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Baseline Data (baseline + data)
Selected AbstractsFactors predicting arrest for homeless persons receiving integrated residential treatment for co-occurring disordersCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 5 2009Blake Barrett Background,Homeless individuals are at increased risk for health and criminal justice problems. Aims,The aim of this study was to examine risk factors affecting arrest rates in a cohort of homeless people with co-occurring psychiatric and substance-abuse disorders. Methods,Baseline data were collected from 96 homeless individuals residing in a residential treatment facility for people with co-occurring disorders. Arrest data were obtained for 2 years following treatment intake. Regression analyses were employed to examine interactions between study variables. Results,One third of the sample was arrested during the 2-year follow-up period, principally for drug offences. People referred to treatment directly from the criminal justice system were four times more likely to re-offend than those referred from other sources. Participants' perceived need for mental-health services reduced risk of arrest while their perception of medical needs increased this risk. Conclusions,The relationship between referral from a criminal justice source and re-arrest after admission to the treatment facility is unsurprising, and consistent with previous literature, but the suggestion of an independently increased risk in the presence of perceived physical health-care needs is worthy of further study. The lower risk of arrest for people who perceive that they have psychological needs is encouraging. Copyright © 2009 John Wiley & Sons, Ltd. [source] School-based alcohol education: results of a cluster-randomized controlled trialADDICTION, Issue 3 2009Matthis Morgenstern ABSTRACT Objective This study aimed to examine the effects of a school-based alcohol education intervention. Design Two-arm three-wave cluster-randomized controlled trial, with schools as the unit for randomization. Surveys were conducted prior to intervention implementation, then 4 and 12 months after baseline. Setting A total of 30 public schools in Schleswig-Holstein, Germany. Participants Baseline data were obtained from 1686 7th graders. The retention rate was 85% over 12 months. Intervention The intervention consisted of four interactive lessons conducted by teachers, booklets for students and booklets for parents. Measures Knowledge, attitudes, life-time alcohol consumption (ever use alcohol without parental knowledge, ever been drunk and ever binge drinking) and past-month alcohol use. Results Intention-to-treat analyses revealed that intervention status was associated with more general knowledge about alcohol and lower levels of life-time binge drinking. No effects were found with respect to students' self-reported attitudes, intentions to drink, life-time alcohol use and past-month alcohol use. Conclusions The results indicate that this brief school-based intervention had a small short-term preventive effect on alcohol misuse. [source] Exposure to opioid maintenance treatment reduces long-term mortalityADDICTION, Issue 3 2008Amy Gibson ABSTRACT Aims To (i) examine the predictors of mortality in a randomized study of methadone versus buprenorphine maintenance treatment; (ii) compare the survival experience of the randomized subject groups; and (iii) describe the causes of death. Design Ten-year longitudinal follow-up of mortality among participants in a randomized trial of methadone versus buprenorphine maintenance treatment. Setting Recruitment through three clinics for a randomized trial of buprenorphine versus methadone maintenance. Participants A total of 405 heroin-dependent (DSM-IV) participants aged 18 years and above who consented to participate in original study. Measurements Baseline data from original randomized study; dates and causes of death through data linkage with Births, Deaths and Marriages registries; and longitudinal treatment exposure via State health departments. Predictors of mortality examined through survival analysis. Findings There was an overall mortality rate of 8.84 deaths per 1000 person-years of follow-up and causes of death were comparable with the literature. Increased exposure to episodes of opioid treatment longer than 7 days reduced the risk of mortality; there was no differential mortality among methadone versus buprenorphine participants. More dependent, heavier users of heroin at baseline had a lower risk of death, and also higher exposure to opioid treatment. Older participants randomized to buprenorphine treatment had significantly improved survival. Aboriginal or Torres Strait Islander participants had a higher risk of death. Conclusions Increased exposure to opioid maintenance treatment reduces the risk of death in opioid-dependent people. There was no differential reduction between buprenorphine and methadone. Previous studies suggesting differential effects may have been affected by biases in patient selection. [source] INDIVIDUAL AND COPARENTING DIFFERENCES BETWEEN DIVORCING AND UNMARRIED FATHERSFAMILY COURT REVIEW, Issue 3 2003Implications for Family Court Services The current study examines differences in demographic characteristics, parental conflict, and nonresidential father involvement between divorcing and unmarried fathers with young children. Participants were 161 families (36 unmarried) with children aged 0 to 6 years, involved in a larger longitudinal study of separating and divorcing families. Baseline data were gathered from parenting plans, court databases, and parent reports. Results indicated that unmarried fathers were younger, more economically disadvantaged, less well educated, less likely to have their children living with them, and had less influence on decision making. Unmarried fathers reported more conflict regarding their attempts to be involved with their children in their day-to-day activities. Understanding these unique characteristics and dynamics will help to maximize effective services in the legal system for unmarried couples. [source] Evaluation of patient opinions in a pharmacy-level intervention studyINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 3 2003M. C. M. Pronk PhD researcher ABSTRACT Objective To explore patients' satisfaction with their community pharmacy's services and to evaluate the effects of an intervention programme in which a trained technician organised patient education activities in the pharmacy. Method We surveyed patients visiting the participating pharmacies at three stages: at the start of the intervention period (0 months, T0), at the end (after 12 months, T1), and 12 months after the intervention had been completed (24 months from baseline, T2). At each stage, 500 questionnaires were distributed by each pharmacy. Setting 28 Dutch community pharmacies: 14 intervention and 14 controls. Key findings The response rates were 54%, 44% and 43% at T0, T1 and T2, respectively. Baseline data showed that patients reported satisfaction with helpfulness, waiting time, ease of asking questions, answers to questions, and patient leaflets provided. Around two thirds (59.5%) of the patients said they would ask a pharmacy employee questions if they were concerned about side effects of their medication. Asking questions was not reported to be difficult for most patients (88.9%). The reasons most often given for experiencing difficulties with asking questions were related to lack of privacy (16.9% of all patients), waiting time of other patients (8.8%) and busy pharmacy employees (6.7%). The most frequently