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PubMedDate not supplied

Age, lifestyle, health risk indicators, and prostate-specific antigen scores in men participating in the world senior games.

BACKGROUND: A number of risk factors have been implicated for prostate cancer, with dietary fat intake the most commonly accepted modifiable risk. OBJECTIVE: To assess the relationship between health risk indicators (e.g., cholesterol, blood pressure, blood sugar, and percent body fat), which are related to dietary fat intake, and prostate-specific antigen (PSA) scores. Relationships between demographics and select behaviors (e.g., cigarette smoking and physical activity) with PSA scores are also considered. The setting was the 1999 Huntsman World Senior Games in St. George, Utah. Subjects' analysis is based on 536 men aged 50 years and older completing a questionnaire and receiving free screening, including a PSA. METHODS: Frequency distributions, multiple regression techniques, and the Spearman correlation coefficients. RESULTS: A positive relationship was observed between increasing age groups and mean PSA scores (Cochran-Mantel-Haenszel Chi-Square: 53.8, p < 0.0001). After adjusting for age, none of the personal risk factor indicators (i.e., cholesterol, blood pressure, blood sugar, and percent body fat) were related to PSA scores. Other factors not related to PSA scores after adjusting for age were race, marital status, education, history of chronic disease, cigarette smoking, alcohol use, and physical activity. CONCLUSION: Because risk indicators such as cholesterol, blood pressure, blood sugar, and percent body fat are associated with dietary fat intake, their failure to be related with PSA scores makes it further unclear how this commonly accepted modifiable risk factor for prostate cancer may influence the disease.

Age Factors↗

PubMed2004

Determinants of breast-feeding and weaning in Alberta, Canada.

OBJECTIVE: To assess the determinants of breast-feeding initiation and duration at the population level in Alberta, Canada. METHODS: Determinants of breast-feeding were assessed based on data from a sample of 1113 women, who represented 150,898 fertile women in Alberta, in the second cycle of the National Population Health Survey conducted 1996-97. Logistic regression analysis was used to estimate the independent effects of various determinants of breast-feeding initiation and duration dichotomized at 4 weeks, 8 weeks, 12 weeks, and 6 months postpartum. All analyses used analytic weights to take both the average design effect and population weights for the complex survey design into account. RESULTS: The proportion of breast-feeding initiation was 85.6%. It was observed that 71.3% of mothers continued breast-feeding for at least 3 months, and 37.2% of mothers breast-fed their infants for more than 6 months. Determinants of breast-feeding initiation were marital status, education, maternal smoking behaviour, and annual family income. White women and women who were older than 35 years of age were more likely to continue breast-feeding for longer periods, whereas those who smoked during pregnancy were less likely to breast-feed their infants for extended periods. The primary reasons for weaning were breast problems at less than 1 week, insufficient milk production during weeks 1 to 12, and infants who weaned themselves after 3 months. CONCLUSIONS: Smoking cessation during pregnancy, adequate treatment of early breast problems, and breast-feeding promotion campaigns targeting socioeconomically disadvantaged populations could serve to increase breast-feeding in Canada.

Adolescent↗

PubMed2003

Perception of risk of HIV/AIDS and sexual behaviour in Kenya.

The association between perception of risk of HIV infection and sexual behaviour remains poorly understood, although perception of risk is considered to be the first stage towards behavioural change from risk-taking to safer behaviour. Using data from the 1998 Kenya Demographic and Health Survey, logistic regression models were fitted to examine the direction and the strength of the association between perceived risk of HIV/AIDS and risky sexual behaviour in the last 12 months before the survey. The findings indicate a strong positive association between perceived risk of HIV/AIDS and risky sexual behaviour for both women and men. Controlling for sociodemographic, sexual exposure and knowledge factors such as age, marital status, education, work status, residence, ethnicity, source of AIDS information, specific knowledge of AIDS, and condom use to avoid AIDS did not change the direction of the association, but altered its strength slightly. Young and unmarried women and men were more likely than older and married ones to report risky sexual behaviour. Ethnicity was significantly associated with risky sexual behaviour, suggesting a need to identify the contextual and social factors that influence behaviour among Kenyan people.

