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Demographic Characteristics (demographic + characteristic)
Kinds of Demographic Characteristics Selected AbstractsDemographic Characteristics, Life Context, and Patterns of Substance Use Among Alcohol-Dependent Treatment Clients in a Health Maintenance OrganizationALCOHOLISM, Issue 12 2000Tammy W. Tam Background: Although individuals dependent only on alcohol and those dependent on both alcohol and drugs typically are not studied together in clinical trials, they are treated together in most treatment programs. In this study we compared epidemiological characteristics of the alcohol-only and alcohol-and-drug dependents in a treatment sample to assess differential treatment needs. Method: Patients admitted to treatment at a health maintenance organization's chemical dependency program were sampled and interviewed by using a structured questionnaire. The sample included 491 alcohol-only and 217 alcohol-and-drug dependents. Demographic characteristics, lifetime and current substance use, Addiction Severity Index composite scores, and DSM-IV criteria for alcohol and drug dependence were assessed at admission . Results: The odds of alcohol-and-drug dependence were higher among males, African Americans (when compared with whites), those who were younger, and those with less than college education. The risk was also higher among those who initiated heavy drinking or drug use before the age of 18. Increased psychiatric and family/social problems also were associated with combined dependence. Conclusions: Even in this relatively homogeneous socioeconomic status population, demographic characteristics were important predictors of type of dependence. Treatment programs which provide services that address prevention and psychosocial problems should pay attention to age of initiation as well as psychiatric and social problems. [source] Demographic Characteristics of Lytechinus variegatus (Echinoidea: Echinodermata) from Three Habitats in a North Florida Bay, Gulf of MexicoMARINE ECOLOGY, Issue 1 2000Steven D. Beddingfield Abstract. The population densities, spatial distributions, size frequencies, growth rates, longevity and reproductive activities of sub-populations of the sea urchin Lytechinus variegatus were investigated over a two-year period. Sea urchins were examined in three habitats in Saint Joseph Bay, Florida, which is within the northern limits of their distribution. Densities of sea urchins, which ranged as high as 35 individuals ·,2, fluctuated seasonally at all sites and were higher in seagrass beds comprised of Thalassia testudinum than Syringodium filiforme or on a sand flat. A cold front caused large-scale, catastrophic mortality among adult, and especially juvenile, sea urchins in nearshore habitats of the Bay in the spring of 1993, leading to a dramatic decline in sea urchin densities at the Thalassia seagrass site. The population recovered over 6 months at this site and was attributable to immigration of new adults. Juvenile recruitment displayed both interannual and site-specific variability, with recruitment being highest in seagrass habitats in fall and spring. The most pronounced recruitment event occurred in fall 1993 at the Thalassia site. Spatial distributions of adult individuals ascertained monthly never varied from random in the seagrass beds (T. testudinum and S. filiforme) or during spring, summer or fall months on the sand flat. Nonetheless, aggregations of adult sea urchins were observed on the sand flat in the winter months and were associated with patchy distributions of plant food resources. Juvenile sea urchins (< 25 mm test diameter) exhibited aggregations at all sites and 67 % of all juveniles under 10 mm test diameter (91 of 165 individuals observed) were found under the spine canopies of adults. Measurements of the inducibility of spawning indicated peak gametic maturity in all three sub-populations in spring and summer. Gonad indices varied between habitats and years, but distinct maxima were detected, particularly in spring 1993 and late summer 1994. The mean gonad index of individuals at the Syringodium seagrass site was 2- to 4-fold higher than the other sites in spring 1993 and gonad indices were much higher at all sites in spring of 1993 than 1994. Estimates of growth based on changes in size frequency cohorts coupled with measurements of growth bands on lantern demipyramids indicated that L. variegatus in three habitats of Saint Joseph Bay have similar growth rates and attain a mean test diameter of approximately 35 mm in one year. In contrast to populations within the central biogeographical range of the species, which may attain test diameters up to 90 mm, the largest individuals recorded in Saint Joseph Bay were 60 mm in test diameter, and almost all individuals were no more than 45 mm in test diameter or two years of age. The demographics of L. variegatus in the northern limits of their distribution appear to be strongly influenced by latitudinally driven, low-temperature events and secondarily by local abiotic factors, especially springtime low salinities, which may negatively impact larval development and recruitment. [source] Serum and 24-hour Urine Analysis in Adult Cyanotic and Noncyanotic Congenital Heart Disease PatientsCONGENITAL HEART DISEASE, Issue 3 2009Efrén Martínez-Quintana MD ABSTRACT Introduction., Glomerulopathy is a complication of congenital heart disease patients. The risk of developing renal impairment is particularly high in cyanotic patients. Objective., The aim of this study was to determine the prevalence of renal dysfunction and microalbumiuria in adult cyanotic and non cyanotic congenital heart disease patients. Methods., Fourteen cyanotic and 22 noncyanotic congenital heart disease patients were studied in the Adult Congenital Heart Disease Unit at the Complejo Hospitalario Universitario Insular-Materno Infantil. Demographic characteristics, complete blood count, and 24-hour urianalysis were obtained, including abdominal ultrasound in those with cyanosis. Results., No differences were seen between age (years) (27.4 ± 8.2; 26.4 ± 8.3; P = .71), sex, size, weight, or glomerular filtration rate (mL/min/1.73 m2) (81.1 ± 22.9 vs. 84.9 ± 9.2, P = .482) between cyanotic and noncyanotic patients. However, Eisenmenger patients had significantly impaired renal function when compared with noncyanotic patients (73.0 ± 17.3 vs. 84.9 ± 9.2 mL/min/1.73 m2, P = .023). Significant differences were obtained in oxygen saturation (%) (83.8 ± 5.8 vs. 97.8 ± 0.8; P = .000), hematocrit (%) (59.3 ± 8.1 vs. 40.9 ± 8.5; P = .000), platelets (103/µL) (161.5 ± 70.5 vs. 277.9 ± 57.6; P = .000), serum uric acid (mg/dL) (7.5 ± 2.3 vs. 5.6 ± 1.5; P = .008) and microalbuminuria (mg/24 hours) (12.8 [0, 700.2] vs. 2.4 [0, 18.9]; P = .000) between cyanotic and noncyanotic patients. Five cyanotic patients (35.7%) had microalbuminuria (>30 mg/24 hours) and three of them (21.4%) proteinuria (>1 g/24 hours). No significant differences were seen between serum and urine parameters between cyanotic patients who had microalbuminuria (>30 mg/24 hours) and those cyanotic patients who did not have it (<30 mg/24 hours). Conclusions., Renal impairment is frequently seen in congenital heart disease patients, being associated occasionally with proteinuria and microalbuminuria in cyanotic ones. [source] Drug use patterns and mental health of regular amphetamine users during a reported ,heroin drought'ADDICTION, Issue 7 2004Amanda Baker ABSTRACT Aims The present study extends the findings of a pilot study conducted among regular amphetamine users in Newcastle, NSW, in 1998. It compares key features between current participants in a state capital city (Brisbane) and a regional city (Newcastle) and between the 1998 and current Newcastle sample. Design Cross-sectional survey. Setting Brisbane and Newcastle, Australia. Participants The survey was conducted among 214 regular amphetamine users within the context of a randomized controlled trial of brief interventions for amphetamine use. Measurements Demographic characteristics, past and present alcohol and other drug use and mental health, treatment, amphetamine-related harms and severity of dependence. Findings The main findings were as follows: (i) the rate of mental health problems was high among regular amphetamine users and these problems commonly emerged after commencement of regular amphetamine use; (ii) there were regional differences in drug use with greater accessibility to a wider range of drugs in a state capital city and greater levels of injecting risk-taking behaviour outside the capital city environment; and (iii) there was a significant increase in level of amphetamine use and percentage of alcohol users, a trend for a higher level of amphetamine dependence and a significant reduction in the percentage of people using heroin and benzodiazepines among the 2002 Newcastle cohort compared to the 1998 cohort. Conclusions Further longitudinal research is needed to elucidate transitions from one drug type to another and from recreational to injecting and regular use and the relationship between drug use and mental health in prospective studies among users. Implications Intervention research should evaluate the effectiveness of interventions aimed at: preventing transition to injecting and regular use of amphetamines; toward reducing levels of depression among amphetamine users and interventions among people with severe psychopathology and personality disorders; and toward reducing the prevalence of tobacco dependence among amphetamine users. [source] Patient preferences for managing asthma: results from a discrete choice experimentHEALTH ECONOMICS, Issue 7 2007Madeleine T. King Abstract Effective control of asthma requires regular preventive medication. Poor medication adherence suggests that patient preferences for medications may differ from the concerns of the prescribing clinicians. This study investigated patient preferences for preventive medications across symptom control, daily activities, medication side-effects, convenience and costs, using a discrete choice experiment embedded in a randomized clinical trial involving patients with mild,moderate persistent asthma. The present data were collected after patients had received 6 weeks' treatment with one of two drugs. Three choice options were presented, to continue with the current drug, to change to an alternative, hypothetical drug, or to take no preventive medication. Analysis used random parameter multinomial logit. Most respondents chose to continue with their current drug in most choice situations but this tendency differed depending on which medication they had been allocated. Respondents valued their ability to participate in usual daily activities and sport, preferred minimal symptoms, and were less likely to choose drugs with side-effects. Cost was also significant, but other convenience attributes were not. Demographic characteristics did not improve the model fit. This study illustrates how discrete choice experiments may be embedded in a clinical trial to provide insights into patient preferences. Copyright © 2007 John Wiley & Sons, Ltd. [source] Degree of discrepancy between self and other-reported everyday functioning by cognitive status: dementia, mild cognitive impairment, and healthy eldersINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 9 2005Sarah Tomaszewski Farias Abstract Background Previous studies show individuals with dementia overestimate their cognitive and functional abilities compared to reports from caregivers. Few studies have examined whether individuals with Mild Cognitive Impairment (MCI) also tend to underestimate their deficits. In this study we examined whether degree of discrepancy between patient and informant-reported everyday functioning was associated with cognitive status. Methods The sample consisted of 111 ethnically diverse community-dwelling older adults (46 Caucasians and 65 Hispanic individuals), which was divided into four diagnostic categories: cognitively normal, MCI-memory impaired, MCI-nonmemory impaired, and demented. Everyday functional abilities were measured using both a self-report and informant-report version of the Daily Function Questionnaire (DFQ). A Difference Score was calculated by subtracting patients' DFQ score from their informants' score. Results DFQ Difference Scores were significantly higher in the demented group compared to normals and both of the MCI groups. However, the Difference Scores for the MCI groups were not significantly different than the normals. Further, while patient reported everyday functioning did not differ among the four diagnostic groups, informant reported functional status was significantly different across all diagnostic groups except MCI-nonmemory impaired vs normals. Performance on objective memory testing was associated with informant-rated but not patient-rated functional status. Demographic characteristics of the patients and informants, including ethnicity, had no association with the degree of discrepancy between raters. Conclusions Although there may be some mild functional changes associated particularly with the MCI-memory impaired subtype, individuals with MCI do not appear to under-report their functional status as can often been seen in persons with dementia. Copyright © 2005 John Wiley & Sons, Ltd. [source] Contribution of PTSD/POW history to behavioral disturbances in dementiaINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 