[Agreement in the responses to self-reported and proxy-reported versions of QOL-HC: a new quality-of-life scale for patients receiving home-based medical care].

AIM: We developed quality-of-life (QOL) scales for patients receiving home medical care. The objective of this study was to examine the agreement between the scores of the scales answered by patients and those answered by their proxy, as cognitive decline may interfere with one's ability to understand complex topics, such as the QOL. METHODS: Participants were pairs of patients receiving home medical care and their proxy. The patients were asked to complete self-reported QOL scales (QOL-HC), and their proxies were asked to complete proxy-reported versions of the QOL scales (QOL-HC for caregivers). We then statistically examined the extent of agreement between the self- and proxy-reported QOL-HC scores using contingency tables and Spearman's rank correlation coefficient. The SPSS software program, version 24, was used for all statistical analyses. RESULTS: The concordance rate between patients and caregivers for questions 1 ( "Do you have peace of mind?" ), 2 ( "Do you feel satisfied with your life when you reflect on it?" ), 3 ( "Do you have someone that you spend time talking with?" ), and 4 ( "Are you satisfied with the home care service system?" ) were 52.3%, 52.3%, 79.5%, and 81.8%, respectively. The total scores for the patients and caregivers were significantly correlated (Spearman's ρ=0.364*). CONCLUSIONS: We created the first QOL scale for patients receiving home-based medical care and for caregivers. The findings of this study suggest that the QOL-HC can be used in clinical practice for the assessment of patients receiving professional home care.

Vision and hearing impairments, cognitive impairment and mortality among long-term care recipients: a population-based cohort study.

BACKGROUND: Vision and hearing impairments among elders are common, and cognitive impairment is a concern. This study assessed the association of vision and hearing impairments with cognitive impairment and mortality among long-term care recipients. METHODS: Data of 1754 adults aged 65 or older were included in analysis from the Gujo City Long-Term Care Insurance Database in Japan for a mean follow-up period of 4.7 years. Trained and certified investigators assessed sensory impairments and cognitive impairment using a national assessment tool. Five-level scales were used to measure vision and hearing impairments. Cognitive performance was assessed on two dimensions, namely communication/cognition and problem behaviors. We performed logistic regression analysis to estimate odd ratios (ORs) and 95 % confidence intervals (CIs) for the association of vision and hearing impairments with cognitive impairment. Using Cox proportional hazard regression models, we obtained hazard ratios (HRs) for mortality. RESULTS: Of 1754 elders, 773 (44.0 %) had normal sensory function, 252 (14.4 %) vision impairment, 409 (23.3 %) hearing impairment, and 320 (18.2 %) dual sensory impairment. After adjusting for potential cofounders, ORs of cognitive impairment were 1.46 (95 % CI 1.07-1.98) in individuals with vision impairment, 1.47 (95 % CI 1.13-1.92) in those with hearing impairment, and 1.97 (95 % CI 1.46-2.65) in those with dual sensory impairment compared to individuals with normal sensory function. The adjusted HR of overall mortality was 1.29 (95 % CI 1.01-1.65) in individuals with dual sensory impairment and cognitive impairment relative to normal sensory and cognitive functions. CONCLUSIONS: Cognitive impairment was most common in individuals with dual sensory impairment, and those with dual sensory impairment and cognitive impairment had increased mortality.

Does the Japanese Society for Hygiene need its own Code of Conduct? A comparison of the responses of councilors and junior members based on a questionnaire survey.

