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Longitudinal analysis of flexibility and reorganization in early adolescence: a dynamic systems study of family interactions.

A dynamic systems (DS) approach was used to study changes in the structure of family interactions during the early adolescent transition period. Longitudinal observational data were collected in 5 waves prior to, during, and after the transition. Boys (n = 149 families) were videotaped problem solving with their parents at 9-10 years old and every 2 years thereafter until they were 18 years old State space grids (a new DS method) were constructed for all families across all waves. Two variables indexing the variability of the family interactions were derived from the grids. As hypothesized, the DS variables revealed a significant quadratic effect related to a peak in variability at 13-14 years of age.

Adolescent↗

Longitudinal analysis of development among single and nonsingle children in Nanjing, China: ten-year follow-up study.

In order to examine the impact of "one-child-per-couple" family planning policy on child development, a longitudinal study of a group of children in Nanjing, China, was carried out between 1984 and 1995. The same cohort of children was examined at four stages of development: preschool, early school, preadolescence, and adolescence. Achenbach's Child Behavior Checklist was used to measure the child's behavior. A total of 274 children were surveyed in all four stages. The total behavior problem scores obtained at different stages of development were compared among boys and girls. The results showed that the total score declined significantly in association with the time. As the child grew older, the problems score decreased significantly. This maturation effect was seen for both boys and girls. On average, boys' scores dropped from 21 to 11, whereas girls' scores went from 19.5 to 12. In comparing single with nonsingle boys, there were no significant differences throughout the four stages of development. However, girls who were single children, in contrast to girls with siblings, had significantly higher scores of total behavior problems at each stage of development. These findings illustrate that the longitudinal effect of being a "single-child" is similar to other studies, indicating a minimal impact of family policy. However, the effects were more prominent among girls. This phenomenon can be explained by parents' different attitude toward single-children because of gender difference.

Adolescent↗

Age, working conditions, and sleep disorders: a longitudinal analysis in the French cohort E.S.T.E.V.

STUDY OBJECTIVES: To investigate the effects of occupational factors on both the incidence and the disappearance of sleep disorders after a five-year follow-up period. DESIGN: A prospective longitudinal investigation E.S.T.E.V. carried out in 1990 and 1995. SETTING: Seven regions of France. SUBJECTS: A random sample of employed men and women born in 1938, 1943, 1948, and 1953. In 1990, 21,378 subjects were interviewed (87% of those contacted), and 88% were interviewed again in 1995. MEASURES: Sleep disorders (SD), objectifiable and psychosocial working conditions. RESULTS: Prevalence of SD increased with age and were more frequent among women than men in every age group. Incidence of SD varied little with age, but their disappearance decreased with age. After adjustment for age and sex, SD in 1995 were found to be associated both with objectifiable working conditions and with psychosocial aspects of the way work is experienced. Among objectifiable occupational risk factors, shift work, work week often longer than 48 hours, and exposure to vibrations appeared to be the principal risk factors for SD. Among psychosocial occupational factors, finding it difficult or irksome to have to hurry appeared to be the principal risk factor. CONCLUSIONS: Taking into account the adjustments for health criteria, sociodemographic characteristics, and leisure activities, these results suggest useful courses of action for prevention which, it seems to us, must not be only limited to objectifiable working conditions. Issues about work organization, while clearly difficult to resolve, must also be taken into account.

Adult↗

Functional cerebral asymmetries during the menstrual cycle: a cross-sectional and longitudinal analysis.

This study aims at answering two basic questions regarding the mechanisms with which hormones modulate functional cerebral asymmetries. Which steroids or gonadotropins fluctuating during the menstrual cycle affect perceptual asymmetries? Can these effects be demonstrated in a cross-sectional (follicular and midluteal cycle phases analyzed) and a longitudinal design, in which the continuous hormone and asymmetry fluctuations were measured over a time course of 6 weeks? To answer these questions, 12 spontaneously cycling right-handed women participated in an experiment in which their levels of progesterone, estradiol, testosterone, LH, and FSH were assessed every 3 days by blood-sample based radioimmunoassays (RIAs). At the same points in time their asymmetries were analyzed with visual half-field (VHF) techniques using a lexical decision, a figure recognition, and a face discrimination task. Both cross-sectional and longitudinal analyzes showed that an increase of progesterone is related to a reduction in asymmetries in a figure recognition task by increasing the performance of the left-hemisphere which is less specialized for this task. Cross-sectionally, estradiol was shown to have significant relationships to the accuracy and the response speed of both hemispheres. However, since these effects were in the same direction, asymmetry was not affected. This was not the case in the longitudinal design, where estradiol affected the asymmetry in the lexical decision and the figural comparison task. Overall, these data show that hormonal fluctuations within the menstrual cycle have important impacts on functional cerebral asymmetries. The effect of progesterone was highly reliable and could be shown in both analysis schemes. By contrast, estradiol mainly, but not exclusively, affected both hemispheres in the same direction.

