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Sample records for absence register study

  1. Predictors of sickness absence in college and university educated self-employed: a historic register study

    PubMed Central

    2014-01-01

    Background Despite a large proportion of the workforce being self-employed, few studies have been conducted on risk factors for sickness absence in this population. The aim of this study is to identify risk factors for future sickness absence in a population of college and university educated self-employed. Methods In a historic register study based on insurance company files risk factors were identified by means of logistic regression analysis. Data collected at application for private disability insurance from 634 applicants were related to subsequent sickness absence periods of 30 days or more during a follow-up period of 7.95 years. Variables studied were self-reported lifestyle variables, variables concerning medical history and present health conditions and variables derived from the general medical examination including blood tests and urinary analysis. Results Results from analysis of data from 634 applicants for private disability insurance show that previous periods of sickness absence (OR 2.07), female gender (OR 2.04), health complaints listed in the health declaration (OR 1.88), elevated erythrocyte sedimentation rate (ESR) (OR 4.05) and the nature of the profession were related to a higher risk of sickness absence. Conclusions Sickness absence was found to be related to demographic variables (gender, profession), medical variables (health complaints and erythrocyte sedimentation rate) and to variables with both a medical and a behavioural component (previous sickness absence). PMID:24886527

  2. Sleep and Sickness Absence: A Nationally Representative Register-Based Follow-Up Study

    PubMed Central

    Lallukka, Tea; Kaikkonen, Risto; Härkänen, Tommi; Kronholm, Erkki; Partonen, Timo; Rahkonen, Ossi; Koskinen, Seppo

    2014-01-01

    Study Objectives: We aimed to examine various sleep measures as determinants of sickness absence while considering confounders. Design: Nationally representative Health 2000 Survey linked with sickness absence data from the Finnish Social Insurance Institution. Setting: Finland. Participants: Working-aged women (n = 1,875) and men (n = 1,885). Interventions: N/A. Measurements and Results: Insomnia-related symptoms, early morning awakenings, being more tired during daytime than other people of same age, use of sleeping pills, excessive daytime sleepiness, probable sleep apnea (4 items about snoring/apnea), and reporting that sleep duration varies between different seasons were examined as determinants of sickness absence over a 7.2 year follow-up. Poisson and gamma regression models were fitted. After adjusting age, all examined sleep disturbances except excessive daytime sleepiness were associated with sickness absence among men (RRs 1.3-2.5). Among women, after adjusting for age, insomnia-related symptoms, early morning awakenings, being more tired than others, and use of sleeping pills were associated with sickness absence (RRs 1.4-1.8). After further adjustments for education, working conditions, health behaviors, and objectively measured mental and somatic health, the associations somewhat attenuated but mainly remained. The optimal sleep duration with the lowest risk of sickness absence was 7.6 hours for women and 7.8 hours for men. Although persistence of other health problems could affect the estimates, direct costs due to sickness absence could decrease by up to 28% if sleep disturbances could be fully addressed. Conclusions: This study highlights the need for prevention of sleep disturbances and promotion of optimal sleep length to prevent sickness absence. Citation: Lallukka T, Kaikkonen R, Härkänen T, Kronholm E, Partonen T, Rahkonen O, Koskinen S. Sleep and sickness absence: a nationally representative register-based follow-up study. SLEEP 2014

  3. Celotex (Registered) Replacement Study

    SciTech Connect

    Couture, S; Hafner, R

    2002-10-01

    The AL-R8 is the pit storage container in most widespread use at Pantex. The AL-R8 container family consists of standard 20-in.-diameter steel drums, 30 to 60 in. in height, with insulation inserts made of Celotex{reg_sign}--a fiberboard product made from processed sugar cane. Celotex is an acceptable material for inserts in many radioactive material shipping and storage containers. It is a good shock mitigator/insulator, does a fair job in fire protection (when oxygen is excluded), shielding, and criticality, and is inexpensive and easily available. However, the fiberboard absorbs water in humid environments which, when combined with chemical residues in the fiberboard, forms corrosive compounds that can shorten the life of the container and affect container contents. To protect the contents from this potentially damaging environment, the AL-R8 SI was developed to isolate the contents within a sealed stainless steel vessel inside the AL-R8. Although the SI protected the contents, corrosion studies indicated the SI lid bolts might corrode over time and surveillance showed that areas of the outer drum were still subject to corrosion. To address this potential problem, DOE/Albuquerque sponsored bolt and Celotex replacement studies. The bolt replacement study was assigned to Mason and Hanger's Pantex Facility and this Celotex Replacement Study to Lawrence Livermore National Laboratory. The Celotex Replacement Study evaluated options for replacing Celotex with a material that is chemically compatible with the AL-R8 SI container. The evaluation was limited to materials either used previously in nuclear materials shipping and storage containers or materials with known properties in a low-radiation environment. This limitation was set to ensure that the long-term aging effect on the new material is known a priori. Initial material evaluations narrowed the material choices to foam and cork. Although cork performed better than foam in some tests, cork was considered a less

  4. Return to Work among Employees with Long-Term Sickness Absence in Eldercare: A Prospective Analysis of Register-Based Outcomes

    ERIC Educational Resources Information Center

    Clausen, Thomas; Friis Andersen, Malenea; Bang Christensen, Karl; Lund, Thomas

    2011-01-01

    This study investigates whether psychosocial work characteristics and work-related psychological states predict return to work (RTW) after long-term sickness absence among eldercare staff. We followed 9947 employees in a national register on payment of sickness-absence compensation for 1 year and found that 598 employees had absence periods of 8…

  5. Context Switching with Multiple Register Windows: A RISC Performance Study

    NASA Technical Reports Server (NTRS)

    Konsek, Marion B.; Reed, Daniel A.; Watcharawittayakul, Wittaya

    1987-01-01

    Although previous studies have shown that a large file of overlapping register windows can greatly reduce procedure call/return overhead, the effects of register windows in a multiprogramming environment are poorly understood. This paper investigates the performance of multiprogrammed, reduced instruction set computers (RISCs) as a function of window management strategy. Using an analytic model that reflects context switch and procedure call overheads, we analyze the performance of simple, linearly self-recursive programs. For more complex programs, we present the results of a simulation study. These studies show that a simple strategy that saves all windows prior to a context switch, but restores only a single window following a context switch, performs near optimally.

  6. Focus Group Study Exploring Factors Related to Frequent Sickness Absence

    PubMed Central

    van Rhenen, Willem

    2016-01-01

    Introduction Research investigating frequent sickness absence (3 or more episodes per year) is scarce and qualitative research from the perspective of frequent absentees themselves is lacking. The aim of the current study is to explore awareness, determinants of and solutions to frequent sickness absence from the perspective of frequent absentees themselves. Methods We performed a qualitative study of 3 focus group discussions involving a total of 15 frequent absentees. Focus group discussions were audiotaped and transcribed verbatim. Results were analyzed with the Graneheim method using the Job Demands Resources (JD–R) model as theoretical framework. Results Many participants were not aware of their frequent sickness absence and the risk of future long-term sickness absence. As determinants, participants mentioned job demands, job resources, home demands, poor health, chronic illness, unhealthy lifestyles, and diminished feeling of responsibility to attend work in cases of low job resources. Managing these factors and improving communication (skills) were regarded as solutions to reduce frequent sickness absence. Conclusions The JD–R model provided a framework for determinants of and solutions to frequent sickness absence. Additional determinants were poor health, chronic illness, unhealthy lifestyles, and diminished feeling of responsibility to attend work in cases of low job resources. Frequent sickness absence should be regarded as a signal that something is wrong. Managers, supervisors, and occupational health care providers should advise and support frequent absentees to accommodate job demands, increase both job and personal resources, and improve health rather than express disapproval of frequent sickness absence and apply pressure regarding work attendance. PMID:26872050

  7. Prenatal Maternal Smoking and Tourette Syndrome: A Nationwide Register Study.

    PubMed

    Leivonen, Susanna; Chudal, Roshan; Joelsson, Petteri; Ekblad, Mikael; Suominen, Auli; Brown, Alan S; Gissler, Mika; Voutilainen, Arja; Sourander, Andre

    2016-02-01

    This is the first nationwide register-based study to examine the relationship between prenatal maternal smoking and Tourette syndrome. A total of 767 children diagnosed with Tourette syndrome were identified from the Finnish Hospital Discharge Register. Each case was matched to four controls. Information on maternal smoking during pregnancy was obtained from the Finnish Medical Birth Register. Conditional logistic regression models were used for statistical analyses. Prenatal maternal smoking was associated with Tourette syndrome when comorbid with ADHD (OR 4.0, 95 % CI 1.2-13.5, p = 0.027 for exposure during first trimester, OR 1.7, 95 % CI, 1.05-2.7, p = 0.031 for exposure for the whole pregnancy). There was no association between maternal smoking during pregnancy and Tourette syndrome without comorbid ADHD (OR 0.5, 95 % CI 0.2-1.3, p = 0.166, OR 0.9, 95 % CI 0.7-1.3, p = 0.567). Further research is needed to elucidate the mechanisms behind the association between prenatal maternal smoking and Tourette syndrome with comorbid ADHD. PMID:25796373

  8. An explorative study from the Norwegian Quality Register Gastronet comparing self-estimated versus registered quality in colonoscopy performance

    PubMed Central

    Moritz, Volker; Holme, Oyvind; Leblanc, Marissa; Hoff, Geir

    2016-01-01

    Background and study aims: The value of a colonoscopy quality assurance (QA) register may be questioned if it brings no new information on which to act for quality improvement, e. g. if self-assessed quality of colonoscopy performance correlates perfectly with registered performance. Patients and methods: In this explorative study, 39 (33 Norwegian and 6 Swedish) out of 99 new endoscopists joining the Norwegian QA register Gastronet from 2008 to 2013 responded to an invitation to fill in a questionnaire for self-assessment of cecal intubation rate, polyp detection rate for polyps ≥ 5 mm (PDR-5 mm), withdrawal time, total examination time, and rates for severely painful and pain-free colonoscopies before receiving their first-time feedback of actually registered results from Gastronet. A linear regression analysis was applied to explore the correlation between experience level and quality of estimation. Results: We included 2654 colonoscopies in our study. Endoscopists underestimated their cecal intubation rate (estimated 88.8 %, registered 93.1 %, P < 0.001), total procedure time (estimated 31.7 minutes, registered 37.2 minutes, P = 0.014), withdrawal time (estimated 9.8 minutes, registered 14.4 minutes, P = 0.006) and the rate of pain-free procedures (estimated 18.3 %, registered 24.5 %, P = 0.001). Pre-study colonoscopy experience was not correlated with estimated quality for any of the indicators. Conclusions: Apart from overestimation of severely painful examinations, endoscopists most often underestimated their colonoscopy performance. Self-assessed quality of colonoscopy performance may not be a satisfactory substitute for systematic registration of quality and not sufficiently valid to be acted upon. PMID:27004252

  9. Does Postponement of First Pregnancy Increase Gender Differences in Sickness Absence? A Register Based Analysis of Norwegian Employees in 1993–2007

    PubMed Central

    Ariansen, Anja M. S.; Mykletun, Arnstein

    2014-01-01

    Background From 1970–2012, the average age at first delivery increased from 23.2–28.5 in Norway. Postponement of first pregnancy increases risks of medical complications both during and after pregnancy. Sickness absence during pregnancy has over the last two decades increased considerably more than in non-pregnant women. The aim of this paper is twofold: Firstly to investigate if postponement of pregnancy is related to increased sickness absence and thus contributing to the increased gender difference in sickness absence; and secondly, to estimate how much of the increased gender difference in sickness absence that can be accounted for by increased sickness absence amongst pregnant women. Methods We employed registry-data to analyse sickness absence among all Norwegian employees with income equivalent to full-time work in the period 1993–2007. Results After control for age, education, and income, pregnant women's sickness absence (age 20–44) increased on average 0.94 percentage points each year, compared to 0.29 in non-pregnant women and 0.14 in men. In pregnant women aged 20–24, sickness absence during pregnancy increased by 0.96 percent points per calendar year, compared to 0.60 in age-group 30–34. Sickness absence during pregnancy accounted for 25% of the increased gender gap in sickness absence, accounting for changes in education, income and age. Conclusions Postponement of first pregnancy does not explain the increase in pregnant women's sickness absence during the period 1993–2007 as both the highest level and increase in sickness absence is seen in the younger women. Reasons are poorly understood, but still important as it accounts for 25% of the increased gender gap in sickness absence. PMID:24667483

  10. Shiftwork and Sickness Absence Among Police Officers: The BCOPS Study

    PubMed Central

    Fekedulegn, Desta; Burchfiel, Cecil M.; Hartley, Tara A.; Andrew, Michael E.; Charles, Luenda E.; Tinney-Zara, Cathy A.; Violanti, John M.

    2015-01-01

    Shiftwork, regarded as a significant occupational stressor, has become increasingly prevalent across a wide range of occupations. The adverse health outcomes associated with shiftwork are well documented. Shiftwork is an integral part of law enforcement, a high-stress occupation with elevated risks of chronic disease and mortality. Sickness absence is an important source of productivity loss and may also serve as an indirect measure of workers’ morbidity. Prior studies of shiftwork and sickness absenteeism have yielded varying results and the association has not been examined specifically among police officers. The objective of this study was to compare the incidence rate of sick leave (any, ≥3 consecutive days) among day-, afternoon-, and night-shift workers in a cohort of police officers and also examine the role of lifestyle factors as potential moderators of the association. Participants (N = 464) from the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) study examined between 2004 and 2009 were used. Daily work history records that included the shift schedule, number of hours worked, and occurrence of sick leave were available for up to 15 yrs starting in 1994 to the date of the BCOPS study examination for each officer. Poisson regression analysis for ungrouped data was used to estimate incidence rates (IRs) of sick leave by shift, and comparison of IRs across shifts were made by computing incidence rate ratios (IRRs) and their 95% confidence intervals (CIs). Sick leave occurred at a higher rate on the night shift (4.37 per 10 000 person-hours) compared with either day (1.55 per 10000 person-hours) or afternoon (1.96 per 10000 person-hours) shifts. The association between shiftwork and sickness absence depended on body mass index (BMI). For overweight individuals (BMI ≥ 25 kg/m2), the covariate-adjusted incidence rate of sick leave (≥1 day) was twice as large for night-shift officers compared with those working on the day (IRR = 2.29, 95% CI

  11. Shiftwork and sickness absence among police officers: the BCOPS study.

    PubMed

    Fekedulegn, Desta; Burchfiel, Cecil M; Hartley, Tara A; Andrew, Michael E; Charles, Luenda E; Tinney-Zara, Cathy A; Violanti, John M

    2013-08-01

    Shiftwork, regarded as a significant occupational stressor, has become increasingly prevalent across a wide range of occupations. The adverse health outcomes associated with shiftwork are well documented. Shiftwork is an integral part of law enforcement, a high-stress occupation with elevated risks of chronic disease and mortality. Sickness absence is an important source of productivity loss and may also serve as an indirect measure of workers' morbidity. Prior studies of shiftwork and sickness absenteeism have yielded varying results and the association has not been examined specifically among police officers. The objective of this study was to compare the incidence rate of sick leave (any, ≥3 consecutive days) among day-, afternoon-, and night-shift workers in a cohort of police officers and also examine the role of lifestyle factors as potential moderators of the association. Participants (N=464) from the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) study examined between 2004 and 2009 were used. Daily work history records that included the shift schedule, number of hours worked, and occurrence of sick leave were available for up to 15 yrs starting in 1994 to the date of the BCOPS study examination for each officer. Poisson regression analysis for ungrouped data was used to estimate incidence rates (IRs) of sick leave by shift, and comparison of IRs across shifts were made by computing incidence rate ratios (IRRs) and their 95% confidence intervals (CIs). Sick leave occurred at a higher rate on the night shift (4.37 per 10,000 person-hours) compared with either day (1.55 per 10,000 person-hours) or afternoon (1.96 per 10,000 person-hours) shifts. The association between shiftwork and sickness absence depended on body mass index (BMI). For overweight individuals (BMI≥25 kg/m2), the covariate-adjusted incidence rate of sick leave (≥1 day) was twice as large for night-shift officers compared with those working on the day (IRR=2.29, 95% CI: 1

  12. Studies on Freezing RAM Semen in Absence of Glycerol.

    NASA Astrophysics Data System (ADS)

    Abdelnaby, Abdelhady Abdelhakeam

    1988-12-01

    Glycerol is widely used as a major cryoprotective agent for freezing spermatozoa of almost all species. However, it reduces fertility of sheep inseminated cervically compared with intrauterine insemination. Studies were conducted to develop a method and procedure for freezing ram semen in the absence of glycerol. Post -thaw survival of ram spermatozoa frozen in the absence of glycerol was affected by time and temperature after collection and before dilution and time after dilution and before freezing. Increase in time at 5^ circC before or after dilution and before freezing increased both post-thaw motility and number of cells passing through Sephadex filter. A cold dilution method was developed. Slow cooling of fresh ram semen and diluting at 5^circ C 2-3 hr. after collection, then freezing 1 hr. after dilution improved both post-thaw motility and number of cells passing through Sephadex filter compared with immediate dilution at 30-37^circC after collection and freezing 3-4 hr. later (P < 0.05). An extender was developed to freeze ram semen in the absence of glycerol. An increase in post-thaw motility was obtained when semen was extended in TES titrated with Tris to pH 7.0 (TEST) and osmotic pressure of 375-400 mOsm/kg, containing 25-30% (v/v) egg yolk and 10% (v/v) maltose. A special device (boat) for freezing was constructed to insure the same height of the sample above LN _2 and thus the same freezing rate from freeze to freeze. Freezing of semen in 0.25cc straws at 5-10 cm above LN_2 (73.8 to 49.5 ^circC/min) yielded higher post-thaw motility than the rates resulted from freezing at 15 cm above LN_2 or 1 cm above LN _2. Faster Thawing in 37^ circC water for 30 sec. (7.8^ circC/sec.) increased post-thaw motility compared with slower thawing in 5 or 20^circ C water (P < 0.05). A lambing rate of 52.2% was obtained in one fertility trial conducted with ram semen frozen without glycerol and 17.1% in a second trial. One injection (IM) of 15 mg PGF_{2alpha}/ewe for

  13. Sickness absence and return to work among Japanese stroke survivors: a 365-day cohort study

    PubMed Central

    Endo, Motoki; Sairenchi, Toshimi; Kojimahara, Noriko; Haruyama, Yasuo; Sato, Yasuto; Kato, Rika; Yamaguchi, Naohito

    2016-01-01

    Objectives The objective of this study was to investigate the cumulative return to work (RTW) rate and to clarify the predictors of the time to full-time RTW (full RTW) and resignation among Japanese stroke survivors, within the 365-day period following their initial day of sickness absence due to stroke. Setting This study was based on tertiary prevention of occupational health in large-scaled Japanese companies of various industries. Participants The participants in this study were 382 Japanese workers who experienced an episode of sickness leave due to clinically certified stroke diagnosed between 1 January 2000 and 31 December 2011. Data were obtained from an occupational health register. Participants were followed up for 365 days after the start day of the first sickness absence. The cumulative RTW rates by Kaplan-Meier estimates and predictors for time to full RTW and resignation by Cox regression were calculated. Results A total of 382 employees had their first sickness absence due to stroke during the 12-year follow-up period. The cumulative full RTW rates at 60, 120, 180 and 365 days were 15.1%, 33.6%, 43.5% and 62.4%, respectively. Employees who took sick leave due to cerebral haemorrhage had a longer time to full RTW (HR, 0.50; 95% CI 0.36 to 0.69) than those with cerebral infarction. Older employees (over 50 years of age) demonstrated a shorter time to resignation than younger employees (HR, 3.30; 95% CI 1.17 to 9.33). Manual workers had a longer time to resignation than non-manual workers (HR, 0.24; 95% CI 0.07 to 0.78). Conclusions Cumulative RTW rates depended on the subtype of stroke, and older age was a predictor of resignation. PMID:26729388

  14. Pain in multiple sites and sickness absence trajectories: a prospective study among Finns.

    PubMed

    Haukka, Eija; Kaila-Kangas, Leena; Ojajärvi, Anneli; Miranda, Helena; Karppinen, Jaro; Viikari-Juntura, Eira; Heliövaara, Markku; Leino-Arjas, Päivi

    2013-02-01

    We studied the number of musculoskeletal pain sites as a predictor of sickness absence during a 7-year follow-up among a nationally representative sample (the Health 2000 survey) of occupationally active Finns 30 to 55years of age (3420 subjects who did not retire or die during the follow-up). Baseline data (questionnaire, interview, clinical examination by a physician) were gathered in 2000 to 2001 and linked with information from national registers on annual compensated sickness absence periods (⩾10workdays) covering the years 2002 to 2008. Pain during the preceding month in 18 body locations was inquired and combined into 4 sites (neck, upper limbs, low back, lower limbs). Demographic factors, BMI, smoking, leisure-time physical activity, sleep disorders, physical and psychosocial workload, and chronic diseases were assessed. Four distinct sickness absence trajectories emerged, labeled as Low (59% of the subjects), Ascending (21%), Mixed (11%), and High (9%). In multinomial logistic regression, the odds ratios (ORs) for belonging to the High vs. the Low trajectory increased with the number of pain sites, being 2.1 for single-site pain, 2.6 for 2 pain sites, 2.9 for 3 pain sites, and 4.1 for 4 pain sites, after adjustment for chronic diseases, demographic and lifestyle factors, and workload. The confidence intervals of the ORs did not include unity. The adjusted ORs for belonging to the Ascending trajectory were 1.1, 1.3, 1.7, and 1.7, respectively. As the number of pain sites was a strong independent predictor of work absenteeism, early screening of workers with multisite pain and interventions to support work ability seem warranted. PMID:23245998

  15. The Present Absence: Assessment in Social Studies Classrooms

    ERIC Educational Resources Information Center

    Torrez, Cheryl A.; Claunch-Lebsack, Elizabeth Ann

    2014-01-01

    In this article, first the authors describe the aims of and a definition of social studies education and classroom assessment. Second, the authors provide an overview of issues related to classroom assessment followed by trends in social studies classrooms and assessment. Then the authors address essential systems and best practices related to…

  16. A Study in Difference: Structures and Cultures in Australian Registered Training Organisations. Full Report

    ERIC Educational Resources Information Center

    Clayton, Berwyn; Fisher, Thea; Harris, Roger; Bateman, Andrea; Brown, Mike

    2008-01-01

    This report presents the findings of a study examining organisational culture and structure in ten Australian registered training organisations (RTOs) and is part of a program of research examining the factors which affect and help build the capability of vocational education and training (VET) providers. The study sought to determine: (1) how…

  17. An Exploration of Registered Nurses' Intentions to Leave the Profession: A Qualitative Study

    ERIC Educational Resources Information Center

    Lutter, Stacy Lynn

    2011-01-01

    The purpose of this qualitative study was to explore the perceptions of female registered nurses who have intentions to leave the profession with particular attention to the influence of gender. The theoretical framework of feminist poststructuralism informed this study, which emphasizes the role of discourse and power relations in the…

  18. Epilepsy in Individuals with a History of Asperger's Syndrome: A Danish Nationwide Register-Based Cohort Study

    ERIC Educational Resources Information Center

    Mouridsen, Svend Erik; Rich, Bente; Isager, Torben

    2013-01-01

    We performed a nationwide, register-based retrospective follow-up study of epilepsy in all people who were born between January 1, 1980 and June 29, 2006 and registered in the Danish Psychiatric Central Register with Asperger's syndrome on February 7, 2011. All 4,180 identified cases with AS (3,431 males and 749 females) were screened through the…

  19. Vocal tract in female registers--a dynamic real-time MRI study.

    PubMed

    Echternach, Matthias; Sundberg, Johan; Arndt, Susan; Markl, Michael; Schumacher, Martin; Richter, Bernhard

    2010-03-01

    The area of vocal registers is still unclarified. In a previous investigation, dynamic real-time magnetic resonance imaging (MRI), which is able to produce up to 10 frames per second, was successfully applied for examinations of vocal tract modifications in register transitions in male singers. In the present study, the same MRI technique was used to study vocal tract shapes during four professional young sopranos' lower and upper register transitions. The subjects were asked to sing a scale on the vowel /a/ across their transitions. The transitions were acoustically identified by four raters. In neither of these transitions, clear vocal tract changes could be ascertained. However, substantial changes, that is, widening of the lips, opening of the jaw, elevation of the tongue dorsum, and continuous widening of the pharynx, were observed when the singers reached fundamental frequencies that were close to the frequency of the first formant of the vowel sung. These findings suggest that in these subjects register transition was not primarily the result of modifications of the vocal tract. PMID:19185452

  20. Factors Associated with Musculoskeletal Disorders among Registered Nurses: Evidence from the Thai Nurse Cohort Study.

    PubMed

    Thinkhamrop, W; Laohasiriwong, W

    2015-01-01

    Background Health, safety, and well being have been known to be influenced by occupational characteristics. Nurses constantly encounter musculoskeletal disorders (MSDs) from work demands worldwide. Nevertheless, there is insufficient of knowledge regarding causes of musculoskeletal disorders among nurses in Thailand. Objective To investigate factors associated with musculoskeletal disorder among registered nurses in Thailand. Method This study is part of the 2009 Thai Nurse Cohort Study which consisted of 18,756 nationally representative sample of registered nurses. Data collection was performed via postal self-administered questionnaires. Manifesting musculoskeletal disorders was self-reported by registered nurses, 1,070 nurses were excluded since they were unemployed during previous 12 months. Multiple logistic regression was used for data analysis. Result Of 17,686 registered nurses, the overall 12 months prevalence of musculoskeletal disorders was 47.8%. It was found that workplace violence was the strongest factor which statistically significant associated with musculoskeletal disorders (adjusted odds ratio, OR, 2.01; 95% confidence interval, 95% CI, 1.42 to 2.83; P < 0.001), anxiety/depression (OR = 1.96: 95% CI: 1.78 to 2.15; P < 0.001), perceiving job required a lot of physical effort (OR = 1.69; 95% CI: 1.52 to 1.87; P < 0.001), every 10 years increased of age (OR = 1.40; 95% CI: 1.22 to 1.62; P < 0.001), overweight (OR = 1.39; 95% CI: 1.01 to 1.52; P = 0.015). Conclusion Registered nurses were most vulnerable of musculoskeletal disorders especially those who experienced workplace violence, anxiety/depression, strenuous work, older age, and overweight. Consequently, recommending safety practices to nurses should be considered for musculoskeletal disorders (MSDs) prevention by ergonomics and workplace design. PMID:27180371

  1. A register-based study of the antimicrobial usage in Danish veal calves and young bulls.

    PubMed

    Fertner, Mette; Toft, Nils; Martin, Henrik Læssøe; Boklund, Anette

    2016-09-01

    High antimicrobial usage and multidrug resistance have been reported in veal calves in Europe. This may be attributed to a high risk of disease as veal calves are often purchased from numerous dairy herds, exposed to stress related to the transport and commingling of new animals, and fed a new ration. In this study, we used national register data to characterize the use of antimicrobials registered for large Danish veal calf and young bull producing herds in 2014. A total of 325 herds with veal calf and potentially young bull production were identified from the Danish Cattle database. According to the national Danish database on drugs for veterinary use (VetStat), a total of 537,399 Animal Daily Doses (ADD200) were registered for these 325 herds during 2014. The amount of antimicrobials registered in 2014 varied throughout the year, with the highest amounts registered in autumn and winter. Antimicrobials were registered for respiratory disorders (79%), joints/limbs/CNS disorders (17%), gastrointestinal disorders (3.7%) and other disorders (0.3%). Of the registered antimicrobials, 15% were for oral and 85% for parenteral administration. Long-acting formulations with a therapeutic effect of more than 48h covered 58% of the drugs for parenteral use. Standardized at the herd-level, as ADD200/100 calves/day, antimicrobial use distributed as median [CI95%] for starter herds (n=22): 2.14 [0.19;7.58], finisher herds (n=24): 0.48 [0.00;1.48], full-line herds (n=183): 0.78 [0.05;2.20] and herds with an inconsistent pattern of movements (n=96): 0.62 [0.00;2.24]. Full-line herds are herds, which purchase calves directly from a dairy herd and raise them to slaughter. Furthermore, we performed a risk factor analysis on the 183 herds with a full-line production. Here, we investigated, whether the number of suppliers, the number of calves purchased, the frequency of purchase, the average age at introduction, the average time in the herd and vaccination influenced the amount of

  2. Chronic lower respiratory diseases among demolition and cement workers: a population-based register study

    PubMed Central

    Mølgaard, Ellen Fischer; Hannerz, Harald; Tüchsen, Finn; Brauer, Charlotte; Kirkeskov, Lilli

    2013-01-01

    Objective To estimate standardised hospitalisation ratios (SHR) for chronic lower respiratory diseases among demolition and cement workers in Denmark, 1995–2009. Design This is a population-based register study on data from ‘the Occupational Hospitalisation Register’. SHR of chronic obstructive pulmonary disease (COPD) was calculated for both demolition and cement workers. Settings Register study with data from all hospitals in Denmark. Participants 895 demolition workers and 5633 cement and concrete workers were included in the study and all economical active men were used as reference group. Results We found a statistically significant high SHR for the cement workers, SHR=134 (95% CI 117 to 153). The SHR for demolition workers was 131 (95% CI 87 to 188). Conclusions We find a higher risk of being hospitalised due to COPD in cement and concrete workers (significant) and demolition workers (insignificant) compared to gainfully employed men. PMID:23315517

  3. Cross-Cultural Register Differences in Infant-Directed Speech: An Initial Study.

    PubMed

    Farran, Lama K; Lee, Chia-Cheng; Yoo, Hyunjoo; Oller, D Kimbrough

    2016-01-01

    Infant-directed speech (IDS) provides an environment that appears to play a significant role in the origins of language in the human infant. Differences have been reported in the use of IDS across cultures, suggesting different styles of infant language-learning. Importantly, both cross-cultural and intra-cultural research suggest there may be a positive relationship between the use of IDS and rates of language development, underscoring the need to investigate cultural differences more deeply. The majority of studies, however, have conceptualized IDS monolithically, granting little attention to a potentially key distinction in how IDS manifests across cultures during the first two years. This study examines and quantifies for the first time differences within IDS in the use of baby register (IDS/BR), an acoustically identifiable type of IDS that includes features such as high pitch, long duration, and smooth intonation (the register that is usually assumed to occur in IDS), and adult register (IDS/AR), the type of IDS that does not include such features and thus sounds as if it could have been addressed to an adult. We studied IDS across 19 American and 19 Lebanese mother-infant dyads, with particular focus on the differential use of registers within IDS as mothers interacted with their infants ages 0-24 months. Our results showed considerable usage of IDS/AR (>30% of utterances) and a tendency for Lebanese mothers to use more IDS than American mothers. Implications for future research on IDS and its role in elucidating how language evolves across cultures are explored. PMID:26981626

  4. Cross-Cultural Register Differences in Infant-Directed Speech: An Initial Study

    PubMed Central

    Farran, Lama K.; Lee, Chia-Cheng; Yoo, Hyunjoo; Oller, D. Kimbrough

    2016-01-01

    Infant-directed speech (IDS) provides an environment that appears to play a significant role in the origins of language in the human infant. Differences have been reported in the use of IDS across cultures, suggesting different styles of infant language-learning. Importantly, both cross-cultural and intra-cultural research suggest there may be a positive relationship between the use of IDS and rates of language development, underscoring the need to investigate cultural differences more deeply. The majority of studies, however, have conceptualized IDS monolithically, granting little attention to a potentially key distinction in how IDS manifests across cultures during the first two years. This study examines and quantifies for the first time differences within IDS in the use of baby register (IDS/BR), an acoustically identifiable type of IDS that includes features such as high pitch, long duration, and smooth intonation (the register that is usually assumed to occur in IDS), and adult register (IDS/AR), the type of IDS that does not include such features and thus sounds as if it could have been addressed to an adult. We studied IDS across 19 American and 19 Lebanese mother-infant dyads, with particular focus on the differential use of registers within IDS as mothers interacted with their infants ages 0–24 months. Our results showed considerable usage of IDS/AR (>30% of utterances) and a tendency for Lebanese mothers to use more IDS than American mothers. Implications for future research on IDS and its role in elucidating how language evolves across cultures are explored. PMID:26981626

  5. International variation in absence from work attributed to musculoskeletal illness: findings from the CUPID study

    PubMed Central

    Coggon, David; Ntani, Georgia; Vargas-Prada, Sergio; Martinez, José Miguel; Serra, Consol; Benavides, Fernando G; Palmer, Keith T

    2013-01-01

    Objectives To quantify the variation in rates of absence due to musculoskeletal pain across 47 occupational groups (mostly nurses and office workers) from 18 countries, and to explore personal and group-level risk factors that might explain observed differences. Methods A standardised questionnaire was used to obtain information about musculoskeletal pain, sickness absence and possible risk factors in a cross-sectional survey of 12 416 workers (92–1017 per occupational group). Additionally, group-level data on socioeconomic variables, such as sick pay and unemployment rates, were assembled by members of the study team in each country. Associations of sickness absence with risk factors were examined by Poisson regression. Results Overall, there were more than 30-fold differences between occupational groups in the 12-month prevalence of prolonged musculoskeletal sickness absence, and even among office workers carrying out similar occupational tasks, the variation was more than tenfold. Personal risk factors included older age, lower educational level, tendency to somatise, physical loading at work and prolonged absence for non-musculoskeletal illness. However, these explained little of the variation between occupational groups. After adjustment for individual characteristics, prolonged musculoskeletal sickness absence was more frequent in groups with greater time pressure at work, lower job control and more adverse beliefs about the work-relatedness of musculoskeletal disorders. Conclusions Musculoskeletal sickness absence might be reduced by eliminating excessive time pressures in work, maximising employees’ responsibility and control and providing flexibility of duties for those with disabling symptoms. Care should be taken not to overstate work as a cause of musculoskeletal injury. PMID:23695413

  6. Sickness absence, marginality, and medically unexplained physical symptoms: A focus-group study of patients’ experiences

    PubMed Central

    2013-01-01

    Abstract Purpose Medically unexplained physical symptoms (MUPS) form a major cause of sickness absence. The purpose of this study was to explore factors which may influence further marginalization among patients with MUPS on long-term sickness absence. Methods Two focus-group discussions were conducted with a purposive sample of 12 participants, six men and six women, aged 24–59 years. Their average duration of sickness absence was 10.5 months. Participants were invited to share stories about experiences from the process leading to the ongoing sickness absence, with a focus on the causes being medically unexplained. Systematic text condensation was applied for analysis. Inspired by theories of marginalization and coping, the authors searched for knowledge of how patients’ positive resources can be mobilized to counteract processes of marginality. Results Analysis revealed how invisible symptoms and lack of objective findings were perceived as an additional burden to the sickness absence itself. Factors that could counteract further marginalization were a supportive social network, positive coping strategies such as keeping to the daily schedule and physical activity, and positive attention and confidence from professionals. Conclusions Confidence from both personal and professional contacts is crucial. GPs have an important and appreciated role in this aspect. PMID:23659708

  7. Meta-Analysis of Studies Investigating the Effects of Father Absence on Children's Cognitive Performance.

    ERIC Educational Resources Information Center

    Salzman, Stephanie A.

    A meta-analysis was conducted of 137 studies investigating the effects of father absence due to employment, military service, death, divorce, separation, or desertion on children's cognitive performance as assessed by scores on standardized intelligence, scholastic aptitude, and academic achievement tests and school grades. Aggregation of the…

  8. Breed predisposition to canine gastric carcinoma - a study based on the Norwegian canine cancer register

    PubMed Central

    2013-01-01

    Background Previous research has indicated a breed predisposition to gastric carcinoma in dogs. However, results to date are inconsistent since several studies have failed to prove such a predisposition. Better knowledge of breeds at risk could facilitate early detection of gastric carcinoma in dogs. The aim of the study was to retrospectively investigate the proportion and possible breed predisposition to canine gastric carcinoma using the Norwegian Canine Cancer Register for calculations of proportional morbidity ratios (PMRs) for the period 1998–2009. Results Histologically verified tumours recorded in the Norwegian Canine Cancer Register were studied (n = 19,715). A total of 31 (0.16%) cases of canine gastric carcinomas were identified. The median age of affected dogs was 10 years. The most commonly reported clinical signs were vomiting, anorexia, and weight loss. Males had significantly higher odds of gastric carcinoma than females (P = 0.02). The PMR with 95% confidence interval (CI) was calculated for each breed, and a breed predisposition was identified. Individuals of the breeds Tervuren (PMR 56.1), Bouvier des Flandres (PMR 36.5), Groenendael (PMR 34.5), Collie (PMR 26.1), Standard poodle (PMR 7.6), and Norwegian elkhound (PMR 6.1) had a significantly increased risk of developing gastric carcinoma. Discussion and conclusion The proportion of cases of gastric carcinoma recorded in the Norwegian Canine Cancer Register was found to be 0.16%, and a breed predisposition was identified. The breed predisposition observed in the current study indicates a genetic susceptibility to gastric carcinoma. PMID:23514604

  9. Migration and health: exploring the role of migrant status through register-based studies.

    PubMed

    Nørredam, Marie

    2015-04-01

    This thesis aims to explore migrant status as a determinant in register-based studies on migrant health. It is based on eight studies that investigate the following three main issues: 1) What is the importance of migrant status for morbidity patterns among migrants compared with Native Danes? 2) Do migrant status and ethnicity affect clinical indicators of access among migrants compared with native Danes? 3) What is the importance of migrant status for mortality patterns among migrants compared with Native Danes? The thesis builds on a register-based historical prospective cohort design. Through Statistics Denmark, all refugees (n = 29,174) and family reunification immigrants (n = 33,287) who received residence permits in Denmark from 1 January 1993 to 31 December 1999 were included and matched 4:1 on age and sex with Native Danes. Register linkage was obtained twice during follow-ups in 2004 and 2008 respectively. Personal identification numbers were cross-linked to the Danish Psychiatric Central Register, the National Patient Registry, the Registry of Coercive Measures in Psychiatric Treatment, the Register of Causes of Death, and the Danish Cancer Registry. Migrant status defined by legal grounds for obtaining a residence permit was dichotomised into refugees and family reunification immigrants and used as the determinant in most studies. Analyses involved both Poisson and Cox regression analysis. Most analyses were stratified by ethnicity and adjusted for age and sex. Some were also stratified for individual income. Three sub-themes were investigated: morbidity, clinical indicators of access, and mortality. The first sub-theme (Papers I-III) showed that refugees had a consistently higher morbidity from several mental health disorders in contrast to family reunification immigrants, whose morbidity from mental disorders was lower than or similar to native Danes. The cancer incidence study did not find an effect of migrant status but found, rather, that migrants

  10. Psychosocial work environment and sickness absence among British civil servants: the Whitehall II study.

    PubMed Central

    North, F M; Syme, S L; Feeney, A; Shipley, M; Marmot, M

    1996-01-01

    OBJECTIVES. This study sought to examine the association between the psychosocial work environment and subsequent rates of sickness absence. METHODS. The analyses were based on a cohort of male and female British civil servants (n=9072). Rates of short spells (7 days) of sickness absence were calculated for different aspects of the psychosocial work environment, as measured by self-reports and personnel managers' ratings (external assessments). RESULTS. Low levels of work demands, control, and support were associated with higher rates of short and long spells of absence in men and, to a lesser extent, in women. The differences were similar for the self-reports and external assessments. After adjustment for grade of employment, the differences were diminished but generally remained significant for short spells. The combination of high demands and low control was only associated with higher rates of short spells in the lower grades. CONCLUSIONS. The psychosocial work environment predicts rates of sickness absence. Increased levels of control and support at work could have beneficial effects in terms of both improving the health and well-being of employees and increasing productivity. PMID:8604757

  11. Das sprachliche Register (Speech Registers)

    ERIC Educational Resources Information Center

    Hess-Luttich, Ernest W. B.

    1974-01-01

    The linguistic behavior of a given individual varies; he will on different occasions speak (or write) differently according to what may be roughly described as different social situations: he will use a number of different registers. The application of such registers both in the field of text analysis and in the preparation of teaching materials…

  12. Socioeconomic status and duration and pattern of sickness absence. A 1-year follow-up study of 2331 hospital employees

    PubMed Central

    2010-01-01

    Background Sickness absence increases with lower socioeconomic status. However, it is not well known how this relation depends on specific aspects of sickness absence or the degree to which socioeconomic differences in sickness absence may be explained by other factors. The purpose of the study was to examine differences in sickness absence among occupational groups in a large general hospital; how they depend on combinations of frequency and duration of sickness absence spells; and if they could be explained by self-reported general health, personal factors and work factors. Methods The design is a 1-year prospective cohort study of 2331 hospital employees. Baseline information include job title, work unit, perceived general health, work factors and personal factors recorded from hospital administrative files or by questionnaire (response rate 84%). Sickness absence during follow-up was divided into short (1-3 days), medium (4-14 days) and long (>14 days) spells, and into no absence, "normal" absence (1-3 absences of certain durations) and "abnormal" absence (any other absence than "normal"). Socioeconomic status was assessed by job titles grouped in six occupational groups by level of education (from doctors to cleaners/porters). Effects of occupational group on sickness absence were adjusted for significant effects of age, gender, general health, personal factors and work factors. We used Poisson or logistic regression analysis to estimate the effects of model covariates (rate ratios (RR) or odds ratios (OR)) and their 95% confidence intervals (CI). Results With a few exceptions sickness absence increased with decreasing socioeconomic status. However, the social gradient was quite different for different types of sickness absence. The gradient was strong for medium spells and "abnormal" absence, and weak for all spells, short spells, long spells and "normal" absence. For cleaners compared to doctors the adjusted risk estimates increased 4.2 (95% CI 2.8-6.2) and

  13. Early-Life Factors and Risk of Parkinson's Disease: A Register-Based Cohort Study.

    PubMed

    Liu, Bojing; Chen, Honglei; Fang, Fang; Tillander, Annika; Wirdefeldt, Karin

    2016-01-01

    Parkinson's disease (PD) may take decades to develop and early life exposures such as infection may be important. However, few epidemiological studies have evaluated early life risk factors in relation to PD risk. We therefore examined such associations in a prospective analysis of 3 545 612 individuals born in Sweden between 1932 and 1970 without PD on January 1, 2002. Incident PD cases were identified using the Swedish Patient Register during 2002-2010. Information on sibship size, number of older and younger siblings, multiple births, parental age, birth month and season was obtained from the Swedish Multi-Generation Register. Monthly data on national burden of influenza-like illness during 1932-1970 were obtained from the Swedish Public Health Agency. Hazard ratios with 95% confidence intervals (CI) were estimated using Cox proportional hazards regression. During the follow-up, 8779 incident PD cases were identified. As expected, older age, male sex, parental occupation as farmers, and family history of PD were associated with higher PD risk. Overall, early life factors, including flu burden in the year of birth, were not associated with PD risk, although we did find a lower PD risk among participants with older siblings than those without (HR = 0.93, 95%CI: 0.89, 0.98). Our study therefore provided little support for important etiological contributions of early life factors to the PD risk late in life. The finding of a lower PD risk among individuals with older siblings will need confirmation and further investigation. PMID:27082111

  14. Absence seizure

    MedlinePlus

    Seizure - petit mal; Seizure - absence; Petit mal seizure; Epilepsy - absence seizure ... Abou-Khalil BW, Gallagher MJ, Macdonald RL. Epilepsies. In: Daroff ... Practice . 7th ed. Philadelphia, PA: Elsevier; 2016:chap 101. ...

