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Results for “Multivariate response regression”

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PubMed1999

Association of dietary protein intake and coffee consumption with serum homocysteine concentrations in an older population.

BACKGROUND: Elevated blood concentrations of total homocysteine (tHcy) have been implicated in the pathogenesis of atherosclerotic cardiovascular disease. Previous studies identified suboptimal nutritional status and dietary intake of folate, vitamin B-6, and vitamin B-12 as determinants of elevated tHcy. OBJECTIVE: We identified other nutritional factors associated with tHcy in 260 retired schoolteachers in the Baltimore metropolitan area. DESIGN: We performed observational analyses of baseline and 2-4-mo follow-up data collected in a study designed to test the feasibility of conducting a large-scale clinical trial of vitamin supplements by mail. The study population consisted of 151 women and 109 men with a median age of 64 y. At baseline, each participant completed a food-frequency questionnaire. At follow-up, fasting serum tHcy was measured. RESULTS: In multivariable linear regression and generalized linear models, there was an independent, inverse dose-response relation between dietary protein and In tHcy (P = 0.002) and a positive, significant dose-response relation between coffee consumption and In tHcy (P for trend = 0.01). Other significant predictors of In tHcy were creatinine (positive; P = 0.0001) and prestudy use of supplemental B vitamins (inverse; P = 0.03). In stratified analyses restricted to persons receiving standard multivitamin therapy, the association of 1n tHcy with dietary protein and coffee persisted. CONCLUSIONS: These results support the hypothesis that increased protein intake and decreased coffee consumption may reduce tHcy and potentially prevent atherosclerotic cardiovascular disease and other disease outcomes.

Aged↗

PubMed2006

Prevalence and profile of methamphetamine users in adolescents at a juvenile classification home.

The objective of the present study was to investigate the prevalence and risk factors of methamphetamine use in adolescents at a juvenile classification home. The present subjects were 1362 adolescents (1172 male and 190 female) who had been admitted to the Nagoya Juvenile Classification Home. The participants were divided into two groups, a methamphetamine user group and a control group, based on history of methamphetamine use. The presence of methamphetamine use was analyzed in terms of gender, age, number of admissions, violence (types of crime), history of psychiatric treatment, family history (crime, drug misuse and/or alcohol-related disorder), and experience of being abused by their parents or by the persons who were responsible for raising them. The prevalence of methamphetamine use was 6.8% (93/1362). Multivariate logistic regression analyses indicated that gender (female; odds ratio [OR]: 8.1; 95% confidence interval [CI]: 4.6-14.3), age (OR: 1.8, 95%CI: 1.5-2.1), number of admissions (>2, OR: 2.9, 95%CI: 1.8-4.8), violence (OR: 0.4, 95%CI: 0.2-0.7), history of psychiatric treatment (OR: 8.7, 95%CI: 4.0-19.0), and family history of drug misuse (OR: 4.0, 95%CI: 1.6-9.6) were all significantly associated with methamphetamine use. Approximately 7% of participants used methamphetamine. Female gender was a risk factor. Higher age and multiple admissions suggest the persistency and repetition of delinquency. Methamphetamine users were less violent than control subjects. Psychosocial environment (family history of drug misuse) and psychiatric problems (history of psychiatric treatment) were also related to methamphetamine use.

Adolescent↗

PubMed2002

Hygiene levels in a contemporary population cohort are associated with wheezing and atopic eczema in preschool infants.

BACKGROUND: The hygiene hypothesis states that insufficient exposure to certain infectious agents during childhood increases the risk of developing asthma and atopic diseases. Improvements in hygiene levels may be partly responsible for this decline in exposure. AIMS: To assess whether hygiene levels in infancy are associated with wheeze and/or atopic eczema, independent of a number of possible confounding factors. METHODS: Data were gathered from the Avon Longitudinal Study of Parents and Children (ALSPAC). Parental self completion questionnaires provided symptom data on infant wheeze and atopic eczema at 0-6 months and 30-42 months, respectively. A simple hygiene score was derived using questionnaire responses at 15 months, which ranged from least hygienic to most hygienic. Multivariable logistic regression models analysed the effect of hygiene scores on health outcomes, while adjusting for a number of important confounding variables. RESULTS: Increasing hygiene scores were independently associated with wheezing (OR = 1.04; 95% CI: 1.00 to 1.08) and atopic eczema (OR = 1.04; 95% CI: 1.01 to 1.07) between 30 and 42 months, but not in the first six months. The odds ratio was higher for atopic eczema if the rash was reported to have become sore and oozy (OR = 1.09; 95% CI: 1.02 to 1.16). CONCLUSIONS: High levels of hygiene at 15 months of age were independently associated with wheeze and atopic eczema reported between 30 and 42 months, and there was an increased risk for children with more severe eczema during this period. The importance of hygiene in public health should not be dismissed; however, the creation of a sterile environment through excessive cleanliness may potentially be harmful to the immune system.

