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PubMed1986

Blood pressure concordance between spouses.

In 1982, 4,474 noninstitutionalized residents of Connecticut who were 18 years or older were interviewed as part of the Connecticut High Blood Pressure Program. This cross-sectional study was undertaken to determine the prevalence of hypertension among the 2.1 million adults in the state. Spouse correlations for systolic and diastolic blood pressures were examined in 1,260 white spouse pairs. Upon demonstrating a significant correlation in blood pressure between spouses (r = 0.262 for systolic and 0.248 for diastolic, p less than 0.001), subsequent stepwise multiple regressions were used to determine which aspects of the shared marital environment might influence the spouse concordance. Variables related to each spouse as well as variables reflecting similarity between spouses were analyzed. When spouse concordance in blood pressure was examined controlling for age, obesity, dietary salt intake, socioeconomic status, income, education, occupation, smoking, and exercise of both spouses and similarities in these variables, the correlations between spouses' blood pressures remained significant.

Adolescent↗
PubMed1994

Mother-daughter and husband-wife attachment as predictors of psychological well-being during pregnancy.

This study explores the influence of mother-daughter and husband-wife attachment, and social support on the psychological well-being of women during pregnancy. The design represents passive observational approach. Self-completed instruments were used to measure mother-daughter, and husband-wife attachment, social support, and psychological well-being for a convenience sample of 115 middle-class women, who attended prenatal classes at an urban health department in Canada. Multiple correlational and regression techniques were used to analyze the relationships among study variables. Results supported the hypothesis that mother-daughter and husband-wife attachment relationships were significant predictors of psychological well-being of women during pregnancy. There was significant pairwise relationship between psychological well-being and social support; however, after adjusting for husband-wife and mother-daughter attachment, there was no longer any significant relationship between the two variables. Findings provide new insights into the role of unique attachment relationships in promoting psychological well-being for pregnant women.

Adult↗
PubMedDate not supplied

Spouse similarities in high blood pressure knowledge: implications for control of high blood pressure.

This study describes the general knowledge about high blood pressure of husbands and wives using data from all 1,260 white spouse pairs from the 1982 Connecticut Blood Pressure Survey and examines the relationship between high blood pressure knowledge and control of hypertension. We found the average level of knowledge to be high; about 70% of the items were answered correctly. The correlation between spouses' knowledge about high blood pressure was significantly high (r = .41). Multiple regression analysis was used to control for other variables that might influence the spousal correlation in knowledge. When controlling for education, age, socioeconomic status, and hypertension status of both spouses, the correlation between spouses' knowledge remained significant (r = .24). Respondents' knowledge and spouses' knowledge about high blood pressure were significantly related to high blood pressure control among hypertensive persons, particularly to being aware of hypertension and being in current treatment.

Adolescent↗
PubMed2001

Risk factors for cancer of the oral cavity and oro-pharynx in Cuba.

In terms of worldwide levels, Cuba has an intermediate incidence of cancer of the oral cavity and oro-pharynx. We studied 200 cases of cancer of the oral cavity and pharynx, of whom 57 women (median age = 64) and 200 hospital controls, frequency matched with cases by age and sex, in relation to smoking and drinking history, intake of 25 foods or food groups, indicators of oral hygiene and sexual activity, and history of sexually transmitted diseases. Odds ratios (OR) and 95% confidence intervals (CI) were obtained from unconditional multiple logistic regressions and adjusted for age, sex, area of residence, education, and smoking and drinking habits. In the multivariate model, high educational level and white-collar occupation, but not white race, were associated with halving of oral cancer risk. Smoking > or =30 cigarettes per day showed an OR of 20.8 (95% CI: 8.9-48.3), similar to smoking > or =4 cigars daily (OR = 20.5). Drinking > or = 70 alcoholic drinks per week showed an OR of 5.7 (95% CI: 1.8-18.5). Hard liquors were by far the largest source of alcohol. Increased risk was associated with the highest tertile of intake for maize (OR = 1.9), meat (OR = 2.2) and ham and salami (OR = 2.0), whereas high fruit intake was associated with significantly decreased risk (OR = 0.4). Among indicators of dental care, number of missing teeth and poor general oral condition at oral inspection showed ORs of 2.7 and 2.6, respectively. Number of sexual partners, marriages or contacts with prostitutes, practice of oral sex and history of various sexually transmitted diseases, including genital warts, were not associated with oral cancer risk. 82% of oral cancer cases in Cuba were attributable to tobacco smoking, 19% to smoking cigars or pipe only. The fractions attributable to alcohol drinking (7%) and low fruit intake (11%) were more modest. Thus, decreases in cigarette and cigar smoking are at present the key to oral cancer prevention in Cuba.

