1
|
Sugebo ES, Kassie TW, Gobena T, Tibore TK, Sebro SF, Ermolo TL. Self-care behavior and associated factors among adult heart failure patients in outpatient cardiac follow-up unit at Wachemo University Nigist Eleni Comprehensive Specialized Hospital, Southern Ethiopia. BMC Cardiovasc Disord 2024; 24:238. [PMID: 38714943 PMCID: PMC11075198 DOI: 10.1186/s12872-024-03901-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 04/24/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Heart failure is a serious medical condition that occurs when the heart is unable to pump sufficient blood to meet the needs of the tissues. Good self-care is an essential behavior in long term management and maintenance of physiologic stability, better medical and person-centered outcomes. Poor self-care behavior deteriorates the outcomes of heart failure patients. However, there were no sufficient evidences that illustrate the topic in the country, including the study area. METHODOLOGY Institutional based cross-sectional study was conducted among 250 heart failure patients from July 5-August 4, 2021. All adult heart failure patients who fulfill the inclusion criteria and have appointment during study period were included in the study. Interview and medical chart review was used to collect data. Epidata version 3.1 and SPSS version 20 were used for data entry and analysis respectively. Bivariate and multivariable analysis was computed. The model fitness was checked by Hosmer and Lemeshow test. RESULTS From the total patients, 240 were interviewed with the response rate of 96%. Among these, 140(58.3%) [95% CI: 52.6, 64.9] had poor self-care behavior. Age>54: 9.891 [2.228, 43.922], poor knowledge: 6.980[1.065, 45.727], depression: 4.973[1.107, 22.338], low social support: 6.060[1.373, 26.739], insomnia: 4.801[1.019, 22.622] and duration with heart failure <1 year: 5.782[1.438, 23.247] were factors associated with poor self-care behavior. CONCLUSION In this study, more than half of participants attending at Wachemo University Nigist Eleni Comprehensive Specialized Hospital in outpatient cardiac follow-up unit had poor self-care behavior. Of the study variables, older age, poor knowledge, depressive symptoms, low social support, insomnia and short duration with heart failure were related with poor self-care behavior. Thus, the findings highlight importance of assessing level of self-care behavior and implicate direction to take action to enhance level of self-care behavior.
Collapse
Affiliation(s)
- Ermias Sigebo Sugebo
- Department of Nursing, Wachemo University College of Medicine and Health Science, Hosaena, Southern, Ethiopia.
| | - Teshager Worku Kassie
- Department of Nursing, Haramaya University College of Health and Medical Science, Harar, Ethiopia
| | - Tesfaye Gobena
- Department of Public Health, Haramaya University College of Health and Medical Science, Harar, Ethiopia
| | - Temesgen Kechine Tibore
- Department of Nursing, Wachemo University College of Medicine and Health Science, Hosaena, Southern, Ethiopia
| | - Sisay Foga Sebro
- Department of Nursing, Wachemo University College of Medicine and Health Science, Hosaena, Southern, Ethiopia
| | - Tadesse Lelago Ermolo
- Department of Nursing, Wachemo University College of Medicine and Health Science, Hosaena, Southern, Ethiopia
| |
Collapse
|
2
|
Witt LJ, Wroblewski KE, Pinto JM, Wang E, McClintock MK, Dale W, White SR, Press VG, Huisingh-Scheetz M. Beyond the Lung: Geriatric Conditions Afflict Community-Dwelling Older Adults With Self-Reported Chronic Obstructive Pulmonary Disease. Front Med (Lausanne) 2022; 9:814606. [PMID: 35237627 PMCID: PMC8884078 DOI: 10.3389/fmed.2022.814606] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 01/14/2022] [Indexed: 12/27/2022] Open
Abstract
Rationale Chronic obstructive pulmonary disease (COPD) predominantly affects older adults. However, the co-morbid occurrence of geriatric conditions has been understudied. Objective Characterize the prevalence of geriatric conditions among community-dwelling U.S. older adults with self-reported COPD. Methods We conducted a nationally representative, cross-sectional study of 3,005 U.S. community-dwelling older adults (ages 57–85 years) from the National Social Life, Health, and Aging Project (NSHAP). We evaluated the prevalence of select geriatric conditions (multimorbidity, functional disability, impaired physical function, low physical activity, modified frailty assessment, falls, polypharmacy, and urinary incontinence) and psychosocial measures (frequency of socializing, sexual activity in the last year, loneliness, cognitive impairment, and depressive symptoms) among individuals with self-reported COPD as compared to those without. Using multivariate logistic and linear regressions, we investigated the relationships between COPD and these geriatric physical and psychosocial conditions. Main Results Self-reported COPD prevalence was 10.7%, similar to previous epidemiological studies. Individuals with COPD had more multimorbidity [modified Charlson score 2.6 (SD 1.9) vs. 1.6 (SD 1.6)], more functional disability (58.1 vs. 29.6%; adjusted OR 3.1, 95% CI 2.3, 4.3), falls in the last year (28.4 vs. 20.8%; adjusted OR 1.4, 95% CI 1.01, 2.0), impaired physical function (75.8 vs. 56.6%; adjusted OR 2.1, 95% CI 1.1, 3.7), more frequently reported extreme low physical activity (18.7 vs. 8.1%; adjusted OR 2.3, 95% CI 1.5, 3.5) and higher frailty prevalence (16.0 vs. 2.7%; adjusted OR 6.3, 95% CI 3.0,13.0) than those without COPD. They experienced more severe polypharmacy (≥10 medications, 37.5 vs. 16.1%; adjusted OR 2.9, 95% CI 2.0, 4.2). They more frequently reported extreme social disengagement and were lonelier, but the association with social measures was eliminated when relationship status was accounted for, as those with COPD were less frequently partnered. They more frequently endorsed depressive symptoms (32.0 vs. 18.9%, adjusted OR 1.9, 95% CI 1.4, 2.7). There was no noted difference in cognitive impairment between the two populations. Conclusions Geriatric conditions are common among community-dwelling older adults with self-reported COPD. A “beyond the lung” approach to COPD care should center on active management of geriatric conditions, potentially leading to improved COPD management, and quality of life.
