Physical activity, physical fitness, and all-cause and cancer mortality: a prospective study of men and women

We studied physical fitness and physical activity in relation to all-cause and cancer mortality in a cohort of 7080 women and 25,341 men examined at the Cooper Clinic in Dallas, Texas, during 1970 to 1989. Physical fitness was assessed at baseline by a maximal treadmill exercise test, while physical activity was self-reported on the attendant health habits questionnaire. Both men and women averaged about 43 years of age at baseline (range, 20 to 88 years), and they were followed for approximately 8 years on average. Through the end of 1989, the women contributed 52,982 person-years of observation and incurred 89 deaths, including 44 deaths due to cancer. The men contributed 211,996 person-years and incurred 601 deaths, with 179 due to cancer. After adjustment for baseline differences in age, examination year, cigarette habit, chronic illnesses, and electrocardiogram abnormalities, we found a strong inverse association between risk of all-cause mortality and level of physical fitness in both men and women (P for trend < 0.001). Physically active men also were at lower risk of all-cause mortality than were sedentary ones (P for trend = 0.01). Among women, however, self-reported physical activity was not significantly related to risk of death from all causes. The risk of mortality from cancer declined sharply across increasing levels of fitness among men (P for trend < 0.001), whereas among women the gradient was suggestive but not significant (P for trend = 0.07). Physically active men also were at lower risk of death from cancer than were sedentary men (P for trend = 0.002), but among women physical activity was unrelated to cancer mortality.     

A case-control study of prostate cancer

We present tyndallometry as a method for investigation of subclinical changes in anterior-chamber flare in patients with risk factors regarding anterior-segment ischemia after squint surgery. The cases of six adult patients who underwent surgery on the vertical recti and who had additional risk either because of dysthyroid orbitopathy or because of transpositions carried out on the recti are presented. In one case a transient subclinical increase in the flare value was observed. This noninvasive method seems suitable for the provision of further information on the pathophysiology of anterior-segment ischemia and for monitoring of patients at special risk postoperatively such that early treatment can be started if necessary. Additionally, early detection of nonischemic intraocular inflammation in the postoperative course is rendered possible by this examination.     

Hardiness and health: A prospective study.

Hypothesized that hardiness—commitment, control, and challenge—functions to decrease the effect of stressful life events to producing illness symptoms. 259 upper- and middle-level male managers (mean age 48 yrs) were administered a battery of tests (including Rotter's Internal–External Locus of Control Scale, the Schedule of Life Events, and the Seriousness of Illness Survey) covering a 5-yr period. Results support the hypothesis by showing main effects on illness for both stressful life events and hardiness and an interaction effect for these independent variables. (37 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A prospective study of prognostic value of type IV collagenase activity in colorectal cancer tissue

The purpose of this prospective study was to evaluate the prognostic value of the type IV collagenase (IVase) activity in colorectal cancer tissue on disease-free and overall survival in 31 colorectal cancer patients. The clinicopathologic factors studied for prognostic value were age, tumor location, tumor differentiation, preoperative serum levels of carcinoembryonic antigen, Dukes' stage, and IVase activity in colorectal cancer tissue. IVase activities in colorectal cancer tissue were significantly higher in the group of patients with recurrences than in the group without recurrences (P = 0.019). Patients with high IVase activity in colorectal cancer tissue had a significantly shorter disease-free survival (P = 0.0016) and overall survival (P = 0.022) time than those with low IVase activity. Univariate and multivariate analysis showed that significant prognostic factors for disease-free survival were Dukes' stage (P = 0.029, P = 0.046, respectively) and IVase activity status (P = 0.0016, P = 0.0026, respectively). With respect to overall survival, only IVase activity status provided significant predictive value in multivariate analysis (P = 0.041). This prospective study suggests that IVase activity is a valuable prognostic factor in colorectal cancer patients.     

Leisure-time physical activity and marital status in relation to depression between men and women: A prospective study.