Adult↗

Impact of self-assessed hearing loss on a spouse: a longitudinal analysis of couples.

OBJECTIVES: Hearing loss is increasingly common among older persons and is negatively associated with health and well-being. Its impact on spouses, however, is poorly researched. This study analyzed the relationship between a spouse's self-assessed hearing loss and his or her partner's physical, psychological, and social well-being 5 years later. METHODS: Subjects were 418 older married couples from the Alameda County Study. Hearing loss and adjustment variables were assessed in 1994 and outcomes in 1999. Longitudinal analyses included multivariate statistical models using generalized estimating equations to adjust for paired data and partners' hearing loss, age, gender, chronic conditions, and financial problems. RESULTS: Spouse hearing loss increased the likelihood of subsequent poorer physical, psychological, and social well-being in partners. The negative impact of husbands' hearing loss on wives' well-being appears stronger than the reverse. DISCUSSION: Findings suggest that early diagnosis and treatment of hearing loss constitute important clinical strategies to enhance the well-being of both hearing-impaired individuals and their spouses and support policy change to cover hearing devices by insurance. Further research incorporating theoretical perspectives from communication theory and qualitative methodology would enhance understanding of how hearing loss impacts older couples and support refinement of interventions to promote quality of life.

Adaptation, Psychological↗

A longitudinal analysis of the association between menopause and depression. Results from the Massachusetts Women's Health Study.

The present article prospectively examines the effect of change in menopause status on depression, while controlling for prior depression. This is a longitudinal follow-up of previous cross-sectional analyses reported by McKinlay, McKinlay, and Brambilla who examined the relative contribution of menopause to depression. The data derive from the Massachusetts Women's Health Study, a 5-year longitudinal study of a cohort of 2565 women aged 45 to 55 years at baseline (1981 to 1982). Results show that prior depression is the variable most predictive of subsequent depression, as measured by the Center for Epidemiologic Studies-Depression (CES-D) scale. Onset of natural menopause was not associated with increased risk of depression. Experiencing a long perimenopausal period (at least 27 months), however, was associated with increased risk of depression. The association between a long perimenopause and depression appeared to be explained by increased menopausal symptoms rather than by the menopause status itself. The observed increase in depression during a lengthy perimenopause appears to be transitory.

Climacteric↗

A longitudinal analysis of nursing home outcomes.

OBJECTIVE: To investigate resident and facility attributes associated with long-term care health outcomes in nursing homes. DATA SOURCES: Quarterly Management Minutes Questionnaire (MMQ) survey data for Medicaid case-mix reimbursement of nursing homes in Massachusetts from 1991 to 1994, for specification of outcomes and resident attributes. Facility attributes are specified from cost report data. STUDY DESIGN: Multivariate logistic and "state-dependence" regression models are estimated for survival, ADL functional status, incontinence status, and mental status outcomes from longitudinal residence histories of Medicaid residents spanning 3 to 36 months in length. Outcomes are specified to be a function of resident demographic and diagnostic attributes and facility-level operating and nurse staffing attributes. PRINCIPAL FINDINGS: The estimated parameters for resident demographic and diagnostic attributes showed a great deal of construct validity with respect to clinical expectations regarding risk factors for adverse outcomes. Few facility attributes were associated with outcomes generally, and none was significantly associated with all four outcomes. CONCLUSIONS: The absence of uniform associations between facility attributes and the various long-term care health outcomes studied suggests that strong facility performance on one health outcome may coexist with much weaker performance on other outcomes. This has implications for the aggregation of individual facility performance measures on multiple outcomes and the development of overall outcome performance measures.

Activities of Daily Living↗

Which lifestyle parameters discriminate high- from low-risk participants for coronary heart disease risk factors. Longitudinal analysis covering adolescence and young adulthood.

