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PubMed2004

Bone age progression during the first year of growth hormone therapy in pre-pubertal children with idiopathic growth hormone deficiency, Turner syndrome or idiopathic short stature, and in short children born small for gestational age: analysis of data from KIGS (Pfizer International Growth Database).

BACKGROUND/AIMS: The beneficial effects of growth hormone (GH) therapy on statural growth in children are well established, but the effects on skeletal maturation are less clear. The progression of bone age (BA) was therefore studied during the first year of GH treatment in pre-pubertal children with idiopathic GH deficiency (GHD), Turner syndrome (TS) or idiopathic short stature (ISS), and in short pre-pubertal children born small for gestational age (SGA). METHODS: Cross-sectional data on 2,209 short children with idiopathic GHD, 694 with TS, 569 with ISS and 153 with SGA were analysed. Longitudinal data were also analysed from 308 children with idiopathic GHD, 99 with TS, 57 with ISS and 29 with SGA. All patients included in the study were enrolled in KIGS (Pfizer International Growth Database) and were being treated with recombinant human GH (Genotropin). BA was assessed using the Greulich and Pyle method at baseline and after 1 year of GH therapy. RESULTS: In all groups of patients the mean progression of BA was 1 year during the year of GH therapy, although there was considerable individual variation. Progression of BA was not correlated with chronological age, BA, height SD score (SDS) or body mass index SDS at the onset of GH therapy. There was also no consistent effect of the GH dose on BA progression. CONCLUSION: Progression of BA appears to be normal in patients receiving GH in these diagnostic groups, at least over the first year of treatment in pre-puberty.

Aging↗

PubMed1999

Interpreting age, period and cohort effects in plasma lipids and serum insulin using repeated measures regression analysis: the CARDIA Study.

Observed changes in health-related behaviours and disease risk factors may arise from physiological or environmental changes, or from biases due to sampling or measurement errors. We illustrate problems in the interpretation of such changes with longitudinal data from the Coronary Artery Risk Development in Young Adults (CARDIA) study. Mean plasma cholesterol was 14 mg/dl higher in 27- than in 20-year-old black men cross-sectionally, but longitudinally it declined by 4 mg/dl during the 7 years. To sort out these contradictory assessments of the effect of age/passage of time, we estimated age and period effects under the assumptions that age effects are a smooth function of age independent of period, and that period effects are changes common to persons across all ages. Simple estimates the age effect, such as the cross-sectional age slopes, may be confounded by cohort effects, by interactions of time and age after baseline, or by the occurrence of non-linearities in response after baseline. We note examples of each potential type of bias. The data and background literature support the assumption that cohort effects do not seriously compromise interpretation for these variables in the CARDIA study. Strong secular decreases in plasma cholesterol, apparently due to population-wide dietary change, mask increases with ageing. Age increases in triglycerides are largely explained by increases in body fatness. For these data, we cautiously accept the cross-sectional age slope as an estimate of ageing and the age-matched time trend as an estimate of secular trend.

Adolescent↗

PubMed2005

More data on major depression as an antecedent risk factor for first onset of chronic back pain.

BACKGROUND: Few epidemiological studies have examined the temporal relationship between chronic pain and depression using longitudinal data. In the present study, we examined major depression as both an antecedent risk factor and consequence of chronic back pain (CBP) in the general population. METHOD: Data on 9909 pain-free individuals 15 years and older with no history of back problems were drawn from cycle 1 of the National Population Health Survey and followed up 24 months later. Major depression was assessed using a structured diagnostic interview. RESULTS: At cycle 2, the rate of new cases of CBP in persons who were depressed at cycle 1 was 3.6% compared to 1.1% in non-depressed persons. Compared to pain-free individuals, new cases of CBP were more likely to perceive their health status as poor or fair at cycle 1, were less likely to be working, reported more chronic health problems, and sustained a back or neck injury in the preceding 12 months. After controlling for other factors, pain-free individuals diagnosed as major depressed at cycle 1 were almost three times more likely (OR 2.9, 95% CI 1.2-7.0) to develop CBP at cycle 2. CONCLUSIONS: Consistent with other longitudinal studies major depression increases the risk of developing future chronic pain. The causal mechanism linking these conditions is unknown however depression may represent a modifiable risk factor in the development of CBP.

