High School Education (high + school_education)

Distribution by Scientific Domains

Selected Abstracts

Alcohol consumption patterns and risk factors among childhood cancer survivors compared to siblings and general population peers

ADDICTION, Issue 7 2008
E. Anne Lown
ABSTRACT Aims This study describes alcohol consumption among adult survivors of pediatric cancer compared to sibling controls and a national sample of healthy peers. Risk factors for heavy drinking among survivors are described. Design, setting and participants Cross-sectional data were utilized from the Childhood Cancer Survivor Study including adult survivors of pediatric cancer (n = 10 398) and a sibling cohort (n = 3034). Comparison data were drawn from the National Alcohol Survey (n = 4774). Measurement Alcohol consumption, demographic, cancer diagnosis, treatment and psychosocial factors were measured. Findings Compared to peers, survivors were slightly less likely to be risky [adjusted odds ratio (ORadj) = 0.9; confidence interval (CI) 0.8,1.0] and heavy drinkers (ORadj = 0.8; CI 0.7,0.9) and more likely to be current drinkers. Compared to siblings, survivors were less likely to be current, risky and heavy drinkers. Risk factors for survivors' heavy drinking included being age 18,21 years (ORadj = 2.0; 95% CI 1.5,2.6), male (ORadj = 2.1; 95% CI 1.8,2.6), having high school education or less (ORadj = 3.4; 95% CI 2.7,4.4) and drinking initiation before age 14 (ORadj = 6.9; 95% CI 4.4,10.8). Among survivors, symptoms of depression, anxiety or somatization, fair or poor self-assessed health, activity limitations and anxiety about cancer were associated with heavy drinking. Cognitively compromising treatment, brain tumors and older age at diagnosis were protective. Conclusions Adult survivors of childhood cancer show only a modest reduction in alcohol consumption compared to peers despite their more vulnerable health status. Distress and poorer health are associated with survivor heavy drinking. Screening for alcohol consumption should be instituted in long-term follow-up care and interventions among survivors and siblings should be established to reduce risk for early drinking. [source]

Patients' perceptions of cultural factors affecting the quality of their medical encounters

Anna M. Nápoles-Springer PhD
Abstract Objective, The aim of this study was to identify key domains of cultural competence from the perspective of ethnically and linguistically diverse patients. Design, The study involved one-time focus groups in community settings with 61 African,Americans, 45 Latinos and 55 non-Latino Whites. Participants' mean age was 48 years, 45% were women, and 47% had less than a high school education. Participants in 19 groups were asked the meaning of ,culture' and what cultural factors influenced the quality of their medical encounters. Each text unit (TU or identifiable continuous verbal utterance) of focus group transcripts was content analysed to identify key dimensions using inductive and deductive methods. The proportion of TUs was calculated for each dimension by ethnic group. Results, Definitions of culture common to all three ethnic groups included value systems (25% of TUs), customs (17%), self-identified ethnicity (15%), nationality (11%) and stereotypes (4%). Factors influencing the quality of medical encounters common to all ethnic groups included sensitivity to complementary/alternative medicine (17%), health insurance-based discrimination (12%), social class-based discrimination (9%), ethnic concordance of physician and patient (8%), and age-based discrimination (4%). Physicians' acceptance of the role of spirtuality (2%) and of family (2%), and ethnicity-based discrimination (11%) were cultural factors specific to non-Whites. Language issues (21%) and immigration status (5%) were Latino-specific factors. Conclusions, Providing quality health care to ethnically diverse patients requires cultural flexibility to elicit and respond to cultural factors in medical encounters. Interventions to reduce disparities in health and health care in the USA need to address cultural factors that affect the quality of medical encounters. [source]

Racial and ethnic disparities in low birth weight delivery associated with maternal occupational characteristics

