7,353 research outputs found

    Predictors of Increases in Alcohol Problems and Alcohol Use Disorders in Offspring in the San Diego Prospective Study.

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    BackgroundThe 35-year-long San Diego Prospective Study documented 2-fold increases in alcohol problems and alcohol use disorders (AUDs) in young-adult drinking offspring compared to rates in their fathers, the original probands. The current analyses use the same interviews and questionnaires at about the same age in members of the 2 generations to explore multiple potential contributors to the generational differences in adverse alcohol outcomes.MethodsUsing data from recent offspring interviews, multiple cross-generation differences in characteristics potentially related to alcohol problems were evaluated in 3 steps: first through direct comparisons across probands and offspring at about age 30; second by backward linear regression analyses of predictors of alcohol problems within each generation; and finally third through R-based bootstrapped linear regressions of differences in alcohol problems in randomly matched probands and offspring.ResultsThe analyses across the analytical approaches revealed 3 consistent predictors of higher alcohol problems in the second generation. These included the following: (i) a more robust relationship to alcohol problems for offspring with a low level of response to alcohol; (ii) higher offspring values for alcohol expectancies; and (iii) higher offspring impulsivity.ConclusionsThe availability of data across generations offered a unique perspective for studying characteristics that may have contributed to a general finding in the literature of substantial increases in alcohol problems and AUDs in recent generations. If replicated, these results could suggest approaches to be used by parents, healthcare workers, insurance companies, and industry in their efforts to mitigate the increasing rates of alcohol problems in younger generations

    Use of an Adaptive Climbing Program to Improve Social Skills in Children with Developmental Delays: A Feasibility Study

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    Purpose: A repeated measures single-group feasibility study was used to investigate the potential success and feasibility of an adaptive climbing program including group social skills activities to positively impact social skills in children with developmental delays. Methods: A convenience sample of 10 children aged 4 to 12 years participated in six social skills activity groups and adaptive climbing sessions at a rock-climbing facility in North Carolina. Trained observers measured targeted social skills via an author-generated social skills tracking form. Results: A paired t-test indicates a statistically significant improvement in social skills from session 1 to session 6 (pConclusions: Outcomes suggest participation in a community-based adaptive climbing program that involves group social skills activities may be beneficial for promoting social skill development in children with developmental delays. Opportunities exist for occupational therapists to partner with climbing gyms or other organizations to develop and tailor programming specific to each child’s developmental level and needs

    Statin use and adverse effects among adults \u3e 75 years of age: Insights from the Patient and Provider Assessment of Lipid Management (PALM) registry

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    Background: Current statin use and symptoms among older adults in routine community practice have not been well characterized since the release of the 2013 American College of Cardiology/American Heart Association guideline. Methods and results: We compared statin use and dosing between adults \u3e75 and ≤75 years old who were eligible for primary or secondary prevention statin use without considering guideline-recommended age criteria. The patients were treated at 138 US practices in the Patient and Provider Assessment of Lipid Management (PALM) registry in 2015. Patient surveys also evaluated reported symptoms while taking statins. Multivariable logistic regression models examined the association between older age and statin use and dosing. Among 6717 people enrolled, 1704 (25%) were \u3e75 years old. For primary prevention, use of any statin or high-dose statin did not vary by age group: any statin, 62.6% in those \u3e75 years old versus 63.1% in those ≤75 years old (P=0.83); high-dose statin, 10.2% versus 12.3% in the same groups (P=0.14). For secondary prevention, older patients were slightly less likely to receive any statin (80.1% versus 84.2% [P=0.003]; adjusted odds ratio, 0.81; 95% confidence interval, 0.66-1.01 [P=0.06]), but were much less likely to receive a high-intensity statin (23.5% versus 36.2% [PP=0.0001]). Among current statin users, older patients were slightly less likely to report any symptoms (41.3% versus 46.6%; P=0.003) or myalgias (27.3% versus 33.3%; Conclusions: Overall use of statins was similar for primary prevention in those aged \u3e75 years versus younger patients, yet older patients were less likely to receive high-intensity statins for secondary prevention. Statins appear to be similarly tolerated in older and younger adult

    The Ursinus Weekly, January 19, 1959

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    Progoff addresses Forum; Discusses depth psychology • WSGA plans board for information and registration • Radio station receives campus approval • WSGA sets dates, elects chairmen; Plans activities • Junior class meeting • Negro student T. Y. Rogers is vesper speaker • Dr. Conyers Read talks to frosh hist. section • Bob Schmoyer tapped for \u2758 soccer honors • MSGA to review 1960 custom program • APO has formal initiation • Editorial: Jazz • Student opinion • Prof\u27s opinion • A criticism • Protest • Sports team in full swing after finals • Track team plans for 1959 season • Matmen whip Albright in thriller by 19 to 13 • Courtmen lose to Drexel, PMC; 8th loss in row • Bell\u27s speech at employees banquet • Art Alliance presents one-man showshttps://digitalcommons.ursinus.edu/weekly/1376/thumbnail.jp

