadth taken on the left side in each subject were included in the study. Stature was measured using standard anthropometric techniques. Multiplication factors were calculated and linear regression models were derived for estimation of stature from hand and foot dimensions. Derived multiplication factors and regression formula were applied to the hand and foot measurements in the study sample. The estimated stature from the multiplication factors and regression analysis was compared with the actual stature to find the error in estimated stature. The results indicate that the range of error in estimation of stature from regression analysis method is less than that of multiplication factor method thus, confirming that the regression analysis method is better than multiplication factor analysis in stature estimation. Copyright © 2012 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

[Establishment of cervical vertebral skeletal maturation of female children in Shanghai].

PubMed

Sun, Yan; Chen, Rong-jing; Yu, Quan; Fan, Li; Chen, Wei; Shen, Gang

2009-06-01

To establish a method for quantitatively evaluating skeletal maturation of cervical vertebrae of female children in Shanghai. The samples were selected from lateral cephalometric radiographs of 240 Shanghai girls, aged 8 to 15 years. The parameters were measured to indicate the morphological changes of the third (C3) and fourth (C4) vertebrae in width, height and the depth of the inferior curvature. The independent-sample t test and stepwise multiple regression analysis were used to estimate the growth status and the ratios of C3, C4 cervical vertebrae by SPSS 15.0 software package. The physical and morphological contour of C3, C4 cervical vertebrae increased proportionately with the increment of age. The regression formula for indicating cervical vertebral skeletal age of female children in Shanghai was expressed by the equation Y= -5.696+8.010 AH3/AP3+6.654 AH3/H3+6.045AH4/PH4 (r=0.912). The regression formula resulted from morphological measurements quantitatively indicates the skeletal maturation of cervical vertebrae of female children in Shanghai.

HIV Status Disclosure Among Postpartum Women in Zambia with Varied Intimate Partner Violence Experiences.

PubMed

Hampanda, Karen M; Rael, Christine Tagliaferri

2018-05-01

HIV-positive pregnant and postpartum women's status disclosure to male sexual partners is associated with improved HIV and maternal and child health outcomes. Yet, status disclosure remains a challenge for many women living with HIV in sub-Saharan Africa, particularly those who are fearful of violence. The objective of the present study is to advance the current understanding of the relationship between intimate partner violence against women and their HIV status disclosure behaviors. We specifically evaluate how the severity, frequency, and type of violence against postpartum HIV-positive women affect status disclosure within married/cohabiting couples. A cross-sectional survey was administered by trained local research assistants to 320 HIV-positive postpartum women attending a large public health center for pediatric immunizations in Lusaka, Zambia. Survey data captured women's self-reports of various forms of intimate partner violence and whether they disclosed their HIV status to the current male partner. Multiple logistic regression models determined the odds of status disclosure by the severity, frequency, and type of violence women experienced. Our findings indicate a negative dose-response relationship between the severity and frequency of intimate partner violence and status disclosure to male partners. Physical violence has a more pronounced affect on status disclosure than sexual or emotional violence. Safe options for women living with HIV who experience intimate partner violence, particularly severe and frequent physical violence, are urgently needed. This includes HIV counselors' ability to evaluate the pros and cons of status disclosure among women and support some women's decisions not to disclose.

The Silk Road Health Project: How Mobility and Migration Status Influence HIV Risks among Male Migrant Workers in Central Asia

PubMed Central

El-Bassel, Nabila; Gilbert, Louisa; Shaw, Stacey A.; Mergenova, Gaukhar; Terlikbayeva, Assel; Primbetova, Sholpan; Ma, Xin; Chang, Mingway; Ismayilova, Leyla; Hunt, Tim; West, Brooke; Wu, Elwin; Beyrer, Chris

2016-01-01

Objectives We examined whether mobility, migrant status, and risk environments are associated with sexually transmitted infections (STIs) and HIV risk behaviors (e.g. sex trading, multiple partners, and unprotected sex). Methods We used Respondent Driven Sampling (RDS) to recruit external male migrant market vendors from Kyrgyzstan, Uzbekistan, and Tajikistan as well internal migrant and non-migrant market vendors from Kazakhstan. We conducted multivariate logistic regressions to examine the effects of mobility combined with the interaction between mobility and migration status on STIs and sexual risk behaviors, when controlling for risk environment characteristics. Results Mobility was associated with increased risk for biologically-confirmed STIs, sex trading, and unprotected sex among non-migrants, but not among internal or external migrants. Condom use rates were low among all three groups, particularly external migrants. Risk environment factors of low-income status, debt, homelessness, and limited access to medical care were associated with unprotected sex among external migrants. Conclusion Study findings underscore the role mobility and risk environments play in shaping HIV/STI risks. They highlight the need to consider mobility in the context of migration status and other risk environment factors in developing effective prevention strategies for this population. PMID:26967159

Prediction of habitual physical activity level and weight status from fundamental movement skill level.

PubMed

Bryant, Elizabeth Sarah; James, Rob S; Birch, Samantha Louise; Duncan, Mike

2014-01-01

Fundamental movement skills (FMS) have been assessed in children in order to investigate the issues of the low proportion of children who meet physical activity (PA) guidelines and rising levels of obesity. The aim of this research was to identify whether previous or current FMS level is a better predictor of PA levels and weight status in children. In January 2012 (year 1), 281 children were recruited from one primary school in the West Midlands, UK. Children performed eight FMS three times, which were videoed and assessed using a subjective checklist. Sprint speed and jump height were measured objectively. Height and mass were measured to calculate the body mass index to determine the weight status. Skinfold calliper readings were used to calculate body fat percentage. One year later, in January 2013, all these tests were repeated on the same children, with the additional collection of PA data via the use of pedometers. Following multiple linear regression, it was identified that prior mastery in FMS was a better predictor of current PA, whereas current FMS was a better predictor of current weight status. Overall, FMS mastery is needed in childhood to be able to participate in PA and maintain a healthy weight status.

Exclusive breastfeeding and other foods in the first six months of life: effects on nutritional status and body composition of Brazilian children.

PubMed

Magalhães, Taís C A; Vieira, Sarah A; Priore, Silvia E; Ribeiro, Andréia Q; Lamounier, Joel A; Franceschini, Sylvia C C; Sant'Ana, Luciana F R

2012-01-01

To evaluate the effect of exclusive breastfeeding and consumption of other foods in the first six months of life in the nutritional status and body composition of children. A retrospective cohort study with 185 children aged from 4 to 7 years was monitored during the first months of life in a program of support to breastfeeding. We evaluated weight, height, waist circumference, and body composition by using DEXA. The nutritional status was assessed by the BMI/age index. The parameters of adiposity were classified by using as the cutoff point, the 85th percentile of the sample itself, according to gender and age. Confounding factors considered were variables related to maternal, pregnancy, birth, sociodemographic, health, lifestyle, and diet. Bivariate and multivariate analyses were performed, the latter by means of multiple logistic regression. The median exclusive breastfeeding was 3 months. Of the children, 42.7% received cow's milk and 35.7% received infant formula. Regarding nutritional status, 21.1% of the children showed changes. The variables of infant feeding were not independently associated with nutritional status and body composition of the children and there were no differences between the groups studied. Breastfeeding was not a protective factor to overweight and body fat in children.

Influence of weight gain rate on early life nutritional status and body composition of children.

PubMed

Vieira, Sarah Aparecida; Magalhães, Taís Cristina Araújo; Ribeiro, Andréia Queiroz; Priore, Silvia Eloiza; Franceschini, Sylvia do Carmo Castro; Sant'Ana, Luciana Ferreira da Rocha

2014-01-01

To evaluate the influence of the weight gain rate at 4-6 months on nutritional status and body composition in children between 4 and 7 years of age. Retrospective cohort study, sample of 257 children. Data collection was performed in two stages, with the first relating to retrospective data of weight gain from birth to the first 4-6 months of life in the patient records. Measurements of weight, height, waist circumference, and body composition in children between ages 4 and 7 years were obtained. Nutritional status was assessed by the BMI/age. Control variables, such as pregnancy, breastfeeding, lifestyle, and sociodemographics, were studied. Descriptive analysis and multiple linear regression were performed. In the nutritional status assessment, the prevalence of overweight observed was 24.9%. After adjusting for control variables, it was found that the increase of the WGR at 4-6 months of age explained the occurrence of higher BMI/age, percentage of total body fat, body fat percentage in the android region, and waist circumference in children between 4 and 7 years of age. The increase of the WGR in the first months of life can lead to the occurrence of higher values of parameters of nutritional status and body composition in later life.

Exclusive Breastfeeding and Other Foods in the First Six Months of Life: Effects on Nutritional Status and Body Composition of Brazilian Children

PubMed Central

Magalhães, Taís C. A.; Vieira, Sarah A.; Priore, Silvia E.; Ribeiro, Andréia Q.; Lamounier, Joel A.; Franceschini, Sylvia C. C.; Sant'Ana, Luciana F. R.

2012-01-01

Objective. To evaluate the effect of exclusive breastfeeding and consumption of other foods in the first six months of life in the nutritional status and body composition of children. Methods. A retrospective cohort study with 185 children aged from 4 to 7 years was monitored during the first months of life in a program of support to breastfeeding. We evaluated weight, height, waist circumference, and body composition by using DEXA. The nutritional status was assessed by the BMI/age index. The parameters of adiposity were classified by using as the cutoff point, the 85th percentile of the sample itself, according to gender and age. Confounding factors considered were variables related to maternal, pregnancy, birth, sociodemographic, health, lifestyle, and diet. Bivariate and multivariate analyses were performed, the latter by means of multiple logistic regression. Results. The median exclusive breastfeeding was 3 months. Of the children, 42.7% received cow's milk and 35.7% received infant formula. Regarding nutritional status, 21.1% of the children showed changes. The variables of infant feeding were not independently associated with nutritional status and body composition of the children and there were no differences between the groups studied. Conclusion. Breastfeeding was not a protective factor to overweight and body fat in children. PMID:23193378

Differences in mental health outcomes by acculturation status following a major urban disaster.

PubMed

Adams, Richard E; Boscarino, Joseph A

2013-01-01

A number of studies have assessed the association between acculturation and psychological outcomes following a traumatic event. Some suggest that low acculturation is associated with poorer health outcomes, while others show no differences or that low acculturation is associated with better outcomes. One year after the terrorist attacks on the World Trade Center, we surveyed a multi-ethnic population of New York City adults (N= 2,368). We assessed posttraumatic stress disorder (PTSD), major depression, panic attack, anxiety symptoms, and general physical and mental health status. We classified study respondents into "low," "moderate," or "high" acculturation, based on survey responses. Bivariate results indicated that low acculturation individuals were more likely to experience negative life events, have low social support, and less likely to have pre-disaster mental health disorders. Those in the low acculturation group were also more likely to experience post-disaster perievent panic attacks, have higher anxiety, and have poorer mental health status. However, using logistic regression to control for confounding, and adjusting for multiple comparisons, we found that none of these outcomes were associated with acculturation status. Thus, our study suggests that acculturation was not associated with mental health outcomes following a major traumatic event.

Mother's body mass index as a predictor of infant's nutritional status in the post-emergency phase of a flood.

PubMed

Goudet, Sophie; Griffths, Paula; Bogin, Barry A

2011-10-01

Maternal nutritional status is a determinant of child health. This paper studies the association between a mother's body mass index (BMI) and her infant's nutritional status over a one year time frame after the 1998 flood crisis in Bangladesh. The paper uses secondary analysis of data collected from 757 households in seven rural areas of Bangladesh affected by the 1998 flood using multiple-stage probability sampling techniques (n = 143). Logistic regression models were employed to investigate the predictive impact of maternal BMI on infant's nutritional status after controlling for a range of child and maternal factors. An underweight mother was a significant factor with regard to the risk of infants suffering stunting (odds ratio (OR) = 4.45, 95 per cent confidence interval (CI) = 1.04-18.94) and being underweight (OR = 3.51, 95 per cent CI = 1.02-12.05) a year later, but not wasting (OR = 2.09, 95 per cent CI = 0.51-8.67). The findings suggest that there is a post-emergency link between maternal and infant nutritional health. © 2011 The Author(s). Disasters © Overseas Development Institute, 2011.

Associations of HLA DRB1 alleles with IgG oligoclonal bands and their influence on multiple sclerosis course and disability status.

PubMed

Balnytė, Renata; Rastenytė, Daiva; Vaitkus, Antanas; Skrodenienė, Erika; Vitkauskienė, Astra; Ulozienė, Ingrida

2016-01-01

Oligoclonal bands (OCB) may be associated with the genes of HLA complex, which allows to consider the possible interaction of genetic and immunological factors and its importance in the development and progression of multiple sclerosis (MS). The aim of this study was to evaluate the associations between HLA DRB1 alleles and oligoclonal bands (OCBs) in the disease course and disability of multiple sclerosis (MS) patients. This was a prospective study of 120 patients with MS. HLA DRB1 alleles were genotyped using the polymerase chain reaction. Matched cerebrospinal fluid (CSF) and plasma samples were analyzed using isoelectric focusing and IgG specific immunofixation to test for the presence of intrathecal specific OCB. HLA DRB1*08 allele was related to a lower degree of disability. Oligoclonal bands were an independent and significant factor that influenced disability status irrespective of HLA DRB1* 04, *07, *08, *13, *15 and *16 alleles. Age at the onset and duration of the disease were independent and significant factors for MS progression in all logistic regression models with each newly added HLA DRB1 allele. HLA DRB1*08 allele was related to 75% lower odds that relapsing remitting (RR) MS will change to a progressive course MS irrespective of the other factors investigated. Detection of OCBs in the CSF was associated with the higher possibility of RR MS progression in all cases, except when the *08 allele was present. OCBs had an influence on disability status, while HLA DRB1*08 allele was significantly associated with lower possibility that RR MS will change to progressive course MS. Copyright © 2016 The Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

Comparison of Personal Resources in Patients Who Differently Estimate the Impact of Multiple Sclerosis.

PubMed

Wilski, Maciej; Tomczak, Maciej

2017-04-01

Discrepancies between physicians' assessment and patients' subjective representations of the disease severity may influence physician-patient communication and management of a chronic illness, such as multiple sclerosis (MS). For these reasons, it is important to recognize factors that distinguish patients who differently estimate the impact of MS. The purpose of this study was to verify if the patients who overestimate or underestimate the impact of MS differ in their perception of personal resources from individuals presenting with a realistic appraisal of their physical condition. A total of 172 women and 92 men diagnosed with MS completed Multiple Sclerosis Impact Scale, University of Washington Self Efficacy Scale, Rosenberg Self-Esteem Scale, Body Esteem Scale, Brief Illness Perception Questionnaire, Treatment Beliefs Scale, Actually Received Support Scale, and Socioeconomic resources scale. Physician's assessment of health status was determined with Expanded Disability Status Scale. Linear regression analysis was conducted to identify the subsets of patients with various patterns of subjective health and Expanded Disability Status Scale (EDSS) scores. Patients overestimating the impact of their disease presented with significantly lower levels of self-esteem, self-efficacy in MS, and body esteem; furthermore, they perceived their condition more threatening than did realists and underestimators. They also assessed anti-MS treatment worse, had less socioeconomic resources, and received less support than underestimators. Additionally, underestimators presented with significantly better perception of their disease, self, and body than did realists. Self-assessment of MS-related symptoms is associated with specific perception of personal resources in coping with the disease. These findings may facilitate communication with patients and point to new directions for future research on adaptation to MS.

Single versus multiple sets of resistance exercise: a meta-regression.

PubMed

Krieger, James W

2009-09-01

There has been considerable debate over the optimal number of sets per exercise to improve musculoskeletal strength during a resistance exercise program. The purpose of this study was to use hierarchical, random-effects meta-regression to compare the effects of single and multiple sets per exercise on dynamic strength. English-language studies comparing single with multiple sets per exercise, while controlling for other variables, were considered eligible for inclusion. The analysis comprised 92 effect sizes (ESs) nested within 30 treatment groups and 14 studies. Multiple sets were associated with a larger ES than a single set (difference = 0.26 +/- 0.05; confidence interval [CI]: 0.15, 0.37; p < 0.0001). In a dose-response model, 2 to 3 sets per exercise were associated with a significantly greater ES than 1 set (difference = 0.25 +/- 0.06; CI: 0.14, 0.37; p = 0.0001). There was no significant difference between 1 set per exercise and 4 to 6 sets per exercise (difference = 0.35 +/- 0.25; CI: -0.05, 0.74; p = 0.17) or between 2 to 3 sets per exercise and 4 to 6 sets per exercise (difference = 0.09 +/- 0.20; CI: -0.31, 0.50; p = 0.64). There were no interactions between set volume and training program duration, subject training status, or whether the upper or lower body was trained. Sensitivity analysis revealed no highly influential studies, and no evidence of publication bias was observed. In conclusion, 2 to 3 sets per exercise are associated with 46% greater strength gains than 1 set, in both trained and untrained subjects.

Association Between Nutritional Status and Quality of Life in (Pre) Frail Community-Dwelling Older Persons.

PubMed

Luger, E; Haider, S; Kapan, A; Schindler, K; Lackinger, C; Dorner, T E

2016-01-01

BACKGROUND: For developed countries, healthy aging is one of the challenges and the number of healthy life years and especially the quality of life (QoL) are important. OBJECTIVE: This study aimed to assess the association between nutritional status and different domains of QoL in (pre)frail community-dwelling elders. DESIGN: Baseline data from persons, who participated in a 12-week nutritional and physical training intervention program, conducted from September 2013 - July 2015. Setting: (Pre)frail community-dwelling elders living in Vienna, Austria. PARTICIPANTS: A total of 83 older persons living at home, 12 men and 71 women (86%) aged 65 to 98 years. Measurements: Structured interviews were conducted at participants’ homes. Mini Nutritional Assessment® long-form (MNA®-LF) was used to investigate the nutritional status. The QoL domains were assessed with the World Health Organization Quality of Life questionnaires. Simple and multiple linear regression analyses were performed to evaluate the association between nutritional status and QoL domains, adjusted for possible confounders. RESULTS: 45% of the participants were at risk of malnutrition and 3% were malnourished. Compared to normal nourished people, persons who had an impaired nutritional status, significantly differed in the QoL domain ‘autonomy’ with mean (SD) scores of 50.0 (14.9) vs. 57.3 (13.7); p=0.022 and in the QoL domain ‘social participation’ with scores of 40.1 (13.6) vs. 47.0 (11.2); p=0.014, respectively. According to linear regression analyses, the MNA®-LF score was significantly associated with ‘overall QoL’ (β=0.26; p=0.016) and the QoL domains ‘physical health’ (β=0.23; p=0.036), ‘autonomy’ (β=0.27; p=0.015), and ‘social participation’ (β=0.28; p=0.013).CONCLUSIONS: There was a significant association between nutritional status and QoL in elderly (pre)frail community-dwelling people, in particular for the QoL domains ‘autonomy’ and ‘social participation’. However, it remains unclear whether malnutrition was the cause or the consequence, or it was mediated through a third possible factor e.g. the functional status.

I Wanna Play Too: Factors Related to Changes in Social Behavior for Children With and Without Autism Spectrum Disorder After Implementation of a Structured Outdoor Play Curriculum.

PubMed

Morrier, Michael J; Ziegler, Sonja M T

2018-02-27

Children with autism spectrum disorder (ASD) have difficulties interacting with same-aged peers during unstructured play (e.g., on the playground). Thirty-five toddler and preschool children with and without ASD participated in a structured 15-min outdoor play curriculum. The intervention, the Buddy Game, used familiar songs, movement, and games to promote peer social interaction. A 2 × 3 ANOVA assessed changes in overall targeted social behaviors during baseline, the Buddy Game, and generalization to free-pay. Multiple regression analyses examined factors related to increases in social interactions. Predictors were ASD status of child and age of child. Results indicated the Buddy Game increased overall social interactions and that social interactions were influenced more by ASD status than age. Implications for practitioners are highlighted.

Honest Labor Bears a Lovely Face: Will Late-Life Unemployment Impact Health and Satisfaction in Retirement?

PubMed

Voss, Maren Wright; Birmingham, Wendy Church; Wadsworth, Lori; Chen, Wei; Bounsanga, Jerry; Gu, Yushan; Hung, Man

2017-02-01

Unemployment among older adults during recessionary cycles has been tied to early retirement decisions and negative health outcomes. This study explored episodes of unemployment experienced between age 50 and retirement as predictors of retirement age and health outcomes. A total of 1540 participants from the U.S. Health and Retirement Study aged 50 years and older who transitioned from workforce to retirement were analyzed with descriptive statistics and multiple regression controlling for unemployment, demographics, and health status. Late-life unemployment significantly related to earlier retirement age and lowered life satisfaction, independent of income effects. We found no main effect for late-life unemployment on physical health status. Potential improvements in future life satisfaction might be gained if job search obstacles are removed for older unemployed adults, reducing reliance on involuntary early retirement as an income source.

Religiosity, dietary habit, intake of fruit and vegetable, and vegetarian status among Seventh-Day Adventists in West Malaysia.

PubMed

Tan, Min-Min; Chan, Carina K Y; Reidpath, Daniel D

2016-08-01

Religion has been shown to be salutary on health, and a possible link between religion and positive health outcomes is diet. Research has shown that religiosity is associated with better diet but most studies were conducted in a multi-denominational context, which might be confounded with theological differences. This study examined the relationship between religiosity and diet within a homogenous group of believers. Data from survey of 574 Seventh-Day Adventists residing in West Malaysia, aged 18-80, were analyzed using multiple regressions. While none of the religious variables were significantly associated with fruit and vegetable intake, a higher level of religiosity was associated with a better dietary habit and vegetarian status. The mixed relationship between religiosity and diet suggest that further research is needed to explore how religion might influence the diet of adherents.

Associations between health literacy and established predictors of smoking cessation.

PubMed

Stewart, Diana W; Adams, Claire E; Cano, Miguel A; Correa-Fernández, Virmarie; Li, Yisheng; Waters, Andrew J; Wetter, David W; Vidrine, Jennifer Irvin

2013-07-01

We examined associations between health literacy and predictors of smoking cessation among 402 low-socioeconomic status (SES), racially/ethnically diverse smokers. Data were collected as part of a larger study evaluating smoking health risk messages. We conducted multiple linear regression analyses to examine relations between health literacy and predictors of smoking cessation (i.e., nicotine dependence, smoking outcome expectancies, smoking risk perceptions and knowledge, self-efficacy, intentions to quit or reduce smoking). Lower health literacy was associated with higher nicotine dependence, more positive and less negative smoking outcome expectancies, less knowledge about smoking health risks, and lower risk perceptions. Associations remained significant (P < .05) after controlling for demographics and SES-related factors. These results provide the first evidence that low health literacy may serve as a critical and independent risk factor for poor cessation outcomes among low-socioeconomic status, racially/ethnically diverse smokers. Research is needed to investigate potential mechanisms underlying this relationship.

Housing Satisfaction of Older (55+) Single-Person Householders in U.S. Rural Communities.

PubMed

Ahn, Mira; Lee, Sung-Jin

2016-08-01

This study aims to understand the housing satisfaction of older (55+) single-person householders in U.S. rural communities using the available variables from a secondary data set, the 2011 American Housing Survey (AHS). In this study, housing satisfaction was considered to be an indicator of quality of life. Based on previous studies, we developed a model to test a hypothesized relationship between older (55+) single-person householders' (N = 1,017) housing satisfaction and their personal, physical, financial, and environmental characteristics. Multiple regression results showed that the model was supported, indicating that significant variables in housing satisfaction include age, gender, health status, age of house, structure type, and unit location. Among the significant variables, health status was revealed to be the strongest factor in housing satisfaction. Housing satisfaction was discussed as potential indicators of quality of life. © The Author(s) 2015.

Multiple pregnancy, short cervix, part-time worker, steroid use, low educational level and male fetus are risk factors for preterm birth in Japan: a multicenter, prospective study.

PubMed

Shiozaki, Arihiro; Yoneda, Satoshi; Nakabayashi, Masao; Takeda, Yoshiharu; Takeda, Satoru; Sugimura, Motoi; Yoshida, Koyo; Tajima, Atsushi; Manabe, Mami; Akagi, Kozo; Nakagawa, Shoko; Tada, Katsuhiko; Imafuku, Noriaki; Ogawa, Masanobu; Mizunoe, Tomoya; Kanayama, Naohiro; Itoh, Hiroaki; Minoura, Shigeki; Ogino, Mitsuharu; Saito, Shigeru

2014-01-01

To examine the relationship between preterm birth and socioeconomic factors, past history, cervical length, cervical interleukin-8, bacterial vaginosis, underlying diseases, use of medication, employment status, sex of the fetus and multiple pregnancy. In a multicenter, prospective, observational study, 1810 Japanese women registering their future delivery were enrolled at 8⁺⁰ to 12⁺⁶ weeks of gestation. Data on cervical length and delivery were obtained from 1365 pregnant women. Multivariate logistic regression analysis was performed. Short cervical length, steroid use, multiple pregnancy and male fetus were risk factors for preterm birth before 34 weeks of gestation. Multiple pregnancy, low educational level, short cervical length and part-timer were risk factors for preterm birth before 37 weeks of gestation. Multiple pregnancy and cervical shortening at 20-24 weeks of gestation was a stronger risk factor for preterm birth. Any pregnant woman being part-time employee or low educational level, having a male fetus and requiring steroid treatment should be watched for the development of preterm birth. © 2013 The Authors. Journal of Obstetrics and Gynaecology Research © 2013 Japan Society of Obstetrics and Gynecology.

Does hypervascularity of liver metastases as detected on MRI predict disease progression in breast cancer patients?

PubMed

Braga, Larissa; Semelka, Richard C; Pietrobon, Ricardo; Martin, Diego; de Barros, Nestor; Guller, Ulrich

2004-05-01

The aim of our study was to evaluate the association of the vascularity of liver metastases, as characterized by MRI, and disease progression in breast cancer patients. Sixteen breast cancer patients with liver metastases who underwent MRI before and after systemic therapy were retrospectively identified. On the basis of comparison of each MRI examination with the previous examination, disease status of the patients was classified as complete response, partial response, stable disease, or progressive disease. Liver metastases were characterized as hyper- or hypovascular on the basis of the degree of enhancement in the arterial, portal, and interstitial phases of imaging after administration of a contrast agent. Fisher's exact test and ordinal logistic regression models, including the type of systemic therapy, presence of multiple metastases, and hormone receptor status, were used to estimate the unadjusted and risk-adjusted association between the presence of hypervascular liver metastases and disease progression. All patients in our sample (n = 16) were women and most (12/16, 75%) were white. Their median age was 51.5 years. In unadjusted analyses, the association between the presence of hypervascular liver metastases and disease progression was statistically significant (p < 0.0001). In multiple logistic regression analyses, hypervascular liver metastases were found to be an independent predictor of disease progression. Patients with hypervascular liver lesions were 20.5 times more likely to experience disease progression than patients without hypervascular metastases (odds ratio, 20.5; 95% confidence interval, 5.1-83.5; p < 0.0001). Our analysis provides suggestive evidence that disease progression can be predicted through MRI assessment of the vascularity of liver metastases in patients with breast cancer.

Catastrophic health expenditure among households with members with special diseases: A case study in Kurdistan

PubMed Central

Moradi, Ghobad; Safari, Hossein; Piroozi, Bakhtiar; Qanbari, Laila; Farshadi, Salahadin; Qasri, Homan; Farhadifar, Fariba

2017-01-01

Background: One of the main goals of health systems is to protect people against financial risks associated with diseases that can be catastrophic for patients. In 2014, Health Sector Evolution Plan (HSEP) was implemented in Iran; one of the objectives of HSEP was to reduce out-of-pocket payments and provide more financial protection for people. Therefore, the present study aimed at exploring the likelihood of facing catastrophic health expenditures (CHE) among households with members suffering from dialysis, kidney transplant, or multiple sclerosis (MS) after the implementation of HSEP. Methods: A total number of 385 households were selected using stratified random sampling and were asked to complete the World Health Survey questionnaire through telephone conversations. As outlined by the World Health Organization (WHO), when household out-of-pocket expense for health services is ≥40% of its capacity to pay, then that household is considered to be facing CHE. Furthermore, determinants of CHE were identified using logistic regression. Results: The percentage of facing catastrophic health care expenditures for households with a MS, dialysis, and kidney transplant patient was 20.6%, 18.7%, and 13.8%, respectively. Results of logistic regression analysis revealed that patient’s economic status, level of education, supplementary insurance status, type of disease, multiple members with special diseases in the household, rural residence, use of inpatient, dental, and rehabilitation services were effective factors for determining the likelihood of facing CHE. Conclusion: Despite the implementation of HSEP, the percentage of CHE is still high for households that have members who suffer from special diseases. However, basic health insurance packages should be amended and more cost-sharing exemptions should be granted to provide more financial protection for the vulnerable households. PMID:29445672

Ghrelin, leptin and insulin in cirrhotic children and adolescents: relationship with cirrhosis severity and nutritional status.

PubMed

Dornelles, Cristina T L; Goldani, Helena A S; Wilasco, Maria Inês A; Maurer, Rafael L; Kieling, Carlos O; Porowski, Marilene; Ferreira, Cristina T; Santos, Jorge L; Vieira, Sandra M G; Silveira, Themis R

2013-01-10

Ghrelin, leptin, and insulin concentrations are involved in the control of food intake and they seem to be associated with anorexia-cachexia in cirrhotic patients. The present study aimed to investigate the relationship between the nutritional status and fasting ghrelin, leptin and insulin concentrations in pediatric cirrhotic patients. Thirty-nine patients with cirrhosis and 39 healthy controls aged 0-15 years matched by sex and age were enrolled. Severity of liver disease was assessed by Child-Pugh classification, and Pediatric for End Stage Liver Disease (PELD) or Model for End-stage Liver Disease (MELD) scores. Blood samples were collected from patients and controls to assay total ghrelin, acyl ghrelin, leptin and insulin by using a commercial ELISA kit. Anthropometry parameters used were standard deviation score of height-for-age and triceps skinfold thickness-for-age ratio. A multiple linear regression analysis was used to determine the correlation between dependent and independent variables. Acyl ghrelin was significantly lower in cirrhotic patients than in controls [142 (93-278) pg/mL vs 275 (208-481) pg/mL, P=0.001]. After multiple linear regression analysis, total ghrelin and acyl ghrelin showed an inverse correlation with age; acyl ghrelin was associated with the severity of cirrhosis and des-acyl ghrelin with PELD or MELD scores ≥15. Leptin was positively correlated with gender and anthropometric parameters. Insulin was not associated with any variable. Low acyl ghrelin and high des-acyl ghrelin concentrations were associated with cirrhosis severity, whereas low leptin concentration was associated with undernourishment in children and adolescents with cirrhosis. Copyright © 2012 Elsevier B.V. All rights reserved.

The effect of human immunodeficiency virus type 1 antibody status on military applicant aptitude test scores.

