A survey of 652 nonvegetarian and 130 vegetarian women aged 40-70 years using real-time ultrasonography was carried out to determine the prevalence of gallstones. 24.6% of nonvegetarian women were found to have gallstones compared with 11.5% of vegetarian women (p < 0.05). Each participant completed a postal questionnaire on general health aspects and dietary habits. Aetiological factors shown to have a strong influence on the development of gallstones included increasing age, obesity and positive family history. The prevalence of gallstones increased steadily with age (p < 0.01) and obesity (p < 0.001). Women with gallstones were much more likely to have a first degree relative with a history of gallstones (p < 0.01). The vegetarian participants were younger and less likely to be obese than the nonvegetarian participants but/ even after correction for these confounding influences/ gallstones were significantly less prevalent in vegetarian women (p < 0.05). Other aetiological factors that have been purported to to be risk factors in the pathogenesis of gallstones but were not shown to be so in this study were parity, exogenous oestrogen intake and a history of smoking. In order to further study the effect of diet in the pathogenesis of gallstones, an age-matched case-control study was carried out using the women with gallstones identified in the prevalence survey as cases and women proven to be free of gallstones as the controls. 107 nonvegetarian and 12 vegetarian pairs completed a four-day dietary diary and were subsequently interviewed about their dietary habits, exogenous oestrogen intake and upper gastrointestinal symptomatology. There were no significant differences in energy intake/ total protein and animal and vegetable protein, fat and cholesterol, carbohydrate, simple sugars and fibre intake in the diet consumed by cases compared with controls. Vegetarian women, however, ate a very different diet to the nonvegetarian women suggesting that diet does play an important role in the pathogenesis of gallstones. Failure to demonstrate a dietary association in the case-control study may be due to the fact that the overwhelming majority of people in western communities consume a diet that is too high in fat, animal protein and simple sugar content and too low in unrefined starches to be able to detect any dietary differences between cases and controls - the threshold effect. Another important aspect of gallstone disease revealed by the study was the proportion of cases shown to be asymptomatic. Over 70% of all cases had not been previously diagnosed. Moreover, the case-control study showed that cases were no more likely to suffer from "biliary" symptoms than controls except for those symptoms associated with acute cholecystitis or common bile duct obstruction. These data provide persuasive support for the conservative management of asymptomatic gallstones.

The purpose of this secondary analysis was to test a multivariate model of disability separately in women with two different conditions, multiple sclerosis (MS) and fibromyalgia syndrome (FMS), and to compare respective models across groups. Guided by the Disablement Process Model, this study examined the influences of functional limitations, depressive symptoms, economic adequacy, and social support on disability by use of two-group structural equation modeling (SEM). Nonprobability samples of women with MS (N = 118) and women with FMS (N = 197) were recruited for separate health promotion intervention studies. Baseline data collection occurred between 1997 and 1998 for women with MS enrolled in the Wellness Intervention and between 2004 and 2006 for women with FMS enrolled in the Lifestyle Counts Intervention. Participants in both samples were largely married, well-educated, middle-age, and Caucasian. Descriptive statistics, bivariate correlations, and SEM were conducted with the Statistical Package for the Social Sciences 15.0 and Amos 7.0 software programs. Mean scores of the major study variables indicated poorer physical and mental health for the sample of women with FMS compared to that with MS. Controlling for age, duration of illness, and education, greater functional limitations predicted greater SFdisability and Role Physical (RP)-disability in both groups. The influence of Functional Limitations on both SF-disability and RP-disability was greater for women with FMS than MS. The effect of Depressive Symptoms on SF-disability was equivalent across groups. Feeling depressed significantly impacted RP-disability, although these effects were not equal across groups. Depressive Symptoms played a larger role than did Functional Limitations in explaining SF- and RP-disability in women with MS. Social Support affected Depressive Symptoms equally for both groups. For women with MS, compared to women with FMS, Economic Adequacy had greater detrimental effects on Depressive Symptoms and both measures of disability. Social Support and Depressive Symptoms mediated the effect of Functional Limitations on disability. Adjustment to life with a chronic illness depends on, at the very least, individual physical, social, and psychological capacities. Practitioners should be sensitive to depressive symptoms and availability of social support in women with MS or FMS. / text

No description available.

