scholarly journals Differing determinants of disability trends among men and women aged 50 years and older

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Ya-Mei Chen ◽  
Tung-Liang Chiang ◽  
Duan-Rung Chen ◽  
Yu-Kang Tu ◽  
Hsiao-Wei Yu ◽  
...  
Keyword(s):  
Functional Status ◽  
Leisure Time ◽  
Growth Curves ◽  
Rate Of Change ◽  
Physically Active ◽  
Men And Women ◽  
Latent Growth Curves ◽  
Lower Baseline ◽  
Nationally Representative ◽  
Over Time

Abstract Background Researchers have emphasized the importance of examining how different factors affect men’s and women’s functional status over time. To date, the literature is unclear about whether sex affects the rate of change in disability in middle to older age. Researchers have further emphasized the importance of examining how different factors affect men’s and women’s functional status over time. We examined (a) sex differences in disability trends and (b) the determinants of the rate of change in disability for men and women 50 years and older. Methods This study utilized the Taiwan Longitudinal Study on Aging Survey, a nationally representative database (four waves of survey data 1996–2007, N = 3429). We modeled and compared the differences in disability trends and the influences of determinants on trends among men and women using multiple-indicator and multiple-group latent growth curves modeling (LGCM). Equality constraints were imposed on 10 determinants across groups. Results Once disability began, women progressed toward greater disability 18% faster than men. Greater age added about 1.2 times the burden to the rate of change in disability for women than men (p < 0.001). More comorbidities also added significantly more burden to baseline disability and rate of change in disability among women than men (p < 0.001), but women benefited more from higher education levels in lower baseline disability and slower rate of change. Having a better social network was associated with lower baseline disability among women only (p < 0.05). For both men and women, physically active leisure-time activities were beneficial in lower baseline disability (pmen and women < 0.001) and rate of change in disability (pmen < 0.01; pwomen < 0.05), with no significant differences between groups. Conclusions Age may widen the sex gap in the rate of change in disability. However, both sexes benefit from participating in leisure-time activities. Promoting health literacy improves health outcomes and physical function among women.

Is Medicaid expansion associated with increases in palliative treatments for metastatic cancer?

2021 ◽  
Author(s):  
Alexander P Cole ◽  
Stuart R Lipsitz ◽  
Adam S Kibel ◽  
Brandon A Mahal ◽  
Nelya Melnitchouk ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Affordable Care Act ◽  
Odds Ratio ◽  
Metastatic Cancer ◽  
Mixed Effects ◽  
Rate Of Change ◽  
Medicaid Expansion ◽  
Demographic Differences ◽  
Men And Women ◽  
Lower Baseline

Background: Medicaid expansion following the 2010 Affordable Care Act has an unknown impact on palliative treatments. Materials & methods: This registry-based study of individuals with metastatic cancer from 2010 to 2016 identified men and women with metastatic cancer in expansion and non-expansion states who received palliative treatments. A mixed effects logistic regression compared trends in expansion and non-expansion states and generated risk-adjusted probabilities or receiving palliative treatments each year. Results: Despite lower baseline use of palliative treatments, the rate of change was more rapid in expansion states (odds ratio [OR]: 1.02; 95% CI: 1.01–1.03; p < 0.001). The adjusted probability of receiving palliative treatments rose from 21.3 to 26.0% in non-expansion states, and from 19.7 to 26.9% in expansion states. Conclusion: Use of palliative treatments among metastatic cancer patients increased from 2010 to 2016 with a significantly greater increase in Medicaid expansion states, even when adjusting for demographic differences between states.

scholarly journals Assessing Recovery and Establishing Prognosis Following Total Knee Arthroplasty

2008 ◽  
Vol 88 (1) ◽  
pp. 22-32 ◽  
Author(s):  
Deborah M Kennedy ◽  
Paul W Stratford ◽  
Daniel L Riddle ◽  
Steven E Hanna ◽  
Jeffrey D Gollish
Keyword(s):  
Total Knee Arthroplasty ◽  
Lower Extremity ◽  
Functional Status ◽  
Knee Arthroplasty ◽  
Rate Of Change ◽  
Change Over Time ◽  
Total Knee ◽  
Preoperative Status ◽  
And Gender ◽  
Over Time