Acquired Immunodeficiency Syndrome↗

PubMed2002

DSM-IV generalized anxiety disorder in the Australian National Survey of Mental Health and Well-Being.

BACKGROUND: This paper reports population data on DSM-IV generalized anxiety disorder from the Australian National Survey of Mental Health and Well-Being. METHODS: The data were obtained from a nationwide household survey of adults using a stratified multi-stage sampling process. A response rate of 78.1% resulted in 10,641 persons being interviewed. Diagnoses were made using the Composite International Diagnostic Interview. The interview was computerized and conducted by trained lay interviewers. RESULTS: Prevalence in the total sample was 2.8% for 1-month GAD and 36% for 12-month GAD. Persons over 55 years of age were less likely to have GAD than those in the younger age groups. Logistic regression analysis also showed that a diagnosis of GAD was significantly associated with being of younger to middle age, being separated divorced or widowed, not having tertiary qualifications or being unemployed. Co-morbidity with another affective, anxiety, substance use or personality disorders was common, affecting 68% of the sample with 1-month DSM-IV GAD. GAD was associated with significant disablement, and 57% of the sample with DSM-IV GAD had consulted a health professional for a mental health problem in the prior 12 months. CONCLUSIONS: The survey provides population data on DSM-IV GAD and its correlates. GAD is a common disorder that is accompanied by significant morbidity and high rates of co-morbidity with affective and anxiety disorders, and is associated with marital status, education, employment status, but not sex. Changes to DSM-IV diagnostic criteria did not appear to affect the prevalence rate compared to previous population surveys.

Adolescent↗

PubMed2001

Maternal smoking and gestational age in twin pregnancies.

BACKGROUND: A twin pregnancy imposes greater demands on maternal physiology and smoking may thus be associated theoretically with a greater risk of preterm delivery than in singleton pregnancies. POPULATION AND METHODS: From 1989 to 1996 all women who booked for antenatal care at the Department of Gynecology and Obstetrics, Aarhus University Hospital, Denmark were asked to fill in two questionnaires. Apart from smoking habits, these questionnaires provided information on medical and obstetric history together with information on sociodemographic and other lifestyle variables. Gestational age at delivery was calculated from ultrasonographically determined fetal biparietal diameter and information about the last menstrual period. Only women carrying twins were included in the present study (n=401). RESULTS: Mean gestational age was 5 days (95% CI 1-9 days) shorter among smokers compared with non-smokers. Among non-smokers mean gestational age was 261 days (+/-18), among women who smoked 1-9 and 10+ cigarettes per day 257 days (+/-23) and 255 days (+/-20), respectively. The overall risk of preterm delivery (< 37 weeks) and delivery before 34 completed weeks was 1.3 (95% CI 0.9-2.2) and 1.4 (95% CI 0.8-2.4), respectively. Primiparous women had shorter gestational age than did multiparous women. Still, among primiparous as well as among multiparous women gestational age decreased with smoking. Adjustment for maternal age, height and prepregnancy weight, alcohol and caffeine intake, marital status, education, occupational status, preterm birth in previous pregnancies, and in vitro fertilization in the present pregnancy did not change the results. CONCLUSIONS: Smoking has a substantial effect on mean gestational age in twin pregnancies, and a dose response like relationship is present.

Adolescent↗

PubMed2003

Exposure to fluoridated drinking water and dental caries experience in Australian army recruits, 1996.

OBJECTIVES: The purpose of this study was to investigate a group of young Australian adults to determine their caries experience and measure associations between caries experience and age, gender, socioeconomic status, education level and lifetime exposure to fluoridated water. METHODS: This was achieved through a cross-sectional study involving Australian Army recruits seen for their initial dental examination on enlistment into the Australian Army. A total of 499 recruits had a clinical examination with the aid of bitewing radiographs and an orthopantomograph (OPG). Sociodemographic and fluoride exposure data were obtained via a questionnaire. RESULTS: This study showed that subjects with a lifetime exposure to fluoridated water reported a 23% lower level of caries experience than subjects with no exposure to fluoridated water, with a greater effect on proximal surfaces compared to smooth and occlusal surfaces. Female subjects had a level of caries experience 25% higher than male subjects, while subjects from the lowest socioeconomic background had a level of caries experience 89% times greater than subjects from the highest socioeconomic group. CONCLUSIONS: Although it is not possible to directly establish a causal relationship from a cross-sectional study such as this, the results from this study show a dose-response relationship which suggests that there are benefits of lifetime exposure to fluoridated drinking water through young adulthood.