OBJECTIVE: The purpose of this study was to compare current awareness of the "On a Code of Conduct for Scientists" (OCCS) among members of the Japanese Society for Hygiene (JSH). METHOD: An anonymous self-administered questionnaire was mailed to JSH members, including 439 councilors and 376 junior members (who were under 50 years of age with a membership of 3 years or longer, excluding councilors). Councilors were surveyed from November to December 2007, while junior members were surveyed from November to December 2008. RESULTS: The overall response rate was 40.6% (n = 331/815), with responses from 46.7% of the councilors (n = 205/439) and 33.5% of the junior members (n = 126/376). Among the respondents, 36.0% of councilors (n = 68) and 59.8% of junior members (n = 73) did not know the contents of "On the Code of Conduct for Scientists" (P < 0.01), while 76.3% of councilors (n = 145) and 61.4% of junior members (n = 75) had not heard of it (P < 0.05). However, a majority of the respondents reported interest in the Code [70.0% of councilors (n = 133), 68.6% of junior members (n = 83)] (P < 0.05) and a favorable attitude towards research ethics education [69.3% of councilors (n = 133), 68.9% of junior members (n = 84)] (P < 0.54). In addition, 24.3% of the responding councilors (n = 46) and 15.7% of the responding junior members (n = 19) believe it necessary for JSH to formulate its own code of conduct for scientists (P < 0.01). CONCLUSION: We clarified the current state of awareness of the OCCS among JSH members as well as the opinion of members for the JSH to have its own Code of Conduct for Scientists. This result provides important information that should be considered during the formulation of an individual code of conduct for scientists in the JSH.

[Blood pressure control through awareness of hypertension among female in-home caregivers].

OBJECTIVES: Our purpose was to clarify the situation regarding blood pressure control through awareness of hypertension among female groups of in-home caregivers and non-caregivers. METHODS: We used one existing data generated between December 2005 and April 2007. The subjects were females who were suffering from hypertension (66 caregivers were aged 49-84 years; 52 non-caregivers were aged 47-81 years). We defined persons suffering from hypertension on the basis of results of a self-administered questionnaire and blood pressure values. On the question of awareness of hypertension, we defined the persons who replied positively to any one of "I have hypertension," "I have suffered from hypertension," or "I take antihypertensive agents" as belonging to the "awareness group." We categorized the other respondents, who replied to all three questions in the negative as belonging to the "non-awareness group." We used blood pressure values, to build an index of the control with the chi2 test and the t-test for statistical comparisons. Values of P < 0.05 were considered statistically significant. RESULTS: The results showed that blood pressure values of caregivers in both the awareness group and the non-awareness group were high (awareness group vs non-awareness group overall SBP: 148 +/- 20 mmHg vs 154 +/- 9 mmHg, DBP: 79 +/- 13 mmHg vs 82 +/- 10 mmHg, P > 0.05). Furthermore, values were significantly lower for the awareness than non-awareness group with respect to the non-caregivers (SBP: 135 +/- 15 mmHg vs 149 +/- 7 mmHg, DBP: 73 +/- 10 mmHg vs 78 +/- 6 mmHg). Caregivers who took the antihypertensive agent in the awareness group demonstrated high values exceeding SBP 140 mmHg, which was the hypertensive standard value, not different from the values for caregivers not taking such medication. (taking vs non-taking SBP: 148 +/- 21 mmHg vs 149 +/- 8 mmHg). CONCLUSION: Among the caregivers, it was not only the members of the non-awareness group but also those of the awareness group who were found to have high blood pressure values. Though the caregivers took antihypertensive agents, their blood pressure values remained high.

[Attitudes towards the code of conduct for scientists among council members of the Japanese Society for Hygiene].

OBJECTIVES: The aim of this study was to clarify the attitudes towards the code of conduct for scientists among council members of the Japanese Society for Hygiene (JSH). We also aimed to collect information to be used as baseline data for future studies. METHODS: From November to December 2007, 439 Council members of the Japanese Society for Hygiene completed a self-administered questionnaire. RESULTS: The valid response rate was 43.7% (n=192/439). The mean ages of the subjects were 56.2 years for males (n=171), and 53.0 years for females (n=19). Many council members were unfamiliar with the "Code of Conduct for Scientists" established by the Science Council of Japan, suggesting that most of the regular members were also unfamiliar with these guidelines. However, the high level of interest in the "Code of Conduct for Scientists" established by the Science Council of Japan indicated a positive attitude towards learning about research ethics. Moreover, one-half of the subjects responded that JSH should establish a code of conduct for scientists. Below are some of the reasons for requiring JSH to establish a code of conduct: 1. Private information is prevalent in the field of hygiene. 2. The overall stance as an academic society would be established and would encourage individuality in academic societies. 3. Members have various backgrounds within the field of hygiene, and they should have a code of conduct different from that of their institution of affiliation. CONCLUSION: We clarified attitudes towards the Code of Conduct for Scientists among council members of the Japanese Society for Hygiene.

