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PubMed2002

The interaction of cognitive and emotional status on subsequent physical functioning in older mexican americans: findings from the Hispanic established population for the epidemiologic study of the elderly.

BACKGROUND: Optimal mental health (cognitive and emotional functioning) is an important factor for maintaining physical function. This study investigated the effects of cognitive and emotional status on subsequent lower body function in a population-based sample of older Mexican Americans. METHODS: A 2-year prospective cohort study included Mexican Americans aged 65 and older who scored 18 or higher on the Mini-Mental State Examination (MMSE) at baseline interview and for whom complete data on a summary performance measure of lower body function were available at the 2-year follow-up interview (n = 2068). In-home interviews in 1993-1994 and 1995-1996 assessed sociodemographic variables, physical health conditions, cognitive function, emotional health, and lower body function. RESULTS: In a multivariate analysis, continuous MMSE (b = 0.06; SE 0.02, p =.004) and Center for Epidemiological Studies-Depression (CES-D) (b = -0.53; SE 0.17, p =.002) scores at baseline were significantly associated with a summary performance measure of lower body function 2 years later, controlling for age, gender, marital status, education, selected medical conditions, and baseline summary performance score. A significant MMSE-by-CES-D interaction (p =.002) on summary performance score was also found after adjustments were made for age, gender, marital status, education, chronic health conditions, and baseline summary performance score. After adjusting for age, gender, marital status, education, selected medical conditions, and baseline summary performance score, subjects with low cognition (MMSE score 18-21) and high depressive symptoms (CES-D score > or = 16) were the most likely to have poor summary performance scores 2 years later (b = -0.95, SE 0.36, p =.008), followed by subjects with high cognition (MMSE score > 21) and high depressive symptoms (CES-D score > or = 16) (b = -0.57, SE 0.19, p =.003), and those with low cognition (MMSE score 18-21) and low depressive symptoms (CES-D score < 16) (b = -0.47, SE 0.22, p =.03), with high cognition (MMSE score > 21) and low depressive symptoms (CES-D score < 16) used as the reference. CONCLUSIONS: Our results confirm prior investigations showing both cognitive function and emotional health predict subsequent lower body function, and extend these findings to older Mexican Americans. In addition, our results indicate that good emotional health moderates the impact of low cognition on subsequent physical function.

Age Factors↗
PubMedDate not supplied

Sociodemographic descriptors of personal exposure to fine particles (PM2.5) in EXPOLIS Helsinki.

Demographic and socioeconomic differences between population sub-groups were analyzed, as a component of the EXPOLIS (Air Pollution Exposure Distributions Within Adult Urban Populations in Europe) Helsinki study, to explain variation in personal exposures to fine particles (PM2.5). Two-hundred one individuals were randomly selected among 25--55-year-old inhabitants of Helsinki Metropolitan area. Personal exposure samples and residential indoor, residential outdoor and workplace indoor microenvironment measurements of PM2.5 were collected between October 1996 and December 1997. Variation in PM2.5 personal exposures, between sociodemographic sub-groups, was best described by differences in occupational status, education and age. Lower occupational status, less educated and young participants had greater exposures than upper occupational status, more educated and older participants. Different workplace concentrations explained most of the socioeconomic differences, and personal day and night exposures and concentrations in home (but not workplace or outdoor concentrations) caused the PM2.5 exposure differences between age groups. Men had higher exposures and much larger exposure differences between the sociodemographic groups than women. No gender, socioeconomic or age differences were observed in home outdoor concentrations between groups. Exposure to tobacco smoke did not seem to create new differences between the sociodemographic groups; instead, it amplified the existing differences.

Activities of Daily Living↗
PubMed2004

Education, marital status, and total and cardiovascular mortality in Novosibirsk, Russia: a prospective cohort study.

