Completed High School Education Research Articles

Apathy in Dementia: An Examination of the Psychometric Properties of the Apathy Evaluation Scale

Apathy in Dementia: An Examination of the Psychometric Properties of the Apathy Evaluation Scale

Effect of Written Instructions on Accuracy of Self-Reporting Medication Regimen in Glaucoma Patients

Our purpose was to evaluate the accuracy of self-reporting of the prescribed medication regimen in a glaucoma population, identify contributing factors, and assess the effect of written instructions. All patients at an urban resident glaucoma clinic were offered participation in this prospective, case-controlled study. Two trained interviewers administered a confidential questionnaire consisting of six questions regarding the name and dosage of ophthalmic medications, education level, ability to read, and age. A verbatim response for each question was recorded on the questionnaire. At the end of the visit, patients were given a written chart describing their ophthalmic medications, frequency, and dosage. At their next scheduled visit, the same questionnaire was repeated. The patients' responses from both visits were compared with the regimen they were prescribed and with each other. This information was used to determine the accuracy of reporting medications. A total of 193 patients were enrolled in the study over a 10-month period; 164 patients completed both phases (85% completion rate). The study population consisted of 85 women and 79 men with a mean age of 68.40+/-11.6 years. Eighty-four patients had attained less than 12th grade education and 80 had completed high school. At the first visit, 66 patients (40%) showed less than 100% accuracy. Forty-nine of 84 (58%) patients who had not completed high school education showed less than 100% accuracy with a mean score of 65% (P=0.001), whereas 17 of 80 (21%) of patients who had completed high school showed less than 100% accuracy with a mean score of 87% (P=0.001). After written instruction, the accuracy of reporting improved by 23.36+/-30.8 percentile points in patients without completion of high school education and improved by 8.46+/-21.7 percentile points in patients who had completed high school (P<0.001). The mean number of ophthalmic medications prescribed was 2.10+/-0.93 (range 1 to 4). Patients on one medication had 100% accuracy in reporting 82% of the time, whereas those with four medications had 100% accuracy 21% of the time. Gender, age, and race of the patient were not correlated with the accuracy of self-reporting (P>0.05). The education level of the patient and the number of medications showed direct correlation with patients' ability to report medications accurately. Patients showed improvement in accuracy of reporting medications when given written instructions about their regimen, regardless of their level of education or number of medications.

AIR POLLUTION EFFECTS ON FIBRINOGEN, HIGH-SENSITIVITY C REACTIVE PROTEIN, AND MUCOPROTEIN IN TRAFFIC CONTROLLERS

ISEE-8 Abstract: Air pollutants are related with cardiovascular morbidity and mortality. Objective: In order to investigate the effects of urban air pollutants on blood markers for cardiovascular risks (fibrinogen, high-sensitivity C reactive protein -HSCRP, and mucoprotein) we carried out a panel study with 48 traffic controllers working in high traffic avenues in São Paulo City. Methods: All participants were males, mean age of 39.2 years (± 6.4), non-smokers, with at least complete high school education, and healthy. Blood samples were collected in working days, in three different periods: August 2000 (winter), January/February 2001 (summer), and August 2001 (winter), corresponding to different mean levels of air pollutants exposure. Linear regression models with generalized estimating equations (GEE) were used to assess the effect of particulate matter with an aerodynamic diameter less than 10 mm (PM10), CO, SO2, NO2, and O3 on the blood markers, controlling for temperature, humidity, age, and body mass index. Results: CO, SO2, PM10, and O3 where associated with changes in blood markers. In general, the effects presented short time lags. An interquartile range increase of CO (1.1 ppm) was associated with an increase of 25.78 mg/dl on fibrinogen (95% CI: 8.12–43.44), increase of 1.66 mg/l on HSCRP (95% CI: 0.09–3.23), and 0.28 mg/dl on mucoprotein (95% CI: 0.02–0.42). An interquartile range increase of SO2 (9.6 mg/m3) was associated with an increase of 0.49 mg/dl on mucoprotein (95% CI: 0.28–0.70), increase of 1.48 mg/l on HSCRP (95% CI: 0.22–2,74). An interquartile range of PM10 (33.6 mg/m3) was associated with increases of 0.34 mg/dl on mucoprotein (95% CI: 0.01–0.67). An interquartile range increase of O3 (42.6 mg/m3) was associated with increase of 0.25 mg/dl on mucoprotein (95% CI: 0.08–0.42). Conclusion: In São Paulo City, primary pollutants presented positively association with, at least, one of the blood markers of cardiovascular risk. These results are in agreement with other studies focusing the same endpoints and with our studies that showed air pollution effects on heart rate, blood pressure and other blood markers in the same population. Also, they reinforce the epidemiological association between air pollution and cardiovascular deaths reported in time-series studies.

