GLORIA

GEOMAR Library Ocean Research Information Access

X

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    Online Resource
    Online Resource
    Multi-morbidity and patient-reported functional limitations: a population-based cohort study
    SAGE Publications ; 2022
    In:  Journal of Multimorbidity and Comorbidity Vol. 12 ( 2022-01), p. 263355652211054-
    Details
    In: Journal of Multimorbidity and Comorbidity, SAGE Publications, Vol. 12 ( 2022-01), p. 263355652211054-
    Abstract: Persons who accumulate chronic conditions at a rate faster than their peers may experience accelerated aging and poor health outcomes, including functional limitations. Methods Adults aged ≥40 years who resided in Olmsted County, Minnesota on 1 January 2006 were identified. The prevalence of 21 chronic conditions was ascertained, and age-specific quartiles of the number of chronic conditions was estimated within 4 age groups: 40–54, 55–64, 65–74, and ≥75 years. Difficulty with nine patient-reported functional limitations (including basic and instrumental activities of daily living and mobility activities) were ascertained through 31 October 2018. Cox regression was used to model associations of chronic condition quartiles with new-onset functional limitations considered separately. We estimated absolute risk differences and hazard ratios stratified by age group, and adjusted for sex, race, ethnicity, marital status, education, and the residual effect of age. Results Among 39,624 persons (44.5% men, 93.2% white), the most common reported new functional limitations were difficulty with climbing stairs, walking, and housekeeping. For all functional limitations, the absolute risk differences were largest among the oldest age group (≥75 years). Approximately twofold increased hazard ratios were observed among those in the highest vs. lowest quartile for the three oldest age groups, and approximately threefold or higher hazard ratios were observed for persons aged 40-54 years. Conclusion Persons with increased accumulation of chronic conditions experience increased risks of developing functional limitations compared to their peers. These findings underscore the importance of assessing health status and of employing interventions to prevent and effectively manage multi-morbidity at all ages.
    Type of Medium: Online Resource
    ISSN: 2633-5565 , 2633-5565
    URL: Article
    DOI: 10.1177/26335565221105448
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 3105397-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 2
    Online Resource
    Online Resource
    Convergence of four measures of multi-morbidity
    SAGE Publications ; 2023
    In:  Journal of Multimorbidity and Comorbidity Vol. 13 ( 2023-12), p. 263355652211501-
    Details
    In: Journal of Multimorbidity and Comorbidity, SAGE Publications, Vol. 13 ( 2023-12), p. 263355652211501-
    Abstract: To compare the agreement between percentile ranks from 4 multi-morbidity scores. Design Population-based descriptive study. Setting Olmsted County, Minnesota (USA). Participants We used the medical records-linkage system of the Rochester Epidemiology Project (REP; http://www.rochesterproject.org ) to identify all residents of Olmsted County, Minnesota who reached one or more birthdays between 1 January 2005 and 31 December 2014 (10 years). Methods For each person, we calculated 4 multi-morbidity scores using readily available diagnostic code lists from the US Department of Health and Human Services, the Clinical Classifications Software, and the Elixhauser Comorbidity Index. We calculated scores using diagnostic codes received in the 5 years before the index birthday and fit quantile regression models across age and separately by sex to transform unweighted, simple counts of conditions into percentile ranks as compared to peers of same age and of same sex. We compared the percentile ranks of the 4 multi-morbidity scores using intra-class correlation coefficients (ICCs). Results We assessed agreement in 181,553 persons who reached a total of 1,075,433 birthdays at ages 18 years through 85 years during the study period. In general, the percentile ranks of the 4 multi-morbidity scores exhibited high levels of agreement in 6 score-to-score pairwise comparisons. The agreement increased with older age for all pairwise comparisons, and ICCs were consistently greater than 0.65 at ages 50 years and older. Conclusions The assignment of percentile ranks may be a simple and intuitive way to assess the underlying trait of multi-morbidity across studies that use different measures.
    Type of Medium: Online Resource
    ISSN: 2633-5565 , 2633-5565
    URL: Article
    DOI: 10.1177/26335565221150124
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 3105397-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 3
    Online Resource
    Online Resource
    Addressing Task Avoidance in Middle School Students : Academic Behavior Check-In/Check-Out
    SAGE Publications ; 2014
    In:  Journal of Positive Behavior Interventions Vol. 16, No. 3 ( 2014-07), p. 159-167
    Details
    In: Journal of Positive Behavior Interventions, SAGE Publications, Vol. 16, No. 3 ( 2014-07), p. 159-167
    Abstract: Multitier prevention systems consist of a continuum of interventions to address the needs of all students. Within such systems, Tier I supports are in place for all students and are designed to enhance prosocial (social behavior interventions) and academic (instructional interventions) skills. Tier II interventions supplement the Tier I intervention for students who have not responded to Tier I supports and are designed to prevent the development of serious behavioral challenges or academic failure. This study evaluated a Tier II intervention for students whose problem behavior was maintained by avoidance of instructional activities. We evaluated effects of academic behavior check-in/check-out (ABC) on disruptive behavior, work completion, and homework completion using an ABAB reversal design. Across three typically developing middle school students, ABC resulted in reductions in problem behavior and increases in work completion and homework accuracy.