Child, Preschool↗

PubMed2003

Correlates of sexual risk behaviors among HIV-positive men who have sex with men.

This study examines correlates of unprotected sexual risk practices of an ethnically diverse sample of HIV-seropositive men who have sex with men (MSM) from the New York City and San Francisco metropolitan areas. Participants completed a self-report survey that assessed sexual risk behaviors and potential correlates. A total of 367 men reported sex with a casual male partner in the previous 3 months. Participants were divided into three groups based on level of HIV-transmission risk with HIV negative or unknown-status partners: no unprotected anal sex (58.9%), unprotected receptive anal sex only (14.2%), and unprotected insertive anal sex (22.6%). Multivariate logistic regression analyses indicated that men reporting unprotected anal insertive sex perceived less responsibility to protect their partners from HIV. Men reporting no unprotected anal sex also reported less use of nitrate inhalants, lower temptation for unsafe sex, and fewer HIV-negative and unknown-status partners. Men reporting unprotected receptive anal sex were less anxious than the other two groups but also reported greater depression than those not reporting unprotected anal sex and greater loneliness than those reporting unprotected anal insertive sex. Implications for interventions with HIV-positive MSM are presented.

Adolescent↗

PubMedDate not supplied

[Recent determination of cholesterolemia in a healthy adult population from Pamplona].

BACKGROUND: The aims of the study were to assess the proportion of the healthy adult population from Pamplona who were aware of their blood cholesterol levels, and to identify factors associated with this awareness. METHODS: A cross-sectional study was implemented with personal interview to 1066 citizens from Pamplona selected by a random routes sampling procedure. The city was stratified in three urban districts according to the socioeconomic status (high, middle, low). The response rate was 91.8%. The crude odds ratios were computed and a multivariable logistic regression model was fitted using awareness of the blood cholesterol level as the dependent variable, and age, sex, socioeconomic status and smoking as independent variables. RESULTS: 71.2% of the sample (95% CI: 68.3-74.0) reported having some cholesterol determination during the last five years. The multivariate analysis disclosed that non-smokers were aware of their cholesterol levels more frequently than smokers (adjusted OR = 1.38; 95% CI 1.0-1.9), determination of cholesterolemia was also less frequent in individuals under 30 years old and in females (adjusted OR in males: 1.5; 95% CI 1.1-2.0). Regarding socioeconomic status, cholesterol measurement was more frequent in middle and high levels with adjusted OR = 3.2; 95% CI 2.2-4.71 and 1.59; 95% CI 1.11-2.27), respectively. CONCLUSIONS: Cholesterol awareness was more frequent in older individuals and among males. It is remarkable that blood cholesterol measurement was less likely in population groups with worse coronary risk profile (lower socioeconomic status, smokers). This study suggests that there is a need for improving the awareness and control of blood cholesterol levels in healthy adults from Pamplona.

Adult↗

PubMed2004

[Preliminary study on outcome assessment system of treatment of stroke].

