A pilot study was conducted to evaluate whether premenstrual syndrome was a risk factor for breast cancer among premenopausal women. As subjects, 54 women between the ages of 26 and 46 years, each diagnosed with breast cancer, were compared to three separate control groups, consisting of 193 female patients seen in medical offices for routine physical exams, 51 female nursing students, and 559 female graduate students. Each eligible subject was either mailed or personally given a survey questionnaire probing premenstrual and menstrual symptomatology and general descriptive characteristics. An association between premenstrual syndrome and breast cancer was evaluated by estimating exposure odds ratios and associated confidence intervals. Analysis of the data suggested that premenstrual syndrome did not pose a breast cancer risk among premenopausal women. / Graduation date: 1993

Statistics Canada data indicates that between 2002 and 2006, the late stillbirth incidence (at or beyond 28 weeks gestation) was 3.0/1000 and 4.0/1000 among Canadian and Saskatchewan births respectively. This difference questions the characteristics and associations of late losses in our province; this work aims to assess late Saskatchewan stillbirths in regard to incidence, causes, characteristics, and area-level factors.<p> Accessing Vital Statistics cases (1987 to 2007, n=1119), descriptive statistics and incidence were examined utilizing Chi-square testing and Poisson regression. Associations between variables were evaluated by log-linear models. Area-level factors relating to incidence within census divisions were explored using Poisson regression.<p> Although some variation existed by time and region, women were most often less than 35 years, of moderate parity, non-Aboriginal, had no previous stillbirths, and were not carrying multiple fetuses. Approximately half of the losses were preterm and half were inadequately grown. Incidence per 1000 births differed significantly for Saskatchewan (3.86) and Canada (3.43) with only Canada declining. Several division values were also higher than Saskatoons Division 11. Associations were seen between characteristics; most notably the combination of Aboriginality, increased maternal age, and large-for-gestational-age appeared over-represented compared to live births. Regions with higher proportions of Aboriginal preschoolers or land area with herbicide application had higher incidence (RR = 1.53 and 1.55, p-value less than 0.001). Further work is required to understand Saskatchewans lack of decline, what can be done about areas where incidence is increased, the significance of the associated characteristics as actual risk factors, and how Aboriginality and herbicide influence risk at the individual level.

In contrast to cardiac rehabilitation (CR) programs, traditional stroke rehabilitation aims to maximize functional independence and does not have a strong focus on exercise training and risk factor modification. Given the parallels between stroke and heart disease in cardiovascular etiology and risk factors, CR may be suited to supplement stroke rehabilitation by providing opportunities to enhance fitness and manage stroke risk factors. The aim of this work was to 1) examine the use of a non-adapted CR program of care with individuals with stroke and/or transient ischemic attack (TIA) through a retrospective database review, 2) using a prospective trial, determine the feasibility and effects of an adapted CR program for people with mild to moderate impairment from stroke, and 3) explore characteristics related to degree of program response in aerobic and functional capacity through secondary data analysis. The results from Study 1 demonstrated that traditional CR is an underutilized service for individuals with stroke or TIA, yet improvements in aerobic fitness were comparable to their non-stroke counterparts. In Study 2, adapted CR was feasible for individuals with a range of stroke-related disability and effective in increasing aerobic capacity. The anticipated carry over to improved walking capacity was not observed. There were no changes in health-related quality of life or stroke risk factors. Study 3 identified subgroups of participants who improved or declined in aerobic and ambulatory capacity after the adapted CR program. There were no differences in baseline characteristics, indices of time, intensity or volume of exercise performed across the response subgroups. In summary, given the parallels between stroke and heart disease, the needs of the stroke population and dearth of community-based exercise programming available for them, the CR model of care may be applied for individuals with stroke to provide opportunities for exercise training and risk factor modification.

