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Medical Factors (medical + factor)
Selected AbstractsPsychosocial Adjustment of People with Epilepsy in Hong KongEPILEPSIA, Issue 9 2001Vanessa W. Y. Lau Summary: ,Purpose: In light of the issues associated with the psychosocial adjustment of people with epilepsy that have been widely reported, this study examined these issues within a Chinese cultural context. Methods: Fifty patients with epilepsy completed The Washington Psychosocial Inventory, the Coping Inventory for Stressful Situations, and a questionnaire that assessed their psychosocial difficulties and coping styles. Multiple regression procedure was used to examine the strength of various medical and social factors in predicting the psychosocial adjustment problems of these participants. Results: Social factors, such as self-perception and coping strategies, were more powerful predictors of psychosocial adjustment in people with epilepsy than the medical factors associated with epilepsy. Conclusions: These findings showed that psychosocial maladjustment is a significant issue for people with epilepsy in Hong Kong. The emerging importance of social factors as predictors of psychosocial adjustment in epilepsy, as compared with medical factors, highlights the need for developing tailored counseling therapy and social support groups for people with epilepsy. [source] The Impact of Childhood Epilepsy on Neurocognitive and Behavioral Performance: A Prospective Longitudinal StudyEPILEPSIA, Issue 4 2000Laura L. Bailet Summary: Purpose: To assess neurocognitive and behavioral performance in children with idiopathic epilepsy (CWE, n = 74), their siblings without epilepsy (control, n = 23), and children with migraine (CWM, n = 13), and to identify medical factors related to learning or behavioral problems in CWE. Methods: Subjects, ages 8,13 years with IQs of ,80, completed a neurocognitive test battery annually for ,3 years. For CWE, age at seizure onset, most recent EEG results, seizure type, seizure frequency, current antiepileptic drug (AED), and most recent AED serum levels were documented at each visit. Results: CWE and CWM had high rates of grade retention and placement in special education compared with sibling controls. CWE performed worse than controls on numerous neurocognitive variables. These differences persisted over time. CWE with abnormal EEGs scored lower than CWE with normal EEGs on reading and spelling measures, even with comparable IQs. Age at seizure onset, seizure type, and seizure frequency were not related to neurocognitive or behavioral test scores. CWE taking carbamazepine (CBZ) performed better than CWE taking valproate (VPA) on academic achievement measures, although the study lacked controls necessary to assess this finding thoroughly. CWM did not differ from CWE or controls in cognitive or academic achievement skills. Conclusions: Long-term risk of learning problems exists among CWE as compared with controls, even with normal IQs and well-controlled seizures. Predicting learning problems in CWE based on medical factors remains elusive. Monitoring of educational progress and neurocognitive screening may be most effective in assessing academic risk for CWE. [source] Parenting and attachment among toddlers with congenital anomalies: Examining the Strange Situation and attachment Q-sortINFANT MENTAL HEALTH JOURNAL, Issue 6 2002Melissa Clements This study assessed parent and child predictors of attachment in a sample of 72 toddlers with neurological (e.g., cerebral palsy) and non-neurological (e.g., cleft lip and palate) birth defects and their mothers. Parenting quality (e.g., sensitivity) was expected to be more important in predicting the attachment relationship than type and severity of child medical condition. Parenting and indices of severity of child condition were measured via researcher observation. Attachment was measured via the Strange Situation and parent reported Attachment Q-sort. Parenting quality was better for children with more severe appearance disfigurements. Strange Situation and Q-sort assessments of attachment were not significantly related. Children with neurological impairments were at greater risk for developing insecure attachments than were children with non-neurological conditions. Parenting quality also directly predicted Strange Situation assessed attachment security and Q-sort comfort seeking/exploration but not standard Q-sort criterion scores. Parenting quality partially mediated the relation between child medical condition and attachment security. Results suggest child medical factors influence parenting, and thereby, child attachment. ©2002 Michigan Association for Infant Mental