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Congestive heart failure despite normal left ventricular systolic function in a population-based sample: The strong heart study

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AMERICAN JOURNAL OF CARDIOLOGY 2000年第10期86卷 1090-1096页

作者： Devereux, RB Roman, MJ Liu, JE Welty, TK Lee, ET Rodeheffer, R Fabsitz, RR Howard, BV New York Presbyterian Hosp Weill Cornell Med Ctr Dept Med New York NY 10021 USA Aberdeen Area Tribal Chairmens Hlth Board Rapid City SD USA Univ Oklahoma Hlth Sci Ctr Sch Publ Hlth Oklahoma City OK USA Mayo Clin Rochester MN USA NHLBI Bethesda MD 20892 USA MedStar Res Inst Washington DC USA Johns Hopkins Univ Sch Hyg & Publ Hlth Baltimore MD USA

In selected clinical series, greater than or equal to 50% of adults with congestive heart failure (CHF) do not have left ventricular (LV) systolic dysfunction. Little is known of the prevalence of this phenomenon in population samples. Therefore, clinical examination and echocardiography were used in the second examination of the Strong Heart Study (3,184 men and women, 47 to 81 years old) to identify 95 participants with CHF, 50 of whom had normal LV ejection fraction (EF) (>54%), 19 of whom had mildly reduced EF (40% to 54%), and 26 of whom had EF less than or equal to 40%. Compared with those with no CHF, participants with CHF and no, mild, or severe decrease in EF had higher creatinine levels (2.34 to 2.85 vs 1.01 mg/dl, p <0.001) and higher prevalences of diabetes (60% to 70% vs 50%) and hypertension (75% to 96% vs 46%, p <0.05). Compared with those with no CHF, participants with CHF and normal EF had prolonged deceleration time:(233 vs 204 ms, p <0.05) and a reduced E/A, whereas those with CHF and EF 40% had short deceleration time (158 ms, p <0.05) and high E/A (1.70, p <0.001);patients with CHF and normal EF had higher LV mass (98 vs 84 g/m(2), p <0.001) and relative wall thickness (0.37 vs 0.35, p <0.05) than those without CHF. Patients with CHF with normal EF were, compared with those without CHF or with CHF and EF less than or equal to 40%, disproportionately women (mean 84% vs 63% and 42%, p <0.001), older (mean 64 vs 60 years and 63 years, respectively, p <0.01), had higher body mass index (mean 33.1 vs 31.0 and 27.7 kg/m(2), p <0.05), and higher systolic blood pressure (mean 137 vs 130 and 128 mm Hg, both p <0.05). Thus, in a population-based sample, patients with CHF and normal LV EF were older and overweight, more often women, had renal dysfunction, impaired early diastolic LV relaxation, and concentric LV geometry, whereas patients with CHF and severe LV dysfunction were more often men, had lower body mass index, a restrictive

关键词：高血压/并发症印第安人北美洲/统计学和数值数据北达科他/流行病学肥胖症/并发症俄克拉何马/流行病学人群监测患病率抽样研究疾病严重程度指数性别分布南达科他/流行病学每搏输出量心缩期心室功能左人类男(雄)性中年人

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Familial aggregation of end-stage renal failure: aetiological implications

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NEPHROLOGY DIALYSIS TRANSPLANTATION 1999年第2期14卷 295-297页

作者： Freedman, BI Wake Forest Univ Bowman Gray Sch Med Med Ctr Winston Salem NC 27157 USA Wake Forest Univ Bowman Gray Sch Med Dept Internal Med Nephrol Winston Salem NC 27157 USA

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Characteristics of American Indian women cigarette smokers: Prevalence and cessation status

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Health Care for Woman International 1999年第5期20卷 455-469页

