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1.

Background  

The ability to predict future onset of depression is required for primary prevention of depression. Many cross-sectional studies have reported a correlation between sense of coherence (SOC) and the presence of depressive symptoms. However, it is unclear whether SOC can predict future onset of depression. Therefore, whether measures to prevent onset of depression are needed in for persons with low SOC is uncertain. Thus, the aim of this cohort study was to determine whether SOC could predict onset of depression and to assess the need for measures to prevent onset of depression for persons with low SOC.  相似文献   

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This study investigated the association between the recently minted concept of linking social capital and incidence of coronary heart disease (CHD). A follow-up study of 1,358,932 men and 1,446,747 women in Sweden aged 45-74 years was conducted between 1 January 1998 and 31 December 1999. Neighbourhood linking social capital was conceptualised as proportions of individuals voting in local government elections at neighbourhood level. The neighbourhood- and individual-level factors were analysed within a multilevel framework. Linking social capital was associated with CHD in both men and women beyond individual-level factors: in neighbourhoods with low linking social capital the odds ratios were 1.19 (CI = 1.14-1.24) and 1.29 (CI = 1.21-1.38) for men and women, respectively, after adjustment for age, country of birth, education, marital status, and housing tenure. The significant between-neighbourhood variance (i.e. the random intercept) showed significant differences in CHD incidence between neighbourhoods. Even in a relatively egalitarian society, as exemplified by the Swedish Welfare State, individual health is affected by differences between neighbourhoods in linking social capital. The use of linking social capital represents a novel conceptual advance in research on the association between CHD, one of the major causes of death in Western countries, and the multidimensional aspects of social capital.  相似文献   

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Purpose  

The objective of this study was to assess whether the EQ-5D independently predicts all-cause mortality and first hospitalization in a generic elderly population and to evaluate the relationship between the EQ-5D “Class of problems,” the EQ-5D index, the EQ-Visual Analogue Scale (EQ-VAS), and the number of hospitalizations occurring over a 2-year period.  相似文献   

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BACKGROUND: The depression is a principal problem of public health. The principal aim of this study is to determine the role of the social groups as factor protective in elderly, to evaluate the agreement by American Psychiatric Association Criterions and Hamilton Depression test, and also to determine other socio-cultural risk factors associated with depressive syndrome in elderly. METHOD: Cross-sectional survey. The sample consisted of 602 elderly people (eligible subjects) were men (223) and women (379) between 60 and 94 years (males and females), residents in the south-west of Barranquilla, Colombia. A previously tested, self answer questionnaire was used, therefore, we needed a report consent. Risk measures: Odds Ratio (OR-95% Confidence intervalue), Kappa test to agreement by the nine criteria of the American Psychiatric Association and Hamilton test so, screening testing. RESULTS: The participation in social groups was a protector factor. (Odds Ratio = 0.5; 95% CI 0.34-0.73, p = 0.001). The rate 29.9% was obtained with prevalence of depression in elderly (21.4%-39.4%) affecting principally males (32.7%). The agreement by Kappa test = 0.63 was very important or good. Sensibility = 56.1% (48.5%-63.4%) Specificity = 0.93% (97.8%-99.8%) and Predictive Positive Value = 97.1% (91.2%-99.3%). CONCLUSIONS: This survey was to determine risk factors related to depression in elderly in anyway can be potentially modifiable. The familiar disfunction by moderate and serious, the lack as blindness and deafness, the loneliness, the housingness and low incomes were obtained with risk factors associated to depression. The participation in a social group is a protective factor to depression syndrome in elders. The nine criteria of the American Psychiatric Association to allow the depressed patient exactly as sick even though is not necessary to screening because this test is low sensibility for used in a population elderly.  相似文献   

