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Sample records for 13-year population-based prospective

  1. Reciprocal relations between body satisfaction and self-esteem: A large 13-year prospective study of adolescents.

    PubMed

    Wichstrøm, Lars; von Soest, Tilmann

    2016-02-01

    Previous research has demonstrated that body satisfaction and self-esteem are highly correlated in adolescence, but reasons are poorly understood. We tested three explanations: (i) the two constructs are actually one; (ii) the correlation is explained by a third factor; (iii) there are prospective relationships between body satisfaction and self-esteem. A population based sample of Norwegian adolescents (n = 3251) was examined four times over a 13-year period. Confirmatory factor analysis showed that body satisfaction and self-esteem were separate constructs and the correlation between them was not attenuated when adjusting for 3rd variables. Autoregressive cross-lagged analysis showed reciprocal relations between body satisfaction and self-esteem. The prospective relationship between body satisfaction during adolescence and self-esteem in late adolescence and emerging adulthood was stronger than at later stages. PMID:26713411

  2. Predictors of Cerebral Palsy in Very Preterm Infants: The EPIPAGE Prospective Population-Based Cohort Study

    ERIC Educational Resources Information Center

    Beaino, Ghada; Khoshnood, Babak; Kaminski, Monique; Pierrat, Veronique; Marret, Stephane; Matis, Jacqueline; Ledesert, Bernard; Thiriez, Gerard; Fresson, Jeanne; Roze, Jean-Christophe; Zupan-Simunek, Veronique; Arnaud, Catherine; Burguet, Antoine; Larroque, Beatrice; Breart, Gerard; Ancel, Pierre-Yves

    2010-01-01

    Aim: The aim of this study was to assess the independent role of cerebral lesions on ultrasound scan, and several other neonatal and obstetric factors, as potential predictors of cerebral palsy (CP) in a large population-based cohort of very preterm infants. Method: As part of EPIPAGE, a population-based prospective cohort study, perinatal data…

  3. Asthma and Attention-Deficit/Hyperactivity Disorder: A Nationwide Population-Based Prospective Cohort Study

    ERIC Educational Resources Information Center

    Chen, Mu-Hong; Su, Tung-Ping; Chen, Ying-Sheue; Hsu, Ju-Wei; Huang, Kai-Lin; Chang, Wen-Han; Chen, Tzeng-Ji; Bai, Ya-Mei

    2013-01-01

    Background: Previous cross-sectional studies have suggested an association between asthma and attention-deficit/hyperactivity disorder (ADHD), but the temporal relationship was not determined. Using a nationwide population-based prospective case-control cohort study (1:4, age-/gender-matched), we hypothesized that asthma in infanthood or early…

  4. Annual risk of tuberculosis infection in rural China: a population-based prospective study.

    PubMed

    Gao, Lei; Bai, Liqiong; Liu, Jianmin; Lu, Wei; Wang, Xinhua; Li, Xiangwei; Du, Jiang; Chen, Xinchun; Zhang, Haoran; Xin, Henan; Sui, Hongtao; Li, Hengjing; Su, Haoxiang; He, Jian; Pan, Shouguo; Peng, Hong; Xu, Zuhui; Catanzaro, Antonino; Evans, Thomas G; Zhang, Zongde; Ma, Yu; Li, Mufei; Feng, Boxuan; Li, Zhen; Guan, Ling; Shen, Fei; Wang, Zhijian; Zhu, Tao; Yang, Shumin; Si, Hongyan; Wang, Yi; Tan, Yunhong; Chen, Tianzhu; Chen, Chen; Xia, Yinyin; Cheng, Shiming; Xu, Weiguo; Jin, Qi

    2016-07-01

    Prospective population data on the incidence of tuberculosis (TB) infection has been sparsely reported in the global literature.A population-based prospective study was conducted in rural China to investigate the annual risk of TB infection, and its persistence using serial tuberculin skin tests (TSTs) and an interferon-γ release assay. In total, 13 580 eligible participants from four rural sites, identified as TST negative (<10 mm) or QuantiFERON-TB Gold In-Tube (QFT) (an interferon-γ release assay) negative from a baseline survey, were included in the first year's follow-up examination.The annual conversion rate of QFT among the study sites ranged between 2.1% and 4.9% (average 3.1%), and the incidence of TST conversion ranged between 6.0% and 31.1% (average 14.5%). During the second year's follow-up, infection persistence was investigated using 390 subjects with QFT conversions. Among them, 49.7% (164 out of 330) were found to be consistently QFT positive. Both the conversion and the persistence of QFT positivity were found to be significantly increased with increasing age.In conclusion, the annual TB infection rate was suggested to be ∼1.5% based on persistent positive results after QFT conversion in rural China. Therefore, infection control among those high-risk populations, including the elderly, should be prioritised for TB control in China. PMID:27230438

  5. Evidence for prospective associations among depression and obesity in population-based studies.

    PubMed

    Faith, M S; Butryn, M; Wadden, T A; Fabricatore, A; Nguyen, A M; Heymsfield, S B

    2011-05-01

    Obesity may lead to depression or be one of its consequences. We reviewed population-based studies in order to, first, identify the most commonly used research methods, and, second, to evaluate the strength of evidence for prospective associations among obesity and depression. We examined 25 studies, of which 10 tested 'obesity-to-depression' pathways, and 15 tested 'depression-to-obesity' pathways. Descriptive statistics summarized the frequency with which various measurements, designs and data analytic strategies were used. We tallied the number of studies that reported any vs. no statistically significant associations, and report on effect sizes, identified moderating variables within reports, and sought common findings across studies. Results indicated considerable methodological heterogeneity in the literature. Depression was assessed by clinical interview in 44% of studies, weight and height were directly measured in 32%, and only 12% used both. In total, 80% of the studies reported significant obesity-to-depression associations, with odds ratios generally in the range of 1.0 to 2.0, while only 53% of the studies reported significant depression-to-obesity associations. Sex was a common moderating variable. Thus, there was good evidence that obesity is prospectively associated with increased depression, with less consistent evidence that depression leads to obesity. Recommendations for future research regarding study samples, measurement and data analysis are provided. PMID:21414128

  6. Adipocytokines, C-Reactive Protein, and Cardiovascular Disease: A Population-Based Prospective Study

    PubMed Central

    Seven, Ekim; Husemoen, Lise L. N.; Sehested, Thomas S. G.; Ibsen, Hans; Wachtell, Kristian; Linneberg, Allan; Jeppesen, Jørgen L.

    2015-01-01

    Background Being overweight or obese is associated with a greater risk of coronary heart disease and stroke compared with normal weight. The role of the specific adipose tissue-derived substances, called adipocytokines, in overweight- and obesity-related cardiovascular disease (CVD) is still unclear. Objective To investigate the associations of three adipose tissue-derived substances: adiponectin, leptin, and interleukin-6 with incident CVD in a longitudinal population-based study, including extensive adjustments for traditional and metabolic risk factors closely associated with overweight and obesity. C-reactive protein (CRP) was used as a proxy for interleukin-6. Methods Prospective population-based study of 6.502 participants, 51.9% women, aged 30–60 years, free of CVD at baseline, with a mean follow-up time of 11.4 years, equivalent to 74,123 person-years of follow-up. As outcome, we defined a composite outcome comprising of the first event of fatal and nonfatal coronary heart disease and fatal and nonfatal stroke. Results During the follow-up period, 453 composite CV outcomes occurred among participants with complete datasets. In models, including gender, age, smoking status, systolic blood pressure, treatment for hypertension, diabetes, body mass index (BMI), total cholesterol, high-density-lipoprotein cholesterol, homeostasis model assessment of insulin resistance, estimated glomerular filtration rate, adiponectin, leptin, and CRP, neither adiponectin (hazard ratio [HR] with 95% confidence interval [CI]: 0.97 [0.87–1.08] per SD increase, P = 0.60) nor leptin (0.97 [0.85–1.12] per SD increase, P = 0.70) predicted the composite outcome, whereas CRP was significantly associated with the composite outcome (1.19 [1.07–1.35] per SD increase, P = 0.002). Furthermore, in mediation analysis, adjusted for age and sex, CRP decreased the BMI-associated CV risk by 43% (95%CI 29–72). Conclusions In this study, neither adiponectin nor leptin were independently

  7. Cognitive decline in short and long sleepers: A prospective population-based study (NEDICES)

    PubMed Central

    Benito-León, Julián; Louis, Elan D.; Bermejo-Pareja, Félix

    2013-01-01

    Background It is not clear whether cognitive decline progresses more quickly in long sleepers than in short sleepers or than in participants with usual sleep duration. We assessed cognitive decline as a function of self-reported sleep duration in a prospective population-based cohort (NEDICES). Methods Participants were evaluated at baseline and 3 years later. Baseline demographic variables were recorded and participants indicated their daily sleep usual duration as the sum of nighttime sleep and daytime napping. The average daily total usual sleep duration was grouped into three categories: ≤5 hours (short sleepers), 6 to 8 hours (reference category), and ≥9 hours (long sleepers). At baseline and at follow-up, a 37-item version of the Mini-Mental State Examination (37-MMSE) was administered. Results The final sample, 2,715 participants (72.9±6.1 years), comprised 298 (11%) short sleepers, 1,086 (40%) long sleepers, and 1,331 (49%) in the reference group (6 to 8 hours). During the three year follow-up period, the 37-MMSE declined by 0.5±4.0 points in short sleepers, 0.6±4.3 points in long sleepers, and 0.2±3.8 points in the reference group (p=0.08). The difference between short sleepers and the reference group was not significant (p=0.142); however, the difference between long sleepers and the reference group was significant (p=0.040). In analyses adjusted for baseline age and other potential confounders, this difference remained robust. Conclusions In this study, cognitive test scores among long sleepers declined more rapidly than observed in a reference group. Additional studies are needed to confirm these results. PMID:24094933

  8. Benzodiazepine use and risk of incident dementia or cognitive decline: prospective population based study

    PubMed Central

    Dublin, Sascha; Yu, Onchee; Walker, Rod; Anderson, Melissa; Hubbard, Rebecca A; Crane, Paul K; Larson, Eric B

    2016-01-01

    Objective To determine whether higher cumulative use of benzodiazepines is associated with a higher risk of dementia or more rapid cognitive decline. Design Prospective population based cohort. Setting Integrated healthcare delivery system, Seattle, Washington. Participants 3434 participants aged ≥65 without dementia at study entry. There were two rounds of recruitment (1994-96 and 2000-03) followed by continuous enrollment beginning in 2004. Main outcomes measures The cognitive abilities screening instrument (CASI) was administered every two years to screen for dementia and was used to examine cognitive trajectory. Incident dementia and Alzheimer’s disease were determined with standard diagnostic criteria. Benzodiazepine exposure was defined from computerized pharmacy data and consisted of the total standardized daily doses (TSDDs) dispensed over a 10 year period (a rolling window that moved forward in time during follow-up). The most recent year was excluded because of possible use for prodromal symptoms. Multivariable Cox proportional hazard models were used to examine time varying use of benzodiazepine and dementia risk. Analyses of cognitive trajectory used linear regression models with generalized estimating equations. Results Over a mean follow-up of 7.3 years, 797 participants (23.2%) developed dementia, of whom 637 developed Alzheimer’s disease. For dementia, the adjusted hazard ratios associated with cumulative benzodiazepine use compared with non-use were 1.25 (95% confidence interval 1.03 to 1.51) for 1-30 TSDDs; 1.31 (1.00 to 1.71) for 31-120 TSDDs; and 1.07 (0.82 to 1.39) for ≥121 TSDDs. Results were similar for Alzheimer’s disease. Higher benzodiazepine use was not associated with more rapid cognitive decline. Conclusion The risk of dementia is slightly higher in people with minimal exposure to benzodiazepines but not with the highest level of exposure. These results do not support a causal association between benzodiazepine use and

  9. The population-based Occupational and Environmental Health Prospective Cohort Study (AMIGO) in the Netherlands

    PubMed Central

    Slottje, Pauline; Yzermans, C Joris; Korevaar, Joke C; Hooiveld, Mariëtte; Vermeulen, Roel C H

    2014-01-01

    Purpose Occupational and environmental exposures remain important modifiable risk factors of public health. Existing cohort studies are often limited by the level of detail of data collected on these factors and health. It is also often assumed that the more healthy group is over-represented in cohort studies, which is of concern for their external validity. In this cohort profile, we describe how we set up the population-based Occupational and Environmental Health Cohort Study (AMIGO) to longitudinally study occupational and environmental determinants of diseases and well-being from a multidisciplinary and life course point of view. Reviewed by the Medical Ethics Research Committee of the University Medical Center Utrecht (protocol 10-268/C). All cohort members participate voluntarily and gave informed consent prior to their inclusion. Participants 14 829 adult cohort members (16% of those invited) consented and filled in the online baseline questionnaire. Determinants include chemical, biological, physical (eg, electromagnetic fields), and psychosocial factors. Priority health outcomes include cancer, neurological, cardiovascular and respiratory diseases and non-specific symptoms. Owing to the recruitment strategy via general practitioners of an established network, we also collect longitudinal data registered in their electronic medical records including symptoms, diagnosis and treatments. Besides the advantage of health outcomes that cannot be easily captured longitudinally by other means, this created a unique opportunity to assess health-related participation bias by comparing general practitioner-registered prevalence rates in the cohort and its source population. Findings to date We found no indications of such a systematic bias. The major assets of the AMIGO approach are its detailed occupational and environmental determinants in combination with the longitudinal health data registered in general practice besides linkage to cancer and mortality

  10. Untreated clinical course of cerebral cavernous malformations: a prospective, population-based cohort study

    PubMed Central

    Salman, Rustam Al-Shahi; Hall, Julie M; Horne, Margaret A; Moultrie, Fiona; Josephson, Colin B; Bhattacharya, Jo J; Counsell, Carl E; Murray, Gordon D; Papanastassiou, Vakis; Ritchie, Vaughn; Roberts, Richard C; Sellar, Robin J; Warlow, Charles P

    2012-01-01

    Summary Background Cerebral cavernous malformations (CCMs) are prone to bleeding but the risk of intracranial haemorrhage and focal neurological deficits, and the factors that might predict their occurrence, are unclear. We aimed to quantify these risks and investigate whether they are affected by sex and CCM location. Methods We undertook a population-based study using multiple overlapping sources of case ascertainment (including a Scotland-wide collaboration of neurologists, neurosurgeons, stroke physicians, radiologists, and pathologists, as well as searches of registers of hospital discharges and death certificates) to identify definite CCM diagnoses first made in Scottish residents between 1999 and 2003, which study neuroradiologists independently validated. We used multiple sources of prospective follow-up both to identify outcome events (which were assessed by use of brain imaging, by investigators masked to potential predictive factors) and to assess adults' dependence. The primary outcome was a composite of intracranial haemorrhage or focal neurological deficits (not including epileptic seizure) that were definitely or possibly related to CCM. Findings 139 adults had at least one definite CCM and 134 were alive at initial presentation. During 1177 person-years of follow-up (completeness 97%), for intracranial haemorrhage alone the 5-year risk of a first haemorrhage was lower than the risk of recurrent haemorrhage (2·4%, 95% CI 0·0–5·7 vs 29·5%, 4·1–55·0; p<0·0001). For the primary outcome, the 5-year risk of a first event was lower than the risk of recurrence (9·3%, 3·1–15·4 vs 42·4%, 26·8–58·0; p<0·0001). The annual risk of recurrence of the primary outcome declined from 19·8% (95% CI 6·1–33·4) in year 1 to 5·0% (0·0–14·8) in year 5 and was higher for women than men (p=0·01) but not for adults with brainstem CCMs versus CCMs in other locations (p=0·17). Interpretation The risk of recurrent intracranial haemorrhage or

  11. Marital status and risk of dementia: a nationwide population-based prospective study from Sweden

    PubMed Central

    Sundström, Anna; Westerlund, Olle; Kotyrlo, Elena

    2016-01-01

    Objectives To examine the association between marital status and dementia in a cohort of young-old (50–64) and middle-old (65–74) adults, and also whether this may differ by gender. Design Prospective population-based study with follow-up time of up to 10 years. Setting Swedish national register-based study. Participants 2 288 489 individuals, aged 50–74 years, without prior dementia diagnosis at baseline. Dementia was identified using the Swedish National Patient Register and the Cause of Death Register. Outcome measures The influence of marital status on dementia was analysed using Cox proportional hazards models, adjusted stepwise for multiple covariates (model 1: adjusted for age and gender; and model 2: additionally adjusted for having adult children, education, income and prior cardiovascular disease). Results During follow-up, 31 572 individuals in the study were identified as demented. Cox regression showed each non-married subcategory to be associated with a significantly higher risk of dementia than the married group, with the highest risk observed among people in the young-old age group, especially among those who were divorced or single (HRs 1.79 vs 1.71, fully adjusted model). Analyses stratified by gender showed gender differences in the young-old group, with indications of divorced men having a higher relative risk compared with divorced women (HRs 2.1 vs 1.7, only-age adjusted model). However, in the fully adjusted model, these differences were attenuated and there was no longer any significant difference between male and female participants. Conclusions Our results suggest that those living alone as non-marrieds may be at risk for early-onset and late-onset dementia. Although more research is needed to understand the underlying mechanism by which marital status is associated with dementia, this suggests that social relationships should be taken seriously as a risk factor for dementia and that social-based interventions may provide

  12. Treatment of community-onset, childhood convulsive status epilepticus: a prospective, population-based study

    PubMed Central

    Chin, Richard FM; Neville, Brian GR; Peckham, Catherine; Wade, Angie; Bedford, Helen; Scott, Rod C

    2008-01-01

    Summary Background Episodes of childhood convulsive status epilepticus (CSE) commonly start in the community. Treatment of CSE aims to minimise the length of seizures, treat the causes, and reduce adverse outcomes; however, there is a paucity of data on the treatment of childhood CSE. We report the findings from a systematic, population-based study on the treatment of community-onset childhood CSE. Methods We collected data prospectively on children in north London, UK, who had episodes of CSE (ascertainment 62–84%). The factors associated with seizure termination after first-line and second-line therapies, episodes of CSE lasting for longer than 60 min, and respiratory depression were analysed with logistic regression. Analysis was per protocol, and adjustment was made for repeat episodes in individuals. Results 182 children of median age 3·24 years (range 0·16–15·98 years) were included in the North London Convulsive Status Epilepticus in Childhood Surveillance Study (NLSTEPSS) between May, 2002, and April, 2004. 61% (147) of 240 episodes were treated prehospital, of which 32 (22%) episodes were terminated. Analysis with multivariable models showed that treatment with intravenous lorazepam (n=107) in the accident and emergency department was associated with a 3·7 times (95% CI 1·7–7·9) greater likelihood of seizure termination than was treatment with rectal diazepam (n=80). Treatment with intravenous phenytoin (n=32) as a second-line therapy was associated with a 9 times (95% CI 3–27) greater likelihood of seizure termination than was treatment with rectal paraldehyde (n=42). No treatment prehospital (odds ratio [OR] 2·4, 95% CI 1·2–4·5) and more than two doses of benzodiazepines (OR 3·6, 1·9–6·7) were associated with episodes that lasted for more than 60 min. Treatment with more than two doses of benzodiazepines was associated with respiratory depression (OR 2·9, 1·4–6·1). Children with intermittent CSE arrived at the accident and

  13. The Prospective and Retrospective Memory Questionnaire: a population-based random sampling study.

    PubMed

    Piauilino, D C; Bueno, O F A; Tufik, S; Bittencourt, L R; Santos-Silva, R; Hachul, H; Gorenstein, C; Pompéia, S

    2010-05-01

    The Prospective and Retrospective Memory Questionnaire (PRMQ) has been shown to have acceptable reliability and factorial, predictive, and concurrent validity. However, the PRMQ has never been administered to a probability sample survey representative of all ages in adulthood, nor have previous studies controlled for factors that are known to influence metamemory, such as affective status. Here, the PRMQ was applied in a survey adopting a probabilistic three-stage cluster sample representative of the population of Sao Paulo, Brazil, according to gender, age (20-80 years), and economic status (n=1042). After excluding participants who had conditions that impair memory (depression, anxiety, used psychotropics, and/or had neurological/psychiatric disorders), in the remaining 664 individuals we (a) used confirmatory factor analyses to test competing models of the latent structure of the PRMQ, and (b) studied effects of gender, age, schooling, and economic status on prospective and retrospective memory complaints. The model with the best fit confirmed the same tripartite structure (general memory factor and two orthogonal prospective and retrospective memory factors) previously reported. Women complained more of general memory slips, especially those in the first 5 years after menopause, and there were more complaints of prospective than retrospective memory, except in participants with lower family income. PMID:20408038

  14. Population-Based Prospective Study of Cigarette Smoking and Risk of Incident Essential Tremor

    PubMed Central

    Louis, Elan D.; Benito-León, Julián; Bermejo-Pareja, Félix

    2009-01-01

    BACKGROUND Smoking cigarettes is associated with lower risk of Parkinson’s disease (PD). Despite the clinical links between PD and essential tremor (ET), there are few data on smoking in ET. One study showed an association between smoking and lower ET prevalence. We now study whether baseline smoking is associated with lower risk of incident ET. METHODS Using a population-based, cohort design, baseline cigarette smoking habits were assessed in 3,348 participants in an epidemiological study in Spain, among whom 77 developed incident ET. RESULTS There were 3,348 participants, among whom 397 (11.9%) were smokers at baseline. Five (6.5%) of 77 incident ET cases had been smokers at baseline compared with 392 (12.0%) of 3,271 controls (p = 0.14). Baseline pack-years were lower in incident ET cases than controls (9.2 ± 17.7 vs. 15.7 ± 28.4, p = 0.002). Participants were stratified into baseline pack-year tertiles and few incident ET cases were in the highest tertile (4 [5.2%] cases vs. 431 [13.2%] controls, p = 0.039). In Cox Proportional Hazards Models, highest baseline pack-year tertile was associated with lower risk of incident ET; those in the highest pack-year tertile were one-third as likely to develop ET when compared to non-smokers (RR = 0.37, 95% CI = 0.14–1.03, p = 0.057 [unadjusted model] and RR = 0.29, 95% CI = 0.09–0.90, p = 0.03 [adjusted model]). CONCLUSIONS We demonstrated an association between baseline heavy cigarette smoking and lower risk of incident ET. The biological basis for this association requires future investigation. PMID:18458228

  15. Predictors of ovarian cancer survival: a population-based prospective study in Sweden.

    PubMed

    Yang, Ling; Klint, Asa; Lambe, Mats; Bellocco, Rino; Riman, Tomas; Bergfeldt, Kjell; Persson, Ingemar; Weiderpass, Elisabete

    2008-08-01

    Ovarian cancer is the leading cause of death from gynecologic malignancies among women worldwide. Little is known about reproductive factors or lifestyle determinants and ovarian cancer prognosis. The objective of this study was to examine whether ovarian cancer survival is influenced by reproductive history, anthropometric characteristics, prediagnostic life-style factors and family history of breast or ovarian cancer. The study population consisted of 635 epithelial ovarian cancer (EOC) cases derived from a nationwide population-based case-control study conducted in Sweden between 1993 and 1995. Exposure data on prediagnostic factors of interest were collected through questionnaires at the beginning of the parent study. Clinical data were abstracted from medical records. Cases were followed-up by means of record linkage to nationwide registers until December 31, 2002. Cox proportional hazard regression model was used to estimate the prognostic effect of each factor in terms of hazard ratios (HR) and 95% confidence intervals (CI), following adjustment for age at diagnosis, FIGO tumor stage and WHO grade of tumor differentiation. Tumor characteristics significantly influenced the risk of death from EOC. After adjustment for these, no clear associations were detected between reproductive history (parity, age at first or last birth, oral contraceptive use, age at menarche or menopause), anthropometric characteristics (body size and shape in different periods of life), lifestyle factors before diagnosis (alcohol consumption, smoking and physical activity over lifetime), nor family history of breast cancer or ovarian cancer and EOC survival. Our findings indicate that these prediagnostic factors do not influence the EOC survival. Nevertheless, among women with early stage disease (FIGO stage I and II), there was some indication that overweight in young adulthood or recent years increased the risk of death, while physical activity in young adult life appeared to reduce

  16. Etiology of Childhood Diarrhea Following Rotavirus Vaccine Introduction: A Prospective, Population-Based Study in Nicaragua

    PubMed Central

    Becker-Dreps, Sylvia; Bucardo, Filemon; Vilchez, Samuel; Zambrana, Luis Enrique; Liu, Lan; Weber, David J.; Peña, Rodolfo; Barclay, Leslie; Vinjé, Jan; Hudgens, Michael G.; Nordgren, Johan; Svensson, Lennart; Morgan, Douglas R.; Espinoza, Félix; Paniagua, Margarita

    2014-01-01

    Background Nicaragua was the first developing nation to implement routine immunization with the pentavalent rotavirus vaccine (RV5). In this RV5-immunized population, understanding infectious etiologies of childhood diarrhea is necessary to direct diarrhea treatment and prevention efforts. Methods We followed a population-based sample of children less than 5 years in León, Nicaragua for diarrhea episodes through household visits. Information was obtained on RV5 history and sociodemographics. Stool samples collected during diarrhea episodes and among healthy children underwent laboratory analysis for viral, bacterial, and parasitic enteropathogens. Detection frequency and incidence of each enteropathogen was calculated. Results The 826 children in the cohort experienced 677 diarrhea episodes during 607.5 child-years of exposure time (1.1 episodes per child-year). At least one enteropathogen was detected among 61.1% of the 337 diarrheal stools collected. The most common enteropathogens among diarrheal stools were: norovirus (20.4%), sapovirus (16.6%), enteropathogenic Escherichia coli (EPEC, 11.3%), Entamoeba histolytica/dispar (8.3%), Giardia lamblia (8.0%), and enterotoxigenic E.coli (ETEC, 7.7%), with rotavirus detected among 5.3% of diarrheal stools. EPEC and ETEC were frequently detected among stools from healthy children. Among children with diarrhea, norovirus was more commonly detected among younger children (< 2 years) and G. lamblia was more commonly detected among older children (2-4 years). The mean age of rotavirus detection was 34.6 months. Conclusions In this Central American community following RV5 introduction, rotavirus was not commonly detected among children with diarrhea. Prevention and appropriate management of norovirus and sapovirus should be considered to further reduce the burden of diarrheal disease. PMID:24879131

  17. Antihypertensive Agents and Risk of Parkinson's Disease, Essential Tremor and Dementia: A Population-Based Prospective Study (NEDICES)

    PubMed Central

    Louis, Elan D.; Benito-León, Julián; Bermejo-Pareja, Félix

    2009-01-01

    Background Recent interest in antihypertensive agents, especially calcium channel blockers, has been sparked by the notion that these medications may be neuroprotective. A modest literature, with mixed results, has examined whether these medications might lower the odds or risk of Parkinson's disease (PD) or dementia. There are no data for essential tremor (ET). Objective To examine the association between antihypertensive use (defined broadly and by individual subclasses) and ET, PD and dementia. For each disorder, we used cross-sectional data (association with prevalent disease) and prospective data (association with incident disease). Methods Prospective population-based study in Spain enrolling 5,278 participants at baseline. Results Use of antihypertensive medications (aside from β-blockers) was similar in prevalent ET cases and controls. Baseline use of antihypertensive agents was not associated with reduced risk of incident ET. Antihypertensive medication use was not associated with prevalent or incident PD. Calcium channel blocker use was marginally reduced in prevalent dementia cases (ORadjusted = 0.63, p = 0.06) but was not associated with reduced risk of incident dementia (RRadjusted = 1.02, p = 0.95). Conclusions We did not find evidence of a protective effect of antihypertensive medications in these three neurodegenerative disorders. PMID:19696520

  18. Metabolite Profiling and Cardiovascular Event Risk: A Prospective Study of Three Population-Based Cohorts

    PubMed Central

    Würtz, Peter; Havulinna, Aki S; Soininen, Pasi; Tynkkynen, Tuulia; Prieto-Merino, David; Tillin, Therese; Ghorbani, Anahita; Artati, Anna; Wang, Qin; Tiainen, Mika; Kangas, Antti J; Kettunen, Johannes; Kaikkonen, Jari; Mikkilä, Vera; Jula, Antti; Kähönen, Mika; Lehtimäki, Terho; Lawlor, Debbie A; Gaunt, Tom R; Hughes, Alun D; Sattar, Naveed; Illig, Thomas; Adamski, Jerzy; Wang, Thomas J; Perola, Markus; Ripatti, Samuli; Vasan, Ramachandran S; Raitakari, Olli T; Gerszten, Robert E; Casas, Juan-Pablo; Chaturvedi, Nish; Ala-Korpela, Mika; Salomaa, Veikko

    2015-01-01

    Background High-throughput profiling of circulating metabolites may improve cardiovascular risk prediction over established risk factors. Methods and Results We applied quantitative NMR metabolomics to identify biomarkers for incident cardiovascular disease during long-term follow-up. Biomarker discovery was conducted in the FINRISK study (n=7256; 800 events). Replication and incremental risk prediction was assessed in the SABRE study (n=2622; 573 events) and British Women’s Health and Heart Study (n=3563; 368 events). In targeted analyses of 68 lipids and metabolites, 33 measures were associated with incident cardiovascular events at P<0.0007 after adjusting for age, sex, blood pressure, smoking, diabetes and medication. When further adjusting for routine lipids, four metabolites were associated with future cardiovascular events in meta-analyses: higher serum phenylalanine (hazard ratio per standard deviation: 1.18 [95%CI 1.12–1.24]; P=4×10−10) and monounsaturated fatty acid levels (1.17 [1.11–1.24]; P=1×10−8) were associated with increased cardiovascular risk, while higher omega-6 fatty acids (0.89 [0.84–0.94]; P=6×10−5) and docosahexaenoic acid levels (0.90 [0.86–0.95]; P=5×10−5) were associated with lower risk. A risk score incorporating these four biomarkers was derived in FINRISK. Risk prediction estimates were more accurate in the two validation cohorts (relative integrated discrimination improvement 8.8% and 4.3%), albeit discrimination was not enhanced. Risk classification was particularly improved for persons in the 5–10% risk range (net reclassification 27.1% and 15.5%). Biomarker associations were further corroborated with mass spectrometry in FINRISK (n=671) and the Framingham Offspring Study (n=2289). Conclusions Metabolite profiling in large prospective cohorts identified phenylalanine, monounsaturated and polyunsaturated fatty acids as biomarkers for cardiovascular risk. This study substantiates the value of high

  19. Consuming More of Daily Caloric Intake at Dinner Predisposes to Obesity. A 6-Year Population-Based Prospective Cohort Study

    PubMed Central

    Bo, Simona; Musso, Giovanni; Beccuti, Guglielmo; Fadda, Maurizio; Fedele, Debora; Gambino, Roberto; Gentile, Luigi; Durazzo, Marilena; Ghigo, Ezio; Cassader, Maurizio

    2014-01-01

    Background/Objectives It has been hypothesized that assuming most of the caloric intake later in the day leads to metabolic disadvantages, but few studies are available on this topic. Aim of our study was to prospectively examine whether eating more of the daily caloric intake at dinner leads to an increased risk of obesity, hyperglycemia, metabolic syndrome, and non-alcoholic fatty liver disease (NAFLD). Subjects/Methods 1245 non-obese, non-diabetic middle-aged adults from a population-based cohort underwent a 3-day food record questionnaire at enrollment. Anthropometric values, blood pressure, blood metabolic variables, and estimated liver fat were measured at baseline and at 6-year follow-up. Design Prospective cohort study. Results Subjects were divided according to tertiles of percent daily caloric intake at dinner. A significant increase in the incidence rate of obesity (from 4.7 to 11.4%), metabolic syndrome (from 11.1 to 16.1%), and estimated NAFLD (from 16.5 to 23.8%) was observed from the lower to higher tertile. In a multiple logistic regression model adjusted for multiple covariates, subjects in the highest tertile showed an increased risk of developing obesity (OR = 2.33; 95% CI 1.17–4.65; p = 0.02), metabolic syndrome (OR = 1.52; 95% CI 1.01–2.30; p = 0.04), and NAFLD (OR = 1.56; 95% CI 1.10–2.22; p = 0.01). Conclusions Consuming more of the daily energy intake at dinner is associated with an increased risk of obesity, metabolic syndrome, and NAFLD. PMID:25250617

  20. Physical fitness as a protective factor for cognitive impairment in a prospective population-based study in Germany.

    PubMed

    Sattler, Christine; Erickson, Kirk I; Toro, Pablo; Schröder, Johannes

    2011-01-01

    To evaluate the predictive effects of subjective measures of physical activity (PA) and objective measures of physical fitness (PF) on dementia risk, Participants of the prospective population-based ILSE-study (*1930-1932; 12-year follow-up) were examined at three examination waves (t1 : 1993/94; t2 : 1997/98; t3 : 2005/07). 381 subjects of the original cohort (n = 500) were re-examined at t3. 29% of the subjects who were cognitively healthy at baseline received the diagnosis of mild cognitive impairment (MCI) and 7% of Alzheimer's disease (AD). Subjects were screened for physical and mental health using medical interviews, physical, and neuropsychological examinations. Participants completed a questionnaire on their current and past PA at t1. Subjects were classified as physically active if they reported a regular sport activity for at least 2 hours per week in the past year. Muscular strength (handgrip) and motor coordination (balance) served as objective indicators of PF. Subjects who passed the balance-test at t1 had a reduced risk of developing MCI/AD at t3 (OR = 0.35, 95%CI 0.19-0.66, p < 0.01) and performed significantly better on various neuropsychological measures. Muscular strength or subjective reports of PA did not predict MCI/AD development. Our results confirm the hypothesis that PF acts as a protective factor for the development of cognitive disorders. In our study, context, motor coordination served as a better predictor than muscular strength or self-rated PA. Since subjects with cognitive disorders due to cerebral and/or systemic disorders were excluded from the analyses, our findings suggest that the effect of skill-related PF extends beyond the reduction of cardiovascular risk factors. PMID:21694450

  1. Risk factors for Clostridium difficile toxin-positive diarrhea: a population-based prospective case-control study.

    PubMed

    Vesteinsdottir, I; Gudlaugsdottir, S; Einarsdottir, R; Kalaitzakis, E; Sigurdardottir, O; Bjornsson, E S

    2012-10-01

    Increased incidence and severity of Clostridium difficile infections (CDIs) is of major concern. However, by minimizing known risk factors, the incidence can be decreased. The aim of this investigation was to calculate the incidence and assess risk factors for CDI in our population. A 1-year prospective population-based nationwide study in Iceland of CDIs was carried out. For risk factor evaluation, each case was matched with two age- and sex-matched controls that tested negative for C. difficile toxin. A total of 128 CDIs were identified. The crude incidence was 54 cases annually per 100,000 population >18 years of age. Incidence increased exponentially with older age (319 per 100,000 population >86 years of age). Community-acquired origin was 27 %. Independent risk factors included: dicloxacillin (odds ratio [OR]: 7.55, 95 % confidence interval [CI]: 1.89-30.1), clindamycin (OR: 6.09, 95 % CI: 2.23-16.61), ceftriaxone (OR: 4.28, 95 % CI: 1.59-11.49), living in a retirement home (OR: 3.9, 95 % CI: 1.69-9.16), recent hospital stay (OR: 2.3, 95 % CI: 1.37-3.87). Proton pump inhibitors (PPIs) were used by 60/111 (54 %) versus 91/222 (41 %) (p = 0.026) and ciprofloxacin 19/111 (17 %) versus 19/222 (9 %) (p = 0.027) for cases and controls, respectively. In all, 75 % of primary CDIs treated with metronidazole recovered from one course of treatment. CDI was mostly found among elderly patients. The most commonly identified risk factors were broad-spectrum antibiotics and recent contact with health care institutions. PPI use was significantly more prevalent among CDI patients. PMID:22441775

  2. Late Mortality During the First Year After Acute Traumatic Spinal Cord Injury: A Prospective, Population-Based Study

    PubMed Central

    Divanoglou, Anestis; Westgren, Ninni; Seiger, Åke; Hulting, Claes; Levi, Richard

    2010-01-01

    Background: Little is known about the possible impact of the system of care on mortality during the first year after acute traumatic spinal cord injury (TSCI). Objective: To evaluate late mortality (ie, >7 days after trauma) during the first year after acute TSCI in 2 European Union (EU) regions, Thessaloniki in Greece and Stockholm in Sweden. Methods: This paper is part of the Stockholm Thessaloniki Acute Traumatic Spinal Cord Injury Study (STATSCIS), which is a prospective, population-based study. Incidence cohorts of TSCI cases were identified and followed up in both study regions through STATSCIS. Data from Thessaloniki region were collected through physical examination, medical records review, and interviews with TSCI individuals and the medical teams. Data from Stockholm were retrieved mainly from the Nordic Spinal Cord Injury Registry, as well as from direct contact with all intensive care facilities of the region. Results: The annual case mortality rate after acute TSCI was nearly 20% in Thessaloniki and 0% in Stockholm. The mean time of survival after trauma for the 12 mortality cases of Thessaloniki was 47 days (median  =  24, SD ± 67, range  =  8–228). Factors associated with mortality were higher age and presence of comorbid spinal disorders but also the inefficient transfer logistics, initially missed spinal instability, and unsuccessfully treated complications. Conclusions: The annual case mortality rate in Thessaloniki was dramatically higher than in Stockholm. The different approaches to care, one systematic and the other not, is postulated to be an important factor leading to such major discrepancies between the outcomes of these 2 EU regions. PMID:20486530

  3. The risk-stratified osteoporosis strategy evaluation study (ROSE): a randomized prospective population-based study. Design and baseline characteristics.