Association between Passive Smoking from the Mother and Pediatric Crohn's Disease: A Japanese Multicenter Study.

Smoking is a risk factor for adult-onset Crohn's disease (CD). Although passive smoking from family members is a major concern, especially in pediatric CD, the number of existing epidemiological studies is limited. This multicenter case-control study aimed to assess the effects of familial smoking on pediatric CD. We examined 22 pediatric CD cases and 135 controls. The subjects' mothers were given a self-administered questionnaire about family smoking before disease onset in the CD group or the corresponding period in the control group. Univariable logistic regression model was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs), whereas dose-response relationship analyses were performed for more in-depth evaluations. Univariable analyses indicated that passive smoking from the mother (OR, 2.09; 95% CI, 0.61-7.10) was not a significant, but a candidate risk factor for developing pediatric CD. In contrast, the dose-response relationship analyses revealed that passive smoking from the mother (OR, 1.17; 95% CI, 1.04-1.31) was significantly associated with pediatric CD. Therefore, passive smoking from the mother may be predominantly associated with the development of pediatric CD. Further follow-up studies comprising environmental measurements of passive smoking exposure doses and genetic factors interaction analysis are necessary.

The joint effect of oxidative stress and antioxidants on the risk of an aneurysmal rupture subarachnoid hemorrhage: a case-control study in Japan.

PURPOSE: A case-control study was conducted in Japan to examine the joint effects of oxidative stress and antioxidants on the risk of subarachnoid hemorrhage (SAH). METHODS: The study included 201 consecutive patients with first spontaneous SAH aged 30 to 79 years who had aneurysm(s) confirmed by angiography and/or computed tomographic scan and were admitted to two medical hospitals in Nagoya, Japan, from April 1992 to March 1997. Community control subjects were identified and matched to each case by gender and age (+/-2 years). Conditional logistic regression modeling was used to compute odds ratios (ORs) adjusted for body mass index, physical activity, family history of SAH, a history of hypertension, drinking habit, and frequency of green-yellow vegetables and fruits, and tea consumption. RESULTS: The greatest risk for SAH was posed by combination of current smoking and a less frequent intake of soy products (adjusted OR = 5.3; 95% confidence interval [CI], 2.0 to 14.3). Less frequent intake of soy products significantly elevated SAH risk, independent of smoking habits. CONCLUSION: These data suggested that enhancement of the antioxidant defense system such as much intake of soy products may be important in preventing SAH rather than the reduction of such oxidants as smoking. Our findings should prove useful for targeting individuals/populations in programs for primary prevention of SAH.

Risk factors for 6-year mortality by gender in a Japanese elderly population.

The aim of this study is to examine gender differences in the factors associated with 6-year mortality among 784 elderly residents (mean age=73 years) in Japan from 1995 (baseline) to 2001. Survival status during 6 years of follow-up was confirmed by either inquiries of older participants or family members or data from official death certificates, or both in 2001. Information on variables associated with mortality was elicited by using a face-to-face interview at baseline (1995). Results of longitudinal analyses showed that self-rated health (SRH) was not an independent predictor of mortality among men or women after adjustment of the other factors. Instead of SRH, having much feeling of usefulness among men and being married among women were significantly associated with increased mortality risk, suggesting that these findings may play an important role in enhancing survival in the elderly.

Much communication with family and appetite among elderly persons in Japan.

