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At least 379 records · Page 21Linked to original sources
PubMed2003

Assessment of quality of life in outpatients with advanced cancer: the accuracy of clinician estimations and the relevance of spiritual well-being--a Hoosier Oncology Group Study.

PURPOSE: To evaluate the association between quality-of-life (QOL) impairment as reported by patients and QOL impairment as judged by nurses or physicians, with and without consideration of spiritual well-being (SWB). PATIENTS AND METHODS: A total of 163 patients with advanced cancer were enrolled onto a therapeutic trial, and cross-sectional data were derived from clinical and demographic questionnaires obtained at baseline, including assessment of patient QOL and SWB. Clinicians rated the QOL impairment of their patients as mild, moderate, or severe. Clinician-estimated QOL impairment and patient-derived QOL categories were compared. Correlation coefficients were estimated to associate QOL scores using different instruments. The analysis of variance method was used to compare Functional Assessment of Cancer Therapy-General scores on categorical variables. RESULTS: There was no significant association between self-assessment scores and marital status, education level, performance status, or predicted life expectancy. However, a strong relationship between SWB and QOL was noted (P <.0001). Clinician-estimated QOL impairment matched the level of patient-derived QOL correctly in approximately 60% of cases, with only slight variation depending on the method of categorizing patient-derived QOL scores. The accuracy of clinician estimates was not associated with the level of SWB. Interestingly, a subset analysis of the inaccurate estimates revealed an association between lower SWB and clinician underestimation of QOL impairment (P =.0025). CONCLUSION: Clinician estimates of QOL impairment were accurate in more than 60% of patients. SWB is strongly associated with QOL, but it is not associated with the overall accuracy of clinicians' judgments about QOL impairment.

Activities of Daily Living↗
PubMed1998

Drug abuse--related mortality in the United States: patterns and correlates.

This study examines the sociodemographic determinants of psychoactive drug-related mortality in the United States, using data from the National Health Interview Survey (1987-1990 combined) linked with National Death Index data (deaths through 1991). Proportional hazards models are used to estimate the gross and net effects of age, sex, race, marital status, education, income, employment status, and health status on the risk of drug-related mortality. Results show that age, sex, and race (the main breakdowns in previous studies), as well as marital status, income, and health status have significant net effects on the risk of drug-related mortality.

Adolescent↗
PubMed2006

Factors associated with health-related quality of life among outpatients with major depressive disorder: a STAR*D report.

OBJECTIVE: Major depressive disorder (MDD) is often chronic and is often associated with significant morbidity and mortality. The importance of assessing disability and health-related quality of life (HRQOL) in patients with MDD has only recently been recognized. The aim of this study was to examine sociodemographic and clinical correlates of HRQOL in a large cohort of outpatients with MDD. METHOD: Baseline assessments were completed for 1500 consecutive patients enrolled in the Sequenced Treatment Alternatives to Relieve Depression trial, including sociodemographic characteristics and measures of depressive symptom severity, clinical features, and HRQOL. Multiple domains of HRQOL were assessed with the 12-item Short Form Health Survey, the Work and Social Adjustment Scale, and the Quality of Life Enjoyment and Satisfaction Questionnaire. The current analyses were conducted on HRQOL data available for 1397 of the 1500 subjects. RESULTS: Greater symptom severity was associated with reduced HRQOL by all measures. Even after age and symptom severity were controlled for, a number of clinical features and sociodemographic characteristics were independently associated with HRQOL in multiple domains, including age at onset of MDD, ethnicity, marital status, employment status, education level, insurance status, and monthly household income. CONCLUSION: Results strongly suggest the need to assess HRQOL in addition to symptoms in order to gauge the true severity of MDD. This study also highlights the necessity of measuring HRQOL in multiple domains. These results have implications for the assessment of remission and functional recovery in the treatment of MDD.

Adult↗
PubMedDate not supplied

Motives for smoking cessation are associated with stage of readiness to quit smoking and sociodemographics among German industrial employees.

PURPOSE: To test the relationships among particular motives for smoking cessation, stage of readiness to quit (preparation or contemplation), and sociodemographic characteristics. DESIGN: A cross-sectional study to examine attitudes toward and use of health promotion at the worksite, using a self-administered questionnaire. SETTING: Two German metal companies. SUBJECTS: Of 1641 responding employees (response rate 65% in company A and 44% in company B), 360 smokers who intended to quit immediately (n = 105) or in the near future (n = 255) were analyzed. MEASURES: The questionnaire comprised of sociodemographic characteristics, smoking behavior, smoking history, readiness to quit smoking, motives to quit, such as coworkers' complaints and health-related or financial concerns. Chi-squared tests and multiple logistic regression analyses were performed. RESULTS: Health-related reasons (94%) predominated financial (27%) or image-related (14%) reasons for smoking cessation. Participants in the cessation preparation group were more likely to report an awareness of being addicted (79.6% vs. 58.2%; p < .001) and the negative public image (22.5% vs. 11.6%; p < .01) as reasons for quitting compared with those in the contemplation group. In multivariable regression models, the motives for smoking cessation, including reduced performance, family's and coworkers' complaints, pregnancy/children, and negative public image, but not health-related and financial concerns, differed significantly by gender, age, marital status, education, and occupational status. CONCLUSIONS: Motives for smoking cessation vary according to the individual's level of readiness to quit and sociodemographic background.