Adult↗
PubMed1998

[Dermatophytic disease: exuberant hyperkeratosis with cutaneous horns].

BACKGROUND: Dermatophytic disease is a chronic dermatophytosis involving the skin and viscera and caused by benign dermatophytes which cross the skin barrier. We present a case presenting previously unreported giant cutaneous horns. CASE REPORT: A male Algerian patient aged 29 years consulted for chronic skin disease which had progressed for 2 years. Manifestations included warts, papulonodules, eczematiform lesions, lichenifications, alopecia, onyxis, multiple node enlargement and giant cutaneous horns on the plantar aspect of the feet making walking difficult. The patient's kinhood included 10 members and the patient's parents were first cousins; no other family member had a similar disease state. Laboratory findings included eosinophilia (11%, 550 cells/mm3), an inflammatory syndrome, and normal phosphorus and calcium levels despite demineralization of the hands and feet. The tuberculin interdermal reaction was positive but the trichophytine interdermal reaction was negative. Trichophyton violaceum was found in all mycological samples from skin and nails. The histology examination of skin biopsies revealed acanthosis, considerable hyperkeratosis, and myceleal filaments invading the horny layer, the sweat glands and hair follicles. Abscesses and granulomas were also seen in the superficial dermis. Oral griseofulvin 1 g per day and topical applications with ketoconazole gave clear improvement. DISCUSSION: Dermatophytic disease is a chronic dermatophytosis observed mainly in North Africa. The locally high rate of consanguinous marriages would suggest autosomal recessive inheritance of a genetic anomaly possibly associated with deficient cellular immunity. The lesions are polymorphous and develop progressively, probably due to diminished cellular immunity. This case with giant cutaneous horns would be a new variant. Antifungals can provide definitive cure. The pathogenesis of this severe dermatophytosis remains to be established.

Administration, Oral↗
PubMed1987

Precursors of depression in World War II veterans 40 years after the war.

The impact of wartime stress and other psychosocial and health variables on depressive illness in the 40 years since the Second World War is examined in this study of Australian male prisoners of the Japanese and other veterans. A random sample of 170 surviving members of the captured Eighth Division of the Australian Army residing in Sydney in 1983 (POWs) was compared with a similar sample of 172 veterans who fought in Southeast Asia during the war but were not imprisoned (non-POWs). Multiple regression analysis involving nine predictor variables revealed that self-reported nervous illness during the war and depressive illness since the war had pronounced independent effects on current depression as measured by the Zung Scale. Being married and better educated had significant protective effects against depression for the non-POWs while being employed and having higher socioeconomic status were protective for POWs. A clear linkage was shown from wartime nervous illness to postwar depressive illness to present-day depression.

Aged↗
PubMed1999

Exact product operator evolution of weakly coupled spin-12 I(m)S(n) systems during arbitrary RF irradiation of the I spins.

