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PubMed2006

Selenium and antioxidant vitamin status of elderly German women.

OBJECTIVE: Low antioxidant intake and status have been shown to be associated with an elevated risk for various diseases. Data on the status of antioxidant vitamins, selenium and coenzyme Q10 of younger female seniors are scarce. The aim of this study was to assess the status of these antioxidants, as well as influencing factors such as dietary intake, anthropometric data and educational level in female seniors (60-70 years) in Germany. DESIGN: Dietary intake of alpha-tocopherol, beta-carotene and ascorbic acid was determined by a 3-day diet record. Serum concentrations of alpha-tocopherol, beta-carotene, ascorbic acid, selenium and coenzyme Q10 were measured. Anthropometric measures, socioeconomic and educational status were assessed. SETTING: In total, 178 elderly women without severe diseases in the region of Hannover, Germany, were included in the study. The mean (+/- s.d.) age and BMI of the women was 63.2 (2.73) years and 25.6 (3.77) kg/m2, respectively. The study participants were generally better educated than the overall German female population. RESULTS: Dietary intake of the ascorbic acid and alpha-tocopherol was below RDA in six and 75% of the women, respectively. In comparison to estimated desirable serum concentrations of alpha-tocopherol, ascorbic acid, beta-carotene and selenium, lower concentrations were found in 23, 1, 6, and 39% of the women, respectively. Ascorbic acid (r = 0.205, P = 0.009) and beta-carotene (r = 0.173, P = 0.025) intake were significantly associated with serum concentrations. Beta-carotene concentrations were influenced by the type of diet, BMI, and school education (R2 = 0.128, P < 0.001). Serum selenium was positively associated with alcohol intake (r = 0.229, P = 0.003). Neither employment nor vocational training was predictive for the serum concentrations of antioxidant vitamins, selenium or coenzyme Q10. CONCLUSIONS: Poor status of selenium and alpha-tocopherol is highly prevalent even among younger, well-educated female seniors, whereas ascorbic acid and beta-carotene status seems sufficient in most women.

Aged↗
PubMed1998

Depressive symptoms of Alzheimer caregivers are mainly due to personal rather than patient factors.

OBJECTIVES: To investigate the predictors of caregiver's depressive symptoms in a sample of community-dwelling Alzheimer's patients. DESIGN: A cross-sectional study was conducted in an Alzheimer's unit specifically devoted to the care of demented patients in Brescia Province (Italy). One hundred and three dyads were consecutively recruited between July 1994 and July 1995. Caregivers were sons/daughters (65%) or husbands/wives; mean age was 54.6 +/- 13.2. Alzheimer's patients Mini Mental State Examination score was 11.3 +/- 8.3; patients were equally distributed among disease severity levels. The following variables have been collected: (a) background and context variables (caregiver's age, gender, marital status, education, relationship and cohabitation with the patient, employment status, satisfaction with household income);(b) caregiver's personal resources (health, social relationships and social interactions, formal supports use, assistance and vigilance); (d) primary stressors (patient's age and gender, cognitive status, functional status, frequency of behavioural disturbances). Caregiver's depressive symptoms represented the main outcome measure. RESULTS: Being husband or wife, low self-rated health and caregiving competence, high numbers of hours for assistance and patient's behavioural disturbances and younger age were associated caregiver's depressive symptoms. With multivariate analysis only relationship to the patient, caregiver's health and competence were independent predictors of caregiver's depressive symptoms. CONCLUSION: Factors related to the caregiver--relationship, health and competence--rather than to the patient constitute the main risk factors for caregiver's depressive symptomatology.

Adult↗
PubMedDate not supplied

Is there any effect of compliance on clinical parameters of renal transplant recipients?

