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Biomedical subjects

N Krause

Publications and source records attributed to N Krause.

At least 55 records · Page 3Linked to original sources
PubMed1998

Laparoscopic adnexal preservation in a patient with complete torsion--a case report.

OBJECTIVE: Laparoscopic adnexal preservation in a patient with complete torsion. STUDY DESIGN: Laparoscopy was performed in a 20-year-old nulliparous patient with a 24-h history of lower abdominal pain. RESULTS: Torsion of the left adnexa was diagnosed and detorsion was performed. After detorsion the patient reported complete resolution of pain. At second look laparoscopy blood supply of the left adnexa was completely normalized and a cystadenofibroma was excised with preservation of the ovary. CONCLUSIONS: Complete torsion of adnexa associated with edema and ischemia can be treated by laparoscopic detorsion.

Adnexal Diseases↗
PubMed1998

Financial strain, received support, anticipated support, and depressive symptoms in the People's Republic of China.

The purpose of this study is to examine the interface between financial strain, informal received economic support, informal anticipated financial support, and psychological distress in later life. Data provided by a large probability sample of older adults in the People's Republic of China reveal that the relationship between financial difficulty and psychological distress is stronger for older adults who receive more economic assistance. However, the results involving anticipated support are in the opposite direction. More specifically, the association between financial problems and psychological distress is lower for older adults who believe that others stand ready to help in the future should the need arise. A detailed theoretical rationale is developed to explain these results.

Aged↗
PubMed1998

Stressors in highly valued roles, religious coping, and mortality.

This study examines the relationships among stress, religious coping, and mortality. It is hypothesized that religious coping will offset the effects of stressors arising in highly valued roles on mortality, but similar stress-buffering effects will not emerge with events in less important roles. It is further predicted that the beneficial properties of religious coping will be especially evident among older adults with less education. Data from a nationwide survey of older adults (N = 819; M age = 73.8 years; 41% male) indicate that religious coping offsets the effects of stressors in highly valued roles on mortality, but only among older adults with less educational attainment (p < .05). In contrast, events in roles that are not valued highly do not have significant additive effects on mortality or significant interaction effects with religious coping.

Adaptation, Psychological↗
PubMed1998

Objective stress factors, accidents, and absenteeism in transit operators: a theoretical framework and empirical evidence.

The authors used observational job analysis as a conceptually based technique to measure stress factors unbiased by worker appraisal with 81 transit driving tasks on 27 transit lines. Stressor dimensions included work barriers that interfere with task performance due to poor technical-organizational design, time pressure, time binding (autonomy over time management), and monotonous conditions. Line-specific average stressor values were assigned to 308 transit operators who mainly worked the particular line. Logistic regression analyses showed associations for high work barriers and sickness absences (odds ratio [OR] = 3.8, p = .05). There were elevated risks for work accidents for high time pressure operators (OR = 4.0, p = .04) and for the medium time-binding group (OR = 3.3, p = .04) and significant (alpha = .20) unadjusted interaction terms for barriers and time pressure in predicting accidents and absences, and barriers and time binding in predicting absences. Findings suggest guaranteed rest breaks and flexible timing for accident prevention and removal of work barriers for reducing absenteeism.

Absenteeism↗
PubMed1998

Studies of health outcomes in transit operators: policy implications of the current scientific database.

Urban transit operators' medical symptoms and conditions exceed other occupational groups, resulting partly from working conditions. Medical outcomes among operators have an impact on the transit system, including on performance, work attendance, and medical costs. This is exacerbated by external economic and political pressures in which expected service often exceeds the system's capacity in a congested, chaotic urban environment. A vicious cycle of poor working environment, reduced health and well-being among operators, and lowered efficiency and increased costs often results. Operator-health policies focusing solely on individuals are not sufficient to address these problems. A broader approach is needed, acknowledging the relationship between health of the system and health of employees, including redesigning the interface between transit systems and the urban environment and organizational change within companies. This comprehensive approach recognizes the dynamic reciprocity among the transit operators, the transit system, and the larger community.