PURPOSE: Mortality from cardiovascular diseases in Russia is among the highest in the world but little is known about its distribution by socio-demographic factors. We investigated this question in a prospective cohort study based on the Novosibirsk MONICA Project. METHOD: The cohort consisted of 6485 men and 4919 women aged 25 to 64 years at baseline, examined in 4 surveys in 1984, 1985/86, 1988/89, and 1994/95, and followed up for an average 10.3 (range 3.1-15.2) years. Participants reported their education and marital status in a questionnaire; the information on risk factors was collected in a short medical examination. RESULTS: A total of 836 male and 226 female deaths occurred during the follow up. High education was associated with reduced mortality from all causes, cardiovascular disease, and coronary heart disease in both genders. Age-adjusted relative risk of death from cardiovascular diseases for university vs. primary education was 0.6 (0.4-0.8) in men and 0.4 (0.2-0.8) in women. Adjustment for coronary risk factors and marital status substantially reduced the relative risk in men but not in women. There was no consistent relation between education and stroke. Unmarried men had higher mortality from all causes, cardiovascular and coronary heart disease than married subjects; the increased risk of divorced men was not explained by coronary risk factors or low education. Unmarried women had higher all-cause mortality than married women but associations between marital status and cardiovascular diseases were inconsistent. CONCLUSION: The educational differences in total and cardiovascular mortality in Russia are of similar direction and magnitude as in western populations. The educational differences in cardiovascular mortality in women and the increased mortality of divorced men were not explained by classical risk factors.

Adult↗
PubMed2001

Risk factors associated with age-related nuclear and cortical cataract : a case-control study in the Age-Related Eye Disease Study, AREDS Report No. 5.

OBJECTIVE: To investigate possible risk factors for age-related nuclear and cortical cataracts in participants in the Age-Related Eye Disease Study (AREDS). DESIGN: Case-control study. PARTICIPANTS: Of the 4757 persons enrolled in AREDS, 4477 age 60 to 80 years are included in the study. MAIN OUTCOME MEASURES: Slit-lamp lens photographs were used to classify participants into one of three nuclear opacity groups (moderate nuclear, mild nuclear, and controls), ignoring cortical opacities. Retroillumination lens photographs were used to classify participants into one of three cortical opacity groups (moderate cortical, mild cortical, and controls), ignoring nuclear opacities. RESULTS: Persons with moderate nuclear opacities were more likely to be female, nonwhite, and smokers and to have large drusen. Moderate nuclear opacities were less common in persons with higher educational status, a history of diabetes, and among those taking nonsteroidal antiinflammatory drugs. Moderate cortical opacities were associated with dark iris color, large drusen, weight change, and, at a borderline level of significance, higher levels of sunlight exposure and use of thyroid hormones. Moderate cortical opacities were less common in persons with higher educational status. CONCLUSION: Consistent findings have now been reported across many studies for gender, educational status, sunlight exposure, and smoking. Our findings that use of nonsteroidal antiinflammatory drugs is inversely associated with nuclear cataract and that dark iris color and use of thyroid hormones may increase cortical cataract risk are less well substantiated and require further investigation.

Aged↗
PubMed2000

Understanding income inequalities in health among men and women in Britain and Finland.

The aims of this study were to investigate whether the relationship between income and self-perceived health is similar for men and women in two contrasting welfare states, Britain and Finland; whether the relationship between income and health is accounted for by employment status, education, and occupational social class; and whether the association differs when using alternative ways of measuring income: gross individual and net household equivalent income. Among British and Finnish men, low household and low individual income were related to poor health, even after adjusting for employment status, education, and social class. The adjusted relationship between individual income and health was stronger for British than Finnish men. Among British and Finnish women, net household equivalent income was strongly related to health, but after adjusting for employment status, education, and social class this relationship became weaker for British women and practically disappeared for Finnish women. For British women the association between income and health differed strongly depending on the income measure used; gross individual income had almost no effect on health. These results indicate that the association between health and income has no threshold in the sense that only people in poverty have poorer health than others. In further studies of income and health, household equivalent income should be used as the principal measure of income with adjustments for employment status, and men and women should be studied separately.