作者： Hodge, Felicia Schanche Casken, John Ctr. for Amer. Indian Res. and Educ. School of Public Health University of California Berkeley CA United States School of Public Health University of Hawaii Honolulu HI United States Ctr. for Amer. Indian Res. and Educ. School of Public Health University of California Berkeley CA 94704 1918 University Avenue United States

A high rate of cigarette smoking is documented among the American Indian population in California, but data on Indian women smokers have not been widely studied. This paper reports on a survey conducted in a smoking cessation project implemented and evaluated as part of a National Cancer Institute (NCI) cooperative agreement. Characteristics of Indian women smokers are presented and cessation status is examined. The overall goal of the project was to increase long-term smoking cessation among American Indian populations through a reproducible clinic-based smoking cessation program. To ascertain smoking prevalence and tobacco use patterns, a self-administered survey was completed by 1,369 adult male and female American Indian health clinic users in Northern California. Study results reported several important characteristics of Indian women smokers. Single and divorced participants had a higher smoking rate (40.4% and 42%) than married participants (34.4%);54.5% of unemployed women smoked;and level of education was strongly associated with smoking status (p = .011). Almost 80% (79.9%) of women former smokers quit using the "cold turkey" method. Fewer than 50% of Indian women smokers reported willingness to quit at the following smoking cessation stages: "immediately" or "ready" (12.4%), "in one month" (10.5%), and "in six months" (25.2%).

关键词：加利福尼亚/流行病学印第安人北美洲/心理学印第安人北美洲/统计学和数值数据需求估价人群监测患病率危险因素吸烟/人种学吸烟/预防和控制戒烟/人种学戒烟/方法戒烟/统计学和数值数据成年人老年人女(雌)性人类男(雄)性中年人

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Native American cancer survivors

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Health Care for Woman International 1999年第5期20卷 505-515页

作者： Burhansstipanov, Linda Lovato, Mary P. Krebs, Linda V. Native American Cancer Initiatives Pine CO United States A Gathering of Cancer Support Santo Domingo NM United States School of Nursing University of Colorado Denver CO United States Native American Cancer Initiatives Pine CO 80470-7830 3022 S. Nova Road United States

This paper provides a brief review of cancer survival data for both Native American men and women, information about cancer survivor support groups, survivor resources, and some examples of how cancer is perceived by ... 详细信息

关键词：健康态度/人种学印第安人北美洲/心理学印第安人北美洲/统计学和数值数据信息服务肿瘤/人种学肿瘤/死亡率自助小组社会支持幸存患者/心理学幸存患者/统计学和数值数据美国/流行病学女(雌)性人类男(雄)性

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JOURNAL OF RURAL HEALTH 1997年第1期13卷 38-44页

作者： Landen, MG ALASKA DEPT HLTH & SOCIAL SERV EPIDEMIOL SECTPOB 240249ANCHORAGEAK 99524 USA

American Indian alcohol-related mortality rates differ widely among tribes, even within the same geographic region. In addition, there are many different legislative approaches to alcohol beverage control employed by tribes. This paper explores the association between alcohol legislation and alcohol-related mortality rates among American Indian tribes located in a region of the northwestern United States from 1979 to 1990. Both an unweighted analysis of alcohol-related mortality and a weighted analysis, using the Alcohol-Related Disease Impact (ARDI) approach, are used. Alcohol-related mortality rates did not differ significantly between reservations with alcohol prohibition statutes or where alcohol was legal in this region. However, evidence suggests that more comprehensive tribal alcohol legislation may be correlated with lower alcohol-related mortality among American Indian tribes.

