A multinational case-control study on childhood brain tumours, anthropogenic factors, birth characteristics and prenatal exposures: A validation of interview data.

PubMed

Vienneau, Danielle; Infanger, Denis; Feychting, Maria; Schüz, Joachim; Schmidt, Lisbeth Samsø; Poulsen, Aslak Harbo; Tettamanti, Giorgio; Klæboe, Lars; Kuehni, Claudia E; Tynes, Tore; Von der Weid, Nicolas; Lannering, Birgitta; Röösli, Martin

2016-02-01

Little is known about the aetiology of childhood brain tumours. We investigated anthropometric factors (birth weight, length, maternal age), birth characteristics (e.g. vacuum extraction, preterm delivery, birth order) and exposures during pregnancy (e.g. maternal: smoking, working, dietary supplement intake) in relation to risk of brain tumour diagnosis among 7-19 year olds. The multinational case-control study in Denmark, Sweden, Norway and Switzerland (CEFALO) included interviews with 352 (participation rate=83.2%) eligible cases and 646 (71.1%) population-based controls. Interview data were complemented with data from birth registries and validated by assessing agreement (Cohen's Kappa). We used conditional logistic regression models matched on age, sex and geographical region (adjusted for maternal age and parental education) to explore associations between birth factors and childhood brain tumour risk. Agreement between interview and birth registry data ranged from moderate (Kappa=0.54; worked during pregnancy) to almost perfect (Kappa=0.98; birth weight). Neither anthropogenic factors nor birth characteristics were associated with childhood brain tumour risk. Maternal vitamin intake during pregnancy was indicative of a protective effect (OR 0.75, 95%-CI: 0.56-1.01). No association was seen for maternal smoking during pregnancy or working during pregnancy. We found little evidence that the considered birth factors were related to brain tumour risk among children and adolescents. Copyright © 2015 Elsevier Ltd. All rights reserved.

Case-Control Studies of Sporadic Enteric Infections: A Review and Discussion of Studies Conducted Internationally from 1990 to 2009

PubMed Central

Fullerton, Kathleen E.; Scallan, Elaine; Kirk, Martyn D.; Mahon, Barbara E.; Angulo, Frederick J.; de Valk, Henriette; van Pelt, Wilfrid; Gauci, Charmaine; Hauri, Anja M.; Majowicz, Shannon; O’Brien, Sarah J.

2015-01-01

Epidemiologists have used case-control studies to investigate enteric disease outbreaks for many decades. Increasingly, case-control studies are also used to investigate risk factors for sporadic (not outbreak-associated) disease. While the same basic approach is used, there are important differences between outbreak and sporadic disease settings that need to be considered in the design and implementation of the case-control study for sporadic disease. Through the International Collaboration on Enteric Disease “Burden of Illness” Studies (the International Collaboration), we reviewed 79 case-control studies of sporadic enteric infections caused by nine pathogens that were conducted in 22 countries and published from 1990 through to 2009. We highlight important methodological and study design issues (including case definition, control selection, and exposure assessment) and discuss how approaches to the study of sporadic enteric disease have changed over the last 20 years (e.g., making use of more sensitive case definitions, databases of controls, and computer-assisted interviewing). As our understanding of sporadic enteric infections grows, methods and topics for case-control studies are expected to continue to evolve; for example, advances in understanding of the role of immunity can be used to improve control selection, the apparent protective effects of certain foods can be further explored, and case-control studies can be used to provide population-based measures of the burden of disease. PMID:22443481

Is case-based learning an effective teaching strategy to challenge students' alternative conceptions regarding chemical kinetics?

NASA Astrophysics Data System (ADS)

Yalçınkaya, Eylem; Taştan-Kırık, Özgecan; Boz, Yezdan; Yıldıran, Demet

2012-07-01

Background: Case-based learning (CBL) is simply teaching the concept to the students based on the cases. CBL involves a case, which is a scenario based on daily life, and study questions related to the case, which allows students to discuss their ideas. Chemical kinetics is one of the most difficult concepts for students in chemistry. Students have generally low levels of conceptual understanding and many alternative conceptions regarding it. Purpose: This study aimed to explore the effect of CBL on dealing with students' alternative conceptions about chemical kinetics. Sample: The sample consists of 53 high school students from one public high school in Turkey. Design and methods : Nonequivalent pre-test and post-test control group design was used. Reaction Rate Concept Test and semi-structured interviews were used for data collection. Convenience sampling technique was followed. For data analysis, the independent samples t-test and ANOVA was performed. Results : Both concept test and interview results showed that students instructed with cases had better understanding of core concepts of chemical kinetics and had less alternative conceptions related to the subject matter compared to the control group students, despite the fact that it was impossible to challenge all the alternative conceptions in the experimental group. Conclusions: CBL is an effective teaching method for challenging students' alternative conceptions in the context of chemical kinetics. Since using cases in small groups and whole class discussions has been found to be an effective way to cope with the alternative conceptions, it can be applied to other subjects and grade levels in high schools with a higher sample size. Furthermore, the effect of this method on academic achievement, motivation and critical thinking skills are other variables that can be investigated for future studies in the subject area of chemistry.

Childhood Leukemia and 50 Hz Magnetic Fields: Findings from the Italian SETIL Case-Control Study

PubMed Central

Salvan, Alberto; Ranucci, Alessandra; Lagorio, Susanna; Magnani, Corrado

2015-01-01

We report on an Italian case-control study on childhood leukemia and exposure to extremely low frequency magnetic fields (ELF-MF). Eligible for inclusion were 745 leukemia cases, aged 0–10 years at diagnosis in 1998–2001, and 1475 sex- and age-matched population controls. Parents of 683 cases and 1044 controls (92% vs. 71%) were interviewed. ELF-MF measurements (24–48 h), in the child’s bedroom of the dwelling inhabited one year before diagnosis, were available for 412 cases and 587 controls included in the main conditional regression analyses. The magnetic field induction was 0.04 μT on average (geometric mean), with 0.6% of cases and 1.6% of controls exposed to >0.3 μT. The impact of changes in the statistical model, exposure metric, and data-set restriction criteria was explored via sensitivity analyses. No exposure-disease association was observed in analyses based on continuous exposure, while analyses based on categorical variables were characterized by incoherent exposure-outcome relationships. In conclusion, our results may be affected by several sources of bias and they are noninformative at exposure levels >0.3 μT. Nonetheless, the study may contribute to future meta- or pooled analyses. Furthermore, exposure levels among population controls are useful to estimate attributable risk. PMID:25689995

Reliability in the DSM-III field trials: interview v case summary.

PubMed

Hyler, S E; Williams, J B; Spitzer, R L

1982-11-01

A study compared the reliability of psychiatric diagnoses obtained from the live interviews and from case summaries, on the same patients, by the same clinicians, using the same DSM-III diagnostic criteria. The results showed that the reliability of the major diagnostic classes of DSM-III was higher when diagnoses were made from live interviews than when they were made from case summaries. We conclude that diagnoses based on information contained in traditionally prepared case summaries may lead to an underestimation of the reliability of diagnoses made based on information collected during a "live" interview.

Social organization and control of tuberculosis: the experience of a Brazilian town.

PubMed

Bulgarelli, Alexandre Favero; Villa, Tereza Cristina Scatena; Pinto, Ione Carvalho

2013-01-01

This study was aimed at analyzing the participation of a committee formed by representatives of the community in tuberculosis control based on a participatory management model. This is a Case Study involving a tuberculosis committee with data collected through semi-structured interviews conducted with nine individuals. The data, organized through the Association of Ideas Map technique, were analyzed based on the Social Constructionism perspective. The participation of the Tuberculosis Committee studied was shown to be effective and associated with aspects articulated according to the measures taken by the social parties involved in the committee, culminating with assistances inserted into certain parts of the town's co-management. It was concluded that the reality of this case study shows that relationships among civil society can guide the management model in the search for effective processes of tuberculosis control.

Cigarette smoking and risk of pancreatic cancer: a clinic-based case-control study in the San Francisco Bay Area.

PubMed

Lea, C Suzanne; Holly, Elizabeth A; Bracci, Paige M

2015-11-01

Cigarette smoking is an established risk factor for pancreatic cancer (PC). We examined the association between cigarette smoking and PC in a San Francisco Bay Area clinic-based, case-control study. A total of 536 cases and sex and age frequency-matched controls (n = 869) were recruited predominately from the University of California San Francisco (UCSF) medical clinics between 2006 and 2011. Participants were interviewed in-person using structured questionnaires. Adjusted odds ratios (ORs) were computed. Forty-eight percent of cases and controls reported never having smoked cigarettes; 39% of cases and 40% of controls were former smokers; 13% of cases and 12% of controls were current smokers. No association was found for either former (OR = 0.85, 95% confidence interval [CI] = 0.66-1.1) or current cigarette smoking (men: OR = 1.0, 95% CI = 0.60-1.7; women: OR = 1.2, 95% CI = 0.73-2.1). No dose-response relationships were detected with number of cigarettes/day, smoking intensity, duration, or years since last smoked. Comparisons with a 1995-1999 population-based UCSF study demonstrated a significantly increased proportion of never smokers in this study (P < .001). This study revealed no significant associations between cigarette smoking and PC in the San Francisco Bay Area during 2006-2011. Data suggest a reduction in the duration of smoking within the referral population. Copyright © 2015 Elsevier Inc. All rights reserved.

Gender-specific suicide risk factors: a case-control study of individuals with major depressive disorder.

PubMed

Dalca, Ioana Mioara; McGirr, Alexander; Renaud, Johanne; Turecki, Gustavo

2013-12-01

Available information on risk for suicide completion in females is limited and often extrapolated from studies conducted in males. However, the validity of extending to females risk factors identified among male suicide cases is unclear. In this study, we aimed to investigate clinical and behavioral risk factors for suicide among female depressed patients and compare them to similar factors among male depressed patients. We identified 201 suicide completers (160 male and 41 female) who died during an episode of major depressive disorder (MDD). Cases were compared to 127 living patients with MDD (88 male and 39 female). All subjects were characterized for Axis I and II diagnoses using the Structured Clinical Interview for DSM-IV Axis I Disorders and Structured Clinical Interview for DSM-IV Axis II Personality Disorders according to the DSM-IV, as well as behavioral and temperament dimensions using proxy-based interviews. The primary outcome was measures of impulsive and impulsive-aggressive behaviors. Compared to controls, male, but not female suicide cases had higher levels of impulsive aggression (P < .05). Nonimpulsive aggression differentiated both female (P < .05) and male (P < .01) suicide cases from controls. However, nonimpulsive aggression and impulsive aggression were correlated constructs in males (r = 0.297; P < .001), yet uncorrelated among females (r = 0.121; P = .390). Established risk factors for suicide, such as alcohol and substance dependence, cluster B disorders, and elevated hostility and aggression, were replicated in the pooled-sex analyses, and, though not statistically significant in discriminating between suicide cases and controls by gender, maintained strong group differences. Males and females share many risk factors for suicide in MDD, yet alcohol dependence is much more specific though less sensitive among depressed females. Nonimpulsive aggression is part of a diathesis for suicide in females, which is distinct from the well-characterized impulsive aggression that is consistently reported in a portion of male suicide cases. © Copyright 2013 Physicians Postgraduate Press, Inc.

Improving a Case-Control Study of Multiple Sclerosis Using Formative Research

PubMed Central

Williamson, Dhelia M.; Wagner, Laurie; Henry, Judy P.

2015-01-01

Formative research (i.e. focus groups and key informant interviews) was conducted to understand risk perceptions and identify barriers to participation in a case-control study of environmental exposures and genetic susceptibility as risk factors for multiple sclerosis (MS). Individuals with MS were recruited to participate in a focus group discussion and individual interviews. Participants were asked to review and comment on study materials and process including participation, interview, genetic testing, confidentiality, and questionnaire. A structured discussion guide was used with all participants to ensure uniformity and coverage of all predetermined topics. Participants reported an increased likelihood of participation if they were informed about the study by their neurologist and not a government agency. All participants expressed willingness to provide a blood sample for genotyping but disagreed about the setting for the blood draw (at home or in a lab). Participants were concerned that they would not receive their individual genotyping results. The study protocol and materials were revised based on comments from the focus group participants. Formative research is an under-utilized resource for researchers conducting epidemiologic studies. Even with limited resources, piloting study materials with individuals similar to the proposed study population can provide opportunities to make modifications to effectively meet the needs of participants and promote participation and retention. PMID:25741529

High risk of brain tumors in military personnel: a case control study.

PubMed

Fallahi, P; Elia, G; Foddis, R; Cristaudo, A; Antonelli, A

2017-01-01

Scientific literature suggests a relationship between military occupation and the development of brain tumors, but no italian study has investigated on the impact of this job on the brain cancer morbidity. In this a study information were obtained from patients recruited in the Neurosurgical Department of the University-Hospital of Pisa, Italy, from 1990 to 1999. The study has been conducted as a case-control study. 161, newly diagnosed cases of brain tumors (glioma and meningiomas, histologically confirmed), were recruited, such as 483 controls (with other non tumoral neurologic diseases: trauma, hemorrhagic brain disorders, aneurism, etc), by matching cases and controls (1:3), for age (± 5 years) and gender. Cases and controls were interviewed in the Neurosurgical Department, University-Hospital of Pisa, Italy, and the occupational histories of cases and controls were compared. Cases and controls have showed a statistically significant difference, based on their occupation (military vs. non-military occupation). A statistically significant association was seen between brain tumors and military occupation among evaluated patients (p=0.013). Further studies regarding this population group are needed, to determine the causes for the increased risk of this cancer. Furthermore, a subsequent reevaluation in other patients collected in more recent years will be needed to evaluate the trend of this association.

