Poor Self Research Articles

Posttraumatic stress in breast cancer patients

Background. Breast cancer diagnosis is a potential life-threatening event associated with significant distress. The present study aimed to identify the prevalence of posttraumatic stress and its association with clinical and social factors in early breast cancer patients and one year after surgery. Materials and methods. Four hundred twenty one newly diagnosed breast cancer patients completed three questionnaires: Impact of Event Scale – revised (IES-R), Beck Depression Inventory II (BDI-II), Vrana & Lauterbach Traumatic Events Scale-Civilian (TEQ). Women were questioned before surgery and one year later. Patients were 18–80 years old resident Lithuanian women with histologically confirmed breast cancer and no history of other cancers. Additional requirements were as follows: ability to read Lithuanian and being capable of completing a questionnaire. Results. 51.5% of newly diagnosed breast cancer patients had from moderate to severe symptoms of PTSD (score average of IES-R ≥ 1.5). After one year it decreased and there were 33.5% of patients who had symptoms of PTSD. The scores of all subscales were decreased a bit as well. Immediately after statement of diagnosis, PTSD correlated with sadness, often cry and earlier traumatic experience. One year later, PTSD correlated with poor self perception, sadness and traumatic experience during this year. Pessimistic mood, lack of energy, difficulties to concentrate were significant to breast cancer patients. Conclusions. A significant number of breast cancer patients suffers from PTSD symptoms. After one year, the amount of patients suffering from PTSD decreased almost twice. Depression and traumatic experience are the predictors of PTSD. The findings show that early evaluation of psychoemotional needs of breast cancer patients is necessary and early interventions are meaningful.

Factors associated with a diabetes diagnosis and late diabetes diagnosis for males and females

AimsTo examine the factors associated with diabetes, a late diabetes diagnosis, and whether these factors are different for males and females. MethodsCross-sectional study including 7101 individuals aged ≥25 years in Newfoundland and Labrador, Canada (466 with diabetes; 332 diagnosed late). Logistic regression analysis was used to determine the factors associated with a diabetes diagnosis and late diabetes diagnosis. ResultsFor males, overweight/obesity (HR, 1.35; 95% CI, 1.06–1.72) was positively associated with diabetes while being a regular/occasional drinker (HR, 0.53; 95% CI, 0.32–0.88) was inversely associated with diabetes. Living in a rural area (HR, 1.47; 95% CI, 1.01–2.15), receiving social assistance (HR, 2.80; 95% CI, 1.52–5.15), having poor self perceived health (HR, 2.06; 95% CI, 1.32–3.21), and considering most days stressful (HR, 1.45; 95% CI, 1.01–2.10) were positively associated with diabetes for females. No factors were significantly associated with a late diabetes diagnosis for males. Having a low education (OR, 0.33; 95% CI, 0.11–0.99) was inversely associated with a late diabetes diagnosis for females. ConclusionsDifferent factors are associated with diabetes for males and females. Disadvantaged females appear to be at the greatest risk. The factors associated with a late diabetes diagnosis were also different for males and females. Females with lower education levels are diagnosed with diabetes earlier than females with higher education levels. Certain risk factors appear to impact males and females differently and more research is needed on how males and females develop diabetes and when they are diagnosed.

Prevalence and Factors Influencing Diabetic Foot Ulcer among Diabetic Patients Attending Arbaminch Hospital, South Ethiopia

