Gender differences in lifestyles of the middle-aged and the elderly--a study in Satomi village, Ibaraki, Japan

The purpose of this study was to examine the gender differences in the total lifestyles of the middle-aged and the elderly. A self-administered questionnaire was employed to assess the lifestyles of inhabitants aged 40 years and over. Only 400 middle-aged and elderly who lived in Satomi village, Ibaraki Prefecture were randomly sampled for this study. Though the questionnaires contained 99 items such as nutrition, exercise, cigarette use, alcohol use, rest; we used only 84 items in this study. Satomi village is a rural area with a population size of approximately 4,500 and an aging rate of 25.9%. Questionnaires were sent to the subjects by mail. The response proportion was 90%, and the valid response proportion was 85.3%. Subjects included 155 men and 186 women. The average age of all subjects was 61.5 +/- 12.0 years old: males; 60.8 +/- 11.5 years old, females; 62.1 +/- 12.4 years old. Gender differences were assessed for selected items with the chi 2 test. Women tended to have significantly better health habits on items such as nutrition, alcohol intake, and cigarette use (p < 0.05). Factor analysis with varimax rotation was used to separate the items. Three factors that had eigenvalues substantially > 1.0 were extracted and explained 49.7% of the total variance. Factor 1 reflects health promotional activities; Factor 2 denotes health preventive activities; Factor 3 reflects the avoidance of health risk. Though gender differences were not observed for Factor 1 (p = 0.8647), they were seen for Factor 2 (p = 0.0003) and Factor 3 (p = 0.0001) with the Wilcoxon rank sum test. Wilks'lambda test was utilized as likelihood ratio test mean vectors of Factor 1, Factor 2, and Factor 3 (p = 0.0001). The results of the Wilks'lambda test indicated significant gender differences. Our findings suggest significant gender differences in the total lifestyles, but not in the individual lifestyle habits.     

Dietary assessment in epidemiology: comparison on food frequency and a diet history questionnaire with a 7-day food record

The validity of two types of diet assessment methods, a self-administered food frequency questionnaire and and interviewer-administered detailed diet history, was assessed relative to a 7-day food record on a population- based sample of 95 men and 108 women in Toronto, Canada, between May 1989 and July 1990. Each study subject completed both questionnaire methods, a food frequency questionnaire and an interviewer-administered diet history, as well as a 7-day food record in a crossover design. Data were analyzed for both unadjusted and energy-adjusted nutrients to estimate Pearson's and intraclass correlations and agreement within the categories. Mean values for the intake of most nutrients assessed by the two questionnaire methods were similar. Average, energy-adjusted Pearson's correlation coefficients for men between a food frequency questionnaire and a 7-day food record were 0.55 for macronutrients and 0.48 for micronutrients compared with 0.47 for macro- and 0.48 for micronutrients between an interviewer-administered diet history and a 7-day food record. For women, they were 0.48 for macro- and 0.54 for micronutrients between a food frequency questionnaire and a 7-day food record and 0.46 and 0.49, respectively, between an interviewer-administered diet history and a 7-day food record. The energy-adjusted Pearson correlations were generally higher than were the energy-unadjusted Pearson correlations and the intraclass correlations. The present study suggests that a food frequency questionnaire is comparable with an interviewer-administered diet history as a predictor of nutrients as estimated form a 7-day food record.     

Cellular localization of antiviral polyoxometalates in J774 macrophages

The main objective of the present study was to examine the relationship between regular benzodiazepine (BZD) use and drinking patterns in 55-year-old female residents of Malm?, Sweden. All women born in 1935 (a total of 1223 subjects) were invited to a health screening at the Preventive Medicine Section, Malm? General Hospital; 69% agreed to participate. The screening included an extensive health questionnaire, and the responses to 33 items assessing social background, including immigrant status, use of BZD and analgesics, alcohol consumption (the revised Malm?-MAST), smoking and morbidity were analysed. A psychiatric symptoms scale including five of these items was constructed, yielding a Cronbach's alpha of 0.57. Present use of BZD hypnotics and/or tranquillizers was acknowledged by 6% of the women. BZD use at any time in the past or present was endorsed by 23%. Endorsement of > or = 3 revised Malm?-MAST items, indicating problem drinking, occurred in 3% of the participants; 16% were teetotallers and about 25% were regular weekend drinkers. BZD use was significantly more likely to occur in women with the following characteristics: early retirement, pain symptoms, longstanding use of analgesics, multiple psychiatric symptoms. Drinking patterns in relation to BZD use indicated that regular weekend drinkers were significantly less likely to be current and/or previous BZD users than problem drinkers and teetotallers. Logistic regression analyses indicated that use of BZDs was mainly predicted by endorsement of multiple psychiatric symptoms.     