reported reason for being less satisfied with the answers to questions was receiving too little information (7.5%). Our analyses showed a significant improvement only on the outcome variable "helpfulness" experienced by patients between 0 (T0) and 12 months (T1), and this was found to be sustained one year later (T2). Conclusion The overall findings on patient satisfaction showed that almost two-thirds of the respondents saw the pharmacy as a source of information about medication. Community pharmacies clearly have an important role in providing such information. Lack of privacy was the most common reason for patients reporting difficulties in asking questions about medicines and this needs pharmacists' attention. Our analysis showed that the intervention had an effect on "helpfulness" experienced by patients, which slightly increased in the intervention period (T0-T1 differences) and appeared to have remained at the higher level one year later (T2). [source] Daily activity budget of captive and released Scarlet macaw Ara macao at Playa San Josecito Release Site, Costa RicaINTERNATIONAL ZOO YEARBOOK, Issue 1 2005J. CORNEJO Baseline data for 17 behaviours grouped into six categories were collected for ten captive and nine soft-released Scarlet macaws Ara macao, in order to analyse daily activity budgets. Most of the birds were captive-bred and hand-reared. The captive birds spent less time on Socializing and Feeding behaviours than the released birds but spent more time on Maintenance behaviour and No Activity. The observation protocol developed here is a useful tool for monitoring the birds during pre-release training and, once released, to determine quantitatively whether a bird was properly prepared for survival in the wild. [source] The Cross-Sectional Relationship Between Body Mass Index, Waist,Hip Ratio, and Cognitive Performance in Postmenopausal Women Enrolled in the Women's Health InitiativeJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2010Diana R. Kerwin MD OBJECTIVES: To determine whether body mass index (BMI) is independently associated with cognitive function in postmenopausal women and the relationship between body fat distribution as estimated by waist-hip ratio (WHR). DESIGN: Cross-sectional data analysis. SETTING: Baseline data from the Women's Health Initiative (WHI) hormone trials. PARTICIPANTS: Eight thousand seven hundred forty-five postmenopausal women aged 65 to 79 free of clinical evidence of dementia who completed the baseline evaluation in the WHI hormone trials. MEASUREMENTS: Participants completed a Modified Mini-Mental State Examination (3MSE), health and lifestyle questionnaires, and standardized measurements of height, weight, body circumference, and blood pressure. Statistical analysis was performed of associations between 3MSE score, BMI, and WHR after controlling for known confounders. RESULTS: With the exception of smoking and exercise, vascular disease risk factors, including hypertension, waist measurement, heart disease, and diabetes mellitus, were significantly associated with 3MSE score and were included as covariables in subsequent analyses. BMI was inversely related to 3MSE score; for every 1-unit increase in BMI, 3MSE score decreased 0.988 points (P<.001) after adjusting for age, education, and vascular disease risk factors. BMI had the most pronounced association with poorer cognitive functioning scores in women with smaller waist measurements. In women with the highest WHR, cognitive scores increased with BMI. CONCLUSION: Higher BMI was associated with poorer cognitive function in women with smaller WHR. Higher WHR, estimating central fat mass, was associated with higher cognitive function in this cross-sectional study. Further research is needed to clarify the mechanism for this association. [source] Nursing Home Facility Risk Factors for Infection and Hospitalization: Importance of Registered Nurse Turnover, Administration, and Social FactorsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 12 2002Sheryl Zimmerman PhD OBJECTIVES: Determine the relationship between a broad array of structure and process elements of nursing home care and (a) resident infection and (b) hospitalization for infection. DESIGN: Baseline data were collected from September 1992 through March 1995, and residents were followed for 2 years; facility data were collected at the midpoint of follow-up. SETTING: A stratified random sample of 59 nursing homes across Maryland. PARTICIPANTS: Two thousand fifteen new admissions aged 65 and older. MEASUREMENTS: Facility-level data were collected from interviews with facility administrators, directors of nursing, and activity directors; record abstraction; and direct observation. Main outcome measures included infection (written diagnosis, a course of antibiotic therapy, or radiographic confirmation of pneumonia) and hospitalization for infection (indicated on medical records). RESULTS: The 2-year rate of infection was 1.20 episodes per 100 resident days, and the hospitalization rate for infection was 0.17 admissions per 100 resident days. Except for registered nurse (RN) turnover, which related to both infection and hospitalization, different variables related to each outcome. High rates of incident infection were associated with more Medicare recipients, high levels of physical/occupational therapist staffing, high licensed practical nurse staffing, low nurses' aide staffing, high intensity of medical and therapeutic services, dementia training, staff privacy, and low levels of psychotropic medication use. High rates of hospitalization for infection were associated with for-profit ownership, chain affiliation, poor environmental quality, lack of resident privacy, lack of administrative emphasis on staff satisfaction, and low family/friend visitation rates. Adjustment for resident sex, age, race, education, marital status, number of morbid diagnoses, functional status, and Resource Utilization Group, Version III score did not alter the relationship between the structure and process of care and outcomes. CONCLUSIONS: The association between RN turnover and both outcomes underscores the relationship between nursing leadership and quality of care in these settings. The relationship between hospitalization for infection and for-profit ownership and chain affiliation could reflect policies not to treat acute illnesses in house. The link between social factors of care (environmental quality, prioritizing staff satisfaction, resident privacy, and facility visitation) and hospitalization indicates that a nonmedical model of care may not jeopardize, and may in fact benefit, health-related outcomes. All of these facility characteristics may be modifiable, may affect healthcare costs, and may hold promise for other, less-medical, forms of residential long-term care. [source] Pain, physical functioning and quality of life of individuals awaiting total joint replacement: a longitudinal studyJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 1 2008Gretl A. McHugh PhD MSc Abstract Objectives, To investigate if pain, physical function and the quality of life changed among adults with osteoarthritis while on the waiting list for hip or knee joint replacement. Methods, A longitudinal study of patients listed for primary hip or knee joint replacement. Participants were interviewed at baseline (n = 105) and followed up at 3 (n = 84), 6 (n = 47) and 9 months (n = 24), or until their joint replacement. Measurement tools used were a visual analogue scale (VAS), Western Ontario and McMaster's Universities (WOMAC) Osteoarthritis Index and the Medical Outcomes Study Short Form Health Survey (SF-36). Results, Baseline data indicated high levels of pain as measured by VAS [mean 7.0 (SD 2.2)] and WOMAC pain [mean 11.2 (SD 3.5)]. At baseline, the mean physical function measured by WOMAC was 40.3 (SD 12.1). At the 3-month follow-up, there was significant deterioration in VAS pain scores (0.6; 95% CI mean difference 0.3, 1.0); WOMAC pain scores (1.2; 95% CI mean difference 0.7, 1.8) and WOMAC physical function scores (4.8; 95% CI mean difference 2.8, 6.7) compared with baseline. Conclusion, The often long wait for joint replacement surgery and deterioration in pain and physical function has highlighted the need for active management by health professionals while patients are on the waiting list. [source] Existence of the School Health Coordinator in a Frontier StateJOURNAL OF SCHOOL HEALTH, Issue 9 2005Scott D. Winnail Baseline data were collected soliciting the involvement of all 48 state school districts and the state girl's school (N = 49). Thirty-seven districts responded (75.5%). Identified school health coordinators were predominantly health and physical education teachers. Most coordinators spent minimal time (less than 10% of time) each week on school health coordination activities; nearly one half identified little or no coordination of school health efforts in their school districts; few identified personal involvement in budgetary matters concerning school health; and most identified their primary teaching responsibilities as the areas where the majority of their time was spent. Data collected help create a profile of the "typical" district level-school health coordinator in this frontier state and can assist in the development of future efforts aimed at school health coordination through the work of district-level school health coordinators. (J Sch Health. 2005;75(9):329,333) [source] Disruptions in Sleep Time and Sleep Architecture in a Mouse Model of Repeated Ethanol WithdrawalALCOHOLISM, Issue 7 2006Lynn M. Veatch Background: Insomnia and other sleep difficulties are perhaps the most common and enduring symptoms reported by alcoholics undergoing detoxification, especially those alcoholics with a history of multiple detoxifications. While some studies have reported sleep disruptions in animal models after chronic ethanol exposure, the reports are inconsistent and few address sleep architecture across repeated ethanol exposures and withdrawals. The present study evaluated sleep time and architecture in a well-characterized mouse model of repeated chronic ethanol exposure and withdrawal. Methods: C57BL6/J mice were fitted with electrodes in frontal cortex, hippocampus, and nuchal muscle for collection of continuous electroencephalogram (EEG)/electromyogram (EMG) data. Baseline data were collected, after which mice received 4 cycles of 16-hour exposure to alcohol (ethanol: EtOH) vapor separated by 8-hour periods of withdrawal or similar handling in the absence of EtOH vapor. Ethanol-exposed mice attained a blood ethanol concentration of 165 mg%. Upon completion of vapor exposure, EEG/EMG data were again collected across 4 days of acute withdrawal. Data were subjected to automated analyses classifying 10-second epochs into wake, non,rapid eye movement (REM) sleep, or REM sleep states. Results: Mice in withdrawal after chronic EtOH exposure showed profound disruptions in the total time asleep, across the acute withdrawal period. Sleep architecture, the composition of sleep, was also disrupted with a reduction in non-REM sleep concomitant with a profound increase in REM sleep. While altered sleep time and non-REM sleep loss resolved by the fourth day of withdrawal, the increase in REM sleep ("REM rebound") persisted. Conclusions: These results mirror those reported for the human alcoholic and demonstrate that EtOH withdrawal,induced sleep disruptions are evident in this mouse model of alcohol withdrawal,induced sensitization. This mouse model may provide mechanisms to investigate fully the high correlation between unremitting sleep problems and increased risk of relapse documented clinically. [source] Bone Mineral Density in Postmenopausal Breast Cancer SurvivorsJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 6 2001APRN, Janice J. Twiss PhD Purpose The overall purpose of this longitudinal 18-month study was to test the feasibility and effectiveness of a multicomponent intervention for prevention and treatment of osteoporosis. The purpose of this article is to describe the baseline bone mineral density (BMD) findings for 30 postmenopausal women and to compare these BMD findings to time since menopause, body mass index, and tamoxifen use. Data Sources Baseline data of BMD findings for 30 post-menopausal women, who have had a variety of treatments including surgery, adjuvant chemotherapy and or tamoxifen, and are enrolled in the 18-month longitudinal study. A demographic questionnaire and a three day dietary record were used to collect baseline data. Conclusions Eighty percent of the women with breast cancer history had abnormal BMDs at baseline (t-scores below -1.00 SD). Thinner women showed a greater risk for accelerated trabecular bone loss at the spine and hip. Implications for Practice These findings suggest the need for early BMD assessments and for aggressive health promotion intervention strategies that include a multifaceted protocol of drug therapy for bone remodeling, 1500 mg of daily calcium, 400 IU vitamin D and a strength weight training program that is implemented immediately following chemotherapy treatment and menopause in this high risk population of women. [source] Smoking and venous thromboembolism: a Danish follow-up studyJOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 8 2009M. T. SEVERINSEN Summary.,Background: Large-scale prospective studies are needed to assess whether smoking is associated with venous thromboembolism (VTE) (i.e. deep venous thrombosis and pulmonary embolism) independently of established risk factors. Objective: To investigate the association between smoking and the risk of VTE among middle-aged men and women. Methods: From 1993 to 1997, 27 178 men and 29 875 women, aged 50,64 years and born in Denmark, were recruited into the Danish prospective study ,Diet, Cancer and Health'. During follow-up, VTE cases were identified in the Danish National Patient Registry. Medical records were reviewed and only verified VTE cases were included in the study. Baseline data on smoking and potential confounders were included in gender stratified Cox proportional hazard models to asses the association between smoking and the risk of VTE. The analyses were adjusted for alcohol intake, body mass index, physical activity, and in women also for use of hormone replacement therapy. Results: During follow-up, 641 incident cases of VTE were verified. We found a positive association between current smoking and VTE, with a hazard ratio of 1.52 (95% CI, 1.15,2.00) for smoking women and 1.32 (95% CI, 1.00,1.74) for smoking men, and a positive dose-response relationship. Former smokers had the same hazard as never smokers. Conclusions: Smoking was an independent risk factor for VTE among middle-aged men and women. Former smokers have the same risk of VTE as never smokers, indicating acute effects of smoking, and underscoring the potential benefits of smoking cessation. [source] Fluid challenge in patients at risk for fluid loading-induced pulmonary edemaACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 1 2004M. Matejovic Background:, This study evaluated the effects of protocol-guided fluid loading on extravascular lung water (EVLW) and hemodynamics in a group of patients at high risk for volume