Background: Previous studies have identified the preventive effect of leisure-time physical activity (LTPA) on depression. Women and men have different emotional vulnerabilities. The impact of LTPA on depression varies by gender. Little is known about the impact of LTPA on depression for people with different marital status. Objectives: The objective of this study was to assess the long-term effects of LTPA, changes in LTPA, and marital status on the risk of developing depression for general Canadians. Methods: Data from the biennial National Population Health Survey (NPHS) cycles conducted between 1994/95 and 2004/05 were analyzed in 2008. After excluding individuals with preexisting depression at baseline, respondents were classified as physically active or inactive and then followed up in subsequent cycles of the NPHS to look at risk of developing depression. Individuals who changed their activity level were also examined. Subgroup analyses by different marital status were performed to identify high-risk populations. Results: In 1994/1995, 17,276 participants were included in the NPHS longitudinal panel. Respondents who were inactive were more likely to be older, female, obese, widowed/separated/divorced, not working, low income, and lacking social support. After controlling for potential confounding factors, it was found that LTPA reduced the risk of developing depression for women. The modest risk reduction observed for men was not statistically significant. Women who were active at baseline and two years of follow-up were significantly less likely to report depression at four years of follow-up compared to women who were inactive at baseline and at two years of follow-up. A 51% greater probability of developing depression was observed after two years for women who changed their LTPA from active to inactive compared to women who remained active. No significant results were found for men. Divorced/separated/widowed women who stopped LTPA had 4.2 times the risk of developing depression after two years compared to those who remained active. The risk of developing depression after stopping activity did not vary according to marital status among men. Conclusions: LTPA has preventive effects on depression for women. Reduction in LTPA level is associated with subsequent depression for women. Divorced/separated/widowed women are at particularly high risk of developing depression if LTPA is stopped. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Concepts of schizophrenia among mental health professionals: A factor-analytic study.

Factor analyzed the questionnaire responses of 183 mental health professionals to identify relevant dimensions of beliefs about the phenomenology, etiology, and prognosis of schizophrenia. 8 factors were chosen for interpretation: interpersonal etiology, Bleulerian phenomenology, disease concept of schizophrenia, poor prognosis, poor understanding of schizophrenia, schizophrenia as thinking disorder, adaptive symptomatology, and irreversibility. In relating factor scores to S variables, it was found that professional discipline accounted for a significant proportion of variance in both etiological factors. Theoretical orientation was significantly related to opinions about the purposeful nature of schizophrenic symptoms and about prognosis, and place of employment was significantly related to various opinions about etiology and phenomenology. Findings are interpreted as casting doubt on the remaining usefulness of the term "schizophrenia." (26 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationships of serum androgens and estrogens to prostate cancer risk: results from a prospective study in Finland

Several lines of evidence suggest that sex hormones may be involved in the etiology of prostate cancer. We conducted a prospective nested case-control study to evaluate the relationships of serum androgens and estrogens to prostate cancer using serum collected at baseline for the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. The 29,133 male smokers who participated in the trial were 50-69 years old at baseline. During 5-8 years of follow-up, 246 men were diagnosed with prostate cancer, and 116 of these were randomly selected for inclusion in the current study. For each case, two controls matched on age, date of blood collection, intervention group, and study center were selected. Hormones were measured in serum by RIA using standard procedures. None of the individual androgens or estrogens was significantly related to prostate cancer. These findings were unaltered by simultaneous evaluation of serum androgen and estrogen concentrations in multivariate models. These results do not support a strong relationship of serum androgens and estrogens with prostate cancer in smokers. Within-person variation in concentrations of some hormones may have contributed to the lack of significant associations.     