Collapse
Affiliation(s)
- Leah J Witt
- Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Kristen E Wroblewski
- Department of Public Health Sciences, The University of Chicago, Chicago, IL, United States
| | - Jayant M Pinto
- Department of Surgery, The University of Chicago Medicine, Chicago, IL, United States
| | - Esther Wang
- Pritzker School of Medicine, The University of Chicago, Chicago, IL, United States
| | - Martha K McClintock
- Department of Comparative Human Development, The Institute for Mind and Biology, University of Chicago, Chicago, IL, United States
| | - William Dale
- Department of Supportive Care Medicine, City of Hope, Duarte, CA, United States
| | - Steven R White
- Department of Medicine, The University of Chicago, Chicago, IL, United States
| | - Valerie G Press
- Department of Medicine, The University of Chicago, Chicago, IL, United States
| | | |
Collapse
|
3
|
Arphorn S, Ishimaru T, Lertvarayut T, Kiatkitroj K, Theppitak C, Manothum A, Hara K. Risk factors for occupational falls among middle-aged and elderly farm workers in Nan province, Thailand. J Agromedicine 2022; 27:402-408. [DOI: 10.1080/1059924x.2022.2040071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sara Arphorn
- Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Center of Excellence on Environmental Health and Toxicology, Bangkok, Thailand
| | - Tomohiro Ishimaru
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Teepapipat Lertvarayut
- Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Public Health, Faculty of Physical Education, Srinakharinwirot University, Nakhon Nayok, Thailand
| | - Kanpitcha Kiatkitroj
- Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Program of Occupational Health and Safety, Faculty of Public Health, Naresuan University, Phitsanulok, Thailand
| | - Chalermsiri Theppitak
- Institute of Public Health, Suranaree University of Technology, Nakhon Ratchasima, Thailand
| | - Aniruth Manothum
- Faculty of Industrial Technology, Lampang Rajabhat University, Lampang, Thailand
| | - Kunio Hara
- Department of Occupational Safety and Health Management, School of Health Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| |
Collapse
|
4
|
Ho Y, Lee H, Lin M, Chang H. Correlations among life stress, smoking behavior, and depressive symptoms in adolescents: A descriptive study with a mediating model. Nurs Health Sci 2020; 22:949-957. [DOI: 10.1111/nhs.12752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 06/16/2020] [Accepted: 06/16/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Yen‐Chung Ho
- School of Nursing, College of Nursing, Taipei Medical University Taipei Taiwan
| | - Hsin‐Chien Lee
- Department of Psychiatry School of Medicine, College of Medicine, Taipei Medical University Taipei Taiwan
| | - Mei‐Feng Lin
- Department of Nursing, College of Medicine National Cheng Kung University Tainan Taiwan
| | - Hsiu‐Ju Chang
- School of Nursing, College of Nursing, Taipei Medical University Taipei Taiwan
| |
Collapse
|
5
|
Siegel JK, Wroblewski KE, McClintock MK, Pinto JM. Olfactory dysfunction persists after smoking cessation and signals increased cardiovascular risk. Int Forum Allergy Rhinol 2019; 9:977-985. [PMID: 31365791 PMCID: PMC6730657 DOI: 10.1002/alr.22357] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 05/08/2019] [Accepted: 05/09/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Olfaction plays a critical role in health and function in older adults, and impaired sense of smell is a strong predictor of morbidity and mortality. Smoking cigarettes causes olfactory impairment, but the mechanism of damage and ability to recover after cessation are unknown. We investigated the relationship between time since quitting and olfactory dysfunction in order to elucidate the mechanism(s) by which smoking damages the olfactory system and to inform patient counseling. METHODS Using longitudinal data from the National Social Life Health and Aging Project (n = 3528 older adults, including 1526 former smokers), we analyzed the association between odor identification performance and time since smoking cessation using multivariate ordinal logistic regression, adjusting for cognition and demographic variables. To test whether vascular disease plays a role, we also assessed the relationship between olfactory decline and incidence of heart attack and heart disease. RESULTS Former smokers who quit ≤15 years before testing had significantly impaired olfaction compared to never smokers (p = 0.04), but those who quit >15 years prior did not. Olfactory decline over 5 years showed modest evidence toward predicting increased incidence of heart attack or heart disease (p = 0.08). CONCLUSION Olfactory impairment in smokers persists 15 years after quitting, which is consistent with a vascular mechanism of impairment. Indeed, olfactory decline is a predictor of the development of cardiovascular disease. Taken together, these data suggest that olfactory loss may be a useful sign of underlying vascular pathology. Further investigation of olfactory loss as an early biomarker for cardiovascular disease is warranted.
