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Ostbye, Truls

Overview:

Chronic disease epidemiology; obesity; health services research; population health; public health; social medicine; health information systems; health surveys; programme evaluation; clinical trials; aging; nutrition; dementia; Global Health

Positions:

Professor in Community and Family Medicine

Community and Family Medicine
School of Medicine

Research Professor of Global Health

Duke Global Health Institute
Institutes and Provost's Academic Units

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 1979

M.D. — University of Bergen

M.P.H. 1983

M.P.H. — Harvard University

News:

Grants:

Dissemination and Implementation Science in Cardiovascular Outcomes (DISCO)

Administered By
Basic Science Departments
AwardedBy
National Institutes of Health
Role
Faculty Member
Start Date
September 01, 2017
End Date
August 31, 2022

Building Interdisciplinary Research Careers in Women's Health

Administered By
Obstetrics and Gynecology
AwardedBy
National Institutes of Health
Role
Mentor
Start Date
September 26, 2002
End Date
July 31, 2022

Maternal obesity, child executive functions and child weight gain

Administered By
Psychiatry & Behavioral Sciences, Addictions
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
August 01, 2015
End Date
May 31, 2020

Early child care and risk of obesity

Administered By
Community and Family Medicine
AwardedBy
Johns Hopkins University - School of Public Health
Role
Principal Investigator
Start Date
July 01, 2015
End Date
June 30, 2018

The Business of Childcare Homes and Child Health

Administered By
Community and Family Medicine
AwardedBy
University of North Carolina - Chapel Hill
Role
Principal Investigator
Start Date
May 01, 2012
End Date
April 30, 2018

Preventing obesity in infants and toddlers in child care

Administered By
Community and Family Medicine
AwardedBy
Johns Hopkins University - School of Public Health
Role
Principal Investigator
Start Date
January 01, 2016
End Date
December 31, 2017

Early child care and risk of obesity

Administered By
Community and Family Medicine
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
August 01, 2012
End Date
June 30, 2017

Teen CHAT:Improving physician communication with adolescents about healthy weight

Administered By
Duke Cancer Institute
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
September 15, 2009
End Date
June 30, 2016

Steps to Health: Targeting Obesity in the Health Care Workplace

Administered By
Community and Family Medicine
AwardedBy
National Institute for Occupational Safety and Health
Role
Principal Investigator
Start Date
June 01, 2010
End Date
May 31, 2016

Preventing obesity in infants and toddlers in child care

Administered By
Community and Family Medicine, Community Health
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
January 01, 2013
End Date
December 31, 2015

Evaluation of SAS Worksite Health Center

Administered By
Center for Health Policy & Inequalities Research
AwardedBy
SAS Institute
Role
Co Investigator
Start Date
October 01, 2013
End Date
September 30, 2015

FitFab 4 Survivors

Administered By
Community and Family Medicine
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
July 01, 2011
End Date
June 30, 2014

The Sri Lanka Healthy Minds Study

Administered By
Duke Global Health Institute
AwardedBy
National Institutes of Health
Role
Investigator
Start Date
July 01, 2011
End Date
June 29, 2014

KAN-DO: A Family-Based Intervention to Prevent Childhood Obesity

Administered By
Community and Family Medicine
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
September 11, 2006
End Date
August 31, 2012

Epidemiology of Dementia in Cache County, Utah (Bridge-Funding Request)

Administered By
Neurology, Behavioral Neurology
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
July 15, 2002
End Date
March 31, 2011

Epidemiology of dementia in Cache County, Utah

Administered By
Neurology, Behavioral Neurology
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
September 30, 1994
End Date
March 31, 2011

Obesity Prevention in Early Childhood

Administered By
Community and Family Medicine
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
September 01, 2008
End Date
August 31, 2010

PREMIER Mental Health Interventions Training Program

Administered By
Psychiatry & Behavioral Sciences, Geriatric Behavioral Health
AwardedBy
National Institutes of Health
Role
Mentor
Start Date
July 23, 2002
End Date
June 30, 2010

Obesity as a Barrier to Patient-Physician Communication

Administered By
Duke Cancer Institute
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
June 01, 2006
End Date
May 31, 2010

Promoting Postpartum Weight Loss in Overweight Women

Administered By
Community and Family Medicine
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
August 15, 2003
End Date
June 30, 2009

Surveillance Methods for Health Care and Related Workers

Administered By
Community and Family Medicine, Occupational & Environmental Medicine
AwardedBy
National Institutes of Health
Role
Epidemiologist
Start Date
September 30, 2001
End Date
September 29, 2006

Residency Training in Family Medicine No. 93.884A

Administered By
Community and Family Medicine, Family Medicine
AwardedBy
National Institutes of Health
Role
Researcher
Start Date
July 01, 2000
End Date
June 30, 2003
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Publications:

Complementary and alternative medicine for rheumatic diseases: A systematic review of randomized controlled trials

© 2018 Elsevier Ltd Objectives: To summarize all good quality randomized controlled trials (RCTs) using complementary and alternative medicine (CAM) interventions in patients with rheumatic diseases. Methods: A systematic literature review guided by the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) was performed. We excluded non–English language articles and abstract-only publications. Due to the large number of RCTs identified, we only include “good quality” RCTs with Jadad score of five. Results: We identified 60 good quality RCTs using CAM as intervention for patients with rheumatic diseases: acupuncture (9), Ayurvedic treatment (3), homeopathic treatment (3), electricity (2), natural products (31), megavitamin therapies (8), chiropractic or osteopathic manipulation (3), and energy healing therapy (1). The studies do not seem to suggest a particular type of CAM is effective for all types for rheumatic diseases. However, some CAM interventions appear to be more effective for certain types of rheumatic diseases. Acupuncture appears to be beneficial for osteoarthritis but not rheumatoid arthritis. For the other therapeutic modalities, the evidence base either contains too few trials or contains trials with contradictory findings which preclude any definitive summary. There were only minor adverse reactions observed for CAM interventions presented. Conclusion: We identified 60 good quality RCTs which were heterogenous in terms of interventions, disease, measures used to assess outcomes, and efficacy of CAM interventions. Evidence indicates that some CAM therapies may be useful for rheumatic diseases, such as acupuncture for osteoarthritis. Further research with larger sample size is required for more conclusive evidence regarding efficacy of CAM interventions.

Authors
Phang, JK; Kwan, YH; Goh, H; Tan, VIC; Thumboo, J; Østbye, T; Fong, W
MLA Citation
Phang, JK, Kwan, YH, Goh, H, Tan, VIC, Thumboo, J, Østbye, T, and Fong, W. "Complementary and alternative medicine for rheumatic diseases: A systematic review of randomized controlled trials (Accepted)." Complementary Therapies in Medicine 37 (April 1, 2018): 143-157. (Review)
Source
scopus
Published In
Complementary Therapies in Medicine
Volume
37
Publish Date
2018
Start Page
143
End Page
157
DOI
10.1016/j.ctim.2018.03.003

Measurement properties of patient reported outcome measures for spondyloarthritis: A systematic review.

This systematic review aimed to identify studies investigating measurement properties of patient reported outcome measures (PROMs) for spondyloarthritis (SpA), and to evaluate their methodological quality and level of evidence relating to the measurement properties of PROMs.This systematic review was guided by the preferred reporting items for systematic review and meta-analysis (PRISMA). Articles published before 30 June 2017 were retrieved from PubMed®, Embase®, and PsychINFO® (Ovid). Methodological quality and level of evidence were evaluated according to recommendations from the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN).We identified 60 unique PROMs from 125 studies in 39 countries. Twenty-one PROMs were validated for two or more SpA subtypes. The literature examined hypothesis testing (82.4%) most frequently followed by reliability (60.0%). A percentage of 77.7% and 42.7% of studies that assessed PROMs for hypothesis testing and reliability, respectively had "fair" or better methodological quality. Among the PROMs identified, 41.7% were studied in ankylosing spondylitis (AS) only and 23.3% were studied in psoriatic arthritis (PsA) only. The more extensively assessed PROMs included the ankylosing spondylitis quality of life (ASQoL) and bath ankylosing spondylitis functional index (BASFI) for ankylosing spondylitis, and the psoriatic arthritis quality of life questionnaire (VITACORA-19) for psoriatic arthritis.This study identified 60 unique PROMs through a systematic review and synthesized evidence of the measurement properties of the PROMs. There is a lack of validation of PROMs for use across SpA subtypes. Future studies may consider validating PROMs for use across different SpA subtypes.

Authors
Png, K; Kwan, YH; Leung, YY; Phang, JK; Lau, JQ; Lim, KK; Chew, EH; Low, LL; Tan, CS; Thumboo, J; Fong, W; Østbye, T
MLA Citation
Png, K, Kwan, YH, Leung, YY, Phang, JK, Lau, JQ, Lim, KK, Chew, EH, Low, LL, Tan, CS, Thumboo, J, Fong, W, and Østbye, T. "Measurement properties of patient reported outcome measures for spondyloarthritis: A systematic review." Seminars in arthritis and rheumatism (March 21, 2018). (Review)
PMID
29573848
Source
epmc
Published In
Seminars in Arthritis and Rheumatism
Publish Date
2018
DOI
10.1016/j.semarthrit.2018.02.016

Place of Residence and Cognitive Function among the Adult Population in India.

The place of residence has been linked to cognitive function among adults in developed countries. This study examined how urban and rural residence was associated with cognitive function among adults in India.The World Health Organization Study on Global AGEing and Adult Health data was used to examine cognition among 6,244 community-residing adults age 50+ in 6 states in India. Residential status was categorized as urban, rural, urban-to-urban, rural-to-urban, rural-to-rural, and urban-to-rural. Cognition was assessed by immediate and delayed recall tests, digit span test, and verbal fluency test. Multilevel models were used to account for state-level differences and adjusted for individual-level sociodemographic, psychosocial, and health-related factors.Urban residents and urban-to-urban migrants had the highest levels of cognition, whereas rural residents and those who migrated to (or within) rural areas had the lowest cognition. The differences largely persisted after adjustment for multiple covariates; however, rural-to-urban migrants had no difference in cognition from urban residents once socioeconomic factors were taken into account.Cognition among adults in India differed significantly according to their current and past place of residence. Socioeconomic factors played an important role in the cognitive function of adults in urban areas.

Authors
Xu, H; Ostbye, T; Vorderstrasse, AA; Dupre, ME; Wu, B
MLA Citation
Xu, H, Ostbye, T, Vorderstrasse, AA, Dupre, ME, and Wu, B. "Place of Residence and Cognitive Function among the Adult Population in India." Neuroepidemiology 50.3-4 (March 7, 2018): 119-127.
PMID
29514168
Source
epmc
Published In
Neuroepidemiology
Volume
50
Issue
3-4
Publish Date
2018
Start Page
119
End Page
127
DOI
10.1159/000486596

The association between pre pregnancy body mass index and risk of preeclampsia: a registry based study from Tanzania.

Preeclampsia is among the leading causes of maternal mortality and morbidity worldwide, occurs in 2-8% of all pregnancies, and is estimated to account for at least 9 % of maternal deaths in Africa. Studies from developed countries show that high pre pregnancy body mass index (BMI) increases the risk of preeclampsia. We examined the association between pre pregnancy BMI and the risk of preeclampsia in Tanzania, a low income country.Data from the Kilimanjaro Christian Medical Center (KCMC) Medical Birth Registry recorded between July 2000 and May 2013 were used. We restricted the study population to singleton deliveries among women with no or one previous pregnancy. Pre pregnancy BMI (kg/m2) was categorized according to the WHO categories of underweight (less than 18.5), normal (18.5 - 24.9), overweight (25.0 - 29.9) and obese (30 or more). Potential confounders were adjusted for in multivariable analyses.Among the 17,738 singleton births, 6.6% of the mothers were underweight, 62.1% were of normal BMI, 24.0% were overweight, and 7.3% were obese. Five hundred and eighty-two pregnancies (3.3%) were affected by preeclampsia. Compared to those with normal BMI, overweight and obese women had a higher risk of preeclampsia (aOR (95% CI) 1.4 (1.2 - 1.8) and 1.8 (1.3 - 2.4)), respectively, while underweight women had a lower risk (0.7 (0.4-1.1)).Pre pregnancy maternal overweight and obesity were associated with an increased risk of preeclampsia in Tanzania. Risks were similar to those reported in high income countries.

Authors
Mrema, D; Lie, RT; Østbye, T; Mahande, MJ; Daltveit, AK
MLA Citation
Mrema, D, Lie, RT, Østbye, T, Mahande, MJ, and Daltveit, AK. "The association between pre pregnancy body mass index and risk of preeclampsia: a registry based study from Tanzania." BMC pregnancy and childbirth 18.1 (February 21, 2018): 56-.
PMID
29466949
Source
epmc
Published In
BMC Pregnancy and Childbirth
Volume
18
Issue
1
Publish Date
2018
Start Page
56
DOI
10.1186/s12884-018-1687-3

Evaluation of the WHO 2009 classification for diagnosis of acute dengue in a large cohort of adults and children in Sri Lanka during a dengue-1 epidemic.

Dengue is a leading cause of fever and mimics other acute febrile illnesses (AFI). In 2009, the World Health Organization (WHO) revised criteria for clinical diagnosis of dengue.The new WHO 2009 classification of dengue divides suspected cases into three categories: dengue without warning signs, dengue with warning signs and severe dengue. We evaluated the WHO 2009 classification vs physicians' subjective clinical diagnosis (gestalt clinical impression) in a large cohort of patients presenting to a tertiary care center in southern Sri Lanka hospitalized with acute febrile illness. We confirmed acute dengue in 388 patients (305 adults ≥ 18 years and 83 children), including 103 primary and 245 secondary cases, of 976 patients prospectively enrolled with AFI. At presentation, both adults and children with acute dengue were more likely than those with other AFI to have leukopenia and thrombocytopenia. Additionally, adults were more likely than those with other AFI to have joint pain, higher temperatures, and absence of crackles on examination whereas children with dengue were more likely than others to have sore throat, fatigue, oliguria, and elevated hematocrit and transaminases. Similarly, presence of joint pain, thrombocytopenia, and absence of cough were independently associated with secondary vs primary dengue in adults whereas no variables were different in children. The 2009 WHO dengue classification was more sensitive than physicians' clinical diagnosis for identification of acute dengue (71.5% vs 67.1%), but was less specific. However, despite the absence of on-site diagnostic confirmation of dengue, clinical diagnosis was more sensitive on discharge (75.2%). The 2009 WHO criteria classified almost 75% as having warning signs, even though only 9 (2.3%) patients had evidence of plasma leakage and 16 (4.1%) had evidence of bleeding.In a large cohort with AFI, we identified features predictive of dengue vs other AFI and secondary vs primary dengue in adults versus children. The 2009 WHO dengue classification criteria had high sensitivity but low specificity compared to physicians' gestaldt diagnosis. Large cohort studies will be needed to validate the diagnostic yield of clinical impression and specific features for dengue relative to the 2009 WHO classification criteria.

Authors
Bodinayake, CK; Tillekeratne, LG; Nagahawatte, A; Devasiri, V; Kodikara Arachchi, W; Strouse, JJ; Sessions, OM; Kurukulasooriya, R; Uehara, A; Howe, S; Ong, XM; Tan, S; Chow, A; Tummalapalli, P; De Silva, AD; Østbye, T; Woods, CW; Gubler, DJ; Reller, ME
MLA Citation
Bodinayake, CK, Tillekeratne, LG, Nagahawatte, A, Devasiri, V, Kodikara Arachchi, W, Strouse, JJ, Sessions, OM, Kurukulasooriya, R, Uehara, A, Howe, S, Ong, XM, Tan, S, Chow, A, Tummalapalli, P, De Silva, AD, Østbye, T, Woods, CW, Gubler, DJ, and Reller, ME. "Evaluation of the WHO 2009 classification for diagnosis of acute dengue in a large cohort of adults and children in Sri Lanka during a dengue-1 epidemic." PLoS neglected tropical diseases 12.2 (February 9, 2018): e0006258-.
PMID
29425194
Source
epmc
Published In
PLoS neglected tropical diseases
Volume
12
Issue
2
Publish Date
2018
Start Page
e0006258
DOI
10.1371/journal.pntd.0006258

Road traffic crashes and built environment analysis of crash hotspots based on local police data in Galle, Sri Lanka.

Road traffic crashes (RTCs) are a leading cause of death and disability. In low- and middle-income countries, vulnerable road users are commonly involved in injurious RTCs. This study describes epidemiological and built environment analysis (BEA) of in Galle, Sri Lanka. After ethical and police permission, police data were collected and descriptive statistics tabulated. Spatial analysis identified hot spots and BEA was conducted at each location. Seven hundred and fifty-two victim data from 389 reported RTCs were collected. Most victims were male (91%) 21-50 years of age (>70%). Forty-nine percent of RTCs were non-grievous. Crashes commonly included motorcycles (33.9%), three-wheelers (18.3%) or cars (14.4%). Most victims were drivers (33.4%) or pedestrians (21.3%). Factors contributing to RTCs include aggressive driving (44.5%) or speeding (42.7%). All hotspots were in urban areas, and most were at intersections (63%). Further analysis of hot spots is necessary to identify areas for intervention.

Authors
De Silva, V; Tharindra, H; Vissoci, JRN; Andrade, L; Mallawaarachchi, BC; Østbye, T; Staton, CA
MLA Citation
De Silva, V, Tharindra, H, Vissoci, JRN, Andrade, L, Mallawaarachchi, BC, Østbye, T, and Staton, CA. "Road traffic crashes and built environment analysis of crash hotspots based on local police data in Galle, Sri Lanka." International journal of injury control and safety promotion (February 7, 2018): 1-8.
PMID
29411680
Source
epmc
Published In
International Journal of Injury Control & Safety Promotion
Publish Date
2018
Start Page
1
End Page
8
DOI
10.1080/17457300.2018.1431932

The Effect of Telemedicine Follow-up Care on Diabetes-Related Foot Ulcers: A Cluster-Randomized Controlled Noninferiority Trial.

To evaluate whether telemedicine (TM) follow-up of patients with diabetes-related foot ulcers (DFUs) in primary health care in collaboration with specialist health care was noninferior to standard outpatient care (SOC) for ulcer healing time. Further, we sought to evaluate whether the proportion of amputations, deaths, number of consultations per month, and patient satisfaction differed between the two groups.Patients with DFUs were recruited from three clinical sites in western Norway (2012-2016). The cluster-randomized controlled noninferiority trial included 182 adults (94/88 in the TM/SOC groups) in 42 municipalities/districts. The intervention group received TM follow-up care in the community; the control group received SOC. The primary end point was healing time. Secondary end points were amputation, death, number of consultations per month, and patient satisfaction.Using mixed-effects regression analysis, we found that TM was noninferior to SOC regarding healing time (mean difference -0.43 months, 95% CI -1.50, 0.65). When competing risk from death and amputation were taken into account, there was no significant difference in healing time between the groups (subhazard ratio 1.16, 95% CI 0.85, 1.59). The TM group had a significantly lower proportion of amputations (mean difference -8.3%, 95% CI -16.3%, -0.5%), and there were no significant differences in the proportion of deaths, number of consultations, or patient satisfaction between groups, although the direction of the effect estimates for these clinical outcomes favored the TM group.The results suggest that use of TM technology can be a relevant alternative and supplement to usual care, at least for patients with more superficial ulcers.

Authors
Smith-Strøm, H; Igland, J; Østbye, T; Tell, GS; Hausken, MF; Graue, M; Skeie, S; Cooper, JG; Iversen, MM
MLA Citation
Smith-Strøm, H, Igland, J, Østbye, T, Tell, GS, Hausken, MF, Graue, M, Skeie, S, Cooper, JG, and Iversen, MM. "The Effect of Telemedicine Follow-up Care on Diabetes-Related Foot Ulcers: A Cluster-Randomized Controlled Noninferiority Trial." Diabetes care 41.1 (January 2018): 96-103.
PMID
29187423
Source
epmc
Published In
Diabetes Care
Volume
41
Issue
1
Publish Date
2018
Start Page
96
End Page
103
DOI
10.2337/dc17-1025

Primary care multidisciplinary teams in practice: a qualitative study.

Current recommendations for strengthening the US healthcare system consider restructuring primary care into multidisciplinary teams as vital to improving quality and efficiency. Yet, approaches to the selection of team designs remain unclear. This project describes current primary care team designs, primary care professionals' perceptions of ideal team designs, and perceived facilitating factors and barriers to implementing ideal team-based care.Qualitative study of 44 health care professionals at 6 primary care practices in North Carolina using focus group discussions and surveys. Data was analyzed using framework content analysis.Practices used a variety of multidisciplinary team designs with the specific design being influenced by the social and policy context in which practices were embedded. Practices overwhelmingly located barriers to adopting ideal multidisciplinary teams as being outside of their individual practices and outside of their control. Participants viewed internal organizational contexts as the major facilitators of multidisciplinary primary care teams. The majority of practices described their ideal team design as including a social worker to meet the needs of socially complex patients.Primary care multidisciplinary team designs vary across practices, shaped in part by contextual factors perceived as barriers outside of the practices' control. Facilitating factors within practices provide a culture of support to team members, but they are insufficient to overcome the perceived barriers. The common desire to add social workers to care teams reflects practices' struggles to meet the complex demands of patients and external agencies. Government or organizational policies should avoid one-size-fits-all approaches to multidisciplinary care teams, and instead allow primary care practices to adapt to their specific contextual circumstances.

Authors
Leach, B; Morgan, P; Strand de Oliveira, J; Hull, S; Østbye, T; Everett, C
MLA Citation
Leach, B, Morgan, P, Strand de Oliveira, J, Hull, S, Østbye, T, and Everett, C. "Primary care multidisciplinary teams in practice: a qualitative study." BMC family practice 18.1 (December 29, 2017): 115-.
Website
http://hdl.handle.net/10161/16033
PMID
29284409
Source
epmc
Published In
BMC Family Practice
Volume
18
Issue
1
Publish Date
2017
Start Page
115
DOI
10.1186/s12875-017-0701-6

Challenges faced by older nurses in Singapore: a mixed methods study.

In Singapore, employees aged 62-65 can continue to be employed if they meet the re-employment eligibility criteria. This policy, coupled with an ageing workforce, calls for age-friendly initiatives, specific to work-related challenges faced by older nurses.To determine work-related challenges faced by older nurses.A mixed method sequential explanatory study was conducted with nurses, aged 50 and above, working in a healthcare cluster in Singapore. In the quantitative phase, a questionnaire was administered to 534 nurses to elicit work-related challenges, then in-depth interviews with 30 nurses were carried out to help explain why certain tasks and work circumstances became harder.Results of the survey indicated that the top three challenges were coping with changes, working with computers and reading labels. Place of work, salary range, gender and race were significantly associated with different work-related challenges. Five themes emerged from the qualitative data: physical demands of work and workload, new technology, need for further education, working with younger nurses and in intercultural teams, and changing public expectations and professional image.The study supports the current literature on the challenges older nurses face with technological advancement. However, older nurses in our study reported less aches and pain as compared to that reported elsewhere. There is a need for specific strategies that will address changes in work processes and environment in order to retain older nurses.When devising age-friendly work improvement initiatives, it is important for nurse leaders to factor in the needs of nurses working in different care environments, who are of different ranks, or are from different ethnic backgrounds.

Authors
Ang, SY; Ayoob, SBM; Hussain, NBS; Uthaman, T; Adenan, H; Chiang, P; Ong, LT; Fong, MK; Ostbye, T
MLA Citation
Ang, SY, Ayoob, SBM, Hussain, NBS, Uthaman, T, Adenan, H, Chiang, P, Ong, LT, Fong, MK, and Ostbye, T. "Challenges faced by older nurses in Singapore: a mixed methods study." International nursing review 64.4 (December 2017): 502-510.
PMID
28093735
Source
epmc
Published In
International Nursing Review
Volume
64
Issue
4
Publish Date
2017
Start Page
502
End Page
510
DOI
10.1111/inr.12348

The association between distance to public amenities and cardiovascular risk factors among lower income Singaporeans.

Existing evidence on the association between built environment and cardiovascular disease (CVD) risk factors focused on the general population, which may not generalize to higher risk subgroups such as those with lower socio-economic status (SES). We examined the associations between distance to 5 public amenities from residential housing (public polyclinic, subsidized private clinic, healthier eatery, public park and train station) and 12 CVD risk factors (physical inactivity, medical histories and unhealthy dietary habits) among a study sample of low income Singaporeans aged ≥ 40 years (N = 1972). Using data from the Singapore Heart Foundation Health Mapping Exercise 2013-2015, we performed a series of logistic mixed effect regressions, accounting for clustering of respondents in residential blocks and multiple comparisons. Each regression analysis used the minimum distance (in km) between residential housing and each public amenity as an independent continuous variable and a single risk factor as the dependent variable, controlling for demographic characteristics. Increased distance (geographical inaccessibility) to a train station was significantly associated with lower odds of participation in sports whereas greater distance to a subsidized private clinic was associated with lower odds of having high cholesterol diagnosed. Increasing distance to park was positively associated with higher odds of less vegetable and fruits consumption, deep fried food and fast food consumption in the preceding week/month, high BMI at screening and history of diabetes, albeit not achieving statistical significance. Our findings highlighted potential effects of health-promoting amenities on CVD risk factors in urban low-income setting, suggesting gaps for further investigations.

Authors
Lim, KK; Kwan, YH; Tan, CS; Low, LL; Chua, AP; Lee, WY; Pang, L; Tay, HY; Chan, SY; Ostbye, T
MLA Citation
Lim, KK, Kwan, YH, Tan, CS, Low, LL, Chua, AP, Lee, WY, Pang, L, Tay, HY, Chan, SY, and Ostbye, T. "The association between distance to public amenities and cardiovascular risk factors among lower income Singaporeans." Preventive medicine reports 8 (December 2017): 116-121.
PMID
29021948
Source
epmc
Published In
Preventive Medicine Reports
Volume
8
Publish Date
2017
Start Page
116
End Page
121
DOI
10.1016/j.pmedr.2017.09.004

Levels and risk factors for urinary metabolites of polycyclic aromatic hydrocarbons in children living in Chongqing, China.

Since childhood exposure to polycyclic aromatic hydrocarbons (PAHs) have been associated with a variety of adverse health outcomes, the aims of this study were to1) document PAH exposure levels among children in Chongqing, China by measuring urinary concentrations of four PAH metabolites, 1-hydroxypyrene (1-OHPyr), 2-hydroxynaphthalene (2-OHNap), 2-hydroxyfluorine (2-OHFlu) and 9-hydroxyphenanthrene (9-OHPhe), and 2) assess the associations of urinary concentrations of these PAH metabolites with risk factors related to sources of PAHs inhalation and ingestion exposures and with personal attributes such as sex, age, and BMI.The present study is a cross-sectional analysis using data drawn from the third follow up of a longitudinal study. Purposive sampling was used with all students in grades one to four in four schools being eligible to participate. The baseline survey included a total of 1237 students 5.8 to 12.2years of age. At the third follow up survey, 1.5years after the baseline survey, 1230 of the children had a physical exam and provided urine samples. Their parents completed a questionnaire including social-demographic information and possible sources of children's exposure to PAHs. Urine samples were measured for the four OH-PAHs using an HPLC-MS/MS technique. Concentrations were corrected by specific gravity. Linear regression analysis was used to investigate factors related to sources of PAHs exposure.The urinary concentrations were highest for 9-OHPhe (median at the range of 3661ng/L), followed by 2-OHNap (3189ng/L), 2-OHFlu (1116ng/L), and 1-OHPyr (250ng/L). In multiple linear regressions, being female (P=0.04), school location near a thermal power plant (P=0.02) and higher maternal age at birth (P<0.01) were associated with increased concentrations of urinary 1-OHPyr; no significant associations were found for 2-OHNap; school location near a thermal power plant (P<0.01) and lower family income (P<0.01) were associated with increased concentrations of urinary 2-OHFlu; higher age (P<0.01), school location near a thermal power plant (P=0.01), frequent consumption of smoked foods (P=0.04) and lower family income (P=0.07) were all found to be associated with increased concentrations of 9-OHPhe.Urinary concentrations of OH-PAHs, especially 9-OHPhe, were elevated in Chongqing Children compared to children in other countries. Being female, older age, school location near an industrial site, frequent consumption of smoked foods and lower family income were all associated with higher OH-PAHs concentrations. Further cohort studies are needed to confirm the associations between potential exposure sources and children's exposure to PAHs, in order to provide recommendations to reduce exposure.

Authors
Liu, S; Liu, Q; Ostbye, T; Story, M; Deng, X; Chen, Y; Li, W; Wang, H; Qiu, J; Zhang, J
MLA Citation
Liu, S, Liu, Q, Ostbye, T, Story, M, Deng, X, Chen, Y, Li, W, Wang, H, Qiu, J, and Zhang, J. "Levels and risk factors for urinary metabolites of polycyclic aromatic hydrocarbons in children living in Chongqing, China." The Science of the total environment 598 (November 2017): 553-561.
PMID
28454027
Source
epmc
Published In
Science of the Total Environment
Volume
598
Publish Date
2017
Start Page
553
End Page
561
DOI
10.1016/j.scitotenv.2017.04.103

Shared Electronic Health Record Systems: Key Legal and Security Challenges.

Use of shared electronic health records opens a whole range of new possibilities for flexible and fruitful cooperation among health personnel in different health institutions, to the benefit of the patients. There are, however, unsolved legal and security challenges. The overall aim of this article is to highlight legal and security challenges that should be considered before using shared electronic cooperation platforms and health record systems to avoid legal and security "surprises" subsequent to the implementation. Practical lessons learned from the use of a web-based ulcer record system involving patients, community nurses, GPs, and hospital nurses and doctors in specialist health care are used to illustrate challenges we faced. Discussion of possible legal and security challenges is critical for successful implementation of shared electronic collaboration systems. Key challenges include (1) allocation of responsibility, (2) documentation routines, (3) and integrated or federated access control. We discuss and suggest how challenges of legal and security aspects can be handled. This discussion may be useful for both current and future users, as well as policy makers.

Authors
Christiansen, EK; Skipenes, E; Hausken, MF; Skeie, S; Østbye, T; Iversen, MM
MLA Citation
Christiansen, EK, Skipenes, E, Hausken, MF, Skeie, S, Østbye, T, and Iversen, MM. "Shared Electronic Health Record Systems: Key Legal and Security Challenges." Journal of diabetes science and technology 11.6 (November 2017): 1234-1239.
PMID
28560899
Source
epmc
Published In
Journal of Diabetes Science and Technology
Volume
11
Issue
6
Publish Date
2017
Start Page
1234
End Page
1239
DOI
10.1177/1932296817709797

SCRUB TYPHUS AS A MAJOR CAUSE OF ILLNESS FOR PATIENTS WITH UNKNOWN FEVER ORIGIN IN GALLE, SRI LANKA

Authors
Chao, C-C; Zhang, Z; Belinskaya, T; Wood, C; Nicholson, BP; Tilekeratne, LG; Session, OM; Hsiang, J; Lewis, M; Reller, M; Bodinayake, CK; Nagahawatte, A; Devasiri, V; Kodikara-Arachichi, W; de Silva, AD; Kurukulasooriya, R; Ostbye, T; Gubler, DJ; Ching, W-M
MLA Citation
Chao, C-C, Zhang, Z, Belinskaya, T, Wood, C, Nicholson, BP, Tilekeratne, LG, Session, OM, Hsiang, J, Lewis, M, Reller, M, Bodinayake, CK, Nagahawatte, A, Devasiri, V, Kodikara-Arachichi, W, de Silva, AD, Kurukulasooriya, R, Ostbye, T, Gubler, DJ, and Ching, W-M. "SCRUB TYPHUS AS A MAJOR CAUSE OF ILLNESS FOR PATIENTS WITH UNKNOWN FEVER ORIGIN IN GALLE, SRI LANKA." November 2017.
Source
wos-lite
Published In
American Journal of Tropical Medicine and Hygiene
Volume
95
Issue
5
Publish Date
2017
Start Page
531
End Page
531

Association of obesity with patient-reported outcomes in patients with axial spondyloarthritis: a cross-sectional study in an urban Asian population.

To determine if obesity is associated with poorer patient-reported outcomes (PROs) in patients with axial spondyloarthritis (axSpA), we conducted a cross-sectional study using data of the PRESPOND registry from a tertiary referral center in Singapore between 2011 and 2015. Demographics, clinical, and PRO variables were collected. Patients were divided into three categories: normal (BMI < 23 kg/m2), overweight (23 kg/m2 ≤ BMI < 27.5 kg/m2) and obese (BMI ≥ 27.5 kg/m2), using Asian BMI classification. The dependent variables are Pain score, Bath Ankylosing Spondylitis Patient Global Score (BAS-G), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Health Assessment Questionnaire (HAQ), and Medical Outcomes Study Short Form 36 version 2 (SF-36). Multivariate regression analyses were performed with these dependent variables and obesity categories, adjusting for confounders. Among 194 patients with axSpA, 32% are overweight while 22% are obese. We found that obese patients had significant poorer pain (β: 11.87, 95%CI 2.13, 21.60) and BAS-G scores (β: 10.18, 95%CI 1.59, 18.76) when compared to normal BMI patients. However, obesity was not associated with BASDAI (β 0.50, 95%CI -0.22, 1.22), BASFI (β 0.08, 95%CI -0.66, 0.81), HAQ (β -0.07, 95%CI -0.21, 0.06), physical component summary (β -0.02, 95%CI -4.47, 4.44), and mental component summary (β -2.85, 95%CI -7.57, 1.88) of SF-36. Obesity was associated with pain score and BAS-G but not with BASDAI, BASFI, HAQ, and SF-36. Further study is needed to examine the causal relationship between obesity and poorer PROs.

Authors
Lee, YX; Kwan, YH; Png, WY; Lim, KK; Tan, CS; Lui, NL; Chew, EH; Thumboo, J; Østbye, T; Fong, W
MLA Citation
Lee, YX, Kwan, YH, Png, WY, Lim, KK, Tan, CS, Lui, NL, Chew, EH, Thumboo, J, Østbye, T, and Fong, W. "Association of obesity with patient-reported outcomes in patients with axial spondyloarthritis: a cross-sectional study in an urban Asian population." Clinical rheumatology 36.10 (October 2017): 2365-2370.
PMID
28378098
Source
epmc
Published In
Clinical Rheumatology
Volume
36
Issue
10
Publish Date
2017
Start Page
2365
End Page
2370
DOI
10.1007/s10067-017-3585-x

A systematic review of quality-of-life domains and items relevant to patients with spondyloarthritis.

To summarize, from the literature, quality-of-life (QoL) domains and items relevant to patients with spondyloarthritis (SpA), and to determine if commonly used SpA patient-reported outcome (PRO) instruments include the identified domains.We used PRISMA statement for systematic review and searched Medline® , Embase®, and PsycInfo® using relevant keywords. In addition, hand searches of references of the included articles were conducted. All articles were reviewed for inclusion by 2 independent reviewers. QoL domains and items relevant to patients with axial or peripheral SpA were extracted and presented using the adapted World Health Organization Quality-of-Life (WHOQOL) domain framework. SpA PROs were assessed to determine if they included the domains identified.We retrieved 14,343 articles, of which 34 articles fulfilled inclusion criteria for review. Twenty-five articles were conducted in the European population. Domains such as negative feelings and activities of daily living were found to be present in 28 and 27 articles, respectively. SpA impacted QoL in all domains of the adapted WHOQOL framework. Domains that differed between types of SpA were financial resources, general levels of independence and medication side effects. Embarrassment, self-image, and premature ageing were items that differed by geographical setting. PROs to capture domains for peripheral SpA were similar for axial SpA.We found that a wide range of domains and items of QoL were relevant to patients with SpA with minimal differences between patients with axial and peripheral SpA. Clinicians may consider using peripheral SpA PROs to measure QoL of patients with axial SpA.

Authors
Kwan, YH; Fong, W; Tan, VIC; Lui, NL; Malhotra, R; Østbye, T; Thumboo, J
MLA Citation
Kwan, YH, Fong, W, Tan, VIC, Lui, NL, Malhotra, R, Østbye, T, and Thumboo, J. "A systematic review of quality-of-life domains and items relevant to patients with spondyloarthritis." Seminars in arthritis and rheumatism 47.2 (October 2017): 175-182.
PMID
28487138
Source
epmc
Published In
Seminars in Arthritis and Rheumatism
Volume
47
Issue
2
Publish Date
2017
Start Page
175
End Page
182
DOI
10.1016/j.semarthrit.2017.04.002

Physician Weight-Related Counseling Is Unrelated to Extreme Weight Loss Behaviors Among Overweight and Obese Adolescents.

Some physicians may be hesitant to counsel overweight and obese adolescents about weight because of concerns that such counseling may result in extreme weight loss behaviors and the subsequent development of eating disorders. We compared self-reported extreme weight loss behaviors in 535 overweight/obese adolescents prior to receiving weight-related counseling during primary care visits, and again after 3 months. We found no change in fasting (7.7% vs 6.3%, P = .45), and decreases in diet pill use (4.1% vs 1.7%, P = .003) and laxative use/vomiting (2.6% vs 1.0%, P = .02). Three months following their medical appointment, patients were also less likely to report trying to lose weight in general (80.0% vs 75.6%, P = .04). Physicians should be reassured that providing weight-related counseling to their obese adolescents is unlikely to induce extreme weight loss behaviors. Frequent counseling may be required in order to help patients maintain motivation to attain a healthy weight.

Authors
Bravender, T; Lyna, P; Coffman, CJ; Bodner, ME; Østbye, T; Alexander, SC; Lin, P-H; Pollak, KI
MLA Citation
Bravender, T, Lyna, P, Coffman, CJ, Bodner, ME, Østbye, T, Alexander, SC, Lin, P-H, and Pollak, KI. "Physician Weight-Related Counseling Is Unrelated to Extreme Weight Loss Behaviors Among Overweight and Obese Adolescents." Clinical pediatrics (October 2017): 9922817737081-.
PMID
29084439
Source
epmc
Published In
Clinical Pediatrics
Publish Date
2017
Start Page
9922817737081
DOI
10.1177/0009922817737081

Assessment of nutrition and physical activity environments in family child care homes: modification and psychometric testing of the Environment and Policy Assessment and Observation.

Early care and education (ECE) settings play an important role in shaping the nutrition and physical activity habits of young children. Increasing research attention is being directed toward family child care homes (FCCHs) specifically. However, existing measures of child care nutrition and physical activity environments are limited in that they have been created for use with center-based programs and require modification for studies involving FCCHs. This paper describes the modification of the Environment and Policy Assessment and Observation (EPAO) for use in FCCHs.The EPAO underwent a through modification process that incorporated an updated format for the data collection instrument, assessment of emerging best practices, tailoring to the FCCH environment, and creation of a new scoring rubric. The new instrument was implemented as part of a larger randomized control trial. To assess inter-rater reliability, observations on 61 different days were performed independently by two data collectors. To assess construct validity, associations between EPAO scores and measures of children's dietary intake (Healthy Eating Index (HEI) score) and physical activity (accelerometer-measured minutes per hour of moderate to vigorous physical activity, MVPA) were examined.The modified EPAO assesses 38 nutrition and 27 physical activity best practices, which can be summarized into 7 nutrition-related and 10 physical activity-related environmental sub- scores as well as overall nutrition and overall physical activity scores. There was generally good agreement between data collectors (ICC > 0.60). Reliability was slightly lower for feeding practices and physical activity education and professional development (ICC = 0.56 and 0.22, respectively). Child HEI was significantly correlated with the overall nutrition score (r = 0.23), foods provided (r = 0.28), beverages provided (r = 0.15), nutrition education and professional development (r = 0.21), and nutrition policy (r = 0.18). Child MVPA was significantly associated with overall time provided for activity (r = 0.18) and outdoor playtime (r = 0.20). There was also an unexpected negative association between child MVPA and screen time (-0.16) and screen time practices (r = -0.21).The EPAO for the FCCH instrument is a useful tool for researchers working with this unique type of ECE setting. It has undergone rigorous development and testing and appears to have good psychometric properties.NCT01814215 , March 15, 2013.

Authors
Vaughn, AE; Mazzucca, S; Burney, R; Østbye, T; Benjamin Neelon, SE; Tovar, A; Ward, DS
MLA Citation
Vaughn, AE, Mazzucca, S, Burney, R, Østbye, T, Benjamin Neelon, SE, Tovar, A, and Ward, DS. "Assessment of nutrition and physical activity environments in family child care homes: modification and psychometric testing of the Environment and Policy Assessment and Observation." BMC public health 17.1 (August 29, 2017): 680-.
PMID
28851348
Source
epmc
Published In
BMC Public Health
Volume
17
Issue
1
Publish Date
2017
Start Page
680
DOI
10.1186/s12889-017-4686-9

Validity and Reliability of the Positive Aspects of Caregiving (PAC) Scale and Development of Its Shorter Version (S-PAC) Among Family Caregivers of Older Adults.

To (a) assess the validity and reliability of the 9-item Positive Aspects of Caregiving (PAC) scale among a national sample of caregivers for older adults with functional limitations, (b) develop a shorter version (short-PAC [S-PAC] scale) and assess its psychometric properties, and (c) investigate both scales' measurement equivalence/invariance (ME/I) across language of administration (Chinese/English/Malay).Scale/item measurement property assessment, confirmatory factor analysis (CFA), testing the "original" 2-factor model (6 items: first factor; 3 items: second factor), and exploratory FA (EFA) of the 9-item PAC scale was done. Consequently, alternate CFA models were tested. The S-PAC was developed and subjected to CFA. For both scales, convergent (correlation with caregiver esteem) and divergent (correlation with caregiver depressive symptoms) validity, and language ME/I was assessed.For the 9-item PAC scale, the "original" 2-factor CFA model had a poor fit; its EFA and scale/item measurement properties supported a single factor. Among alternate CFA models, a bi-factor model (all nine items: first factor [overall PAC]; six items: second factor [self-affirmation]; three items: third factor [outlook-on-life]) had the best fit. The bi-factor CFA model also had a good fit for the S-PAC scale, developed after eliminating 2 items from the 9-item PAC scale. Both scales demonstrated convergent and divergent validity, and partial ME/I across language of administration.Both the 9-item PAC and 7-item S-PAC scales can be used to assess positive feelings resulting from care provision among family caregivers of older adults with functional limitations.

Authors
Siow, JYM; Chan, A; Østbye, T; Cheng, GH-L; Malhotra, R
MLA Citation
Siow, JYM, Chan, A, Østbye, T, Cheng, GH-L, and Malhotra, R. "Validity and Reliability of the Positive Aspects of Caregiving (PAC) Scale and Development of Its Shorter Version (S-PAC) Among Family Caregivers of Older Adults." The Gerontologist 57.4 (August 2017): e75-e84.
PMID
28082275
Source
epmc
Published In
The Gerontologist
Volume
57
Issue
4
Publish Date
2017
Start Page
e75
End Page
e84
DOI
10.1093/geront/gnw198

Perceived Barriers to Healthy Eating and Physical Activity Among Participants in a Workplace Obesity Intervention.

To characterize barriers to healthy eating (BHE) and physical activity (BPA) among participants in a workplace weight management intervention.Steps to health participants completed a questionnaire to ascertain barriers to physical activity and healthy eating faced. Exploratory factor analysis was used to determine the factor structure for BPA and BHE. The relationships of these factors with accelerometer data and dietary behaviors were assessed using linear regression.Barriers to physical activity included time constraints and lack of interest and motivation, and to healthy eating, lack of self-control and convenience, and lack of access to healthy foods. Higher BHE correlated with higher sugary beverage intake but not fruit and vegetable and fat intake.To improve their effectiveness, workplace weight management programs should consider addressing and reducing barriers to healthy eating and physical activity.

Authors
Stankevitz, K; Dement, J; Schoenfisch, A; Joyner, J; Clancy, SM; Stroo, M; Østbye, T
MLA Citation
Stankevitz, K, Dement, J, Schoenfisch, A, Joyner, J, Clancy, SM, Stroo, M, and Østbye, T. "Perceived Barriers to Healthy Eating and Physical Activity Among Participants in a Workplace Obesity Intervention." Journal of occupational and environmental medicine 59.8 (August 2017): 746-751.
PMID
28692017
Source
epmc
Published In
Journal of Occupational and Environmental Medicine
Volume
59
Issue
8
Publish Date
2017
Start Page
746
End Page
751
DOI
10.1097/jom.0000000000001092

Burden and Seasonality of Viral Acute Respiratory Tract Infections among Outpatients in Southern Sri Lanka.

In tropical and subtropical settings, the epidemiology of viral acute respiratory tract infections varies widely between countries. We determined the etiology, seasonality, and clinical presentation of viral acute respiratory tract infections among outpatients in southern Sri Lanka. From March 2013 to January 2015, we enrolled outpatients presenting with influenza-like illness (ILI). Nasal/nasopharyngeal samples were tested in duplicate using antigen-based rapid influenza testing and multiplex polymerase chain reaction (PCR) for respiratory viruses. Monthly proportion positive was calculated for each virus. Bivariable and multivariable logistic regression were used to identify associations between sociodemographic/clinical information and viral detection. Of 571 subjects, most (470, 82.3%) were ≥ 5 years of age and 53.1% were male. A respiratory virus was detected by PCR in 63.6% (N = 363). Common viral etiologies included influenza (223, 39%), human enterovirus/rhinovirus (HEV/HRV, 14.5%), respiratory syncytial virus (RSV, 4.2%), and human metapneumovirus (hMPV, 3.9%). Both ILI and influenza showed clear seasonal variation, with peaks from March to June each year. RSV and hMPV activity peaked from May to July, whereas HEV/HRV was seen year-round. Patients with respiratory viruses detected were more likely to report pain with breathing (odds ratio [OR] = 2.60, P = 0.003), anorexia (OR = 2.29, P < 0.001), and fatigue (OR = 2.00, P = 0.002) compared with patients with no respiratory viruses detected. ILI showed clear seasonal variation in southern Sri Lanka, with most activity during March to June; peak activity was largely due to influenza. Targeted infection prevention activities such as influenza vaccination in January-February may have a large public health impact in this region.

Authors
Shapiro, D; Bodinayake, CK; Nagahawatte, A; Devasiri, V; Kurukulasooriya, R; Hsiang, J; Nicholson, B; De Silva, AD; Østbye, T; Reller, ME; Woods, CW; Tillekeratne, LG
MLA Citation
Shapiro, D, Bodinayake, CK, Nagahawatte, A, Devasiri, V, Kurukulasooriya, R, Hsiang, J, Nicholson, B, De Silva, AD, Østbye, T, Reller, ME, Woods, CW, and Tillekeratne, LG. "Burden and Seasonality of Viral Acute Respiratory Tract Infections among Outpatients in Southern Sri Lanka." The American journal of tropical medicine and hygiene 97.1 (July 2017): 88-96.
PMID
28719323
Source
epmc
Published In
American Journal of Tropical Medicine and Hygiene
Volume
97
Issue
1
Publish Date
2017
Start Page
88
End Page
96
DOI
10.4269/ajtmh.17-0032

Development of the FitSight Fitness Tracker to Increase Time Outdoors to Prevent Myopia.

To develop a fitness tracker (FitSight) to encourage children to increase time spent outdoors. To evaluate the wear pattern for this tracker and outdoor time pattern by estimating light illumination levels among children.The development of the FitSight fitness tracker involved the designing of two components: (1) the smartwatch with custom-made FitSight watch application (app) to log the instant light illuminance levels the wearer is exposed to, and (2) a companion smartphone app that synchronizes the time outdoors recorded by the smartwatch to smartphone via Bluetooth communication. Smartwatch wear patterns and tracker-recorded daily light illuminance levels data were gathered over 7 days from 23 Singapore children (mean ± standard deviation age: 9.2 ± 1.4 years). Feedback about the tracker was obtained from 14 parents using a three-level rating scale: very poor/poor/good.Of the 14 parents, 93% rated the complete "FitSight fitness tracker" as good and 64% rated its wearability as good. While 61% of 23 children wore the watch on all study days (i.e., 0 nonwear days), 26% had 1 nonwear day, and 4.5% children each had 3, 4, and 5 nonwear days, respectively. On average, children spent approximately 1 hour in light levels greater than 1000 lux on weekdays and 1.3 hours on weekends (60 ± 46 vs. 79 ± 53 minutes, P = 0.19). Mean number of outdoor "spurts" (light illuminance levels >1000 lux) per day was 8 ± 3 spurts with spurt duration of 34 ± 32 minutes.The FitSight tracker with its novel features may motivate children to increase time outdoors and play an important role in supplementing community outdoor programs to prevent myopia.If the developed noninvasive, wearable, smartwatch-based fitness tracker, FitSight, promotes daytime outdoor activity among children, it will be beneficial in addressing the epidemic of myopia.

Authors
Verkicharla, PK; Ramamurthy, D; Nguyen, QD; Zhang, X; Pu, S-H; Malhotra, R; Ostbye, T; Lamoureux, EL; Saw, S-M
MLA Citation
Verkicharla, PK, Ramamurthy, D, Nguyen, QD, Zhang, X, Pu, S-H, Malhotra, R, Ostbye, T, Lamoureux, EL, and Saw, S-M. "Development of the FitSight Fitness Tracker to Increase Time Outdoors to Prevent Myopia." Translational vision science & technology 6.3 (June 16, 2017): 20-.
PMID
28660095
Source
epmc
Published In
Translational Vision Science & Technology
Volume
6
Issue
3
Publish Date
2017
Start Page
20
DOI
10.1167/tvst.6.3.20

Lessons from Singapore's national weight management program, Lose To Win.

The prevalence of overweight and obesity in Singapore is lower than in most countries, but it is increasing. There is evidence health complications may appear at lower weights among Asians. We describe the evolution of a national weight management program [Lose To Win (LTW)] organized by the Singapore Health Promotion Board from 2009 to 2013. LTW is a 12-week program comprising nutrition education, physical activity and mental wellbeing sessions and interim assessments. Individuals aged 18-69 years with a body mass index (BMI) between 23 and 37.4 kg/m2 were included. Primary outcomes were change in weight and BMI from baseline to end of 12-weeks. Effectiveness of the weight loss program was assessed using non-randomized control group (delayed intervention) during LTW 2010 and 2012. LTW 2009 enrolled 285 participants from 72 worksites. LTW 2010, expanded to the community, enrolling 952 participants (641 community-based and 311 workplace-based). In LTW 2012 and 2013, 959 and 1412 participants, respectively, were recruited from the community only. Completion rates of the 12-week program varied from 49 to 88%. Average weight loss ranged from 1.3 to 3.6 kg. For rounds including a control group, weight loss was higher in the intervention than in the control group. Competition and incentives were important motivators for participation. The LTW program was well-received and effective in producing short-term weight loss. Enhancements will be done to reinforce success factors in subsequent rounds to boost participation and follow-up rates and to ensure long-term sustainability.

Authors
Vasquez, K; Malhotra, R; Østbye, T; Low, W; Chan, MF; Chew, L; Ling, A
MLA Citation
Vasquez, K, Malhotra, R, Østbye, T, Low, W, Chan, MF, Chew, L, and Ling, A. "Lessons from Singapore's national weight management program, Lose To Win." Health promotion international (May 24, 2017).
PMID
28541435
Source
epmc
Published In
Health Promotion International
Publish Date
2017
DOI
10.1093/heapro/dax021

The Relationship Between BMI and Work-Related Musculoskeletal (MSK) Injury Rates is Modified by Job-Associated Level of MSK Injury Risk.

The aim of this study was to examine the relationship between body mass index (BMI) and occupational musculoskeletal (MSK) injury rates, and the statistical interaction between BMI and occupational exposure to MSK hazards (measured by level of MSK injury risk based on job category).Using 17 years of data from 38,214 university and health system employees, multivariate Poisson regression modeled the interaction between BMI and MSK injury risk on injury rates.A significant interaction between BMI and MSK injury risk was observed. Although the effect of BMI was strongest for 'low' MSK injury risk occupations, absolute MSK injury rates for 'mid'/'high' MSK injury risk occupations remained larger.To address the occupational MSK injury burden, initiatives focused on optimal measures of workers' BMI are important but should not be prioritized over (or used in lieu of) interventions targeting job-specific MSK injury hazards.

Authors
Schoenfisch, A; Dement, J; Stankevitz, K; Østbye, T
MLA Citation
Schoenfisch, A, Dement, J, Stankevitz, K, and Østbye, T. "The Relationship Between BMI and Work-Related Musculoskeletal (MSK) Injury Rates is Modified by Job-Associated Level of MSK Injury Risk." Journal of occupational and environmental medicine 59.5 (May 2017): 425-433.
PMID
28379879
Source
epmc
Published In
Journal of Occupational and Environmental Medicine
Volume
59
Issue
5
Publish Date
2017
Start Page
425
End Page
433
DOI
10.1097/jom.0000000000000982

ASSOCIATION BETWEEN ACCESS TO HEALTH-PROMOTING FACILITIES AND PARTICIPATION IN CARDIOVASCULAR DISEASE (CVD) RISK SCREENING AMONG POPULATIONS WITH LOW SOCIOECONOMIC STATUS (SES) IN SINGAPORE

Authors
Lim, KK; Lim, C; Kwan, YH; Ostbye, T; Tay, HY; Chan, SY; Fong, W; Tan, CS
MLA Citation
Lim, KK, Lim, C, Kwan, YH, Ostbye, T, Tay, HY, Chan, SY, Fong, W, and Tan, CS. "ASSOCIATION BETWEEN ACCESS TO HEALTH-PROMOTING FACILITIES AND PARTICIPATION IN CARDIOVASCULAR DISEASE (CVD) RISK SCREENING AMONG POPULATIONS WITH LOW SOCIOECONOMIC STATUS (SES) IN SINGAPORE." May 2017.
Source
wos-lite
Published In
Value in Health
Volume
20
Issue
5
Publish Date
2017
Start Page
A381
End Page
A382

A SYSTEMATIC REVIEW OF THE FACTORS ASSOCIATED WITH THE INITIATION OF BIOLOGICS IN PATIENTS WITH RHEUMATOLOGICAL CONDITIONS

Authors
Png, WY; Kwan, YH; Lim, KK; Chew, EH; Lui, NL; Tan, CS; Ostbye, T; Thumboo, J; Fong, W
MLA Citation
Png, WY, Kwan, YH, Lim, KK, Chew, EH, Lui, NL, Tan, CS, Ostbye, T, Thumboo, J, and Fong, W. "A SYSTEMATIC REVIEW OF THE FACTORS ASSOCIATED WITH THE INITIATION OF BIOLOGICS IN PATIENTS WITH RHEUMATOLOGICAL CONDITIONS." May 2017.
Source
wos-lite
Published In
Value in Health
Volume
20
Issue
5
Publish Date
2017
Start Page
A151
End Page
A151

ASSOCIATION OF OBESITY WITH PATIENT-REPORTED OUTCOMES IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS: A CROSS-SECTIONAL STUDY IN AN URBAN ASIAN POPULATION

Authors
Kwan, YH; Lee, YX; Png, WY; Lim, KK; Tan, CS; Lui, NL; Chew, EH; Ostbye, T; Thumboo, J; Fong, W
MLA Citation
Kwan, YH, Lee, YX, Png, WY, Lim, KK, Tan, CS, Lui, NL, Chew, EH, Ostbye, T, Thumboo, J, and Fong, W. "ASSOCIATION OF OBESITY WITH PATIENT-REPORTED OUTCOMES IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS: A CROSS-SECTIONAL STUDY IN AN URBAN ASIAN POPULATION." May 2017.
Source
wos-lite
Published In
Value in Health
Volume
20
Issue
5
Publish Date
2017
Start Page
A149
End Page
A149

FACTORS ASSOCIATED WITH INITIATION OF BIOLOGICS IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS IN AN URBAN ASIAN CITY: A PRESPOND STUDY

Authors
Kwan, YH; Png, WY; Lee, YX; Lim, KK; Chew, EH; Lui, NL; Tan, CS; Thumboo, J; Ostbye, T; Fong, W
MLA Citation
Kwan, YH, Png, WY, Lee, YX, Lim, KK, Chew, EH, Lui, NL, Tan, CS, Thumboo, J, Ostbye, T, and Fong, W. "FACTORS ASSOCIATED WITH INITIATION OF BIOLOGICS IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS IN AN URBAN ASIAN CITY: A PRESPOND STUDY." May 2017.
Source
wos-lite
Published In
Value in Health
Volume
20
Issue
5
Publish Date
2017
Start Page
A151
End Page
A151

FACTORS OF CARDIOVASCULAR DISEASE RISK SCREENING UPTAKE AMONG POPULATIONS WITH LOW SOCIOECONOMIC STATUS: A SYSTEMATIC REVIEW

Authors
Lim, KK; Lim, C; Kwan, YH; Tan, CS; Chan, SY; Fong, W; Tay, HY; Ostbye, T
MLA Citation
Lim, KK, Lim, C, Kwan, YH, Tan, CS, Chan, SY, Fong, W, Tay, HY, and Ostbye, T. "FACTORS OF CARDIOVASCULAR DISEASE RISK SCREENING UPTAKE AMONG POPULATIONS WITH LOW SOCIOECONOMIC STATUS: A SYSTEMATIC REVIEW." May 2017.
Source
wos-lite
Published In
Value in Health
Volume
20
Issue
5
Publish Date
2017
Start Page
A381
End Page
A381

A SYSTEMATIC REVIEW OF THE ASSOCIATION BETWEEN OBESITY AND OUTCOME OF RHEUMATIC DISEASES

Authors
Kwan, YH; Lee, YX; Lim, KK; Tan, CS; Lui, NL; Chew, EH; Ostbye, T; Thumboo, J; Fong, W
MLA Citation
Kwan, YH, Lee, YX, Lim, KK, Tan, CS, Lui, NL, Chew, EH, Ostbye, T, Thumboo, J, and Fong, W. "A SYSTEMATIC REVIEW OF THE ASSOCIATION BETWEEN OBESITY AND OUTCOME OF RHEUMATIC DISEASES." May 2017.
Source
wos-lite
Published In
Value in Health
Volume
20
Issue
5
Publish Date
2017
Start Page
A150
End Page
A150

Mental health paraprofessional training for filipina foreign domestic workers in Singapore: Feasibility and effects on knowledge about depression and cognitive behavioral therapy skills

Authors
Wong, M; Keng, S; Buck, P; Ostbye, T; Wessels, A; Suthendran, S
MLA Citation
Wong, M, Keng, S, Buck, P, Ostbye, T, Wessels, A, and Suthendran, S. "Mental health paraprofessional training for filipina foreign domestic workers in Singapore: Feasibility and effects on knowledge about depression and cognitive behavioral therapy skills." April 2017.
Source
crossref
Published In
European Psychiatry
Volume
41
Publish Date
2017
Start Page
S626
End Page
S626
DOI
10.1016/j.eurpsy.2017.01.1014

Antibiotic overuse for acute respiratory tract infections in Sri Lanka: a qualitative study of outpatients and their physicians.

Acute respiratory tract infections (ARTIs) are a common reason for antibiotic overuse worldwide. We previously showed that over 80% of outpatients presenting to a tertiary care hospital in Sri Lanka with influenza-like illness received antibiotic prescriptions, although almost half were later confirmed to have influenza. The purpose of this qualitative study was to assess Sri Lankan patients' and physicians' attitudes towards ARTI diagnosis and treatment.Semi-structured interviews were conducted with 50 outpatients with ARTIs and five physicians in the Outpatient Department (OPD) at a large, public tertiary care hospital in southern Sri Lanka. Interviews were audio-recorded, transcribed, and analyzed for themes related to ARTI diagnosis and treatment.Patients frequently sought ARTI care in the public sector due to the receipt of free care and the perception that government hospitals carried a sense of responsibility for patients' health. Patients reported multiple medical visits for their illnesses of short duration and many indicated that they were seeking care in the OPD while at the hospital for another reason. While patients generally expected to receive medication prescriptions at their visit, most patients were not specifically seeking an antibiotic prescription. However, more than 70% of patients received antibiotic prescriptions at their OPD visit. Physicians incorrectly perceived that patients desired antibiotics or "capsules," a common formulation of antibiotics dispensed in this outpatient setting, and cited patient demand as an important cause of antibiotic overuse. Physicians also indicated that high patient volume and fear of bacterial superinfection drove antibiotic overuse.Patients in this study were seeking medication prescriptions for their ARTIs, but physicians incorrectly perceived that antibiotic prescriptions were desired. High patient volume and fear of bacterial superinfection were also important factors in antibiotic overuse. Training of physicians regarding guideline-concordant management and dealing with diagnostic uncertainty, education of patients regarding ARTI etiology and management, and systematic changes in the public outpatient care structure may help decrease unnecessary antibiotic prescriptions for ARTIs in this setting.

Authors
Tillekeratne, LG; Bodinayake, CK; Dabrera, T; Nagahawatte, A; Arachchi, WK; Sooriyaarachchi, A; Stewart, K; Watt, M; Østbye, T; Woods, CW
MLA Citation
Tillekeratne, LG, Bodinayake, CK, Dabrera, T, Nagahawatte, A, Arachchi, WK, Sooriyaarachchi, A, Stewart, K, Watt, M, Østbye, T, and Woods, CW. "Antibiotic overuse for acute respiratory tract infections in Sri Lanka: a qualitative study of outpatients and their physicians." BMC family practice 18.1 (March 16, 2017): 37-.
Website
http://hdl.handle.net/10161/16127
PMID
28302056
Source
epmc
Published In
BMC Family Practice
Volume
18
Issue
1
Publish Date
2017
Start Page
37
DOI
10.1186/s12875-017-0619-z

Validation of serum progesterone <35nmol/L as a predictor of miscarriage among women with threatened miscarriage.

Our recent paper, based on a pilot cohort of 119 women, showed that serum progesterone <35 nmol/L was prognostic of spontaneous miscarriage by 16 weeks in women with threatened miscarriage in early pregnancy. Using a larger cohort of women from the same setting (validation cohort), we aim to assess the validity of serum progesterone <35 nmol/L with the outcome of spontaneous miscarriage by 16 weeks.In a prospective cohort study, 360 pregnant women presenting with threatened miscarriage between gestation weeks 6-10 at a tertiary hospital emergency unit for women in Singapore were recruited for this study. The main outcome measure measured is spontaneous miscarriage prior to week 16 of gestation. Area under the ROC curve (AUC) and test characteristics (sensitivity, specificity, positive and negative predictive value) at a serum progesterone cutpoint of <35 nmol/L for predicting high and low risk of spontaneous miscarriage by 16 weeks were compared between the Pilot and Validation cohorts.Test characteristics and AUC values using serum progesterone <35 nmol/L in the validation cohort were not significantly different from those in the Pilot cohort, demonstrating excellent accuracy and reproducibility of the proposed serum progesterone cut-off level.The cut-off value for serum progesterone (35 nmol/L) demonstrated clinical relevance and allow clinicians to stratify patients into high and low risk groups for spontaneous miscarriage.

Authors
Lek, SM; Ku, CW; Allen, JC; Malhotra, R; Tan, NS; Østbye, T; Tan, TC
MLA Citation
Lek, SM, Ku, CW, Allen, JC, Malhotra, R, Tan, NS, Østbye, T, and Tan, TC. "Validation of serum progesterone <35nmol/L as a predictor of miscarriage among women with threatened miscarriage." BMC pregnancy and childbirth 17.1 (March 6, 2017): 78-.
PMID
28264669
Source
epmc
Published In
BMC Pregnancy and Childbirth
Volume
17
Issue
1
Publish Date
2017
Start Page
78
DOI
10.1186/s12884-017-1261-4

Family child care home providers as role models for children: Cause for concern?

Health behaviors associated with chronic disease, particularly healthy eating and regular physical activity, are important role modeling opportunities for individuals working in child care programs. Prior studies have not explored these risk factors in family child care home (FCCH) providers which care for vulnerable and at-risk populations. To address this gap, we describe the socio-demographic and health risk behavior profiles in a sample of providers (n = 166 FCCH) taken from baseline data of an ongoing cluster-randomized controlled intervention (2011-2016) in North Carolina. Data were collected during on-site visits where providers completed self-administered questionnaires (socio-demographics, physical activity, fruit and vegetable consumption, number of hours of sleep per night and perceived stress) and had their height and weight measured. A risk score (range: 0-6; 0 no risk to 6 high risk) was calculated based on how many of the following were present: not having health insurance, being overweight/obese, not meeting physical activity, fruit and vegetable, and sleep recommendations, and having high stress. Mean and frequency distributions of participant and FCCH characteristics were calculated. Close to one third (29.3%) of providers reported not having health insurance. Almost all providers (89.8%) were overweight or obese with approximately half not meeting guidelines for physical activity, fruit and vegetable consumption, and sleep. Over half reported a "high" stress score. The mean risk score was 3.39 (± 1.2), with close to half of the providers having a risk score of 4, 5 or 6 (45.7%). These results stress the need to promote the health of these important care providers.

Authors
Tovar, A; Vaughn, AE; Grummon, A; Burney, R; Erinosho, T; Østbye, T; Ward, DS
MLA Citation
Tovar, A, Vaughn, AE, Grummon, A, Burney, R, Erinosho, T, Østbye, T, and Ward, DS. "Family child care home providers as role models for children: Cause for concern?." Preventive medicine reports 5 (March 2017): 308-313.
PMID
28239538
Source
epmc
Published In
Preventive Medicine Reports
Volume
5
Publish Date
2017
Start Page
308
End Page
313
DOI
10.1016/j.pmedr.2016.11.010

Caregiving-related needs of family caregivers of older Singaporeans.

To describe the extent and correlates of caregiving-related needs among family caregivers of Singaporeans aged 75+ with ≥1 activity of daily living limitations (care-recipients).National survey data of 1181 care-recipient/caregiver dyads were used. Caregiver's report (yes/no) of 16 needs was assessed. Care-recipient and caregiver correlates of each need were determined through logistic regression analysis.Caregiving-related needs were expressed by 42.3% caregivers. The most commonly reported need was keeping care-recipient safe at home (24.5%). Needs concerned with caring for care-recipients were more frequent than those concerned with the caregiver's own needs. The most frequent correlate was care-recipient's extent of mood impairment (associated with 13 needs).Caregivers should not neglect themselves when engaging in care provision. Families and service providers should explore whether reported lack of needs reflects limited awareness and/or under-reporting.

Authors
Ajay, S; Østbye, T; Malhotra, R
MLA Citation
Ajay, S, Østbye, T, and Malhotra, R. "Caregiving-related needs of family caregivers of older Singaporeans." Australasian journal on ageing 36.1 (March 2017): E8-E13.
PMID
28191735
Source
epmc
Published In
Australasian Journal on Ageing
Volume
36
Issue
1
Publish Date
2017
Start Page
E8
End Page
E13
DOI
10.1111/ajag.12370

Knowledge, Attitudes and Practices relating to Leprosy among Public Health Care Providers in Colombo, Sri Lanka

Authors
Wijeratne, MP; Ostbye, T
MLA Citation
Wijeratne, MP, and Ostbye, T. "Knowledge, Attitudes and Practices relating to Leprosy among Public Health Care Providers in Colombo, Sri Lanka." LEPROSY REVIEW 88.1 (March 2017): 75-84.
Source
wos-lite
Published In
Leprosy Review
Volume
88
Issue
1
Publish Date
2017
Start Page
75
End Page
84

Time Trends and Educational Inequalities in Out-of-Hospital Coronary Deaths in Norway 1995-2009: A Cardiovascular Disease in Norway (CVDNOR) Project.

Recent time trends and educational gradients characterizing out-of-hospital coronary deaths (OHCD) are poorly described.We identified all deaths from coronary heart disease occurring outside the hospital in Norway during 1995 to 2009. Time trends were explored using Poisson regression analysis with year as the independent, continuous variable. Information on the highest achieved education was obtained from The National Education Database and classified as primary (up to 10 years of compulsory education), secondary (high school or vocational school), or tertiary (college/university). Educational gradients in OHCD were explored using Poisson regression, stratified by sex and age (<70 and ≥70 years), and results were expressed as incidence rate ratios (IRRs) and 95%CIs. Of 100 783 coronary heart disease deaths, 58.8% were OHCDs. From 1995 to 2009, age-adjusted OHCD rates declined across all education categories (primary, secondary, and tertiary) in younger men (IRR=0.35; 95%CI 0.32-0.38; IRR=0.38; 95%CI 0.35-0.42; IRR=0.33; 95%CI 0.28-0.40), younger women (IRR=0.47; 95% CI 0.40-0.56; IRR=0.55; 95%CI 0.45-0.67; IRR=0.28; 95% CI 0.16-0.47), older men (IRR=0.20; 95%CI 0.19-0.22; IRR=0.20; 95%CI 0.18-0.22; IRR=0.20; 95%CI 0.17-0.23), and older women (IRR=0.26; 95%CI 0.24-0.28; IRR=0.25; 95%CI 0.23-0.28; IRR=0.28; 95%CI 0.22-0.34). Tertiary education was associated with lower risk of OHCD compared to primary education (IRR=0.37; 95%CI 0.35-0.40 in younger men, IRR=0.26; 95%CI 0.22-0.30 in younger women, IRR=0.52; 95%CI 0.49-0.55 in older men, and IRR=0.61; 95%CI 0.57-0.66 in older women). These gradients did not change over time (P interaction=0.25).Although OHCD rates declined substantially during 1995 to 2009, they displayed educational gradients that remained constant over time.

Authors
Sulo, E; Nygård, O; Vollset, SE; Igland, J; Ebbing, M; Østbye, T; Jørgensen, T; Sulo, G; Tell, GS
MLA Citation
Sulo, E, Nygård, O, Vollset, SE, Igland, J, Ebbing, M, Østbye, T, Jørgensen, T, Sulo, G, and Tell, GS. "Time Trends and Educational Inequalities in Out-of-Hospital Coronary Deaths in Norway 1995-2009: A Cardiovascular Disease in Norway (CVDNOR) Project." Journal of the American Heart Association 6.2 (February 20, 2017).
PMID
28219924
Source
epmc
Published In
Journal of the American Heart Association
Volume
6
Issue
2
Publish Date
2017
DOI
10.1161/jaha.116.005236

Cohort profile for the Nurture Observational Study examining associations of multiple caregivers on infant growth in the Southeastern USA.

Childcare has been associated with obesity in children in cross-sectional and longitudinal studies, although some observed no association. Few studies have focused on care during infancy, a period when children may be especially vulnerable.The Nurture Study is an observational birth cohort designed to assess longitudinal associations of childcare and the presence of multiple caregivers on infant adiposity and weight trajectories throughout the first year of life. We examine as potential mediators feeding, physical activity, sleep and stress. We completed recruitment in 2015. Of the 860 women who enrolled during pregnancy, 799 delivered a single live infant who met our inclusion criteria. Of those, 666 mothers (77.4%) agreed to participate in the study for themselves and their infants.Among the 666 women in the study, 472 (71%) identified as black, 127 (19%) as white, 7 (1%) as Asian or Asian American, 6 (1%) as Native American and 49 (7%) as other race or more than one race; 43 (7%) identified as Hispanic/Latina. Just under half (48%) had a high school diploma or less, 61% had household incomes <$20 000/year and 59% were married or living with a partner. The mean (SD) infant gestational age was 41.28 weeks (2.29) and birth weight for gestational age z-score was -0.31 (0.93). Just under half (49%) of infants were females, 69% received some human milk and 40% were exclusively breast fed at hospital discharge. Data collection began in 2013, is currently underway, and is scheduled to conclude in late 2016.Results will help assess the magnitude of associations between childcare in infancy and subsequent obesity. Findings will also inform intervention and policy efforts to improve childcare environments and help prevent obesity in settings where many infants spend time.Clinicaltrials.gov, NCT01788644.

Authors
Benjamin Neelon, SE; Østbye, T; Bennett, GG; Kravitz, RM; Clancy, SM; Stroo, M; Iversen, E; Hoyo, C
MLA Citation
Benjamin Neelon, SE, Østbye, T, Bennett, GG, Kravitz, RM, Clancy, SM, Stroo, M, Iversen, E, and Hoyo, C. "Cohort profile for the Nurture Observational Study examining associations of multiple caregivers on infant growth in the Southeastern USA." BMJ open 7.2 (February 8, 2017): e013939-.
PMID
28179416
Source
epmc
Published In
BMJ Open
Volume
7
Issue
2
Publish Date
2017
Start Page
e013939
DOI
10.1136/bmjopen-2016-013939

Cohort profile for the Nurture Observational Study examining associations of multiple caregivers on infant growth in the Southeastern USA

Authors
Benjamin Neelon, SE; Østbye, T; Bennett, GG; Kravitz, RM; Clancy, SM; Stroo, M; Iversen, E; Hoyo, C
MLA Citation
Benjamin Neelon, SE, Østbye, T, Bennett, GG, Kravitz, RM, Clancy, SM, Stroo, M, Iversen, E, and Hoyo, C. "Cohort profile for the Nurture Observational Study examining associations of multiple caregivers on infant growth in the Southeastern USA." BMJ Open 7.2 (February 2017): e013939-e013939.
Source
crossref
Published In
BMJ Open
Volume
7
Issue
2
Publish Date
2017
Start Page
e013939
End Page
e013939
DOI
10.1136/bmjopen-2016-013939

Severity and duration of diabetic foot ulcer (DFU) before seeking care as predictors of healing time: A retrospective cohort study.

To investigate whether A) duration of ulcer before start of treatment in specialist health care, and B) severity of ulcer according to University of Texas classification system (UT) at start of treatment (baseline), are independent predictors of healing time.This retrospective cohort study, based on electronic medical record data, included 105 patients from two outpatient clinics in Western Norway with a new diabetic foot ulcer during 2009-2011. The associations of duration of ulcer and ulcer severity with healing time were assessed using cumulative incidence curves and subdistribution hazard ratio estimated using competing risk regression with adjustment for potential confounders.Of the 105 participants, 45.7% achieved ulcer healing, 36.2% underwent amputations, 9.5% died before ulcer healing and 8.5% were lost to follow-up. Patients who were referred to specialist health care by a general practitioner ≥ 52 days after ulcer onset had a 58% (SHR 0.42, CI 0.18-0.98) decreased healing rate compared to patients who were referred earlier, in the adjusted model. High severity (grade 2/3, stage C/D) according to the UT classification system was associated with a decreased healing rate compared to low severity (grade1, stage A/B or grade 2, stage A) with SHR (95% CI) equal to 0.14 (0.05-0.43) after adjustment for referral time and other potential confounders.Early detection and referral by both the patient and general practitioner are crucial for optimal foot ulcer healing. Ulcer grade and severity are also important predictors for healing time, and early screening to assess the severity and initiation of prompt treatment is important.

Authors
Smith-Strøm, H; Iversen, MM; Igland, J; Østbye, T; Graue, M; Skeie, S; Wu, B; Rokne, B
MLA Citation
Smith-Strøm, H, Iversen, MM, Igland, J, Østbye, T, Graue, M, Skeie, S, Wu, B, and Rokne, B. "Severity and duration of diabetic foot ulcer (DFU) before seeking care as predictors of healing time: A retrospective cohort study." PloS one 12.5 (January 2017): e0177176-.
PMID
28498862
Source
epmc
Published In
PloS one
Volume
12
Issue
5
Publish Date
2017
Start Page
e0177176
DOI
10.1371/journal.pone.0177176

Time trends in management of HIV-positive pregnant women in Northern Tanzania: A registry-based study.

To examine time trends in antenatal factors and delivery characteristics in Northern Tanzania, and relate these to national guidelines for HIV in pregnancy.Registry-based study.Northern Tanzania, 2000-2014.Deliveries (n = 33 346).HIV-positive women were compared with HIV-negative women during four periods spanning changing national guidelines.Known maternal HIV status, HIV treatment for woman, number of antenatal care (ANC) visits, routine folate/iron in pregnancy, anemia, delivery complications/interventions.We observed an increase in deliveries with known maternal HIV status and women receiving HIV treatment, and a decline in deliveries with positive maternal HIV status (p-values for trend <0.001). The proportion of women with less than four ANC visits increased to above 30 percent irrespective of HIV status. Use of routine folate/iron increased, corresponding to a decrease in anemia which was strongest in HIV-negative women. Incidence of elective caesarean section (CS) and emergency CS remained unchanged for HIV-positive women (7.1% and 25.5%, respectively, in the last period). Use of invasive procedures declined in both groups of women. Mothers who were young, single, had low education, high parity or lived in the rural area more often had indicators of poor antenatal care.Increasing adherence to national guidelines over time was found for most selected outcomes. Still, a high occurrence of insufficient ANC, anemia and emergency CS call for efforts to explore and identify barriers that hinder optimal care.

Authors
Rebnord, T; Østbye, T; Mmbaga, BT; Mchome, B; Lie, RT; Daltveit, AK
MLA Citation
Rebnord, T, Østbye, T, Mmbaga, BT, Mchome, B, Lie, RT, and Daltveit, AK. "Time trends in management of HIV-positive pregnant women in Northern Tanzania: A registry-based study." PloS one 12.9 (January 2017): e0184362-.
PMID
28957345
Source
epmc
Published In
PloS one
Volume
12
Issue
9
Publish Date
2017
Start Page
e0184362
DOI
10.1371/journal.pone.0184362

Barriers to Engagement in a Workplace Weight Management Program: A Qualitative Study.

To investigate (1) why some participants in a workplace weight management program were more engaged in the program, (2) specific barriers and facilitators for engagement and weight loss, and (3) suggest how workplaces may better engage employees in these programs to improve their effectiveness.Qualitative study (8 focus groups).A large academic university and medical system.Twenty-six (5%) of the 550 employees who participated in a weight management program as part of the Steps to Health study.A trained moderator guided the audio-recorded focus groups.Transcripts were analyzed using the directed content analysis approach.Participants faced numerous barriers to engagement in workplace weight management programs, both within and outside the workplace. Participants viewed the coaches positively and reported that the coaches had a strong influence on their engagement in the program. Participants suggested increased frequency and variety of contact by coaches, on-site group exercise classes, and tailored educational materials.Workplace weight management programs may be improved by being more flexible around participants' schedules and changing needs, by increasing access to affordable, convenient exercise facilities, and by implementing institutional changes that encourage healthy eating and physical activity during the workday. Employers should measure program engagement and solicit participant feedback to ensure that the programs are appropriate and delivered in an optimal manner.

Authors
Clancy, SM; Stroo, M; Schoenfisch, A; Dabrera, T; Østbye, T
MLA Citation
Clancy, SM, Stroo, M, Schoenfisch, A, Dabrera, T, and Østbye, T. "Barriers to Engagement in a Workplace Weight Management Program: A Qualitative Study." American journal of health promotion : AJHP (January 2017): 890117117696373-.
PMID
29214814
Source
epmc
Published In
American journal of health promotion : AJHP
Publish Date
2017
Start Page
890117117696373
DOI
10.1177/0890117117696373

Effects of a portion design plate on food group guideline adherence among hospital staff.

Food group guideline adherence is vital to prevent obesity and diabetes. Various studies have demonstrated that environmental variables influence food intake behaviour. In the present study we examined the effect of a portion design plate with food group portion guidelines demarcated by coloured lines (ETE Plate™). A two-group quasi-experimental design was used to measure proportions of carbohydrate, vegetable and protein portions and user experience in a hospital staff lounge setting in Singapore. Lunch was served on the portion design plate before 12.15 hours. For comparison, a normal plate (without markings) was used after 12.15 hours. Changes in proportions of food groups from 2 months before the introduction of the design plate were analysed in a stratified sample at baseline (859 subjects, all on normal plates) to 1, 3 and 6 months after (in all 1016 subjects on the design plate, 968 subjects on the control plate). A total of 151 participants were asked about their experiences and opinions. Between-group comparisons were performed using t tests. Among those served on the portion design plate at 6 months after its introduction, the proportion of vegetables was 4·71 % (P < 0·001) higher and that of carbohydrates 2·83 % (P < 0·001) lower relative to the baseline. No significant change was found for proteins (-1·85 %). Over 6 months, we observed different change patterns between the different food group proportions. While participants were positive about the portion design plate, they did not think it would influence their personal behaviour. A portion design plate might stimulate food group guideline adherence among hospital staff and beyond.