PubMed

Arday, D R; Brundage, J F; Gardner, L I; Goldenbaum, M; Wann, F; Wright, S

1991-06-15

The authors conducted a population-based study to attempt to estimate the effect of human immunodeficiency virus type 1 (HIV-1) seropositivity on Armed Services Vocational Aptitude Battery test scores in otherwise healthy individuals with early HIV-1 infection. The Armed Services Vocational Aptitude Battery is a 10-test written multiple aptitude battery administered to all civilian applicants for military enlistment prior to serologic screening for HIV-1 antibodies. A total of 975,489 induction testing records containing both Armed Services Vocational Aptitude Battery and HIV-1 results from October 1985 through March 1987 were examined. An analysis data set (n = 7,698) was constructed by choosing five controls for each of the 1,283 HIV-1-positive cases, matched on five-digit ZIP code, and a multiple linear regression analysis was performed to control for demographic and other factors that might influence test scores. Years of education was the strongest predictor of test scores, raising an applicant's score on a composite test nearly 0.16 standard deviation per year. The HIV-1-positive effect on the composite score was -0.09 standard deviation (99% confidence interval -0.17 to -0.02). Separate regressions on each component test within the battery showed HIV-1 effects between -0.39 and +0.06 standard deviation. The two Armed Services Vocational Aptitude Battery component tests felt a priori to be the most sensitive to HIV-1-positive status showed the least decrease with seropositivity. Much of the variability in test scores was not predicted by either HIV-1 serostatus or the demographic and other factors included in the model. There appeared to be little evidence of a strong HIV-1 effect.

Catastrophic health expenditure among households with members with special diseases: A case study in Kurdistan.

PubMed

Moradi, Ghobad; Safari, Hossein; Piroozi, Bakhtiar; Qanbari, Laila; Farshadi, Salahadin; Qasri, Homan; Farhadifar, Fariba

2017-01-01

Background: One of the main goals of health systems is to protect people against financial risks associated with diseases that can be catastrophic for patients. In 2014, Health Sector Evolution Plan (HSEP) was implemented in Iran; one of the objectives of HSEP was to reduce out-of-pocket payments and provide more financial protection for people. Therefore, the present study aimed at exploring the likelihood of facing catastrophic health expenditures (CHE) among households with members suffering from dialysis, kidney transplant, or multiple sclerosis (MS) after the implementation of HSEP. Methods: A total number of 385 households were selected using stratified random sampling and were asked to complete the World Health Survey questionnaire through telephone conversations. As outlined by the World Health Organization (WHO), when household out-of-pocket expense for health services is ≥40% of its capacity to pay, then that household is considered to be facing CHE. Furthermore, determinants of CHE were identified using logistic regression. Results: The percentage of facing catastrophic health care expenditures for households with a MS, dialysis, and kidney transplant patient was 20.6%, 18.7%, and 13.8%, respectively. Results of logistic regression analysis revealed that patient's economic status, level of education, supplementary insurance status, type of disease, multiple members with special diseases in the household, rural residence, use of inpatient, dental, and rehabilitation services were effective factors for determining the likelihood of facing CHE. Conclusion: Despite the implementation of HSEP, the percentage of CHE is still high for households that have members who suffer from special diseases. However, basic health insurance packages should be amended and more cost-sharing exemptions should be granted to provide more financial protection for the vulnerable households.

Cross-sectional study of equol producer status and cognitive impairment in older adults.

PubMed

Igase, Michiya; Igase, Keiji; Tabara, Yasuharu; Ohyagi, Yasumasa; Kohara, Katsuhiko

2017-11-01

It is well known that consumption of isoflavones reduces the risk of cardiovascular disease. However, the effectiveness of isoflavones in preventing dementia is controversial. A number of intervention studies have produced conflicting results. One possible reason is that the ability to produce equol, a metabolite of a soy isoflavone, differs greatly in individuals. In addition to existing data, we sought to confirm whether an apparent beneficial effect in cognitive function is observed after soy consumption in equol producers compared with non-producers. The present study was a cross-sectional, observational study of 152 (male/female = 61/91, mean age 69.2 ± 9.2 years) individuals. Participants were divided into two groups according to equol production status, which was determined using urine samples collected after a soy challenge test. Cognitive function was assessed using two computer-based questionnaires (touch panel-type dementia assessment scale [TDAS] and mild cognitive impairment [MCI] screen). Overall, 60 (40%) of 152 participants were equol producers. Both TDAS and prevalence of MCI were significantly higher in the equol producer group than in the non-producer group. In univariate analyses, TDAS significantly correlated with age, serum creatinine, estimated glomerular filtration rate and low-density lipoprotein cholesterol. In multiple regression analysis using TDAS as a dependent variable, equol producer (β = 0.236, P = 0.005) was selected as an independent variable. In addition, multiple logistic regression analysis to assess the presence of MCI showed that being an equol producer was an independent risk factor for MCI (odds ratio 3.961). Compared with equol non-producers, equol producers showed an apparent beneficial effect in cognitive function after soy intake. Geriatr Gerontol Int 2017; 17: 2103-2108. © 2017 Japan Geriatrics Society.

Risk factors of indoor fall injuries in community-dwelling older women: a prospective cohort study.

PubMed

Hu, Jia; Xia, Qinghua; Jiang, Yu; Zhou, Peng; Li, Yuhua

2015-01-01

The aims of the study were to explore the characteristics and the potential risk factors of indoor fall injuries in community-dwelling older women, and to provide evidence for the future intervention strategy. A prospective cohort of 3043 women aged 60 years old and above from 3 selected counties in Shanghai was followed up on the outcomes of indoor fall injuries for up to 1 year. Demographic and health data were collected during admission; the physical function, balance ability and home-living environment were examined by a structured questionnaire when admitted. The outcome of indoor fall injury was investigated by a visit in month 3, month 6 and month 12 after baseline survey. Univariate analysis and Multiple Logistic Regression Model were used to examine the associations between potential risk factors and outcomes of indoor fall injuries. Two hundred and thirty-one of the 3043 women (7.6%) eventually suffered indoor fall injuries at least once during the 1-year follow-up. The injurious falls of women were significantly associated with age, educational level, marital status, health status, balance ability, physical activity and home-living environment in the univariate analyses. Women who worried about falls and restrained activities for it were more likely to suffer fall injury. Younger women, with less chronic disease, with good balance ability and living in good corridor environment, were less likely to receive fall injury in multiple logistic regression analyses. Multidimensional factors were associated with indoor fall injuries for community-dwelling older women. Proper clinical treatment of chronic disease and improvement of women's balance ability, as well as reducing the risk factor of indoor environment, which will play vital roles in preventing indoor fall injuries, should be prioritized for the intervention strategy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

High Dietary Magnesium Intake Is Associated with Low Insulin Resistance in the Newfoundland Population

PubMed Central

Shea, Jennifer; Wadden, Danny; Gulliver, Wayne; Randell, Edward; Vasdev, Sudesh; Sun, Guang

2013-01-01

Background Magnesium plays a role in glucose and insulin homeostasis and evidence suggests that magnesium intake is associated with insulin resistance (IR). However, data is inconsistent and most studies have not adequately controlled for critical confounding factors. Objective The study investigated the association between magnesium intake and IR in normal-weight (NW), overweight (OW) and obese (OB) along with pre- and post- menopausal women. Design A total of 2295 subjects (590 men and 1705 women) were recruited from the CODING study. Dietary magnesium intake was computed from the Willett Food Frequency Questionnaire (FFQ). Adiposity (NW, OW and OB) was classified by body fat percentage (%BF) measured by Dual-energy X-ray absorptiometry according to the Bray criteria. Multiple regression analyses were used to test adiposity-specific associations of dietary magnesium intake on insulin resistance adjusting for caloric intake, physical activity, medication use and menopausal status. Results Subjects with the highest intakes of dietary magnesium had the lowest levels of circulating insulin, HOMA-IR, and HOMA-ß and subjects with the lowest intake of dietary magnesium had the highest levels of these measures, suggesting a dose effect. Multiple regression analysis revealed a strong inverse association between dietary magnesium with IR. In addition, adiposity and menopausal status were found to be critical factors revealing that the association between dietary magnesium and IR was stronger in OW and OB along with Pre-menopausal women. Conclusion The results of this study indicate that higher dietary magnesium intake is strongly associated with the attenuation of insulin resistance and is more beneficial for overweight and obese individuals in the general population and pre-menopausal women. Moreover, the inverse correlation between insulin resistance and dietary magnesium intake is stronger when adjusting for %BF than BMI. PMID:23472169

Pain in patients with transverse myelitis and its relationship to aquaporin 4 antibody status.

PubMed

Kong, Yazhuo; Okoruwa, Helen; Revis, Jon; Tackley, George; Leite, Maria Isabel; Lee, Michael; Tracey, Irene; Palace, Jacqueline

2016-09-15

Pain in transverse myelitis has been poorly studied. The aim of the study was to investigate the relationship between transverse myelitis related pain and disability, quality of life, anxiety and depression, cognitive-affective states in neuromyelitis optica (NMO) patients and aquaporin4 antibody status (AQP4-Ab +ve as positive and AQP4-Ab -ve as negative). Transverse myelitis patients (44 in total; 29 AQP4-Ab +ve and 15 AQP4-Ab -ve) completed questionnaires including Pain Severity Index (PSI), Pain Catastrophising Scale (PCS), Hospital Anxiety and Depression Scale (HADS), Short Form-36 quality of life (SF-36 QOL). Clinical details such as disability, gender, age and spinal cord lesion type (short or long lesion) were noted. Correlation and multiple linear regression tests were performed using these clinical scores. Pain was found to be correlated strongly with quality of life in both groups but only correlated with disability in the AQP4-Ab +ve group. PCS, HADS and EDMUS were found to be highly correlated with pain severity using partial correlation, however, a stronger relationship between pain severity and PCS was found in the AQP4-Ab -ve group. Multiple regression analysis showed that pain severity was the most important factor for quality of life but not disability or anxiety and depression symptoms in the whole patient group. We confirm that pain is an important symptom of transverse myelitis and has more influence on quality of life than disability despite health services being predominantly focused on the latter. There may be different factors associated with pain between AQP4-Ab +ve and -ve patients. Copyright © 2016 Elsevier B.V. All rights reserved.

Use of physical therapy services among middle-aged and older adults with multiple sclerosis.

PubMed

Finlayson, Marcia; Plow, Matthew; Cho, Chi

2010-11-01

There is limited understanding of the utilization of and perceived need for physical therapy services among middle-aged and older adults with multiple sclerosis (MS). The resulting knowledge gap compromises efforts for physical therapy service planning for this population. The purpose of this study was to examine the use of and need for physical therapy services in a sample of adults with MS living in the Midwestern United States. This was a cross-sectional, descriptive study. Data from telephone interviews with 1,065 people with MS, aged 45 to 90 years, were used for the study. A multinomial regression model was used to determine factors associated with use of physical therapy services (never, within the past year, more than a year ago). Logistic regression analysis examined factors associated with unmet needs for these services. Thirty-six percent of the sample reported never using physical therapy services, 33% reported using physical therapy services within the past year, and 31% reported using physical therapy services more than a year prior to the interview. Factors associated with recent use of physical therapy services included living in an urban or suburban community, deteriorating MS status, experiencing problems with spasticity (ie, hypertonicity), having difficulty moving inside the house, being hospitalized in the past 6 months, and seeing a family physician. These same factors were associated with unmet needs. Limitations Physical therapy service use was self-reported. Data were collected in 5 Midwestern states from people 45 years of age or older, which may limit generalizability. Factors associated with use of and need for physical therapy services reflect issues of access (geographical, referrals), MS status, and mobility difficulties.

Perceptions of Shared Decision Making Among Patients with Spinal Cord Injuries/Disorders.

PubMed

Locatelli, Sara M; Etingen, Bella; Heinemann, Allen; Neumann, Holly DeMark; Miskovic, Ana; Chen, David; LaVela, Sherri L

2016-01-01

Background: Individuals with spinal cord injuries/disorders (SCI/D) are interested in, and benefit from, shared decision making (SDM). Objective: To explore SDM among individuals with SCI/D and how demographics and health and SCI/D characteristics are related to SDM. Method: Individuals with SCI/D who were at least 1 year post injury, resided in the Chicago metropolitan area, and received SCI care at a Veterans Affairs (VA; n = 124) or an SCI Model Systems facility ( n = 326) completed a mailed survey measuring demographics, health and SCI/D characteristics, physical and mental health status, and perceptions of care, including SDM, using the Combined Outcome Measure for Risk Communication and Treatment Decision-Making Effectiveness (COMRADE) that assesses decision-making effectiveness (effectiveness) and risk communication (communication). Bivariate analyses and multiple linear regression were used to identify variables associated with SDM. Results: Participants were mostly male (83%) and White (70%) and were an average age of 54 years ( SD = 14.3). Most had traumatic etiology, 44% paraplegia, and 49% complete injury. Veteran/civilian status and demographics were unrelated to scores. Bivariate analyses showed that individuals with tetraplegia had better effectiveness scores than those with paraplegia. Better effectiveness was correlated with better physical and mental health; better communication was correlated with better mental health. Multiple linear regressions showed that tetraplegia, better physical health, and better mental health were associated with better effectiveness, and better mental health was associated with better communication. Conclusion: SCI/D and health characteristics were the only variables associated with SDM. Interventions to increase engagement in SDM and provider attention to SDM may be beneficial, especially for individuals with paraplegia or in poorer physical and mental health.

Protective Effect of HLA-DQB1 Alleles Against Alloimmunization in Patients with Sickle Cell Disease

PubMed Central

Tatari-Calderone, Zohreh; Gordish-Dressman, Heather; Fasano, Ross; Riggs, Michael; Fortier, Catherine; Andrew; Campbell, D.; Charron, Dominique; Gordeuk, Victor R.; Luban, Naomi L.C.; Vukmanovic, Stanislav; Tamouza, Ryad

2015-01-01

Background Alloimmunization or the development of alloantibodies to Red Blood Cell (RBC) antigens is considered one of the major complications after RBC transfusions in patients with sickle cell disease (SCD) and can lead to both acute and delayed hemolytic reactions. It has been suggested that polymorphisms in HLA genes, may play a role in alloimmunization. We conducted a retrospective study analyzing the influence of HLA-DRB1 and DQB1 genetic diversity on RBC-alloimmunization. Study design Two-hundred four multi-transfused SCD patients with and without RBC-alloimmunization were typed at low/medium resolution by PCR-SSO, using IMGT-HLA Database. HLA-DRB1 and DQB1 allele frequencies were analyzed using logistic regression models, and global p-value was calculated using multiple logistic regression. Results While only trends towards associations between HLA-DR diversity and alloimmunization were observed, analysis of HLA-DQ showed that HLA-DQ2 (p=0.02), -DQ3 (p=0.02) and -DQ5 (p=0.01) alleles were significantly higher in non-alloimmunized patients, likely behaving as protective alleles. In addition, multiple logistic regression analysis showed both HLA-DQ2/6 (p=0.01) and HLA-DQ5/5 (p=0.03) combinations constitute additional predictor of protective status. Conclusion Our data suggest that particular HLA-DQ alleles influence the clinical course of RBC transfusion in patients with SCD, which could pave the way towards predictive strategies. PMID:26476208

Socioeconomic Status and Stroke Prevalence in Morocco: Results from the Rabat-Casablanca Study

PubMed Central

Engels, Thomas; Baglione, Quentin; Audibert, Martine; Viallefont, Anne; Mourji, Fouzi; El Alaoui Faris, Mustapha

2014-01-01

Background Stroke is a growing public health concern in low- and middle- income countries. Improved knowledge about the association between socioeconomic status and stroke in these countries would enable the development of effective stroke prevention and management strategies. This study presents the association between socioeconomic status and the prevalence of stroke in Morocco, a lower middle-income country. Methods Data on the prevalence of stroke and stroke-related risk factors were collected during a large population-based survey. The diagnosis of stroke in surviving patients was confirmed by neurologists while health, demographic, and socioeconomic characteristics of households were collected using structured questionnaires. We used Multiple Correspondence Analysis to develop a wealth index based on characteristics of the household dwelling as well as ownership of selected assets. We used logistic regressions controlling for multiple variables to assess the statistical association between socioeconomic status and stroke. Findings Our results showed a significant association between household socioeconomic status and the prevalence of stroke. This relationship was non-linear, with individuals from both the poorest (mainly rural) and richest (mainly urban) households having a lower prevalence of stroke as compared to individuals with medium wealth level. The latter belonged mainly to urban households with a lower socioeconomic status. When taking into account the urban population only, we observed that a third of poorest households experienced a significantly higher prevalence of stroke compared to the richest third (OR = 2.06; CI 95%: 1.09; 3.89). Conclusion We conclude that individuals from the most deprived urban households bear a higher risk of stroke than the rest of the population in Morocco. This result can be explained to a certain extent by the higher presence of behavioral risk factors in this specific category of the population, which leads in turn to metabolic and physiological risk factors of stroke, such as obesity, diabetes, and hypertension. PMID:24586649

Anemia and Iron Status Among Different Body Size Phenotypes in Chinese Adult Population: a Nation-Wide, Health and Nutrition Survey.

PubMed

Li, Jiang; Xiao, Cheng; Yang, Hui; Zhou, Yun; Wang, Rui; Cao, Yongtong

2017-12-09

Previous studies have shown that there is a controversial relationship between iron homeostasis and obesity. This study aims to explore the relationship of anemia and iron status with different body size phenotypes in adult Chinese population. Using information on iron status-related parameters and lifestyle data from 8462 participants of the 2009 wave of China Health and Nutrition Survey (2009 CHNS), we performed multivariable logistic regression analyses to estimate the odds ratios (ORs) for the risk of anemia and iron parameters according to different body size phenotypes. Participants with higher body mass index (BMI) had a lower anemia prevalence with significant trends in both metabolic status groups (P < 0.001). Serum ferritin, transferrin, and soluble transferrin receptor (sTfR)/log ferritin index were significant in different metabolic status groups and in different body size phenotypes, respectively. The ORs for higher ferritin and transferrin increased across different body size phenotypes in both genders, and for sTfR/log ferritin index decreased (P < 0.01 for trend). This association was still statistically significant after adjustment for multiple confounders. We found an inverse association of BMI levels with the prevalence of anemia and strong association of serum ferritin and transferrin with higher risk of obesity or overweight in both metabolic status groups.

The effect of micro and macro stressors in the work environment on computer professionals' subjective health status and productive behavior in Japan.

PubMed

Tominaga, Maki; Asakura, Takashi; Akiyama, Tsuyoshi

2007-06-01

To investigate the effect of micro and macro stressors in the work environment on the subjective health status and productive behavior of computer professionals, we conducted a web-based investigation with Japanese IT-related company employees in 53 company unions. The questionnaire consisted of individual attributes, employment characteristics, working hour characteristics, company size and profitability, personal characteristics (i.e., Growth Need Strength), micro and macro stressors scale, and four outcome scales concerning the subjective health status and productive behavior. We obtained 1,049 Japanese IT-related company employees' data (response rate: 66%), and analyzed the data of computer engineers (80%; n=871). The results of hierarchical multiple regressions showed that each full model explained 23% in psychological distress, 20% in cumulative fatigue, 44% in job dissatisfaction, and 35% in intentions to leave, respectively. In micro stressors, "quantitative and qualitative work overload" had the strongest influence on both the subjective health status and intentions to leave. Furthermore, in macro stressors, "career and future ambiguity" was the most important predictor of the subjective health status, and "insufficient evaluation systems" and "poor supervisor's support" were important predictors of productive behavior as well. These findings suggest that improving not only micro stressors but also macro stressors will enhance the subjective health status and increase the productive behavior of computer professionals in Japan.

The association of insurance status on the probability of transfer for pediatric trauma patients.

PubMed

Hamilton, Emma C; Miller, Charles C; Cotton, Bryan A; Cox, Charles; Kao, Lillian S; Austin, Mary T

2016-12-01

The purpose of this study was to evaluate the association of insurance status on the probability of transfer of pediatric trauma patients to level I/II centers after initial evaluation at lower level centers. A retrospective review of all pediatric trauma patients (age<16years) registered in the 2007-2012 National Trauma Data Bank was performed. Multiple regression techniques controlling for clustering at the hospital level were used to determine the impact of insurance status on the probability of transfer to level I/II trauma centers. Of 38,205 patients, 33% of patients (12,432) were transferred from lower level centers to level I/II trauma centers. Adjusting for demographics and injury characteristics, children with no insurance had a higher likelihood of transfer than children with private insurance. Children with public or unknown insurance status were no more likely to be transferred than privately insured children. There were no variable interactions with insurance status. Among pediatric trauma patients, lack of insurance is an independent predictor for transfer to a major trauma center. While burns, severely injured, and younger patients remain the most likely to be transferred, these findings suggest a triage bias influenced by insurance status. Additional policies may be needed to avoid unnecessary transfer of uninsured pediatric trauma patients. Case-control study, level III. Copyright © 2016 Elsevier Inc. All rights reserved.

Food security status among grade 5 students in Nova Scotia, Canada and its association with health outcomes.

PubMed

Kirk, Sara F L; Kuhle, Stefan; McIsaac, Jessie-Lee D; Williams, Patty L; Rossiter, Melissa; Ohinmaa, Arto; Veugelers, Paul J

2015-11-01

Food security (FS) exists when all people, at all times, have physical and economic access to sufficient, safe and nutritious food to meet their needs. The present research sought to determine whether students from households experiencing moderate or severe food insecurity (FI) had poorer diet quality, higher body weights and poorer psychosocial outcomes than students from households classed as having high FS or marginal FI status. Population-based survey conducted in schools. Multiple regression analysis was used to explore associations between FS status (high FS; marginal, moderate, severe FI), dietary behaviours and intake, and health-related outcomes (body weight, quality of life, mood, peer relationships, externalizing problems). Nova Scotia, Canada. Grade 5 students (n 5853), aged 10-11 years, with complete information on FS status and student outcomes. In this sample, rates of household FS were 73·5% (high FS), 8·3% (marginal FI) 10·2% (moderate FI) and 7·1% (severe FI status). Students living in households experiencing moderate or severe FI had poorer diet quality, higher BMI and poorer psychosocial outcomes than students classed as having high FS or marginal FI. These findings provide important evidence for policy makers on the prevalence of FI among families in Nova Scotia with grade 5 children and its relationship with childhood nutrition, psychosocial and quality of life factors, and weight status.

Does emotion and its daily fluctuation correlate with depression? A cross-cultural analysis among six developing countries.

PubMed

Chan, Derwin K C; Zhang, Xin; Fung, Helene H; Hagger, Martin S

2015-03-01

Utilizing a World Health Organization (WHO) multi-national dataset, the present study examined the relationships between emotion, affective variability (i.e., the fluctuation of emotional status), and depression across six developing countries, including China (N=15,050); Ghana (N=5,573); India (N=12,198); Mexico (N=5,448); South Africa (N=4,227); and Russia (N=4,947). Using moderated logistic regression and hierarchical multiple regression, the effects of emotion, affective variability, culture, and their interactions on depression and depressive symptoms were examined when statistically controlling for a number of external factors (i.e., age, gender, marital status, education level, income, smoking, alcohol drinking, physical activity, sedentary behavior, and diet). The results revealed that negative emotion was a statistically significant predictor of depressive symptoms, but the strength of association was smaller in countries with a lower incidence of depression (i.e., China and Ghana). The association between negative affective variability and the risk of depression was higher in India and lower in Ghana. Findings suggested that culture not only was associated with the incidence of depression, but it could also moderate the effects of emotion and affective variability on depression or the experience of depressive symptoms. Copyright © 2014 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

Medication adherence among patients in a chronic disease clinic.

PubMed

Tourkmani, Ayla M; Al Khashan, Hisham I; Albabtain, Monirah A; Al Harbi, Turki J; Al Qahatani, Hala B; Bakhiet, Ahmed H

2012-12-01

To assess motivation and knowledge domains of medication adherence intention, and to determine their predictors in an ambulatory setting. We conducted a cross-sectional survey study among patients attending a chronic disease clinic at the Family and Community Medicine Department, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia between June and September 2010. Adherence intention was assessed using Modified Morisky Scale. Predictors of low motivation and/or knowledge were determined using logistic regression models. A total of 347 patients were interviewed during the study duration. Most patients (75.5%) had 2 or more chronic diseases with an average of 6.3 +/- 2.3 medications, and 6.5 +/- 2.9 pills per prescription. The frequency of adherence intention was low (4.6%), variable (37.2%), and high (58.2%). In multivariate logistic regression analysis, younger age and having asthma were significantly associated with low motivation, while male gender, single status, and not having hypertension were significantly associated with low knowledge. Single status was the only independent predictor of low adherence intention. In a population with multiple chronic diseases and high illiteracy rate, more than 40% had low/variable intention to adhere to prescribed medications. Identifying predictors of this group may help in providing group-specific interventional programs.

Household food security status in the Northeast of Iran: a cross-sectional study.

PubMed

Gholami, Ali; Foroozanfar, Zohre

2015-01-01

An important issue the world faces today is ensuring that households living in different countries have access to enough food to maintain a healthy life. Food insecurity is prevalent in both developed and developing countries. The objective of this study was to assess the household food security status and related factors among different rural districts of Neyshabur (A city in northeast of Iran). Of 5000 selected rural households 4647 were studied in this cross-sectional study. A validated short questionnaire (with six questions) was used to measure food security. Chi-square test and logistic regression were used for data analysis through SPSS software. In total, 2747 households (59.1%) were identified as food secure. The highest prevalence of food security was observed in Central district (62.3%) and the lowest was in Miyanjolgeh district (52.9%). Backward multiple logistic regression revealed that car ownership, presence of chronic disease in household and household income (per month) were significantly associated with food security in all of surveyed districts (p< 0.05). According to results of this study, lower than 60% of Neyshabur rural households were food secure and economic variables were the most important factors. Therefore, a special attention should be paid to this health problem in these regions.

Axial cervical vertebrae-based multivariate regression model for the estimation of skeletal-maturation status.

PubMed

Yang, Y-M; Lee, J; Kim, Y-I; Cho, B-H; Park, S-B

2014-08-01

This study aimed to determine the viability of using axial cervical vertebrae (ACV) as biological indicators of skeletal maturation and to build models that estimate ossification level with improved explanatory power over models based only on chronological age. The study population comprised 74 female and 47 male patients with available hand-wrist radiographs and cone-beam computed tomography images. Generalized Procrustes analysis was used to analyze the shape, size, and form of the ACV regions of interest. The variabilities of these factors were analyzed by principal component analysis. Skeletal maturation was then estimated using a multiple regression model. Separate models were developed for male and female participants. For the female estimation model, the adjusted R(2) explained 84.8% of the variability of the Sempé maturation level (SML), representing a 7.9% increase in SML explanatory power over that using chronological age alone (76.9%). For the male estimation model, the adjusted R(2) was over 90%, representing a 1.7% increase relative to the reference model. The simplest possible ACV morphometric information provided a statistically significant explanation of the portion of skeletal-maturation variability not dependent on chronological age. These results verify that ACV is a strong biological indicator of ossification status. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Minority stress and sexual problems among African-American gay and bisexual men.

PubMed

Zamboni, Brian D; Crawford, Isiaah

2007-08-01

Minority stress, such as racism and gay bashing, may be associated with sexual problems, but this notion has not been examined in the literature. African-American gay/bisexual men face a unique challenge in managing a double minority status, putting them at high risk for stress and sexual problems. This investigation examined ten predictors of sexual problems among 174 African-American gay/bisexual men. Covarying for age, a forward multiple regression analysis showed that the measures of self-esteem, male gender role stress, HIV prevention self-efficacy, and lifetime experiences with racial discrimination significantly added to the prediction of sexual problems. Gay bashing, psychiatric symptoms, low life satisfaction, and low social support were significantly correlated with sexual problems, but did not add to the prediction of sexual problems in the regression analysis. Mediation analyses showed that stress predicted psychiatric symptoms, which then predicted sexual problems. Sexual problems were not significantly related to HIV status, racial/ethnic identity, or gay identity. The findings from this study showed a relationship between experiences with racial and sexual discrimination and sexual problems while also providing support for mediation to illustrate how stress might cause sexual problems. Addressing minority stress in therapy may help minimize and treat sexual difficulties among minority gay/bisexual men.

Presenilin E318G variant and Alzheimer's disease risk: the Cache County study.

PubMed

Hippen, Ariel A; Ebbert, Mark T W; Norton, Maria C; Tschanz, JoAnn T; Munger, Ronald G; Corcoran, Christopher D; Kauwe, John S K

2016-06-29

Alzheimer's disease is the leading cause of dementia in the elderly and the third most common cause of death in the United States. A vast number of genes regulate Alzheimer's disease, including Presenilin 1 (PSEN1). Multiple studies have attempted to locate novel variants in the PSEN1 gene that affect Alzheimer's disease status. A recent study suggested that one of these variants, PSEN1 E318G (rs17125721), significantly affects Alzheimer's disease status in a large case-control dataset, particularly in connection with the APOEε4 allele. Our study looks at the same variant in the Cache County Study on Memory and Aging, a large population-based dataset. We tested for association between E318G genotype and Alzheimer's disease status by running a series of Fisher's exact tests. We also performed logistic regression to test for an additive effect of E318G genotype on Alzheimer's disease status and for the existence of an interaction between E318G and APOEε4. In our Fisher's exact test, it appeared that APOEε4 carriers with an E318G allele have slightly higher risk for AD than those without the allele (3.3 vs. 3.8); however, the 95 % confidence intervals of those estimates overlapped completely, indicating non-significance. Our logistic regression model found a positive but non-significant main effect for E318G (p = 0.895). The interaction term between E318G and APOEε4 was also non-significant (p = 0.689). Our findings do not provide significant support for E318G as a risk factor for AD in APOEε4 carriers. Our calculations indicated that the overall sample used in the logistic regression models was adequately powered to detect the sort of effect sizes observed previously. However, the power analyses of our Fisher's exact tests indicate that our partitioned data was underpowered, particularly in regards to the low number of E318G carriers, both AD cases and controls, in the Cache county dataset. Thus, the differences in types of datasets used may help to explain the difference in effect magnitudes seen. Analyses in additional case-control datasets will be required to understand fully the effect of E318G on Alzheimer's disease status.

What is different about workers' compensation patients? Socioeconomic predictors of baseline disability status among patients with lumbar radiculopathy.

PubMed

Atlas, Steven J; Tosteson, Tor D; Hanscom, Brett; Blood, Emily A; Pransky, Glenn S; Abdu, William A; Andersson, Gunnar B; Weinstein, James N

2007-08-15

Combined analysis of 2 prospective clinical studies. To identify socioeconomic characteristics associated with workers' compensation in patients with an intervertebral disc herniation (IDH) or spinal stenosis (SpS). Few studies have compared socioeconomic differences between those receiving or not receiving workers' compensation with the same underlying clinical conditions. Patients were identified from the Spine Patient Outcomes Research Trial (SPORT) and the National Spine Network (NSN) practice-based outcomes study. Patients with IDH and SpS within NSN were identified satisfying SPORT eligibility criteria. Information on disability and work status at baseline evaluation was used to categorize patients into 3 groups: workers' compensation, other disability compensation, or work-eligible controls. Enrollment rates of patients with disability in a clinical efficacy trial (SPORT) and practice-based network (NSN) were compared. Independent socioeconomic predictors of baseline workers' compensation status were identified in multivariate logistic regression models controlling for clinical condition, study cohort, and initial treatment designation. Among 3759 eligible patients (1480 in SPORT and 2279 in NSN), 564 (15%) were receiving workers' compensation, 317 (8%) were receiving other disability compensation, and 2878 (77%) were controls. Patients receiving workers' compensation were less common in SPORT than NSN (9.2% vs. 18.8%, P < 0.001), but patients receiving other disability compensation were similarly represented (8.9% vs. 7.7%, P = 0.19). In univariate analyses, many socioeconomic characteristics significantly differed according to baseline workers' compensation status. In multiple logistic regression analyses, gender, educational level, work characteristics, legal action, and expectations about ability to work without surgery were independently associated with receiving workers' compensation. Clinical trials involving conditions commonly seen in patients with workers' compensation may need special efforts to ensure adequate representation. Socioeconomic characteristics markedly differed between patients receiving and not receiving workers' compensation. Identifying the independent effects of workers' compensation on outcomes will require controlling for these baseline characteristics and other clinical features associated with disability status.