Immunohistochemical localization of Na+/Ca2+ exchanger in human retina and retinal pigment epithelium

OBJECTIVE: Validation a self-administered form used by patients to record their food intake and compare the recorded data with the observed intake. DESIGN: Data were obtained from an unselected cross-sectional group of hospitalized patients. SUBJECTS: Forty-five adult men and women volunteered to participate. Five of these dropped out. METHODS: Observed intake at breakfast, lunch and dinner was obtained by recording the servings of food before they were served to the patients and subtracting weighed leftovers. At meal times the patients recorded food items eaten in fractions of amount served to the nearest 25%. SETTING: Inpatients from five different wards at Rikshospitalet, Oslo. RESULTS: There was a significant under-reporting of the number of foods served (P < 0.005) resulting in a significant underestimation of energy 231 kJ (P < 0.02). There was good agreement between the patients and the observers for the portions of most foods (Kappa 0.44-0.92, P < 0.00001). The differences in amount had little influence on the difference in total energy. The difference in number of foods correlated with the difference in energy (r = 0.68, P < 0.001) and with the difference in protein (r = 0.50, P < 0.01). Patients with an underestimation of energy above 20% had forgotten seven or more food items. CONCLUSIONS: For most patients, the self-administered form adapted to the hospital menu appears to have acceptable validity, but for some patients it was unacceptable, mainly owing to food items being omitted and not because of incorrect estimate of amounts of food.     

Social desirability and the randomized response technique.

The randomized response technique (RRT) is designed to increase respondents' willingness to answer truthfully questions of a sensitive or socially undesirable nature. This study tested the hypothesis that the difference between the proportion of "yes" responses obtained under self-administered direct questioning and the proportion of "yes" responses obtained under an RRT procedure would be related to the social desirability of a "yes" response to the question. The hypothesis was confirmed by data from 404 undergraduates; the RRT may provide more valid responses to items of a socially desirable and undesirable nature. The RRT deserves more attention because it can circumvent biases due to untruthful responding, demand characteristics, and evaluation apprehension as well as assure the confidentiality of the data. (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship between orthostatic dysregulation and the orthostatic test in dizzy patients

The orthostatic test was administered to 134 dizzy patients (37 males and 97 females) who were identified as having orthostatic dysregulation from December 1990 through November 1994. The mean age of the male and female patients was 42.5 and 44.6 years, respectively, and the peak age decade was the 50s. Among the questionnaire items for orthostatic dysregulation, orthostatic dizziness was the most frequent major symptom and occurred in 116 of the patients (86.6%). Fatigue was the most frequent minor symptom and was found in 97 (72.4%). The incidence of positive orthostatic test results in the patients with orthostatic dysregulation (50.7%) was significantly higher (P < 0.01) than that in the control subjects (27.8%). There was also a significant difference (P < 0.01 or P < 0.05) between systolic pressure decrease during the orthostatic test procedure in the patients with orthostatic dysregulation and that in the control subjects. These results suggest that autonomic imbalance as reflected by the orthostatic dysregulation questionnaire and orthostatic test results is closely related to the occurrence of dizziness or vertigo.     

Effect of anonymity on return rate and response bias in a mail survey.