4 2001Swapna Verma Abstract As many World War II and Korean Conflict veterans suffering from posttraumatic stress disorder (PTSD) grow older, increasing numbers will be diagnosed with dementia. We retrospectively analyzed patients with dementia, comparing the behavioral disturbances of those with PTSD to those without PTSD. We hypothesized that due to the additive effect of the neurobiological and behavioral changes associated with PTSD and dementia, the dementia with PTSD group would show more agitation and disinhibition than the dementia without PTSD group. Sixteen patients with diagnoses of dementia and PTSD were matched on age and Mini-Mental States Examination (MMSE) scores to 16 patients with dementia without PTSD. Demographic characteristics, co-morbid diagnoses, global Assessment of Functioning (GAF), Cohen-Mansfield Agitation Inventory (CMAI), and paranoid items of Brief Psychiatric Rating Scale (BPRS) and Positive and Negative Syndrome Scale for Schizophrenia (PANSS) were assessed. The patients with diagnoses of dementia with PTSD did not differ significantly in their clinical presentation, hospital course, and condition at discharge from patients with dementia without PTSD. Chi-square analysis showed that significantly more subjects in the PTSD group were prescribed anti-depressants compared to the non-PTSD group. Interestingly, within the PTSD group, the subgroup of patients who were former prisoners of war had a significantly higher mean score for paranoia and significantly less verbal agitation. This pilot study reveals that a diagnosis of PTSD alone is not sufficient to influence behavior in veterans with dementia; however, we also present provocative results that patients with more severe trauma (POW) do have changes in their behavior. Copyright © 2001 John Wiley & Sons, Ltd. [source] TIEBOUT DYNAMICS: NEIGHBORHOOD RESPONSE TO A CENTRAL-CITY/SUBURBAN HOUSE-PRICE DIFFERENTIAL,JOURNAL OF REGIONAL SCIENCE, Issue 4 2007Paul Thorsnes ABSTRACT We take advantage of an unusual natural experiment,a high-quality 1920s subdivision split neatly in half by a central-city/suburban boundary,to study the response over 30 years to the relative decline in the quality of central-city services since the 1960s. As expected, a large sale price differential opens in the 1960s. Demographic characteristics are nevertheless similar across the boundary. Survey data indicate Tiebout sorting: the central city side attracts households who prefer alternatives to suburban public schools. Children attend parochial and public "magnet" schools. A neighborhood association supplements municipal services. Rigid service district boundaries inhibit closure of the house-price differential. [source] When Can We Expect the Unexpected?JOURNAL OF SOCIAL ISSUES, Issue 1 2008Predicting Educational Attainment When it Differs from Previous Expectations Individuals' expectations are strong predictors of their behaviors; educational expectations predict enrollment in postsecondary education. Yet in many cases, a youth's previous educational expectations are not met or are exceeded. This study examines correlates of educational expectations and unexpected educational attainment using longitudinal data from Monitoring the Future, a U.S. national study. Demographic characteristics, educational experiences in high school, and other risk and protective factors were related to expectations for educational attainment during high school. Logistic regressions indicated that high school curriculum, average grades, educational aspirations, and parents' educational level were particularly strong indicators of youth not meeting their expectation to graduate from a 4-year college, or graduating from college despite expecting not to graduate by age 25/26. We discuss the implications of unexpected pathways in terms of discontinuity during transitions and consider the implications for improved educational and career counseling during high school. [source] Demographic Characteristics, Life Context, and Patterns of Substance Use Among Alcohol-Dependent Treatment Clients in a Health Maintenance OrganizationALCOHOLISM, Issue 12 2000Tammy W. Tam Background: Although individuals dependent only on alcohol and those dependent on both alcohol and drugs typically are not studied together in clinical trials, they are treated together in most treatment programs. In this study we compared epidemiological characteristics of the alcohol-only and alcohol-and-drug dependents in a treatment sample to assess differential treatment needs. Method: Patients admitted to treatment at a health maintenance organization's chemical dependency program were sampled and interviewed by using a structured questionnaire. The sample included 491 alcohol-only and 217 alcohol-and-drug dependents. Demographic characteristics, lifetime and current substance use, Addiction Severity Index composite scores, and DSM-IV criteria for alcohol and drug dependence were assessed at admission . Results: The odds of alcohol-and-drug dependence were higher among males, African Americans (when compared with whites), those who were younger, and those with less than college education. The risk was also higher among those who initiated heavy drinking or drug use before the age of 18. Increased psychiatric and family/social problems also were associated with combined dependence. Conclusions: Even in this relatively homogeneous socioeconomic status population, demographic characteristics were important predictors of type of dependence. Treatment programs which provide services that address prevention and psychosocial problems should pay attention to age of initiation as well as psychiatric and social problems. [source] Pediatric renal transplantation in a South African teaching hospital: A 20-year perspectivePEDIATRIC TRANSPLANTATION, Issue 4 2006G. J. Pitcher Abstract:, Introduction:, Renal transplantation is established as the standard of care for end-stage renal failure (ESRF) in the developed world. In emerging nations, the appropriateness of such costly interventions has been questioned. We undertook an analysis of all renal transplants undertaken under the care of the pediatric nephrology service at the Johannesburg Hospital, South Africa, in order to establish the outcomes of a transplantation service in a resource-constrained environment in a developing country. Methods:, This was a retrospective review of renal transplantation undertaken at a single teaching hospital in Johannesburg, part of the University of the Witwatersrand. Two hundred and eighty-two transplants were performed between 1984 and 2003. Demographic characteristics of the transplanted population, diagnosis, morbidity, graft survival, and mortality were recorded. Results:, Overall 