Community-based case–control study of depression in older people

1999 ◽  
Vol 175 (4) ◽  
pp. 340-347 ◽  
Author(s):  
J. R. M. Copeland ◽  
Ruoling Chen ◽  
Michael Dewey ◽  
C. F. M. McCracken ◽  
Chris Gilmore ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older People ◽  
Early Stage ◽  
Statistical Significance ◽  
Later Life ◽  
Alcohol Problems ◽  
Computer Assisted ◽  
Data Set ◽  
Mental Problems ◽  
Assisted Diagnosis

BackgroundRisk factors of depression in later life, particularly for sub-cases and for psychotic and neurotic types of depression, are unclear.AimsTo identify such risk factors.MethodOver 5200 older people ($65 years), randomly selected from Liverpool, were interviewed using the Geriatric Mental State (GMS)and the Minimum Data Set (MDS). The computer-assisted diagnosis AGECAT identified 483 cases and 575 sub-cases of depression and 2451 with no mental problems. Logistic regression was employed to examine factors relevant to caseness.ResultsIn multiple logistical regression, odds ratios (ORs) were significantly high for being female (2.04, 95% CI 1.56–2.69), widowed (2.00, 1.18–3.39), having alcohol problems (4.37, 1.40–2.94), physical disablement (2.03, 1.40–2.94), physical illness (1.98,.1.25–3.15), taking medications to calm down (10.04, 6.41 −15.71), and dissatisfaction with life (moderate 4.54, 3.50–5.90; more severe 29.00, 16.00–52.59). Good social networks reduced the ORs. If sub-cases were included as controls, the statistical significance was reduced.ConclusionsAge was not associated with depression in later life whereas gender, physical disablement and dissatisfaction with life were. The sub-cases shared many risk factors with cases, suggesting that prevention may need to be attempted at an early stage.

Computer-assisted Diagnosis for Early Stage Pleural Mesothelioma

2007 ◽  
Vol 46 (03) ◽  
pp. 324-331 ◽  
Author(s):  
P. Jäger ◽  
S. Vogel ◽  
A. Knepper ◽  
T. Kraus ◽  
T. Aach ◽  
...  
Keyword(s):  
Early Stage ◽  
Computation Time ◽  
Hounsfield Unit ◽  
Computer Assisted ◽  
Clinical Test ◽  
Pleural Mesothelioma ◽  
Data Sets ◽  
Data Set ◽  
Average Computation Time ◽  
Ct Data

Summary Objectives: Pleural thickenings as biomarker of exposure to asbestos may evolve into malignant pleural mesothelioma. Foritsearly stage, pleurectomy with perioperative treatment can reduce morbidity and mortality. The diagnosis is based on a visual investigation of CT images, which is a time-consuming and subjective procedure. Our aim is to develop an automatic image processing approach to detect and quantitatively assess pleural thickenings. Methods: We first segment the lung areas, and identify the pleural contours. A convexity model is then used together with a Hounsfield unit threshold to detect pleural thickenings. The assessment of the detected pleural thickenings is based on a spline-based model of the healthy pleura. Results: Tests were carried out on 14 data sets from three patients. In all cases, pleural contours were reliably identified, and pleural thickenings detected. PC-based Computation times were 85 min for a data set of 716 slices, 35 min for 401 slices, and 4 min for 75 slices, resulting in an average computation time of about 5.2 s per slice. Visualizations of pleurae and detected thickeningswere provided. Conclusion: Results obtained so far indicate that our approach is able to assist physicians in the tedious task of finding and quantifying pleural thickenings in CT data. In the next step, our system will undergo an evaluation in a clinical test setting using routine CT data to quantifyits performance.

scholarly journals Loneliness as a Biographical Disruption—Theoretical Implications for Understanding Changes in Loneliness

2020 ◽  
Vol 75 (9) ◽  
pp. 2029-2039
Author(s):  
Deborah J Morgan ◽  
Vanessa Burholt
Keyword(s):  
Risk Factors ◽  
Social Network ◽  
Older People ◽  
Later Life ◽  
Well Being ◽  
Narrative Interviews ◽  
Biographical Disruption ◽  
Stability And Change ◽  
Life Study ◽  
Over Time

Abstract Objectives While a great deal is known about the risk factors that increase vulnerability to loneliness in later life, little research has explored stability and change in levels of loneliness. Methods Narrative interviews were conducted with 11 participants who were identified as being lonely during Wave 1 of the Maintaining Function and Well-being in Later Life Study Wales (CFAS Wales). The interviews were used to explore stability and change in levels of loneliness from the perspective of older people themselves. The interviews focused on participant’s perspectives of the events that triggered loneliness, stability, and change in levels of loneliness over time as well as participant’s responses to loneliness. Results The findings show that participants experienced losses and loneliness as biographical disruption. How participants and their wider social network responded to these losses had implications for the individual’s trajectory through loneliness. Discussion Drawing on a biographical lens, the study reframed the events that triggered loneliness as disruptive events. This article discusses the utility of biographical disruption in understanding stability and change in loneliness. The findings suggest how drawing on valued identities may help lonely adults transition out of loneliness.

