Amniotic fluid lamellar body count as a novel biochemical marker for timing elective caesarean delivery.

The aim of this study is to evaluate the performance of amniotic fluid lamellar body count (LBC) on the timing of elective caesarean delivery (CS) at ≥ 39 weeks. After allocating the study group (group I, transient tachypnoea of newborn (TTN), n = 14), an age-matched control group (group II, no TTN, n = 79) was selected for amniotic fluid LBC analysis. The median amniotic fluid LBC levels in group I were significantly lower than in the control group. Furthermore, the median values of mean lamellar body volume, median lamellar body distribution width and lamellar bodycrit in group I were also significantly lower than in group II. The best amniotic fluid LBC value to predict TTN was 40.15 × 10(3)/µl, with 82.3% sensitivity and 64.3% specificity. The favourable sensitivity and specificity values to predict the TTN for amniotic fluid LBC may suggest using it as an elective caesarean delivery-time scheduling marker.

Assessing the reliability of the EORTC QLQ-C30 in a sample of older African American and Caucasian adults.

The purpose of this study was to examine the structure and reliability of the EORTC QLQ-C30. This 30-item instrument has five functional scales (physical, role, cognitive, emotional, and social), three symptom scales (fatigue, pain, and nausea and vomiting) and a global health and quality of life scale. Confirmatory factor analysis and Cronbach's alpha estimates were used to assess the functioning of the EORTC QLQ-C30 in a sample of 489 African American (n = 255) and Caucasian (n = 234) adults aged 50 + years. Seven of the nine EORTC QLQ-C30 scales showed good reliability for both the African Americans and the Caucasians in the sample (Cronbach's alpha > 0.75). In contrast, the cognitive functioning scale had a reliability coefficient of only 0.69 for the African Americans and 0.40 for the Caucasians, and the nausea and vomiting scale had a reliability coefficient of only 0.49 for the African Americans and 0.51 for the Caucasians. In summary, although the overall reliabilities of seven of the scales showed good fit, many of the item-to-scale correlations did not. Researchers planning to use the EORTC QLQ-C30 might first consider conducting separate analyses on the different racial or ethnic subgroups in their study populations to determine whether a common set of factors or scales is available for further analysis.

Symptom reporting during physician consultation. Results of a health diary study.

Most studies of physician consultation focus on decisions to contact health care providers. In this article, the authors examine decisions regarding which symptoms to report once people contact physicians. Data for the analysis were gathered through interviews and health diaries completed by a probability sample of 667 elderly people, based on a subsample of 152 respondents who consulted physicians during the 3-week reporting period. A qualitative analysis produced behavioral patterns underlying decisions to report some but not other symptoms experienced on the day of physician contact. Logistic regression was used to explore the extent to which predispositions of individuals that precede the onset of symptoms and the type of symptom experience explain the distribution of these reporting patterns. Variation in the percentages of people reporting particular symptoms indicates that these reporting patterns cannot be explained solely by the type of symptoms people experience. The decisions regarding which symptoms to report reflect respondents' attribution of cause, the impact of symptoms on their daily lives, and the broader health and social context in which they confront particular symptoms.

Predisposition to self-health care: who does what for themselves and why?

Data collected on a national sample of 714 respondents aged 55 years and over were used to investigate predisposition to self-health care. Three different indicators of self-health care were employed in this work, including a measure of actual self-care behavior (ASCB), a behavioral indicator, and two attitudinal indicators, normative self-care response (NSCR) and global self-care. In OLS regression modeling, predisposing characteristics from the health-behavior model yielded levels of variance consistent with those found in the extant literature on health- and social-services utilization among elderly Americans. Age showed limited utility as an explanatory variable; it appeared as a direct effect only on global self-care. Race was the only variable to achieve a statistically significant effect on NSCR, and being female showed direct effects on ASCB and global self-care.

Factors contributing to the early rehospitalization of elderly people.

The main determinants of rehospitalization of elderly people were studied with a longitudinal sample of 264 persons older than 60 years at a midwestern, urban, university-affiliated hospital. Path analysis was applied to survey data collected for this study. Seventeen percent of subjects were readmitted within 30 days of discharge. Controlling for health and socioeconomic factors, the main determinant of readmission was the discharge placement; those placed back into the community for care in the home were more likely to be rehospitalized than those discharged to institutions. Contrary to predictions in the literature and the authors' expectations, patient involvement in discharge planning had no discernible effect on placement decisions and subsequent hospitalization. The implications of these findings for discharge planning by social workers are discussed.