Noncompliance with regard to diet, medications and routine physician visits is frequently observed among some patient groups. This results in late graft dysfunction and behavior loss. In the present study, we defined compliance as attendance at 80% or more outpatient visits. The study included 63 cadaveric and 158 living-related renal transplant recipients namely, 150 men and 76 women of 8 to 70 years of age (median 38 +/- 12) who were operated between 1986 and 2001. Demographic data, number of visits attended per month, cigarette smoking, and alcohol intake were probed with a questionnaire that was delivered to the patients, 8 of whom died; hemophagocytic syndrome (n = 4), cardiovascular disease (n = 2), Kaposi' sarcoma (n = 1), and cerebrovascular bleeding (n = 1). Twenty-three patients had lost their graft. Compliance among men was lower than among women, a result that trended toward statistical significance (P =.087). Compliance was not related to marital status (P =.297), but tended to increase with educational background (P =.059). Graft loss (P =.546) and aging (P =.509) were not related to compliance. There was no relationship between compliance and mortality rate (P =.526). Interestingly, living-related kidney transplant recipients showed lower compliance than cadaveric kidney recipients, a result that was statistically significant (P =.04). Noncompliance was also related to cigarette smoking during the pre- and posttransplant periods (P =.008 and P =.03, respectively), as well as alcohol intake (P =.000). In conclusion, male gender and living-related donation are related to noncompliance, but (in contrast with literature) not young age, graft loss, or mortality. Compliance increases with educational status of the patients. Smoking and alcohol intake are closely related to noncompliance.

Adolescent↗
PubMed1977

Sociological and social-psychological correlates of anomia among a random sample of aged.

In this investigation the distribution of responses on an anomia index (Srole's anomia scale) was examined for a national probability sample of the elderly. Step-wise multiple regression procedures were used to determine the relative importance of the independent variables in explaining the variation of anomia. Of the zero-order correlations, the "sociological" variables, e.g., education, work status, occupational prestige, and yearly income, were the strongest correlates of anomia. The social psychological variables, viz., various attitudinal and perceptual phenomena, also exhibited reasonably strong correlations. Those variables labeled "activity/organizational," e.g., various indices of social engagement, revealed the lowest correlations. In step-wise regression analysis six statistically significant explanatory variables were, in descending order: (1) a judgement of one's relative financial standing, (2) city size, (3) race, (4) work status, (5) education, and (6) occupational prestige.

Aged↗
PubMed2002

Dairy foods and risk of breast cancer: a case-control study in Montevideo, Uruguay.

In order to investigate possible associations of milk and dairy products and the risk of breast cancer (BC) in Montevideo, the authors performed a case-control study in the period 1999-2001. A total of 333 women were interviewed with a specific questionnaire; 111 of them had been diagnosed with BC and 222 were frequency-matched healthy women, with a recent normal mammography (BIRADS 1). The questionnaire included a detailed 120-item food-frequency section, as well as questions related to socio-demographic, reproductive, familial, medical and lifestyle variables. There was particular emphasis on types of milk and dairy products. After controlling for age, years of urban status, education, body mass index, age at menarche, menopausal status, family history of BC, number of childbirths, total energy and total fruits, a multivariate analysis found that high intakes of whole milk, chocolate milk and Gruyère cheese were associated with significant increased risk of BC, whereas ricotta cheese and skim yoghurt were associated with significant decreased risks. Low-fat and fermented products combined appear to be the most protective dairy foods. The results suggest that separate analyses for types of milk and cheese, as well as for dairy products in general should be performed in the future.

Aged↗
PubMed2006

The impact of cognitive functioning on mortality and the development of functional disability in older adults with diabetes: the second longitudinal study on aging.