Authors
de Korne, DF; Malhotra, R; Lim, WY; Ong, C; Sharma, A; Tan, TK; Tan, TC; Ng, KC; Østbye, T
MLA Citation
de Korne, DF, Malhotra, R, Lim, WY, Ong, C, Sharma, A, Tan, TK, Tan, TC, Ng, KC, and Østbye, T. "Effects of a portion design plate on food group guideline adherence among hospital staff." Journal of nutritional science 6 (January 2017): e60-.
PMID
29299308
Source
epmc
Published In
Journal of Nutritional Science
Volume
6
Publish Date
2017
Start Page
e60
DOI
10.1017/jns.2017.60

GEOSPATIAL ANALYSIS OF DENGUE EMERGENCE IN RURAL AREAS IN THE SOUTHERN PROVINCE OF SRI LANKA: 2012-2013

Authors
Mutucumarana, CP; Bodinayake, CK; Nagahawatte, A; Devasiri, V; Kurukulasooriya, R; Anuradha, T; De Silva, AD; Ostbye, T; Woods, CW; Reller, ME; Tillekeratne, LG; Lantos, PM
MLA Citation
Mutucumarana, CP, Bodinayake, CK, Nagahawatte, A, Devasiri, V, Kurukulasooriya, R, Anuradha, T, De Silva, AD, Ostbye, T, Woods, CW, Reller, ME, Tillekeratne, LG, and Lantos, PM. "GEOSPATIAL ANALYSIS OF DENGUE EMERGENCE IN RURAL AREAS IN THE SOUTHERN PROVINCE OF SRI LANKA: 2012-2013." 2017.
Source
wos-lite
Published In
American Journal of Tropical Medicine and Hygiene
Volume
97
Issue
5
Publish Date
2017
Start Page
247
End Page
247

THE 2009 WORLD HEALTH ORGANIZATION DENGUE CLASSIFICATION OVER-ESTIMATES DENGUE DISEASE SEVERITY IN SRI LANKA

Authors
Bodinayake, CK; Tillekeratne, LG; Nagahawatte, A; Mutucumarana, C; Devasiri, V; Kurukulasooriya, R; Ostbye, T; Reller, ME; Woods, CW
MLA Citation
Bodinayake, CK, Tillekeratne, LG, Nagahawatte, A, Mutucumarana, C, Devasiri, V, Kurukulasooriya, R, Ostbye, T, Reller, ME, and Woods, CW. "THE 2009 WORLD HEALTH ORGANIZATION DENGUE CLASSIFICATION OVER-ESTIMATES DENGUE DISEASE SEVERITY IN SRI LANKA." 2017.
Source
wos-lite
Published In
American Journal of Tropical Medicine and Hygiene
Volume
97
Issue
5
Publish Date
2017
Start Page
361
End Page
362

HIGH PREVALENCE OF SUSPECTED NOSOCOMIAL COLONIZATION WITH METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS AT A TERTIARY CARE HOSPITAL IN SOUTHERN SRI LANKA

Authors
Kurukulasooriya, R; Tillekeratne, LG; Wijayaratne, WMDGB; Bodinayake, CK; Rajapakshe, MD; Umesha, BG; Abewickrama, TD; Anuradha, KVT; De Silva, AD; Nicholson, BP; Ostbye, T; Woods, CW; Nagahawatte, A
MLA Citation
Kurukulasooriya, R, Tillekeratne, LG, Wijayaratne, WMDGB, Bodinayake, CK, Rajapakshe, MD, Umesha, BG, Abewickrama, TD, Anuradha, KVT, De Silva, AD, Nicholson, BP, Ostbye, T, Woods, CW, and Nagahawatte, A. "HIGH PREVALENCE OF SUSPECTED NOSOCOMIAL COLONIZATION WITH METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS AT A TERTIARY CARE HOSPITAL IN SOUTHERN SRI LANKA." 2017.
Source
wos-lite
Published In
American Journal of Tropical Medicine and Hygiene
Volume
97
Issue
5
Publish Date
2017
Start Page
143
End Page
143

Computer-Automated Malaria Diagnosis and Quantitation Using Convolutional Neural Networks.

Authors
Mehanian, C; Jaiswal, M; Delahunt, CB; Thompson, C; Horning, MP; Hu, L; McGuire, SK; Ostbye, T; Mehanian, M; Wilson, BK; Champlin, CR; Long, E; Proux, S; Gamboa, D; Chiodini, P; Carter, J; Dhorda, M; Isaboke, D; Ogutu, B; Oyibo, W; Villasis, E; Tun, KM; Bachman, C; Bell, D
MLA Citation
Mehanian, C, Jaiswal, M, Delahunt, CB, Thompson, C, Horning, MP, Hu, L, McGuire, SK, Ostbye, T, Mehanian, M, Wilson, BK, Champlin, CR, Long, E, Proux, S, Gamboa, D, Chiodini, P, Carter, J, Dhorda, M, Isaboke, D, Ogutu, B, Oyibo, W, Villasis, E, Tun, KM, Bachman, C, and Bell, D. "Computer-Automated Malaria Diagnosis and Quantitation Using Convolutional Neural Networks." IEEE Computer Society, 2017.
Source
dblp
Published In
ICCV Workshops
Publish Date
2017
Start Page
116
End Page
125
DOI
10.1109/ICCVW.2017.22

Validity and reliability of the Short Form 36 Health Surveys (SF-36) among patients with spondyloarthritis in Singapore.

The Short Form 36 Health Survey (SF-36) is a popular health-related quality of life (HrQoL) tool. However, few studies have assessed its psychometric properties in patients with spondyloarthritis (SpA). We therefore aimed to assess the reliability and validity of the SF-36 in patients with SpA in Singapore. Cross-sectional data from a registry of 196 SpA patients recruited from a dedicated tertiary referral clinic in Singapore from 2011 to 2014 was used. Analyses were guided by the COnsensus-based Standards for the selection of health Measurement INstruments framework. Internal consistency reliability was assessed using Cronbach's alpha. Construct validity was assessed through 33 a priori hypotheses by correlations of the eight subscales and two summary scores of SF-36 with other health outcomes. Known-group construct validity was assessed by comparison of the means of the subscales and summary scores of the SF-36 of SpA patients and the general population of Singapore using student's t tests. Among 196 patients (155 males (79.0 %), median (range) age: 36 (17-70), 166 Chinese (84.6 %)), SF-36 scales showed high internal consistency ranging from 0.88 to 0.90. Convergent construct validity was supported as shown by fulfillment of all hypotheses. Divergent construct validity was supported, as SF-36 MCS was not associated with PGA, pain and HAQ. Known-group construct validity showed SpA patients had lower scores of 3.8-12.5 when compared to the general population at p < 0.001. This study supports the SF-36 as a valid and reliable measure of HrQoL for use in patients with SpA at a single time point.

Authors
Kwan, YH; Fong, WWS; Lui, NL; Yong, ST; Cheung, YB; Malhotra, R; Østbye, T; Thumboo, J
MLA Citation
Kwan, YH, Fong, WWS, Lui, NL, Yong, ST, Cheung, YB, Malhotra, R, Østbye, T, and Thumboo, J. "Validity and reliability of the Short Form 36 Health Surveys (SF-36) among patients with spondyloarthritis in Singapore." Rheumatology international 36.12 (December 2016): 1759-1765.
PMID
27664139
Source
epmc
Published In
Rheumatology International
Volume
36
Issue
12
Publish Date
2016
Start Page
1759
End Page
1765
DOI
10.1007/s00296-016-3567-3

Older nurses in Singapore: Factors associated with attitudes towards extending working life

Authors
Ang, SY; Ayoob, SBM; Hussain, NBS; Uthaman, T; Adenan, H; Chiang, P; Ong, LT; Fong, MK; Ostbye, T
MLA Citation
Ang, SY, Ayoob, SBM, Hussain, NBS, Uthaman, T, Adenan, H, Chiang, P, Ong, LT, Fong, MK, and Ostbye, T. "Older nurses in Singapore: Factors associated with attitudes towards extending working life." Proceedings of Singapore Healthcare 25.4 (December 2016): 222-229.
Source
crossref
Published In
Proceedings of Singapore Healthcare
Volume
25
Issue
4
Publish Date
2016
Start Page
222
End Page
229
DOI
10.1177/2010105816655553

Association Between Exercise Frequency and Health Care Costs Among Employees at a Large University and Academic Medical Center.

The aim of this study was to evaluate the relationship between exercise frequency and health care costs associated with medical and pharmacy claims among a 10-year employee cohort.The relationship between self-reported exercise (days/week) and health care costs was analyzed with negative binomial regression, using an integrated database involving 32,044 person-years and linking employee demographics, health risk appraisal information, and health insurance claims.An association demonstrating exercise frequency lowering health care costs was present in most medical and prescription drug categories and was strongest among employees reporting 2 to 3 and 4 to 5 days/week of exercise. Increased exercise was associated with statistically significant reductions in endocrine disease costs and gastrointestinal prescription drug costs.This cohort demonstrates lower health care costs in employee populations when exercise frequency is increased. Employers may lower modifiable risk factors for chronic disease and reduce health care costs by promoting exercise among their employee population.

Authors
Caretto, DC; Ostbye, T; Stroo, M; Darcey, DJ; Dement, J
MLA Citation
Caretto, DC, Ostbye, T, Stroo, M, Darcey, DJ, and Dement, J. "Association Between Exercise Frequency and Health Care Costs Among Employees at a Large University and Academic Medical Center." Journal of occupational and environmental medicine 58.12 (December 2016): 1167-1174.
PMID
27930473
Source
epmc
Published In
Journal of Occupational and Environmental Medicine
Volume
58
Issue
12
Publish Date
2016
Start Page
1167
End Page
1174
DOI
10.1097/jom.0000000000000882

Challenges for strengthening the health workforce in the Lao People's Democratic Republic: perspectives from key stakeholders.

The Lao People's Democratic Republic is facing a critical shortage and maldistribution of health workers. Strengthening of the health workforce has been adopted as one of the five priorities of the National Health Sector Strategy (2013-2025). This study aims to identify, explore, and better understand the key challenges for strengthening the Laotian health workforce.This study applied exploratory and descriptive qualitative methods and adapted a working life-span framework. Twenty-three key stakeholders with particular insights into the current situation of the health workforce were purposively recruited for in-depth interviews. Important policy documents were also collected from key informants during the interviews. Thematic analysis was employed for the textual data using MAXQDA 10.The overarching problem is that there is a perceived severe shortage of skilled health workers (doctors, nurses, and midwives) and lab technicians, especially in primary health facilities and rural areas. Key informants also identified five problems: insufficient production of health workers both in quantity and quality, a limited national budget to recruit enough health staff and provide sufficient and equitable salaries and incentives, limited management capacity, poor recruitment for work in rural areas, and lack of well-designed continuing education programs for professional development. These problems are interrelated, both in how the issues arise and in the effect they have on one another.To improve the distribution of health workers in rural areas, strategies for increasing production and strengthening retention should be well integrated for better effectiveness. It is also essential to take the Laotian-specific context into consideration during intervention development and implementation. Furthermore, the government should acknowledge the inadequate health management capacity and invest to improve human resource management capacity at all levels. Finally, assessment of interventions for health workforce strengthening should be developed as early as possible to learn from the experiences and lessons in the Lao People's Democratic Republic.

Authors
Qian, Y; Yan, F; Wang, W; Clancy, S; Akkhavong, K; Vonglokham, M; Outhensackda, S; Østbye, T
MLA Citation
Qian, Y, Yan, F, Wang, W, Clancy, S, Akkhavong, K, Vonglokham, M, Outhensackda, S, and Østbye, T. "Challenges for strengthening the health workforce in the Lao People's Democratic Republic: perspectives from key stakeholders." Human resources for health 14.1 (November 29, 2016): 72-.
PMID
27899109
Source
epmc
Published In
Human Resources for Health
Volume
14
Issue
1
Publish Date
2016
Start Page
72
DOI
10.1186/s12960-016-0167-y

Validity and reliability of the Health Assessment Questionnaire among patients with spondyloarthritis in Singapore.

The Health Assessment Questionnaire (HAQ) is a popular tool used to measure disability. Few studies have assessed its psychometric properties in patients with spondyloarthritis (SpA). We therefore aimed to assess the reliability and validity of the HAQ in patients with SpA in Singapore.Cross-sectional data from a registry of 196 patients with SpA recruited from a dedicated tertiary referral clinic in Singapore from 2011 to 2014 was used. Analyses were guided by the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) framework. Internal consistency reliability was assessed using Cronbach's alpha. Convergent construct validity was assessed by 30 a priori hypotheses through correlation of the summary score and the eight domain scores of the HAQ with other health outcome measures: Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Global Score (BASG), pain, Patient's Global Assessment (PGA) and Short Form-36 Health Survey (SF-36). Divergent construct validity was assessed by poor correlation of HAQ with SF-36 Mental component score (MCS).Among 196 patients (155 males [79.1%] median [range] age: 36 [17-70]; 166 Chinese [84.7%]), the HAQ showed a high internal consistency of 0.78-0.84. Convergent validity was supported by achieving 26 out of the 30 a priori hypotheses. Divergent validity was also established- correlation of SF-36 MCS with seven domains and summary scores of the HAQ were not statistically significant.This study supports the HAQ as a valid and reliable measure of disability for use in patients with SpA.

Authors
Kwan, YH; Fong, W; Lui, NL; Yong, ST; Cheung, YB; Malhotra, R; Thumboo, J; Østbye, T
MLA Citation
Kwan, YH, Fong, W, Lui, NL, Yong, ST, Cheung, YB, Malhotra, R, Thumboo, J, and Østbye, T. "Validity and reliability of the Health Assessment Questionnaire among patients with spondyloarthritis in Singapore." International journal of rheumatic diseases (November 14, 2016).
PMID
27860306
Source
epmc
Published In
International Journal of Rheumatic Diseases
Publish Date
2016
DOI
10.1111/1756-185x.12989

POSITIVE ASPECTS OF CAREGIVING SCALE: PSYCHOMETRIC PROPERTIES IN CAREGIVERS OF ELDERLY SINGAPOREANS

MLA Citation
"POSITIVE ASPECTS OF CAREGIVING SCALE: PSYCHOMETRIC PROPERTIES IN CAREGIVERS OF ELDERLY SINGAPOREANS." The Gerontologist 56.Suppl_3 (November 2016): 44-44.
Source
crossref
Published In
The Gerontologist
Volume
56
Issue
Suppl_3
Publish Date
2016
Start Page
44
End Page
44
DOI
10.1093/geront/gnw162.183

GENDER DIFFERENCES IN OLDER SINGAPOREANS RECEIVING AND PROVIDING SUPPORT WHILE IN NEED

MLA Citation
"GENDER DIFFERENCES IN OLDER SINGAPOREANS RECEIVING AND PROVIDING SUPPORT WHILE IN NEED." The Gerontologist 56.Suppl_3 (November 2016): 227-227.
Source
crossref
Published In
The Gerontologist
Volume
56
Issue
Suppl_3
Publish Date
2016
Start Page
227
End Page
227
DOI
10.1093/geront/gnw162.900

Reliability and Validity of the Short-Form 36 (SF-36) Health Survey in Patients with Spondyloarthritis

Authors
Kwan, Y; Yong, S; Fong, W; Lui, N; Malhotra, R; Ostbye, T; Thumboo, J
MLA Citation
Kwan, Y, Yong, S, Fong, W, Lui, N, Malhotra, R, Ostbye, T, and Thumboo, J. "Reliability and Validity of the Short-Form 36 (SF-36) Health Survey in Patients with Spondyloarthritis." November 2016.
Source
crossref
Published In
Value in Health
Volume
19
Issue
7
Publish Date
2016
Start Page
A854
End Page
A854
DOI
10.1016/j.jval.2016.08.455

Reliability and Validity of the Health Assessment Questionnaire (Haq) in Patients with Spondyloarthritis

Authors
Kwan, Y; Yong, S; Fong, W; Lui, N; Malhotra, R; Thumboo, J; Ostbye, T
MLA Citation
Kwan, Y, Yong, S, Fong, W, Lui, N, Malhotra, R, Thumboo, J, and Ostbye, T. "Reliability and Validity of the Health Assessment Questionnaire (Haq) in Patients with Spondyloarthritis." November 2016.
Source
crossref
Published In
Value in Health
Volume
19
Issue
7
Publish Date
2016
Start Page
A810
End Page
A811
DOI
10.1016/j.jval.2016.08.711

Prevalence of occupational injury and its contributing factors among rubber tappers in Galle, Sri Lanka.

Rubber tapping involves carrying heavy loads, navigating rough terrain, and using sharp tools. However, little is known about occupational injury among this vulnerable working population.To assesses the prevalence, severity, and contributing factors associated with occupational injury among Sri Lankan rubber tappers and to identify possible interventions to improve occupational safety.A questionnaire was administered to 300 Sri Lankan rubber tappers. The associations between tapper characteristics and injury within the last year were examined using log-binomial regression models. Short response answers were analyzed using qualitative content analysis.300 tappers reported 594 injuries in the previous 12 months, and missed 1,080 days of work. The prevalence of one or more injuries was 49%. Factors associated with injury were being female, working an additional job, tapping with a two-handed approach, and depressive symptomology. Qualitative findings suggest three interventions to address injuries: (1) landscaping, (2) personal protective equipment, and (3) provision of eyeglasses.Work-related injuries are common among Sri Lankan rubber tappers. These results highlight the importance of working with and including informal workers in the creation of Sri Lankan occupational health and safety regulations. We believe that the three interventions identified by respondents could help to reduce the risk of occupational injury among rubber tappers.

Authors
Stankevitz, K; Staton, C; Schoenfisch, A; de Silva, V; Tharindra, H; Stroo, M; Ostbye, T
MLA Citation
Stankevitz, K, Staton, C, Schoenfisch, A, de Silva, V, Tharindra, H, Stroo, M, and Ostbye, T. "Prevalence of occupational injury and its contributing factors among rubber tappers in Galle, Sri Lanka." International journal of occupational and environmental health 22.4 (October 27, 2016): 333-340.
PMID
27784205
Source
epmc
Published In
International journal of occupational and environmental health
Volume
22
Issue
4
Publish Date
2016
Start Page
333
End Page
340
DOI
10.1080/10773525.2016.1247026

Emergence of Epidemic Dengue-1 Virus in the Southern Province of Sri Lanka.

Dengue is a frequent cause of acute febrile illness with an expanding global distribution. Since the 1960s, dengue in Sri Lanka has been documented primarily along the heavily urbanized western coast with periodic shifting of serotypes. Outbreaks from 2005-2008 were attributed to a new clade of DENV-3 and more recently to a newly introduced genotype of DENV-1. In 2007, we conducted etiologic surveillance of acute febrile illness in the Southern Province and confirmed dengue in only 6.3% of febrile patients, with no cases of DENV-1 identified. To re-evaluate the importance of dengue as an etiology of acute febrile illness in this region, we renewed fever surveillance in the Southern Province to newly identify and characterize dengue.A cross-sectional surveillance study was conducted at the largest tertiary care hospital in the Southern Province from 2012-2013. A total of 976 patients hospitalized with acute undifferentiated fever were enrolled, with 64.3% male and 31.4% children. Convalescent blood samples were collected from 877 (89.6%). Dengue virus isolation, dengue RT-PCR, and paired IgG ELISA were performed. Acute dengue was confirmed as the etiology for 388 (39.8%) of 976 hospitalizations, with most cases (291, 75.0%) confirmed virologically and by multiple methods. Among 351 cases of virologically confirmed dengue, 320 (91.2%) were due to DENV-1. Acute dengue was associated with self-reported rural residence, travel, and months having greatest rainfall. Sequencing of selected dengue viruses revealed that sequences were most closely related to those described from China and Southeast Asia, not nearby India.We describe the first epidemic of DENV-1 in the Southern Province of Sri Lanka in a population known to be susceptible to this serotype because of prior study. Dengue accounted for 40% of acute febrile illnesses in the current study. The emergence of DENV-1 as the foremost serotype in this densely populated but agrarian population highlights the changing epidemiology of dengue and the need for continued surveillance and prevention.

Authors
Bodinayake, CK; Tillekeratne, LG; Nagahawatte, A; Devasiri, V; Kodikara Arachichi, W; Strouse, JJ; Sessions, OM; Kurukulasooriya, R; Uehara, A; Howe, S; Ong, XM; Tan, S; Chow, A; Tummalapalli, P; De Silva, AD; Østbye, T; Woods, CW; Gubler, DJ; Reller, ME
MLA Citation
Bodinayake, CK, Tillekeratne, LG, Nagahawatte, A, Devasiri, V, Kodikara Arachichi, W, Strouse, JJ, Sessions, OM, Kurukulasooriya, R, Uehara, A, Howe, S, Ong, XM, Tan, S, Chow, A, Tummalapalli, P, De Silva, AD, Østbye, T, Woods, CW, Gubler, DJ, and Reller, ME. "Emergence of Epidemic Dengue-1 Virus in the Southern Province of Sri Lanka." PLoS neglected tropical diseases 10.10 (October 6, 2016): e0004995-.
Website
http://hdl.handle.net/10161/13031
PMID
27711206
Source
epmc
Published In
PLoS neglected tropical diseases
Volume
10
Issue
10
Publish Date
2016
Start Page
e0004995
DOI
10.1371/journal.pntd.0004995

Teaching primary care physicians the 5 A's for discussing weight with overweight and obese adolescents.

We developed an online intervention to teach physicians both MI (addressed in outcomes paper) and the 5 A's (Ask, Advise, Assess, Assist, and Arrange) when discussing weight with overweight/obese adolescents.We audio recorded 527 encounters between adolescents and physicians and coded the 5 A's during weight/BMI discussions. Half of physicians were randomized to receive a tailored, intervention that included their own audio-recorded clips. To examine arm differences, we used multilevel linear mixed-effects models for sum of 5 A's and generalized estimating equations (GEE) models with a logit link for each of the A's separately.Intervention arm physicians used more A's than control physicians (estimated difference=0.6; 95%CI(0.2,1.0);p=0.001). Intervention physicians used Assess (p=0.004), Assist (p=0.001) and Arrange (p=0.02) more when compared to control arm physicians.An online intervention increased physicians' use of the 5 A's when discussing weight with overweight adolescents. These results are promising as the online intervention improved performance for the three A's that are infrequently used (Assess, Assist, and Arrange) yet have the most impact.A tailored online program can increase physicians' use of the 5 A's behavioral counseling approach in clinical practice with adolescents.

Authors
Pollak, KI; Tulsky, JA; Bravender, T; Østbye, T; Lyna, P; Dolor, RJ; Coffman, CJ; Bilheimer, A; Lin, P-H; Farrell, D; Bodner, ME; Alexander, SC
MLA Citation
Pollak, KI, Tulsky, JA, Bravender, T, Østbye, T, Lyna, P, Dolor, RJ, Coffman, CJ, Bilheimer, A, Lin, P-H, Farrell, D, Bodner, ME, and Alexander, SC. "Teaching primary care physicians the 5 A's for discussing weight with overweight and obese adolescents." Patient education and counseling 99.10 (October 2016): 1620-1625.
PMID
27228899
Source
epmc
Published In
Patient Education and Counseling
Volume
99
Issue
10
Publish Date
2016
Start Page
1620
End Page
1625
DOI
10.1016/j.pec.2016.05.007

Providers' response to child eating behaviors: A direct observation study.

Child care providers play an important role in feeding young children, yet little is known about children's influence on providers' feeding practices. This qualitative study examines provider and child (18 months -4 years) feeding interactions. Trained data collectors observed 200 eating occasions in 48 family child care homes and recorded providers' responses to children's meal and snack time behaviors. Child behaviors initiating provider feeding practices were identified and practices were coded according to higher order constructs identified in a recent feeding practices content map. Analysis examined the most common feeding practices providers used to respond to each child behavior. Providers were predominately female (100%), African-American (75%), and obese (77%) and a third of children were overweight/obese (33%). Commonly observed child behaviors were: verbal and non-verbal refusals, verbal and non-verbal acceptance, being "all done", attempts for praise/attention, and asking for seconds. Children's acceptance of food elicited more autonomy supportive practices vs. coercive controlling. Requests for seconds was the most common behavior, resulting in coercive controlling practices (e.g., insisting child eat certain food or clean plate). Future interventions should train providers on responding to children's behaviors and helping children become more aware of internal satiety and hunger cues.

Authors
Tovar, A; Vaughn, AE; Fallon, M; Hennessy, E; Burney, R; Østbye, T; Ward, DS
MLA Citation
Tovar, A, Vaughn, AE, Fallon, M, Hennessy, E, Burney, R, Østbye, T, and Ward, DS. "Providers' response to child eating behaviors: A direct observation study." Appetite 105 (October 2016): 534-541.
PMID
27328098
Source
epmc
Published In
Appetite
Volume
105
Publish Date
2016
Start Page
534
End Page
541
DOI
10.1016/j.appet.2016.06.020

Prevalence and Correlates of Leprosy in a High-Risk Community Setting in Sri Lanka.

Leprosy is caused by the Mycobacterium leprae bacillus. Pockets of high endemicity remain in a number of countries including Sri Lanka, in spite of the fact that elimination has been achieved at the national level. In 2012, in a village in the Puttlam district, dermatologists reported an increase in individuals with leprosy. This village had been established in the 1990s for people displaced from Northern Sri Lanka during a civil war. A comprehensive household survey was conducted by district health officials from June to July 2012, and all household members present during the survey period were examined for leprosy lesions. Patients with suspected leprosy were referred to a dermatology clinic for clinical or pathological confirmation. The prevalence of leprosy was high (511 per 10 000 population). Household contact with another patient with leprosy increased the risk of leprosy (odds ratio = 6.69; P < .001). Continued vigilance is needed to keep leprosy at bay in high-risk communities.

Authors
Dabrera, TME; Tillekeratne, LG; Fernando, MSN; Kasturiaratchi, STK; Østbye, T
MLA Citation
Dabrera, TME, Tillekeratne, LG, Fernando, MSN, Kasturiaratchi, STK, and Østbye, T. "Prevalence and Correlates of Leprosy in a High-Risk Community Setting in Sri Lanka." Asia-Pacific journal of public health 28.7 (October 2016): 586-591.
PMID
27605468
Source
epmc
Published In
Asia Pacific Journal of Public Health
Volume
28
Issue
7
Publish Date
2016
Start Page
586
End Page
591
DOI
10.1177/1010539516666360

Normative Values of Hand Grip Strength for Elderly Singaporeans Aged 60 to 89 Years: A Cross-Sectional Study.

What are normative values for hand grip strength (HGS) for elderly Singaporeans? Which elderly characteristics influence the normative values of HGS for elderly Singaporeans?Nationally representative, cross-sectional observational study.Singapore.A total of 2664 community-dwelling elderly Singaporeans aged 60 to 89 years.HGS was measured in a standing position with elbows extended twice for each hand; a Smedley spring-type dynamometer was used. Elderly characteristics known to affect HGS, including age, sex, hand dominance, height, weight, occupation, education, and ethnicity, were also assessed.We present single-year age, sex-, and hand-specific graphs for normative values (5th, 20th, and 50th percentiles) of HGS. The influence of specific elderly characteristics on the normative values of HGS varies by sex, hand, and considered percentile. We present equations for considered percentiles of HGS that account for such influences.This study uses a large, nationally representative sample to establish normative values for HGS for elderly Singaporeans aged 60 to 89 years. These results will facilitate the interpretation of HGS measurements conducted using Smedley spring-type dynamometers in clinical and research settings in Singapore, and potentially other Asian countries.

Authors
Malhotra, R; Ang, S; Allen, JC; Tan, NC; Østbye, T; Saito, Y; Chan, A
MLA Citation
Malhotra, R, Ang, S, Allen, JC, Tan, NC, Østbye, T, Saito, Y, and Chan, A. "Normative Values of Hand Grip Strength for Elderly Singaporeans Aged 60 to 89 Years: A Cross-Sectional Study." Journal of the American Medical Directors Association 17.9 (September 2016): 864.e1-864.e7.
PMID
27569714
Source
epmc
Published In
Journal of the American Medical Directors Association
Volume
17
Issue
9
Publish Date
2016
Start Page
864.e1
End Page
864.e7
DOI
10.1016/j.jamda.2016.06.013

580 Prevalence and associated factors of work-related injuries among rubber tappers in Sri Lanka

Authors
Stankevitz, K; Staton, C; Schoenfisch, A; Silva, VD; Tharindra, H; Stroo, M; Ostbye, T
MLA Citation
Stankevitz, K, Staton, C, Schoenfisch, A, Silva, VD, Tharindra, H, Stroo, M, and Ostbye, T. "580 Prevalence and associated factors of work-related injuries among rubber tappers in Sri Lanka." September 2016.
Source
crossref
Published In
Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention
Volume
22
Issue
Suppl 2
Publish Date
2016
Start Page
A208.3
End Page
A209
DOI
10.1136/injuryprev-2016-042156.580

500 The effect of comorbidity and gender on in-hospital mortality in patients with falls: results from a large asian tertiary care hospital

Authors
Yang, Y; Ho, E; Thumboo, J; Østbye, T; Ng, YS; Fong, CHJ; Fong, KY
MLA Citation
Yang, Y, Ho, E, Thumboo, J, Østbye, T, Ng, YS, Fong, CHJ, and Fong, KY. "500 The effect of comorbidity and gender on in-hospital mortality in patients with falls: results from a large asian tertiary care hospital." September 2016.
Source
crossref
Published In
Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention
Volume
22
Issue
Suppl 2
Publish Date
2016
Start Page
A181.1
End Page
A181
DOI
10.1136/injuryprev-2016-042156.500

Recruitment of Family Child Care Homes for an Obesity Prevention Intervention Study.

Critical to the success of any intervention study is successful recruitment. The aim of this paper was to examine the recruitment process of a randomized controlled trial evaluating an intervention conducted with family child care home providers. Specifically, the recruitment challenges, the efforts employed to address the challenges, and their impact on participant recruitment are discussed.The study's original recruitment protocol was employed during waves 1 and 2 (out of 5). However, recruitment tracking showed a failure to meet enrollment targets, particularly in wave 2. Low enrollment prompted an all-day retreat to discuss potential revisions and enhancements to recruitment strategies. Four strategies to enhance the recruitment protocol emerged from the retreat: improving recruitment materials to enhance communication, increasing engagement with community partners, addressing provider concerns about participation and study burden, and facilitating parent engagement.The study successfully recruited 166 family child care home providers across the 5 waves. There was a significant impact on the recruitment of waves 3-5 versus waves 1-2 using the enhanced recruitment protocol. There was a dramatic increase in those who "consented" (43% vs. 60%, respectively) and a corresponding decrease in the percent of "interested and eligible" who then "failed to consent" (57% vs. 40%, respectively).Results of these enhanced recruitment strategies demonstrate the many lessons learned about successful recruitment of a difficult-to-reach population, family child care homes; specifically, the importance of building relationships, communicating clearly, and identifying key motivators.

Authors
Ward, DS; Vaughn, AE; Burney, RV; Østbye, T
MLA Citation
Ward, DS, Vaughn, AE, Burney, RV, and Østbye, T. "Recruitment of Family Child Care Homes for an Obesity Prevention Intervention Study." Contemporary clinical trials communications 3 (August 2016): 131-138.
PMID
27617326
Source
epmc
Published In
Contemporary Clinical Trials Communications
Volume
3
Publish Date
2016
Start Page
131
End Page
138
DOI
10.1016/j.conctc.2016.05.001

Telemedicine Versus Standard Follow-Up Care for Diabetes-Related Foot Ulcers: Protocol for a Cluster Randomized Controlled Noninferiority Trial (DiaFOTo).

This paper presents the protocol for an ongoing study to evaluate a telemedicine follow-up intervention for patients with diabetes-related foot ulcers. Diabetes-related foot ulcers represent challenges for patients and the health services. The large increase in the prevalence of diabetes, combined with the aging population, means that the absolute number of patients with diabetes-related foot ulcers is likely to continue to increase. Health care services therefore need to provide close clinical follow-up care for people with diabetes both in primary and specialist care. Information and communication technologies may enable more integrated treatment and care pathways across organizational boundaries. However, we lack knowledge about the effect of telemedicine follow-up and how such services can be optimally organized.To present the design and methods of a study evaluating a telemedicine follow-up intervention for patients with diabetes-related foot ulcers.The study is designed as a cluster randomized controlled trial (noninferiority trial) involving municipalities or municipality districts (clusters) belonging to one clinical site in Western Norway. The study includes patients with type 1 and type 2 diabetes presenting with a new foot ulcer at the initial visit to the clinic. Patients in the intervention group receive telemedicine follow-up care in the community. The key ingredient in the intervention is the close integration between health care levels. The intervention is facilitated by the use of an interactive wound platform consisting of a Web-based ulcer record combined with a mobile phone, enabling counseling and communication between nurses in the community and specialist health care. Patients in the control group receive standard hospital outpatient care. The primary endpoint in the trial is healing time; secondary outcomes include amputation and death, patient-reported outcome measures, and follow-up data on the recurrence of foot ulcers. In addition, qualitative substudies are being performed to provide a more comprehensive evaluation of the ongoing processes during the trial with the patients in the intervention and control groups and those health care professionals either working in primary care or in specialist care delivering the intervention.The project has been funded. The inclusion of patients started in September 2012. Because recruitment goals were not met in the initial period, two more clinical sites have been included to meet sample size requirements. Patient recruitment will continue until June 2016. Data collection in the qualitative substudies has been completed.This telemedicine trial operates in a novel setting and targets patients with diabetes-related foot ulcers during a 12-month follow-up period. The trial addresses whether integrated care using telemedicine between primary and specialist health care can be an equivalent alternative to standard outpatient care.ClinicalTrials.gov NCT01710774; https://clinicaltrials.gov/ct2/show/NCT01710774 (Archived by WebCite at http://www.webcitation.org/6im6KfFov).

Authors
Iversen, MM; Espehaug, B; Hausken, MF; Graue, M; Østbye, T; Skeie, S; Cooper, JG; Tell, GS; Günther, BE; Dale, H; Smith-Strøm, H; Kolltveit, B-CH; Kirkevold, M; Rokne, B
MLA Citation
Iversen, MM, Espehaug, B, Hausken, MF, Graue, M, Østbye, T, Skeie, S, Cooper, JG, Tell, GS, Günther, BE, Dale, H, Smith-Strøm, H, Kolltveit, B-CH, Kirkevold, M, and Rokne, B. "Telemedicine Versus Standard Follow-Up Care for Diabetes-Related Foot Ulcers: Protocol for a Cluster Randomized Controlled Noninferiority Trial (DiaFOTo)." JMIR research protocols 5.3 (July 18, 2016): e148-.
PMID
27430301
Source
epmc
Published In
JMIR Research Protocols
Volume
5
Issue
3
Publish Date
2016
Start Page
e148
DOI
10.2196/resprot.5646

Health-related quality of life in older depressed psychogeriatric patients: one year follow-up.

Knowledge about long-term change in health related quality of life (HQoL) among older adults after hospitalization for treatment of depression has clinical relevance. The aim was firstly to describe the change of HQoL one year after admission for treatment of depression, secondly to explore if improved HQoL was associated with remission of depression at follow-up and lastly to study how HQoL in patients with remission from depression were compared to a reference group of older persons without depression.This study had the one year follow-up information of 108 older patients (≥60 years), all hospitalized for depression at baseline, and a reference sample of 106 community-living older adults (≥60 years) without depression. HQoL was measured using the EuroQol Group's EQ-5D Index and a visual analog scale (EQ-VAS). Depression and remission were diagnosed according to ICD-10. Socio-demographic variables (age, gender, and education), depressive symptom score (Montgomery-Aasberg Depression Rating Scale), cognitive functioning (Mini Mental State Examination scale), instrumental activities of daily living (the Lawton and Brody's Instrumental Activities of Daily Living Scale), and poor general physical health (General Medical Health Rating) were included as covariates.HQoL had improved at follow-up for the total group of depressed patients, as indicated by better scores on the EQ-5D Index and EQ-VAS. In the multivariate linear regression model, improved EQ-5D Index and EQ-VAS was significantly better in those with remission of depression and those with better baseline physical health. In adjusted analyses, the HQoL in patients with remission from depression at follow-up did not differ from the HQoL in a reference group without depression.Older hospital patients with depression who experienced remission one year after admission gained HQoL and their HQoL was comparable with the HQoL in a reference group of older adults without depression when adjusting for differences in socio-demographics and health conditions.

Authors
Helvik, A-S; Corazzini, K; Selbæk, G; Bjørkløf, GH; Laks, J; Šaltytė Benth, J; Østbye, T; Engedal, K
MLA Citation
Helvik, A-S, Corazzini, K, Selbæk, G, Bjørkløf, GH, Laks, J, Šaltytė Benth, J, Østbye, T, and Engedal, K. "Health-related quality of life in older depressed psychogeriatric patients: one year follow-up." BMC geriatrics 16 (July 7, 2016): 131-.
PMID
27388445
Source
epmc
Published In
BMC Geriatrics
Volume
16
Publish Date
2016
Start Page
131
DOI
10.1186/s12877-016-0310-6

Teaching Physicians Motivational Interviewing for Discussing Weight With Overweight Adolescents.

We tested whether an online intervention combined with a patient feedback report improved physicians' use of motivational interviewing (MI) techniques when discussing weight with overweight and obese adolescents.We randomized 46 pediatricians and family physicians and audio recorded 527 patient encounters. Half of the physicians received an individually tailored, online intervention. Then, all physicians received a summary report detailing patient's weight-related behaviors. We coded MI techniques and used multilevel linear mixed-effects models to examine arm differences. We assessed patients' motivation to change and perceived empathy after encounter.We found arm differences in the Intervention Phase and the Summary Report Phase: Empathy (p < .001), MI Spirit (p < .001), open questions (p = .02), and MI consistent behaviors (p = .04). Across all three phases (Baseline, Intervention, and Summary Report), when physicians had higher Empathy scores, patients were more motivated to change diet (p = .03) and physical activity (p = .03). In addition, patients rated physicians as more empathic when physicians used more MI consistent techniques (p = .02).An individually tailored, online intervention coupled with a Summary Report improved physicians' use of MI, which improved the patient experience.

Authors
Pollak, KI; Coffman, CJ; Tulsky, JA; Alexander, SC; Østbye, T; Farrell, D; Lyna, P; Dolor, RJ; Bilheimer, A; Lin, P-H; Bodner, ME; Bravender, TD
MLA Citation
Pollak, KI, Coffman, CJ, Tulsky, JA, Alexander, SC, Østbye, T, Farrell, D, Lyna, P, Dolor, RJ, Bilheimer, A, Lin, P-H, Bodner, ME, and Bravender, TD. "Teaching Physicians Motivational Interviewing for Discussing Weight With Overweight Adolescents." The Journal of adolescent health : official publication of the Society for Adolescent Medicine 59.1 (July 2016): 96-103.
PMID
27155958
Source
epmc
Published In
Journal of Adolescent Health
Volume
59
Issue
1
Publish Date
2016
Start Page
96
End Page
103
DOI
10.1016/j.jadohealth.2016.03.026

Improvements in Functional Exercise Capacity after a Residential Behavioural Change, Diet and Fitness Program for Obese Adults.

Obese adults are at an increased risk for mobility-related problems. National guidelines recommend calorie restrictions and exercise for obese adults as a means to improve functional fitness capacity and to increase mobility. Yet, lifestyle weight loss interventions often fail to measure fitness changes. The aim of this study was to assess whether a 1-month, intensive behavioural change, diet and fitness intervention for overweight and obese adults would result in statistically significant and clinically meaningful changes in functional exercise.A pre-post test design was used in this study. Seventy-two participants (40 women, 32 men; mean baseline body mass index (BMI) = 42.6 + 9.0; mean age = 45.8 + 16.8) completed a modified 6-minute walk test (6MWT), performed on a treadmill, at baseline and at end of treatment.Significant improvements included decreased BMI (2.7 + 1.7 kg m(-2) , p < 0.001) and increased 6MWT distance (66.4 + 73.0 m, p < 0.001). The 6MWT improved by 66 m on average, a reported clinically meaningful difference. Greater improvements in the 6MWT were significantly correlated with greater weight loss and BMI reduction.Our findings suggest that rehabilitation beyond weight loss may be derived from participation in a brief, intensive behavioural change, diet and fitness programme. Physiotherapists are in a prime position to address the physical and motivational challenges participants face while living with severe obesity: targeting functional exercise capacity is one key strategy for addressing immobility associated with obesity. Copyright © 2015 John Wiley & Sons, Ltd.

Authors
Errickson, SP; Kolotkin, RL; Skidmore, MS; Endress, G; Østbye, T; Crosby, R; Eisenson, H
MLA Citation
Errickson, SP, Kolotkin, RL, Skidmore, MS, Endress, G, Østbye, T, Crosby, R, and Eisenson, H. "Improvements in Functional Exercise Capacity after a Residential Behavioural Change, Diet and Fitness Program for Obese Adults." Physiotherapy research international : the journal for researchers and clinicians in physical therapy 21.2 (June 2016): 84-90.
PMID
25781859
Source
epmc
Published In
Physiotherapy Research International
Volume
21
Issue
2
Publish Date
2016
Start Page
84
End Page
90
DOI
10.1002/pri.1623

Validation of the use of serum progesterone cut off value and progesterone - risk of miscarriage index (Prog-RMI) as predictors of adverse pregnancy outcomes among women with threatened miscarriage

Authors
Lek, SM; Ku, CW; Allen, JC; Malhotra, R; Tan, NS; Ostbye, T; Tan, TC
MLA Citation
Lek, SM, Ku, CW, Allen, JC, Malhotra, R, Tan, NS, Ostbye, T, and Tan, TC. "Validation of the use of serum progesterone cut off value and progesterone - risk of miscarriage index (Prog-RMI) as predictors of adverse pregnancy outcomes among women with threatened miscarriage." BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY 123 (June 2016): 73-73.
Source
wos-lite
Published In
Bjog : An International Journal of Obstetrics & Gynaecology
Volume
123
Publish Date
2016
Start Page
73
End Page
73

Are coping strategies and locus of control orientation associated with health-related quality of life in older adults with and without depression?

The aim of this study was to investigate relationships between coping and health related quality of life (HRQoL) in older adults (aged ≥60 years) with and without depression. This cross-sectional study included 144 depressed inpatients from seven psychogeriatric hospital units in Norway and 106 community-living older adults without depression. HRQoL was measured using Euro Qol Group's EQ-5D Index and visual analog scale (EQ-VAS). Two aspects of coping were of primary interest for HRQoL: locus of control (LOC) and ways of coping (WOC). Measures of depressive symptoms, cognitive functioning, instrumental activities of daily living, and general physical health were included as covariates. In linear regression analyses adjusted for age, stronger external LOC was associated with poorer HRQoL in both depressed and non-depressed older adults. In the fully-specified regression models for both groups, the association between stronger external LOC and poorer HRQoL remained significant for the EQ-VAS score but not the EQ-5D Index. WOC was not associated with HRQoL in either group. Total amount of explained variance in fully-specified models was considerably lower in the sample of depressed, hospitalized older adults (17.1% and 15.5% for EQ-5D index and EQ-VAS, respectively), than in the sample of non-depressed, community-based older adults (45.8% and 48.9% for EQ-5D Index and EQ-VAS, respectively). One aspect of coping (LOC orientation) was associated with HRQoL in both depressed and non-depressed older adult samples, and therefore may be an important target for intervention for both groups. Differences in the amount of variance explained in models for the two groups warrant further research.

Authors
Helvik, A-S; Bjørkløf, GH; Corazzini, K; Selbæk, G; Laks, J; Østbye, T; Engedal, K
MLA Citation
Helvik, A-S, Bjørkløf, GH, Corazzini, K, Selbæk, G, Laks, J, Østbye, T, and Engedal, K. "Are coping strategies and locus of control orientation associated with health-related quality of life in older adults with and without depression?." Archives of gerontology and geriatrics 64 (May 2016): 130-137.
PMID
26874239
Source
epmc
Published In
Archives of Gerontology and Geriatrics
Volume
64
Publish Date
2016
Start Page
130
End Page
137
DOI
10.1016/j.archger.2016.01.014

Preventing childhood obesity in early care and education settings: lessons from two intervention studies.

Obesity prevention in young children is a public health priority. In the USA, nearly 10% of children less than 5 years of age are obese, and most attend some form of out-of-home child care. While a number of interventions have been conducted in early care and education settings, few have targeted the youngest children in care or the less formal types of child care like family child care homes. Additionally, only two previous studies provided recommendations to help inform future interventions.This paper presents lessons learned from two distinct intervention studies in early care and education settings to help guide researchers and public health professionals interested in implementing and evaluating similar interventions. We highlight two studies: one targeting children ages 4 to 24 months in child care centres and the other intervening in children 18 months to 4 years in family child care homes. We include lessons from our pilot studies and the ongoing larger trials.To date, our experiences suggest that an intervention should have a firm basis in behaviour change theory; an advisory group should help evaluate intervention materials and plan for delivery; and realistic recruitment goals should recognize economic challenges of the business of child care. A flexible data collection approach and realistic sample size calculations are needed because of high rates of child (and sometimes facility) turnover. An intervention that is relatively easy to implement is more likely to appeal to a wide variety of early care and education providers.Interventions to prevent obesity in early care and education have the potential to reach large numbers of children. It is important to consider the unique features and similarities of centres and family child care homes and take advantage of lessons learned from current studies in order to develop effective, evidence-based interventions.

Authors
Benjamin Neelon, SE; Østbye, T; Hales, D; Vaughn, A; Ward, DS
MLA Citation
Benjamin Neelon, SE, Østbye, T, Hales, D, Vaughn, A, and Ward, DS. "Preventing childhood obesity in early care and education settings: lessons from two intervention studies." Child: care, health and development 42.3 (May 2016): 351-358.
PMID
26987658
Source
epmc
Published In
Child: Care, Health and Development
Volume
42
Issue
3
Publish Date
2016
Start Page
351
End Page
358
DOI
10.1111/cch.12329

The Affordable Care Act, State Policies and Demand for Primary Care Physicians

Authors
Huesch, M; Ostbye, T; Michener, JL
MLA Citation
Huesch, M, Ostbye, T, and Michener, JL. "The Affordable Care Act, State Policies and Demand for Primary Care Physicians." (April 20, 2016).
Source
ssrn
Publish Date
2016

Prevalence and risk factors of musculoskeletal disorders among Sri Lankan rubber tappers.

Rubber tapping exposes workers to risk factors for musculoskeletal disorders (MSDs).This cross-sectional study assessed the prevalence and factors associated with MSDs among Sri Lankan rubber tappers.Questionnaires were administered to 300 rubber tappers to measure MSDs and potential associated factors. Ergonomic exposure levels were measured for 90 tappers using the Quick Exposure Check instrument. MSD prevalence and prevalence ratios were calculated using log-binomial regression.In the past 12 months, 66% of rubber tappers in our sample experienced an MSD. Ergonomic exposure levels were high or very high in the back (94.4%), shoulders (96.7%), and neck (83.3%). Being female, older, Tamil, working two jobs, alternating tapping hands, and depression were significantly associated with increased risk of MSDs.MSDs are common among rubber tappers in Sri Lanka. These results suggest a need for work process modifications to prevent MSDs.

Authors
Stankevitz, K; Schoenfisch, A; de Silva, V; Tharindra, H; Stroo, M; Ostbye, T
MLA Citation
Stankevitz, K, Schoenfisch, A, de Silva, V, Tharindra, H, Stroo, M, and Ostbye, T. "Prevalence and risk factors of musculoskeletal disorders among Sri Lankan rubber tappers." International journal of occupational and environmental health 22.2 (April 19, 2016): 91-98.
PMID
27092589
Source
epmc
Published In
International journal of occupational and environmental health
Volume
22
Issue
2
Publish Date
2016
Start Page
91
End Page
98
DOI
10.1080/10773525.2016.1168073

Identifying types of sex conversations in adolescent health maintenance visits.

Background Physician-adolescent sexuality discussions are a recommended element in health maintenance visits, but such discussions - if they occur at all - probably vary by adolescents' characteristics and situations, and physicians' personal beliefs and training. However, little is known about the form and content of physician-adolescent sexuality discussions during health maintenance visits.We evaluated 245 physician-adolescent sexuality conversations. Using latent class analysis, we identified conversation types based on 13 sexually related topics, which occurred in at least 10% of all conversations.We found four discrete types of sexuality conversations, which differed in terms of emphasis, topics addressed as part of the sexual history and risk assessment, and topics addressed in anticipatory guidance. Inquiry about partnered sexual experience was typical across all conversation types, as well as over half including discussions about body development and protective behaviours. In all four types of conversation, sexuality discussions were typically embedded in a sequence of psychosocial and behavioural topics recommended for health maintenance visits.The presence of sexuality conversations in the majority of these visits suggests that physicians consider sexuality to be an important issue and part of their responsibility in caring for their adolescent patients. However, the substantial variability in the types of sexuality conversations, particularly the notable omissions of many key topics, supports the importance of teaching sexual health interview skills in medical school and residency, and as part of continuing medical education and quality improvement.

Authors
Alexander, SC; Christ, SL; Fortenberry, JD; Pollak, KI; Østbye, T; Bravender, T; Shields, CG
MLA Citation
Alexander, SC, Christ, SL, Fortenberry, JD, Pollak, KI, Østbye, T, Bravender, T, and Shields, CG. "Identifying types of sex conversations in adolescent health maintenance visits." Sexual health 13.1 (February 2016): 22-28.
PMID
26370470
Source
epmc
Published In
Sexual Health
Volume
13
Issue
1
Publish Date
2016
Start Page
22
End Page
28
DOI
10.1071/sh15080

The Effects of Two Workplace Weight Management Programs and Weight Loss on Health Care Utilization and Costs.

The aim of this study was to compare the impact of two worksite weight management (WM [education] and WM+ [education plus counseling]) programs, on health care utilization and costs. Secondarily, compare the intervention groups to an observational control group of obese workers. Finally, evaluate the impact of actual weight loss on these outcomes.Estimate the change in the WM and WM+ intervention groups. Using propensity score adjustment compare the two intervention groups with the observational control group; and compare those who lost weight with those who did not.No significant differences between the two intervention groups, or between these intervention groups and the observational control group. Those who lost weight reduced their overall health care costs.To achieve weight loss and associated morbidity reductions, more extensive and intensive interventions, with more attention to motivation and compliance, are required.

Authors
Østbye, T; Stroo, M; Eisenstein, EL; Dement, JM
MLA Citation
Østbye, T, Stroo, M, Eisenstein, EL, and Dement, JM. "The Effects of Two Workplace Weight Management Programs and Weight Loss on Health Care Utilization and Costs." Journal of occupational and environmental medicine 58.2 (February 2016): 162-169.
PMID
26849260
Source
epmc
Published In
Journal of Occupational and Environmental Medicine
Volume
58
Issue
2
Publish Date
2016
Start Page
162
End Page
169
DOI
10.1097/jom.0000000000000586

High road utilizers surveys compared to police data for road traffic crash hotspot localization in Rwanda and Sri Lanka.

Road traffic crashes (RTCs) are a leading cause of death. In low and middle income countries (LMIC) data to conduct hotspot analyses and safety audits are usually incomplete, poor quality, and not computerized. Police data are often limited, but there are no alternative gold standards. This project evaluates high road utilizer surveys as an alternative to police data to identify RTC hotspots.Retrospective police RTC data was compared to prospective data from high road utilizer surveys regarding dangerous road locations. Spatial analysis using geographic information systems was used to map dangerous locations and identify RTC hotspots. We assessed agreement (Cohen's Kappa), sensitivity/specificity, and cost differences.In Rwanda police data identified 1866 RTC locations from 2589 records while surveys identified 1264 locations from 602 surveys. In Sri Lanka, police data identified 721 RTC locations from 752 records while survey data found 3000 locations from 300 surveys. There was high agreement (97 %, 83 %) and kappa (0.60, 0.60) for Rwanda and Sri Lanka respectively. Sensitivity and specificity are 92 % and 95 % for Rwanda and 74 % and 93 % for Sri Lanka. The cost per crash location identified was $2.88 for police and $2.75 for survey data in Rwanda and $2.75 for police and $1.21 for survey data in Sri Lanka.Surveys to locate RTC hotspots have high sensitivity and specificity compared to police data. Therefore, surveys can be a viable, inexpensive, and rapid alternative to the use of police data in LMIC.

Authors
Staton, CA; De Silva, V; Krebs, E; Andrade, L; Rulisa, S; Mallawaarachchi, BC; Jin, K; RicardoVissoci, J; Østbye, T
MLA Citation
Staton, CA, De Silva, V, Krebs, E, Andrade, L, Rulisa, S, Mallawaarachchi, BC, Jin, K, RicardoVissoci, J, and Østbye, T. "High road utilizers surveys compared to police data for road traffic crash hotspot localization in Rwanda and Sri Lanka." BMC public health 16 (January 20, 2016): 53-.
PMID
26792526
Source
epmc
Published In
BMC Public Health
Volume
16
Publish Date
2016
Start Page
53
DOI
10.1186/s12889-015-2609-1

Association of maternal serum progesterone in early pregnancy with low birth weight and other adverse pregnancy outcomes.

To investigate the association of serum progesterone in first trimester with low birth weight (LBW, birth weight <2500 g) and other adverse pregnancy outcomes including hypertensive disorders of pregnancy, preterm delivery, premature rupture of membranes at term, and preterm premature rupture of membranes in a general population.We conducted a cohort study of 263 women with low-risk singleton intrauterine pregnancies who had a spot serum progesterone measurement in the first trimester in a Singapore tertiary maternity hospital. Study outcomes were retrieved from clinical records. Follow-up data were available for 131 women. Univariate and multivariate logistic regression analyses were performed to assess the association of low serum progesterone (<35 nmol/L) with LBW and other adverse pregnancy outcomes.Low serum progesterone was associated with a significantly increased risk of LBW (adjusted odds ratio: 5.28 [1.02, 27.3]; p=0.047). Low serum progesterone was associated with a significantly increased risk of hypertensive disorders of pregnancy in univariate analysis (unadjusted odds ratio: 8.43 [1.31, 54.2]; p=0.025).Low serum progesterone in the first trimester is a significant risk factor for LBW and possibly other placental dysfunction disorders such as hypertensive disorders of pregnancy. Further studies with larger sample sizes are needed to confirm the associations.

Authors
He, S; Allen, JC; Malhotra, R; Østbye, T; Tan, TC
MLA Citation
He, S, Allen, JC, Malhotra, R, Østbye, T, and Tan, TC. "Association of maternal serum progesterone in early pregnancy with low birth weight and other adverse pregnancy outcomes." The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 29.12 (January 2016): 1999-2004.
PMID
26335272
Source
epmc
Published In
Journal of Maternal-Fetal and Neonatal Medicine (Informa)
Volume
29
Issue
12
Publish Date
2016
Start Page
1999
End Page
2004
DOI
10.3109/14767058.2015.1072159

Application of the Intervention Mapping protocol to develop Keys, a family child care home intervention to prevent early childhood obesity.

Many families rely on child care outside the home, making these settings important influences on child development. Nearly 1.5 million children in the U.S. spend time in family child care homes (FCCHs), where providers care for children in their own residences. There is some evidence that children in FCCHs are heavier than those cared for in centers. However, few interventions have targeted FCCHs for obesity prevention. This paper will describe the application of the Intervention Mapping (IM) framework to the development of a childhood obesity prevention intervention for FCCHsFollowing the IM protocol, six steps were completed in the planning and development of an intervention targeting FCCHs: needs assessment, formulation of change objectives matrices, selection of theory-based methods and strategies, creation of intervention components and materials, adoption and implementation planning, and evaluation planningApplication of the IM process resulted in the creation of the Keys to Healthy Family Child Care Homes program (Keys), which includes three modules: Healthy You, Healthy Home, and Healthy Business. Delivery of each module includes a workshop, educational binder and tool-kit resources, and four coaching contacts. Social Cognitive Theory and Self-Determination Theory helped guide development of change objective matrices, selection of behavior change strategies, and identification of outcome measures. The Keys program is currently being evaluated through a cluster-randomized controlled trialThe IM process, while time-consuming, enabled rigorous and systematic development of intervention components that are directly tied to behavior change theory and may increase the potential for behavior change within the FCCHs.

Authors
Mann, CM; Ward, DS; Vaughn, A; Benjamin Neelon, SE; Long Vidal, LJ; Omar, S; Namenek Brouwer, RJ; Østbye, T
MLA Citation
Mann, CM, Ward, DS, Vaughn, A, Benjamin Neelon, SE, Long Vidal, LJ, Omar, S, Namenek Brouwer, RJ, and Østbye, T. "Application of the Intervention Mapping protocol to develop Keys, a family child care home intervention to prevent early childhood obesity." BMC public health 15 (December 10, 2015): 1227-.
Website
http://hdl.handle.net/10161/11437
PMID
26654726
Source
epmc
Published In
BMC Public Health
Volume
15
Publish Date
2015
Start Page
1227
DOI
10.1186/s12889-015-2573-9

Studying physician-adolescent patient communication in community-based practices: recruitment challenges and solutions.

Practice-based studies are needed to assess how physicians communicate health messages about weight to overweight/obese adolescent patients, but successful recruitment to such studies is challenging. This paper describes challenges, solutions, and lessons learned to recruit physicians and adolescents to the Teen Communicating Health Analyzing Talk (CHAT) study, a randomized controlled trial of a communication skills intervention for primary care physicians to enhance communication about weight with overweight/obese adolescents.A "peer-to-peer" approach was used to recruit physicians, including the use of "clinic champions" who liaised between study leaders and physicians. Consistent rapport and cooperative working relationships with physicians and clinic staff were developed and maintained. Adolescent clinic files were reviewed (HIPAA waiver) to assess eligibility. Parents could elect to opt-out for their children. To encourage enrollment, confidentiality of audio recordings was emphasized, and financial incentives were offered to all participants.We recruited 49 physicians and audio-recorded 391 of their overweight/obese adolescents' visits. Recruitment challenges included 1) physician reticence to participate; 2) variability in clinic operating procedures; 3) variability in adolescent accrual rates; 4) clinic open access scheduling; and 5) establishing communication with parents and adolescents. Key solutions included the use of a "clinic champion" to help recruit physicians, pro-active, consistent communication with clinic staff, and adapting calling times to reach parents and adolescents.Recruiting physicians and adolescents to audio-recorded, practice-based health communication studies can be successful. Anticipated challenges to recruiting can be met with advanced planning; however, optimal solutions to challenges evolve as recruitment progresses.

Authors
Bodner, ME; Bilheimer, A; Gao, X; Lyna, P; Alexander, SC; Dolor, RJ; Østbye, T; Bravender, T; Tulsky, JA; Graves, S; Irons, A; Pollak, KI
MLA Citation
Bodner, ME, Bilheimer, A, Gao, X, Lyna, P, Alexander, SC, Dolor, RJ, Østbye, T, Bravender, T, Tulsky, JA, Graves, S, Irons, A, and Pollak, KI. "Studying physician-adolescent patient communication in community-based practices: recruitment challenges and solutions." International journal of adolescent medicine and health 29.4 (November 13, 2015).
PMID
26565534
Source
epmc
Published In
International journal of adolescent medicine and health
Volume
29
Issue
4
Publish Date
2015
DOI
10.1515/ijamh-2015-0064

Use of Rapid Influenza Testing to Reduce Antibiotic Prescriptions Among Outpatients with Influenza-Like Illness in Southern Sri Lanka.

Acute respiratory tract infections (ARTIs) are a common reason for unnecessary antibiotic prescriptions worldwide. Our objective was to determine if providing access to rapid influenza test results could reduce antibiotic prescriptions for ARTIs in a resource-limited setting. We conducted a prospective, pre-post study from March 2013 to October 2014. Outpatients presenting to a hospital in Sri Lanka were surveyed for influenza-like illness-onset of fever ≥ 38.0°C and cough in prior 7 days. Enrolled patients were administered a structured questionnaire, physical examination, and nasal/nasopharyngeal sampling for rapid influenza A/B testing. Influenza test results were released only during phase 2 (January-October 2014). We enrolled 571 patients with ILI-316 in phase 1 and 241 in phase 2. The proportion positive for influenza was 46.5% in phase 1 and 28.6% in phase 2, P < 0.001. Between phases, antibiotic prescriptions decreased from 81.3% to 69.3% (P = 0.001) among all patients and from 83.7% to 62.3% (P = 0.001) among influenza-positive patients. On multivariable analysis, a positive influenza result during phase 2 was associated with lower odds of antibiotic prescriptions (OR = 0.50, 95% CI = 0.26-0.95). This prospective study suggests that providing access to rapid influenza testing may reduce unnecessary antibiotic prescriptions in resource-limited settings.

Authors
Tillekeratne, LG; Bodinayake, CK; Nagahawatte, A; Vidanagama, D; Devasiri, V; Arachchi, WK; Kurukulasooriya, R; De Silva, AD; Østbye, T; Reller, ME; Woods, CW
MLA Citation
Tillekeratne, LG, Bodinayake, CK, Nagahawatte, A, Vidanagama, D, Devasiri, V, Arachchi, WK, Kurukulasooriya, R, De Silva, AD, Østbye, T, Reller, ME, and Woods, CW. "Use of Rapid Influenza Testing to Reduce Antibiotic Prescriptions Among Outpatients with Influenza-Like Illness in Southern Sri Lanka." The American journal of tropical medicine and hygiene 93.5 (November 2015): 1031-1037.
PMID
26283748
Source
epmc
Published In
American Journal of Tropical Medicine and Hygiene
Volume
93
Issue
5
Publish Date
2015
Start Page
1031
End Page
1037
DOI
10.4269/ajtmh.15-0269

The Relationship of Socioeconomic and Behavioral Risk Factors With Trends of Overweight in Korea.

OBJECTIVES: Previous studies have shown that overweight (including obesity) has increased significantly in Korea in recent decades. However, it remains unclear whether this change has been uniform among all Koreans and to what extent socioeconomic and behavioral factors have contributed to this increase. METHODS: Changes in overweight were estimated using data from the 1998, 2001, 2005, 2007-2009, and 2010-2012 Korea National Health and Nutrition Examination Survey (n=55 761). RESULTS: Overweight increased significantly among men but not among women between 1998 and 2012. Changes in socioeconomic and behavioral factors over the time period were not associated with overall trends for both men and women. However, we found significant differences in the prevalence of overweight relative to key risk factors. For men, overweight increased at a significantly greater rate among the non-exercising (predicted probability [PP] from 0.23 to 0.32] and high-calorie (PP from 0.18 to 0.37) groups compared to their active and lower-calorie counterparts, respectively. For women, overweight increased only among the non-exercising (PP from 0.27 to 0.28) and low-income (PP from 0.31 to 0.36) groups during this period. CONCLUSIONS: These findings suggest that programs aimed at reducing overweight should target Korean men and women in specific socioeconomic and behavioral risk groups differentially.

Authors
Shin, JH; Dupre, ME; Østbye, T; Murphy, G; Silberberg, M
MLA Citation
Shin, JH, Dupre, ME, Østbye, T, Murphy, G, and Silberberg, M. "The Relationship of Socioeconomic and Behavioral Risk Factors With Trends of Overweight in Korea." J Prev Med Public Health 48.6 (November 2015): 310-318.
PMID
26639745
Source
pubmed
Published In
Journal of Preventive Medicine and Public Health
Volume
48
Issue
6
Publish Date
2015
Start Page
310
End Page
318
DOI
10.3961/jpmph.15.001

The Effect of Parental Presence on Weight-Related Discussions Between Physicians and Their Overweight Adolescent Patients.

Authors
Østbye, T; Lyna, P; Bodner, ME; Alexander, SC; Coffman, C; Tulsky, JA; Dolor, R; Pollak, K
MLA Citation
Østbye, T, Lyna, P, Bodner, ME, Alexander, SC, Coffman, C, Tulsky, JA, Dolor, R, and Pollak, K. "The Effect of Parental Presence on Weight-Related Discussions Between Physicians and Their Overweight Adolescent Patients." Clinical pediatrics 54.12 (October 2015): 1218-1220.
PMID
25575503
Source
epmc
Published In
Clinical Pediatrics
Volume
54
Issue
12
Publish Date
2015
Start Page
1218
End Page
1220
DOI
10.1177/0009922814566027

Descriptive study of the psychosocial and physical environments of school in relation to violence among adolescents in the Gampaha District of Sri Lanka

Authors
Wijeratne, MP; Seneviratne, R; Gunawardena, N; Østbye, T; Lynch, C
MLA Citation
Wijeratne, MP, Seneviratne, R, Gunawardena, N, Østbye, T, and Lynch, C. "Descriptive study of the psychosocial and physical environments of school in relation to violence among adolescents in the Gampaha District of Sri Lanka." Sri Lanka Journal of Child Health 44.3 (September 12, 2015): 138-138.
Source
crossref
Published In
Sri Lanka Journalof Child Health
Volume
44
Issue
3
Publish Date
2015
Start Page
138
End Page
138
DOI
10.4038/sljch.v44i3.8009

The Relationship Between the Use of a Worksite Medical Home and ED Visits or Hospitalizations

Authors
Stroo, M; Conover, C; Adcock, G; Myneni, R; Olaleye, D; Østbye, T
MLA Citation
Stroo, M, Conover, C, Adcock, G, Myneni, R, Olaleye, D, and Østbye, T. "The Relationship Between the Use of a Worksite Medical Home and ED Visits or Hospitalizations." INQUIRY: The Journal of Health Care Organization, Provision, and Financing 52 (September 7, 2015): 004695801560960-004695801560960.
Source
crossref
Published In
Inquiry : a journal of medical care organization, provision and financing
Volume
52
Publish Date
2015
Start Page
004695801560960
End Page
004695801560960
DOI
10.1177/0046958015609608

Racial Differences in Obesity-Related Risk Factors Between 2-Year-Old Children Born of Overweight Mothers.

Investigate racial differences in a range of obesity-related socio-behavioral risk factors in children born of obese mothers.142 Black and 151 White 2-year-old children and their parents were surveyed on their physical activity environment, food environment, parental role modeling, eating behaviors, feeding practices, child physical activity, dietary intake, and eating behaviors; body mass index (BMI) for parents and children (BMI z-score) were calculated.In bivariate analyses, Black families reported significantly more risk factors for early-childhood obesity than White families, including greater availability of soda, more television viewing, and poorer dietary intake. In multivariate analyses adjusting for maternal and socioeconomic factors, the differences between Black and White families on factors including television watching and dietary intake remained significant.These data show a greater number of risk factors for obesity among Black children and their families compared with White children even after adjustment for maternal BMI and socioeconomic status.

Authors
Fuemmeler, BF; Stroo, M; Lee, C-T; Bazemore, S; Blocker, B; Østbye, T
MLA Citation
Fuemmeler, BF, Stroo, M, Lee, C-T, Bazemore, S, Blocker, B, and Østbye, T. "Racial Differences in Obesity-Related Risk Factors Between 2-Year-Old Children Born of Overweight Mothers." Journal of pediatric psychology 40.7 (August 2015): 649-656.
PMID
25797946
Source
epmc
Published In
Journal of Pediatric Psychology
Volume
40
Issue
7
Publish Date
2015
Start Page
649
End Page
656
DOI
10.1093/jpepsy/jsv023

Occupational risk factors for low back pain among drivers of three-wheelers in Sri Lanka.

Approximately 5% of all households in Sri Lanka operate a three-wheeler as their primary source of income. However, very little is known about the occupational health risks associated with driving these vehicles.The aim of this study was to assess occupational risk factors, including the number of hours worked associated with the 4-week prevalence of low back pain (LBP) among drivers of three-wheelers.Questionnaires were administered to 200 full-time drivers of three-wheelers from the Galle District in Sri Lanka. Occupational, psychological, socio-demographic, lifestyle, and anthropometric variables were collected. Univariate and multivariate analysis were used to investigate the correlation between occupational risk factors of the prevalence of LBP.15·5% of respondents reported experiencing LBP in the previous 4 months. Univariate analysis revealed that the number of hours worked per week, feeling pressure to compete with other drivers, and perceived stress scale scores were significantly associated with the 4-week prevalence of LBP. Multivariate analysis found that the number of hours worked per week and engine type were significantly associated with LBP.LBP is common among drivers of three-wheelers in Sri Lanka. Long work hours and two-stroke engines were significantly associated with LBP. Results from this study point towards a role for educational, behavioral health, and policy interventions to help prevent and reduce LBP among these drivers.

Authors
Noda, M; Malhotra, R; DeSilva, V; Sapukotana, P; DeSilva, A; Kirkorowicz, J; Allen, J; Østbye, T
MLA Citation
Noda, M, Malhotra, R, DeSilva, V, Sapukotana, P, DeSilva, A, Kirkorowicz, J, Allen, J, and Østbye, T. "Occupational risk factors for low back pain among drivers of three-wheelers in Sri Lanka." International journal of occupational and environmental health 21.3 (July 2015): 216-224.
PMID
25133353
Source
epmc
Published In
International journal of occupational and environmental health
Volume
21
Issue
3
Publish Date
2015
Start Page
216
End Page
224
DOI
10.1179/2049396714y.0000000071

Worksite medical home: health services use and claim costs.

To examine the relationship among use of an on-site employer-provided primary care medical home, and health services use and health plan costs for inpatient and outpatient services and pharmaceuticals.The study was a retrospective observational analysis of health plan claims, human resources data, and Health Care Center (HCC) encounters.Three years of data for employees and dependents designating the HCC as their primary care provider (HCC major users) were compared with data from 2 comparison groups: "casual" HCC users and HCC nonusers. The outcomes of interest were: 1) health services utilization, and 2) monetized use of the health plan. Secondary data from an employer-provided Health Care Center (HCC).After adjusting for several potential confounders, HCC major users had less use of external healthcare services than the comparison groups (employees had 2.7 fewer external encounters than HCC casual users [P < .001] and 1.2 fewer external encounters than nonusers [P < .001]; dependents had 3.5 fewer external encounters than HCC casual users [P < .001] and 1.9 fewer external encounters than non-users [P < .001]). Annual monetized use of the health plan for employees and dependents was highest for HCC casual users relative to HCC major users (employees: $482 greater, P < .01; dependents: $598 greater, P < .001).Employees and their dependents who were "casual users" of the HCC had the highest claims costs and use of outside healthcare services. Additional research is needed to assess the extent to which employees' utilization of services at on-site primary care medical homes affects employee health outcomes, resulting in potential effects on company healthcare plan expenditures, worker productivity, and return on investment.

Authors
Conover, C; Namenek Brouwer, R; Adcock, G; Olaleye, D; Shipway, J; Østbye, T
MLA Citation
Conover, C, Namenek Brouwer, R, Adcock, G, Olaleye, D, Shipway, J, and Østbye, T. "Worksite medical home: health services use and claim costs." The American journal of managed care 21.7 (July 2015): e422-e429.
Website
http://hdl.handle.net/10161/11442
PMID
26295270
Source
epmc
Published In
American Journal of Managed Care
Volume
21
Issue
7
Publish Date
2015
Start Page
e422
End Page
e429

Associations between Benzodiazepine Use and Neuropsychological Test Scores in Older Adults.

Benzodiazepines are widely prescribed for anxiety, although use of this class of medications has been associated with dependency and cognitive changes. This article describes the study in which we investigated the relationship between the class of benzodiazepine available for use and associated performance on neuropsychological tests in a community sample of 1,754 older Canadians from the Canadian Study of Health and Aging. Benzodiazepines were classified as short-, intermediate-, and long-acting. Associations were calculated between each class of benzodiazepine and eight neuropsychological measures, using multiple regression analysis and controlling for demographic variables. Results showed different effects of the co-variates across the three drug classes, and short half-life benzodiazepines were not associated with any neuropsychological measure. Intermediate half-life and long half-life benzodiazepine use were each associated with two measures. Increased focus on specific domains of cognitive function is needed to improve our understanding of how benzodiazepine use influences cognition.

Authors
Helmes, E; Østbye, T
MLA Citation
Helmes, E, and Østbye, T. "Associations between Benzodiazepine Use and Neuropsychological Test Scores in Older Adults." Canadian journal on aging = La revue canadienne du vieillissement 34.2 (June 2015): 207-214.
PMID
25790264
Source
epmc
Published In
Canadian journal on aging = La revue canadienne du vieillissement
Volume
34
Issue
2
Publish Date
2015
Start Page
207
End Page
214
DOI
10.1017/s0714980815000082

Disclosure of Sexual Intercourse by Teenagers: Agreement Between Telephone Survey Responses and Annual Visit Disclosures.

Physicians can help guide teenagers in their emerging sexuality; however, teens rarely inform physicians about their sexual activity.We audio-recorded annual visits between 365 teenagers and 49 physicians. Before the recorded visit, the teens were asked in a confidential telephone survey whether they had ever engaged in sexual intercourse. Recordings were coded for teenage disclosures about previous sexual intercourse. We measured agreement between telephone survey responses and annual visit disclosures, and examined factors associated with agreement between the two.Fifty-six teenagers (15%) reported previous sexual intercourse in either the telephone survey or to their physician. Among those who reported sexual intercourse, 57% shared this information to both the telephone survey and their physician (κ = .72, confidence interval = 0.63-0.82).Although a slight majority of teenagers disclosed their sexual activity to both the telephone survey and their doctor, a significant number disclosed to just one source.

Authors
Alexander, SC; Fortenberry, JD; Pollak, KI; Østbye, T; Bravender, T; Tulsky, JA; Dolor, R; Shields, CG
MLA Citation
Alexander, SC, Fortenberry, JD, Pollak, KI, Østbye, T, Bravender, T, Tulsky, JA, Dolor, R, and Shields, CG. "Disclosure of Sexual Intercourse by Teenagers: Agreement Between Telephone Survey Responses and Annual Visit Disclosures." Clinical pediatrics 54.6 (June 2015): 529-533.
PMID
25857726
Source
epmc
Published In
Clinical Pediatrics
Volume
54
Issue
6
Publish Date
2015
Start Page
529
End Page
533
DOI
10.1177/0009922815580074

A community-based intervention increases physical activity and reduces obesity in school-age children in North Carolina.

Community-based interventions are promising approaches to obesity prevention, but few studies have prospectively evaluated them. The aim of this study was to evaluate a natural experiment—a community intervention designed to promote active living and decrease obesity within a small southern town.In 2011, community leaders implemented the Mebane on the Move intervention—a community-wide effort to promote physical activity (PA) and decrease obesity among residents of Mebane, North Carolina. We measured child PA and BMI before and after the intervention, using a nearby town not implementing an intervention as the comparison. In total, we assessed 64 children from Mebane and 40 from the comparison community 6 months before, as well as 34 and 18 children 6 months after the intervention. We assessed PA with accelerometers worn for 7 days and calculated BMI z-scores using children's height and weight. We conducted multivariable linear regressions examining pre- to postintervention change in minutes of PA and BMI z-score, adjusting for confounders.At follow-up, children in Mebane modestly increased their moderate-to-vigorous PA (1.3 minutes per hour; 95% confidence interval (CI): 0.2, 2.3; p=0.03) and vigorous activity (0.8 minutes per hour; 95% CI: 0.1, 1.5; p=0.04) more than comparison children. In intervention children, BMI z-scores decreased 0.5 units (kg/m(2); 95% CI: -0.9, -0.02; p=0.045), compared to children in the comparison community.We observed positive effects on PA level and weight status of children in Mebane, despite high rates of attrition, suggesting that the community-based intervention may have been successful.

Authors
Benjamin Neelon, SE; Namenek Brouwer, RJ; Østbye, T; Evenson, KR; Neelon, B; Martinie, A; Bennett, G
MLA Citation
Benjamin Neelon, SE, Namenek Brouwer, RJ, Østbye, T, Evenson, KR, Neelon, B, Martinie, A, and Bennett, G. "A community-based intervention increases physical activity and reduces obesity in school-age children in North Carolina." Childhood obesity (Print) 11.3 (June 2015): 297-303.
Website
http://hdl.handle.net/10161/11436
PMID
25938983
Source
epmc
Published In
Childhood Obesity
Volume
11
Issue
3
Publish Date
2015
Start Page
297
End Page
303
DOI
10.1089/chi.2014.0130

Is there a multiplicative adverse effect of cardiovascular and kidney disease on neuropsychological measures?

Increasing age is accompanied by increased incidence and comorbidity of various chronic diseases. Many of these conditions, such as cardiovascular and kidney disease, can lead to declines in cognitive functioning. A simple additive effect may be commonly assumed. We here evaluate the hypothesis that such effects may be multiplicative/interactive rather than simply additive, resulting in disproportionate decrements in performance on tests of different cognitive functions. Participants were the 1,782 Canadians aged 65 years and older who completed the clinical assessment of the national Canadian Study of Health and Aging and who were without dementia. Participants were categorized as having either kidney disease, cardiovascular disease, neither, or both. Scores on a measure of verbal fluency showed the predicted interaction effects, but not in the predicted pattern of worst performance in the group with both disorders. Reasons for the relative lack of observed main effects of disease and multiplicative interactions, such as the exclusion of people with dementia and nature of the sample from the community, are discussed.

Authors
Helmes, E; Østbye, T; Steenhuis, R
MLA Citation
Helmes, E, Østbye, T, and Steenhuis, R. "Is there a multiplicative adverse effect of cardiovascular and kidney disease on neuropsychological measures?." Applied neuropsychology. Adult 22.3 (May 2015): 209-214.
PMID
25275656
Source
epmc
Published In
Applied Neuropsychology Adult
Volume
22
Issue
3
Publish Date
2015
Start Page
209
End Page
214
DOI
10.1080/23279095.2014.908379

Micronized Progesterone Compared With Dydrogesterone for Threatened Miscarriage

Authors
Siew, S; Yan Hui, CY; Tan, TC; Allen, JC; Malhotra, R; Ostbye, T
MLA Citation
Siew, S, Yan Hui, CY, Tan, TC, Allen, JC, Malhotra, R, and Ostbye, T. "Micronized Progesterone Compared With Dydrogesterone for Threatened Miscarriage." May 2015.
Source
crossref
Published In
Obstetrics & Gynecology (Elsevier)
Volume
125
Publish Date
2015
Start Page
104S
End Page
104S
DOI
10.1097/01.AOG.0000463637.28791.c1

Innovative bridging of the rural-urban divide: comparison of scope, safety, and impact of collaborative rural surgery camps and an urban surgical program.

In medically under-resourced regions worldwide, non-permanent surgery programs or camps have been conducted to expand access to surgical services. Surgery camp programs have been reported in rural India, primarily in the ophthalmic and obstetric fields; however, the provision of general surgical services in these settings is largely unknown.A 12-month retrospective review of non-ambulatory procedures performed at a rural hospital surgery camp program and at an urban hospital in Maharashtra, India, was completed to characterize relative differences in procedural activity, frequency and severity of perioperative complications, and to evaluate efficacy of care.A total of 449 cases performed in rural hospital surgery camps were compared with 344 cases performed in an urban hospital during the course of the study period. The majority of rural surgical cases were elective and of intermediate complexity. Approximately 4% of rural cases were complex-major compared to 17% of urban cases. Intraoperative complications occurred in 0.2% rural cases compared to 5.5% of urban cases; p = 0.01. Postoperative complications were predominantly low grade in both groups. The postoperative complication rate was higher among rural surgical patients (43.4%; 23.5%; p < 0.01), though the Surgical Risk Score was significantly lower in this group (p < 0. 01). Rural surgery camp activity over 12 months achieved diagnostic and/or therapeutic goals in 92.2% of procedures and rendered 1.74-2.69 disability-adjusted life-years (DALYs) averted per patient.Rural general surgery camps can safely and effectively provide a wide range of surgical services under appropriate collaborative and clinical conditions. Surgery camps may be a safe, temporizing solution to unmet needs until substantial gains in rural healthcare are realized.

Authors
Belle, JM; Bang, RA; Kelkar, D; Østbye, T; Lagoo-Deenadayalan, SA
MLA Citation
Belle, JM, Bang, RA, Kelkar, D, Østbye, T, and Lagoo-Deenadayalan, SA. "Innovative bridging of the rural-urban divide: comparison of scope, safety, and impact of collaborative rural surgery camps and an urban surgical program." World journal of surgery 39.4 (April 2015): 871-878.
PMID
25002242
Source
epmc
Published In
World Journal of Surgery
Volume
39
Issue
4
Publish Date
2015
Start Page
871
End Page
878
DOI
10.1007/s00268-014-2678-9

Neighborhood socioeconomic status and the prevalence of stroke and coronary heart disease in rural China: a population-based study.

Lower neighborhood-level socioeconomic status (SES) is associated with an increased risk of vascular disease in developed countries.This study aims to identify village- and individual-level determinants of stroke and coronary heart disease (CHD) in a rural Chinese population.We analyzed data from a population-based survey of 14,424 rural Chinese adults aged over 40 years from 54 villages. Primary outcomes were stroke and coronary heart disease (CHD) prevalence. Village-level SES was determined from the Chinese government's official statistical yearbook. Individual-level characteristics were obtained by in-person interviews. Prevalence rate ratios (RRs) and 95% confidence intervals (95% CIs) were calculated using generalized linear mixed models with log-link function to explore associations of village-level SES and individual social, demographic, and cardiovascular risk factors with stroke or CHD. Variance was expressed using the median rate ratio (MRR) and interval rate ratio (IRR).Village accounted for significant variability in the prevalence of stroke (MRR = 1.70; 95% CI: 1.42-1.94; P < 0.05) and CHD (MRR = 1.59; 95% CI: 1.35-1.78, P < 0.05), with village-level income alone accounting for 10% and 13.5% of between-village variation in stroke and CHD, respectively. High-income villages were at higher risk of both stroke (RR = 1.69, 95% CI: 1.09-2.62) and CHD (RR = 1.63, 95% CI: 1.13-2.34) than lower-income villages. Among individual-level risk factors, hypertension was associated with a higher prevalence of stroke (RR = 2.33, 95% CI: 1.93-2.80) than CHD (RR = 1.58, 95% CI: 1.38-1.82), whereas obesity was only associated with CHD (RR = 1.43, 95% CI: 1.23-1.66). In addition, there was an interaction between age and income; residents of higher-income villages below age 60 had a higher prevalence of CHD (RR = 1.58, 95% CI: 1.15-2.18) but not stroke.There were differences in vascular risk across rural villages in China, with higher lifetime stroke and CHD prevalence in higher-income villages. For CHD, neighborhood effects were stronger among younger residents of high-income villages. The results may have implications for public health interventions targeting populations at risk.

Authors
Tang, X; Laskowitz, DT; He, L; Østbye, T; Bettger, JP; Cao, Y; Li, N; Li, J; Zhang, Z; Liu, J; Yu, L; Xu, H; Hu, Y; Goldstein, LB
MLA Citation
Tang, X, Laskowitz, DT, He, L, Østbye, T, Bettger, JP, Cao, Y, Li, N, Li, J, Zhang, Z, Liu, J, Yu, L, Xu, H, Hu, Y, and Goldstein, LB. "Neighborhood socioeconomic status and the prevalence of stroke and coronary heart disease in rural China: a population-based study." International journal of stroke : official journal of the International Stroke Society 10.3 (April 2015): 388-395.
PMID
25088683
Source
epmc
Published In
International Journal of Stroke
Volume
10
Issue
3
Publish Date
2015
Start Page
388
End Page
395
DOI
10.1111/ijs.12343

THE TEEN CHAT TRIAL: TEACHING PCPS MI TO IMPROVE WEIGHT DISCUSSIONS WITH OVERWEIGHT ADOLESCENTS

Authors
Pollak, KI; Coffman, CJ; Tulsky, JA; Alexander, SC; Ostbye, T; Farrell, D; Lyna, P; Dolor, RJ; Bilheimer, AK; Bodner, ME; Bravender, T
MLA Citation
Pollak, KI, Coffman, CJ, Tulsky, JA, Alexander, SC, Ostbye, T, Farrell, D, Lyna, P, Dolor, RJ, Bilheimer, AK, Bodner, ME, and Bravender, T. "THE TEEN CHAT TRIAL: TEACHING PCPS MI TO IMPROVE WEIGHT DISCUSSIONS WITH OVERWEIGHT ADOLESCENTS." ANNALS OF BEHAVIORAL MEDICINE 49 (April 2015): S82-S82.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
49
Publish Date
2015
Start Page
S82
End Page
S82

Extent and correlates of change in anthropometric and fitness outcomes among participants in a corporate team-based weight loss challenge in Singapore: lose to win 2009.

