Biomedical subjects

Tara W Strine

Publications and source records attributed to Tara W Strine.

At least 19 recordsLinked to original sources

PubMed2006

Healthy lifestyle behaviors among older U.S. adults with and without disabilities, Behavioral Risk Factor Surveillance System, 2003.

INTRODUCTION: Little is known about the relationship between healthy behaviors and the prevalence of chronic diseases in older adults with disabilities. This study examines the prevalence of selected healthy lifestyle behaviors related to chronic diseases among adults aged 65 years and older with and without disabilities. METHODS: Data from the 2003 Behavioral Risk Factor Surveillance System (BRFSS) were used to assess having a healthy weight and six behaviors: current cigarette smoking status, consumption of at least one alcoholic beverage daily, consumption of at least five fruits or vegetables daily, physical activity during the average week, influenza immunization in the past year, and lifetime pneumococcal immunization. RESULTS: People with a disability were less likely than people without a disability to have a healthy weight (28.5% vs 37.2%) and to engage in the recommended level of weekly physical activity (14.7% vs 26.2%). However, people with a disability were more likely than those without a disability to be nonsmokers (91.8% vs 89.9%), to consume up to one alcoholic beverage daily (95.1% vs 91.5%), to have received their influenza immunization in the past year (72.7% vs 69.0%), and to have received a lifetime pneumococcal immunization (72.1% vs 63.0%). There was no difference between people with and without a disability in the prevalence rates of consuming at least five fruits or vegetables daily. CONCLUSION: The prevalence of having a healthy weight and six chronic-disease related behaviors among adults aged 65 years and older varies by disability status and by specific modifiable lifestyle behavior. Screening older adults with and without disabilities and counseling them about health behaviors should be integrated into every interaction between older adults and their health care providers to potentially lower the rates of morbidity and mortality related to chronic diseases in the later years.

Aged↗

PubMed2006

Psychological distress and impaired quality of life common among community-dwelling adults with lower gastrointestinal disorders.

This study examines the comparison of psychological well-being and health-related quality of life (HRQOL) between adults with and without lower gastrointestinal (GI) disorders and between adults with lower GI disorders and those with other common chronic illnesses. Data of adults aged 18 years or older from the 2002 National Health Interview Survey (n=29,828) were analyzed. Approximately 5.4% of survey participants reported they had been told by a physician that they had lower GI disorders. Those reporting lower GI disorders were 1.8 times more likely to meet the criteria for serious mental illness (SMI) and were significantly more likely to report impaired HRQOL than those without GI disorders. In addition, those with lower GI disorders were significantly more likely than those with heart disease and diabetes and equally as likely as those with arthritis and asthma to meet the criteria for SMI. Because psychological comorbidity is common among adults with lower GI disorders and may complicate their course and treatment, clinicians should consider screening patients presenting with lower GI disorders for these comorbid conditions.

Adolescent↗

PubMed2006

Association between the metabolic syndrome and its components and gait speed among U.S. adults aged 50 years and older: a cross-sectional analysis.

BACKGROUND: To examine the relationship between the metabolic syndrome and its components and gait speed among older U.S. men and women. Whether these associations are independent of physical activity was also explored. METHODS: Eight hundred and thirty-five men and 850 women aged > or =50 years from the continuous National Health and Nutrition Examination Survey 1999-2002 were examined. We used the definition of the metabolic syndrome developed by the U.S. National Cholesterol Education Program Adult Treatment Panel III. Gait speed was measured with a 6.10-meter timed walk examination. RESULTS: The prevalence of the metabolic syndrome was 40.2% in men and 45.6% in women (P = .127). The prevalence of gait speed impairment was 29.3% in men and 12.5% in women (P < .001). No association was found between the metabolic syndrome and gait speed impairment. After including the individual components of the metabolic syndrome in a logistic model adjusted for age and leisure-time physical activity, abdominal obesity, low HDL cholesterol, and high fasting glucose were significantly associated with gait speed impairment among women (adjusted odds ratio [AOR] = 0.48, 95% confidence interval [CI] = 0.26 to 0.89; AOR = 2.26, 95% CI = 1.08 to 4.75; and AOR = 2.05, 95% CI = 1.12 to 3.74, respectively). Further adjustment for race/ethnicity, education, smoking status, alcohol consumption, arthritis status, and use of an assistive device attenuated these associations; among women, abdominal obesity and low HDL cholesterol remained significantly associated with gait speed impairment (AOR = 0.37, 95% CI = 0.18 to 0.76 and AOR = 2.45, 95% CI = 1.07 to 5.63, respectively) while the association between hyperglycemia and impaired gait speed attenuated to nonsignificance. CONCLUSION: Among women, gait speed impairment is associated with low HDL cholesterol and inversely with abdominal obesity. These associations may be sex-dependent and warrant further research.