Quantifying the impact of selection bias caused by nonparticipation in a case-control study of mobile phone use.

PubMed

Vrijheid, Martine; Richardson, Lesley; Armstrong, Bruce K; Auvinen, Anssi; Berg, Gabriele; Carroll, Matthew; Chetrit, Angela; Deltour, Isabelle; Feychting, Maria; Giles, Graham G; Hours, Martine; Iavarone, Ivano; Lagorio, Susanna; Lönn, Stefan; McBride, Mary; Parent, Marie-Elise; Sadetzki, Siegal; Salminen, Tina; Sanchez, Marie; Schlehofer, Birgitte; Schüz, Joachim; Siemiatycki, Jack; Tynes, Tore; Woodward, Alistair; Yamaguchi, Naohito; Cardis, Elisabeth

2009-01-01

To quantitatively assess the impact of selection bias caused by nonparticipation in a multinational case-control study of mobile phone use and brain tumor. Non-response questionnaires (NRQ) were completed by a sub-set of nonparticipants. Selection bias factors were calculated based on the prevalence of mobile phone use reported by nonparticipants with NRQ data, and on scenarios of hypothetical exposure prevalence for other nonparticipants. Regular mobile phone use was reported less frequently by controls and cases who completed the NRQ (controls, 56%; cases, 50%) than by those who completed the full interview (controls, 69%; cases, 66%). This relationship was consistent across study centers, sex, and age groups. Lower education and more recent start of mobile phone use were associated with refusal to participate. Bias factors varied between 0.87 and 0.92 in the most plausible scenarios. Refusal to participate in brain tumor case-control studies seems to be related to less prevalent use of mobile phones, and this could result in a downward bias of around 10% in odds ratios for regular mobile phone use. The use of simple selection bias estimation methods in case-control studies can give important insights into the extent of any bias, even when nonparticipant information is incomplete.

Risk factors for chronic periodontitis in Sri Lankan adults: a population based case-control study.

PubMed

Wellapuli, Nimali; Ekanayake, Lilani

2017-09-07

To determine risk factors for chronic periodontitis in 30-60 year olds in Sri Lanka. Cases and controls for this population based unmatched case-control study were identified from a broader cross-sectional study which was conducted to determine the prevalence of chronic periodontitis in 30-60 year old adults in Colombo district Sri Lanka. The study included 694 cases and 706 controls. Data were collected by means of a pre-tested interviewer administered questionnaire to obtain information about socio-demographic and behavioural factors, a physical examination to record anthropometric measurements and an oral examination. Being a male, a Muslim, belonging to the 45-60 year old age group, having less than 12 years of education, using the finger to clean teeth, current smoking, current betel quid chewing, self-reported diabetes and hypertension emerged as risk factors for chronic periodontitis. Several socio-demographic and behavioural factors as well as co-morbid conditions emerged as independent risk factors for chronic periodontits in this population. The findings could be used for planning programmes to reduce the burden of chronic periodontits in Colombo district Sri Lanka.

Life course body mass index and risk and prognosis of amyotrophic lateral sclerosis: results from the ALS registry Swabia.

PubMed

Peter, Raphael Simon; Rosenbohm, Angela; Dupuis, Luc; Brehme, Torben; Kassubek, Jan; Rothenbacher, Dietrich; Nagel, Gabriele; Ludolph, Albert Christian

2017-10-01

Weight loss appears as a strong predictor of survival of patients with amyotrophic lateral sclerosis, yet no data are currently available to describe the life course history of pre-diagnostic body mass index (BMI) in these patients. 393 ALS cases (mean age: 65.8 years, 57.3% men) and 791 controls matched by age and sex from a population-based case-control study of the ALS Registry Swabia were analyzed. Differences of BMI change in cases and controls over time were modeled using a multilevel additive model. In addition, survival in ALS cases by BMI change was modeled using an accelerated failure time model adjusted for prognostic factors. In ALS cases, BMI was consistently higher than in controls in the 20-70 years before the interview. Conditional logistic regression revealed an odds ratio of 1.05 (95% confidence interval (CI) 1.00-1.11, p = 0.041) per 1 kg/m 2 higher BMI 35-45 years before interview. However, a sharp decrease was evident in the BMI of ALS cases about 10 years before disease onset. Moreover, weight loss was strongly associated with shorter survival in ALS patients. Illustrating this, patients with stable weight showed a median survival time of 22.1 (95%-CI 19.2-25.0) months, as compared to 13.4 (95%-CI 10.5-16.3) months for patients with weight loss of 2.5 kg/m 2 over the last 3 months before the interview. Thus, alterations in body weight are present in ALS patients already decades before clinical manifestation of ALS, while weight loss precedes motor symptoms of several years and is associated with poor prognosis.

Does living near heavy industry cause lung cancer in women? A case-control study using life grid interviews.

PubMed

Edwards, R; Pless-Mulloli, T; Howel, D; Chadwick, T; Bhopal, R; Harrison, R; Gribbin, H

2006-12-01

The incidence of lung cancer among women is high in the highly industrialised area of Teesside in north-east England. Previous research has implicated industrial pollution as a possible cause. A study was undertaken to investigate whether prolonged residence close to heavy industry is associated with lung cancer among women in Teesside. Two hundred and four women aged <80 years with incident primary lung cancer and 339 age matched community controls were recruited to a population based case-control study. Life course residential, occupational, and active and passive smoking histories were obtained using an interviewer administered questionnaire. The age adjusted odds ratio (OR) for lung cancer among people living >25 years v 0 years near (within 0-5 km) heavy industry in Teesside was 2.13 (95% CI 1.34 to 3.38). After adjustment for confounding factors the OR was 1.83 (95% CI 0.82 to 4.08) for >25 years or 1.10 (95% CI 0.96 to 1.26) for an additional 10 years living near industry. ORs were similar after residence near heavy industry outside Teesside was also included, and when latency was allowed for by disregarding residential exposures within the last 20 years. Adjustment for active smoking had the greatest effect on the OR. This population based study using life grid interviews for life course exposure assessment has addressed many deficiencies in the design of previous studies. The findings support those in most of the international literature of a modestly raised risk of lung cancer with prolonged residence close to heavy industry, although the confidence intervals were wide. The effect of air pollution on the incidence of lung cancer merits continued study.

Spatial variation in mortality risk for haematological malignancies near a petrochemical refinery: a population-based case-control study

PubMed Central

Di Salvo, Francesca; Meneghini, Elisabetta; Vieira, Veronica; Baili, Paolo; Mariottini, Mauro; Baldini, Marco; Micheli, Andrea; Sant, Milena

2015-01-01

Introduction The study investigated the geographic variation of mortality risk for hematological malignancies (HMs) in order to identify potential high-risk areas near an Italian petrochemical refinery. Material and methods A population-based case-control study was conducted and residential histories for 171 cases and 338 sex- and age-matched controls were collected. Confounding factors were obtained from interviews with consenting relatives for 109 HM deaths and 267 controls. To produce risk mortality maps, two different approaches were applied. We mapped (1) adptive kernel density relative risk estimation (KDE) for case-control studies which estimates a spatial relative risk function using the ratio between cases and controls’ densities, and (2) estimated odds ratios for case-control study data using generalized additive models (GAMs) to smooth the effect of location, a proxy for exposure, while adjusting for confounding variables. Results No high-risk areas for HM mortality were identified among all subjects (men and women combined), by applying both approaches. Using the adaptive KDE approach, we found a significant increase in death risk only among women in a large area 2–6 km southeast of the refinery and the application of GAMs also identified a similarly-located significant high-risk area among women only (global p-value<0.025). Potential confounding risk factors we considered in the GAM did not alter the results. Conclusion Both approaches identified a high-risk area close to the refinery among women only. Those spatial methods are useful tools for public policy management to determine priority areas for intervention. Our findings suggest several directions for further research in order to identify other potential environmental exposures that may be assessed in forthcoming studies based on detailed exposure modeling. PMID:26073202

High School Economics, Cooperative Learning, and the End-of-Course-Test--A Case Study

ERIC Educational Resources Information Center

Beavers, Sharon

2011-01-01

The primary purpose of this twelve-week case study was to explore the use of a cooperative learning strategy with small groups of students in a 12th-grade economics class as diverse learners prepared for tests. The complete case study was based on observations of students, student surveys, focus group interviews, and interviews with educators at…

Khat use as risk factor for psychotic disorders: a cross-sectional and case-control study in Somalia.

PubMed

Odenwald, Michael; Neuner, Frank; Schauer, Maggie; Elbert, Thomas; Catani, Claudia; Lingenfelder, Birke; Hinkel, Harald; Häfner, Heinz; Rockstroh, Brigitte

2005-02-12

Little is known about the prevalence of khat-induced psychotic disorders in East African countries, where the chewing of khat leaves is common. Its main psycho-active component cathinone produces effects similar to those of amphetamine. We aimed to explore the prevalence of psychotic disorders among the general population and the association between khat use and psychotic symptoms. In an epidemiological household assessment in the city of Hargeisa, North-West Somalia, trained local interviewers screened 4,854 randomly selected persons from among the general population for disability due to severe mental problems. The identified cases were interviewed based on a structured interview and compared to healthy matched controls. Psychotic symptoms were assessed using the items of the WHO Composite International Diagnostic Interview and quantified with the Positive and Negative Symptoms Scale. Statistical testing included Student's t-test and ANOVA. Local interviewers found that rates of severe disability due to mental disorders were 8.4% among males (above the age of 12) and differed according to war experiences (no war experience: 3.2%; civilian war survivors: 8.0%; ex-combatants: 15.9%). The clinical interview verified that in 83% of positive screening cases psychotic symptoms were the most prominent manifestations of psychiatric illness. On average, cases with psychotic symptoms had started to use khat earlier in life than matched controls and had been using khat 8.6 years before positive symptoms emerged. In most cases with psychotic symptoms, a pattern of binge use (> two 'bundles' per day) preceded the onset of psychotic symptoms, in contrast to controls of the same age. We found significant correlations between variables of khat consumption and clinical scales (0.35 to 0.50; p < 0.05), and between the age of onset of khat chewing and symptom onset (0.70; p <0.001). Evidence indicates a relationship between the consumption of khat and the onset of psychotic symptoms among the male population, whereby not the khat intake per se but rather early onset and excessive khat chewing seemed to be related to psychotic symptoms. The khat problem must be addressed by means other than prohibition, given the widespread use and its role in Somali culture.

Modifiable risk factors of hypertension: A hospital-based case-control study from Kerala, India.

PubMed

Pilakkadavath, Zarin; Shaffi, Muhammed

2016-01-01

Hypertension is a major cause of cardiovascular morbidity and mortality in Kerala. Excess dietary salt, low dietary potassium, overweight and obesity, physical inactivity, excess alcohol, smoking, socioeconomic status, psychosocial stressors, and diabetes are considered as modifiable risk factors for hypertension. To estimate and compare the distribution of modifiable risk factors among hypertensive (cases) and nonhypertensive (controls) patients and to estimate the effect relationship of risk factors. Age- and sex-matched case-control study was conducted in a tertiary care hospital in Kerala using a pretested interviewer-administered structured questionnaire based on the WHO STEPS instrument for chronic disease risk factor surveillance. Bivariate and multiple logistic regression analyses were done. A total of 296 subjects were included in the study. The mean age of study sample was 50.13 years. All modifiable risk factors studied vis-ΰ-vis obesity, lack of physical activity, inadequate fruits and vegetable intake, diabetes, smoking, and alcohol use were significantly different in proportion among cases and controls. Obesity, lack of physical activity, smoking, and diabetes were found to be significant risk factors for hypertension after adjusting for other risk factors. Hypertension is strongly driven by a set of modifiable risk factors. Massive public awareness campaign targeting risk factors is essential in controlling hypertension in Kerala, especially focusing on physical exercise and control of diabetes, obesity, and on quitting smoking.

Outbreak of hepatitis A in two federal states of Germany: bakery products as vehicle of infection.

PubMed

Schenkel, K; Bremer, V; Grabe, C; Van Treeck, U; Schreier, E; Höhne, M; Ammon, A; Alpers, K

2006-12-01

In April 2004, increased numbers of hepatitis A were noted in six neighbouring districts in Germany. Exploratory interviews showed that patients had consumed bakery products from company X where two employees had been diagnosed with hepatitis A in February. A case-control study of consumption of products of company X was carried out through telephone interviews. Altogether, 64 cases were identified. Fifty-two cases and 112 controls aged >or=16 years were included in the case-control study. In total, 46/52 cases and 37/112 controls had consumed company X products [odds ratio (OR) 15.5, 95% confidence interval (CI) 6.1-39.7]. Of these, 36/46 cases and 16/37 controls had consumed pastries (OR 4.7, 95% CI 1.8-12.3), 25/46 cases and 12/37 controls had consumed filled doughnuts (OR 2.5, 95% CI 1.0-6.1). Sequence analysis of the VP1-2A junction region indicated 100% strain homology between cases and an infected employee of company X. We recommended reinforcement of hygiene precautions, and consideration of a prolongation of compulsory work absence after post-exposure vaccination.

