RESUMO
Given the important role of parent-youth communication in adolescent well-being and quality of life, we sought to examine the relationship between specific communication variables and youth perceived quality of life in general and as a deaf or hard-of-hearing (DHH) individual. A convenience sample of 230 youth (mean age = 14.1, standard deviation = 2.2; 24% used sign only, 40% speech only, and 36% sign + speech) was surveyed on communication-related issues, generic and DHH-specific quality of life, and depression symptoms. Higher youth perception of their ability to understand parents' communication was significantly correlated with perceived quality of life as well as lower reported depressive symptoms and lower perceived stigma. Youth who use speech as their single mode of communication were more likely to report greater stigma associated with being DHH than youth who used both speech and sign. These findings demonstrate the importance of youths' perceptions of communication with their parents on generic and DHH-specific youth quality of life.
Assuntos
Implantes Cocleares , Compreensão/fisiologia , Surdez/reabilitação , Pais/psicologia , Pessoas com Deficiência Auditiva/reabilitação , Qualidade de Vida , Adolescente , Surdez/cirurgia , Humanos , Inquéritos e QuestionáriosRESUMO
PURPOSE: To assess the association between health-risk behaviors and self-perceived quality of life among adolescents METHODS: A sample of 2801 students (957 seventh and eighth graders and 1844 ninth through twelfth graders) completed the Teen Assessment Survey (TAP) and the surveillance module of the Youth Quality of Life Instrument (YQOL-S). TAP responses were used to determine health-risks related to tobacco use, alcohol use, illicit drug use, and high risk sexual behavior. Separate multivariate analyses of variance showed mean differences in contextual and perceptual items of the YQOL-S for each health-risk behavior. Differences among engagers (adolescents who often engage), experimenters (occasionally engage), and abstainers (never engage) in the health-risk behavior were evaluated by gender and junior/senior high school groups. RESULTS: In general, adolescent abstainers reported higher quality of life (QoL) than engagers and experimenters on YQOL-S items. Adolescents who engaged in multiple risk behaviors scored even lower than those who engaged in only one health-risk behavior. Experimenters tended to rate their QoL more similar to that of abstainers than to that of engagers. CONCLUSIONS: The framework of QoL proved useful in the evaluation of adolescents' engagement in health-risk behaviors. Additionally, assessing the areas of QoL that differ between the groups may provide information for planning interventions aimed at risk reduction among engagers and experimenters.
Assuntos
Comportamento do Adolescente , Qualidade de Vida , Assunção de Riscos , Adolescente , Consumo de Bebidas Alcoólicas/epidemiologia , Análise de Variância , Feminino , Humanos , Masculino , Análise Multivariada , Comportamento Sexual , Fumar/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Estados Unidos/epidemiologiaRESUMO
OBJECTIVE: To examine the rates of use and expenditures on alternative therapies by adults with osteoarthritis (OA). METHODS: Adults with OA recruited from the community to participate in a randomized clinical trial recorded alternative and traditional health care use on postcard diaries. General and arthritis-specific quality of life was assessed by questionnaires. RESULTS: More than 47% of participants reported using at least one type of alternative care during the 20-week intervention period. Among alternative care consumers, the most commonly used treatments were massage therapy (57%), chiropractic services (20.7%), and nonprescribed alternative medications (17.2%). Four percent of subjects reported using only alternative care during the study period. Expenditures for alternative therapy averaged $1,127 per year, compared with $1,148 for traditional therapies. CONCLUSION: Use of and expenditures for alternative care were high among this cohort of older adults with OA. Clinicians may want to inquire about use of these therapies before recommending treatments for this condition.
Assuntos
Terapias Complementares , Osteoartrite/terapia , Idoso , Terapias Complementares/economia , Custos e Análise de Custo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite/economiaRESUMO
OBJECTIVES: To estimate cost and outcomes of the Arthritis Foundation aquatic exercise classes from the societal perspective. DESIGN: Randomized trial of 20-week aquatic classes. Cost per quality-adjusted life year (QALY) gained was estimated using trial data. Sample size was based on 80% power to reject the null hypothesis that the cost/QALY gained would not exceed $50,000. SUBJECTS AND METHODS: Recruited 249 adults from Washington State aged 55 to 75 with a doctor-confirmed diagnosis of osteoarthritis to participate in aquatic classes. The Quality of Well-Being Scale (QWB) and Current Health Desirability Rating (CHDR) were used for economic evaluation, supplemented by the arthritis-specific Health Assessment Questionnaire (HAQ), Center for Epidemiologic Studies-Depression Scale (CES-D), and Perceived Quality of Life Scale (PQOL) collected at baseline and postclass. Outcome results applied to life expectancy tables were used to estimate QALYs. Use of health care facilities was assessed from diaries/questionnaires and Medicare reimbursement rates used to estimate costs. Nonparametric bootstrap sampling of costs/QALY ratios established the 95% CI around the estimates. RESULTS: Aquatic exercisers reported equal (QWB) or better (CHDR, HAQ, PQOL) health-related quality of life compared with controls. Outcomes improved with regular class attendance. Costs/QALY gained discounted at 3% were $205,186 using the QWB and $32,643 using the CHRD. CONCLUSION: Aquatic exercise exceeded $50,000 per QALY gained using the community-weighted outcome but fell below this arbitrary budget constraint when using the participant-weighted measure. Confidence intervals around these ratios suggested wide variability of cost effectiveness of aquatic exercise.