Collapse
Affiliation(s)
| | | | - Martha K. McClintock
- Department of Comparative Human Development and The Institute for Mind and Biology, The University of Chicago
| | - Jayant M. Pinto
- Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, The University of Chicago
| |
Collapse
|
6
|
Birditt KS, Polenick CA, Antonucci TC. Drinking Together: Implications of Drinking Partners for Negative Marital Quality. J Stud Alcohol Drugs 2019; 80:167-176. [PMID: 31014461 PMCID: PMC6489547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 01/09/2019] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVE Concordant and discordant alcohol use has significant implications for negative marital quality among married couples. Yet, we know little about the frequency with which individuals drink with their spouse versus with other social partners, or the implications of drinking with one's spouse and with others for negative marital quality. METHOD Participants were from the third wave of the Social Relations and Health Study, in which 312 (59% women; ages 22-87) married/cohabitating respondents completed a baseline telephone survey followed by monthly web surveys regarding their alcohol use, drinking partners, and negative marital quality. RESULTS Multilevel models revealed that men and women drink more often with their spouse than with others. Drinking any amount of alcohol with one's spouse for a greater proportion of months was associated with lower negative marital quality (e.g., less criticism and fewer demands) among men and women. The effects of drinking with others varied by gender such that more frequent drinking with others (family and nonfamily) was associated with lower negative marital quality among women and higher negative marital quality among men in the next month. CONCLUSIONS These findings reveal that drinking with one's spouse may partly explain why concordant drinking spouses report lower negative marital quality. Furthermore, drinking with others may be beneficial for women's marriages but harmful for men's. The findings are consistent with the concept of the drinking partnership, which suggests that drinking with one's spouse is often linked to positive outcomes, including lower negative marital quality.
Collapse
Affiliation(s)
- Kira S. Birditt
- Life Course Development Program, Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| | - Courtney A. Polenick
- Program for Positive Aging, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Toni C. Antonucci
- Life Course Development Program, Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| |
Collapse
|
7
|
Birditt KS, Cranford JA, Manalel JA, Antonucci TC. Drinking Patterns Among Older Couples: Longitudinal Associations With Negative Marital Quality. J Gerontol B Psychol Sci Soc Sci 2018; 73:655-665. [PMID: 27353031 DOI: 10.1093/geronb/gbw073] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 06/06/2016] [Indexed: 11/14/2022] Open
Abstract
Objectives Research with younger couples indicates that alcohol use has powerful effects on marital quality, but less work has examined the effects of drinking among older couples. This study examined whether dyadic patterns of drinking status among older couples are associated with negative marital quality over time. Method Married participants (N = 4864) from the Health and Retirement Study reported on alcohol consumption (whether they drink alcohol and average amount consumed per week) and negative marital quality (e.g., criticism and demands) across two waves (Wave 1 2006/2008 and Wave 2 2010/2012). Results Concordant drinking couples reported decreased negative marital quality over time, and these links were significantly greater among wives. Wives who reported drinking alcohol reported decreased negative marital quality over time when husbands also reported drinking and increased negative marital quality over time when husbands reported not drinking. Discussion The present findings stress the importance of considering the drinking status rather than the amount of alcohol consumed of both members of the couple when attempting to understand drinking and marital quality among older couples. These findings are particularly salient given the increased drinking among baby boomers and the importance of marital quality for health among older couples.
Collapse
Affiliation(s)
- Kira S Birditt
- Institute for Social Research, University of Michigan, Ann Arbor
| | | | | | - Toni C Antonucci
- Institute for Social Research, University of Michigan, Ann Arbor
| |
Collapse
|
8
|
Adams DR, Wroblewski KE, Kern DW, Kozloski MJ, Dale W, McClintock MK, Pinto JM. Factors Associated with Inaccurate Self-Reporting of Olfactory Dysfunction in Older US Adults. Chem Senses 2017; 42:223-231. [PMID: 28007787 DOI: 10.1093/chemse/bjw108] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Self-reported olfactory function has poor sensitivity (i.e., people with measured olfactory dysfunction are unlikely to accurately report it). We aimed to identify factors associated with lack of awareness of smell dysfunction. Objective odor identification was evaluated using a validated 5-item test in respondents from the National Social Life, Health, and Aging Project, a representative sample of home-dwelling, US adults ages 57-85 (n = 1468). Self-reported olfaction was assessed with a 5-point Likert scale. Using multivariate logistic regression, we tested factors that might influence inaccuracy of self-reported olfaction, including age, gender, race/ethnicity, education, marital status, cognition, comorbidity, smoking, depression, anxiety, self-rated mental and physical health, and social activity. Among older US adults, 12.4% reported their sense of smell as fair or poor, while 22.0% had objective olfactory dysfunction (≤3 items correct out of 5). Among those with measured olfactory dysfunction, 74.2% did not recognize it; these individuals were more likely to be older, Black, never married, and to have worse cognitive function compared to individuals who recognized their dysfunction (P < 0.05, all). Individuals who lacked awareness of their olfactory dysfunction had the greatest cognitive impairment at 5-year follow-up, followed by individuals aware of their dysfunction and finally normosmics (P < 0.001). Older Americans with measured olfactory dysfunction are unlikely to report it, and those who lack awareness of this dysfunction have distinct demographic, social, and cognitive characteristics. Therefore, clinicians should objectively test patients. Individuals who lack awareness of their olfactory dysfunction have poor cognitive outcomes and should receive additional clinical scrutiny.