BACKGROUND: For older adults without diabetes, cognitive functioning has been implicated as a predictor of death and functional disability for older adults and those with mild to severe cognitive impairment. However, little is known about the relationship between cognition functioning on mortality and the development of functional disability in late life for persons with diabetes. We examined the relative contribution of cognitive functioning to mortality and functional disability over a 2-year period in a sample of nationally representative older US adults with diabetes who were free from cognitive impairment through secondary data analyses of the Second Longitudinal Study of Aging (LSOA II). METHODS: Participants included 559 US adults (232 males and 327 females) >or= 70 years old who had diabetes and who were free from cognitive impairment were examined using an adapted Telephone Interview of Cognitive Status (TICS), Activities of Daily Living (ADL), and Instrumental Activities of Daily Living (IADL). RESULTS: Multivariate logistic regression was conducted to investigate the independent contribution of cognitive functioning to three mutually exclusive outcomes of death and two measures of functional disability status. The covariates included in the model were participants' sex, age, race, marital status, educational level, duration of diabetes, cardiovascular disease (CVD) status, and self-rated health. Persons with diabetes who had the lowest levels of cognitive functioning relative to the highest level of cognitive functioning had a greater odds of dying (AOR = 0.80, 95% CI = 0.67-0.96) or becoming disabled (AOR = 0.87, 95% CI = 0.78-0.97) compared to those people who were disability free. CONCLUSION: Older adults with diabetes and low normal levels of cognition, yet within normal ranges, were approximately 20% more likely to die and 13% more likely to become disabled than those with higher levels of cognitive functioning over a 2-year period. Brief screening measures of cognitive functioning could be used to identify older adults with diabetes who are at increased risk for mortality and functional disability, as well as those who may benefit from interventions to prevent or minimize further disablement and declines in cognitive functioning.

Activities of Daily Living↗
PubMed2006

Acculturation, socioeconomic status, obesity and lifestyle factors among low-income Puerto Rican women in Connecticut, U.S., 1998-1999.

OBJECTIVES: To examine the associations of socioeconomic status and acculturation with obesity and lifestyle characteristics that may be risk factors for diabetes and cardiovascular disease among low-income Puerto Rican women. METHODS: This cross-sectional study was conducted between 1998 and 1999 by interviewing a convenience sample of 200 low-income Puerto Rican female caretakers of young children in Hartford, Connecticut, United States of America. Various recruitment methods were used to ensure adequate representation of the target community. The associations of obesity (body mass index > or = 30.0) and lifestyle factors (physical activity, cigarette smoking, alcohol consumption, food intake) with socioeconomic status (education, employment, car ownership), acculturation, age, and marital status were examined with Spearman rho, chi-squared, and Mann-Whitney U tests and logistic regression analyses. RESULTS: Mean age was 29 years. Obesity (40%), physical inactivity (47%), and cigarette smoking (32%) were common. Less acculturated participants were 57% less likely to smoke and 54% less likely to be obese than their more acculturated counterparts. Lower socioeconomic status (not finishing high school or not owning a car) was associated with a higher likelihood of obesity, but unemployed (vs. employed) women were less likely to be obese (P < 0.05). Women who did not own a car consumed meat, eggs and fish less often than those who owned a car. Smokers were more likely to have an unhealthy food intake pattern than nonsmokers. CONCLUSIONS: The associations of acculturation and socioeconomic status with some lifestyle characteristics suggest the need for culturally appropriate programs to promote healthy lifestyle behaviors in this low-income community.

Acculturation↗
PubMed2003

Racial and ethnic disparities in satisfaction with doctors and health providers in the United States.

OBJECTIVE: To assess racial and ethnic disparities in satisfaction with doctors and health providers in the United States. DESIGN: Analyses were based on cross-sectional data from a healthcare satisfaction module added to the 2000 Behavior Risk Factor Surveillance System (BRFSS), completed by 3 US states. METHODS: Cross-tabulations and multiple logistic regression. Five models were estimated with dependent variables involving satisfaction with doctors and health providers in the last 12 months with respect to how carefully they listen to the patient, explain so the patient can understand, show respect for what the patient has to say, spend enough time with the patient, and overall performance. Independent variables considered included race/ethnicity, age, gender, marital status, education, annual household income, regular physician, and health status. RESULTS: Hispanics, compared with Whites, were significantly more likely to be dissatisfied with overall healthcare and how their doctors and health providers listen, explain, show respect, and spend enough time with them. This difference became insignificant after adjustment for the other independent variables in the models, with the exception of the model involving listening carefully, where Hispanics were more likely to be dissatisfied (OR=1.6, 95% CI=1.0-2.6), and Blacks were less likely to be dissatisfied (OR=0.3, 95% CI=0.1-0.9). Each of the independent variables, except gender and marital status, were significant in at least one of the models, and regular physician and health status variables were significant in all of the models. CONCLUSIONS: With the exception of listening, race/ethnicity is not directly associated with the healthcare variables considered.

