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Cross-sectional Data (cross-sectional + data)
Selected AbstractsThe importance of family management, closeness with father and family structure in early adolescent alcohol useADDICTION, Issue 10 2010Cherine Habib ABSTRACT Aims To examine the importance of family management, family structure and father,adolescent relationships on early adolescent alcohol use. Design Cross-sectional data was collected across 30 randomly selected Australian communities stratified to represent a range of socio-economic and regional variation. Setting Data were collected during school time from adolescents attending a broad range of schools. Participants The sample consisted of a combined 8256 students (aged 10,14 years). Measurements Students completed a web-based survey as part of the Healthy Neighbourhoods project. Findings Family management,which included practices such as parental monitoring and family rules about alcohol use,had the strongest and most consistent relationship with alcohol use in early adolescence. Adolescents reporting higher family management were less likely to have drunk alcohol in their life-time, less likely to drink alcohol in the preceding 30 days and less likely to have had an alcohol binge. Adolescents reporting emotionally close relationships with their fathers were less likely to have drunk alcohol in their life-time and less likely to have had an alcohol binge in the preceding fortnight. Conclusions Findings indicate that family management practices may contribute to alcohol abstinence in adolescents. Furthermore, emotionally close father,adolescent relationships may also foster abstinence; however, fathers' drinking behaviours need to be considered. [source] Alcohol consumption patterns and risk factors among childhood cancer survivors compared to siblings and general population peersADDICTION, Issue 7 2008E. 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] Recent life problems and non-fatal overdose among heroin users entering treatmentADDICTION, Issue 2 2005Joanne Neale ABSTRACT Aims To investigate the role of recent life problems in non-fatal overdose among heroin users entering various drug treatment settings. Design Cross-sectional data from a longitudinal study investigating drug treatment effectiveness. Setting Five prison drug treatment services, three residential rehabilitation units, three residential detoxification units and 21 community drug treatment services located in rural, urban and inner-city areas of Scotland. Participants Of a total of 793 primary heroin users commencing drug treatment during 2001,02, 337 (42.5%) were prison drug service clients; 91 (11.5%) were residential rehabilitation clients; 97 (12.2%) were residential detoxification clients; and 268 (33.8%) were community drug treatment clients. Measurements Univariate and stepwise multivariate logistic regression analyses examined associations between overdosing in the 90 days prior to treatment entry and basic demographic characteristics, recent drug use and recent life problems. Findings Ninety-one study participants (11.5%) reported at least one overdose and 19 (2.4%) reported more than one overdose in the 90 days prior to treatment entry. A ,2 test revealed no significant difference in rates of recent overdosing between the four treatment settings (P = 0.650). Recent drug use and recent life problems,but not demographic characteristics,were associated independently with recent overdosing. However, recent life problems were not associated independently with recent overdosing among clients entering prison, clients entering residential rehabilitation or with multiple recent overdosing. Conclusions Associations between recent life problems and recent overdose were evident, but varied by treatment setting. Treatment providers should identify and address heroin users' life problems as part of a broad strategy of overdose prevention. [source] Measuring the productive efficiency and clinical quality of institutional long-term care for the elderlyHEALTH ECONOMICS, Issue 3 2005Juha Laine Abstract The authors consider the association between productive efficiency and clinical quality in institutional long-term care for the elderly. Cross-sectional data were collected from 122 wards in health-centre hospitals and residential homes in Finland in 2001. Productive efficiency was measured in terms of technical efficiency, which was defined as the unit's distance from the (best practice) production frontier. The analysis employed stochastic production frontier estimation, where technical inefficiency in the production function was specified to be a function of ward characteristics and clinical quality of care. Several quality indicators based on the Resident Assessment Instrument, such as prevalence of pressure ulcers and depression with no treatment, were used in the analysis. The results did not reveal systematic association between technical efficiency and clinical quality of care. However, the prevalence of pressure ulcers, indicating poor quality of care was associated with technical efficiency, a fact which highlights the importance of including quality measures in the assessment of efficiency in long-term care. Copyright © 2004 John Wiley & Sons, Ltd. [source] A National Study of Efficiency for Dialysis Centers: An Examination of Market Competition and Facility Characteristics for Production of Multiple Dialysis OutputsHEALTH SERVICES RESEARCH, Issue 3 2002Hacer Ozgen Objective. To examine market competition and facility characteristics that can be related to technical efficiency in the production of multiple dialysis outputs from the perspective of the industrial organization model. Study Setting. Freestanding dialysis facilities that operated in 1997 submitted cost report forms to the Health Care Financing Administration (HCFA), and offered all three outputs,outpatient dialysis, dialysis training, and home program dialysis. Data Sources. The Independent Renal Facility Cost Report Data file (IRFCRD) from HCFA was utilized to obtain information on output and input variables and market and facility features for 791 multiple-output facilities. Information regarding population characteristics was obtained from the Area Resources File. Study Design. Cross-sectional