Abdominal Fat↗

PubMed2006

Serious psychological distress in U.S. adults with arthritis.

BACKGROUND: Arthritis and mental health disorders are leading causes of disability commonly seen by health care providers. Several studies demonstrate a higher prevalence of anxiety and depression in persons with arthritis versus those without arthritis. OBJECTIVES: Determine the national prevalence of serious psychological distress (SPD) and frequent anxiety or depression (FAD) in adults with arthritis, and in adults with arthritis, identify risk factors associated with SPD. METHODS: Cross-sectional data from the 2002 National Health Interview Survey, an in-person household interview survey, were used to estimate the prevalence of SPD and FAD in adults with (n=6,829) and without (n=20,676) arthritis. In adults with arthritis, the association between SPD and sociodemographic, clinical, and functional factors was evaluated using multivariable logistic regression. RESULTS: The prevalence of SPD and FAD in adults with arthritis is significantly higher than in adults without arthritis (5.6% vs 1.8% and 26.2% vs 10.7%, P<.001, respectively). In adults with arthritis, SPD was significantly associated with younger age, lower socioeconomic status, divorce/separation, recurrent pain, physical inactivity, having functional or social limitations, and having comorbid medical conditions. Adults aged 18 to 44 years were 6.5 times more likely to report SPD than those 65 years or older, and adults with recurrent pain were 3 times more likely to report SPD than those without recurrent pain. CONCLUSIONS: Serious psychological distress and FAD affect persons with arthritis and should be addressed in their treatment. Younger adults with arthritis, and those with recurrent pain or either functional or social limitations, may be at higher risk for SPD.

Adolescent↗

PubMed2006

Dementia and its implications for public health.

INTRODUCTION: With the aging of the U.S. population, a better understanding of the presentation and impact of dementia is essential to the future of public health. Dementia refers not to a single disorder but to a number of syndromes characterized by diverse behavioral, cognitive, and emotional impairments. Because dementia is costly in terms of both personal suffering and economic loss, an understanding of its prevalence, risk factors, and potential interventions is emerging as an increasingly important facet of public health and health care delivery. Recent advances in the understanding of its presentation, course, and relevant interventions have taken place. METHODS: We identified articles for review primarily by conducting a Medline search using the subject headings dementia, mild cognitive impairment, Alzheimer's disease, vascular dementia, frontotemporal dementia, and Lewy body dementia. Other relevant studies were elicited through a Medline search using the subject headings mental disorders and stigma. RESULTS: Dementia represents a diverse category of syndromes characterized by deficits in memory, cognitive function, and behavior. Symptoms associated with dementia appear to be distributed along a continuum, with even subsyndromal presentations affecting the health of older adults and meriting intervention. To promote cognitive functioning and independence among older adults, public health interventions need to facilitate both early detection and treatment of dementia. The availability of adult day care and respite services is important in maintaining the health and quality of life of individuals caring for older adults with dementia. Recent advances in the treatment of dementia may slow the course of cognitive decline, thereby enhancing the quality of life of older individuals as well as decreasing costs associated with institutional care. CONCLUSION: Despite the growing availability of pharmacologic and psychosocial interventions that are potentially helpful to people with dementia and their caregivers, the majority of older adults with dementia do not receive appropriate treatment. With the aging of the U.S. population, efforts to foster recognition of dementia and its treatments and to destigmatize them are emerging as an increasingly important facet of public health intervention.

Caregivers↗

PubMed2006

Emotional and behavioral difficulties and impairments in everyday functioning among children with a history of attention-deficit/hyperactivity disorder.