Adolescent↗

PubMed1995

Neuropsychological functioning among the nonpsychotic relatives of schizophrenic patients: a diagnostic efficiency analysis.

Numerous studies suggest that the relatives of schizophrenic patients exhibit neuropsychological impairments that are milder yet similar to those seen among schizophrenic patients. The authors assessed 35 nonpsychotic relatives of schizophrenic patients and 72 normal controls using a clinical and experimental neuropsychological test battery. Three neuropsychological functions met criteria for risk indicators of the schizophrenia genotype: abstraction, verbal memory, and auditory attention. These findings could not be attributed to parental socioeconomic status, education, general visual-spatial ability, or psychopathology. Furthermore, exploratory analyses were performed to determine whether the diagnostic efficiency of the indicators could be adjusted to meet the needs of genetic linkage analyses. These analyses suggest that psychometric considerations may help to create measures for genetic linkage studies.

Adolescent↗

PubMed2007

Lifecourse socioeconomic position and weight change among blacks: The Pitt County study.

OBJECTIVE: The elevated prevalence of obesity among U.S. blacks has been attributed to low socioeconomic position (SEP), despite inconsistent empirical findings. It is unclear whether low SEP at various lifecourse stages differentially influences adulthood BMI and BMI change. RESEARCH METHODS AND PROCEDURES: Among 1167 black adults in the Pitt County Study, we examined independent cross-sectional and longitudinal associations between SEP, measured in childhood and adulthood, and BMI and 13-year BMI change. Low vs. high childhood SEP was measured by parental occupation and childhood household deprivation; low vs. high adulthood SEP was assessed by employment status, education, and occupation. Using childhood and adulthood SEP, four lifecourse SEP categories were created: low-low, low-high, high-low, high-high. RESULTS: We found no consistent associations between SEP and BMI or BMI change among men. Among women, we observed the expected inverse association between SEP and BMI at baseline. In multivariable-adjusted analyses, socioeconomically advantaged women demonstrated larger 13-year increases in BMI: skilled vs. unskilled parental occupation (6.1 vs. 4.8 kg/m2, p = 0.04); college-educated vs. < high school (6.2 vs. 4.5 kg/m2, p = 0.04); white-collar vs. blue-collar job (5.8 vs. 4.8 kg/m2, p = 0.05); and high-high vs. low-low lifecourse SEP (6.5 vs. 4.6 kg/m2, p = 0.02). DISCUSSION: For women in this black cohort, lower SEP predicted earlier onset of obesity; however, low SEP was less predictive of BMI increases over time. Our findings demonstrate complex patterns of association between SEP and BMI change among black women.

Adult↗

PubMed2003

Dietary and nutritional patterns in an elderly rural population in Northern and Southern Italy: (I). A cluster analysis of food consumption.

OBJECTIVE: To describe the food consumption patterns of Italian elderly subjects and the factors associated with different dietary habits. DESIGN: Cross-sectional study. SETTING: Population-based study. SUBJECTS: A total of 847 men and 1465 women aged 65 y or older, living in rural areas in the province of Pavia (Northern Italy) and near Cosenza (Southern Italy) in 1992-1993. INTERVENTIONS: The dietary information was collected by means of a quantitative food-frequency questionnaire, with cluster analysis being used to segregate the subjects on the basis of similarities in their food consumption. A generalised logistic regression model including residence, age, living status, education, physical activity and degree of disability was fitted to assess the factors associated with different food consumption habits. RESULTS: Six dietary clusters were selected for men and seven for women. The largest cluster for both genders was "small eaters" (46% of men and 51% of women); "big eaters", "light diet" and "alcohol" clusters were also identified for both genders. The men were also grouped into "balanced diet" and "cheese" clusters, and the women into "sweet", "greens" and "butter" clusters. CONCLUSIONS: In addition to the influence of the area of residence--residents in Northern Italy consume greater amounts of animal fats, sugar and alcoholic beverages, and those living in Southern Italy have a greater intake of fruit, vegetables, fish and olive oil--all of the other studied variables predicted the probabilities of falling into a specific dietary cluster. SPONSORSHIP: National Research Council (Italy)--Invecchiamento Project No. 95.01048. PF40.

