Offord Centre for Child Studies, McMaster University, Chedoke Site, Central Building, Room 310, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada; Department of Psychiatry and Behavioural Neurosciences, St. Joseph's Healthcare Hamilton, West 5th Campus, Administration - J Wing, 100 West 5th, Hamilton, Ontario L8N 3K7, Canada. Electronic address: email@example.com.
The aim of this study was to test for measurement invariance and examine differences in global self-concept between adolescents with and without physical illness or developmental disability. The sample consisted of adolescents 10-19 years who participated in the Canadian National Longitudinal Survey of Children and Youth (N=8491). Multiple group confirmatory factor analysis was used to test for measurement invariance. Twenty-three percent (n=1966) of participants had a physical illness or developmental disability. Support was found for strict measurement invariance between groups suggesting adolescents in both groups perceived items similarly, indicating that comparisons between adolescents with and without physical illness or developmental disability are meaningful. Controlling for several sociodemographic characteristics, evidence suggested that self-concept is lower in adolescents with physical illness or developmental disability, ß=-0.24, p=0.0005, compared to their healthy peers. Future work should attempt to understand the processes leading to compromised self-concept in adolescents with physical illness or developmental disability.
Palliative care patients experience many debilitating symptoms and functional loss, but few longitudinal studies on the subject are available.
To assess the symptoms and functional status of patients admitted to specialised palliative care, to investigate whether changes occur over the admission period, and to establish whether symptoms and physical and cognitive function differ, based on the service setting. In addition, to participate in the development of the interRAI Palliative Care instrument (interRAI PC).
A prospective longitudinal study (N=123) was conducted at three time points: at admission to specialised palliative care, 14 days post-admission, and at discharge or death. The interRAI PC version 8 was used for data collection. Descriptive statistics were used, together with the Friedman statistical test and Wilcoxon post-hoc test.
Patients experienced a wide spectrum of symptoms; the most frequent were fatigue, loss of appetite, pain, difficulty sleeping, insufficient nutritional intake and nausea. Some symptoms stayed relatively stable over time, but others increased, while physical and cognitive function decreased over time. The interRAI PC version 8 proved comprehensive and simple to use.
Patients experienced a significant symptom burden and functional loss from admission to discharge or death. Symptoms indicating progressive deterioration became more frequent and severe, while physical and cognitive function decreased at all levels. Overall, inpatients had more symptoms and functional decline than home-care patients. The interRAI PC version 8 proved valuable in collecting clinical information and detecting changes over time as other interRAI suite instruments.
As part of the Swedish state-funded healthcare system, housing adaptations are used to promote safe and independent living for disabled people in ordinary housing through the elimination of physical environmental barriers in the home. The aim of this study was to describe the cohabitants' expectations and experiences of how a housing adaptation, intended for the partner, would impact their everyday life. In-depth interviews were conducted with cohabitants of nine people applying for a housing adaptation, initially at the time of the application and then again 3 months after the housing adaptation was installed. A longitudinal analysis was performed including analysis procedures from Grounded Theory. The findings revealed the expectations and experiences in four categories: partners' activities and independence; cohabitants' everyday activities and caregiving; couples' shared recreational/leisure activities; and housing decisions. A core category putting the intervention into perspective was called 'Housing adaptations - A piece of the puzzle'. From the cohabitants' perspective, new insights on housing adaptations emerged, which are important to consider when planning and carrying out successful housing adaptations.
Longitudinal twin studies on long term conservation of individual metabolic phenotypes can help to explore the genetic and environmental basis in maintaining metabolic homeostasis and metabolic health. We performed a longitudinal twin study on 12 metabolic phenotypes from Danish twins followed up for 12 years and Chinese twins traced for 7 years. The study covered a relatively large sample of 502 pairs of Danish adult twins with a mean age at intake of 38 years and a total of 181 Chinese adult twin pairs with a mean baseline age of 39.5 years. Bivariate twin models were fitted to the longitudinal measurements taken at two time points (at baseline and follow-up) to estimate the genetic and environmental contributions to phenotype variation and correlation at and between the two time points. High genetic components in the regulation of intra-individual phenotype correlation or stability over time were estimated in both Danish (h2>0.75 except fasting blood glucose) and Chinese (h2>0.72 except blood pressure) twins; moderate to high genetic contribution to phenotype variation at the two time points were also estimated except for the low genetic regulation on glucose in Danish and on blood pressure in Chinese twins. Meanwhile the bivariate twin models estimated shared environmental contributions to the variance and covariance in fasting blood glucose in Danish twins, and in systolic and diastolic blood pressure, low and high density lipoprotein cholesterol in Chinese twins. Overall, our longitudinal twin study on long-term stability of metabolic phenotypes in Danish and Chinese twins identified a common pattern of high genetic control over phenotype conservation, and at the same time revealed population-specific patterns of genetic and common environmental regulation on the variance as well as covariance of glucose and blood pressure.
Genetic-evolutionary theories of aging predict that the genetic variance for fitness traits increases with age, while epidemiological-gerontological theories predict an increase in the environmental variance for most traits. In this study we examine the age trajectories of the genetic and environmental variance in physical functioning in a sample of 4731 Danish twins aged 70+ who are being followed longitudinally every second year with up to four assessments completed. A biometric growth model (Neale and McArdle, 2000) was applied to a validated physical ability score. The model included an overall level effect, a rate of linear change effect, and residual effects. The best-fitting model was a sex-specific model including additive genetic and nonshared environmental factors affecting level and rate of change and only nonshared environmental factors affecting the wave-specific levels. For both sexes there is an approximate doubling of both the total variance and the genetic variance in the physical ability score over the four waves and, hence, a rather stable heritability. However, the heritability is approximately.10 for males and.30 for females in all four waves. The heritability of level and slope showed a similar pattern:.11-14 in males and.35-.39 in females. The increase in both additive genetic variance and environmental variance is in agreement with genetic-evolutionary and epidemiological-gerontological theories of aging, respectively. The present study suggests that overall level of strength may be a better phenotype for future molecular genetic studies on physical functioning in the elderly than rate of change, because rate of change is vulnerable to sample attrition due to mortality and dropout and because four waves were needed to be able to detect a heritability for rate of change of the same magnitude as the heritability for level of physical functioning.