As the population of the United States continues to expand, the ratio of elderly individuals will also escalate. Because the incidence of breast cancer increases with age, it can be expected there will be a proliferation in the number of older women with breast cancer in the future. The purpose of this study was to conduct a secondary analysis of a qualitative data set of elderly women newly diagnosed with breast cancer for the purposes of exploring the experiences of having breast cancer in later life. A qualitative phenomenological design was used. A prior data set was used consisting of interviews with 16 women aged 65 and older newly diagnosed with breast cancer and in their first week of treatment. Giorgi's stepwise approach to data analysis served as the method for data analysis. Major themes identified included: (a) participants had knowledge deficits of breast cancer risks and treatments, (b) some participants utilized routine mammography for breast cancer screening, (c) most breast cancer was diagnosed by mammography, (d) all participants experienced overwhelming emotional reactions to the diagnosis of breast cancer, and ( e) outlook for the future included both immediate and future plans. In conclusion, it is important for health care providers to understand the meaning of having breast cancer in later life, to educate older women about this disease, and to conduct future research including this population.

published_or_final_version / abstract / Microbiology / Master / Master of Philosophy

Background: Premenopausal black women have a 2-3 fold greater rate of coronary heart disease (CHD) than premenopausal white women. The purpose of this study was to provide insight into the reasons for this difference. Methods and Results: We compared CHD risk factors in 100 black and 100 white, healthy premenopausal women age 18-45 years and of relatively advantaged socioeconomic status. Black women consumed diets higher in saturated fat and cholesterol (12% of kcal as saturated fat and 360 mg of cholesterol per day) than did white women (10% of kcal and 290 mg/day) (p=0.008). Black women also had a higher body mass index (BMI) (32.0±9.2 vs. 29.0±9.4 kg/m², p=0.021), and higher systolic (124±17 vs. 115±14 mmHg, p<0.0001), and diastolic (79±14 vs. 75±11 mmHg, p=0.048) blood pressures. The mean plasma Lp(a) concentration was higher in the black women (40.2±31.3 mg/dl) than in the white women (19.2±23.7 mg/dl)(p<0.0001). The black women, however, had lower plasma triglyceride levels (0.91±0.46 vs. 1.22±0.60 mmol/L, p<0.0001), and a trend toward higher HDL cholesterol levels (1.37±0.34 vs. 1.29±0.31 mmol/L, p=0.064) than the white women. Plasma total and LDL cholesterol levels were similar. Rates of cigarette smoking and alcohol intake were low and similar between the races. Black women additionally had higher levels of plasma total homocysteine (8.80 vs. 7.81 μmol/L, p=0.013), lower plasma folates (3.52 vs. 5.23 ng/ml, p<0.0001), and higher vitamin B₁₂ levels (522 vs. 417 pg/ml, p<0.0001) than white women. More white women than black women took a multivitamin supplement (42.4% vs. 24.7%, p=0.019). When adjusted for multivitamin use, homocysteine levels did not differ, but plasma folate remained significantly lower in black women. Sixty-eight percent of black women carried the wild-type methylenetetrahydrofolate reductase genotype, 32.0% were heterozygotes, and none were homozygotes. Of the white women, 47.4% were wild-type, 40.3% heterozygotes, and 12.3% homozygotes (p=0.013). Conclusions: Premenopausal black women consumed more saturated fat and cholesterol and had a higher mean body mass index, blood pressure, Lp(a), and plasma total homocysteine levels than white women. These differences in coronary risk factors may explain the higher incidence of CHD in premenopausal black compared to white women. / Graduation date: 1998

