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PubMed2006

Factors associated with prevalent and incident urinary incontinence in a cohort of midlife women: a longitudinal analysis of data: study of women's health across the nation.

To compare the characteristics of and baseline factors associated with prevalent and incident urinary incontinence in a diverse cohort of midlife women, the authors analyzed the baseline and first five annual follow-up visits of the Study of Women's Health Across the Nation (SWAN), 1995-2001. From responses to annual questionnaires, the authors defined prevalent incontinence as at least monthly incontinence reported at baseline and incident incontinence as at least monthly incontinence first reported over follow-up. They used multiple logistic regression for their comparison. The mean age of their cohort at baseline was 45.8 (standard deviation: 2.7) years. Prevalent incontinence was 46.7%, and the average incidence was 11.1% per year. Most women reported stress, but a higher proportion developed urge incontinence (15.9% vs. 7.6% at baseline). African Americans (29.5%) and Hispanics (27.5%) had the lowest prevalence of incontinence; African Americans (11.6%) and Caucasians (13.4%) had the highest average annual incidence. Parity, diabetes, fibroids, and poor social support were associated with prevalent incontinence, while high body mass index, high symptom sensitivity, and poor health were associated with incident incontinence. In midlife women, incident incontinence is mild with different characteristics and baseline risk factors; overweight women have a higher risk of developing incontinence.

Adult↗
PubMed1997

Longitudinal analysis of mandibular asymmetry in hemifacial microsomia.

Reconstruction of the mandible is one of the key elements in the skeletal rehabilitation of patients with hemifacial microsomia. Unfortunately, knowledge about long-term mandibular skeletal growth in these patients is lacking. The purpose of this study was to analyze mandibular skeletal growth longitudinally in unoperated hemifacial microsomia patients from childhood to adolescence. The longitudinal records of 26 patients with unoperated unilateral hemifacial microsomia were utilized. The average age at initial records was 3.1 years, and the average age at final records was 16.7 years. Posteroanterior cephalometric radiographs were utilized to evaluate both horizontal and vertical mandibular asymmetry. Patients also were analyzed according to the grade and side of the mandibular deformity. A paired t-test (p < 0.05) and a two-way ANOVA were used to analyze the data. There were 5 patients with grade I, 14 with grade II, and 7 with grade III. The results indicated that the skeletal mandibular asymmetry in hemifacial microsomia is not progressive in nature and that growth of the affected side in these patients parallels that of the nonaffected side. The grade and the side of the mandibular deformity did not influence these findings. These results should be considered when treatment strategies are developed to reconstruct the asymmetrical mandible in hemifacial microsomia.

Anthropometry↗
PubMed1997

Prospective longitudinal analysis of viral load and surrogate markers in relation to clinical progression in HIV type 1-infected persons.

The temporal relationship between viral and surrogate markers and clinical status was analyzed prospectively every 8 weeks in 34 asymptomatic HIV-1-infected persons. After 3 years, 25 persons remained clinically healthy whereas 9 persons showed clinical progression. In accordance with other reports we found that at study entry HIV-RNA load was predictive of clinical progression. All markers tested evolved significantly in time in both progressors and nonprogressors. The HIV RNA load in plasma and HIV DNA load in T cells were linearly related only in nonprogressors. In addition, the RNA/DNA ratio during follow-up was significantly higher in progressors, indicating a higher replication rate in progressors. The HIV DNA load correlated inversely with CD4+ T cell counts and positively with p24 antigenemia in both nonprogressors and progressors. A significant correlation of HIV DNA load with SI phenotype occurred in progressors only. HIV RNA levels correlated with beta 2-microglobulin level and with p24 antigenemia but not with SI phenotype. These three markers can all routinely be measured in plasma; however, only the HIV RNA levels appear to be informative for clinical progression. Six to 8 months before clinical progression, an SI phenotype switch, increased HIV RNA in plasma, and decreased CD4+ T cell counts were all indicative of an impending clinical event.

Adult↗
PubMed1996

Employment and coronary risk in women at midlife: a longitudinal analysis.

This study investigated the relation between employment and cholesterol in 541 women aged 42-50 years who resided in Allegheny County, Pennsylvania, in 1985-1988. Employment, health-related variables, and cholesterol were assessed at baseline and 3 years later. At baseline, employed and nonemployed women did not differ in cholesterol or health behaviors. However, women employed at baseline had a significant decrease in total high density lipoprotein cholesterol (1.9 mg/dl) and high density lipoprotein2 cholesterol subfraction (3.2 mg/dl) at follow-up. Those who were employed at both assessments had the lowest high density lipoprotein cholesterol at follow-up. These effects could not be accounted for by sociodemographics or employment quality variables. Post hoc analyses were conducted to examine health behaviors as a potential mechanism to account for the association between employment status and cholesterol. Over the study period, those who were employed at baseline were less likely to increase exercise and more likely to gain weight than those who were not employed at baseline. With menopause-related changes in metabolism, this can result in detrimental effects for cholesterol levels and coronary health. The results highlight the importance of longitudinal assessment in the study of employment and health.