1 group of 22,750 officers and enlisted men to whom the Navy Personnel Survey 71-1 was mailed were instructed to record their service numbers on their answer sheets, while another group of 22,750 officers and enlisted men were instructed not to identify their answer sheets. Answer sheets were returned more frequently by officers asked to identify their answer sheets. Differences in answers to attitude questions were low in relative frequency and small in magnitude. Pro-Navy statements were endorsed by a higher proportion of the officers who identified their answer sheets; negative statements were endorsed by a higher proportion of the officers who did not identify their answer sheets. None of the anonymous-identified group differences for the enlisted men's questionnaire were large enough to be of practical importance. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gender, quality of life, and mental disorders in primary care: results from the PRIME-MD 1000 study

BACKGROUND: Recently there has been increased interest in the special mental health needs of women. We used data from the PRIME-MD 1000 study to assess gender differences in the frequency of mental disorders in primary care settings, and to explore the potential impact of these differences on health-related quality of life (HRQL). SUBJECTS AND METHODS: One thousand primary care patients (559 women) were interviewed during the PRIME-MD study, which was conducted at four primary care clinics affiliated with university hospitals throughout the eastern United States. Patients completed a one-page questionnaire in the waiting room prior to being seen by the physician; patients and physicians then completed together a clinician evaluation guide that used DSM-III-R algorithms to diagnose mood, anxiety, somatoform, eating, and alcohol related disorders. Health-related quality of life was assessed with the Medical Outcomes Study SF-20 General Health Survey. RESULTS: Women were more likely than men to have at least one mental disorder (43% versus 33%, P < 0.05). Higher rates were particularly prominent for mood disorders (31% of women versus 19% of men, odds ratio [OR] = 1.9, 95% confidence interval [CI] 1.4 to 2.6), anxiety disorders (22% versus 13%, OR = 1.9, CI = 1.3 to 2.8), and somatoform disorders (18% versus 9%, OR = 2.2, CI = 1.5 to 3.4). Psychiatric comorbidity was also more common in women (26% of women had two or more mental disorders versus 15% of men, P < 0.05). Unadjusted HRQL scores, ranging from 0 to 100, with 100 = best health, were all significantly lower in women than in men (eg, physical function = 67 in women versus 76 in men, P < 0.0001; mental health = 69 in women versus 76 in men, P < 0.0001). Many HRQL differences persisted after controlling for age, education, ethnicity, marital status, and number of physical disorders; however, differences in HRQL were eliminated in 5 of 6 domains after controlling for number of mental disorders. When compared with female patients of male physicians, female patients of female physicians demonstrated similar satisfaction with care, health care utilization, HRQL, and recognition rate of mental disorders. CONCLUSIONS: In the 1,000 patients of the PRIME-MD study, mood, anxiety, and somatoform disorders and psychiatric comorbidity were all significantly more common in women than men. The HRQL scores were poorer in women than men, although most of this difference was accounted for by the difference in prevalence of mental disorders. These data suggest that one of the most important aspects of a primary care physician's care of female patients is to screen for and treat common mental disorders.     

An improved questionnaire for assessing quality of life after acute myocardial infarction

This paper reports our experience with the use of an improved self-administered questionnaire for assessing quality of life (QOL) after acute myocardial infarction. The modified questionnaire significantly increased the proportion of patients able to answer all questions from 84%-92%. The additional questions in the improved questionnaire increased the total variance explained by the Emotional, Physical and Social QOL factors from 65.8%-66.5%. Internal consistency and construct validity were assessed and found to be high. Overall, we have found that this improved questionnaire is easy to administer and that it possesses desirable properties of validity and reliability.     

Time course of symptom resolution in patients with community-acquired pneumonia

The majority of patients with community-acquired pneumonia are at low risk for short-term mortality or serious morbidity and are increasingly managed in the outpatient setting. Efforts to improve the quality of care for these patients will need to measure patient outcomes such as disease-specific symptom resolution. The aims of this study were to (1) develop a self-administered daily version of a symptom questionnaire for patients with pneumonia, (2) measure the reliability of this instrument, and (3) provide estimates for recovery rates based on symptom resolution in a cohort of low-risk patients with community-acquired pneumonia. This study was conducted as part of a prospective study of a new emergency department protocol for pneumonia at the Massachusetts General Hospital. Eligible study subjects included all adult patients with pneumonia presenting to the emergency department with a predicted low risk of short-term mortality. The main outcome measures were based on a new five item symptom questionnaire which rates the severity of cough, fatigue, dyspnea, myalgia, and fever. The questionnaires were self-administered on days 0-7, 14, 21 and 28 from the time of diagnosis of pneumonia. The symptom questions were also administered during patient interviews on days 0, 7, 14 and 28 in order to assess the questionnaire's reliability. Of the 166 eligible patients, 134 (81%) consented to participate in this study. The mean intra-class reliability coefficient of the symptom questionnaire was 0.75. The median times to resolution of individual symptoms ranged from 3 days for fever to 14 days for cough and fatigue. Thirty-five percent of patients had at least one symptom still present at the end of the 28-day study period. We found that a daily self-report questionnaire is a reliable measure of symptom resolution for patients with pneumonia. Full resolution of symptoms takes more than 28 days for a significant proportion of patients with pneumonia.     