Aged↗

PubMed1997

Energy intake and net weight gain in pregnant women according to body mass index (BMI) status.

OBJECTIVE: To investigate whether body mass index (BMI) is related to energy intake during pregnancy, and whether BMI, energy intake and other factors are related to net weight gain. DESIGN: Longitudinal, duration of pregnancy. SUBJECTS: 156 healthy pregnant women residing in Quedlinburg county, Germany. METHODS: Weighed 7 d food records and standardized anthropometric measures in the first, second and third trimester. The analysis of variance (ANOVA) statistical technique was used to analyze differences in energy intake, net weight gain and birthweight across BMI groups, and the Cochran-Mantel Haenszel test was used to analyze food group intake by BMI group. RESULTS: Women at the highest level of BMI were significantly less often in the high energy intake category than women at the medium or low level of BMI (15% vs 36% and 48%). Net weight gain during pregnancy was independently influenced by BMI status and energy intake. Women at the highest level of BMI gained significantly less weight (4.2 kg) from first to third trimester than women at the medium or low levels of BMI (weight gains of 6.2 kg and 5.9 kg, respectively). Women with a low daily energy intake gained 4.6 kg during pregnancy, while women with medium and high energy intakes gained 6.0 kg and 6.1 kg, respectively. Examination of net weight gain simultaneously across BMI and parity groups revealed a much lower net weight gain among multigravid women at the highest BMI level (3.3 kg). Primigravid high BMI women, in contrast, gained 6.9 kg, whereas multigravid and primigravid women at medium and low BMI levels gained average of 4.8 kg and 6.5 kg, respectively. The mean birth weight in the three BMI groups did not differ and was not influenced by age, marital status, education, parity or smoking. CONCLUSION: Because other studies have shown that weight gain during pregnancy increases the risk of subsequent overweight, multigravid high BMI women may prevent an increased weight retention after pregnancy due to lower weight gain in the current gestation. A lower caloric diet may help to accomplish a lower weight gain during pregnancy in overweight women without increased risk of low birth weight infants. These findings indicate further investigation of the associations between BMI, parity and caloric intake during pregnancy are needed to increase understanding of factors affecting subsequent weight gain.

Adult↗

PubMed2002

Smoking cessation among daily smokers, aged 45-69 years: a longitudinal study in Malmö, Sweden.

OBJECTIVE: To investigate differences in snuff consumption, socio-demographic and psychosocial characteristics between baseline daily smokers who had remained daily smokers, become intermittent smokers or stopped smoking at the 1-year follow-up. DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS: A population of 12 507 individuals aged 45-69 years, interviewed at baseline in 1992-94 and at a 1-year follow-up, was investigated in this longitudinal study. The three groups of baseline daily smokers were compared to the total population according to socio-demographic, psychosocial and snuff consumption characteristics. A multivariate logistic regression model was used to assess differences in psychosocial conditions, adjusting for age, sex, country of origin, marital status, education and snuff consumption. FINDINGS: Eighty-six per cent of all baseline daily smokers remained daily smokers, 6.5% had become intermittent smokers and 7.3% had stopped smoking at the 1-year follow-up. The daily smokers who remained daily smokers were more likely to be born in other countries than Sweden, not married, have a lower educational level and poorer psychosocial conditions than the total population, while the socio-demographic characteristics and psychosocial resources of those daily smokers who had become intermittent smokers or had stopped smoking were much more similar to the general population, with the exception of a higher snuff consumption, especially for intermittent smokers. CONCLUSIONS: Daily smokers who remained daily smokers at the 1-year follow-up had poorer psychosocial assets, especially social participation, than baseline daily smokers who had become intermittent smokers or had stopped smoking, and the general population. The results suggest that low levels of social participation are a potent barrier against smoking cessation. Snuff consumption may explain a part of the increase in smoking cessation among men as opposed to women in Sweden.

Aged↗

PubMed1980

[The social destiny of operated patients with femoral and trochanteric fractures (author's transl)].