  15. Absence seizure

    MedlinePlus

    Seizure - petit mal; Seizure - absence; Petit mal seizure; Epilepsy - absence seizure ... Abou-Khalil BW, Gallagher MJ, Macdonald RL. Epilepsies. In: Daroff RB, ... 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap ...

  16. A Prospective Study of Ventilation Rates and Illness Absence in California Office Buildings

    SciTech Connect

    Eliseeva, Ekaterina A.; Spears, Michael; Chan, Wanyu R.; Cohn, Sebastian; Sullivan, Douglas P.; Fisk, William J.

    2014-10-07

    Background – This study investigated the associations of ventilation rates (VRs), estimated from indoor CO2 concentrations, in offices with the amount of respiratory infections, illness absences, and building-related health symptoms in occupants. Methods – Office buildings were recruited from three California climate zones. In one or more study spaces within each building, real-time logging sensors measured carbon dioxide, temperature, and relative humidity for one year. Ventilation rates were estimated using daily peak CO2 levels, and also using an alternative metric. Data on occupants and health outcomes were collected through web-based surveys every three months. Multivariate models were used to assess relationships between metrics of ventilation rate or CO2 and occupant outcomes. For all outcomes, negative associations were hypothesized with VR metrics, and positive associations with CO2 metrics. Results – Difficulty recruiting buildings and low survey response limited sample size and study power. In 16 studied spaces within 9 office buildings, VRs were uniformly high over the year, from twice to over nine times the California office VR standard (7 L/s or 15 cfm per person). VR and CO2 metrics had no statistically significant relationships with occupant outcomes, except for a small significantly positive association of the alternative VR metric with respiratory illness-related absence, contrary to hypotheses. Conclusions– The very high time-averaged VRs in the California office buildings studied presumably resulted from “economizer cycles” bringing in large volumes of outdoor air; however, in almost all buildings even the estimated minimum VRs supplied (without the economizer) substantially exceeded the minimum required VR. These high VRs may explain the absence of hypothesized relationships with occupant outcomes. Among uniformly high VRs, little variation in contaminant concentration and occupant effects would be expected. These findings may

  17. Suicides after pregnancy in Finland, 1987-94: register linkage study.

    PubMed Central

    Gissler, M.; Hemminki, E.; Lönnqvist, J.

    1996-01-01

    OBJECTIVE: To determine rates of suicide associated with pregnancy by the type of pregnancy. DESIGN: Register linkage study. Information on suicides in women of reproductive age was linked with the Finnish birth, abortion, and hospital discharge registers to find out how many women who committed suicide had had a completed pregnancy during her last year of life. SETTING: Nationwide data from Finland. SUBJECTS: Women who committed suicide in 1987-94. RESULTS: There were 73 suicides associated with pregnancy, representing 5.4% of all suicides in women in this age group. The mean annual suicide rate was 11.3 per 100,000. The suicide rate associated with birth was significantly lower (5.9) and the rates associated with miscarriage (18.1) and induced abortion (34.7) were significantly higher than in the population. The risk associated with birth was higher among teenagers and that associated with abortion was increased in all age groups. Women who had committed a suicide tended to come from lower social classes and were more likely to be unmarried than other women who had had a completed pregnancy. CONCLUSIONS: The increased risk of suicide after an induced abortion indicates either common risk factors for both or harmful effects of induced abortion on mental health. PMID:8973229

  18. Antidepressants and the risk of hyponatremia: a Danish register-based population study

    PubMed Central

    Leth-Møller, Katja Biering; Hansen, Annette Højmann; Torstensson, Maia; Andersen, Stig Ejdrup; Ødum, Lars; Gislasson, Gunnar; Torp-Pedersen, Christian; Holm, Ellen Astrid

    2016-01-01

    Objective To examine the association between classes of antidepressants and hyponatremia, and between specific antidepressants and hyponatremia. Design Retrospective register-based cohort study using nationwide registers from 1998 to 2012. Setting The North Denmark Region. Participants In total, 638 352 individuals were included. Primary and secondary outcome measures Plasma sodium was obtained from the LABKA database. The primary outcome was hyponatremia defined as plasma sodium (p-sodium) below 135 mmol/L and secondary outcome was severe hyponatremia defined as p-sodium below 130 mmol/L. The association between use of specific antidepressants and hyponatremia was analysed using multivariable Poisson regression models. Results An event of hyponatremia occurred in 72 509 individuals and 11.36% (n=6476) of these events happened during treatment with antidepressants. Incidence rate ratios and CIs for the association with hyponatremia in the first p-sodium measured after initiation of treatment were for citalopram 7.8 (CI 7.42 to 8.20); clomipramine 4.93 (CI 2.72 to 8.94); duloxetine 2.05 (CI 1.44 to 292); venlafaxine 2.90 (CI 2.43 to 3.46); mirtazapine 2.95 (CI 2.71 to 3.21); and mianserin 0.90 (CI 0.71 to 1.14). Conclusions All antidepressants except mianserin are associated with hyponatremia. The association is strongest with citalopram and lowest with duloxetine, venlafaxine and mirtazapine. PMID:27194321

  19. Epilepsy in individuals with a history of Asperger's syndrome: a Danish nationwide register-based cohort study.

    PubMed

    Mouridsen, Svend Erik; Rich, Bente; Isager, Torben

    2013-06-01

    We performed a nationwide, register-based retrospective follow-up study of epilepsy in all people who were born between January 1, 1980 and June 29, 2006 and registered in the Danish Psychiatric Central Register with Asperger's syndrome on February 7, 2011. All 4,180 identified cases with AS (3,431 males and 749 females) were screened through the nationwide Danish National Hospital Register (DNHR) with respect to epilepsy. Mean age at follow-up was 18.1 years (range 4-31 years). Of the 4,180 individuals with AS, 164 (3.9%) were registered with at least one epilepsy diagnosis in the DNHR, which is significantly increased (p < 0.0001) relative to the same age group in the general population, where an estimate is about 2.0%. PMID:23054204

  20. Twin-singleton differences in intelligence: a register-based birth cohort study of Norwegian males.

    PubMed

    Eriksen, Willy; Sundet, Jon M; Tambs, Kristian

    2012-10-01

    The aim was to determine the difference in intelligence between singletons and twins in young adulthood. Data from the Medical Birth Register of Norway were linked with register data from the Norwegian National Conscript Service. The study base consisted of data on the 445,463 males who were born alive in either single or twin births in Norway during 1967-1984 and who were examined at the time of the mandatory military conscription (age 18-20). Within this study base, there were data on 1,653 sibships of full brothers that included at least one man born in single birth and at least one man born in twin birth (4,307 persons, including 2,378 twins and 1,929 singletons). The intelligence scores of the singletons were 11% (95% confidence interval [CI]: 9-14%) of a standard deviation higher than those of the twins, after adjustment for birth year, birth order, parental ages at delivery, parental education levels, and other factors. The adjusted within-family difference was also 11% (95 % CI: 6-16%) of a standard deviation, indicating that unmeasured factors shared by siblings (e.g., maternal body height) have not influenced the estimate in important ways. When gestational age at birth was added to the model, the estimate for the difference in intelligence score was approximately the same. Including birth weight in the model strongly reduced the estimate. In conclusion, twins born in Norway during 1967-1984 had slightly lower intelligence in early adulthood compared with the singletons. PMID:22877999

  1. Fertility treatment and risk of childhood and adolescent mental disorders: register based cohort study

    PubMed Central

    Mortensen, Erik Lykke; Hvidtjørn, Dorte; Kesmodel, Ulrik Schiøler

    2013-01-01

    Objective To assess the mental health of children born after fertility treatment by comparing their risk of mental disorders with that of spontaneously conceived children. Design Prospective register based cohort study. Setting Nationwide register based information from Danish National Health Registers cross linked by a unique personal identification number assigned to all citizens in Denmark. Participants All children born in Denmark in 1995-2003 with follow-up in 2012 when the children were aged 8-17; 33 139 children were conceived after fertility treatment and 555 828 children were born after spontaneous conception. Main outcome measures Absolute risks and hazard ratios for overall and specific mental disorders estimated with adjustment for potential confounding variables. Estimated association between the risk of mental disorders and subtypes of procedures, hormone treatments, gamete types, and cause of infertility. Results The risk of mental disorders in children born after in vitro fertilisation or intracytoplasmic sperm injection was low, and was no higher than in spontaneously conceived children, except for a borderline significant increased risk of tic disorders (hazard ratio 1.40, 95% confidence interval 1.01 to 1.95; absolute risk 0.3%). In contrast, children born after ovulation induction with or without insemination had low but significantly increased risks of any mental disorder (1.20, 1.11 to 1.31; absolute risk 4.1%), autism spectrum disorders (1.20, 1.05 to 1.37; 1.5%), hyperkinetic disorders (1.23, 1.08 to 1.40; 1.7%), conduct, emotional, or social disorder (1.21, 1.02 to 1.45; 0.8%), and tic disorders (1.51, 1.16 to 1.96; 0.4%). There was no risk systematically related to any specific type of hormone drug treatment. Conclusions There was a small increase in the incidence of mental disorders in children born after ovulation induction/intrauterine insemination. Children born after in vitro fertilisation/intracytoplasmic sperm injection were

  2. Consumption of Dental Treatment in Patients with Inflammatory Bowel Disease, a Register Study

    PubMed Central

    Johannsen, Annsofi; Fored, Michael C.; Håkansson, Jan; Ekbom, Anders; Gustafsson, Anders

    2015-01-01

    Objective The aim of this study was to compare the consumption of dental treatment among patients with Crohn´s disease (CD) or ulcerative colitis (UC) compared to age and gender matched control groups. Design The study group comprised 2085 patients with CD and 3161 with UC from the Uppsala-Örebro region and from the Stockholm region. The patients in the cohort were diagnosed between 1960 and 1989. Patients up to 70 years of age were included in the study. The two patients groups were compared to age- and gender-matched, randomly selected control groups from the same geographic area comprising a corresponding number of participants. Results CD patients had significantly higher total number of procedures registered (p < 0.000). The difference was most pronounced for removable dentures (+65%), fillings in front teeth (+52%) and endodontic treatment (+46%) when Crohn’s patients were compared to controls (p<0.001). The corresponding figures for UC patients were also a significantly higher total number of procedures (p < 0.005), more clinical examinations (p<0.000), fillings in canines and incisors (p < 0.001) and fillings in bicuspids and molars (p < 0.000). Conclusion This study demonstrate that CD and UC individuals use more dental treatment compared to an age-gender matched control group, and more caries-related treatments. The difference was most pronounced for restorative treatment in patients with Crohn’s. PMID:26267797

  3. Childhood leukemia and parental occupation: a register-based case-control study

    SciTech Connect

    Van Steensel-Moll, H.A.; Valkenburg, H.A.; Van Zanen, G.E.

    1985-02-01

    To explore possible etiologic factors of childhood leukemia, a case-control study was performed in the Netherlands. Cases were selected from a complete nationwide register of cases of childhood leukemia which were diagnosed between 1973 and 1980. Controls were matched with cases for year of birth, sex, and place of residence at the time of diagnosis. Information about possible exposure was collected by a postal questionnaire addressed to the parents. This report concerns the results of the analysis of parental occupations and occupational exposures for 519 children with acute lymphocytic leukemia and 507 controls. During pregnancy, more mothers of patients were working in ''hydrocarbon-related'' occupations; relative risk (RR) = 2.5 (95% confidence interval (CI) = 0.7 - 9.4). Likewise, greater occupational exposure to chemicals (paint, petroleum products, and unspecified chemicals) during pregnancy was found for mothers of patients (RR = 2.4, 95% CI = 1.2 - 4.6). The kind of work being performed by the mothers one year before diagnosis did not differ between cases and controls. For the fathers, no relationship was found between a hydrocarbon-related occupation or occupational exposure to chemicals and leukemia in the offspring. Adjustment for birth order, social class, and degree of urbanization did not materially change the relative risks. 16 references, 5 tables.

  4. Changes in mortality inequalities over two decades: register based study of European countries

    PubMed Central

    Kulhánová, Ivana; Artnik, Barbara; Bopp, Matthias; Borrell, Carme; Clemens, Tom; Costa, Giuseppe; Dibben, Chris; Kalediene, Ramune; Lundberg, Olle; Martikainen, Pekka; Menvielle, Gwenn; Östergren, Olof; Prochorskas, Remigijus; Rodríguez-Sanz, Maica; Strand, Bjørn Heine; Looman, Caspar W N; de Gelder, Rianne

    2016-01-01

    Objective To determine whether government efforts in reducing inequalities in health in European countries have actually made a difference to mortality inequalities by socioeconomic group. Design Register based study. Data source Mortality data by level of education and occupational class in the period 1990-2010, usually collected in a census linked longitudinal study design. We compared changes in mortality between the lowest and highest socioeconomic groups, and calculated their effect on absolute and relative inequalities in mortality (measured as rate differences and rate ratios, respectively). Setting All European countries for which data on socioeconomic inequalities in mortality were available for the approximate period between years 1990 and 2010. These included Finland, Norway, Sweden, Scotland, England and Wales (data applied to both together), France, Switzerland, Spain (Barcelona), Italy (Turin), Slovenia, and Lithuania. Results Substantial mortality declines occurred in lower socioeconomic groups in most European countries covered by this study. Relative inequalities in mortality widened almost universally, because percentage declines were usually smaller in lower socioeconomic groups. However, as absolute declines were often smaller in higher socioeconomic groups, absolute inequalities narrowed by up to 35%, particularly among men. Narrowing was partly driven by ischaemic heart disease, smoking related causes, and causes amenable to medical intervention. Progress in reducing absolute inequalities was greatest in Spain (Barcelona), Scotland, England and Wales, and Italy (Turin), and absent in Finland and Norway. More detailed studies preferably using individual level data are necessary to identify the causes of these variations. Conclusions Over the past two decades, trends in inequalities in mortality have been more favourable in most European countries than is commonly assumed. Absolute inequalities have decreased in several countries, probably

  5. Inequity of access to ACE inhibitors in Swedish heart failure patients: a register-based study

    PubMed Central

    Lindahl, Bertil; Hanning, Marianne; Westerling, Ragnar

    2016-01-01

    Background Several international studies suggest inequity in access to evidence-based heart failure (HF) care. Specifically, studies of ACE inhibitors (ACEIs) point to reduced ACEI access related to female sex, old age and socioeconomic position. Thus far, most studies have either been rather small, lacking diagnostic data, or lacking the possibility to account for several individual-based sociodemographic factors. Our aim was to investigate differences, which could reflect inequity in access to ACEIs based on sex, age, socioeconomic status or immigration status in Swedish patients with HF. Methods Individually linked register data for all Swedish adults hospitalised for HF in 2005–2010 (n=93 258) were analysed by multivariate regression models to assess the independent risk of female sex, high age, low employment status, low income level, low educational level or foreign country of birth, associated with lack of an ACEI dispensation within 1 year of hospitalisation. Adjustment for possible confounding was made for age, comorbidity, Angiotensin receptor blocker therapy, period and follow-up time. Results Analysis revealed an adjusted OR for no ACEI dispensation for women of 1.31 (95% CI 1.27 to 1.35); for the oldest patients of 2.71 (95% CI 2.53 to 2.91); and for unemployed patients of 1.59 (95% CI 1.46 to 1.73). Conclusions Access to ACEI treatment was reduced in women, older patients and unemployed patients. We conclude that access to ACEIs is inequitable among Swedish patients with HF. Future studies should include clinical data, as well as mortality outcomes in different groups. PMID:26261264

  6. Increasing illness among people out of labor market - A Danish register-based study.

    PubMed

    Andersen, Ingelise; Brønnum-Hansen, Henrik; Kriegbaum, Margit; Hougaard, Charlotte Ørsted; Hansen, Finn Kenneth; Diderichsen, Finn

    2016-05-01

    In spite of decades of very active labor market policies, 25% of Denmark's population in the working ages are still out-of-work. The aim of this study was to investigate whether that is due to consistent or even increasing prevalence of ill health. For the period of 2002-2011, we investigated if i) the prevalence of four chronic diseases (cardiovascular disease, diabetes, cancer and mental disorders) among those out-of-work had changed, ii) the occurrence of new cases of those diseases were higher among those who were already out-of-work, or iii) if non-health-related benefits were disproportionately given to individuals recently diagnosed with a disease compared to those without disease. The study was register-based and comprised all Danish residents aged 20-60. During the study period, the prevalence of cardiovascular diseases and mental disorders increased among both employed and non-employed people. The increased prevalence for mental disorder was particularly high among people receiving means-tested benefits. Disease incidence was higher among people outside rather than inside the labor market, especially for mental disorders. Employed people with incident diseases had an unsurprisingly increased risk of leaving the labor market. However, a high proportion of people with incident mental disorders received low level means-tested benefits in the three years following this diagnosis, which is concerning. Men treated for mental disorders in 2006 had high excess probability of receiving a cash-benefit, OR = 4.83 (4.53-5.14) for the period 2007-2010. The estimates were similar for women. PMID:27017087

  7. Background radiation and childhood leukemia: A nationwide register-based case-control study.

    PubMed

    Nikkilä, Atte; Erme, Sini; Arvela, Hannu; Holmgren, Olli; Raitanen, Jani; Lohi, Olli; Auvinen, Anssi

    2016-11-01

    High doses of ionizing radiation are an established cause of childhood leukemia. However, substantial uncertainty remains about the effect of low doses of radiation, including background radiation and potential differences between genetic subgroups of leukemia have rarely been explored. We investigated the effect of the background gamma radiation on childhood leukemia using a nationwide register-based case-control study. For each of the 1,093 cases, three age- and gender matched controls were selected (N = 3,279). Conditional logistic regression analyses were adjusted for confounding by Down syndrome, birth weight (large for gestational age), and maternal smoking. Complete residential histories and previously collected survey data of the background gamma radiation in Finland were used to assess the exposure of the study subjects to indoor and outdoor gamma radiation. Overall, background gamma radiation showed a non-significant association with the OR of childhood leukemia (OR 1.01, 95% CI 0.97, 1.05 for 10 nSv/h increase in average equivalent dose rate to red bone marrow). In subgroup analyses, age group 2-<7 years displayed a larger effect (OR 1.27, 95% CI 1.01, 1.60 for 1 mSv increase in equivalent cumulative dose to red bone marrow). Suggestive difference in OR by genetic subtype was found. Our results provide further support to the notion that low doses of ionizing radiation increase the risk for childhood leukemia, particularly at age 2-<7 years. Our findings suggest a larger effect of radiation on leukemia with high hyperpdiploidy than other subgroups, but this result requires further confirmation. PMID:27405274

  8. Non-cancer morbidity among Estonian Chernobyl cleanup workers: a register-based cohort study

    PubMed Central

    Rahu, Kaja; Bromet, Evelyn J; Hakulinen, Timo; Auvinen, Anssi; Uusküla, Anneli; Rahu, Mati

    2014-01-01

    Objective To examine non-cancer morbidity in the Estonian Chernobyl cleanup workers cohort compared with the population sample with special attention to radiation-related diseases and mental health disorders. Design Register-based cohort study. Setting Estonia. Participants An exposed cohort of 3680 men (cleanup workers) and an unexposed cohort of 7631 men (population sample) were followed from 2004 to 2012 through the Population Registry and Health Insurance Fund database. Methods Morbidity in the exposed cohort compared with the unexposed controls was estimated in terms of rate ratio (RR) with 95% CIs using Poisson regression models. Results Elevated morbidity in the exposed cohort was found for diseases of the nervous system, digestive system, musculoskeletal system, ischaemic heart disease and for external causes. The most salient excess risk was observed for thyroid diseases (RR=1.69; 95% CI 1.38 to 2.07), intentional self-harm (RR=1.47; 95% CI 1.04 to 2.09) and selected alcohol-related diagnoses (RR=1.25; 95% CI 1.12 to 1.39). No increase in morbidity for stress reactions, depression, headaches or sleep disorders was detected. Conclusions No obvious excess morbidity consistent with biological effects of radiation was seen in the exposed cohort, with the possible exception of benign thyroid diseases. Increased alcohol-induced morbidity may reflect alcohol abuse, and could underlie some of the higher morbidity rates. Mental disorders in the exposed cohort were probably under-reported. The future challenge will be to study mental and physical comorbidities in the Chernobyl cleanup workers cohort. PMID:24833681

  9. Subliminal semantic priming in near absence of attention: A cursor motion study.

    PubMed

    Xiao, Kunchen; Yamauchi, Takashi

    2015-12-15

    The role of attention in subliminal semantic priming remains controversial: some researchers argue that attention is necessary for subliminal semantic priming, while others suggest that subliminal semantic processing is free from the influence of attention. The present study employs a cursor motion method to measure priming and evaluate the influence of attention. Specifically, by employing a semantic priming task developed by Naccache, Blandin, and Dehaene (2002), we investigate the extent to which top-down attention influences semantic priming. Results indicate that, consistent with the Naccache et al. (2002) results, attention facilitates priming. However, inconsistent with their theory, significant priming is still observed even in near absence of attention. We suggest that top-down attention helps but is not necessary for subliminal semantic processing. PMID:26547054

  10. Co-Prescribing of Potentially Interacting Drugs during Warfarin Therapy - A Population-Based Register Study.

    PubMed

    Rikala, Maria; Hauta-Aho, Milka; Helin-Salmivaara, Arja; Lassila, Riitta; Korhonen, Maarit Jaana; Huupponen, Risto

    2015-08-01

    We analysed the occurrence of co-prescribing of potentially interacting drugs during warfarin therapy in the community-dwelling population of Finland. We identified drugs having interaction potential with warfarin using the Swedish Finnish INteraction X-referencing drug-drug interaction database (SFINX) and obtained data on drug purchases from the nationwide Prescription Register. We defined warfarin users as persons purchasing warfarin in 2010 (n = 148,536) and followed them from their first prescription in 2010 until the end of the calendar year. Co-prescribing was defined as at least 1-day overlap between warfarin and interacting drug episodes. In addition, we identified persons who initiated warfarin therapy between 1 January 2007 and 30 September 2010 (n = 110,299) and followed these incident users for a 3-month period since warfarin initiation. Overall, 74.4% of warfarin users were co-prescribed interacting drugs. Co-prescribing covered 46.4% of the total person-years of warfarin exposure. Interacting drugs that should be avoided with warfarin were co-prescribed for 13.4% of warfarin users. The majority of the co-prescriptions were for drugs that are not contraindicated during warfarin therapy but require special consideration. Among incident users, 57.1% purchased potentially interacting drugs during the 3-month period after initiation, while 9.0% purchased interacting drugs that should be avoided with warfarin. To conclude, the occurrence of co-prescribing of potentially interacting drugs was high during warfarin therapy. Our findings highlight the importance of close monitoring of warfarin therapy and the need for further studies on the clinical consequences of co-prescribing of interacting drugs with warfarin. PMID:25537751

  11. Incidence of Incisional Hernia after Cesarean Delivery: A Register-Based Cohort Study

    PubMed Central

    Aabakke, Anna J. M.; Krebs, Lone; Ladelund, Steen; Secher, Niels J.

    2014-01-01

    Objective To estimate the incidence of incisional hernias requiring surgical repair after cesarean delivery over a 10-year period. Methods This population- and register-based cohort study identified all women in Denmark with no history of previous abdominal surgery who had a cesarean delivery between 1991 and 2000. The cohort was followed from their first until 10 years after their last cesarean delivery within the inclusion period or until the first of the following events: hernia repair, death, emigration, abdominal surgery, or cesarean delivery after the inclusion period. For women who had a hernia repair, hospital records regarding the surgery and previous cesarean deliveries were tracked and manually analyzed to validate the relationship between hernia repair and cesarean delivery. Data were analyzed with a competing risk analysis that included each cesarean delivery. Results We identified 57,564 women who had had 68,271 cesarean deliveries during the inclusion period. During follow-up, 134 of these women had a hernia requiring repair. Of these 68 (51% [95% CI 42–60%]) were in a midline incision although the transverse incision was the primary approach at cesarean delivery during the inclusion period. The cumulated incidence of a hernia repair within 10 years after a cesarean delivery was 0.197% (95% CI 0.164–0.234%). The risk of a hernia repair was higher during the first 3 years after a cesarean delivery, with an incidence after 3 years of 0.157% (95% CI 0.127–0.187%). Conclusions The overall risk of an incisional hernia requiring surgical repair within 10 years after a cesarean delivery was 2 per 1000 deliveries in a population in which the transverse incision was the primary approach at cesarean delivery. PMID:25268746

  12. A Five-Year Study of a Positive Incentive Absence Control Program.

    ERIC Educational Resources Information Center

    Schlotzhauer, Dale L.; Rosse, Joseph G.

    1985-01-01

    Results of a positive incentive program designed to reduce absenteeism at a hospital are reported. Absence for the treatment group decreased significantly during the first and third years of the program; no changes occured in the comparison group's absence level. Overall, the program produced an 11.7 percent return on investment. (Author/BL)

  13. Patterns of Contact with Hospital for Children with an Autism Spectrum Disorder: A Danish Register-Based Study

    ERIC Educational Resources Information Center

    Atladottir, Hjordis Osk; Schendel, Diana E.; Lauritsen, Marlene B.; Henriksen, Tine Brink; Parner, Erik T.

    2012-01-01

    The aim of this study was to study patterns of contact with hospital for children with autism spectrum disorder (ASD) using Danish population based register data. We included all children born in Denmark from 1994 through 2002. We found that children diagnosed with ASD had an increased rate of contact with hospital, almost regardless of the cause…

  14. Gender Differences in Filicide Offense Characteristics--A Comprehensive Register-Based Study of Child Murder in Two European Countries

    ERIC Educational Resources Information Center

    Putkonen, Hanna; Amon, Sabine; Eronen, Markku; Klier, Claudia M.; Almiron, Maria P.; Cederwall, Jenny Yourstone; Weizmann-Henelius, Ghitta

    2011-01-01

    Objective: This study searched for gender differences in filicidal offense characteristics and associated variables. Methods: In this binational register-based study all filicide perpetrators (75 mothers and 45 fathers) and their crimes in Austria and Finland 1995-2005 were examined for putative gender differences. The assessed variables were…

  15. The Prevalence of Absence of the Palmaris Longus Muscle Tendon in the North of Iran: A Comparative Study

    PubMed Central

    Nasiri, Ebrahim; Pourghasem, Mohsen; Moladoust, Hassan

    2016-01-01

    Background: The palmaris longus is a degenerating weak flexor muscle in the anterior of the forearm. Many techniques for clinically determining the presence of the palmaris longus have been described. Ethnic variations in the prevalence of the absence of the palmaris longus are well known. Objectives: This study considered the prevalence of absence of the palmaris longus muscle tendon in the north of Iran. Patients and Methods: The presence of the palmaris longus was clinically determined in 562 men and women from the Guilan population, using the standard technique (Schaeffer’s test). In subjects with an absent palmaris longus, three other tests (Thompson, Pushpakumar and Mishra tests) were performed to confirm the absence. Results: The overall prevalence of right, left, bilateral and total absence of the palmaris longus were 4.1%, 5.2%, 3.9% and 13.2%, respectively. There was no significant difference in its absence with regard to the body side or gender (P > 0.05). Conclusions: This study demonstrated that the presence of the palmaris longus muscle tendon in the Guilan population was considerably higher than the absence of the palmaris longus tendon. The overall prevalence of right, left, bilateral and total absence of the palmaris longus was not significantly different between men and women. The prevalence of the left-absent palmaris longus was more common in the present study. PMID:27247789

  16. Multimorbidity and Its Patterns according to Immigrant Origin. A Nationwide Register-Based Study in Norway

    PubMed Central

    Diaz, Esperanza; Poblador-Pou, Beatriz; Gimeno-Feliu, Luis-Andrés; Calderón-Larrañaga, Amaia; Kumar, Bernadette N.; Prados-Torres, Alexandra

    2015-01-01

    Introduction As the flows of immigrant populations increase worldwide, their heterogeneity becomes apparent with respect to the differences in the prevalence of chronic physical and mental disease. Multimorbidity provides a new framework in understanding chronic diseases holistically as the consequence of environmental, social, and personal risks that contribute to increased vulnerability to a wide variety of illnesses. There is a lack of studies on multimorbidity among immigrants compared to native-born populations. Methodology This nationwide multi-register study in Norway enabled us i) to study the associations between multimorbidity and immigrant origin, accounting for other known risk factors for multimorbidity such as gender, age and socioeconomic levels using logistic regression analyses, and ii) to identify patterns of multimorbidity in Norway for immigrants and Norwegian-born by means of exploratory factor analysis technique. Results Multimorbidity rates were lower for immigrants compared to Norwegian-born individuals, with unadjusted odds ratios (OR) and 95% confidence intervals 0.38 (0.37–0.39) for Eastern Europe, 0.58 (0.57–0.59) for Asia, Africa and Latin America, and 0.67 (0.66–0.68) for Western Europe and North America. Results remained significant after adjusting for socioeconomic factors. Similar multimorbidity disease patterns were observed among Norwegian-born and immigrants, in particular between Norwegian-born and those from Western European and North American countries. However, the complexity of patterns that emerged for the other immigrant groups was greater. Despite differences observed in the development of patterns with age, such as ischemic heart disease among immigrant women, we were unable to detect the systematic development of the multimorbidity patterns among immigrants at younger ages. Conclusions Our study confirms that migrants have lower multimorbidity levels compared to Norwegian-born. The greater complexity of

  17. Registered Nurses’ Perceptions about the Situation of Family Caregivers to Patients with Heart Failure - A Focus Group Interview Study

    PubMed Central

    2016-01-01

    Introduction Heart failure is a growing public health problem associated with poor quality of life and significant morbidity and mortality. The majority of heart failure care is provided by family caregivers, and is associated with caregiver burden and reduced quality of life. Research emphasizes that future nursing interventions should recognize the importance of involving family caregivers to achieve optimal outcomes. Aims The aims of this study are to explore registered nurses’ perceptions about the situation of family caregivers to patients with heart failure, and registered nurses’ interventions, in order to improve family caregivers’ situation. Methods The study has a qualitative design with an inductive approach. Six focus group interviews were held with 23 registered nurses in three hospitals and three primary health care centres. Data were analysed using qualitative content analysis. Results Two content areas were identified by the a priori study aims. Four categories and nine sub-categories emerged in the analysis process. The content area “Family caregivers' situation” includes two categories: “To be unburdened” and “To comprehend the heart failure condition and its consequences”. The content area “Interventions to improve family caregivers' situation” includes two categories: “Individualized support and information” and “Bridging contact”. Conclusions Registered nurses perceive family caregivers' situation as burdensome, characterized by worry and uncertainty. In the PHCCs, the continuity and security of an RN as a permanent health care contact was considered an important and sustainable intervention to better care for family caregivers' worry and uncertainty. In the nurse-led heart failure clinics in hospitals, registered nurses can provide family caregivers with the opportunity of involvement in their relative's health care and address congruence and relationship quality within the family through the use of "Shared care

  18. Diagnosed Anxiety Disorders and the Risk of Subsequent Anorexia Nervosa: A Danish Population Register Study.

    PubMed

    Meier, Sandra M; Bulik, Cynthia M; Thornton, Laura M; Mattheisen, Manuel; Mortensen, Preben B; Petersen, Liselotte

    2015-11-01

    Anxiety disorders and anorexia nervosa are frequently acknowledged to be highly comorbid conditions, but still, little is known about the clinical and aetiological cohesion of specific anxiety diagnoses and anorexia nervosa. Using the comprehensive Danish population registers, we aimed to determine the risk of anorexia nervosa in patients with register-detected severe anxiety disorders. We also explored whether parental psychopathology was associated with offspring's anorexia nervosa. Anxiety disorders increased the risk of subsequent anorexia nervosa, with the highest risk observed in obsessive-compulsive disorder. Especially, male anxiety patients were at an increased risk for anorexia nervosa. Furthermore, an increased risk was observed in offspring of fathers with panic disorder. A diagnosis of an anxiety disorder, specifically obsessive-compulsive disorder, constitutes a risk factor for subsequent diagnosis of anorexia nervosa. These observations support the notion that anxiety disorders and anorexia nervosa share etiological mechanisms and/or that anxiety represents one developmental pathway to anorexia nervosa. PMID:26347124

  19. Understanding eating in the absence of hunger among young children: A systematic review of existing studies

    PubMed Central

    Lansigan, Reina K.; Emond, Jennifer A.; Gilbert-Diamond, Diane

    2014-01-01

    Background Eating in the Absence of Hunger (EAH), or consuming highly palatable foods when satiated, is one behavioral pathway that may lead to childhood obesity. EAH is an objective, laboratory-based measure. A more comprehensive understanding of potential determinants of EAH could inform childhood obesity programs outside of a laboratory setting. Objective Systematic review of EAH experiments to identify individual, familial, and societal-level correlates of EAH among children 12 years of age or younger. Design 1,487 studies were retrieved from five electronic databases (Medline [PubMed], Web of Science, Cochrane Library, CINAHL, PsycINFO). Eligible studies were those that measured EAH as initially operationalized in a laboratory setting enrolling children ≤12 years or reporting age-specific results for children ≤12 years. Only articles written in English were included. Results 12 cross-sectional, six prospective, and one behavioral-intervention studies were included in the review. EAH was observable among boys and girls; absolute levels of EAH increased with age; and maternal feeding styles were associated with EAH among girls. The most consistent evidence supported increased levels of EAH among overweight and obese versus normal weight children, both cross-sectionally and prospectively. Two studies supported a genetic component to EAH. Conclusions Studies enrolling independent samples support a positive association between weight status and EAH among children; studies addressing causality are needed. Other various individual, genetic, and familiar characteristics were associated with EAH, yet studies among more heterogeneous sample populations are needed to confirm findings. Studies addressing societal-level factors related to EAH were absent. PMID:25450900

  20. Using Plant Clinic Registers to Assess the Quality of Diagnoses and Advice Given to Farmers: A Case Study from Uganda

    ERIC Educational Resources Information Center

    Danielsen, Solveig; Boa, Eric; Mafabi, Moses; Mutebi, Emmanuel; Reeder, Robert; Kabeere, Flavia; Karyeija, Robert

    2013-01-01

    Purpose: This study developed a framework for quality assessment of diagnoses and advice given at plant clinics. Design/methodology/approach: Clinic registers from five plant clinics in Uganda (2006-2010) were used to develop quality assessment protocols for diagnoses and advice given by plant doctors. Assessment of quality of diagnoses was based…

  1. Social Conditions for People With Down Syndrome: A Register-Based Cohort Study in Denmark

    PubMed Central

    Zhu, Jin Liang; Obel, Carsten; Hasle, Henrik; Rasmussen, Sonja A.; Li, Jiong; Olsen, Jørn

    2015-01-01

    Today, most persons with Down syndrome (DS) survive into middle age, but information on their social conditions as adults is limited. We addressed this knowledge gap using data from national registers in Denmark. We identified a national cohort of 1,998 persons with DS who were born between 1968 and 2007 (1,852 with standard trisomy 21, 80 with Robertsonian translocations and 66 with mosaicism) using the Danish Cytogenetic Register. We followed this cohort from 1980 to 2007. Information on social conditions (education, employment, source of income, marital status, etc.) was obtained by linkages to national registers, including the Integrated Database for Longitudinal Labor Market Research. For those aged 18 and older, more than 80%of persons with DS attended 10 years of primary school, with about 2% completing secondary or post-secondary education. About 4% obtained a full-time job, whereas the remaining mainly received public support from the government. Only a few (1–2%) of persons with DS were married or had a child. No significant differences in these social conditions were seen between males and females. More persons with mosaic DS attended secondary or post-secondary education, had a full-time job, were married, or had a child (18%, 28%, 15%, and 7%, respectively), compared with persons with standard DS (1%, 2%, 1%, and 1%, respectively). These data may provide families with better insight into social conditions and society with a better understanding of the social support needed for persons with DS. PMID:24273114

  2. Social conditions for people with Down syndrome: a register-based cohort study in Denmark.

    PubMed

    Zhu, Jin Liang; Obel, Carsten; Hasle, Henrik; Rasmussen, Sonja A; Li, Jiong; Olsen, Jørn

    2014-01-01

    Today, most persons with Down syndrome (DS) survive into middle age, but information on their social conditions as adults is limited. We addressed this knowledge gap using data from national registers in Denmark. We identified a national cohort of 1,998 persons with DS who were born between 1968 and 2007 (1,852 with standard trisomy 21, 80 with Robertsonian translocations and 66 with mosaicism) using the Danish Cytogenetic Register. We followed this cohort from 1980 to 2007. Information on social conditions (education, employment, source of income, marital status, etc.) was obtained by linkages to national registers, including the Integrated Database for Longitudinal Labor Market Research. For those aged 18 and older, more than 80% of persons with DS attended 10 years of primary school, with about 2% completing secondary or post-secondary education. About 4% obtained a full-time job, whereas the remaining mainly received public support from the government. Only a few (1-2%) of persons with DS were married or had a child. No significant differences in these social conditions were seen between males and females. More persons with mosaic DS attended secondary or post-secondary education, had a full-time job, were married, or had a child (18%, 28%, 15%, and 7%, respectively), compared with persons with standard DS (1%, 2%, 1%, and 1%, respectively). These data may provide families with better insight into social conditions and society with a better understanding of the social support needed for persons with DS. PMID:24273114

  3. A study of the medical causes of absence from duty aboard South African merchant ships

    PubMed Central

    Levy, Samuel

    1972-01-01

    Levy, S. (1972).Brit. J. industr. Med.,29, 196-200. A study of the medical causes of absence from duty aboard South African merchant ships. Over a period of four and a half years 556 instances occurred in which crew members were put off duty on medical grounds for a period of four or more days. Illness accounted for 297 cases whereas accidents were responsible for 259 cases. Illiness and accident cases were off duty for an average period of 28 and 34 days respectively. Slightly more working days were thus lost on account of accidents. Admission to hospital was required in 90% of illnesses compared with only 36% of accidents. Appendicitis (of questionable veracity), peptic ulceration, and psychiatric disturbances were among the more common causes of incapacity. Forty percent of accidents occurred on deck and in the cargo holds. Fractures occurred most commonly in the upper limbs, especially the hand. Eleven percent of the accidents occurred ashore, mostly due to assault. Further study is required to elucidate whether the emotional problems encountered are brought to sea by the personnel or are a result of life on board ship. The high incidence of accidents stresses the fact that a sea career is one of the more dangerous occupations. PMID:5067298

  4. Msx1 Gene Variant - Its Presence in Tooth Absence - A Case Control Genetic Study

    PubMed Central

    Reddy, Naveen Admala; Adusumilli, Gopinath; Devanna, Raghu; Pichai, Saravanan; Rohra, Mayur Gobindram; Arjunan, Sharmila

    2013-01-01

    Background: Non Syndromic tooth agenesis is a congenital anomaly with significant medical, psychological and social ramifications. There is sufficient evidence to hypothesize that locus for this condition can be identified by candidate genes. The aim of this study was to test whether MSX1 671 T>C gene variant was involved in etiology of Non Syndromic tooth agenesis in Raichur Patients. Materials & Methods: Blood samples were collected with informed consent from 50 subjects having Non Syndromic tooth agenesis and 50 controls. Genomic DNA was extracted from the blood samples, Polymerase Chain Reaction was performed (PCR) and Restriction Fragment Length Polymorphism (RFLP) was performed for digestion products that were evaluated. Results: The Results showed positive correlation between MSX1671 T>C gene variant and Non Syndromic tooth agenesis in Raichur Patients. Conclusion: MSX1 671 T>C gene variant may be a good screening marker for Non Syndromic tooth agenesis in Raichur Patients . How to cite this article:Reddy NA, Adusumilli G, Devanna R, Pichai S, Rohra MG, Arjunan S. Msx1 Gene Variant - Its Presence in Tooth Absence - A Case Control Genetic Study. J Int Oral Health 2013; 5(5):20-6. PMID:24324300

  5. High-pressure study of lithium amidoborane using Raman spectroscopy and insight into dihydrogen bonding absence

    PubMed Central

    Najiba, Shah; Chen, Jiuhua

    2012-01-01

    One of the major obstacles to the use of hydrogen as an energy carrier is the lack of proper hydrogen storage material. Lithium amidoborane has attracted significant attention as hydrogen storage material. It releases ∼10.9 wt% hydrogen, which is beyond the Department of Energy target, at remarkably low temperature (∼90 °C) without borazine emission. It is essential to study the bonding behavior of this potential material to improve its dehydrogenation behavior further and also to make rehydrogenation possible. We have studied the high-pressure behavior of lithium amidoborane in a diamond anvil cell using in situ Raman spectroscopy. We have discovered that there is no dihydrogen bonding in this material, as the N—H stretching modes do not show redshift with pressure. The absence of the dihydrogen bonding in this material is an interesting phenomenon, as the dihydrogen bonding is the dominant bonding feature in its parent compound ammonia borane. This observation may provide guidance to the improvement of the hydrogen storage properties of this potential material and to design new material for hydrogen storage application. Also two phase transitions were found at high pressure at 3.9 and 12.7 GPa, which are characterized by sequential changes of Raman modes. PMID:23115332

  6. High-pressure study of lithium amidoborane using Raman spectroscopy and insight into dihydrogen bonding absence.

    PubMed

    Najiba, Shah; Chen, Jiuhua

    2012-11-20

    One of the major obstacles to the use of hydrogen as an energy carrier is the lack of proper hydrogen storage material. Lithium amidoborane has attracted significant attention as hydrogen storage material. It releases ∼10.9 wt% hydrogen, which is beyond the Department of Energy target, at remarkably low temperature (∼90 °C) without borazine emission. It is essential to study the bonding behavior of this potential material to improve its dehydrogenation behavior further and also to make rehydrogenation possible. We have studied the high-pressure behavior of lithium amidoborane in a diamond anvil cell using in situ Raman spectroscopy. We have discovered that there is no dihydrogen bonding in this material, as the N-H stretching modes do not show redshift with pressure. The absence of the dihydrogen bonding in this material is an interesting phenomenon, as the dihydrogen bonding is the dominant bonding feature in its parent compound ammonia borane. This observation may provide guidance to the improvement of the hydrogen storage properties of this potential material and to design new material for hydrogen storage application. Also two phase transitions were found at high pressure at 3.9 and 12.7 GPa, which are characterized by sequential changes of Raman modes. PMID:23115332

  7. Functional Study of NIPA2 Mutations Identified from the Patients with Childhood Absence Epilepsy

    PubMed Central

    Xie, Han; Zhang, Yuehua; Zhang, Pingping; Wang, Jingmin; Wu, Ye; Wu, Xiru; Netoff, Theoden; Jiang, Yuwu

    2014-01-01

    Recently many genetic mutations that are associated with epilepsy have been identified. The protein NIPA2 (non-imprinted in Prader-Willi/Angelman syndrome region protein 2) is a highly selective magnesium transporter encoded by the gene NIPA2 in which we have found three mutations (p.I178F, p.N244S and p.N334_E335insD) within a population of patients with childhood absence epilepsy (CAE). In this study, immunofluorescence labeling, inductively coupled plasma-optical emission spectroscopy (ICP-OES), MTT metabolic rate detection and computational modeling were utilized to elucidate how these mutations result in CAE. We found in cultured neurons that NIPA2 (wild-type) proteins were localized to the cell periphery, whereas mutant proteins were not effectively trafficked to the cell membrane. Furthermore, we found a decrease in intracellular magnesium concentration in the neurons transfected with mutant NIPA2, but no effect on the survival of neurons. To understand how low intracellular magnesium resulted in hyperexcitability, we built and analyzed a computational model to simulate the effects of mutations. The model suggested that lower intracellular magnesium concentration enhanced synaptic N-methyl-D-aspartate receptor (NMDAR) currents. This study primarily reveals that a selective magnesium transporter NIPA2 may play a role in the pathogenesis of CAE. PMID:25347071

  8. A Study of Semiotic Registers in the Development of the Definite Integral of Functions of Two and Three Variables

    ERIC Educational Resources Information Center

    McGee, Daniel Lee; Martinez-Planell, Rafael

    2014-01-01

    Tracing the path from a numerical Riemann sum approximating the area under a curve to a definite integral representing the precise area in various texts and online presentations, we found 3 semiotic registers that are used: the geometric register, the numerical register, and the symbolic register. The symbolic register had 3 representations: an…

  9. An experimental study of a plasma actuator in absence of free airflow: Ionic wind velocity profile

    SciTech Connect

    Mestiri, R.; Hadaji, R.; Ben Nasrallah, S.