The purpose of this study is to examine cross-sectionally the factors associated with appetite among the elderly persons living in the community in Japan. The subjects of this study were 754 non-institutionalized elderly men and women aged 65 years and older living in community in Japan. The data were collected by face-to-face interviews. The factors related to subjective health was examined using multiple logistic regression analyses. Four hundred and forty-nine (56.4%) participants evaluated appetite as very good; 239 (30.0%) as somewhat good; 92 (11.6%) as little/not at all. Subjects with good appetite were more physically active, had less depressive symptoms, subjective stress, much more communication with family and much more social support, as compared to those without appetite. Appetite was significantly associated with better subjective good health after controlling for other variables in the model. Only communication with family was significantly associated with good appetite after controlling for other variables (odds ratio, OR=2.43; 95% confidence interval, CI=1.30-4.74). The indirect effect of communication with family on appetite was much greater than the direct effect. These findings suggest that communication with family may be beneficial promoter of the appetite in the elderly.

Prediction of subarachnoid hemorrhage from a ruptured cerebral aneurysm by discriminant analysis in women.

BACKGROUND: Using a discriminant analysis study of Japanese women, we sought to construct a predictive model of individuals who are at a higher risk factor of the occurrence of subarachnoid hemorrhage (SAH) from a ruptured cerebral aneurysm. METHODS: Patients consisted of a consecutive series of 124 female patients with first spontaneous SAH aged 30 to 79 years and aneurysm or aneurysms confirmed by angiography, computed tomography scan, or both at two medical hospitals in Nagoya, Aichi Prefecture, Japan, from April 1992 to March 1997. Community control subjects were identified, and matched to each patient by age (+/-2 years). Linear discrimination analysis was used to construct a predictive model to select individuals who have a higher chance of SAH. RESULTS: All of the 5 predictor variables (lower antioxidant intake score, current smoking, family history of SAH, nulligravidity, and hypertension) were independently associated with the risk of SAH. The discriminant analysis yielded a statistically significant function, which explained 52% of the whole (canonical correlation [Rc] = 0.73; degrees of freedom [df] = 6; P = .000). This function showed that the rate of correct prediction was 76.2% for patients with SAH, and 82.7% for control subjects, and that it was able to produce an 80.4% rate of correct classification. CONCLUSIONS: The current study suggests that the calculated discriminant function, which was determined congenital (family history of SAH) and acquired variables simultaneously, may provide greater predictive accuracy for screening individuals at high risk of the occurrence of SAH in women. Prospective studies are needed to confirm validity and feasibility of the model for earlier screening for the occurrence of SAH in women.

Physical Function Differences Between the Stages From Normal Cognition to Moderate Alzheimer Disease.

OBJECTIVES: We investigated the differences in the physical function test results across stages from normal cognition (NC) to moderate Alzheimer disease (AD) and how risk factors of physical function decline are correlated with the physical function test results. DESIGN: A cross-sectional study of outpatients at the Memory Disorder Outpatient Center of Japan's National Center of Geriatrics and Gerontology. PARTICIPANTS: We enrolled 882 individuals aged ≥65 diagnosed with NC (n = 210), amnestic mild cognitive impairment (aMCI; n = 273), mild AD (n = 181) or moderate AD (n = 197). MEASUREMENTS: We measured the participants' results for functional reach (FR), the one-leg standing (OLS) test, the Timed Up and Go (TUG) test, tandem gait (TG), and grip strength (GS). A one-way analysis of covariance (ANCOVA) was used to identify significant differences among the groups' results on the physical function tests, controlling for age, sex, educational year, Mini-Nutritional Assessment, senior activity and exercise frequency, low-density lipoprotein, body mass index, free-fat mass index, and assistance for the TUG test. Multiple regression analysis was also used to investigate the correlation between these covariates and physical function tests results. RESULTS: The ANCOVA showed that FR, OLS, and TG were significantly worse among the individuals with aMCI, mild AD, or moderate AD compared with NC. However, TUG was significantly worse only in the moderate AD group compared with the NC, aMCI, and mild AD group. Multiple regression analysis showed that aging was correlated with poorer scores on all physical function tests, women had poorer scores on FR and GS than men, and low frequency of senior activity was significantly correlated with poorer scores on FR, OLS, and TG. CONCLUSION: Postural impairment and instability on TG was seen in earlier AD stages compared with instability on TUG. As were the covariates of age and sex, senior activity frequency was significantly related to 2 or more physical function tests.

