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PubMed2004

Relation between sense of coherence and glycemic control in type 1 and type 2 diabetes.

In this study, the authors examined the relation between glycemic control and sense of coherence (SOC) and the mediating role of psychological distress and of adherence to self-care behaviors in 67 people with type 1 and type 2 diabetes. In addition, 29 individuals without any chronic disease composed a control group. The authors determined glycemic control by glycosylated hemoglobin (HbA1c) measures. The participants answered a questionnaire that included questions about medical data, an adherence to self-care behaviors inventory, Derogatis' Brief Symptoms Inventory, and Antonovsky's SOC scale. People with diabetes showed higher levels of psychological distress than matched controls, but similar SOC scores. A path analysis revealed that SOC was indirectly related to glycemic control, through adherence to self-care behaviors and psychological distress. Adherence did not mediate the effect of psychological distress on glycemic control In addition, the type of diabetes of the subject was directly related to glycemic control. The model explained 38% of the variance of glycemic control. The results suggest a possible role of SOC in the psychological and physical wellbeing of people with diabetes. SOC should constitute a focus of further research, particularly studies of possible psychological intervention to enhance SOC in people with diabetes.

Adult↗

PubMed2026

AI-integrated digital breeding for crop improvement.

Crop breeding increasingly depends on the effective integration and interpretation of large, heterogeneous datasets spanning genomic, phenotypic, multi-omics, and environmental layers. Conventional breeding approaches are often insufficient to capture the complex relationships among these data or to support timely selection decisions. Digital breeding can help address this limitation by complementing field experimentation, mixed models, and genomic prediction with the integration of biological data and computational prediction throughout the breeding process. In particular, the rapid advancement of artificial intelligence (AI) has improved the analysis of high-dimensional datasets and broadened its application to trait prediction, selection, and breeding design. Here, we review recent developments in AI-enabled digital breeding, encompassing genomic, phenomic, and multi-omics data generation and analysis, predictive modeling, explainable and generative AI, and data-driven breeding decision support. We further discuss emerging AI applications, their current contributions to crop research and breeding, and the major considerations affecting their reliable and practical implementation. Collectively, this review provides a structured understanding of the roles of AI across the digital breeding process and offers guidance for future methodological development and practical application in crop improvement.

artificial intelligence↗

PubMed1990

Hard and soft interacting dimensions: differential effects of dual context on classification.

In this article, we extend Garner's speeded classification procedure to investigate processes underlying the interaction of the auditory dimensions pitch, loudness, and timbre. In the experiments reported here, subjects classified attributes on these three auditory dimensions. Our extended procedure, called multiclass, is based conceptually on our model of how such dimensions interact; the model explains the perception of attributes from an attended dimension through the action of contextual constraints created by variation along an unattended dimension. Two forms of context are present simultaneously in each multiclass task: intraclass context, variation along the unattended dimension that interferes with the classification of attributes, and redundant context, variation along the unattended dimension that enhances classification. We find that such dual-context situations reliably distinguish two kinds of interacting dimensions. Subjects classifying hard dimensions, here pitch and timbre, resist the ill effects of intraclass context and reap gains from redundant context. Subjects classifying soft dimensions, here loudness, show interference because the attributes are veiled perceptually in dual context. These findings, we argue, demonstrate the power of the multiclass procedure and fit well our view that dimensional interaction entails processing both at the level of the stimulus whole and at the level of stimulus attributes.

Adult↗

PubMed2004

Variables affecting the academic and social integration of nursing students.

This study attempted to analyze the variables that influence the academic integration of nursing students. The theoretical model presented by Leigler was adapted to the existing conditions in a school of nursing in northern Israel. The independent variables included the student's background; amount of support received in the course of studies; extent of outside family and social commitments; satisfaction with the school's facilities and services; and level of social integration. The dependent variable was the student's level of academic integration. The findings substantiated four central hypotheses, with the study model explaining approximately 45% of the variance in the dependent variable. Academic integration is influenced by a number of variables, the most prominent of which is the social integration of the student with colleagues and educational staff. Among the background variables, country of origin was found to be significant to both social and academic integration for two main groups in the sample: Israeli-born students (both Jewish and Arab) and immigrant students.

Acculturation↗

PubMed2003

[Factors influencing care dependency in patients with dementia].