Birth outcomes of cases with isolated atrial septal defect type II--a population-based case-control study.

PubMed

Vereczkey, Attila; Kósa, Zsolt; Csáky-Szunyogh, Melinda; Urbán, Róbert; Czeizel, Andrew E

2013-07-01

In general, epidemiological studies have evaluated cases with congenital cardiovascular abnormalities together. The aim of this study is to describe the birth outcomes of cases with isolated/single atrial septal defect type II (ASD-II, i.e. only a fossa ovalis defect) after surgical correction or lethal outcome in the light of maternal sociodemographic data. Comparison of birth outcomes and maternal characteristics of cases with ASD-II and controls without defect. The population-based Hungarian Case-Control Surveillance of Congenital Abnormalities. Hungarian newborn infants with or without ASD-II. Medically recorded birth outcomes, maternal age and birth order were evaluated. Marital and employment status was based on maternal information. The lifestyle factors were analyzed in a subsample of mothers visited at home based on a personal interview with mothers and their close relatives, and the family consensus was accepted. Mean gestational age at delivery and birthweight, rate of preterm birth and low birthweight, maternal age, birth order, marital and employment status. The evaluation of 471 cases with ASD-II and 38,151 controls without any defects showed a female excess in cases with ASD-II, having shorter gestational age and lower mean birthweight, and thus a higher rate of preterm births and low birthweight. Intrauterine growth restriction and shorter gestational age were found in cases with ASD-II, particularly in female children. These factors may have a general developmental process in which there was not closure of the foramen ovale, thus echocardiographic screening of these babies might be of value. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica © 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

Online market research panel members as controls in case-control studies to investigate gastrointestinal disease outbreaks: early experiences and lessons learnt from the UK.

PubMed

Mook, P; McCormick, J; Kanagarajah, S; Adak, G K; Cleary, P; Elson, R; Gobin, M; Hawker, J; Inns, T; Sinclair, C; Trienekens, S C M; Vivancos, R; McCarthy, N D

2018-03-01

Established methods of recruiting population controls for case-control studies to investigate gastrointestinal disease outbreaks can be time consuming, resulting in delays in identifying the source or vehicle of infection. After an initial evaluation of using online market research panel members as controls in a case-control study to investigate a Salmonella outbreak in 2013, this method was applied in four further studies in the UK between 2014 and 2016. We used data from all five studies and interviews with members of each outbreak control team and market research panel provider to review operational issues, evaluate risk of bias in this approach and consider methods to reduce confounding and bias. The investigators of each outbreak reported likely time and cost savings from using market research controls. There were systematic differences between case and control groups in some studies but no evidence that conclusions on the likely source or vehicle of infection were incorrect. Potential selection biases introduced by using this sampling frame and the low response rate are unclear. Methods that might reduce confounding and some bias should be balanced with concerns for overmatching. Further evaluation of this approach using comparisons with traditional methods and population-based exposure survey data is recommended.

Hobbies with solvent exposure and risk of non-Hodgkin lymphoma.

PubMed

Colt, Joanne S; Hartge, Patricia; Davis, Scott; Cerhan, James R; Cozen, Wendy; Severson, Richard K

2007-05-01

Occupational exposure to solvents has been reported to increase non-Hodgkin lymphoma (NHL) risk in some, but not all, studies. In a population-based case-control study, we examined whether participation in selected hobbies involving solvent exposure increases NHL risk. We identified NHL cases diagnosed at ages 20-74 years between 1998 and 2000 in Iowa or metropolitan Los Angeles, Detroit, and Seattle. Controls were selected using random digit dialing or Medicare files. Computer-assisted personal interviews (551 cases, 462 controls) elicited data on model building, painting/silkscreening/artwork, furniture refinishing, and woodworking/home carpentry. Hobby participation (68% of cases, 69% of controls) was not associated with NHL risk (OR = 0.9, 95% CI = 0.7-1.2). Compared to people with none of the hobbies evaluated, those who built models had significantly lower risk (OR = 0.7, CI = 0.5-1.0), but risk did not vary with the number of years or lifetime hours. Risk estimates for the other hobbies were generally less than one, but the associations were not significant and there were no notable patterns with duration of exposure. Use of oil-based, acrylic, or water-based paints; paint strippers; polyurethane; or varnishes was not associated with NHL risk. We conclude that participation in hobbies involving exposure to organic solvents is unlikely to increase NHL risk.

Occupational exposures to engine exhausts and other PAHs and breast cancer risk: A population-based case-control study.

PubMed

Rai, Rajni; Glass, Deborah C; Heyworth, Jane S; Saunders, Christobel; Fritschi, Lin

2016-06-01

Some previous studies have suggested that exposure to engine exhausts may increase risk of breast cancer. In a population-based case-control study of breast cancer in Western Australia we assessed occupational exposure to engine exhausts using questionnaires and telephone interviews. Odds Ratios (OR) and 95% Confidence Intervals (CI) were calculated using logistic regression. We found no association between risk of breast cancer and occupational exposure to diesel exhaust (OR 1.07, 95%CI: 0.81-1.41), gasoline exhaust (OR 0.98, 95%CI: 0.74-1.28), or other exhausts (OR 1.08, 95%CI: 0.29-4.08). There were also no significant dose- or duration-response relationships. This study did not find evidence supporting the association between occupational exposures to engine exhausts and breast cancer risk. Am. J. Ind. Med. 59:437-444, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

High risk of brain tumors in farmers: a mini-review of the literature, and report of the results of a case control study.

PubMed

Fallahi, P; Foddis, R; Cristaudo, A; Antonelli, A

2017-01-01

Even though a relationship between farmer work and the development of brain tumors was suggest by the scientific literature, a small number of italian studies investigate on the impact of this job on the cancer morbidity of farmer population. The informations about this case-control study were obtained from patients recruited in the Neurosurgical Department of the University-Hospital of Pisa, Italy, from 1990 to 2000. One hundred and seventy-four, newly diagnosed cases of brain tumors (glioma and meningiomas, histologically confirmed), were recruited, such as 522 controls (with other non tumoral neurologic diseases: trauma, etc), by matching cases and controls (1:3), for age (± 5 years) and gender. Cases and controls were interviewed in the Neurosurgical Department, University-Hospital of Pisa, Italy, and the occupational histories of cases and controls were compared. Cases and controls have showed a statistically significant difference, based on their occupation (agricultural vs. non-agricultural). We observed a significant association among brain tumors and rural activity in evaluated patients (P=0.008). Further studies regarding this population group are needed, to determine the causes for the increased risk of this cancer, particularly in regions where there is an intense agricultural activity and where pesticides are used. Furthermore, a subsequent reevaluation in other patients collected in more recent years will be needed to evaluate the trend of this association.

Students' Learning Experiences from Didactic Teaching Sessions Including Patient Case Examples as Either Text or Video: A Qualitative Study.

PubMed

Pedersen, Kamilla; Moeller, Martin Holdgaard; Paltved, Charlotte; Mors, Ole; Ringsted, Charlotte; Morcke, Anne Mette

2017-10-06

The aim of this study was to explore medical students' learning experiences from the didactic teaching formats using either text-based patient cases or video-based patient cases with similar content. The authors explored how the two different patient case formats influenced students' perceptions of psychiatric patients and students' reflections on meeting and communicating with psychiatric patients. The authors conducted group interviews with 30 medical students who volunteered to participate in interviews and applied inductive thematic content analysis to the transcribed interviews. Students taught with text-based patient cases emphasized excitement and drama towards the personal clinical narratives presented by the teachers during the course, but never referred to the patient cases. Authority and boundary setting were regarded as important in managing patients. Students taught with video-based patient cases, in contrast, often referred to the patient cases when highlighting new insights, including the importance of patient perspectives when communicating with patients. The format of patient cases included in teaching may have a substantial impact on students' patient-centeredness. Video-based patient cases are probably more effective than text-based patient cases in fostering patient-centered perspectives in medical students. Teachers sharing stories from their own clinical experiences stimulates both engagement and excitement, but may also provoke unintended stigma and influence an authoritative approach in medical students towards managing patients in clinical psychiatry.

Nutrient intake and gastric cancer risk: a case-control study in Spain.

PubMed

Ramón, J M; Serra-Majem, L; Cerdó, C; Oromí, J

1993-12-01

A case-control study of dietary factors and gastric cancer was conducted between September 1986 and March 1989 in the Barcelona metropolitan area, Spain. In all 117 cases with histologically confirmed diagnosis of gastric adenocarcinoma were matched on sex, age and possession of a telephone to 234 population controls. Of the controls 188 (80.3%) were selected by random digit telephone dialing and 46 (19.7%) by neighbourhood of residence. Information about frequency and amount of consumption of 89 alimentary items was gathered by questionnaire, and cases and controls were interviewed in their homes by trained interviewers. The gastric cancer risk decreased in proportion to vitamin C intake. In multivariate analysis adjusting for major covariables, energy and vitamin A intake, the estimated odds ratio (OR) for the upper quartile of vitamin C intake was 0.3 (95% confidence interval [CI]: 0.1-0.8). After adjustment for major covariables, calories and vitamin C intake, vitamin A did not show significant association with the gastric cancer risk. Our findings are consistent with previous case-control studies and with the hypothesis that vitamin C may inhibit the intragastric nitrosation process.

Epidemiological evidence of carcinogenicity of chlorinated organics in drinking water.

PubMed

Cantor, K P

1982-12-01

Concern has recently been voiced over possible chronic toxicity associated with chlorination of public drinking water supplies in the United States. This paper reviews the available evidence and the studies underway to further evaluate hypothesized associations between cancer risk and byproducts of chlorination. Preliminary data from measures of halogenated volatiles and personal exposure histories from respondents in a large epidemiologic study of bladder cancer are presented. These data support the use in epidemiologic studies of categorical measures of exposure and suggest that results from completed case-control studies, based on death certificates, may have underestimated the true risk of exposure to chlorination by-products. The current generation of studies which use a case-control interview design offer many advantages over earlier efforts to evaluate this issue.

Epidemiological evidence of carcinogenicity of chlorinated organics in drinking water.

PubMed Central

Cantor, K P

1982-01-01

Concern has recently been voiced over possible chronic toxicity associated with chlorination of public drinking water supplies in the United States. This paper reviews the available evidence and the studies underway to further evaluate hypothesized associations between cancer risk and byproducts of chlorination. Preliminary data from measures of halogenated volatiles and personal exposure histories from respondents in a large epidemiologic study of bladder cancer are presented. These data support the use in epidemiologic studies of categorical measures of exposure and suggest that results from completed case-control studies, based on death certificates, may have underestimated the true risk of exposure to chlorination by-products. The current generation of studies which use a case-control interview design offer many advantages over earlier efforts to evaluate this issue. PMID:6759108

Risk and protective factors for meningococcal disease in adolescents: matched cohort study.

PubMed

Tully, Joanna; Viner, Russell M; Coen, Pietro G; Stuart, James M; Zambon, Maria; Peckham, Catherine; Booth, Clare; Klein, Nigel; Kaczmarski, Ed; Booy, Robert

2006-02-25

To examine biological and social risk factors for meningococcal disease in adolescents. Prospective, population based, matched cohort study with controls matched for age and sex in 1:1 matching. Controls were sought from the general practitioner. Six contiguous regions of England, which represent some 65% of the country's population. 15-19 year olds with meningococcal disease recruited at hospital admission in six regions (representing 65% of the population of England) from January 1999 to June 2000, and their matched controls. Blood samples and pernasal and throat swabs were taken from case patients at admission to hospital and from cases and matched controls at interview. Data on potential risk factors were gathered by confidential interview. Data were analysed by using univariate and multivariate conditional logistic regression. 144 case control pairs were recruited (74 male (51%); median age 17.6). 114 cases (79%) were confirmed microbiologically. Significant independent risk factors for meningococcal disease were history of preceding illness (matched odds ratio 2.9, 95% confidence interval 1.4 to 5.9), intimate kissing with multiple partners (3.7, 1.7 to 8.1), being a university student (3.4, 1.2 to 10) and preterm birth (3.7, 1.0 to 13.5). Religious observance (0.09, 0.02 to 0.6) and meningococcal vaccination (0.12, 0.04 to 0.4) were associated with protection. Activities and events increasing risk for meningococcal disease in adolescence are different from in childhood. Students are at higher risk. Altering personal behaviours could moderate the risk. However, the development of further effective meningococcal vaccines remains a key public health priority.

Psychological Factors in Deliberate Self-Harm as Seen in an Urban African Population in Uganda: A Case-Control Study

ERIC Educational Resources Information Center

Kinyanda, Eugene; Hjelmeland, Heidi; Musisi, Seggane

2005-01-01

Psychological factors associated with deliberate self-harm (DSH) as seen in an African population in Uganda are described. A case-control study design was employed in which a Luganda version (predominant language in the study area) of the modified European Parasuicide Interview Schedule I (EPSIS I) was used to collect data. The controls were…

Homicide in children and adolescents: a case-control study in Recife, Brazil.

