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BackgroundChronic obstructive lung disease frequently leads to disability. Older patients may experience transitions between states of disability and independence over time.ObjectiveTo identify factors associated with transition between states of disability and independent function in obstructive lung disease.MethodsWe analyzed data on 4,394 participants in the Cardiovascular Health Study who completed prebronchodilator spirometry. We calculated the 1-year probability of developing and resolving impairment in ≥1 instrumental activity of daily living (IADL) or ≥1 activity of daily living (ADL) using transition probability analysis. We identified factors associated with resolving disability using relative risk (RR) regression.ResultsThe prevalence of IADL impairment was higher with moderate (23.9%) and severe (36.9%) airflow obstruction compared to normal spirometry (22.5%; p < 0.001). Among participants with severe airflow obstruction, 23.5% recovered independence in IADLs and 40.5% recovered independence in ADLs. In the adjusted analyses, airflow obstruction predicted the development of IADL, but not ADL impairment. Participants with severe airflow obstruction were less likely to resolve IADL impairment [RR 0.67 and 95% confidence interval (CI) 0.49-0.94]. Compared to the most active individuals (i.e. who walked ≥28 blocks per week), walking less was associated with a decreased likelihood of resolving IADL impairment (7-27 blocks: RR 0.81 and 95% CI 0.69-0.86 and

RationaleRelationships between chronic health conditions and acute infections remain poorly understood. Preclinical studies suggest crosstalk between nervous and immune systems.ObjectivesTo determine bidirectional relationships between cognition and pneumonia.MethodsWe conducted longitudinal analyses of a population-based cohort over 10 years. We determined whether changes in cognition increase risk of pneumonia hospitalization by trajectory analyses and joint modeling. We then determined whether pneumonia hospitalization increased risk of subsequent dementia using a Cox model with pneumonia as a time-varying covariate.Measurements and main resultsOf the 5,888 participants, 639 (10.9%) were hospitalized with pneumonia at least once. Most participants had normal cognition before pneumonia. Three cognition trajectories were identified: no, minimal, and severe rapid decline. A greater proportion of participants hospitalized with pneumonia were on trajectories of minimal or severe decline before occurrence of pneumonia compared with those never hospitalized with pneumonia (proportion with no, minimal, and severe decline were 67.1%, 22.8%, and 10.0% vs. 76.0%, 19.3%, and 4.6% for participants with and without pneumonia, respectively; P < 0.001). Small subclinical changes in cognition increased risk of pneumonia, even in those with normal cognition and physical function before pneumonia (β = -0.02; P < 0.001). Participants with pneumonia were subsequently at an increased risk of dementia (hazard ratio, 2.24 [95% confidence interval, 1.62-3.11]; P = 0.01). Associations were independent of demographics, health behaviors, other chronic conditions, and physical function. Bidirectional relationship did not vary based on severity of disease, and similar associations were noted for those with severe sepsis and other infections.ConclusionsA bidirectional relationship exists between pneumonia and cognition and may explain how a single episode of infection in well-appearing older individuals accelerates decline in chronic health conditions and loss of functional independence.

Investigated individual characteristics and peer influences related to adolescents' sexual behavior, considering gender and sexual experience. Students reported on intentions to engage in sexual activity and use condoms in the next year, amount of pressure to engage in sexual activity, and perceptions about the number of their peers engaging in sexual activity. Responses differed by gender and sexual experience status. (SM)

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1559-1816.2007.00285.x Byline: Blair Beadnell (2a), Anthony Wilsdon (a), Elizabeth A. Wells (a), Diane M. Morison (a), Mary Rogers Gillmore (b), Marilyn Hoppe (a) Abstract: This study tested the theory of planned behavior's (TPB) expectation that attitudes, social norms, and self-efficacy would mediate other variables' effects on intention for having sex and probability of having sex. Longitudinal data were collected from 790 high-school-aged adolescents. In an intrapersonal variable model, sensation seeking, alcohol use, hard work, smoking, and moral beliefs had mediated effects, but the last 2 also had direct effects (on intention and behavior, respectively). In an interpersonal model, school attachment had mediated effects, pressure to have sex had a direct effect on behavior, and parent communication and number of sexually active friends had both. Intrapersonal variable effects were better described by the TPB than those of interpersonal variables. Targeting distal psychosocial factors may enhance intervention efficacy. Author Affiliation: (a)School of Social WorkUniversity of Washington (b)School of Social Work, College of Public ProgramsArizona State University Article note: (2) Correspondence concerning this article should be directed to Blair Beadnell, School of Social Work, 4101 15th Avenue, NE, University of Washington, Seattle, WA 98105. E-mail: blairb@u.washington.edu

This research examined the applicability of the theory of reasoned action to school-age children. Using structural equation modeling, we longitudinally modeled children's attitudes, norms, intentions, and behavior with regard to drinking alcohol. Respondents were 1,061 children attending public schools in the northwestern United States. Attitude, norms, and intentions (measured when the children were in 6th, 7th, 8th, and 9th grades) were used to predict alcohol use 1 year later. Two modifications of the model improved the overall fit at each grade level: separating attitude into 2 dimensions (positive and negative), and adding a path from social norm to behavior. The theoretical and practical implications of these results are discussed.

