{"title":"Reintegration to normal living as a proxy to quality of life","authors":"Sharon Wood-Dauphinee , J.Ivan Williams","doi":"10.1016/0021-9681(87)90005-1","DOIUrl":"10.1016/0021-9681(87)90005-1","url":null,"abstract":"<div><p>The impact of disease and treatment on patients' lives is frequently measured by endpoints such as health status, well being and quality of life. The objective of this paper is to introduce a new but related outcome concept termed “reintegration to normal living” and to compare it to the quality of life. The concept of “reintegration” is closely allied to functional performance. Like quality of life, it is important to measure when therapeutic goals cannot include a cure but are directed at controlling the disease process or fostering compensation for impairment. A Reintegration to Normal Living (RNL) Index has been developed. Although more limited in conceptual focus, its content is similar to global quality of life measures. It is internally consistent, demonstrates content and construct validity, can be completed by patients or significant others and is sensitive to changes in patient status. The degree of reintegration achieved by patients after an incapacitating illness is seen as contributing to the quality of their lives.</p></div>","PeriodicalId":15427,"journal":{"name":"Journal of chronic diseases","volume":"40 6","pages":"Pages 491-499"},"PeriodicalIF":0.0,"publicationDate":"1987-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0021-9681(87)90005-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14719742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The association of body fat distribution with hypertension, hypertensive heart disease, coronary heart disease, diabetes and cardiovascular risk factors in men and women aged 18–79 years","authors":"Richard F. Gillum","doi":"10.1016/0021-9681(87)90175-5","DOIUrl":"10.1016/0021-9681(87)90175-5","url":null,"abstract":"<div><p>To confirm the reported association of body fat distribution with cardiovascular disease, diabetes, blood pressure and serum cholesterol, data from the 1960-62 Health Examination Survey were analyzed. In this sample drawn from the noninstitutionalized population of the United States aged 18–79, mean values of two indices of upper versus lower body fat distribution increased steadily with age. Men had higher values than women, and black women had higher values than white women. Higher values of the indices were significantly associated with higher blood pressure, post-load serum glucose and greater prevalence of definite hypertension and definite hypertensive heart disease independent of multiple confounders. Associations with higher serum cholesterol and definite coronary heart disease prevalence were independent of overall ponderosity but not of age and multiple other confounders. Greater abdominal relative to lower body fat deposits were independently associated with increased cardiovascular risk in men and women, blacks and whites.</p></div>","PeriodicalId":15427,"journal":{"name":"Journal of chronic diseases","volume":"40 5","pages":"Pages 421-428"},"PeriodicalIF":0.0,"publicationDate":"1987-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0021-9681(87)90175-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14617187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Declining trends in blood pressure level and the prevalence of hypertension, and changes in related factors in Japan, 1956–1980","authors":"Hirotsugu Ueshima , Kozo Tatara , Shintaro Asakura , Masashi Okamoto","doi":"10.1016/0021-9681(87)90065-8","DOIUrl":"10.1016/0021-9681(87)90065-8","url":null,"abstract":"<div><p>Trends in age-specific and age-adjusted blood pressure and the prevalence of hypertension were obtained from the National Nutrition Survey of Japan, 1956–1980. The national trends in the age-adjusted blood pressure of people (30–69 years old) in Japan during the 1956–1980 period show an increasing pattern reaching a peak around 1964 followed by a descreasing pattern. To explore the possible factors which have contributed to the change in blood pressure levels, we analyzed the relationship between the blood pressure and several possible factors, including the rate of treatment for cardiovascular diseases (CVD) for men and women, annual salt and alcohol consumption per capita and body mass index (MB1) for men and women. Only alcohol consumption was considered in the analysis of men because women in Japan still tend to drink relatively little alcohol.</p><p>In simple descriptive analyses, the increasing trend in the treatment rates of CVD seemed to be related to the decrease in the blood pressure level and in the prevalence rate of hypertension for both men and women. The impact of treatment rate seemed to overcome the adverse influence of the increasing trends in BMI. Recent decrease in salt consumption may account in part for the later period of the decreasing trends in blood pressure level and the prevalence of hypertension. In multiple regression analysis using these time series data. CVD. BMI and alcohol consumption were significantly related to blood pressure level and the prevalence of hypertension, although salt was not significant in these analyses.</p></div>","PeriodicalId":15427,"journal":{"name":"Journal of chronic diseases","volume":"40 2","pages":"Pages 137-147"},"PeriodicalIF":0.0,"publicationDate":"1987-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0021-9681(87)90065-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14937434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Martin T. Schechter, Anthony B. Miller, Cornelia J. Baines, Geoffrey R. Howe
