Sociodemographic and psychological predictors of changes in dietary fat consumption in adults with high blood cholesterol following counseling in primary care.

The associations between sociodemographic variables, psychological factors, and changes in dietary fat consumption over 4 months were assessed in a randomized controlled trial of behavioral counseling versus standard advice. Patients were 141 men and 150 women, with an average age of 52.1 years and total cholesterol level of 7.27 mmol/l (278 mg/dl). Smokers, younger patients, and those with greater body mass index had higher fat intake at baseline. Behavioral counseling led to greater reductions in fat intake than did standard advice. Self-efficacy and ratings of benefits of low-fat diets were related to fat consumption at baseline, and changes in these measures were correlated with changes in fat intake. Family support, baseline anticipated regret, and (for the behavioral counseling group only) baseline behavioral intentions predicted reductions in fat intake. The results indicated that psychosocial variables associated cross-sectionally with fat consumption do not necessarily predict change and that factors involved in the process of change and the prediction of change need to be differentiated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Joint impairment and self-reported disability in elderly persons

Recent findings indicating that arthritis is a major contributor to disability in elderly persons are based on self-reported diagnostic information. We conducted physical examinations of the joints at baseline on 541 older persons. We then tested a multivariate model of total/generic disability which included respondent group, demographic and chronic disease variables (joint impairment and comorbid conditions), arthritis pain, and psychological status. Hierarchical multiple regression found that the model explained 55 percent (adjusted R2 = .55) of the variance in baseline disability with joint impairment accounting for 15 percent (change in R2 = .15) of the variance. When joint impairment was removed from the model, arthritis pain worked well as a surrogate. Together, these findings strongly support the importance of musculoskeletal disease in explaining disability in the elderly population.     

Pathways between physical activity and quality of life in adults with multiple sclerosis.

Objective: This prospective study examined symptoms of depression, fatigue, pain, self-efficacy, and social support as possible intermediaries in the pathway between changes in physical activity and quality of life (QOL) across a 6-month period in persons with multiple sclerosis (MS). Design and Main Outcome Measures: Adults with a definite diagnosis of MS wore an accelerometer for 7 days and then completed a battery of questionnaires at baseline (n = 292) and 6-months follow-up (n = 276). The data were analyzed using panel analysis and covariance modeling in Mplus 3.0. Results: The initial analysis indicated that change in physical activity was associated with a statistically significant and small residual change in QOL (β = .07). The subsequent analysis indicated that change in physical activity was associated with residual changes in fatigue (γ = ?.17), pain (γ = ?.13), social support (γ = .07), and self-efficacy (γ = .11), and, in turn, changes in fatigue (β = ?.13), pain (β = ?.09), social support (β = .18), and self-efficacy (β = .10) were associated with a residual change in QOL. Conclusion: The observed pattern of relationships supports the possibility that physical activity is indirectly associated with improved QOL through pathways that include fatigue, pain, social support, and self-efficacy in individuals with MS. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Longitudinal findings from the normative aging study: I. Does mental health change with age?

Longitudinal changes in self-reported symptoms were investigated using the Cornell Medical Index (CMI) in a sample of 2,041 men. The average man completed 5 CMIs (range?=?2–8) over 17 (range?=?2–25) years. Using a two-stage growth model, we first regressed symptoms against time on study for each man. The average slope of physical symptoms showed a moderate increase over time, but the average slope of psychological symptoms showed little change. Next individual differences in change were examined using age at entry as an explanatory variable. Age accounted for 50% of the variance in physical symptoms at entry and 7% of the variance in slopes, but explained neither baseline level nor change in psychological symptoms. Rather, a U-shaped curve described the relation between age and psychological symptom change. These results, in concert with a developmental perspective, may help reconcile conflicting findings on aging and mental health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changes in general health and musculoskeletal outcomes in the workforce of a hospital undergoing rapid change: A longitudinal study.

