Social support and psychological distress: a longitudinal analysis.
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Adult↗
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Longitudinal analysis of bone mineral density in pre-menopausal female systemic lupus erythematosus patients: deleterious role of glucocorticoid therapy at the lumbar spine.
OBJECTIVE: To evaluate whether bone loss occurs over time in pre-menopausal systemic lupus erythematosus (SLE) patients. METHODS: We performed a longitudinal bone mineral density (BMD) analysis in a group of 35 pre-menopausal female SLE patients. Lumbar spine and hip (total and sub-regions) BMDs were measured twice 21 +/- 11 (mean +/- S.D.) months apart by dual-energy X-ray absorptiometry. RESULTS: In the whole cohort of SLE patients, significant bone loss was observed at the lumbar spine (-1.22%/yr) but not at the total hip. Further analyses indicated that lumbar spine bone loss (-2.12%/yr) occurred exclusively in the subgroup of patients who had taken a mean prednisolone daily dose >7.5 mg between the two BMD measurements. Moreover, bone loss was more important in patients who had previously received a cumulative prednisolone dose </=5 g by the time of their first BMD evaluation. CONCLUSIONS: These results, by demonstrating a loss of lumbar spine bone over time in pre-menopausal SLE patients given glucocorticoid (GC) therapy, strongly support the use of preventive treatment to minimize GC-induced osteoporosis in pre-menopausal female SLE patients given prednisolone daily doses >7.5 mg.
Adult↗
Association between iron deficiency and blood lead level in a longitudinal analysis of children followed in an urban primary care clinic.
OBJECTIVE: To determine if iron deficiency (ID) is longitudinally associated with lead poisoning. STUDY DESIGN: Blood lead levels, hemoglobin, mean corpuscular volume (MCV), red cell distribution width (RDW), insurance status, and age were determined for 1,275 children. ID was defined as MCV <70 fl and RDW >14.5 if age was <2 years and MCV <73 fl and RDW >14.5 if age was >/=2 years. Logistic regression models were constructed by using the second-visit blood lead levels dichotomized at >/=0.48 microm/L (10 microg/dL) as the outcome. RESULTS: The odds ratio (OR) for baseline ID predicting lead poisoning at the second visit was 4.12 (95% CI, 1.96-8.65). In the second model, using children who were iron-replete at both visits as the referent group, for children with ID at both visits, the OR for predicting lead poisoning at the second visit was 5.54 (95% CI, 2.25-13.62). For children with ID at the first visit and iron-replete at the second visit, the OR was 2.73 (95% CI, 0.90-8.27), and for children iron-replete at the first visit and ID at the second visit, the OR was 0.81 (95% CI, 0.10-6.30). CONCLUSIONS: ID is associated with subsequent lead poisoning. These data are consistent with a biological mechanism of increased lead absorption among iron deficient children.
Anemia, Iron-Deficiency↗
Aging, religiosity, and adjustment: a longitudinal analysis.
The relationships between church attendance, self-rated religiosity, and private prayer with aging are investigated with longitudinal data on older Mexican-Americans and Anglos. It is found that church attendance and practice of private prayer remained relatively stable over time (4 years) and that self-rated religiosity increased somewhat. Of the three measures only church attendance showed a significant effect on life satisfaction (net of other important predictors of life satisfaction) for both ethnic groups and at both points of observation. Among Anglos the effect of church attendance on life satisfaction increased significantly during the study interval.
Aged↗
A longitudinal analysis of pulmonary function in rats during a 12 month cigarette smoke exposure.
We wanted to examine the longitudinal effects of chronic cigarette smoke exposure, and to determine whether the chronic alterations in pulmonary function induced by long-term cigarette smoke exposure in an animal model could be predicted by initial or early alterations in function. A group of Sprague Dawley rats was exposed to the smoke of 7 cigarettes x day(-1) for 5 days x week(-1) during a total period of 12 months. Lung volume, flow-volume curves and pressure-volume curves were recorded at baseline, and after 2, 4, 8 and 12 months of smoke exposure. A control group of rats was subjected to the same regimen of testing, but was not exposed to smoke. Thirteen rats completed the study in the smoke-exposed group and seven rats in the control group. We found that chronic exposure to cigarette smoke produced early abnormalities in pulmonary function, with the forced expiratory volume in one second/forced vital capacity (FEV1/FVC) ratio showing an acceleration of ageing effect, particularly between 4 and 8 months of exposure. In this model, although the two groups had significantly different airflow after 12 months, the initial values in each group were remarkably similar, and we could not identify any pulmonary function test which had predictive value. We conclude that longitudinal studies of cigarette smoke exposure in this rat model allow better characterization of the nature and time course of the effects of smoking on the lung.