Development and validation of a new quality of life scale for patients receiving home-based medical care: The Observational Study of Nagoya Elderly with Home Medical Care.

AIM: To develop and validate a scale that assesses quality of life in patients receiving home-based medical care. METHODS: A new quality of life scale was developed and evaluated in four phases: (i) item generation; (ii) first field study with a 14-item questionnaire; (iii) preliminary validation study, to reduce the number of items to four; and (iv) second field study comprising 40 patients, to evaluate the validity of the final version. Participants were requested to answer both the final version of the scale and the Short Form-8, to enable identification of any relationship between the two. RESULTS: Items were generated after discussions with doctors and care managers, and 14 items were selected for the draft version. In the preliminary validation study, 10 items were deleted, based on the results of statistical analysis of the data from the first field study. A psychometric analysis showed that the final four-item questionnaire had internal consistency (Cronbach's α = 0.7), and a significant association with the Short Form-8. CONCLUSIONS: We created the first quality of life scale for patients receiving home-based medical care. The scale's internal consistency was confirmed, as well as its external validity. This scale can be used independently of factors such as a patient's age, sex, level of independence in the presence of dementia or disability, swallowing function, hearing ability and communication ability, and can be used with ease in routine clinical practice. Geriatr Gerontol Int 2017; 17: 440-448.

Lifestyle Changes and Oxidative Stress in a High-incidence Area of Amyotrophic Lateral Sclerosis in the Southwestern Kii Peninsula, Japan.

Objective Lifestyle changes may play an important role in the incidence reduction and delay of onset age of amyotrophic lateral sclerosis (ALS) in the Koza/Kozagawa/Kushimoto (K) area. The aim of this study was to evaluate recent lifestyle changes in the K area and to investigate the relationships between lifestyle and oxidative stress among the residents. Methods We conducted a medical checkup for elderly residents in the K area and the control area and evaluated the urinary 8-OHdG levels, cognitive function test scores and metal contents in serum and scalp hair, coupled with a lifestyle questionnaire survey between 2010 and 2015. Results Recent lifestyle changes among the K residents, including a decrease in the Japanese pickle consumption, increase in fresh vegetable consumption and decrease in farm work, were evaluated in this study. Low consumption of Japanese pickles, high consumption of fresh vegetables, rare farm work and low levels of 8-OHdG/creatinine were all associated with high scores in the cognitive function tests. Frequent farm work and consumption of Japanese pickles was associated with high contents of transition metals, such as Mn, Al and V, in the scalp hair. Conclusion These lifestyle changes among residents in the K area may be associated with their oxidative stress.

Life expectancy at the age of 65 years and environmental factors: an ecological study in Japan.

The purpose of this study was to examine the factors associated with life expectancy at the age of 65 years used as the index of longevity, using published data in Japan. Life expectancy at the age of 65 years was obtained from the 19th life table in 2000 published by the Ministry of Health, Labour and Welfare of Japan. The associations between life expectancy at the age of 65 years and environmental factors were assessed by Spearman correlation coefficients. Life expectancy at the age of 65 years was higher in females (22.54 years) than in males (17.42 years). In this study, the number of public health nurses and leisure time per day were found significantly associated with life expectancy at the age of 65 years in both men and women. For men, life expectancy at the age of 65 years was significantly associated with leisure time for sports and exercises and higher proportion of participation in volunteer activities in the community; for women, it was associated with a higher number of hospitals and proportion of participation in educational classes for the aged. Our ecological study might provide some clues to more practical planning for longevity in consideration of gender differences.