scholarly journals There Is No Community Here: Living Alone, Place, and Older Peoples' Risk of Social Isolation

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 122-123
Author(s):  
Rachel Weldrick
Keyword(s):  
Risk Factors ◽  
Older People ◽  
Social Exclusion ◽  
Social Isolation ◽  
Significant Risk ◽  
Later Life ◽  
Community Dwelling ◽  
Living Alone ◽  
Future Research ◽  
Diverse Range

Abstract Existing research has identified significant risk factors for experiencing social isolation in later life including chronic health conditions, mobility impairments, and living alone among others. Although many older people who live alone maintain active social lives, living alone remains a top predictor of social isolation. Less is known about other types of risk factors, such as place-based risks and social exclusion. Despite calls to examine the role of place and social exclusion in social isolation risk, few studies have investigated the links. Models of isolation risk have often omitted place-based factors and social exclusion and focused largely on individual-level risks. In order to address these gaps, this paper presents the findings of 17 in-depth, qualitative interviews with community-dwelling older people who live alone (aged 65-93). Participants were recruited using a theoretical sampling strategy to ensure that a diverse range of neighbourhood types were represented among the participants (e.g., walkable vs. car-dependent neighbourhoods). Interview transcripts were analyzed using a constructivist grounded approach resulting in several major themes. Participants described aspects of their local environments as shaping their risk of isolation including infrastructure and amenities delivered in place, and neighbourhood makeup, among others. These themes are further examined through the lens of place-based exclusion and used to conceptualize how dimensions of both place and social exclusion fit into the model of known isolation risk factors. An adapted model of risk is presented to guide future research and intervention planning.

scholarly journals Early Prediction of Unplanned 30-Day Hospital Readmission: Model Development and Retrospective Data Analysis

10.2196/16306 ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. e16306
Author(s):  
Peng Zhao ◽  
Illhoi Yoo ◽  
Syed H Naqvi
Keyword(s):  
Risk Factors ◽  
Protective Factors ◽  
Hospital Readmission ◽  
Inpatient Care ◽  
Early Stage ◽  
Multivariate Logistic Regression Analysis ◽  
Day Hospital ◽  
Multivariate Logistic Regression ◽  
Data Set ◽  
Readmission Risk

Background Existing readmission reduction solutions tend to focus on complementing inpatient care with enhanced care transition and postdischarge interventions. These solutions are initiated near or after discharge, when clinicians’ impact on inpatient care is ending. Preventive intervention during hospitalization is an underexplored area that holds potential for reducing readmission risk. However, it is challenging to predict readmission risk at the early stage of hospitalization because few data are available. Objective The objective of this study was to build an early prediction model of unplanned 30-day hospital readmission using a large and diverse sample. We were also interested in identifying novel readmission risk factors and protective factors. Methods We extracted the medical records of 96,550 patients in 205 participating Cerner client hospitals across four US census regions in 2016 from the Health Facts database. The model was built with index admission data that can become available within 24 hours and data from previous encounters up to 1 year before the index admission. The candidate models were evaluated for performance, timeliness, and generalizability. Multivariate logistic regression analysis was used to identify readmission risk factors and protective factors. Results We developed six candidate readmission models with different machine learning algorithms. The best performing model of extreme gradient boosting (XGBoost) achieved an area under the receiver operating characteristic curve of 0.753 on the development data set and 0.742 on the validation data set. By multivariate logistic regression analysis, we identified 14 risk factors and 2 protective factors of readmission that have never been reported. Conclusions The performance of our model is better than that of the most widely used models in US health care settings. This model can help clinicians identify readmission risk at the early stage of hospitalization so that they can pay extra attention during the care process of high-risk patients. The 14 novel risk factors and 2 novel protective factors can aid understanding of the factors associated with readmission.