Statistics Canada data indicates that between 2002 and 2006, the late stillbirth incidence (at or beyond 28 weeks gestation) was 3.0/1000 and 4.0/1000 among Canadian and Saskatchewan births respectively. This difference questions the characteristics and associations of late losses in our province; this work aims to assess late Saskatchewan stillbirths in regard to incidence, causes, characteristics, and area-level factors.<p> Accessing Vital Statistics cases (1987 to 2007, n=1119), descriptive statistics and incidence were examined utilizing Chi-square testing and Poisson regression. Associations between variables were evaluated by log-linear models. Area-level factors relating to incidence within census divisions were explored using Poisson regression.<p> Although some variation existed by time and region, women were most often less than 35 years, of moderate parity, non-Aboriginal, had no previous stillbirths, and were not carrying multiple fetuses. Approximately half of the losses were preterm and half were inadequately grown. Incidence per 1000 births differed significantly for Saskatchewan (3.86) and Canada (3.43) with only Canada declining. Several division values were also higher than Saskatoons Division 11. Associations were seen between characteristics; most notably the combination of Aboriginality, increased maternal age, and large-for-gestational-age appeared over-represented compared to live births. Regions with higher proportions of Aboriginal preschoolers or land area with herbicide application had higher incidence (RR = 1.53 and 1.55, p-value less than 0.001). Further work is required to understand Saskatchewans lack of decline, what can be done about areas where incidence is increased, the significance of the associated characteristics as actual risk factors, and how Aboriginality and herbicide influence risk at the individual level.

Syftet med denna litteraturstudie var att beskriva riskfaktorer som påverkade uppkomsten av trycksår samt de vanligaste förekommande preventiva åtgärderna. Vidare var syftet att beskriva sjuksköterskans roll vid förebyggandet samt behandlingen av trycksår. De vetenskapliga artiklar (n=21) som ingick i studien söktes manuellt samt datoriserat via databaserna Blackwell Synergy, CHINAL, Elin@Dalarna och Elsiever. Inklusionskriterierna var att de skulle vara vetenskapliga samt av kvalitativ och kvantitativ design. Även litteraturstudier inkluderades. Artiklarna skulle vara publicerade 1990 eller senare och vara svensk eller engelskspråkiga. Resultatet visade att patienter med lågt nutritionsstatus och låga serum albuminvärden riskerade att utveckla trycksår. En annan stor riskgrupp var patienter i peri- och postoperativa skeden där operationstiden kraftigt inverkade på uppkomsten av sår. Även anestesiformen spelade roll. Trycksåren uppkom vanligen på hälarna och korsbenet. I preventativt syfte var evidensbaserade mätskalor viktiga. Även trycksårsreducerande madrasser visade sig vara betydelsefulla. Vidare framkom att hälso- och sjukvårdspersonalen visade ett svalt intresse för trycksår och att kvalitetssäkringen var bristfällig. Sjuksköterskan hade främst en informerande roll inom trycksårspreventionen. Såren rengjordes lämpligast med fysiologisk koksaltlösning och omlades med våt omläggning. Resultatet visade även att smärtanalyser i högre grad borde involveras i trycksårsbehandlingen.

