Although Black end-stage renal disease (ESRD) patients on dialysis report better functioning and well-being than do White patients, little is known about the association of race with disease symptoms and treatment side effects. Interviews were conducted with 183 older Black and 125 older White in-center hemodialysis (HD) patients in Georgia. Patients were identified in a stratified (by race and sex) random sample of patients aged 60+ years selected from the ESRD Network census of all patients in that age category. Self-assessed disease symptoms and/or side effects of treatment, disability days, and health satisfaction were measured. Data were analyzed via logistic or linear regression, controlling for the effects of patients' gender, age, months on dialysis, primary diagnosis of diabetes, cardiovascular co-morbidity, HD treatment time, and usual interdialytic weight gain. Older Whites, compared to older Blacks, were at increased risk for reporting nausea, sexual dysfunction, recent bed disability days, fatigue, greater HD recovery time, and health dissatisfaction. The relation of these complaints to dialysis adequacy and patients' nutritional status merits continued study.
Introduction: These analyses were designed to elucidate U.S. physicians’ perception of residential radon risk, as measured by the prevalence of residential radon testing using a representative sample of U.S. women physicians from the Women Physicians’ Health Study database. In addition, characteristics of women physicians who were more likely to have conducted a residential radon test were identified. Methods: A random sample (n = 4,501 respondents) of U.S. women physicians aged 30 to 70 was obtained in the Women Physicians’ Health Study. Analyses were conducted using SUDAAN. Results: The overall prevalence of residential radon testing among respondents was 18%, 2- to 6-fold higher than any estimate of residential radon testing in the general population. The strongest relationship with radon testing observed through logistic regression was with marital status; age, ethnicity, and region of residence were also related. Conclusion: This study demonstrates that although U.S. women physicians are more likely to have conducted a personal residential radon test than the general population, 82% report not having done so. Increasing the awareness of physicians about the health risks associated with prolonged radon exposure will be essential if they are to play a role in addressing this important public health problem.
Colloidal semiconductor nanoplatelets (NPLs) are a scalable materials platform for optoelectronic applications requiring fast and narrow emission, including spin-to-photon transduction within quantum information networks. In particular, three-particle negative trions of NPLs are appealing emitters since, unlike excitons, they do not have an optically "dark" sublevel. In CdSe NPLs, trion emission dominates the photoluminescence (PL) spectrum at low temperature but using them as single photon-emitting states requires more knowledge about their preparation, since trions in these materials are not directly optically accessible from the ground state. This work demonstrates, using power-dependent time-resolved transient absorptions (TA) of CdSe NPLs, that trions form via biexciton decay in 1.6 ps. The scaling of the trion population and formation lifetime with excitation power indicates that they do not form through collisional mechanisms typical for 2D materials, but rather by a unimolecular hole transfer. This work is a step toward deterministic single photon emission from trions.
The association of baseline characteristics with long-term survival (7 years past baseline interview) was investigated in a prevalent sample of 349 dialysis patients aged 60-87 at baseline. In primary diagnosis, treatment modality, and months on dialysis, the sample was representative of all patients aged 60 + living in the state of Georgia. There were 38 surviving patients at a 7-year follow-up. At their baseline assessment, long-term survivors were significantly younger and less likely to report cardiovascular comorbidity. With age and cardiovascular comorbidity controlled, long-term survivors were more likely at baseline to desire a transplant, and reported needing less time to “ recover” from HD treatments. Survivors ' physical functioning resources at baseline included less health limitation of activity, lower functional impairment, and more frequent activity / exercise. Psychosocial well-being resources included higher self-esteem, higher sense of mastery, and higher self-rated health status. Ongoing assessment of these resource variables, with targeted interventions, might contribute to improved survival as well as improved functioning and well-being for older patients.
In a household community sample of 1,285, 9-17 years-olds with mental disorders who had received outpatient specialty mental health services in the past year were compared with youths with mental disorders who had not received those services to determine if samples drawn from clinical settings are representative of youths with mental disorders in the general population. Those who had used services were more impaired, less competent, more likely to have comorbid disorders, more likely to belong to non-Hispanic White relative to other ethnic groups, and less likely to be prepubertal girls. Their parents were more educated, but less satisfied with family life, engaged in less monitoring of their children, and more likely to have used mental health services themselves. These findings suggest the hypothesis that samples of youths with mental disorders drawn from outpatient clinical settings are not representative of all youths with mental disorders. If confirmed, this would indicate the importance of population-based samples for the study of psychopathology in youths.