Adolescent↗

PubMed2006

Subchondral bone micro-architectural alterations in osteoarthritis: a synchrotron micro-computed tomography study.

OBJECTIVES: We evaluated the three-dimensional (3D) micro-architecture of subchondral trabecular (Tb) bone in osteoarthritis (OA). Due to high signal-to-noise ratio and high resolution, micro-computed tomography (micro-CT) by synchrotron radiation is considered as the gold standard for bone micro-architecture imaging. DESIGN: Subchondral bone were extracted from femoral heads in OA cases in areas without cartilage (OAc-; n=6) and in adjacent areas with cartilage (OAc+; n=6) and compared to eight subchondral bone cores from osteoporosis cases (OP). The voxel size of images was 10.13 microm. We measured the bone volume fraction (BV/TV) and morphological parameters: Tb thickness (TbTh), Tb spacing (TbSp), Tb number (TbN), and bone surface/bone volume (BS/BV). The degree of anisotropy (DA), the connectivity by the Euler number and the degree of mineralization (DM) were equally assessed. RESULTS: BV/TV and morphological parameters showed significant differences between OAc- and OP samples (P<0.01 except TbTh: P<0.05) and between OAc- and OAc+ (0.05<P<0.01) but no difference between OAc+ and OP except TbN (P<0.01). The connectivity was higher in OAc- comparatively to OAc+ and OP. The DA were significantly different between OA and OP cases (P<0.01) but not between OAc- and OAc+ specimens. The DMs (mean+/-SD) were 0.817+/-0.142 g/cm(3), 0.873+/-0.161 g/cm(3), 0.906+/-0.156 g/cm(3) for OAc-, OAc+, OP (P<0.01), respectively. CONCLUSION: Subchondral bone changes were mainly observed in advanced OA, when cartilage has been deleted and preserved in adjacent area. These data suggest that subchondral bone changes would be rather secondary to the cartilage deterioration than a primitive mechanism of OA. Nevertheless, longitudinal data could bring more accurate conclusions.

Aged↗

PubMed1995

Overly positive self-evaluations and personality: negative implications for mental health.

The relation between overly positive self-evaluations and psychological adjustment was examined. Three studies, two based on longitudinal data and another on laboratory data, contrasted self-descriptions of personality with observer ratings (trained examiners or friends) to index self-enhancement. In the longitudinal studies, self-enhancement was associated with poor social skills and psychological maladjustment 5 years before and 5 years after the assessment of self-enhancement. In the laboratory study, individuals who exhibited a tendency to self-enhance displayed behaviors, independently judged, that seemed detrimental to positive social interaction. These results indicate there are negative short-term and long-term consequences for individuals who self-enhance and, contrary to some prior formulations, imply that accurate appraisals of self and of the social environment may be essential elements of mental health.

Adaptation, Psychological↗

PubMed2005

Pediatric ARF epidemiology at a tertiary care center from 1999 to 2001.

BACKGROUND: Previous epidemiological data for pediatric patients with acute renal failure (ARF) predate current intensive care unit (ICU) technology and practice, and do not reflect newer disease therapies for bone marrow, hepatic, and cardiac transplantation and congenital heart disease surgery. METHODS: We conducted a retrospective review of 254 ARF episodes in 248 children discharged from a tertiary referral center, Texas Children's Hospital (Houston, TX), between January 1998 and June 2001 to update current pediatric ARF epidemiological characteristics. RESULTS: The most common causes of ARF were renal ischemia (21%), nephrotoxic medications (16%), and sepsis (11%). Primary renal diseases accounted for only 17 cases (7%), and hemolytic uremic syndrome accounted for only 3 cases. Overall ARF survival for the entire cohort was 176 of 254 patients (70%), whereas 110 of 185 patients (60%) requiring ICU admission and 43 of 77 patients (56%) receiving renal replacement therapy survived. CONCLUSION: These current pediatric ARF data show that pediatric ARF epidemiological characteristics have changed from primary renal disease to renal involvement secondary to other systemic illness. Longitudinal data from this cohort are underway to determine the long-term sequelae of pediatric ARF.