Background: Diabetic foot ulcer is one of the long standing complications of diabetic mellitus with the life time risk up to 25%. In Africa in general, particularly in Ethiopia, there are limited epidemiological studies related to diabetic foot ulcer. Objective: The main objective of this study is to assess prevalence and factors influencing diabetic foot ulcer among diabetic patients attending Arbaminch hospital. Methods: A cross sectional study was conducted on 216 diabetic clients attending Arbaminch hospital from Feb10, 2013 to April 10, 2013. Subjects were identified using simple random sampling and data was collected by four trained diploma level nurses using interviewer administered questioner, record review check list and observation check lists. The data was coded and entered to Epidata version 3.1 and exported to SPSS version 16.0 for analysis. Descriptive analysis was done for sociodemographic variables, diabetic knowledge, diabetes self care practice and attitude and clinical factors. Binary logistic regression analysis was also done to identify independent factors associated with diabetic foot ulcer and significant factors was declared at p<0.05 with 95% confidence interval. Finally data was presented with explanatory statements, tables and graphs. Result: All of the study subjects were interviewed which gives 100% response rate with the mean ± SD age of 50.72 ± 13.39 years. Out of the total 216 study subjects , about 32(14.8%) has diabetic foot ulcer, 129(59.7%) were male, 61(28.2%) from rural, 132(61.11%) were overweight, 97(44.5%) have poor diabetic foot self care practice and 80(37%) of them have secondary education. rural residence (AOR=4.074, 95% CI 1.262-13.151), absence of co-morbidity (AOR=0.611, 95% CI 0.131-0.955), mean arterial blood pressure greater than 90(AOR=5.113, 95% CI 1.285-20.347), duration of diabetes for more than 10years (AOR=8.452, 95% CI 2.365-30.994), are independent factor associated with DFU. Conclusions and recommendations: Significant proportion of patients with diabetes developed diabetic foot ulcer. Rural residence; presence of co-morbidity; duration of diabetes, mean arterial blood pressure and occupation are factors associated with diabetic foot ulcer. In addition to regular diabetic care emphasis should be given on enhancing diabetic patient’s knowledge of self care practice and regular diabetic foot evaluation

Low Dopamine Function in Attention Deficit/Hyperactivity Disorder: Should Genotyping Signify Early Diagnosis in Children?

Attention deficit/hyperactivity disorder (ADHD) is present in 8% to 12% of children, and 4% of adults worldwide. Children with ADHD can have learning impairments, poor self–esteem, social dysfunction, and an increased risk of substance abuse, including cigarette smoking. Overall, the rate of treatment with medication for patients with ADHD has been increasing since 2008, with > 2 million children now being treated with stimulants. The rise of adolescent prescription ADHD medication abuse has occurred along with a concomitant increase of stimulant medication availability. Of adults presenting with a substance use disorder (SUD), 20% to 30% have concurrent ADHD, and 20% to 40% of adults with ADHD have a history of SUD. Following a brief review of the etiology of ADHD, its diagnosis and treatment, we focus on the benefits of early and appropriate testing for a predisposition to ADHD. We suggest that by genotyping patients for a number of known, associated dopaminergic polymorphisms, especially at an early age, misdiagnoses and/or over–diagnosis can be reduced. Ethical and legal issues of early genotyping are considered. As many as 30% of individuals with ADHD are estimated to either have secondary side–effects or are not responsive to stimulant medication. We also consider the benefits of non–stimulant medication and alternative treatment modalities, which include diet, herbal medications, iron supplementation, and neurofeedback. With the goals of improving treatment of patients with ADHD and SUD prevention, we encourage further work in both genetic diagnosis and novel treatment approaches.

Prevalence and Factors Influencing Diabetic Foot Ulcer among Diabetic Patients Attending Arbaminch Hospital, South Ethiopia

