To assess the ability and accuracy of elderly men to recall their weights and determine what characteristics might predict recall ability and accuracy.
Eight hundred sixty-nine elderly men (mean age, 84 years), participants of the Manitoba Follow-up Study (MFUS), responded to a questionnaire asking them to recall their weights at ages 20, 30, 50, and 65 years. Recalled weights were compared with measured weights collected since MFUS began in 1948. Logistic regression was used to predict ability and accuracy of weight recall.
Only 75% of respondents attempted to recall their weights at all 4 ages. Among men recalling 4 weights, fewer than half were accurate within +/- 10%, just 7% were within +/- 5% of their measured weights. Accuracy of recall was significantly and independently associated with body mass index during middle age (5 kg/m(2)) (odds ratio 0.83, 95% confidence interval: 0.76, 0.90) and weight change. Unmarried men were less likely than married men to attempt recalling all 4 weights. Men overweight at middle age were more likely to underestimate their recalled weights.
Studies relating weight in early adulthood or middle age with outcomes in later life should not rely on elderly male participants recalling those weights.
Being able to anticipate future needs for health services presents a challenge for health planners. Using existing population projections, two models are presented to estimate the demand for hospital beds in regions of Manitoba in 2020. The first, a current-use projection model, simply projects the average use for a recent 3-year period into the future. The second, a 10-year trend analysis, uses Poisson regression to project future demand. The current-use projection suggests a substantial increase in the demand for hospital beds, while the trend analysis projects a decline. The last projections are consistent with ongoing increases in rates of day surgeries and declines in lengths of stay. The current-use projections need to be considered in the context of relatively low occupancy rates in rural hospitals and previous research on appropriateness of stays in acute care hospitals. If measures are taken to ensure more appropriate use of acute care hospital beds in the future, then the current-use projections of bed shortages are not a cause for concern.
This study is an extension of a previously published analysis of cancer mortality in a transformer manufacturing plant where there had been extensive use of mineral oil transformer fluid. The objectives of the present study were to update the mortality analysis and include deaths for the past 6 years as well as to do an analysis of cancer incidence of the cohort.
A cohort of 2,222 males working at a transformer manufacturing plant between 1946 and 1975 was constructed. Using a classical historical cohort study design, cancer incidence and mortality were determined through record linkage with Canadian provincial and national registries. The rates of cancer incidence and mortality experienced by this cohort were compared to that of the Canadian male population.
A statistically significant increased risk of developing and dying of pancreatic cancer was found but not an increase in overall cancer mortality. This was consistent with the previous report from this group. Interestingly, the cohort demonstrated a statistically significant risk of overall cancer incidence and specific increased incidence of gallbladder cancer.
This study contributes further evidence to the growing body of literature indicating the carcinogenic properties of mineral oils used in occupational settings, in particular those used prior to 1970s.
Department of Family Practice, University of British Columbia and Vancouver Coastal Health Research Institute, Centre for Clinical Epidemiology and Evaluation, Family Practice Research Office, Vancouver, BC, Canada. email@example.com
This study investigated whether for-profit (FP) versus not-for-profit (NP) ownership of long-term care facilities resulted in a difference in hospital admission and mortality rates among facility residents in British Columbia, Canada.
This retrospective cohort study used administrative data on all residents of British Columbia long-term care facilities between April 1, 1996, and August 1, 1999 (n = 43,065). Hospitalizations were examined for 6 diagnoses (falls, pneumonia, anemia, dehydration, urinary tract infection, and decubitus ulcers and/or gangrene), which are considered to be reflective of facility quality of care. In addition to FP versus NP status, facilities were divided into ownership subgroups to investigate outcomes by differences in governance and operational structures.
We found that, overall, FP facilities demonstrated higher adjusted hospitalization rates for pneumonia, anemia, and dehydration and no difference for falls, urinary tract infections, or DCU/gangrene. FP facilities demonstrated higher adjusted hospitalization rates compared with NP facilities attached to a hospital, amalgamated to a regional health authority, or that were multisite. This effect was not present when comparing FP facilities to NP single-site facilities. There was no difference in mortality rates in FP versus NP facilities.
The higher adjusted hospitalization rates in FP versus NP facilities is consistent with previous research from U.S. authors. However, the superior performance by the NP sector is driven by NP-owned facilities connected to a hospital or health authority, or that had more than one site of operation.
It is increasingly recognized that individual values, beliefs and behavior operate within a social context. There is growing consensus that local perceptions and indigenous knowledge should be important elements in the evaluation of programs aimed at improving health. Thus, an assessment of changes in health risk perception was included in the evaluation of a multi-component intervention project undertaken between 1996 and 1999 aimed at improving the health and well-being of residents in the inner city community of Cayo Hueso, in Centro Habana, Cuba. The community intervention involved a tremendous mobilization of government and non-governmental organizations, to promote social and cultural activities and address deficiencies in housing, water supply, waste disposal and street illumination. Prior to the interventions, 365 adults were surveyed regarding their perceived health risks regarding 41 health determinants, scored on four-point Likert scales ranging from 'without risk' to 'very risky'. A factor analysis of these data classified perception of risk into five areas: social environment, threats to personal health, lifestyle choices, environmental sanitation and housing conditions. The objective of the current analysis was to determine if there were changes in the level of perceived risk to health over the 5 years pre- versus post-intervention in Cayo Hueso, and if so, whether these changes were significantly different from changes seen during the same 5-year period in Colón, another community in Centro Habana not receiving focused interventions. During the first quarter of 2001, 1703 individuals living in 654 households in Cayo Hueso and Colón were interviewed in their homes using an enhanced version of the 1996 risk perception instrument. Ordinal logistic regression models, adjusted for age, gender and years of education, were fit to assess change in health risk perception between 1996 and 2001. Significant declines in perceived health risk were found in both Cayo Hueso and Colón within all five domains, with significantly greater declines in many areas in Cayo Hueso compared with Colón, particularly with respect to housing-related health risks, indeed the main target of the intervention. Risk perception surveys are useful characterizations of widely held views in a target population. Our findings of decreased perceived health risk following public health, physical and social interventions to improve health suggests that this line of inquiry merits consideration in planning evaluations of multi-sectoral community-based health promotion interventions.