Thirty females, 55 to 70 years old, participated in an investigation comparing two methods of teaching the diabetic diet. Subjects were required to take the WRAT-R, a test which assessed their reading capabilities. Only those scoring at the seventh grade level or below qualified for this investigation. Following the test, subjects were assigned to one of two groups. Participants in Group 1 received one-on-one instructions of Healthy Food Choices, whereas participants in Group 2 received videotaped instructions of Healthy Food Choices. Healthy Food Choices is a more simplified meal planning tool designed for those that cannot understand the concepts of the Exchange Lists for Meal Planning. Participants were instructed by the researcher, either on videotape or one-on-one. A follow-up visit occurred in a mean of 10.3 days to assess comprehension of the instructions provided. Each participant was contacted again by telephone in a mean of 28.7 days from the follow-up visit to assess long-term retention of the instructions they were provided. The sample menu collected from the two contacts provided data on choice deletions and additions. These data were analyzed by t-tests. There were no statistically significant differences found between diabetic diet instructions done by videotape or one-on-one at either follow-up visit or telephone contact. In this sample, videotaped instructions of the diabetic diet were just as effective as one-on-one instructions. / Master of Science

Not available / text

We examined the nutrient intake of women with rheumatoid arthritis (RA) before and after initiation of treatment with arthritis medication. Results of past (before taking arthritis medication) and present diets of RA subjects were compared to the past and present diets of the non-RA group. Subjects with RA were 19 women with a mean age of 65 ± 9 years who were diagnosed with RA and were receiving arthritis medication on a regular basis. The non-RA subjects were 19 women with a mean age of 57 ± 3 years who were apparently healthy and were not taking any prescription medication. Both groups were interviewed to determine past and present dietary nutrient intake by using the Health Habits and History food frequency questionnaire (FFQ) developed by the National Cancer Institute. Nutrient intake determined from 3-day dietary records and present diet FFQs were comparable. Total energy and fat in the past diets of the RA group were significantly higher (p<0.05) than the past diets of the non-RA group. Within each group there were significant reductions (p<0.05) between the past and present mean dietary intakes of total energy, fat and protein. There were no significant differences between the past and present micronutrient intakes between or within the two groups. However, the micronutrient content of the present diets of the RA group was lower in calcium, iron, thiamin and riboflavin than the non-RA group as measured by the number of subjects who had <67% of the RDA. There was a significant (p<0.05) decrease in the mean daily consumption of the meat, poultry, fish, eggs and bean group in both non-RA and RA groups. There was also a significant (p<0.05) decrease in the mean daily consumption of the fat, oil and sweets group among the RA subjects. RA subjects were taking an average of 3±1 arthritis medications. There were no significant correlations between the number of medications taken by the RA group and their dietary nutrient intake. However, the significant (p<0.05) decline in total energy intake by the RA group could possibly be due to medication side effects. Since present total energy intake was lower in both groups, these results could reflect the general decline in energy intake with advancing age. There were significant (p<0.05) differences between the past and present self-reported weights of the non-RA and RA groups showing a general reduction in weight over time in both groups. Mean body mass indexes (BMI) for RA subjects was higher than the non-RA subjects', possibly reflecting the lower activity level of the RA group. / Graduation date: 1996

Bone loss among the elderly is of increasing concern to the medical community. In a study combining retrospective data on 438 women from southern Arizona and current bone mineral values determined at the one-third distal radius, the effects of premenopausal reproductive events on postmenopausal bone mineral are investigated. Among those women who reach menarche at an early age are some whose growth is not accompanied by normal height and long bone growth. These women tend to exhibit lower bone mineral density postmenopausally. In addition, the early accumulation of weight in excess of height and a later age at menarche appears to result in wider bones still observed postmenopausally. Pregnancy normally is accompanied by an acceleration of calcium accumulation in excess of the fetal demand. However, parity appears to have little significant impact on postmenopausal bone mineral status. However, women pregnant during their teens tend to accumulate a greater amount of bone than women who first become pregnant later. These benefits to the teenage mother can be lost during lactation, an impairment of the skeleton which may continue into the postmenopausal years. The skeleton appears to require a recovery period between pregnancy and lactation cycles. Inadequate recovery time, particularly when accompanied by advanced maternal age, may have adverse effects on postmenopausal bone mineral status.