INTRODUCTION: Attention-deficit/hyperactivity disorder (ADHD) affects 3% to 7% of school-aged children and has been associated with a variety of comorbid mental illnesses and functional impairments, largely in clinical samples. However, little is known about the spectrum of emotional and behavioral problems and areas of impairment among children with a history of ADHD in nonclinical, nationally representative samples. METHODS: Data were analyzed from the 2003 National Health Interview Survey, an ongoing, computer-assisted, random-sample, personal-interview survey of the noninstitutionalized U.S. population. We examined the associations between history of parent-reported ADHD diagnosis and levels of parent-reported emotional and behavioral difficulties and related impairments among a nationally representative sample of U.S. children aged 4 to 17 years (n = 8681). The extended version of the Strengths and Difficulties Questionnaire was used to measure and score levels of difficulty and impairment. RESULTS: Approximately 5.9% of children had a history of ADHD diagnosis. Children with a history of ADHD were 6 times as likely as those without ADHD to have a high level of overall difficulties including emotional, conduct, and peer problems and were 9 times as likely to manifest a high level of impairment including interference with home life, friendships, classroom learning, and leisure activities. CONCLUSION: This study documents the significant level of current emotional and behavioral difficulties and impairments in everyday functioning experienced by children with a history of ADHD diagnosis, suggesting that people involved with the care of children--parents, health care providers, and teachers--need to be informed about the signs, symptoms, and appropriate treatment of ADHD and other comorbid disorders.

Adolescent↗

PubMed2006

Population-based U.S. study of severe headaches in adults: psychological distress and comorbidities.

OBJECTIVE: To examine the associations between severe headaches (SH), psychological distress, and comorbid conditions among U.S. adults. BACKGROUND: The lifetime prevalence of headaches is over 90% and headaches, particularly migraines, have been associated with disability, increased healthcare costs, and mood disorders. METHODS: We analyzed data obtained from adults aged 18 years or older (n = 29,828) who participated in the 2002 National Health Interview Survey, an ongoing, computer-assisted personal interview of a representative sample of the U.S. population. RESULTS: Approximately 15.1% of adults aged 18 years or older reported SH in the previous 3 months. Those reporting such headaches were significantly more likely, than those who did not, to report insomnia, excessive sleepiness, recurrent pain, and depressive or anxiety symptoms during the preceding 12 months. Approximately 88% of those who reported having had SH within the previous 3 months also indicated that they had at least one comorbid medical condition, relative to 67% of those without SH. CONCLUSION: Despite their episodic nature, our results suggest that SH are associated with impairments in both physical and mental health. As the presence of SH may serve as an indicator of significant psychological distress and medical comorbidities, eliciting information about their occurrence during a standard medical examination appears to be warranted.

Adolescent↗

PubMed2006

The associations among childhood headaches, emotional and behavioral difficulties, and health care use.

BACKGROUND: Headaches are common among children and adolescents, particularly migraine and tension-type headaches. They contribute to missed school days, affect children's peer and family relationships, and significantly impact children's quality of life, often times into adulthood. OBJECTIVES: This study, based on responses to the Strengths and Difficulties Questionnaire, was designed to examine difficulties and impairments related to emotions, concentration, behavior, and social functioning among children with frequent or severe headaches (FSH). METHODS: We used a cross-sectional study of 9264 children aged 4-17 years from the 2003 National Health Interview Survey, an ongoing, computer-assisted personal interview survey of the noninstitutionalized US population. RESULTS: Approximately 6.7% of children experienced FSH during the previous 12 months. Overall, children with FSH were 3.2 times more likely than children without FSH to have a high level of difficulties and 2.7 times more likely to have a high level of impairment, suggesting potential mental health issues. More specifically, analyses revealed that children with FSH were significantly more likely than those without FSH to exhibit high levels of emotional, conduct, inattention-hyperactivity, and peer problems and were significantly more likely than children without FSH to be upset or distressed by their difficulties and to have their difficulties interfere with home life, friendships, classroom learning, and leisure activities. CONCLUSION: Because children with FSH experience notable pain, mental health issues, and functional limitations, integrated care using a biopsychosocial approach is warranted.

Adolescent↗

PubMed2005

Health-related quality of life, health risk behaviors, and disability among adults with pain-related activity difficulty.