The population of alternate level care (ALC) patients utilizing acute-care hospital resources inappropriate to their needs is growing. The purpose of this study was to explore how the care of ALC patients was managed at 4 acute-care facilities in the Canadian province of British Columbia and to examine how this care impacts on outcomes of staff injury. Interviews were conducted to identify and characterize the different models of ALC. Injury outcomes for all caregivers were obtained (n = 2,854) and logistic regression conducted to compare staff injuries across ALC models. Injured workers were surveyed regarding their perceptions of injury risk and ALC. Five ALC models were identified: low-mix, high-mix, dedicated ALC units, extended care units, and geriatric assessment units. The risk for caregiver injuries was lowest on dedicated ALC units. These findings suggest that acute-care facilities faced with a growing ALC population should consider creating dedicated ALC units.
Of all Canadian and American men who live to age 75 years, about half can expect to live to age 85. Our objective is to examine how clinical diagnoses made before age 75 relate to a man's survival to age 85 years.
Since 1948, a cohort of 3,983 young men (mean age of 31 years at entry) has been followed with routine contact and medical examinations to prospectively document incident disease. Over 62 years of follow-up, 2,414 of the cohort lived to celebrate their 75th birthday. Of these survivors, 1,060 (44%) died before their 85th birthday. Cox proportional hazard models were used to examine the effects of ischemic heart disease, cancer, cerebrovascular disease, diabetes mellitus, peripheral arterial disease, and chronic obstructive pulmonary disease on all-cause mortality between age 75 and 85 years.
Modeled as six binary risk factors at age 75 years, all were significantly (p
ABSTRACTIn the absence of a universally agreed-upon definition of successful aging, researchers increasingly look to older adults for layperson views of aging and definitions of successful aging. To use lay definitions in studies of aging, however, researchers must address the definitions' consistency. In 2004, surviving members of the Manitoba Follow-up Study male cohort (mean age: 83 years) were asked twice for their definition of successful aging. A consistency category was assigned based on the similarity of themes in each of 654 pairs of definitions. At least half of the main themes were similar in 70 per cent of the definition pairs; 80 per cent of respondents repeated at least one theme. Positive or negative health events in the four-week interval between definitions and specific respondents' characteristics did not vary across consistency categories. This evidence for consistency supports our continued reliance on lay definitions of successful aging.
Although the concept of successful aging is used widely in the field of gerontology, there is no agreed-on standard or common underlying definition for measuring success in aging. Our recent survey of an elderly male population asked respondents to define "successful aging." This paper describes the themes that evolved from those definitions, explores interrelationships between the themes, and examines the association between characteristics of respondents and the themes provided in their definition.
The Manitoba Follow-up Study has followed a cohort of 3,983 World War II Royal Canadian Air Force male aircrew recruits since July 1, 1948. At a mean age of 78 years in 1996, the survivors were surveyed and asked, "What is your definition of successful aging?" and "Would you say you have aged successfully?" A content analysis identified themes emerging from their definitions.
The most frequent of the 20 component themes from the definitions of successful aging as provided by 30% of the 1,771 respondents related to "health and disease"; "physical," "mental," and "social activity" were more likely to be found in a definition including "interest," "having goals," "family," or "diet," and they were less likely to be mentioned with themes of "independence" or "health." Many of the themes reflect an individual's attitudes toward life and the aging process. Current life satisfaction, self-rated health, and limitation in activities of daily living were significantly associated with an increased likelihood of reporting specific themes in definitions.
As health care professionals adapt to the changing demographic composition of society, it should be of interest to understand what successful aging might mean to the elderly males to whom they are attending.
As the population ages, chronic conditions such as heart failure are becoming more prevalent. An important goal is to understand how patients with heart failure learn to manage the often debilitating disease symptoms. The research objective was to examine the determinants of general and therapeutic self-care behaviors among community-dwelling heart failure patients. Guided by Connelly's Model of Self-care in Chronic Illness, enabling and predisposing factors were evaluated using sociodemographic characteristics, functional ability, and psychological status. Self-care maintenance, self-efficacy, and self-care management characteristics were also evaluated.
Using a cross-sectional design, a convenience sample of 65 ambulatory care patients were recruited. Data were collected through chart reviews and questionnaires.
Common self-care maintenance behaviors included taking medication as prescribed (95%), seeking physician guidance (80%), and following sodium dietary restrictions (70%). These behaviors were influenced by enabling characteristics such as psychological status (P = .030), ethnicity (P = .048), and comorbidity (P = .023). A unique finding was that self-care maintenance behaviors were significantly lower in aboriginal participants. The predisposing characteristic of self-efficacy influenced self-maintenance behaviors (P = .0002), overall self-care (P = .04) and number of hospital admissions (P