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The role of motion sickness in predicting anticipatory nausea.

Susceptibility to motion sickness has been demonstrated to be a predictor of anticipatory nausea in cancer patients receiving chemotherapy. However, previous research did not test whether motion sickness increases anticipatory nausea only by increasing the base rate of posttreatment nausea and vomiting (which has traditionally served as the unconditioned stimulus in the conditioning model for anticipatory nausea) or, alternatively, whether motion sickness might facilitate the association of external stimuli to posttreatment nausea and vomiting. Using two different analytic approaches--a series of logistic analyses that controlled for drug-induced nausea and vomiting following the initial injection, along with an event history analysis which allows for updating on the posttreatment nausea and vomiting factors--motion sickness was found to be an independent predictor of anticipatory nausea. Further, the predictive power of motion sickness is also independent of the effects of pretreatment anxiety, taste during injection, and age.

Adult↗

[Grandparenthood and multigenerational families: are they a social reality or a demographic myth?].

During the last 20 years, there has been growing literature on the consequences of population aging. Longer life expectancies mean that current cohorts can expect to spend more years as members of a family than was the case 200 years ago. The focus of this paper is on how three lineage generations are affected by the increase of the life expectancy, especially the increase in a multi-generational family and the common life time of the family members. Using event history analysis and the data of the German Socio-economic panel, it is shown, on the basis of different birth cohorts, that both Word Wars and the period after World War II have had profound negative effects on the common life time of grandfathers and their grandchildren. But there has been only a limited influence on the life courses of grandmothers and their grandchildren. One surprising result is that grandparenthood in Germany has developed into a broader phenomenon of the 20th century -- one that arose especially for children born after World War II.

Adolescent↗

Dynamics of functional impairment in late adulthood.

The inconclusive debate about Fries' theory of "natural death and the compression of morbidity" has diverted attention from two key issues--the modifiability and related dynamics of functional impairment in late adulthood. Evidence is presented from a large (N = 11,000) panel of adults aged initially 58-63 over the period of a decade which documents substantial modification of functional status. Further, patterned changes in functional status are related to the dynamics of income, historically a major determinant of functional status, and independently to educational attainment. The dynamics of functional status, of income, and of their relationship are explored using discrete time hazard models in an event history analysis incorporating time-varying income and functional status indicators. The importance of income and of education as positive, independent predictors of functional status and patterned changes of functional status is confirmed. The implications of this finding for differentiating distal (e.g. education) and proximate (e.g. income) measures of socioeconomic status and for assessing competing theories of social causation and social selection are discussed.

Aged↗

Public place restrictions on smoking in Canada: assessing the role of the state, media, science and public health advocacy.

While much is known about the impact of law and public policy, we know considerably less about their antecedents. Theories of policy adoption suggest that a variety of policy inputs help to shape legislative change. This research considers the enactment of municipal smoking bylaws in Canada between 1970 and 1995. The emergence of second-hand smoke (SHS) has been offered as a viable explanation for the increased enactment of local smoking restrictions. A number of indicators confirm the rising public health concern around SHS. Using Health Canada data on municipal smoking bylaw enactment in Canada, this paper employs an event history analysis to trace the role of four indicators of the increased recognition of SHS as a public health concern-scientific research, parliamentary debate, print media, and health advocacy. Findings indicate that the print media and health advocacy play the strongest role in explaining the increase in the adoption of municipal smoking bylaws in Canada. Results lend support to the quantitative study of the policy adoption process and to theories of policy making that consider multiple influences on policy adoption.

Canada↗

Stability and transitions in mother-infant face-to-face communication during the first 6 months: a microhistorical approach.

In this study the authors attempted to unravel the relational, dynamical, and historical nature of mother-infant communication during the first 6 months. Thirteen mothers and their infants were videotaped weekly from 4 to 24 weeks during face-to-face interactions. Three distinct patterns of mother-infant communication were identified: symmetrical, asymmetrical, and unilateral. Guided by a dynamic systems perspective, the authors explored the stability of and transitions between these communication patterns. Findings from event history analysis showed that (a) there are regularly recurring dyadic communication patterns in early infancy, (b) these recurring patterns show differential stabilities and likelihoods of transitions, (c) dynamic stability in dyadic communication is shaped not only by individual characteristics (e.g., infant sex and maternal parity) but also by the dyad's communication history, and (d) depending on their recency, communication histories varying in temporal proximity exert differential effects on the self-organization processes of a dyadic system.