关键词：酒精中毒/死亡率药品和麻醉品检定/立法和法学印第安人北美洲/统计学和数值数据美国西北部/流行病学政府政策美国/流行病学美国印第安人卫生处青少年成年人老年人儿童人类中年人

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Measures of American Indian traditionality and its relationship to cervical cancer screening

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Health Care for Woman International 1999年第5期20卷 493-504页

作者： Arambula Solomon, Teshia G. Gottlieb, Nell H. School of Public Health University of Texas-Houston San Antonio TX United States Dept. of Kinesiology and Hlth. Educ. University of Texas Austin TX United States Univ. of Texas-Houston Sch. of Public Health at San Antonio Mail Code 7976 San Antonio TX 78229-3900 7703 Floyd Curl Dr. United States

The goal of this study was to evaluate the relationship between culture and attitudes about cervical cancer screening among young American Indian women living and working in northeast Oklahoma. A cohort of 199 American Indian women, ages 18-40, were surveyed to determine their blood quantum, self-identification, and beliefs and practices regarding traditional behavior in order to develop a traditional behavior scale (the degree to which an individual maintained traditional tribal ways or behaviors). The use of this scale indicated that the degree of American Indian blood quantum, blood quantum for primary tribe, and self-identification are correlated to the traditional behavior scale. The scale, however, was unable to predict intention to get a Pap test. Results indicate that it is useful to understand the variation of traditional behavior within the specific population group to be served when planning and implementing culturally appropriate interventions for American Indian women. It is also useful to evaluate which segments of the population current programs are reaching.

关键词：文化适应健康态度/人种学健康行为/人种学健康知识态度实践印第安人北美洲/心理学印第安人北美洲/统计学和数值数据普查/心理学普查/利用俄克拉何马问卷调查宫颈肿瘤/人种学宫颈肿瘤/预防和控制阴道涂片/心理学阴道涂片/利用青少年成年人女(雌)性人类

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Relationship of prenatal alcohol use with maternal and prenatal factors in American Indian women

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SOCIAL BIOLOGY 1998年第3-4期45卷 214-222页

作者： Kvigne, VL Bull, LBH Welty, BK Leonardson, GR Lacina, L Indian Hosp Publ Hlth Serv Aberdeen Area Indian Hlth Serv Rapid City SD 57702 USA Mt Plains Res Bozeman MT 59715 USA

Demographic factors and patterns of substance use among women who did not consume alcohol during pregnancy were compared to women who did consume alcohol during pregnancy. One-hundred seventy-seven Northern Plains Indian women who received prenatal care at an urban clinic in a rural state were screened for substance use as part of the validation study with a self-administered questionnaire. Women who drank during pregnancy were more likely to be single and have less education than women who did not drink. While most of the women in the study had available transportation resources, the women who drank during pregnancy were less likely to have transportation than the women who did not drink. Women who drank during pregnancy consumed more alcohol more frequently before pregnancy than did women who drank before but not during pregnancy. Compared to women who did not drink during pregnancy semen who drank during pregnancy were mere likely to smoke cigarettes and use illicit drugs, to have parents who drank, to feel they drank the same or more than other pregnant women, or to have experienced more relationship breakups and physical and emotional abuse. Prenatal patients who drink alcohol during pregnancy need more intensive counseling regarding their multiple risk behaviors.

关键词：饮酒/人种学病例对照研究教育程度印第安人北美洲/心理学印第安人北美洲/统计学和数值数据婚姻状况普查蒙大拿妊娠并发症/人种学问卷调查危险因素成年人女(雌)性人类妊娠

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Pap prevalence and cervical cancer prevention among Alaska Native women

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Health Care for Woman International 1999年第5期20卷 471-486页

作者： Lanier, Anne P. Kelly, Janet J. Holck, Peter Alaska Native Health Board Anchorage AK United States Alaska Native Health Board 4201 Tudor Centre Anchorage AK 99508 United States

The goals of the Alaska Native Women's Health Project (WHP) were to determine the following: (1) Pap prevalence based on chart review before and during an intervention period;(2) the level of understanding of cancer and cancer screening services with emphasis on cervical cancer;(3) use and satisfaction with current health maintenance services;and (4) improvement in knowledge and cancer screening rates following intervention. A random sample of 481 Alaska Native (Eskimo, Aleut, Indian) women living in Anchorage were interviewed face to face about their understanding of cancer risk factors (tobacco use, sexually transmitted diseases (STDs), reproductive issues), cancer screening examinations (Pap test, breast self-examination (BSE), breast exam by a provider, mammography), and their attitudes about health care and health care services. Sixty-two percent of control women were documented to have had at least one Pap test within the 3-year period prior to the beginning of the study;however, only 9% were documented to have had annual Pap screening. The intervention included distribution of educational materials, counseling on any woman's health issue, special evening clinics, and reminders (mail/phone call) of scheduled Pap appointments.