Background: Diabetic foot ulcer is one of the long standing complications of diabetic mellitus with the life time risk up to 25%. In Africa in general, particularly in Ethiopia, there are limited epidemiological studies related to diabetic foot ulcer. Objective: The main objective of this study is to assess prevalence and factors influencing diabetic foot ulcer among diabetic patients attending Arbaminch hospital. Methods: A cross sectional study was conducted on 216 diabetic clients attending Arbaminch hospital from Feb10, 2013 to April 10, 2013. Subjects were identified using simple random sampling and data was collected by four trained diploma level nurses using interviewer administered questioner, record review check list and observation check lists. The data was coded and entered to Epidata version 3.1 and exported to SPSS version 16.0 for analysis. Descriptive analysis was done for sociodemographic variables, diabetic knowledge, diabetes self care practice and attitude and clinical factors. Binary logistic regression analysis was also done to identify independent factors associated with diabetic foot ulcer and significant factors was declared at p<0.05 with 95% confidence interval. Finally data was presented with explanatory statements, tables and graphs. Result: All of the study subjects were interviewed which gives 100% response rate with the mean ± SD age of 50.72 ± 13.39 years. Out of the total 216 study subjects , about 32(14.8%) has diabetic foot ulcer, 129(59.7%) were male, 61(28.2%) from rural, 132(61.11%) were overweight, 97(44.5%) have poor diabetic foot self care practice and 80(37%) of them have secondary education. rural residence (AOR=4.074, 95% CI 1.262-13.151), absence of co-morbidity (AOR=0.611, 95% CI 0.131-0.955), mean arterial blood pressure greater than 90(AOR=5.113, 95% CI 1.285-20.347), duration of diabetes for more than 10years (AOR=8.452, 95% CI 2.365-30.994), are independent factor associated with DFU. Conclusions and recommendations: Significant proportion of patients with diabetes developed diabetic foot ulcer. Rural residence; presence of co-morbidity; duration of diabetes, mean arterial blood pressure and occupation are factors associated with diabetic foot ulcer. In addition to regular diabetic care emphasis should be given on enhancing diabetic patient’s knowledge of self care practice and regular diabetic foot evaluation

Litter production and nutrient cycling in two plantations and a Podocarpus falcatus dominated natural forest ecosystems in south-eastern highlands of Ethiopia

The production of litter plays a fundamental role in the biogeochemical cycle of organic matter and mineral nutrients in forest ecosystems. The amount of litter produced and nutrients returned, and their accumulation in the organic layers of Eucalyptus globulus and Cupressus lusitanica plantations, and an adjacent Podocarpus falcatus dominated natural forest were monitored over a one year period in Ethiopia. The objective of the study was to asses the general trends of nutrient cycling by litter fall under the two plantations relative to the natural forest. The results showed that annual litter production was significantly highest in the natural forest (4.4 t ha-1year-1) and least in Cupressus plantation (2.2 t ha-1year-1). Litter fall in the natural forest was of high quality and richer in most nutrients than the two plantations which behaved similarly. The annual fluxes of N, S, P, Ca, Mg and K were 1.3 to 2.3 times as much in the natural forest as in Eucalyptus and Cupressus. The organic layer under Cupressus had poor quality litter compared to Eucalyptus and natural forest which behaved similarly mainly due to the influence of the understorey vegetation on Eucalyptus organic layer. Although statistically not significant, dry mass accumulation in the organic layer of Cupressus was higher than in Eucalyptus and lower than in the natural forest, but the approximate residence time was in the order: Cupressus >natural forest>Eucalyptus. The organic layer in the natural forest had always the maximum quantity of nutrients compared to the two plantations. Except for Ca in which Cupressus far better, the other elements were accumulated in larger quantity in the Eucalyptus organic layer than in Cupressus. Overall, the results show that the Cupressus plantation is poor self fertilizing owing to the low quality homogenous materials which could result in a gradual impoverishment of the soil. Key words: Cupressus, Ethiopia, Eucalyptus, litter fall, nutrient cycling, organic layer.

Too Many Boys Are Failing In American Schools: What Can We Do About It?

This research studied those factors that impact the failure of boys in American schools. Multiple areaswere explored. Among the broadlyinvestigated area were: physiological, social and cognitive. Attributing to the failure of boys includedbrain structure, cultural standards, teaching practices, economics, environmentalfactors, and familial expectations.Included among the list of negative factors attributed to the failure ofboys were: poor academic performance, behavioral penalties, substance abuse,and self inflicted death. Greateremphasis was give to seeking solutions to the failure of the African Americanmale because the data reflected higher failure rates among this group. Alternatives to these negative attributes areoffered to a range of publics in soliciting their support in ameliorating theproblem. Among the public are: parents,educators, community organizers, government personnel, and medical professionals.