BACKGROUND: The purpose of this study was to analyse which lifestyle parameters (daily physical activity, dietary intake, smoking habits and alcohol consumption) discriminate between participants at high-risk and those at low-risk for coronary heart disease (CHD) [systolic and diastolic blood pressure (SBP/DBP), total serum cholesterol (TC), high-density lipoprotein cholesterol (HDL), the TC: HDL ratio, body fatness (sum of skinfolds [SSF]) and cardiopulmonary fitness (VO2-max)]. METHODS: The data were derived from the Amsterdam Growth and Health Study (AGHS); an observational longitudinal study in which six repeated measurements were carried out over a period of 15 years on 181 participants aged 13 years at entry to the study. To assess possible discriminating factors, generalized estimating equations were used. This method makes use of risk group changing behaviour over time by using all available longitudinal data. RESULTS: For DBP no significant relationships were found; high risk for SBP was inversely related to smoking habits (OR=0.52; P<0.01). No significant relationships were found for TC; high risk for HDL was positively related to the intake of carbohydrates (OR=1.2; P=0.02) and to smoking habits (OR=1.6; P=0.04); high risk for the TC:HDL ratio was positively related to the intake of carbohydrates (OR=1.3; P=0.01). High risk for SSF was positively related to the intake of protein (OR=1.5; P<0.01) and smoking habits (OR=1.8; P=0.01) and inversely related to daily physical activity (OR=0.81; P=0.01). High risk for VO2-max was inversely related to daily physical activity (OR=0.67; P<0.01). CONCLUSIONS: In the relative young and healthy population of the AGHS during adolescence and young adulthood, physical inactivity was the most important lifestyle parameter related to high risk for CHD.

Adolescent↗

Attachment style, gender, and relationship stability: a longitudinal analysis.

Adult attachment styles in 354 heterosexual couples in serious dating relationships were examined. Principal findings included the following: (a) male and female attachment styles were nonrandomly paired, for example, no anxious-anxious or avoidant-avoidant pairs were found; (b) male and female styles related to concurrent relationship ratings of both partners in different but theoretically meaningful ways; (c) male and female styles contributed significantly to longitudinal prediction of relationship stability and status, even when prior duration and commitment to the relationship were statistically controlled; (d) specifically, relationships of avoidant men and of anxious women were surprisingly stable over 3 years, particularly in light of the relatively poor ratings of these relationships by both partners at Time 1. Discussion focuses on the need to integrate gender role considerations and relationship dynamics and processes into theorizing on adult attachment.

Adult↗

Phthalates and sex steroid hormones across the perimenopausal period: A longitudinal analysis of the Midlife Women's Health Study.

BACKGROUND: The menopausal transition involves significant sex hormone changes. Environmental chemicals, such as urinary phthalate metabolites, are associated with sex hormone levels in cross-sectional studies. Few studies have assessed longitudinal associations between urinary phthalate metabolite concentrations and sex hormone levels during menopausal transition. METHODS: Pre- and perimenopausal women from the Midlife Women's Health Study (MWHS) (n&#xa0;=&#xa0;751) contributed data at up to 4 annual study visits. We quantified 9 individual urinary phthalate metabolites and 5 summary measures (e.g., phthalates in plastics (&#x2211;Plastic)), using pooled annual urine samples. We measured serum estradiol, testosterone, and progesterone collected at each study visit, unrelated to menstrual cycling. Linear mixed-effects models and hierarchical Bayesian kernel machine regression analyses evaluated adjusted associations between individual and phthalate mixtures with sex steroid hormones longitudinally. RESULTS: We observed associations between increased concentrations of certain phthalate metabolites and lower testosterone and higher sub-ovulatory progesterone levels, e.g., doubling of monoethyl phthalate (MEP), monobenzyl phthalate (MBzP), di-2-ethylhexyl phthalate (&#x2211;DEHP) metabolites, &#x2211;Plastic, and &#x2211;Phthalates concentrations were associated with lower testosterone (e.g., for &#x2211;DEHP: -4.51%; 95% CI: -6.72%, -2.26%). For each doubling of MEP, certain DEHP metabolites, and summary measures, we observed higher mean sub-ovulatory progesterone (e.g., &#x2211;AA (metabolites with anti-androgenic activity): 6.88%; 95% CI: 1.94%, 12.1%). Higher levels of the overall time-varying phthalate mixture were associated with lower estradiol and higher progesterone levels, especially for 2nd year exposures. CONCLUSIONS: Phthalates were longitudinally associated with sex hormone levels during the menopausal transition. Future research should assess such associations and potential health impacts during this understudied period.

