Simplified Japanese Self-Perception Scale for Young Adults (SJS-PSYA) to identify risk cases

AIM: The purpose of this study was to investigate the effectiveness of the newly devised Simplified Japanese Self-Perception Scale for Young Adults (SJS-PSYA) for identifying risk cases. The SJS-PSYA was used to measure self-perception of young adults and its validity was examined. The subjects were 196 Japanese young adults (91 males, 105 females) who had participated in the longitudinal study of Ueda (1996, 1998) from infancy and preschool years to adolescence. METHOD: Questionnaires for subjects and their parents were mailed separately and then interviews were conducted for possible risk subjects and their parents. RESULTS: (1) The total score of the SJS-PSYA was correlated negatively with the total number of risk variables. (2) Eight out of 10 single risk variables were correlated with the total self-perception score. Better subjective health, higher aspiration for future, employed at present, much satisfaction in life, much support from friends as well as family and higher appraisal of nurturance of own parents, higher was the total self-perception score. These results suggest that the SJS-PSYA could be used in identifying young adults at risk and for intervention.     

Early Warning of Acute Altitude Sickness by Physiological Variables and Noninvasive Cardiovascular Indicators

Objective To examine if the variations at sea level would be able to predict subsequent susceptibility to acute altitude sickness in subjects upon a rapid ascent to high altitude.Methods One hundred and six Han nationality male individuals were recruited to this research. Dynamic electrocardiogram, treadmill exercise test, echocardiography, routine blood examination and biochemical analysis were performed when subjects at sea level and entering the plateau respectively. Then multiple regression analysis was performed to construct a multiple linear regression equation using the Lake Louise Score as dependent variable to predict the risk factors at sea level related to acute mountain sickness (AMS).Results Approximately 49.05% of the individuals developed AMS. The tricuspid annular plane systolic excursion (22.0±2.66 vs. 23.2±3.19 mm, t=1.998, P=0.048) was significantly lower in the AMS group at sea level, while count of eosinophil [(0.264±0.393)×10⁹/L vs. (0.126±0.084)×10⁹/L, t=-2.040, P=0.045], percentage of differences exceeding 50 ms between adjacent normal number of intervals (PNN50, 9.66%±5.40% vs. 6.98%±5.66%, t=-2.229, P=0.028) and heart rate variability triangle index (57.1±16.1 vs. 50.6±12.7, t=-2.271, P=0.025) were significantly higher. After acute exposure to high altitude, C-reactive protein (0.098±0.103 vs. 0.062±0.045 g/L, t=-2.132, P=0.037), aspartate aminotransferase (19.7±6.72 vs. 17.3±3.95 U/L, t=-2.231, P=0.028) and creatinine (85.1±12.9 vs. 77.7±11.2 mmol/L, t=-3.162, P=0.002) were significantly higher in the AMS group, while alkaline phosphatase (71.7±18.2 vs. 80.6±20.2 U/L, t=2.389, P=0.019), standard deviation of normal-to-normal RR intervals (126.5±35.9 vs. 143.3±36.4 ms, t=2.320, P=0.022), ejection time (276.9±50.8 vs. 313.8±48.9 ms, t=3.641, P=0.001) and heart rate variability triangle index (37.1±12.9 vs. 41.9±11.1, t=2.020, P=0.047) were significantly lower. Using the Lake Louise Score as the dependent variable, prediction equation were established to estimate AMS: Lake Louise Score=3.783+0.281×eosinophil-0.219×alkaline phosphatase+0.032×PNN50.Conclusions We elucidated the differences of physiological variables as well as noninvasive cardiovascular indicators for subjects after high altitude exposure compared with those at sea level. We also created an acute high altitude reaction early warning equation based on the physiological variables and noninvasive cardiovascular indicators at sea level.     

Estimated Effect of Climatic Variables on the Transmission of Plasmodium vivax Malaria in the Republic of Korea

Background: Climate change may affect Plasmodium vivax malaria transmission in a wide region including both subtropical and temperate areas.Objectives: We aimed to estimate the effects of climatic variables on the transmission of P. vivax in temperate regions.Methods: We estimated the effects of climatic factors on P. vivax malaria transmission using data on weekly numbers of malaria cases for the years 2001-2009 in the Republic of Korea. Generalized linear Poisson models and distributed lag nonlinear models (DLNM) were adopted to estimate the effects of temperature, relative humidity, temperature fluctuation, duration of sunshine, and rainfall on malaria transmission while adjusting for seasonal variation, between-year variation, and other climatic factors.Results: A 1°C increase in temperature was associated with a 17.7% [95% confidence interval (CI): 16.9, 18.6%] increase in malaria incidence after a 3-week lag, a 10% rise in relative humidity was associated with 40.7% (95% CI: -44.3, -36.9%) decrease in malaria after a 7-week lag, a 1°C increase in the diurnal temperature range was associated with a 24.1% (95% CI: -26.7, -21.4%) decrease in malaria after a 7-week lag, and a 10-hr increase in sunshine per week was associated with a 5.1% (95% CI: -8.4, -1.7%) decrease in malaria after a 2-week lag. The cumulative relative risk for a 10-mm increase in rainfall (≤ 350 mm) on P. vivax malaria was 3.61 (95% CI: 1.69, 7.72) based on a DLNM with a 10-week maximum lag.Conclusions: Our findings suggest that malaria transmission in temperate areas is highly dependent on climate factors. In addition, lagged estimates of the effect of rainfall on malaria are consistent with the time necessary for mosquito development and P. vivax incubation.     