1-, 5-, and 10-yr graft survival was 82, 44, and 23%. Overall 1-, 5-, and 10-yr patient survival was 97, 84, and 68%. The median graft survival for all transplantation episodes was 4.38 yr; 70% of patients survive 10 yr and 54% survive 20 yr or more. Although early graft survival was good, there was a more rapid rate of graft loss than when compared to results from developed centers with much poorer results at 5 and 10 yr. Causes of ESRF show marked variation between the races, and black patients have significantly worse outcomes than others. Compared with white patients, black recipients received fewer living donor kidneys (26 vs. 10%, p = 0.0019), a greater proportion of totally mismatched organs (56 vs. 36%, p = 0.015), less pre-emptive transplantation (7 vs. 35%, p = 0.0001) and experienced a higher rate of primary non-function (13 vs. 3%, p = 0.004). Surgical complications of transplantation occurred in 9% of recipients, but rarely led to graft loss. Conclusion:, Pediatric renal transplantation in Johannesburg can be accomplished with low complication rates, but medium and long-term graft survival is poor when compared with contemporary results achieved in developed countries. The difficulties of undertaking such complex, multidisciplinary interventions in a developing nation are daunting, but we believe that renal transplantation should still be the treatment of choice for all children with ESRF. The poorer outcomes in black recipients can be addressed by increasing education in our communities and expanding the pool of appropriate donors. Better institutional support would allow for improved long-term patient care. [source] An empirical taxonomy of youths' fears: Cluster analysis of the American fear survey schedulePSYCHOLOGY IN THE SCHOOLS, Issue 6 2006Joy J. Burnham Fears profiles among children and adolescents were explored using the Fear Survey Schedule for Children-American version (FSSC-AM; J.J. Burnham, 1995, 2005). Eight cluster profiles were identified via multistage Euclidean grouping and supported by homogeneity coefficients and replication. Four clusters reflected overall level of fears (i.e., very low, below average, moderate, and multiple), and four others exhibited specific peaks associated with school-related fears, medical fears, and scary things. Demographic characteristics associated with cluster profile membership revealed variability primarily based on gender and age, with some differences associated with community type. Comparisons with prior results on earlier fear surveys and implications for school refusal behavior provide a useful context for discussion. © 2006 Wiley Periodicals, Inc. Psychol Schs 43: 673,683, 2006. [source] The role of traumatic event history in non-medical use of prescription drugs among a nationally representative sample of US adolescentsTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 1 2010Jenna L. McCauley Background:, Building on previous research with adolescents that examined demographic variables and other forms of substance abuse in relation to non-medical use of prescription drugs (NMUPD), the current study examined potentially traumatic events, depression, posttraumatic stress disorder (PTSD), other substance use, and delinquent behavior as potential correlates of past-year non-medical use of prescription drugs. Method:, A nationally representative sample of 3,614 non-institutionalized, civilian, English-speaking adolescents (aged 12,17 years) residing in households with a telephone was selected. Demographic characteristics, traumatic event history, mental health, and substance abuse variables were assessed. NMUPD was assessed by asking if, in the past year, participants had used a prescription drug in a non-medical manner. Multivariable logistic regressions were conducted for each theoretically derived predictor set. Significant predictors from each set were then entered into a final multivariable logistic regression to determine significant predictors of past-year NMUPD. Results:, NMUPD was endorsed by 6.7% of the sample (n = 242). The final multivariable model showed that lifetime history of delinquent behavior, other forms of substance use/abuse, history of witnessed violence, and lifetime history of PTSD were significantly associated with increased likelihood of NMUPD. Conclusions: Risk reduction efforts targeting NMUPD among adolescents who have witnessed significant violence, endorsed abuse of other substances and delinquent behavior, and/or endorsed PTSD are warranted. Interventions for adolescents with history of violence exposure or PTSD, or those adjudicated for delinquent behavior, should include treatment or prevention modules that specifically address NMUPD. [source] Risk Factors for Mortality of Bacteremic Patients in the Emergency DepartmentACADEMIC EMERGENCY MEDICINE, Issue 8 2009Jiun-Nong Lin MD Abstract Objectives:, Patients with bacteremia have a high mortality and generally require urgent treatment. The authors conducted a study to describe bacteremic patients in emergency departments (EDs) and to identify risk factors for mortality. Methods:, Bacteremic patients in EDs were identified retrospectively at a university hospital from January 2007 to December 2007. Demographic characteristics, underlying illness, clinical conditions, microbiology, and the source of bacteremia were collected and analyzed for their association with 28-day mortality. Results:, During the study period, 621 cases (50.2% male) were included, with a mean (±SD) age of 62.8 (±17.4) years. The most common underlying disease was diabetes mellitus (39.3%). Escherichia coli (39.2%) was the most frequently isolated pathogen. The most common source of bacteremia was urinary tract infection (41.2%), followed by primary bacteremia (13.2%). The overall 28-day mortality rate was 12.6%. Multivariate stepwise logistic regression analysis showed age > 60 years (odds ratio [OR] = 2.52, 95% confidence interval [CI] = 1.29 to 4.92, p = 0.007), malignancy (OR = 2.66, 95% CI = 1.44 to 4.91, p = 0.002), liver cirrhosis (OR = 2.08, 95% CI = 1.02 to 4.26, p = 0.044), alcohol use (OR = 5.73, 95% CI = 2.10 to 15.63, p = 0.001), polymicrobial bacteremia (OR = 3.99, 95% CI = 1.75 to 9.10, p = 0.001), anemia (OR = 2.33, 95% CI = 1.34 to 4.03, p = 0.003), and sepsis (OR = 1.94, 95% CI = 1.16 to 3.37, p = 0.019) were independent risk factors for 28-day mortality. Conclusions:, Bacteremic patients in the ED have a high mortality, particularly with these risk factors. It is important for physicians to recognize the factors that potentially contribute to mortality of bacteremic patients in the ED. [source] Epidemiological changes in colorectal cancer in Shiraz, Iran: 1980,2000ANZ JOURNAL OF SURGERY, Issue 7 2004Seyed Vahid