John D. Meyer MD
Abstract Objectives Work characteristics and maternal education have both been associated with low birth weight (LBW) delivery. We sought to examine the relative contribution of these two factors to LBW delivery and determine whether ethnic/racial differentials in educational attainment and work characteristics might play a role in well-described disparities in LBW. Methods Scores for work substantive complexity (SC) derived from the O*NET were imputed to maternal occupation for Connecticut singleton births in 2000. Risks for LBW were estimated separately for black, Hispanic, and white mothers using logistic regression controlling for maternal covariates. Results Using white mothers as a referent, working is associated with reduced LBW risk in black mothers compared to those not in work (OR 2.06 vs. 3.07). LBW in working black women was strongly associated with less that a high school education (OR 4.80, 95% CI 1.68,13.7), and with low work SC in blacks in those with a college education or greater (OR 4.48, 95% CI 1.24,16.2). Examination of work SC scores, controlling for age and educational level, showed lower values for blacks; increased work SC was seen in Hispanics after adjustment for lower educational attainment. A decrease in risk for LBW was seen in black mothers, compared with whites, as work SC increased. By contrast, college-educated black mothers had a greater risk for LBW than those with high school or some college education. Conclusions Maternal employment and work in a job with greater SC were associated with a reduced risk of LBW in black mothers. Improved LBW risk was also seen with employment in Hispanics. Low work SC in those with higher educational attainment was strongly associated with LBW in blacks, but not whites or Hispanics. Education/work mismatch may play a role in racial disparities in birth outcomes. Am. J. Ind. Med. 53:153,162 2010. © 2009 Wiley-Liss, Inc. [source]

Obesity and Physical Inactivity in Rural America

Paul Daniel Patterson MPH
ABSTRACT: Context and Purpose: Obesity and physical inactivity are common in the United States, but few studies examine this issue within rural populations. The present study uses nationally representative data to study obesity and physical inactivity in rural populations. Methods: Data came from the 1998 National Health Interview Survey Sample Adult and Adult Prevention Module. Self-reported height and weight were used to calculate body mass index. Physical inactivity was defined using self-reported leisure-time physical activity. Analyses included descriptive statistics, x2 tests, and logistic regression. Findings: Obesity was more common among rural (20.4%, 95% CI 19.2%,21.6%) than urban adults (17.8%, 95% CI 17.2%,18.4%). Rural residents of every racial/ethnic group were at higher risk of obesity than urban whites, other factors held equal. Other predictors of obesity included being male, age 25,74, lacking a high school diploma, having physical limitations, fair to poor health, and a history of smoking. Proportionately more rural adults were physically inactive than their urban peers (62.8% versus 59.3%). Among rural residents, minorities were not significantly more likely to be inactive than whites. Males and younger adults were less likely to be inactive. Rural adults who were from the Midwest and South, had less than a high school education, had fair to poor health, and currently smoked were more likely to be inactive compared to their respective referent group. Conclusions: The high prevalence of obesity and inactive lifestyles among rural populations call for research into effective rural interventions. [source]

Prevalence and Correlates of Erectile Dysfunction by Race and Ethnicity Among Men Aged 40 or Older in the United States: From the Male Attitudes Regarding Sexual Health Survey

Edward O. Laumann PhD
ABSTRACT Introduction., Most U.S. population-based estimates of erectile dysfunction (ED) prevalence restricted upper age, were not nationally representative, or underrepresented minority groups. Aim., To estimate, by race/ethnicity in the United States, the prevalence of ED and the impact of sociodemographic, health, relationship, psychological, and lifestyle variables. Methods., This cross-sectional, population-based, nationally representative probability survey conducted between May 2001 and January 2002 in the general community setting facilitated equivalent representation among U.S. non-Hispanic white (N = 901), non-Hispanic black (N = 596), and Hispanic (N = 676) men aged 40 and older by using targeted phone lists to oversample the minority populations. Main Outcome Measure., Estimated prevalence of moderate or severe ED, defined as a response of "sometimes" or "never" to the question "How would you describe your ability to get and keep an erection adequate for satisfactory intercourse?" Results., The estimated prevalence was 22.0% (95% confidence interval [CI], 19.4,24.6) overall, 21.9% (95% CI, 18.8,24.9) in whites, 24.4% (95% CI, 18.4,30.5) in blacks, and 19.9% (95% CI, 13.9,25.9) in Hispanics, and increased with increasing age. The odds ratio increased with increasing age. Probability also increased with diabetes, hypertension, and moderate or severe lower urinary tract symptoms (LUTS) overall; age ,70 years and diabetes in whites; severe LUTS in blacks; and age ,60 years, moderate LUTS, hypertension, and depression in Hispanics. It decreased with exercise and college vs. less than high school education overall; with exercise, good relationship quality, and according to alcohol intake in blacks; and with high school or college education in Hispanics. Conclusions., The odds of ED increased with increasing age across race/ethnicity when controlling for sociodemographic, health, relationship, psychological, and lifestyle variables. These initial analyses suggest further study of the interrelationships among risk factors for ED. Laumann EO, West S, Glasser D, Carson C, Rosen R, and Kang J-H. Prevalence and correlates of erectile dysfunction by race and ethnicity among men aged 40 or older in the United States: From the Male Attitudes Regarding Sexual Health survey. J Sex Med 2007;4:57,65. [source]

