Long-term ambient air pollution exposure and self-reported morbidity in the Australian Longitudinal Study on Women's Health: A cross-sectional study

- Objective We sought to assess the effect of long-term exposure to ambient air pollution on the prevalence of self-reported health outcomes in Australian women. - Design Cross-sectional study - Setting and participants The geocoded residential addresses of 26 991 women across 3 age cohorts in the Australian Longitudinal Study on Women's Health between 2006 and 2011 were linked to nitrogen dioxide (NO2) exposure estimates from a land-use regression model. Annual average NO2 concentrations and residential proximity to roads were used as proxies of exposure to ambient air pollution. - Outcome measures Self-reported disease presence for diabetes mellitus, heart disease, hypertension, stroke, asthma, chronic obstructive pulmonary disease and self-reported symptoms of allergies, breathing difficulties, chest pain and palpitations. - Methods Disease prevalence was modelled by population-averaged Poisson regression models estimated by generalised estimating equations. Associations between symptoms and ambient air pollution were modelled by multilevel mixed logistic regression. Spatial clustering was accounted for at the postcode level. - Results No associations were observed between any of the outcome and exposure variables considered at the 1% significance level after adjusting for known risk factors and confounders. - Conclusions Long-term exposure to ambient air pollution was not associated with self-reported disease prevalence in Australian women. The observed results may have been due to exposure and outcome misclassification, lack of power to detect weak associations or an actual absence of associations with self-reported outcomes at the relatively low annual average air pollution exposure levels across Australia.

Dissonances in self-reported health and mortality across denominational groups in Northern Ireland

Measures of self-reported health status are increasingly used in research and health policy. However, the inherent subjectivity of the responses gives rise to lingering concerns about their utility, especially across national and cultural boundaries. In this study we use religious denomination as a proxy for Scottish ancestry within Northern Ireland and demonstrate significant differences in levels of self-reported ill-health that are not fully reflected in mortality risks. These findings mirror the differences between Scotland and Northern Ireland previously shown in ecological studies and provide more definitive evidence that even within the United Kingdom factors other than morbidity levels influence the perception and reporting of health status. Possible explanations for the dissonance between morbidity and mortality levels are discussed and the reasons for a preference for socio-economic rather than cultural factors are described. (C) 2010 Elsevier Ltd. All rights reserved.

The Nurse Professional Competence (NPC) scale : self-reported competence among nursing students on the point of graduation

BACKGROUND: International organisations, e.g. WHO, stress the importance of competent registered nurses (RN) for the safety and quality of healthcare systems. Low competence among RNs has been shown to increase the morbidity and mortality of inpatients. OBJECTIVES: To investigate self-reported competence among nursing students on the point of graduation (NSPGs), using the Nurse Professional Competence (NPC) Scale, and to relate the findings to background factors. METHODS AND PARTICIPANTS: The NPC Scale consists of 88 items within eight competence areas (CAs) and two overarching themes. Questions about socio-economic background and perceived overall quality of the degree programme were added. In total, 1086 NSPGs (mean age, 28.1 [20-56]years, 87.3% women) from 11 universities/university colleges participated. RESULTS: NSPGs reported significantly higher scores for Theme I "Patient-Related Nursing" than for Theme II "Organisation and Development of Nursing Care". Younger NSPGs (20-27years) reported significantly higher scores for the CAs "Medical and Technical Care" and "Documentation and Information Technology". Female NSPGs scored significantly higher for "Value-Based Nursing". Those who had taken the nursing care programme at upper secondary school before the Bachelor of Science in Nursing (BSN) programme scored significantly higher on "Nursing Care", "Medical and Technical Care", "Teaching/Learning and Support", "Legislation in Nursing and Safety Planning" and on Theme I. Working extra paid hours in healthcare alongside the BSN programme contributed to significantly higher self-reported scores for four CAs and both themes. Clinical courses within the BSN programme contributed to perceived competence to a significantly higher degree than theoretical courses (93.2% vs 87.5% of NSPGs). SUMMARY AND CONCLUSION: Mean scores reported by NSPGs were highest for the four CAs connected with patient-related nursing and lowest for CAs relating to organisation and development of nursing care. We conclude that the NPC Scale can be used to identify and measure aspects of self-reported competence among NSPGs.

