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Baseline Survey (baseline + survey)
Selected Abstracts"I Am Not Alone": The Feasibility and Acceptability of Interactive Voice Response-Facilitated Telephone Peer Support Among Older Adults With Heart FailureCONGESTIVE HEART FAILURE, Issue 3 2007Michele Heisler MD Patient self-management is a critical determinant of heart failure (HF) outcomes, yet patients with HF are often frail and socially isolated, factors that may limit their ability to manage self-care and access clinic-based services. Mobilizing peer support among HF patients is a promising strategy to improve self-management support. In this pilot, the authors evaluated the feasibility and acceptability of an interactive voice response (IVR)-based platform to facilitate telephone peer support among older adults with HF. Participants completed a baseline survey, were offered a 3-hour training session in peer communication skills, and were paired with another patient who had HF. Participants were asked to contact their partner weekly using a toll-free IVR phone system that protected their anonymity and provided automated reminders if contacts were not made. Times and duration of participants' telephone contacts were monitored and recorded. After the 7-week intervention, participants completed surveys and brief face-to-face interviews. The authors found high levels of use and satisfaction and improvements in depressive symptoms among the 20 pilot study participants. An IVR peer-support intervention is feasible, is acceptable to patients, and may have positive effects on patients' HF social support and health outcomes, in conjunction with structured health system support, that warrant more rigorous evaluation in a randomized trial. [source] Twenty-five-year course and outcome in anxiety and depression in the Upper Bavarian Longitudinal Community StudyACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2010M. M. Fichter Fichter MM, Quadflieg N, Fischer UC, Kohlboeck G. Twenty-five-year course and outcome in anxiety and depression in the Upper Bavarian Longitudinal Community Study. Objective:, Assessment of 25-year course of pure and mixed anxiety and depression in a community sample. Method:, Participants were grouped into pure anxiety, pure depression, mixed anxiety and depression, and no anxiety or depressive syndrome at baseline. Assessments consisted of a: i) baseline survey, ii) 5-year follow-up, iii) 25-year follow-up. Self-rating scales as well as expert-rating interviews yielded data on social and psychopathological risk factors and outcome measures. Results:, Baseline prevalence for mixed anxiety and depressive syndrome was 8.7%. Subjects with combined anxiety and depressive syndrome were more predisposed towards later adverse mental health outcomes and reduced functionality. The transition from anxiety syndrome (pure and mixed) to depressive syndrome over the 25-year study is more likely than the reverse. Logistic regression analysis emphasized the impact of early anxiety syndromes on later depression. Conclusion:, Results underscore the long-term risks of suffering from a combined anxiety and depressive syndrome. [source] Changes in HIV/AIDS/STI Knowledge, Attitudes and Practices among Commercial Sex Workers and Military Forces in Port Loko, Sierra LeoneDISASTERS, Issue 3 2004Mandi M. Larsen Sierra Leone suffered from 11 years of civil war (1991,2002) resulting in tens of thousands of deaths and mutilations together with massive population displacement. In 2001, ARC International, Sierra Leone conducted a baseline survey of 201 commercial sex workers (CSWs) and 202 military respondents on the knowledge, attitudes and practices surrounding HIV/AIDS and STIs in Port Loko, Sierra Leone. In 2003, a comparable post-intervention survey of 202 CSWs and 205 military respondents was performed. Comparison of baseline and post-intervention results showed that HIV/AIDS knowledge increased among both groups, with those able to name three effective means of avoiding AIDS increasing from 5 per cent to 70 per cent among CSWs, and 11 to 75 per cent among the military. Reported condom use during last sex increased among CSWs from 38 to 68 per cent and among military from 39 to 68 per cent. These results demonstrate that, despite the challenges inherent in a post-conflict country, good-quality AIDS-prevention programmes can be effective. [source] Mental disorders as risk factors for substance use, abuse and dependence: results from the 10-year follow-up of the National Comorbidity SurveyADDICTION, Issue 6 2010Joel Swendsen ABSTRACT Aims The comorbidity of mental disorders and substance dependence is well documented, but prospective investigations in community samples are rare. This investigation examines the role of primary mental disorders as risk factors for the later onset of nicotine, alcohol and illicit drug use, abuse and dependence with abuse. Design The National Comorbidity Survey (NCS) was a nationally representative survey of mental and substance disorders in the United States carried out in 1990,92. The NCS-2 re-interviewed a probability subsample of NCS respondents in 2001,03, a decade after the baseline survey. Participants A total of 5001 NCS respondents were re-interviewed in the NCS-2 (87.6% of baseline sample). Results Aggregate analyses demonstrated significant prospective risks posed by baseline mental disorders for the onset of nicotine, alcohol