The authors describe a national corporate team-based weight loss intervention targeting groups of overweight/obese employees and assess its effectiveness. A 12-week weight loss program comprising nutrition education and physical activity sessions, enhanced by a nationwide media campaign, was organized by the Singapore Health Promotion Board. A total of 285 participants, forming 72 teams (1 per workplace), had their anthropometric (weight, body mass index [BMI], and body fat percentage) and fitness (fitness index score based on UKK 2-km walk test) measurements taken pre-intervention and post-intervention. Average decreases, from baseline to end of intervention, in weight, BMI, and body fat percentage were 3.58 kg, 1.32 kg/m(2), and 2.14%, respectively. The fitness index score increased by 34.1 units. Greater participation in physical activity and nutrition education sessions was associated with more beneficial anthropometric and fitness changes. The intervention was well received and effective in producing short-term weight loss. Further research needs to be done to ascertain its long-term effectiveness and generalizability.

Authors
Vasquez, K; Malhotra, R; Østbye, T; Chan, MF; Amin, H; Khoo, G; Choo, L; Chew, L; Thilagaratnam, S
MLA Citation
Vasquez, K, Malhotra, R, Østbye, T, Chan, MF, Amin, H, Khoo, G, Choo, L, Chew, L, and Thilagaratnam, S. "Extent and correlates of change in anthropometric and fitness outcomes among participants in a corporate team-based weight loss challenge in Singapore: lose to win 2009." Asia Pac J Public Health 27.2 (March 2015): NP425-NP436.
PMID
22887805
Source
pubmed
Published In
Asia Pacific Journal of Public Health
Volume
27
Issue
2
Publish Date
2015
Start Page
NP425
End Page
NP436
DOI
10.1177/1010539512455044

Perceived barriers to and ideas for weight control interventions in Malay homemakers: results from focus groups.

OBJECTIVE: To develop a better understanding of perceived barriers to and ideas for weight loss and maintenance among Malay homemakers in Singapore. METHODS: Interventions for weight management were reviewed, and 5 focus groups were conducted among overweight and obese Malay homemakers (n = 24) to explore barriers to and concepts and ideas pertaining to weight loss and maintenance. RESULTS: Barriers identified included the lack of time, finances, and motivation. Ideas that were most appealing included free health screening, workshops on how best to manage children and family, regular fun group activities, monetary incentives for participation in activities for healthy living, and flexible part-time jobs. CONCLUSION: The focus groups provided useful insights pointing toward possible interventions that could appeal to Malay homemakers in Singapore. The most appealing approaches were those that were time flexible and had the least financial burden or had a financial benefit.

Authors
Ng, LWC; Malhotra, R; Lai, D; Tai, ES; Østbye, T
MLA Citation
Ng, LWC, Malhotra, R, Lai, D, Tai, ES, and Østbye, T. "Perceived barriers to and ideas for weight control interventions in Malay homemakers: results from focus groups." Asia Pac J Public Health 27.2 (March 2015): NP552-NP561.
PMID
23482708
Source
pubmed
Published In
Asia Pacific Journal of Public Health
Volume
27
Issue
2
Publish Date
2015
Start Page
NP552
End Page
NP561
DOI
10.1177/1010539513479966

Short-term trajectories of use of a caloric-monitoring mobile phone app among patients with type 2 diabetes mellitus in a primary care setting.

Self-management plays an important role in maintaining good control of diabetes mellitus, and mobile phone interventions have been shown to improve such self-management. The Health Promotion Board of Singapore has created a caloric-monitoring mobile health app, the "interactive Diet and Activity Tracker" (iDAT).The objective was to identify and describe short-term (8-week) trajectories of use of the iDAT app among patients with type 2 diabetes mellitus in a primary care setting in Singapore, and identify patient characteristics associated with each trajectory.A total of 84 patients with type 2 diabetes mellitus from a public primary care clinic in Singapore who had not previously used the iDAT app were enrolled. The app was demonstrated and patients' weekly use of the app was monitored over 8 weeks. Weekly use was defined as any record in terms of food entry or exercise workout entry in that week. Information on demographics, diet and exercise motivation, diabetes self-efficacy (Diabetes Empowerment Scale-Short Form), and clinical variables (body mass index, blood pressure, and glycosylated hemoglobin/HbA1c) were collected at baseline. iDAT app use trajectories were delineated using latent-class growth modeling (LCGM). Association of patient characteristics with the trajectories was ascertained using logistic regression analysis.Three iDAT app use trajectories were observed: Minimal Users (66 out of 84 patients, 78.6%, with either no iDAT use at all or use only in the first 2 weeks), Intermittent-Waning Users (10 out of 84 patients, 11.9%, with occasional weekly use mainly in the first 4 weeks), and Consistent Users (8 out of 84 patients, 9.5%, with weekly use throughout all or most of the 8 weeks). The adjusted odds ratio of being a Consistent User, relative to a Minimal User, was significantly higher for females (OR 19.55, 95% CI 1.78-215.42) and for those with higher exercise motivation scores at baseline (OR 4.89, 95% CI 1.80-13.28). The adjusted odds ratio of being an Intermittent-Waning User relative to a Minimal User was also significantly higher for those with higher exercise motivation scores at baseline (OR 1.82, 95% CI 1.00-3.32).This study provides insight into the nature and extent of usage of a caloric-monitoring app among patients with type 2 diabetes and managed in primary care. The application of LCGM provides a useful framework for evaluating future app use in other patient populations.

Authors
Goh, G; Tan, NC; Malhotra, R; Padmanabhan, U; Barbier, S; Allen, JC; Østbye, T
MLA Citation
Goh, G, Tan, NC, Malhotra, R, Padmanabhan, U, Barbier, S, Allen, JC, and Østbye, T. "Short-term trajectories of use of a caloric-monitoring mobile phone app among patients with type 2 diabetes mellitus in a primary care setting." Journal of medical Internet research 17.2 (February 3, 2015): e33-.
PMID
25648130
Source
epmc
Published In
Journal of Medical Internet Research
Volume
17
Issue
2
Publish Date
2015
Start Page
e33
DOI
10.2196/jmir.3938

Association between psoriasis and leisure-time physical activity: findings from the National Health and Nutrition Examination Survey.

Despite evidence that physical activity can reduce the cardiometabolic risk of patients with psoriasis, these patients may engage in less physical activity than those without psoriasis. The aim of this study was to examine the association of the extent of psoriatic skin lesions with the likelihood of participating in leisure-time moderate to vigorous physical activity (MVPA) and metabolic equivalent task (MET)-minutes of MVPA amongst those who participated. The National Health and Nutrition Examination Survey (NHANES) is a population-based survey among U.S. adults. A total of 6549 persons aged 20-59 years responded to the 2003-2006 NHANES dermatology questionnaires, which asked about participation in leisure-time MVPA and MET-minutes of MVPA amongst those who participated. Compared with individuals without psoriasis, those with psoriasis were less likely to have engaged in leisure MVPA in the past 30 days, although this association was not statistically significant. Amongst those who participated in leisure-time MVPA, MET-minutes of leisure-time MVPA were lower on average for patients currently having few to extensive cutaneous lesions (but not for those currently having little or no psoriatic patches), relative to individuals never diagnosed with psoriasis by approximately 30%. Clinicians should encourage patients with psoriasis, especially those with more severe disease, to be more physically active; they should help identify and address possible psychological and physical barriers to their patients' physical activity.

Authors
Do, YK; Lakhani, N; Malhotra, R; Halstater, B; Theng, C; Østbye, T
MLA Citation
Do, YK, Lakhani, N, Malhotra, R, Halstater, B, Theng, C, and Østbye, T. "Association between psoriasis and leisure-time physical activity: findings from the National Health and Nutrition Examination Survey." The Journal of dermatology 42.2 (February 2015): 148-153.
PMID
25491719
Source
epmc
Published In
The Journal of Dermatology
Volume
42
Issue
2
Publish Date
2015
Start Page
148
End Page
153
DOI
10.1111/1346-8138.12721

Steps to Health employee weight management randomized control trial: short-term follow-up results.

To present the short-term follow-up findings of the Steps to Health study, a randomized trial to evaluate the effectiveness of two employee weight management programs offered within Duke University and the Health System.A total of 550 obese (body mass index, ≥30 kg/m2) employees were randomized 1:1 between January 2011 and June 2012 to the education-based Weight Management (WM) or the WM+ arm, which focused on behavior modification. Employees were contacted to complete a follow-up visit approximately 14 months after baseline.There were no clinically, or statistically, meaningful differences between arms, but there were modest reductions in body mass index, and positive, meaningful changes in diet and physical activity for both arms.The modest positive effects observed in this study may suggest that to achieve weight loss through the workplace more intensive interventions may be required.

Authors
Østbye, T; Stroo, M; Brouwer, RJN; Peterson, BL; Eisenstein, EL; Fuemmeler, BF; Joyner, J; Gulley, L; Dement, JM
MLA Citation
Østbye, T, Stroo, M, Brouwer, RJN, Peterson, BL, Eisenstein, EL, Fuemmeler, BF, Joyner, J, Gulley, L, and Dement, JM. "Steps to Health employee weight management randomized control trial: short-term follow-up results." Journal of occupational and environmental medicine 57.2 (February 2015): 188-195.
Website
http://hdl.handle.net/10161/11443
PMID
25654520
Source
epmc
Published In
Journal of Occupational and Environmental Medicine
Volume
57
Issue
2
Publish Date
2015
Start Page
188
End Page
195
DOI
10.1097/jom.0000000000000335

Association between psoriasis and leisure-time physical activity: Findings from the National Health and Nutrition Examination Survey

© 2014 Japanese Dermatological Association. Despite evidence that physical activity can reduce the cardiometabolic risk of patients with psoriasis, these patients may engage in less physical activity than those without psoriasis. The aim of this study was to examine the association of the extent of psoriatic skin lesions with the likelihood of participating in leisure-time moderate to vigorous physical activity (MVPA) and metabolic equivalent task (MET)-minutes of MVPA amongst those who participated. The National Health and Nutrition Examination Survey (NHANES) is a population-based survey among US adults. A total of 6549 persons aged 20-59 years responded to the 2003-2006 NHANES dermatology questionnaires, which asked about participation in leisure-time MVPA and MET-minutes of MVPA amongst those who participated. Compared with individuals without psoriasis, those with psoriasis were less likely to have engaged in leisure MVPA in the past 30 days, although this association was not statistically significant. Amongst those who participated in leisure-time MVPA, MET-minutes of leisure-time MVPA were lower on average for patients currently having few to extensive cutaneous lesions (but not for those currently having little or no psoriatic patches), relative to individuals never diagnosed with psoriasis by approximately 30%. Clinicians should encourage patients with psoriasis, especially those with more severe disease, to be more physically active; they should help identify and address possible psychological and physical barriers to their patients' physical activity.

Authors
Do, YK; Lakhani, N; Malhotra, R; Halstater, B; Theng, C; Østbye, T
MLA Citation
Do, YK, Lakhani, N, Malhotra, R, Halstater, B, Theng, C, and Østbye, T. "Association between psoriasis and leisure-time physical activity: Findings from the National Health and Nutrition Examination Survey." Journal of Dermatology 42.2 (January 1, 2015): 148-153.
Source
scopus
Published In
The Journal of Dermatology
Volume
42
Issue
2
Publish Date
2015
Start Page
148
End Page
153
DOI
10.1111/1346-8138.12721

Neighborhood socioeconomic status and the prevalence of stroke and coronary heart disease in rural China: A population-based study

© 2014 World Stroke Organization. Lower neighborhood-level socioeconomic status (SES) is associated with an increased risk of vascular disease in developed countries. Aims: This study aims to identify village- and individual-level determinants of stroke and coronary heart disease (CHD) in a rural Chinese population. Methods: We analyzed data from a population-based survey of 14424 rural Chinese adults aged over 40 years from 54 villages. Primary outcomes were stroke and coronary heart disease (CHD) prevalence. Village-level SES was determined from the Chinese government's official statistical yearbook. Individual-level characteristics were obtained by in-person interviews. Prevalence rate ratios (RRs) and 95% confidence intervals (95% CIs) were calculated using generalized linear mixed models with log-link function to explore associations of village-level SES and individual social, demographic, and cardiovascular risk factors with stroke or CHD. Variance was expressed using the median rate ratio (MRR) and interval rate ratio (IRR). Results: Village accounted for significant variability in the prevalence of stroke (MRR=1·70; 95% CI: 1·42-1·94; P < 0·05) and CHD (MRR=1·59; 95% CI: 1·35-1·78, P < 0·05), with village-level income alone accounting for 10% and 13·5% of between-village variation in stroke and CHD, respectively. High-income villages were at higher risk of both stroke (RR=1·69, 95% CI: 1·09-2·62) and CHD (RR=1·63, 95% CI: 1·13-2·34) than lower-income villages. Among individual-level risk factors, hypertension was associated with a higher prevalence of stroke (RR=2·33, 95% CI: 1·93-2·80) than CHD (RR=1·58, 95% CI: 1·38-1·82), whereas obesity was only associated with CHD (RR=1·43, 95% CI: 1·23-1·66). In addition, there was an interaction between age and income; residents of higher-income villages below age60 had a higher prevalence of CHD (RR=1·58, 95% CI: 1·15-2·18) but not stroke. Conclusions: There were differences in vascular risk across rural villages in China, with higher lifetime stroke and CHD prevalence in higher-income villages. For CHD, neighborhood effects were stronger among younger residents of high-income villages.

Authors
Tang, X; Laskowitz, DT; He, L; Østbye, T; Bettger, JP; Cao, Y; Li, N; Li, J; Zhang, Z; Liu, J; Yu, L; Xu, H; Hu, Y; Goldstein, LB
MLA Citation
Tang, X, Laskowitz, DT, He, L, Østbye, T, Bettger, JP, Cao, Y, Li, N, Li, J, Zhang, Z, Liu, J, Yu, L, Xu, H, Hu, Y, and Goldstein, LB. "Neighborhood socioeconomic status and the prevalence of stroke and coronary heart disease in rural China: A population-based study." International Journal of Stroke 10.3 (January 1, 2015): 388-395.
Source
scopus
Published In
International Journal of Stroke
Volume
10
Issue
3
Publish Date
2015
Start Page
388
End Page
395
DOI
10.1111/ijs.12343

Perceptions of successful ageing in Sri Lankan older people: A qualitative study

© 2015, Hong Kong Academy of Medicine Press. All rights reserved. Background. This study explores the opinions and views of Sri Lankan older people about successful ageing. Methods. 30 females and 28 males aged 63 to 85 (median, 69) years recruited from 4 locations in a southern district in Sri Lanka participated in 8 focus groups (4 in rural and 4 in urban). Each focus group contained a single sex of participants so as to enable women to express their views freely. Discussions were audio recorded and transcribed. Transcripts were independently reviewed by the researchers and recurring themes were identified and coded using a content analysis approach. Analytic memos were prepared to elaborate on the themes and identify exemplary quotes. Results. Four major themes related to successful ageing were identified: (1) being physically active and healthy, (2) being free from burdens and responsibilities, (3) having fulfilling family relationships, and (4) pursuing spiritual development. In addition, a living environment conducive to physical activity and charitable work, and living with children were identified as facilitators of successful ageing. Economic hardship, having unsettled and vulnerable children, disrespect by the community, limited access to health care, and negative attitudes of health service providers towards older people were identified as important barriers to successful ageing. Conclusions. Strategies that can improve the quality of life of Sri Lankan older people include increased community awareness of population ageing and expectations of older people, a strengthened primary health care system that caters to their needs, and development of support systems for home-based care.

Authors
Perera, B; Watt, M; Ostbye, T; Rajapakse, H; Ranabahu, S; Maselko, J
MLA Citation
Perera, B, Watt, M, Ostbye, T, Rajapakse, H, Ranabahu, S, and Maselko, J. "Perceptions of successful ageing in Sri Lankan older people: A qualitative study." Asian Journal of Gerontology and Geriatrics 10.1 (January 1, 2015): 22-30.
Source
scopus
Published In
Asian Journal of Gerontology and Geriatrics
Volume
10
Issue
1
Publish Date
2015
Start Page
22
End Page
30

Factors associated with caregiver burden among caregivers of children with cerebral palsy in Sri Lanka.

A cross-sectional study was conducted among 375 caregivers of children with cerebral palsy attending a tertiary care setting in Sri Lanka, to identify factors associated with caregiver burden. Caregiver burden was defined as "caregiver's response to various stressors associated with caregiving" and was measured using Caregiver Difficulties Scale (CDS), developed specifically for this purpose. Multivariate linear regression was used to assess associations between sociodemographic, stressor, and coping factors and caregiver burden; and to examine whether coping reduces the effect of stressors on burden. Low income, rural residence, male sex, and number of functional deficits of the disabled child correlated significantly with higher caregiver burden, while spousal support correlated with lower burden. Seeking social support reduced the increased burden associated with greater functional impairments. Psychosocial interventions focused on evaluating and improving social support for caregivers may help families at high risk for caregiver distress, to minimize negative outcomes.

Authors
Wijesinghe, CJ; Cunningham, N; Fonseka, P; Hewage, CG; Østbye, T
MLA Citation
Wijesinghe, CJ, Cunningham, N, Fonseka, P, Hewage, CG, and Østbye, T. "Factors associated with caregiver burden among caregivers of children with cerebral palsy in Sri Lanka." Asia-Pacific journal of public health 27.1 (January 2015): 85-95.
PMID
25204802
Source
epmc
Published In
Asia Pacific Journal of Public Health
Volume
27
Issue
1
Publish Date
2015
Start Page
85
End Page
95
DOI
10.1177/1010539514548756

Is depression a risk factor for diabetic foot ulcers? 11-years follow-up of the Nord-Trøndelag Health Study (HUNT).

To prospectively examine whether depressive symptoms increase the risk of diabetes and a diabetic foot ulcer.The Nord-Trøndelag Health Study (HUNT) is a community-based longitudinal study. The Hospital Anxiety and Depression Scale (HADS-D subscale) assessed depressive symptoms. We followed individuals with complete HADS-D data from HUNT2 (1995-97) and assessed whether they reported diabetes with or without a history of diabetic foot ulcer (DFU) in HUNT3 (2006-08) (n=36,031). Logistic regression was used to investigate the effect of depressive symptoms on subsequent development of diabetes and of DFU.Unadjusted odds for reporting diabetes at follow-up was higher among individuals who reported a HADS-D score≥8 at baseline (OR 1.30 95% CI, 1.07-1.57) than among those reporting a lower score. After adjusting for age, gender and BMI, this association was no longer significant. The odds of developing a DFU was almost two-fold (OR=1.95 95% CI, 1.02-3.74) for those reporting a HADS-D score of 8-10, and 3-fold (OR=3.06 95% CI, 1.24-7.54) for HADS-D scores≥11, compared to HADS-D scores<8, after adjusting for age, gender and serum glucose.Symptoms of depression at baseline are associated with an increased risk of a diabetic foot ulcer in a dose response manner during this 11-year follow-up.

Authors
Iversen, MM; Tell, GS; Espehaug, B; Midthjell, K; Graue, M; Rokne, B; Berge, LI; Østbye, T
MLA Citation
Iversen, MM, Tell, GS, Espehaug, B, Midthjell, K, Graue, M, Rokne, B, Berge, LI, and Østbye, T. "Is depression a risk factor for diabetic foot ulcers? 11-years follow-up of the Nord-Trøndelag Health Study (HUNT)." Journal of diabetes and its complications 29.1 (January 2015): 20-25.
PMID
25283486
Source
epmc
Published In
Journal of Diabetes and its Complications
Volume
29
Issue
1
Publish Date
2015
Start Page
20
End Page
25
DOI
10.1016/j.jdiacomp.2014.09.006

The keys to healthy family child care homes intervention: study design and rationale.

Obesity is a major public health problem for which early preventive interventions are needed. Large numbers of young children are enrolled in some form of child care program, making these facilities influential environments in children's development. Family child care homes (FCCH) are a specific type of child care in which children are cared for within the provider's own residence. FCCHs serve approximately 1.5 million children in the U.S.; however, research to date has overlooked FCCH providers and their potential to positively influence children's health-related behaviors.Keys to Healthy Family Child Care Homes (Keys) is a cluster-randomized controlled trial testing the efficacy of an intervention designed to help providers become healthy role models, provide quality food- and physical activity-supportive FCCH environments, and implement effective business practices. The intervention is delivered through workshops, home visits, tailored coaching calls, and educational toolkits. Primary outcomes are child physical activity measured via accelerometry data and dietary intake data collected using direct observation at the FCCH. Secondary outcomes include child body mass index, provider weight-related behaviors, and observed obesogenic environmental characteristics.Keys is an innovative approach to promoting healthy eating and physical activity in young children. The intervention operates in a novel setting, targets children during a key developmental period, and addresses both provider and child behaviors to synergistically promote health.

Authors
Østbye, T; Mann, CM; Vaughn, AE; Namenek Brouwer, RJ; Benjamin Neelon, SE; Hales, D; Bangdiwala, SI; Ward, DS
MLA Citation
Østbye, T, Mann, CM, Vaughn, AE, Namenek Brouwer, RJ, Benjamin Neelon, SE, Hales, D, Bangdiwala, SI, and Ward, DS. "The keys to healthy family child care homes intervention: study design and rationale." Contemporary clinical trials 40 (January 2015): 81-89.
Website
http://hdl.handle.net/10161/11720
PMID
25460337
Source
epmc
Published In
Contemporary Clinical Trials
Volume
40
Publish Date
2015
Start Page
81
End Page
89
DOI
10.1016/j.cct.2014.11.003

Treatment of chronic conditions with traditional Chinese medicine: findings from traditional Chinese medicine hospitals in Hubei, China.

OBJECTIVES: This study aimed to document clinical use of Traditional Chinese Medicine (TCM) for chronic conditions in all TCM hospitals in a Chinese province and to recommend treatments most in need of evaluation for use in community health centers. DESIGN: A cross-sectional survey was conducted in the summer of 2010. It included 119 of 132 TCM hospitals in Hubei Province, China. TCM physicians were asked to recommend specific TCM treatments for common chronic conditions. Nine types of chronic conditions recommended more than 3.7 times (mean of frequencies of chronic conditions) are included in this analysis. Frequency of each TCM treatment and the number of visits by type of chronic conditions were calculated. RESULTS: The total number of recommendations by TCM physicians was 411. For seven types of treatments, six were recommended for musculoskeletal pain, five for soft tissue injuries, four for visceral pain and fractures, three for stroke and asthma, two for hemorrhoids, and one for hypertension. The most frequently recommended treatments for specific conditions include orally ingested herbs for visceral pain (n=3), type 2 diabetes (n=5), and hypertension (n=7); herbs for external use for soft tissue injuries (n=10), asthma (n=6), and hemorrhoids (n=8); acupuncture for musculoskeletal pains (n=43) and for stroke (n=10); and Chinese external fixation for fractures (n=24). The number of visits for recommended treatments per year of was 671,759. The most frequently recommended treatments for specific chronic conditions have most visits, except for chronic conditions such as musculoskeletal pains, visceral pains, soft tissue injuries, and asthma. CONCLUSIONS: Patients with musculoskeletal pain have more treatment options than other patients. Herbal medicine is the option most commonly used for chronic conditions. These treatments for these conditions should be targeted for further evaluation of effectiveness and, only if found effective, considered for use in primary care settings.

Authors
Cai, Y; Boyd, DL; Coeytaux, RR; Østbye, T; Wu, B; Mao, Z
MLA Citation
Cai, Y, Boyd, DL, Coeytaux, RR, Østbye, T, Wu, B, and Mao, Z. "Treatment of chronic conditions with traditional Chinese medicine: findings from traditional Chinese medicine hospitals in Hubei, China." Journal of alternative and complementary medicine (New York, N.Y.) 21.1 (January 2015): 40-45.
PMID
25521531
Source
epmc
Published In
Journal of Alternative and Complementary Medicine
Volume
21
Issue
1
Publish Date
2015
Start Page
40
End Page
45
DOI
10.1089/acm.2014.0125

Depression in persons with diabetes by age and antidiabetic treatment: a cross-sectional analysis with data from the Hordaland Health Study.

Persons with diabetes have increased risk of depression, however, studies addressing whether the risk varies by age and type of antidiabetic treatment have yielded conflicting results. The aim of this study was to investigate if the association between diabetes and depression varied by type of antidiabetic treatment in a large community based sample of middle-aged (40-47 years) and older adults (70-72 years).Data from 21845 participants in the Hordaland Health Study (HUSK) were analyzed in a cross-sectional design. Diabetes was assessed by self-report and classified as un-medicated, treated by oral antidiabetic agents or by insulin. Depression was defined as a score ≥ 8 on the depression subscale of the Hospital Anxiety and Depression Scale and/or self-reported use of antidepressant agents. Associations between diabetes and depression were estimated using logistic regression.Persons in their forties with diabetes had a doubled prevalence of depression (OR: 1.96 (95% C.I.: 1.35, 2.83)) compared to persons without diabetes, while a lower and non-significant association was found among persons in their seventies. Persons in their forties with orally treated diabetes had about three times higher prevalence of depression (OR: 2.92 (95% C.I.: 1.48, 5.77)) after adjustment for gender, BMI, physical activity, alcohol consumption and education, compared to non-diabetic persons in the same age-group. No association between depression and insulin or un-medicated diabetes was found.Clinicians should be aware that persons in their forties with orally treated diabetes are at a marked increased risk of depression.

Authors
Berge, LI; Riise, T; Tell, GS; Iversen, MM; Østbye, T; Lund, A; Knudsen, AK
MLA Citation
Berge, LI, Riise, T, Tell, GS, Iversen, MM, Østbye, T, Lund, A, and Knudsen, AK. "Depression in persons with diabetes by age and antidiabetic treatment: a cross-sectional analysis with data from the Hordaland Health Study." PloS one 10.5 (January 2015): e0127161-.
PMID
26010615
Source
epmc
Published In
PloS one
Volume
10
Issue
5
Publish Date
2015
Start Page
e0127161
DOI
10.1371/journal.pone.0127161

How can we better predict the risk of spontaneous miscarriage among women experiencing threatened miscarriage?

This study seeks to establish progesterone and progesterone-induced blocking factor (PIBF) levels as predictors of subsequent completed miscarriage among women presenting with threatened miscarriage between 6 and 10 weeks of gestation. Our secondary objective was to assess the known maternal risk factors, toward development of a parsimonious and clinician-friendly risk assessment model for predicting completed miscarriage. In this article, we present a prospective cohort study of 119 patients presenting with threatened miscarriage from gestation weeks 6 to 10 at a tertiary women's hospital emergency unit in Singapore. Thirty (25.2%) women had a spontaneous miscarriage. Low progesterone and PIBF levels are similarly predictive of subsequent completed miscarriage. Study results (OR, 95% CI) showed that higher levels of progesterone (0.91, 95% CI 0.88-0.94) and PIBF (0.99, 95% CI 0.98-0.99) were associated with lower risk of miscarriage. Low progesterone level was a very strong predictor of miscarriage risk in our study despite previous concerns about its pulsatile secretion. Low serum progesterone and PIBF levels predicted spontaneous miscarriage among women presenting with threatened miscarriage between gestation weeks 6 to 10. Predictive models to calculate probability of spontaneous miscarriage based on serum progesterone, together with maternal BMI and fetal heart are proposed.

Authors
Ku, CW; Allen, JC; Malhotra, R; Chong, HC; Tan, NS; Østbye, T; Lek, SM; Lie, D; Tan, TC
MLA Citation
Ku, CW, Allen, JC, Malhotra, R, Chong, HC, Tan, NS, Østbye, T, Lek, SM, Lie, D, and Tan, TC. "How can we better predict the risk of spontaneous miscarriage among women experiencing threatened miscarriage?." Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology 31.8 (January 2015): 647-651.
PMID
26036717
Source
epmc
Published In
Gynecological Endocrinology (Informa)
Volume
31
Issue
8
Publish Date
2015
Start Page
647
End Page
651
DOI
10.3109/09513590.2015.1031103

Alcohol consumption among pregnant women in Northern Tanzania 2000-2010: a registry-based study.

Alcohol can be harmful to the development of the foetus. In most developed countries, pregnant women are recommended to abstain from alcohol, however in developing countries, women are less likely to receive these recommendations. With respect to pregnant women in Northern Tanzania, this study aims to 1) describe time trends in level of alcohol consumption, 2) assess socio-demographic predictors of alcohol consumption, and 3) describe associations between alcohol consumption and health-related maternal and foetal outcomes.Data related to 34,090 births between 2000 and 2010 was obtained from the Medical Birth Registry at Kilimanjaro Christian Medical Centre (KCMC) in Moshi, Tanzania and analysed. Poisson regression analysis was used to assess associations between potential risk factors and alcohol consumption, and between alcohol consumption during pregnancy and maternal and foetal health outcomes.From 2000 to 2010, the proportion of women reporting alcohol consumption during pregnancy decreased from 49.5 to 21.5%. The socio-demographic predictors most strongly related to alcohol consumption were religion (Catholics 53.6%, Protestants 25.9%, Muslims 14.8%) and tribe (Chaggas 45.2%, Pares 17.3%, Maasais 6.6%). Pregnant women consuming alcohol were more likely to be older, taller, and have higher pre-pregnancy body mass index, and were less likely to present with anaemia (Hb < 11.0 g/dl) at last antenatal care (ANC) visit/at admission; adjusted relative risk (ARR) 0.84 (95% confidence interval 0.79-0.90) for alcohol consumption vs. abstinence. Maternal alcohol consumption during pregnancy was associated with a decreased risk of being small for gestational age (ARR 0.87 (0.80-0.94) and a decreased risk of gestational age less than 37 weeks (ARR 0.89 (0.81-0.99).The proportion of pregnant women reporting alcohol consumption decreased by 56.5% from 2000 to 2010. Alcohol intake was strongly associated with socio-demographic factors. The association between alcohol intake and favourable perinatal outcomes remained significant after maternal factors were adjusted for. Information on diet, lifestyle factors and maternal health might give further insight into this unexpected observation. The proportion of pregnant women consuming alcohol in Northern Tanzania is high, and greater awareness of health outcomes associated with alcohol consumption is advised.

Authors
Isaksen, AB; Østbye, T; Mmbaga, BT; Daltveit, AK
MLA Citation
Isaksen, AB, Østbye, T, Mmbaga, BT, and Daltveit, AK. "Alcohol consumption among pregnant women in Northern Tanzania 2000-2010: a registry-based study." BMC pregnancy and childbirth 15 (January 2015): 205-.
PMID
26337194
Source
epmc
Published In
BMC Pregnancy and Childbirth
Volume
15
Publish Date
2015
Start Page
205
DOI
10.1186/s12884-015-0630-0

Innovative bridging of the rural-urban divide: Comparison of scope, safety, and impact of collaborative rural surgery camps and an urban surgical program

© 2014 Société Internationale de Chirurgie.Background: In medically under-resourced regions worldwide, non-permanent surgery programs or camps have been conducted to expand access to surgical services. Surgery camp programs have been reported in rural India, primarily in the ophthalmic and obstetric fields; however, the provision of general surgical services in these settings is largely unknown. Methods: A 12-month retrospective review of non-ambulatory procedures performed at a rural hospital surgery camp program and at an urban hospital in Maharashtra, India, was completed to characterize relative differences in procedural activity, frequency and severity of perioperative complications, and to evaluate efficacy of care. Results: A total of 449 cases performed in rural hospital surgery camps were compared with 344 cases performed in an urban hospital during the course of the study period. The majority of rural surgical cases were elective and of intermediate complexity. Approximately 4 % of rural cases were complex-major compared to 17 % of urban cases. Intraoperative complications occurred in 0.2 % rural cases compared to 5.5 % of urban cases; p = 0.01. Postoperative complications were predominantly low grade in both groups. The postoperative complication rate was higher among rural surgical patients (43.4 %; 23.5 %; p < 0.01), though the Surgical Risk Score was significantly lower in this group (p < 0. 01). Rural surgery camp activity over 12 months achieved diagnostic and/or therapeutic goals in 92.2 % of procedures and rendered 1.74-2.69 disability-adjusted life-years (DALYs) averted per patient. Conclusions: Rural general surgery camps can safely and effectively provide a wide range of surgical services under appropriate collaborative and clinical conditions. Surgery camps may be a safe, temporizing solution to unmet needs until substantial gains in rural healthcare are realized.

Authors
Belle, JM; Bang, RA; Kelkar, D; Østbye, T; Lagoo-Deenadayalan, SA
MLA Citation
Belle, JM, Bang, RA, Kelkar, D, Østbye, T, and Lagoo-Deenadayalan, SA. "Innovative bridging of the rural-urban divide: Comparison of scope, safety, and impact of collaborative rural surgery camps and an urban surgical program." World Journal of Surgery 39.4 (2015): 871-878.
Source
scival
Published In
World Journal of Surgery
Volume
39
Issue
4
Publish Date
2015
Start Page
871
End Page
878
DOI
10.1007/s00268-014-2678-9

Physicians Use of Inclusive Sexual Orientation Language During Teenage Annual Visits.

Physicians are encouraged to use inclusive language regarding sexuality in order to help all adolescent patients feel accepted. Non-inclusive language by physicians may influence relationships with adolescent patients, especially those with still-developing sexual identities. The aim of this study was to identify patterns of physicians' use of inclusive and non-inclusive language when discussing sexuality.A total of 393 conversations between 393 adolescents and 49 physicians from 11 clinics located throughout the Raleigh-Durham, North Carolina, area were audio recorded. Conversations were coded for the use of inclusive talk (language use that avoids the use of specific gender, sex, or sexual orientation language), direct non-inclusive talk (language use that assumes the teenager is heterosexual or exclusively engages in heterosexual sexual activity), and indirect non-inclusive talk (language use that frames talk heterosexually but does not pre-identify the adolescent as heterosexual).Nearly two-thirds (63%, 245) of the visits contained some sexuality talk. Inclusive talk rarely occurred (3.3%) while non-inclusive language was predominant (48.1% direct and 48.6% indirect). There were no significant differences in language use by gender, age, adolescent race, or visit length. These non-significant findings suggest that all adolescents regardless of race, gender, or age are receiving non-inclusive sexuality talk from their providers.Physicians are missing opportunities to create safe environments for teenagers to discuss sexuality. The examples of inclusive talk from this study may provide potentially useful ways to teach providers how to begin sexuality discussions, focusing on sexual attraction or asking about friends' sexual behavior, and maintain these discussions.

Authors
Alexander, SC; Fortenberry, JD; Pollak, KI; Bravender, T; Østbye, T; Shields, CG
MLA Citation
Alexander, SC, Fortenberry, JD, Pollak, KI, Bravender, T, Østbye, T, and Shields, CG. "Physicians Use of Inclusive Sexual Orientation Language During Teenage Annual Visits." LGBT health 1.4 (December 2014): 283-291.
PMID
26789857
Source
epmc
Published In
LGBT health
Volume
1
Issue
4
Publish Date
2014
Start Page
283
End Page
291
DOI
10.1089/lgbt.2014.0035

Weight-related SMS texts promoting appropriate pregnancy weight gain: A pilot study

© 2014 Elsevier Ireland Ltd. Objectives: Excessive gestational weight gain (GWG) puts women and children at risk of obesity. We piloted an SMS-texting intervention to promote healthy GWG among overweight and obese women. Methods: We recruited 35 women and randomized them in a 2:1 fashion to: a tailored SMS-texting intervention (Preg CHAT) vs. a generic texting intervention (Txt4baby). Preg CHAT texts provided personalized feedback based on women's intake of sweetened beverages, fruits and vegetables, fast food, daily steps taken, and weight. We abstracted women's weights from charts and surveyed women at baseline and 32 weeks gestation. Results: Few women refused the study; many (30%) did not complete the study, however. Of those in the Preg CHAT arm, 86% responded to texts, and 80% said they would recommend this program to a friend. For women who completed the surveys (. n=. 23), those in the Preg CHAT arm had a mean gain of 6 less pounds than women in the Txt4Baby arm (95% CI -15.9, 4.0; p=. 0.24). Conclusions: This pilot study shows feasibility, acceptability, and potential efficacy of a low-intensity and disseminable intervention to help overweight and obese women reduce GWG. Practice implications: An SMS texting program might help overweight women reduce excessive GWG.

Authors
Pollak, KI; Alexander, SC; Bennett, G; Lyna, P; Coffman, CJ; Bilheimer, A; Farrell, D; Bodner, ME; Swamy, GK; Østbye, T
MLA Citation
Pollak, KI, Alexander, SC, Bennett, G, Lyna, P, Coffman, CJ, Bilheimer, A, Farrell, D, Bodner, ME, Swamy, GK, and Østbye, T. "Weight-related SMS texts promoting appropriate pregnancy weight gain: A pilot study." Patient Education and Counseling 97.2 (November 1, 2014): 256-260.
Source
scopus
Published In
Patient Education and Counseling
Volume
97
Issue
2
Publish Date
2014
Start Page
256
End Page
260
DOI
10.1016/j.pec.2014.07.030

Weight-related SMS texts promoting appropriate pregnancy weight gain: a pilot study.

Excessive gestational weight gain (GWG) puts women and children at risk of obesity. We piloted an SMS-texting intervention to promote healthy GWG among overweight and obese women.We recruited 35 women and randomized them in a 2:1 fashion to: a tailored SMS-texting intervention (Preg CHAT) vs. a generic texting intervention (Txt4baby). Preg CHAT texts provided personalized feedback based on women's intake of sweetened beverages, fruits and vegetables, fast food, daily steps taken, and weight. We abstracted women's weights from charts and surveyed women at baseline and 32 weeks gestation.Few women refused the study; many (30%) did not complete the study, however. Of those in the Preg CHAT arm, 86% responded to texts, and 80% said they would recommend this program to a friend. For women who completed the surveys (n=23), those in the Preg CHAT arm had a mean gain of 6 less pounds than women in the Txt4Baby arm (95% CI -15.9, 4.0; p=0.24).This pilot study shows feasibility, acceptability, and potential efficacy of a low-intensity and disseminable intervention to help overweight and obese women reduce GWG.An SMS texting program might help overweight women reduce excessive GWG.

Authors
Pollak, KI; Alexander, SC; Bennett, G; Lyna, P; Coffman, CJ; Bilheimer, A; Farrell, D; Bodner, ME; Swamy, GK; Østbye, T
MLA Citation
Pollak, KI, Alexander, SC, Bennett, G, Lyna, P, Coffman, CJ, Bilheimer, A, Farrell, D, Bodner, ME, Swamy, GK, and Østbye, T. "Weight-related SMS texts promoting appropriate pregnancy weight gain: a pilot study." Patient education and counseling 97.2 (November 2014): 256-260.
PMID
25153313
Source
epmc
Published In
Patient Education and Counseling
Volume
97
Issue
2
Publish Date
2014
Start Page
256
End Page
260
DOI
10.1016/j.pec.2014.07.030

Use of diuretics is associated with reduced risk of Alzheimer's disease: the Cache County Study.

Although the use of antihypertensive medications has been associated with reduced risk of Alzheimer's disease (AD), it remains unclear which class provides the most benefit. The Cache County Study of Memory Health and Aging is a prospective longitudinal cohort study of dementing illnesses among the elderly population of Cache County, Utah. Using waves I to IV data of the Cache County Study, 3417 participants had a mean of 7.1 years of follow-up. Time-varying use of antihypertensive medications including different class of diuretics, angiotensin converting enzyme inhibitors, β-blockers, and calcium channel blockers was used to predict the incidence of AD using Cox proportional hazards analyses. During follow-up, 325 AD cases were ascertained with a total of 23,590 person-years. Use of any antihypertensive medication was associated with lower incidence of AD (adjusted hazard ratio [aHR], 0.77; 95% confidence interval [CI], 0.61-0.97). Among different classes of antihypertensive medications, thiazide (aHR, 0.7; 95% CI, 0.53-0.93), and potassium-sparing diuretics (aHR, 0.69; 95% CI, 0.48-0.99) were associated with the greatest reduction of AD risk. Thiazide and potassium-sparing diuretics were associated with decreased risk of AD. The inverse association of potassium-sparing diuretics confirms an earlier finding in this cohort, now with longer follow-up, and merits further investigation.

Authors
Chuang, Y-F; Breitner, JCS; Chiu, Y-L; Khachaturian, A; Hayden, K; Corcoran, C; Tschanz, J; Norton, M; Munger, R; Welsh-Bohmer, K; Zandi, PP; Cache County Investigators,
MLA Citation
Chuang, Y-F, Breitner, JCS, Chiu, Y-L, Khachaturian, A, Hayden, K, Corcoran, C, Tschanz, J, Norton, M, Munger, R, Welsh-Bohmer, K, Zandi, PP, and Cache County Investigators, . "Use of diuretics is associated with reduced risk of Alzheimer's disease: the Cache County Study." Neurobiology of aging 35.11 (November 2014): 2429-2435.
PMID
24910391
Source
epmc
Published In
Neurobiology of Aging
Volume
35
Issue
11
Publish Date
2014
Start Page
2429
End Page
2435
DOI
10.1016/j.neurobiolaging.2014.05.002

Impact of offspring death on cognitive health in late life: the Cache County study.

OBJECTIVE: Experiencing the death of a child is associated with negative short-term mental health consequences, but less is known about cognitive outcomes and whether such associations extend to late life. We tested the hypothesis that experiencing an offspring death (OD) is associated with an increased rate of cognitive decline in late life. METHODS: This population-based longitudinal study observed four cognitive statuses spaced 3-4 years apart, linked to an extensive database containing objective genealogic and vital statistics data. Home visits were conducted with 3,174 residents of a rural county in northern Utah, initially without dementia, aged 65-105. Cognitive status was measured with the Modified Mini-Mental State Exam at baseline and at 3-, 7-, and 10-year follow-ups. OD was obtained from the Utah Population Database, which contains statewide birth and death records. RESULTS: In linear mixed models, controlling for age, gender, education, and apolipoprotein E status, subjects who experienced OD while younger than age 31 years experienced a significantly faster rate of cognitive decline in late life, but only if they had an ε4 allele. Reclassifying all OD (regardless of age) according to subsequent birth of another child, OD was only related to faster cognitive decline when there were no subsequent births. CONCLUSION: Experiencing OD in early adulthood has a long-term association with cognitive functioning in late life, with a gene-environment interaction at the apolipoprotein E locus. Subsequent birth of another child attenuates this association.

Authors
Greene, D; Tschanz, JT; Smith, KR; Ostbye, T; Corcoran, C; Welsh-Bohmer, KA; Norton, MC; Cache County Investigators,
MLA Citation
Greene, D, Tschanz, JT, Smith, KR, Ostbye, T, Corcoran, C, Welsh-Bohmer, KA, Norton, MC, and Cache County Investigators, . "Impact of offspring death on cognitive health in late life: the Cache County study." Am J Geriatr Psychiatry 22.11 (November 2014): 1307-1315.
PMID
23954042
Source
pubmed
Published In
American Journal of Geriatric Psychiatry
Volume
22
Issue
11
Publish Date
2014
Start Page
1307
End Page
1315
DOI
10.1016/j.jagp.2013.05.002

Physicians' assurances of confidentiality and time spent alone with adolescents during primary care visits.

Authors
Bravender, T; Lyna, P; Tulsky, JA; Ostbye, T; Alexander, SC; Dolor, RJ; Coffman, CJ; Lin, P-H; Pollak, KI
MLA Citation
Bravender, T, Lyna, P, Tulsky, JA, Ostbye, T, Alexander, SC, Dolor, RJ, Coffman, CJ, Lin, P-H, and Pollak, KI. "Physicians' assurances of confidentiality and time spent alone with adolescents during primary care visits." Clinical pediatrics 53.11 (October 2014): 1094-1097.
PMID
24322956
Source
epmc
Published In
Clinical Pediatrics
Volume
53
Issue
11
Publish Date
2014
Start Page
1094
End Page
1097
DOI
10.1177/0009922813512022

Contribution of generative leisure activities to cognitive function in elderly Sri Lankan adults

© 2014, The American Geriatrics Society. Objectives To examine the unique contribution of generative leisure activities, def ined as activities motivated by a concern for others and a need to contribute something to the next generation. Design Cross-sectional survey. Setting Peri-urban and rural area in southern Sri Lanka. Participants Community-dwelling adults aged 60 and older (N = 252). Measurements The main predictors were leisure activities, grouped into generative, social, or solitary. The main outcome was cognitive function, assessed using the Montreal Cognitive Assessment (MoCA) and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Results More-frequent engagement in generative leisure activities was associated with higher levels of cognitive function, independent of the effect of other social and solitary leisure activities. In a fully adjusted model combining all three leisure activities, generative activities independently predicted cognitive function as measured using the MoCA (β = 0.47, 95% confidence interval (CI) = 0.11-0.83) and the IQCODE (β = -0.81, 95% CI = -1.54 to -0.09). In this combined model, solitary activities were also independently associated with slower cognitive decline using the MoCA (β = 0.40, 95% CI = 0.16-0.64) but not the IQCODE (β = -0.38, 95% CI = -0.88-0.12); the association with social activities did not reach statistical significance with either measure. These associations did not differ meaningfully according to sex. Conclusion Generative leisure activities are a promising area for the development of interventions aimed at reducing cognitive decline in elderly adults.

Authors
Maselko, J; Sebranek, M; Mun, MH; Perera, B; Ahs, J; Østbye, T
MLA Citation
Maselko, J, Sebranek, M, Mun, MH, Perera, B, Ahs, J, and Østbye, T. "Contribution of generative leisure activities to cognitive function in elderly Sri Lankan adults." Journal of the American Geriatrics Society 62.9 (September 1, 2014): 1707-1713.
Source
scopus
Published In
Journal of American Geriatrics Society
Volume
62
Issue
9
Publish Date
2014
Start Page
1707
End Page
1713
DOI
10.1111/jgs.12985

Weight's up? Predictors of weight-related communication during primary care visits with overweight adolescents.

Physicians' use of Motivational Interviewing (MI) techniques when discussing weight with adolescent patients is unknown.We coded audio-recorded encounters between 49 primary care physicians and 180 overweight adolescent patients. During weight discussions, we used the MITI 3.0 to assess: Empathy, MI Spirit, open-ended questions, reflections, MI consistent behaviors (e.g., praising) and MI inconsistent behaviors (e.g., confronting). We examined associations of patient and physician characteristics with (1) MI techniques, (2) time discussing weight, and (3) encounter time.Physicians used more MI consistent techniques with female patients (p=0.06) and with heavier patients (p=0.02). Physicians with prior MI training also used more MI consistent techniques (p=0.04) and asked more open-ended questions (p=0.05). Pediatricians had a higher MI Spirit score than family physicians (p=0.03). Older patient age was associated with physicians spending less time discussing weight-related topics (p=0.04) and higher BMI percentile was associated with physicians spending more time discussing weight-related topics (p=0.01). Increased use of MI inconsistent techniques was associated with longer encounters (p=0.02).Physicians' weight discussions vary based on adolescent and physician characteristics. Importantly, not using MI lengthened encounter time.Physicians might consider using MI techniques more and attempt to use these equally with all adolescents.

Authors
Pollak, KI; Coffman, CJ; Alexander, SC; Østbye, T; Lyna, P; Tulsky, JA; Bilheimer, A; Dolor, RJ; Lin, P-H; Bodner, ME; Bravender, T
MLA Citation
Pollak, KI, Coffman, CJ, Alexander, SC, Østbye, T, Lyna, P, Tulsky, JA, Bilheimer, A, Dolor, RJ, Lin, P-H, Bodner, ME, and Bravender, T. "Weight's up? Predictors of weight-related communication during primary care visits with overweight adolescents." Patient education and counseling 96.3 (September 2014): 327-332.
PMID
25130793
Source
epmc
Published In
Patient Education and Counseling
Volume
96
Issue
3
Publish Date
2014
Start Page
327
End Page
332
DOI
10.1016/j.pec.2014.07.025

Contribution of generative leisure activities to cognitive function in elderly Sri Lankan adults.

To examine the unique contribution of generative leisure activities, defined as activities motivated by a concern for others and a need to contribute something to the next generation.Cross-sectional survey.Peri-urban and rural area in southern Sri Lanka.Community-dwelling adults aged 60 and older (N = 252).The main predictors were leisure activities, grouped into generative, social, or solitary. The main outcome was cognitive function, assessed using the Montreal Cognitive Assessment (MoCA) and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE).More-frequent engagement in generative leisure activities was associated with higher levels of cognitive function, independent of the effect of other social and solitary leisure activities. In a fully adjusted model combining all three leisure activities, generative activities independently predicted cognitive function as measured using the MoCA (β = 0.47, 95% confidence interval (CI) = 0.11-0.83) and the IQCODE (β = -0.81, 95% CI = -1.54 to -0.09). In this combined model, solitary activities were also independently associated with slower cognitive decline using the MoCA (β = 0.40, 95% CI = 0.16-0.64) but not the IQCODE (β = -0.38, 95% CI = -0.88-0.12); the association with social activities did not reach statistical significance with either measure. These associations did not differ meaningfully according to sex.Generative leisure activities are a promising area for the development of interventions aimed at reducing cognitive decline in elderly adults.

Authors
Maselko, J; Sebranek, M; Mun, MH; Perera, B; Ahs, J; Ostbye, T
MLA Citation
Maselko, J, Sebranek, M, Mun, MH, Perera, B, Ahs, J, and Ostbye, T. "Contribution of generative leisure activities to cognitive function in elderly Sri Lankan adults." Journal of the American Geriatrics Society 62.9 (September 2014): 1707-1713.
PMID
25139145
Source
epmc
Published In
Journal of American Geriatrics Society
Volume
62
Issue
9
Publish Date
2014
Start Page
1707
End Page
1713
DOI
10.1111/jgs.12985

Trajectories of depressive symptoms over 2 years postpartum among overweight or obese women.

Although depressive symptoms are common postpartum, few studies have followed women beyond 12 months postpartum to investigate changes in the number and severity of these symptoms over time, especially in overweight and obese women. Using two complementary analytical methods, this study aims to identify trajectories of depressive symptoms over 2 years postpartum among overweight or obese mothers, and assess the demographic, socioeconomic, and health covariates for these trajectories.Using longitudinal data from two behavioral intervention studies (Kids and Adults Now!-Defeat Obesity [KAN-DO] and Active Mothers Postpartum (AMP); n = 844), we used latent growth modeling to identify the overall trajectory of depressive symptoms and how it was related to key covariates. Next, we used latent class growth analysis to assess the heterogeneity in the depressive symptom trajectories over time, and thereby, identify subgroups of women with distinct trajectories.The overall trajectory of depressive symptoms over 2 years postpartum was relatively stable in our sample. However, the presence of three distinct latent class trajectories (stable-low [82.5%], decreasing symptoms [7.3%], and increasing symptoms [10.2%]), identified based on trajectory shape and mean depressive symptom score, supported heterogeneity in depressive symptom trajectories over time. Lower maternal education was related to a higher symptom score, and poorer subjective health status at baseline predicted inclusion in the increasing symptoms trajectory.In some overweight or obese mothers, postpartum depressive symptoms do not resolve quickly. Practitioners should be aware of this phenomenon and continue to screen for depression for longer periods of time postpartum.

Authors
Lee, C-T; Stroo, M; Fuemmeler, B; Malhotra, R; Østbye, T
MLA Citation
Lee, C-T, Stroo, M, Fuemmeler, B, Malhotra, R, and Østbye, T. "Trajectories of depressive symptoms over 2 years postpartum among overweight or obese women." Women's health issues : official publication of the Jacobs Institute of Women's Health 24.5 (September 2014): 559-566.
PMID
25213748
Source
epmc
Published In
Women's Health Issues
Volume
24
Issue
5
Publish Date
2014
Start Page
559
End Page
566
DOI
10.1016/j.whi.2014.05.008

Correlates of handgrip strength and activities of daily living in elderly Sri Lankans.

Authors
Ukegbu, U; Maselko, J; Malhotra, R; Perera, B; Ostbye, T
MLA Citation
Ukegbu, U, Maselko, J, Malhotra, R, Perera, B, and Ostbye, T. "Correlates of handgrip strength and activities of daily living in elderly Sri Lankans." Journal of the American Geriatrics Society 62.9 (September 2014): 1800-1801. (Letter)
PMID
25243688
Source
epmc
Published In
Journal of American Geriatrics Society
Volume
62
Issue
9
Publish Date
2014
Start Page
1800
End Page
1801
DOI
10.1111/jgs.13000

Correlates of Peer Violence Among 13- to 15-Year-Olds in Gampaha District Schools in Sri Lanka

Authors
Wijeratne, MP; Seneviratne, R; Gunawardena, N; Lynch, C; Sandøy, IF; Ostbye, T
MLA Citation
Wijeratne, MP, Seneviratne, R, Gunawardena, N, Lynch, C, Sandøy, IF, and Ostbye, T. "Correlates of Peer Violence Among 13- to 15-Year-Olds in Gampaha District Schools in Sri Lanka." SAGE Open 4.3 (August 12, 2014): 215824401455061-215824401455061.
Source
crossref
Published In
SAGE Open
Volume
4
Issue
3
Publish Date
2014
Start Page
215824401455061
End Page
215824401455061
DOI
10.1177/2158244014550616

Weight changes in obese adults 6-months after discontinuation of double-blind zonisamide or placebo treatment.

We evaluated weight changes in obese patients at 6-months after they ended participation in a 12-month randomised controlled trial in which they received daily placebo, zonisamide 200 mg or zonisamide 400 mg, in addition to lifestyle counselling. Of the originally randomised 225 patients, 218 completed month-12 when study interventions were discontinued. For the 154 patients who returned for 6-month follow-up off-treatment, weight changes between month-12 and month-18 for placebo (n = 53), zonisamide 200 mg (n = 49) and zonisamide 400 mg groups (n = 52) were 0.5 kg [95% confidence interval (CI), -0.8 to 1.8; 0.7%], 1.5 kg (0.2-2.8; 1.6%; p = 0.26 vs. placebo) and 2.4 kg (1.1-3.7; 2.6%; p = 0.04 vs. placebo), respectively. Our results suggest that although zonisamide 400 mg daily for 12-months resulted in greater weight loss than with placebo, weight regain after discontinuation of interventions was greater in the zonisamide 400 mg group than placebo group.

Authors
Shin, JH; Gadde, KM; Østbye, T; Bray, GA
MLA Citation
Shin, JH, Gadde, KM, Østbye, T, and Bray, GA. "Weight changes in obese adults 6-months after discontinuation of double-blind zonisamide or placebo treatment." Diabetes, obesity & metabolism 16.8 (August 2014): 766-768.
PMID
25123600
Source
epmc
Published In
Diabetes Obesity & Metabolism
Volume
16
Issue
8
Publish Date
2014
Start Page
766
End Page
768
DOI
10.1111/dom.12275

Erratum: Young adult weight trajectories through midlife by body mass category

Authors
Malhotra, R; Østbye, T; Riley, CM; Finkelstein, EA
MLA Citation
Malhotra, R, Østbye, T, Riley, CM, and Finkelstein, EA. "Erratum: Young adult weight trajectories through midlife by body mass category." Obesity 22.7 (July 2014): 1770-1770.
Source
crossref
Published In
Obesity (Silver Spring, Md.)
Volume
22
Issue
7
Publish Date
2014
Start Page
1770
End Page
1770
DOI
10.1002/oby.20780

Young Adult Weight Trajectories Through Midlife by Body Mass Category (vol 21, pg 1923, 2013)

Authors
Malhotra, R; Ostbye, T; Riley, CM; Finkelstein, EA
MLA Citation
Malhotra, R, Ostbye, T, Riley, CM, and Finkelstein, EA. "Young Adult Weight Trajectories Through Midlife by Body Mass Category (vol 21, pg 1923, 2013)." OBESITY 22.7 (July 2014): 1770-1770.
Source
wos-lite
Published In
Obesity (Silver Spring, Md.)
Volume
22
Issue
7
Publish Date
2014
Start Page
1770
End Page
1770
DOI
10.1002/oby.20780

Maternal autonomy and child health care utilization in India: results from the National Family Health Survey.

The objective of this study was to examine the association of maternal autonomy with preventive and curative child health care utilization in India. Data from the National Family Health Survey 2005-2006 were used to ascertain association of maternal autonomy (in 3 dimensions: decision making, access to financial resources, freedom of movement) with child's primary immunization status (indicative of preventive health care use) and treatment seeking for child's acute respiratory infection (indicative of curative health care use). Low maternal freedom of movement was associated with higher odds of incomplete primary immunization of the child and for not seeking treatment for the child's acute respiratory infection. Low maternal financial access was associated with increased odds for incomplete primary immunization of the child. The findings show that improvement in autonomy of Indian mothers, especially their freedom of movement, may help improve utilization of health care for their children.

Authors
Malhotra, C; Malhotra, R; Østbye, T; Subramanian, SV
MLA Citation
Malhotra, C, Malhotra, R, Østbye, T, and Subramanian, SV. "Maternal autonomy and child health care utilization in India: results from the National Family Health Survey." Asia Pac J Public Health 26.4 (July 2014): 401-413.
PMID
22652247
Source
pubmed
Published In
Asia Pacific Journal of Public Health
Volume
26
Issue
4
Publish Date
2014
Start Page
401
End Page
413
DOI
10.1177/1010539511420418

Preventing obesity in infants and toddlers in child care: results from a pilot randomized controlled trial.

Few interventions have focused on very young children for obesity prevention. This study evaluated a pilot intervention to improve the nutrition and physical activity environments of child care centers serving infants and toddlers. This randomized controlled trial took place in 32 centers in Boston, Massachusetts. The intervention aimed to improve policies and practices related to nutrition and physical activity within the center. For the outcome, observers assessed center environments using the Environment and Policy Assessment and Observation (EPAO) instrument (range 0-320 points) at baseline and the 6-month follow-up. We fit linear regression models with change in EPAO score from baseline to follow-up, controlling for potential confounders for total score, nutrition sub-score, and physical activity sub-score. Intervention centers had a mean (SD) of 98.2 (144.8) children enrolled, while control centers had 59.2 (34.5). In intervention centers, 47.5% of children were white, compared to 46.2% in controls. Fewer intervention centers had outdoor play areas on site (75 vs. 100%) but more had indoor play space (67 vs. 25%). At baseline, intervention centers had a mean (SD) EPAO score of 134.5 (7.0) points and controls had 146.8 (4.8) points. Compared with controls, intervention centers improved their EPAO scores at follow-up by 18.5 points (95% CI 0.1, 37.0; p = 0.049), chiefly through greater improvement in physical activity (12.2; 95% CI -1.6, 26.0; p = 0.075) and not nutrition (6.4; 95% CI -7.1, 19.8; p = 0.385). The pilot showed promise as an intervention to improve center environments, but future studies should include child-level outcomes.

Authors
Benjamin Neelon, SE; Taveras, EM; Ostbye, T; Gillman, MW
MLA Citation
Benjamin Neelon, SE, Taveras, EM, Ostbye, T, and Gillman, MW. "Preventing obesity in infants and toddlers in child care: results from a pilot randomized controlled trial." Maternal and child health journal 18.5 (July 2014): 1246-1257.
PMID
24065371
Source
epmc
Published In
Maternal and Child Health Journal
Volume
18
Issue
5
Publish Date
2014
Start Page
1246
End Page
1257
DOI
10.1007/s10995-013-1359-x

Age and gender differences in substance screening may underestimate injury severity: a study of 9793 patients at level 1 trauma center from 2006 to 2010.

BACKGROUND: Although the relationship between psychoactive substance use and injury is known, evidence remains conflicting on the impact of substance use on clinical outcomes after injury. We hypothesized that preinjury substance use would negatively impact clinical outcomes. METHODS: National Trauma Registry American College of Surgeons identified patients (n = 9793) presenting to Duke Hospital from 2006 to 2010. Logistic regression models assessed potential predictors of receiving substance screening, mortality, length of stay, ventilator requirement, intensive care admission, or emergency department disposition. RESULTS: Forty-seven percent (4607/9793) of patients received blood alcohol screen (BAS) and 31% (3017/9793) received urine drug screen (UDS). Men were more likely to receive both BASs (P < 0.001) and UDSs (P = 0.001) than women after controlling for potential confounders. There was no significant difference between men and women over the legal limit for alcohol (OLLA; 27.2%, 95% confidence interval [CI]: 25.7%-28.8% versus 24.8%, 95% CI: 22.3%-27.5%). Similarly, younger patients more likely received both BASs (P < 0.001) and UDSs (P < 0.001) compared with older patients. The proportion of patients aged ≤45 y OLLA (26.5 %, 95% CI: 24.9%-28.2%) was similar to those aged >45 y OLLA (26.8%, 95% CI: 24.5%-29.3%). After controlling for potential confounders neither alcohol, nor tetrahydrocannabinol, nor cocaine was predictive of mortality, ventilator requirement, length of stay, or emergency department disposition, but a higher alcohol level (P = 0.0174) predicted intensive care admission. CONCLUSIONS: Females and those aged >45 y are less likely to receive BASs and UDSs. Differential screening that is biased may place patients at risk for receiving inadequate care.

Authors
Beasley, GM; Ostbye, T; Muhlbaier, LH; Foley, C; Scarborough, J; Turley, RS; Shapiro, ML
MLA Citation
Beasley, GM, Ostbye, T, Muhlbaier, LH, Foley, C, Scarborough, J, Turley, RS, and Shapiro, ML. "Age and gender differences in substance screening may underestimate injury severity: a study of 9793 patients at level 1 trauma center from 2006 to 2010." J Surg Res 188.1 (May 1, 2014): 190-197.
PMID
24370454
Source
pubmed
Published In
Journal of Surgical Research
Volume
188
Issue
1
Publish Date
2014
Start Page
190
End Page
197
DOI
10.1016/j.jss.2013.11.1103

Age and gender differences in substance screening may underestimate injury severity: A study of 9793 patients at level 1 trauma center from 2006 to 2010

Background Although the relationship between psychoactive substance use and injury is known, evidence remains conflicting on the impact of substance use on clinical outcomes after injury. We hypothesized that preinjury substance use would negatively impact clinical outcomes. Methods National Trauma Registry American College of Surgeons identified patients (n = 9793) presenting to Duke Hospital from 2006 to 2010. Logistic regression models assessed potential predictors of receiving substance screening, mortality, length of stay, ventilator requirement, intensive care admission, or emergency department disposition. Results Forty-seven percent (4607/9793) of patients received blood alcohol screen (BAS) and 31% (3017/9793) received urine drug screen (UDS). Men were more likely to receive both BASs (P < 0.001) and UDSs (P = 0.001) than women after controlling for potential confounders. There was no significant difference between men and women over the legal limit for alcohol (OLLA; 27.2%, 95% confidence interval [CI]: 25.7%-28.8% versus 24.8%, 95% CI: 22.3%-27.5%). Similarly, younger patients more likely received both BASs (P < 0.001) and UDSs (P < 0.001) compared with older patients. The proportion of patients aged < 45 y OLLA (26.5 %, 95% CI: 24.9%-28.2%) was similar to those aged > 45 y OLLA (26.8%, 95% CI: 24.5%-29.3%). After controlling for potential confounders neither alcohol, nor tetrahydrocannabinol, nor cocaine was predictive of mortality, ventilator requirement, length of stay, or emergency department disposition, but a higher alcohol level (P = 0.0174) predicted intensive care admission. Conclusions Females and those aged > 45 y are less likely to receive BASs and UDSs. Differential screening that is biased may place patients at risk for receiving inadequate care. © 2014 Elsevier Inc. All rights reserved.

Authors
Beasley, GM; Ostbye, T; Muhlbaier, LH; Foley, C; Scarborough, J; Turley, RS; Shapiro, ML
MLA Citation
Beasley, GM, Ostbye, T, Muhlbaier, LH, Foley, C, Scarborough, J, Turley, RS, and Shapiro, ML. "Age and gender differences in substance screening may underestimate injury severity: A study of 9793 patients at level 1 trauma center from 2006 to 2010." Journal of Surgical Research 188.1 (May 1, 2014): 190-197.
Source
scopus
Published In
Journal of Surgical Research
Volume
188
Issue
1
Publish Date
2014
Start Page
190
End Page
197
DOI
10.1016/j.jss.2013.11.1103

Caregiving expectations and challenges among elders and their adult children in Southern Sri Lanka.

The elderly population in Sri Lanka is growing rapidly. Elders are traditionally cared for in the homes of their adult children, but the shifting socio-economic environment in Sri Lanka challenges this arrangement. This paper describes the dynamics of elder-caregiver relationships in Southern Sri Lanka. Data included 4 focus group discussions and 5 in-depth interviews with elderly, and 10 in-depth interviews with adult children of the elderly. Discussion guide topics included caregiving arrangements, and roles/responsibilities of elders and caregivers. Using a grounded theory approach, a comprehensive analytic memo was developed and discussed to explore emerging themes on the caregiver dynamic. Both elders and caregivers felt that elders should be taken care of in the home by their children. They pointed to a sense of duty and role modeling of parental caregiving that is passed down through generations. Even as elders desired support from their children, they feared losing their independence, and saw financial autonomy as important for maintaining relationship balance. Caregiving challenges included: households where both the adult child and his/her spouse worked outside the home; households where elders had a disproportionate amount of household work; economically stressed households; and lack of direct communication between elders and caregivers regarding conflicts. Results point to strong values around caring for elderly in the home, but identify challenges to this arrangement in the future.

Authors
Watt, MH; Perera, B; Ostbye, T; Ranabahu, S; Rajapakse, H; Maselko, J
MLA Citation
Watt, MH, Perera, B, Ostbye, T, Ranabahu, S, Rajapakse, H, and Maselko, J. "Caregiving expectations and challenges among elders and their adult children in Southern Sri Lanka." Ageing and society 34.5 (May 2014): 838-858.
PMID
25152553
Source
epmc
Published In
Ageing & Society
Volume
34
Issue
5
Publish Date
2014
Start Page
838
End Page
858
DOI
10.1017/s0144686x12001365

Comorbid visual and cognitive impairment: relationship with disability status and self-rated health among older Singaporeans.

The objective of this study was to examine the prevalence and consequences of coexisting vision and cognitive impairments in an Asian population. Data were collected from 4508 community-dwelling Singaporeans aged 60 years and older. Cognition was assessed by the Short Portable Mental Status Questionnaire whereas vision, disability, and self-rated health (SRH) were determined by self-report. Vision impairment was present in 902 (18.5%) participants and cognitive impairment in 835 (13.6%), with 232 (3.5%) participants experiencing both impairments. Persons with the comorbidity experienced higher odds of disability than persons with either single impairment. The association of vision impairment with SRH was stronger among women (odds ratio [OR] = 6.79, 95% confidence interval [CI] = 4.64-9.92) than among men (OR = 1.71, 95% CI = 1.21-2.41). Concurrent cognitive and vision impairment is prevalent in older Singaporeans and is associated with high rates of disability. Gender differences in vision-dependent roles may affect the patient-perceived impact of this comorbidity.

Authors
Whitson, HE; Malhotra, R; Chan, A; Matchar, DB; Østbye, T
MLA Citation
Whitson, HE, Malhotra, R, Chan, A, Matchar, DB, and Østbye, T. "Comorbid visual and cognitive impairment: relationship with disability status and self-rated health among older Singaporeans." Asia Pac J Public Health 26.3 (May 2014): 310-319.
PMID
22535554
Source
pubmed
Published In
Asia Pacific Journal of Public Health
Volume
26
Issue
3
Publish Date
2014
Start Page
310
End Page
319
DOI
10.1177/1010539512443698

Satiety responsiveness and the relationship between breastfeeding and weight status of toddlers of overweight and obese women.

Numerous studies indicate an association between breastfeeding and decreased toddler adiposity. The mechanism behind this association is still unknown. One possibility is that children who are breastfed may have increased responsiveness to internal satiety cues. This study assessed the effect of satiety responsiveness on the association between breastfeeding and weight status among toddlers. We conducted a secondary analysis of data from 428 toddlers aged 2 years. Mothers' body mass index (BMI) and children's BMI z score were calculated from measured height and weight. Mothers completed a detailed breastfeeding survey and the satiety responsiveness subscale of the Child Eating Behaviour Questionnaire. Multiple linear regression and logistic regression were used to determine if satiety responsiveness mediated the effect of breastfeeding on BMI z score or overweight/obesity (BMI ≥ 85th percentile). Establishment of breastfeeding was associated with decreased BMI z score (0.40 vs. 0.60; p = 0.04), and increased breastfeeding intensity was associated with lower odds of overweight/obesity (OR 0.97, p = 0.04). Satiety responsiveness was not associated with either breastfeeding measures, suggesting it does not play a meditational role in the relationship between breastfeeding and toddler weight status. Furthermore, a relationship between satiety responsiveness and obesity does not exist after controlling for well-known confounders. This study did not find a mediation effect of satiety responsiveness on the association between breastfeeding and weight status in toddlers. More research is needed to characterize satiety responsiveness and its influence on the relationship between breastfeeding and childhood obesity.

Authors
Hathcock, A; Krause, K; Viera, AJ; Fuemmeler, BF; Lovelady, C; Østbye, T
MLA Citation
Hathcock, A, Krause, K, Viera, AJ, Fuemmeler, BF, Lovelady, C, and Østbye, T. "Satiety responsiveness and the relationship between breastfeeding and weight status of toddlers of overweight and obese women." Maternal and child health journal 18.4 (May 2014): 1023-1030.
PMID
23925718
Source
epmc
Published In
Maternal and Child Health Journal
Volume
18
Issue
4
Publish Date
2014
Start Page
1023
End Page
1030
DOI
10.1007/s10995-013-1331-9

Determining optimal gestational weight gain in a multiethnic Asian population.

To define the optimal gestational weight gain (GWG) for the multiethnic Singaporean population.Data from 1529 live singleton deliveries was analyzed. A multinomial logistic regression analysis, with GWG as the predictor, was conducted to determine the lowest aggregated risk of a composite perinatal outcome, stratified by Asia-specific body mass index (BMI) categories. The composite perinatal outcome, based on a combination of delivery type (cesarean section [CS], vaginal delivery [VD]) and size for gestational age (small [SGA], appropriate [AGA], large [LGA]), had six categories: (i) VD with LGA; (ii) VD with SGA; (iii) CS with AGA; (iv) CS with SGA; (v) CS with LGA; (vi) and VD with AGA. The last was considered as the 'normal' reference category. In each BMI category, the GWG value corresponding to the lowest aggregated risk was defined as the optimal GWG, and the GWG values at which the aggregated risk did not exceed a 5% increase from the lowest aggregated risk were defined as the margins of the optimal GWG range.The optimal GWG by pre-pregnancy BMI category, was 19.5 kg (range, 12.9 to 23.9) for underweight, 13.7 kg (7.7 to 18.8) for normal weight, 7.9 kg (2.6 to 14.0) for overweight and 1.8 kg (-5.0 to 7.0) for obese.The results of this study, the first to determine optimal GWG in the multiethnic Singaporean population, concur with the Institute of Medicine (IOM) guidelines in that GWG among Asian women who are heavier prior to pregnancy, especially those who are obese, should be lower. However, the optimal GWG for underweight and obese women was outside the IOM recommended range.

Authors
Ee, TX; Allen, JC; Malhotra, R; Koh, H; Østbye, T; Tan, TC
MLA Citation
Ee, TX, Allen, JC, Malhotra, R, Koh, H, Østbye, T, and Tan, TC. "Determining optimal gestational weight gain in a multiethnic Asian population." The journal of obstetrics and gynaecology research 40.4 (April 2014): 1002-1008.
PMID
24611987
Source
epmc
Published In
Journal of Obstetrics and Gynaecology Research
Volume
40
Issue
4
Publish Date
2014
Start Page
1002
End Page
1008
DOI
10.1111/jog.12307

Older person behavioral and psychological symptoms (BPS) and functional limitations mediate the association between older person cognitive impairment and depressive symptoms in the caregiver

We assess for the mediation of the association between older person cognitive impairment and caregiver depressive symptoms through older person BPS and functional limitations, and whether the mediation varies by caregiver-older person relationship (spouse/adult child). Data for 1111 older person (aged 75+ with activity of daily living (ADL) limitation)-caregiver dyads from Singapore were used. The outcome variable was dichotomous (caregiver clinically significant depressive symptoms [CSDS]: yes/no) in the primary analysis and continuous (caregiver depressive symptoms score) in the sensitivity analysis. The causal steps approach assessed for the mediation of the association between older person cognitive impairment (yes/no) and the outcome variable through the two potential mediators. A bootstrapping approach calculated point estimates and confidence intervals (CIs) of the indirect (~mediated) effects. Variation of the indirect effects by caregiver-older person relationship was also assessed. In the primary analysis, the causal steps approach supported older person BPS and functional limitations as mediators. The bootstrapping approach confirmed both as significant mediators, though BPS (indirect effect odds ratio (OR) 1.32 [95% bootstrap CI 1.19,1.48] ; %mediation: 70.6%) was a stronger mediator than functional limitations (1.04 [1.01,1.11]; %mediation: 11.5%). Variation of the indirect effects by caregiver-older person relationship was not supported. Results of the sensitivity analysis confirmed these results. We conclude that while caring for an older person with cognitive impairment is detrimental for the caregiver's mood, management of associated BPS and functional limitations, especially the former, among such older persons may reduce depressive symptoms among their caregivers. Spouse as well as adult child caregivers benefit. © 2013 Elsevier Ireland Ltd.

Authors
Malhotra, R; Chei, CL; Østbye, T; Chan, A; Matchar, DB
MLA Citation
Malhotra, R, Chei, CL, Østbye, T, Chan, A, and Matchar, DB. "Older person behavioral and psychological symptoms (BPS) and functional limitations mediate the association between older person cognitive impairment and depressive symptoms in the caregiver." Archives of Gerontology and Geriatrics 58.2 (March 1, 2014): 269-277.
Source
scopus
Published In
Archives of Gerontology and Geriatrics
Volume
58
Issue
2
Publish Date
2014
Start Page
269
End Page
277
DOI
10.1016/j.archger.2013.10.004

Diabetes-related foot ulcers and associated factors: Results from the Nord-Trøndelag Health Survey (HUNT3) (2006-2008)

Aim To determine the proportion of people with diabetes reporting a history of foot ulcer and investigate associated factors and healing time in the Nord-Trøndelag Health Survey (HUNT3), Norway. Methods In 2006-2008, all inhabitants in Nord-Trøndelag County aged ≥ 20 years were invited to take part in this population-based study; 54% (n = 50,807) attended. In participants reporting to have diabetes we examined the relationships between foot ulcers requiring more than 3 weeks to heal (DFU) and sociodemographic, lifestyle and clinical variables using logistic regression analysis. Results Among participants with diabetes, 7.4% (95% confidence interval (CI) 6.2%-8.6%) reported a DFU. The median healing time was 6.0 weeks. In the final model, factors associated with a DFU were age ≥ 75 years (odds ratio (OR) 2.3, 95% CI 1.4-3.7), male sex (OR 2.0, 95% CI 1.3-3.1), waist circumference ≥ 102 cm (men) or 88 cm (women) (OR 1.95, 95% CI 1.2-3.2), insulin use (OR 2.1, 95% CI 1.3-3.4) and any macrovascular complication (OR 1. 8, 95% CI 1.1-2.8). Conclusions The proportion of people with diabetes reporting a DFU was 7.4%, associated factors were age ≥ 75 years, male sex, waist circumference ≥ 102 cm (men) or 88 cm (women), insulin use and any macrovascular complication. The median healing time was 6 weeks. © 2014 Elsevier Inc. All rights reserved.

Authors
Molvær, AK; Graue, M; Espehaug, B; Ostbye, T; Midthjell, K; Iversen, MM
MLA Citation
Molvær, AK, Graue, M, Espehaug, B, Ostbye, T, Midthjell, K, and Iversen, MM. "Diabetes-related foot ulcers and associated factors: Results from the Nord-Trøndelag Health Survey (HUNT3) (2006-2008)." Journal of Diabetes and its Complications 28.2 (March 1, 2014): 156-161.
Source
scopus
Published In
Journal of Diabetes and its Complications
Volume
28
Issue
2
Publish Date
2014
Start Page
156
End Page
161
DOI
10.1016/j.jdiacomp.2013.10.010

Diabetes-related foot ulcers and associated factors: results from the Nord-Trøndelag Health Survey (HUNT3) (2006-2008).

AIM: To determine the proportion of people with diabetes reporting a history of foot ulcer and investigate associated factors and healing time in the Nord-Trøndelag Health Survey (HUNT3), Norway. METHODS: In 2006-2008, all inhabitants in Nord-Trøndelag County aged ≥ 20 years were invited to take part in this population-based study; 54% (n=50,807) attended. In participants reporting to have diabetes we examined the relationships between foot ulcers requiring more than 3 weeks to heal (DFU) and sociodemographic, lifestyle and clinical variables using logistic regression analysis. RESULTS: Among participants with diabetes, 7.4% (95% confidence interval (CI) 6.2%-8.6%) reported a DFU. The median healing time was 6.0 weeks. In the final model, factors associated with a DFU were age ≥ 75 years (odds ratio (OR) 2.3, 95% CI 1.4-3.7), male sex (OR 2.0, 95% CI 1.3-3.1), waist circumference ≥ 102 cm (men) or 88 cm (women) (OR 1.95, 95% CI 1.2-3.2), insulin use (OR 2.1, 95% CI 1.3-3.4) and any macrovascular complication (OR 1.8, 95% CI 1.1-2.8). CONCLUSIONS: The proportion of people with diabetes reporting a DFU was 7.4%, associated factors were age ≥ 75 years, male sex, waist circumference ≥ 102 cm (men) or 88 cm (women), insulin use and any macrovascular complication. The median healing time was 6 weeks.

Authors
Molvær, AK; Graue, M; Espehaug, B; Østbye, T; Midthjell, K; Iversen, MM
MLA Citation
Molvær, AK, Graue, M, Espehaug, B, Østbye, T, Midthjell, K, and Iversen, MM. "Diabetes-related foot ulcers and associated factors: results from the Nord-Trøndelag Health Survey (HUNT3) (2006-2008)." J Diabetes Complications 28.2 (March 2014): 156-161.
PMID
24360341
Source
pubmed
Published In
Journal of Diabetes and Its Complications
Volume
28
Issue
2
Publish Date
2014
Start Page
156
End Page
161
DOI
10.1016/j.jdiacomp.2013.10.010

Older person behavioral and psychological symptoms (BPS) and functional limitations mediate the association between older person cognitive impairment and depressive symptoms in the caregiver.

We assess for the mediation of the association between older person cognitive impairment and caregiver depressive symptoms through older person BPS and functional limitations, and whether the mediation varies by caregiver-older person relationship (spouse/adult child). Data for 1111 older person (aged 75+ with activity of daily living (ADL) limitation)-caregiver dyads from Singapore were used. The outcome variable was dichotomous (caregiver clinically significant depressive symptoms [CSDS]: yes/no) in the primary analysis and continuous (caregiver depressive symptoms score) in the sensitivity analysis. The causal steps approach assessed for the mediation of the association between older person cognitive impairment (yes/no) and the outcome variable through the two potential mediators. A bootstrapping approach calculated point estimates and confidence intervals (CIs) of the indirect (∼mediated) effects. Variation of the indirect effects by caregiver-older person relationship was also assessed. In the primary analysis, the causal steps approach supported older person BPS and functional limitations as mediators. The bootstrapping approach confirmed both as significant mediators, though BPS (indirect effect odds ratio (OR) 1.32 [95% bootstrap CI 1.19,1.48]; %mediation: 70.6%) was a stronger mediator than functional limitations (1.04 [1.01,1.11]; %mediation: 11.5%). Variation of the indirect effects by caregiver-older person relationship was not supported. Results of the sensitivity analysis confirmed these results. We conclude that while caring for an older person with cognitive impairment is detrimental for the caregiver's mood, management of associated BPS and functional limitations, especially the former, among such older persons may reduce depressive symptoms among their caregivers. Spouse as well as adult child caregivers benefit.

Authors
Malhotra, R; Chei, C-L; Østbye, T; Chan, A; Matchar, DB
MLA Citation
Malhotra, R, Chei, C-L, Østbye, T, Chan, A, and Matchar, DB. "Older person behavioral and psychological symptoms (BPS) and functional limitations mediate the association between older person cognitive impairment and depressive symptoms in the caregiver." Arch Gerontol Geriatr 58.2 (March 2014): 269-277.
PMID
24211024
Source
pubmed
Published In
Archives of Gerontology and Geriatrics
Volume
58
Issue
2
Publish Date
2014
Start Page
269
End Page
277
DOI
10.1016/j.archger.2013.10.004

Sexuality talk during adolescent health maintenance visits.

