Symptom profile of affirmative responses to a self-report concussion question, United States 2019

Purpose This study used a mixed-methods design to assess changes in students' cultural awareness during and following a short-term study abroad. Method Thirty-six undergraduate and graduate students participated in a 2-week study abroad to England during the summers of 2016 and 2017. Quantitative data were collected using standardized self-report measures administered prior to departure and after returning to the United States and were analyzed using paired-samples t tests. Qualitative data were collected in the form of daily journal reflections during the trip and interviews after returning to the United States and analyzed using phenomenological methods. Results No statistically significant changes were evident on any standardized self-report measures once corrections for multiple t tests were applied. In addition, a ceiling effect was found on one measure. On the qualitative measures, themes from student transcripts included increased global awareness and a sense of personal growth. Conclusions Measuring cultural awareness poses many challenges. One is that social desirability bias may influence responses. A second is that current measures of cultural competence may exhibit ceiling or floor effects. Analysis of qualitative data may be more useful in examining effects of participation in a short-term study abroad, which appears to result in decreased ethnocentrism and increased global awareness in communication sciences and disorders students. Future work may wish to consider the long-term effects of participation in a study abroad for emerging professionals in the field.

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Assessing OCD Symptoms and Severity

10.1093/oxfordhb/9780195376210.013.0051 ◽

2012 ◽

Author(s):

Nicole M. Dorfan ◽

Sheila R. Woody

Keyword(s):

Treatment Plan ◽

Behavioral Assessment ◽

Assessment Tools ◽

Self Report ◽

Obsessive Compulsive ◽

Self Monitoring ◽

Evidence Based Treatment ◽

Compulsive Disorder ◽

Symptom Profile ◽

Diagnostic Interviews

This chapter describes methods and tools for assessing obsessive compulsive disorder (OCD). The chapter outlines the purposes of assessment and discusses special challenges presented by OCD, such as shame associated with socially unacceptable obsessional content. Several types of assessment tools are discussed, including structured diagnostic interviews, semistructured clinician interviews to assess OCD symptom profile and severity, self-report instruments, behavioral assessment and self-monitoring, assessment of appraisals and beliefs relevant to OCD, and functional impairment. The importance of linking assessment findings to an evidence-based treatment plan is discussed.

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Racial/Ethnic Disparities in Hypertension Prevalence, Awareness, Treatment, and Control in the United States, 2013 to 2018

Hypertension ◽

10.1161/hypertensionaha.121.17570 ◽

2021 ◽

Author(s):

Rahul Aggarwal ◽

Nicholas Chiu ◽

Rishi K. Wadhera ◽

Andrew E. Moran ◽

Inbar Raber ◽

...

Keyword(s):

United States ◽

Ethnic Disparities ◽

The United States ◽

Self Report ◽

Similar Treatment ◽

Hypertension Prevalence ◽

Health And Nutrition ◽

Race Ethnicity ◽

And Control ◽

White Adults

We evaluated the prevalence, awareness, treatment, and control of hypertension (defined as a systolic blood pressure [BP]) ≥140 mm Hg, diastolic BP ≥90 mm Hg, or a self-reported use of an antihypertensive agent) among US adults, stratified by race/ethnicity. This analysis included 16 531 nonpregnant US adults (≥18 years) in the three National Health and Nutrition Examination Survey cycles between 2013 and 2018. Race/ethnicity was defined by self-report as White, Black, Hispanic, Asian, or other Americans. Among 76 910 050 (74 449 985–79 370 115) US adults with hypertension, 48.6% (47.3%–49.8%, unadjusted) have controlled BP. When compared with BP control rates for White adults (49.0% [46.8%–51.2%], age-adjusted), BP control rates are lower in Black (39.2%, adjusted odds ratio [aOR], 0.71 [95% CI, 0.59–0.85], P <0.001), Hispanic (40.0%, aOR, 0.71 [95% CI, 0.58–0.88], P =0.003), and Asian (37.8%, aOR, 0.68 [95% CI, 0.55–0.84], P =0.001) Americans. Black adults have higher hypertension prevalence (45.3% versus 31.4%, aOR, 2.24 [95% CI, 1.97–2.56], P <0.001) but similar awareness and treatment rates as White adults. Hispanic adults have similar hypertension prevalence, but lower awareness (71.1% versus 79.1%, aOR, 0.72 [95% CI, 0.58–0.89], P =0.005) and treatment rates (60.5% versus 67.3%, aOR, 0.78 [95% CI, 0.66–0.94], P =0.010) than White adults. Asian adults have similar hypertension prevalence, lower awareness (72.5% versus 79.1%, aOR, 0.75 [95% CI, 0.58–0.97], P =0.038) but similar treatment rates. Black, Hispanic, and Asian Americans have different vulnerabilities in the hypertension control cascade of prevalence, awareness, treatment, and control. These differences can inform targeted public health efforts to promote health equity and reduce the burden of hypertension in the United States.

