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PubMed1994

Levels of burnout in general dental practitioners in the south-east of England.

There is some evidence to suggest that dentists suffer a high level of job-related stress. Specifically, social interaction between dentist and patient is considered to be a type of job-related stress which may produce 'burnout', a syndrome of emotional exhaustion, depersonalisation and reduced personal accomplishment that can occur in individuals whose work involves close personal contact with their clients. A study was carried out during January to June 1992 to assess the levels of burnout, using the Maslach Burnout Inventory, in three samples of British GDPs recruited from the south-east of England. A total of 440 dentists were surveyed and 340 usable replies were returned. There were high levels of burnout in the British dentists. A number of demographic variables relating to marital status, educational status, time since qualification, numbers of dentists in the practice, number of days per week spent in practice and the proportion of NHS/private work undertaken were identified as being associated with some aspects of the burnout syndrome.

Burnout, Professional↗
PubMedDate not supplied

Intensive positive behavior supports for adolescents with acquired brain injury: long-term outcomes in community settings.

BACKGROUND: Based on the technologies of applied behavior analysis and person-centered planning, positive behavior support is a process for designing and implementing proactive behavioral interventions with the goal of positive lifestyle changes. PARTICIPANTS: The two adolescents who received the intensive, longitudinal, multicomponent intervention had experienced escalating behavior challenges over several years after brain injury in early childhood. MAIN OUTCOME MEASURES: Quantitative data included episodes of aggression and property destruction. Qualitative data included intensity of supports, family involvement, peer relationships, medication regime, vocational status, educational status, community access, and self-help skills. RESEARCH DESIGN: A long-term, natural-environment, case-study method was used. RESULTS: The targeted challenging behaviors were reduced to zero. In addition, the participants' domains of activity increased and self-management improved even as supports were systematically withdrawn. CONCLUSIONS: These results illustrate the potential for successfully treating extreme chronic behavior disorders after childhood brain injury.

Adolescent↗
PubMed2000

Determinants of disability after lower extremity fracture.

BACKGROUND: Factors influencing the progression of physical impairment to patient-perceived disability are not well known. We sought to better understand this relationship in the setting of injury. METHODS: We followed a cohort of 302 patients with lower extremity fractures over a 1-year period. Physical impairment was assessed by range of motion, strength, and pain. Range of motion and strength were assessed together as a proportion of normal function of the extremity (impairment score). Pain was assessed using a Visual Analogue Scale (VAS) pain score. Disability was assessed using the Sickness Impact Profile (SIP), a widely used measure of patient-perceived limitations of everyday activities attributable to illness. The SIP was administered during hospitalization to assess preinjury baseline. Impairment assessment and readministration of the SIP were performed at 12 months after injury. RESULTS: Impairment in leg function (range of motion and strength) was highly correlated (p < 0.001) with overall SIP score at 12 months, but accounted for only 23% of the variance in overall SIP scores. Likewise, VAS pain score was highly correlated (p < 0.001) with overall SIP score at 12 months, but accounted for only 29% of the variance in overall SIP scores. In a multivariate linear regression analysis, variables that were independently associated with overall SIP score included impairment score, VAS pain score, preinjury SIP, poverty status, education status, social support, having hired a lawyer, and involvement with workers' compensation. These variables accounted for 52% of the variance in overall SIP scores at 12 months. CONCLUSION: The degree of physical impairment accounts for only a small amount of the variance in disability from lower extremity fracture. Identifiable patient characteristics including age, socioeconomic status, preinjury health, and social support together with impairment account for over half of the variance in long-term disability. Further research is needed to increase understanding of other factors that influence the progression of impairment to disability, especially those factors that may be amenable to intervention.

Adolescent↗
PubMed2005

Wine drinking is associated with increased heart rate variability in women with coronary heart disease.