A whole blood gene expression-based signature for smoking status

PubMed Central

2012-01-01

Background Smoking is the leading cause of preventable death worldwide and has been shown to increase the risk of multiple diseases including coronary artery disease (CAD). We sought to identify genes whose levels of expression in whole blood correlate with self-reported smoking status. Methods Microarrays were used to identify gene expression changes in whole blood which correlated with self-reported smoking status; a set of significant genes from the microarray analysis were validated by qRT-PCR in an independent set of subjects. Stepwise forward logistic regression was performed using the qRT-PCR data to create a predictive model whose performance was validated in an independent set of subjects and compared to cotinine, a nicotine metabolite. Results Microarray analysis of whole blood RNA from 209 PREDICT subjects (41 current smokers, 4 quit ≤ 2 months, 64 quit > 2 months, 100 never smoked; NCT00500617) identified 4214 genes significantly correlated with self-reported smoking status. qRT-PCR was performed on 1,071 PREDICT subjects across 256 microarray genes significantly correlated with smoking or CAD. A five gene (CLDND1, LRRN3, MUC1, GOPC, LEF1) predictive model, derived from the qRT-PCR data using stepwise forward logistic regression, had a cross-validated mean AUC of 0.93 (sensitivity=0.78; specificity=0.95), and was validated using 180 independent PREDICT subjects (AUC=0.82, CI 0.69-0.94; sensitivity=0.63; specificity=0.94). Plasma from the 180 validation subjects was used to assess levels of cotinine; a model using a threshold of 10 ng/ml cotinine resulted in an AUC of 0.89 (CI 0.81-0.97; sensitivity=0.81; specificity=0.97; kappa with expression model = 0.53). Conclusion We have constructed and validated a whole blood gene expression score for the evaluation of smoking status, demonstrating that clinical and environmental factors contributing to cardiovascular disease risk can be assessed by gene expression. PMID:23210427

Usage patterns, health, and nutritional status of long-term multiple dietary supplement users: a cross-sectional study

PubMed Central

Block, Gladys; Jensen, Christopher D; Norkus, Edward P; Dalvi, Tapashi B; Wong, Les G; McManus, Jamie F; Hudes, Mark L

2007-01-01

Background Dietary supplement use in the United States is prevalent and represents an important source of nutrition. However, little is known about individuals who routinely consume multiple dietary supplements. This study describes the dietary supplement usage patterns, health, and nutritional status of long-term multiple dietary supplement users, and where possible makes comparisons to non-users and multivitamin/mineral supplement users. Methods Using a cross-sectional study design, information was obtained by online questionnaires and physical examination (fasting blood, blood pressure, body weight) from a convenience sample of long-term users of multiple dietary supplements manufactured by Shaklee Corporation (Multiple Supp users, n = 278). Data for non-users (No Supp users, n = 602) and multivitamin/mineral supplement users (Single Supp users, n = 176) were obtained from the National Health and Nutrition Examination Survey (NHANES) 2001–2002 and NHANES III 1988–1994. Logistic regression methods were used to estimate odds ratios with 95% confidence intervals. Results Dietary supplements consumed on a daily basis by more than 50% of Multiple Supp users included a multivitamin/mineral, B-complex, vitamin C, carotenoids, vitamin E, calcium with vitamin D, omega-3 fatty acids, flavonoids, lecithin, alfalfa, coenzyme Q10 with resveratrol, glucosamine, and a herbal immune supplement. The majority of women also consumed gamma linolenic acid and a probiotic supplement, whereas men also consumed zinc, garlic, saw palmetto, and a soy protein supplement. Serum nutrient concentrations generally increased with increasing dietary supplement use. After adjustment for age, gender, income, education and body mass index, greater degree of supplement use was associated with more favorable concentrations of serum homocysteine, C-reactive protein, high-density lipoprotein cholesterol, and triglycerides, as well as lower risk of prevalent elevated blood pressure and diabetes. Conclusion This group of long-term multiple dietary supplement users consumed a broad array of vitamin/mineral, herbal, and condition-specific dietary supplements on a daily basis. They were more likely to have optimal concentrations of chronic disease-related biomarkers, and less likely to have suboptimal blood nutrient concentrations, elevated blood pressure, and diabetes compared to non-users and multivitamin/mineral users. These findings should be confirmed by studying the dietary supplement usage patterns, health, and nutritional status of other groups of heavy users of dietary supplements. PMID:17958896

Maternal iron status during pregnancy compared with neonatal iron status better predicts placental iron transporter expression in humans.

PubMed

Best, Cora M; Pressman, Eva K; Cao, Chang; Cooper, Elizabeth; Guillet, Ronnie; Yost, Olivia L; Galati, Jonathan; Kent, Tera R; O'Brien, Kimberly O

2016-10-01

The placenta richly expresses nonheme and heme Fe transport proteins. To address the impact of maternal and neonatal Fe status and hepcidin on the regulation of these proteins, mRNA expression and protein abundance of nonheme and heme Fe transport proteins were evaluated in placental tissue from 154 adolescents. Regression analyses found maternal Fe status was significantly associated with multiple placental nonheme and heme transporters, whereas neonatal Fe status was related to only 3 heme transporters. Across statistical analyses, maternal Fe status was consistently associated with the placental nonheme Fe importer transferrin receptor 1 (TfR1). Protein abundance of TfR1 was related to midgestation maternal serum ferritin (SF) (β = -0.32; P = 0.005) and serum TfR (β = 0.25; P = 0.024). Protein abundance of the heme importer, proton-coupled folate transporter, was related to neonatal SF (β = 0.30; P = 0.016) and serum TfR (β = -0.46; P < 0.0001). Neonatal SF was also related to mRNA expression of the heme exporter feline leukemia virus subgroup C receptor 1 (β = -0.30; P = 0.004). In summary, maternal Fe insufficiency during pregnancy predicts increased expression of the placental nonheme Fe transporter TfR1. Associations between placental heme Fe transporters and neonatal Fe status require further study.-Best, C. M., Pressman, E. K., Cao, C., Cooper, E., Guillet, R., Yost, O. L., Galati, J., Kent, T. R., O'Brien, K. O. Maternal iron status during pregnancy compared with neonatal iron status better predicts placental iron transporter expression in humans. © FASEB.

Prediction of hearing outcomes by multiple regression analysis in patients with idiopathic sudden sensorineural hearing loss.

PubMed

Suzuki, Hideaki; Tabata, Takahisa; Koizumi, Hiroki; Hohchi, Nobusuke; Takeuchi, Shoko; Kitamura, Takuro; Fujino, Yoshihisa; Ohbuchi, Toyoaki

2014-12-01

This study aimed to create a multiple regression model for predicting hearing outcomes of idiopathic sudden sensorineural hearing loss (ISSNHL). The participants were 205 consecutive patients (205 ears) with ISSNHL (hearing level ≥ 40 dB, interval between onset and treatment ≤ 30 days). They received systemic steroid administration combined with intratympanic steroid injection. Data were examined by simple and multiple regression analyses. Three hearing indices (percentage hearing improvement, hearing gain, and posttreatment hearing level [HLpost]) and 7 prognostic factors (age, days from onset to treatment, initial hearing level, initial hearing level at low frequencies, initial hearing level at high frequencies, presence of vertigo, and contralateral hearing level) were included in the multiple regression analysis as dependent and explanatory variables, respectively. In the simple regression analysis, the percentage hearing improvement, hearing gain, and HLpost showed significant correlation with 2, 5, and 6 of the 7 prognostic factors, respectively. The multiple correlation coefficients were 0.396, 0.503, and 0.714 for the percentage hearing improvement, hearing gain, and HLpost, respectively. Predicted values of HLpost calculated by the multiple regression equation were reliable with 70% probability with a 40-dB-width prediction interval. Prediction of HLpost by the multiple regression model may be useful to estimate the hearing prognosis of ISSNHL. © The Author(s) 2014.

Coping with prescription medication costs: a cross-sectional look at strategies used and associations with the physical and psychosocial health of individuals with arthritis.

PubMed

Martin, Kathryn Remmes; Shreffler, Jack; Schoster, Britta; Callahan, Leigh F

2012-10-01

Prescription medication costs increase financial burden, often leading individuals to engage in intentional nonadherence. Little is known about what specific medication cost-coping strategies individuals with arthritis employ. The purposes of this study are (1) to identify characteristics of individuals with arthritis who self-report prescription medication cost-coping strategies and (2) to examine the association between medication cost-coping strategies and health status. Seven hundred twenty-nine people self-reporting arthritis and prescription medication use completed a telephone survey. Adjusted regression models examined medication cost-coping strategies and five health status outcomes. Participants reported engaging in cost-coping strategies due to medication costs. Those borrowing money had worse psychosocial health and greater disability; those with increasing credit card debt reported worse physical functioning, self-rated health, and greater helplessness. Medication underuse was associated with worse psychosocial health, greater disability, and depressive symptoms. Individuals with arthritis use multiple strategies to cope with medication costs, and these strategies are associated with adverse physical and psychosocial health status.

Maternal request CS--role of hospital teaching status and for-profit ownership.

PubMed

Xirasagar, Sudha; Lin, Herng-Ching

2007-05-01

To examine whether hospitals' for-profit (FP) ownership and non-teaching status are associated with greater likelihood of maternal request cesarean (CS) relative to public and not-for-profit (NFP) and teaching status, respectively. Retrospective, cross-sectional, population-based study of Taiwan's National Health Insurance claims data, covering all 739,531 vaginal delivery-eligible singleton deliveries during 1997-2000, using multiple logistic regression analyses. Adjusted for maternal age and geographic location, FP district hospitals (almost all non-teaching), followed by ob/gyn clinics were significantly more likely to perform request CS (OR=3.5-2.3) than public and NFP teaching hospitals. Among non-teaching and teaching hospitals, FPs were more likely to perform request CS than public and NFP hospitals (OR=2.3 and 2.5, respectively). Our findings are consistent with greater propensity of physicians in FP institutions to accommodate patient requests involving revenue-maximizing procedures such as request CS. This effect is moderated by teaching hospitals' preference for complicated cases, consistent with their teaching mission and hi-tech infrastructure.

Brief report: personality correlates of susceptibility to peer influence in adolescence.

PubMed

Stautz, Kaidy; Cooper, Andrew

2014-06-01

Adolescents show a heightened susceptibility to peer influence compared to adults. Individual differences in this susceptibility exist, yet there has been little effort to link these with broader personality processes. Reward sensitivity and impulsive behaviour are also heightened in adolescence and could affect the tendency to be influenced by peers. This study examined associations between self-reported resistance to peer influence, facets of reward sensitivity and impulsivity, and subjective social status in a sample of 269 British sixth form students (mean age 16.79). Multiple regression analyses showed that negative and positive urgency were significantly negatively associated with resistance to peer influence. The relationship between negative urgency and resistance was moderated by subjective social status, such that individuals reporting low status showed a stronger negative relationship. Results suggest that a susceptibility to peer influence is linked with a tendency to act impulsively when in heightened emotional states. Adolescents high in negative urgency who feel lower in their social hierarchy may be particularly vulnerable. Copyright © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

The relationship between adolescents' physical activity, fundamental movement skills and weight status.

PubMed

O' Brien, Wesley; Belton, Sarahjane; Issartel, Johann

2016-01-01

The aim of this study was to determine if a potential relationship among physical activity (PA), fundamental movement skills and weight status exists amongst early adolescent youth. Participants were a sample of 85 students; 54 boys (mean age = 12.94 ± 0.33 years) and 31 girls (mean age = 12.75 ± 0.43 years). Data gathered during physical education class included PA (accelerometry), fundamental movement skills and anthropometric measurements. Standard multiple regression revealed that PA and total fundamental movement skill proficiency scores explained 16.5% (P < 0.001) of the variance in the prediction of body mass index. Chi-square tests for independence further indicated that compared with overweight or obese adolescents, a significantly higher proportion of adolescents classified as normal weight achieved mastery/near-mastery in fundamental movement skills. Results from the current investigation indicate that weight status is an important correlate of fundamental movement skill proficiency during adolescence. Aligned with most recent research, school- and community-based programmes that include developmentally structured learning experiences delivered by specialists can significantly improve fundamental movement skill proficiency in youth.

Mental Health of Children Living in Foster Families in Rural Rwanda: The Role of HIV and the Family Environment

PubMed Central

Nduwimana, Estella; Mukunzi, Sylvere; Ng, Lauren C.; Kirk, Catherine M.; Bizimana, Justin I.; Betancourt, Theresa S.

2016-01-01

Fostering children is common in sub-Saharan Africa, but few studies examine these children’s mental health needs. This study investigated the impact of living in a foster family on the mental health of HIV-positive, HIV-affected and HIV-unaffected children (n = 681 aged 10–17) in rural Rwanda. Regression analyses assessed the impact of living in a foster family on mental health, parenting, and daily hardships; multiple mediation analyses assessed whether family factors mediated the association between foster status and mental health. HIV-positive children were eight times more likely to live in foster families than HIV-unaffected children. Being HIV-affected was predictive of depression and irritability symptoms after controlling for family factors. Controlling for HIV-status, foster children had more symptoms of depression, anxiety, and irritability than non-fostered children. Positive parenting fully mediated the association between foster status and mental health. Mental health and parenting interventions for foster children and HIV-affected children may improve child outcomes. PMID:27578000

The Role of Parental Misperception of Child's Body Weight in Childhood Obesity.

PubMed

McKee, Colleen; Long, Lisa; Southward, Linda H; Walker, Ben; McCown, John

2016-01-01

To investigate the accuracy of parental perceptions of their child's weight status and also the relationship between parental perceptions and the prevalence of childhood obesity in Mississippi. Data from multi-year surveys (2009-2012) with random samples of public school parents (N=14,808). Descriptive statistics and multiple logistic regression were conducted with quantitative data to examine the relationship between parental perception and childhood obesity. More than 2 out of 5 parents misperceived the weight status of their child (k-12). The greatest difference occurred with kindergartners, 83.9% of parents categorized them as "healthy", when only 28.3% actually were. Parents who misperceived their child's weight were almost 12 times more likely of having an obese child. Only half of the children in this study had a healthy weight (54.5%). Health care providers, nutritionists, social workers, teachers, and school health councils could play an important role in educating parents and children on how to recognize an unhealthy weight. The strongest predictor of childhood obesity was parental misperception of their child's weight status. Copyright © 2016 Elsevier Inc. All rights reserved.

Adolescent gambling and impulsivity: Does employment during high school moderate the association?

PubMed

Canale, Natale; Scacchi, Luca; Griffiths, Mark D

2016-09-01

The aim of the present study was to examine the potential moderating relationships between adolescent gambling and impulsivity traits (negative urgency, positive urgency, lack of premeditation, lack of perseverance and sensation seeking) with employment status. High-school students (N=400; 69% male; mean age=18.35years; SD=1.16; past year gamblers) were surveyed to provide data on impulsivity and employment. Multiple linear regression analysis was applied to examine associations with gambling and related problems. Positive urgency was associated with stronger scores of both gambling frequency and problem gambling. Students in employment had substantially higher frequency of gambling and greater problem gambling. Moreover, the combination of having a job and low perseverance was associated with a particularly high frequency on gambling. These findings further support the importance of positive urgency and employment status in adolescent gambling. The study highlights unique moderating relationship between gambling and lack of perseverance with employment status. Youth with a low perseverance and having a job may have particular need for interventions to reduce gambling. Copyright © 2016 Elsevier Ltd. All rights reserved.

Women's Retirement Expectations: How Stable Are They?

PubMed Central

Hardy, Melissa A.

2009-01-01

Objective Using the National Longitudinal Survey of Mature Women, we examine between- and within-person differences in expected retirement age as a key element of the retirement planning process. The expectation typologies of 1,626 women born between 1923 and 1937 were classified jointly on the basis of specificity and consistency. Methods Latent class analysis was used to determine retirement expectation patterns over a 7-year span. Multinomial logistic regression analyses were employed to estimate the effects of demographic and status characteristics on the likelihood of reporting 4 distinct longitudinal patterns of retirement expectations. Results Substantial heterogeneity in reports of expected retirement age between and within individuals over the 7-year span was found. Demographic and status characteristics, specifically age, race, marital status, job tenure, and recent job change, sorted respondents into different retirement expectation patterns. Conclusions The frequent within-person fluctuations and substantial between-person heterogeneity in retirement expectations indicate uncertainty and variability in both expectations and process of expectation formation. Variability in respondents' reports suggests that studying retirement expectations at multiple time points better captures the dynamics of preretirement planning. PMID:19176483

False Positives in Multiple Regression: Unanticipated Consequences of Measurement Error in the Predictor Variables

ERIC Educational Resources Information Center

Shear, Benjamin R.; Zumbo, Bruno D.

2013-01-01

Type I error rates in multiple regression, and hence the chance for false positive research findings, can be drastically inflated when multiple regression models are used to analyze data that contain random measurement error. This article shows the potential for inflated Type I error rates in commonly encountered scenarios and provides new…

Using Robust Standard Errors to Combine Multiple Regression Estimates with Meta-Analysis

ERIC Educational Resources Information Center

Williams, Ryan T.

2012-01-01

Combining multiple regression estimates with meta-analysis has continued to be a difficult task. A variety of methods have been proposed and used to combine multiple regression slope estimates with meta-analysis, however, most of these methods have serious methodological and practical limitations. The purpose of this study was to explore the use…

Use of Multiple Regression and Use-Availability Analyses in Determining Habitat Selection by Gray Squirrels (Sciurus Carolinensis)

Treesearch

John W. Edwards; Susan C. Loeb; David C. Guynn

1994-01-01

Multiple regression and use-availability analyses are two methods for examining habitat selection. Use-availability analysis is commonly used to evaluate macrohabitat selection whereas multiple regression analysis can be used to determine microhabitat selection. We compared these techniques using behavioral observations (n = 5534) and telemetry locations (n = 2089) of...

Building Regression Models: The Importance of Graphics.

ERIC Educational Resources Information Center

Dunn, Richard

1989-01-01

Points out reasons for using graphical methods to teach simple and multiple regression analysis. Argues that a graphically oriented approach has considerable pedagogic advantages in the exposition of simple and multiple regression. Shows that graphical methods may play a central role in the process of building regression models. (Author/LS)

Testing Different Model Building Procedures Using Multiple Regression.

ERIC Educational Resources Information Center

Thayer, Jerome D.

The stepwise regression method of selecting predictors for computer assisted multiple regression analysis was compared with forward, backward, and best subsets regression, using 16 data sets. The results indicated the stepwise method was preferred because of its practical nature, when the models chosen by different selection methods were similar…

The effect of marital status on breast cancer-related outcomes in women under 65: A SEER database analysis.

PubMed

Hinyard, Leslie; Wirth, Lorinette Saphire; Clancy, Jennifer M; Schwartz, Theresa

2017-04-01

Marital status is strongly associated with improved health and longevity. Being married has been shown to be positively associated with survival in patients with multiple different types of malignancy; however, little is known about the relationship between marital status and breast cancer in younger women. The purpose of this study is to investigate the effect of marital status on diagnosis, and survival of women under the age of 65 with breast cancer. The SEER 18 regions database was used to identify women between the ages of 25-64 diagnosed with invasive breast cancer in the years 2004-2009. Logistic regression was used to predict later stage diagnosis by marital status and Cox proportional hazards models were used to compare breast cancer-related and all-cause survival by marital status classification. Models were stratified by AJCC stage. After adjusting for age, race, and ER status, unmarried women were 1.18 times more likely to be diagnosed at a later stage than married women (95% CI 1.15, 1.20). In adjusted analysis unmarried women were more likely to die of breast cancer and more likely to die of all causes than married women across all AJCC stages. Younger unmarried women with breast cancer may benefit from additional counseling, psychosocial support and case management at the time of diagnosis to ensure their overall outcomes are optimized. Copyright © 2016 Elsevier Ltd. All rights reserved.

Self-Reported Health Status in Primary Health Care: The Influence of Immigration and Other Associated Factors

PubMed Central

Salinero-Fort, Miguel Á.; Jiménez-García, Rodrigo; del Otero-Sanz, Laura; de Burgos-Lunar, Carmen; Chico-Moraleja, Rosa M.; Martín-Madrazo, Carmen; Gómez-Campelo, Paloma

2012-01-01

Objective The aims of this study are to compare self-reported health status between Spanish-born and Latin American-born Spanish residents, adjusted by length of residence in the host country; and additionally, to analyse sociodemographic and psychosocial variables associated with a better health status. Design This is a cross-sectional population based study of Latin American-born (n = 691) and Spanish-born (n = 903) in 15 urban primary health care centres in Madrid (Spain), carried out between 2007 and 2009. The participants provided information, through an interview, about self-reported health status, socioeconomic characteristics, psychosocial factors and migration conditions. Descriptive and multiple logistic regression analyses were conducted. Results The Spanish-born participants reported a better health status than the Latin America-born participants (79.8% versus 69.3%, p<0.001). Different patterns of self-reported health status were observed depending on the length of residence in the host country. The proportion of immigrants with a better health status is greater in those who have been in Spain for less than five years compared to those who have stayed longer. Better health status is significantly associated with being men, under 34 years old, being Spanish-born, having a monthly incomes of over 1000 euros, and having considerable social support and low stress. Conclusions Better self-reported health status is associated with being Spanish-born, men, under 34 years old, having an uppermiddle-socioeconomic status, adequate social support, and low stress. Additionally, length of residence in the host country is seen as a related factor in the self-reported health status of immigrants. PMID:22675564

Self- Perception of Body Weight Status in Older Dutch Adults.

PubMed

Monteagudo, C; Dijkstra, S C; Visser, M

2015-06-01

The prevalence of obesity is highest in older persons and a correct self-perception of body weight status is necessary for optimal weight control. The aim of this study was to determine self-perception of, and satisfaction with, body weight status, and to compare current versus ideal body image in a large, nationally representative sample of older people. Furthermore, determinants of misperception were explored. A cross-sectional study. The Longitudinal Aging Study Amsterdam (LASA), conducted in a population-based sample in the Netherlands. 1295 men and women aged 60-96 years. Body weight status was assessed using measured weight and height. Self-perceived body weight status, satisfaction with body weight and current and ideal body image were also assessed. Multiple logistic regression analysis was used to investigate the association of age, educational level and objectively measured BMI with underestimation of body weight status. The prevalence of obesity was 19.9% in men and 29.3% in women. The agreement between objective and self-perceived body weight status was low (Kappa < 0.2). Among overweight and obese persons, 42.1% of men and 44.1% of women were (very) dissatisfied with their body weight status and >99% of obese participants desired to be thinner (ideal body image < current image). Only 4.4% of obese men and 12.3% of obese women perceived their body weight status correctly. Higher age (women), lower educational level (men) and higher BMI (all) were associated with greater underestimation of body weight status. Many older persons misperceive their body weight status. Future actions to improve body weight perception in older persons are necessary to increase the impact of public health campaigns focussing on a healthy body weight in old age.

Decreasing Multicollinearity: A Method for Models with Multiplicative Functions.

ERIC Educational Resources Information Center

Smith, Kent W.; Sasaki, M. S.

1979-01-01

A method is proposed for overcoming the problem of multicollinearity in multiple regression equations where multiplicative independent terms are entered. The method is not a ridge regression solution. (JKS)

Analysing the effect of multiple sclerosis on vitamin D related biochemical markers of bone remodelling.

PubMed

McKenna, Malachi J; Murray, Barbara; Lonergan, Roisin; Segurado, Ricardo; Tubridy, Niall; Kilbane, Mark T

2018-03-01

The Irish population is at risk of vitamin D deficiency during the winter months, but the secular trend over the past 40 years is for marked improvement. Multiple sclerosis (MS) is common in Ireland with a latitudinal pattern favouring highest incidence in northern regions; MS is linked strongly with vitamin D status as a causal factor. We sought firstly to study the relationship between vitamin D status and vitamin D-related bone biochemistry, and secondly to evaluate if MS had an independent effect on vitamin D related markers of bone remodelling. Using a case-control design of 165 pairs (MS patient and matched control) residing in three different geographic regions during winter months, we measured serum 25-hydroxyvitamin D (25OHD), parathyroid hormone (PTH), C-terminal telopeptide of type I collagen (CTX) and total procollagen type I amino-terminal propeptide (PINP). Given the paired case-control design, associations were explored using mixed-effects linear regression analysis with the patient-control pair as a random effect and after log transformation of 25OHD. A two-way interaction effect was tested for vitamin D status (25OHD <30nmol/L) and the presence of MS on PTH, CTX, and PINP. In the total group, just over one-third (34.5%) had 25OHD <30nmol/L. PTH was elevated in 7.6%. CTX was not elevated in any case, and PINP was elevated in 4.5%. On mixed-effects linear regression analysis after adjusting for confounders (age, sex, renal function, and serum albumin), we demonstrated the principal determinant of 25OHD was geographical location (p<0.001), of PTH was 25OHD (p<0.001), of CTX was PTH (p<0.001), and of PINP was PTH (p<0.001). MS did not have an independent effect on PTH (p=0.921), CTX (p=0.912), or PINP (p=0.495). As regards an interaction effect, the presence of MS and 25OHD <30nmol/L was not significant but tended towards having lower PTH (p=0.207). In conclusion, in Ireland in winter only a minority had any abnormality in the secondary indices of vitamin D deficiency, and MS had no independent effect on parathyroid status or bone remodelling activity. Copyright © 2017 Elsevier Ltd. All rights reserved.

Disentangling the Correlates of Drug Use in a Clinic and Community Sample: A Regression Analysis of the Associations between Drug Use, Years-of-School, Impulsivity, IQ, Working Memory, and Psychiatric Symptoms.

PubMed

Heyman, Gene M; Dunn, Brian J; Mignone, Jason

2014-01-01

Years-of-school is negatively correlated with illicit drug use. However, educational attainment is positively correlated with IQ and negatively correlated with impulsivity, two traits that are also correlated with drug use. Thus, the negative correlation between education and drug use may reflect the correlates of schooling, not schooling itself. To help disentangle these relations we obtained measures of working memory, simple memory, IQ, disposition (impulsivity and psychiatric status), years-of-school and frequency of illicit and licit drug use in methadone clinic and community drug users. We found strong zero-order correlations between all measures, including IQ, impulsivity, years-of-school, psychiatric symptoms, and drug use. However, multiple regression analyses revealed a different picture. The significant predictors of illicit drug use were gender, involvement in a methadone clinic, and years-of-school. That is, psychiatric symptoms, impulsivity, cognition, and IQ no longer predicted illicit drug use in the multiple regression analyses. Moreover, high risk subjects (low IQ and/or high impulsivity) who spent 14 or more years in school used stimulants and opiates less than did low risk subjects who had spent <14 years in school. Smoking and drinking had a different correlational structure. IQ and years-of-school predicted whether someone ever became a smoker, whereas impulsivity predicted the frequency of drinking bouts, but years-of-school did not. Many subjects reported no use of one or more drugs, resulting in a large number of "zeroes" in the data sets. Cragg's Double-Hurdle regression method proved the best approach for dealing with this problem. To our knowledge, this is the first report to show that years-of-school predicts lower levels of illicit drug use after controlling for IQ and impulsivity. This paper also highlights the advantages of Double-Hurdle regression methods for analyzing the correlates of drug use in community samples.

A population-based study on health-related quality of life among urban community residents in Shenyang, Northeast of China.

PubMed

Song, Tian; Ding, Yan-wei; Sun, Yan; He, Yi-Ni; Qi, Dian-Jun; Wu, Ying; Wu, Bin; Lang, Lang; Yu, Kai; Zhao, Xin; Zhu, Liang-liang; Wang, Shuang; Yu, Xiao-Song

2015-09-19

Due to the rising standard of living environment and advances in public health and medical care in China, it has been a tendency in recent years that health-related quality of life (HRQoL) has been increasingly acknowledged in community health management. However, large-scale population-based study on evaluating HQRoL in northeast of China was not conducted. This article aims to investigate the HRQoL in community residents in Northeast China and explore the associated factors. Stratified multiple-stage sampling method was used in the cross-sectional survey to investigate HRQoL of community residents in northeast of China. Univariate analysis and multiple linear regressions were used to analyze the factors associated to HRQoL of the community residents. The results were confirmed that HRQoL in general population was well performed for the first time in northeast of China in a large scale population. Community residents had better mental health than physical health. The factors influencing HRQoL included gender, age, educational level, marital status, ethnic group, chronic disease status, having breakfast frequency weekly and sleep quality. However, drinking and smoking habits did not affect residents' HRQoL. In this study, the result of the large-scale survey was satisfactory in northeast of China, providing HRQoL status of community residents. Policies on specific health management in community public health would emphasize on lifestyle behaviors especially eating habits in order to improving HRQoL.

Inverse Association between Diabetes and Altitude: A Cross Sectional Study in the Adult Population of the United States

PubMed Central

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

Sociodemographic risk factors associated with low birthweight in United Arab Emirates.

PubMed

Bener, A; Abdulrazzaq, Y M; Dawodu, A

1996-07-01

This case-control study was undertaken to determine sociodemographic risk factors for low birth weight in Al-Ain (United Arab Emirates) over a 12-month period in 1992-93. A total of 3485 live births occurred of which 293 (8.4%) were low birth weight. The risk factors considered were mother's occupation, house conditions, place of residence (urban or rural), maternal smoking habits, antenatal care, availability of help in the home, maternal BMI and educational status. Multiple logistic regression analysis showed that mother's occupation, maternal smoking, antenatal care, and lack of help in the home were associated with increased risk of low birth weight.

Factors influencing health behaviors in the National Health and Nutritional Examination Survey, III (NHANES III).

PubMed

Barkley, Geoffrey S

2008-01-01

This study investigated the influence of age, gender, race, place of residence, social networks, and socioeconomic status (SES) on health behaviors in the NHANES III, a large public domain database of approximately 16,000 subjects. Multiple regression analysis indicated that age, gender, social networks, and SES were statistically significant predictors of both positive and negative health behaviors, while race and place of residence were not. These results suggest an influence of age, gender, SES, and social support factors on health behaviors and reinforce the need for social work to take into account these factors at both the individual and public policy levels.

Effects of psychological distress on blood pressure in adolescents.

PubMed

Weinrich, S; Weinrich, M; Hardin, S; Gleaton, J; Pesut, D J; Garrison, C

2000-10-01

This cross-sectional survey measured relationships among blood pressure and measures of psychologic distress, family structure, and economic status in a sample of adolescents exposed to Hurricane Hugo. Spielberger's Anger Scale and Derogatis' Brief Symptom Inventory were used. Data analysis revealed 5% of the 1079 adolescents were hypertensive. Multiple regression analyses revealed the following predictors of higher diastolic blood pressure: African-American race, recipient of subsidized lunch, exposure to Hurricane Hugo, and higher anger-in scores in males. The effects of a catastrophic event such as a hurricane on blood pressure and the effects of introjected anger have implications for both health care consumers and providers.