OBJECTIVE: In order to scientifically reflect the real efficacy of TCM treatment and to preliminarily establish a definitely valid and reliable assessment system of stroke treatment, with multi-dimensional outcome assessment indexes, including efficacy evaluation system of conventional western medicine, syndrome evaluation criteria in TCM and quality of life assessment system. METHODS: An integrative approach of cross-sectional survey and prospective follow-up was adopted. Two hundred and forty-five case-episodes of stroke patients were assessed by determining such parameters as nerve functional deficit scale, grading of total status of living ability, activity of daily living (ADL), TCM stroke criteria of diagnosing-treatment, TCM syndrome related symptoms/signs, Health Survey Questionnaire (Short form 36, SF-36), and index of quality of life (QOL), and their construction and relation were analyzed by such methods as multivariate relation, partial relation, linear regression, factor analysis, Cronbach's alpha coefficients, and the responsiveness estimation. RESULTS: The multi-dimensional assessment system of stroke treatment, containing 57 indexes with clarified constructions and classification, was created, and its validity and reliability confirmed after assessement. Various degrees of relationship were found between different TCM Syndromes and different domains of QOL. CONCLUSION: The assessment system of stroke treatment preliminarily created has satisfied reliability and validity. It could be expected to reflect the real efficacy of TCM treatment more inclusive and accurate. TCM Syndrome indexes are considered to be the factor related to both domains of mental and physical health, particularly with the former, therefore, to improve the TCM Syndrome would imply improvement of the mental health, physical health and QOL of the patients.

Aged↗

PubMed1994

Prior crash and violation records of pilots in commuter and air taxi crashes: a case-control study.

With a case-control design, this study examined the relationships of crash/incident history, violation history, pilot age, flight experience, and recent flight time with the likelihood of being involved in commuter aircraft and air taxi crashes. Cases (n = 725) were pilots who had been involved in commuter aircraft or air taxi crashes during 1983-88, identified from the National Transportation Safety Board aviation crash data base. From the Federal Aviation Administration (FAA) airmen information system, 1,555 pilots were randomly selected as controls. Controls were frequently-matched with cases on medical class and calendar year. Different data bases within the FAA's airmen information system were linked to ascertain information about crash/incident and violation records in the previous 3 years, age, total flight time, and flight time in the prior 6 months. Multivariate logistic regression models were fitted to estimate odds ratios and evaluate dose-response effects, non-linear relationships, and interactions. Cases had significantly higher prevalence rates of prior crash/incident and violation records. The estimated odds ratio of being involved in a commuter aircraft or an air taxi crash was 1.7 (95% confidence interval [CI], 1.3-2.4) for crash/incident history, and 1.6 (95% CI, 1.1-2.2) for violation history. A "dose-response effect" was found with both crash/incident history and violation history, with higher odds ratios for pilots with crashes versus incidents or with more serious violations. Total flight time showed a diminishing protective effect. Either very small or very large recent flight time increased the risk of being involved in a commuter aircraft or an air taxi crash.

Accidents, Aviation↗

PubMed1996

Multiple tumour marker assays in advanced cervical cancer: relationship to chemotherapy response and clinical outcome.

Serum levels of squamous cell carcinoma antigen (SCC), CA 125 and CA 15.3 were measured in 102 patients with locally advanced cervical cancer undergoing neoadjuvant chemotherapy (NACT) and radical surgery. We found a significant correlation between SCC concentration and stage, histotype, cervical tumour size and lymph node status. For CA 125 and CA 15.3, no significant difference in the distribution of marker levels according to histopathological variables was found. In a multivariate analysis, histological type, FIGO stage and SCC positivity (> 5 ng/ml) proved to be independent predictors of response to neoadjuvant chemotherapy. Moreover, logistic regression analysis showed that CA 15.3 may be a significant adjunct to SCC in the prediction of chemotherapy response. Of the three markers tested, only CA 125 was significantly related to patient survival. In the multivariate analysis, clinical response to chemotherapy and CA 125 status (> 35 U/ml) retained an independent prognostic value. Our data suggest that the tumour markers used in this study could be useful in the management of locally advanced cervical cancer. Pretreatment serum levels of SCC, together with CA 15.3 assay, may be a useful tool in the determination of response to chemotherapy, while CA 125 assay could be evaluated as a prognostic risk factor in these patients.

Adult↗

PubMed1992

A multivariate analysis of weight-loss behavior.

This study used a theoretical framework with multiple variables in multivariate analyses (factor, multiple regression, and path analyses) to investigate the sociopsychological predictors of weight loss. Responses from 309 participants of a comprehensive weight-loss program indicated that self-assurance was the most significant predictor of actual weight loss, followed by weeks completed. Other factors, such as program satisfaction and perceived importance, indirectly predicted weight loss through the intervening variables of self-assurance and weeks completed. Differences in the factors predicting weight loss were observed between completers and dropouts. The implications of these results for professionals concerned with weight control are discussed.