A restricted mixture model for dietary pattern analysis in small samples

Multivariate finite mixture models have been applied to the identification of dietary patterns. These models are known to have many parameters, and consequently large samples are usually required. We present a special case of a multivariate mixture model that reduces the number of parameters to be estimated and seems adequate for small to moderately sized samples. We illustrate our approach with an analysis of Portuguese data from a food-frequency questionnaire and with a simulation study.     

Social capital and self-rated health--a study of temporal (causal) relationships

Despite the vast amount of research over the past fifteen years, there is still lively debate surrounding the role of social capital on individual health outcomes. This seems to stem from a lack of consistency regarding the definition, measurement and plausible theories linking this contextual phenomenon to health. We have further identified a knowledge gap within this field - a distinct lack of research investigating temporal relationships between social capital and health outcomes. To remedy this shortfall, we use four waves of the British Household Panel Survey to follow the same individuals (N = 8114) between years 2000 and 2007. We investigate temporal relationships and association between our outcome variable self-rated health (SRH) and time-lagged explanatory variables, including three individual-level social capital proxies and other well-known health determinants. Our results suggest that levels of the social capital proxy 'generalised trust' at time point (t - 1) are positively associated with SRH at subsequent time point (t), even after taking into consideration levels of other well-known health determinants (such as smoking status) at time point (t - 1). That we investigate temporal relationships at four separate occasions over the seven-year period lends considerable weight to our results and the argument that generalised trust is an independent predictor of individual health. However, lack of consensus across a variety of disciplines as to what generalised trust is believed to measure creates ambiguity when attempting to identify possible pathways from higher trust to better health.     

Heterogeneity of income and lifestyle determinants of body weight among adult women in Mexico, 2006

In Mexico, the combined prevalence of overweight and obesity among Mexican women increased from 64% in 2000 to 72% in 2006. In this paper, we report our findings on the relation of women's body mass index (BMI) with income and lifestyles choices using data from a cross-sectional survey conducted in 2006. The two following approaches were executed. First, we estimated a two-stage least-squares regression to control for the potential endogeneity of income stratified by urban or rural residency. The second approach was aimed at exploring whether the determinants of weight varied among different weight levels using latent class models. Our findings from the two-stage least-squares regression show a positive non-significant association between income and BMI in the overall and urban samples but a significant positive relationship among rural women. Our results suggest that one unit increase in income is associated with 4.1% increase in body weight in rural areas. Estimates from the latent class model (LCM) show a positive but marginally significant association between income and BMI in the overall sample only in the class where there is a greater likelihood that women have normal weight or overweight compared to the class with a higher probability of being obese, but we also found a large association in rural areas for both classes. Lifestyle choices were associated with BMI. Results from the two-stage least-squares regressions reveal that more hours sitting per day and a higher percentage of expenditures in sugary beverages were associated with higher BMI levels. In the LCM, for women who eventually belong to the higher body weight class, lifestyles seem to matter more. Findings from this research suggest that policies to tackle the obesity epidemic among adult women should be different for women living in urban and rural areas and women with different weight levels.     

Toward human resource management in inter-professional health practice: linking organizational culture, group identity and individual autonomy

The literature on team and inter-professional care practice describes numerous barriers to the institutionalization of inter-professional healthcare. Responses to slow institutionalization of inter-professional healthcare practice have failed to describe change variables and to identify change agents relevant to inter-professional healthcare practice. The purpose of this paper is to (1) describe individual and organizational level barriers to collaborative practice in healthcare; (2) identify change variables relevant to the institutionalization of inter-professional practice at individual and organizational levels of analysis; and (3) identify human resource professionals as change agents and describe how the strategic use of the human resource function could transform individual and organizational level change variables and therefore facilitate the healthcare system's shift toward inter-professional practice. A proposed program of institutionalization includes the following components: a strategic plan to align human resource functions with organizational level inter-professional healthcare strategies, activities to enhance professional competencies and the organizational position of human resource personnel, activities to integrate inter-professional healthcare practices into the daily routines of institutional and individual providers, activities to stand up health provider champions as permanent leaders of inter-professional teams with human resource professionals as consultants and activities to bring all key players to the table including health providers.     

The effect of retirement on cognitive functioning

Cognitive impairment has emerged as a major driver of disability in old age, with profound effects on individual well-being and decision making at older ages. In the light of policies aimed at postponing retirement ages, an important question is whether continued labour supply helps to maintain high levels of cognition at older ages. We use data of older men from the US Health and Retirement Study to estimate the effect of continued labour market participation at older ages on later-life cognition. As retirement itself is likely to depend on cognitive functioning and may thus be endogenous, we use offers of early retirement windows as instruments for retirement in econometric models for later-life cognitive functioning. These offers of early retirement are legally required to be nondiscriminatory and thus, inter alia, unrelated to cognitive functioning. At the same time, these offers of early retirement options are significant predictors of retirement. Although the simple ordinary least squares estimates show a negative relationship between retirement duration and various measures of cognitive functioning, instrumental variable estimates suggest that these associations may not be causal effects. Specifically, we find no clear relationship between retirement duration and later-life cognition for white-collar workers and, if anything, a positive relationship for blue-collar workers.