Nutrition, physical activity, and bone health in women

Calcium and vitamin D can significantly impact bone mineral and fracture risk in women. Unfortunately, calcium intakes in women are low and many elderly have poor vitamin D status. Supplementation with calcium (approximately 1000 mg) can reduce bone loss in premenopausal and late postmenopausal women, especially at sites that have a high cortical bone composition. Vitamin D supplementation slows bone loss and reduces fracture rates in late postmenopausal women. While an excess of nutrients such as sodium and protein potentially affect bone mineral through increased calcium excretion, phytoestrogens in soy foods may attenuate bone loss through estrogenlike activity. Weight-bearing physical activity may reduce the risk of osteoporosis in women by augmenting bone mineral during the early adult years and reducing the loss of bone following menopause. High-load activities, such as resistance training, appear to provide the best stimulus for enhancing bone mineral; however, repetitive activities, such as walking, may have a positive impact on bone mineral when performed at higher intensities. Irrespective of changes in bone mineral, physical activities that improve muscular strength, endurance, and balance may reduce fracture risk by reducing the risk of falling. The combined effect of physical activity and calcium supplementation on bone mineral needs further investigation.     

A prospective study of church attendance and health over the lifespan.

Objective: The objective of the current study was to help clarify the previously ambiguous results concerning the relationship between church attendance and later physical health. Design: The current study examined the effect of church attendance on 4 different indicators of later health in a sample of inner city men followed throughout their lifecourse. Measures of previous health status, mood, substance abuse, smoking, education, and social class were used as covariates in regression analyses predicting health at age 70 from church attendance at age 47. Main outcome measures: Health at age 70 was assessed by 4 indicators: mortality, objective physical health, subjective physical health, and subjective well-being. Results: Though church attendance was related to later physical health, this was only through indirect means, as both physical health and church attendance were associated with substance use and mood. However, findings do suggest a more direct link between church attendance and well-being. Conclusion: Indirect effects of church attendance on health were clearly observed, with alcohol use/dependence, smoking, and mood being possible mediators of the church attendance-health relationship. The effects of church attendance on more subjective ratings of health, however, may be more direct. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comorbid survival among elderly male participants of the Canada health survey: relevance to prostate cancer screening and treatment

This study assessed the survival of a nationally representative sample of older Canadian men, taking into account common comorbid conditions. Mortality follow-up between 1978 and 1989 was conducted for male participants of the Canada Health Survey who were at least 60 years of age at baseline. The proportional hazards model and life table methods were used to examine survival by comorbidity status. Comorbid conditions examined included history of stroke and/or heart disease, high blood pressure, chronic bronchitis or emphysema, diabetes and smoking status, but excluded cancer because of small numbers. For those subjects aged 80 and older, comorbidity was not a significant predictor of survival. A large portion of men between the ages of 60 and 79, even those with pre-existing comorbid conditions, survived at least 10 years after interview. In a clinical setting, more detailed information on comorbid conditions can be obtained to better estimate long-term survival. Notwithstanding, our findings may have implications for the administration of population-based health interventions (e.g. the use of prostate-specific antigen [PSA] blood tests for the early detection of prostate cancer). In particular, our results suggest that there may be little benefit in restricting access to PSA screening based on survival probability in men under age 80.     

Social support and physical disability in older people after hospitalization: A prospective study.

This prospective study examined the effects of social support on physical disability in 269 older people (aged 65–97 yrs). Hospital monitoring identified longitudinal study participants who were admitted for hip fracture, stroke, or myocardial infarction. Interviews before the illness and at 6 wks and 6 mo after admission assessed social support and physical disability; medical records indicated illness severity and comorbidity. The number of emotional support providers and the adequacy of task support were higher after hospitalization. Medical factors and premorbid emotional support predicted disability at 6 wks; not needing support was associated with less disability than needing and receiving adequate support. Task support adequacy at 6 wks predicted less disability at 6 mo. The results reveal a dynamic relationship between social support and recovery. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patient-reported symptoms after primary therapy for early prostate cancer: results of a prospective cohort study