In this article, we consider the evolution of weakly coupled I(m)S(n) systems of spin-12 nuclei during arbitrary RF irradiation of the I spins. Exact solutions are presented for the time dependence of the density operator in terms of its constituent product operator components for a complete set of initial states derived from polarization of either the I or the S spin. The solutions extend the range of applications that are accessible to the product operator formalism and its associated vector picture of nuclear spin evolution. This marriage of quantum mechanics and a literal vector description of spin dynamics during RF irradiation supports physical intuition and has led to simple pulses for selective coherence transfer, among other new applications. The evolution of initial states that are free of transverse S-spin components can be described by classical precession of the I-spin components about effective fields defined by the interaction between the coupling and RF fields. Although there is no analogue involving classical rotations for the evolution of initial states composed of S(x) or S(y), a vector description is still possible, and the solutions completely characterize the nature of J-coupling modulation during RF pulses. We emphasize the Cartesian product operator basis in the present treatment, but the solutions are readily obtained in any other basis that might prove suitable in analyzing an experiment. For a system of N coupled spins, standard exact methods involving diagonalization and multiplication of the 2(N) x 2(N) matrices that represent the system require on the order of (2(N))(3) operations to calculate the system response to a general RF waveform at each point in the time domain. By contrast, the efficiency of the present method scales linearly with the number of spins. Since the formalism presented also accommodates the absence of either RF irradiation or the coupling, the solutions provide an efficient means of general pulse sequence simulation, encompassing any combination of arbitrary RF waveforms, delays, and coherence gradients.

Algorithms↗
PubMed1993

Anthropology and AIDS: the cultural context of sexual risk behavior among urban Baganda women in Kampala, Uganda.

One hundred and thirty Baganda women (65 HIV antibody positive and 65 HIV antibody negative), recruited from the Makerere University-Case Western Reserve University Collaborative Pediatric follow-up clinic in Kampala, Uganda were interviewed about cultural rules and norms for sexual behavior and HIV-specific risk behaviors. Interviews were analyzed for themes related to sexual risk, cultural rules regarding sex, and individual sexual practices. Statistical relationships were tested using chi 2 and t-test statistics. The mean age of the women was 21 years (range 15-30). Despite sexual norms prohibiting sex for women outside marriage, subjects reported that there are certain circumstances when a woman may take other partners, including economic need, desire for greater sexual satisfaction, or revenge on a husband with other partners. Cases were more likely to state that women may have outside partners for economic reasons (P < 0.05) and that women have outside partners for sexual satisfaction (P < 0.01). Women interviewed for this study are complying with Ugandan AIDS control messages to 'zerograze' and 'stick to one partner'. Fear of AIDS remains high, however, because women fear that their partners have not responded to risk reduction messages. Of those women stating fear of AIDS, 57% of cases and 62% of controls based their fear on their perceptions of their partners' activities. Therefore, women feel that they remain at risk of infection despite their own behavior change. We find that, while the potential for risk reduction is high for these women, cultural norms permitting males to have multiple partners limit a woman's ability to control her risk reduction. Important conclusions are: (1) a focus on women's behavior alone is not sufficient as both partners must respond to risk reduction messages; (2) knowledge about AIDS is not sufficient to achieve change in sexual behavior because sexual behavior is linked to economics, gender relations, and other complex socio-cultural factors; and (3) a study of Baganda male sexual values and behavior is urgently needed.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Coping with chronic sorrow.

This qualitative study was designed to examine the presence of chronic sorrow in diverse populations of individuals with chronic or life threatening conditions and to identify strategies for coping with feelings of chronic sorrow. Chronic sorrow was defined as a pervasive sadness that is permanent, periodic, and progressive in nature. The sample comprised 5 infertile couples, 10 individuals with long-term cancer, 10 individuals with multiple sclerosis, 6 individuals with Parkinson's disease, and 4 spouse caregivers. Data were collected through audiotaped face-to-face or telephone interviews using the Burke/NCRCS Chronic Sorrow Questionnaire. The audiotapes were transcribed, entered into a computer analysis program, and collaboratively analyzed by the researchers. The findings indicate that 83% of the subjects experienced chronic sorrow. The four coping strategies that were identified by the subjects as being helpful to their situation were categorized by the researchers as interpersonal, emotional, cognitive, and action.

Adaptation, Psychological↗
PubMed1979

Chronic bronchitis and bronchial asthma in a rural community in Israel: relation to socioenvironmental factors.