This study investigated whether social and/or psychologic factors help to predict older dialysis patients' continued survival. A stratified (by race and sex) random sample of patients aged 60+ years was selected from the ESRD Network census of all patients in that age category residing in a single southeastern state (Georgia) and receiving chronic dialysis as of November 1987; personal interviews with patients were completed in 1988. This analysis includes 287 patients (mean age, 69 years) receiving outpatient hemodialysis for whom primary cause of renal failure and functional status data were complete. Patient tracking and vital statistics data determined that 49% of the sample survived as of October 31, 1990. Study variables included demographic, dialysis, health status, social situation, and psychologic outlook variables reported at the patients' 1988 interviews. Log rank tests showed univariate associations between patients' continued survival and race/gender, recovery time following dialysis treatments, cardiovascular co-morbidity, exercise activity score, freedom from health limitation of daily activity, functional status, leisure activity score, self-rated health status, overall life satisfaction, depression, and public religiosity. The Cox proportional hazards model was fit to the data, with continued survival from the time of the 1988 interview as the dependent variable. There was a significantly increased mortality risk for white men relative to the other race/gender groups and for patients reporting severely impaired functional status at the 1988 interview. With functional status in the model, no other social or psychologic variables were significant predictors of mortality.(ABSTRACT TRUNCATED AT 250 WORDS)
The relation between maternal unipolar major depression and children's self-concept, self-control, and peer relationships were studied in a middle-class, predominantly white sample of 96 families. Each family included a target child between the ages of 5 and 10. Depressed mothers varied on whether or not the child's father also had a psychiatric disorder. Well mothers all had spouses with no psychiatric disorders. Analyses controlled for marital status, age, and sex of child. Children completed measures of self-concept and peer relations skills; teachers completed measures of self-control and a rating of popularity with peers. Results supported the multiple risk factor model in that fathers' psychiatric status and parents' marital status explained much of the variability in children's social and emotional competence. Maternal depression alone, in the context of a well husband/father, was only related to children having been rated by their teachers as less popular. Results are discussed in terms of possible mechanisms by which maternal depression may interact with paternal psychopathology and divorce in relation to children's social and emotional competence. The findings may further indicate that older children are more vulnerable to these multiple risk factors than younger children.
Followup interviews were conducted after three years with 127 older dialysis patients whose treatment modality was unchanged. The mean age of black patients was 70; the mean age of white patients was 72. A significant race difference in reported change in quality of life (QOL) was found for only one variable; white patients, but not black patients, felt they were not taking care of their health as well at Time 2 as at Time 1. For the total sample of patients who were reinterviewed, significant change in QOL responses was found for 9 measures. Vascular access problems were reported significantly less often at Time 2 by hemodialysis patients. Physical complaints related to ESRD and dialysis, use of assist devices, functional impairment, exercise involvement, number of leisure activities, perceived control over future health, depressive symptoms, and mood state responses at Time 2 indicated decline in QOL self-assessments. For the majority of QOL measures that were investigated, including overall life satisfaction, no significant change was found. A clinical challenge is to identify interventions that effectively target areas in which older dialysis patients are at risk for declining QOL over time.
In this paper, we describe the responses obtained in 1988 in a large, statewide study of quality of life among dialysis patients age 60 years or older, and responses obtained from a control group of older, non treated persons living in the same state
283 patients, age 18-59 years on chronic dialysis were interviewed about their current work status and their ability to work if currently not employed. Only 11% of the total sample was currently employed. However, one third of the nonemployed patients said they were able to work, and most of these patients had made an effort to be employed. Age, race, educational level, health status, and physical ability to perform job tasks, recent work experience, and interest in working were related to the reported ability to work. Patients who said they were able to work were also likely to be rated able to work by the medical director of their dialysis facility. The data indicate the importance of helping work-interested patients maintain their jobs when they start chronic dialysis treatment.
To better define the relationship between residual refractive error, uncorrected visual acuity, and pupil diameter, we compared 42 eyes that had an eight-incision radial keratotomy according to the Prospective Evaluation of Radial Keratotomy Study protocol with 42 matched control eyes. The parameters measured were best corrected visual acuity, uncorrected visual acuity, and the change in cycloplegic refraction with enlarging pupil diameter. The best corrected visual acuity was 20/16 in both the radial keratotomy and control groups, but the variability (SD) was higher in the radial keratotomy group. The average uncorrected visual acuity was 0.35 (35%) better in the radial keratotomy group, but the variability was 1.77 times higher. Change in refraction with dilation occurred in 9% of the controls and 36% of the radial keratotomy patients, indicating a significant difference (P = .002). The change in refraction with dilation in the eyes with radial keratotomy was almost equally split between a hyperopic change (17%) and a myopic change (18%), which was much different than in the control eyes, only 2% of which changed in a hyperopic direction and 7% in a myopic direction. The radial keratotomy patients with a myopic change had the best uncorrected visual acuity, indicating that positive spherical aberration yielded the best aspherical surface for uncorrected visual acuity.
The Prospective Evaluation of Radial Keratotomy Study is a nine-center clinical trial of a surgical technique to reduce simple myopia by making incisions in the cornea. There were 435 patients (one eye per patient is reported) enrolled in the study with a 91% follow-up rate at 4 years after surgery. After surgery, uncorrected visual acuity was 20/40 or better in 76% of eyes. Fifty-five percent of the eyes had a refractive error within +/- 1.00 diopter; 28% were undercorrected, and 17% were overcorrected by more than 1.00 D. The width of the prediction 90% interval for the refractive change was 4.42 D, indicating a lack of predictability. The refractive error was not stable in some eyes; between 6 months and 4 years after surgery, 23% of eyes had a continued effect of the surgery of more than 1.00 D. For 323 patients with both eyes operated on, 64% stated they wore no optical correction. There were few serious complications. Eleven eyes (3%) lost two or three lines of best corrected visual acuity. Two eyes developed delayed bacterial keratitis without significant loss in best corrected visual acuity.