Adult↗
PubMed1998

Living alone and neighborhood characteristics as predictors of social support in late life.

OBJECTIVES: The purpose of this study was to devise and test a conceptual model that explains how neighborhood quality, fear of crime, and received emotional support affect an elderly person's expectations of future assistance should the need arise (i.e., anticipated support). METHODS: Using a nationwide survey of older adults, a series of nested latent variable models was tested to determine if the social support process differs between older adults living alone and those living with others. RESULTS: Consistent with a social ecological perspective, data suggest that anticipated support is lower among elders who live in deteriorated neighborhoods than among older adults who live in well-maintained neighborhoods. Moreover, the deleterious effects of run-down neighborhoods appear to be especially pronounced for older adults who live alone. DISCUSSION: Select constructs that link deteriorated neighborhoods with anticipated support are explored. Suggestions for future research are made.

Age Factors↗
PubMed1998

Neighborhood deterioration, religious coping, and changes in health during late life.

Research indicates that older adults who reside in deteriorated neighborhoods experience more physical health problems than elderly people who dwell in more favorable living environments. The purpose of this study is to see whether the deleterious effects of run-down neighborhoods are reduced for older people who use religious coping responses. Data from a nationwide longitudinal survey of elderly people suggest that the noxious impact of living in a dilapidated neighborhood on changes in self-rated health over time is offset completely for older adults who rely heavily on religious coping strategies. In contrast, significant stress-buffering effects failed to emerge when functional disability served as the outcome measure.

Adaptation, Psychological↗
PubMed1998

Early parental loss, recent life events, and changes in health among older adults.

The purpose of this study is to see whether older adults who lost a parent early in life are more vulnerable to the effects of recent stressful events than elderly people who were raised in an intact home. Data from a nationwide longitudinal survey of older adults provide support for this view. The findings indicate that the combined effects of early parental loss and recent stressful events are associated with a decline over time in global self-rated health, as well as the number of chronic and acute conditions. In contrast, significant effects failed to emerge with functional disability. This study contributes to the literature by suggesting that only certain kinds of recent events (i.e., stressors arising in highly valued roles) act in concert with early parental loss to compromise health in late life.

Age Factors↗
PubMed1997

Physical workload and ergonomic factors associated with prevalence of back and neck pain in urban transit operators.

STUDY DESIGN: Back and neck pain was studied cross-sectionally in 1,449 urban transit drivers by linking medical data, self-reported ergonomic factors, and company records on job history. OBJECTIVES: The goal was to examine the relation between physical workload, ergonomic factors, and the prevalence of back and neck pain. SUMMARY OF BACKGROUND DATA: Researchers, to date, have not found an independent effect of ergonomic factors on back and neck pain while accounting for the effects of past and current physical workload. METHODS: Self-reported ergonomic factors, vehicle type, physical workload (measured as duration of driving), height, weight, age, and gender were analyzed in relation to back and neck pain, using multivariable logistic regression models. RESULTS: Physical workload showed a positive dose-response relation with back and neck pain after controlling for vehicle type, height, weight, age, and gender. The odds ratio for 10 years of driving was 3.43. Additional adjustment for ergonomic factors decreased this odds ratio to 2.55. Six out of seven ergonomic factors were significantly related to the prevalence of back and neck pain after adjustment for age, gender, height, weight, and physical workload. Problems with adjusting the seat had the largest effect (odds ratio = 3.52). Women had back and neck pain twice as frequently as men. CONCLUSION: The results support the hypothesis of a causal role of physical workload for the development of back and neck pain. Ergonomic factors partially mediated the risk of back and neck pain associated with driving, suggesting a potential for prevention of back and neck pain by ergonomic redesign of transit vehicles. Elevated risks for back and neck pain for female drivers were not explained by anthropometric and ergonomic factors.

Adult↗
PubMed1997

Workplace demands, economic reward, and progression of carotid atherosclerosis.