Collapse
Affiliation(s)
- Dara R Adams
- Pritzker School of Medicine, The University of Chicago, 924 E 57th St, Chicago, IL 60637, USA
| | - Kristen E Wroblewski
- Department of Public Health Sciences, The University of Chicago, 5841 South Maryland Avenue, Chicago, IL 60637, USA
| | - David W Kern
- Department of Psychology, Northeastern Illinois University, 5500 North St. Louis Avenue, Chicago, IL 60625, USA
| | - Michael J Kozloski
- National Opinion Research Center, 1155 East 60th Street, 3rd Floor, Chicago, IL 60637, USA
| | - William Dale
- Section of Geriatrics and Palliative Medicine, Department of Medicine, The University of Chicago, 5841 South Maryland Avenue, Chicago, IL 60637, USA
| | - Martha K McClintock
- Department of Comparative Human Development and the Institute for Mind and Biology, The University of Chicago, 5736 South Woodlawn Avenue #102, Chicago, IL 60637, USA and
| | - Jayant M Pinto
- Section of Otolaryngology-Head and Neck Surgery, The University of Chicago, 5841 South Maryland Avenue, Chicago, IL 60637, USA
| |
Collapse
|
9
|
Kotwal AA, Lauderdale DS, Waite LJ, Dale W. Differences between husbands and wives in colonoscopy use: Results from a national sample of married couples. Prev Med 2016; 88:46-52. [PMID: 27009632 PMCID: PMC5554589 DOI: 10.1016/j.ypmed.2016.03.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 03/07/2016] [Accepted: 03/16/2016] [Indexed: 10/22/2022]
Abstract
Marriage is linked to improved colorectal cancer-related health, likely in part through preventive health behaviors, but it is unclear what role spouses play in colorectal cancer screening. We therefore determine whether self-reported colonoscopy rates are correlated within married couples and the characteristics of spouses associated with colonoscopy use in each partner. We use US nationally-representative 2010 data which includes 804 male-female married couples drawn from a total sample of 3137 community-dwelling adults aged 55-90years old. Using a logistic regression model in the full sample (N=3137), we first find married men have higher adjusted colonoscopy rates than unmarried men (61% versus 52%, p=0.023), but women's rates do not differ by marital status. In the couples' sample (N=804 couples), we use a bivariate probit regression model to estimate multiple regression equations for the two spouses simultaneously as a function of individual and spousal covariates, as well as the adjusted correlation within couples. We find that individuals are nearly twice as likely to receive a colonoscopy if their spouse recently has had one (OR=1.94, 95% CI: 1.39, 2.67, p<0.001). Additionally, we find that husbands have higher adjusted colonoscopy rates whose wives are: 1) happier with the marital relationship (65% vs 51%, p=0.020); 2) more highly educated (72% vs 51%, p=0.020), and 3) viewed as more supportive (65% vs 52%, p=0.020). Recognizing the role of marital status, relationship quality, and spousal characteristics on colonoscopy uptake, particularly in men, could help physicians increase guideline adherence.
Collapse
Affiliation(s)
- Ashwin A Kotwal
- Brigham and Women's Hospital, Department of Medicine, 75 Francis St, Boston, MA 02115, USA
| | - Diane S Lauderdale
- University of Chicago, Department of Public Health Sciences, 5841 S. Maryland Ave, Chicago, IL 60637, USA
| | - Linda J Waite
- University of Chicago, Department of Sociology, 1159 E. 59(th) Street, Chicago, IL 60637, USA
| | - William Dale
- University of Chicago, Department of Medicine, Section of Geriatrics & Palliative Medicine and Hematology/Oncology, 5841 S. Maryland Ave, Chicago, IL 60637, USA.
| |
Collapse
|
10
|
Iveniuk J, O'Muircheartaigh C, Cagney KA. Religious Influence on Older Americans' Sexual Lives: A Nationally-Representative Profile. ARCHIVES OF SEXUAL BEHAVIOR 2016; 45:121-31. [PMID: 26063533 PMCID: PMC5565759 DOI: 10.1007/s10508-015-0534-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 04/18/2014] [Accepted: 11/01/2014] [Indexed: 05/15/2023]
Abstract
This study investigated the relationship between religious influence and sexual expression in older Americans, with specific attention to gender. Using the National Social Life, Health, and Aging Project, a nationally-representative survey of older adults, we created a composite measure of religious influence on sexual expression using Latent Class Analysis. We found more variability within denominations than between in terms of membership in the high-influence class; this indicated that religious influence on sexual expression was diverse within faiths. We show that religious influence was associated with higher self-reported satisfaction with frequency of sex, as well as higher physical and emotional satisfaction with sex, but only for men. Men were also significantly more likely than women to report that they would only have sex with a person they love. These results persisted in the presence of controls for demographic characteristics, religious affiliation, church attendance, intrinsic religiosity, political ideology, and functional health.
Collapse
Affiliation(s)
- James Iveniuk
- Department of Sociology, University of Chicago, Chicago, IL, USA.
- , 254 Castlefield Ave., Toronto, ON, M4R 1G7, Canada.
| | | | | |
Collapse
|
11
|
Abstract
OBJECTIVES To date, there has been no evidence about objectively measured sleep characteristics from a representative national probability sample of adults in the United States. We used actigraphy to measure the sleep characteristics of older Americans. DESIGN Cross-sectional study. SETTING Sleep sub-study within Wave 2 (2010-2011) of the ongoing National Social Life, Health and Aging Project (NSHAP). PARTICIPANTS Seven hundred and thirty-nine NSHAP participants aged 62-90. INTERVENTION Not applicable. MEASUREMENTS Study participants wore a wrist actigraph for 72 hours and sleep properties were compared across demographic, socioeconomic, and health-behavior related lines. RESULTS Actigraph-estimated sleep time averaged 7.2 hours (SE 0.06 hr) each night; the majority of the sample (80%) slept between 5.8 and 8.6 hours/night. Average time spent awake after sleep onset (WASO) was 39 minutes (SE 1.2 min). Women had significantly more total sleep time and lower sleep fragmentation compared to men. Total sleep time increased significantly with age although sleep percentage decreased with age. Compared with White participants, African American participants had significantly more WASO (9.2 minutes, p < 0.01) and greater sleep fragmentation (2.3 percentage points, p < 0.001). WASO was significantly higher and sleep percentage significantly lower among those with less education. CONCLUSIONS Both short sleepers and long sleepers - often conventionally defined as obtaining <6 and >9 hrs/night, respectively - are relatively rare among older Americans when sleep is estimated by actigraphy. Sleep quality is significantly poorer among men, African Americans, and those with less education.