PURPOSE: The purpose of this study was to explore factors that influence care dependency of institutionalized patients with dementia. METHOD: This study utilized descriptive correlational design. The convenience sample was composed of 110 residents with dementia of two long-term care facilities in Korea. Stepwise multiple regression was used to identify significant factors influencing care dependency in patients with dementia. Care dependency was measured using the Care Dependency Scale, Korean version(CDS-K). Cognition was measured by the MMSE-K. Functional disability was measured by the PULSES Profile. Behavioral dysfunction was measured by the modified E-BEHAVE AD. RESULT: Care dependency was significantly influenced by cognition, functional disability, behavioral dysfunction, and duration of dementia. This regression model explained 61% of the variances in care dependency. Cognition explained 37% of the variances, and functional disability explained 21% of the variances. CONCLUSION: Results of this study suggest that professional caregivers intervene more effectively in caring for their patients with dementia by recognizing the patients cognitive, functional, behavioral disability, and its periodic change. Individually, remaining abilities-focused intervention should be applied to enhance patient to be dependent and to prevent unnecessary independency.

English Abstract↗

PubMed2003

The attribution of somatization in schizophrenia patients: a naturalistic follow-up study.

BACKGROUND: Knowledge is limited concerning somatic symptoms that cannot be accounted for by detectable somatic illness among schizophrenia patients. This study aimed to explore the prevalence, correlates, and predictors of somatization among schizophrenia patients. METHOD: Initial data on all consecutively admitted adult patients with DSM-IV schizophrenia, schizoaffective disorder, major depressive disorder, or bipolar disorder were collected between August 1998 and August 2000. Standardized measures of psychopathology, somatization, emotional distress, adverse effects, insight, and stress process-related (psychosocial) variables were administered to 237 schizophrenia patients at admission and at least 12 months thereafter (N = 148). Partial correlation and multiple regression analyses were performed. RESULTS: The frequency of somatization, defined as the presentation of 5 or more medically unexplained somatic symptoms (Somatic Symptom Index-5), among the inpatient population (27%) did not change significantly after at least 12 months (30%; p =.61). Regression analysis showed that somatization scores were best predicted by the combination of scores for emotional distress attributed to psychopathology and side effects, expressed emotion, and insight. This combined model explains at least 40% of the variance in somatization scores. Self-esteem and social support showed negative association with somatization scores. Somatization scores were not associated with gender, age, education, age at onset, observed severity of psychopathology, subtype and duration of illness, number of admissions and treatment settings, or type and dose of antipsychotic agents. CONCLUSIONS: Somatization is a prevalent problem among schizophrenia patients and is associated with emotional distress attributed to psychopathology, side effects of antipsychotic agents, and family members' attitudes toward schizophrenia patients. This study suggests that insight, self-esteem, and social support may protect against somatization in schizophrenia patients.

Adult↗

PubMedDate not supplied

The relationship between obesity and the prevalence of fast food restaurants: state-level analysis.

PURPOSE: Obesity accounts for approximately 300,000 deaths a year in the United States, and prevalence rates have been increasing over the past decade. The nutrition environment may be contributing to this epidemic. This study examined the relationship between fast food restaurants and obesity on a state-wide basis. DESIGN: A one-time cross-sectional analysis of secondary data was used for this study. SETTING: The setting for this study was the United States. SUBJECTS: State-level data were used as the unit of analysis. Alaska was excluded as an outlier, and the District of Columbia was added (N = 50). MEASURES: Measures included aggregate state-level means for square miles per fast food restaurant, population per fast food restaurant, population density, ethnicity, age, gender, physical inactivity, fruit and vegetable intake, and obesity rates. Data were obtained from the 2002 Behavioral Risk Factor and Surveillance Survey, the 2000 U.S. Census, and the 2002 U.S. Yellow Pages. RESULTS: Multiple hierarchal regressions revealed that square miles per fast food restaurants and residents per restaurant accounted for 6% of the variance in state obesity rates after controlling for population density, ethnicity, age, gender, physical inactivity, and fruit and vegetable intake. The entire model explained 70% of the total variance in state obesity rates. CONCLUSIONS: These results indicate a correlational relationship between both the number of residents per fast food restaurant and the square miles per fast food restaurants with state-level obesity prevalence. Limitations include the use of correlational aggregate data.

Adolescent↗

PubMed1999

A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group.