Background The demand of long-term care facilities has increased because of the geriatric population growing up rapidly. How to reduce the frequency of the nursing home residents¡¦ being hospitalized is one of the most important indicators for the quality of long-term care. Objective To understand the characteristics of facilities and nursing home residents. To test the effect of the characteristics on the probability of hospitalization of nursing home residents and to analyze the predictors of readmission in order to improve the quality of nursing care and the life quality of their residents. Methods We collected 329 residents of a hospital-based nursing home in southern Taiwan before March 31, 2011 and who stayed more than 90 days at the facility. The medical records were reviewed retrospectively. Data were analyzed using descriptive statistics (correlation and one way ANOVA) to test the effect of the resident¡¦s and facility¡¦s characteristics on the probability of hospitalization. Multiple linear regression was used to study the risk factors and the predictors of readmission frequency. Results Of the 29 residents, 141(42.9%) were male. The average age was 78.06. 33.7% of the residents died in the facility. The total individual admissions were from 0 to 18. The hospitalized frequency was 0.42 in each 90-day period. Infectious disease was the majority diagnosis of admission. The three leading causes of admission were pneumonia(45.5%), urinary tract infection (20.0%) and upper gastrointestinal bleeding(10.3%). Correlation analysis showed the age had a positive correlation with the frequency of readmission. The hemoglobin level, serum albumin level, serum cholesterol level, body mass index, mini-nutritional assessment score and mini-mental status evaluation score disclosed a negative correlation with the frequency of readmission. Multiple linear regression showed the male gender, age, lung diseases, complete bed-ridden and mini-nutritional assessment score were significant predictors of readmission frequency. Conclusion The evaluation of the risk factors and predictors might help to identify the nursing home residents who are likely to be readmitted. It is hoped that the hospitalizations from nursing home may be prevented and the results of this study might contribute to the quality of long-term care facilities.

Objective: Urinary catheterization is associated with urinary tract infection, a common complication of stroke. We aimed to investigate the incidence and risk factors associated with urinary catheterization following acute stroke, and its impact on stroke outcome. Method: We prospectively studied a cohort of stroke patients hospitalized within 10 days after onset from August 2006 to December 2008. Kaplan-Meier method was used to estimate the cumulative incidence of Foley catheter insertion over time, and Cox proportional hazards regression analysis to evaluate the independent predictors. The impact of urinary catheterization on poor stroke outcome (modified Rankin Scale >2 or dead) at 3 months was analyzed by logistic regression. Results: Of 2789 study patients, 761 (27%) received Foley catheter insertion. Most urinary catheterization was carried out within two days of admission, with estimated cumulative incidence of 23% (95% CI, 22% to 25%) at 2 days, and 27% (25% to 29%) at 7 days. Predictors of urinary catheterization were advanced age (HR 1.01 per year; 95% CI, 1.00-1.01), increased National Institutes of Health Stroke Scale score (HR 1.08 per point; 1.07-1.09), and hemorrhagic (versus ischemic) stroke (HR 2.03; 1.69-2.44), after adjustment for gender, diabetes mellitus and previous stroke/transient ischemic attack. The influence of urinary catheterization on poor outcome at 3 months remained significant (OR 2.43; 1.65-3.58) after adjustment for relevant covariates. Conclusion: Urinary catheterization was common among hospitalized acute stroke patients, and associated with poor outcome at 3 months. Judicious use of urinary catheter in acute stroke patients is crucial to improve quality of care.

No description available.

This study applies the Washington State Ergonomics Tool to waste industry jobs in Texas. Exposure data were collected by on-site observation of fourteen different multi-task jobs in a major national solid waste management company employing more than 26,000 employees. This company has nationwide operations, and these jobs represent the majority of workers involved in the collection and processing of solid waste. The WSET uses observational checklist methodology to evaluate generic risk factors in the following six major categories: awkward posture, highly repetitive motion, high hand force, repeated impact, lifting, and hand-arm vibration. The assessment tool incorporates these risk factors and combinations of risk factors into checklists for identifying three levels of potential exposure: safe, -caution zone" and -hazard zone" jobs. The tool was developed for employers to use in determining whether a job was likely to increase the risk of workplace musculoskeletal disorders (WMSDs) to their employees. OSHA 200 logs were used as the main source of morbidity data. If there was one recorded WMSD, the job was classified as -positive. "If there was no recorded WMSD, the job was classified as -negative. "-Safe"jobs were those predicted not to expose workers to increased risk of WMSDs. Those that possessed one or more -caution zone"criteria but still fell below the -hazard zone" threshold required the employer to provide -awareness education" for employees and to further analyze the job for the presence of -hazard zone" risk factors. If hazard zone risk factors were not present, no further action was required. Jobs that upon further analysis possessed one or more of the -hazard zone"criteria were labeled -hazardous" jobs. If the further analysis shows the presence of risk factors established in the hazard zone criteria (Appendix B), the employer would be required to take corrective action to reduce exposures to below the hazardous level. Of the three jobs predicted to be -safe"by -caution zone" criteria, two did not have injuries and one did. Of the eleven jobs predicted by -caution zone"criteria to increase the risk of WMSDs, six resulted in injuries and five did not. Of the four jobs predicted by -hazard zone"criteria to be -problem"jobs, two jobs did result in injury and two did not. This study found that the WSET -caution zone"criteria were more effective at predicting which jobs were likely to increase the risk of WMSDs than was the -hazard zone"checklist. The caution zone had high sensitivity and low specificity. The hazard zone criteria reflect a low sensitivity and a low specificity. Further analysis revealed the WSET was helpful in predicting back injuries associated with lifting but not effective at predicting jobs with the potential for upper extremity injuries.