    2010-08-15

    In this study, we are interested in the direct current electrical corona discharge created between two wire electrodes. The experimental results are related to some electroaerodynamic actuators based on the direct current corona discharge at the surface of a dielectric material. Several geometrical forms are selected for the dielectric surface, such as a plate, a cylinder, and a NACA 0015 aircraft wing. The current density-electric field characteristics are presented for different cases in order to determine the discharge regimes. The corona discharge produces nonthermal plasma, so it is called plasma discharge. Plasma discharge creates a tangential ionic wind above the surface at the vicinity of the wall. The ionic wind induced by the corona discharge is measured in absence of free external airflow. The ionic wind velocity profiles and the maximum induced tangential force are given for different surface forms, so it is possible to compare the actuators effect based on the span of the ionic wind velocity and thrust values. The higher ionic wind velocity is obtained with the NACA profile, which shows the effectiveness of this actuator for the airflow control.

  10. Workplace Psychosocial Factors Associated with Work-Related Injury Absence: A Study from a Nationally Representative Sample of Korean Workers

    PubMed Central

    Lu, Ming-Lun; Nakata, Akinori; Swanson, Naomi G.

    2015-01-01

    Background Little is known about the association between psychosocial factors and injury absence in the workplace. Purpose This study aims to assess the association of comprehensive workplace psychosocial factors with work-related injury absence among Korean workers. Methods The data (n=7,856) were derived from the First Korean Working Conditions Survey conducted in 2006 with a representative sample (n=10,043) of the Korean working population. The survey instrument contained questions about hours of work, physical risk factors, work organization, and the effect of work on health/injury. Work-related injury absence was indicated by a dichotomous variable with at least 1 day absence during the preceding 12 months. Logistic regression models were used to calculate odds ratio and confidence interval (CI). Incremental adjustments for sociodemographic, health behavior, and occupational confounding variables were employed in the models. Results The overall 1-year prevalence of work-related injury absence in this study was 1.37 % (95 % CI, 1.11–1.63 %). Those who experienced violence at work (adjusted odds ratio (aOR), 7.05 (95 % CI, 2.69–18.5)), threat of violence at work (aOR, 4.25 (95 % CI, 1.32–13.64)), low job autonomy (aOR, 1.79 (95 % CI, 1.17–2.74)), and high job strain (aOR, 2.38 (95 % CI, 1.29–4.42) had an increased risk of injury absence, compared with their respective counterparts (p<0.05). Among all job types, skilled workers in Korea were at a near fourfold risk of work absence due to occupational injuries, compared with managers in low-risk jobs. Conclusion Workplace violence and increased job strain were two key workplace psychosocial factors associated with work-related injury absence. PMID:23794229

  11. Perceived job security and sickness absence: a study on moral hazard.

    PubMed

    Khan, Jahangir; Rehnberg, Clas

    2009-10-01

    A moral hazard problem was investigated by analysing the individual behaviour of female and male employees with regard to utilisation of sickness insurance in connection with perceived job security. It was hypothesised that employees with a higher perceived job security take more frequent sickness absence. Perceived higher job security is indicated by three variables, namely a permanent job contract, no unemployment history, and native ethnicity. The effect of perceived job security is expected to be stronger on short-term than on long-term sickness absence, since a medical certificate is required for the latter. Public health survey data from Stockholm County, Sweden, covering the year 2002 was used. Using logistic regression analyses separately for short- and long-term sickness absence and for females and males, we found that short-term sickness absence is more strongly influenced by perceived job security than long-term sickness absence. We observe indications of moral hazard in both female and male employees. However, the three indicators of perceived job security have a different influence on females and males. PMID:19283417

  12. Levetiracetam in Absence Epilepsy

    ERIC Educational Resources Information Center

    Verrotti, Alberto; Cerminara, Caterina; Domizio, Sergio; Mohn, Angelika; Franzoni, Emilio; Coppola, Giangennaro; Zamponi, Nelia; Parisi, Pasquale; Iannetti, Paola; Curatolo, Paolo

    2008-01-01

    The aim of the study was to assess the efficacy, tolerability, and safety of levetiracetam therapy in children and adolescents with absence epilepsy. Twenty-one participants (11 male, 10 female) with typical absence seizures were enrolled in this prospective study from seven centres in Italy. The mean age and age range at time of enrolment into…

  13. Job stress as a risk factor for absences among manual workers: a 12-month follow-up study

    PubMed Central

    HEO, Yong-Seok; LEEM, Jong-Han; PARK, Shin-Goo; JUNG, Dal-Young; KIM, Hwan-Cheol

    2015-01-01

    This study was conducted to evaluate the impact of job stress on absence from work caused by illnesses and accidents through a prospective research design. A total of 2,349 manual workers were included in this analysis. In the first survey, job stress was determined using the Korean Occupational Stress Scale-Short Form. In the second survey, information on absence due to accidents or illnesses during the past one year was obtained through a questionnaire. The relationship was analyzed using a logistic regression model with multiple imputation. After adjusting for confounding variables for males, absence due to accidents was statistically associated with high job demand, insufficient job control, inadequate social support, and organizational injustice. In addition, high job demands and organizational injustice were related to increased absence due to illnesses in both genders. A lack of reward was associated with increased absence due to illnesses among female workers. We found that job stress was associated with a higher risk of absence caused by accidents or illnesses of manual workers. PMID:26212413

  14. Sickness absence and concurrent low back and neck–shoulder pain: results from the MUSIC-Norrtälje study

    PubMed Central

    Grooten, Wilhelmus Johannes Andreas; Wiktorin, Christina; Liwing, Johan; Norrman, Linda

    2006-01-01

    In Sweden, musculoskeletal disorders, in particular low back disorders (LBD) and neck–shoulder disorders (NSD) constitute by far the most common disorders, causing sick leave and early retirement. Studies that compare sickness absence in individuals with LBD and individuals with NSD are lacking. Moreover, it is likely that having concurrent complaints from the low back region and the neck–shoulder region could influence sickness absence. The purpose of the present study was to explore potential differences in sickness absence and in long-term sickness absence during a 5-year period, 1995–2001, among individuals with (1) solely LBD, (2) solely NSD, and (3) concurrent LBD and NSD. The present study was based on 817 subjects from the MUSIC-Norrtälje study, whom were working at baseline and whom at both baseline and follow-up reported LBD and/or NSD. Three groups were identified based on pain and pain-related disability at both baseline and follow-up: (1) solely LBD, (2) solely NSD, and (3) concurrent LBD and NSD. Subjects who did not give consistent answers at both the baseline and follow-up occasions were assigned a fourth group: (4) migrating LBD/NSD. Two outcomes were analysed: (1) prevalence of sickness absence, and (2) long-term sickness absence among those with sickness absence days. Logistic regression analysis was used to calculate odds ratios (OR) for sickness absence in the different disorder groups, taking into account confounding factors such as gender, age and other non-musculoskeletal-related disorders. In the group concurrent LBD and NSD, 59% had been sickness absent between baseline and follow up, compared to 42% in the group solely LBD, 41% in the group solely NSD, and 46% in the group migrating LBD/NSD. No difference in sickness absence was found between the group solely LBD compared to the group solely NSD [OR 0.65 (0.36–1.17)]. The adjusted OR for sickness absence in the group concurrent LBD and NSD compared to subjects with solely LBD or

  15. An exploratory study of selected female registered nurses: meaning and expression of nurturance.

    PubMed

    Geissler, E M

    1990-05-01

    The words 'nurse' and 'nursing' originate in the word 'nurture' which dates back to the 14th century. 'Nurturance' appeared for the first time in the 1976 Supplement to the Oxford English Dictionary and in a United States dictionary in 1983. Etymologically and semantically bound to nursing, little is known about the term nurturance. An exploratory design using phenomenological analysis was applied to understand the female registered nurses' experience of nurturing patients throughout the life-span and to uncover behaviours commonly believed nurturant. Interviews with 14 RNs practising in diverse settings revealed 39 nurturant behaviours that were intuited into four themes describing the subjects' perceived structure of nurturance as: (1) enabling maximum potential; (2) providing physical and emotional protection; (3) engaging in a supportive interaction; and (4) conveying shared humanity. Data were formulated into an exhaustive description of the phenomenon nurturance. Additionally, the results support Greenberg-Edelstein's theoretical model of the positive reciprocity of nurturance between nurse and patient. PMID:2358570

  16. Non-minor injuries among children sustained in an outdoor environment--a retrospective register study.

    PubMed

    Gyllencreutz, Lina; Rolfsman, Ewa; Saveman, Britt-Inger

    2015-01-01

    The aim was to investigate non-minor injuries sustained during outdoor activities among 0-12 year old children and to explore self-reported circumstances surrounding these incidents. During 2007-2009, the Umeå University Hospital injury database (IDB) registered 795 children with moderate (n = 778) and serious (n = 17) injuries, such as fractures. The IDB includes data from a questionnaire completed in the emergency department by the injured child or a parent. The open-ended questions catch the injured child's description of what circumstances precede the injury incident. The most commonly reported activities contributing to injuries were play, sport, and transport. Surface impacts were also reported as contributing factors along with products such as trampolines, bicycles, and downhill skis. By achieving a deeper knowledge about the activities and circumstances that precede non-minor injury incidents, creating safer outdoor environments may be feasible. PMID:24024526

  17. Epidemiology of Cardiovascular Malformations among Newborns in Monchegorsk (North-West Russia): a Register-Based Study

    PubMed Central

    Postoev, Vitaly A.; Talykova, Ljudmila V.; Vaktskjold, Arild

    2014-01-01

    Background Cardiovascular malformations (CVM) are one of the most prevalent groups of birth defects. Knowledge about the prevalence, distribution and survival in Russia has been limited. The aim of our study was to assess the perinatal prevalence, structure and risk factors for CVM among newborns in Monchegorsk (Murmansk Oblast, Russia) and the mortality among the affected newborns in the period 1973-2008. Design and methods A register-based study on data from the Kola and Murmansk County Birth Registers. The study included 28,511 births. Results The registered perinatal prevalence was 3.0 per 1000 new-borns, with septal defects as the most prevalent. CVM was twenty times more prevalent among stillborn than live born, and one-third of the live born with a CVM died during the first week of life. The perinatal mortality rate with CVM was 442 per 1000 newborns. This indicator decreased over time. The mothers of newborns with a CVM were ten times more likely to have stillbirth in their anamnesis. The adjusted odds ratio between maternal smoking during pregnancy and CVM was 4.09 [95% confidence interval: 1.75-9.53]. Conclusions The diagnosed perinatal prevalence was relatively low. A previous stillbirth by the mother was highly associated with being born with a CVM. An adjusted elevated risk was also observed among smoking mothers. Perinatal survival increased over time, but varied to a large extent between the different types of CVM. Significance for public health Cardiovascular malformation is one of the most common groups of birth defects. It is considered an important public health issue, as these malformations are the main cause of infant deaths in developed countries. Precise estimates about the prevalence and perinatal survival are needed to organise and plan health care for such newborns. Our study is the first report from the Russian Federation based on data from population-based birth registers. PMID:25343136

  18. Sickness absence poses a threat to the Swedish Welfare State: a cross-sectional study of sickness absence and self-reported illness

    PubMed Central

    Sundquist, Jan; Al-Windi, Ahmad; Johansson, Sven-Erik; Sundquist, Kristina

    2007-01-01

    Background The increasing cost of public social sickness insurance poses a serious economic threat to the Swedish welfare state. In recent years, expenditures for social insurance in general, as well as social sickness insurance in particular, have risen steeply in Sweden. This cross-sectional study analyzed the association between sickness absence (SA) and self-reported reduced working capacity due to a longstanding illness (>3 months), as well between SA and a number of other health problems. Methods Self-reported data on longstanding illness and resultant reduced working capacity, socioeconomic factors, working environment, psychosomatic complaints, anxiety, and general health were obtained for 22,281 employed (paid) persons aged 25 to 64 years. These data were retrieved from the Swedish Living Conditions Survey for 1995 to 2002. National civic registration numbers, replaced with serial numbers to ensure anonymity, were used to link these data to individual-level SA records from the National Social Insurance Board. A logistic regression model was used to estimate the odds ratio of the main outcome variable for the three levels of the SA variable (0–28, 29–90, >90 days/year). Results There was an obvious increasing gradient in length of SA and increasing odds of reporting reduced working capacity. Odds ratios ranged from 3.5 to 19.0; i.e., those with more than ninety days of SA had 19.0 times higher odds of reporting reduced working capacity than those with 0–28 days of SA a year. This very strong association changed less than 10% after adjusting for demographic, socioeconomic, and working environment characteristics. A total of 48.7% of persons on sick leave ≥ 29 days reported no longstanding illness and reduced working capacity. Of these persons, about 43% reported one or more other health problem. Conclusion We confirmed that longstanding illness that results in self-reported reduced working capacity is an important variable related to length of SA

  19. Analysis of risk factors for schizophrenia with two different case definitions: a nationwide register-based external validation study.

    PubMed

    Sørensen, Holger J; Larsen, Janne T; Mors, Ole; Nordentoft, Merete; Mortensen, Preben B; Petersen, Liselotte

    2015-03-01

    Different case definitions of schizophrenia have been used in register based research. However, no previous study has externally validated two different case definitions of schizophrenia against a wide range of risk factors for schizophrenia. We investigated hazard ratios (HRs) for a wide range of risk factors for ICD-10 DCR schizophrenia using a nationwide Danish sample of 2,772,144 residents born in 1955-1997. We compared one contact only (OCO) (the case definition of schizophrenia used in Danish register based studies) with two or more contacts (TMC) (a case definition of at least 2 inpatient contacts with schizophrenia). During the follow-up, the OCO definition included 15,074 and the TMC 7562 cases; i.e. half as many. The TMC case definition appeared to select for a worse illness course. A wide range of risk factors were uniformly associated with both case definitions and only slightly higher risk estimates were found for the TMC definition. Choosing at least 2 inpatient contacts with schizophrenia (TMC) instead of the currently used case definition would result in almost similar risk estimates for many well-established risk factors. However, this would also introduce selection and include considerably fewer cases and reduce power of e.g. genetic studies based on register-diagnosed cases only. PMID:25620118

  20. Impact of headache on sickness absence and utilisation of medical services: a Danish population study.

    PubMed Central

    Rasmussen, B K; Jensen, R; Olesen, J

    1992-01-01

    STUDY OBJECTIVE--The aim was to study the extent and type of health service utilisation, medication habits, and sickness absence due to the primary headaches. DESIGN--This was a cross sectional epidemiological survey of headache disorders in a general population. Headache was diagnosed according to a structured interview and a neurological examination using the criteria of the International Headache Society. SETTING--A random sample of 25-64 year-old individuals was drawn from the Danish National Central Person Registry. All subjects were living in the Copenhagen County. PARTICIPANTS--740 subjects participated (76% of the sample); 119 had migraine and 578 had tension type headache. MAIN RESULTS--Among subjects with migraine 56% had, at some time, consulted their general practitioner because of the migraine. The corresponding percentage among subjects with tension type headache was 16. One or more specialists had been consulted by 16% of migraine sufferers and by 4% of subjects with tension type headache. The consultation rates of chiropractors and physiotherapists were 5-8%. Hospital admissions and supplementary laboratory investigations due to headache were rare (< 3%). Half of the migraine sufferers and 83% of subjects with tension type headache in the previous year had managed with at least one type of drug in the current year. Acetylsalicylic acid preparations and paracetamol were the most commonly used analgesics. Prophylaxis of migraine was used by 7%. In the preceding year 43% of employed migraine sufferers and 12% of employed subjects with tension type headache had missed one or more days of work because of headache. Most common was 1-7 days off work. The total loss of workdays per year due to migraine in the general population was estimated at 270 days per 1000 persons. For tension type headache the corresponding figure was 820. Women were more likely to consult a practitioner than men, whereas no significant sex difference emerged as regards absenteeism

  1. Lunasin in wheat: a chemical and molecular study on its presence or absence.

    PubMed

    Dinelli, Giovanni; Bregola, Valeria; Bosi, Sara; Fiori, Jessica; Gotti, Roberto; Simonetti, Emanuela; Trozzi, Caterina; Leoncini, Emanuela; Prata, Cecilia; Massaccesi, Luca; Malaguti, Marco; Quinn, Robert; Hrelia, Silvana

    2014-05-15

    Lunasin is a peptide whose anticancer properties are widely reported. Originally isolated from soybean seeds, lunasin was also found in cereal (wheat, rye, barley and Triticale), Solanum and amaranthus seeds. However, it was recently reported that searches of transcript and DNA sequence databases for wheat and other cereals failed to identify sequences with similarity to those encoding the lunasin peptide in soy. In order to clarify the presence or absence of lunasin in wheat varieties, a broad investigation based on chemical (LC-ESI-MS) and molecular (PCR) analyses was conducted. Both approaches pointed out the absence of lunasin in the investigated wheat genotypes; in particular no compounds with a molecular weight similar to that of lunasin standard and no lunasin-related sequences were found in the analysed wheat samples. These findings confirm the hypothesis, reported in recent researches, that lunasin is not a wheat-derived peptide. PMID:24423565

  2. Experimental study bearing on the absence of carbonate in mantle-derived xenoliths

    SciTech Connect

    Canil, D. )

    1990-10-01

    Experimentation at high pressures in peridotite + CO{sub 2} systems has suggested that some CO{sub 2}-rich, Si-undersaturated magmas originate in mantle source regions consisting of carbonated peridotite. However, a caveat to the petrological application of such experiments has been the virtual absence of carbonate in mantle xenoliths. Decompression experiments were undertaken to resolve this problem and to test the hypothesis that carbonated peridotite exists in the upper mantle, but decomposes during ascent as xenoliths in its host magma. The author demonstrate that carbonate coexisting with silicates in mantle-derived xenoliths could not survive entrainment even in the fastest ascending magmas due to rapid decarbonation upon decompression. The author conclude that carbonate may indeed exist in the upper mantle, and that the paucity of this phase in mantle-derived xenoliths does not require its absence in the mantle source regions of many primary, alkalic magmas.

  3. [Polygraphical sleep study on typical absence: relationship between the effect of sodium valproate and nigrostriatal function].

    PubMed

    Hasegawa, T; Shimohira, M; Itoh, M; Hayashi, M; Kohyama, J; Kumada, S; Iwakawa, Y

    1994-05-01

    In order to clarify the mechanism of the effect of sodium valproate (VPA) on absence seizures, we performed sleep polygraph recordings in 10 patients with typical absence. VPA was effective in six cases (group A), partially effective in two (group B), and ineffective in two (group C). In 5 of 9 cases, the tonic sleep components were abnormal. In 4 cases, the percentage of slow wave sleep increased before administration of VPA, and did not change remarkably by its administration. In group A and B, twitch movements (TM), one of the phasic sleep components detected in the mentalis muscle on surface EMG, decreased or were unchanged after administration of VPA, especially during the REM period. In contrast, TM increased in group C. We speculate that the changes of TM (especially in the REM periods) after administration of VPA are well related to its effectiveness. Since TMs are thought to be controlled by the nigrostriatal dopaminergic pathway, the different response of basal ganglia to VPA among cases with absence epilepsy would have some relation to the different effectiveness of VPA in controlling seizures. PMID:8185977

  4. Differences in sickness absence between self-employed and employed doctors: a cross-sectional study on national sample of Norwegian doctors in 2010

    PubMed Central

    2014-01-01

    Background Doctors have a low prevalence of sickness absence. Employment status is a determinant in the multifactorial background of sickness absence. The effect of doctors’ employment status on sickness absence is unexplored. The study compares the number of sickness absence days during the last 12 months and the impact of employment status, psychosocial work stress, self-rated health and demographics on sickness absence between self-employed practitioners and employed hospital doctors in Norway. Methods The study population consisted of a representative sample of 521 employed interns and consultants and 313 self-employed GPs and private practice specialists in Norway, who received postal questionnaires in 2010. The questionnaires contained items on sickness absence days during the last 12 months, employment status, demographics, self-rated health, professional autonomy and psychosocial work stress. Results 84% (95% CI 80 to 88%) of self-employed and 60% (95% CI 55 to 64%) of employed doctors reported no absence at all last year. In three multivariate logistic regression models with sickness absence as response variable, employment category was a highly significant predictor for absence vs. no absence, 1 to 3 days of absence vs. no absence and 4 to 99 days of absence vs. no absence), while in a model with 100 or more days of absence vs. no absence, there was no difference between employment categories, suggesting that serious chronic disease or injury is less dependent on employment category. Average or poor self-rated health and low professional autonomy, were also significant predictors of sickness absence, while psychosocial work stress, age and gender were not. Conclusion Self-employed GPs and private practice specialist reported lower sickness absence than employed hospital doctors. Differences in sickness compensation, and organisational and individual factors may to a certain extent explain this finding. PMID:24885230

  5. Exploring the effect of absence selection on landslide susceptibility models: A case study in Sicily, Italy

    NASA Astrophysics Data System (ADS)

    Conoscenti, Christian; Rotigliano, Edoardo; Cama, Mariaelena; Caraballo-Arias, Nathalie Almaru; Lombardo, Luigi; Agnesi, Valerio

    2016-05-01

    A statistical approach was employed to model the spatial distribution of rainfall-triggered landslides in two areas in Sicily (Italy) that occurred during the winter of 2004-2005. The investigated areas are located within the Belice River basin and extend for 38.5 and 10.3 km2, respectively. A landslide inventory was established for both areas using two Google Earth images taken on October 25th 2004 and on March 18th 2005, to map slope failures activated or reactivated during this interval. Geographic Information Systems (GIS) were used to prepare 5 m grids of the dependent variables (absence/presence of landslide) and independent variables (lithology and 13 DEM-derivatives). Multivariate Adaptive Regression Splines (MARS) were applied to model landslide susceptibility whereas receiver operating characteristic (ROC) curves and the area under the ROC curve (AUC) were used to evaluate model performance. To evaluate the robustness of the whole procedure, we prepared 10 different samples of positive (landslide presence) and negative (landslide absence) cases for each area. Absences were selected through two different methods: (i) extraction from randomly distributed circles with a diameter corresponding to the mean width of the landslide source areas; and (ii) selection as randomly distributed individual grid cells. A comparison was also made between the predictive performances of models including and not including the lithology parameter. The models trained and tested on the same area demonstrated excellent to outstanding fit (AUC > 0.8). On the other hand, predictive skill decreases when measured outside the calibration area, although most of the landslides occur where susceptibility is high and the overall model performance is acceptable (AUC > 0.7). The results also showed that the accuracy of the landslide susceptibility models is higher when lithology is included in the statistical analysis. Models whose absences were selected using random circles showed a

  6. Association of classroom ventilation with reduced illness absence: a prospective study in California elementary schools.

    PubMed

    Mendell, M J; Eliseeva, E A; Davies, M M; Spears, M; Lobscheid, A; Fisk, W J; Apte, M G

    2013-12-01

    Limited evidence associates inadequate classroom ventilation rates (VRs) with increased illness absence (IA). We investigated relationships between VRs and IA in California elementary schools over two school years in 162 3rd-5th-grade classrooms in 28 schools in three school districts: South Coast (SC), Bay Area (BA), and Central Valley (CV). We estimated relationships between daily IA and VR (estimated from two year daily real-time carbon dioxide in each classroom) in zero-inflated negative binomial models. We also compared IA benefits and energy costs of increased VRs. All school districts had median VRs below the 7.1 l/s-person California standard. For each additional 1 l/s-person of VR, IA was reduced significantly (p<0.05) in models for combined districts (-1.6%) and for SC (-1.2%), and nonsignificantly for districts providing less data: BA (-1.5%) and CV (-1.0%). Assuming associations were causal and generalizable, increasing classroom VRs from the California average (4 l/s-person) to the State standard would decrease IA by 3.4%, increase attendance-linked funding to schools by $33 million annually, and increase costs by only $4 million. Further increasing VRs would provide additional benefits. These findings, while requiring confirmation, suggest that increasing classroom VRs above the State standard would substantially decrease illness absence and produce economic benefits. PMID:23506393

  7. Hospital Contacts With Infection and Risk of Schizophrenia: A Population-Based Cohort Study With Linkage of Danish National Registers

    PubMed Central

    Nielsen, Philip R.; Benros, Michael. E.; Mortensen, Preben B.

    2014-01-01

    Infections and immune responses have been suggested to play an important role in the etiology of schizophrenia. Several studies have reported associations between maternal infections during pregnancy and the child’s risk of schizophrenia; however, infection during childhood and adolescence unrelated to maternal infection during pregnancy has not been studied to nearly the same extent and the results are far from conclusive. Data were drawn from 2 population-based registers, the Danish Psychiatric Central Register and the Danish National Hospital Register. We used a historical population-based cohort design and selected all individuals born in Denmark between 1981 and 1996 (n = 843 390). We identified all individuals with a first-time hospital contact with schizophrenia from 1991 through 2010. Out of the 3409 individuals diagnosed with schizophrenia, a total of 1549 individuals had had a hospital contact with infection before their schizophrenia diagnosis (45%). Our results indicate that individuals who have had a hospital contact with infection are more likely to develop schizophrenia (relative risk [RR] = 1.41; 95% CI: 1.32–1.51) than individuals who had not had such a hospital contact. Bacterial infection was the type of infection that was associated with the highest risk of schizophrenia (RR = 1.63; 95% CI: 1.47–1.82). Our study does not exclude that a certain type of infection may have a specific effect; yet, it does suggest that schizophrenia is associated with a wide range of infections. This association may be due to inflammatory responses affecting the brain or genetic and environmental risk factors aggregating in families. PMID:24379444

  8. INDUSTRIAL TRAINING RESEARCH REGISTER.

    ERIC Educational Resources Information Center

    Ministry of Labour, London (England).

    IN THIS CLASSIFIED REGISTER OF CURRENT AND RECENTLY COMPLETED STUDIES OF INDUSTRIAL TRAINING IN GREAT BRITAIN, INDIVIDUAL PROJECTS ARE ARRANGED BY THE ITEM NUMBER JUDGED MOST IMPORTANT, AND THE NUMBERS OF OTHER RELEVANT INDUSTRIAL RESEARCH PROJECTS ARE INSERTED AT THE END OF EACH SECTION TO PROVIDE CROSS REFERENCES. DESCRIPTIONS INCLUDE THE TITLE…

  9. In vivo Studies of VEGFR2 Interactions in the Presence and Absence of VEGF

    NASA Astrophysics Data System (ADS)

    King, Christopher; Hristova, Kalina, , Dr.

    Vascular Endothelial Growth Factor Receptor 2 (VEGFR2) is a receptor tyrosine kinase (RTK) that is critical for vasculogenesis and angiogenesis. Enhanced VEGFR2 signaling is often correlated with malignancy. Recently, it was shown that full-length VEGFR2 exists in a monomer-dimer equilibrium in the absence of bound VEGF. Thus, the canonical model of RTK activation does not seem to adequately describe the behavior of VEGFR2 in the cell membrane. In order to understand the role that VEGFR2 extracellular domain plays in unliganded dimerization in live cells, we utilize Fully Quantified Spectral Imaging (FSI) to probe the interactions of VEGFR2 mutant constructs with rationally truncated EC domains. In addition, we investigate the stoichiometry of ligand binding to VEGFR2 EC domain as a function of VEGF concentration and total receptor expression. Supported by NSF MCB 1157687 and NIH GM068619 (to KH) and and NSF Graduate Research Fellowship DGE-1232825 (to CK).

  10. Young registered nurses' intention to leave the profession and professional turnover in early career: a qualitative case study.

    PubMed

    Flinkman, Mervi; Isopahkala-Bouret, Ulpukka; Salanterä, Sanna

    2013-01-01

    In a time of global nursing shortages an alarming number of young registered nurses have expressed a willingness to leave the profession. In this qualitative case study we investigate in depth why young nurses leave nursing profession and reeducate themselves for a new career. The study is based on longitudinal interviews of three young registered nurses in Finland. These nurses were first interviewed between December 2006 and May 2007, when they were 29-32 years old and having an intention to leave the profession. The second interview took place four years later, from January 2011 to March 2011 when all of them had made the transition to a new career. Data were analyzed in two stages. In the first stage, comprehensive career story narratives were formed on the basis of the interviews. In the second stage, emerging themes in these stories were compared, contrasted, and interpreted in the context of the overall career histories. Nursing as a second career choice and demanding work content as well as poor practice environment and the inability to identify with the stereotypical images of nurses were main themes that emerged from these career stories. The results of this interpretative qualitative study reflect a shift toward insights into understanding professional turnover as a complex and long-lasting process. PMID:24027640

  11. Young Registered Nurses' Intention to Leave the Profession and Professional Turnover in Early Career: A Qualitative Case Study

    PubMed Central

    Salanterä, Sanna

    2013-01-01

    In a time of global nursing shortages an alarming number of young registered nurses have expressed a willingness to leave the profession. In this qualitative case study we investigate in depth why young nurses leave nursing profession and reeducate themselves for a new career. The study is based on longitudinal interviews of three young registered nurses in Finland. These nurses were first interviewed between December 2006 and May 2007, when they were 29–32 years old and having an intention to leave the profession. The second interview took place four years later, from January 2011 to March 2011 when all of them had made the transition to a new career. Data were analyzed in two stages. In the first stage, comprehensive career story narratives were formed on the basis of the interviews. In the second stage, emerging themes in these stories were compared, contrasted, and interpreted in the context of the overall career histories. Nursing as a second career choice and demanding work content as well as poor practice environment and the inability to identify with the stereotypical images of nurses were main themes that emerged from these career stories. The results of this interpretative qualitative study reflect a shift toward insights into understanding professional turnover as a complex and long-lasting process. PMID:24027640

  12. Methodological challenges in using the Finnish Hospital Discharge Register for studying fire-related injuries leading to inpatient care

    PubMed Central

    2013-01-01

    Background The objective was to examine feasibility of using hospital discharge register data for studying fire-related injuries. Methods The Finnish National Hospital Discharge Register (FHDR) was the database used to select relevant hospital discharge data to study usability and data quality issues. Patterns of E-coding were assessed, as well as prominent challenges in defining the incidence of injuries. Additionally, the issue of defining the relevant amount of hospital days accounted for in injury care was considered. Results Directly after the introduction of the ICD-10 classification system, in 1996, the completeness of E-coding was found to be poor, but to have improved dramatically around 2000 and thereafter. The scale of the challenges to defining the incidence of injuries was found to be manageable. In counting the relevant hospital days, psychiatric and long-term care were found to be the obvious and possible sources of overestimation. Conclusions The FHDR was found to be a feasible data source for studying fire-related injuries so long as potential challenges are acknowledged and taken into account. Hospital discharge data can be a unique and powerful means for injury research as issues of representativeness and coverage of traditional probability samples can frequently be completely avoided. PMID:23496937

  13. Electronic Mail, a New Written-Language Register: A Study with French-Speaking Adolescents

    ERIC Educational Resources Information Center

    Volckaert-Legrier, Olga; Bernicot, Josie; Bert-Erboul, Alain

    2009-01-01

    The aim of this study was to determine the extent to which the linguistic forms used by adolescents in electronic mail (e-mail) differ from those used in standard written language. The study was conducted in French, a language with a deep orthography that has strict, addressee-dependent rules for using second person personal pronouns (unfamiliar…

  14. The Incidence of Eating Disorders in a Danish Nationwide Register Study Associations with Suicide Risk and Mortality

    PubMed Central

    Zerwas, Stephanie; Larsen, Janne Tidselbak; Petersen, Liselotte; Thornton, Laura M.; Mortensen, Preben Bo; Bulik, Cynthia M.

    2015-01-01

    Our aim was to characterize the incidence rates and cumulative incidence of anorexia nervosa (AN), bulimia nervosa (BN), and eating disorder not otherwise specified (EDNOS), and examine associations among eating disorder diagnoses, suicide attempts, and mortality. Individuals born in Denmark between 1989 and 2006 were included (N=966,141, 51.3% male). Eating disorders diagnoses (AN, Broad AN, BN, EDNOS) were drawn from the Danish Psychiatric Central Research Register (PCRR) and Danish National Patient Register (NPR). Suicide attempts and deaths were captured in the NPR, the PCRR, and the Danish Civil Registration System (CRS). In females, AN had a peak hazard at approximately age 15 years, BN at 22 years, and EDNOS had an extended peak that spanned 18 years to 22 years. Eating disorder diagnoses predicted a significantly higher hazard for death and suicide attempt compared with the referent of individuals with no eating disorders. In males, peak hazard for diagnosis was earlier than in females. The present study represents one of the largest and longest studies of eating disorder incidence and suicide attempts and death in both females and males. Eating disorders are accompanied by increased hazard of suicide attempts and death even in young adults. PMID:25958083

  15. Gender-Specific Risk Factors for Intimate Partner Homicide: A Nationwide Register-Based Study

    ERIC Educational Resources Information Center

    Weizmann-Henelius, Ghitta; Gronroos, Matti; Putkonen, Hanna; Eronen, Markku; Lindberg, Nina; Hakkanen-Nyholm, Helina

    2012-01-01

    The present study examined gender differences in intimate partner homicide (IPH) and offender characteristics with the focus on putative gender-specific risk factors in a nationwide consecutive sample of homicide offenders. Data on all offenders (N = 642; 91 females, 551 males) convicted of homicide and subjected to a forensic psychiatric…

  16. Enhancing Literacy in the Second Grade: Five Related Studies Using the Register Music/Reading Curriculum

    ERIC Educational Resources Information Center

    Darrow, Alice-Ann; Cassidy, Jane W.; Flowers, Patricia J.; Register, Dena; Sims, Wendy; Standley, Jayne M.; Menard, Elizabeth; Swedberg, Olivia

    2009-01-01

    The purpose of these five related studies was to ascertain the effects of a music curriculum designed to enhance reading skills of second-grade students. The dependent variables were subtest scores on the Gates-MacGinitie Reading Test administered pre and post the music/reading intervention. Results showed that the total test gain scores of…

  17. Forensic Psychiatric Perspective on Criminality Associated with Intellectual Disability: A Nationwide Register-Based Study

    ERIC Educational Resources Information Center

    Mannynsalo, L.; Putkonen, H.; Lindberg, N.; Kotilainen, I.

    2009-01-01

    Background: Contrasting views exist over the association of intellectual disability (ID) and criminal offending. This nationwide study attempts to shed further light to expand understanding to substantiate the relation between socio-demographic characteristics, psychiatric co-morbidity and criminal behaviour among the Finnish forensic population…

  18. Ten-Year Trend Analysis of Autism Severity: A Nationwide Population-Based Register Study

    ERIC Educational Resources Information Center

    Lin, Jin-Ding; Sung, Chang-Lin; Lin, Lan-Ping; Hsu, Shang-Wei; Chien, Wu-Chien; Su, Sui-Lung; Wu, Jia-Ling

    2011-01-01

    The severity of autism spectrum disorder was strongly related to the education and service outcome. Without a clear profile of autistic population and its change, efforts to understand its nature and improve the quality of service or education will be impossible. The present study aims to describe the over time reported rate of autism severity…

  19. Upper Secondary French Students, Chemical Transformations and the "Register of Models": A Cross-Sectional Study

    ERIC Educational Resources Information Center

    Cokelez, Aytekin; Dumon, Alain; Taber, Keith S.

    2008-01-01

    The purpose of this study is to identify how upper secondary school French students (Grade 10-12) interpret chemical transformation with regards to the changes within molecules and atoms, and in terms of intramolecular and/or intermolecular bond breaking. In order to identify and describe the students' assimilated knowledge, four questions were…

  20. Perceptions of Writing Confidence, Critical Thinking, and Writing Competence among Registered Nurse-Learners Studying Online

    ERIC Educational Resources Information Center

    Carter, Lorraine

    2008-01-01

    Historically, nursing education has recognized that writing enhances critical thinking, the basis of the clinical reasoning process. The online learning recently adopted by Nursing involves considerable writing, which may enhance critical thinking more than face-to-face courses. In the study reported here, the critical thinking and writing…

  1. Primary Care Use before Cancer Diagnosis in Adolescents and Young Adults – A Nationwide Register Study

    PubMed Central

    Ahrensberg, Jette Møller; Fenger-Grøn, Morten; Vedsted, Peter

    2016-01-01

    Introduction Survival rates of cancer patients have generally improved in recent years. However, children and older adults seem to have experienced more significant clinical benefits than adolescents and young adults (AYAs). Previous studies suggest a prolonged diagnostic pathway in AYAs, but little is known about their pre-diagnostic healthcare use. This study investigates the use of primary care among AYAs during the two years preceding a cancer diagnosis. Methods The study is a retrospective population-based matched cohort study using Danish nationwide registry data. All persons diagnosed with cancer during 2002–2011 in the age group 15–39 years were included (N = 12,306); each participant was matched on gender, age and general practice with 10 randomly selected references (N = 123,060). The use of primary healthcare services (face-to-face contacts, blood tests and psychometric tests) was measured during the two years preceding the diagnosis (index date), and collected data were analysed in a negative binomial regression model. Results The cases generally increased their use of primary care already from 8 months before a cancer diagnosis, whereas a similar trend was not found for controls. The increase was observed for all cancer types, but it started at different times: 17 months before a diagnosis of CNS tumour, 12 months before a diagnosis of soft tissue sarcoma, 9 months before a diagnosis of lymphoma, 5–6 months before a diagnosis of leukaemia, bone tumour or GCT, and 3 months before a diagnosis of malignant melanoma. Conclusion The use of primary care among AYAs increase several months before a cancer diagnosis. The diagnostic intervals are generally short for malignant melanomas and long for brain tumours. A prolonged diagnostic pathway may indicate non-specific or vague symptomatology and low awareness of cancer among AYAs primary-care personnel. The findings suggest potential of faster cancer diagnosis in AYAs. PMID:27203083

  2. A study of clinical decision making by certified registered nurse anesthetists.

    PubMed

    Kremer, Michael J; Faut-Callahan, Margaret; Hicks, Frank D

    2002-10-01

    Anesthesia outcomes and related risk factors have been studied for more than 100 years. Varying sample sizes and research methods have been used, with research findings that were open to multiple interpretations. Research with closed malpractice claims demonstrates that American Society of Anesthesiologists physical status II patients undergoing elective procedures are most likely to experience damaging events intraoperatively with resultant postoperative adverse outcomes. The process of care, including clinical decision making, contributes to adverse outcomes. Clinical decision making can be difficult to assess and measure. In this study, the cognitive psychology framework of information-processing theory and literature pertaining to the use of heuristics, or rules of thumb, and clinical biases, were used to analyze cases from the AANA Foundation closed malpractice claims database. This database contains more than 300 files involving St Paul Fire and Marine Insurance Company-covered CRNAs from across the United States. These files were analyzed by 10 CRNA investigators on the AANA Closed Claims research team. Variables such as inadequate preinduction activities, e.g., incomplete preanesthetic assessments, and use of cognitive biases and inaccurate probability estimation were associated with adverse outcomes in this research sample. Teaching of decision science in basic and continuing nurse anesthesia education is advocated. PMID:12425129

  3. The association between immigrant subgroup and poor mental health: a population-based register study.

    PubMed

    Hollander, Anna-Clara; Bruce, Daniel; Burström, Bo; Ekblad, Solvig

    2013-08-01

    Ethnicity and immigrant subgroup (classified as refugee or nonrefugee) are associated with poor mental health among immigrants. The aim of this study was to assess whether national origin-based differences in poor mental health can be explained by immigrant subgroup and if its importance varies depending on origin. A cross-sectional, population-based study of Swedish residents was conducted in 2006. The outcome was poor mental health, measured with the proxy variable psychotropic drugs purchased. Explanatory variables included immigrant subgroup and origin. Potential confounders were age, marital status, education, time in Sweden, and children. Logistic regression was carried out. The total population was 5,507,262. Immigrants from countries outside the Organisation for Economic Co-operation and Development (OECD) numbered 298,641. Immigrant subgroup partly explained the higher likelihood of poor mental health among non-OECD immigrants; when each country or area was analyzed separately, most refugees had a higher likelihood than nonrefugees did. Immigrant subgroup partly explained the origin-based differences in mental health, but this varied between different groups of origin. PMID:23896844

  4. Toward Synthesizing Our Knowledge of Morphology: Using Ontologies and Machine Reasoning to Extract Presence/Absence Evolutionary Phenotypes across Studies.