OBJECTIVE: To test the hypothesis that alcohol consumption is positively related to heart rate variability (HRV) in women with coronary heart disease (CHD) and therefore that cardiac autonomic activity is potentially implicated in the mediation of the favourable effects of moderate drinking. DESIGN, SETTINGS, AND PATIENTS: Cross sectional study of female patients who survived hospitalisation for acute myocardial infarction or underwent a revascularisation procedure, percutaneous transluminal coronary angioplasty, or coronary artery bypass grafting. MAIN OUTCOME MEASURES: Ambulatory 24 hour ECG was recorded during normal activities. The mean of the standard deviations of all normal to normal intervals for all five minute segments of the entire recording (SDNNI) and the following frequency domain parameters were assessed: total power, high frequency power, low frequency power, and very low frequency power. A standardised questionnaire evaluated self reported consumption of individual alcoholic beverage types: beer, wine, and spirits. Other clinical characteristics, such as age, body mass index, smoking habits, history of diabetes mellitus, menopausal status, educational status, and treatment, were also assessed. RESULTS: Wine intake was associated with increased HRV in both time and frequency domains independently of other clinical covariates (for example, ln SDNNI was 3.89 among wine drinkers v 3.59 among wine non-drinkers in the multivariate model; p = 0.014). In contrast, consumption of beer and spirits and the total amount of alcohol consumed did not relate significantly to any of the HRV parameters. CONCLUSION: Intake of wine, but not of spirits or beer, is positively and independently associated with HRV in women with CHD. These results may contribute to the understanding of the complex relation between alcohol consumption and CHD.

Age Factors↗
PubMed2024

Prediction of metabolic syndrome using machine learning approaches based on genetic and nutritional factors: a 14-year prospective-based cohort study.

INTRODUCTION: Metabolic syndrome is a chronic disease associated with multiple comorbidities. Over the last few years, machine learning techniques have been used to predict metabolic syndrome. However, studies incorporating demographic, clinical, laboratory, dietary, and genetic factors to predict the incidence of metabolic syndrome in Koreans are limited. In the present study, we propose a genome-wide polygenic risk score for the prediction of metabolic syndrome, along with other factors, to improve the prediction accuracy of metabolic syndrome. METHODS: We developed 7 machine learning-based models and used Cox multivariable regression, deep neural network (DNN), support vector machine (SVM), stochastic gradient descent (SGD), random forest (RAF), Na&#xef;ve Bayes (NBA) classifier,&#xa0;and AdaBoost (ADB) to predict the incidence of metabolic syndrome at year 14 using the dataset from the Korean Genome and Epidemiology Study (KoGES) Ansan and Ansung. RESULTS: Of the 5440 patients, 2,120 were considered to have new-onset metabolic syndrome. The AUC values of model, which included sex, age, alcohol intake, energy intake, marital status, education status, income status, smoking status, dried laver intake, and genome-wide polygenic risk score (gPRS)&#xa0;Z-score based on 344,447 SNPs (p-value&#x2009;<&#x2009;1.0), were the highest for RAF (0.994 [95% CI 0.985, 1.000]) and ADB (0.994 [95% CI 0.986, 1.000]). CONCLUSIONS: Incorporating both gPRS and demographic, clinical, laboratory, and seaweed data led to enhanced metabolic syndrome risk prediction by capturing the distinct etiologies of metabolic syndrome development. The RAF- and ADB-based models predicted metabolic syndrome more accurately than the NBA-based model for the Korean population.

Humans↗
PubMedDate not supplied

Statistical profile of traumatic brain injury: a Canadian rehabilitation population.

A retrospective clinical hospital chart study was undertaken to prepare a statistical profile of traumatic brain-injured patients in rehabilitation. It included 498 consecutive admissions to the Traumatic Brain Injury Rehabilitation Program of the Queen Elizabeth Hospital (Toronto, Canada) from 1978 to 1991. Descriptive statistics were obtained for age, gender, marital status, educational status, occupational status, history of drug and alcohol use, cause of injury, month of injury and length of coma. Comparisons are made between the studied population and several Canadian centres, as well as international brain injury demographics in the literature. Results are discussed in terms of the gender differences and lifestyle parameters associated with brain injury.

Adolescent↗
PubMed2003

[Anemia among rural pregnant women living at 540 meters above sea level].

OBJECTIVE: To assess the prevalence of anemia among rural pregnant women living at 540 meters above sea level in Colima, Mexico. MATERIAL AND METHOD: A cross-sectional studied was carried out, we included women attending antenatal clinic between January 1996 and December 2000, who are not receiving prenatal iron and folato supplements previously. Blood samples were examined for hemoglobin (Hb) concentration. Information on date of examination, name, private residence, age, gestational age, marital status, educational status, work, menarche, parity, cesarean sections, miscarriages, intergestation lapse, and hemoglobin levels was recorded. The information was confirmed by visit at private residence. Altitude was derived from official maps. Our measures to diagnose anemia were gestational age and low hemoglobin concentration. Three groups were integrated with the following criterions: GROUP I: Gestational age 1st to 5th week, Hb less than 12.0 g/dL. GROUP II: Gestational age 6th to 15th week, Hb less than 11.0 g/dL. GROUP III: Gestational age 16th to 40th week, Hb less than 10.4 g/dL. We calculated percentages, frequencies, and prevalence. RESULTS: We found 35 women, 25.7% showed anemia, the higher Hb concentration was of 14.6 g/dL and the lower was of 9 g/dL. CONCLUSIONS: The prevalence of anemia was of 0 x 1000 women in-group I, 117 x 1000 women in-group II, and 437 x 1000 women in-group III.