Self-reported hearing loss among elderly individuals in the city of Sao Paulo, Brazil: prevalence and associated factors (SABE Study, 2006)

This article describes the prevalence of self-reported hearing loss in an elderly population in the city of Sao Paulo, Brazil, and associated factors, based on a cross-sectional descriptive and quantitative study. The sample consisted of individuals over 65 years of age selected from census tracts in two stages, with replacement and probability proportional to the population 75 years of age or older. Statistical analysis used Stata 10 with weighted data, Rao-Scott test, and backward stepwise Poisson regression. 1,115 elders were interviewed. Prevalence of self-reported hearing loss was 30.4%, and higher levels were associated with age over 75 years, male gender, self-reported musculoskeletal conditions, dizziness, visual impairment, and difficulty using the telephone. Increased knowledge of factors associated with hearing loss would support public policies on hearing. The high prevalence found in this study underlines the importance of addressing this issue among the elderly.

Self-reported alcohol consumption and its association with adherence and outcome of antiretroviral therapy in the Swiss HIV Cohort Study

BACKGROUND: Alcohol consumption leading to morbidity and mortality affects HIV-infected individuals. Here, we aimed to study self-reported alcohol consumption and to determine its association with adherence to antiretroviral therapy (ART) and HIV surrogate markers. METHODS: Cross-sectional data on daily alcohol consumption from August 2005 to August 2007 were analysed and categorized according to the World Health Organization definition (light, moderate or severe health risk). Multivariate logistic regression models and Pearson's chi(2) statistics were used to test the influence of alcohol use on endpoints. RESULTS: Of 6,323 individuals, 52.3% consumed alcohol less than once a week in the past 6 months. Alcohol intake was deemed light in 39.9%, moderate in 5.0% and severe in 2.8%. Higher alcohol consumption was significantly associated with older age, less education, injection drug use, being in a drug maintenance programme, psychiatric treatment, hepatitis C virus coinfection and with a longer time since diagnosis of HIV. Lower alcohol consumption was found in males, non-Caucasians, individuals currently on ART and those with more ART experience. In patients on ART (n=4,519), missed doses and alcohol consumption were positively correlated (P<0.001). Severe alcohol consumers, who were pretreated with ART, were more often off treatment despite having CD4+ T-cell count <200 cells/microl; however, severe alcohol consumption per se did not delay starting ART. In treated individuals, alcohol consumption was not associated with worse HIV surrogate markers. CONCLUSIONS: Higher alcohol consumption in HIV-infected individuals was associated with several psychosocial and demographic factors, non-adherence to ART and, in pretreated individuals, being off treatment despite low CD4+ T-cell counts.

Cross-cultural differences in self-reported decision-making style and confidence

The Melbourne Decision Making Questionnaire (Mann, Burnett, Radford, & Ford, 1997) measures selfreported decision-making coping patterns. The questionnaire was administered to samples of University students in the US (N = 475), Australia (N = 262), New Zealand (N = 260), Japan (N = 359), Hong Kong (N = 281), and Taiwan (N = 414). As predicted, students from the three Western, individualistic cultures (US, Australia, and New Zealand) were more con® dent of their decision-making ability than students from the three East Asian, group-oriented cultures (Japan, Hong Kong, Taiwan). No cross-cultural differences were found in scores on decision vigilance (a careful decision-making style). However, compared with Western students, the Asian students tended to score higher on buck-passing and procrastination (avoidant styles of decision making) as well as hypervigilance (a panicky style of decision making). Japanese students scored lowest on decision self-esteem and highest on procrastination and hypervigilance. It was argued that the con¯ ict model and its attendant coping patterns is relevant for describing and comparing decision making in both Western and Asian cultures.

Being stoned : a review of self-reported cannabis effects.

Although there has been considerable research into the adverse effects of cannabis, less attention has been directed toward subjective effects that may be associated with ongoing cannabis use. Examination of self-reported cannabis effects is an important issue in understanding the widespread use of cannabis. While reviews have identified euphoria as a primary factor in maintaining cannabis use, relaxation is the effect reported most commonly in naturalistic studies of cannabis users, irrespective of the method used. Self-reported effects in 12 naturalistic and 18 laboratory studies were compared. Regardless of methodology there was considerable variation in the effects experienced. Variation has been reported in terms of opposite effects being experienced by different individuals, variation of effects by individuals within a single occasion and between occasions of use. Factors that might explain this variation are outlined. Limitations of the available literature and suggested directions for future research are discussed.

