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PubMed1985

Reference equations for the single-breath diffusing capacity. A cross-sectional analysis and effect of body size and age.

A longitudinal study was implemented in an unpolluted rural area of northern Italy (near Venice), before the start of the operation of a large oil-burning thermoelectric power plant, in order to investigate the effects of the future exposure to air pollution and to elucidate the natural history of obstructive airways diseases. During the first cross-sectional survey, a sample of the general population (n=3,300, 8 to 64 yr of age) performed several lung function tests, and information on risk factors and on the presence of respiratory symptoms were obtained by a standardized questionnaire. There were 712 subjects who were classified as normal on the basis of rigid criteria and who were able to perform satisfactorily a single-breath CO diffusing capacity (DLCOsb) test. The DLCOsb values showed an increase with height and age early in life and a later decrease with age. Two age groups were selected to determine an age at which DLCOsb stopped increasing and began to decline. Reference equations were computed (using age and height) in these 2 different age groups in each of the sexes. Similar equations were calculated for the total lung capacity derived from single-breath helium dilution measurements. The DLCOsb values in this study were higher than reported by other investigators. The method of selection of the study population, the strict criteria for normal, as well as technical, differences probably explain this finding. Reference equations for diffusing capacity corrected to lung volume (DL/VA) were computed only for adults (much greater than 20) in both sexes, because age and height coefficients in young subjects were insignificant.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed2006

Practice size and quality attainment under the new GMS contract: a cross-sectional analysis.

BACKGROUND: The Quality and Outcomes Framework (QOF) of the new General Medical Services contract, for the first time, incentivises certain areas of general practice workload over others. The ability of practices to deliver high quality care may be related to the size of the practice itself. AIM: To explore the relationship between practice size and points attained in the QOF. DESIGN OF STUDY: Cross-sectional analyses of routinely available data. SETTING: Urban general practice in mainland Scotland. METHOD: QOF points and disease prevalence were obtained for all urban general practices in Scotland (n = 638) and linked to data on the practice, GP and patient population. The relationship between QOF point attainment, disease prevalence and practice size was examined using univariate statistical analyses. RESULTS: Smaller practices were more likely to be located in areas of socioeconomic deprivation; had patients with poorer health; and were less likely to participate in voluntary practice-based quality schemes. Overall, smaller practices received fewer QOF points compared to larger practices (P = 0.003), due to lower point attainment in the organisational domain (P = 0.002). There were no differences across practice size in the other domains of the QOF, including clinical care. Smaller practices reported higher levels of chronic obstructive pulmonary disease (COPD) and mental health conditions and lower levels of asthma, epilepsy and hypothyroidism. There was no difference in the reported prevalence of hypertension or coronary heart disease (CHD) across practices, in contrast to CHD mortality for patients aged under 70 years, where the mortality rate was 40% greater for single-handed practices compared with large practices. CONCLUSIONS: Although smaller practices obtained fewer points than larger practices under the QOF, this was due to lower scores in the organisational domain of the contract rather than to lower scores for clinical care. Single-handed practices, in common with larger practices serving more deprived populations, reported lower than expected CHD prevalence in their practice populations. Our results suggest that smaller practices continue to provide clinical care of comparable quality to larger practices but that they may need increased resources or support, particularly in the organisational domain, to address unmet need or more demanding QOF criteria.

Adult↗

PubMed2004

Relationship of good and poor Wisconsin Card Sorting Test performance to illness duration in schizophrenia: a cross-sectional analysis.

The authors investigated whether schizophrenic patients with good and poor performance on the Wisconsin Card Sorting Test (WCST) showed cognitive modifications related to duration of illness. Of the 154 patients evaluated with the WCST, 56 subjects had normal or mildly impaired performance and 98 showed impairment on the basis of the number of categories achieved (0-3 categories = poor performance). These subsamples were then cross-sectionally divided into three subsamples depending on length of illness (< 5 years, 6-10 years, > 10 years). The inclusion of 69 healthy controls allowed the effect of age to be taken into account. The schizophrenic group as a whole and the group of poor performers did not show differences in any of the WCST indices related to length of illness. Good performers instead showed improvement on the intermediate length-of-illness group (6-10 years of illness), and then decline in the third one (> 10 years). Good performers only showed a positive significant correlation between age, age at onset, educational level and successful WCST performance. Results for the poor performers support the hypothesis of no progressive 'deteriorating' course of schizophrenia, while good performers show an unstable pattern of cognitive functions. These data support the hypothesis that cognitive deficits associated with schizophrenia cannot be considered a unitary trait, but emerge along different hypothetical trajectories.