Prevalence rates of chronic bronchitis and asthma in a rural community in Israel in 1976 were 2.5 and 2.1%, respectively. The relationships with age, sex, country of origin, marital status, number of children, household crowding, education, occupation and cigarette-smoking habits were studied. A number of significant univariate associations were found. A multiple regression analysis showed a significant independent association between chronic bronchitis and age. Age alone accounted for 4.6% of the variance in chronic bronchitis. Five other variables were significantly associated with chronic bronchitis. Together, these accounted for an additional 1.3% of the variance in chronic bronchitis. The multivariate analysis showed that only one variable--the number of children--had an independent relationship with asthma. It accounted for 0.8% of the variance. All the variables together accounted for 1.3% of the variance observed in bronchial asthma.

Adult↗
PubMed1989

Mental health of caregiving spouses: coping as mediator, moderator, or main effect?

Coping strategies used by 315 persons providing care to a spouse diagnosed with Alzheimer's disease were characterized as either emotion-focused (wishfulness, acceptance, intrapsychic) or problem-focused (instrumental). Models in which coping strategies were postulated as having mediator, moderator, and independent main effects were tested using multiple indexes of mental health. Wishfulness and intrapsychic strategies mediated the relationship between degree of stress and CES-D, Anxiety, and Depression. Wishfulness had a direct effect on Obsessive-Compulsive, Somatization, and Interpersonal Sensitivity; intrapsychic strategies had a direct effect on Obsessive-Compulsive, Somatization, and Interpersonal Sensitivity; and instrumental strategies had a direct effect on Positive Affect. Hierarchical regression analyses indicated that stressors and coping strategies explained between 12% and 40% of the variance on mental health indexes.

Adaptation, Psychological↗
PubMedDate not supplied

Medical utilization patterns of migrant farm workers in Wayne County, New York.

A representative sample of 218 migrant farm workers was randomly drawn in Wayne County, NY, during the summer of 1982. Three distinct migrant groups were identified: immigrants, recent migrants, and long-term migrants. Medical utilization patterns, including physician visits and use of medical services in the community health center, were compared among the three migrant groups. The determinants of physician visits were examined in a multiple regression model. The focus was also placed on types of health problems for which medical treatment had been delayed, and the reasons for the delay were clearly identified. Furthermore, this study examined migrants' subjective assessment of quality of health care in the community. The results of this study indicate that the provision of comprehensive health programs, removal of structural barriers in the health delivery system, and a program of migrant health education are the necessary steps to alter the medical utilization behavior of migrant farm workers.

Adult↗
PubMed2003

From PACS to integrated EMR.

The integration of medical images as part of the patient record has always been a critical component of documentation and information supporting clinical decisions. In the past two decades the increased number of imaging procedures that allows a more accurate and more specific diagnosis has significantly increased and their role in patient management has grown rapidly. With the evolution toward digital modalities and management of medical images in a fully digital environment with the deployment of enterprise wide Picture Archiving Communication Systems (PACS) a wider and more rapid access to the images by referring physicians and clinicians has become possible. The parallel evolution of electronic medical records (EMR) supporting all other documents and clinical data in electronic format led to the necessity of integrating medial image data with the rest of the patient record. Although the marriage of medical images and patient record data in electronic format seems a very natural and necessary combination it has often been very slow in development due to the lack of standardization and clear understanding of clinical workflows and clinical requirements. Several early implementations demonstrated the added value of combining medical images with the patient record and have shown that the availability of data and images facilitates and improves the accuracy and efficiency of patient management. Recent efforts in industry and the academic community to harmonize and improve the integration of medical images with patient record, with the promotion of new standards and better definitions of clinical workflows and standard mechanism of integration of different types of data into unified data models, has facilitated the deployment of modern EMR. Also, a shift in paradigm due to recent technological revolutions such as the development of the World Wide Web and the concepts of portal servers for accessing data for multiple sources has significantly boosted the trends into open systems which allows easier and more functional integration of medical data from different sources. Furthermore, the emergence of a new strategy for software development, based on open source components, allows software programs to be shared and exchanged between different institutions leading to more rapid deployment of standardized electronic patient record.

Diffusion of Innovation↗
PubMed1995

[Social support and social stress in tumor patients and their partners].