    PubMed

    Dececchi, T Alexander; Balhoff, James P; Lapp, Hilmar; Mabee, Paula M

    2015-11-01

    The reality of larger and larger molecular databases and the need to integrate data scalably have presented a major challenge for the use of phenotypic data. Morphology is currently primarily described in discrete publications, entrenched in noncomputer readable text, and requires enormous investments of time and resources to integrate across large numbers of taxa and studies. Here we present a new methodology, using ontology-based reasoning systems working with the Phenoscape Knowledgebase (KB; kb.phenoscape.org), to automatically integrate large amounts of evolutionary character state descriptions into a synthetic character matrix of neomorphic (presence/absence) data. Using the KB, which includes more than 55 studies of sarcopterygian taxa, we generated a synthetic supermatrix of 639 variable characters scored for 1051 taxa, resulting in over 145,000 populated cells. Of these characters, over 76% were made variable through the addition of inferred presence/absence states derived by machine reasoning over the formal semantics of the source ontologies. Inferred data reduced the missing data in the variable character-subset from 98.5% to 78.2%. Machine reasoning also enables the isolation of conflicts in the data, that is, cells where both presence and absence are indicated; reports regarding conflicting data provenance can be generated automatically. Further, reasoning enables quantification and new visualizations of the data, here for example, allowing identification of character space that has been undersampled across the fin-to-limb transition. The approach and methods demonstrated here to compute synthetic presence/absence supermatrices are applicable to any taxonomic and phenotypic slice across the tree of life, providing the data are semantically annotated. Because such data can also be linked to model organism genetics through computational scoring of phenotypic similarity, they open a rich set of future research questions into phenotype

  5. Toward Synthesizing Our Knowledge of Morphology: Using Ontologies and Machine Reasoning to Extract Presence/Absence Evolutionary Phenotypes across Studies

    PubMed Central

    Dececchi, T. Alexander; Balhoff, James P.; Lapp, Hilmar; Mabee, Paula M.

    2015-01-01

    The reality of larger and larger molecular databases and the need to integrate data scalably have presented a major challenge for the use of phenotypic data. Morphology is currently primarily described in discrete publications, entrenched in noncomputer readable text, and requires enormous investments of time and resources to integrate across large numbers of taxa and studies. Here we present a new methodology, using ontology-based reasoning systems working with the Phenoscape Knowledgebase (KB; kb.phenoscape.org), to automatically integrate large amounts of evolutionary character state descriptions into a synthetic character matrix of neomorphic (presence/absence) data. Using the KB, which includes more than 55 studies of sarcopterygian taxa, we generated a synthetic supermatrix of 639 variable characters scored for 1051 taxa, resulting in over 145,000 populated cells. Of these characters, over 76% were made variable through the addition of inferred presence/absence states derived by machine reasoning over the formal semantics of the source ontologies. Inferred data reduced the missing data in the variable character-subset from 98.5% to 78.2%. Machine reasoning also enables the isolation of conflicts in the data, that is, cells where both presence and absence are indicated; reports regarding conflicting data provenance can be generated automatically. Further, reasoning enables quantification and new visualizations of the data, here for example, allowing identification of character space that has been undersampled across the fin-to-limb transition. The approach and methods demonstrated here to compute synthetic presence/absence supermatrices are applicable to any taxonomic and phenotypic slice across the tree of life, providing the data are semantically annotated. Because such data can also be linked to model organism genetics through computational scoring of phenotypic similarity, they open a rich set of future research questions into phenotype

  6. Persistent Spatial Clusters of Prescribed Antimicrobials among Danish Pig Farms – A Register-Based Study

    PubMed Central

    Fertner, Mette; Sanchez, Javier; Boklund, Anette; Stryhn, Henrik; Dupont, Nana; Toft, Nils

    2015-01-01

    The emergence of pathogens resistant to antimicrobials has prompted political initiatives targeting a reduction in the use of veterinary antimicrobials in Denmark, especially for pigs. This study elucidates the tendency of pig farms with a significantly higher antimicrobial use to remain in clusters in certain geographical regions of Denmark. Animal Daily Doses/100 pigs/day were calculated for all three age groups of pigs (weaners, finishers and sows) for each quarter during 2012–13 in 6,143 commercial indoor pig producing farms. The data were split into four time periods of six months. Repeated spatial cluster analyses were performed to identify persistent clusters, i.e. areas included in a significant cluster throughout all four time periods. Antimicrobials prescribed for weaners did not result in any persistent clusters. In contrast, antimicrobial use in finishers clustered persistently in two areas (157 farms), while those issued for sows clustered in one area (51 farms). A multivariate analysis including data on antimicrobial use for weaners, finishers and sows as three separate outcomes resulted in three persistent clusters (551 farms). Compared to farms outside the clusters during this period, weaners, finishers and sows on farms within these clusters had 19%, 104% and 4% higher use of antimicrobials, respectively. Production type, farm type and farm size seemed to have some bearing on the clustering effect. Adding these factors as categorical covariates one at a time in the multivariate analysis reduced the persistent clusters by 24.3%, 30.5% and 34.1%, respectively. PMID:26317206

  7. Comparative analysis of premature mortality among urban immigrants in Bremen, Germany: a retrospective register-based linkage study

    PubMed Central

    Makarova, Nataliya; Brand, Tilman; Brünings-Kuppe, Claudia; Pohlabeln, Hermann; Luttmann, Sabine

    2016-01-01

    Objectives The main objective of this study was to explore differences in mortality patterns among two large immigrant groups in Germany: one from Turkey and the other from the former Soviet Union (FSU). To this end, we investigated indicators of premature mortality. Design This study was conducted as a retrospective population-based study based on mortality register linkage. Using mortality data for the period 2004–2010, we calculated age-standardised death rates (SDR) and standardised mortality ratios (SMR) for premature deaths (study, we made use of the unique possibilities of register-based research in relation to migration and health. Analyses were performed in three population groups in the federal state of Bremen, Germany: immigrants from Turkey, those from the FSU and the general population. Results The SDRs for premature deaths of the two immigrant groups were lower compared to those of the general population. The SMRs remained under 1. Using the indicator of YPLL, we observed higher age-standardised YPLL rates among immigrant populations, particularly among males from the FSU compared to females and population groups 4238/100 000, 95% CI (4119 to 4358). Regarding main causes of premature death, we found larger contributions of infant mortality and diseases of the respiratory system among Turkish immigrants, and of injuries and poisonings, and mental and behavioural disorders among immigrants from the FSU. Conclusions While the overall trends favour the immigrant populations, the indicator of YPLL and cause-specific results indicate areas where the healthcare systems responsiveness may need to be improved, including preventive services. Further work with broader databases providing a similar level of differentiation is necessary to substantiate these findings. PMID:27000782

  8. Total ankle replacement: a population-based study of 515 cases from the Finnish Arthroplasty Register

    PubMed Central

    Koivu, Helka; Eskelinen, Antti; Ikävalko, Mikko; Paavolainen, Pekka; Remes, Ville

    2010-01-01

    Background and purpose Although total ankle replacement (TAR) is a recognized procedure for treatment of the painful arthritic ankle, the best choice of implant and the long-term results are still unknown. We evaluated the survival of two TAR designs and factors associated with survival using data from the nationwide arthroplasty registry in Finland. Methods 573 primary TARs were performed during the period 1982–2006 because of rheumatic, arthritic, or posttraumatic ankle degeneration. We selected contemporary TAR designs that were each used in more than 40 operations, including the S.T.A.R. (n = 217) and AES (n = 298), to assess their respective survival rates. The mean age of the patients was 55 (17–86) years and 63% of operations were performed in women. Kaplan-Meier analysis and the Cox regression model were used for survival analysis. The effects of age, sex, diagnosis, and hospital volume were also studied. Results The annual incidence of TAR was 1.5 per 105 inhabitants. The 5-year overall survivorship for the whole TAR cohort was 83% (95% CI: 81–86), which agrees with earlier reports. The most frequent reasons for revision were aseptic loosening of one or both of the prosthesis components (39%) and instability (39%). We found no difference in survival rate between the S.T.A.R. and AES designs. Furthermore, age, sex, diagnosis, and hospital volume (< 10 and > 100 replacements in each of 17 hospitals) did not affect the TAR survival. Interpretation Based on our findings, we cannot conclude that any prosthesis was superior to any other. A high number of technical errors in primary TARs suggests that this low-volume field of implant arthroplasty should be centralized to fewer units. PMID:20180720

  9. Current management of intracerebral haemorrhage in China: a national, multi-centre, hospital register study

    PubMed Central

    2011-01-01

    Background We aimed to examine current practice of the management and secondary prevention of intracerebral haemorrhage (ICH) in China where the disease is more common than in Western populations. Methods Data on baseline characteristics, management in-hospital and post-stroke, and outcome of ICH patients are from the ChinaQUEST (QUality Evaluation of Stroke Care and Treatment) study, a multi-centre, prospective, 62 hospital registry in China during 2006-07. Results Nearly all ICH patients (n = 1572) received an intravenous haemodiluting agent such as mannitol (96%) or a neuroprotectant (72%), and there was high use of intravenous traditional Chinese medicine (TCM) (42%). Neurosurgery was undertaken in 137 (9%) patients; being overweight, having a low Glasgow Coma Scale (GCS) score on admission, and Total Anterior Circulation Syndrome (TACS) clinical pattern on admission, were the only baseline factors associated with this intervention in multivariate analyses. Neurosurgery was associated with nearly three times higher risk of death/disability at 3 months post-stroke (odd ratio [OR] 2.60, p < 0.001). Continuation of antihypertensives in-hospital and at 3 and 12 months post-stroke was reported in 732/935 (78%), 775/935 (83%), and 752/935 (80%) living patients with hypertension, respectively. Conclusions The management of ICH in China is characterised by high rates of use of intravenous haemodiluting agents, neuroprotectants, and TCM, and of antihypertensives for secondary prevention. The controversial efficacy of these therapies, coupled with the current lack of treatments of proven benefit, is a call for action for more outcomes based research in ICH. PMID:21276264

  10. Age, occupational class and sickness absence during pregnancy: a retrospective analysis study of the Norwegian population registry

    PubMed Central

    Ariansen, Anja M S

    2014-01-01

    Objective Western women increasingly delay having children to advance their career, and pregnancy is considered to be riskier among older women. In Norway, this development surprisingly coincides with increased sickness absence among young pregnant women, rather than their older counterparts. This paper tests the hypothesis that young pregnant women have a higher number of sick days because this age group includes a higher proportion of working class women, who are more prone to sickness absence. Design A zero-inflated Poisson regression was conducted on the Norwegian population registry. Participants All pregnant employees giving birth in 2004–2008 were included in the study. A total number of 216 541 pregnancies were observed among 180 483 women. Outcome measure Number of sick days. Results Although the association between age and number of sick days was U-shaped, pregnant women in their early 20s had a higher number of sick days than those in their mid-40s. This was particularly the case for pregnant women with previous births. In this group, 20-year-olds had 12.6 more sick days than 45-year-olds; this age difference was reduced to 6.3 after control for class. Among women undergoing their first pregnancy, 20-year-olds initially had 1.2 more sick days than 45-year-olds, but control for class altered this age difference. After control for class, 45-year-old first-time pregnant women had 2.9 more sick days than 20-year-olds with corresponding characteristics. Conclusions The negative association between age and sickness absence was partly due to younger age groups including more working class women, who were more prone to sickness absence. Young pregnant women's needs for job adjustments should not be underestimated. PMID:24793246

  11. Associations between Stroke Mortality and Weekend Working by Stroke Specialist Physicians and Registered Nurses: Prospective Multicentre Cohort Study

    PubMed Central

    Bray, Benjamin D.; Ayis, Salma; Campbell, James; Cloud, Geoffrey C.; James, Martin; Hoffman, Alex; Tyrrell, Pippa J.; Wolfe, Charles D. A.; Rudd, Anthony G.

    2014-01-01

    Background Observational studies have reported higher mortality for patients admitted on weekends. It is not known whether this “weekend effect” is modified by clinical staffing levels on weekends. We aimed to test the hypotheses that rounds by stroke specialist physicians 7 d per week and the ratio of registered nurses to beds on weekends are associated with mortality after stroke. Methods and Findings We conducted a prospective cohort study of 103 stroke units (SUs) in England. Data of 56,666 patients with stroke admitted between 1 June 2011 and 1 December 2012 were extracted from a national register of stroke care in England. SU characteristics and staffing levels were derived from cross-sectional survey. Cox proportional hazards models were used to estimate hazard ratios (HRs) of 30-d post-admission mortality, adjusting for case mix, organisational, staffing, and care quality variables. After adjusting for confounders, there was no significant difference in mortality risk for patients admitted to a stroke service with stroke specialist physician rounds fewer than 7 d per week (adjusted HR [aHR] 1.04, 95% CI 0.91–1.18) compared to patients admitted to a service with rounds 7 d per week. There was a dose–response relationship between weekend nurse/bed ratios and mortality risk, with the highest risk of death observed in stroke services with the lowest nurse/bed ratios. In multivariable analysis, patients admitted on a weekend to a SU with 1.5 nurses/ten beds had an estimated adjusted 30-d mortality risk of 15.2% (aHR 1.18, 95% CI 1.07–1.29) compared to 11.2% for patients admitted to a unit with 3.0 nurses/ten beds (aHR 0.85, 95% CI 0.77–0.93), equivalent to one excess death per 25 admissions. The main limitation is the risk of confounding from unmeasured characteristics of stroke services. Conclusions Mortality outcomes after stroke are associated with the intensity of weekend staffing by registered nurses but not 7-d/wk ward rounds by stroke

  12. Epidemiology of sickness absence in a Swedish county in 1985, 1986 and 1987. A three year longitudinal study with focus on gender, age and occupation.

    PubMed

    Alexanderson, K; Leijon, M; Akerlind, I; Rydh, H; Bjurulf, P

    1994-03-01

    In order to get a better epidemiological base for preventive intervention in the county of Ostergötland, Sweden, a comprehensive study of sickness absence was done. During the years 1985, 1986 and 1987, all new periods of sick-leave exceeding seven days were registered with demographic variables. This information was related to data about the total population of Ostergötland. Each year approx. 45,000 persons had approx. 61,000 sickness spells. These figures were stable over the years while the number of sick-leave days increased. Blue-collar occupations had the highest sick-leave rates and the female sick-leave rate was higher in general and much higher in most male-dominated occupations. The male rate was lower within female-dominated areas, except among secretaries and textile workers. Females in extremely male-dominated groups had the highest rates, while both male and female sick-leave rates were lower in more gender-integrated occupations. PMID:8029663

  13. Occupational injuries for consecutive and cumulative shifts among hospital registered nurses and patient care associates: a case-control study.

    PubMed

    Hopcia, Karen; Dennerlein, Jack Tigh; Hashimoto, Dean; Orechia, Terry; Sorensen, Glorian

    2012-10-01

    Nontraditional work shifts for hospital registered nurses and patient care associates and associated injuries were examined through a case-control study. Inpatient care requires that many staff work nontraditional shifts, including nights and 12-hour shifts, but some characteristics remain unexplored, especially consecutive shifts. A total of 502 cases (injured workers) were matched to single controls based on their hospital, unit type, job type, gender, and age (± 5 years). Conditional logistic regression was used for the analysis, controlling for weekly hours scheduled. For both, consecutive shifts of 2 or more days and some various cumulative shifts over a week and month period, especially night shifts, were associated with increased odds of injury. More investigations on the phenomenon of consecutive shifts are recommended. Additionally, the assessment of shift policy and subsequent injury outcomes is necessary before implementing intervention strategies. PMID:22998692

  14. Involvement and structure: A qualitative study of organizational change and sickness absence among women in the public sector in Sweden

    PubMed Central

    2011-01-01

    Background Organizational changes in modern corporate life have become increasingly common and there are indications that they often fail to achieve their ends. An earlier study of 24,036 employees showed that those who had repeatedly been exposed to large increases in staffing during 1991-1996 had an excess risk of both long-term sickness absence and hospital admission during 1997-1999, while moderate expansion appeared to be protective. The former was most salient among female public sector employees. We used qualitative interviews to explore work environment factors underlying the impact of organizational changes (moderate and large expansions in staffing) on sickness absence from an employee perspective. Method We interviewed 21 strategically selected women from the earlier study using semi-structured telephone interviews focusing on working conditions during the organizational changes. We identified 22 themes which could explain the association between organizational changes and sickness absence. We then used Qualitative Comparative Analysis (QCA) to reduce the number of themes and discover patterns of possible causation. Results The themes that most readily explained the outcomes were Well Planned Process of Change (a clear structure for involvement of the employees in the changes), Agent of Change (an active role in the implementation of the changes), Unregulated Work (a lack of clear limits and guidelines regarding work tasks from the management and among the employees), and Humiliating Position (feelings of low status or of not being wanted at the workplace), which had been salient throughout the analytic process, in combination with Multiple Contexts (working in several teams in parallel) and Already Ill (having already had a debilitating illness at the beginning of 1991), which may indicate degree of individual exposure and vulnerability. Well Planned Process of Change, Agent of Change and Multiple Contexts are themes that were associated with low

  15. Previous sickness absence and current low perceived social support at work among employees in the general population: a historical cohort study

    PubMed Central

    Knapstad, Marit; Holmgren, Kristina; Hensing, Gunnel; Øverland, Simon

    2014-01-01

    Objective Although sickness absence often is a process over time, most studies have treated the phenomenon as a discrete event and focused more on its causes than its consequences. We aimed to examine whether various patterns of previous long-term sickness absence were associated with current low perceived social support at work. Method This is a historical cohort study based on data from a population-based survey among Swedish employees (n=2581). The survey data were linked to official registries yielding data on sickness absence 1–7 years prior to the survey. Results The main finding was that previous sickness absence was associated with current low perceived social support at work. The highest odds for low social support were found among those who had a stable high level of sickness absence. The two indicators of perceived social support employed were somewhat differently associated with previous sickness absence: Recency of absence showed to be of importance for general support at the workplace and the relationship with colleagues and superiors. Experiencing that one's immediate superior rarely or never regards one's view was, on the other hand, mainly related to having had a high level of sickness absence, irrespective of recency. Conclusions Our results indicate that recency and extent of previous sickness absence are related to perceived social support at work. Future research on the relationship between social support and sickness absence should use repeated measurements and acknowledge the possible bidirectional relationship. PMID:25351599

  16. Early-Life Factors and Risk of Parkinson’s Disease: A Register-Based Cohort Study

    PubMed Central

    Liu, Bojing; Chen, Honglei; Fang, Fang; Tillander, Annika; Wirdefeldt, Karin

    2016-01-01

    Parkinson’s disease (PD) may take decades to develop and early life exposures such as infection may be important. However, few epidemiological studies have evaluated early life risk factors in relation to PD risk. We therefore examined such associations in a prospective analysis of 3 545 612 individuals born in Sweden between 1932 and 1970 without PD on January 1, 2002. Incident PD cases were identified using the Swedish Patient Register during 2002–2010. Information on sibship size, number of older and younger siblings, multiple births, parental age, birth month and season was obtained from the Swedish Multi-Generation Register. Monthly data on national burden of influenza-like illness during 1932–1970 were obtained from the Swedish Public Health Agency. Hazard ratios with 95% confidence intervals (CI) were estimated using Cox proportional hazards regression. During the follow-up, 8779 incident PD cases were identified. As expected, older age, male sex, parental occupation as farmers, and family history of PD were associated with higher PD risk. Overall, early life factors, including flu burden in the year of birth, were not associated with PD risk, although we did find a lower PD risk among participants with older siblings than those without (HR = 0.93, 95%CI: 0.89, 0.98). Our study therefore provided little support for important etiological contributions of early life factors to the PD risk late in life. The finding of a lower PD risk among individuals with older siblings will need confirmation and further investigation. PMID:27082111

  17. Monitoring the use of lipid-lowering medication among persons with newly diagnosed diabetes: a nationwide register-based study

    PubMed Central

    Vehko, Tuulikki; Sund, Reijo; Arffman, Martti; Manderbacka, Kristiina; Ilanne-Parikka, Pirjo; Keskimäki, Ilmo

    2013-01-01

    Objectives To develop a register-based monitoring system to provide information on the use of lipid-lowering medication among persons with diabetes in different patient groups and by socioeconomic position. Design Longitudinal and register-based, before and after diabetes diagnosis. Setting Finnish population. Participants A total of 121 053 persons aged 30–79 years with a new diagnosis of diabetes during 2000–2006. The annual cohorts were divided at the time of diabetes diagnosis by coronary heart disease (CHD) status. Primary and secondary outcome measures Lipid-lowering medication purchases after diabetes diagnosis and prior to the diagnosis. Results According to the health insurance reimbursement data the use of lipid-lowering medication advanced rapidly among people with diabetes in the early 2000s in Finland. Of the patients diagnosed with diabetes in 2000 only one-fourth used lipid-lowering medication in 6–12 months after their diagnosis. For those diagnosed in 2006, the utilization rate was 46%. Among those with a history of CHD the use of medication was markedly higher; 51–58% in 2000 and 77–79% in 2006. Taking into account the increasing trend and measuring the independent effect of the diagnosis of diabetes on lipid-lowering medication, setting the diagnosis increased the use by 10–50%. Despite increasing overall utilisation rates, socioeconomic difference in the use of lipid-lowering medication remained throughout the study period. In particular, the lowest income quintile differed from other income groups and in 2006 its use of lipid-lowering medication remained approximately 10% points lower compared with the overall level. Conclusions The lipid-lowering medication is being applied in an increasing population of new diabetes cases; however, modelling the independent effect of the diagnosis of diabetes on lipid-lowering medication shows that the diagnosis increased use, but did not abolish socioeconomic differences. PMID:24189078

  18. Systems, Ideologies and History: A Three-Dimensional Absence in the Study of Assessment Reform Processes

    ERIC Educational Resources Information Center

    Flórez Petour, María Teresa

    2015-01-01

    This paper makes the case for the need to study assessment reform processes from a broader and more complex perspective that takes the historical, ideological and systemic aspects of assessment policies into account. It draws on a larger study to demonstrate how the understanding of Assessment for Learning (AfL) reforms is enriched by such a…

  19. Alternation between Work and Education. A Study of Educational Leave of Absence at Enterprise Level.

    ERIC Educational Resources Information Center

    Organisation for Economic Cooperation and Development, Paris (France). Centre for Educational Research and Innovation.

    The study reported here involves six countries (Germany, Italy, Yugoslavia, United Kingdom, United States, and Sweden) and focuses on the ways in which those who are actively employed have access to opportunities to alternate education and training with their employment. The first chapter discusses the study structure and defines the field covered…

  20. Differences between homicide and filicide offenders; results of a nationwide register-based case-control study

    PubMed Central

    Putkonen, Hanna; Weizmann-Henelius, Ghitta; Lindberg, Nina; Eronen, Markku; Häkkänen, Helinä

    2009-01-01

    Background Filicide, the killing of one's child, is an extraordinary form of homicide. It has commonly been associated with suicide and parental psychiatric illness. In the research on filicide, nationwide studies with comparison groups, specific perpetrator subgroups, and assessment of possible risk factors have been called for. The purpose of the current study was to provide all that. Methods In this nationwide register-based case-control study all filicide offenders who were in a forensic psychiatric examination in Finland 1995–2004 were examined and compared with an age- and gender matched control group of homicide offenders. The assessed variables were psychosocial history, index offence, and psychiatric variables as well as psychopathy using the PCL-R. Results Filicide offenders were not significantly more often diagnosed with psychotic disorders than the controls but they had attempted suicide at the crime scene significantly more often. Filicide offenders had alcohol abuse/dependence and antisocial personality less often than the controls. Filicide offenders scored significantly lower on psychopathy than the controls. Within the group of filicide offenders, the psychopathy items with relatively higher scores were lack of remorse or guilt, shallow affect, callous/lack of empathy, poor behavioral controls, and failure to accept responsibility. Conclusion Since filicide offenders did not seem significantly more mentally disordered than the other homicide offenders, psychiatry alone cannot be held responsible for the prevention of filicide. Extensive international studies are needed to replicate our findings and provide more specific knowledge in order to enhance prevention. PMID:19480648

  1. The Association Between Self-Assessed Future Work Ability and Long-Term Sickness Absence, Disability Pension and Unemployment in a General Working Population: A 7-Year Follow-Up Study.

    PubMed

    Lundin, A; Kjellberg, K; Leijon, O; Punnett, L; Hemmingsson, T

    2016-06-01

    Purpose Work ability is commonly measured with self-assessments, in the form of indices or single items. The validity of these assessments lies in their predictive ability. Prospective studies have reported associations between work ability and sickness absence and disability pension, but few examined why these associations exist. Several correlates of work ability have been reported, but their mechanistic role is largely unknown. This study aims to investigate to what extent individual's own prognosis of work ability predicts labor market participation and whether this was due to individual characteristics and/or working conditions. Methods Self-assessed prognosis of work ability, 2 years from "now," in the Stockholm Public Health Questionnaire (2002-2003) was linked to national registers on sickness absence, disability pension and unemployment up to year 2010. Effects were studied with Cox regression models. Results Of a total of 12,064 individuals 1466 reported poor work ability. There were 299 cases of disability pension, 1466 long-term sickness absence cases and 765 long-term unemployed during follow-up. Poor work ability increased the risk of long-term sickness absence (HR 2.25, CI 95 % 1.97-2.56), disability pension (HR 5.19, CI 95 % 4.07-6.62), and long-term unemployment (HR 2.18, CI 95 % 1.83-2.60). These associations were partially explained by baseline health conditions, physical and (less strongly) psychosocial aspects of working conditions. Conclusions Self-assessed poor ability predicted future long-term sickness absence, disability pension and long-term unemployment. Self-assessed poor work ability seems to be an indicator of future labor market exclusion of different kinds, and can be used in public health monitoring. PMID:26319413

  2. Absence of lymphatic vessels in the dog dental pulp: an immunohistochemical study

    PubMed Central

    Martin, Anna; Gasse, Hagen; Staszyk, Carsten

    2010-01-01

    In spite of numerous investigations it has not been precisely determined whether lymphatic vessels are present in the dental pulp of dogs. Therefore, this study attempted a specific immunohistochemical detection of lymphatic endothelium. The canine teeth of 19 healthy beagle dogs were dissected into three segments (apical, intermediate and occlusal). After decalcification, specimens were embedded in paraffin wax and histologic cross-sections were stained immunohistochemically using a reliable antibody (anti-Prox-1) against the homeobox transcription factor Prox-1, which is located within the nucleus of lymphatic endothelium. Anti-Prox-1 reacted positively with canine control tissues (lymph nodes, gingiva, nasal mucosa), but showed no staining in tissue sections of the dental pulp. The dog dental pulp contained no vascular structures lined with lymphatic endothelium. This suggests that drainage of interstitial fluid makes use of other routes, i.e. extravascular pathways. PMID:20854283

  3. Fluid stimulation elicits hearing in the absence of air and bone conduction-An animal study.

    PubMed

    Perez, Ronen; Adelman, Cahtia; Sohmer, Haim

    2016-04-01

    Conclusion Cochlea can be directly excited by fluid (soft-tissue) stimulation. Objective To determine whether there is no difference in auditory-nerve-brainstem evoked response (ABR) thresholds to fluid stimulation between normal and animal models of post radical-mastoidectomy, as seen in a previous human study. Background It has been shown in humans that hearing can be elicited with stimulation to fluid in the external auditory meatus (EAM), and radical-mastoidectomy cavity. These groups differed in age, initial hearing, and drilling exposure. To overcome this difference, experiments were conducted in sand-rats, first intact, and after inducing a radical-mastoidectomy. Methods The EAM of five sand-rats was filled with 0.3 ml saline. ABR thresholds were determined in response to vibratory stimulation by a clinical bone-vibrator with a plastic rod, applied to the saline in the EAM. Then the tympanic membrane was removed, and malleus dislocated (radical-mastoidectomy model). The cavity was filled with 0.45 ml saline and the ABR threshold was determined in response to vibratory stimulation to the cavity fluid. Results There was no difference in ABR fluid thresholds to EAM and mastoidectomy cavity stimulation. Air-conduction stimulation from the bone-vibrator was not involved (conductive loss due to fluid). Bone-conduction stimulation was not involved (large difference in acoustic impedance between fluid and bone). PMID:26824146

  4. Studies on the absence of photodynamic mechanism in the normal pancreas

    NASA Astrophysics Data System (ADS)

    Mang, Thomas S.; Wieman, Thomas J.; Crean, David H.

    1991-06-01

    Extraction procedures to quantitate porfimer sodium concentration in tissues were correlated with fluorescence measurements made in vivo, on hamster and rat normal pancreas and intra-pancreatic tumors. The uptake of photosensitizer has been shown to be high in both normal and malignant pancreatic tissues, in both animal models studied. Photobleaching of the drug, as evidenced by both techniques within the pancreatic tumor, occurs in a typical manner during PDT, with resultant tissue destruction. In contrast, when the normal pancreas is exposed to PDT, a negligible photobleaching effect, as well as a lack of tissue response, is observed. The lack of observable response is corroborated by a lack of measurable physiological response. Both serum amylase and serum glucose show acute changes up to 12 hours post treatment but quickly return to normal. HPLC analysis shows that the drug extracted from both the normal pancreas and intrapancreatic tumor is essentially the same as that extracted from other tissues and similar to that which has been injected into the animal. Fluorescence microscopy has shown that at time points between 12-120 hours the drug is associated with lymphatic channels. This would not, however, necessarily preclude normal tissue destruction. Similar results have been found with other photosensitizers. Understanding the lack of response in the pancreas may lead to a deeper understanding of the diseased state which is normally refractory to all therapy as well as understanding the fundamental concepts of the mechanisms of PDT.

  5. Sense of coherence and disability pensions. A nationwide, register based prospective population study of 2196 adult Finns

    PubMed Central

    Suominen, S.; Gould, R.; Ahvenainen, J.; Vahtera, J.; Uutela, A.; Koskenvuo, M.

    2005-01-01

    Background: Strong sense of coherence (SOC) has been shown to be associated with good, perceived health both in cross sectional and longitudinal studies. Study objective: To find out if level of SOC was associated to incidence of disability pension. Study design: A prospective cohort study based on survey data on sense of coherence in 1989 or 1993 and data on disability pensions in 1990–1996 from national registers. Participants: 2196 identifiable subjects derived from a representative sample (n = 5000) in 1989 of male and female Finns between 15 and 64 years of age. Initial health was categorised on the basis of number of long term illnesses reported on entry into the study (no illnesses; one illness or several illnesses resulting in only mild or moderate functional limitation; one illness or several illnesses resulting in severe or very severe functional limitation). Main results: In an interindividual comparison a decrease in initial SOC score by one point was significantly (hazard ratio 1.56, 95% confidence intervals 1.15 to 2.12) associated with receipt of a disability pension by subjects who had been 50 years of age or less on entry into the study. Sex was not associated with outcome once initial level of health, level of occupational training, level of engagement in physical exercise, and alcohol consumption were taken into consideration. No similar significant association was seen in relation to people who had been more than 50 years of age on entry into the study. Conclusions: It seems probable that a weak SOC in people of 50 years or younger increases the likelihood of grant of a disability pension. PMID:15911639

  6. Pressure ulcer knowledge of registered nurses, assistant nurses and student nurses: a descriptive, comparative multicentre study in Sweden.

    PubMed

    Gunningberg, Lena; Mårtensson, Gunilla; Mamhidir, Anna-Greta; Florin, Jan; Muntlin Athlin, Åsa; Bååth, Carina

    2015-08-01

    The aim of this study was to describe and compare the knowledge of registered nurses (RNs), assistant nurses (ANs) and student nurses (SNs) about preventing pressure ulcers (PUs). PU prevention behaviours in the clinical practice of RNs and ANs were also explored. A descriptive, comparative multicentre study was performed. Hospital wards and universities from four Swedish county councils participated. In total, 415 participants (RN, AN and SN) completed the Pressure Ulcer Knowledge Assessment Tool. The mean knowledge score for the sample was 58·9%. The highest scores were found in the themes 'nutrition' (83·1%) and 'risk assessment' (75·7%). The lowest scores were found in the themes 'reduction in the amount of pressure and shear' (47·5%) and 'classification and observation' (55·5%). RNs and SNs had higher scores than ANs on 'aetiology and causes'. SNs had higher scores than RNs and ANs on 'nutrition'. It has been concluded that there is a knowledge deficit in PU prevention among nursing staff in Sweden. A major educational campaign needs to be undertaken both in hospital settings and in nursing education. PMID:23919728

  7. Problem Gambling Associated with Violent and Criminal Behaviour: A Danish Population-Based Survey and Register Study.

    PubMed

    Laursen, Bjarne; Plauborg, Rikke; Ekholm, Ola; Larsen, Christina Viskum Lytken; Juel, Knud

    2016-03-01

    This study compares the number of criminal charges among problem gamblers (N = 384) and non-problem gamblers including non-gamblers (N = 18,241) and examines whether problem gambling is more strongly associated with income-generating crimes like theft, fraud and forgery than other types of crimes such as violent crimes. A cohort study was carried out, based on data from the Danish Health and Morbidity Surveys in 2005 and 2010, which were linked at the individual level with data from The Danish National Criminal Register. Multiple logistic regression analyses were used to determine the association between problem gambling and charges for different categories of crime. We found that problem gamblers had significantly higher odds of being charged than non-problem gamblers (adjusted odds ratio 1.5; 95 % confidence interval 1.1-1.9). The odds ratio for economic crime charges was 2.6 (1.5-4.5), for violence charges 2.2 (1.1-4.5), and for drug charges 3.7 (1.7-8.0). For road traffic charges the odds ratio was 1.3 (1.0-1.8). Hence, there was a strong association between problem gambling and being charged except for road traffic charges; however the association was not stronger for economic charges than for violence and drug charges. PMID:25773870

  8. NMR studies of interactions between Bax and BH3 domain-containing peptides in the absence and presence of CHAPS.

    PubMed

    Yao, Shenggen; Westphal, Dana; Babon, Jeffrey J; Thompson, Geoff V; Robin, Adeline Y; Adams, Jerry M; Colman, Peter M; Czabotar, Peter E

    2014-03-01

    Activation and oligomerisation of Bax, a key pro-apoptotic Bcl-2 family protein, are key steps in the mitochondrial pathway to apoptosis. The signals for apoptosis are conveyed by the distantly related BH3-only proteins, which use their short BH3 domain, an amphipathic α-helix, to interact with other Bcl-2 family members. Here we report an NMR study of interactions between BaxΔC and BH3 domain-containing peptides in the absence and presence of CHAPS, a zwitterionic detergent. We find for the first time that CHAPS interacts weakly with BaxΔC (fast exchange on the NMR chemical shift timescale), at concentrations below micelle formation and with an estimated Kd in the tens of mM. Direct and relatively strong-interactions (slow exchange on the NMR chemical shift timescale) were also observed for BaxΔC with BaxBH3 (estimated Kd of circa 150μM) or BimBH3 in the absence of CHAPS. The interaction with either peptide alone induced widespread chemical shift perturbations to BaxΔC in solution which implies that BaxΔC might have undergone significant conformation change upon binding the BH3 peptide. However, BaxΔC remained monomeric upon binding either CHAPS or a BH3 peptide alone, but the presence of both provoked it to form a dimer. PMID:24434006

  9. Mortality and use of psychotropic medication in patients with stroke: a population-wide, register-based study

    PubMed Central

    Jennum, Poul; Baandrup, Lone; Iversen, Helle K; Ibsen, Rikke; Kjellberg, Jakob

    2016-01-01

    Objectives The study sought to describe whether psychotropic medication may have long-term side effects in patients with stroke compared with controls. Setting Use of national register data from healthcare services were identified from the Danish National Patient Registry in Denmark. Information about psychotropic medication use was obtained from the Danish Register of Medicinal Product Statistics. Objectives We aimed to evaluate all-cause mortality in relation to the use of benzodiazepines, antidepressants and antipsychotics in patients with stroke and matched controls. Participants Patients with a diagnosis of stroke and either no drug use or preindex use of psychotropic medication (n=49 968) and compared with control subjects (n=86 100) matched on age, gender, marital status and community location. Primary outcome measure All-cause mortality. Results All-cause mortality was higher in patients with previous stroke compared with control subjects. Mortality HRs were increased for participants prescribed serotonergic antidepressant drugs (HR=1.699 (SD=0.030), p=0.001 in patients; HR=1.908 (0.022), p<0.001 in controls, respectively), tricyclic antidepressants (HR=1.365 (0.045), p<0.001; HR=1.733 (0.022), p<0.001), benzodiazepines (HR=1.643 (0.040), p<0.001; HR=1.776 (0.053), p<0.001), benzodiazepine-like drugs (HR=1.776 (0.021), p<0.001; HR=1.547 (0.025), p<0.001), first-generation antipsychotics (HR=2.001 (0.076), p<0.001; HR=3.361 (0.159), p<0.001) and second-generation antipsychotics (HR=1.645 (0.070), p<0.001; HR=2.555 (0.086), p<0.001), compared with no drug use. Interaction analysis suggested statistically significantly higher mortality HRs for most classes of psychotropic drugs in controls compared with patients with stroke. Conclusions All-cause mortality was higher in patients with stroke and controls treated with benzodiazepines, antidepressants and antipsychotics than in their untreated counterparts. Our findings suggest that care should be taken in

  10. Surgical trials and trial registers: a cross-sectional study of randomized controlled trials published in journals requiring trial registration in the author instructions

    PubMed Central

    2013-01-01

    Background Trial registration and the reporting of trial results are essential to increase transparency in clinical research. Although both have been strongly promoted in recent years, it remains unclear whether they have been successfully implemented in surgery and surgery-related disciplines. In this cross-sectional study, we assessed whether randomized controlled trials (RCTs) published in surgery journals requiring trial registration in their author instructions were indeed registered, and whether the study results of registered RCTs had been submitted to the trial register and were thus publicly available. Methods The ten highest ranked surgery journals requiring trial registration by impact factor (Journal Citation Reports, JCR, 2011) were chosen. We then searched MEDLINE (in PubMed) for RCTs published in the selected journals between 1 June 2012 and 31 December 2012. Any trials recruiting participants before 2004 were excluded because the International Committee of Medical Journal Editors (ICMJE) first proposed trial registration in 2004. We then searched the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) to assess whether the identified RCTs were indeed registered and whether the results of the registered RCTs were available in the register. Results The search retrieved 588 citations. Four hundred and sixty references were excluded in the first screening. A further 25 were excluded after full-text screening. A total of 103 RCTs were finally included. Eighty-five of these RCTs (83%) could be found via the ICTRP. For 7 of 59 (12%) RCTs, which were registered on ClinicalTrials.gov, summary study data had been posted in the results database. Conclusions Although still not fully implemented, trial registration in surgery has gained momentum. In general, however, the submission of summary study data to ClinicalTrials.gov remains poor. PMID:24289719

  11. Does Moral Distress Differ Between California Certified Registered Nurse Anesthetists in Independent Versus Medically Supervised Practice: An Exploratory Study.

