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Moylett S, Hevey D. Testing threat-to-efficacy ratios in health communications about cardiovascular disease among an older population. Health Promot Int 2020; 35:255-266. [PMID: 30879077 DOI: 10.1093/heapro/daz019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
To test threat-to-efficacy ratios within health communications about cardiovascular disease (CVD) for older individuals. Participants were randomly assigned to one of six messages: (i) 'standard' message with 1/1 threat-to-efficacy ratio, (ii) 'low efficacy' message with 1/0 threat-to-efficacy ratio, (iii) 'low threat' message with 0/1 threat-to-efficacy ratio, (iv) 'high efficacy' message with 1/2 threat-to-efficacy ratio; (v) 'high threat' message with 2/1 threat-to-efficacy ratio and (vi) 'overload' message with 2/2 threat-to-efficacy ratio. Participants had to be of 60 years of age or older (N = 242, Male = 92, Age: M = 68.29, SD = 6.71). Advanced univariate analyses and multiple regression modelling were conducted to examine associations between the message groups, and danger- and fear-control processes, as well as the impact of threat and efficacy appraisals on the relationship between the message groups and behavioural intentions. No differences were found between the message groups for danger-control processes. Those who received the 'overload' message did report higher levels of fear, nervousness and anxiety in comparison to the 'standard' message group. For physical activity, it was found that efficacy impacted the relationship between the message groups and behavioural intentions, as participants' levels of efficacy increased and if these individuals received high levels of efficacy information, their behavioural intentions for physical activity increased. Results from this study were dissimilar to those of previous research. However, they highlighted the impact of efficacy and negative emotional reactions when communicating to older individuals about CVD and the associated health behaviours.
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Affiliation(s)
- Sinéad Moylett
- School of Psychology, Trinity College Dublin, Dublin, Ireland.,Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - David Hevey
- School of Psychology, Trinity College Dublin, Dublin, Ireland
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Cruise SM, Hughes J, Bennett K, Kouvonen A, Kee F. The Impact of Risk Factors for Coronary Heart Disease on Related Disability in Older Irish Adults. J Aging Health 2019; 31:165-184. [PMID: 28823193 DOI: 10.1177/0898264317726242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of this study is to examine the prevalence of coronary heart disease (CHD)-related disability (hereafter also "disability") and the impact of CHD risk factors on disability in older adults in the Republic of Ireland (ROI) and Northern Ireland (NI). METHOD Population attributable fractions were calculated using risk factor relative risks and disability prevalence derived from The Irish Longitudinal Study on Ageing and the Northern Ireland Health Survey. RESULTS Disability was significantly lower in ROI (4.1% vs. 8.8%). Smoking and diabetes prevalence rates, and the fraction of disability that could be attributed to smoking (ROI: 6.6%; NI: 6.1%), obesity (ROI: 13.8%; NI: 11.3%), and diabetes (ROI: 6.2%; NI: 7.2%), were comparable in both countries. Physical inactivity (31.3% vs. 54.8%) and depression (10.2% vs. 17.6%) were lower in ROI. Disability attributable to depression (ROI: 16.3%; NI: 25.2%) and physical inactivity (ROI: 27.5%; NI: 39.9%) was lower in ROI. DISCUSSION Country-specific similarities and differences in the prevalence of disability and associated risk factors will inform public health and social care policy in both countries.
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Affiliation(s)
| | - John Hughes
- 1 Queen's University Belfast, Northern Ireland, UK
- 2 Northern Ireland Statistics and Research Agency, Belfast, UK
| | | | - Anne Kouvonen
- 1 Queen's University Belfast, Northern Ireland, UK
- 4 University of Helsinki, Finland
- 5 SWPS University of Humanities and Social Sciences, Wroclaw, Poland
| | - Frank Kee
- 1 Queen's University Belfast, Northern Ireland, UK
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Rücker V, Wiedmann S, O’Flaherty M, Busch MA, Heuschmann PU. Decline in Regional Trends in Mortality of Stroke Subtypes in Germany From 1998 to 2015. Stroke 2018; 49:2577-2583. [DOI: 10.1161/strokeaha.118.023193] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Viktoria Rücker
- From the Institute of Clinical Epidemiology and Biometry, University of Würzburg, Germany (V.R., S.W., P.U.H.)
| | - Silke Wiedmann
- From the Institute of Clinical Epidemiology and Biometry, University of Würzburg, Germany (V.R., S.W., P.U.H.)
| | - Martin O’Flaherty
- Department of Public Health and Policy, Institute of Psychology, Health, and Society, University of Liverpool, United Kingdom (M.O.)
| | - Markus A. Busch
- Department of Epidemiology, Robert Koch Institute, Berlin, Germany (M.A.B.)
| | - Peter U. Heuschmann
- From the Institute of Clinical Epidemiology and Biometry, University of Würzburg, Germany (V.R., S.W., P.U.H.)