Background and PurposeInformation about expected rate of change after arthroplasty is critical for making prognostic decisions related to rehabilitation. The goals of this study were: (1) to describe the pattern of change in lower-extremity functional status of patients over a 1-year period after total knee arthroplasty (TKA) and (2) to describe the effect of preoperative functional status on change over time.SubjectsEighty-four patients (44 female, 40 male) with osteoarthritis, mean age of 66 years (SD=9), participated.MethodsRepeated measurements for the Lower Extremity Functional Scale (LEFS) and the Six-Minute Walk Test (6MWT) were taken over a 1-year period. Data were plotted to examine the pattern of change over time. Different models of recovery were explored using nonlinear mixed-effects modeling that accounted for preoperative status and gender.ResultsGrowth curves were generated that depict the rate and amount of change in LEFS scores and 6MWT distances up to 1 year following TKA. The curves account for preoperative status and gender differences across participants.Discussion and ConclusionThe greatest improvement occurred in the first 12 weeks after TKA. Slower improvement continued to occur from 12 weeks to 26 weeks after TKA, and little improvement occurred beyond 26 weeks after TKA. The findings can be used by physical therapists to make prognostic judgments related to the expected rate of improvement following TKA and the total amount of improvement that may be expected.

scholarly journals Prevalence of sufficient MVPA among Thai adults: pooled panel data analysis from Thailand’s surveillance on physical activity 2012–2019

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Piyawat Katewongsa ◽  
Chutima Yousomboon ◽  
Narumol Haemathulin ◽  
Niramon Rasri ◽  
Dyah Anantalia Widyastari
Keyword(s):  
Physical Activity ◽  
Panel Data ◽  
Panel Data Analysis ◽  
Work Force ◽  
Pooled Analysis ◽  
Recreational Physical Activity ◽  
Physically Active ◽  
Work Related ◽  
Nationally Representative ◽  
Over Time

Abstract Background The role of data in informing decision makers in formulating policy to improve population health is undeniably important. During the past few years, the Thai government has undertaken continuous health promotion campaigns and programs. Nevertheless, evidence of how physical activity (PA) has improved is lacking. This study aims to present PA prevalence and trends from nationally-representative surveillance data collected during 2012–2019. Methods This study employed 8 rounds of Thailand’s Surveillance on Physical Activity (SPA) survey from 2012 to 2019 as a pooled analysis from two-panel data (SPA2012–2016 and SPA2017–2019). Multistage random sampling was applied to select Thai adults aged 18 or over to produce a nationally-representative dataset, by considering the place of residence (urban or rural), gender, and single year of age. Face-to-face interviews using a structured questionnaire were conducted in 5 regions, 13 provinces, and 36 villages to follow up 5648 individuals in Panel 1 (SPA2012–2016) and 6074 persons in Panel 2 (SPA2017–2019). Results The prevalence (%) of Thai adults who met WHO recommendations on sufficient PA tended to increase over time, from 66.6 (CI 65–68) in SPA2012 to 70.1 (CI 69–71), 69.5 (CI 68–71), 73.1 (CI 72–74), 70.6 (CI 69–72), 73.0 (CI 72–74), 75.6 (CI 74–77), and 74.3 (73–75) in SPA2013–2019, respectively. Thai females are less physically active than males, and the prevalence of sufficient moderate and vigorous PA (MVPA) was highest among middle-aged adults (35–64 years), and lowest among older adults (65+ years). Work-related PA dominated the cumulative minutes of MVPA per week, followed by recreational PA. Conclusion The prevalence of sufficient MVPA has fluctuated over time with a tendency to increase in the most recent years. Work-related is the most common modes of PA among Thai adults, implying further improvement in recreational physical activity is required. Workplace intervention should also be the focus in improving PA of Thai adults by encouraging their work force to engage in more occupational PA.