    PubMed

    Rubin, Katrine Hass; Holmberg, Teresa; Rothmann, Mette Juel; Høiberg, Mikkel; Barkmann, Reinhard; Gram, Jeppe; Hermann, Anne Pernille; Bech, Mickael; Rasmussen, Ole; Glüer, Claus C; Brixen, Kim

    2015-02-01

    The risk-stratified osteoporosis strategy evaluation study (ROSE) is a randomized prospective population-based study investigating the effectiveness of a two-step screening program for osteoporosis in women. This paper reports the study design and baseline characteristics of the study population. 35,000 women aged 65-80 years were selected at random from the population in the Region of Southern Denmark and-before inclusion-randomized to either a screening group or a control group. As first step, a self-administered questionnaire regarding risk factors for osteoporosis based on FRAX(®) was issued to both groups. As second step, subjects in the screening group with a 10-year probability of major osteoporotic fractures ≥15% were offered a DXA scan. Patients diagnosed with osteoporosis from the DXA scan were advised to see their GP and discuss pharmaceutical treatment according to Danish National guidelines. The primary outcome is incident clinical fractures as evaluated through annual follow-up using the Danish National Patient Registry. The secondary outcomes are cost-effectiveness, participation rate, and patient preferences. 20,904 (60%) women participated and included in the baseline analyses (10,411 in screening and 10,949 in control group). The mean age was 71 years. As expected by randomization, the screening and control groups had similar baseline characteristics. Screening for osteoporosis is at present not evidence based according to the WHO screening criteria. The ROSE study is expected to provide knowledge of the effectiveness of a screening strategy that may be implemented in health care systems to prevent fractures. PMID:25578146

  4. Prevalence and risk factors for anaemia in pregnant women: a population-based prospective cohort study in China.

    PubMed

    Zhang, Qiaoyi; Li, Zhu; Ananth, Cande V

    2009-07-01

    Maternal anaemia is a common pregnancy complication in developing countries; however, its epidemiology remains largely unexplored in China. This study was designed to explore the epidemiology and risk factors of anaemia during pregnancy. A prospective cohort study was conducted, using data from a population-based pregnancy-monitoring system in 13 counties in East China (1993-96). Women who delivered singleton infants at 20-44 weeks with at least one haemoglobin assessment during pregnancy were included (n = 164 667). The prevalence of anaemia (haemoglobin < 10 g/dL) during pregnancy as well as in each trimester was estimated. Multivariable log-binomial regression models were used to evaluate risk factors. The overall prevalence of anaemia in pregnancy was 32.6%, with substantial variations across trimesters (11.2%, 20.1% and 26.2% in the 1st, 2nd and 3rd trimesters respectively). Risk factors for anaemia included older maternal age, education below junior high school (prevalence rate ratio [RR] 1.10, 95% confidence interval [CI] 1.08, 1.12), farming occupation (1.05, 95% CI 1.03, 1.06), and mild pregnancy-induced hypertension (PIH) (RR 1.09, 95% CI 1.05, 1.13) and severe PIH (RR 1.13, 95% CI 1.06, 1.19). Peri-conception folic acid use was associated with a reduced risk for anaemia in the 1st trimester (RR 0.75, 95% CI 0.72, 0.78). Initiating prenatal care after the 1st trimester was associated with increased risk of anaemia in the 2nd and 3rd trimesters. Our study found anaemia during pregnancy is highly prevalent in this indigenous Chinese population. The risk increases with the severity of hypertensive disorders. Folic acid supplementation during the peri-conception period is associated with reduced risk of 1st trimester anaemia. PMID:19523075

  5. The BELFRAIL (BFC80+) study: a population-based prospective cohort study of the very elderly in Belgium

    PubMed Central

    2010-01-01

    Background In coming decades the proportion of very elderly people living in the Western world will dramatically increase. This forthcoming "grey epidemic" will lead to an explosion of chronic diseases. In order to anticipate booming health care expenditures and to assure that social security is funded in the future, research focusing on the relationship between chronic diseases, frailty and disability is needed. The general aim of the BELFRAIL cohort study (BFC80+) is to study the dynamic interaction between health, frailty and disability in a multi-system approach focusing on cardiac dysfunction and chronic heart failure, lung function, sarcopenia, renal insufficiency and immunosenescence. Methods/Design The BFC80+ is a prospective, observational, population-based cohort study of subjects aged 80 years and older in three well-circumscribed areas of Belgium. In total, 29 general practitioner (GP) centres were asked to include patients aged 80 and older. Only three exclusion criteria were used: severe dementia, in palliative care and medical emergency. Two sampling methods for the recruitment of patients were used. Between November 2, 2008 and September 15, 2009, 567 subjects were included in the BFC80+ study. Every study participant was invited to undergo four study visits. The GP recorded background variables and medical history and performed a detailed anamnesis and clinical examination. The clinical research assistant performed an extensive examination including performance testing, questionnaires and technical examinations. Echocardiography was performed at home by a cardiologist. A blood sample was collected in the morning. Follow-up reporting of hard outcome measures including mortality, hospitalization and morbidity was organized. A second data collection is planned after 18 months. Discussion The BFC80+ was designed to acquire a better understanding of the epidemiology and pathophysiology of chronic diseases in the very elderly and to study the dynamic

  6. Validating prediction scales of type 2 diabetes mellitus in Spain: the SPREDIA-2 population-based prospective cohort study protocol

    PubMed Central

    Salinero-Fort, Miguel Ángel; de Burgos-Lunar, Carmen; Mostaza Prieto, José; Lahoz Rallo, Carlos; Abánades-Herranz, Juan Carlos; Gómez-Campelo, Paloma; Laguna Cuesta, Fernando; Estirado De Cabo, Eva; García Iglesias, Francisca; González Alegre, Teresa; Fernández Puntero, Belén; Montesano Sánchez, Luis; Vicent López, David; Cornejo Del Río, Víctor; Fernández García, Pedro J; Sabín Rodríguez, Concesa; López López, Silvia; Patrón Barandío, Pedro

    2015-01-01

    Introduction The incidence of type 2 diabetes mellitus (T2DM) is increasing worldwide. When diagnosed, many patients already have organ damage or advance subclinical atherosclerosis. An early diagnosis could allow the implementation of lifestyle changes and treatment options aimed at delaying the progression of the disease and to avoid cardiovascular complications. Different scores for identifying undiagnosed diabetes have been reported, however, their performance in populations of southern Europe has not been sufficiently evaluated. The main objectives of our study are: to evaluate the screening performance and cut-off points of the main scores that identify the risk of undiagnosed T2DM and prediabetes in a Spanish population, and to develop and validate our own predictive models of undiagnosed T2DM (screening model), and future T2DM (prediction risk model) after 5-year follow-up. As a secondary objective, we will evaluate the atherosclerotic burden of the population with undiagnosed T2DM. Methods and analysis Population-based prospective cohort study with baseline screening, to evaluate the performance of the FINDRISC, DANISH, DESIR, ARIC and QDScore, against the gold standard tests: Fasting plasma glucose, oral glucose tolerance and/or HbA1c. The sample size will include 1352 participants between the ages of 45 and 74 years. Analysis: sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio positive, likelihood ratio negative and receiver operating characteristic curves and area under curve. Binary logistic regression for the first 700 individuals (derivation) and last 652 (validation) will be performed. All analyses will be calculated with their 95% CI; statistical significance will be p<0.05. Ethics and dissemination The study protocol has been approved by the Research Ethics Committee of the Carlos III Hospital (Madrid). The score performance and predictive model will be presented in medical conferences, workshops

  7. Disability pension due to common mental disorders and subsequent suicidal behaviour: a population-based prospective cohort study

    PubMed Central

    Rahman, Syed Ghulam; Alexanderson, Kristina; Jokinen, Jussi; Mittendorfer-Rutz, Ellenor

    2016-01-01

    Objective Adverse health outcomes, including suicide, in individuals on disability pension (DP) due to mental diagnoses have been reported. However, scientific knowledge on possible risk factors for suicidal behaviour (suicide attempt and suicide) in this group, such as age, gender, underlying DP diagnoses, comorbidity and DP duration and grade, is surprisingly sparse. This study aimed to investigate associations of different measures (main and secondary diagnoses, duration and grade) of DP due to common mental disorders (CMD) with subsequent suicidal behaviour, considering gender and age differences. Design Population-based prospective cohort study based on Swedish nationwide registers. Methods A cohort of 46 515 individuals aged 19–64 years on DP due to CMD throughout 2005 was followed-up for 5 years. In relation to different measures of DP, univariate and multivariate HRs and 95% CIs for suicidal behaviour were estimated by Cox regression. All analyses were stratified by gender and age. Results During 2006–2010, 1036 (2.2%) individuals attempted and 207 (0.5%) completed suicide. Multivariate analyses showed that a main DP diagnosis of ‘stress-related mental disorders’ was associated with a lower risk of subsequent suicidal behaviour than ‘depressive disorders’ (HR range 0.4–0.7). Substance abuse or personality disorders as a secondary DP diagnosis predicted suicide attempt in all subgroups (HR range 1.4–2.3) and suicide in women and younger individuals (HR range 2.6–3.3). Full-time DP was associated with a higher risk of suicide attempt compared with part-time DP in women and both age groups (HR range 1.4–1.7). Conclusions Depressive disorders as the main DP diagnosis and substance abuse or personality disorders as the secondary DP diagnosis were risk markers for subsequent suicidal behaviour in individuals on DP due to CMD. Particular attention should be paid to younger individuals on DP due to anxiety disorders because of the higher

  8. Risk of Adverse Pregnancy Outcomes among Women Practicing Poor Sanitation in Rural India: A Population-Based Prospective Cohort Study

    PubMed Central

    Padhi, Bijaya K.; Baker, Kelly K.; Dutta, Ambarish; Cumming, Oliver; Freeman, Matthew C.; Satpathy, Radhanatha; Das, Bhabani S.; Panigrahi, Pinaki

    2015-01-01

    Background The importance of maternal sanitation behaviour during pregnancy for birth outcomes remains unclear. Poor sanitation practices can promote infection and induce stress during pregnancy and may contribute to adverse pregnancy outcomes (APOs). We aimed to assess whether poor sanitation practices were associated with increased risk of APOs such as preterm birth and low birth weight in a population-based study in rural India. Methods and Findings A prospective cohort of pregnant women (n = 670) in their first trimester of pregnancy was enrolled and followed until birth. Socio-demographic, clinical, and anthropometric factors, along with access to toilets and sanitation practices, were recorded at enrolment (12th week of gestation). A trained community health volunteer conducted home visits to ensure retention in the study and learn about study outcomes during the course of pregnancy. Unadjusted odds ratios (ORs) and adjusted odds ratios (AORs) and 95% confidence intervals for APOs were estimated by logistic regression models. Of the 667 women who were retained at the end of the study, 58.2% practiced open defecation and 25.7% experienced APOs, including 130 (19.4%) preterm births, 95 (14.2%) births with low birth weight, 11 (1.7%) spontaneous abortions, and six (0.9%) stillbirths. Unadjusted ORs for APOs (OR: 2.53; 95% CI: 1.72–3.71), preterm birth (OR: 2.36; 95% CI: 1.54–3.62), and low birth weight (OR: 2.00; 95% CI: 1.24–3.23) were found to be significantly associated with open defecation practices. After adjustment for potential confounders such as maternal socio-demographic and clinical factors, open defecation was still significantly associated with increased odds of APOs (AOR: 2.38; 95% CI: 1.49–3.80) and preterm birth (AOR: 2.22; 95% CI: 1.29–3.79) but not low birth weight (AOR: 1.61; 95% CI: 0.94–2.73). The association between APOs and open defecation was independent of poverty and caste. Even though we accounted for several key

  9. A Population-based Prospective Birth Cohort Study of Childhood Neurocognitive and Psychological Functioning in Healthy Survivors of Early-life Meningitis

    PubMed Central

    Khandaker, Golam M.; Stochl, Jan; Zammit, Stanley; Lewis, Glyn; Jones, Peter B.

    2015-01-01

    PURPOSE To determine neurocognitive, educational and psychological functioning during childhood and early-adolescence among survivors of early-life meningitis who are apparently healthy. METHODS In the general population-based Avon Longitudinal Study of Parents and Children birth cohort, meningitis exposure was determined at age 18 months. The outcomes of IQ, short-term memory, working memory, reading and spelling abilities, psychological and behavioural problems, depressive and anxiety symptoms, and psychotic experiences at ages 9 to 13 years were compared between those exposed and unexposed to meningitis. Individuals with special educational needs were excluded. RESULTS By age 18 months, 67 out of 11,035 children were reported to have suffered from meningitis (0.61%). These children, compared with the unexposed, performed worse on all neurocognitive and educational measures; mean difference in total IQ 7.36 (95% CI 1.60-13.11). Meningitis was associated with higher depressive and anxiety symptoms (p=0.02), psychological and behavioural problems (p=0.09), and increased risk of psychotic experiences; risk ratio 2.22 (95% CI 1.12-4.38). CONCLUSIONS Exposure to meningitis in the early-life is associated with neurocognitive, educational and psychological difficulties during childhood and early-adolescence among survivors who are apparently healthy. Therefore, focusing only on serious neurologic disabilities may underestimate the true impact of early-life meningitis. PMID:25794764

  10. Low morale is associated with increased risk of mortality in the elderly: a population-based prospective study (NEDICES)

    PubMed Central

    Benito-León, Julián; Louis, Elan D.; Rivera-Navarro, Jesús; Medrano, María José; Vega, Saturio; Bermejo-Pareja, Félix

    2010-01-01

    Objective: the study aimed to assess the association between morale and mortality. Design: we used data from the Neurological Disorders in Central Spain (NEDICES), a population-based study. Subjects: 2,516 older persons (mean age 75.7 years) participated in the study. Methods: Cox models were used to estimate risk of mortality. Morale was assessed using the Philadelphia Geriatric Center Morale Scale. Results: 489 (21.8%) participants died over a median follow-up of 5.9 years (range 0.1–7.7 years), including 253 (21.8%) deaths among 1,163 participants with low morale scores, 168 (19.3%) among 870 participants with moderate scores and 68 (14.1%) among participants with high scores. In an unadjusted Cox model, relative risk (RR) of mortality in participants with low morale scores = 1.69 (P < 0.001) and RR in participants with moderate scores = 1.47 (P < 0.01) were compared to the reference group (participants with high scores). In a Cox model that adjusted for a variety of demographic factors and co-morbidities, RR of mortality in participants with low morale scores = 1.35 (P <0.05) and moderate scores = 1.16 (not significant) were compared to the reference group. Conclusion: low morale may be an independent predictor of mortality in the elderly. By assessing morale, practitioners might be better positioned to identify patients with poorer prognoses. PMID:20299322

  11. Prospective population-based study of the association between vitamin D status and incidence of autoimmune disease.

    PubMed

    Skaaby, Tea; Husemoen, Lise Lotte Nystrup; Thuesen, Betina Heinsbæk; Linneberg, Allan

    2015-09-01

    Beside its traditional role in skeletal health, vitamin D is believed to have multiple immunosuppressant properties, and low vitamin D status has been suggested to be a risk factor in the development of autoimmune disease. We investigated the association between vitamin D status and development of autoimmune disease. We included a total of 12,555 individuals from three population-based studies with measurements of vitamin D status (25-hydroxy vitamin D). We followed the participants by linkage to the Danish National Patient Register (median follow-up time 10.8 years). Relative risks of autoimmune disease were estimated by Cox regression and expressed as hazard ratios, HRs (95 % confidence intervals CIs). There were 525 cases of incident autoimmune disease. The risk for a 10 nmol/l higher vitamin D was: for any autoimmune disease (HR = 0.94 % CI 0.90, 0.98); thyrotoxicosis (HR = 0.83, 95 % CI 0.72, 0.96); type 1 diabetes (HR = 0.95, 95 % CI 0.88, 1.02), multiple sclerosis (HR = 0.89, 95 % CI 0.74, 1.07), iridocyclitis (HR = 1.00, 95 % CI 0.86, 1.17); Crohn's disease (HR = 0.95, 95 % CI 0.80, 1.13), ulcerative colitis (HR = 0.88, 95 % CI 0.75, 1.04); psoriasis vulgaris (HR = 0.99, 95 % CI 0.86, 1.13); seropositive rheumatoid arthritis (HR = 0.97, 95 % CI 0.89, 1.07), and polymyalgia rheumatica (HR = 0.94, 95 % CI 0.83, 1.06). We found statistically significant inverse associations between vitamin D status and development of any autoimmune disease and thyrotoxicosis in particular. Our findings suggest a possible protective role of a higher vitamin D status on autoimmune disease but warrant further studies to clarify causality. PMID:25666936

  12. The Association Between Perceived Stress and Mortality Among People With Multimorbidity: A Prospective Population-Based Cohort Study.

    PubMed

    Prior, Anders; Fenger-Grøn, Morten; Larsen, Karen Kjær; Larsen, Finn Breinholt; Robinson, Kirstine Magtengaard; Nielsen, Marie Germund; Christensen, Kaj Sparle; Mercer, Stewart W; Vestergaard, Mogens

    2016-08-01

    Multimorbidity is common and is associated with poor mental health and high mortality. Nevertheless, no studies have evaluated whether mental health may affect the survival of people with multimorbidity. We investigated the association between perceived stress and mortality in people with multimorbidity by following a population-based cohort of 118,410 participants from the Danish National Health Survey 2010 for up to 4 years. Information on perceived stress and lifestyle was obtained from the survey. We assessed multimorbidity using nationwide register data on 39 conditions and identified 4,229 deaths for the 453,648 person-years at risk. Mortality rates rose with increasing levels of stress in a dose-response relationship (P-trend < 0.0001), independently of multimorbidity status. Mortality hazard ratios (highest stress quintile vs. lowest) were 1.51 (95% confidence interval (CI): 1.25, 1.84) among persons without multimorbidity, 1.39 (95% CI: 1.18, 1.64) among those with 2 or 3 conditions, and 1.43 (95% CI: 1.18, 1.73) among those with 4 or more conditions, when adjusted for disease severities, lifestyle, and socioeconomic status. The numbers of excess deaths associated with high stress were 69 among persons without multimorbidity, 128 among those with 2 or 3 conditions, and 255 among those with 4 or more conditions. Our findings suggested that perceived stress contributes significantly to higher mortality rates in a dose-response pattern, and more stress-associated deaths occurred in people with multimorbidity. PMID:27407085

  13. Gender differences in the prodromal signs of dementia: memory complaint and IADL-restriction. a prospective population-based cohort.

    PubMed

    Pérès, Karine; Helmer, Catherine; Amieva, Hélène; Matharan, Fanny; Carcaillon, Laure; Jacqmin-Gadda, Hélène; Auriacombe, Sophie; Orgogozo, Jean-Marc; Barberger-Gateau, Pascale; Dartigues, Jean-François

    2011-01-01

    Subjective memory complaint (SMC) and restriction in cognitively-complex activities of daily living (such as instrumental ADL) are two early symptoms observed in the prodromal phase of dementia and may represent useful alarm signals for general practitioners for an increased risk of subsequent dementia. We here studied in a large population-based epidemiological cohort on aging, the risk of dementia associated with SMC and restriction in IADL, with a specific interest in a potential interaction by gender. The sample included 2,901 subjects, aged 65 years and over, initially free of dementia and followed over 15 years. After controlling for education, marital status, depressive symptomatology, and global cognition (MMSE), IADL-restriction was associated with an increased risk of dementia only in men (HR = 2.04, 1.27 to 3.29), whereas SMC was not (p = 0.95). The reverse was observed in females, in whom SMC almost doubled the risk of dementia (1.48 to 2.41), with no association with IADL-restriction (p = 0.74). Finally, we distinguished the risk of dementia at short-term (in the first 5 years), mid-term (between 5 and 10 years), and long-term (between 10 and 15 years). In women, SMC was significantly associated with greater risk of dementia whatever the risk period considered, even at longer term (HR = 1.61, p = 0.0216), whereas in men the increased risk was also observed with IADL-restriction and only in the first 5 years. To conclude, women would report the first symptoms very early in the process by SMC, whereas men would tend to later report their difficulties and only in terms of IADL-restriction. PMID:21725162

  14. Current asthma contributes as much as smoking to chronic bronchitis in middle age: a prospective population-based study

    PubMed Central

    Dharmage, Shyamali C; Perret, Jennifer L; Burgess, John A; Lodge, Caroline J; Johns, David P; Thomas, Paul S; Giles, Graham G; Hopper, John L; Abramson, Michael J; Walters, E Haydn; Matheson, Melanie C

    2016-01-01

    Background and objective Personal smoking is widely regarded to be the primary cause of chronic bronchitis (CB) in adults, but with limited knowledge of contributions by other factors, including current asthma. We aimed to estimate the independent and relative contributions to adult CB from other potential influences spanning childhood to middle age. Methods The population-based Tasmanian Longitudinal Health Study cohort, people born in 1961, completed respiratory questionnaires and spirometry in 1968 (n=8,583). Thirty-seven years later, in 2004, two-thirds responded to a detailed postal survey (n=5,729), from which the presence of CB was established in middle age. A subsample (n=1,389) underwent postbronchodilator spirometry between 2006 and 2008 for the assessment of chronic airflow limitation, from which nonobstructive and obstructive CB were defined. Multivariable and multinomial logistic regression models were used to estimate relevant associations. Results The prevalence of CB in middle age was 6.1% (95% confidence interval [CI]: 5.5, 6.8). Current asthma and/or wheezy breathing in middle age was independently associated with adult CB (odds ratio [OR]: 6.2 [95% CI: 4.6, 8.4]), and this estimate was significantly higher than for current smokers of at least 20 pack-years (OR: 3.0 [95% CI: 2.1, 4.3]). Current asthma and smoking in middle age were similarly associated with obstructive CB, in contrast to the association between allergy and nonobstructive CB. Childhood predictors included allergic history (OR: 1.3 [95% CI: 1.1, 1.7]), current asthma (OR: 1.8 [95% CI: 1.3, 2.7]), “episodic” childhood asthma (OR: 2.3 [95% CI: 1.4, 3.9]), and parental bronchitis symptoms (OR: 2.5 [95% CI: 1.6, 4.1]). Conclusion The strong independent association between current asthma and CB in middle age suggests that this condition may be even more influential than personal smoking in a general population. The independent associations of childhood allergy and asthma, though not

  15. Vaccination timing of low-birth-weight infants in rural Ghana: a population-based, prospective cohort study

    PubMed Central

    Thomas, Sara; Hurt, Lisa; Floyd, Sian; Shannon, Caitlin; Newton, Sam; Thomas, Gyan; Amenga-Etego, Seeba; Tawiah-Agyemang, Charlotte; Gram, Lu; Hurt, Chris; Bahl, Rajiv; Owusu-Agyei, Seth; Kirkwood, Betty; Edmond, Karen

    2016-01-01

    Abstract Objective To investigate delays in first and third dose diphtheria–tetanus–pertussis (DTP1 and DTP3) vaccination in low-birth-weight infants in Ghana, and the associated determinants. Methods We used data from a large, population-based vitamin A trial in 2010–2013, with 22 955 enrolled infants. We measured vaccination rate and maternal and infant characteristics and compared three categories of low-birth-weight infants (2.0–2.4 kg; 1.5–1.9 kg; and < 1.5 kg) with infants weighing ≥ 2.5 kg. Poisson regression was used to calculate vaccination rate ratios for DTP1 at 10, 14 and 18 weeks after birth, and for DTP3 at 18, 22 and 24 weeks (equivalent to 1, 2 and 3 months after the respective vaccination due dates of 6 and 14 weeks). Findings Compared with non-low-birth-weight infants (n = 18 979), those with low birth weight (n = 3382) had an almost 40% lower DTP1 vaccination rate at age 10 weeks (adjusted rate ratio, aRR: 0.58; 95% confidence interval, CI: 0.43–0.77) and at age 18 weeks (aRR: 0.63; 95% CI: 0.50–0.80). Infants weighing 1.5–1.9 kg (n = 386) had vaccination rates approximately 25% lower than infants weighing ≥ 2.5 kg at these time points. Similar results were observed for DTP3. Lower maternal age, educational attainment and longer distance to the nearest health facility were associated with lower DTP1 and DTP3 vaccination rates. Conclusion Low-birth-weight infants are a high-risk group for delayed vaccination in Ghana. Efforts to improve the vaccination of these infants are warranted, alongside further research to understand the reasons for the delays. PMID:27274596

  16. Population-Based Assessment of Cancer Survivors' Financial Burden and Quality of Life: A Prospective Cohort Study

    PubMed Central

    Zafar, S. Yousuf; McNeil, Rebecca B.; Thomas, Catherine M.; Lathan, Christopher S.; Ayanian, John Z.; Provenzale, Dawn

    2015-01-01

    Purpose: The impact of financial burden among patients with cancer has not yet been measured in a way that accounts for inter-relationships between quality of life, perceived quality of care, disease status, and sociodemographic characteristics. Patients and Methods: In a national, prospective, observational, population- and health care systems–based cohort study, patients with colorectal or lung cancer were enrolled from 2003 to 2006 within 3 months of diagnosis. For this analysis, surviving patients who were either disease free or had advanced disease were resurveyed a median 7.3 years from diagnosis. Structural equation modeling was used to investigate relationships between financial burden, quality of life, perceived quality of care, and sociodemographic characteristics. Results: Among 1,000 participants enrolled from five geographic regions, five integrated health care systems, or 15 Veterans Administration Hospitals, 89% (n = 889) were cancer free, and 11% (n = 111) had advanced cancer. Overall, 48% (n = 482) reported difficulties living on their household income, and 41% (n = 396) believed their health care to be “excellent.” High financial burden was associated with lower household income (adjusted odds ratio [OR] = 0.61 per $20k per year, P < .001) and younger age (adjusted OR = 0.63 per 10 years; P < .001). High financial burden was also associated with poorer quality of life (adjusted beta = −0.06 per burden category; P < .001). Better quality of life was associated with fewer perceptions of poorer quality of care (adjusted OR = 0.85 per 0.10 EuroQol units; P < .001). Conclusion: Financial burden is prevalent among cancer survivors and is related to patients' health-related quality of life. Future studies should consider interventions to improve patient education and engagement with regard to financial burden. PMID:25515717

  17. Human semen quality in the new millennium: a prospective cross-sectional population-based study of 4867 men

    PubMed Central

    Joensen, Ulla Nordström; Jensen, Tina Kold; Jensen, Martin Blomberg; Almstrup, Kristian; Olesen, Inge Ahlmann; Juul, Anders; Andersson, Anna-Maria; Carlsen, Elisabeth; Petersen, Jørgen Holm; Toppari, Jorma; Skakkebæk, Niels E

    2012-01-01

    Objectives Considerable interest and controversy over a possible decline in semen quality during the 20th century raised concern that semen quality could have reached a critically low level where it might affect human reproduction. The authors therefore initiated a study to assess reproductive health in men from the general population and to monitor changes in semen quality over time. Design Cross-sectional study of men from the general Danish population. Inclusion criteria were place of residence in the Copenhagen area, and both the man and his mother being born and raised in Denmark. Men with severe or chronic diseases were not included. Setting Danish one-centre study. Participants 4867 men, median age 19 years, included from 1996 to 2010. Outcome measures Semen volume, sperm concentration, total sperm count, sperm motility and sperm morphology. Results Only 23% of participants had optimal sperm concentration and sperm morphology. Comparing with historic data of men attending a Copenhagen infertility clinic in the 1940s and men who recently became fathers, these two groups had significantly better semen quality than our study group from the general population. Over the 15 years, median sperm concentration increased from 43 to 48 million/ml (p=0.02) and total sperm count from 132 to 151 million (p=0.001). The median percentage of motile spermatozoa and abnormal spermatozoa were 68% and 93%, and did not change during the study period. Conclusions This large prospective study of semen quality among young men of the general population showed an increasing trend in sperm concentration and total sperm count. However, only one in four men had optimal semen quality. In addition, one in four will most likely face a prolonged waiting time to pregnancy if they in the future want to father a child and another 15% are at risk of the need of fertility treatment. Thus, reduced semen quality seems so frequent that it may impair the fertility rates and further increase the

  18. Data quality monitoring and performance metrics of a prospective, population-based observational study of maternal and newborn health in low resource settings

    PubMed Central

    2015-01-01

    Background To describe quantitative data quality monitoring and performance metrics adopted by the Global Network’s (GN) Maternal Newborn Health Registry (MNHR), a maternal and perinatal population-based registry (MPPBR) based in low and middle income countries (LMICs). Methods Ongoing prospective, population-based data on all pregnancy outcomes within defined geographical locations participating in the GN have been collected since 2008. Data quality metrics were defined and are implemented at the cluster, site and the central level to ensure data quality. Quantitative performance metrics are described for data collected between 2010 and 2013. Results Delivery outcome rates over 95% illustrate that all sites are successful in following patients from pregnancy through delivery. Examples of specific performance metric reports illustrate how both the metrics and reporting process are used to identify cluster-level and site-level quality issues and illustrate how those metrics track over time. Other summary reports (e.g. the increasing proportion of measured birth weight compared to estimated and missing birth weight) illustrate how a site has improved quality over time. Conclusion High quality MPPBRs such as the MNHR provide key information on pregnancy outcomes to local and international health officials where civil registration systems are lacking. The MNHR has measures in place to monitor data collection procedures and improve the quality of data collected. Sites have increasingly achieved acceptable values of performance metrics over time, indicating improvements in data quality, but the quality control program must continue to evolve to optimize the use of the MNHR to assess the impact of community interventions in research protocols in pregnancy and perinatal health. Trial registration number NCT01073475 PMID:26062714

  19. Protocol for a multicentre, prospective, population-based cohort study of variation in practice of cholecystectomy and surgical outcomes (The CholeS study)

    PubMed Central

    Vohra, Ravinder S; Spreadborough, Philip; Johnstone, Marianne; Marriott, Paul; Bhangu, Aneel; Alderson, Derek; Morton, Dion G; Griffiths, Ewen A

    2015-01-01

    Introduction Cholecystectomy is one of the most common general surgical operations performed. Despite level one evidence supporting the role of cholecystectomy in the management of specific gallbladder diseases, practice varies between surgeons and hospitals. It is unknown whether these variations account for the differences in surgical outcomes seen in population-level retrospective data sets. This study aims to investigate surgical outcomes following acute, elective and delayed cholecystectomies in a multicentre, contemporary, prospective, population-based cohort. Methods and analysis UK and Irish hospitals performing cholecystectomies will be recruited utilising trainee-led research collaboratives. Two months of consecutive, adult patient data will be included. The primary outcome measure of all-cause 30-day readmission rate will be used in this study. Thirty-day complication rates, bile leak rate, common bile duct injury, conversion to open surgery, duration of surgery and length of stay will be measured as secondary outcomes. Prospective data on over 8000 procedures is anticipated. Individual hospitals will be surveyed to determine local policies and service provision. Variations in outcomes will be investigated using regression modelling to adjust for confounders. Ethics and dissemination Research ethics approval is not required for this study and has been confirmed by the online National Research Ethics Service (NRES) decision tool. This novel study will investigate how hospital-level surgical provision can affect patient outcomes, using a cross-sectional methodology. The results are essential to inform commissioning groups and implement changes within the National Health Service (NHS). Dissemination of the study protocol is primarily through the trainee-led research collaboratives and the Association of Upper Gastrointestinal Surgeons (AUGIS). Individual centres will have access to their own results and the collective results of the study will be published

  20. Diet and lung cancer risk from a 14-year population-based prospective study in Japan: with special reference to fish consumption.

    PubMed

    Takezaki, Toshiro; Inoue, Manami; Kataoka, Hiroki; Ikeda, Syuhei; Yoshida, Miyako; Ohashi, Yoko; Tajima, Kazuo; Tominaga, Suketami

    2003-01-01

    N-3 polyunsaturated fatty acids in fish oil exhibit a variety of health benefits, and there is evidence that they can inhibit the development of human lung mucoepidermoid and other carcinomas. To examine the hypothesis that fish consumption reduces the risk of lung cancer, we conducted a population-based prospective study, following 5,885 residents for 14 yr. Person-years were used to calculate the relative risk (RR) by the Cox proportional hazards model, with adjustment for potential confounding factors. A total of 51 incident lung cancer cases were observed, and we found linearly decreasing RRs for lung cancer with increased frequency of consumption of fish and shellfish (RRs = 1.00, 0.99, and 0.32, P for trend = 0.003) but not with intake of dried/salted fish. Decreased RRs were apparent with both broiling and boiling cooking methods, but reduction with raw and deep-fried fish consumption was not statistically significant. We conclude that frequent fresh fish consumption, irrespective of the cooking method, may reduce the risk of lung cancer. PMID:12881009

  1. "Cancer 2015": A Prospective, Population-Based Cancer Cohort-Phase 1: Feasibility of Genomics-Guided Precision Medicine in the Clinic.

    PubMed

    Parisot, John P; Thorne, Heather; Fellowes, Andrew; Doig, Ken; Lucas, Mark; McNeil, John J; Doble, Brett; Dobrovic, Alexander; John, Thomas; James, Paul A; Lipton, Lara; Ashley, David; Hayes, Theresa; McMurrick, Paul; Richardson, Gary; Lorgelly, Paula; Fox, Stephen B; Thomas, David M

    2015-01-01

    "Cancer 2015" is a longitudinal and prospective cohort. It is a phased study whose aim was to pilot recruiting 1000 patients during phase 1 to establish the feasibility of providing a population-based genomics cohort. Newly diagnosed adult patients with solid cancers, with residual tumour material for molecular genomics testing, were recruited into the cohort for the collection of a dataset containing clinical, molecular pathology, health resource use and outcomes data. 1685 patients have been recruited over almost 3 years from five hospitals. Thirty-two percent are aged between 61-70 years old, with a median age of 63 years. Diagnostic tumour samples were obtained for 90% of these patients for multiple parallel sequencing. Patients identified with somatic mutations of potentially "actionable" variants represented almost 10% of those tumours sequenced, while 42% of the cohort had no mutations identified. These genomic data were annotated with information such as cancer site, stage, morphology, treatment and patient outcomes and health resource use and cost. This cohort has delivered its main objective of establishing an upscalable genomics cohort within a clinical setting and in phase 2 aims to develop a protocol for how genomics testing can be used in real-time clinical decision-making, providing evidence on the value of precision medicine to clinical practice. PMID:26529019

  2. “Cancer 2015”: A Prospective, Population-Based Cancer Cohort—Phase 1: Feasibility of Genomics-Guided Precision Medicine in the Clinic

    PubMed Central

    Parisot, John P.; Thorne, Heather; Fellowes, Andrew; Doig, Ken; Lucas, Mark; McNeil, John J.; Doble, Brett; Dobrovic, Alexander; John, Thomas; James, Paul A.; Lipton, Lara; Ashley, David; Hayes, Theresa; McMurrick, Paul; Richardson, Gary; Lorgelly, Paula; Fox, Stephen B.; Thomas, David M.

    2015-01-01

    “Cancer 2015” is a longitudinal and prospective cohort. It is a phased study whose aim was to pilot recruiting 1000 patients during phase 1 to establish the feasibility of providing a population-based genomics cohort. Newly diagnosed adult patients with solid cancers, with residual tumour material for molecular genomics testing, were recruited into the cohort for the collection of a dataset containing clinical, molecular pathology, health resource use and outcomes data. 1685 patients have been recruited over almost 3 years from five hospitals. Thirty-two percent are aged between 61–70 years old, with a median age of 63 years. Diagnostic tumour samples were obtained for 90% of these patients for multiple parallel sequencing. Patients identified with somatic mutations of potentially “actionable” variants represented almost 10% of those tumours sequenced, while 42% of the cohort had no mutations identified. These genomic data were annotated with information such as cancer site, stage, morphology, treatment and patient outcomes and health resource use and cost. This cohort has delivered its main objective of establishing an upscalable genomics cohort within a clinical setting and in phase 2 aims to develop a protocol for how genomics testing can be used in real-time clinical decision-making, providing evidence on the value of precision medicine to clinical practice. PMID:26529019

  3. IMPaCT Back study protocol. Implementation of subgrouping for targeted treatment systems for low back pain patients in primary care: a prospective population-based sequential comparison

    PubMed Central

    2010-01-01

    Background Prognostic assessment tools to identify subgroups of patients at risk of persistent low back pain who may benefit from targeted treatments have been developed and validated in primary care. The IMPaCT Back study is investigating the effects of introducing and supporting a subgrouping for targeted treatment system in primary care. Methods/Design A prospective, population-based, quality improvement study in one Primary Care Trust in England with a before and after design. Phases 1 and 3 collect data on current practice, attitudes and behaviour of health care practitioners, patients' outcomes and health care costs. Phase 2 introduces and supports the subgrouping for targeted treatment system, via a multi-component, quality improvement intervention that includes educational courses and outreach visits led by opinion leaders, audit/feedback, mentoring and organisational support to embed the subgrouping tools within IT and clinical management systems. We aim to recruit 1000 low back pain patients aged 18 years and over consulting 7 GP practices within one Primary Care Trust in England, UK. The study includes GPs in participating practices and physiotherapists in associated services. The primary objective is to determine the effect of the subgrouping for targeted treatment system on back pain related disability and catastrophising at 2 and 6 months, comparing data from phase 1 with phase 3. Key secondary objectives are to determine the impact on: a) GPs' and physiotherapists' attitudes and behaviour regarding low back pain; b) The process of care that patients receive; c) The cost-effectiveness and sustainability of the new clinical system. Discussion This paper details the rationale, design, methods, planned analysis and operational aspects of the IMPaCT Back study. We aim to determine whether the new subgrouping for targeted treatment system is implemented and sustained in primary care, and evaluate its impact on clinical decision-making, patient outcomes and

  4. Hospital Utilisation in Indigenous and Non-Indigenous Infants under 12 Months of Age in Western Australia, Prospective Population Based Data Linkage Study

    PubMed Central

    McAullay, Daniel; Strobel, Natalie A.; Marriott, Rhonda; Atkinson, David N.; Marley, Julia V.; Stanley, Fiona J.

    2016-01-01

    Background Indigenous infants (infants aged under 12 months) have the highest hospital admission and emergency department presentation risks in Australia. However, there have been no recent reports comparing hospital utilisation between Indigenous and non-Indigenous infants. Methods Our primary objective was to use a large prospective population-based linked dataset to assess the risk of all-cause hospital admission and emergency department presentation in Indigenous compared to non-Indigenous infants in Western Australia (WA). Secondary objectives were to assess the effect of socio-economic status (Index of Relative Socio-Economic Disadvantage [IRSD]) on hospital utilisation and to understand the causes of hospital utilisation. Findings There were 3,382 (5.4%) Indigenous and 59,583 (94.6%) non-Indigenous live births in WA from 1 January 2010 to 31 December 2011. Indigenous infants had a greater risk of hospital admission (adjusted odds ratio [aOR] 1.90, 95% confidence interval [95% CI] 1.77–2.04, p = <0.001) and emergency department presentation (aOR 2.15, 95% CI 1.98–2.33, p = <0.001) compared to non-Indigenous infants. Fifty nine percent (59.0%) of admissions in Indigenous children were classified as preventable compared to 31.2% of admissions in non-Indigenous infants (aOR 2.12, 95% CI 1.88–2.39). The risk of hospital admission in the most disadvantaged (IRSD 1) infants in the total cohort (35.7%) was similar to the risk in the least disadvantaged (IRSD 5) infants (30.6%) (aOR 1.04, 95% CI 0.96–1.13, p = 0.356). Interpretation WA Indigenous infants have much higher hospital utilisation than non Indigenous infants. WA health services should prioritise Indigenous infants regardless of their socio economic status or where they live. PMID:27120331

  5. Performance on Specific Cognitive Domains and Cause of Death: A Prospective Population-Based Study in Non-Demented Older Adults (NEDICES).

    PubMed

    Benito-León, Julián; Contador, Israel; Mitchell, Alex J; Domingo-Santos, Ángela; Bermejo-Pareja, Félix

    2016-02-01

    Evidence regarding the relationship between performance on specific cognitive domains and cause of death is scarce. We assessed whether specific cognitive domains predicted mortality and the presence of any association with specific causes of death in a population-dwelling sample of non-demented older adults. In this population-based, prospective study (NEDICES), 2,390 non-demented subjects ≥65 years completed a brief neuropsychological battery. Cox's proportional hazards models, adjusted by sociodemographic and comorbidity factors, global cognitive performance, educational level, and premorbid intelligence were used to assess the risk of death. Participants were followed for a median of 9.2 years (range 0.01-10.7), after which the death certificates of those who died were examined. 880 (36.8%) of 2,390 participants died over a median follow-up of 5.5 years (range 0.01-10.5). Using adjusted Cox regression models, we found that hazard ratios for mortality in participants within the lowest tertiles (worse performance) were 1.31 (speed of cognitive processing, p = 0.03); 1.22 (semantic fluency, p = 0.04), 1.32 (delayed free recall, p = 0.003), and 1.23 (delayed logical memory, p = 0.03). Poor performance on delayed recall and speed of cognitive processing tests were associated with dementia and cerebrovascular disease mortality, respectively. Further, poor performance on semantic fluency was associated with decreased cancer mortality. In this study of community dwelling non-demented older adults, worse neuropsychological performance was associated with increased risk of mortality. Performance on specific cognitive domains were related to different causes of death. Of particular note there appears to be an inverse association between poor semantic fluency and cancer mortality. PMID:26890757

  6. The effects of household wealth on HIV prevalence in Manicaland, Zimbabwe – a prospective household census and population-based open cohort study

    PubMed Central

    Schur, Nadine; Mylne, Adrian; Mushati, Phyllis; Takaruza, Albert; Ward, Helen; Nyamukapa, Constance; Gregson, Simon

    2015-01-01

    Introduction Intensified poverty arising from economic decline and crisis may have contributed to reductions in HIV prevalence in Zimbabwe. Objectives To assess the impact of the economic decline on household wealth and prevalent HIV infection using data from a population-based open cohort. Methods Household wealth was estimated using data from a prospective household census in Manicaland Province (1998 to 2011). Temporal trends in summed asset ownership indices for sellable, non-sellable and all assets combined were compared for households in four socio-economic strata (small towns, agricultural estates, roadside settlements and subsistence farming areas). Multivariate logistic random-effects models were used to measure differences in individual-level associations between prevalent HIV infection and place of residence, absolute wealth group and occupation. Results Household mean asset scores remained similar at around 0.37 (on a scale of 0 to 1) up to 2007 but decreased to below 0.35 thereafter. Sellable assets fell substantially from 2004 while non-sellable assets continued increasing until 2008. Small-town households had the highest wealth scores but the gap to other locations decreased over time, especially for sellable assets. Concurrently, adult HIV prevalence fell from 22.3 to 14.3%. HIV prevalence was highest in better-off locations (small towns) but differed little by household wealth or occupation. Initially, HIV prevalence was elevated in women from poorer households and lower in men in professional occupations. However, most recently (2009 to 2011), men and women in the poorest households had lower HIV prevalence and men in professional occupations had similar prevalence to unemployed men. Conclusions The economic crisis drove more households into extreme poverty. However, HIV prevalence fell in all socio-economic locations and sub-groups, and there was limited evidence that increased poverty contributed to HIV prevalence decline. PMID:26593453

  7. Consumption of Lean Fish Reduces the Risk of Type 2 Diabetes Mellitus: A Prospective Population Based Cohort Study of Norwegian Women

    PubMed Central

    Rylander, Charlotta; Sandanger, Torkjel M.; Engeset, Dagrun; Lund, Eiliv

    2014-01-01

    Background The effects of fish consumption and n-3 fatty acids on type 2 diabetes mellitus (T2DM) have recently been debated. Objective We explored the risk of T2DM in relation to consumption of lean fish, fatty fish, fish products and total fish as well as cod liver oil supplements in a representative sample of Norwegian women. Design This was a prospective population based cohort study in 33740 women free of T2DM, stroke, angina or heart attack and with detailed information on important co-variates and dietary intake at baseline. Risk ratios and corresponding 95% CI were estimated using Poisson regression with log-person time as offset. Results Lean fish consumption was inversely associated with T2DM compared to zero intake. Risk ratios and 95% CI for intake of 75 and 100 g lean fish per day were 0.71 (0.51, 0.98) and 0.67 (0.46, 0.98), respectively. There was no effect of intake of fatty fish, fish products, total fish or use of cod liver oil supplements on the risk of T2DM. Conclusion Lean fish consumption of 75–100 g/d had a beneficial effect on T2DM. It remains unclear whether lean fish in itself has a protective effect on T2DM or that lean fish consumers have a protective life-style that we were not able to take into account in this study. Unfavorable effects of fatty fish consumption or use of cod liver oil supplements on T2DM were not observed. PMID:24587071

  8. Effects of Adolescent Childbearing on Maternal Depression and Problem Behaviors: A Prospective, Population-Based Study Using Risk-Set Propensity Scores.

    PubMed

    Hipwell, Alison E; Murray, Joseph; Xiong, Shuangyan; Stepp, Stephanie D; Keenan, Kate E

    2016-01-01

    Adolescent mothers are reportedly at risk for depression and problem behaviors in the postpartum period, but studies have rarely considered developmental context and have yet to disentangle the effects of childbearing on adolescent functioning from selection effects that are associated with early pregnancy. The current study examined changes in adolescent depression, conduct problems and substance use (alcohol, tobacco and marijuana) across the peripartum period using risk-set propensity scores derived from a population-based, prospective study that began in childhood (the Pittsburgh Girls Study, PGS). Each of 147 childbearing adolescents (ages 12-19) was matched with two same-age, non-childbearing adolescents (n = 294) on pregnancy propensity using 15 time-varying risk variables derived from sociodemographic, psychopathology, substance use, family, peer and neighborhood domains assessed in the PGS wave prior to each pregnancy (T1). Postpartum depression and problem behaviors were assessed within the first 6 months following delivery (T2); data gathered from the non-childbearing adolescent controls spanned the same interval. Within the childbearing group, conduct problems and marijuana use reduced from T1 to T2, but depression severity and frequency of alcohol or tobacco use showed no change. When change was compared across the matched groups, conduct problems showed a greater reduction among childbearing adolescents. Relative to non-childbearing adolescents who reported more frequent substance use with time, childbearing adolescents reported no change in alcohol use and less frequent use of marijuana across the peripartum period. There were no group differences in patterns of change for depression severity and tobacco use. The results do not support the notion that adolescent childbearing represents a period of heightened risk for depression or problem behaviors. PMID:27176826

  9. The effect of asset-based wealth inequality on problem drinking among rural Thai elders: A prospective population-based cohort study☆

    PubMed Central

    Jirapramukpitak, Tawanchai; Abas, Melanie; Tangchonlatip, Kanchana; Punpuing, Sureeporn

    2014-01-01

    Evidence on the link between income inequality and alcohol-related problems is scarce, inconclusive and dominated by studies from the developed world. The use of income as a proxy measure for wealth is also questionable, particularly in developing countries. The goal of the present study is to explore the contextual influence of asset-based wealth inequality on problem drinking among Thai older adults. A population-based cohort study with a one-year follow-up was nested in a Demographic Surveillance System (DSS) of 100 villages in western Thailand. Data were drawn from a random sample of 1104 older residents, aged 60 or over (one per household) drawn from all 100 villages, of whom 982 (89%) provided problem drinking data at follow-up. The primary outcome measure was a validated Thai version of the Alcohol-Used Disorder Identification Test for problem drinking. Living in areas of high wealth inequality was prospectively associated with a greater risk for problem drinking among older people (adjusted odds ratio 2.30, 95% confidence intervals 1.02–5.22), after adjusting for individual-level and village-level factors. A rise in wealth inequality over the year was also independently associated with an increased risk of problem drinking (adjusted odds ratio 2.89, 95% confidence intervals 1.24–6.65). The associations were not explained by the social capital, status anxiety or psychosocial stress variables. The data suggest that wealth inequality and an increase in inequality across time lead to a greater risk of problem drinking. Efforts should be directed towards reducing gaps and preventing large jumps in inequality in the communities. Further research should investigate the effect of asset-based inequality on various health risk behaviors and its specific mediating pathways. PMID:24444845

  10. Effects of Adolescent Childbearing on Maternal Depression and Problem Behaviors: A Prospective, Population-Based Study Using Risk-Set Propensity Scores

    PubMed Central

    Murray, Joseph; Xiong, Shuangyan; Stepp, Stephanie D.; Keenan, Kate E.