data for the year 1997 were utilized to obtain facility-specific technical efficiency scores estimated through Data Envelopment Analysis (DEA). A binary variable of efficiency status was then regressed against its market and facility characteristics and control factors in a multivariate logistic regression analysis. Principal Findings. The majority of the facilities in the sample are functioning technically inefficiently. Neither the intensity of market competition nor a policy of dialyzer reuse has a significant effect on the facilities' efficiency. Technical efficiency is significantly associated, however, with type of ownership, with the interaction between the market concentration of for-profits and ownership type, and with affiliations with chains of different sizes. Nonprofit and government-owned facilities are more likely than their for-profit counterparts to become inefficient producers of renal dialysis outputs. On the other hand, that relationship between ownership form and efficiency is reversed as the market concentration of for-profits in a given market increases. Facilities that are members of large chains are more likely to be technically inefficient. Conclusions. Facilities do not appear to benefit from joint production of a variety of dialysis outputs, which may explain the ongoing tendency toward single-output production. Ownership form does make a positive difference in production efficiency, but only in local markets where competition exists between nonprofit and for-profit facilities. The increasing inefficiency associated with membership in large chains suggests that the growing consolidation in the dialysis industry may not, in fact, be the strategy for attaining more technical efficiency in the production of multiple dialysis outputs. [source] Association between cognition and daily life functioning in dementia subtypesINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 7 2009Sharon F. M. Bouwens Abstract Objective To investigate the association between cognition and daily life functioning in dementia subtypes. Methods Cross-sectional data were used from 615 patients with dementia who were referred to the Maastricht Memory Clinic of the Maastricht University Medical Centre. Pearson correlation coefficients were calculated between the Mini-Mental State Examination (MMSE; to measure cognitive status) and the Blessed Dementia Scale (BDS; to measure daily life functioning) for the following types of dementia: Alzheimer's Disease (AD, n,=,442); Vascular dementia (VaD, n,=,113); frontotemporal dementia (FTD, n,=,18); Parkinson's dementia (PD, n,=,21); and primary progressive aphasia (PPA, n,=,21). One-way ANOVA was used to test differences in age, MMSE scores and BDS scores across dementia subtypes. Results Scores on the MMSE showed strong correlation with BDS scores in cases of FTD (r,=,,0.80); moderate correlation in cases of AD, VaD, and PD (range r,=,,0.50,0.60); while no correlation was found in PPA cases. Conclusions The association between cognition and daily life functioning varied among dementia subtypes for AD, VaD, FTD and PD. Furthermore, the overall scores on both domains differ between dementia subtypes, indicating that different types of dementia are characterized by a specific pattern of cognitive status and daily life functioning. These findings underline the need for multidomain assessment in patients with dementia. Copyright © 2009 John Wiley & Sons, Ltd. [source] Age- versus time-comparative self-rated health in Hong Kong Chinese older adultsINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 8 2006Zhi Bin Li Abstract Objectives The main objectives were to examine the relation between age-comparative (self vs others of same age) self-rated health (SRH) and time-comparative (self this year vs last year) SRH, and to evaluate which was more strongly associated with specific physical health problems. Methods Cross-sectional data on two SRH measures and various physical health problems from 18749 male and 37413 female clients aged 65 or over from 18 Elderly Health Centres in Hong Kong were analysed using logistic regression with adjustment for potential confounders. Results Men were more likely to report ,better' and less likely to report ,worse' SRH than women. ,Normal' was the most common option but the proportions choosing this decreased with age on both SRH measures. There was a fairly weak but statistically significant correlation between these two measures, with Kappa coefficients of 0.125 and 0.167 for men and women, respectively. For both men and women, there were significantly positive linear trends between age-comparative SRH options from ,better' to ,worse' and physical health problems, such as respiratory diseases, musculoskeletal diseases, any active chronic diseases, functional disability, depressive symptoms, taking medication regularly, and admission to hospital last year. However, for time-comparative SRH, those who rated ,normal' had the smallest odds ratios in all of the physical health problems above than those who rated ,better' or ,worse'. Conclusions The two SRH measures correlated with each other weakly but significantly. Age-comparative SRH was linearly, and time-comparative SRH was curvilinearly associated with physical health problems. Copyright © 2006 John Wiley & Sons, Ltd. [source] Stages of Change , Continuous Measure (URICA-E2): psychometrics of a Norwegian versionJOURNAL OF ADVANCED NURSING, Issue 1 2009Anners Lerdal Abstract Title.,Stages of Change , Continuous Measure (URICA-E2): psychometrics of a Norwegian version. Aim., This paper is a report of research to translate the English version of the Stages of Change continuous measure questionnaire (URICA-E2) into Norwegian and to test the validity of the questionnaire and its usefulness in predicting behavioural change. Background., While the psychometric properties of the Stages of Change categorical measure have been tested extensively, evaluation of the psychometric properties of the continuous questionnaire has not been described elsewhere in the literature. Method., Cross-sectional data were collected with a convenience sample of 198 undergraduate nursing students in 2005 and 2006. The English version of URICA-E2 was translated into Norwegian according to