Cross-Sectional Studies↗
PubMed2004

Educational and social competencies at 8 years in children with threshold retinopathy of prematurity in the CRYO-ROP multicenter study.

OBJECTIVE: To describe the educational status and special education services at 8 years among children who had threshold retinopathy of prematurity (ROP). METHODS: A prospective study was conducted of a cohort of children who had birth weight of <1251 g and threshold ROP in the Cryotherapy for Retinopathy of Prematurity multicenter study. At age 5.5 years, visual status, functional skills, and social information were obtained. At 8 years, special education classes, developmental disabilities, rehabilitation therapies, and academic and social competencies were determined by questionnaire. Visual status was considered favorable/unfavorable on the basis of the better eye. RESULTS: Of 255 survivors, 216 (85%) were evaluated at both 5.5 and 8 years. Major impairments were significantly more prevalent in children with unfavorable versus favorable visual status: cerebral palsy (39% vs 16%), developmental disability (57% vs 22%), autism (9% vs 1%), and epilepsy (23% vs 3%). Special education services (63% vs 27%), below-grade-level academic performance (84% vs 48%), and school-based rehabilitation services were significantly less common in children with favorable visual status. Favorable visual status, favorable functional ratings at 5.5 years, markers of higher socioeconomic status, and nonblack race were associated with significantly lower rates of both special education placement and below-grade-level academic performance at age 8. On multivariate logistic regression, only favorable visual status and functional status remained significant predictors for decreasing special education placement. CONCLUSION: Threshold ROP is associated with high rates of developmental, educational, and social challenges in middle childhood; preserved vision was associated with a clear advantage, with more than half of the children with favorable visual status performing at grade level.

Analysis of Variance↗
PubMed1998

[Incidence of operations in Switzerland related to insurance status].

Several studies reported in the literature show that surgical procedures can be carried out for other than clinical indications. In Switzerland, no statistics on the "demography" of surgical procedures are available. But an earlier analysis of the "Swiss Health Survey 1992/93" gave first indications on differences in rates of surgical procedures (hysterectomy, appendectomy, tonsillectomy and operation of the hip and gallbladder) by sex, educational status and region. This study, based on the same datasource (N = 10792), reveals an additional link with the health insurance status. The prevalence of surgical procedures is higher in privately insured than in persons with only basic insurance, independent of age, sex and region. The highest rates of surgical procedures (except tonsillectomy) are found among privately insured persons with a low educational status. Among 25-74 year old privately insured women, the lifetime-prevalence of a hysterectomy is 30% with low and 13% with high educational status (p < .001). The corresponding prevalences of at least one of the mentioned surgical procedures (without tonsillectomy) are 49% versus 28% (p < .001). As these are lifetime-prevalences, these rates do not necessarily reflect the actual surgical procedures. However, an analysis of the period of operation for hysterectomy and for the gallbladder shows the same pattern as the mentioned lifetime-prevalences. Higher rates among privately insured are also a frequent finding in the international literature. These findings should stimulate patients to ask for a "second opinion". Furthermore, there is an urge for the implementation of general hospital statistics to verify such findings. In addition, the scientific consensus on the indication of several surgical procedures should be promoted on the way to more evidence-based-medicine.

Adolescent↗
PubMedDate not supplied

The National Breast Screening Study: pre-recruitment sources of awareness in participants.