Adult↗
PubMed2004

Longitudinal analysis of efficiency in multiple output dialysis markets.

Provider efficiency in the dialysis industry in the U.S.A. has been of great interest for a variety of parties mainly because of the continuing growth in the number of such patients and providers and in the industry's costs. This study examined technical efficiency longitudinally among the multiple-output producers of freestanding facilities, as the dominant group of providers, using the DEA-based Malmquist index. Nationally representative data were obtained from Independent Renal Facility Cost Report Data Files for the years 1994 through 2000. The resulting sample comprised 140 facilities that had operated throughout the seven study years and jointly produced all dialysis outputs with nonzero inputs. The results show that over the period 1994-2000, on average multi-output, freestanding dialysis facilities did not achieve improvement in productivity. Decomposition of the Malmquist productivity indices showed improvement in technical efficiency but at the same time regress in technologies with potential to improve their quality of care. Negative change in technology was the major source of negative movement in productivity. The study concludes that under the fixed-price payment policy, multiple dialysis outputs are produced efficiently, but it may be that the quality of care is being sacrificed.

Ambulatory Care Facilities↗
PubMed2005

Subjective life satisfaction and objective functional outcome in bipolar and unipolar mood disorders: a longitudinal analysis.

BACKGROUND: Quality of life (QOL) has gained increasing attention as an important yet underappreciated component of functional outcome in mood disorders. In particular, the relationship between subjective life satisfaction and objective measures of psychosocial adjustment has not been well-studied. The goal of the present study was to examine the longitudinal associations between subjective life satisfaction and objective functional outcome among individuals with bipolar and unipolar mood disorders. METHOD: One hundred fifty-seven mood disordered subjects were assessed at index hospitalization for bipolar mania (n=35), unipolar psychotic depression (n=27), or unipolar nonpsychotic depression (n=95). All were prospectively followed up three times, at approximately 2, 4.5 and 7-8 years. Global outcome, work performance, social adjustment, recurrent depressive episodes, and dimensions of life satisfaction were assessed by semi-structured interviews using standardized ratings. RESULTS: Subjective life satisfaction strongly paralleled global functioning, work performance and social adjustment at each follow-up for patients with unipolar nonpsychotic depression, but not bipolar disorder or unipolar psychotic depression. Depressive symptoms and objective functional impairment contributed to poor QOL in most domains, independent of illness chronicity, medication use, or affective disorder subtype. LIMITATIONS: Findings might have differed had a different QOL measure been used, although the present measure showed concurrent validity with a previously used instrument. Sample sizes for the bipolar and psychotic depression groups were sufficient to detect moderate, but not small, correlations between objective functioning and subjective QOL. CONCLUSIONS: Recurrent depression remains a substantial contributor to poor life satisfaction across affective disorder subtypes. Subjective QOL in bipolar and unipolar psychotic depression patients may not accurately reflect objective functional outcome status, potentially due to diminished insight, demoralization, or altered life expectations over time.

Activities of Daily Living↗
PubMedDate not supplied

Predictors of depressive symptomatology of geriatric patients with lung cancer-a longitudinal analysis.

BACKGROUND: Lung cancer is a major health problem throughout the world. It is the leading cause of cancer-related death in men and women in the USA, with a 5-year survival rate of only 14%. It has been hypothesized that variables such as physical and social functioning, cancer-related symptomatology, comorbid conditions, cell type, and treatment are valid predictors of the psychological response to a diagnosis of lung cancer. METHODS: As part of a larger longitudinal study, 211 patients, 65 years of age or older, with an incident diagnosis of lung cancer, were recruited from 23 sites within a midwestern state. Repeated measures analysis of variance techniques were used to analyse how age, gender, comorbid conditions, stage of disease, cell type, as well as the time-dependent variables symptoms, physical functioning, social functioning, and treatment predict depressive symptomatology at four assessments over the first year following diagnosis. RESULTS: Social functioning (p<0.0001), symptoms severity (p<0.0001) and radiation treatment (p=0.017) were significant predictors of depressive symptomatology, with more symptoms and more restricted social functioning generally corresponding to higher levels of depressive symptomatology. Patients who had not received radiation treatment were more depressed than those who had received treatment at least 40 days prior to the interview. CONCLUSIONS: At a clinical level of patient care, these findings mandate early identification of psychosocial difficulties experienced, an individualized symptom management plan and the application of other interventions, such as information giving, reassurance and referral to other resources.