Association between mental health and fall injury in Canadian immigrants and non-immigrants

The study was to determine the association between mental health and the incidence of injury among Canadian immigrants and non-immigrants. We used data from 15,405 individuals aged 12 years or more, who were living in British Columbia, Canada, and participated in the 2007–2008 Canadian Community Health Survey (CCHS). We calculated a 12-month cumulative incidence of fall injury based on self-reporting. Logistic regression model was used to examine the association of the 12-month cumulative incidence of fall injury with immigration status and mental health before and after adjustment for covariates. The results show that self-reported mood and anxiety disorders were significantly associated with an increased incidence of fall injury. The adjusted odds ratios were 1.81 (95% CI: 1.37, 2.38) for mood disorder and 1.55 (95% CI: 1.12, 2.13) for anxiety disorder. Immigrant status was a significant effect modifier for the association between mental health and fall injury, with stronger associations in immigrants than in non-immigrants especially in elderly people. People with poor self perceived health were more likely to have a fall injury. Both mental health and general health were related to fall injury. There was a stronger association between mental health and fall injury in immigrants compared with non-immigrants in the elderly. More attention should be paid to mental health in immigrants associated with fall injury.

The AMEL study, a cross sectional population-based survey on aging and malnutrition in 1200 elderly Lebanese living in rural settings: protocol and sample characteristics

BackgroundLebanon is faced with a particular challenge because of large socioeconomic inequality and accelerated demographic transition. Rural residents seem more vulnerable because of limited access to transport, health and social services. No information is available regarding health, nutrition and living conditions of this specific population. The purpose of the AMEL (Aging and Malnutrition in Elderly Lebanese) study is to assess the nutritional status of community dwelling elderly people, aged 65 years and above, living in a rural settings in Lebanon, in line of socioeconomic factors, health and living conditions. The present paper will describe the gender specific characteristics of the study population.MethodsAMEL is a cross-sectional population based study conducted between April 2011 and April 2012 including 1200 elderly individuals living in the 24 rural Caza (districts) of Lebanon. People aged greater than or equal to 65 y were randomly selected through multistage cluster sampling. Subjects were interviewed at their homes by trained interviewers. The questionnaire included the following measures: socio-demographic factors, nutritional status (Mini Nutritional Assessment, MNA), health related characteristics, functional ability, cognitive status, mood and social network.ResultsThe sample included 591 men (49.3%) and 609 women (50.8%). Mean age was 75.32 years and similar between genders. Malnutrition (MNA < 17) and risk of malnutrition (MNA between 17 and 23.5) were present in 8.0% (95%CI 4.9%-11.1%) and 29.1% (95%CI 24.0%-34.2%) respectively of the participants, and more frequent in women (9.1% and 35.3% respectively). Regarding socio-demographic status, among women the level of illiteracy and poor income was significantly higher than in men. Moreover, chronic diseases, poor self perceived health, frailty, functional disability, depressive symptoms and cognitive impairment were particularly high and significantly more frequent in women than in men.ConclusionThe present study provides unique information about nutritional status, health and living conditions of community dwelling rural residents of Lebanon. These findings may alert policy makers to plan appropriate intervention in order to improve the quality of life and increase successful aging.

Damgalanma ve Ruh Sağlığı

Stigmatizasyon represent a chronic negative interaction with the environment that most of people with a of diagnosis mental disorders. Different types of stigma may have harmful effects. Poor psychological well being, poor quality of life and poor self esteem are related stigmatization. In this article, definition and mechanism of stigmatization, influenced factors and consequences of stigmatization are reviewed. Stigmatization is a modifiable environmental risk factor. Integrating approaches against stigma in treatment may represent cost-effective way to reduce the risk of relapse and poor outcome occasioned by chronic exposure to stigma.