IMPORTANCE: Physicians may be important sources of sexuality information and preventive services, and one-on-one confidential time during health maintenance visits is recommended to allow discussions of sexual development, behavior, and risk reduction. However, little is known about the occurrence and characteristics of physician-adolescent discussions about sexuality. OBJECTIVE: To examine predictors of time spent discussing sexuality, level of adolescent participation, and physician and patient characteristics associated with sexuality discussions during health maintenance visits by early and middle adolescents. DESIGN, SETTING, AND PARTICIPANTS: Observational study of audio-recorded conversations between 253 adolescents (mean age, 14.3 years; 53% female; 40% white; 47% African American) and 49 physicians (82% pediatricians; 84% white; 65% female; mean age, 40.9 years; mean [SD] duration in practice, 11.8 [8.7] years) coded for sexuality content at 11 clinics (3 academic and 8 community-based practices) located throughout the Raleigh/Durham, North Carolina, area. MAIN OUTCOMES AND MEASURES: Total time per visit during which sexuality issues were discussed. RESULTS One hundred sixty-five (65%) of all visits had some sexual content within it. The average time of sexuality talk was 36 seconds (35% 0 seconds; 30% 1-35 seconds; and 35% ≥ 36 seconds). Ordinal logistic regression (outcome of duration: 0, 1-35, or ≥ 36 seconds), adjusted for clustering of patients within physicians, found that female patients (odds ratio [OR] = 2.58; 95% CI, 1.53-4.36), older patients (OR = 1.37; 95% CI, 1.13-1.65), conversations with explicit confidentiality discussions (OR = 4.33; 95% CI, 2.58-7.28), African American adolescents (OR = 1.58; 95% CI, 1.01-2.48), and longer overall visit (OR = 1.07; 95% CI, 1.03-1.11) were associated with more sexuality talk, and Asian physicians were associated with less sexuality talk (OR = 0.13; 95% CI, 0.08-0.20). In addition, the same significant associations between adolescent, physician, and visit characteristics were significantly associated with greater adolescent participation. CONCLUSIONS AND RELEVANCE: Our study may be the first to directly observe sexuality talk between physicians and adolescents. We found that one-third of all adolescents had annual visits without any mention of sexuality issues; when sexuality talk occurred, it was brief. Research is needed to identify successful strategies physicians can use to engage adolescents in discussions about sexuality to help promote healthy sexual development and decision making. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01040975.

Authors
Alexander, SC; Fortenberry, JD; Pollak, KI; Bravender, T; Davis, JK; Ostbye, T; Tulsky, JA; Dolor, RJ; Shields, CG
MLA Citation
Alexander, SC, Fortenberry, JD, Pollak, KI, Bravender, T, Davis, JK, Ostbye, T, Tulsky, JA, Dolor, RJ, and Shields, CG. "Sexuality talk during adolescent health maintenance visits." JAMA Pediatr 168.2 (February 2014): 163-169.
PMID
24378686
Source
pubmed
Published In
JAMA Pediatrics
Volume
168
Issue
2
Publish Date
2014
Start Page
163
End Page
169
DOI
10.1001/jamapediatrics.2013.4338

Is overweight and class i obesity associated with increased health claims costs?

Objectives Evaluate the relationship between body mass index (BMI) and health claims costs over the last decade, assess the strength and nature of the relationship between BMI and costs, and identify comorbidities that may drive any increased costs. Methods Using 2001-2011 claims data for employees participating in annual health appraisals, annual paid claims costs were calculated. One-part negative binomial models were fit to evaluate the relationship between BMI and costs, controlling for age, gender, race/ethnicity, and calendar year period. Results The relationship between increasing BMI and increasing health claims costs is gradual and starts already at a BMI of 19. The nature of the relationship did not change notably over time. The most important obesity-related comorbidities, expressed as percent increase in cost per BMI unit, was cardiovascular disease (males 10.53, 95% CI [6.46, 14.77], females 4.27, 95% CI [1.25, 7.38), while cardiovascular agents (7.23, 95% CI [6.08, 8.39] ) were the most important driver of pharmacy costs. Conclusion In contrast to recent evidence relating to effects on mortality, we observed a gradual increase in health claims costs starting at the low end of the recommended BMI range. Copyright © 2013 The Obesity Society.

Authors
Østbye, T; Stroo, M; Eisenstein, EL; Peterson, B; Dement, J
MLA Citation
Østbye, T, Stroo, M, Eisenstein, EL, Peterson, B, and Dement, J. "Is overweight and class i obesity associated with increased health claims costs?." Obesity 22.4 (January 1, 2014): 1179-1186.
Source
scopus
Published In
Obesity (Silver Spring, Md.)
Volume
22
Issue
4
Publish Date
2014
Start Page
1179
End Page
1186
DOI
10.1002/oby.20669

Satiety responsiveness and the relationship between breastfeeding and weight status of toddlers of overweight and obese women

Numerous studies indicate an association between breastfeeding and decreased toddler adiposity. The mechanism behind this association is still unknown. One possibility is that children who are breastfed may have increased responsiveness to internal satiety cues. This study assessed the effect of satiety responsiveness on the association between breastfeeding and weight status among toddlers. We conducted a secondary analysis of data from 428 toddlers aged 2 years. Mothers' body mass index (BMI) and children's BMI z score were calculated from measured height and weight. Mothers completed a detailed breastfeeding survey and the satiety responsiveness subscale of the Child Eating Behaviour Questionnaire. Multiple linear regression and logistic regression were used to determine if satiety responsiveness mediated the effect of breastfeeding on BMI z score or overweight/obesity (BMI ≥ 85th percentile). Establishment of breastfeeding was associated with decreased BMI z score (0.40 vs. 0.60; p = 0.04), and increased breastfeeding intensity was associated with lower odds of overweight/obesity (OR 0.97, p = 0.04). Satiety responsiveness was not associated with either breastfeeding measures, suggesting it does not play a meditational role in the relationship between breastfeeding and toddler weight status. Furthermore, a relationship between satiety responsiveness and obesity does not exist after controlling for well-known confounders. This study did not find a mediation effect of satiety responsiveness on the association between breastfeeding and weight status in toddlers. More research is needed to characterize satiety responsiveness and its influence on the relationship between breastfeeding and childhood obesity. © 2013 Springer Science+Business Media New York.

Authors
Hathcock, A; Krause, K; Viera, AJ; Fuemmeler, BF; Lovelady, C; Østbye, T
MLA Citation
Hathcock, A, Krause, K, Viera, AJ, Fuemmeler, BF, Lovelady, C, and Østbye, T. "Satiety responsiveness and the relationship between breastfeeding and weight status of toddlers of overweight and obese women." Maternal and Child Health Journal 18.4 (January 1, 2014): 1023-1030.
Source
scopus
Published In
Maternal and Child Health Journal
Volume
18
Issue
4
Publish Date
2014
Start Page
1023
End Page
1030
DOI
10.1007/s10995-013-1331-9

Weight changes in obese adults 6-months after discontinuation of double-blind zonisamide or placebo treatment

We evaluated weight changes in obese patients at 6-months after they ended participation in a 12-month randomised controlled trial in which they received daily placebo, zonisamide 200mg or zonisamide 400mg, in addition to lifestyle counselling. Of the originally randomised 225 patients, 218 completed month-12 when study interventions were discontinued. For the 154 patients who returned for 6-month follow-up off-treatment, weight changes between month-12 and month-18 for placebo (n=53), zonisamide 200mg (n=49) and zonisamide 400mg groups (n=52) were 0.5kg [95% confidence interval (CI), -0.8 to 1.8; 0.7%], 1.5kg (0.2-2.8; 1.6%; p=0.26 vs. placebo) and 2.4kg (1.1-3.7; 2.6%; p=0.04 vs. placebo), respectively. Our results suggest that although zonisamide 400mg daily for 12-months resulted in greater weight loss than with placebo, weight regain after discontinuation of interventions was greater in the zonisamide 400mg group than placebo group. © 2014 John Wiley & Sons Ltd.

Authors
Shin, JH; Gadde, KM; Østbye, T; Bray, GA
MLA Citation
Shin, JH, Gadde, KM, Østbye, T, and Bray, GA. "Weight changes in obese adults 6-months after discontinuation of double-blind zonisamide or placebo treatment." Diabetes, Obesity and Metabolism 16.8 (January 1, 2014): 766-768.
Source
scopus
Published In
Diabetes Obesity & Metabolism
Volume
16
Issue
8
Publish Date
2014
Start Page
766
End Page
768
DOI
10.1111/dom.12275

Weight's up? Predictors of weight-related communication during primary care visits with overweight adolescents

Objective: Physicians' use of Motivational Interviewing (MI) techniques when discussing weight with adolescent patients is unknown. Methods: We coded audio-recorded encounters between 49 primary care physicians and 180 overweight adolescent patients. During weight discussions, we used the MITI 3.0 to assess: Empathy, MI Spirit, open-ended questions, reflections, MI consistent behaviors (e.g., praising) and MI inconsistent behaviors (e.g., confronting). We examined associations of patient and physician characteristics with (1) MI techniques, (2) time discussing weight, and (3) encounter time. Results: Physicians used more MI consistent techniques with female patients (p= 0.06) and with heavier patients (p= 0.02). Physicians with prior MI training also used more MI consistent techniques (p= 0.04) and asked more open-ended questions (p= 0.05). Pediatricians had a higher MI Spirit score than family physicians (p= 0.03). Older patient age was associated with physicians spending less time discussing weight-related topics (p= 0.04) and higher BMI percentile was associated with physicians spending more time discussing weight-related topics (p= 0.01). Increased use of MI inconsistent techniques was associated with longer encounters (p= 0.02). Conclusion: Physicians' weight discussions vary based on adolescent and physician characteristics. Importantly, not using MI lengthened encounter time. Practice implications: Physicians might consider using MI techniques more and attempt to use these equally with all adolescents. © 2014 Elsevier Ireland Ltd.

Authors
Pollak, KI; Coffman, CJ; Alexander, SC; Østbye, T; Lyna, P; Tulsky, JA; Bilheimer, A; Dolor, RJ; Lin, PH; Bodner, ME; Bravender, T
MLA Citation
Pollak, KI, Coffman, CJ, Alexander, SC, Østbye, T, Lyna, P, Tulsky, JA, Bilheimer, A, Dolor, RJ, Lin, PH, Bodner, ME, and Bravender, T. "Weight's up? Predictors of weight-related communication during primary care visits with overweight adolescents." Patient Education and Counseling 96.3 (January 1, 2014): 327-332.
Source
scopus
Published In
Patient Education and Counseling
Volume
96
Issue
3
Publish Date
2014
Start Page
327
End Page
332
DOI
10.1016/j.pec.2014.07.025

Impact of offspring death on cognitive health in late life: The cache county study

© 2014 American Association for Geriatric Psychiatry. Objective Experiencing the death of a child is associated with negative short-term mental health consequences, but less is known about cognitive outcomes and whether such associations extend to late life. We tested the hypothesis that experiencing an offspring death (OD) is associated with an increased rate of cognitive decline in late life. Methods This population-based longitudinal study observed four cognitive statuses spaced 3-4 years apart, linked to an extensive database containing objective genealogic and vital statistics data. Home visits were conducted with 3,174 residents of a rural county in northern Utah, initially without dementia, aged 65-105. Cognitive status was measured with the Modified Mini-Mental State Exam at baseline and at 3-, 7-, and 10-year follow-ups. OD was obtained from the Utah Population Database, which contains statewide birth and death records. Results In linear mixed models, controlling for age, gender, education, and apolipoprotein E status, subjects who experienced OD while younger than age 31 years experienced a significantly faster rate of cognitive decline in late life, but only if they had an ε4 allele. Reclassifying all OD (regardless of age) according to subsequent birth of another child, OD was only related to faster cognitive decline when there were no subsequent births. Conclusion Experiencing OD in early adulthood has a long-term association with cognitive functioning in late life, with a gene-environment interaction at the apolipoprotein E locus. Subsequent birth of another child attenuates this association.

Authors
Greene, D; Tschanz, JT; Smith, KR; Østbye, T; Corcoran, C; Welsh-Bohmer, KA; Norton, MC
MLA Citation
Greene, D, Tschanz, JT, Smith, KR, Østbye, T, Corcoran, C, Welsh-Bohmer, KA, and Norton, MC. "Impact of offspring death on cognitive health in late life: The cache county study." American Journal of Geriatric Psychiatry 22.11 (January 1, 2014): 1307-1315.
Source
scopus
Published In
American Journal of Geriatric Psychiatry
Volume
22
Issue
11
Publish Date
2014
Start Page
1307
End Page
1315
DOI
10.1016/j.jagp.2013.05.002

Accuracy and congruence of patient and physician weight-related discussions: from project CHAT (Communicating Health: Analyzing Talk).

OBJECTIVE: Primary care providers should counsel overweight patients to lose weight. Rates of self-reported, weight-related counseling vary, perhaps because of self-report bias. We assessed the accuracy and congruence of weight-related discussions among patients and physicians during audio-recorded encounters. METHODS: We audio-recorded encounters between physicians (n = 40) and their overweight/obese patients (n = 461) at 5 community-based practices. We coded weight-related content and surveyed patients and physicians immediately after the visit. Generalized linear mixed models assessed factors associated with accuracy. RESULTS: Overall, accuracy was moderate: patient (67%), physician (70%), and congruence (62%). When encounters containing weight-related content were analyzed, patients (98%) and physicians (97%) were highly accurate and congruent (95%), but when weight was not discussed, patients and physicians were more inaccurate and incongruent (patients, 36%; physicians, 44%; 28% congruence). Physicians who were less comfortable discussing weight were more likely to misreport that weight was discussed (odds ratio, 4.5; 95% confidence interval, 1.88-10.75). White physicians with African American patients were more likely to report accurately no discussion about weight than white physicians with white patients (odds ratio, 0.30; 95% confidence interval, 0.13-0.69). CONCLUSION: Physician and patient self-report of weight-related discussions were highly accurate and congruent when audio-recordings indicated weight was discussed but not when recordings indicated no weight discussions. Physicians' overestimation of weight discussions when weight is not discussed constitutes missed opportunities for health interventions.

Authors
Bodner, ME; Dolor, RJ; Ostbye, T; Lyna, P; Alexander, SC; Tulsky, JA; Pollak, KI
MLA Citation
Bodner, ME, Dolor, RJ, Ostbye, T, Lyna, P, Alexander, SC, Tulsky, JA, and Pollak, KI. "Accuracy and congruence of patient and physician weight-related discussions: from project CHAT (Communicating Health: Analyzing Talk)." J Am Board Fam Med 27.1 (January 2014): 70-77.
PMID
24390888
Source
pubmed
Published In
Journal of the American Board of Family Medicine
Volume
27
Issue
1
Publish Date
2014
Start Page
70
End Page
77
DOI
10.3122/jabfm.2014.01.130110

Projecting the number of older singaporeans with activity of daily living limitations requiring human assistance through 2030.

In the context of rapid population ageing and the increase in number of activity of daily living (ADL) limitations with age, the number of older persons requiring human assistance in Singapore is likely to grow. To promote informed planning for the needs of these elderly, we project the number of resident Singaporeans 60 years of age and older with 1 or more ADL limitations requiring human assistance through 2030.The proportion of community-dwelling older adults with ADL limitations requiring human assistance, stratified by gender and age group, was calculated utilising a recent nationally-representative survey of older Singaporeans. The proportion of older adults in nursing homes with ADL limitations was estimated based on available literature. Together, these prevalence estimates were applied to a simulation of the future population of older adults in Singapore to derive an estimate of the number of individuals with ADL limitations requiring human assistance through 2030.By 2030, the number of resident Singaporeans aged 60 years or older with 1 or more ADL limitations requiring human assistance is projected to be 82,968 persons (7% of the total population aged 60 years or older). Of this number, 38,809 (47%) are estimated to have 1 or 2 ADL limitations, and 44,159 (53%) are estimated to have 3 or more.The number of elderly Singaporeans with activity limitations is expected grow rapidly from 31,738 in 2010 to 82,968 in 2030. Estimates of the number of older individuals with ADL limitations requiring human assistance are of value for policymakers as well as acute and long-term care capacity planners as they seek to meet demand for health and social services in Singapore.

Authors
Thompson, J; Malhotra, R; Love, S; Ostbye, T; Chan, A; Matchar, D
MLA Citation
Thompson, J, Malhotra, R, Love, S, Ostbye, T, Chan, A, and Matchar, D. "Projecting the number of older singaporeans with activity of daily living limitations requiring human assistance through 2030." Annals of the Academy of Medicine, Singapore 43.1 (January 2014): 51-56.
PMID
24557466
Source
epmc
Published In
Annals of the Academy of Medicine, Singapore
Volume
43
Issue
1
Publish Date
2014
Start Page
51
End Page
56

Development of the Sri Lankan early teenagers' violence inventory: an instrument to measure peer violence in schools.

This study was designed to develop an inventory to measure peer violence among early teens (13-15 years of age) in schools in Sri Lanka. Development of SLETVI was carried out in two phases. In phase I, development of an operational definition for peer violence, identification, and finalizing violent acts for inventory was done by a combination of qualitative methods: a comprehensive literature review, focus group discussions among 13-15-year-old adolescents, their teachers and parents, and consultative meetings with experts in the field. Inventory was then pretested. In phase II, elaboration of SLETVI was carried out by administering it to a sample of 1700 adolescents (13-15 years old). Exploratory factor analysis using principal component analysis was performed separately for experiences of victimization and perpetration. Test-retest reliability of SLETVI was assessed. SLETVI included 37 items in three factors: "less severe violence," "severe physical," and "severe relational" violence. Combined use of qualitative and quantitative methods enabled development of a culturally valid and reliable operational inventory to assess early teenagers' peer violence in Sri Lankan and other South Asian schools.

Authors
Wijeratne, M; Seneviratne, R; Gunawardena, N; Østbye, T; Lynch, C; Sandøy, IF
MLA Citation
Wijeratne, M, Seneviratne, R, Gunawardena, N, Østbye, T, Lynch, C, and Sandøy, IF. "Development of the Sri Lankan early teenagers' violence inventory: an instrument to measure peer violence in schools." BioMed research international 2014 (January 2014): 563143-.
PMID
25061607
Source
epmc
Published In
BioMed Research International
Volume
2014
Publish Date
2014
Start Page
563143
DOI
10.1155/2014/563143

Trends in and socio-demographic factors associated with caesarean section at a Tanzanian referral hospital, 2000 to 2013.

BACKGROUND: Caesarean section (CS) can prevent maternal or fetal complications. Sub-Saharan Africa has the lowest CS levels in the world but large variations are seen between and within countries. The tertiary hospital, Kilimanjaro Christian Medical Centre (KCMC) in Tanzania has had a high level of CS over years. The aim of this study was to examine trends in the socio-demographic background of babies born at KCMC from year 2000 to 2013, and trends in the CS percentage, and to identify socio-demographic factors associated with CS at KCMC during this period. METHODS: This is a registry-based study. The analyses were limited to singletons born by women from Moshi urban and rural districts. The Chi square test for linear trend was used to examine trends in the CS percentage and trends in the socio-demographic background of the baby. The association between different socio-demographic factors and CS was assessed using logistic regression. The analyses were stratified by the mother's residence. RESULTS: The educational level of mothers and fathers and the age of the mothers of singletons born at KCMC increased significantly from year 2000 to 2013 both among urban and rural residents. Among 29,752 singletons, the overall CS percentage was 28.9%, and there was no clear trend in the overall CS percentage between 2000 and 2013. In the multivariable model, factors associated with higher odds of CS were: having been referred for delivery, maternal age above 25 and no- or primary education level of the baby's father. Among rural mothers, no- or primary education, being from the Pare tribe and para 2-3 were also associated with higher odds of CS. Being from the Chagga tribe and high parity were associated with lower odds of CS compared to other tribes and parity 1. CONCLUSIONS: The CS percentage remained high but stable over time. Large variations in CS levels between different socio-demographic groups were observed. The educational level of the parents of babies born at KCMC increased over time, possibly reflecting persistent inequitable access to the services offered at the hospital.

Authors
Nilsen, C; Østbye, T; Daltveit, AK; Mmbaga, BT; Sandøy, IF
MLA Citation
Nilsen, C, Østbye, T, Daltveit, AK, Mmbaga, BT, and Sandøy, IF. "Trends in and socio-demographic factors associated with caesarean section at a Tanzanian referral hospital, 2000 to 2013." International journal for equity in health 13 (January 2014): 87-.
PMID
25319518
Source
epmc
Published In
International Journal for Equity in Health
Volume
13
Publish Date
2014
Start Page
87
DOI
10.1186/s12939-014-0087-1

Diabetes-related foot ulcers and associated factors: Results from the Nord-Trøndelag Health Survey (HUNT3) (2006-2008)

Authors
Molvær, AK; Graue, M; Espehaug, B; Ostbye, T; Midthjell, K; Iversen, MM
MLA Citation
Molvær, AK, Graue, M, Espehaug, B, Ostbye, T, Midthjell, K, and Iversen, MM. "Diabetes-related foot ulcers and associated factors: Results from the Nord-Trøndelag Health Survey (HUNT3) (2006-2008)." Journal of Diabetes and its Complications 28.2 (2014): 156-161.
Source
scopus
Published In
Journal of Diabetes and its Complications
Volume
28
Issue
2
Publish Date
2014
Start Page
156
End Page
161

Is There a Multiplicative Adverse Effect of Cardiovascular and Kidney Disease on Neuropsychological Measures?

Increasing age is accompanied by increased incidence and comorbidity of various chronic diseases. Many of these conditions, such as cardiovascular and kidney disease, can lead to declines in cognitive functioning. A simple additive effect may be commonly assumed. We here evaluate the hypothesis that such effects may be multiplicative/interactive rather than simply additive, resulting in disproportionate decrements in performance on tests of different cognitive functions. Participants were the 1,782 Canadians aged 65 years and older who completed the clinical assessment of the national Canadian Study of Health and Aging and who were without dementia. Participants were categorized as having either kidney disease, cardiovascular disease, neither, or both. Scores on a measure of verbal fluency showed the predicted interaction effects, but not in the predicted pattern of worst performance in the group with both disorders. Reasons for the relative lack of observed main effects of disease and multiplicative interactions, such as the exclusion of people with dementia and nature of the sample from the community, are discussed.

Authors
Helmes, E; Østbye, T; Steenhuis, R
MLA Citation
Helmes, E, Østbye, T, and Steenhuis, R. "Is There a Multiplicative Adverse Effect of Cardiovascular and Kidney Disease on Neuropsychological Measures? (Accepted)." Applied Neuropsychology:Adult (2014).
Source
scopus
Published In
Applied Neuropsychology Adult
Publish Date
2014
DOI
10.1080/23279095.2014.908379

Teen CHAT: Development and utilization of a web-based intervention to improve physician communication with adolescents about healthy weight

Objective: To describe the theoretical basis, use, and satisfaction with Teen CHAT, an online educational intervention designed to improve physician-adolescent communication about healthy weight. Methods: Routine health maintenance encounters between pediatricians and family practitioners and their overweight adolescent patients were audio recorded, and content was coded to summarize adherence with motivational interviewing techniques. An online educational intervention was developed using constructs from social cognitive theory and using personalized audio recordings. Physicians were randomized to the online intervention or not, and completed post-intervention surveys. Results: Forty-six physicians were recruited, and 22 physicians were randomized to view the intervention website. The educational intervention took an average of 54. min to complete, and most physicians thought it was useful, that they would use newly acquired skills with their patients, and would recommend it to others. Fewer physicians thought it helped them address confidentiality issues with their adolescent patients. Conclusion: The Teen CHAT online intervention shows potential for enhancing physician motivational interviewing skills in an acceptable and time-efficient manner. Practice implications: If found to be effective in enhancing motivational interviewing skills and changing adolescent weight-related behaviors, wide dissemination will be feasible and indicated. © 2013 Elsevier Ireland Ltd.

Authors
Bravender, T; Tulsky, JA; Farrell, D; Alexander, SC; Østbye, T; Lyna, P; Dolor, RJ; Coffman, CJ; Bilheimer, A; Lin, PH; Pollak, KI
MLA Citation
Bravender, T, Tulsky, JA, Farrell, D, Alexander, SC, Østbye, T, Lyna, P, Dolor, RJ, Coffman, CJ, Bilheimer, A, Lin, PH, and Pollak, KI. "Teen CHAT: Development and utilization of a web-based intervention to improve physician communication with adolescents about healthy weight." Patient Education and Counseling 93.3 (December 1, 2013): 525-531.
Source
scopus
Published In
Patient Education and Counseling
Volume
93
Issue
3
Publish Date
2013
Start Page
525
End Page
531
DOI
10.1016/j.pec.2013.08.017

Risk factors and midwife-reported reasons for episiotomy in women undergoing normal vaginal delivery

Purpose: In Singapore, a developed Asian nation, a relatively high proportion of women undergo episiotomy. We assess risk factors and midwife-reported reasons for episiotomy among women undergoing normal vaginal deliveries (NVDs) conducted by midwives and ascertain the association between episiotomy and degree of perineal tear. Methods: Participants included 77 midwives from a high-volume delivery unit in Singapore. The study had three sequential phases: (1) medical record review of women undergoing NVDs conducted by midwives over a 1-month period to document the proportion with episiotomy; (2) focus group discussions with midwives to form a checklist of reasons for episiotomy; (3) checklist-based documentation of midwife-reported reasons for episiotomy and data collection on maternal, neonatal, practice and midwife factors, and degree of perineal tear among women undergoing NVDs conducted by midwives over a 2-month period. Risk factors for episiotomy were assessed through logistic regression. Results: Primiparity, advanced maternal age, Indian ethnicity, higher birth weight and older midwife age were associated with episiotomy. The most common midwife-reported reason for episiotomy among primiparous women was primiparity (55.1 %), and among multiparous women was fetal distress (20.0 %) and poor maternal effort (20.0 %). All women with episiotomy sustained at least a second-degree perineal tear versus 27.1 % among women without episiotomy. Conclusion: Most midwife-reported reasons for episiotomy were not congruent with international practice guidelines. Women without episiotomy have lesser tears than those with episiotomy. Practice protocols and educational programs are needed to change episiotomy practice. © 2013 Springer-Verlag Berlin Heidelberg.

Authors
Wu, LC; Malhotra, R; Allen, JC; Lie, D; Tan, TC; Østbye, T
MLA Citation
Wu, LC, Malhotra, R, Allen, JC, Lie, D, Tan, TC, and Østbye, T. "Risk factors and midwife-reported reasons for episiotomy in women undergoing normal vaginal delivery." Archives of Gynecology and Obstetrics 288.6 (December 1, 2013): 1249-1256.
Source
scopus
Published In
Archives of Gynecology and Obstetrics
Volume
288
Issue
6
Publish Date
2013
Start Page
1249
End Page
1256
DOI
10.1007/s00404-013-2897-6

Risk factors and midwife-reported reasons for episiotomy in women undergoing normal vaginal delivery.

PURPOSE: In Singapore, a developed Asian nation, a relatively high proportion of women undergo episiotomy. We assess risk factors and midwife-reported reasons for episiotomy among women undergoing normal vaginal deliveries (NVDs) conducted by midwives and ascertain the association between episiotomy and degree of perineal tear. METHODS: Participants included 77 midwives from a high-volume delivery unit in Singapore. The study had three sequential phases: (1) medical record review of women undergoing NVDs conducted by midwives over a 1-month period to document the proportion with episiotomy; (2) focus group discussions with midwives to form a checklist of reasons for episiotomy; (3) checklist-based documentation of midwife-reported reasons for episiotomy and data collection on maternal, neonatal, practice and midwife factors, and degree of perineal tear among women undergoing NVDs conducted by midwives over a 2-month period. Risk factors for episiotomy were assessed through logistic regression. RESULTS: Primiparity, advanced maternal age, Indian ethnicity, higher birth weight and older midwife age were associated with episiotomy. The most common midwife-reported reason for episiotomy among primiparous women was primiparity (55.1%), and among multiparous women was fetal distress (20.0%) and poor maternal effort (20.0%). All women with episiotomy sustained at least a second-degree perineal tear versus 27.1% among women without episiotomy. CONCLUSION: Most midwife-reported reasons for episiotomy were not congruent with international practice guidelines. Women without episiotomy have lesser tears than those with episiotomy. Practice protocols and educational programs are needed to change episiotomy practice.

Authors
Wu, LC; Malhotra, R; Allen, JC; Lie, D; Tan, TC; Østbye, T
MLA Citation
Wu, LC, Malhotra, R, Allen, JC, Lie, D, Tan, TC, and Østbye, T. "Risk factors and midwife-reported reasons for episiotomy in women undergoing normal vaginal delivery." Arch Gynecol Obstet 288.6 (December 2013): 1249-1256.
PMID
23708390
Source
pubmed
Published In
Archives of Gynecology and Obstetrics
Volume
288
Issue
6
Publish Date
2013
Start Page
1249
End Page
1256
DOI
10.1007/s00404-013-2897-6

Teen CHAT: Development and utilization of a web-based intervention to improve physician communication with adolescents about healthy weight.

OBJECTIVE: To describe the theoretical basis, use, and satisfaction with Teen CHAT, an online educational intervention designed to improve physician-adolescent communication about healthy weight. METHODS: Routine health maintenance encounters between pediatricians and family practitioners and their overweight adolescent patients were audio recorded, and content was coded to summarize adherence with motivational interviewing techniques. An online educational intervention was developed using constructs from social cognitive theory and using personalized audio recordings. Physicians were randomized to the online intervention or not, and completed post-intervention surveys. RESULTS: Forty-six physicians were recruited, and 22 physicians were randomized to view the intervention website. The educational intervention took an average of 54min to complete, and most physicians thought it was useful, that they would use newly acquired skills with their patients, and would recommend it to others. Fewer physicians thought it helped them address confidentiality issues with their adolescent patients. CONCLUSION: The Teen CHAT online intervention shows potential for enhancing physician motivational interviewing skills in an acceptable and time-efficient manner. PRACTICE IMPLICATIONS: If found to be effective in enhancing motivational interviewing skills and changing adolescent weight-related behaviors, wide dissemination will be feasible and indicated.

Authors
Bravender, T; Tulsky, JA; Farrell, D; Alexander, SC; Østbye, T; Lyna, P; Dolor, RJ; Coffman, CJ; Bilheimer, A; Lin, P-H; Pollak, KI
MLA Citation
Bravender, T, Tulsky, JA, Farrell, D, Alexander, SC, Østbye, T, Lyna, P, Dolor, RJ, Coffman, CJ, Bilheimer, A, Lin, P-H, and Pollak, KI. "Teen CHAT: Development and utilization of a web-based intervention to improve physician communication with adolescents about healthy weight." Patient Educ Couns 93.3 (December 2013): 525-531.
PMID
24021419
Source
pubmed
Published In
Patient Education and Counseling
Volume
93
Issue
3
Publish Date
2013
Start Page
525
End Page
531
DOI
10.1016/j.pec.2013.08.017

Under reporting of road traffic injuries in the district of Kandy, Sri Lanka.

OBJECTIVES: To conduct a community survey to estimate the degree to which road traffic injuries (RTIs) are under reported and to compare the characteristics of RTI reported to the police to those not reported. DESIGN: A cross-sectional population-based study. SETTING: Kandy district, Sri Lanka. PARTICIPANTS: RTIs and deaths during the preceding 12 months were identified through a community-based cross-sectional survey with a sample size of 3080 households. A stratified multistage cluster sampling with population proportion to size was used. 'Events reported' to the police were cross checked against events in the police records of the given or adjacent police stations, and either were 'Events found' or 'Not found'. 'Under reported' included those 'Not reported' and those reported but 'Not found' in the police dataset. RESULTS: Information about 11 724 persons were obtained from 3080 households, identifying 149 persons who suffered an RTI. Of these, 57% were 'Events reported', and of these 43.6% (n=65) were 'Events found' in police records (95% CI, 36.0 to 51.6). There were 42 events 'Not reported' to police while an additional 7 were 'Not found' in the police records of the given police station. Although they were claimed to have been reported to the police, 33% (95% CI 25.8 to 40.7) were 'Under reported'. There were significant differences in age (p=0.02), family income (p<0.001), road user type (p=0.001), injury severity (p<0.001) and injury category (p=0.01) between 'Events found' in the police records and 'Under reported' events. CONCLUSIONS: In the Kandy district, 33% of RTIs were 'under reported'. These findings could be used as evidence for policy planning to prevent RTIs, and highlights the need for a nation-wide community-based survey to determine the true rates of RTI for a better understanding of the reasons for under reporting.

Authors
Periyasamy, N; Lynch, CA; Dharmaratne, SD; Nugegoda, D; Ostbye, T
MLA Citation
Periyasamy, N, Lynch, CA, Dharmaratne, SD, Nugegoda, D, and Ostbye, T. "Under reporting of road traffic injuries in the district of Kandy, Sri Lanka. (Published online)" BMJ Open 3.11 (November 8, 2013): e003640-.
PMID
24213095
Source
pubmed
Published In
BMJ Open
Volume
3
Issue
11
Publish Date
2013
Start Page
e003640
DOI
10.1136/bmjopen-2013-003640

Diet quality of overweight and obese mothers and their preschool children.

Children of obese parents are more likely to become obese than children of normal-weight parents. However, there is little information regarding the diet intakes of children of obese parents.Our objective was to determine the diet quality of preschoolers and their overweight/obese mothers, whether maternal and child diet quality were correlated, and predictors of child's diet quality.Results are from baseline measurements from a randomized controlled behavioral intervention.Participants were English-literate, postpartum mothers and their preschoolers (n=177 mother-child dyads) in North Carolina. Visits took place in the Triangle and Triad regions of North Carolina between September 2007 and November 2009.We measured diet quality of mothers and preschoolers using the Healthy Eating Index-2005.Descriptive statistics, χ(2), analysis of variance, Pearson correlations, and stepwise regression models were used.Only 11% of children and 7% of mothers had Healthy Eating Index-2005 scores ≥80. Most children did not meet recommendations for fruits, vegetables, whole grains, meat and beans, sodium, saturated fat, and energy from solid fat and added sugars. Child diet quality was correlated with maternal diet quality (r=0.44; P<0.001). However, children and mothers differed in the proportion that met food-group recommendations: children vs mothers: total fruit (50% vs 14%), whole fruit (46% vs 28%), total vegetables (6% vs 18%), dark green and orange vegetables and legumes (7% vs 19%), total grains (57% vs 71%), milk (63% vs 22%), and meat and beans (33% vs 60%). Maternal diet quality and household income were positively correlated with child diet quality.The diets of children of overweight/obese mothers need improvement in several areas. Mother's diet quality and household income are important contributors to child's diet quality and should be considered in efforts to improve the diets of these children.

Authors
Laster, LER; Lovelady, CA; West, DG; Wiltheiss, GA; Brouwer, RJN; Stroo, M; Østbye, T
MLA Citation
Laster, LER, Lovelady, CA, West, DG, Wiltheiss, GA, Brouwer, RJN, Stroo, M, and Østbye, T. "Diet quality of overweight and obese mothers and their preschool children." Journal of the Academy of Nutrition and Dietetics 113.11 (November 2013): 1476-1483.
PMID
23871105
Source
epmc
Published In
Journal of the Academy of Nutrition and Dietetics
Volume
113
Issue
11
Publish Date
2013
Start Page
1476
End Page
1483
DOI
10.1016/j.jand.2013.05.018

Trends in racial disparities in pancreatic cancer surgery.

OBJECTIVES: We tested three hypotheses: (1) blacks with pancreatic cancer are recommended surgical resection less often than whites; (2) when recommended surgical resection, blacks refuse surgery more often than whites; and lastly, (3) racial differences in refusal of surgical resection have decreased over time. METHODS: A retrospective cohort study was conducted on patients with potentially resectable, nonmetastatic pancreatic adenocarcinoma of the Surveillance, Epidemiology, and End Results registry from 1988 to 2009. Univariate and multivariable logistic regression analyses were performed to assess whether differences in the proportion of whites versus blacks refusing surgery among patients recommended for resection changed over time. RESULTS: A total of 35,944 patients were included; most were white (87.6 %). After adjusting for covariates including tumor stage, pancreatic cancer resection was less often recommended to and performed in blacks compared with whites (adjusted odds ratio (aOR) 0.88, 95 % confidence interval (CI) 0.82-0.95; aOR 0.83, 95 % CI 0.76-0.91, respectively). Blacks also underwent surgical resection less often when surgery was recommended (aOR 0.73, 95 % CI 0.64-0.85). Racial disparities in surgery recommendation and its performance did not decrease from 1988 to 2009. In multivariable adjusted analyses, blacks refused surgery more often when it was recommended (aOR in 1988 4.75, 95 % CI 2.51-9.01); this disparity decreased over time (aOR 0.93 per year, 95 % CI 0.89-0.97). CONCLUSIONS: Although racial disparities in pancreatic cancer surgery refusal have diminished over the past two decades, significant disparities in the recommendation and performance of surgery persist. It is likely that both provider- and patient-level factors have a substantial impact on surgery recommendation and its acceptance. The identification of such factors is critical to design a framework for eliminating disparities in cancer-directed surgery for pancreatic cancer.

Authors
Shah, A; Chao, KSC; Ostbye, T; Castleberry, AW; Pietrobon, R; Gloor, B; Clary, BM; White, RR; Worni, M
MLA Citation
Shah, A, Chao, KSC, Ostbye, T, Castleberry, AW, Pietrobon, R, Gloor, B, Clary, BM, White, RR, and Worni, M. "Trends in racial disparities in pancreatic cancer surgery." J Gastrointest Surg 17.11 (November 2013): 1897-1906.
PMID
24002757
Source
pubmed
Published In
Journal of Gastrointestinal Surgery
Volume
17
Issue
11
Publish Date
2013
Start Page
1897
End Page
1906
DOI
10.1007/s11605-013-2304-4

Health issues of female foreign domestic workers: A systematic review of the scientific and gray literature

Background: Although the number of female foreign domestic workers (FDWs) is increasing worldwide, little is known about their health issues. Ob jective: To systematically review the literature on health issues of female FDWs to ascertain the problems studied, identify limitations, and suggest future research and policy implications. Methods: A systematic database (PubMed, EBSCO Host, and Google Scholar) and bibliographic search identified the English-language scientific and gray literature published during 1990-2012 addressing health issues of female FDWs living with the family of the employer, using qualitative and/or quantitative research methods. Studies in which female FDWs constituted less than half of the participants were excluded. Results: The health issues studied and identified were adverse work conditions and associated health problems (such as physical, verbal, and sexual abuse at the workplace, caregiving tasks associated with musculoskeletal strain, and chemical exposure associated with respiratory difficulty), mental health (psychotic, neurotic, and mood disorders), infectious diseases (most of the studies were on intestinal parasitic infections), and health knowledge/attitudes/practices (most of the studies were in context of sexual and reproductive health). Most of the studies were medical record reviews or questionnaire-based surveys utilizing convenience sampling or qualitative interviews/focus group discussions. Conclusion: Female FDWs face numerous health problems. Studies on representative, possibly longitudinal, samples of female FDWs focusing on specific health conditions are needed to better understand the epidemiology of such conditions. Concerted efforts through the governments of both laborsending and host countries are required to improve the health, work conditions, and safety of this vulnerable group of women. © W. S. Maney & Son Ltd 2013.

Authors
Malhotra, R; Arambepola, C; Tarun, S; de Silva, V; Kishore, J; Østbye, T
MLA Citation
Malhotra, R, Arambepola, C, Tarun, S, de Silva, V, Kishore, J, and Østbye, T. "Health issues of female foreign domestic workers: A systematic review of the scientific and gray literature." International Journal of Occupational and Environmental Health 19.4 (October 1, 2013): 261-277. (Review)
PMID
24588033
Source
scopus
Published In
International journal of occupational and environmental health
Volume
19
Issue
4
Publish Date
2013
Start Page
261
End Page
277
DOI
10.1179/2049396713Y.0000000041

The effect of the home environment on physical activity and dietary intake in preschool children.

The effects of the home environment on child health behaviors related to obesity are unclear.To examine the role of the home physical activity (PA) and food environment on corresponding outcomes in young children, and assess maternal education/work status as a moderator.Overweight or obese mothers reported on the home PA and food environment (accessibility, role modeling and parental policies). Outcomes included child moderate-vigorous PA (MVPA) and sedentary time derived from accelerometer data and two dietary factors ('junk' and healthy food intake scores) based on factor analysis of mother-reported food intake. Linear regression models assessed the net effect (controlling for child demographics, study arm, supplemental time point, maternal education/work status, child body mass index and accelerometer wear time (for PA outcomes)) of the home environment on the outcomes and moderation by maternal education/work status. Data were collected in North Carolina from 2007 to 2011.Parental policies supporting PA increased MVPA time, and limiting access to unhealthy foods increased the healthy food intake score. Role modeling of healthy eating behaviors increased the healthy food intake score among children of mothers with no college education. Among children of mothers with no college education and not working, limiting access to unhealthy foods and role modeling reduced 'junk' food intake scores whereas parental policies supporting family meals increased 'junk' food intake scores.To promote MVPA, parental policies supporting child PA are warranted. Limited access to unhealthy foods and role modeling of healthy eating may improve the quality of the child's food intake.

Authors
Østbye, T; Malhotra, R; Stroo, M; Lovelady, C; Brouwer, R; Zucker, N; Fuemmeler, B
MLA Citation
Østbye, T, Malhotra, R, Stroo, M, Lovelady, C, Brouwer, R, Zucker, N, and Fuemmeler, B. "The effect of the home environment on physical activity and dietary intake in preschool children." International journal of obesity (2005) 37.10 (October 2013): 1314-1321.
Website
http://hdl.handle.net/10161/11440
PMID
23736357
Source
epmc
Published In
International Journal of Obesity
Volume
37
Issue
10
Publish Date
2013
Start Page
1314
End Page
1321
DOI
10.1038/ijo.2013.76

Erratum: Greater risk of dementia when spouse has dementia? The cache county study (Journal of the American Geriatrics Society (2010) (895-900))

Authors
Norton, MC; Smith, KR; Østbye, T
MLA Citation
Norton, MC, Smith, KR, and Østbye, T. "Erratum: Greater risk of dementia when spouse has dementia? The cache county study (Journal of the American Geriatrics Society (2010) (895-900))." Journal of the American Geriatrics Society 61.9 (September 1, 2013): 1642-.
Source
scopus
Published In
Journal of American Geriatrics Society
Volume
61
Issue
9
Publish Date
2013
Start Page
1642
DOI
10.1111/jgs.12538

Use of and attitudes toward tobacco and alcohol among adults in southern Sri Lanka.

The adverse health effects of tobacco and alcohol are well known. Alcohol consumption is increasing in Sri Lanka, but few population studies have been conducted. The objective of this study was to document tobacco and alcohol consumption levels among adults in southern Sri Lanka and to identify the main reasons for using or refraining from alcohol and tobacco products. Tobacco and alcohol use within Sri Lanka is relatively common, particularly among adult males. Reasons given for smoking and drinking frequently relate to social and image-based motivators. Women may be especially susceptible to the influence of peer pressure in social situations. Public health efforts should consider the use of demographic-specific anti-tobacco and anti-alcohol messages, as the motivators driving behavior appear to differ across gender and age groups.

Authors
Lombardo, S; Perera, B; Beaudry, L; Grad, J; Maselko, J; Ostbye, T
MLA Citation
Lombardo, S, Perera, B, Beaudry, L, Grad, J, Maselko, J, and Ostbye, T. "Use of and attitudes toward tobacco and alcohol among adults in southern Sri Lanka." The Southeast Asian journal of tropical medicine and public health 44.5 (September 2013): 880-899.
PMID
24437324
Source
epmc
Published In
The Southeast Asian journal of tropical medicine and public health
Volume
44
Issue
5
Publish Date
2013
Start Page
880
End Page
899

The assistant medical officer in Sri Lanka: mid-level health worker in decline.

The history of Assistant Medical Officers (AMOs) in Sri Lanka can be traced back to the 1860s. Their training from the beginning followed an allopathic, 'evidence based' model. AMOs have played a key role in rural and peripheral health care, through staffing of government central dispensaries and maternity homes and may have contributed to Sri Lanka's favorable health outcomes. While there are currently approximately 2000 AMOs, their training course was discontinued in 1995. It was argued that the quality of care provided by the AMOs is substandard relative to that of physicians. The success, rapid expansion and integration of physician assistant programs into the US health care system have recently spurred other countries to introduce similar programs. This paper reviews Sri Lanka's move in the opposite direction, phasing out the AMO profession, without any research into their contributions to access to interprofessional primary health care and positive health outcomes.

Authors
De Silva, V; Strand de Oliveira, J; Liyanage, M; Østbye, T
MLA Citation
De Silva, V, Strand de Oliveira, J, Liyanage, M, and Østbye, T. "The assistant medical officer in Sri Lanka: mid-level health worker in decline." J Interprof Care 27.5 (September 2013): 432-433.
PMID
23659623
Source
pubmed
Published In
Journal of Interprofessional Care (Informa)
Volume
27
Issue
5
Publish Date
2013
Start Page
432
End Page
433
DOI
10.3109/13561820.2013.776023

Young adult weight trajectories through midlife by body mass category.

OBJECTIVE: To estimate the expected weight gain through midlife for those in a given BMI category in young adulthood. DESIGN AND METHODS: Group-based trajectory modeling and National Longitudinal Survey of Youth 1979 data from 1990 to 2008 were used to quantify weight trajectories through midlife for 10,038 young adult men and women stratified by BMI category. Logistic regression was used to assess the association of trajectory membership with obesity-related conditions (hypertension, diabetes, arthritis) in middle age. RESULTS: Annual weight gain averaged 0.53 kg (1.17 lb) across the entire sample. However, there was considerable variation by and within BMI categories. More than 98% of men and 92% of women were on upward-sloping trajectories, generally moving into a higher BMI category by middle age. Those who experienced early and rapid weight gain during young adulthood were most likely to be on a steeper trajectory and had greater risks for obesity-related conditions. CONCLUSION: This study points to the health and weight benefits of entering young adulthood with a normal BMI, but further reveals that this is no guarantee of maintaining a healthy weight through midlife. For those who are young adults today, weight maintenance is unlikely to occur without significant environmental or technical innovation.

Authors
Malhotra, R; Ostbye, T; Riley, CM; Finkelstein, EA
MLA Citation
Malhotra, R, Ostbye, T, Riley, CM, and Finkelstein, EA. "Young adult weight trajectories through midlife by body mass category." Obesity (Silver Spring) 21.9 (September 2013): 1923-1934.
PMID
23408493
Source
pubmed
Published In
Obesity
Volume
21
Issue
9
Publish Date
2013
Start Page
1923
End Page
1934
DOI
10.1002/oby.20318

Health impacts of caregiving for older adults with functional limitations: results from the Singapore survey on informal caregiving.

OBJECTIVE: To estimate the health impact, in terms of depression, self-rated health, and health services utilization, of providing care to older adults (75+) requiring human assistance in at least one activity of daily living (ADL) limitation. METHOD: Data from 1,077 caregivers and 318 noncaregivers, interviewed in the Singapore Survey on Informal Caregiving, was used to examine differences in depressive symptoms, self-rated health, and number of outpatient visits in the last 1 month between caregivers and noncaregivers. Multivariate models for the outcomes, adjusting for characteristics of the caregiver/noncaregiver and care-recipient/potential care recipient, were run. RESULTS: Caregivers were more depressed, had poorer self-rated health, and had a higher rate of outpatient visits in the past month compared to noncaregivers. DISCUSSION: The study indicates the need for support services to family caregivers of older adults with ADL limitations.

Authors
Chan, A; Malhotra, C; Malhotra, R; Rush, AJ; Østbye, T
MLA Citation
Chan, A, Malhotra, C, Malhotra, R, Rush, AJ, and Østbye, T. "Health impacts of caregiving for older adults with functional limitations: results from the Singapore survey on informal caregiving." J Aging Health 25.6 (September 2013): 998-1012.
PMID
23872822
Source
pubmed
Published In
Journal of Aging and Health
Volume
25
Issue
6
Publish Date
2013
Start Page
998
End Page
1012
DOI
10.1177/0898264313494801

Stressful life events and cognitive decline in late life: moderation by education and age. The Cache County Study.

OBJECTIVE: Stressful life events (SLE) have been associated with increased dementia risk, but their association with cognitive decline has been inconsistent. In a longitudinal population-based study of older individuals, we examined the association between SLE and cognitive decline, and the role of potential effect modifiers. METHODS: A total of 2665 non-demented participants of the Cache County Memory Study completed an SLE questionnaire at Wave 2 and were revisited 4 and 7 years later. The events were represented via several scores: total number, subjective rating (negative, positive, and unexpected), and a weighted summary based on their impact. Cognition was assessed at each visit with the modified Mini-Mental State Exam. General linear models were used to examine the association between SLE scores and cognition. Effect modification by age, education, and APOE genotype was tested. RESULTS: Years of formal education (p = 0.006) modified the effect of number of SLE, and age (p = 0.009) modified the effect of negative SLE on the rate of cognitive decline. Faster decline was observed among those with fewer years of education experiencing more SLE and also among younger participants experiencing more negative SLE. There was no association between other indicators of SLE and cognitive decline. APOE genotype did not modify any of the aforementioned associations. CONCLUSIONS: The effects of SLE on cognition in late life are complex and vary by individual factors such as age and education. These results may explain some of the contradictory findings in the literature.

Authors
Tschanz, JT; Pfister, R; Wanzek, J; Corcoran, C; Smith, K; Tschanz, BT; Steffens, DC; Østbye, T; Welsh-Bohmer, KA; Norton, MC
MLA Citation
Tschanz, JT, Pfister, R, Wanzek, J, Corcoran, C, Smith, K, Tschanz, BT, Steffens, DC, Østbye, T, Welsh-Bohmer, KA, and Norton, MC. "Stressful life events and cognitive decline in late life: moderation by education and age. The Cache County Study." Int J Geriatr Psychiatry 28.8 (August 2013): 821-830.
PMID
23037866
Source
pubmed
Published In
International Journal of Geriatric Psychiatry
Volume
28
Issue
8
Publish Date
2013
Start Page
821
End Page
830
DOI
10.1002/gps.3888

What factors influence midwives' decision to perform or avoid episiotomies? A focus group study.

OBJECTIVE: to explore midwives' reasons for performing or avoiding episiotomies and motivation to change episiotomy practice in a large tertiary maternity hospital. DESIGN: using purposive sampling, three focus groups were conducted to achieve theme saturation. Open-ended questions elicited personal reasons for performing or avoiding episiotomy, information sources, and opinions about past and future practice trends. Sessions were audiotaped, and transcripts independently examined by three researchers who coded for themes. An iterative process was used to achieve consensus. Grounded theory was used to interpret data and to derive a theoretical framework for understanding the reasoning that influences episiotomy practice. SETTING: a high volume delivery unit in Singapore. PARTICIPANTS: 20 of 79 licensed midwives, aged 28-70, who performed independent deliveries at the delivery unit. FINDINGS: participants recognised maternal, fetal and other factors affecting their own decision to perform episiotomies. Patient request, better healing, midwife's reputation and job satisfaction were cited as main reasons to avoid episiotomy. Key sources informing practice were past training, delivery experience, anecdotal learning and lack of a protocol. There was no consensus on current trends in episiotomy practice. There was an absence of recognition of individual roles in reducing episiotomy rates. Clinicians were perceived as having both positive and negative influence. CONCLUSIONS: midwives' reasons for performing episiotomies were attributed to midwifery training, fear of doing harm and perceived clinician expectation, and were not consistent with current international practice guidelines. Reasons for avoiding episiotomies were associated with patient-centeredness and job satisfaction. Midwives agreed on the need to reduce episiotomy rates. IMPLICATIONS FOR PRACTICE: with reduction in episiotomy rates as a goal, a combination of guideline education, feedback, peer coaching and collaborative care with doctors may be needed to achieve desired outcomes. Views and experiences of midwives should also be incorporated into strategies to change episiotomy practice.

Authors
Wu, LC; Lie, D; Malhotra, R; Allen, JC; Tay, JSL; Tan, TC; Ostbye, T
MLA Citation
Wu, LC, Lie, D, Malhotra, R, Allen, JC, Tay, JSL, Tan, TC, and Ostbye, T. "What factors influence midwives' decision to perform or avoid episiotomies? A focus group study." Midwifery 29.8 (August 2013): 943-949.
PMID
23453700
Source
pubmed
Published In
Midwifery
Volume
29
Issue
8
Publish Date
2013
Start Page
943
End Page
949
DOI
10.1016/j.midw.2012.11.017

A prospective study of risk factors for first trimester miscarriage in Asian women with threatened miscarriage.

INTRODUCTION: The present study aimed to assess the demographic, socioeconomic, medical and lifestyle factors associated with the progression of a threatened miscarriage to a complete miscarriage in the first trimester. METHODS: A prospective cohort study was conducted on 157 women who presented with vaginal bleeding in the fifth to tenth week of gestation. Cox regression analysis was used to determine the risk factors for progression to a complete miscarriage within 16 weeks of gestation. RESULTS: Of the 139 women included for data analysis, 36 (25.9%) had a miscarriage, mostly within two weeks of presentation. The results of our study showed that women aged ≥ 34 years were more likely to miscarry (hazard ratio [HR] = 1.95). Compared to women whose partner was 20-30 years of age, women whose partner was ≥ 41 years of age also had a higher likelihood of experiencing a miscarriage (HR = 8.33). However, the presence of nausea (HR = 0.33) and a high stress score (i.e. ≥ 17) on the Perceived Stress Scale (HR = 0.49) were associated with a reduced likelihood of miscarriage. CONCLUSION: Older pregnant women experiencing a threatened miscarriage should be counselled about their higher risk of miscarriage, especially if they have an older partner.

Authors
Kouk, LJ; Neo, GH; Malhotra, R; Allen, JC; Beh, ST; Tan, TC; Ostbye, T
MLA Citation
Kouk, LJ, Neo, GH, Malhotra, R, Allen, JC, Beh, ST, Tan, TC, and Ostbye, T. "A prospective study of risk factors for first trimester miscarriage in Asian women with threatened miscarriage." Singapore Med J 54.8 (August 2013): 425-431.
PMID
24005448
Source
pubmed
Published In
Singapore medical journal
Volume
54
Issue
8
Publish Date
2013
Start Page
425
End Page
431

Body mass trajectories through midlife among adults with class I obesity.

BACKGROUND: Little is known about the body mass trajectories for adults with class I obesity. Our objective was to map the body mass trajectories through midlife for young adults with class I obesity in the United States. METHODS: Data from the National Longitudinal Study of Youth 1979 was used to generate a cohort of 1058 men and women, aged 25-33 years with class I obesity in 1990. Group-based trajectory modeling was used to identify the number and shape of the body mass index trajectories from 1990 to 2008 for this cohort. RESULTS: By 2008, about 15% of men and women with class I obesity in 1990 experienced a body mass index increase to >40 kg/m(2). The trajectory analyses showed that roughly one third of the sample were on 1 of 2 body mass index trajectory groups that culminated with an average BMI well above 35 kg/m(2). CONCLUSION: The large majority of young adults with class I obesity are likely to gain weight over time. For many, the weight gain will be significant and greatly increase their risk of obesity-related co-morbidities and reduced life expectancy. As a result, bariatric surgery or other intensive weight management options might be warranted.

Authors
Finkelstein, EA; Østbye, T; Malhotra, R
MLA Citation
Finkelstein, EA, Østbye, T, and Malhotra, R. "Body mass trajectories through midlife among adults with class I obesity." Surg Obes Relat Dis 9.4 (July 2013): 547-553.e1.
PMID
22341531
Source
pubmed
Published In
Surgery for Obesity and Related Diseases
Volume
9
Issue
4
Publish Date
2013
Start Page
547
End Page
553.e1
DOI
10.1016/j.soard.2012.01.004

The steps to health employee weight management randomized control trial: rationale, design and baseline characteristics.

BACKGROUND: The workplace can be an important setting for addressing obesity. An increasing number of employers offer weight management programs. PURPOSE: Present the design, rationale and baseline characteristics of the Steps to Health study (STH), a randomized trial to evaluate the effectiveness of two preexisting employee weight management programs offered at Duke University and Medical Center. METHODS: 550 obese (BMI ≥30) employee volunteers were randomized 1:1 to two programs. Baseline data, collected between January 2011 and July 2012, included height/weight, accelerometry, workplace injuries, health care utilization, and questionnaires querying socio-cognitive factors, perceptions of health climate, physical activity, and dietary intake. In secondary analyses participants in the two programs will also be compared to a non-randomized observational control group of obese employees. RESULTS: At baseline, the mean age was 45 years, 83% were female, 41% white, and 53% black. Mean BMI was 37.2. Participants consumed a mean of 2.37 servings of fruits and vegetables per day (in the past week), participated in 11.5 min of moderate-to-vigorous physical activity, and spent 620 min being sedentary. CONCLUSION: STH addresses the need for evaluation of worksite interventions to promote healthy weight. In addition to having direct positive effects on workers' health, worksite programs have the potential to increase productivity and reduce health care costs.

Authors
Østbye, T; Stroo, M; Brouwer, RJN; Peterson, BL; Eisenstein, EL; Fuemmeler, BF; Joyner, J; Gulley, L; Dement, JM
MLA Citation
Østbye, T, Stroo, M, Brouwer, RJN, Peterson, BL, Eisenstein, EL, Fuemmeler, BF, Joyner, J, Gulley, L, and Dement, JM. "The steps to health employee weight management randomized control trial: rationale, design and baseline characteristics." Contemp Clin Trials 35.2 (July 2013): 68-76.
PMID
23648394
Source
pubmed
Published In
Contemporary Clinical Trials
Volume
35
Issue
2
Publish Date
2013
Start Page
68
End Page
76
DOI
10.1016/j.cct.2013.04.007

Does support from foreign domestic workers decrease the negative impact of informal caregiving? Results from Singapore survey on informal caregiving.

OBJECTIVES: To assess the instrumental support from a foreign domestic worker (FDW) as a moderator of the association of 4 types of impairments (physical function, memory, behavior, and mood) among older persons (OPs) with caregiving-related outcomes among their informal caregivers (CGs). METHOD: Data from a national survey of 1,190 Singaporeans aged 75 and older receiving human assistance for functional limitations and their CGs were used. Severity scores for the four OP impairments were calculated. A modified version of the Caregiver Reaction Assessment (CRA) assessed the impact of caregiving in four domains: disturbed schedule and poor health, lack of finances, lack of family support, and CG esteem. Linear regression models, one for each CRA domain, with interaction terms of the four impairment severity scores with FDW support, were developed. RESULTS: FDW instrumental support, reported for 50% of the OPs, moderated the direct association of OP physical impairment with disturbed schedule and poor health (p = .009), OP memory impairment with disturbed schedule and poor health (p < .0001) and lack of finances (p = .02), and OP behavior impairment with lack of family support (p = .001). Although such support buffered the inverse association of OP behavior impairment with CG esteem (p = .01), it also buffered the positive association of OP mood impairment with CG esteem (p = .02). DISCUSSION: FDW support is associated with better caregiving outcomes. Given its aging population, the number of FDWs in Singapore is likely to increase as families try to cope with caregiving for their older members. This has policy implications for (a) immigration patterns into Singapore and (b) training of and support networks for FDWs.

Authors
Østbye, T; Malhotra, R; Malhotra, C; Arambepola, C; Chan, A
MLA Citation
Østbye, T, Malhotra, R, Malhotra, C, Arambepola, C, and Chan, A. "Does support from foreign domestic workers decrease the negative impact of informal caregiving? Results from Singapore survey on informal caregiving." J Gerontol B Psychol Sci Soc Sci 68.4 (July 2013): 609-621.
PMID
23723433
Source
pubmed
Published In
Journals of Gerontology: Series B
Volume
68
Issue
4
Publish Date
2013
Start Page
609
End Page
621
DOI
10.1093/geronb/gbt042

Baseline disability in activities of daily living predicts dementia risk even after controlling for baseline global cognitive ability and depressive symptoms.

OBJECTIVES: Late-life disability in activities of daily living (ADL) is theorized to be driven by underlying cognitive and/or physical impairment, interacting with psychological and environmental factors. Although we expect that cognitive deficits would explain associations between ADL disability and dementia risk, the current study examined ADL as a predictor of future dementia after controlling for global cognitive status. METHODS: The population-based Cache County Memory Study (N = 3547) assessed individuals in four triennial waves (average age 74.9 years, years of education 13.36 years; 57.9% were women). Cox proportional hazards regression models assessed whether baseline ADL disability (presence of 2+ Instrumental ADL and/or 1+ Personal ADL) predicted incident dementia after controlling for APOE status, gender, age, baseline cognitive ability (Modified Mini-mental State Exam, 3MS-R; adjusted for education level), and baseline depressive symptoms (Diagnostic Interview Schedule). RESULTS: Over the course of study, 571 cases of incident dementia were identified through in-depth cognitive assessment, ending in expert consensus diagnosis. Results from Cox models suggest that ADL disability is a statistically significant predictor of incident dementia (adjusted hazard ratio = 1.83, p < 0.001), even after controlling for covariates. CONCLUSIONS: Findings suggest that ADL disability offers unique contributions in risk for incident dementia, even after controlling for global cognitive status. We discuss how physical impairment and executive function may play important roles in this relationship, and how ADL is useful, not just a diagnostic tool at, or after dementia onset, but also as a risk factor for future dementia, even in individuals not impaired on global cognitive tests.

Authors
Fauth, EB; Schwartz, S; Tschanz, JT; Østbye, T; Corcoran, C; Norton, MC
MLA Citation
Fauth, EB, Schwartz, S, Tschanz, JT, Østbye, T, Corcoran, C, and Norton, MC. "Baseline disability in activities of daily living predicts dementia risk even after controlling for baseline global cognitive ability and depressive symptoms." Int J Geriatr Psychiatry 28.6 (June 2013): 597-606.
PMID
22968965
Source
pubmed
Published In
International Journal of Geriatric Psychiatry
Volume
28
Issue
6
Publish Date
2013
Start Page
597
End Page
606
DOI
10.1002/gps.3865

The application of comorbidity indices to predict early postoperative outcomes after laparoscopic Roux-en-Y gastric bypass: a nationwide comparative analysis of over 70,000 cases.

BACKGROUND: Patients undergoing laparoscopic Roux-en-Y gastric bypass (LRYGB) often have substantial comorbidities, which must be taken into account to appropriately assess expected postoperative outcomes. The Charlson/Deyo and Elixhauser indices are widely used comorbidity measures, both of which also have revised algorithms based on enhanced ICD-9-CM coding. It is currently unclear which of the existing comorbidity measures best predicts early postoperative outcomes following LRYGB. METHODS: Using the Nationwide Inpatient Sample, patients 18 years or older undergoing LRYGB for obesity between 2001 and 2008 were identified. Comorbidities were assessed according to the original and enhanced Charlson/Deyo and Elixhauser indices. Using multivariate logistic regression, the following early postoperative outcomes were assessed: overall postoperative complications, length of hospital stay, and conversion to open surgery. Model performance for the four comorbidity indices was assessed and compared using C-statistics and the Akaike's information criterion (AIC). RESULTS: A total of 70,287 patients were included. Mean age was 43.1 years (SD, 10.8), 81.6 % were female and 60.3 % were White. Both the original and enhanced Elixhauser indices modestly outperformed the Charlson/Deyo in predicting the surgical outcomes. All four models had similar C-statistics, but the original Elixhauser index was associated with the smallest AIC for all of the surgical outcomes. CONCLUSIONS: The original Elixhauser index is the best predictor of early postoperative outcomes in our cohort of patients undergoing LRYGB. However, differences between the Charlson/Deyo and Elixhauser indices are modest, and each of these indices provides clinically relevant insight for predicting early postoperative outcomes in this high-risk patient population.

Authors
Shin, JH; Worni, M; Castleberry, AW; Pietrobon, R; Omotosho, PA; Silberberg, M; Østbye, T
MLA Citation
Shin, JH, Worni, M, Castleberry, AW, Pietrobon, R, Omotosho, PA, Silberberg, M, and Østbye, T. "The application of comorbidity indices to predict early postoperative outcomes after laparoscopic Roux-en-Y gastric bypass: a nationwide comparative analysis of over 70,000 cases." Obes Surg 23.5 (May 2013): 638-649.
PMID
23318945
Source
pubmed
Published In
Obesity Surgery
Volume
23
Issue
5
Publish Date
2013
Start Page
638
End Page
649
DOI
10.1007/s11695-012-0853-3

Predictors and adverse outcomes of inadequate or excessive gestational weight gain in an Asian population.

AIM: The aim of this study was to assess maternal characteristics as predictors of inadequate or excessive gestational weight gain (GWG) and to characterize maternal and neonatal outcomes associated with inadequate or excessive GWG in Asian women. MATERIAL AND METHODS: A study was conducted among 1166 Chinese, Malay, and Indian women who delivered a live singleton infant at KK Women's and Children's Hospital, Singapore. Logistic regression analysis was used to determine predictors and maternal and neonatal outcomes of inadequate or excessive GWG, relative to adequate (recommended) GWG. RESULTS: While maternal age less than 20 years, Malay ethnicity and underweight pre-pregnancy body mass index increased the risk of inadequate GWG, overweight pre-pregnancy body mass index decreased this risk. Tall stature and Malay ethnicity were associated with an increased risk of excessive GWG, while maternal age greater than 30 years was associated with a decreased risk. Inadequate GWG increased the risk of preterm birth and decreased the risk of delivery by cesarean section and postpartum weight retention at 6 months. Excessive GWG increased the risk of delivery by cesarean section, postpartum weight retention at 6, 12 and 24 months and having a high-birthweight baby. CONCLUSION: Maternal predictors and perinatal outcomes of GWG among Asian women are similar to those identified previously among Caucasian, African-American and Hispanic women.

Authors
Koh, H; Ee, TX; Malhotra, R; Allen, JC; Tan, TC; Østbye, T
MLA Citation
Koh, H, Ee, TX, Malhotra, R, Allen, JC, Tan, TC, and Østbye, T. "Predictors and adverse outcomes of inadequate or excessive gestational weight gain in an Asian population." J Obstet Gynaecol Res 39.5 (May 2013): 905-913.
PMID
23379547
Source
pubmed
Published In
Journal of Obstetrics and Gynaecology Research
Volume
39
Issue
5
Publish Date
2013
Start Page
905
End Page
913
DOI
10.1111/j.1447-0756.2012.02067.x

Do high-risk preschoolers or overweight mothers meet AAP-recommended behavioral goals for reducing obesity?

The American Academy of Pediatrics (AAP) has issued specific behavioral recommendations to prevent obesity. It is unclear how often high-risk preschoolers and overweight mothers meet recommended behavior goals and whether meeting these goals is negatively associated with overweight/obesity.To describe the proportion of preschoolers and mothers that meet AAP-recommended behavior goals and examine the associations of meeting goals with weight-status, and mothers meeting goals and children meeting corresponding goals.Secondary analysis of baseline data (before an intervention) from mother-preschooler dyads in a weight-control study. Mothers were overweight or obese. Preschoolers were 2-5 years old. Dietary and feeding practices were assessed by the use of questionnaires. Activity was measured directly using accelerometry. Outcomes included preschooler overweight and maternal obesity.The respective proportions of children and mothers that met behavior goals were: 17% and 13% for ≥5 fruits/vegetables/day, 46% and 33% for zero sugar-sweetened beverages/day, 41% and 13% for fast-food <1×/week, and 46% and 13% for screentime ≤2 hours/day. Moderate-to-vigorous physical activity did not exceed 60 minutes/day in any participant. A total of 49% ate family meals together 7×/week. For each additional goal met, the adjusted odds for preschooler overweight was 0.9 (95% confidence interval 0.8-1.1) and for maternal obesity, 0.8 (95% confidence interval 0.6-0.9). Preschoolers had significantly greater odds of meeting each goal when mothers met the corresponding goal.Few high-risk preschoolers or overweight mothers meet AAP-recommended behavior goals. Meeting a greater number of behavior goals may be particularly important for maternal weight. Preschoolers have greater odds of meeting behavior goals when mothers meet behavior goals.

Authors
Turer, CB; Stroo, M; Brouwer, RJ; Krause, KM; Lovelady, CA; Bastian, LA; Peterson, B; Østbye, T
MLA Citation
Turer, CB, Stroo, M, Brouwer, RJ, Krause, KM, Lovelady, CA, Bastian, LA, Peterson, B, and Østbye, T. "Do high-risk preschoolers or overweight mothers meet AAP-recommended behavioral goals for reducing obesity?." Academic pediatrics 13.3 (May 2013): 243-250.
PMID
23491583
Source
epmc
Published In
Academic Pediatrics
Volume
13
Issue
3
Publish Date
2013
Start Page
243
End Page
250
DOI
10.1016/j.acap.2013.01.003

Parental obesity moderates the relationship between childhood appetitive traits and weight.

OBJECTIVE: In this study, the independent and combined associations between childhood appetitive traits and parental obesity on weight gain from 0 to 24 months and body mass index (BMI) z-score at 24 months in a diverse community-based sample of dual parent families (n = 213) were examined. DESIGN AND METHODS: Participants were mothers who had recently completed a randomized trial of weight loss for overweight/obese postpartum women. As measures of childhood appetitive traits, mothers completed subscales of the Children's Eating Behavior Questionnaire, including Desire to Drink (DD), Enjoyment of Food (EF), and Satiety Responsiveness (SR), and a 24-h dietary recall for their child. Heights and weights were measured for all children and mothers and self-reported for mothers' partners. The relationship between children's appetitive traits and parental obesity on toddler weight gain and BMI z-score were evaluated using multivariate linear regression models, controlling for a number of potential confounders. RESULTS: Having two obese parents was related to greater weight gain from birth to 24 months independent of childhood appetitive traits, and although significant associations were found between appetitive traits (DD and SR) and child BMI z-score at 24 months, these associations were observed only among children who had two obese parents. When both parents were obese, increasing DD and decreasing SR were associated with a higher BMI z-score. CONCLUSIONS: The results highlight the importance of considering familial risk factors when examining the relationship between childhood appetitive traits on childhood obesity.

Authors
Fuemmeler, BF; Lovelady, CA; Zucker, NL; Østbye, T
MLA Citation
Fuemmeler, BF, Lovelady, CA, Zucker, NL, and Østbye, T. "Parental obesity moderates the relationship between childhood appetitive traits and weight." Obesity (Silver Spring) 21.4 (April 2013): 815-823.
PMID
23712985
Source
pubmed
Published In
Obesity
Volume
21
Issue
4
Publish Date
2013
Start Page
815
End Page
823
DOI
10.1002/oby.20144

MILA CELESTIAL BLOOM: AN APP FOR PROMOTING HEALTH AMONG ADOLESCENTS CANCER SURVIVORS

Authors
Fuemmeler, BF; Ostbye, T; Blatt, J; Cox, L; Holzwarth, E
MLA Citation
Fuemmeler, BF, Ostbye, T, Blatt, J, Cox, L, and Holzwarth, E. "MILA CELESTIAL BLOOM: AN APP FOR PROMOTING HEALTH AMONG ADOLESCENTS CANCER SURVIVORS." March 2013.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
45
Publish Date
2013
Start Page
S71
End Page
S71

LATENT POSTPARTUM DEPRESSION TRAJECTORY GROUPS AMONG OVERWEIGHT OR OBESE WOMEN

Authors
Lee, C-T; Stroo, M; Fuemmeler, BF; Malhotra, R; Ostbye, T
MLA Citation
Lee, C-T, Stroo, M, Fuemmeler, BF, Malhotra, R, and Ostbye, T. "LATENT POSTPARTUM DEPRESSION TRAJECTORY GROUPS AMONG OVERWEIGHT OR OBESE WOMEN." March 2013.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
45
Publish Date
2013
Start Page
S253
End Page
S253

High risks for adverse outcomes after gastric bypass surgery following failed gastric banding: a population-based trend analysis of the United States.

OBJECTIVES: The objectives of this investigation were to (1) compare short-term outcomes for patients undergoing primary gastric bypass surgery with those who had gastric bypass procedures performed as a rescue procedure after failed gastric banding and (2) study trends in the frequency of reoperations between 2005 and 2008 for patients who had prior gastric banding. BACKGROUND: The use of gastric banding to treat obesity has increased drastically in the United States. However, the frequency of reoperations related to gastric banding and associated short-term outcomes are unknown. METHODS: The Nationwide Inpatient Sample from 2005 to 2008 was used for this population-based study. Descriptive statistics as well as unadjusted and risk-adjusted generalized linear models were performed to assess adverse short-term outcomes. RESULTS: A total of 66,303 patients were included in the analysis, 63,171 (95.3%) underwent a primary gastric bypass procedure and 3132 patients (4.7%) underwent a gastric band-related reoperation. Patients undergoing a gastric bypass procedure concomitant with a band-related reoperation had more intraoperative complications [risk-adjusted odds ratio (OR): 2.3, P = 0.002] and postoperative complications (risk-adjusted OR: 8.0, P < 0.001), were at higher risk of reoperations/reinterventions (risk-adjusted OR: 6.0, P < 0.001), increased length of hospital stay (adjusted mean difference: 0.89 days, P < 0.001), and higher hospital charges (adjusted mean difference: $13,257, P < 0.001). The number of gastric band-related reoperations increased from 579 in 2005 to 1132 in 2008 (196%). CONCLUSIONS: The number of reoperations after gastric banding is rapidly increasing in the United States. To our knowledge, this is the first population-based study providing strong evidence that patients undergoing gastric bypass procedure after failed gastric banding have more adverse outcomes than those undergoing gastric bypass alone. The broad indication for gastric banding should be reaffirmed for the US population.

Authors
Worni, M; Østbye, T; Shah, A; Carvalho, E; Schudel, IM; Shin, JH; Pietrobon, R; Guller, U
MLA Citation
Worni, M, Østbye, T, Shah, A, Carvalho, E, Schudel, IM, Shin, JH, Pietrobon, R, and Guller, U. "High risks for adverse outcomes after gastric bypass surgery following failed gastric banding: a population-based trend analysis of the United States." Ann Surg 257.2 (February 2013): 279-286.
PMID
23011388
Source
pubmed
Published In
Annals of Surgery
Volume
257
Issue
2
Publish Date
2013
Start Page
279
End Page
286
DOI
10.1097/SLA.0b013e3182683037

Racial differences among patients undergoing laparoscopic gastric bypass surgery: a population-based trend analysis from 2002 to 2008.

BACKGROUND: Laparoscopic gastric bypass surgery (LGBS) has become the most widely used bariatric procedure due to its beneficial long-term outcomes for patients with morbid obesity. However, it is unclear whether racial differences in admission for LGBS have changed over time compared to racial differences in all other admissions. We aimed to investigate the trends and differences in the use of LGBS among white, African-American, and Hispanic patients from 2002 to 2008. METHODS: We performed a secondary analysis of data on obese adult patients operated between 2002 and 2008, using the Nationwide Inpatient Sample (NIS) database. The probability of being admitted for LGBS was estimated using logistic regression with race, year, and year by race interaction as predictors, controlling for numerous patient and hospital characteristics. RESULTS: Among 1,704,972 obese hospitalized patients captured through NIS from 2002 to 2008, 2.6 % underwent LGBS (2.8 % Whites, 1.7 % African-Americans, and 2.6 % Hispanics). In adjusted analysis, obese African-American (OR 0.48, p < 0.001) and Hispanic patients (OR 0.59, p < 0.001) were less likely to be admitted for LGBS than white patients in 2002. Race-year interactions showed that the odds of African-Americans undergoing LGBS significantly increased from 2002 to 2008 compared with Whites (annual OR 1.03, p < 0.001) while no such increase was detected for Hispanics (annual OR 1.02, p = 0.11). In 2008, African-American (OR 0.58, p < 0.001) and Hispanic patients (OR 0.65, p < 0.001) still had lower odds than white patients. CONCLUSIONS: This is the first study showing that the difference in the use of LGBS between obese African-American and white patients declined between 2002 and 2008. However, LGBS use still remained significantly lower for both African-American and Hispanic patients in 2008 compared with white patients.

Authors
Worni, M; Guller, U; Maciejewski, ML; Curtis, LH; Gandhi, M; Pietrobon, R; Jacobs, DO; Østbye, T
MLA Citation
Worni, M, Guller, U, Maciejewski, ML, Curtis, LH, Gandhi, M, Pietrobon, R, Jacobs, DO, and Østbye, T. "Racial differences among patients undergoing laparoscopic gastric bypass surgery: a population-based trend analysis from 2002 to 2008." Obes Surg 23.2 (February 2013): 226-233.
PMID
23207831
Source
pubmed
Published In
Obesity Surgery
Volume
23
Issue
2
Publish Date
2013
Start Page
226
End Page
233
DOI
10.1007/s11695-012-0832-8

156. Primary Care Physicians' Assurances of Confidentiality and Time Spent Alone With Adolescents During Routine Health Care Visits

Authors
Bravender, T; Lyna, P; Tulsky, J; Ostbye, T; Dolor, R; Coffman, C; Bilheimer, A; Lin, P-H; Pollak, K
MLA Citation
Bravender, T, Lyna, P, Tulsky, J, Ostbye, T, Dolor, R, Coffman, C, Bilheimer, A, Lin, P-H, and Pollak, K. "156. Primary Care Physicians' Assurances of Confidentiality and Time Spent Alone With Adolescents During Routine Health Care Visits." Journal of Adolescent Health 52.2 (February 2013): S95-S96.
Source
crossref
Published In
Journal of Adolescent Health
Volume
52
Issue
2
Publish Date
2013
Start Page
S95
End Page
S96
DOI
10.1016/j.jadohealth.2012.10.225

Variation in and correlates of body mass status of older singaporean men and women: results from a national survey.

This study describes the body mass status of older (≥60 years) Singaporeans, using the international and Asian body mass index (BMI) classifications, assesses sociodemographic correlates of BMI, underweight, obesity, and "high-risk" BMI (≥27.5 kg/m(2)), and ascertains the relationship between body mass and important health outcomes. Prevalence of underweight, obesity, and high-risk BMI among 4371 older Singaporeans was 6.8%, 7.4%, and 18.6%, respectively. Women (vs men) and Malays and Indians (vs Chinese) were more likely to have obesity or high-risk BMI. Increasing education decreased the odds of obesity and high-risk BMI only among women. Prevalence and odds of various health conditions was similar in corresponding categories of the two BMI classifications. Whereas the prevalence of obesity is lower among elderly in Singapore than in many other countries, the prevalence of high-risk BMI is considerable. It is important to address high-risk BMI among them, with elderly of minority ethnic groups, especially females, being a priority.

Authors
Ostbye, T; Malhotra, R; Chan, A
MLA Citation
Ostbye, T, Malhotra, R, and Chan, A. "Variation in and correlates of body mass status of older singaporean men and women: results from a national survey." Asia Pac J Public Health 25.1 (January 2013): 48-62.
PMID
21362671
Source
pubmed
Published In
Asia Pacific Journal of Public Health
Volume
25
Issue
1
Publish Date
2013
Start Page
48
End Page
62
DOI
10.1177/1010539510393726

Diet quality and weight change among overweight and obese postpartum women enrolled in a behavioral intervention program.

Postpartum weight retention is a risk factor for long-term weight gain. Encouraging new mothers to consume a healthy diet may result in weight loss.To assess predictors of diet quality during the early postpartum period; to determine whether diet quality, energy intake, and lactation status predicted weight change from 5 to 15 months postpartum; and to determine whether an intervention improved diet quality, reduced energy intake, and achieved greater weight loss compared with usual care.Randomized clinical trial (KAN-DO: Kids and Adults Now-Defeat Obesity), a family- and home-based, 10-month, behavioral intervention to prevent childhood obesity, with secondary aims to improve diet and physical activity habits of mothers to promote postpartum weight loss.Overweight/obese, postpartum women (n=400), recruited from 14 counties in the Piedmont region of North Carolina.Eight education kits, each mailed monthly; motivational counseling; and one group class.Anthropometric measurements and 24-hour dietary recalls collected at baseline (approximately 5 months postpartum) and follow-up (approximately 10 months later). Diet quality was determined using the Healthy Eating Index-2005 (HEI-2005).Descriptive statistics, χ(2), analysis of variance, bi- and multivariate analyses were used.At baseline, mothers consumed a low-quality diet (HEI-2005 score=64.4 ± 11.4). Breastfeeding and income were positive, significant predictors of diet quality, whereas body mass index was a negative predictor. Diet quality did not predict weight change. However, total energy intake, not working outside of the home, and breastfeeding duration/intensity were negative predictors of weight loss. There were no significant differences in changes in diet quality, decreases in energy intake, or weight loss between the intervention (2.3 ± 5.4 kg) and control (1.5 ± 4.7 kg) arms.The family-based intervention did not promote postpartum weight loss. Reducing energy intake, rather than improving diet quality, should be the focus of weight-loss interventions for overweight/obese postpartum women.

Authors
Wiltheiss, GA; Lovelady, CA; West, DG; Brouwer, RJN; Krause, KM; Østbye, T
MLA Citation
Wiltheiss, GA, Lovelady, CA, West, DG, Brouwer, RJN, Krause, KM, and Østbye, T. "Diet quality and weight change among overweight and obese postpartum women enrolled in a behavioral intervention program." Journal of the Academy of Nutrition and Dietetics 113.1 (January 2013): 54-62.
PMID
23146549
Source
epmc
Published In
Journal of the Academy of Nutrition and Dietetics
Volume
113
Issue
1
Publish Date
2013
Start Page
54
End Page
62
DOI
10.1016/j.jand.2012.08.012

Life-course socioeconomic status and obesity among older Singaporean Chinese men and women.

OBJECTIVES: To elucidate the association between life-course socioeconomic status (SES) and obesity among older (aged 60 and older) Singaporean Chinese men and women. METHODS: Data from the Social Isolation, Health and Lifestyles Survey (single-stage stratified random sampling design) was utilized. Obesity (body mass index >27.4 kg/m(2)) was assessed for 1,530 men and 2,036 women. Childhood (family financial status while growing up), adult (education), and older adult (housing type) SES indicators were used to define the accumulation of risk (cumulative socioeconomic disadvantage), social mobility (8 trajectories using the 3 SES indicators), and sensitive period (independent effect of each SES indicator) conceptual models. Association between the 3 life-course SES conceptual models and obesity was assessed using logistic regression analysis. RESULTS: Among women and men, low childhood SES lowered the odds of obesity. Low adult SES increased the odds of obesity only among women. There was no association between cumulative socioeconomic disadvantage and obesity. Women experiencing upward social mobility had lower odds of obesity relative to both those experiencing low SES and high SES through the life-course. DISCUSSION: Association of the life-course SES conceptual models with obesity among older Singaporeans is different from that reported among younger Western populations, suggesting the association to be context specific. The different conceptual models complement each other.