    2016-01-01

    Adolescent mothers are reportedly at risk for depression and problem behaviors in the postpartum period, but studies have rarely considered developmental context and have yet to disentangle the effects of childbearing on adolescent functioning from selection effects that are associated with early pregnancy. The current study examined changes in adolescent depression, conduct problems and substance use (alcohol, tobacco and marijuana) across the peripartum period using risk-set propensity scores derived from a population-based, prospective study that began in childhood (the Pittsburgh Girls Study, PGS). Each of 147 childbearing adolescents (ages 12–19) was matched with two same-age, non-childbearing adolescents (n = 294) on pregnancy propensity using 15 time-varying risk variables derived from sociodemographic, psychopathology, substance use, family, peer and neighborhood domains assessed in the PGS wave prior to each pregnancy (T1). Postpartum depression and problem behaviors were assessed within the first 6 months following delivery (T2); data gathered from the non-childbearing adolescent controls spanned the same interval. Within the childbearing group, conduct problems and marijuana use reduced from T1 to T2, but depression severity and frequency of alcohol or tobacco use showed no change. When change was compared across the matched groups, conduct problems showed a greater reduction among childbearing adolescents. Relative to non-childbearing adolescents who reported more frequent substance use with time, childbearing adolescents reported no change in alcohol use and less frequent use of marijuana across the peripartum period. There were no group differences in patterns of change for depression severity and tobacco use. The results do not support the notion that adolescent childbearing represents a period of heightened risk for depression or problem behaviors. PMID:27176826

  11. Neonatal mortality and coverage of essential newborn interventions 2010 - 2013: a prospective, population-based study from low-middle income countries

    PubMed Central

    2015-01-01

    Background Approximately 3 million neonatal deaths occur each year worldwide. Simple interventions have been tested and found to be effective in reducing the neonatal mortality. In order to effectively implement public health interventions, it is important to know the rates of neonatal mortality and understand the contributing risk factors. Hence, this prospective, population-based, observational study was carried out to inform these needs. Methods The Global Network’s Maternal Newborn Health Registry was initiated in the seven sites in 2008. Registry administrators (RAs) attempt to identify and enroll all eligible women by 20 weeks gestation and collect basic health data, and outcomes after delivery and at 6 weeks post-partum. All study data were collected, reviewed, and edited by staff at each study site. The study was reviewed and approved by each sites’ ethics review committee. Results Overall, the 7-day neonatal mortality rate (NMR) was 20.6 per 1000 live births and the 28-day NMR was 25.7 per 1000 live births. Higher neonatal mortality was associated with maternal age > 35 and <20 years relative to women 20-35 years of age. Preterm births were at increased risk of both early and 28-day neonatal mortality (RR 8.1, 95% CI 7.5-8.8 and 7.5, 95% CI 6.9-8.1) compared to term as were those with low birth weight (<2500g). Neonatal resuscitation rates were 4.8% for hospital deliveries compared to 0.9% for home births. In the hospital, 26.5% of deliveries were by cesarean section with an overall cesarean section rate of 12.5%. Neonatal mortality rates were highest in the Pakistan site and lowest in Argentina. Conclusions Using prospectively collected data with high follow up rates (99%), we documented characteristics associated with neonatal mortality. Low birth weight and prematurity are among the strongest predictors of neonatal mortality. Other risk factors for neonatal deaths included male gender, multiple gestation and major congenital anomalies. Breech

  12. Is Nephrolithiasis an Unrecognized Extra-Articular Manifestation in Ankylosing Spondylitis? A Prospective Population-Based Swedish National Cohort Study with Matched General Population Comparator Subjects

    PubMed Central

    Jakobsen, Ane Krag; Jacobsson, Lennart T. H.; Patschan, Oliver; Askling, Johan; Kristensen, Lars Erik

    2014-01-01

    Background Ankylosing spondylitis (AS) is associated with several extra-articular manifestations. Nephrolithiasis (NL) has not been recognized as one of those, however, several factors known to increase the risk of NL are at play in AS patients. The objective was to estimate rates and predictors of NL in Swedish patients with AS compared to the general population. Methods and Findings We performed a prospective population-based nationwide cohort study based on linkage of data from Swedish registries. 8,572 AS patients were followed for 49,258 person-years (py) and 39,639 matched general population comparators were followed for 223,985 py. Patients were followed prospectively together with comparator subjects from January 2001 through December 2009. The first occurrence of NL during follow-up was the primary outcome. Hazard Ratios (HR) were used to compare these rates adjusting for comorbidities and treatment, and to assess predictors for NL. Mean age at study entry was 46 years (inter quartile range 36–56 years), 65% were males. Based on 250 vs. 466 NL events, the adjusted HR of NL in AS patients was 2.1 (95%CI 1.8 to 2.4). Predictors of NL within the AS group included prior diagnosis of inflammatory bowel disease (IBD) (HR 2.3; 95%CI 1.7 to 3.3), prior diagnosis of NL (HR 16.4; 95%CI 11.5 to 23.4), and patients receiving anti-TNF treatment (HR 1.6; 95%CI 1.2 to 2.1). Male sex was a risk factor for NL both in AS patients and in the general population. Limitations The risk for residual confounding and inability to study the chemical nature of NL were considered the main limitations of the study. Conclusions Patients with AS are at increased risk of NL, which may be considered a novel extra-articular manifestation. Previous history of NL, IBD, AS disease severity and male sex were identified as predictors of NL in AS. PMID:25423471

  13. Australian Cerebral Palsy Child Study: protocol of a prospective population based study of motor and brain development of preschool aged children with cerebral palsy

    PubMed Central

    2013-01-01

    . Discussion This protocol describes a large population-based study of early motor development and brain structure in a representative sample of preschool aged children with CP, using direct clinical assessment. The results of this study will be published in peer reviewed journals and presented at relevant international conferences. Trial registration Australia and New Zealand Clinical Trials Register (ACTRN1261200169820) PMID:23758951

  14. [13-Year old boy with abdominal pain].

    PubMed

    Thomassen, Irene; Klinkhamer, Paul J J M; van de Poll, Marcel C G

    2012-01-01

    A 13-year old boy presents with pain in the lower right abdomen, showing clinical signs of appendicitis. During McBurney' incision an appendix sana was seen. Histologic examination showed penetrating enterobiasis. This was treated with mebendazol. PMID:22551758

  15. Health-Related Quality of Life and Cognitive Functioning at On- and Off-Treatment Periods in Children Aged between 6-13 Years Old with Brain Tumors: A Prospective Longitudinal Study

    PubMed Central

    An, Kyung Jin; Sung, Ki Woong; Kim, Ji-Hae

    2013-01-01

    Purpose Our study aimed to examine the relationship between intelligence and health-related quality of life (HRQOL) in children (6-13 years old) diagnosed as having a brain tumor. Materials and Methods We administered a Korean version of the Wechsler Intelligence Scale for Children-III, the Pediatric Quality of Life Inventory, version 4.0 (PedsQL), the Korean version of the Parenting Stress Index-Short Form, and the Korean Version of the Parenting Sense of Competence (K-PSOC) scale before or after initial radiotherapy (T1) and after treatment termination (T2). In total, 13 patients completed both the T1 and T2 interviews. Results Scores significantly declined between T1 and T2 on the full-scale intelligence quotients (FIQ), verbal intelligence quotients (VIQ), performance intelligence quotients (PIQ), similarity and coding tests, as well as the K-PSOC, which measures parental anxiety. FIQ scores at T1 were correlated with the self-reported PedsQL total scores (r=0.739) and the parent proxy-report PedsQL scores for school functioning (r=0.706) at T2. Also, the FIQ scores at T2 were correlated with the self-reported PedsQL total scores (r=0.748) and scores for physical health (r=0.728) at T2. Conclusion The cognitive ability and intelligence level of the patients significantly declined between on and off treatment periods, and higher intelligence functioning at both on and off treatment was correlated with long-term higher HRQOL. Further investigations that monitor intelligence, HRQOL and parenting stress over a longer period, using a greater number of participants, are needed. PMID:23364961

  16. Cyclin D1 expression in colorectal cancer is a favorable prognostic factor in men but not in women in a prospective, population-based cohort study

    PubMed Central

    2011-01-01

    Background Although colorectal cancer (CRC) is generally not considered to be a hormone-dependent malignancy, several sex-related differences in incidence, molecular characteristics and survival have been reported. Epidemiological studies have consistently shown that increased exposure to female sex hormones is associated with a lower risk of CRC in women, and cyclin D1, an important downstream effector in estrogen-mediated signaling, is commonly activated in CRC. In this study, we analyzed the prognostic significance of cyclin D1 expression in CRC, with particular reference to sex-related differences, in tumors from a large, prospective, population-based cohort. Methods Using tissue microarrays and immunohistochemistry, the fraction and intensity of cyclin D1 expression was evaluated in 527 incident CRC cases from the Malmö Diet and Cancer Study. The χ2 and Spearman's rho (ρ) tests were used for comparison of cyclin D1 expression and relevant clinicopathological characteristics. Kaplan-Meier analysis and Cox proportional hazards modeling were used to assess the effect of cyclin D1 expression on cancer-specific survival (CSS) in univariate and multivariate analysis, adjusted for established prognostic factors. Results Cyclin D1 intensity was significantly lower in male compared with female CRC (P = 0.018). In the full cohort, cyclin D1 expression was associated with a significantly prolonged CSS (hazard ratio (HR) = 0.69; 95% CI 0.49 to 0.96, P = 0.026) but subgroup analysis according to gender revealed a strongly accentuated prognostic effect of cyclin D1 in male CRC (HR = 0.48; 95% CI 0.31 to 0.74, P < 0.001), which was in contrast to female CRC, where cyclin D1 was not prognostic (HR = 1.05; 95% CI 0.62 to 1.78, P = 0.864) (Pinteraction = 0.024). The prognostic value of cyclin D1 was not retained in multivariate analysis, either in the full cohort or in male CRC. Conclusions Cyclin D1 expression is strongly associated with prolonged survival in male CRC

  17. Giant intradiploic arachnoid cyst for 13 years

    PubMed Central

    Verma, Satish Kumar; Satyarthee, Guru Dutta; Sharma, Bhawani Shankar

    2014-01-01

    A case of intradiploic arachnoid cyst is reported. The patient presented with a progressively enlarging swelling situated over left frontal region for approximately 13-years following blunt trauma to head. Magnetic resonance imaging showed an intradiploic fluid containing cyst having intensity like cerebrospinal fluid (CSF). He underwent craniotomy and successful surgical repair. Intraoperatively CSF cyst was located in the frontal pole with a large defect over inner table and large rent in the dura. It was lined with arachnoid membrane. Pertinent literature is reviewed in brief. PMID:25250069

  18. Comparative effectiveness and safety of gastric bypass, sleeve gastrectomy and adjustable gastric banding in a population-based bariatric program: prospective cohort study

    PubMed Central

    Gill, Richdeep S.; Majumdar, Sumit R.; Rueda-Clausen, Christian F.; Apte, Sameer; Birch, Daniel W.; Karmali, Shahzeer; Sharma, Arya M.; Klarenbach, Scott; Padwal, Raj S.

    2016-01-01

    Background Bariatric surgery in Canada is primarily delivered within publicly funded specialty clinics. Previous studies have demonstrated that bariatric surgery is superior to intensive medical management for reduction of weight and obesity-related comorbidities. Our objective was to compare the effectiveness and safety of laparoscopic Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (LSG) and adjustable gastric banding (LAGB) in a publicly funded, population-based bariatric treatment program. Methods We followed consecutive bariatric surgery patients for 2 years. The primary outcome was weight change (in kilograms). Between-group changes were analyzed using multivariable regression. Last-observation-carried-forward imputation was used for missing data. Results We included 150 consecutive patients (51 RYGB; 51 LSG; 48 LAGB) in our study. At baseline, mean age was 43.5 ± 9.5 years, 87.3% of patients were women, and preoperative body mass index (BMI) was 46.2 ± 7.4. Absolute and relative (% of baseline) weight loss at 2 years were 36.6 ± 19.5 kg (26.1 ± 12.2%) for RYGB, 21.4 ± 16.0 kg (16.4 ± 11.6%) for LSG and 7.0 ± 9.7 kg (5.8 ± 7.9%) for LAGB (p < 0.001). Change in BMI was greater for the RYGB (−13.0 ± 6.6) than both the LSG (−7.6 ± 5.7) and the LAGB (−2.6 ± 3.5) groups (p < 0.001). The reduction in diabetes, hypertension and dyslipidemia was greater after RYGB than after LAGB (all p < 0.05). There were no deaths. The anastomotic and staple leakage rate was 1.3%. Conclusion In a publicly funded, population-based bariatric surgery program, RYGB and LSG demonstrated greater weight loss than the LAGB procedure. Bypass resulted in the greatest reduction in obesity-related comorbidities. All procedures were safe. PMID:27240132

  19. Intimate Partner Violence and Depression Symptom Severity among South African Women during Pregnancy and Postpartum: Population-Based Prospective Cohort Study

    PubMed Central

    Tsai, Alexander C.; Tomlinson, Mark; Comulada, W. Scott; Rotheram-Borus, Mary Jane

    2016-01-01

    Background Violence against women by intimate partners remains unacceptably common worldwide. The evidence base for the assumed psychological impacts of intimate partner violence (IPV) is derived primarily from studies conducted in high-income countries. A recently published systematic review identified 13 studies linking IPV to incident depression, none of which were conducted in sub-Saharan Africa. To address this gap in the literature, we analyzed longitudinal data collected during the course of a 3-y cluster-randomized trial with the aim of estimating the association between IPV and depression symptom severity. Methods and Findings We conducted a secondary analysis of population-based, longitudinal data collected from 1,238 pregnant women during a 3-y cluster-randomized trial of a home visiting intervention in Cape Town, South Africa. Surveys were conducted at baseline, 6 mo, 18 mo, and 36 mo (85% retention). The primary explanatory variable of interest was exposure to four types of physical IPV in the past year. Depression symptom severity was measured using the Xhosa version of the ten-item Edinburgh Postnatal Depression Scale. In a pooled cross-sectional multivariable regression model adjusting for potentially confounding time-fixed and time-varying covariates, lagged IPV intensity had a statistically significant association with depression symptom severity (regression coefficient b = 1.04; 95% CI, 0.61–1.47), with estimates from a quantile regression model showing greater adverse impacts at the upper end of the conditional depression distribution. Fitting a fixed effects regression model accounting for all time-invariant confounding (e.g., history of childhood sexual abuse) yielded similar findings (b = 1.54; 95% CI, 1.13–1.96). The magnitudes of the coefficients indicated that a one–standard-deviation increase in IPV intensity was associated with a 12.3% relative increase in depression symptom severity over the same time period. The most important

  20. Prevalence and predictors of hospitalization in Crohn’s disease in a prospective population-based inception cohort from 2000-2012

    PubMed Central

    Golovics, Petra A; Lakatos, Laszlo; Mandel, Michael D; Lovasz, Barbara D; Vegh, Zsuzsanna; Kurti, Zsuzsanna; Szita, Istvan; Kiss, Lajos S; Pandur, Tunde; Lakatos, Peter L

    2015-01-01

    AIM: To analyze the prevalence, length and predictors of hospitalization in the biological era in the population-based inception cohort from Veszprem province. METHODS: Data of 331 incident Crohn’s disease (CD) patients diagnosed between January 1, 2000 and December 31, 2010 were analyzed (median age at diagnosis: 28; IQR: 21-40 years). Both in- and outpatient records were collected and comprehensively reviewed. RESULTS: Probabilities of first CD-related hospitalization and re-hospitalization were 32.3%, 45.5%, 53.7% and 13.6%, 23.9%, 29.8%, respectively after one, three and five years of follow-up in Kaplan-Meier analysis. First-year hospitalizations were related to diagnostic procedures (37%), surgery or disease activity (27% and 21%). Non-inflammatory disease behavior at diagnosis (HR = 1.32, P = 0.001) and perianal disease (HR = 1.47, P = 0.04) were associated with time to first CD-related hospitalization, while disease behavior change (HR = 2.38, P = 0.002) and need for steroids (HR = 3.14, P = 0.003) were associated with time to first re-hospitalization in multivariate analyses. Early CD-related hospitalization (within the year of diagnosis) was independently associated with need for immunosuppressives (OR = 2.08, P = 0.001) and need for surgeries (OR = 7.25, P < 0.001) during the disease course. CONCLUSION: Hospitalization and re-hospitalization rates are still high in this cohort, especially during the first-year after the diagnosis. Non-inflammatory disease behavior at diagnosis was identified as the pivotal predictive factor of both hospitalization and re-hospitalization. PMID:26109815

  1. Marital transitions and associated changes in fruit and vegetable intake: Findings from the population-based prospective EPIC-Norfolk cohort, UK

    PubMed Central

    Vinther, Johan L.; Conklin, Annalijn I.; Wareham, Nicholas J.; Monsivais, Pablo

    2016-01-01

    Background Diet is critical to health and social relationships are an important determinant of diet. We report the association between transitions in marital status and healthy eating behaviours in a UK population. Methods Longitudinal study of middle-age and older adults 39−78y (n = 11 577) in EPIC-Norfolk, a population-based cohort, who completed food frequency questionnaires in 1993–97 and 1998–2002. Multivariable linear regression analyses assessed gender-specific associations between five categories of marital transitions and changes in quantity (g/d), and variety (no/month) of fruits or vegetables. Results In 3.6 years of follow-up and relative to men who stayed married, widowed men showed significant declines (mean difference, 95% CI) in all four indicators of healthy eating including fruit quantity (−47.7, −80.6 to −14.9 g/d), fruit variety (−0.6, −1.1 to −0.2 no/month), vegetable quantity (−27.7, −50.5 to −4.9 g/d), and vegetable variety (−1.6, −2.2 to −0.9 no/month). Men who were separated or divorced or who remained single also showed significant declines in three of the indicators. Among women, only those who became separated/divorced or stayed single showed declines in one indicator, vegetable variety. Conclusion Unhealthy changes to diet accompanying divorce, separation and becoming widowed may be more common among men than women. Moreover, deterioration in fruit and vegetable intakes was more apparent for variety rather than quantity consumed. Programmes to promote healthy eating among older adults need to recognise these social determinants of diet and consider prioritising people who live alone and in particular men who have recently left relationships or who have been widowed. PMID:27082023

  2. Acute viral infections of upper respiratory tract in elderly people living in the community: comparative, prospective, population based study of disease burden.

    PubMed Central

    Nicholson, K. G.; Kent, J.; Hammersley, V.; Cancio, E.

    1997-01-01

    OBJECTIVE: To evaluate the disease burden of upper respiratory infections in elderly people living at home. DESIGN: Prospective surveillance of elderly people. INTERVENTION: None. SETTING: Leicestershire, England SUBJECTS: 533 subjects 60 to 90 years of age. MAIN OUTCOME MEASURES: Pathogens, symptoms, restriction of activity, duration of illness, medical consultations, interval between onset of illness and medical consultation, antibiotic use, admission to hospital, and death. RESULTS: 231 pathogens were identified for 211 (43%) of 497 episodes for which diagnostic specimens were available: 121 (52%) were rhinoviruses, 59 (26%) were coronaviruses, 22 (9.5%) were influenza A or B, 17 (7%) were respiratory syncytial virus, 7 (3%) were parainfluenza viruses, and 3 (1%) were Chlamydia species; an adenovirus and Mycoplasma pneumoniae caused one infection each. Infections occurred at a rate of 1.2 episodes per person per annum (95% confidence interval 1.0 to 1.7; range 0-10) and were clinically indistinguishable. Lower respiratory tract symptoms complicated 65% of upper respiratory infections and increased the medical consultation rate 2.4-fold (chi 2 test P < 0.001). The median interval between onset of illness and medical consultation was 3 days for influenza and 5 days for other infections. Rhinoviruses caused the greatest disease burden overall followed by episodes of unknown aetiology, coronaviruses, influenza A and B, and respiratory syncytial virus. CONCLUSIONS: Respiratory viruses cause substantial morbidity in elderly people. Although respiratory syncytial virus and influenza cause considerable individual morbidity, the burden of disease from rhinovirus infections and infections of unknown aetiology seems greater overall. The interval between onset of illness and consultation together with diagnostic difficulties raises concern regarding the role of antiviral drugs in treating influenza. PMID:9366736

  3. Predictors of mortality among elderly people living in a south Indian urban community; a 10/66 Dementia Research Group prospective population-based cohort study

    PubMed Central

    2010-01-01

    Background Eighty percent of deaths occur in low and middle income countries (LMIC), where chronic diseases are the leading cause. Most of these deaths are of older people, but there is little information on the extent, pattern and predictors of their mortality. We studied these among people aged 65 years and over living in urban catchment areas in Chennai, south India. Methods In a prospective population cohort study, 1005 participants were followed-up after three years. Baseline assessment included sociodemographic and socioeconomic characteristics, health behaviours, physical, mental and cognitive disorders, disability and subjective global health. Results At follow-up, 257 (25.6%) were not traced. Baseline characteristics were similar to the 748 whose vital status was ascertained; 154 (20.6%) had died. The mortality rate was 92.5/1000 per annum for men and 51.0/1000 per annum for women. Adjusting for age and sex, mortality was associated with older age, male sex, having no friends, physical inactivity, smaller arm circumference, dementia, depression, poor self-rated health and disability. A parsimonious model included, in order of aetiologic force, male sex, smaller arm circumference, age, disability, and dementia. The total population attributable risk fraction was 0.90. Conclusion A balanced approach to prevention of chronic disease deaths requires some attention to proximal risk factors in older people. Smoking and obesity seem much less relevant than in younger people. Undernutrition is preventable. While dementia makes the largest contribution to disability and dependency, comorbidity is the rule, and more attention should be given to the chronic care needs of those affected, and their carers. PMID:20573243

  4. Future marginalisation and mortality in young Swedish men with non-psychotic psychiatric disorders and the resilience effect of cognitive ability: a prospective, population-based study

    PubMed Central

    Löve, J; Hensing, G; Söderberg, M; Torén, K; Waern, M; Åberg, M

    2016-01-01

    Objective Large-scale studies examining future trajectories of marginalisation and health in adolescents with mental illness are scarce. The aim of this study was to examine if non-psychotic psychiatric disorders (NPDs) were associated with future indicators of marginalisation and mortality. We also aimed to determine whether these associations might be mediated by education level and attenuated by high cognitive ability. Design This is a prospective cohort study with baseline data from the Swedish Conscription register. Setting The study was carried out in Sweden from 1969 to 2005. Participants All of the participants were 18-year-old men at mandatory conscription in Sweden between 1969 and 2005 (n=1 609 690). Measures NPDs were clinically diagnosed at conscription. Cognitive ability was measured by a standardised IQ test at conscription. National register data covered information on welfare support, long-term unemployment, disability pension (DP) and mortality over a period of 1–36 years. Results NPD at the age of 18 years was a predictor of future welfare support, OR 3.73 (95% CI 3.65 to 3.80); long-term unemployment, OR 1.97 (95% CI 1.94 to 2.01); DP, HR 2.95 (95% CI 2.89 to 3.02); and mortality, HR 2.45 (2.33–2.52). The adjusted models suggested that these associations were not confounded by fathers’ educational level, cognitive ability had only a minor attenuating effect on most associations and the mediating effect of own educational level was small. Conclusions The present study underlines a higher prevalence of future adversities in young men experiencing NPDs at the age of 18 years. It also indicates that higher cognitive ability may work as a potential resilience factor against future marginalisation and mortality. PMID:27515748

  5. Quality of Life and Associated Socio-Clinical Factors after Encephalitis in Children and Adults in England: A Population-Based, Prospective Cohort Study

    PubMed Central

    Ramanuj, Parashar Pravin; Granerød, Julia; Davies, Nicholas W. S.; Conti, Stefano; Brown, David W. G.; Crowcroft, Natasha S.

    2014-01-01

    Objective We sought to measure HRQoL in all-cause encephalitis survivors and assess the impact of various socio-clinical factors on outcome. Methods We used a prospective cohort study design, using the short-form 36 (SF-36) to measure the HRQoL in patients 15 years and older, and the short-form 10 (SF-10) for patients less than 15 years old. We posted questionnaires to individuals six months after discharge from hospital. All scores were normalised to the age- and sex-matched general population. We used multivariate statistical analysis to assess the relative association of clinical and socio-demographic variables on HRQoL in adults. Results Of 109 individuals followed-up, we received 61 SF-36 and twenty SF-10 questionnaires (response rate 74%). Patients scored consistently worse than the general population in all domains of the SF-36 and SF-10, although there was variation in individual scores. Infectious encephalitis was associated with the worst HRQoL in those aged 15 years and over, scoring on average 5.64 points less than immune-mediated encephalitis (95% CI −8.77– −2.89). In those aged less than 15 years the worst quality of life followed encephalitis of unknown cause. Immuno compromise, unemployment, and the 35–44 age group all had an independent negative association with HRQoL. A poor Glasgow Outcome Score was most strongly associated with a poor HRQoL. Less than half of those who had made a ‘good’ recovery on the score reported a HRQoL equivalent to the general population. Conclusions Encephalitis has adverse effects on the majority of survivors’ wellbeing and quality of life. Many of these adverse consequences could be minimised by prompt identification and treatment, and with better rehabilitation and support for survivors. PMID:25072738

  6. A national population-based e-cohort of people with psychosis (PsyCymru) linking prospectively ascertained phenotypically rich and genetic data to routinely collected records: overview, recruitment and linkage.

    PubMed

    Lloyd, Keith; McGregor, Joanna; John, Ann; Craddock, Nick; Walters, James T; Linden, David; Jones, Ian; Bentall, Richard; Lyons, Ronan A; Ford, David V; Owen, Michael J

    2015-08-01

    PsyCymru was initially established as a proof of concept to investigate the feasibility of linking a prospectively ascertained, well-characterised (linked clinical cohort) of people with psychosis in Wales, UK with large amounts of anonymised routinely collected health record data. We are now additionally linking genetic data. PsyCymru aims to create a research platform and infrastructure for psychosis research in Wales by the establishment of two cohorts. The first is a well characterised clinically-assessed cohort of 490 individuals aged 16 and over, including genetic data. Consented individuals underwent a structured interview using a series of well-validated questionnaires and gave blood for the purpose of DNA extraction for sequencing and candidate gene identification. This data was linked to routinely collected health and social datasets with identity encryption used to protect privacy. The second is a much larger (12,097 individuals) but less well characterised population-based e-cohort of prevalent psychosis cases created using a previously validated algorithm applied to anonymised routine data. Both cohorts can be tracked prospectively and retrospectively using anonymised routinely collected electronic health and administrative data in the Secure Anonymised Information Linkage (SAIL) databank. This unique platform pools data together from multiple sources; linking clinical, psychological, biological, genetic and health care factors to address a wide variety of research questions. This resource will continue to expand over the coming years in size, breadth and depth of data, with continued recruitment and additional measures planned. PMID:26139629

  7. Pattern of care and effectiveness of treatment for glioblastoma patients in the real world: Results from a prospective population-based registry. Could survival differ in a high-volume center?

    PubMed Central

    Brandes, Alba A.; Franceschi, Enrico; Ermani, Mario; Tosoni, Alicia; Albani, Fiorenzo; Depenni, Roberta; Faedi, Marina; Pisanello, Anna; Crisi, Girolamo; Urbini, Benedetta; Dazzi, Claudio; Cavanna, Luigi; Mucciarini, Claudia; Pasini, Giuseppe; Bartolini, Stefania; Marucci, Gianluca; Morandi, Luca; Zunarelli, Elena; Cerasoli, Serenella; Gardini, Giorgio; Lanza, Giovanni; Silini, Enrico Maria; Cavuto, Silvio; Baruzzi, Agostino

    2014-01-01

    Background As yet, no population-based prospective studies have been conducted to investigate the incidence and clinical outcome of glioblastoma (GBM) or the diffusion and impact of the current standard therapeutic approach in newly diagnosed patients younger than aged 70 years. Methods Data on all new cases of primary brain tumors observed from January 1, 2009, to December 31, 2010, in adults residing within the Emilia-Romagna region were recorded in a prospective registry in the Project of Emilia Romagna on Neuro-Oncology (PERNO). Based on the data from this registry, a prospective evaluation was made of the treatment efficacy and outcome in GBM patients. Results Two hundred sixty-seven GBM patients (median age, 64 y; range, 29–84 y) were enrolled. The median overall survival (OS) was 10.7 months (95% CI, 9.2–12.4). The 139 patients ≤aged 70 years who were given standard temozolomide treatment concomitant with and adjuvant to radiotherapy had a median OS of 16.4 months (95% CI, 14.0–18.5). With multivariate analysis, OS correlated significantly with KPS (HR = 0.458; 95% CI, 0.248–0.847; P = .0127), MGMT methylation status (HR = 0.612; 95% CI, 0.388–0.966; P = .0350), and treatment received in a high versus low-volume center (HR = 0.56; 95% CI, 0.328–0.986; P = .0446). Conclusions The median OS following standard temozolomide treatment concurrent with and adjuvant to radiotherapy given to (72.8% of) patients aged ≤70 years is consistent with findings reported from randomized phase III trials. The volume and expertise of the treatment center should be further investigated as a prognostic factor. PMID:26034628

  8. Outcomes of Early- and Late-identified Children at 3 Years of Age: Findings from a Prospective Population-based Study

    PubMed Central

    Ching, Teresa Y.C.; Dillon, Harvey; Marnane, Vivienne; Hou, Sanna; Day, Julia; Seeto, Mark; Crowe, Kathryn; Street, Laura; Thomson, Jessica; Van Buynder, Patricia; Zhang, Vicky; Wong, Angela; Burns, Lauren; Flynn, Christopher; Cupples, Linda; Cowan, Robert S.C.; Leigh, Greg; Sjahalam-King, Jessica; Yeh, Angel

    2013-01-01

    Objectives To address the question of whether, on a population level, early detection and amplification improve outcomes of children with hearing impairment. Design All families of children who were born between 2002 and 2007, and who presented for hearing services below 3 years of age at Australian Hearing pediatric centers in New South Wales, Victoria and Southern Queensland were invited to participate in a prospective study on outcomes. Children’s speech, language, functional and social outcomes were assessed at 3 years of age, using a battery of age-appropriate tests. Demographic information relating to the child, family, and educational intervention was solicited through the use of custom-designed questionnaires. Audiological data were collected from the national database of Australian Hearing and records held at educational intervention agencies for children. Regression analysis was used to investigate the effects of each of 15 predictor variables, including age of amplification, on outcomes. Results Four hundred and fifty-one children enrolled in the study, 56% of whom received their first hearing-aid fitting before 6 months of age. Based on clinical records, 44 children (10%) were diagnosed with auditory neuropathy spectrum disorder. There were 107 children (24%) reported to have additional disabilities. At 3 years of age, 317 children (70%) were hearing-aid users and 134 children (30%) used cochlear implants. Based on parent reports, about 71% used an aural/oral mode of communication, and about 79% used English as the spoken language at home. Children’s performance scores on standardized tests administered at 3 years of age were used in a factor analysis to derive a global development factor score. On average, the global score of hearing-impaired children was more than one standard deviation (SD) below the mean of normal-hearing children at the same age. Regression analysis revealed that five factors, including female gender, absence of additional

  9. A prospective population-based study of maternal, fetal, and neonatal outcomes in the setting of prolonged labor, obstructed labor and failure to progress in low- and middle-income countries

    PubMed Central

    2015-01-01

    Background This population-based study sought to quantify maternal, fetal, and neonatal morbidity and mortality in low- and middle-income countries associated with obstructed labor, prolonged labor and failure to progress (OL/PL/FTP). Methods A prospective, population-based observational study of pregnancy outcomes was performed at seven sites in Argentina, Guatemala, India (2 sites, Belgaum and Nagpur), Kenya, Pakistan and Zambia. Women were enrolled in pregnancy and delivery and 6-week follow-up obtained to evaluate rates of OL/PL/FTP and outcomes resulting from OL/PL/FTP, including: maternal and delivery characteristics, maternal and neonatal morbidity and mortality and stillbirth. Results Between 2010 and 2013, 266,723 of 267,270 records (99.8%) included data on OL/PL/FTP with an overall rate of 110.4/1000 deliveries that ranged from 41.6 in Zambia to 200.1 in Pakistan. OL/PL/FTP was more common in women aged <20, nulliparous women, more educated women, women with infants >3500g, and women with a BMI >25 (RR 1.4, 95% CI 1.3 – 1.5), with the suggestion of OL/PL/FTP being less common in preterm deliveries. Protective characteristics included parity of ≥3, having an infant <1500g, and having a BMI <18. Women with OL/PL/FTP were more likely to die within 42 days (RR 1.9, 95% CI 1.4 – 2.4), be infected (RR 1.8, 95% CI 1.5 – 2.2), and have hemorrhage antepartum (RR 2.8, 95% CI 2.1 – 3.7) or postpartum (RR 2.4, 95% CI 1.8 – 3.3). They were also more likely to have a stillbirth (RR 1.6, 95% CI 1.3 – 1.9), a neonatal demise at < 28 days (RR 1.9, 95% CI 1.6 – 2.1), or a neonatal infection (RR 1.2, 95% CI 1.1 – 1.3). As compared to operative vaginal delivery and cesarean section (CS), women experiencing OL/PL/FTP who gave birth vaginally were more likely to become infected, to have an infected neonate, to hemorrhage in the antepartum and postpartum period, and to die, have a stillbirth, or have a neonatal demise. Women with OL/PL/FTP were far more likely

  10. Relationship of HbA1c variability, absolute changes in HbA1c, and all-cause mortality in type 2 diabetes: a Danish population-based prospective observational study

    PubMed Central

    Skriver, Mette V; Sandbæk, Annelli; Kristensen, Jette K; Støvring, Henrik

    2015-01-01

    Objective We assessed the relationship of mortality with glycated hemoglobin (HbA1c) variability and with absolute change in HbA1c. Design A population-based prospective observational study with a median follow-up time of 6 years. Methods Based on a validated algorithm, 11 205 Danish individuals with type 2 diabetes during 2001–2006 were identified from public data files, with at least three HbA1c measurements: one index measure, one closing measure 22–26 months later, and one measurement in-between. Medium index HbA1c was 7.3%, median age was 63.9 years, and 48% were women. HbA1c variability was defined as the mean absolute residual around the line connecting index value with closing value. Cox proportional hazard models with restricted cubic splines were used, with all-cause mortality as the outcome. Results Variability between 0 and 0.5 HbA1c percentage point was not associated with mortality, but for index HbA1c ≤8% (64 mmol/mol), a variability above 0.5 was associated with increased mortality (HR of 1 HbA1c percentage point variability was 1.3 (95% CI 1.1 to 1.5) for index HbA1c 6.6–7.4%). For index HbA1c≤8%, mortality increased when HbA1c declined, but was stable when HbA1c rose. For index HbA1c>8%, change in HbA1c was associated with mortality, with the lowest mortality for greatest decline (HR=0.9 (95% CI 0.80 to 0.98) for a 2-percentage point decrease). Conclusions For individuals with an index HbA1c below 8%, both high HbA1c variability and a decline in HbA1c were associated with increased mortality. For individuals with index HbA1c above 8%, change in HbA1c was associated with mortality, whereas variability was not. PMID:25664182

  11. 20 CFR 336.13 - Years of service requirement.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Years of service requirement. 336.13 Section... INSURANCE ACT DURATION OF NORMAL AND EXTENDED BENEFITS Extended Benefits § 336.13 Years of service... unemployment or sickness benefits if he or she does not have at least 10 years of railroad service. An...

  12. 20 CFR 336.13 - Years of service requirement.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true Years of service requirement. 336.13 Section... INSURANCE ACT DURATION OF NORMAL AND EXTENDED BENEFITS Extended Benefits § 336.13 Years of service... unemployment or sickness benefits if he or she does not have at least 10 years of railroad service. An...

  13. 20 CFR 336.13 - Years of service requirement.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true Years of service requirement. 336.13 Section... INSURANCE ACT DURATION OF NORMAL AND EXTENDED BENEFITS Extended Benefits § 336.13 Years of service... unemployment or sickness benefits if he or she does not have at least 10 years of railroad service. An...

  14. Bone Mineral Density and Parathyroid Hormone as Independent Risk Factors for Mortality in Community-Dwelling Older Adults: A Population-Based Prospective Cohort Study in Brazil. The São Paulo Ageing & Health (SPAH) Study.

    PubMed

    Domiciano, Diogo S; Machado, Luana G; Lopes, Jaqueline B; Figueiredo, Camille P; Caparbo, Valéria F; Oliveira, Ricardo M; Scazufca, Márcia; McClung, Michael R; Pereira, Rosa Mr

    2016-06-01

    Previous studies have shown a relationship between osteoporosis and increased mortality risk. However, none of these studies performed a concomitant evaluation of the parathyroid hormone (PTH)-calcium-vitamin D axis and bone mass to accurately determine the contribution of each of these parameters to survival in older subjects. Thus, we sought to investigate the association between bone parameters and mortality in a longitudinal, prospective, population-based cohort of 839 elderly subjects. Clinical data (including history of fractures and cardiovascular events) were assessed using a specific questionnaire. Laboratory exams, including serum 25OHD and PTH, were also performed. Bone mineral density (BMD) at the lumbar spine and hip were evaluated using DXA. All analyses were performed at baseline (2005 to 2007). Mortality was recorded during follow-up. Multivariate Cox proportional regression was used to compute hazard ratios for all-cause and cardiovascular mortality. Over a mean 4.06 ± 1.07 years, there were 132 (15.7%) deaths. These individuals were compared to 707 subjects who were alive at the end of the coverage period for mortality data collection. In a multivariate Cox proportional hazards model, age (HR 1.32; 95% CI, 1.13 to 1.55; p = 0.001, for each 5-year increase), male gender (HR 1.90; 95% CI, 1.30 to 2.79; p = 0.001), recurrent falls (more than two in the previous year; HR 1.65; 95% CI, 1.06 to 2.56; p = 0.026), diabetes mellitus (HR 2.17; 95% CI, 1.46 to 3.21; p < 0.001), low physical activity score (HR 1.78; 95% CI, 1.14 to 2.79; p = 0.011), prior cardiovascular event (HR 1.76; 95% CI, 1.18 to 2.63; p = 0.006), total hip BMD (HR 1.41; 95% CI, 1.15 to 1.72; p = 0.001, per each 1 SD decrease), and intact PTH (iPTH) (HR 1.06; 95% CI, 1.04 to 1.08; p < 0.001, per each 10 pg/mL increase) were independently associated with all-cause mortality. The subjects in the highest quartile of PTH (>49 pg/mL) were at a higher

  15. Endometrial adenocarcinoma in a 13-year-old girl

    PubMed Central

    Kim, Sung Mee; Shin, So Jin; Bae, Jin Gon; Kwon, Kun Young

    2016-01-01

    Endometrial cancer is the third most common gynecologic cancer in the Korea and occurs mainly in menopausal women. Although it can develop in young premenopausal women cancer as well, an attack in the adolescent girl is very rare. A 13-year-old girl visited gynecology department with the complaint of abnormal uterine bleeding. An endometrial biopsy revealed FIGO (International Federation of Gynecology and Obstetrics) grade II endometrial adenocarcinoma. In the treatment of endometrial cancer, conservative management should be considered if the patient is nulliparous or wants the fertility preservation. Therefore, we decided to perform a hormonal therapy and a follow-up endometrial biopsy after progestin administration for eight months revealed no residual tumor. We report a case of endometrial cancer occurred in a 13-year-old girl with a brief review of the literature. PMID:27004208

  16. Endometrial adenocarcinoma in a 13-year-old girl.

    PubMed

    Kim, Sung Mee; Shin, So Jin; Bae, Jin Gon; Kwon, Kun Young; Rhee, Jeong Ho

    2016-03-01

    Endometrial cancer is the third most common gynecologic cancer in the Korea and occurs mainly in menopausal women. Although it can develop in young premenopausal women cancer as well, an attack in the adolescent girl is very rare. A 13-year-old girl visited gynecology department with the complaint of abnormal uterine bleeding. An endometrial biopsy revealed FIGO (International Federation of Gynecology and Obstetrics) grade II endometrial adenocarcinoma. In the treatment of endometrial cancer, conservative management should be considered if the patient is nulliparous or wants the fertility preservation. Therefore, we decided to perform a hormonal therapy and a follow-up endometrial biopsy after progestin administration for eight months revealed no residual tumor. We report a case of endometrial cancer occurred in a 13-year-old girl with a brief review of the literature. PMID:27004208

  17. Dietary Habits of Welsh 12-13 Year Olds

    ERIC Educational Resources Information Center

    Thomas, Non-Eleri; Cooper, Stephen-Mark; Graham, Mike; Boobier, Wyndham; Baker, Julien; Davies, Bruce

    2007-01-01

    This study examined the dietary habits of Welsh 12-13 year olds. A cohort of 84 boys and 81 girls, age 12.9 SD 0.3 years; body mass 51.3 SD 12.6kg; and stature 1.54 SD 0.08m, completed a food frequency questionnaire and seven-day food diary. Mean daily kilocalories (kcal/d), and percentages of total fat, saturated fat, carbohydrate, and protein,…

  18. [Massive ovarian edema in a 13-year-old girl].