关键词：阿拉斯加健康态度/人种学健康教育/组织和管理健康知识态度实践印第安人北美洲/教育印第安人北美洲/心理学印第安人北美洲/统计学和数值数据方案评价问卷调查宫颈肿瘤/人种学宫颈肿瘤/预防和控制阴道涂片/心理学阴道涂片/利用妇女卫生成年人老年人女(雌)性人类中年人

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Native women and cancer

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Health Care for Woman International 1999年第5期20卷 445-453页

作者： Kaur, Judith Salmon Department of Oncology Mayo Clinic Rochester MN United States Department of Oncology Mayo Clinic Rochester MA 55905 200 1st St. and SW United States

Literature regarding cancer patterns in American Indians and Alaska Native women is reviewed and attention is paid to promising research initiatives to improve cancer prevention and control as well as approaches to enhance exchange of knowledge through a new national resource center. Lung, breast, and colorectal cancer are the leading cause of cancer deaths in American Indians and Alaska Native women. There continues to be a disproportionate death rate from cervical cancer. Enhanced availability for breast and cervical cancer screening in conjunction with community education is showing promising trends toward reversing the patterns of late diagnosis. Communities can benefit from sharing their collective resources in a new national resource center called "Native C.I.R.C.L.E." housed in the Mayo Cancer Center.

关键词：健康态度/人种学发病率印第安人北美洲/心理学印第安人北美洲/统计学和数值数据普查/方法需求估价肿瘤/人种学肿瘤/预防和控制人群监测患病率生活质量美国/流行病学妇女卫生女(雌)性人类

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The Effects of On‐ and Off‐reservation Residence on In‐home Service Use Among Great Lakes American Indians

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The Journal of Rural Health 1995年第3期11卷 204-216页

作者： Chapleski, Elizabeth E. Institute of Gerontology Wayne State University Detroit Michigan 48202 87 E. Ferry United States

Abstract: Community‐based, in‐home services are a crucial component in the long‐term care continuum. Research has shown rural populations to be less likely to use these services. American Indian elders are more likely than their non‐American Indian counterparts to reside in non‐metropolitan areas, yet little rural research has focused on this subpopulation. The purpose of this article is to explore differences in in‐home service use among urban, rural off‐reservation, and rural on‐reservation older American Indians using data from a statewide needs assessment. The sample includes 206 206 Great Lakes American Indians aged 55 and older. Predictor variables include the residential classification variable (rural off‐reservation, rural on‐reservation, and urban) along with sociodemographic, social support, health and functional status, and general knowledge of services. Results of logistic regression analysis indicate that the odds are significantly greater for on‐reservation rural American Indian elders use of home services, home health aides, and home visits, than for urban American Indian elders. The off‐reservation rural American Indian elder is significantly less likely than the urban American Indian elder to use a home health aid. Health rating, activities of daily living/instrumental activities of daily living (ADL/IADL) impairments, and general knowledge of in‐home service availability increase the odds for all groups use of home services and home health aides. Copyright © 1995, Wiley Blackwell. All rights reserved

关键词：大湖地区/流行病学家庭医疗保健服务/利用印第安人北美洲/统计学和数值数据密执安/流行病学居住特征农村卫生/统计学和数值数据社会支持美国/流行病学城市卫生/统计学和数值数据老年人人类中年人

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