expansion-induced pulmonary and systemic edema. Methods:, Nine acutely admitted septic patients with acute lung injury (ALI) were prospectively studied. In addition to sepsis and ALI, the following criteria indicating increased risk for edema formation had to be fulfilled: increased vascular permeability defined as microalbuminuria greater than fivefold normal and hypoalbuminemia <30 g l,1. Two hundred-ml boluses of a 10% hydroxyethyl starch (HES) was titrated to obtain best filling pressure/stroke volume relation. Extravascular lung water and intrathoracic blood volume (ITBV) were measured using a transpulmonary double-indicator dilution technique. Baseline data were compared with data at the end of fluid loading and 3 h postchallenge. Results:, At study entry the mean EVLW was 13 ml kg,1, and the mean EVLW/ITBV ratio (indicator of pulmonary permeability) was 0.72 (normal range 0.20,0.30). To attain optimal preload/stroke volume relation 633 ± 240 ml of HES was needed. Fluid loading significantly increased preload (CVP, PAOP and ITBV), and stroke volume. Effective pulmonary capillary pressure (Pcap) rose only slightly. As a result, the Pcap,PAOP gradient decreased. Despite increased cardiac output, EVLW did not change by plasma expansion. Conclusion:, In this selected group of at-risk patients, the optimization of cardiac output guided by the concept of best individual filling pressure/stroke volume relationship did not worsen permeability pulmonary edema. [source] Volume targeted ventilation (volume guarantee) in the weaning phase of premature newborn infantsPEDIATRIC PULMONOLOGY, Issue 10 2007F. Scopesi MD Abstract Objective Several options are currently available in neonatal mechanical ventilation: complete breathing synchronization (patient triggered ventilation, synchronized intermittent positive pressure ventilation,SIPPV); positive pressure flow-cycled ventilation (pressure support ventilation, PSV); and volume targeted positive pressure ventilation (volume guarantee, VG). The software algorithm for the guarantee volume attempts to deliver a tidal volume (Vt) as close as possible to what has been selected by the clinician as the target volume. Main objectives of the present study were to compare patient,ventilator interactions and Vt variability in premature infants recovering from respiratory distress syndrome (RDS) who were weaned by various ventilator modes (SIMV/PSV,+,VG/SIPPV,+,VG and SIMV,+,VG). Methods This was a short-term crossover trial in which each infant served as his/her own control. Ten premature infants born before the 32nd week of gestation in the recovery phase of RDS were enrolled in the study. All recruited infants started ventilation with SIPPV and in the weaning phase were switched to synchronized intermittent mandatory ventilation (SIMV). Baseline data were collected during an initial 20-min period of monitoring with the infant receiving SIMV alone, then they were switched to SIPPV,+,VG for a 20-min period and then switched back to SIMV for 15 min. Next, they were switched to PSV,+,VG for the study period and switched back to SIMV for a further 15 min. Finally, they were switched to SIMV,+,VG and, at the end of monitoring, they were again switched back to SIMV alone. Results Each mode combined with VG discharged comparable Vts, which were very close to the target volume. Among the VG-combined modes, mean variability of Vt from preset Vt was significantly different. Variability from the target value was significantly lower in SIPPV and PSV modes than in SIMV (P,<,0.0001 and P,<,0.04 respectively). SIPPV,+,VG showed greater stability of Vt, fewer large breaths, lower respiratory rate, and allowed for lower peak inspiratory pressure than what was delivered by the ventilator during other modes. No significant changes in blood gases were observed after each of the study periods. Conclusions With regards to the weaning phase, among combined modes, both of the ones in which every breath is supported (SIPPV/PSV) are likely to be the most effective in the delivery of stable Vt using a low working pressure, thus, at least in the short term, likely more gentle for the neonatal lung. In summary, we can suggest that the VG option, when combined with traditional, patient triggered ventilation, adheres very closely to the proposed theoretical algorithm, achieving highly effective ventilation. Pediatr Pulmonol. 2007; 42:864,870. © 2007 Wiley-Liss, Inc. [source] The Link Between Couples' Pregnancy Intentions And Behavior: Does It Matter Who Is Asked?PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH, Issue 4 2008Maureen R. Waller CONTEXT:,Previous studies have linked pregnancy intentions with some pregnancy-related behaviors and infant health outcomes. However, most have used only women's reports of intentions and examined only maternal behaviors. METHODS:,Baseline data from the Fragile Families and Child Wellbeing Study (1998,2000) are used to examine whether parents of newborns considered abortion upon learning of the pregnancy and whether this measure of pregnancy intention is associated with their behaviors during pregnancy or with infant birth weight. Associations between outcomes and each parent's pregnancy intention are explored with multivariate probit regressions or least squares regressions for 737 married and 2,366 unmarried couples. RESULTS:,If at least one parent considered abortion, unmarried mothers had a significantly reduced probability of initiating early prenatal care, and unmarried fathers had a significantly reduced probability of providing cash or in-kind support during the pregnancy. The proportion of mothers receiving care in the first trimester was 12 percentage points lower when the mother only or both parents considered abortion than when neither parent did; depending on which parent reported on fathers' support during pregnancy, the proportion of fathers who provided cash or in-kind assistance was 6,10 percentage points lower when the father only considered abortion and 6,14 points lower when both parents considered abortion than when neither did. CONCLUSIONS:,Future research on pregnancy intentions should incorporate both men and women. Understanding men's pregnancy intentions and their associations with early support of mothers may inform discussions of how to encourage men's involvement in family planning, prenatal health care and parenting. [source] Hearing loss among Ohio farm youth: A comparison to a national sampleAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 3 2009Katherine M. Renick MS Abstract Background Hearing loss is prevalent among adults in the farming community, with some evidence it begins in childhood. Our objective was to compare hearing thresholds of Ohio farm youth to published data on national norms. Methods Baseline data were collected on youth (n,=,212) in 1994,1996 with follow-up (n,=,132) in 2003,2004 including pure-tone air conduction thresholds at 0.5, 1, 2, 3, 4, 6, and 8 kHz. Results When compared to nationally-representative data, study youth had a higher prevalence of hearing loss. The high-frequency range was most affected, particularly at 6 kHz where nearly 50% of the farm youth exhibited some degree of hearing loss at baseline testing. The prevalence of noise-induced threshold shifts, characterized by an audiometric notch, was nearly twice that of the national sample. Conclusions These data suggest that hearing loss, which is common among adult farmers, may be problematic for farm youth as well. Am. J. Ind. Med. 52:233,239, 2009. © 2008 Wiley-Liss, Inc. [source] Postoperative Orgasmic Function Increases over Time in Patients Undergoing Nerve-Sparing Radical