Brief cognitive assessment in schizophrenia: normative data for the Repeatable Battery for the Assessment of Neuropsychological Status

Background: The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a brief, standardized cognitive screening instrument that assesses several domains of interest and offers an efficient approach to screening for cognitive impairment in schizophrenia (SC). Prior studies have established the clinical validity and test–retest reliability of the RBANS in SC. Aims: The purpose of the current study was to guide clinical interpretation by providing normative data for the use of the RBANS as a measure of cognitive impairment in SC. We also sought to evaluate the role of demographic factors and to present percentile data accordingly. Methods: 575 patients (391 male, 184 female) meeting the diagnostic criteria for SC or schizoaffective disorder were recruited from 4 inpatient ( n=117) and 6 outpatient ( n=458) sites in 2 different mental health treatment systems. All participants were administered the RBANS according to standardized instructions and a subgroup of 242 patients were also administered the Wide Range Achievement Test (3rd Edition) (WRAT-3) Reading subtest. Results: RBANS Total Scale score for patients with SC was approximately 2 standard deviations below the normal mean, was approximately 1 standard deviation below WRAT-3 Reading scores, and expected patterns of impairment were observed: measures of language and visuospatial ability were preserved relative to those of memory and attention. Aside from weak associations with Language (0.139) and Attention (0.112), age was not significantly associated with RBANS Index scores (which are age adjusted in healthy controls). Education was significantly associated with all RBANS scores and one-way ANOVA indicates that those with more than high school education scored consistently higher than the other two groups (less than and equal to a complete high school education). Normative tables with age and education based percentiles are presented. Conclusions: The RBANS is an efficient screening tool for assessing cognitive impairment in patients with SC thereby making it a useful instrument for clinical and research applications.

Trends in pregnancy-related smoking rates in the United States, 1987-1996.

Rates of smoking are increasing among adolescents and young adults, but trends in smoking among pregnant women have not been studied. To assess pregnancy-related variations in smoking behaviors and their determinants among women of childbearing age in the United States. Analysis of data collected between 1987-1996 from the Behavioral Risk Factor Surveillance System survey. A total of 187302 (178499 nonpregnant and 8803 pregnant) noninstitutionalized women aged 18 to 44 years from 33 states. Prevalence rates of smoking initiation and current smoking, median number of cigarettes smoked, and adjusted odds ratios for smoking stratified by pregnancy status; prevalence rate ratio for current smoking comparing pregnant with nonpregnant women. The overall percentage of women who had ever initiated smoking decreased significantly from 44.1% in 1987 to 38.2% in 1996. During that 10-year period, the prevalence of current smoking also decreased significantly among both pregnant women (16.3% to 11.8%) and nonpregnant women (26.7% to 23.6%). Overall, pregnant women were about half (54%) as likely as nonpregnant women to be current smokers during 1987-1996. Over time, the median number of cigarettes smoked per day by pregnant smokers remained at 10, whereas among nonpregnant smokers it decreased from 19 to 15 (P<.05 for trend). In the same period, among young women (aged 18-20 years), prevalence rates of smoking initiation and current smoking increased slightly. Sociodemographic subgroups of women at increased risk for current smoking were the same for pregnant and nonpregnant women (ie, those with a completed high school education or less, whites, and those who were unmarried). In this analysis, the decline in smoking over time among pregnant women was primarily due to the overall decline in smoking initiation rates among women of childbearing age, not to an increased rate of smoking cessation related to pregnancy. To foster effective perinatal tobacco control, efforts are needed to further reduce the number of young women who begin smoking. Clinicians should query all pregnant women and women of childbearing age about smoking and provide cessation and relapse interventions to each smoker.