Authors
Malhotra, R; Malhotra, C; Chan, A; Østbye, T
MLA Citation
Malhotra, R, Malhotra, C, Chan, A, and Østbye, T. "Life-course socioeconomic status and obesity among older Singaporean Chinese men and women." J Gerontol B Psychol Sci Soc Sci 68.1 (January 2013): 117-127.
PMID
23161348
Source
pubmed
Published In
Journals of Gerontology: Series B
Volume
68
Issue
1
Publish Date
2013
Start Page
117
End Page
127
DOI
10.1093/geronb/gbs102

Changes in physical activity among postpartum overweight and obese women: results from the KAN-DO Study.

Few studies have assessed physical activity at multiple time points in the postpartum period or used both self-reported and objective measures of assessment. The purpose of this study was to describe physical activity and sedentary behavior at two time points in a cohort of overweight or obese postpartum women using both self-reported and objective measures. In total, 132 women completed physical activity assessments at a median of 24 weeks postpartum and again approximately 10 months later. At both time points, women wore an Actical accelerometer for one week and completed the Kaiser Physical Activity Survey. Adjusted Poisson regression models were used to determine whether physical activity changed over time for the cohort. Overall counts per minute and moderate to vigorous physical activity increased from baseline to 10 months later, although the absolute levels were modest (median 6.9 to 8.8 minutes/day). A median of 64%-71% at baseline and 63%-67% at follow-up of their monitored times were sedentary. More intensive interventions are needed to help postpartum women integrate physical activity and reduce sedentary behavior. [Supplementary material is available for this article. Go to the publisher's online edition of Women & Health for the following resource: three figures that show the distribution of physical activity and sedentary behavior by study periods among control participants].

Authors
Evenson, KR; Brouwer, RJN; Østbye, T
MLA Citation
Evenson, KR, Brouwer, RJN, and Østbye, T. "Changes in physical activity among postpartum overweight and obese women: results from the KAN-DO Study." Women & health 53.3 (January 2013): 317-334.
PMID
23705761
Source
epmc
Published In
Women & Health
Volume
53
Issue
3
Publish Date
2013
Start Page
317
End Page
334
DOI
10.1080/03630242.2013.769482

Chikungunya as a cause of acute febrile illness in southern Sri Lanka.

BACKGROUND: Chikungunya virus (CHIKV) re-emerged in Sri Lanka in late 2006 after a 40-year hiatus. We sought to identify and characterize acute chikungunya infection (CHIK) in patients presenting with acute undifferentiated febrile illness in unstudied rural and semi-urban southern Sri Lanka in 2007. METHODOLOGY/PRINCIPAL FINDINGS: We enrolled febrile patients ≥ 2 years of age, collected uniform epidemiologic and clinical data, and obtained serum samples for serology, virus isolation, and real-time reverse-transcriptase PCR (RT-PCR). Serology on paired acute and convalescent samples identified acute chikungunya infection in 3.5% (28/797) patients without acute dengue virus (DENV) infection, 64.3% (18/28) of which were confirmed by viral isolation and/or real-time RT-PCR. No CHIKV/DENV co-infections were detected among 54 patients with confirmed acute DENV. Sequencing of the E1 coding region of six temporally distinct CHIKV isolates (April through October 2007) showed that all isolates posessed the E1-226A residue and were most closely related to Sri Lankan and Indian isolates from the same time period. Except for more frequent and persistent musculoskeletal symptoms, acute chikungunya infections mimicked DENV and other acute febrile illnesses. Only 12/797 (1.5%) patients had serological evidence of past chikungunya infection. CONCLUSIONS/SIGNIFICANCE: Our findings suggest CHIKV is a prominent cause of non-specific acute febrile illness in southern Sri Lanka.

Authors
Reller, ME; Akoroda, U; Nagahawatte, A; Devasiri, V; Kodikaarachchi, W; Strouse, JJ; Chua, R; Hou, Y; Chow, A; Sessions, OM; Østbye, T; Gubler, DJ; Woods, CW; Bodinayake, C
MLA Citation
Reller, ME, Akoroda, U, Nagahawatte, A, Devasiri, V, Kodikaarachchi, W, Strouse, JJ, Chua, R, Hou, Y, Chow, A, Sessions, OM, Østbye, T, Gubler, DJ, Woods, CW, and Bodinayake, C. "Chikungunya as a cause of acute febrile illness in southern Sri Lanka. (Published online)" PLoS One 8.12 (2013): e82259-.
Website
http://hdl.handle.net/10161/12505
PMID
24312651
Source
pubmed
Published In
PloS one
Volume
8
Issue
12
Publish Date
2013
Start Page
e82259
DOI
10.1371/journal.pone.0082259

Trends in Racial Disparities in Pancreatic Cancer Surgery

Objectives: We tested three hypotheses: (1) blacks with pancreatic cancer are recommended surgical resection less often than whites; (2) when recommended surgical resection, blacks refuse surgery more often than whites; and lastly, (3) racial differences in refusal of surgical resection have decreased over time. Methods: A retrospective cohort study was conducted on patients with potentially resectable, nonmetastatic pancreatic adenocarcinoma of the Surveillance, Epidemiology, and End Results registry from 1988 to 2009. Univariate and multivariable logistic regression analyses were performed to assess whether differences in the proportion of whites versus blacks refusing surgery among patients recommended for resection changed over time. Results: A total of 35,944 patients were included; most were white (87.6 %). After adjusting for covariates including tumor stage, pancreatic cancer resection was less often recommended to and performed in blacks compared with whites (adjusted odds ratio (aOR) 0.88, 95 % confidence interval (CI) 0.82-0.95; aOR 0.83, 95 % CI 0.76-0.91, respectively). Blacks also underwent surgical resection less often when surgery was recommended (aOR 0.73, 95 % CI 0.64-0.85). Racial disparities in surgery recommendation and its performance did not decrease from 1988 to 2009. In multivariable adjusted analyses, blacks refused surgery more often when it was recommended (aOR in 1988 4.75, 95 % CI 2.51-9.01); this disparity decreased over time (aOR 0.93 per year, 95 % CI 0.89-0.97). Conclusions: Although racial disparities in pancreatic cancer surgery refusal have diminished over the past two decades, significant disparities in the recommendation and performance of surgery persist. It is likely that both provider- and patient-level factors have a substantial impact on surgery recommendation and its acceptance. The identification of such factors is critical to design a framework for eliminating disparities in cancer-directed surgery for pancreatic cancer. © 2013 The Society for Surgery of the Alimentary Tract.

Authors
Shah, A; Chao, KSC; Østbye, T; Castleberry, AW; Pietrobon, R; Gloor, B; Clary, BM; White, RR; Worni, M
MLA Citation
Shah, A, Chao, KSC, Østbye, T, Castleberry, AW, Pietrobon, R, Gloor, B, Clary, BM, White, RR, and Worni, M. "Trends in Racial Disparities in Pancreatic Cancer Surgery." Journal of Gastrointestinal Surgery 17.11 (2013): 1897-1906.
Source
scival
Published In
Journal of Gastrointestinal Surgery
Volume
17
Issue
11
Publish Date
2013
Start Page
1897
End Page
1906
DOI
10.1007/s11605-013-2304-4

Diet quality of overweight and obese mothers and their preschool children

Background: Children of obese parents are more likely to become obese than children of normal-weight parents. However, there is little information regarding the diet intakes of children of obese parents. Objective: Our objective was to determine the diet quality of preschoolers and their overweight/obese mothers, whether maternal and child diet quality were correlated, and predictors of child's diet quality. Design: Results are from baseline measurements from a randomized controlled behavioral intervention. Participants: Participants were English-literate, postpartum mothers and their preschoolers (n=177 mother-child dyads) in North Carolina. Visits took place in the Triangle and Triad regions of North Carolina between September 2007 and November2009. Main outcome measures: We measured diet quality of mothers and preschoolers using the Healthy Eating Index-2005. Statistical analyses performed: Descriptive statistics, χ2, analysis of variance, Pearson correlations, and stepwise regression models were used. Results: Only 11% of children and 7% of mothers had Healthy Eating Index-2005 scores ≥80. Most children did not meet recommendations for fruits, vegetables, whole grains, meat and beans, sodium, saturated fat, and energy from solid fat and added sugars. Child diet quality was correlated with maternal diet quality (r=0.44; P<0.001). However, children and mothers differed in the proportion that met food-group recommendations: children vs mothers: total fruit (50% vs 14%), whole fruit (46% vs 28%), total vegetables (6% vs 18%), dark green and orange vegetables and legumes (7% vs 19%), total grains (57% vs 71%), milk (63% vs 22%), and meat and beans (33% vs 60%). Maternal diet quality and household income were positively correlated with child diet quality. Conclusions: The diets of children of overweight/obese mothers need improvement in several areas. Mother's diet quality and household income are important contributors to child's diet quality and should be considered in efforts to improve the diets of these children. © 2013 Academy of Nutrition and Dietetics.

Authors
Laster, LER; Lovelady, CA; West, DG; Wiltheiss, GA; Brouwer, RJN; Stroo, M; Østbye, T
MLA Citation
Laster, LER, Lovelady, CA, West, DG, Wiltheiss, GA, Brouwer, RJN, Stroo, M, and Østbye, T. "Diet quality of overweight and obese mothers and their preschool children." Journal of the Academy of Nutrition and Dietetics 113.11 (2013): 1476-1483.
Source
scival
Published In
Journal of the Academy of Nutrition and Dietetics
Volume
113
Issue
11
Publish Date
2013
Start Page
1476
End Page
1483
DOI
10.1016/j.jand.2013.05.018

The effect of the home environment on physical activity and dietary intake in preschool children

Background:The effects of the home environment on child health behaviors related to obesity are unclear.Purpose:To examine the role of the home physical activity (PA) and food environment on corresponding outcomes in young children, and assess maternal education/work status as a moderator.Methods:Overweight or obese mothers rePORted on the home PA and food environment (accessibility, role modeling and parental policies). Outcomes included child moderate-vigorous PA (MVPA) and sedentary time derived from accelerometer data and two dietary factors ('junk' and healthy food intake scores) based on factor analysis of mother-rePORted food intake. Linear regression models assessed the net effect (controlling for child demographics, study arm, supplemental time point, maternal education/work status, child body mass index and accelerometer wear time (for PA outcomes)) of the home environment on the outcomes and moderation by maternal education/work status. Data were collected in North Carolina from 2007 to 2011.Results:Parental policies supPORting PA increased MVPA time, and limiting access to unhealthy foods increased the healthy food intake score. Role modeling of healthy eating behaviors increased the healthy food intake score among children of mothers with no college education. Among children of mothers with no college education and not working, limiting access to unhealthy foods and role modeling reduced 'junk' food intake scores whereas parental policies supPORting family meals increased 'junk' food intake scores.Conclusions:To promote MVPA, parental policies supPORting child PA are warranted. Limited access to unhealthy foods and role modeling of healthy eating may improve the quality of the child's food intake. © 2013 Macmillan Publishers Limited.

Authors
Østbye, T; Malhotra, R; Stroo, M; Lovelady, C; Brouwer, R; Zucker, N; Fuemmeler, B
MLA Citation
Østbye, T, Malhotra, R, Stroo, M, Lovelady, C, Brouwer, R, Zucker, N, and Fuemmeler, B. "The effect of the home environment on physical activity and dietary intake in preschool children." International Journal of Obesity 37.10 (2013): 1314-1321.
Source
scival
Published In
International Journal of Obesity
Volume
37
Issue
10
Publish Date
2013
Start Page
1314
End Page
1321
DOI
10.1038/ijo.2013.76

Is overweight and class I obesity associated with increased health claims costs?

Authors
Østbye, T; Stroo, M; Eisenstein, EL; Peterson, B; Dement, J
MLA Citation
Østbye, T, Stroo, M, Eisenstein, EL, Peterson, B, and Dement, J. "Is overweight and class I obesity associated with increased health claims costs?." Obesity (2013).
PMID
24796000
Source
scopus
Published In
Obesity (Silver Spring, Md.)
Publish Date
2013

The application of comorbidity indices to predict early postoperative outcomes after laparoscopic roux-en-Y gastric bypass: A nationwide comparative analysis of over 70,000 cases

Background: Patients undergoing laparoscopic Roux-en-Y gastric bypass (LRYGB) often have substantial comorbidities, which must be taken into account to appropriately assess expected postoperative outcomes. The Charlson/Deyo and Elixhauser indices are widely used comorbidity measures, both of which also have revised algorithms based on enhanced ICD-9-CM coding. It is currently unclear which of the existing comorbidity measures best predicts early postoperative outcomes following LRYGB. Methods: Using the Nationwide Inpatient Sample, patients 18 years or older undergoing LRYGB for obesity between 2001 and 2008 were identified. Comorbidities were assessed according to the original and enhanced Charlson/Deyo and Elixhauser indices. Using multivariate logistic regression, the following early postoperative outcomes were assessed: overall postoperative complications, length of hospital stay, and conversion to open surgery. Model performance for the four comorbidity indices was assessed and compared using C-statistics and the Akaike's information criterion (AIC). Results: A total of 70,287 patients were included. Mean age was 43.1 years (SD, 10.8), 81.6 % were female and 60.3 % were White. Both the original and enhanced Elixhauser indices modestly outperformed the Charlson/Deyo in predicting the surgical outcomes. All four models had similar C-statistics, but the original Elixhauser index was associated with the smallest AIC for all of the surgical outcomes. Conclusions: The original Elixhauser index is the best predictor of early postoperative outcomes in our cohort of patients undergoing LRYGB. However, differences between the Charlson/Deyo and Elixhauser indices are modest, and each of these indices provides clinically relevant insight for predicting early postoperative outcomes in this high-risk patient population. © 2013 Springer Science+Business Media New York.

Authors
Shin, JH; Worni, M; Castleberry, AW; Pietrobon, R; Omotosho, PA; Silberberg, M; Østbye, T
MLA Citation
Shin, JH, Worni, M, Castleberry, AW, Pietrobon, R, Omotosho, PA, Silberberg, M, and Østbye, T. "The application of comorbidity indices to predict early postoperative outcomes after laparoscopic roux-en-Y gastric bypass: A nationwide comparative analysis of over 70,000 cases." Obesity Surgery 23.5 (2013): 638-649.
Source
scival
Published In
Obesity Surgery
Volume
23
Issue
5
Publish Date
2013
Start Page
638
End Page
649
DOI
10.1007/s11695-012-0853-3

Baseline disability in activities of daily living predicts dementia risk even after controlling for baseline global cognitive ability and depressive symptoms

Objectives Late-life disability in activities of daily living (ADL) is theorized to be driven by underlying cognitive and/or physical impairment, interacting with psychological and environmental factors. Although we expect that cognitive deficits would explain associations between ADL disability and dementia risk, the current study examined ADL as a predictor of future dementia after controlling for global cognitive status. Methods The population-based Cache County Memory Study (N = 3547) assessed individuals in four triennial waves (average age 74.9 years, years of education 13.36 years; 57.9% were women). Cox proportional hazards regression models assessed whether baseline ADL disability (presence of 2+ Instrumental ADL and/or 1+ Personal ADL) predicted incident dementia after controlling for APOE status, gender, age, baseline cognitive ability (Modified Mini-mental State Exam, 3MS-R; adjusted for education level), and baseline depressive symptoms (Diagnostic Interview Schedule). Results Over the course of study, 571 cases of incident dementia were identified through in-depth cognitive assessment, ending in expert consensus diagnosis. Results from Cox models suggest that ADL disability is a statistically significant predictor of incident dementia (adjusted hazard ratio = 1.83, p < 0.001), even after controlling for covariates. Conclusions Findings suggest that ADL disability offers unique contributions in risk for incident dementia, even after controlling for global cognitive status. We discuss how physical impairment and executive function may play important roles in this relationship, and how ADL is useful, not just a diagnostic tool at, or after dementia onset, but also as a risk factor for future dementia, even in individuals not impaired on global cognitive tests. Copyright © 2012 John Wiley & Sons, Ltd.

Authors
Fauth, EB; Schwartz, S; Tschanz, JT; Østbye, T; Corcoran, C; Norton, MC
MLA Citation
Fauth, EB, Schwartz, S, Tschanz, JT, Østbye, T, Corcoran, C, and Norton, MC. "Baseline disability in activities of daily living predicts dementia risk even after controlling for baseline global cognitive ability and depressive symptoms." International Journal of Geriatric Psychiatry 28.6 (2013): 597-606.
Source
scival
Published In
International Journal of Geriatric Psychiatry
Volume
28
Issue
6
Publish Date
2013
Start Page
597
End Page
606
DOI
10.1002/gps.3865

Do high-risk preschoolers or overweight mothers meet AAP-recommended behavioral goals for reducing obesity?

Background: The American Academy of Pediatrics (AAP) has issued specific behavioral recommendations to prevent obesity. It is unclear how often high-risk preschoolers and overweight mothers meet recommended behavior goals and whether meeting these goals is negatively associated with overweight/obesity. Objective: To describe the proportion of preschoolers and mothers that meet AAP-recommended behavior goals and examine the associations of meeting goals with weight-status, and mothers meeting goals and children meeting corresponding goals. Methods: Secondary analysis of baseline data (before an intervention) from mother-preschooler dyads in a weight-control study. Mothers were overweight or obese. Preschoolers were 2-5 years old. Dietary and feeding practices were assessed by the use of questionnaires. Activity was measured directly using accelerometry. Outcomes included preschooler overweight and maternal obesity. Results: The respective proportions of children and mothers that met behavior goals were: 17% and 13% for ≥5 fruits/vegetables/day, 46% and 33% for zero sugar-sweetened beverages/day, 41% and 13% for fast-food <1×/week, and 46% and 13% for screentime ≤2 hours/day. Moderate-to-vigorous physical activity did not exceed 60 minutes/day in any participant. A total of 49% ate family meals together 7×/week. For each additional goal met, the adjusted odds for preschooler overweight was 0.9 (95% confidence interval 0.8-1.1) and for maternal obesity, 0.8 (95% confidence interval 0.6-0.9). Preschoolers had significantly greater odds of meeting each goal when mothers met the corresponding goal. Conclusions: Few high-risk preschoolers or overweight mothers meet AAP-recommended behavior goals. Meeting a greater number of behavior goals may be particularly important for maternal weight. Preschoolers have greater odds of meeting behavior goals when mothers meet behavior goals. Copyright © 2013 by Academic Pediatric Association.

Authors
Turer, CB; Stroo, M; Brouwer, RJ; Krause, KM; Lovelady, CA; Bastian, LA; Peterson, B; Østbye, T
MLA Citation
Turer, CB, Stroo, M, Brouwer, RJ, Krause, KM, Lovelady, CA, Bastian, LA, Peterson, B, and Østbye, T. "Do high-risk preschoolers or overweight mothers meet AAP-recommended behavioral goals for reducing obesity?." Academic Pediatrics 13.3 (2013): 243-250.
Source
scival
Published In
Academic Pediatrics
Volume
13
Issue
3
Publish Date
2013
Start Page
243
End Page
250
DOI
10.1016/j.acap.2013.01.003

Racial differences among patients undergoing laparoscopic gastric bypass surgery: A population-based trend analysis from 2002 to 2008

Background: Laparoscopic gastric bypass surgery (LGBS) has become the most widely used bariatric procedure due to its beneficial long-term outcomes for patients with morbid obesity. However, it is unclear whether racial differences in admission for LGBS have changed over time compared to racial differences in all other admissions. We aimed to investigate the trends and differences in the use of LGBS among white, African-American, and Hispanic patients from 2002 to 2008. Methods: We performed a secondary analysis of data on obese adult patients operated between 2002 and 2008, using the Nationwide Inpatient Sample (NIS) database. The probability of being admitted for LGBS was estimated using logistic regression with race, year, and year by race interaction as predictors, controlling for numerous patient and hospital characteristics. Results: Among 1,704,972 obese hospitalized patients captured through NIS from 2002 to 2008, 2.6 % underwent LGBS (2.8 % Whites, 1.7 % African-Americans, and 2.6 % Hispanics). In adjusted analysis, obese African-American (OR 0.48, p < 0.001) and Hispanic patients (OR 0.59, p < 0.001) were less likely to be admitted for LGBS than white patients in 2002. Race-year interactions showed that the odds of African-Americans undergoing LGBS significantly increased from 2002 to 2008 compared with Whites (annual OR 1.03, p < 0.001) while no such increase was detected for Hispanics (annual OR 1.02, p = 0.11). In 2008, African-American (OR 0.58, p < 0.001) and Hispanic patients (OR 0.65, p < 0.001) still had lower odds than white patients. Conclusions: This is the first study showing that the difference in the use of LGBS between obese African-American and white patients declined between 2002 and 2008. However, LGBS use still remained significantly lower for both African-American and Hispanic patients in 2008 compared with white patients. © 2012 Springer Science+Business Media New York.

Authors
Worni, M; Guller, U; MacIejewski, ML; Curtis, LH; Gandhi, M; Pietrobon, R; Jacobs, DO; Østbye, T
MLA Citation
Worni, M, Guller, U, MacIejewski, ML, Curtis, LH, Gandhi, M, Pietrobon, R, Jacobs, DO, and Østbye, T. "Racial differences among patients undergoing laparoscopic gastric bypass surgery: A population-based trend analysis from 2002 to 2008." Obesity Surgery 23.2 (2013): 226-233.
Source
scival
Published In
Obesity Surgery
Volume
23
Issue
2
Publish Date
2013
Start Page
226
End Page
233
DOI
10.1007/s11695-012-0832-8

What factors influence midwives' decision to perform or avoid episiotomies? A focus group study

Objective: to explore midwives' reasons for performing or avoiding episiotomies and motivation to change episiotomy practice in a large tertiary maternity hospital. Design: using purposive sampling, three focus groups were conducted to achieve theme saturation. Open-ended questions elicited personal reasons for performing or avoiding episiotomy, information sources, and opinions about past and future practice trends. Sessions were audiotaped, and transcripts independently examined by three researchers who coded for themes. An iterative process was used to achieve consensus. Grounded theory was used to interpret data and to derive a theoretical framework for understanding the reasoning that influences episiotomy practice. Setting: a high volume delivery unit in Singapore. Participants: 20 of 79 licensed midwives, aged 28-70, who performed independent deliveries at the delivery unit. Findings: participants recognised maternal, fetal and other factors affecting their own decision to perform episiotomies. Patient request, better healing, midwife's reputation and job satisfaction were cited as main reasons to avoid episiotomy. Key sources informing practice were past training, delivery experience, anecdotal learning and lack of a protocol. There was no consensus on current trends in episiotomy practice. There was an absence of recognition of individual roles in reducing episiotomy rates. Clinicians were perceived as having both positive and negative influence. Conclusions: midwives' reasons for performing episiotomies were attributed to midwifery training, fear of doing harm and perceived clinician expectation, and were not consistent with current international practice guidelines. Reasons for avoiding episiotomies were associated with patient-centeredness and job satisfaction. Midwives agreed on the need to reduce episiotomy rates. Implications for practice: with reduction in episiotomy rates as a goal, a combination of guideline education, feedback, peer coaching and collaborative care with doctors may be needed to achieve desired outcomes. Views and experiences of midwives should also be incorporated into strategies to change episiotomy practice. © 2012 Elsevier Ltd.

Authors
Wu, LC; Lie, D; Malhotra, R; Allen, JC; Tay, JSL; Tan, TC; Østbye, T
MLA Citation
Wu, LC, Lie, D, Malhotra, R, Allen, JC, Tay, JSL, Tan, TC, and Østbye, T. "What factors influence midwives' decision to perform or avoid episiotomies? A focus group study." Midwifery 29.8 (2013): 943-949.
Source
scival
Published In
Midwifery
Volume
29
Issue
8
Publish Date
2013
Start Page
943
End Page
949
DOI
10.1016/j.midw.2012.11.017

Stressful life events and cognitive decline in late life: Moderation by education and age. the Cache County Study

Objective Stressful life events (SLE) have been associated with increased dementia risk, but their association with cognitive decline has been inconsistent. In a longitudinal population-based study of older individuals, we examined the association between SLE and cognitive decline, and the role of potential effect modifiers. Methods A total of 2665 non-demented participants of the Cache County Memory Study completed an SLE questionnaire at Wave 2 and were revisited 4 and 7 years later. The events were represented via several scores: total number, subjective rating (negative, positive, and unexpected), and a weighted summary based on their impact. Cognition was assessed at each visit with the modified Mini-Mental State Exam. General linear models were used to examine the association between SLE scores and cognition. Effect modification by age, education, and APOE genotype was tested. Results Years of formal education (p = 0.006) modified the effect of number of SLE, and age (p = 0.009) modified the effect of negative SLE on the rate of cognitive decline. Faster decline was observed among those with fewer years of education experiencing more SLE and also among younger participants experiencing more negative SLE. There was no association between other indicators of SLE and cognitive decline. APOE genotype did not modify any of the aforementioned associations. Conclusions The effects of SLE on cognition in late life are complex and vary by individual factors such as age and education. These results may explain some of the contradictory findings in the literature. Copyright © 2012 John Wiley & Sons, Ltd. Copyright © 2012 John Wiley & Sons, Ltd.

Authors
Tschanz, JT; Pfister, R; Wanzek, J; Corcoran, C; Smith, K; Tschanz, BT; Steffens, DC; Østbye, T; Welsh-Bohmer, KA; Norton, MC
MLA Citation
Tschanz, JT, Pfister, R, Wanzek, J, Corcoran, C, Smith, K, Tschanz, BT, Steffens, DC, Østbye, T, Welsh-Bohmer, KA, and Norton, MC. "Stressful life events and cognitive decline in late life: Moderation by education and age. the Cache County Study." International Journal of Geriatric Psychiatry 28.8 (2013): 821-830.
Source
scival
Published In
International Journal of Geriatric Psychiatry
Volume
28
Issue
8
Publish Date
2013
Start Page
821
End Page
830
DOI
10.1002/gps.3888

Body mass trajectories through midlife among adults with class i obesity

Background: Little is known about the body mass trajectories for adults with class I obesity. Our objective was to map the body mass trajectories through midlife for young adults with class I obesity in the United States. Methods: Data from the National Longitudinal Study of Youth 1979 was used to generate a cohort of 1058 men and women, aged 25-33 years with class I obesity in 1990. Group-based trajectory modeling was used to identify the number and shape of the body mass index trajectories from 1990 to 2008 for this cohort. Results: By 2008, about 15% of men and women with class I obesity in 1990 experienced a body mass index increase to >40 kg/m2. The trajectory analyses showed that roughly one third of the sample were on 1 of 2 body mass index trajectory groups that culminated with an average BMI well above 35 kg/m2. Conclusion: The large majority of young adults with class I obesity are likely to gain weight over time. For many, the weight gain will be significant and greatly increase their risk of obesity-related co-morbidities and reduced life expectancy. As a result, bariatric surgery or other intensive weight management options might be warranted. © 2013 American Society for Metabolic and Bariatric Surgery.

Authors
Finkelstein, EA; Ostbye, T; Malhotra, R
MLA Citation
Finkelstein, EA, Ostbye, T, and Malhotra, R. "Body mass trajectories through midlife among adults with class i obesity." Surgery for Obesity and Related Diseases 9.4 (2013): 547-553.
Source
scival
Published In
Surgery for Obesity and Related Diseases
Volume
9
Issue
4
Publish Date
2013
Start Page
547
End Page
553
DOI
10.1016/j.soard.2012.01.004

Young adult weight trajectories through midlife by body mass category

Objective: To estimate the expected weight gain through midlife for those in a given BMI category in young adulthood. Design and Methods: Group-based trajectory modeling and National Longitudinal Survey of Youth 1979 data from 1990 to 2008 were used to quantify weight trajectories through midlife for 10,038 young adult men and women stratified by BMI category. Logistic regression was used to assess the association of trajectory membership with obesity-related conditions (hypertension, diabetes, arthritis) in middle age. Results: Annual weight gain averaged 0.53 kg (1.17 lb) across the entire sample. However, there was considerable variation by and within BMI categories. More than 98% of men and 92% of women were on upward-sloping trajectories, generally moving into a higher BMI category by middle age. Those who experienced early and rapid weight gain during young adulthood were most likely to be on a steeper trajectory and had greater risks for obesity-related conditions. Conclusion: This study points to the health and weight benefits of entering young adulthood with a normal BMI, but further reveals that this is no guarantee of maintaining a healthy weight through midlife. For those who are young adults today, weight maintenance is unlikely to occur without significant environmental or technical innovation. Copyright © 2013 The Obesity Society.

Authors
Malhotra, R; Østbye, T; Riley, CM; Finkelstein, EA
MLA Citation
Malhotra, R, Østbye, T, Riley, CM, and Finkelstein, EA. "Young adult weight trajectories through midlife by body mass category." Obesity 21.9 (2013): 1923-1934.
Source
scival
Published In
Obesity (Silver Spring, Md.)
Volume
21
Issue
9
Publish Date
2013
Start Page
1923
End Page
1934
DOI
10.1002/oby.20318

Sexual functioning and obesity: a review.

We review the literature on the relationship between obesity and sexual functioning. Eleven population-based studies, 20 cross-sectional non-population-based studies, and 16 weight loss studies are reviewed. The consistency of findings suggests that the relationship between obesity and reduced sexual functioning is robust, despite diverse methods, instruments, and settings. In most population-based studies, erectile dysfunction (ED) is more common among obese men than among men of recommended weight. Studies of patients in clinical settings often include individuals with higher degrees of obesity, with most studies showing a relationship between obesity and lower levels of sexual functioning, especially ED. The few studies that include both genders generally report more problems among women. Most studies of patients with comorbidities associated with obesity also find an association between obesity and reduced sexual functioning. Most weight loss studies demonstrate improvement in sexual functioning concurrent with weight reduction despite varying study designs, weight loss methods, and follow-up periods. We recommend that future studies (i) investigate differences and similarities between men and women with respect to obesity and sexual functioning, (ii) use instruments that go beyond the assessment of sexual dysfunction to include additional concepts such as sexual satisfaction, interest, and arousal and, (iii) assess how and the degree to which obese individuals are affected by sexual difficulties. Given the high prevalence of obesity and the inverse association between body mass and sexual functioning, we also recommend that sexual functioning should be more fully addressed by clinicians, both in general practice and in weight loss programs.

Authors
Kolotkin, RL; Zunker, C; Østbye, T
MLA Citation
Kolotkin, RL, Zunker, C, and Østbye, T. "Sexual functioning and obesity: a review." Obesity (Silver Spring) 20.12 (December 2012): 2325-2333. (Review)
PMID
22522887
Source
pubmed
Published In
Obesity
Volume
20
Issue
12
Publish Date
2012
Start Page
2325
End Page
2333
DOI
10.1038/oby.2012.104

Predictors of attrition from a clinical pediatric obesity treatment program.

OBJECTIVE: To assess the predictors of attrition from a clinical pediatric obesity treatment program. METHODS: We evaluated 2- through 20-year-old patients first seen at the Duke University Healthy Lifestyles Program between October 2006 and December 2008. We assessed the predictors of early dropout (not returning for any follow-up visits within 1 year) and of noncompletion (not attending at least 6 visits within 1 year after entry). RESULTS: The sample included 983 patients. In adjusted analyses, non-white non-Hispanic children were more likely to be early dropouts than white non-Hispanic children (odds ratio [OR] = 1.46, 95% confidence interval [CI] = 1.03-2.07). Non-white non-Hispanic children were more likely to be noncompleters than white non-Hispanic (OR = 1.56, 95% CI = 1.03-2.36) and Hispanic children (OR = 2.56, 95% CI = 1.34-4.90). CONCLUSIONS: Race/ethnicity predicted patient attrition. Investigation into this association and program modification are needed to reduce attrition in certain racial/ethnic groups.

Authors
Dolinsky, DH; Armstrong, SC; Østbye, T
MLA Citation
Dolinsky, DH, Armstrong, SC, and Østbye, T. "Predictors of attrition from a clinical pediatric obesity treatment program." Clin Pediatr (Phila) 51.12 (December 2012): 1168-1174.
PMID
22935220
Source
pubmed
Published In
Clinical Pediatrics
Volume
51
Issue
12
Publish Date
2012
Start Page
1168
End Page
1174
DOI
10.1177/0009922812458355

HEALTH IMPACT OF CAREGIVING: RESULTS FROM THE SINGAPORE SURVEY ON INFORMAL CAREGIVING

Authors
Malhotra, C; Chan, A; Malhotra, R; Rush, J; Ostbye, T
MLA Citation
Malhotra, C, Chan, A, Malhotra, R, Rush, J, and Ostbye, T. "HEALTH IMPACT OF CAREGIVING: RESULTS FROM THE SINGAPORE SURVEY ON INFORMAL CAREGIVING." GERONTOLOGIST 52 (November 2012): 51-51.
Source
wos-lite
Published In
The Gerontologist
Volume
52
Publish Date
2012
Start Page
51
End Page
51

FOREIGN DOMESTIC WORKERS LOWER THE NEGATIVE IMPACT OF OLDER ADULT IMPAIRMENTS ON THEIR INFORMAL CAREGIVERS

Authors
Malhotra, R; Ostbye, T; Malhotra, C; Chan, A
MLA Citation
Malhotra, R, Ostbye, T, Malhotra, C, and Chan, A. "FOREIGN DOMESTIC WORKERS LOWER THE NEGATIVE IMPACT OF OLDER ADULT IMPAIRMENTS ON THEIR INFORMAL CAREGIVERS." GERONTOLOGIST 52 (November 2012): 233-233.
Source
wos-lite
Published In
The Gerontologist
Volume
52
Publish Date
2012
Start Page
233
End Page
233

PSYCHOMETRIC PROPERTIES OF THE CAREGIVER REACTION ASSESSMENT SCALE AMONG INFORMAL CAREGIVERS FOR OLDER SINGAPOREANS

Authors
Malhotra, R; Malhotra, C; Chan, A; Ostbye, T
MLA Citation
Malhotra, R, Malhotra, C, Chan, A, and Ostbye, T. "PSYCHOMETRIC PROPERTIES OF THE CAREGIVER REACTION ASSESSMENT SCALE AMONG INFORMAL CAREGIVERS FOR OLDER SINGAPOREANS." GERONTOLOGIST 52 (November 2012): 717-717.
Source
wos-lite
Published In
The Gerontologist
Volume
52
Publish Date
2012
Start Page
717
End Page
717

Measuring the effect of policy interventions at the population level: some methodological concerns.

Health policy evaluations estimate the response of population aggregate outcomes to interventions. However, clarity on the form of the expected causal relationship, the parameter identification strategy, and the mode of hypothesis testing is required to overcome a number of conceptual and methodological problems. We use the New Jersey statewide smoking ban as an example. We examine statewide admission rates for acute myocardial infarctions, strokes and lower limb fractures, and emergency room encounter rates for asthma exacerbations before and after the smoking ban. We discuss the identification options and show the sensitivity of estimates of the response function to different specifications of the stochastic and intervention components and to different modes of inference. Model misspecification is demonstrated by rolling Chow tests for structural breaks in repeated observations.

Authors
Huesch, MD; Østbye, T; Ong, MK
MLA Citation
Huesch, MD, Østbye, T, and Ong, MK. "Measuring the effect of policy interventions at the population level: some methodological concerns." Health Econ 21.10 (October 2012): 1234-1249.
PMID
21887723
Source
pubmed
Published In
Health Economics
Volume
21
Issue
10
Publish Date
2012
Start Page
1234
End Page
1249
DOI
10.1002/hec.1783

Can physicians accurately predict which patients will lose weight, improve nutrition and increase physical activity?

BACKGROUND: Physician counselling may help patients increase physical activity, improve nutrition and lose weight. However, physicians have low outcome expectations that patients will change. The aims are to describe the accuracy of physicians' outcome expectations about whether patients will follow weight loss, nutrition and physical activity recommendations. The relationships between physician outcome expectations and patient motivation and confidence also are assessed. METHODS: This was an observational study that audio recorded encounters between 40 primary care physicians and 461 of their overweight or obese patients. We surveyed physicians to assess outcome expectations that patients will lose weight, improve nutrition and increase physical activity after counselling. We assessed actual patient change in behaviours from baseline to 3 months after the encounter and changes in motivation and confidence from baseline to immediately post-encounter. RESULTS: Right after the visit, ~55% of the time physicians were optimistic that their individual patients would improve. Physicians were not very accurate about which patients actually would improve weight, nutrition and physical activity. More patients had higher confidence to lose weight when physicians thought that patients would be likely to follow their weight loss recommendations. CONCLUSIONS: Physicians are moderately optimistic that patients will follow their weight loss, nutrition and physical activity recommendations. Patients might perceive physicians' confidence in them and thus feel more confident themselves. Physicians, however, are not very accurate in predicting which patients will or will not change behaviours. Their optimism, although helpful for patient confidence, might make physicians less receptive to learning effective counselling techniques.

Authors
Pollak, KI; Coffman, CJ; Alexander, SC; Tulsky, JA; Lyna, P; Dolor, RJ; Cox, ME; Brouwer, RJN; Bodner, ME; Østbye, T
MLA Citation
Pollak, KI, Coffman, CJ, Alexander, SC, Tulsky, JA, Lyna, P, Dolor, RJ, Cox, ME, Brouwer, RJN, Bodner, ME, and Østbye, T. "Can physicians accurately predict which patients will lose weight, improve nutrition and increase physical activity?." Fam Pract 29.5 (October 2012): 553-560.
PMID
22315467
Source
pubmed
Published In
Family Practice
Volume
29
Issue
5
Publish Date
2012
Start Page
553
End Page
560
DOI
10.1093/fampra/cms004

Parent-focused change to prevent obesity in preschoolers: results from the KAN-DO study.

OBJECTIVE: The study presents the immediate post-intervention results of Kids and Adults Now - Defeat Obesity!, a randomized controlled trial to enhance healthy lifestyle behaviors in mother-preschooler (2-5 years old) dyads in North Carolina (2007-2011). The outcomes include change from baseline in the child's diet, physical activity and weight, and in the mother's parenting behaviors, diet, physical activity, and weight. METHOD: The intervention targeted parenting through maternal emotion regulation, home environment, feeding practices, and modeling of healthy behaviors. 400 mother-child dyads were randomized. RESULTS: Mothers in the intervention arm, compared to the control arm, reduced instrumental feeding (-0.24 vs. 0.01, p<0.001) and TV snacks (-.069 vs. -0.24, p=0.001). There were also improvements in emotional feeding (p=0.03), mother's sugary beverage (p=0.03) and fruit/vegetable (p=0.04) intake, and dinners eaten in front of TV (p=0.01); these differences were not significant after adjustment for multiple comparisons. CONCLUSION: KAN-DO, designed to maximize the capacity of mothers as agents of change, improved several channels of maternal influence. There were no group differences in the primary outcomes, but differences were observed in the parenting and maternal outcomes and there were trends toward improvement in the preschoolers' diets. Long-term follow-up will address whether these short-term trends ultimately improve weight status.

Authors
Østbye, T; Krause, KM; Stroo, M; Lovelady, CA; Evenson, KR; Peterson, BL; Bastian, LA; Swamy, GK; West, DG; Brouwer, RJN; Zucker, NL
MLA Citation
Østbye, T, Krause, KM, Stroo, M, Lovelady, CA, Evenson, KR, Peterson, BL, Bastian, LA, Swamy, GK, West, DG, Brouwer, RJN, and Zucker, NL. "Parent-focused change to prevent obesity in preschoolers: results from the KAN-DO study." Prev Med 55.3 (September 2012): 188-195.
PMID
22705016
Source
pubmed
Published In
Preventive Medicine
Volume
55
Issue
3
Publish Date
2012
Start Page
188
End Page
195
DOI
10.1016/j.ypmed.2012.06.005

Depressive symptoms among informal caregivers of older adults: insights from the Singapore Survey on Informal Caregiving.

BACKGROUND: This paper determines care recipient and caregiver characteristics and caregiving dimensions - associated with depression among caregivers of older adults, using path analysis and assesses whether the identified path model differs between spousal and adult child caregivers. METHODS: Data from 1,190 dyads comprising care recipients (community-dwelling adults aged ≥ 75 years with at least one activity of daily living (ADL) limitation) and caregivers (family member/friend most involved in providing care/ensuring provision of care to care recipient), who were interviewed through the Singapore Survey on Informal Caregiving (2010-2011), were used. Using path analysis, we assessed the direct and indirect associations between primary stressors (care recipient's ADL and instrumental ADL status, and memory and behavior problems), caregiver health status, receipt of assistance from a foreign domestic worker/maid, amount of caregiving, negative reaction to caregiving, caregiver's self-esteem, perceived emotional support, and caregiver depressive symptoms. RESULTS: Our analysis showed that primary stressors, receipt of assistance from a foreign domestic worker/maid, perceived emotional support, and caregiver health status were directly or indirectly associated with caregiver depressive symptoms, and this association was mediated by negative reaction to caregiving. Caregiver self-esteem mediated the relationship between perceived emotional support and negative reaction to caregiving only among adult child caregivers. CONCLUSIONS: The results provide insights into factors associated with depressive symptoms among spousal and adult child caregivers, and help identify targeted interventions for improving caregiver mood.

Authors
Malhotra, C; Malhotra, R; Østbye, T; Matchar, D; Chan, A
MLA Citation
Malhotra, C, Malhotra, R, Østbye, T, Matchar, D, and Chan, A. "Depressive symptoms among informal caregivers of older adults: insights from the Singapore Survey on Informal Caregiving." Int Psychogeriatr 24.8 (August 2012): 1335-1346.
PMID
22436145
Source
pubmed
Published In
International psychogeriatrics / IPA
Volume
24
Issue
8
Publish Date
2012
Start Page
1335
End Page
1346
DOI
10.1017/S1041610212000324

Parenting styles and body mass index trajectories from adolescence to adulthood.

OBJECTIVE: Parenting styles such as authoritarian, disengaged, or permissive are thought to be associated with greater adolescent obesity risk than an authoritative style. This study assessed the relationship between parenting styles and changes in body mass index (BMI) from adolescence to young adulthood. METHOD: The study included self-reported data from adolescents in the National Longitudinal Study of Adolescent Health. Factor mixture modeling, a data-driven approach, was used to classify participants into parenting style groups based on measures of acceptance and control. Latent growth modeling (LGM) identified patterns of developmental changes in BMI. After a number of potential confounders were controlled for, parenting style variables were entered as predictors of BMI trajectories. Analyses were also conducted for male and female individuals of 3 racial-ethnic groups (Hispanic, black, white) to assess whether parenting styles were differentially associated with BMI trajectories in these 6 groups. RESULTS: Parenting styles were classified into 4 groups: authoritarian, disengaged, permissive, and balanced. Compared with the balanced parenting style, authoritarian and disengaged parenting styles were associated with a less steep average BMI increase (linear slope) over time, but also less leveling off (quadratic) of BMI over time. Differences in BMI trajectories were observed for various genders and races, but the differences did not reach statistical significance. CONCLUSION: Adolescents who reported having parents with authoritarian or disengaged parenting styles had greater increases in BMI as they transitioned to young adulthood despite having a lower BMI trajectory through adolescence.

Authors
Fuemmeler, BF; Yang, C; Costanzo, P; Hoyle, RH; Siegler, IC; Williams, RB; Ostbye, T
MLA Citation
Fuemmeler, BF, Yang, C, Costanzo, P, Hoyle, RH, Siegler, IC, Williams, RB, and Ostbye, T. "Parenting styles and body mass index trajectories from adolescence to adulthood." Health Psychol 31.4 (July 2012): 441-449.
PMID
22545979
Source
pubmed
Published In
Health Psychology
Volume
31
Issue
4
Publish Date
2012
Start Page
441
End Page
449
DOI
10.1037/a0027927

Worse outcomes in patients undergoing urgent surgery for left-sided diverticulitis admitted on weekends vs weekdays: a population-based study of 31 832 patients.

HYPOTHESIS: Among patients undergoing urgent surgery for left-sided diverticulitis, those admitted on weekends vs weekdays have higher rates of Hartmann procedure and adverse outcomes. DESIGN: Analysis of data from the Nationwide Inpatient Sample between January 2002 and December 2008. Unadjusted and risk-adjusted generalized linear regression models were used. SETTING: Academic research. PATIENTS: Data on patients undergoing urgent surgery for acute diverticulitis. MAIN OUTCOME MEASURES: Rates of Hartmann procedure vs primary anastomosis, complications, length of hospital stay, and total hospital charges. RESULTS: In total, 31 832 patients were included; 7066 (22.2%) were admitted on weekends, and 24 766 (77.8%) were admitted on weekdays. The mean (SD) age of patients was 60.8 (15.3) years, and 16 830 (52.9%) were female. A Hartmann procedure was performed in 4580 patients (64.8%) admitted on weekends compared with 13 351 patients (53.9%) admitted on weekdays (risk-adjusted odds ratio [OR], 1.57; P < .001). In risk-adjusted analyses, patients admitted on weekends had significantly higher risk for any postoperative complication (OR, 1.10; P = .005) and nonroutine hospital discharge (OR, 1.33; P < .001) compared with patients admitted on weekdays, as well as a median length of hospital stay that was 0.5 days longer and median total hospital charges that were $3734 higher (P < .001 for both). CONCLUSIONS: Patients undergoing urgent surgery for left-sided diverticulitis who are admitted on a weekend have a higher risk for undergoing a Hartmann procedure and worse short-term outcomes compared with patients who are admitted on a weekday. Further research is warranted to investigate possible underlying mechanisms and to develop strategies for reducing this substantial weekend effect.

Authors
Worni, M; Schudel, IM; Østbye, T; Shah, A; Khare, A; Pietrobon, R; Thacker, JKM; Guller, U
MLA Citation
Worni, M, Schudel, IM, Østbye, T, Shah, A, Khare, A, Pietrobon, R, Thacker, JKM, and Guller, U. "Worse outcomes in patients undergoing urgent surgery for left-sided diverticulitis admitted on weekends vs weekdays: a population-based study of 31 832 patients." Arch Surg 147.7 (July 2012): 649-655.
PMID
22802061
Source
pubmed
Published In
Archives of Surgery
Volume
147
Issue
7
Publish Date
2012
Start Page
649
End Page
655
DOI
10.1001/archsurg.2012.825

Laparoscopic appendectomy outcomes on the weekend and during the week are no different: a national study of 151,774 patients.

BACKGROUND: The "weekend effect" is defined as increased morbidity and mortality for patients admitted on weekends compared with weekdays. It has been observed for several diseases, including myocardial infarction and renal insufficiency; however, it has not yet been investigated for laparoscopic appendectomy in acute appendicitis-one of the most prevalent surgical diagnoses. METHODS: The present study is based on the Nationwide Inpatient Sample (NIS) from 1999 to 2008. The following outcomes were compared between patients undergoing laparoscopic appendectomy for acute appendicitis admitted on weekdays versus weekends: severity of appendicitis, intraoperative and postoperative complications, conversion rate, in-hospital mortality, and length of hospital stay. Unadjusted and risk-adjusted generalized linear regression analyses were performed. RESULTS: Overall, 151,774 patients were included, mean age was 39.6 years, 52.6% (n = 79,801) were male, and 25.3% (n = 38,317) were admitted on weekends. After risk adjustment, the conversion rate was lower [odds ratio (OR): 0.94, p = 0.004, number needed to harm (NNH): 244], whereas pulmonary complications (OR: 1.12, p = 0.028, NNH: 649) and reoperations (OR: 1.21, p = 0.013, NNH: 1,028) were slightly higher on weekends than on weekdays. Overall postoperative complications (OR: 1.03, p = 0.24), mortality (OR: 1.37, p = 0.075) and length of hospital stay (mean on weekday: 2.00 days, weekends: 2.01 days, p = 0.29) were not statistically different. CONCLUSIONS: The present investigation provides evidence that no clinically significant "weekend effect" for patients undergoing laparoscopic appendectomy exists. Therefore, hospital or staffing policy changes are not justified based on the findings from this large national study.

Authors
Worni, M; Østbye, T; Gandhi, M; Rajgor, D; Shah, J; Shah, A; Pietrobon, R; Jacobs, DO; Guller, U
MLA Citation
Worni, M, Østbye, T, Gandhi, M, Rajgor, D, Shah, J, Shah, A, Pietrobon, R, Jacobs, DO, and Guller, U. "Laparoscopic appendectomy outcomes on the weekend and during the week are no different: a national study of 151,774 patients." World J Surg 36.7 (July 2012): 1527-1533.
PMID
22411091
Source
pubmed
Published In
World Journal of Surgery
Volume
36
Issue
7
Publish Date
2012
Start Page
1527
End Page
1533
DOI
10.1007/s00268-012-1550-z

Musculoskeletal symptoms among female garment factory workers in Sri Lanka.

OBJECTIVES: To assess the prevalence of musculoskeletal symptoms and their association with sociodemographic risk factors among female garment factory workers in Sri Lanka. METHODS: 1058 randomly selected female garment factory workers employed in the free trade zone of Kogalla, Sri Lanka were recruited to complete two interviewer-administered questionnaires assessing musculoskeletal symptoms and health behaviors. DISCUSSION: Musculoskeletal complaints among female garment workers in the FTZ of Kogalla are less common than expected. Sociocultural factors may have resulted in underreporting and similarly contribute to the low rates of healthcare utilization by these women. RESULTS: 164 (15.5%) of workers reported musculoskeletal symptoms occurring more than 3 times or lasting a week or more during the previous 12-month period. Back (57.3%) and knee (31.7%) were the most common sites of pain. Although most symptomatic women reported that their problems interfered with work and leisure activities, very few missed work as a result of their pain. Prevalence correlated positively with increased age and industry tenure of less than 12 months. Job type, body mass index, and education were not significant predictors of musculoskeletal symptoms.

Authors
Lombardo, SR; Vijitha de Silva, P; Lipscomb, HJ; Ostbye, T
MLA Citation
Lombardo, SR, Vijitha de Silva, P, Lipscomb, HJ, and Ostbye, T. "Musculoskeletal symptoms among female garment factory workers in Sri Lanka." Int J Occup Environ Health 18.3 (July 2012): 210-219.
PMID
23026006
Source
pubmed
Published In
International journal of occupational and environmental health
Volume
18
Issue
3
Publish Date
2012
Start Page
210
End Page
219
DOI
10.1179/1077352512Z.00000000029

Predictors of and health services utilization related to depressive symptoms among elderly Koreans.

While the prevalence, comorbidity, risk profile and health care utilization for late-life depression have been described for many Western countries, much less is known about the recent epidemiology of late-life depression in East Asian countries such as Korea. We investigated predictors for depressive symptoms and the association between depressive symptoms and the utilization of both medical care and preventive services in elderly Koreans. Data were obtained from a nationally representative sample of Koreans aged 60 and above (2226 men, 2911 women) who participated in the 2008 wave of the Korean Longitudinal Study of Ageing. Depressive symptoms were measured using the 10-item Center for Epidemiological Studies-Depression scale. Risk factors considered included sociodemographics, health behaviors, chronic diseases, and physical function. Health care utilization factors included hospitalization, outpatient clinic use and basic medical checkup. Being female, being unmarried, and having less education, lower household income, physical inactivity and lower weight were associated with depressive symptoms. Presence of chronic diseases and limited physical function also showed a significant association with depressive symptoms. Depressive symptoms were associated with increased odds of hospitalization and outpatient visits, but decreased the odds of utilization of basic medical checkup after controlling for potential confounders. Findings on most risk factors, except lower weight, were consistent with reports from Western countries. It is important to recognize the burden of depressive symptoms in the elderly. The interaction of such symptoms with chronic diseases should be acknowledged and considered in the clinical setting as well as in health care planning and policymaking.

Authors
Shin, JH; Do, YK; Maselko, J; Brouwer, RJN; Song, SW; Østbye, T
MLA Citation
Shin, JH, Do, YK, Maselko, J, Brouwer, RJN, Song, SW, and Østbye, T. "Predictors of and health services utilization related to depressive symptoms among elderly Koreans." Social science & medicine (1982) 75.1 (July 2012): 179-185.
PMID
22531571
Source
epmc
Published In
Social Science & Medicine
Volume
75
Issue
1
Publish Date
2012
Start Page
179
End Page
185
DOI
10.1016/j.socscimed.2012.03.012

Factors associated with prenatal folic acid and iron supplementation among 21,889 pregnant women in Northern Tanzania: a cross-sectional hospital-based study.

BACKGROUND: Folate and iron deficiency during pregnancy are risk factors for anaemia, preterm delivery, and low birth weight, and may contribute to poor neonatal health and increased maternal mortality. The World Health Organization recommends supplementation of folic acid (FA) and iron for all pregnant women at risk of malnutrition to prevent anaemia. We assessed the use of prenatal folic acid and iron supplementation among women in a geographical area with a high prevalence of anaemia, in relation to socio-demographic, morbidity and health services utilization factors. METHODS: We analysed a cohort of 21,889 women who delivered at Kilimanjaro Christian Medical Centre (KCMC), Moshi, Tanzania, between 1999 and 2008. Logistic regression models were used to describe patterns of reported intake of prenatal FA and iron supplements. RESULTS: Prenatal intake of FA and iron supplements was reported by 17.2% and 22.3% of pregnant women, respectively. Sixteen percent of women reported intake of both FA and iron. Factors positively associated with FA supplementation were advanced maternal age (OR = 1.17, 1.02-1.34), unknown HIV status (OR = 1.54, 1.42-1.67), a diagnosis of anaemia during pregnancy (OR = 12.03, 9.66-14.98) and indicators of lower socioeconomic status. Women were less likely to take these supplements if they reported having had a malaria episode before (OR = 0.57, 0.53-0.62) or during pregnancy (OR = 0.45, 0.41-0.51), reported having contracted other infectious diseases (OR = 0.45, 0.42-0.49), were multiparous (OR = 0.73, 0.66-0.80), had preeclampsia/eclampsia (OR = 0.48, 0.38-0.61), or other diseases (OR = 0.55, 0.44-0.69) during pregnancy. Similar patterns of association emerged when iron supplementation alone and supplementation with both iron and FA were evaluated. CONCLUSIONS: FA and iron supplementation are low among pregnant women in Northern Tanzania, in particular among women with co-morbidities before or during pregnancy. Attempts should be made to increase supplementation both in general and among women with pregnancy complications.

Authors
Ogundipe, O; Hoyo, C; Østbye, T; Oneko, O; Manongi, R; Lie, RT; Daltveit, AK
MLA Citation
Ogundipe, O, Hoyo, C, Østbye, T, Oneko, O, Manongi, R, Lie, RT, and Daltveit, AK. "Factors associated with prenatal folic acid and iron supplementation among 21,889 pregnant women in Northern Tanzania: a cross-sectional hospital-based study. (Published online)" BMC Public Health 12 (June 26, 2012): 481-.
PMID
22734580
Source
pubmed
Published In
BMC Public Health
Volume
12
Publish Date
2012
Start Page
481
DOI
10.1186/1471-2458-12-481

Predictors of latent tuberculosis treatment initiation and completion at a U.S. public health clinic: a prospective cohort study.

BACKGROUND: Treatment of latent tuberculosis infection (LTBI) is a key component in U.S. tuberculosis control, assisted by recent improvements in LTBI diagnostics and therapeutic regimens. Effectiveness of LTBI therapy, however, is limited by patients' willingness to both initiate and complete treatment. We aimed to evaluate the demographic, medical, behavioral, attitude-based, and geographic factors associated with LTBI treatment initiation and completion of persons presenting with LTBI to a public health tuberculosis clinic. METHODS: Data for this prospective cohort study were collected from structured patient interviews, self-administered questionnaires, clinic intake forms, and U.S. census data. All adults (>17 years) who met CDC guidelines for LTBI treatment between January 11, 2008 and May 6, 2009 at Wake County Health and Human Services Tuberculosis Clinic in Raleigh, North Carolina were included in the study. In addition to traditional social and behavioral factors, a three-level medical risk variable (low, moderate, high), based on risk factors for both progression to and transmission of active tuberculosis, was included for analysis. Clinic distance and neighborhood poverty level, based on percent residents living below poverty level in a person's zip code, were also analyzed. Variables with a significance level <0.10 by univariate analysis were included in log binomial models with backward elimination. Models were used to estimate risk ratios for two primary outcomes: (1) LTBI therapy initiation (picking up one month's medication) and (2) therapy completion (picking up nine months INH therapy or four months rifampin monthly). RESULTS: 496 persons completed medical interviews and questionnaires addressing social factors and attitudes toward LTBI treatment. 26% persons initiated LTBI therapy and 53% of those initiating completed therapy. Treatment initiation predictors included: a non-employment reason for screening (RR 1.6, 95% CI 1.0-2.5), close contact to an infectious TB case (RR 2.5, 95% CI 1.8-3.6), regular primary care(RR 1.4, 95% CI 1.0-2.0), and history of incarceration (RR 1.7, 95% CI 1.0-2.8). Persons in the "high" risk category for progression/transmission of TB disease had higher likelihood of treatment initiation (p < 0.01), but not completion, than those with lower risk. CONCLUSIONS: Investment in social support and access to regular primary care may lead to increased LTBI therapy adherence in high-risk populations.

Authors
Goswami, ND; Gadkowski, LB; Piedrahita, C; Bissette, D; Ahearn, MA; Blain, MLM; Østbye, T; Saukkonen, J; Stout, JE
MLA Citation
Goswami, ND, Gadkowski, LB, Piedrahita, C, Bissette, D, Ahearn, MA, Blain, MLM, Østbye, T, Saukkonen, J, and Stout, JE. "Predictors of latent tuberculosis treatment initiation and completion at a U.S. public health clinic: a prospective cohort study. (Published online)" BMC Public Health 12 (June 21, 2012): 468-.
Website
http://hdl.handle.net/10161/13903
PMID
22720842
Source
pubmed
Published In
BMC Public Health
Volume
12
Publish Date
2012
Start Page
468
DOI
10.1186/1471-2458-12-468

Unsuspected rickettsioses among patients with acute febrile illness, Sri Lanka, 2007.

We studied rickettsioses in southern Sri Lanka. Of 883 febrile patients with paired serum samples, 156 (17.7%) had acute rickettsioses; rickettsioses were unsuspected at presentation. Additionally, 342 (38.7%) had exposure to spotted fever and/or typhus group rickettsioses and 121 (13.7%) scrub typhus. Increased awareness of rickettsioses and better tests are needed.

Authors
Reller, ME; Bodinayake, C; Nagahawatte, A; Devasiri, V; Kodikara Arachichi, W; Strouse, JJ; Flom, JE; Østbye, T; Woods, CW; Dumler, JS
MLA Citation
Reller, ME, Bodinayake, C, Nagahawatte, A, Devasiri, V, Kodikara Arachichi, W, Strouse, JJ, Flom, JE, Østbye, T, Woods, CW, and Dumler, JS. "Unsuspected rickettsioses among patients with acute febrile illness, Sri Lanka, 2007." Emerging infectious diseases 18.5 (May 2012): 825-829. (Academic Article)
PMID
22516455
Source
manual
Published In
Emerging infectious diseases
Volume
18
Issue
5
Publish Date
2012
Start Page
825
End Page
829
DOI
10.3201/eid1805.111563

ACCURACY AND CONGRUENCY OF PATIENT AND PHYSICIAN PERCEPTIONS OF WEIGHT-RELATED DISCUSSIONS: PROJECT CHAT

Authors
Bodner, ME; Dolor, RJ; Ostbye, T; Lyna, P; Coffman, CJ; Alexander, SC; Tulsky, JA; Pollak, KI
MLA Citation
Bodner, ME, Dolor, RJ, Ostbye, T, Lyna, P, Coffman, CJ, Alexander, SC, Tulsky, JA, and Pollak, KI. "ACCURACY AND CONGRUENCY OF PATIENT AND PHYSICIAN PERCEPTIONS OF WEIGHT-RELATED DISCUSSIONS: PROJECT CHAT." ANNALS OF BEHAVIORAL MEDICINE 43 (April 2012): S238-S238.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
43
Publish Date
2012
Start Page
S238
End Page
S238

Diet quality of preschoolers and their mothers enrolled in an obesity prevention program

Authors
Laster, LER; Lovelady, CA; West, DG; Wiltheiss, GA; Brouwer, RJN; Ostbye, T
MLA Citation
Laster, LER, Lovelady, CA, West, DG, Wiltheiss, GA, Brouwer, RJN, and Ostbye, T. "Diet quality of preschoolers and their mothers enrolled in an obesity prevention program." April 2012.
Source
wos-lite
Published In
The FASEB journal : official publication of the Federation of American Societies for Experimental Biology
Volume
26
Publish Date
2012

The influence of physician communication style on overweight patients' perceptions of length of encounter and physician being rushed.

BACKGROUND AND OBJECTIVES: Little is known about how patients and physicians perceive time and the extent to which they perceive the physician being rushed during encounters. One aim of this paper is to examine whether patient and physician characteristics and physician communication influence patient perception of the duration of the encounter and their perception of physicians being rushed. Another aim is to examine the relationship between patient and physician perceptions of physicians feeling rushed. METHODS: We audiorecorded 461 encounters of overweight or obese patients with 40 primary care physicians and included 320 encounters in which weight was discussed. We calculated time spent with physician and coded all communication about weight using the Motivational Interview Treatment Integrity scale (MITI). Patients completed post-visit questionnaires in which they reported the estimated duration of the encounter and how rushed they thought the physician was during the encounter. Physicians reported how rushed they felt. RESULTS: Patients estimated encounters to be longer than they actually were by an average of 2.6 minutes (SD=11.0). When physicians used reflective statements when discussing weight, patients estimated the encounter to be shorter than when physicians did not use reflective statements (1.17 versus 4.56 minutes more than actual duration). Whites perceived the encounter as shorter than African Americans (1.45 versus 4.28 minutes more than actual duration). Physicians felt rushed in 66% of visits; however, most patients did not perceive this. Internists were perceived to be more rushed than family physicians. CONCLUSIONS: There is wide variation in patients' ability to estimate the length of time they spend with their physician. Some physician and patient characteristics were related to patient perceptions of the length of the encounter. Reflective statements might lead patients to perceive encounters as shorter. Physicians, especially family physicians, appear able to conceal that they are feeling rushed.

Authors
Gulbrandsen, P; Østbye, T; Lyna, P; Dolor, RJ; Tulsky, JA; Alexander, SC; Pollak, KI
MLA Citation
Gulbrandsen, P, Østbye, T, Lyna, P, Dolor, RJ, Tulsky, JA, Alexander, SC, and Pollak, KI. "The influence of physician communication style on overweight patients' perceptions of length of encounter and physician being rushed." Fam Med 44.3 (March 2012): 183-188.
PMID
22399481
Source
pubmed
Published In
Family medicine
Volume
44
Issue
3
Publish Date
2012
Start Page
183
End Page
188

Predictors of postpartum weight change among overweight and obese women: results from the Active Mothers Postpartum study.

BACKGROUND: The postpartum period may be critical for the development of midlife obesity. Identifying factors associated with postpartum weight change could aid in targeting women for healthy lifestyle interventions. METHODS: Data from Active Mothers Postpartum (AMP), a study of overweight and obese postpartum women (n=450), were analyzed to determine the effect of baseline characteristics, breastfeeding, diet, physical activity, and contraception on weight change from 6 weeks to 12, 18, and 24 months postpartum. The repeated measures mixed model was used to test the association of these effects with weight change. RESULTS: Although mean weight loss was modest (0.49 kg by 24 months), the range of weight change was striking (+21.5 kg to -24.5 kg, standard deviation [SD] 7.4). Controlling only for baseline weight, weight loss was associated with breastfeeding, hormonal contraception, lower junk food and greater healthy food intake, and greater physical activity. Only junk food intake and physical activity were significant after controlling for all other predictors. CONCLUSIONS: Eating less healthy foods and being less physically active put overweight and obese women at risk of gaining more weight after a pregnancy.

Authors
Østbye, T; Peterson, BL; Krause, KM; Swamy, GK; Lovelady, CA
MLA Citation
Østbye, T, Peterson, BL, Krause, KM, Swamy, GK, and Lovelady, CA. "Predictors of postpartum weight change among overweight and obese women: results from the Active Mothers Postpartum study." J Womens Health (Larchmt) 21.2 (February 2012): 215-222.
PMID
22092110
Source
pubmed
Published In
Journal of Women's Health
Volume
21
Issue
2
Publish Date
2012
Start Page
215
End Page
222
DOI
10.1089/jwh.2011.2947

Cholecystectomy concomitant with laparoscopic gastric bypass: a trend analysis of the nationwide inpatient sample from 2001 to 2008.

BACKGROUND: Gallstone formation is common in obese patients, particularly during rapid weight loss. Whether a concomitant cholecystectomy should be performed during laparoscopic gastric bypass surgery is still contentious. We aimed to analyze trends in concomitant cholecystectomy and laparoscopic gastric bypass surgery (2001-2008), to identify factors associated with concomitant cholecystectomy, and to compare short-term outcomes after laparoscopic gastric bypass with and without concomitant cholecystectomy. METHODS: We used data from adults undergoing laparoscopic gastric bypass for obesity from the Nationwide Inpatient Sample. The Cochran-Armitage trend test was used to assess changes over time. Unadjusted and risk-adjusted generalized linear models were performed to assess predictors of concomitant cholecystectomy and to assess postoperative short-term outcomes. RESULTS: A total of 70,287 patients were included: mean age was 43.1 years and 81.6% were female. Concomitant cholecystectomy was performed in 6,402 (9.1%) patients. The proportion of patients undergoing concomitant cholecystectomy decreased significantly from 26.3% in 2001 to 3.7% in 2008 (p for trend < 0.001). Patients who underwent concomitant cholecystectomy had higher rates of mortality (unadjusted odds ratios [OR], 2.16; p = 0.012), overall postoperative complications (risk-adjusted OR, 1.59; p = 0.001), and reinterventions (risk-adjusted OR, 3.83; p < 0.001), less frequent routine discharge (risk-adjusted OR, 0.70; p = 0.05), and longer adjusted hospital stay (median difference, 0.4 days; p < 0.001). CONCLUSIONS: Concomitant cholecystectomy and laparoscopic gastric bypass surgery have decreased significantly over the last decade. Given the higher rates of postoperative complications, reinterventions, mortality, as well as longer hospital stay, concomitant cholecystectomy should only be considered in patients with symptomatic gallbladder disease.

Authors
Worni, M; Guller, U; Shah, A; Gandhi, M; Shah, J; Rajgor, D; Pietrobon, R; Jacobs, DO; Ostbye, T
MLA Citation
Worni, M, Guller, U, Shah, A, Gandhi, M, Shah, J, Rajgor, D, Pietrobon, R, Jacobs, DO, and Ostbye, T. "Cholecystectomy concomitant with laparoscopic gastric bypass: a trend analysis of the nationwide inpatient sample from 2001 to 2008." Obes Surg 22.2 (February 2012): 220-229.
PMID
22183984
Source
pubmed
Published In
Obesity Surgery
Volume
22
Issue
2
Publish Date
2012
Start Page
220
End Page
229
DOI
10.1007/s11695-011-0575-y

Unsuspected dengue and acute febrile illness in rural and semi-urban southern Sri Lanka.

Dengue virus (DENV), a globally emerging cause of undifferentiated fever, has been documented in the heavily urbanized western coast of Sri Lanka since the 1960s. New areas of Sri Lanka are now being affected, and the reported number and severity of cases have increased. To study emerging DENV in southern Sri Lanka, we obtained epidemiologic and clinical data and acute- and convalescent-phase serum samples from patients >2 years old with febrile illness. We tested paired serum samples for DENV IgG and IgM and serotyped virus by using isolation and reverse transcription PCR. We identified acute DENV infection (serotypes 2, 3, and 4) in 54 (6.3%) of 859 patients. Only 14% of patients had clinically suspected dengue; however, 54% had serologically confirmed acute or past DENV infection. DENV is a major and largely unrecognized cause of fever in southern Sri Lanka, especially in young adults.

Authors
Reller, ME; Bodinayake, C; Nagahawatte, A; Devasiri, V; Kodikara-Arachichi, W; Strouse, JJ; Broadwater, A; Østbye, T; de Silva, A; Woods, CW
MLA Citation
Reller, ME, Bodinayake, C, Nagahawatte, A, Devasiri, V, Kodikara-Arachichi, W, Strouse, JJ, Broadwater, A, Østbye, T, de Silva, A, and Woods, CW. "Unsuspected dengue and acute febrile illness in rural and semi-urban southern Sri Lanka." Emerg Infect Dis 18.2 (February 2012): 256-263.
PMID
22304972
Source
pubmed
Published In
Emerging infectious diseases
Volume
18
Issue
2
Publish Date
2012
Start Page
256
End Page
263
DOI
10.3201/eid1802.110962

Prevalence, correlates and perceived causes of limitations in activities of daily living among older Singaporeans.

AIMS: To describe the prevalence of limitations in Activities of Daily Living (ADL) among older Singaporeans, examine the association of ADL limitations with various self-reported health conditions, assess perceived causes of ADL limitations, and compare prevalence of health conditions among those who perceive only 'old age' vs those who perceive at least one specific health condition as the cause of their limitations. METHODS: Data from a national survey of Singaporeans 60 years and over was used. The association between ADL limitations and health conditions was assessed through logistic regression. Those with ADL limitations were asked about the perceived cause/s of their limitation/ s. Any significant difference in the prevalence of health conditions between those attributing their ADL limitations only to old age and those attributing to at least one specific health condition was ascertained. RESULTS: Overall prevalence of ADL limitations was 9.7%. Joint/nerve pain, stroke, pelvic/femoral fractures, heart diseases, diabetes, osteoporosis, chronic respiratory illness and renal/urinary tract illness were significantly associated with ADL limitations, and the most common perceived cause was 'old age' (33%). The prevalence of most health conditions was similar in older adults attributing their limitations to only 'old age' and to at least one specific health condition. CONCLUSION: Clinical suspicion is called for if individuals with ADL limitations attribute them solely to 'old age'.

Authors
Malhotra, C; Chan, A; Malhotra, R; Ostbye, T
MLA Citation
Malhotra, C, Chan, A, Malhotra, R, and Ostbye, T. "Prevalence, correlates and perceived causes of limitations in activities of daily living among older Singaporeans." Aging Clin Exp Res 24.1 (February 2012): 56-61.
PMID
22643305
Source
pubmed
Published In
Aging clinical and experimental research
Volume
24
Issue
1
Publish Date
2012
Start Page
56
End Page
61

Does PACS improve diagnostic accuracy in chest radiograph interpretations in clinical practice?

OBJECTIVES: To assess the impact of a Picture Archiving and Communication System (PACS) on the diagnostic accuracy of the interpretation of chest radiology examinations in a "real life" radiology setting. MATERIALS AND METHODS: During a period before PACS was introduced to radiologists, when images were still interpreted on film and reported on paper, images and reports were also digitally stored in an image database. The same database was used after the PACS introduction. This provided a unique opportunity to conduct a blinded retrospective study, comparing sensitivity (the main outcome parameter) in the pre and post-PACS periods. We selected 56 digitally stored chest radiograph examinations that were originally read and reported on film, and 66 examinations that were read and reported on screen 2 years after the PACS introduction. Each examination was assigned a random number, and both reports and images were scored independently for pathological findings. The blinded retrospective score for the original reports were then compared with the score for the images (the gold standard). RESULTS: Sensitivity was improved after the PACS introduction. When both certain and uncertain findings were included, this improvement was statistically significant. There were no other statistically significant changes. CONCLUSION: The result is consistent with prospective studies concluding that diagnostic accuracy is at least not reduced after PACS introduction. The sensitivity may even be improved.

Authors
Hurlen, P; Borthne, A; Dahl, FA; Ostbye, T; Gulbrandsen, P
MLA Citation
Hurlen, P, Borthne, A, Dahl, FA, Ostbye, T, and Gulbrandsen, P. "Does PACS improve diagnostic accuracy in chest radiograph interpretations in clinical practice?." Eur J Radiol 81.1 (January 2012): 173-177.
PMID
20888718
Source
pubmed
Published In
European Journal of Radiology
Volume
81
Issue
1
Publish Date
2012
Start Page
173
End Page
177
DOI
10.1016/j.ejrad.2010.08.043

Validity of proxy-reported weight for older adults.

Authors
Malhotra, R; Chan, A; Ostbye, T
MLA Citation
Malhotra, R, Chan, A, and Ostbye, T. "Validity of proxy-reported weight for older adults." J Am Geriatr Soc 60.1 (January 2012): 189-190. (Letter)
PMID
22239318
Source
pubmed
Published In
Journal of American Geriatrics Society
Volume
60
Issue
1
Publish Date
2012
Start Page
189
End Page
190
DOI
10.1111/j.1532-5415.2011.03736.x

Validity and reliability of the Caregiver Reaction Assessment scale among primary informal caregivers for older persons in Singapore.

Previous studies evaluating the validity and reliability of the Caregiver Reaction Assessment (CRA) scale (24 items; five subscales: schedule, health, finances, family support, and esteem) in different countries are not fully congruent. This article assesses the validity and reliability of the CRA among informal caregivers of older persons in Singapore. Data from a national survey of 1190 primary informal caregivers of Singaporeans aged ≥75 years with ≥1 activity of daily living limitation was analyzed. Fit of the five-factor model was tested in half of the sample using confirmatory factor analysis (CFA) and the other half subjected to exploratory factor analysis (EFA). The CRA was modified accordingly and again subjected to CFA. The CRA's measurement equivalence/invariance (ME/I) across language of administration (Chinese/English/Malay) was assessed. CFA showed a poor fit for the five-factor model. EFA suggested the presence of four factors, three items to have neither sufficient nor unique factor loadings and items on two of the subscales to load on a single factor. CFA of the 'modified' CRA (21 items; four subscales: schedule and health, finances, family support, and esteem) suggested a better fit for the four-factor model than for the five-factor model. ME/I analysis supported partial invariance of the CRA across language of administration. The CRA scale should be assessed for relevance in Asian settings. With the suggested modifications, it is suitable for assessing negative and positive effects of caregiving among informal caregivers of older persons with activity limitations in Singapore.

Authors
Malhotra, R; Chan, A; Malhotra, C; Østbye, T
MLA Citation
Malhotra, R, Chan, A, Malhotra, C, and Østbye, T. "Validity and reliability of the Caregiver Reaction Assessment scale among primary informal caregivers for older persons in Singapore." Aging Ment Health 16.8 (2012): 1004-1015.
PMID
22838393
Source
pubmed
Published In
Aging & Mental Health
Volume
16
Issue
8
Publish Date
2012
Start Page
1004
End Page
1015
DOI
10.1080/13607863.2012.702728

Unsuspected rickettsioses among patients with acute febrile Illness, Sri Lanka, 2007

We studied rickettsioses in southern Sri Lanka. Of 883 febrile patients with paired serum samples, 156 (17.7%) had acute rickettsioses; rickettsioses were unsuspected at presentation. Additionally, 342 (38.7%) had exposure to spotted fever and/or typhus group rickettsioses and 121 (13.7%) scrub typhus. Increased awareness of rickettsioses and better tests are needed.

Authors
Reller, ME; Bodinayake, C; Nagahawatte, A; Devasiri, V; Kodikara-Arachichi, W; Strouse, JJ; Flom, JE; Østbye, T; Woods, CW; Dumler, JS
MLA Citation
Reller, ME, Bodinayake, C, Nagahawatte, A, Devasiri, V, Kodikara-Arachichi, W, Strouse, JJ, Flom, JE, Østbye, T, Woods, CW, and Dumler, JS. "Unsuspected rickettsioses among patients with acute febrile Illness, Sri Lanka, 2007." Emerging Infectious Diseases 18.5 (2012): 825-829.
Source
scival
Published In
Emerging infectious diseases
Volume
18
Issue
5
Publish Date
2012
Start Page
825
End Page
829
DOI
10.3201/eid1805/111563

Effects of counseling techniques on patients' weight-related attitudes and behaviors in a primary care clinic.

OBJECTIVE: Examine primary care physicians' use of counseling techniques when treating overweight and obese patients and the association with mediators of behavior change as well as change in nutrition, exercise, and weight loss attempts. METHODS: We audio recorded office encounters between 40 physicians and 461 patients. Encounters were coded for physician use of selected counseling techniques using the Motivational Interviewing Treatment Integrity (MITI) scale. Patient motivation and confidence as well as Fat and Fiber Diet score (1-4), Framingham physical activity questionnaire (MET-minutes), and weight loss attempts (yes/no) were assessed by surveys. Generalized linear models were fit, including physician, patient, and visit level covariates. RESULTS: Patients whose physicians were rated higher in empathy improved their Fat and Fiber intake 0.18 units (95% CI 0, 0.4). When physicians used "MI consistent" techniques, patients reported higher confidence to improve nutrition (OR 2.57, 95% CI 1.2, 5.7). CONCLUSION: When physicians used counseling techniques consistent with MI principles, some of their patients' weight-related attitudes and behaviors improved. PRACTICE IMPLICATIONS: Physicians may not be able to employ formal MI during a clinic visit. However, use of counseling techniques consistent with MI principles, such as expression of empathy, may improve patients' weight-related attitudes and behaviors.

Authors
Cox, ME; Yancy, WS; Coffman, CJ; Ostbye, T; Tulsky, JA; Alexander, SC; Brouwer, RJN; Dolor, RJ; Pollak, KI
MLA Citation
Cox, ME, Yancy, WS, Coffman, CJ, Ostbye, T, Tulsky, JA, Alexander, SC, Brouwer, RJN, Dolor, RJ, and Pollak, KI. "Effects of counseling techniques on patients' weight-related attitudes and behaviors in a primary care clinic." Patient Educ Couns 85.3 (December 2011): 363-368.
PMID
21316897
Source
pubmed
Published In
Patient Education and Counseling
Volume
85
Issue
3
Publish Date
2011
Start Page
363
End Page
368
DOI
10.1016/j.pec.2011.01.024

Predictors of weight loss communication in primary care encounters.

OBJECTIVE: Evidence suggests that physicians' use of motivational interviewing (MI) techniques helps patients lose weight. We assessed patient, physician, relationship, and systems predictors of length of weight-loss discussions and whether physicians' used MI techniques. METHODS: Forty primary care physicians and 461 of their overweight or obese patients were audio recorded and surveyed. RESULTS: Weight-related topics were commonly discussed (nutrition 78%, physical activity 82%, and BMI/weight 72%). Use of MI techniques was low. A multivariable linear mixed model was fit to time spent discussing weight, adjusting for patient clustering within physician. More time was spent with obese patients (p=.0002), by African American physicians (p=.03), family physicians (p=.02), and physicians who believed patients were embarrassed to discuss weight (p=.05). Female physicians were more likely to use MI techniques (p=.02); African American physicians were more likely to use MI-inconsistent techniques (p<.001). CONCLUSION: Primary care physicians routinely counsel about weight and are likely to spend more time with obese than with overweight patients. Internists spend less time on weight. Patient and systems factors do not seem to influence physicians' use MI techniques. PRACTICE IMPLICATIONS: All physicians, particularly, male and African American physicians, could increase their use of MI techniques to promote more weight loss among patients.

Authors
Pollak, KI; Coffman, CJ; Alexander, SC; Manusov, JRE; Ostbye, T; Tulsky, JA; Lyna, P; Esoimeme, I; Brouwer, RJN; Dolor, RJ
MLA Citation
Pollak, KI, Coffman, CJ, Alexander, SC, Manusov, JRE, Ostbye, T, Tulsky, JA, Lyna, P, Esoimeme, I, Brouwer, RJN, and Dolor, RJ. "Predictors of weight loss communication in primary care encounters." Patient Educ Couns 85.3 (December 2011): e175-e182.
PMID
21474267
Source
pubmed
Published In
Patient Education and Counseling
Volume
85
Issue
3
Publish Date
2011
Start Page
e175
End Page
e182
DOI
10.1016/j.pec.2011.03.001

Self reported pain severity among multiethnic older Singaporeans: does adjusting for reporting heterogeneity matter?

The objective of this paper is to test and correct for systematic differences in reporting of pain severity among older adults by age, gender, ethnic group and socio-economic status using anchoring vignettes. Data from a national survey of community-dwelling older Singaporeans (aged 60 years and over) conducted in 2009 was used. Respondents were asked to rate the severity of their own pain as well as that of others described in the vignettes on a five-point scale ranging from none to extreme. An ordered probit model was used to estimate the coefficients of the independent variables (age, gender, ethnic group, education, housing type) on self-reported pain. Reporting heterogeneity in pain severity was then corrected using a Hierarchical Ordered Probit model. The results showed that before correcting for reporting heterogeneity, women, those older, and those of Malay ethnicity reported greater severity of pain, while there was no association of reported pain severity with housing type and education. However, after correcting for reporting heterogeneity, while women and those older were found to have an even greater severity of pain than what they had reported, Malays were found to have a lower severity of pain than what they had reported. We conclude that there are systematic differences in reporting pain severity by age, gender and ethnic group. We propose that pain management may be improved if medical professionals take into account reporting heterogeneity for pain severity among various population sub-groups in Singapore.

Authors
Chan, A; Malhotra, C; Do, YK; Malhotra, R; Ostbye, T
MLA Citation
Chan, A, Malhotra, C, Do, YK, Malhotra, R, and Ostbye, T. "Self reported pain severity among multiethnic older Singaporeans: does adjusting for reporting heterogeneity matter?." Eur J Pain 15.10 (November 2011): 1094-1099.
PMID
21646030
Source
pubmed
Published In
European Journal of Pain
Volume
15
Issue
10
Publish Date
2011
Start Page
1094
End Page
1099
DOI
10.1016/j.ejpain.2011.05.006

Risk factors for lower extremity amputation among patients with diabetes in Singapore.