    PubMed

    Sailer, V; Huss, S; Wardelmann, E; Müller, A M

    2013-11-01

    Massive ovarian edema is a rare tumor-like condition found in young women resulting from accumulation of fluid mostly due to partial or intermittent torsion of the ovary or secondary, to a preexisting ovarian lesion. We report a case of a 13-year-old girl presenting with an ovarian mass measuring 16 cm. CA-12-5 levels were slightly elevated. Concerns regarding underlying malignancy led to salpingo-oophorectomy. Pathological evaluation revealed a massive ovarian edema and multiple thromboses of ovarian veins. Differentiating massive ovarian edema from malignant ovarian tumor is crucial to prevent patients from undergoing unnecessary surgery. PMID:23649810

  19. Global Ammonia Concentrations Seen by the 13-years AIRS Measurements

    NASA Astrophysics Data System (ADS)

    Warner, Juying; Wei, Zigang; Larrabee Strow, L.; Dickerson, Russell; Nowak, John; Wang, Yuxuan

    2016-04-01

    Ammonia is an integral part of the nitrogen cycle and is projected to be the largest single contributor to each of acidification, eutrophication and secondary particulate matter in Europe by 2020 (Sutton et al., 2008). The impacts of NH3 also include: aerosol production affecting global radiative forcing, increases in emissions of the greenhouse gases nitrous oxide (N2O) and methane (CH4), and modification of the transport and deposition patterns of SO2 and NOx. Therefore, monitoring NH3 global distribution of sources is vitally important to human health with respect to both air and water quality and climate change. We have developed new daily and global ammonia (NH3) products from AIRS hyperspectral measurements. These products add value to AIRS's existing products that have made significant contributions to weather forecasts, climate studies, and air quality monitoring. With longer than 13 years of data records, these measurements have been used not only for daily monitoring purposes but also for inter-annual variability and short-term trend studies. We will discuss the global NH3 emission sources from biogenic and anthropogenic activities over many emission regions captured by AIRS. We will focus their variability in the last 13 years.

  20. Prenatal Diagnosis of Chromosome Abnormalities: A 13-Year Institution Experience

    PubMed Central

    Comas, Carmen; Echevarria, Mónica; Rodríguez, María Ángeles; Rodríguez, Ignacio; Serra, Bernat; Cirigliano, Vincenzo

    2012-01-01

    Objective: To analyze trends in screening and invasive prenatal diagnosis of chromosome abnormalities (CA) over a 13-year period and correlate them to changes in the national prenatal screening policy. Methods: We retrospectively reviewed Down syndrome (DS) screening tests and fetal karyotypes obtained by prenatal invasive testing (IT) in our fetal medicine unit between January 1999 and December 2011. Results: A total of 24,226 prenatal screening tests for DS and 11,045 invasive procedures have been analyzed. Over a 13-year period, utilization of non-invasive screening methods has significantly increased from 57% to 89%. The percentage of invasive procedures has declined from 49% to 12%, although the percentage of IT performed for maternal anxiety has increased from 22% to 55%. The percentage of detected CA increased from 2.5% to 5.9%. Overall, 31 invasive procedures are needed to diagnose 1 abnormal case, being 23 procedures in medical indications and 241 procedures in non-medical indications. Conclusions: Our experience on screening and invasive prenatal diagnostic practice shows a decrease of the number of IT, with a parallel decline in medical indications. There is an increasing efficiency of prenatal screening program to detect CA. Despite the increasing screening policies, our population shows a growing request for prenatal IT. The a priori low risk population shows a not negligible residual risk for relevant CA. This observation challenges the current prenatal screening strategy focused on DS; showing that the residual risk is higher than the current cut-off used to indicate an invasive technique. PMID:26859399

  1. Distal biceps reconstruction 13 years post-injury

    PubMed Central

    Burrus, M. Tyrrell

    2015-01-01

    Distal biceps tendon ruptures are relatively rare injuries most commonly caused by an eccentric contraction of the biceps brachii. The majority of complete ruptures receive early surgical intervention, however, some patients do present in a delayed fashion. There are many surgical options at this time for acute and chronic injuries, and this case report describes an Achilles allograft reconstruction in a male who sustained a complete tear 13 years prior to presentation. At 12-month follow up, he had regained full function of his dominant extremity as evidence by returning to work with no limitations and by a Disabilities of the Arm, Shoulder, and Hand (DASH) score of zero. We are unaware of a successfully surgically reconstructed distal biceps tendon of this chronicity. As the literature on this subject is sparse, this case report gives credence to the idea that certain patients with a chronic distal biceps rupture should be considered for operative reconstruction and not relegated to continued failed conservative treatment. Discussed are the surgical treatment options and controversies for chronic distal biceps ruptures, and we review various outcome studies using different surgical techniques. PMID:25829956

  2. CYP1A1, GSTM1 and GSTT1 genetic polymorphisms and gastric cancer risk among Japanese: A nested case-control study within a large-scale population-based prospective study.

    PubMed

    Hidaka, Akihisa; Sasazuki, Shizuka; Matsuo, Keitaro; Ito, Hidemi; Charvat, Hadrien; Sawada, Norie; Shimazu, Taichi; Yamaji, Taiki; Iwasaki, Motoki; Inoue, Manami; Tsugane, Shoichiro

    2016-08-15

    Cytochrome P450 (CYP) 1A1 and glutathione S-transferases (GST) M1 and T1 are major enzymes in the carcinogen metabolizing pathway. We examined the association between single nucleotide polymorphisms (SNPs) of CYP1A1 (rs4646421, rs4646422 and rs1048943), GSTM1 and GSTT1 and gastric cancer risk in Japan. This is a nested case-control study (457 cases and 457 matched controls) of our population-based cohort involving 36,745 subjects who answered a baseline questionnaire and supplied blood samples. The odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were calculated using conditional logistic regression models. We found that CYP1A1 (rs4646422) variant allele was associated with a statistically significant increased risk of gastric cancer compared with the homozygous wild-type genotype (OR = 1.65; 95% CI = 1.17-2.32). GSTM1 null, GSTT1 null and GSTM1/T1 both or either null genotypes were associated with increased risk, but not statistically significantly. Combination of the CYP1A1 (rs4646422) variant allele and GSTM1/T1 both or either null genotypes was associated with a statistically significant increased risk compared with the combination of the CYP1A1 homozygous wild-type genotype and the GSTM1/T1 both active genotypes. In addition, compared with CYP1A1 (rs4646422) homozygous wild-type genotypes in those who were never-smokers, CYP1A1 variant alleles in those who smoked ≥30 pack-years were associated with an increased risk; neither gene-gene nor gene-environment interactions were significant. The CYP1A1 (rs4646422) polymorphism might be involved in gastric carcinogenesis among the Japanese population. PMID:27062139

  3. Predictors of Disordered Eating in Adolescence and Young Adulthood: A Population-Based, Longitudinal Study of Females and Males in Norway

    ERIC Educational Resources Information Center

    Abebe, Dawit Shawel; Torgersen, Leila; Lien, Lars; Hafstad, Gertrud S.; von Soest, Tilmann

    2014-01-01

    We investigated longitudinal predictors for disordered eating from early adolescence to young adulthood (12-34 years) across gender and different developmental phases among Norwegian young people. Survey data from a population-based sample were collected at four time points (T) over a 13-year time span. A population-based sample of 5,679 females…

  4. Physical Fitness of Adults with an Intellectual Disability: A 13-Year Follow-up Study.

    ERIC Educational Resources Information Center

    Graham, Andrew; Reid, Greg

    2000-01-01

    Examined changes in physical fitness of middle-aged adults with mental retardation over 13 years. The subjects had participated in a physical fitness study in 1983. They were re-evaluated for cardiovascular endurance, muscular strength, muscular endurance, flexibility, and body composition. Fitness levels declined over the 13 years and were low…

  5. Prevalence of immediate-type food allergy in Korean schoolchildren: a population-based study.

    PubMed

    Ahn, Kangmo; Kim, Jihyun; Hahm, Myung-Il; Lee, So-Yeon; Kim, Woo Kyung; Chae, Yoomi; Park, Yong Mean; Han, Man Yong; Lee, Kee-Jae; Kim, Ja Kyoung; Yang, Eun Seok; Kwon, Ho-Jang

    2012-01-01

    Although the prevalence and causes of food allergy (FA) vary by geographic location, large well-designed epidemiological studies in Asia are lacking. The purpose of this study was to evaluate the prevalence of immediate-type FA in the general population of Korean schoolchildren. A population-based, cross-sectional study was conducted in 2010 using a stratified two-stage cluster-sampling design. In this survey, children aged 6-7 years and 12-13 years were randomly selected, and the presence of FA was determined by a questionnaire survey and assessment of specific IgE. After adjustment for missing data, 3907 children aged 6-7 years and 3975 students aged 12-13 years who completed the questionnaire were included in this study. In children aged 6-7 years, the prevalence of confirmed immediate-type FA was 0.3%, and the prevalence of possible immediate-type FA was 0.3%. By contrast, 0.6 and 1.0% of children aged 12-13 years had confirmed immediate-type FA and possible immediate-type FA, respectively. In 6- to 7-year-old children, egg was the most frequent causative food associated with a confirmed or possible immediate-type FA. In 12- to 13-year-old children, crustaceans were the most frequent cause of confirmed immediate-type FA, and fruit was most frequently involved in possible immediate-type FA. This is the first nationwide population-based study of FA in Korean schoolchildren. Unlike in western countries, the prevalence of immediate-type FA seems to be low. In 12- to 13 year-old children with confirmed immediate-type FA, peanuts/tree nuts are not common causes, whereas crustaceans are frequent triggers. PMID:23394505

  6. Lifetime exposure to environmental lead and children's intelligence at 11-13 years: the Port Pirie cohort study.

    PubMed Central

    Tong, S.; Baghurst, P.; McMichael, A.; Sawyer, M.; Mudge, J.

    1996-01-01

    OBJECTIVE--To examine the association between environmental exposure to lead and children's intelligence at age 11-13 years, and to assess the implications of exposure in the first seven years of life for later childhood development. DESIGN--Prospective cohort study. SUBJECTS--375 children born in or around the lead smelting town of Port Pirie, Australia, between 1979 and 1982. MAIN OUTCOME MEASURE--Children's intelligence quotient (IQ) measured at 11-13 years of age. RESULTS--IQ was inversely associated with both antenatal and postnatal blood lead concentrations. Verbal, performance, and full scale IQ were inversely related to blood lead concentration with no apparent threshold. Multivariate analyses indicated that after adjustment for a wide range of confounders, the postnatal blood lead concentrations (particularly within the age range 15 months to 7 years) exhibited inverse associations with IQ. Strong associations with IQ were observed for lifetime average blood lead concentrations at various ages. The expected mean full scale IQ declined by 3.0 points (95% confidence interval 0.07 to 5.93) for an increase in lifetime average blood lead concentration from 0.48 to 0.96 mumol/l (10 to 20 micrograms/dl). CONCLUSION--Exposure to environmental lead during the first seven years of life is associated with cognitive deficits that seem to persist into later childhood. PMID:8664666

  7. Intentional Weight Loss and Longevity in Overweight Patients with Type 2 Diabetes: A Population-Based Cohort Study

    PubMed Central

    Køster-Rasmussen, Rasmus; Simonsen, Mette Kildevæld; Siersma, Volkert; Henriksen, Jan Erik; Heitmann, Berit Lilienthal; de Fine Olivarius, Niels

    2016-01-01

    Objective This study examined the influence of weight loss on long-term morbidity and mortality in overweight (BMI≥25kg/m2) patients with type 2 diabetes, and tested the hypothesis that therapeutic intentional weight loss supervised by a medical doctor prolongs life and reduces the risk for cardiovascular disease in these patients. Methods This is a 19 year cohort study of patients in the intervention arm of the randomized clinical trial Diabetes Care in General Practice. Weight and prospective intentions for weight loss were monitored every third month for six years in 761 consecutive patients (≥40 years) newly diagnosed with diabetes in general practices throughout Denmark in 1989–92. Multivariable Cox regression was used to estimate the association between weight change during the monitoring period (year 0 to 6) and the outcomes during the succeeding 13 years (year 6 to 19) in 444 patients who were overweight at diagnosis and alive at the end of the monitoring period (year 6). The analysis was adjusted for age, sex, education, BMI at diagnosis, change in smoking, change in physical activity, change in medication, and the Charlson comorbidity 6-year score. Outcomes were from national registers. Results Overall, weight loss regardless of intention was an independent risk factor for increased all-cause mortality (P<0.01). The adjusted hazard ratio for all-cause mortality, cardiovascular mortality, and cardiovascular morbidity attributable to an intentional weight loss of 1 kg/year was 1.20 (95%CI 0.97–1.50, P = 0.10), 1.26 (0.93–1.72, P = 0.14), and 1.06 (0.79–1.42, P = 0.71), respectively. Limiting the analysis to include only those patients who survived the first 2 years after the monitoring period did not substantially change these estimates. A non-linear spline estimate indicated a V-like association between weight change and all-cause mortality, suggesting the best prognosis for those who maintained their weight. Conclusions In this population-based

  8. A Population-based Longitudinal Study of Childhood Neurodevelopmental Disorders, IQ and Subsequent Risk of Psychotic Experiences in Adolescence

    PubMed Central

    Khandaker, Golam M.; Stochl, Jan; Zammit, Stanley; Lewis, Glyn; Jones, Peter B

    2014-01-01

    Background Schizophrenia has a neurodevelopmental component to its origin, and may share overlapping pathogenic mechanisms with childhood neurodevelopmental disorders (ND). Yet longitudinal studies of psychotic outcomes among individuals with ND are limited. We report a population-based prospective study of six common childhood ND, subsequent neurocognitive performance and the risk of psychotic experiences (PEs) in early adolescence. Methods PEs were assessed by semi-structured interviews at age 13 years. IQ and working memory were measured between ages 9 and 11 years. The presence of six neurodevelopmental disorders (autism spectrum, dyslexia, dyspraxia, dysgraphia, dysorthographia, dyscalculia) was determined from parent-completed questionnaire at age 9 years. Linear regression calculated mean difference in cognitive scores between those with and without ND. The association between ND and PEs was expressed as odds ratio (OR); effects of cognitive deficits were examined. Potential confounders included age, gender, father’s social class, ethnicity and maternal education. Results Out of 8,220 children, 487 (5.9%) were reported to have ND at age 9 years. Children with, compared with those without ND performed worse on all cognitive measures; adjusted mean difference in total IQ 6.84 (95% CI 5.00- 8.69). The association between total IQ and ND was linear (p<0.0001). The risk of PEs was higher in those with, compared with those without ND; adjusted OR for definite PEs 1.76 (95% CI 1.11- 2.79). IQ (but not working memory) deficit partly explained this association. Conclusion Higher risk of PEs in early adolescence among individuals with childhood ND is consistent with the neurodevelopmental hypothesis of schizophrenia. PMID:25066026

  9. Maximum bite force at age 70 years predicts all-cause mortality during the following 13 years in Japanese men.

    PubMed

    Iwasaki, M; Yoshihara, A; Sato, N; Sato, M; Taylor, G W; Ansai, T; Ono, T; Miyazaki, H

    2016-08-01

    There is limited information on the impact of oral function on mortality among older adults. The aim of this prospective cohort study was to examine whether an objective measure of oral function, maximum bite force (MBF), is associated with mortality in older adults during a 13-year follow-up period. Five hundred and fifty-nine community-dwelling Japanese (282 men and 277 women) aged 70 years at baseline were included in the study. Medical and dental examinations and a questionnaire survey were conducted at baseline. Maximum bite force was measured using an electronic recording device (Occlusal Force-Meter GM10). Follow-up investigation to ascertain vital status was conducted 13 years after baseline examinations. Survival rates among MBF tertiles were compared using Cox proportional hazards regression models stratified by sex. There were a total of 111 deaths (82 events for men and 29 for women). Univariable analysis revealed that male participants in the lower MBF tertile had increased risk of all-cause mortality [hazard ratio (HR) = 1·94, 95% confidence interval (CI) = 1·13-3·34] compared with those in the upper MBF tertile. This association remained significant after adjustment for confounders (adjusted HR = 1·84, 95% CI = 1·07-3·19). Conversely, no association between MBF and all-cause mortality was observed in female participants. Maximum bite force was independently associated with all-cause mortality in older Japanese male adults. These data provide additional evidence for the association between oral function and geriatric health. PMID:27084614

  10. Mixed foods are similarly categorized by 8-13 year old children

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Food search in a computerized 24-h dietary recall (24hdr) for children should be easiest when the categories reflect children's categorization of foods, in contrast to professional categories. This study assessed how 8- to 13-year-old children categorized and labeled mixed foods (e.g., fried rice, l...

  11. Who Says You Need to Teach Reading to 11-13-Year-Olds?

    ERIC Educational Resources Information Center

    Parkhill, Faye Fiona; Fletcher, Jo Florence; Greenwood, Janinka; Grimley, Michael; Bridges, Sue

    2013-01-01

    Research indicates that as students move through the school system, many begin to experience difficulties with reading. With this mind, this study explored current practices and perceptions about reading programmes for 11-13-year-old students in New Zealand schools. The study employed an online survey designed to investigate current reading…

  12. 13-Year-Olds' Perception of Bullying: Definitions, Reasons for Victimisation and Experience of Adults' Response

    ERIC Educational Resources Information Center

    Frisen, Ann; Holmqvist, Kristina; Oscarsson, Daniel

    2008-01-01

    This study formed the second wave of a longitudinal research project examining bullying from the students' perspective. A sample of 877 Swedish 13-year-olds filled out a questionnaire regarding the definition of bullying, reasons for why some students are bullied and the experience of adults' response to bullying. In their definitions, girls were…

  13. Diverse Food Items Are Similarly Categorized by 8- to 13-Year-Old Children

    ERIC Educational Resources Information Center

    Beltran, Alicia; Knight Sepulveda, Karina; Watson, Kathy; Baranowski, Tom; Baranowski, Janice; Islam, Noemi; Missaghian, Mariam

    2008-01-01

    Objective: Assess how 8- to 13-year-old children categorized and labeled food items for possible use as part of a food search strategy in a computerized 24-hour dietary recall. Design: A set of 62 cards with pictures and names of food items from 18 professionally defined food groups was sorted by each child into piles of similar food items.…

  14. Grains are similarly categorized by 8- to 13-year-old children

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This study assessed how 8- to 13-year-old children categorized and labeled grain foods and how these categories and labels were influenced by child characteristics. The main hypotheses were that children categorized foods in consistent ways and these food categories differed from the professional fo...

  15. Fruit and vegetables are similarly categorised by 8-13-year-old children

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This exploratory study assessed how 8- to 13-year-old children categorized and labelled fruit and vegetables (FaV), and how these were influenced by child characteristics, to specify second-level categories in a hierarchical food search system for a computerised 24-h dietary recall (hdr). Two sets o...

  16. Recidivism among Child Sexual Abusers: Initial Results of a 13-Year Longitudinal Random Sample

    ERIC Educational Resources Information Center

    Patrick, Steven; Marsh, Robert

    2009-01-01

    In the initial analysis of data from a random sample of all those charged with child sexual abuse in Idaho over a 13-year period, only one predictive variable was found that related to recidivism of those convicted. Variables such as ethnicity, relationship, gender, and age differences did not show a significant or even large association with…

  17. Diverse Food Items Are Similarly Categorized by 8- to 13-year-old Children

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The study objective was to assess how 8- to 13-year-old children categorized and labeled food items, for possible use as part of a food search strategy in a computerized 24-hour dietary recall. A set of 62 cards with pictures and names of food items from 18 professionally defined food groups was sor...

  18. Self-Concept of Gifted Children Aged 9 to 13 Years Old

    ERIC Educational Resources Information Center

    Shi, Jiannong; Li, Ying; Zhang, Xingli

    2008-01-01

    Ninety-four gifted children and 200 nongifted children (aged 9 to 13 years old) were involved in the present study. Their self-concept was assessed by the Revised Song-Hattie Self-Concept Inventory (Zhou & He, 1996). Academic self-concepts pertaining to abilities, school achievements, and grade concepts and nonacademic self-concepts pertaining to…

  19. Analysis of high-resolution foreign exchange data of USD-JPY for 13 years

    NASA Astrophysics Data System (ADS)

    Mizuno, Takayuki; Kurihara, Shoko; Takayasu, Misako; Takayasu, Hideki

    2003-06-01

    We analyze high-resolution foreign exchange data consisting of 20 million data points of USD-JPY for 13 years to report firm statistical laws in distributions and correlations of exchange rate fluctuations. A conditional probability density analysis clearly shows the existence of trend-following movements at time scale of 8-ticks, about 1 min.

  20. Maternal mortality in a teaching hospital in southern India. A 13-year study.

    PubMed

    Rao, K B

    1975-10-01

    During the 13 years 1960-1972, in a teaching hospital that serves a predominantly rural and semiurban population in southern India, there were 74,384 deliveries and 1245 maternal deaths, a maternal mortality rate of 16.7 per 1000 births. Direct obstetric factors caused 854 (65.5%) of these deaths. The leading indirect or associated causes of maternal deaths were anemia, cerebrovascular accidents, and infectious hepatitis. During the past 13 years, monthly maternal mortality meetings have helped to reduce the incidence of avoidable factors in maternal deaths among patients from the city but not among those brought from the surrounding countryside. The important causes of maternal deaths in this developing country, and their prevention, are individually discussed. PMID:1080844

  1. Gastric adenocarcinoma presenting with thromboembolism in a 13-year-old boy.

    PubMed

    Hunter, Wendy L M

    2015-03-01

    Abdominal pain is a frequent complaint in the pediatric emergency department. A 13-year-old boy presented with complaints of abdominal pain, hematemesis, headache, and leg pain. Further investigation revealed an advanced-stage gastric adenocarcinoma with multiple thromboembolism including the greater saphenous vein and nonbacterial thrombotic endocarditis. This case points out the challenges of diagnosing this rare condition and treating the primary tumor and thromboembolism in the setting of both hypercoagulable state and gastrointestinal bleeding. PMID:25738239

  2. Pulmonary Aspergillosis in a Previously Healthy 13-Year-Old Boy

    PubMed Central

    Rayment, Jonathan H.; Narang, Indra

    2016-01-01

    Chronic granulomatous disease (CGD) is a rare, polygenic primary immunodeficiency. In this case report, we describe a previously healthy 13-year-old boy who presented with multifocal pulmonary aspergillosis and was subsequently diagnosed with an autosomal recessive form of chronic granulomatous disease. CGD has a variable natural history and age of presentation and should be considered when investigating a patient with recurrent or severe infections with catalase-positive organisms.

  3. Young adults' trajectories of Ecstasy use: a population based study.

    PubMed

    Smirnov, Andrew; Najman, Jake M; Hayatbakhsh, Reza; Plotnikova, Maria; Wells, Helene; Legosz, Margot; Kemp, Robert

    2013-11-01

    Young adults' Ecstasy use trajectories have important implications for individual and population-level consequences of Ecstasy use, but little relevant research has been conducted. This study prospectively examines Ecstasy trajectories in a population-based sample. Data are from the Natural History Study of Drug Use, a retrospective/prospective cohort study conducted in Australia. Population screening identified a probability sample of Ecstasy users aged 19-23 years. Complete data for 30 months of follow-up, comprising 4 time intervals, were available for 297 participants (88.4% of sample). Trajectories were derived using cluster analysis based on recent Ecstasy use at each interval. Trajectory predictors were examined using a generalized ordered logit model and included Ecstasy dependence (World Mental Health Composite International Diagnostic Instrument), psychological distress (Hospital Anxiety Depression Scale), aggression (Young Adult Self Report) and contextual factors (e.g. attendance at electronic/dance music events). Three Ecstasy trajectories were identified (low, intermediate and high use). At its peak, the high-use trajectory involved 1-2 days Ecstasy use per week. Decreasing frequency of use was observed for intermediate and high-use trajectories from 12 months, independently of market factors. Intermediate and high-use trajectory membership was predicted by past Ecstasy consumption (>70 pills) and attendance at electronic/dance music events. High-use trajectory members were unlikely to have used Ecstasy for more than 3 years and tended to report consistently positive subjective effects at baseline. Given the social context and temporal course of Ecstasy use, Ecstasy trajectories might be better understood in terms of instrumental rather than addictive drug use patterns. PMID:23899430

  4. Coincident 1.3-year Periodicities in the ap Geomagnetic Index and the Solar Wind

    NASA Technical Reports Server (NTRS)

    Paularena, K. I.; Szabo, A.; Richardson, J. D.

    1995-01-01

    Recent observations show an approximately 1.3-year period in the speed of the solar wind detected by the IMP 8 and Voyager 2 spacecraft. A similar period is also seen in the north-south (GSE) component of the magnetic field observed by IMP 8. Since both parameters are commonly used as input to models of geomagnetic activity, the 'ap' index (a measure of geomagnetic disturbance) is examined to look for this periodicity. The Lomb-Scargle periodogram method is used on the ap, plasma, and magnetic field data during the 1973-1994 time range. A dynamic FFT periodogram method is also used to analyze the ap data during this time, as well as to look for periods present between 1932 and 1972. A clear 1.3-year periodicity is present in the post-1986 data when the same period is observed in the plasma and field data. The V(2)B(zsm) and V(2)B(s) proxies for geomagnetic activity also show this periodicity. However, the southward (GSM) component of the magnetic field does not have a 1.3-year period, and neither do solar wind or ap data from 1973-1985. This demonstrates that the ap geomagnetic index can act as a proxy for solar wind periodicities at this time scale. Historic ap data are examined, and show that a similar periodicity in ap exists around 1942. Since auroral data show a 1.4-year periodicity, all these similar periods may result from a common underlying solar mechanism.

  5. Ethics and the proposed treatment for a 13-year-old with atypical gender identity.

    PubMed

    Spriggs, Merle P

    2004-09-20

    The case of a 13-year-old girl given permission by the Family Court of Australia to begin a sex-change process involves complex issues. Nevertheless, the ethical justification for the decision is not complicated. In this case, it can be argued that the net benefit eclipses concerns about competence, autonomy and the appropriateness of the intervention. The debate this case generated in the media reminds us that one of the essential tasks in ethics debates is to get our facts straight. PMID:15377242

  6. [Mucoepidermoid carcinoma in a 13-year-old girl; report of a case].

    PubMed

    Fujita, Koichi

    2009-05-01

    A 13-year-old girl was referred to our hospital for chest pain and atelectasis of left upper lobe on chest X-ray film. Bronchoscopy revealed an endobronchial tumor obstructing left main bronchus. Left upper lobectomy with bronchoplasty was performed. The tumor was a polyp 34 x 17 x 17 mm in size and obstructed left main bronchus. Histologically the tumor was a low-grade malignant mucoepidermoid carcinoma with malignant pleural effusin. The patient has been well and free of recurrence for 8 years postoperatively. PMID:19425387

  7. Atypical Fibroxanthoma in a 13-Year-Old Guatemalan Girl with Xeroderma Pigmentosum.

    PubMed

    Chappell, Ava G; Chase, Elizabeth P; Chang, Beverly; Cunningham, Eric; Mihm, Fred; Calame, Antoanella; Fudem, Gary; Cunningham, Bari

    2016-05-01

    Xeroderma pigmentosum (XP) is a rare, autosomal recessive disease involving a defect in DNA repair leading to the premature development of numerous aggressive cutaneous malignancies. Although atypical fibroxanthoma (AFX) is a neoplasm typically found in the setting of extensive sun exposure or therapeutic radiation, AFXs are rarely associated with children with XP. We report the case of a 13-year-old Guatemalan girl with the XP type C variant who developed one of the largest AFXs reported on a child's finger. PMID:27046537

  8. Cytogenetic and clinical features of a 13 year old male with trisomy 8

    PubMed Central

    Balkan, Mahmut; Fidanboy, Mehmet; Özmen, Cihan; Özbek, M. Nuri; Otçu, Selçuk; Kapı, Emin; Budak, Turgay

    2012-01-01

    Trisomy 8 is a relatively rare chromosomal abnormality. The majority of cases present with the mosaic form. Regular trisomy 8 is usually lethal and frequently results in miscarriage, while those with “trisomy 8 mosaicism” are more likely to survive. We report clinical observations and cytogenetic studies of a 13-year-old male with regular trisomy 8 and compared with those of other known cases of trisomy 8. The most discriminating findings for this condition are skeletal anomalies, restricted articular function, and speech problems. Our results are in agreement with those of previous studies for trisomy 8.

  9. Spine Shape in Sagittal and Frontal Planes in Short- and Tall-Statured Children Aged 13 Years

    ERIC Educational Resources Information Center

    Lichota, Malgorzata

    2008-01-01

    Study aim: To assess spine curvatures, postural categories and scolioses in short and tall children aged 13 years. Material and methods: Short-statured (below Percentile 10) and tall-statured (above Percentile 90) boys (n = 13 and 18, respectively) and girls (n = 10 and 11, respectively) aged 13 years were studied. The following angles of spine…

  10. Global Ammonia Distributions and Recent Trends from AIRS 13-years Measurements

    NASA Astrophysics Data System (ADS)

    Warner, J. X.; Wei, Z.; Strow, L. L.; Nowak, J. B.; Dickerson, R. R.

    2015-12-01

    Ammonia is an integral part of the nitrogen cycle and is projected to be the largest single contributor to each of acidification, eutrophication and secondary particulate matter in Europe by 2020 (Sutton et al., 2008). The impacts of NH3 also include: aerosol production affecting global radiative forcing, increases in emissions of the greenhouse gases nitrous oxide (N2O) and methane (CH4), and modification of the transport and deposition patterns of SO2 and NOx. Therefore, monitoring NH3 global distribution of sources is vitally important to human health with respect to both air and water quality and climate change. We have developed new daily and global ammonia (NH3) products from AIRS hyperspectral measurements. These products add value to AIRS's existing products that have made significant contributions to weather forecasts, climate studies, and air quality monitoring. With longer than 13 years of data records, these measurements have been used not only for daily monitoring purposes but also for inter-annual variability and short-term trend studies. We will discuss the global NH3 emission sources from biogenic and anthropogenic activities over many emission regions captured by AIRS. We will focus their variability in the last 13 years. Validation examples using in situ measurements for AIRS NH3 will also be presented.

  11. The Morscher Press Fit acetabular component: a nine- to 13-year review.

    PubMed

    Gwynne-Jones, D P; Garneti, N; Wainwright, C; Matheson, J A; King, R

    2009-07-01

    We reviewed the results at nine to 13 years of 125 total hip replacements in 113 patients using the monoblock uncemented Morscher press-fit acetabular component. The mean age at the time of operation was 56.9 years (36 to 74). The mean clinical follow-up was 11 years (9.7 to 13.5) and the mean radiological follow-up was 9.4 years (7.7 to 13.1). Three hips were revised, one immediately for instability, one for excessive wear and one for deep infection. No revisions were required for aseptic loosening. A total of eight hips (7.0%) had osteolytic lesions greater than 1 cm, in four around the acetabular component (3.5%). One required bone grafting behind a well-fixed implant. The mean wear rate was 0.11 mm/year (0.06 to 0.78) and was significantly higher in components with a steeper abduction angle. Kaplan-Meier survival curves at 13 years showed survival of 96.8% (95% confidence interval 90.2 to 99.0) for revision for any cause and of 95.7% (95% confidence interval 88.6 to 98.4) for any acetabular re-operation. PMID:19567847

  12. MIXED FOODS ARE SIMILARLY CATEGORIZED BY 8 – 13 YEAR OLD CHILDREN

    PubMed Central

    Beltran, Alicia; Sepulveda, Karina Knight; Watson, Kathy; Baranowski, Tom; Baranowski, Janice; Islam, Noemi; Missaghian, Mariam

    2008-01-01

    Food search in a computerized 24 hour recall (24hdr) for children should be easiest when the categories reflect children’s categorization of foods, in contrast to professional categories. This study assessed how 8–13 year old children categorized and labeled mixed foods (e.g. fried rice, lasagna), and how these were influenced by child characteristics. A set of 48 cards with pictures and names of mixed foods from 14 professionally defined food groups was sorted by each child into piles of similar foods. Participants (n= 146), including 8 to13 year old 130 English speaking, and 16 Spanish speaking children, attended data collection in the summer, 2006. One way ANOVA, pairwise comparisons and Robinson matrices for identification of clusters were used. Children created an average of 10.5 (± 5.5) piles with 6.0 (±4.1) cards per pile. No substantial differences in Robinson clustering were detected across subcategories for each of the demographic characteristics, body mass index, or 6-n-propylthiouracil sensitivity. For the majority of the piles, children provided “Taxonomic-Professional” (26.0%) labels, such as Vegetables, Sandwiches and Drinks, or “Specific-food item” (23.0%) labels, i.e. the name of the food. These categories may be used to facilitate mixed food search in a computerized 24hdr for children in this age group. PMID:17936412

  13. A population-based Habitable Zone perspective

    NASA Astrophysics Data System (ADS)

    Zsom, Andras

    2015-08-01

    What can we tell about exoplanet habitability if currently only the stellar properties, planet radius, and the incoming stellar flux are known? The Habitable Zone (HZ) is the region around stars where planets can harbor liquid water on their surfaces. The HZ is traditionally conceived as a sharp region around the star because it is calculated for one planet with specific properties e.g., Earth-like or desert planets , or rocky planets with H2 atmospheres. Such planet-specific approach is limiting because the planets’ atmospheric and geophysical properties, which influence the surface climate and the presence of liquid water, are currently unknown but expected to be diverse.A statistical HZ description is outlined which does not select one specific planet type. Instead the atmospheric and surface properties of exoplanets are treated as random variables and a continuous range of planet scenarios are considered. Various probability density functions are assigned to each observationally unconstrained random variable, and a combination of Monte Carlo sampling and climate modeling is used to generate synthetic exoplanet populations with known surface climates. Then, the properties of the liquid water bearing subpopulation is analyzed.Given our current observational knowledge of small exoplanets, the HZ takes the form of a weakly-constrained but smooth probability function. The model shows that the HZ has an inner edge: it is unlikely that planets receiving two-three times more stellar radiation than Earth can harbor liquid water. But a clear outer edge is not seen: a planet that receives a fraction of Earth's stellar radiation (1-10%) can be habitable, if the greenhouse effect of the atmosphere is strong enough. The main benefit of the population-based approach is that it will be refined over time as new data on exoplanets and their atmospheres become available.

  14. Aspects of Quality of Life in Adults Diagnosed with Autism in Childhood: A Population-Based Study

    ERIC Educational Resources Information Center

    Billstedt, Eva; Gillberg, I. Carina; Gillberg, Christopher

    2011-01-01

    The present study is a long-term prospective follow-up study of a population-based cohort of 120 individuals diagnosed with autism in childhood, followed into late adolescence/early adulthood. Specific aims of the study were to attempt to measure and study social aspects/quality of life in those 108 individuals with autism alive and available for…

  15. Population-Based Age Group Specific Annual Incidence Rates of Symptomatic Age-Related Macular Degeneration

    PubMed Central

    Saari, Jukka M

    2014-01-01

    Purpose To study the population-based annual incidence rates of exudative, dry and all cases of symptomatic age-related macular degeneration (AMD) in different age and sex groups. Methods. This is a one year, prospective, population-based study on all consecutive new patients with AMD in the hospital district of Central Finland. The diagnosis was confirmed in all patients with slit lamp biomicroscopy, optical coherence tomography (OCT) using a Spectralis HRA + OCT device, and the Heidelberg Eye Explorer 1.6.2.0 program. Fluorescein angiograms were taken when needed. Results. The population-based annual incidence rates of all cases of symptomatic AMD increased from 0.03% (95% CI, 0.01-0.05%) in the age group 50-59 years to 0.82% (95% CI, 0.55-1.09%) in the age group 85-89 years and were 0.2% (95% CI, 0.17-0.24%) in exudative, 0.11% (95% CI, 0.09-0.14%) in dry, and 0.32% (95% CI, 0.28-0.36%) in all cases of AMD in the age group 60 years and older. During the next 20 years in Central Finland the population-based annual incidence rates can be estimated to increase to 0.27% (95% CI, 0.24-0.30%) in exudative, to 0.13% (95% CI, 0.11-0.15%) in dry, and to 0.41% (95% CI, 0.37-0.45%) in all cases of AMD in the age group 60 years and older. The population-based annual incidence of AMD did not show statistically significant differences between males and females (p>0.1). Conclusion: The population-based age-group specific annual incidence rates of symptomatic AMD of this study may help to plan health care provision for patients of AMD. PMID:25674187

  16. Early onset of colorectal cancer in a 13-year-old girl with Lynch syndrome

    PubMed Central

    Ahn, Do Hee; Rho, Jung Hee; Tchah, Hann

    2016-01-01

    Lynch syndrome is the most common inherited colon cancer syndrome. Patients with Lynch syndrome develop a range of cancers including colorectal cancer (CRC) and carry a mutation on one of the mismatched repair (MMR) genes. Although CRC usually occurs after the fourth decade in patients with Lynch syndrome harboring a heterozygous MMR gene mutation, it can occur in children with Lynch syndrome who have a compound heterozygous or homozygous MMR gene mutation. We report a case of CRC in a 13-year-old patient with Lynch syndrome and congenital heart disease. This patient had a heterozygous mutation in MLH1 (an MMR gene), but no compound MMR gene defects, and a K-RAS somatic mutation in the cancer cells. PMID:26893603

  17. Patterns of game animal attacks on hunters in Croatia over a 13-year period.

    PubMed

    Sprem, Nikica; Skavić, Petar; Krupec, Ivan; Budor, Ivica

    2013-09-01

    Hunter-game animal conflicts are occasionally reported from various parts of the world. This case series comprises all 7 game animal attacks on hunters reported to the Croatian Hunting Association over a period of 13 years (1999-2011), covering the entire Croatian territorial area. Seasonally, attacks occurred most frequently in the winter time, when the hunting season is at its peak. The most common attacking animal, representing 5 of 7 cases (71.4%), was the wild boar, and the majority of the attacks happened in the morning. All of our victims were male, with an average age of 51 years (range 26 to 69 years). Six victims sustained a bite wound or wounds and 1 was rammed by the animal. Almost all of our patients (5 of 7, with one unknown) recovered completely and without significant complications. PMID:23870764

  18. XYY syndrome: a 13-year-old boy with tall stature.

    PubMed

    Jo, Won Ha; Jung, Mo Kyung; Kim, Ki Eun; Chae, Hyun Wook; Kim, Duk Hee; Kwon, Ah Reum; Kim, Ho-Seong

    2015-09-01

    When evaluating the underlying causes of tall stature, it is important to differentiate pathologic tall stature from familial tall stature. Various pathologic conditions leading to adult tall stature include excess growth hormone secretion, Marfan syndrome, androgen or estrogen deficiency, testicular feminization, and sex chromosome anomaly, such as Klinefelter syndrome and XYY syndrome. Men with 47,XYY syndrome can exhibit multiple phenotypes. A 13-year-old boy visited the hospital for evaluation of tall stature. The boy had no other physical abnormalities except tall stature. All biochemical and imaging studies were within the normal ranges. He was diagnosed with XYY syndrome in this chromosome study. When evaluating men with tall stature, XYY syndrome should be ruled out. PMID:26512355

  19. Early onset of colorectal cancer in a 13-year-old girl with Lynch syndrome.

    PubMed

    Ahn, Do Hee; Rho, Jung Hee; Tchah, Hann; Jeon, In-Sang

    2016-01-01

    Lynch syndrome is the most common inherited colon cancer syndrome. Patients with Lynch syndrome develop a range of cancers including colorectal cancer (CRC) and carry a mutation on one of the mismatched repair (MMR) genes. Although CRC usually occurs after the fourth decade in patients with Lynch syndrome harboring a heterozygous MMR gene mutation, it can occur in children with Lynch syndrome who have a compound heterozygous or homozygous MMR gene mutation. We report a case of CRC in a 13-year-old patient with Lynch syndrome and congenital heart disease. This patient had a heterozygous mutation in MLH1 (an MMR gene), but no compound MMR gene defects, and a K-RAS somatic mutation in the cancer cells. PMID:26893603

  20. The speed of information processing of 9- to 13-year-old intellectually gifted children.

    PubMed

    Duan, Xiaoju; Dan, Zhou; Shi, Jiannong

    2013-02-01

    In general, intellectually gifted children perform better than non-gifted children across many domains. The present validation study investigated the speed with which intellectually gifted children process information. 184 children, ages 9 to 13 years old (91 gifted, M age = 10.9 yr., SD = 1.8; 93 non-gifted children, M age = 11.0 yr., SD = 1.7) were tested individually on three information processing tasks: an inspection time task, a choice reaction time task, an abstract matching task. Intellectually gifted children outperformed their non-gifted peers on all three tasks obtaining shorter reaction time and doing so with greater accuracy. The findings supported the validity of the information processing speed in identifying intellectually gifted children. PMID:23654024

  1. The Rochester OSA Optics Suitcase: 13 years of middle school outreach

    NASA Astrophysics Data System (ADS)

    Canavesi, Cristina; Donlon, Theresa M.; Jacobs, Stephen D.

    2012-10-01

    The Rochester Section of the Optical Society of America (ROSA) developed a youth outreach program in 1999 to be presented in middle schools by scientists, engineers and engineering students. The objective was to kindle interest in technology careers, especially those related to optics, photonics, and optical engineering. Three in-class experiments using individual take-home theme packets that explore color in white light were devised early in the program, and these have proven to be the key to its success. Over the past 13 years, with financial support from a variety of organizations and individuals, ROSA has manufactured and delivered over 450 Optics Suitcases to groups in 34 US states and 54 countries. The presentation guide is now available in 4 languages besides English. In this paper, the elements of an Optics Suitcase presentation are reviewed, and examples of outreach events are used to document its success.

  2. The 13 years of TRMM Lightning Imaging Sensor: From Individual Flash Characteristics to Decadal Tendencies

    NASA Technical Reports Server (NTRS)

    Albrecht, R. I.; Goodman, S. J.; Petersen, W. A.; Buechler, D. E.; Bruning, E. C.; Blakeslee, R. J.; Christian, H. J.