Adolescent↗
PubMed2006

Relationship between body size and severity of dengue hemorrhagic fever among children aged 0-14 years.

A hospital based case-control study was conducted from October 2002 to November 2003 among children aged 0-14 years at Queen Sirikit National Institute of Child Health (Children's Hospital), Bangkok, Thailand. This study focused on body size and severity of dengue hemorrhagic fever (DHF) in children. One hundred five patients diagnosed as having DHF grade III or IV were the cases and 105 diagnosed as having DHF grade I or II were controls. They were matched at a ratio of 1:1 by their gender and age (within 5 years). Normal growth charts were used to differentiate child body size into normal, thin and obese. Data were collected using face to face interviews with caregivers, questionnaires, laboratory and physical examination reports as research tools. Multiple logistic regression analysis revealed that only two variables were related to severity of DHF: obesity (OR = 3.00, 95 % CI = 1.20-7.48) and dengue virus type II (OR = 4.94, 95 % CI = 2.57-9.47), respectively. Other variables were childhood factors: duration of breast-feeding, education, and parity; caregivers factors: age, gender, marital status, education, occupation, family income, knowledge of DHF, antipyretic type, treatment before hospitalization, and duration of fever; environmental factors: history of DHF patients in house, house pattern, time from house to hospital, and residence; and etiological factors: type of infection and history of DHF among children. These factors showed no significant association (p > 0.05). This result can be utilized in a preventive and control program, particularly in more aggressive management of overweight children. Health personnel should continue to provide health education, particularly, signs and symptoms of shock, to the community and private sectors. Government and Non-Government Protective Projects in primary schools (5-9 years children) should be continued in the high risk groups.

Adolescent↗
PubMed1993

Racial comparison of outcomes of male Department of Veterans Affairs patients with lung and colon cancer.

BACKGROUND: A study was performed to distinguish between genetic vs socioeconomic factors or artifacts inherent in retrospective studies to discover explanations for the apparent shorter survival of blacks than whites with lung and colon cancer. METHODS: Detailed biological and socioeconomic data were collected prospectively from a large cohort of patients with advanced lung and colon cancer who had not previously received chemotherapy and who consented to be entered in the clinical trial. Twelve medical centers within the Department of Veterans Affairs hospital system (Veterans Affairs Cooperative Study 188) entered patients between May 1981 and May 1986. These patients were evaluated and treated in a uniform manner within this hospital system and followed up to death. Outcome measures included time to tumor progression, tumor response, and survival. RESULTS: A total of 719 patients were entered in the study, 704 of whom were either black or white men. Blacks were found to have a significantly lower socioeconomic status than whites as measured by marital and educational status, occupation, income, housing, and number of individuals residing in household. Blacks had a significantly lower frequency of prior tumor resection and a significantly increased frequency of mediastinal lymph node involvement and of metastasis than whites. Trends existed toward a shorter time interval from original diagnosis to entry and a lower frequency of prior radiation therapy among blacks in comparison with whites at the time of entry to the study. However, no differences in intensity of treatment or follow-up, time to progression, response to treatment, or overall survival (measured from entry to the study to death) were observed for blacks vs whites. CONCLUSIONS: Lung and colon cancer are not necessarily more aggressive diseases in blacks than in whites. Based on a comparison of these data with those reported from other practice settings, we postulate that lung and colon cancer outcomes may be similar among black and white patients who receive equal access to comparable medical care in spite of socioeconomic differences. Findings suggest that future studies might focus profitably on racial factors that may exist at the time of patient entry to the health care system.

Black or African American↗
PubMed2000

[Self-perception of health and mortality in elderly from a rural community].