ProstatectomyTHE JOURNAL OF SEXUAL MEDICINE, Issue 1pt1 2010Andrew Salonia MD ABSTRACT Introduction., Postprostatectomy orgasmic function (OF) remains poorly defined. Aims., To assess OF over time in patients who underwent bilateral nerve-sparing radical retropubic prostatectomy (BNSRRP) for organ-confined prostate cancer (PCa). Methods., Baseline data were obtained from 334 consecutive preoperatively sexually active PCa patients at hospital admission; data included a medical and sexual history, IIEF domain scores, and ICIQ-SF. Questionnaire were then completed every 12 months postoperatively, and patients participated in a semistructured interview at the 12-month (191/334 [57.2%] patients), 24-month (95/334 [28.4%] patients), 36-month (42/334 [12.6%] patients), and 48-month (19/334 [5.7%] patients) follow-up (FU). Main Outcome Measures., IIEF-OF domain values throughout the FU. Multivariate linear regression analysis (MVA) of the association between predictors (patient's age, IIEF-erectile function [EF], ICIQ-SF, and the use of postoperative proerectile pharmacological treatments) and the IIEF-OF at 12-month, 24-month, and 36-month FU. Results., Preoperative mean (median) IIEF-OF was 7.6 (10). The anova analysis showed an increase of the IIEF-OF values (P = 0.008; F = 4.009) throughout the FU (namely, IIEF-OF 12-month: 6.1 [6]; 24-month: 7.2 [8]; 36-month: 7.3 [8]; and 48-month: 7.7 [9.50]). The 12-month MVA showed that while proerectile oral therapy did not affect postoperative OF (P = 0.150; Beta 0.081), IIEF-OF linearly increased with IIEF-EF (P < 0.001; Beta 0.425). Conversely, IIEF-OF linearly decreased with patient's age (P < 0.001; Beta ,0.135) and with ICQ-SF scores (P < 0.001; Beta ,0.438). The 24-month and 36-month analyses showed that IIEF-OF still linearly increased with IIEF-EF (P < 0.001; Beta 0.540, and P < 0.001; Beta 0.536 respectively at the 24- and 36-month FU), whereas pharmacological therapy, rate of urinary continence, and patient's age did not significantly affect postoperative OF. Conclusions., Postoperative OF significantly ameliorates over time in patients undergoing BNSRRP. The higher the postoperative EF score, the higher the OF throughout the FU time frame. Salonia A, Gallina A, Briganti A, Colombo R, Bertini R, Da Pozzo LF, Zanni G, Sacca A, Rocchini L, Guazzoni G, Rigatti P, and Montorsi F. Postoperative Orgasmic Function Increases over Time in Patients Undergoing Nerve-Sparing Radical Prostatectomy. J Sex Med 2010;7:149,155. [source] Evaluation of the Pneupac Ventipac portable ventilator in critically ill patientsANAESTHESIA, Issue 11 2001apparatus We assessed adequacy of ventilation in 20 critically ill patients with multiple organ failure using a Pneupac Ventipac portable ventilator and the effects on patients' haemodynamic stability. Baseline data were recorded over 15 min for a range of respiratory, haemodynamic and oxygen transport variables during ventilation with a standard intensive care ventilator (Engström Erica). Patients were then ventilated for 40 min using the portable ventilator. Finally, they were ventilated for a further 40 min using the standard intensive care ventilator. Heart rate, arterial and pulmonary artery pressures were recorded at 5-min intervals throughout the study period. Cardiac index and other haemodynamic data derived from a pulmonary artery catheter were recorded at 20-min intervals. Blood gas analysis was performed and oxygen transport data (oxygen delivery, oxygen consumption and physiological shunt) were calculated at the end of each of the three periods of ventilation. In general, no significant adverse effects of ventilation using the portable ventilator were observed for any of the variables studied. Arterial Po2 increased significantly during ventilation with the portable ventilator, reflecting the use of a higher inspired oxygen fraction during this part of the study. Oxygen consumption decreased significantly in one patient during ventilation by the portable ventilator although none of the other variables measured in this patient was altered. We conclude that ventilation of critically ill patients using the Pneupac Ventipac portable ventilator was safe, satisfactory and associated with minimal adverse effects on respiratory, haemodynamic and oxygen transport variables. [source] Urological symptom clusters and health-related quality-of-life: results from the Boston Area Community Health SurveyBJU INTERNATIONAL, Issue 11 2009Susan A. Hall OBJECTIVE To determine whether urological symptom clusters, as identified in previous studies, were associated with health-related quality-of-life (HRQoL) and use of healthcare. SUBJECTS AND METHODS The Boston Area Community Health Survey is a population-based epidemiological study of 2301 male and 3201 female residents of Boston, MA, USA, aged 30,79 years. Baseline data collected from 2002 to 2005 were used in this analysis. Data on 14 urological symptoms were used for the cluster analysis, and five derived symptom clusters among men and four among women were used in multivariate linear regression models (adjusted for age group, race/ethnicity, and comorbidity) to determine their association with physical (PCS-12) and mental health component scores (MCS-12) calculated from the Medical Outcomes Study 12-item Short Form Survey. RESULTS For both men and women, being in the most symptomatic cluster was associated with decrements in the PCS-12 score (men, cluster 5, ,10.42; women, cluster 4, ,9.80; both P < 0.001) and the MCS-12 score (men, cluster 5, ,9.35; women, cluster 4, ,6.24; both P < 0.001) compared with the asymptomatic groups. Both men and women in these most symptomatic clusters appeared to have adequate access to healthcare. CONCLUSION For men and women, those with the most urological symptoms reported poorer HRQoL in two domains after adjusting for age and comorbidity, and despite adequate access to care. [source] The association of diet and other lifestyle factors with overactive bladder and stress incontinence: a longitudinal study in womenBJU INTERNATIONAL, Issue 1 2003H.M. Dallosso OBJECTIVES To investigate the role of diet and other lifestyle factors in the incidence of overactive bladder and stress incontinence in women. Studies have suggested relationships between different aspects of lifestyle and symptoms of urinary incontinence, but there is a lack of firm evidence about their role in its cause. SUBJECTS AND METHODS A random sample of women aged , 40 years living at home took part in a prospective cohort study. Baseline data on urinary symptoms, diet and lifestyle were collected from 7046 women using a postal survey and food-frequency questionnaire. Follow-up data on urinary symptoms were collected from 6424 of the women in a postal survey 1 year later. Logistic regression was used to investigate the association of food and drink consumption and other lifestyle factors with the incidence of overactive bladder and stress incontinence. RESULTS In the multivariate model for the onset of an overactive bladder, there were significantly increased risks associated with obesity, smoking and consumption of carbonated drinks, and reduced risks with higher consumption of vegetables, bread and chicken. Obesity and carbonated drinks were also significant risk factors for the onset of stress incontinence, while consumption of bread was associated with a reduced risk. CONCLUSIONS Causal associations with obesity, smoking and carbonated drinks are confirmed for bladder disorders associated with incontinence, and additional associations with diet are suggested. Behavioural modification of lifestyle may be important for preventing and