Measuring disability, the agreement between self evaluation and observation of performance

PURPOSE: In 1981, eight countries and the World Health Organization (WHO) reached consensus about applying a similar disability questionnaire in their health surveys that was related to the ICIDH. In 1992 a revised version, the WHO-disability questionnaire, was recommended. In this paper the concurrent validity of 10 items of the questionnaire is evaluated by measuring the agreement with observed performance of corresponding tasks. METHOD: The disability questionnaire was sent to 750 subjects. From the respondents (468) 93 were selected, based on their reported disability, and 10 performance tasks were observed. The agreement was measured for individual items and for all items together in distinguishing between persons with no, or at least one disability. RESULTS: A low to moderate agreement was found between self reported and observed disability. In general, observation resulted in lower disability ratings. Among 24% of those who reported at least one disability, no disability was observed. Persons among whom at least one disability was observed, only 2% (n = 1) reported no disability in the questionnaire. CONCLUSIONS: Although the concurrent validity is low to moderate between the results of the WHO-disability questionnaire and observation, the questionnaire is highly sensitive for detecting persons with at least one disability. The specificity of the questionnaire must be increased by additional questions.     

Mucin secretion in papillary (chromophil) renal cell carcinoma

BACKGROUND: In Canada, primary care physicians manage most musculoskeletal problems. However, their training in this area is limited, and some aspects of management may be suboptimal. This study was conducted to examine primary care physicians' management of 3 common musculoskeletal problems, ascertain the determinants of management and compare management with that recommended by a current practice panel. METHODS: A stratified computer-generated random sample of 798 Ontario members of the College of Family Physicians of Canada received a self-administered questionnaire by mail. Respondents selected various items in the management of 3 hypothetical patients: a 77-year-old woman with a shoulder problem, a 64-year-old man with osteoarthritis of the knee and a 30-year-old man with an acutely hot, swollen knee. Scores reflecting the proportion of recommended investigations, interventions and referrals selected for each scenario were calculated and examined for their association with physician and practice characteristics and physician attitudes. RESULTS: The response rate was 68.3% (529/775 eligible physicians). For the shoulder problem, all of the recommended items were chosen by the majority of respondents. However, of the items not recommended, ordering blood tests was selected by almost half (242 [45.7%]) as was prescribing an NSAID (236 [44.7%]). For the knee osteoarthritis the majority of respondents chose the recommended items except exercise (selected by only 175 [33.1%]). Of the items not recommended, tests were chosen by about half of the respondents and inappropriate referrals (chiefly for orthopedic surgery) were chosen by a quarter. For the acutely hot knee, the majority of physicians chose all of the recommended items except use of ice or heat (selected by only 188 [35.6%]). Although most (415 [78.5%]) of the respondents selected the recommended joint aspiration for this scenario, 84 (15.9%) omitted this investigation or referral to a specialist. The selection of recommended items was strongly associated with training in musculoskeletal specialties during medical school and residency. INTERPRETATION: Primary care physicians' management of 3 common musculoskeletal problems was for the most part in accord with panel recommendations. However, the unnecessary use of diagnostic tests, inappropriate prescribing of NSAIDs, low use of patient-centred options such as exercise, and lack of diagnostic suspicion of infectious arthritis are cause for concern. The results point to the need for increased exposure to musculoskeletal problems during undergraduate and residency training and in continuing medical education.     

Social desirability and responses to items from three MMPI scales: D, Sc, and K.