This article aimed to examine changes in general health and time with back pain and neck pain and to identify predictors of any such changes. Hospital workers were studied longitudinally with surveys in 1995, 1996, and 1997 (N?=?712). Back and neck pain were reported only at the 2nd and 3rd surveys. There was a significant decline in general health and significant increases in time with neck pain and back pain. Predictors of changes in these outcomes were mainly work-related variables (initial or change values), such as job interference with family, job influence, work psychological demands, and hours worked. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Daily life patterns associated with 18-months changes of disability among frail elderly living at home

The purpose of this study was to investigate daily life patterns associated with changes of disability over 18-months among frail elderly living at home. Subjects were 50 frail elderly living at home who were interviewed at baseline, in July-September 1995. By detailed time budgets among them, five life patterns were classified. Lying-rest life pattern, Sitting-rest life pattern, Hobby life pattern, Walking life pattern, and Houseworking life pattern. Activities of daily living (ADL) measured by Extended ADL Index consisted of 8 items of Barthel Index and 4 items of TMIG Index of Competence. Information for follow-up were obtained from home health nurses or mail-questionnaires February-March in 1997. The results were as follows: All samples were able to be followed. Seven people died within the 18 months follow-up. Overall change of score on ADL was not seen between baseline and follow-up study. ADL improvement was seen in 45.0% and 43.7% had declines. Daily life patterns were not correlated with changes in ADL score. However, analysis of decline in ability to perform each activities, relative associations (not statistically significant) were found for changes in function and daily life patterns. Lying-rest life pattern and Sitting-rest life pattern elderly were more likely to decline in ADL than Walking life pattern and HouseworKing life pattern elderly. Hobby life pattern elderly only declined in walking. These findings support previous studies showing that disability of home frail elderly could be improved. Daily life pattern among them would be a helpful predictor of changes in specific physical performance over years.     

Symptoms of depression and changes in body weight from adolescence to mid-life

OBJECTIVE: To investigate the relationship of symptoms of depression to weight changes in healthy individuals of normal weight across a follow-up of over 20 y. PARTICIPANTS AND DESIGN: College students (3885 men and 841 women) were administered a self-report depression measure in the mid-1960s. Their baseline body mass index (BMI) was calculated from their college medical records. Participants were contacted by mail in the late 1980s and asked to report their current height and weight as well as their smoking and exercise habits. Another measure of depressive symptoms was obtained from 3560 individuals at follow-up. Multiple regression models were used to relate changes in weight to depression scores while controlling for background (gender, baseline BMI and the gender by BMI interaction) and behavioral (exercise and smoking) predictors. RESULTS: The relationship between depressive symptoms and body weight change took the form of an interaction with baseline BMI (P < 0.001). Those with high baseline depression scores gained less weight than their nondepressed counterparts if they were initially lean, but more if they were initially heavy. This trend was especially strong in those with high depression scores at both baseline and follow-up. CONCLUSIONS: The findings support the hypothesis that depression exaggerates pre-existing weight change tendencies. This pattern would not have been detected by an examination of main effects alone, illustrating the need to move toward more complicated interactive models in the study of psychological factors and weight.     

Long-term effects of lifestyle changes on well-being and cardiac variables among coronary heart disease patients.

Objective: To focus on psychological well-being in the Lifestyle Heart Trial (LHT), an intensive lifestyle intervention including diet, exercise, stress management, and group support that previously demonstrated maintenance of comprehensive lifestyle changes and reversal of coronary artery stenosis at 1 and 5 years. Design and Main Outcome Measures: The LHT was a randomized controlled trial using an invitational design. The authors compared psychological distress, anger, hostility, and perceived social support by group (intervention group, n = 28; control group, n = 20) and time (baseline, 1 year, 5 years) and examined the relationships of lifestyle changes to cardiac variables. Results: Reductions in psychological distress and hostility in the experimental group (compared with controls) were observed after 1 year (p     

To lump or to split? Comparing individuals with traumatic and nontraumatic limb loss in the first year after amputation.