    2011-01-01

    How often lightning strikes the Earth has been the object of interest and research for decades. Several authors estimated different global flash rates using ground-based instruments, but it has been the satellite era that enabled us to monitor lightning thunderstorm activity on the time and place that lightning exactly occurs. Launched into space as a component of NASA s Tropical Rainfall Measuring Mission (TRMM) satellite, in November 1997, the Lighting Imaging Sensor (LIS) is still operating. LIS detects total lightning (i.e., intracloud and cloud-to-ground) from space in a low-earth orbit (35deg orbit). LIS has collected lightning measurements for 13 years (1998-2010) and here we present a fully revised and current total lightning climatology over the tropics. Our analysis includes the individual flash characteristics (number of events and groups, total radiance, area footprint, etc.), composite climatological maps, and trends for the observed total lightning during these 13 years. We have identified differences in the energetics of the flashes and/or the optical scattering properties of the storms cells due to cell-relative variations in microphysics and kinematics (i.e., convective or stratiform rainfall). On the climatological total lightning maps we found a dependency on the scale of analysis (resolution) in identifying the lightning maximums in the tropics. The analysis of total lightning trends observed by LIS from 1998 to 2010 in different temporal (annual and seasonal) and spatial (large and regional) scales, showed no systematic trends in the median to lower-end of the distributions, but most places in the tropics presented a decrease in the highest total lightning flash rates (higher-end of the distributions).

  3. Injuries from batteries among children aged <13 years--United States, 1995-2010.

    PubMed

    2012-08-31

    Injuries to children caused by batteries have been documented in the medical literature and by poison control centers for decades. Of particular concern is the ingestion of button batteries, especially those ≥20 mm in diameter (coin size), which can lodge in the esophagus, leading to serious complications or death. To estimate the number of nonfatal battery injuries among children aged <13 years, U.S. Consumer Product Safety Commission (CPSC) staff analyzed 1997-2010 data from the National Electronic Injury Surveillance System (NEISS). To identify fatal battery exposures, other CPSC databases covering 1995-2010 were examined, including the 1) Injury and Potential Injury Incident File; 2) Death Certificate Database (DTHS); and 3) In-Depth Investigation File (INDP). From 1997 to 2010, an estimated 40,400 children aged <13 years were treated in hospital emergency departments (EDs) for battery-related injuries, including confirmed or possible battery ingestions. Nearly three quarters of the injuries involved children aged ≤4 years; 10% required hospitalization. Battery type was reported for 69% of cases, and of those, button batteries were implicated in 58%. Fourteen fatal injuries were identified in children ranging in age from 7 months to 3 years during 1995-2010. Battery type was reported in 12 of these cases; all involved button batteries. CPSC is urging the electronics industry and battery manufacturers to develop warnings and industry standards to prevent serious injuries and deaths from button batteries. Additionally, public health and health-care providers can encourage parents to keep button batteries and products containing accessible button batteries (e.g., remote controls) away from young children. PMID:22932299

  4. Multidrug-resistant pulmonary & extrapulmonary tuberculosis: A 13 years retrospective hospital-based analysis

    PubMed Central

    Raveendran, Reena; Oberoi, Jaswinder Kaur; Wattal, Chand

    2015-01-01

    Background & objectives: Multidrug-resistant tuberculosis (MDR-TB) is a public health problem of great significance in India. In the present study an attempt was made to analyse the progression of MDR-TB pattern during a course of 13 years (2000-2012) among the patient population at a tertiary care centre in New Delhi, India. Methods: Mycobacterial isolates obtained on Lowenstein-Jensen (L-J) medium/BacT/ALERT 3D were identified using AccuProbe molecular identification system, routine biochemical tests or GenoType Mycobacteria CM. Antimycobacterial susceptibility testing was performed using resistance ratio method on L-J medium (2000-2004) and one per cent proportion method on BacT/ALERT 3D system (2005-2012). Results: Of the total 14,849 samples subjected to mycobacterial culture, 6569 pulmonary and 8280 extrapulmonary, 2364 were detected positive for mycobacteria. The average percentage positivity rate was 15.9 per cent (18.9 and 13.6% in case of pulmonary and extrapulmonary samples, respectively). Our study revealed a significant increase (P<0.001) in multidrug resistance by 12 per cent (4.7% in 2000 to 19.8% in 2012). MDR-TB was more in case of pulmonary (28.2%) than extrapulmonary (11.6%) TB (P<0.001). Only 6.5 per cent (154) of mycobacterial isolates were non-tuberculous mycobacteria and rapid growers represented by Mycobacterium fortuitum and M. abscessus were the most commonly isolated species. Interpretation & conclusions: Increase in prevalence of MDR-TB by 12 per cent in the past 13 years is alarming. Policy modifications may have to be done to strengthen the existing TB control programmes to encourage contact tracing and culture and drug susceptibility testing for all smear positive pulmonary cases to ensure early and appropriate therapy. PMID:26658593

  5. Guiding principles and checklist for population-based quality metrics.

    PubMed

    Krishnan, Mahesh; Brunelli, Steven M; Maddux, Franklin W; Parker, Thomas F; Johnson, Douglas; Nissenson, Allen R; Collins, Allan; Lacson, Eduardo

    2014-06-01

    The Centers for Medicare and Medicaid Services oversees the ESRD Quality Incentive Program to ensure that the highest quality of health care is provided by outpatient dialysis facilities that treat patients with ESRD. To that end, Centers for Medicare and Medicaid Services uses clinical performance measures to evaluate quality of care under a pay-for-performance or value-based purchasing model. Now more than ever, the ESRD therapeutic area serves as the vanguard of health care delivery. By translating medical evidence into clinical performance measures, the ESRD Prospective Payment System became the first disease-specific sector using the pay-for-performance model. A major challenge for the creation and implementation of clinical performance measures is the adjustments that are necessary to transition from taking care of individual patients to managing the care of patient populations. The National Quality Forum and others have developed effective and appropriate population-based clinical performance measures quality metrics that can be aggregated at the physician, hospital, dialysis facility, nursing home, or surgery center level. Clinical performance measures considered for endorsement by the National Quality Forum are evaluated using five key criteria: evidence, performance gap, and priority (impact); reliability; validity; feasibility; and usability and use. We have developed a checklist of special considerations for clinical performance measure development according to these National Quality Forum criteria. Although the checklist is focused on ESRD, it could also have broad application to chronic disease states, where health care delivery organizations seek to enhance quality, safety, and efficiency of their services. Clinical performance measures are likely to become the norm for tracking performance for health care insurers. Thus, it is critical that the methodologies used to develop such metrics serve the payer and the provider and most importantly, reflect

  6. Is hydroxyapatite a reliable fixation option in unicompartmental knee arthroplasty? A 5- to 13-year experience with the hydroxyapatite-coated unix prosthesis.

    PubMed

    Epinette, Jean-Alain; Manley, Michael T

    2008-10-01

    Hydroxyapatite-coated unicompartmental knee arthroplasty (UKA) is a debatable approach to unicompartmental knee arthritis because UKA isoften viewed as a short-term solution, at best, fora condition that will eventually require a total knee arthroplasty (TKA). Unicompartmental knee arthroplasty is a more technically demanding procedure than TKA, and appropriate patient selection, careful surgical technique, and correct choice of implant geometry are all critical components to its success. A fundamental issue surrounding UKA is whether hydroxyapatite-coated unicompartmental components can provide a long-term solution to unicondylar arthritis. We address this issue in the current study, which is based on a prospective series of 125 hydroxyapatite-coated Unix knee prostheses implanted consecutively between 1994 and 2002, with a 5-year minimum follow-up and a 13-year maximum follow-up. The results of our study indicate that uncemented hydroxyapatite-coated UKA can be successful in the long term. PMID:18979933

  7. Increase in the Inflammatory Marker GlycA over 13 Years in Young Adults Is Associated with Poorer Cognitive Function in Midlife

    PubMed Central

    Cohen-Manheim, Irit; Doniger, Glen M.; Sinnreich, Ronit; Simon, Ely S.; Pinchas-Mizrachi, Ronit; Otvos, James D.; Kark, Jeremy D.

    2015-01-01

    inflammation measures, was inversely related to global cognition (standardized β = -.109, p = .011) as well as to the information processing speed and memory domains (standardized β = -.124, p = .008 and-.117, p = .014, respectively). The multivariable-adjusted odds ratio for low ranked global cognitive function (lowest fifth) comparing the extreme quintiles of GlycA change was 4.8 (95%CI, 1.7–13.5, p = .003; p for trend = .031). Conclusions In this longitudinal study of a novel systemic inflammatory marker in a population-based cohort of young adults, GlycA increase over 13 years, but not baseline measures of inflammation, was associated with poorer cognitive function in midlife. PMID:26406330

  8. Non-Hodgkin's lymphoma “masquerading” as Pott's disease in a 13-year old boy

    PubMed Central

    Adegboye, Olasunkanmi Abdulrasheed

    2011-01-01

    Lymphomas are malignant neoplasms of the lymphoid lineage. They are broadly classified as either Hodgkin disease or as non-Hodgkin lymphoma (NHL). Burkitt's lymphoma, a variety of NHL, is significantly most common in sub-Saharan Africa, where it accounts for approximately one half of childhood cancers. Lymphoblastic lymphoma is less common. A case of paravertebral high grade non-Hodgkin's lymphoma (lymphoblastic lymphoma) “masquerading” as Pott's disease in a 13-year-old child is reported. The present report was informed by the unusual presentation of this case and the intent of increasing the index of diagnostic suspicion. A brief appraisal is provided of the clinical parameters, management strategies and challenges. AT was a 13-year boy that presented on account of a slowly evolving and progressively increasing hunch on the back and inability to walk over 4 and 8 months duration, respectively. There was subsequent inability to control defecation and urination. There was no history of cough. He and his twin brother lived with their paternal grandfather who had chronic cough with associated weight loss. The grandfather died shortly before the child's admission. The child had no BCG immunization. The essential findings on examination were in keeping with lower motor neurons (LMN) paralysis of the lower limbs. The upper limbs appeared normal. There was loss of cutaneous sensation from the umbilicus (T10) downward. There was a firm, (rather tense), non-tender non-pulsatile, smooth swelling over the mid-third of the back (T6-L1) the mass had no differential warmth. It measures about 20×12 cm. Chest radiograph showed no active focal lung lesion, but the thoraco-lumbar spine showed a vertebral planner at L1 and a wedged collapse of T11-T12 vertebrae. There was sclerosis of the end plates of all the vertebral bodies with associated reduction in the bone density. He had an excision biopsy on the 90th day on admission, following which his clinical state rapidly

  9. Acute myocardial infarction due to vasospasm in a 13-year-old-boy.

    PubMed

    Hosoi, T; Koyama, Y; Tange, S; Sumino, H; Kawai, Y; Kumakura, H; Takayama, Y; Ichikawa, S; Imai, S; Suzuki, T

    1997-06-01

    We describe an unusual case of acute myocardial infarction due to vasospasm in a 13-year-old boy. He was admitted to our hospital with severe congestive heart failure and shock. He had experienced a feeling of chest oppression with dyspnea while running, which grew worse. He then lost consciousness and was brought by ambulance to our intensive care unit. He had had similar but milder episodes of chest oppression months earlier. The family history revealed that his father had died suddenly from hypertrophic cardiomyopathy and that his grandmother also had hypertrophic cardiomyopathy. On admission, the patient was bathed in a cold sweat, his pulse was weak, and his blood pressure was too low to measure. Coarse crackling and wheezing were audible in both lung fields. Administration of catecholamine and intra-aortic balloon pumping failed to stabilize the hemodynamic variables, but percutaneous cardiopulmonary support proved to be lifesaving. Coronary arteriography performed during his convalescence showed on evidence of atherosclerosis. The acetylcholine provocation test ultimately revealed a diagnosis of acute myocardial infarction due to vasospasm. PMID:9225201

  10. Chagas Disease Control Programme in Brazil: a study of the effectiveness of 13 years of intervention.

    PubMed Central

    Costa, F. C.; Vitor, R. W.; Antunes, C. M.; Carneiro, M.

    1998-01-01

    Reported is an evaluation of 13 years of intervention by the Chagas Disease Control Programme in an endemic area (Montalvania) in the State of Minas Gerais, Brazil. The design used was an epidemiological panel study. The reduction of Trypanosoma cruzi infection rates was estimated from data collected on three separate occasions: a serological survey in 1975-80, a quasi-experimental study in 1987, and the present investigation. A random sample of 156 households was selected and blood samples were collected from 653 inhabitants. The data routinely collected by the control programme were analysed to correlate the results with the incidence of T. cruzi. The overall prevalence of infection was 2.3%; however, no participant under 14 years of age was found to have a positive serological test. The total reduction in T. cruzi infection rates in this area from the start of the programme's activities was estimated to be 83.5%. Cross-sectional comparisons for the age groups 2-6 years and 7-14 years indicated a 100% reduction in T. cruzi incidence rates; but cohort comparisons showed that 100% reduction was achieved only for the 2-6-years age group. PMID:9803589

  11. The global tropospheric ammonia distribution as seen in the 13 year AIRS measurement record

    NASA Astrophysics Data System (ADS)

    Warner, J. X.; Wei, Z.; Strow, L. L.; Dickerson, R. R.; Nowak, J. B.

    2015-12-01

    Ammonia (NH3) plays an increasingly important role in the global biogeochemical cycle of reactive nitrogen as well as in aerosol formation and climate. We present extensive and nearly continuous global ammonia measurements made by the Atmospheric Infrared Sounder (AIRS) from the Aqua satellite to identify and quantify major persistent and episodic sources as well as to characterize seasonality. We examine the 13 year period from September 2002 through August 2015 with a retrieval algorithm using an optimal estimation technique with a set of three, spatially and temporally uniform a priori profiles. Vertical profiles show good agreement (~5-15 %) between AIRS NH3 and the in situ profiles from the winter 2013 DISCOVER-AQ field campaign in central California, despite the likely biases due to spatial resolution differences between the two instruments. AIRS captures the strongest consistent NH3 emissions from the anthropogenic (agricultural) source regions, such as, South Asia (India/Pakistan), China, the US, parts of Europe, SE Asia (Thailand/Myanmar/Laos), the central portion of South America, as well as Western and Northern Africa. These correspond primarily to croplands with extensive animal feeding operations and fertilizer applications where a summer maximum and secondary spring maximum are reliably observable. In the Southern Hemisphere (SH) regular agricultural fires contribute to a spring maximum. Regions of strong episodic emissions include Russia and Alaska as well as parts of South America, Africa, and Indonesia. Biomass burning, especially wildfires, dominate these episodic NH3 emissions.

  12. Juvenile Osteochondritis Dissecans in a 13-year-old male athlete: A case report

    PubMed Central

    D’Angelo, Kevin; Kim, Peter; Murnaghan, M. Lucas

    2014-01-01

    Objective: To present the clinical management of juvenile osteochondritis dissecans (OCD) of the knee and highlight the importance of a timely diagnosis to optimize the time needed for less invasive, non-operative therapy. Clinical Features: A 13-year-old provincial level male soccer player presenting with recurrent anterior knee pain despite ongoing manual therapy. Intervention and Outcome: A multidisciplinary, non-operative treatment approach was utilized to promote natural healing of the osteochondral lesion. The plan of management consisted of patient education, activity modification, manual therapy, passive modalities and rehabilitation, while being overseen by an orthopaedic surgeon. Conclusions: Considering the serious consequences of misdiagnosing osteochondritis dissecans, such as the potential for future joint instability and accelerated joint degeneration, a high degree of suspicion should be considered with young individuals presenting with nonspecific, recurrent knee pain. A narrative review of the literature is provided to allow practitioners to apply current best practices to appropriately manage juvenile OCD and become more cognizant of the common knee differential diagnoses in the young athletic population. PMID:25550663

  13. A media violence-inspired juvenile sexual homicide offender 13 years later.

    PubMed

    Myers, Wade C; Eggleston, Chris F; Smoak, Pamela

    2003-11-01

    No follow-up studies exist on how minors who commit sexual homicides adjust once released back into the community. This is an important question given the extreme nature of their crimes, lack of recidivism data, and the expectation that one-half of them will be freed from prison by mid-life. Likewise, no studies exist on the role our culture's pervasive media violence plays in these offenses. This report describes a 13-year-old boy who committed a witnessed media violence-inspired sexual homicide. Follow-up information is provided on his community adjustment as an adult four years after release from prison. He had multiple indicators of brain dysfunction, and watched a "slasher" film just before committing the blitz style crime upon a female neighbor. Media violence literature is reviewed--against a backdrop of developmental abnormalities, neuropsychiatric vulnerabilities, family dysfunction, and mental illness. This case illustrates how the confluence of such variables, combined with the tinder of erotic screen violence, may lead to sexual murder. PMID:14640290

  14. The adverse consequences of pyoderma gangrenosum in a 13 year old child

    PubMed Central

    Lambropoulos, Vassilis; Patsatsi, Aikaterini; Tsona, Afroditi; Papakonstantinou, Antonios; Filippopoulos, Antonios; Sotiriadis, Dimitrios

    2011-01-01

    Introduction Pyoderma gangrenosum (PG) is an uncommon, but serious, non infectious, neutrophilic dermatosis that causes cutaneous necrosis with a characteristically rapid evolution. Presentation of case A 13 year-old girl was admitted with a postoperative infected wound, which was surgically debrided. A new more aggressive lesion on the left upper extremity led the patient to the intensive care unit. Clinical diagnosis of pyoderma gangrenosum was introduced with a crucial delay. An immediate clinical improvement after immunosuppressive therapy with systemic corticosteroids and cyclosporine was observed. The extensive cutaneous deficits were covered with keratinocyte cultured cells with an aesthetically good outcome. Discussion Diagnosis of PG in young children is very difficult, especially without dermatological evaluation. This deforming ulcerative skin disease is probably a result of altered immunologic reactivity. Its early recognition may prevent unnecessary surgical treatment which leads to dangerous complications. Conclusion To our knowledge this is the first case of PG with such a widespread distribution reported in a child, as a consequence of iatrogenic pathergy. PMID:22096733

  15. The development of fear learning and generalization in 8-13 year-olds.

    PubMed

    Glenn, Catherine R; Klein, Daniel N; Lissek, Shmuel; Britton, Jennifer C; Pine, Daniel S; Hajcak, Greg

    2012-11-01

    The current study examined developmental changes in fear learning and generalization in 40 healthy 8-13 year-olds using an aversive conditioning paradigm adapted from Lau et al. [Lau et al. [2008] Journal of the American Academy of Child and Adolescent Psychiatry 47:94-102]. In this task, the conditioned stimuli (CS+/CS-) are two neutral female faces, and the unconditioned stimulus is a fearful, screaming face. The second phase of the study also included a generalization stimulus (GS): a 50% blend of the CS± faces. The eye-blink startle reflex was utilized to measure defensive responding. Patterns of fear learning and generalization were qualified by child age. Older children demonstrated greater fear learning (i.e., larger startle during CS+ than CS-) than younger children. In addition, older children exhibited the typical pattern of generalization observed in adults, whereas younger children did not. Finally, fear learning also related to contingency awareness; only children who correctly identified the CS+ demonstrated fear-potentiated startle to the CS+. Clinical implications and future directions are discussed. PMID:22072276

  16. Spectrum of autoimmune vesiculobullous diseases in Iran: a 13-year retrospective study

    PubMed Central

    Sobhan, Mohammadreza; Farshchian, Mahmood; Tamimi, Maryam

    2016-01-01

    Background Autoimmune bullous diseases (ABDs) represent a group of rare, acquired disorders characterized by overlapping features with involvement of the skin and mucous membranes, resistance to treatment, and potential lethality that comprise pemphigus, bullous pemphigoid (BP), epidermolysis bullosa, dermatitis herpetiformis, and linear immunoglobulin A bullous dermatosis. Aim The main aim of this study was to identify the epidemiologic characteristics and clinical courses of these common diseases in Hamadan, Iran. Few surveys have been carried out to demonstrate the whole spectrum of ABDs in the literature. Notably, in Hamadan we are the first. Materials and methods This 13-year retrospective study was designed to evaluate all of documented data obtained from hospitalized patients with ABDs at Farshchian Hospital from October 1999 to October 2012. We collected information on epidemiologic data, clinical aspects, histologic findings, and therapy prescribed. Data were analyzed using SPSS. Results Of 168 patients, 78% had pemphigus. The age of patients at presentation ranged from 1 month to 115 years, with a mean of 47.5±19.93 years. Mucosal or skin involvement of ABDs was statistically significant (P<0.001). The incidence of ABDs differed significantly based on anatomic location (P=0.003). We documented three deaths. Conclusion Compared to previous literature, our findings showed equal epidemiologic properties in Iran. Although pemphigus was the most common ABD followed by BP, it is expected that in line with the global trend, an increase in BP will be driven by population aging in Iran. PMID:26811692

  17. Prevalence of dental caries in 12-13-year-old Jordanian students.

    PubMed

    Albashaireh, Z; al-Hadi Hamasha, A

    2002-03-01

    The purpose of this study was to determine the caries experience of 12-13-year-old 6th grade students in Jordan. A total of 694 students were selected randomly from a list of schools teaching 6th grade students in Irbid, Jordan. The data were collected by interview and clinical examination performed by two examiners. Dental examinations were done by using dental mirrors and probes under artificial light in classrooms and the diagnosis of dental caries was made by the criteria recommended by the World Health Organisation (1987). On average students had 24.4 sound teeth, 2.3 decayed teeth (D), 0.05 missing teeth (M) and 0.16 filled teeth (F). The mean DMFT index was 2.51. The D represents 92% of the DMF cases. Of the students examined 188 were caries free (27.1%). Of the 19,432 permanent teeth examined the highest frequency of dental caries (61%) and fillings (77%) was found in first molars, and these were the most commonly missing teeth (67%). Second molars and second premolars had the second and third highest frequencies respectively, whereas incisors and canines were the least affected teeth (< 2%). PMID:12061150

  18. Part I. A look at population-based medical care.

    PubMed

    Weiss, K

    1998-08-01

    Recent trends toward managed health care have generated interest in developing strategies to manage the health care of a population as a whole. Population-based medicine places the individual patient within the context of the larger community, which is composed of both sick and well individuals; when viewed in these terms, only a small proportion of the people who consult a primary care physician are at risk for substantial morbidity. However, the physician serves as the central figure for delivering population-based health care to the entire community. Many strategies for population-based care contain the following 4 basic elements: 1. Identifying the health and disease states that are likely to be responsive to population-based care, 2. Applying principles of epidemiology to define the population-of-interest, 3. Assembling a multidisciplinary team, and 4. Building information systems to support ongoing surveillance of population-based care. To date, most of the published examples of population-based management have been conducted in managed care environments, but population-based management may also be used by a single physician practice or a small group practice. Programs aimed at health promotion or disease prevention are among the easiest to implement. By examining the results of an entire population with a given condition, physicians and their teams may begin to identify ways to improve the overall delivery of care, either by establishing new procedures or improving old ones. PMID:9735940

  19. Spectrum of Lesions Affecting the Renal Pelvis and Pelviureteric Junction: A 13-Year Retrospective Analysis

    PubMed Central

    Kini, Hema; Suresh, Pooja Kundapur; Guni, Laxman Prabhu Gurupur; Bhat, Shaila; Kini, Jyoti Ramanath

    2016-01-01

    Introduction Both, the renal pelvis and the ureter, are affected by developmental, reactive and neoplastic disorders, though rare in incidence. Aim This series of cases were analysed to study the clinicopathological characteristics of the common and comparatively rare lesions involving the renal pelvis and pelviureteric junction. Materials and Methods A retrospective collection of 476 nephrectomies and pelviureteric junction resections, received over a period of 13 years from 2001 to 2013 was done. The patients’ clinical details were obtained and the histopathological findings reviewed. The lesions were classified into non-neoplastic and neoplastic categories. Results Primary involvement of the renal pelvis and pelviureteric junction was seen in 105 of 476 specimens. The mean age was 54.5 years with a male to female ratio of 2.2:1. The non-neoplastic lesions accounted for 76.2% of cases with a majority being pelviureteric junction obstruction due to inflammation induced fibromuscular hypertrophy (68.6%) causing hydronephrosis. Urothelial carcinomas were encountered in 20% of the cases. A majority of the urothelial carcinomas were infiltrative (81%) and high grade (71%) tumours. Conclusion Renal pelvis, a conduit to propel urine, can be the site for numerous disorders. Non-neoplastic lesions were more common than neoplasms. Pelviureteric junction obstruction due to inflammation induced fibromuscular hypertrophy was the commonest lesion in our study. In the neoplastic category, urothelial carcinoma was most common. However, rare lesions such as hamartomatous fibroepithelial polyp, Von Brunn’s nests, flat urothelial hyperplasia and intramuscular haemangioma of upper ureter at the pelviureteric junction were encountered along with occasional cases of tuberculosis and squamous cell carcinomas. PMID:27042468

  20. Hypoglycemia and Risk Factors for Death in 13 Years of Pediatric Admissions in Mozambique.

    PubMed

    Madrid, Lola; Acacio, Sozinho; Nhampossa, Tacilta; Lanaspa, Miguel; Sitoe, Antonio; Maculuve, Sónia Amós; Mucavele, Helio; Quintó, Llorenç; Sigaúque, Betuel; Bassat, Quique

    2016-01-01

    Hypoglycemia is a life-threatening complication of several diseases in childhood. We describe the prevalence and incidence of hypoglycemia among admitted Mozambican children, establishing its associated risk factors. We retrospectively reviewed clinical data of 13 years collected through an ongoing systematic morbidity surveillance in Manhiça District Hospital in rural Mozambique. Logistic regression was used to identify risk factors for hypoglycemia and death. Minimum community-based incidence rates (MCBIRs) for hypoglycemia were calculated using data from the demographic surveillance system. Of 49,089 children < 15 years hospitalized in Manhiça District Hospital, 45,573 (92.8%) had a glycemia assessment on admission. A total of 1,478 children (3.2%) presented hypoglycemia (< 3 mmol/L), of which about two-thirds (972) were with levels < 2.5 mmol/L. Independent risk factors for hypoglycemia on admission and death among hypoglycemic children included prostration, unconsciousness, edema, malnutrition, and bacteremia. Hypoglycemic children were significantly more likely to die (odds ratio [OR] = 7.11; P < 0.001), with an associated case fatality rate (CFR) of 19.3% (245/1,267). Overall MCBIR of hypoglycemia was 1.57 episodes/1,000 child years at risk (CYAR), significantly decreasing throughout the study period. Newborns showed the highest incidences (9.47 episodes/1,000 CYAR, P < 0.001). Hypoglycemia remains a hazardous condition for African children. Symptoms and signs associated to hypoglycemia should trigger the verification of glycemia and the implementation of life-saving corrective measures. PMID:26503282

  1. AB196. Multivariate analyses of urinary calculi composition: a 13-year single-center study

    PubMed Central

    Yang, Xiong; Liu, Chunyu; Xu, Yong

    2016-01-01

    Background The incidence and prevalence of urinary stone are increasing throughout the world. Compared with the past, urolithiasis compositions by patient demographics are strikingly different. Furthermore, recent clinical studies implied that seasonal cyclicity might influence the distribution of stone composition. Methods We sought to determine the trends in pathogenesis of urolithiasis based on urinary stone analyses. A total of 2,383 eligible urinary stone samples from different patients between 2002 and 2014 in our center were collected. Infrared spectroscopy was used for urinary calculi analysis. Logistic regression analysis was used to investigate the relationship of urinary calculi composition and calendar month (season), gender and age in North China during the past 13 years. Results Calcium containing calculi were the most frequent with an overall incidence of 84.1%. Calcium phosphate (CaP) or magnesium ammonium phosphate (MAP) stones were more frequent in females, while monohydrate calcium oxalate (COM), dihydrate calcium oxalate (COD) or uric acid (UA) stones were more common in males. Older individuals were associated with an increased risk of UA stones and a decreased risk of COD, CaP or cystine stones. Additionally, from 2002 to 2014, the frequency of COD and MAP stone increased, whereas the trend of CaP, UA and cystine stones decreased. However, calendar month (season) was not significantly associated with differences in composition. Conclusions This study provides a picture of the present distribution of urolithiasis compositions in China. From 2002 to 2014, age and gender were significantly associated with stone composition, whereas calendar month not.

  2. A 13-year-old caucasian boy with cleidocranial dysplasia: a case report

    PubMed Central

    2013-01-01

    Background Cleidocranial dysplasia (CCD) is a rare congenital autosomal dominant skeletal disorder. The disorder is caused by heterozygosity of mutations in human RUNX2, which is present on the short arm of chromosome 6p21. The incidence of CCD is one per million births. CCD appears spontaneously with no apparent genetic cause in approximately 40% of affected patients, and one in three patients has unaffected parents. The most prevalent features associated with CCD are aplastic or hypoplastic clavicles, supernumerary teeth, failed eruption of permanent teeth, and a hypoplastic maxilla. Case presentation A 13-year-old Caucasian boy presented with a chief complaint of delayed eruption of the permanent anterior teeth. The patient was subsequently diagnosed with CCD based on the clinical examination, panoramic X-ray, anterior-posterior and lateral cephalogram, and chest radiograph findings. The details of this case are herein reported because of the extremely low incidence of this disorder. Conclusions CCD is of clinical importance in dentistry and medicine because it affects the bones and teeth and is characterized by many changes in skeletal patterning and growth. Particularly in dentistry, CCD is of great clinical significance because is associated with delayed ossification of the skull sutures, delayed exfoliation of the primary teeth, lack of permanent teeth eruption, multiple supernumerary teeth, and morphological abnormalities of the maxilla and mandible. Patients with CCD seek treatment mainly for dental problems. Knowledge of the pathogenesis, clinical characteristics, and diagnostic tools of CCD will enable clinicians to render the appropriate treatment to improve function and aesthetics. Early diagnosis of CCD is crucial for timely initiation of an appropriate treatment approach. PMID:23289840

  3. Climatology of monsoon precipitation over the Tibetan Plateau from 13-year TRMM observations

    NASA Astrophysics Data System (ADS)

    Aijuan, Bai; Guoping, Li

    2015-07-01

    Based on the 13-year data from the Tropical Rainfall Measuring Mission (TRMM) satellite during 2001-2013, the influencing geographical location of the Tibetan Plateau (Plateau) monsoon is determined. It is found that the domain of the Plateau monsoon is bounded by the latitude between 27° N and 37° N and the longitude between 60° E and 103° E. According to the annual relative precipitation, the Plateau monsoon can be divided into three sections: the Plateau winter monsoon (PWM) over Iran and Afghanistan, the Plateau summer monsoon (PSM) over the central Plateau, and the transiting zone of the Plateau monsoon (TPM) over the south, west, and east edges of the Plateau. In PWM and PSM, the monsoon climatology has a shorter rainy season with the mean annual rainfall of less than 800 mm. In TPM, it has a longer rainy season with the mean annual rainfall of more than 1800 mm. PWM experiences a single-peak monthly rainfall with the peak during January to March; PSM usually undergoes a multi-peak pattern with peaks in the warm season; TPM presents a double-peak pattern, with a strong peak in late spring to early summer and a secondary peak in autumn. The Plateau monsoon also characterizes an asymmetrical seasonal advance of the rain belt. In the east of the Plateau, the rain belt migrates in a south-north orientation under the impact of the tropical and subtropical systems' oscillation. In the west of the Plateau, the rain belt advances in an east-west direction, which is mainly controlled by the regional Plateau monsoon.

  4. The global tropospheric ammonia distribution as seen in the 13-year AIRS measurement record

    NASA Astrophysics Data System (ADS)

    Warner, Juying X.; Wei, Zigang; Larrabee Strow, L.; Dickerson, Russell R.; Nowak, John B.

    2016-05-01

    Ammonia (NH3) plays an increasingly important role in the global biogeochemical cycle of reactive nitrogen as well as in aerosol formation and climate. We present extensive and nearly continuous global ammonia measurements made by the Atmospheric Infrared Sounder (AIRS) from the Aqua satellite to identify and quantify major persistent and episodic sources as well as to characterize seasonality. We examine the 13-year period from September 2002 through August 2015 with a retrieval algorithm using an optimal estimation technique with a set of three, spatially and temporally uniform a priori profiles. Vertical profiles show good agreement (˜ 5-15 %) between AIRS NH3 and the in situ profiles from the winter 2013 DISCOVER-AQ (DISCOVER-Air Quality) field campaign in central California, despite the likely biases due to spatial resolution differences between the two instruments. The AIRS instrument captures the strongest consistent NH3 concentrations due to emissions from the anthropogenic (agricultural) source regions, such as South Asia (India/Pakistan), China, the United States (US), parts of Europe, Southeast (SE) Asia (Thailand/Myanmar/Laos), the central portion of South America, as well as Western and Northern Africa. These correspond primarily to irrigated croplands, as well as regions with heavy precipitation, with extensive animal feeding operations and fertilizer applications where a summer maximum and a secondary spring maximum are reliably observable. In the Southern Hemisphere (SH) regular agricultural fires contribute to a spring maximum. Regions of strong episodic emissions include Russia and Alaska as well as parts of South America, Africa, and Indonesia. Biomass burning, especially wildfires, dominate these episodic NH3 high concentrations.

  5. Association between Number of Teeth and Chronic Systemic Diseases: A Cohort Study Followed for 13 Years

    PubMed Central

    Oluwagbemigun, Kolade; Dietrich, Thomas; Pischon, Nicole; Bergmann, Manuela; Boeing, Heiner

    2015-01-01

    Background There is growing evidence of an association between oral health, specifically dental status, and chronic systemic diseases. However, varying measures of dental status across different populations and low study sample has made comparison of studies and conclusion of findings unclear. Our aim is to examine whether the number of teeth as a measure of dental status is associated with incident chronic diseases in a cohort setting. Methods We conducted a cohort study among 24,313 middle-aged Germans followed up for 13 years. Data on number of teeth as a measure of dental status were obtained through self-reports. Outcomes were clinically–verified incident non–fatal myocardial infarction, stroke, type 2 diabetes mellitus, and cancer. Hazard ratio (HR) and 95% confidence intervals (CI) were obtained from Cox regression models. Results Increasing number of teeth is inversely related to risk of myocardial infarction (HR: 0.97; 95% CI: 0.96, 0.99). The full multivariate model of teeth groups showed a strong linear trend for myocardial infarction, a less strong trend for stroke, and no relation with type 2 diabetes mellitus and cancer in a competing risk model. Participants with 18–23 teeth and those without teeth were at 76% (95%CI: 1.04, 3) and 2.93 times (95%CI: 1.61, 5.18) higher risk of myocardial infarction compared to those with nearly all teeth (28–32 teeth). Conclusions Number of teeth is specifically associated with myocardial infarction and not with other chronic disease indicating that dental status further strengthens the link between oral health and cardiovascular diseases. PMID:25945503

  6. Breastfeeding and dietary variety among preterm children aged 1-3 years.

    PubMed

    Husk, Jesse S; Keim, Sarah A

    2016-04-01

    Among infants born at term, breastfeeding is associated with increased dietary variety in childhood. Preterm birth can limit early feeding options while simultaneously increasing risk for negative health outcomes that could benefit from dietary-based preventative measures. We assessed whether breastfeeding is associated with increased dietary variety at 1-3 years amongst children born preterm. We analyzed baseline data from two clinical trials investigating cognitive development after fatty-acid supplementation for 10-39 month-old children born before 35 weeks gestation (n = 189). At baseline, mothers reported breastfeeding history and completed a 161-item food-frequency questionnaire for their child. Dietary variety was assessed via 3 measures: (1) proportion items consumed at least once per month, (2) servings of a given item consumed relative to total monthly food servings, (3) daily probability of consuming a given item. Overall, 88% of children were ever breastfed (median duration = 89 days, range = 0-539), and 48% of children were ever exclusively breastfed (median duration = 59 days, range = 3-240). Exclusive breastfeeding duration was associated with dietary variety increases of 0.9% (95% CI = 0.1-1.7) for vegetables, 1.6% (95% CI = 0.2-3.0) for meat/fish, and 1.3% (95% CI = 0.2-2.4) for grain/starch, for each additional month of exclusive breastfeeding after adjustment for key confounders. Correspondingly, the variety of sweets consumed decreased by 1.2% (CI: -2.1, -0.3) per month of any breastfeeding after adjustment. These results are consistent with those in children born at term, and if causal, could provide additional support for exclusive breastfeeding to improve diet and health in children born preterm. PMID:26792771

  7. Anaplastic astrocytoma mimicking herpes simplex encephalitis in 13-year old girl.

    PubMed

    Talathi, Saurabh; Gupta, Neha; Reddivalla, Naresh; Prokhorov, Sergey; Gold, Menachem

    2015-11-01

    Astrocytoma is the most common childhood brain tumor. Anaplastic astrocytoma (AA) are high grade gliomas (HGG), found very rarely in pediatric patients. AA mainly results from a dedifferentiation of a low grade astrocytoma. Clinical features of supra-tentorial tumors vary according to their anatomic location, biologic aggressiveness and age of the patient. They can be either completely asymptomatic or present with signs of raised intracranial pressure, seizures (about 40% of cases), behavior changes, speech disorders, declining school performance, or hemiparesis. There have been published adult cases of brain tumor misdiagnosed as viral encephalitis. Due to variety of clinical presentations, diagnosis of AA can be challenging. Here we report a case of a 13 year old girl who presented with clinical features suggestive of viral encephalitis, such as fever, headache, dizziness, and first seizure with postictal sleep and prolonged drowsiness. However, her brain MRI findings were consistent with long standing mass effect from the underlying intracranial contents and that coupled with her history of unusual taste led to further investigations and the diagnosis of the AA. In retrospect, this presentation could have been a temporal epileptic aura. High grade astrocytomas are particularly difficult to treat with a two-year survival rates range from 10% to 30%. The treatment is multimodal with gross total surgical resection of the tumor, followed by radiotherapy with or without nitrosourea-containing chemotherapy regimen. Recent promising results seen with the use of temozolamide in adults has not been yet demonstrated in the pediatric patients. The extent of tumor resection remains the most significant indicator of survival and early recognition of this tumor is essential. This case report emphasizes the fact that mass lesions in the temporal lobe, including high-grade astrocytoma, should be considered in the differential diagnosis of suspected herpes simplex encephalitis

  8. Spirometric reference values for Hopi Native American children ages 4-13 years.

    PubMed

    Arnall, David A; Nelson, Arnold G; Hearon, Christopher M; Interpreter, Christina; Kanuho, Verdell

    2016-04-01

    Spirometry is the most important tool in diagnosing pulmonary disease and is the most frequently performed pulmonary function test. Respiratory disease is also one of the greatest causes for morbidity and mortality on the Hopi Nation, but no specific reference equations exist for this unique population. The purpose of this study was to determine if population reference equations were necessary for these children and, if needed, to create new age and race-specific pulmonary nomograms for Hopi children. Two hundred and ninety-two healthy children, ages 4-13 years, attending Hopi Nation elementary schools in Arizona, were asked to perform spirometry for a full battery of pulmonary volumes and capacities of which the following were analyzed: forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1 ), FEV1 % (FEV1 /FVC), FEF25-75% and peak expiratory flow rate (PEFR). Spirometric data from Navajo children living in the same geographical region as the Hopi children were compared as well as spirometric data from common reference values used for other ethnic groups in the USA. Spirometry tests from 165 girls and 127 boys met American Thoracic Society quality control standards. We found that the natural log of height, body mass and age were significant predictors of FEV1 , FVC, and FEF25-75% in the gender-specific models and that lung function values all increased with height and age as expected. The predictions using the equations derived for Navajo, Caucasian, Mexican-American, African-American youth were significantly different (P ≤ 0.05) from the predictions derived from the Hopi equations for all of the variables across both genders, with the exceptions of Hopi versus Navajo FEV1 /FVC in the males and Hopi versus Caucasians FEF25-75% in the females. Thus it would appear for this population important to have specific formulae to provide more accurate reference values. PMID:26584469

  9. A population-based cohort study of oral health in South Brazil: The Porto Alegre Study.

    PubMed

    Haas, Alex Nogueira; Gaio, Eduardo José; Wagner, Marcius Comparsi; Rios, Fernando Silva; Costa, Ricardo dos Santos Araujo; Rösing, Cassiano Kuchenbecker; Oppermann, Rui Vicente; Albandar, Jasim; Susin, Cristiano

    2015-01-01

    Few population-based cohort studies have been established in Dentistry and this is especially true for Latin America. We conducted a population-based prospective study focusing on oral health in Porto Alegre, south Brazil, and herein we describe its methodology and discuss directions for further research. The cohort was established in 2001 using a multistage probability sample of 1,465 toothed and 121 edentulous subjects. A 5-year follow-up was performed in 2006 that included 755 individuals. The main aim of this study was to determine the pattern and risk factors for periodontal disease progression and tooth loss incidence. A full-mouth protocol was used including periodontal assessments at six sites per tooth. Primary outcomes were periodontal attachment loss and tooth loss. Oral mucosal lesions, dental plaque, gingivitis, supragingival calculus, probing depths, gingival recession, and dental caries were also assessed. This is the first population-based cohort study to focus on periodontal disease in Latin America. Findings will contribute to our understanding of the epidemiology of periodontal disease and provide valuable data for the planning and implementation of preventive and therapeutic strategies. PMID:26083520

  10. Development of the Comprehensive General Parenting Questionnaire for caregivers of 5-13 year olds

    PubMed Central

    2014-01-01

    Background Despite the large number of parenting questionnaires, considerable disagreement exists about how to best assess parenting. Most of the instruments only assess limited aspects of parenting. To overcome this shortcoming, the “Comprehensive General Parenting Questionnaire” (CGPQ) was systematically developed. Such a measure is frequently requested in the area of childhood overweight. Methods First, an item bank of existing parenting measures was created assessing five key parenting constructs that have been identified across multiple theoretical approaches to parenting (Nurturance, Overprotection, Coercive control, Behavioral control, and Structure). Caregivers of 5- to 13-year-olds were asked to complete the online survey in the Netherlands (N = 821), Belgium (N = 435) and the United States (N = 241). In addition, a questionnaire regarding personality characteristics (“Big Five”) of the caregiver was administered and parents were asked to report about their child’s height and weight. Factor analyses and Item-Response Modeling (IRM) techniques were used to assess the underlying parenting constructs and for item reduction. Correlation analyses were performed to assess the relations between general parenting and personality of the caregivers, adjusting for socio-economic status (SES) indicators, to establish criterion validity. Multivariate linear regressions were performed to examine the associations of SES indicators and parenting with child BMI z-scores. Additionally, we assessed whether scores on the parenting constructs and child BMI z-scores differed depending on SES indicators. Results The reduced questionnaire (62 items) revealed acceptable fit of our parenting model and acceptable IRM item fit statistics. Caregiver personality was related as hypothesized with the GCPQ parenting constructs. While correcting for SES, overprotection was positively related to child BMI. The negative relationship between structure and BMI was

  11. Backstroke Technical Characterization of 11-13 Year-Old Swimmers

    PubMed Central

    Silva, Ana Filipa; Figueiredo, Pedro; Seifert, Ludovic; Soares, Susana; Vilas-Boas, João Paulo; Fernandes, Ricardo J.

