Previous research has found that current smokers are less likely to have access to the Internet than nonsmokers. As access to the Internet continues to expand, does this finding remain true? Also, how many smokers are interested in Web-assisted tobacco interventions (WATIs)? These questions are important to determine the potential role that WATIs might play in promoting tobacco cessation.
The aims of the study were to determine whether smokers are less likely than nonsmokers to have access to the Internet and to establish the level of interest in WATIs among a representative sample of smokers.
A random digit dialing telephone survey was conducted of 8467 adult respondents, 18 years and older, in Ontario, Canada from September 2006 to August 2007. All respondents were asked their smoking status and whether they used the Internet (at home or work in the past 12 months; where; how often in the past 12 months). To assess the level of interest in WATIs, current daily smokers were asked whether they would be interested in a confidential program that they could access on the Internet, free of charge, that would allow them to check their smoking and compare it to other Canadians.
Smokers were marginally less likely to have used the Internet than nonsmokers (74% vs 81% in the last year), and, of those who had access to the Internet, smokers used the Internet less often than nonsmokers. Overall, 40% of smokers said they would be interested in a WATI. The number of cigarettes smoked per day was unrelated to level of interest in the WATI, but time to first cigarette after waking was. Smokers who used the Internet were more interested in the WATI than smokers who did not use the Internet (46% vs 20%).
While the difference in level of Internet use between smokers and nonsmokers was greatly reduced compared to 2002 and 2004 data, smokers still remain marginally less likely to use the Internet than nonsmokers. Overall, there was a substantial level of interest in the WATI among smokers, in particular among smokers who currently use the Internet. These results indicate that WATIs have a substantial potential audience among smokers, and, given the growing body of evidence regarding their efficacy, there is growing support that WATIs have a significant role to play in promoting tobacco cessation.
In medical practices that do not have rosters, only the number of patients who come to the practice can be enumerated: the number who might have visited if they had had a reason to do so remains unknown. The Quadratic Odds Estimator is a technique for estimating the total number of patients cared for by a primary care medical practice, including the non-visitors. A revised version of the model is shown to have an error of less than 1% in predicting the number of patients at risk of visiting a primary care medical practice. Aggregate and sex-specific estimates of total practice size are shown to be comparable to within 2%. The model estimates the prevalence of hypertension among the patients of two family practice resdencies as 18 and 11%. The rationale for employing unconventional regression weights and dual regressions is explained.
The present study examined the influence of driver age and vengeance on mild aggression among drivers with at least 5 years experience. Mild aggression decreased with age among low vengeance drivers and changed little across age groups among moderately vengeful drivers. However, mild driver aggression actually increased with age among highly vengeful drivers. Results are interpreted in terms of the aggressive nature of an enduring vengeful attitude.
The objectives of this study were to explore age and gender differences in attitudes toward seeking professional psychological help, and to examine whether attitudes negatively influence intentions to seek help among older adults and men, whose mental health needs are underserved. To achieve these objectives 206 community-dwelling adults completed questionnaires measuring help-seeking attitudes, psychiatric symptomatology, prior help-seeking, and intentions to seek help. Older age and female gender were associated with more positive help-seeking attitudes in this sample, although age and gender interacted with marital status and education, and had varying influences on different attitude components. Age and gender also influenced intentions to seek professional psychological help. Women exhibited more favourable intentions to seek help from mental health professionals than men, likely due to their positive attitudes concerning psychological openness. Older adults exhibited more favourable intentions to seek help from primary care physicians than younger adults, a finding that was not explained by age differences in attitudes. Results from this study suggest that negative attitudes related to psychological openness might contribute to men's underutilization of mental health services. Help-seeking attitudes do not appear to be a barrier to seeking professional help among older adults, although their intentions to visit primary care physicians might be. These findings suggest the need for education to improve men's help-seeking attitudes and to enhance older adults' willingness to seek specialty mental health services.
We have evaluated genetic and environmental influences in multiple sclerosis (MS) by comparing age of onset in 99 sibling pairs concordant for the disease. We used three methods of analysis: (1) comparison of mean differences in age of onset and year of onset, (2) linear regression of differences in age or year of onset vs difference in ages, and (3) intraclass correlation of age of onset which is also used for monozygotic twins concordant for MS. Comparison of the mean differences in age of onset or year of onset is found to be inappropriate and potentially misleading. No significant results were found in linear regression of the age of onset or year of onset vs differences in ages, although a trend towards onset at the same age is present. However, nontwin siblings show a significant intraclass correlation for age of onset (P less than 0.01) as is seen in genetic disorders. A stronger intraclass correlation in age of onset in concordant monozygotic twins vs concordant sibling pairs further suggests that age of onset is partly under genetic control, assuming common exposure to an environmental agent. The results give little support for common exposure to an environmental trigger in concordant MS sibling pairs. They are consistent with a mixture of random independent exposures and common exposures leading to the development of the disease, with the former predominating.