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A case-control study of squamous cell cancer of the maxillary sinus was performed in Hokkaido with 106 cases and 212 controls matched for sex, age (within five years), and residence (same health centre region). Univariate analyses showed that a history of chronic sinusitis (relative risk, RR = 3.2), nasal polyps (RR = 5.0), an occupational history of being a carpenter, joiner, furniture worker, or other woodworker (RR = 2.9), and current or past smoking habits (RR = 3.0) were statistically significant risk factors for men. No single item was a significant risk factor for women.  相似文献   

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BACKGROUND: This prospective cohort study examined the association between educational level and major causes of death in Japan. METHOD: A baseline survey was conducted between 1988 and 1990 among 110,792 inhabitants of 45 areas aged 40-79 years. Follow-up surveys were conducted annually and causes of death were identified from death certificates. The analysis was restricted to 16,715 men and 23,284 women. RESULTS: During the follow-up period (377,139 person-years), 6628 deaths were recorded. Individuals with low levels of education had an increased overall risk of death [relative risk (RR)=1.16, 95% confidence interval (CI): 1.08, 1.25, in men; RR=1.26, 95% CI: 1.14, 1.39, in women], cancers (RR=1.17, 95% CI: 1.04, 1.32, in men; RR=1.10, 95% CI: 0.93, 1.30, in women), and death from external causes (RR=1.81, 95% CI: 1.29. 2.54, in men; RR=1.78, 95% CI: 1.18, 2.70, in women). Ischemic heart disease risk was marginally reduced in men with low levels of education (RR=0.77, 95% CI: 0.58, 1.01). CONCLUSIONS: These results show that health inequalities exist in Japan, even though wealth inequalities are relatively low. Social and political initiatives will be needed to correct these inequities between different socioeconomic statuses.  相似文献   

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A case-control study of squamous cell cancer of the maxillary sinus was performed in Hokkaido with 106 cases and 212 controls matched for sex, age (within five years), and residence (same health centre region). Univariate analyses showed that a history of chronic sinusitis (relative risk, RR = 3.2), nasal polyps (RR = 5.0), an occupational history of being a carpenter, joiner, furniture worker, or other woodworker (RR = 2.9), and current or past smoking habits (RR = 3.0) were statistically significant risk factors for men. No single item was a significant risk factor for women.  相似文献   

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OBJECTIVE: To examine whether downsizing, the reduction of personnel in organisations, is a predictor of increased risk of disability retirement among employees who kept their jobs. DESIGN: Prospective cohort study. Based on reductions of personnel in participants' occupation and workplace, employees were grouped into exposure categories of no downsizing (less than 8% reduction), minor downsizing (reduction between 8% and 18%), and major downsizing (more than 18% reduction). They were followed up for a five year period after downsizing. SETTING: Four towns in Finland. PARTICIPANTS: 19 273 municipal employees, aged 21-54 years. MAIN OUTCOME MEASURES: All permanent full disability pensions granted because of medical reasons below 55 years of age between 1 January 1994 and 31 December 1998 from the national registers. RESULTS: In all, 223 employees were granted a permanent disability pension. The overall rate for disability pensions per 1000 employees was 7.7 after no downsizing, 13.1 after minor downsizing, and 14.9 after major downsizing. Cox proportional hazard models adjusted for age, sex, occupational status, type of employment contract, and town showed 1.81 (95% confidence intervals 1.22 to 2.70) times higher risk of disability retirement after major downsizing than after no downsizing. CONCLUSIONS: The immediate financial advantages of downsizing need to be considered in relation to increased occupational disability and the resulting extra costs to employers and society.  相似文献   