OBJECTIVES: We examined the association between pain-related activity difficulty (PRAD) in the past 30 days and health-related quality of life, health behaviors, disability indices, and major health impairments in the general US population. METHODS: We obtained data from 18 states in the 2002 Behavioral Risk Factor Surveillance System, an ongoing, cross-sectional, state-based, random-digit-dialed telephone survey of noninstitutionalized adults aged 18 years or older. RESULTS: Nearly one quarter of people in the 18 states and the District of Columbia reported at least 1 day of PRAD in the past 30 days. PRAD was associated with obesity, smoking, physical inactivity, impaired general health, infrequent vitality, and frequent occurrences of physical distress, mental distress, depressive symptoms, sleep insufficiency, and anxiety symptoms. Moreover, a general dose-response relationship was noted between increased days of PRAD and increased prevalence of impaired health-related quality of life, disability indices, and health risk behaviors. CONCLUSION: Pain negatively influences various domains of health, not only among clinical populations, but also in the general community, suggesting a critical need for the dissemination of targeted interventions to enhance recognition and treatment of pain among adult community-dwellers.

Adolescent↗

PubMed2005

Ranking states' immunization coverage: an example from the National Immunization Survey.

The National Immunization Survey (NIS) provides state-level estimates of preschool immunization coverage. These coverages are frequently presented in ranked lists, and ranks are frequently over-interpreted. In this paper, we highlight the difficulty in interpreting ranked point estimates. To demonstrate the uncertainty of ranks, parametric bootstrap methods were used to derive 90 per cent confidence intervals for ranks of state vaccination coverage levels among preschool children. We graphically compared states to a reference state. If NIS data are used to rank states, one should consider presenting confidence intervals for rank and the results of comparisons of one state with another graphically.

Child, Preschool↗

PubMed2005

Associations of self-reported anxiety symptoms with health-related quality of life and health behaviors.

BACKGROUND: Anxiety disorders affect approximately 19 million American adults annually and have been associated with impaired health-related quality of life (HRQOL), an increased rate of adverse health behaviors, and poor outcomes related to chronic illness in studies conducted in clinical populations. Our study was designed to examine the association of self-reported anxiety symptoms with HRQOL and health behaviors among a representative sample of US community-dwellers. METHODS: Data were obtained from the Behavioral Risk Factor Surveillance System,an ongoing, state-based, random-digit telephone survey of the noninstitutionalized US population aged > or = 18 years. In 2002, HRQOL measures were administered in 18 states and the District of Columbia. RESULTS: An estimated 15% of persons reported frequent (> or = 14 days in the past 30 days) anxiety symptoms. After adjusting for frequent depressive symptoms and sociodemographic characteristics, those with frequent anxiety symptoms were significantly more likely than those without to report fair or poor general health (vs. excellent, very good, or good general health), frequent physical distress, frequent activity limitations, frequent sleep insufficiency, infrequent vitality, frequent mental distress, and frequent pain. In addition, they were more likely to smoke, to be obese, to be physically inactive, and to drink heavily. CONCLUSION: Given their association with impaired HRQOL and adverse health behaviors, our results suggest that assessment of anxiety symptoms should be a facet of routine standard medical examinations.

Adolescent↗

PubMed2005

Health-related quality of life and health risk behaviors among smokers.

BACKGROUND: It is well established that smoking has detrimental effects on physical health, but its associations with health-related quality of life (HRQOL) and a variety of health behaviors have not been widely investigated in the U.S. population. METHODS: Data obtained from the Behavioral Risk Factor Surveillance System (BRFSS), an ongoing, state-based, random-digit-dialed telephone survey of non-institutionalized persons aged > or =18 years in the United States, Guam, Puerto Rico, and the Virgin Islands, were used in this investigation. The BRFSS monitors the prevalence of key health- and safety-related behaviors and characteristics. In 2001 and 2002 combined, trained interviewers administered HRQOL questions in 23 states and the District of Columbia (n=82,918). This analysis was conducted in 2004. RESULTS: Overall, an estimated 22.4% of adults were current smokers, 24.1% were former smokers, and 53.6% never smoked. Current smokers had significantly poorer HRQOL than those who had never smoked, and were more likely to drink heavily, to binge drink, and to report depressive and anxiety symptoms. Additionally, current smokers were significantly more likely than those who never smoked to be physically inactive, to report frequent sleep impairment, to report frequent pain, and to eat less than five servings of fruits and vegetables per day. CONCLUSIONS: While there are strong positive relationships between smoking and both alcohol consumption and mood disturbance, smoking is also associated with an array of other modifiable risk factors meriting assessment and intervention. In addition to smoking cessation, the increased morbidity and mortality characterizing smokers may potentially be further reduced by improvements in diet, physical activity, and sleep.