Cross-Sectional Studies↗
PubMed2006

Knowledge and risks of human immunodeficiency virus transmission among veterans with severe mental illness.

This study is among the first to examine knowledge about human immunodeficiency virus (HIV) and behavioral risks for HIV transmission among veterans with severe mental illness (SMI), a group at high risk for HIV infection. This study examined associations between accuracy of HIV knowledge, risk behaviors, and clinical and demographic characteristics in a sample of male veteran psychiatric inpatients diagnosed with SMI (N = 353). Results showed high rates of inaccurate HIV knowledge, with > 40% of patients demonstrating some inaccuracies, particularly those related to the progression and symptoms of acquired immunodeficiency syndrome. Inaccurate HIV knowledge was associated with older age, minority status, education level, marital status, no homelessness within the previous 6 months, and no reported history of illicit intranasal drug use. There is a need for more effective HIV prevention interventions for persons with SMI.

Cross-Sectional Studies↗
PubMed2000

Platelet monoamine oxidase activity, ego strength, and neuroticism in soldiers with combat-related current posttraumatic stress disorder.

AIM: To assess possible differences in platelet monoamino oxidase-B (MAO-B) activity, ego strength, and neuroticism in combat-experienced soldiers with or without current posttraumatic stress disorder (PTSD). METHOD: The soldiers with current PTSD (N=36) and a control group of 34 healthy soldiers were matched in combat experience, time passed between combat experience and the study, demographic variables (age, marital status, education), and smoking status. Platelet MAO-B was assayed fluorometrically, ego strength was measured by the Croatian version of the Ego Identity Scale, and neuroticism by the N-scale from Eysenck's EPQ-R questionnaire. RESULTS: Soldiers with combat-related current PTSD had lower platelet MAO-B activity than the control group (9.1+/-3.9 vs. 11.9+/-4.0; p<0.05), as well as lower ego-strength (86.3+/-8.3 vs. 108.6+/-13.4; p<0.05) and higher neuroticism (23.5+/-13.2 vs. 5. 9+/-4.7; p<0.05). There was no association of ego strength or neuroticism with platelet MAO-B activity. CONCLUSION: Ego identity strength and emotional stability are associated with successful coping with combat trauma. The involvement of platelet MAO-B activity in biological basis of ego strength and neuroticism could not be demonstrated.

Adult↗
PubMed2001

[An analysis on the forearm bone mass density of rural female and the environmental risk factors].

The distribution of distal and proximal forearm bone mass densities (BMD) with age was discribed and the environmental risk factors of rural female analyzed. A group of 1432 rural female aged 15 and over were sellected. Their demographic characteristics, living and eating habit were obtained by standardized questionnaire. The distal and proximal forearm bone mass density were measured by peripheral dual-energy X ray absorptionmetry (pDEXA). The results showed that the distal and proximal forearm BMDs were increased with age before age 25 and 30 respectively, and reached the peak value at age 30-35. The distal forearm bone density decreased significantly at age 40 while the proximal forearm BMD decreased at age 45. Bone loss rate of the two bone sites was increased significantly at age 50 and reached the peak value at age 55-60. Only the the density of proximal forearm bone, and the year of menopause was the main cause of low bone density. Body weight was the positive factor for bone density at age less than 60. Height only positively affected the proximal forearm bone of those at age 30-45. More ever, drinking tea, parity and educational status may affect distal forearm bone in certain age group while parity, educational status, occupation and marital status were possible risk factors of proximal forearm BMD. It is concluded that environmental risk factors of BMD varied with bone site and age. The prevention of low BMD must rely on subject's age and bone site. The surveillance of low bone density must put the emphasis on spony bone.

Adult↗
PubMed2002

Patient complaints within 1 month of mild traumatic brain injury: a controlled study.