Directive Art Therapy and Food Addiction: Motivational Interviewing and Adjunctive Art Therapy in Obesity Management Programs

Obesity is a physical illness that has reached epidemic levels within Canada 24.5% of the population is classed obese without an agreed upon attributed psychological cause (Public Health, 2011). This causes significant stress on both those that suffer from it as well as the health system that support their treatment plan. Obesity management programs lack patient compliance for many psychologically based issues such as poor self image and weight bias (Puhl & Heuver, 2009). Due to the broad nature of obesity research, cause origins, and definitions of terminology this literature review focuses on the investigation of obesity caused by Food Addiction (FA), as outlined in the Yale Food and Addiction Scale and food-related STROOP test. Obesogenic environments as an additional factor are evaluated from an Ecological Systems Viewpoint. The primary addictions model examined is Motivational Interviewing, which is currently showing progress in obesity management (Armstrong et al., 2011; Limbers et al., 2008). Art Therapy has been shown to be an effective adjunctive approach when used in conjunction with MI. By reviewing existing research on MI as an FA treatment alongside existing research on the benefits of adding art therapy to MI models, an argument for the inclusion of art therapy in an FA MI model is developed. Although alternative and qualitative in nature, this research allows for a tangible look at ways to promote patient/client adherence to weight management programs that have been shown to be effective when followed as recommended by the patients primary care physician. Further, problems that have been outlined as obstacles by patients will be shown to be accessible through the utilization of art therapy (Puhl & Heuer, 2009). Additionally, promising preliminary studies have been produced that examine art therapies unique role in obesity management through body image work (Anzules, Haenni, & Golay, 2007).

Psychological Problems in Breast Cancer Patients: A Review

Introduction: Breast cancer is not only the second most prevalent type of cancer but also most frequent cause of cancer deaths in women. Psychological problems like depression, anxiety, poor self image and use of unhealthy coping strategies affect quality of life of breast cancer patient. This article sought to review the available evidence regarding psychological problems in patients with breast cancer. Method: Literature was searched by using Google scholar database and articles from last 10 years, meeting inclusion criteria of this article were reviewed. Review of 36 articles was included. Results: For prevalence of depression and anxiety, 17 articles were review showing high prevalence of depression as well as anxiety in breast cancer patients. Poor self image was found in patients receiving any type of treatment for breast cancer. Avoidance coping was commonly used by most of patients with breast cancer. Poor quality of life has been highlighted by several studies and association was found between poor quality of life and depression in breast cancer patients. Conclusion: Majority of the studies reported high prevalence of depression and anxiety in breast cancer patients. Use of poor coping strategies is common in breast cancer patients at all stages even after treatment. Poor self image and quality of life is associated with all types of treatments.

Effectiveness of Structured Teaching Program on Knowledge Regarding Epilepsy in Children among school teachers.

Childhood is a unique phase of human development. Children are the important feature of every society and also a future of a nation.Though epilepsy is a symptom primarily of a neurological disorder it has a great extent psychiatric and psychological involvement. Epilepsy may cause personality disturbance, depression, poor academic ability, poor self confidence, learning difficulties. The aim of the study was to assess the knowledge regarding epilepsy in children among school teachers before and after the Structured Teaching Programme (STP). The data were generated by using structured questionnaire, Simple random sampling technique was adopted to select 50 subjects based on the sample frame and every 2 nd sample was selected for the study. STP was developed in regard to knowledge on epilepsy in children. The data obtained from the study subjects were analyzed and interpreted in term of the objectives and hypothesis of the study. Descriptive and inferential statistics were used for data analysis; the level was set at 0.05 levels. The mean post test score 36.10 was higher than the mean pre test score 25.38. The computedt value 23.321, indicated that there was a significant difference between pre test and post test knowledge score. The findings identified that there was no significant association between pre test knowledge score of teachers and the selected personal variables, which shows the knowledge of school teachers was independent of selected personal variables. This study revealed that the knowledge of teachers regarding epilepsy in children was inadequate and was increased after the administration of STP. Thus the research hypothesis was accepted.

907 – Barriers to self care, illness perceptions and their relationship with self care in type 2 diabetes mellitus