Dietary risk factors for inflammatory bowel disease: a multicenter case-control study in Japan.

To evaluate the role of dietary factors in the etiology of inflammatory bowel disease (IBD), we conducted a multicenter hospital-based case-control study in a Japanese population. Cases were IBD patients aged 15 to 34 years [ulcerative colitis (UC) 111 patients; Crohn's disease (CD) 128 patients] within 3 years after diagnosis in 13 hospitals. One control subject was recruited for each case who was matched for sex, age, and hospital. A semiquantitative food frequency questionnaire was used to estimate preillness intakes of food groups and nutrients. All the available control subjects (n = 219) were pooled, and unconditional logistic models were applied to calculate odds ratios (ORs). In the food groups, a higher consumption of sweets was positively associated with UC risk [OR for the highest versus lowest quartile, 2.86; 95% confidence interval (CI), 1.24 to 6.57], whereas the consumption of sugars and sweeteners (OR, 2.12; 95% CI, 1.08 to 4.17), sweets (OR, 2.83; 95% CI, 1.38 to 5.83), fats and oils (OR, 2.64; 95% CI, 1.29 to 5.39), and fish and shellfish (OR, 2.41; 95% CI, 1.18-4.89) were positively associated with CD risk. In respect to nutrients, the intake of vitamin C (OR, 0.45; 95% CI, 0.21 to 0.99) was negatively related to UC risk, while the intake of total fat (OR, 2.86; 95% CI, 1.39 to 5.90), monounsaturated fatty acids (OR, 2.49; 95% CI, 1.23 to 5.03) and polyunsaturated fatty acids (OR, 2.31; 95% CI, 1.12 to 4.79), vitamin E (OR, 3.23; 95% CI, 1.45 to 7.17), and n-3 (OR, 3.24; 95% CI, 1.52 to 6.88) and n-6 fatty acids (OR, 2.57; 95% CI, 1.24 to 5.32) was positively associated with CD risk. Although this study suffers from the shortcoming of recall bias, which is inherent in most retrospective studies (prospective studies are warranted to confirm the associations between diet and IBD risk), the present findings suggest the importance of dietary factors for IBD prevention.

The relationships of gender, cigarette smoking, and hypertension with the risk of aneurysmal subarachnoid hemorrhage: a case-control study in Nagoya, Japan.

PURPOSE: To examine the relationship of gender, cigarette smoking, and a history of hypertension to the risk of aneurysmal subarachnoid hemorrhage (SAH), using a case-control study. METHODS: Case subjects consisted of a consecutive series of 201 patients with spontaneous SAH with aneurysm(s) confirmed by angiography and/or CT scan. One hospital and one community control subject was matched to each case by gender and age (+/- 2 years). Multiple conditional logistic regression was used to calculate the odds ratio (OR) and 95% confidence interval (CI) adjusted for potential confounders. RESULTS: Current smoking and a history of hypertension were each significantly associated with an increased risk of subarachnoid hemorrhage for men and women combined. There was also a non-significant trend towards synergism between these two factors with respect to an increased risk of subarachnoid hemorrhage for each gender separately and both combined. A significantly increased risk was observed for a history of hypertension (adjusted OR, 3.5; 95% CI, 1.2-14.7) among men, for current smoking alone (adjusted OR, 2.9; 95% CI, 1.1-7.7), and a history of hypertension alone (adjusted OR, 2.6; 95% CI, 1.4-5.1) among women. CONCLUSIONS: Trends towards gender differences and synergism emerged in the relationship of cigarette smoking and a history of hypertension of the risk of SAH provides useful information for targeting individuals/populations in programs for the primary prevention of SAH by gender.

Computerized assessment of communication for cognitive stimulation for people with cognitive decline using spectral-distortion measures and phylogenetic inference.