Abstract Drug abuse is a major public issue concerned by the general public. The objective of this research is to investigate the relation among drug behavior, mental cognition and environmental influences for the first-time adult male drug users. In addition, the correlation between mental cognition and degree of environmental influences will also be studied. Suggestions and strategies derived from the result will be proposed for government authorities for formulating an effective strategy against drug abuse. Through the study and analysis of literature references, different aspects of problems are incorporated into a questionnaire scale. A questionnaire survey is conducted on 431 drug offenders in the Penghu Prison. The results are analyzed using the SPSS 10.0 statistic software to determine the fundamental characteristics of the samples and the presence of dissimilarity and correlation between the mental cognition and environmental influences for samples with different attributes. The result revealed that, in terms of the fundamental characteristics, the age group of first-time adult male users is primarily between 18-24 years old, when teenagers are about to enter their adulthood. The ratio of first-time drug abuse declines with the increase of age. The ratio of heroin and amphetamine used in the first-time drug abuse is 46% versus 54%. Despite the expensive price and addictive nature, no significant reduction is observed in the frequency of heroin use. More single users are observed, indicating that most first-time use takes place before marriage. As for the education level, first-time users are mainly junior high school graduates, and the number declines with higher education received. In terms of occupation, the percentage of labor and driver population are the highest among first-time drug users, while the percentage of farmers, fishermen, soldiers, government servants and teachers are the lowest. Financial ability is the basic requirement of drug abuse; therefore, there is a positive correlation between the percentage of first-time adult male users and the level of monthly income. Having friends who are doing drugs is a prerequisite and hence over 90% of first-time adult male users have, on average, three drug user friends. In regard to the mental cognition, researches discovered that most adult male users are in lack of a deep and correct understanding towards the danger of drugs. Most drug users in general hold a less negative attitude towards drugs and believe they will be luckier. At the same time, they have a higher expectation towards the psychological relief which they believe can be brought upon by drugs. As for the environmental influences, peer pressure has the highest impact on the first-time adult male drug users. Other factors such as cheap drugs and easily accessible drug environment resulted from ineffective anti-drug policies, inadequate media report under highly developed society, curiosity and unhealthy social culture all have a significant influence. Family, however, does not show any significant influence over first-time adult male drug users. Finally, no significant correlation between the mental cognition of self-control on drug behavior and family influence is observed for first-time adult male users in the research conducted on the relation between mental cognition and environmental influences. Yet, a relative degree of correlation exists between the overall mental cognition and environmental influences, where a mutually amplifying characteristic is observed between the two factors. This indicates that mental cognition and environmental influences are both critical risk factors for first-time adult male drug users. Suggestions are made in our research that the promotional tasks should be reinforced, pressure management should be focused, comprehensive family functions should be established, positive development should be encouraged among peers, anti-drug units should be organized, long-term drug abuse monitoring mechanism should be constructed, and alternative thinkings should be incorporated into drug policies. The suggestions are of great importance for preventing first-time drug use by adult males and can be used as a reference by the government.