treating these disorders. [source] Airway cell and cytokine changes in early asthma deterioration after inhaled corticosteroid reductionCLINICAL & EXPERIMENTAL ALLERGY, Issue 8 2007Y. H. Khor Summary Background Back-titration of inhaled corticosteroid (ICS) dose in well-controlled asthma patients is emphasized in clinical guidelines, but there are few published data on the airway cell and cytokine changes in relation to ICS reduction. In our study, 20 mild-to-moderate persistent (inspite of low-moderate dose ICS treatment) asthmatic subjects prospectively rendered largely asymptomatic by high-dose ICS were assessed again by clinical, physiological, and airway inflammatory indices after 4,8 weeks of reduced ICS treatment. We aimed at assessing the underlying pathological changes in relation to clinical deterioration. Methods Patients recorded daily symptom scores and peak expiratory flows (PEF). Spirometry and airways hyperreactivity (AHR) were measured and bronchoscopy was performed with assessment of airway biopsies (mast cells, eosinophils, neutrophils, and T lymphoctyes), bronchoalveolar lavage (BAL) IL-5 and eotaxin levels and cellular profiles at the end of high-dose ICS therapy and again after ICS dose reduction. Baseline data were compared with symptomatic steroid-free asthmatics (n=42) and non-asthmatic controls (n=28). Results After ICS reduction, subjects experienced a variable but overall significant increase in symptoms and reductions in PEF and forced expiratory volume in 1 s. There were no corresponding changes in AHR or airways eosinophilia. The most relevant pathogenic changes were increased CD4+/CD8+ T cell ratio, and decreased sICAM-1 and CD18 macrophage staining (potentially indicating ligand binding). However, there was no relationship between the spectrum of clinical deterioration and the changes in cellular profiles or BAL cytokines. Conclusions These data suggest that clinical markers remain the most sensitive measures of early deterioration in asthma during back-titration of ICS, occurring at a time when AHR and conventional indices of asthmatic airway inflammation appear unchanged. These findings have major relevance to management and to how back-titration of ICS therapy is monitored. [source] Patients' Evaluation of Two Occlusal Schemes for Implant OverdenturesCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2008BHealSc, John M. Aarts BEd, MhealSc, PGDipCDTech ABSTRACT Background: There is an absence of conclusive evidence for occlusal schemes in implant overdentures. Purpose: To investigate the consequences of two different occlusal schemes on levels of satisfaction for patients wearing implant overdentures. Materials and Methods: Within an existing randomized controlled clinical trial, a physiologic occlusal scheme was compared with a lingualized occlusal scheme for 18 selected participants all with implant overdentures. Nine participants had conventional maxillary complete dentures opposing mandibular 2-implant overdentures; a further nine participants had maxillary 3-implant overdentures opposing mandibular 2-implant overdentures. All participants recruited had been wearing their original prostheses for 3 years with a bilateral balance occlusal scheme. The participants' existing satisfaction levels, as a baseline, were determined using visual analogue scale questionnaires. They were followed by similar assessments of two further occlusal schemes using 2-month assessment periods. On completion of the study, the participants selected their preferred occlusal scheme and semiformal interviews were conducted to assess the rationale for their choices. Results: Baseline data showed all the participants had pre-existing high satisfaction levels. Thereafter, of those participants that received lingualized occlusion first, 55.6% reported that the physiologic occlusion was better than lingualized occlusion. For those participants who received the physiologic occlusion first, 85.7% reported that physiologic occlusion was better than lingualized occlusion. On completion of the study, 64.7% of the participants preferred the physiologic occlusion, 35.3% preferred the lingualized occlusion. However, when the two groups' satisfaction scores were modeled using the three main key indicator questions (general satisfaction, general ability to chew, or general function), there were no significant differences between them. Conclusions: Within the limitations of a small number of participants, the majority of them still indicated a preference for a physiologic occlusion for implant overdentures. Improved function was given as the main indicator for that preference. Having implant overdentures in one or both jaws is not a formative factor in patient's opinions on occlusal schemes. [source] A school-based fluoride mouth rinsing programme in Sarawak: a 3-year field studyCOMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 4 2010Catherine Jean-Ai Chen Chen CJ-A, Ling KS, Esa R, Chia JC, Eddy A, Yaw SL. A school-based fluoride mouth rinsing programme in Sarawak: a 3-year field study. Community Dent Oral Epidemiol 2010; 38: 310,314. © 2010 John Wiley & Sons A/S Abstract,,, Background:, This study was undertaken to assess the impact of fluoride mouth rinsing on caries experience in a cohort of schoolchildren 3 years after implementation. Methods:, 270 children aged 8,9 years from four schools in Sarawak were selected at baseline. Baseline data was collected to ensure that the selected schools did not differ significantly. Children from two schools rinsed with 0.2% sodium fluoride under supervision, while those from the other schools did not. Results:, After 3 years, 242 schoolchildren remained in the study. At the end of the study, the mean DMFT for the test group was 2.3 (95% CI, 1.93,2.67) while the mean DMFT for the control group was 4.01 (95% CI, 3.39,4.63). The mean DMFS for the test group was 3.40 (95% CI, 2.68,4.12) while the mean DMFS for the control group was 6.67 (95% CI, 5.47,7.87). After 3 years, 24.2% of those in the test group remained caries free compared to 11.5% in the control group. The risk of developing caries decreased 0.52 times among the children from the ,test' group exposed to the fluoride mouth rinsing programme as compared to the unexposed ,control' group (RR = 0.48, 95% CI, 0.26,0.85). Discussion and conclusion:, The findings show that a school-based weekly 0.2% sodium fluoride mouth rinsing programme is an effective caries preventive measure and should be implemented in fluoride-deficient areas as a means of reducing the prevalence of dental caries in these communities. [source] Reference-Free Damage Classification Based on Cluster AnalysisCOMPUTER-AIDED CIVIL AND INFRASTRUCTURE ENGINEERING, Issue 5 2008Hoon Sohn The ultimate goal of this study was to develop an in-site non-destructive testing (NDT) technique that can continuously and autonomously inspect the bonding condition between a carbon FRP (CFRP) layer and a host reinforced concrete (RC) structure, when the CRFP layer is used for strengthening the RC structure. The uniqueness of this reference-free NDT is two-fold: First, features, which are sensitive to CFRP debonding but insensitive to operational and environmental variations of the structure, have been extracted only from current data without direct comparison with previously obtained baseline data. Second, damage classification is performed instantaneously without relying on predetermined decision boundaries. The extraction of the reference-free features is accomplished based on the concept of time reversal acoustics, and the instantaneous decision-making is achieved using cluster analysis. Monotonic