Adult↗

PubMed2001

Farm-related dermatoses in Iowa male farmers and wives of farmers: a cross-sectional analysis of the Iowa Farm Family Health and Hazard Surveillance Project.

Agricultural workers are exposed to a variety of hazards that increase their risk for dermatitis. Nevertheless, the prevalence, patterns, and risk factors for dermatitis have not been well characterized among farmers in the United States. We assessed the prevalence and risk factors for dermatitis among 382 male farmers and 256 wives of farmers in Iowa using a cross-sectional study design. From 1992 to 1994, we collected data on potential risk factors and dermatitis. The results showed that 9.6% of male farmers and 14.4% of wives of farmers reported dermatitis during the previous 12-month period. In multivariable models, a history of allergy (odds ratio [OR], 8.2; 95% confidence interval [CI], 2.0 to 33.3) was strongly associated with dermatitis among male farmers. Among wives of farmers, some college education (OR, 3.4; 95% CI, 1.1 to 9.9) and exposure to petroleum products (OR, 3.1; 95% CI, 1.3 to 7.0) were associated with dermatitis. These results can be used to form preventive efforts in controlling farmwork-related exposures.

Adult↗

PubMed2001

Association between job strain and prevalence of hypertension: a cross sectional analysis in a Japanese working population with a wide range of occupations: the Jichi Medical School cohort study.

OBJECTIVES: To explore the association between the prevalence of hypertension in a Japanese working population and job strain (a combination of low control over work and high psychological demands), and to estimate this association in different sociodemographic strata. METHODS: From a multicentre community based cohort study of Japanese people, sex specific cross sectional analyses were performed on 3187 men and 3400 women under 65 years of age, all of whom were actively engaged in various occupations throughout Japan. The baseline period was 1992-95 [corrected]. The association between job characteristics--measured with a Japanese version of the Karasek demand-control questionnaire--and the prevalence of hypertension defined by blood pressure and from clinical diagnoses were examined. Adjustments were made for possible confounders. The analyses were repeated for stratified categories of occupational class, educational attainment, and age group. RESULTS: In men, the level of job strain (the ratio of psychological job demands to job control) correlated with the prevalence of hypertension. In a multiple logistic regression model, job strain was significantly related to hypertension (odds ratio 1.18; 95% confidence interval 1.05 to 1.32), after adjustment for age, employment (white collar v blue collar), marital status, family history of hypertension, cigarette smoking, alcohol intake, physical activity, and body mass index. The stratified analyses showed significant excess risks in the subordinate groups compared with managers, blue collar workers, less educated workers, and the older age groups. This association was not significant in women. Multiple linear regression analyses, with systolic and diastolic blood pressures as dependent variables, did not show any significant association. CONCLUSIONS: The findings provided limited proof that job strain is related to hypertension in Japanese working men. Older men in a lower social class may be more vulnerable to the hypertensive effects of job strain.

Adult↗

PubMed2006

Higher patient perceived side effects related to higher daily doses of inhaled corticosteroids in the community: a cross-sectional analysis.