and illicit drug dependence with abuse over the follow-up period. Particularly strong and consistent associations were observed for behavioral disorders and previous substance use conditions, as well as for certain mood and anxiety disorders. Conditional analyses demonstrated that many observed associations were limited to specific categories of use, abuse or dependence, including several mental disorders that were non-significant predictors in the aggregate analyses. Conclusions Many mental disorders are associated with an increased risk of later substance use conditions, but important differences in these associations are observed across the categories of use, abuse and dependence with abuse. These prospective findings have implications for the precision of prevention and treatment strategies targeting substance use disorders. [source] Smoking cessation patterns and predictors of quitting smoking among the Japanese general population: a 1-year follow-up studyADDICTION, Issue 1 2010Akiko Hagimoto ABSTRACT Aim To examine the percentage of Japanese adult smokers who make quit attempts and succeed in smoking cessation over a 1-year period, and to identify predictors of attempts to stop and successful smoking cessation. Design and setting This study used Ipsos JSR Company's access panel, whose sampling framework is based on the Basic Resident Register in Japan. We tracked and monitored a selected sample of smokers who were at least 20 years of age through a baseline postal questionnaire survey in 2005 and a follow-up survey 1 year later. Participants The original response rate was 72.1% (1874 of 2600 smokers). There were 1627 current smokers in the baseline survey, and of those, 1358 were followed-up 1 year later. Findings Among the current smokers, 23.0% reported that they had attempted to quit smoking at least once in the past year. Of those who made quit attempts, 25.6% had achieved 1-week abstinence successfully and 13.5% reported having achieved sustained 6-month abstinence successfully at the time of the follow-up survey. The predictors associated with quit attempts were non-daily smoker, higher motivation to quit and previous attempts to stop smoking. Among smokers who made quit attempts, only 13.5% used nicotine replacement therapy. Higher nicotine dependence was associated with lower probability of success in quitting. Conclusions Japanese smokers attempt to quit at a lower rate than smokers in the United Kingdom and United States, but factors that predict attempts (primarily markers of motivation) and success of attempts (primarily dependence) are similar to those found in western samples. [source] Socio-demographic risk factors for alcohol and drug dependence: the 10-year follow-up of the national comorbidity surveyADDICTION, Issue 8 2009Joel Swendsen ABSTRACT Aims Continued progress in etiological research and prevention science requires more precise information concerning the specific stages at which socio-demographic variables are implicated most strongly in transition from initial substance use to dependence. The present study examines prospective associations between socio-demographic variables and the subsequent onset of alcohol and drug dependence using data from the National Comorbidity Survey (NCS) and the NCS Follow-up survey (NCS-2). Design The NCS was a nationally representative survey of the prevalence and correlates of DSM-III-R mental and substance disorders in the United States carried out in 1990,2002. The NCS-2 re-interviewed a probability subsample of NCS respondents a decade after the baseline survey. Baseline NCS socio-demographic characteristics and substance use history were examined as predictors of the first onset of DSM-IV alcohol and drug dependence in the NCS-2. Participants A total of 5001 NCS respondents were re-interviewed in the NCS-2 (87.6% of baseline sample). Findings Aggregate analyses demonstrated significant associations between some baseline socio-demographic variables (young age, low education, non-white ethnicity, occupational status) but not others (sex, number of children, residential area) and the subsequent onset of DSM-IV alcohol or drug dependence. However, conditional models showed that these risk factors were limited to specific stages of baseline use. Moreover, many socio-demographic variables that were not significant in the aggregate analyses were significant predictors of dependence when examined by stage of use. Conclusions The findings underscore the potential for socio-demographic risk factors to have highly specific associations with different stages of the substance use trajectory. [source] Brief screening tool for mild cognitive impairment in older Japanese: Validation of the Japanese version of the Montreal Cognitive AssessmentGERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 3 2010Yoshinori Fujiwara Aim: The Montreal Cognitive Assessment (MoCA), developed by Dr Nasreddine (Nasreddine et al. 2005), is a brief cognitive screening tool for detecting older people with mild cognitive impairment (MCI). We examined the reliability and validity of the Japanese version of the MoCA (MoCA-J) in older Japanese subjects. Methods: Subjects were recruited from the outpatient memory clinic of Tokyo Metropolitan Geriatric Hospital or community-based medical health check-ups in 2008. The MoCA-J, the Mini-Mental State Examination (MMSE), the revised version of Hasegawa's Dementia Scale (HDS-R), Clinical Dementia