Adult↗

PubMed1998

Results of interleukin-2-based treatment in advanced melanoma: a case record-based analysis of 631 patients.

PURPOSE: In patients with stage IV melanoma, durable responses have been reported with treatment regimens that involve high-dose interleukin-2 (IL-2). We analyze long-term results of 631 melanoma patients from 12 institutions who had received IL-2 alone, in combination with interferon alfa 2a or 2b (IFNalpha), or with cytotoxic drugs. METHODS: Case records that contained pretreatment parameters, response data, and updated survival information were collected. After univariate analysis, the multivariate evaluation of the impact of pretreatment parameters on response and survival was performed by logistic regression and Cox's regression, respectively. RESULTS: Patients were divided into four groups according to treatment: IL-2 alone (n=117), IL-2 and chemotherapy (n=49), IL-2 and IFNalpha (n=153), and IL-2, chemotherapy, and IFNalpha (n=312). The median survival of all patients was 10.5 months and the 2- and 5-year survival rates were 19.9% and 10.4%, respectively. Independent prognostic factors for response and survival were entirely different, treatment group being the only significant factor for response, and serum lactate dehydrogenase (LDH), metastatic site, and performance predicting survival. The addition of IFNalpha to IL-2 was associated with prolonged survival, but the effect of additional chemotherapy was less obvious. CONCLUSION: Serum LDH, metastatic site, and performance status are useful stratification factors for randomized trials in metastatic melanoma. The improved long-term survival rates observed in melanoma patients treated with IL-2/IFNalpha-containing regimens are notable in contrast to the reported 5-year survival rates of 2% to 6% achieved with chemotherapy, but because selection bias cannot be ruled out, the impact of IL-2, as well as all other components of the treatment regimens, on survival needs to be confirmed in prospective randomized trials.

Adult↗

PubMed1999

Personal risk factors for first-time low back pain.

STUDY DESIGN: A prospective study of personal risk factors for first-time low back pain. OBJECTIVES: To construct and validate a multivariate model to predict low back pain. SUMMARY OF BACKGROUND DATA: Various physical and psychological factors have been reported to increase the risk of low back pain, but conflicting results may be attributable to inaccurate "clinical" measures and to poorly validated statistical models. METHODS: A total of 403 health care workers aged 18-40 years volunteered for the study. None had any history of "serious" back pain requiring medical attention or time off work. The volunteers completed the following questionnaires: the modified somatic perception questionnaire, the Zung depression scale, and the Health Locus of Control. Anthropometric factors were quantified using standard techniques. The 3Space Isotrak device (Polhemus, VT) was used to measure lumbar curvature and hip and lumbar spine mobility. Leg and back strength and back muscle fatiguability were measured in functional postures. Postal follow-up questionnaires, sent after 6, 12, 18, 24, 30, and 36 months, inquired about back pain, and multivariate logistic regression was used to identify risk factors at each follow-up. RESULTS: The response rate fell from 99% at 12 months to 90% at 36 months, at which time 90 volunteers reported "serious" back pain and 266 reported "any" back pain. The following were consistent predictors of serious back pain: reduced range of lumbar lateral bending, a long back, reduced lumbar lordosis, increased psychological distress, and previous nonserious low back pain. Only the latter three were consistent predictors of "any" back pain. Physical factors had the most influence in a sub-population of volunteers who were new to the job. CONCLUSIONS: Personal risk factors explained up to 12% of first-time low back pain.

Adolescent↗

PubMed1994

Prognostic factors in inflammatory breast cancer and therapeutic implications.

223 inflammatory breast cancer patients were diagnosed at the Institut Curie between 1977 and 1987. Patients received chemotherapy and radiation treatment according to three consecutive randomised trials. Five- and 10- year survival rates were 41 and 32%, respectively. Disease-free interval rates were 25.5% at 5 years and 19% at 10 years. Parameters significantly linked with a pejorative prognosis in a multivariate analysis were: diffuse erythema, lymph node involvement, chest wall adherence, and age above 50 years. When therapeutic response parameters were included in the multivariate analysis, the five most important prognostic factors in order of significance were complete tumour regression after completion of induction treatment (at 8 months), complete regression of inflammatory symptoms after 3 months of neoadjuvant chemotherapy, limited erythema at presentation and, less significantly, complete regression of inflammatory symptoms at 8 months and tumour regression at 3 months. In conclusion, patients who achieved a rapid and complete remission had a better prognosis than patients who had an incomplete response to chemotherapy. High-dose chemotherapy and reversal or prevention of drug resistance will be evaluated in future trials. Detailed information on the biology of this disease should allow the design of new strategies aiming to improve patient management.