standardized procedures. Findings., Principal components analysis clearly confirmed five of the dimensions of readiness to change (Precontemplation Non-Believers, Precontemplation Believers, Contemplation, Preparation and Maintenance), while the sixth dimension, Action, showed the lowest Eigenvalue (0·93). Findings from the cluster analysis indicate distinct profiles among the respondents in terms of readiness to change their exercise behaviour. Conclusion., The URICA-E2 was for the most part replicated from Reed's original work. The result of the cluster analysis of the items associated with the factor ,Action' suggests that these do not adequately measure the factor. [source] The Effects of Staffing on In-Bed Times of Nursing Home ResidentsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 6 2004Barbara M. Bates-Jensen PhD, CWOCN Objectives: To examine the effect of staffing level on time observed in bed during the daytime in nursing home (NH) residents. Design: Descriptive, cross-sectional study. Setting: Thirty-four southern California NHs. Participants: A total of 882 NH residents: 837 had hourly observation data, 777 had mealtime observations, 837 completed interviews, and 817 completed a physical performance test. Measurements: Cross-sectional data collected from participants at each NH site included direct observations (hourly and mealtime), resident interviews, medical record review, and physical performance tests. Results: In multivariate analyses, staffing level remained the strongest predictor of time observed in bed after controlling for resident functional measures (odds ratio=4.89; P=.042). Residents observed in bed during the daytime in more than 50% of hourly observations were observed also to experience increased daytime sleeping (P<.001) and less social engagement (P=.026) and consumed less food and fluids during mealtimes than those observed in bed in less than 50% of observations, after adjusting for resident function (P<.001). Conclusion: In this sample of NHs, resident functional measures and NH staffing level predicted observed time in bed according to hourly observations, with staffing level the most powerful predictor. Neither of these predictors justifies the excessive in-bed times observed in this study. Staff care practices relevant to encouraging residents to be out of bed and resident preferences for being in bed should be examined and improved. Practice recommendations regarding in-bed time should be considered, and further research should seek to inform the development of such recommendations. [source] Breast Cancer Detection in Asymptomatic Women: Health Beliefs Implicated in Secondary PreventionJOURNAL OF APPLIED BIOBEHAVIORAL RESEARCH, Issue 2 2003Kanayo Umeh This study assessed the usefulness of health belief model (HBM) constructs in predicting the frequency and proficiency of breast self-examination among Greek women. Both additive and multiplicative functions were tested. Cross-sectional data from 195 women were analyzed. Health beliefs explained 16.5% and 19.7% of the variance in frequency and proficiency, respectively. Frequent and proficient breast examination was associated with fewer perceived barriers. Moreover, elevated confidence and susceptibility estimates predicted greater frequency and proficiency, respectively. One moderator interaction emerged, but this was attenuated after accounting for other health beliefs. These findings provide qualified support for the HBM and present a useful template for developing interventions to promote secondary prevention. [source] Dental nomograms for benchmarking based on the study of health in Pomerania data setJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 12 2004C. Schwahn Abstract Aim: Benchmarking is a means of setting goals or targets. On an oral health level, it denotes retaining more teeth and/or improving the quality of life. The goal of this pilot investigation was to assess whether the data generated by a population-based study (SHIP 0) can be used as a benchmark data set to characterize different practice profiles. Material and Methods: The data collected in the population-based study SHIP (n=4310) in eastern Germany were used to generate nomograms of tooth loss, attachment loss, and probing depth. The nomograms included twelve 5-year age strata (20,79 years) presented as quartiles, and additional percentiles of the dental parameters for each age group. Cross-sectional data from a conventional dental office (n=186) and from a periodontology unit (n=130, Greifswald) in the study region as well as longitudinal data set of a another periodontology unit (n=135, Kiel) were utilized in order to verify whether the given practice profile was accurately reflected by the nomogram. Results: In terms of tooth loss, the data from the conventional dental office agree with the median from the nomogram. For attachment loss and probing depth, some age groups yielded slight but not uniform deviations from the median. Cross-sectional data from the periodontology unit Greifswald showed attachment loss higher than the median in younger but not in older age groups. The probing depth was uniformly less than the median and tended toward the 25th percentile with increasing age. The longitudinal data of the Unit of Periodontology in Kiel showed a pronounced trend towards higher percentiles of residual teeth, meaning that the patients retained more teeth. Conclusion: The profile of the Pomeranian dental office does not deviate noticeably from the population-based nomograms. The higher attachment loss of the Unit of Periodontology in Greifswald in younger age strata clearly reflects their selection because of periodontal disease; the combination of higher attachment loss and decreased probing depth may reflect the success of the treatment. The tendency of attachment loss towards the median with increasing age may indicate that the Unit of Periodontology in Greifswald does not fulfill its function as a special care unit in the older subjects. The longitudinal data set of the Unit of Periodontology in Kiel impressively reflects the potential of population-based data sets as a means for benchmarking. Thus, nomograms can help to determine the practice profile, potentially yielding benefits for the dentist, health insurance