Rating (CDR) scale, and routine neuropsychological batteries were conducted on 96 older subjects. Mild Alzheimer's disease (AD) was found in 30 subjects and MCI in 30, with 36 normal controls. Results: The Cronbach's alpha of MoCA-J as an index of internal consistency was 0.74. The test,retest reliability of MoCA, using intraclass correlation coefficient between the scores at baseline survey and follow-up survey 8 weeks later was 0.88 (P < 0.001). MoCA-J score was highly correlated with MMSE (r = 0.83, P < 0.001), HDS-R (r = 0.79, P < 0.001) and CDR (r = ,0.79, P < 0.001) scores. The areas under receiver,operator curves (AUC) for predicting MCI and AD groups by the MoCA-J were 0.95 (95% confidence interval [CI] = 0.90,1.00) and 0.99 (95% CI = 0.00,1.00), respectively. The corresponding values for MMSE and HDS-R were 0.85 (95% CI = 0.75,0.95) and 0.97 (95% CI = 0.00,1.00), and 0.86 (95% CI = 0.76,0.95) and 0.97 (95% CI = 0.00,1.00), respectively. Using a cut-off point of 25/26, the MoCA-J demonstrated a sensitivity of 93.0% and a specificity of 87.0% in screening MCI. Conclusion: The MoCA-J could be a useful cognitive test for screening MCI, and could be recommended in a primary clinical setting and for geriatric health screening in the community. Geriatr Gerontol Int 2010; 10: 225,232. [source] Cigarette smoking, alcohol drinking and the risk of gallbladder cancer death: A prospective cohort study in JapanINTERNATIONAL JOURNAL OF CANCER, Issue 4 2008Kiyoko Yagyu Abstract Gallbladder cancer is a rare cancer with a poor prognosis, and few risk factors have been identified to date. This prospective study was conducted to evaluate the association of cigarette smoking and alcohol consumption with the risk of gallbladder cancer death. A baseline survey in 45 areas throughout Japan was conducted from 1988 to 1990 using a self-administered questionnaire, and a total of 113,496 participants (65,740 women) aged 40,89 years at entry were followed for 15 years. During the follow-up period, 165 gallbladder cancer deaths (95 women) were observed. Among women, the hazard ratio (HR) [95 percent confidence interval: 95% CI] of current smoker was 2.00 [0.91,4.42], when adjusted for age and drinking. There was no clear association between alcohol consumption and the risk. Among men, HR of current smoker was 2.27 [1.05,4.90]. HRs of those who smoked 21 cigarettes or more per day and those with 801,1,000 cigarette-years were 3.18 [1.18,8.53] and 3.44 [1.40,8.45], respectively, and positive linear associations were observed between that risk and the number of cigarettes per day (p for trend = 0.007) or "cigarette-years" (p for trend = 0.012). The alcohol dose was linearly associated with risk (p for trend = 0.004), where the HR among those who consumed 72.0 g or more of alcohol per day was 3.60 [1.29,9.85]. Among both men and women, cigarette smoking may elevate the risk of death from gallbladder cancer. Drinking may pose an elevated risk among men, but that seems to be less true among women. © 2007 Wiley-Liss, Inc. [source] Prospective study of transfusion history and thyroid cancer incidence among females in JapanINTERNATIONAL JOURNAL OF CANCER, Issue 4 2004Yoshihisa Fujino Abstract A link between hepatitis C virus (HCV) infection and thyroid cancer was recently reported in a series of case-control studies in southern Italy. A prospective study could reinforce these findings. However, cohort studies that began before 1990 rarely assessed serological HCV infection. In addition, thyroid cancer is rare and generally has a good prognosis. Therefore, incidence outcome data are required, rather than mortality data, to evaluate the risk of thyroid cancer. Blood transfusion history might be a possible substitute measure to evaluate the cancer risks associated with HCV infection because blood transfusions were the major HCV transmission route in Japan until 1992. The purpose of our study was therefore to examine the association between transfusion history and thyroid cancer. A baseline survey of members of the JACC Study was conducted from 1988 until 1990, which involved 110,792 participants from 45 areas throughout Japan. Data were collected from a total of 37,983 women with no history of cancer at the baseline (337,906 person-years) and 79 cases of thyroid cancer were identified among this group. A history of blood transfusion marginally increased the risk of thyroid cancer [risk ratio (RR) = 1.77, 95% confidence interval (CI) = 0.95,3.30], and a history of transfusion and/or liver disease significantly increased the thyroid cancer risk (RR = 1.84, 95% CI = 1.07,3.16). These results indirectly support an association between HCV and thyroid cancer. In addition, our data reveal an association between blood transfusion and thyroid cancer, which might be facilitated by transfusion-associated immunomodulation. © 2004 Wiley-Liss, Inc. [source] Patterns and Predictors of Smoking Cessation in an Elderly CohortJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2006Heather E. Whitson MD OBJECTIVES: To identify subject characteristics that predict smoking cessation and describe patterns of cessation and recidivism in a cohort of elderly smokers. DESIGN: Prospective cohort study. SETTING: Piedmont region, North Carolina. PARTICIPANTS: Five hundred seventy-three subjects enrolled in the North Carolina Established Populations for Epidemiologic Studies of the Elderly who responded "yes" to question 179 on