Animals↗
A residuals-based transition model for longitudinal analysis with estimation in the presence of missing data.
We propose a transition model for analysing data from complex longitudinal studies. Because missing values are practically unavoidable in large longitudinal studies, we also present a two-stage imputation method for handling general patterns of missing values on both the outcome and the covariates by combining multiple imputation with stochastic regression imputation. Our model is a time-varying auto-regression on the past innovations (residuals), and it can be used in cases where general dynamics must be taken into account, and where the model selection is important. The entire estimation process was carried out using available procedures in statistical packages such as SAS and S-PLUS. To illustrate the viability of the proposed model and the two-stage imputation method, we analyse data collected in an epidemiological study that focused on various factors relating to childhood growth. Finally, we present a simulation study to investigate the behaviour of our two-stage imputation procedure.
Bias↗
Longitudinal analysis of multiple indicators of health decline among spousal caregivers.
The hazards for experiencing major health events were studied longitudinally among 150 spousal caregivers of Alzheimer's disease (AD) patients and 46 married control participants. Based on longitudinal assessments from one to six years, the hazards of reaching any of three health events (extended physical illness or disability > 1 month, unhealthy medical rating from a nurse interview, or hospitalization) were not significantly different in a group comparison of caregivers to controls (Cox proportional hazards assumption, p > .05). However, there was a trend [X2(1, N = 107) = 3.13, p = .08] for caregivers to have a greater hazard for serious illness. Among caregivers only, a greater hazard for reaching at least one of these health events was associated with providing more activities of daily living (ADL) assistance [X2(1, N = 125) = 3.83, p = .05] but not with problem behaviors of the AD patient (p > .05). These results suggest that providing extensive ADL assistance may have health implications for spousal AD caregivers, while caregiving, per se, does not. Furthermore, these physical health impacts of caregiving may be best characterized using multidimensional assessments. Contrary to our guiding hypothesis, caregivers encountering more problem behaviors of their AD spouse were less likely to be hospitalized, X2(1, N = 145) = 5.88, p = .02. This finding may reflect a reluctance by caregivers to schedule necessary medical care when their spouses are most problematic, and this may have further long-term health implications for caregivers.
Activities of Daily Living↗
Longitudinal analysis of illness uncertainty, coping, hopefulness, and mood during participation in a clinical drug trial.
The purpose of this longitudinal study was to examine the relationships among illness uncertainty, coping effectiveness, hopefulness, and mood in persons with chronic, progressive multiple sclerosis (MS) during participation in a double-blind clinical drug trial. The similarities and differences in the pattern of relationships among variables were investigated within each of four data collection time frames and across time. The convenience sample comprised 52 participants with clinically definite MS who participated in a 2-year trial using methotrexate to treat progressive MS. Participants with more severe disability were found to be less hopeful and more emotionally distressed. Participants with higher levels of hopefulness used more effective coping strategies and had more positive moods, and those with greater uncertainty about their MS were likely to experience less hopefulness and more negative moods. The pattern of relationships among uncertainty, coping, hopefulness, and mood did not change throughout participation in the drug trial. The findings may be used as a foundation for planning nursing interventions with patients involved in drug studies.
Adaptation, Psychological↗
Early radiographic joint space narrowing and erosion and later malalignment in rheumatoid arthritis: a longitudinal analysis.
OBJECTIVE: To analyze the time course of development of radiographic erosion, joint space narrowing, and malalignment in a longitudinal study of radiographs of the hands and wrists of 58 patients with rheumatoid arthritis (RA) taken over 18 years. METHODS: Among 210 consecutive patients in a reported cohort, 58 had at least one prior available radiograph 2-18 years earlier. A total of 141 hand and wrist radiographs in the 58 patients were scored for joint space narrowing, erosion, and malalignment in individual joints. RESULTS: Of the 58 patients studied, all developed joint space narrowing, 56 (96.5%) developed erosions, while only 24 (41.4%) developed malalignment. In radiographs of 22 patient studied within the first 5 years of disease, joint space narrowing was seen in 17 (77.3%), erosion in 16 (72.7%), and malalignment in only 3 (13.6%). Radiographic progression was seen in all 36 patients in whom the interval between radiographs was longer than 2 years. CONCLUSION: Joint space narrowing and erosion are seen in hand radiographs of most patients with RA seen in treatment centers within the first 5 years of disease. By contrast, malalignment develops in fewer patients, and generally only after 5 years of disease.
