Excessive daytime sleepiness and falls among older men and women: cross-sectional examination of a population-based sample

Background: Excessive daytime sleepiness (EDS) has been associated with an increased risk for falls among clinical samples of older adults. However, there is little detailed information among population-representative samples. The current study aimed to assess the relationship between EDS and falls among a cohort of population-based older adults. Methods: This study assessed 367 women aged 60-93years (median 72, interquartile range 65-79) and 451 men aged 60-92years (median 73, interquartile range 66-80) who participated in the Geelong Osteoporosis Study between the years 2001 and 2008. Falls during the prior year were documented via self-report, and for men, falls risk score was obtained using an Elderly Fall Screening Test (EFST). Sleepiness was assessed using the Epworth Sleepiness Scale (ESS), and scores of≥10 indicated EDS. Differences among those with and without EDS in regard to falls were tested using logistic regression models. Results: Among women, 50 (13.6 %) individuals reported EDS. Women with EDS were more likely to report a fall, and were more likely to report the fall occurring outside. EDS was similarly associated with an increased risk of a fall following adjustment for use of a walking aid, cases of nocturia and antidepressant medication use (adjusted OR∈=∈2.54, 95 % CI 1.24-5.21). Multivariate modelling revealed antidepressant use (current) as an effect modifier (p∈<∈.001 for the interaction term). After stratifying the data by antidepressant medication use, the association between EDS and falls was sustained following adjustment for nocturia among antidepressant non-users (adjusted OR∈=∈2.63, 95 % CI 1.31-5.30). Among men, 72 (16.0 %) individuals reported EDS. No differences were detected for men with and without EDS in regard to reported falls, and a trend towards significance was noted between EDS and a high falls risk as assessed by the EFST (p∈=∈0.06), however, age explained this relationship (age adjusted OR∈=∈2.20, 95 % CI 1.03-1.10). Conclusions: For women, EDS is independently associated with at least one fall during the previous year, and this is more likely to occur whilst located outside. Amelioration of EDS may assist in improving functional outcomes among these individuals by reducing the risk for falls.

The Uses of Violence: An Examination of some Cross-Cutting Issues

A general theory of violence may only be possible in the sense of a meta-theoretical framework, As such it should comprise a parsimonious set of general mechanisms that operate across various manifestations of violence. In order to identify such mechanisms, a general theory of violence needs to equally consider all manifestations of violence, in all societies, and at all times. Departing from this assumption this paper argues that three theoretical approaches may be combined in a non-contradictory way to understand violence as goal-directed instrumental behaviour: a theory of the judgment and decision-making processes operating in the situations that give rise to violence; a theory of the evolutionary processes that have resulted in universal cognitive and emotional mechanisms associated with violence; and a theory of the way in which social institutions structure violence by selectively enhancing its effectiveness for some purposes (i.e legitimate use of force) and controlling other types of violence (i.e crime). To illustrate the potential use of such a perspective the paper then examines some general mechanisms that may explain many different types of violence. In particular, it examines how the mechanisms of moralistic aggression (Trivers) and moral disengagement (Bandura) may account for many different types of violence.

A cross sectional examination of risky sexual behaviors among a population of drug users

This study is a secondary data analysis that assesses the relationship between risky sexual behaviors and sexually transmitted infections (STIs) among drug users. This study analyzes data collected from drug users in the Houston Metropolitan area during 2004 and through August 2005, by researchers with the DASH (Drugs, AIDS, STDs and Hepatitis) project at The University of Texas at Houston School of Public Health. Specifically, the sexually transmitted infections that will be of interest in this proposed study are Human Immunodeficiency Virus (HIV) and Hepatitis B Virus (HBV). Risky sexual behaviors that will be examined include lack of condom use, sexual orientation, trading sex for drugs, trading sex for money, and number of male and female sexual partners in the last 4 weeks. ^ Unadjusted, gender, sexual orientation, number of recent male and female sex partners, and a history of injection drug use were all found to be significant independent variables that increased the odds of STI status. When included in an overall model, these variables significantly increased the odds of STI status, including HBV infection, HIV infection, and HBV/HIV co-infection. History of injection drug use was significant for both HBV and HBV/HIV co-infection, whereas a gay sexual orientation was significant for both HIV and HBV/HIV co-infection. Additionally, having excessive female sex partners was significant for HIV infection. This significant association increases the need for implementation of stronger intervention programs tailored to suit this population's needs such as a combination of drug and sexually transmitted disease (STD) treatment. ^ The importance of these findings is that they establish the strength of associations between the previously mentioned risky sexual behaviors and STI status among drug users. This is crucial for assessing future risk of infection as well as for serving as a necessary component in intervention and treatment programs both for drug use and STIs. ^