the baseline survey (Do you smoke cigarettes regularly now?) and survived at least 3 years, until the next in-person follow-up (1989/90). Subjects were classified as quitters (n=100) or nonquitters (n=473) based on subsequent smoking behavior. MEASUREMENTS: Reported smoking behavior, demographic characteristics of the smokers at baseline or subsequent interviews, 7-year mortality. RESULTS: After controlling for all characteristics studied, subjects who quit smoking were more likely to be female (P=.03) and showed a trend toward greater likelihood of a recent cancer diagnosis (P=.11). Recidivism was observed in only 16% (19/119) of subjects who reported no smoking in 1989/90. The percentage of subjects who died during 7 years of follow-up was 44.0% of quitters, compared with 51.6% of nonquitters. Smoking cessation was not associated with a statistically significant decrease in risk of death after controlling for other variables (odds ratio=0.78, 95% confidence interval=0.48,1.26). CONCLUSION: Smoking cessation in this elderly cohort was associated with different subject characteristics from those that predict successful cessation in younger populations, suggesting that older smokers may have unique reasons to stop smoking. Further study is needed to assess potential motives and benefits associated with smoking cessation at an advanced age. [source] Hormone therapy and mortality during a 14-year follow-up of 14 324 Norwegian womenJOURNAL OF INTERNAL MEDICINE, Issue 5 2004S. Graff-Iversen Abstract. Objectives., We evaluated mortality from cardiovascular disease (CVD), coronary heart disease (CHD) and all causes in relation to use of any hormone therapy (HT) and HT with oestradiol and norethisterone or levonorgestrel. Design., Population-based cohort study. Setting and subjects., Women in three Norwegian counties were invited to a health survey in 1985,88 and 82.8% participated. In all 14 324 post- or perimenopausal women aged 35,62 years, including 702 HT users with a mean age of 48.8 years, were followed for 14 years. Results., Women using HT had mortality from all causes and CVD comparable with that of nonusers. The relative risk (RRs) for CVD mortality amongst all women were 0.69 (95% CI: 0.35,1.33) for users of HT, and 0.96 (95% CI: 0.43,2.17) for users of HT with norethisterone or levonorgestrel. Amongst women free of self-reported cardiovascular health problems at baseline all-cause, CVD and CHD mortality tended to be lower amongst users of HT whilst HT use was linked with increased mortality amongst women with cardiovascular health problems. Conclusions., In this cohort of women around the usual age of menopause all-cause or CVD mortality amongst users of HT, most often oestradiol combined with norethisterone or levonorgestrel, was not markedly different from that of nonusers. Early CHD events amongst HT users prior to the baseline survey, together with selective inclusion of healthy subjects, may in part explain protective effects of HT on CHD reported from previous observational studies. [source] Driving towards an improved research and development cultureJOURNAL OF NURSING MANAGEMENT, Issue 3 2008MARY P. McNICHOLL BSc (Hons) Background, This study examined the research and development culture and capacity within one NHS Trust in Northern Ireland. Strengths and challenges were identified and opportunities for further research and development expansion were sought. Methods, This is a two-stage project incorporating a baseline survey (n = 379) followed by consultation with key stakeholders across the Trust (n = 11). Findings, In the survey, over half of the respondents (n = 194) stated they had participated in a research project and a significant number (n = 313) read health care journals. Identification of barriers to research resulted in findings similar to other published work. Staff responded positively about using research in practice (n = 328) and that practice should be influenced by research (n = 312). Nurse Managers indicated support for research and development activity. Conclusion, The study provides a starting point from which to develop a positive research and development culture within this Trust. Implications for nursing management, After establishing a baseline of research and development activity across a large acute Trust, the strengths and weaknesses of such activity were identified with a view to informing a strategy to develop this aspect of professional activity. A change in an organizational culture cannot be made without full support of both the clinicians and their managers. [source] Clinical supervision for mental health nurses in Northern Ireland: formulating best practice guidelinesJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 5 2007F. RICE rmn msc Nurses work in a constantly challenging and changing environment. Within this context, there is a continuing need for support. Such support will help increase morale, decrease strain and burnout, and encourage self-awareness and self-expression. Clinical supervision address all these issues and enhances the quality of care for patients. While clinical supervision is a policy imperative in Northern Ireland, it was clear that there were problems in its implementation in mental health nursing. The aim of this project was to explore ways to make clinical supervision available to all mental health nurses and to improve and evaluate their contribution to patient care. The research team undertook