Change in Level of Service Inventory–Ontario Revised (LSI-OR) Risk Scores Over Time: An Examination of Overall Growth Curves and Subscale-Dependent Growth Curves

2015 ◽  
Vol 61 (14) ◽  
pp. 1606-1622 ◽  
Author(s):  
David M. Day ◽  
Holly A. Wilson ◽  
Kelly Bodwin ◽  
Candice M. Monson
Keyword(s):  
Risk Factors ◽  
Risk Score ◽  
Growth Curves ◽  
Criminal History ◽  
Rate Of Change ◽  
Level Of Service ◽  
Dynamic Risk Factors ◽  
Dynamic Risk ◽  
Over Time ◽  
Overall Risk

The dynamic nature of risk to re-offend is an important issue in the management of offenders and has stimulated extensive research into dynamic risk factors that can alter an individual’s overall risk to re-offend if addressed. However, few studies have examined the relative importance of these dynamic risk factors, complicating the task of developing case management and treatment plans that will effect the most change. Using a large, high-risk sample and multi-wave data of a common risk assessment tool, the Level of Service Inventory–Ontario Revised (LSI-OR), the current study investigated the relationship among criminogenic risk factors and their role in influencing the overall risk score. Results indicated a diverse pattern of effects on the eight subscale scores, specifically suggesting that changes on Procriminal Attitude/Orientation, Criminal History, and Leisure/Recreation subscales resulted in a quicker rate of change to the overall risk score over time. These results suggest that some factors may be driving the change in overall risk and could potentially effect the most change if prioritized for intervention. Practical implications and implications for further research are discussed.

scholarly journals Healthcare spending in U.S. emergency departments by health condition, 2006–2016

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258182
Author(s):  
Kirstin Woody Scott ◽  
Angela Liu ◽  
Carina Chen ◽  
Alexander S. Kaldjian ◽  
Amber K. Sabbatini ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Spending ◽  
Healthcare Spending ◽  
The United States ◽  
Health Condition ◽  
Rate Of Change ◽  
Nationally Representative ◽  
National Emergency ◽  
The U.S ◽  
Over Time

Background Healthcare spending in the emergency department (ED) setting has received intense focus from policymakers in the United States (U.S.). Relatively few studies have systematically evaluated ED spending over time or disaggregated ED spending by policy-relevant groups, including health condition, age, sex, and payer to inform these discussions. This study’s objective is to estimate ED spending trends in the U.S. from 2006 to 2016, by age, sex, payer, and across 154 health conditions and assess ED spending per visit over time. Methods and findings This observational study utilized the National Emergency Department Sample, a nationally representative sample of hospital-based ED visits in the U.S. to measure healthcare spending for ED care. All spending estimates were adjusted for inflation and presented in 2016 U.S. Dollars. Overall ED spending was $79.2 billion (CI, $79.2 billion-$79.2 billion) in 2006 and grew to $136.6 billion (CI, $136.6 billion-$136.6 billion) in 2016, representing a population-adjusted annualized rate of change of 4.4% (CI, 4.4%-4.5%) as compared to total healthcare spending (1.4% [CI, 1.4%-1.4%]) during that same ten-year period. The percentage of U.S. health spending attributable to the ED has increased from 3.9% (CI, 3.9%-3.9%) in 2006 to 5.0% (CI, 5.0%-5.0%) in 2016. Nearly equal parts of ED spending in 2016 was paid by private payers (49.3% [CI, 49.3%-49.3%]) and public payers (46.9% [CI, 46.9%-46.9%]), with the remainder attributable to out-of-pocket spending (3.9% [CI, 3.9%-3.9%]). In terms of key groups, the majority of ED spending was allocated among females (versus males) and treat-and-release patients (versus those hospitalized); those between age 20–44 accounted for a plurality of ED spending. Road injuries, falls, and urinary diseases witnessed the highest levels of ED spending, accounting for 14.1% (CI, 13.1%-15.1%) of total ED spending in 2016. ED spending per visit also increased over time from $660.0 (CI, $655.1-$665.2) in 2006 to $943.2 (CI, $934.3-$951.6) in 2016, or at an annualized rate of 3.4% (CI, 3.3%-3.4%). Conclusions Though ED spending accounts for a relatively small portion of total health system spending in the U.S., ED spending is sizable and growing. Understanding which diseases are driving this spending is helpful for informing value-based reforms that can impact overall health care costs.

scholarly journals Leisure-time physical activity among adults in Estonia 2000 − 2016

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
K Pärna ◽  
M Mikk
Keyword(s):  
Physical Activity ◽  
Health Promotion ◽  
Leisure Time ◽  
Leisure Time Physical Activity ◽  
Smoking Status ◽  
Noncommunicable Diseases ◽  
Physically Active ◽  
Men And Women ◽  
Factors Associated ◽  
Study Results