Adolescent↗

PubMed2005

Tooth loss and heart disease: findings from the Behavioral Risk Factor Surveillance System.

BACKGROUND: The purpose of this study was to examine the association between tooth loss and heart disease. METHODS: Data were analyzed from the 1999 to 2002 Behavioral Risk Factor Surveillance System, an ongoing telephone survey operated by state health agencies with assistance from the Centers for Disease Control and Prevention. The study was conducted based on 41,891 adults aged 40 to 79 years old in 22 states and the District of Columbia. RESULTS: A significant association was observed between the extent of tooth loss and heart disease prevalence. After adjustment for age, gender, race/ethnicity, education, and marital status, respondents who had 1 to 5 missing teeth, 6 to 31 missing teeth, or were edentulous were significantly more likely than those without tooth loss to have heart disease (adjusted prevalence: 6.8%, 10.2%, and 11.5%, respectively, vs. 5.3%; p<0.001). These associations persisted after further adjustment for smoking status, diabetes, alcohol consumption, hypertension, hypercholesterolemia, and body mass index (5.7%, 7.5%, and 8.5%, respectively, vs. 4.7%; p<0.05); and after stratification by age group (40 to 59 years and 60 to 79 years) and smoking status (ever smoked and never smoked). CONCLUSIONS: Tooth loss is associated in a consistent and graded fashion with the self-reported prevalence of heart disease. Health promotion counseling should include the prevention and control of cardiovascular disease risk factors and the maintenance of good oral health.

Adult↗

PubMed2005

Low prevalence of influenza vaccination among people with cardiovascular disease--BRFSS.

BACKGROUND: People with cardiovascular disease are at high risk of complication from influenza. However, little is known about influenza vaccine coverage among this population. METHODS: Using 2002 Behavioral Risk Factor Surveillance System data, the authors studied the prevalence of influenza vaccination in the previous 12 months among participants aged > or = 18 years with cardiovascular disease or hypertension. RESULTS: After adjustment for age, gender, race/ethnicity, and education, the prevalence of influenza vaccination ranged from 35.9% to 42.6%. The prevalence was particularly low among participants with cardiovascular disease aged 18-49 years (range, 23.9% to 42.2%). The prevalence of influenza vaccination varied considerably between states among people with hypertension (range, from 30.2% to 45.9%) and those with other cardiovascular diseases (range, from 37.0% to 51.5%). CONCLUSIONS: Influenza vaccination levels are low among people with cardiovascular disease, especially those less than 50 years old. They should be encouraged to receive an annual influenza vaccination to avoid cardiovascular complications from influenza.

Adolescent↗

PubMed2005

Associations of frequent sleep insufficiency with health-related quality of life and health behaviors.

BACKGROUND AND PURPOSE: Sleep-related problems, which affect 50-70 million Americans, involve all areas of life, including cognitive performance, emotional well-being, work and leisure-time activities, and general physical and mental well-being. We examined the association of insufficient sleep with health-related quality of life (HRQOL) and health behaviors. PATIENTS AND METHODS: Data were obtained from the Behavioral Risk Factor Surveillance System, an ongoing, state-based, random-digit telephone survey of the non-institutionalized US population aged >or =18 years. In 2002, HRQOL measures were administered in 18 states and the District of Columbia, yielding complete responses to questions regarding sleep and demographic characteristics from 98% of study participants (n=79,625). RESULTS: An estimated 26% of adults reported frequent (> or =14 days in the past 30 days) sleep insufficiency. They were significantly more likely than those without frequent sleep insufficiency to report fair/poor general health, frequent physical distress, frequent mental distress, activity limitations, depressive symptoms, anxiety, and pain. In addition, they were significantly more likely to smoke, to be physically inactive, to be obese, and, among men, to drink heavily. CONCLUSION: Insufficient sleep is associated with a variety of adverse health behaviors and impairment in all HRQOL domains investigated. Accordingly, assessment of sleep appears to be an important component of general medical care. Moreover, expanded assessment of sleep in the general population may provide a better understanding of prevalence of impaired sleep and its many implications.