Genetic and Environmental Influences on Odor Identification Ability in the Very Old

PubMed Central

Doty, Richard L.; Petersen, Inge; Mensah, Nii; Christensen, Kaare

2013-01-01

Odor identification ability and cognition were measured in a population-based cohort of 1,222 very old twins and singletons, including 91 centenarians. Heritability for identifying odors was low, in contrast to that for cognition. Common genes were found to contribute to both olfaction and cognition. In a multiple regression model, sex, age, cognitive function, and smoking, but not APOEε4 status, were significant predictors of the olfactory test scores (all ps < 0.001). This study, along with data from other studies, suggests that indices of heritability for odor identification decline with age, likely reflecting adverse environmental influences on the smell system. PMID:21639645

Factors associated with physical inactivity among korean men and women.

PubMed

Lee, Chung Yul; Hwang, Seon Young; Ham, Ok Kyung

2007-01-01

To identify the independently associating factors on physical inactivity in Korean men and women. The data of 5554 men and women (18-74 years) were analyzed using national health and nutritional examination survey data that included questionnaires and physical examinations. Multiple logistic regression analyses showed that significant factors were low monthly income, low education, current smoking, increased waist-to-hip ratio, and low health concern among men; living in rural areas, low monthly income, low education, perceived poor health status, low health concern, and emotional stress among women. Health care providers should focus on education and counseling regarding the factors that influence physical inactivity.

Quality of life in breast cancer patients--a quantile regression analysis.

PubMed

Pourhoseingholi, Mohamad Amin; Safaee, Azadeh; Moghimi-Dehkordi, Bijan; Zeighami, Bahram; Faghihzadeh, Soghrat; Tabatabaee, Hamid Reza; Pourhoseingholi, Asma

2008-01-01

Quality of life study has an important role in health care especially in chronic diseases, in clinical judgment and in medical resources supplying. Statistical tools like linear regression are widely used to assess the predictors of quality of life. But when the response is not normal the results are misleading. The aim of this study is to determine the predictors of quality of life in breast cancer patients, using quantile regression model and compare to linear regression. A cross-sectional study conducted on 119 breast cancer patients that admitted and treated in chemotherapy ward of Namazi hospital in Shiraz. We used QLQ-C30 questionnaire to assessment quality of life in these patients. A quantile regression was employed to assess the assocciated factors and the results were compared to linear regression. All analysis carried out using SAS. The mean score for the global health status for breast cancer patients was 64.92+/-11.42. Linear regression showed that only grade of tumor, occupational status, menopausal status, financial difficulties and dyspnea were statistically significant. In spite of linear regression, financial difficulties were not significant in quantile regression analysis and dyspnea was only significant for first quartile. Also emotion functioning and duration of disease statistically predicted the QOL score in the third quartile. The results have demonstrated that using quantile regression leads to better interpretation and richer inference about predictors of the breast cancer patient quality of life.

Multiple-Instance Regression with Structured Data

NASA Technical Reports Server (NTRS)

Wagstaff, Kiri L.; Lane, Terran; Roper, Alex

2008-01-01

We present a multiple-instance regression algorithm that models internal bag structure to identify the items most relevant to the bag labels. Multiple-instance regression (MIR) operates on a set of bags with real-valued labels, each containing a set of unlabeled items, in which the relevance of each item to its bag label is unknown. The goal is to predict the labels of new bags from their contents. Unlike previous MIR methods, MI-ClusterRegress can operate on bags that are structured in that they contain items drawn from a number of distinct (but unknown) distributions. MI-ClusterRegress simultaneously learns a model of the bag's internal structure, the relevance of each item, and a regression model that accurately predicts labels for new bags. We evaluated this approach on the challenging MIR problem of crop yield prediction from remote sensing data. MI-ClusterRegress provided predictions that were more accurate than those obtained with non-multiple-instance approaches or MIR methods that do not model the bag structure.

Relationship between Health Literacy, Health-Related Behaviors and Health Status: A Survey of Elderly Chinese

PubMed Central

Liu, Yong-Bing; Liu, Liu; Li, Yan-Fei; Chen, Yan-Li

2015-01-01

Background: Despite the large volume of research dedicated to health-related behavior change, chronic disease costs continue to rise, thus creating a major public health burden. Health literacy, the ability to seek, understand, and utilize health information, has been identified as an important factor in the course of chronic conditions. Little research has been conducted on the relationship between health literacy and health-related behaviors and health status in elderly Chinese. The aim of this study was to elucidate the relationship between health literacy and health-related behaviors and health status in China. Methods: The subjects enrolled in this study were selected based on a stratified cluster random sampling design. Information involving >4500 older adults in 44 pension institutions in Urumqi, Changji, Karamay, and Shihezi of Xinjiang between September 2011 and June 2012 was collected. The Chinese Citizen Health Literacy Questionnaire (China Health Education Centre, 2008) and a Scale of the General Status were administered and the information was obtained through face-to-face inquiries by investigators. A total of 1452 respondents met the inclusion criteria. A total of 1452 questionnaires were issued and the valid response rate was 96.14% (1396 of 1452). Factors affecting health literacy and the relationship to health literacy were identified by one-way ANOVA and a multiple linear regression model. Results: The average health literacy level of the elderly in nursing homes was relatively low (71.74 ± 28.35 points). There were significant differences in the health literacy score among the factors of age, gender, race, education level, household income, marital conditions, and former occupation (p < 0.001). The health literacy score was significantly associated with smoking, drinking, physical exercise, and health examination (p < 0.001). The elderly with higher health literacy scores were significantly less likely to have risky behaviors (smoking, regular drinking, and lack of physical exercise), and in turn significantly more likely to undergo health examinations regularly, report good self-rated health, and significantly more likely to access sufficient health information from multiple sources (p < 0.001). No differences were noted between the health literacy score and BMI (p > 0.05). Multiple linear regression analysis showed that the independent influencing factors of health literacy included education level, race, former occupation, household income, age, physical exercise, health examination, smoking, and health information access (p < 0.001). Conclusions: Health literacy was significantly associated with health-related behaviors in elderly Chinese. Further longitudinal studies are needed to help confirm that improving health literacy in the elderly may be effective in changing health-related behaviors. To reduce risky habits, educational interventions to improve health literacy should be simultaneously conducted in health promotion work. PMID:26295246

Relationship between Health Literacy, Health-Related Behaviors and Health Status: A Survey of Elderly Chinese.

PubMed

Liu, Yong-Bing; Liu, Liu; Li, Yan-Fei; Chen, Yan-Li

2015-08-18

Despite the large volume of research dedicated to health-related behavior change, chronic disease costs continue to rise, thus creating a major public health burden. Health literacy, the ability to seek, understand, and utilize health information, has been identified as an important factor in the course of chronic conditions. Little research has been conducted on the relationship between health literacy and health-related behaviors and health status in elderly Chinese. The aim of this study was to elucidate the relationship between health literacy and health-related behaviors and health status in China. The subjects enrolled in this study were selected based on a stratified cluster random sampling design. Information involving >4500 older adults in 44 pension institutions in Urumqi, Changji, Karamay, and Shihezi of Xinjiang between September 2011 and June 2012 was collected. The Chinese Citizen Health Literacy Questionnaire (China Health Education Centre, 2008) and a Scale of the General Status were administered and the information was obtained through face-to-face inquiries by investigators. A total of 1452 respondents met the inclusion criteria. A total of 1452 questionnaires were issued and the valid response rate was 96.14% (1396 of 1452). Factors affecting health literacy and the relationship to health literacy were identified by one-way ANOVA and a multiple linear regression model. The average health literacy level of the elderly in nursing homes was relatively low (71.74 ± 28.35 points). There were significant differences in the health literacy score among the factors of age, gender, race, education level, household income, marital conditions, and former occupation (p < 0.001). The health literacy score was significantly associated with smoking, drinking, physical exercise, and health examination (p < 0.001). The elderly with higher health literacy scores were significantly less likely to have risky behaviors (smoking, regular drinking, and lack of physical exercise), and in turn significantly more likely to undergo health examinations regularly, report good self-rated health, and significantly more likely to access sufficient health information from multiple sources (p < 0.001). No differences were noted between the health literacy score and BMI (p > 0.05). Multiple linear regression analysis showed that the independent influencing factors of health literacy included education level, race, former occupation, household income, age, physical exercise, health examination, smoking, and health information access (p < 0.001). Health literacy was significantly associated with health-related behaviors in elderly Chinese. Further longitudinal studies are needed to help confirm that improving health literacy in the elderly may be effective in changing health-related behaviors. To reduce risky habits, educational interventions to improve health literacy should be simultaneously conducted in health promotion work.

Patient demographics, insurance status, race, and ethnicity as predictors of morbidity and mortality after spine trauma: a study using the National Trauma Data Bank.

PubMed

Schoenfeld, Andrew J; Belmont, Philip J; See, Aaron A; Bader, Julia O; Bono, Christopher M

2013-12-01

Predictors of complications and mortality after spine trauma are underexplored. At present, no study exists capable of predicting the impact of demographic factors, injury-specific predictors, race, ethnicity, and insurance status on morbidity and mortality after spine trauma. This study endeavored to describe the impact of patient demographics, comorbidities, injury-specific factors, race/ethnicity, and insurance status on outcomes after spinal trauma using the National Sample Program (NSP) of the National Trauma Data Bank (NTDB). The weighted sample of 75,351 incidents of spine trauma in the NTDB was used to develop a predictive model for important factors associated with mortality, postinjury complications, length of hospital stay, intensive care unit (ICU) days, and time on a ventilator. A weighted sample of 75,351 incidents of spine trauma as contained in the NTDB. Mortality, postinjury complications, length of hospital stay, ICU days, and time on a ventilator as reported in the NTDB. The 2008 NSP of the NTDB was queried to identify patients sustaining spine trauma. Patient demographics, race/ethnicity, insurance status, comorbidities, injury-specific factors, and outcomes were recorded, and a national estimate model was derived. Unadjusted differences in baseline characteristics between racial/ethnic groups and insurance status were evaluated using the t test for continuous variables and Wald chi-square analysis for categorical variables with Bonferroni correction for multiple comparisons. Weighted logistic regression was performed for categorical variables (mortality and risk of one or more complications), and weighted multiple linear regression analysis was used for continuous variables (length of hospital stay, ICU days, and ventilator time). Initial determinations were checked against a sensitivity analysis using imputed data. The weighted sample contained 75,351 incidents of spine trauma. The average age was 45.8 years. Sixty-four percent of the population was male, 9% was black/African American, 38% possessed private/commercial insurance, and 12.5% lacked insurance. The mortality rate was 6% and 16% sustained complications. Increased age, male gender, Injury Severity Score (ISS), and blood pressure at presentation were significant predictors of mortality, whereas age, male gender, other mechanism of injury, ISS, and blood pressure at presentation influenced the risk of one or more complications. Nonwhite and black/African American race increased risk of mortality, and lack of insurance increased mortality and decreased the number of hospital days, ICU days, and ventilator time. This is the first study to postulate predictors of morbidity and mortality after spinal trauma in a national model. Race/ethnicity and insurance status appear to be associated with greater risk of mortality after spine trauma. Published by Elsevier Inc.

Self-reported burden among caregivers of patients with multiple sclerosis.

PubMed

Gupta, Shaloo; Goren, Amir; Phillips, Amy L; Stewart, Michelle

2012-01-01

Multiple sclerosis (MS) and Alzheimer's disease (AD) are chronic and progressive diseases that may impose a significant burden on caregivers and patients' immediate families. Extensive research shows MS and AD caregiver burden on physical and mental health, but no direct comparisons between MS and AD caregivers have been reported in the literature. The objective of this study was to examine the extent of MS caregiver burden compared with that of noncaregivers and AD caregivers. Data were obtained from the 2009 National Health and Wellness Survey administered online to a US representative adult sample (N = 75,000). Respondents reported health status, quality of life, work productivity, health-care utilization, and caregiver status. Multivariable regressions, adjusting for key characteristics (eg, age, gender, marital status, depression), were conducted to explore differences between MS caregivers (n = 215) and noncaregivers (n = 69,224) and between MS caregivers and AD caregivers (n = 1341). The results indicated that MS caregivers had significantly greater activity impairment (P = .01), poorer mental (P = .015) and physical (P = .002) health status, lower health utility scores (P = .002), and more traditional health-care provider visits (P < .001), emergency room (ER) visits (P < .001), and hospitalizations (P = .001) than noncaregivers, adjusting for covariates. After adjustments, MS caregivers had greater activity impairment (P = .044), more ER visits (P = .017), and more hospitalizations (P = .008) than AD caregivers. Significant work productivity differences were not observed across groups, possibly owing to fewer employed respondents. Thus, in this study, MS caregivers had significantly more burden than noncaregivers, and for some measures, even AD caregivers. The results reveal the hidden toll on those providing care for MS patients and highlight the need for health-care providers to recognize their burden so that appropriate measures can be implemented.

Contribution of neurocognition to 18-month employment outcomes in first-episode psychosis.

PubMed

Karambelas, George J; Cotton, Sue M; Farhall, John; Killackey, Eóin; Allott, Kelly A

2017-10-27

To examine whether baseline neurocognition predicts vocational outcomes over 18 months in patients with first-episode psychosis enrolled in a randomized controlled trial of Individual Placement and Support or treatment as usual. One-hundred and thirty-four first-episode psychosis participants completed an extensive neurocognitive battery. Principal axis factor analysis using PROMAX rotation was used to determine the underlying structure of the battery. Setwise (hierarchical) multiple linear and logistic regressions were used to examine predictors of (1) total hours employed over 18 months and (2) employment status, respectively. Neurocognition factors were entered in the models after accounting for age, gender, premorbid IQ, negative symptoms, treatment group allocation and employment status at baseline. Five neurocognitive factors were extracted: (1) processing speed, (2) verbal learning and memory, (3) knowledge and reasoning, (4) attention and working memory and (5) visual organization and memory. Employment status over 18 months was not significantly predicted by any of the predictors in the final model. Total hours employed over 18 months were significantly predicted by gender (P = .027), negative symptoms (P = .032) and verbal learning and memory (P = .040). Every step of the regression model was a significant predictor of total hours worked overall (final model: P = .013). Verbal learning and memory, negative symptoms and gender were implicated in duration of employment in first-episode psychosis. The other neurocognitive domains did not significantly contribute to the prediction of vocational outcomes over 18 months. Interventions targeting verbal memory may improve vocational outcomes in early psychosis. © 2017 John Wiley & Sons Australia, Ltd.

Iron status of young children from immigrant families.

PubMed

Saunders, Natasha Ruth; Parkin, Patricia C; Birken, Catherine S; Maguire, Jonathon L; Borkhoff, Cornelia M

2016-12-01

Children from immigrant families may be at risk for iron deficiency (ID) due to differences in pre-migration and post-migration exposures. Our objectives were to determine whether there is an association between family immigrant status and iron stores and to evaluate whether known dietary, environmental or biological determinants of low iron status influence this relationship. This was a cross-sectional study of healthy urban preschool children (12-72 months) recruited from seven primary care practices in Toronto. Laboratory assessment of serum ferritin and haemoglobin and standardised parent-completed surveys were completed between 2008 and 2013 during routine health maintenance visits. Multiple regression analyses were used to evaluate the association between family immigrant status and serum ferritin, ID (ferritin <14 μg/L) and iron deficiency anaemia (IDA) (ferritin <14 μg/L and haemoglobin ≤110 g/L). Of 2614 children included in the analysis, 47.6% had immigrant family status. The median serum ferritin was 30 μg/L and 10.4% of all children had ID and 1.9% had IDA. After adjusting for maternal ethnicity and education, age, sex, income quintile, cow's milk intake, breastfeeding duration and bottle use, there were no significant associations between immigrant status and ferritin, ID or IDA. Significant predictors of low iron status included age, sex, cow's milk intake and breastfeeding duration. We found no association between family immigrant status and iron status after including clinically important covariates in the models. These data suggest immigrant children may not need enhanced screening for iron status or targeted interventions for iron supplementation. 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/.

Is subjective social status a summary of life-course socioeconomic position?

PubMed

Ferreira, Wasney de Almeida; Camelo, Lidyane; Viana, Maria Carmen; Giatti, Luana; Barreto, Sandhi Maria

2018-01-01

Very little is known about the association between objective indicators of socioeconomic position in childhood and adolescence and low subjective social status in adult life, after adjusting for adult socioeconomic position. We used baseline data (2008-2010) from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a multicenter cohort study of 15,105 civil servants from six Brazilian states. Subjective social status was measured using the The MacArthur Scale of Subjective Social Status, which represents social hierarchy in the form of a 10-rung ladder with the top rung representing the highest subjective social status. Participants who chose the bottom four rungs in the ladder were assigned to the low subjective social status category. The following socioeconomic position indicators were investigated: childhood (maternal education), adolescence (occupational social class of the household head; participant's occupational social class of first job; nature of occupation of household head; participant's nature of occupation of first job), and adulthood (participant's occupational social class, nature of occupation and education). The associations between low subjective social status and socioeconomic position were determined using multiple logistic regression, after adjusting for sociodemographic factors and socioeconomic position indicators from other stages of life. After adjustments, low socioeconomic position in childhood, adolescence and adulthood remained significantly associated with low subjective social status in adulthood with dose-response gradients. The magnitude of these associations was stronger for intra-individual than for intergenerational socioeconomic positions. Results suggest that subjective social status in adulthood is the result of a complex developmental process of acquiring socioeconomic self-perception, which is intrinsic to subjective social status and includes current and past, individual and family household experiences.

Estimating the effects of land use at different scales on high ecological status in Irish rivers.

PubMed

Roberts, William M; Fealy, Reamonn M; Doody, Donnacha G; Jordan, Phil; Daly, Karen

2016-12-01

High ecological status at river sites is an indicator of minimal disturbance from anthropogenic activities and the presence of ecologically important species and communities. However, a lack of clarity on what factors cause sites to lose high ecological status is limiting the ability to maintain the quality of these sites. Examination of ecological status records at 508 high status river sites throughout the Republic of Ireland revealed that 337 had fallen below high status at some point between 2001 and 2012 due to changes in invertebrate communities. A geographical information system was used to characterise land use and environmental variables in the catchment, riparian and reach areas upstream of the sites. The relationships between these variables at the three spatial scales and whether or not river sites had maintained high ecological status were then estimated by multiple logistic regression and propensity modelling. The results indicated that grassland at either catchment or riparian scales had a greater negative impact on high ecological status than at the reach scale. This effect appeared to be strongest for upland, steeply sloping rivers that are subject to high rainfall, possibly due to the presence of sensitive biota and/or a greater potential for erosion. These results highlighted the need for better management of grassland upstream of the high status sites, with a focus on river alterations and critical source areas of nutrients, sediments and pesticides that are hydrologically connected to the river. Sustainable management practices and land use planning in those areas will need to be considered carefully if the aim of maintaining high ecological status at river sites is to be achieved. Copyright © 2016 Elsevier B.V. All rights reserved.

Estimating increment-decrement life tables with multiple covariates from panel data: the case of active life expectancy.

PubMed

Land, K C; Guralnik, J M; Blazer, D G

1994-05-01

A fundamental limitation of current multistate life table methodology-evident in recent estimates of active life expectancy for the elderly-is the inability to estimate tables from data on small longitudinal panels in the presence of multiple covariates (such as sex, race, and socioeconomic status). This paper presents an approach to such an estimation based on an isomorphism between the structure of the stochastic model underlying a conventional specification of the increment-decrement life table and that of Markov panel regression models for simple state spaces. We argue that Markov panel regression procedures can be used to provide smoothed or graduated group-specific estimates of transition probabilities that are more stable across short age intervals than those computed directly from sample data. We then join these estimates with increment-decrement life table methods to compute group-specific total, active, and dependent life expectancy estimates. To illustrate the methods, we describe an empirical application to the estimation of such life expectancies specific to sex, race, and education (years of school completed) for a longitudinal panel of elderly persons. We find that education extends both total life expectancy and active life expectancy. Education thus may serve as a powerful social protective mechanism delaying the onset of health problems at older ages.

Application of neural networks to prediction of fish diversity and salmonid production in the Lake Ontario basin

USGS Publications Warehouse

McKenna, James E.

2005-01-01

Diversity and fish productivity are important measures of the health and status of aquatic systems. Being able to predict the values of these indices as a function of environmental variables would be valuable to management. Diversity and productivity have been related to environmental conditions by multiple linear regression and discriminant analysis, but such methods have several shortcomings. In an effort to predict fish species diversity and estimate salmonid production for streams in the eastern basin of Lake Ontario, I constructed neural networks and trained them on a data set containing abiotic information and either fish diversity or juvenile salmonid abundance. Twenty percent of the original data were retained as a test data set and used in the training. The ability to extend these neural networks to conditions throughout the streams was tested with data not involved in the network training. The resulting neural networks were able to predict the number of salmonids with more than 84% accuracy and diversity with more than 73% accuracy, which was far superior to the performance of multiple regression. The networks also identified the environmental variables with the greatest predictive power, namely, those describing water movement, stream size, and water chemistry. Thirteen input variables were used to predict diversity and 17 to predict salmonid abundance.

Health-related lifestyle behaviors among male and female rural-to-urban migrant workers in Shanghai, China.

PubMed

Yang, Hua; He, Fang; Wang, Tianhao; Liu, Yao; Shen, Yao; Gong, Jian; Dai, Wei; Zhou, Jing; Gu, Jie; Tu, Yimin; Wang, Tianying; Shen, Lei; Wu, Yumiao; Xia, Xiuping; Xu, Donghao; Pan, Zhigang; Zhu, Shanzhu

2015-01-01

Lifestyle behaviors significantly impact health, yet remain poorly defined in Chinese rural-to-urban migrants. In a cross-sectional study of health-related behaviors of 5484 rural-to-urban migrants who had worked in Shanghai for at least six months, we assessed the contribution of demographics and physical and mental health to lifestyle behaviors in male and female participants by multiple stepwise cumulative odds logistic regression. Respondents were 51.3% male. 9.9% exhibited abnormal blood pressure; 27.0% were overweight or obese; 11.2% reported abnormal mental health; 36.9% reported healthy lifestyle. Multiple stepwise cumulative odds logistic regression indicated that men working in manufacturing reported less unhealthy lifestyle than those in hospitality (cumulative odds ratio (COR) = 1.806, 95%CI 1.275-2.559) or recreation/leisure (COR = 3.248, 95%CI 2.379-4.435); and women working in manufacturing and construction reported less unhealthy lifestyle than those in all other sectors. Unhealthy lifestyle was associated with small workplaces for men (COR = 1.422, 95%CI 1.154-1.752), working more than 8 or 11 hours per day for women and men, respectively, and earning over 3500 RMB in women (COR = 1.618, 95%CI 1.137-2.303). Single women and women who had previously resided in three or more cities were more likely to report unhealthy lifestyle (COR = 2.023, 95%CI 1.664-2.461, and COR = 1.311, 95%CI 1.072-1.602, respectively). Abnormal mental status was also correlated with unhealthy lifestyle in men (COR = 3.105, 95%CI 2.454-3.930) and women (COR = 2.566, 95%CI 2.024-3.252). There were different risk factors of unhealthy lifestyle score in male and female rural-to-urban migrants, especially in number of cities experienced, salary, marital status, work place scale. Several demographic groups: employment sectors (e.g. hospitality and recreation/leisure), working conditions (e.g. long hours) and abnormal mental status were associated with unhealthy lifestyle behaviors in Chinese rural-to-urban migrants, and health interventions should be targeted to these groups.

Health-Related Lifestyle Behaviors among Male and Female Rural-to-Urban Migrant Workers in Shanghai, China

PubMed Central

Yang, Hua; He, Fang; Wang, Tianhao; Liu, Yao; Shen, Yao; Gong, Jian; Dai, Wei; Zhou, Jing; Gu, Jie; Tu, Yimin; Wang, Tianying; Shen, Lei; Wu, Yumiao; Xia, Xiuping; Xu, Donghao; Pan, Zhigang; Zhu, Shanzhu

2015-01-01

Background Lifestyle behaviors significantly impact health, yet remain poorly defined in Chinese rural-to-urban migrants. Methods In a cross-sectional study of health-related behaviors of 5484 rural-to-urban migrants who had worked in Shanghai for at least six months, we assessed the contribution of demographics and physical and mental health to lifestyle behaviors in male and female participants by multiple stepwise cumulative odds logistic regression. Results Respondents were 51.3% male. 9.9% exhibited abnormal blood pressure; 27.0% were overweight or obese; 11.2% reported abnormal mental health; 36.9% reported healthy lifestyle. Multiple stepwise cumulative odds logistic regression indicated that men working in manufacturing reported less unhealthy lifestyle than those in hospitality (cumulative odds ratio (COR) = 1.806, 95%CI 1.275–2.559) or recreation/leisure (COR = 3.248, 95%CI 2.379–4.435); and women working in manufacturing and construction reported less unhealthy lifestyle than those in all other sectors. Unhealthy lifestyle was associated with small workplaces for men (COR = 1.422, 95%CI 1.154–1.752), working more than 8 or 11 hours per day for women and men, respectively, and earning over 3500 RMB in women (COR = 1.618, 95%CI 1.137–2.303). Single women and women who had previously resided in three or more cities were more likely to report unhealthy lifestyle (COR = 2.023, 95%CI 1.664–2.461, and COR = 1.311, 95%CI 1.072–1.602, respectively). Abnormal mental status was also correlated with unhealthy lifestyle in men (COR = 3.105, 95%CI 2.454–3.930) and women (COR = 2.566, 95%CI 2.024–3.252). Conclusions There were different risk factors of unhealthy lifestyle score in male and female rural-to-urban migrants, especially in number of cities experienced, salary, marital status, work place scale. Several demographic groups: employment sectors (e.g. hospitality and recreation/leisure), working conditions (e.g. long hours) and abnormal mental status were associated with unhealthy lifestyle behaviors in Chinese rural-to-urban migrants, and health interventions should be targeted to these groups. PMID:25710464

Outcome-based health equity across different social health insurance schemes for the elderly in China.

PubMed

Liu, Xiaoting; Wong, Hung; Liu, Kai

2016-01-14

Against the achievement of nearly universal coverage for social health insurance for the elderly in China, a problem of inequity among different insurance schemes on health outcomes is still a big challenge for the health care system. Whether various health insurance schemes have divergent effects on health outcome is still a puzzle. Empirical evidence will be investigated in this study. This study employs a nationally representative survey database, the National Survey of the Aged Population in Urban/Rural China, to compare the changes of health outcomes among the elderly before and after the reform. A one-way ANOVA is utilized to detect disparities in health care expenditures and health status among different health insurance schemes. Multiple Linear Regression is applied later to examine the further effects of different insurance plans on health outcomes while controlling for other social determinants. The one-way ANOVA result illustrates that although the gaps in insurance reimbursements between the Urban Employee Basic Medical Insurance (UEBMI) and the other schemes, the New Rural Cooperative Medical Scheme (NCMS) and Urban Residents Basic Medical Insurance (URBMI) decreased, out-of-pocket spending accounts for a larger proportion of total health care expenditures, and the disparities among different insurances enlarged. Results of the Multiple Linear Regression suggest that UEBMI participants have better self-reported health status, physical functions and psychological wellbeing than URBMI and NCMS participants, and those uninsured. URBMI participants report better self-reported health than NCMS ones and uninsured people, while having worse psychological wellbeing compared with their NCMS counterparts. This research contributes to a transformation in health insurance studies from an emphasis on the opportunity-oriented health equity measured by coverage and healthcare accessibility to concern with outcome-based equity composed of health expenditure and health status. The results indicate that fragmented health insurance schemes generate inequitable health care utilization and health outcomes for the elderly. This study re-emphasizes the importance of reforming health insurance systems based on their health outcome rather than entitlement, which will particularly benefit the most vulnerable older groups.

Should I stay or should I go? A prospective investigation examining individual factors impacting employment status among individuals with multiple sclerosis (MS).

PubMed

Strober, Lauren B; Chiaravalloti, Nancy; DeLuca, John

2018-01-01

Rates of unemployment among individuals with multiple sclerosis (MS) are as high as 80%. While several factors for such high rates of unemployment have been identified, they do not account for the majority of the variance. This study examines person-specific factors such as personality and coping, which may better account for individuals leaving the workforce. Forty individuals with MS (20 considering reducing work hours or leaving the workforce and 20 remaining employed) were matched on age, gender, education, disease duration, and disease course, and administered a comprehensive survey of factors purported to be related to employment status. Based on multiple, logistic regression analyses certain disease factors and person-specific factors differentiate those who are considering leaving work or reducing work hours and those staying employed. In particular, those expressing the need to reduce work hours or leaving the workforce reported more fatigue, anxiety, depression, and use of behavioral disengagement as a means of coping. In contrast, those staying employed reported greater levels of extraversion, self-efficacy, and use of humor as a means of coping. Together, fatigue, use of humor, and use of behavioral disengagement as a means of coping were the most significant factors, accounting for 44% of the variance. Findings suggest that greater consideration be given to these factors and that interventions tailored to address these factors may assist individuals with MS staying employed and/or making appropriate accommodations.

Visual Acuity Is Correlated with the Area of the Foveal Avascular Zone in Diabetic Retinopathy and Retinal Vein Occlusion.

PubMed

Balaratnasingam, Chandrakumar; Inoue, Maiko; Ahn, Seungjun; McCann, Jesse; Dhrami-Gavazi, Elona; Yannuzzi, Lawrence A; Freund, K Bailey

2016-11-01

To determine if the area of the foveal avascular zone (FAZ) is correlated with visual acuity (VA) in diabetic retinopathy (DR) and retinal vein occlusion (RVO). Cross-sectional study. Ninety-five eyes of 66 subjects with DR (65 eyes), branch retinal vein occlusion (19 eyes), and central retinal vein occlusion (11 eyes). Structural optical coherence tomography (OCT; Spectralis, Heidelberg Engineering) and OCT angiography (OCTA; Avanti, Optovue RTVue XR) data from a single visit were analyzed. FAZ area, point thickness of central fovea, central 1-mm subfield thickness, the occurrence of intraretinal cysts, ellipsoid zone disruption, and disorganization of retinal inner layers (DRIL) length were measured. VA was also recorded. Correlations between FAZ area and VA were explored using regression models. Main outcome measure was VA. Mean age was 62.9±13.2 years. There was no difference in demographic and OCT-derived anatomic measurements between branch retinal vein occlusion and central retinal vein occlusion groups (all P ≥ 0.058); therefore, data from the 2 groups were pooled together to a single RVO group for further statistical comparisons. Univariate and multiple regression analysis showed that the area of the FAZ was significantly correlated with VA in DR and RVO (all P ≤ 0.003). The relationship between FAZ area and VA varied with age (P = 0.026) such that for a constant FAZ area, an increase in patient age was associated with poorer vision (rise in logarithm of the minimum angle of resolution visual acuity). Disruption of the ellipsoid zone was significantly correlated with VA in univariate and multiple regression analysis (both P < 0.001). Occurrence of intraretinal cysts, DRIL length, and lens status were significantly correlated with VA in the univariate regression analysis (P ≤ 0.018) but not the multiple regression analysis (P ≥ 0.210). Remaining variables evaluated in this study were not predictive of VA (all P ≥ 0.225). The area of the FAZ is significantly correlated with VA in DR and RVO and this relationship is modulated by patient age. Further study about FAZ area and VA correlations during the natural course of retinal vascular diseases and following treatment is warranted. Copyright © 2016 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Marginal regression approach for additive hazards models with clustered current status data.