company, or , as in the case of the special care unit , public health research. [source] Branding behavior in the Danish food industryAGRIBUSINESS : AN INTERNATIONAL JOURNAL, Issue 1 2006Derek Baker Cross-sectional data from a survey of Danish firms are used to examine branding behavior in 2002 and its change between 1997 and 2002. Summary data from the survey are presented. Branding behavior is defined and relevant literature is reviewed. Based on hypotheses developed from this literature and supporting features of the Danish food marketing chain, six econometric models are specified. Specification accounts for dependent variables' characteristics (count and fractional data, and truncated samples). Missing values are replaced using Griliches' method (Griliches, 1986). Large firms are found to own and introduce the most brands, although few associations with the commodity sector are identified. Firms' use of retail brands is found to substitute for brand introduction in the long run and to increase with ownership by retail firms. Conclusions are drawn regarding the strategic stance of retailers in the Danish food system and its employment of retailers' own-label brands. [ECONLIT Classifications: Q120; Q130; L190]. © 2006 Wiley Periodicals, Inc. Agribusiness 22: 31,49, 2006. [source] Evolving patterns of tobacco use in northern SwedenJOURNAL OF INTERNAL MEDICINE, Issue 6 2003B. Rodu Abstract., Rodu B, Stegmayr B, Nasic S, Cole P, Asplund K (University of Alabama at Birmingham, Birmingham, AL, USA; Umeå Hospital, Umeå, Sweden). Evolving patterns of tobacco use in northern Sweden. J Intern Med 2003; 253: 660,665. Background and objectives., Cross-sectional data from northern Sweden suggest that the increased use of Swedish moist snuff (snus) may have contributed to a decline in the prevalence of smoking, especially amongst men. This study describes the evolving patterns of tobacco use in this population over the period 1986,1999. Design., This is a prospective follow-up study of 1651 men and 1756 women, aged 25,64 years, who were enrolled in the northern Sweden MONICA project (entry in 1986, 1990, 1994) and who were followed-up in 1999. Information on tobacco use at entry and at follow-up was used to describe the stability of tobacco use over a period of 5,13 years ending in 1999. Results., Snus was the most stable form of tobacco use amongst men (75%); only 2% of users switched to cigarettes and 20% quit tobacco altogether. Smoking was less stable (54%); 27% of smokers were tobacco-free and 12% used snus at follow-up. Combined use (smoking and snus) was the least stable (39%), as 43% switched to snus and 6% switched to cigarettes. Former users of both products were much less stable than former users of either cigarettes or snus. The stability of smoking amongst women was 69%, which was higher than that amongst men (P < 0.05). Conclusions., The use of snus played a major role in the decline of smoking rates amongst men in northern Sweden. The evolution from smoking to snus use occurred in the absence of a specific public health policy encouraging such a transition and probably resulted from historical and societal influences. [source] Providing support to siblings of hospitalised childrenJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 3 2010Amanda S Newton Abstract The purpose of this study was to describe child life services provided to siblings of hospitalised children and the resources associated with these services in major paediatric hospitals throughout the United States (U.S.) and Canada. Cross-sectional data on sibling support services and resources needed for capacity building were collected via a web-based survey from administrative and clinical practice leads in identified Child Life Departments. The 34-item survey targeted three domains: Facility Demography, Sibling Support Resources, and Capacity Building and Funding. Surveys were sent to 217 leads and 109 responded (50% response rate). Of the 109 respondents, 48% indicated their facilities provided sibling support including grief or palliative support (90% of facilities) and therapeutic play (94% of facilities). More than 50% indicated that these services were not evaluated for improved family or sibling outcomes. Twenty-six percent of the respondents indicated having monies earmarked for sibling support from the following sources: hospital budget (34%), private donation (25%), foundation (22%), other (14%) and government (4%). There was a significant relationship between respondents who indicated sibling support services and funding (,2= 0.0001). Resources identified included staff availability and funding as needed for sibling support capacity building. Given the limited sibling support available in major paediatric hospitals across the U.S. and Canada, hospitals with existing resources should act as exemplars and evaluate the impact of their services with clear dissemination to other facilities. In addition to defining service effectiveness, this evaluation can help to determine the most fiscally responsible ways to deliver sibling support in their established facilities and others. [source] Factors influencing breastfeeding rates in south-western SydneyJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 4 2007Berlinda H Yeoh Aim: To explore the socio-demographic factors and other maternal characteristics that influence breastfeeding initiation rates. In particular, this paper aims to (i) estimate the rate of breastfeeding by maternal socio-demographic factors and other maternal characteristics at first well-baby visit; and (ii) investigate the relationship between breastfeeding rates and these maternal factors. Methods: Cross-sectional data were obtained for 9618 babies in south-western Sydney in New South Wales from the Ingleburn Baby Information Systems database from January 2000 to June 2004 and included information on breastfeeding status, socio-demographic factors and other maternal characteristics. Results: At first visit, 59.8% of mothers were breastfeeding. The factors that increased the risk for NOT breastfeeding on multivariate analysis were being Australian-born (OR = 1.67, 95% CI 1.45,1.89, P < 0.001), unmarried (OR = 1.79, 95% CI 1.52,2.11, P < 0.001), living in disadvantaged accommodation (OR = 1.90, 95% CI 