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PubMedDate not supplied

[The "restraint" controversy in geriatric psychiatry. Focus study of factors influencing restraint measures].

The study examines the relationship between frequency and duration of restraints in psychogeriatric inpatients with their respective diagnosis, medication, reason for restraints, and age as a socio-demographic variable. Entered in the analysis were data from 590 inpatients from a total of 29 institutions within the Federal Republic of Germany psychogeriatric facilities; this was 24.7% of all psychogeriatrically treated inpatients on the survey day in the said 29 institutions. The data were analyzed via simple multifactorial analyses of variance followed by multiple classification analysis (SPSS for Windows). Neither age nor diagnosis showed any differential influence on frequency or duration of restraints. Among the reasons for restrains hetero-aggression led to fewer and shorter restraints; self-aggression led to fewer but longer restraints. Restless patients were restrained more often but for shorter intervals. The main psychopharmacological strategy, while having no influence on the frequency of restraints, showed a marked influence on their duration; patients treated with low potent neuroleptics had particularly short intervals of restraints, whereas patients free from psychopharmacological agents showed distinctly longer intervals of restraints than the mean of restrained patients.

Accidental Falls↗
PubMed1992

[Fatigue symptoms and their related factors of workers in institutions for the mentally retarded].

This study examined the fatigue symptoms and their relative factors in a group of nursery teachers and guidance workers (n = 480) belonging to institutions for the mentally retarded. 1) More than 50% of the respondents complained of neck stiffness and/or backache. The mean scores of the physical symptoms were higher than the standard cumulative fatigue symptoms index, while those of the mental symptoms were lower. 2) Analysis of variance showed that physical fatigue symptoms were higher in females, younger workers, those with longer years of service, those with more night duties per month, and those who expressed more dissatisfaction with their co-workers, wages, working hours, and work shift. Physical fatigue symptoms were not related to the severity of the mental disease of their clients. 3) Analysis of variance also showed that mental fatigue symptoms were higher in females, younger workers, and persons who expressed more dissatisfaction with their jobs, supervisors, co-workers, wages, working hours, and work shift. The severity of the mental disease of their clients was directly related to the mental fatigue symptoms. Furthermore, multiple classification analysis showed that those working with children had both higher irritability and morale than those working with adults.

Analysis of Variance↗
PubMed1980

Sources of ambulatory care and utilization models.

For this study I gathered information on sources of ambulatory care and ambulatory care utilization, together with social, demographic, and health information. I applied a revision of Andersen's behavioral utilization model to all these data to try to explain patterns of ambulatory care utilization. Data are from a household survey of Rhode Island residents that was conducted in 1974. I have used multiple classification analysis (MCA), since the provider variable formed from the information on medical care sources is best conceptualized as being measured at a nominal level. It emphasizes both the number of different affiliations and the specialty and type of each affiliation. The MCA analysis with the provider set variable and the social, demographic, and need variables has a multiple R2 (adjusted) of 0.40. The most important explanatory variable is the number of conditions, a need variable; the next most important is the provider variable. This study demonstrates the value of variables that account for providers of care and ambulatory care patterns as well as measures of need and social and demographic variables in a complete model of utilization behavior.

Adolescent↗
PubMed1981

Negativism, equivocation, and wobbly assent: public "support" for the prochoice platform on abortion.

Although disapproval of all justifications for abortion is rare in the United States, our analysis of numerous surveys taken in the 1960s and 1970s shows that support for the full prochoice platform is also rare. This means that respondents who endorse some justifications for abortion and reject others typically constitute about 50 percent of these samples. If forced to choose politically between polar positions, would these people be more likely to side with a positive or a negative extreme? Using Multiple Classification Analysis as a form of discriminant analysis, we examine whether people who appear to form a "middle" group actually are closer in their characteristics to those who are positive, or to those who are negative. Finally, we test to see whether those respondents who endorse all four justifications for abortion (health, child defect, financial stress, and elective abortion) also endorse additional prochoice positions, such as government payments for abortion, abortion without the husband's or the parent's consent, and abortion after the first trimester.