Hosseini Background: The present study was performed to determine trends in colorectal cancer rates over the past two decades (1970,80 vs 1990,2000) with in a main referral centre in Shiraz, Iran. Methods: The Cancer Registry data on all colorectal cancer cases from 1970 to 2000 in Shiraz, Iran, were analysed. Demographic characteristics, clinical features, cancer site and type and stage of cancer were compared in the populations of two different decades. Results: The age-adjusted incidence of colorectal cancer per 100 000 population per year increased in men from a mean annual incidence of 1.61 in the decade 1970,80 to 4.2 in 1990,2000 (P < 0.05), and in women from 2.35 to 2.72 (P < 0.05). In 1970,80, patients over 60 years had 62.5% of all the colorectal cancers, which decreased to 30% in 1990,2000 (P < 0.05). The distribution of right and left sided cancers were almost equal and showed no significant difference between the two decades (P > 0.05). Conclusion: A marked increase in the incidence of colorectal cancer has been shown in Shiraz. Also, the marked increase in the incidence of colorectal cancer in the 40,60-year-old age group shown in the present study necessitates a more detailed work-up in younger age group patients. [source] Vascular cell adhesion molecule 1 as a predictor of severe osteoarthritis of the hip and knee jointsARTHRITIS & RHEUMATISM, Issue 8 2009Georg Schett Objective Osteoarthritis (OA) is a leading cause of pain and physical disability in middle-aged and older individuals. We undertook this study to determine predictors of the development of severe OA, apart from age and overweight. Methods Joint replacement surgery due to severe hip or knee OA was recorded over a 15-year period in the prospective Bruneck cohort study. Demographic characteristics and lifestyle and biochemical variables, including the level of soluble vascular cell adhesion molecule 1 (VCAM-1), were assessed at the 1990 baseline visit and tested as predictors of joint replacement surgery. Results Between 1990 and 2005, hip or knee joint replacement due to OA was performed in 60 subjects. VCAM-1 level emerged as a highly significant predictor of the risk of joint replacement surgery. Intervention rates were 1.9, 4.2, and 10.1 per 1,000 person-years in the first, second, and third tertiles, of the VCAM-1 level, respectively. In multivariable logistic regression analysis, the adjusted relative risk of joint replacement surgery in the highest versus the lowest tertile group of VCAM-1 level was 3.9 (95% confidence interval 1.7,8.7) (P < 0.001). Findings were robust in various sensitivity analyses and were consistent in subgroups. Addition of the VCAM-1 level to a risk model already including age, sex, and body mass index resulted in significant gains in model discrimination (C statistic) and calibration and in more accurate risk classification of individual participants. Conclusion The level of soluble VCAM-1 emerged as a strong and independent predictor of the risk of hip and knee joint replacement due to severe OA. If our findings can be reproduced in other epidemiologic cohorts, they will assist in routine risk classification and will contribute to a better understanding of the etiology of OA. [source] Methaemoglobinaemia risk factors with inhaled nitric oxide therapy in newborn infantsACTA PAEDIATRICA, Issue 10 2010I Hamon Abstract Background:, Inhaled nitric oxide (iNO), commonly used for hypoxic neonates, may react with haemoglobin to form methaemoglobin (MetHb). MetHb monitoring during iNO therapy has been questioned since low doses of iNO are used. Aim:, To evaluate the incidence of and identify risk factors associated with elevated MetHb in neonates treated with iNO. Methods:, Neonates who were treated with iNO and had at least one MetHb measurement were included. Demographic characteristics and methods of iNO administration (dosage, duration) at the time of each MetHb measurement were analysed. Results:, Four hundred and fifty-two MetHb measurements from 81 premature and 82 term and near-term infants were analysed. MetHb was above 5% in one-term infant, and between 2.5,5% in 16 infants. A higher maximum dose of iNO (22.7 vs 17.7 p.p.m.), but not gestational age, was a significant risk factor for elevated MetHb. Significantly higher oxygen levels (75.5% vs 51.7%) were associated with higher MetHb in term infants. Preterm infants had no risk for high MetHb when iNO was kept below 8 p.p.m. These data suggest the possibility of limiting blood withdrawal when low doses iNO are used. Conclusion:, High MetHb is exceptional in neonates treated with low dose iNO. Associated risk factors are related to high iNO dose and the simultaneous use of high concentrations of oxygen. [source] Statutory health assessments for looked-after children: what do they achieve?CHILD: CARE, HEALTH AND DEVELOPMENT, Issue 1 2003C. M. Hill Abstract Objective To examine the outcomes of statutory health assessment of children looked after by an English City Council. Design Retrospective longitudinal documentary analysis. Setting and participants Health records of all children looked after by Southampton City Council who had attended at least two statutory health assessments within a designated paediatric service from 1996 to 1999. Main variables studied Demographic characteristics of the children; physical and mental health problems identified at assessment and extent to which health recommendations were implemented. Results Twenty-seven boys and 22 girls aged 6 months,15 years were identified who had attended at least two assessments. One-hundred and four physical and mental health needs were identified at care entry requiring further assessment or intervention. More health problems were identified for girls than boys. At care entry 15/49 of the children were not fully immunized. At review, on average 14 months later, recommendations had only been implemented in just over half of children. Conclusions In common with previous studies this work confirms that the statutory health assessment identifies health need and health neglect that may otherwise go unrecognized. Whereas children's needs and problems were diverse, many continued to suffer health neglect in the system of public care designed to help them. In order to be effective, statutory health assessments must be a health promoting rather than disease screening exercise delivered by professionals skilled to address diverse health needs. Crucially, the heath assessment can only succeed as a tool for health advocacy if complementary to and integrated with local authority care and review. [source] Factors affecting nest predation on forest songbirds in North AmericaIBIS, Issue 2007FRANK R. THOMPSON III Nest predation is an important factor in the