Adolescent↗
PubMed2006

Gender and oral manifestations of HIV infection among adult Nigerians.

Oral manifestations were studied in 305 adult Nigerians with HIV infection. Data collected were demographic (age, sex, marital status, educational status and occupation) and clinical (mode of transmission, general manifestations and oral manifestations of HIV infection). The chi- square test was used in test for significance between variables and p values less than 0.05 were regarded as significant. A total of 47.5% patients had oral manifestations. There were 67.6% females and 32.4% males (p <0.001). The patients ranged in age from 19-70 years. Heterosexual contact with multiple sex partners was the most common mode of transmission of infection (42.9% in females and 74.5% in males, p < 0.05). Candidiasis was the most common oral manifestation (78.6% in females and 78.7% in males p >0.05). The study concluded that similar demographic and clinical characteristics were observed in the occurrence of oral manifestations of HIV infection in both male and female Nigerians.

Adult↗
PubMed1995

Epidemiology of meningococcal carrier state amongst recruits of a military training centre.

An epidemiological study was carried out to determine meningococcal carrier state amongst recruits of a military training centre. 360 recruits with divergent socioeconomic, ethnic backgrounds were studied. Epidemiological factors such as age, religion, educational status, housing conditions, family structure were considered. The overall carrier rate was 11.94%. Carrier rate was higher amongst recruits from poor background and joint families. No association was found between carrier state and smoking as well as those suffering from upper respiratory tract infection. Carrier rate was aslo studied in relation to age, marital status, educational back ground and region.

Adolescent↗
PubMed1996

Sexual behaviour, and knowledge and attitude towards HIV/AIDS among out of school youth in Bahir Dar Town, northwest Ethiopia.

Intervention to control the spread of HIV/AIDS in out of school youth is under way in Bahir Dar Town. This survey was therefore conducted in April 1994 to provide baseline data on sexual behaviour, knowledge and attitude towards HIV/AIDS. A total of 1115 out of school young people from eight randomly selected kebeles of the town were interviewed. Fifty one (4.6%) respondents said they have never heard of AIDS. Mean number of sexual partners for those who practised sex was 3.9 +/- 2.5. Knowledge scores were better than attitude and practice scores. Age, sex, marital status, educational status and occupation were significantly related with knowledge, attitude and practice scores (p < 0.05). The association of knowledge scores with attitude and practice scores was not statistically significant; p = 0.056 and p = 0.07, respectively. In addition to improving knowledge, emphasis should be given to other measures such as making the services accessible to the youth. A similar survey is recommended after the intervention programme is over.

Adolescent↗
PubMed1998

Perceptions of well-being among the older metropolitan and nonmetropolitan populations in the United States.

The relationships were examined between selected sociodemographic variables and perceptions of well-being among residents 60 years and older of metropolitan and nonmetropolitan areas in the United States. Multiple regression models were used in analyzing data from the 1982-1991 NORC General Social Survey. Such sociodemographic variables as gender, race, marital status, education, financial status, place of residence, religious membership, and religious attendance were independent variables. A composite score of perceptions of well-being was the dependent variable. Race, marital status, education, financial status, religious attendance, and place of residence were important to well-being; gender and religious membership were not significant. The effects of nonmetropolitan living also significantly enhanced perceptions of well-being. Other facets of mental health in metropolitan and nonmetropolitan areas were also examined.

Aged↗
PubMed2006

Influence of height on attained level of education in males at 19 years of age.