BACKGROUND: Characteristics of the work environment have been associated with cardiovascular morbidity and mortality, but it is unclear whether these factors are associated with preclinical manifestations of disease. METHODS AND RESULTS: We investigated the association between job demands, economic reward, and the 4-year progression of carotid atherosclerosis in a population-based sample of 940 Finnish men. Data from the Kuopio Ischemic Heart Disease Risk Factor Study were used to estimate changes in plaque height, maximum and mean intima-media thicknesses across combinations of job demands, and income. Associations were examined in relation to atherosclerotic risk factors and were stratified by baseline levels of atherosclerosis and prevalent ischemic heart disease. Men who had jobs with high demands and low economic rewards had significantly greater 4-year progression of plaque height (0.33 mm, P = .008) and maximum intima-media thickness (0.32, P = .03) than men with low-demand, high-income jobs. The magnitude of these differences was not greatly attenuated by risk factor adjustment and did not differ when examined by the level of workplace resources, social support, or employment status. Larger differences were observed in a subsample of men who had more advanced atherosclerosis at baseline. CONCLUSIONS: These results show that men with demanding work that produces little economic reward have significantly greater progression of carotid atherosclerosis than more advantaged men. The relationship between job demands and health should be understood in a broad framework of interacting economic conditions, social circumstances, and behaviors that cascade over the life course and may ultimately contribute to socioeconomic inequalities in morbidity and mortality.

Arteriosclerosis↗
PubMed1997

Laparoscopically assisted vaginal hysterectomy as an alternative to abdominal hysterectomy in patients with fibroids.

OBJECTIVE: Introduction of laparoscopically assisted vaginal hysterectomy (LAVH) was evaluated for its usefulness to replace abdominal hysterectomy in fibroids. STUDY DESIGN: A total of 240 women with a mean age of 46.7 years underwent hysterectomy over a period of one year. The technique of LAVH was introduced starting in the second quarter of the study period. Clinical data of 60 patients undergoing either LAVH or abdominal hysterectomy for fibroids were compared in a cross-sectional study by chi 2- and t-test. RESULTS: A comparison between the first and the last quarter of the study period showed that the rate of abdominal hysterectomies decreased from 66% to 12%, whereas LAVH increased from 0 to 40% (p < 0.05). The rate of vaginal hysterectomies remained between 34% and 48%. Compared to abdominal hysterectomy, LAVH operating time was about 1/3 longer, hospital stay was shorter (3 days), and LAVH proved more cost-effective than abdominal hysterectomy (significance of all differences: p < 0.05). CONCLUSIONS: LAVH is a valid alternative to abdominal hysterectomy in fibroids.

Adult↗
PubMed1997

Objective measurement of occupational stress factors--an example with San Francisco urban transit operators.

Eighty-one observational work analyses were conducted to measure stressors independently of worker appraisal in the San Francisco transit system. On the basis of action regulation theory, stress factors were defined as hindrances for task performance due to poor work organization or technological design. Stressors included (a) work barriers, defined as obstacles that cause extra work or unsafe behavior; (b) time pressure; (c) monotonous conditions; and (d) time binding, defined as control over timing. Reliability, measured as interrater agreement, ranged between 80 and 97%, with kappas of .46-.70. Validity analyses were done with 71 transit operators who participated in the observations and 177 operators who were assigned mean line-specific observational stressor measures. High odds ratios (ORs) were found for barriers and psychosomatic complaints (OR = 3.8, p = .00), time pressure and relaxation time needed after work (OR = 3.1, p = .05), and barriers and smoking to cope (OR = 3.8, p = .02). Using observational data in conjunction with self-report data can reduce confounding and improve interpretability of stress and health studies.

Adult↗
PubMed1997

Anticipated support, received support, and economic stress among older adults.

This study examined the interface between anticipated support, received support, recent economic stressors, and depressive symptoms in later life. A theoretical perspective was developed suggesting that received support exacerbates the effects of financial stress on depressive symptoms. However, this conceptual framework further specified that the noxious effects of economic stress are buffered or offset by anticipated support. Data from a nationwide survey of elderly people provided empirical support for both hypotheses.