PubMed Central

Falbo, G. H.; Buzzetti, R.; Cattaneo, A.

2001-01-01

OBJECTIVE: The homicide rate for children and adolescents in Recife, Brazil, mostly caused by firearms, is one of the highest that has been reported. The present case-control study was designed to identify factors that were potentially modifiable through preventive interventions. METHODS: Cases were 255 homicide victims under 20 years of age, who had died in 1997 and been identified at the Institute of Forensic Medicine, Police Department, Recife, and whose relatives were interviewed by two community health workers when they claimed the corpse. The 255 controls were neighbours of the cases, paired by age and sex to them, and identified within one week of identification of each case, and whose relatives were interviewed by a third community health worker. FINDINGS: The overall homicide rate in Recife for under-20-year-olds in 1997 was 49 per 100,000; among males aged 15-19 years it was 324 per 100,000. Firearms were responsible for 97% of deaths. After multivariate logistic regression, history of personal police records (odds ratio (OR) = 18.65; 95% confidence interval (CI) = 1.91-182.50), use of illicit drugs (OR = 7.48; 95% CI = 1.86-30.17), tap water at home (OR = 7.30; 95% CI = 1.80-29.59), and maternal age at birth over 26 years (OR = 3.98; 95% CI = 1.79-8.84) were identified as risk factors, while higher education (OR = 0.22; 95% CI = 0.11-0.43), religious practice (OR = 0.25; 95% CI = 0.10-0.65), and presence of the father in the household (OR = 0.28; 95% CI = 0.09-0.81) were protective factors. CONCLUSION: Public health authorities should plan preventive interventions based on the findings of this study and should control the acquisition, possession and carrying of firearms. PMID:11217662

Case-control study of an outbreak of acute toxoplasmosis in an industrial plant in the state of São Paulo, Brazil.

PubMed

Ekman, Claudio Cesar Jaguaribe; Chiossi, Maria Fernanda do Valle; Meireles, Luciana Regina; Andrade Júnior, Heitor Franco de; Figueiredo, Walter Manso; Marciano, Maria Aparecida Moraes; Luna, Expedito José de Albuquerque

2012-01-01

Foodborne diseases represent operational risks in industrial restaurants. We described an outbreak of nine clustered cases of acute illness resembling acute toxoplasmosis in an industrial plant with 2300 employees. These patients and another 36 similar asymptomatic employees were diagnosed with anti-T. gondii IgG titer and avidity by ELISA. We excluded 14 patients based on high IgG avidity and chronic toxoplasmosis: 13 from controls and one from acute disease other than T. gondii infection. We also identified another three asymptomatic employees with T.gondii acute infection and also anti-T. gondii IgM positive as remaining acute cases. Case control study was conducted by interview in 11 acute infections and 20 negative controls. The ingestion of green vegetables, but not meat or water, was observed to be associated with the incidence of acute disease. These data reinforce the importance of sanitation control in industrial restaurants and also demonstrate the need for improvement in quality control regarding vegetables at risk for T. gondii oocyst contamination. We emphasized the accurate diagnosis of indexed cases and the detection of asymptomatic infections to determine the extent of the toxoplasmosis outbreak.

Advancing our Understanding of the Etiologies and Mutational Landscapes of Basal-Like, Luminal A, and Luminal B Breast Cancers

DTIC Science & Technology

2015-11-30

consents and conducting telephone interviews. A total of 1082 cases and controls have been enrolled in the study. Case enrollment is on target and...Subject Refusal 148 78 226 Subject Refusal CSS Opt Out 21 NA 21 TOTAL IN PROCESS FOR INTERVIEW 551 34 585 TOTAL ENROLLED 958 124 1082

Risk factors associated with purchasing pesticide from shops for self-poisoning: a protocol for a population-based case-control study.

PubMed

Weerasinghe, Manjula; Konradsen, Flemming; Eddleston, Michael; Pearson, Melissa; Gunnell, David; Hawton, Keith; Jayamanne, Shaluka; Pabasara, Chathurani; Jayathilaka, Tharidu; Dissanayaka, Kalpani; Rajapaksha, Sandamali; Thilakarathna, Prasanna; Agampodi, Suneth

2015-05-20

Pesticide self-poisoning is one of the most frequently used methods of suicide worldwide, killing over 300,000 people annually. Around 15-20% of pesticide self-poisonings occur soon after the person has bought the pesticide from a shop. We aim to determine the characteristics of individuals who purchase pesticides directly from shops and how they differ from individuals who access pesticides from other sources such as home, home garden or farmland. This information will help inform possible vendor/shop-based intervention strategies aimed at reducing access to pesticides used for self-harm. This study will investigate risk factors associated with purchasing pesticides for acts of self-poisoning from pesticide shops, including cases identified over a 9-month period using a population-based case-control group approach. Four interviewer-administered data collection tools will be used for this study: a semistructured questionnaire, Beck Suicidal Intent Scale (SIS), Clinical Interview Schedule-Sinhalese version (CIS-Sn) and Alcohol Use Disorders Identification Test (AUDIT). Each case (expected n=33) will be compared with two groups of individuals: (1) those who have self-poisoned using pesticides from the home, home garden or farmland and (2) those who bought pesticides from the same shops as the above cases, but not did not self-poison. Logistic regression models will be used to identify risk factors of purchasing pesticides for self-poisoning from shops. The study has received ethical approval from the Ethical Review Committee of the Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka. A sensitive data collection technique will be used and ethical issues will be considered throughout the study. Results will be disseminated in scientific peer-reviewed articles. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Determinants of abortion among clients coming for abortion service at felegehiwot referral hospital, northwest Ethiopia: a case control study.

PubMed

Tilahun, Fikreselassie; Dadi, Abel Fekadu; Shiferaw, Getachew

2017-01-01

According to the World Health Organization (WHO) estimate, one-third of pregnancies end in miscarriage, stillbirth, or induced abortion in the world. There are various reasons for a woman to seek induced abortion. However, limited information is available so far in the country and particularly in the study area. Therefore, the aim of the current study was to identify the determinants of induced abortion among clients coming for abortion care services at Bahirdar Felegehiwote referral hospital, Northwest Ethiopia. Institutional based unmatched case-control study was conducted from September to December 2014. Interview administered questioner was used to collect primary data. Enumeration and systematic random sampling (K = 3) method was used to select 175 cases and 350 controls. A binary logistic regression model was fitted to identify determinant factors. Odds ratio with 95% CI was computed to assess the strength and significance of the association. All sampled cases and controls were actually interviewed. The likelihood of abortion was higher among non-married women [AOR: 18.23, 95% CI: 8.04, 41.32], students [AOR: 11.46, 95% CI: 6.29, 20.87], and women having a monthly income of less than 500 ETB [AOR: 11.46, 95% CI: 6.29, 20.87]. However, the likelihood of abortion was lower among women age greater than 24 years [AOR: 0.29, 95% CI: 0.11, 0.79] and who had the previous history of induced abortion [AOR: 0.31, 95% CI: 0.15, 0.65]. The study identified being non-married, student, women age less than 24 years, having the previous history of induced abortion, and low monthly income as an independent determinant of induced abortion. Interventions focused on the identified determinant factors are recommended.

Effectiveness of pre-travel consultation in the prevention of travel-related diseases: a retrospective cohort study.

PubMed

Tafuri, Silvio; Guerra, Rocco; Gallone, Maria Serena; Cappelli, Maria Giovanna; Lanotte, Serafina; Quarto, Michele; Germinario, Cinzia

2014-01-01

This study aims to evaluate the effectiveness of pre-travel counselling carried out in Travel Clinics. This is a retrospective cohort. Three hundred international travellers were enrolled; 150 people were from users of Bari Travel Clinic, 150 were users of a travel agency. Enrolled subjects were interviewed using a questionnaire. The average age of the enrolled subjects was 37.5 ± 13.9, without statistically significant differences between the two groups. 86% of cases and 19.3% of the controls reported the use of anti-malaria prophylaxis (p < 0.0001). Vaccination against cholera was given to 62% of cases and 7.3% of the controls (p < 0.001). Travel Clinic users, 6% reported diarrhoea and these figures were 27% in the control group (p < 0.0001). The proportion of those interviewed who reported fever (3.7) or insomnia (1.3) did not differ between the two groups. Mosquito bites were reported by 8% of cases and 20% of the controls (p = 0.003). Three cases of malaria were reported among the controls but no cases were detected among the cases (chi-square = 3.03; p = 0.08). Our study demonstrated the effectiveness of pre-travel counselling; in the future, new studies must investigate the cost-effectiveness of pre-travel prevention measures.

Public health case studies in diabetes prevention and control: innovation, partnerships, and funding.

PubMed

Davis, Mary V; Cannon, Margaret M; Reese, April; Lovette, Beth; Porterfield, Deborah S

2011-01-01

In 2006, we conducted case studies of 4 North Carolina local health departments (LHDs) that scored highly on an index of diabetes prevention and control performance, to explore characteristics that may serve as barriers or facilitators of diabetes prevention and control services. Case studies involving in-depth interviews were conducted at 4 LHDs. Sites were selected on the basis of 2 variables, known external funding for diabetes services and population size, that were associated with performance in diabetes prevention and control in a 2005 survey of all North Carolina LHDs. Fourteen interviews (individual and group) were conducted among 17 participants from the 4 LHDs. The main outcome measures were LHD characteristics that facilitate or hinder the performance of diabetes programs and services. Interviews revealed that all 4 high-performing LHDs had received some sort of funding from a source external to the LHD. Case study participants indicated that barriers to additional service delivery included low socioeconomic status of the population and lack of financial resources. Having a diabetes self-management education program that was recognized by the American Diabetes Association appeared to be a facilitator of diabetes services provision. Other facilitators were leadership and staff commitment, which appeared to facilitate the leveraging of partnerships and funding opportunities, leading to enhanced service delivery. The small number of LHDs participating in the study and the cross-sectional study design were limitations. Leadership, staff commitment, partnership leveraging, and funding appear to be associated with LHD performance in diabetes prevention and control services. These factors should be further studied in future public health systems and services research.

Risk factors associated with purchasing pesticide from shops for self-poisoning: a protocol for a population-based case–control study

PubMed Central

Weerasinghe, Manjula; Konradsen, Flemming; Eddleston, Michael; Pearson, Melissa; Gunnell, David; Hawton, Keith; Jayamanne, Shaluka; Pabasara, Chathurani; Jayathilaka, Tharidu; Dissanayaka, Kalpani; Rajapaksha, Sandamali; Thilakarathna, Prasanna; Agampodi, Suneth

2015-01-01

Introduction Pesticide self-poisoning is one of the most frequently used methods of suicide worldwide, killing over 300 000 people annually. Around 15–20% of pesticide self-poisonings occur soon after the person has bought the pesticide from a shop. We aim to determine the characteristics of individuals who purchase pesticides directly from shops and how they differ from individuals who access pesticides from other sources such as home, home garden or farmland. This information will help inform possible vendor/shop-based intervention strategies aimed at reducing access to pesticides used for self-harm. Methods and analysis This study will investigate risk factors associated with purchasing pesticides for acts of self-poisoning from pesticide shops, including cases identified over a 9-month period using a population-based case–control group approach. Four interviewer-administered data collection tools will be used for this study: a semistructured questionnaire, Beck Suicidal Intent Scale (SIS), Clinical Interview Schedule—Sinhalese version (CIS-Sn) and Alcohol Use Disorders Identification Test (AUDIT). Each case (expected n=33) will be compared with two groups of individuals: (1) those who have self-poisoned using pesticides from the home, home garden or farmland and (2) those who bought pesticides from the same shops as the above cases, but not did not self-poison. Logistic regression models will be used to identify risk factors of purchasing pesticides for self-poisoning from shops. Ethics and dissemination The study has received ethical approval from the Ethical Review Committee of the Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka. A sensitive data collection technique will be used and ethical issues will be considered throughout the study. Results will be disseminated in scientific peer-reviewed articles. PMID:25995242

Major depressive disorder in a family study of obsessive-compulsive disorder with pediatric probands.

PubMed

Hanna, Gregory L; Himle, Joseph A; Hanna, Barbara S; Gold, Katherine J; Gillespie, Brenda W

2011-06-01

This study examined the comorbidity of obsessive-compulsive disorder (OCD) with major depressive disorder (MDD) in a family study of OCD with pediatric probands. This study assessed the lifetime prevalence of MDD in 141 first-degree relatives (FDR) and 452 second-degree relatives (SDR) of pediatric probands with OCD and healthy controls, and identified variables associated with MDD in case FDR. All available FDR were directly interviewed blind to proband status; parents were also interviewed to assess the family psychiatric history of FDR and SDR. Best-estimate diagnoses were made using all sources of information. Data were analyzed with logistic regression and robust Cox regression models. Lifetime MDD prevalence was significantly higher in case than in control FDR (30.4 versus 15.4%). Lifetime MDD prevalence was significantly higher in FDR of case probands with MDD than in FDR of case probands without MDD or control FDR (46.3 versus 19.7 versus 15.4%, respectively). MDD in case FDR was significantly associated with MDD in case probands and with age and OCD in those relatives. Lifetime MDD prevalence was similar in case and control SDR. However, lifetime MDD prevalence was significantly higher in SDR of case probands with MDD than in SDR of case probands without MDD or control SDR (31.9 versus 16.8 versus 15.4%, respectively). MDD prevalence was significantly higher in both FDR and SDR of case probands with MDD than in relatives of case probands without MDD or control relatives, suggesting that pediatric OCD comorbid with MDD is a complex familial syndrome. © 2011 Wiley-Liss, Inc.