An examination of the cross-cultural reliability and construct validity of a measure of loneliness

Loneliness is a pervasive, rather common experience in American culture, particularly notable among adolescents. However, the phenomenon is not well documented in the cross-cultural psychiatric literature. For psychiatric epidemiology to encompass a wide array of psychopathologic phenomena, it is important to develop useful measures to characterize and classify both non-clinical and clinical dysfunction in diverse subgroups and cultures.^ The goal of this research was to examine the cross-cultural reliability and construct validity of a scale designed to measure loneliness. The Roberts Loneliness Scale (RLS-8) was administered to 4,060 adolescents ages 10-19 years enrolled in high schools along either side of the Texas-Tamaulipas border region between the U.S. and Mexico. Data collected in 1988 from a study focusing on substance use and psychological distress among adolescents in these regions were used to examine the operating characteristics of the RLS-8. A sample stratified by nationality and language, age, gender, and grade was used for analysis.^ Results indicated that in general the RLS-8 has moderate reliability in the U.S. sample, but not in the Mexican sample. Validity analyses demonstrated that there was evidence for convergent validity of the RLS-8 in the U.S. sample, but none in the Mexican sample. Discriminant validity of the measures in neither sample could be established. Based on the factor structure of the RLS-8, two subscales were created and analyzed for construct validity. Evidence for convergent validity was established for both subscales in both national samples. However, the discriminant validity of the measure remains unsubstantiated in both national samples. Also, the dimensionality of the scale is unresolved.^ One primary goal for future cross-cultural research would be to develop and test better defined culture-specific models of loneliness within the two cultures. From such scientific endeavor, measures of loneliness can be developed or reconstructed to classify the phenomenon in the same manner across cultures. Since estimates of prevalence and incidence are contingent upon reliable and valid screening or diagnostic measures, this objective would serve as an important foundation for future psychiatric epidemiologic inquiry into loneliness. ^

A Cross-Cultural Examination of the Use of Multimodal Metaphor in English and Arabic Cartoons of the ‘Arab Spring’ in Egypt