Abortion, Legal↗
PubMed1981

Current excessive drinking among Vietnam veterans: a comparison with other veterans and non-veterans.

Analysis of recent data collected in a 1977 U.S. national epidemiologic study of substance abuse revealed that Vietnam veterans (N=87) had substantially higher levels of alcohol consumption and binge drinking, than comparable groups of Vietnam "era" veterans with no Vietnam service (N=107), other veterans (N=483), and nonveterans (N=2,600). Vietnam veterans and Vietnam era veterans also had a somewhat higher level of drug abuse than expected for individuals from similar social backgrounds. Multiple Classification Analysis (MCA) was the technique used to adjust for demographic differences between these four groups. The results of these analyses reinforced previous research findings and substantiated the President's Commission on Mental Health, which speculated that alcohol abuse may become a special health problem among this population. Since evidence for "post-traumatic" or delayed stress among Vietnam veterans has been culminating, and some research has indicated a link between stress and increased alcohol consumption, it was suggested that the drinking pattern found among this Vietnam veteran sample may be a symptom of post-traumatic stress.

Adult↗
PubMed1982

The relative impacts of vertical and integrated FP/MCH programs in rural Nepal.

The objectives of this analysis were to assess the probable impacts of vertical and integrated FP/MCH programs on family planning (knowledge, use, and intentions to use), family size preferences, fertility, and mortality (child and infant). The following discussion summarizes and draws conclusions regarding the results of this investigation. The vertical program showed a greater impact on knowledge of family planning than the integrated program. Increases in knowledge between 1975 and 1978 while controlling for social and demographic variables were greater in the vertical than the integrated areas. Multiple classification analysis at both household and village levels showed that the vertical program was a better predictor of knowledge and changes in knowledge than the integrated program. In addition, the vertical program showed consistently higher proportions of women with awareness of family planning among those segments of the population that could have the greatest impact on fertility reduction in the future--namely, the younger women who are either childless or just beginning their childbearing and those with husbands who have little or no education. Neither the vertical nor the integrated FP/MCH program showed an impact on current use or ever use of family planning. The very low levels and changes in levels of these factors between the programs showed almost no difference throughout the selected demographic and socioeconomic groups. In both program areas the proportions of ever use and current use increased substantially with the number of living sons, exceeding 14 percent and 10 percent, respectively, among women with three or more sons. There were virtually no family planning users or ever users among women with no sons. This appears to indicate that "son preference" (documented in the Nepal Fertility Survey) is an important factor affecting the incidence of family planning practice and may be a formidable obstacle to a substantial reduction in fertility. Family limitation generally may not be taken seriously until a couple has produced the desired number of sons. Hence, until the value of sons (perhaps as sources of labor, financial support and security in old age, and as performers of funeral rites for fathers) can be altered it is unlikely that a reduction in fertility beyond certain levels could occur. The vertical program showed a slightly greater impact on future intentions to use family planning than the integrated program.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1997

The sequelae of hospitalization for congestive heart failure among older adults.