Acute Kidney Injury↗

PubMedDate not supplied

What leads to good health in midlife women physicians? Some clues from a longitudinal study.

Data from a longitudinal study of women physicians is used to study psychosocial and current implications of good health in midlife. The women comprise the classes 1964 to 1967 of the University of California School of Medicine at San Francisco. The subjects were interviewed and tested using the California Psychological Inventory while they were still in medical school (Time 1, average age 24 years) and at midlife (Time 2, average age 46 years). The women in good health at midlife, in contrast to their peers, were characterized by certain personality traits, including a higher degree of intellectual efficiency and empathy and relatively less hostility. Early antecedents of good health included having better educated parents. Good physical health at Time 2 was also predicted by Time 1 personality traits reflecting planful, logical, and efficacious use of intellectual resources and having optimistic, trusting relationships with others.

Adult↗

PubMed1993

Methadone dose and heroin use during maintenance treatment.

A retrospective study examined the association between methadone dose and in-treatment heroin use as measured by fixed-interval urine testing in a cohort of 62 patients admitted to an Australian maintenance program. Urinalysis and methadone dose data were collected on subjects for a maximum two years and were analysed using Zeger & Liang's (1986) method for modelling longitudinal data. While allowing for patient descriptors and the time period in which urine samples were collected, the relative odds of using heroin were reduced by 2% for every 1 mg increase in the maintenance dose of methadone. It is estimated that the odds of patients maintained on 40 mg of methadone using heroin were 2.2 times those of patients maintained on 80 mg.

Adult↗

PubMed1994

Alcohol in the mass media and drinking by adolescents: a longitudinal study.

Data from a longitudinal study carried out in Dunedin, New Zealand, were used to investigate associations between alcohol consumption at age 18 years and alcohol-related mass media communications recalled at ages 13 and 15 years. The respondents' recall of alcohol-related mass media material were categorized as: commercial alcohol advertising, alcohol moderation messages or the portrayal of alcohol in entertainment. An additional media variable was the number of hours spent watching television. Non-media variables, such as peer approval of drinking, living situation and occupation (all at age 18 years) were also included in the analyses. The period between the interviews at ages 13 and 15 years saw an increase in the broadcast of commercial alcohol advertisements on television in New Zealand and this was reflected in an increase in the proportion of the mass media material recalled which was categorized as commercial advertising. At age 15 years television advertising, mostly for beer companies, was the predominant material recalled. No relationships were found between the commercial advertising and wine and spirits consumption, among either men or women, but young women who had watched more hours of television drank more wine/spirits. Among women there were two unexpected negative relationships between recall of alcohol in the media at age 13 years and beer consumption. However, among men there was a consistent positive relationship such that those who had recalled more alcohol advertisements at age 15 years drank larger quantities of beer at age 18 years.

Adolescent↗

PubMed2004

Child welfare privatization: quantitative indicators and policy issues.

The purpose of this study was to demonstrate the development of safety, permanency, and child well-being indicators by using administrative data sets as well as by using these indicators as tools for evaluating Florida's Community-Based Care (CBC) initiative. Longitudinal data from 37 counties including 4 counties that implemented community-based care were examined in this study. The results of the study indicated that the overall performance of CBC counties is at least as good as the performance of their comparison run by the state counties. The findings that emerged from this study may provide important lessons for developing a performance measurement system in the child welfare field.

Child Welfare↗

PubMed2001

Understanding needs is important for assessing the impact of food assistance program participation on nutritional and health status in U.S. elderly persons.