In this study it is hypothesized that taller individuals are more likely to move up the scale of educational attainment compared with shorter individuals from the same social background. Three national cohorts of 19-year-old males were considered: 29,464 born in 1967 and surveyed in 1986, 31,062 born in 1976 and surveyed in 1995, and 30,851 born in 1982 and surveyed in 2001. Four social variables were used to describe the social background of each conscript in the three surveys: degree of urbanization, family size, and parental and maternal educational status. The educational status of each conscript was classified into two groups: (1) those who were secondary school students or graduates, or who had entered college, and (2) those who had completed their education at the primary school level or who had gone to a basic trade school. Multiple binomial logistic regressions were used to estimate the relative risk of achieving higher educational status by 19-year-old males relative to height and the four social factors. Consistently across the three cohorts the odd ratios (ORs) indicate that height exerts an independent and significant effect on the attained level of education at the age of 19 years in males (1986: OR=1.24, p<0.001; 1995: OR=1.24, p <0.001; 2001: OR=1.20, p<0.001). Two possible, not mutually exclusive, selective mechanisms are postulated and discussed: 'passive' and 'active' action.

Adult↗
PubMed2004

Gender and procreation among patients with schizophrenia.

OBJECTIVE: Reduced procreation among men with schizophrenia has been reported consistently when compared with female patients, but the cause is unknown. Reports on Caucasian individuals predominate in the published literature. Therefore, analyses were conducted concurrently among independent Indian and US samples in the present study. METHOD: Individuals with schizophrenia or schizoaffective disorder (DSM-IV criteria) were ascertained and interviewed at New Delhi and in the northeastern United States using identical procedures (n=224 and 144, respectively). Selected indices of fertility and fecundity were compared among men and women at each site. RESULTS: In the smaller US sample, male cases were significantly more likely to be single and childless compared with female cases. They also had fewer children. In contrast, there were no significant gender differences in the larger Indian sample with regard to the reproductive indices. Multivariate analyses revealed that the indices of reproduction were associated with different variables in the US and Indian samples. Fertility (the presence or absence of offspring) was associated with gender and age in the US sample while in the Indian sample conjugal status and age were significant predictors. Fecundity (the number of offspring) was associated with gender, conjugal status and educational status in the US sample while in the Indian sample conjugal status and educational status were both significant. CONCLUSIONS: The reproductive deficit observed among US males was not observed among the Indian men. Conjugal status was a significant covariate for reproduction in both samples. The reproductive deficit may be due to difficulties in establishing long-term conjugal relationships among the US men. The differences may also reflect underlying cultural variations related to marital practices in these two countries. Our analyses suggest that the male reproductive deficit in schizophrenia is variable and may be overcome.

Adolescent↗
PubMed2003

Socio-demographic predictors of self-rated health in the Republic of Ireland: findings from the National Survey on Lifestyle, Attitudes and Nutrition, SLAN.

Though Ireland continues to have a poor health profile compared with other European Union countries, previous research on social variations has been limited. For the first time in the Republic of Ireland, the influence on self-rated health of various socio-demographic indicators was assessed in a multi-variate logistic regression model, separately for men and women. Data were from the first National Survey of Lifestyles, Attitudes and Nutrition, SLAN, conducted by post in a multi-stage, cluster random sample across 26 counties. There were 6539 respondents (45.4% males). Mean self-rated health differed significantly according to age, marital status, tenure, educational status, social class, household size and eligibility for general medical services (GMS), but not according to gender or rurality. There were also differences if residing in a district with low level of affluence, or according to social cluster groupings. There were numerous significant correlations between the nine socio-demographic measures, but the most consistent pattern was between GMS eligibility and the various indicators, for both men and women. In the case of men, whether social class was included in the multi-variate model or not, education status remained predictive in the final model, (OR 2.36 CI 1.35-4.12) as did smoking status (OR 2.11 CI 1.47-3.02). Odds ratio for GMS eligibility was 3.33 (CI 2.61-4.26) attenuated to 1.70 (CI 1.12-2.56) in the final model. For women the pattern was somewhat different. Only GMS status (OR 2.64 CI 1.74-3.99) and level of education (2.25 CI 1.19-4.24) were predictive in the final model. A multi-level analysis showed that area level of affluence was not significantly predictive of self-rated health when individual level factors were taken into account.

Adult↗
PubMed2006

Racial and socioeconomic disparity in perforated appendicitis among children: where is the problem?