and fatigue load tests of large-scale CFRP-strengthened RC beams are conducted to demonstrate the potential of the proposed reference-free debonding monitoring technique. Based on the experimental studies, it has been shown that the proposed reference-free NDT technique may minimize false alarms of debonding and unnecessary data interpretation by end users. [source] Bayesian Networks and Adaptive Management of Wildlife HabitatCONSERVATION BIOLOGY, Issue 4 2010ALISON L. HOWES herramientas para la toma de decisiones; incertidumbre ecológica; pastoreo feral; regímenes de quema; validación de modelos Abstract:,Adaptive management is an iterative process of gathering new knowledge regarding a system's behavior and monitoring the ecological consequences of management actions to improve management decisions. Although the concept originated in the 1970s, it is rarely actively incorporated into ecological restoration. Bayesian networks (BNs) are emerging as efficient ecological decision-support tools well suited to adaptive management, but examples of their application in this capacity are few. We developed a BN within an adaptive-management framework that focuses on managing the effects of feral grazing and prescribed burning regimes on avian diversity within woodlands of subtropical eastern Australia. We constructed the BN with baseline data to predict bird abundance as a function of habitat structure, grazing pressure, and prescribed burning. Results of sensitivity analyses suggested that grazing pressure increased the abundance of aggressive honeyeaters, which in turn had a strong negative effect on small passerines. Management interventions to reduce pressure of feral grazing and prescribed burning were then conducted, after which we collected a second set of field data to test the response of small passerines to these measures. We used these data, which incorporated ecological changes that may have resulted from the management interventions, to validate and update the BN. The network predictions of small passerine abundance under the new habitat and management conditions were very accurate. The updated BN concluded the first iteration of adaptive management and will be used in planning the next round of management interventions. The unique belief-updating feature of BNs provides land managers with the flexibility to predict outcomes and evaluate the effectiveness of management interventions. Resumen:,El manejo adaptativo es un proceso interactivo de recopilación de conocimiento nuevo relacionado con el comportamiento de un sistema y el monitoreo de las consecuencias ecológicas de las acciones de manejo para refinar las opciones de manejo. Aunque el concepto se originó en la década de los 1970s, rara vez es incorporado activamente en la restauración ecológica. Las redes Bayesianas (RBs) están emergiendo como herramientas eficientes para la toma de decisiones ecológicas en el contexto del manejo adaptativo, pero los ejemplos de su aplicación en este sentido son escasos. Desarrollamos una RB en el marco del manejo adaptativo que se centra en el manejo de los efectos del pastoreo feral y los regímenes de quemas prescritas sobre la diversidad de aves en bosques subtropicales del este de Australia. Construimos la RB con datos para predecir la abundancia de aves como una función de la estructura del hábitat, la presión de pastoreo y las quemas prescritas. Los resultados del análisis de sensibilidad sugieren que la presión de pastoreo incrementó la abundancia de melífagos agresivos, que a su vez tuvieron un fuerte efecto negativo sobre paserinos pequeños. Posteriormente se llevaron a cabo intervenciones de manejo para reducir la presión del pastoreo feral y quemas prescritas, después de las cuales recolectamos un segundo conjunto de datos de campo para probar la respuesta de paserinos pequeños a estas medidas. Utilizamos estos datos, que incorporaron cambios ecológicos que pueden haber resultado de la intervención de manejo, para validar y actualizar la RB. Las predicciones de la abundancia de paserinos pequeños bajo las nuevas condiciones de hábitat y manejo fueron muy precisas. La RB actualizada concluyó la primera iteración de manejo adaptativo y será utilizada para la planificación de la siguiente ronda de intervenciones de manejo. La característica única de actualización de la RBs permite que los manejadores tengan flexibilidad para predecir los resultados y evaluar la efectividad de las intervenciones de manejo. [source] One Hundred Fifty Years of Change in Forest Bird Breeding Habitat: Estimates of Species DistributionsCONSERVATION BIOLOGY, Issue 6 2005LISA A. SCHULTE aptitud del hábitat; ecología aviar; ecología de paisaje; planificación de conservación Abstract:,Evaluating bird population trends requires baseline data. In North America the earliest population data available are those from the late 1960s. Forest conditions in the northern Great Lake states (U.S.A.), however, have undergone succession since the region was originally cut over around the turn of the twentieth century, and it is expected that bird populations have undergone concomitant change. We propose pre-Euro-American settlement as an alternative baseline for assessing changes in bird populations. We evaluated the amount, quality, and distribution of breeding bird habitat during the mid-1800s and early 1990s for three forest birds: the Pine Warbler (Dendroica pinus), Blackburnian Warbler (D. fusca), and Black-throated Green Warbler (D. virens). We constructed models of bird and habitat relationships based on literature review and regional data sets of bird abundance and applied these models to widely available vegetation data. Original public-land survey records represented historical habitat conditions, and a combination of forest inventory and national land-cover data represented current conditions. We assessed model robustness by comparing current habitat distribution to actual breeding bird locations from the Wisconsin Breeding Bird Atlas. The model showed little change in the overall amount of Pine Warbler habitat, whereas both the Blackburnian Warber and the Black-throated Green Warbler have experienced substantial habitat losses. For the species we examined, habitat quality has degraded since presettlement and the spatial distribution of habitat shifted among ecoregions, with range expansion accompanying forest incursion into previously open habitats or the replacement of native forests with pine plantations. Sources of habitat loss and degradation include loss of conifers and loss of large trees. Using widely available data sources in a habitat suitability model framework, our method provides a long-term analysis of change in bird habitat and a presettlement baseline for assessing current conservation priority. Resumen:,La evaluación de tendencias de las poblaciones de aves requiere de datos de referencia. En Norte América, los primeros datos disponibles de poblaciones son del final de la década de 1960. Sin embargo, las condiciones de los bosques en los estados de los Grandes Lagos (E.U.A.) han experimentado sucesión desde que la región fue talada en los inicios del siglo veinte, y se espera que las poblaciones de aves hayan experimentado cambios concomitantes. Proponemos que se considere al período previo a la colonización euro americana como referencia alternativa para evaluar los cambios en las poblaciones de aves. Evaluamos la cantidad, calidad y distribución del hábitat para reproducción de tres especies de aves de bosque (Dendroica pinus, D. fusca y D. virens) a mediados del siglo XIX e inicios del XX. Construimos modelos de las relaciones entre las aves y el