A case-control study of eye injuries in the workplace in Hong Kong.

PubMed

Yu, Tak Sun Ignatius; Liu, Hongjie; Hui, Karen

2004-01-01

Eye injury in the workplace is common worldwide. This study proposed to explore both risk and preventive factors re eye injuries in Hong Kong. Case-control study. A total of 239 work-related eye injury patients, and 253 subjects without a history of any eye injury as controls. Patients with all incident cases of work-related eye injuries attending the ophthalmology clinics of 3 major public hospitals in Hong Kong during the first 3 months of 2000 were invited to participate. Controls were selected from the general population and were frequency matched to patients based on gender. Patients were interviewed face-to-face by trained interviewers in the ophthalmology clinics, using a structured questionnaire. Telephone interviews were used for controls. Risk and protective factors associated with eye injuries. Among eye injury cases, 158 patients (66.1%) reported having incurred 1 episode of eye injury during employment, 49 (20.5%) having suffered 2 episodes, and 32 (13.4%) having experienced >/==" BORDER="0">3 eye injuries at work. Most of the patients (85.4%) did not wear any protective devices at the time of injury. Subjects who wore safety glasses regularly were less likely to have eye injuries (odds ratio [OR] = 0.29, 95% confidence interval [CI] = 0.14-0.62). Having a safety requirement for wearing safety glasses was negatively associated with eye injuries (OR = 0.31, 95% CI = 0.15-0.62). Multivariate analysis indicated that exposures to certain work hazards and working in the construction industry were positively associated with eye injuries. Subjects who worked longer in their current job, who reported having received job safety training before employment, or whose machines or equipment were maintained or repaired regularly by employers were at lower risk of experiencing eye injuries. Construction workers and those exposed to multiple hazards may get eye injuries at work. They should be provided with protective devices that are effective in preventing such exposures. Health education and safety training are important in preventing eye injuries. Maintenance and repair of machines and equipment may effectively reduce or eliminate the sources of exposures.

A case-control study of malignant and non-malignant respiratory disease among employees of a fiberglass manufacturing facility.

PubMed Central

Chiazze, L; Watkins, D K; Fryar, C

1992-01-01

A case-control study was conducted to determine the influence of non-workplace factors on risk of respiratory disease among workers at the Owens-Corning Fiberglas plant in Newark, Ohio. Cases and controls were drawn from a historical cohort mortality study conducted on behalf of the Thermal Insulation Manufacturers Association (TIMA) of workers employed at Newark for at least one year between 1 January 1940 and 31 December 1963 and followed up to the end of 1982. The TIMA study reported a statistically significant increase in respiratory cancer (compared with national death rates). Interviews were completed for 144 lung cancer cases and 299 matching controls and 102 non-malignant respiratory disease cases and 201 matching controls. Unadjusted odds ratios (ORs) were used to assess the association between lung cancer or non-malignant respiratory disease and birthplace, education, income, marital state, smoking with a duration of six months or more, age at which smoking first started, and duration of smoking. Only the smoking variables were statistically significant. For lung cancer, of the variables entered into a conditional logistic regression model, only the smoking OR of 23.4 (95% CI 3.2-172.9) was statistically significant. For non-malignant respiratory disease no variables entered into the final model were statistically significant. Results of the interview portion of our case-control study clearly indicate that smoking is the most important non-workplace factor for risk of lung cancer in this group of workers. Smoking does not seem to play as important a part, however, for non-malignant respiratory disease. Prevalence of cigarette smoking at the Newark plant was estimated for birth cohorts by calendar year. Corresponding data for the United States were compiled from national smoking surveys. Prevalence of cigarette smoking for Newark in 1955 appears to be sufficiently greater than the corresponding United States data in 1955 to suggest that some of the previously reported excess of lung cancer for Newark based on United States mortality may be accounted for by differences in the prevalence of cigarette smoking between white men in Newark and those in the United States as a whole. PMID:1599870

Population versus hospital controls for case-control studies on cancers in Chinese hospitals

PubMed Central

2011-01-01

Background Correct control selection is crucial to the internal validity of case-control studies. Little information exists on differences between population and hospital controls in case-control studies on cancers in Chinese hospital setting. Methods We conducted three parallel case-control studies on leukemia, breast and colorectal cancers in China between 2009 and 2010, using population and hospital controls to separately match 540 incident cases by age, gender and residency at a 1:1 ratio. Demographic and lifestyle factors were measured using a validated questionnaire in face-to-face interview. Odds ratios (ORs) and 95% confidence intervals (CIs) were obtained using conditional logistic regression analyses. Results The two control groups had closely similar exposure distributions of 15 out of 16 factors, with the only exception being that hospital controls were less likely to have a BMI ≥ 25 (OR = 0.71, 95% CI: 0.54, 0.93). For exposure of green tea drinking, the adjusted ORs (95% CIs) comparing green tealeaves intake ≥ 1000 grams annually with non-drinkers were 0.51 (0.31, 0.83) and 0.21 (0.27, 0.74) for three cancers combined, 0.06 (0.01, 0.61) and 0.07 (0.01, 0.47) for breast cancer, 0.52 (0.29, 0.94) and 0.45 (0.25, 0.82) for colorectal cancer, 0.65 (0.08, 5.63) and 0.57 (0.07, 4.79) for leukemia using hospital and population controls respectively. Conclusions The study found that hospital controls were comparable with population controls for most demographic characteristics and lifestyle factors measured, but there was a slight difference between the two control groups. Hospital outpatients provide a satisfactory control group in hospital-based case-control study in the Chinese hospital setting. PMID:22171783

Population versus hospital controls for case-control studies on cancers in Chinese hospitals.

PubMed

Li, Lin; Zhang, Min; Holman, D'Arcy

2011-12-15

Correct control selection is crucial to the internal validity of case-control studies. Little information exists on differences between population and hospital controls in case-control studies on cancers in Chinese hospital setting. We conducted three parallel case-control studies on leukemia, breast and colorectal cancers in China between 2009 and 2010, using population and hospital controls to separately match 540 incident cases by age, gender and residency at a 1:1 ratio. Demographic and lifestyle factors were measured using a validated questionnaire in face-to-face interview. Odds ratios (ORs) and 95% confidence intervals (CIs) were obtained using conditional logistic regression analyses. The two control groups had closely similar exposure distributions of 15 out of 16 factors, with the only exception being that hospital controls were less likely to have a BMI ≥ 25 (OR = 0.71, 95% CI: 0.54, 0.93). For exposure of green tea drinking, the adjusted ORs (95% CIs) comparing green tealeaves intake ≥ 1000 grams annually with non-drinkers were 0.51 (0.31, 0.83) and 0.21 (0.27, 0.74) for three cancers combined, 0.06 (0.01, 0.61) and 0.07 (0.01, 0.47) for breast cancer, 0.52 (0.29, 0.94) and 0.45 (0.25, 0.82) for colorectal cancer, 0.65 (0.08, 5.63) and 0.57 (0.07, 4.79) for leukemia using hospital and population controls respectively. The study found that hospital controls were comparable with population controls for most demographic characteristics and lifestyle factors measured, but there was a slight difference between the two control groups. Hospital outpatients provide a satisfactory control group in hospital-based case-control study in the Chinese hospital setting.

Models and impact of patient and public involvement in studies carried out by the Medical Research Council Clinical Trials Unit at University College London: findings from ten case studies.

PubMed

South, Annabelle; Hanley, Bec; Gafos, Mitzy; Cromarty, Ben; Stephens, Richard; Sturgeon, Kate; Scott, Karen; Cragg, William J; Tweed, Conor D; Teera, Jacqueline; Vale, Claire L

2016-07-29

Patient and public involvement (PPI) in studies carried out by the UK Medical Research Council Clinical Trials Unit (MRC CTU) at University College London varies by research type and setting. We developed a series of case studies of PPI to document and share good practice. We used purposive sampling to identify studies representing the scope of research at the MRC CTU and different approaches to PPI. We carried out semi-structured interviews with staff and patient representatives. Interview notes were analysed descriptively to categorise the main aims and motivations for involvement; activities undertaken; their impact on the studies and lessons learned. We conducted 19 interviews about ten case studies, comprising one systematic review, one observational study and 8 randomised controlled trials in HIV and cancer. Studies were either open or completed, with start dates between 2003 and 2011. Interviews took place between March and November 2014 and were updated in summer 2015 where there had been significant developments in the study (i.e. if the study had presented results subsequent to the interview taking place). A wide range of PPI models, including representation on trial committees or management groups, community engagement, one-off task-focused activities, patient research partners and participant involvement had been used. Overall, interviewees felt that PPI had a positive impact, leading to improvements, for example in the research question; study design; communication with potential participants; study recruitment; confidence to carry out or complete a study; interpretation and communication of results; and influence on future research. A range of models of PPI can benefit clinical studies. Researchers should consider different approaches to PPI, based on the desired impact and the people they want to involve. Use of multiple models may increase the potential impacts of PPI in clinical research.

Population Health Trial for Smokeless Tobacco Cessation with Military Personnel

DTIC Science & Technology

2007-05-01

increased health risks including, but not limited to, oral cancer ,1-4 pancreatic cancer ,5-6 and cardiovascular disease .7-10 However, despite the...tobacco use and pancreatic cancer : a case-control study based on direct interviews. Cancer Epidemiol Biomarkers Prev. 2004;13:55-8. 6. Boffetta P...LF, Lopez-Guzman A, Hodges JS. The association of periodontal disease parameters with systemic medical conditions and tobacco use. J Clin

Participation rates in the selection of population controls in a case-control study of colorectal cancer using two recruitment methods.

PubMed

Castaño-Vinyals, Gemma; Nieuwenhuijsen, Mark J; Moreno, Víctor; Carrasco, Estela; Guinó, Elisabet; Kogevinas, Manolis; Villanueva, Cristina M

2011-01-01

Low participation rates in the selection of population controls are an increasing concern for the validity of case-control studies worldwide. We conducted a pilot study to assess two approaches to recruiting population controls in a study of colorectal cancer, including a face-to-face interview and blood sample collection. In the first approach, persons identified through a population roster were invited to participate through a telephone call by an interviewer telephoning on behalf of our research center. In the second approach, individuals were identified from the lists of selected family practitioners and were telephoned on behalf of the family practitioner. When the second method was used, participation rates increased from 42% to 57% and the percentage of refusals decreased from 47% to 13%. The reasons for refusing to participate did not differ significantly between the two methods. Contact through the family practitioner yielded higher response rates in population controls in the study area. 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

Leukemia and brain tumors in Norwegian railway workers, a nested case-control study.

PubMed

Tynes, T; Jynge, H; Vistnes, A I

1994-04-01

In an attempt to assess whether exposure to electromagnetic fields on Norwegian railways induces brain tumors or leukemia, the authors conducted a nested case-control study of railway workers based on incident cases from the Cancer Registry of Norway in a cohort of 13,030 male Norwegian railway workers who had worked on either electric or non-electric railways. The cohort comprised railway line, outdoor station, and electricity workers. The case series comprised 39 men with brain tumors and 52 men with leukemia (follow-up, 1958-1990). Each case was matched on age with four or five controls selected from the same cohort. The exposure of each study subject to electric and magnetic fields was evaluated from cumulative exposure measures based on present measurements and historical data. Limited information on potential confounders such as creosote, solvents, and herbicides was also collected; information on whether the subject had smoked was obtained by interviews with the subjects or work colleagues. The case-control analysis showed that men employed on electric railways, compared with non-electric ones, had an odds ratio for leukemia of 0.70 (adjusted for smoking) and an odds ratio for brain tumor of 0.87. No significant trend was shown for exposure to either magnetic or electric fields. These results do not support an association between exposure to 16 2/3-Hertz electric or magnetic fields and the risk for leukemia or brain tumors.

Defending sleepwalkers with science and an illustrative case.

PubMed

Cartwright, Rosalind D; Guilleminault, Christian

2013-07-15

To test whether laboratory-based research differentiating sleepwalkers (SW) from controls (C) can be applied in an uncontrolled forensic case as evidence the alleged crime was committed during an arousal from sleep in which the mind is not fully conscious due to a SW disorder. A PSG study recorded 8 months after the defendant was charged was analyzed independently by spectral analysis. Slow wave activity (SWA) and cyclic alternating pattern (CAP) rates were computed. Clinical interviews and police records were reviewed for data re: the defendant's sleep prior to the event and use of drugs, alcohol, and stimulants. The SWA distribution was abnormally low and flat, significantly lower than published controls; in the first NREM cycle, CAP rate 55 was above normal. Two weeks of prior sleep deprivation was confirmed from interviews and defendant's observed daytime sleepiness. Caffeine intake the day before the event was calculated at 826 mg over 14 hours. Snoring and a mild breathing disorder were present in the PSG. Testimony based on spectral analysis of PSG recorded following an alleged criminal event supported a SW explanation for the non-rational behaviors charged. The defendant was acquitted of all charges and has been successfully treated.