BACKGROUND: Among other risk factors, renal disease and ethnicity have been associated with diabetic lower extremity amputation (LEA) in Western populations. However, little is known about risk factors for LEA among Asian patients. OBJECTIVE: The objective was to assess the proportion of hospitalized patients with diabetes who have a LEA among all hospital patients with diabetes mellitus (DM) and to investigate risk factors for diabetic LEA (especially renal disease and ethnicity) using hospital discharge database. METHOD: A retrospective study of hospital discharge database (2004-2009) was performed to identify patients with DM, LEA and renal disease using the International Statistical Classification of Diseases and Related Health Problems, Ninth Revision, Australian Modification codes. RESULTS: Of 44 917 hospitalized patients with DM during the 6 years, 7312 (16.3%) patients had renal disease, and 1457 (3.2%) patients had LEA. DM patients with renal disease had significant higher rates of LEA (7.1%) compared to DM patients without renal disease (2.5%, P < .001). The differences were present for foot (2.7% vs. 1.2%), ankle or leg (2.8% vs. 0.9%), and knee or above amputation (1.6% vs. 0.4%, all P<.001). Malays had the highest rate of diabetic LEA (5.1%), followed by Indians (3.0%), Chinese (3.0%), and others (2.3%, P < .001). In logistic regression analyses, renal disease and ethnicity were significant predictors of diabetic LEA (renal disease: odds ratio 3.2, 95% confidence interval 2.8-3.6; ethnicity: odds ratio, 1.6, Malays vs. Chinese, P < .001; 1.0, Indians vs. Chinese, P = .784) after adjustment for age, gender, and year of discharge. CONCLUSION: DM patients with renal disease and Malay ethnicity had higher rates of LEA in this Asian patient population. Malay patients with DM and diabetic patients with renal disease should be considered as high-risk groups for LEA and therefore screened and monitored systematically.

Authors
Yang, Y; Østbye, T; Tan, SB; Abdul Salam, Z-H; Ong, BC; Yang, KS
MLA Citation
Yang, Y, Østbye, T, Tan, SB, Abdul Salam, Z-H, Ong, BC, and Yang, KS. "Risk factors for lower extremity amputation among patients with diabetes in Singapore." J Diabetes Complications 25.6 (November 2011): 382-386.
PMID
21983153
Source
pubmed
Published In
Journal of Diabetes and Its Complications
Volume
25
Issue
6
Publish Date
2011
Start Page
382
End Page
386
DOI
10.1016/j.jdiacomp.2011.08.002

Correlates of sedentary time and physical activity among preschool-aged children.

Few studies have examined the correlates of objectively measured amounts of sedentary time and physical activity in young children. We evaluated the demographic, biological, behavioral, social, and environmental correlates of the amount of sedentary time and moderate-to-vigorous physical activity (MVPA) as measured by accelerometry in preschool-aged children.We obtained baseline measurements of physical activity by using an Actical accelerometer among 337 preschool-aged children (aged 2-5) of overweight or obese mothers. For children, we defined sedentary time as less than 12 counts per 15 seconds and MVPA as 715 or more counts per 15 seconds. Body mass index of the mother and child (calculated from measured height and weight) and maternal physical activity as measured by accelerometer were included as potential correlates. Mothers self-reported all other potential correlates. We used multivariable linear regression analyses to examine correlates of the amount of sedentary time and MVPA.Children had an average of 6.1 hours per day of sedentary time and 14.9 minutes per day of MVPA. In multivariable analysis, boys (P <.001) had fewer minutes per day of sedentary time, whereas older children (P <.001), boys (P <.001), children in high-income households (>$60,000/y [P = .005]), and children who spent more time outdoors (P = .001) had more MVPA.Both modifiable and nonmodifiable factors were correlated with preschool children's amount of MVPA, which can be helpful when designing interventions for this age group. The lack of correlates for sedentary time indicates the need for further investigation into this behavior.

Authors
Dolinsky, DH; Brouwer, RJN; Evenson, KR; Siega-Riz, AM; Østbye, T
MLA Citation
Dolinsky, DH, Brouwer, RJN, Evenson, KR, Siega-Riz, AM, and Østbye, T. "Correlates of sedentary time and physical activity among preschool-aged children." Preventing chronic disease 8.6 (November 2011): A131-.
Website
http://hdl.handle.net/10161/11438
PMID
22005624
Source
epmc
Published In
Preventing Chronic Diseases: Public health research, practice, and policy
Volume
8
Issue
6
Publish Date
2011
Start Page
A131

Unmet social support for healthy behaviors among overweight and obese postpartum women: results from the Active Mothers Postpartum Study.

In the United States, about two thirds of women of reproductive age are overweight or obese. Postpartum is a transitional period. Life changes during this time can put mothers under high levels of stress when interpersonal support is inadequate. This study sought to explore predictors of unmet social support (support inadequacy) for healthy behaviors among postpartum women who were overweight or obese before pregnancy.Potential predictors of unmet social support for healthy behaviors were derived from baseline and 6-month postpartum data from the Active Mothers Postpartum (AMP) study. The Postpartum Support Questionnaire queried three dimensions of social support: (1) informational support, (2) emotional support, and (3) instrumental support. The main outcome, the overall Unmet Social Support Score (USSS), was the sum of the differences between the perceived need of support and perceived receipt of support in all three dimensions. Subscores were defined for each of the three support dimensions.One hundred ninety women completed the 6-month Postpartum Support Questionnaire. Depression (p=0.018), unmarried status (p=0.049), and postpartum weight gain (p=0.003) were crude predictors for the overall USSS. After controlling for covariates, depression (p=0.009) and living with a spouse (p=0.040) were significant predictors for overall USSS. In adjusted analysis, depression remained a significant predictor for unmet emotional (p=0.035) and instrumental (p=0.001) social support.Certain psychosocial factors predict support inadequacy expectations among postpartum women. Targeting the factors related to unmet social support may be a helpful way to promote healthy behaviors among overweight postpartum women.

Authors
Boothe, AS; Brouwer, RJN; Carter-Edwards, L; Østbye, T
MLA Citation
Boothe, AS, Brouwer, RJN, Carter-Edwards, L, and Østbye, T. "Unmet social support for healthy behaviors among overweight and obese postpartum women: results from the Active Mothers Postpartum Study." Journal of women's health (2002) 20.11 (November 2011): 1677-1685.
PMID
21916619
Source
epmc
Published In
Journal of Women's Health
Volume
20
Issue
11
Publish Date
2011
Start Page
1677
End Page
1685
DOI
10.1089/jwh.2010.2509

Physician empathy and listening: associations with patient satisfaction and autonomy.

PURPOSE: Motivational Interviewing (MI) is used to help patients change their behaviors. We sought to determine if physician use of specific MI techniques increases patient satisfaction with the physician and perceived autonomy. METHODS: We audio-recorded preventive and chronic care encounters between 40 primary care physicians and 320 of their overweight or obese patients. We coded use of MI techniques (eg, empathy, reflective listening). We assessed patient satisfaction and how much the patient felt the physician supported him or her to change. Generalized estimating equation models with logit links were used to examine associations between MI techniques and patient perceived autonomy and satisfaction. RESULTS: Patients whose physicians were rated as more empathic had higher rates of high satisfaction than patients whose physicians were less empathic (29% vs 11%; P = .004). Patients whose physicians made any reflective statements had higher rates of high autonomy support than those whose physicians did not (46% vs 30%; P = .006). CONCLUSIONS: When physicians used reflective statements, patients were more likely to perceive high autonomy support. When physicians were empathic, patients were more likely to report high satisfaction with the physician. These results suggest that physician training in MI techniques could potentially improve patient perceptions and outcomes.

Authors
Pollak, KI; Alexander, SC; Tulsky, JA; Lyna, P; Coffman, CJ; Dolor, RJ; Gulbrandsen, P; Ostbye, T
MLA Citation
Pollak, KI, Alexander, SC, Tulsky, JA, Lyna, P, Coffman, CJ, Dolor, RJ, Gulbrandsen, P, and Ostbye, T. "Physician empathy and listening: associations with patient satisfaction and autonomy." J Am Board Fam Med 24.6 (November 2011): 665-672.
PMID
22086809
Source
pubmed
Published In
Journal of the American Board of Family Medicine
Volume
24
Issue
6
Publish Date
2011
Start Page
665
End Page
672
DOI
10.3122/jabfm.2011.06.110025

BASELINE FUNCTIONAL DISABILITY PREDICTS DEMENTIA RISK EVEN AFTER CONTROLLING FOR COGNITIVE STATUS

Authors
Fauth, EB; Schwartz, S; Smith, K; Tschanz, J; Ostbye, T; Corcoran, C; Norton, MC
MLA Citation
Fauth, EB, Schwartz, S, Smith, K, Tschanz, J, Ostbye, T, Corcoran, C, and Norton, MC. "BASELINE FUNCTIONAL DISABILITY PREDICTS DEMENTIA RISK EVEN AFTER CONTROLLING FOR COGNITIVE STATUS." GERONTOLOGIST 51 (November 2011): 36-37.
Source
wos-lite
Published In
The Gerontologist
Volume
51
Publish Date
2011
Start Page
36
End Page
37

DEMENTIA AND THE RISK ASSOCIATED WITH MEDICAL CO-MORBIDITIES: RESULTS FROM THE CACHE COUNTY STUDY LINKED TO MEDICARE CLAIMS

Authors
Smith, K; Hanson, H; Ostbye, T; Tschanz, J; Schwartz, S; Corcoran, C; Norton, MC
MLA Citation
Smith, K, Hanson, H, Ostbye, T, Tschanz, J, Schwartz, S, Corcoran, C, and Norton, MC. "DEMENTIA AND THE RISK ASSOCIATED WITH MEDICAL CO-MORBIDITIES: RESULTS FROM THE CACHE COUNTY STUDY LINKED TO MEDICARE CLAIMS." GERONTOLOGIST 51 (November 2011): 94-94.
Source
wos-lite
Published In
The Gerontologist
Volume
51
Publish Date
2011
Start Page
94
End Page
94

Early parental death and remarriage of widowed parents as risk factors for Alzheimer disease: the Cache County study.

OBJECTIVES: Early parental death is associated with lifelong tendencies toward depression and chronic stress. We tested the hypothesis that early parental death is associated with higher risk for Alzheimer disease (AD) in offspring. DESIGN: A population-based epidemiological study of dementia with detailed clinical evaluations, linked to one of the world's richest sources of objective genealogical and vital statistics data. SETTING: Home visits with residents of a rural county in northern Utah. PARTICIPANTS: 4,108 subjects, aged 65-105. MEASUREMENTS: Multistage dementia ascertainment protocol implemented in four triennial waves, yielding expert consensus diagnoses of 570 participants with AD and 3,538 without dementia. Parental death dates, socioeconomic status, and parental remarriage after widowhood were obtained from the Utah Population Database, a large genealogical database linked to statewide birth and death records. RESULTS: Mother's death during subject's adolescence was significantly associated with higher rate of AD in regression models that included age, gender, education, APOE genotype, and socioeconomic status. Father's death before subject age 5 showed a weaker association. In stratified analyses, associations were significant only when the widowed parent did not remarry. Parental death associations were not moderated by gender or APOE genotype. Findings were specific to AD and not found for non-AD dementia. CONCLUSIONS: Parental death during childhood is associated with higher prevalence of AD, with different critical periods for father's versus mother's death, with strength of these associations attenuated by remarriage of the widowed parent.

Authors
Norton, MC; Smith, KR; Østbye, T; Tschanz, JT; Schwartz, S; Corcoran, C; Breitner, JCS; Steffens, DC; Skoog, I; Rabins, PV; Welsh-Bohmer, KA; Cache County Investigators,
MLA Citation
Norton, MC, Smith, KR, Østbye, T, Tschanz, JT, Schwartz, S, Corcoran, C, Breitner, JCS, Steffens, DC, Skoog, I, Rabins, PV, Welsh-Bohmer, KA, and Cache County Investigators, . "Early parental death and remarriage of widowed parents as risk factors for Alzheimer disease: the Cache County study." Am J Geriatr Psychiatry 19.9 (September 2011): 814-824.
PMID
21873837
Source
pubmed
Published In
American Journal of Geriatric Psychiatry
Volume
19
Issue
9
Publish Date
2011
Start Page
814
End Page
824
DOI
10.1097/JGP.0b013e3182011b38

Postpartum physical activity in overweight and obese women.

BACKGROUND: Low physical activity (PA) during the postpartum period is associated with weight retention. While patterns of PA have been examined in normal weight women during this period, little is known about PA among overweight and obese women. The aim of this cross-sectional study was to investigate PA and determine the proportion of women meeting recommendations for PA. METHODS: Women (n = 491), with a body mass index (BMI) ≥ 25 kg/m² were enrolled in a behavioral intervention. PA was assessed at six weeks postpartum using the Seven-Day PA Recall. RESULTS: Women averaged 923 ± 100 minutes/day of sedentary/ light and 33 ± 56 minutes/day of combined moderate, hard, and very hard daily activity. Women with a BMI ≥ 40 kg/m² reported more time in sedentary/light activities and less hours of sleep than those with a lower BMI. Only 34% met national PA guidelines; this proportion was significantly lower among blacks (OR 0.5, CI 0.3-0.9). CONCLUSIONS: These overweight and obese postpartum women reported a large percentage of time spent in sedentary/light activity, and a high proportion failed to meet minimal guidelines for PA. Promotion of PA in the postpartum period should focus on reducing sedentary behaviors and increasing moderate PA.

Authors
Durham, HA; Morey, MC; Lovelady, CA; Namenek Brouwer, RJ; Krause, KM; Østbye, T
MLA Citation
Durham, HA, Morey, MC, Lovelady, CA, Namenek Brouwer, RJ, Krause, KM, and Østbye, T. "Postpartum physical activity in overweight and obese women." J Phys Act Health 8.7 (September 2011): 988-993.
PMID
21885890
Source
pubmed
Published In
Journal of physical activity & health
Volume
8
Issue
7
Publish Date
2011
Start Page
988
End Page
993

Cognitive associations of benzodiazepine use in older adults

Authors
Helmes, E; Ostbye, T
MLA Citation
Helmes, E, and Ostbye, T. "Cognitive associations of benzodiazepine use in older adults." INTERNATIONAL PSYCHOGERIATRICS 23 (September 2011): S349-S350.
Source
wos-lite
Published In
International psychogeriatrics / IPA
Volume
23
Publish Date
2011
Start Page
S349
End Page
S350

Living arrangements, social networks and depressive symptoms among older men and women in Singapore.

OBJECTIVES: To examine the association of living arrangements and social networks outside the household with depressive symptoms among older men and women, ascertain if these relationships differ between older men and women, and investigate whether the association of living arrangements with depressive symptoms varies by strength of social networks. METHODS: Data for 4489 community-dwelling Singaporeans, aged 60 years and older, from a recent nationally representative survey were analyzed. Depressive symptoms were assessed using the 11-item CES-D (Center for Epidemiologic Studies) scale, social networks through Lubben's revised social network scale, and living arrangements through household composition. Analysis was stratified by gender, and descriptive and multivariate statistics were used to assess the risk of depressive symptoms by living arrangements and social networks, adjusting for age, ethnic group, education, housing type, functional status, number of chronic diseases and involvement in social activities. RESULTS: Women had higher depressive symptom scores than men. Living alone and living with at least 1 child (no spouse) (relative to living with spouse and children), and weak social networks outside the household were associated with higher depressive symptom scores among both men and women. Men living alone with weak social networks outside the household had higher depressive symptom scores than those with strong networks. CONCLUSION: The findings have implications regarding the importance of strengthening non-familial social networks of older adults, particularly for those living alone.

Authors
Chan, A; Malhotra, C; Malhotra, R; Ostbye, T
MLA Citation
Chan, A, Malhotra, C, Malhotra, R, and Ostbye, T. "Living arrangements, social networks and depressive symptoms among older men and women in Singapore." Int J Geriatr Psychiatry 26.6 (June 2011): 630-639.
PMID
20677171
Source
pubmed
Published In
International Journal of Geriatric Psychiatry
Volume
26
Issue
6
Publish Date
2011
Start Page
630
End Page
639
DOI
10.1002/gps.2574

Association between attention-deficit/hyperactivity disorder symptoms and obesity and hypertension in early adulthood: a population-based study.

OBJECTIVE: To examine the associations between attention-deficit/hyperactivity disorder (ADHD) symptoms, obesity and hypertension in young adults in a large population-based cohort. DESIGN, SETTING AND PARTICIPANTS: The study population consisted of 15,197 respondents from the National Longitudinal Study of Adolescent Health, a nationally representative sample of adolescents followed from 1995 to 2009 in the United States. Multinomial logistic and logistic models examined the odds of overweight, obesity and hypertension in adulthood in relation to retrospectively reported ADHD symptoms. Latent curve modeling was used to assess the association between symptoms and naturally occurring changes in body mass index (BMI) from adolescence to adulthood. RESULTS: Linear association was identified between the number of inattentive (IN) and hyperactive/impulsive (HI) symptoms and waist circumference, BMI, diastolic blood pressure and systolic blood pressure (all P-values for trend <0.05). Controlling for demographic variables, physical activity, alcohol use, smoking and depressive symptoms, those with three or more HI or IN symptoms had the highest odds of obesity (HI 3+, odds ratio (OR)=1.50, 95% confidence interval (CI) = 1.22-2.83; IN 3+, OR = 1.21, 95% CI = 1.02-1.44) compared with those with no HI or IN symptoms. HI symptoms at the 3+ level were significantly associated with a higher OR of hypertension (HI 3+, OR = 1.24, 95% CI = 1.01-1.51; HI continuous, OR = 1.04, 95% CI = 1.00-1.09), but associations were nonsignificant when models were adjusted for BMI. Latent growth modeling results indicated that compared with those reporting no HI or IN symptoms, those reporting 3 or more symptoms had higher initial levels of BMI during adolescence. Only HI symptoms were associated with change in BMI. CONCLUSION: Self-reported ADHD symptoms were associated with adult BMI and change in BMI from adolescence to adulthood, providing further evidence of a link between ADHD symptoms and obesity.

Authors
Fuemmeler, BF; Østbye, T; Yang, C; McClernon, FJ; Kollins, SH
MLA Citation
Fuemmeler, BF, Østbye, T, Yang, C, McClernon, FJ, and Kollins, SH. "Association between attention-deficit/hyperactivity disorder symptoms and obesity and hypertension in early adulthood: a population-based study." Int J Obes (Lond) 35.6 (June 2011): 852-862.
Website
http://hdl.handle.net/10161/5916
PMID
20975727
Source
pubmed
Published In
International Journal of Obesity
Volume
35
Issue
6
Publish Date
2011
Start Page
852
End Page
862
DOI
10.1038/ijo.2010.214

Longitudinal adherence to fecal occult blood testing impacts colorectal cancer screening quality.

OBJECTIVES: Existing cross-sectional quality measures for colorectal cancer (CRC) screening do not assess longitudinal adherence and thus may overestimate the quality of care. Our goal was to evaluate the adherence to repeated yearly fecal occult blood tests (FOBTs) in order to better understand the extent to which longitudinal adherence may impact screening quality. METHODS: This was a retrospective cohort analysis of 1,122,645 patients aged 50-75 years seen at any of the 136 Department of Veterans Affairs medical centers across the United States in 2000 and followed through 2005. The primary outcome was receipt of adequate CRC screening as defined by receipt of FOBTs in at least 4 out of 5 years or receipt of any number of FOBTs in addition to at least one colonoscopy, flexible sigmoidoscopy, or double-contrast barium enema. In a predefined subset of patients receiving exclusively FOBT, adherence with repeated testing was determined over the 5-year study period. RESULTS: Only 41.1% of men and 43.6% of women received adequate screening. Of the 384,527 men who received exclusively FOBT, 42.1% received a single FOBT, 26.0% received 2 tests, 17.8% received 3 tests, and only 14.1% were documented to have received at least 4 tests during the study period. Among the 10,469 female veterans receiving FOBT alone, rates were similar with only 13.7% completing at least 4 FOBTs in the 5-year study period. CONCLUSIONS: Adherence to repeated FOBT is low, suggesting that cross-sectional measurements of quality may overestimate the programmatic success of CRC screening.

Authors
Gellad, ZF; Stechuchak, KM; Fisher, DA; Olsen, MK; McDuffie, JR; Ostbye, T; Yancy, WS
MLA Citation
Gellad, ZF, Stechuchak, KM, Fisher, DA, Olsen, MK, McDuffie, JR, Ostbye, T, and Yancy, WS. "Longitudinal adherence to fecal occult blood testing impacts colorectal cancer screening quality." Am J Gastroenterol 106.6 (June 2011): 1125-1134.
PMID
21304501
Source
pubmed
Published In
The American Journal of Gastroenterology (Elsevier)
Volume
106
Issue
6
Publish Date
2011
Start Page
1125
End Page
1134
DOI
10.1038/ajg.2011.11

Concomitant cholecystectomy in laparoscopic gastric bypass surgery is decreasing: a national study of 69,182 patients

Authors
Worni, M; Ostbye, T; Rajgor, D; Shah, J; Jacobs, DO; Pietrobon, R; Guller, U
MLA Citation
Worni, M, Ostbye, T, Rajgor, D, Shah, J, Jacobs, DO, Pietrobon, R, and Guller, U. "Concomitant cholecystectomy in laparoscopic gastric bypass surgery is decreasing: a national study of 69,182 patients." June 2011.
Source
wos-lite
Published In
British Journal of Surgery
Volume
98
Publish Date
2011
Start Page
7
End Page
7

Kids and adults now! Defeat Obesity (KAN-DO): rationale, design and baseline characteristics.

BACKGROUND: Prevention of childhood obesity is a public health priority. Parents influence a child's weight by modeling healthy behaviors, controlling food availability and activity opportunities, and appropriate feeding practices. Thus interventions should target education and behavioral change in the parent, and positive, mutually reinforcing behaviors within the family. METHODS: This paper presents the design, rationale and baseline characteristics of Kids and Adults Now! - Defeat Obesity (KAN-DO), a randomized controlled behavioral intervention trial targeting weight maintenance in children of healthy weight, and weight reduction in overweight children. 400 children aged 2-5 and their overweight or obese mothers in the Triangle and Triad regions of North Carolina are randomized equally to control or the KAN-DO intervention, consisting of mailed family kits encouraging healthy lifestyle change. Eight (monthly) kits are supported by motivational counseling calls and a single group session. Mothers are targeted during a hypothesized "teachable moment" for health behavior change (the birth of a new baby), and intervention content addresses: parenting skills ((e.g., emotional regulation, authoritative parenting), healthy eating, and physical activity. RESULTS: The 400 mother-child dyads randomized to trial are 75% white and 22% black; 19% have a household income of $30,000 or below. At baseline, 15% of children are overweight (85th-95th percentile for body mass index) and 9% are obese (≥ 95th percentile). CONCLUSION: This intervention addresses childhood obesity prevention by using a family-based, synergistic approach, targeting at-risk children and their mothers during key transitional periods, and enhancing maternal self-regulation and responsive parenting as a foundation for health behavior change.

Authors
Ostbye, T; Zucker, NL; Krause, KM; Lovelady, CA; Evenson, KR; Peterson, BL; Bastian, LA; Swamy, GK; West, DG; Brouwer, RJN
MLA Citation
Ostbye, T, Zucker, NL, Krause, KM, Lovelady, CA, Evenson, KR, Peterson, BL, Bastian, LA, Swamy, GK, West, DG, and Brouwer, RJN. "Kids and adults now! Defeat Obesity (KAN-DO): rationale, design and baseline characteristics." Contemp Clin Trials 32.3 (May 2011): 461-469.
PMID
21300177
Source
pubmed
Published In
Contemporary Clinical Trials
Volume
32
Issue
3
Publish Date
2011
Start Page
461
End Page
469
DOI
10.1016/j.cct.2011.01.017

Correlates of limitations in activities of daily living and mobility among community-dwelling older Singaporeans

Authors
Chan, A; Malhotra, C; Ostbye, T
MLA Citation
Chan, A, Malhotra, C, and Ostbye, T. "Correlates of limitations in activities of daily living and mobility among community-dwelling older Singaporeans." AGEING & SOCIETY 31 (May 2011): 663-682.
Source
wos-lite
Published In
Ageing & Society
Volume
31
Publish Date
2011
Start Page
663
End Page
682
DOI
10.1017/S0144686X10001200

Predictors of breastfeeding in overweight and obese women: data from Active Mothers Postpartum (AMP).

Excess maternal weight has been negatively associated with breastfeeding. We examined correlates of breastfeeding initiation and intensity in a racially diverse sample of overweight and obese women. This paper presents a secondary analysis of data from 450 women enrolled in a postpartum weight loss intervention (Active Mothers Postpartum [AMP]). Sociodemographic measures and body mass index (BMI), collected at 6 weeks postpartum, were examined for associations with breastfeeding initiation and lactation score (a measure combining duration and exclusivity of breastfeeding until 12 months postpartum). Data were collected September 2004-April 2007. In multivariable analyses, BMI was negatively associated with both initiation of breastfeeding (OR: .96; CI: .92-.99) and lactation score (β -0.22; P = 0.01). Education and infant gestational age were additional correlates of initiation, while race, working full-time, smoking, parity, and gestational age were additional correlates of lactation score. Some racial differences in these correlates were noted, but were not statistically significant. Belief that breastfeeding could aid postpartum weight loss was initially high, but unrelated to breastfeeding initiation or intensity. Maintenance of this belief over time, however, was associated with lower lactation scores. BMI was negatively correlated with breastfeeding initiation and intensity. Among overweight and obese women, unrealistic expectations regarding the effect of breastfeeding on weight loss may negatively impact breastfeeding duration. In general, overweight and obese women may need additional encouragement to initiate breastfeeding and to continue breastfeeding during the infant's first year.

Authors
Krause, KM; Lovelady, CA; Østbye, T
MLA Citation
Krause, KM, Lovelady, CA, and Østbye, T. "Predictors of breastfeeding in overweight and obese women: data from Active Mothers Postpartum (AMP)." Matern Child Health J 15.3 (April 2011): 367-375.
PMID
20821042
Source
pubmed
Published In
Maternal and Child Health Journal
Volume
15
Issue
3
Publish Date
2011
Start Page
367
End Page
375
DOI
10.1007/s10995-010-0667-7

Impact of Comorbid Cognitive and Vision Impairment on Disability and Self-Rated Health

Authors
Whitson, HE; Malhotra, R; Chan, A; Ostbye, T
MLA Citation
Whitson, HE, Malhotra, R, Chan, A, and Ostbye, T. "Impact of Comorbid Cognitive and Vision Impairment on Disability and Self-Rated Health." April 2011.
Source
wos-lite
Published In
Journal of American Geriatrics Society
Volume
59
Publish Date
2011
Start Page
S177
End Page
S178

Weight-loss talks: What works (and what doesn't)

Authors
Alexander, SC; Cox, ME; Jr, YWS; Turer, CB; Lyna, P; Ostbye, T; Dolor, RJ; Tulsky, JA; Pollak, KI
MLA Citation
Alexander, SC, Cox, ME, Jr, YWS, Turer, CB, Lyna, P, Ostbye, T, Dolor, RJ, Tulsky, JA, and Pollak, KI. "Weight-loss talks: What works (and what doesn't)." JOURNAL OF FAMILY PRACTICE 60.4 (April 2011): 213-+.
PMID
26048291
Source
wos-lite
Published In
Journal of Family Practice
Volume
60
Issue
4
Publish Date
2011
Start Page
213
End Page
+

Diet quality is higher among overweight and obese women who breastfeed as compared to those who formula feed

Authors
Moening, GA; Lovelady, C; West, D; Brouwer, R; Krause, K; Ostbye, T
MLA Citation
Moening, GA, Lovelady, C, West, D, Brouwer, R, Krause, K, and Ostbye, T. "Diet quality is higher among overweight and obese women who breastfeed as compared to those who formula feed." April 2011.
Source
wos-lite
Published In
The FASEB journal : official publication of the Federation of American Societies for Experimental Biology
Volume
25
Publish Date
2011

Do the five A's work when physicians counsel about weight loss?

BACKGROUND AND OBJECTIVES: More than two thirds of Americans are overweight or obese. Physician counseling may help patients lose weight; however, physicians perceive these discussions as somewhat futile and time-consuming. An effective and efficient tool for smoking cessation is the Five A's (Ask, Advise, Assess, Assist, and Arrange). We studied the effectiveness of the Five A's in weight-loss counseling. METHODS: We audiorecorded primary care encounters between 40 physicians and 461 of their overweight or obese patients. All were told the study was about preventive health, not weight specifically. Encounters were coded for physician use of the Five A's. Patients' motivation and confidence were assessed before and immediately after the encounter. Three months later, we assessed patient change in dietary fat intake, exercise, and weight. RESULTS: Generalized linear models were fit adjusting for patient clustering within physician. Physicians used at least one of the Five A's often (83%). Physicians routinely Ask and Advise patients to lose weight; however, they rarely Assess, Assist, or Arrange. Assist and Arrange were related to diet improvement, whereas Advise was associated with increases in motivation and confidence to change dietary fat intake and confidence to lose weight. CONCLUSIONS: Similar to smoking cessation counseling, physicians routinely Asked and Advised patients to lose weight; however, they rarely Assessed, Assisted, or Arranged. Given the potential impact of using all of these counseling tools on changing patient behavior, physicians should be encouraged to increase their use of the Five A's when counseling patients to lose weight.

Authors
Alexander, SC; Cox, ME; Boling Turer, CL; Lyna, P; Østbye, T; Tulsky, JA; Dolor, RJ; Pollak, KI
MLA Citation
Alexander, SC, Cox, ME, Boling Turer, CL, Lyna, P, Østbye, T, Tulsky, JA, Dolor, RJ, and Pollak, KI. "Do the five A's work when physicians counsel about weight loss?." Fam Med 43.3 (March 2011): 179-184.
PMID
21380950
Source
pubmed
Published In
Family medicine
Volume
43
Issue
3
Publish Date
2011
Start Page
179
End Page
184

Levels and Predictors of Unmet Social Support for Healthy Behaviors Among Overweight and Obese Postpartum Women: Results from the Active Mothers Postpartum Study

Authors
Boothe, A; Brouwer, R; Carter-Edwards, L; Ostbye, T
MLA Citation
Boothe, A, Brouwer, R, Carter-Edwards, L, and Ostbye, T. "Levels and Predictors of Unmet Social Support for Healthy Behaviors Among Overweight and Obese Postpartum Women: Results from the Active Mothers Postpartum Study." JOURNAL OF WOMENS HEALTH 20.3 (March 2011): 459-460.
Source
wos-lite
Published In
Journal of Women's Health
Volume
20
Issue
3
Publish Date
2011
Start Page
459
End Page
460

Marriage, Widowhood and Divorce: Affects on Dementia Risk

Authors
Hatch, DJ; Smith, K; Tschanz, JT; Corcoran, C; Ostbye, T; Norton, MC
MLA Citation
Hatch, DJ, Smith, K, Tschanz, JT, Corcoran, C, Ostbye, T, and Norton, MC. "Marriage, Widowhood and Divorce: Affects on Dementia Risk." March 2011.
Source
wos-lite
Published In
American Journal of Geriatric Psychiatry
Volume
19
Issue
3
Publish Date
2011
Start Page
S58
End Page
S58

Body mass trajectories through adulthood: results from the National Longitudinal Survey of Youth 1979 Cohort (1981-2006).

BACKGROUND: Most studies describing change in body mass through adulthood model an 'average' trajectory bearing the same functional form in the underlying population. Latent-class growth modelling has revealed the presence of several underlying body mass/obesity trajectory groups among children and adolescents, but has not been applied to capture adult body mass trajectories. We apply the technique to identify adult body mass trajectory groups, risk factors for group membership and (time-varying) modifiers of trajectory level within each group, and assess association between group membership and important health outcomes in midlife. METHODS: Body mass trajectory groups, from age 18 to 49 years, were identified using latent-class growth modelling based on the National Longitudinal Survey of Youth 1979 (n = 9681). Role of gender, race/ethnicity and age cohort as risk factors for group membership, and of highest grade of education completed, years of urban living, years in employment, years in poverty and years married as modifiers of trajectory level was evaluated. RESULTS: Four trajectory groups, 'normal weight', 'overweight', 'late adulthood obesity' and 'early adulthood obesity' were identified. Males, Blacks and those born later had higher odds of being in the three latter groups. More education and years married lowered the trajectory within each group. The prevalence of most health outcomes was lowest in the 'normal weight' group, somewhat greater in the 'overweight' group, greater again in the 'late adult obesity group' and highest in the 'early adulthood obesity' group. CONCLUSION: Regular body mass index screening and monitoring in early adult life may identify a person as belonging to one of these four groups early, and allow the individual and health-care providers opportunities to initiate behavioural or other interventions better tailored to the specific group.

Authors
Ostbye, T; Malhotra, R; Landerman, LR
MLA Citation
Ostbye, T, Malhotra, R, and Landerman, LR. "Body mass trajectories through adulthood: results from the National Longitudinal Survey of Youth 1979 Cohort (1981-2006)." Int J Epidemiol 40.1 (February 2011): 240-250.
PMID
20819785
Source
pubmed
Published In
International Journal of Epidemiology
Volume
40
Issue
1
Publish Date
2011
Start Page
240
End Page
250
DOI
10.1093/ije/dyq142

Comparison of dietary intake of overweight postpartum mothers practicing breastfeeding or formula feeding.

Weight gain in the postpartum period is a risk factor for long-term obesity. Investigations of dietary intake among lactating and nonlactating overweight women might identify nutritional concerns specific to this population.To compare nutrient, meal, and snack intakes, food-group servings and prevalence of dieting among fully breastfeeding (BF), mixed breast and formula feeding (MF), and formula feeding (FF) overweight and obese women. The second aim was to compare nutrient intakes and food-group servings to the Dietary Reference Intake and MyPyramid recommendations, respectively.Data were collected from September 2004 through April 2006 in Durham, NC. Infant feeding practices and dietary information were collected on 450 women between 6 and 9 weeks postpartum. Two 24-hour dietary recalls were completed by phone, using Nutrition Data Systems for Research. Analysis of covariance was used to compare infant feeding groups in dietary quality (nutrient intake per 1,000 kcal) and food-group servings, controlling for prepregnancy body mass index, race, age, education, income, and marital status. χ² analysis was performed to determine differences in meal and snack intake and dieting among infant feeding groups.BF women consumed more energy (2,107 ± 50 kcal) than MF (1,866 ± 56 kcal) or FF (1,657 ± 50 kcal) women (P < 0.001). Adjusted nutrient intake did not differ between groups. All groups were at risk for inadequate intakes of vitamins A, E, C, and folate and did not meet recommended servings of all food groups. BF women consumed lunch and snacks more frequently, were less likely to diet, and reported higher intakes of grains and desserts than MF and FF women.To help increase intakes of nutrients lacking in the diet and prevent postpartum weight gain, overweight women should be encouraged to increase fruits, vegetables, low-fat dairy, whole grains, legumes, and healthy types of fat, while decreasing refined grains, regular soda, sweetened beverages, and desserts.

Authors
Durham, HA; Lovelady, CA; Brouwer, RJN; Krause, KM; Ostbye, T
MLA Citation
Durham, HA, Lovelady, CA, Brouwer, RJN, Krause, KM, and Ostbye, T. "Comparison of dietary intake of overweight postpartum mothers practicing breastfeeding or formula feeding." Journal of the American Dietetic Association 111.1 (January 2011): 67-74.
PMID
21185967
Source
epmc
Published In
Journal of the American Dietetic Association
Volume
111
Issue
1
Publish Date
2011
Start Page
67
End Page
74
DOI
10.1016/j.jada.2010.10.001

Sexual functioning in obese adults enrolling in a weight loss study.

The authors assessed sexual functioning among treatment-seeking obese men (n = 91) and women (n = 134) using the comprehensive validated Sexual Functioning Questionnaire. Scores were lower for women than for men, indicating reduced sexual functioning. Men's scores fell between those of a group of cancer survivors and a general population group, whereas women generally had lower scores than both of these groups. Increasing body mass index was associated with decreasing sexual functioning only for arousal and behavior. Sexual functioning was also reduced on most subscales for individuals who reported sexual inactivity in the past month.

Authors
Ostbye, T; Kolotkin, RL; He, H; Overcash, F; Brouwer, R; Binks, M; Syrjala, KL; Gadde, KM
MLA Citation
Ostbye, T, Kolotkin, RL, He, H, Overcash, F, Brouwer, R, Binks, M, Syrjala, KL, and Gadde, KM. "Sexual functioning in obese adults enrolling in a weight loss study." Journal of sex & marital therapy 37.3 (January 2011): 224-235.
PMID
21512941
Source
epmc
Published In
Journal of Sex & Marital Therapy
Volume
37
Issue
3
Publish Date
2011
Start Page
224
End Page
235
DOI
10.1080/0092623x.2011.564530

Latex allergy symptoms among health care workers: results from a university health and safety surveillance system.

We sought to describe risk factors for latex glove allergy symptoms among health care workers by combining data from an active clinical surveillance program and a comprehensive occupational health surveillance system. A total of 4,584 employers completed a latex allergy questionnaire. Six percent (n = 276) of subjects reported symptoms consistent with latex allergy. Years of latex glove use was a significant risk factor for latex allergy symptoms even after controlling for the effects of atopy, gender, age, race, fruit, and other allergies. Nurses, medical or lab technicians, physician's assistants, other clinical professionals, and housekeepers had the highest prevalence of latex glove allergy symptoms. Forty subjects (0.87%) who were confirmed as having latex sensitization. Sensitizsation may have been underestimated due to use of specific IgE antibody, less sensitive than skin-prick testing, and tiered design leading to laboratory assessment on a subset of the cohort. This surveillance program identified risk factors for latex allergy symptoms. Our findings provide a basis for tailoring future prevention strategies.

Authors
Epling, C; Duncan, J; Archibong, E; Østbye, T; Pompeii, LA; Dement, J
MLA Citation
Epling, C, Duncan, J, Archibong, E, Østbye, T, Pompeii, LA, and Dement, J. "Latex allergy symptoms among health care workers: results from a university health and safety surveillance system." Int J Occup Environ Health 17.1 (January 2011): 17-23.
PMID
21344815
Source
pubmed
Published In
International journal of occupational and environmental health
Volume
17
Issue
1
Publish Date
2011
Start Page
17
End Page
23
DOI
10.1179/107735211799031176

Incremental contribution of reported previous head injury to the prediction of diagnosis and cognitive functioning in older adults.

BACKGROUND: Severe brain injuries may be a risk factor for the development of dementia in later life. Less severe incidents with relatively short or even no loss of consciousness may not carry the same prognosis. OBJECTIVES: This study used data from the first two waves of the Canadian Study of Health and Ageing (CSHA-1 and CSHA-2) to investigate two questions. (1) Does a history of head injury improve the prediction of the diagnosis of dementia? This analysis was based on the 921 elderly individuals who underwent a clinical assessment in CSHA-2 and, 5 years earlier, had reported whether or not they had had a head injury. (2) Does adding information about a history of head injury improve the prediction of neuropsychological test scores? This second analysis included 585 elderly people who underwent neuropsychological assessment in both waves and who also reported whether or not they had had a history of mild or moderate-to-severe head injury. RESULTS: RESULTS showed that the inclusion of head injury information did not improve the prediction of diagnostic outcome of dementia. Age and overall cognitive status were associated with most neuropsychological test scores, more so than the more limited influence of chronic health problems, which was associated with about half of the neuropsychological measures.

Authors
Helmes, E; Østbye, T; Steenhuis, RE
MLA Citation
Helmes, E, Østbye, T, and Steenhuis, RE. "Incremental contribution of reported previous head injury to the prediction of diagnosis and cognitive functioning in older adults." Brain Inj 25.4 (2011): 338-347.
PMID
21314278
Source
pubmed
Published In
Brain Injury
Volume
25
Issue
4
Publish Date
2011
Start Page
338
End Page
347
DOI
10.3109/02699052.2011.556104

Fifteen Dimensions of Health among Community-Dwelling Older Singaporeans.

This paper aims to present a broad perspective of health of older Singaporeans spanning 15 health dimensions and study the association between self-rated health (SRH) and other health dimensions. Using data from a survey of 5000 Singaporeans (≥60 years), SRH and health in 14 other dimensions were assessed. Generalized logit model was used to assess contribution of these 14 dimensions to positive and negative SRH, compared to average SRH. About 86% reported their health to be average or higher. Prevalence of positive SRH and "health" in most other dimensions was lower in older age groups. Positive and negative SRH were associated with mobility, hearing, vision, major physical illness, pain, personal mastery, depressive symptoms, and perceived financial adequacy. The findings show that a majority of older Singaporeans report themselves as healthy overall and in a wide range of health dimensions.

Authors
Malhotra, C; Chan, A; Malhotra, R; Ostbye, T
MLA Citation
Malhotra, C, Chan, A, Malhotra, R, and Ostbye, T. "Fifteen Dimensions of Health among Community-Dwelling Older Singaporeans." Curr Gerontol Geriatr Res 2011 (2011): 128581-.
PMID
22110500
Source
pubmed
Published In
Current Gerontology and Geriatrics Research
Volume
2011
Publish Date
2011
Start Page
128581
DOI
10.1155/2011/128581

Predicting Latent Tuberculosis Treatment Initiation And Completion At A Public Health Clinic

Authors
Goswami, ND; Gadkowski, LB; Piedrahita, C; Bissette, D; Ahearn, MA; Blain, MLM; Ostbye, T; Saukkonen, J; Stout, JE
MLA Citation
Goswami, ND, Gadkowski, LB, Piedrahita, C, Bissette, D, Ahearn, MA, Blain, MLM, Ostbye, T, Saukkonen, J, and Stout, JE. "Predicting Latent Tuberculosis Treatment Initiation And Completion At A Public Health Clinic." AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE 183 (2011).
Source
wos-lite
Published In
American journal of respiratory and critical care medicine
Volume
183
Publish Date
2011

Effect of breast-feeding on weight retention at 3 and 6 months postpartum: data from the North Carolina WIC Programme.

OBJECTIVE: Pregnancy-related weight retention can contribute to obesity, and breast-feeding may facilitate postpartum weight loss. We investigated the effect of breast-feeding on postpartum weight retention. DESIGN: A retrospective follow-up study of weight retention, compared in women who were fully breast-feeding, combining breast-feeding with formula-feeding (mixed feeding), or formula-feeding at 3 months (n 14 330) or 6 months (n 4922) postpartum, controlling for demographic and weight-related covariates using multiple linear regression. SETTING: The North Carolina Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). SUBJECTS: Participants in the North Carolina WIC Programme who delivered a baby between 1996 and 2004. RESULTS: In covariate-adjusted analyses, there was no association between breast-feeding and weight retention at 3 months postpartum. At 6 months postpartum, as compared to formula-feeders, mean weight retention was 0·84 kg lower in mixed feeders (95 % CI 0·39, 1·29; P = 0·0002) and 1·38 kg lower in full breast-feeders (95 % CI 0·89, 1·87; P ≤ 0·0001). CONCLUSIONS: Breast-feeding was inversely associated with weight retention at 6 months postpartum in this large, racially diverse sample of low-income women. Further, full breast-feeding had a larger protective effect than did breast-feeding combined with formula-feeding.

Authors
Krause, KM; Lovelady, CA; Peterson, BL; Chowdhury, N; Østbye, T
MLA Citation
Krause, KM, Lovelady, CA, Peterson, BL, Chowdhury, N, and Østbye, T. "Effect of breast-feeding on weight retention at 3 and 6 months postpartum: data from the North Carolina WIC Programme." Public Health Nutr 13.12 (December 2010): 2019-2026.
PMID
20519049
Source
pubmed
Published In
Public health nutrition
Volume
13
Issue
12
Publish Date
2010
Start Page
2019
End Page
2026
DOI
10.1017/S1368980010001503

Prevalence, awareness, treatment and control of hypertension in the elderly population of Singapore.

A comprehensive picture of the management of hypertension in the increasing elderly population in Singapore is lacking. In this study, we assess the prevalence and correlates of hypertension and of awareness, treatment and control of hypertension among 4494 elderly Singaporeans (≥60 years) participating in a recent representative survey. The weighted prevalences of hypertension (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or current use of antihypertension medication) and of awareness, treatment and control of hypertension were assessed. We assessed the extent of association of these outcomes with socio-demographic (age, gender, ethnicity, education, housing type, living arrangement and social participation) and health (body mass, diabetes and cognitive status) variables using multivariable logistic regression. Nearly three-fourths (73.9%) of participants were found to have hypertension. Of this number, 30.8% were unaware that they had hypertension, 32.0% were not being treated for the disease and 75.9% had suboptimal control of their blood pressure. Among those aware of their hypertension, only 1.9% were untreated. However, nearly two-thirds (64.5%) of treated hypertensives had suboptimal control. Age, gender, ethnicity, education, housing type, body mass and diabetes were significantly correlated with lack of awareness, treatment and control of hypertension. Although the specific 'at-risk' subgroups varied by the outcome, men and Malays had consistently higher odds for all three unfavorable outcomes. There is a need to improve awareness, treatment and especially control of hypertension among elderly Singaporeans. Primary and secondary prevention efforts targeting the elderly and their primary health-care providers are called for, as are regular data collection efforts based on representative samples.

Authors
Malhotra, R; Chan, A; Malhotra, C; Østbye, T
MLA Citation
Malhotra, R, Chan, A, Malhotra, C, and Østbye, T. "Prevalence, awareness, treatment and control of hypertension in the elderly population of Singapore." Hypertens Res 33.12 (December 2010): 1223-1231.
PMID
20882026
Source
pubmed
Published In
Hypertension research : official journal of the Japanese Society of Hypertension
Volume
33
Issue
12
Publish Date
2010
Start Page
1223
End Page
1231
DOI
10.1038/hr.2010.177

Effect of breastfeeding on weight retention from one pregnancy to the next: results from the North Carolina WIC program.

OBJECTIVES: Pregnancy-related weight retention can contribute to obesity, and breastfeeding may facilitate postpartum weight loss. We investigated the effect of breastfeeding on long-term postpartum weight retention. METHODS: Using data from the North Carolina Special Supplemental Nutrition Program for Women, Infants, and Children (WIC; 1996-2004), weight retention was assessed in women aged 18 years or older who had more than one pregnancy available for analysis (n=32,920). Using multivariable linear regression, the relationship between duration of breastfeeding after the first pregnancy and change in pre-pregnancy weight from the first pregnancy to the second pregnancy was estimated, controlling for demographic and weight-related covariates. RESULTS: Mean time between pregnancies was 2.8 years (standard deviation (SD) 1.5), and mean weight retention from the first to the second pregnancy was 4.9kg (SD 8.7). In covariate-adjusted analyses, breastfeeding for 20 weeks or more resulted in 0.39kg (standard error (SE) 0.18) less weight retention at the beginning of the second pregnancy relative to no breastfeeding (p=0.025). CONCLUSION: In this large, racially diverse sample of low-income women, long-term weight retention was lower among those who breastfed for at least 20 weeks.

Authors
Østbye, T; Krause, KM; Swamy, GK; Lovelady, CA
MLA Citation
Østbye, T, Krause, KM, Swamy, GK, and Lovelady, CA. "Effect of breastfeeding on weight retention from one pregnancy to the next: results from the North Carolina WIC program." Prev Med 51.5 (November 2010): 368-372.
PMID
20655944
Source
pubmed
Published In
Preventive Medicine
Volume
51
Issue
5
Publish Date
2010
Start Page
368
End Page
372
DOI
10.1016/j.ypmed.2010.07.017

What are physicians' and patients' beliefs about diet, weight, exercise, and smoking cessation counseling?

Authors
Dolor, RJ; Østbye, T; Lyna, P; Coffman, CJ; Alexander, SC; Tulsky, JA; Brouwer, RJN; Esoimeme, I; Pollak, KI
MLA Citation
Dolor, RJ, Østbye, T, Lyna, P, Coffman, CJ, Alexander, SC, Tulsky, JA, Brouwer, RJN, Esoimeme, I, and Pollak, KI. "What are physicians' and patients' beliefs about diet, weight, exercise, and smoking cessation counseling?." Prev Med 51.5 (November 2010): 440-442. (Letter)
PMID
20692283
Source
pubmed
Published In
Preventive Medicine
Volume
51
Issue
5
Publish Date
2010
Start Page
440
End Page
442
DOI
10.1016/j.ypmed.2010.07.023

Physician communication techniques and weight loss in adults: Project CHAT.

BACKGROUND: Physicians are encouraged to counsel overweight and obese patients to lose weight. PURPOSE: It was examined whether discussing weight and use of motivational interviewing techniques (e.g., collaborating, reflective listening) while discussing weight predicted weight loss 3 months after the encounter. METHODS: Forty primary care physicians and 461 of their overweight or obese patient visits were audio recorded between December 2006 and June 2008. Patient actual weight at the encounter and 3 months after the encounter (n=426); whether weight was discussed; physicians' use of motivational interviewing techniques; and patient, physician, and visit covariates (e.g., race, age, specialty) were assessed. This was an observational study and data were analyzed in April 2009. RESULTS: No differences in weight loss were found between patients whose physicians discussed weight or did not. Patients whose physicians used motivational interviewing-consistent techniques during weight-related discussions lost weight 3 months post-encounter; those whose physician used motivational interviewing-inconsistent techniques gained or maintained weight. The estimated difference in weight change between patients whose physician had a higher global motivational interviewing-Spirit score (e.g., collaborated with patient) and those whose physician had a lower score was 1.6 kg (95% CI=-2.9, -0.3, p=0.02). The same was true for patients whose physician used reflective statements: 0.9 kg (95% CI=-1.8, -0.1, p=0.03). Similarly, patients whose physicians expressed only motivational interviewing-consistent behaviors had a difference in weight change of 1.1 kg (95% CI=-2.3, 0.1, p=0.07) compared to those whose physician expressed only motivational interviewing-inconsistent behaviors (e.g., judging, confronting). CONCLUSIONS: In this observational study, use of motivational interviewing techniques during weight loss discussions predicted patient weight loss.

Authors
Pollak, KI; Alexander, SC; Coffman, CJ; Tulsky, JA; Lyna, P; Dolor, RJ; James, IE; Brouwer, RJN; Manusov, JRE; Østbye, T
MLA Citation
Pollak, KI, Alexander, SC, Coffman, CJ, Tulsky, JA, Lyna, P, Dolor, RJ, James, IE, Brouwer, RJN, Manusov, JRE, and Østbye, T. "Physician communication techniques and weight loss in adults: Project CHAT." Am J Prev Med 39.4 (October 2010): 321-328.
PMID
20837282
Source
pubmed
Published In
American Journal of Preventive Medicine
Volume
39
Issue
4
Publish Date
2010
Start Page
321
End Page
328
DOI
10.1016/j.amepre.2010.06.005

Factors Associated With Physical Activity Among Two-to-Five-Year Old Children

Authors
Dolinsky, DH; Brouwer, RN; Evenson, K; Ostbye, T
MLA Citation
Dolinsky, DH, Brouwer, RN, Evenson, K, and Ostbye, T. "Factors Associated With Physical Activity Among Two-to-Five-Year Old Children." October 2010.
Source
wos-lite
Published In
Obesity (Silver Spring, Md.)
Volume
18
Publish Date
2010
Start Page
S107
End Page
S107

Body Mass Trajectories Through Adulthood: Analysis of the National Longitudinal Survey of Youth 1979 Cohort (1981-2006)

Authors
Ostbye, T; Malhotra, R; Landerman, RL
MLA Citation
Ostbye, T, Malhotra, R, and Landerman, RL. "Body Mass Trajectories Through Adulthood: Analysis of the National Longitudinal Survey of Youth 1979 Cohort (1981-2006)." October 2010.
Source
wos-lite
Published In
Obesity (Silver Spring, Md.)
Volume
18
Publish Date
2010
Start Page
S225
End Page
S225

Body Mass Status of Older Singaporeans: Results From a National Survey

Authors
Ostbye, T; Malhotra, R; Chan, A
MLA Citation
Ostbye, T, Malhotra, R, and Chan, A. "Body Mass Status of Older Singaporeans: Results From a National Survey." October 2010.
Source
wos-lite
Published In
Obesity (Silver Spring, Md.)
Volume
18
Publish Date
2010
Start Page
S198
End Page
S198

FIFTEEN DIMENSIONS OF HEALTH AMONG ELDERLY SINGAPOREANS

Authors
Malhotra, C; Chan, A; Malhotra, R; Ostbye, T
MLA Citation
Malhotra, C, Chan, A, Malhotra, R, and Ostbye, T. "FIFTEEN DIMENSIONS OF HEALTH AMONG ELDERLY SINGAPOREANS." GERONTOLOGIST 50 (October 2010): 498-498.
Source
wos-lite
Published In
The Gerontologist
Volume
50
Publish Date
2010
Start Page
498
End Page
498

TIMING OF OFFSPRING DEATH IN PARENTS' LIVES AND LATE-LIFE COGNITIVE DECLINE. THE CACHE COUNTY STUDY

Authors
Bradford, D; Smith, K; Schwartz, S; Tschanz, J; Ostbye, T; Corcoran, C; Welsh-Bohmer, K; Norton, MC
MLA Citation
Bradford, D, Smith, K, Schwartz, S, Tschanz, J, Ostbye, T, Corcoran, C, Welsh-Bohmer, K, and Norton, MC. "TIMING OF OFFSPRING DEATH IN PARENTS' LIVES AND LATE-LIFE COGNITIVE DECLINE. THE CACHE COUNTY STUDY." GERONTOLOGIST 50 (October 2010): 462-462.
Source
wos-lite
Published In
The Gerontologist
Volume
50
Publish Date
2010
Start Page
462
End Page
462

FAMILY SIZE MODERATES THE ASSOCIATION BETWEEN OFFSPRING DEATH AND RATE OF COGNITIVE DECLINE. THE CACHE COUNTY STUDY

Authors
Norton, MC; Bradford, D; Smith, K; Schwartz, S; Tschanz, J; Ostbye, T; Corcoran, C; Welsh-Bohmer, K
MLA Citation
Norton, MC, Bradford, D, Smith, K, Schwartz, S, Tschanz, J, Ostbye, T, Corcoran, C, and Welsh-Bohmer, K. "FAMILY SIZE MODERATES THE ASSOCIATION BETWEEN OFFSPRING DEATH AND RATE OF COGNITIVE DECLINE. THE CACHE COUNTY STUDY." GERONTOLOGIST 50 (October 2010): 464-464.
Source
wos-lite
Published In
The Gerontologist
Volume
50
Publish Date
2010
Start Page
464
End Page
464

STRESSFUL EVENTS IN LATE-LIFE: EFFECTS ON COGNITIVE DECLINE. THE CACHE COUNTY STUDY

Authors
Tschanz, J; Pfister, R; Steffens, DC; Corcoran, C; Smith, K; Ostbye, T; Welsh-Bohmer, K; Norton, MC
MLA Citation
Tschanz, J, Pfister, R, Steffens, DC, Corcoran, C, Smith, K, Ostbye, T, Welsh-Bohmer, K, and Norton, MC. "STRESSFUL EVENTS IN LATE-LIFE: EFFECTS ON COGNITIVE DECLINE. THE CACHE COUNTY STUDY." GERONTOLOGIST 50 (October 2010): 354-354.
Source
wos-lite
Published In
The Gerontologist
Volume
50
Publish Date
2010
Start Page
354
End Page
354

Does improved access to diagnostic imaging results reduce hospital length of stay? A retrospective study.

BACKGROUND: One year after the introduction of Information and Communication Technology (ICT) to support diagnostic imaging at our hospital, clinicians had faster and better access to radiology reports and images; direct access to Computed Tomography (CT) reports in the Electronic Medical Record (EMR) was particularly popular. The objective of this study was to determine whether improvements in radiology reporting and clinical access to diagnostic imaging information one year after the ICT introduction were associated with a reduction in the length of patients' hospital stays (LOS). METHODS: Data describing hospital stays and diagnostic imaging were collected retrospectively from the EMR during periods of equal duration before and one year after the introduction of ICT. The post-ICT period was chosen because of the documented improvement in clinical access to radiology results during that period. The data set was randomly split into an exploratory part used to establish the hypotheses, and a confirmatory part. The data was used to compare the pre-ICT and post-ICT status, but also to compare differences between groups. RESULTS: There was no general reduction in LOS one year after ICT introduction. However, there was a 25% reduction for one group - patients with CT scans. This group was heterogeneous, covering 445 different primary discharge diagnoses. Analyses of subgroups were performed to reduce the impact of this divergence. CONCLUSION: Our results did not indicate that improved access to radiology results reduced the patients' LOS. There was, however, a significant reduction in LOS for patients undergoing CT scans. Given the clinicians' interest in CT reports and the results of the subgroup analyses, it is likely that improved access to CT reports contributed to this reduction.

Authors
Hurlen, P; Østbye, T; Borthne, AS; Gulbrandsen, P
MLA Citation
Hurlen, P, Østbye, T, Borthne, AS, and Gulbrandsen, P. "Does improved access to diagnostic imaging results reduce hospital length of stay? A retrospective study. (Published online)" BMC Health Serv Res 10 (September 6, 2010): 262-.
Website
http://hdl.handle.net/10161/4367
PMID
20819224
Source
pubmed
Published In
BMC Health Services Research
Volume
10
Publish Date
2010
Start Page
262
DOI
10.1186/1472-6963-10-262

Gestational weight gain in consecutive pregnancies.

OBJECTIVE: The purpose of this study was to examine the association between gestational weight gain (GWG) in a woman's first and second pregnancies. STUDY DESIGN: We conducted a retrospective observational cohort study of 27,771 women with their first and second births in North Carolina's Pregnancy Nutrition Surveillance System database from 1996-2004. GWG was categorized as inadequate, appropriate, or excessive, according to 2009 Institute of Medicine guidelines. Covariate adjusted polytomous logistic regression was used to test the association between GWG category in the first and second pregnancy. RESULTS: Compared with women with appropriate GWG in their first pregnancy, women with excessive GWG in their first pregnancy had an odds ratio of 2.6 (95% confidence interval, 2.4-2.7) for excessive GWG in their second pregnancy. Women with inadequate GWG in their first pregnancy were similarly likely to repeat this category in their subsequent pregnancy. CONCLUSION: GWG category in a woman's first pregnancy is a significant predictor of GWG category in her subsequent pregnancy.

Authors
Chin, JR; Krause, KM; Ostbye, T; Chowdhury, N; Lovelady, CA; Swamy, GK
MLA Citation
Chin, JR, Krause, KM, Ostbye, T, Chowdhury, N, Lovelady, CA, and Swamy, GK. "Gestational weight gain in consecutive pregnancies." Am J Obstet Gynecol 203.3 (September 2010): 279.e1-279.e6.
PMID
20816151
Source
pubmed
Published In
American Journal of Obstetrics & Gynecology
Volume
203
Issue
3
Publish Date
2010
Start Page
279.e1
End Page
279.e6
DOI
10.1016/j.ajog.2010.06.038

Obesity and receipt of clinical preventive services in veterans.

Although obese individuals utilize health care at higher rates than their normal weight counterparts, they may be less likely to receive certain preventive services. We conducted a retrospective cohort study of veterans with visits to 136 national Veterans Affairs (VA) outpatient clinics in the United States in the year 2000. The cohort included 1,699,219 patients: 94% men, 48% white, and 76% overweight or obese. Overweight and obese patients had higher adjusted odds of receiving each of the targeted clinical preventive services as recommended over 5 years compared with normal weight patients. The odds for receiving vaccinations increased linearly with BMI category: influenza (men: odds ratio (OR) = 1.13 for overweight to OR = 1.42 for obese class 3; women: OR = 1.15 for overweight to OR = 1.61 for obese class 3) and pneumococcus (men: OR = 1.02 for overweight to OR = 1.15 for obese class 3; women: OR = 1.08 for overweight to OR = 1.28 for obese class 3). The odds for receiving the cancer screening services typically peaked in the mild-moderately obese categories. The highest OR for prostate cancer screening was in obese class 2 (OR = 1.29); for colorectal cancer, obese class 1 (men: OR = 1.15; women OR = 1.10); for breast cancer screening, obese class 2 (OR = 1.19); and for cervical cancer screening, obese class 2 (OR = 1.06). In a large national sample, obese patients received preventive services at higher, not lower, rates than their normal weight peers. This may be due to the VA health service coverage and performance directives, a more homogeneous patient demographic profile, and/or unmeasured factors related to service receipt.

Authors
Yancy, WS; McDuffie, JR; Stechuchak, KM; Olsen, MK; Oddone, EZ; Kinsinger, LS; Datta, SK; Fisher, DA; Krause, KM; Østbye, T
MLA Citation
Yancy, WS, McDuffie, JR, Stechuchak, KM, Olsen, MK, Oddone, EZ, Kinsinger, LS, Datta, SK, Fisher, DA, Krause, KM, and Østbye, T. "Obesity and receipt of clinical preventive services in veterans." Obesity (Silver Spring) 18.9 (September 2010): 1827-1835.
PMID
20203629
Source
pubmed
Published In
Obesity
Volume
18
Issue
9
Publish Date
2010
Start Page
1827
End Page
1835
DOI
10.1038/oby.2010.40

Occupational exposure to pesticides increases the risk of incident AD: the Cache County study.

BACKGROUND: Commonly used organophosphate and organochlorine pesticides inhibit acetylcholinesterase at synapses in the somatic, autonomic, and central nervous systems and may therefore have lasting effects on the nervous system. Few studies have examined the relationship of pesticide exposure and risk of dementia or Alzheimer disease (AD). We sought to examine the association of occupational pesticide exposure and the risk of incident dementia and AD in later life. METHODS: Residents of the agricultural community of Cache County, UT, who were aged 65 years and older as of January 1995, were invited to participate in the study. At baseline, participants completed detailed occupational history questionnaires that included information about exposures to various types of pesticides. Cognitive status was assessed at baseline and after 3, 7, and 10 years. Standardized methods were used for detection and diagnosis of dementia and AD. Cox proportional hazards survival analyses were used to evaluate the risk of incident dementia and AD associated with pesticide exposure. RESULTS: Among 3,084 enrollees without dementia, more men than women reported pesticide exposure (p < 0.0001). Exposed individuals (n = 572) had more years of education (p < 0.01) but did not differ from others in age. Some 500 individuals developed incident dementia, 344 with AD. After adjustment for baseline age, sex, education, APOE epsilon4 status, and baseline Modified Mini-Mental State Examination scores, Cox proportional hazards models showed increased risks among pesticide-exposed individuals for all-cause dementia, with hazard ratio (HR) 1.38 and 95% confidence interval (CI) 1.09-1.76, and for AD (HR 1.42, 95% CI 1.06-1.91). The risk of AD associated with organophosphate exposure (HR 1.53, 95% CI 1.05-2.23) was slightly higher than the risk associated with organochlorines (HR 1.49, 95% CI 0.99-2.24), which was nearly significant. CONCLUSIONS: Pesticide exposure may increase the risk of dementia and Alzheimer disease in late life.

Authors
Hayden, KM; Norton, MC; Darcey, D; Ostbye, T; Zandi, PP; Breitner, JCS; Welsh-Bohmer, KA; Cache County Study Investigators,
MLA Citation
Hayden, KM, Norton, MC, Darcey, D, Ostbye, T, Zandi, PP, Breitner, JCS, Welsh-Bohmer, KA, and Cache County Study Investigators, . "Occupational exposure to pesticides increases the risk of incident AD: the Cache County study." Neurology 74.19 (May 11, 2010): 1524-1530.
PMID
20458069
Source
pubmed
Published In
Neurology
Volume
74
Issue
19
Publish Date
2010
Start Page
1524
End Page
1530
DOI
10.1212/WNL.0b013e3181dd4423

Validity and reliability of the expectations regarding aging (ERA-12) instrument among middle-aged Singaporeans.

INTRODUCTION: The 12-item Expectations Regarding Aging (ERA-12) instrument measures expectations that individuals have about how their health and cognitive function will be when they age. To date, primarily assessed among older adults in Western settings, expectations regarding ageing have been associated with physical activity and healthcare seeking behaviour. It has been suggested that it may be possible to develop interventions that promote positive expectations about ageing. Assessment of expectations regarding ageing among today's middle-aged population would allow for earlier interventions to help give them positive (but realistic) ageing expectations, and age successfully. We assess the reliability and validity of ERA-12 for middle-aged Singaporeans. MATERIALS AND METHODS: A questionnaire that included ERA-12 was administered to 1020 patients aged 41 to 62 years attending 2 SingHealth polyclinics in Singapore. Data from 981 respondents who completed the ERA-12 instrument were analysed. ERA-12's construct validity was determined using Exploratory Factor Analysis (EFA), and through its correlation with depressive symptoms, and self-rated health and education. Internal consistency reliability was assessed using Cronbach's alpha. RESULTS: EFA confirmed that the ERA-12 consisted of 3 factors (each with 4 items)--expectations regarding physical health, mental health and cognitive function, together explaining 64% of the variance in ERA-12 total score with high factor loadings (range, 0.6 to 0.8). The ERA-12 total score was positively correlated with self-rated health (r = 0.13) and education (r = 0.19), and negatively correlated with depressive symptoms (r = -0.25). Cronbach's alpha exceeded 0.7 for ERA-12 overall, and for each subscale. CONCLUSION: ERA-12 can be used to evaluate expectations regarding ageing not only among elderly populations in the West, but also among middle-aged Singaporeans.

Authors
Joshi, VD; Malhotra, R; Lim, JFY; Østbye, T; Wong, M
MLA Citation
Joshi, VD, Malhotra, R, Lim, JFY, Østbye, T, and Wong, M. "Validity and reliability of the expectations regarding aging (ERA-12) instrument among middle-aged Singaporeans." Ann Acad Med Singapore 39.5 (May 2010): 394-398.
PMID
20535431
Source
pubmed
Published In
Annals of the Academy of Medicine, Singapore
Volume
39
Issue
5
Publish Date
2010
Start Page
394
End Page
398

Greater risk of dementia when spouse has dementia? The Cache County study.

OBJECTIVES: To examine the effects of caring for a spouse with dementia on the caregiver's risk for incident dementia. DESIGN: Population-based study of incident dementia in spouses of persons with dementia. SETTING: Rural county in northern Utah. PARTICIPANTS: Two thousand four hundred forty-two subjects (1,221 married couples) aged 65 and older. MEASUREMENTS: Incident dementia was diagnosed in 255 subjects, with onset defined as age when subject met Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised, criteria for dementia. Cox proportional hazards regression tested the effect of time-dependent exposure to dementia in one's spouse, adjusted for potential confounders. RESULTS: A subject whose spouse experienced incident dementia onset had a six times greater risk for incident dementia as subjects whose spouses were dementia free (hazard rate ratio (HRR)=6.0, 95% confidence interval (CI)=2.2-16.2, P<.001). In sex-specific analyses, husbands had higher risks (HRR=11.9, 95% CI=1.7-85.5, P=.01) than wives (HRR=3.7, 95% CI=1.2-11.6, P=.03). CONCLUSION: The chronic and often severe stress associated with dementia caregiving may exert substantial risk for the development of dementia in spouse caregivers. Additional (not mutually exclusive) explanations for findings are discussed.

Authors
Norton, MC; Smith, KR; Østbye, T; Tschanz, JT; Corcoran, C; Schwartz, S; Piercy, KW; Rabins, PV; Steffens, DC; Skoog, I; Breitner, JCS; Welsh-Bohmer, KA; Cache County Investigators,
MLA Citation
Norton, MC, Smith, KR, Østbye, T, Tschanz, JT, Corcoran, C, Schwartz, S, Piercy, KW, Rabins, PV, Steffens, DC, Skoog, I, Breitner, JCS, Welsh-Bohmer, KA, and Cache County Investigators, . "Greater risk of dementia when spouse has dementia? The Cache County study." J Am Geriatr Soc 58.5 (May 2010): 895-900.
PMID
20722820
Source
pubmed
Published In
Journal of American Geriatrics Society
Volume
58
Issue
5
Publish Date
2010
Start Page
895
End Page
900
DOI
10.1111/j.1532-5415.2010.02806.x

Diet quality of preschoolers and their mothers enrolled in an obesity prevention program

Authors
Laster, LER; Lovelady, CA; West, DG; Wiltheiss, GA; Brouwer, RJN; Ostbye, T
MLA Citation
Laster, LER, Lovelady, CA, West, DG, Wiltheiss, GA, Brouwer, RJN, and Ostbye, T. "Diet quality of preschoolers and their mothers enrolled in an obesity prevention program." FASEB JOURNAL 24 (April 2010).
Source
wos-lite
Published In
The FASEB journal : official publication of the Federation of American Societies for Experimental Biology
Volume
24
Publish Date
2010

Relationship of early infant feeding (breast vs. formula) and fruit and vegetable variety in dietary intake of 2-3 year olds

Authors
Strong, LA; Strong, E; West, D; Brouwer, R; Ostbye, T; Lovelady, C
MLA Citation
Strong, LA, Strong, E, West, D, Brouwer, R, Ostbye, T, and Lovelady, C. "Relationship of early infant feeding (breast vs. formula) and fruit and vegetable variety in dietary intake of 2-3 year olds." FASEB JOURNAL 24 (April 2010).
Source
wos-lite
Published In
The FASEB journal : official publication of the Federation of American Societies for Experimental Biology
Volume
24
Publish Date
2010

Prevalence and correlates of clinically significant depressive symptoms among elderly people in Sri Lanka: findings from a national survey.

BACKGROUND: Elderly Sri Lankans (11.2% of the nation's population) have witnessed many years of ethnic conflict, a destructive tsunami and increasing emigration of young adults. However, very little is known about the prevalence and correlates of depression among them. The present study utilizes data from a national aging survey to document the prevalence and correlates of clinically significant depressive symptoms among community-dwelling elderly Sri Lankans (aged > or =60 years). METHODS: The 15-item Geriatric Depression Scale (GDS-15) was administered to 1181 elderly Sri Lankans; the presence of clinically significant depressive symptoms was defined as a GDS-15 score of > or =6. Sociodemographic and health correlates of depressive symptoms were assessed using logistic regression analysis. Interactions between gender and other correlates were also assessed. RESULTS: The prevalence of depressive symptoms was observed to be 27.8% overall: 24.0% for men, and 30.8% for women. Certain subgroups of the elderly, i.e. those with disabilities, functional limitations, perceived income inadequacy, minorities, and elderly living alone, were significantly more likely to report depressive symptoms. There was a significant interaction between gender and ethnicity. CONCLUSION: The prevalence of depressive symptoms among Sri Lankan elderly people is higher than that reported for most Asian countries. Clinicians and caregivers need to be aware of the potential presence of depressive symptoms among the elderly, especially among those with lower educational levels, functional limitations, hearing difficulty, physical disability, perceived income inadequacy, and among those who live alone, and ethnic minority males.

Authors
Malhotra, R; Chan, A; Ostbye, T
MLA Citation
Malhotra, R, Chan, A, and Ostbye, T. "Prevalence and correlates of clinically significant depressive symptoms among elderly people in Sri Lanka: findings from a national survey." Int Psychogeriatr 22.2 (March 2010): 227-236.
Website
http://hdl.handle.net/10161/3983
PMID
19747421
Source
pubmed
Published In
International psychogeriatrics / IPA
Volume
22
Issue
2
Publish Date
2010
Start Page
227
End Page
236
DOI
10.1017/S1041610209990871

The effect of body mass on health-related quality of life among Singaporean adolescents: results from the SCORM study.

PURPOSE: To investigate the relationship between body mass and health-related quality of life (HRQOL) among Singaporean adolescents. Variation in this relationship by age, gender and ethnicity, and association of HRQOL with change in body mass over time and with demographic, socioeconomic and health variables were also assessed. METHODS: HRQOL was assessed for Singaporean adolescents aged 11-18 from their own (N=1,249) and their parent’s (N=948) perspective using PedsQLTM 4.0 generic core scales. Body mass, measured as body mass index z-score based on the WHO Reference 2007, was categorized as thin, healthy weight, overweight and obese. Multiple linear regression models assessed the relationship between current body mass and HRQOL, adjusting for demographic, socioeconomic and health variables. Differences between adolescent and parent-proxy reported HRQOL were also investigated. RESULTS: Obese adolescents (and their parents) reported significantly lower HRQOL, overall and in most domains, compared to healthy weight adolescents. Parents tended to report lower HRQOL for their adolescents than the adolescents did themselves; however, this difference was much larger and statistically significant for obese adolescents. CONCLUSIONS: Obesity is associated with reduced HRQOL among adolescents. The effect in these Singaporean adolescents is similar to that in populations with higher rates of obesity. Awareness of this relationship can make it easier for health professionals, teachers, parents and peers to be supportive of obese adolescents.

Authors
Østbye, T; Malhotra, R; Wong, H-B; Tan, S-B; Saw, S-M
MLA Citation
Østbye, T, Malhotra, R, Wong, H-B, Tan, S-B, and Saw, S-M. "The effect of body mass on health-related quality of life among Singaporean adolescents: results from the SCORM study." Qual Life Res 19.2 (March 2010): 167-176.
PMID
20066564
Source
pubmed
Published In
Quality of Life Research
Volume
19
Issue
2
Publish Date
2010
Start Page
167
End Page
176
DOI
10.1007/s11136-009-9578-8

Multiparity is associated with high motivation to change diet among overweight and obese postpartum women.

BACKGROUND: Pregnancy is associated with weight gain and obesity. The aim of this study was to identify the effect of parity and other factors on motivation to change diet to lose weight in a cohort of overweight and obese postpartum women. STUDY DESIGN: Active Mothers Postpartum is a randomized, controlled trial aimed at postpartum weight reduction. At baseline, we measured motivation to change diet to lose weight among 491 overweight/obese postpartum women. Logistic regression was used to model the effect of parity on motivation to change diet at baseline while adjusting for potential confounders including age, race, education, body mass index category, and breastfeeding status. RESULTS: Approximately two thirds (68%) of participants were highly motivated to change their diet to lose weight. In the multivariable model, women with three or more children had 2.5 times the odds of high motivation compared with primigravid women, and women not breastfeeding had 1.6 times the odds of high motivation compared with any breastfeeding. CONCLUSION: Although risk for obesity is incurred starting with a woman's first pregnancy, women in this study were more motivated to change their diet to lose weight after their third pregnancy. Further research is needed to understand how to best capitalize on the high motivation in women with several children as well as how to improve motivation for primigravid women and women who are breastfeeding.

Authors
Bastian, LA; Pathiraja, VC; Krause, K; Namenek Brouwer, RJ; Swamy, GK; Lovelady, CA; Østbye, T
MLA Citation
Bastian, LA, Pathiraja, VC, Krause, K, Namenek Brouwer, RJ, Swamy, GK, Lovelady, CA, and Østbye, T. "Multiparity is associated with high motivation to change diet among overweight and obese postpartum women." Womens Health Issues 20.2 (March 2010): 133-138.
PMID
20149971
Source
pubmed
Published In
Women's Health Issues
Volume
20
Issue
2
Publish Date
2010
Start Page
133
End Page
138
DOI
10.1016/j.whi.2009.11.005

Introducing PACS to the late majority. A longitudinal study.

The purpose of this study was to study whether the benefits from introducing a picture archiving and communication systems (PACS) reported by innovators and early adopters also can be achieved by a hospital belonging to the "late majority" and to see whether such benefits are sustained, using report turnaround time (RTAT) as an indicator. Activity-related data was retrieved from the radiology information system (RIS) over a 2-year period. The median RTAT for preliminary reports was initially reduced from 12 to 2 h then increased to 3 h. For final reports, the median RTAT was initially reduced from 23 to 13 h then gradually reverted back to 22 h. Innovators and early adopters demonstrate not only that positive results can be achieved but also the importance of involving key personnel. We believe that such involvement and the focus on wider organizational concerns are important when introducing PACS to the late majority, both for achieving and sustaining positive results.

Authors
Hurlen, P; Østbye, T; Borthne, A; Gulbrandsen, P
MLA Citation
Hurlen, P, Østbye, T, Borthne, A, and Gulbrandsen, P. "Introducing PACS to the late majority. A longitudinal study." J Digit Imaging 23.1 (February 2010): 87-94.
PMID
18979133
Source
pubmed
Published In
Journal of Digital Imaging
Volume
23
Issue
1
Publish Date
2010
Start Page
87
End Page
94
DOI
10.1007/s10278-008-9160-x

Body image and body satisfaction differ by race in overweight postpartum mothers.

Body image (BI) and body satisfaction may be important in understanding weight loss behaviors, particularly during the postpartum period. We assessed these constructs among African American and white overweight postpartum women.The sample included 162 women (73 African American and 89 white) in the intervention arm 6 months into the Active Mothers Postpartum (AMP) Study, a nutritional and physical activity weight loss intervention. BIs, self-reported using the Stunkard figure rating scale, were compared assessing mean values by race. Body satisfaction was measured using body discrepancy (BD), calculated as perceived current image minus ideal image (BD<0: desire to be heavier; BD>0: desire to be lighter). BD was assessed by race for: BD(Ideal) (current image minus the ideal image) and BD(Ideal Mother) (current image minus ideal mother image).Compared with white women, African American women were younger and were less likely to report being married, having any college education, or residing in households with annual incomes >$30,000 (all p < 0.01). They also had a higher mean body mass index (BMI) (p = 0.04), although perceived current BI did not differ by race (p = 0.21). African Americans had higher mean ideal (p = 0.07) and ideal mother (p = 0.001) BIs compared with whites. African Americans' mean BDs (adjusting for age, BMI, education, income, marital status, and interaction terms) were significantly lower than those of whites, indicating greater body satisfaction among African Americans (BD(Ideal): 1.7 vs. 2.3, p = 0.005; BD(Ideal Mother): 1.1 vs. 1.8, p = 0.0002).Racial differences exist in postpartum weight, ideal images, and body satisfaction. Healthcare providers should consider tailored messaging that accounts for these racially different perceptions and factors when designing weight loss programs for overweight mothers.

Authors
Carter-Edwards, L; Bastian, LA; Revels, J; Durham, H; Lokhnygina, Y; Amamoo, MA; Ostbye, T
MLA Citation
Carter-Edwards, L, Bastian, LA, Revels, J, Durham, H, Lokhnygina, Y, Amamoo, MA, and Ostbye, T. "Body image and body satisfaction differ by race in overweight postpartum mothers." Journal of women's health (2002) 19.2 (February 2010): 305-311.
Website
http://hdl.handle.net/10161/3243
PMID
20113143
Source
epmc
Published In
Journal of Women's Health
Volume
19
Issue
2
Publish Date
2010
Start Page
305
End Page
311
DOI
10.1089/jwh.2008.1238

Certificate course in outcomes research.

Authors
Rajgor, D; Shah, J; Tay, SK; Ostbye, T; Eisenstein, EL; Krishnan, R; Pietrobon, R
MLA Citation
Rajgor, D, Shah, J, Tay, SK, Ostbye, T, Eisenstein, EL, Krishnan, R, and Pietrobon, R. "Certificate course in outcomes research." Med Teach 32.1 (January 2010): 92-. (Letter)
PMID
20104663
Source
pubmed
Published In
Medical Teacher (Informa)
Volume
32
Issue
1
Publish Date
2010
Start Page
92

Is stroke history reliably reported by elderly with cognitive impairment? A community-based study.

BACKGROUND/AIMS: Self-reported history of stroke has been questioned in the elderly due to the high prevalence of cognitive impairment. We tested the validity of response to a stroke questionnaire versus clinical diagnosis of stroke among elderly people with and without cognitive impairment. METHODS: Community-dwelling participants to the phase 1 Canadian Study of Health and Aging were screened for self-reported stroke. Physician-diagnosed stroke was set as the gold standard. The positive predictive value (PPV), sensitivity and specificity were determined. RESULTS: 1,536/ 1,659 (93%) participants aged 65 years and over had stroke information from both sources. Among stroke positive responders, the PPV was 81% overall: 76% for cognitively normal, 84% for cognitively impairment with no dementia (CIND), and 82% for demented. Among stroke diagnosed by physicians, history of stroke was reported by 38% cognitively normal, 54% CIND, and 55% demented. The specificity was over 97% in all cognitive categories. CONCLUSION: Among community-dwelling elderly people, any cognitive impairment did not imply inaccurate self-reported history of stroke. High prevalence of stroke and frequent contacts with health services among cognitively-impaired elderly may increase the awareness of stroke symptoms and signs. Stroke increases the risk of developing dementia in both cognitively normal and CIND, and efforts to accomplish stroke prevention are justified, especially in these categories.

Authors
Jin, Y-P; Di Legge, S; Østbye, T; Feightner, JW; Saposnik, G; Hachinski, V
MLA Citation
Jin, Y-P, Di Legge, S, Østbye, T, Feightner, JW, Saposnik, G, and Hachinski, V. "Is stroke history reliably reported by elderly with cognitive impairment? A community-based study." Neuroepidemiology 35.3 (2010): 215-220.
PMID
20664296
Source
pubmed
Published In
Neuroepidemiology
Volume
35
Issue
3
Publish Date
2010
Start Page
215
End Page
220
DOI
10.1159/000315484

Minimal difference between aerobic and progressive resistance exercise on metabolic profile and fitness in older adults with diabetes mellitus: a randomised trial.

QUESTION: Is progressive resistance training as effective as aerobic training of similar duration in sedentary older adults with diabetes mellitus? DESIGN: A randomised trial with concealed allocation, assessor blinding and intention-to-treat analysis. PARTICIPANTS: Sixty people with Type 2 diabetes mellitus with glycosylated haemoglobin (HbA1c) between 8% and 10% in the past month. INTERVENTION: One group undertook progressive resistance exercise and the other group undertook aerobic exercise. Both groups completed 18 sessions over 8 weeks. In each session, the progressive resistance exercise group did nine resistive exercises while the aerobic exercise group did 50 minutes of aerobic exercise. OUTCOME MEASURES: HbA1c, blood glucose, lipid profile (total, high- and low-density cholesterol and triglycerides), weight, body mass index, body fat, waist circumference, waist:hip ratio, blood pressure, and peak oxygen consumption. RESULTS: Forty-nine (82%) participants completed the intervention. HbA1c reduced by a similar amount in both groups (MD 0.1%, 95% CI -0.3 to 0.5). However, significant between-group differences occurred in change in waist circumference in favour of progressive resistance exercise (MD -1.8 cm, 95% CI -0.5 to -3.1), and in change in peak oxygen consumption in favour of aerobic exercise (MD 5.2 ml/kg, 95% CI 0.0 to 10.4). CONCLUSIONS: Progressive resistance exercise has similar effects to aerobic exercise and therefore offers a useful alternative for patients unable to participate in aerobic exercise. TRIAL REGISTRATION: NCT01000519.