1.60,2.26, P < 0.001), having lower levels of education (OR = 1.88, 95% CI 1.38,2.54, P < 0.001) and current smoking (OR = 1.72, 95% CI 1.51,1.96, P < 0.001). Conclusion: The results from this large population-based study suggest that breastfeeding rates are significantly influenced by socio-demographic factors and maternal characteristics. Consequently, subgroups of the population ,at risk' for not breastfeeding can be identified and targeted for further strategies to promote breastfeeding. [source] Health-related quality of life in a cohort of adult patients with mild hemophilia AJOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 5 2008M. WALSH Summary.,Objectives:,To compare the health-related quality of life among adult males affected with mild hemophilia A due to the same mutation (Val2016ala) to that of unaffected age and sex matched controls from the same general population. Methods:,The Short-Form 36 (SF-36) and Health Assessment Questionnaire (HAQ) were used to measure health-related quality of life and physical function. Other measures included bleeding history, a measure of joint damage, body mass index, age, and viral infection status. Cross-sectional data were collected through research clinics and a retrospective chart audit over a two-year period. Results and Conclusions:,The study included 47 affected males and 33 controls. The affected males had a higher level of co-morbidity, prior bleeding, and existing joint damage than controls. With the exception of the social function and health transition scales, mean scores for each of the SF-36 domains were worse among affected males. Mean differences were more than a clinically important five points in five of eight domains, with the general health scale showing more than a 10-point difference. Despite the degree of difference noted, only two of the differences were statistically significant (general health and role emotional scales) because of the small sample size and considerable individual variation in SF-36 scale scores. Multiple regression analyses suggested existing joint damage and presence of heart disease as the strongest associates of lower physical health-related quality of life. Joint damage in turn was partly related to prior hemarthroses. Compared to the Canadian population, affected males had lower scores in six out of eight SF-36 domains as well as the physical component summary score. There were no significant differences found in the HAQ scores between the two groups. So-called mild hemophilia A was associated with a negative effect on physical health-related quality of life, contributed to by joint damage as a result of prior bleeding. [source] Trends in the clinical characteristics of the U.S. cystic fibrosis patient population from 1995 to 2005PEDIATRIC PULMONOLOGY, Issue 8 2008Donald R. VanDevanter Abstract Rationale Respiratory signs and symptoms (cough, sputum production, or crackles) are considered bellwethers of underlying cystic fibrosis (CF) lung disease. If respiratory signs and symptoms predict future lung function loss, then improvements in population lung function over the past decade should have been paralleled by a decrease in the prevalence of these variables in the same population. Additionally, changes in these variables over the past decade may provide insight into the improving health of the CF population. Methods Cross-sectional data from the Epidemiologic Study of Cystic Fibrosis for each year between 1995 and 2005 were analyzed to characterize changes in pulmonary function and respiratory signs and symptoms over time. Patients were separated into five age groups: <6, 6,12, 13,17, 18,24, and ,25 years. Results Serial cross-sectional analyses of an average of 13,381 patients per year indicated that mean pulmonary function for the CF population improved and the percent of patients reporting cough or sputum production or having crackles or wheeze at their clinic visit decreased over the study period. Observed changes in pulmonary function were not consistently mirrored by changes in symptoms, which differed as a function of the variable studied and the age group. Conclusions Reductions in respiratory signs and symptoms have paralleled improvements in pulmonary function. Both the absolute and relative magnitude of changes in prevalence for cough, sputum production, crackles, and wheeze differed among age groups and among variables. These results suggest the possibility that differences in respiratory signs and symptoms may arise from different underlying pathologies and may be influenced differently by therapeutic interventions. Pediatr Pulmonol. 2008; 43:739,744. © 2008 Wiley-Liss, Inc. [source] Socioeconomic factors and asthma control in childrenPEDIATRIC PULMONOLOGY, Issue 8 2008Shannon F. Cope MSc Abstract Objectives The objective of this study was to evaluate the association between socioeconomic factors and asthma control in children, as defined by the Canadian Pediatric Asthma Consensus Guidelines. Patients and Methods Cross-sectional data from a completed study of 879 asthmatic children between the ages of 1 and 18 residing in the Greater Toronto Area were used. The database included data on demographics, health status, asthma control, and health-related quality of life. Stepwise forward modeling multiple regression was used to investigate the impact of socioeconomic status on asthma control, based on six control parameters from the 2003 Canadian Pediatric Asthma Consensus Guidelines. Results Only 11% of patients met the requirements for acceptable control, while 20% had intermediate control, and 69% had unacceptable asthma control. Children from families in lower income adequacy levels had poorer control. Conclusions Disparities in asthma control between children from families of different socio-economic strata persist, even with adjustment for utilization of primary care services and use of controller medications. Pediatr Pulmonol. 