This study aimed to assess the impact of food assistance programs on nutritional and health status of nutritionally needy elderly persons. Two cross-sectional and one longitudinal data sets were used: Third National Health and Nutrition Examination Survey (1988-94), Nutrition Survey of the Elderly in New York State (1994) and Longitudinal Study of Aging (1984-1990). Multiple logistic and linear regression analyses were used to examine whether food assistance participants among food insecure elderly (i.e., those whose needs for food assistance programs are met) have better nutrient intake, skinfold thickness and self-reported health status and less nutritional risk, hospitalization and mortality than nonparticipants (i.e., those whose needs are unmet) and whether the benefit is larger than that among food secure elderly persons. Across three data sets, food insecure elderly persons had poorer nutritional and health status than food secure elderly persons. Contrary to the hypotheses, among food insecure elderly persons, food assistance participants had similar or poorer nutrient intakes, skinfold thickness, nutritional risk, self-reported health status, hospitalization and mortality than nonparticipants. Food secure participants had similar nutritional and health status as food secure nonparticipants. Lack of information on the dynamic nature and changes in needs with program participation in the three data sets likely did not allow accurate estimation of the impact of food assistance participation. Different study designs, as well as theory and knowledge of needs that clarifies need status and its change within each older individual across an appropriate time interval, are necessary to accurately assess impacts of food assistance programs.

Aged↗

PubMed2005

Mx scripts library: structural equation modeling scripts for twin and family data.

Structural equation modeling (SEM) provides a flexible tool to carry out genetic analyses of family and twin data. The basic model which decomposes the variance between and within families for a particular trait into genetic and non-genetic components can be generalized to multivariate and/or longitudinal data, incorporate sex differences in parameter estimates, and model the effects of measured environment, candidate genes or DNA marker data. We introduce a web-based library (http://www.psy.vu.nl/mxbib) of scripts for uni- and multivariate genetic epidemiological analyses, as well as for linkage and genetic association tests. The scripts are written to be used with the freely available software package Mx and provide a flexible and uniform approach to the analysis of data from relatives.

DNA↗

PubMed1989

Productivity and collaborative patterns of physical educators.

The purpose of this study was to examine the extent to which gender ratio and patterns of collegiality intersect among physical educators in higher education. An indirect measure of patterns of collegiality was obtained from an examination of the gender of authors and of author teams. Specifically, the investigator focused on publication rates, gender of primary authors of mixed teams and dyads, and size and gender composition of author teams. The data base consisted of articles published by physical educators in 14 research-based physical education journals 1980-1984. In addition, a measure of change was obtained through a comparison of selected data of 1980 and 1984. The results showed that although on the average, women and men had published the same number of articles, type and degree of collaboration differed significantly. Women tended to publish alone while men tended to publish in groups. The data also indicated that men were accorded senior authorship of mixed sex teams significantly more often than were women. In addition, the longitudinal data indicated a decrease in the number of women who were senior authors. The results were explained in terms of the numerical and institutional domination of men physical educators in higher education.

Authorship↗

PubMed1994

Impact of joint impairment on longitudinal disability in elderly persons.

Recent longitudinal data indicating that arthritis is a major contributor to disability in elderly persons are based on self-reported diagnostic information. This longitudinal study included baseline physical examinations of joints of 541 persons over age 60. Previous results from a cross-sectional multivariate model of disability in this sample found that joint impairment (and, its absence, arthritis pain) explained a significant proportion of variance in overall disability. We have retested this model using generalized estimation equations (GEE) analysis to estimate the effect of joint impairment and arthritis pain on baseline and Year 2 disability. Findings indicate that baseline joint impairment contributes substantially to longitudinal disability. If direct measures of baseline joint impairment are unavailable, concurrent self-reported arthritis pain also predicts longitudinal disability well. These findings indicate that longitudinal studies should monitor arthritis pain and that symptomatic arthritis is a risk factor for future disability.

Activities of Daily Living↗

PubMed1975

Prediction of adult height from height, bone age, and occurrence of menarche, at ages 4 to 16 with allowance for midparent height.