Health. [source] Correlates of trabecular and cortical volumetric bone mineral density of the radius and tibia in older men: The osteoporotic fractures in men studyJOURNAL OF BONE AND MINERAL RESEARCH, Issue 5 2010Kamil E Barbour Abstract Quantitative computed tomography (QCT) can estimate volumetric bone mineral density (vBMD) and distinguish trabecular from cortical bone. Few comprehensive studies have examined correlates of vBMD in older men. This study evaluated the impact of demographic, anthropometric, lifestyle, and medical factors on vBMD in 1172 men aged 69 to 97 years and enrolled in the Osteoporotic Fractures in Men Study (MrOS). Peripheral quantitative computed tomography (pQCT) was used to measure vBMD of the radius and tibia. The multivariable linear regression models explained up to 10% of the variance in trabecular vBMD and up to 9% of the variance in cortical vBMD. Age was not correlated with radial trabecular vBMD. Correlates associated with both cortical and trabecular vBMD were age (,), caffeine intake (,), total calcium intake (+), nontrauma fracture (,), and hypertension (+). Higher body weight was related to greater trabecular vBMD and lower cortical vBMD. Height (,), education (+), diabetes with thiazolidinedione (TZD) use (+), rheumatoid arthritis (+), using arms to stand from a chair (,), and antiandrogen use (,) were associated only with trabecular vBMD. Factors associated only with cortical vBMD included clinic site (,), androgen use (+), grip strength (+), past smoker (,), and time to complete five chair stands (,). Certain correlates of trabecular and cortical vBMD differed among older men. An ascertainment of potential risk factors associated with trabecular and cortical vBMD may lead to better understanding and preventive efforts for osteoporosis in men. © 2010 American Society for Bone and Mineral Research [source] Objective and subjective stressors and the psychological adjustment of melanoma survivorsPSYCHO-ONCOLOGY, Issue 4 2007Y. Hamama-Raz Abstract This study of 300 melanoma survivors examines the relative contributions of objective illness-related factors (stage of illness at diagnosis, time since diagnosis, and change in physical condition) and of subjective factors (cognitive appraisal) to their psychological adjustment. The findings show that lower appraisal of their situation as a threat, higher appraisal of it as a challenge, and higher appraisal of their subjective ability to cope with it all increased their well-being, while lower threat appraisal and higher appraisal of subjective ability to cope also reduced their distress. These findings, which are consistent with Lazarus and Folkman's stress coping theory, suggest that subjective factors may be more important than objective medical factors in predicting patients' adjustment. With this, more advanced stage at diagnosis contributed to reducing distress, while being married contributed both to higher well-being and reduced distress. Copyright © 2006 John Wiley & Sons, Ltd. [source] Nighttime Vagal Cardiac Control and Plasma Fibrinogen Levels in a Population of Working Men and WomenANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 2 2009Roland Von Känel M.D. Background: Elevated plasma fibrinogen levels have prospectively been associated with an increased risk of coronary artery disease in different populations. Plasma fibrinogen is a measure of systemic inflammation crucially involved in atherosclerosis. The vagus nerve curtails inflammation via a cholinergic antiinflammatory pathway. We hypothesized that lower vagal control of the heart relates to higher plasma fibrinogen levels. Methods: Study participants were 559 employees (age 17,63 years; 89% men) of an airplane manufacturing plant in southern Germany. All subjects underwent medical examination, blood sampling, and 24-hour ambulatory heart rate recording while kept on their work routine. The root mean square of successive differences in RR intervals during the night period (nighttime RMSSD) was computed as the heart rate variability index of vagal function. Results: After controlling for demographic, lifestyle, and medical factors, nighttime RMSSD explained 1.7% (P = 0.001), 0.8% (P = 0.033), and 7.8% (P = 0.007), respectively, of the variance in fibrinogen levels in all subjects, men, and women. Nighttime RMSSD and fibrinogen levels were stronger correlated in women than in men. In all workers, men, and women, respectively, there was a mean ± SEM increase of 0.41 ± 0.13 mg/dL, 0.28 ± 0.13 mg/dL, and 1.16 ± 0.41 mg/dL fibrinogen for each millisecond decrease in nighttime RMSSD. Conclusions: Reduced vagal outflow to the heart correlated with elevated plasma fibrinogen levels independent of the