Quality of Alcohol Use Histories Collected at Intake to Substance User Treatment

Many survey questions on alcohol require complex cognitive tasks, such as long-term recall, shifting reference periods, and numeric calculation. Moreover, alcohol-related impairment is known to affect cognitive ability. To assess the quality of data on self-reported alcohol use, internal consistency analyses were conducted as part of a comprehensive multisite prospective study of drug user treatment outcome undertaken in 11 cities throughout the United States (DATOS). Contrary to expectation, analyses found high levels of internal consistency. For questions on age of initiation of different types of alcohol use, over 99% of respondents (N = 2,842) reported consistent answers for each pair of logically related questions. Reports of being drunk and of quantity of alcohol consumed were similarly consistent.     

Periodontal disease and systemic diseases in an older population

Objective

To evaluate the relationship between older adults’ medical and oral conditions and their self-reports of periodontal conditions with clinically obtained data.

Background

Concerns about oral health of elders and its association with systemic diseases have been gaining more attention.

Methods

A total of 201 older subjects were interviewed about their previous medical and dental histories and were asked to complete a health questionnaire. Each subject received full mouth exam, including counting number of natural teeth remaining, gingival (GI) and plaque index (PI), CPITN and denture status.

Results

Elders who completed health questionnaires had mean age of 62.5. Mean CPITN score was 1.62(±1.12), PI was 1.57(±1.48), and GI was 1.55(±1.31). Women had higher prevalence of CVD and osteoporosis than men (p = 0.008, p = 0.0001, respectively). Subjects who reported bleeding upon brushing had higher PI and GI scores (p = 0.03, p = 0.05, respectively). Smokers were more likely to describe their periodontal tissues as unhealthy (72.3% vs. 27.7%, p = 0.01), whereas self-reports of healthy vs. unhealthy gums did not differ between non-smokers.

Conclusion

These findings suggest that a number of systemic conditions are associated with indicators of periodontal disease, and self-reports of oral conditions are independent of systemic diseases.     

Reliability of self-reports of cigarette use in novice smokers

This analysis reports the 3-month test-retest reliability of self-reports of cigarette use in novice smokers, and identifies factors associated with adequate recall. Participants included 63 novice smokers (mean age 14.1 years) from the McGill University Study on the Natural History of Nicotine Dependence in Teens. We compared data for three cigarette use indicators obtained in a 1-month recall of smoking, to data obtained for that same month, 3 months later. Forty-three participants (68.3%) smoked infrequently; 12.7%, 6.4%, and 12.7% were monthly, weekly, and daily smokers, respectively. Test-retest reliability for the cigarette use frequency and intensity indicators was good (kappa=0.78 and 0.75, respectively); it was lower for total number of cigarettes smoked per month (ICC=0.64). Older age was independently associated with adequate recall for all three indicators. These data suggest that novice smokers recall the frequency and intensity of their cigarette use reliably after 3 months, and that older adolescents have better recall than younger adolescents.     

Validity of a diary estimating exposure to tasks,activities, and postures of the trunk

The validity of a diary that estimates exposure to tasks, activities, and postures of the trunk was determined by comparing these self-reported exposure data with observational data of a whole working day. Two populations were studied: 32 professional drivers and five nurses. The nurses and 16 drivers also filled out a shortened version of the diary during another working day. Both versions of the diary showed poor agreement with observations over the same period. However, for variables concerning activities and postures of the trunk agreement was improved by the shortening of the diary. It is concluded that in epidemiologic studies observational measurements of exposure cannot validly be replaced by diaries or similar self-reported exposure data, because the self-reports easily lead to misclassification.     

Use of self - administered joint counts in the evaluation of rheumatoid arthritis patients

The validity and reliability of self-administered joint counts are reported in a group of32 rheumatoid arthritis patients being followed at a university-based practice located in theSoutheast region of the United States, serving low to middle income urban and rural patients. Adequate inter-rater reliability among the patients' and the research assistant's joint counts was obtained for upper (r = 0.74), lower (r = 0.96), and upper and lower extremities (r = 0.89). Convergent validity correlations for pain, helplessness, and the Joint Alignment and Motion scale were found to be adequate. We conclude that rheumatoid arthritis patients can reliably assess their joint counts. Self joint counts along with other validated self-reportsof health status may be applicable to busy outpatient settings, as well as in clinical research.     