    Type of Medium: Online Resource
    ISSN: 1098-3007 , 1538-4772
    URL: Article
    DOI: 10.1177/1098300713484063
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2014
    detail.hit.zdb_id: 2070483-5
    SSG: 5,2
    SSG: 5,3
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 4
    Online Resource
    Online Resource
    Net benefit of statins for primary prevention of cardiovascular disease in people 75 years or older: a benefit–harm balance modeling study
    SAGE Publications ; 2019
    In:  Therapeutic Advances in Chronic Disease Vol. 10 ( 2019-01), p. 204062231987774-
    Details
    In: Therapeutic Advances in Chronic Disease, SAGE Publications, Vol. 10 ( 2019-01), p. 204062231987774-
    Abstract: We determined the risk thresholds above which statin use would be more likely to provide a net benefit for people over the age of 75 years without history of cardiovascular disease (CVD). Methods: An exponential model was used to estimate the differences in expected benefit and harms in people treated with statins over a 10-year horizon versus not treated. The analysis was repeated 100,000 times to consider the statistical uncertainty and produce a distribution of the benefit–harm balance index from which we determined the 10-year CVD risk threshold where benefits outweighed the harms. We considered treatment estimates from trials and observational studies, baseline risks, patient preferences, and competing risks of non-CVD death, and statistical uncertainty. Results: Based on average preferences, statins were more likely to provide a net benefit at a 10-year CVD risk of 24% and 25% for men aged 75–79 years and 80–84 years, respectively, and 21% for women in both age groups. However, these thresholds varied significantly depending on differences in individual patient preferences for the statin-related outcomes, with interquartile ranges of 21–33% and 23–36% for men aged 75–79 years and 80–84 years, respectively, as well as 20–32% and 21–32% for women aged 75–79 years and 80–84 years, respectively. Conclusions: Statins would more likely provide a net benefit for primary prevention in older people taking the average preferences if their CVD risk is well above 20%. However, the thresholds could be much higher or lower depending on preferences of individual patients, which suggests more emphasis should be placed on individual-based decision-making, instead of recommending statins for everyone based on a single or a small number of thresholds.
    Type of Medium: Online Resource
    ISSN: 2040-6223 , 2040-6231
    URL: Article
    DOI: 10.1177/2040622319877745
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2554816-5
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 5
    Online Resource
    Online Resource
    Improving the Evidence Base on Multimorbidities through Better Research: A Commentary on the U.S. HHS Initiative, Multiple Chronic Conditions: A Strategic Framework
    SAGE Publications ; 2013
    In:  Journal of Comorbidity Vol. 3, No. 2 ( 2013-01), p. 18-21
    Details
    In: Journal of Comorbidity, SAGE Publications, Vol. 3, No. 2 ( 2013-01), p. 18-21
    Type of Medium: Online Resource
    ISSN: 2235-042X , 2235-042X
    URL: Article
    DOI: 10.15256/joc.2013.3.28
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2013
    detail.hit.zdb_id: 2831678-2
    detail.hit.zdb_id: 3105397-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 6
    Online Resource
    Online Resource
    How Do Older Adults Consider Age, Life Expectancy, Quality of Life, and Physician Recommendations When Making Cancer Screening Decisions? Results from a National Survey Using a Discrete Choice Experiment
    SAGE Publications ; 2019
    In:  Medical Decision Making Vol. 39, No. 6 ( 2019-08), p. 621-631
    Details
    In: Medical Decision Making, SAGE Publications, Vol. 39, No. 6 ( 2019-08), p. 621-631
    Abstract: Background. Older adults with limited life expectancy frequently receive cancer screening, although on average, harms outweigh benefits. We examined the influence of life expectancy on older adults’ cancer screening decisions relative to three other factors. Methods. Adults aged 65+ years ( N = 1272) were recruited from a national online survey panel. Using a discrete choice experiment, we systematically varied a hypothetical patient’s life expectancy, age, quality of life, and physician’s recommendation and asked whether the participant would choose screening. Participants were randomized to questions about colonoscopy or prostate-specific antigen/mammography screenings. Logistic regression produced preference weights that quantified the relative influence of the 4 factors on screening decisions. Results. 879 older adults completed the survey, 660 of whom varied their screening choices in response to the 4 factors we tested. The age of the hypothetical patient had the largest influence on choosing screening: the effect of age being 65 versus 85 years had a preference weight of 2.44 (95% confidence interval [CI] : 2.22, 2.65). Life expectancy (10 versus 1 year) had the second largest influence (preference weight: 1.64, CI: 1.41, 1.87). Physician recommendation (screen versus do not screen) and quality of life (good versus poor) were less influential, with preference weights of 0.90 (CI: 0.72, 1.08) and 0.68 (CI: 0.52, 0.83), respectively. Conclusions. While clinical practice guidelines increasingly use life expectancy in addition to age to guide screening decisions, we find that age is the most influential factor, independent of life expectancy, quality of life, and physician recommendation, in older adults’ cancer screening choices. Strategies to reduce overscreening should consider the importance patients give to continuing screening at younger ages, even when life expectancy is limited.
    Type of Medium: Online Resource
    ISSN: 0272-989X , 1552-681X
    URL: Article
    DOI: 10.1177/0272989X19853516
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2040405-0
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...