- Comprehensive Heart Failure, University of Würzburg, Germany (P.U.H.)
- Center for Clinical Studies, University Hospital Würzburg, Germany (P.U.H.)
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Smith R, Frazer K, Hyde A, O'Connor L, Davidson P. “Heart disease never entered my head”: Women's understanding of coronary heart disease risk factors. J Clin Nurs 2018; 27:3953-3967. [DOI: 10.1111/jocn.14589] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 05/23/2018] [Accepted: 06/24/2018] [Indexed: 12/20/2022]
Affiliation(s)
- Rita Smith
- UCD School of Nursing, Midwifery and Health Systems; University College Dublin; Dublin 4 Ireland
| | - Kate Frazer
- UCD School of Nursing, Midwifery and Health Systems; University College Dublin; Dublin 4 Ireland
| | - Abbey Hyde
- UCD School of Nursing, Midwifery and Health Systems; University College Dublin; Dublin 4 Ireland
| | - Laserina O'Connor
- UCD School of Nursing, Midwifery and Health Systems; University College Dublin; Dublin 4 Ireland
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Hughes J, Kabir Z, Kee F, Bennett K. Cardiovascular risk factors-using repeated cross-sectional surveys to assess time trends in socioeconomic inequalities in neighbouring countries. BMJ Open 2017; 7:e013442. [PMID: 28373251 PMCID: PMC5387991 DOI: 10.1136/bmjopen-2016-013442] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 10/21/2016] [Accepted: 11/16/2016] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVES This study compares trends in socioeconomic inequalities related to key cardiovascular risk factors in neighbouring countries Northern Ireland (NI) and the Republic of Ireland (RoI). DESIGN Repeated cross-sectional studies. SETTING Population based. PARTICIPANTS 3500-4000 in national surveys in NI and 5000-9000 in RoI, aged 20-69 years. MEASURES Educational attainment was used as a socioeconomic indicator by which the magnitude and direction of trends in inequalities for smoking, diabetes, obesity and physical inactivity in NI and RoI were examined between 1997/1998 and 2007/2011. Gender-specific relative and absolute inequalities were calculated using the Relative Index of Inequality (RII) and Slope Index of Inequality (SII) for both countries. RESULTS In both countries, the prevalence of diabetes and obesity increased whereas levels of smoking and physical inactivity decreased over time. In NI relative inequalities increased for obesity (RII 1.1 in males and 2.1 in females in 2010/2011) and smoking (RII 4.5 in males and 4.2 in females in 2010/2011) for both genders and absolute inequalities increased for all risk factors in men and increased for diabetes and obesity in women. In RoI greater inequality was observed in women, particularly for smoking (RII 2.8 in 2007) and obesity (RII 8.2 in 2002) and in men for diabetes (RII 3.2 in 2002). CONCLUSIONS Interventions to reduce inequalities in risk factors, particularly smoking, obesity and diabetes are encouraged across both countries.
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Affiliation(s)
- John Hughes
- UKCRC Centre of Excellence for Public Health, Queen's University, Belfast, UK
| | - Zubair Kabir
- Department of Epidemiology & Public Health University College Cork, Cork, Ireland
| | - Frank Kee
- UKCRC Centre of Excellence for Public Health, Queen's University, Belfast, UK
| | - Kathleen Bennett
- Population Health Sciences Division, RCSI St Stephen's Green, Dublin, Ireland
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Smith R, Frazer K, Hall P, Hyde A, O'Connor L. 'Betwixt and between health and illness' - women's narratives following acute coronary syndrome. J Clin Nurs 2017; 26:3457-3470. [PMID: 28054410 DOI: 10.1111/jocn.13711] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2016] [Indexed: 01/12/2023]
Abstract
AIMS AND OBJECTIVES This study investigated experiences of women with a primary diagnosis of ACS (NSTEMI and Unstable Angina) in the 6-8 week period following discharge from hospital. The aim was to report the experience of the mediating impact of a newly-diagnosed disease. BACKGROUND Cardiovascular disease is the main cause of mortality in women. Treatment modalities have improved health outcomes and survival rates, however, quality of life and ongoing morbidity after discharge is not clearly understood from a gender specific perspective. DESIGN A naturalistic case study design guided this study. METHODS Thirty women participated (n = 30); a within-case followed by a cross-case analysis provided meticulous knowledge of each case. Data collection included participant diaries and face to face interviews. Data were analysed using modified analytic induction which allowed the emergence of theoretical insights. The theoretical concepts, liminality and transitioning were used to inform the analysis. Within-methods triangulation captured the depth and breadth of the women's experiences. RESULTS The data provide an insight into women's experiences following ACS and highlight a need for support structures and services after discharge. Many women reported a period of disrupted normality following discharge from hospital. While a number of women had transitioned towards recovery, many remained in a liminal space 'betwixt and between' health and illness. Cardiac rehabilitation was reported as a positive experience for those who were attending. CONCLUSIONS The findings provide a platform for a wider discourse on the needs of women with ACS in the immediate period after discharge from hospital. Women may benefit from gender-specific, appropriately timed, and targeted interventions to facilitate recovery and adaptation to living with CHD. RELEVANCE TO CLINICAL PRACTICE It is essential that secondary prevention services are modelled and tailored to meet the needs of women and evaluated appropriately to ensure positive outcomes. Nursing could have a key role to play in managing and providing this support.