Adenocarcinoma↗

PubMed1991

Increased incidence of diabetes mellitus in relation to abdominal adiposity in older women.

The relationship between body fat distribution, measured by the ratio of waist-to-hip circumferences (WHR), and the 2 year incidence of diabetes mellitus was examined in a cohort of 41,837 women aged 55-69 years. The 399 women who reported the new onset of diabetes had a significantly greater mean body mass index (kg/m2) and WHR than non-cases. After adjustment for body mass index (BMI), age and education level using multivariate logistic regression, WHR was a significant independent predictor of diabetes in a dose-response fashion. Cases were 4.6 times (95% CI = 3.8, 5.6) more likely than non-cases to be in the upper tertile of WHR and 2.2 times (95% CI = 1.8, 2.7) more likely to be in the middle tertile. Women in the highest tertiles of both WHR and BMI had a 14.4-fold (95% CI = 9.5, 21.9) higher risk of diabetes than women in the lowest tertiles. These results demonstrate that increased abdominal adiposity is a significant independent risk factor for the development of diabetes mellitus in older women.

Aged↗

PubMed1997

A randomized study of epirubicin monotherapy every four or every two weeks in advanced breast cancer. A Hellenic Cooperative Oncology Group study.

PURPOSE: To evaluate the impact on the response rate in patients with advanced breast cancer (ABC) of the doubling of the dose intensity (DI) of epirubicin monotherapy. PATIENTS AND METHODS: From January 1991 until April 1996, 167 patients with ABC were randomized to receive epirubicin (110 mg/m2) either every four (81 patients, group A) or every two weeks (86 patients, group B). Filgrastim (5 micrograms/kg/daily) was administered prophylactically on days 2-12 of each cycle. RESULTS: The two groups were equally balanced in terms of major patient and tumor characteristics. Even though the median cumulative dose of epirubicin was identical in the two groups (651 mg/m2), the median DI of epirubicin was doubled in group B (27.2 vs. 52.9 mg/m2/wk, respectively). The complete response (CR) rate was significantly increased in group B (5%, 95% CI: 0.16%-9.84% vs. 17%, 95% CI: 8.9%-25.08%, P = 0.011), although overall response rates were similar (49% vs. 53%, P = 0.5957). Also, there was no significant difference in the incidence of grade 3-4 toxicity between the two groups. After a median follow-up of 25 months (range, 0.43-43.3+) no significant difference was observed in the duration of response (median, 10 months vs. 8.5 months, P = 0.5130), time to progression (median, 7.2 months vs. 7.4 months, P = 0.2970) or survival (median, 14.6 months vs. 14.9 months, P = 0.4483). Logistic regression analysis showed that performance status was a significant variable for response (P = 0.0068) and multivariate analysis using the Cox proportional hazards model revealed that performance status was significant for survival (P = 0.0049), while the presence of multiple metastases (P = 0.0020) was significant for time to progression. CONCLUSION: Doubling the planned DI of epirubicin monotherapy significantly increases the CR rate but has no influence on time to progression or survival in patients with ABC.

Adult↗

PubMed1993

Gender difference in mate preference among law students: divergence and convergence of criteria.

We examined six hypotheses derived from evolutionary theory regarding sex differences in mate-selection criteria. The subjects were 160 law students who viewed color photographs of live models that were paired with different status cues such as costume variation and descriptions of income and occupation. A multivariate analysis of variance and regression analyses revealed highly significant sex differences in the following responses: reported willingness to engage in unqualified sexual relations; reported willingness to have sexual relations with stimulus persons as compared with the willingness to engage in higher investment relationships such as dating and marriage; the effects of stimulus persons' status and physical attractiveness in determining thresholds of initial acceptability; and tradeoffs, that is the ability of high physical attractiveness to compensate for low status, and of high status to compensate for low physical attractiveness. Law students also responded to nine statements concerning prospective spouses' relative income, occupational prestige, and physical attractiveness. These responses exhibited sex differences consistent with those found in the experimental manipulation.