Degenerative Prefrontal Damage in a Young Adult: Static and Dynamic Imaging and Neuropsychological Correlates

Abstract A 26-year-old woman with massive bilateral prefrontal damage of unknown aetlology is described. Frontal lobe degeneration was examined with magnetic resonance imaging and (1 8F)2-fluoro-2-deoxy—glucose positron-emission tomography, and was found to include both orbital and dorsolateral aspects of the frontal lobes. For the left prefrontai cortex, degeneration was most marked along the medial frontal gyrus; for the right, the degeneration of the middle frontal gyrus extended nearly up to the precentral sulcus; furthermore, portions of the superior frontal gyrus and most of the orbitofrontal cortex were affected as well. The patient had complete high-school education, superior verbal long-term memory, normal short-term memory, and normal priming, but manifested grossly deficient scores in various frontal lobe sensitive tests. Although a number of neurological measures were taken, no plausible cause of the damage was obtained. She does not fulfil the criteria of schizophrenia. Because of the focus of brain Impairment and the behavioural disturbances, the young woman suffers presumably from frontal lobe degeneratlon of non-Alzheimer type.

Degenerative prefrontal damage in a young adult: Static and dynamic imaging and Neuropsychological Correlates

A 26-year-old woman with massive bilateral prefrontal damage of unknown aetlology is described. Frontal lobe degeneration was examined with magnetic resonance imaging and (1 8F)2-fluoro-2-deoxy—glucose positron-emission tomography, and was found to include both orbital and dorsolateral aspects of the frontal lobes. For the left prefrontai cortex, degeneration was most marked along the medial frontal gyrus; for the right, the degeneration of the middle frontal gyrus extended nearly up to the precentral sulcus; furthermore, portions of the superior frontal gyrus and most of the orbitofrontal cortex were affected as well. The patient had complete high-school education, superior verbal long-term memory, normal short-term memory, and normal priming, but manifested grossly deficient scores in various frontal lobe sensitive tests. Although a number of neurological measures were taken, no plausible cause of the damage was obtained. She does not fulfil the criteria of schizophrenia. Because of the focus of brain Impairment and the behavioural disturbances, the young woman suffers presumably from frontal lobe degeneratlon of non-Alzheimer type.

The Impact of Nutritional Knowledge on the Quantity and the Quality of Diet Among the Southern Rural Elderly.

LEARNING OUTCOME: To examine the relationship between diet quality and nutrition knowledge of the rural elderly.Volunteers (n=1555) of elderly residing in counties with 70% or more rural population from 9 Southern states (AL, AK, GA, KY, MD, MO, MS, TN, TX) participated in the study. This study was designed to delineate whether there was a relationship between nutrition knowledge and the quality of diet and nutrient consumption among the rural elderly, one of most neglected segments of our population. The sample consisted of 47.8% Blacks and 51.9% Whites, 15.8% male and 84.2% female. The age ranged from 60 to 102 yrs. (mean ± SD: 72.8 yrs. ± 7.6) and 57.6% lived alone; only 34.9% of the elderly completed high school or higher education. 43% of the elderly had a per capita monthly income less than $450, and 27.5% were Food Stamp Program participants. Information collected from these participants through face-to-face interviews included: socioeconomic factors, health history, 2 non-consecutive days food intakes by 24-hr recall, and nutritional knowledge, practice, and attitudes. The nutrition knowledge and practice questions were adapted from the USDA Diet and Health Knowledge Survey. Nutrient intakes were computed from the 24-hr recall data by using Nutritionist IV (N-Squared, San Bruno, CA). The Diet Quality Index (DQI) was computed based on R. Patterson's method (JADA,. 94: 57-64, 1994). Knowledge scores on dietary fiber and fat/cholesterol were trisected - high, medium and low. One-way factorial ANOVA technique was used to discern the difference in DQI and nutrient consumption as related to their knowledge scores. The DQI increased significantly with the knowledge scores on dietary fiber ((p<0.001) and on fat/cholesterol (p<0.0001). Those with higher knowledge scores on fiber consumed significantly more fiber (p<0.001), and those with higher scores on fat/cholesterol consumed significantly lower amounts of cholesterol (p<0.0002) and fat (p<0.05), particularly saturated fat (p<0.003). This study clearly demonstrated the importance of nutrition knowledge to quality of diet and higher consumtion of fiber as well as lower fat consumtion. (Supported by USDA, CSREES, RR6)