Multiple regression equations for predicting the adult height of boys and girls from height and bone age at ages 4 and upwards are presented. There is a separate equation for each half year of chronological age; and for pre- and postmenarcheal girls at ages 11 to 14. These are based on longitudinal data from 116 boys and 95 girls of the Harpenden Growth Study and the London group of the International Children's Centre longitudinal study. The bone age used is the revised version of the Tanner-Whitehouse standards, omitting the score for carpal bones (RUS age, TW 2 system). Boys aged 4 to 12 are predicted in 95% of instances to within plus or minus 7 cm of true height, and at ages 13 and 14 to within plus or minus 6 cm. Girls ages 4 to 11 are predicted to within plus or minus 6 cm; premenarcheal girls aged 12 and 13 to within plus or minus 5 and plus or minus 4 cm, respectively; and postmenarcheal girls aged 12 and 13 to within plus or minus 4 and plus or minus 3 cm, respectively. Prediction can be somewhat imporved by allowing for midparent height. One-third of the amount that midparent height differs from mean midparent height is added or subtracted. An alternative system of equations which are based on initial classification by bone age rather than chronological age is given. These have about the same accuracy as the equations based on initial classification by chronological age, but allowance for bone age retardation is less. It is not clear which system is preferable. The equations probably apply to girls complaining of tall stature and boys or girls complaining of shortness and needing reassurance as to normality. In clearly pathological children, such as those with endocrinopathies, they do not apply.

Adolescent↗

PubMed2006

The Son-Rise Program intervention for autism: prerequisites for evaluation.

With increasing availability of interventions for children with autism, it is important that these are backed by rigorous evaluation data that have high levels of ecological validity. To achieve this, a key prerequisite for any evaluation is to gather data on typical consumers and typical implementation patterns of the intervention. This study collected such data longitudinally in relation to the Son-Rise Program, a home-based parent-run intervention for autism. Questionnaires and interview data on family demographics, implementation patterns, and perceived treatment fidelity were gathered three times over the course of a year from families who had attended a Son-Rise initial training course. Although it proved possible to produce a profile of intervention use, findings indicated that the programme is not always implemented as it is typically described in the literature. The study also highlighted methodological challenges likely to be encountered in any future evaluation of this and similar interventions for autism.

Autistic Disorder↗

PubMed1996

Healthcare cost of risk initiative: preliminary findings.

The Cost of Risk Initiative, jointly sponsored by HFMA and MMI Companies, Inc., is designed to identify the cost of risk in health care organizations and to gather case study examples of best practices in the management of the cost of risk. The first phase of the ongoing initiative, a pilot study, was completed in 1995. Although response to the pilot study was low, and the findings therefore are not statistically significant, the study provides initial insight into the cost of risk and the extent to which the cost of each component of risk contributes to the total cost of risk in various types of healthcare organizations. The total cost of risk ranged from 1 percent to 12.5 percent of net patient revenues among study participants. The organizations with the greatest average cost of risk were medical group practices. Costs for employee benefits, professional and general liability, workers' compensation, and risk management administration contributed the most to the total cost of risk. Baseline studies that will be conducted later this year and longitudinal data to be collected over the next five years will provide more reliable data that healthcare financial managers can use to assess and improve risk management in their organizations.

Cost Allocation↗

PubMed1992

Longitudinal study of the amniotic fluid index in post-dates pregnancy.

Amniotic fluid (AF) was measured in 511 post-dates pregnancies (at least 41 weeks of gestational age) with the use of the AF index. Ultrasonographic evaluations were conducted on a semiweekly basis. Only patients with reliable gestational ages calculated from certain last menstrual period and confirmed by early sonographic estimates participated in the study. Oligohydramnios (AF index of 5.0 cm or less) was detected in 11.5% of the study population. Longitudinal data were available from 121 patients who demonstrated a mean 25% decrease in AF index per week beyond 41 weeks' gestation. The longitudinal change in AF index was statistically significant (P less than .0005). Amniotic fluid index measurements ranged from 1.7-24.6 cm, with a mean of 12.4 at 41 weeks' gestation. Compared with previous cross-sectional studies, this longitudinal study provides a more accurate estimate of changes in AF levels as a function of gestational age.

Amniotic Fluid↗