Adult↗

PubMed2003

Current Internet use and preferences of IVF and ICSI patients.

BACKGROUND: Nowadays, the Internet has a tremendous impact on modern society, including healthcare practice. The study aim was to characterize current Internet use by IVF and ICSI patients and to identify their preferences regarding Internet applications in fertility care. METHODS: A total of 163 couples with fertility problems awaiting an IVF or ICSI procedure in the University Medical Centre Nijmegen, The Netherlands, was asked to complete a written questionnaire on Internet use in general, and also for fertility-related problems, preferences regarding Internet applications in fertility care and demographic characteristics. RESULTS: The response rate was 82%. In total, 81% of infertile couples used the Internet. Multivariate logistic regression analysis showed ethnic background and annual family income to be significant predictors of Internet use. Some 66% of Internet users and 54% of the total study population used the Internet for fertility-related problems. The female partners were the main Internet users with regard to fertility-related issues. In terms of preferences of the study participants, the majority favoured personal medical information online. CONCLUSIONS: Most infertile couples used the Internet with respect to fertility-related problems and were interested in implementation of Internet applications in fertility care. Healthcare providers should actively participate in the development and implementation of Internet applications in fertility care.

Adult↗

PubMed2005

Radiographic measures of chronic periodontitis and carotid artery plaque.

BACKGROUND AND PURPOSE: Chronic periodontitis (CP) is associated with stroke and subclinical atherosclerosis, but clinical measurement of CP can be time consuming and invasive. The purpose of this study was to determine whether radiographically assessed CP is associated with nonstenotic carotid artery plaque as an ultrasound measure of subclinical atherosclerosis. METHODS: Panoramic oral radiographs were obtained from 203 stroke-free subjects ages 54 to 94 during the baseline examination of the Oral Infections and Vascular Disease Epidemiology Study (INVEST). CP exposure among dentate subjects was defined either categorically (periodontal bone loss > or =50% [severe] versus <50% bone loss) or via tertile formation (for dose-response investigation), with edentulous subjects categorized separately. In all subjects, high-resolution B-mode carotid ultrasound was performed. Carotid plaque thickness (CPT) and prevalence (present/absent) were recorded. Covariates included age, sex, smoking, diabetes, hypertension, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein cholesterol. RESULTS: Among dentate subjects with severe periodontal bone loss, mean CPT was significantly greater (1.20+/-1.00 mm versus 0.73+/-0.89 mm; P=0.003). CPT increased with more severe bone loss (upper versus lower tertile bone loss; P=0.049; adjusted for age, sex, and hypertension). This apparent dose-response effect was more evident among never-smokers. In a fully adjusted multivariate logistic regression model, severe periodontal bone loss was associated with a nearly 4-fold increase in risk for the presence of carotid artery plaque (adjusted odds ratio, 3.64; CI, 1.37 to 9.65). CONCLUSIONS: Severe periodontal bone loss is associated independently with carotid atherosclerosis. Panoramic oral radiographs may thus provide an efficient means to assess CP in studies of atherosclerosis risk.

Aged↗

PubMed2006

Recruitment of patients for a clinical trial: factors on the physician side and reasons on the patient side.

OBJECTIVES: To examine the factors related to actual patient recruiters among the physicians who initially agreed to collaborate in a randomized control trial. METHODS: We conducted a questionnaire survey of 679 physicians (512 actual recruiter and 167 non-recruiters) who had initially agreed to recruit patients for a clinical trial to determine factors to predict who would actually do so. RESULTS: Response rates among recruiters and non-recruiters were 87.5% and 73.1%, respectively. Multivariate logistic regression model showed that the proportions of regular users of computer [odds ratio (OR) =2.1, 95% confidence intervals (CI)=1.3-3.3] (p=0.002) and current participants in other clinical trials (OR=2.2, CI=1.5-3.4) (p=0.001) were significantly higher among recruiters than non-recruiters. Patients' reasons for non-participation as perceived by the physicians did not differ between recruiters and non-recruiters. CONCLUSION: Results of this study might be useful in predicting actual recruiters at the outset of clinical trials.

Adult↗