ecology of passerines and can be a large source of mortality for birds. I provide an overview of factors affecting nest predation of passerines in North America with the goal that it may provide some insight into the ecology and management of woodland birds in the United Kingdom. Although several factors influence productivity, nest success is perhaps the most widely measured demographic characteristic of open-cup-nesting birds, and nest predation is usually the largest cause of nest failure. The identity of predator species, and how their importance varies with habitat and landscape factors, must be known for managers and scientists to design effective conservation plans and place research on nest predation in the appropriate context. Recent studies using video surveillance have made significant contributions to our understanding of the relative importance of different predator taxa in North America. Spatial and temporal variation in nest predation can be better understood when landscapes are placed in a biogeographical context and local habitat and nest-site effects are placed in a landscape context. Low productivity resulting from high nest predation is one of several potential causes of bird population declines in North America and the UK. Although the ,forest fragmentation paradigm' from the eastern US may not apply directly to the UK, thinking about avian demographics from a multiscale perspective, and consideration of factors affecting nest predation with knowledge of the dominant predator species, may provide insight into population declines. [source] Conflict resolution among early childhood educatorsCONFLICT RESOLUTION QUARTERLY, Issue 4 2008Sandy Jenkins Little attention has been given to conflict resolution in preschools. Early childhood educators working with children aged three to five completed a ten-to fifteen-minute survey to examine their attitudes and practices toward conflict. This study explored the types of conflict resolution strategies they used and thought were effective in their classrooms. The strategies were also examined in relation to the demographic characteristics of the participants. Results indicated that educators used cooperative strategies in their classrooms. Significant relationships were demonstrated involving the types of strategies used and demographic factors. [source] Managers' profile in environmental strategy: a review of the literatureCORPORATE SOCIAL RESPONSIBILITY AND ENVIRONMENTAL MANAGEMENT, Issue 5 2006Esteban Fernández Abstract Environmental legislation and stakeholders are putting pressure on organizations to change. The role of management is a key factor. The aim of the present work is to determine the key characteristics required of a manager with environmental responsibilities and determine which are the critical aptitudes and attitudes for environmental success through a deep review of the literature. We include three kinds of characteristic: (a) managerial attitude and social influence, (b) individual characteristics (demographic characteristics, capability to perceive strategic opportunities, leadership, individual entrepreneurial ability and international awareness) and (c) organizational characteristics (organizational culture, capability to influence strategy, long-term orientation, organizational structure and demographic characteristics). With this purpose, we have collected and integrated the most relevant contributions of the literature. We have also suggested future research streams: for example, analysis of the interdependences among the diverse dimensions of a manager with environmental responsibilities, analysis of the characteristics typical of external stakeholders that condition the managerial behaviour and other aspects of environmental strategy on which management attitude has an influence. Copyright © 2006 John Wiley & Sons, Ltd and ERP Environment. [source] Panic and suicidal ideation and suicide attempts: results from the National Comorbidity SurveyDEPRESSION AND ANXIETY, Issue 3 2006M.P.H., Renee D. Goodwin Ph.D. Abstract Our objective was to determine the association between panic attacks (PAs) and panic disorder (PD), and suicidal ideation (SI) and suicide attempts (SAs) in a nationally representative sample of adults in the community. Data were drawn from the National Comorbidity Survey (n=5,877), a representative household sample of adults ages 15,54 in the United States. Multiple logistic regression analyses were used to examine the relationship between current and lifetime PA and PD and SI and SA, adjusting for differences in demographic characteristics, comorbid mental disorders (major depression, alcohol dependence, and substance dependence), childhood trauma (physical and sexual abuse), and number of lifetime mental disorders. Past-year and lifetime PA and PD were associated with increased SI (both past year and lifetime), and persisted after adjusting for comorbidity and early trauma. Associations between PA and SA were no longer statistically significant after adjusting for comorbidity. Past-year and lifetime PD were associated with lifetime SA, but these associations were no longer statistically significant after adjusting for comorbidity. Past-year and lifetime PD were associated with past-year SA, and this association persisted after adjusting for demographics, comorbidity, and number of lifetime mental disorders. These findings are consistent with previous results, and further help to clarify the relationships between panic and suicide behavior by identifying potential methodological reasons for inconsistencies in results from previous studies. Depression and Anxiety 23:124,132, 2006. © 2006 Wiley-Liss, Inc. [source] Baseline profiles of adolescent vs. adult-onset first-episode psychosis in an early detection programACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2009I. Joa Objective:, Psychotic disorders often start in adolescence. We aim to investigate premorbid and baseline differences characterizing patients with an onset of psychosis in adolescence versus adulthood. Method:, We compare first-episode, DSM-IV non-affective psychosis with onset before (n = 43) and after (n = 189) 18 years on duration of untreated psychosis (DUP), level of symptoms, suicidal behaviour, and other baseline clinical and demographic characteristics. Results:, Adolescent onset patients had poorer premorbid functioning, a longer DUP, higher suicidality, and more depressive symptoms. They also had better cognition, fewer psychotic symptoms, and were more likely to be treated on an out-patient basis. Conclusion:, Adolescents with first-episode psychosis may have a slower and more silent, i.e. insidious onset, and are at risk of experiencing longer treatment delays than adults. They