Symptom complaints of 118 patients with mild traumatic brain injury (MTBI), within 1 month postinjury, were compared with those of 118 control participants without a MTBI. The MTBI and control subjects were group-matched on age, gender, socioeconomic status (SES), and education status. Differences in symptom endorsements and severity ratings were found between the groups, with 16 of the 43 queried symptoms endorsed significantly more often (Bonferroni-corrected P<.00116) by MTBI patients than by controls. A total of 23 of the 43 symptoms were endorsed at a significantly higher severity by MTBI patients. The MTBI sample showed significantly higher within-group variability, with severity ranging from minimal to high. Perhaps because of this high variability, a logistic regression used to discriminate MTBI patients from controls was only moderately successful. This indicates that subjective complaints probably cannot be used, even soon after injury, to decisively distinguish individual MTBI patients from uninjured persons.

Journal Article↗
PubMed2006

Disparities in colorectal cancer screening: a guideline-based analysis of adherence.

PURPOSE: This study's primary objective was to describe colorectal cancer (CRC) screening disparities using a guideline-derived definition of CRC screening adherence while controlling for confounding factors associated with CRC screening. METHODS: This secondary data analysis of the 2000 National Health Interview Survey (NHIS) included 12,677 individuals age > or = 50 years. The primary outcome assessed was adherence to CRC screening guidelines, defined as a sigmoidoscopy or proctoscopy within the last five years, colonoscopy within the last 10 years, or home fecal occult blood test within the last 12 months. Age, race/ethnicity, gender, physical disability, household income, insurance status, education level, marriage status, rural or urban geographic area, and family history of CRC were analyzed as covariates in a logistic regression model. We assessed the association between these sociodemographic variables and receipt of physician recommendation for CRC screening among those respondents not adherent to CRC screening recommendations. RESULTS: In the multivariate model, the odds for being adherent with current CRC screening recommendations were lower for Hispanics (odds ratio [OR] 0.71, 95% confidence interval [CI] 0.59-0.86) and African Americans (OR 0.82, 95% CI 0.71-0.95) than for Whites. Residents of urban areas had higher odds (OR 1.19, 95% CI 1.06-1.34) of being up-to-date than rural residents. Among subjects who were not up-to-date with CRC screening, similar disparities were noted in receipt of physician recommendation for CRC screening. CONCLUSIONS: Certain groups are at increased risk of not receiving CRC screening or recommendations for screening from their physicians. Interventions to reduce these disparities should be an integral part of overall efforts to improve CRC prevention and control.

Black or African American↗
PubMed1991

Dietary habits of elderly persons with diabetes.

The dietary habits and nutrient intakes of a group of 151 persons with diabetes were compared with those of a group without diabetes in a random postal survey of 3,000 individuals aged 65 years and older residing in Adelaide, South Australia. A semiquantitative food frequency questionnaire was used. The response rate was 77%. Only 64% of individuals with diabetes reported following a diabetic diet at the time of the survey, and only 6% were consuming a high-carbohydrate, low-fat diet (greater than or equal to 50% energy intake from carbohydrate and less than or equal to 30% from fat). The dietary habits of elderly persons with diabetes suggested an awareness of the need to limit simple sugars; however, adherence to the latest recommendations concerning dietary fat and fiber was poor. Individuals with diabetes had lower intakes of refined carbohydrate but were just as likely as those without diabetes to eat high-fat foods, and they ate eggs and cheese more frequently. Those with diabetes were no more likely than those without diabetes to consume the recommended complex-carbohydrate and fiber-rich foods. The extent of adherence to current dietary recommendations for the management of diabetes was found to be independent of sex, age, occupational status, educational attainment, marital status, living arrangements (alone vs with a spouse), and source of income.

Aged↗
PubMed1991

Immunity against diphtheria in the age group 15 to 25 years.

Levels of diphtheria antitoxin in 254 serum samples were estimated in subjects in the age group 15 to 25 years with no previous history of immunisation against diphtheria using indirect haemagglutination test. All the individuals showed more than 0.03 IU/ml of diphtheria antitoxin level. This indicates that the age group studied was not susceptible to diphtheria. No significant relationship could be, however, ascertained between diphtheria antitoxin level and epidemiological factors like age, area (rural/urban), socioeconomic status, family size, education status and religion.

Adolescent↗
PubMed1996

Food patterns of elderly Europeans. SENECA Investigators.