Child Behavior↗

Multistate life-tables and regression models.

"A survey is given of the use of modern statistical techniques in event history analysis, and in particular in the study of multi-state life-tables in demography. Emphasis is placed on the interplay between partial likelihood and nonparametric maximum likelihood based methods, a) when analysing semi-Markov models or models with repeated spells, and b) in frailty models for unobservable heterogeneity."

Demography↗

Dry chemistry instruments in primary care. I. Operating conditions and financial considerations.

The objectives of this study were to describe the operating conditions of dry chemistry instruments in primary care, as well as to elucidate financial aspects in general practice fee-for-service settings. We used questionnaires mailed to all users of the two most used dry chemistry instruments in Norway, as well as to a 14% random sample of Norwegian GPs. The overall response rate was 79%. The mean number of dry chemistry analyses varied considerably between individual users, but in general a substantial number of analyses were carried out. Even though most analyses on the instruments' repertoire were available in all user groups, a total of 13 additional constituents were suggested to be included in the repertoire. In occupational health care most results were ready when the client was present; this was not the case in general practice. The instruments were more profitable when more constituents were analysed per sample, although profitability varied substantially in the period studied (1986-1989). A discrete time history event analysis revealed that net profit earned, lower instrument price, available information about the technology and being in solo practice significantly influenced the decision to buy an instrument in fee-for-service practices.

Blood Chemical Analysis↗

Women's caregiving: changing profiles and pathways.

This study draws on panel data from a random sample of 293 wives and mothers, interviewed in 1956 and 1986, to: (1) examine changes in women's caregiving experiences across four different birth cohorts, and (2) assess the likelihood of women becoming caregivers. Women born in the late 1920s and early 1930s reported more episodes of caring for members of an older generation, for disabled children, and for more than one person at a time than women born prior to 1926. The percentage of women with two or more episodes of caregiving increases significantly from the earliest (born 1905-1917) to the most recent cohort (born 1927-1934). Using event history analysis, we tested the effects of social structural variables and subjective dispositions, as well as the number, duration, and timing of competing roles, on the likelihood of women becoming caregivers. We find that women with more traditional life styles are more likely to become caregivers; however, potentially competing roles, such as employment, do not seem to decrease, and actually are positively related to, the likelihood of caregiving. To consider various pathways to caregiving, we also conduct subgroup analyses by cohort and educational level.

Adult↗

Predictors of institutionalization of cognitively impaired elders: family help and the timing of placement.

Although predictors of nursing home placement have attracted a good deal of attention in gerontological research, the type and amount of family assistance offered to caregivers prior to institutionalization has not been extensively examined. This study analyzed the impact of family help on the timing of placement among cognitively impaired care recipients. Using longitudinal data from the Adult Day Care Collaborative Study, an event-history analysis was performed to determine the effects of family help after sociodemographic characteristics, caregiving stressors, and indicators of caregiver well-being were taken into account. Results showed that caregivers were far less likely to institutionalize their relatives when family members provided overnight help and assisted with activities of daily living care. These findings suggest that specific types of family help play an important role in delaying nursing home placement among older adults suffering from dementia.

Aged↗

The influence of social relations on mortality in later life: a study on elderly Danish twins.

PURPOSE: We examined whether the presence of a spouse and the frequency of interaction with children, relatives, and friends significantly influence the risk of dying in late life. We assessed these effects separately by gender, controlling for self-reported health. In addition, we examined whether interaction with the co-twin has a different impact on mortality for identical and fraternal twins. DESIGN AND METHODS: The data set consists of 2,147 Danish twins aged 75 years and older, who were followed prospectively from 1995 to 2001. We modeled the effect of social ties on mortality by using event history analysis. RESULTS: Survival is extended by having a spouse and close ties with friends and the co-twin. However, contact frequency with friends and the co-twin is significant, respectively, only for women and identical twins. IMPLICATIONS: Investigating social relations sheds light on the life span of individuals older than 75 years of age. We stress the importance of social relations beyond the presence of the spouse for survival even at very old ages.

Aged↗

Risk of multiple reoperations after lumbar discectomy: a population-based study.

