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Seniors
Terms modified by Seniors Selected AbstractsThe Neuropsychological Impairment Scale,Senior: A procedure for evaluating awareness disturbance in geriatric patientsJOURNAL OF CLINICAL PSYCHOLOGY, Issue 3 2001William E. O'Donnell The Neuropsychological Impairment Scale,Senior (NIS-S) is a 30-item, orally administered questionnaire for geriatric patients about symptoms of cognitive impairment, affective disturbance, and defensiveness. Clinical and nonclinical norms are described along with validity and reliability information. A procedure is presented for comparing a patient's self-reported cognitive impairment with scores on performance testing, which gauges whether the patient is over- or under-reporting cognitive deficits. © 2001 John Wiley & Sons, Inc. J Clin Psychol 57: 423,427, 2001. [source] Phenolic compounds, lycopene and antioxidant activity in commercial varieties of tomato (Lycopersicum esculentum)JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE, Issue 3 2002Isabel Martínez-Valverde Abstract Nine commercial varieties of tomato (Rambo, Senior, Ramillete, Liso, Pera, Canario, Durina, Daniella and Remate) produced in Spain were analysed for their lycopene content, content of phenolic compounds and antioxidant capacity. The phenolic compounds were characterised as flavonoids (quercetin, kaempferol and naringenin) and hydroxycinnamic acids (caffeic, chlorogenic, ferulic and p -coumaric acids). Antioxidant activity was measured using the DPPH and ABTS assays. The concentrations of lycopene and the various phenolic compounds as well as the antioxidant activity were significantly influenced by the tomato variety. Quercetin, the most abundant flavonoid, was found in concentrations ranging between 7.19 and 43.59,mg,kg,1 fresh weight, while naringenin levels were lower than 12.55,mg,kg,1. The most abundant hydroxycinnamic acid was chlorogenic acid, with values ranging from 14 to 32,mg,kg,1 fresh weight, followed by caffeic acid, while p -coumaric and ferulic acids showed similar concentrations lower than 5,mg,kg,1. The highest content of lycopene was found in Ramillete, Pera and Durina (>50,mg,kg,1 fresh weight), while the concentration in the other varieties was between 50 and 30,mg,kg,1, with the exception of Liso (less than 20,mg,kg,1). The antioxidant activity of tomato extracts varied with the tomato variety and the assay method used. Individual compounds found to be significantly related to antioxidant capacity were lycopene and ferulic and caffeic acids, but not quercetin and chlorogenic acid. © 2002 Society of Chemical Industry [source] Senior,Loken syndrome associated with mental retardation and microcephalyPEDIATRICS INTERNATIONAL, Issue 3 2001Hiroshi Tanaka No abstract is available for this article. [source] Howard's End: The Unravelling of a Government by Peter van Onselen and Philip SeniorAUSTRALIAN JOURNAL OF PUBLIC ADMINISTRATION, Issue 4 2008Paul Williams No abstract is available for this article. [source] Comparative Cognitive Effects of Carbamazepine and Gabapentin in Healthy Senior AdultsEPILEPSIA, Issue 6 2001Roy Martin Summary: ,Purpose: This study compared the cognitive effects of carbamazepine (CBZ) and gabapentin (GBP) in healthy senior adults by using a randomized, double-blind crossover design. Methods: Thirty-four senior adults were randomized to receive one of the two drugs followed by a 5-week treatment period. A 4-week washout phase preceded initiation of the second drug. Antiepileptic drugs (AEDs) were titrated to target doses of either CBZ (800 mg/day) or GBP (2,400 mg/day). Primary outcome measures were standardized neuropsychological tests of attention/vigilance, psychomotor speed, motor speed, verbal and visual memory, and the Profile of Mood State (POMS), yielding a total of 17 variables. Each subject received cognitive testing at predrug baseline, end of first drug phase, end of second drug phase, and 4 weeks after completion of the second drug phase. Results: Fifteen senior adults (mean age, 66.5 years; range, 59,76 years) completed the study. Seniors completing the study did not differ significantly from noncompleting seniors in terms of demographic features or baseline cognitive performances. Fifteen of the 19 seniors not completing the study dropped out while receiving CBZ. Adverse events were frequently reported for both AEDs, although they were more common for CBZ. Mean serum levels for the completers were within midrange clinical doses (CBZ, 6.8 ,g/ml; GBP, 7.1 ,g/ml). Significant differences between CBZ and GBP were found for only one of 11 cognitive variables, with better attention/vigilance for GBP, although the effect was modest. Performances on the nondrug average were significantly better on 45% of cognitive variables compared with CBZ and 36% compared with GBP. The overall pattern of means favored GBP over CBZ on 15 of 17 (p < 0.001), nondrug over CBZ on 17 of 17 (p < 0.0000), and nondrug over GBP on eight of 17 (NS). Conclusions: Mild cognitive effects were found for both AEDs compared with the nondrug average condition. The magnitude of difference between the two AEDs across the cognitive variables was modest. Self-reported mood was not significantly affected by either AED. However, overall tolerability and side-effect profile of CBZ were poorer than those of GBP in senior adults at doses and titration rates reported in this study. [source] Activating Seniors to Improve Chronic Disease Care: Results from a Pilot Intervention StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2010Dominick L. Frosch PhD OBJECTIVES: To evaluate the effect of an activation intervention delivered in community senior centers to improve health outcomes for chronic diseases that disproportionately affect older adults. DESIGN: Two-group quasi-experimental study. SETTING: Two Los Angeles community senior centers. PARTICIPANTS: One hundred sixteen senior participants. INTERVENTION: Participants were invited to attend group screenings of video programs intended to inform about and motivate self-management of chronic conditions common in seniors. Moderated discussions reinforcing active patient participation in chronic disease management followed screenings. Screenings were scheduled over the course of 12 weeks. MEASUREMENTS: One center was assigned by coin toss to an encouragement condition in which participants received a $50 gift card if they attended at least three group screenings. Participants in the nonencouraged center received no incentive for attendance. Validated study measures for patient activation, physical activity, and health-related quality of life were completed at baseline and 12 weeks and 6 months after enrollment. RESULTS: Participants attending the encouraged senior center were more likely to attend three or more group screenings (77.8% vs 47.2%, P=.001). At 6-month follow-up, participants from either center who attended three or more group screenings (n=74, 64%) reported significantly greater activation (P<.001), more minutes walking (P<.001) and engaging in vigorous physical activity (P=.006), and better health-related quality of life (Medical Outcomes Study 12-item Short-Form Survey (SF-12) mental component summary, P<.001; SF-12 physical component summary, P=.002). CONCLUSION: Delivering this pilot intervention in community senior centers is a potentially promising approach to activating seniors that warrants further investigation for improving chronic disease outcomes. [source] Comparisons of Self-Reported and Chart-Identified Chronic Diseases in Inner-City SeniorsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 7 2009John Leikauf BA OBJECTIVES: To examine agreement between self-report of chronic disease and medical record data for inner-city seniors, their sensitivity and specificity, and the association between patient characteristics and accuracy of self-reports. DESIGN: Cross-sectional analysis. SETTING: Two hospital-based primary care practices serving a low-income inner-city population. PARTICIPANTS: Adults aged 65 and older (n=323). MEASURES: Data on self-reported asthma, depression, diabetes mellitus, and hypertension were collected through interviewer-administered surveys (in English and Spanish) and chart abstraction. Chart-based disease was defined in two ways: physician documentation and physician documentation plus use of a medication to treat that condition. Sensitivity, specificity, and agreement were calculated. Univariate and multivariable regression analyses were used to determine the associations between patient characteristics and patient,chart agreement. RESULTS: Agreement between self-report and chart data was high for diabetes mellitus (kappa=0.94) intermediate for asthma (kappa=0.66), and hypertension (kappa=0.54) and low for depression (kappa=0.4). Sensitivity and specificity were high for diabetes mellitus (0.99 and 0.96, respectively) and low for depression (0.74 and 0.72, respectively). Specificity for hypertension was lowest (0.67). Age, education, health literacy, and other patient characteristics did not have clear associations across conditions. CONCLUSION: Self-reports may be most reliable for diabetes mellitus and least reliable for depression for surveys involving older, inner-city adults. Survey research with older adults should include confirmatory data when assessing presence of depression, hypertension, and asthma. [source] Energy-Containing Nutritional Supplements Can Affect Usual Energy Intake Postsupplementation in Institutionalized Seniors with Probable Alzheimer's DiseaseJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2006Matthew D. Parrott BSc OBJECTIVES: To determine whether increases in caloric intake associated with consumption of a mid-morning nutritional supplement for 3 weeks were maintained in the week after stopping the supplement and to investigate the effects of body mass index (BMI) and cognitive and behavioral measures on this response. DESIGN: Secondary analysis of a previously published randomized, crossover, nonblinded clinical trial. SETTING: A fully accredited geriatric care facility affiliated with the University of Toronto. PARTICIPANTS: Thirty institutionalized seniors with probable Alzheimer's disease (AD) who ate independently. MEASUREMENTS: Investigator-weighed food intake, body weight, cognitive (Severe Impairment Battery; Global Deterioration Scale) and behavioral (Neuropsychiatric Inventory,Nursing Home version; London Psychogeriatric Rating Scale) assessments. RESULTS: Individuals who responded successfully to supplementation as indicated by increases in daily energy intake were likely to maintain 58.8% of that increase postsupplementation, although stopping the supplement was associated with decreased habitual energy intake in low-BMI individuals who reduced their daily intakes during supplementation in response to the extra calories. Cognitive/behavioral tests were not reliable predictors of postsupplement intake. CONCLUSION: Institutionalized seniors with probable AD are likely to alter