Activities of Daily Living↗
PubMed1990

Gender, social competence, and symptomatology in schizophrenia: a longitudinal analysis.

The relationship between gender and social skill measured by performance on a role play test was examined in a sample of 57 schizophrenics, 33 affective disorder patients, and 20 nonpatient controls. Female schizophrenics were more skilled than male schizophrenics, but no gender differences were present in the affective patients or the controls. Longitudinal analyses conducted on the schizophrenic group indicated that the superior social skill of women was stable over the year following a symptom exacerbation. Symptoms and social adjustment improved for both men and women over the year, but did not differ according to gender. The implications of the results for gender differences in the long-term outcome of schizophrenia are discussed.

Adolescent↗
PubMed1998

The association of weight change in Alzheimer's disease with severity of disease and mortality: a longitudinal analysis.

OBJECTIVE: To describe weight loss in relation to the severity of Alzheimer's disease (AD), to identify confounders that might account for weight loss, and to investigate the association of weight change with mortality. METHODS: This study included 666 subjects with AD from the Consortium to Establish a Registry for Alzheimer's Disease, a longitudinal study of subjects with AD studied for < or = 6 years. Body weight was measured on entry and at annual follow-up examinations as part of standardized clinical assessments. Hierarchical linear models were used to estimate weight change per change in stage of AD, as measured by the Clinical Dementia Rating scale, and to assess the impact of possible confounders on the tendency for weight loss. Linear correlation of the trajectories of weight and CDR over time were used to determine the association between weight change and stage change. The association between weight change and mortality was modeled using the Cox proportional hazards model. RESULTS: Each change in stage of AD was associated with an estimated average weight loss of nearly 2 lb (P = .0001). The correlation between change in stage of AD and weight change was statistically significant (r = -0.09, P = .005), which indicates a greater tendency toward weight loss with progression of AD. Weight loss of > or = 5% in any year before death was a significant predictor of mortality. When weight loss in the year before death or censoring was analyzed as a continuous variable, it was a significant predictor of mortality. Additionally, the relative risk of death increased as weight loss increased. In contrast, weight gain decreased the risk of mortality. CONCLUSION: The risk of weight loss tends to increase with severity and progression of AD. Weight loss is a predictor of mortality among subjects with AD, whereas weight gain appears to have a protective effect.

Aged↗
PubMedDate not supplied

Impact of increased physician supply on use of health services: a longitudinal analysis in rural Minnesota.

Prevalence studies of the use of ambulatory health care services have consistently reported relatively lower demand for services in rural areas. Such studies have implied that low use rates may be fixed characteristics of rural populations and may be resistant to the influence of manipulable variables such as supply of physicians. This longitudinal study suggests that use rates are in fact significantly changed after improvement of manpower resources, but that the effects are limited to the vicinity of new practice locations.

Adolescent↗
PubMed1989

Absenteeism among hospital nurses: an idiographic-longitudinal analysis.

For several months, nurses completed ratings of the degree to which certain events relevant to absence were present during each of their scheduled workdays. The event ratings for days when the nurses decided to be absent were then compared with those for days when the nurses attended. As expected, certain events, such as ill health and tiredness, tended to covary and proved to be consistently related to absenteeism across nurses. Also as expected, some events that were not especially relevant for the nurses as a whole, like having a sick family member or friend and concerns about previous poor attendance, nonetheless emerged as being relevant to the absence behavior of certain individuals. Finally, some events were consistently related to the nurses' expressed desire to be absent but not to actual absences. We discuss these differences from two perspectives, one emphasizing the role of attribution bias and the other, a two-stage process in which such bias has no major role.

Absenteeism↗
PubMed2002

Longitudinal analysis of midlife generativity, intergenerational roles, and caregiving.

Items from the California Adult Q-Sort (CAQ) were used to assess psychosocial generativity (E. H. Erikson, 1950) in a sample of educated women at midlife. CAQ scores measured at age 43 demonstrated convergent validity with an inventory measure of generativity assessed at age 53. According to other longitudinal analyses, women who attained a generative stance at age 43 reported greater investment 10 years later in intergenerational roles (e.g., daughter, mother) but not nonintergenerational ones (e.g., friend, sister). Generative women also reported less subjective burden in caring for aging parents and more knowledge about community elder care programs. Further evidence suggests that participants felt embedded in a reciprocal caregiving network in which they themselves were the recipients of care.

Adult↗
PubMed2006

Changing times: a longitudinal analysis of international firearm suicide data.