STUDY DESIGN: Retrospective follow-up study of patients undergoing multiple (two or more) reoperations after initial lumbar discectomy using an administrative database. OBJECTIVES: To identify the population-based risk of multiple reoperations after lumbar discectomy and to analyze factors associated with the risk. SUMMARY OF BACKGROUND DATA: Although multiple reoperations after initial lumbar discectomy are likely uncommon, research to better understand reasons for and outcomes of reoperations is needed because of the large number of discectomies performed. METHODS: Data on all lumbar spine operations during 1987-1998 were obtained from the Finnish Hospital Discharge Register. The patient's initial disc operation during the study period was linked to subsequent operations, and patients with two or more reoperations were analyzed further. The risk of multiple reoperations was determined using the methods of event history analysis. RESULTS: Among 35,309 patients undergoing an initial discectomy, 4943 (14.0%) had at least one reoperation and 803 (2.3%) had two or more reoperations. A total of 63% of the second reoperations were discectomies, 14% were fusions, and the remaining 23% were decompressions. Patients with one reoperation after lumbar discectomy had a 25.1% cumulative risk of further spinal surgery in a 10-year follow-up. Reduced risk was seen when the first reoperation took place more than 1 year after the initial discectomy (relative risk 0.83, 95% confidence interval 0.72-0.96), in patients for whom the first reoperation had been a fusion (relative risk 0.27, 95% confidence interval 0.12-0.61), and in patients 50-64 years of age (relative risk 0.62, 95% confidence interval 0.48-0.79). CONCLUSION: Patients with one reoperation after lumbar discectomy are at considerable risk of further spinal surgery.

Adult↗

The Timing of Entry Into Fatherhood in Young, At-Risk Men.

Timing of first fatherhood was examined in a sample of 206 at-risk, predominantly White men, followed prospectively for 17 years. An event history analysis was used to test a model wherein antisocial behavior, the contextual and familial factors that may contribute to the development of antisocial behavior, and common correlates of such behavior, including academic failure, substance use, and early initiation of sexual behaviors, lead both directly and indirectly to an early transition to fatherhood. Having a mother who was younger at first birth, low family SES, poor academic skills, failure to use condoms, and being in a cohabitating or marital relationship predicted entry into fatherhood. Implications of the findings for prevention of and intervention with early fathering are discussed.

Journal Article↗

Treatment persistence: a comparison among patients with schizophrenia who were initiated on atypical antipsychotic agents.

BACKGROUND: Although clinical trials have demonstrated the efficacy of atypical antipsychotic agents in reducing symptoms of schizophrenia, the likelihood of sustaining control of schizophrenic symptoms may depend on treatment persistence. OBJECTIVE: In this study, we compared treatment persistence between patients who were initiated on risperidone or olanzapine, the two most widely prescribed atypical antipsychotic agents. METHOD: We identified patients with schizophrenia by ICD-9-CM codes (> or =1 inpatient or > or =2 outpatient ICD-9-CM codes > or =7 days apart) between 1 July 1998 and 30 June 1999. We further selected those who were prescribed the target drug during 1 April 1999 through 31 March 2000 provided that they were not on any antipsychotic agents during the prior 6 months. Using event history analysis, we compared the treatment persistence in terms of hazard ratio between olanzapine and risperidone initiators, adjusting for patient's sociodemographic and clinical characteristics. RESULTS: Following the initiation of the target drug, more patients switched from risperidone to olanzapine than vice versa. However, among patients with schizophrenia who had comorbid diabetes, there were more patients who made a switch from olanzapine to risperidone; whereas among those who used anxiolytics, there were more patients who switched from risperidone to olanzapine. Finally, olanzapine initiators had decreased hazards of discontinuation by 14% (unadjusted; P < 0.001) and 12% (adjusted; P = 0.002), respectively, than risperidone initiators. CONCLUSIONS: Compared with risperidone, olanzapine seems to be better tolerated by patients as indicated by better treatment persistence. As such, initiation of olanzapine may increase the likelihood of sustaining control of symptoms of schizophrenia. Future research needs to provide a more comprehensive assessment of treatment persistence by considering other antipsychotic agents in the study and developing models to assess treatment persistence and switching as two interdependent competing risks.