Collapse
|
12
|
Higgins ST, Kurti AN, Redner R, White TJ, Gaalema DE, Roberts ME, Doogan NJ, Tidey JW, Miller ME, Stanton CA, Henningfield JE, Atwood GS. A literature review on prevalence of gender differences and intersections with other vulnerabilities to tobacco use in the United States, 2004-2014. Prev Med 2015; 80:89-100. [PMID: 26123717 PMCID: PMC4592404 DOI: 10.1016/j.ypmed.2015.06.009] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 06/19/2015] [Accepted: 06/21/2015] [Indexed: 01/27/2023]
Abstract
This report describes results from a systematic literature review examining gender differences in U.S. prevalence rates of current use of tobacco and nicotine delivery products and how they intersect with other vulnerabilities to tobacco use. We searched PubMed on gender differences in tobacco use across the years 2004-2014. For inclusion, reports had to be in English, in a peer-reviewed journal or federal government report, report prevalence rates for current use of a tobacco product in males and females, and use a U.S. nationally representative sample. Prevalence rates were generally higher in males than in females across all products. This pattern remained stable despite changes over time in overall prevalence rates. Gender differences generally were robust when intersecting with other vulnerabilities, although decreases in the magnitude of gender differences were noted among younger and older users, and among educational levels and race/ethnic groups associated with the highest or lowest prevalence rates. Overall, these results document a pervasive association of gender with vulnerability to tobacco use that acts additively with other vulnerabilities. These vulnerabilities should be considered whenever formulating tobacco control and regulatory policies.
Collapse
Affiliation(s)
- Stephen T Higgins
- Vermont Center on Tobacco Regulatory Science, University of Vermont, USA.
| | - Allison N Kurti
- Vermont Center on Tobacco Regulatory Science, University of Vermont, USA
| | - Ryan Redner
- Vermont Center on Tobacco Regulatory Science, University of Vermont, USA
| | - Thomas J White
- Vermont Center on Tobacco Regulatory Science, University of Vermont, USA
| | - Diann E Gaalema
- Vermont Center on Tobacco Regulatory Science, University of Vermont, USA
| | - Megan E Roberts
- Center of Excellence in Regulatory Tobacco Science, The Ohio State University, USA
| | - Nathan J Doogan
- Center of Excellence in Regulatory Tobacco Science, The Ohio State University, USA
| | - Jennifer W Tidey
- Vermont Center on Tobacco Regulatory Science, University of Vermont, USA; Department of Psychiatry and Human Behavior, Brown University, USA
| | - Mollie E Miller
- Vermont Center on Tobacco Regulatory Science, University of Vermont, USA; Department of Psychiatry and Human Behavior, Brown University, USA
| | | | | | | |
Collapse
|
13
|
Stival MM, Lima LRD, Karnikowski MGDO. Relações hipotéticas entre os determinantes sociais da saúde que influenciam na obesidade em idosos. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2015. [DOI: 10.1590/1809-9823.2015.14023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Os elevados índices de prevalência de obesidade em idosos suscitam a necessidade de compreender os fatores envolvidos nesta desordem nutricional, por meio de métodos quantitativos que permitam uma análise relacional desses determinantes. O objetivo deste estudo foi propor um modelo hipotético que estabeleça as relações entre os determinantes sociais da saúde associados à obesidade em idosos. Para a construção do modelo hipotético, foram delineadas as variáveis latentes e observadas de acordo com a análise de 45 artigos nacionais e internacionais e em concordância com o referencial da Modelagem de Equações Estruturais. Foi construído um diagrama representativo para evidenciar as correlações entre os 11 determinantes sociais da saúde relacionados à obesidade no idoso: atividade física, tabagismo, etilismo, consumo alimentar, contato social, ocupação, renda, escolaridade, idade, sexo e estado civil. Espera-se que as relações hipotéticas estabelecidas no estudo contribuam para a compreensão das relações dos fatores que estão envolvidos nesse contexto visando ao desenvolvimento de estratégias para a saúde da pessoa idosa.
Collapse
|
14
|
Gaber R, Watermann I, Kugler C, Reinmuth N, Huber RM, Schnabel PA, Vollmer E, Reck M, Goldmann T. Correlation of EGFR expression, gene copy number and clinicopathological status in NSCLC. Diagn Pathol 2014; 9:165. [PMID: 25227424 PMCID: PMC4176848 DOI: 10.1186/s13000-014-0165-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 08/16/2014] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Epidermal Growth Factor Receptor (EGFR) targeting therapies are currently of great relevance for the treatment of lung cancer. For this reason, in addition to mutational analysis immunohistochemistry (IHC) of EGFR in lung cancer has been discussed for the decision making of according therapeutic strategies. The aim of this study was to obtain standardization of EGFR-expression methods for the selection of patients who might benefit of EGFR targeting therapies. METHODS As a starting point of a broad investigation, aimed at elucidating the expression of EGFR on different biological levels, four EGFR specific antibodies were analyzed concerning potential differences in expression levels by Immunohistochemistry (IHC) and correlated with fluorescence in situ hybridization (FISH) analysis and clinicopathological data. 206 tumor tissues were analyzed in a tissue microarray format employing immunohistochemistry with four different antibodies including Dako PharmDx kit (clone 2-18C9), clone 31G7, clone 2.1E1 and clone SP84 using three different scoring methods. Protein expression was compared to FISH utilizing two different probes. RESULTS EGFR protein expression determined by IHC with Dako PharmDx kit, clone 31G7 and clone 2.1E1 (p ≤ 0.05) correlated significantly with both FISH probes independently of the three scoring methods; best correlation is shown for 31G7 using the scoring method that defined EGFR positivity when ≥ 10% of the tumor cells show membranous staining of moderate and severe intensity (p=0.001). CONCLUSION Overall, our data show differences in EGFR expression determined by IHC, due to the applied antibody. Highest concordance with FISH is shown for antibody clone 31G7, evaluated with score B (p=0.001). On this account, this antibody clone might by utilized for standard evaluation of EGFR expression by IHC. VIRTUAL SLIDES The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/13000_2014_165.