Arthritis, Rheumatoid↗
Longitudinal analysis of dental services provided to urban low-income (Medicaid) preschool children seeking initial dental care.
This retrospective longitudinal study analyzed profile and cost of dental services provided to urban low-income (Medicaid) preschool children seeking initial dental care. Clinical and sociodemographic data for Medicaid children, ages five years and under at the time of their first dental visit, were obtained from the dental records of an urban community health center clinic located in a fluoridated area. The sample consisted predominantly of minority children (males = 54; females = 43) who were initially seen during a continuous six-month period in 1991. The children were then observed for a period of one year from the date of first service. At the initial dental visit, the children had a mean age of 3.7 years and dmft of 4.4 with two-thirds of them exhibiting dental caries. The children made an average of 2.3 visits with more than two-fifths of them receiving at least one treatment service during the year. Children four years of age and older at the initial visit, had greater caries prevalence, higher mean dmft, made more dental visits and incurred greater annual expenditure. Greater proportion of females and older children (> or = 4 years) received restorations and extractions. It is concluded that treatment for dental caries is a significant dental service provided to urban low-income (Medicaid) preschool children seeking initial dental care. The results of this study suggest that preschool programs should target these children and promote an initial dental visit before four years of age particularly among females.
Age Factors↗
Longitudinal analysis of functional disabilities in older men.
This study examined the prevalence of functional disabilities in a representative sample of older American men. Longitudinal changes in various disabilities and the effects of such changes on self-appraised health, normal role function, mobility and self-sufficiency in personal care were analyzed. The relationship between disabilities and survivorship was also investigated. The analysis showed that sizable percentages of men report motor-sensory dysfunctions, with blacks experiencing higher prevalence rates than whites. The risk of functional disablement rises with age and increases the likelihood of reporting unfavorable health outcomes or handicaps. There is also some evidence that functional capacities are restored and that these changes lead to more favorable health outcomes. The analysis showed finally that functional disabilities are strong predictors of mortality.
Black or African American↗
Nursing care quality in nursing homes: cross-sectional versus longitudinal analysis.
This empirical study of the relationship between nursing care adequacy and nursing care quality demonstrates that a positive relationship exists between the process and outcome dimensions of quality of nursing care. The results from the analysis of national data on nursing homes' deficiencies highlight the importance of conducting a longitudinal study of the effect of nurse staffing and nursing care adequacy on the quality of care.
Aged↗
A longitudinal analysis of infant morbidity and the extent of breastfeeding in the United States.
BACKGROUND: Studies on the health benefits of breastfeeding in developed countries have shown conflicting results. These studies often fail to account for confounding, reverse causality, and dose-response effects. We addressed these issues in analyzing longitudinal data to determine if breastfeeding protects US infants from developing diarrhea and ear infections. METHODS: Mothers participating in a mail panel provided information on their infants at ages 2, 3, 4, 5, 6, and 7 months. Infants were classified as exclusively breastfed; high, middle, or low mixed breast- and formula-fed; or exclusively formula-fed. Diarrhea and ear infection diagnoses were based on mothers' reports. Infant age and gender; other liquid and solid intake; maternal education, occupation, and smoking; household size; family income; and day care use were adjusted for in the full models. RESULTS: The risk of developing either diarrhea or ear infection increased as the amount of breast milk an infant received decreased. In the full models, the risk for diarrhea remained significant only in infants who received no breast milk compared with those who received only breast milk (odds ratio = 1.8); the risk for ear infection remained significant in the low mixed feeding group (odds ratio = 1.6) and among infants receiving no breast milk compared with those who received only breast milk (odds ratio = 1.7). CONCLUSIONS: Breastfeeding protects US infants against the development of diarrhea and ear infection. Breastfeeding does not have to be exclusive to confer this benefit. In fact, protection is afforded in a dose-response manner. The more breast milk an infant receives in the first 6 months of life, the less likely that he or she
Breast Feeding↗
Longitudinal analysis of the impact of a level 1 trauma center designation at a university hospital.