Phosphoribosyl-ATP pyrophosphohydrolase (PRA-PH) and phosphoribosyl-AMP cyclohydrolase (PRA-CH) are encoded by HIS4 in yeast and by hisIE in bacteria and catalyze the second and the third step, respectively, in the histidine biosynthetic pathway. By complementing a hisI mutation of Escherichia coli with an Arabidopsis cDNA library, we isolated an Arabidopsis cDNA (At-IE) that possesses these two enzyme activities. The At-IE cDNA encodes a bifunctional protein of 281 amino acids with a calculated molecular mass of 31,666 D. Genomic DNA-blot analysis with the At-IE cDNA as a probe revealed a single-copy gene in Arabidopsis, and RNA-blot analysis showed that the At-IE gene was expressed ubiquitously throughout development. Sequence comparison suggested that the At-IE protein has an N-terminal extension of about 50 amino acids with the properties of a chloroplast transit peptide. We demonstrated through heterologous expression studies in E. coli that the functional domains for the PRA-CH (hisI) and PRA-PH (hisE) resided in the N-terminal and the C-terminal halves, respectively, of the At-IE protein.     

Exercise and physical health: cancer and immune function

Over the last decade, there has been accumulating epidemiological data suggesting that exercise may decrease the risk of cancer, particularly colon cancer. However, exercise appears unrelated to rectal cancer risk. With regard to other cancers, because physical activity can alter levels of reproductive hormones, investigators have hypothesized that active individuals should experience decreased incidence of breast or prostate cancer. The better conducted studies suggest that exercise may reduce the risk of developing breast cancer. However, the epidemiological data on prostate cancer have been inconsistent. Meanwhile, data on other site-specific cancers have been sparse. An exciting and emerging body of research has suggested that exercise, at least in moderate amounts, can enhance the human immune system. Theoretically, then, this provides a further biological basis for expecting an inverse relationship between physical activity and cancer risk. However, the changes seen in immune function tend to be transient in nature; thus, the physiological significance with respect to cancer development is uncertain. Preliminary data also suggest that exercise may be beneficial for cancer patients by improving the quality of life and enhancing immune function. Although promising, this needs more careful research. Again, it is unclear whether the enhanced immune function is of any clinical significance in retarding the spread of cancer that has already developed. Finally, with regard to URTIs, moderate exercise appears to decrease the risk of this infection, although high-endurance exercise may increase the risk. This finding parallels the changes seen in the immune system in response to exercise and comes as no surprise, as the immune system also regulates susceptibility to infections.     

Heart rate and prostate cancer mortality: results of a prospective analysis

Recent studies suggest that local levels of sympathetic nervous activity influence the growth of prostatic tissue. In several epidemiological studies, resting heart rate, an indicator of overall sympathetic activity, was positively associated with all noncardiovascular and cancer death among men. However, no previous analyses have focused on the specific relationship of heart rate to prostate cancer mortality. We studied 22,380 men enrolled in the Chicago Heart Association cohort from 1967-1973, who had heart rate (HR) determined by electrocardiogram. Mean length of follow-up (for mortality) was 19.2 years. We computed age-adjusted rates for prostate cancer death by variable of interest and fitted proportional hazards models to estimate relative risks (RRs) adjusted for potential confounders. In a model controlling for age, body mass index, blood pressure, serum cholesterol, smoking, postload plasma glucose, and years of education, the RR for a 10 beat/min higher HR was 1.26 (95% confidence interval = 1.04-1.51). Age-adjusted RRs across higher quintiles for HR were 1.00, 1.55, 1.85, 2.18, and 2.69 (P trend = 0.006). Survival curves indicated that the elevated risk was not confined to the early years of follow-up. Because little is known about factors that determine risk of prostate cancer death, these results could prove important even if due to an unmeasured etiological factor other than heart rate itself. The results are consistent with the hypothesis that local neurotrophic factors associated with sympathetic activity influence the progression of prostate cancer     