Data collected by questionnaire from 89,835 women on entry into 15 Canadian National Breast Screening Study (NBSS) centres reveal pre-recruitment sources of awareness: radio and television were reported by 30%; workplace 6%; friends 35%; physician 6%; and other by 23% of respondents. Personalized letters of invitation employed in 5 centres were an important source of awareness. In the age group recruited, 40-59 years, age had no influence on the source reported. However women with post-secondary school education were less likely to report radio and television as a source and more likely to report newspapers compared to women with less education. Women with only public school education were less likely to report the workplace as a source of awareness than women with post-secondary education. Recruitment strategies for screening programs may be more successful if publicity on radio and television is geared to women of lower educational status and if publicity in newspapers is geared to women of higher educational status, supplementing both with personalized letters of invitation.

Adult↗
PubMed2006

Socioeconomic issues and demographics of total knee arthroplasty revision.

UNLABELLED: Despite rising numbers of total knee arthroplasty revision (TKAR) procedures there remains a paucity of information regarding the relationships between total knee arthroplasty failure and socioeconomic and educational status, demographics, general health and functional disability. We performed a multicenter prospective study of 290 consecutive TKAR patients in order to determine whether they differed from the population they were drawn from in terms of socioeconomic or educational status, race or gender. Secondary aims were to establish the relative comorbid status of this population, social supports and their general health status compared to national norms and their modes of failure. Our cohort consisted of 137 males and 153 females with a mean age of 68.6 years (range, 34-85 years), substantial overall functional disability according to the SF-36 and a large average number of comorbidities at baseline. We found a relative overrepresentation of patients of comparatively low socioeconomic and educational status and also of Caucasian patients in the TKAR population. This large prospective investigation demonstrates demographic features associated with TKA failure and provides a platform for further investigations on the effect demographic characteristics have on the outcomes of TKAR. LEVEL OF EVIDENCE: Prognostic Study, Level II (Lesser quality prospective study). See Guidelines for Authors for a complete description of the Levels of Evidence.

Adult↗
PubMed2005

The impact of the Women's Health Initiative Randomized Controlled Trial 2002 on perceived risk communication and use of postmenopausal hormone therapy in Germany.

OBJECTIVE: The purpose of this representative, nationwide telephone survey was to collect information about postmenopausal hormone therapy (HT) use in relation to women's knowledge about the Women's Health Initiative Randomized Controlled Trial 2002 (WHI-RCT) in Germany. DESIGN: During July 2003, telephone interviews were conducted with randomly selected women aged 45 to 60 years (N = 10,030; response 59.9%; completed interviews n = 6,007). They were asked about information sources regarding the WHI-RCT, and use of HT in conjunction with it. RESULTS: Most women stated that they knew about the WHI-RCT (88.6%), and those with high educational status appeared to have more information than those with middle or low educational status. Among informed women (uninformed excluded), 46.6% continued, 25.7% stopped, and 14.2% ceased use of HT before the WHI-RCT. The prevalence of lifetime use of HT was higher in West Germany (37.4%) than in East Germany (29.2%), the highest prevalence of use was in the group aged 55 to 59 years. The most common reason to continue HT was the benefit risk assessment by physicians (58%); the most common reason to stop HT were women's perceptions that the risks of HT exceeded the benefits (56%). If information was solely given by physicians, women were more likely to continue HT (60.4%), compared with mass media (46.1%), as a source of information. CONCLUSIONS: The survey demonstrates the impact of the WHI-RCT in Germany, and shows that both the media and advice given by physicians were important. Women who continued to use HT did so largely because of their physician's advice. Women who discontinued were mainly those who had a negative subjective perception about risk of HT.

Age Distribution↗
PubMed2001

Overweight, stature, and socioeconomic status among women--cause or effect: Israel National Women's Health Interview Survey, 1998.