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Affiliation(s)
- Rita Smith
- UCD School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland
| | - Kate Frazer
- UCD School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland
| | | | - Abbey Hyde
- UCD School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland
| | - Laserina O'Connor
- UCD School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland
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Kazlauskas HA, Raskauskiene N, Radziuviene R, Janusonis V. Twenty years trends in mortality rates from stroke in Klaipeda. Brain Behav 2016; 6:e00499. [PMID: 27547501 PMCID: PMC4893389 DOI: 10.1002/brb3.499] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 04/02/2016] [Accepted: 04/27/2016] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND During the past decades, mortality from stroke decreased in many western European countries; however, changes concerning long-term stroke mortality in eastern European countries are less evident. OBJECTIVE To assess age- and gender-specific trends in stroke mortality in Klaipeda (Lithuania) from 1994 to 2013. DESIGN Descriptive epidemiological study. SETTING/SUBJECTS Permanent population of Klaipeda. METHODS Data on 2509 permanent residents of Klaipeda aged 35-79 years who died from stroke between 1994 and 2013 were gathered. Directly, age-standardized (European population) stroke mortality rates were analyzed using joinpoint regression separately for specific age groups (35-64, 65-79, and 35-79 years) and by gender. Annual percentage change (APC) and 95% CIs were presented. RESULTS Stroke mortality in the 35- to 79-year-old age group peaked in 1994-1997, it then decreased by -9.9% (95% CI: -18.7, -0.2) yearly up until 2001 and leveled off by -0.2% (-5.1, 4.9) between 2001 and 2013. Among men aged 35-64 years, mortality decreased substantially by 12.8% (-21.5, -3.3) per year from 1994 to 2001 and turned positive by 6.3% (0.8, 12.1) between 2000 and 2013. Among women aged 35-64 years, mortality decreased significantly by 15.5% (-28.1, -0.7) from 1994 to 2000. There was evidence of recent plateauing of trends for 35- to 64-year-old women between 2000 and 2013. In the 65- to 79-year-old age group, mortality decreased from 1994 onward yearly by -5.5% (-7.9, -3.0) in women and by -3.3% (-5.6, -0.9) in men. CONCLUSIONS Joinpoint regression revealed steadily decreasing trend in stroke mortality between 1994 and 2001. The decline in death rates flattened out in the recent decade. Mortality rates varied among age groups and were more pronounced in adults aged 35-64 years. It is essential to monitor and manage stroke risk factors, especially among middle-aged population.