PubMed

Su, Pei-Fang; Chi, Yunchan

2014-01-15

Current status data arise naturally from tumorigenicity experiments, epidemiology studies, biomedicine, econometrics and demographic and sociology studies. Moreover, clustered current status data may occur with animals from the same litter in tumorigenicity experiments or with subjects from the same family in epidemiology studies. Because the only information extracted from current status data is whether the survival times are before or after the monitoring or censoring times, the nonparametric maximum likelihood estimator of survival function converges at a rate of n(1/3) to a complicated limiting distribution. Hence, semiparametric regression models such as the additive hazards model have been extended for independent current status data to derive the test statistics, whose distributions converge at a rate of n(1/2) , for testing the regression parameters. However, a straightforward application of these statistical methods to clustered current status data is not appropriate because intracluster correlation needs to be taken into account. Therefore, this paper proposes two estimating functions for estimating the parameters in the additive hazards model for clustered current status data. The comparative results from simulation studies are presented, and the application of the proposed estimating functions to one real data set is illustrated. Copyright © 2013 John Wiley & Sons, Ltd.

Natural history of age-related lobular involution and impact on breast cancer risk.

PubMed

Radisky, Derek C; Visscher, Daniel W; Frank, Ryan D; Vierkant, Robert A; Winham, Stacey; Stallings-Mann, Melody; Hoskin, Tanya L; Nassar, Aziza; Vachon, Celine M; Denison, Lori A; Hartmann, Lynn C; Frost, Marlene H; Degnim, Amy C

2016-02-01

Age-related lobular involution (LI) is a physiological process in which the terminal duct lobular units of the breast regress as a woman ages. Analyses of breast biopsies from women with benign breast disease (BBD) have found that extent of LI is negatively associated with subsequent breast cancer development. Here we assess the natural course of LI within individual women, and the impact of progressive LI on breast cancer risk. The Mayo Clinic BBD cohort consists of 13,455 women with BBD from 1967 to 2001. The BBD cohort includes 1115 women who had multiple benign biopsies, 106 of whom had developed breast cancer. Within this multiple biopsy cohort, the progression of the LI process was examined by age at initial biopsy and time between biopsies. The relationship between LI progression and breast cancer risk was assessed using standardized incidence ratios and by Cox proportional hazards analysis. Women who had multiple biopsies were younger age and had a slightly higher family history of breast cancer as compared with the overall BBD cohort. Extent of LI at subsequent biopsy was greater with increasing time between biopsies and for women age 55 + at initial biopsy. Among women with multiple biopsies, there was a significant association of higher breast cancer risk among those with involution stasis (lack of progression, HR 1.63) as compared with those with involution progression, p = 0.036. The multiple biopsy BBD cohort allows for a longitudinal study of the natural progression of LI. The majority of women in the multiple biopsy cohort showed progression of LI status between benign biopsies, and extent of progression was highest for women who were in the perimenopausal age range at initial biopsy. Progression of LI status between initial and subsequent biopsy was associated with decreased breast cancer risk.

Depression is a predictor for balance in people with multiple sclerosis.

PubMed

Alghwiri, Alia A; Khalil, Hanan; Al-Sharman, Alham; El-Salem, Khalid

2018-05-26

Balance impairments are common and multifactorial among people with multiple sclerosis (MS). Depression is the most common psychological disorder in MS population and is strongly correlated with MS disease. Depression might be one of the factors that contribute to balance deficits in this population. However, the relationship between depression and balance impairments has not been explored in people with MS. To investigate the association between depression and balance impairments in people with MS. Cross sectional design was used in patients with MS. The Activities-specific Balance Confidence scale (ABC) and Berg Balance Scale (BBS) was used to assess balance. Beck Depression Inventory (BDI-II) was used to quantify depression and Kurtizki Expanded Disability Status Scale (EDSS) was utilized for the evaluation of MS disability severity. Pearson correlation coefficient was used to examine the association between depression and balance measurements. Multiple linear stepwise regressions were also conducted to find out if depression is a potential predictor for balance deficits. Seventy-five individuals with MS (Female = 69%) with a mean age (SD) of 38.8 (10) and a mean (SD) EDSS score of 3.0 (1.4) were recruited in this study. Depression was present in 53% of the patients. Depression was significantly correlated with balance measurements and EDSS. However, multiple linear stepwise regressions found that only depression and age significantly predict balance. Depression and balance were found frequent and associated in people with MS. Importantly depression was a significant predictor for balance impairments in individuals with MS. Balance rehabilitation may be hindered by depression. Therefore, depression should be evaluated and treated properly in individuals with MS. Copyright © 2018 Elsevier B.V. All rights reserved.

A metabolomic study of low estimated GFR in non-proteinuric type 2 diabetes mellitus.

PubMed

Ng, D P K; Salim, A; Liu, Y; Zou, L; Xu, F G; Huang, S; Leong, H; Ong, C N

2012-02-01

We carried out a urinary metabolomic study to gain insight into low estimated GFR (eGFR) in patients with non-proteinuric type 2 diabetes. Patients were identified as being non-proteinuric using multiple urinalyses. Cases (n = 44) with low eGFR and controls (n = 46) had eGFR values <60 and ≥60 ml min(-1) 1.73 m(-2), respectively, as calculated using the Modification of Diet in Renal Disease formula. Urine samples were analysed by liquid chromatography/mass spectrometry (LC/MS) and GC/MS. False discovery rates were used to adjust for multiple hypotheses testing, and selection of metabolites that best predicted low eGFR status was achieved using least absolute shrinkage and selection operator logistic regression. Eleven GC/MS metabolites were strongly associated with low eGFR after correction for multiple hypotheses testing (smallest adjusted p value = 2.62 × 10(-14), largest adjusted p value = 3.84 × 10(-2)). In regression analysis, octanol, oxalic acid, phosphoric acid, benzamide, creatinine, 3,5-dimethoxymandelic amide and N-acetylglutamine were selected as the best subset for prediction and allowed excellent classification of low eGFR (AUC = 0.996). In LC/MS, 19 metabolites remained significant after multiple hypotheses testing had been taken into account (smallest adjusted p value = 2.04 × 10(-4), largest adjusted p value = 4.48 × 10(-2)), and several metabolites showed stronger evidence of association relative to the uraemic toxin, indoxyl sulphate (adjusted p value = 3.03 × 10(-2)). The potential effect of confounding on the association between metabolites was excluded. Our study has yielded substantial new insight into low eGFR and provided a collection of potential urinary biomarkers for its detection.

A Quantile Regression Approach to Understanding the Relations Between Morphological Awareness, Vocabulary, and Reading Comprehension in Adult Basic Education Students

PubMed Central

Tighe, Elizabeth L.; Schatschneider, Christopher

2015-01-01

The purpose of this study was to investigate the joint and unique contributions of morphological awareness and vocabulary knowledge at five reading comprehension levels in Adult Basic Education (ABE) students. We introduce the statistical technique of multiple quantile regression, which enabled us to assess the predictive utility of morphological awareness and vocabulary knowledge at multiple points (quantiles) along the continuous distribution of reading comprehension. To demonstrate the efficacy of our multiple quantile regression analysis, we compared and contrasted our results with a traditional multiple regression analytic approach. Our results indicated that morphological awareness and vocabulary knowledge accounted for a large portion of the variance (82-95%) in reading comprehension skills across all quantiles. Morphological awareness exhibited the greatest unique predictive ability at lower levels of reading comprehension whereas vocabulary knowledge exhibited the greatest unique predictive ability at higher levels of reading comprehension. These results indicate the utility of using multiple quantile regression to assess trajectories of component skills across multiple levels of reading comprehension. The implications of our findings for ABE programs are discussed. PMID:25351773

ℓ(p)-Norm multikernel learning approach for stock market price forecasting.

PubMed

Shao, Xigao; Wu, Kun; Liao, Bifeng

2012-01-01

Linear multiple kernel learning model has been used for predicting financial time series. However, ℓ(1)-norm multiple support vector regression is rarely observed to outperform trivial baselines in practical applications. To allow for robust kernel mixtures that generalize well, we adopt ℓ(p)-norm multiple kernel support vector regression (1 ≤ p < ∞) as a stock price prediction model. The optimization problem is decomposed into smaller subproblems, and the interleaved optimization strategy is employed to solve the regression model. The model is evaluated on forecasting the daily stock closing prices of Shanghai Stock Index in China. Experimental results show that our proposed model performs better than ℓ(1)-norm multiple support vector regression model.

The association between dental, general, and mental health status among underserved and vulnerable populations served at health centers in the US.

PubMed

Nguyen, Vy H; Lin, Sue C; Cappelli, David P; Nair, Suma

2018-12-01

Vulnerable populations in underserved communities are disproportionately at high risk for multiple medical, dental, and behavioral health conditions. This study aims to: a) examine the occurrence of acute dental needs and b) investigate the association of acute dental needs and self-rated general and mental health status among the adult dentate health center population. This cross-sectional study analyzed data on adult patients (n = 5,035) from the 2014 Health Center Patient Survey, a nationally representative survey of health center patients. Multivariate logistic regression was used to assess the association of acute dental needs and a) self-rated general health status and b) mental health status. Approximately, two thirds of adult dentate heath center patients reported having an acute dental need. After adjusting for confounding factors, not having or having had health insurance that pays for dental care, general health status of fair or poor, and ever having a mental illness were associated with higher odds of having an acute dental need. The results highlight the role of health centers in addressing oral health disparities among vulnerable populations and the importance of a team-based multidisciplinary approach to ensuring the integration and coordination of oral health services within a comprehensive primary care delivery system. © 2017 American Association of Public Health Dentistry.

Association between nutritional status and dental caries in permanent dentition among primary schoolchildren aged 12-14 years, Thailand.

PubMed

Narksawat, Kulaya; Tonmukayakul, Utsana; Boonthum, Angsana

2009-03-01

This cross-sectional study assessed associations between nutrition and dental caries in permanent dentition and identified oral hygiene indicators among older children aged 12-14 years in primary schools in Thailand. The study was comprised of 862 schoolchildren from five provinces representing five regions of Thailand, from both rural and urban areas, including Bangkok. The dental hygeine status was assessed by evaluating for decayed teeth, missing teeth due to decay, and filled teeth index (DMFT index). Weight and height were measured to evaluate the nutritional status; hygiene practices assessed by interview. The results show a negative relationship between nutritional status and the DMFT index, which increased when the nutritional status decreased (Spearman's rho correlation = -0.140, p < 0.001). The results from multiple logistic regression analysis showed normal weight and thin schoolchildren were more likely to have a DMFT of at least 1 by 1.94 times (OR = 1.94; 95%CI = 1.25-3.00, p = 0.004) and 2.22 times (OR = 2.22; 95%CI = 1.20-4.09, p = 0.001), respectively, compared to overweight and obese children. Normal and thin schoolchildren had a higher risk for dental caries than overweight and obese children aged 12-14 years in Thailand. School health promotion activities should emphasize eating habit improvement in order to reduce the incidence of caries.

Factors associated with low vitamin D status of Australian alpacas.

PubMed

Judson, G J; McGregor, B A; Partington, D L

2008-12-01

To investigate factors associated with low vitamin D status of alpacas at pasture in southern Australia. A 2-year survey of alpacas from two farms in South Australia and three in Victoria. Blood samples were collected from 20 to 30 alpacas on each farm on five occasions each year. Breed, gender, age and fleece colour of animals were recorded. Blood samples were assayed for plasma 2.5-hydroxycholecalciferol (25-OH D(3)) and plasma inorganic phosphorus (Pi). Data sets from 802 animal samples were analysed by multiple regression to determine variables associated with low vitamin D status of alpacas. The relationship between plasma 25-OH D(3) and plasma Pi was also investigated. Vitamin D status was significantly affected by month of sampling, with low values in late winter and high values in summer. Plasma vitamin D concentrations increased with age, were higher in alpacas with light fleeces than in those with dark fleeces and were also higher in the Suri than in the Huacaya breed. Plasma Pi concentrations were generally lower in alpacas with plasma 25-OH D(3) values < 25 nmol/L. Young alpacas with dark fleeces are most at risk from vitamin D insufficiency in late winter in southern Australia. The present study indicates that plasma Pi values are not a reliable indicator of vitamin D status of alpacas as assessed by plasma 25-OH D(3) concentrations.

Blood donation, being Asian, and a history of iron deficiency are stronger predictors of iron deficiency than dietary patterns in premenopausal women.

PubMed

Beck, Kathryn L; Conlon, Cathryn A; Kruger, Rozanne; Heath, Anne-Louise M; Matthys, Christophe; Coad, Jane; Jones, Beatrix; Stonehouse, Welma

2014-01-01

This study investigated dietary patterns and nondietary determinants of suboptimal iron status (serum ferritin < 20 μg/L) in 375 premenopausal women. Using multiple logistic regression analysis, determinants were blood donation in the past year [OR: 6.00 (95% CI: 2.81, 12.82); P < 0.001], being Asian [OR: 4.84 (95% CI: 2.29, 10.20); P < 0.001], previous iron deficiency [OR: 2.19 (95% CI: 1.16, 4.13); P = 0.016], a "milk and yoghurt" dietary pattern [one SD higher score, OR: 1.44 (95% CI: 1.08, 1.93); P = 0.012], and longer duration of menstruation [days, OR: 1.38 (95% CI: 1.12, 1.68); P = 0.002]. A one SD change in the factor score above the mean for a "meat and vegetable" dietary pattern reduced the odds of suboptimal iron status by 79.0% [OR: 0.21 (95% CI: 0.08, 0.50); P = 0.001] in women with children. Blood donation, Asian ethnicity, and previous iron deficiency were the strongest predictors, substantially increasing the odds of suboptimal iron status. Following a "milk and yoghurt" dietary pattern and a longer duration of menstruation moderately increased the odds of suboptimal iron status, while a "meat and vegetable" dietary pattern reduced the odds of suboptimal iron status in women with children.

Vitamin D status and its predictors in New Zealand aged-care residents eligible for a government-funded universal vitamin D supplementation programme.

PubMed

MacDonell, Sue O; Miller, Jody C; Harper, Michelle J; Waters, Debra L; Houghton, Lisa A

2016-12-01

The provision of prescribed vitamin D to all aged-care residents has been implemented in New Zealand as part of a government-led falls prevention programme. To our knowledge, there has been no evaluation of this universal programme on vitamin D status and functional and health outcomes. Thus, we aimed to determine 25-hydroxyvitamin D (25(OH)D) concentrations and their predictors in aged-care residents across the country and to investigate whether the government-funded programme was associated with adequate vitamin D status. Cross-sectional survey of sociodemographic, biochemical, anthropometric, dietary and health characteristics. Blood samples were analysed for serum 25(OH)D and other biochemical measures. Multiple regression was used to examine predictors of vitamin D status. Sixteen residential aged-care facilities throughout New Zealand. Residents aged ≥60 years with residency duration >12 weeks (n 309). Mean serum 25(OH)D was 89·9 (95 % CI 85·2, 94·5) nmol/l and monthly supplements (1250 µg (50 000 IU)) were taken by 75 % of all residents. Of those not taking a funded supplement, 65·3 % had serum 25(OH)D 125 nmol/l. Residents taking supplemental vitamin D had adequate vitamin D status; however monitoring of long-term supplementation should be considered, due to the high proportion of participants with high serum 25(OH)D levels.

Risk factors for suicidal ideation in Korean middle-aged adults: the role of socio-demographic status.

PubMed

Moon, Sang-Sik; Park, Sang-Mi

2012-11-01

The investigations of the risk factors for suicidal ideation among middle-aged adults may be especially important for predicting suicidal actions, given the steep increase in suicide among Koreans aged 45-54. Few studies have sought to investigate the effect of socio-demographic status on suicidal ideation among middle-aged adults. This study investigated the influence of socio-demographic status on suicidal ideation among middle-aged adults in South Korea. The sample consisted of middle-aged men (n = 3,214) and middle-aged women (n = 4,087) aged 40-64 years who had participated in the 2005 cross-sectional Seoul Citizens Health and Social Indicators Survey. Using multiple logistic regression analysis, we examined the effect of socio-demographic status, health behaviours and health status on suicidal ideation in middle-aged adults. The outstanding finding was that suicidal ideation was most prevalent among middle-aged women who engaged in manual labour (i.e. blue-collar workers) (OR = 2.77, 95% CI = 1.20-6.42). The absence of a spouse was significantly associated with suicidal ideation among middle-aged men (OR = 2.10, 95% CI = 1.30-3.40). The effect of enhanced security related to stable employment was strongest among middle-aged women in blue-collar jobs, and the effect of intensive counselling services was strongest among divorced or widowed middle-aged men.

Depression and Functional Status Among African American Stroke Survivors in Inpatient Rehabilitation.

PubMed

Harris, Gabrielle M; Collins-McNeil, Janice; Yang, Qing; Nguyen, Vu Q C; Hirsch, Mark A; Rhoads, Charles F; Guerrier, Tami; Thomas, J George; Pugh, Terrence M; Hamm, Deanna; Pereira, Carol; Prvu Bettger, Janet

2017-01-01

To examine the prevalence of poststroke depression (PSD) among African American stroke survivors and the association of depression with functional status at inpatient rehabilitation facility (IRF) discharge. Secondary data analysis was conducted of a patient cohort who received care at 3 IRFs in the United States from 2009 to 2011. Functional status was measured by the Functional Independence Measure (FIM). Multiple linear regression models were used to examine associations of PSD and FIM motor and cognitive scores. Of 458 African American stroke survivors, 48.5% were female, 84% had an ischemic stroke, and the mean age was 60.8 ± 13.6 years. Only 15.4% (n = 71) had documentation of PSD. Bivariate analyses to identify factors associated with depression identified a higher percentage of patients with depression than without who were retired due to disability (17.1% versus 11.6%) or employed (31.4% versus 19.6%) prestroke (P = .041). Dysphagia, cognitive deficits, and a lower admission motor FIM score were also significantly more common among those with depression. There was no significant relationship between depression and functional status after adjusting for patient characteristics. In this study, 15% of the African Americans who received rehabilitation after a stroke had documentation of PSD but this was not associated with functional status at discharge. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Attitude to Substance Abuse: Do Personality and Socio-Demographic Factors Matter?

PubMed Central

Rahimian Boogar, Isaac; Tabatabaee, Sayed Mosa; Tosi, Jalileh

2014-01-01

Background: Substance abuse is a serious global problem that is affected by multiple psychosocial and socio-demographic factors. Objectives: This study aimed to investigate the leading factors in positive attitude and tendency toward substance abuse in terms of personality, socio-economic, and socio-demographic factors. Patients and Methods: In a cross-sectional study, 200 college students (105 females and 95 males) residing in Damghan University dormitory in northeast of Iran were recruited by random sampling from March to July 2013. The participants were instructed and asked to complete the NEO FIVE-factor Inventory, the attitude to substance abuse scale, and the demographic questionnaire. Then data were analyzed by stepwise multiple regression employing PASW 18. Results: Being male sex and neuroticism had a significant positive role in predicting positive attitude toward substance abuse in university students. In addition, agreeableness, conscientiousness, openness, and socio-economic status had a significant negative role in predicting tendency toward substance abuse (P < 0.001). Extraversion had no significant role in prediction of positive attitude to substance abuse (P > 0.05). Conclusions: Lower agreeableness, decreased conscientiousness, higher neuroticism, diminished openness, low socio-economic status, and male sex might make university students more inclined to substance abuse. Thus, it is reasonable to show the importance of these factors in tailored prevention programs. PMID:25593892

Disclosure of disease status among employed multiple sclerosis patients: association with negative work events and accommodations.

PubMed

Frndak, Seth E; Kordovski, Victoria M; Cookfair, Diane; Rodgers, Jonathan D; Weinstock-Guttman, Bianca; Benedict, Ralph H B

2015-02-01

Unemployment is common in multiple sclerosis (MS) and detrimental to quality of life. Studies suggest disclosure of diagnosis is an adaptive strategy for patients. However, the role of cognitive deficits and psychiatric symptoms in disclosure are not well studied. The goals of this paper were to (a) determine clinical factors most predictive of disclosure, and (b) measure the effects of disclosure on workplace problems and accommodations in employed patients. We studied two overlapping cohorts: a cross-sectional sample (n = 143) to determine outcomes associated with disclosure, and a longitudinal sample (n = 103) compared at four time points over one year on reported problems and accommodations. A case study of six patients, disclosing during monitoring, was also included. Disclosure was associated with greater physical disability but not cognitive impairment. Logistic regression predicting disclosure status retained physical disability, accommodations and years of employment (p < 0.0001). Disclosed patients reported more work problems and accommodations over time. The case study revealed that reasons for disclosing are multifaceted, including connection to employer, decreased mobility and problems at work. Although cognitive impairment is linked to unemployment, it does not appear to inform disclosure decisions. Early disclosure may help maintain employment if followed by appropriate accommodations. © The Author(s), 2014.

Attitude to substance abuse: do personality and socio-demographic factors matter?

PubMed

Rahimian Boogar, Isaac; Tabatabaee, Sayed Mosa; Tosi, Jalileh

2014-09-01

Substance abuse is a serious global problem that is affected by multiple psychosocial and socio-demographic factors. This study aimed to investigate the leading factors in positive attitude and tendency toward substance abuse in terms of personality, socio-economic, and socio-demographic factors. In a cross-sectional study, 200 college students (105 females and 95 males) residing in Damghan University dormitory in northeast of Iran were recruited by random sampling from March to July 2013. The participants were instructed and asked to complete the NEO FIVE-factor Inventory, the attitude to substance abuse scale, and the demographic questionnaire. Then data were analyzed by stepwise multiple regression employing PASW 18. Being male sex and neuroticism had a significant positive role in predicting positive attitude toward substance abuse in university students. In addition, agreeableness, conscientiousness, openness, and socio-economic status had a significant negative role in predicting tendency toward substance abuse (P < 0.001). Extraversion had no significant role in prediction of positive attitude to substance abuse (P > 0.05). Lower agreeableness, decreased conscientiousness, higher neuroticism, diminished openness, low socio-economic status, and male sex might make university students more inclined to substance abuse. Thus, it is reasonable to show the importance of these factors in tailored prevention programs.

Socio-Economic Status and Prevalence of Self-Reported Osteoporosis in Tehran: Results from a Large Population-Based Cross-Sectional Study (Urban HEART-2).

PubMed

Asadi-Lari, M; Salimi, Y; Vaez-Mahdavi, M R; Faghihzadeh, S; Haeri Mehrizi, A A; Jorjoran Shushtari, Z; Cheraghian, Bahman

2018-04-10

Osteoporosis is a widespread disease among older peoples. The aim of this study is to estimate the prevalence of self-reported osteoporosis and assessing its association with socio-economic status. A population-based cross-sectional study was conducted in Tehran, Iran in 2011. Participants were 45,990 individuals aged above 20 years from 22 urban districts. Osteoporosis was measured by self-administrative questionnaire. Wealth index was constructed using principal component analysis based on household assets. Chi-square test, chi square test for trend, and crude odds ratio were used to assess associations in univariate analysis. Multiple logistic regression utilized to estimate adjusted associations between self-reported osteoporosis and socio-economic status.The overall estimated prevalence of self-reported osteoporosis was 4% (95% CI 3.88-4.13), 1.19% in men, and 6.84% in women (P < 0.001). The prevalence increased considerably as age increased (P for trend < 0.001). In multivariable analysis, education and wealth status were negative, and smoking was positively associated with the prevalence of self-reported osteoporosis. No association was found between participants' skill levels and Townsend deprivation index with the prevalence of self-reported osteoporosis.The findings of the present study have improved understanding of the association between socioeconomic status and osteoporosis in the Iranian population. It is important to consider socioeconomic status in screening and prevention programs.

Decreased Glucose Metabolism in Medial Prefrontal Areas is Associated with Nutritional Status in Patients with Prodromal and Early Alzheimer's Disease.

PubMed

Sugimoto, Taiki; Nakamura, Akinori; Kato, Takashi; Iwata, Kaori; Saji, Naoki; Arahata, Yutaka; Hattori, Hideyuki; Bundo, Masahiko; Ito, Kengo; Niida, Shumpei; Sakurai, Takashi

2017-01-01

Weight loss is frequently observed in patients with Alzheimer's disease (AD); however, the underlying mechanisms are not well understood. To clarify the associations between nutritional status and AD-related brain changes using Pittsburgh Compound-B (PiB)-PET, fluorodeoxyglucose (FDG)-PET, and structural MRI. The subjects were 34 amyloid-β (Aβ)-positive individuals with mild cognitive impairment or early AD (prodromal/early AD), and 55 Aβ-negative cognitively normal (CN) subjects who attended the Multimodal Neuroimaging for AD Diagnosis (MULNIAD) study. Nutritional status of the subjects was assessed by body mass index and waist to height ratio (waist circumference/height). The associations between nutritional status and brain changes were examined by multiple regression analysis using statistical parametric mapping. In the prodromal/early AD group, nutritional status was significantly positively correlated with regional cerebral glucose metabolism (rCGM) in the medial prefrontal cortices, while different topographical associations were seen in the CN group, suggesting these changes were AD-specific. Aβ deposition and gray matter volume were not significantly associated with nutritional status. Sub-analysis in the prodromal/early AD group demonstrated that fat mass index, but not fat-free mass index, was positively correlated with rCGM in the medial prefrontal areas. This present study provides preliminary results suggesting that hypometabolism in the medial prefrontal areas is specifically associated with AD-related weight loss, and decrease in fat mass may have a key role.

Helicobacter pylori infection in peptic ulcer disease: the importance of smoking and ethnicity.

PubMed

Pillay, K V K; Htun, M; Naing, N N; Norsa'adah, B

2007-11-01

This study was conducted to determine the prevalence of Helicobacter pylori (H. pylori) and its associated factors among patients with peptic ulcer disease in Taiping Hospital. Consecutive peptic ulcer disease patients who had undergone esophagogastro-duodenoscopy were included. The H. pylori status was assessed by the rapid urease test. We excluded those who had active bleeding, a perforated peptic ulcer, severe vomiting, a history of gastric surgery, peptic ulcer disease or renal or liver diseases, carcinoma of the stomach, and recent use of antibiotics or proton pump inhibitors. Socio-demography, H. pylori status, medication history and other relevant clinical data were collected from case notes. A total of 416 subjects were selected, 49.7% were positive and 50.3% were negative for H. pylori infection. There were significant associations between H. pylori and age, ethnicity, smoking status and NSAID usage. However, there were no significant relationships between H. pylori status and gender or type of peptic ulcer. Multiple logistic regression showed that other ethnicities than Malays and smokers had a higher risk of H. pylori. Our prevalence rate was low and the identified risk factors were consistent with previous studies. Ethnic differences may be related to genetic and sociocultural behaviors. Quitting smoking may benefit peptic ulcer patients with H. pylori infection.

Behavioral lifestyle and mental health status of Japanese factory workers.

PubMed

Ezoe, S; Morimoto, K

1994-01-01

Lifestyle factors, sometimes associated with physical health and mortality, have also been known to be associated with mental health status. This study seeks to correlate behavioral lifestyles with major components of mental health among Japanese factory workers. We administered the 28-item version of the General Health Questionnaire (GHQ-28) and a questionnaire concerning eight personal health practices to 2,132 male and 668 female factory workers at a camera-manufacturing company in Japan. There were strong negative relationships of a higher total number of favorable lifestyles as indicated by the Health Practice Index (HPI) to psychological distress and its components: somatic symptoms, anxiety-insomnia, and social dysfunction. After controlling for the effects of confounding factors that included age, marital status, and somatic condition, multiple logistic regression analysis indicated that five of the eight health factors among male workers--mental stress, nutritional balance, eating breakfast regularly, physical exercise, and working hours--were significantly related to the grade of psychological distress or its three components. Among female workers, five health practices, i.e., mental stress, physical exercise, sleeping hours, working hours, and cigarette smoking, were significantly associated with the grade of psychological distress or its three components. Good health practices might be individually and as a whole associated with better mental health status in factory workers.

Food security and nutritional outcomes among urban poor orphans in Nairobi, Kenya.

PubMed

Kimani-Murage, Elizabeth W; Holding, Penny A; Fotso, Jean-Christophe; Ezeh, Alex C; Madise, Nyovani J; Kahurani, Elizabeth N; Zulu, Eliya M

2011-06-01

The study examines the relationship between orphanhood status and nutritional status and food security among children living in the rapidly growing and uniquely vulnerable slum settlements in Nairobi, Kenya. The study was conducted between January and June 2007 among children aged 6-14 years, living in informal settlements of Nairobi, Kenya. Anthropometric measurements were taken using standard procedures and z scores generated using the NCHS/WHO reference. Data on food security were collected through separate interviews with children and their caregivers, and used to generate a composite food security score. Multiple regression analysis was done to determine factors related to vulnerability with regards to food security and nutritional outcomes. The results show that orphans were more vulnerable to food insecurity than non-orphans and that paternal orphans were the most vulnerable orphan group. However, these effects were not significant for nutritional status, which measures long-term food deficiencies. The results also show that the most vulnerable children are boys, those living in households with lowest socioeconomic status, with many dependants, and female-headed and headed by adults with low human capital (low education). This study provides useful insights to inform policies and practice to identify target groups and intervention programs to improve the welfare of orphans and vulnerable children living in urban poor communities.

Perceived timeliness of referral to hospice palliative care among bereaved family members in Korea.

PubMed

Jho, Hyun Jung; Chang, Yoon Jung; Song, Hye Young; Choi, Jin Young; Kim, Yeol; Park, Eun Jung; Paek, Soo Jin; Choi, Hee Jae

2015-09-01

We aimed to explore the perceived timeliness of referral to hospice palliative care unit (HPCU) among bereaved family members in Korea and factors associated therewith. Cross-sectional questionnaire survey was performed for bereaved family members of patients who utilized 40 designated HPCUs across Korea. The questionnaire assessed whether admission to the HPCU was "too late" or "appropriate" and the Good Death Inventory (GDI). A total of 383 questionnaires were analyzed. Of participants, 25.8 % replied that admission to HPCU was too late. Patients with hepatobiliary cancer, poor performance status, abnormal consciousness level, and unawareness of terminal status were significantly related with the too late perception. Family members with younger age and being a child of the patient were more frequently noted in the too late group. Ten out of 18 GDI scores were significantly lower in the too late group. Multiple logistic regression analysis revealed patients' unawareness of terminal status, shorter stay in the HPCU, younger age of bereaved family, and lower scores for two GDI items (staying in a favored place, living without concerning death or disease) were significantly associated with the too late group. To promote timely HPCU utilization and better quality of end of life care, patients need to be informed of the terminal status and their preference should be respected.

The Association of Free Testosterone Levels in Men and Lifestyle Factors and Chronic Disease Status: A North Texas Healthy Heart Study.

PubMed

Cardarelli, Roberto; Singh, Meharvan; Meyer, Jason; Balyakina, Elizabeth; Perez, Oscar; King, Michael

2014-07-01

Hypogonadism is highly prevalent in men older than 45 years and is associated with an increased risk of chronic diseases, including obesity, metabolic syndrome, diabetes, and cardiovascular disease. The objective of this study was to determine whether lifestyle factors such as smoking, diet, and exercise are associated with reduced testosterone levels. In this cross-sectional study, 147 men older than 44 years were recruited from a collaborative network of primary care clinics in the Dallas/Fort Worth, Texas, metropolitan area. Free testosterone levels were measured in plasma samples via an enzyme-linked immunosorbent assay-based method, and analyzed by simple and multiple linear regression in relationship to age, race/ethnicity, smoking, diet, exercise, obesity, diabetes, hypertension, and dyslipidemia. The participants had a mean free testosterone level of 3.1 ng/mL (standard deviation [SD] = 1.5) and mean age of 56.8 years (SD = 7.9). In simple regression analysis, free testosterone levels were associated with increased age (β = -0.04; P = .02), diet (β = -0.49; P = .05), diabetes (β = -0.9; P = .003), and hypertension (β = -0.55; P = .03) but not with race/ethnicity, smoking, exercise, obesity, or dyslipidemia. In multiple regression analysis, free testosterone values were significantly associated only with age (β = -0.05; P = .01) and diet (β = -0.72; P = .01). This study implicates diet, in addition to advanced age as a possible risk factor in the development of reduced testosterone levels. © The Author(s) 2014.