Socio-economic status and survival from breast cancer for young, Australian, urban women

Katherine I. Morley
Abstract Objective: To estimate the association between measures of socio-economic status (SES) and breast cancer (BC) survival for young, urban Australian women. Methods: We used a population-based sample of 1,029 women followed prospectively for a median of 7.9 years. SES was defined by education and area of residence. Hazard ratios (HRs) associated with SES measures were estimated for (i) distant recurrence (DR) and (ii) all-cause mortality as end-points. Results: HRs for area of residence were not significantly different from unity, with or without adjustment for age at diagnosis and education level. The univariable HR estimate of DR for women with university education compared with women with incomplete high school education was 1.51 (95% CI = 1.08 , 2.13, p = 0.02), which reduced to 1.20 (95% CI = 0.85 , 1.72, p = 0.3) after adjusting for age at diagnosis and area of residence. Adjusting for prognostic factors differentially distributed across SES groups did not substantially alter the association between survival and SES. Conclusions: Among young, urban Australian women there is no association between SES and BC survival. Implications: This lack of estimates of association may be partly attributed to universal access to adequate breast cancer care in urban areas. [source]

Multicenter Study of Preferences for Health Education in the Emergency Department Population

M. Kit Delgado MD
Abstract Objectives:, Emergency departments (EDs) are increasingly proposed as high-yield venues for providing preventive health education to a population at risk for unhealthy behaviors and unmet primary care needs. This study sought to determine the preferred health education topics and teaching modality among ED patients and visitors. Methods:, For two 24-hour periods, patients aged 18 years and older presenting to four Boston EDs were consecutively enrolled, and waiting room visitors were surveyed every 3 hours. The survey assessed interest in 28 health conditions and topics, which were further classified into nine composite health education categories. Also assessed was the participants' preferred teaching modality. Results:, Among 1,321 eligible subjects, 1,010 (76%) completed the survey, of whom 56% were patients and 44% were visitors. Among the health conditions, respondents were most interested in learning about stress and depression (32%). Among the health topics, respondents were most interested in exercise and nutrition (43%). With regard to learning modality, 34% of subjects chose brochures/book, 25% video, 24% speaking with an expert, 14% using a computer, and 3% another mode of learning (e.g., a class). Speaking with an expert was the overall preferred modality for those with less than high school education and Hispanics, as well as those interested in HIV screening, youth violence, and stroke. Video was the preferred modality for those interested in learning more about depression, alcohol, drugs, firearm safety, and smoke detectors. Conclusions:, Emergency department patients and visitors were most interested in health education on stress, depression, exercise, and nutrition, compared to topics more commonly targeted to the ED population such as substance abuse, sexual health (including HIV testing), and injury prevention. Despite many recent innovations in health education, most ED patients and visitors in our study preferred the traditional form of books and brochures. Future ED health education efforts may be optimized by taking into account the learning preferences of the target ED population. ACADEMIC EMERGENCY MEDICINE 2010; 17:652,658 © 2010 by the Society for Academic Emergency Medicine [source]

A hidden periodontitis epidemic during the 20th century?

P. P. Hujoel
Abstract , Objectives: Increasing evidence suggests a strong causal link between smoking and periodontitis. The goal of this study was to impute how the secular changes in smoking prevalence during the 20th century impacted the advanced periodontitis incidence in the US. Methods: Epidemiological analyses based on US prevalence data of advanced periodontitis and smoking, and predictions of future smoking prevalence. Results: Assuming other risk factors for periodontitis remained constant, we estimated that the incidence of advanced periodontitis decreased by 31% between 1955 and 2000. The changes in smoking habits, and consequently the changes in periodontitis incidence, depended strongly on education and gender. Between 1966 and 1998, we estimated a 43% decreased periodontitis incidence among college-educated individuals versus only an 8% decrease among individuals with less than a high school education. Between 1955 and 1999, we estimated a 41% decrease among males versus a 14% decrease among females. By the year 2020, the incidence of advanced periodontitis may decrease 43% from its level in 1955. Conclusions: A periodontitis epidemic fueled by smoking remained hidden for most of the 20th century. Because this epidemic was hidden, it distorted our understanding of the treatment and etiology of periodontitis. The socioeconomic polarization of this epidemic will dictate alterations in patterns of periodontal care. [source]