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Affiliation(s)
- Henrikas A. Kazlauskas
- Department of Neurology and RehabilitationKlaipeda University HospitalKlaipedaLithuania
- Behavioral Medicine Institute Lithuanian University of Health SciencesPalangaLithuania
| | - Nijole Raskauskiene
- Behavioral Medicine Institute Lithuanian University of Health SciencesPalangaLithuania
| | - Rima Radziuviene
- Behavioral Medicine Institute Lithuanian University of Health SciencesPalangaLithuania
| | - Vinsas Janusonis
- Klaipeda University HospitalKlaipeda UniversityKlaipedaLithuania
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Tobin K, Gilthorpe MS, Rooney J, Heverin M, Vajda A, Staines A, Hardiman O. Age-period-cohort analysis of trends in amyotrophic lateral sclerosis incidence. J Neurol 2016; 263:1919-26. [PMID: 27372451 DOI: 10.1007/s00415-016-8215-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 06/21/2016] [Accepted: 06/22/2016] [Indexed: 12/13/2022]
Abstract
Amyotrophic Lateral Sclerosis (ALS) is a progressive neurodegenerative disease with an unknown cause. Studies have reported that the incidence rate of ALS might be changing. As ALS is an age related disease, crude incidence could increase as population structure changes and overall life expectancy improves. Age-period-cohort (APC) models are frequently used to investigate trends in demographic rates such as incidence. Age-specific incidence rate for ALS from 1996 to 2014 were taken from a population-based ALS register in Ireland. To circumvent the well-known identifiability issue in APC models, we apply the method of Partial Least Squares Regression to separate the effects of Age, Period and Cohort on ALS incidence over time. This APC analysis shows no cohort effect and the initial signs of a period effect; increasing incidence of ALS in the most recently diagnosed group. As further years of data accrue to the Irish register it will become clear if this effect emerges as a strong trend in the incidence of ALS in Ireland and replication of these analyses in other populations will show if our findings on temporal patterns in ALS incidence are shared elsewhere.
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Affiliation(s)
- Katy Tobin
- Academic Unit of Neurology, School of Medicine, Trinity College Dublin, TBSI, 152-160 Pearse Street, Dublin 2, Ireland. .,Centre for Health Policy and Management, Trinity College Dublin, Dublin 2, Ireland.
| | - Mark S Gilthorpe
- Division of Epidemiology and Biostatistics, School of Medicine, University of Leeds, Leeds, UK
| | - James Rooney
- Academic Unit of Neurology, School of Medicine, Trinity College Dublin, TBSI, 152-160 Pearse Street, Dublin 2, Ireland
| | - Mark Heverin
- Academic Unit of Neurology, School of Medicine, Trinity College Dublin, TBSI, 152-160 Pearse Street, Dublin 2, Ireland
| | - Alice Vajda
- Academic Unit of Neurology, School of Medicine, Trinity College Dublin, TBSI, 152-160 Pearse Street, Dublin 2, Ireland
| | - Anthony Staines
- School of Nursing and Health Sciences, Dublin City University, Dublin 9, Ireland
| | - Orla Hardiman
- Academic Unit of Neurology, School of Medicine, Trinity College Dublin, TBSI, 152-160 Pearse Street, Dublin 2, Ireland
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Jennings S, Bennett K, Shelley E, Kearney P, Daly K, Fennell W. Trends in percutaneous coronary intervention and angiography in Ireland, 2004-2011: Implications for Ireland and Europe. INTERNATIONAL JOURNAL OF CARDIOLOGY. HEART & VESSELS 2014; 4:35-39. [PMID: 29450183 PMCID: PMC5802397 DOI: 10.1016/j.ijchv.2014.08.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 08/01/2014] [Indexed: 01/13/2023]
Abstract
BACKGROUND/OBJECTIVES To study temporal trends in crude and age standardised rates of cardiac catheterisation and percutaneous coronary intervention (PCI) in Ireland, 2004-2011. METHODS Two data sources were used: a) a survey of publicly and privately funded hospitals with cardiac catheter laboratories to obtain the annual number of procedures performed and b) anonymised data from the Hospital In-Patient Enquiry (HIPE) for angiography and PCI in acute publicly funded hospitals; age standardised rates were calculated to study trends over time. RESULTS From 2004 to 2011 the crude rate of angiography and PCI increased by 47.8% and 35.9% respectively, with rates of 6689 and 1825 per million population in 2011. Following age standardisation, however, PCI activity showed a non-significant decrease over time. The PCI to angiography ratio decreased from 30% to 27% and PCI was performed predominantly for stable coronary heart disease (54%) in 2011. CONCLUSION Angiography and PCI rates have increased in Ireland but PCI crude and age adjusted rates show divergent trends. While Ireland differs from USA and UK, with a higher proportion of PCI being performed for stable CHD in recent years, little systematic surveillance of cardiological interventions within Europe is available to benchmark improvements in Ireland.
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Affiliation(s)
- S. Jennings
- Department of Public Health, HSE, Dublin, Ireland
| | - K. Bennett
- Department of Pharmacology and Therapeutics, St James Hospital, Dublin, Ireland
| | - E. Shelley
- Department of Public Health, HSE, Dublin, Ireland
| | - P. Kearney
- Cardiology Department, Cork University Hospital, Cork, Ireland
| | - K. Daly
- Cardiology Department, University College Hospital Galway, Galway, Ireland
| | - W. Fennell
- Cardiology Department, Bon Secours Hospital, Cork, Ireland
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