Advanced statistics: linear regression, part II: multiple linear regression.

PubMed

Marill, Keith A

2004-01-01

The applications of simple linear regression in medical research are limited, because in most situations, there are multiple relevant predictor variables. Univariate statistical techniques such as simple linear regression use a single predictor variable, and they often may be mathematically correct but clinically misleading. Multiple linear regression is a mathematical technique used to model the relationship between multiple independent predictor variables and a single dependent outcome variable. It is used in medical research to model observational data, as well as in diagnostic and therapeutic studies in which the outcome is dependent on more than one factor. Although the technique generally is limited to data that can be expressed with a linear function, it benefits from a well-developed mathematical framework that yields unique solutions and exact confidence intervals for regression coefficients. Building on Part I of this series, this article acquaints the reader with some of the important concepts in multiple regression analysis. These include multicollinearity, interaction effects, and an expansion of the discussion of inference testing, leverage, and variable transformations to multivariate models. Examples from the first article in this series are expanded on using a primarily graphic, rather than mathematical, approach. The importance of the relationships among the predictor variables and the dependence of the multivariate model coefficients on the choice of these variables are stressed. Finally, concepts in regression model building are discussed.

Maternal iron status during pregnancy compared with neonatal iron status better predicts placental iron transporter expression in humans

PubMed Central

Best, Cora M.; Pressman, Eva K.; Cao, Chang; Cooper, Elizabeth; Guillet, Ronnie; Yost, Olivia L.; Galati, Jonathan; Kent, Tera R.; O’Brien, Kimberly O.

2016-01-01

The placenta richly expresses nonheme and heme Fe transport proteins. To address the impact of maternal and neonatal Fe status and hepcidin on the regulation of these proteins, mRNA expression and protein abundance of nonheme and heme Fe transport proteins were evaluated in placental tissue from 154 adolescents. Regression analyses found maternal Fe status was significantly associated with multiple placental nonheme and heme transporters, whereas neonatal Fe status was related to only 3 heme transporters. Across statistical analyses, maternal Fe status was consistently associated with the placental nonheme Fe importer transferrin receptor 1 (TfR1). Protein abundance of TfR1 was related to midgestation maternal serum ferritin (SF) (β = −0.32; P = 0.005) and serum TfR (β = 0.25; P = 0.024). Protein abundance of the heme importer, proton-coupled folate transporter, was related to neonatal SF (β = 0.30; P = 0.016) and serum TfR (β = −0.46; P < 0.0001). Neonatal SF was also related to mRNA expression of the heme exporter feline leukemia virus subgroup C receptor 1 (β = −0.30; P = 0.004). In summary, maternal Fe insufficiency during pregnancy predicts increased expression of the placental nonheme Fe transporter TfR1. Associations between placental heme Fe transporters and neonatal Fe status require further study.—Best, C. M., Pressman, E. K., Cao, C., Cooper, E., Guillet, R., Yost, O. L., Galati, J., Kent, T. R., O’Brien, K. O. Maternal iron status during pregnancy compared with neonatal iron status better predicts placental iron transporter expression in humans. PMID:27402672

Bullied Status and Physical Activity in Texas Adolescents.

PubMed

Case, Kathleen R; Pérez, Adriana; Saxton, Debra L; Hoelscher, Deanna M; Springer, Andrew E

2016-06-01

This study examined the association between having been bullied at school during the past 6 months ("bullied status") and not meeting physical activity (PA) recommendations of 60 minutes of daily PA during the past week among 8th- and 11th-grade Texas adolescents. Multiple logistic regression analysis was conducted to examine this association, adjusted for weight status, grade, race/ethnicity, and stratified by gender; furthermore, a significant interaction was found between bullied status and weight status. Results are presented by interaction status. Results indicated that overweight girls who reported never being bullied, as well as those who reported being bullied more than twice, had higher odds of not meeting PA recommendations than normal weight girls who were never bullied (adjusted odds ratio [AOR] = 2.12, 95% confidence interval [CI: 1.12, 3.99]; AOR = 9.18, 95% CI [2.26, 37.27], respectively). Obese girls who were bullied once or twice had higher odds of not meeting PA recommendations than normal weight girls who were never bullied (AOR = 2.89, 95% CI [1.06, 7.89]). Overweight boys who reported never being bullied had lower odds of not meeting PA recommendations than normal weight boys who were never bullied (AOR = 0.62, 95% CI [0.39, 0.97]). Conversely, obese boys who were bullied once or twice reported higher odds of not meeting PA recommendations than normal weight boys who were never bullied (AOR = 3.61, 95% CI [1.22, 10.67]). Findings from this study indicate that the association between bullied status and meeting PA recommendations is complex and may differ by gender and the interaction between bullied status and weight status. © 2015 Society for Public Health Education.

Factors associated with motor performance among overweight and nonoverweight Tyrolean primary school children.

PubMed

Ruedl, Gerhard; Greier, Klaus; Kirschner, Werner; Kopp, Martin

2016-01-01

The increasing prevalence of overweight and obesity among children is often associated with motor deficits. Motor performance among children partly depends on modifiable factors, for example, weight status, electronic media use, sports club participation, and on nonmodifiable factors, for example, sex, age, migration background, or socio-economic status. To evaluate factors associated with motor performance among overweight and nonoverweight Tyrolean primary school children. Height, weight, and sport motor performance of primary school children were measured using the German motor performance test DMT 6-18. In addition, children were asked about migration background, sports club participation, and electronic media use in their room. A total of 304 children (48.7% girls) with a mean age of 8.0 ± 1.2 years were tested. In total, 61 (20.1%) children were overweight or obese. Regarding motor performance, nonoverweight children showed significantly higher total z-scores (106.8 ± 5.7 vs. 102.4 ± 6.8). For the total cohort, results of the multiple linear regression analysis (R (2) = 0.20) revealed that factors male sex (β = 0.12), nonoverweight children (β = 0.28), higher school grade (β = 0.23), sports club participation (β = 0.18),and > 2 weekly lessons of physical education (β = 0.26) were associated with an increased motor performance. For nonoverweight children results of the multiple linear regression analysis (R (2) = 0.09) found that a higher school grade (β = 0.17), sports club participation (β = 0.16),and more than 2 weekly lessons of physical education (β = 0.22) were associated with an increased motor performance. For the overweight children, results of the multiple linear regression analysis (R (2) = 0 .43) showed that no migration background (β = 0.23), a higher school grade (β = 0.55), sports club participation (β = 0.33) and more than 2 weekly lessons of physical education (β = 0.48) were associated with an increased motor performance. Regarding modifiable factors, motor performance among overweight and nonoverweight children is strongly associated with a higher number of weekly lessons in physical education. Therefore, daily lessons in physical education are strongly recommended to improve motor performance especially among overweight primary school children.

Health-Related Quality of Life, Functional Status, and Cardiac Event-Free Survival in Patients With Heart Failure.

PubMed

Wu, Jia-Rong; Lennie, Terry A; Frazier, Susan K; Moser, Debra K

2016-01-01

Health-related quality of life (HRQOL), functional status, and cardiac event-free survival are outcomes used to assess the effectiveness of interventions in patients with heart failure (HF). However, the nature of the relationships among HRQOL, functional status, and cardiac event-free survival remains unclear. The purpose of this study is to examine the nature of the relationships among HRQOL, functional status, and cardiac event-free survival in patients with HF. This was a prospective, observational study of 313 patients with HF that was a secondary analysis from a registry. At baseline, patient demographic and clinical data were collected. Health-related quality of life was assessed using the Minnesota Living With Heart Failure Questionnaire and functional status was measured using the Duke Activity Status Index. Cardiac event-free survival data were obtained by patient interview, hospital database, and death certificate review. Multiple linear and Cox regressions were used to explore the relationships among HRQOL, functional status, and cardiac event-free survival while adjusting for demographic and clinical factors. Participants (n = 313) were men (69%), white (79%), and aged 62 ± 11 years. Mean left ventricular ejection fraction was 35% ± 14%. The mean HRQOL score of 32.3 ± 20.6 indicated poor HRQOL. The mean Duke Activity Status Index score of 16.2 ± 12.9 indicated poor functional status. Cardiac event-free survival was significantly worse in patients who had worse HRQOL or poorer functional status. Patients who had better functional status had better HRQOL (P < .001). Health-related quality of life was not a significant predictor of cardiac event-free survival after entering functional status in the model (P = .54), demonstrating that it was a mediator of the relationship between HRQOL and outcome. Functional status was a mediator between HRQOL and cardiac event-free survival. These data suggest that intervention studies to improve functional status are needed.

Modeling Polytomous Item Responses Using Simultaneously Estimated Multinomial Logistic Regression Models

ERIC Educational Resources Information Center

Anderson, Carolyn J.; Verkuilen, Jay; Peyton, Buddy L.

2010-01-01

Survey items with multiple response categories and multiple-choice test questions are ubiquitous in psychological and educational research. We illustrate the use of log-multiplicative association (LMA) models that are extensions of the well-known multinomial logistic regression model for multiple dependent outcome variables to reanalyze a set of…

[Effects of nutritional status on the multiple sclerosis disease: systematic review].

PubMed

Ródenas Esteve, Irene; Wanden-Berghe, Carmina; Sanz-Valero, Javier

2018-01-19

To review the available scientific literature about the effects of nutritional status on the multiple sclerosis disease. A systematic review of the scientific literature in the Medline (PubMed), Scopus, Cochrane Library and Web of Science databases through November 2016. Search equation: ("Multiple Sclerosis"[Mesh] OR "Multiple Sclerosis"[Title/Abstract] OR "Disseminated Sclerosis"[Title/Abstract] OR "Multiple Sclerosis Acute Fulminating"[Title/Abstract]) AND ("Nutritional Status"[Mesh] OR "Nutritional Status"[Title/Abstract] OR "Nutrition Status"[Title/Abstract]). The quality of the selected articles was discussed using the STROBE questionnaire. The search was completed through experts inquiry and additional review of the bibliographic references included in the selected papers. The concordance between authors (Kappa index) had to be higher than 80% for inclusion in this review. Of the 160 references recovered, after applying inclusion and exclusion criteria, 29 articles were selected for review. Concordance between evaluators was 100.00%. The most studies established vitamin D levels. Others focused their research on finding out which nutrient deficits might be related to the multiple sclerosis development. Vitamin D may influence multiple sclerosis improvement. Sunlight and physical activity would be important factors, with nutritional status, in the course of this disease. It is necessary to produce new specific works that will delve into the subject to find out more about the relationship between nutritional status and multiple sclerosis.

Outcomes of reirradiation in the treatment of patients with multiple brain metastases of solid tumors: a retrospective analysis

PubMed Central

Koc, Mehmet; Kanyilmaz, Gul; Tezcan, Yilmaz

2015-01-01

Background Patients with multiple brain metastases are often treated with whole brain radiation therapy (WBRT). Second course of WBRT is an important treatment option for patients with clinical or radiological intracranial disease progression. This study examines the outcomes in patients with multiple brain metastases who underwent reirradiation. Methods We examined the medical records of 34 patients with multiple brain metastases who were treated WBRT. The median dose for the first course of WBRT was 30 Gy (range, 25–30 Gy) and for the second course 25 Gy (range, 20–30 Gy). Statistical analyses were performed with using Cox regression analyses, log-rank test and Kaplan-Meier method. Results The median Karnofsky performance status (KPS) was 80 (range, 50–100) before reirradiation. Patients with KPS of >70 had a median survival of 11.4 months, compared to 2.2 months with KPS of ≤70 (P=0.012) and patients who have severe symptoms at the time of reirradiation with median survival 2.2 months while those with mild symptoms had a median of 4.8 months survival (P=0.08). The median overall survival for all patients after diagnosis of metastases was 24.7 months, after the re-irradiation WBRT (re-WBRT) it was 5.3 months (95% CI, 4.08–6.62) and from the diagnosis of primary tumor was 27.1 months (95% CI, 17.75–37.04). Conclusions In select patients who have good performance status and who do not have severe symptoms might benefit from re-WBRT and re-WBRT seems to be associated with minimal toxicity in patients treated with lower palliation doses. PMID:26734635

Outcomes of reirradiation in the treatment of patients with multiple brain metastases of solid tumors: a retrospective analysis.

PubMed

Aktan, Meryem; Koc, Mehmet; Kanyilmaz, Gul; Tezcan, Yilmaz

2015-12-01

Patients with multiple brain metastases are often treated with whole brain radiation therapy (WBRT). Second course of WBRT is an important treatment option for patients with clinical or radiological intracranial disease progression. This study examines the outcomes in patients with multiple brain metastases who underwent reirradiation. We examined the medical records of 34 patients with multiple brain metastases who were treated WBRT. The median dose for the first course of WBRT was 30 Gy (range, 25-30 Gy) and for the second course 25 Gy (range, 20-30 Gy). Statistical analyses were performed with using Cox regression analyses, log-rank test and Kaplan-Meier method. The median Karnofsky performance status (KPS) was 80 (range, 50-100) before reirradiation. Patients with KPS of >70 had a median survival of 11.4 months, compared to 2.2 months with KPS of ≤70 (P=0.012) and patients who have severe symptoms at the time of reirradiation with median survival 2.2 months while those with mild symptoms had a median of 4.8 months survival (P=0.08). The median overall survival for all patients after diagnosis of metastases was 24.7 months, after the re-irradiation WBRT (re-WBRT) it was 5.3 months (95% CI, 4.08-6.62) and from the diagnosis of primary tumor was 27.1 months (95% CI, 17.75-37.04). In select patients who have good performance status and who do not have severe symptoms might benefit from re-WBRT and re-WBRT seems to be associated with minimal toxicity in patients treated with lower palliation doses.

Plurality of Birth and Infant Mortality Due to External Causes in the United States, 2000-2010.

PubMed

Ahrens, Katherine A; Thoma, Marie E; Rossen, Lauren M; Warner, Margaret; Simon, Alan E

2017-03-01

Risk of death during the first year of life due to external causes, such as unintentional injury and homicide, may be higher among twins and higher-order multiples than among singletons in the United States. We used national birth cohort linked birth-infant death data (2000-2010) to evaluate the risk of infant mortality due to external causes in multiples versus singletons in the United States. Risk of death from external causes during the study period was 3.6 per 10,000 live births in singletons and 5.1 per 10,000 live births in multiples. Using log-binomial regression, the corresponding unadjusted risk ratio was 1.40 (95% confidence interval (CI): 1.30, 1.50). After adjustment for maternal age, marital status, race/ethnicity, and education, the risk ratio was 1.68 (95% CI: 1.56, 1.81). Infant deaths due to external causes were most likely to occur between 2 and 7 months of age. Applying inverse probability weighting and assuming a hypothetical intervention where no infants were low birth weight, the adjusted controlled direct effect of plurality on infant mortality due to external causes was 1.64 (95% CI: 1.39, 1.97). Twins and higher-order multiples were at greater risk of infant mortality due to external causes, particularly between 2 and 7 months of age, and this risk appeared to be mediated largely by factors other than low-birth-weight status. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Assessing interactions between HLA-DRB1*15 and infectious mononucleosis on the risk of multiple sclerosis.

PubMed

Disanto, Giulio; Hall, Carolina; Lucas, Robyn; Ponsonby, Anne-Louise; Berlanga-Taylor, Antonio J; Giovannoni, Gavin; Ramagopalan, Sreeram V

2013-09-01

Gene-environment interactions may shed light on the mechanisms underlying multiple sclerosis (MS). We pooled data from two case-control studies on incident demyelination and used different methods to assess interaction between HLA-DRB1*15 (DRB1-15) and history of infectious mononucleosis (IM). Individuals exposed to both factors were at substantially increased risk of disease (OR=7.32, 95% CI=4.92-10.90). In logistic regression models, DRB1-15 and IM status were independent predictors of disease while their interaction term was not (DRB1-15*IM: OR=1.35, 95% CI=0.79-2.23). However, interaction on an additive scale was evident (Synergy index=2.09, 95% CI=1.59-2.59; excess risk due to interaction=3.30, 95%CI=0.47-6.12; attributable proportion due to interaction=45%, 95% CI=22-68%). This suggests, if the additive model is appropriate, the DRB1-15 and IM may be involved in the same causal process leading to MS and highlights the benefit of reporting gene-environment interactions on both a multiplicative and additive scale.

The impact of self-transcendence on physical health status promotion in multiple sclerosis patients attending peer support groups.

PubMed

JadidMilani, Maryam; Ashktorab, Tahereh; AbedSaeedi, Zhila; AlaviMajd, Hamid

2015-12-01

This study aimed to investigate the effect of self-transcendence on the physical health of multiple sclerosis (MS) patients attending peer support groups. This study was a quasi-experimental before-and-after design including 33 MS patients in three groups: 10 men in the men-only group, 11 women in the women-only group, and 12 men and women in the mixed group. Participants were required to attend eight weekly sessions of 2 h each. Instruments included the physical health section of the Multiple Sclerosis Quality of Life Inventory and Reed's Self-Transcendence Scale. Peer support group attendance was found to have a significant positive effect on the physical health and self-transcendence of MS patients when comparing average scores before and after attendance. Regression analysis showed that improvement in self-transcendence predicted improvement in physical health. Results show the positive effects of peer support groups on self-transcendence and physical health in MS patients, and suggest that improvement in well-being can be gained by promoting self-transcendence and physical health. © 2015 Wiley Publishing Asia Pty Ltd.

Associated factors of radiation pneumonitis induced by precise radiotherapy in 186 elderly patients with esophageal cancer.

PubMed

Cui, Zhen; Tian, Ye; He, Bin; Li, Hongwei; Li, Duojie; Liu, Jingjing; Cai, Hanfei; Lou, Jianjun; Jiang, Hao; Shen, Xueming; Peng, Kaigui

2015-01-01

Radiation pneumonitis is one of the most severe complications of esophageal cancer. To explore the factors correlated to radiation pneumonitis induced by precise radiotherapy for elderly patients with esophageal cancer. The retrospective analysis was used to collect clinical data from 186 elderly patients with esophageal cancer. The incidence of radiation pneumonitis was observed, followed by statistical analysis through ANVON or multiple regression analysis. 27 in 186 cases of esophageal cancer suffered from radiation pneumonitis, with incidence of 14.52%. The single factor analysis showed that, Karnofsky performance status (KPS) score, chronic obstructive pulmonary disease, concurrent chemoradiotherapy, gross tumor volume (GTV) dose, lung V20, mean lung dose (MLD) and planning target volume (PTV) were associated with radiation pneumonitis. The logistic regression analysis indicated that, concurrent chemoradiotherapy, GTV dose, lung V20 and PTV were the independent factors of radiation pneumonitis. The concurrent chemoradiotherapy, GTV dose, lung V20, MLD and PTV are the major risk factors of radiation pneumonitis for elderly patients with esophageal cancer.

Malnutrition risk and its association with appetite, functional and psychosocial status among elderly Malays in an agricultural settlement.

PubMed

Suzana, S; Boon, P C; Chan, P P; Normah, C D

2013-04-01

Malnutrition is a common phenomenon among the elderly and quite often related to psychosocial problems. The objective of this study was to determine malnutrition risk and its association with appetite, functional and psychosocial status among elderly Malays in an agricultural settlement, i.e. FELDA Sungai Tengi, Selangor. A cross-sectional study was conducted among 160 subjects (men = 36.2%), with a mean age of 65.0 +/- 3.9 years, who were interviewed to obtain information on malnutrition risk and appetite using Mini Nutritional Assessment Short Form and Simplified Nutritional Appetite Questionnaire, respectively. Functional status was determined using Instrumental Activities of Daily Living (IADL), Elderly Mobility Scale (EMS) and handgrip strength. Mini Mental Status Examination (MMSE), Geriatric Depression Scale and De Jong Gierveld Loneliness Scale were used to identify cognitive impairment, depressive symptoms and loneliness status of subjects respectively. A total of 42.5% of subjects were at risk of malnutrition and 61.2% had poor appetite. The mean scores of IADL and EMS were lower in subjects at risk of malnutrition, compared to those who were not at high risk (p < 0.05 for both parameters). Multiple linear regression showed that 19.8% of malnutrition risk was predicted by poor appetite, decreased functional status (IADL) and depression. Malnutrition risk was prevalent and associated with poor appetite, functional status and psychosocial problems among the elderly subjects. The psychosocial aspect should also be incorporated in nutrition intervention programmes in order to improve mental well-being and functional independancy.

Uveal Melanoma Regression after Brachytherapy: Relationship with Chromosome 3 Monosomy Status.

PubMed

Salvi, Sachin M; Aziz, Hassan A; Dar, Suhail; Singh, Nakul; Hayden-Loreck, Brandy; Singh, Arun D

2017-07-01

The objective was to evaluate the relationship between the regression rate of ciliary body melanoma and choroidal melanoma after brachytherapy and chromosome 3 monosomy status. We conducted a prospective and consecutive case series of patients who underwent biopsy and brachytherapy for ciliary/choroidal melanoma. Tumor biopsy performed at the time of radiation plaque placement was analyzed with fluorescence in situ hybridization to determine the percentage of tumor cells with chromosome 3 monosomy. The regression rate was calculated as the percent change in tumor height at months 3, 6, and 12. The relationship between regression rate and tumor location, initial tumor height, and chromosome 3 monosomy (percentage) was assessed by univariate linear regression (R version 3.1.0). Of the 75 patients included in the study, 8 had ciliary body melanoma, and 67 were choroidal melanomas. The mean tumor height at the time of diagnosis was 5.2 mm (range: 1.90-13.00). The percentage composition of chromosome 3 monosomy ranged from 0-20% (n = 35) to 81-100% (n = 40). The regression of tumor height at months 3, 6, and 12 did not statistically correlate with tumor location (ciliary or choroidal), initial tumor height, or chromosome 3 monosomy (percentage). The regression rate of choroidal melanoma following brachytherapy did not correlate with chromosome 3 monosomy status.

Isolating and Examining Sources of Suppression and Multicollinearity in Multiple Linear Regression

ERIC Educational Resources Information Center

Beckstead, Jason W.

2012-01-01

The presence of suppression (and multicollinearity) in multiple regression analysis complicates interpretation of predictor-criterion relationships. The mathematical conditions that produce suppression in regression analysis have received considerable attention in the methodological literature but until now nothing in the way of an analytic…

General Nature of Multicollinearity in Multiple Regression Analysis.

ERIC Educational Resources Information Center

Liu, Richard

1981-01-01

Discusses multiple regression, a very popular statistical technique in the field of education. One of the basic assumptions in regression analysis requires that independent variables in the equation should not be highly correlated. The problem of multicollinearity and some of the solutions to it are discussed. (Author)

Factors contributing to tooth loss among the elderly: A cross sectional study.

PubMed

Natto, Zuhair S; Aladmawy, Majdi; Alasqah, Mohammed; Papas, Athena

2014-12-01

The present study evaluates the influence of several demographic, health, personal, and clinical factors on the number of missing teeth in old age sample. The number of patients included was 259; they received a full mouth examination and answered a questionnaire provided by one examiner. All the variables related to teeth loss based on the literature were included. These variables focused on age, gender, race, marital status, clinical attachment level, pocket depth, year of smoking, number of cigarettes smoked per day, number of medications, root decay, coronal decay, health status, and year of education. Statistical analysis involved stepwise multivariate linear regression. Teeth loss was statistically associated with clinical attachment level (CAL)(p value 0.0001), pocket depth (PD) (0.0007) and education level (0.0048). When smoking was included in the model, age was significantly associated with teeth loss (0.0037). At least one of these four factors was also related to teeth loss in several specific groups such as diabetes mellitus, male, and White. The multiple linear regressions for all the proposed variables showed that they contributed to teeth loss by about 23%. It can be concluded that less education or increased clinical attachment level loss may increase number of missing teeth. Additionally, age may cause teeth loss in the presence of smoking. Copyright © 2014. Published by Elsevier B.V.

A cross-sectional evaluation of the prevalence and associations of HIV among female sex workers in the Gambia.

PubMed

Peitzmeier, Sarah; Mason, Krystal; Ceesay, Nuha; Diouf, Daouda; Drame, Fatou; Loum, Jaegan; Baral, Stefan

2014-03-01

To determine HIV prevalence among female sex workers in the Gambia and HIV risk factors, we accrued participants (n = 251) through peer-referral and venue-based recruitment. Blood samples were screened for HIV and participants were administered a questionnaire. Bivariate and multivariate logistic regression identified factors associated with HIV status. Forty respondents (15.9%) were HIV-positive: 20 (8.0%) were infected with HIV-1 only, 10 (4.0%) with HIV-2 only, and 10 (4.0%) with both HIV-1 and HIV-2; 12.5% (n = 5/40) knew their status. Condom usage at last sex was 97.1% (n = 170/175) with new clients and 44.2% (n = 53/120) with non-paying partners. Having a non-paying partner, living with relatives or friends, having felt scared to walk in public, selling sex in multiple locations, and recent depressive symptoms were positively associated with HIV under multivariate regression. Female sex workers have a higher prevalence of HIV compared to the general Gambian population. Interventions should be rights-based, promote safer sex practices and regular testing for female sex workers and linkage to HIV treatment and care with adherence support for those living with HIV. In addition, service providers should consider non-paying partners of female sex workers, improve knowledge and availability of condoms and lubricant, and address safety and mental health needs.

Resource utilization in home health care: results of a prospective study.

PubMed

Trisolini, M G; Thomas, C P; Cashman, S B; Payne, S M

1994-01-01

Resource utilization in home health care has become an issue of concern due to rising costs and recent initiatives to develop prospective payment systems for home health care. A number of issues remain unresolved for the development of prospective reimbursement in this sector, including the types of variables to be included as payment variables and appropriate measures of resource use. This study supplements previous work on home health case-mix by analyzing the factors affecting one aspect of resource use for skilled nursing visits--visit length--and explores the usefulness of several specially collected variables which are not routinely available in administrative records. A data collection instrument was developed with a focus group of skilled nurses, identifying a range of variables hypothesized to affect visit length. Five categories of variables were studied using multiple regression analysis: provider-related; patient's socio-economic status; patient's clinical status; patient's support services; and visit-specific. The final regression model identifies 9 variables which significantly affect visit time. Five of the 9 are visit-specific variables, a significant finding since these are not routinely collected. Case-mix systems which include visit time as a measure of resource use will need to investigate visit-specific variables, as this study indicates they could have the largest influence on visit time. Two other types of resources used in home health care, supplies and security drivers, were also investigated in less detail.

Internal Structure of Kidney Calculi as a Predictor for Shockwave Lithotripsy Success.

PubMed

Christiansen, Frederikke Eichner; Andreassen, Kim Hovgaard; Osther, Susanne Sloth; Osther, Palle Joern Sloth

2016-03-01

The internal structure of renal calculi can be determined on CT using bone windows and may be classified as homogeneous or inhomogeneous with void regions. In vitro studies have shown homogeneous stones to be less responsive to extracorporeal shockwave lithotripsy (SWL). The objective was to evaluate whether the internal morphology of calculi defined by CT bone window influences SWL outcome in vivo. One hundred eleven patients with solitary renal calculi treated with SWL were included. Treatment data were registered prospectively and follow-up data were collected retrospectively. All patients had noncontrast computed tomography (NCCT) performed before SWL and at 3-month follow-up. The stones were categorized as homogeneous or inhomogeneous. At follow-up, the patient's stone status was registered. Stone-free status was defined as no evidence of calculi on NCCT. Treatment was considered successful if the patient was either stone free or had clinically insignificant residual fragments. Using simple logistic regression, the odds for being stone free 3 months post-SWL were significantly reduced in the patients with inhomogeneous stones compared with patients with homogeneous stones (odds ratio 0.43 [95% confidence interval 0.20, 0.92; p < 0.05]). However, when adjusting for stone size by multiple logistic regression, including stone size (area) as a covariate, this difference became insignificant. The internal structure of kidney stones did not predict the outcome of SWL in vivo.

Factors influencing the hospitalization costs of patients with type 2 diabetes.

PubMed

Cao, Ping; Wang, Kaixiu; Zhang, Hua; Zhao, Rongzhi; Li, Chenglong

2015-03-01

This study aims to research the factors influencing the hospitalization costs of patients with type 2 diabetes, so as to provide some references for reducing their economic burden. Based on the Hospital Information System of a 3A grade hospital in China, we analyzed 2970 cases with type 2 diabetes during 2005-2012. Both the number of inpatients and the hospitalization costs had increased in the study period. Using multiple linear regression analysis, we found that patients in Urban Employee Basic Medical Insurance had higher costs than those in New Rural Cooperative Medical Scheme. We also found hospitalization costs to be higher in male patients and older patients, patients who stayed more days at hospital and who had surgeries, patients who had at least 1 complication, and patients whose admission status was emergency. After standardizing the regression coefficients, we found that the hospital stay, the forms of payment, and presence of complications were the first 3 factors influencing hospitalization costs in our study. In conclusion, the hospitalization costs of patients with type 2 diabetes could be influenced by age, gender, forms of payment, hospital stay, admission status, complications, and surgery. Medical workers in the studied region should take actions to reduce the duration of hospital stay for diabetic patients and prevent relevant complications. What is more, medical insurance needs further improvement. © 2015 APJPH.

Determinants of postnatal care utilization in urban community among women in Debre Birhan Town, Northern Shewa, Ethiopia.

PubMed

Angore, Banchalem Nega; Tufa, Efrata Girma; Bisetegen, Fithamlak Solomon

2018-04-19

Reducing maternal mortality and improving maternal health care through increased utilization of postnatal care utilization is a global and local priority. However studies that have been carried out in Ethiopia regarding determinants are limited. So This study aims to assess the magnitude of postnatal care utilization and its determinants in Debre Birhan Town, North Ethiopia. A community-based cross-sectional study was conducted from March 1 to April 25, 2015, in Debre Birhan Town. Data were collected through face-to-face interviews using structured pre-tested questionnaires. The data were entered and cleaned in Epi Info version 3.5 and analyzed using SPSS version 20. Bivariate and multiple logistic regression analyses were used. Variable with p value less than or equal to 0.2 at bivariate analysis were entered into multiple logistic regression. Significance was declared at 0.05 in multiple logistic regressions and considered to be an independent factor. From the total respondents, we found that 327 (83.3%) mothers utilized the postnatal care services. Single mothers were less likely to utilize postnatal care services than those mothers who are married and live together [adjusted odds ratio (AOR) = 0.06, 95% CI (0.01, 0.45)]. This study revealed that respondent's knowledge about postnatal care services is an important predictor of postnatal care utilization [AOR = 0.03, 95% CI (0.00, 0.44)] and mothers who delivered in a health care facility were more likely to receive PNC than mothers who did not deliver in a health care facility [AOR = 0.65, 95% CI (0.58, 0.94)]. The postnatal care utilization rate in Debre Birhan town was 83.3%. Marital status, maternal knowledge, and place of delivery were predictors of postnatal care service utilization. So specific attention should be directed towards the improvement of women's education since the perception of the need for PNC services were positively correlated with the mother's education.