OBJECTIVES: To estimate the independent effect of hospitalization for congestive heart failure (CHF) on subsequent mortality, readmission for CHF, rehospitalization for any reason, and change in functional status. DESIGN: Secondary analysis of the nationally representative Longitudinal Study on Aging, Baseline (1984) interview data are linked to Medicare hospitalization and death records for 1984-1991 and to functional status reports at three biennial follow-ups. SETTING: In-home and telephone interviews. PARTICIPANTS: a total of 7527 noninstitutionalized older adults aged 70 years or older at baseline. MEASUREMENTS: Hospitalization for CHF was defined as having one or more episodes with primary or secondary discharge ICD9-CM codes of 428. Multivariable proportional hazards, logistic and linear regression, as well as multiple classification analysis, were used to estimate the independent effects of having been hospitalized for CHF. RESULTS: The adjusted risk ratios for having a primary or secondary hospital discharge diagnosis of CHF on mortality (compared with not having any CHF hospital discharge diagnoses) were 1.58 (CI95% = 1.40 to 1.78) and 1.29 (CI95% = 1.15 to 1.45), respectively (P < .001). CHF readmission and rehospitalization rates were substantial, ranging from 16.0 to 47.5% at 1 year, depending on the criteria employed. The adjusted odds ratios for having any subsequent hospitalizations associated with having a primary or secondary hospital discharge diagnosis of CHF (compared with not having any CHF hospital discharge diagnoses) were 7.70 (CI95% = 6.20 to 9.57) and 2.99 (CI95% = 2.51 to 3.56), respectively (P < .001). The percent increases in the number of hospital episodes, total charges, and total length of stay attributable to having been hospitalized for CHF were significant (P < .001) and ranged from 15.5 to 66.7%. Having been hospitalized for CHF was also related significantly to greater increases in the mean number of functional limitations at follow-up. CONCLUSION: Hospitalization for CHF among older adults increases substantially the risk of subsequent mortality, readmission for CHF, rehospitalization for any reason, and greater functional decline. Therefore, greater attention to the prevention and management of CHF is needed.

Activities of Daily Living↗
PubMed1978

Multiple predictors of dropout from alcoholism treatment.

A common problem in treating alcoholics is the high dropout rate. Many studies have identified individual factors associated with dropout, eg, poor motivation and previous dropout. We believe the present study reports the first major effort to use multivariate analyses to predict dropout in a large (792), one-year follow-up study of alcoholics, and examines the possibility that medical and nonmedical treatments lead to differential dropout rates. A multiple classification analysis technique showed that treatment variables as opposed to client characteristics were the best predictors of dropout. Patients remaining in treatment were more likely to have a variety of medical interventions, eg, medication and medical assessment, than those who dropped out. Results were similar to studies using other techniques and have interesting implications for the treatment of alcoholics, raising questions about current trends toward nonmedical treatment of alcoholism.

Alcoholism↗
PubMed1991

Sterilization acceptance and regret in Thailand.

The prevalence of sterilization increased steadily in Thailand from 1969/70 to 1984, but remained unchanged over the period 1984-87. This paper uses data from the 1987 Thai DHS to examine sterilization acceptance and regret. The prevalence of sterilization increases with both the number of children and with the age of the woman. Among women with two or more children, there is a positive association between education and wealth, and tubal ligation, but there is no correlation between education and wealth and the percentage of husbands with a vasectomy. Women whose last delivery was in hospital were more likely to have been sterilized than were women with a home delivery, and among women with a hospital delivery, those who had a cesarean section were more likely to have been sterilized than were women with a vaginal delivery. Both accessibility to medical facilities and medical problems apparently play a role in affecting who gets sterilized. The percentage of women who reported that they regretted that either they had gotten sterilized or that their spouses had gotten sterilized was 11% but regret was higher in cases in which the wife had had surgery (12%) than in cases in which the spouse had had a vasectomy (8%). This difference persisted even when other variables were introduced to examine the correlates of regret (number of children at time of sterilization, subsequent death of a child, whether sterilization was done at time of CS, residence of the respondent) using multiple classification analysis. Perhaps when women themselves are sterilized, they attribute subsequent problems in health to the operation, whereas such changes cannot be attributed to the vasectomy of their husband.

Adolescent↗
PubMedDate not supplied

Social network type and health status in a national sample of elderly Israelis.

A typology of social support networks was examined in relation to five health measures in a national probability sample of Israelis aged 60 and over, using multiple classification analysis (N = 4214). The procedure revealed that the more resourceful diversified and friend and neighbor network types were consistently associated with better scores on measures of basic and instrumental activities of daily living, incontinence, vision and self-rated health, even when controlling for respondents' age, sex and education. The religious family network type, also endowed with considerable support potential, tended to correlate with lower health scores. The narrow family focused network had average health ratings or less, and a moderate support capability. The least resourceful network type, the attenuated network, was most frequently associated with poor health.