The impact of police speed enforcement practices on self-reported speeding: An exploration of the effects of visibility and mobility

Research has highlighted the relationship between vehicle speed and increased crash risk and severity. Evidence suggests that police speed enforcement, in particular speed camera operations, can be an effective tool for reducing traffic crashes. A quantitative survey of Queensland drivers (n = 852) was conducted to investigate the impact of police speed enforcement methods on self-reported speeding behaviour. Results indicate that visible enforcement was associated with significantly greater self-reported compliance than covert operations irrespective of the mobility of the approach, and the effects on behaviour were longer lasting. The mobility of operations appeared to be moderated the visibility of the approach. Specifically, increased mobility was associated with increase reported compliant behaviour, but only for covert operations, and increased longevity of reported compliant behaviour, but only for overt operations. The perceived effectiveness of various speed enforcement approaches are also analysed across a range of driving scenarios. Results are discussed in light of the small effect sizes. Recommendations for policy and future research are presented.

The on-road difficulties of older drivers and their relationship with self-reported motor vehicle crashes

OBJECTIVES: To quantify the driving difficulties of older adults using a detailed assessment of driving performance and to link this with self-reported retrospective and prospective crashes. DESIGN: Prospective cohort study. SETTING: On-road driving assessment. PARTICIPANTS: Two hundred sixty-seven community-living adults aged 70 to 88 randomly recruited through the electoral roll. MEASUREMENTS: Performance on a standardized measure of driving performance. RESULTS: Lane positioning, approach, and blind spot monitoring were the most common error types, and errors occurred most frequently in situations involving merging and maneuvering. Drivers reporting more retrospective or prospective crashes made significantly more driving errors. Driver instructor interventions during self-navigation (where the instructor had to brake or take control of the steering to avoid an accident) were significantly associated with higher retrospective and prospective crashes; every instructor intervention almost doubled prospective crash risk. CONCLUSION: These findings suggest that on-road driving assessment provides useful information on older driver difficulties, with the self-directed component providing the most valuable information.

Parents’ self-efficacy, outcome expectations, and self-reported task performance when managing atopic dermatitis in children: Instrument reliability and validity

BACKGROUND: Support and education for parents faced with managing a child with atopic dermatitis is crucial to the success of current treatments. Interventions aiming to improve parent management of this condition are promising. Unfortunately, evaluation is hampered by lack of precise research tools to measure change. OBJECTIVES: To develop a suite of valid and reliable research instruments to appraise parents' self-efficacy for performing atopic dermatitis management tasks; outcome expectations of performing management tasks; and self-reported task performance in a community sample of parents of children with atopic dermatitis. METHODS: The Parents' Eczema Management Scale (PEMS) and the Parents' Outcome Expectations of Eczema Management Scale (POEEMS) were developed from an existing self-efficacy scale, the Parental Self-Efficacy with Eczema Care Index (PASECI). Each scale was presented in a single self-administered questionnaire, to measure self-efficacy, outcome expectations, and self-reported task performance related to managing child atopic dermatitis. Each was tested with a community sample of parents of children with atopic dermatitis, and psychometric evaluation of the scales' reliability and validity was conducted. SETTING AND PARTICIPANTS: A community-based convenience sample of 120 parents of children with atopic dermatitis completed the self-administered questionnaire. Participants were recruited through schools across Australia. RESULTS: Satisfactory internal consistency and test-retest reliability was demonstrated for all three scales. Construct validity was satisfactory, with positive relationships between self-efficacy for managing atopic dermatitis and general perceived self-efficacy; self-efficacy for managing atopic dermatitis and self-reported task performance; and self-efficacy for managing atopic dermatitis and outcome expectations. Factor analyses revealed two-factor structures for PEMS and PASECI alike, with both scales containing factors related to performing routine management tasks, and managing the child's symptoms and behaviour. Factor analysis was also applied to POEEMS resulting in a three-factor structure. Factors relating to independent management of atopic dermatitis by the parent, involving healthcare professionals in management, and involving the child in the management of atopic dermatitis were found. Parents' self-efficacy and outcome expectations had a significant influence on self-reported task performance. CONCLUSIONS: Findings suggest that PEMS and POEEMS are valid and reliable instruments worthy of further psychometric evaluation. Likewise, validity and reliability of PASECI was confirmed.