ℓ p-Norm Multikernel Learning Approach for Stock Market Price Forecasting

PubMed Central

Shao, Xigao; Wu, Kun; Liao, Bifeng

2012-01-01

Linear multiple kernel learning model has been used for predicting financial time series. However, ℓ 1-norm multiple support vector regression is rarely observed to outperform trivial baselines in practical applications. To allow for robust kernel mixtures that generalize well, we adopt ℓ p-norm multiple kernel support vector regression (1 ≤ p < ∞) as a stock price prediction model. The optimization problem is decomposed into smaller subproblems, and the interleaved optimization strategy is employed to solve the regression model. The model is evaluated on forecasting the daily stock closing prices of Shanghai Stock Index in China. Experimental results show that our proposed model performs better than ℓ 1-norm multiple support vector regression model. PMID:23365561

Sample size determination for logistic regression on a logit-normal distribution.

PubMed

Kim, Seongho; Heath, Elisabeth; Heilbrun, Lance

2017-06-01

Although the sample size for simple logistic regression can be readily determined using currently available methods, the sample size calculation for multiple logistic regression requires some additional information, such as the coefficient of determination ([Formula: see text]) of a covariate of interest with other covariates, which is often unavailable in practice. The response variable of logistic regression follows a logit-normal distribution which can be generated from a logistic transformation of a normal distribution. Using this property of logistic regression, we propose new methods of determining the sample size for simple and multiple logistic regressions using a normal transformation of outcome measures. Simulation studies and a motivating example show several advantages of the proposed methods over the existing methods: (i) no need for [Formula: see text] for multiple logistic regression, (ii) available interim or group-sequential designs, and (iii) much smaller required sample size.

A Quantile Regression Approach to Understanding the Relations Among Morphological Awareness, Vocabulary, and Reading Comprehension in Adult Basic Education Students.

PubMed

Tighe, Elizabeth L; Schatschneider, Christopher

2016-07-01

The purpose of this study was to investigate the joint and unique contributions of morphological awareness and vocabulary knowledge at five reading comprehension levels in adult basic education (ABE) students. We introduce the statistical technique of multiple quantile regression, which enabled us to assess the predictive utility of morphological awareness and vocabulary knowledge at multiple points (quantiles) along the continuous distribution of reading comprehension. To demonstrate the efficacy of our multiple quantile regression analysis, we compared and contrasted our results with a traditional multiple regression analytic approach. Our results indicated that morphological awareness and vocabulary knowledge accounted for a large portion of the variance (82%-95%) in reading comprehension skills across all quantiles. Morphological awareness exhibited the greatest unique predictive ability at lower levels of reading comprehension whereas vocabulary knowledge exhibited the greatest unique predictive ability at higher levels of reading comprehension. These results indicate the utility of using multiple quantile regression to assess trajectories of component skills across multiple levels of reading comprehension. The implications of our findings for ABE programs are discussed. © Hammill Institute on Disabilities 2014.

Stepwise versus Hierarchical Regression: Pros and Cons

ERIC Educational Resources Information Center

Lewis, Mitzi

2007-01-01

Multiple regression is commonly used in social and behavioral data analysis. In multiple regression contexts, researchers are very often interested in determining the "best" predictors in the analysis. This focus may stem from a need to identify those predictors that are supportive of theory. Alternatively, the researcher may simply be interested…

Predictors of burden among lower socioeconomic status caregivers of persons with chronic mental illness.

PubMed

Biegel, D E; Milligan, S E; Putnam, P L; Song, L Y

1994-10-01

This study uses a stress-coping-support framework to examine the predictors of caregiver burden with a sample of 103 lower social class family caregivers of persons with chronic mental illness. Results of multiple regression analyses show that the greater the frequency of client behavioral symptoms and the lower the amount of perceived support from family members, the higher the level of overall caregiver burden. Examination of the predictors of specific types of burden-family disruption, stigma, strain, and dependency-reveal that different constellations of variables predict different types of burden. The need for mental health agencies to address caregiver and client concerns is addressed. Implications are presented for practice and future research.

Immigration Transition and Depressive Symptoms: Four Major Ethnic Groups of Midlife Women in the U.S

PubMed Central

Im, Eun-Ok; Rendell Endowed, Marjorie O.; Chang, Sun Ju; Chee, Wonshik; Chee, Eunice; Mao, Jun

2015-01-01

Our purpose of this study was to explore the relationships between immigration transition and depressive symptoms among 1,054 midlife women in the U.S. This was a secondary analysis of the data from two national Internet survey studies. Questions on background characteristics and immigration transition and the Depression Index for Midlife Women were used to collect the data. The data were analyzed using inferential statistics including multiple regressions. Immigrants reported lower numbers of and less severe symptoms than non-immigrants (p < .01). When controlling for background characteristics, self-reported racial/ethnic identity and immigration status were significant predictors of depressive symptoms (R2=.01, p<.05). PMID:24875592

Differences between husbands and wives in colonoscopy use: Results from a national sample of married couples.

PubMed

Kotwal, Ashwin A; Lauderdale, Diane S; Waite, Linda J; Dale, William

2016-07-01

Marriage is linked to improved colorectal cancer-related health, likely in part through preventive health behaviors, but it is unclear what role spouses play in colorectal cancer screening. We therefore determine whether self-reported colonoscopy rates are correlated within married couples and the characteristics of spouses associated with colonoscopy use in each partner. We use US nationally-representative 2010 data which includes 804 male-female married couples drawn from a total sample of 3137 community-dwelling adults aged 55-90years old. Using a logistic regression model in the full sample (N=3137), we first find married men have higher adjusted colonoscopy rates than unmarried men (61% versus 52%, p=0.023), but women's rates do not differ by marital status. In the couples' sample (N=804 couples), we use a bivariate probit regression model to estimate multiple regression equations for the two spouses simultaneously as a function of individual and spousal covariates, as well as the adjusted correlation within couples. We find that individuals are nearly twice as likely to receive a colonoscopy if their spouse recently has had one (OR=1.94, 95% CI: 1.39, 2.67, p<0.001). Additionally, we find that husbands have higher adjusted colonoscopy rates whose wives are: 1) happier with the marital relationship (65% vs 51%, p=0.020); 2) more highly educated (72% vs 51%, p=0.020), and 3) viewed as more supportive (65% vs 52%, p=0.020). Recognizing the role of marital status, relationship quality, and spousal characteristics on colonoscopy uptake, particularly in men, could help physicians increase guideline adherence. Copyright © 2016. Published by Elsevier Inc.

Comparison of the COPD Assessment Test (CAT) and the Clinical COPD Questionnaire (CCQ) in a Clinical Population.

PubMed

Sundh, Josefin; Ställberg, Björn; Lisspers, Karin; Kämpe, Mary; Janson, Christer; Montgomery, Scott

2016-01-01

The COPD Assessment Test (CAT) and the Clinical COPD Questionnaire (CCQ) are both clinically useful health status instruments. The main objective was to compare CAT and CCQ measurement instruments. CAT and CCQ forms were completed by 432 randomly selected primary and secondary care patients with a COPD diagnosis. Correlation and linear regression analyses of CAT and CCQ were performed. Standardised scores were created for the CAT and CCQ scores, and separate multiple linear regression analyses for CAT and CCQ examined associations with sex, age (≤ 60, 61-70 and >70 years), exacerbations (≥ 1 vs 0 in the previous year), body mass index (BMI), heart disease, anxiety/depression and lung function (subgroup with n = 246). CAT and CCQ correlated well (r = 0.88, p < 0.0001), as did CAT ≥ 10 and CCQ ≥ 1 (r = 0.78, p < 0.0001). CCQ 1.0 corresponded to CAT 9.93 and CAT 10 to CCQ 1.29. Both instruments were associated with BMI < 20 (standardised adjusted regression coefficient (95%CI) for CAT 0.56 (0.18 to 0.93) and CCQ 0.56 (0.20 to 0.92)), exacerbations (CAT 0.77 (0.58 to 0.95) and CCQ 0.94 (0.76 to 1.12)), heart disease (CAT 0.38 (0.17 to 0.59) and CCQ 0.23 (0.03 to 0.43)), anxiety/depression (CAT 0.35 (0.15 to 0.56) and CCQ 0.41 (0.21 to 0.60)) and COPD stage (CAT 0.19 (0.05 to 0.34) and CCQ 0.22 (0.07 to 0.36)). CAT and CCQ correlate well with each other. Heart disease, anxiety/depression, underweight, exacerbations, and low lung function are associated with worse health status assessed by both instruments.

Financial strain and cancer risk behaviors among African Americans.

PubMed

Advani, Pragati S; Reitzel, Lorraine R; Nguyen, Nga T; Fisher, Felicia D; Savoy, Elaine J; Cuevas, Adolfo G; Wetter, David W; McNeill, Lorna H

2014-06-01

African Americans suffer disproportionately from the adverse consequences of behavioral risk factors for cancer relative to other ethnic groups. Recent studies have assessed how financial strain might uniquely contribute to engagement in modifiable behavioral risk factors for cancer, but not among African Americans. The current study examined associations between financial strain and modifiable cancer risk factors (smoking, at-risk alcohol use, overweight/obesity, insufficient physical activity, inadequate fruit and vegetable intake, and multiple risk factors) among 1,278 African American adults (age, 46.5 ± 12.6 years; 77% female) and explored potential mediators (stress and depressive symptoms) of those associations. Logistic regression models were used to examine associations between financial strain and cancer risk factors. Analyses were adjusted for age, sex, partner status, income, educational level, and employment status. Analyses involving overweight/obesity status additionally controlled for fruit and vegetable intake and physical activity. Nonparametric bootstrapping procedures were used to assess mediation. Greater financial strain was associated with greater odds of insufficient physical activity (P < 0.003) and smoking (P = 0.005) and was positively associated with the total number of cancer risk factors (P < 0.0001). There was a significant indirect effect of both stress and depressive symptoms on the relations of financial strain with physical inactivity and multiple risk factors, respectively. Future interventions aimed at reducing cancer disparities should focus on African Americans experiencing higher financial strain while addressing their stress and depressive symptoms. Longitudinal studies are needed to assess the temporal and causal relations between financial strain and modifiable behavioral cancer risk factors among African Americans. ©2014 American Association for Cancer Research.

Medicare capitation model, functional status, and multiple comorbidities: model accuracy

PubMed Central

Noyes, Katia; Liu, Hangsheng; Temkin-Greener, Helena

2012-01-01

Objective This study examined financial implications of CMS-Hierarchical Condition Categories (HCC) risk-adjustment model on Medicare payments for individuals with comorbid chronic conditions. Study Design The study used 1992-2000 data from the Medicare Current Beneficiary Survey and corresponding Medicare claims. The pairs of comorbidities were formed based on the prior evidence about possible synergy between these conditions and activities of daily living (ADL) deficiencies and included heart disease and cancer, lung disease and cancer, stroke and hypertension, stroke and arthritis, congestive heart failure (CHF) and osteoporosis, diabetes and coronary artery disease, CHF and dementia. Methods For each beneficiary, we calculated the actual Medicare cost ratio as the ratio of the individual’s annualized costs to the mean annual Medicare cost of all people in the study. The actual Medicare cost ratios, by ADLs, were compared to the HCC ratios under the CMS-HCC payment model. Using multivariate regression models, we tested whether having the identified pairs of comorbidities affects the accuracy of CMS-HCC model predictions. Results The CMS-HCC model underpredicted Medicare capitation payments for patients with hypertension, lung disease, congestive heart failure and dementia. The difference between the actual costs and predicted payments was partially explained by beneficiary functional status and less than optimal adjustment for these chronic conditions. Conclusions Information about beneficiary functional status should be incorporated in reimbursement models since underpaying providers for caring for population with multiple comorbidities may provide severe disincentives for managed care plans to enroll such individuals and to appropriately manage their complex and costly conditions. PMID:18837646

Predictors for Employment Status in People With Multiple Sclerosis: A 10-Year Longitudinal Observational Study.

PubMed

Forslin, Mia; Fink, Katharina; Hammar, Ulf; von Koch, Lena; Johansson, Sverker

2018-01-31

To identify predictors for employment status after 10 years in a cohort of people with multiple sclerosis (MS), with the aim to increase knowledge concerning factors present at an early stage that are important for working life and work-life balance. A 10-year longitudinal observational cohort study. University hospital. A consecutive sample of people with MS (N=154) of working age were included at baseline, of which a total of 116 people participated in the 10-year follow-up; 27 people declined participation and 11 were deceased. Not applicable. Baseline data on personal factors and functioning were used as independent variables. Employment status 10 years after baseline, categorized as full-time work, part-time work, and no work, was used as the dependent variable. A generalized ordinal logistic regression was used to analyze the predictive value of the independent variables. Predictors for full- or part-time work after 10 years were young age (P=.002), low perceived physical impact of MS (P=.02), fatigue (P=.03), full-time work (P=.001), and high frequency of social/lifestyle activities (P=.001) at baseline. Low perceived physical impact of MS (P=.02) at baseline also predicted full-time work after 10 years. This study underlines the complexity of working life for people with MS, and indicates that it may be valuable to give more attention to the balance between working and private life, both in clinical practice and future research, to achieve a sustainable working life over time. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

The relationship of sociodemographic and psychological variables with chronic pain variables in a low-income population.

PubMed

Newman, Andrea K; Van Dyke, Benjamin P; Torres, Calia A; Baxter, Jacob W; Eyer, Joshua C; Kapoor, Shweta; Thorn, Beverly E

2017-09-01

Chronic pain is a pervasive condition that is complicated by economic, educational, and racial disparities. This study analyzes key factors associated with chronic pain within an understudied and underserved population. The sample is characterized by a triple disparity with respect to income, education/literacy, and racial barriers that substantially increase the vulnerability to the negative consequences of chronic pain. The study examined the pretreatment data of 290 participants enrolled in the Learning About My Pain trial, a randomized controlled comparative effectiveness trial of psychosocial interventions (B.E.T., Principal Investigator, Patient-Centered Outcomes Research Institute Contract No. 941; clinicaltrials.gov identifier NCT01967342) for chronic pain. Hierarchical multiple regression analyses evaluated the relationships among sociodemographic (sex, age, race, poverty status, literacy, and education level) and psychological (depressive symptoms and pain catastrophizing) variables and pain interference, pain severity, and disability. The indirect effects of depressive symptoms and pain catastrophizing on the sociodemographic and pain variables were investigated using bootstrap resampling. Reversed mediation models were also examined. Results suggested that the experience of chronic pain within this low-income sample is better accounted for by psychological factors than sex, age, race, poverty status, literacy, and education level. Depressive symptoms and pain catastrophizing mediated the relationships between age and pain variables, whereas pain catastrophizing mediated the effects of primary literacy and poverty status. Some reversed models were equivalent to the hypothesized models, suggesting the possibility of bidirectionality. Although cross-sectional findings cannot establish causality, our results highlight the critical role psychological factors play in individuals with chronic pain and multiple health disparities.

Growth, behavior, development and intelligence in rural children between 1-3 years of life.

PubMed

Agarwal, D K; Awasthy, A; Upadhyay, S K; Singh, P; Kumar, J; Agarwal, K N

1992-04-01

In a rural cohort of 625 children registered from 1981 to 1983 in 10 villages of K.V. Block, Varanasi, 196 children were assessed for physical growth, development, intelligence and concept development between 1 and 3 years of age. Home environment was also assessed using Caldwell Home inventory. These rural children remained below 3rd centile of NCHS standard for weight, height, skull and mid-arm circumferences throughout the study. Malnourished children scored poorly in all the areas of development, i.e., motor, adaptive, language and personal social, 9% in Grade I and 16.6% children in Grade II + III had IQ less than 79 (inferior). Concept for color shape and size was poorly developed in malnourished children. Maternal involvement and stimulation was strongly associated with better behavior development and intelligence. Multiple regression analysis showed that the effect of home environment on development and intelligence was of a higher magnitude as compared to status and family variables and nutritional status during 1-3 years of age.

[Effect of work and organizational characteristics on workers in call centers: longitudinal study in an information service company].

PubMed

Tei, Maki; Yamazaki, Yoshihiko

2005-09-01

To investigate the effect of work and organizational characteristics on workers' health status, with job dissatisfaction and intentions to leave as "organizational health", we conducted a longitudinal study using a questionnaire survey in call centers of an information service company from July to August in 2001 and 2002. The response rates were 96.2% and 92.0%, respectively. For the statistical analysis, the completed data of 296 technical support staff, which was more than 80% of the data, was used. We identified seven subscales composed of 29 items of work and organizational characteristics as scales of "organizational characteristics" and "work and workplace characteristics". The results of hierarchical multiple regression analysis showed quantitative and qualitative job-overload influenced psychological health status and poor supervisor support influenced all outcome variables. Moreover, "organizational characteristics" influenced cumulative fatigue and job dissatisfaction, showing an indirect effect with poor supervisor support and coworker support. This study suggests that measures of work and organizational characteristics are useful interventions for "organizational health".

Smoking, Physical Activity, and Eating Habits Among Adolescents.

PubMed

Lee, Bokim; Yi, Yunjeong

2016-01-01

The purpose of this study was to compare physical activity and eating habits of adolescent smokers with those of adolescent non-smokers in South Korea. This was a secondary analysis of data collected from the 2012 Korean Youth Risk Behavior Web-Based Survey. The sample included 72,229 adolescents aged 12 to 18. A multiple logistic regression analysis was performed to examine the association between smoking status and physical activity and between smoking status and eating habits, while controlling for other factors. Boys and girls were analyzed separately for all analyses. The proportion of self-reporting smokers was 11%. Surprisingly, girl smokers exercised significantly more frequently than non-smokers. Adolescent smokers were significantly less likely to consume fruits, vegetables, and milk/dairy products, and they ate significantly more fast-food than non-smokers. Health care professionals who plan smoking cessation programs should pay attention to South Korean adolescents' specific characteristics and cultural values in terms of health behavior. © The Author(s) 2014.

Testing healthy immigrant effects among late life immigrants in the United States: using multiple indicators.

PubMed

Choi, Sunha H

2012-04-01

This study tested a healthy immigrant effect (HIE) and postimmigration health status changes among late life immigrants. Using three waves of the Second Longitudinal Study of Aging (1994-2000) and the linked mortality file through 2006, this study compared (a) chronic health conditions, (b) longitudinal trajectories of self-rated health, (c) longitudinal trajectories of functional impairments, and (d) mortality between three groups (age 70+): (i) late life immigrants with less than 15 years in the United States (n = 133), (ii) longer term immigrants (n = 672), and (iii) U.S.-born individuals (n = 8,642). Logistic and Poisson regression, hierarchical generalized linear modeling, and survival analyses were conducted. Late life immigrants were less likely to suffer from cancer, had lower numbers of chronic conditions at baseline, and displayed lower hazards of mortality during the 12-year follow-up. However, their self-rated health and functional status were worse than those of their counterparts over time. A HIE was only partially supported among older adults.

[Validity evidence of the Health-Related Quality of Life for Drug Abusers Test based on the Biaxial Model of Addiction].

PubMed

Lozano, Oscar M; Rojas, Antonio J; Pérez, Cristino; González-Sáiz, Francisco; Ballesta, Rosario; Izaskun, Bilbao

2008-05-01

The aim of this work is to show evidence of the validity of the Health-Related Quality of Life for Drug Abusers Test (HRQoLDA Test). This test was developed to measure specific HRQoL for drugs abusers, within the theoretical addiction framework of the biaxial model. The sample comprised 138 patients diagnosed with opiate drug dependence. In this study, the following constructs and variables of the biaxial model were measured: severity of dependence, physical health status, psychological adjustment and substance consumption. Results indicate that the HRQoLDA Test scores are related to dependency and consumption-related problems. Multiple regression analysis reveals that HRQoL can be predicted from drug dependence, physical health status and psychological adjustment. These results contribute empirical evidence of the theoretical relationships established between HRQoL and the biaxial model, and they support the interpretation of the HRQoLDA Test to measure HRQoL in drug abusers, thus providing a test to measure this specific construct in this population.

Social determinants of loneliness among older Americans.

PubMed

Mullins, L C; Elston, C H; Gutkowski, S M

1996-11-01

To further understand loneliness among older persons, a conceptual model, predicated on a social-support perspective, was examined. Results were based on 1,071 participants in the congregate and home-delivered meal programs of the Senior Citizens Nutrition and Activities Program in Hillsborough County, Florida. A series of stepwise multiple regression analyses showed that loneliness was greater among men, those with no children, those with no friends, those more physically disabled, those who subjectively felt that their health was poorer, and those who subjectively felt that their economic condition was inadequate. Not related directly to loneliness but with indirect influence were age, race, education, marital status, and poverty status. Those variables with no direct or indirect effect included rural or urban location, identification of emotional closeness with existing children or friends, and living alone. Theoretically, the results do not fully support the social-support perspective but point to the impact of a broad spectrum of demographic, health, economic, and social factors.

Acculturative stress and depression in an elderly Arabic sample.

PubMed

Wrobel, Nancy Howells; Farrag, Mohamed F; Hymes, Robert W

2009-09-01

Acculturative stress and relevant demographic variables, including immigration status, English skills, level of education, age, gender, country of origin, and years since immigration to the U. S. are examined along with their relationship to depressive symptoms. The 200 Arab-American and recent Arab immigrant participants ranged from age 60-92 and represented eight countries of origin. Most had limited fluency in English. Arabic versions of the Multi-dimensional Acculturative Stress Inventory (MASI) and Geriatric Depression Scale were administered. MASI and GDS results indicated greater degrees of acculturative stress and depression for those with a refugee or temporary resident status. More recent entry into the U.S. also predicted greater stress, while greater levels of education and English skills predicted lower levels of stress and depression. Composite stress levels and the nature of stress varied by country of origin. Although demographic variables were predictive of depression when examined separately, multiple regression analyses revealed that perceived acculturative stress, particularly pressure to learn English, provided a notable increment in prediction of depression over the demographic variables.

Psychological predictors of children' s recess physical activity motivation and behavior.

PubMed

Stellino, Megan Babkes; Sinclair, Christina D

2013-06-01

This study explored the relationship between children's basic psychological needs satisfaction at recess, level of recess physical activity motivation (RPAM), and recess physical activity (RPA). Fifth-grade children (N = 203; 50.2% boys; 71.7% healthy-weight) completed measures of age, gender, basic psychological need satisfaction, and level of self-determined motivation for RPA. Children also wore pedometers during six consecutive 30-min mid-school-day recesses. Multiple regression analyses indicated unique significant predictors of RPAM and RPA according to gender and weight status. RPAM was significantly predicted by all three basic psychological needs for boys and only competence need satisfaction for girls and healthy-weight children. RPA was predicted by RPAM for girls, competence need satisfaction for overweight children, and autonomy need satisfaction for boys and healthy-weight children. Findings support self-determination theory and provide important insight into the variations in psychological predictors of motivation for RPA and actual physical activity behavior based on gender and weight status.

Risk factors for cancer cervix among rural women of a hilly state: a case-control study.

PubMed

Thakur, Anita; Gupta, Bhupender; Gupta, Anmol; Chauhan, Raman

2015-01-01

In Himachal Pradesh, cancer cervix is a major public health problem since it ranks as the number one female cancer. A case-control study of 226 newly diagnosed, histopathologically confirmed cases of cancer cervix and equal number of matched controls was conducted at Regional Cancer Center, Himachal Pradesh during the period from July 2008 to October 2009 with the objective to study the common factors associated with cancer cervix. Univariate analysis identified 10 risk factors associated significantly with the disease. On multiple logistic regression, however, only seven risk factors were found to be associated significantly with the disease. These were: Age at birth of first child, spacing between two children, age at marriage, literacy, socioeconomic status, multiparity, and poor genital hygiene. Risk factors such as poor genital hygiene, age at birth of first child <19 years, early marriage, illiteracy, multiparity, and low socioeconomic status were highly prevalent in the study subjects and were found to be significantly associated with cancer cervix.

The effect of work on people with severe mental illness in Taiwan using a stress-social support model: an exploratory study.

PubMed

Wu, Hui-Ching

2006-06-01

Satisfaction with quality of life is one aspect of a positive and successful life, and this remains true in the rehabilitation of people with severe mental illness. This study explores the meaning and impact of work on people with severe mental illness in Taiwan and, specifically, the value of encouraging people with severe mental illness to work to enhance their quality of life. We apply stress-social support theory (a Western model) to examine daily life and work stressors in an Eastern cultural environment (Taiwan). We use multiple regression models to analyze predictive factors for their effect on life quality. There are five categories: socio-demographic characteristics, mental illness history, current work status variables (as controls), stress variable and social support variable. Unlike Western studies, current work status, in itself, did not lead to better satisfaction with quality of life, but the stress-social support model did. The implications for rehabilitation success are discussed.

Associations Between Health Literacy and Established Predictors of Smoking Cessation

PubMed Central

Adams, Claire E.; Cano, Miguel A.; Correa-Fernández, Virmarie; Waters, Andrew J.; Wetter, David W.; Vidrine, Jennifer Irvin

2013-01-01

Objectives. We examined associations between health literacy and predictors of smoking cessation among 402 low-socioeconomic status (SES), racially/ethnically diverse smokers. Methods. Data were collected as part of a larger study evaluating smoking health risk messages. We conducted multiple linear regression analyses to examine relations between health literacy and predictors of smoking cessation (i.e., nicotine dependence, smoking outcome expectancies, smoking risk perceptions and knowledge, self-efficacy, intentions to quit or reduce smoking). Results. Lower health literacy was associated with higher nicotine dependence, more positive and less negative smoking outcome expectancies, less knowledge about smoking health risks, and lower risk perceptions. Associations remained significant (P < .05) after controlling for demographics and SES-related factors. Conclusions. These results provide the first evidence that low health literacy may serve as a critical and independent risk factor for poor cessation outcomes among low-socioeconomic status, racially/ethnically diverse smokers. Research is needed to investigate potential mechanisms underlying this relationship. PMID:23678912

Diurnal salivary cortisol and regression status in MECP2 Duplication syndrome

PubMed Central

Peters, Sarika U.; Byiers, Breanne J.; Symons, Frank J.

2015-01-01

MECP2 duplication syndrome is an X-linked genomic disorder that is characterized by infantile hypotonia, intellectual disability, and recurrent respiratory infections. Regression affects a subset of individuals, and the etiology of regression has yet to be examined. In this study, alterations in the hypothalamus-pituitary-adrenal axis, including diurnal patterns in salivary cortisol, were examined in four males with MECP2 duplication syndrome who had regression, and four males with the same syndrome without regression (ages 3–22 years). Individuals who had experienced regression do not exhibit typical diurnal cortisol rhythms, and their profiles were flatter through the day. In contrast, individuals with MECP2 duplication syndrome who had not experienced regression showed more typical patterns of higher cortisol levels in the morning with linear decreases throughout the day. This study is the first to suggest a link between atypical diurnal cortisol rhythms and regression status in MECP2 duplication syndrome, and may have implications for treatment. PMID:25999300

Effects of Medical Insurance on the Health Status and Life Satisfaction of the Elderly

PubMed Central

GU, Liubao; FENG, Huihui; JIN, Jian

2017-01-01

Background: Population aging has become increasingly serious in China. The demand for medical insurance of the elderly is increasing, and their health status and life satisfaction are becoming significant issues. This study investigates the effects of medical insurance on the health status and life satisfaction of the elderly. Methods: The national baseline survey data of the China Health and Retirement Longitudinal Survey in 2013 were adopted. The Ordered Probit Model was established. The effects of the medical insurance for urban employees, medical insurance for urban residents, and new rural cooperative medical insurance on the health status and life satisfaction of the elderly were investigated. Results: Medical insurance could facilitate the improvement of the health status and life satisfaction of the elderly. Accordingly, the health status and life satisfaction of the elderly who have medical insurance for urban residents improved significantly. The regression coefficients were 0.348 and 0.307. The corresponding regression coefficients of the medical insurance for urban employees were 0.189 and 0.236. The regression coefficients of the new rural cooperative medical insurance were 0.170 and 0.188. Conclusion: Medical insurance can significantly improve the health status and life satisfaction of the elderly. This development is of immense significance for the formulation of equal medical security. PMID:29026784

A Method of Calculating Functional Independence Measure at Discharge from Functional Independence Measure Effectiveness Predicted by Multiple Regression Analysis Has a High Degree of Predictive Accuracy.

PubMed

Tokunaga, Makoto; Watanabe, Susumu; Sonoda, Shigeru

2017-09-01

Multiple linear regression analysis is often used to predict the outcome of stroke rehabilitation. However, the predictive accuracy may not be satisfactory. The objective of this study was to elucidate the predictive accuracy of a method of calculating motor Functional Independence Measure (mFIM) at discharge from mFIM effectiveness predicted by multiple regression analysis. The subjects were 505 patients with stroke who were hospitalized in a convalescent rehabilitation hospital. The formula "mFIM at discharge = mFIM effectiveness × (91 points - mFIM at admission) + mFIM at admission" was used. By including the predicted mFIM effectiveness obtained through multiple regression analysis in this formula, we obtained the predicted mFIM at discharge (A). We also used multiple regression analysis to directly predict mFIM at discharge (B). The correlation between the predicted and the measured values of mFIM at discharge was compared between A and B. The correlation coefficients were .916 for A and .878 for B. Calculating mFIM at discharge from mFIM effectiveness predicted by multiple regression analysis had a higher degree of predictive accuracy of mFIM at discharge than that directly predicted. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Nutrient intake and use of dietary supplements among US adults with disabilities.

PubMed

An, Ruopeng; Chiu, Chung-Yi; Andrade, Flavia

2015-04-01

Physical, mental, social, and financial hurdles in adults with disabilities may limit their access to adequate nutrition. To examine the impact of dietary supplement use on daily total nutrient intake levels among US adults 20 years and older with disabilities. Study sample came from 2007-2008 and 2009-2010 waves of the National Health and Nutrition Examination Survey, a nationally representative repeated cross-sectional survey. Disability was classified into 5 categories using standardized indices. Nutrient intakes from foods and dietary supplements were calculated from 2 nonconsecutive 24-hour dietary recalls. Two-sample proportion tests and multiple logistic regressions were used to examine the adherence rates to the recommended daily nutrient intake levels between dietary supplement users and nonusers in each disability category. The association between sociodemographic characteristics and dietary supplement use was assessed using multiple logistic regressions, accounting for complex survey design. A substantial proportion of the US adult population with disabilities failed to meet dietary guidelines, with insufficient intakes of multiple nutrients. Over half of the US adults with disabilities used dietary supplements. Dietary supplement use was associated with higher adherence rates for vitamin A, vitamin B1, vitamin B2, vitamin B6, vitamin B12, vitamin C, vitamin D, vitamin E, calcium, copper, iron, magnesium, and zinc intake among adults with disabilities. Women, non-Hispanic Whites, older age, higher education, and higher household income were found to predict dietary supplement use. Proper use of dietary supplements under the guidance of health care providers may improve the nutritional status among adults with disabilities. Copyright © 2015 Elsevier Inc. All rights reserved.

Traumatic injuries and persistent opioid use in the USA: findings from a nationally representative survey.