BACKGROUND: There have been no quantitative, longitudinal studies on the effect of Level 1 Trauma Center (TC) designation on a facility. The purpose of this study was to evaluate the impact of such designation. STUDY DESIGN: In September 1990, a 416-bed core affiliate hospital of the state medical school system was state-designated as the Level 1 TC for 6 counties. Data collected from five concurrent 1-year periods after TC designation included case number and acuity of condition, length of hospital and ICU stays, preventable death rates, financial coverage, and neurosurgery and orthopaedic volume. No registry data were available before TC designation. RESULTS: While the yearly number of cases remained stable, the overall severity of cases increased coincident with a 50% reduction in overtriage. The need for ICU services increased over 50%. Mean Injury Severity Score increased from 11.0 in year 1 to 13.8 in year 5. There was a 25% to 30% increase in severe neurosurgery injuries and in major orthopaedic trauma. There was no change in the "self-pay" financial category (12% to 16%) or the ratio of blunt to penetrating trauma (90:10). CONCLUSIONS: With Level 1 TC designation in a noninner city setting, planners can expect a shift to more severely injured patients, but should not expect an increase in nonpaying patients. Increases in severe injuries will continue to place strain on the ICU. Impact on neurosurgeons and orthopaedic surgeons mandates their support in TC planning.
Catchment Area, Health↗
[Retirement from work; consequences for well-being. A longitudinal analysis].
Both empirical research and gerontological theories lead to diverging opinions on the effects of finishing the labour process on well-being. On the basis of longitudinal data this paper concludes that the well-being of older persons who retired from the job in the period 1976-1982 did not clearly decrease more than persons who continued working in that period of time. This result still holds in a regression-analysis in which a number of relevant factors are kept constant.
Aged↗
Contraceptive prevalence and continuation: a longitudinal analysis of traditional and other method users in the Philippines.
Contraceptive prevalence rates and estimates of continuation rates are derived from unique longitudinal data on post-partum behaviour collected in the Cebu region of the Philippines. Continuation rates vary by base-line and time-varying socioeconomic characteristics for certain contraceptive methods and for using no contraception. Calendar rhythm users have a much lower relative continuation rate than has been found in cross-sectional samples. For women who use a contraceptive method, breast-feeding does not appear to influence contraceptive continuation, but for those who use no methods, breast-feeding appears to substitute for other forms of contraception. Profiles by socioeconomic characteristics of those who continue to use each type of contraceptive method and who use no method could be used to direct family planning programmes towards population sub-groups. The results suggest that for women wishing to postpone a pregnancy, a family planning programme aimed at the young and less educated could effectively increase contraceptive use and continuation.
Adolescent↗
Does fat intake predict adiposity in healthy children and adolescents aged 2--15 y? A longitudinal analysis.
OBJECTIVE: To investigate the relationship between food energy and macronutrient intake and body fatness assessed up to seven times between 2 and 15 y of age. DESIGN: Prospective, observational study. Generalised linear estimating equations were used to evaluate the longitudinal relationship between body fatness and macronutrient intake. Regression analysis was used to assess whether body fatness at a particular age was predicted by intake at any of the previous ages. SETTING: Community-based project in Adelaide, South Australia. SUBJECTS: In all 143--243 subjects from a representative birth cohort of healthy children recruited in 1975 and followed over 15 y. MAIN OUTCOME MEASURES: The dependent variables were body mass index (BMI), triceps (TC) and subscapular (SS) skinfolds, expressed as standard deviation (s.d.) scores at each age. The predictor variables were energy-adjusted macronutrient intake and total energy intake, estimated from a 3--4 day diet diary, the previous corresponding measure of body fatness, sex and parental BMI, TC or SS. RESULTS: Across 2--15 y energy-adjusted fat and carbohydrate intakes were respectively directly and inversely related to SS skinfold measures but not to either BMI or TC skinfold. The best predictor of fatness was previous adiposity, with the effect strengthening as the age interval shortened. Parental BMI, maternal SS and paternal TC contributed to the variance of the corresponding measure in children at some but not all ages. CONCLUSIONS: The current level of body fatness of the child and parental adiposity are more important predictors than dietary intake variables of risk of children becoming or remaining overweight as they grow.
Adolescent↗
Re: 'Coding error in 'stress process among mothers of infants' and 'longitudinal analysis of stress process among mothers of infants'.
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Humans↗