El estudio de Lakoff y Johnson Metáforas de la vida cotidiana (1980) ha dotado al campo de la metáfora de un renovado interés, y a éste siguieron numerosas publicaciones abordándolo desde diversas perspectivas. Lakoff y Johnson (1980) aseguran que la metáfora es, de hecho, una característica del pensamiento y, por consiguiente, ya no es una propiedad exclusiva del lenguaje. La metáfora sería en realidad un reflejo de cómo concebimos e interpretamos el mundo en que vivimos, en la medida en que está conformada por nuestras experiencias corporales, un fenómeno al que Lakoff y Johnson se refieren como la “mente corpórea”. La metáfora cumple la función de “comprender” y facilitar la interpretación de un ámbito o experiencia en los términos de otro ámbito o experiencia (Lakoff & Johnson, 1980: 36). Los conceptos abstractos son difíciles de ser pensados per se; consecuentemente, las personas recurren a la metáfora para concebirlos en los términos de otras nociones más concretas que están, en cierto grado, vinculadas a nuestras experiencias somáticas. Si bien no escasean las investigaciones en el campo de las metáforas, parece haber, sin embargo, cierto vacío en lo tocante a la manifestación de la metáfora en modos distintos del modo verbal. Forceville (2009: 19) afirma que uno de los principios fundamentales de la Teoría de la Metáfora Conceptual es la idea de que el variado empleo de metáforas por parte del ser humano sugiere “que piensa en gran medida metafóricamente”. Esto lleva a la conclusión de que la manifestación de la metáfora debería estar presente en los diversos modos del pensamiento, y no únicamente en el verbal. Estos otros modos de pensamiento incluyen, entre otros, las imágenes, la música, los sonidos y los gestos. Asimismo, la mayoría de estudios que se han realizado en el área de las metáforas multimodales ha sido aplicada al terreno de la publicidad. Los anunciantes parecen advertir el ! 2! poder que se invierte en las metáforas, y las usan profusamente para transmitir mensajes a los consumidores. No obstante, recientemente existe un nuevo interés por investigar el uso de metáforas multimodales en las caricaturas (véase, por ejemplo, El Refaie 2003, 2009; Schilperoord y Maes 2009; Yus 2009; Bergen 2003; Marin Aresse 2008). Las tiras cómicas se distinguen de los anuncios principalmente por el hecho de que las caricaturas transmiten una postura negativa frente a un sujeto particular, mientras que los anuncios presentan una actitud positiva. Igualmente, les diferencia el hecho de que las tiras cómicas requieren un conocimiento social y político específico. El presente escrito examina y compara el uso de metáforas multimodales en caricaturas políticas – tanto inglesas como árabes – que retratan la Primavera Árabe en Egipto, con el fin de determinar: (1) si la mayoría de caricaturas son conceptualmente específicas o culturalmente específicas; (2) los principales dominios fuente empleados por los caricaturistas ingleses y árabes para interpretar la Primavera Árabe; (3) si hay semejanzas o diferencias entre las caricaturas inglesas y las árabes en su elección del dominio meta; y (4) observar también cómo los distintos modos (aquí esencialmente los modos verbal y pictórico) contribuyen a representar la Primavera Árabe. El corpus para este estudio se compone de un total de 50 tiras cómicas, 25 de ellas inglesas y las 25 restantes árabes. En cada una de estas tiras debe haber al menos una metáfora que representa la Primavera Árabe o alguno de sus subtemas. Las tiras han sido seleccionadas aleatoriamente a través de Internet. Para el análisis, la investigadora ha seguido el marco teórico propuesto por Bounegru y Forceville (2011) en cuanto a la determinación de metáforas en general, así como la determinación de metáforas multimodales de tipo verbovisual en particular. Por cada tira cómica se ha llevado a cabo un análisis independiente, determinando el dominio fuente y el dominio meta, las metáforas, las asignaciones, qué se está representando verbalmente y qué se representa pictóricamente. Además, la autora ha analizado ! 3! posteriormente si estas metáforas son culturalmente específicas o no, y/o si están relacionadas con metáforas más genéricas o universales. El análisis que comprende este trabajo se divide en dos secciones. La primera parte es un estudio detallado de los dos corpora, abordando los distintos escenarios de los dominios fuente empleados por los dibujantes según su similitud. Esta sección presenta a su vez un análisis de los diversos modos que se utilizan para revelar el dominio fuente así como el dominio meta. Del mismo modo, se incluyen las metáforas específicas manejadas en cada tira cómica y, cuando se da el caso, aquellas metáforas genéricas o universales a las que remite. La segunda sección del análisis presenta una comparativa entre ambos corpora basada en el análisis expuesto en la primera parte. Además, trata varios de los fenómenos lingüísticos a los que han recurrido frecuentemente los dibujantes ingleses y árabes. Estos fenómenos son principalmente la metonimia y la personificación. Igualmente, en esta sección la autora investiga en mayor profundidad las metáforas usadas por los dibujantes ingleses y los árabes, determinando si son ora conceptualmente específicas, ora culturalmente específicas, a partir del hecho de que las metáforas sirven como herramienta para reconocer la forma en que personas distintas, o bien culturas distintas, interpretan varias cuestiones. Por ejemplo, a la hora de conceptualizar el futuro, algunas culturas lo representan espacialmente como delante del hablante, mientras que otras se refieren al mismo como localizado detrás del sujeto (Lakoff y Johnson 1980: 14). Este trabajo ha permitido varios hallazgos. En cuanto a las metáforas empleadas para representar la Primavera Árabe, tanto las tiras inglesas como las árabes han recurrido a una cierta variedad de metáforas. Algunas de las tiras presentan más de una metáfora operando a la vez. Los dibujantes ingleses y árabes parecen haberse apoyado siempre en el modo pictórico para presentar el dominio fuente, así como en el modo verbal para mostrar el dominio meta. ! 4! Además, respecto a la naturaleza de las metáforas que figuran en sendos corpora, casi todas las metáforas son conceptuales en cuanto que se corresponden con nuestras experiencias corporales; no hay, por otro lado, ninguna metáfora culturalmente específica. Asimismo, la única diferencia a este respecto entre ambos corpora es una variación en lo que constituye el prototipo de una categoría particular – aquí concretamente la categoría “primavera” en cada una de las culturas –. En las tiras inglesas, una flor es empleada para representar la primavera, mientras que en las árabes el elemento natural más frecuente para simbolizar la primavera es un árbol.