The social destiny of 54 patients with femoral neck and trochanteric fractures was analysed by interview three to five years after the operation and the results were compared with those of 48 control subjects of the same age. In addition to this 50 patients with a similar fracture not yet operated were asked the same questions and the results were compared with those of control subjects of the same age . The groups did not differ in terms of marital status, education and in state of health. The operated patients walked daily less than the control subjects. The capacity for self care of the not yet operated patients before the injury was more often reduced and they had to be helped in all daily activities more often than the control subjects. At follow up the ability to move of operated patients had deteriorated and every second patient had died. Of the operated patients, which were prior to the injury able to work, 40 per cent returned to work after the convalescent.

Activities of Daily Living↗

PubMed2006

Serum selenium determinants in French adults: the SU.VI.M.AX study.

The objective of the present work was to assess the relationship between serum Se concentrations and environmental determinants (i.e. lifestyle, social activity, geographic region, urban status, education, familial status, physical activity, BMI, tobacco, and food and alcohol consumption). Baseline results from 13 017 subjects (7876 women aged 35-60 and 5141 men aged 45-60) who participated in the SU.VI.M.AX (Supplémentation en Vitamines et Minéraux Antioxydants) study were analysed. Fewer than 2 % of the volunteers had a serum Se status under 0.75 micromol/l, which has been quoted as the cut-off of biological Se sub-deficiency. Women had significantly lower serum Se concentrations than men (1.09 (sd 0.19) micromol/l (n 7423) and 1.14 (sd 0.20) micromol/l (n 4915), P<0.0001, respectively). Significant differences in serum Se concentrations were observed between geographic areas. In both sexes, the serum Se concentration increased with alcohol, meat and fish consumption, and decreased with smoking. In premenopausal women, the serum Se concentration was higher in contraceptive-pill users than in non-users. In women only, age was associated with increased serum Se concentrations, and obesity (BMI> or =30 kg/m2) was associated with decreased serum Se levels. In men, we observed a decrease in serum Se concentrations with increased consumption of vegetables and fruits. In conclusion, though few of the volunteers participating in the SU.VI.M.AX study had Se status in the sub-deficiency range, 83 % of women and 75 % of men had serum concentrations below the value considered optimal for glutathione peroxidase activity. The largest Se associations in both sexes were found with regions, smoking, alcohol, meat and fish consumption. Further studies are needed to understand the difference in Se status between genders.

Adult↗

PubMedDate not supplied

Risk factors in male infertility: a case-control study.

A case-control study was undertaken to evaluate environmental risk factors potentially involved in male infertility. One hundred twelve azoospermic or oligospermic subjects and 127 controls were interviewed, before sperm count results were available, about coffee and alcohol consumption, smoking habits, x-ray exposure, usual sitting posture, drug consumption, other nonoccupational risk factors, socioeconomic status, education level, and occupational history. An unmatched analysis was then conducted. None of the occupational risk factors appeared to be related to azoospermia or oligospermia. A high relative risk was associated with (1) occupation in the radioelectric industry, (2) nonsedentary clerical workers, (3) clerical work in the typographic industry, and (4) occupation in the textile industry, but none of these figures were statistically significant. Because of the population from which cases and controls were drawn, certain occupational risks could not be investigated in this study, e.g., exposure of agricultural workers to chemicals.

Adult↗

PubMed2003

Physician-assisted suicide in Oregon: what are the key factors?

Oregon's Death with Dignity Act has been operative since late 1997. The substantial national and international interest in Oregon's law makes it important to document any possible trends in the characteristics of persons who use the law. To do this, the present article examines previously reported data from various sources and places them within the context of the end-of-life decisions more generally. The Oregon data demonstrate that, regardless of the care received, a very small percentage of terminally ill Oregonians seem determined to request a lethal medication so that they may control the manner and timing of their death. College graduates and divorced persons are substantially more likely to use physician-assisted suicide to end their lives than are other persons. Control and autonomy appear to be the primary issues associated with taking legally prescribed medication to hasten one's death. A better understanding of the influence that a patient's marital status, education level, and desire for control may have on her or his ability to cope with, and make decisions related to, a terminal illness may allow health care professionals to better care for dying patients.

Age Factors↗

PubMedDate not supplied

Clinical and demographic factors associated with DSM-IV melancholic depression.