a comprehensive literature review and a baseline survey of relevant stakeholders. Results represent the outcome of the group work. They will assist healthcare providers to develop local policies and procedures on clinical supervision for practising mental health nurses. [source] Buddhist nuns on the move: an innovative approach to improving breastfeeding practices in CambodiaMATERNAL & CHILD NUTRITION, Issue 1 2007Benjamin T. Crookston Abstract The benefits of initiating breastfeeding in the first hour of life and exclusively breastfeeding thereafter are well documented. However, little is known about how best to promote these practices. In this study, we assess the impact of Buddhist nuns and wat (pagoda) grannies on optimal breastfeeding behaviours in rural Cambodia. We did so by interviewing randomly selected mothers of infants less than 6 months of age. A total of 440 mothers in programme and control communities completed the baseline survey (before programme start-up), and 467 mothers responded 1 year later. Mothers' exposure to breastfeeding promotion activities was high. At follow-up, 76% of mothers in programme communities indicated that nuns had advised them about breastfeeding, 73% received a home visit and 72% reported attending an educational session. At baseline, mothers in programme communities were 11% more likely (RR = 1.11, CI: 0.74,1.68) than mothers in control communities to initiate breastfeeding in the first hour of life. At follow-up, they were 62% more likely (RR = 1.62, CI: 1.30,2.01) to do so. Similarly, at baseline, mothers in programme communities were 54% more likely (RR = 1.54, CI: 1.21,1.96) than mothers in control communities to breastfeed exclusively in the previous 24 h. At follow-up, they were 81% more likely (RR = 1.81, CI: 1.49,2.21) to do so. Programme planners may consider using community-based volunteers as one strategy to improve breastfeeding practices and child survival. [source] Influence of physical inactivity on the prevalence of hay feverALLERGY, Issue 11 2006Y. Kohlhammer Background:, Atopic diseases constitute a major public health problem, increasing constantly in frequency and severity. While treatments are improving, the main cause for an increasing trend of hay fever and its definite triggers remain unclear. The aim of our study was to assess whether physical inactivity could be a risk factor for hay fever. Methods:, We analysed data of a cohort of children aged 5,14 years at baseline (1992,1993) who were followed up until 2003,2005. Parental-reported information on physical activity (being active, doing sports) was obtained for 2429 children participating at the baseline survey (active: n = 1923; semi-active: n = 364; inactive: n = 142). A total of 1703 children (70.1%) were reapproached at least once during follow-up. Logistic regression models were applied to study associations between hay fever, allergic sensitization and physical activity, adjusted for potentially relevant confounders such as age, gender, study site, parental education, breastfeeding, crowding, daycare, dampness or visible moulds, contact to cats, current or prior environmental tobacco smoke exposure and parental atopy. Results:, Significantly higher rates of hay fever were seen for inactive children [aOR 2.39 (95% CI 1.31,4.36) for baseline survey 1992,1993 and aOR 1.76 (95% CI 1.14,2.71) for the follow-up-period until 2005]. In addition, the relative risk of incident cases of hay fever increased depending on inactivity [aRR 1.50 (95% CI 1.05,2.13)]. No association was found between physical inactivity and allergic sensitization assessed by radioallergosorbent test determinations. Conclusions:, Although the underlying biological mechanisms could not be clarified, increasing physical activity in childhood is suggested to prevent hay fever. [source] Urinary incontinence across the lifespanNEUROUROLOGY AND URODYNAMICS, Issue 6 2003Yvette D. Miller Abstract Aims The objectives of the current study were (1) to measure type and severity of urinary leakage and (2) to investigate the association between these factors and age-related life events and conditions in three groups of Australian women with a history of urinary leakage. Methods Five hundred participants were randomly selected from women in the young (aged 18,22 in 1996), mid-age (45,50), and older (70,75) cohorts of the Australian Longitudinal Study of Women's Health (ALSWH) who had reported leaking urine in the 1996 baseline survey. Details about leaking urine (frequency, severity, situations) and associated factors (pregnancy, childbirth, body mass index [BMI]) were sought through self-report mailed follow-up surveys in 1999. Results & Conclusions Response rates were 50, 83, and 80% in the young, mid-age, and older women, respectively. Most women confirmed that they had leaked urine in the past month, and the majority of these were cases of "mixed" incontinence. Incontinence severity tended to increase with BMI for women of all ages, and increased severity scores were associated with having urine that burns or stings. Additional independent risk factors for increasing incontinence severity were heavy smoking in young women, past or present use of hormone replacement therapy in older women, and BMI and history of hysterectomy in mid-age women. Neurourol. Urodynam. 