OBJECTIVE: To compare actual food intake of elderly people in Europe and further identify food patterns, which mediate favourable or unfavourable nutrient intakes from cluster analysis of pooled data. DESIGN: Cross-sectional analysis of food patterns of participants of the SENECA follow-up study (1993). SETTING: Twelve traditional European towns. SUBJECTS: Men (n = 647) and women (n = 710) aged 74-79 y in 1993. METHODS: Food intake data were assessed using the same validated dietary history technique in all SENECA towns. Cluster analysis was used to classify subjects into groups based on similarities in dietary variables. RESULTS: A northern and southern European eating pattern emerged. The southern food pattern appeared to be the most healthful being rich in grain, vegetables, fruit, lean meat and olive oil. The north-south gradient did, however, not systematically segregate into the same clusters. All dietary profiles were represented in all sites. The four dietary profiles, identified by cluster analysis, were: 'Lean and green eaters': high carbohydrate and vitamin C intake, 'gourmands': high intake of energy and nutrients, 'milk drinkers': high intake of calcium and vitamin B2 and 'small eaters': marginal energy and nutrient consumption. Marital status, education, smoking, health status and physical activity level differed between clusters. CONCLUSIONS: A north-south gradient of food patterns was identified. The southern diet agreed better with guidelines for healthy eating. A sufficient energy intake seemed, however, to be necessary for an adequate nutrient intake, beside a good choice of food types.

Aged↗
PubMed1990

Effect on famine on child survival in Matlab, Bangladesh.

"This paper examines how the level of child mortality and rate of out-migration, and their covariates were affected during the 1974 famine and the periods immediately following the famine in Bangladesh." The authors examine several variables affecting mortality and out-migration, including socioeconomic status, sex factors, age factors, educational status, and religion. Data are from the Matlab Demographic Surveillance System.

Age Factors↗
PubMed1992

Faculty/student perception of organizational climates in the schools of nursing, Oyo State, Nigeria.

This study examined the influence of educational status and gender on the faculty and students' perceptions of their school climates. A self-designed questionnaire was used to elicit information from the 385 subjects (320 students and 65 tutors). Analysis using the t-test technique revealed that there were no significant differences at the 0.05 level of probability in the perceptions of: (a) faculty and students on climate variables "thrust" (t = 0.31) and "control" (t = 1.19); and (b) both sexes on climate variables "thrust" (t = 1.69), "control" (t = 1.13) and "disengagement" (t = -0.53). The conclusion therefore, is that educational status and gender have little or no influence on the peoples' perception of their school climates.

Educational Status↗
PubMed2001

Formal education and back pain: a review.

OBJECTIVES: To summarise the scientific evidence on the relation between educational status and measures of the frequency and the consequences of back pain and of the outcomes of interventions among back pain patients, and to outline possible mechanisms that could explain such an association if found. DESIGN: Sixty four articles published between 1966 and 2000 that documented the association of formal education with back pain were reviewed. MAIN RESULTS: Overall, the current available evidence points indirectly to a stronger association of low education with longer duration and/or higher recurrence of back pain than to an association with onset. The many reports of an association of low education with adverse consequences of back pain also suggest that the course of a back pain episode is less favourable among persons with low educational attainment. Mechanisms that could explain these associations include variations in behavioural and environmental risk factors by educational status, differences in occupational factors, compromised "health stock" among people with low education, differences in access to and utilisation of health services, and adaptation to stress. Although lower education was not associated with the outcomes of interventions in major studies, it is difficult, in light of the current limited available evidence, to draw firm conclusions on this association. CONCLUSION: Scientific evidence supports the hypothesis that less well educated people are more likely to be affected by disabling back pain. Further study of this association may help advance our understanding of back pain as well as understanding of the relation between socioeconomic status and disease as a general phenomenon.

Adolescent↗
PubMedDate not supplied

Figure connection test: a universal test for assessment of mental state.

The number connection test (NCT), which assesses the extent of organic brain damage, has been used extensively to evaluate mental state in portasystemic encephalopathy, but has certain inherent limitations. It cannot be performed by illiterates and those unfamiliar with Roman alphanumeric notations. We, therefore, devised a figure connection test (FCT) based on the subject's identification of figures rather than alphabets or numerals. Four variations each of FCT-A (A1-A4) and FCT-B (B1-B4) employing different motifs were developed and compared with four variations each of NCT-A (A1-A4) and NCT-B (B1-B4) in groups of healthy volunteers with differing educational status. These volunteer groups were as follows: postgraduates 64; graduates 66; subgraduates 75; and illiterates 45. Significant differences in mean scores of various tests were observed between these normal groups. Control values of the tests for these groups have been standardized and can serve as nomograms. The effect of educational attainments on performance of FCT and other psychometric tests was analysed and trail-making tests were validated for serial use. The FCT was then prospectively validated on 70 patients (classified for comparison with controls according to educational status as follows: postgraduates 7; graduates 21; subgraduates 32; and illiterates 10) with cirrhosis of liver without over encephalopathy, to detect subclinical hepatic encephalopathy. NCT-A was abnormal in 31.7%, NCT-B in 38.3%, FCT-A in 42.9% and FCT-B in 28.6% of patients. Taken together these tests diagnosed subclinical hepatic encephalopathy in 34 (48.5%) patients. We conclude that FCT is as useful as NCT in detecting psychomotor performance defects in cirrhotic patients without overt encephalopathy.

Adult↗