Re-examination of minimum range criteria for radar cross section measurements.

"Prime contract no. AF 04(647)-930. Aerospace Corp. subcontract no. 61-123."

Antecedents and consequences of percieved effective managerial coaching:an individual, team-level and cross-level examination

The major contribution of the study is the identification of a positive link between perceived effective managerial coaching (PEMC) and team task performance and also, the examination of PEMC adopting a multilevel research design and incorporating dual-source data. Specifically, drawing on social psychology, the thesis aims at developing and testing a comprehensive conceptual framework of the antecedents and consequences of PEMC for knowledge workers. The model takes into consideration intrapersonal, interpersonal and team-level characteristics, which relate to PEMC and, subsequently associate with important work outcomes. In this regard, the thesis identifies PEMC as a practice of dual nature in that it may be experienced not only as a one-on-one workplace developmental interaction, but also as a managerial practice that is experienced by each member of a team for co-ordination purposes. Adopting a cross-sectional survey research design, the hypotheses are tested in three organisations in Greece and the UK. In particular, hierarchical linear modelling of 191 employees nested in 60 teams yields that employees’ learning goal orientation (LGO) and high-quality exchanges between an employee and a manager (LMX) are positively related to effective MC, while a manager’s LGO moderates the relationship between employees’ LGO and PEMC. In turn, PEMC, as a one-on-one practice, is related to cognitive outcomes, such as information sharing, while as a shared team practice is related also to behavioural outcomes, including individual and team performance. Overall, the study contributes to a growing body of coaching and management literature that acknowledges PEMC as a core managerial practice.

The World Trade Organization, competition policy, and developing countries: A cross -country examination of domestic policy actions

This dissertation addresses the following research question: in a particular policy area, why do countries that display unanimity in their international policy behavior diverge from each other in their domestic policy actions? I address this question in the context of the divergent domestic competition policy actions undertaken by developing countries during the period 1996-2007, after these countries had quite conspicuously displayed near-unanimity in opposing this policy measure at the World Trade Organization (WTO). This divergence is puzzling because (a) it does not align with their near-unanimous behavior at the WTO over competition policy and (b) it is at variance with the objectives of their international opposition to this policy at the WTO. Using an interdisciplinary approach, this dissertation examines the factors responsible for this divergence in the domestic competition policy actions of developing countries. ^ The theoretical structure employed in this study is the classic second-image-reversed framework in international relations theory that focuses on the domestic developments in various countries following an international development. Methodologically, I employ both quantitative and qualitative methods of analysis to ascertain the nature of the relationship between the dependent variable and the eight explanatory variables that were identified from existing literature. The data on some of the key variables used in this dissertation was uniquely created over a multi-year period through extensive online research and represents the most comprehensive and updated dataset currently available. ^ The quantitative results obtained from logistic regression using data on 131 countries point toward the significant role played by international organizations in engineering change in this policy area in developing countries. The qualitative analysis consisting of three country case studies illuminate the channels of influence of the explanatory variables and highlight the role of domestic-level factors in these three carefully selected countries. After integrating the findings from the quantitative and qualitative analyses, I conclude that a mix of international- and domestic-level variables explains the divergence in domestic competition policy actions among developing countries. My findings also confirm the argument of the second-image-reversed framework that, given an international development or situation, the policy choices that states make can differ from each other and are mediated by domestic-level factors. ^

The effect of consumer risk perceptions and information search on willingness to buy GM food products: A cross cultural analysis

This paper seeks to address the widespread call in the literature for the cross-cultural examination ( and validation) of accepted concepts within consumer behaviour, such as consumer risk perceptions and information search. The findings of the study provide support for a number of accepted relationships, whilst identifying distinct cross cultural differences in external information search and willingness to buy genetically modified (GM) food products by consumers.