22:550,557, 2003. © 2003 Wiley-Liss, Inc. [source] Inhalation incidents and respiratory health: results from the European Community respiratory health surveyAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 1 2009Maria C. Mirabelli MPH Abstract Background Inhalation incidents are an important cause of acute respiratory symptoms, but little is known about how these incidents affect chronic respiratory health. Methods We assessed reported inhalation incidents among 3,763 European Community Respiratory Health Survey (ECRHS) participants with and without cough, phlegm, asthma, wheezing or bronchial hyperresponsiveness. We then examined whether inhalation incidents during the 9-year ECRHS follow-up period were associated with a new onset of any of these respiratory outcomes among 2,809 participants who were free of all five outcomes at the time of the baseline ECRHS survey. Results Inhalation incidents were reported by 5% of participants, with higher percentages reported among individuals with asthma-related outcomes at the time of the baseline survey. Among participants without symptoms at baseline, our analyses generated non-statistically significant elevated estimates of the risk of cough, phlegm, asthma and wheezing and a non-statistically significant inverse estimate of the risk of bronchial hyperresponsiveness among participants who reported an inhalation incident compared to those without such an event reported. Discussion Our findings provide limited evidence of an association between inhalation incidents and asthma-related symptoms. These data could be affected by differences in the reporting of inhalation incidents according to symptom status at the time of the baseline survey; they should thus be interpreted with caution. Am. J. Ind. Med. 52:17,24, 2009. © 2008 Wiley-Liss, Inc. [source] Sociodemographic and Health Profiles of the Oldest Old In ChinaPOPULATION AND DEVELOPMENT REVIEW, Issue 2 2002Zeng Yi Unique data from a 1998 healthy longevity baseline survey provide demographic, socio-economic, and health characteristics of the oldest old, aged 80,105, in China. This subpopu-lation is growing rapidly and is likely to need extensive social and health services. A large majority of Chinese oldest old live with their children and rely mainly on children for financial support and care. Most Chinese oldest old had no or very little education. Ability to function independently in daily living declines rapidly and self-rated health declines moderately across the oldest old ages. As compared to their urban counterparts, the rural oldest old have far less pension support, are significantly less educated, and are more likely to be widowed and to rely on children for support. Apart from higher rates of survival, the female oldest old in China are far more disadvantaged than the male oldest old. [source] New predictive equations for spirometric reference values and comparison with Morris equation in a Korean populationRESPIROLOGY, Issue 3 2008Chang-Hoon LEE Background and objective: The clinical importance of the differences between actual and predicted spirometric indices in non-Western populations is poorly defined. This study evaluated the differences between the spirometric values derived from Morris equation, traditionally used in South Korea, and the actual values, in the classification and detection of patients with respiratory diseases, and developed new predictive equations for the calculation of reference spirometric values for healthy Koreans. Methods: Data derived from a subset of the population who completed the initial baseline survey of the Korean Health and Genome Study were used to develop new predictive equations for spirometric reference values, using multiple linear regression. The effects of the new equations relative to those of Morris on the detection and classification of patients with respiratory diseases were then evaluated. Results: In total, 9999 people completed the baseline survey; a subgroup of 1314 met the study inclusion criteria and were used to develop the new predictive equations. Morris equation are 53.8% less accurate in detecting people with restrictive disorders and 15.8% less accurate in estimating the severity of COPD than the newly derived equations, although the differences between values derived from the traditional equations and values from the new equations were as small as 3.3,7.6%. Conclusions: The use of spirometric reference values that underestimate the actual parameters, despite the small differences, may have a significant influence on the detection of patients with restrictive disorders and the staging of COPD. [source] A baseline biological survey of the proposed Taputeranga Marine Reserve (Wellington, New Zealand): spatial and temporal variability along a natural environmental gradientAQUATIC CONSERVATION: MARINE AND FRESHWATER ECOSYSTEMS, Issue 2 2009Anjali Pande Abstract 1.Four macroalgal, four macroinvertebrate and eight fish species were surveyed at eight sites (three inside, five outside the proposed reserve) over three years before the establishment of the Taputeranga Marine Reserve (MR) on Cook Strait (Wellington, New Zealand). This baseline data set was used to estimate temporal and spatial variability in size and abundance of these taxa, and will be used to quantify taxon-specific changes in size and abundance once the MR is established. 