PubMed

Alghnam, Suliman; Castillo, Renan

2017-04-01

Although opioid abuse is a rising epidemic in the USA, there are no studies to date on the incidence of persistent opioid use following injuries. Therefore, the aims of this study are: (1) to examine the incidence of persistent opioid use among a nationally representative sample of injured and non-injured populations; (2) to evaluate whether an injury is an independent predictor of persistent opioid use. Data from the Medical Expenditure Panel Survey were pooled (years 2009-2012). Adults were followed for about 2 years, during which they were surveyed about injury status and opioid use every 4-5 months. To determine whether injuries are associated with persistent opioid use, weighted multiple logistic regressions were constructed. While 2.3 million injured individuals received any opioid during the follow-up, 371 170 (15.6%) individuals became persistent opioid users (defined as opioid use across multiple time points). In a multiple logistic regression analysis adjusting for sociodemographic characteristics and self-reported health, those who sustained injuries were 1.4 times (95% CI 1.1 to 1.9) more likely to report persistent opioid use than those without injuries. We found injuries to be significantly associated with persistent opioid use in a nationally representative sample. Further investment in injury prevention may facilitate reduction of persistent opioid use and, thus, improve population health and reduce health expenditures. 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/.

Only-Child Status in Relation to Perceived Stress and Studying-Related Life Satisfaction among University Students in China: A Comparison with International Students

PubMed Central

Chu, Janet Junqing; Khan, Mobarak Hossain; Jahn, Heiko J.; Kraemer, Alexander

2015-01-01

Objectives University students in general face multiple challenges, which may affect their levels of perceived stress and life satisfaction. Chinese students currently face specific strains due to the One-Child Policy (OCP). The aim of this study was to assess (1) whether the levels of perceived stress and studying-related life satisfaction are associated with only-child (OC) status after controlling for demographic and socio-economic characteristics and (2) whether these associations differ between Chinese and international students. Materials and Methods A cross-sectional health survey based on a self-administrated standardised questionnaire was conducted among 1,843 (1,543 Chinese, 300 international) students at two Chinese universities in 2010–2011. Cohen’s Perceived Stress Scale (PSS-14) and Stock and Kraemer’s Studying-related Life Satisfaction Scale were used to measure perceived stress and studying-related life satisfaction respectively. Multivariable logistic regression analyses were used to examine the associations of OC status with perceived stress and studying-related life satisfaction by sex for Chinese students and international students separately. Results The Chinese non-only-children (NOCs) were more likely to come from small cities. Multivariable regression models indicate that the Chinese NOCs were more stressed than OCs (OR = 1.39, 1.11–1.74) with a stronger association in men (OR = 1.48, 1.08–2.02) than women (OR = 1.26, 0.89–1.77). NOCs were also more dissatisfied than their OC fellows in the Chinese subsample (OR = 1.37, 1.09–1.73). Among international students, no associations between OC status and perceived stress or studying-related life satisfaction were found. Conclusions To promote equality between OCs and NOCs at Chinese universities, the causes of more stress and less studying-related life satisfaction among NOCs compared to OCs need further exploration. PMID:26675032

Predictors of baseline peritoneal transport status in Australian and New Zealand peritoneal dialysis patients.

PubMed

Rumpsfeld, Markus; McDonald, Stephen P; Purdie, David M; Collins, John; Johnson, David W

2004-03-01

Factors that predict peritoneal transport status in peritoneal dialysis (PD) patients are poorly understood. The aim of the present study is to determine these factors in Australian and New Zealand incident PD patients. The study included all patients on the Australian and New Zealand Dialysis and Transplant Registry who started PD therapy between April 1, 1991, and March 31, 2002, and underwent a peritoneal equilibration test (PET) within the first 6 months. Predictors of peritoneal transport category and dialysate-plasma creatinine ratio at 4 hours (D-P Cr 4h) were assessed by multivariate ordinal logistic regression and multiple linear regression, respectively. A total of 3,188 patients were studied. Mean D-P Cr 4h was 0.69 +/- 0.13. High transport status was associated with older age (adjusted odds ratio [OR], 1.08 for each 10 years; 95% confidence interval [CI], 1.03 to 1.13), Maori and Pacific Islander racial origin (OR, 1.48; 95% CI, 1.13 to 1.94), and normal body mass index (BMI; < 18.5 kg/m2: OR, 0.90; 95% CI, 0.65 to 1.24; BMI of 18.5 to 25 kg/m2: OR, 1 [reference]; BMI of 25 to 30 kg/m2: OR, 0.81; 95% CI, 0.70 to 0.95; BMI > 30 kg/m2: OR, 0.71; 95% CI, 0.58 to 0.86), but was not independently predicted by sex, diabetes, other comorbid diseases, smoking, previous hemodialysis therapy or transplantation, or residual renal function. Similar results were found when peritoneal permeability was modeled as a continuous variable (D-P Cr 4h). In Australian and New Zealand PD patients, higher peritoneal transport status is independently associated with racial origin, older age, and lower BMI. The diversity of peritoneal transport characteristics in different ethnic populations suggests that additional validation of PET measurements in various racial groups and study of their relationship to patient outcomes are warranted.

Obese Chinese Primary-School Students and Low Self-Esteem: A Cross-Sectional Study

PubMed Central

Xue-Yan, Zhang; Dong-Mei, Li; Dan-Dan, Xu; Le-Shan, Zhou

2016-01-01

Objectives The aim of this study was to examine several factors related to low self-esteem among obese Chinese primary-school students. Methods A cross-sectional study was conducted between June 2009 and June 2010. A total of 1,410 primary-school students (China grades 4 - 6) in Changsha city were divided into normal weight (n = 1,084), overweight (n = 211), and obese groups (n = 115) according to world health organization (WHO) growth standards for body mass index (BMI). The students were assessed using the self-esteem scale (SES) and a general situation questionnaire. Caregivers completed questionnaires about their child’s weight status. Self-esteem levels were explored; any factors related to low self-esteem were analyzed using logistic regression analysis. Results The average self-esteem score among overweight or obese primary-school students was found to be lower than that of normal-weight students. The proportion of students with low self-esteem in the obese group was more than that in the normal-weight and overweight groups. Multiple logistic regression analysis showed that obesity status (odds ratio [OR], 3.74; 95% confidence interval [CI], 2.25 - 6.22), overweight status (OR, 2.60; 95% CI, 1.71 - 3.95), obesity considered by children’s grandparents (OR, 1.76; 95% CI, 1.05 - 2.96), dissatisfaction with height (OR, 1.55; 95% CI, 1.11 - 2.18), and dissatisfaction with weight (OR, 1.45; 95% CI, 1.05 - 2.01) were the risk factors for low self-esteem for primary-school students, while satisfaction with academic performance was a protective factor (OR, 0.22; 95% CI, 0.07 - 0.71). Conclusions For Chinese primary-school students, low self-esteem is associated with higher weight status and self-perceived body shape and academic performance. In addition, grandparental opinion of a child’s weight also contributes to low self-esteem. PMID:27713806

What Is Different About Worker’s Compensation Patients?

PubMed Central

Atlas, Steven J.; Tosteson, Tor D.; Hanscom, Brett; Blood, Emily A.; Pransky, Glenn S.; Abdu, William A.; Andersson, Gunnar B.; Weinstein, James N.

2010-01-01

Study Design Combined analysis of 2 prospective clinical studies. Objective To identify socioeconomic characteristics associated with workers’ compensation in patients with an intervertebral disc herniation (IDH) or spinal stenosis (SpS). Summary of Background Data Few studies have compared socioeconomic differences between those receiving or not receiving workers’ compensation with the same underlying clinical conditions. Methods Patients were identified from the Spine Patient Outcomes Research Trial (SPORT) and the National Spine Network (NSN) practice-based outcomes study. Patients with IDH and SpS within NSN were identified satisfying SPORT eligibility criteria. Information on disability and work status at baseline evaluation was used to categorize patients into 3 groups: workers’ compensation, other disability compensation, or work-eligible controls. Enrollment rates of patients with disability in a clinical efficacy trial (SPORT) and practice-based network (NSN) were compared. Independent socioeconomic predictors of baseline workers’ compensation status were identified in multivariate logistic regression models controlling for clinical condition, study cohort, and initial treatment designation. Results Among 3759 eligible patients (1480 in SPORT and 2279 in NSN), 564 (15%) were receiving workers’ compensation, 317 (8%) were receiving other disability compensation, and 2878 (77%) were controls. Patients receiving workers’ compensation were less common in SPORT than NSN (9.2% vs. 18.8%, P < 0.001), but patients receiving other disability compensation were similarly represented (8.9% vs. 7.7%, P = 0.19). In univariate analyses, many socioeconomic characteristics significantly differed according to baseline workers’ compensation status. In multiple logistic regression analyses, gender, educational level, work characteristics, legal action, and expectations about ability to work without surgery were independently associated with receiving workers’ compensation. Conclusion Clinical trials involving conditions commonly seen in patients with workers’ compensation may need special efforts to ensure adequate representation. Socioeconomic characteristics markedly differed between patients receiving and not receiving workers’ compensation. Identifying the independent effects of workers’ compensation on outcomes will require controlling for these baseline characteristics and other clinical features associated with disability status. PMID:17700451

Obese Chinese Primary-School Students and Low Self-Esteem: A Cross-Sectional Study.

PubMed

Xue-Yan, Zhang; Dong-Mei, Li; Dan-Dan, Xu; Le-Shan, Zhou

2016-08-01

The aim of this study was to examine several factors related to low self-esteem among obese Chinese primary-school students. A cross-sectional study was conducted between June 2009 and June 2010. A total of 1,410 primary-school students (China grades 4 - 6) in Changsha city were divided into normal weight (n = 1,084), overweight (n = 211), and obese groups (n = 115) according to world health organization (WHO) growth standards for body mass index (BMI). The students were assessed using the self-esteem scale (SES) and a general situation questionnaire. Caregivers completed questionnaires about their child's weight status. Self-esteem levels were explored; any factors related to low self-esteem were analyzed using logistic regression analysis. The average self-esteem score among overweight or obese primary-school students was found to be lower than that of normal-weight students. The proportion of students with low self-esteem in the obese group was more than that in the normal-weight and overweight groups. Multiple logistic regression analysis showed that obesity status (odds ratio [OR], 3.74; 95% confidence interval [CI], 2.25 - 6.22), overweight status (OR, 2.60; 95% CI, 1.71 - 3.95), obesity considered by children's grandparents (OR, 1.76; 95% CI, 1.05 - 2.96), dissatisfaction with height (OR, 1.55; 95% CI, 1.11 - 2.18), and dissatisfaction with weight (OR, 1.45; 95% CI, 1.05 - 2.01) were the risk factors for low self-esteem for primary-school students, while satisfaction with academic performance was a protective factor (OR, 0.22; 95% CI, 0.07 - 0.71). For Chinese primary-school students, low self-esteem is associated with higher weight status and self-perceived body shape and academic performance. In addition, grandparental opinion of a child's weight also contributes to low self-esteem.

Association between maternal nutritional status of pre pregnancy, gestational weight gain and preterm birth.

PubMed

Xinxo, Sonela; Bimbashi, Astrit; Z Kakarriqi, Eduard; Zaimi, Edmond

2013-01-01

Maternal nutritional status of pre pregnancy and gestational weight gain affects the preterm birth. The association between maternal nutritional status of pre pregnancy and preterm birth appears to be complex and varied by studies from different countries, thus this association between the gestational weight gain and preterm birth is more consolidated. The study aims to determine any association between the pre pregnancy maternal nutritional status, gestational weight gain and the preterm birth rate in the Albanian context. In case control study, we analyzed women who have delivered in obstetric institutions in Tirana during the year 2012. Body mass index and gestational weight gain of 150 women who had a preterm delivery were compared with those of 150 matched control women who had a normal delivery regarding the gestation age. The self-reported pre pregnancy weight, height, gestational weight gain, age, education and parity are collected through a structured questioner. The body mass index and gestational weight gain are categorized based on the Institute of Medicine recommendation. The multiple logistic regression is used to measure the association between the nutritional status of pre pregnancy and gestational weight gain and the preterm birth rate. The women which have a underweight status or obese of pre pregnancy are more likely to have a preterm birth compared to the women of a normal pre-pregnancy nutritional status (respectively OR =2.7 and 4.3 p<0.05). Women who do not reach the recommended gestational weight gain are more likely to have a preterm birth compared to the women which reach this weight (OR=1.8 p< 0.05). Maternal nutritional status and gestational weight gain affects the risk for preterm birth. Pre-pregnancy and gestation nutritional assessments should be part of routine prenatal visits.

Influence of radical prostatectomy for prostate cancer on work status and working life 3 years after surgery.

PubMed

Dahl, Sigrun; Loge, Jon Håvard; Berge, Viktor; Dahl, Alv Andreas; Cvancarova, Milada; Fosså, Sophie Dorothea

2015-06-01

The purpose of this study is to study the influence of radical prostatectomy (RP) for prostate cancer on work status and working life in men 3 years after surgery. In a prospective, questionnaire-based study on adverse effects after RP, 330 prostate cancer (PCa) patients who had been active in the workforce before RP described their work status 3 years after having surgery. We dichotomized their postoperative work status into "unchanged or increased" versus "reduced." The participants also reported whether their working life was influenced by the PCa trajectory to no, some, or a great extent. Univariate and multiple logistic regression models were established with sociodemographic and clinical characteristics as independent variables and "work status" or "influence of PCa trajectory on working life" as dependent variables. Twenty-five percent of the participants had retired. Of the remaining participants, approximately 20 % had a reduced work status, which in the multivariate analyses was significantly associated with increasing age. One third of the men still active in the workforce considered the PCa to negatively influence their working life. This was independently associated with bother related to urinary leakage, fatigue, and having undergone additional oncological therapy (pelvic radiotherapy and/or hormone treatment). Though RP does not affect work status in most men, approximately one third of them experience problems in their working life due to adverse effects related to RP and/or additional post-RP anti-cancer therapy. Most PCa survivors can expect to remain in the workforce for at least 3 years after RP, but for some, persistent adverse effects after RP and /or additional anti-cancer treatment negatively affect their working life. Pre-RP counseling of men within the workforce should cover possible post-RP changes concerning work status and working life.

Medication literacy status of outpatients in ambulatory care settings in Changsha, China.

PubMed

Zheng, Feng; Ding, Siqing; Luo, Aijing; Zhong, Zhuqing; Duan, Yinglong; Shen, Zhiying

2017-02-01

Objective To assess medication literacy status and to examine risk factors of inadequate medication literacy of outpatients in ambulatory care settings. Methods Study participants were recruited randomly from outpatient departments in four tertiary hospitals (Xiangya Hospital of Central South University, Second Xiangya Hospital of Central South University, Third Xiangya Hospital of Central South University, People's Hospital of Hunan Province) in Changsha, Hunan, China, between October 2014 and January 2015. Medication literacy was assessed using the Medication Literacy Scale, Chinese version. Demographic and clinical data were collected using structured interviews. Multiple logistic regression analysis was used to estimate the independent effects of demographic and clinical factors on medication literacy. Results Of 465 participants, 425 (91.4%) produced valid responses for analysis. The mean medication literacy score was 8.31 (standard deviation = 3.47). Medication literacy was adequate in 131 participants (30.8%), marginally adequate in 248 (58.4%), and inadequate in 46 (10.8%). The risk of inadequate medication literacy was greater for older and unmarried patients but lower for more educated patients. Conclusion Many Chinese outpatients in ambulatory care have inadequate medication literacy. Greater age, low education, and unmarried status are important risk factors of inadequate medication literacy.

Early life socioeconomic status, chronic physiological stress and hippocampal N-acetyl aspartate concentrations.

PubMed

McLean, John; Krishnadas, Rajeev; Batty, G David; Burns, Harry; Deans, Kevin A; Ford, Ian; McConnachie, Alex; McGinty, Agnes; McLean, Jennifer S; Millar, Keith; Sattar, Naveed; Shiels, Paul G; Tannahill, Carol; Velupillai, Yoga N; Packard, Chris J; Condon, Barrie R; Hadley, Donald M; Cavanagh, Jonathan

2012-12-01

Early life socioeconomic deprivation has been associated with cognitive and behavioural changes that persist through towards adulthood. In this study, we investigated whether early life socioeconomic status is associated with changes in the hippocampus N-acetyl aspartate (NAA), using the non-invasive technique of magnetic resonance spectroscopy (MRS). We performed proton magnetic resonance spectroscopy ((1)H-MRS) of the hippocampus at 3T in 30 adult males, selected from the PSOBID cohort. We conducted multiple regression analysis to examine the relationship between early socioeconomic status (SES) and concentration of N-acetyl-aspartate in the hippocampus. We also examined whether the relationship between these variables was mediated by markers of chronic physiological stress. Greater socioeconomic deprivation was associated with lower hippocampal NAA concentrations bilaterally. The relationship between early life SES and hippocampal NAA concentrations was mediated by allostatic load index - a marker of chronic physiological stress. Greater early life socioeconomic deprivation was associated with lower concentrations of NAA reflecting lesser neuronal integrity. This relationship was mediated by greater physiological stress. Further work, to better understand the biological processes underlying the effects of poverty, physiological stress on hippocampal metabolites is necessary. Copyright © 2012 Elsevier B.V. All rights reserved.

[Nutritional status and risk factors for malnutrition in low-income urban elders].

PubMed

Hyun, Hye Sun; Lee, Insook

2014-12-01

The purpose of this study was to evaluate the nutritional status of low-income urban elders by diversified ways, and to analyze the risk factors for malnutrition. The participants in this study were 183 low-income elders registered at a visiting healthcare facility in a public health center. Data were collected using anthropometric measurements, and a questionnaire survey. For data analysis, descriptive statistics, χ²-test, t-test, Fisher's exact test, multiple logistic regression analysis were performed using SPSS 20.0. Regarding the nutritional status of low-income elders as measured by the Mini Nutritional Assessment (MNA), 10.4% of the elders were classified as malnourished; 57.4% as at high risk for malnutrition; and 32.2% as having normal nutrition levels. The main factors affecting malnutrition for low-income elders were loss of appetite (OR=3.34, 95% CI: 1.16~9.56) and difficulties in meal preparation (OR=2.35, 95% CI: 1.13~4.88). In order to effectively improve nutrition in low-income urban elders, it is necessary to develop individual intervention strategies to manage factors that increase the risk of malnutrition and to use systematic approach strategies in local communities in terms of a nutrition support system.

Influence of social support on cognitive function in the elderly.

PubMed

Yeh, Shu-Chuan Jennifer; Liu, Yea-Ying

2003-05-30

Social support is important in daily activities of the elderly. This study tests the hypothesis that there is an association between social support and cognitive function among the elderly in a community setting. Face-to-face interviews were conducted in a cross-sectional stratified random sample of 4,993 elderly (> or =65 years) city residents. Using multiple regression analysis, we investigated the influence of social support on cognitive function. 12% were over 80 years old. 53.28% were men. 67.14% were married. Higher Short Portable Mental Status Questionnaire (SPMSQ) scores (higher score means better cognitive function) were associated with strong social support, as measured by marital status and perceived positive support from friends. Lower cognitive function was associated with older and with female respondents. Only instrumental activities of daily living (IADL) were statistically and negatively related to SPMSQ. Lower functional status was associated with lower cognitive function. Elders with grade school educations had lower SPMSQ scores than did elders with high school educations. In Taiwan, higher cognitive function in community-living elderly was associated with increased social support. Life-style management should provide social activities for the elderly to promote a better quality of life.

Drug dependence, parenting responsibilities, and treatment history: why doesn't mom go for help?

PubMed

McMahon, Thomas J; Winkel, Justin D; Suchman, Nancy E; Luthar, Suniya S

2002-01-01

Despite longstanding concern that the presence of children deters drug-dependent women from entering treatment, there have been few empirical tests of the relationship between parenting responsibilities and treatment-seeking behavior. In this study, the relationship between number of biological children and treatment history was examined in a cohort of 153 women seeking methadone maintenance treatment. In a standard multiple regression analysis that also allowed for the potential influence of (a) age, (b) education, (c) ethnic minority status, (d) cohabitation with a sexual partner, (e) chronicity of opioid use, and (f) knowledge of HIV infection, there was a significant, negative relationship between number of children and number of earlier contacts for drug abuse treatment. Ethnic minority status and cohabitation with a sexual partner were also associated with fewer earlier contacts; greater chronicity and knowledge of HIV infection were associated with more earlier contacts. Moreover, there was significant moderation of the negative relationship between parenting responsibilities and treatment history by (a) ethnic minority status, (b) cohabitation, and (c) chronicity of use. Within a cross-sectional research design, the findings highlight ways parenting responsibilities may interact with other factors over time to influence the treatment-seeking behavior of drug-dependent women.

[Predictors of fighting spirit or helplessness/hopelessness in people with cancer].

PubMed

Oh, Pok-Ja; Lee, Yeon-Joo

2008-04-01

This study was done to identify predictors of the fighting spirit or helplessness/hopelessness in the patients' mental adjustment to cancer. Cancer patients' characteristics like performance status, metastasis and duration of diagnosis with demographic factors, spiritual support and social support were used as predictors of a fighting spirit or helplessness/hopelessness. A total of 124 ambulatory cancer patients completed the Mental Adjustment to Cancer (MAC) scale and responded in a structured instrument about their characteristics, spiritual and social support. The results of multiple regression analysis revealed that confidence in the supporter (R(2)=.114, p=.000), duration of cancer diagnosis (R(2)=.041, p=.000) and faith (R(2)=.030, p=.000) were predictive of a fighting spirit (R(2)=.185, p=.000); whereas, education (R(2)=.074, p=.001), performance status (R(2)=.055, p=.000), satisfaction with social support (R(2)=.046, p=.000), and metastasis (R(2)=.037, p=.000) were predictive of helplessness/hopelessness (R(2)=.202, p=.000). Social support, spiritual support and disease related factors like metastasis, performance status, and duration of cancer diagnosis need to be considered in a psychosocial nursing intervention for a fighting spirit or helplessness/hopelessness.

Peritoneal small solute transport rate is related to the malnutrition inflammation score in peritoneal dialysis patients.

PubMed

Sezer, Siren; Elsurer, Rengin; Afsar, Baris; Arat, Zubeyde; Ozdemir, Nurhan F; Haberal, Mehmet

2007-01-01

A high peritoneal membrane transport status and peritoneal albumin leakage are determinants of morbidity and mortality in patients receiving continuous ambulatory peritoneal dialysis. In this study, we analyzed the relationship between the malnutrition inflammation score, peritoneal transport status, and 24-hour peritoneal albumin leakage in patients receiving peritoneal dialysis. Sixty-six patients receiving peritoneal dialysis (male-female ratio 30/36; age 46.2 +/- 14.1 years; mean duration of peritoneal dialysis 32.4 +/- 23.9 months) who had experienced no attacks of peritonitis within the prior 6 months were included. The malnutrition inflammation score was positively correlated with the serum C-reactive protein concentration, dialysate/plasma creatinine ratio, and 24-hour peritoneal albumin leakage. Triceps and biceps skinfold thicknesses and serum concentrations of prealbumin, total cholesterol, and triglyceride were negatively correlated with the malnutrition inflammation score. Multiple linear regression analysis showed that the malnutrition inflammation score was independently associated with the dialysate/plasma creatinine ratio (p = 0.039) and 24-hour peritoneal albumin amount (p = 0.005). High peritoneal transport status and peritoneal albumin leakage are significantly associated with the malnutrition inflammation score. (c) 2007 S. Karger AG, Basel

Maternal Eating and Physical Activity Strategies and their Relation with Children's Nutritional Status.

PubMed

Flores-Peña, Yolanda; Ortiz-Félix, Rosario Edith; Cárdenas-Villarreal, Velia Margarita; Ávila-Alpirez, Hermelinda; Alba-Alba, Corina Mariela; Hernández-Carranco, Roandy Gaspar

2014-01-01

to describe the maternal eating and physical activity strategies (monitoring, discipline, control, limits and reinforcement) [MEES]; to determine the relation between MEES and the child's nutritional status [body mass index (BMI) and body fat percentage (BFP)]; to verify whether the MEES differ according to the child's nutritional status. participants were 558 mothers and children (3 to 11 years of age) who studied at public schools. The Parental Strategies for Eating and Activity Scale (PEAS) was applied and the child's weight, height and BFP were measured. For analysis purposes, descriptive statistics were obtained, using multiple linear regression and the Kruskal-Wallis test. the highest mean score was found for reinforcement (62.72) and the lowest for control (50.07). Discipline, control and limits explained 12% of the BMI, while discipline and control explained 6% of the BFP. Greater control is found for obese children (χ²=38.36, p=0.001) and greater reinforcement for underweight children (χ²=7.19, p<0.05). the mothers exert greater control (pressure to eat) over obese children and greater recognition (congratulating due to healthy eating) in underweight children. Modifications in parental strategies are recommended with a view to strengthening healthy eating and physical activity habits.

Effects of infants' birth order, maternal age, and socio-economic status on birth weight.

PubMed

Ghaemmaghami, Seyed J; Nikniaz, Leila; Mahdavi, Reza; Nikniaz, Zeinab; Razmifard, Farzad; Afsharnia, Farzaneh

2013-09-01

To determine the effects of infants' birth order, maternal age, and socioeconomic status (SES) on birth weight. This cross-sectional study included a sample of 858 mothers recruited over a 6-month period in 2010, in a defined population of 9 urban health centers, and who were admitted for their infants' first vaccination. Maternal clinical data, demographic data, and infants' birth weight were obtained from the interview and maternal hospital files. Multiple regression and analysis of variance were used for data analysis. First and fourth births had lower birth weights compared with second and third births in all maternal ages in controlling parity, birth weight increases with maternal age up to the early 24, and then tends to level off. Male gender, maternal age 20-24 years, second and third births had a significant positive effect on birth weight. Lower family economic status and higher educational attainment were significantly associated with lower birth weight. For women in the 15-19 and 40-44 years age groups, the second birth order was associated with the most undesirable effect on birth weight. Accessibility of health care services, parity, maternal age, and socioeconomic factors are strongly associated with infants' birth weight.

A longitudinal analysis of nursing home outcomes.

PubMed

Porell, F; Caro, F G; Silva, A; Monane, M

1998-10-01

To investigate resident and facility attributes associated with long-term care health outcomes in nursing homes. Quarterly Management Minutes Questionnaire (MMQ) survey data for Medicaid case-mix reimbursement of nursing homes in Massachusetts from 1991 to 1994, for specification of outcomes and resident attributes. Facility attributes are specified from cost report data. Multivariate logistic and "state-dependence" regression models are estimated for survival, ADL functional status, incontinence status, and mental status outcomes from longitudinal residence histories of Medicaid residents spanning 3 to 36 months in length. Outcomes are specified to be a function of resident demographic and diagnostic attributes and facility-level operating and nurse staffing attributes. The estimated parameters for resident demographic and diagnostic attributes showed a great deal of construct validity with respect to clinical expectations regarding risk factors for adverse outcomes. Few facility attributes were associated with outcomes generally, and none was significantly associated with all four outcomes. The absence of uniform associations between facility attributes and the various long-term care health outcomes studied suggests that strong facility performance on one health outcome may coexist with much weaker performance on other outcomes. This has implications for the aggregation of individual facility performance measures on multiple outcomes and the development of overall outcome performance measures.

Gis-Based Spatial Statistical Analysis of College Graduates Employment

NASA Astrophysics Data System (ADS)

Tang, R.

2012-07-01

It is urgently necessary to be aware of the distribution and employment status of college graduates for proper allocation of human resources and overall arrangement of strategic industry. This study provides empirical evidence regarding the use of geocoding and spatial analysis in distribution and employment status of college graduates based on the data from 2004-2008 Wuhan Municipal Human Resources and Social Security Bureau, China. Spatio-temporal distribution of employment unit were analyzed with geocoding using ArcGIS software, and the stepwise multiple linear regression method via SPSS software was used to predict the employment and to identify spatially associated enterprise and professionals demand in the future. The results show that the enterprises in Wuhan east lake high and new technology development zone increased dramatically from 2004 to 2008, and tended to distributed southeastward. Furthermore, the models built by statistical analysis suggest that the specialty of graduates major in has an important impact on the number of the employment and the number of graduates engaging in pillar industries. In conclusion, the combination of GIS and statistical analysis which helps to simulate the spatial distribution of the employment status is a potential tool for human resource development research.

The relationship of work stress and family stress to the self-rated health of women employed in the industrial sector in Korea.

PubMed

Kim, Gwang Suk; Cho, Won Jung; Lee, Chung Yul; Marion, Lucy N; Kim, Mi Ja

2005-01-01

To identify the relationship of work stress and family stress to the health of women in Korea. Cross-sectional study. Three hundred and thirty-one married women working in 14 manufacturing companies in Korea. Subjects responded to a questionnaire that included items on work stress, family stress, social support, and general characteristics. Perceived health status (PHS) was assessed with the Short Form-36. There was a significant positive relationship between social support and PHS, but significant negative relationships were found between PHS and work stress as well as family stress. Hierarchical multiple regression analysis explained the health status of married working women by four categories: personal, work related, family related, and social support, and accounted for 45.4% of the variance. When family-related factors were added to the model, the power of explanation was increased by 17.9% compared with the explained variance. Family stress was a major variable not only for explaining the variance but also for correlating with health status. Both work stress and family stress should be considered together when addressing the health of working women in the industrial sector in Korea.

Gender disparities among the association between cumulative family-level stress & adolescent weight status.

PubMed

Hernandez, Daphne C; Pressler, Emily

2015-04-01

To investigate precursors to gender-related obesity disparities by examining multiple family-level stress indices. Analyses was based on adolescents born between 1975 and 1991 to women from the 1979 National Longitudinal Study of Youth data set (N=4762). Three types of family-level stressors were captured from birth to age 15: family disruption and conflict, financial strain, and maternal risky health behaviors, along with a total cumulative risk index. Body mass index was constructed on reference criteria for children outlined by the Centers for Disease Control. Multivariate logistic regressions were conducted for the three types of family stressors and for the total cumulative index. The accumulation of family disruption and conflict and financial stress was positively related to female adolescents being overweight/obese. Childhood exposure to maternal risky health behaviors was positively associated with higher weight status for male adolescents. Total cumulative stress was related to overweight/obesity for females, but not males. Different family-level stress indices are associated with the weight status of female and male adolescents. Combining types of family-level stress into one cumulative index appears to mask these differences. Copyright © 2015 Elsevier Inc. All rights reserved.

Drug dependence, parenting responsibilities, and treatment history: why doesn’t mom go for help?

PubMed Central

McMahon, Thomas J.; Winkel, Justin D.; Suchman, Nancy E.; Luthar, Suniya S.

2012-01-01

Despite longstanding concern that the presence of children deters drug-dependent women from entering treatment, there have been few empirical tests of the relationship between parenting responsibilities and treatment-seeking behavior. In this study, the relationship between number of biological children and treatment history was examined in a cohort of 153 women seeking methadone maintenance treatment. In a standard multiple regression analysis that also allowed for the potential influence of (a) age, (b) education, (c) ethnic minority status, (d) cohabitation with a sexual partner, (e) chronicity of opioid use, and (f) knowledge of HIV infection, there was a significant, negative relationship between number of children and number of earlier contacts for drug abuse treatment. Ethnic minority status and cohabitation with a sexual partner were also associated with fewer earlier contacts; greater chronicity and knowledge of HIV infection were associated with more earlier contacts. Moreover, there was significant moderation of the negative relationship between parenting responsibilities and treatment history by (a) ethnic minority status, (b) cohabitation, and (c) chronicity of use. Within a cross-sectional research design, the findings highlight ways parenting responsibilities may interact with other factors over time to influence the treatment-seeking behavior of drug-dependent women. PMID:11772472