Collapse
|
15
|
The effects of chronic cigarette smoking on gray matter volume: influence of sex. PLoS One 2014; 9:e104102. [PMID: 25090480 PMCID: PMC4121321 DOI: 10.1371/journal.pone.0104102] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 07/06/2014] [Indexed: 12/31/2022] Open
Abstract
Cigarette smoke contains nicotine and toxic chemicals and may cause significant neurochemical and anatomical brain changes. Voxel-based morphometry studies have examined the effects of smoking on the brain by comparing gray matter volume (GMV) in nicotine dependent individuals (NDs) to nonsmoking individuals with inconsistent results. Although sex differences in neural and behavioral features of nicotine dependence are reported, sex differences in regional GMV remain unknown. The current study examined sex differences in GMV in a large sample of 80 NDs (41 males) and 80 healthy controls (41 males) using voxel-based morphometry. Within NDs, we explored whether GMV was correlated with measures of cigarette use and nicotine dependence. High-resolution T1 structural scans were obtained from all participants. Segmentation and registration were performed in SPM8 using the optimized DARTEL approach. Covariates included age and an estimate of total global GMV. Differences were considered significant at p≤0.001, with a whole brain FWE-corrected cluster probability of p<0.025. Among NDs compared to Controls less GMV was observed in the thalamus and bilateral cerebellum and greater GMV was observed in the bilateral putamen and right parahippocampus. Lower thalamic GMV was observed in both female and male NDs compared to Controls. Female NDs also had lower GMV in the left cerebellum and in the ventral medial and orbitofrontal cortices with no areas of greater GMV. Male NDs had lower GMV in bilateral cerebellum and greater GMV in bilateral parahippocampus and left putamen. Within male NDs, GMV in the left putamen was correlated with number of pack years. This study, conducted in a large cohort, contributes to our knowledge of brain morphology in nicotine addiction and provides additional evidence of sex-specific effects on GMV in NDs. Identifying brain vulnerabilities with respect to sex provides a methodological framework for personalized therapies to improve relapse rates for both sexes.
Collapse
|
16
|
Brown MT, Grossman BR. Same-sex sexual relationships in the national social life, health and aging project: making a case for data collection. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2014; 57:108-129. [PMID: 24329542 DOI: 10.1080/01634372.2013.865695] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2013] [Accepted: 11/11/2013] [Indexed: 06/03/2023]
Abstract
This study describes the previously unexplored subsample of respondents who reported at least 1 same-sex sexual relationship (SSSR) in the National Social Life, Health, and Aging Project (NSHAP). The NSHAP collected data from 3,005 adults (aged 57-85). Approximately 4% (n = 102) of respondents reported at least one SSSR. These sexual minority elders were younger, more educated, were more likely to be working, had fewer social supports, and better physical health. Results may indicate crisis competence in sexual minority elders. Collecting sexual orientation and gender identity data in larger, US-based probability samples would inform the development of appropriate community-based services and supports.
Collapse
Affiliation(s)
- Maria T Brown
- a Aging Studies Institute, Syracuse University , Syracuse , New York , USA
| | | |
Collapse
|
17
|
Pinto JM, Schumm LP, Wroblewski KE, Kern DW, McClintock MK. Racial disparities in olfactory loss among older adults in the United States. J Gerontol A Biol Sci Med Sci 2013; 69:323-9. [PMID: 23689829 DOI: 10.1093/gerona/glt063] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Age-related olfactory loss (presbyosmia) substantially decreases quality of life, presages neurodegenerative disease, impairs nutrition, and predicts mortality. We sought to determine how race is associated with olfactory loss in older American adults in order to inform both health care and policy. METHODS The National Social Life, Health and Aging Project interviewed a cross-sectional nationally representative probability sample of older adults in the United States. African Americans and Hispanics were oversampled, providing power to detect disparities for these subgroups. As part of an omnibus survey of demographic, social, psychological, and biological measures, National Social Life, Health and Aging Project assessed the ability to verbally identify odors by presenting five odor pens. Multivariate ordinal logistic regression quantified racial differences in odor identification, and then tested potential confounders. RESULTS African Americans and Hispanics had markedly worse olfactory function (controlling for gender and age) compared with whites (p < .001), twice the magnitude of gender differences, and comparable to aging 9 years. Cognition, household assets, and education accounted for the disparity found among Hispanics but not among African Americans. Moreover, other potential confounders, such as physical or mental health, including tobacco and alcohol use, did not account for the African American health disparity, which remained significant (p = .001) after including these factors. CONCLUSIONS African Americans are more likely to suffer from presbyosmia, a health disparity not explained by gender, education, cognition, physical or mental health, and health behaviors. This novel health disparity may result from lifetime environmental exposures, diet, or genetic susceptibility. Dissecting the interactions among these putative mechanisms will provide insight into ameliorating this decline in critical human sensory function.