No evidence for marked ethnic differences in accuracy of self-reported diabetes, hypertension, and hypercholesterolemia

OBJECTIVE: To assess whether the accuracy of self-reported diabetes, hypertension, and hypercholesterolemia in high-risk groups differs according to ethnicity. STUDY DESIGN AND SETTING: We analyzed data of 430 patients at high risk of cardiovascular disease from different ethnic origin, including Turkish, Surinamese, and Dutch. Risk factors based on self-reports were compared with data from medical records and with a gold standard based on clinical measurements. Proportions of concordance between self-reports and other methods and kappa statistics (kappa) were determined by ethnicity. RESULTS: Concordance between self-reports and other data sources was highest in diabetes and lowest for hypercholesterolemia. Agreement of self-reports was substantial to almost perfect for diabetes (kappa: 0.84-0.76), substantial to moderate for hypertension (kappa: 0.63-0.51), and moderate for hypercholesterolemia (kappa: 0.55-0.48). There was no statistically significant association between ethnicity and concordance, except for self-reporting of diabetes among Surinamese vs. Dutch indigenous patients (odds ratio=0.37; 95% confidence interval: 0.14-0.97). CONCLUSION: There are no marked ethnic differences in the accuracy of self-reports of diabetes, hypertension, and hypercholesterolemia in high-risk populations. Larger studies including multiple ethnic groups are needed to confirm these findings.     

Validity of self-reported mammography in a multicultural population in Israel

OBJECTIVE: To validate self-reported mammography against claims records in women aged 52-74 living in Israel and belonging to the Jewish (non-orthodox pre-1989 native or former Soviet Union immigrant or ultra-orthodox) or Arab populations. METHODS: In a spring 2007 random telephone survey, 1550 women receiving healthcare at Maccabi Health Services were asked whether they had had a mammography during the previous 2 years. The same information was obtained from claims records and treated as the gold standard. RESULTS: Self-reported mammography and claims records disagreed for 17.4%. Compared to the other populations, Arab women tended to report more often that they had obtained a mammogram when it was not registered in the claims data (specificity=47.3%, 95% CI%=38.4, 56.3). Ultra-orthodox women more often failed to report having had the mammogram while the claims records indicated they had had (sensitivity=90.3%, 95% CI%=86.1, 93.6). CONCLUSION: Agreement between self-reported mammography and claims records depends on cultural and socioeconomic factors.     

Prevalence of Alcohol and Drug Use in an Adolescent Training Facility

This study investigates substance use and crimes among incarcerated adolescents. Chart reviews were conducted between 1997–2000 with 186 adolescent, male offenders, including information on demographics, substance use, and crimes. Results indicate that use of alcohol (88.7%) and marijuana (95.7%) was highly prevalent. The most widely committed crimes included possession of a controlled substance (31.8%), receiving stolen goods (17.8%), and violation of probation (17.2%). Significant differences were observed across racial/ethnic groups; White nonHispanic adolescents were more likely to use cocaine, hallucinogens, and heroin than adolescents of other races. Future research examining relationships between criminal behavior, substance use, and cultural variations in use patterns and delinquency will allow more relevant intervention and prevention strategies in this population.     

Changes in performance markers and wellbeing in elite senior professional rugby union players during a pre-season period: Analysis of the differences across training phases

ObjectivesTo assess the magnitude of change and association with variation in training load of two performance markers and wellbeing, over three pre-season training blocks, in elite rugby union athletes.DesignObservational.MethodsTwenty-two professional players (age 25 ± 5 years; training age 6 ± 5 years; body mass, 99 ± 13 kg; stature 186 ± 6 cm) participated in this study, with changes in lower (CMJ height) and upper body (bench press mean speed) neuromuscular function and self-reported wellbeing (WB) assessed during an 11-week period.ResultsThere was a small increase in CMJ height (0.27, ±0.17 – likely substantial; standardised effect size, ±95% confidence limits – magnitude-based inference) (p = 0.003), bench press speed (0.26, ±0.15 – likely substantial) (p = 0.001) and WB (0.26, ±0.12 – possibly substantial) (p < 0.0001) across the pre-season period. There was a substantial interaction in the effect of training load on these three variables across the three training phases. A two-standard deviation (2SD) change in training load was associated with: a small decrease in CMJ height during the power phase (−0.32, ±0.19 – likely substantial) (p = 0.001); a small reduction in bench press speed during the hypertrophy phase (−0.40, ±0.32 – likely substantial) (p = 0.02); and a small reduction in WB during the strength phase (−0.40, ±0.24 – very likely substantial) (p < 0.0001). The effects of changes in training load across other phases were either likely trivial, only possibly substantial, or unclear.ConclusionsThe effect of training load on performance can vary both according to the type of training stimulus being administered and based on whether upper- or lower-body outcomes are being measured.