Effectiveness of Motivational Interviewing in improving lipid level in patients with dyslipidemia assisted by general practitioners: Dislip-EM study protocol

PubMed Central

2011-01-01

Background The non-pharmacological approach to cholesterol control in patients with hyperlipidemia is based on the promotion of a healthy diet and physical activity. Thus, to help patients change their habits, it is essential to identify the most effective approach. Many efforts have been devoted to explain changes in or adherence to specific health behaviors. Such efforts have resulted in the development of theories that have been applied in prevention campaigns, and that include brief advice and counseling services. Within this context, Motivational Interviewing has proven to be effective in changing health behaviors in specific cases. However, more robust evidence is needed on the effectiveness of Motivational Interviewing in treating chronic pathologies -such as dyslipidemia- in patients assisted by general practitioners. This article describes a protocol to assess the effectiveness of MI as compared with general practice (brief advice), with the aim of improving lipid level control in patients with dyslipidemia assisted by a general practitioner. Methods/Design An open, two-arm parallel, multicentre, cluster, controlled, randomized, clinical trial will be performed. A total of 48-50 general practitioners from 35 public primary care centers in Spain will be randomized and will recruit 436 patients with dyslipidemia. They will perform an intervention based either on Motivational Interviewing or on the usual brief advice. After an initial assessment, follow-ups will be performed at 2, 4, 8 and 12 months. Primary outcomes are lipid levels (total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides) and cardiovascular risk. The study will assess the degree of dietary and physical activity improvement, weight loss in overweight patients, and adherence to treatment guidelines. Discussion Motivational interview skills constitute the primary strategies GPs use to treat their patients. Having economical, simple, effective and applicable techniques is essential for primary care professionals to help their patients change their lifestyle and improve their health. This study will provide scientific evidence on the effectiveness of Motivational interviewing, and will be performed under strict control over the data collected, ensuring the maintenance of therapeutic integrity. Trials Registration ClinicalTrials.gov (NCT01282190). PMID:22054017

Effectiveness of Motivational Interviewing in improving lipid level in patients with dyslipidemia assisted by general practitioners: Dislip-EM study protocol.

PubMed

Pérula, Luis A; Bosch, Josep M; Bóveda, Julia; Campiñez, Manuel; Barragán, Nieves; Arboniés, Juan C; Prados, Jose A; Martín, Enrique; Martín, Remedios; Massons, Josep; Criado, Margarita; Ruiz, Roger; Fernández, José A; Buitrago, Francisco; Olaya, Inmaculada; Pérez, Modesto; Ruiz, Joaquin

2011-11-05

The non-pharmacological approach to cholesterol control in patients with hyperlipidemia is based on the promotion of a healthy diet and physical activity. Thus, to help patients change their habits, it is essential to identify the most effective approach. Many efforts have been devoted to explain changes in or adherence to specific health behaviors. Such efforts have resulted in the development of theories that have been applied in prevention campaigns, and that include brief advice and counseling services. Within this context, Motivational Interviewing has proven to be effective in changing health behaviors in specific cases. However, more robust evidence is needed on the effectiveness of Motivational Interviewing in treating chronic pathologies -such as dyslipidemia- in patients assisted by general practitioners. This article describes a protocol to assess the effectiveness of MI as compared with general practice (brief advice), with the aim of improving lipid level control in patients with dyslipidemia assisted by a general practitioner. An open, two-arm parallel, multicentre, cluster, controlled, randomized, clinical trial will be performed. A total of 48-50 general practitioners from 35 public primary care centers in Spain will be randomized and will recruit 436 patients with dyslipidemia. They will perform an intervention based either on Motivational Interviewing or on the usual brief advice. After an initial assessment, follow-ups will be performed at 2, 4, 8 and 12 months. Primary outcomes are lipid levels (total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides) and cardiovascular risk. The study will assess the degree of dietary and physical activity improvement, weight loss in overweight patients, and adherence to treatment guidelines. Motivational interview skills constitute the primary strategies GPs use to treat their patients. Having economical, simple, effective and applicable techniques is essential for primary care professionals to help their patients change their lifestyle and improve their health. This study will provide scientific evidence on the effectiveness of Motivational interviewing, and will be performed under strict control over the data collected, ensuring the maintenance of therapeutic integrity. ClinicalTrials.gov (NCT01282190).

Breast Cancer and Deodorants/Antiperspirants: a Systematic Review.

PubMed

Allam, Mohamed Farouk

2016-09-01

Over the last decade, the possible association between underarm deodorants/ antiperspirants use and breast cancer risk has raised important interest in the scientific community. The objective of our systematic review is to estimate the pooled risk of deodorants/antiperspirants use for breast cancer. All observational studies that evaluated the association between breast cancer risk and deodorants/antiperspirants use were reviewed. We have only identified two case-control studies, carried out between 2002 and 2006. The first study was conducted in USA and investigated the possible relationship between use of products applied for underarm perspiration and the risk for breast cancer in women aged 20-74 years. This population-based case-control study gathered information by in-person interview. The second study was conducted in Iraq and investigated the possible relationship between use of antiperspirants and the risk for breast cancer in women attending a teaching hospital. This study also gathered information by in-person interview. There was no risk of antiperspirants use in the pooled risk (odds ratio 0.40, 95% confidence interval 0.35-0.46). Our comprehensive search has identified an insufficient number of studies to conduct a quantitative review and obtain reliable results. Further prospective studies are strongly needed. Copyright© by the National Institute of Public Health, Prague 2016

Risk and protective factors for meningococcal disease in adolescents: matched cohort study

PubMed Central

Tully, Joanna; Viner, Russell M; Coen, Pietro G; Stuart, James M; Zambon, Maria; Peckham, Catherine; Booth, Clare; Klein, Nigel; Kaczmarski, Ed; Booy, Robert

2006-01-01

Objective To examine biological and social risk factors for meningococcal disease in adolescents. Design Prospective, population based, matched cohort study with controls matched for age and sex in 1:1 matching. Controls were sought from the general practitioner. Setting Six contiguous regions of England, which represent some 65% of the country's population. Participants 15-19 year olds with meningococcal disease recruited at hospital admission in six regions (representing 65% of the population of England) from January 1999 to June 2000, and their matched controls. Methods Blood samples and pernasal and throat swabs were taken from case patients at admission to hospital and from cases and matched controls at interview. Data on potential risk factors were gathered by confidential interview. Data were analysed by using univariate and multivariate conditional logistic regression. Results 144 case control pairs were recruited (74 male (51%); median age 17.6). 114 cases (79%) were confirmed microbiologically. Significant independent risk factors for meningococcal disease were history of preceding illness (matched odds ratio 2.9, 95% confidence interval 1.4 to 5.9), intimate kissing with multiple partners (3.7, 1.7 to 8.1), being a university student (3.4, 1.2 to 10) and preterm birth (3.7, 1.0 to 13.5). Religious observance (0.09, 0.02 to 0.6) and meningococcal vaccination (0.12, 0.04 to 0.4) were associated with protection. Conclusions Activities and events increasing risk for meningococcal disease in adolescence are different from in childhood. Students are at higher risk. Altering personal behaviours could moderate the risk. However, the development of further effective meningococcal vaccines remains a key public health priority. PMID:16473859

Maternal occupational exposure during pregnancy and the risk of spina bifida.

PubMed Central

Blatter, B M; Roeleveld, N; Zielhuis, G A; Gabreëls, F J; Verbeek, A L

1996-01-01

OBJECTIVES: A case-control study was carried out to explore associations between spina bifida and occupational exposure of the mother. METHODS: The cases were children with spina bifida aperta born between 1980 and 1992 from nine hospitals in the Netherlands. The controls were children born healthy in the same period as the cases, from hospitals and from the general population. Data collection was carried out in two steps. Firstly, postal questionnaires were sent to all the parents of cases and controls to gather information on occupations and potential confounders. In the second phase of the study, information on specific exposures was collected by means of job and task specific personal interviews. Interviews were performed with 55 case mothers and 66 control mothers who had occupations with a potential for chemical or physical exposure. Those exposures were assumed to be negligible for--for example, teachers and secretaries, so personal interviews were not indicated for these women. Information was collected on specific tasks in the period just after conception, and on the associated use of chemical or physical agents, frequency of exposure, and use of protective equipment. RESULTS: The analyses of occupation showed an increased risk for women working in agricultural occupations (OR = 3.4, CI:1.3-9.0), and, although less distinct, for cleaning women (OR = 1.7, CI:0.9-3.4). Only a few women seemed to be occupationally exposed to chemical or physical agents. No differences in occurrence of specific exposures could be detected between cases and controls. Besides, no differences were seen in pesticide or disinfectant exposure among case and control mothers in agricultural occupations. CONCLUSIONS: Occupational exposures of the mother during pregnancy were infrequent and did not seem to play an important part in the aetiology of spina bifida in this study. The association found between spina bifida and maternal agricultural occupations could not be explained by the use of pesticides by the mother or by any other occupational exposure. PMID:8777455

[Teaching of clinical reasoning to medical students using prototypical clinical cases].

PubMed

Montaldo L, Gustavo; Herskovic L, Pedro

2013-07-01

Clinical reasoning is the most important competente in the training process of a physician. To develop a method for teaching clinical reasoning based on prototypes of clinical cases. The study was conducted on sixty-four third year medical students. The study and control groups attended lectures and tutorial sessions with patients. The study group attended additionally discussion seminars of prototypical clinical cases. A clinical reasoning test was applied at the start and end of the learning period to both groups. At the end of the study, the opinions of students of the study group were collected in a focus group. After the learning period, both groups significantly increased their clinical reasoning skills. However, the improvement in the study group was more than double than that of the control group. The absolute improvement in the study group was 30.9%. Students interviewed in the focus group were unanimous in expressing their satisfaction in each and every aspect discussed. The teaching of clinical reasoning to third year medical students by means of pattern recognition in seminars with clinical cases improved significantly their skills.

Asthma in changing environments - chances and challenges of international research collaborations between South America and Europe - study protocol and description of the data acquisition of a case-control-study

PubMed Central

2010-01-01

Background Asthma in children is an emerging public health problem in South America. So far, research in this part of the world is limited. This paper presents the methodology and description of the data acquisition of an asthma case-control study conducted in the Central South of Chile. Methods/Design A hospital-based case-control study about asthma (188 cases, 294 controls) in children (6-15 years) was carried out in Valdivia, Chile between November 2008 and December 2009. Data on asthma risk factors were collected by computer-assisted personal interview using validated questions from e.g. ISAAC phase II. Data on household dust exposure (endotoxin, allergen analyses), skin prick tests to most common allergens, stool examinations for parasitic infection, and blood samples (total IgE, genetics) were collected. Additionally, 492 randomly chosen blood donors were recruited in order to assess allele frequencies in the population of Valdivia. Discussion Overall 1,173 participants were contacted. Response was 82% among cases and 65% among controls. Atopic sensitization was high (78% among cases, 47% among controls). Cases had a statistically significantly (p < .0001) increased self-reported 12-month prevalence of symptoms of rhinitis (82% vs. 51%) and wheeze (68% vs. 16%). The study is well placed to address current hypotheses about asthma and its correlates in the South American context. Results of this study might help develop novel, innovative and individualized prevention strategies in countries in transition with respect to the South American context. PMID:20718949

Colorectal Cancer and Long-Term Exposure to Trihalomethanes in Drinking Water: A Multicenter Case-Control Study in Spain and Italy.

PubMed

Villanueva, Cristina M; Gracia-Lavedan, Esther; Bosetti, Cristina; Righi, Elena; Molina, Antonio José; Martín, Vicente; Boldo, Elena; Aragonés, Nuria; Perez-Gomez, Beatriz; Pollan, Marina; Acebo, Ines Gomez; Altzibar, Jone M; Zabala, Ana Jiménez; Ardanaz, Eva; Peiró, Rosana; Tardón, Adonina; Chirlaque, Maria Dolores; Tavani, Alessandra; Polesel, Jerry; Serraino, Diego; Pisa, Federica; Castaño-Vinyals, Gemma; Espinosa, Ana; Espejo-Herrera, Nadia; Palau, Margarita; Moreno, Victor; La Vecchia, Carlo; Aggazzotti, Gabriella; Nieuwenhuijsen, Mark J; Kogevinas, Manolis

2017-01-01

Evidence on the association between colorectal cancer and exposure to disinfection by-products in drinking water is inconsistent. We assessed long-term exposure to trihalomethanes (THMs), the most prevalent group of chlorination by-products, to evaluate the association with colorectal cancer. A multicenter case-control study was conducted in Spain and Italy in 2008-2013. Hospital-based incident cases and population-based (Spain) and hospital-based (Italy) controls were interviewed to ascertain residential histories, type of water consumed in each residence, frequency and duration of showering/bathing, and major recognized risk factors for colorectal cancer. We estimated adjusted odds ratios (OR) for colorectal cancer in association with quartiles of estimated average lifetime THM concentrations in each participant's residential tap water (micrograms/liter; from age 18 to 2 years before the interview) and estimated average lifetime THM ingestion from drinking residential tap water (micrograms/day). We analyzed 2,047 cases and 3,718 controls. Median values (ranges) for average lifetime residential tap water concentrations of total THMs, chloroform, and brominated THMs were 30 (0-174), 17 (0-63), and 9 (0-145) μg/L, respectively. Total THM concentration in residential tap water was not associated with colorectal cancer (OR = 0.92, 95% CI: 0.66, 1.28 for highest vs. lowest quartile), but chloroform concentrations were inversely associated (OR = 0.31, 95% CI: 0.24, 0.41 for highest vs. lowest quartile). Brominated THM concentrations showed a positive association among men in the highest versus the lowest quartile (OR = 1.43, 95% CI: 0.83, 2.46). Patterns of association were similar for estimated average THM ingestion through residential water consumption. We did not find clear evidence of an association between detailed estimates of lifetime total THM exposure and colorectal cancer in our large case-control study population. Negative associations with chloroform concentrations and ingestion suggest differences among specific THMs, but these findings should be confirmed in other study populations. Citation: Villanueva CM, Gracia-Lavedan E, Bosetti C, Righi E, Molina AJ, Martín V, Boldo E, Aragonés N, Perez-Gomez B, Pollan M, Gomez Acebo I, Altzibar JM, Jiménez Zabala A, Ardanaz E, Peiró R, Tardón A, Chirlaque MD, Tavani A, Polesel J, Serraino D, Pisa F, Castaño-Vinyals G, Espinosa A, Espejo-Herrera N, Palau M, Moreno V, La Vecchia C, Aggazzotti G, Nieuwenhuijsen MJ, Kogevinas M. 2017. Colorectal cancer and long-term exposure to trihalomethanes in drinking water: a multicenter case---control study in Spain and Italy. Environ Health Perspect 125:56-65; http://dx.doi.org/10.1289/EHP155.