Type 2 Diabetes mellitus (T2DM) is a chronic disease that requires long-term medical care and lifestyle change. Many patients find it challenging to implement required behaviour changes and consequently, do not achieve glycaemic control. It is essential to research social cognitive factors that impact self care in T2DM. To study the impact of barriers and illness perceptions on self care in T2DM To explore barriers to self care and illness perception and examine their relationship with self care, metabolic control and quality of life in T2DM. A cross-sectional design was employed. The sample consisted of 60 patients with type 2 DM, meeting specified inclusion and exclusion criteria, recruited from the out-patient services of a hospital at Bangalore. The Barriers of self care questionnaire (Glasgow, 1994), The Revised Illness Perception Questionnaire (Morris et. al, 2002), The Summary of Diabetes Self Care Activities (Toobert & Glasgow, 1994) and The Diabetes Quality of Life Questionnaire Brief Clinical Inventory (Burroughs, Desikan, Waterman, Gilin & McGill, 2004) were administered. Metabolic control was assessed using glycosylated haemoglobin levels (HbA1c). Findings revealed that barriers to self care, negative perceptions of consequences of the illness and negative emotional representations were associated with poorer self care. Adherence was associated with better metabolic control and quality of life. Barriers to self care and maladaptive illness representations pose a challenge in achieving self-care goals. Understanding barriers is the first step in facilitating practitioners to identify their role in enabling patients to overcome them.

Prevalence of diminished kidney function in a representative sample of middle and older age adults in the Irish population

BackgroundThe prevalence of chronic kidney disease (CKD) using available estimating equations with the Republic of Ireland is unknown.MethodsA randomly selected population based cross-sectional study of 1,098 adults aged 45 years and older was conducted using data from the 2007 Survey of Lifestyle, Attitudes and Nutrition (SLÁN). Estimated Glomerular Filtration Rate (eGFR) was calculated from a single IDMS aligned serum creatinine using the CKD-EPI and the MDRD equations, and albumin to creatinine ratio was based on a single random urine sample.ResultsThe sample clinical characteristics and demography was similar to middle and older age adults in the general Irish population, though with an underrepresentation of subjects >75 years and of males. All results are based on subjects with available blood and urine samples. Applying weighting to obtain survey based population estimates, using Irish population census data, the estimated weighted prevalence of CKD-EPI eGFR<60 mL/min/1.73m2 was 11.6%, (95% confidence interval; 9.0, 14.2%), 12.0% ( 9.0, 14.2%) of men and 11.2% (7.3, 15.2%) of women. Unweighted prevalence estimates were similar at 11.8% (9.9, 13.8%). Albuminuria increased with lower CKD-EPI eGFR category. 10.1% of all subjects had albuminuria and an eGFR≥60 mL/min/1.73 m2 giving an overall weighted estimated prevalence of National Kidney Foundation (NKF) defined CKD 21.3% (18.0, 24.6%), with the unadjusted estimate of 21.9% (19.5, 24.4%). MDRD related estimates for eGFR <60 mL/min/1.73 m2, and NFK defined CKD were higher than CKD-EPI and differences were greater in younger and female subjects.ConclusionsCKD is highly prevalent in middle and older aged adults within the Republic of Ireland. In this population, there is poor agreement between CKD-EPI and MDRD equations especially at higher GFRs. CKD is associated with lower educational status and poor self rated health.

Self-Efficacy and Life Satisfaction amongst Undergraduates

Self efficacy is the individuals' assessment of their capabilities to organize and execute actions required to achieve successful levels of performance (Bandura, 1986). Self-efficacy makes a significant difference in how people feel, think and act. Generally the researches indicate that a low sense of self efficacy is linked with psychopathologies like depression and anxiety. Some research data also indicates the linkage of feeling of helplessness with low self efficacy. In terms of cognitive functioning high self efficacy is related to a strong sense of competence in reasoning abilities and performance in a variety of settings, including quality of decisionmaking and academic achievement (Shelton, 1990). Self efficacy levels can enhance or impede motivation. According to Bandura's theory, people with high self efficacythat is, those who believe they can perform wellare more likely to view difficult tasks as something to be mastered rather than something to be avoided. High levels of self efficacy have also been linked to high levels of innovation and skill in bringing about positive change in an organization (Pearlmutter, 1998).Students with poor self efficacy have low aspirations which may result in disappointing academic performances becoming part of a self-fulfilling feedback cycle. (Margolis & McCabe, 2006). Indeed high efficacy levels are vigorous predictors of academic achievement, positive social relationships and pro-social behavior (Bandura, Barbranelli, Caprara P desire to change one's life; satisfaction with past; satisfaction with future; and significant other's views of one's life. …