Authors
Ng, CLW; Goh, S-Y; Malhotra, R; Østbye, T; Tai, ES
MLA Citation
Ng, CLW, Goh, S-Y, Malhotra, R, Østbye, T, and Tai, ES. "Minimal difference between aerobic and progressive resistance exercise on metabolic profile and fitness in older adults with diabetes mellitus: a randomised trial." J Physiother 56.3 (2010): 163-170.
PMID
20795922
Source
pubmed
Published In
Journal of Physiotherapy
Volume
56
Issue
3
Publish Date
2010
Start Page
163
End Page
170

ADULT CHILDREN CARING FOR THEIR ELDERLY PARENTS Results from a national survey of ageing in Sri Lanka

Authors
Ostbye, T; Chan, A; Malhotra, R; Kothalawala, J
MLA Citation
Ostbye, T, Chan, A, Malhotra, R, and Kothalawala, J. "ADULT CHILDREN CARING FOR THEIR ELDERLY PARENTS Results from a national survey of ageing in Sri Lanka." ASIAN POPULATION STUDIES 6.1 (2010): 83-97.
Source
wos-lite
Published In
Asian Population Studies
Volume
6
Issue
1
Publish Date
2010
Start Page
83
End Page
97
DOI
10.1080/17441731003603504

History of foot ulcer increases mortality among individuals with diabetes: ten-year follow-up of the Nord-Trøndelag Health Study, Norway.

OBJECTIVE: To compare mortality rates for individuals with diabetes with and without a history of foot ulcer (HFU) and with that for the nondiabetic population. RESEARCH DESIGN AND METHODS: This population-based study included 155 diabetic individuals with an HFU, 1,339 diabetic individuals without an HFU, and 63,632 nondiabetic individuals who were all followed for 10 years with mortality as the end point. RESULTS: During the follow-up period, a total of 49.0% of diabetic individuals with an HFU died, compared with 35.2% of diabetic individuals without an HFU and 10.5% of those without diabetes. In Cox regression analyses adjusted for age, sex, education, current smoking, and waist circumference, having an HFU was associated with more than a twofold (2.29 [95% CI 1.82-2.88]) hazard risk for mortality compared with that of the nondiabetic group. In corresponding analyses comparing diabetic individuals with and without an HFU, an HFU was associated with 47% increased mortality (1.47 [1.14-1.89]). Significant covariates were older age, male sex, and current smoking. After inclusion of A1C, insulin use, microalbuminuria, cardiovascular disease, and depression scores in the model, each was significantly related to life expectancy. CONCLUSIONS: AN HFU increased mortality risk among community-dwelling adults and elderly individuals with diabetes. The excess risk persisted after adjustment for comorbidity and depression scores, indicating that close clinical monitoring might be warranted among individuals with an HFU, who may be particularly vulnerable to adverse outcomes.

Authors
Iversen, MM; Tell, GS; Riise, T; Hanestad, BR; Østbye, T; Graue, M; Midthjell, K
MLA Citation
Iversen, MM, Tell, GS, Riise, T, Hanestad, BR, Østbye, T, Graue, M, and Midthjell, K. "History of foot ulcer increases mortality among individuals with diabetes: ten-year follow-up of the Nord-Trøndelag Health Study, Norway." Diabetes Care 32.12 (December 2009): 2193-2199.
PMID
19729524
Source
pubmed
Published In
Diabetes Care
Volume
32
Issue
12
Publish Date
2009
Start Page
2193
End Page
2199
DOI
10.2337/dc09-0651

Gestational weight gain in consecutive pregnancies

Authors
Chin, J; Krause, K; Ostbye, T; Chowdhary, N; Lovelady, C; Swamy, G
MLA Citation
Chin, J, Krause, K, Ostbye, T, Chowdhary, N, Lovelady, C, and Swamy, G. "Gestational weight gain in consecutive pregnancies." December 2009.
Source
wos-lite
Published In
American Journal of Obstetrics & Gynecology
Volume
201
Issue
6
Publish Date
2009
Start Page
S204
End Page
S204
DOI
10.1016/j.ajog.2009.10.414

Occurrence and correlates of postpartum depression in overweight and obese women: results from the active mothers postpartum (AMP) study.

OBJECTIVE: Postpartum depression (PPD) is a significant concern for new mothers and their infants, as well as the health professionals who care for them. Obesity may be a risk factor for depression, and therefore, for PPD specifically. We examined the occurrence and risk factors for PPD in a sample of overweight and obese new mothers. METHODS: In this cross-sectional study, 491 women who were overweight or obese prior to pregnancy completed the Edinburgh Postnatal Depression Scale (EPDS) 6 weeks postpartum, along with a number of other health- and pregnancy-related measures. Occurrence of depression was investigated, as well as bivariate and multivariate relationships between depression and demographic and health-related characteristics. RESULTS: As determined by an EPDS score of 13 or higher, the prevalence of PPD was 9.2%. Three items on the scale stood out as drivers of the total score ("blame myself unnecessarily", "anxious or worried," "feel overwhelmed"). Bivariate correlates of depression included education, income, marital status, and self-reported chronic illness; income remained significant in the multivariate logistic regression model. BMI was not related to postpartum depression. DISCUSSION: In this group of overweight and obese women, there was no association between BMI group and postpartum depression.

Authors
Krause, KM; Ostbye, T; Swamy, GK
MLA Citation
Krause, KM, Ostbye, T, and Swamy, GK. "Occurrence and correlates of postpartum depression in overweight and obese women: results from the active mothers postpartum (AMP) study." Matern Child Health J 13.6 (November 2009): 832-838.
PMID
18836820
Source
pubmed
Published In
Maternal and Child Health Journal
Volume
13
Issue
6
Publish Date
2009
Start Page
832
End Page
838
DOI
10.1007/s10995-008-0418-1

Contraceptive use by obese women 1 year postpartum.

BACKGROUND: Obese women have higher rates of pregnancy complications, making the prevention of unintended pregnancies in this group of particular importance. STUDY DESIGN: We performed a secondary analysis of data from Active Mothers Postpartum (AMP), a randomized controlled trial aimed at postpartum weight reduction. We assessed contraceptive use among 361 overweight/obese women 12 months postpartum. Logistic regression was used to model the effect of body mass index (BMI) categories on effective contraceptive use (intrauterine, hormonal or sterilization methods) while adjusting for potential confounders including age, race, parity, breastfeeding, education and chronic illness. RESULTS: Effective contraceptive use was reported by 45% of women. In the multivariable model, women with a BMI >or=35 kg/m(2) were less likely to use effective contraception than women with a BMI <30 kg/m(2) (OR 0.5, 95% CI 0.3-0.8). There was a trend towards less use of effective contraception among women with a BMI 30-34.9 kg/m(2) as compared to women with a BMI <30 kg/m(2). CONCLUSION: At 12 months postpartum, obese women were less likely to use effective contraceptive methods than overweight women. Although certain contraceptive methods may be preferred over others in this population, providers should reinforce the importance of effective contraception to avoid unintended pregnancies in obese women.

Authors
Chin, JR; Swamy, GK; Østbye, T; Bastian, LA
MLA Citation
Chin, JR, Swamy, GK, Østbye, T, and Bastian, LA. "Contraceptive use by obese women 1 year postpartum." Contraception 80.5 (November 2009): 463-468.
PMID
19835721
Source
pubmed
Published In
Contraception
Volume
80
Issue
5
Publish Date
2009
Start Page
463
End Page
468
DOI
10.1016/j.contraception.2009.03.017

Weight's up Doc? Physicians' use of Motivational Interviewing Techniques Predicts Weight Loss Among Overweight and Obese Adults in Primary Care

Authors
Pollak, KI; Alexander, SC; Coffman, CJ; Rilsky, JA; Lyna, P; Dolor, RJ; Esoimeme, I; Brouwer, RN; Manusov, JRE; Ostbye, T
MLA Citation
Pollak, KI, Alexander, SC, Coffman, CJ, Rilsky, JA, Lyna, P, Dolor, RJ, Esoimeme, I, Brouwer, RN, Manusov, JRE, and Ostbye, T. "Weight's up Doc? Physicians' use of Motivational Interviewing Techniques Predicts Weight Loss Among Overweight and Obese Adults in Primary Care." November 2009.
Source
wos-lite
Published In
Obesity (Silver Spring, Md.)
Volume
17
Publish Date
2009
Start Page
S126
End Page
S127

Racial Disparities in the Effect of Parental Obesity on Toddler Adiposity

Authors
Fuemmeler, BF; Pendzich, M; Zucker, N; Ostbye, T
MLA Citation
Fuemmeler, BF, Pendzich, M, Zucker, N, and Ostbye, T. "Racial Disparities in the Effect of Parental Obesity on Toddler Adiposity." November 2009.
Source
wos-lite
Published In
Obesity (Silver Spring, Md.)
Volume
17
Publish Date
2009
Start Page
S237
End Page
S237

Effect of Full Versus Mixed Breastfeeding on Weight Retention at Six Months Postpartum - Data from the North Carolina WIC Program

Authors
Krause, KM; Lovelady, CA; Peterson, BL; Chowdhury, N; Ostbye, T
MLA Citation
Krause, KM, Lovelady, CA, Peterson, BL, Chowdhury, N, and Ostbye, T. "Effect of Full Versus Mixed Breastfeeding on Weight Retention at Six Months Postpartum - Data from the North Carolina WIC Program." November 2009.
Source
wos-lite
Published In
Obesity (Silver Spring, Md.)
Volume
17
Publish Date
2009
Start Page
S301
End Page
S301

KAN-DO - Design, Rationale, and Baseline Characteristics of a Family-based Intervention to Prevent Childhood Obesity

Authors
Ostbye, T; Krause, KM; Zucker, N; Swamy, GK; Bastian, LA; Brouwer, RN; Lavelady, CA
MLA Citation
Ostbye, T, Krause, KM, Zucker, N, Swamy, GK, Bastian, LA, Brouwer, RN, and Lavelady, CA. "KAN-DO - Design, Rationale, and Baseline Characteristics of a Family-based Intervention to Prevent Childhood Obesity." November 2009.
Source
wos-lite
Published In
Obesity (Silver Spring, Md.)
Volume
17
Publish Date
2009
Start Page
S227
End Page
S227

Factors Associated with Self-Reported Overall Health in Overweight and Obese Postpartum Women

Authors
Krause, KM; Ostbye, T; Brouwer, RN; Bastian, LA
MLA Citation
Krause, KM, Ostbye, T, Brouwer, RN, and Bastian, LA. "Factors Associated with Self-Reported Overall Health in Overweight and Obese Postpartum Women." November 2009.
Source
wos-lite
Published In
Obesity (Silver Spring, Md.)
Volume
17
Publish Date
2009
Start Page
S157
End Page
S158

Dietary Intake of Overweight Women Losing Weight in their First Year Postpartum

Authors
West, D; Lovelady, CA; Durham, H; Krause, KM; Brouwer, RN; Ostbye, T
MLA Citation
West, D, Lovelady, CA, Durham, H, Krause, KM, Brouwer, RN, and Ostbye, T. "Dietary Intake of Overweight Women Losing Weight in their First Year Postpartum." November 2009.
Source
wos-lite
Published In
Obesity (Silver Spring, Md.)
Volume
17
Publish Date
2009
Start Page
S132
End Page
S132

The Postpartum Period: A Teachable Moment for Change in Overweight Moms?

Authors
Brouwer, RN; Krause, KM; Bastian, L; Swamy, GK; Zucker, N; Ostbye, T
MLA Citation
Brouwer, RN, Krause, KM, Bastian, L, Swamy, GK, Zucker, N, and Ostbye, T. "The Postpartum Period: A Teachable Moment for Change in Overweight Moms?." November 2009.
Source
wos-lite
Published In
Obesity (Silver Spring, Md.)
Volume
17
Publish Date
2009
Start Page
S309
End Page
S309

Caregiver-recipient closeness and symptom progression in Alzheimer disease. The Cache County Dementia Progression Study.

Applying Rusbult's investment model of dyadic relationships, we examined the effect of caregiver-care recipient relationship closeness (RC) on cognitive and functional decline in Alzheimer's disease. After diagnosis, 167 participants completed up to six visits, observed over an average of 20 months. Participants were 64% women, had a mean age of 86 years, and mean dementia duration of 4 years. Caregiver-rated closeness was measured using a six-item scale. In mixed models adjusted for dementia severity, dyads with higher levels of closeness (p < .05) and with spouse caregivers (p = .01) had slower cognitive decline. Effect of higher RC on functional decline was greater with spouse caregivers (p = .007). These findings of attenuated Alzheimer's dementia (AD) decline with closer relationships, particularly with spouse caregivers, are consistent with investment theory. Future interventions designed to enhance the caregiving dyadic relationship may help slow decline in AD.

Authors
Norton, MC; Piercy, KW; Rabins, PV; Green, RC; Breitner, JCS; Ostbye, T; Corcoran, C; Welsh-Bohmer, KA; Lyketsos, CG; Tschanz, JT
MLA Citation
Norton, MC, Piercy, KW, Rabins, PV, Green, RC, Breitner, JCS, Ostbye, T, Corcoran, C, Welsh-Bohmer, KA, Lyketsos, CG, and Tschanz, JT. "Caregiver-recipient closeness and symptom progression in Alzheimer disease. The Cache County Dementia Progression Study." J Gerontol B Psychol Sci Soc Sci 64.5 (September 2009): 560-568.
PMID
19564210
Source
pubmed
Published In
Journals of Gerontology: Series B
Volume
64
Issue
5
Publish Date
2009
Start Page
560
End Page
568
DOI
10.1093/geronb/gbp052

Food advertising during children's television in Canada and the UK.

BACKGROUND: Television advertisements for less healthy foods are thought to contribute to overweight and obesity in children. In the UK, new regulations on television food advertising to children came into effect in April 2007. These prohibit advertisements for "less healthy" foods during or around programmes "of particular appeal to" (OPAT) children. In Canada, self-regulated codes of practice on television food advertising to children were recently strengthened. OBJECTIVE: To document the nutritional content of food advertised and number of advertisements OPAT children broadcast in the UK and central Canada before the introduction of the new UK regulations. DESIGN: All food advertisements broadcast on four popular channels in Canada and the three terrestrial commercial channels in the UK during 1 week in 2006 were identified and linked to relevant nutritional data. Food advertisements OPAT children and for "less healthy" products were identified using the criteria in the UK regulations. RESULTS: 2315 food related advertisements broadcast in Canada and 1365 broadcast in the UK were included. 52-61% were for "less healthy" products; 5-11% were OPAT children. Around 5% of food advertisements would have been prohibited under the new UK regulations. There were few differences in the nutritional content of food described in advertisements that were and were not OPAT children. CONCLUSION: There was little evidence that food described in advertisements OPAT children were any less healthy than those that were not. Few food advertisements are likely to be prohibited by the new UK regulations.

Authors
Adams, J; Hennessy-Priest, K; Ingimarsdóttir, S; Sheeshka, J; Ostbye, T; White, M
MLA Citation
Adams, J, Hennessy-Priest, K, Ingimarsdóttir, S, Sheeshka, J, Ostbye, T, and White, M. "Food advertising during children's television in Canada and the UK." Arch Dis Child 94.9 (September 2009): 658-662.
PMID
19477912
Source
pubmed
Published In
Archives of Disease in Childhood
Volume
94
Issue
9
Publish Date
2009
Start Page
658
End Page
662
DOI
10.1136/adc.2008.151019

Active Mothers Postpartum: a randomized controlled weight-loss intervention trial.

BACKGROUND: Pregnancy may contribute to overweight and obesity. PURPOSE: The primary objective of Active Mothers Postpartum was to promote a reduction in BMI through 24-months postpartum via sustainable lifestyle changes. DESIGN: Behavioral intervention RCT to enhance postpartum weight loss. SETTING/PARTICIPANTS: A total of 450 overweight or obese women, enrolled 6-weeks postpartum, were recruited through obstetrics clinics and community posters in the Durham NC area. INTERVENTION: Intervention participants were offered eight healthy-eating classes, ten physical-activity classes, and six telephone-counseling sessions over 9 months. MAIN OUTCOME MEASURES: Changes from baseline (6-weeks postpartum) to 1-month post-intervention (12-months postpartum) in: (1) diet (caloric intake, calories from fat, intake of certain foods); (2) physical activity (self-reported physical activity, television time); and (3) weight (collected 2004-2007, analyzed 2007-2008). RESULTS: Mean weight loss was 0.90 kg (+/-5.1 kg) in the intervention group and 0.36 kg (+/-4.9 kg) in the control group; this difference was not significant. There were also no significant group differences in improvement of diet or increased physical activity. In secondary analyses, there was a positive bivariate relationship between classes attended and weight loss (p=0.01). CONCLUSIONS: There were no significant differences among the arms in diet, physical activity, or weight change. Home-based interventions via mail, telephone, or Internet/e-mail may be more feasible and successful in this population. The postpartum period is an important phase in women's lives with regard to weight retention, but engaging them during this busy period remains a challenge. TRIAL REGISTRATION: NCT00212251.

Authors
Østbye, T; Krause, KM; Lovelady, CA; Morey, MC; Bastian, LA; Peterson, BL; Swamy, GK; Brouwer, RJN; McBride, CM
MLA Citation
Østbye, T, Krause, KM, Lovelady, CA, Morey, MC, Bastian, LA, Peterson, BL, Swamy, GK, Brouwer, RJN, and McBride, CM. "Active Mothers Postpartum: a randomized controlled weight-loss intervention trial." Am J Prev Med 37.3 (September 2009): 173-180.
PMID
19595557
Source
pubmed
Published In
American Journal of Preventive Medicine
Volume
37
Issue
3
Publish Date
2009
Start Page
173
End Page
180
DOI
10.1016/j.amepre.2009.05.016

The association between history of diabetic foot ulcer, perceived health and psychological distress: the Nord-Trøndelag Health Study.

BACKGROUND: While the adverse impact of a history of a foot ulcer on physical health among persons with diabetes is well known, little is known about the association between foot ulcer, perceived health and psychological distress. Results from various studies are difficult to compare as different study designs, samples and/or different questionnaires have been used. The aim of this study was to compare levels of anxiety and depression, psychological well-being and perceived health between persons with diabetes, with or without a history of foot ulcer, and persons without diabetes in a large study of community-dwelling individuals. METHODS: This study included 65,126 persons, of whom 63,632 did not have diabetes, 1,339 had diabetes without a history of foot ulcer and 155 had diabetes and a history of foot ulcer. Levels of anxiety and depression were assessed by the Hospital Anxiety and Depression Scale (HADS). Psychological well-being was measured on a four-item scale, and perceived health was measured with a one-item question. We investigated whether levels of anxiety, depression, psychological well-being and perceived health were different in the three study groups using multiple regression models controlling for demographic factors, body mass index, smoking and cardiovascular conditions. Separate multivariate analyses comparing the two diabetes samples were additionally adjusted for diabetes-specific variables. RESULTS: A history of foot ulcer was significantly associated with more depressive symptoms, poorer psychological well-being and poorer perceived health compared to participants without diabetes. In multivariate analyses, perceived health and psychological well-being were significantly poorer among those with a history of foot ulcer compared to those without diabetes. Among persons with diabetes, perceived health was significantly worse among those with a history of foot ulcer. After multivariate adjustment, levels of anxiety and depression and psychological well-being did not differ between the two diabetes groups. CONCLUSION: Perceived health and psychological well-being were significantly poorer among participants with diabetes and a history of foot ulcer compared to those without diabetes. Among people with diabetes, a history of foot ulcer had significant negative impact on perceived health but did not independently contribute to psychological distress.

Authors
Iversen, MM; Midthjell, K; Tell, GS; Moum, T; Ostbye, T; Nortvedt, MW; Uhlving, S; Hanestad, BR
MLA Citation
Iversen, MM, Midthjell, K, Tell, GS, Moum, T, Ostbye, T, Nortvedt, MW, Uhlving, S, and Hanestad, BR. "The association between history of diabetic foot ulcer, perceived health and psychological distress: the Nord-Trøndelag Health Study. (Published online)" BMC Endocr Disord 9 (August 25, 2009): 18-.
PMID
19706152
Source
pubmed
Published In
BMC Endocrine Disorders
Volume
9
Publish Date
2009
Start Page
18
DOI
10.1186/1472-6823-9-18

Barriers to adopting a healthy lifestyle: insight from postpartum women.

Postpartum weight retention can contribute to obesity. There may be unique barriers to weight loss in this period.Cases are presented for three postpartum women who declined to participate in a postpartum weight loss intervention.Despite their desire to engage in healthier behaviors, or partake in an intervention uniquely designed to promote healthy lifestyles for postpartum women, some find it too difficult to make such commitments. Barriers women face in adopting a healthier lifestyle in this period include 1) time availability; 2) prioritizing other competing life responsibilities above their own health; 3) support from family members, friends, and/or co-workers; and 4) lack of flexibility in the intervention structure. These illustrations describe their perspectives in the context of life balance, perceived health, and support, and reflect the multi-dimensional nature of their lives during the life cycle change of the postpartum period.Postpartum women face difficult and complex challenges to prioritizing their health and their weight management.

Authors
Carter-Edwards, L; Østbye, T; Bastian, LA; Yarnall, KSH; Krause, KM; Simmons, T-J
MLA Citation
Carter-Edwards, L, Østbye, T, Bastian, LA, Yarnall, KSH, Krause, KM, and Simmons, T-J. "Barriers to adopting a healthy lifestyle: insight from postpartum women." BMC research notes 2 (August 17, 2009): 161-.
PMID
19686601
Source
epmc
Published In
BMC Research Notes
Volume
2
Publish Date
2009
Start Page
161
DOI
10.1186/1756-0500-2-161

Reproductive and family planning history, knowledge, and needs: a community survey of low-income women in Beijing, China.

BACKGROUND: The reproductive health status of China's low-income urban women is believed to be poor. Therefore, understanding their reproductive history and needs and improving services provision is very important. However, few studies have been done to assess reproductive health status, knowledge and needs in this low-income population. The purpose of this study is to broadly assess reproductive and family planning history, knowledge and health needs among low income urban women with an aim to informing health services interventions. METHODS: 1642 low-income women age 18-49 from Haidian district, Beijing were selected. All were interviewed via a standardized questionnaire in 2006. RESULTS: Most women reported at least one pregnancy and delivery (97.7%, 98.3%). Deliveries in hospitals (97.3%) by medical personnel (98.5%) were commonplace, as was receipt of antenatal care (86.0%). Nearly half had at least one abortion, with most (56.0%) performed in district hospitals, by physicians (95.6%), and paid for out-of-pocket (64.4%). Almost all (97.4%) used contraception, typically IUDs or condoms. Reproductive knowledge was limited. Health needs emphasized by the participants included popularizing reproductive health information, being able to discuss their reproductive health concerns, free reproductive health insurance, examination and treatment. CONCLUSION: Among poor urban women in Beijing, antenatal care and contraceptive use were common. However, abortions were also common. Knowledge about reproductive health was limited. There is a need for better reproductive health education, free medical care and social support.

Authors
He, H; Ostbye, T; Daltveit, AK
MLA Citation
He, H, Ostbye, T, and Daltveit, AK. "Reproductive and family planning history, knowledge, and needs: a community survey of low-income women in Beijing, China. (Published online)" BMC Womens Health 9 (August 10, 2009): 23-.
PMID
19664257
Source
pubmed
Published In
BMC Women's Health
Volume
9
Publish Date
2009
Start Page
23
DOI
10.1186/1472-6874-9-23

Changes in food advertisements during 'prime-time' television from 1991 to 2006 in the UK and Canada.

Food advertisements on mainstream television have received less research attention than those on children's television. Little is known about how television food advertisements vary internationally or if there have been changes over recent years. We describe food-related television advertisements and the nutrient content of foods advertised during prime-time television in Ontario, Canada and the UK in 1991 and 2006. Information on what advertisements were broadcast were obtained from video recordings and audience research bureaux. Data on nutrient content of foods advertised were obtained from manufacturers and standard food tables. The proportion of advertisements that were food related decreased between 1991 and 2006 in both countries. The frequency of food-related advertisements was relatively constant in Canada but decreased between 1991 and 2006 in the UK. In 1991, advertisements for beverages and meals predominated in both countries. By 2006, food-related advertisements in Canada were dominated by meals and restaurants. In the UK advertisements for food stores and beverages predominated. The 'TV diet' in Canada in 1991 was relatively high in fat, high in alcohol and low in fibre, compared to current recommendations. By 2006, this had changed to high in fat and sodium and low in fibre. The 'TV diet' in the UK in 1991 was high in fat, sodium, sugar and alcohol and low in fibre compared to current recommendations. By 2006, the UK 'TV diet' was high in sodium, sugar and alcohol and low in fibre. Foods advertised on 'prime-time' television do not reflect a healthful diet.

Authors
Adams, J; Hennessy-Priest, K; Ingimarsdóttir, S; Sheeshka, J; Østbye, T; White, M
MLA Citation
Adams, J, Hennessy-Priest, K, Ingimarsdóttir, S, Sheeshka, J, Østbye, T, and White, M. "Changes in food advertisements during 'prime-time' television from 1991 to 2006 in the UK and Canada." Br J Nutr 102.4 (August 2009): 584-593.
PMID
19243640
Source
pubmed
Published In
The British journal of nutrition
Volume
102
Issue
4
Publish Date
2009
Start Page
584
End Page
593
DOI
10.1017/S0007114509220848

Thirteen dimensions of health in elderly Sri Lankans: results from a National Sri Lanka Aging Survey.

OBJECTIVES: To explore age and sex differences in distribution of 13 health dimensions with a focus on self-rated health (SRH) and the association between SRH and other health dimensions in elderly Sri Lankans. DESIGN: Sri Lanka Aging Survey, a nationally representative cross-sectional survey. SETTING: Community based. PARTICIPANTS: Inhabitants of 13 districts in Sri Lanka aged 60 and older (N=2,413). MEASUREMENTS: Self-reported SRH, hearing, activities of daily living (ADLs), instrumental activities of daily living (IADLs), mobility, physical disability, chronic diseases, stress and worry, mood, cognition, social participation, social support, and financial health. RESULTS: The prevalence of being "healthy" in most health dimensions, including SRH, declined with age. Men were more likely to report better SRH; independence in ADLs, IADLs, and mobility; absence of physical disability and chronic diseases; and good mental health. Absence of chronic diseases, independence in ADLs and IADLs, freedom from stress and worry, and absence of depression were associated with positive (excellent/very good/good) SRH. The male SRH advantage was not significant in adjusted analyses, and sex did not modify the association between SRH and other health dimensions. CONCLUSION: Several of the dimensions associated with positive SRH are to a certain extent modifiable and therefore provide a potential for improvement in SRH of elderly Sri Lankans. Differences between this study and studies from elsewhere in the associations between different health dimensions and SRH, and in how sex modifies these associations, suggest that some of the associations may depend on cultural context.

Authors
Ostbye, T; Malhotra, R; Chan, A
MLA Citation
Ostbye, T, Malhotra, R, and Chan, A. "Thirteen dimensions of health in elderly Sri Lankans: results from a National Sri Lanka Aging Survey." J Am Geriatr Soc 57.8 (August 2009): 1376-1387.
PMID
19549023
Source
pubmed
Published In
Journal of American Geriatrics Society
Volume
57
Issue
8
Publish Date
2009
Start Page
1376
End Page
1387
DOI
10.1111/j.1532-5415.2009.02350.x

Primary care physicians' discussions of weight-related topics with overweight and obese adolescents: results from the Teen CHAT Pilot study.

Physicians should counsel overweight adolescents about nutrition and exercise. We audio recorded 30 physician-adolescent encounters. Female, older, normal-weight physicians and pediatricians were more Motivational Interviewing (MI) adherent. When physicians used MI skills, patients increased exercise, lost weight, and reduced screen time. Physicians should use MI techniques to help adolescents change.

Authors
Pollak, KI; Alexander, SC; Østbye, T; Lyna, P; Tulsky, JA; Dolor, RJ; Coffman, C; Namenek Brouwer, RJ; Esoimeme, I; Manusov, JRE; Bravender, T
MLA Citation
Pollak, KI, Alexander, SC, Østbye, T, Lyna, P, Tulsky, JA, Dolor, RJ, Coffman, C, Namenek Brouwer, RJ, Esoimeme, I, Manusov, JRE, and Bravender, T. "Primary care physicians' discussions of weight-related topics with overweight and obese adolescents: results from the Teen CHAT Pilot study." J Adolesc Health 45.2 (August 2009): 205-207.
PMID
19628149
Source
pubmed
Published In
Journal of Adolescent Health
Volume
45
Issue
2
Publish Date
2009
Start Page
205
End Page
207
DOI
10.1016/j.jadohealth.2009.01.002

An internet-based weight loss intervention initiated by a newspaper.

An estimated two-thirds of North Carolina residents are overweight or obese. Mass media, such as newspapers and the Internet, can be used to broadly convey health messages for weight loss.Newspapers have traditionally been a primary source of health information for the general public. They may be uniquely suited to initiate and manage a community-based weight loss program by quickly reaching a broad readership.Participants in the 2005 Lose to Win weight loss challenge visited the Herald-Sun Web site and anonymously entered a nickname and identification number and reported their weight each week. Participants had access to weekly articles on diet and physical activity and 4 free educational seminars.Of the 154 participants who self-reported weight at baseline and during the last week of the challenge, the mean weight lost was 5.9 lb.Results suggest that this challenge fostered health awareness and promoted weight loss in the community. Future interventions of this type should use strategies to increase participation and retention, improve the accuracy of reported weight, and evaluate long-term success of the program. This type of intervention may be a useful first step to reach residents who are interested in losing weight.

Authors
Carter-Edwards, L; Bastian, LA; Schultz, M; Amamoo, MA; Østbye, T
MLA Citation
Carter-Edwards, L, Bastian, LA, Schultz, M, Amamoo, MA, and Østbye, T. "An internet-based weight loss intervention initiated by a newspaper." Preventing chronic disease 6.3 (July 2009): A101-.
PMID
19527573
Source
epmc
Published In
Preventing Chronic Diseases: Public health research, practice, and policy
Volume
6
Issue
3
Publish Date
2009
Start Page
A101

Early parental death and late-life dementia risk: findings from the Cache County Study.

Authors
Norton, MC; Østbye, T; Smith, KR; Munger, RG; Tschanz, JT
MLA Citation
Norton, MC, Østbye, T, Smith, KR, Munger, RG, and Tschanz, JT. "Early parental death and late-life dementia risk: findings from the Cache County Study." Age Ageing 38.3 (May 2009): 340-343.
PMID
19276094
Source
pubmed
Published In
Age and Ageing
Volume
38
Issue
3
Publish Date
2009
Start Page
340
End Page
343
DOI
10.1093/ageing/afp023

Family physicians as team leaders: "time" to share the care.

A major contributor to shortfalls in delivery of recommended health care services is lack of physician time. On the basis of recommendations from national clinical care guidelines for preventive services and chronic disease management, and including the time needed for acute concerns, sufficiently addressing the needs of a standard patient panel of 2,500 would require 21.7 hours per day. The problem of insufficient time indicates that primary care requires broad, fundamental changes. The creation of primary care teams that include members such as physician assistants, nurse practitioners, dietitians, health educators, and lay coaches is important to meeting patients' primary care needs.

Authors
Yarnall, KSH; Østbye, T; Krause, KM; Pollak, KI; Gradison, M; Michener, JL
MLA Citation
Yarnall, KSH, Østbye, T, Krause, KM, Pollak, KI, Gradison, M, and Michener, JL. "Family physicians as team leaders: "time" to share the care." Prev Chronic Dis 6.2 (April 2009): A59-.
PMID
19289002
Source
pubmed
Published In
Preventing Chronic Diseases: Public health research, practice, and policy
Volume
6
Issue
2
Publish Date
2009
Start Page
A59

Prevalence and correlates of sexual abuse reported by late adolescent school children in Sri Lanka.

UNLABELLED: Despite emerging evidence that child sexual abuse (CSA) is a significant health problem in Sri Lanka, few studies have been undertaken to understand the scope and associated factors of CSA. OBJECTIVE: To identify the prevalence of and psycho-behavioral and demographic factors related to CSA among late adolescents. STUDY GROUP: A representative sample of late adolescent school children in Southern Sri Lanka. METHODS: A regional sample of 2,389 students was surveyed using a self-report anonymous questionnaire. Of the participants, 54% were female and 98% were 18 years of age. RESULTS: About 14% of both male and female students reported having been subjected to some form of CSA. Students with middle or upper socioeconomic status, not living with parents, and studying science and mathematics were more likely than others to report having been sexual abused during childhood. The odds of CSA among males were significantly higher among those who had low self-esteem, those who reported any use of alcohol, and those who reported family conflict. The odds of CSA among females were significantly higher among those who had suicidal ideation, those who reported any use of alcohol, and those who reported family conflict. CONCLUSIONS: Sexual abuse of children is an important public health issue in Sri Lanka. Causal relations between CSA and related psycho-behavioral risk factors investigated in this study should be further investigated using longitudinal and qualitative studies.

Authors
Perera, B; Østbye, T
MLA Citation
Perera, B, and Østbye, T. "Prevalence and correlates of sexual abuse reported by late adolescent school children in Sri Lanka." Int J Adolesc Med Health 21.2 (April 2009): 203-211.
PMID
19702200
Source
pubmed
Published In
International journal of adolescent medicine and health
Volume
21
Issue
2
Publish Date
2009
Start Page
203
End Page
211

The USDA Nutrition Evidence Library: An Evidence-Based Resource for Development of National Nutrition Policy

Authors
Fungwe, TV; Altman, J; Blum-Kemelor, D; Hopwood, H; MacNeil, PC; McCormick, M; Wong, Y; Lyon, J
MLA Citation
Fungwe, TV, Altman, J, Blum-Kemelor, D, Hopwood, H, MacNeil, PC, McCormick, M, Wong, Y, and Lyon, J. "The USDA Nutrition Evidence Library: An Evidence-Based Resource for Development of National Nutrition Policy." FASEB JOURNAL 23 (April 2009).
Source
wos-lite
Published In
The FASEB journal : official publication of the Federation of American Societies for Experimental Biology
Volume
23
Publish Date
2009

The dietary intake of 2-year-old children born to overweight/obese mothers

Authors
Street, E; Lovelady, C; Ostbye, T; Pendzich, M; Fuemmeler, B
MLA Citation
Street, E, Lovelady, C, Ostbye, T, Pendzich, M, and Fuemmeler, B. "The dietary intake of 2-year-old children born to overweight/obese mothers." FASEB JOURNAL 23 (April 2009).
Source
wos-lite
Published In
The FASEB journal : official publication of the Federation of American Societies for Experimental Biology
Volume
23
Publish Date
2009

Dietary Habits, Media Usage, and Physical Activity in Preschoolers Born to Overweight Mothers

Authors
Bowman, AE; Lovelady, C; Ostbye, T
MLA Citation
Bowman, AE, Lovelady, C, and Ostbye, T. "Dietary Habits, Media Usage, and Physical Activity in Preschoolers Born to Overweight Mothers." FASEB JOURNAL 23 (April 2009).
Source
wos-lite
Published In
The FASEB journal : official publication of the Federation of American Societies for Experimental Biology
Volume
23
Publish Date
2009

Prevalence and correlates of physical and emotional abuse among late adolescents.

OBJECTIVES: To estimate the prevalence of physical and emotional abuse reported by late adolescent school children in southern Sri Lanka, and to identify demographic and behavioural correlates of such abuse. METHOD: A cross-sectional survey was administered to a sample of 1099 male and 1290 female late adolescents, through schools in the southern province. Self-report anonymous questionnaires were used. Study variables included age, gender, body mass index (BMI), socioeconomic status, deliberate self harm, substance use, school absenteeism and family conflicts. RESULTS: Of the total, 22.4% (n = 246) of males and 15.7% (n = 202) of females reported having been subjected to physical abuse at least a few times in the 3 months preceding the survey (p<0.05), and 31.3% (n = 324) of males and 25.4% (n = 328) of females reported having been subjected to emotional abuse at least a few times in the 3 months preceding the survey (p<0.05). Logistic regression analyses revealed that school absenteeism, deliberate self-harm, substance use, and family conflict were associated with physical and emotional abuse. Socio-economic status and BMI were not found to be associated with physical and emotional abuse. CONCLUSION: Physical and emotional abuse are important health issues among late adolescent school children in Sri Lanka. Further research is needed to better understand the causal direction of the associations between physical and emotional abuse experiences, and health-related behaviours.

Authors
Perera, B; Ostbye, T; Ariyananda, PL; Lelwala, E
MLA Citation
Perera, B, Ostbye, T, Ariyananda, PL, and Lelwala, E. "Prevalence and correlates of physical and emotional abuse among late adolescents." Ceylon Med J 54.1 (March 2009): 10-15.
PMID
19391449
Source
pubmed
Published In
The Ceylon medical journal
Volume
54
Issue
1
Publish Date
2009
Start Page
10
End Page
15

Do clinicians read our reports? Integrating the radiology information system with the electronic patient record: experiences from the first 2 years.

This study aimed to determine how clinicians adapted to and utilized new routines for accessing radiology reports after the integration of an electronic patient record (EPR) with a radiology information system (RIS). Activity-related data describing the availability and receipt of radiology reports were collected from the EPR and the RIS over a period of 2 years. Twelve percent of the final radiology reports had not been opened 4 weeks after they had been entered into the EPR. For opened reports, the median time after a report was available in the EPR until it was first opened by a clinician was less than 1 h for preliminary reports and less than 4 h for final radiology reports. The use of radiology reports was stable during the second observation year. Some reports were not opened for professional as well as technical reasons. The integrated information systems offered a potential for improving routines related to the transmission of radiology reports. Clinicians did not fully take advantage of this potential in the 2 years after its introduction.

Authors
Hurlen, P; Østbye, T; Borthne, A; Dahl, FA; Gulbrandsen, P
MLA Citation
Hurlen, P, Østbye, T, Borthne, A, Dahl, FA, and Gulbrandsen, P. "Do clinicians read our reports? Integrating the radiology information system with the electronic patient record: experiences from the first 2 years." Eur Radiol 19.1 (January 2009): 31-36.
PMID
18682959
Source
pubmed
Published In
European Radiology
Volume
19
Issue
1
Publish Date
2009
Start Page
31
End Page
36
DOI
10.1007/s00330-008-1098-3

Neuropsychological performance in advanced age: influences of demographic factors and Apolipoprotein E: findings from the Cache County Memory Study.

The Cache County Study of Memory in Aging (CCMS) is an epidemiological study of Alzheimer's disease (AD), mild cognitive disorders, and aging in a population of exceptionally long-lived individuals (7th to 11th decade). Observation of population members without dementia provides an opportunity for establishing the range of normal neurocognitive performance in a representative sample of the very old. We examined neurocognitive performance of the normal participants undergoing full clinical evaluations (n = 507) and we tested the potential modifying effects of apolipoprotein E (APOE) genotype, a known genetic risk factor for the later development of AD. The results indicate that advanced age and low education are related to lower test scores across nearly all of the neurocognitive measures. Gender and APOE epsilon4 both had negligible and inconsistent influences, affecting only isolated measures of memory and expressive speech (in case of gender). The gender and APOE effects disappeared once age and education were controlled. The study of this exceptionally long-lived population provides useful normative information regarding the broad range of "normal" cognition seen in advanced age. Among elderly without dementia or other cognitive impairment, APOE does not appear to exert any major effects on cognition once other demographic influences are controlled.

Authors
Welsh-Bohmer, KA; Ostbye, T; Sanders, L; Pieper, CF; Hayden, KM; Tschanz, JT; Norton, MC; Cache Country Study Group,
MLA Citation
Welsh-Bohmer, KA, Ostbye, T, Sanders, L, Pieper, CF, Hayden, KM, Tschanz, JT, Norton, MC, and Cache Country Study Group, . "Neuropsychological performance in advanced age: influences of demographic factors and Apolipoprotein E: findings from the Cache County Memory Study." Clin Neuropsychol 23.1 (January 2009): 77-99.
PMID
18609337
Source
pubmed
Published In
Clinical Neuropsychologist
Volume
23
Issue
1
Publish Date
2009
Start Page
77
End Page
99
DOI
10.1080/13854040801894730

The accuracy of Medicare claims as an epidemiological tool: the case of dementia revisited.

Our study estimates the sensitivity and specificity of Medicare claims to identify clinically-diagnosed dementia, and documents how errors in dementia assessment affect dementia cost estimates. We compared Medicare claims from 1993-2005 to clinical dementia assessments carried out in 2001-2003 for the Aging Demographics and Memory Study (ADAMS) cohort (n = 758) of the Health and Retirement Study. The sensitivity and specificity of Medicare claims was 0.85 and 0.89 for dementia (0.64 and 0.95 for AD). Persons with dementia cost the Medicare program (in 2003) $7,135 more than controls (P < 0.001) when using claims to identify dementia, compared to $5,684 more when using ADAMS (P < 0.001). Using Medicare claims to identify dementia results in a 110% increase in costs for those with dementia as compared to a 68% increase when using ADAMS to identify disease, net of other variables. Persons with false positive Medicare claims notations of dementia were the most expensive group of subjects ($11,294 versus $4,065, for true negatives P < 0.001). Medicare claims overcount the true prevalence of dementia, but there are both false positive and negative assessments of disease. The use of Medicare claims to identify dementia results in an overstatement of the increase in Medicare costs that are due to dementia.

Authors
Taylor, DH; Østbye, T; Langa, KM; Weir, D; Plassman, BL
MLA Citation
Taylor, DH, Østbye, T, Langa, KM, Weir, D, and Plassman, BL. "The accuracy of Medicare claims as an epidemiological tool: the case of dementia revisited." J Alzheimers Dis 17.4 (2009): 807-815.
PMID
19542620
Source
pubmed
Published In
Journal of Alzheimer's disease : JAD
Volume
17
Issue
4
Publish Date
2009
Start Page
807
End Page
815
DOI
10.3233/JAD-2009-1099

LOWER URINARY TRACT SYMPTOMS AND QUALITY OF LIFE IN NORWEGIAN MEN: THE HUNT STUDY

Authors
Seim, A; Fjaere, O; Hoyo, C; Ostbye, T; Vatten, LJ
MLA Citation
Seim, A, Fjaere, O, Hoyo, C, Ostbye, T, and Vatten, LJ. "LOWER URINARY TRACT SYMPTOMS AND QUALITY OF LIFE IN NORWEGIAN MEN: THE HUNT STUDY." NEUROUROLOGY AND URODYNAMICS 28.7 (2009): 802-803.
Source
wos-lite
Published In
Neurourology and Urodynamics
Volume
28
Issue
7
Publish Date
2009
Start Page
802
End Page
803

Estimated time spent on preventive services by primary care physicians.

BACKGROUND: Delivery of preventive health services in primary care is lacking. One of the main barriers is lack of time. We estimated the amount of time primary care physicians spend on important preventive health services. METHODS: We analyzed a large dataset of primary care (family and internal medicine) visits using the National Ambulatory Medical Care Survey (2001-4); analyses were conducted 2007-8. Multiple linear regression was used to estimate the amount of time spent delivering each preventive service, controlling for demographic covariates. RESULTS: Preventive visits were longer than chronic care visits (M = 22.4, SD = 11.8, M = 18.9, SD = 9.2, respectively). New patients required more time from physicians. Services on which physicians spent relatively more time were prostate specific antigen (PSA), cholesterol, Papanicolaou (Pap) smear, mammography, exercise counseling, and blood pressure. Physicians spent less time than recommended on two "A" rated ("good evidence") services, tobacco cessation and Pap smear (in preventive visits), and one "B" rated ("at least fair evidence") service, nutrition counseling. Physicians spent substantial time on two services that have an "I" rating ("inconclusive evidence of effectiveness"), PSA and exercise counseling. CONCLUSION: Even with limited time, physicians address many of the "A" rated services adequately. However, they may be spending less time than recommended for important services, especially smoking cessation, Pap smear, and nutrition counseling. Future research is needed to understand how physicians decide how to allocate their time to address preventive health.

Authors
Pollak, KI; Krause, KM; Yarnall, KSH; Gradison, M; Michener, JL; Østbye, T
MLA Citation
Pollak, KI, Krause, KM, Yarnall, KSH, Gradison, M, Michener, JL, and Østbye, T. "Estimated time spent on preventive services by primary care physicians. (Published online)" BMC Health Serv Res 8 (December 1, 2008): 245-.
PMID
19046443
Source
pubmed
Published In
BMC Health Services Research
Volume
8
Publish Date
2008
Start Page
245
DOI
10.1186/1472-6963-8-245

Active Mothers Postpartum (AMP): rationale, design, and baseline characteristics.

BACKGROUND: Pregnancy and the postpartum period have been suggested as important contributors to overweight and obesity among women. This paper presents the design, rationale, and baseline participant characteristics of a randomized controlled intervention trial to enhance weight loss in postpartum women who entered pregnancy overweight or obese. METHODS: Active Mothers Postpartum (AMP) is based on the rationale that the birth of a child can be a teachable moment. AMP's primary objectives are to promote and sustain a reduction in body mass index (BMI) up to 2 years postpartum via changes in diet and exercise behavior, with a secondary aim to assess racial differences in these outcomes. Women in the intervention arm participate in ten physical activity group sessions, eight healthy eating classes, and six telephone counseling sessions over a 9-month period. They also receive motivational tools, including a workbook with recipes and exercises, a pedometer, and a sport stroller. RESULTS: Four hundred fifty women aged > or =18 (mean 30.9), with a BMI > or = 25 kg/m(2) (mean 33.0) at baseline (6 weeks postpartum) were enrolled; 45% of the final sample are black and 53% are white. Baseline characteristics by study arm and by race are presented. CONCLUSIONS: Our intervention is designed to be disseminated broadly to benefit the public health. Behavior change interventions based on principles of social cognitive theory, stage of readiness, and other models that coincide with a teachable moment, such as the birth of a child, could be important motivators for postpartum weight loss.

Authors
Østbye, T; Krause, KM; Brouwer, RJN; Lovelady, CA; Morey, MC; Bastian, LA; Peterson, BL; Swamy, GK; Chowdhary, J; McBride, CM
MLA Citation
Østbye, T, Krause, KM, Brouwer, RJN, Lovelady, CA, Morey, MC, Bastian, LA, Peterson, BL, Swamy, GK, Chowdhary, J, and McBride, CM. "Active Mothers Postpartum (AMP): rationale, design, and baseline characteristics." J Womens Health (Larchmt) 17.10 (December 2008): 1567-1575.
PMID
19049350
Source
pubmed
Published In
Journal of Women's Health
Volume
17
Issue
10
Publish Date
2008
Start Page
1567
End Page
1575
DOI
10.1089/jwh.2007.0674

Factors Associated With Participation in a Postpartum Weight-Loss Intervention

Authors
Brouwer, R; Ostbye, T; Revels, J
MLA Citation
Brouwer, R, Ostbye, T, and Revels, J. "Factors Associated With Participation in a Postpartum Weight-Loss Intervention." October 2008.
Source
wos-lite
Published In
Obesity (Silver Spring, Md.)
Volume
16
Publish Date
2008
Start Page
S164
End Page
S165

Occurrence and Correlates of Postpartum Depression in Overweight and Obese Women

Authors
Krause, K; Ostbye, T; Swamy, G
MLA Citation
Krause, K, Ostbye, T, and Swamy, G. "Occurrence and Correlates of Postpartum Depression in Overweight and Obese Women." October 2008.
Source
wos-lite
Published In
Obesity (Silver Spring, Md.)
Volume
16
Publish Date
2008
Start Page
S134
End Page
S134

Active Mothers Postpartum: Impact on Diet and Physical Activity

Authors
Ostbye, T; Krause, K; Lovelady, C; Morey, M; Bastian, L; Peterson, B; Swamy, G; Brouwer, R
MLA Citation
Ostbye, T, Krause, K, Lovelady, C, Morey, M, Bastian, L, Peterson, B, Swamy, G, and Brouwer, R. "Active Mothers Postpartum: Impact on Diet and Physical Activity." October 2008.
Source
wos-lite
Published In
Obesity (Silver Spring, Md.)
Volume
16
Publish Date
2008
Start Page
S165
End Page
S165

The Relationship Between Obesity and Receipt of Clinical Preventive Services in Veterans

Authors
Jr, YW; McDuffie, J; Stechuchak, K; Olsen, M; Datta, S; Fisher, D; Oddone, E; Krause, K; Ostbye, T
MLA Citation
Jr, YW, McDuffie, J, Stechuchak, K, Olsen, M, Datta, S, Fisher, D, Oddone, E, Krause, K, and Ostbye, T. "The Relationship Between Obesity and Receipt of Clinical Preventive Services in Veterans." October 2008.
Source
wos-lite
Published In
Obesity (Silver Spring, Md.)
Volume
16
Publish Date
2008
Start Page
S248
End Page
S249

Improvements in sexual quality of life after moderate weight loss.

We evaluated changes in sexual quality of life as they relate to weight loss over a 2-year period in individuals undergoing weight loss treatment. Six dimensions of sexual quality of life were measured using items from the Impact of Weight on Quality of Life questionnaire (feeling sexually unattractive, lacking sexual desire, reluctance to be seen undressed, difficulty with sexual performance, avoidance of sexual encounters and lack of enjoyment of sexual activity). At baseline women were more likely than men to report lack of sexual enjoyment and reluctance to be seen undressed in spite of lower body mass index (BMI). Weight loss averaged 13.1% and was significantly associated with improvements in all sexual quality of life dimensions. A 3-4% regain did not appear to negatively affect sexual quality of life. The greatest improvements for women had occurred by 3 months and were observed in all dimensions, whereas for men only 'not feeling sexually attractive' showed marked improvement in this short time frame.

Authors
Kolotkin, RL; Binks, M; Crosby, RD; Østbye, T; Mitchell, JE; Hartley, G
MLA Citation
Kolotkin, RL, Binks, M, Crosby, RD, Østbye, T, Mitchell, JE, and Hartley, G. "Improvements in sexual quality of life after moderate weight loss." Int J Impot Res 20.5 (September 2008): 487-492.
PMID
18596703
Source
pubmed
Published In
International Journal of Impotence Research
Volume
20
Issue
5
Publish Date
2008
Start Page
487
End Page
492
DOI
10.1038/ijir.2008.32

No advantage of A beta 42-lowering NSAIDs for prevention of Alzheimer dementia in six pooled cohort studies.

INTRODUCTION: Observational studies show reduced incidence of Alzheimer dementia (AD) in users of nonsteroidal anti-inflammatory drugs (NSAIDs). One hypothesis holds that the subset of NSAIDs known as selective A beta(42)-lowering agents (SALAs) is responsible for this apparent reduction in AD risk. METHODS: We pooled individual-level data from six prospective studies to obtain a sufficient sample to examine AD risk in users of SALA vs non-SALA NSAIDs. RESULTS: Of 13,499 initially dementia-free participants (70,863 person-years), 820 developed incident AD. Users of NSAIDs (29.6%) showed reduced risk of AD (adjusted hazard ratio [aHR] 0.77, 95% CI 0.65-0.91). The point estimates were similar for SALAs (aHR 0.87, CI 0.72-1.04) and non-SALAs (aHR 0.75, CI 0.56-1.01). Because 573 NSAID users (14.5%) reported taking both a SALA and non-SALA, we examined their use alone and in combination. Resulting aHRs were 0.82 (CI 0.67-0.99) for SALA only, 0.60 (CI 0.40-0.90) for non-SALA only, and 0.87 (CI 0.57-1.33) for both NSAIDs (Wald test for differences, p = 0.32). The 40.7% of participants who used aspirin also showed reduced risk of AD, even when they used no other NSAIDs (aHR 0.78, CI 0.66-0.92). By contrast, there was no association with use of acetaminophen (aHR 0.93, CI 0.76-1.13). CONCLUSIONS: In this pooled dataset, nonsteroidal anti-inflammatory drug (NSAID) use reduced the risk of Alzheimer dementia (AD). However, there was no apparent advantage in AD risk reduction for the subset of NSAIDs shown to selectively lower A beta(42), suggesting that all conventional NSAIDs including aspirin have a similar protective effect in humans.

Authors
Szekely, CA; Green, RC; Breitner, JCS; Østbye, T; Beiser, AS; Corrada, MM; Dodge, HH; Ganguli, M; Kawas, CH; Kuller, LH; Psaty, BM; Resnick, SM; Wolf, PA; Zonderman, AB; Welsh-Bohmer, KA; Zandi, PP
MLA Citation
Szekely, CA, Green, RC, Breitner, JCS, Østbye, T, Beiser, AS, Corrada, MM, Dodge, HH, Ganguli, M, Kawas, CH, Kuller, LH, Psaty, BM, Resnick, SM, Wolf, PA, Zonderman, AB, Welsh-Bohmer, KA, and Zandi, PP. "No advantage of A beta 42-lowering NSAIDs for prevention of Alzheimer dementia in six pooled cohort studies." Neurology 70.24 (June 10, 2008): 2291-2298.
PMID
18509093
Source
pubmed
Published In
Neurology
Volume
70
Issue
24
Publish Date
2008
Start Page
2291
End Page
2298
DOI
10.1212/01.wnl.0000313933.17796.f6

Regularity of preventive foot care in persons with diabetes: results from the Nord-Trøndelag Health Study.

The purpose of the present study was to examine the regularity of preventive care for persons with diabetes in the Nord-Trøndelag Health Study to identify associated demographic, lifestyle, and disease-related factors. Among 1,972 persons with diabetes, 1,459 (74%) answered questions related to preventive foot care. The final sample included 1,312 persons with known diabetes, but without a self-reported history of foot ulcer. Almost 85% reported receiving regular clinical diabetes examinations, 31.7% reported regular foot inspection by health care personnel, and 66.3% reported foot self-inspection. Only 58.8% reported regular clinical diabetes examination combined with foot inspection. Males, patients not using insulin, and those with shorter diabetes duration or macrovascular complications were more likely to report less regular preventive care.

Authors
Iversen, MM; Ostbye, T; Clipp, E; Midthjell, K; Uhlving, S; Graue, M; Hanestad, BR
MLA Citation
Iversen, MM, Ostbye, T, Clipp, E, Midthjell, K, Uhlving, S, Graue, M, and Hanestad, BR. "Regularity of preventive foot care in persons with diabetes: results from the Nord-Trøndelag Health Study." Res Nurs Health 31.3 (June 2008): 226-237.
PMID
18481252
Source
pubmed
Published In
Research in Nursing & Health
Volume
31
Issue
3
Publish Date
2008
Start Page
226
End Page
237
DOI
10.1002/nur.20255

Neuropsychological performance in advanced age: Influences of Demographic factors and Apolipoprotein E: Findings from the Cache County Memory Study.

The Cache County Study of Memory in Aging (CCMS) is an epidemiological study of Alzheimer's disease (AD), mild cognitive disorders, and aging in a population of exceptionally long-lived individuals (7th to 11th decade). Observation of population members without dementia provides an opportunity for establishing the range of normal neurocognitive performance in a representative sample of the very old. We examined neurocognitive performance of the normal participants undergoing full clinical evaluations (n = 507) and we tested the potential modifying effects of apolipoprotein E (APOE) genotype, a known genetic risk factor for the later development of AD. The results indicate that advanced age and low education are related to lower test scores across nearly all of the neurocognitive measures. Gender and APOE epsilon4 both had negligible and inconsistent influences, affecting only isolated measures of memory and expressive speech (in case of gender). The gender and APOE effects disappeared once age and education were controlled. The study of this exceptionally long-lived population provides useful normative information regarding the broad range of "normal" cognition seen in advanced age. Among elderly without dementia or other cognitive impairment, APOE does not appear to exert any major effects on cognition once other demographic influences are controlled.

Authors
Welsh Bohmer, KA; Ostbye, T; Sanders, L; Pieper, CF; Hayden, KM; Tschanz, JT; Norton, MC
MLA Citation
Welsh Bohmer, KA, Ostbye, T, Sanders, L, Pieper, CF, Hayden, KM, Tschanz, JT, and Norton, MC. "Neuropsychological performance in advanced age: Influences of Demographic factors and Apolipoprotein E: Findings from the Cache County Memory Study." The Clinical neuropsychologist (June 2008): 1-23. (Academic Article)
Source
manual
Published In
Clinical Neuropsychologist
Publish Date
2008
Start Page
1
End Page
23

The impact of the Tsunami on hospitalizations at the tertiary care hospital in the Southern Province of Sri Lanka.

OBJECTIVE: Sri Lanka's human, physical, social, and economic resources suffered a massive impact after the tsunami of December 26, 2004. To assist in preparing for future disasters, the authors sought to characterize the pattern of hospitalizations from the main impact zone in the Southern Province. DESIGN: Retrospective chart review. SETTING: Patients admitted to Teaching Hospital, Karapitiya, the only tertiary care hospital in the Southern Province. PATIENTS, PARTICIPANTS: All hospital admissions on the day of and week following the tsunami, and a random sample (5 percent) of admissions from the month preceding, and the 3 months following the tsunami were coded according to the International Classification of Diseases, 10th Edition, analyzed, and geomapped. INTERVENTION: N/A. MAIN OUTCOME MEASURE(S): The overall daily number of hospitalizations increased by 50 percent on the day of the tsunami and decreased in the following week. RESULTS: Before the tsunami, injuries typically accounted for 20 percent of hospital admissions. However, injuries were markedly higher (89 percent of the total) on the day of the tsunami and remained elevated (35 percent) during the following week. After the initial peak in injuries (including near drownings), there was no increase in the frequency of infectious, cardiac, or psychiatric admissions. CONCLUSIONS: Injuries (including near drownings) were the most common cause of admissions immediately after the tsunami. The distribution of specific diagnoses differed from that seen after other natural disasters such as earthquakes and hurricanes. A central aspect of disaster relief operations and planning includes a thorough understanding of the postdisaster health effects and changes in disease patterns.

Authors
Ostbye, T; Ponnamperuma, T; Fernando, N; Abeygunawardena, V; Wijayasiri, WAA; Chen, JJ; Woods, CW
MLA Citation
Ostbye, T, Ponnamperuma, T, Fernando, N, Abeygunawardena, V, Wijayasiri, WAA, Chen, JJ, and Woods, CW. "The impact of the Tsunami on hospitalizations at the tertiary care hospital in the Southern Province of Sri Lanka." Am J Disaster Med 3.3 (May 2008): 147-155.
PMID
18666511
Source
pubmed
Published In
American journal of disaster medicine
Volume
3
Issue
3
Publish Date
2008
Start Page
147
End Page
155

Parental feeding styles and child eating behaviors correlate with dietary intake and BMI of 2-year old children of overweight mothers

Authors
Fuemmeler, BF; Pendzich, MK; Moriarty, L; Street, EE; Lovelady, C; Ostbye, T
MLA Citation
Fuemmeler, BF, Pendzich, MK, Moriarty, L, Street, EE, Lovelady, C, and Ostbye, T. "Parental feeding styles and child eating behaviors correlate with dietary intake and BMI of 2-year old children of overweight mothers." May 2008.
Source
wos-lite
Published In
International Journal of Obesity
Volume
32
Publish Date
2008
Start Page
S183
End Page
S183

Trajectories of caregiving time provided by wives to their husbands with dementia.

Spouses are often the first providers of informal care when their partners develop dementia. We used The National Longitudinal Caregiver Study (NLCS, 4 annual surveys, 1999 to 2002) and identified 3 distinct longitudinal patterns (trajectory classes) of total daily caregiving time provided by the wife to her husband using Generalized growth mixture models (GGMM). About 56.4% of the sample (N=828) was found to have an increase in the trajectory of total daily caregiving time (mean 252 min/d at baseline, rising to 471 min/d at time 4). Four hundred forty-four (30.3%) caregivers had a trajectory described by a moderate increase in caregiving time (an increase from a mean of 464 min/d at baseline to 533 at wave 4), whereas 195 (13.3%) had a sharply declining trajectory (a decline from a mean of 719 min/d at baseline to 421 at wave 4). There was no significant difference in the duration (time since onset) of caregiving at baseline for these 3 trajectories. GGMM are well suited for the identification of distinct trajectory classes. Here they show that there are large differences in caregiving time provided to persons with dementia, who seem to be quite similar.

Authors
Taylor, DH; Kuchibhatla, M; Østbye, T
MLA Citation
Taylor, DH, Kuchibhatla, M, and Østbye, T. "Trajectories of caregiving time provided by wives to their husbands with dementia." Alzheimer Dis Assoc Disord 22.2 (April 2008): 131-136.
PMID
18525284
Source
pubmed
Published In
Alzheimer Disease and Associated Disorders
Volume
22
Issue
2
Publish Date
2008
Start Page
131
End Page
136
DOI
10.1097/WAD.0b013e31815bebba

Breastfeeding as a predictor of body mass index in 2-year-old children at risk for overweight

Authors
Street, EE; Lovelady, C; Ostbye, T; Pendzich, M; Fuemmeler, B
MLA Citation
Street, EE, Lovelady, C, Ostbye, T, Pendzich, M, and Fuemmeler, B. "Breastfeeding as a predictor of body mass index in 2-year-old children at risk for overweight." FASEB JOURNAL 22 (April 2008).
Source
wos-lite
Published In
The FASEB journal : official publication of the Federation of American Societies for Experimental Biology
Volume
22
Publish Date
2008

Association of preterm birth with long-term survival, reproduction, and next-generation preterm birth.

CONTEXT: Preterm birth is a major cause of infant morbidity and mortality. Less is known about long-term health among persons born preterm. OBJECTIVE: To determine the long-term effects of preterm birth on survival, reproduction, and next-generation preterm birth. DESIGN, SETTING, AND PARTICIPANTS: Population-based, observational, longitudinal study using registry data from 1,167,506 singleton births in the Medical Birth Registry of Norway in 1967-1988. The cohort was followed up through 2002 for survival. The cohort was truncated to births from 1967-1976 for assessment of educational achievement and reproductive outcomes through 2004. MAIN OUTCOME MEASURES: In relation to sex and gestational age at birth, absolute mortality, risk of fetal, infant, child, and adolescent mortality, and incidence and risk of reproduction and next-generation preterm birth. Singleton term (37-42 weeks) fetal deaths and live births, stratified by sex, served as the reference group for all analyses. RESULTS: The percentage who were born preterm was higher among boys (5.6%) than among girls (4.7%). Preterm participants had an increased risk of mortality throughout childhood. For boys born at 22 to 27 weeks, mortality rates were 1.33% and 1.01% for early and late childhood death, with relative risks (RRs) of 5.3 (95% confidence interval [CI], 2.0-14.2) and 7.0 (95% CI, 2.3-22.0), respectively. The mortality rate for girls born at 22 to 27 weeks was 1.71% for early childhood death, with an RR of 9.7 (95% CI, 4.0-23.7); there were no late childhood deaths. For 28 to 32 weeks, the early and late childhood mortality rates among boys were 0.73% and 0.37%, with RRs of 2.5 (95% CI, 1.6-3.7) and 2.3 (95% CI, 1.3-4.1), respectively. Girls born at 28 to 32 weeks did not have a significantly increased risk of childhood mortality. Reproduction was diminished for index participants born preterm. For men and women born at 22 to 27 weeks, absolute reproduction was 29.3[corrected]% and 51.9[corrected]%, with RRs of 0.59 [corrected] (95% CI, 0.45[corrected]-0.79[corrected]) and 0.78 [corrected] (95% CI, 0.65[corrected]-0.93[corrected]), respectively. For 28 to 32 weeks, absolute reproduction was 43.1[corrected]% and 63.6[corrected]% for men and women, with RRs of 0.81[corrected] (95% CI, 0.77[corrected]-0.86[corrected]) and 0.89 [corrected] (95% CI, 0.86 [corrected]-0.93 [corrected]), respectively. Preterm women but not men were at increased risk of having preterm offspring. CONCLUSION: In persons born in Norway in 1967-1988, preterm birth was associated with diminished long-term survival and reproduction.

Authors
Swamy, GK; Ostbye, T; Skjaerven, R
MLA Citation
Swamy, GK, Ostbye, T, and Skjaerven, R. "Association of preterm birth with long-term survival, reproduction, and next-generation preterm birth." JAMA 299.12 (March 26, 2008): 1429-1436.
PMID
18364485
Source
pubmed
Published In
JAMA : the journal of the American Medical Association
Volume
299
Issue
12
Publish Date
2008
Start Page
1429
End Page
1436
DOI
10.1001/jama.299.12.1429

Identifying trajectories of depressive symptoms for women caring for their husbands with dementia.

OBJECTIVES: To use an innovative statistical method, Latent Class Trajectory Analysis (LCTA), to identify and describe subgroups (called trajectories) of caregiver depressive symptoms in a national sample of wives providing informal care for their husbands with dementia. DESIGN: Longitudinal. SETTING: Community. PARTICIPANTS: Respondents to the National Longitudinal Caregiver Survey were wife caregivers of veterans with dementia who were identified through Veterans Affairs hospitals nationally. MEASUREMENTS: Mean number of depressive symptoms as measured using the Center for Epidemiologic Studies Depression scale (CES-D, 20-item scale). RESULTS: Overall mean depressive symptoms of wife caregivers were 6.2 of 20, below the cutpoint (8 or 9/20) associated with clinical depression. Four distinct trajectories of caregiver depressive symptoms were identified. The trajectory with the highest number of symptoms (11.9 of 20), contained one-third of the sample. Another third had mean depressive symptoms virtually identical to the overall sample mean. The final third were divided between two trajectories, low depressive symptoms (mean CES-D, 3.0/20, 22% of sample) and very low (mean CES-D, 0.8/20, 14% of sample). Approximately two-thirds of the sample members were in a depressive symptom trajectory, with substantially higher or lower numbers of symptoms than the overall mean. Two subjective measures asked of wife caregivers (desire for more help, life satisfaction) were significantly associated with membership in the highest depressive symptom trajectory. CONCLUSION: LCTA identified important depressive symptom subgroups of wife caregivers. A population-averaging method identified a mean effect that was similar to the effect in one-third of the cases but substantially different from that in two-thirds of the cases.

Authors
Taylor, DH; Ezell, M; Kuchibhatla, M; Østbye, T; Clipp, EC
MLA Citation
Taylor, DH, Ezell, M, Kuchibhatla, M, Østbye, T, and Clipp, EC. "Identifying trajectories of depressive symptoms for women caring for their husbands with dementia." J Am Geriatr Soc 56.2 (February 2008): 322-327.
PMID
18179488
Source
pubmed
Published In
Journal of American Geriatrics Society
Volume
56
Issue
2
Publish Date
2008
Start Page
322
End Page
327
DOI
10.1111/j.1532-5415.2007.01558.x

Identification of dementia: agreement among national survey data, medicare claims, and death certificates.

OBJECTIVE: To estimate the proportion of seniors with dementia from three independent data sources and their agreement. DATA SOURCES: The longitudinal Asset and Health Dynamics among the Oldest Old (AHEAD) study (n=7,974), Medicare claims, and death certificate data. STUDY DESIGN: Estimates of the proportion of individuals with dementia from: (1) self- or proxy-reported cognitive status measures from surveys, (2) Medicare claims, and (3) death certificates. Agreement using Cohen's kappa; multivariate logistic regression. PRINCIPAL FINDINGS: The proportion varied substantially among the data sources. Agreement was poor (kappa: 0.14-0.46 depending upon comparison assessed); the individuals identified had relatively modest overlap. CONCLUSIONS: Estimates of dementia occurrence based on cognitive status measures from three independent data sources were not interchangeable. Further validation of these sources is needed. Caution should be used if policy is based on only one data source.

Authors
Ostbye, T; Taylor, DH; Clipp, EC; Scoyoc, LV; Plassman, BL
MLA Citation
Ostbye, T, Taylor, DH, Clipp, EC, Scoyoc, LV, and Plassman, BL. "Identification of dementia: agreement among national survey data, medicare claims, and death certificates." Health Serv Res 43.1 Pt 1 (February 2008): 313-326.
PMID
18211532
Source
pubmed
Published In
Health Services Research
Volume
43
Issue
1 Pt 1
Publish Date
2008
Start Page
313
End Page
326
DOI
10.1111/j.1475-6773.2007.00748.x

Point and 5-year period prevalence of neuropsychiatric symptoms in dementia: the Cache County Study.

BACKGROUND: Neuropsychiatric symptoms are nearly universal in dementia, yet little is known about their longitudinal course in the community. OBJECTIVE: To estimate point and 5-year period prevalence of neuropsychiatric symptoms in an incident sample of 408 dementia participants from the Cache County Study. METHODS: The Neuropsychiatric Inventory assessed symptoms at baseline and at 1.5 years, 3.0 years, 4.1 years, and 5.3 years. Point prevalence, period prevalence and mean symptom severity at each time point were estimated. RESULTS: Point prevalence for delusions was 18% at baseline and 34-38% during the last three visits; hallucinations, 10% at baseline and 19-24% subsequently; agitation/aggression fluctuated between 13% and 24%; depression 29% at baseline and 41-47% subsequently; apathy increased from 20% at baseline to 51% at 5.3 years; elation never rose above 1%; anxiety 14% at baseline and 24-32% subsequently; disinhibition fluctuated between 2% and 15%; irritability between 17% and 27%; aberrant motor behavior gradually increased from 7% at baseline to 29% at 5.3 years. Point prevalence for any symptom was 56% at baseline and 76-87% subsequently. Five-year period prevalence was greatest for depression (77%), apathy (71%), and anxiety (62%); lowest for elation (6%), and disinhibition (31%). Ninety-seven percent experienced at least one symptom. Symptom severity was consistently highest for apathy. CONCLUSIONS: Participants were most likely to develop depression, apathy, or anxiety, and least likely to develop elation or disinhibition. Give converging evidence that syndromal definitions may more accurately capture neuropsychiatric co-morbidity in dementia, future efforts to validate such syndromes are warranted.

Authors
Steinberg, M; Shao, H; Zandi, P; Lyketsos, CG; Welsh-Bohmer, KA; Norton, MC; Breitner, JCS; Steffens, DC; Tschanz, JT; Cache County Investigators,
MLA Citation
Steinberg, M, Shao, H, Zandi, P, Lyketsos, CG, Welsh-Bohmer, KA, Norton, MC, Breitner, JCS, Steffens, DC, Tschanz, JT, and Cache County Investigators, . "Point and 5-year period prevalence of neuropsychiatric symptoms in dementia: the Cache County Study." Int J Geriatr Psychiatry 23.2 (February 2008): 170-177.
PMID
17607801
Source
pubmed
Published In
International Journal of Geriatric Psychiatry
Volume
23
Issue
2
Publish Date
2008
Start Page
170
End Page
177
DOI
10.1002/gps.1858

Primary care physicians' discussions of weight-related topics with overweight adolescents: Results from the teen chat pilot study

Authors
Pollak, KI; Bravender, T; Alexander, SC; Ostbye, T; Lyna, P; Dolor, R; Coffman, C; Brouwer, RJN; Esoimeme, I; Manusov, JRE; Tulsky, JA
MLA Citation
Pollak, KI, Bravender, T, Alexander, SC, Ostbye, T, Lyna, P, Dolor, R, Coffman, C, Brouwer, RJN, Esoimeme, I, Manusov, JRE, and Tulsky, JA. "Primary care physicians' discussions of weight-related topics with overweight adolescents: Results from the teen chat pilot study." JOURNAL OF ADOLESCENT HEALTH 42.2 (February 2008): S37-S38.
Source
wos-lite
Published In
Journal of Adolescent Health
Volume
42
Issue
2
Publish Date
2008
Start Page
S37
End Page
S38

Joint effect of stroke and APOE 4 on dementia risk: the Canadian Study of Health and Aging.

BACKGROUND: Although stroke and APOE 4 are independent risk factors for dementia, their combined effect remains uncertain. We assessed their joint effect on dementia risk. METHODS: Subjects participated in Phases 1 and 2 of the Canadian Study of Health and Aging (CSHA). Dementia was diagnosed by consensus, and stroke was diagnosed by history or clinical examination. Analyses were first conducted among clinical participants only, and then rerun with the screening sample included as well. RESULTS: Analyses included 949 participants from CSHA-1 and 1,413 from CSHA-2. During a median 4.6-year follow-up, 740 were included in the CSHA-1 to -2 incidence study. Among clinical participants, the highest prevalence (40.6% for CSHA-1 and 57.6% for CSHA-2) and incidence (8.4 per 100 person-years) of dementia occurred in elderly having both stroke and APOE 4; the lowest prevalence (19.8% for CSHA-1 and 23.3% for CSHA-2) and incidence (4.3 per 100 person-years) were among persons having neither. These findings held true when the screening sample was included. The adjusted hazard ratios of incident dementia, relative to elderly with neither stroke nor APOE 4, were 1.33 (95% CI 0.73 to 2.43) for stroke alone, 2.06 (95% CI 1.42 to 2.99) for APOE 4 alone, and 2.57 (95% CI 1.11 to 5.94) for both. No interaction on additive or multiplicative scales was suggested. CONCLUSIONS: The joint presence of stroke and APOE 4 was associated with a greater risk of dementia compared with absence of these two factors. The effect of stroke on dementia does not seem to be modified by APOE 4.

Authors
Jin, YP; Østbye, T; Feightner, JW; Di Legge, S; Hachinski, V
MLA Citation
Jin, YP, Østbye, T, Feightner, JW, Di Legge, S, and Hachinski, V. "Joint effect of stroke and APOE 4 on dementia risk: the Canadian Study of Health and Aging." Neurology 70.1 (January 1, 2008): 9-16.
PMID
17978275
Source
pubmed
Published In
Neurology
Volume
70
Issue
1
Publish Date
2008
Start Page
9
End Page
16
DOI
10.1212/01.wnl.0000284609.77385.03

History of and factors associated with diabetic foot ulcers in Norway: the Nord-Trøndelag Health Study.

AIMS: To determine the proportion of people with diabetes mellitus reporting a history of foot ulcer and to investigate factors associated with this adverse outcome. METHODS: All inhabitants aged 20 years and older residing in a large geographic region were invited to participate in the Nord-Trøndelag Health Study, 71% (n=65,604) attended. Those reporting diabetes (n=1,972) were invited to take part in an ancillary study on diabetes. Based on 1,494 responses to the question: "Have you had a foot ulcer that required more than three weeks to heal'', the proportion with a history of foot ulcer was estimated. RESULTS: The overall proportion with a history of foot ulcer was 10.4% (95% CI 8.8-11.9%). In the final multivariate logistic regression model, significant factors for a foot ulcer history included age > or =75 years (OR 1.8, 95% CI 1.2-2.8), height (men>175 cm, women>161 cm) (1.9, 95% CI 1.3-2.8), gender (male) (1.5, 95% CI 1.03-2.2), using insulin (1.6, 95% CI 1.1-2.4), and macrovascular complications (1.8, 95% CI 1.2-2.6). CONCLUSIONS: The proportion of people reporting a history of foot ulcer in this population-based study exceeded the proportion of foot ulcer history reported previously. Height as a correlate has been occasionally reported in previous studies and needs further attention. Associated factors for a foot ulcer history help identify individuals who may be at particular risk of this adverse outcome.

Authors
Iversen, MM; Midthjell, K; Østbye, T; Tell, GS; Clipp, E; Sloane, R; Nortvedt, MW; Uhlving, S; Hanestad, BR
MLA Citation
Iversen, MM, Midthjell, K, Østbye, T, Tell, GS, Clipp, E, Sloane, R, Nortvedt, MW, Uhlving, S, and Hanestad, BR. "History of and factors associated with diabetic foot ulcers in Norway: the Nord-Trøndelag Health Study." Scand J Public Health 36.1 (January 2008): 62-68.
PMID
18426786
Source
pubmed
Published In
Scandinavian Journal of Public Health (Sage)
Volume
36
Issue
1
Publish Date
2008
Start Page
62
End Page
68
DOI
10.1177/1403494807085314

Tuberculosis knowledge, attitudes, and beliefs among North Carolinians at increased risk of infection.

OBJECTIVE: The purpose of this study was to capture and describe knowledge, attitudes, and beliefs about tuberculosis (TB) among persons at high risk for TB infection. METHODS: We conducted 11 focus groups in 3 different populations at high risk for TB infection: Spanish-speaking immigrants, homeless shelter residents, and persons attending a drug/alcohol rehabilitation center. A standardized list of open-ended questions was used to guide discussion. Using grounded theory, transcripts of the focus group sessions were reviewed by 4 independent reviewers to identify emergent themes. FINDINGS: Participants (N = 52) generally understood that TB is an infectious disease that frequently affects the lungs and can be fatal if untreated. They also knew that a skin test can be used to diagnose TB. However, participants frequently had incorrect beliefs regarding the cause, transmission, and treatment of TB. Many participants thought that TB is transmitted in the same fashion as other infectious diseases such as human immunodeficiency virus or aquired immune deficiency syndrome (HIV/AIDS). A general sentiment of fear and aversion toward persons ill with TB was expressed. LIMITATIONS: Focus groups were a convenience sample and subjects were not necessarily representative of the underlying populations. CONCLUSIONS: Tuberculosis knowledge among high-risk populations is suboptimal, and false beliefs regarding transmission and treatment were common in this study. Knowledge regarding transmission of other infectious diseases such as HIV/AIDS was frequently translated into incorrect knowledge regarding TB. Stigma continues to be a barrier to TB diagnosis and treatment.

Authors
West, EL; Gadkowski, LB; Ostbye, T; Piedrahita, C; Stout, JE
MLA Citation
West, EL, Gadkowski, LB, Ostbye, T, Piedrahita, C, and Stout, JE. "Tuberculosis knowledge, attitudes, and beliefs among North Carolinians at increased risk of infection." N C Med J 69.1 (January 2008): 14-20.
PMID
18429559
Source
pubmed
Published In
North Carolina Medical Journal
Volume
69
Issue
1
Publish Date
2008
Start Page
14
End Page
20

The effect of spousal caregiving and bereavement on depressive symptoms.

The objective of the study was to determine whether spousal caregiving and bereavement increases caregiver depressive symptoms. We followed 1,967 community-dwelling elderly couples from the 1993 Health and Retirement Study (HRS) until 2002 (five bi-annual surveys) or death. Depressive symptoms were measured by the Center for Epidemiological Studies-Depression (CESD) scale. Adjusted depressive symptoms were higher for females for three of the four caregiving arrangements tested (as were unadjusted baseline levels). Depressive symptoms were lowest when neither spouse received caregiving (adjusted CESD of 2.97 for males; 3.44 for females, p<0.001). They were highest when females provided care to their husband with assistance from another caregiver, (4.01) compared to (3.37; p<0.001) when males so cared for their wife. A gender by caregiving arrangements interaction was not significant (p=0.13), showing no differential effect of caregiving on CESD by gender. Depressive symptoms peaked for bereaved spouses within three months of spousal death (4.67; p<0.001) but declined steadily to 2.75 (p<0.001) more than 15 months after death. Depressive symptoms initially increased for the community spouse after institutionalization of the care recipient, but later declined. We conclude that caregiving increases depressive symptoms in the caregiver, but does not have a differential effect by gender. Increases in depressive symptoms following bereavement are short-term.

Authors
Taylor, DH; Kuchibhatla, M; Ostbye, T; Plassman, BL; Clipp, EC
MLA Citation
Taylor, DH, Kuchibhatla, M, Ostbye, T, Plassman, BL, and Clipp, EC. "The effect of spousal caregiving and bereavement on depressive symptoms." Aging Ment Health 12.1 (January 2008): 100-107.
PMID
18297484
Source
pubmed
Published In
Aging & Mental Health
Volume
12
Issue
1
Publish Date
2008
Start Page
100
End Page
107
DOI
10.1080/13607860801936631

Prevalence and awareness of hypertension in an urban township of South Africa: compelling need for action.

Authors
Malhotra, R; Puoane, T; Hoyo, C; Hughes, G; Ostbye, T
MLA Citation
Malhotra, R, Puoane, T, Hoyo, C, Hughes, G, and Ostbye, T. "Prevalence and awareness of hypertension in an urban township of South Africa: compelling need for action." Ethn Dis 18.4 (2008): 401-402. (Letter)
PMID
19157241
Source
pubmed
Published In
Ethnicity & disease
Volume
18
Issue
4
Publish Date
2008
Start Page
401
End Page
402

Determinants of obesity in an urban township of South Africa

Objective: To estimate the prevalence of overweight and obesity, and identity factors associated with Body Mass Index (BMI) and waist circumference (WC) among adults residing in an urban township in South Africa. Design: Cross-sectional study. Setting: Khayelitsha, a large black tow nship located in Cape Town. Subjects: 107 males and 530 females, aged ≥ 18 years. Methods: The pr evalence of overweight/obesity (BMI3 25 kg/m2) and abdominal obesity (WC ≥ 94 cm for men and ≥ 80 cm for women), and their relationship with factors previously found to increase the risk of obesity, such as age, gender, marital status, educational level, employment status, immigrant status from rural to urban, and physical activity level, were assessed using logistic regression analyses. Results: The prevalence of obesity (BMI3 30 kg/m2) was 53.4% and 18.7%, and that of abdominal obesity was 71.5% and 23.4%, among women and men respectively. However, more women (21.3%) than men (11.2%) reported walking more than 45 minutes per day. Female gender and being married were associated with a high BMI and large WC. Recent migration was associated with a smaller WC. The level of physical activity was not associated with BMI or WC. Conclusions: These findings suggest that phy sical activity may play less of a role in obesity control, or that more than 45 minutes of physical activity per day is required to reduce the risk of obesity, especially in women. At least among South African women, obesity control focused on nutritional interventions may be more beneficial than increasing the intensity or duration of physical activity.