OBJECTIVE: Significant racial, ethnic, and socioeconomic disparities have been observed in the rates of perforated appendicitis among children, by using large administrative databases. This study evaluated whether these factors had an impact on the care of patients with appendicitis at a major children's hospital with a well-established, comprehensive, primary referral system. METHODS: A retrospective analysis was performed for all children between the ages of 2 and 20 years who were treated for appendicitis between January 1, 2001, and December 31, 2003. Demographic variables included patient age, gender, race, insurance status, parental educational status, and income level. Coding data were used to identify patients with perforated appendicitis. The use of radiologic imaging was also analyzed. RESULTS: During the 3-year period, 788 patients were treated for appendicitis. The racial distribution (white: 81%; black: 12%; other: 7%) was consistent with the demographic composition of the local population. The overall perforation rate was 25%, and the rate was significantly greater in the age group of <6 years, compared with older children. However, there were no significant differences in the perforation rate with respect to race, insurance status, educational level, or income status. Rates of radiologic imaging use were similar among all racial and socioeconomic groups. CONCLUSIONS: Although racial and socioeconomic disparities in the rates of perforated appendicitis among children have been reported, we found no significant evidence for such inequality at our institution. This may reflect improved access, early diagnosis, and referral by primary care physicians in the community. Pooled national and multiple-state administrative databases have been used to highlight persistent disparities in health care. This study illustrates how single-institution data sources can be used to test a local hypothesis generated by national data, with surprisingly different results.

Acute Disease↗
PubMed2006

Traditional beliefs as forgotten influencing factors on breast-feeding performance in Turkey.

OBJECTIVE: The aim of this cross-sectional study was to identify the infant feeding practices and to evaluate the attitudes and beliefs of mothers on breast-feeding in Turkey. METHODS: This study was established in 10 provinces of Turkey between December 2000 and March 2001 and the study group was comprised of 1,767 women between the ages of 15-49 years (mean 27.6 +/- 6.4 years). Questionnaires were self-filled by mothers in the waiting rooms of the health centers. RESULTS: One hundred seventy-three women (9.9%) were illiterate, 829 (47.7%) had < or =5 years of schooling, and 83.4% were housewives. A significant number of women have traditional beliefs related to breast-feeding practices. According to 23.4% of the women at least 3 calls to prayer (average 12 hours) should be waited before the first breast-feeding postpartum and more than 30% of the mothers believe that colostrum should not be given to the newborn, some mothers breast milk could harm their babies, and an evil eye could harm their breast milk. The traditional belief status and educational status of the women differed significantly between provinces, lower educational status and higher rates of women with traditional beliefs were observed in less developed eastern provinces. Overall, 60.6% of the women were knowledgeable on breast-feeding practices, whereas only 13.5% were scored as good in attitudes. Among all women with breast-feed babies, 35.8% started supplementary feeding in the first 3 months of life. Mother's age, education, occupation and traditional beliefs did not have a significant effect on supplementation time. CONCLUSION: As a result, these findings suggest the importance of taking into account the customs, local beliefs and family influences in planning community health programs.

Adolescent↗
PubMed2000

Health outcome assessment before and after anterior cervical discectomy and fusion for radiculopathy: a prospective analysis.

STUDY DESIGN: A prospective assessment, performed using the Health Status Questionnaire, of the outcomes for 28 patients with cervical radiculopathy treated with one- or two-level anterior cervical discectomy and fusion. OBJECTIVE: To assess patient outcome using the Health Status Questionnaire after one- or two-level anterior cervical discectomy and fusion. SUMMARY OF BACKGROUND DATA: Although outcomes for many types of surgical procedures already have been evaluated, few have focused on the results of cervical surgery. METHODS: Before and after anterior cervical discectomy and fusion for cervical radiculopathy, 28 patients filled out the Health Status Questionnaire. The average follow-up interval was 21.8 months. There were 10 men and 18 women, with an average age of 44 years. All outcome instruments were graded for individual scores of general health, physical function, role limitation because of physical health problems, role limitation because of emotional problems, social function, mental health, bodily pain, and energy. Data were analyzed using the age (< 55 vs. > 55), worker's compensation status, and education status of the patient. Preoperative and postoperative scores were compared for each subscale. RESULTS: Statistically significant improvements were found in postoperative scores for bodily pain (P < 0.001), vitality (P = 0.003), physical function (P = 0.01), role function/physical (P = 0.0003), and social function (P = 0.0004). No significant differences were found before and after surgery for three health scales: general health, mental health, and role function associated with emotional limitations. Age, educational status, and history of compensation litigation did not appear to affect outcome measures. CONCLUSIONS: Although this is a preliminary report involving 28 patients, it would appear, based on the results of the Health Status Questionnaire, that anterior cervical discectomy and fusion performed on appropriately selected patients is a highly reliable surgical procedure for the management of cervical radiculopathy. Additional disease-specific questions may provide more sensitivity in evaluating radiculopathy after surgical and nonsurgical intervention.

Adult↗