OBJECTIVE: To assess the relationship between self-perception of their health and mortality in a representative sample of persons over 65 in a rural community. DESIGN: Survival study of population with three years observance. SETTING: A non-coastal and rural borough in Galicia. PARTICIPANTS: 408 people over 65, chosen by random sampling. MEASUREMENTS AND MAIN RESULTS: The demographic, social and health (objective and subjective) parameters were determined through an initial survey, with subsequent follow-up to find the date and cause of death should this have occurred. Of the 404 elderly people observed, 67 (16%) died. The main causes of death were diseases of the circulatory apparatus (48%) followed by tumours. Mortality was higher in people who were older, unmarried, didn't drink alcohol, were seriously ill, had restricted mobility, consumed more medicines and had a perception of their health as poor. We found an association between self-perceived health and mortality, after adjustment for age, sex, marital status, educational level and consumption of medicines, only when we looked at the elderly without restricted mobility (RR = 2.3; 95% CI = 1.0-5.3). CONCLUSIONS: We think that self-perception of health status can be an overall indicator of health, linked to mortality, and that in the elderly with good mobility, this association can be independent of age, sex, educational level, marital status and consumption of medicines.

Aged↗
PubMed2006

Association among education level, occupation status, and consanguinity in Tunisia and Croatia.

AIM: To investigate the association between education level, occupation status (a proxy for socio-economic status), and consanguinity in 2 large data sets from Tunisia and Croatia countries with different attitudes toward consanguinity. METHODS: The sample of 1016 students, attending 5 university institutions in Monastir, Tunisia, were interviewed about the educational level and occupation status of their parents and the degree of parental relatedness. In Croatia, a sample of 1001 examinees from 9 isolated island populations was interviewed about their own educational level, occupation status, and consanguinity. RESULTS: Prevalence of consanguinity (offspring of second cousins or closer) among 1016 Tunisian students was 20.1%, and 9.3% among 1001 Croatian isolates. In Tunisia, the association between consanguinity and both parental degree of education and parental occupation status was highly significant in women (P<0.001), but not significant in men. In Croatia, no statistically significant associations were noted, although there was a consistent trend of increased prevalence of consanguinity with lower education level or occupation status in both genders, but more pronounced in women. CONCLUSION: Association between education level, socio-economic status, and consanguinity needs to be taken into account in inbreeding studies in human populations. The relationship may be specific for each studied population and highly dependent on the cultural context. It is generally more pronounced among women in most settings.

Adolescent↗
PubMed2005

Surveys of Norwegian youth indicated that breast feeding reduced subsequent risk of obesity.

BACKGROUND AND OBJECTIVE: Breast-feeding protects against overweight in childhood, while it is uncertain if it is protective against adolescent and adult overweight. The objective of this study was to examine whether having been breast fed protects against adolescent and adult overweight and obesity. METHODS: Participants in the Oslo Youth study examined in 1979/1981 (n=635, mean age 13.1 years) and in 1999. Weight and height were measured in 1979/1981 and self-reported in 1999. Breast-feeding information was provided by the parents in 1979/1981. Potential confounders adjusted for included parents' body mass index and education, mother's smoking habits, participants' physical activity, smoking status, education and energy intake. RESULTS: Comparing those having been breast fed more than 3 months with those never breast fed, the adjusted odds ratios (95% confidence interval [CI]) between the two groups were 0.27 (0.13-0.56) for being overweight and 0.15 (0.03-0.72) for being obese in adolescent. In adulthood, the corresponding odds ratios were 0.64 (0.33-1.26) and 0.34 (0.12-1.01), respectively. CONCLUSION: Breast feeding during infancy appears to protect against adolescent overweight and obesity, while the effect on adult weight status is weaker. With increasing age, the impact of any protective physiologic mechanisms of breast feeding seen earlier in life tends to diminish.

Adolescent↗
PubMed1988

Status of menu item forecasting in dietetic education.