UNLABELLED: The range and extent of inhaled corticosteroid (ICS) side effects experienced by patients in the general community are likely to be underestimated. AIMS: To identify the side effects of ICS perceived by patients in the community and, through the use of a self-report questionnaire, measure their intensity, prevalence and relationship with daily medication dose. METHODS: Focus groups and in-depth interviews were conducted to identify side effects that patients associated with their use of ICS. In an international multicentre cross-sectional survey, 395 inhaler users from community pharmacy (mean age 50, 53% female), divided into 4 daily dosage groups (beta2-agonist without ICS n=66, beclometasone dipropionate (BDP) equivalent ICS low dose 400 microg, n=109; mid dose 401-800 microg, n=151; and high dose>800 microg, n=69) reported how much they were affected by these side effects on a 7-point Likert scale. RESULTS: Focus groups and interviews revealed 57 side effects that were associated with ICS use. Cross-sectional survey results showed significant differences in side effect perception between the four dosage groups for 31 items (all P0.01) and a rising intensity with increasing ICS dose for total side effect score (P<0.001). For ICS users reporting the most bothersome side effects (scoring 3 on 0-6 scale) there was a rising prevalence as ICS dose increased for 34 items. A multivariate model confirmed that mid and high ICS dosages were statistically significantly associated with side effect perception after controlling for the other factors and covariates. CONCLUSIONS: Higher daily ICS doses were associated with a higher intensity and a higher prevalence of many patient perceived side effects, lending support to the call for dose titration in clinical practice. Results indicate the usefulness of patient self-report scales for understanding the burden of side effects of ICS in the community.

Administration, Inhalation↗

PubMed2005

[Correlation of duplex sonographic stenosis grading by means of cross-sectional analysis and MR-tomographic blood volume flow quantification in unilateral stenosis of the internal carotid artery].

PURPOSE: Correlation of duplex ultrasonographic grading of unilateral internal carotid artery (ICA) stenosis and ICA blood volume flow (BVF) quantification. MATERIALS AND METHODS: Using a 2D cine phase-contrast MR technique, 62 patients with unilateral ICA stenosis at the level of the bifurcation between 50 % and 98 % and 20 age-matched normal controls were examined. BVF was measured in the stenosed ICA. Ultrasonographic grading of stenoses was based on cross-sectional duplex sonography (color Doppler flow imaging [CDFI], real-time compound imaging) and compared to the changes in BVF in the stenosed ICA. RESULTS: There was no statistically significant difference in BVF in stenoses of the ICA up to 70 % and in normal controls. ICA stenoses greater 70 % began to be hemodynamically relevant. With increasing stenosis, a decrease in BVF in the ipsilateral ICA was determined with a high and linear correlation of r = - 0.83. Normal controls showed a BVF in an ICA of 247.0 +/- 32.0 ml/min, patients with 70 % stenosis a mean BVF of 225.3 +/- 32.2 ml/min (P = 0.4) without significant reduction, patients with 80 % stenosis a significant reduction of BVF to a mean flow of 184.0 +/- 53.8 ml/min (P < 0.005), patients with 90 % stenosis a reduction of the mean BVF in the stenosed ICA to 84.6 +/- 41.9 ml/min (P < 0.0005) and patients with stenoses > 95 % a mean BVF of only 26.0 +/- 4.0 ml/min (P < 0.0005). In patients with unilateral ICA stenosis greater than 81 %, a significant decrease of BVF in the stenosed ICA was documented. CONCLUSION: Comparison of ultrasonographic grading of unilateral ICA stenosis and BVF determination in patients with ICA stenoses demonstrate a high correlation between increase in the stenosis and decrease in the ipsilateral blood flow beginning at 70 % stenosis. ICA stenoses greater than 80 % are significantly hemodynamically relevant.

Aged↗

PubMed1995

Changes observed in Doppler studies of the fetal circulation in pregnancies complicated by pre-eclampsia or the delivery of a small-for-gestational-age baby. I. Cross-sectional analysis.