2008; 43:745,752. © 2008 Wiley-Liss, Inc. [source] Calcium, dietary, and lifestyle factors in the prevention of colorectal adenomasCANCER, Issue 3 2007Eric A. Miller PhD Abstract BACKGROUND. Many studies have suggested a role for calcium in reducing the risk of colorectal adenomas and cancer but its effectiveness may be dependent on interactions with other dietary and/or lifestyle factors. We examined the association between calcium and prevalence of adenomas and assessed whether the association was stronger in biologically plausible subgroups. METHODS. Cross-sectional data from 222 cases and 479 adenoma-free controls who underwent colonoscopies and completed food frequency and lifestyle questionnaires were used in the analyses. Multivariable logistic regression was used to estimate the association between calcium and prevalence of adenomas. Stratified analyses and the likelihood ratio test were used to examine effect modification by various demographic, lifestyle, and behavioral factors. RESULTS. Overall, little association was observed comparing total calcium intake of ,900 mg/day to <500 mg/day (adjusted odds ratio [OR] = 0.85, 95% confidence interval [CI]: 0.53,1.37). However, stronger associations were observed in patients with lower fat intake and in those who regularly (,15 times/month) took nonsteroidal antiinflammatory drugs (NSAIDs). Specifically, total calcium intake of ,900 mg/day was associated with a lower prevalence of adenomas among patients with lower fat intake (OR = 0.47, 95% CI: 0.25,0.91) but not among those with higher fat intake (OR = 1.20, 95% CI: 0.61,2.35; P -value for interaction = .01). For NSAIDs, the associations were OR = 0.37 (95% CI: 0.16,0.86) for regular NSAID users and OR = 1.27 (95% CI: 0.73,2.22) with infrequent or nonuse of NSAIDs, respectively (P = .06). CONCLUSIONS. The data suggest that a lower-fat diet and regular NSAID use may enhance calcium's effectiveness as a colorectal cancer preventive agent. Cancer 2007 © 2007 American Cancer Society. [source] Overweight/obesity and factors associated with body mass index during adolescence: the VYRONAS studyACTA PAEDIATRICA, Issue 3 2009Constantinos Mihas Abstract Aim: To describe overweight and obese adolescents and to determine any correlations between an adolescent's body mass index (BMI) with personal (age, gender), lifestyle (sedentary/sport activities, smoking status) and parental (smoking status, BMI, number of cars) characteristics. Methods: Cross-sectional data on weight, height and various characteristics from 2008 Greek adolescents (12- to 17-year olds, 50.85% boys), measured in 2005,2007, were used. Results: Almost 1 in 5 (19.2%) boys and 1 in 7 (13.2%) girls 12,17 years of age were overweight while 4.4% of the boys and 1.7% of the girls were obese. The adolescents' age, mother's smoking status, father's and mother's BMI predicted boys' and girls' BMI (b = 0.551, 0.203, 0.110, 0.495 for boys, b = 0.233, 0.187, 0.180, 0.531 for girls, respectively, p , 0.05). Univariate analysis revealed that television watching/using personal computer/playing video games and playtime were not correlated with BMI, while an inverse association of exercising for , 5 h/week and BMI was found in both boys and girls (b =,1.098, ,0.528, p = 0.005, 0.004 respectively). Conclusion: The results of our study underline the high prevalence of obesity during adolescence in Greece. Age and parental unhealthy behaviour (increased BMI and maternal smoking status) were positive predictors of increased BMI of adolescents in both genders. [source] Body mass index, waist circumference and waist to hip ratio and change in sex steroid hormones: the Massachusetts Male Ageing StudyCLINICAL ENDOCRINOLOGY, Issue 1 2006Carol A. Derby Summary Objective, Cross-sectional data suggest that obesity, particularly central obesity, may be associated with decreased production of sex steroid hormones in men. However, longitudinal hormone data on men in relation to obesity status are limited. Previous studies have not consistently demonstrated whether sex steroids are associated specifically to body mass index or to measures of central obesity. Our objective was to examine the relation of obesity (body mass index > 30 kg/m2), and of central obesity (waist circumference > 100 cm or waist to hip ratio > 0·95) to longitudinal change in sex steroid hormones in men. Design, Prospective follow-up of a population-based sample of men in Boston. Patients, Nine hundred forty-two (942) men in the Massachusetts Male Ageing Study with complete anthropometry and hormone data at baseline (1987,1989, ages 40,70) and follow-up (1995,1997). Measurements, Free and total testosterone (FT and TT), dehydroepiandrosterone sulphate (DHEAS), and sex hormone-binding globulin (SHBG) were assessed using standardized methods. Health behaviours and medical history were obtained by structured interview. Repeated measures regression was used to describe trends in steroid hormones and SHBG in relation to obesity status, adjusting for age, smoking, alcohol, comorbidities, and physical activity. Results, Obesity was associated with decreased levels of total and free testosterone, and of SHBG at follow-up relative to baseline. For any given baseline concentration of TT, FT or SHBG, follow-up levels were lowest among men who remained obese or who became obese during follow-up. This was true for all three indices of obesity. Central adiposity was associated with lower DHEAS levels at follow-up, while elevated body mass index was not. Conclusions, Obesity may predict greater decline in testosterone and SHBG levels with age. Central adiposity may be a more important predictor of decline in DHEAS than is body mass index. [source] Socioeconomic indicators and prosthetic replacement of missing teeth in a working-age population,Results of the Study of Health in Pomerania (SHIP)COMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 2 2009Torsten Mundt Abstract,,, Objectives:, To analyse the possible effects of the socioeconomic status (SES) on the prosthetic replacement of missing teeth in working-age people and to explore the role of potential confounders. Methods:, Cross-sectional data were collected from 2310 German adults aged 30,59 years. The relationship between each of the three SES indicators (education, income, and occupational status) and dental prostheses were examined by multinomial logistic regression analyses. For that, partially dentate participants with suboptimal and no replacement of missing teeth were compared with partially dentate participants having optimal replacement. Potential confounders (age, sex, dental status, social network