Aged↗
PubMed1997

Assessing the impact of adolescent pregnancy and the premarital conception stress complex on birth weight among young mothers in Gibraltar's civilian community.

PURPOSE: The objective of this study was to assess the impact of young maternal age and the timing of conception on birth weight among primiparous women living in Gibraltar. METHODS: The data for this study were derived from a population of 295 primiparous women who gave birth under 25 years of age. Only married women who had no previous maternal history and delivered live singleton newborns between 1980 and 1984 were included. The confounding effects of gestation length, sex, and socio-economic status on birth weight were taken into account using the multivariate technique of multiple classification analysis. A conception timing variable was constructed and partitioned into four groups which represented the separate and joint effects of maternal age and prenuptial stress on birth weight. RESULTS: The overall mean birth weight was 3344.15 g. After controlling for the specified factors and covariate, the infants of older mother (> 19) who conceived after marriage weighed 57.78 g above the referent group mean. Older mothers who conceived a child before marriage delivered infants weighing 75.67 below the grand mean. Young mother (< 20) who conceived within marriage had infants who weighed 37.32 g less than the grand mean. Infants delivered by young mothers who conceived before marriage weighed 133.66 g less than the overall mean birth weight. The only significant group difference detected within the conception timing variable was between young mothers who conceived before marriage versus older mothers who conceived after marriage. CONCLUSIONS: Premarital conception is identified as a risk factor for lower infant birth weights among mothers under 20 years of age. This study emphasizes the need to take into account the effects of culturally mediated behavior on the pregnancy experience of young women.

Adolescent↗
PubMed2004

The availability of socially marketed condoms in urban Tanzania, 1997-99.

The objective of this study was to evaluate trends in the availability of socially marketed condoms in urban Tanzania, and to assess the effect of changes in the social marketing programme's strategy for distributing condoms to retail outlets. Three retail outlet surveys conducted in urban Tanzania in 1996/97, 1998 and 1999 were analysed. Multiple Classification Analysis (MCA) was used to determine changes in availability of condoms, after adjusting for differences in the composition of the samples. Consistent with the changes in the condom social marketing distribution system, the proportion of condom outlets that were supplied by wholesalers increased from 42% in 1997 to 60% in 1999. The increasing use of wholesalers allowed sales agents to devote more time to opening new outlets. Hence, the percentage of outlets that had been solicited to sell condoms by social marketing condom sales persons increased from 14% in 1997 to 25% in 1999. Following these changes in the distribution system, the percentage of outlets selling socially marketed condoms increased from 25% to 32% between 1997 and 1998, and stabilized at that level. More detailed examination showed that availability of socially marketed condoms increased significantly in most non-traditional outlets, and in all regions of the country. In conclusion, distribution survey data indicate that changes in the distribution system increased the role of wholesalers, and enabled sales teams to allocate more time to soliciting new condom outlets. Concurrent with these changes, the availability of socially marketed condoms in non-traditional retail outlets increased significantly. Regular monitoring of condom availability can ensure that any emerging supply problems are identified and remedied quickly.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Impacts of diabetes and hypertension on the risk of hospitalization among less educated people.

Coexisting hypertension increases the morbidity and mortality associated with diabetes, and may be more so in less educated people. We analysed data from 49 904 Canadians 40-64 years of age who participated in the Canadian Community Health Survey, 2000-2001. Multiple classification analysis was used to adjust for covariates. Population weight and design effect of the survey were taken into account in the analysis. The association between hypertension and hospitalization varied according to diabetes and education. The adjusted difference in hospitalization incidence attributable to hypertension was significantly higher for the lower education group than the higher education group, and such a pattern tended to be more pronounced among diabetic people. The adjusted incidence difference attributable to hypertension was higher in the diabetic group (8.8, 95% confidence interval (CI): 4.6, 13.0%) than in the non-diabetic group (4.6, 95% CI: 3.6, 5.6%) for people with low education, but was similar for those with well-educated people. Possible reasons for the modifying effect of education on the relationship among hypertension, diabetes and hospitalization were discussed.