Therapeutic communication and interpersonal relationships in care homes can help people to improve their mental wellbeing. Assessment of the efficacy of these dynamic and complex processes are necessary for psychosocial planning and management. This paper presents a pilot application of photoplethysmography in synchronized physiological measurements of communications between the care-giver and people with dementia. Signal-based evaluations of the therapy can be carried out using the measures of spectral distortion and the inference of phylogenetic trees. The proposed computational models can be of assistance and cost-effectiveness in caring for and monitoring people with cognitive decline.

Neutron activation analysis of scalp hair from ALS patients and residents in the Kii Peninsula, Japan.

The aim of this study was to evaluate the accumulation of transition metals in the scalp hair of amyotrophic lateral sclerosis (ALS) patients in the Koza/Kozagawa/Kushimoto (K) area (K-ALS) in the Kii Peninsula, Japan. Metal contents were measured in the unpermed, undyed hair samples of 88 K-residents, 20 controls, 7 K-ALS patients, and 10 sporadic ALS patients using neutron activation analysis at the Research Reactor Institute, Kyoto University. A human hair standard and elemental standards were used as comparative standards. The contents of Zn, Mn, and V were higher, while that of S was lower in K-ALS patients than in the controls. The content of Mn in K-ALS patients negatively correlated with clinical durations. The content of Al was significantly higher in K-residents than in the controls, with 15.9 % of K-residents having high Mn contents over the 75th percentile of the controls. The contents of Zn, Mn, and V were high in the scalp hair of K-ALS patients and correlated with the content of Al. The accumulation of these transition metals may chronically increase metal-induced oxidative stress, which may, in turn, trigger the neuronal degeneration associated with K-ALS.

Family history and risk of subarachnoid hemorrhage: a case-control study in Nagoya, Japan.

BACKGROUND AND PURPOSE: We sought to examine the relation between a family history of subarachnoid hemorrhage (SAH) and the risk of SAH by using a case-control study. METHODS: Case subjects consisted of a consecutive series of 195 patients with spontaneous SAH, aged 30 to 79 years, with aneurysms confirmed by angiography and/or CT scan. Hospital and community control subjects were identified and matched to each case by sex and age (+/-2 years). Multiple conditional logistic regression was used to calculate the odds ratio (OR) and 95% interval (CI) adjusted for potential confounders. RESULTS: Having a family member with SAH was significantly associated with an increased risk of SAH (OR, 4.0, 95% CI, 2.0 to 8.0), after adjusting for potential confounders. The risk for a positive family history of SAH was similar for men and women and was inversely related to the SAH patient's age. A maternal positive SAH history (OR, 5.4; 95% CI, 1.8 to 16.0) posed a much greater risk than a paternal positive history (OR, 3.2, 95% CI, 1.1 to 13.4). CONCLUSIONS: A positive family history of SAH was significantly and strongly associated with the risk of SAH. To prevent the onset of SAH at a younger age, much more attention should be given to individuals with any family member (first-degree relatives) suffering SAH episodes.

Comparability of epidemiological information between self- and interviewer-administered questionnaires.

The aim of the present study was to determine the extent to which respondents provided the same answers to a health-related lifestyle questionnaire in self- and interviewer-administered forms. A total of 234 subjects completed a 110-item questionnaire in both interviewer and self-administered forms. Modes of administration were separated by a 2-week interval. The order was determined by random allocation. The presence and the extent of the tendency to give socially acceptable responses were evaluated using percentage of bias calculated as the ratio of the difference in proportion of positive responses or the mean between interviews and questionnaires and those in questionnaires. All percentages of bias were in the positive direction, ranging from 1.4% (physical exercise) to 26.1% (general life stress). The average percentage of bias was higher in women than in men and were stronger for younger respondents. The age differences between interviewer and respondent were inversely and most strongly related to percentage of bias. Self- and interviewer-administered questionnaires yield very similar results in discriminating between subjects, but the interviewer-administered questionnaire showed systematically more desirable responses to questions related to lifestyle factors. The differences in characteristics between interviewer and respondent may be important determinants of the socially desirability bias in the interview.