and social support) were entered if their inclusion in the model led to ,10% change in the coefficient of interest. Results:, Social network and social support did not meet the criterion for confounding. In the maxilla, having no replacement was positively associated with lower categories for each of the three SES indicators [Odds ratios (OR) between 1.6 and 2.1; 95% confidence intervals (CI) between 1.1 and 3.4]. Low occupational status was the single predictor for suboptimal dental prostheses (OR = 3.2; 95% CI: 1.6,6.2). In the mandible, occupational status showed no association with the prosthetic status, whereas low educational level and low household income were determinants for having no replacement (OR = 1.9 and 1.9, 95% CI: 1.0,3.5 and 1.1,3.0, respectively). Low household income was the single determinant for suboptimal replacement of missing teeth (OR = 2.4, 95% CI = 1.1,5.2). Conclusion:, The findings may indicate the relevance of the financing of prosthodontic treatment. The strong association between various forms of upper dentures and occupational prestige can be seen as key contributing concept to how individuals, characteristics affect the outcome in prosthodontic care. [source] TRAJECTORIES OF CRIME AT PLACES: A LONGITUDINAL STUDY OF STREET SEGMENTS IN THE CITY OF SEATTLE,CRIMINOLOGY, Issue 2 2004DAVID WEISBURD Studies of crime at micro places have generally relied on cross-sectional data and reported the distributions of crime statistics over short periods of time. In this paper we use official crime data to examine the distribution of crime at street segments in Seattle, Washington, over a 14-year period. We go beyond prior research in two ways. First, we view crime trends at places over a much longer period than other studies that have examined micro places. Second, we use group-based trajectory analysis to uncover distinctive developmental trends in our data. Our findings support the view that micro places generally have stable concentrations of crime events over time. However, we also find that a relatively small proportion of places belong to groups with steeply rising or declining crime trajectories and that these places are primarily responsible for overall city trends in crime. These findings are particularly important given the more general decline in crime rates observed in Seattle and many other American cities in the 1990s. Our study suggests that the crime drop can be understood not as a general process that occurred across the city landscape but one that was generated in a relatively small group of micro places with strong declining crime trajectories over time. [source] Changes in serum leptin concentrations in overweight Japanese men after exerciseDIABETES OBESITY & METABOLISM, Issue 5 2004N. Miyatake Aim:, To investigate the link between serum leptin concentrations and exercise. Design:, Cross-sectional and longitudinal studies of an exercise intervention. Subjects:, 110 Japanese overweight men aged 32,59 years were recruited. At baseline, the average body mass index (BMI) was 28.5 ± 2.5 kg/m2. From this group, we used data of 36 overweight men (BMI, 28.9 ± 2.3) for a 1-year exercise programme. Measurements:, Leptin was measured at baseline and after 1 year. Fat distribution was evaluated by visceral fat (V) and subcutaneous fat (S) areas measured with computed tomography (CT) scanning at umbilical levels. Anthropometric parameters, aerobic exercise level, muscle strength and flexibility were also investigated at baseline and after 1 year. Results:, In the first analysis, using cross-sectional data, leptin was significantly correlated with total body fat (r = 0.760, p < 0.01), V (r = 0.383, p < 0.01) and S (r = 0.617, p < 0.01) areas. In the second analysis, using longitudinal data, leptin was significantly reduced after 1 year (pre 6.7 ± 4.0 ng/ml vs. post 5.1 ± 3.1 ng/ml, p < 0.01). Results showed that steps per day were increased, and aerobic exercise level, weight-bearing index (WBI) and insulin resistance were significantly improved. Although, there was a positive correlation between , leptin(positive changes in leptin after 1 year) and anthropometric measurements such as , body weight, , BMI and , body fat, leptin/body weight, leptin/BMI and leptin/body fat ratios were significantly reduced during exercise intervention. Conclusion:, The present study indicated exercise significantly lowers serum leptin concentrations, and thus it may improve the leptin resistance observed in overweight Japanese men. [source] Factors affecting improved glycaemic control in youth using insulin pumpsDIABETIC MEDICINE, Issue 10 2010J. Wilkinson Diabet. Med. 27, 1174,1177 (2010) Abstract Aims, The purpose of this study was to evaluate factors associated with insulin pump therapy resulting in lower HbA1c levels in young people with Type 1 diabetes mellitus. Methods, Insulin pumps were downloaded from 150 youth (81 male), ages 5,20 years. Consecutive insulin pump downloads, 3 months apart, were available for 85 (43 male) of the 150 youth and changes in pump use were correlated with changes (, 0.5%, , 6 mmol/mol) in HbA1c levels. Results, Using cross-sectional data, lower HbA1c values correlated with use of more frequent daily insulin boluses (r = ,0.46, P < 0.0001) and more frequent blood glucose checks/day (r = ,0.35, P < 0.0001). Young people with HbA1c levels < 7.5% (58 mmol/mol) vs. values of 7.5,9.0% (58-75 mmol/mol) or , 9.0% (75 mmol/mol) tested blood glucose more frequently/day (P < 0.0001), bolused more frequently/day (P < 0.0001), reported more grams of carbohydrates eaten/day (P < 0.05) and had a higher per cent bolus insulin/day (P < 0.05) compared with the , 9.0% of youth. Using longitudinal data, 48 of 85 patients had a change in HbA1c level of , 0.5% (6 mmol/mol) between downloads (24 improved). Increased bolus insulin (OR = 1.15, P = 0.03) and time of temporary basal rate use (OR = 1.017, P = 0.01) predicted , 0.5% (6 mmol/mol) decrease in HbA1c in logistic regression. Conclusions, This study emphasizes the importance of blood glucose testing, of bolus insulin administration and of an increase in the time of temporary basal rate use in relation to improving glycaemic control. [source] HAS WAL-MART BURIED MOM AND POP?: THE IMPACT OF WAL-MART ON SELF-EMPLOYMENT AND