their usual energy intakes to maintain changes resulting from 3 weeks of supplementation. This effect may allow for rotating supplementation schedules in nursing homes that could reduce staff burden, but only for those individuals who are most likely to respond favorably. These data indicate that nutritional supplements and diet plans should be carefully prescribed in low-BMI individuals to limit variability in total energy provided and thus prevent lower-than-normal intake. [source] Providing Nutrition Supplements to Institutionalized Seniors with Probable Alzheimer's Disease Is Least Beneficial to Those with Low Body Weight StatusJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2004Karen W. H. Young MSc Objectives: To examine whether providing a midmorning nutrition supplement increases habitual energy intake in seniors with probable Alzheimer's disease (AD) and to investigate the effects of body weight status and cognitive and behavioral function on the response to the intervention. Design: Randomized, crossover, nonblinded clinical trial. Setting: A fully accredited geriatric teaching facility affiliated with the University of Toronto's Medical School with a home for the aged. Participants: Thirty-four institutionalized seniors with probable AD who ate independently. Intervention: Nutrition supplements were provided between breakfast and lunch for 21 consecutive days and compared with 21 consecutive days of habitual intake. Measurements: Investigator-weighed food intake, body weight, cognitive function (Severe Impairment Battery and Global Deterioration Scale), behavioral disturbances (Neuropsychiatric Inventory,Nursing Home Version), and behavioral function (London Psychogeriatric Rating Scale). Results: Relative to habitual intake, group mean analyses showed increased 24-hour energy, protein, and carbohydrate intake during the supplement phase, but five of 31 subjects who finished all study phases completely compensated for the energy provided by the supplement by reducing lunch intake, and 24-hour energy intake was enhanced in only 21 of 31 subjects. Compensation at lunch was more likely in subjects with lower body mass indices, increased aberrant motor behavior, poorer attention, and increased mental disorganization/confusion. Conclusion: Nutrition supplements were least likely to enhance habitual energy intake in subjects who would normally be targeted for nutrition intervention,those with low body weight status. Those likely to benefit include those with higher body mass indices, less aberrant motor problems, less mental disorganization, and increased attention. [source] The Identification of Seniors At Risk Screening Tool: Further Evidence of Concurrent and Predictive ValidityJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2004Nandini Dendukuri PhD Objectives: To evaluate the validity of the Identification of Seniors at Risk (ISAR) screening tool for detecting severe functional impairment and depression and predicting increased depressive symptoms and increased utilization of health services. Setting: Four university-affiliated hospitals in Montreal. Design: Data from two previous studies were available: Study 1, in which the ISAR scale was developed (n=1,122), and Study 2, in which it was used to identify patients for a randomized trial of a nursing intervention (n=1,889 with administrative data, of which 520 also had clinical data). Participants: Patients aged 65 and older who were to be released from an emergency department (ED). Measurements: Baseline validation criteria included premorbid functional status in both studies and depression in Study 2 only. Increase in depressive symptoms at 4-month follow-up was assessed in Study 2. Information on health services utilization during the 5 months after the ED visit (repeat ED visits and hospitalization in both studies, visits to community health centers in Study 2) was available by linkage with administrative databases. Results: Estimates of the area under the receiver operating characteristic curve (AUC) for concurrent validity of the ISAR scale for severe functional impairment and depression ranged from 0.65 to 0.86. Estimates of the AUC for predictive validity for increased depressive symptoms and high utilization of health services ranged from 0.61 to 0.71. Conclusion: The ISAR scale has acceptable to excellent concurrent and predictive validity for a variety of outcomes, including clinical measures and utilization of health services. [source] Consistency of Breakfast Consumption in Institutionalized Seniors with Cognitive Impairment: Its Value and Use in Feeding ProgramsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 4 2001Sarah Dyer MSc No abstract is available for this article. [source] Elders' perceptions of formal and informal care: aspects of getting and receiving help for their activities of daily livingJOURNAL OF CLINICAL NURSING, Issue 3 2001Brenda Roe PhD, FRSH ,,A purposive and convenience sample of 16 women and four men receiving informal and formal care for their activities of daily living either at home or institutions in Southeast Washington, USA was interviewed. ,,Qualitative findings related to asking for help, getting and receiving help, interpersonal aspects of receiving help, and met and unmet needs are reported. ,,Some seniors found it more difficult to ask for and accept help and there were gender differences, with men tending to adopt a more logical and pragmatic approach while women viewed receiving help as a loss of independence and an