    2013-01-01

    The aim of this study was to characterize the backstroke swimming technique of 11-13 year-old swimmers when performing at very high intensity. A sample of 114 swimmers was divided into four groups regarding maturational and gender effect, who performed 25- m backstroke swimming at 50-m pace. Using two underwater cameras the general biomechanical parameters (speed, stroke rate, stroke length and stroke index), the arm stroke phases and two indexes of arm coordination (Index of Coordination 1, which characterizes the continuity between propulsive phases of each arm and Index of Coordination 2 that evaluates the simultaneity between the beginning of the pull of one arm and of the recovery of the other arm) were measured. Post- pubertal swimmers achieved higher values of speed (1.06 ± 0.14 and 1.18 ± 0.14 m·s-1 for pubertal and 1.13 ± 0.14 and 1.24 ± 0.12 m·s-1 for post-pubertal girl and boy swimmers, respectively), stroke length (1.64 ± 0.26 and 1.68 ± 0.25 m·cycle-1 for pubertal and 1.79 ± 0.22 and 1.75 ± 0.27 m·cycle-1 for post-pubertal girls and boys, respectively) and stroke index. Regar-ding genders, male were faster than female swimmers. Boys also showed a higher stroke rate and stroke index than girls, who achieved higher results in the ratio between stroke length and arm span. As it was expected, no hand lag time was noticed in young swimmers. Although no differences were noticed between genders, the Index of Coordination 1 was in catch-up mode (-9.89 ± 3.16 and -10.16 ± 3.60 % for girls and -9.77 ± 2.93 and -10.39 ± 2.44 % for boys pubertal and post-pubertal, respectively) and the Index of Coordination 2 was in superposition mode (1.86 ± 4.39 and 2.25 ± 2.25 % from girls and 1.72 ± 2.62 and 1.95 ± 2.95 % for boys, pubertal and post-pubertal, respectively). Key Points Young swimmers adopt the catch-up arm coordina-tion when swimming backstroke. These swimmers present lower stroking parameters then those published for older and higher level

  12. 3D absolute hypocentral determination - 13 years of seismicity in Ecuadorian subduction zone

    NASA Astrophysics Data System (ADS)

    Font, Yvonne; Segovia, Monica; Theunissen, Thomas

    2010-05-01

    In Ecuador, the Nazca plate is subducting beneath the North Andean Block. This subduction triggered, during the last century, 4 major earthquakes of magnitude greater than 7.7. Between 1994 and 2007, the Geophysical Institute (Escuela National Politecnica, Quito) recorded about 40 000 events in whole Ecuador ranging from Mb 1.5 to 6.9. Unfortunately, the local network shows great density discrepancy between the Coastal and Andean regions where numerous stations were installed to survey volcanic activity. Consequently, seismicity in and around the interplate seismogenic zone - producer of the most destructive earthquakes and tsunamis - is not well constrained. This study aims to improve the location of 13 years seismicity occurred during an interseismic period in order to better localize the seismic deformation and gaps. The first step consists in the construction of a 3D "georealistic" velocity model. Because local tomography cannot provide satisfactory model, we combined all local crustal/lithospheric information on the geometry and velocity properties of different geological units. Those information cover the oceanic Nazca plate and sedimentary coverture the subducting plate dip angle; the North Andean Block margin composed of accreted oceanic plateaus (the Moho depth is approximated using gravity modeling); the metamorphic volcanic chain (oceanic nature for the occidental cordillera and inter-andean valley, continental one for the oriental cordillera); The continental Guyana shield and sedimentary basins. The resulting 3D velocity model extends from 2°N to 6.5°S and 277°E to 283°E and reaches a depth of 300 km. It is discretized in constant velocity blocks of 12 x 12 x 3 km in x, y and z, respectively. The second step consists in selecting an adequate sub-set of seismic stations in order to correct the effect of station density disequilibrium between coastal and volcanic regions. Consequently, we only keep the most representative volcanic stations in terms

  13. Clinimetric Properties of Participation Measures for 5- to 13-Year-Old Children with Cerebral Palsy: A Systematic Review

    ERIC Educational Resources Information Center

    Sakzewski, Leanne; Boyd, Roslyn; Ziviani, Jenny

    2007-01-01

    This study systematically reviewed the validity, reliability, sensitivity to change, and clinical utility of measurements of participation for children with cerebral palsy. Sixteen measures were identified and seven met the inclusion criteria of having 30% content measuring participation, for use with children aged 5 to 13 years with physical…

  14. Brain Activation and Deactivation during Location and Color Working Memory Tasks in 11-13-Year-Old Children

    ERIC Educational Resources Information Center

    Vuontela, Virve; Steenari, Maija-Riikka; Aronen, Eeva T.; Korvenoja, Antti; Aronen, Hannu J.; Carlson, Synnove

    2009-01-01

    Using functional magnetic resonance imaging (fMRI) and n-back tasks we investigated whether, in 11-13-year-old children, spatial (location) and nonspatial (color) information is differentially processed during visual attention (0-back) and working memory (WM) (2-back) tasks and whether such cognitive task performance, compared to a resting state,…

  15. Cross-Sectional Study of Phoneme and Rhyme Monitoring Abilities in Children between 7 and 13 Years

    ERIC Educational Resources Information Center

    Sasisekaran, Jayanthi; Weber-Fox, Christine

    2012-01-01

    We investigated phonemic competence in production in three age groups of children (7 and 8, 10 and 11, 12 and 13 years) using rhyme and phoneme monitoring. Participants were required to name target pictures silently while monitoring covert speech for the presence or absence of a rhyme or phoneme match. Performance in the verbal tasks was compared…

  16. An Experimental Study of Spider-Related Covariation Bias in 8- to 13-Year-Old Children

    ERIC Educational Resources Information Center

    Muris, Peter; de Jong, Peter J.; Meesters, Cor; Waterreus, Bregje; van Lubeck, Jenet

    2005-01-01

    Covariation bias can be defined as phobic subjects' tendency to overestimate the association between phobic stimuli and aversive outcomes. The current study presents two experiments that examined this type of cognitive bias in children aged 8-13 years (N=147 in Experiment 1, N=240 in Experiment 2). Children completed a self-report questionnaire…

  17. Identifying with Science: A Case Study of Two 13-Year-Old "High Achieving Working Class" British Asian Girls

    ERIC Educational Resources Information Center

    Wong, Billy

    2012-01-01

    This paper provides an in-depth, "case study" style analysis of the experiences of two 13-year-old British Asian girls from a larger qualitative study investigating minority ethnic students' aspirations in science. Through the lens of identity as performativity and Bourdieu's notions of "habitus" and capital, the ways in which two girls engage…

  18. Test-Taking Strategies of 12 -and 13-Year-Old Hungarian Learners of EFL: Why Whales Have Migraines

    ERIC Educational Resources Information Center

    Nikolov, Marianne

    2006-01-01

    This paper gives an account of a project exploring 12- and 13-year-old children's uses of strategies while solving reading and writing test tasks in English as a foreign language EFL. The study was conducted to provide insights into how learners go about solving tasks and what they think and rely on while doing them. The first part provides an…

  19. Moved to Tears: Technical Considerations and Dilemmas Encountered in Working with a 13-Year-Old Boy with Acquired Quadriplegia

    ERIC Educational Resources Information Center

    Owens, Caroline

    2005-01-01

    This paper is about therapeutic work with David, a 13-year-old boy who, at the age of 5, was the victim of a hit-and-run road traffic accident resulting in quadriplegia. The circumstances leading to the accident and its sequelae reveal a particularly complex picture, which combines early emotional deprivation and trauma. Although cognitively…

  20. Do University Teachers Become More Effective with Experience? A Multilevel Growth Model of Students' Evaluations of Teaching over 13 Years

    ERIC Educational Resources Information Center

    Marsh, Herbert W.

    2007-01-01

    Do university teachers, like good wine, improve with age? The purpose of this methodological/substantive study is to apply a multiple-level growth modeling approach to the long-term stability of students' evaluations of teaching effectiveness (SETs). For a diverse cohort of 195 teachers who were evaluated continuously over 13 years (6,024 classes,…

  1. What Is Happening when Teachers of 11-13-Year-Old Students Take Guided Reading: A New Zealand Snapshot

    ERIC Educational Resources Information Center

    Fletcher, Jo Florence; Greenwood, Janinka; Grimley, Michael; Parkhill, Faye; Davis, Niki

    2012-01-01

    This paper focuses on eight teachers nominated as effective in teaching reading to 11-13-year-old students. Data consisted of interviews and unstructured and structured observations of the guided reading lessons. The qualitative data and their analysis explored the research participants' views to give more detail and filter the quantitative…

  2. Gender, Popularity and Notions of In/Authenticity amongst 12-Year-Old to 13-Year-Old School Girls

    ERIC Educational Resources Information Center

    Read, Barbara; Francis, Becky; Skelton, Christine

    2011-01-01

    This paper draws on data from a research project investigating gendered identities and interactions of high-achieving students in Year Eight in England (12-13 years old), particularly in relation to students' "popularity" amongst their peers. As part of this study 71 students were interviewed from nine different schools in urban, rural and small…

  3. The European Randomized Study of Screening for Prostate Cancer – Prostate Cancer Mortality at 13 Years of Follow-up

    PubMed Central

    Schröder, Fritz H.; Hugosson, Jonas; Roobol, Monique J.; Tammela, Teuvo L.J.; Zappa, Marco; Nelen, Vera; Kwiatkowski, Maciej; Lujan, Marcos; Määttänen, Lissa; Lilja, Hans; Denis, Louis J.; Recker, Franz; Paez, Alvaro; Bangma, Chris H.; Carlsson, Sigrid; Puliti, Donella; Villers, Arnauld; Rebillard, Xavier; Hakama, Matti; Stenman, Ulf-Hakan; Kujala, Paula; Taari, Kimmo; Aus, Gunnar; Huber, Andreas; van der Kwast, Theo; van Schaik R, Ron H.N.; de Koning, Harry J.; Moss, Sue M.; Auvinen, Anssi

    2015-01-01

    Background The European Randomized study of Screening for Prostate Cancer (ERSPC) is a randomized multi-center trial with a predefined centralized database, analysis plan and core age group (55–69 years) evaluating prostate-specific antigen (PSA) testing in eight European countries. Methods The present results are based on prostate cancer (PCa) incidence and mortality truncated at 9, 11, and 13 years of follow-up in the intervention arm (offered PSA testing) relative to the control arm. A secondary analysis corrected for selection bias due to non-participation was performed. Because of incomplete follow-up, only incidence and no mortality data at 9 years follow-up are reported for the French centers. Findings The rate ratio (RR) of PCa incidence between the intervention and control arms was 1.91 after 9 years (1.64 including France), 1.66 after 11 years and 1.57 after 13 years. The RR of PCa mortality was 0.85, 0.78 and 0.79 at 9, 11 and 13 years respectively (95% confidence interval 13-year 0.69–0.91, p = 0.001). This corresponds to a relative risk reduction of 21% and an absolute risk reduction of death from PCa at 13 years of 0.11 per 1,000 person-years or 1.28 per 1,000 men randomized, which is equivalent to one PCa death averted per 781 men invited for screening or one per 27 additional PCa detected. PCa mortality reduction in screened men after adjustment for non–participation was 27%. Interpretation This update of ERSPC confirms a substantial PCa mortality reduction due to PSA testing, with a substantially increased absolute effect at 13 years compared to findings after 9 and 11 years. Funding All sources of funding per center are indicated in the “Web extra material” section. Trial identification This trial is registered under Current Controlled Trials number: ISRCTN49127736. PMID:25108889

  4. Eating Behaviors and Overweight among Adolescents: A Population-Based Survey in Japan

    PubMed Central

    Shirasawa, Takako; Ohtsu, Tadahiro; Nishimura, Rimei; Morimoto, Aya; Hoshino, Hiromi; Tajima, Naoko; Kokaze, Akatsuki

    2013-01-01

    Objectives. The aim of the present study was to investigate the relationship between eating behaviors and overweight among population-based adolescents in Japan. Methods. Study subjects comprised adolescents in the seventh grade (age range, 12–13 years) from Ina, a town in Saitama Prefecture, Japan, between 1999 and 2008. The height and weight of the subjects were measured, and information concerning eating behaviors (eating speed and eating until full) was obtained using a self-administered questionnaire. Results. Among boys (n = 1586), fast eating speed significantly increased the odds ratio (OR) for overweight when compared with medium eating speed, regardless of eating until full or not; moreover, a more marked increase in the OR was observed among boys eating until full (OR: 2.78, 95% confidence interval: 1.76–4.38) than among those not eating until full (2.43, 1.41–4.20). Among girls (n = 1542), fast eating speed led to a significant increase in the OR in those eating until full; however, no significant increases were observed in the OR in those eating quickly and not until full. Conclusions. Among adolescents, fast eating speed was associated with overweight; furthermore, the combination of both fast eating speed and eating until full may have a significant effect on overweight. PMID:23956845

  5. Additive influence of genetic predisposition and conventional risk factors in the incidence of coronary heart disease: a population-based study in Greece

    Technology Transfer Automated Retrieval System (TEKTRAN)

    An additive genetic risk score (GRS) for coronary heart disease (CHD) has previously been associated with incident CHD in the population-based Greek European Prospective Investigation into Cancer and nutrition (EPIC) cohort. In this study, we explore GRS-‘environment’ joint actions on CHD for severa...

  6. Intra-abdominal metastasis of an intracranial germinoma via ventriculo-peritoneal shunt in a 13-year-old female.

    PubMed

    Murray, Matthew J; Metayer, Lucy E; Mallucci, Conor L; Hale, Juliet P; Nicholson, James C; Kirollos, Ramez W; Burke, G A Amos

    2011-12-01

    A 13-year-old patient presented with massive intra-abdominal metastasis and spontaneous acute tumour lysis syndrome, 17-months after VP shunt placement for metastatic pineal germinoma treated with cranio-spinal-irradiation. Hyperhydration/rasburicase improved renal function, allowing chemotherapy with subsequent surgery. The patient remains event-free 34-months later. Risk of intra-abdominal metastasis from VP shunts is discussed. PMID:21501064

  7. Prevalence of Overweight and Obesity among Primary School Children Aged 8–13 Years in Dar es Salaam City, Tanzania

    PubMed Central

    Pangani, Ismail N.; Kiplamai, Festus K.; Kamau, Jane W.; Onywera, Vincent O.

    2016-01-01

    Background. The understanding of obesity as a growing health problem in Africa and Tanzania in particular is hampered by lack of data as well as sociocultural beliefs in which overweight and obesity are revered. This study sought to determine the prevalence of overweight and obesity among primary school children aged 8–13 years in Dar es Salaam, Tanzania. Method. A cross-sectional analytical research design was used to study overweight and obesity in primary schools in Dar es Salaam, Tanzania. The target population was 150,000 children aged 8–13 years. Stratified random sampling was used to select 1781 children. Weight and height were taken and WHO standards for children were used to determine weight status. Results. Findings showed that the prevalence of overweight and obesity was 15.9% and 6.7%, respectively (N = 1781). However, 6.2% of the children were underweight. There were significant differences in mean BMI between children in private and public schools (p = 0.021), between male and female (p < 0.001), and across age groups of 8–10 and 11–13 years (p < 0.001). Conclusion. The prevalence of overweight and obesity among primary school children is significant and requires management and prevention strategies. PMID:27403343

  8. Prevalence of Overweight and Obesity among Primary School Children Aged 8-13 Years in Dar es Salaam City, Tanzania.

    PubMed

    Pangani, Ismail N; Kiplamai, Festus K; Kamau, Jane W; Onywera, Vincent O

    2016-01-01

    Background. The understanding of obesity as a growing health problem in Africa and Tanzania in particular is hampered by lack of data as well as sociocultural beliefs in which overweight and obesity are revered. This study sought to determine the prevalence of overweight and obesity among primary school children aged 8-13 years in Dar es Salaam, Tanzania. Method. A cross-sectional analytical research design was used to study overweight and obesity in primary schools in Dar es Salaam, Tanzania. The target population was 150,000 children aged 8-13 years. Stratified random sampling was used to select 1781 children. Weight and height were taken and WHO standards for children were used to determine weight status. Results. Findings showed that the prevalence of overweight and obesity was 15.9% and 6.7%, respectively (N = 1781). However, 6.2% of the children were underweight. There were significant differences in mean BMI between children in private and public schools (p = 0.021), between male and female (p < 0.001), and across age groups of 8-10 and 11-13 years (p < 0.001). Conclusion. The prevalence of overweight and obesity among primary school children is significant and requires management and prevention strategies. PMID:27403343

  9. Understanding risk and protective factors for child maltreatment: the value of integrated, population-based data.

    PubMed

    Putnam-Hornstein, Emily; Needell, Barbara; Rhodes, Anne E

    2013-01-01

    In this article, we argue for expanded efforts to integrate administrative data systems as a "practical strategy" for developing a richer understanding of child abuse and neglect. Although the study of child maltreatment is often critiqued for being atheoretical, we believe that a more pressing concern is the absence of population-based and prospective epidemiological data that can be used to better understand the distribution and interacting nature of risk and protective factors for maltreatment. We begin by briefly addressing the relevance of empirical observations to etiological theories of child maltreatment. Although the latter is widely cited as critical to the development of effective prevention and intervention responses, less attention has been paid to the role of population-based data in the development of theories relevant to highly applied research questions such as those pertaining to child abuse and neglect. We then discuss how child protection data, in isolation, translates into a relatively narrow range of questions that can be asked and answered, with an inherently pathology-focused construction of risks and little attention paid to strengths or protective factors. We next turn to examples of recent findings--spanning multiple countries--emerging from information integrated across data systems, concluding by calling for expanded administrative data linkages in an effort to better understand and prevent child maltreatment. PMID:23260115

  10. Bully/victims: a longitudinal, population-based cohort study of their mental health.

    PubMed

    Lereya, Suzet Tanya; Copeland, William E; Zammit, Stanley; Wolke, Dieter

    2015-12-01

    It has been suggested that those who both bully and are victims of bullying (bully/victims) are at the highest risk of adverse mental health outcomes. However, unknown is whether most bully/victims were bullies or victims first and whether being a bully/victim is more detrimental to mental health than being a victim. A total of 4101 children were prospectively studied from birth, and structured interviews and questionnaires were used to assess bullying involvement at 10 years (elementary school) and 13 years of age (secondary school). Mental health (anxiety, depression, psychotic experiences) was assessed at 18 years. Most bully/victims at age 13 (n = 233) had already been victims at primary school (pure victims: n = 97, 41.6 % or bully/victims: n = 47, 20.2 %). Very few of the bully/victims at 13 years had been pure bullies previously (n = 7, 3 %). After adjusting for a wide range of confounders, both bully/victims and pure victims, whether stable or not from primary to secondary school, were at increased risk of mental health problems at 18 years of age. In conclusion, children who are bully/victims at secondary school were most likely to have been already bully/victims or victims at primary school. Children who are involved in bullying behaviour as either bully/victims or victims at either primary or secondary school are at increased risk of mental health problems in late adolescence regardless of the stability of victimization. Clinicians should consider any victimization as a risk factor for mental health problems. PMID:25825225

  11. Importance of population-based studies in clinical practice

    PubMed Central

    Ronnie, George; Ve, Ramesh Sathyamangalam; Velumuri, Lokapavani; Asokan, Rashima; Vijaya, Lingam

    2011-01-01

    In the last decade, there have been reports on the prevalence of glaucoma from the Vellore Eye Survey, Andhra Pradesh Eye Diseases Survey, Aravind Comprehensive Eye Survey, Chennai Glaucoma Study and West Bengal Glaucoma Study. Population-based studies provide important information regarding the prevalence and risk factors for glaucoma. They also highlight regional differences in the prevalence of various types of glaucoma. It is possible to gather important insights regarding the number of persons affected with glaucoma and the proportion with undiagnosed disease. We reviewed the different population-based studies from India and compare their findings. The lacunae in ophthalmic care that can be inferred from these studies are identified and possible reasons and solutions are discussed. We also discuss the clinical relevance of the various findings, and how it reflects on clinical practice in the country. Since India has a significantly high disease burden, we examine the possibility of population-based screening for disease in the Indian context. PMID:21150021

  12. Adiposity and incidence of heart failure hospitalization and mortality: a population-based prospective study

    PubMed Central

    Levitan, Emily B.; Yang, Amy Z.; Wolk, Alicja; Mittleman, Murray A.

    2009-01-01

    Background Obesity is associated with heart failure (HF) incidence. We examined the strength of the association of body mass index (BMI) with HF by age and joint associations of BMI and waist circumference (WC). Methods and Results Women aged 48–83 (n = 36,873) and men aged 45–79 (n = 43,487) self-reported height, weight, and WC. HF hospitalization or death (n = 382 women, 718 men) between January 1, 1998 and December 31, 2004 was determined through administrative registers. Hazard ratios (HR), from Cox proportional-hazards models, for an interquartile range higher BMI were 1.39 (95% confidence interval [CI] 1.15–1.68) at age 60 and 1.13 (95% CI 1.02–1.27) at 75 in women. In men, HR were 1.54 (95% CI 1.37–1.73) at 60 and 1.25 (95% CI 1.16–1.35) at 75. A 10 cm higher WC was associated with 15% (95% CI 2%–31%) and 18% (95% CI 4%–33%) higher HF rates among women with BMI 25 and 30 kg/m2, respectively; HR for 1 kg/m2 higher BMI were 1.00 (95% CI 0.96–1.04) and 1.01 (95% CI 0.98–1.04) for WC 70 and 100 cm, respectively. In men, a 10 cm higher WC was associated with 16% and 18% higher rates for BMI 25 and 30 kg/m2, respectively; a 1 kg/m2 higher BMI was associated with 4% higher HF rates regardless of WC. Conclusions Strength of the association between BMI and HF events declined with age. In women, higher WC was associated with HF at all levels of BMI. Both BMI and WC were predictors among men. PMID:19808341

  13. Weight stigma and eating behaviours in elementary school children: A prospective population-based study.

    PubMed

    Jendrzyca, Anna; Warschburger, Petra

    2016-07-01

    The relevance of weight stigma as an important factor in disordered eating has been supported by research. However, because most of the studies were cross-sectional and focussed on older children, the causal relationships could not be fully determined in childhood. The current study explores the role of weight stigma in body dissatisfaction and eating behaviours. The sample consisted of 773 girls and 713 boys, aged 6-11 years, who completed surveys assessing weight stigma experiences, body dissatisfaction and eating behaviours at two points of measurement, approximately one year apart. The children's external and disordered eating was rated via parental questionnaires. As expected, the pattern of the associations between weight status, weight stigma, body dissatisfaction and eating behaviours differed by gender. Experience of weight stigma in girls led to external and restrained eating one year later, whereas in boys no such association was observed. Body dissatisfaction mediated the association between weight stigma and restrained eating behaviours in girls, whereas in boys, body dissatisfaction directly influenced restrained eating behaviours. However, in both girls and boys weight status predicted body dissatisfaction and disordered eating, while weight stigma did not have a direct effect on disordered eating. Results suggest that interventions involving weight stigma should be a part of eating disorder prevention programmes, and gender-specific pathways should be considered. PMID:26851574

  14. Risk Factors for Psychopathology in Children with Intellectual Disability: A Prospective Longitudinal Population-Based Study

    ERIC Educational Resources Information Center

    Wallander, J. L.; Dekker, M. C.; Koot, H. M.

    2006-01-01

    Background: This study examined risk factors for the development of psychopathology in children with intellectual disability (ID) in the developmental, biological, family and social-ecological domains. Methods: A population sample of 968 children, aged 6-18, enrolled in special schools in the Netherlands for educable and trainable ID were assessed…

  15. Plasma cytokine levels and risks of abdominal aortic aneurysms: A population-based prospective cohort study

    PubMed Central

    Liao, Mengyang; Liu, Cong-Lin; Lv, Bing-Jie; Zhang, Jin-Ying; Cheng, Longxian; Cheng, Xiang; Lindholt, Jes S.; Rasmussen, Lars M.; Shi, Guo-Ping

    2015-01-01

    Background Abdominal aortic aneurysm (AAA) is characterized by inflammatory cell accumulation in AAA lesions that produce inflammatory cytokines and advance its pathogenesis. Peripheral cytokines may predict the degree or risk of AAA. Methods and Results ELISA determined plasma interleukin-6 (IL6), IL10, IL17A, IFN-γ, and C-reactive protein (CRP) from 476 AAA patients and 200 controls. AAA patients had lower IL6, IFN-γ, IL10, IL17A, and higher CRP than controls. IL10 correlated positively with IFN-γ, IL17A, or IL6, but not CRP in control or AAA populations. IL10 associated negatively with systolic blood pressure, whereas CRP associated positively with diastolic blood pressure and body mass index. CRP was an independent AAA risk factor and correlated positively with aortic diameters before and after adjustments for other risk factors. IFN-γ, IL17A, and CRP correlated positively with cross-sectional AAA area after adjustment. IL10 correlated positively with AAA growth rate before and after adjustment. AAA patients with CRP levels above the median doubled the risk of death. Conclusions Reduced IFN-γ, IL10, and IL17A in AAA patients, positive correlations of IFN-γ and IL17A with cross-sectional AAA area, IL10 with AAA growth rate, and IL10 with IFN-γ and IL17A suggest combined Th1, Th2, and Th17 immune responses in human AAAs. PMID:25856542

  16. Peripheral labour market position and risk of disability pension: a prospective population-based study

    PubMed Central

    Gustafsson, Klas; Aronsson, Gunnar; Marklund, Staffan; Wikman, Anders; Floderus, Birgitta

    2014-01-01

    Objective To investigate what impact individuals’ position in a labour market core–periphery structure may have on their risk of disability pension (DP) in general and specifically on their risk of DP based on mental or musculoskeletal diagnoses. Methods The study comprised 45 567 individuals who had been interviewed for the annual Swedish Surveys of Living Conditions (1992–2007). The medical DP diagnoses were obtained from the Swedish Social Insurance Agency (1993–2011). The assumed predictors were studied in relation to DP by Cox's proportional hazards regression. The analyses were stratified on sex and age, controlling for social background and self-reported long-standing illness at baseline. Results All three indicators underlying the categorisation of the core–periphery structure: employment income, work hours and unemployment, increased the risk of DP in all strata. The risk of DP tended to increase gradually the more peripheral the labour market position was. The risk estimates for DP in general and for DP based on mental diagnoses were particularly high among men aged 20–39 years. Conclusions The core–periphery position of individuals, representing their labour market attachment, was found to be a predictor of future DP. The association was most evident among individuals below 40 years of age with regard to DP based on mental diagnoses. This highlights the need for preventative measures that increase the participation of young people in working life. PMID:25142263

  17. Are the creation and maintenance of databases in healthcare worthwhile? An example of a unique, population-based, radiation therapy database.

    PubMed

    Jackson, Stewart M; Tyldesley, Scott; Baerg, Barbara; Olivotto, Ivo A

    2012-01-01

    A population-based prospective database targeting 15 key radiation therapy (RT) features was initiated in British Columbia in 1984. This 25-year outcome report assessed the utility of the database and demonstrated that such a database can be used to (1) describe population-based utilization of a health service, (2) inform treatment policy recommendations, (3) inform system planning and resource allocation, (4) audit regional and individual oncology practices, (5) assess whether new observations from randomized trials have been translated into population health gains and (6) produce peer-reviewed publications. Health system managers and researchers could benefit from the development and support of such databases. PMID:23803407

  18. Cross-sectional study of phoneme and rhyme monitoring abilities in children between 7 and 13 years.

    PubMed

    Sasisekaran, Jayanthi; Weber-Fox, Christine

    2012-04-01

    We investigated phonemic competence in production in three age groups of children - 7 and 8 years, 10 and 11 years, 12 and 13 years-using rhyme and phoneme monitoring. Participants were required to name target pictures silently while monitoring covert speech for the presence or absence of a rhyme or phoneme match. Performance in the verbal tasks was compared to a nonverbal control task in which participants monitored tone sequence pairs for a pattern match. Repeated measures ANOVA revealed significant differences between the three age groups in phoneme monitoring while similar differences were limited to the younger age groups in rhyme monitoring. This finding supported early and on-going acquisition of rhyme- and later acquisition of segment-level units. In addition, the 7 and 8-year-olds were significantly slower in monitoring phonemes within consonant clusters compared to the 10 and 11-year-olds and in monitoring both singleton phonemes and phonemes within clusters compared to the 12 and 13-year-olds. Regression analysis revealed that age accounted for approximately 30% variance in the nonverbal and 60% variance in the verbal monitoring tasks. We attribute the observed differences to the emergence of cognitive processes such as segmentation skills that are critical to performing the verbal monitoring tasks. PMID:23204597

  19. [Prevalence, treatment needs, and predisposing factors for traumatic injuries to permanent dentition in 11-13-year-old schoolchildren].

    PubMed

    Traebert, J; Almeida, I C S; Garghetti, C; Marcenes, W

    2004-01-01

    The objective of this study was to assess the prevalence of traumatic injuries to the permanent incisors and the association with clinical predisposing factors and parents' schooling. A cross-sectional survey was conducted with schoolchildren aged 11 to 13 years in Biguaçu, Brazil. Dental examinations were conducted by a dentist, and the criteria for traumatic dental injuries used in the children's dental health survey in the United Kingdom were adopted. the study recorded the type of damage sustained, treatment performed or needed, the size of incisal overjet, and whether lip coverage was adequate. Socio-demographic data included sex, age, and parents' level of schooling. a total of 2,260 children were examined, and prevalence rates were 10.4%, 10.6%, and 11.2% in 11, 12, and 13-year-old children, respectively. Treatment need was 6.3 interventions per thousand incisors. Male gender and overjet greater than 5mm were significantly related to having a traumatic dental injury. Inadequate lip coverage and parents' educational level were not associated with dental trauma. The study concluded that male gender and incisal overjet greater than 5mm are associated with the occurrence of dental injury. PMID:15073619

  20. Long-term monitoring of the human intestinal microbiota from the 2nd week to 13 years of age.

    PubMed

    Endo, Akihito; Pӓrtty, Anna; Kalliomӓki, Marko; Isolauri, Erika; Salminen, Seppo

    2014-08-01

    Microbial contact begins prior to birth and continues rapidly thereafter. Few long term follow-up studies have been reported and we therefore characterized the development of intestinal microbiota of ten subjects from the 2nd week of life to 13 years of age. PCR-denaturing gradient gel electrophoresis combined with several bacterial group-specific primer sets demonstrated the colonization steps of defined bacterial groups in the microbiota. Bifidobacterium species were seen throughout the test period in all subjects. Bacteroides fragilis group and Blautia coccoides-Eubacterium rectale group species were not detected in several subjects during the first 6 months of life but were commonly seen after 12 months of life. Streptococcus group appeared during early life but was not seen in several subjects at the age of 13 years. Although a few species were linked with the increasing age, major bacterial species in the groups did not change dramatically. Rather considerable changes were found in the relative abundances of each bacterial species. Clustering analysis of total bacterial flora indicated that the microbiota changed considerably between 6 months and 12 months of life, and, at the age of 12 months, the intestinal microbiota was already converted toward a profile characteristic of an adult microbiota. Probiotic supplementation in the beginning of life did not have major impacts on later microbiota development. PMID:24933584

  1. 13 Years of TOPEX/POSEIDON Precision Orbit Determination and the 10-fold Improvement in Expected Orbit Accuracy

    NASA Technical Reports Server (NTRS)

    Lemoine, F. G.; Zelensky, N. P.; Luthcke, S. B.; Rowlands, D. D.; Beckley, B. D.; Klosko, S. M.

    2006-01-01

    Launched in the summer of 1992, TOPEX/POSEIDON (T/P) was a joint mission between NASA and the Centre National d Etudes Spatiales (CNES), the French Space Agency, to make precise radar altimeter measurements of the ocean surface. After the remarkably successful 13-years of mapping the ocean surface T/P lost its ability to maneuver and was de-commissioned January 2006. T/P revolutionized the study of the Earth s oceans by vastly exceeding pre-launch estimates of surface height accuracy recoverable from radar altimeter measurements. The precision orbit lies at the heart of the altimeter measurement providing the reference frame from which the radar altimeter measurements are made. The expected quality of orbit knowledge had limited the measurement accuracy expectations of past altimeter missions, and still remains a major component in the error budget of all altimeter missions. This paper describes critical improvements made to the T/P orbit time series over the 13-years of precise orbit determination (POD) provided by the GSFC Space Geodesy Laboratory. The POD improvements from the pre-launch T/P expectation of radial orbit accuracy and Mission requirement of 13-cm to an expected accuracy of about 1.5-cm with today s latest orbits will be discussed. The latest orbits with 1.5 cm RMS radial accuracy represent a significant improvement to the 2.0-cm accuracy orbits currently available on the T/P Geophysical Data Record (GDR) altimeter product.

  2. Is the igeneration a 'we' generation? Social networking use among 9- to 13-year-olds and belonging.

    PubMed

    Quinn, Sally; Oldmeadow, Julian A

    2013-03-01

    Research suggests that online communication is associated with increased closeness to friends and friendship quality. Children under 13 years of age are increasingly using social networking sites (SNSs), but research with this younger age group is scarce. This study examined the relationship between SNS use and feelings of belonging among children aged 9-13 years. A self-report questionnaire was administered to 443 children (48.98% boys), asking about their SNS use and their sense of belonging to their friendship group. SNS users reported a stronger sense of belonging to their friendship group than non-users, but this was found only among older boys. Furthermore, among boy SNS users, a positive linear relationship was found between the intensity of usage and feelings of belonging. No significant relationships were found for girls. These findings suggest that boys who use these sites are gaining friendship benefits over and above those boys who are non-users or low-intensity users. Longitudinal studies should investigate the causal relationships between SNS use and social effects within this age group. PMID:23331112

  3. Circulating t-PA antigen predicts major adverse coronary events in patients with stable coronary artery disease--a 13-year follow-up.

    PubMed

    Niessner, Alexander; Graf, Senta; Nikfardjam, Mariam; Speidl, Walter S; Huber-Beckmann, Renate; Zorn, Gerlinde; Wojta, Johann; Huber, Kurt

    2003-08-01

    Thrombus formation after rupture of an atherosclerotic plaque plays a crucial role in coronary artery disease (CAD). A decreased endogenous fibrinolytic system and prothrombotic factors are supposed to influence coronary thrombosis. It was our aim to investigate the predictive value of tissue plasminogen activator (t-PA) antigen, von Willebrand Factor, Lipoprotein (a) and anti-cardiolipin antibodies for major adverse coronary events in patients with stable CAD in a prospective cohort study of more than 10 years. We observed 141 patients with angiographically proven CAD for a median follow-up period of 13 years. t-PA antigen was the only marker predicting coronary events (logistic regression, p = 0.044) with a poor prognosis for patients in the 5th quintile with an odds ratio of 7.3 (compared to the 1st quintile). The odds ratio even increased to 10.0 for coronary events associated with the "natural course" of CAD excluding events due to restenosis. t-PA antigen had a slightly higher prognostic power (ROC curve; AUC = 0.69) than fasting glucose (AUC = 0.68) and cholesterol (AUC = 0.67). Triglycerides influenced plasma levels of t-PA antigen (regression, p < 0.001). The predictive value of t-PA antigen remained significant after adjustment for inflammation (logistic regression, p = 0.013) and extent of CAD (p = 0.045) but disappeared adjusting for insulin resistance (p = 0.12). In conclusion t-PA antigen predicted coronary events during a very long-term follow-up with a comparable prognostic power to established cardiovascular risk factors. Markers of insulin resistance influenced t-PA antigen and its predictive value. PMID:12888883

  4. Development of Emotion Word Comprehension in Chinese Children from 2 to 13 Years Old: Relationships with Valence and Empathy

    PubMed Central

    Li, Yanwei; Yu, Dongchuan

    2015-01-01

    Children’s emotion word comprehension (EWC) has constantly received a great deal of attention in developmental science. However, since previous reports focused on only English emotion vocabulary, researchers thus far remained unclear as to the developmental trajectories of EWC (to Chinese emotion words) in Chinese children, let alone the cross-cultural difference of EWC in different languages (i.e., English V.S. Chinese). Furthermore, the influence of valence on EWC, as well as the interaction mechanism between EWC and empathy, has not been fully investigated. Finding answers to these research gaps has become the main motivation of the current study. For this purpose, a Chinese emotion vocabulary was first constructed to estimate EWC of Chinese children (ages 2–13 years old). Then, the valence of each emotion word was evaluated using the standard 9-point scale approach. After that, the Chinese children’s EWC and empathy were measured in terms of parental ratings. Finally, all data collected were statistically analyzed to reveal the influence of the valence of EWC, the relation between EWC and empathy, and the cross-cultural difference of children’s EWC between China and UK from the viewpoint of developmental science. The main results of the current study included the following: (i) EWC in general increased with age for Chinese children ages 2–13 years old, however, there was a dramatic increase during ages 6–8 years old; (ii) EWC of positive emotion words in general developed better than that of negative and neutral ones for Chinese children (ages 2–13 years old); and the disadvantage of EWC to negative emotion words over neutral ones was gradually observed with the increase of age, even though there were no significant differences between them from the beginning; (iii) EWC completely mediated the effect of age on empathy; and (iv) EWC of children in UK developed better than Chinese counterparts during the early childhood period (ages 4–6 years old

  5. Development of Emotion Word Comprehension in Chinese Children from 2 to 13 Years Old: Relationships with Valence and Empathy.

    PubMed

    Li, Yanwei; Yu, Dongchuan

    2015-01-01

    Children's emotion word comprehension (EWC) has constantly received a great deal of attention in developmental science. However, since previous reports focused on only English emotion vocabulary, researchers thus far remained unclear as to the developmental trajectories of EWC (to Chinese emotion words) in Chinese children, let alone the cross-cultural difference of EWC in different languages (i.e., English V.S. Chinese). Furthermore, the influence of valence on EWC, as well as the interaction mechanism between EWC and empathy, has not been fully investigated. Finding answers to these research gaps has become the main motivation of the current study. For this purpose, a Chinese emotion vocabulary was first constructed to estimate EWC of Chinese children (ages 2-13 years old). Then, the valence of each emotion word was evaluated using the standard 9-point scale approach. After that, the Chinese children's EWC and empathy were measured in terms of parental ratings. Finally, all data collected were statistically analyzed to reveal the influence of the valence of EWC, the relation between EWC and empathy, and the cross-cultural difference of children's EWC between China and UK from the viewpoint of developmental science. The main results of the current study included the following: (i) EWC in general increased with age for Chinese children ages 2-13 years old, however, there was a dramatic increase during ages 6-8 years old; (ii) EWC of positive emotion words in general developed better than that of negative and neutral ones for Chinese children (ages 2-13 years old); and the disadvantage of EWC to negative emotion words over neutral ones was gradually observed with the increase of age, even though there were no significant differences between them from the beginning; (iii) EWC completely mediated the effect of age on empathy; and (iv) EWC of children in UK developed better than Chinese counterparts during the early childhood period (ages 4-6 years old), then Chinese

  6. Population based mortality surveillance in carbon products manufacturing plants.

    PubMed Central

    Teta, M J; Ott, M G; Schnatter, A R

    1987-01-01

    The utility of a population based, corporate wide mortality surveillance system was evaluated after a 10 year observation period of one of the company's divisions. The subject population, 2219 white male, long term employees from Union Carbide Corporation's carbon based electrode and specialty products operations, was followed up for mortality from 1974 to 1983. External comparisons with the United States male population were supplemented with internal comparisons among subgroups of the study population, defined by broad job categories and time related variables, adjusting for important correlates of the healthy worker effect. Significant deficits of deaths were observed for all causes and the major non-cancer causes of death. The numbers of deaths due to malignant neoplasms and respiratory cancer were less than, but not statistically different from, expected. There was a non-significant excess of deaths from lymphopoietic cancer, occurring predominantly among salaried employees. When specific locations were examined, operations with potential exposure to coal tar products exhibited a mortality pattern similar to that of the total cohort. The risk for lung cancer was significantly raised (five observed, 1.4 expected) in one small, but older, location which did not involve coal tar products during the period of employment of these individuals, but which historically used asbestos materials for several unique applications. Although these findings are limited by small numbers and a short observation period, the population based surveillance strategy has provided valuable information regarding the mortality experience of the population, directions for future research, and the allocation of epidemiological resources. PMID:3593661

  7. Endometrial cancer and antidepressants: A nationwide population-based study.

    PubMed

    Lin, Chiao-Fan; Chan, Hsiang-Lin; Hsieh, Yi-Hsuan; Liang, Hsin-Yi; Chiu, Wei-Che; Huang, Kuo-You; Lee, Yena; McIntyre, Roger S; Chen, Vincent Chin-Hung

    2016-07-01

    To our knowledge, the association between antidepressant exposure and endometrial cancer has not been previously explored. Herein, we aim to investigate the association between antidepressant prescription, including novel antidepressants, and the risk for endometrial cancer in a population-based study.Data for the analysis were derived from National Health Insurance Research Database. We identified 8392 cases with a diagnosis of endometrial cancer and 82,432 matched controls. A conditional logistic regression model was used, with adjusting for potentially confounding variables (e.g., comorbid psychiatric diseases, comorbid physical diseases, and other medications). Risk for endometrial cancer in the population-based study sample was categorized by, and assessed as a function of, antidepressant prescription and cumulative dosage.We report no association between endometrial cancer incidence and antidepressant prescription, including those prescribed either selective serotonin reuptake inhibitors (adjusted odds ratio [OR] = 0.98; 95% confidence interval [CI], 0.84-1.15) or serotonin norepinephrine reuptake inhibitors (adjusted OR = 1.14; 95% CI, 0.76-1.71). We also did not identify an association between higher cumulative doses of antidepressant prescription and endometrial cancer.There was no association between antidepressant prescription and endometrial cancer. PMID:27442640

  8. Cigarette smoking, nicotine dependence and anxiety disorders: a systematic review of population-based, epidemiological studies

    PubMed Central

    2012-01-01

    Background Multiple studies have demonstrated that rates of smoking and nicotine dependence are increased in individuals with anxiety disorders. However, significant variability exists in the epidemiological literature exploring this relationship, including study design (cross-sectional versus prospective), the population assessed (random sample versus clinical population) and diagnostic instrument utilized. Methods We undertook a systematic review of population-based observational studies that utilized recognized structured clinical diagnostic criteria (Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Classification of Diseases (ICD)) for anxiety disorder diagnosis to investigate the relationship between cigarette smoking, nicotine dependence and anxiety disorders. Results In total, 47 studies met the predefined inclusion criteria, with 12 studies providing prospective information and 5 studies providing quasiprospective information. The available evidence suggests that some baseline anxiety disorders are a risk factor for initiation of smoking and nicotine dependence, although the evidence is heterogeneous and many studies did not control for the effect of comorbid substance use disorders. The identified evidence however appeared to more consistently support cigarette smoking and nicotine dependence as being a risk factor for development of some anxiety disorders (for example, panic disorder, generalized anxiety disorder), although these findings were not replicated in all studies. A number of inconsistencies in the literature were identified. Conclusions Although many studies have demonstrated increased rates of smoking and nicotine dependence in individuals with anxiety disorders, there is a limited and heterogeneous literature that has prospectively examined this relationship in population studies using validated diagnostic criteria. The most consistent evidence supports smoking and nicotine dependence as increasing the risk of

  9. Dieting behaviors, body shape perceptions, and body satisfaction: cross-cultural differences in Argentinean and Swedish 13-year-olds.

