Spousal health and older adults’ biomarker change over six years: Investigation of gender differences

ObjectiveRelationship of spousal health and biomarkers over six years were examined.Methods and materialsNationally representative sample of 483 adults aged 54+ in Taiwan were followed for six years. Four classes of spousal health changes and three categories of biomarker indexes were examined. Biomarkers were assessed by counting the adverse progression on items of allostatic load (AL), cardiovascular disease biomarkers (CVD), and metabolic syndromes, respectively.ResultsWhen the health status of an individual’s spouse became worse, women increased their AL by 0.48 (P < 0.05), CVD by 0.56 (P < .001), and metabolic syndrome by 0.43 (P < 0.05). If the health status of a woman’s spouse remained poor, it increased her allostatic load by 0.60 (P < 0.05). These effects were only observed in women. In addition, when the health status of a men’s spouse became better, man’s biomarker profile on AL significantly improved by 0.80 (P < 0.05). No significant moderating effect of education was observed in this sample.ConclusionsMarried couples display concordance in both physical and mental health-related biomarkers, specifically, allostatic load. Women were more likely than men to experience adverse biomarker progress on all the biomarkers examined in this study when the status of their spouse became worse based on their subjective judgment, and men were more sensitive to positive health changes in their spouse than women.     

Reactions of asbestos-exposed workers to notification and screening

In the wake of efforts to pass legislation mandating notification of workers at high risk of developing occupational disease, considerable controversy exists regarding the potential costs and benefits of such notification efforts. It has been suggested that individual notification would cause undue psychological distress, especially when primary prevention efforts are no longer possible. In this study, we assessed reactions of asbestos-exposed workers to a letter notifying them of their risk for asbestos-related illnesses and the availability of a medical screening program. Two hundred forty-seven workers who attended the screening program and 53 who chose not to attend completed a questionnaire that tapped reactions to notification. Workers reported neither undue psychological distress nor avoidance behavior in response to notification, and many respondents reported engaging in active and appropriate coping behaviors. Workers who first learned of their risk through the notification letter (33.7%) were no more likely to report distress or denial than were workers who had learned previously through other sources. Individuals who chose not to attend the screening program were less likely than attenders to report experiencing distress upon learning of their risk status, more likely to engage in minimization of risk, and less likely to have taken direct action. Our results suggest that the psychological costs of notifying workers of increased risk for asbestos-related illness appear to be outweighed by the benefits of notification and screening.     

Knowledge of Density and Screening Ultrasound

To determine breast density awareness and attitudes regarding supplemental breast ultrasound screening since implementation of the nation's first breast density notification law, Connecticut Public Act 09‐41. A self‐administered survey was distributed at a Connecticut academic breast imaging center between February 2013 and February 2014. Women with prior mammography reports describing heterogeneous or extremely dense breast tissue were invited to participate when presenting for screening mammography, screening ultrasound, or both. Data were collected on breast density awareness, history of prior ultrasounds, attitudes toward ultrasound and breast‐cancer risk, and demographics. Data were collected from 950 completed surveys. The majority of surveyed women (92%) were aware of their breast density, and 77% had undergone a prior screening ultrasound. Forty‐three percent of participants who were aware of their breast density also expressed increased anxiety about developing breast cancer due to having dense breast tissue. Caucasian race and higher education were significantly associated (p < 0.05) with knowledge of personal breast density (93% and 95%, respectively) and having a prior screening breast ultrasound (79% and 80%, respectively). Patients with less than a college degree (82%) were significantly more likely to rely exclusively on their provider's recommendation regarding obtaining screening ultrasound (p < 0.05). Breast density awareness is strongly associated with higher education, higher income, and Caucasian race. Non‐Caucasian patients and those with less than a college education rely more heavily on their physicians’ recommendations regarding screening ultrasound. Among women aware of their increased breast density, nearly half reported associated increased anxiety regarding the possibility of developing breast cancer.     

2011-2015年抚州市梅毒报告发病趋势分析

目的 为了控制梅毒疫情,分析2011-2015年抚州市梅毒的流行趋势与特征,提出预防控制对策。方法 采用描述性流行病学方法对2011-2015年抚州市梅毒疫情监测数据进行分析。结果 2011-2015年抚州市报告梅毒年均发病率13.17/10万,发病率呈上升趋势（χ_趋势2=182.340,P<0.001）,发病率年均增长速度22.50%。发病以隐性梅毒和Ⅰ期梅毒为主,隐性梅毒（χ_趋势2=199.544,P< 0.001）和Ⅰ期梅毒（χ_趋势2=13.727,P< 0.001）发病率均呈上升趋势。高发病区依次为广昌县、南丰县、南城县、乐安县、临川区和黎川县。发病以农民、家务及待业人群和职业不祥人群为主,农民发病构成比呈下降趋势（χ_趋势2=8.191,P=0.004）,家务及待业人群发病构成比呈上升趋势（χ_趋势2=25.464,P<0.001）。不同性别人群隐性梅毒、Ⅰ期梅毒、Ⅱ期梅毒和胎传梅毒发病率差异均有统计学意义（均有P<0.05）。发病年龄主要集中在20~49岁年龄段,不同性别人群发病年龄分布不同。结论 抚州市对梅毒高发病区需采取有效的针对性干预措施,以农民、家务及待业人群为重点,加强人群性健康教育,对隐性梅毒和Ⅰ期梅毒早发现、早诊断、早期实行规范治疗。     