This paper reports the results of a study in which age (grade level), racial/ethnic, and gender differences in beliefs and perceived norms about drinking were examined in a multi-ethnic urban sample of 4th through 7th grade children. Results showed that older children held beliefs and perceived norms that were more favorable toward drinking than younger children. The major difference between older and younger children lay in their differential estimates of the likelihood of certain consequences occurring and not in their evaluation of these consequences of drinking. Further, older children riot only displayed less motivation to comply with their parents and greater motivation to comply with their peers, but they also perceived their parents, as well as their peers, as less disapproving of drinking than did younger children. There were few gender or race/ethnicity differences at these ages in children's beliefs and perceived norms about drinking., INTRODUCTION There is mounting evidence that alcohol expectancies (beliefs about the effects of alcohol) play an important etiological role in the initiation and maintenance of adolescent drinking (1-6). Alcohol expectancies [...]

An experiment was carried out wherein six items were given to a multiethnic sample of middle school age participants in a group delivered safer sex intervention to find out their reliability and validity. It was seen that at the within-group level the association between baseline friendship scores and cost concurrently and subsequently measured items were positive and statistically significant.

Background: High rates of disability associated with chronic airway obstruction may be caused by impaired pulmonary function, pulmonary symptoms, other chronic diseases, or systemic inflammation. Methods: We analyzed data from the Cardiovascular Health Study, a longitudinal cohort of 5888 older adults. Categories of lung function (normal; restricted; borderline, mild-moderate, and severe obstruction) were delineated by baseline spirometry (without bronchodilator). Disability-free years were calculated as total years alive and without self-report of difficulty performing &γτ;1 Instrumental Activities of Daily Living over 6 years of follow-up. Using linear regression, we compared disability-free years by lung disease category, adjusting for demographic factors, body mass index, smoking, cognition, and other chronic co-morbidities. Among participants with airflow obstruction, we examined the association of respiratory factors (FEV1 and dyspnea) and non-respiratory factors (ischemic heart disease, congestive heart failure, diabetes, muscle weakness, osteoporosis, depression and cognitive impairment) on disability-free years. Results: The average disability free years were 4.0 out of a possible 6 years. Severe obstruction was associated with 1 fewer disability-free year compared to normal spirometry in the adjusted model. For the 1,048 participants with airway obstruction, both respiratory factors (FEV1 and dyspnea) and non-respiratory factors (heart disease, coronary artery disease, diabetes, depression, osteoporosis, cognitive function, and weakness) were associated with decreased disability-free years. Conclusions: Severe obstruction is associated with greater disability compared to patients with normal spirometery. Both respiratory and non-respiratory factors contribute to disability in older adults with abnormal spirometry. [ABSTRACT FROM AUTHOR]

BACKGROUND: The contribution of obesity to hypoxemia has not been reported in a community- based study. Our hypothesis was that increasing obesity would be independently associated with lower SpO2 in an ambulatory elderly population. METHODS: The Cardiovascular Health Study ascertained resting SpO2in 2,252 subjects over age 64. We used multiple linear regression to estimate the association of body mass index (BMI) with SpO2, and to adjust for potentially confounding factors. Covariates including age, sex, race, smoking, airway obstruction (based on spirometry), self reported diagnosis of emphysema, asthma, heart failure, and left ventricular function (by echocar- diography) were evaluated. RESULTS: Among 2,252 subjects the mean and median SpO2 were 97.6% and 98.0% respectively; 5% of subjects had SpO2values below 95%. BMI was negatively correlated with SpO7 (Spearman R = -0.27, P < .001). The mean difference in SpOi between the lowest and highest BMI categories (< 25 kg/m2 and ≥ 35 kg/m2) was 1.33% (95% CI 0.89-1.78%). In multivariable linear regression analysis, SpO2 was significantly inversely associated with BMI (1.4% per 10 units of BMI, 95% CI 1.2-1.6, for whites/others, and 0.87% per 10 units of BMI, 95% CI 0.47-1.27, for African Americans). CONCLUSIONS: We found a narrow distribution of SpO2) values in a community-based sample of ambulatory elderly. Obesity was a strong independent contributor to a low SpO2, with effects comparable to or greater than other factors clinically associated with lower SpO2 [ABSTRACT FROM AUTHOR]

The article reports on public health efforts to control sexually transmitted diseases and HIV/AIDS within teenage and young adult populations. Prevention intervention efforts are described and their effectiveness is evaluated. Condom and contraceptive use is reported. A prevention intervention course titled Focus on Kids is described and the article reports on its transferability to other locations. African Americans, East Africans, Southeast Asians and rural West Virginians took part in the prevention intervention and the article evaluates its effectiveness.