Social support is widely believed to be an important buffer against stress in patients coping with cancer. Support efforts can, however, in turn prove to become a source of distress in themselves, both in patients and support providers. The present study was designed to explore the connections between support and emotional distress. N = 120 lung cancer patients and their relatives (n = 57) are interviewed at three intervals. Social support is assessed by multiple methods: Content analysis, a questionnaire and a confidant rating performed by experts. Cross-sectional and longitudinal analyses are combined. Content-analytical and self-report data show a correlation of support efforts and emotional distress. In the confidant rating, however, the expected differences between supportive and non-supportive spousal relationships emerge. The results are discussed from an interactional point of view.

Adaptation, Psychological↗
PubMed1988

A family with late onset autosomal dominant cerebellar degeneration.

A family is described in which 5 (4 female and 1 male) of 8 siblings from one marriage developed a late onset cerebellar degeneration. Four of the 5 affected persons presented separately to different neurologists. Because the original enquiries into family history were negative, and because of the exclusion of other recognised causes for the clinical picture, a diagnosis of idiopathic chronic cerebellar degeneration was made for the individual patients. All patients experienced their first symptoms between the ages of 48 and 55 years, with a gradual unremitting deterioration from the onset. Cerebellar atrophy was confirmed on CT head scan in all cases. Clinically, apart from the cerebellar ataxia, there were no consistent signs of degeneration of any other central or peripheral nervous system pathway. Geographical factors severely limited family contact, and consequently none of those afflicted was aware of similarly affected relatives. Hence, this particular family illustrates the great importance of obtaining a detailed, accurate family history and of assiduous follow-up of the entire family. Only after many years did it become obvious that multiple members of the family were affected by a similar neurological problem.

Aged↗
PubMed1977

Observations of conjointly hospitalized "alcoholic couples" during sobriety and intoxication: implications for theory and therapy.

This paper presents clinical data from a research study designed to examine the relation between alcohol consumption and interactional behavior in "alcoholic couples". The central innovative feature of the study was the simultaneous admission to an inpatient setting of up to three couples, one or both members of which was alcoholic. The in-patient experience was part of an intensive, six-week, multiple-couples, group-therapy program. During hospitalization couples were encouraged to reproduce as closely as possible their usual drinking patterns and interactional behavior. Therapists utilized observations of interactional behavior during intoxication and sobriety to formulate central interactional and psychological issues for each couple. The authors utilized these same observations to develop the interactional model of alcoholism in families that is presented in detail in this paper. This model is an extension of earlier work delimiting an interactional theory of alcoholism based on general systems concepts.

Adult↗
PubMed1993

[The multiple interactions between infertility and sexuality].

After investigating into literature and clinical experience, we shall line out in this study 4 types of interactions between sexuality and infertility: sexual causes to feminine (vaginism, with and without heavy dyspareunia) or masculine (impotency, ante-portas ejaculation, anejaculation, dysejaculation), infertility; influence of tests and of treatments for infertility on sexual life; influence of infertility on sexuality focusing on the various ambiguous feelings (of culpability, inferiority, aggressivity, passivity); and last, the psychological and sexual interactions with medical assisted procreation, reinforcing the sexual separation of man and woman if the body is considered a machine. Psychosomatic guidance of the couple during these steps (with reassurance as the being helped conception) will allow maintaining on removing sexual attraction.

Attitude to Health↗
PubMed1986

The hale elderly: health behavior and its correlates.

The purposes of this study were to describe health behavior of the elderly and to explore the determinants and health consequences of that behavior, using survey data from 386 respondents (138 men, 248 women), 55 years of age and older. These elderly persons engaged in a wide variety of activities to protect their health, the most important of which were eating properly, obtaining adequate rest, and exercising. By multiple regression analysis, age, sex, socioeconomic status, and marital status explained only 7.2% of the variance in health protective behavior. Of those variables, sex had the greatest association with health protective behavior and age the least. Married men, but not married women, practiced more health behaviors than their unmarried counterparts. Health protective behavior was not related to overall health status, but was weakly related to perceived health. The lack of association between health protective behavior and health status is interpreted in terms of the nature of the population examined.

Age Factors↗