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Few previous studies have analyzed the association between different dimensions of social capital and mental disorders. This study examines whether there is an association between a relatively new theoretical concept describing the amount of trust between individuals and societal institutions, i.e. linking social capital, and hospitalization due to depression or psychosis. The entire Swedish population aged 25-64, a total of 4.5 million men and women, was followed from January 1, 1997, until the first hospital admission due to depression or psychosis during the study period, or the end of the study on December 31, 1999. Small area neighborhood units were used to define neighborhoods. The definition of linking social capital was based on mean voting participation in each neighborhood unit, categorized in tertiles. Multilevel logistic regression was used to estimate odds ratios and neighborhood-level variance in four different models. The results showed strong associations between linking social capital and hospitalization due to depression or psychosis. These associations decreased considerably in both men and women, but still remained significant, after adjustment for age, housing tenure, education, employment status, marital status, and country of birth. However, the results for depression (both men and women) no longer remained significant after adjustment for neighborhood deprivation. In contrast, the results for psychosis decreased considerably but remained significant after adjustment for neighborhood deprivation. The association between low levels of voting participation and hospitalization due to depression or psychosis might reflect neighborhood differences in linking social capital, which could affect vulnerable individuals negatively. Decision-makers should take into account the evidence of a neighborhood effect on mental health in decisions regarding the sites of psychiatric clinics and other kinds of community support for psychiatric patients.  相似文献   

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Serum albumin levels probably predict subsequent mortality in the elderly, but it is not clear whether this is independent of disease. A 3 year prospective study of 2342 healthy non-institutionalized men and women aged 50-89 years old, residing in Rancho Bernardo, California, confirmed the following findings. Serum albumin levels decreased with increasing age in both men and women, and this association was independent of health status. In addition, for every standard deviation decrease in albumin, the relative odds of dying was 1.24 (p = 0.04), after adjusting for age, sex and lifestyle factors such as smoking, exercise and alcohol consumption. Separating the study sample into those who did and did not report disease at baseline did not appreciably alter these findings. Most of the albumin levels of the older adults (70-89) fall within the normal and narrow range of the younger adults (50-69), nevertheless, albumin levels predict outcome independent of known disease. The albumin-early mortality association suggests that serum albumin levels are a predictor for subclinical disease in the healthy elderly.  相似文献   

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Purpose

Functioning is a necessary diagnostic criterion for depression, and thus routinely assessed in depressive patients. While it is highly informative of disorder severity, its change has not been tested for prognostic purposes. Our study aimed to analyze to what extent early functioning changes predict depression in the mid-term.

Methods

Longitudinal study (four occasions: baseline, 1, 3, and 12 months) of 243 patients with depressive symptomatology at three different services (primary care, outpatients, and hospital). Functioning was assessed on the first three occasions using the Global Assessment of Functioning (GAF), the WHODAS-2.0, and a self-reported functioning (SRF) rating scale. Growth mixture modeling of initial assessments served to estimate individual person-change parameters of each outcome. Person-growth parameters were used as predictors of major depressive episode at 12 months in a logistic regression model, adjusted by sex, age, healthcare level, and depression clinical status at third month. Predictive accuracy of all measures was assessed with area under the receiver operating curve (AUC).

Results

Of the 179 patients who completed all assessments, 58% had an active depression episode at baseline and 20% at 12 months (64% non-recoveries and 36% new onsets). Individual trends of change in functioning significantly predicted patient depression status a year later (AUCWHODAS?=?0.76; AUCGAF?=?0.92; AUCSRF?=?0.93).