{"title":"Response","authors":"Martin T. Schechter, Anthony B. Miller, Cornelia J. Baines, Geoffrey R. Howe","doi":"10.1016/0021-9681(87)90193-7","DOIUrl":"https://doi.org/10.1016/0021-9681(87)90193-7","url":null,"abstract":"","PeriodicalId":15427,"journal":{"name":"Journal of chronic diseases","volume":"40 9","pages":"Pages 909-910"},"PeriodicalIF":0.0,"publicationDate":"1987-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0021-9681(87)90193-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72223812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Methods for analyzing occupational cohort data with application to lung cancer in U.S. Uranium miners","authors":"Jerry Halpern, Alice S. Whittemore","doi":"10.1016/S0021-9681(87)80011-5","DOIUrl":"10.1016/S0021-9681(87)80011-5","url":null,"abstract":"<div><p>We used two methods to examine how lung cancer death rates vary with cumulative exposures to radiation and tobacco among U.S. uranium miners. We assumed that exposures act proportionately on age-specific death rates among nonsmokers who are unexposed to uranium. The two methods produced similar results when death rate ratios were taken to be the product of radiation and tobacco effects. The estimates were discrepant when death rate ratios were taken to be the sum of radiation and tobacco effects. Both methods indicated better fit for the multiplicative model, as judged by the maximized loglikelihood values. Death rates estimated in this way for white males in the absence of mining and smoking increased only weakly with age. This weak relation suggests that our models of death rates fit poorly. It may be that cumulative exposures are inappropriate measures of the effects of radiation and tobacco on lung cancer death rates.</p></div>","PeriodicalId":15427,"journal":{"name":"Journal of chronic diseases","volume":"40 ","pages":"Pages 79S-88S"},"PeriodicalIF":0.0,"publicationDate":"1987-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0021-9681(87)80011-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14787683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Age-related factors in cancers of the breast, ovary, and endometrium","authors":"M.C. Pike","doi":"10.1016/S0021-9681(87)80009-7","DOIUrl":"10.1016/S0021-9681(87)80009-7","url":null,"abstract":"<div><p>The most central epidemiological feature of cancers of the breast, ovary and endometrium is the enormous protective effect of menopause. Simple mathematical “models” of the age-incidence of these tumours suggests that their incidence by age 70 would be between 4 and 8-fold increased if women continued to menstruate into old age. Using the notion of “effective cell-cycle time” to explain this phenomenon, different “models” are constructed for each of these three tumour sites and shown to provide an excellent description of most of the known epidemiology of each of the cancers, and to provide a basis for predicting the long-term effects of various factors on the risk of these diseases. In particular, the model suggests that 5 years of combination-type oral contraceptive use will approximately halve the lifelong risk of both ovarian cancer and endometrial cancer.</p></div>","PeriodicalId":15427,"journal":{"name":"Journal of chronic diseases","volume":"40 ","pages":"Pages 59S-69S"},"PeriodicalIF":0.0,"publicationDate":"1987-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0021-9681(87)80009-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14787764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Calculating cancer latency using data from a nested case-control study of prostatic cancer","authors":"David F. Goldsmith","doi":"10.1016/S0021-9681(87)80015-2","DOIUrl":"10.1016/S0021-9681(87)80015-2","url":null,"abstract":"<div><p>Assessing latency for neoplastic diseases is crucial for determining the causal effects of a complex mix of carcinogenic exposures. An initial assessment of cancer risks in a U.S. tire and rubber plant revealed a significant SMR of 140 for prostatic cancer. Using an industry-based, case-control death certificate study of prostatic malignancies, we found matched odds ratios of about 3 (<em>p</em> < 0.025) for Batch Preparation, the work area with the greatest exposure to carbon black, solvents, and heavy metal oxides. To assess latency, we used the matched case-control series to calculate annual estimates of the odds ratio by determining the proportion of cases and controls employed for greater than 1 month in Batch Preparation during each year under study. This approach produced a plot with great fluctuations. To reduce variability in the resulting curve, a method was developed that measured the “etiologic fraction,” which is its highest point represents an estimate of the peak of the latency distribution. For Batch Preparation the modal point was 29 years before death with the greatest risk occurring from employment in the mid-1940's. The latency method allows risk assessment for time and year of greatest exposure difference, thus suggesting appropriate prevention strategies. Applications of this method for other types of studies and exposures are discussed.</p></div>","PeriodicalId":15427,"journal":{"name":"Journal of chronic diseases","volume":"40 ","pages":"Pages 119S-123S"},"PeriodicalIF":0.0,"publicationDate":"1987-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0021-9681(87)80015-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14788533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Screening and breast cancer","authors":"Paul Silcocks","doi":"10.1016/0021-9681(87)90057-9","DOIUrl":"10.1016/0021-9681(87)90057-9","url":null,"abstract":"","PeriodicalId":15427,"journal":{"name":"Journal of chronic diseases","volume":"40 4","pages":"Page 367"},"PeriodicalIF":0.0,"publicationDate":"1987-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0021-9681(87)90057-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14680768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Commentary: Functional assessment questionnaire for geriatric patients—or the clinical Swiss army knife","authors":"Robert L. Kane","doi":"10.1016/S0021-9681(87)80038-3","DOIUrl":"https://doi.org/10.1016/S0021-9681(87)80038-3","url":null,"abstract":"","PeriodicalId":15427,"journal":{"name":"Journal of chronic diseases","volume":"40 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"1987-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0021-9681(87)80038-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72260874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}