We investigated changes in the proportion of firearm suicides in Western countries since the 1980s and the relation of these changes to the change in the proportion of households owning firearms. Several countries had an obvious decline in firearm suicides: Norway, United Kingdom, Canada, Australia, and New Zealand. Multilevel modeling of longitudinal data confirmed the effect of the proportion of households owning firearms. Legislation and regulatory measures reducing the availability of firearms in private households can distinctly strengthen the prevention of firearm suicides.

Australia↗
PubMed2001

Memory complaints as a precursor of memory impairment in older people: a longitudinal analysis over 7-8 years.

BACKGROUND: There is considerable dispute about the validity of memory complaints. While some studies find that complaints are an early indicator of dementia or cognitive decline, there are also many studies showing that complaints are more closely associated with negative affect (depression, anxiety and neuroticism). The present paper used three-wave longitudinal data to test three hypotheses: (1) that memory complaints reflect an evaluation of present and past memory performance; (2) that memory complaints predict future memory performance; and (3) that memory complaints predict current and future negative affect. METHODS: A longitudinal study was carried out with a community sample of people aged 70 and over. Participants were assessed for memory complaints, memory performance and negative affect at three waves separated by 3.6 years and 4.0 years. There were 331 persons with data on all relevant variables. The data were analysed using structural equation modelling. RESULTS: Significant paths in the structural model were found from memory performance to future memory complaints, as well as from memory complaints to future memory performance, supporting hypotheses 1 and 2. Memory complaints were associated with current negative affect, but did not predict future negative affect. CONCLUSIONS: Memory complaints do reflect perceptions of past memory performance and are also an early manifestation of memory impairment. However, current negative affect (anxiety and depression symptoms) shows the greatest association with memory complaints.

Affect↗
PubMed1994

Longitudinal analysis of amyotrophic lateral sclerosis mortality in Norway, 1966-1989: evidence for a susceptible subpopulation.

Mortality from amyotrophic lateral sclerosis (ALS) in Norway has increased substantially over the last two or three decades, as it has in other Western nations. The reasons for this general increase are not clear, but the rise has been attributed to increasing exposure to a broad range of environmental agents. Our previous research has indicated that another explanation for the substantial rise in ALS mortality is more likely to be valid. In particular, the mortality rate curve for ALS is consistent with deaths being confined to an inherently susceptible subpopulation. The size of susceptible subpopulations and mortality rates within them have been shown to be consistent in England and Wales, Japan and the United States. The same methods have been used to analyse Norwegian mortality data. The analysis demonstrates that the rise in ALS mortality is real and that the cause of the increase is almost entirely attributable to the increasing life expectancy of the Norwegian population. Increased life expectancy, a consequence of decreasing general mortality, allows ALS susceptible individuals to survive to the ages at which ALS is expressed. As in other national populations, it is expected that mortality from the disease will continue to increase with continuing increases in life expectancy.

Adolescent↗
PubMed1998

Longitudinal analysis of the effect of smoking cessation on cardiovascular risk factors in a community sample: the Busselton Study.

BACKGROUND: Cessation of smoking is known to have health benefits, but individuals who give up smoking can also suffer adverse effects. This study investigated the effects of smoking cessation on cardiovascular risk factors in a community-based sample. METHODS: Longitudinal risk factor data were analysed in 1372 women and 888 men who took part in population-based mass health screenings in the rural town of Busselton, Western Australia. Age-adjusted changes in body weight, forced expiratory volume in 1 s (FEV1), forced vital capacity, blood pressure and total cholesterol over 3-year and 6-year follow-up periods were compared for 235 ex-smokers ('quitters'), 1499 never-smokers and 526 continuing smokers. RESULTS: In women, weight gain was larger in 'quitters' than in continuing smokers after 3 years (1.74 versus 0.32 kg, P = 0.015) and after 6 years (2.39 versus 1.24 kg, P = 0.085). Male 'quitters' had gained significantly more weight after both 3 years (2.84 versus 0.93 kg, P < 0.001) and 6 years (4.46 versus 2.40 kg, P < 0.001). Although FEV1 declined less in 'quitters' than in continuing smokers, this was statistically significant only for men and women aged less than 45 years. Smoking cessation was associated with smaller increases in cholesterol level in women, but not in men. Smoking cessation had no significant effect on changes in forced vital capacity or blood pressure. CONCLUSIONS: Smoking cessation has different consequences for cardiovascular risk factors in men and women. Although giving up smoking is associated with weight gain in both men and women, the magnitude of the gain is larger in men. Smoking cessation has beneficial effects on lung function, especially in younger people, and on lipid levels in women, but this requires further study. Smoking cessation does not appear to influence blood pressure.

Adult↗