Objective: To compare individuals with traumatic (TE) vs. nontraumatic (NTE) amputation etiology on pain, psychological, and social variables over the first 12 months postamputation, and to explore changes in mean levels of and correlations between these variables over time. Participants: There were 111 adults with newly acquired limb loss. Settings: A VA medical center and a Level I trauma hospital in a large metropolitan area. Main Outcome Measures: Characteristic Pain Severity, Pain Interference, Patient Health Questionnaire depression module, Posttraumatic Stress Disorder Checklist, Social Constraints Scale, Aversive Emotional Support Scale, Centers for Disease Control and Prevention single item Social Support measure, single item loneliness measure. Results: The NTE group was significantly older, had lower income, and had greater medical comorbidity, preamputation pain, and physical disability. The etiology groups did not differ significantly in mean levels of outcome variables except that the TE group reported greater aversive emotional support at 6 and 12 months. The TE group demonstrated a quadratic change in pain interference, with highest levels at 6 months and a linear increase in social constraints. Both etiology groups showed a linear increase in PTSD symptoms over time. Correlations between physical, psychological, and social distress were observed earlier in the year for the NTE group. Conclusion: Despite significant demographic and preamputation experience differences, few differences in outcomes emerged by etiology group in the first year after amputation. Findings suggest that the year after amputation may be a time of greater change for those with traumatic amputation compared to those with nontraumatic amputation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluation of hypertensive patients after care provided by community pharmacists in a rural setting

We evaluated blood pressure control, quality of life, quality of care, and satisfaction of patients who were monitored by specially trained community pharmacists in a group medical practice. After participating in an intensive skill development program, pharmacists performed in an interdisciplinary team in a rural clinic. The primary objective was assessed by evaluating outcome variables at 6 months compared with baseline in 25 patients randomly assigned to a study group. A control group of 26 patients was also evaluated to determine if outcome variables remained constant from baseline to 6 months. Systolic blood pressure was reduced in the study group (151 mm Hg baseline, 140 mm Hg at 6 mo, p<0.001) and diastolic blood pressure was significantly lower at 2, 4, and 5 months compared with baseline. Ratings from a blinded peer review panel indicated significant improvement in the appropriateness of the blood pressure regimen, going from 8.7 +/- 4.7 to 10.9 +/- 4.5 in the study group (p<0.01), but they did not change in the control group. Several quality of life scores improved significantly in the study group after 6 months (p<0.05). These included physical functioning (61.6 vs 70.7), physical role limitations (56.8 vs 72.8), and bodily pain (60.0 vs 71.7) at baseline and 6 months, respectively. There were no significant changes in the control group. Patient satisfaction scores were consistently higher in the study group at the end of the study. Our results indicate that when community pharmacists in a clinic setting are trained and included as members of the primary care team, significant improvements in blood pressure control, quality of life, and patient satisfaction can be achieved.     

Psychosocial predictors of changing sleep patterns in aging women: A multiple pathway approach.

The authors of this investigation sought to examine changes in the sleep quality of older women over time and to determine whether dimensions of psychological well-being, health (subjective health and number of illnesses), and psychological distress (depression and anxiety) predict these changes. A secondary analysis was conducted with a longitudinal sample of aging women (Kwan, Love, Ryff, & Essex, 2003). Of 518 community-dwelling older women in the parent study, 115 women (baseline M age = 67 years, SD = 7.18) with data at baseline, 8 years, and 10 years were used for this investigation. Participants completed self-administered questionnaires and participated in in-home interviews and observations. Growth curve modeling was used to examine the overall linear trajectories of sleep quality. Growth mixture modeling was used to examine whether there were different patterns of change in sleep quality over time and to examine baseline predictors of each pattern. Sleep quality declined over time but not for all women. Two distinctly different sleep patterns emerged: good but declining sleep quality and disrupted sleep quality. Higher psychological well-being (positive relations with others, environmental mastery, personal growth, purpose in life, and self-acceptance), fewer illnesses, and lower depression scores at baseline predicted reduced odds for membership in the disrupted sleep group. Future research is needed to examine whether interventions focused on maintaining or enhancing psychological well-being could minimize later life declines in sleep quality. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Grip strength changes over 27 yr in Japanese-American men

The aim of this study was to describe changes in grip strength over a follow-up period of approximately 27 yr and to study the associations of rate of strength decline with weight change and chronic conditions. The data are from the Honolulu Heart Program, a prospective population-based study established in 1965. Participants at exam 1 were 8,006 men (ages 45-68 yr) who were of Japanese ancestry and living in Hawaii. At follow-up, 3,741 men (age range, 71-96 yr) participated. Those who died before the follow-up showed significantly lower grip-strength values at baseline than did the survivors. The average annualized strength change among the survivors was -1.0%. Steeper decline (>1.5%/yr) was associated with older age at baseline, greater weight decrease, and chronic conditions such as stroke, diabetes, arthritis, coronary heart disease, and chronic obstructive pulmonary disease. The risk factors for having very low hand-grip strength at follow-up, here termed grip-strength disability (相似文献   