Examination of social demographic status, disease status, health behaviours and quality of life in older Australians using the theory of planned behaviour model

The increase of life expectancy worldwide during the last three decades has increased age-related disability leading to the risk of loss of quality of life. How to improve quality of life including physical health and mental health for older people and optimize their life potential has become an important health issue. This study used the Theory of Planned Behaviour Model to examine factors influencing health behaviours, and the relationship with quality of life. A cross-sectional mailed survey of 1300 Australians over 50 years was conducted at the beginning of 2009, with 730 completed questionnaires returned (response rate 63%). Preliminary analysis reveals that physiological changes of old age, especially increasing waist circumference and co morbidity was closely related to health status, especially worse physical health summary score. Physical activity was the least adherent behaviour among the respondents compared to eating healthy food and taking medication regularly as prescribed. Increasing number of older people living alone with co morbidity of disease may be the barriers that influence their attitude and self control toward physical activity. A multidisciplinary and integrated approach including hospital and non hospital care is required to provide appropriate services and facilities toward older people.

An examination of communication across cultures in news media and at informal/personal levels : with concentration on relations among two South East Asian countries and Australia and those two countries and Germany

In the age of globalisation dominated by mass communication, the flow of information contributes to a big extent to the worldviews of its "global citizens". From this point of view the mass media can be seen as one of the most salient sources of cross-cultural communication. This study investigates mass communication across cultures, focusing on South East Asia (Malaysia and Singapore), Australia and Germany. The centre of attention is the Western media coverage of South East Asia and vice versa. In this context a content analysis of newspapers of the three regions has been conducted. In addition, working practices and conditions of Western foreign correspondents in South East Asia have been examined. Apart from the investigation of inter-cultural media coverage, another focus of attention will be the examination of two levels of communication: The business level, concentrating on issues like e.g. the Asian business etiquette; and the private level, looking into the transition to a different culture from the perspective of Australian and German expatriates. Apart from investigating mass communication across cultures and to provide a written analysis of the findings, a series of radio documentaries in English and in German has been produced. They cover the following issues: Foreign correspondents in South East Asia, the expatriate-lifestyle of Australians and Germans in South East Asia, business etiquette in Asia, student exchange Germany-Asia, image and prejudices East-West and Tourism.

Examination of relationships between urban form, household activities, and time allocation in the Atlanta Metropolitan Region

A substantial body of research is focused on understanding the relationships between socio-demographics, land-use characteristics, and mode specific attributes on travel mode choice and time-use patterns. Residential and commercial densities, inter-mixing of land uses, and route directness in conjunction with transportation performance characteristics interact to influence accessibility to destinations as well as time spent traveling and engaging in activities. This study uniquely examines the activity durations undertaken for out-of-home subsistence; maintenance, and discretionary activities. Also examined are total tour durations (summing all activity categories within a tour). Cross-sectional activities are obtained from household activity travel survey data from the Atlanta Metropolitan Region. Time durations allocated to weekdays and weekends are compared. The censoring and endogeneity between activity categories and within individuals are captured using multiple equations Tobit models. The analysis and modeling reveal that land-use characteristics such as net residential density and the number of commercial parcels within a kilometer of a residence are associated with differences in weekday and weekend time-use allocations. Household type and structure are significant predictors across the three activity categories, but not for overall travel times. Tour characteristics such as time-of-day and primary travel mode of the tours also affect traveler's out-of-home activity-tour time-use patterns.