Variation in long-term care service use by aged blacks. Data from the Supplement on Aging.

Data from the Supplement on Aging to the 1984 National Health Interview Survey were used to identify patterns of long-term care (LTC) service use among older Blacks. A subset of the SOA, including all 1,217 Blacks aged 55 and over, was the focus of the research. About 37% of all older Blacks in the sample reported difficulty in carrying out at least one activity of daily living (ADL) or instrumental activity of daily living (IADL); 27% reported receiving help with at least one of the ADLs or IADLs. Older Blacks were not significant users of community-based LTC services, with 11.9% reporting using a senior center, the highest percentage of use among a list of 10 community and social services. Five LTC factors were identified: ADL Help, Community Services, Home Health Services, Home Management Services, and Personal Services. Multiple regression analyses identify need factors as most dominant in explaining variation in LTC service use by older Blacks.

Comparing the economically advantaged and the pension elite: 1980 census profiles.

The number of economically advantaged retirees has grown rapidly since World War II. About 50% of retired individuals and 40% of retired households in the U.S. in 1980 had family income of more than double the poverty level. Economically advantaged retired households are most often headed by married, noncentral-city homeowners who show residential stability. They tend to have multiple income sources, some with income from at least three sources (the pension elite).

The support systems of older people: A test of the exchange paradigm.

This article tests the efficacy of the exchange paradigm for explaining the distribution of feelings of obligation and life satisfaction among 1,346 persons interviewed in the Social Security Administration's 1977 Midwestern Retirement Community Study. A simple correlational analysis was employed with these data. No substantive support is provided for the exchange paradigm as presented by Homans, Adams, and Dowd. Only the support given by older respondents in their primary relationships seems to be systematically and inversely related to life satisfaction. And, even these correlations are quite modest by any standard. The advantages of formalizing the exchange theory are discussed. In addition, problems of operationalization as well as conceptual and theoretical problems are addressed in an attempt to facilitate replication and reformulation by other researchers.

A survey of retired dentists in the United States. Council on Dental Practice.

This paper reports on the results of a national survey of retired dentists carried out in the winter and spring of 1984. More than eight in ten of the respondents were general practitioners. Most retirees are between the ages of 60 and 69, married, and report their overall health at retirement to be excellent or good. As do retired scientists, dentists find intrinsic gratification in the work role, but apparently accept retirement as part of the life cycle. Retired dentists have income substantially greater than retirees in general. As is the case for the greater majority of older Americans, Social Security provides an important income support for respondent dentists. However, the primary source of retirement income for dentists comes from savings and investments. One of three retired dentists reports net worth in 1984 as between $200-$499,999. Retired dentists are well adjusted to retirement. Overall, most dentists report high satisfaction with retirement to date. Additional leisure time for hobbies, flexibility in owning one's time, and social activities with family and friends seem the main contributors to this satisfaction. Investment planning, health assessment, enthusiasm for outside interests, and personal preparation for retirement with a spouse are reported as important in retirement planning. Retirement is not a satisfying experience for all dentists. Some do report experiencing uselessness and depression. A still smaller proportion report feelings of loneliness and inadequacy. As is the case for older people in general, solitary activities including reading, watching television, and gardening are important for retired dentists. Most older people attempt to retain activity patterns and preferences developed earlier in life.(ABSTRACT TRUNCATED AT 250 WORDS)

Explicating activity theory: a formal replication.

The principal intent of this paper is to replicate formally the work of Lemon, Bengtson, and Peterson (1972), the first researchers to carefully articulate a systematic statement of the activity theory of aging, but whose test of the theory resulted in disappointing ambiguous findings. Probability samples of three distinct types of retirement communities (N = 1209) provided far greater variation in background variables than existed in the original study. Behaviorally based activity scales were drawn from daily activity inventories rather than the single-item ordinal measures of activity items used in the original research. Multiple Classification Analysis was employed to sort out the effects of each activity type from the others and from the effects of age, gender, and health upon life satisfaction. Different from the results of Lemon, Bengtson, and Peterson, our findings, although mixed, lend strong support to the activity theory of aging. Informal activity contributed positively, strongly, and frequently to the life satisfaction of respondents. Solitary activities had no effect on life satisfaction. Formal activity had a negative effect. All activity effects were similar in the three communities. The implications of these findings for activity theory are discussed at length.