Undergraduate Social Work Students: Learning Interviewing Skills in a Hybrid Practice Class

ERIC Educational Resources Information Center

Barclay, Barbara

2012-01-01

This action research case study explored undergraduate social work students' perceived learning of interviewing skills in a hybrid environment course delivery. The single case study consisted of 19 students enrolled in a practice course blending web-based and face-to-face (f2f) meetings (4 of 15 f2f) within a large urban college. As part of…

Case control study of neuroblastoma in west-Germany after the Chernobyl accident.

PubMed

Michaelis, J; Haaf, H G; Zöllner, J; Kaatsch, P; Krummenauer, F; Berthold, F

1996-01-01

To explore possible causes of a 1988 incidence peak of infant neuroblastoma in west German regions which were contaminated with more than 6000 Bq/m2 Cs137 from the Chernobyl accident. The primary working hypothesis was that parents of the diseased children had been contaminated by an excessive intake of locally produced food, especially mushrooms or deer. Case control study with 1:2 (cases:controls) matching. Data were collected from the children's parents by questionnaires and telephone interviews. Nation-wide study (former FRG) based on the German Childhood Cancer Registry. Cases born in 1988 and reported with a neuroblastoma to the registry until March 1992. Population-based healthy controls, matched for age, sex and residence at time of diagnosis. The working hypothesis could not be confirmed by the study, because the parents of cases tended to eat less locally grown food than the parents of controls (RR = 0.63, 95% CI:0.20-1.97). Possible influence factors which previously have been described to be associated with neuroblastoma incidence could not be confirmed by the study. Parental exposure to herbicides and pesticides was associated with the occurrence of neuroblastoma (RR = 4.2, 95% CI:1.4-12.9). Neuroblastoma stage distribution in the contaminated regions was shifted towards lower stages as compared to the less contaminated regions and previous age cohorts. The study does not show additional evidence that the observed increase in neuroblastoma incidence might have been caused by exposure to fallout from the Chernobyl accident. The observed shift towards lower clinical stages may rather indicate increased diagnostic awareness. The association between neuroblastoma and parental exposure with herbicides and pesticides resulted from an extensive exploratory data analysis and needs to be confirmed in further studies.

Participation in paediatric cancer studies: timing and approach to recruitment

PubMed Central

2013-01-01

Background Participation in epidemiological studies has fallen significantly over the past 30 years; this has been attributed to a busier lifestyle and longer working hours. In case–control studies, participation among cases is usually higher than among controls due to the personal relevance. In Australia, between 2003 and 2011, we conducted three national population-based case–control studies of risk factors for childhood cancers; brain tumors, acute leukemia and neuroblastoma and Wilms’ tumor. In this sub-study, we aimed to investigate factors that may have influenced study participation and completeness of survey completion. Findings The proportion of incident cases that were eligible to participate was lowest in the brain tumor study (Aus-CBT) (83.1%), as was the proportion of eligible families that consented (57%). The percentage of eligible cases that consented was highest in the leukemia study (Aus-ALL) (80.2%). The mode of invitation used was associated with families’ consent in each of the studies. Families invited in person, at clinic appointments, were more likely to consent than families invited by letter or phone. Timing of invitation following the child’s diagnosis differed among studies but, the likelihood of consent did not appear to be directly related to this. The return of questionnaires, completion of interview, and provision of DNA (blood sample) was highest in Aus-ALL (93%) and lowest in Aus-CBT (81%). Conclusions Studies of childhood cancer, and possibly other childhood diseases, should arrange for the family to be invited in person and, where possible, by a doctor with whom they are familiar. Whilst telephone interviews are time consuming and costly, particularly for large studies, they should be preferred over questionnaires for obtaining complete data. PMID:23656733

Effective Change: A Case Study of Implementation of A Standards Based Grading Initiative

ERIC Educational Resources Information Center

MacCrindle, Amy N.

2017-01-01

This study followed mindset changes in elementary teachers as they transitioned from traditional grading to standards based grading during the earliest stages of the change process. A pre- and post-survey of mindsets of participants, individual interviews, and a focus group interview were conducted. While the results of the pre- and post-survey…

Consanguinity and family clustering of male factor infertility in Lebanon.

PubMed

Inhorn, Marcia C; Kobeissi, Loulou; Nassar, Zaher; Lakkis, Da'ad; Fakih, Michael H

2009-04-01

To investigate the influence of consanguineous marriage on male factor infertility in Lebanon, where rates of consanguineous marriage remain high (29.6% among Muslims, 16.5% among Christians). Clinic-based, case-control study, using reproductive history, risk factor interview, and laboratory-based semen analysis. Two IVF clinics in Beirut, Lebanon, during an 8-month period (January-August 2003). One hundred twenty infertile male patients and 100 fertile male controls, distinguished by semen analysis and reproductive history. None. Standard clinical semen analysis. The rates of consanguineous marriage were relatively high among the study sample. Patients (46%) were more likely than controls (37%) to report first-degree (parental) and second-degree (grandparental) consanguinity. The study demonstrated a clear pattern of family clustering of male factor infertility, with patients significantly more likely than controls to report infertility among close male relatives (odds ratio = 2.58). Men with azoospermia and severe oligospermia showed high rates of both consanguinity (50%) and family clustering (41%). Consanguineous marriage is a socially supported institution throughout the Muslim world, yet its relationship to infertility is poorly understood. This study demonstrated a significant association between consanguinity and family clustering of male factor infertility cases, suggesting a strong genetic component.

Associated factors with attention deficit hyperactivity disorder (ADHD): a case-control study.

PubMed

Malek, Ayyoub; Amiri, Shahrokh; Sadegfard, Majid; Abdi, Salman; Amini, Saeedeh

2012-09-01

The current study attempted to investigate factors associated with attention deficit hyperactivity disorder (ADHD) in children without co-morbidities. In this case-control study, 164 ADHD children who attended the Child and Adolescent Psychiatric Clinics of Tabriz University of Medical Sciences, Iran were compared with 166 normal children selected in a random-cluster method from primary and secondary schools. Clinical interviews based on DSM-IV-TR using K-SADS were used to diagnose ADHD cases and to select the control group. Participants were matched for age. We used chi-square and binary logistic regression for data analysis. Among the associated factors with ADHD were gender and maternal employment. Boys (OR 0.54; 95% confidence interval: 0.34 - 0.86) and those children with working mothers (OR 0.16: 95% confidence interval: 0.06 - 0.86) suffered more from ADHD. The birth season, family size, birth order, and parental kinship were not among risk factors for ADHD. The results of the study show that maternal employment and male gender are among the associated risk factors for ADHD.

Risk factors of breast cancer among women in eastern India: a tertiary hospital based case control study.

PubMed

Das, Soumen; Sen, Santanu; Mukherjee, Anindya; Chakraborty, Debadatta; Mondal, Pankaj Kumar

2012-01-01

Breast cancer is one of the most common cancers of women in India with high fatality rate. Over a 1 year study period 105 consecutive biopsy or fine needle aspiration cytology confirmed breast cancer patients were interviewed by direct questionnaire method regarding risk factors attending Surgery and Radiotherapy OPD of Medical College Kolkata, West Bengal while taking other 105 patients attending Surgery Department for some other disease as controls. The data were compiled in MS Excel 2007 and analyzed by Epi info 3.5.1 software. Among the cases, rural residence, illiteracy and low socio-economic status was significantly higher than controls. Late onset of menarche, late onset of menopause, ever OCP usage, breast feeding for 1-2 years and age of 1st childbirth between 20-30 years were found to be significant protective factors. People should be made aware regarding the modifiable risk factors to prevent breast cancer.

Investigator Ratings of ADHD Symptoms during a Randomized, Placebo-Controlled Trial of Atomoxetine: A Comparison of Parents and Teachers as Informants

ERIC Educational Resources Information Center

Bohnstedt, Bradley N.; Kronenberger, William G.; Dunn, David W.; Giauque, Ann L.; Wood, Elisabeth A.; Rembusch, Mary E.; Lafata, Deborah

2005-01-01

This study compared investigator ratings of ADHD symptoms based on interviews with parents and teachers during a doubleblind, placebo-controlled study of atomoxetine. Investigators completed the ADHD Rating Scale: Investigator (ADHDRS-I) based on separate semistructured interviews with the primary caretaker and teacher of the participant.…

Environmental factors in infancy and ulcerative colitis in the Central South of Chile: a case-control study.

PubMed

Boneberger, Anja; Weiss, Eduardo Hebel; Calvo, Mario; Torres, Lilibeth; Wagner, Johanna; Kabesch, Michael; Radon, Katja

2011-10-01

Evidence for the role of the hygiene hypothesis and the development of Ulcerative Colitis (UC) is unclear. We aimed to explore the association between environmental factors in infancy and UC. A hospital-based case-control study (52 UC cases, response: 77%, 174 age- , sex and place of living matched controls, response: 62%) was carried out in the Central South of Chile in 2009/2010. Patients or parents underwent a personal interview about early life experiences. High paternal education (adjusted Odds Ratio (aOR): 2.1; 95% CI: 1.0-4.5) as proxy for socioeconomic status was positively associated with case status in the final multivariate logistic regression model. Likewise, having older siblings was a risk factor for UC (aOR: 2.2; 95%CI: 1.1.-4.4). The importance for some early life environmental factors in the development of UC was established. However, the role of the hygiene hypothesis could not be confirmed for all environmental factors. Copyright © 2011 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

Selection of population controls for a Salmonella case-control study in the UK using a market research panel and web-survey provides time and resource savings.

PubMed

Mook, P; Kanagarajah, S; Maguire, H; Adak, G K; Dabrera, G; Waldram, A; Freeman, R; Charlett, A; Oliver, I

2016-04-01

Timely recruitment of population controls in infectious disease outbreak investigations is challenging. We evaluated the timeliness and cost of using a market research panel as a sampling frame for recruiting controls in a case-control study during an outbreak of Salmonella Mikawasima in the UK in 2013. We deployed a web-survey by email to targeted members of a market research panel (panel controls) in parallel to the outbreak control team interviewing randomly selected public health staff by telephone and completing paper-based questionnaires (staff controls). Recruitment and completion of exposure history web-surveys for panel controls (n = 123) took 14 h compared to 15 days for staff controls (n = 82). The average staff-time cost per questionnaire for staff controls was £13·13 compared to an invoiced cost of £3·60 per panel control. Differences in the distribution of some exposures existed between these control groups but case-control studies using each group found that illness was associated with consumption of chicken outside of the home and chicken from local butchers. Recruiting market research panel controls offers time and resource savings. More rapid investigations would enable more prompt implementation of control measures. We recommend that this method of recruiting controls is considered in future investigations and assessed further to better understand strengths and limitations.

Driving following Kava Use and Road Traffic Injuries: A Population-Based Case-Control Study in Fiji (TRIP 14).

PubMed

Wainiqolo, Iris; Kafoa, Berlin; Kool, Bridget; Robinson, Elizabeth; Herman, Josephine; McCaig, Eddie; Ameratunga, Shanthi

2016-01-01

To investigate the association between kava use and the risk of four-wheeled motor vehicle crashes in Fiji. Kava is a traditional beverage commonly consumed in many Pacific Island Countries. Herbal anxiolytics containing smaller doses of kava are more widely available. Data for this population-based case-control study were collected from drivers of 'case' vehicles involved in serious injury-involved crashes (where at least one road user was killed or admitted to hospital for 12 hours or more) and 'control' vehicles representative of 'driving time' in the study base. Structured interviewer administered questionnaires collected self-reported participant data on demographic characteristics and a range of risk factors including kava use and potential confounders. Unconditional logistic regression models estimated odds ratios relating to the association between kava use and injury-involved crash risk. Overall, 23% and 4% of drivers of case and control vehicles, respectively, reported consuming kava in the 12 hours prior to the crash or road survey. After controlling for assessed confounders, driving following kava use was associated with a four-fold increase in the odds of crash involvement (Odds ratio: 4.70; 95% CI: 1.90-11.63). The related population attributable risk was 18.37% (95% CI: 13.77-22.72). Acknowledging limited statistical power, we did not find a significant interaction in this association with concurrent alcohol use. In this study conducted in a setting where recreational kava consumption is common, driving following the use of kava was associated with a significant excess of serious-injury involved road crashes. The precautionary principle would suggest road safety strategies should explicitly recommend avoiding driving following kava use, particularly in communities where recreational use is common.