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Abstract T P139: Rising Rates of the Metabolic Syndrome Among Stroke Survivors in the United States

Stroke ◽

10.1161/str.45.suppl_1.tp139 ◽

2014 ◽

Vol 45 (suppl_1) ◽

Author(s):

Michael McManus ◽

Daniela Markovic ◽

Natalie Valle ◽

Bruce Ovbiagele ◽

Amytis Towfighi

Keyword(s):

United States ◽

Metabolic Syndrome ◽

Stroke Risk ◽

Recurrent Stroke ◽

Temporal Trends ◽

The United States ◽

Self Report ◽

Stroke Survivors ◽

Middle Aged ◽

The Metabolic Syndrome

BACKGROUND: Metabolic syndrome (MetS), a constellation of cardiometabolic risk factors clustering together, affects >47 million US adults and has been independently linked to primary and recurrent stroke risk. Prevalence and trends in MetS among stroke survivors in the United States are unknown. OBJECTIVES: To evaluate recent temporal trends in age and sex-specific MetS prevalence among adults with/without stroke in the US. METHODS: Prevalence of MetS was assessed among fasting adults ≥35 years who participated in National Health and Nutrition Examination Surveys 1999-2010 (n=9,343). Prevalence estimates were weighted to obtain nationally representative estimates (n=430,371,669). MetS was defined by the 2009 harmonized definition. Stroke was determined by self-report. RESULTS: In all groups except men 35-64 years, MetS prevalence was similar among adults with and without stroke in 1999-2002 (Table). MetS prevalence rates were flat from 1999 to 2010 among those without stroke, but increased among stroke survivors, such that up to 80% of men and 86% of women with stroke had MetS, with the greatest rise among the middle-aged. Stroke survivors aged 35-64 years were ~3 times more likely to have MetS than their counterparts without stroke (OR 3.24, 95% CI 1.60-6.55 for men and OR 2.55, 95% CI 1.45-4.50 for women). DISCUSSION: Due to a differential rise in MetS in stroke survivors over the last 10 years, as many as 9 out of 10 stroke survivors now have MetS, suggesting that Mets may increasingly be placing people at risk for stroke. Intensified efforts aimed at identifying and treating MetS, especially among middle-aged individuals, may be warranted to avert stroke risk.

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Accuracy of self-referral in health anxiety: comparison of patients self-referring to internet-delivered treatment versus patients clinician-referred to face-to-face treatment

BJPsych Open ◽

10.1192/bjo.2019.54 ◽

2019 ◽

Vol 5 (5) ◽

Author(s):

Ditte Hoffmann ◽

Charlotte Ulrikka Rask ◽

Erik Hedman-Lagerlöf ◽

Trine Eilenberg ◽

Lisbeth Frostholm

Keyword(s):

Health Anxiety ◽

Diagnostic Delay ◽

Accurate Method ◽

Diagnostic Interview ◽

Self Report ◽

Eligibility Criteria ◽

Recruitment Methods ◽

Face To Face ◽

Symptom Profile ◽

Mean Differences

Background Severe health anxiety is a chronic and costly disorder if untreated. Patient self-referral may lower barriers to treatment and decrease diagnostic delay. Aims This study evaluated the accuracy of self-referral for severe health anxiety and compared characteristics of patients self-referred to internet-delivered treatment with patients referred by a clinician to face-to-face treatment. Method Two trials in the same clinic employed different referral methods for health anxiety, namely self-referral and clinician-referral (trial registration: clinicaltrials.gov: NCT01158430 and NCT02735434). The trials were conducted at different time points but with largely comparable eligibility criteria. The accuracy of the recruitment methods was compared by looking at the number of eligible patients in the two trials. Patients completed a baseline questionnaire and subsequently underwent a diagnostic interview by experienced clinicians. Mean differences in self-report and clinical data explored between-group demographic and clinical characteristics. Results In total, 101/151 (67%) self-referred patients were eligible compared with 126/254 (50%) clinician-referred patients (P = 0.001). Self-referred patients were 3.4 years older (P = 0.008) and had a somewhat higher educational level (P = 0.030). Patients who self-referred reported significantly higher levels of health anxiety, emotional distress and somatic symptoms compared with clinician-referred patients. Yet, they had less clinician-assessed comorbid anxiety disorders (P<0.001) and better physical health-related quality of life (P<0.001) suggesting a more distinct symptom profile. Conclusions Self-referral was found to be an accurate method to recruit highly relevant patients with treatment-demanding health anxiety. Thus, both self-referral and clinician-referral seem feasible and valid referral methods, but they may recruit patients with slightly different characteristics. Declaration of interest None.