Changes in health behaviors made by pregnant substance users.

A descriptive survey was conducted with 31 pregnant women who were substance users enrolled in a perinatal treatment program. The purpose of the study was to determine the women's health behaviors by using open-ended questions. Most of the women were between 20 and 29 years of age, Hispanic, not married, unemployed, and had partial or completed high-school education. The women had multiple pregnancies with few living children. The majority of the women were 4 to 6 months pregnant and all had received prenatal care. The women made health behavior changes during pregnancy related to nutrition, substance use, self-care, exercise, lifestyle, and seeking counseling. Over 52% of the women reported they made these behavioral changes because they wanted a healthy baby.

Impact of aging on nutritional risk and nutritional status

The nutritional status of older male veterans was assessed during a three year prospective cohort study. One objective of the study was to compare older old (age ≥ 75) and younger old (65–74 years) to assess the impact of age differences relative to nutritional status risk factors, nutritional status indicators, and health status reports during year one of the study. Sampling was randomized and analysis of nonresponders vs. responders indicated subject representativeness. Exclusion criteria included being born later than 1920, hospitalization within the past 3 months, and living in a nursing home as a permanent residence. The total sample consisted of 300 medical outpatients partitioned as n=219 in the younger old group and n=81 in the older old group. Data collection instruments were either standardized or pilot tested. Quality assurance procedures to assure reliability and validity of the data were conducted through the study's duration. Results of the study include finding that the older old veterans had more risk factors for poor nutrition when compared to the younger old. The older group more often lived alone, had incomes below the poverty level, and had less than a completed high school education. Sickness impact profile, abnormal gait, reduced hand strength, and reduced near vision indicated diminished physical functioning in the older old. However, intakes of 17 nutrients were not significantly different between age groups. Protein intake for younger old (76.8 ± 30.9 gm) was significantly (p ≤ 0.05) different from that of older old (68.6 ± 23.5 gm). Nevertheless, significant (p ≤ 0.001) differences in fat skinfolds, arm muscle circumference, and arm muscle areas were found. Biochemical assessment revealed no statistically or clinically significant indices except for total and LDL cholesterol which was significantly (p ≤ 0.001) higher in the younger old. Although findings may represent cohort differences, results suggest that age has little impact on the nutritional status of older old veterans as compared to younger old veterans.

Comparison of long-term outcome after acute myocardial infarction in patients never graduated from high school with that in more educated patients

The clinical course of 363 patients with acute myocardial infarction who did not complete high school education was compared with that of 453 who completed at least high school. Both the inhospital and 4-year mortality rates were markedly greater for the less educated than for the more educated patients (13 vs 5% [p < 0.001], and 36 vs 17% [p < 0.001]). Adverse baseline characteristics were partially responsible for the increased inhospital (p = 0.059 after adjustment) and longterm (p = 0.024 after adjustment) mortality. The less educated patients were not as likely to quit smoking after acute myocardial infarction as were the more educated ones (38 vs 49%; p < 0.05). Patients who continued smoking had a greater mortality than did those who quit (24 vs 15% [p < 0.05] for less educated, and 10 vs 4% [p < 0.05] for better educated). Therefore, greater effort should be directed to smoking cessation among the high-risk group of less educated patients. However, the smoking continuation was responsible for only a small portion of the mortality difference, suggesting unidentified causes of mortality, such as lack of compliance with therapy and possible social isolation. Despite the high-risk status of the less educated patients, cardiac catheterization tended not to be performed as frequently as in the more educated patients after discharge from the hospital (16 vs 21%; p < 0.06 at 6 months).