Collapse
Affiliation(s)
- Jayant M Pinto
- Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, The University of Chicago Medicine and Biological Sciences, 5841 South Maryland Avenue, MC1035, Chicago, IL 60637.
| | | | | | | | | |
Collapse
|
18
|
Bennett JM, Glaser R, Andridge RR, Peng J, Malarkey WB, Kiecolt-Glaser JK. Long lasting effects of smoking: breast cancer survivors' inflammatory responses to acute stress differ by smoking history. Psychoneuroendocrinology 2013; 38:179-87. [PMID: 22727479 PMCID: PMC3488120 DOI: 10.1016/j.psyneuen.2012.05.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2011] [Revised: 04/23/2012] [Accepted: 05/22/2012] [Indexed: 11/25/2022]
Abstract
Cigarette smoking continues to be the most preventable cause of illness and death and has been linked to the development and prognosis of cancer. Current smokers have higher levels of inflammation than nonsmokers, and inflammation can remain elevated in former smokers even years following cessation. Inflammation can also be enhanced by stress. This study examined cortisol and inflammatory responses to a laboratory stressor in breast cancer survivors who formerly smoked compared to their counterparts who had never smoked. Participants included 89 women (age=51.6±8.9 years) who had completed treatment for stage 0-IIIA breast cancer within the past three years and were at least two months post surgery, radiation or chemotherapy, whichever occurred last. Cortisol and interleukin-6 (IL-6) were evaluated in response to a standardized laboratory speech and mental arithmetic stressor. Former (n=25) and never (n=64) smokers did not differ by cancer stage, cancer treatment, comorbidities, time since cancer treatment, depression, or stress. Despite having similar cortisol responses to the stressor, former smokers had exaggerated IL-6 responses two hours post-stressor compared to never smokers. This effect persisted after controlling for age, BMI, time since treatment, education, and antidepressant use. An exaggerated and prolonged inflammatory response to stress could be one mechanism underlying the persistent inflammation observed in former smokers.
Collapse
Affiliation(s)
- Jeanette M. Bennett
- Division of Oral Biology, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA,Institute for Behavioral Medicine Research, College of Medicine, The Ohio State University, Columbus, OH 43210, USA,Corresponding Author: Jeanette M. Bennett, PhD, Institute for Behavioral Medicine Research, Ohio State University College of Medicine, 460 Medical Center Drive, Room 131B, Columbus, OH 43210-1228 USA, Phone: 614-366-5029; Fax: 614-366-3627,
| | - Ronald Glaser
- Institute for Behavioral Medicine Research, College of Medicine, The Ohio State University, Columbus, OH 43210, USA,Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH 43210, USA,Department of Molecular Virology, Immunology and Medical Genetics, College of Medicine, The Ohio State University, Columbus, OH 43210, USA,Comprehensive Cancer Center, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Rebecca R. Andridge
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH 43210, USA
| | - Juan Peng
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH 43210, USA
| | - William B. Malarkey
- Institute for Behavioral Medicine Research, College of Medicine, The Ohio State University, Columbus, OH 43210, USA,Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH 43210, USA,Comprehensive Cancer Center, College of Medicine, The Ohio State University, Columbus, OH 43210, USA,Department of Psychiatry, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Janice K. Kiecolt-Glaser
- Institute for Behavioral Medicine Research, College of Medicine, The Ohio State University, Columbus, OH 43210, USA,Comprehensive Cancer Center, College of Medicine, The Ohio State University, Columbus, OH 43210, USA,Department of Psychiatry, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| |
Collapse
|
19
|
Das A. How does race get "under the skin"?: inflammation, weathering, and metabolic problems in late life. Soc Sci Med 2013; 77:75-83. [PMID: 23201190 PMCID: PMC3587959 DOI: 10.1016/j.socscimed.2012.11.007] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Revised: 10/28/2012] [Accepted: 11/05/2012] [Indexed: 01/22/2023]
Abstract
Using nationally representative data from the 2005-2006 U.S. National Social Life, Health, and Aging Project, this study queries the mechanisms underlying worse metabolic outcomes--blood-sugar control and cardiovascular health--among black than white men ages 57-85. Results indicate that contrary to much of the academic literature as well as media accounts-implicitly rooted in a "culture of irresponsibility" model--older black men's social isolation, poor health behaviors, or obesity may not play a major role in their worse metabolic problems. Instead, these outcomes seem to derive more consistently from a factor almost unexamined in the literature--chronic inflammation, arguably a biological "weathering" mechanism induced by these men's cumulative and multi-dimensional stress. These findings highlight the necessity of focusing attention not simply on proximal behavioral interventions, but on broader stress-inducing social inequalities, to reduce men's race disparities in health.
Collapse
Affiliation(s)
- Aniruddha Das
- Department of Sociology, McGill University, Room 712, Leacock Building, 855 Sherbrooke Street West, Montreal, Quebec H3A 2T7, Canada.
| |
Collapse
|
20
|
Abstract
OBJECTIVE This study queries the linkage of older adults' spousal loss to multiple dimensions of their health. METHODS Data are from the 2005-2006 National Social Life, Health, and Aging Project, nationally representative of U.S. adults ages 57 to 85. Analyses examine associations of spousal loss and time since loss with multiple health dimensions. RESULTS Spousal loss is linked to a system of mental, social, behavioral, and biological issues, consistent with a stress-induced weathering process. Biological problems are more uniformly associated with women's than men's loss. While emotional sequelae may partially subside with time, a range of other outcomes remain worse even among individuals a decade or more past loss, than those with current partners. DISCUSSION Older adults' spousal loss influences multiple dimensions of their health. Gender differences in biological linkages suggest women's greater physiological vulnerability to this weathering event. Effects of loss are long term rather than transient, especially with biological conditions.