invasion of privacy. Intimacy and nudity were also threats for women. ,,Three styles of adjustment and acceptance were identified within the data and related to positive acceptance, resigned acceptance and passive acceptance. ,,There appeared to be a relationship between independence and control, with elders losing some independence but retaining control through choice, payment and involvement in decision making. ,,Reciprocity was found to bring added value to relationships between care providers and elders, with a rhythm and symmetry developing in relationships where needs were known, anticipated and met. ,,Seniors should be encouraged to plan for their future and to find out about local help and services available to them in advance of their requiring any assistance. [source] Prevalence of Pervasive Developmental Disorders in Two Canadian ProvincesJOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES, Issue 3 2006Hélène Ouellette-Kuntz Abstract, Although it is generally accepted that the proportion of children diagnosed with pervasive developmental disorders (PDDs) has increased in the past two decades, there is no consensus on the prevalence of these conditions. The accompanying large rise in demand for services, together with uncertainty regarding the extent to which the observed increases are due to a true change in risk, has made PDDs a major public health concern. As few data exist on the prevalence of PDDs in Canada, the aim of this study was to estimate the prevalence of diagnosed PDDs in two Canadian provinces (Manitoba and Prince Edward Island (PEI)) and compare characteristics of diagnosed cases between the two regions. To obtain the estimates, children under the age of 15 years with a PDD diagnosis who lived in either province in 2002 were identified by workers at Children's Special Services, a provincial government program that supports children with special needs in Manitoba, and by the PEI provincial early intervention coordinator (Department of Social Services and Seniors) and special education autism coordinator (Department of Education). The findings show that the prevalence among children 1,14 years of age was 28.4 per 10,000 (95% confidence interval: 26.1,30.8) in Manitoba and 35.2 per 10,000 (95% confidence interval: 28.2,43.4) in PEI. In Manitoba, children of aboriginal identity with PDDs (8.3%) were significantly underrepresented compared with the general population of aboriginal children living off native reserves (15.6%). Sex ratio, sibling risk, and age at initial diagnosis were similar in the two provinces. These findings can serve as a baseline from which to monitor the prevalence of these conditions over time, providing valuable data for researchers, planners, and service providers. [source] Using the chronic care model to tackle depression among older adults who have long-term physical conditionsJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 3 2007P. MCEVOY phd bsc Effective psychological and pharmacological treatments are available, but for depressed older adults with long-term physical conditions, the outcome of routine care is generally poor. This paper introduces the chronic care model, a systemic approach to quality improvement and service redesign, which was developed by Ed Wagner and colleagues. The model highlights six key areas that need to be addressed, if depression is to be tackled more effectively in this neglected patient group: delivery system design, patient,provider relationships, decision support, clinical information systems, community resources and healthcare organization. Three influential programmes, the Improving Mood Promoting Access to Collaborative Treatment programme, the Prevention of Suicide in Primary Care Elderly Collaborative Trial, and the Program to Encourage Active, and Rewarding Lives for Seniors, have shown that when the model is adopted, significant improvements in outcomes can be achieved. The paper concludes with a case study, which illustrates the difference that adopting the chronic care model can make. Radical changes in working practices may be required, to implement the model in practice. However, Greg Simon, a leading researcher in the field of depression care, has suggested that there is already sufficient evidence to justify a shift in emphasis from research towards dissemination and implementation. [source] Dental Health Differences by Social Class in Home-Dwelling Seniors of Barcelona, SpainJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 4 2006Vladimir Pizarro DDS Abstract Background:The aim of this study was to assess dental health differences by social class in home-dwelling seniors in Spain. Methods:A cross-sectional household survey of a cohort of senior residents in Barcelona (Spain) was undertaken. Of 891 survivors (72 years or older), 561 (62.9%) oral examinations were completed according to the DMF Index (Decayed, Missing and Filled teeth). Results:42% of participants were edentate. The individuals of social class IV-V were more likely to be edentate, and to have fewer than 15 teeth compared to those in social class I-II. The DMF Index in dentate individuals (Adjusted mean=16.4) also showed significantly worse dental health for lower social classes (p = 0.001). Conclusions:The results of this study indicate a different level of utilization of dental health services and dental health by social class in home-dwelling seniors. Further research is needed to understand the barriers of access and social inequality. [source] Older age and liver