OBJECTIVE: To determine if short stature and overweight/obesity are predictors of low socioeconomic status (SES), measured by educational attainment. DESIGN: A cross-sectional study on a random sample carried out through telephone interviews over a period of five months (March through August 1998). SUBJECTS: A total of 1587 Jewish and Arab Israeli women--773 women age 20-44 years, and 814 women age 45-74 years. METHODS: Two cross-sectional telephone surveys were conducted; both times, telephone numbers were drawn from the population registry. Multiple logistic regression analysis was used to determine significant predictors of body mass index (BMI), while controlling for population group, parity, smoking, and physical activity. RESULTS: The level of one's education and one's stature were significantly, independently associated with BMI. Low stature and obesity were indicators of low educational attainment. LIMITATIONS: The subjects of the study reported their own weight and height. The tendency to overestimate one's height and underestimate one's weight places the accuracy of data under question. However, as there is no reason to believe that the biases in the reports would vary with educational status, the results of the study remain valid. CONCLUSIONS: Obesity/overweight is directly related to the level of education and inversely to stature. Together, one's level of education and stature may be determinants of low SES. Therefore, in subpopulations with high rates of obesity and short stature, comprehensive programs should include welfare in addition to dietary measures.

Adult↗
PubMed1987

The family-school relation and the child's school performance.

Using a nationally representative sample of American households, we examine the relation between parental involvement in schooling and the child's school performance. With a sample of 179 children, parents, and teachers, we investigate 3 hypotheses: (1) the higher the educational status of the mother the greater the degree of parental involvement in school activities; (2) the younger the age of the child the greater the degree of parental involvement; and (3) children of parents who are more involved in school activities do better in school than children with parents who are less involved. In an analysis of cross-sectional data, we discover support for the 3 hypotheses. The educational status of the mother is related to the degree of parental involvement in schooling, so that parents with more education are more involved. Parental involvement is related to the child's school performance. Also, parents are more involved in school activities if the child is younger. The mother's educational level and the age of the child are stronger predictors of parental involvement in schooling for boys than for girls. We do not, however, find a direct effect of maternal educational status on school performance independent of parental involvement in school activities. We discuss these findings in light of the relation between families and schools.

Achievement↗
PubMed2006

Quality of life and sociodemographic characteristics of patients with cancer in Turkey.

PURPOSE/OBJECTIVES: To determine whether a relationship exists between quality of life (QOL) and the sociodemographic characteristics of gender, age, marital status, educational level, occupation, and level of income in patients with cancer in Turkey. DESIGN: Exploratory study using a convenience sample. SETTING: Five hospitals in the capital city of Turkey. SAMPLE: 620 patients with cancer (44 inpatients and 576 outpatients). METHODS: The study was carried out using face-to-face interviews. A questionnaire was used as a tool for collecting data on the sociodemographic characteristics of patients, and the Rolls-Royce Quality-of-Life Scale was employed to measure QOL. MAIN RESEARCH VARIABLES: Gender, age, marital status, educational level, occupation, level of income, and QOL. FINDINGS: Men, older adults, widowed spouses, patients with lower levels of education, housewives, and those with lower income had lower QOL scores. CONCLUSIONS: Considering the results and giving the groups referred to in the study priority in the planning of patient care would be useful. IMPLICATIONS FOR NURSING: In the field of nursing in Turkey, a limited number of studies have examined the relationship between the sociodemographic characteristics of patients with cancer and QOL. The results will help nurses assess patient needs and engage in nursing interventions that are appropriate to the needs.

Adolescent↗
PubMed2002

The relationship between socio-demographic characteristics and dental health knowledge and attitudes of parents with young children.

OBJECTIVE: To determine if parental socio-demographic characteristics are associated with dental knowledge and attitude. DESIGN: A questionnaire survey of 500 consecutive parents with children aged approximately 8-months, attending clinics in 1999/2000, in Burnley, Pendle and Rossendale, for health visitor distraction-hearing tests. OUTCOME MEASURES: Scores were obtained for dental knowledge and attitudes. The socio-demographic variables of parental ethnicity, age, education and area of residence were used to determine any associations. RESULTS: Parental age ranged between 16-46 years. Child age ranged between 7-11 months. Significant differences were detected for parental dental knowledge according to ethnicity (P = 0.003), educational status (P = 0.000), and area of residence (P = 0.016). Significant differences were also found in dental attitudes; ethnicity (P = 0.000), educational status (P = 0.004) and area of residence (P = 0.005). Parental age was not significant for either knowledge or attitude. CONCLUSIONS: Lack of further education, being Asian and living in a deprived area means parents have less chances of high dental knowledge and positive dental attitudes.