BACKGROUND: Serum creatinine concentration is widely used as an index of renal function, but this concentration is affected by factors other than glomerular filtration rate (GFR). OBJECTIVE: To develop an equation to predict GFR from serum creatinine concentration and other factors. DESIGN: Cross-sectional study of GFR, creatinine clearance, serum creatinine concentration, and demographic and clinical characteristics in patients with chronic renal disease. PATIENTS: 1628 patients enrolled in the baseline period of the Modification of Diet in Renal Disease (MDRD) Study, of whom 1070 were randomly selected as the training sample; the remaining 558 patients constituted the validation sample. METHODS: The prediction equation was developed by stepwise regression applied to the training sample. The equation was then tested and compared with other prediction equations in the validation sample. RESULTS: To simplify prediction of GFR, the equation included only demographic and serum variables. Independent factors associated with a lower GFR included a higher serum creatinine concentration, older age, female sex, nonblack ethnicity, higher serum urea nitrogen levels, and lower serum albumin levels (P < 0.001 for all factors). The multiple regression model explained 90.3% of the variance in the logarithm of GFR in the validation sample. Measured creatinine clearance overestimated GFR by 19%, and creatinine clearance predicted by the Cockcroft-Gault formula overestimated GFR by 16%. After adjustment for this overestimation, the percentage of variance of the logarithm of GFR predicted by measured creatinine clearance or the Cockcroft-Gault formula was 86.6% and 84.2%, respectively. CONCLUSION: The equation developed from the MDRD Study provided a more accurate estimate of GFR in our study group than measured creatinine clearance or other commonly used equations.

Age Factors↗

PubMed1986

Functional health measure for adjusting health maintenance organization capitation rates.

Because of increasing interest in at-risk enrollment of Medicare beneficiaries by health maintenance organizations, a number of modifications to the adjusted average per capita cost (AAPCC) formula employed by the Health Care Financing Administration have been proposed recently. Researchers have found that new models, which include measures of prior years' utilization and costs, predict Medicare payments significantly better than does the purely demographic formula currently used. In this article, we show that inclusion of instrumental activities of daily living (IADL), a measure of beneficiaries' functional health status, can further improve AAPCC models that already incorporate measures of previous-period utilization and costs. Various models for predicting Medicare payments were examined and compared using survey data and Medicare claims for a random sample of 1,934 beneficiaries. For these models, explained variation in subsequent Medicare payments (as indicated by R2 values) increased considerably when the IADL variable was included. Although actuarial concerns are associated with inclusion of the IADL score in the AAPCC, use of this measure is likely to offset other, possibly more serious, actuarial problems associated with including measures of previous utilization and costs.

Activities of Daily Living↗

PubMedDate not supplied

Is there a link between the variation in gastric cancer mortality and differences in Helicobacter pylori prevalence in different regions of France?

An ecological study was performed to correlate the cumulative gastric cancer mortality rate to the prevalence of Helicobacter pylori infection in France. National data on mortality, standardized for age and gender, and the results of a nationwide prevalence study on Helicobacter pylori infection among 1,586 patients consulting for symptoms other than upper digestive tract symptoms, in seven defined French regions were used. The correlation was described by linear regression with the standardized data and then evaluated in a linear regression model including age and gender as co-variables. The Southwest region was the least affected by the infection (15.2%) while prevalence varied from 20.5 to 25.3% for the other regions. The cumulative gastric cancer mortality rate varied from 34.4 to 51.8/100,000. The prevalence of Helicobacter pylori infection in the model explained 5% of the variability in the gastric cancer mortality. A number of biases which were difficult to control could explain the lack of association between these variables.

Adolescent↗

PubMed2000

Multivariate approach for quantification of morphologic and functional damage in glaucoma.

PURPOSE: To determine the usefulness of confirmatory factor analysis in examination of morphometric, electrophysiological, and psychophysical quantitative methods that measure the extent of global glaucomatous damage without referring to a preselected gold standard. METHODS: In a cross-sectional clinical study, 406 eyes of 203 glaucoma patients and 200 eyes of 100 normal control subjects 18 to 70 years old underwent optic disc morphometry, automated perimetry, measurement of temporal contrast sensitivity by a full-field flicker test, blue-on-yellow visually evoked potential (VEP), and black-and-white pattern-reversal electroretinogram (ERG). Diagnosis of glaucoma was based on a qualitative classification of the optic nerve head and retinal nerve fiber layer independent of intraocular pressure and visual field. Confirmatory factor analysis was performed in the patient group as a whole and in a subgroup showing moderate to advanced glaucomatous optic nerve head damage. RESULTS: The confirmatory factor analysis models explained the data satisfactorily (P > 0.18, all patients; P > 0.34, subgroup). Global glaucomatous damage was quantified best by the mean defect of automated perimetry (r = 0.81; r = 0.87), followed by the area of the neuroretinal rim (r = 0.64; r = 0.73), the full-field flicker test (r = 0.59; r = 0.65), the pattern-reversal ERG amplitude (r = 0.54; r = 0.55), and the VEP peak time (r = 0.55; r = 0.54). CONCLUSIONS: Confirmatory factor analysis allows quantification of the validity of established and new procedures that measure global glaucomatous damage using cross-sectional data. The results are not dependent on the preselection of a specific gold standard. Psychophysical testing and morphometry quantified glaucomatous damage best, compared with electrophysiological procedures.