transplantation: A reviewLIVER TRANSPLANTATION, Issue 8 2004Rajesh N. Keswani Patients older than 60 are undergoing transplantation with increasing frequency. Reports from several transplant centers document that overall short-term patient survival rates in seniors undergoing liver transplantation are comparable to survival rates of younger adults. However, specific subgroups of older patients may not fare as well. Seniors with far-advanced end-stage liver disease are high-risk for liver transplantation and have poor survival rates. In addition, seniors older than 65 have worse outcomes than those who are 60 to 65, and studies have shown increased mortality with increasing age as a continuous variable. On the other hand, the majority of seniors who survive liver transplantation have full or only minimally limited functional status. Preoperative evaluation of older patients for transplantation requires careful screening to exclude cardiopulmonary disease, malignancy, and other diseases of the aged. Paradoxically, seniors may benefit from a senescent immune system, which results in decreased requirements for immunosuppressive drugs, and possibly a lower rate of acute allograft rejection. Despite good overall short-term survival in the elderly, long-term survival may be worse because of an increased rate of long-term complications, such as malignancy and heart disease. In conclusion, although advanced age is a negative risk factor, advanced age alone should not exclude a patient from liver transplantation; however, it mandates thorough pretransplant evaluation and careful long-term follow-up with attention to usual health maintenance issues in the elderly. (Liver Transpl 2004;10:957,967.) [source] Epidemiology of Voice Disorders in the Elderly: Preliminary FindingsTHE LARYNGOSCOPE, Issue 4 2007Nelson Roy PhD Abstract Objectives: Epidemiologic studies of the prevalence and risk factors of voice disorders in the elderly, nontreatment seeking population are nonexistent. The purpose of this preliminary investigation was to 1) estimate the prevalence of voice disorders, 2) identify variables associated with increased risk of voice disorders, and 3) measure the socioemotional impact of voice disorders on the elderly who live independently. Study Design: Prospective, cross-sectional survey. Methods: One hundred seventeen seniors (39 males and 78 females; mean age, 76.1 yr; SD, 8.5 yr; range, 65,94 yr), residing in Utah and Kentucky, were interviewed using a questionnaire that addressed three areas related to voice disorders: prevalence, potential risk factors, and socioemotional consequences/effects. Results: The lifetime prevalence of a voice disorder was 47%, with 29.1% of participants reporting a current voice disorder. The majority of respondents (60%) reported chronic voice problems persisting for at least 4 weeks. Seniors who had experienced esophageal reflux, severe neck/back injury, and chronic pain were at increased risk. Voice-related effort and discomfort, combined with increased anxiety and frustration and the need to repeat oneself, were specific areas that adversely affected quality of life. Conclusions: This preliminary epidemiologic study confirmed that voice disorders are common among the elderly, and further research is needed to identify additional risk factors contributing to voice disorder vulnerability. [source] Framing U.S. Redistributive Policies: Tough Love for Poor Women and Tax Cuts for SeniorsANALYSES OF SOCIAL ISSUES & PUBLIC POLICY, Issue 1 2009Wendy M. Limbert In recent years, income inequality in the U.S. has risen to historically high levels. Redistributive policies that differentially benefit lower- versus upper-income households play a significant role in the widening economic gap. A discourse analysis of 284 articles from five major U.S. newspapers was conducted to examine dominant media framing of the Bush administration's welfare reauthorization proposal and the 2003 dividend tax cuts. Guided by critical theory (Delgado & Stefancic, 2001;,Wing, 1997), we found that dominant issue frames favored reduced support for progressive welfare policies and increased support for tax cuts. Implications for pursuing an economic justice agenda are discussed. [source] Social Capital and the Care Networks of Frail SeniorsCANADIAN REVIEW OF SOCIOLOGY/REVUE CANADIENNE DE SOCIOLOGIE, Issue 4 2009NORAH KEATING Le capital social a constitué un cadre important pour la conceptualisation de la place des liens sociaux dans la qualité de vie. La famille n'a pas fait partie des groupes d'intérêts dans les recherches sur le capital social. Néanmoins, dans le contexte de la recherche et de la politique publique sur le vieillissement, le discours contemporain sur les familles et sur les soins est congruent avec les hypothèses sur le capital social. Les auteurs s'inspirent de la documentation sur le capital social pour encadrer leur compréhension du capital social inhérent aux familles ayant des personnes âgées de santé fragile. Ils émettent l'hypothèse de leur capacité de bénéficier des soins des membres de la famille. Les données proviennent de l'Enquête sociale générale sur le vieillissement et le soutien social (ESG 2002) de Statistique Canada. Social capital has been a key framework in conceptualizing the place of social ties in quality of life. Families have not been among groups of interest in social capital research. Yet within the context of research and public policy on aging, the contemporary discourse on families and care is congruent with