    PubMed

    Dumouchel, Michael; Boytim, Michael; Gorman, Nicholas; Weismuller, Penny

    2015-06-01

    The purpose of this exploratory, descriptive study was to determine if moral distress levels differed between certified registered nurse anesthetists (CRNAs) working in medically supervised versus independent practice in California. A 63-question survey was administered to 1,190 California CRNAs. Moral distress was measured by the included Ethics Stress Scale. The response rate was 14.7%, yielding demographic and Ethics Stress scores for 175 respondents. Sixty-five participants answered an open-ended question about moral distress yielding qualitative data. Medically supervised CRNAs had a lower mean moral distress scores (176.8) versus independent practice CRNAs (187.8) (p = .002). Lower scores on the ESS indicate higher moral distress. Qualitative data demonstrated that CRNAs experienced moral distress in the following situations: when pressured to give anesthesia to unoptimized patients, when differences of opinion regarding anesthetic plans occurred, in dealing with end-of-life issues, when working with incompetent providers, and during interprofessional struggles between CRNAs and anesthesiologists. In order to reduce moral distress among CRNAs, implications for practice include increased administrative support, increased communication and reciprocated collegial respect between anesthesiologists and CRNAs, and CRNA representation on ethics committees. PMID:26137763

  12. Excess mortality in women of reproductive age from low-income countries: a Swedish national register study

    PubMed Central

    Haglund, Bengt; Högberg, Ulf; Essén, Birgitta

    2013-01-01

    Background: Cause-of-death statistics is widely used to monitor the health of a population. African immigrants have, in several European studies, shown to be at an increased risk of maternal death, but few studies have investigated cause-specific mortality rates in female immigrants. Methods: In this national study, based on the Swedish Cause of Death Register, we studied 27 957 women of reproductive age (aged 15–49 years) who died between 1988 and 2007. Age-standardized mortality rates per 100 000 person years and relative risks for death and underlying causes of death, grouped according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, were calculated and compared between women born in Sweden and in low-, middle- and high-income countries. Results: The total age-standardized mortality rate per 100 000 person years was significantly higher for women born in low-income (84.4) and high-income countries (83.7), but lower for women born in middle-income countries (57.5), as compared with Swedish-born women (68.1). The relative risk of dying from infectious disease was 15.0 (95% confidence interval 10.8–20.7) and diseases related to pregnancy was 6.6 (95% confidence interval 2.6–16.5) for women born in low-income countries, as compared to Swedish-born women. Conclusions: Women born in low-income countries are at the highest risk of dying during reproductive age in Sweden, with the largest discrepancy in mortality rates seen for infectious diseases and diseases related to pregnancy, a cause of death pattern similar to the one in their countries of birth. The World Bank classification of economies may be a useful tool in migration research. PMID:22850186

  13. Portable shift register

    SciTech Connect

    Halbig, J.K.; Bourret, S.C.; Hansen, W.J.; Hicks, D.V.; Klosterbuer, S.F.; Krick, M.S.

    1994-01-01

    An electronics package for a small, battery-operated, self-contained, neutron coincidence counter based on a portable shift-register (PSR) has been developed. The counter was developed for applications not adequately addressed by commercial packages, including in-plant measurements to demonstrate compliance with regulations (domestic and international), in-plant process control, and in-field measurements (environmental monitoring or safeguards). Our package's features, which address these applications, include the following: Small size for portability and ease of installation;battery or mains operation; a built-in battery to power the unit and a typical detector such as a small sample counter, for over 6 h if power lines are bad or noisy, if there is a temporary absence of power, or if portability is desired; complete support, including bias, for standard neutron detectors; a powerful communications package to easily facilitate robust external control over a serial port; and a C-library to simplify creating external control programs in computers or other controllers. Whereas the PSR specifically addresses the applications mentioned above, it also performs all the measurements made by previous electronics packages for neutron coincidence counters developed at Los Alamos and commercialized. The PSR electronics package, exclusive of carrying handle, is 8 by 10 by 20 cm; it contains the circuit boards, battery, and bias supply and weighs less than 2 kg. This instrument package is the second in an emerging family of portable measurement instruments being developed; the first was the Miniature and Modular Multichannel Analyzer (M[sup 3]CA). The PSR makes extensive use of hardware and software developed for the M[sup 3]CA; like the M[sup 3]CA, it is intended primarily for use with an external controller interfaced over a serial channel.

  14. Experimental study of a constrained vapor bubble fin heat exchanger in the absence of external natural convection.

    PubMed

    Basu, Sumita; Plawsky, Joel L; Wayner, Peter C

    2004-11-01

    In preparation for a microgravity flight experiment on the International Space Station, a constrained vapor bubble fin heat exchanger (CVB) was operated both in a vacuum chamber and in air on Earth to evaluate the effect of the absence of external natural convection. The long-term objective is a general study of a high heat flux, low capillary pressure system with small viscous effects due to the relatively large 3 x 3 x 40 mm dimensions. The current CVB can be viewed as a large-scale version of a micro heat pipe with a large Bond number in the Earth environment but a small Bond number in microgravity. The walls of the CVB are quartz, to allow for image analysis of naturally occurring interference fringes that give the pressure field for liquid flow. The research is synergistic in that the study requires a microgravity environment to obtain a low Bond number and the space program needs thermal control systems, like the CVB, with a large characteristic dimension. In the absence of natural convection, operation of the CVB may be dominated by external radiative losses from its quartz surface. Therefore, an understanding of radiation from the quartz cell is required. All radiative exchange with the surroundings occurs from the outer surface of the CVB when the temperature range renders the quartz walls of the CVB optically thick (lambda > 4 microns). However, for electromagnetic radiation where lambda < 2 microns, the walls are transparent. Experimental results obtained for a cell charged with pentane are compared with those obtained for a dry cell. A numerical model was developed that successfully simulated the behavior and performance of the device observed experimentally. PMID:15644365

  15. Phase II study of capecitabine (Xeloda (registered) ) and concomitant boost radiotherapy in patients with locally advanced rectal cancer

    SciTech Connect

    Krishnan, Sunil; Janjan, Nora A.; Skibber, John M.; Rodriguez-Bigas, Miguel A.; Wolff, Robert A.; Das, Prajnan; Delclos, Marc E.; Chang, George J.; Hoff, Paulo M.; Eng, Cathy; Brown, Thomas D.; Crane, Christopher H.; Feig, Barry W.; Morris, Jeffrey; Vadhan-Raj, Saroj; Hamilton, Stanley R.; Lin, Edward H. . E-mail: elin@u.washington.edu

    2006-11-01

    Purpose: The aim of this study was to determine the efficacy of capecitabine (Xeloda (registered) ), an oral fluoropyrimidine, as a radiosensitizer in the neoadjuvant treatment of locally advanced rectal cancer (LARC). Methods and Materials: We conducted a phase II study of capecitabine (825 mg/m{sup 2} orally, twice daily continuous) with radiotherapy (52.5 Gy/30 fractions to the primary tumor and perirectal nodes) in 54 patients with LARC (node-negative {>=}T3 or any node-positive tumor) staged by endoscopic ultrasound (EUS). The primary endpoint was pathologic response rate; secondary endpoints included toxicity profiles and survival parameters. Results: Of the 54 patients (median age, 56.7 years; range, 21.3-78.7 years; male:female ratio, 1.7; Eastern Cooperative Oncology Group performance status 0-1: 100%), 51 patients (94%) had T3N0 or T3N1 disease by EUS. Surgery was not performed in 3 patients; 2 of these patients had metastatic disease, and the third patient refused after a complete clinical response. Of the 51 patients evaluable for pathologic response, 9 patients (18%) achieved complete response, and 12 patients (24%) had microscopic residual disease (<10% viable cells). In addition, 26 patients of all 54 patients (51%) achieved T-downstaging, and 15 patients of 29 patients (52%) achieved N-downstaging. Grade 3/4 toxicities were radiation dermatitis (9%) and diarrhea (2%). Sphincter preservation rate for tumor {<=}5 cm from the anal verge was 67% (18/27). Conclusion: This regimen of radiotherapy plus capecitabine is well tolerated and is more convenient than protracted venous infusion of 5-FU. The pathologic response rate is comparable to our previous experience using protracted venous infusion 5-FU for LARC.

  16. GP utilisation by education level among adults with COPD or asthma: a cross-sectional register-based study.

    PubMed

    Hetlevik, Øystein; Melbye, Hasse; Gjesdal, Sturla

    2016-01-01

    There is a marked socioeconomic gradient in the prevalence of chronic obstructive pulmonary disease (COPD) and asthma, but a large proportion of patients remain undiagnosed. It is a challenge for general practitioners (GPs) to both identify patients and contribute to equity and high quality in services delivered. The aim of this study was to identify patients with COPD and asthma diagnoses recorded by GPs and explore their utilisation of GP services by education level. This was a cross-sectional, national, register-based study from Norwegian general practice in the period 2009-2011. Based on claims from GPs, the number of patients aged ⩾40 years with a diagnosis of COPD or asthma and their GP services utilisation were estimated and linked to the national education database. Multivariate Poisson and logistic regression models were used to explore the variations in GP utilisation. In the population aged ⩾40 years, 2.8% had COPD and 3.8% had asthma according to GPs' diagnoses. COPD was four times more prevalent in patients with basic education than higher education; this increase was ⩽80% for asthma. Consultation rates were 12% higher (P<0.001) for COPD and 25% higher (P<0.001) for asthma in patients with low versus high education in the age group of 40-59 years after adjusting for comorbidity, and patient and GP characteristics. Approximately 25% of COPD patients and 20% of asthma patients had ⩾1 spirometry test in general practice in 2011, with no significant education differences in adjusted models. The higher consultation rate in lower-education groups indicates that GPs contribute to fair distribution of healthcare. PMID:27279354

  17. Increased cancer mortality in diabetic people treated with insulin: a register-based follow-up study

    PubMed Central

    2013-01-01

    Background The national 10-year Development Programme for the Prevention and Care of Diabetes (DEHKO) was launched in Finland in 2000. The program focused on improving early diagnosis of type 2 diabetes and preventing diabetes-related complications. The FinDM database was established for epidemiological monitoring of diabetes and its complications. This study monitors mortality trends among people with diabetes during the DEHKO programme. Methods A database obtained from a compilation of several administrative national health registers was used to study mortality in people with diabetes in 1998–2007. Relative excess mortality between people with and without diabetes was analyzed using Poisson regression models. Results The number of diabetic people in Finland increased by 66% from 1997 reaching 284 832 in 2007. Like among non-diabetic people, all-cause mortality decreased in people with diabetes. Overall excess mortality remained high in people with diabetes; in 2003–2007 RRs in the non-insulin treated was 1.82 for men and 1.95 for women and in the insulin treated 3.45 and 4.29, and excess coronary heart disease mortality in the insulin treated: RR was 4.71 in men and 7.80 in women. A striking result was mortality from neoplasms; an increase in mortality emerged in almost every age group of insulin treated women. Conclusion Compared to non-diabetic people our monitoring showed declining excess mortality in non-insulin treated diabetic people mainly due to a decrease in mortality from cardiovascular diseases. For insulin treated, relative overall excess mortality remained unchanged and mortality from neoplasms increased among women. PMID:23837500

  18. GP utilisation by education level among adults with COPD or asthma: a cross-sectional register-based study

    PubMed Central

    Hetlevik, Øystein; Melbye, Hasse; Gjesdal, Sturla

    2016-01-01

    There is a marked socioeconomic gradient in the prevalence of chronic obstructive pulmonary disease (COPD) and asthma, but a large proportion of patients remain undiagnosed. It is a challenge for general practitioners (GPs) to both identify patients and contribute to equity and high quality in services delivered. The aim of this study was to identify patients with COPD and asthma diagnoses recorded by GPs and explore their utilisation of GP services by education level. This was a cross-sectional, national, register-based study from Norwegian general practice in the period 2009–2011. Based on claims from GPs, the number of patients aged ⩾40 years with a diagnosis of COPD or asthma and their GP services utilisation were estimated and linked to the national education database. Multivariate Poisson and logistic regression models were used to explore the variations in GP utilisation. In the population aged ⩾40 years, 2.8% had COPD and 3.8% had asthma according to GPs’ diagnoses. COPD was four times more prevalent in patients with basic education than higher education; this increase was ⩽80% for asthma. Consultation rates were 12% higher (P<0.001) for COPD and 25% higher (P<0.001) for asthma in patients with low versus high education in the age group of 40–59 years after adjusting for comorbidity, and patient and GP characteristics. Approximately 25% of COPD patients and 20% of asthma patients had ⩾1 spirometry test in general practice in 2011, with no significant education differences in adjusted models. The higher consultation rate in lower-education groups indicates that GPs contribute to fair distribution of healthcare. PMID:27279354

  19. Social inequalities in mental health and mortality among refugees and other immigrants to Sweden – epidemiological studies of register data

    PubMed Central

    Hollander, Anna-Clara

    2013-01-01

    The aim of this PhD project was to increase knowledge, using population-based registers, of how pre- and post-migration factors and social determinants of health are associated with inequalities in poor mental health and mortality among refugees and other immigrants to Sweden. Study I and II had cross-sectional designs and used logistic regression analysis to study differences in poor mental health (measured with prescribed psychotropic drugs purchased) between refugee and non-refugee immigrants. In Study I, there was a significant difference in poor mental health between female refugees and non-refugees (OR=1.27; CI=1.15–1.40) when adjusted for socio-economic factors. In Study II, refugees of most origins had a higher likelihood of poor mental health than non-refugees of the same origin. Study III and IV had cohort designs and used Cox regression analysis. Study III analysed mortality rates among non-labour immigrants. Male refugees had higher relative risks of mortality from cardiovascular disease (HR=1.53; CI=1.04–2.24) and external causes (HR=1.59; CI=1.01–2.50) than male non-refugees did, adjusted for socio-economic factors. Study IV included the population with a strong connection to the labour market in 1999 to analyse the relative risk of hospitalisation due to depressive disorder following unemployment. The lowest relative risk was found among employed Swedish-born men and the highest among foreign-born females who lost employment during follow-up (HR=3.47; CI=3.02–3.98). Immigrants, and particularly refugees, have poorer mental health than native Swedes. Refugee men have a higher relative mortality risk for cardiovascular disease and external causes of death than do non-refugees. The relative risk of hospitalisation due to depressive disorder following unemployment was highest among immigrant women. To promote mental health and reduce mortality among immigrants, it is important to consider pre- and post-migration factors and the general social

  20. Social inequalities in mental health and mortality among refugees and other immigrants to Sweden--epidemiological studies of register data.

    PubMed

    Hollander, Anna-Clara

    2013-01-01

    The aim of this PhD project was to increase knowledge, using population-based registers, of how pre- and post-migration factors and social determinants of health are associated with inequalities in poor mental health and mortality among refugees and other immigrants to Sweden. Study I and II had cross-sectional designs and used logistic regression analysis to study differences in poor mental health (measured with prescribed psychotropic drugs purchased) between refugee and non-refugee immigrants. In Study I, there was a significant difference in poor mental health between female refugees and non-refugees (OR=1.27; CI=1.15-1.40) when adjusted for socio-economic factors. In Study II, refugees of most origins had a higher likelihood of poor mental health than non-refugees of the same origin. Study III and IV had cohort designs and used Cox regression analysis. Study III analysed mortality rates among non-labour immigrants. Male refugees had higher relative risks of mortality from cardiovascular disease (HR=1.53; CI=1.04-2.24) and external causes (HR=1.59; CI=1.01-2.50) than male non-refugees did, adjusted for socio-economic factors. Study IV included the population with a strong connection to the labour market in 1999 to analyse the relative risk of hospitalisation due to depressive disorder following unemployment. The lowest relative risk was found among employed Swedish-born men and the highest among foreign-born females who lost employment during follow-up (HR=3.47; CI=3.02-3.98). Immigrants, and particularly refugees, have poorer mental health than native Swedes. Refugee men have a higher relative mortality risk for cardiovascular disease and external causes of death than do non-refugees. The relative risk of hospitalisation due to depressive disorder following unemployment was highest among immigrant women. To promote mental health and reduce mortality among immigrants, it is important to consider pre- and post-migration factors and the general social

  1. Sickness Absence from Work among Persons with New Physician-Diagnosed Carpal Tunnel Syndrome: A Population-Based Matched-Cohort Study

    PubMed Central

    Atroshi, Isam; Zhou, Caddie; Jöud, Anna; Petersson, Ingemar F.; Englund, Martin

    2015-01-01

    Background Carpal tunnel syndrome is common among employed persons. Data on sickness absence from work in relation to carpal tunnel syndrome have been usually based on self-report and derived from clinical or occupational populations. We aimed to determine sickness absence among persons with physician-diagnosed carpal tunnel syndrome as compared to the general population. Methods In Skåne region in Sweden we identified all subjects, aged 17–57 years, with new physician-made diagnosis of carpal tunnel syndrome during 5 years (2004–2008). For each subject we randomly sampled, from the general population, 4 matched reference subjects without carpal tunnel syndrome; the two cohorts comprised 5456 and 21,667 subjects, respectively (73% women; mean age 43 years). We retrieved social insurance register data on all sickness absence periods longer than 2 weeks from 12 months before to 24 months after diagnosis. Of those with carpal tunnel syndrome 2111 women (53%) and 710 men (48%) underwent surgery within 24 months of diagnosis. We compared all-cause sickness absence and analyzed sickness absence in conjunction with diagnosis and surgery. Results Mean number of all-cause sickness absence days per each 30-day period from 12 months before to 24 months after diagnosis was significantly higher in the carpal tunnel syndrome than in the reference cohort. A new sickness absence period longer than 2 weeks in conjunction with diagnosis was recorded in 12% of the women (n = 492) and 11% of the men (n = 170) and with surgery in 53% (n = 1121) and 58% (n = 408) of the surgically treated, respectively; median duration in conjunction with surgery was 35 days (IQR 27–45) for women and 41 days (IQR 28–50) for men. Conclusions Persons with physician-diagnosed carpal tunnel syndrome have substantially more sickness absence from work than age and sex-matched persons from the general population from1 year before to 2 years after diagnosis. Gender differences were small. PMID:25803841

  2. An ecological study of lactococci isolated from raw milk in the camembert cheese registered designation of origin area.

    PubMed

    Corroler, D; Mangin, I; Desmasures, N; Gueguen, M

    1998-12-01

    The genetic diversity of lactococci isolated from raw milk in the Camembert cheese Registered Designation of Origin area was studied. Two seasonal samples (winter and summer) of raw milk were obtained from six farms in two areas (Bessin and Bocage Falaisien) of Normandy. All of the strains analyzed had a Lactococcus lactis subsp. lactis phenotype, whereas the randomly amplified polymorphic DNA (RAPD) technique genotypically identified the strains as members of L. lactis subsp. lactis or L. lactis subsp. cremoris. The genotypes were confirmed by performing standard PCR with primers corresponding to a region of the histidine biosynthesis operon. The geographic distribution of each subspecies of L. lactis was determined; 80% of the Bocage Falaisien strains were members of L. lactis subsp. lactis, and 30.5% of the Bessin strains were members of L. lactis subsp. lactis. A dendrogram was produced from a computer analysis of the RAPD profiles in order to evaluate the diversity of the lactococci below the subspecies level. The coefficient of similarity for 117 of the 139 strains identified as members of L. lactis subsp. cremoris was as high as 66%. The L. lactis subsp. lactis strains were more heterogeneous and formed 10 separate clusters (the level of similarity among the clusters was 18%). Reference strains of L. lactis subsp. lactis fell into 2 of these 10 clusters, demonstrating that lactococcal isolates are clearly different. As determined by the RAPD profiles, some L. lactis subsp. lactis strains were specific to the farms from which they originated and were recovered throughout the year (in both summer and winter). Therefore, the typicality of L. lactis subsp. lactis strains was linked to the farm of origin rather than the area. These findings emphasize the significance of designation of origin and the specificity of "Camembert de Normandie" cheese. PMID:9835555

  3. Insomnia symptoms and mortality: a register-linked study among women and men from Finland, Norway and Lithuania.

    PubMed

    Lallukka, Tea; Podlipskytė, Aurelija; Sivertsen, Børge; Andruškienė, Jurgita; Varoneckas, Giedrius; Lahelma, Eero; Ursin, Reidun; Tell, Grethe S; Rahkonen, Ossi

    2016-02-01

    Evidence on the association between insomnia symptoms and mortality is limited and inconsistent. This study examined the association between insomnia symptoms and mortality in cohorts from three countries to show common and unique patterns. The Finnish cohort comprised 6605 employees of the City of Helsinki, aged 40-60 years at baseline in 2000-2002. The Norwegian cohort included 6236 participants from Western Norway, aged 40-45 years at baseline in 1997-1999. The Lithuanian cohort comprised 1602 participants from the City of Palanga, aged 35-74 years at baseline in 2003. Mortality data were derived from the Statistics Finland and Norwegian Cause of Death Registry until the end of 2012, and from the Lithuanian Regional Mortality Register until the end of 2013. Insomnia symptoms comprised difficulties initiating sleep, nocturnal awakenings, and waking up too early. Covariates were age, marital status, education, smoking, alcohol, physical inactivity, obesity, diabetes, cardiovascular diseases, depression, shift work, sleep duration, and self-rated health. Cox regression analysis was used. Frequent difficulties initiating sleep were associated with all-cause mortality among men after full adjustments in the Finnish (hazard ratio 2.51; 95% confidence interval 1.07-5.88) and Norwegian (hazard ratio 3.42; 95% confidence interval 1.03-11.35) cohorts. Among women and in Lithuania, insomnia symptoms were not statistically significantly associated with all-cause mortality after adjustments. In conclusion, difficulties initiating sleep were associated with mortality among Norwegian and Finnish men. Variation and heterogeneity in the association between insomnia symptoms and mortality highlights that further research needs to distinguish between men and women, specific symptoms and national contexts, and focus on more chronic insomnia. PMID:26420582

  4. The CCC2000 Birth Cohort Study of Register-Based Family History of Mental Disorders and Psychotic Experiences in Offspring.

    PubMed

    Jeppesen, Pia; Larsen, Janne Tidselbak; Clemmensen, Lars; Munkholm, Anja; Rimvall, Martin Kristian; Rask, Charlotte Ulrikka; van Os, Jim; Petersen, Liselotte; Skovgaard, Anne Mette

    2015-09-01

    Psychotic experiences (PE) in individuals of the general population are hypothesized to mark the early expression of the pathology underlying psychosis. This notion of PE as an intermediate phenotype is based on the premise that PE share genetic liability with psychosis. We examined whether PE in childhood was predicted by a family history of mental disorder with psychosis rather than a family history of nonpsychotic mental disorder and whether this association differed by severity of PE. The study examined data on 1632 children from a general population birth cohort assessed at age 11-12 years by use of a semistructured interview covering 22 psychotic symptoms. The Danish national registers were linked to describe the complete family history of hospital-based psychiatric diagnoses. Uni- and multivariable logistic regressions were used to test whether a family history of any mental disorder with psychosis, or of nonpsychotic mental disorder, vs no diagnoses was associated with increased risk of PE in offspring (hierarchical exposure variable). The occurrence of PE in offspring was significantly associated with a history of psychosis among the first-degree relatives (adjusted relative risk [RR] = 3.29, 95% CI: 1.82-5.93). The risk increased for combined hallucinations and delusions (adjusted RR = 5.90, 95% CI: 2.64-13.16). A history of nonpsychotic mental disorders in first-degree relatives did not contribute to the risk of PE in offspring nor did any mental disorder among second-degree relatives. Our findings support the notion of PE as a vulnerability marker of transdiagnostic psychosis. The effect of psychosis in first-degree relatives may operate through shared genetic and environmental factors. PMID:25452427

  5. Fractures in Individuals with and without a History of Infantile Autism. A Danish Register Study Based on Hospital Discharge Diagnoses

    ERIC Educational Resources Information Center

    Mouridsen, Svend Erik; Rich, Bente; Isager, Torben

    2012-01-01

    We compared the prevalence and types of fractures in a clinical sample of 118 individuals diagnosed as children with infantile autism (IA) with 336 matched controls from the general population. All participants were screened through the nationwide Danish National Hospital Register. The average observation time was 30.3 years (range 27.3-30.4…

  6. What If? Conditionals in Educational Registers

    ERIC Educational Resources Information Center

    Louwerse, Max M.; Crossley, Scott A.; Jeuniaux, Patrick

    2008-01-01

    Many corpus linguistic studies have investigated classification of texts into genres and registers, but relatively few of these studies have looked at linguistic features in educational registers. From a pedagogical perspective it is important to determine whether certain linguistic features behave differently across registers within particular…

  7. Fracture Risk Is Decreased in Women With Polycystic Ovary Syndrome: A Register-Based and Population-Based Cohort Study.

    PubMed

    Rubin, Katrine Hass; Glintborg, Dorte; Nybo, Mads; Andersen, Marianne; Abrahamsen, Bo

    2016-04-01

    Hyperandrogenism, obesity, and hyperinsulinemia may protect against osteoporosis, whereas amenorrhea, increased cortisol, and low growth hormone may be associated with higher fracture risk in polycystic ovary syndrome (PCOS). The objective of this study was to investigate fracture risk in PCOS. In the PCOS Denmark study, women with PCOS and/or hirsutism were identified in the Danish National Patient Register (1995-2012). Each patient was assigned three age-matched controls on the index date of PCOS diagnosis. Individuals with a previous endocrine diagnosis were excluded. Within PCOS Denmark, we embedded a well-characterized subcohort of patients, PCOS OUH, diagnosed with PCOS at Odense University Hospital (n = 1217). We identified incident fractures by International Classification of Diseases, 10th Revision (ICD-10) codes and used conditional Cox regression analyses to compare fracture risk. In the PCOS Denmark study, there were 19,199 women with PCOS and 57,483 controls were included, mean age 30.6 years (range, 12-60 years). Fracture rates were decreased in PCOS Denmark (10.3/1000 patient years) versus controls (13.6/1000 patient years). The adjusted ORs were 0.76 (95% CI, 0.71 to 0.80) for all fractures, 0.82 (95% CI, 0.74 to 0.92) for major osteoporotic fractures, and 0.57 (95% CI, 0.47 to 0.70) for fractures of head and face. The risk reduction was more pronounced below the age of 30 years at diagnosis. Women with PCOS had significant more hospital contacts due to strains and sprains. In the PCOS OUH subcohort, the risk reduction of fractures did not differ between PCOS women with elevated versus normal testosterone levels and the risk reduction was nominally smaller in overweight versus normal weight PCOS women. Women with PCOS had reduced risk of fractures, in particular of the appendicular skeleton. The risk reduction was greater in women with younger age at diagnosis suggesting that the skeletal effects of PCOS may be greater in women who have not yet

  8. Mortality among different occupational groups of workers with pneumoconiosis: results from a register-based cohort study.

    PubMed

    Starzyński, Z; Marek, K; Kujawska, A; Szymczak, W

    1996-12-01

    A mortality cohort study was carried out on 11,224 men with pneumoconiosis diagnosed during the period 1970-1985. The cohort was selected from among subjects entered into the National Register of Occupational Diseases and included 7,065 coal miners, 924 employees of underground work enterprises, 1,796 workers of the metallurgical industry and iron and nonferrous foundries, as well as 1,439 refractory materials, china, ceramics, and quarry workers. The cohort was traced up to the end of 1991. The mortality of all groups enrolled in the study, as compared with that of general male population of Poland, showed a statistically significant excess of overall mortality (SMRs ranging from 105; 95% confidence interval [CI]: 100-110 to 136; CI: 121-153) as well as a great excess of deaths from diseases of the respiratory system (SMRs from 383; 95% CI: 345-424 to 588; 95% CI: 457-744). In workers of the metallurgical industry, foundries, and those from refractory materials, china, and ceramics manufacturing plants as well as quarries, a statistically significant excess of deaths from infectious diseases (mostly tuberculosis) was found (SMRs: 503; 95% CI: 364-677 and 286; 95% CI: 177-437, respectively). Mortality from lung cancer was significantly elevated only in the group of metallurgical industry and iron and nonferrous foundry workers (SMR: 159; 95% CI: 124-201). In the remaining subcohorts, no significant excess of deaths from lung cancer was noted. The study does not support the hypothesis on the role of exposure to crystalline silica in the induction of lung cancer. Significantly lower mortality was seen for diseases of the circulatory system (SMR: 89; 95% CI: 82-96), hypertensive disease (SMR: 63; 95% CI: 38-98), cerebrovascular disease (SMR: 79; 95% CI: 62-99), atherosclerosis (SMR: 79; 95% CI: 66-93), and injuries and poisonings (SMR: 50; 95% CI: 38-64) in coal miners. In addition, lower mortality was noted for cerebrovascular disease (SMR: 56; 95% CI: 32-91) and

  9. Usage of a self-adhesive mesh in TAPP hernia repair: A prospective study based on Herniamed Register

    PubMed Central

    Klobusicky, Pavol; Feyerherd, Peter

    2016-01-01

    INTRODUCTION: Inguinal hernia repair is one of the most frequently performed surgical procedures worldwide in general surgery. The transabdominal laparoscopic (TAPP) approach in the therapy of inguinal hernia seems to be a suitable alternative to classical open inguinal hernia repair mainly in the hands of an experienced surgeon. TAPP repair offers the possibility of gentle dissection with implantation of the mesh and the possibility of non-invasive fixation of the implanted mesh. MATERIALS AND METHODS: Data analysis encompassed all patients who underwent inguinal hernia surgery at our Surgical Department within the period from July 1, 2012 to September 30, 2014 and who fulfilled the inclusion criteria. The standard surgical technique was used. Data were entered and subsequently analysed on the Herniamed platform. Herniamed is an Internet-based register in German and English, and includes all data of outpatient and hospitalised patients who underwent surgery for some type of hernia. All relevant patient data are collected via Internet. RESULTS: There were 241 patients enrolled in the group and there were 396 inguinal hernias repaired in total. Standard long-term follow-up after 12 months was evaluated in 205 patients (85.06%), and in the rest of the patients during the closing of the study, but at least 6 months after operation. The mean follow-up was at 19.69 months. At the 1-year assessment, mild discomfort was reported in the groin in 10 patients (4.88%) [1-3 on the visual analogue scale (VAS)]. Post-operative pain lasting over 12 months in the groin of moderate degree (4-6 VAS) was reported in two cases (0.97%). There was no recurrence and no chronic post-operative pain of severe degree reported. CONCLUSION: Our study demonstrates that laparoscopic inguinal hernia repair using the TAPP technique with the implantation of a self-fixation mesh is fast, effective, reliable and economically advantageous method in experienced hands and, according to our results

  10. Sick Leave within 5 Years of Whiplash Trauma Predicts Recovery: A Prospective Cohort and Register-Based Study

    PubMed Central

    Carstensen, Tina Birgitte Wisbech; Fink, Per; Oernboel, Eva; Kasch, Helge; Jensen, Troels Staehelin; Frostholm, Lisbeth

    2015-01-01

    Background 10–22% of individuals sustaining whiplash trauma develop persistent symptoms resulting in reduced working ability and decreased quality of life, but it is poorly understood why some people do not recover. Various collision and post-collision risk factors have been studied, but little is known about pre-collision risk factors. In particular, the impact of sickness and socioeconomic factors before the collision on recovery is sparsely explored. The aim of this study was to examine if welfare payments received within five years pre-collision predict neck pain and negative change in provisional situation one year post-collision. Methods and Findings 719 individuals with acute whiplash trauma consecutively recruited from emergency departments or primary care after car accidents in Denmark completed questionnaires on socio-demographic and health factors immediately after the collision. After 12 months, a visual analogue scale on neck pain intensity was completed. 3595 matched controls in the general population were sampled, and national public register data on social benefits and any other welfare payments were obtained for participants with acute whiplash trauma and controls from five years pre-collision to 15 months after. Participants with acute whiplash trauma who had received sickness benefit for more than 12 weeks pre-collision had increased odds for negative change in future provisional situation (Odds Ratio (OR) (95% Confidence Interval (CI) = 3.8 (2.1;7.1)) and future neck pain (OR (95%CI) = 3.3 (1.8;6.3)), controlling for other known risk factors. Participants with acute whiplash trauma had weaker attachment to labour market (more weeks of sick leave (χ2(2) = 36.7, p < 0.001) and unemployment (χ2(2) = 12.5, p = 0.002)) pre-collision compared with controls. Experiencing a whiplash trauma raised the odds for future negative change in provisional situation (OR (95%CI) = 3.1 (2.3;4.4)) compared with controls. Conclusions Sick leave before the

  11. Does the socioeconomic context explain both mortality and income inequality? Prospective register-based study of Norwegian regions

    PubMed Central

    2011-01-01

    Background Studies from various countries have observed worse population health in geographical areas with more income inequality. The psychosocial interpretation of this association is that large income disparities are harmful to health because they generate relative deprivation and undermine social cohesion. An alternative explanation contends that the association between income inequality and ill health arises because the underlying social and economic structures will influence both the level of illness and disease and the size of income differences. This paper examines whether the observed association between mortality and income inequality in Norwegian regions can be accounted for by the socioeconomic characteristics of the regions. Methods Norwegian register data covering the entire population were utilised. An extensive set of contextual and individual predictors were included in multilevel Poisson regression analyses of mortality 1994-2003 among 1.6 millions individuals born 1929-63, distributed across 35 residential regions. Results Mean income, composition of economic branches, and percentage highly educated in the regions were clearly connected to the level of income inequality. These social and economic characteristics of the regions were also markedly related to regional mortality levels, after adjustment for population composition, i.e., the individual-level variables. Moreover, regional mortality was significantly higher in regions with larger income disparities. The regions' social and economic structure did not, however, account for the association between regional income inequality and mortality. A distinct independent effect of income inequality on mortality remained after adjustment for regional-level social and economic characteristics. Conclusions The results indicate that the broader socioeconomic context in Norwegian regions has a substantial impact both on mortality and on the level of income disparities. However, the results also suggest

  12. Association between registered nurse staffing and management outcomes of patients with type 2 diabetes within primary care: a cross-sectional linkage study

    PubMed Central

    Lukewich, Julia; Edge, Dana S.; VanDenKerkhof, Elizabeth; Williamson, Tyler; Tranmer, Joan

    2016-01-01

    Background: As the organization of primary care continues to evolve toward more interdisciplinary team structures, demonstrating effectiveness of care delivery is becoming important, particularly for nonphysician providers. Nurses are the most common nonphysician provider within primary care. The purpose of this study was to examine the relation between primary care delivery models that incorporate registered nurses and clinical outcomes of patients with type 2 diabetes. Methods: Patient data from the Canadian Primary Care Sentinel Surveillance Network were matched with survey data from 15 Family Health Team practices in southeastern Ontario. Included patients were adults with type 2 diabetes mellitus who had at least 1 primary care encounter at a Family Health Team practice that completed the organizational survey between Apr. 1, 2013, and Mar. 31, 2014. The clinical outcomes explored included hemoglobin A1c, fasting plasma glucose, blood pressure, low-density lipoprotein cholesterol and urine albumin:creatinine ratio. Results: Of the 15 practices, 13 (86.7%) had at least 1 registered nurse. The presence of 1 or more registered nurses in the practice was associated with increased odds of patients' having their hemoglobin A1c, fasting plasma glucose, blood pressure and low-density lipoprotein cholesterol values meet recommended targets. Practices with the lowest ratios of patients with diabetes to registered nurse had a significantly greater proportion of patients with hemoglobin A1c and fasting plasma glucose values on target than did practices with the highest ratios of patients to registered nurse (p < 0.01 and p = 0.03, respectively). Interpretation: The findings suggest that registered nurse staffing within primary care practice teams contributes to better diabetic care, as measured by diabetes management indicators. This study sets the groundwork for further exploration of nursing and organizational contributions to patient care in the primary care setting

  13. Practice Leadership at the Front Line in Supporting People with Intellectual Disabilities and Challenging Behaviour: A Qualitative Study of Registered Managers of Community-Based, Staffed Group Homes

    ERIC Educational Resources Information Center

    Deveau, Roy; McGill, Peter

    2016-01-01

    Background: The front-line management role in services for people with intellectual disabilities remains rather under-researched. The aim of this study was to examine the experiences of registered managers in services for adults with intellectual disability who exhibit challenging behaviour. Method: Interviews, primarily focussed upon staff…

  14. Sick Leave and Work Participation among Parents of Children with Autism Spectrum Disorder in the Stockholm Youth Cohort: A Register Linkage Study in Stockholm, Sweden

    ERIC Educational Resources Information Center

    McEvilly, Miranda; Wicks, Susanne; Dalman, Christina

    2015-01-01

    This population-based register study explored the association between having a child with/without autism spectrum disorder (ASD) and parental sick leave and work participation. Parents of children with ASD living in Stockholm, Sweden in 2006 were more likely to be on sick leave, not in the labor force, or earning low income when compared to…

  15. What factors influence people's decisions to register for organ donation? The results of a nominal group study.

    PubMed

    Irving, Michelle J; Jan, Stephen; Tong, Allison; Wong, Germaine; Craig, Jonathan C; Chadban, Steven; Rose, John; Cass, Alan; Allen, Richard D; Howard, Kirsten

    2014-06-01

    Rates of transplantation from deceased donors remain low, despite high rates of expressed support. We aimed to better understand this mismatch through determining community attitudes regarding willingness to register as organ donors. Participants were recruited from the general public in four Australian states. Using nominal group techniques, participants ranked factors they believed were important when deciding to register as a deceased donor. Thirteen nominal groups with 114 participants were conducted. 24 factors were ranked by three or more groups. The top ten factors were as follows: saving lives, own decision to donate, family opinions, benefit to recipients, process of organ donation, positive media, positive closure, clarity of consent and body dignity. Other factors included: the consent system, religious and cultural beliefs and incentives for donation. Participant age was a potential modifier of responses. Willingness to register as an organ donor is highly influenced by the altruistic motive of saving lives and improving lives for others; this should be harnessed in communication campaigns. Further research on ethical incentives for organ donation and continued efforts to promote support from religious groups may be useful. Many believe the sole right to consent to donation is theirs and not their families; consent policies reflecting this should be explored. PMID:24617320

  16. On Vocal Registers.

    ERIC Educational Resources Information Center

    Hollien, Harry

    A vocal register is a series or range of consecutive frequencies that can be produced with nearly identical voice quality. On the basis of research three fundamental registers can be defined and described: pulse, a low range of phonation; modal, a middle or "normal" range; and loft, a high range, described by some as falsetto. These three…

  17. Registered Nurse (Associate Degree).

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. Center on Education and Training for Employment.

    This document, which is designed for use in developing a tech prep competency profile for the occupation of registered nurse (with an associate degree), lists technical competencies and competency builders for 19 units pertinent to the health technologies cluster in general and 5 units specific to the occupation of registered nurse. The following…

  18. Cesarean Section and Rate of Subsequent Stillbirth, Miscarriage, and Ectopic Pregnancy: A Danish Register-Based Cohort Study

    PubMed Central

    O'Neill, Sinéad M.; Agerbo, Esben; Kenny, Louise C.; Henriksen, Tine B.; Kearney, Patricia M.; Greene, Richard A.; Mortensen, Preben Bo; Khashan, Ali S.

    2014-01-01

    Background With cesarean section rates increasing worldwide, clarity regarding negative effects is essential. This study aimed to investigate the rate of subsequent stillbirth, miscarriage, and ectopic pregnancy following primary cesarean section, controlling for confounding by indication. Methods and Findings We performed a population-based cohort study using Danish national registry data linking various registers. The cohort included primiparous women with a live birth between January 1, 1982, and December 31, 2010 (n = 832,996), with follow-up until the next event (stillbirth, miscarriage, or ectopic pregnancy) or censoring by live birth, death, emigration, or study end. Cox regression models for all types of cesarean sections, sub-group analyses by type of cesarean, and competing risks analyses for the causes of stillbirth were performed. An increased rate of stillbirth (hazard ratio [HR] 1.14, 95% CI 1.01, 1.28) was found in women with primary cesarean section compared to spontaneous vaginal delivery, giving a theoretical absolute risk increase (ARI) of 0.03% for stillbirth, and a number needed to harm (NNH) of 3,333 women. Analyses by type of cesarean section showed similarly increased rates for emergency (HR 1.15, 95% CI 1.01, 1.31) and elective cesarean (HR 1.11, 95% CI 0.91, 1.35), although not statistically significant in the latter case. An increased rate of ectopic pregnancy was found among women with primary cesarean overall (HR 1.09, 95% CI 1.04, 1.15) and by type (emergency cesarean, HR 1.09, 95% CI 1.03, 1.15, and elective cesarean, HR 1.12, 95% CI 1.03, 1.21), yielding an ARI of 0.1% and a NNH of 1,000 women for ectopic pregnancy. No increased rate of miscarriage was found among women with primary cesarean, with maternally requested cesarean section associated with a decreased rate of miscarriage (HR 0.72, 95% CI 0.60, 0.85). Limitations include incomplete data on maternal body mass index, maternal smoking, fertility treatment, causes of

  19. An EEG-fMRI Study on the Termination of Generalized Spike-And-Wave Discharges in Absence Epilepsy

    PubMed Central

    Benuzzi, Francesca; Ballotta, Daniela; Mirandola, Laura; Ruggieri, Andrea; Vaudano, Anna Elisabetta; Zucchelli, Micaela; Ferrari, Elisabetta; Nichelli, Paolo Frigio; Meletti, Stefano

    2015-01-01

    Introduction Different studies have investigated by means of EEG-fMRI coregistration the brain networks related to generalized spike-and-wave discharges (GSWD) in patients with idiopathic generalized epilepsy (IGE). These studies revealed a widespread GSWD-related neural network that involves the thalamus and regions of the default mode network. In this study we investigated which brain regions are critically involved in the termination of absence seizures (AS) in a group of IGE patients. Methods Eighteen patients (6 male; mean age 25 years) with AS were included in the EEG-fMRI study. Functional data were acquired at 3T with continuous simultaneous video-EEG recording. Event-related analysis was performed with SPM8 software, using the following regressors: (1) GSWD onset and duration; (2) GSWD offset. Data were analyzed at single-subject and at group level with a second level random effect analysis. Results A mean of 17 events for patient was recorded (mean duration of 4.2 sec). Group-level analysis related to GSWD onset respect to rest confirmed previous findings revealing thalamic activation and a precuneus/posterior cingulate deactivation. At GSWD termination we observed a decrease in BOLD signal over the bilateral dorsolateral frontal cortex respect to the baseline (and respect to GSWD onset). The contrast GSWD offset versus onset showed a BOLD signal increase over the precuneus-posterior cingulate region bilaterally. Parametric correlations between electro-clinical variables and BOLD signal at GSWD offset did not reveal significant effects. Conclusion The role of the decreased neural activity of lateral prefrontal cortex at GSWD termination deserve future investigations to ascertain if it has a role in promoting the discharge offset, as well as in the determination of the cognitive deficits often present in patients with AS. The increased BOLD signal at precuneal/posterior cingulate cortex might reflect the recovery of neural activity in regions that are

  20. Factors Associated with Long-Term Sickness Absence Due to Mental Disorders: A Cohort Study of 7.112 Patients during the Spanish Economic Crisis

    PubMed Central

    Real, Eva; Jover, Lluís; Verdaguer, Ricard; Griera, Antoni; Segalàs, Cinto; Alonso, Pino; Contreras, Fernando; Arteman, Antoni; Menchón, José M.