established cardiovascular risk factors. This relationship seemed comparably stronger in women than men. Such an autonomic mechanism might contribute to the atherosclerotic process and its thrombotic complications. [source] Infant and Neonatal Mortality for Primary Cesarean and Vaginal Births to Women with "No Indicated Risk," United States, 1998,2001 Birth CohortsBIRTH, Issue 3 2006Marian F. MacDorman PhD ABSTRACT:,Background: The percentage of United States' births delivered by cesarean section has increased rapidly in recent years, even for women considered to be at low risk for a cesarean section. The purpose of this paper is to examine infant and neonatal mortality risks associated with primary cesarean section compared with vaginal delivery for singleton full-term (37,41 weeks' gestation) women with no indicated medical risks or complications. Methods: National linked birth and infant death data for the 1998,2001 birth cohorts (5,762,037 live births and 11,897 infant deaths) were analyzed to assess the risk of infant and neonatal mortality for women with no indicated risk by method of delivery and cause of death. Multivariable logistic regression was used to model neonatal survival probabilities as a function of delivery method, and sociodemographic and medical risk factors. Results: Neonatal mortality rates were higher among infants delivered by cesarean section (1.77 per 1,000 live births) than for those delivered vaginally (0.62). The magnitude of this difference was reduced only moderately on statistical adjustment for demographic and medical factors, and when deaths due to congenital malformations and events with Apgar scores less than 4 were excluded. The cesarean/vaginal mortality differential was widespread, and not confined to a few causes of death. Conclusions: Understanding the causes of these differentials is important, given the rapid growth in the number of primary cesareans without a reported medical indication. (BIRTH 33:3 September 2006) [source] An epidemic of parvovirus B19 in a population of 3596 pregnant women: a study of sociodemographic and medical risk factorsBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 5 2000Inge Panum Jensen Consultant Objectives To estimate the incidence of human parvovirus B19 among pregnant women before and during an epidemic, to elucidate possible sociodemographic and medical risk factors during pregnancy and to estimate the association between parvovirus B19 infection and negative pregnancy outcome. Design Prospective study among pregnant women followed from their first antenatal visit before 24 full weeks of gestation until delivery. Setting Department of Obstetrics and Gynaecology, Odense University Hospital, Denmark, November 1992 to February 1994. Methods 3596 pregnant women were invited to participate. The women were examined at first antenatal visit in the period from November 1992 to February 1994 and at delivery. The last delivery was in August 1994 and samples were thus collected before and during a large parvovirus B19 epidemic in Denmark January to September 1994. A blood sample for parvovirus B19 serology was taken at enrolment and from the umbilical cord at delivery. Three questionnaires were completed during 2nd and 3rd trimesters and a registration form at delivery. In total, 3174 (87.6%) were enrolled and 79.5% completed the study. Results The prevalence of B19 IgG seropositivity at the first antenatal visit before 24 full weeks of gestation was 66%. The cumulative prevalence proportion of acute parvovirus B19 infection during pregnancy among IgG negative women was found to be 10.3% (IgM seropositivity and/or IgG sero-conversion). The IgG seroconversion incidence increased significantly from 1.0% to 13.5% among 932 seronegative pregnant women before and during the epidemic, respectively (P < 0.001). Independent risk factors related to increased risk of B19 infection during pregnancy, adjusted for other sociodemographic and medical factors, were: children at home (adjusted OR 2.1, 95% CI 1.3,3.2); serious medical disease (adjusted OR 3.0, 95% CI 1.0,8.5); and a stressful job (adjusted OR 1.8, 95% CI 1.0,3.3). Parvovirus B19 IgM seropositivity was associated with events of late spontaneous abortions and stillbirths (crude OR 9.9; 95% CI 3.3,29.4). Conclusion Before and during an epidemic of acute B19 infection incidences were measured among pregnant women to be 1.0% and 13.5%, respectively. Three factors, significantly increasing the risk of acute B19, were identified as: having children at home; suffering from serious medical diseases; and having a stressful job. IgM positivity for parvovirus B19 was associated with negative outcome of pregnancy. [source] | ||||||||||