Collapse
Affiliation(s)
- Aniruddha Das
- McGill University, Leacock, Montreal, Quebec, Canada.
| |
Collapse
|
21
|
Zaitune MPDA, Barros MBDA, Lima MG, César CLG, Carandina L, Goldbaum M, Alves MCGP. [Factors associated with smoking in the elderly: a health survey in São Paulo (ISA-SP)]. CAD SAUDE PUBLICA 2012; 28:583-96. [PMID: 22415190 DOI: 10.1590/s0102-311x2012000300018] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2010] [Accepted: 11/21/2011] [Indexed: 03/15/2023] Open
Abstract
This article reports on smoking prevalence and associated factors in the elderly, based on a population-based cross-sectional study with multi-stage sampling including 1,954 individuals 60 years or older living in four areas of São Paulo State, Brazil. Overall smoking prevalence was 12.2%, and higher rates were associated with male gender, age 60-69 years, not belonging to an Evangelical church, lower income, low body weight, lack of leisure-time physical activity, depression/anxiety, and hypertension. There was a high prevalence of smokers among individuals with a history of stroke, cancer, and chronic obstructive pulmonary disease. The results point to the need for effective interventions in healthcare services to promote smoking cessation among the elderly, since many are unable to stop on their own, even when they have tobacco-related illnesses. Special attention should be paid to individuals that depend on the National Health System, since smoking prevalence is higher in underprivileged socioeconomic groups.
Collapse
|
22
|
Kotwal AA, Mohile SG, Dale W. Remaining Life Expectancy Measurement and PSA Screening of Older Men. J Geriatr Oncol 2012; 3:196-204. [PMID: 22773938 DOI: 10.1016/j.jgo.2012.02.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND: Guidelines recommend informed decision-making regarding prostate specific antigen (PSA) screening for men with at least 10 years of remaining life expectancy (RLE). Comorbidity measures have been used to judge RLE in previous studies, but assessments based on other common RLE measures are unknown. We assessed whether screening rates varied based on four clinically relevant RLE measures, including comorbidities, in a nationally-representative, community-based sample. METHODS: Using the National Social Life, Health and Aging Project (NSHAP), we selected men over 65 without prostate cancer (n=709). They were stratified into three RLE categories (0-7 years, 8-12 years, and 13+ years) based on validated measures of comorbidities, self-rated health status, functional status, and physical performance. The independent relationship of each RLE measure and a combined measure to screening was determined using multivariable logistic regressions. RESULTS: Self-rated health (OR = 6.82; p < 0.01) most closely correlated with RLE-based screening, while the comorbidity index correlated the least (OR = 1.50; p = 0.09). The relationship of RLE to PSA screening significantly strengthened when controlling for the number of doctor visits, particularly for comorbidities (OR= 43.6; p < 0.001). Men who had consistent estimates of less than 7 years RLE by all four measures had an adjusted PSA screening rate of 43.3%. CONCLUSIONS: Regardless of the RLE measure used, men who were estimated to have limited RLE had significant PSA screening rates. However, different RLE measures have different correlations with PSA screening. Specific estimates of over-screening should therefore carefully consider the RLE measure used.
Collapse
Affiliation(s)
- Ashwin A Kotwal
- University of Chicago, Department of Medicine, Section of Geriatrics & Palliative Medicine
| | | | | |
Collapse
|
23
|
Balsam KF, Lehavot K, Beadnell B. Sexual revictimization and mental health: a comparison of lesbians, gay men, and heterosexual women. JOURNAL OF INTERPERSONAL VIOLENCE 2011; 26:1798-814. [PMID: 20724297 DOI: 10.1177/0886260510372946] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Childhood sexual abuse (CSA) has several deleterious effects on health and well-being, including increased risk for rape in adulthood. Such revictimization experiences are linked to negative mental health outcomes. The vast majority of literature on prevalence and impact of sexual revictimization has focused on heterosexual women. In an effort to extend this research to lesbians and gay men, who are known to face higher rates of both CSA and adult rape, we conducted a study (N = 871) comparing adult lesbians, gay men, and heterosexual women on prevalence and mental health correlates of sexual revictimization. Results indicated that CSA is associated with elevated rates of adult rape for all three groups. In addition, revictimization showed comparable associations with mental health variables for all three groups. Participants with both CSA and adult rape had higher levels of psychological distress, suicidality, alcohol use, and self-harm behaviors relative to those with only one type of victimization and those with no victimization, and those with any victimization were more likely to report recent use of drugs compared to those with no victimization.
Collapse
|
24
|
Gavrilova N, Lindau ST. Salivary sex hormone measurement in a national, population-based study of older adults. J Gerontol B Psychol Sci Soc Sci 2009; 64 Suppl 1:i94-105. [PMID: 19204073 PMCID: PMC2763516 DOI: 10.1093/geronb/gbn028] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2008] [Accepted: 11/04/2008] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES To describe the methods used for, correlates of cooperation with, and validity of in-home salivary specimens collected from older adults. METHODS Salivary specimens were collected between 2005 and 2006 during in-home interviews with a probability sample of 3,005 U.S. men and women, ages 57-85 years. Sex hormone levels were assessed by enzyme-linked immunoassay conducted at Salimetrics, LLC (State College, PA). Mean salivary sex hormone concentrations were compared by gender and in relation to medication use and health conditions. RESULTS Self-collected saliva specimens were provided by 2,722 (90.6%) individuals; 95.8% of these were adequate for analysis. Black participants were significantly less likely than individuals of other racial/ethnic groups to provide a salivary specimen; age, gender, education, and self-rated health were not associated with participation. Mean testosterone levels were higher in men compared with women, and estradiol levels were higher in women using estrogens. Salivary hormone measurements obtained in the National Social Life, Health, and Aging Project (NSHAP) and other studies are of similar magnitude. CONCLUSION NSHAP is the first large, population-based study of older adults to measure salivary estradiol, progesterone, dehydroepiandrosterone (DHEA), and, in women, testosterone. These data demonstrate a high cooperation rate with in-home salivary specimen collection from older adults and good validity of sex hormone measurements.
Collapse
Affiliation(s)
- Natalia Gavrilova
- Department of Obstetrics and Gynecology, University of Chicago, 5841 S. Maryland Avenue, MC2050, Chicago, IL 60637, USA.
| | | |
Collapse
|