    2016-01-01

    Background Mental health problems are very common and often lead to prolonged sickness absence, having serious economic repercussions for most European countries. Periods of economic crisis are important social phenomena that are assumed to increase sickness absence due to mental disorders, although research on this topic remains scarce. The aim of this study was to gather data on long-term sickness absence (and relapse) due to mental disorders in Spain during a period of considerable socio-economic crisis. Methods Relationships were analyzed (using chi-squared tests and multivariate modelling via binary logistic regression) between clinical, social/employment-related and demographic factors associated and long-term sickness absence (>60 consecutive days) due to mental disorders in a cohort of 7112 Spanish patients during the period 2008–2012. Results Older age, severe mental disorders, being self-employed, having a non-permanent contract, and working in the real estate and construction sector were associated with an increased probability of long-term sickness absence (gender had a mediating role with respect to some of these variables). Relapses were associated with short-term sick leave (return to work due to ‘improvement’) and with working in the transport sector and public administration. Conclusions Aside from medical factors, other social/employment-related and demographic factors have a significant influence on the duration of sickness absence due to mental disorders. PMID:26730603

  1. Acute non-ambulatory tetraparesis with absence of the dens in two large breed dogs: case reports with a radiographic study of relatives

    PubMed Central

    2013-01-01

    Background Non-ambulatory tetraparesis with an absence of the dens of C2 (axis) has not previously been reported in large breed dogs. An absence or hypoplasia of the dens has been reported in both small, medium and large breed dogs, but not in closely related animals. Methods Two young large-breed dogs (a German shepherd and a Standard poodle) both with an acute onset of non-ambulatory tetraparesis were subjected to physical, neurological and radiographic examinations. Both dogs were euthanased and submitted for postmortem examination within one week of onset of clinical signs. To investigate possible heritability of dens abnormalities, oblique radiographs of the cranial cervical vertebrae were taken of nine and eighteen dogs related to the German shepherd and the Standard poodle, respectively. Results Absence of the dens, atlantoaxial instability and extensive spinal cord injury was found in both case dogs. Radiographs revealed a normal dens in both parents and in the seven littermates of the German shepherd. An absence or hypoplasia of the dens was diagnosed in six relatives of the Standard poodle. Conclusions Atlantoaxial subluxation with cervical spinal cord injury should be considered as a differential diagnosis in non-ambulatory tetraparetic young large breed dogs. Absence of the dens and no history of external trauma increase the likelihood for this diagnosis. This study provides evidence to suggest that absence or hypoplasia of the dens is inherited in an autosomal way in Standard poodle dogs. PMID:23591104

  2. No Evidence of the Ego-Depletion Effect across Task Characteristics and Individual Differences: A Pre-Registered Study.

    PubMed

    Lurquin, John H; Michaelson, Laura E; Barker, Jane E; Gustavson, Daniel E; von Bastian, Claudia C; Carruth, Nicholas P; Miyake, Akira

    2016-01-01

    Ego-depletion, a psychological phenomenon in which participants are less able to engage in self-control after prior exertion of self-control, has become widely popular in the scientific community as well as in the media. However, considerable debate exists among researchers as to the nature of the ego-depletion effect, and growing evidence suggests the effect may not be as strong or robust as the extant literature suggests. We examined the robustness of the ego-depletion effect and aimed to maximize the likelihood of detecting the effect by using one of the most widely used depletion tasks (video-viewing attention control task) and by considering task characteristics and individual differences that potentially moderate the effect. We also sought to make our research plan transparent by pre-registering our hypotheses, procedure, and planned analyses prior to data collection. Contrary to the ego-depletion hypothesis, participants in the depletion condition did not perform worse than control participants on the subsequent self-control task, even after considering moderator variables. These findings add to a growing body of evidence suggesting ego-depletion is not a reliable phenomenon, though more research is needed that uses large sample sizes, considers moderator variables, and pre-registers prior to data collection. PMID:26863227

  3. No Evidence of the Ego-Depletion Effect across Task Characteristics and Individual Differences: A Pre-Registered Study

    PubMed Central

    Lurquin, John H.; Michaelson, Laura E.; Barker, Jane E.; Gustavson, Daniel E.; von Bastian, Claudia C.; Carruth, Nicholas P.; Miyake, Akira

    2016-01-01

    Ego-depletion, a psychological phenomenon in which participants are less able to engage in self-control after prior exertion of self-control, has become widely popular in the scientific community as well as in the media. However, considerable debate exists among researchers as to the nature of the ego-depletion effect, and growing evidence suggests the effect may not be as strong or robust as the extant literature suggests. We examined the robustness of the ego-depletion effect and aimed to maximize the likelihood of detecting the effect by using one of the most widely used depletion tasks (video-viewing attention control task) and by considering task characteristics and individual differences that potentially moderate the effect. We also sought to make our research plan transparent by pre-registering our hypotheses, procedure, and planned analyses prior to data collection. Contrary to the ego-depletion hypothesis, participants in the depletion condition did not perform worse than control participants on the subsequent self-control task, even after considering moderator variables. These findings add to a growing body of evidence suggesting ego-depletion is not a reliable phenomenon, though more research is needed that uses large sample sizes, considers moderator variables, and pre-registers prior to data collection. PMID:26863227

  4. The mental health effects of multiple work and family demands : A prospective study of psychiatric sickness absence in the French GAZEL study

    PubMed Central

    Melchior, Maria; Berkman, Lisa; Niedhammer, Isabelle; Zins, Marie; Goldberg, Marcel

    2007-01-01

    Background Individuals who experience work stress or heavy family demands are at elevated risk of poor mental health. Yet, the cumulative effects of multiple work and family demands are not well known, particularly in men. Methods We studied the association between multiple work and family demands and sickness absence due to non-psychotic psychiatric disorders in a longitudinal study conducted among members of the French GAZEL cohort study (8869 men, 2671 women) over a period of 9 years (1995–2003). Work stress and family demands were measured by questionnaire. Medically-certified psychiatric sickness absence data were obtained directly from the employer. Rate ratios (RRs) of sickness absence were calculated using Poisson regression models, adjusting for age, marital status, social support, stressful life events, alcohol consumption, body mass and depressive symptoms at baseline. Results Participants simultaneously exposed to high levels of work and family demands (>=2 work stress factors and >=4 dependents) had significantly higher rates of sickness absence due to non-psychotic psychiatric disorders than participants with lower levels of demands (compared to participants exposed to 0–1 work stress factors and with 1–3 dependents, age-adjusted rate ratios were 2.37 (95% CI 1.02–5.52) in men and 6.36 (95% CI 3.38–11.94) in women. After adjusting for baseline socio-demographic, behavioral and health characteristics, these RRs were respectively reduced to 1.82 (95% CI 0.86–3.87) in men, 5.04 (95% CI 2.84–8.90) in women. The effect of multiple work and family demands was strongest for sickness absence due to depression : age-adjusted RRs among participants with the highest level of work and family demands were 4.70 (1.96–11.24) in men, 8.57 (4.26–17.22) in women; fully-adjusted RRs: 3.55 (95% CI 1.62–7.77) in men, 6.58 (95% CI 3.46–12.50) in women. Conclusions Men and women simultaneously exposed to high levels of work stress and family demands

  5. River discharge estimation by using remote sensing data in absence of bathymetry: the Po River case study

    NASA Astrophysics Data System (ADS)

    Tarpanelli, Angelica; Barbetta, Silvia; Brocca, Luca; Lacava, Teodosio; Faruolo, Mariapia; Moramarco, Tommaso

    2014-05-01

    River discharge is an important quantity of the hydrologic cycle and it is essential for both scientific and operational applications related to water resources management and flood risk prevention. The absence of flow measurements along the natural channels and, sometimes, their poor accessibility, contribute to make difficult the discharge estimation. In recent years, also thanks to the increased availability of remote sensing data, the great potential of satellite sensors for discharge estimation has been already demonstrated. In particular, recent advances in radar altimetry technology have improved the accuracy in the water levels monitoring of both large rivers and lakes located in ungauged or poorly gauged inland regions. However, the remote sensing based technologies cannot observe river channel bathymetry below the water surface, limiting their value for estimating river depth and/or discharge. This study focuses on the estimation of discharge by coupling information coming from Moderate Resolution Imaging Spectroradiometer (MODIS) and radar altimetry and by using the entropy theory for simulating the river channel bathymetry. Specifically, the MODIS-derived velocity is obtained by exploiting the different behavior of water and land in the Near Infrared (NIR) portion of the electromagnetic spectrum (MODIS channel 2). The ratio of reflectance values between two pixels located within and outside the river increases with the presence of the water and, hence, with flow velocity. The flow area is then assessed considering the dataset of water surface elevation derived by radar altimetry and the maximum flow velocity derived by MODIS images. Based on the dataset, an optimization method for estimating the lowest river bottom level is applied and the cross-section flow area is assessed considering the bathymetry simulated by maximization of entropy. The procedure is tested by comparing in-situ and satellite-derived discharge data for a gauged river site along the

  6. Molecular Electronic Shift Registers

    NASA Technical Reports Server (NTRS)

    Beratan, David N.; Onuchic, Jose N.

    1990-01-01

    Molecular-scale shift registers eventually constructed as parts of high-density integrated memory circuits. In principle, variety of organic molecules makes possible large number of different configurations and modes of operation for such shift-register devices. Several classes of devices and implementations in some specific types of molecules proposed. All based on transfer of electrons or holes along chains of repeating molecular units.

  7. Absence of adverse events in healthy individuals using probiotics - analysis of six randomised studies by one study group.

    PubMed

    Tapiovaara, L; Lehtoranta, L; Poussa, T; Mäkivuokko, H; Korpela, R; Pitkäranta, A

    2016-03-11

    Consumption of live bacteria as probiotic supplements is increasing. There is, however, a lack of information on the safety of ingested probiotics. The main objective of this study was to investigate the adverse events (AEs) of specific probiotics (Lactobacillus rhamnosus GG (LGG) alone or LGG in combination with L. rhamnosus Lc705, Propionibacterium freudenreichii JS, Bifidobacterium lactis BB12, or Bifidobacterium breve 99) studied in six of our study groups' clinical trials, by analysing individual participant data. A secondary objective was to study AEs associated with the consumed probiotic species and mixtures in three specific categories; 'gastrointestinal disorders', 'respiratory, thoracic and mediastinal disorders' and 'infections and infestations'. Six randomised, double-blind, placebo-controlled clinical studies by our study group were included in this AE analysis (study population n=1,909). All AE data were classified according to the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE) v4.0. From the 26 CTCAE System Organ Classes, we identified AEs in 20 classes among 1,909 subjects. Probiotic ingestion did not result in statistically significant differences in AEs in different groups, when compared to placebo. A subgroup analysis of gastrointestinal, respiratory, thoracic and mediastinal disorders, infections and infestations, found no differences between the intervention groups or for different probiotic combinations (risk ratio (RR) = 0.97, 95% confidence interval (CI): 0.93-1.02, P=0.30; RR=0.99, 95% CI: 0.97-1.01, P=0.35; RR=0.99, 95% CI: 0.93-1.06, P=0.62, respectively). As a conclusion, ingestion of probiotic supplementations containing LGG alone, or LGG in combination with L. rhamnosus Lc705, P. freudenreichii JS, B. breve 99, or B. lactis BB12 did not seem to cause AEs in young and elderly subjects in this analysis. PMID:26689224

  8. Preterm and postterm birth in immigrant- and Swedish-born parents: a population register-based study.

    PubMed

    Khanolkar, Amal R; Wedrén, Sara; Essén, Birgitta; Sparén, Pär; Koupil, Ilona

    2015-05-01

    Ethnic minorities/immigrant groups tend to have increased risk for preterm birth. Less is known about this risk in diverse immigrant groups, couples of mixed ethnic-origin and in relation to duration of residence. Data from the Swedish Medical Birth Register on 1,028,303 mothers who gave birth to 1,766,026 singleton live born infants (1982-2002), was linked to the Education and Total Population Registers. Immigrant parents were identified by country of birth. Risk of early preterm, late preterm and postterm birth was analyzed using multinomial logistic regression. Polish, Yugoslavian, Iranian, South Asian, East Asian and Sub-Saharan African parents, Swedish mothers who had children with non-Swedish fathers, and parents from two different immigrant groups had higher risk of early preterm birth [adjusted relative risk (RR) (95% CI) 1.76 (1.24-2.50), 1.57 (1.31-1.87), 1.67 (1.30-2.14), 1.52 (1.07-2.16), 1.51 (1.08-2.10), 2.03 (1.32-3.12), 1.56 (1.45-1.67), and 1.55 (1.35-1.77) respectively] compared to Swedish-born parents. South Asian, Sub-Saharan African, and East Asian immigrants had a higher risk of late preterm birth compared to Swedish-born parents. North African and Middle Eastern, Somali, and Ethiopian/Eritrean groups had increased risk of postterm birth [adjusted RR 1.31 (1.16-1.47), 2.57 (2.31-2.86), 1.85 (1.67-2.04) respectively]. Adjustment for covariates did not substantially change associations. Immigrant mothers resident <3 years had higher risk for early preterm and postterm birth compared to residents >10 years [adjusted RR 1.46 (1.24-1.71) and 1.16 (1.11-1.23) respectively]. In addition to higher risk of preterm birth in select immigrant groups, some immigrant groups are also at higher risk of postterm birth. Shorter duration of residence is associated with higher risk of non-term deliveries. PMID:25687167

  9. Registered nurse, healthcare support worker, medical staffing levels and mortality in English hospital trusts: a cross-sectional study

    PubMed Central

    Griffiths, Peter; Ball, Jane; Murrells, Trevor; Jones, Simon; Rafferty, Anne Marie

    2016-01-01

    Objectives To examine associations between mortality and registered nurse (RN) staffing in English hospital trusts taking account of medical and healthcare support worker (HCSW) staffing. Setting Secondary care provided in acute hospital National Health Service (NHS) trusts in England. Participants Two data sets are examined: Administrative data from 137 NHS acute hospital trusts (staffing measured as beds per staff member). A cross-sectional survey of 2917 registered nurses in a subsample of 31 trusts (measured patients per ward nurse). Outcome measure Risk-adjusted mortality rates for adult patients (administrative data). Results For medical admissions, higher mortality was associated with more occupied beds per RN (RR 1.22, 95% CI 1.04 to 1.43, p=0.02) and per doctor (RR 1.10, 95% CI 1.05 to 1.15, p <0.01) employed by the trust whereas, lower HCSW staffing was associated with lower mortality (RR 0.95, 95% CI 0.91 to 1.00, p=0.04). In multivariable models the relationship was statistically significant for doctors (RR 1.08, 95% CI 1.02 to 1.15, p=0.02) and HCSWs (RR 0.93, 95% CI 0.89 to 0.98, p<01) but not RNs (RR 1.14, 95% CI 0.95 to 1.38, p=0.17). Trusts with an average of ≤6 patients per RN in medical wards had a 20% lower mortality rate compared to trusts with >10 patients per nurse (RR 0.80, 95% CI 0.76 to 0.85, p<0.01). The relationship remained significant in the multivariable model (RR 0.89, 95% CI 0.83 to 0.95, p<0.01). Results for surgical wards/admissions followed a similar pattern but with fewer significant results. Conclusions Ward-based RN staffing is significantly associated with reduced mortality for medical patients. There is little evidence for beneficial associations with HCSW staffing. Higher doctor staffing levels is associated with reduced mortality. The estimated association between RN staffing and mortality changes when medical and HCSW staffing is considered and depending on whether ward or trust wide staffing levels are considered. PMID

  10. The characteristics of suicides within a week of discharge after psychiatric hospitalisation – a nationwide register study

    PubMed Central

    Pirkola, Sami; Sohlman, Britta; Wahlbeck, Kristian

    2005-01-01

    Background The characteristics of victims of immediate post-discharge suicides are not well known. We explored these characteristics for the purposes of better recognition and preventive efforts of potential immediate post-discharge suicides. Methods Suicides from a Finnish nationwide register were linked with preceding periods of psychiatric inpatient treatment. Characteristics of suicides within a week of discharge were compared to those occurring later after discharge. Results Compared to other previously hospitalised suicide victims, those committing suicide within a week of discharge were more often female, unmarried, had a higher grade of education and a diagnosis of schizophrenia spectrum or affective disorder, tended to use more drowning and jumping from heights as the methods for suicide and had gained a smaller improvement in psychological functioning during hospitalization. Conclusion These characteristics indicate a more severe psychopathology, relatively poorer level of functioning, less global response to hospitalisation, and a more frequent choice of lethal and easily available method for suicide. Potentially suicidal psychiatric patients should be better recognized and an immediate follow-up arranged if it is decided they be discharged. PMID:16120228

  11. [Multiple sclerosis: study of patients with relapsing-remitting form registered at Minas Gerais Secretary of State for Health].

    PubMed

    Santos, Eustáquio Claret dos; Yokota, Mitico; Dias, Nádia Fernanda Rezende

    2007-09-01

    Multiple sclerosis is a chronic inflammatory demyelinating disease of the central nervous system. The recommended treatment for the relapsing-remitting form is carried out with the immunomodulatory drugs, which are provided, in Belo Horizonte, by Minas Gerais Secretary of State for Health (MG/SSH). We analyzed data of 283 patients registered at Exceptional Drug Program (immunomodulators) of SES/MG from May to October 2004. There was predominance of females (3.7:1) and the mean age was 38.4 +/-10.7 years old. The first clinical manifestations were 29.7+/-10.2 years old. The initial symptoms included sensorial (46.4%), visual (33.1%), brainstem/cerebellar syndromes (30.1%) and motor (pyramidal) syndrome (25.9%). The symptoms observed in subsequent relapses were motor (22.3%), brainstem/cerebellar syndromes (18.9%), visual (18.9%) and sensorial findings (9.6%). In 234 brain MRI and 109 spine MRI there were demyelinating lesions at 97.4% and 85.3% respectively. We compared our findings with other series described on Brazilian literature. PMID:17952303

  12. Early coordinated multidisciplinary intervention to prevent sickness absence and labour market exclusion in patients with low back pain: study protocol of a randomized controlled trial

    PubMed Central

    2013-01-01

    recommendations in CONSORT-statement in designing and reporting RCTs. Discussion This large RCT is testing the effectiveness of a preventive intervention targeting patients on short term sick leave or at risk being sick listed because of low back pain. We have developed a novel multidisciplinary team structure using the treating physiotherapist as the return to work coordinator, and having the case manager from the municipal sickness benefit office participating in team meetings. The study has the potential to contribute to the knowledge about how to target the challenges in the treatment of LBP. The aim is to prevent sickness absence and labour market exclusion - both on the individual level and economic costs at community level. Short term results will be available in 2014. This study is approved by the Danish Regional Ethics Committee (J.nr: H-C-2008-112) and is registered at. Trial registration ClinicalTrials.gov: NCT01690234 PMID:23496897

  13. The impact of effort-reward imbalance and learning motivation on teachers' sickness absence.

    PubMed

    Derycke, Hanne; Vlerick, Peter; Van de Ven, Bart; Rots, Isabel; Clays, Els

    2013-02-01

    The aim of this study was to analyse the impact of the effort-reward imbalance and learning motivation on sickness absence duration and sickness absence frequency among beginning teachers in Flanders (Belgium). A total of 603 teachers, who recently graduated, participated in this study. Effort-reward imbalance and learning motivation were assessed by means of self-administered questionnaires. Prospective data of registered sickness absence during 12 months follow-up were collected. Multivariate logistic regression analyses were performed. An imbalance between high efforts and low rewards (extrinsic hypothesis) was associated with longer sickness absence duration and more frequent absences. A low level of learning motivation (intrinsic hypothesis) was not associated with longer sickness absence duration but was significantly positively associated with sickness absence frequency. No significant results were obtained for the interaction hypothesis between imbalance and learning motivation. Further research is needed to deepen our understanding of the impact of psychosocial work conditions and personal resources on both sickness absence duration and frequency. Specifically, attention could be given to optimizing or reducing efforts spent at work, increasing rewards and stimulating learning motivation to influence sickness absence. PMID:22337584

  14. Distribution of lymphomas in Poland according to World Health Organization classification: analysis of 11718 cases from National Histopathological Lymphoma Register project - the Polish Lymphoma Research Group study

    PubMed Central

    Szumera-Ciećkiewicz, Anan; Gałązka, K; Szpor, J; Rymkiewicz, G; Jesionek-Kupnicka, D; Gruchała, A; Ziarkiewicz-Wróblewska, B; Poniatowska-Broniek, G; Demczuk, S; Prochorec-Sobieszek, M

    2014-01-01

    Most national lymphoma registers rely on broad classifications which include Hodgkin and non-Hodgkin lymphomas (NHL), multiple myeloma and leukaemia. In Poland the National Histopathological Lymphoma Register project (NHLR) was implemented by hematopathologists in accordance with the 2008 WHO classification into haematopoietic and lymphoid tissues. We present the NHLR data and compare lymphoma distribution in Poland, Europe, as well as in North Central and South America. Records of 11718 patients diagnosed in 24 pathology departments from all over the country were retrieved and reclassified into indolent and aggressive lymphomas according to the 2008 revised WHO classification system. DLBCL (32.9%; 2587), CLL/SLL (31.84%; 2504) and MCL (9.04%; 711) were the three most frequent NHL. The ratio of indolent to aggressive NHL was 1.72; 63.25% (4809) to 36.25% (2794) of cases respectively. Multiple myeloma was less frequent as compared to the data from population-based national cancer register (13.32% vs. 28.94%). Major differences between NHLR and European and American data on NHL subtypes concered: higher incidence of aggressive B-cell lymphomas including DLBCL, lower FL and MALT incidence rate. The percentage of unclassified lymphomas in the study was minimal due to participation of hematopathologists. PMID:25031749

  15. Hello! Are You Registered?

    ERIC Educational Resources Information Center

    Institute for Political/Legal Education, Sewell, NJ.

    Organizational procedures and appropriate forms for high school students to conduct a community survey of non-registered voters are provided. Duties for student coordinator, field staff, and clerical staff are described and a flow chart depicts the relationship of personnel to one another and to the community. Students are instructed to notify…

  16. Household economic resources, labour-market advantage and health problems - a study on causal relationships using prospective register data.

    PubMed

    Aittomäki, Akseli; Martikainen, Pekka; Laaksonen, Mikko; Lahelma, Eero; Rahkonen, Ossi

    2012-10-01

    Our aim was to find out whether the associations between health and both individual and household economic position reflected a causal effect on health of household affluence and consumption potential. We attempted to separate this effect from health-selection effects, in other words the potential effect of health on economic position, and from various effects related to occupational position and prestige that might correlate with the economic indicators. We made a distinction between individual labour-market advantage and household economic resources in order to reflect these theoretical definitions. Our aim was to test and compare two hypotheses: 1) low household economic resources lead to an increase in health problems later on, and 2) health problems are disadvantageous on the labour market, and consequently decrease the level of economic resources. We used prospective register data obtained from the databases of Statistics Finland and constituting an 11-per-cent random sample of the Finnish population in 1993-2006. Health problems were measured in terms of sickness allowance paid by the Finnish Social Insurance Institution, household economic resources in terms of household-equivalent disposable income and taxable wealth, and labour-market advantage in terms of individual taxable income and months of unemployment. We used structural equation models (n = 211,639) to examine the hypothesised causal pathways. Low household economic resources predicted future health problems, and health problems predicted future deterioration in labour-market advantage. The effect of economic resources on health problems was somewhat stronger. These results suggest that accumulated exposure to low economic resources leads to increasing health problems, and that this causal mechanism is a more significant source of persistent health inequalities than health problems that bring about a permanent decrease in economic resources. PMID:22727652

  17. Register file soft error recovery

    DOEpatents

    Fleischer, Bruce M.; Fox, Thomas W.; Wait, Charles D.; Muff, Adam J.; Watson, III, Alfred T.

    2013-10-15

    Register file soft error recovery including a system that includes a first register file and a second register file that mirrors the first register file. The system also includes an arithmetic pipeline for receiving data read from the first register file, and error detection circuitry to detect whether the data read from the first register file includes corrupted data. The system further includes error recovery circuitry to insert an error recovery instruction into the arithmetic pipeline in response to detecting the corrupted data. The inserted error recovery instruction replaces the corrupted data in the first register file with a copy of the data from the second register file.

  18. Dose perturbations due to contrast medium and air in MammoSite registered treatment: An experimental and Monte Carlo study

    SciTech Connect

    Cheng, C.-W.; Mitra, R.; Allen Li, X.; Das, Indra J.

    2005-07-15

    In the management of early breast cancer, a partial breast irradiation technique called MammoSite registered (Proxima Therapeutic Inc., Alpharetta, GA) has been advocated in recent years. In MammoSite, a balloon implanted at the surgical cavity during tumor excision is filled with a radio-opaque solution, and radiation is delivered via a high dose rate brachytherapy source situated at the center of the balloon. Frequently air may be introduced during placement of the balloon and/or injection of the contrast solution into the balloon. The purpose of this work is to quantify as well as to understand dose perturbations due to the presence of a high-Z contrast medium and/or an air bubble with measurements and Monte Carlo calculations. In addition, the measured dose distribution is compared with that obtained from a commercial treatment planning system (Nucletron PLATO system). For a balloon diameter of 42 mm, the dose variation as a function of distance from the balloon surface is measured for various concentrations of a radio-opaque solution (in the range 5%-25% by volume) with a small volume parallel plate ion chamber and a micro-diode detector placed perpendicular to the balloon axis. Monte Carlo simulations are performed to provide a basic understanding of the interaction mechanism and the magnitude of dose perturbation at the interface near balloon surface. Our results show that the radio-opaque concentration produces dose perturbation up to 6%. The dose perturbation occurs mostly within the distances <1 mm from the balloon surface. The Plato system that does not include heterogeneity correction may be sufficient for dose planning at distances {>=}10 mm from the balloon surface for the iodine concentrations used in the MammoSite procedures. The dose enhancement effect near the balloon surface (<1 mm) due to the higher iodine concentration is not correctly predicted by the Plato system. The dose near the balloon surface may be increased by 0.5% per cm{sup 3} of air

  19. Absence of a Tourniquet Does Not Affect Fixation of Cemented TKA: A Randomized RSA Study of 70 Patients.

    PubMed

    Ejaz, Ashir; Laursen, Anders C; Jakobsen, Thomas; Rasmussen, Sten; Nielsen, Poul Torben; Laursen, Mogens B

    2015-12-01

    We aimed to determine whether not using a tourniquet in cemented TKA would affect migration of the tibial component measured by radiosterometric analysis (RSA). Seventy patients were randomized into a tourniquet group and a non-tourniquet group and using model-based RSA, the migration of the tibial component was analyzed. Primary and secondary outcome measures were maximum total point motion (MTPM) and translations and rotations. Follow-up period was 2 years. The tibial component was well fixated in both groups and no significant difference in migration between the two groups was detected (P=0.632). Mean MTPM (SD) was 0.47 mm (0.16) in the tourniquet group and 0.45 mm (0.21) in the non-tourniquet group. Absence of tourniquet indicates that stable fixation of the tibial component can be achieved in cemented TKA. PMID:26162514

  20. Genetic and environmental influences on Anxious/Depression during childhood: a study from the Netherlands Twin Register.

    PubMed

    Boomsma, D I; van Beijsterveldt, C E M; Hudziak, J J

    2005-11-01

    For a large sample of twin pairs from the Netherlands Twins Register who were recruited at birth and followed through childhood, we obtained parental ratings of Anxious/Depression (A/D). Maternal ratings were obtained at ages 3 years (for 9025 twin pairs), 5 years (9222 pairs), 7 years (7331 pairs), 10 years (4430 pairs) and 12 years (2363 pairs). For 60-90% of the pairs, father ratings were also available. Multivariate genetic models were used to test for rater-independent and rater-specific assessments of A/D and to determine the genetic and environmental influences on individual differences in A/D at different ages. At all ages, monozygotic twins resembled each other more closely for A/D than dizygotic twins, implying genetic influences on variation in A/D. Opposite sex twin pairs resembled each other to same extent as same-sex dizygotic twins, suggesting that the same genes are expressed in boys and girls. Heritability estimates for rater-independent A/D were high in 3-year olds (76%) and decreased in size as children grew up [60% at age 5, 67% at age 7, 53% at age 10 (60% in boys) and 48% at age 12 years]. The decrease in genetic influences was accompanied by an increase in the influence of the shared family environment [absent at ages 3 and 7, 16% at age 5, 20% at age 10 (5% in boys) and 18% at age 12 years]. The agreement between parental A/D ratings was between 0.5 and 0.7, with somewhat higher correlations for the youngest group. Disagreement in ratings between the parents was not merely the result of unreliability or rater bias. Both the parents provided unique information from their own perspective on the behavior of their children. Significant influences of genetic and shared environmental factors were found for the unique parental views. At all ages, the contribution of shared environmental factors to variation in rater-specific views was higher for father ratings. Also, at all ages except age 12, the heritability estimates for the rater

  1. Development and Validation of a Web-Based Survey on the Use of Personal Communication Devices by Hospital Registered Nurses: Pilot Study

    PubMed Central

    LeVasseur, Sandra A; Li, Dongmei

    2013-01-01

    Background The use of personal communication devices (such as basic cell phones, enhanced cell phones or smartphones, and tablet computers) in hospital units has risen dramatically in recent years. The use of these devices for personal and professional activities can be beneficial, but also has the potential to negatively affect patient care, as clinicians may become distracted by these devices. Objective No validated questionnaire examining the impact of the use of these devices on patient care exists; thus, we aim to develop and validate an online questionnaire for surveying the views of registered nurses with experience of working in hospitals regarding the impact of the use of personal communication devices on hospital units. Methods A 50-item, four-domain questionnaire on the views of registered nursing staff regarding the impact of personal communication devices on hospital units was developed based on a literature review and interviews with such nurses. A repeated measures pilot study was conducted to examine the psychometrics of a survey questionnaire and the feasibility of conducting a larger study. Psychometric testing of the questionnaire included examining internal consistency reliability and test-retest reliability in a sample of 50 registered nurses. Results The response rate for the repeated measures was 30%. Cronbach coefficient alpha was used to examine the internal consistency and reliability, and in three of the four question groups (utilization, impact, and opinions), the correlation was observed to be very high. This suggests that the questions were measuring a single underlying theme. The Cronbach alpha value for the questions in the performance group, describing the use of personal communication devices while working, was lower than those for the other question groups. These values may be an indication that the assumptions underlying the Cronbach alpha calculation may have been violated for this group of questions. A Spearman rho correlation

  2. Young People's Risk of Suicide Attempts in Relation to Parental Death: A Population-Based Register Study

    ERIC Educational Resources Information Center

    Jakobsen, Ida Skytte; Christiansen, Erik

    2011-01-01

    Background: The objective of this study was to examine the association between the death of a biological parent and subsequent suicide attempts by young people (aged 10-22 years), and to explore sociodemographic factors as modifying factors in the process. Methods: The study used a nested case-control design. The full study population was obtained…

  3. Development in Children's Comprehension of Linguistic Register

    ERIC Educational Resources Information Center

    Wagner, Laura; Greene-Havas, Maia; Gillespie, Rebecca

    2010-01-01

    For socially appropriate communication, speakers must command a variety of linguistic styles, or "registers", that vary according to social context and social relationships. This study examined preschool children's ability to use a speaker's register choice to infer the identity of their addressee. Four-year-olds could draw correct inferences…

  4. "Legal Language": Varieties, Genres, Registers, Discourses.

    ERIC Educational Resources Information Center

    Kurzon, Dennis

    1997-01-01

    Analyzes classification of "legal language," clarifying terms such as "variety,""genre,""register," and "discourse," and related issues in languages for special purposes, particularly as they apply to professions. Argues that "genre," not "register," is the most appropriate term for legal language, and that study of legal discourse should focus on…

  5. Registered Nurse Persistence in Baccalaureate Education

    ERIC Educational Resources Information Center

    Krov, Kathleen Nadler

    2010-01-01

    There is a need to increase the number of baccalaureate prepared registered nurses to safely meet the complex healthcare needs of citizens of the United States. Since there is no research on the characteristics of registered nurse students persisting in baccalaureate education, this quantitative descriptive case study was designed to identify the…

  6. Multiple social roles, health, and sickness absence--a five-year follow-up study of professional women in Sweden.

    PubMed

    Nyman, Carin Staland; Spak, Lena; Hensing, Gunnel

    2012-01-01

    The aim of this study was to analyze associations between changes in social roles and physical health, mental well-being, psychiatric disorder, and long-term sickness absence over a five-year period. The study was part of a general population-based multipurpose project. Professional women from six birth cohorts born in 1935, 1945, 1955, 1965, 1970, or 1975 (N = 532) were interviewed twice. Self-rated information on physical health, mental well-being, long-term sickness absence, and changes in social roles was used. Information on psychiatric disorders was based on Diagnostic and Statistical Manual of Mental Disorders-III-R and Diagnostic and Statistical Manual of Mental Disorders-IV diagnoses. Multivariate logistic regressions were adjusted for age, socio-economic position, alcohol dependence and abuse, and health at baseline. An increase in number of social roles was associated with lower odds for poor mental well-being, odds ratio (OR) 0.4 (confidence interval [CI] 0.2 to 0.8), while a decrease was associated with higher odds for poor mental well-being, OR 4.5 (CI 1.8 to 11.0), psychiatric disorder, OR 2.6 (1.0 to 6.8), and sickness absence, OR 4.4 (1.6 to 11.7). The results indicated that an increase in number of social roles might be protective against poor mental well-being, while a decrease in number of roles might be related to increased psychiatric disorders and long-term sickness absence. More studies on long-term health implications of gender-specific experiences are needed. PMID:22591231

  7. Presence-absence surveys of prey and their use in predicting leopard (Panthera pardus) densities: a case study from Armenia.

    PubMed

    Khorozyan, Igor G; Malkhasyan, Alexander G; Abramov, Alexei V

    2008-12-01

    It is important to predict how many individuals of a predator species can survive in a given area on the basis of prey sufficiency and to compare predictive estimates with actual numbers to understand whether or not key threats are related to prey availability. Rugged terrain and low detection probabilities do not allow for the use of traditional prey count techniques in mountain areas. We used presence-absence occupancy modeling and camera-trapping to estimate the abundance and densities of prey species and regression analysis to predict leopard (Panthera pardus) densities from estimated prey biomass in the mountains of the Nuvadi area, Meghri Ridge, southern Armenia. The prey densities were 12.94 ± 2.18 individuals km(-2) for the bezoar goat (Capra aegagrus), 6.88 ± 1.56 for the wild boar (Sus scrofa) and 0.44 ± 0.20 for the roe deer (Capreolus capreolus). The detection probability of the prey was a strong function of the activity patterns, and was highest in diurnal bezoar goats (0.59 ± 0.09). Based on robust regression, the estimated total ungulate prey biomass (720.37 ± 142.72 kg km(-2) ) can support a leopard density of 7. 18 ± 3.06 individuals 100 km(-2) . The actual leopard density is only 0.34 individuals 100 km(-2) (i.e. one subadult male recorded over the 296.9 km(2) ), estimated from tracking and camera-trapping. The most plausible explanation for this discrepancy between predicted and actual leopard density is that poaching and disturbance caused by livestock breeding, plant gathering, deforestation and human-induced wild fires are affecting the leopard population in Armenia. PMID:21396082

  8. Use and Distribution of Rehabilitation Services: A Register Linkage Study in One Hospital District Area in Finland

    ERIC Educational Resources Information Center

    Pulkki, Jutta Maarit; Rissanen, Pekka; Raitanen, Jani A.; Viitanen, Elina A.

    2011-01-01

    This study focuses on a large set of rehabilitation services used between 2004 and 2005 in one hospital district area in Finland. The rehabilitation system consists of several subsystems. This complex system is suggested to produce arbitrary rehabilitation services. Despite the criticisms against the system during decades, no attempts have been…

  9. Using ictal high-frequency oscillations (80-500Hz) to localize seizure onset zones in childhood absence epilepsy: a MEG study.

    PubMed

    Miao, Ailiang; Xiang, Jing; Tang, Lu; Ge, Huaiting; Liu, Hongxing; Wu, Ting; Chen, Qiqi; Hu, Zheng; Lu, Xiaopeng; Wang, Xiaoshan

    2014-04-30

    This study aimed to use ictal high-frequency oscillations (HFOs) ranging from 80Hz to 500Hz to locate seizure onset zones in childhood absence epilepsy (CAE) using non-invasive magnetoencephalography (MEG). Ten drug-naïve children with CAE were studied using a 275-channel MEG system. MEG data were digitized at a sampling rate of 6000Hz. HFO spectral power in real-time spectrograms was assessed using Morlet continuous wavelet transform. Magnetic sources were volumetrically localized through dynamic magnetic source imaging with a slide window. HFOs were identified in all patients. The total time of fast ripples (250-500Hz) was greater than that of ripples (80-250Hz) during absence seizures. The rate of fast ripples was associated with seizure frequency. HFO duration was significantly longer when co-occurring with spikes than when occurring independently, and the maximum frequency of HFOs co-occurring with spikes was higher than that of HFOs occurring independently. HFOs were predominantly localized in the medial prefrontal cortex (MPFC), whereas spikes were widespread to a variety of regions during the absence seizures. Compared with spikes, HFOs appeared to be more focal. The findings indicate that HFOs in the MPFC have a primary function in initializing epileptic activity in CAE. PMID:24582907

  10. Factors influencing morbidity after paediatric tonsillectomy: a study of 18,712 patients in the National Tonsil Surgery Register in Sweden.

    PubMed

    Elinder, Karolina; Söderman, Anne-Charlotte Hessén; Stalfors, Joacim; Knutsson, Johan

    2016-08-01

    The objective of this study was to examine factors affecting morbidity after tonsillectomy in children. Data from the National Tonsil Surgery Register in Sweden on 18,712 patients who underwent tonsillectomy with or without simultaneous adenoidectomy between 1 and 18 years of age were analysed. This register includes data on sex, gender, surgical indication, and the surgical and haemostasis techniques used for each patient, as well as patient-reported outcomes for haemorrhage, analgesic use and antibiotic use. Comparison of patients who underwent surgery for infection versus upper airway obstruction revealed a significant increase in haemorrhage complications in the infection group. However, no significant difference remained after the adjustments for confounders in multivariable regression analysis. Instead, the increased risk among patients who underwent surgery for infection was mainly attributable to the use of bipolar diathermy and increased patient age. Patients who received surgery for infection reported more days of analgesic use, as well as more unplanned contacts with a health care service provider due to pain, compared with those who underwent surgery for upper airway obstruction. These results remained significant in multivariate analysis. The use of bipolar diathermy for haemostasis resulted in an increased risk, while the use of cold steel surgical instruments, a younger patient age and female sex led to a decreased risk. The surgical and haemostasis techniques used are the most important factors that affect morbidity after tonsillectomy in the paediatric age group. The choice of surgical techniques is of utmost importance for decreasing morbidity in these patients. PMID:27020269

  11. Risk factors for motor neuron disease: a case-control study based on patients from the Scottish Motor Neuron Disease Register.

    PubMed Central

    Chancellor, A M; Slattery, J M; Fraser, H; Warlow, C P

    1993-01-01

    In order to identify risk factors for the subsequent development of motor neuron disease (MND) we have carried out a case-control study of incident patients in Scotland, identified using the Scottish Motor Neuron Disease Register. A standard questionnaire was given to 103 patients and the same number of community controls matched on a one to one basis using the general practitioner's (GP) age and sex register. Recall bias was minimised by using GP records to verify the subject's report. There was an overall lifetime excess of fractures in patients, odds ratio (OR) = 1.3 (95% confidence interval (CI), 0.7-2.5) and this was highest in the 5 years before symptom onset (OR = 15, 95% CI, 3.3-654). There was no association with non-fracture trauma but the OR for a manual occupation in patients was 2.6 (95% CI, 1.1-6.3). Both occupational exposure to lead (OR = 5.7, 95% CI, 1.6-30) and solvents/chemicals (OR = 3.3, 95% CI 1.3-10) were significantly more common in patients. No consistent association was found between MND and factors reflecting socioeconomic deprivation in childhood; childhood infections or social class. Our results identify a number of different factors which may contribute to the aetiology of MND. PMID:8229031

  12. Sickness and sickness absence of remaining employees in a time of economic crisis: a study among employees of municipalities in Iceland.

