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Functional outcome one year following cataract surgery in elderly persons.

We conducted a prospective study of 164 patients aged 70 and over who had undergone cataract removal and intraocular lens implantation to determine variables which predicted change in physical function experienced by the patients one year after cataract surgery. Path analysis was used to estimate direct and indirect effects of ADL change. Direct effects were estimated for mental status (-.35), mental status change (.51), binocular visual disability (-.39), binocular visual disability change over one year (.51), and baseline ADL (.36), with 45% of variance explained. Age and baseline mental status had important indirect effects through mental status change, and presurgical visual disability had important indirect effects through both visual disability change and mental status change. In summary, change in level of function one year after cataract surgery was not explained solely by change in vision, but was conditional on baseline function and baseline mental status and mediated in part by change in mental status.

Activities of Daily Living↗

Nursing care delivery models and nurse satisfaction.

The relative impact of various nursing care delivery models and management interventions on nurse satisfaction was assessed in 37 New Jersey hospitals. Nurses ranked pay as the most important factor, followed by autonomy and professional status. Changes in scores between pilot and comparison units were significantly different for satisfaction with interactions and task requirements. Change in satisfaction with interaction was significant for all initiatives in aggregate, as well as for each of the five types of initiatives separately. The change in satisfaction with task requirements was significant for all initiatives taken as a group and for those units that implemented reorganization, computer, and education initiatives. Even among nurses who eventually liked the new environment there was a period of initial dissatisfaction.

Humans↗

The stability of health status in rheumatoid arthritis: a five-year study of patients with established disease.

We employed a health status measure to describe the outcomes of rheumatoid arthritis patients over five years. Of the 410 rheumatoid arthritis patients who were originally administered the Arthritis Impact Measurement Scales (AIMS), 299 completed a follow-up five years later. Data were analyzed using nine health status scales, three components of health status, and an overall arthritis impact item. Results for survivors indicated that there were no clinically important deteriorations in any of these measures. In fact, small improvements on most measures were found. The health status changes were similar for patients originally in a clinical trial and for those receiving routine specialty care. Age was found to positively relate to improvements in psychological status and overall arthritis impact, but we were unable to demonstrate any consistent effects of sex, marital status, education, or disease duration. Our results contrast with other studies that have noted major declines over time in the health status of patients with rheumatoid arthritis. Furthermore, level of education was not a major determinant of morbidity in this group. These results suggest that health status in certain patients with rheumatoid arthritis is more stable than previously thought. This has implications for both clinical practice and clinical research in rheumatology.

Arthritis, Rheumatoid↗

Profile of Danish women undergoing reversal of sterilization, 1978-1983.

To help identify those women who might regret undergoing sterilization, the Danish women refertilized from 1978 to 1983 were contacted by mailed questionnaire. Eighty-three percent (120/144) responded. These women were younger at the time of sterilization than Danish women sterilized in the same period (mean age 29 years versus 34 years). Furthermore, they had more children at the time of sterilization and had their first and last child at a younger age than Danish women generally, in the same age group. Their social and educational status was lower than the background population and fewer were in gainful employment. At sterilization, most of the women were in an emotionally stressful situation (e.g., marital disharmony (78% of the married women), single parenthood (28%), unwanted pregnancy (27%], or had chronic health problems in the family. Alternative contraceptive methods had not been fully explored. Thirty-eight percent complained of late secondary effects attributable to the sterilization, but the main reason for wanting reversal of sterilization was a new partner (75%). The study suggests that the psycho-social situation and contraceptive alternatives should be carefully evaluated in women requesting sterilization, especially in those below the age of 30.

Adult↗

[One-year effect of health counseling on life style and risk factors of heart disease].

INTRODUCTION: We examined the need for counselling and the effect on willingness and ability to change life-style, and subsequent changes in risk factors for CHD. MATERIAL AND METHODS: All 152 male employees in a computer company, 25-45 years of age, were invited to participate in a controlled intervention study over one year. The subjects were randomised to an intervention group (I group) and a control group. The I group was divided into subgroups based on baseline behaviour and risk factor status. Changes were evaluated after one year. After an initial health examination, participants in the I group were counselled at baseline and at 5 months. RESULTS: Eighty-five (56%) men participated. Twenty-nine were assigned to a control group and 56 to an intervention group (I group) (dropouts = 8). An exercise group (E group) was advised to take up aerobics exercise three times/week, a diet group to reduce the intake of saturated fat and increase fish products, and smokers to stop smoking. Forty were recommended one or more behavioural changes and eight had no need. Thirty-four were willing to make behavioural changes. Compared to the control group, the fitness level increased (p < 0.01) and body weight decreased in the I group (p < 0.05). DISCUSSION: Individual counselling promotes regular exercise with subsequent improvements in CHD risk factors. The diet and smoking counselling models were less successful in terms of compliance.

Adult↗

Female literacy in Rajasthan, 1961-1981.

"The paper attempts to highlight the significance of female literacy in Rajasthan [India] as an instrument of socio-economic change, [especially] among its scheduled tribe and scheduled caste components."

Asia↗

Women, population and development trends since 1984.

This paper review progress over the past 5 years with respect to the 6 recommendations adopted at the International Conference on Population 1984, which specifically address the situation of women. They include: 1) integrating women into development, 2) women's economic participation, 3) education, training, and employment, 4) raising the age at marriage, 5) the active involvement of men in all areas of family responsibility, and 6) the ratification of the Convention on the Elimination of All Forms of Discrimination against Women. Several important areas potentially relevant to population issues which were omitted from the Conference recommendations are identified and discussed--namely, the situation of women (in particular, older women, women who are the sole supporters of families, and women and migration) and the situation of women in times of severe economic adversity. Finally, progress made with respect to data on women is highlighted, and caution is advised with respect to continued calls for new data. In contrast to the Nairobi Forward-Looking Strategies for the Advancement of Women, the recommendations are noted for implying an almost unresolvable conflict between women's biological and economic roles. However, it is pointed out that the goals of the Convention on the Elimination of All Forms of Discrimination against Women for full equality of men and women would require that the same choices be available to both sexes with respect to labor force participation. While it is too soon to have a clear perspective on the pace and direction of change during the past 5 years, the author finds it impossible to be optimistic about current trends because, in too many areas, progress regarding women has either stagnated or moved into reverse gear. The disappointing record is partially attributed to the tendency for policy makers to see the promotion of economic growth through sound economic policy and advancing the status of women as competing rather than complementary goals.

Adult↗