Authors
Malhotra, R; Hoyo, C; Østbye, T; Hughes, G; Schwartz, D; Tsolekile, L; Zulu, J; Puoane, T
MLA Citation
Malhotra, R, Hoyo, C, Østbye, T, Hughes, G, Schwartz, D, Tsolekile, L, Zulu, J, and Puoane, T. "Determinants of obesity in an urban township of South Africa." South African Journal of Clinical Nutrition 21.4 (2008): 315-320.
Source
scival
Published In
The South African journal of clinical nutrition : SAJCN : the official journal of the South African Society of Parenteral and Enteral Nutrition and the Association for Dietetics in South Africa
Volume
21
Issue
4
Publish Date
2008
Start Page
315
End Page
320

Preterm birth, long-term survival, and fertility - Reply

Authors
Swamy, GK; Østbye, T; Skjærven, R
MLA Citation
Swamy, GK, Østbye, T, and Skjærven, R. "Preterm birth, long-term survival, and fertility - Reply." JAMA - Journal of the American Medical Association 300.2 (2008): 167-168.
PMID
18612111
Source
scival
Published In
JAMA : the journal of the American Medical Association
Volume
300
Issue
2
Publish Date
2008
Start Page
167
End Page
168
DOI
10.1001/jama.300.2.167-b

Empathy goes a long way in weight loss discussions.

PURPOSE: This study explores how weight-related topics are discussed between physicians and their overweight and obese female patients. METHODS: We surveyed and audio-recorded preventive health and chronic care visits with 25 overweight and obese female patients. We coded both for quantity (content and time) of weight-related discussions and quality (adherence to Motivational Interviewing [MI] techniques). We then tested correlations of these measures with patients' reported attempts to lose weight, change diet, and change exercise patterns 1 month after the visit. RESULTS: Weight was routinely addressed (19 of 25 encounters). Patients usually initiated the topic (67% of time). Physicians' use of MI techniques resulted in patients attempting to lose weight and changing their exercise patterns. CONCLUSION: Physicians may benefit from MI training to help patients lose weight.

Authors
Pollak, KI; Østbye, T; Alexander, SC; Gradison, M; Bastian, LA; Brouwer, RJN; Lyna, P
MLA Citation
Pollak, KI, Østbye, T, Alexander, SC, Gradison, M, Bastian, LA, Brouwer, RJN, and Lyna, P. "Empathy goes a long way in weight loss discussions." J Fam Pract 56.12 (December 2007): 1031-1036.
PMID
18053443
Source
pubmed
Published In
Journal of Family Practice
Volume
56
Issue
12
Publish Date
2007
Start Page
1031
End Page
1036

Missing in action: care by physician assistants and nurse practitioners in national health surveys.

OBJECTIVE: To assess applicability of national health survey data for generalizable research on outpatient care by physician assistants (PAs) and nurse practitioners (NPs). DATA SOURCES: Methodology descriptions and 2003 data files from the National Ambulatory Medical Care Survey, the National Hospital Ambulatory Medical Care Survey, the Medical Expenditure Panel Survey, and the Community Tracking Study. STUDY DESIGN: Surveys were assessed for utility for research on PA and NP patient care, with respect to survey coverage, structure, content, generalizability to the U.S. population, and validity. National estimates of patient encounters, statistically adjusted for survey design and nonresponse, were compared across surveys. DATA COLLECTION/EXTRACTION METHODS: Surveys were identified through literature review, selected according to inclusion criteria, and analyzed based on methodology descriptions. Quantitative analyses used publicly available data downloaded from survey websites. PRINCIPAL FINDINGS: Surveys varied with respect to applicability to PA and NP care. Features limiting applicability included (1) sampling schemes that inconsistently capture nonphysician practice, (2) inaccurate identification of provider type, and (3) data structure that does not support analysis of team practice. CONCLUSIONS: Researchers using national health care surveys to analyze PA and NP patient interactions should account for design features that may differentially affect nonphysician data. Workforce research that includes NPs and PAs is needed for national planning efforts, and this research will require improved survey methodologies.

Authors
Morgan, PA; Strand, J; Østbye, T; Albanese, MA
MLA Citation
Morgan, PA, Strand, J, Østbye, T, and Albanese, MA. "Missing in action: care by physician assistants and nurse practitioners in national health surveys." Health Serv Res 42.5 (October 2007): 2022-2037.
PMID
17850531
Source
pubmed
Published In
Health Services Research
Volume
42
Issue
5
Publish Date
2007
Start Page
2022
End Page
2037
DOI
10.1111/j.1475-6773.2007.00700.x

Changing the organization of health care.

Authors
Østbye, T; Michener, L
MLA Citation
Østbye, T, and Michener, L. "Changing the organization of health care." JAMA 298.3 (July 18, 2007): 286-287. (Letter)
PMID
17635887
Source
pubmed
Published In
JAMA : the journal of the American Medical Association
Volume
298
Issue
3
Publish Date
2007
Start Page
286
End Page
287
DOI
10.1001/jama.298.3.286-b

Autopsy-confirmed Alzheimer's disease versus clinically diagnosed Alzheimer's disease in the Cache County Study on Memory and Aging: a comparison of quantitative MRI and neuropsychological findings.

Atrophy of specific, regional, and generalized brain structures occurs as a result of the Alzheimer's disease (AD) process. Comparing AD patients with histopathological confirmation of the disease at autopsy to those without autopsy but who were clinically diagnosed using the same antemortem criteria will provide further evidence of the utility and accuracy of neuropsychological assessments at the time of diagnosis, as well as the efficacy of quantitative magnetic resonance imaging (qMRI) in demonstrating gross neuropathological changes associated with the disease. The Cache County Study of Aging provides a unique opportunity to determine how closely AD subjects with only the clinical diagnosis match similarly diagnosed AD subjects but with postmortem confirmation of the disease. qMRI volumes of various brain structures, as well as neuropsychological outcome measures from an expanded battery, were obtained in 31 autopsy-confirmed AD subjects and 45 clinically diagnosed AD subjects. Of the various qMRI variables examined, only total temporal lobe volume was different, where those with postmortem confirmation had reduced volume. No significant differences between the two groups were found with any of the neuropsychological outcome measures. These findings confirm the similarity in neuroimaging and neuropsychological assessment findings between those with just the clinical diagnosis of AD and those with an autopsy-confirmed diagnosis in the moderate-to-severe stage of the disease at the time of diagnosis.

Authors
Fearing, MA; Bigler, ED; Norton, M; Tschanz, JA; Hulette, C; Leslie, C; Welsh-Bohmer, K; Cache County Investigators,
MLA Citation
Fearing, MA, Bigler, ED, Norton, M, Tschanz, JA, Hulette, C, Leslie, C, Welsh-Bohmer, K, and Cache County Investigators, . "Autopsy-confirmed Alzheimer's disease versus clinically diagnosed Alzheimer's disease in the Cache County Study on Memory and Aging: a comparison of quantitative MRI and neuropsychological findings." J Clin Exp Neuropsychol 29.5 (July 2007): 553-560.
PMID
17564920
Source
pubmed
Published In
Journal of Clinical and Experimental Neuropsychology
Volume
29
Issue
5
Publish Date
2007
Start Page
553
End Page
560
DOI
10.1080/13803390600826579

Physicians' beliefs about discussing obesity: results from focus groups.

PURPOSE: Physicians are expected to discuss weight loss with overweight and obese patients. Physicians' beliefs, outcome expectancies, and strategies for addressing weight with patients have not been examined. DESIGN: Two focus groups of family physicians and internists included questions about obesity and how physicians discuss weight loss with patients. SETTING/SUBJECTS: Family physicians (n = 11) and internists (n = 6) from Duke University Medical Center's Department of Community and Family Medicine and Department of Medicine. ANALYSIS: Qualitative analysis approach using grounded theory methodology. RESULTS: Physicians' responses centered on five key themes: (1) responsibility, (2) barriers, (3) target populations, (4) introducing topic, and (5) ways to talk about obesity. CONCLUSION: Physicians have many barriers related to discussing weight loss with patients. Given the obesity epidemic, the need to understand how to have these discussions, when to have these discussions, and with whom to have these discussions becomes paramount to providing effective care for patients with obesity. Limited physician training in weight-loss counseling explains why physicians find it challenging to discuss obesity with patients.

Authors
Alexander, SC; Ostbye, T; Pollak, KI; Gradison, M; Bastian, LA; Brouwer, RJN
MLA Citation
Alexander, SC, Ostbye, T, Pollak, KI, Gradison, M, Bastian, LA, and Brouwer, RJN. "Physicians' beliefs about discussing obesity: results from focus groups." Am J Health Promot 21.6 (July 2007): 498-500.
PMID
17674636
Source
pubmed
Published In
American journal of health promotion : AJHP
Volume
21
Issue
6
Publish Date
2007
Start Page
498
End Page
500
DOI
10.4278/0890-1171-21.6.498

Obesity and workers' compensation: results from the Duke Health and Safety Surveillance System.

BACKGROUND: Obese individuals have increased morbidity and use of health services. Less is known about the effect of obesity on workers' compensation. The objective of this study was to determine the relationship between body mass index (BMI) (calculated as weight in kilograms divided by height in meters squared) and number and types of workers' compensation claims, associated costs, and lost workdays. METHODS: Retrospective cohort study. Participants included 11 728 health care and university employees (34 858 full-time equivalents [FTEs]) with at least 1 health risk appraisal between January 1, 1997, and December 31, 2004. The main outcome measures were stratified rates of workers' compensation claims, associated costs, and lost workdays, calculated by BMI, sex, age, race/ethnicity, smoking status, employment duration, and occupational group. The body part affected, nature of the illness or injury, and cause of the illness or injury were also investigated. Multivariate Poisson regression models examined the effects of BMI, controlling for demographic and work-related variables. RESULTS: There was a clear linear relationship between BMI and rate of claims. Employees in obesity class III (BMI >/=40) had 11.65 claims per 100 FTEs, while recommended-weight employees had 5.80; the effect on lost workdays (183.63 vs 14.19 lost workdays per 100 FTEs), medical claims costs ($51 091 vs $7503 per 100 FTEs), and indemnity claims costs ($59 178 vs $5396 per 100 FTEs) was even stronger. The claims most strongly affected by BMI were related to the following: lower extremity, wrist or hand, and back (body part affected); pain or inflammation, sprain or strain, and contusion or bruise (nature of the illness or injury); and falls or slips, lifting, and exertion (cause of the illness or injury). The combination of obesity and high-risk occupation was particularly detrimental. CONCLUSIONS: Maintaining healthy weight not only is important to workers but should also be a high priority for their employers given the strong effect of BMI on workers' injuries. Complementing general interventions to make all workplaces safer, work-based programs targeting healthy eating and physical activity should be developed and evaluated.

Authors
Ostbye, T; Dement, JM; Krause, KM
MLA Citation
Ostbye, T, Dement, JM, and Krause, KM. "Obesity and workers' compensation: results from the Duke Health and Safety Surveillance System." Arch Intern Med 167.8 (April 23, 2007): 766-773.
PMID
17452538
Source
pubmed
Published In
Archives of internal medicine
Volume
167
Issue
8
Publish Date
2007
Start Page
766
End Page
773
DOI
10.1001/archinte.167.8.766

Racial disparities in diabetes a century ago: evidence from the pension files of US Civil War veterans.

Using a comprehensive database constructed from the pension files of US Civil War veterans, we explore characteristics and occurrence of type 2 diabetes among older black and white males, living circa 1900. We find that rates of diagnosed diabetes were much lower among males in this period than a century later. In contrast to the late 20th Century, the rates of diagnosed diabetes were lower among black than among white males, suggesting that the reverse pattern is of relatively recent origin. Two-thirds of both white and black veterans had body-mass indexes (BMIs) in the currently recommended weight range, a far higher proportion than documented by recent surveys. Longevity among persons with diabetes was not reduced among Civil War veterans, and those with diabetes suffered comparatively few sequelae of the condition. Over 90% of black veterans engaged in low paying, high-physical effort jobs, as compared to about half of white veterans. High rates of work-related physical activity may provide a partial explanation of low rates of diagnosed diabetes among blacks. We found no evidence of discrimination in testing by race, as indicated by rates of examinations in which a urinalysis was performed. This dataset is valuable for providing a national benchmark against which to compare modern diabetes prevalence patterns.

Authors
Humphreys, M; Costanzo, P; Haynie, KL; Ostbye, T; Boly, I; Belsky, D; Sloan, F
MLA Citation
Humphreys, M, Costanzo, P, Haynie, KL, Ostbye, T, Boly, I, Belsky, D, and Sloan, F. "Racial disparities in diabetes a century ago: evidence from the pension files of US Civil War veterans." Soc Sci Med 64.8 (April 2007): 1766-1775.
PMID
17240029
Source
pubmed
Published In
Social Science & Medicine
Volume
64
Issue
8
Publish Date
2007
Start Page
1766
End Page
1775
DOI
10.1016/j.socscimed.2006.12.004

Affective mental health and the risk of fracture in the Canadian study of health-and aging.

Authors
Whitson, HE; Pieper, CE; Ostbye, T; Sanders, L; Gold, DT; Lyles, KW
MLA Citation
Whitson, HE, Pieper, CE, Ostbye, T, Sanders, L, Gold, DT, and Lyles, KW. "Affective mental health and the risk of fracture in the Canadian study of health-and aging." April 2007.
Source
wos-lite
Published In
Journal of American Geriatrics Society
Volume
55
Issue
4
Publish Date
2007
Start Page
S144
End Page
S144

Predicting antipsychotic use in children.

UNLABELLED: Psychotropic medications are increasingly being used by children and adolescents. In an earlier report, we noted that boys were receiving atypical antipsychotics more frequently than were girls, (70% of the claims). Since diagnosis was not available in the data, we were unable to ascertain the reasons for this. In the present analysis, we examined a large clinical mental health database to ascertain the reason for antipsychotic use.We evaluated the extent to which race, gender, age and type of diagnosis accounted for atypical antipsychotic use in children. METHODS: The authors used an anonymous clinical database created at Duke University Medical Center. The database is based on the clinical document of care in the Department of Psychiatry. The data are de-identified per HIPAA guidelines and has an IRB exemption for use in clinical research. Patients analyzed were seen from 1999 to 2005 and were below the age of 18 at the time of clinical care. A total 3,268 patients, with a total of 7,701 visits comprise the analysis sample. Age, gender, race, and diagnosis were extracted as predictors of use of atypical antipsychotics. RESULTS: Males and older children were also more likely to use an atypical. African Americans were slightly more likely to use an atypical than whites. Patients whose diagnoses were classified as either psychotic or internalizing were also more likely to use an antipsychotic. CONCLUSION: The underlying reasons for the high level of use of atypicals in boys and in African Americans need to be investigated further.

Authors
Gersing, K; Burchett, B; March, J; Ostbye, T; Krishnan, KRR
MLA Citation
Gersing, K, Burchett, B, March, J, Ostbye, T, and Krishnan, KRR. "Predicting antipsychotic use in children." Psychopharmacol Bull 40.3 (2007): 116-124.
PMID
18007573
Source
pubmed
Published In
Psychopharmacology bulletin
Volume
40
Issue
3
Publish Date
2007
Start Page
116
End Page
124

Couples' reports of support for smoking cessation predicting women's late pregnancy cessation.

PURPOSE: Although social support has been linked to smoking cessation, no studies have examined whether social support predicts women's late pregnancy cessation. Further, few have included reports from both support recipients and providers. DESIGN: Longitudinal. SUBJECTS: Pregnant couples (n = 394) reported support for cessation in early (13-20 weeks) and late (28 weeks) pregnancy. MEASURES: Different measures of couples' support were tested for predicting women's late pregnancy, cessation. Measures of couples' support that were calculated included: summative (added women's and male partners' support scores, possible range 2-10), difference (subtracted the lower score from the higher, possible range 0-4), strong link (used higher positive or lower negative score, possible range 1-5), weak link (lower positive or higher negative score, possible range 1-5), and female and male reports alone (possible ranges 1-5). Covariate-adjusted odds ratios for the association of these various measures of couples' support with women's late pregnancy cessation were calculated. RESULTS: Of the 12 scores (6 positive, 6 negative), only summative (p = .03) and weak link (p = .05) for positive support predicted women's quitting. CONCLUSION: Neither women's nor male partners' reports alone predicted women's cessation; only when both scores were considered, either by adding the scores or by taking the lower score, was the positive support score predictive. Future studies of social support should include support recipients' and providers' perspectives.

Authors
Pollak, KI; Baucom, DH; Palmer, CA; Peterson, BL; Ostbye, T; Stanton, S
MLA Citation
Pollak, KI, Baucom, DH, Palmer, CA, Peterson, BL, Ostbye, T, and Stanton, S. "Couples' reports of support for smoking cessation predicting women's late pregnancy cessation." Am J Health Promot 21.2 (November 2006): 90-96.
PMID
17152247
Source
pubmed
Published In
American journal of health promotion : AJHP
Volume
21
Issue
2
Publish Date
2006
Start Page
90
End Page
96
DOI
10.4278/0890-1171-21.2.90

Use of email in a family practice setting: opportunities and challenges in patient- and physician-initiated communication.

BACKGROUND: Electronic mail (email) has the potential to improve communication between physicians and patients. METHODS: We conducted two research studies in a family practice setting: 1) a brief, anonymous patient survey of a convenience sample to determine the number of clinic patients receptive to communicating with their physician via email, and 2) a randomized, controlled pilot study to assess the feasibility of providing health education via email to family practice patients. RESULTS: Sixty-eight percent of patients used email, and the majority of those (80%) were interested in using email to communicate with the clinic. The majority also reported that their email address changed less frequently than their home address (65%, n = 173) or telephone number (68%, n = 181). Forty-two percent were willing to pay an out-of-pocket fee to have email access to their physicians. When evaluating email initiated by the clinic, 26% of otherwise eligible patients could not participate because they lacked email access; those people were more likely to be black and to be insured through Medicaid. Twenty-four subjects agreed to participate, but one-third failed to return the required consent form by mail. All participants who received the intervention emails said they would like to receive health education emails in the future. CONCLUSION: Our survey results show that patients are interested in email communication with the family practice clinic. Our feasibility study also illustrates important challenges in physician-initiated electronic communication. The 'digital divide' - decreased access to electronic technologies in lower income groups - is an ethical concern in the use of email for patient-physician communication.

Authors
Virji, A; Yarnall, KSH; Krause, KM; Pollak, KI; Scannell, MA; Gradison, M; Østbye, T
MLA Citation
Virji, A, Yarnall, KSH, Krause, KM, Pollak, KI, Scannell, MA, Gradison, M, and Østbye, T. "Use of email in a family practice setting: opportunities and challenges in patient- and physician-initiated communication. (Published online)" BMC Med 4 (August 15, 2006): 18-.
PMID
16911780
Source
pubmed
Published In
BMC Medicine
Volume
4
Publish Date
2006
Start Page
18
DOI
10.1186/1741-7015-4-18

Tuberculosis knowledge and attitudes among physicians who treat young children in North Carolina, USA.

SETTING: North Carolina, USA. OBJECTIVE: To understand physicians' knowledge and attitudes toward the treatment of young children with latent tuberculosis infection (LTBI) in a low-incidence region. DESIGN: Cross-sectional survey of 525 pediatricians and 525 family practitioners in North Carolina. RESULTS: Of 1050 surveys mailed, 149 (14%) were returned. In the previous year, 96% of responding physicians had treated children who had emigrated from a tuberculosis (TB) endemic country. During the last 2 years, 84% of physicians had not diagnosed any young children with TB disease, and 46% had not treated any young children with LTBI. Most (83%) physicians routinely placed tuberculin skin tests (TSTs), and 26% reported placing > 10 TSTs per month. Experience in treating children with LTBI was the only predictor of TB knowledge. Physicians were particularly confused about two issues: 1) TST among bacille Calmette-Guérin (BCG) vaccinated children and 2) treatment of young children with recent exposure to an adult with infectious TB. CONCLUSIONS: Knowledge of important issues related to management of LTBI in children aged < 5 years was limited among physicians in an area with relatively low TB incidence. Creative methods must be developed to help physicians in low-incidence areas to appropriately diagnose and treat LTBI among young children.

Authors
Stout, JE; Ostbye, T; Walter, EB; Hamilton, CD
MLA Citation
Stout, JE, Ostbye, T, Walter, EB, and Hamilton, CD. "Tuberculosis knowledge and attitudes among physicians who treat young children in North Carolina, USA." Int J Tuberc Lung Dis 10.7 (July 2006): 783-788.
PMID
16848341
Source
pubmed
Published In
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease
Volume
10
Issue
7
Publish Date
2006
Start Page
783
End Page
788

The Kate B. Reynolds smoking education lifestyle fitness improvement program: Preventing and reducing chronic disease in low-income North Carolina communities.

Authors
Sauer, ML; Frank, JH; Michener, JL; Yaggy, SD; Ostbye, T
MLA Citation
Sauer, ML, Frank, JH, Michener, JL, Yaggy, SD, and Ostbye, T. "The Kate B. Reynolds smoking education lifestyle fitness improvement program: Preventing and reducing chronic disease in low-income North Carolina communities." N C Med J 67.4 (July 2006): 317-323.
PMID
17066667
Source
pubmed
Published In
North Carolina Medical Journal
Volume
67
Issue
4
Publish Date
2006
Start Page
317
End Page
323

The reciprocal risks of stroke and cognitive impairment in an elderly population.

BACKGROUND: Stroke, dementia, and cognitive impairment no dementia (CIND) pose major threats to the elderly but have rarely been studied together in the same population. We aimed to compare the relative frequencies of stroke, CIND, and dementia in an elderly population and to examine whether cognitive impairment poses a risk for stroke. METHODS: Prevalences of stroke, CIND, and dementia were estimated among participants in the first clinical examination of the Canadian Study of Health and Aging (CSHA-1, n = 2,914). Incidence rates were determined at the 5-year follow-up (CSHA-2) among those cognitively normal and stroke free at CSHA-1 (n = 828). The associations between cognitive impairment and stroke were assessed by Cox regression analyses. RESULTS: Among elderly Canadians, the age-standardized prevalence of stroke, CIND, and dementia were 8%, 17%, and 8%, respectively. Alone or combined, they affected one fourth of the elderly. Among stroke survivors, 64% had cognitive impairment compared with 21% among stroke-free persons. Among the cognitively impaired, 25% had a stroke compared with 4% among the cognitively normal. The incidence rates of stroke, CIND, and dementia were 3, 6, and 3 per 100 person-years, respectively. Compared with cognitively normal subjects, the adjusted risk for incident stroke was 1.3 (95% confidence interval [CI], 0.9 to1.9) in patients with CIND and 2.3 (95% CI, 1.7 to 3.2) in patients with dementia regardless of whether "questionable stroke" was included. CONCLUSIONS: Stroke and cognitive impairment pose risk for each other. CIND is highly prevalent, and some of its subtypes may represent treatable preludes to stroke and/or dementia.

Authors
Jin, Y-P; Di Legge, S; Ostbye, T; Feightner, JW; Hachinski, V
MLA Citation
Jin, Y-P, Di Legge, S, Ostbye, T, Feightner, JW, and Hachinski, V. "The reciprocal risks of stroke and cognitive impairment in an elderly population." Alzheimers Dement 2.3 (July 2006): 171-178.
PMID
19595880
Source
pubmed
Published In
Alzheimer's & Dementia
Volume
2
Issue
3
Publish Date
2006
Start Page
171
End Page
178
DOI
10.1016/j.jalz.2006.03.006

A longitudinal study of the relationship between health behavior risk factors and dependence in activities of daily living.

OBJECTIVES: The purpose of this study was to shed further light on the effect of modifiable health behavior risk factors on dependence in activities of daily living, defined in a multidimensional fashion. METHODS: The study participants were 10,278 middle aged Americans in a longitudinal health study, the Health and Retirement Survey (HRS). A multi-stage probability sampling design incorporating the effect of population sizes (Metropolitan and non-metropolitan), ethnicity (the non-Hispanic White, the Hispanic, and the Black), and age (age 51-61) was utilized. Basic Activities of Daily Living (ADL) were measured using five activities necessary for survival (impairment in dressing, eating, bathing, sleeping, and moving across indoor spaces). Explanatory variables were four health behavior risk factors included smoking, exercise, Body Mass Index (BMI), and alcohol consumption. RESULTS: Most participants at baseline were ADL independent (1992). 97.8% of participants were independent in all ADL's at baseline and 78.2% were married. Approximately 27.5% were current smokers at baseline, and the subjects reported moderate or heavy exercise were 74.8%. All demographic characteristics and behavioral risk factors were significantly associated with the ADL status at Wave 4 except alcohol consumption. Risk behaviors such as current smoking, sedentary life style and high BMI at Wave 1 were associated with ADL status deterioration; however, moderate alcohol consumption tended to be more related to better ADL status than abstaining at Wave 4. ADL status at Wave 1 was the strongest factor and the next was exercise and smoking affecting ADL status at Wave 4. People who were in ADL dependent at Wave 1 were 15.17 times more likely to be ADL dependent at Wave 4 than people who were in ADL independent at Wave 1. Concerning smoking cigarettes, people who kept only light exercise or sedentary life style at Wave 1 were 1.70 times more likely to be died at Wave 4 than the people who did not smoke at Wave 1. CONCLUSIONS: All demographics and health behaviors at wave 1 had consistently similar OR trends for ADL status to each other except alcohol consumption. Smoking and exercise in health behaviors, and age and gender in demographics at Wave 1 were significant factors associated with ADL group separation at Wave 4.

Authors
Jung, S-H; Ostbye, T; Park, K-O
MLA Citation
Jung, S-H, Ostbye, T, and Park, K-O. "A longitudinal study of the relationship between health behavior risk factors and dependence in activities of daily living." J Prev Med Public Health 39.3 (May 2006): 221-228.
PMID
16764496
Source
pubmed
Published In
Journal of preventive medicine and public health = Yebang Uihakhoe chi
Volume
39
Issue
3
Publish Date
2006
Start Page
221
End Page
228

Alternative models for academic family practices.

BACKGROUND: The Future of Family Medicine Report calls for a fundamental redesign of the American family physician workplace. At the same time, academic family practices are under economic pressure. Most family medicine departments do not have self-supporting practices, but seek support from specialty colleagues or hospital practice plans. Alternative models for academic family practices that are economically viable and consistent with the principles of family medicine are needed. This article presents several "experiments" to address these challenges. METHODS: The basis of comparison is a traditional academic family medicine center. Apart of the faculty practice plan, our center consistently operated at a deficit despite high productivity. A number of different practice types and alternative models of service delivery were therefore developed and tested. They ranged from a multi-specialty office arrangement, to a community clinic operated as part of a federally-qualified health center, to a team of providers based in and providing care for residents of an elderly public housing project. Financial comparisons using consistent accounting across models are provided. RESULTS: Academic family practices can, at least in some settings, operate without subsidy while providing continuity of care to a broad segment of the community. The prerequisites are that the clinicians must see patients efficiently, and be able to bill appropriately for their payer mix. CONCLUSION: Experimenting within academic practice structure and organization is worthwhile, and can result in economically viable alternatives to traditional models.

Authors
Michener, JL; Østbye, T; Kaprielian, VS; Krause, KM; Yarnall, KSH; Yaggy, SD; Gradison, M
MLA Citation
Michener, JL, Østbye, T, Kaprielian, VS, Krause, KM, Yarnall, KSH, Yaggy, SD, and Gradison, M. "Alternative models for academic family practices. (Published online)" BMC Health Serv Res 6 (March 20, 2006): 38-.
PMID
16549030
Source
pubmed
Published In
BMC Health Services Research
Volume
6
Publish Date
2006
Start Page
38
DOI
10.1186/1472-6963-6-38

Is self-reported stroke history reliable in elderly with cognitive impairment? A community-based study

Authors
Jin, YP; Di Legge, S; Ostbye, T; Feightner, JW; Saposnik, G; Hachinski, V
MLA Citation
Jin, YP, Di Legge, S, Ostbye, T, Feightner, JW, Saposnik, G, and Hachinski, V. "Is self-reported stroke history reliable in elderly with cognitive impairment? A community-based study." March 14, 2006.
Source
wos-lite
Published In
Neurology
Volume
66
Issue
5
Publish Date
2006
Start Page
299
End Page
300

Dietary intake of overweight or obese women enrolled in an intervention program to lose postpartum weight.

Authors
Durham, H; Lovelady, C; Ayella, H; Harvin, M; Ostbye, T; Brouwer, R; Chowdhary, J; Krause, K
MLA Citation
Durham, H, Lovelady, C, Ayella, H, Harvin, M, Ostbye, T, Brouwer, R, Chowdhary, J, and Krause, K. "Dietary intake of overweight or obese women enrolled in an intervention program to lose postpartum weight." March 7, 2006.
Source
wos-lite
Published In
The FASEB journal : official publication of the Federation of American Societies for Experimental Biology
Volume
20
Issue
5
Publish Date
2006
Start Page
A1030
End Page
A1030

Obesity and sexual quality of life.

OBJECTIVES: Reduced sexual quality of life is a frequently reported yet rarely studied consequence of obesity. The objectives of this study were to 1) examine the prevalence of sexual quality-of-life difficulties in obese individuals and 2) investigate the association between sexual quality of life and BMI class, sex, and obesity treatment-seeking status. RESEARCH METHODS AND PROCEDURES: Subjects consisted of 1) 500 participants in an intensive residential program for weight loss and lifestyle modification (BMI = 41.3 kg/m2), 2) 372 patients evaluated for gastric bypass surgery (BMI = 47.1 kg/m2), and 3) 286 obese control subjects not seeking weight loss treatment (BMI = 43.6 kg/m2). Participants completed the Impact of Weight on Quality of Life-Lite, a measure of weight-related quality of life. Responses to the four Sexual Life items (assessing enjoyment, desire, performance, and avoidance) were analyzed by BMI, sex, and group. RESULTS: Higher BMI was associated with greater impairments in sexual quality of life. Obese women reported more impairment in sexual quality of life than obese men for three of four items. Gastric bypass surgery candidates reported more impairment in sexual quality of life than residential patients and controls for most items. In general, residential patients reported levels of impairment greater than or equal to controls. DISCUSSION: Obesity is associated with lack of enjoyment of sexual activity, lack of sexual desire, difficulties with sexual performance, and avoidance of sexual encounters. Sexual quality of life is most impaired for women, individuals with Class III obesity, and patients seeking gastric bypass surgery.

Authors
Kolotkin, RL; Binks, M; Crosby, RD; Østbye, T; Gress, RE; Adams, TD
MLA Citation
Kolotkin, RL, Binks, M, Crosby, RD, Østbye, T, Gress, RE, and Adams, TD. "Obesity and sexual quality of life." Obesity (Silver Spring) 14.3 (March 2006): 472-479.
PMID
16648619
Source
pubmed
Published In
Obesity (Silver Spring, Md.)
Volume
14
Issue
3
Publish Date
2006
Start Page
472
End Page
479
DOI
10.1038/oby.2006.62

Ten dimensions of health and their relationships with overall self-reported health and survival in a predominately religiously active elderly population: the cache county memory study.

OBJECTIVES: To document the extent of healthy aging along 10 different dimensions in a population known for its longevity. DESIGN: A cohort study with baseline measures of overall self-reported health and health along 10 specific dimensions; analyses investigated the 10 dimensions as predictors of self-reported health and 10-year mortality. SETTING: Cache County, Utah, which is among the areas with the highest conditional life expectancy at age 65 in the United States. PARTICIPANTS: Inhabitants of Cache County aged 65 and older (January 1, 1995). MEASUREMENTS: Self-reported overall health and 10 specific dimensions of healthy aging: independent living, vision, hearing, activities of daily living, instrumental activities of daily living, absence of physical illness, cognition, healthy mood, social support and participation, and religious participation and spirituality. RESULTS: This elderly population was healthy overall. With few exceptions, 80% to 90% of persons aged 65 to 75 were healthy according to each measure used. Prevalence of excellent and good self-reported health decreased with age, to approximately 60% in those aged 85 and older. Even in the oldest old, the majority of respondents were independent in activities of daily living. Although vision, hearing, and mood were significant predictors of overall self-reported health in the final models, age, sex, and cognition were significant only in the final survival models. CONCLUSION: This population has a high prevalence of most factors representing healthy aging. The predictors of overall self-reported health are distinct from the predictors of survival in this age group and, being potentially modifiable, are amenable to clinical and public health efforts.

Authors
Østbye, T; Krause, KM; Norton, MC; Tschanz, J; Sanders, L; Hayden, K; Pieper, C; Welsh-Bohmer, KA; Cache County Investigators,
MLA Citation
Østbye, T, Krause, KM, Norton, MC, Tschanz, J, Sanders, L, Hayden, K, Pieper, C, Welsh-Bohmer, KA, and Cache County Investigators, . "Ten dimensions of health and their relationships with overall self-reported health and survival in a predominately religiously active elderly population: the cache county memory study." J Am Geriatr Soc 54.2 (February 2006): 199-209.
PMID
16460369
Source
pubmed
Published In
Journal of American Geriatrics Society
Volume
54
Issue
2
Publish Date
2006
Start Page
199
End Page
209
DOI
10.1111/j.1532-5415.2005.00583.x

Problem-based learning of research skills.

PURPOSE: To determine whether a short-term, problem-based educational intervention leads to increased research activity among health care practitioners. SUBJECTS AND METHODS: Participant's success was evaluated as a composite of 2 outcomes. These were (1) reporting results for the project designed during the practicum and (2) conducting subsequent research activities. The study population included 36 clinical research outcomes projects developed by clinical practitioners, postgraduate trainees, and medical students during 6 separate practicums. All project teams received the same educational intervention, an "outcomes research practicum" that was divided into 4 primary learning modules administered over a 1 to 4 month period. Each module included a preparatory videotape lecture, supplemental readings, and a 90-minute interactive laboratory session during which faculty members worked with participants to develop answers to a series of predefined questions relating to the design of clinical outcomes research projects. Follow-up continued for a minimum of 12 months and a maximum of 36 months. RESULTS: Eighty-three percent of project teams completed all 4 practicum modules, and 69% completed one of the study outcomes (50% completed their research project and 47% completing a subsequent research activity). Practitioners were more likely to complete subsequent research activities, whereas trainees were more likely to complete their study project. DISCUSSION: This short-term, problem-based educational intervention was successful in increasing the collective research activities of participants. Further, more rigorous structured research is needed to determine the ultimate impact on practice change and patient outcomes.

Authors
Davis, TH; Wagner, GS; Gleim, G; Andolsek, KM; Arheden, H; Austin, R; Courtney-Eighmy, A; Gradison, M; Leist, JC; Maynard, C; Noga, EM; Ostbye, T; Eisenstein, EL
MLA Citation
Davis, TH, Wagner, GS, Gleim, G, Andolsek, KM, Arheden, H, Austin, R, Courtney-Eighmy, A, Gradison, M, Leist, JC, Maynard, C, Noga, EM, Ostbye, T, and Eisenstein, EL. "Problem-based learning of research skills." J Electrocardiol 39.1 (January 2006): 120-128.
PMID
16387065
Source
pubmed
Published In
Journal of Electrocardiology
Volume
39
Issue
1
Publish Date
2006
Start Page
120
End Page
128
DOI
10.1016/j.jelectrocard.2005.06.107

A population-based study of the association between coronary artery bypass graft surgery (CABG) and cognitive decline: The Cache County Study

Background: The relationship between coronary artery bypass graft (CABG) surgery and cognitive decline remains uncertain, in particular with regard to whether there is delayed cognitive decline associated with this procedure. Methods: This was a population-based cohort study involving participants in the Cache County Study of Memory Health and Aging. At baseline the study enrolled 5,092 persons age 65 and older and followed them up three years later and again four years after that. Individuals who reported having undergone CABG surgery at study baseline or had this surgery in between follow-up waves were compared to individuals who never reported having the surgery. The main outcome measure was the Modified Mini Mental State (3MS). Multilevel models were used to examine the relationship between CABG surgery and cognitive decline over time. Results: Study participants who had CABG surgery evidenced 0.95 points of greater decline relative to baseline on the 3MS at the first follow-up interview after CABG, and an average of 1.9 points of greater decline at the second follow-up interview, than those without CABG (t = -2.51, df = 2,316, p = 0.0121), after adjusting for several covariates, including number of vascular conditions. This decline was restricted to individuals who were more than five years past the procedure and was not evident in the early years after the surgery. Conclusions: CABG surgery is associated with accelerated cognitive decline more than five years after the procedure in a long-lived population. This decline is small and its clinical significance is uncertain. We could not find an association between CABG and decline in the first five post-operative years. Copyright © 2006 John Wiley & Sons, Ltd.

Authors
Lyketsos, CG; Toone, L; Tschanz, J; Corcoran, C; Norton, M; Zandi, P; Munger, R; Breitner, JCS; Welsh-Bohmer, K; Anthony, J; Bigler, E; Burke, J; Green, RC; Klien, L; Townsend, JJ; Rabins, PV; Steinberg, M; Østbye, T; Pieper, C; Plassman, B; Steffens, DC; Leslie, C; Wyse, BW; Williams, M; Onyike, CU
MLA Citation
Lyketsos, CG, Toone, L, Tschanz, J, Corcoran, C, Norton, M, Zandi, P, Munger, R, Breitner, JCS, Welsh-Bohmer, K, Anthony, J, Bigler, E, Burke, J, Green, RC, Klien, L, Townsend, JJ, Rabins, PV, Steinberg, M, Østbye, T, Pieper, C, Plassman, B, Steffens, DC, Leslie, C, Wyse, BW, Williams, M, and Onyike, CU. "A population-based study of the association between coronary artery bypass graft surgery (CABG) and cognitive decline: The Cache County Study." International Journal of Geriatric Psychiatry 21.6 (2006): 509-518.
PMID
16645936
Source
scival
Published In
International Journal of Geriatric Psychiatry
Volume
21
Issue
6
Publish Date
2006
Start Page
509
End Page
518
DOI
10.1002/gps.1502

Long term effects of prematurity: Results from the medical birth registry of Norway

Authors
Swamy, GK; Ostbye, T; Skjaerven, R
MLA Citation
Swamy, GK, Ostbye, T, and Skjaerven, R. "Long term effects of prematurity: Results from the medical birth registry of Norway." December 2005.
Source
wos-lite
Published In
American Journal of Obstetrics & Gynecology
Volume
193
Issue
6
Publish Date
2005
Start Page
S35
End Page
S35
DOI
10.1016/j.ajog.2005.10.092

Body Mass Index (BMI), BMI change and mortality in community-dwelling seniors without dementia.

UNLABELLED: Recently Canada adopted the World Health Organization's (WHO)Weight Classification system for Body Mass Index (BMI). To date, there has been minimal investigation on the predictive ability of BMI on mortality in seniors. This study investigates the predictive ability of the BMI categories identified in this Weight Classification System and change in BMI on mortality in Canadian seniors. METHODS: Canadian Study of Health and Aging (CSHA) participants who completed clinical examination (including body weight measurements) in 1991 (CSHA1) and 1996 (CSHA2) were included (n = 539). BMI change (CSHA1 to CSHA2) was categorized as no change/mild increase (0 to < 2.0 units), mild decrease (-0.1 to < -2.0 units), or significant increase/decrease (> or = +/-2.0 units). The outcome was subsequent 5-year-mortality, i.e. death between CSHA2 and CSHA3 (2001). Logistic regression controlled for age, gender, education level, marital status, smoking and cognitive status. RESULTS: BMI at CSHA1 was not a significant predictor of all-cause mortality between CSHA2 and CSHA3. A significant decrease in BMI regardless of BMI category predicted death (OR 2.10 95% CI 1.17, 3.80). Other factors predictive of death were age and cognitive impairment without dementia. CONCLUSION: A static measure of BMI is a less useful measure of mortality risk than weight change in older adults. Weight change, especially weight loss resulting in a BMI change of at least 2.0 units, is predictive of mortality and should be considered a warning sign.

Authors
Keller, HH; Østbye, T
MLA Citation
Keller, HH, and Østbye, T. "Body Mass Index (BMI), BMI change and mortality in community-dwelling seniors without dementia." J Nutr Health Aging 9.5 (September 2005): 316-320.
PMID
16222397
Source
pubmed
Published In
The Journal of Nutrition Health and Aging
Volume
9
Issue
5
Publish Date
2005
Start Page
316
End Page
320

Associations between obesity and receipt of screening mammography, Papanicolaou tests, and influenza vaccination: results from the Health and Retirement Study (HRS) and the Asset and Health Dynamics Among the Oldest Old (AHEAD) Study.

OBJECTIVES: Obese Americans, who receive more care for chronic diseases, may receive fewer preventive services. We evaluated the association between body mass index (BMI) and receipt of screening mammography and Papanicolaou tests among middle-aged women and the association between BMI and receipt of influenza vaccination among the elderly. METHODS: We analyzed 2 datasets: the Health and Retirement Study (4439 women aged 50-61 years) and the Asset and Health Dynamics Among the Oldest Old (AHEAD) Study (4045 women and 2154 men aged 70 years or more). RESULTS: When BMI was greater than 18.5 kg/m2, we found an inverse dose-response relationship between BMI and receipt of screening mammography and Pap tests among White, but not Black, middle-aged women. We found a similar association between BMI and influenza vaccination among the elderly. CONCLUSIONS: Higher BMI was associated with less frequent receipt of preventive services among middle-aged White women and elderly White women and men. The Healthy People 2010 clinical preventive service goals remain elusive, especially for overweight and obese White persons.

Authors
Østbye, T; Taylor, DH; Yancy, WS; Krause, KM
MLA Citation
Østbye, T, Taylor, DH, Yancy, WS, and Krause, KM. "Associations between obesity and receipt of screening mammography, Papanicolaou tests, and influenza vaccination: results from the Health and Retirement Study (HRS) and the Asset and Health Dynamics Among the Oldest Old (AHEAD) Study." Am J Public Health 95.9 (September 2005): 1623-1630.
PMID
16051935
Source
pubmed
Published In
American journal of public health
Volume
95
Issue
9
Publish Date
2005
Start Page
1623
End Page
1630
DOI
10.2105/AJPH.2004.047803

Changes in sexual quality of life in individuals undergoing weight loss treatment - A 2-year longitudinal study

Authors
Binks, M; Kolotkin, R; Ostbye, T; Crosby, R; Hartley, G
MLA Citation
Binks, M, Kolotkin, R, Ostbye, T, Crosby, R, and Hartley, G. "Changes in sexual quality of life in individuals undergoing weight loss treatment - A 2-year longitudinal study." September 2005.
Source
wos-lite
Published In
Obesity research
Volume
13
Publish Date
2005
Start Page
A15
End Page
A15

Active mothers postpartum: Rationale, study design and participation

Authors
Ostbye, T; Krause, K; Chowdhary, J; Brouwer, R; Swamy, G; Carter-Edwards, L; Bastian, L; Lovelady, C; Morey, M
MLA Citation
Ostbye, T, Krause, K, Chowdhary, J, Brouwer, R, Swamy, G, Carter-Edwards, L, Bastian, L, Lovelady, C, and Morey, M. "Active mothers postpartum: Rationale, study design and participation." September 2005.
Source
wos-lite
Published In
Obesity research
Volume
13
Publish Date
2005
Start Page
A196
End Page
A197

Physical & quality of life outcomes one year following participation in a residential lifestyle change program

Authors
Binks, M; Ostbye, T; Eisenson, H; Sha, R; Kolotkin, R; Politi, E; Westman, E
MLA Citation
Binks, M, Ostbye, T, Eisenson, H, Sha, R, Kolotkin, R, Politi, E, and Westman, E. "Physical & quality of life outcomes one year following participation in a residential lifestyle change program." September 2005.
Source
wos-lite
Published In
Obesity research
Volume
13
Publish Date
2005
Start Page
A76
End Page
A76

Population-based study of medical comorbidity in early dementia and "cognitive impairment, no dementia (CIND)": association with functional and cognitive impairment: The Cache County Study.

OBJECTIVE: Authors investigated medical comorbidity in persons with dementia and "Cognitive Impairment, No Dementia" (CIND). METHODS: The Cache County Study is an ongoing population-based study of the epidemiology of dementia, the risk factors for conversion from CIND to dementia, and the progression of dementia. As part of the study's first incidence wave, persons with dementia (N=149), CIND (N=225), or without cognitive impairment (N=321) were identified and studied. Participants received comprehensive clinical evaluations and were rated on the General Medical Health Rating (GMHR), a global measure of seriousness of medical comorbidity. Participants and informants also completed the Mini-Mental State Exam and provided self-report information about comorbid medical conditions and functioning in activities of daily living. RESULTS: There were few differences in number or type of comorbid medical conditions between persons with CIND and dementia, but persons with dementia were prescribed more medications. Stroke was more common in dementia participants, but other illnesses common in old age were not significantly different across cognitive groups. Medical comorbidity was more serious in both dementia and CIND, such that both groups were less likely to have "little to no" comorbidity. Seriousness of medical comorbidity was significantly associated with worse day-to-day functioning and cognition. CONCLUSIONS: Persons with CIND and dementia have more serious medical comorbidity than comparable persons without cognitive impairment. This comorbidity may play a role in the progression of CIND and dementia. Future studies should investigate the role of medical comorbidity and its treatment on dementia onset or progression, as well as the mechanisms mediating its neuropathologic effects.

Authors
Lyketsos, CG; Toone, L; Tschanz, J; Rabins, PV; Steinberg, M; Onyike, CU; Corcoran, C; Norton, M; Zandi, P; Breitner, JCS; Welsh-Bohmer, K; Anthony, J; Østbye, T; Bigler, E; Pieper, C; Burke, J; Plassman, B; Green, RC; Steffens, DC; Klein, L; Leslie, C; Townsend, JJ; Wyse, BW; Munger, R; Williams, M; Cache County Study Group,
MLA Citation
Lyketsos, CG, Toone, L, Tschanz, J, Rabins, PV, Steinberg, M, Onyike, CU, Corcoran, C, Norton, M, Zandi, P, Breitner, JCS, Welsh-Bohmer, K, Anthony, J, Østbye, T, Bigler, E, Pieper, C, Burke, J, Plassman, B, Green, RC, Steffens, DC, Klein, L, Leslie, C, Townsend, JJ, Wyse, BW, Munger, R, Williams, M, and Cache County Study Group, . "Population-based study of medical comorbidity in early dementia and "cognitive impairment, no dementia (CIND)": association with functional and cognitive impairment: The Cache County Study." Am J Geriatr Psychiatry 13.8 (August 2005): 656-664.
PMID
16085781
Source
pubmed
Published In
American Journal of Geriatric Psychiatry
Volume
13
Issue
8
Publish Date
2005
Start Page
656
End Page
664
DOI
10.1176/appi.ajgp.13.8.656

The prevalence and correlates of urinary tract symptoms in Norwegian men: the HUNT study.

OBJECTIVES: To estimate the prevalence of lower urinary tract symptoms (LUTS) by severity (using the International Prostate Symptom Score, IPSS) in a population-based study of men aged > or = 20 years, and to assess the association between putative risk factors and the presence of moderate to severe LUTS. SUBJECTS AND METHODS: Between 1995 and 1997, LUTS data were collected from 21 694 male residents aged > or = 20 years in Nord Trøndelag County in Norway, using the IPSS; from the IPSS (score 0-35) LUTS was defined as a score of > or = 8, indicating moderate to severe symptoms. We estimated the prevalence of LUTS and used logistic regression analysis to study lifestyle and anthropometric factors, and comorbidity related to LUTS. RESULTS: The overall prevalence of moderate to severe LUTS was 15.8% (13.2% moderate and 2.6% severe). The prevalence of LUTS increased strongly with age, from approximately 5% among men aged < 40 years to > 30% when aged > or = 70 years. Factors positively associated with an increased risk of moderate and severe LUTS were anthropometric (body mass index and waist hip ratio) and lifestyle factors (alcohol consumption and smoking), as well as comorbid conditions, including diabetes, history of stroke, muscle complaints and osteoarthritis. CONCLUSION: The findings from this population-based study suggest that the prevalence of LUTS among men aged > or = 20 years may be lower than previously estimated. Although LUTS may be viewed as an inevitable consequence of ageing, it appears to be exacerbated by lifestyle factors and comorbid conditions.

Authors
Seim, A; Hoyo, C; Ostbye, T; Vatten, L
MLA Citation
Seim, A, Hoyo, C, Ostbye, T, and Vatten, L. "The prevalence and correlates of urinary tract symptoms in Norwegian men: the HUNT study." BJU Int 96.1 (July 2005): 88-92.
PMID
15963127
Source
pubmed
Published In
Bju International
Volume
96
Issue
1
Publish Date
2005
Start Page
88
End Page
92
DOI
10.1111/j.1464-410X.2005.05573.x

Identification of VaD and AD prodromes: the Cache County Study.

BACKGROUND: It is unclear whether vascular dementia (VaD) has a cognitive prodrome, akin to the mild cognitive impairment (MCI) prodrome to Alzheimer's dementia (AD). To evaluate whether VaD has a cognitive prodrome, and if it can be differentiated from prodromal AD, we examined neuropsychological test performance of participants in a nested case-control study within a population-based cohort aged 65 or older. METHODS: Participants (n = 485) were identified from the Cache County Study, a large population-based study of aging and dementia. After an average of 3 years of follow-up, a total of 62 incident dementia cases were identified (14 VaD, 48 AD). We identified a number of neuropsychological tests (executive and memory) that discriminated between diagnosed VaD and AD cases. Multivariate analyses sought to differentiate between these same groups 3 years before clinical diagnosis. RESULTS: The Consortium to Establish a Registry for Alzheimer's Disease Word List Recognition Test correct recognition of foils (mean difference, 1.25; 95% confidence interval [CI], 0.42 to 2.07; p < 0.01), Logical Memory I (mean difference, 7.16; 95% CI, 0.78 to 13.55, p < 0.05), Logical Memory II delayed recall (mean difference, 8.67; 95% CI, 1.59 to 15.74, p < 0.05), and percent savings (mean difference, 51.07; 95% CI, 32.58 to 69.56, p < 0.0001) differentiated VaD from AD cases after adjustment for age, sex, education, and dementia severity. Three years before dementia diagnosis, word list recognition ("no" responses mean difference, 1.40; 95% CI, 0.64 to 2.17; p < 0.001, and "yes" responses mean difference, -1.14; 95% CI, -2.14 to -0.13; p < 0.03) discriminated between prodromal VaD and AD. CONCLUSION: These results suggest that VaD has a prodromal syndrome, the cognitive features of which are distinguishable from the cognitive prodrome of AD.

Authors
Hayden, KM; Warren, LH; Pieper, CF; Østbye, T; Tschanz, JT; Norton, MC; Breitner, JCS; Welsh-Bohmer, KA
MLA Citation
Hayden, KM, Warren, LH, Pieper, CF, Østbye, T, Tschanz, JT, Norton, MC, Breitner, JCS, and Welsh-Bohmer, KA. "Identification of VaD and AD prodromes: the Cache County Study." Alzheimers Dement 1.1 (July 2005): 19-29.
PMID
19595812
Source
pubmed
Published In
Alzheimer's & Dementia
Volume
1
Issue
1
Publish Date
2005
Start Page
19
End Page
29
DOI
10.1016/j.jalz.2005.06.002

The impact of own and spouse's urinary incontinence on depressive symptoms.

This study investigated the impact of own and spouse's urinary incontinence on depressive symptoms. Attention was paid to the possibility that gender and caregiving might be important factors in understanding significant effects. We used negative binomial regression to analyze survey data for 9974 middle-aged and older respondents to the Health and Retirement Study in the USA. Results supported the hypothesis that the respondents' own urinary incontinence was associated with depressive symptoms (unadj. IRR = 1.73, 95% CIs = 1.53, 1.95 for men; unadj. IRR = 1.50, 95% CIs = 1.38, 1.63 for women). Controlling sociodemographic and health variables reduced this relationship, but it remained statistically significant for both men and women. Having an incontinent wife put men at greater risk for depressive symptoms (unadj. IRR = 1.13, 95% CIs = 1.02, 1.25), although this relation became nonsignificant with the addition of control variables. No relation between women's depressive symptoms and husbands' (in)continence status was found. Caregiving was not a significant variable in the adjusted analyses, but spouses' depressive symptoms emerged as a significant predictor of the respondents' own depressive symptoms. Health care providers must be sensitive to the emotional impact of urinary incontinence. Our findings also suggest the importance of considering the patient's mental health within a wider context, particularly including the physical and mental health of the patient's spouse.

Authors
Fultz, NH; Rahrig Jenkins, K; Østbye, T; Taylor, DH; Kabeto, MU; Langa, KM
MLA Citation
Fultz, NH, Rahrig Jenkins, K, Østbye, T, Taylor, DH, Kabeto, MU, and Langa, KM. "The impact of own and spouse's urinary incontinence on depressive symptoms." Soc Sci Med 60.11 (June 2005): 2537-2548.
PMID
15814179
Source
pubmed
Published In
Social Science & Medicine
Volume
60
Issue
11
Publish Date
2005
Start Page
2537
End Page
2548
DOI
10.1016/j.socscimed.2004.11.019

Atypical antipsychotic drugs and diabetes mellitus in a large outpatient population: a retrospective cohort study.

PURPOSE: Previous research has suggested an association between use of atypical antipsychotics and onset of diabetes mellitus. We sought to compare the incidence of new onset diabetes among patients receiving atypical antipsychotics, traditional antipsychotics or antidepressants. METHODS: Retrospective cohort study of outpatients with claims for atypical antipsychotics (n = 10 265) compared to controls with claims for traditional antipsychotics (n = 4607), antidepressants (n = 60 856) or antibiotics (n = 59 878) in the administrative claims database of a large pharmaceutical benefit manager between June 2000 and May 2002. Main outcome measures were adjusted and unadjusted incidence rates of diabetes (new cases per 1000 per year) in a 12-month period, as measured using new prescriptions for antidiabetic drugs after a 6-month lead-in period. RESULTS: Annual unadjusted incidence rates of diabetes (new cases per 1000 per year) were 7.5 for atypical antipsychotics, 11.3 for traditional antipsychotics, 7.8 for antidepressants and 5.1 for antibiotics. In multivariable analyses, age, male sex and Chronic Disease Score were associated with greater odds of diabetes onset. There were no statistically significant differences in outcome between the atypical antipsychotic, traditional antipsychotic and antidepressant groups. Multivariable comparisons among specific agents showed increased odds of diabetes for clozapine, olanzapine, ziprasidone and thioridazine (relative to risperidone), but these comparisons did not reach statistical significance. CONCLUSIONS: In a large prescription claims database, outpatients taking atypical antipsychotics did not have higher rates of diabetes onset, compared to subjects taking traditional antipsychotics or antidepressants.

Authors
Østbye, T; Curtis, LH; Masselink, LE; Hutchison, S; Wright, A; Dans, PE; Schulman, KA; Krishnan, RR
MLA Citation
Østbye, T, Curtis, LH, Masselink, LE, Hutchison, S, Wright, A, Dans, PE, Schulman, KA, and Krishnan, RR. "Atypical antipsychotic drugs and diabetes mellitus in a large outpatient population: a retrospective cohort study." Pharmacoepidemiol Drug Saf 14.6 (June 2005): 407-415.
PMID
15372671
Source
pubmed
Published In
Pharmacoepidemiology and Drug Safety
Volume
14
Issue
6
Publish Date
2005
Start Page
407
End Page
415
DOI
10.1002/pds.1016

Do seniors understand their risk of moving to a nursing home?

OBJECTIVE: To determine whether seniors understand their risk of moving to a nursing home. Data Sources. We used longitudinal data from the Asset and Health Dynamics Among the Oldest Old (AHEAD) database. AHEAD is a nationally representative survey (n=8,203) of community dwellers aged 70+ years and their spouses. STUDY DESIGN: We followed respondents for 5 years from the date of the first interview fielded in 1993. Our primary dependent variable was whether respondents moved to a nursing home within 5 years of baseline; self-assessed probability of moving to a nursing home within 5 years, also assessed at baseline, was the primary explanatory variable. PRINCIPAL FINDINGS: We found that seniors who believed they were more likely to move to a nursing home within 5 years were indeed more likely to do so, and that most elders overestimated their likelihood of moving to a nursing home. CONCLUSIONS: Low rates of private long-term care insurance are not plausibly a result of seniors underestimating their personal risk of moving to a nursing home; such an assumption is inherent in many strategies to plan for the future long-term care needs of the baby boom generation.

Authors
Taylor, DH; Osterman, J; Will Acuff, S; Ostbye, T
MLA Citation
Taylor, DH, Osterman, J, Will Acuff, S, and Ostbye, T. "Do seniors understand their risk of moving to a nursing home?." Health Serv Res 40.3 (June 2005): 811-828.
PMID
15960692
Source
pubmed
Published In
Health Services Research
Volume
40
Issue
3
Publish Date
2005
Start Page
811
End Page
828
DOI
10.1111/j.1475-6773.2005.00386.x

Is there time for management of patients with chronic diseases in primary care?

PURPOSE: Despite the availability of national practice guidelines, many patients fail to receive recommended chronic disease care. Physician time constraints in primary care are likely one cause. METHODS: We applied guideline recommendations for 10 common chronic diseases to a panel of 2,500 primary care patients with an age-sex distribution and chronic disease prevalences similar to those of the general population, and estimated the minimum physician time required to deliver high-quality care for these conditions. The result was compared with time available for patient care for the average primary care physician. RESULTS: Eight hundred twenty-eight hours per year, or 3.5 hours a day, were required to provide care for the top 10 chronic diseases, provided the disease is stable and in good control. We recalculated this estimate based on increased time requirements for uncontrolled disease. Estimated time required increased by a factor of 3. Applying this factor to all 10 diseases, time demands increased to 2,484 hours, or 10.6 hours a day. CONCLUSIONS: Current practice guidelines for only 10 chronic illnesses require more time than primary care physicians have available for patient care overall. Streamlined guidelines and alternative methods of service delivery are needed to meet recommended standards for quality health care.

Authors
Østbye, T; Yarnall, KSH; Krause, KM; Pollak, KI; Gradison, M; Michener, JL
MLA Citation
Østbye, T, Yarnall, KSH, Krause, KM, Pollak, KI, Gradison, M, and Michener, JL. "Is there time for management of patients with chronic diseases in primary care?." Ann Fam Med 3.3 (May 2005): 209-214.
PMID
15928223
Source
pubmed
Published In
Annals of family medicine
Volume
3
Issue
3
Publish Date
2005
Start Page
209
End Page
214
DOI
10.1370/afm.310

Prevalence of atypical antipsychotic drug use among commercially insured youths in the United States.

BACKGROUND: Use of atypical antipsychotic medications in pediatric populations is increasing. Although previous studies have presented data by age or sex, none has documented sex-specific prevalence by age group. OBJECTIVE: To estimate the 1-year prevalence of atypical antipsychotic use by age and sex among commercially insured youths in the United States. DESIGN: Period prevalence study, January through December 2001. SETTING: Administrative claims database of a large pharmaceutical benefit manager for 6 213 824 outpatients. MAIN OUTCOME MEASURES: Period prevalence of outpatient prescription claims for atypical antipsychotic drugs among commercially insured, continuously enrolled youths. RESULTS: The prevalence of atypical antipsychotic use was 267.1 per 100 000 subjects aged 19 years and younger (16 599/6 213 824) and was more than twice as high for male patients as for female patients, although male and female patients were nearly equally represented in the overall population. Prevalence peaked at 594.3 per 100 000 subjects among male patients aged 10 to 14 years and 291.0 per 100 000 subjects among female patients aged 15 to 19 years. Nearly one fourth (3830/16 599) of patients with a claim for an atypical antipsychotic were aged 9 years and younger, and nearly 80% of these (3021/3830) were boys. CONCLUSIONS: Although evidence regarding the safety and efficacy of atypical antipsychotics in young children is limited, nearly one fourth of patients with claims for these drugs were aged 9 years or younger, and a large majority of these were boys. Understanding the long-term effects on the developing brain of early and prolonged exposure to atypical antipsychotics is crucial given their use in pediatric populations.

Authors
Curtis, LH; Masselink, LE; Østbye, T; Hutchison, S; Dans, PE; Wright, A; Krishnan, RR; Schulman, KA
MLA Citation
Curtis, LH, Masselink, LE, Østbye, T, Hutchison, S, Dans, PE, Wright, A, Krishnan, RR, and Schulman, KA. "Prevalence of atypical antipsychotic drug use among commercially insured youths in the United States." Arch Pediatr Adolesc Med 159.4 (April 2005): 362-366.
PMID
15809391
Source
pubmed
Published In
Archives of Pediatrics and Adolescent Medicine
Volume
159
Issue
4
Publish Date
2005
Start Page
362
End Page
366
DOI
10.1001/archpedi.159.4.362

Effectiveness of case-based on-line learning of evidence-based practice guidelines.

BACKGROUND: Traditional continuing medical education (CME) has not been successful in improving physicians'practice. This project evaluated the use of e-mail to deliver evidence-based moderated case discussions to family physicians. METHODS: In a randomized controlled trial, 58 southwestern Ontario physicians were recruited and randomly assigned to receive two evidence-based cases (type 2 diabetes, prevention) or were put on a waiting list to receive the same. On-line discussions took place about each case. Data were collected using two knowledge questionnaires, charts audits, and standardized patient visits for each of the two cases. RESULTS: The two groups were similar except for rural/urban and solo versus group practice. The latter was related to outcomes, and analyses were controlled for this variable. The intervention group showed statistically significant improvements compared to the control group for knowledge and chart-audit scores for one of the two cases. CONCLUSIONS: Using a randomized control design, this e-mail CME method demonstrated mixed effectiveness.

Authors
Stewart, M; Marshall, JN; Østbye, T; Feightner, JW; Brown, JB; Harris, S; Galajda, J
MLA Citation
Stewart, M, Marshall, JN, Østbye, T, Feightner, JW, Brown, JB, Harris, S, and Galajda, J. "Effectiveness of case-based on-line learning of evidence-based practice guidelines." Fam Med 37.2 (February 2005): 131-138.
PMID
15690254
Source
pubmed
Published In
Family medicine
Volume
37
Issue
2
Publish Date
2005
Start Page
131
End Page
138

Prevalence and predictors of depression in elderly Canadians: The Canadian Study of Health and Aging.

Depression in elderly Canadians is an important but often unrecognized public health problem. Numerous studies have examined depression in the general community, but studies of depression in the elderly have generally been small and limited. The Canadian Study of Health and Aging (CSHA) includes a large and national representation of both the cognitively intact and the cognitively impaired elderly. The current analyses of 2,341 participants from the CSHA who completed a clinical rating scale for depression have two objectives: 1) to determine the prevalence of minor and major depression and 2) to examine the importance of several risk factors. The prevalences of major and minor depression were 2.6 percent and 4.0 percent, respectively, and were higher for females, specifically those in institutions, those who reported that their health problems limited activities, and those with chronic health conditions. Women were more likely to exhibit depression (OR = 3.5; 95% CI: 1.4-8.8) than men, and those with dementia more likely to exhibit depression than those without (OR = 2.4; 95% CI: 0.9-3.1). Depression is a significant mental health problem among elderly Canadians, particularly among women and those with physical limitations. More attention should be paid to the detection and treatment of depression in the elderly, particularly among those most at risk.

Authors
Østbye, T; Kristjansson, B; Hill, G; Newman, SC; Brouwer, RN; McDowell, I
MLA Citation
Østbye, T, Kristjansson, B, Hill, G, Newman, SC, Brouwer, RN, and McDowell, I. "Prevalence and predictors of depression in elderly Canadians: The Canadian Study of Health and Aging." Chronic diseases in Canada 26.4 (January 2005): 93-99.
PMID
16390626
Source
epmc
Published In
Chronic diseases in Canada
Volume
26
Issue
4
Publish Date
2005
Start Page
93
End Page
99

Re-utilization outcomes and costs of minor acute illness treated at family physician offices, walk-in clinics, and emergency departments.

OBJECTIVE: To examine factors associated with re-utilization of health services and to estimate and compare costs of treatment for minor acute illnesses in family physicians' offices (FPOs), walk-in clinics (WICs), and emergency departments (EDs). DESIGN: Prospective cohort study using questionnaires, telephone follow up, medical chart data, and costs according to Ontario Health Insurance Plan (OHIP) schedules. SETTING: 16 FPOs, 12 WICs, and 13 EDs in three Ontario cities. PARTICIPANTS: Consecutive patients with one of eight predefined minor acute illnesses found in all three settings (upper respiratory infection, pharyngitis, acute bronchitis, acute otitis media, serous otitis media, low back pain, gastroenteritis, and urinary tract infection). MAIN OUTCOME MEASURES: "Early" (< 3 days) versus "later" (3 days to 2 weeks) re-utilization of health services after initial encounter and direct cost to OHIP. RESULTS: The overall rate of re-utilization of health services for the same episode of illness was 11.3% for early and 20.6% for later re-utilization. Factors associated with early re-utilization were initial evaluation in ED setting (odds ratio [OR] = 6.5, confidence interval [CI] = 2.2-19.2) and, regardless of setting, less satisfaction with patient-centred care (OR = 1.7 for each one-point decrease on a four-point scale; CI = 1.1-2.7). Factors associated with later re-utilization were ED setting (OR = 4.9; CI = 2.4-9.9) and diagnosis of urinary tract infection (OR = 2.4; CI = 1.1-5.2). Factors tested and found not signifcantly associated with rate of re-utilization were patients' age, sex, responses to a variety of questions assessing psychosocial factors (stress, social support, independence), and opinions on health care. Cost of care was similar for FPOs and WICs and higher for EDs for all diagnoses. The initial visit was the largest component of cost in all settings, and this component (as well as total cost) was consistently higher in EDs. CONCLUSION: Both re-utilization rates and costs are higher for those seeking care in EDs for minor acute illness. Patient-centred care, an important feature of health care encounters regardless of setting, can reduce re-utilization rates.

Authors
Campbell, MK; Silver, RW; Hoch, JS; Østbye, T; Stewart, M; Barnsley, J; Hutchison, B; Mathews, M; Tyrrell, C
MLA Citation
Campbell, MK, Silver, RW, Hoch, JS, Østbye, T, Stewart, M, Barnsley, J, Hutchison, B, Mathews, M, and Tyrrell, C. "Re-utilization outcomes and costs of minor acute illness treated at family physician offices, walk-in clinics, and emergency departments." Can Fam Physician 51 (January 2005): 82-83.
PMID
16926958
Source
pubmed
Published In
Canadian family physician Medecin de famille canadien
Volume
51
Publish Date
2005
Start Page
82
End Page
83

Re-utilization outcomes and costs of minor acute illness treated at family physician offices, walk-in clinics, and emergency departments

Authors
Campbell, MK; Silver, RW; Hoch, JS; Ostbye, T; Stewart, M; Barnsley, J; Hutchison, B; Mathews, M; Tyrrell, C
MLA Citation
Campbell, MK, Silver, RW, Hoch, JS, Ostbye, T, Stewart, M, Barnsley, J, Hutchison, B, Mathews, M, and Tyrrell, C. "Re-utilization outcomes and costs of minor acute illness treated at family physician offices, walk-in clinics, and emergency departments." CANADIAN FAMILY PHYSICIAN 51 (January 2005): 83-83.
Source
wos-lite
Published In
Canadian family physician Medecin de famille canadien
Volume
51
Publish Date
2005
Start Page
83
End Page
83

Reproducibility of self-reported pap test utilization in middle-aged African-American women.

Both clinicians who perform Pap tests and prescribe re-screens and public health officials, who periodically evaluate the success of Pap test screening programs, often depend on women to self-report their most recent Pap test. However, reliability of self-reported Pap test utilization is putatively low, and even lower in African-American women compared to Whites. Between 2001 and 2002, Pap test screening histories were obtained from 144 African-American women, aged 45 to 64 years at two in-person interviews conducted three to six weeks apart. Reproducibility of self-reported Pap test was substantial (kappa=0.64; 95% confidence interval: .46-.82), with the highest agreement among women with greater income and educational attainment, and those who were younger. This level of reproducibility is likely sufficient both to evaluate the population coverage of public health screening programs and for prescribing re-screens among younger African-American women and those of higher income and education. Not using self-reports to base clinic decisions may still be prudent among those with less education.

Authors
Hoyo, C; Ostbye, T; Skinner, CS; Yarnall, KSH; Chowdhary, J
MLA Citation
Hoyo, C, Ostbye, T, Skinner, CS, Yarnall, KSH, and Chowdhary, J. "Reproducibility of self-reported pap test utilization in middle-aged African-American women." Ethn Dis 15.1 (2005): 84-89.
PMID
15720053
Source
pubmed
Published In
Ethnicity & disease
Volume
15
Issue
1
Publish Date
2005
Start Page
84
End Page
89

The effects of nutrition-related factors on four-year mortality among a biracial sample of community-dwelling elders in the North Carolina piedmont.

The purpose of this epidemiological study was to estimate mortality risk associated with poor diet quality (consumption of five food groups), extremes of body mass index (BMI), waist circumference, and impaired food-related activities of daily living among community-dwelling older Black and White men and women. The design of the current study was a retrospective-prospective cohort study. The sample included residents (n = 1920) of five North Carolina Piedmont counties. The dependent variable was four-year all-cause mortality. Analyses were stratified by gender and race, and controlled covariates included: age, living with others, income, smoking and alcohol use, cognitive status, and overall self-rated health. Data were self-reported to interviewers, except BMI and waist, which were measured by trained interviewers. Difficulty in fixing meals elevated the risk of mortality between 2.7 and 6.5 times across the four gender-race groups. Among older adults, inability to fix a meal conferred more risk of mortality than did lack of financial means. Adequate servings of vegetables were uniformly protective, although significant only among Black males. Neither BMI nor waist circumference conferred significant mortality risk. These population-based findings suggest relationships between nutrition risk factors and mortality that are unique and require further focused studies.

Authors
Hays, JC; Keller, HH; Ostbye, T
MLA Citation
Hays, JC, Keller, HH, and Ostbye, T. "The effects of nutrition-related factors on four-year mortality among a biracial sample of community-dwelling elders in the North Carolina piedmont." J Nutr Elder 25.2 (2005): 41-67.
PMID
17182466
Source
pubmed
Published In
Journal of Nutrition for the Elderly
Volume
25
Issue
2
Publish Date
2005
Start Page
41
End Page
67

A population study of Alzheimer's disease: findings from the Cache County Study on Memory, Health, and Aging.

There are several population-based studies of aging, memory, and dementia being conducted worldwide. Of these, the Cache County Study on Memory, Health and Aging is noteworthy for its large number of "oldest-old" members. This study, which has been following an initial cohort of 5,092 seniors since 1995, has reported among its major findings the role of the Apolipoprotein E gene on modifying the risk for Alzheimer's disease (AD) in males and females and identifying pharmacologic compounds that may act to reduce AD risk. This article summarizes the major findings of the Cache County study to date, describes ongoing investigations, and reports preliminary analyses on the outcome of the oldest-old in this population, the subgroup of participants who were over age 84 at the study's inception.

Authors
Tschanz, JT; Treiber, K; Norton, MC; Welsh-Bohmer, KA; Toone, L; Zandi, PP; Szekely, CA; Lyketsos, C; Breitner, JCS; Cache County Study Group,
MLA Citation
Tschanz, JT, Treiber, K, Norton, MC, Welsh-Bohmer, KA, Toone, L, Zandi, PP, Szekely, CA, Lyketsos, C, Breitner, JCS, and Cache County Study Group, . "A population study of Alzheimer's disease: findings from the Cache County Study on Memory, Health, and Aging." Care Manag J 6.2 (2005): 107-114.
PMID
16544872
Source
pubmed
Published In
Care management journals : Journal of case management ; The journal of long term home health care
Volume
6
Issue
2
Publish Date
2005
Start Page
107
End Page
114

Blood and body fluid exposure risks among health care workers: results from the Duke Health and Safety Surveillance System.

BACKGROUND: Health care workers (HCWs) are at risk of exposures to human blood and body fluids (BBF). Needlestick injuries and splashes place HCWs at risk for numerous blood-borne infections including human immunodeficiency virus (HIV), hepatitis B (HBV), and hepatitis C (HCV). Utilizing a new comprehensive occupational health surveillance system, the objective of this research was to better define the BBF exposure risk and risk factors among employees of a large tertiary medical center. METHODS: A population of 24,425 HCWs employed in jobs with potential BBF exposures was followed for BBF exposure events from 1998 to 2002. BBF exposure rates were calculated for strata defined by age, race, gender, occupation, work location, and duration of employment. Poisson regression was used for detailed analyses of risk factors for BBF exposure. RESULTS: The study population reported 2,730 BBF exposures during the study period, resulting in an overall annual rate of 5.5 events/100 FTEs and a rate of 3.9 for percutaneous exposures. Higher rates were observed for males, persons employed less than 4 years, Hispanic employees, and persons less than 45 years of age. Much higher rates were observed for house staff, nurse anesthetists, inpatient nurses, phlebotomists, and surgical/operating room technicians. Poisson regression results strengthened and extended results from stratified analyses. Rates of percutaneous exposures from hollow needles were found to decrease over the study period; however, exposure rates from suture needles appear to be increasing. CONCLUSION: While continued training efforts need to be directed toward new HCWs, our data also suggest that employees who have been in their job 1-4 years continue to be at higher risk of BBF exposures. This research also points to the need for better safety devices/products and work practices to reduce suture-related injuries.

Authors
Dement, JM; Epling, C; Ostbye, T; Pompeii, LA; Hunt, DL
MLA Citation
Dement, JM, Epling, C, Ostbye, T, Pompeii, LA, and Hunt, DL. "Blood and body fluid exposure risks among health care workers: results from the Duke Health and Safety Surveillance System." Am J Ind Med 46.6 (December 2004): 637-648.
PMID
15551378
Source
pubmed
Published In
American Journal of Industrial Medicine
Volume
46
Issue
6
Publish Date
2004
Start Page
637
End Page
648
DOI
10.1002/ajim.20106

Fractures in the elderly: Predictors, occurrence and consequences: the Canadian Study of Health and Aging (CSHA)

Authors
Ostbye, T; Walton, RE; Steenhuis, R; Hodsman, AB; Krause, KM
MLA Citation
Ostbye, T, Walton, RE, Steenhuis, R, Hodsman, AB, and Krause, KM. "Fractures in the elderly: Predictors, occurrence and consequences: the Canadian Study of Health and Aging (CSHA)." EUROPEAN JOURNAL OF PUBLIC HEALTH 14.4 (December 2004): 86-86.
Source
wos-lite
Published In
European Journal of Public Health
Volume
14
Issue
4
Publish Date
2004
Start Page
86
End Page
86

Diabetes mellitus after atypical antipsychotic agents: a retrospective cohort study of a large outpatient population

Authors
Curtis, L; Ostbye, T; Masselink, LE; Hutchison, S; Wright, A; Dans, PE; Schulman, K; Krishnan, RR
MLA Citation
Curtis, L, Ostbye, T, Masselink, LE, Hutchison, S, Wright, A, Dans, PE, Schulman, K, and Krishnan, RR. "Diabetes mellitus after atypical antipsychotic agents: a retrospective cohort study of a large outpatient population." EUROPEAN JOURNAL OF PUBLIC HEALTH 14.4 (December 2004): 75-75.
Source
wos-lite
Published In
European Journal of Public Health
Volume
14
Issue
4
Publish Date
2004
Start Page
75
End Page
75

Obesity and receipt of pap smear tests among women working in a medical center

Authors
Ostbye, T; Dement, J; Krause, K; Pollak, K
MLA Citation
Ostbye, T, Dement, J, Krause, K, and Pollak, K. "Obesity and receipt of pap smear tests among women working in a medical center." October 2004.
Source
wos-lite
Published In
Obesity research
Volume
12
Publish Date
2004
Start Page
A182
End Page
A183

Obesity and sexual quality of life

Authors
Kolotkin, R; Binks, M; Crosby, R; Ostbye, T
MLA Citation
Kolotkin, R, Binks, M, Crosby, R, and Ostbye, T. "Obesity and sexual quality of life." October 2004.
Source
wos-lite
Published In
Obesity research
Volume
12
Publish Date
2004
Start Page
A77
End Page
A77

The tender point injection trial: A double-blind, randomized comparison of xylocaine versus saline tender point injections in patients with fibromyalgia (FM)

Authors
White, KP; Harth, M; Speechley, M; Ostbye, T; Nielson, W
MLA Citation
White, KP, Harth, M, Speechley, M, Ostbye, T, and Nielson, W. "The tender point injection trial: A double-blind, randomized comparison of xylocaine versus saline tender point injections in patients with fibromyalgia (FM)." September 2004.
Source
wos-lite
Published In
Arthritis and Rheumatism
Volume
50
Issue
9
Publish Date
2004
Start Page
S312
End Page
S312

Inappropriate prescribing for elderly Americans in a large outpatient population.

BACKGROUND: We sought to determine the extent of potentially inappropriate outpatient prescribing for elderly patients, as defined by the Beers revised list of drugs to be avoided in elderly populations. METHODS: We conducted a retrospective cohort study using the outpatient prescription claims database of a large, national pharmaceutical benefit manager. The cohort included 765,423 subjects 65 years or older, who were covered by a pharmaceutical benefit manager and filed 1 or more prescription drug claims during 1999. Main outcome measures were the proportion of subjects who filled a prescription for 1 or more drugs of concern and the proportion of subjects who filled prescriptions for 2 or more of the drugs. RESULTS: A total of 162,370 subjects (21%) filled a prescription for 1 or more drugs of concern. Amitriptyline and doxepin accounted for 23% of all claims for Beers list drugs, and 51% of those claims were for drugs with the potential for severe adverse effects. More than 15% of subjects filled prescriptions for 2 drugs of concern, and 4% filled prescriptions for 3 or more of the drugs within the same year. The most commonly prescribed classes were psychotropic drugs and neuromuscular agents. CONCLUSIONS: The common use of potentially inappropriate drugs should serve as a reminder to monitor their use closely. Pharmaceutical claims databases can be important tools for accomplishing this task, though clinical and laboratory data are needed to improve the sensitivity and specificity of patient-specific alerts.

Authors
Curtis, LH; Østbye, T; Sendersky, V; Hutchison, S; Dans, PE; Wright, A; Woosley, RL; Schulman, KA
MLA Citation
Curtis, LH, Østbye, T, Sendersky, V, Hutchison, S, Dans, PE, Wright, A, Woosley, RL, and Schulman, KA. "Inappropriate prescribing for elderly Americans in a large outpatient population." Arch Intern Med 164.15 (August 9, 2004): 1621-1625.
PMID
15302631
Source
pubmed
Published In
Archives of internal medicine
Volume
164
Issue
15
Publish Date
2004
Start Page
1621
End Page
1625
DOI
10.1001/archinte.164.15.1621

A problem-based approach to teaching outcomes research in family medicine residency.

OBJECTIVE: This study's objective was to introduce research concepts and skills in family medicine residency through a problem-based course. METHODS: Eight third-year residents per year in 3 academic years participated. Groups of two-three were presented with the task of developing, executing, and reporting on a small research project within the family medicine clinic. RESULTS: Residents' research skills and attitudes toward research improved. The projects resulted in successful presentations to colleagues and submissions to national conferences and peer-reviewed journals. CONCLUSIONS: This problem- based approach to research education for family medicine residents is productive and enjoyable.

Authors
Ostbye, T; Krause, KM; Gradison, M; Eisenstein, EL; Wagner, GS
MLA Citation
Ostbye, T, Krause, KM, Gradison, M, Eisenstein, EL, and Wagner, GS. "A problem-based approach to teaching outcomes research in family medicine residency." Fam Med 36.7 (July 2004): 470-472.
PMID
15243824
Source
pubmed
Published In
Family medicine
Volume
36
Issue
7
Publish Date
2004
Start Page
470
End Page
472

The effect of smoking on years of healthy life (YHL) lost among middle-aged and older Americans.

OBJECTIVE: To estimate the effects of smoking on quality of life over time, using the Years of Healthy Life (YHL) construct. DATA SOURCES/STUDY SETTING: The Health and Retirement Study (HRS) survey (N=12,652) of persons 50 to 60 years old and the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey (N=8,124) of persons > or =70 years old, plus spouses regardless of age, followed from 1992/1993 to 2000. STUDY DESIGN: Years of healthy life from baseline to death were estimated. Regression models were developed with smoking as the main explanatory variable and with both YHL and years of life remaining as the outcome variables. PRINCIPAL FINDINGS: Smoking was strongly and consistently related to YHL lost. In HRS, individuals who had quit smoking at least 15 years prior to baseline had a similar number of YHL left as never smokers. CONCLUSIONS: Efforts to encourage smoking cessation should emphasize the impact of these factors on quality of life.

Authors
Østbye, T; Taylor, DH
MLA Citation
Østbye, T, and Taylor, DH. "The effect of smoking on years of healthy life (YHL) lost among middle-aged and older Americans." Health Serv Res 39.3 (June 2004): 531-552.
PMID
15149477
Source
pubmed
Published In
Health Services Research
Volume
39
Issue
3
Publish Date
2004
Start Page
531
End Page
552
DOI
10.1111/j.1475-6773.2004.00243.x

Does binge eating disorder impact weight-related quality of life?

OBJECTIVES: To determine whether binge eating disorder (BED) impacts weight-related quality of life in obese individuals seeking weight loss treatment and to investigate the role of psychological symptoms, BMI, and demographic variables in the relationship between BED and weight-related quality of life. RESEARCH METHODS AND PROCEDURES: Three hundred seventeen women (BMI = 37.6) and 213 men (BMI = 41.3) completed questionnaires on admission into an intensive residential lifestyle modification program. Weight-related quality of life was assessed using the Impact of Weight on Quality of Life-Lite (IWQOL-Lite). The presence of BED was determined using the Questionnaire on Eating and Weight Patterns-Revised. Psychological symptoms were assessed using