    PubMed

    Sigursteinsdóttir, Hjördís; Rafnsdóttir, Gudbjörg Linda

    2015-05-01

    This article focuses on sickness and sickness absence among employees of 20 municipalities in Iceland who remained at work after the economic crisis in October 2008. The aim was to examine the impact of economic crisis on sickness and sickness absence of "survivors" working within the educational system (primary school teachers and kindergarten teachers) and the care services (elderly care and care of disabled people) operated by the municipalities. The study was based on mixed methods research comprising a balanced panel data set and focus groups. An online survey conducted three times among 2356 employees of 20 municipalities and seven focus group interviews in two municipalities (39 participants). The generalized estimating equations (GEE) were used to analyze the quantitative data, and focused coding was used to analyze the qualitative data. The main finding showed that the economic crisis had negative health implications for the municipal employees. The negative effects grew stronger over time. Employee sickness and sickness absence increased substantially in both downsized and non-downsized workplaces. However, employees of downsized workplaces were more likely to be sick. Sickness and sickness absence were more common among younger than older employees, but no gender differences were observed. The study demonstrates the importance of protecting the health and well-being of all employees in the wake of an economic crisis, not only those who lose their jobs or work in downsized workplaces. This is important in the immediate aftermath of a crisis, but also for a significant time thereafter. This is of practical relevance for those responsible for occupational health and safety, as most Western countries periodically go through economic crises, resulting in strains on employees. PMID:25795993

  13. Do parental education and income matter? A nationwide register-based study on HPV vaccine uptake in the school-based immunisation programme in Norway

    PubMed Central

    Feiring, Berit; Laake, Ida; Molden, Tor; Cappelen, Inger; Håberg, Siri E; Magnus, Per; Steingrímsdóttir, Ólöf Anna; Strand, Bjørn Heine; Stålcrantz, Jeanette; Trogstad, Lill

    2015-01-01

    Objective Vaccine against human papillomavirus (HPV) has been offered free of charge to all 12-year-old girls in Norway since 2009. Nevertheless, the uptake of HPV vaccine is lower than for other childhood vaccines. The aim of this study was to examine whether parental education and income are associated with initiation and completion of HPV vaccination. Design Nationwide register-based study. Setting Publicly funded childhood immunisation programme in Norway. Participants 91 405 girls born between 1997 and 1999 and registered in the Norwegian Central Population Registry were offered HPV vaccine during the first 3 programme years. Of these, 84 139 had complete information on all variables and were included in the study. Measurements Information on HPV-vaccination status was obtained from the Norwegian Immunisation Registry. Data on socioeconomic factors were extracted from Statistics Norway. Risk differences (RDs) and CIs were estimated with Poisson regression. Results In the study sample, 78.3% received at least one dose of HPV vaccine and 73.6% received all three doses. High maternal education was significantly associated with lower probability of initiating HPV vaccination (multivariable RD=−5.5% (95% CI −7.0% to −4.0%) for highest compared with lowest education level). In contrast, high maternal income was significantly associated with higher probability of initiating vaccination (multivariable RD=10.1% (95% CI 9.0% to 11.3%) for highest compared with lowest quintile). Paternal education and income showed similar, but weaker, associations. The negative association between education and initiation was only seen for incomes below the median value. Conclusions In spite of the presumably equal access to HPV vaccine in Norway, we found socioeconomic disparities in vaccine uptake. More studies are needed to explain the underlying factors responsible for the observed socioeconomic differences. Insight into these factors is necessary to target information and

  14. Regional trends in avoidable hospitalisations due to complications among population with diabetes in Finland in 1996−2011: a register-based cohort study

    PubMed Central

    Manderbacka, Kristiina; Arffman, Martti; Lumme, Sonja; Lehikoinen, Markku; Winell, Klas; Keskimäki, Ilmo

    2016-01-01

    Objectives Diabetes requires continuous medical care including prevention of acute complications and risk reduction for long-term complications. Diabetic complications impose a substantial burden on public health and care delivery. We examined trends in regional differences in hospitalisations due to diabetes-related complications among the total diabetes population in Finland. Research design A longitudinal register-based cohort study 1996−2011 among a total population with diabetes in Finland. Participants All persons with diabetes identified from several administrative registers in Finland in 1964−2011 and alive on 1 January 1996. Outcome measures We examined hospitalisations due to diabetes-related short-term and long-term complications, uncomplicated diabetes, myocardial infarction, stroke, lower extremity amputation and end-stage renal disease (ESRD). We calculated annual age-adjusted rates per 10 000 person years and the systematic component of variation. Multilevel models were used for studying time trends in regional variation. Results There was a steep decline in complication-related hospitalisation rates during the study period. The decline was relatively small in ESRD (30%), whereas rates of hospitalisations for short-term and long-term complications as well as uncomplicated diabetes diminished by about 80%. The overall correlation between hospital district intercepts and slopes in time was −0.72 (p<0.001) among men and −0.99 (p<0.001) among women indicating diminishing variation. Diminishing variation was found in each of the complications studied. The variation was mainly distributed at the health centre level. Conclusions Our study suggests that the prevention of complications among persons with diabetes has improved in Finland between 1996 and 2011. The results further suggest that the prevention of complications has become more uniform throughout the country. PMID:27550651

  15. First attack of acute pancreatitis in Sweden 1988 – 2003: incidence, aetiological classification, procedures and mortality – a register study

    PubMed Central

    2009-01-01

    Background Population-based studies suggest that the incidence of first attack of acute pancreatitis (FAAP) is increasing and that old age is associated with increased mortality. Beacuse nationwide data are limited and information on standardized mortality ratio (SMR) versus age is lacking, we wanted to describe incidence and mortality of first attack acute pancreatitis (FAAP) in Sweden. Methods Hospital discharge data concerning diagnoses and surgical procedures and death certificate data were linked for patients with FAAP in Sweden. Mortality was calculated as case fatality rate (CFR), i.e. deaths per 1000 patients and SMR using age-, gender- and calendar year-specific expected survival estimates, and is given as mean with 95% confidence intervals. Data are presented as median values with 25% and 75% percentiles, means and standard deviations, or proportions. Proportions have been compared using the chi square test, Poisson-regression test or Fisher exact test. Location of two groups of ratio scale variables were compared using independent samples t-test or Mann-Whitney U-test. Results From 1988 through 2003, 43415 patients (23801 men and 19614 women) were admitted for FAAP. Age adjusted incidence rose from 27.0 to 32.0 per 100000 individuals and year. Incidence increased with age for both men and women. At index stay 19.7% of men and 35.4% of women had biliary diagnoses, and 7.1% of men and 2.1% of women alcohol-related diagnoses. Of 10072 patients who underwent cholecystectomy, 7521 (74.7%) did so after index stay within the audit period. With increasing age CFR increased and SMR decreased. For the whole period studied SMR was 11.75 (11.34–12.17) within 90 days of index admission and 2.03 (1.93–2.13) from 91 to 365 days. Alcohol-related diagnoses and young age was associated with increased SMR. Length of stay and SMR decreased significantly during the audit period. Conclusion Incidence of FAAP increased slightly from 1988 to 2003. Incidence increased and

  16. Risk of Gastrointestinal Cancers among Patients with Appendectomy: A Large-Scale Swedish Register-Based Cohort Study during 1970-2009

    PubMed Central

    Song, Huan; Abnet, Christian C.; Andrén-Sandberg, Åke; Chaturvedi, Anil K.; Ye, Weimin

    2016-01-01

    Background Removal of the appendix might induce physiological changes in the gastrointestinal tract, and subsequently play a role in carcinogenesis. Therefore, we conducted a nationwide register-based cohort study in Sweden to investigate whether appendectomy is associated with altered risks of gastrointestinal cancers. Methods A population-based cohort study was conducted using the Swedish national registries, including 480,382 eligible patients followed during the period of 1970–2009 for the occurrence of site-specific gastrointestinal cancer (esophageal/gastric/colon/rectal cancer). Outcome and censoring information was collected by linkage to health and demography registers. We examined the incidence of appendectomy in Sweden using data from 1987–2009. We also calculated standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) to estimate the relative gastrointestinal cancer risk through comparison to the general population. Results We noted an overall decrease in the age-standardized incidence of appendectomy among the entire Swedish population from 189.3 to 105.6 per 100,000 individuals between 1987 and 2009. Grouped by different discharge diagnosis, acute appendicitis, incidental appendectomy, and entirely negative appendectomy continuously decreased over the study period, while the perforation ratio (18%–23%) stayed relatively constant. Compared to the general population, no excess cancer risk was observed for gastrointestinal cancers under study with the exception of a marginally elevated risk for esophageal adenocarcinoma (SIR 1.32, 95% CI 1.09–1.58). Conclusions In Sweden, the incidence of appendectomy and acute appendicitis has decreased during 1987–2009. No excess gastrointestinal cancer risks were observed among these appendectomized patients, with the possible exception of esophageal adenocarcinoma. PMID:26959234

  17. Changing associations of episiotomy and anal sphincter injury across risk strata: results of a population-based register study in Finland 2004–2011

    PubMed Central

    Räisänen, Sari; Cartwright, Rufus; Gissler, Mika; Kramer, Michael R; Laine, Katariina; Jouhki, Maija-Riitta; Heinonen, Seppo

    2013-01-01

    Objectives To evaluate the changing association between lateral episiotomy and obstetric anal sphincter injury (OASIS) for women with low and high baseline risk of OASIS. Design A population-based register study. Setting Data gathered from the Finnish Medical Birth Register for the years 2004−2011. Participants All women with spontaneous vaginal or vacuum-assisted singleton births in Finland (n=384 638). Main outcome measure OASIS incidence. Results During the study period, the incidence of OASIS increased from 1.3% to 1.7% in women with first vaginal births, including women admitted for first vaginal birth after a prior caesarean section and from 0.1% to 0.3% in women with at least one prior birth, whereas episiotomy rates declined from 56.7% to 45.5% and 10.1– 5.3%, respectively. At the study onset, when episiotomy was used more widely, it was negatively associated with OASIS in women with first vaginal births, but as episiotomy use declined it became positively associated with OASIS. Women with episiotomy were complicated by OASIS with clearly higher risk scores than women without episiotomy suggesting that episiotomy was clearly protective against OASIS. OASIS occurred with lower mean risk scores among women with and without episiotomy over time. However, OASIS incidences increased only among women with episiotomy, whereas it decreased or remained among women without episiotomy. Conclusions The cross-over effect between episiotomy and OASIS could be explained by increasing disparity in baseline OASIS risk between treated and untreated women, since episiotomy use declined most in women at low OASIS risk. Episiotomy rate can be safely reduced in low-risk women but interestingly along with the policy change the practice to cut the episiotomy became less protective among high-risk women. PMID:23955189

  18. Gender-Specific Differences in Low-Dose Haloperidol Response for Prevention of Postoperative Nausea and Vomiting: A Register-Based Cohort Study

    PubMed Central

    Prüll, Kathrin; Weninger, Ernst; Mansmann, Ulrich; Küchenhoff, Helmut; Jovanovic, Alexander; Pollwein, Bernhard; Chappell, Daniel; Zwissler, Bernhard; von Dossow, Vera

    2016-01-01

    Background Postoperative nausea and vomiting (PONV) is one of the most common and distressing complications after general anesthesia and surgery, with young non-smoking females receiving postoperative opioids being high-risk patients. This register-based study aims to evaluate the effect of low-dose haloperidol (0.5 mg intravenously) directly after induction of general anesthesia to reduce the incidence of PONV in the postoperative anesthesiological care unit (PACU). Methods Multivariable regression models were used to investigate the association between low-dose haloperidol and the occurrence of PONV using a patient registry containing 2,617 surgical procedures carried out at an university hospital. Results Haloperidol 0.5 mg is associated with a reduced risk of PONV in the total collective (adjusted odds ratio = 0.75, 95% confidence interval: [0.56, 0.99], p = 0.05). The results indicate that there is a reduced risk in male patients (adjusted odds ratio = 0.45, 95% confidence interval: [0.28, 0.73], p = 0.001) if a dose of 0.5 mg haloperidol was administered while there seems to be no effect in females (adjusted odds ratio = 1.02, 95% confidence interval: [0.71, 1.46], p = 0.93). Currently known risk factors for PONV such as female gender, duration of anesthesia and the use of opioids were confirmed in our analysis. Conclusion This study suggests that low-dose haloperidol has an antiemetic effect in male patients but has no effect in female patients. A confirmation of the gender-specific effects we have observed in this register-based cohort study might have major implications on clinical daily routine. PMID:26751066

  19. Familial aggregation of arthritis-related diseases in seropositive and seronegative rheumatoid arthritis: a register-based case-control study in Sweden

    PubMed Central

    Frisell, Thomas; Hellgren, Karin; Alfredsson, Lars; Raychaudhuri, Soumya; Klareskog, Lars; Askling, Johan

    2015-01-01

    Objectives Our objective was to estimate the risk of developing rheumatoid arthritis (RA) associated with a family history of non-RA arthritis-related diseases. This familial co-aggregation is of clinical interest since it is often encountered when assessing family history of RA specifically, but also informative on the genetic overlap between these diseases. Since anticitrullinated peptide antibodies/rheumatoid factor (RF)-positive and RF-negative RA have both specific and shared genetic factors, the familial co-aggregation was assessed separately for seropositive and seronegative disease. Methods Nested case-control study in prospectively recorded Swedish total population data. The Multi-Generation Register identified first-degree relatives. RA and arthritis-related diseases were ascertained through the nationwide patient register. RA serology was based on International Classification of Diseases tenth revision coded diagnoses, mainly reflecting RF. Familial risks were calculated using conditional logistic regression. Results were replicated using the Swedish rheumatology register. Results Familial co-aggregation was found between RA and every studied arthritis-related disease, but the magnitude varied widely, from juvenile idiopathic arthritis (JIA) (seropositive RA OR=3.98 (3.01 to 5.26); seronegative RA OR=5.70 (3.47 to 9.36)) to osteoarthritis (seropositive RA OR=1.03 (1.00 to 1.06); seronegative RA OR=1.05 (1.00 to 1.09)). The familial co-aggregation pattern of non-RA arthritis-related diseases was overall similar for seropositive and seronegative RA. Among those with family history of RA, relatives’ other arthritis-related diseases conferred little or no additional risk. Conclusions Although family history of several arthritis-related diseases may be useful to predict RA (eg, lupus and JIA), others (eg, osteoarthritis and arthralgia) are less useful. Seropositive and seronegative RA had rather similar familial co-aggregation patterns with arthritis

  20. We Won't Get Fooled Again: On the Absence of Angry Responses to Plagiarism in Composition Studies

    ERIC Educational Resources Information Center

    Robillard, Amy E.

    2007-01-01

    This is an article about the complex relationship between anger and plagiarism in composition studies. Here, the author brings into dialogue two strands of inquiry that have shaped recent disciplinary conversations in composition studies but that have yet to publicly influence each other. Because emotions and authorship have both been perceived…

  1. The Role of Marital Status in the Association between Benzodiazepines, Psychotropics and Injurious Road Traffic Crashes: A Register-Based Nationwide Study of Senior Drivers in Sweden

    PubMed Central

    Johnell, Kristina; Laflamme, Lucie; Möller, Jette; Monárrez-Espino, Joel

    2014-01-01

    Background Among senior drivers, benzodiazepines (BZDs) have a documented effect on the risk of road traffic crashes (RTCs). It remains unclear however if BZDs play the same role when considering marital status. Therefore, we aimed to investigate the role of marital status in the association between BZD use and injurious RTCs among senior drivers. Methods Matched case-control study based on five national Swedish registers (n = 154 225). Cases comprised the first non-alcohol-related injurious RTC sustained by drivers aged 50–80 years from July 2005 to December 2009 and controls included registered residents with a valid license who did not crash during that period. Four controls were matched to each case by sex, age and place of residence. Conditional logistic regression analysis for injurious RTC was performed with adjustment for occupation and number of medications. The main exposure was dispensation of BZDs, alone or in combination with other psychotropic medications, 1–30 days prior to the crash date stratified by marital status. Results BZD use, alone or in combination with other psychotropic medications, increased the risk of being involved in an RTC (BZD only: adjusted OR: 1.26, 95% CI: 1.17–1.36; BZDs and other psychotropics: adjusted OR: 1.25, 95% CI: 1.12–1.41). Compared to married drivers, those divorced (1.48, 1.43–1.53) and widowed (1.54; 1.45–1.63) had higher adjusted ORs. Marital status modified the association between BZDs and RTCs, particularly among younger male drivers. Conclusions Both BZDs and marital status independently affect the risk for senior drivers to be involved in an RTC. However, marital status plays a role in the association between BZD use and RTCs and this may have implications for targeting risk populations for RTCs among senior drivers. PMID:24489781

  2. Living arrangements as determinants of myocardial infarction incidence and survival: A prospective register study of over 300,000 Finnish men and women.

    PubMed

    Kilpi, Fanny; Konttinen, Hanna; Silventoinen, Karri; Martikainen, Pekka

    2015-05-01

    Living with a spouse is associated with a reduced risk of coronary heart disease mortality in middle age, but it remains unclear whether marriage and other living arrangements are important both for the development of the disease and the survival following incidence. Cohabitation and living alone have also become more common in many Western societies and thus warrant further study. We explored the association between living arrangements and myocardial infarction (MI) incidence and fatality. We used a population-based register sample of adults aged 40-60 in Finland in 1995 (n = 302,885) followed up until the end of 2007. MI incidence and mortality were identified from hospital discharge records and cause of death register (5917 incident cases in men and 1632 in women). Living with a marital partner was contrasted to three alternatives: cohabiting with non-marital partner, co-residence with persons other than a partner and living alone. MI incidence and long-term fatality were analysed with Cox proportional hazards regression with time-varying covariates and first-day fatality with logistic regression. Men who were married had a lower risk of MI incidence even after adjusting for socioeconomic factors - i.e. education, occupation, income, wealth and employment status - with small differences between the other living arrangement groups. For women the effects of living arrangements on incidence were fully explained by the same socioeconomic factors. However, our findings revealed that living arrangements were strong determinants for survival after MI independent of other socio-demographic factors. The results demonstrate greater fatality associated with living alone in men and suggest that cohabitation in midlife may be associated with a greater fatality risk in women. The social support and control offered by a marital relationship may protect from MI fatality in particular. PMID:25863724

  3. The Danish vaccination register.

    PubMed

    Grove Krause, T; Jakobsen, S; Haarh, M; Mølbak, K

    2012-01-01

    Immunisation information systems (IIS) are valuable tools for monitoring vaccination coverage and for estimating vaccine effectiveness and safety. Since 2009, an advanced IIS has been developed in Denmark and will be implemented during 2012–14. This IIS is based on a database existing since 2000. The reporting of all administered vaccinations including vaccinations outside the national programme will become mandatory. Citizens will get access to data about their own vaccinations and healthcare personnel will get access to information on the vaccinations of their patients. A national concept of identification, a national solution combining a personal code and a card with codes, ensures easy and secure access to the register. From the outset, the IIS will include data on childhood vaccinations administered from 1996 and onwards. All Danish citizens have a unique identifier, a so called civil registration number, which allows the linking of information on vaccinations coming from different electronic data sources. The main challenge will be to integrate the IIS with the different electronic patient record systems currently existing at general practitioner, vaccination clinic and hospital level thereby avoiding double-entry. A need has been identified for an updated international classification of vaccine products on the market. Such a classification would also be useful for the future exchange of data on immunisations from IIS between countries. PMID:22551494

  4. A Study of Undercooling Behavior Of Immiscible Metal Alloys in the Absence of Crucible-Induced Nucleation

    NASA Technical Reports Server (NTRS)

    Robinson, Michael B.; Rathz, Thomas J.; Li, Delin; Workman, Gary

    1998-01-01

    The purpose of this study is to investigate the question: Would eliminating the crucible eliminate the wall-induced nucleation of one of the liquid phases in an immiscible alloy and result in undercooling of the liquid into the metastable region thereby producing significant differences in the separation process and the microstructure upon solidification. Another primary objective of this research is to study systems with a metastable miscibility gap and to directly determine the metastable liquid miscibility gap by undercooling experiments. Nucleation and growth of droplets in these undercooled metallic liquid-liquid mixtures is also being studied. Results of this investigation indicate that containerless processing of immiscibles may not promote the undercooling of the single-phase liquid into the metastable region. Although no recalescence event was observed for this liquid-liquid transition, undercooling did occur across the miscibility gap for the solidification of the Ti phase that eventually separated.

  5. Separate and combined associations of pain and emotional exhaustion with sickness absence.

    PubMed

    Saastamoinen, Peppiina; Leino-Arjas, Päivi; Rahkonen, Ossi; Lahelma, Eero

    2016-01-01

    Pain and emotional exhaustion are prevalent conditions with consequences for sickness absence. Although they often co-occur, their combined associations with sickness absence are poorly understood. This study aimed to examine the separate and combined associations of pain and emotional exhaustion with subsequent sickness absence. The data were derived from a cross-sectional questionnaire survey sent to 40 to 60-year-old employees of the City of Helsinki in 2000 to 2002 (n = 6457) linked with the City of Helsinki personnel register information on sickness absence (3 years on from the survey). Self-certified (1-3 days) and medically certified sickness absence spells (4-14 days, more than 14 days) were used as outcomes. Acute and chronic pain and emotional exhaustion were measured in a questionnaire survey. For the purposes of this study, sickness absence and pain variables were merged to form a new variable with 6 mutually exclusive categories. The main statistical method was negative binomial regression analysis. The synergy index was used to estimate the interaction. Among women, acute and chronic pain with and without emotional exhaustion predicted sickness absence, particularly absence lasting for more than 2 weeks, whereas emotional exhaustion alone did not. The associations persisted when further adjusted for socioeconomic and sociodemographic factors, health-related behaviors, and somatic and mental health. A synergistic interaction effect was found for co-occurring pain and emotional exhaustion on medically certified sickness absence. The results for men were mainly similar, but less stable. In order to tackle sickness absence, special attention should be paid to the prevention and treatment of employees with co-occurring pain and emotional exhaustion. PMID:26397934

  6. A Study of Children's Conceptions of School Rules by Investigating Their Judgements of Transgressions in the Absence of Rules

    ERIC Educational Resources Information Center

    Thornberg, Robert

    2010-01-01

    This study investigated 202 elementary school children's judgements and reasoning about transgressions when school rules regulating these transgressions have been removed in hypothetical school situations. As expected, moral transgressions were judged as more wrong and less accepted than structuring, protecting and etiquette transgressions. In…

  7. Absence of Tumor-Infiltrating Lymphocyte Is a Reproducible Predictive Factor for Sentinel Lymph Node Metastasis: A Multicenter Database Study by the Brazilian Melanoma Group

    PubMed Central

    Duprat, João Pedreira; Brechtbülh, Eduard René; Costa de Sá, Bianca; Enokihara, Mauro; Fregnani, Jose Humberto; Landman, Gilles; Maia, Marcus; Riccardi, Felice; Belfort, Francisco Alberto; Wainstein, Alberto; Moredo, Luciana F.; Steck, Higino; Brandão, Miguel; Moreno, Marcelo; Miranda, Eduardo; Santos, Ivan Dunshee de Oliveira

    2016-01-01

    Aims The aim of this study is to confirm the function of tumor-infiltrating lymphocytes (TILs) in sentinel lymph node (SLN) metastasis. Materials and Methods This retrospective study included 633 patients with invasive melanoma who underwent sentinel lymph node biopsy in 7 referral centers certified by the Brazilian Melanoma Group. Independent risk factors of sentinel node metastasis (SNL) were identified by multiple logistic regression. Results SLN metastasis was detected in 101 of 633 cases (16.1%) and in 93 of 428 patients (21.7%) when melanomas ≤ 1mm were excluded. By multiple logistic regression, the absence of TILs was as an independent risk factor of SLN metastasis (OR = 1.8; 95%CI: 1.1–3.0), in addition to Breslow index (greater than 2.00 mm), lymph vascular invasion, and presence of mitosis. Conclusion SLNB can identify patients who might benefit from immunotherapy, and the determination of predictors of SLNB positivity can help select the proper population for this type of therapy. The absence of TILs is a reproducible parameter that can predict SLNB positivity in melanoma patients, since this study was made with several centers with different dermatopathologists. PMID:26859408

  8. Absence of magnetism in Cr-doped In2O3: a case study of phase separation versus phase formation

    NASA Astrophysics Data System (ADS)

    Gaur, Anand P. S.; Sahoo, Satyaprakash; Katiyar, R. K.; Rinaldi, C.; Scott, J. F.; Katiyar, R. S.

    2011-12-01

    Bulk ceramic Cr-doped In2O3 have been prepared using a solid-state reaction method at two different annealing temperatures. Room-temperature ferromagnetic behaviour is observed for all the compositions prepared at relatively low temperature. But from the Raman study the ferromagnetic oxide phase of CrO2 was identified. On the other hand, samples prepared at relatively high temperature show no detectable secondary phases as confirmed by x-ray diffraction and Raman study, but also no ferromagnetism. With increase in Cr content the paramagnetism state is merely enhanced. This is a strong indication that reports of ferromagnetism in Cr : In2O3 are due to a second phase, probably CrO2.

  9. Absence of Association between N-Acetyltransferase 2 Acetylator Status and Colorectal Cancer Susceptibility: Based on Evidence from 40 Studies

    PubMed Central

    Wang, Jun; Liang, Guo dong; Li, Jing ying; Zhu, Yi dan; Su, Yun tao

    2012-01-01

    Background and Objectives N-Acetyltransferase (NAT) 2 is an important enzyme involved in the metabolism of different xenobiotics, including potential carcinogens, whose phenotypes were reported to be related to individual susceptibility to colorectal cancer (CRC). However, the results remain conflicting. To assess the relationship between NAT2 phenotypes and CRC risk, we performed this meta-analysis. Methods A comprehensive literature search was conducted to identify all case-control or cohort studies of NAT2 acetylator status on the susceptibility of CRC by searching of PubMed and EMBASE, up to May 20, 2011. Crude odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the association. Results A total of over 40,000 subjects from 40 published literatures were identified by searching the databases. No significantly elevated CRC risk in individuals with NAT2 slow acetylators compared with fast acetylators was found when all studies pooled (OR = 0.95, 95% CI: 0.87–1.04, I2 = 52.6%). While three studies contributed to the source of heterogeneity were removed, there was still null result observed (OR = 0.96, 95% CI: 0.90–1.03, P = 0.17 for heterogeneity, I2 = 17.8%). In addition, we failed to detect any associations in the stratified analyses by race, sex, source of controls, smoking status, genotyping methods or tumor localization. No publication bias was observed in this study. Conclusions This meta-analysis suggests that the NAT2 phenotypes may not be associated with colorectal cancer development. PMID:22403658

  10. An analysis of sickness absence in chronically ill patients receiving Complementary and Alternative Medicine: A longterm prospective intermittent study

    PubMed Central

    Moebus, Susanne; Lehmann, Nils; Bödeker, Wolfgang; Jöckel, Karl-Heinz

    2006-01-01

    Background The popularity of complementary and alternative medicine (CAM) has led to a growing amount of research in this area. All the same little is known about the effects of these special treatments in every-day practice of primary care, delivered by general practitioners within the health insurance system. From 1994 to 2000 more than 20 German Company health insurances initiated the first model project on CAM according to the German social law. Aim of this contribution is to investigate the effectiveness of multi-modal CAM on chronic diseases within primary health care. Methods A long-term prospective intermittent study was conducted including 44 CAM practitioners and 1221 self-selected chronically ill patients (64% women) of whom 441 were employed. Main outcome measure is sick-leave, controlled for secular trends and regression-to-the mean and self-perceived health status. Results Sick-leave per year of 441 patients at work increased from 22 (SD ± 45.2) to 31 (± 61.0) days within three years prior to intervention, and decreased to 24 (± 55.6) in the second year of treatment, sustaining at this level in the following two years. Detailed statistical analysis show that this development exceeds secular trends and the regression-toward-the-mean effect. Sick-leave reduction was corroborated by data on self-reported improvement of patients' health status. Conclusion Results of this longterm observational study show a reduction of sick leave in chronically ill patients after a complex multimodal CAM intervention. However, as this is an uncontrolled observational study efficacy of any specific CAM treatment can not be proven. The results might indicate an general effectiveness of CAM in primary care, worthwhile further investigations. Future studies should identify the most suitable patients for CAM practices, the most appropriate and safe treatments, provide information on the magnitude of the effects to facilitate subsequent definitive randomised controlled

  11. Filicide in Austria and Finland - A register-based study on all filicide cases in Austria and Finland 1995-2005

    PubMed Central

    2009-01-01

    Background Filicide is the tragic crime of murdering one's own child. Previous research has found that the offending parents are commonly depressed and that suicide is often associated as an actual act or an intention. Yet, filicide is an underreported crime and previous studies have been strained with methodological problems. No comprehensive international studies on filicide have been presented in the literature until now. Methods This was a descriptive, comprehensive, register-based study of all filicides in Austria and Finland during 1995-2005. Filicide-suicide cases were also included. Results Most of the perpetrators were the biological mothers; in Austria 72%, in Finland 52%. Suicide followed filicide either as an attempt or a fulfilled act in 32% and 54% of the cases in Austria and Finland, respectively. Psychotic mood disorders were diagnosed for 10% of the living perpetrators in Austria, and 12% in Finland. Non-psychotic depression was diagnosed in 9% of surviving perpetrators in Austria, 35% in Finland. Conclusion The data from the two countries demonstrated that filicide is such a multifaceted and rare phenomenon that national data from individual countries seldom offer sufficient scope for its thorough study. Further analyses are needed to produce a complete picture of filicide. PMID:19930581

  12. Can Microfiltered Seminal Plasma Preserve the Morphofunctional Characteristics of Porcine Spermatozoa in the Absence of Antibiotics? A Preliminary Study.

    PubMed

    Barone, F; Ventrella, D; Zannoni, A; Forni, M; Bacci, M L

    2016-08-01

    Artificial insemination is extensively performed in pig farms in Europe, the United States and Canada. Antibiotics are typically added to the inseminating dose to limit bacterial growth during liquid phase storage at 16°C, as bacterial contamination is unavoidable. The World Organization for Animal Health (OIE) and the Food and Agriculture Organization (FAO) take action to control and reduce antibiotic use in animals as more bacteria are becoming resistant to antimicrobials. To avoid the use of antibiotics, we prepared inseminating doses using microfiltered seminal plasma (SP). Microfiltration is a common technology used to reduce bacterial contamination but may retain seminal substances, influencing sperm quality during storage. Therefore, the aim of this study was to evaluate the morphofunctional parameters of spermatozoa during storage at 16°C in doses prepared with or without microfiltered SP, with or without the addition of antibiotics, in a Latin square design. Artificial insemination doses with microfiltered SP and without antibiotic addition preserved spermatozoa viability, mitochondrial membrane potential, acrosome integrity and objective motility, with absolute values equal or even better than those observed in conventional doses. In conclusion, although the results could be considered preliminary due to the small sample size, this study suggests that microfiltration of SP can be a simple method, feasible on farms, to replace antibiotic use in extended doses stored in the liquid phase at 16°C for up to 7 days. PMID:27174664

  13. Absence of nonresponse bias in a study of sport-caught Great Lakes fish consumption and conception failure

    SciTech Connect

    Stein, A.D.; Tay, E.; Courval, J.M.

    1999-04-01

    The authors have reported that men`s lifetime sport-caught Great Lakes fish consumption was associated with lifetime prevalence of conception delay or failure. Those cross-sectional data were based on responses to a postal questionnaire. The present study was conducted to evaluate whether nonresponse bias could explain the cross-sectional findings. The authors conducted telephone interviews with 230 men and 38 women who did not respond to the original responders with respect to key demographic, behavioral, and reproductive characteristics. Nonresponders were approximately 1.5 years older at interview, were more likely to be Caucasian, and reported higher incomes than responders. Among men, nonresponders had fished fewer days in the past year. Almost one half of nonresponders reported no fish consumption in the past year, compared to one quarter of responders. Nonresponders were more likely than responders to have ever conceived a live-born child, had more children, and were less likely to intend to have additional children in the next 5 years. Among both responders and nonresponders there was an increased prevalence of a period of conception failure among men who reported consuming greater quantities of sport-caught Great Lakes fish. The study provides support for the cross-sectional analyses presented previously, insofar as nonresponse bias is unlikely to have a major role in the observed association.

  14. Randomized, Controlled, Thorough QT/QTc Study Shows Absence of QT Prolongation with Luseogliflozin in Healthy Japanese Subjects

    PubMed Central

    Kumagai, Yuji; Hasunuma, Tomoko; Sakai, Soichi; Ochiai, Hidekazu; Samukawa, Yoshishige

    2015-01-01

    Luseogliflozin is a selective sodium glucose co-transporter 2 (SGLT2) inhibitor. To evaluate the cardiac safety of luseogliflozin, a thorough QT/QTc study was conducted in healthy Japanese subjects. The effects of moxifloxacin on QT prolongation in Japanese subjects were also evaluated. In this double-blind, placebo- and open-label positive-controlled, 4-way crossover study, 28 male and 28 female subjects received a single dose of luseogliflozin 5 mg (therapeutic dose), luseogliflozin 20 mg (supratherapeutic dose), placebo, and moxifloxacin 400 mg. Serial triplicate digital 12-lead electrocardiograms (ECGs) were recorded before and after dosing, and results were analyzed using the Fridericia correction (QTcF) method. Serial blood sampling was performed for pharmacokinetic analyses of luseogliflozin and moxifloxacin to analyze the relationship between QTcF interval and plasma concentration. The upper limits of the two-sided 90% confidence intervals (CIs) for baseline and placebo-adjusted QTcF intervals (ΔΔQTcF) in the 5 mg and 20 mg luseogliflozin groups were less than 10 ms at all time points. No correlation between plasma luseogliflozin concentrations and ΔΔQTcF was observed. In the moxifloxacin group, the lower limits of the two-sided 90% CIs for ΔΔQTcF were greater than 5 ms at all time points. A positive relationship was observed between plasma moxifloxacin concentration and change in ΔΔQTcF. Luseogliflozin was well tolerated at both dose levels. The majority of adverse events were mild in severity, and no serious or life-threatening adverse events occurred. Neither therapeutic (5 mg) nor supratherapeutic (20 mg) doses of luseogliflozin affected QT prolongation in healthy Japanese subjects. PMID:26444986

  15. Anti-reflux mucosectomy for gastroesophageal reflux disease in the absence of hiatus hernia: a pilot study

    PubMed Central

    Inoue, Haruhiro; Ito, Hiroaki; Ikeda, Haruo; Sato, Chiaki; Sato, Hiroki; Phalanusitthepha, Chainarong; Hayee, Bu’Hussain; Eleftheriadis, Nikolas; Kudo, Shin-ei

    2014-01-01

    Background In our previous case report of circumferential mucosal resection for short-segment Barrett’s esophagus with high-grade dysplasia, symptoms of gastro-esophageal reflux disease (GERD) were significantly improved. This observation suggests that anti-reflux mucosectomy (ARMS) could represent an effective anti-reflux procedure, with the advantage that no artificial devices or prostheses would be left in situ. Methods In this pilot study, 10 patients with treatment-refractory GERD received ARMS, 2 of whom circumferential, and the remaining 8 crescentic. Results Key symptoms of GERD improved significantly after ARMS. In the DeMeester score, mean heartburn score decreased from 2.7 to 0.3 (P=0.0011), regurgitation score from 2.5 to 0.3 (P=0.0022), and total score from 5.2 to 0.67 (P=0.0011). At endoscopic examination, the flap valve grade decreased from 3.2 to 1.2 (P=0.0152). In 24-h esophageal pH monitoring the fraction of time at pH <4 improved from 29.1% to 3.1% (P=0.1). Fraction time absorbance more than >0.14 of bile reflux was controlled from 52% to 4% (P=0.05). In 2 cases of total circumferential resection, repeat balloon dilation was necessary to control stenosis. In all cases, proton pump inhibitor prescription could be discontinued with no ill effects. Conclusion This initial case series demonstrated the potential anti-reflux effect of ARMS, with a crescentic mucosal resection appearing adequate. Further longitudinal study of patients without sliding hiatus hernia will be required to establish ARMS as an effective technique to control GERD in this setting. PMID:25330784

  16. Impact of the Provision of Safe Drinking Water on School Absence Rates in Cambodia: A Quasi-Experimental Study

    PubMed Central

    Hunter, Paul R.; Risebro, Helen; Yen, Marie; Lefebvre, Hélène; Lo, Chay; Hartemann, Philippe; Longuet, Christophe; Jaquenoud, François

    2014-01-01

    Background Education is one of the most important drivers behind helping people in developing countries lift themselves out of poverty. However, even when schooling is available absenteeism rates can be high. Recently interest has focussed on whether or not WASH interventions can help reduce absenteeism in developing countries. However, none has focused exclusively on the role of drinking water provision. We report a study of the association between absenteeism and provision of treated water in containers into schools. Methods and Findings We undertook a quasi-experimental longitudinal study of absenteeism rates in 8 schools, 4 of which received one 20 L container of treated drinking water per day. The water had been treated by filtration and ultraviolet disinfection. Weekly absenteeism rates were compared across all schools using negative binomial model in generalized estimating equations. There was a strong association with provision of free water and reduced absenteeism (Incidence rate ratio = 0.39 (95% Confidence Intervals 0.27–0.56)). However there was also a strong association with season (wet versus dry) and a significant interaction between receiving free water and season. In one of the intervention schools it was discovered that the water supplier was not fulfilling his contract and was not delivering sufficient water each week. In this school we showed a significant association between the number of water containers delivered each week and absenteeism (IRR = 0.98 95%CI 0.96–1.00). Conclusion There appears to be a strong association between providing free safe drinking water and reduced absenteeism, though only in the dry season. The mechanism for this association is not clear but may in part be due to improved hydration leading to improved school experience for the children. PMID:24632573

  17. The experiences of parents of children with severe autism in connection with their children's anaesthetics, in the presence and absence of the perioperative dialogue: a hermeneutic study.

    PubMed

    Lindberg, Susan; von Post, Iréne; Eriksson, Katie

    2012-12-01

    The aim of this study was to obtain an understanding of what parents of children with severe autism experience in connection with their child's anaesthetics, in the presence and absence of the perioperative dialogue. Twelve parents who had experience of their child receiving anaesthetics on one or more occasions took part in this study, in which anaesthesia care was organized as a perioperative dialogue. Data were collected by means of conversational interviews, and the text was interpreted using a hermeneutic approach. The hermeneutic text interpretation led to a new understanding based on the knowledge that in the absence of the perioperative dialogue, previous anaesthetics had meant the suffering of care by the following: a hopeless struggle, unspeakable suffering and a disgraceful scenario. However, continuity in the perioperative dialogue provided to be a way out of the suffering by being received by warm hands, being received by a known face and a subtle interplay between the child and nurse. Although health and well-being may be unobtainable goals in this special context of care, the findings provided ample descriptions of the positive effects of the perioperative dialogue, which is all the more valuable when dealing with children who will need repeated anaesthetics in the future. PMID:22324909

  18. Burnout Subtypes and Absence of Self-Compassion in Primary Healthcare Professionals: A Cross-Sectional Study

    PubMed Central

    Montero-Marin, Jesus; Zubiaga, Fernando; Cereceda, Maria; Piva Demarzo, Marcelo Marcos; Trenc, Patricia; Garcia-Campayo, Javier

    2016-01-01

    Background Primary healthcare professionals report high levels of distress and burnout. A new model of burnout has been developed to differentiate three clinical subtypes: ‘frenetic’, ‘underchallenged’ and ‘worn-out’. The aim of this study was to confirm the validity and reliability of the burnout subtype model in Spanish primary healthcare professionals, and to assess the explanatory power of the self-compassion construct as a possible protective factor. Method The study employed a cross-sectional design. A sample of n = 440 Spanish primary healthcare professionals (214 general practitioners, 184 nurses, 42 medical residents) completed the Burnout Clinical Subtype Questionnaire (BCSQ-36), the Maslach Burnout Inventory General Survey (MBI-GS), the Self-Compassion Scale (SCS), the Utrecht Work Engagement Scale (UWES) and the Positive and Negative Affect Schedule (PANAS). The factor structure of the BCSQ-36 was estimated using confirmatory factor analysis (CFA) by the unweighted least squares method from polychoric correlations. Internal consistency (R) was assessed by squaring the correlation between the latent true variable and the observed variables. The relationships between the BCSQ-36 and the other constructs were analysed using Spearman’s r and multiple linear regression models. Results The structure of the BCSQ-36 fit the data well, with adequate CFA indices for all the burnout subtypes. Reliability was adequate for all the scales and sub-scales (R≥0.75). Self-judgement was the self-compassion factor that explained the frenetic subtype (Beta = 0.36; p<0.001); isolation explained the underchallenged (Beta = 0.16; p = 0.010); and over-identification the worn-out (Beta = 0.25; p = 0.001). Other significant associations were observed between the different burnout subtypes and the dimensions of the MBI-GS, UWES and PANAS. Conclusions The typological definition of burnout through the BCSQ-36 showed good structure and appropriate internal consistence

  19. The dynamic process of cognitive mapping in the absence of visual cues: human data compared with animal studies.

    PubMed

    Yaski, Osnat; Portugali, Juval; Eilam, David

    2009-08-01

    The present study aimed to investigate the behavior involved in constructing spatial representation in humans. For this, blindfolded adult human subjects were introduced into an unfamiliar environment, where they were requested to move incessantly for 10 min. Analysis of the locomotor activity of the participants revealed the following exploratory behaviors: (1) ;looping'; (2) ;wall-following'; (3) ;step-counting'; (4) ;cross-cutting'; and (5) ;free traveling'. Looping is a typical exploratory mode of sightless explorers, based on returning to a recently traveled place. Wall-following is common in enclosed spaces, whereby explorers follow the perimeter of the environment. Both looping and wall-following are based on an egocentric frame of reference by which explorers obtain information about the shape, size and landmarks in the environment. Blindfolded explorers displayed step-counting in order to scale the environment and the relationships in it. Altogether, exploration by looping, wall-following and step-counting resulted in an allocentric spatial representation. The acquisition of spatial representation was manifested by cross-cutting and free travel, with subjects walking in a relatively fast and decisive manner. In light of the above modes of activity, we suggest that exploration of an unfamiliar environment is a synergetic self-organized process (synergetic inter-representation networks, SIRN model); an interplay between external and internal representations. According to this model, the interplay gives rise to an order parameter, such as the environment's dimensions or geometry, enabling progression to a subsequent exploratory behavior. This dynamic and sequential interplay reaches a steady state when a spatial representation (i.e. ;cognitive map') is established. PMID:19648407

  20. Steatohepatitic variant of hepatocellular carcinoma in the absence of metabolic syndrome or background steatosis: a clinical, pathological, and genetic study.