Adult↗

PubMed2005

Access to health care among older adults and receipt of preventive services. Results from the Behavioral Risk Factor Surveillance System, 2002.

BACKGROUND: Although most of the 34 million U.S. adults aged 65 years and older have health care coverage, many do not receive preventive care. To investigate why, we examined various barriers to access of health care and their effect on obtaining preventive care. METHODS: A cross-sectional study was conducted of noninstitutionalized adults, aged 65 years or older, in states that participated in the Behavioral Risk Factor Surveillance System in 2002. RESULTS: Of the 46,659 respondents aged 65 years and older, 93% had a regular care provider, 98% had a regular place of care, and 98% were able to obtain needed medical care. Those with a regular care provider or a regular place of care were more likely to receive clinical preventive services than those without either of these. Reasons for not obtaining needed medical care were cost (27%), too long a wait for an appointment (20%), no transportation or distance (9%), office not open when the individual could get there (8%), and other reasons (32%). CONCLUSIONS: Having a regular care provider or a regular place of care is associated with a significant likelihood of receipt of clinical preventive services among older adults. Efforts to eliminate barriers to health care access may increase older adults' receipt of such services.

Aged↗

PubMed2005

Menstrual-related problems and psychological distress among women in the United States.

OBJECTIVE: To examine the associations of menstrual-related problems with mental health and health behaviors in a U.S. population-based study. METHODS: We analyzed data obtained from women aged 18-55 years (n = 11,648) who participated in the 2002 National Health Interview Survey, an ongoing, computer-assisted personal interview of the noninstitutionalized U.S. population. RESULTS: Approximately 19% of women aged 18-55 years reported experiencing menstrual-related problems (e.g., heavy bleeding, bothersome cramping, or premenstrual syndrome [PMS]). These women were significantly more likely than those without menstrual-related problems to report frequent anxiety and depression, insomnia, excessive sleepiness, and pain over the past 12 months. Women with menstrual-related problems were also significantly more likely to report feeling sad, nervous, restless, hopeless, or worthless and that everything was an effort all or most of the time during the past 30 days. Cigarette smoking, drinking heavily, and being overweight or obese were also more frequently reported among women with menstrual-related problems than those without. CONCLUSIONS: Menstrual-related problems pose substantial implications for public health. Healthcare providers should examine mental health concerns in women reporting menstrual-related problems.

Adult↗

PubMed2005

Psychological distress, comorbidities, and health behaviors among U.S. adults with seizures: results from the 2002 National Health Interview Survey.

PURPOSE: To examine the association of seizures with health-related quality of life (HRQOL), physical and psychiatric comorbidities, and health behaviors. METHODS: We analyzed data obtained from adults aged 18 years or older (n = 30,445) who participated in the 2002 National Health Interview Survey, an ongoing, computer-assisted personal interview of the noninstitutionalized U.S. population. RESULTS: An estimated 1.4% of adults 18 years or older reported being told by a health care professional that they had seizures. Persons with seizures were significantly more likely than those without seizures to report lower levels of education, higher levels of unemployment, pain, hypersomnia and insomnia, and psychological distress (e.g., feelings of sadness, nervousness, hopelessness, and worthlessness). In addition, they were significantly more likely to report insufficient leisure-time physical activity as well as physical comorbidities such as cancer, arthritis, heart disease, stroke, asthma, severe headaches, lower back pain, and neck pain. CONCLUSIONS: Our findings suggest that it is advisable for health care professionals to assess psychiatric and physical comorbidities among patients with a history of seizures potentially to improve patient health outcomes. Furthermore, public health surveillance systems should include questions on seizures, epilepsy, and mental health to better examine associations among these disorders and to better identify populations meriting further assessment and intervention.

Adolescent↗