For random samples of 25 D and 32 Sc items, and for 29 of the 30 K items, ratings of social desirability were correlated with the probabilities that the items would be endorsed when the MMPI was used as a personality test (based on proportion of a college student sample actually endorsing each item). The correlations were .82 and .89 for the D and Sc items respectively. For the K-scale items, correlations of social desirability were computed with endorsement probabilities from a "typical college sample" (r = .50), and "Average-K" group (r = .38), and a "high-K" group (r = .66). "The results were interpreted as demonstrating the validity of K as a measure of the set to respond to items in terms of their social desirability." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Initial validation of a computer-administered Addiction Severity Index: The ASI–MV.

The Addiction Severity Index—Multimedia Version (ASI–MV) is a CD-ROM-based simulation of the interview-administered Addiction Severity Index (ASI). Clients in treatment (N ?=?202) self-administered the ASI–MV to examine the test–retest reliability, criterion validity, and convergent–discriminant validity of the ASI–MV. Excellent test–retest reliability was observed for composite scores and severity ratings. Criterion validity, tested against the interviewer-administered ASI, was good for the composite scores. For severity ratings, variable agreement was observed between the ASI–MV and each interviewer, suggesting poor interrater reliability among interviewers. This conclusion was bolstered by a finding of superior convergent–discriminant validity for both composite scores and severity ratings compared to the standard ASI. The ASI–MV is a viable alternative to the expensive and potentially unreliable interviewer-administered version. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Standardization of APPIC predoctoral psychology internship application forms.

Internship application forms sent by officials from 81 Association of Professional Psychology Internship Centers (APPIC) predoctoral internship sites accredited by the American Psychological Association were examined to identify common items for the purpose of developing a single standardized questionnaire. Questions found on at least 20% of 50 application forms composed a master list against which items on the remaining 31 validation applications were compared. The final revision of the standardized questionnaire includes three additional items from the validation sample and changes suggested by 72 APPIC internship directors of training. The proposed standardized application form has 47 major questions and eight requirements; it could be made available through computer technology, duplicated, and mailed electronically by applicants. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Streptococcus pyogenes strains containing emm12 and emm55 possess a novel gene coding for distantly related SIC protein

OBJECTIVE: To identify subtypes of attention-deficit/hyperactivity disorder (ADHD) and characterize them as either categorical or continuous; to investigate familial resemblance for ADHD among sibling pairs; and to test the robustness of all results by using contrasting data sets. METHOD: Latent class analysis was applied to the ADHD symptom profiles obtained from parents or best informant about their offspring in 3 samples: a population-based set of female adolescent twins (724 monozygotic pairs, 594 dizygotic pairs) and male (N = 425) and female (N = 430) child and adolescent offspring ascertained from high-risk alcoholic families. RESULTS: Latent class analysis revealed 2 categories of clinically significant ADHD which were replicated in all 3 study groups: a subtype with high endorsements of ADHD inattention symptoms and a second combined type with high endorsements of both inattention and hyperactivity-impulsivity items. Both appeared to be continuous across all 3 data groups. The high-risk families contained a class in which members heavily endorsed the ADHD "fidget" item but not other ADHD items. A large proportion of the monozygotic sibs (80%) versus a smaller proportion of dizygotic sibs (52%) were assigned to the same latent class. Among the high-risk children and adolescents, 51% of the female and 41% of the male siblings were concordant for class membership. CONCLUSIONS: The pattern of latent classes suggested that ADHD consists of an inattentive and a combined subtype, within each of which lies a dimensional domain. These analyses further support that genetic factors are significant determinants of latent class membership.     

Psychological distress and its correlates in secondary school students in Pavia, Italy

Adolescence is a time of social as well as biological transition; nevertheless, there are very few epidemiological studies in this field in Italy. Therefore, we felt it would be useful to conduct a cross-sectional study on a sample of 1346 adolescents aged 14-19 years attending high schools in the Health Authority Area of Pavia (northern Italy) through a multi-dimensional approach, taking into consideration physical and psychological health, life habits, family environment and social life of teen-agers. We used a structured self-administered questionnaire consisting of 264 question items to achieve the study aim, which was to find the variables (among personal data, scholastic, family, relational characteristics and habits) correlated with psychological distress. The results showed that in this sample psychological distress (evaluated by GHQ-30) was significatively (p < 0.005) associated with female sex, problems with school friends and teachers, having at least one immigrant parent (from a region different from that of residence), little love for parents and poor parental psycho-physical health status, staying at home on the weekend, smoking and using psychoactive medicines.     