    PubMed

    Holmqvist, Kristina; Lunde, Carolina; Frisén, Ann

    2007-06-01

    This exploratory study represents a cross-cultural effort to examine differences in dieting practices and weight loss attempts, perceived body shape, and body satisfaction between young Argentinean and Swedish adolescents. The study group consisted of 358 Argentinean (193 girls, 165 boys) and 874 Swedish (474 girls, 400 boys) 13-year-olds. A main finding was that Argentinean and Swedish adolescents did not differ on body satisfaction, although girls in both countries displayed greater body dissatisfaction than did boys. Dieting and weight loss attempts were more prevalent among the Argentinean adolescents, especially among girls, and did not appear to depend on overweight or perception of body shape. The samples also differed in their perceptions of body shape and the effect those perceptions had on their body satisfaction, with Swedish adolescents suffering more from negative body shape perceptions. PMID:18089264

  10. Virilizing ovarian fibrothecoma with minor sex cord elements in a 13 year old girl: a rare case.

    PubMed

    Sood, Neelam; Nigam, Jitendra Singh; Goyal, Geetika; Ranjan, Reeta

    2014-08-12

    Fibrothecoma accounts for 3-4% of all ovarian neoplasms; it is usually hormonally inactive, but can be estrogenic or sometimes androgenic (11%); it is rare under 30 years. In a very few cases, minor sex cord elements (less than 10% of the tumor area) are present; therefore, it is considered as a separate subgroup of stromal tumors. The importance of immunohistochemistry in recognizing this kind of tumor has been fully documented, with variable results on inhibin staining, but specific positivity for calretenin in such cases. We report here the rare case of a 13-year-old child with ovarian fibrothecoma and minor sex cord stromal elements, who showed negativity for inhibin and positivity for calretenin. PMID:25635214

  11. A 13-Year-Old Girl in Trigeminy During Anesthesia for Outpatient Dental Surgery: A Case Report.

    PubMed

    Waxman, Bryan Neil

    2015-01-01

    A 13-year-old girl presented to a private office for dental rehabilitation under general anesthesia. The patient had a previous uneventful anesthetic 5 years prior in the same office by another dental anesthesiologist. The patient was highly anxious and would not allow monitors placed prior to induction. After an uneventful mask induction with sevoflurane, nitrous oxide, and oxygen, monitors were placed and a 22-gauge intravenous cannula inserted. The initial rhythm on the electrocardiogram was trigeminy interspersed with normal sinus rhythm. The volatile anesthetic sevoflurane was discontinued immediately, and intravenous anesthesia was started but still the patient was consistently entering trigeminy. The patient was always hemodynamically stable and never hypoxic. An in-depth discussion of the case and discussion of ventricular dysrhythmias is presented. PMID:26398127

  12. Pelvic recurrence of stage 1a well-differentiated endometrial carcinoma after 13 years: A case report

    PubMed Central

    Kim, Annie; Nguyen, Long; Kalir, Tamara; Chuang, Linus

    2016-01-01

    A great majority of endometrial carcinoma recurrences are observed in high-risk patients and within the first 3 years of treatment. The relapse of endometrial carcinoma occurring more than 10 years after initial treatment has rarely been described. Initially diagnosed and treated for International Federation of Gynecology and Obstetrics (FIGO) stage 1a, grade 1 adenocarcinoma, our patient presented 13 years later with an isolated pelvic recurrence, demonstrating, to our knowledge, the longest disease-free interval with recurrence in the pelvis reported in literature. After surgical resection, the patient is being considered for enrollment in a clinical trial. Despite favorable prognostic features, it is possible to observe the recurrence of endometrial carcinoma even 5 years after surveillance and remission. Successful salvage therapies are available but may depend upon early diagnosis. PMID:27026780

  13. A 13-Year-Old Girl in Trigeminy During Anesthesia for Outpatient Dental Surgery: A Case Report

    PubMed Central

    Waxman, Bryan Neil

    2015-01-01

    A 13-year-old girl presented to a private office for dental rehabilitation under general anesthesia. The patient had a previous uneventful anesthetic 5 years prior in the same office by another dental anesthesiologist. The patient was highly anxious and would not allow monitors placed prior to induction. After an uneventful mask induction with sevoflurane, nitrous oxide, and oxygen, monitors were placed and a 22-gauge intravenous cannula inserted. The initial rhythm on the electrocardiogram was trigeminy interspersed with normal sinus rhythm. The volatile anesthetic sevoflurane was discontinued immediately, and intravenous anesthesia was started but still the patient was consistently entering trigeminy. The patient was always hemodynamically stable and never hypoxic. An in-depth discussion of the case and discussion of ventricular dysrhythmias is presented. PMID:26398127

  14. An experimental study of spider-related covariation bias in 8- to 13-year-old children.

    PubMed

    Muris, Peter; de Jong, Peter J; Meesters, Cor; Waterreus, Bregje; Vanlubeck, Jenet

    2005-01-01

    Covariation bias can be defined as phobic subjects' tendency to overestimate the association between phobic stimuli and aversive outcomes. The current study presents two experiments that examined this type of cognitive bias in children aged 8-13 years (N=147 in Experiment 1, N=240 in Experiment 2). Children completed a self-report questionnaire for measuring spider fear and then participated in a card game in which fear-relevant (i.e., spider) and fear-irrelevant (i.e., weapon and Pokémon) pictures were equally paired with negative and positive outcomes (respectively losing and winning candy). No evidence was found for a relationship between children's level of spider fear and the tendency to link negative consequences to fear-relevant pictures. Various methodological and theoretical explanations for this null finding are discussed. PMID:15731886

  15. Large moderately-differentiated ovarian Sertoli-Leydig cell tumor in a 13-year-old female: A case report

    PubMed Central

    ZHANG, HUI; HAO, JING; LI, CHUN-YAN; LI, TAO; MU, YU-LAN

    2016-01-01

    Sertoli-Leydig cell tumor of the ovary, also known as androblastoma, is a rare neoplasm from the group of sex cord-stromal tumors of the ovary. The tumor accounts for <0.5% of all primary ovarian neoplasms. The clinical signs and symptoms of Sertoli-Leydig cell tumors can be associated with either hormonal production or the presence of a mass-occupying lesion. In the current study, a 13-year-old female was diagnosed with a stage Ic ovarian Sertoli-Leydig cell tumor following abdominal pain and distension. One month after a right oophorectomy, the follow-up magnetic resonance imaging scan was negative for residual or recurrent tumor. The overall 5-year survival rate for moderately-differentiated (grade 2) and poorly-differentiated (grade 3) Sertoli-Leydig cell tumors is 80%, and long-term follow-up is therefore highly advised in this patient. PMID:26893701

  16. Attachment-Based Family Therapy With a 13-Year-Old Girl Presenting With High Risk for Suicide.

    PubMed

    Krauthamer Ewing, E Stephanie; Levy, Suzanne A; Boamah-Wiafe, Linda; Kobak, Roger; Diamond, Guy

    2016-01-01

    This article describes the application of Attachment-Based Family Therapy (ABFT) to the treatment of a 13-year-old female adolescent presenting with high risk of suicide, complicated by a history of depression and sexual trauma. The article begins with an overview of ABFT, including (a) how attachment theory guides treatment; (b) the structure of the clinical model; and (c) the data that provide empirical support. A case example is then presented that exemplifies the primary clinical procedures used to reach therapeutic goals in ABFT, including attachment repair and autonomy/competence promotion. Weekly changes in suicide ideation and depression scores are presented. The article concludes with a discussion about implications for family-based treatment of suicidal youth. PMID:25329356

  17. Identifying with Science: A case study of two 13-year-old `high achieving working class' British Asian girls

    NASA Astrophysics Data System (ADS)

    Wong, Billy

    2012-01-01

    This paper provides an in-depth, 'case study' style analysis of the experiences of two 13-year-old British Asian girls from a larger qualitative study investigating minority ethnic students' aspirations in science. Through the lens of identity as performativity and Bourdieu's notions of habitus and capital, the ways in which two girls engage with the field of science is examined. Samantha is British Indian and Fay is British Bangladeshi and they are both 'top set' students in science, but only one aspired to study triple science, while the other desired to be 'famous'. The experiences of the two girls are explicated in this paper, teasing out their experiences and constructions of science. It is argued that cultural discourses of family, peers and teacher expectations can shape students' perceptions of science and education.

  18. Population Based Cohort Study for Pediatric Infectious Diseases Research in Vietnam

    PubMed Central

    Yoshida, Lay-Myint; Suzuki, Motoi; Thiem, Vu Dinh; Smith, Wolf Peter; Tsuzuki, Ataru; Huong, Vu Thi Thu; Takahashi, Kensuke; Miyakawa, Masami; Anh, Nguyen Thi Hien; Watanabe, Kiwao; Ai, Nguyen Thu Thuy; Tho, Le Huu; Kilgore, Paul; Yoshino, Hiroshi; Toizumi, Michiko; Yasunami, Michio; Moriuchi, Hiroyuki; Anh, Dang Duc; Ariyoshi, Koya

    2014-01-01

    A population-based cohort study on pediatric infectious diseases was established at Khanh Hoa Province, central Vietnam in 2006, to determine the etiology and risk factors for severe pediatric infectious diseases (SPID) such as acute respiratory infection (ARI), diarrhea and dengue which are the major causes of under 5 mortality. A population census survey was conducted in Nha-Trang and Ninh-Hoa to collect demographic, social-behavioral data and disease burden on SPID. The study site covered a population of 353,525 residing in 75,826 households with 24,781 children less than 5 years. Hospital databases from two hospitals covering the region were obtained. Linking the census and hospital databases, we were able to investigate on a variety of SPID such as environmental tobacco smoking exposure and increased risked of pediatric pneumonia hospitalization, population density, water supply and risk of dengue fever and animal livestock and risk of hospitalized diarrhea. To determine incidence, viral etiology and risk factors for pediatric ARI/pneumonia, we setup a population based prospective hospitalized Pediatric ARI surveillance at Khanh Hoa General Hospital, Nha-Trang in February 2007. The study has revealed RSV, rhinovirus and influenza A as major viral pathogens, role of multiple viral infection and its interaction with bacteria in the development of pneumonia. In addition, we are also conducting a birth cohort study to investigate the incidence of congenital infection and its impact on physical-neurological development, and role of host genetic polymorphism on SPID hospitalization in Vietnam. Population mobility, high cost of regular census update and low mortality are the challenges. PMID:25425951

  19. Population based cohort study for pediatric infectious diseases research in Vietnam.

    PubMed

    Yoshida, Lay-Myint; Suzuki, Motoi; Thiem, Vu Dinh; Smith, Wolf Peter; Tsuzuki, Ataru; Huong, Vu Thi Thu; Takahashi, Kensuke; Miyakawa, Masami; Anh, Nguyen Thi Hien; Watanabe, Kiwao; Ai, Nguyen Thu Thuy; Tho, Le Huu; Kilgore, Paul; Yoshino, Hiroshi; Toizumi, Michiko; Yasunami, Michio; Moriuchi, Hiroyuki; Anh, Dang Duc; Ariyoshi, Koya

    2014-06-01

    A population-based cohort study on pediatric infectious diseases was established at Khanh Hoa Province, central Vietnam in 2006, to determine the etiology and risk factors for severe pediatric infectious diseases (SPID) such as acute respiratory infection (ARI), diarrhea and dengue which are the major causes of under 5 mortality. A population census survey was conducted in Nha-Trang and Ninh-Hoa to collect demographic, social-behavioral data and disease burden on SPID. The study site covered a population of 353,525 residing in 75,826 households with 24,781 children less than 5 years. Hospital databases from two hospitals covering the region were obtained. Linking the census and hospital databases, we were able to investigate on a variety of SPID such as environmental tobacco smoking exposure and increased risked of pediatric pneumonia hospitalization, population density, water supply and risk of dengue fever and animal livestock and risk of hospitalized diarrhea. To determine incidence, viral etiology and risk factors for pediatric ARI/pneumonia, we setup a population based prospective hospitalized Pediatric ARI surveillance at Khanh Hoa General Hospital, Nha-Trang in February 2007. The study has revealed RSV, rhinovirus and influenza A as major viral pathogens, role of multiple viral infection and its interaction with bacteria in the development of pneumonia. In addition, we are also conducting a birth cohort study to investigate the incidence of congenital infection and its impact on physical-neurological development, and role of host genetic polymorphism on SPID hospitalization in Vietnam. Population mobility, high cost of regular census update and low mortality are the challenges. PMID:25425951

  20. Heterogeneity in ALSFRS-R decline and survival: a population-based study in Italy.

    PubMed

    Mandrioli, Jessica; Biguzzi, Sara; Guidi, Carlo; Sette, Elisabetta; Terlizzi, Emilio; Ravasio, Alessandro; Casmiro, Mario; Salvi, Fabrizio; Liguori, Rocco; Rizzi, Romana; Pietrini, Vladimiro; Borghi, Annamaria; Rinaldi, Rita; Fini, Nicola; Chierici, Elisabetta; Santangelo, Mario; Granieri, Enrico; Mussuto, Vittoria; De Pasqua, Silvia; Georgoulopoulou, Eleni; Fasano, Antonio; Ferro, Salvatore; D'Alessandro, Roberto

    2015-12-01

    Very few studies examined trend over time of the revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R) and factors influencing it; previous studies, then, included only patients attending tertiary ALS Centres. We studied ALSFRS-R decline, factors influencing this trend and survival in a population-based setting. From 2009 onwards, a prospective registry records all incident ALS cases among residents in Emilia Romagna (population: 4.4 million). For each patient, demographic and clinical details (including ALSFRS-R) are collected by caring physicians at each follow-up. Analysis was performed on 402 incident cases (1279 ALSFRS-R assessments). The average decline of the ALSFRS-R was 0.60 points/month during the first year after diagnosis and 0.34 points/month in the second year. ALSFRS-R decline was heterogeneous among subgroups. Repeated measures mixed model showed that ALSFRS-R score decline was influenced by age at onset (p < 0.01), phenotype (p = 0.01), body mass index (BMI) (p < 0.01), progression rate at diagnosis (ΔFS) (p < 0.01), El Escorial Criteria-Revised (p < 0.01), and FVC% at diagnosis (p < 0.01). Among these factors, at multivariate analysis, only age, site of onset and ΔFS independently influenced survival. In this first population-based study on ALSFRS-R trend, we confirm that ALSFRS-R decline is not homogeneous among ALS patients and during the disease. Factors influencing ALSFRS-R decline may not match with those affecting survival. These disease modifiers should be taken into consideration for trials design and in clinical practice during discussions with patients on prognosis. PMID:26205535

  1. Predictors of Childhood Anxiety: A Population-Based Cohort Study

    PubMed Central

    2015-01-01

    Background Few studies have explored predictors of early childhood anxiety. Objective To determine the prenatal, postnatal, and early life predictors of childhood anxiety by age 5. Methods Population-based, provincial administrative data (N = 19,316) from Manitoba, Canada were used to determine the association between demographic, obstetrical, psychosocial, medical, behavioral, and infant factors on childhood anxiety. Results Risk factors for childhood anxiety by age 5 included maternal psychological distress from birth to 12 months and 13 months to 5 years post-delivery and an infant 5-minute Apgar score of ≤7. Factors associated with decreased risk included maternal age < 20 years, multiparity, and preterm birth. Conclusion Identifying predictors of childhood anxiety is a key step to early detection and prevention. Maternal psychological distress is an early, modifiable risk factor. Future research should aim to disentangle early life influences on childhood anxiety occurring in the prenatal, postnatal, and early childhood periods. PMID:26158268

  2. A population-based study of birth defects in Malaysia.

    PubMed

    Thong, M K; Ho, J J; Khatijah, N N

    2005-01-01

    Birth defects are one of the leading causes of paediatric disability and mortality in developed and developing countries. Data on birth defects from population-based studies originating from developing countries are lacking. One of the objectives of this study was to determine the epidemiology of major birth defects in births during the perinatal period in Kinta district, Perak, Malaysia over a 14-month period, using a population-based birth defect register. There were 253 babies with major birth defects in 17,720 births, giving an incidence of 14.3/1000 births, a birth prevalence of 1 in 70. There were 80 babies with multiple birth defects and 173 with isolated birth defects. The exact syndromic diagnosis of the babies with multiple birth defects could not be identified in 18 (22.5%) babies. The main organ systems involved in the isolated birth defects were cardiovascular (13.8%), cleft lip and palate (11.9%), clubfeet (9.1%), central nervous system (CNS) (including neural tube defects) (7.9%), musculoskeletal (5.5%) and gastrointestinal systems (4.7%), and hydrops fetalis (4.3%). The babies with major birth defects were associated with lower birth weights, premature deliveries, higher Caesarean section rates, prolonged hospitalization and increased specialist care. Among the cohort of babies with major birth defects, the mortality rate was 25.2% during the perinatal period. Mothers with affected babies were associated with advanced maternal age, birth defects themselves or their relatives but not in their other offspring, and significantly higher rates of previous abortions. The consanguinity rate of 2.4% was twice that of the control population. It is concluded that a birth defects register is needed to monitor these developments and future interventional trials are needed to reduce birth defects in Malaysia. PMID:16096215

  3. Birth Prevalence of Cerebral Palsy: A Population-Based Study

    PubMed Central

    Van Naarden Braun, Kim; Doernberg, Nancy; Schieve, Laura; Christensen, Deborah; Goodman, Alyson; Yeargin-Allsopp, Marshalyn

    2015-01-01

    OBJECTIVE Population-based data in the United States on trends in cerebral palsy (CP) birth prevalence are limited. The objective of this study was to examine trends in the birth prevalence of congenital spastic CP by birth weight, gestational age, and race/ethnicity in a heterogeneous US metropolitan area. METHODS Children with CP were identified by a population-based surveillance system for developmental disabilities (DDs). Children with CP were included if they were born in metropolitan Atlanta, Georgia, from 1985 to 2002, resided there at age 8 years, and did not have a postneonatal etiology (n = 766). Birth weight, gestational age, and race/ethnicity subanalyses were restricted to children with spastic CP (n = 640). Trends were examined by CP subtype, gender, race/ethnicity, co-occurring DDs, birth weight, and gestational age. RESULTS Birth prevalence of spastic CP per 1000 1-year survivors was stable from 1985 to 2002 (1.9 in 1985 to 1.8 in 2002; 0.3% annual average prevalence; 95% confidence interval [CI] −1.1 to 1.8). Whereas no significant trends were observed by gender, subtype, birth weight, or gestational age overall, CP prevalence with co-occurring moderate to severe intellectual disability significantly decreased (−2.6% [95% CI −4.3 to −0.8]). Racial disparities persisted over time between non-Hispanic black and non-Hispanic white children (prevalence ratio 1.8 [95% CI 1.5 to 2.1]). Different patterns emerged for non-Hispanic white and non-Hispanic black children by birth weight and gestational age. CONCLUSIONS Given improvements in neonatal survival, evidence of stability of CP prevalence is encouraging. Yet lack of overall decreases supports continued monitoring of trends and increased research and prevention efforts. Racial/ethnic disparities, in particular, warrant further study. PMID:26659459

  4. Population-based register of stroke: manual of operations.

    PubMed

    Giampaoli, Simona; Hammar, Niklas; Adany, Roza; De Peretti, Christine

    2007-12-01

    Cardiovascular disease is the leading cause of death and hospitalization in both sexes in nearly all countries of Europe. The main forms of cardiovascular disease are ischaemic heart disease and stroke. Stroke by itself is the second leading cause of death in the European Union, and the annual number of cases of stroke is expected to increase within the next few decades, mainly owing to a growth in the proportion of older people. Stroke is an expensive disease because of the large number of premature deaths, ongoing disability in survivors, and the impact on families or caregivers and on health services (treatment and rehabilitation). Therefore, there is a pressing need to make stroke prevention and treatment a priority, to reduce the growing health burden and lessen its socioeconomic impact. The magnitude of the problem contrasts with the shortage, weak quality, and comparability of data available in most European countries. A stepwise surveillance procedure based on standardized data collection, appropriate record linkage, and validation methods was set up by the EUROCISS project (EUROpean Cardiovascular Indicators Surveillance Set), to build up comparable and reliable indicators for the surveillance of stroke at the population level.This manual of operations is intended for health professionals and policy makers. It provides a standardized and simple model for the implementation of a population-based register, which can provide estimates of attack rate and case fatality. The manual recommends starting from a minimum data set. Before implementing a population-based register, it is important to identify the target population under surveillance, which should preferably cover a well defined geographical and administrative area or region representative of the whole country, where population data and vital statistics (mortality and hospital discharge records at least) are routinely collected and easily available each year. All cases among residents should be recorded

  5. ["Risk factors for childhood depression"--research design, implementation, proceedings: history of 13 years: experience in grant preparation, writing, organization in connection with an American NIMH Grant].

    PubMed

    Vetró, Agnes; Baji, Ildikó; Benák, István; Besnyo, Márta; Csorba, János; Daróczy, Gabriella; Dombóvári, Edit; Kiss, Eniko; Gádoros, Jmúlia; Kaczvinszky, Emília; Kapornai, Krisztina; Mayer, László; Rimay, Tímea; Skultéty, Dóra; Szabó, Krisztina; Tamás, Zsuzsanna; Székely, Judit; Kovács, Mária

    2009-01-01

    The authors summarize their experiences in research organization accumulated during 13 years. At first they outline preliminary studies which are prerequisites of high prestige international grants. Then they describe the huge administrative apparatus dedicated - besides skilled professionals - for the construction and organization of the research, the management, continuous checking and evaluation of data in such a multisite study. Finally, they report on the scientific results obtained after 13 years of hard work. PMID:19542566

  6. Clinician Use and Acceptance of Population-Based Data about Respiratory Pathogens: Implications for Enhancing Population-Based Clinical Practice

    PubMed Central

    Gesteland, Per H; Allison, Mandy A; Staes, Catherine J; Samore, Matthew H; Rubin, Michael A; Carter, Marjorie E; Wuthrich, Amyanne; Kinney, Anita Y; Mottice, Susan; Byington, Carrie L

    2008-01-01

    Front line health care providers (HCPs) play a central role in endemic (e.g., pertussis), epidemic (e.g., influenza) and pandemic (e.g., avian influenza) infectious disease outbreaks. Effective preparedness for this role requires access to and awareness of population-based data (PBD). We investigated the degree to which this is currently achieved among HCPs in Utah by surveying a sample about access, awareness and attitudes concerning PBD in clinical practice. We found variability in the number and nature (national vs. local, pushed vs. pulled) of PBD sources accessed by HCPs, with a subset using multiple sources and using them frequently. We found that HCPs believe PBD improves their clinical performance and that they cannot rely on their own practice to remain informed. These findings suggest that an integrated system, which interprets PBD from multiple sources and optimizes the delivery of PBD, may facilitate preparedness of HCPs through the application of PBD in routine clinical practice. PMID:18999305

  7. Association between Education Level and Prognosis after Esophageal Cancer Surgery: A Swedish Population-Based Cohort Study

    PubMed Central

    Brusselaers, Nele; Mattsson, Fredrik; Lindblad, Mats; Lagergren, Jesper

    2015-01-01

    Background An association between education level and survival after esophageal cancer has recently been indicated, but remains uncertain. We conducted a large study with long follow-up to address this issue. Methods This population-based cohort study included all patients operated for esophageal cancer in Sweden between 1987 and 2010 with follow-up until 2012. Level of education was categorized as compulsory (≤9 years), intermediate (10–12 years), or high (≥13 years). The main outcome measure was overall 5-year mortality after esophagectomy. Cox regression was used to estimate associations between education level and mortality, expressed as hazard ratios (HRs) with 95% confidence intervals (CIs), with adjustment for sex, age, co-morbidity, tumor stage, tumor histology, and assessing the impact of education level over time. Results Compared to patients with high education, the adjusted HR for mortality was 1.29 (95% CI 1.07–1.57) in the intermediate educated group and 1.42 (95% CI 1.17–1.71) in the compulsory educated group. The largest differences were found in early tumor stages (T-stage 0–1), with HRs of 1.73 (95% CI 1.00–2.99) and 2.58 (95% CI 1.51–4.42) for intermediate and compulsory educated patients respectively; and for squamous cell carcinoma, with corresponding HRs of 1.38 (95% CI 1.07–1.79) and 1.52 (95% CI 1.19–1.95) respectively. Conclusions This Swedish population-based study showed an association between higher education level and improved survival after esophageal cancer surgery, independent of established prognostic factors. The associations were stronger in patients of an early tumor stage and squamous cell carcinoma. PMID:25811880

  8. Acromial apophysitis in a 13-year-old adolescent boy: a common condition in an uncommon location

    PubMed Central

    Quinlan, Erin; Bogar, William C.

    2012-01-01

    Objective Traction apophysitis is a common condition in physically active and skeletally immature adolescents. This case study describes the clinical presentation and plain film imaging of traction apophysitis of the acromion process of the scapula. Clinical Features A physically active 13-year-old adolescent boy presented to a chiropractic physician with an acute onset of moderate shoulder pain. Plain film radiographs of the shoulder were performed that revealed fragmentation, sclerosis, and irregularity of the left acromial apophysis. Intervention and Outcome The patient was treated with conservative therapy for 10 weeks, with complete resolution of symptoms. Follow-up radiographs 9 weeks later revealed no radiographic change in the appearance of the apophysis; however, clinical symptoms were absent. The apophyseal growth cartilage is the most vulnerable site in the muscle-tendon unit in the skeletally immature patient and is more susceptible to very small avulsion fractures. Repetitive microtrauma following chronic overuse at a tendon insertion site in a skeletally immature patient may result in traction apophysitis. Conclusions Acromial apophysitis should be included in the differential diagnosis when presented with a young active patient with shoulder pain. Early treatment with restriction of activities is important in the prevention of permanent injury to the acromial cartilaginous growth plate. This case demonstrates that a prompt diagnosis can be made with a careful history, physical examination, and conventional imaging. PMID:23204953

  9. Assessing Progress in Reducing the At-Risk Population after 13 Years of the Global Programme to Eliminate Lymphatic Filariasis

    PubMed Central

    Hooper, Pamela J.; Chu, Brian K.; Mikhailov, Alexei; Ottesen, Eric A.; Bradley, Mark

    2014-01-01

    Background In 1997, the World Health Assembly adopted Resolution 50.29, committing to the elimination of lymphatic filariasis (LF) as a public health problem, subsequently targeted for 2020. The initial estimates were that 1.2 billion people were at-risk for LF infection globally. Now, 13 years after the Global Programme to Eliminate Lymphatic Filariasis (GPELF) began implementing mass drug administration (MDA) against LF in 2000—during which over 4.4 billion treatments have been distributed in 56 endemic countries—it is most appropriate to estimate the impact that the MDA has had on reducing the population at risk of LF. Methodology/Principal Findings To assess GPELF progress in reducing the population at-risk for LF, we developed a model based on defining reductions in risk of infection among cohorts of treated populations following each round of MDA. The model estimates that the number of people currently at risk of infection decreased by 46% to 789 million through 2012. Conclusions/Significance Important progress has been made in the global efforts to eliminate LF, but significant scale-up is required over the next 8 years to reach the 2020 elimination goal. PMID:25411843

  10. Prevalence of oral squamous cell carcinoma of tongue in and around Davangere, Karnataka, India: A retrospective study over 13 years

    PubMed Central

    Selvamani, M.; Yamunadevi, Andamuthu; Basandi, Praveen S.; Madhushankari, G. S.

    2015-01-01

    Aim: The aim was to determine the frequency and distribution of oral squamous cell carcinoma (OSCC) involving tongue among patients by studying biopsy specimens obtained from the archives of the Department of Oral and Maxillofacial Pathology, College of Dental Sciences, Davangere, Karnataka, India, during the past 13 years. Methodology: Data for the study were retrieved from the case records of patients. Analyzed clinical variables included age, sex, anatomical site, and histological diagnosis. Results: Of the 369 squamous cell carcinoma involving head and neck region, we found 52 biopsies reported exclusively involving tongue. Lateral border of the tongue was most commonly involved (43 cases, 82.7%), followed by base of tongue and posterior part of tongue. The patient were affected over a wide range of 27–80 years with mean age of 55.75 years and peak incidence was seen in the fourth and fifth decades of life, with the male: female ratio of 1.7:1. Conclusion: The prevalence rate of OSCC involving tongue showed a definite geographic variation when compared with a study done in other parts of the world. PMID:26538904

  11. [Diagnosis of mild hemophilia A made by massive intraabdominal bleeding in a 13-year-old boy].

    PubMed

    Terao, Yoko; Akiyama, Masaharu; Yokoi, Kentaro; Yamaoka, Masayoshi; Shimizu, Mika; Kato, Yoko; Tanaka, Keiichiro; Baba, Yuji; Kuwashima, Naruo; Ashizuka, Shuichi; Yoshizawa, Jyoji; Motoki, Takanori; Saito, Yoshihiro; Ida, Hiroyuki

    2012-08-01

    We report a 13-year-old boy who had massive intra-abdominal bleeding without a history of bleeding episodes or traumatic cause of bleeding. The patient underwent surgical treatment because bleeding was not controlled after treatment with tranexamic acid and transfusions including fresh-frozen plasma. Bleeding was traced to the lower left lobe of the liver. The mother's side of the family had a history of bleeding episodes in the boy's grandfather, great uncle, and son of a great aunt. A low level of plasma factor VIII coagulant activity (22%) led to a diagnosis of mild hemophilia A. Compared with severe hemophilia, mild hemophilia is more difficult to diagnose because bleeding episodes are less frequent. Most cases are found after incidental trauma or uncontrolled surgery-related bleeding, there is rarely a family history of hemophilia and activated partial thromboplastin time is normal or slightly prolonged. However, bleeding episodes in mild hemophilia may result in excessive, sometimes life-threatening hemorrhage and require early diagnosis and replacement treatment with adequate amounts of factor VIII, as in severe hemophilia. PMID:22975817

  12. [T-cell granular lymphocyte-proliferative disorder without severe infection for 13 years despite severe neutropenia].

    PubMed

    Tanaka, Hiroaki; Hashimoto, Shinichiro; Sakai, Chikara; Abe, Daijiro; Sakai, Shio; Takagi, Toshiyuki

    2010-02-01

    A 68-year-old woman was referred to Oami Hospital for severe leukocytopenia. Laboratory data revealed severe leukocytopenia (0.8x10(9)/l), severe neutropenia (0.22x10(9)/l) and IgM-kappa monoclonal gammopathy. Granular lymphocytes accounted for more than 90% of leukocytes. Surface marker analysis revealed that these lymphocytes were CD3+, CD4-, CD8+ and CD16+, and monoclonal rearrangement of T-cell receptor genes was seen on Southern blot hybridization analysis. She was diagnosed with T-cell lineage granular lymphocyte proliferative disorder (T-GLPD). During 13-year follow-up without granulocyte-colony stimulating factor (G-CSF) administration, except for one hospitalization because of bacterial pneumonia, she has not experienced severe infection, despite severe neutropenia. T-GLPD should be kept in mind as a cause of leukocytopenia with or without monoclonal gammopathy, and surface marker or Southern blot hybridization analysis should be considered for determining the diagnosis. There are many reports about Caucasian patients with T-GLPD suffering from recurrent infections and dying of severe infection, but in Japanese T-GLPD patients, severe infection is very rare, as shown in the present case report. PMID:20379107

  13. Natural history of cardiac involvement in myotonic dystrophy (Steinert's disease): a 13-year follow-up study.

    PubMed

    Mammarella, A; Paradiso, M; Antonini, G; Paoletti, V; De Matteis, A; Basili, S; Donnarumma, L; Labbadia, G; Di Franco, M; Musca, A

    2000-01-01

    Myotonic dystrophy (MD) is associated with a wide spectrum of cardiac abnormalities, but only a few longitudinal studies have investigated the natural course of heart disease in MD. To assess whether neuromuscular involvement significantly predicts cardiac disorders in MD, 83 patients with various grades of disease severity were enrolled in a 13-year follow-up study (mean, 60.6 +/- 37.8 months) that included periodic physical and instrumental cardiac examinations (standard and Holter electrocardiography, echocardiography). During follow-up, muscular disease worsened clinically in 9 patients (11%) whose baseline severity grade changed accordingly; only 3 of them demonstrated parallel worsening of cardiac disturbance, however, compared with a large number of patients who showed additional cardiac abnormalities. These included further worsening of pre-existing pathologic features (19/83) and the appearance de novo of serious arrhythmias and/or conduction defects (23/83). Pacemaker implantation was necessary in 11 of 83 patients (13.2%) who had symptomatic bradyarrhythmias, bifascicular block, and P-R prolongation with a His-to-ventricle interval exceeding 55 ms, as documented by electrophysiologic study. Eight (9.6%) patients died: 2 from noncardiac and 1 from unknown causes, 1 from heart failure, and 4 from sudden death closely related to documented ventricular tachycardia. The incidence and seriousness of arrhythmic and conduction disturbances correlated with the severity of the muscular involvement. Nevertheless, cardiac and muscular disease did not show a linear progression. Cardiac involvement generally worsened more rapidly than did skeletal muscle disease. PMID:11186144

  14. Hematometra presenting as an acute abdomen in a 13-year-old postmenarchal girl: a case report

    PubMed Central

    2012-01-01

    Introduction Most underlying diseases for abdominal pain in children are not dangerous. However some require rapid diagnosis and treatment, such as acute ovarian torsion or appendicitis. Since reaching a diagnosis can be difficult, and delayed treatment of potentially dangerous diseases might have significant consequences, exploratory laparoscopy is a diagnostic and therapeutic option for patients who have unclear and potentially hazardous abdominal diseases. Here we describe a case where the anomaly could not be identified using a laparoscopy in an adolescent girl with acute abdomen. Case presentation A 13-year old postmenarchal caucasian female presented with an acute abdomen. Emergency sonography could not exclude ovarian torsion. Accurate diagnosis and treatment were achieved only after an initial laparoscopy followed by a laparotomy and after a magnetic resonance imaging scan a further laparotomy. The underlying disease was hematometra of the right uterine horn in a uterus didelphys in conjunction with an imperforate right cervix. Conclusion This report demonstrates that the usual approach for patients with acute abdominal pain may not be sufficient in emergency situations. PMID:23234497

  15. Cross-sectional study of phoneme and rhyme monitoring abilities in children between 7 and 13 years

    PubMed Central

    Sasisekaran, Jayanthi; Weber-Fox, Christine

    2011-01-01

    We investigated phonemic competence in production in three age groups of children – 7 and 8 years, 10 and 11 years, 12 and 13 years—using rhyme and phoneme monitoring. Participants were required to name target pictures silently while monitoring covert speech for the presence or absence of a rhyme or phoneme match. Performance in the verbal tasks was compared to a nonverbal control task in which participants monitored tone sequence pairs for a pattern match. Repeated measures ANOVA revealed significant differences between the three age groups in phoneme monitoring while similar differences were limited to the younger age groups in rhyme monitoring. This finding supported early and on-going acquisition of rhyme- and later acquisition of segment-level units. In addition, the 7 and 8-year-olds were significantly slower in monitoring phonemes within consonant clusters compared to the 10 and 11-year-olds and in monitoring both singleton phonemes and phonemes within clusters compared to the 12 and 13-year-olds. Regression analysis revealed that age accounted for approximately 30% variance in the nonverbal and 60% variance in the verbal monitoring tasks. We attribute the observed differences to the emergence of cognitive processes such as segmentation skills that are critical to performing the verbal monitoring tasks. PMID:23204597

  16. Lifetime Paid Work and Mental Health Problems among Poor Urban 9-to-13-Year-Old Children in Brazil

    PubMed Central

    Pires, Ivens H.; Paula, Cristiane S.