The aim of this study was to compare changes in Doppler ultrasound studies of the fetal circulation in normal pregnancies with a group of pregnancies complicated by proteinuric pregnancy-induced hypertension (PPIH), delivery of a small-for-gestational-age (SGA) baby, or both. A total of 167 uncomplicated pregnancies with a term delivery of an appropriately grown baby (AGA) were used to define the normal range. Altogether, 123 high-risk pregnancies with a known outcome constituted the study group. A color duplex ultrasound machine was used to perform biometry and fetal Doppler studies. Measurements obtained from the fetal circulation included the umbilical artery (UA) pulsatility index (PI), the middle cerebral artery (MCA) PI and time-averaged velocity (TAV), the thoracic aorta (AO) PI and TAV. In addition, the ratio between the MCA PI and UA PI, the MCA PI and the AO PI, and the product of the MCA PI and AO TAV were used in the analysis. A total of 105 pregnancies had a complicated outcome. They were divided into three categories: PPIH only (pregnancies complicated by PPIH with the delivery of an AGA fetus, n = 17), SGA only (delivery of an SGA baby, with no evidence of PPIH, n = 55), and PPIH + SGA (pregnancies complicated by pre-eclampsia and delivery of an SGA baby, n = 37). The PPIH + SGA group represented true clinical intrauterine growth retardation. Cross-sectional reference ranges were created using the observations from the normal group. z-scores (standard deviation from the mean of the normal range) of the last observations made before delivery were calculated for each of the vessel velocimetry measurements and ratios. The statistical significance of z-score values was calculated using analysis of variance. The MCA and UA PI values showed the greatest deviation for any single-vessel parameter. The ratios of fetal Doppler indices (MCA/UA PI ratio, MCA/AO PI ratio and the MCA PI/AO TAV index) demonstrated greater deviation from normal than any individual vessel. The UA PI z-score for PPIH+SGA delivering < 34 weeks gestation (2.92) was significantly greater than the z-score for PPIH+SGA delivering > or = 34 weeks (1.20, p < 0.05). Fetal Doppler indices, in particular ratios that include measurements obtained from the cerebral circulation, help in the recognition of the small fetus that is growth-retarded. At term, evidence of fetal hemodynamic redistribution may exist in the presence of a normal umbilical artery PI. Fetal Doppler indices provide information that is not readily obtained from more conventional tests of fetal well-being.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

PubMedDate not supplied

Child mortality in Goa: a cross-sectional analysis.

This paper is a study of the determinants of child mortality in the relatively developed Indian state of Goa. Data from the National Family Health Survey (NFHS, 1992-93) conducted in the state of Goa have been used to examine the child mortality experiences of 1,331 women who were within a marriage lasting 15 years. An aggregated index of child mortality, which summarizes the mortality experiences of a woman with exposure adjustment, is the study variable. Maternal education and longer birth spacing were found to lower child mortality risks significantly.

Birth Intervals↗

PubMed1982

Implications of an expanding supply of physicians: evidence from a cross-sectional analysis.

In the fall of 1980 the Graduate Medical Education National Advisory Committee (GMENAC) issued a report estimating that the supply of physicians will increase by 43% from 1978 to 1990, compared with an increase of 11% in the United States population. GMENAC estimated that this will lead to a surplus of 70,000 physicians by 1990, increasing to 145,000 by the turn of the century. Particularly marked surpluses are estimated to occur for nearly all surgical specialties, as well as most medical subspecialties. This paper attempts to estimate the impact of this increase in the supply of physicians on health care utilization and spending for health care services. Using cross-sectional data for 1978 this study estimates that an increased supply of physicians increases hospital admissions, lengths of hospital stays, costs per hospital day, physician fees for specialty services, and physician expenditures per capita. However, physician incomes appear to be lower in areas with more physicians. Projections to 1990 indicate that total health expenditures may be $50 billion higher as a result of the increase in physician supply. Real incomes of physicians, however, may be no greater than in 1978.

Cross-Sectional Studies↗

PubMed1976

Perceptions of the use of drugs--a cross-sectional analysis.

Samples of six specific groups were surveyed regarding their differential perceptions of the use of drugs. Current use was discussed in terms of comparisons of different groups' ratings of each group, comparisons of differential use of drugs by each group and comparisons between each groups' perception of its own use and its perception of use by other groups.

Adolescent↗

PubMed1995

A cross-sectional analysis of WAIS-R aging patterns with psychiatric inpatients: support for Horn's hypothesis that fluid cognitive abilities decline.