Health practices and mortality in a rural Japanese population

Association of personal health practices with mortality from all causes was studied. In 1988, 4,318 residents aged 40 years and over in a rural town of Miyagi Prefecture, north-eastern part of Japan, completed a self-administered questionnaire including items on smoking, alcohol consumption, physical activity, sleeping patterns, and weight status. During the four year follow-up, 207 subjects had died. Relative risks (95 percent confidence intervals) of death from all causes adjusted for age, sex, and other confounding variables were 0.62 (0.39-0.98) for never smoking, 0.51 (0.34-0.78) for no or moderate alcohol consumption, 0.66 (0.42-1.04) for exercising physical activity, 0.78 (0.56-1.10) for 7-8 hours of sleep, and 0.75 (0.52-1.07) for not being underweight. Compared with performing only 0-1 of the five low-risk practices concerning the items mentioned above, relative risks (95 percent confidence intervals) of all-cause mortality for performing 3, or all 5 practices were, 0.49 (0.30-0.80) and 0.14 (0.03-0.61), respectively (trend p = 0.0001). The results remained unchanged even after excluding early death occurring within the first year of the follow-up, or excluding the subjects with past history of diseases. Further research is required to explore the combined effects of the practices on mortality for longer observational period.     

Dietary assessment in the elderly: validation of a semiquantitative food frequency questionnaire

OBJECTIVE: The study was conducted to assess the relative validity of a 170-item semiquantitative food frequency questionnaire (SFFQ) adapted for use in the elderly. DESIGN AND SUBJECTS: The study was carried out in a sample of 80 men and women aged 55-75 y participating in a community based prospective cohort study in Rotterdam, The Netherlands. The two-step dietary assessment comprised a simple self-administered questionnaire (20 min) followed by a structured interview with trained dietitians (20 min) based on the completed questionnaire. Multiple food records (FR) collected over a one year period served as reference method. 24 h urine urea was used as indirect marker for protein intake. RESULTS: Compared with FR, the SFFQ generally overestimated nutrient intake as reflected by difference in means and the ratio of SFFQ to FR. Energy adjustment reduced the observed overestimation. Pearson's correlation coefficients varied from close to 0.5 to about 0.9 for crude data, and after adjustment for age, sex, total energy intake, and for within-person variability in daily intake for 0.4-0.8. Cross-classification into quintiles resulted in correct classification into the same or adjacent quintile of 75.8% for crude and 76.8% for energy-adjusted data. Validation of protein intake estimated by SFFQ with protein excretion from 24h urine urea indicated overestimation of protein intake by SFFQ. Spearman correlation coefficient between protein intake estimated from urea excretion and SFFQ was 0.67. CONCLUSIONS: Adaptation of a SFFQ for use in the elderly resulted in a valid and time-efficient dietary assessment instrument. Its ability to adequately rank study subjects according to their dietary intake support its application in epidemiological studies in the elderly.     

The personality of societal groups.

Examined the personality of social situations and evidence for the construct validity of the Multivariate Personality Inventory (MPI). The instrument was administered to 20 car salespersons (mean age 39.75 yrs), 25 fundamentalist church members (mean age 27.8 yrs), 40 campus nondenominational church members (mean age 21.28 yrs), 15 patrons of singles bars (mean age 27 yrs), 50 members of women's social organizations (mean age 32.39 yrs), 131 sorority members (mean age 20.25 yrs), 32 women's softball team members (mean age 27.38 yrs), 31 medical technologists (mean age 31.13 yrs), and 44 computer programmers (mean age 31.58 yrs). ANOVA yielded a significant scale effect and a significant interaction between the social-occupational groups and their scores on the personality scales. Five of the 7 groups about which predictions were made endorsed the predicted personality scale. Church members endorsed more depressive items, computer programmers endorsed more compulsive items, car salespersons endorsed more manic items, and sorority members endorsed more hysteric items. Findings support the hypothesis of the existence of a personality of situations and provide construct validity evidence for the MPI. (38 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)