An Appraisal of the Status of Nigerian Women: Educational Implications and National Development

This paper critically examines the status of women at different levels of development. It tries to examine the role Nigerian women played at three different epochs and how they were being influenced by the system of education prevalent at the time. This was discussed under three broad headings: Women’s status in pre-colonial era, women status in colonial era and women’s status in post colonial era. Emphasis was made on over all view of women status vis-à -vis women education and national development. It concluded by saying that there has been slight improvement on the status of women at present, though not as expected compared with the women population in the country. The paper however recommended the following among which are: Joint effort of the three tiers of government for effective implementation of women’s programmes in the country. Literate women should endeavor to use any women forum as ‘classroom’ where knowledge, skills and values that will alleviate their poor self esteem can be effectively impacted.

Long-term health consequences of violence exposure in adolescence: a 26–year prospective study

BackgroundViolence victimization represents a serious risk factor for health related symptoms, for both men and women. The aim of this study was to evaluate the long-term effects of violence exposure in late adolescence and early adulthood on adult health, physical as well as mental, using a long-term prospective population-based study, with a follow up of 9, 19, and 26 years.MethodsThe primary data source is a longitudinal panel from one of the longest running social science surveys in the world, the Swedish Level-of-Living surveys (LNU). We analyzed three cohorts, individuals aged 15–19 in 1974 and 1981, and individuals aged 18–19 in 1991 which were followed up 2000. Structured interviews on childhood, family relationships, life-events, living conditions, health history and status, working conditions, behavioral, psychosocial, and demographic variables were repeatedly used in all cohorts.ResultsMultivariate models of violence exposures in adolescence in the 1974–91 cohorts as predictors of adult health in 2000 are reported for both men and women. Women exposed to violence had raised odds ratios for ill health, measured as heavy illness burden, and poor self rated health, after controlling for possible confounders. No such associations were found for men.ConclusionsThis study’s findings provide additional empirical support for the importance of policies and practices to identify and prevent violence exposure in adolescence and young adulthood and to supply treatments for adolescence exposed to violence and above all the young women.

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A study of the association of higher parathormone levels with health-related quality of life in hemodialysis patients

Secondary hyperparathyroidism (SHPT) is associated with poor outcome including mortality, hospitalization, as well as greater healthcare resource utilization and costs in chronic kidney disease (CKD). We hypothesized that SHPT is also associated with poor self reported health-related quality of life (HRQOL) in prevalent hemodialysis (HD) patients. We conducted a case-control study in patients with CKD receiving longterm HD treatment, in six dialysis clinics in Greece. HRQOL was estimated with the KDQOL-SFTM questionnaire, version 1.3, which includes 43 kidney disease targeted items, and 36 items that provide a generic core and an overall health rating item, with a higher score reflecting a more favorable health state. A total of 156 completed the questionnaire, 50 with high parathormone levels (i.e., PTH > 300 pg/ml and or under vitamin D receptor activators, mean: 329 ± 160.9 pg/ml) and 106 with low parathormone levels (PTH < 300 pg/ml, mean: 132.4 ± 69.0 pg/ml) in a 2 : 1 randomization assignment. Patients with high and with low PTH were 62.1 ± 14.9 and 65.9 ± 14.2 y old and the median dialysis vintage time was 31 and 37 months, respectively. There were no significant differences regarding the presence of comorbidities between groups. Patients with high PTH, compared to patients with low PTH, had lower pain component summary (57.6 ± 33.5 vs. 69.2 ± 28.9; p = 0.041) and physical component summary (41.0 ± 23.8 vs. 50.0 ± 20.8; p = 0.031). Both pain component summary and physical component summary differences remained significant after adjustment for age, gender and vintage (p = 0.036 and p = 0.029, respectively). Low PTH patients scored better in 18 out of 23 subscales. In HD patients, SHPT appears to be associated with worse pain component summary score (p = 0.036) and physical component summary score (p = 0.029). Additional studies are needed to verify these associations and to examine whether correction of SHPT can improve HRQOL.