Abstract Background Leisure-time physical activity (LTPA) can be an effective tool in the prevention and treatment of the majority of noncommunicable diseases, which are the leading cause of death worldwide. Therefore, the knowledge on the level and trends of LTPA is an important task for the public health sector and enables identification of adults at high risk of hypokinetic diseases. The aim of this study was to describe LTPA trend among adults in Estonia in 2000-2016 and to analyze the association between LTPA and sociodemographic, -economic, health- and work-related factors, and risk behaviours. Methods This study was based on 25 − 64-year-old adults (n = 16,903) of the postal cross-sectional surveys of Health Behaviour among Estonian Adult Population in 2000-2016. For data analysis, LTPA was divided into two categories: physically active (at least 2 − 3 times per week) and physically inactive (less than 2 times a week). Chi-square test was used to analyze changes in prevalence trend of LTPA over the study period. Logistic regression analysis was used to test associations between LTPA and different factors. Results The prevalence of LTPA increased from 26.2% to 42.6% among men (p &lt; 0.001) and from 28.0% to 43.6% among women (p &lt; 0.001) in Estonia in 2000-2016. Odds to be physically active during leisure time was significantly associated with marital status, education, income, economic activity, self-rated health, body mass index and smoking status among men and women. Compared to adults with basic education, men and women with higher education had higher odds (OR = 1.61, 95% CI 1.30 − 2.01; OR = 1.36, 95% CI 1.10 − 1.68, respectively) to be physically active. LTPA was associated with age among men and with nationality and alcohol use among women only. Conclusions Based on the study results, health promotion activities should be addressed in particular to the adults with lower LTPA paying attention to the factors associated with LTPA. Key messages LTPA increased significantly among men and women in Estonia in 2000 − 2016 being higher among women than men. Health promotion activities should be addressed in particular to the adults with lower LTPA paying attention to the different factors associated with LTPA.

scholarly journals Race and Trends in Pornography Viewership, 1973-2016: Examining the Moderating Roles of Gender and Religion

2017 ◽  
Author(s):  
Samuel Perry ◽  
Cyrus Schleifer
Keyword(s):  
Black Men ◽  
Racial Differences ◽  
White Women ◽  
White Men ◽  
Moral Issue ◽  
Men And Women ◽  
Social Surveys ◽  
Pornography Use ◽  
Nationally Representative ◽  
Over Time

While some research has uncovered racial differences in patterns of pornography viewership, no studies to date have considered how these patterns may be changing over time or how these trends may be moderated by other key predictors of pornography viewership, specifically, gender and religion. Using nationally representative data from the 1973-2016 General Social Surveys (N = 20,620), and taking into account different ethno-religious histories with pornography as a moral issue, we examine how race, gender, and religion intersect to influence trends in pornography viewership over 43 years. Analyses reveal that black Americans in general are more likely to view pornography than whites, and they are increasing in their pornography viewership at a higher rate than whites. Moreover, black men are more likely to consume pornography than all other race-gender combinations, but only differ from white women in their increasing rate of pornography viewership. Lastly, frequent worship attendance only moderates trends in pornography viewership for white men. By contrast, regardless of attendance frequency, black men and women show increasing rates of pornography use while white women show flat rates. We conclude by discussing the implications of these findings for research on the intersections of race, gender, religion, and sexuality.

scholarly journals Shifting Cost-drivers of Health Care Expenditures in Inflammatory Bowel Disease

2019 ◽  
Vol 26 (8) ◽  
pp. 1268-1275 ◽  
Author(s):  
Benjamin Click ◽  
Rocio Lopez ◽  
Susana Arrigain ◽  
Jesse Schold ◽  
Miguel Regueiro ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Expenditures ◽  
Cost Of Care ◽  
Rate Of Change ◽  
Cost Driver ◽  
Medical Expenditure ◽  
Cost Drivers ◽  
Inflammatory Bowel ◽  
Nationally Representative ◽  
Over Time