    The Ursinus Weekly, January 19, 1959

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    Progoff addresses Forum; Discusses depth psychology • WSGA plans board for information and registration • Radio station receives campus approval • WSGA sets dates, elects chairmen; Plans activities • Junior class meeting • Negro student T. Y. Rogers is vesper speaker • Dr. Conyers Read talks to frosh hist. section • Bob Schmoyer tapped for \u2758 soccer honors • MSGA to review 1960 custom program • APO has formal initiation • Editorial: Jazz • Student opinion • Prof\u27s opinion • A criticism • Protest • Sports team in full swing after finals • Track team plans for 1959 season • Matmen whip Albright in thriller by 19 to 13 • Courtmen lose to Drexel, PMC; 8th loss in row • Bell\u27s speech at employees banquet • Art Alliance presents one-man showshttps://digitalcommons.ursinus.edu/weekly/1376/thumbnail.jp

    Patient-reported reasons for declining or discontinuing statin therapy: Insights from the PALM registry

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    Background: Many adults eligible for statin therapy for cardiovascular disease prevention are untreated. Our objective was to investigate patient‐reported reasons for statin underutilization, including noninitiation, refusal, and discontinuation.Methods and Results: This study included the 5693 adults recommended for statin therapy in the PALM (Patient and Provider Assessment of Lipid Management) registry. Patient surveys evaluated statin experience, reasons for declining or discontinuing statins, and beliefs about statins and cardiovascular disease risk. Overall, 1511 of 5693 adults (26.5%) were not on treatment. Of those not on a statin, 894 (59.2%) reported never being offered a statin, 153 (10.1%) declined a statin, and 464 (30.7%) had discontinued therapy. Women (relative risk: 1.22), black adults (relative risk: 1.48), and those without insurance (relative risk: 1.38) were most likely to report never being offered a statin. Fear of side effects and perceived side effects were the most common reasons cited for declining or discontinuing a statin. Compared with statin users, those who declined or discontinued statins were less likely to believe statins are safe (70.4% of current users vs. 36.9% of those who declined and 37.4% of those who discontinued) or effective (86.3%, 67.4%, and 69.1%, respectively). Willingness to take a statin was high; 67.7% of those never offered and 59.7% of patients who discontinued a statin would consider initiating or retrying a statin.Conclusions: More than half of patients eligible for statin therapy but not on treatment reported never being offered one by their doctor. Concern about side effects was the leading reason for statin refusal or discontinuation. Many patients were willing to reconsider statin therapy if offered

    Measurement of low‐density lipoprotein cholesterol levels in primary and secondary prevention patients: Insights from the PALM registry

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    Background The 2013 American College of Cardiology/American Heart Association Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults recommended testing low-density lipoprotein cholesterol ( LDL -C) to identify untreated patients with LDL -C ≥190 mg/dL, assess lipid-lowering therapy adherence, and consider nonstatin therapy. We sought to determine whether clinician lipid testing practices were consistent with these guidelines. Methods and Results The PALM (Patient and Provider Assessment of Lipid Management) registry enrolled primary and secondary prevention patients from 140 US cardiology, endocrinology, and primary care offices in 2015 and captured demographic data, lipid treatment history, and the highest LDL -C level in the past 2 years. Core laboratory lipid levels were drawn at enrollment. Among 7627 patients, 2787 (36.5%) had no LDL -C levels measured in the 2 years before enrollment. Patients without chart-documented LDL -C levels were more often women, nonwhite, uninsured, and non-college graduates (all P\u3c0.01). Patients without prior lipid testing were less likely to receive statin treatment (72.6% versus 76.0%; P=0.0034), a high-intensity statin (21.5% versus 24.3%; P=0.016), nonstatin lipid-lowering therapy (24.8% versus 27.3%; P=0.037), and had higher core laboratory LDL -C levels at enrollment (median 97 versus 92 mg/dL; P\u3c0.0001) than patients with prior LDL -C testing. Of 166 individuals with core laboratory LDL -C levels ≥190 mg/dL, 36.1% had no LDL -C measurement in the prior 2 years, and 57.2% were not on a statin at the time of enrollment. Conclusions In routine clinical practice, LDL -C testing is associated with higher-intensity lipid-lowering treatment and lower achieved LDL -C level
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