hábitat con base en la literatura y conjuntos de datos de abundancia de aves y los aplicamos a los datos de vegetación ampliamente disponibles. Los registros topográficos de tierras públicas originales representaron las condiciones históricas del hábitat, y una combinación de datos del inventario forestal y de cobertura de suelo representaron las condiciones actuales. Evaluamos la robustez del modelo mediante la comparación de la distribución de hábitat actual con sitios de reproducción de aves registrados en el Wisconsin Breeding Bird Atlas. El modelo mostró poco cambio en la cantidad total de hábitat de Dendroica pinus, mientras que tanto D. fusca como D. virens han experimentado pérdidas sustanciales de hábitat. Para las especies examinadas, la calidad del hábitat se ha degradado desde antes de la colonización y la distribución espacial del hábitat cambió entre ecoregiones, con la expansión del rango acompañando la incursión de bosques en hábitats anteriormente abiertos o el reemplazo de bosques nativos con plantaciones de pinos. Las fuentes de pérdida y degradación de hábitats incluyen la pérdida de coníferas y de árboles grandes. Mediante la utilización de fuentes de datos ampliamente disponibles en un modelo de aptitud de hábitat, nuestro método proporciona un análisis a largo plazo de los cambios en el hábitat de aves y una referencia precolonización para evaluar prioridades de conservación actuales. [source] UNITED STATES V. BOOKER AS A NATURAL EXPERIMENT: USING EMPIRICAL RESEARCH TO INFORM THE FEDERAL SENTENCING POLICY DEBATE,CRIMINOLOGY AND PUBLIC POLICY, Issue 3 2007PAUL J. HOFER Research Summary: In United States v. Booker, the U.S. Supreme Court held that the federal sentencing guidelines must be considered advisory, rather than mandatory, if they are to remain constitutional under the Sixth Amendment. Since the decision, the U.S. Sentencing Commission has provided policy makers with accurate and current data on changes and continuity in federal sentencing practices. Unlike previous changes in legal doctrine, Booker immediately increased the rates of upward and downward departures from the guideline range. Government-sponsored downward departures remain the leading category of outside,the-range sentences. The rate of within-range sentences, although lower than in the period immediately preceding Booker, remains near rates observed earlier in the guidelines era. Despite the increase in departures, average sentence lengths for the overall caseload remain stable, because of offsetting increases in the seriousness of the crimes being sentenced and in the severity of penalties for those crimes. Analyses of the reasons that judges reported for downward departures suggest that treatment of criminal history and offender characteristics are the two leading areas of dissatisfaction with the guidelines. Policy Implications: Assessment of changes in sentencing practices following Booker by different observers depends partly on competing institutional perspectives and on different degrees of trust in the judgment of judges, prosecutors, the Sentencing Commission, and Congress. No agreement on whether Booker has bettered or worsened the system can be achieved until agreement exists on priorities among the purposes of sentencing and the goals of sentencing reform. Both this lack of agreement and an absence of needed data make consensus on Booker's effects on important sentencing goals, such as reduction of unwarranted disparity, unlikely in the near future. Similarly, lack of baseline data before Booker on the effectiveness of federal sentencing at crime control makes before-after comparisons impossible. Despite these limitations, research provides a sounder framework for policy making than do anecdotes or speculation and sets valuable empirical parameters for the federal sentencing policy debate. [source] Early identification of non-remission in first-episode psychosis in a two-year outcome studyACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2010E. Simonsen Simonsen E, Friis S, Opjordsmoen S, Mortensen EL, Haahr U, Melle I, Joa I, Johannessen JO, Larsen TK, Røssberg JI, Rund BR, Vaglum P, McGlashan TH. Early identification of non-remission in first-episode psychosis in a two-year outcome study. Objective:, To identify predictors of non-remission in first-episode, non-affective psychosis. Method:, During 4 years, we recruited 301 patients consecutively. Information about first remission at 3 months was available for 299 and at 2 years for 293 cases. Symptomatic and social outcomes were assessed at 3 months, 1 and 2 years. Results:, One hundred and twenty-nine patients (43%) remained psychotic at 3 months and 48 patients (16.4%) remained psychotic over 2 years. When we compared premorbid and baseline data for the three groups, the non-remitted (n = 48), remitted for <6 months (n = 38) and for more than 6 months (n = 207), duration of untreated psychosis (DUP) was the only variable that significantly differentiated the groups (median DUP: 25.5, 14.4 and 6.0 weeks, respectively). Three months univariate predictors of non-remission were being single, longer DUP, core schizophrenia, and less excitative and more negative symptoms at baseline. Two-year predictors were younger age, being single and male, deteriorating premorbid social functioning, longer DUP and core schizophrenia. In multivariate analyses DUP, negative and excitative symptoms predicted non-remission at 3 months, but only DUP predicted at 2 years. Conclusion:, Long DUP predicted both 3 month and 2-year non-remission rates in first-episode psychosis. [source] Severity of anxiety and work-related outcomes of patients with anxiety disordersDEPRESSION AND ANXIETY, Issue 12 2009Steven R. Erickson PharmD. Abstract Background: This study examined associations between anxiety and work-related outcomes in an anxiety disorders clinic population, examining both pretreatment links and the impact of anxiety change over 12 weeks of treatment on work outcomes. Four validated instruments were used to also allow examination of their psychometric properties, with the goal of improving measurement of work-related quality of life in this population. Methods: Newly enrolled adult patients seeking treatment in a university-based anxiety clinic were administered four work performance measures: Work Limitations Questionnaire (WLQ), Work Productivity and Activity Impairment Questionnaire (WPAI), Endicott Work Productivity Scale (EWPS), and Functional Status Questionnaire Work Performance Scale (WPS). Anxiety severity was determined using the Beck Anxiety Inventory (BAI). The Clinical Global Impressions, Global Improvement Scale (CGI-I) was completed by patients to evaluate symptom change at a 12-week follow-up. Two severity groups (minimal/mild vs. moderate/severe, based on baseline BAI score) were compared to each other on work measures. Results: Eighty-one patients provided complete baseline data. Anxiety severity groups did not differ in job type, time on job, job satisfaction, or job choice. Patients with greater anxiety generally showed lower work performance on all instruments. Job advancement was impaired for the moderate/severe group. The multi-item performance scales demonstrated better validity and internal consistency. The WLQ and the WPAI detected change with symptom improvement. Conclusion: Level of work performance was generally associated with severity of anxiety. Of the instruments tested, the WLQ and the WPAI questionnaire demonstrated acceptable validity and internal reliability. Depression and Anxiety, 2009. © 2009 Wiley-Liss, Inc. [source] | ||||||||||||||||||||||||||||||||||||||||