fit the description of what used to be labeled process (versus reactive) schizophrenia. [source] Risk factors for suicide attempts in patients with alcohol dependence or abuse and a history of depressive symptoms: A subgroup analysis from the WHO/ISBRA studyDRUG AND ALCOHOL REVIEW, Issue 1 2010ÖZGÜR YALDIZLI Abstract Introduction and Aims. Alcoholism, depression and suicide attempts (SA) are strongly interrelated. The aims were to determine risk factors and develop a prognostic predictor model for SA in a subgroup of patients with a history of alcohol dependence or abuse and depressive symptoms. Design and Methods. A subgroup analysis from the data of the World Health Organisation (WHO)/the International Society for Biomedical Research on Alcoholism (ISBRA)-collaborative study on biological state and trait marker of alcohol use and dependence, an international multi-centre study with a cross-sectional design, based on a standardised questionnaire. We analysed from 1314 variables 43 factors,including demographic characteristics, dependence variables, comorbid disorders, personality trait markers and family history,that were supposed to be most predictive for SA according to the literature. Correlation analyses by the ,2 -test and Mann,Whitney U -test were performed to obtain statistical meaningful parameters for logistic regression analysis. Results. Of the 1863 persons included in the WHO/ISBRA study, 292 had both a history of depressive symptoms and alcohol dependence or abuse and were included in the subgroup analysis. In the logistic regression analysis, drinking status, depressive symptoms, adverse drinking experiences during alcohol consumption, bad experiences from drug abuse and antidepressant therapy were found to be independent risk factors for SA. Positive family history of alcoholism was a model-improving co-factor. This predictive model explains approximately 60% of the variance (Nagelkerkes' square). Discussion and Conclusions. This prognostic model derived from data of the WHO/ISBRA collaborative study shows important risk factors for SA in patients with history of alcohol abuse or dependence and depressive symptoms. [ Yaldizli Ö, Kuhl HC, Graf M, Wiesbeck GA, Wurst FM. Risk factors for suicide attempts in patients with alcohol dependence or abuse and a history of depressive symptoms: A subgroup analysis from the WHO/ISBRA study. Drug Alcohol Rev 2009] [source] Patterns of co-morbidity between alcohol use and other substance use in the Australian populationDRUG AND ALCOHOL REVIEW, Issue 1 2003Dr. LOUISA DEGENHARDT Abstract The present study describes patterns of co-morbidity between alcohol use and other substance use problems in the Australian population using data from the 1997 National Survey of Mental Health and Well-Being. Multiple regression analyses examined whether the observed associations between alcohol and other drug use disorders were explained by other variables, including demographic characteristics and neuroticism. We also assessed whether the presence of co-morbid substance use disorders affected treatment seeking for a mental health problem. Alcohol use was related strongly to the use of other substances. Those who did not report alcohol use within the past 12 months were less likely to report using tobacco, cannabis, sedatives, stimulants or opiates. Higher rates again were observed among those with alcohol use disorders: half (51%) of those who were alcohol-dependent were regular tobacco smokers, one-third had used cannabis (32%); 15% reported other drug use; 15% met criteria for a cannabis use disorder and 7% met criteria for another drug use disorder. These associations were not accounted for by the demographic and other variables considered here. Co-morbid substance use disorders (sedatives, stimulants or opioids) predicted a high likelihood of seeking treatment for a mental health problem among alcohol-dependent people. [source] Empirical support for a multi-dimensional model of sensations experienced by youth during their initial smoking episodesADDICTION, Issue 10 2010Chris G. Richardson ABSTRACT Aims To examine the dimensionality of sensations experienced during initial tobacco smoking. Design Cross-sectional survey. Setting Thirteen secondary schools located in British Columbia, Canada. Participants Data from 1187 adolescents who responded ,yes' to the question: ,Have you ever tried cigarette smoking, even one or two puffs?'. Measurements Participants answered questions about their demographic characteristics, tobacco smoking history and sensations experienced during their initial smoking episodes. Findings The sensations appear to represent the following three separate but modestly correlated dimensions: a pleasant dimension defined by feeling good and relaxed; an unpleasant dimension defined by coughing, feeling sick and nervous; and a ,buzz' dimension defined by feeling high and dizzy. The three factors made statistically significant contributions to the prediction of transition to regular smoking (defined as having smoked at least 100 cigarettes in one's life-time) after adjusting for age, sex and age at first puff. Conclusions The results suggest that three relatively distinct physiological systems appear to explain the relationship between initial smoking sensations and probability of becoming a regular smoker. Researchers examining sensations experienced during initial tobacco smoking episodes should consider using a three-dimensional profile of symptoms composed of pleasant, unpleasant and buzz dimensions. [source] Areca nut dependence among chewers in a South Indian community who do not also use tobaccoADDICTION, Issue 7 2010Shrihari J. S. Bhat ABSTRACT Aims Previously reported research suggests a dependence syndrome for areca nut use, though well-designed studies are virtually non-existent. The goal of this study was to examine evidence of areca dependence in a sample of areca-only (i.e. no tobacco) chewers using modified measurement scales. Design A purposive sample of chewers, identified via local informants and advertisements, was surveyed from January to March of 2005. Setting Six villages in Dakshina Kannada District, Karnataka State, India. Participants Fifty-nine daily areca chewers who do not also currently use any form of tobacco. Measurements Questionnaires included modified versions of the Fagerström Tolerance Questionnaire, Cigarette Dependence Scale (CDS-5) and the Smokeless Tobacco Dependence Scale (STDS). Additional questions assessed demographic characteristics and patterns of use. Findings Approximately half of respondents reported 1,3 chews/day (mean = 1.9; SD = 0.98). The average number of chewing episodes/day was 4.4 (SD = 3.4) and the average number of nuts/day was 1.2 (SD = 1.1). Users' typical