Adolescent↗

PubMed2000

Evidence for natural selection in a fern hybrid zone.

Morphological characters, chloroplast DNA, and allozymes were used to analyze the distribution of individuals within a hybrid population of the ferns Polystichum munitum and P. imbricans in northwestern California. Microsites within the population were characterized according to soil moisture and light levels reaching the plants. In sites with low soil moisture and high light levels, all of the ferns were genetically and morphologically like P. imbricans. In contrast, ferns with the genetic and morphological identity of P. munitum predominated in moist shady sites. Intermediate sites supported very few P.munitum, a wide variety of hybrid recombinants, and a majority of ferns with P. imbricans characteristics. The pattern of variation within the population is noteworthy because of the close proximity of the habitat extremes and the long-range dispersal of fern spores. We conclude that natural selection along environmental gradients must be a major factor in determining the ecological and genetic associations within the hybrid zone. The results of this study are evaluated in the context of the fern life cycle and compared to the assumptions of models explaining the establishment and maintenance of hybrid zones, which vary in the role attributed to environmentally mediated natural selection.

Journal Article↗

PubMed1975

Platelet size in man.

The shape and parameters of platelet size distributions were studied in 50 normal persons and 97 patients in order to test the proposed thesis that platelet size heterogeneity results mainly from aging in the circulation. This thesis was contradicted (1) by size distributions of age-homogeneous, newly-born cell populations which were lognormal with increased (instead of decreased) dispersion of volumes and (2) by the macrothrombocytosis found in some populations with normal age distribution. For these reasons, thrombocytopoiesis appeared to play the major role in determining platelet size. A model was built in which the volume variation of platelet territories due to megakaryocyte growth and membrane demarcation at each step of maturation was a random proportion of the previous value of the volume. This model explains the lognormal shape of both newborn and circulating platelet size distributions. It also implies that (1) the mean and standard deviation of platelet logvolumes depend on the rates of volume change of the individual platelet territories (growth rate minus demarcation rate) as well as on megakaryocyte maturation time; (2) platelet hyperdestruction causes an increase in the mean and dispersion of the rates of territory volume change; (3) Mediterranean macrothrombocytosis and some hereditary macrothrombocytotic thrombocytopenias or dysthrombocytopoieses reflect a diminished rate of territory demarcation, and (4) platelet size heterogeneity is caused mainly by the variations in territory growth and demarcation and not by aging in the circulation.

Anemia, Aplastic↗

PubMed2000

The influence of genetic predisposition on the prevalence of atopic diseases in Carinthian school children.

The reasons for the origin and increasing rise in incidence of atopic diseases such as bronchial asthma, allergic rhinoconjunctivitis and eczema in many countries are still unknown. Our survey carried out within the frame of the ISAAC protocol comprised three districts in the Austrian province of Carinthia. A complete study of first and second year elementary school children was done in order to uncover a relationship between "presumed exposure" to different possible risk factors with that of an atopic disorder (i.e. asthma, hay fever, eczema). The results show a significant association between the occurrence of atopic disorders and genetic predisposition and the fact that a carpet which had previously been present in the child's bedroom, had been removed due to the presence of an allergic disease in a family member. The logistic regression model explains a very small part of the overall variability (R2 = 7.32%).

Air Pollution, Indoor↗

PubMed2001

Symptom clusters and their effect on the functional status of patients with cancer.

PURPOSE/OBJECTIVES: To determine the effect of the symptom cluster of pain, fatigue, and sleep insufficiency on functional status during three cycles of chemotherapy. DESIGN: Prospective, longitudinal. SETTING: 23 outpatient offices and clinics. SAMPLE: 93 patients with cancer. The typical participant was female (72%), married/partnered (65%), white (87%), and middle-aged (55.4 years), with an average of 14.8 years of education. METHODS: The Quality of Life-Cancer (QOL-CA) version instrument and the Karnofsky Performance Scale (KPS) were completed by 93 outpatients receiving chemotherapy at baseline (Time 1) and at the end of the third cycle (Time 2). Three items (pain, tires easily, sleeps enough to meet needs) from the QOL-CA questionnaire were used to measure the symptom cluster. MAIN RESEARCH VARIABLES: Symptom cluster, outcome, functional status, chemotherapy. FINDINGS: A hierarchical multiple regression model explained 48.4% of the variance in functional status. The KPS at Time 1 explained 30.8% of the variance in KPS at Time 2 (p < 0.001). After KPS at Time 1 was partialled out from KPS at Time 2, the four independent variables entered in the next step were considered predictors of the change in functional status between Time 1 and Time 2. Age explained 11.8% of the change (p = 0.001), pain explained 10.7% of the change (p = 0.002), and fatigue explained 7.3% of the change (p = 0.011). Sleep insufficiency statistically was not significant, only explaining 1% of the change (p = 0.344). CONCLUSION: This study provides beginning insights into the effect of a symptom cluster on patients' functional status. IMPLICATIONS FOR NURSING PRACTICE: Healthcare professionals need to be aware of the presence of symptom clusters and their possible synergistic adverse effect on patients' future morbidity.