Critical Test Result Notification via Mobile Phone-Based Automated Text Message System in the Radiologic Field: Single Institutional Experience

PurposeTo investigate the feasibility of sharing critical test result (CTR) notifications (CTRNs) via automated text messaging.Materials and methodsCTRNs via automated text messaging was used to notify physicians of CTRs in a tertiary hospital with 1,786 beds. From June 2016 to September 2016, notifications for 545 CTRs were given via a CTRN system. Among them, 490 CTRs (292 male and 198 female patients; mean age, 53.6 years old [range, 1-88]) were included in analysis. CTR levels (CTRLs) were assigned to four categories (CTRL1 to CTRL3 and unclassified) when reported, and reclassified into three CTRLs according to their clinical relevance and urgency. Response time was defined as time lapse between CTR reporting and documentation by physicians. Analysis of variance was performed to compare response times according to CTRLs and patients’ location.ResultsCorresponding actions were taken in 404 of 490 cases (82.4%) without any delayed CTRN-related morbidity. There were 15 CTRL1 (3.1%), 50 CTRL2 (10.2%), 112 CTRL3 (22.9%) cases, and the remaining 313 CTRL cases were unclassified. After reclassification, CTRL1, CTRL2, and CTRL3 were 81 (16.5%), 177 (36.1%), and 232 cases (47.3%), respectively. Response time of reclassified CTRL3 was significantly longer than that of reclassified CTRL1 (median 23.0, [interquartile range 2.0-133.5] hours versus 4.0 [0.0-22.0] hours; P < .001). Response time of outpatient cases (80.0 [6.0 to 157.0] hours) was significantly longer (P < .001) than those of inpatient (3.0 [0.0-16.0]) and emergency department cases (5.0 [1.0-21.0]).ConclusionAutomated text messaging could be a feasible option for CTRNs in the radiologic field. Further large-scale investigations regarding efficiency of this system are warranted.     

The daily impact of pain from metastatic breast cancer on spousal relationships: A dyadic electronic diary study

Women with metastatic breast cancer (MBC) experience high levels of emotional distress and pain. Although individuals often rely on their intimate partners to provide physical and emotional support when they are in pain, the daily impact of pain on the spousal relationship in the context of advanced cancer is unclear. To understand how relationships are affected by pain, 57 MBC patients and their partners completed electronic diary assessments 6 times a day for 14 days. Patients and partners rated the patient’s pain, their own mood (circumplex adjectives), the provision/receipt of social support, and the degree to which cancer interfered with their relationship. Multilevel mediation models with the couple as the unit of analysis were estimated. Partners and patients reported greater relationship interference when patients experienced more pain and less aroused (i.e., more tired, less peppy, less active) mood. Greater tired mood during the day accounted for 17% and 82% of the association between patients’ morning pain and their evening ratings of emotional and physical support from their partners, respectively. Partners did not directly respond to patients’ pain by providing emotional or physical support; however, they were more likely to provide support when patients experienced more tired and less active mood as a consequence of their pain. Results suggest that one way that pain may wear on couples’ relationships is through its adverse effects on patients’ daily mood. They also suggest that partners may base their provision of support on their perception of the adverse effects of pain on patients’ aroused mood.     

General practitioner notifications of gastroenteritis and food poisoning: cause for concern

BACKGROUND: Under the Public Health (Infectious Diseases) Regulations 1988, all doctors are required by law to notify suspected cases of specific infections and food poisoning. Doctors' propensity to notify is known to be low, and we sought to quantify this locally. METHODS: From July 2000 to June 2002, we conducted a baseline audit of notifications by Wakefield GPs of cases of suspected gastrointestinal infection or food poisoning. We repeated the audit during 2005-06, following a series of local interventions to improve notification. RESULTS: The baseline audit demonstrated considerable variation in reporting behaviour and timeliness of notification. Following the re-audit, we found that notification rates and timeliness had not improved, indeed they had deteriorated. CONCLUSION: We suggest that the current notification system is not working in respect of gastroenteritis and food poisoning, and should be either substantially revised or abandoned.