Air pollution data from 17 sampling stations between Windsor and Peterborough in Southern Ontario, for January, February, July, and August in 1974 and 1976 to 1983, have been analyzed. Each station reported O3, NO3, SO2, and the coefficient of haze (COH) every hour and aerosol sulfates for a 24-hr period every sixth day using glass-fiber filters. Data on mean daily temperature and relative humidity for the region were also recorded. It is shown that there are high correlations between different pollutants and between these and temperature in the summer. In the summer, sulfate levels were significantly correlated with relative humidity. In winter, the highest correlation was between COH and NO2. Over the 9-year period, SO2 levels in both winter and summer have fallen considerably; there have been no significant trends in O3, NO3, or COH data. Aerosol sulfates increased between 1976 and 1980 in both summer and winter and have since declined slightly. Hospital admission data for the 79 acute care hospitals serving the region, which contains about 5.9 million people, have been analyzed on a daily basis for the same months of the same years. Total admissions and total respiratory admissions have declined about 15% over the period, but asthma admissions appear to have risen. The asthma category of admissions is complicated by the effects of a change in ICD coding in 1979. It has been shown that significant correlations exist between O3, SO4, SO2, and temperature, on the one hand, and deviations from the mean respiratory admissions for that day of the week, for that season, for that year, on the other. These correlations exist if asthma is excluded from the diagnoses. In winter, asthma admissions are correlated with temperature only. A group of nonrespiratory conditions showed no correlations with air pollutants in winter or summer. Stepwise multiple regression analysis based on each year considered individually indicates that in summer SO4 and temperature account for about 5% of the variance in respiratory or asthma admissions. It is shown that the mean of the hourly ozone maxima has a high correlation with the maximal 8-hr average for ozone, and that using this index instead of the mean of the hourly maxima does not increase the correlation coefficient with respiratory disease. Another analysis has been performed by grouping the hospitals and sampling stations into nine separate regions.(ABSTRACT TRUNCATED AT 400 WORDS)
This study was designed to examine the pattern and strength of relationships among coping styles and alcohol outcome expectancies with regard to drinking behavior in young adult social drinkers. Quantity and frequency of weekly consumption were used as criterion measures, and alcohol outcome expectancies/valences (CEOA: Fromme, Stroot & Kaplan, 1993) and coping styles (COPE: Carver, Scheier, & Weintraub, 1989) were used as predictor variables. For males, the expectancy of risk and aggression, and the valence of cognitive and behavioral impairment, were predictive of drinking behavior. For females, sociability valence and the expectancy of negative self-evaluation positively predicted the alcohol-use measures. With regards to coping styles, alcohol and drug disengagement and suppression of competing activities uniquely predicted alcohol use in males, whereas alcohol and drug disengagement, turning to religion, and behavioral disengagement were predictive of female alcohol use. In general, coping styles were more predictive of the alcohol-use measures than were alcohol-outcome expectancies. Practical implications of these results are highlighted.
The purpose of this exploratory descriptive study was to examine a process model of the nervios experience of 30 Mexican seasonal farm workers. Focused interviews were conducted in Spanish to determine the workers' perspectives on their experiences of nervios while residing in rural, southwest Ontario. Data for analysis originated from variables created to represent key themes that had emerged from open coding of the interviews. Simultaneous entry, multiple regression analyses revealed that provocation, control salience, and cognitive sensory motor distress directly explained 67.2% of the variation in worker expressions of negative affectivity. The combination fear, feeling trapped, and giving in mediated the relationship of provocation, control salience and cognitive sensory motor distress to expressions of negative affectivity (R(2) = 88.1%). Control salience and its dampening effect on other elements of the nervios experience, however, appeared to be key to whether subjects experienced negative reactions to being provoked or distressed. This evidence points to nervios being a powerful, holistic idiom of distress with at least six variables contributing to its affective negativity. This information is important to our understanding of how nervios unfolds and for accurate specification of a nervios model for clinical practice and research. It also sets the stage for improved therapeutic alliances with nervios sufferers, and social action to reduce factors that provoke nervios.
Data in health research are frequently structured hierarchically. For example, data may consist of patients nested within physicians, who in turn may be nested in hospitals or geographic regions. Fitting regression models that ignore the hierarchical structure of the data can lead to false inferences being drawn from the data. Implementing a statistical analysis that takes into account the hierarchical structure of the data requires special methodologies. In this paper, we introduce the concept of hierarchically structured data, and present an introduction to hierarchical regression models. We then compare the performance of a traditional regression model with that of a hierarchical regression model on a dataset relating test utilization at the annual health exam with patient and physician characteristics. In comparing the resultant models, we see that false inferences can be drawn by ignoring the structure of the data.
While medical student debt is increasing, the effect of debt on student well-being and performance remains unclear.
As a part of a larger study examining medical student views of their future profession, data were collected to examine the role that current and anticipated debt has in predicting stress among medical students.
A survey was administered to medical students in all four years at the University of Toronto. Of the 804 potential respondents across the four years of training, 549 surveys had sufficient data for inclusion in this analysis, for a response rate of 68%. Through multiple regression analysis, we evaluated the correlation between current and anticipated debt and financial stress.
Although perceived financial stress correlates with both current and anticipated debt levels, anticipated debt was able to account for an additional 11.5% of variance in reported stress when compared to current debt levels alone.
This study demonstrates a relationship between perceived financial stress and debt levels, and suggests that anticipated debt levels might be a more robust metric to capture financial burden, as it standardizes for year of training and captures future financial liabilities (future tuition and other future expenses).