Aged↗
PubMed1997

Workplace conditions, socioeconomic status, and the risk of mortality and acute myocardial infarction: the Kuopio Ischemic Heart Disease Risk Factor Study.

OBJECTIVES: This study investigated whether the association between workplace conditions and the risk of all-cause and cardiovascular mortality and acute myocardial infarction differed by socioeconomic status. METHODS: Prospective data were used to examine these associations in 2297 Finnish men, with adjustment for prevalent diseases and biological, behavioral, and psychosocial covariates, and stratified by employment status and workplace social support. RESULTS: Elevated age-adjusted relative hazards for all-cause mortality were found for men who reported high demands, low resources, and low income; high demands, high resources, and low income; and low demands, high resources, and low income. Similar patterns were found for cardiovascular mortality. In contrast, elevated age-adjusted relative hazards for acute myocardial infarction were observed only in men who reported high demands, low resources, and low income. These results did not differ by level of workplace social support or employment status. CONCLUSIONS: The negative effects of workplace conditions on mortality and of myocardial infarction risk depended on income level and were largely mediated by known risk factors.

Adult↗
PubMed1997

Negative interaction and body weight in later life.

This study assesses the relationship between negative interaction and body mass index values among older adults. Throughout, an emphasis is placed on probing for individual differences in response to unpleasant encounters with significant others. Individual variations in personality (introversion-extraversion) as well as social status (gender) are evaluated within this context. Tests of the complex three-way interaction between negative interaction, gender, and introversion reveal that more negative interaction is associated with higher body mass index values among elderly women who are introverted. In contrast, a significant relationship between negative interaction, introversion, and body mass failed to emerge for older men.

Aged↗
PubMed1997

Psychosocial job factors associated with back and neck pain in public transit operators.

OBJECTIVES: This cross-sectional study examined associations between psychosocial job factors and the prevalence of nondisabling back and neck pain in professional drivers after physical work load was taken into account. METHODS: A total of 1449 transit vehicle operators completed a medical examination and a questionnaire yielding information on demographic and anthropometric variables, health status, and physical and psychosocial job factors. Company records were used to supplement information on employment history. Physical work load was measured in life-time years and current weekly hours of professional driving. The relation of psychosocial factors with back or neck pain was analyzed by logistic regression models adjusted for past and current physical work load, vehicle type, age, gender, body height, and weight. RESULTS: The main result of this study was that both physical work load and psychosocial factors were simultaneously and independently associated with back or neck pain. Psychosocial factors associated with back or neck pain included extended uninterrupted driving driving periods, frequency of job problems, high psychosocial demands, high job dissatisfaction, and low supervisory support. An analysis of specific job problems is provided which may be useful in setting priorities for research and intervention efforts in this high risk occupation. CONCLUSION: The results provide support for the role of psychosocial job characteristics in the etiology of back or neck pain in occupational settings.

Adult↗
PubMed1997

Predictors of disability retirement.

OBJECTIVES: Disability retirement may increase as the work force ages, but there is little information on factors associated with retirement because of disability. This is the first prospective population-based study of predictors of disability retirement including information on workplace, socioeconomic, behavioral, and health-related factors. METHODS: The subjects were 1038 Finnish men who were enrolled in the Kuopio Ischemic Heart Disease Risk Factor Study, who were 42, 48, 54, or 60 years of age at the beginning of the study, and who participated in a 4-year follow-up medical examination. RESULTS: Various job characteristics predicted disability retirement. Heavy work, work in uncomfortable positions, long workhours, noise at work, physical job strain, musculoskeletal strain, repetitive or continuous muscle strain, mental job strain, and job dissatisfaction were all significantly associated with the incidence of disability retirement. The ability to communicate with fellow workers and social support from supervisors tended to reduce the risk of disability retirement. The relationships persisted after control for socioeconomic factors, prevalent disease, and health behavior, which were also associated with disability retirement. CONCLUSIONS: The strong associations found between workplace factors and the incidence of disability retirement link the problem of disability retirement to the problem of poor work conditions.

Adult↗