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Education-Related Inequalities in Dental Services Use among Older Adults in 23 Countries

Journal of Dental Research ◽

10.1177/0022034520935854 ◽

2020 ◽

Vol 99 (12) ◽

pp. 1341-1347

Author(s):

F. Bof de Andrade ◽

J.L.F. Antunes ◽

F.C.D. Andrade ◽

M.F.F. Lima-Costa ◽

J. Macinko

Keyword(s):

United States ◽

Older Adults ◽

South Korea ◽

The United States ◽

Self Report ◽

Absolute Difference ◽

Dental Services ◽

Cross Sectional ◽

Relative Index ◽

Index Of Inequality

This study aimed to measure the magnitude of education-related inequalities in the use of dental services among older adults (aged 50 y or older) from a sizable multicountry sample of 23 upper-middle- and high-income countries. This study used cross-sectional data from nationally representative surveys of people aged 50 y and over. Countries included in the Health and Retirement Study surveys were the following: Brazil, China, South Korea, Mexico, United States, Austria, Belgium, Croatia, Czech Republic, Denmark, Estonia, France, Germany, Greece, Italy, Israel, Luxembourg, Poland, Portugal, Slovenia, Spain, Sweden, and Switzerland. The dependent variable was the use of dental services, based on the self-report of having had a dental visit within the previous year, except for the United States and South Korea, which used 2-y recall periods. Educational level was used as the measure of socioeconomic position and was standardized across countries. Multivariate logistic regression modeling was used to evaluate the factors associated with the use of dental services, and the magnitude of education inequalities in the use of dental services was assessed using the slope index of inequality (SII) to measure absolute inequalities and the relative index of inequality for relative inequalities. The pooled prevalence of the use of dental services was 31.7% and ranged from 18.7% in China to 81.2% in Sweden. In the overall sample, the absolute difference in the prevalence of use between the lowest and highest educational groups was 20 percentage points. SII was significant for all countries except Portugal. Relative educational inequalities were significant for all countries and ranged from 3.2 in Poland to 1.2 in Sweden. There were significant education-related inequalities in the use of dental care by older adults in all countries. Monitoring these inequalities is critical to the planning and delivery of dental services.

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Childhood Maltreatment Among Hispanic Women in the United States

Child Maltreatment ◽

10.1177/1077559512444593 ◽

2012 ◽

Vol 17 (2) ◽

pp. 119-131 ◽

Cited By ~ 14

Author(s):

Lynn A. Warner ◽

Margarita Alegría ◽

Glorisa Canino

Keyword(s):

United States ◽

Asian American ◽

Childhood Maltreatment ◽

Interpersonal Violence ◽

Depressive Disorders ◽

Hispanic Women ◽

The United States ◽

Self Report ◽

Nativity Status ◽

Increased Risk

Prevalence rates of childhood maltreatment among Hispanic women in the United States are presented separately for nativity status and ethnic origin subgroups, and the associations between different types of maltreatment and the development of anxiety and depressive disorders are examined. Analyses used self-report data from 1,427 Hispanic women who participated in the National Latino and Asian American Survey. Foreign-born Hispanic women compared to U.S.-born Hispanic women reported significantly lower rates of sexual assault and witnessing interpersonal violence, and a significantly higher rate of being beaten. Ethnic subgroups reported similar rates of maltreatment, with the exception of rape. Bivariate analyses were remarkably consistent in that regardless of nativity status or ethnic subgroup, each type of maltreatment experience increased the risk of psychiatric disorder. In multivariate models controlling for all types of victimization and proxies of acculturation, having been beaten and witnessing interpersonal violence remained significant predictors of both disorders, but sexual abuse increased risk of anxiety only. A significant interaction effect of family cultural conflict and witnessing violence on anxiety provided very limited support for the hypothesis that acculturation moderates the influence of maltreatment on mental health outcomes. Implications for culturally relevant prevention and intervention approaches are presented.