WAIS-R aging patterns were examined for a group of 200 psychiatric inpatients. Inpatients were grouped into six age categories: less than 24, 24-28, 29-32, 33-38, 39-43, and greater than 43 years. Verbal and Performance sums of scaled score, subtest scaled score, and raw score total, and individual item score means were examined for each age category. The classical aging pattern was observed wherein more crystallized cognitive abilities remained stable over age groups of the life span while more fluid abilities dropped sharply with their increasing ages. Results supported the decline in fluid cognitive abilities hypothesis for WAIS-R aging patterns advocated by Horn in 1985 and Kaufman in 1990.

Age Factors↗

PubMedDate not supplied

Health effects of air pollution due to coal combustion in the Chestnut Ridge Region of Pennsylvania: results of cross-sectional analysis in adults.

Respiratory questionnaires (ATS-DLD-78) were administered to 5557 adult women in a rural area of Western Pennsylvania to evaluate the health effects of air pollution resulting from coal combustion. Air pollution data were derived from 17 air quality monitor sites and stratified to define low, medium, and high pollution areas. The means of 4 yr (1975-1978) annual averages for sulfur dioxide in each strata were 62, 66, and 99 micrograms/m3, respectively. Total suspended particulates were not tested as a risk factor because they reflected air pollution from sources other than coal combustion (e.g., agricultural, road dusts). Risks of respiratory symptoms were evaluated in a multiple logistic model that adjusted for several potential confounding factors. The risk of "wheeze most days or nights" in nonsmokers residing in the high and medium pollution areas was 1.58 and 1.26 (P = .02), respectively, relative to residents in the low pollution area. In the subset of residents who had lived in the same location for at least 5 yr, relative risks increased to 1.95 and 1.40 (P less than .01), respectively. An increased risk of grade 3 dyspnea in nonsmokers was associated with sulfur dioxide but did not achieve statistical significance (P = .11), and there was no association of cough or phlegm and air pollution in nonsmokers. Cigarette smoking characteristics were the major determinant of respiratory symptoms in smokers, and no independent association of air pollution was found. This study suggests that wheezing may be associated with ambient exposure to sulfur dioxide in nonsmokers, but no effect of sulfur dioxide on cigarette smokers was observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1993

The relationship of outlet densities to alcohol consumption: a time series cross-sectional analysis.

The implementation of regulations on access to alcoholic beverages, whether through beverage taxes or restrictions on the availability of this commodity through alcohol outlets, has often been proposed as a legitimate and politically feasible approach to the prevention of alcohol-related problems. Empirical studies of the effects of these approaches to regulation on alcohol consumption and problems, however, have not been unanimous in their support of these preventive measures. While support exists for the suggestion that increases in alcohol beverage prices reduce consumption and have preventive effects upon the occurrence of problems, relatively little evidence exists for the supposition that the regulation of alcohol availability will have similar preventive effects. The lack of evidence in support of the latter thesis rests primarily upon the difficulty of obtaining sufficient data to examine comprehensive models of access to alcohol. The current paper analyzes aggregate time series cross-sectional data from states of the U.S. to evaluate the relationships between alcohol beverage prices, availability, and alcohol sales within one analytic model. The model relates beverage prices and alcohol availability directly to alcohol sales in the context of an assumed simultaneous relationship between sales and availability. The results show that, independent of the effects of beverage prices, and controlling for the endogeneity of sales and availability, physical availability of alcohol was directly related to sales of spirits and wine.

Adolescent↗

PubMed2002

Aerobic work capacity in elite wheelchair athletes: a cross-sectional analysis.

OBJECTIVE: To give a descriptive analysis of aerobic capacity among elite wheelchair athletes in association with various personal characteristics and sprint or anaerobic capacity. DESIGN: Sixty-eight wheelchair athletes who participated in the World Games and Championships for the Disabled were included. Parameters for aerobic capacity were evaluated in a standardized wheelchair exercise test on a computer-controlled wheelchair ergometer at the games. The ergometer setting was individually tuned according to standardized procedures. RESULTS: Mean maximum power output was 72.2 +/- 36.7 W. Peak oxygen uptake showed similar strong variations among different subject groups. High values were seen in a group of six subjects with amputations. Results stressed that, apart from sex, functionality and training status had a strong influence on aerobic capacity. Anaerobic and aerobic capacity were strongly associated. CONCLUSIONS: Functionality, training status, and sex are important determinants of aerobic capacity. The functional classification used at international sports events is represented in the data, and further study into the possible contribution of standardized exercise tests within the issue of classification must be considered. The use of standardized exercise tests for the evaluation of training and for rehabilitation progress must be advocated, with power output being an important outcome measure at the level of ability, whereas oxygen uptake represents outcome at the level of organ systems.

