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Purpose: This study investigates gender differences in the association between self-rated health (SRH) and mortality. This association has been well-documented, but findings regarding gender differences are inconsistent. The specific objectives were (a) to examine these differences in a short and a long time frame, (b) to examine these differences among old and old-old people, and (c) to address the question of whether this association is based on the accuracy of poor SRH as a predictor of future decline, and/or of better SRH as a predictor of longevity. Design and Methods: The study is based on an Israeli nationally representative sample of 622 women and 730 men who were interviewed about their SRH, as well as sociodemographic information and other measures of health, physical functioning, cognitive status, and depression. Results: For both genders, SRH was associated only with shorter term mortality (within the next 4 years) and not with longer-term mortality (9 years of follow-up). This association was strongest among the old (ages 75-84) women, compared with the old men and with the old-old (85-94) women and men. A possible explanation may be related to differences in the accuracy of excellent SRH at very old age. Implications: The SRH-mortality association may differ among age and gender groups. Identifying the conditions under which it is more accurate will enable researchers and practitioners to know when it can be utilized. It is important to assess differences in the accuracy of poor SRH as well as of excellent SRH as predictors of future health outcomes.

Background. The optimal setting and design of a comprehensive treatment for elderly hip fracture patients is unknown. The aims of this study were to compare the functional outcomes associated with an innovative comprehensive single-step (geriatric-based) and classic double-step (orthopedic-based) treatment of such patients. Methods. This is a partially concurrent prospective study, taking place in the orthogeriatric unit of a department of geriatric rehabilitation, in a large urban academic freestanding hospital. The participants were 336 consecutive elderly people, admitted for surgry of extracapsular or intracapsular hip fracture. 204 patients were admitted to the department of orthopedic surgery and transferred, shortly after surgery, to the orthogeriatric ward for ongoing rehabilitation (ORTgroup). Another 116 patients were admitted directly to a geriatric-based orthogeriatric ward, and they received surgical, medical, and rehabilitation treatment within the same facility (ORTGER group). The main outcome measures were length of stay, absolute functional gains of the motor functional independence measure (FIM), and relative functional motor gains according to the Montebello rehabilitation factor score. Succesful rehabilitation was defined as relative functional gain > .5. Results. 320 patients were included in the final analysis. The two groups were similar, yet ORT-group patients were somewhat younger (p < .02) and were cognitively better preserved (p < .01). Admission cognitive FIM was the strongest positive predictive factor associated with successful rehabilitation (odds ratio = 2.45, 95% confidence interval 1.89-3.31, and p < .001). Significant improvement of total FIM scores occurred during rehabilitation in both groups. The relative functional gain was smilar in the two groups, but total hospital length of stay was 5 days shorter in the ORTGER group (p < .01). After the effect of age, sex, length of stay, fracture type, and cognition at onset of the rehabilitation period were adjusted for, patients of the ORTGER group had a twofold chance for successful rehabilitation, compared with ORT-group patients (odds ratio = 1.97, 95% confidence interval 1.09-3.65, and p = .03). Conclusions. The functional outcome of elderly hip fracture patients is better for those treated in the orthogeriatric setting, as compared with the common two-steps model of orthopedic surgery followed by transfer to a geriatric rehabilitation facility.

The Israeli population is characterized by its marked ethnic diversity. These ethnic groups (originating mainly from Yemen/Aden, the Middle East, North Africa and Europe/America) have kept traditional distinct lifestyle habits and exhibit different morbidity and mortality trends. The aim of the present study was to evaluate the associations among ethnic background, lifestyle patterns and 18-y all-cause mortality. A subgroup of 632 individuals aged 41-70 y, drawn from a larger stratified cohort from the Israel Glucose Intolerance, Obesity and Hypertension study, were personally interviewed, using a quantified food-frequency questionnaire, including most food items consumed by the different subpopulations in Israel. Physical activity was also evaluated, as well as smoking status. Weight, height and blood pressure (BP) measurements were taken. Predictors of mortality were assessed using Cox proportional hazards models. Over the 18-y follow-up period, 151 deaths occurred (24%). In comparison with Yemenites, the adjusted hazard ratios (HR) for all cause mortality were HR = 1.77 [95% confidence interval (CI): 1.01-3.09] for Europeans/Americans; HR = 1.63 (95% CI: 0.89-2.99) for those from a Middle Eastern background; and HR = 1.56 (95% CI: 0.82-2.97) for North Africans. Mortality risk was 43% lower among those consuming [greater than or equal to] 25 g of dietary fiber daily [HR = 0.57 (95% CI: 0.41-0.72)], and 42% lower for those consuming KEY WORDS: * ethnicity * nutrition * lifestyle habits * mortality

Objective. Nosocomial infections are a serious problem among very low birth weight (VLBW) infants. We studied the association between late-onset sepsis (LOS) and mortality and morbidity in VLBW infants. Methods. From a national cohort of 5555 VLBW infants born in Israel during 1995 through 1998, 4829 survived at least 3 days and composed the study population. Maternal, perinatal, or postnatal variables that showed a significant association with LOS in a univariate analysis were tested in a bivariate analysis (adjusted for gestational age). Variables with P [less than or equal to] .1 were then tested by a multiple logistic regression for assessing the net effect of each variable on the risk for LOS. Results. One or more episodes of bloodstreamproven LOS occurred in 1453 infants (30%). Gram-positive and Gram-negative bacteria accounted for 55.4% and 31.2% of microbes, respectively, mainly coagulase-negative Staphylococci and Klebsiella. Compared with those without LOS, infants with LOS had a significantly higher mortality rate (16.9% vs 8.6%). Mortality after Gram-negative LOS (26.2%) and Candida LOS (27.6%) was similar and significantly higher than with Gram-positive LOS (8.7%). Significant independent predictors of LOS were decreasing gestational age, cesarean section, mechanical ventilation, patent ductus arteriosus, necrotizing enterocolitis, and bronchopulmonary dysplasia. Conclusions. LOS occurred in 30% of Israeli VLBW infants. Six strong independent predictors for LOS were identified. Recognition and awareness of the epidemiologic, clinical, and microbiologic characteristics of LOS remain the keystones for management of this nosocomial infection. Pediatrics 2002;109:34-39; sepsis, premature infant, very low birth weight infant, morbidity, mortality., ABBREVIATIONS. LOS, late-onset sepsis; VLBW, very low birth weight; SCN, Staphylococcus-coagulase-negative; RDS, respiratory distress syndrome; PDA, patent ductus arteriosus; IVH, intraventricular hemorrhage; NEC, necrotizing enterocolitis; BPD, bronchopulmonary dysplasia; GA, gestational [...]