Adult↗
PubMed1984

Size of family of orientation and family size preference: a replication.

"Past studies have found a modest, positive association between size of family of orientation and preferred family size and fertility behavior in the family of procreation. While there is some consistency in the findings, contradictions are also noted. The present study replicates earlier studies dealing with preferred family size, and seeks to resolve some of the contradictions by utilizing multiple classification analysis to determine the simultaneous impact of parental family size, religion, happiness, life style stability, and birth order on family size preference." The data, collected in 1981-1982, concern 379 U.S. college students.

Americas↗
PubMedDate not supplied

Growth status of schoolchildren in a rural Zapotec community in the Valley of Oaxaca, Mexico, in 1968 and 1978.

Stature, weight, arm circumference, triceps skinfold and estimated mid-arm muscle circumference were compared in schoolchildren, 6 to 14 years of age, in 1968 and 1978. The children were resident in a rural Zapotec-speaking community in the Valley of Oaxaca in southern Mexico. There were no differences in stature, weight and arm circumference over the ten-year period. Triceps skinfold and estimated mid-arm muscle circumference showed small, significant changes. Multiple classification analysis, adjusting for age and sex variation, indicated that schoolchildren in 1978 were slightly heavier and fatter, but also slightly shorter and less muscular than children in 1968. Results of this follow-up survey indicate little improvement in the growth status of rural Zapotec schoolchildren over ten years from 1968 to 1978, and are consistent with adult stature data which show little evidence of secular change over 80 years.

Age Factors↗
PubMed1984

Factors affecting primary health care utilization.

Using a one-stage random probability sample of households, 5806 people in an area of Norway were interviewed about illness, use of medicines, self-treatment and visits to the doctor in the previous two weeks. Several social and demographic variables that might influence primary health care utilization were divided into five categories: need of medical care; self-care; availability of the doctor; sociodemographic factors; social network factors. Multiple classification analysis was used for the statistical analysis. The greatest influence on the percentage of people seeing the doctor was the need for medical care, the second largest influence was self-care. The availability of the doctor had a different effect according to whether the illness was chronic or non-chronic. Difficulties in reaching the doctor reduced the number of consultations for non-chronic diseases while the opposite was the case for chronic diseases. Among the sociodemographic variables neither level of education nor income had any influence on utilization when other variables were taken into account. Increasing age, however, caused a large increase in the percentage seeing the doctor, except after the age of 85 years when there was a large drop in consultation rate despite increasing illness. Social network factors had little effect on health care utilization.

Acute Disease↗
PubMed2003

Age differences in home computer availability and use.

OBJECTIVES: The purpose of this study was to determine whether age differences in home computer availability and use are due to variations in compositional characteristics (e.g., income or disabilities) of age cohorts. METHODS: Data are drawn from the September 2001 Current Population Survey and its supplement on computer and Internet use (N = 71,182). Patterns of age differences in home computer use are examined using Multiple Classification Analysis with controls for several measures of compositional variability (employment status, marital status, Hispanic origin and race, gender, family income, living arrangements, education, and number of disabilities). RESULTS: Even though home computer availability declines steadily with age, a portion of this zero-order relationship is due to composition effects, with their greatest impact occurring at the oldest ages. Among persons living in households where a computer is available, use also declines with age, but these age differences in computer use are less due to compositional differences. DISCUSSION: The lower rates of home computer availability and use exhibited by older persons may be accounted for to some extent by compositional characteristics negatively associated with availability and, to a lesser extent, use of computers, although unmeasured attitudes, experience, and support undoubtedly play a role.

Adult↗