Border region minority students: A note on educational policies for the 1990s

The quality of education and the economic development of the Mexican-American border are closely related phenomena. Hansen (1981), for example, explains the high correlation between income and educational levels among the Mexican-American population. In his study of median income of Mexican-origin males and all males by school years completed, Hansen concluded that as the Mexican-American's educational levels advance, so do their earnings in relation to the rest of the population (Hansen 1981:142). Because of the significance of a completed high school education, we must pay particular attention to border school dropout problems and policies promoting increased retention. Researchers and the general public alike are impetuous in making vast educational generalizations such as: Dropout rates are threatening minority border populations, It is obvious that Hispanic dropout rates are increasing, Dropout rates occur more often among Hispanics than among blacks and more often among blacks than whites and Fewer Hispanics are attending post-secondary educational institutions. Educators studying the border populations of minority high school students, are finding that there are confusing complexities, some truths, and many contradictions to these broad generalizations and assumptions. Unfortunately, this confusion is often reflected in educational policy. Thus, the purpose of this article is to examine some of these assertions and to suggest, in general terms, educational policies that may lead to improved educational opportunities in the border region.

Educational and emotional problems in students in Sweden.

Onehundredninety students who consulted the student psychiatrist for the first time in Stockholm 1976 were interviewed. Thirty six had not completed their high-school education but were admitted to university studies after a recent government reform aimed at greater educational equality. Serious family problems, working-class background, and addiction problems were more frequent in the group without complete high-school education as compared with other students seeking consultation.

A Preliminary Study of the Characteristics of the Cultural Growth of the Soviet Peasantry Before Collectivization (On Data of Budget Studies of Peasant Farms in the 1920s)

Soviet Russia inherited from the past cultural backwardness, ignorance, and a downtrodden condition among the broad masses of the peasantry. In preparing for his speech at the Eleventh Congress of the Russian Communist Party (Bolsheviks), V. I. Lenin observed: "What the proletarian state has done, minus what has already been yielded to the New Economic Policy, is sufficient for us (to assure socialism). Success is assured, if there is enough of? what? civilization!!! (1) And further "The ‘key to the moment’ (the link in the chain) = the gap between the magnitude of the goals set and poverty, not only in terms of material goods but culturally as well." (2) This circumstance made the tasks of cultural uplift in the countryside particularly acute. If capitalism triumphed over the Revolution, Lenin observed, it would triumph by taking advantage of rises. However, examination of the changes in the average educational level of various social strata shows that while educational levels show a general rise, there is also a tendency for different social strata to converge in terms of that indicator. Whereas in 1965 the difference in average educational level between unskilled and highly skilled workers was 2.2 years, in 1976-77 it was 1.4. According to the 1976-77 data, 75 to 80% of workers aged 30 and under have completed secondary, specialized secondary, or higher education. There is a tendency for educational levels of different strata of the working class to even out. The tendency for the working class to become a class possessing complete high-school education is quite obvious. Consequently, general secondary education is gradually losing its role as a socially differentiating factor, as social strata converge in this regard. At the same time, the role of systematic occupational training in the shaping of the skilled worker is rising. It is specifically occupational training that today largely determines the socio-occupational affiliation of the worker and the character of his labor. Naturally, this tendency is thus far characteristic only of the youthful new recruits to the working class, who are characterized by a high level of general education. For workers in older age groups, among whom fluctuations in educational level are considerable, a more rigorous connection between education and nature of work is obvious. Therefore, on the whole, differences in educational level of workers of different social strata continue to exist up to this point.