2.Statistically significant differences in size and/or abundance were observed for many taxa among the sites. These differences are consistent with the existence of a natural environmental gradient from the west (entrance to Cook Strait) to the east (Wellington Harbour). This gradient highlights the importance of conducting a pre-reserve baseline survey at multiple sites and over multiple years to better understand the conservation or fisheries benefits that MRs are expected to deliver. 3.Two macroalgal, one macroinvertebrate, and six fish species showed statistically significant seasonal variation in abundance. Subsequent multi-taxa monitoring needs to include a seasonal component to capture this natural variability. 4.This multi-site and multi-year data set represents one of the most comprehensive and robust baseline data sets available anywhere in the world. It will be used to quantify the ecological changes associated with a newly established full no-take marine reserve. Ongoing monitoring will enhance understanding of the sizes and abundances of key taxa, allow a detailed determination of the conservation effects of reserve establishment, and inform management decisions for Wellington's south coast. Copyright © 2008 John Wiley & Sons, Ltd. [source] Cross-sectional and longitudinal comparisons of health-related quality of life between patients with prostate carcinoma and matched controls,,§CANCER, Issue 9 2004M.P.H., Richard M. Hoffman M.D. Abstract BACKGROUND Prostate carcinoma and treatments affect health-related quality of life (HRQOL). The authors prospectively compared prostate and general HRQOL between prostate carcinoma cases and an age-matched and ethnicity-matched control group. METHODS The case cohort consisted of 293 men with localized prostate carcinoma who were selected randomly from the population-based New Mexico Tumor Registry, and the control cohort consisted of 618 men who were selected randomly from administrative databases and matched for age and ethnicity. Subjects completed a baseline survey of demographics, socioeconomic status, comorbidity, and prostate and general HRQOL. Also, 210 cases (71.7%) and 421 controls (67.8%) completed a follow-up survey 5 years later. Multinomial logistic regression models compared baseline characteristics as well as 5-year general HRQOL outcomes measured by selected domains of the Medical Outcomes Study SF-36. The authors used a mixed-model repeated-measures analysis of variance and multinomial regression analyses to compare longitudinal changes in urinary, bowel, and sexual function between groups. RESULTS At baseline, patients with prostate carcinoma had better urinary control and sexual function than controls. Over 5 years, sexual function declined significantly among controls, although urinary function remained stable. However, patients with cancer subsequently reported significant declines in both domains and were left with much worse function and more bother than controls. Bowel function and general HRQOL were similar for both groups at follow-up. CONCLUSIONS Prostate carcinoma treatment led to significant 5-year declines in urinary and sexual function that far exceeded age-related changes in controls. Patients with cancer had significantly worse function and more bother than controls for these disease-specific domains of HRQOL. Bowel function and general HRQOL were not affected by cancer status. Cancer 2004. Published 2004 American Cancer Society. [source] Bioterrorism Training in U.S. Emergency Medicine Residencies: Has It Changed since 9/11?ACADEMIC EMERGENCY MEDICINE, Issue 3 2007MSPH, Philip Kevin Moye MD Objectives: To assess the change in prevalence of bioterrorism training among emergency medicine (EM) residencies from 1998 to 2005, to characterize current training, and to identify characteristics of programs that have implemented more intensive training methods. Methods: This was a national cross sectional survey of the 133 U.S. EM residencies participating in the 2005 National Resident Matching Program; comparison with a baseline survey from 1998 was performed. Types of training provided were assessed, and programs using experiential methods were identified. Results: Of 112 programs (84.2%) responding, 98% reported formal training in bioterrorism, increased from 53% (40/76) responding in 1998. In 2005, most programs with bioterrorism training (65%) used at least three methods of instruction, mostly lectures (95%) and disaster drills (80%). Fewer programs used experiential methods such as field exercises or bioterrorism-specific rotations (35% and 13%, respectively). Compared with other programs, residency programs with more complex, experiential methods were more likely to teach bioterrorism-related topics at least twice a year (83% vs. 59%; p = 0.018), to teach at least three topics (60% vs. 40%; p = 0.02), and to report funding for bioterrorism research and education (74% vs. 45%; p = 0.007). Experiential and nonexperiential programs were similar in program type (university or nonuniversity), length of program, number of residents, geographic location, and urban or rural setting. Conclusions: Training of EM residents in bioterrorism preparedness has increased markedly since 1998. However, training is often of low intensity, relying mainly on nonexperiential instruction such as lectures. Although current recommendations are that training in bioterrorism include experiential learning experiences, the authors found the rate of these experiences to be low. [source] Comparison of three plating media for the isolation of Salmonella from poultry environmental samples in Great Britain using