    2013-01-01

    Objective. To verify if emotional/behavioral problems are associated with lifetime paid work in poor urban children, when taking into account other potential correlates. Methods. Cross-sectional study focused on 9-to-13-year-old children (n = 212). In a probabilistic sample of clusters of eligible households (women 15–49 years and son/daughter <18 years), one mother-child pair was randomly selected per household (n = 813; response rate = 82.4%). CBCL/6-18 identified child emotional/behavioral problems. Potential correlates include child gender and age, socioeconomic status/SES, maternal education, parental working status, and family social isolation, among others. Multivariate analysis examined the relationship between emotional/behavioral problems and lifetime paid work in the presence of significant correlates. Findings. All work activities were non-harmful (e.g., selling fruits, helping parents at their small business, and baby sitting). Children with lower SES and socially isolated were more involved in paid work than less disadvantaged peers. Children ever exposed to paid work were four times more likely to present anxiety/depression symptoms at a clinical level compared to non-exposed children. Multivariate modeling identified three independent correlates: child pure internalizing problems, social isolation, and low SES. Conclusion. There is an association between lifetime exposure to exclusively non-harmful paid work activities and pure internalizing problems even when considering SES variability and family social isolation. PMID:24302872

  17. Provider communication on perinatal depression: a population-based study.

    PubMed

    Farr, Sherry L; Ko, Jean Y; Burley, Kim; Gupta, Seema

    2016-02-01

    Women's lack of knowledge on symptoms of perinatal depression and treatment resources is a barrier to receiving care. We sought to estimate the prevalence and predictors of discussing depression with a prenatal care provider. We used the 2011 population-based data from 24 sites participating in the Pregnancy Risk Assessment Monitoring System (n = 32,827 women with recent live births) to examine associations between maternal characteristics and report that a prenatal care provider discussed with her what to do if feeling depressed during or after pregnancy. Overall, 71.9 % of women reported discussing perinatal depression with their prenatal care provider (range 60.7 % in New York City to 85.6 % in Maine). Women were more likely to report a discussion on perinatal depression with their provider if they they were 18-29 years of age than over 35 years of age compared to older (adjusted prevalence ratio [aPR] 18 to 19 y = 1.08, 20 to 24 y = 1.10, 25 to 29 y = 1.09), unmarried (aPR = 1.07) compared to married, had <12 years of education (aPR = 1.05) compared to > 12 years, and had no previous live births (aPR = 1.03) compared to ≥ 1 live births. Research is needed on effective ways to educate women about perinatal depression and whether increased knowledge on perinatal depression results in higher rates of treatment and shorter duration of symptoms. PMID:25578631

  18. Glycemic Change After Pancreaticoduodenectomy: A Population-Based Study.

    PubMed

    Wu, Jin-Ming; Ho, Te-Wei; Kuo, Ting-Chun; Yang, Ching-Yao; Lai, Hong-Shiee; Chiang, Pin-Yi; Hsieh, Su-Hua; Lai, Feipei; Tien, Yu-Wen

    2015-07-01

    The purpose of this population-based study was to determine the change of glucose metabolism in patients undergoing pancreaticoduodenectomy (PD).We conducted a nationwide cohort study using data from Taiwan's National Health Insurance Research Database collected between 2000 and 2010. Our sample included 861 subjects with type 2 diabetes mellitus (DM) and 3914 subjects without DM.Of 861 subjects with type 2 diabetes, 174 patients (20.2%) experienced resolution of their diabetes after PD, including patients with pancreatic ductal adenocarcinoma (PDAC) (20.5%), and non-PDAC (20.1%). Using a multiple logistic regression model, we found that subjects with comorbid chronic pancreatitis (odds ratio, 0.356; 95% CI, 0.167-0.759; P = 0.007) and use of insulin (odds ratio, 0.265; 95% CI, 0.171-0.412; P < 0.001) had significantly lower rates of resolution of diabetes. In the 3914 subjects without diabetes, the only statistically significant comorbidity contributing to pancreatogenic diabetes was chronic pancreatitis (odds ratio, 1.446; 95% CI, 1.146-1.823; P = 0.002).Subjects with comorbid chronic pancreatitis and use of insulin had lower rates of resolution of DM after PD. In subjects without diabetes, chronic pancreatitis contributed significantly to the development of pancreatogenic DM. PMID:26166104

  19. The simcyp population based simulator: architecture, implementation, and quality assurance.

    PubMed

    Jamei, Masoud; Marciniak, Steve; Edwards, Duncan; Wragg, Kris; Feng, Kairui; Barnett, Adrian; Rostami-Hodjegan, Amin

    2013-01-01

    Developing a user-friendly platform that can handle a vast number of complex physiologically based pharmacokinetic and pharmacodynamic (PBPK/PD) models both for conventional small molecules and larger biologic drugs is a substantial challenge. Over the last decade the Simcyp Population Based Simulator has gained popularity in major pharmaceutical companies (70% of top 40 - in term of R&D spending). Under the Simcyp Consortium guidance, it has evolved from a simple drug-drug interaction tool to a sophisticated and comprehensive Model Based Drug Development (MBDD) platform that covers a broad range of applications spanning from early drug discovery to late drug development. This article provides an update on the latest architectural and implementation developments within the Simulator. Interconnection between peripheral modules, the dynamic model building process and compound and population data handling are all described. The Simcyp Data Management (SDM) system, which contains the system and drug databases, can help with implementing quality standards by seamless integration and tracking of any changes. This also helps with internal approval procedures, validation and auto-testing of the new implemented models and algorithms, an area of high interest to regulatory bodies. PMID:25505654

  20. Population-based absolute risk estimation with survey data.

    PubMed

    Kovalchik, Stephanie A; Pfeiffer, Ruth M

    2014-04-01

    Absolute risk is the probability that a cause-specific event occurs in a given time interval in the presence of competing events. We present methods to estimate population-based absolute risk from a complex survey cohort that can accommodate multiple exposure-specific competing risks. The hazard function for each event type consists of an individualized relative risk multiplied by a baseline hazard function, which is modeled nonparametrically or parametrically with a piecewise exponential model. An influence method is used to derive a Taylor-linearized variance estimate for the absolute risk estimates. We introduce novel measures of the cause-specific influences that can guide modeling choices for the competing event components of the model. To illustrate our methodology, we build and validate cause-specific absolute risk models for cardiovascular and cancer deaths using data from the National Health and Nutrition Examination Survey. Our applications demonstrate the usefulness of survey-based risk prediction models for predicting health outcomes and quantifying the potential impact of disease prevention programs at the population level. PMID:23686614

  1. A population-based study of large granular lymphocyte leukemia.

    PubMed

    Shah, M V; Hook, C C; Call, T G; Go, R S

    2016-01-01

    Large granular lymphocyte (LGL) leukemia is a lymphoproliferative disorder of cytotoxic cells. T-cell LGL (T-LGL) leukemia is characterized by accumulation of cytotoxic T cells in blood and infiltration of the bone marrow, liver or spleen. Population-based studies have not been reported in LGL leukemia. We present clinical characteristics, natural history and risk factors for poor survival in patients with LGL leukemia using the Surveillance, Epidemiology, and End Results Program (SEER) and the United States National Cancer Data Base (NCDB). LGL leukemia is an extremely rare disease with the incidence of 0.2 cases per 1 000 000 individuals. The median age at diagnosis was 66.5 years with females likely to be diagnosed at 3 years earlier compared with males. Analysis of patient-level data using NCDB (n=978) showed that 45% patients with T-LGL leukemia required some form of systemic treatment at the time of diagnosis. T-LGL leukemia patients have reduced survival compared with general population, with a median overall survival of 9 years. Multivariate analysis showed that age >60 years at the time of diagnosis and the presence of significant comorbidities were independent predictors of poor survival. PMID:27494824

  2. Histocompatibility antigens in a population based silicosis series.

    PubMed Central

    Kreiss, K; Danilovs, J A; Newman, L S

    1989-01-01

    Individual susceptibility to silicosis is suggested by the lack of a uniform dose response relation and by the presence of immunological epiphenomena, such as increased antibody levels and associated diseases that reflect altered immune regulation. Human leucocyte antigens (HLA) are linked with immune response capability and might indicate a possible genetic susceptibility to silicosis. Forty nine silicotic subjects were identified from chest radiographs in a population based study in Leadville, Colorado. They were interviewed for symptoms and occupational history and gave a blood specimen for HLA-A, -B, -DR, and -DQ typing and for antinuclear antibody, immune complexes, immunoglobulins, and rheumatoid factor. Silicotic subjects had twice the prevalence of B44 (45%) of the reference population and had triple the prevalence of A29 (20%), both of which were statistically significant when corrected for the number of comparisons made. No perturbations in D-region antigen frequencies were detected. B44-positive subjects were older at diagnosis and had less dyspnoea than other subjects. A29-positive subjects were more likely to have abnormal levels of IgA and had higher levels of immune complexes. This study is the first to find significant HLA antigen excesses among a series of silicotic cases and extends earlier reported hypotheses that were based on groups of antigens of which B44 and A29 are components. PMID:2818968

  3. Toxicogenetics: population-based testing of drug and chemical safety in mouse models.

    PubMed

    Rusyn, Ivan; Gatti, Daniel M; Wiltshire, Timothy; Wilshire, Timothy; Kleeberger, Steven R; Threadgill, David W

    2010-08-01

    The rapid decline in the cost of dense genotyping is paving the way for new DNA sequence-based laboratory tests to move quickly into clinical practice, and to ultimately help realize the promise of 'personalized' therapies. These advances are based on the growing appreciation of genetics as an important dimension in science and the practice of investigative pharmacology and toxicology. On the clinical side, both the regulators and the pharmaceutical industry hope that the early identification of individuals prone to adverse drug effects will keep advantageous medicines on the market for the benefit of the vast majority of prospective patients. On the environmental health protection side, there is a clear need for better science to define the range and causes of susceptibility to adverse effects of chemicals in the population, so that the appropriate regulatory limits are established. In both cases, most of the research effort is focused on genome-wide association studies in humans where de novo genotyping of each subject is required. At the same time, the power of population-based preclinical safety testing in rodent models (e.g., mouse) remains to be fully exploited. Here, we highlight the approaches available to utilize the knowledge of DNA sequence and genetic diversity of the mouse as a species in mechanistic toxicology research. We posit that appropriate genetically defined mouse models may be combined with the limited data from human studies to not only discover the genetic determinants of susceptibility, but to also understand the molecular underpinnings of toxicity. PMID:20704464

  4. Interactive voice response and web-based questionnaires for population-based infectious disease reporting.

    PubMed

    Bexelius, Christin; Merk, Hanna; Sandin, Sven; Nyrén, Olof; Kühlmann-Berenzon, Sharon; Linde, Annika; Litton, Jan-Eric

    2010-10-01

    The authors aimed to evaluate the web and an Interactive Voice Response (IVR) phone service as vehicles in population-based infectious disease surveillance. Fourteen thousand subjects were randomly selected from the Swedish population register and asked to prospectively report all respiratory tract infections, including Influenza-like Illness (ILI-clinical symptoms indicative of influenza but no laboratory confirmation), immediately as they occurred during a 36-week period starting October 2007. Participants were classified as belonging to the web or IVR group based on their choice of technology for initial registration. In all, 1,297 individuals registered via IVR while 2,044 chose the web. The latter were more often young and well-educated than those registered via IVR. Overall, 52% of the participants reported at least one infection episode. The risk of an infectious disease report was 14% (95% CI: 6, 22%) higher in the web group than in the IVR group. For ILI the excess was 27% (95% CI: 11, 47%). After adjustments for socio-demographic factors, statistically non-significant excesses of 1 and 8% remained, indicating trivial differences potentially attributable to the two reporting techniques. With attention to confounding, it should be possible to combine the web and IVR for simple reporting of infectious disease symptoms. PMID:20596884

  5. NSAID Use and Incident Cognitive Impairment in a Population-based Cohort.

    PubMed

    Wichmann, Margarete A; Cruickshanks, Karen J; Carlsson, Cynthia M; Chappell, Rick; Fischer, Mary E; Klein, Barbara E K; Klein, Ronald; Schubert, Carla R

    2016-01-01

    Nonsteroidal anti-inflammatory drugs (NSAIDs) may prevent dementia, but previous studies have yielded conflicting results. This study estimated the association of prior NSAID use with incident cognitive impairment in the population-based Epidemiology of Hearing Loss Study (EHLS, n=2422 without cognitive impairment in 1998-2000). Prospectively collected medication data from 1988-1990, 1993-1995, and 1998-2000 were used to categorize NSAID use history at the cognitive baseline (1998-2000). Aspirin use and nonaspirin NSAID use were separately examined. Cox regression models were used to estimate the associations between NSAID use history at baseline and incident cognitive impairment in 2003-2005 or 2009-2010. Logistic regression analyses were used to estimate associations with a second outcome, mild cognitive impairment/dementia, available in 2009-2010. Participants using aspirin at baseline but not 5 years prior were more likely to develop cognitive impairment (adjusted hazard ratio=1.77; 95% confidence interval=1.11, 2.82; model 2), with nonsignificant associations for longer term use. Nonaspirin NSAID use was not associated with incident cognitive impairment or mild cognitive impairment/dementia odds. These results provided no evidence to support a potential protective effect of NSAIDs against dementia. PMID:26079710

  6. Population-based cohort studies of type 2 diabetes and stomach cancer risk in Chinese men and women

    PubMed Central

    Xu, Hong-Li; Tan, Yu-Ting; Epplein, Meira; Li, Hong-Lan; Gao, Jing; Gao, Yu-Tang; Zheng, Wei; Shu, Xiao-Ou; Xiang, Yong-Bing

    2015-01-01

    Although positive associations have been found for diabetes and a number of cancer sites, investigations of stomach cancer are limited and the results lack consistency. In this prospective study we investigated the relationship between type 2 diabetes mellitus (T2DM) and stomach cancer risk in mainland China. We assessed the associations among T2DM, T2DM duration, and stomach cancer risk in two prospective population-based cohorts, the Shanghai Women's Health Study and the Shanghai Men's Health Study. Included in the study were 61 480 men and 74 941 women. Stomach cancer cases were identified through annual record linkage to the Shanghai Cancer Registry, and verified through home visits and review of medical charts. After a median follow-up of 7.5 years for the Shanghai Men's Health Study and 13.2 years for the Shanghai Women's Health Study, a total of 755 incident cases of stomach cancer (376 men and 379 women) were identified through to September 2013. Overall, we did not find any evidence that T2DM was associated with an increased risk of stomach cancer either in men (multi-adjusted hazard ratio = 0.83, 95% confidence interval, 0.59–1.16) or in women (multi-adjusted hazard ratio = 0.92, 95% confidence interval, 0.68–1.25). Our findings from two large prospective population-based cohorts suggest that T2DM was not associated with stomach cancer risk. PMID:25557005

  7. Long-term Survival (>13 Years) in a Child With Recurrent Diffuse Pontine Gliosarcoma: A Case Report

    PubMed Central

    Burzynski, Stanislaw R.; Janicki, Tomasz J.; Marszalek, Ania

    2014-01-01

    Pediatric gliosarcoma (GS) is a rare variant of glioblastoma multiforme. The authors describe the case of an unusual pontine location of GS in a 9-year-old boy who was initially diagnosed with low-grade astrocytoma (LGA) that was successfully controlled for 4 years. Subsequently, his brain tumor transformed into a GS. Prior treatment of his LGA included subtotal tumor resection 3 times, standard radiation therapy, and Gamma Knife procedure twice. His LGA was also treated with a standard chemotherapy regimen of carboplatin and vincristine, and his GS with subtotal resection, high-dose cyclophosphamide, and thiotepa with stem cell rescue and temozolomide. Unfortunately, he developed disseminated disease with multiple lesions and leptomeningeal involvement including a tumor occupying 80% of the pons. Upon presentation at our clinic, he had rapidly progressing disease. He received treatment with antineoplastons (ANP) A10 and AS2-1 for 6 years and 10 months under special exception to our phase II protocol BT-22. During his treatment with ANP his tumor stabilized, then decreased, and, ultimately, did not show any metabolic activity. The patient’s response was evaluated by magnetic resonance imaging and positron emission tomography scans. His pathology diagnosis was confirmed by external neuropathologists, and his response to the treatment was determined by central radiology review. He experienced the following treatment-related, reversible toxicities with ANP: fatigue, xerostomia and urinary frequency (grade 1), diarrhea, incontinence and urine color change (grade 2), and grade 4 hypernatremia. His condition continued to improve after treatment with ANP and, currently, he complains only of residual neurological deficit from his previous surgery. He achieved a complete response, and his overall and progression-free survival is in excess of 13 years. This report indicates that it is possible to obtain long-term survival of a child with a highly aggressive recurrent GS

  8. The prevalence of middle ear diseases among 7- to 13-year-old primary school students in Yozgat province.

    PubMed

    Ozkiriş, Mahmut; Kapusuz, Zeliha; Saydam, Levent

    2012-01-01

    External and/or middle ear pathologies are commonly encountered by otolaryngologists, family practitioners and pediatricians. If left undiagnosed, these conditions may result in significant irreversible damage such as varying degree of hearing loss that can affect the social or professional performance of the individuals in later stages of life. In this study, we aimed to investigate the prevalence of several external and/or middle ear diseases among 7-13-year-old primary school students in Yozgat province. The province of Yozgat serves as a transition point between the Central Anatolian and Black Sea regions of Turkey. Nine hundred and seventy-eight primary school students were included in the study between March 1, 2012 and March 15, 2012. All subjects underwent a routine ear examination in school with a diagnostic otoscope. The students with pathologic ear findings were further evaluated to identify the underlying process. The age range of 978 students (527 males, 451 females) was 7 to 13 (mean: 10.5) years. Tympanic membrane (TM) pathology was detected in 33 (3.37%) of the cases overall. Of the cases, 3 (0.30%) had TM perforation, 11 (1.12%) had myringosclerosis (MS), 13 (1.32%) had serous otitis media, 1 (0.10%) had atresia of the left ear, and 4 (0.40%) had retraction pocket. One patient (0.10%) had undergone a left cochlear implantation procedure. The results of our study seem to be comparable with the other studies reported in the literature. Routine periodic ear examinations during the primary school ages are mandatory to obtain the exact prevalence of these pathologies in the entire population. We believe that early childhood screening of middle ear disease will have a positive effect on treatment. PMID:23427512

  9. Assessment of clinicopathologic features in patients with pituitary adenomas in Northeast of Iran: A 13-year retrospective study

    PubMed Central

    Anvari, Kazem; Kalantari, Mahmoud Reza; Samini, Fariborz; Shahidsales, Soodabeh; Seilanian-Toussi, Mehdi; Ghorbanpour, Zakiyeh

    2015-01-01

    Background: Intracranial lesions of the pituitary gland are common pituitary adenomas, accounting for 6-10% of all symptomatic intracranial tumors. In this retrospective study, the clinicopathologic features and survival rate of pituitary adenomas were evaluated. Methods: The present retrospective study was conducted on 83 patients with pituitary adenomas, referring to radiation oncology departments of Ghaem and Omid Hospitals, Mashhad, Iran, over a period of 13 years (1999-2012). Data obtained from clinical records including clinical features, type of surgery (if performed), treatment modality, overall survival rate, and progression-free survival rate were analyzed. Results: Eighty-three patients including 44 males (53%) and 39 females (47%) participated in this study. The median age was 40 years (age range: 10-69 years). Chiasm compression was reported in 62 patients (74.4%), and 45.78% of the subjects suffered from headaches. Functional and non-functional adenomas were reported in 44 (53.01%) and 39 (46.99%) patients, respectively. In cases with functional and non-functional adenomas, the disease was controlled in 95 and 84.5% of the subjects for 3 years, respectively. Furthermore, 1- and 3-year survival rates for functional adenoma were 84.6 and 23%, respectively; the corresponding values were 90.9 and 22.7% in non-functional adenomas, respectively. Conclusion: In this study, a significant correlation between headache severity and type of adenoma was observed. So, application of surgery and radiotherapy together could be a highly effective approach for treating functional adenomas, although it is less efficient for the non-functional type. PMID:26885336

  10. Unusual finding of a mediastinal T-cell lymphoma in a 13-year-old patient - a case report.

    PubMed

    Bălănescu, Radu Ninel; Bălănescu, Laura; Cordoş, Ioan; Sfrijan, Doiniţa; Pop, Florinel; CaragaŢă, Florentina-Ruxandra; Mălăescu, Gheorghe Dan

    2015-01-01

    T-cell lymphoblastic lymphoma is an aggressive malignancy that represents 85% of all lymphoblastic lymphomas. It usually occurs in late childhood, adolescence and young adulthood with a 2:1 male preponderance and it presents with pleural effusion and respiratory symptoms and in rare cases vena cava syndrome can be encountered. We present the case of a 13-year-old patient who was referred to our clinic from a local hospital where he was diagnosed with a mediastinal tumor. The patient presented with thoracic pain, fever, coughing and fatigability for a month prior to admission, after having underwent surgery for abdominal pain (appendectomy). On admission to our hospital, a thoracic computed tomography (CT) scan was performed and showed the presence of an anterior mediastinal mass measuring 109/76/140 mm, well defined, which came in close contact with the superior vena cava, the ascending aorta and the pulmonary artery, right pleural effusion and a collapsed lung on the right side. The decision was taken to perform a tumor biopsy and a right pleural drain was placed. The patient's post-operative evolution was favorable with the remission of the respiratory symptoms. The histopathological result showed the presence of T-cell lymphoblastic lymphoma and the patient was then transferred to the oncology ward where he underwent chemotherapeutic treatment, with a favorable outcome. T-cell lymphoblastic lymphoma is an aggressive type of lymphoma and it is usually hard to diagnose considering the fact that the symptoms are often vague. It is essential to establish the diagnosis without delay and start appropriate chemotherapeutic treatment. PMID:26743307

  11. Recurrent Wheezing in Infants: A Population-Based Study.

    PubMed

    Belhassen, Manon; De Blic, Jacques; Laforest, Laurent; Laigle, Valérie; Chanut-Vogel, Céline; Lamezec, Liliane; Brouard, Jacques; Fauroux, Brigitte; de Pouvourville, Gérard; Ginoux, Marine; Van Ganse, Eric

    2016-04-01

    Recurrent wheezing (RW) has a significant impact on infants, caregivers, and society, but morbidity and related medical resource utilization (MRU) have not been thoroughly explored. The burden of RW needs to be documented with population-based data. The objective was to assess the characteristics, medical management, and MRU of RW infants identified from national claims data.Infants aged from 6 to 24 months, receiving ≥2 dispensations of respiratory drugs within 3 months, and presenting a marker of poor control (index date), were selected. During the 6 months after index date, MRU was described in the cohort and among 3 subgroups with more severe RW, defined as ≥4 dispensations of respiratory drugs, ≥3 dispensations of oral corticosteroids (OCS), or ≥1 hospitalization for respiratory symptoms.A total of 115,489 infants had RW, corresponding to 8.2% of subjects in this age group. During follow-up, 68.7% of infants received inhaled corticosteroids, but only 1.8 U (unit) were dispensed over 6 months, suggesting discontinuous use. Control was mostly inadequate: 61.7% of subjects received OCS, 80.2% antibiotics, and 71.2% short-acting beta-agonists, and medical/paramedical visits were numerous, particularly for physiotherapy. Severe RW concerned 39.0% of the cohort; 32.8% and 11.7% of infants had repeated use of respiratory drugs and OCS, respectively, and 5.5% were hospitalized for respiratory symptoms.In this real-life nation-wide study, RW was common and infants had poor control and high MRU. Interventions are needed to support adequate use of controller therapy, and to improve medical care. PMID:27082618

  12. Gender differences in mortality and risk factors in a 13-year cohort study of street-recruited injecting drug users

    PubMed Central

    2014-01-01

    Background Injecting drug users (IDUs) are at risk of premature mortality. This study examined gender differences in mortality, risk factors, and causes of death among IDUs. Methods In a 13-year cohort study including 172 street-recruited IDUs from Oslo, Norway in 1997, interview data was merged with the National Cause of Death Registry. Crude mortality rate (CMR) and indirect standardized mortality ratio (SMR) were estimated with 95% confidence intervals (CI). A log-logistic multivariate survival analysis model was estimated for the full sample. For a smaller data set (1.1.1998-31.12.2004) the influence of substitution treatment and prison were assessed using cox regression survival analysis. Results Eight females and 37 males died. Acute intoxications were the most common cause of death. Women were more at risk in the short-term, but more protected in the long-term. CMR was 16.0 [95% CI 8.0, 31.9] for women and 26.0 [95% CI 18.0, 35.8]) for men. SMR was 39.4 [95% CI 0.2, 220.8]) for women and 21.3 [95% CI 5.7, 54.1] for men. More women injected heroin (98% vs. 88% [x2 = 3.5, p = 0.063]), used prescription drugs (73% vs. 52% [x2 = 5.6, p = 0.018]) and combined these to inject (45% vs. 26% [x2 = 5.9, p = 0.015]). Mixing prescription drugs in heroin injections, and sex work (only women) were associated with decreased survival time. There were no gender differences in access to substitution treatment, while significantly more men had been in prison (74% vs. 51% [x2 = 7.5, p = 0.006]). The instance of substitution treatment and prison significantly decreased the mortality risk. Prison release increased the risk, but not statistically significantly. Conclusions There were gender differences in mortality and risk factors; sex work and prison were gender specific risk factors. These factors should be investigated further to better design future preventive measures. PMID:24886464

  13. Cyberbullying among Finnish adolescents – a population-based study

    PubMed Central

    2012-01-01

    Background Cyberbullying, threatening or harassing another via the internet or mobile phones, does not cause physically harm and thus the consequences are less visible. Little research has been performed on the occurrence of cyberbullying among adolescents or the perception of its seriousness. Only a few population-based studies have been published, none of which included research on the witnessing of cyberbullying. Here, we examined exposure to cyberbullying during the last year, and its frequency and perceived seriousness among 12 to 18-year-old adolescents in Finland. We studied four dimensions of cyberbullying: being a victim, bully, or both victim and bully of cyberbullying, and witnessing the cyberbullying of friends. Methods Self-administered questionnaires, including four questions on cyberbullying, were mailed to a representative sample of 12-, 14-, 16-, and 18-year-old Finns in 2009 (the Adolescent Health and Lifestyle Survey). The respondents could answer via the internet or paper questionnaire. Results The number of respondents was 5516 and the response rate was 56%. Girls more often than boys reported experiencing at least one dimension of cyberbullying during the last year. The proportion was highest among 14-year-olds and lowest among 18-year-olds of both sexes. Among girls, the most commonly encountered dimension was witnessing the cyberbullying of friends (16%); and being a victim was slightly more common than being a bully (11% vs. 9%). Among boys, an equal proportion, approximately 10%, had been a victim, a bully, or had witnessed cyberbullying. The proportion of bully-victims was 4%. Serious and disruptive cyberbullying was experienced by 2% of respondents and weekly cyberbullying by 1%; only 0.5% of respondents had been bullied weekly and considered bullying serious and disruptive. Conclusions Adolescents are commonly exposed to cyberbullying, but it is rarely frequent or considered serious or disruptive. Cyberbullying exposure differed between

  14. Familial risk of cerebral palsy: population based cohort study

    PubMed Central

    Wilcox, Allen J; Lie, Rolv T; Moster, Dag

    2014-01-01

    Objective To investigate risks of recurrence of cerebral palsy in family members with various degrees of relatedness to elucidate patterns of hereditability. Design Population based cohort study. Setting Data from the Medical Birth Registry of Norway, linked to the Norwegian social insurance scheme to identify cases of cerebral palsy and to databases of Statistics Norway to identify relatives. Participants 2 036 741 Norwegians born during 1967-2002, 3649 of whom had a diagnosis of cerebral palsy; 22 558 pairs of twins, 1 851 144 pairs of first degree relatives, 1 699 856 pairs of second degree relatives, and 5 165 968 pairs of third degree relatives were identified. Main outcome measure Cerebral palsy. Results If one twin had cerebral palsy, the relative risk of recurrence of cerebral palsy was 15.6 (95% confidence interval 9.8 to 25) in the other twin. In families with an affected singleton child, risk was increased 9.2 (6.4 to 13)-fold in a subsequent full sibling and 3.0 (1.1 to 8.6)-fold in a half sibling. Affected parents were also at increased risk of having an affected child (6.5 (1.6 to 26)-fold). No evidence was found of differential transmission through mothers or fathers, although the study had limited power to detect such differences. For people with an affected first cousin, only weak evidence existed for an increased risk (1.5 (0.9 to 2.7)-fold). Risks in siblings or cousins were independent of sex of the index case. After exclusion of preterm births (an important risk factor for cerebral palsy), familial risks remained and were often stronger. Conclusions People born into families in which someone already has cerebral palsy are themselves at elevated risk, depending on their degree of relatedness. Elevated risk may extend even to third degree relatives (first cousins). The patterns of risk suggest multifactorial inheritance, in which multiple genes interact with each other and with environmental factors. These data offer additional

  15. Risk of Parkinson Disease in Diabetes Mellitus: An Updated Meta-Analysis of Population-Based Cohort Studies

    PubMed Central

    Yue, Xuejing; Li, Hehua; Yan, Haiqing; Zhang, Ping; Chang, Li; Li, Tong

    2016-01-01

    Abstract Previous meta-analysis has identified the associations between diabetes mellitus (DM) and the risk of Parkinson disease (PD). However, the results are still debatable. The purpose of this study is to perform an updated meta-analysis to investigate the up-to-date pooling evidence based on published population-based cohort studies and assess the association between DM and the risk of PD. Electronic database including Pubmed and Embase were searched to identify cohort studies published before October, 2015. Studies were selected if they reported the risk estimates for PD associated with DM. We pooled the adjusted effect estimates using random-effects meta-analysis. Funnel plot, Begg, or Egger test as well as Duval and Tweedie trim-and-fill approach were applied to assess publication bias. A total of 7 population-based cohort studies, representing 1,761,632 individuals were included in the meta-analysis. The pooled adjusted relative risk (RR) of PD associated with DM was 1.38 (95% CI 1.18–1.62, P < 0.001). An effect was consistent in female (RR 1.50 95% CI 1.07–2.11, P = 0.019) and in male (RR 1.40, 95% CI 1.17–1.67). The association was similar when stratified by study quality, research region, study design, sample size, published year, diabetes duration, and baseline age. The trim-and-fill approach confirmed the robutness of the result (RR 1.31, 95% CI 1.09–1.57, P = 0.015). Our findings based on population-based cohort studies indicate that diabetes is associated with increased PD risk by about 38%. More large-scale prospective studies are warranted to further clarify this association and its mechanism. PMID:27149468

  16. Risk of Parkinson Disease in Diabetes Mellitus: An Updated Meta-Analysis of Population-Based Cohort Studies.

    PubMed

    Yue, Xuejing; Li, Hehua; Yan, Haiqing; Zhang, Ping; Chang, Li; Li, Tong

    2016-05-01

    Previous meta-analysis has identified the associations between diabetes mellitus (DM) and the risk of Parkinson disease (PD). However, the results are still debatable. The purpose of this study is to perform an updated meta-analysis to investigate the up-to-date pooling evidence based on published population-based cohort studies and assess the association between DM and the risk of PD.Electronic database including Pubmed and Embase were searched to identify cohort studies published before October, 2015. Studies were selected if they reported the risk estimates for PD associated with DM. We pooled the adjusted effect estimates using random-effects meta-analysis. Funnel plot, Begg, or Egger test as well as Duval and Tweedie trim-and-fill approach were applied to assess publication bias.A total of 7 population-based cohort studies, representing 1,761,632 individuals were included in the meta-analysis. The pooled adjusted relative risk (RR) of PD associated with DM was 1.38 (95% CI 1.18-1.62, P < 0.001). An effect was consistent in female (RR 1.50 95% CI 1.07-2.11, P = 0.019) and in male (RR 1.40, 95% CI 1.17-1.67). The association was similar when stratified by study quality, research region, study design, sample size, published year, diabetes duration, and baseline age. The trim-and-fill approach confirmed the robutness of the result (RR 1.31, 95% CI 1.09-1.57, P = 0.015).Our findings based on population-based cohort studies indicate that diabetes is associated with increased PD risk by about 38%. More large-scale prospective studies are warranted to further clarify this association and its mechanism. PMID:27149468

  17. Hyperthyroidism is a Risk Factor for Developing Adhesive Capsulitis of the Shoulder: A Nationwide Longitudinal Population-Based Study

    PubMed Central

    Huang, Shih-Wei; Lin, Jia-Wei; Wang, Wei-Te; Wu, Chin-Wen; Liou, Tsan-Hon; Lin, Hui-Wen

    2014-01-01

    The purpose of this study was to investigate the prevalence and risk of adhesive capsulitis among hyperthyroidism patients. The data were obtained from the Longitudinal Health Insurance Database 2005 (LHID 2005) in Taiwan, using 1 million participants and a prospective population-based 7-year cohort study of survival analysis. The ambulatory-care claim records of patients diagnosed according to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes relating to hyperthyroidism between January 1, 2004 and December 31, 2007, were obtained. The prevalence and the adjusted hazard ratio (HR) of adhesive capsulitis among hyperthyroid patients and the control group were estimated. Of 4472 hyperthyroid patients, 162 (671/100 000 person-years) experienced adhesive capsulitis during the 24 122 person-year follow-up period. The crude HR of stroke was 1.26 (95% confidence interval [CI], 1.06 to 1.49), which was larger than that of the control group. The adjusted HR of developing adhesive capsulitis was 1.22 (95% CI, 1.03 to 1.45) for hyperthyroid patients during the 7-year follow-up period, which achieved statistical significance. The results of our large-scale longitudinal population-based study indicated that hyperthyroidism is an independent risk factor of developing adhesive capsulitis. PMID:24567049

  18. Patterns of Physical Activity and Overweight among 7-13-Year-Old Russian Children: A 7-Year Nationally Representative Monitoring Study

    ERIC Educational Resources Information Center

    Tudor-Locke, Catrine; Ainsworth, Barbara E.; Popkin, B. M.

    2008-01-01

    This is a repeated cross-sectional study of overweight and physical activity (PA) and inactivity patterns of successive samples of 7-13-year-old Russian children who were surveyed six times between 1995 and 2002 as part of the Russian Longitudinal Monitoring Survey. This analysis focused on moderate/vigorous (MOD/VIG) PA (e.g., active commuting to…

  19. "You Looking at Me?": Investigating 9 and 13 Year-Olds' Ability to Encode and Decode Nonverbal Communication and Demonstrate "Emotional Literacy"

    ERIC Educational Resources Information Center

    Dickson, Esther; Burton, Neil

    2011-01-01

    This small-scale study reports the findings from an investigation into non-verbal communication. It primarily seeks to analyse whether 9 and 13 year-olds can encode and decode non-verbal communication in the context of classroom behaviour management. This research showed that, in contrast to previous published research, there were no distinct…

  20. Human Papillomavirus Vaccination Coverage Among Girls Before 13 Years: A Birth Year Cohort Analysis of the National Immunization Survey-Teen, 2008-2013.

    PubMed

    Jeyarajah, Jenny; Elam-Evans, Laurie D; Stokley, Shannon; Smith, Philip J; Singleton, James A

    2016-09-01

    Routine human papillomavirus (HPV) vaccination is recommended at 11 or 12 years by the Advisory Committee on Immunization Practices. National Immunization Survey-Teen data were analyzed to evaluate, among girls, coverage with one or more doses of HPV vaccination, missed opportunities for HPV vaccination, and potential achievable coverage before 13 years. Results were stratified by birth year cohorts. HPV vaccination coverage before 13 years (≥1 HPV dose) increased from 28.4% for girls born in 1995 to 46.8% for girls born in 2000. Among girls born during 1999-2000 who had not received HPV vaccination before 13 years (57.2%), 80.1% had at least 1 missed opportunity to receive HPV vaccination before 13 years. Opportunities to vaccinate for HPV at age 11 to 12 years are missed. Strategies are needed to decrease these missed opportunities for HPV vaccination. This can be facilitated by the administration of all vaccines recommended for adolescents at the same visit. PMID:26603581

  1. Causes, Processes and Consequences of "Desertification": Results of a Qualitative Study about the Conceptions of 12- and 13-Year-Old Students in Germany

    ERIC Educational Resources Information Center

    Schubert, Jan Christoph

    2015-01-01

    Preconceptions are a crucial factor in the educational learning process. Hence, the investigation of preconceptions is important for learning and teaching in the field of geography. This study examines the preconceptions of 12- and 13-year-old students, regarding the major environmental problem of "desertification." The students'…

  2. Renal Branch Artery Occlusion in a 13-Year-Old Hypertensive Girl: Initial Treatment and Treatment of Recurrent Stenosis by Balloon Angioplasty

    SciTech Connect

    Konez, Orhan; Burrows, Patricia E.; Harmon, William E.

    2001-09-15

    A 13-year-old girl who recently developed hypertension was diagnosed to have an occluded right renal branch artery and was treated successfully with percutaneous transluminal angioplasty (PTA). To our knowledge, PTA has not been reported as a treatment for totally occluded renal branch arteries, and there is no data available regarding the success rate and possible complications.

  3. Evidence of Secular Changes in Physical Activity and Fitness, but Not Adiposity and Diet, in Welsh 12-13 Year Olds

    ERIC Educational Resources Information Center

    Thomas, Non E.; Williams, D. R. R.; Rowe, David A.; Davies, Bruce; Baker, Julien S.

    2010-01-01

    Objective: The aim of the present study was to investigate secular trends in selected cardiovascular disease risk factors (namely adiposity, physical activity, physical fitness and diet) in a sample of Welsh 12-13 year olds between 2002 and 2007. Design: Cross-sectional. Setting: A secondary school based in South West Wales. Method: Two studies in…

  4. Absence of Widespread Psychosocial and Cognitive Effects of School-Based Music Instruction in 10-13-Year-Old Students

    ERIC Educational Resources Information Center

    Rickard, Nikki S.; Bambrick, Caroline J.; Gill, Anneliese

    2012-01-01

    Previous studies demonstrate that private music training has benefits which may transfer to other domains, including verbal memory, intelligence and self-esteem. The current paper reports on the impact of an increase in school-based music training on a range of cognitive and psychosocial measures for 10-13-year-olds in two independent studies. In…

  5. Nutritional contribution of lean beef in diets of children (9-13 Years): National Health and Nutrition Examination Survey, 1999-2004

    Technology Transfer Automated Retrieval System (TEKTRAN)

    NHANES, 1999-2004, 24-hr dietary recalls were used to examine the contribution of Lean Beef (LB) to total nutrient intake in diets of children 9-13 years (n=3,273), and determine dietary intake differences between LB consumers and non-consumers. LB was defined by MyPyramid Equivalents Database as be...

  6. What Matters Most for Predicting Survival? A Multinational Population-Based Cohort Study

    PubMed Central

    Goldman, Noreen; Glei, Dana A; Weinstein, Maxine

    2016-01-01

    Despite myriad efforts among social scientists, epidemiologists, and clinicians to identify variables with strong linkages to mortality, few researchers have evaluated statistically the relative strength of a comprehensive set of predictors of survival. Here, we determine the strongest predictors of five-year mortality in four national, prospective studies of older adults. We analyze nationally representative surveys of older adults in four countries with similar levels of life expectancy: England (n = 6113, ages 52+), the US (n = 2023, ages 50+), Costa Rica (n = 2694, ages 60+), and Taiwan (n = 1032, ages 53+). Each survey includes a broad set of demographic, social, health, and biological variables that have been shown previously to predict mortality. We rank 57 predictors, 25 of which are available in all four countries, net of age and sex. We use the area under the receiver operating characteristic curve and assess robustness with additional discrimination measures. We demonstrate consistent findings across four countries with different cultural traditions, levels of economic development, and epidemiological transitions. Self-reported measures of instrumental activities of daily living limitations, mobility limitations, and overall self-assessed health are among the top predictors in all four samples. C-reactive protein, additional inflammatory markers, homocysteine, serum albumin, three performance assessments (gait speed, grip strength, and chair stands), and exercise frequency also discriminate well between decedents and survivors when these measures are available. We identify several promising candidates that could improve mortality prediction for both population-based and clinical populations. Better prognostic tools are likely to provide researchers with new insights into the behavioral and biological pathways that underlie social stratification in health and may allow physicians to have more informed discussions with patients about end-of-life treatment

  7. Neurodevelopmental outcomes following late and moderate prematurity: a population-based cohort study

    PubMed Central

    Johnson, Samantha; Evans, T Alun; Draper, Elizabeth S; Field, David J; Manktelow, Bradley N; Marlow, Neil; Matthews, Ruth; Petrou, Stavros; Seaton, Sarah E; Smith, Lucy K; Boyle, Elaine M

    2015-01-01

    Objective There is a paucity of data relating to neurodevelopmental outcomes in infants born late and moderately preterm (LMPT; 32+0–36+6 weeks). This paper present the results of a prospective, population-based study of 2-year outcomes following LMPT birth. Design 1130 LMPT and 1255 term-born children were recruited at birth. At 2 years corrected age, parents completed a questionnaire to assess neurosensory (vision, hearing, motor) impairments and the Parent Report of Children's Abilities-Revised to identify cognitive impairment. Relative risks for adverse outcomes were adjusted for sex, socio-economic status and small for gestational age, and weighted to account for over-sampling of term-born multiples. Risk factors for cognitive impairment were explored using multivariable analyses. Results Parents of 638 (57%) LMPT infants and 765 (62%) controls completed questionnaires. Among LMPT infants, 1.6% had neurosensory impairment compared with 0.3% of controls (RR 4.89, 95% CI 1.07 to 22.25). Cognitive impairments were the most common adverse outcome: LMPT 6.3%; controls 2.4% (RR 2.09, 95% CI 1.19 to 3.64). LMPT infants were at twice the risk for neurodevelopmental disability (RR 2.19, 95% CI 1.27 to 3.75). Independent risk factors for cognitive impairment in LMPT infants were male sex, socio-economic disadvantage, non-white ethnicity, preeclampsia and not receiving breast milk at discharge. Conclusions Compared with term-born peers, LMPT infants are at double the risk for neurodevelopmental disability at 2 years of age, with the majority of impairments observed in the cognitive domain. Male sex, socio-economic disadvantage and preeclampsia are independent predictors of low cognitive scores following LMPT birth. PMID:25834170

  8. Complementary and alternative asthma treatments and their association with asthma control: a population-based study

    PubMed Central

    Chen, Wenjia; FitzGerald, J Mark; Rousseau, Roxanne; Lynd, Larry D; Tan, Wan C; Sadatsafavi, Mohsen

    2013-01-01

    Objectives Many patients with asthma spend time and resources consuming complementary and alternative medicines (CAMs). This study explores whether CAM utilisation is associated with asthma control and the intake of asthma controller medications. Design Population-based, prospective cross-sectional study. Setting General population residing in two census areas in the province of British Columbia, Canada. Recruitment was based on random-digit dialling of both landlines and cell phones. Participants 486 patients with self-reported physician diagnosis of asthma (mean age 52 years; 67.3% woman). Primary and secondary outcome measures We assessed CAM use over the previous 12 months, level of asthma control as defined by the Global Initiative for Asthma and the self-reported intake of controller medications. Multivariate logistic regression was performed to study the relationship between any usage of CAMs (outcome), asthma control and controller medication usage, adjusted for potential confounders. Results A total of 179 (36.8%) of the sample reported CAM usage in the past 12 months. Breathing exercises (17.7%), herbal medicines (10.1%) and vitamins (9.7%) were the most popular CAMs reported. After adjustment, female sex (OR 1.66; 95% CI 1.09 to 2.52) and uncontrolled asthma (vs controlled asthma, OR 2.25, 95% CI 1.30 to 3.89) were associated with a higher likelihood of using any CAMs in the past 12 months. Controller medication use was not associated with CAM usage in general and in the subgroups defined by asthma control. Conclusions Clinicians and policy makers need to be aware of the high prevalence of CAM use in patients with asthma and its association with lack of asthma control. PMID:24005131

  9. Dietary patterns and risk of oesophageal cancers: a population-based case-control study.

    PubMed

    Ibiebele, Torukiri I; Hughes, Maria Celia; Whiteman, David C; Webb, Penelope M

    2012-04-01

    Epidemiological studies investigating the association between dietary intake and oesophageal cancer have mostly focused on nutrients and food groups instead of dietary patterns. We conducted a population-based case-control study, which included 365 oesophageal adenocarcinoma (OAC), 426 oesophagogastric junction adenocarcinoma (OGJAC) and 303 oesophageal squamous cell carcinoma (OSCC) cases, with frequency matched on age, sex and geographical location to 1580 controls. Data on demographic, lifestyle and dietary factors were collected using self-administered questionnaires. We used principal component analysis to derive three dietary patterns: 'meat and fat', 'pasta and pizza' and 'fruit and vegetable', and unconditional logistic regression models to estimate risks of OAC, OGJAC and OSCC associated with quartiles (Q) of dietary pattern scores. A high score on the meat-and-fat pattern was associated with increased risk of all three cancers: multivariable-adjusted OR 2·12 (95 % CI 1·30, 3·46) for OAC; 1·88 (95% CI 1·21, 2·94) for OGJAC; 2·84 (95% CI 1·67, 4·83) for OSCC (P-trend <0·01 for all three cancers). A high score on the pasta-and-pizza pattern was inversely associated with OSCC risk (OR 0·58, 95 % CI 0·36, 0·96, P for trend=0·009); and a high score on the fruit-and-vegetable pattern was associated with a borderline significant decreased risk of OGJAC (OR for Q4 v. Q1 0·66, 95% CI 0·42, 1·04, P=0·07) and significantly decreased risk of OSCC (OR 0·41, 95% CI 0·24, 0·70, P for trend=0·002). High-fat dairy foods appeared to play a dominant role in the association between the meat-and-fat pattern and risk of OAC and OGJAC. Further investigation in prospective studies is needed to confirm these findings. PMID:21899799

  10. Shift-work and cardiovascular disease: a population-based 22-year follow-up study.

    PubMed

    Hublin, Christer; Partinen, Markku; Koskenvuo, Karoliina; Silventoinen, Karri; Koskenvuo, Markku; Kaprio, Jaakko

    2010-05-01

    Studies on the association between shift-work and cardiovascular disease (CVD), in particular coronary heart disease (CHD), have given conflicting results. In this prospective population-based study we assessed the association of shift-work with three endpoints: CHD mortality, disability retirement due to CVD, and incident hypertension. A cohort of 20,142 adults (the Finnish Twin Cohort) was followed from 1982 to 2003. Type of working time (daytime/nighttime/shift-work) was assessed by questionnaires in 1975 (response rate 89%) and in 1981 (84%). Causes of death, information on disability retirement and hypertension medication were obtained from nationwide official registers. Cox proportional hazard models were used to obtain hazard ratios (HR) for each endpoint by type of working time. Adjustments were made for 14 socio-demographic and lifestyle covariates. 76.9% were daytime workers and 9.5% shift-workers both in 1975 and in 1981. During the follow-up, 857 deaths due to CHD, 721 disability retirements due to CVD, and 2,642 new cases of medicated hypertension were observed. However, HRs for shift-work were not significant (mortality HR men 1.09 and women 1.22; retirement 1.15 and 0.96; hypertension 1.15 and 0.98, respectively). The results were essentially similar after full adjustments for all covariates. Within twin pairs, no association between shift work and outcome was observed. Our results do not support an association between shift-work and cardiovascular morbidity. PMID:20229313