Grade A Taipei junior high school principals’ self-reported leadership practices

The principal’s leadership and curriculum development are considered the core elements for creating a high performing junior high school. In Taiwan, mathematics curriculum reform has been an ongoing topic since 1994. The pedagogy, classroom interactions, and the underlying philosophy of mathematics education have varied with different versions of guidelines. These changes inevitably increase the requirement for principals’ leadership in order to effectively implement the curriculum reform. Principals’ leadership is essential to the success of the implementation in their school. This study aimed to explore and identify the leadership of junior high school principals whose schools had been judged by the Taipei City Government as Grade A junior high schools. Principals’ implementations of the reformed mathematics curriculum were used as examples to generate insights of their leadership. This study drew upon a multiple-case study approach. Data were collected from interviews, observations, and documentations. Bass and Avolio’s (1997) full range leadership theory provided a structure for gaining insight into these principals’ leadership practices. Five Grade A Taipei junior high school principals participated and shared their leadership concepts and experiences. Findings revealed that the leadership preferences of the five principles varied considerably. Management by exception-active, contingent reward, individualised consideration, and idealised influence were Grade A Taipei junior high school principals’ preferred leadership practices. In addition, principals’ leadership strategies associated with these practices were identified. These principals had adopted a range of leadership strategies according to the staff and school needs. Results of this study have implications for both Taiwanese principals and education departments. Principals can enhance their leadership by gaining more understanding about the Grade A principals’ leadership practices and strategies. Taiwanese education departments can improve school leadership training programs by focusing on these practices and strategies, which may also lead to more effective strategies for implementing national curriculum reform.

The prevalence and characteristics of self-reported dangerous driving behaviours among a young cohort

Background: Young motorists engaging in anti-social and often dangerous driving manoeuvres (which is often referred to as “hooning” within Australia) is an increasing road safety problem. While anecdotal evidence suggests that such behaviour is positively linked with crash involvement, researchers have yet to examine whether younger drivers who deliberately break road rules and drive in an erratic manner (usually with peers) are in fact over represented in crash statistics. This paper outlines research that aimed to identify the characteristics of individuals most likely to engaging in hooning behaviours, as well as examine the frequency of such driving behaviours and if such activity is linked with self-reported crash involvement.---------- Methods: A total of 717 young drivers in Queensland voluntarily completed a questionnaire to investigate their driving behaviour and crash history.---------- Results: Quantitative analysis of the data revealed that almost half the sample reported engaging in some form of “hooning” behaviour at least once in their lifetime, although only 4% indicated heavy participation in the behaviour e.g., >50 times. Street racing was the most common activity reported by participants followed by “drifting” and then “burnouts”. Logistic regression analysis indicated that being younger and a male was predictive of reporting such anti-social driving behaviours, and importantly, a trend was identified between such behaviour and self-reported crash involvement.---------- Conclusions: This research provides preliminary evidence that younger male drivers are more likely to engage in dangerous driving behaviours, which ultimately may prove to increase their overall risk of becoming involved in a crash. This paper will further outline the study findings in regards to current enforcement efforts to deter such driving activity as well as provide direction for future research efforts in this area.---------- Research highlights: ► The self-reported driving behaviours of 717 younger Queensland drivers were examined to investigate the relationship between deliberately breaking road rules and self-reported crash involvement. ► Younger male drivers were most likely to engage in such aberrant driving behaviours and a trend was identified between such behaviour and self-reported crash involvement.

Self-reported driving difficulty by persons with Hemianopia and Quadrantanopia

Purpose: To compare self-reported driving difficulty by persons with hemianopic or quadrantanopic field loss with that reported by age-matched drivers with normal visual fields; and to examine how their self- reported driving difficulty compares to ratings of driving performance provided by a certified driving rehabilitation specialist(CDRS). Method: Participants were 17 persons with hemianopic field loss, 7 with quadrantanopic loss, and 24 age-matched controls with normal visual fields, all of whom had current drivers’ licenses. Information was collected via questionnaire regarding driving difficulties experienced in 21 typical driving situations grouped into 3 categories(involvement of peripheral vision, low visibility conditions, and independent mobility). On-road driving performance was evaluated by a CDRS using a standard assessment scale. Results: Drivers with hemianopic and quadrantanopic field loss expressed significantly more difficulty with driving maneuvers involving peripheral vision and independent mobility, compared to those with normal visual fields. Drivers with hemianopia and quadrantanopia who were rated as unsafe to drive based upon an on-road assessment by the CDRS were no more likely to report driving difficulty than those rated as safe. Conclusion: This study highlights aspects of driving that hemianopic or quadrantanopic persons find particularly problematic, thus suggesting areas that could be focused on driving rehabilitation. Some drivers with hemianopia or quadrantanopia may inappropriately view themselves as good drivers when in fact their driving performance is unsafe as judged by a driving professional.