A REVIEW ON ARTERY WALL SEGMENTATION TECHNIQUES AND INTIMA-MEDIA THICKNESS MEASUREMENT FOR CAROTID ULTRASOUND IMAGES

2012 ◽  
Vol 05 (01) ◽  
pp. 1230001 ◽  
Author(s):  
XIN YANG ◽  
WANJI HE ◽  
KAITONG LI ◽  
JIAOYING JIN ◽  
XUMING ZHANG ◽  
...  
Keyword(s):  
Early Stage ◽  
Imaging Techniques ◽  
Atherosclerotic Lesion ◽  
Intima Media Thickness ◽  
Thickness Measurement ◽  
Medical Intervention ◽  
Computer Assisted ◽  
Ultrasound Images ◽  
Media Thickness ◽  
Assisted Diagnosis

Stroke and heart attack, which could be led by a kind of cerebrovascular and cardiovascular disease named as atherosclerosis, would seriously cause human morbidity and mortality. It is important for the early stage diagnosis and monitoring medical intervention of the atherosclerosis. Carotid stenosis is a classical atherosclerotic lesion with vessel wall narrowing down and accumulating plaques burden. The carotid artery of intima-media thickness (IMT) is a key indicator to the disease. With the development of computer assisted diagnosis technology, the imaging techniques, segmentation algorithms, measurement methods, and evaluation tools have made considerable progress. Ultrasound imaging, being real-time, economic, reliable, and safe, now seems to become a standard in vascular assessment methodology especially for the measurement of IMT. This review firstly attempts to discuss the clinical relevance of measurements in clinical practice at first, and then followed by the challenges that one has to face when approaching the segmentation of ultrasound images. Secondly, the commonly used methods for the IMT segmentation and measurement are presented. Thirdly, discussion and evaluation of different segmentation techniques are performed. An overview of summary and future perspectives is given finally.

The place of theatre in representations of ageing

2018 ◽  
pp. 285-306
Author(s):  
Miriam Bernard ◽  
David Amigoni ◽  
Ruth Basten ◽  
Lucy Munro ◽  
Michael Murray ◽  
...  
Keyword(s):  
Older People ◽  
Later Life ◽  
Complex Data ◽  
Data Set

Despite increasing evidence that continued engagement in creative activities is beneficial as we navigate later life, we still know comparatively little about what participation in theatre, and specifically in theatre-making, means to participants. This chapter presents selected findings from a detailed interdisciplinary case study of one particular theatre - the Victoria/New Victoria Theatre in North Staffordshire - in the lives of older people. The chapter describes how the project took shape; how each of its three strands (archival, interview and performative) developed; and how its rich and complex data set has been used: with a focus on articulating the place of the theatre in people’s lives, and on their understandings of its role in relation to ageing and later life.

Competing mortality (CM) risk in patients with resected stage I and II non-small cell lung cancer (NSCLC): A Surveillance, Epidemiology, and End Results (SEER) analysis.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 7563-7563
Author(s):  
Gayathri Nagaraj ◽  
Janakiraman Subramanian ◽  
Feng Gao ◽  
Siddhartha Devarakonda ◽  
Ramaswamy Govindan
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Clinical Trials ◽  
Sample Size ◽  
Cumulative Incidence ◽  
Early Stage ◽  
Stage I ◽  
Data Set ◽  
Early Stage Nsclc ◽  
The Impact

7563 Background: CM risk has been identified as a potential confounder in the interpretation of treatment effects in head and neck cancer (Rose et al. J Clin Oncol. 2011). Lung cancer patients (pts) are at considerable risk for CM due to their advanced age at diagnosis and smoking related chronic diseases. We plan to identify risk factors for CM in pts with early stage NSCLC and develop a statistical model to estimate the effect of CM on power calculation for lung cancer clinical trials. Methods: Using SEER registry we identified 32104 pts who had undergone surgical resection with or without radiation for stage I and II NSCLC between 1994 and 2006. The data set was split into two groups: training set (75%) and testing set (25%). Risk factors for lung cancer-specific mortality (LCSM) and CM were identified using training data by Gray’s sub-distribution regression of competing risk. Pts from the testing data were then stratified according to CM risk and the impact of this risk on power loss was evaluated. Results: The 5-year cumulative incidence of death from lung cancer, other causes and overall mortality was 32.7%, 14.2% and 46.9% respectively. Risk factors for CM were: age (hazard ratio [HR] 1.05), male gender (HR 1.43), divorced (HR 1.30), widowed (HR 1.23) or single (HR 1.29) marital status, squamous (HR 1.40) or not-otherwise-specified (HR 1.22) histology, stage I NSCLC (HR 1.27) and sublobar resection (HR 1.23). The 5-year cumulative incidence of CM in low, mid and high-risk tertiles was 7%, 14% and 21% respectively. Sample size calculations based on all-cause mortality (ACM) result in over-estimation of power as the risk for CM increases. In order to restore the underestimated power in LCSM, 19% and 35% more pts are required in the mid and high CM risk groups respectively (Table). Conclusions: Our findings indicate that conventional sample size calculation methods can result in significant loss of power and incorporating CM risk models in power estimation should be considered for clinical trials involving early stage NSCLC pts. [Table: see text]

scholarly journals Older people and Social Quality – what difference does income make?