    PubMed

    Yeh, Matthew M; Liu, Yajuan; Torbenson, Michael

    2015-11-01

    Association between the steatohepatitic hepatocellular carcinoma (SH-HCC) and metabolic syndrome has been suggested. Most SH-HCC morphology appears to result from a typical HCC that retains the ability to respond to the metabolic syndrome and develops features of steatohepatitis. We aim to ask if this is true for all SH-HCC cases, or does the SH-HCC morphology in some cases reflect genetic changes inherent to the HCC itself, as opposed to wide tissue response in liver to the metabolic syndrome. Twelve SH-HCC cases occurring in individuals without metabolic syndrome were identified and examined pathologically. Genomic microarray analysis was performed in a subset. The SH-HCC in all cases showed diffuse moderate to marked fatty change, abundant balloon cells often containing Mallory-Denk bodies, and pericellular fibrosis. The background livers showed no significant fatty change in any cases. The background livers showed cirrhosis in seven cases and had no fibrosis in five cases. The underlying liver diseases were hepatitis C (n = 4) and no known (n = 8). The clinical and pathological characteristics of these cases did not differ significantly from the cases with the classical HCC morphology. Loss of 9q12-q31.1 was observed in a subset of cases, a finding that has not been previously reported in HCC. Our results indicate HCC can also develop steatohepatitic morphology outside the setting of fatty liver disease or metabolic syndrome. This SH-HCC is more likely to result from genetic changes to shared genes or metabolic pathways within the tumor and is an ideal subtype for future genetic studies. In this regard, potential genetic alterations include loss of 9q12-q31.1. PMID:26410018

  1. Impact of HIV Status on Treatment Outcome of Tuberculosis Patients Registered at Arsi Negele Health Center, Southern Ethiopia: A Six Year Retrospective Study

    PubMed Central

    Gebremariam, Gebreslassie; Asmamaw, Getachew; Hussen, Muktar; Hailemariam, Mengistu Z.; Asegu, Demissie; Astatkie, Ayalew; Amsalu, Anteneh G.

    2016-01-01

    Background Despite implementation of different strategies, the burden and mortality of human immunodeficiency virus (HIV)-associated tuberculosis (TB) remains a challenge in Ethiopia. The aim of this study was to assess the impact of HIV status on treatment outcome of tuberculosis patients registered at Arsi Negele Health Center, Southern Ethiopia. Methods A six-year retrospective data (from September 2008 to August 2014) of tuberculosis patients (n = 1649) registered at the directly observed therapy short-course (DOTS) clinic of Arsi Negele Health Center was reviewed. Treatment outcome and tuberculosis type were categorized according to the national tuberculosis control program guideline. Data were entered and analyzed using SPSS version 20. Multinomial logistic regression analysis was used to examine the effect of HIV status separately on default/failure and death in relation to those who were successfully treated. Odds ratios with 95% confidence intervals were used to check the presence and strength of association between TB treatment outcome and HIV status and other independent variables. Results Out of the 1649 TB patients, 94.7% (1562) have been tested for HIV of whom 156(10%) were HIV co-infected. The mean (standard deviation) age of the patients was 28.5(15.5) years. The majority were new TB cases (96.7%), male (53.7%), urban (54.7%), and had smear negative pulmonary TB (44.1%). Overall, the treatment success rate of TB patients with or without HIV was 87.3%. Using cure/completion as reference, patients without known HIV status had significantly higher odds of default /failure [aOR, 4.26; 95%CI, 1.684–10.775] and transfer-out [aOR, 2.92; 95%CI, 1.545–5.521] whereas those who tested positive for HIV had a significantly higher odds of death [aOR, 6.72; 95%CI, 3.704–12.202] and transfer-out [aOR, 2.02; 95%CI, 1.111–3.680]. Conclusion Overall, treatment outcome and HIV testing coverage for TB patients is promising to reach the WHO target in the study

  2. Indications of a Scarring Effect of Sickness Absence Periods in a Cohort of Higher Educated Self-Employed

    PubMed Central

    Wijnvoord, Liesbeth E. C.; Brouwer, Sandra; Buitenhuis, Jan; van der Klink, Jac J. L.; de Boer, Michiel R.

    2016-01-01

    Objectives Little is known regarding incidence and recurrence of sickness absence in self-employed. The primary aim of this study was to evaluate the influence of the number of prior episodes of sickness absence on the risk of subsequent periods of sickness absence in higher educated self-employed. Methods In a historic register study based on the files of a Dutch private disability insurance company all sickness absence periods of 30 days or more were analysed. Results A total of 15,868 insured persons contributed 141,188 person years to the study. In total, 5608 periods of sickness absence occurred during follow-up. The hazard of experiencing a new period of sickness absence increased with every previous period, ranging from a hazard ratio of 2.83 in case of one previous period of sickness absence to a hazard ratio of 6.72 in case of four previous periods. This effect was found for both men and women and for all diagnostic categories of the first period of sickness absence. Conclusions Our study shows that for all diagnostic categories the hazard of experiencing a recurrence of sickness absence is appreciably higher than for experiencing a first episode. This suggests that this increased hazard may be related to the occurrence of sickness absence itself rather than related to characteristics of the insured person or of the medical condition. These findings could indicate that sickness absence periods may have a scarring effect on the self-employed person experiencing the sickness absence. PMID:27213963

  3. Evidence of Absence software

    USGS Publications Warehouse

    Dalthorp, Daniel; Huso, Manuela M. P.; Dail, David; Kenyon, Jessica

    2014-01-01

    Evidence of Absence software (EoA) is a user-friendly application used for estimating bird and bat fatalities at wind farms and designing search protocols. The software is particularly useful in addressing whether the number of fatalities has exceeded a given threshold and what search parameters are needed to give assurance that thresholds were not exceeded. The software is applicable even when zero carcasses have been found in searches. Depending on the effectiveness of the searches, such an absence of evidence of mortality may or may not be strong evidence that few fatalities occurred. Under a search protocol in which carcasses are detected with nearly 100 percent certainty, finding zero carcasses would be convincing evidence that overall mortality rate was near zero. By contrast, with a less effective search protocol with low probability of detecting a carcass, finding zero carcasses does not rule out the possibility that large numbers of animals were killed but not detected in the searches. EoA uses information about the search process and scavenging rates to estimate detection probabilities to determine a maximum credible number of fatalities, even when zero or few carcasses are observed.

  4. Use of Fall-Risk Inducing Drugs in Patients Using Anti-Parkinson Drugs (APD): A Swedish Register-Based Study

    PubMed Central

    Haasum, Ylva; Fastbom, Johan; Johnell, Kristina

    2016-01-01

    Objectives Many drugs increase the risk of falls in old age. Although persons with Parkinson’s disease (PD) are at increased risk of experiencing falls and fractures, the use of fall-risk inducing drugs (FRIDs) in this population has not previously been investigated. The objective of this study was to investigate the burden of use of FRIDs in older persons treated with anti-Parkinson drugs (APD; used as a proxy for PD), compared to persons without APD. Methods We analyzed individual data on age, sex, type of housing and drug use in 1 346 709 persons aged ≥ 65 years in the Swedish Prescribed Drug Register on the date of 30 September 2008. Main outcome measure was the use of FRIDs. Results FRIDs were used by 79% of persons with APD and 75% of persons without APD. Persons with APD were more likely to use ≥ 1 FRIDs compared to persons without APD (adjusted OR: 1.09; 95% CI: 1.06-1-12). The association was stronger for concomitant use of ≥ 5 FRIDS (adjusted OR: 1.49; 95% CI: 1.44–1.55). Conclusions The high use of FRIDs among persons with APD indicates that these patients may be at increased risk of drug-induced falls. Further studies are needed to investigate how these drugs affect the risk of falling in persons with PD. PMID:27537366

  5. Water and tissue equivalence of a new PRESAGE{sup Registered-Sign} formulation for 3D proton beam dosimetry: A Monte Carlo study

    SciTech Connect

    Gorjiara, Tina; Kuncic, Zdenka; Doran, Simon; Adamovics, John; Baldock, Clive

    2012-11-15

    Purpose: To evaluate the water and tissue equivalence of a new PRESAGE{sup Registered-Sign} 3D dosimeter for proton therapy. Methods: The GEANT4 software toolkit was used to calculate and compare total dose delivered by a proton beam with mean energy 62 MeV in a PRESAGE{sup Registered-Sign} dosimeter, water, and soft tissue. The dose delivered by primary protons and secondary particles was calculated. Depth-dose profiles and isodose contours of deposited energy were compared for the materials of interest. Results: The proton beam range was found to be Almost-Equal-To 27 mm for PRESAGE{sup Registered-Sign }, 29.9 mm for soft tissue, and 30.5 mm for water. This can be attributed to the lower collisional stopping power of water compared to soft tissue and PRESAGE{sup Registered-Sign }. The difference between total dose delivered in PRESAGE{sup Registered-Sign} and total dose delivered in water or tissue is less than 2% across the entire water/tissue equivalent range of the proton beam. The largest difference between total dose in PRESAGE{sup Registered-Sign} and total dose in water is 1.4%, while for soft tissue it is 1.8%. In both cases, this occurs at the distal end of the beam. Nevertheless, the authors find that PRESAGE{sup Registered-Sign} dosimeter is overall more tissue-equivalent than water-equivalent before the Bragg peak. After the Bragg peak, the differences in the depth doses are found to be due to differences in primary proton energy deposition; PRESAGE{sup Registered-Sign} and soft tissue stop protons more rapidly than water. The dose delivered by secondary electrons in the PRESAGE{sup Registered-Sign} differs by less than 1% from that in soft tissue and water. The contribution of secondary particles to the total dose is less than 4% for electrons and Almost-Equal-To 1% for protons in all the materials of interest. Conclusions: These results demonstrate that the new PRESAGE{sup Registered-Sign} formula may be considered both a tissue- and water

  6. Persistence with anti-tumour necrosis factor therapies in patients with psoriatic arthritis: observational study from the British Society of Rheumatology Biologics Register

    PubMed Central

    Saad, Amr A; Ashcroft, Darren M; Watson, Kath D; Hyrich, Kimme L; Noyce, Peter R; Symmons, Deborah PM

    2009-01-01

    Introduction Anti-TNF therapies represent a breakthrough in the treatment of severe psoriatic arthritis. However, little is known about long-term drug persistence with these treatments in patients with psoriatic arthritis in routine clinical practice. The aim of this study was to assess persistence with first-course and second-course treatment with anti-TNF agents in a prospective cohort of psoriatic arthritis patients and to identify factors associated with and reasons for drug discontinuation. Methods A total of 566 patients with psoriatic arthritis were registered with the British Society for Rheumatology Biologics Register (first anti-TNF agent: etanercept, n = 316; infliximab, n = 162; and adalimumab, n = 88). Treating physicians completed 6-monthly follow-up questionnaires detailing changes to anti-TNF therapies. Persistence with treatment was examined using Kaplan–Meier survival analysis. Reasons for withdrawal were classified as due to inefficacy, adverse events or other reasons. Univariate and multivariate Cox proportional hazard models were developed to examine potential predictors of withdrawals due to inefficacy or adverse events, using a range of demographic, baseline disease-specific and therapeutic variables. Results At baseline, the mean (standard deviation) age of patients was 45.7 (11.1) years, 53% were female and the mean disease duration was 12.4 (8.7) years. Persistence data were available for a mean (standard deviation) follow-up of 2.3 (0.9) person-years. In total, 422 patients had completed at least 12 months of follow-up, 75.5% of whom remained on their first anti-TNF drug while 9.5% discontinued due to inefficacy, 10.0% due to adverse events and 5.0% due to other reasons. During the period of follow-up, 178 patients received a second anti-TNF therapy. The survivor function on second anti-TNF for switchers was 74% at 12 months. Conclusions Psoriatic arthritis patients show high persistence rates with both initial and second anti

  7. Aspirin treatment and risk of first incident cardiovascular diseases in patients with type 2 diabetes: an observational study from the Swedish National Diabetes Register

    PubMed Central

    Ekström, Nils; Cederholm, Jan; Zethelius, Björn; Eliasson, Björn; Fhärm, Eva; Rolandsson, Olov; Miftaraj, Mervete; Svensson, Ann-Marie; Gudbjörnsdottir, Soffia

    2013-01-01

    Objectives To investigate the benefits and risks associated with aspirin treatment in patients with type 2 diabetes and no previous cardiovascular disease (CVD) in clinical practice. Design Population-based cohort study between 2005 and 2009, mean follow-up 3.9 years. Setting Hospital outpatient clinics and primary care in Sweden. Participants Men and women with type 2 diabetes, free from CVD, including atrial fibrillation and congestive heart failure, at baseline, registered in the Swedish National Diabetes Register, with continuous low-dose aspirin treatment (n=4608) or no aspirin treatment (n=14 038). Main outcome measures Risks of CVD, coronary heart disease (CHD), stroke, mortality and bleedings, associated with aspirin compared with no aspirin, were analysed in all patients and in subgroups by gender and estimated cardiovascular risk. Propensity scores were used to adjust for several baseline risk factors and characteristics at Cox regression, and the effect of unknown covariates was evaluated in a sensitivity analysis. Results There was no association between aspirin use and beneficial effects on risks of CVD or death. Rather, there was an increased risk of non-fatal/fatal CHD associated with aspirin; HR 1.19 (95% CI 1.01 to 1.41), p=0.04. The increased risk of cardiovascular outcomes associated with aspirin was seen when analysing women separately; HR 1.41 (95% CI 1.07 to 1.87), p=0.02, and HR 1.28 (95% CI 1.01 to 1.61), p=0.04, for CHD and CVD, respectively, but not for men separately. There was a trend towards increased risk of a composite of bleedings associated with aspirin, n=157; HR 1.41 (95% CI 0.99 to 1.99). Conclusions The results support the trend towards more restrictive use of aspirin in patients with type 2 diabetes and no previous CVD. More research is needed to explore the differences in aspirin's effects in women and men. PMID:23604419

  8. Effectiveness and cost-effectiveness of the Salut Programme: a universal health promotion intervention for parents and children—protocol of a register-based retrospective observational study

    PubMed Central

    Feldman, Inna; Eurenius, Eva; Häggström, Jenny; Sampaio, Filipa; Lindkvist, Marie; Pulkki-Brännström, Anni-Maria; Ivarsson, Anneli

    2016-01-01

    Introduction There is inadequate evidence for the effectiveness and cost-effectiveness of health promotion interventions. The Salut Programme aims to reach all parents and children in the Västerbotten County of Sweden with a combination of health promotion interventions initiated during pregnancy and continued over the childhood period. This study protocol describes an effectiveness study and an economic evaluation study, where the ongoing Salut Programme is compared to care-as-usual over the periods of pregnancy, delivery and the child's first 2 years of life. Methods A register-based retrospective observational study design will be used with existing data sources with respect to exposures and outcomes. Outcomes of interest are clustered at 3 points: around the child's birth, 1 month after the child's birth and 2 years after the child's birth. We will simulate an experiment by retrospectively identifying and comparing children and their parents in the geographical areas where the Salut Programme was implemented since 2006 and onwards, and the areas where the Programme was not implemented before 2009. Outcomes will be analysed and compared for the premeasure period, and the postmeasure period for both groups. Our analysis combines difference-in-difference estimation with matching. A complementary analysis will be carried out on the longitudinal subsample of mothers who gave birth at least once during each of the time periods. The economic evaluation aims to capture the wider societal costs and benefits of the Salut Programme for the first 2 years of the children's lives. Incremental costs will be compared with incremental health gains and the results will be presented as a cost-consequence analysis. Ethics and dissemination The Regional Ethical Review Board in Umeå has given clearance for the Salut Programme research (2010-63-31M). No individual's identity will be revealed when presenting results. This study will provide information that can guide

  9. Combined use of selective serotonin reuptake inhibitors and sedatives/hypnotics during pregnancy: risk of relatively severe congenital malformations or cardiac defects. A register study

    PubMed Central

    Reis, Margareta; Källén, Bengt

    2013-01-01

    Objectives To investigate the proposed synergistic teratogenic effect of use of selective serotonin receptor inhibitors (SSRI) together with sedatives or hypnotics, primarily benzodiazepines, during pregnancy. Design Cohort study of congenital malformations after maternal use of SSRI, sedatives/hypnotics or the combination of the two drug categories. Setting Swedish national health registers. Participants A total of 10 511 infants born of women who had used SSRI drugs but no other central nervous system (CNS)-active drug, 1000 infants born of women who had used benzodiazepines and no other CNS-active drug, and 406 infants whose mothers had used both SSRI and benzodiazepines but no other CNS-active drug. Results None of the three groups showed a higher risk for any relatively severe congenital malformation or any cardiac defect when comparison was made with the general population risk (adjusted risk ratio (RR) for the combination of SSRI and benzodiazepines and a relatively severe malformation=1.17 (95% CI 0.70 to 1.73). Similar results were obtained for the combination of SSRI with other sedative/hypnotic drugs. Conclusions The previously stated increased risk associated with the combined use of these drug categories, notably for a cardiac defect, could not be replicated. PMID:23427202

  10. Sick leave and the impact of job-to-job mobility on the likelihood of remaining on the labour market - a longitudinal Swedish register study

    PubMed Central

    2014-01-01

    Background Change of job could be a strategy in vocational rehabilitation when return to the original job is not possible, but research is very limited concerning the effects of job mobility on the future vocational situation. The aim of the study was to investigate whether job-to-job mobility affects the likelihood of remaining on the labour market over time among persons who are employed and have experienced long-term sick leave. Methods In a longitudinal register study, cohorts from three base years (1994, 1999 and 2004) were created, based on the Swedish population who were 20–60 years old, had sickness allowance insurance, and were employed in the base year and the following year (n > 3,000,000). The likelihood that individuals on long-term sick leave were employed later depending on whether or not they changed workplace during the present or next year of long-term sick leave was analyzed using logistic regression analysis. Age, sector, industry, children, marital status, education, income, rate of sick leave and earlier sick leave and earlier mobility were taken into consideration. Results Women with more than 180 days’ sick leave who changed workplaces were more likely to have a job later compared with those who did not change jobs. For men, the association was statistically significant with 1994 and 2004 as base years, but not in the cohort from 1999. Conclusions The present study indicates that for those on long-term sick leave that changed workplaces, the opportunities to stay on the labour market might increase. However, the study has methodological limitations and the results for men are ambiguous. We do not therefore have enough evidence for recommending job change as a strategy for vocational rehabilitation. PMID:24694029

  11. Violation of Kohler's rule in Ta2PdTe6 and absence of same in Nb2PdS5: A high field magneto transport study

    NASA Astrophysics Data System (ADS)

    Goyal, Reena; Jha, Rajveer; Awana, V. P. S.

    2016-05-01

    Here, we present the comparative study of magnetotransport properties of recently discovered Ta2PdTe6 and Nb2PdS5 superconductors. The XRD and magnetotransport measurements are performed on these samples to investigate structure and superconducting properties as well as normal state transport properties of these compounds. Both the compounds are crystallized in monoclinic structure within space group C 2/m. Here, we observe superconductivity in both the compounds Ta2PdTe6 (Tc =4.4 K) and Nb2PdS5 (Tc =6.6 K). We see a linear magnetoresistance in Ta2PdTe6 as well as violation of Kohler's rule in same compound. On the other hand, we find the absence of same in Nb2PdS5 compound.

  12. Registering Researchers in Authority Files

    ERIC Educational Resources Information Center

    Smith-Yoshimura, Karen; Altman, Micah; Conlon, Michael; Cristán, Ana Lupe; Dawson, Laura; Dunham, Joanne; Hickey, Thom; Hook, Daniel; Horstmann, Wolfram; MacEwan, Andrew; Schreur, Philip; Smart, Laura; Wacker, Melanie; Woutersen, Saskia

    2014-01-01

    Written by OCLC Research Program Officer Karen Smith-Yoshimura and the 13 members of the Registering Researchers in Authority Files Task Group comprised of specialists from the US, UK, and the Netherlands, this report summarizes their research into approaches to providing authoritative researcher identifiers. Registering researchers in some type…

  13. Variations in male-female infant ratios among births to Canadian- and Indian-born mothers, 1990-2011: a population-based register study

    PubMed Central

    Urquia, Marcelo L.; Ray, Joel G.; Wanigaratne, Susitha; Moineddin, Rahim; O'Campo, Patricia J.

    2016-01-01

    Background: We assessed variations in the male-female infant ratios among births to Canadian-born and Indian-born mothers according to year of birth, province and country of birth of each parent. Methods: In this population-based register study, we analyzed birth certificates of 5 853 970 singleton live births to Canadian-born and 177 990 singleton live births to Indian-born mothers giving birth in Canada from 1990 to 2011. Male-female ratios were stratified by live birth order and plotted by year of birth. Logistic regression was used to assess whether ratios varied between Canadian provinces and according to the birthplace of each parent. The deficit in the number of girls was estimated using bootstrap methods. Results: Among Canadian-born mothers, male-female ratios were about 1.05, with negligible fluctuations by birth order, year and province. Among Indian-born mothers, the overall male-female ratio at the third birth was 1.38 (95% confidence interval [CI] 1.34-1.41) and was 1.66 (95% CI 1.56-1.76) at the fourth or higher-order births. There was little variability in the ratios between provinces. Couples involving at least 1 Indian-born parent had higher than expected male-female ratios at the second and higher-order births, particularly when the father was Indian-born. The deficit in the expected number of girls among Indian immigrants to Canada in the study period was estimated to be 4472 (95% CI 3211-5921). Interpretation: Fewer than expected girls at the third and higher-order births have been born to Indian immigrants across Canada since 1990. This trend was also seen among couples of mixed nativity, including those involving a Canadian-born mother and an Indian-born father. Fathers should be considered when investigating sex ratios at birth. PMID:27398354

  14. Plasma aldosterone levels are elevated in patients with pulmonary arterial hypertension in the absence of left ventricular heart failure: a pilot study

    PubMed Central

    Maron, Bradley A.; Opotowsky, Alexander R.; Landzberg, Michael J.; Loscalzo, Joseph; Waxman, Aaron B.; Leopold, Jane A.

    2013-01-01

    Aims Elevated levels of the mineralocorticoid hormone aldosterone are recognized as a modifiable contributor to the pathophysiology of select cardiovascular diseases due to left heart failure. In pulmonary arterial hypertension (PAH), pulmonary vascular remodelling induces right ventricular dysfunction and heart failure in the absence of left ventricular (LV) dysfunction. Hyperaldosteronism has emerged as a promoter of pulmonary vascular disease in experimental animal models of PAH; however, the extent to which hyperaldosteronism is associated with PAH in patients is unknown. Thus, the central aim of the current study is to determine if hyperaldosteronism is an unrecognized component of the PAH clinical syndrome. Methods and results Plasma aldosterone levels and invasive cardiopulmonary haemodynamic measurements were obtained for 25 patients referred for evaluation of unexplained dyspnoea or pulmonary hypertension. Compared with controls (n = 5), patients with PAH (n = 18) demonstrated significantly increased plasma aldosterone levels (1200.4 ± 423.9 vs. 5959.1 ± 2817.9 pg/mL, P < 0.02), mean pulmonary artery pressure (21.4 ± 5.0 vs. 45.5 ± 10.4 mmHg, P < 0.002), and pulmonary vascular resistance (PVR) (1.41 ± 0.6 vs. 7.3 ± 3.8 Wood units, P < 0.003) without differences in LV ejection fraction or pulmonary capillary wedge pressure between groups. Among patients not prescribed PAH-specific pharmacotherapy prior to cardiac catheterization, a subgroup of the cohort with severe pulmonary hypertension, aldosterone levels correlated positively with PVR (r = 0.72, P < 0.02) and transpulmonary gradient (r = 0.69, P < 0.02), but correlated inversely with cardiac output (r = –0.79, P < 0.005). Conclusions These data demonstrate a novel cardiopulmonary haemodynamic profile associated with hyperaldosteronism in patients: diminished cardiac output due to pulmonary vascular disease in the absence of LV heart failure. PMID:23111998

  15. Direct gas-solid carbonation of serpentinite residues in the absence and presence of water vapor: a feasibility study for carbon dioxide sequestration.

    PubMed

    Veetil, Sanoopkumar Puthiya; Pasquier, Louis-César; Blais, Jean-François; Cecchi, Emmanuelle; Kentish, Sandra; Mercier, Guy

    2015-09-01

    Mineral carbonation of serpentinite mining residue offers an environmentally secure and permanent storage of carbon dioxide. The strategy of using readily available mining residue for the direct treatment of flue gas could improve the energy demand and economics of CO2 sequestration by avoiding the mineral extraction and separate CO2 capture steps. The present is a laboratory scale study to assess the possibility of CO2 fixation in serpentinite mining residues via direct gas-solid reaction. The degree of carbonation is measured both in the absence and presence of water vapor in a batch reactor. The gas used is a simulated gas mixture reproducing an average cement flue gas CO2 composition of 18 vol.% CO2. The reaction parameters considered are temperature, total gas pressure, time, and concentration of water vapor. In the absence of water vapor, the gas-solid carbonation of serpentinite mining residues is negligible, but the residues removed CO2 from the feed gas possibly due to reversible adsorption. The presence of small amount of water vapor enhances the gas-solid carbonation, but the measured rates are too low for practical application. The maximum CO2 fixation obtained is 0.07 g CO2 when reacting 1 g of residue at 200 °C and 25 barg (pCO2 ≈ 4.7) in a gas mixture containing 18 vol.% CO2 and 10 vol.% water vapor in 1 h. The fixation is likely surface limited and restricted due to poor gas-solid interaction. It was identified that both the relative humidity and carbon dioxide-water vapor ratio have a role in CO2 fixation regardless of the percentage of water vapor. PMID:25940479

  16. Current and emerging treatments for absence seizures in young patients

    PubMed Central

    Vrielynck, Pascal

    2013-01-01

    In this report, we review the pharmacological and non-pharmacological treatments of the different absence seizure types as recently recognized by the International League Against Epilepsy: typical absences, atypical absences, myoclonic absences, and eyelid myoclonia with absences. Overall, valproate and ethosuximide remain the principal anti-absence drugs. Typical absence seizures exhibit a specific electroclinical semiology, pathophysiology, and pharmacological response profile. A large-scale comparative study has recently confirmed the key role of ethosuximide in the treatment of childhood absence epilepsy, more than 50 years after its introduction. No new antiepileptic drug has proven major efficacy against typical absences. Of the medications under development, brivaracetam might be an efficacious anti-absence drug. Some experimental drugs also show efficacy in animal models of typical absence seizures. The treatment of other absence seizure types is not supported with a high level of evidence. Rufinamide appears to be the most promising new antiepileptic drug for atypical absences and possibly for myoclonic absences. The efficacy of vagal nerve stimulation should be further evaluated for atypical absences. Levetiracetam appears to display a particular efficacy in eyelid myoclonia with absences. Finally, it is important to remember that the majority of antiepileptic drugs, whether they be old or new, may aggravate typical and atypical absence seizures. PMID:23885176

  17. The return of dissociation as absence within absence.

    PubMed

    Gurevich, Hayuta

    2014-12-01

    My aim is to translate Ferenczi's central concepts of the intrapsychic impact and imprint of early developmental trauma into both revived and contemporary conceptualizations. The concept of dissociation was renounced by Freud, yet it is returning as a cornerstone of recent trauma theories. Ferenczi used the concept of "repression," but used it in the sense of an intrapsychic imprint of early external trauma that fragments consciousness, that is, as dissociation. Furthermore, early trauma is double: an absence of protection that threatens existence of the self, combined with an absence of attachment and of recognition of this threat and terror; thus it is an absence-within-absence. This contemporary conceptualization entails a widening of the intrapsychic realm to include an intersubjective one, and regards dissociation as a unique and complex intrapsychic absence, which is a negative of the external absence-within-absence in the early environment. PMID:25434884

  18. Differential Drug Survival of Biologic Therapies for the Treatment of Psoriasis: A Prospective Observational Cohort Study from the British Association of Dermatologists Biologic Interventions Register (BADBIR).

    PubMed

    Warren, Richard B; Smith, Catherine H; Yiu, Zenas Z N; Ashcroft, Darren M; Barker, Jonathan N W N; Burden, A David; Lunt, Mark; McElhone, Kathleen; Ormerod, Anthony D; Owen, Caroline M; Reynolds, Nick J; Griffiths, Christopher E M

    2015-11-01

    Drug survival reflects a drug's effectiveness, safety, and tolerability. We assessed the drug survival of biologics used to treat psoriasis in a prospective national pharmacovigilance cohort (British Association of Dermatologists Biologic Interventions Register (BADBIR)). The survival rates of the first course of biologics for 3,523 biologic-naive patients with chronic plaque psoriasis were compared using survival analysis techniques and predictors of discontinuation analyzed using a multivariate Cox proportional hazards model. Data for patients on adalimumab (n=1,879), etanercept (n=1,098), infliximab (n=96), and ustekinumab (n=450) were available. The overall survival rate in the first year was 77%, falling to 53% in the third year. Multivariate analysis showed that female gender (hazard ratio (HR) 1.22; 95% confidence interval (CI): 1.09-1.37), being a current smoker (HR 1.19; 95% CI: 1.03-1.38), and a higher baseline dermatology life quality index (HR 1.01; 95% CI: 1.00-1.02) were predictors of discontinuation. Presence of psoriatic arthritis (HR 0.82; 95% CI: 0.71-0.96) was a predictor for drug survival. As compared with adalimumab, patients on etanercept (HR 1.63; 95% CI: 1.45-1.84) or infliximab (HR 1.56; 95% CI: 1.16-2.09) were more likely to discontinue therapy, whereas patients on ustekinumab were more likely to persist (HR 0.48; 95% CI: 0.37-0.62). After accounting for relevant covariates, ustekinumab had the highest first-course drug survival. The results of this study will aid clinical decision making when choosing biologic therapy for psoriasis patients. PMID:26053050

  19. Recurring alcohol-related care between 1998 and 2007 among people treated for an alcohol-related disorder in 1997: A register study in Stockholm County

    PubMed Central

    2011-01-01

    Background Inpatient care for alcohol intoxication is increasing in Sweden, especially among young women. Since it is well known that alcohol disorder is a chronic relapsing illness, this study examines the extent to which people return for more care. Method All inpatients with alcohol-related diagnoses in Stockholm County during 1997 were followed prospectively to 2007 through registers. The proportion reappearing for the same diagnosis, other alcohol-related inpatient, or outpatient care each year after baseline, as well as the number of years the inpatients reappeared were calculated (n = 2735). Three diagnoses were examined separately; alcohol dependence, harmful use of alcohol, and alcohol intoxication. Results Three out of five inpatients with an alcohol diagnoses reappeared for more alcohol-related inpatient care during the following decade. The proportion returning was largest the year after baseline and then decreased curvilinearly over time. The inclusion of outpatient care increased proportions, but did not change patterns. Of those with an alcohol dependence diagnosis at baseline 42 percent returned for more alcohol-related inpatient care the first, 28 percent the fifth, and 25 percent the tenth year. Corresponding proportions for harmful use and intoxication were smaller. One in five among those with an alcohol dependence returned for more than five of the ten years. Ordered logistic regressions confirmed that besides diagnosis, age and gender were independently related to the number of years returning to care. Conclusions While middle-aged males with alcohol dependence were in a revolving door, young female inpatients with intoxication diagnosis returned to a comparably lower degree. PMID:21771291

  20. Health Problems during Compulsory Military Service Predict Disability Retirement: A Register-Based Study on Secular Trends during 40 Years of Follow-Up

    PubMed Central

    Frilander, Heikki; Lallukka, Tea; Viikari-Juntura, Eira; Heliövaara, Markku; Solovieva, Svetlana

    2016-01-01

    Disability retirement causes a significant burden on the society and affects the well-being of individuals. Early health problems as determinants of disability retirement have received little attention. The objective was to study, whether interrupting compulsory military service is an early indicator of disability retirement among Finnish men and whether seeking medical advice during military service increases the risk of all-cause disability retirement and disability retirement due to mental disorders and musculoskeletal diseases. We also looked at secular trends in these associations. We examined a nationally representative sample of 2069 men, who had entered military service during 1967–1996. We linked military service health records with cause-specific register data on disability retirement from 1968 to 2008. Secular trends were explored in three service time strata. We used the Cox regression model to estimate proportional hazard ratios and their 95% confidence intervals. During the follow-up time altogether 140 (6.8%) men retired due to disability, mental disorders being the most common cause. The men who interrupted service had a remarkably higher cumulative incidence of disability retirement (18.9%). The associations between seeking medical advice during military service and all-cause disability retirement were similar across the three service time cohorts (overall hazard ratio 1.40 per one standard deviation of the number of visits; 95% confidence interval 1.26–1.56). Visits due to mental problems predicted disability retirement due to mental disorders in the men who served between 1987 and 1996 and a tendency for a similar cause-specific association was seen for musculoskeletal diseases in the men who served in 1967–1976. In conclusion, health problems—in particular mental problems—during late adolescence are strong determinants of disability retirement. Call-up examinations and military service provide access to the entire age cohort of men

  1. Do antidepressants increase the risk of mania and bipolar disorder in people with depression? A retrospective electronic case register cohort study

    PubMed Central

    Reiss, Peter; Shetty, Hitesh; Broadbent, Matthew; Stewart, Robert; McGuire, Philip; Taylor, Matthew

    2015-01-01

    Objectives To investigate the association between antidepressant therapy and the later onset of mania/bipolar disorder. Design Retrospective cohort study using an anonymised electronic health record case register. Setting South London and Maudsley National Health Service (NHS) Trust (SLaM), a large provider of inpatient and community mental healthcare in the UK. Participants 21 012 adults presenting to SLaM between 1 April 2006 and 31 March 2013 with unipolar depression. Exposure Prior antidepressant therapy recorded in electronic health records. Main outcome measure Time to subsequent diagnosis of mania or bipolar disorder from date of diagnosis of unipolar depression, censored at 31 March 2014. Methods Multivariable Cox regression analysis with age and gender as covariates. Results The overall incidence rate of mania/bipolar disorder was 10.9 per 1000 person-years. The peak incidence of mania/bipolar disorder incidence was seen in patients aged between 26 and 35 years (12.3 per 1000 person-years). Prior antidepressant treatment was associated with an increased incidence of mania/bipolar disorder ranging from 13.1 to 19.1 per 1000 person-years. Multivariable analysis indicated a significant association with selective serotonin reuptake inhibitors (HR 1.34, 95% CI 1.18 to 1.52) and venlafaxine (1.35, 1.07 to 1.70). Conclusions In people with unipolar depression, antidepressant treatment is associated with an increased risk of subsequent mania/bipolar disorder. These findings highlight the importance of considering risk factors for mania when treating people with depression. PMID:26667012

  2. Suicides in Visually Impaired Persons: A Nation-Wide Register-Linked Study from Finland Based on Thirty Years of Data

    PubMed Central

    Meyer-Rochow, Victor Benno; Hakko, Helinä; Ojamo, Matti; Uusitalo, Hannu; Timonen, Markku

    2015-01-01

    Focusing on seasonality, gender, age, and suicide methods a Finnish nation-wide cohort-based study was carried out to compare suicide data between sighted, visually-impaired (WHO impairment level I-II, i.e., visual acuity >0.05, but <0.3) and blind (WHO impairment level III-V, i.e., visual acuity <0.05) victims. Standardized mortality ratios (SMR) of age- and gender-matched populations from official 1982–2011 national registers were used. Group differences in categorical variables were assessed with Pearson's Chi-square or Fisher's Exact test and in continuous variables with Mann-Whitney U-test. Seasonality was assessed by Chi-square for multinomials; ratio of observed to expected number of suicides was calculated with 95% confidence level. Hanging, poisoning, drowning, but rarely shooting or jumping from high places, were preferred suicide methods of the blind. Mortality was significantly increased in the visually impaired (SMR = 1.3; 95% CI 1.07–1.61), but in gender-stratified analyses the increase only affected males (1.34; 95% CI = 1.06–1.70) and not females (1.24; 95% CI 0.82–1.88). Age-stratified analyses identified blind males of working age rather than older men (as in the general population) as a high risk group that requires particular attention. The statistically significant spring suicide peak in blind subjects mirrors that of sighted victims and its possible cause in the blind is discussed. PMID:26509899

  3. A Case Study of Connecticut Community Colleges Nursing Programs to Describe Gerontological Content Inclusion in Associate Degree Registered Nursing Programs Using an Educational Curriculum Framework

    ERIC Educational Resources Information Center

    Harris, Leslie J.

    2013-01-01

    The population of adults over age 65 must have competently prepared registered nurses to meet their current and future health care needs. There is a societal component in nursing to ensure that all nurses have the content, skills, and strategies, which includes a focus on basic gerontology preparation. Therefore, the purpose of this descriptive…

  4. Register of hydrogen technology experts

    NASA Technical Reports Server (NTRS)

    Ludtke, P. R.

    1975-01-01

    This register presents the names of approximately 235 individuals who are considered experts, or very knowledgeable, in various fields of technology related to hydrogen. Approximately 90 organizations are represented. Each person is listed by organizational affiliation, address, and principal area of expertise. The criteria for selection of names for the register are extensive experience in a given field of work, participation in or supervision of relevant research programs, contributions to the literature, or being recognized as an expert in a particular field. The purpose of the register is to present, in easy form, sources of dependable information regarding highly technical areas of hydrogen technology, with particular emphasis on safety. The register includes two indexes: an alphabetical listing of the experts and an alphabetical listing of the organizations with which they are affiliated.

  5. Circumstance Adverbials in Registers of Indian English

    ERIC Educational Resources Information Center

    Balasubramanian, Chandrika

    2009-01-01

    This is a corpus-based investigation of "also" and "too" in 11 registers of Indian English. The corpus used for this study is a combination of a Corpus of Contemporary Indian English (CCIE), and certain sections of ICE-India. The study: (1) determines the proportions of "also" and "too" with respect to each other in the Indian corpus; (2) compares…

  6. The Finnish Arthroplasty Register: report of the hip register.

    PubMed

    Puolakka, T J; Pajamäki, K J; Halonen, P J; Pulkkinen, P O; Paavolainen, P; Nevalainen, J K

    2001-10-01

    The Finnish Arthroplasty Register was established in 1980. Between 1980 and 1999, 62,841 primary and 12,224 revision total hip arthroplasties (THA) were recorded. The annual number of both primary and revision THA has increased: in 1999, the incidence of primary THAs was 93/100,000. 174 implant designs have been used, but the 6 commonest implants comprised 82% in 1999. Since the late 1980s, more than 40% of the hips were inserted without cement. Over 47% of the cementless primary hip prostheses were used in patients younger than 60 years and over 93% of the cemented primary hips were used in patients 60 years or older. The 10-year survival rate was 72 (95% CI 67-76)% in patients younger than 55 years and 90 (89-91)% in patients older than 70 years. The commonest reasons for revision were aseptic loosening (65%), dislocation (9%) and infection (7%). In revisions, the 5-year survival of the cementless hip prosthesis improved over time: it was 85 (82-87)% in 1985-1989, 89 (88-91)% in 1990-1994 and 92 (88-95)% in 1995-1999. There are striking differences between the Arthroplasty Registers of Scandinavia as regards the end-point definition of survival. The Finnish Arthroplasty Register considers all reasons for revisions as the end-point of survival, but the Swedish register takes into account only aseptic loosening, so direct comparisons between registers are not possible. Recent data from the Finnish Arthroplasty Register indicate that the results of total hip replacements are improving in Finland. With the civic registration number, one can link and match data files. For example, with use of the Finnish Cancer Register, we found no increase in the risk of cancer after a THA. PMID:11728068

  7. Generic Detection of Register Realignment

    NASA Astrophysics Data System (ADS)

    Durfina, Lukáš; Kolář, Dušan

    2011-09-01

    The register realignment is a method of binary obfuscation and it is used by malware writers. The paper introduces the method how register realignment can be recognized by analysis based on the scattered context grammars. Such an analysis includes exploration of bytes affected by realignment, finding new valid values for them, building the scattered context grammar and parse an obfuscated code by this grammar. The created grammar has LL property—an ability for parsing by this type of grammar.

  8. Generic Detection of Register Realignment

    NASA Astrophysics Data System (ADS)

    Ďurfina, Lukáš; Kolář, Dušan

    2011-09-01

    The register realignment is a method of binary obfuscation and it is used by malware writers. The paper introduces the method how register realignment can be recognized by analysis based on the scattered context grammars. Such an analysis includes exploration of bytes affected by realignment, finding new valid values for them, building the scattered context grammar and parse an obfuscated code by this grammar. The created grammar has LL property--an ability for parsing by this type of grammar.

  9. The effects of marriage and separation on the psychotropic medication use of non-married cohabiters: a register-based longitudinal study among adult Finns.

    PubMed

    Metsä-Simola, Niina; Martikainen, Pekka

    2014-11-01

    Non-marital cohabitation has become increasingly common and is suggested to offer similar mental-health benefits as marriage does. We studied levels and changes in cohabiters' mental health five years before and five years after entering into marriage or separating, and compared long-term non-married and married cohabiters. We analysed changes in the three-month prevalence of psychotropic medication use (psycholeptics and psychoanaleptics, excluding medication for dementia) by proximity to non-marital transition and gender, using register data on 189,394 Finns aged 25 to 64. Similar levels of psychotropic-medication use were found among individuals in long unions that continued throughout the follow-up and were non-marital, marital, or changed from non-marital to marital. Among men and women who separated from longer cohabiting unions of more than five years, however, an increase in medication prevalence was observed immediately before separation, followed by a similar decline after separation. At the time of separation the level of medication use was 9.9 per cent (95% CI = 8.7 - 11.3) among men and 15.7 per cent (95% CI = 14.2 - 17.4) among women compared to 4.3 per cent (95% CI = 3.7 - 5.0) and 8.0 per cent (95% CI = 7.2 - 9.0), respectively, among those who cohabited continuously. No changes in medication use were observed before or after separation among those leaving shorter cohabiting unions of less than five years. Among those marrying following shorter cohabiting unions a positive effect of approaching marriage was observed only among women. Compared to continuous cohabiters, the level of medication use was higher among men and women separating from both short-term and long-term cohabiting unions five years before separation. This selective effect suggests that cohabiters with mental-health problems might benefit from relationship counselling. In a long-term stable union it seems to matter little for mental health whether the union is marital or non

  10. Registered Nurse Education and the Registered Nurse Job Market.

    ERIC Educational Resources Information Center

    Hunt, Howard Allan

    This effort compares the graduates of the three types of Registered Nurse (RN) education programs (three-year Diploma in Nursing, two-year Associate Degree in Nursing (ADN), and four-year Bachelor of Science Degree in Nursing). The basic objective is to determine whether they are perfect substitutes, especially whether ADN graduates can adequately…