BACKGROUND: The purpose of this paper is to use demographic and clinical data from a large diverse group of outpatients diagnosed with non-psychotic major depression to investigate the validity of the DSM-IV concept of melancholic depression. METHODS: Baseline clinical and demographic data were collected on 1500 outpatients (1456 of whom melancholia could be determined) with non-psychotic major depressive disorder (MDD) participating in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. Depressive symptom severity was assessed by clinical telephone interview using the 17-item Hamilton Rating Scale for Depression (HRS-D17) and the 30-item Inventory of Depressive Symptomatology (IDS-C30). The types and degrees of concurrent psychiatric symptoms were measured using a self report, the Psychiatric Diagnostic Screening Questionnaire (PDSQ), by recording the number of items relevant to each diagnostic category endorsed by study participants. RESULTS: Adjusting for severity of depression (as measured by the total HRS-D17 scores), no differences were found in the rate of melancholic depression by race, marital status, education, employment status, family history of depression, primary care versus specialty care, monthly income, and degree of psychiatric and medical co-morbidity. Melancholic depression was significantly more likely in men than women. Melancholic depression after adjustment for severity was associated with a slightly younger age at study entry, as well as with greater illness severity, and slightly shorter duration of current episode. Hispanic ethnicity was associated with lower melancholic depression rates at the .06 level of significance. CONCLUSIONS: Among outpatients with MDD, melancholic features were less likely in Hispanic patients, but more likely in slightly younger patients and in men. Melancholic features were also related to a slightly shorter current episode. These findings are consistent with the notion that external socio-demographic factors do not play an important role in the pathophysiology of melancholic depression.

Adult↗

PubMedDate not supplied

Preventive healthcare use, smoking, and alcohol use among Rhode Island women experiencing intimate partner violence.

OBJECTIVE: Intimate partner violence (IPV) poses major health threats to women, including increased risk for several chronic health conditions. The impact of IPV on use of preventive health services is not well understood. Although several studies indicate that female victims of IPV have higher rates of alcohol abuse, this has not been replicated in population-based studies. The association of IPV with smoking has not been a major research focus. The purpose of this study was to examine the association between physical and psychological IPV in the past 12 months and preventive healthcare use, smoking, and alcohol use among women. METHODS: Data on 1643 women aged 18-54 from the 1999 Rhode Island Behavioral Risk Factor Surveillance System were analyzed. Logistic regression, controlling for age, race, marital status, education, insurance status, and functional disability, was used to model the associations of IPV with (1) checkups, (2) clinical breast examinations (CBEs), (3) Pap smear screening, (4) cigarette smoking, and (5) high-risk alcohol use. RESULTS: Prevalence of physical IPV was 4.1%. The prevalence of psychological IPV, in the absence of physical IPV was 4.5%. Physical IPV was associated with receiving regular Pap smears odds ratio ([OR] = 2.39, 95% confidence interval [CI] 1.01-5.70), current smoking (OR = 2.07, 95% CI 1.03-4.18), and high-risk alcohol use (OR = 4.85, 95% CI 2.02-11.60). Psychological IPV was associated with high-risk alcohol use (OR = 3.22, 95% CI 1.46-7.09). CONCLUSIONS: Women experiencing IPV regularly access preventive healthcare, providing healthcare providers with opportunities to assess and counsel women for IPV in addition to smoking and high-risk alcohol use.

Adult↗

PubMed2005

Altruism relates to health in an ethnically diverse sample of older adults.

The existing literature indicates links between aspects of social network functioning and health outcomes. It is generally believed that networks that are larger or provide greater instrumental and emotional support contribute to improved health and, perhaps, greater longevity. Recently, it has been suggested that giving as well as receiving social support may be of benefit. On the basis of evolutionary theories of emotion and altruism, the current study sought to test this thesis in a large, ethnically diverse sample of community-dwelling older adults. As expected, levels of social support given were associated with lower morbidity, whereas levels of receiving were not. It is important that these relations held even when (a) socioeconomic status, education, marital status, age, gender, ethnicity, and (b) absolute network size and activity limitation were controlled for. Results are discussed in terms of their implications for theory regarding the relations among social exchanges, giving, and later life adaptation among older adults.

Aged↗