Conclusions

Longitudinal modeling of functioning was highly predictive of patients’ clinical status after 1 year. Although clinical and patient-reported assessment had high prognostic value, the use of very simple patient-reported outcome measures could improve case management outside specialized psychiatric services.
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ABSTRACT: BACKGROUND: Poor indoor air quality (IAQ) and psychosocial problems are common in schools worldwide, yet longitudinal research on the issue is scarce. We examined whether the level of or a change in pupil-reported school environment (IAQ, school satisfaction, and bullying) predicts recorded sick leaves among teachers. METHODS: Changes in the school environment were assessed using pupil surveys at two time points (2001/02 and 2004/05) in 92 secondary schools in Finland. Variables indicating change were based on median values at baseline. We linked these data to individual-level records of teachers' (n = 1678) sick leaves in 2001--02 and in 2004--05. RESULTS: Multilevel multinomial logistic regression models adjusted for baseline sick leave and covariates showed a decreased risk for short-term (one to three days) sick leaves among teachers working in schools with good perceived IAQ at both times (OR = 0.6, 95% CI: 0.5-0.9), and for those with a positive change in IAQ (OR = 0.6, 95% CI: 0.4-0.9), compared to teachers in schools where IAQ was constantly poor. Negative changes in pupil school satisfaction (OR = 1.8, 95% CI: 1.1-2.8) and bullying (OR = 1.5, 95% CI: 1.0-2.3) increased the risk for short-term leaves among teachers when compared to teachers in schools where the level of satisfaction and bullying had remained stable. School environment factors were not associated with long-term sick leaves. CONCLUSIONS: Good and improved IAQ are associated with decreased teacher absenteeism. While pupil-related psychosocial factors also contribute to sick leaves, no effect modification or mediation of psychosocial factors on the association between IAQ and sick leave was observed.  相似文献   

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目的 探讨中国中老年人抑郁症状对高血压发病的影响。方法 基于中国健康与养老追踪调查(CHARLS)2015年和2018年的数据,选取11 281例基线没有高血压且有完善抑郁量表评估问卷的中老年人(年龄≥45岁)作为研究对象,进行随访调查。抑郁情况采用流调中心抑郁量表(CES-D)简表进行测量。采用Cox比例风险回归模型探讨抑郁症状及其严重程度与高血压发病风险的关联。结果 在平均时长为2.85年的随访中,1 045名研究对象发生高血压。多因素Cox回归分析结果显示,抑郁症状评分每增加1分,高血压的发生风险增加2% (HR=1.02,95%CI:1.01~1.03)。与无抑郁症状的研究对象相比,有抑郁症状的研究对象高血压发病风险增加22%(HR=1.22,95%CI:1.07~1.39)。进一步分析抑郁症状严重程度与高血压发病风险的结果显示,与无抑郁症状的研究对象相比,轻度抑郁症状的研究对象高血压发病风险增加17%(HR=1.17,95%CI:1.01~1.34),重度抑郁症状的研究对象高血压发病风险增加53%(HR=1.53,95%CI:1.19~1.97)。结论 中国中老年人群中抑郁症状与高血压发病风险增加显著相关,且抑郁症状越严重,高血压发病风险越高。  相似文献   

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We conducted a 5-year cohort study among 162 self-sufficient residents in a public home for the elderly in Rome, Italy, to evaluate the association between the consumption of specific food groups and nutrients and overall 5-year survival. We used a validated, semiquantitative food-frequency questionnaire to assess diet at baseline. Individuals consuming citrus fruit at least twice a week had an adjusted risk of dying that was half that of individuals who consumed citrus fruit less than once a week [relative risk (RR) = 0.52; 95% confidence interval (CI) = 0.28-0.95] (with adjustment for gender, age, education, body mass index, smoking status, cognitive function, and chronic diseases). The adjusted RRs of mortality were 0.38 (95% CI = 0.14-1.01) for consumption of milk and yogurt at least three times a week vs less than once a week; 0.21 (95% CI = 0.08-0.35) for moderate consumption of espresso coffee (1-2 cups weekly) vs less than once a week; and 0.35 (95% CI = 0.17-0.69) for > 2 cups a week of espresso coffee vs less than once a week. High levels of intake of ascorbic acid, riboflavin, and linoleic acid were associated with 50-60% decreases in mortality risk. High consumption of meat was associated with a higher risk of mortality (RR = 9.72; 95% CI = 2.68-35.1) among subjects with chronic diseases. Our findings indicate that frequent consumption of citrus fruit, milk, and yogurt; low consumption of meat; and high intake of vitamin C, riboflavin, and linoleic acid are associated with longevity.  相似文献   

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