Hormonal changes during parturition in heifers and goats are related to the phases and severity of labour

BACKGROUND: Although the literature on increased physical fitness and psychological outcomes has grown large, a number of methodological limitations remain unaddressed. The present study was designed to address a number of these limitations while examining the short- and long-term psychological effects following completion of a 12-week aerobic fitness program using bicycle ergometry (and confirmed increases in fitness). METHOD: Following completion of a 12-week aerobic fitness program (and through 12 months of follow-up), 82 adult participants completed the Beck Depression Inventory, Profile of Mood States, State-Trait Anxiety Inventory, and the Tennessee Self-Concept Scale. Physiological measures used to assess changes in aerobic fitness were maximal work load, submaximal heart rate at a standard work load, predicted maximum oxygen uptake, and resting heart rate. RESULTS: Exercise participants experienced a positive fitness change and psychological improvement over the initial 12-week program compared to a control group. At 1 year follow-up, physiological and psychological benefits remained significantly improved from baseline. CONCLUSIONS: Overall, results indicate that exercise-induced increases in aerobic fitness have beneficial short-term and long-term effects on psychological outcomes. We postulate that participants in the exercise group did not increase the amount of weekly exercise they performed over the 12-month follow-up period and thus the maintenance of the psychological improvements occurred concurrent with equal or lesser amounts of exercise.     

The prevalence of TMD in orthodontic patients prior to treatment at NCKUH in southern Taiwan. National Cheng Kung University Hospital

Orthodontic treatment is considered one of the risk factors for temporomandibular disorders (TMD). However, TMD may occur before orthodontic treatment. The purpose of this study was to investigate the prevalence of TMD in orthodontic patients prior to treatment. The samples consisted of 508 patients (214 males and 294 females) at the National Cheng Kung University Hospital (NCKUH) in southern Taiwan. Ages ranged from 6 to 56 years. TMD signs were recorded by clinical examination prior to treatment. The overall prevalence of TMD was 26.6%. The prevalence was slightly higher in females (27.2%) than males (24.8%). However, the difference was not statistically significant. The prevalence of TMD in children (ages 6-17) and adults (ages 18-56) was 16.5% and 43.6%, respectively. The difference was statistically significant. Distribution of TMD signs was joint sounds (32.3%), muscle or joint pains (32.3%), muscle or joint pains (32.3%), mouth opening less than 35 mm (18%), combination of two signs (16.5%) and combination of three signs (0.8%).     

Longitudinal analysis of physical activity and symptoms as predictors of change in functional limitations and disability in multiple sclerosis.

Objective: This longitudinal, observational study examined changes in physical activity and symptoms as correlates of changes in functional limitations and disability across a 6-month period among individuals with multiple sclerosis (MS). Method: Individuals with MS wore an accelerometer for a 7-day period and completed a battery of measures including the Godin Leisure-Time Exercise Questionnaire (Godin & Shephard, 1985), Symptom Inventory (Schwartz, Vollmer, & Lee, 1999), MS-Related Symptom Checklist (Gulick, 1989), and abbreviated Late-Life Function and Disability Inventory (McAuley, Konopack, Motl, Rosengren, & Morris, 2005) at baseline (n = 292) and 6-month follow-up (n = 276). The data were analyzed using panel analysis with latent variables in AMOS 16.0. Results: The standardized coefficients indicated that (a) change in physical activity was associated with residual change in function (β = .22), (b) change in symptoms was associated with residual changes in both function (β = –.29) and disability (γ = –.15), and (c) change in function was associated with residual change in disability (β = .20). Conclusion: Our findings indicate that change in physical activity is associated with change in disability through a pathway that is consistent with Nagi’s (1976) Disablement Model and its extension in individuals with MS. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Long-term follow-up study on drop-out TMD patients with self-administered questionnaires