Factors that affect health outcomes in adults with type 2 diabetes : a cross-sectional study

Background: Factors that individually influence blood sugar control, health-related quality of life, and diabetes self-care behaviors have been widely investigated; however, most previous diabetes studies have not tested an integrated association between a series of factors and multiple health outcomes. ---------- Objectives: The purposes of this study are to identify risk factors and protective factors and to examine the impact of risk factors and protective factors on adaptive outcomes in people with type 2 diabetes.---------- Design: A descriptive correlational design was used to examine a theoretical model of risk factors, protective factors, and adaptive outcomes.---------- Settings: This study was conducted at the endocrine outpatient departments of three hospitals in Taiwan. Participants A convenience sample of 334 adults with type 2 diabetes aged 40 and over.---------- Methods: Data were collected by a self-reported questionnaire and physiological examination. Using the structural equation modeling technique, measurement and structural regression models were tested.---------- Results: Age and life events reflected the construct of risk factors. The construct of protective factors was explained by diabetes symptoms, coping strategy, and social support. The construct of adaptive outcomes comprised HbA1c, health-related quality of life, and self-care behaviors. Protective factors had a significant direct effect on adaptive outcomes (β = 0.68, p < 0.001); however, risk factors did not predict adaptive outcomes (β = − 0.48, p = 0.118).---------- Conclusions: Identifying and managing risk factors and protective factors are an integral part of diabetes care. This theoretical model provides a better understanding of how risk factors and protective factors work together to influence multiple adaptive outcomes in people living with type 2 diabetes.

An examination of the relationships between lifestyle factors and mental health among Australian midlife and older women

Background It is well known that lifestyle factors including overweight/obesity, physical inactivity, smoking and alcohol use are largely related with morbidity and mortality of chronic diseases including diabetes and cardiovascular diseases. The effect of lifestyle factors on people’s mental health who have a chronic disease is less defined in the research. The World Health Organisation has defined health as “a state of complete physical, mental and social well-being”. It is important, therefore to develop an understanding of the relationships between lifestyle and mental health as this may have implications for maximising the efficacy of health promotion in people with chronic diseases. Objectives The overall aim of the research was to examine the relationships between lifestyle factors and mental health among Australian midlife and older women. Methodology The current research measured four lifestyle factors including weight status, physical activity, smoking and alcohol use. Three interconnecting studies were undertaken to develop a comprehensive understanding of the relationships between lifestyle factors and mental health. Study 1 investigated the longitudinal effect of lifestyle factors on mental health by using midlife and older women randomly selected from the community. Study 2 adopted a cross-sectional design, and compared the effect of lifestyle factors on mental health between midlife and older women with and without diabetes. Study 3 examined the mediating effect of self-efficacy in the relationships between lifestyle factors and mental health among midlife and older women with diabetes. A questionnaire survey was chosen as the means to gather information, and multiple linear regression analysis was conducted as the primary statistical approach. Results The research showed that the four lifestyle factors including weight status, physical activity, smoking and alcohol use did impact on mental health among Australian midlife and older women. First, women with a higher BMI had lower levels of mental health than women with normal weight, but as women age, the mental health of women who were overweight and obese becomes better than that of women with normal weight. Second, women who were physically active had higher levels of mental health than those who were not. Third, smoking adversely impacted on women’s mental health. Finally, those who were past-drinkers had less anxiety symptoms than women who were non-drinkers as they age. Women with diabetes appeared to have lower levels of mental health compared to women without. However, the disparities of mental health between two groups were confounded by low levels of physical activity and co-morbidities. This finding underlines the effect of physical activity on women’s mental health, and highlights the potential of reducing the gap of mental health by promoting physical activity. In addition, self-efficacy was shown to be the mediator of the relationships between BMI, physical activity and depression, suggesting that enhancing people’s self-efficacy may be useful for mental health improvement. Conclusions In conclusion, Australian midlife and older women who live with a healthier lifestyle have higher levels of mental health. It is suggested that strategies aiming to improve people’s mental health may be more effective if they focus on enhancing people’s self-efficacy levels. This study has implications to both health education and policy development. It indicates that health professionals may need to consider clients’ mental health as an integrated part of lifestyle changing process. Furthermore, given that lifestyle factors impact on both physical and mental health, lifestyle modification should continue to be the focus of policy development.