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Research Domain Criteria and OCD

10.1093/med/9780190228163.003.0062 ◽

2017 ◽

Author(s):

Eyal Kalanthroff ◽

Gideon E. Anholt ◽

Helen Blair Simpson

Keyword(s):

Mental Health ◽

United States ◽

Mental Disorders ◽

The United States ◽

Self Report ◽

Research Domain Criteria ◽

Diagnostic Systems ◽

Behavioral Measures ◽

Research Domain

This chapter discusses the Research Domain Criteria (RDoC) project, an initiative of the National Institutes of Mental Health (NIMH) of the United States to develop for research purposes new ways of classifying mental disorders based on dimensions of observable behavior and neurobiological measures, and explores how the hallmark symptoms of OCD (obsessions, compulsions, and anxiety) can be mapped onto RDoC domains. Unlike current categorical diagnostic systems (e.g., DSM), RDoC seeks to integrate many levels of information (from genomics to self-report) to validate dimensions defined by neurobiology and behavioral measures that cut across current disorder categories. The chapter explores, for heuristic reasons, how the RDoC matrix might be used to elucidate the neurobehavioral domains of dysfunction that lead to the characteristic symptoms of OCD. It then selectively reviews the OCD literature from the perspective of the RDoC domains, aiming to guide future transdiagnostic studies to examine specific neurobehavioral domains across disorders.

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Change in the symptom profile treated as asthma – two cross-sectional studies twenty years apart

Respiratory Research ◽

10.1186/s12931-020-1308-3 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Mihkel Pindus ◽

Hans Orru ◽

Rain Jõgi

Keyword(s):

Respiratory Symptoms ◽

Medication Use ◽

Asthma Medication ◽

Self Report ◽

Smoking History ◽

Asthma Treatment ◽

Chest Tightness ◽

Cross Sectional ◽

Symptom Profile ◽

The Impact

Abstract Aims The aims of the study were to investigate prevalence trends of respiratory symptoms, asthma and asthma treatment among young adults in Estonia and to estimate changes in symptom profile among subjects who self-report asthma attacks or use asthma medications. Methods Two similar questionnaires on respiratory health were sent to subjects in Tartu, Estonia, aged between 20 and 44 years; first in 1993/94, and then in 2014/15. To study the impact of different respiratory symptoms on asthma diagnosis and treatment, the log–binomial regression was used to estimate the association between ‘attack of asthma’ (as a proxy for current asthma) and respiratory symptoms as well as asthma treatment and respiratory symptoms, adjusted for age, sex and smoking history. Results Self–reported prevalence of asthma attack, asthma medication use and nasal allergies increased over the twenty years between studies, whereas there was no change in prevalence of asthma–related symptoms, and the prevalence of most respiratory symptoms either decreased, or remained unchanged. For women experiencing asthma attacks, the prevalence of nasal allergies increased and waking with chest tightness decreased. For men using asthma medication, the prevalence of a wheeze without a cold decreased. Women using asthma medication reported decreased prevalence of waking with chest tightness. Conclusion Self-reported asthma attacks and asthma medication use has increased in last 20 years, while the prevalence of most respiratory symptoms either decreased or did not change. It is likely that changes in asthma symptom profile have had an impact on the prevalence of asthma and asthma treatment.

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Use of Population-Based Surveys for Estimating the Population Size of Persons Who Inject Drugs in the United States

The Journal of Infectious Diseases ◽

10.1093/infdis/jiaa318 ◽

2020 ◽

Vol 222 (Supplement_5) ◽

pp. S218-S229

Author(s):

Heather Bradley ◽

Elizabeth M Rosenthal ◽

Meredith A Barranco ◽

Tomoko Udo ◽

Patrick S Sullivan ◽

...

Keyword(s):

United States ◽

Drug Use ◽

Population Size ◽

Prescription Drugs ◽

The United States ◽

Population Based ◽

Self Report ◽

Persons Who Inject Drugs ◽

Population Size Estimates ◽

Prevalence Estimates

Abstract Background In the United States, injection is an increasingly common route of administration for opioids and other substances. Estimates of the number of persons who inject drugs (PWID) are needed for monitoring risk-specific infectious disease rates and health services coverage. Methods We reviewed design and instruments for 4 national household surveys, 2012–2016, for their ability to produce unbiased injection drug use (IDU) prevalence estimates. We explored potential analytic adjustments for reducing biases through use of external data on (1) arrest, (2) narcotic overdose mortality, and (3) biomarker-based sensitivity of self-reported illicit drug use. Results Estimated national past 12 months IDU prevalence ranged from 0.24% to 0.59% across surveys. All surveys excluded unstably housed and incarcerated persons, and estimates were based on <60 respondents reporting IDU behavior in 3 surveys. No surveys asked participants about nonmedical injection of prescription drugs. Analytic adjustments did not appreciably change IDU prevalence estimates due to suboptimal specificity of data points. Conclusions PWID population size estimates in the United States are based on small numbers and are likely biased by undercoverage of key populations and self-report. Novel methods as discussed in this article may improve our understanding of PWID population size and their health needs.

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