Antineoplastic Agents↗

PubMedDate not supplied

A comparative study of outcome in myositis and other musculoskeletal disorders assessed using the Nottingham health profile.

OBJECTIVE: This study evaluated the comparative impact of myositis and other musculoskeletal disorders on general health using the Nottingham health profile (NHP) as a generic measure of health status. METHODS: A prospective observational study of 113 females with myositis, 142 females with rheumatoid arthritis, 45 females with spinal osteoporosis and 96 females with knee osteoarthritis. RESULTS: All mean NHP section scores were higher in myositis and other musculoskeletal disorders compared to population mean values. Section scores for energy and social isolation were high in myositis compared to all other disorders. Scores for physical disability in myositis were similar to RA. Pain scores were higher in RA and OA compared to myositis. Backwards linear regression models explained 26-42% of the variation in energy and social isolation scores. Emotion and physical section scores were the major determinants and the pattern was similar in all disorders. Disease duration and age had little effect. CONCLUSIONS: Myositis is not simply a disease with physical problems but has wide ranging effects on social and emotional well being. Until disease-specific instruments are available, a generic measure like the NHP can be used to assess problems other than muscle pain and loss of strength.

Activities of Daily Living↗

PubMed2001

Pain, mood disturbance, and quality of life in patients with multiple myeloma.

PURPOSE/OBJECTIVES: To determine the levels of pain intensity and pain interference in patients with multiple myeloma, the relationship between pain and mood disturbance, and factors that influence quality of life (QOL). DESIGN: Descriptive correlational mailed survey. SETTING: A private tertiary institution in the Midwest. SAMPLE: Convenience sample of 346 adult patients with multiple myeloma identified through an institutional database, 206 of whom responded to the surveys. METHODS: Mailed, self-administered questionnaires: Brief Pain Inventory Short Form, Profile of Mood States, QOL Scale (Cancer Patient Version), and a demographic tool. Treatment details were obtained from the database on subjects consenting to participate. MAIN RESEARCH VARIABLES: Pain intensity, pain interference, psychologic functioning, and QOL. FINDINGS: 29% (n = 60) of subjects reported moderate to severe pain intensity. Significant associations were found between pain intensity and mood disturbance scores. As pain interference increased, so did levels of mood disturbance. A joint predictive model explained 74.6% of the variability in total QOL scores. CONCLUSIONS: Cancer pain remains undertreated, and patients with myeloma are no exception. Pain and mood disturbance scores were significant predictors of QOL in this group of patients. Subjects with multiple myeloma reported higher levels of mood disturbance than patients with cancer from other studies. IMPLICATIONS FOR NURSING PRACTICE: The oncology nurse is in a key position to facilitate ongoing, adequate pain and psychosocial assessment of patients with myeloma. Further study is needed to determine if control of pain and mood disturbance factors has a positive effect on the various domains of QOL.

Adult↗

PubMed2000

Does Acculturation Influence Physical Activity in Japanese American Older Adults?

PURPOSE: Despite the health benefits of physical activity, demographic and health factors as well as cultural backgrounds are thought to influence participation in physical activity. The aim of this study is to examine whether acculturation is associated with physical activity in a sample of Japanese American older adults living on the continental United States. METHODS: A survey was mailed to Japanese Americans identified from the mailing list of two communitybased organizations. The survey included questions on physical activity, acculturation, demographics, health behaviors, and selfreported health status. Data were analyzed using bivariate and multiple regression techniques. FINDINGS: Acculturation was not a significant predictor of phsical activity in either community sample, or the pooled sample, after conrolling for other sociodemographic andhealth status variables. The models explained 23% to 2% of the variance in physical activity. Statistically significant predictors of physical activity included gender, work status, age, income, and health status. CONCLUSIONS: Our findings differ from studies of Japanese Americans in Hawaii and other racial/ethnic groups, suggesting that accultraion may have differential effects depending on the environment and the racial/ethnic group under study. KEY WORDS: Japanese American, physical activity, acculturation

Journal Article↗