Adult↗

PubMed1990

A cross-sectional analysis of variables impacting on AIDS-related knowledge, attitudes, and behaviors among employees of a Minnesota teaching hospital.

We examined variables that were correlated with the AIDS-related knowledge, attitudes, and behaviors among employees of a 455-bed acute-care Minnesota teaching hospital and its associated clinics, located in a low-prevalence area for HIV infection. In August 1987, an anonymous questionnaire was sent via interdepartmental mail to all employees (2,980), including 270 physicians. The four-page survey obtained demographic information and measured 14 variables, including degree of homosexual bias, degree of homophobia, and AIDS-related knowledge, behaviors, attitudes, and anxiety level. Responses were obtained from 2,351 (79%) of the employees. By multivariate analysis, the following variables were highly correlated with positive behaviors and attitudes toward AIDS patients (p less than .0001): lower homophobia scores, higher AIDS knowledge scores, expressed confidence in AIDS-related medical information, and a greater number of previous contacts with AIDS patients. Those with a family member or close friend with AIDS also showed more positive attitudes and behaviors (p less than .02). Level of education was correlated with knowledge about AIDS (p less than .0001) but was not correlated (p greater than .05) with more positive behaviors or attitudes inrelation to AIDS patients. Educational efforts should attempt to improve hospital employees' knowledge about AIDS and their confidence in AIDS-related medical information. Efforts to address homophobia should also be considered.

Acquired Immunodeficiency Syndrome↗

PubMed1999

Psychological and perceived situational predictors of physical activity: a cross-sectional analysis.

The purpose of this study was to identify psychological and self-reported situational factors that are associated with degree of involvement in moderate-intensity physical activity at various stages of adult life. The study is grounded in Personal Investment Theory which proposes that personal incentives, sense of self and perceived options determine behavior. Participants aged 18 and above, selected by random-digit dialling, were invited to participate in a study on physical activity habits. Of 251 who agreed to participate, 41.4% were male (N = 104) and 58.6% were female (N = 147). These participants were asked the number of days per week that they engaged in physical activity which accumulated a total of 30 min or more. The 140 participants who indicated one or more days of activity answered questions concerning personal incentives for physical activity, sense of self and perceived barriers. Stepwise multiple regression analyses and discriminant function analysis indicated that Personal Investment Theory is able to predict up to 29% of the variance associated with voluntary participation in moderate-intensity physical activity. Discussion focuses on implications for physical activity programs for citizens at different stages of their adult life.

Adolescent↗

PubMed1996

Cross-sectional analysis of Alzheimer disease effects on oral discourse in a picture description task.

To examine the relation of dementia severity to the quality and quantity of oral discourse of individuals with Alzheimer disease (AD), a picture description task was administered to elicit oral discourse samples from 63 AD subjects, five individuals with very mild cognitive impairment, and 52 normal controls. Eight measures of discourse were used: total words, information units, conciseness, circumlocutions, frustrations, aborted phrases, revisions, and ideational repetitions. Information units, which decreased with increased dementia severity, proved to be the best measure for evaluating the effects of AD on oral descriptive discourse. The conciseness index also decreased with increased dementia severity, and a significantly greater proportion of AD discourse samples contained ideational repetitions. Circumlocutions and frustrations rarely occurred, and although the discourse of AD subjects was more likely to contain an aborted phrase, the frequency of aborted phrases did not vary by stage of dementia. Revisions were commonly observed in the discourse of both normal controls and AD subjects and did not differentiate the two groups.

Aged↗