Adolescent↗
PubMedDate not supplied

When urban adolescents choose abortion: effects on education, psychological status and subsequent pregnancy.

A group of 360 black teenage women of similar socioeconomic background who sought pregnancy tests from two Baltimore family planning providers was followed for two years to determine if those who obtained abortions were adversely affected by their abortion experience. After two years, the young women who had terminated their pregnancies were far more likely to have graduated from high school or to still be in school and at the appropriate grade level than were those who had decided to carry their pregnancy to term or those whose pregnancy test had been negative. Those who had obtained an abortion were also better off economically than were those in the other two groups after two years. An analysis of psychological stress showed that those who terminated their pregnancy had experience no greater levels of stress or anxiety than had the other teenagers at the time of the pregnancy test, and they were no more likely to have psychological problems two years later. The teenagers who had obtained abortions were also less likely than the other two groups to experience a subsequent pregnancy during the following two years and were slightly more likely to practice contraception. Thus, two years after their abortions, the young women who had chosen to terminate an unwanted pregnancy were doing as well as (and usually better than) those who had had a baby or who had not been pregnant.

Abortion, Induced↗
PubMed2003

Public perceptions of the causes and prevention of obesity among primary school children.

OBJECTIVE: To investigate lay perceptions of the causes and prevention of obesity among primary school children. DESIGN: A cross-sectional survey of randomly selected sample of adults in a shopping centre. SUBJECTS: 315 adults in Melbourne, Australia. MEASUREMENTS: Subjects completed a self-completion questionnaire, in which they rated the importance of 25 possible causes of obesity and the importance of 13 preventive measures on four-point scales: not important; quite important; very important; extremely important. Demographic information about the respondents' age, sex, marital status, education level and parental status was also collected. RESULTS: The most important reported causes of childhood obesity were related to overconsumption of unhealthy food, parental responsibility, modern technology and the mass media. The most popular prevention activities were associated with specific actions aimed at children. Principal components analysis of the causes data revealed eight factors, provisionally named: parental responsibility, modern technology and media, overconsumption of unhealthy food, children's lack of knowledge and motivation, physical activity environment, lack of healthy food, lack of physical activity and genes. Two prevention factors were also derived, named government action and children's health promotion. Parents saw modern technology and media, and government activities as more important causes, and government policy as a more important means of prevention than nonparents and men. Women's responses tended to be similar to those of parents. There were few educational differences, although nontertiary educated respondents reported that modern technology and media were more important causes of obesity than did the tertiary educated. CONCLUSION: The findings suggest that the public appears to hold quite sophisticated views of the causes and prevention of children's obesity. They suggest that a number of prevention strategies would be widely supported by the public, especially by parents.

Adult↗
PubMed2000

Cancrum oris (noma): Level of education and occupation of parents of affected children in Nigeria.

A total of 173 cancrum oris patients who were brought by their parents to the University College Hospital, Ibadan, Nigeria, were analyzed. Ninety-one (52.6%) were males and 82 (47.4%) females. Their ages ranged from 1.5 to 11 years with a mean of 4.36 (standard deviation 2.13) years. One hundred and twenty-one (69.9%) and 52 (30.1%) were from monogamous and polygamous family respectively. The average number of children per family was 7.0. The number of parents with no formal education was 148 (85.5%) and 98.3% were low-income earners. The relationships between occupation, income and educational status were highly significant. This study suggests that apart from poverty, large family units and low educational status of parents are contributing factors in the aetiology of cancrum oris.

Chi-Square Distribution↗