Adolescent↗

Relationship between entry into child welfare and mental health service use.

OBJECTIVE: This study examined the relationship between initiation of outpatient mental health service use and level of child welfare involvement. METHODS: Three levels of child welfare involvement were examined: in-home care and no child welfare services beyond an initial investigation, in-home care and additional child welfare services, and placement in out-of-home care (foster care). Longitudinal data were collected for a subsample of children (N=3,592) aged two through 14 years who were enrolled in the National Survey of Child and Adolescent Well-Being, a nationally representative sample of children undergoing investigation for abuse or neglect. Event history analysis was used to model relative risk of initiation of mental health service use over time. RESULTS: Hazard functions revealed a large increase in onset of mental health services immediately after the time of the initial contact with child welfare, varying by level of child welfare involvement and leveling off by three months after the initial contact. The multivariate Cox proportional-hazards model indicated that compared with children who were placed in out-of-home care, those in in-home care who did not receive any further child welfare services were about one-third as likely to use mental health services and those in in-home care who received additional child welfare services were one-half as likely to use mental health services. Other covariates in the model predicted mental health service use, including being older, being Caucasian, having a history of maltreatment (specifically, physical abuse, physical neglect, or abandonment), being uninsured, and need for mental health services, as measured by the Child Behavior Checklist. CONCLUSIONS: Contact with child welfare functions as a gateway into mental health services for children in child welfare, even when need for such services is controlled for.

Adolescent↗

Case management and recidivism of mentally ill persons released from jail.

OBJECTIVE: The study tested the hypothesis that case management provided to mentally ill offenders both in jail and after release from jail would reduce their recidivism. METHODS: A total of 261 inmates of the Lucas County (Toledo, Ohio) jail who were diagnosed with a mental disorder were tracked for three years after their release. The relationships between recidivism and diagnostic, demographic, and case management variables were examined through event history analysis. RESULTS: Recidivism was associated with age, employment, previous arrests, and receipt of community-based case management. Receipt of jail-based case management, although not directly related to recidivism, significantly increased the probability of receiving community-based case management. Receipt of community case management was significantly associated with a lower probability of rearrest and a longer period before rearrest. CONCLUSIONS: This study found hopeful signs that expanding access to case management, both inside and outside jail, will help mentally ill people live in their communities and stay out of jail.

Adult↗

Premarital cohabitation and postmarital cohabiting union formation.

"Previous research has indicated that premarital cohabitation decreases marital stability. This study examined the role of premarital cohabitation as a determinant of cohabitation after marital disruption. The author proposed that people who cohabited with their first spouse prior to marriage have a greater propensity to cohabit after marital disruption than people who did not cohabit before their first marriage. Event history analysis of the postmarital union experiences of women and men from the Canadian 1990 Family and Friends Survey (FFS) supports this proposition. It was found that the hazard rate of postmarital cohabitation was over 50% higher for premarital cohabitants than for noncohabitants."

Americas↗

Predicting the timing of women's departure from abusive relationships.

The aim of this study was to investigate forces that affect the timing of women's exit from violent relationships with men. Abused women were recruited from posters in the community and battered women's shelters, interviewed, and followed up for 10 years. Data for this study are based on 100 women and were analyzed using event history analysis. Age, ethnicity, and alcohol consumption levels of both partners predicted the timing of women's termination of abusive relationships. An interaction effect showed that women who scored above the mean on an index of physical aggression and who never used shelter services had the longest trajectories of violence exposure; severely abused women without shelter use were more likely to stay. Our findings indicate that women who receive shelter services endure shorter periods of violence than women who do not access such services. Further outreach, especially to women experiencing high rates of physical aggression, is recommended.

Adult↗

Factors related to recidivism among juvenile sexual offenders.

This recidivism study retrospectively examined the juvenile court case records of 170 first-time juvenile sexual offenders in a 5-year observation period. Cox regression, a model of event history analysis, was used to test hypotheses and to build multivariate competing risk models predictive of criminal recidivism. The multivariate analyses found that nonsexual offense recidivism was significantly (p < .01) associated with (a) prior nonsexual offenses and (b) failure to complete treatment. Sexual offense recidivism was significantly associated with larger numbers of female victims, but results were inconclusive due to the small size (n = 13) of the sexual reoffending sample.

Adolescent↗