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51.
Derek H. Tang Daniel C. Malone Terri L. Warholak Jenny Chong Edward P. Armstrong Marion K. Slack Chiu-Hsieh Hsu David M. Labiner 《JOURNAL OF CLINICAL NEUROLOGY》2015,11(3):252-261
Background and Purpose
The purpose of this study was to estimate the incidence and prevalence of epilepsy among an elderly and poor population in the United States.Methods
Arizona Medicaid claims data from January 1, 2008 to December 31, 2010 were used for this analysis. Subjects who were aged ≥65 years and were continuously enrolled in any Arizona Medicaid health plans (eligible to patients with low income) for ≥12 months between January 1, 2008 and December 31, 2009 were considered eligible for inclusion in the study cohort. In addition to meeting the aforementioned criteria, incident and prevalent cases must have had epilepsy-related healthcare claims. Furthermore, incident cases were required to have a 1-year "clean" period immediately preceding the index date. Negative binomial and logistic regression models were used to assess the factors associated with epilepsy incidence and prevalence.Results
The estimated epilepsy incidence and prevalence for this population in 2009 were 7.9 and 19.3 per 1,000 person-years, respectively. The incidence and prevalence rates were significantly higher for patients with comorbid conditions that were potential risk factors for epilepsy and were of younger age than for their non-comorbid and older counterparts (p<0.05). The prevalence rates were significantly higher for non-Hispanic Blacks and male beneficiaries than for non-Hispanic Whites and female beneficiaries, respectively (p<0.05).Conclusions
This patient population had higher epilepsy incidence and prevalence compared with the general US population. These differences may be at least in part attributable to their low socioeconomic status. 相似文献52.
Barnes DE Blackwell T Stone KL Goldman SE Hillier T Yaffe K;Study of Osteoporotic Fractures 《Journal of the American Geriatrics Society》2008,56(9):1658-1664
OBJECTIVES: To determine whether an objective measure of daytime movement is associated with better cognitive function in women in their 80s. DESIGN: Cross‐sectional. SETTING: A study of health and aging. PARTICIPANTS: Two thousand seven hundred thirty‐six older women without evidence of dementia. MEASUREMENTS: Daytime movement was assessed using actigraphy, which involved wearing a watch‐like device that objectively quantified accelerometer motion over a mean of 3.0±0.8 days. Cognitive function was measured using the Trail‐Making Test, Part B (Trails B) and the Mini‐Mental State Examination (MMSE). Cognitive impairment was defined as performing 1.5 standard deviations (SDs) worse than the mean on a given test. RESULTS: Participants had a mean age of 83±4; 10% were African American. After adjustment for age, race, and education, women in the highest movement quartiles had better mean cognitive test scores (20±0.3 seconds faster on Trails B and 0.3±0.2 points higher on MMSE, both P<.001) than those in the lowest quartile and were less likely to be cognitively impaired (odds ratio (OR)=0.61, 95% confidence interval (CI)=0.41–0.92 for Trails B; OR=0.68, 95% CI=0.44–1.07 for MMSE). Associations were similar in different subgroups and were independent of self‐reported walking, medical comorbidities, physical function, and other health‐related behaviors. CONCLUSION: Daytime movement as measured objectively using actigraphy was associated with better cognitive function and lower odds of cognitive impairment in women in their 80s. Additional studies are needed to clarify the direction of the association and to explore potential mechanisms. 相似文献
53.
McMahon RC Malow RM Devieux J Rosenberg R Jennings T 《The American journal of drug and alcohol abuse》2008,34(3):329-337
The purpose of this investigation is to investigate HIV risk-related attitudes, beliefs, expectancies, behaviors, and histories of lifetime sexually transmitted diseases in the Millon Clinical Multiaxial Inventory III (MCMI-III) defined psychopathology cluster subgroups. Hierarchical agglomerative cluster analysis, using Ward's method, was employed that led to identification of high (n = 37), medium (n = 132), and low (n = 28) MCMI-III psychopathology cluster subgroups. Members of the low psychopathology subgroup demonstrated significantly higher levels of knowledge about HIV and AIDS and less anxiety about HIV infection than high and moderate psychopathology subgroups. The high psychopathology subgroup reported greater importance of approval of condom use by partners but less sexual self-efficacy than the moderate psychopathology subgroup. This high pathology group revealed less favorable condom attitudes than did the low psychopathology subgroup and a significantly higher percentage of unprotected vaginal sex acts in the past 6 months than did members of the other two subgroups. A comparatively low rate of lifetime syphilis was reported in the low psychopathology subgroup (all ps < .05). Results are discussed in the context of a growing literature indicating distinctive treatment needs among members of high psychopathology subgroups of drug treatment participants. 相似文献
54.
Associations Between Sleep‐Disordered Breathing,Nocturnal Hypoxemia,and Subsequent Cognitive Decline in Older Community‐Dwelling Men: The Osteoporotic Fractures in Men Sleep Study 下载免费PDF全文
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Lauren S. Blum Holly Dentz Felix Chingoli Benson Chilima Thomas Warne Carla Lee Terri Hyde Jacqueline Gindler James Sejvar Eric D. Mintz 《The American journal of tropical medicine and hygiene》2014,91(4):729-737
Typhoid fever affects an estimated 22 million people annually and causes 216,000 deaths worldwide. We conducted an investigation in August and September 2010 to examine the acceptability of typhoid vaccine in Neno District, Malawi where a typhoid outbreak was ongoing. We used qualitative methods, including freelisting exercises, key informant and in-depth interviews, and group discussions. Respondents associated illness with exposure to “bad wind,” and transmission was believed to be airborne. Typhoid was considered extremely dangerous because of its rapid spread, the debilitating conditions it produced, the number of related fatalities, and the perception that it was highly contagious. Respondents were skeptical about the effectiveness of water, sanitation, and hygiene (WaSH) interventions. The perceived severity of typhoid and fear of exposure, uncertainty about the effectiveness of WaSH measures, and widespread belief in the efficacy of vaccines in preventing disease resulted in an overwhelming interest in receiving typhoid vaccine during an outbreak. 相似文献