chew lasts up to 20 minutes and includes spitting out the juices and rinsing the mouth with water. Overall, the levels of reported dependence symptoms were quite low, but approximately 44% of chewers endorsed at least one of the following items: continued use despite illness or mouth wounds, difficulty refraining from chewing in forbidden places, or craving during periods of abstinence. Approximately 15.4% of chewers reported at least one intentional quit attempt and a subset had summary scores indicative of dependence (13.6% had scores >16 on the CDS-5 and 5.3% had scores >11 on the STDS). Dependence scores were positively correlated with frequency of chews/day. Conclusions The symptoms of dependence observed in a subset of areca-only chewers warrant further investigation. Next steps should include well-controlled laboratory evaluation of dependence features. [source] The utility of online panel surveys versus computer-assisted interviews in obtaining substance-use prevalence estimates in the NetherlandsADDICTION, Issue 10 2009Renske Spijkerman ABSTRACT Aims Rather than using the traditional, costly method of personal interviews in a general population sample, substance-use prevalence rates can be derived more conveniently from data collected among members of an online access panel. To examine the utility of this method, we compared the outcomes of an online survey with those obtained with the computer-assisted personal interviews (CAPI) method. Design Data were gathered from a large sample of online panellists and in a two-stage stratified sample of the Dutch population using the CAPI method. Setting The Netherlands. Participants The online sample comprised 57 125 Dutch online panellists (15,64 years) of Survey Sampling International LLC (SSI), and the CAPI cohort 7204 respondents (15,64 years). Measurements All participants answered identical questions about their use of alcohol, cannabis, ecstasy, cocaine and performance-enhancing drugs. The CAPI respondents were asked additionally about internet access and online panel membership. Both data sets were weighted statistically according to the distribution of demographic characteristics of the general Dutch population. Findings Response rates were 35.5% (n = 20 282) for the online panel cohort and 62.7% (n = 4516) for the CAPI cohort. The data showed almost consistently lower substance-use prevalence rates for the CAPI respondents. Although the observed differences could be due to bias in both data sets, coverage and non-response bias were higher in the online panel survey. Conclusions Despite its economic advantage, the online panel survey showed stronger non-response and coverage bias than the CAPI survey, leading to less reliable estimates of substance use in the general population. [source] Characteristics of Household Addresses That Repeatedly Contact 911 to Report Intimate Partner ViolenceACADEMIC EMERGENCY MEDICINE, Issue 6 2004Debra Houry MD Abstract Objectives: To determine whether households that generate several 911 calls differ in important ways from those that make a single call and to determine whether households that generate repeat 911 calls for intimate partner violence (IPV) experience more severe violence than those that do not. Methods: All cases of police-documented IPV were reviewed and linked with their respective 911 calls. Each incident report was reviewed to determine the relationship between the offender and victim, demographic characteristics of the offender and victim, weapon and substance involvement, prior incidents of IPV, and violence severity. Results: Of the 1,505 IPV addresses identified during the 12-month study interval, 1,010 (67.1%) placed more than one phone call to report IPV. Sixty-nine percent of African American victims, 50.6% of white victims, and 36.8% of Hispanic victims were repeat callers (p < 0.001). There were no differences between addresses that generated repeat calls versus single calls with respect to offender alcohol or drug involvement, presence of children, victim age, or offender age. Sixty-seven percent of households with severe violence and 66.9% of households with minor violence generated repeat 911 calls (p = 0.98). Conclusions: Ethnic differences in 911 use for IPV exist between African Americans, whites, and Hispanics. However, unknown societal, economic, or cultural issues could have influenced this finding. Households that repeatedly contacted 911 during the study interval to report IPV were not more likely to experience severe violence than those that placed a single 911 call. [source] Factors associated with incarceration and incident human immunodeficiency virus (HIV) infection among injection drug users participating in an HIV vaccine trial in Bangkok, Thailand, 1999,2003ADDICTION, Issue 2 2009Pravan Suntharasamai ABSTRACT Aims To determine if incarceration was associated with human immunodeficiency virus (HIV) infection and identify risk factors for incarceration among injection drug users (IDUs) participating in an HIV vaccine trial in Bangkok. Design The AIDSVAX B/E HIV vaccine trial was a randomized, double-blind, placebo-controlled study. A proportional hazards model was used to evaluate demographic characteristics, risk behavior and incarceration as predictors of HIV infection and generalized estimation equation logistic regression analysis to investigate demographic characteristics and risk behaviors for predictors of incarceration. Setting The trial was conducted in Bangkok Metropolitan Administration drug-treatment clinics, 1999,2003. Participants A total of 2546 HIV-uninfected IDUs enrolled in the trial. Measurements HIV testing was performed and an interviewer-administered questionnaire was used to assess risk behavior and incarceration at baseline and every 6 months for a total of 36 months. Findings HIV incidence was 3.4 per 100 person-years [95% confidence interval (CI), 3.0,3.9] and did not differ among vaccine and placebo recipients. In multivariable analysis, being in jail (P < 0.04), injecting (P < 0.0001), injecting daily (P < 0.0001) and sharing needles (P = 0.02) were associated with HIV infection and methadone maintenance was protective (P = 0.0006). Predictors of incarceration in multivariable analysis included: male sex (P = 0.04), younger age (P < 0.0001), less education (P = 0.001) and being in jail (P < 0.0001) or prison (P < 0.0001) before enrollment. Conclusions Among IDUs in the AIDSVAX B/E trial, incarceration in jail was associated with incident HIV infection. IDUs in Thailand remain at high risk of HIV infection and additional prevention tools are needed urgently. HIV prevention services, including methadone, should be made available to IDUs. [source] | |||||||||||||||||||||||||||||||||||||||||||