ISO 6579:2002 (Annex D)JOURNAL OF APPLIED MICROBIOLOGY, Issue 6 2009J.J. Carrique-Mas Abstract Aims:, To evaluate the performance of three Salmonella plating media (Rambach, Xylose Lysine Deoxycholate agar and modified Brilliant Green Agar plus Novobiocin) as part of the ISO 6579: 2002 (Annex D) on poultry environmental samples. Methods and Results:, The samples analysed were those for the European Union Salmonella baseline surveys of laying (N = 3087), broiler (N = 1550), turkey fattening (N = 1540) and turkey breeding (N = 580) flocks for Great Britain. Results were considered separately for Rambach (including and excluding pale orange colonies) and for growth on selective media [Modified semi-solid Rappaport Vassiliadis (MSRV)] after 24 and 48 h of incubation. Overall, Rambach was the most sensitive medium, provided that pale orange colonies were checked. In all cases, an increase in the sensitivity of detection was obtained by plating growth on MSRV after 48 h of incubation. In broilers and laying flocks, the specificity significantly improved when Rambach only was used. Conclusion:, The use of Rambach results in considerable savings compared with the two-plate method prescribed by ISO 6579:2002 (Annex D) without compromising sensitivity. Significance and Impact of the Study:,Salmonella isolation protocols should be reviewed in terms of their efficiency and cost. [source] Biotic affinities of rocky reef fishes, invertebrates and macroalgae in different zones of the Port Davey marine protected area, south-western TasmaniaAQUATIC CONSERVATION: MARINE AND FRESHWATER ECOSYSTEMS, Issue 3 2010Graham J. Edgar Abstract 1.Assemblages of fishes, invertebrates, and macroalgae showed strong and predictable distributional patterns within the newly declared Port Davey marine protected area (MPA) in south-western Tasmania. Biotic assemblages in the eastern estuarine section of the MPA within Bathurst Channel were extremely anomalous, both in relation to biota elsewhere in the Port Davey region and also to those present along the wider Tasmanian and Australian coasts. Much of this variation was due to the phenomenon of deepwater emergence, with species in 5,m water depth in eastern Bathurst Channel possessing a mean maximum recorded depth of 200,m, compared with<80,m for the same metric when calculated for sites studied elsewhere around Australia. Deepwater emergence in Bathurst Channel was particularly notable for sessile organisms, although also evident among fishes and mobile macro-invertebrates. 2.Quantitative baseline surveys of reef-associated species were undertaken at sites interspersed among MPA management zone types and biotic community types, thereby providing an appropriate benchmark for assessing ecological changes in different management zones within the Port Davey region through the long term. Distinctive biota present in eastern and western Bathurst Channel, and eastern Port Davey, are well protected within ,no-take' sanctuary zones; however, a bias in location of sanctuary zones towards areas with little fishery resources resulted in less protection for the western Port Davey biota, which also extends along the open coast. Although the lack of high level protection for sites with fishery resources detracts from conservation goals, the Port Davey MPA nevertheless represents a major advance in environmental protection because the ecologically unique, fully protected locations are a necessary inclusion within any comprehensive Australian MPA network. Copyright © 2009 John Wiley & Sons, Ltd. [source] People, places and policies , trying to account for health inequalities in impoverished neighbourhoodsAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 1 2009Peter Feldman Abstract Objective: We consider associations between individual, household and area-level characteristics and self-reported health. Method: Data is taken from baseline surveys undertaken in 13 socio-economically disadvantaged neighbourhoods in Victoria (n=3,944). The neighbourhoods are sites undergoing Neighbourhood Renewal (NR), a State government initiative redressing place-based disadvantage. Analysis:This focused on the relationship between area and compositional factors and self-reported health. Area was coded into three categories; LGA, NR residents living in public housing (NRPU) and NR residents who lived in private housing (NRPR). Compositional factors included age, gender, marital status, identifying as a person with a disability, level of education, unemployment and receipt of pensions/benefits. Results: There was a gradient in socio-economic disadvantage on all measures. People living in NR public housing were more disadvantaged than people living in NR private housing who, in turn, were more disadvantaged than people in the same LGA. NR public housing residents reported the worst health status and LGA residents reported the best. Conclusions: Associations between compositional characteristics of disability, educational achievement and unemployment income and poorer self-reported health were shown. They suggested that area characteristics, with housing policies, may be contributing to differences in self-reported health at the neighbourhood level. Implications: The clustering of socio-economic disadvantage and health outcomes requires the integration of health and social support interventions that address the circumstances of people and places. [source] | |||||||||||||||||||||||||||||||