Abstract Background Inflammatory bowel diseases (IBD) are costly, chronic illnesses. Key cost-drivers of IBD health care expenditures include pharmaceuticals and unplanned care, but evolving treatment approaches have shifted these factors. We aimed to assess changes in cost of care, determine shifts in IBD cost-drivers, and examine differences by socioeconomic and insurance status over time. Methods The Medical Expenditure Panel Survey (MEPS), a nationally representative database that collects data on health care utilization and expenditures from a nationally representative sample since 1998, was utilized. Adult subjects with IBD were identified by ICD-9 codes. To determine changes in per-patient costs or cost-drivers unique to IBD, a control population of rheumatoid arthritis (RA) subjects was generated and matched in 1:1 case to control. Total annual health care expenditures were obtained and categorized as outpatient, inpatient, emergency, or pharmacy related. Temporal cohorts from 1998 to 2015 were created to assess change over time. Per-patient expenditures were compared by disease state and temporal cohort using weighted generalized linear models. Results A total of 641 IBD subjects were identified and matched to 641 RA individuals. From 1998 to 2015, median total annual health care expenditures nearly doubled (adjusted estimate 2.20; 95% CI, 1.6–3.0) and were 36% higher in IBD compared with RA. In IBD, pharmacy expenses increased 7% to become the largest cost-driver (44% total expenditures). Concurrently, inpatient spending in IBD decreased by 40%. There were no significant differences in the rate of change of cost-drivers in IBD compared with RA. Conclusions Per-patient health care costs for chronic inflammatory conditions have nearly doubled over the last 20 years. Increases in pharmaceutical spending in IBD may be accompanied by reduction in inpatient care. Additional studies are needed to explore patient-, disease-, system-, and industry-level cost mitigation strategies.

scholarly journals Marriage as a training ground: Examining change in self-control and forgiveness over the first 4 years of marriage

2017 ◽  
Vol 36 (1) ◽  
pp. 109-130 ◽  
Author(s):  
Tila M. Pronk ◽  
Asuman Buyukcan-Tetik ◽  
Marina M.A.H. Iliás ◽  
Catrin Finkenauer
Keyword(s):  
Growth Curves ◽  
Self Control ◽  
Latent Growth ◽  
Latent Growth Curves ◽  
Over Time

Do partners’ levels of self-control and forgiveness change over the course of marriage? Based on the idea that marriage may function as a training ground for these vital relationship abilities, we hypothesized that people increase their levels of self-control and forgiveness over time and that these developments take place simultaneously. We tested these predictions among 199 newlywed couples in the first 4 years of marriage, using a dyadic latent growth curves analysis. Confirming our hypotheses, results showed significant increases in self-control and forgiveness as well as a positive concurrent correlation between these variables. However, the developments of self-control and forgiveness were unrelated. So, while people become more self-controlled and forgiving over the course of a marriage, these developments do not coincide.

scholarly journals Gender Differences in the Prevalence of Chronic Pain and Leisure Time Physical Activity Among US Adults: A NHANES Study

2019 ◽  
Vol 16 (6) ◽  
pp. 988 ◽  
Author(s):  
Masataka Umeda ◽  
Youngdeok Kim
Keyword(s):  
Physical Activity ◽  
Gender Differences ◽  
Chronic Pain ◽  
Leisure Time ◽  
Leisure Time Physical Activity ◽  
Gender Disparities ◽  
Self Report ◽  
Men And Women ◽  
Nationally Representative ◽  
Primary Type

Gender disparities in chronic pain are well documented in the literature. However, little is known regarding the relationship between physical activity (PA) and gender disparities in chronic pain. This study described gender differences in prevalence of chronic pain and PA, and identified a type of leisure time PA that individuals frequently chose in a nationally representative sample of US adults (N = 14,449). Data from the National Health Nutrition Examination Survey 1999–2004 were analyzed. Individuals were categorized into no chronic pain (NCP), localized chronic pain (LCP), and widespread chronic pain (WCP) groups based on responses to a pain questionnaire. A self-report PA questionnaire was used to estimate the time spent in different types of PA. Women showed higher prevalence of LCP and WCP compared to men. Men spent more hours per week for leisure time PA compared to women, but men and women showed similar prevalence of sufficient PA to meet a PA recommendation (≥150 min/week of moderate-to-vigorous intensity PA) across chronic pain categories. However, the prevalence of sufficient PA was substantially higher among men and women with NCP compared to men and women with LCP and WCP. Additionally, both men and women chose walking as the primary type of leisure time PA. Together, gender disparities exist in the prevalence of chronic pain and hours spent for leisure time PA. More research is needed to explore the role of increasing leisure time PA, such as walking, in reducing gender disparities in chronic pain.

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