Although patient attrition might be a serious threat to the validity of treatment-outcome studies on temporomandibular disorders (TMD), studies on TMD patient attrition are scarce. Of the 1405 consecutive TMD patients examined in a recent 10-year period, 367 (26.1%) drop-out patients or patients identified with a control group were sampled. A mailed questionnaire failed to reach 41 patients, and 203 (62.3%) were returned. The questionnaire elicited information on reasons for dropping out, changes in symptoms, treatment received in other clinics after dropping out, present treatment needs, and current signs and symptoms. Dropouts were divided into two groups: (1) those who failed to show up for their first scheduled appointment after the clinical examination; (2) those who failed to complete treatment. A group of patients who were judged by the examiner not to need treatment were included as a control group. The main reasons for dropping out were environmental obstacles, perceived improvement of the disease, and dissatisfaction with services. Only 21.7% considered themselves to be in need of treatment, and only 10.3% had visited other clinics after dropping out. Only 8.9% complained of the continued aggravation of symptoms, whereas 57.6% reported improvement. In addition, pain, dysfunction, and daily activity limitation tended to improve with time, although temporomandibular joint noise tended to persist. These results suggest that TMD signs and symptoms tend to decrease in patients after dropping out, and that the natural fluctuation of TMD signs and symptoms should be taken into consideration when treating TMD.     

Longitudinal findings from the normative aging study: III. Personality, individual health trajectories, and mortality.

Individual differences in physical and psychological health trajectories were examined in 1,515 Normative Aging Study men. Mean age at baseline was 47.15 yrs (range 28–80 yrs), and average follow up was 18.55 yrs (range 8–25 yrs). Both linear and nonlinear growth curves were estimated with random-effects models and then clustered to identify patterns of change. Men whose physical health trajectories were characterized by high, increasing symptoms were higher in hostility and anxiety, were overweight, and smoked. Those whose trajectories were characterized by low symptoms were emotionally stable, educated, nonsmokers, and thin. Men with high, stable psychological trajectories had high hostility; those with low, stable trajectories had high emotional stability; those with moderate anxiety levels had nonlinear trajectories with peaks in psychological symptoms at different life stages. Personality had life-long effects on health trajectories, but these effects varied across traits and health outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Timing of dietary change in response to a telephone counseling intervention: Evidence from the WHEL study.

Objective: Little is known about temporal patterns of diet change within interventions, nor about predictors of early and sustained successful change. Social-cognitive theory asserts that early successes in achieving behavior change increase self-efficacy, leading to longer-term success. Design: The authors conducted exploratory cluster analyses using dietary data from the first month of the telephone counseling intervention of the Women's Healthy Eating and Living (WHEL) Study. Main Outcome Measure: Change in dietary pattern at three early intervention timepoints. Results: Three clusters were identified: Cluster 1 (25%) was close to meeting study goals at baseline, but still made major changes; Cluster 2 (49%) and Cluster 3 (26%) were not achieving study goals at baseline, but Cluster 2 made substantial immediate changes, while Cluster 3 changed their diet more gradually. Baseline demographic and behavioral variables were associated with cluster membership; however, the strongest predictors of cluster were self-efficacy, motivation, and approaches to study goals. Cluster membership predicted dietary pattern at 12 months. Conclusion: These data suggest that a one-on-one telephone counseling intervention that is intensive in the early weeks may maximize the level of change achieved in a study. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Oral dolasetron mesylate for prevention of postoperative nausea and vomiting: a multicenter, double-blind, placebo-controlled study. The Oral Dolasetron PONV Prevention Study Group

Parafunctional activities are assumed to play an important role in temporomandibular disorders (TMD), but experimental data in support of this hypothesis are lacking. This study examined the role of parafunctional clenching on various measures of TMD pain. Five subjects participated in daily 17-minute electromyogram biofeedback training sessions structured in three phases. Subjects were instructed to maintain temporalis and masseter muscle activity below 2 microV in the first (decrease) phase of training (10 sessions), above 10 microV in the second (increase) phase (1 to 8 sessions), and below 2 microV in the third (decrease) phase (10 to 15 sessions). Preliminary screening examinations showed that none of the subjects had TMD. Two subjects reported intolerable pain during increase training, and both were diagnosed with a TMD during this phase. No subject was diagnosed with TMD pain during either decrease training phase. The authors conclude that chronic, low-level parafunctional clenching may be a factor in the cause of TMD pain.