social capital assumptions. In this paper, we draw on social capital literature to frame our understanding of the social capital inherent in families of frail older adults, and hypothesize their abilities to benefit family members. Data are drawn from Statistics Canada 2002 General Social Survey on Aging and Social Support. [source] Atherosclerosis measured by whole body magnetic resonance angiography and carotid artery ultrasound is related to arterial compliance, but not to endothelium-dependent vasodilation , the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) studyCLINICAL PHYSIOLOGY AND FUNCTIONAL IMAGING, Issue 5 2009Lars Lind Summary Background:, Arterial compliance and endothelium-dependent vasodilation are two characteristics of the vessel wall. In the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study, we studied the relationships between arterial compliance and endothelium-dependent vasodilation versus atherosclerosis as measured with two imaging modalities. Methods:, In the population-based PIVUS study (1016 subjects aged 70), arterial compliance was determined by ultrasound in the carotid artery and the stroke volume to pulse pressure ratio by echocardiography, while endothelium-dependent vasodilation was assessed by the invasive forearm technique with acetylcholine and brachial artery ultrasound. Intima-media thickness was evaluated by ultrasound in the carotid artery (n = 954). Stenosis in the carotid, aorta, renal, upper and lower leg arteries were determined by magnetic resonance angiography in a random subsample of 306 subjects. Results:, After adjustments for gender, Framingham risk score, obesity, myocardial infarction and stroke, distensibility in the carotid artery and the stroke volume to pulse pressure ratio were both significantly related to a weighted index of stenosis in the five arterial territories evaluated by magnetic resonance angiography (p<0·02 for both). Distensibility in the carotid artery (P = 0·021), but not the stroke volume to pulse pressure ratio (P = 0·08), was also significantly related to intima-media thickness. Conclusion:, In the elderly population, atherosclerosis is mainly related to arterial compliance, but not to endothelium-dependent vasodilation in peripheral conduit or resistance vessels. [source] Production Efficiency and the Pricing of Audit Services,CONTEMPORARY ACCOUNTING RESEARCH, Issue 1 2003Nicholas Dopuch Abstract In this paper, we examine the relative efficiency of audit production by one of the then Big 6 public accounting firms for a sample of 247 geographically dispersed audits of U.S. companies performed in 1989. To test the relative efficiency of audit production, we use both stochastic frontier estimation (SFE) and data envelopment analysis (DEA). A feature of our research is that we also test whether any apparent inefficiencies in production, identified using SFE and DEA, are correlated with audit pricing. That is, do apparent inefficiencies cause the public accounting firm to reduce its unit price (billing rate) per hour of labor utilized on an engagement? With respect to results, we do not find any evidence of relative (within-sample) inefficiencies in the use of partner, manager, senior, or staff labor hours using SFE. This suggests that the SFE model may not be sufficiently powerful to detect inefficiencies, even with our reasonably large sample size. However, we do find apparent inefficiencies using the DEA model. Audits range from about 74 percent to 100 percent relative efficiency in production, while the average audit is produced at about an 88 percent efficiency level, relative to the most efficient audits in the sample. Moreover, the inefficiencies identified using DEA are correlated with the firm's realization rate. That is, average billing rates per hour fall as the amount of inefficiency increases. Our results suggest that there are moderate inefficiencies in the production of many of the subject public accounting firm's audits, and that such inefficiencies are economically costly to the firm. [source] Addiction research centres and the nurturing of creativity: Centre for Social Research on Alcohol and Drugs (SoRAD), Stockholm University, SwedenADDICTION, Issue 3 2010Kerstin Stenius ABSTRACT The Centre for Social Research on Alcohol and Drugs (SoRAD) was established as a national research centre and department within the Faculty of Social Science at Stockholm University in 1997, following a Government Report and with the aim to strengthen social alcohol and drug research. Initially, core funding came from the Swedish Council for Working Life and Social Research and from the Ministry of Health and Social Affairs for several long-term projects. Today, SoRAD, with 25 senior and junior researchers, has core funding from the university but most of its funding comes from external national and international grants. Research is organized under three themes: consumption, problems and norms, alcohol and drug policy and societal reactions, treatment and recovery processes. SoRADs scientific approach, multi-disciplinarity, a mix of qualitative and quantitative methods and international comparisons was established by the centre's first leader, Robin Room. Regular internal seminars are held and young researchers are encouraged to attend scientific meetings and take part in collaborative projects. SoRAD researchers produce government-funded monthly statistics on alcohol consumption and purchase, and take part in various national government committees, but SoRADs research