The status of forecasting techniques included in educational programs and the need for instructional material on this topic were investigated. A survey instrument was developed to determine which forecasting techniques were included in instructional programs. The validated questionnaire was mailed to directors of coordinated undergraduate programs or to Plan IV representatives at all universities with programs approved or accredited by the ADA. The response rate was 59%, or 156 dietetic programs. Analysis of the survey data revealed that mathematical techniques (Box-Jenkins, regression, exponential smoothing, moving average) were not taught in the majority of educational programs. Educators responded that forecasting was an important concept and that continuing education concerning forecasting techniques that may be employed in foodservice management was needed. As a result of the analysis of the data, two self-instructional modules that could be utilized by both practitioners and educators to enhance the level of practice and education were developed. Graduate and undergraduate students at 11 universities and 35 randomly selected practitioners tested the self-instructional modules. For all groups--undergraduate, graduate, and practitioners--the t-statistic was significant at the p less than .0000 level; thus the modules were effective in teaching foodservice forecasting concepts.

Dietary Services↗
PubMed2005

Environmental exposure to lead and its correlation with biochemical indices in children.

Lead is a global concern because of its ubiquity in the environment and known to be associated with abnormal neurobehavioral and cognitive development of young children. There is no study from India to describe a composite profile of blood lead and its biochemical influences in children. The present study was aimed at determining the proportion of children with >10 mug/dL blood lead levels (BLLs), association between BLLs, and sociodemographic characteristics, if any, and alterations in biochemical indices in the blood as an underlying mechanism of lead intoxication. A total of 62 children (4--12 y) of Lucknow and nearby areas were recruited to determine BLLs, delta-amimolevulinic acid dehydratase (delta-ALAD) activity, catalase (CAT) activity, and malondialdehyde (MDA) and glutathione (GSH) levels in the blood. Mean level of blood lead was 7.47+/-3.06 microg/dL (2.78--15.0) and 29%-exceeded 10 microg/dL, CDC intervention level. The BLLs were found to be significantly influenced by social status, area of residence, source of water supply, maternal educational status (p<0.001), type of house, and proximity to traffic density (p<0.01). delta-ALAD was significantly lower in the group of children with BLLs 11.39+/-1.39 microg/dL when compared to children with BLLs 7.11+/-1.25 microg/dL and 3.93+/-0.61 microg/dL (p=0.0007, 0.0005, respectively). However, CAT activity was higher in the groups of children with higher blood levels than with lower BLLs (p=0.0159, 0.0001, respectively). There was an increase in MDA level with a concomitant decrease of GSH in children with BLLs 11.39+/-1.39 microg/dL compared with those of children with BLLs 7.11+/-1.25 microg/dL and 3.93+/-0.61 microg/dL (p=0.0001, 0.0002, and p=0.0001, respectively). There was statistically significant correlation of BLLs with delta-ALAD (r=-0.44, p=0.00035), MDA (r=0.46, p=0.00018), GSH (r=-0.62, p=0.00001), and CAT (r=0.44, p=0.00035). Significantly, CAT activity, MDA, and GSH levels were in turn, found to be correlated with delta-ALAD (r=-0.45, p=0.00024; r=-0.43, p=0.00053; r=0.43, p=0.00053, respectively). Results of the present study indicate a declining trend of BLLs in children when compared with those reported from metropolitan cities of India when leaded gasoline was in practice and that the BLLs were significantly associated with biochemical indices in the blood which have the potential to be used as biomarkers of lead intoxication.

Biomarkers↗
PubMed2006

Relationships between self-reported unfair treatment and prescription medication use, illicit drug use, and alcohol dependence among Filipino Americans.

OBJECTIVES: We examined associations between self-reported unfair treatment and prescription medication use, illicit drug use, and alcohol dependence. METHODS: We used data from the Filipino American Community Epidemiological Survey, a cross-sectional investigation involving 2217 Filipino Americans interviewed in 1998-1999. Multinomial logistic and negative binomial regression analyses were used in assessing associations between unfair treatment and the substance use categories. RESULTS: Reports of unfair treatment were associated with prescription drug use, illicit drug use, and alcohol dependence after control for age, gender, location of residence, employment status, educational level, ethnic identity level, nativity, language spoken, marital status, and several health conditions. CONCLUSIONS: Unfair treatment may contribute to illness and subsequent use of prescription medications. Furthermore, some individuals may use illicit drugs and alcohol to cope with the stress associated with such treatment. Addressing the antecedents of unfair treatment may be a potential intervention route.

Adaptation, Psychological↗