Assuntos
Terapia por Exercício/economia , Custos de Cuidados de Saúde/estatística & dados numéricos , Osteoartrite/economia , Osteoartrite/reabilitação , Anos de Vida Ajustados por Qualidade de Vida , Natação/economia , Idoso , Análise Custo-Benefício , Custos Diretos de Serviços/estatística & dados numéricos , Feminino , Serviços de Saúde/economia , Serviços de Saúde/estatística & dados numéricos , Pesquisa sobre Serviços de Saúde , Humanos , Expectativa de Vida , Masculino , Medicare/economia , Pessoa de Meia-Idade , Osteoartrite/psicologia , Mecanismo de Reembolso/economia , Inquéritos e Questionários , Natação/psicologia , Resultado do Tratamento , WashingtonRESUMO
Parental reports and children's self-reports of manifest anxiety were obtained from a community-based sample of twin pairs on two occasions approximately 19 months apart, using the Revised Child Manifest Anxiety Scale (Reynolds & Richmond, 1978). In prior cross-sectional studies, a low degree of agreement between parent and child assessments of anxiety was found. Furthermore, parental reports were found to reflect a higher heritability than children's self-reports (Eaves et al., 1997; Thapar & McGuffin, 1995). The index of temporal stability was moderate for all informants (circa r = .5 to r = .6). To test whether the components contributing to the temporal stability differed between the informants, structural equation models were fitted to the data using the program, Mx: Statistical Modeling (Neale, 1995). The results showed substantial differences in genetic effects according to both gender and informant. For children's self-reports, temporal stability was largely a function of environmental effects, with genetic effects contributing a modest 20%, whereas for parental reports, temporal stability was largely a function of genetic effects. The heritability was higher for parental reports than for boys' self-reports and the genetic covariance between parents and their sons was near zero, indicating that they were reporting on quite different aspects of anxiety. However, for girls, heritability for maternal reports was lower than for self-reports, and the genetic covariance between mother and daughter was about the same as that between mothers and fathers, meaning that they were assessing the same genetically influenced aspect of anxiety. These results highlight the need to focus on gender differences.
Assuntos
Ansiedade/diagnóstico , Ansiedade/genética , Pais , Psicologia da Criança , Autorrevelação , Adulto , Fatores Etários , Análise de Variância , Criança , Feminino , Seguimentos , Genética Comportamental , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Fatores Sexuais , Meio Social , Gêmeos Dizigóticos/genética , Gêmeos Monozigóticos/genéticaRESUMO
Genetic and environmental influences in the determination of individual differences in self-reported symptoms of separation anxiety (SAD), overanxious disorder (OAD), and manifest anxiety (MANX) were evaluated in children and adolescents for three age groups (8-10, 11-13, and 14-16). Symptom counts for SAD and OAD were assessed for 1,412 twin pairs using the children's version of the Child and Adolescent Psychiatric Assessment, and MANX scores were based on child report from the Revised Children's Manifest Anxiety Scales. Despite significant age and gender differences in thresholds of liability for child reports of symptoms of SAD and OAD, additive genetic and environmental effects could be set equal across age and gender for these variables. For MANX, however, the best-fitting model was a common effects sex-limitation model with estimates of heritability varying dependent upon age and gender. Parameter estimates from the ACE models of OAD and SAD showed that additive genetic variation was a necessary component in the explanation of individual differences in child-reported symptoms of OAD (h2 = .37) across gender, but does not appear to be a major contributor to the explanation of individual differences in symptoms of SAD reported by children. Shared environmental effects (c2 = .40) were found to play a moderate role for SAD but could be dropped from the model for OAD and from all of the age groups for MANX, although the parameter approached significance among 11 yr to 13-year-old males.
Assuntos
Transtornos de Ansiedade/genética , Ansiedade de Separação/genética , Doenças em Gêmeos/genética , Escala de Ansiedade Manifesta/estatística & dados numéricos , Meio Social , Adolescente , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/psicologia , Ansiedade de Separação/diagnóstico , Ansiedade de Separação/psicologia , Criança , Doenças em Gêmeos/psicologia , Feminino , Humanos , Masculino , Modelos Genéticos , PsicometriaRESUMO
Findings from the first twin analysis using the University of Pennsylvania Smell Identification Test (UPSIT) and a phenyl ethyl alcohol (PEA) threshold detection test are presented. A genetic influence on odor identification was suggested for males, but not for females, consistent with previous twin research on physical measures. In addition, females scored significantly higher on the UPSIT than males. A curvilinear age trend for odor identification was detected for males, but not for females. In contrast, neither genetic, age, nor gender effects were suggested for PEA sensitivity. Performance on the olfactory tests was unrelated to scores on standard measures of intelligence.
Assuntos
Odorantes , Percepção/fisiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Criança , Etanol , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Álcool Feniletílico , Olfato , Gêmeos Dizigóticos , Gêmeos MonozigóticosRESUMO
Interindividual variation in odor identification and olfactory sensitivity has been explained primarily with reference to age, sex and/or experiential factors. A twin study of olfaction can, therefore, substantially contribute to current research in this area. Thirty-nine monozygotic and twenty dizygotic twin pairs have completed the University of Pennsylvania Smell Identification Test (UPSIT), an olfactory preference questionnaire, and two odor detection threshold tests (phenyl ethyl alcohol and butanol). A genetic influence on odor identification, as assessed by the UPSIT, has been demonstrated. Future plans and directions for this research program are discussed.