has no clear political or bureaucratic constraints. One of the future challenges for SoRAD will be the proposed system for university grants allocation, where applied social science will have difficulties competing with basic biomedical research if decisions are based on publication and citation measures. [source] Young managers' interpersonal stress and its relationship to management development practices: an exploratory studyINTERNATIONAL JOURNAL OF TRAINING AND DEVELOPMENT, Issue 1 2009Jin-Feng Uen This exploratory study investigates whether there is a relationship between young managers' interpersonal stress and various management development practices. In recent years, practitioners and researchers have focused on stress studies and related practices in the workplace. However, stress encountered by young managers has received less attention. We examine possible sources of young managers' interpersonal stress and develop a scale through exploratory factor analysis. Participants are less than 35 years old, mainly from the financial, high-tech and service industries in Taiwan. Organizational managerial development practices are discussed to understand their relevance to young managers' interpersonal stress. The results suggest that the more opportunities young managers have to make decisions, the more their opinions will differ from those of their middle-aged fellow managers and senior subordinates. However, organizations with formal assessment may lessen disagreements with middle-aged fellow managers. Future studies regarding young managers' interpersonal stress can be carried out using this scale and can explore whether other, specific organizational management development practices are related to lower stress levels among young managers. [source] Evidence-based practice-focused interactive teaching strategy: a controlled studyJOURNAL OF ADVANCED NURSING, Issue 6 2009Son C. Kim Abstract Title.,Evidence-based practice-focused interactive teaching strategy: a controlled study. Aim., This paper is a report of a study to evaluate the effectiveness of the evidence-based practice (EBP)-focused interactive teaching (E-FIT) strategy. Background., Although EBP is a mandatory competency for all healthcare professionals, little is known about the effectiveness of E-FIT in nursing. Methods., A quasi-experimental, controlled, pre- and post-test study involving senior, 4th-year nursing students (N = 208) at two nursing schools in the USA was carried out from August 2007 to May 2008. The experimental group (n = 88) received the E-FIT strategy intervention and the control group (n = 120) received standard teaching. A Knowledge, Attitudes and Behaviors Questionnaire for Evidence-Based Practice was used to assess the effectiveness of the E-FIT strategy. Results., Independent t -tests showed that the experimental group had statistically significant higher post-test Evidence-Based Practice Knowledge (mean difference = 0·25; P = 0·001) and Evidence-Based Practice Use (mean difference = 0·26; P = 0·015) subscale scores compared to the control group, but showed no statistically significant differences in Attitudes toward Evidence-Based Practice and Future Use of Evidence-Based Practice (mean difference = ,0·12; P = 0·398 and mean difference = 0·13; P = 0·255 respectively). Hierarchical multiple regression analyses of the post-test data indicated that the intervention explained 7·6% and 5·1% of variance in Evidence-Based Practice Knowledge and Evidence-Based Practice Use respectively. Conclusion., The EBP-focused interactive teaching strategy was effective in improving the knowledge and use of EBP among nursing students but not attitudes toward or future use of EBP. [source] Managing An Organizational Learning System By Aligning Stocks and FlowsJOURNAL OF MANAGEMENT STUDIES, Issue 4 2002Nick Bontis This paper considers the relationship between the stocks and flows of learning across levels in an overall organizational learning system. A survey instrument based on the Strategic Learning Assessment Map (SLAM) was administered to 15 individuals representing senior-, middle- and non-management levels from each of 32 organizations, resulting in a total sample of 480 respondents. This research supports the premise that there is a positive relationship between the stocks of learning at all levels and business performance. Furthermore, the proposition that the misalignment of stocks and flows in an overall organizational learning system is negatively associated with business performance is also supported. [source] Dual Diagnosis: Prevalence, Risk Factors, and Relationship With Suicide Risk in a Nationwide Sample of French PrisonersALCOHOLISM, Issue 1 2009Michael Lukasiewicz Background:, Axis I psychiatric disorders (PD) and substance use disorders (SUD) are common in prison, but only few studies have focused on their association in this setting. Dual diagnosis (DD) (the co-occurrence of a SUD and any axis I disorder) is known to have a poorer prognosis and to require more intense supportive care. Objectives:, The objectives of this study were (1) to describe prisoners with DD (prevalence and characteristics); (2) to compare DD prisoners with 3 other groups of prisoners: no diagnosis (ND), SUD alone, or other isolated PD; and (3) to evaluate the impact of DD on suicide risk in prison. Method:, A random stratified strategy was used to select 23 various types of prisons and 998 prisoners. Diagnoses were assessed using a unique procedure, each prisoner being evaluated by 2 