Humans↗

Longitudinal analysis of changes in indices of obesity from age 8 years to age 18 years. Project HeartBeat!

To compare growth patterns of obesity indices derived from body composition and anthropometric measures, the authors analyzed data from Project HeartBeat!, a longitudinal study of cardiovascular disease risk factors in childhood and adolescence. A total of 678 children initially aged 8, 11, and 14 years in The Woodlands and Conroe, Texas, were enrolled and followed with 4-monthly examinations between October 1991 and August 1995. Trajectories of change from age 8 years to age 18 years were estimated for body mass index, percent body fat, abdominal circumference, the sum of two skinfolds, and the sum of six skinfolds. All indices varied importantly with age. Percent body fat, sum of two skinfolds, and sum of six skinfolds shared similar growth patterns, with strong divergence between males and females. Males' body fat decreased with age and females' increased or remained nearly constant with age. In contrast, both body mass index and abdominal circumference increased monotonically with age in both sexes, exhibiting little sex difference as children reached late adolescence. Sex differences were more striking among Blacks than among non-Blacks. The authors conclude that growth patterns of adiposity differ according to the measure chosen. Furthermore, changes in different obesity indices may not relate in the same way to changes in blood pressure or blood lipid concentrations.

Adolescent↗

Patient safety in the clinical laboratory: a longitudinal analysis of specimen identification errors.

CONTEXT: Patient safety is an increasingly visible and important mission for clinical laboratories. Attention to improving processes related to patient identification and specimen labeling is being paid by accreditation and regulatory organizations because errors in these areas that jeopardize patient safety are common and avoidable through improvement in the total testing process. OBJECTIVE: To assess patient identification and specimen labeling improvement after multiple implementation projects using longitudinal statistical tools. DESIGN: Specimen errors were categorized by a multidisciplinary health care team. Patient identification errors were grouped into 3 categories: (1) specimen/requisition mismatch, (2) unlabeled specimens, and (3) mislabeled specimens. Specimens with these types of identification errors were compared preimplementation and postimplementation for 3 patient safety projects: (1) reorganization of phlebotomy (4 months); (2) introduction of an electronic event reporting system (10 months); and (3) activation of an automated processing system (14 months) for a 24-month period, using trend analysis and Student t test statistics. RESULTS: Of 16,632 total specimen errors, mislabeled specimens, requisition mismatches, and unlabeled specimens represented 1.0%, 6.3%, and 4.6% of errors, respectively. Student t test showed a significant decrease in the most serious error, mislabeled specimens (P < .001) when compared to before implementation of the 3 patient safety projects. Trend analysis demonstrated decreases in all 3 error types for 26 months. CONCLUSIONS: Applying performance-improvement strategies that focus longitudinally on specimen labeling errors can significantly reduce errors, therefore improving patient safety. This is an important area in which laboratory professionals, working in interdisciplinary teams, can improve safety and outcomes of care.

Clinical Laboratory Techniques↗

Longitudinal analysis of the humoral immune response to human immunodeficiency virus type 1 (HIV-1) gp160 epitopes in rapidly progressing and nonprogressing HIV-1-infected subjects.

Antibody response to conserved human immunodeficiency virus type 1 (HIV-1)IIIB gp160 epitopes was longitudinally examined in HIV-1-infected persons. Twelve hundred individuals were evaluated, and sequential sera from 25 rapidly progressing (RP) and 30 nonprogressing (NP) subjects collected over an average of 4 years were examined. Initial sera from the RP group contained greater reactivity to a gp120 epitope defined by peptide 503-528 than did sera from the NP group (P < .001). Reactivity declined with sequential sera for the RP group, paralleling disease progression. Conversely, antibody recognition to this site developed in 23% of the NP group with time. However, 60% of the NP group never developed a response to this epitope. This suggests sequential examination of antibody response to an epitope within the gp120 carboxyl-terminus may have prognostic significance. No association between antibodies directed against the gp160 epitopes and in vitro neutralizing activity against HIV-1IIIB was observed.

Adult↗