A prospective study of family history and the risk of colorectal cancer

BACKGROUND: A family history of colorectal cancer is recognized as a risk factor for the disease. However, as a result of the retrospective design of prior studies, the strength of this association is uncertain, particularly as it is influenced by characteristics of the person at risk and the affected family members. METHODS: We conducted a prospective study of 32,085 men and 87,031 women who had not previously been examined by colonoscopy or sigmoidoscopy and who provided data on first-degree relatives with colorectal cancer, diet, and other risk factors for the disease. During the follow-up period, colorectal cancer was diagnosed in 148 men and 315 women. RESULTS: The age-adjusted relative risk of colorectal cancer for men and women with affected first-degree relatives, as compared with those without a family history of the disease, was 1.72 (95 percent confidence interval, 1.34 to 2.19). The relative risk among study participants with two or more affected first-degree relatives was 2.75 (95 percent confidence interval, 1.34 to 5.63). For participants under the age of 45 years who had one or more affected first-degree relatives, the relative risk was 5.37 (95 percent confidence interval, 1.98 to 14.6), and the risk decreased with increasing age (P for trend, < 0.001). CONCLUSIONS: A family history of colorectal cancer is associated with an increased risk of the disease, especially among younger people.     

A prospective study of reproductive factors and risk of epithelial ovarian cancer

BACKGROUND: Parity and long term use of oral contraceptives have been associated consistently with a decreased risk of ovarian cancer. However, previous reports of the relationship of other reproductive factors (time since first use or last use of oral contraceptives, age at menarche or menopause, age at first birth) with ovarian cancer have been inconsistent. METHODS: The authors studied these relationships in the Nurses' Health Study, a prospective cohort study of 121,700 female registered nurses aged 30-55 years in 1976 when the study began. From 1976 to 1988, 260 cases of confirmed epithelial ovarian cancer occurred among 1.2 million person-years of follow-up. RESULTS: A statistically significant inverse association was observed between parity and ovarian cancer risk (relative risk [RR] = 0.84; 95% confidence interval [CI] = 0.77-0.91 per pregnancy); age at first birth was not associated independently with risk. In age-adjusted analyses, a significant inverse association was noted between long term use of oral contraceptives and ovarian cancer, which was no longer significant after controlling for other ovarian cancer risk factors (RR with > or = 5 years' use: 0.65; 95% CI = 0.40-1.05). After control for duration of use, a weak nonsignificant inverse association was observed with time since first oral contraceptive use and no independent effect of time since last use. Neither age at menarche nor age at menopause was associated significantly with ovarian cancer risk. CONCLUSIONS: In this large prospective study, parity was the only reproductive factor that had a substantial independent association with ovarian cancer. Long term oral contraceptive use also appeared to have an inverse relationship with ovarian cancer, although this association was of borderline significance (P = 0.11) after adjustment for other risk factors.     

Comparing two theories of health behavior: A prospective study of noncompletion of treatment following cervical cancer screening.

Some women receiving abnormal cervical screening tests do not complete recommended treatment. A prospective study (N = 660) investigated the value of conceptualizing attendance at colposcopy for treatment as either (a) an active problem-solving response to a health threat, motivated by attitudes toward an abnormal result, as implied by self-regulation theory (H. Leventhal, D. Meyer, & D. Nerenz, 1980); or (b) as a behavior motivated by attitudes toward clinic attendance, as implied by the theory of planned behavior (TPB; I. Ajzen, 1985). Responses to questionnaires containing variables specified by these models were used to predict women's subsequent attendance or nonattendance for treatment over the following 15 months. Although the TPB offered superior prediction of intentions and completion of treatment, discriminant function analyses showed that consideration of both models was important in distinguishing between those who attended all their appointments as scheduled, attended after being prompted, or ceased attending. Implications for measurement and theory in health protection are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health habits of health professionals

The conduct of medical professionals is an important educational point of reference for the many people who see and know them. Nurses and other medical workers are often role models in which their daily health habits may be imitated by their patients, family of friends. With this in mind a study, based on a previously published work in the United States (Health Practices of Nursing Students), was performed to determine, first, if the daily habits of nurses are indeed healthy and adequate to communicate a salubrious lifestyle; second, to see if this group considers themselves capable and responsible for changing those unsanitary habits that they do have. Results of the surveys of 125 subject nurses from the University of Navarra indicate that there is a great amount of consciousness regarding the danger of most unsanitary habits and the need to avoid them, although many of them remain firmly entrenched in their daily lives. The percentage of nurses who felt capable or responsible for changing unhealthy practices was low (67.5%).