psychiatrists, 1 junior, using a structured interview (MINI 5 plus), and 1 senior, using an open clinical interview. Following interviews, clinicians met to establish a list of diagnoses. Cloninger's temperament and character inventory was also used. Results:, Of the prisoners, 26.3% had a DD. DD prevalence was almost 80% in prisoners with SUD, while only one-third of the prisoners with an axis I PD had co-morbid SUD. No significant differences were observed in drug use patterns between DD and SUD without co-morbid PDs. DD showed the strongest association with suicide risk [OR = 5.7 (1.7,4.6)]. Conclusion:, DD is very frequent in prison and is a major risk factor for suicide. Systematic psychiatric/SUD screening of prisoners with either a SUD or an axis I PD should be encouraged. [source] Development and validation of the Unified Multiple System Atrophy Rating Scale (UMSARS)MOVEMENT DISORDERS, Issue 12 2004Gregor K. Wenning MD Abstract We aimed to develop and validate a novel rating scale for multiple system atrophy (Unified Multiple System Atrophy Rating Scale - UMSARS). The scale comprises the following components: Part I, historical, 12 items; Part II, motor examination, 14 items; Part III, autonomic examination; and Part IV, global disability scale. For validation purposes, 40 MSA patients were assessed in four centers by 4 raters per center (2 senior and 2 junior raters). The raters applied the UMSARS, as well as a range of other scales, including the Unified Parkinson's Disease Rating Scale (UPDRS) and the International Cooperative Ataxia Rating Scale (ICARS). Internal consistency was high for both UMSARS-I (Crohnbach's alpha = 0.84) and UMSARS-II (Crohnbach's alpha = 0.90) sections. The interrater reliability of most of the UMSARS-I and -II items as well as of total UMSARS-I and -II subscores was substantial (k (w) = 0.6,0.8) to excellent (k (w) > 0.8). UMSARS-II correlated well with UPDRS-III and ICARS (rs > 0.8). Depending on the degree of the patient's disability, completion of the entire UMSARS took 30 to 45 minutes. Based on our findings, the UMSARS appears to be a multidimensional, reliable, and valid scale for semiquantitative clinical assessments of MSA patients. © 2004 Movement Disorder Society [source] Evaluation of age-related labels by senior citizensPSYCHOLOGY & MARKETING, Issue 9 2006Bert Weijters The age-related labels third age, elderly, 50+, senior, and retired were evaluated by a 40+ sample. Results of a qualitative and quantitative study showed that the labels third age and elderly evoked predominantly negative associations, and the evaluations of the latter three age-related labels were generally positive. Cognitive age did not appear to add explanatory power, but group membership did (being retired or not, perceiving oneself as a senior or not). Moreover, a significant interaction effect between group membership and age emerged. When people did not belong or did not perceive themselves to belong to a given age group, the evaluation of the related label became more negative when the respondents approached the age to be eligible for group membership. After becoming or accepting to become part of the group, evaluations of the label increased again. On the basis of these results, an alternative-stage model is proposed: status irrelevance, status rejection, status acceptance, and status championship. © 2006 Wiley Periodicals, Inc. [source] The Odyssey of Senior Public Service: What Memoirs Can Teach UsPUBLIC ADMINISTRATION REVIEW, Issue 1 2003J. Patrick Dobel This article examines the political, psychological, and moral challenges of senior public service in the executive office. The study uses memoirs published by members of the Clinton administration. The memoirs discuss the consistent background conditions of senior public service as the personality of the chief executive, the vagaries of election cycles, the tension between staff and agency executives, and the role of the media. Senior executives adopt a number of stances to address the tension between the realities of public service and the ideals they bring. The memoirs suggest several stances, such as politics as original sin, seduction, hard work and compromise, and game. The memoirs demonstrate the high cumulative cost that public service exacts on the health and personal lives of senior officials. Finally, the study reveals a number of consistent themes about how senior appointed public officials can navigate the dilemmas and challenges of senior public service at all levels of government. [source] Low-Growth Equilibrium Accompanied by High Levels of Educational AttainmentTHE JAPANESE ECONOMIC REVIEW, Issue 4 2002Koichi Yotsuya The paper demonstrates the low-growth trap associated with high educational attainment in an overlapping-generations model by examining the dual positive effect of senior educated workers in leading-edge technology: on technological progress and on young workers' on-the-job learning. If new technology is sufficiently productive, young workers will demand education to update technology when old, and high technological growth is sustained in the future. Conversely, if new technology is unproductive, they will demand education merely to improve the skills necessary for existing technology, and technological progress will stagnate. Nevertheless, vigorous investment in education occurs since young workers have little hope for on-the-job learning. JEL Classification Numbers: I20, J24, O33, O40. 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