SMALL ESTABLISHMENTS IN THE UNITED STATESECONOMIC INQUIRY, Issue 4 2008RUSSELL S. SOBEL This paper explores the widely accepted view that Wal-Mart causes significant harm to the traditional, small "mom and pop" business sector of the U.S. economy. We present the first rigorous econometric investigation of this issue by examining the rate of self-employment and the number of small employer establishments using both time series and cross-sectional data. We also examine alternative measures and empirical techniques for robustness. Contrary to popular belief, our results suggest that the process of creative destruction unleashed by Wal-Mart has had no statistically significant long-run impact on the overall size and profitability of the small business sector in the United States. (JEL L81, D59, C21) [source] Coenzyme Q10 and vitamin E deficiency in Friedreich's ataxia: predictor of efficacy of vitamin E and coenzyme Q10 therapyEUROPEAN JOURNAL OF NEUROLOGY, Issue 12 2008J. M. Cooper Background and purpose:, A pilot study of high dose coenzyme Q10 (CoQ10)/vitamin E therapy in Friedreich's ataxia (FRDA) patients resulted in significant clinical improvements in most patients. This study investigated the potential for this treatment to modify clinical progression in FRDA in a randomized double blind trial. Methods:, Fifty FRDA patients were randomly divided into high or low dose CoQ10/ vitamin E groups. The change in International Co-operative Ataxia Ratings Scale (ICARS) was assessed over 2 years as the primary end-point. A post hoc analysis was made using cross-sectional data. Results:, At baseline serum CoQ10 and vitamin E levels were significantly decreased in the FRDA patients (P < 0.001). During the trial CoQ10 and vitamin E levels significantly increased in both groups (P < 0.01). The primary and secondary end-points were not significantly different between the therapy groups. When compared to cross-sectional data 49% of all patients demonstrated improved ICARS scores. This responder group had significantly lower baseline serum CoQ10 levels. Conclusions:, A high proportion of FRDA patients have a decreased serum CoQ10 level which was the best predictor of a positive clinical response to CoQ10/vitamin E therapy. Low and high dose CoQ10/vitamin E therapies were equally effective in improving ICARS scores. [source] A developmental typology of adolescent personalityEUROPEAN JOURNAL OF PERSONALITY, Issue 4 2010Theo A. Klimstra Abstract The purpose of the current study is to examine whether Block's personality types (i.e. Resilients, Undercontrollers and Overcontrollers) are replicable as developmental trajectories. We applied a Latent Class Growth Analysis (LCGA) framework to five- annual-wave data on a sample of early to middle adolescents (n,=,923). Our results showed that Block's Resilients, Undercontrollers and Overcontrollers are indeed replicable as developmental trajectories across adolescence. These developmental types were related to problem behaviour in a similar way as types found in studies using cross-sectional data. As such, Resilients reflected low levels of problem behaviour, Undercontrollers had high levels of delinquency and Overcontrollers had high levels of depression. Implications and suggestions for further research are discussed. Copyright © 2009 John Wiley & Sons, Ltd. [source] Life history correlates of oxidative damage in a free-living mammal populationFUNCTIONAL ECOLOGY, Issue 4 2009Daniel H. Nussey Summary 1Reactive oxygen species, produced as a by-product of normal metabolism, can cause intracellular damage and negatively impact on cell function. Such oxidative damage has been proposed as an evolutionarily important cost of growth and reproduction and as a mechanistic explanation for organismal senescence, although few tests of these ideas have occurred outside the laboratory. 2Here, we examined correlations between a measure of phospholipid oxidative damage in plasma samples and age, growth rates, parasite burden and investment in reproduction in a population of wild Soay sheep on St. Kilda, Scotland. 3We found that, amongst females of different ages, lambs had significantly elevated levels of oxidative damage compared to all other age classes and there was no evidence of increasing damage with age amongst adult sheep. 4Amongst lambs, levels of oxidative damage increased significantly with increasing growth rates over the first 4 months of life. Neither mean damage nor the effect of growth rate on damage differed between male and female lambs. 5Amongst adult female sheep, there was no evidence that body mass, current parasite burden or metrics of recent and past reproductive effort significantly predicted oxidative damage levels. 6This study is the first to examine age variation in an assay of oxidative damage and correlations between oxidative damage, growth and reproduction in a wild mammal. Our results suggest strong links between early conditions and oxidative damage in lambs, but also serve to highlight the limitations of cross-sectional data for studies examining associations between oxidative stress, ageing and life history in free-living populations. [source] How much confidence should we place in efficiency estimates?HEALTH ECONOMICS, Issue 11 2003Andrew StreetArticle first published online: 3 DEC 200 Abstract Ordinary least squares (OLS) and stochastic frontier (SF) analyses are commonly used to estimate industry-level and firm-specific efficiency. Using cross-sectional data for English public hospitals, a total cost function based on a specification developed by the English Department of Health is estimated. Confidence intervals are calculated around the OLS residuals and around the inefficiency component of the SF residuals. Sensitivity analysis is conducted to assess whether conclusions about relative performance are robust to choices of error distribution, functional form and model specification. It is concluded that estimates of relative hospital efficiency are sensitive to estimation decisions and that little confidence can be placed in the point estimates for individual hospitals. The use of these techniques to set annual performance targets should be avoided. Copyright © 2002 John Wiley & Sons, Ltd. [source] | ||||||||||||||||||||||||||||||||||||||||||||||