2018 ◽  
Vol 39 (11) ◽  
pp. 2351-2376
Author(s):  
Liam Foster ◽  
Mark Tomlinson ◽  
Alan Walker
Keyword(s):  
Older People ◽  
Low Income ◽  
Significant Relationship ◽  
Later Life ◽  
Economic Security ◽  
Policy Implications ◽  
Income Poverty ◽  
Data Set ◽  
Social Quality ◽  
The Impact

AbstractThis article explores the relationship between Social Quality and income in later life and represents the first application of the concept to a United Kingdom data-set with an explicit focus on older people. In order to undertake this analysis, confirmatory factor analysis models are employed in conjunction with the British Household Panel Survey (BHPS). This enables various dimensions or domains of Social Quality to be measured and then subjected to further scrutiny via regression analysis. Initially, the paper explores links between low income, poverty and older people, prior to outlining the concept of Social Quality and its four conditional factors. Following the methodology, the impact of income on Social Quality domains is explored. We identify that differences in income in older age provide a partial explanation of differences in individual Social Quality. While there is a statistically significant relationship between income and certain aspects of Social Quality such as economic security, altruism, social networks and culture/participation, other factors such as health, identity and time did not have a statistically significant relationship with income. This indicates that improvements in the income of older people are likely to positively impact on aspects of their Social Quality. Finally, some policy implications of the finding are outlined with particular reference to the potential role for pensions in enhancing aspects of Social Quality in retirement.

scholarly journals The prevalence of, and risk factors for, loneliness in later life: a survey of older people in Great Britain

2005 ◽  
Vol 25 (6) ◽  
pp. 357-375 ◽  
Author(s):  
CHRISTINA R. VICTOR ◽  
SASHA J. SCAMBLER ◽  
ANN BOWLING ◽  
JOHN BOND
Keyword(s):  
Risk Factors ◽  
Great Britain ◽  
Older People ◽  
Basic Education ◽  
Rating Scale ◽  
Late Onset ◽  
Later Life ◽  
Social Resources ◽  
Current Health ◽  
Previous Decade

This study examines the prevalence of loneliness amongst older people in Great Britain, and makes comparisons with the findings of studies undertaken during the last five decades. In addition, the risk factors for loneliness are examined using a conceptual model of vulnerability and protective factors derived from a model of depression. Loneliness was measured using a self-rating scale, and measures of socio-demographic status and health/social resources were included. Interviews were undertaken with 999 people aged 65 or more years living in their own homes, and the sample was broadly representative of the population in 2001. Among them the prevalence of ‘severe loneliness’ was seven per cent, indicating little change over five decades. Six independent vulnerability factors for loneliness were identified: marital status, increases in loneliness over the previous decade, increases in time alone over the previous decade; elevated mental morbidity; poor current health; and poorer health in old age than expected. Advanced age and possession of post-basic education were independently protective of loneliness. From this evidence we propose that there are three loneliness pathways in later life: continuation of a long-established attribute, late-onset loneliness, and decreasing loneliness. Confirmation of the different trajectories suggests that policies and interventions should reflect the variability of loneliness in later life, for undifferentiated responses may be neither appropriate nor effective.

scholarly journals Retina blood vessel extraction based on kirsch’s template method

2020 ◽  
Vol 18 (1) ◽  
pp. 318
Author(s):  
Nur Syazlin Zolkifli ◽  
Ain Nazari ◽  
Mohd Marzuki Mustafa ◽  
Wan NurShazwani Wan Zakaria ◽  
Nor Surayahani Suriani ◽  
...  
Keyword(s):  
Feature Extraction ◽  
Blood Vessel ◽  
Blood Vessels ◽  
Early Stage ◽  
Medical Community ◽  
Computer Assisted ◽  
Early Screening ◽  
Online Databases ◽  
Assisted Diagnosis ◽  
Vessel Extraction

<p class="IJASEITAbtract">Analysis on the retina blood vessels from fundus images have been widely used in the medical community to detect the disorder condition in the blood vessels. An automated tracing of retina blood vessel can help to provide valuable computer-assisted diagnosis for the ophthalmic disorders. Thus, it helps to reduce the time for the ophthalmologist to analyses and diagnose the result of the fundus image of patient. The purpose of this research is to build an algorithm to trace the retina blood vessels. The method to be used in this research consist of two parts which are the pre-processing part and the feature extraction by using the Kirsch’s template. Combining the pre-processing at the early stage and feature extraction at the next stage is applied to extract the edges of the blood vessels.  The proposed algorithm was verified by using two online databases, DRIVE and HRF to validate the performance measures. Hence, proposed method is capable to extract the retina blood vessel and give the accuracy of 0.7917, the sensitivity of 0.9077 and the specificity of 0.7215. In conclusion, the extraction of the blood vessels is highly recommended as the early screening stage for the eye diseases beneficially.</p>

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