Parental Concerns Regarding a Centre-Based Early Intervention Programme for Down Syndrome in Malaysia: A Case Study

ERIC Educational Resources Information Center

Kunagaratnam, Nagasangari; Loh, Sau Cheong

2010-01-01

This qualitative study provides information on the concerns faced by parents having children with Down syndrome in a centre-based Early Intervention Programme in Malaysia and how they coped with these concerns. Semi-structured interviews were conducted with a total of five parents and two special educators. The interview and observation findings…

Sugary food and beverage consumption and epithelial ovarian cancer risk: a population-based case-control study.

PubMed

King, Melony G; Olson, Sara H; Paddock, Lisa; Chandran, Urmila; Demissie, Kitaw; Lu, Shou-En; Parekh, Niyati; Rodriguez-Rodriguez, Lorna; Bandera, Elisa V

2013-02-27

Ovarian cancer is the deadliest gynecologic cancer in the US. The consumption of refined sugars has increased dramatically over the past few decades, accounting for almost 15% of total energy intake. Yet, there is limited evidence on how sugar consumption affects ovarian cancer risk. We evaluated ovarian cancer risk in relation to sugary foods and beverages, and total and added sugar intakes in a population-based case-control study. Cases were women with newly diagnosed epithelial ovarian cancer, older than 21 years, able to speak English or Spanish, and residents of six counties in New Jersey. Controls met same criteria as cases, but were ineligible if they had both ovaries removed. A total of 205 cases and 390 controls completed a phone interview, food frequency questionnaire, and self-recorded waist and hip measurements. Based on dietary data, we computed the number of servings of dessert foods, non-dessert foods, sugary drinks and total sugary foods and drinks for each participant. Total and added sugar intakes (grams/day) were also calculated. Multiple logistic regression models were used to estimate odds ratios and 95% confidence intervals for food and drink groups and total and added sugar intakes, while adjusting for major risk factors. We did not find evidence of an association between consumption of sugary foods and beverages and risk, although there was a suggestion of increased risk associated with sugary drink intake (servings per 1,000 kcal; OR=1.63, 95% CI: 0.94-2.83). Overall, we found little indication that sugar intake played a major role on ovarian cancer development.

Case-Based Instructional Practices: A Multiple-Case Study from Torts, Marketing, and Online Instructional Design Classes

ERIC Educational Resources Information Center

Jung, Ji yoon

2017-01-01

The purpose of this study is to provide a comprehensive account on case-based instructional practices. Semester-long participant observation records in torts, marketing, and online instructional design classes, instructor interviews, course syllabi and teaching materials were used to describe the within-class complexity of the practices in terms…

Radium-contaminated water: a risk factor for cancer of the upper digestive tract.

PubMed

Hirunwatthanakul, Phatcha; Sriplung, Hutcha; Geater, Alan

2006-01-01

There is a high incidence of oral, pharynx and esophagus cancer among males in Na Mom district in Songkhla Province in Thailand, an area where radium concentration in shallow well water is found to be higher than other areas in this province. A population-based case control study was conducted from June to November 2004 to determine the association of oral exposure to radium-contaminated water and cancer of the upper digestive tract in the district.Thirty-two confirmed cases and 128 sex and five-year birth cohort matched neighborhood controls were selected by multistage sampling from six villages in four sub-districts. All subjects were verified to have been permanent residents in the district for more than 10 years. Thirty cases were dead at the time of the study, thus their relatives were interviewed to determine their amount of water drinking, tobacco smoking, alcohol drinking, betel chewing and exposure to other potential risk factors in the past. The other two cases and all controls were directly interviewed. The concentration of radium in shallow well water at the subject's houses was estimated using a contour map of Ra-226 in the water at the location of their residence. The results showed a strong and dose-dependent associationb etween consumption of radium-contaminated shallow well water and cancer of the upper digestive tract. In multivariate analysis controlled for important risk factors of the cancer, the odds ratios for exposure to oral radium consumption 50-100 mBq/day and >100 mBq/day compared with <50 mBq/day were 2.83 (95% CI: 0.50-16.19) and 29.76 (95% CI: 4.39-201.6) respectively. The risk also increased with consumption of fresh water fish which might have been contaminated by dissolved radium in the water. This study offers the first evidence of the association between radium and cancer of the upper digestive tract to the world literature. Further studies with other methods such as area-wide correlation of radium-uranium concentration and the incidence of the cancer and case-control studies in other populations are needed to confirm the evidence.

Migraine with aura and risk of silent brain infarcts and white matter hyperintensities: an MRI study

PubMed Central

Garde, Ellen; Blaabjerg, Morten; Nielsen, Helle H.; Krøigård, Thomas; Østergaard, Kamilla; Møller, Harald S.; Hjelmborg, Jacob; Madsen, Camilla G.; Iversen, Pernille; Kyvik, Kirsten O.; Siebner, Hartwig R.; Ashina, Messoud

2016-01-01

Abstract A small number of population-based studies reported an association between migraine with aura and risk of silent brain infarcts and white matter hyperintensities in females. We investigated these relations in a population-based sample of female twins. We contacted female twins ages 30–60 years identified through the population-based Danish Twin Registry. Based on questionnaire responses, twins were invited to participate in a telephone-based interview conducted by physicians. Headache diagnoses were established according to the International Headache Society criteria. Cases with migraine with aura, their co-twins, and unrelated migraine-free twins (controls) were invited to a brain magnetic resonance imaging scan performed at a single centre. Brain scans were assessed for the presence of infarcts, and white matter hyperintensities (visual rating scales and volumetric analyses) blinded to headache diagnoses. Comparisons were based on 172 cases, 34 co-twins, and 139 control subjects. Compared with control subjects, cases did not differ with regard to frequency of silent brain infarcts (four cases versus one control), periventricular white matter hyperintensity scores [adjusted mean difference (95% confidence interval): −0.1 (−0.5 to 0.2)] or deep white matter hyperintensity scores [adjusted mean difference (95% confidence interval): 0.1 (−0.8 to 1.1)] assessed by Scheltens’ scale. Cases had a slightly higher total white matter hyperintensity volume compared with controls [adjusted mean difference (95% confidence interval): 0.17 (−0.08 to 0.41) cm 3 ] and a similar difference was present in analyses restricted to twin pairs discordant for migraine with aura [adjusted mean difference 0.21 (−0.20 to 0.63)], but these differences did not reach statistical significance. We found no evidence of an association between silent brain infarcts, white matter hyperintensities, and migraine with aura. PMID:27190013

Scientific. Risk of intraoral cancer associated with tobacco and alcohol--a case-control study.

PubMed

Chandran, R; Lalloo, R; Myburgh, N G; Chandran, T M

2005-09-01

The study examined the role of tobacco, alcohol consumption and their synergistic effect on the aetiology of intraoral cancer. A hospital-based, analytical case-control study. Information was collected from 67 intraoral cancer patients attending a cancer unit (cases) and 67 controls attending other clinics in the same hospital. Cases and controls were individually matched for age, gender and ethnicity. A structured interview was used to collect the data on items related to smoking status and alcohol consumption. The odds of developing intraoral cancer were 41 times (OR = 4.63; 95% CI: 1.74-12.30) higher for current smokers compared to non-smokers. The odds of developing intraoral cancer were eight times higher for past drinkers (OR = 8.59; 95% CI: 2.96-24.92) and current drinkers (OR = 8.54; 95% CI: 3.55-20.50) compared to non-drinkers. Consumers of both tobacco and alcohol were ten times more likely to develop intraoral cancer compared to those who do neither. The risk of intraoral cancer arising from use of alcohol and tobacco, icant. The findings of the study strongly endorse the rationale behind efforts by the South African government to implement strict tobacco legislation and campaign for responsible drinking.

Habitual tea drinking associated with a lower risk of type 2 diabetes in Vietnamese adults.

PubMed

Nguyen, Chung Thanh; Lee, Andy H; Pham, Ngoc Minh; Do, Vuong Van; Ngu, Nghia Duy; Tran, Binh Quang; Binns, Colin

2018-01-01

The association between tea consumption and type 2 diabetes risk remains inconsistent in Asian populations. This case-control study investigated the association between habitual tea consumption and the risk of type 2 diabetes among Vietnamese adults. A hospital-based case-control study was conducted during 2013-2015 in Vietnam. A total of 599 newly diagnosed diabetic cases (aged 40-65 years) and 599 hospital-based controls, frequency matched by age and sex, were recruited. Information about frequency, quantity, and duration of tea drinking, together with demographics, habitual diet and lifestyle characteristics, was obtained from direct interviews using a validated and reliable questionnaire. Unconditional logistic regression analyses were performed to assess the association between different metrics of tea consumption and the type 2 diabetes risk. Control subjects reported higher tea consumption levels than the cases in terms of duration, frequency, and quantity of tea drunk. After accounting for confounding factors, increasing tea consumption was found to be associated with a reduced risk of type 2 diabetes; the adjusted odds ratio (95% confidence interval) was 0.66 (0.49, 0.89) for participants drinking >2 cups/day, relative to those drinking <1 cup/day. Significant inverse dose-response relationships were also observed for average number of cups consumed daily and years of tea drinking (p<0.01). Habitual tea consumption is associated with a reduced risk of type 2 diabetes among Vietnamese adults.

Are obese adolescents more depressed?

PubMed

Roohafza, Hamidreza; Kelishadi, Roya; Sadeghi, Masoumeh; Hashemipour, Mahin; Pourmoghaddas, Ali; Khani, Azam

2014-01-01

Obesity is a growing problem in all countries which leads to various physical, psychological, and social problems. The present study aimed to assess depression in children and adolescents aged 10-18-year old compared with the control group. In a case-control study, from among the 10- to 18-year-old students of the five education districts of Isfahan, 100 people (50 girls and 50 boys) were selected as obese children with the Body Mass Index (BMI) of greater than 95(th) percentile for their age and gender and 100 others (50 girls and 50 boys) as the control group with the BMI of 5(th) to 85(th) percentile. The case and control groups were matched for age, gender, and socio-economic status. After calculating BMI based on weight (kg)/height(2) (meter), subjects were interviewed based on DSM IV criteria to diagnose clinical depression. The severity of children's depression was measured using standardized questionnaire. The mean age of the case group was 12.2 ± 1.86-years old and that of the control group 13.06 ± 2.25. They were, respectively, diagnosed with depression of 7% and 6%. The mean depression score of the case group was 11.7 ± 5.3 and that of the control group was 10.6 ± 6.03 with no statistical significance. Given our findings, the Jolly fat hypothesis applies to the case group. It seems that health policy-makers need to make intervention plans to change behavior; attitude, skill, and knowledge (BASK) of the public toward obesity and its long-term side-effects.

Are obese adolescents more depressed?

PubMed Central

Roohafza, Hamidreza; Kelishadi, Roya; Sadeghi, Masoumeh; Hashemipour, Mahin; Pourmoghaddas, Ali; Khani, Azam

2014-01-01

Introduction: Obesity is a growing problem in all countries which leads to various physical, psychological, and social problems. The present study aimed to assess depression in children and adolescents aged 10-18-year old compared with the control group. Materials and Methods: In a case-control study, from among the 10- to 18-year-old students of the five education districts of Isfahan, 100 people (50 girls and 50 boys) were selected as obese children with the Body Mass Index (BMI) of greater than 95th percentile for their age and gender and 100 others (50 girls and 50 boys) as the control group with the BMI of 5th to 85th percentile. The case and control groups were matched for age, gender, and socio-economic status. After calculating BMI based on weight (kg)/height2 (meter), subjects were interviewed based on DSM IV criteria to diagnose clinical depression. The severity of children's depression was measured using standardized questionnaire. Results: The mean age of the case group was 12.2 ± 1.86-years old and that of the control group 13.06 ± 2.25. They were, respectively, diagnosed with depression of 7% and 6%. The mean depression score of the case group was 11.7 ± 5.3 and that of the control group was 10.6 ± 6.03 with no statistical significance. Discussion: Given our findings, the Jolly fat hypothesis applies to the case group. It seems that health policy-makers need to make intervention plans to change behavior; attitude, skill, and knowledge (BASK) of the public toward obesity and its long-term side-effects. PMID:25077167

Large outbreak of Legionnaires' disease and Pontiac fever at a military base.

PubMed

Ambrose, J; Hampton, L M; Fleming-Dutra, K E; Marten, C; McClusky, C; Perry, C; Clemmons, N A; McCormic, Z; Peik, S; Mancuso, J; Brown, E; Kozak, N; Travis, T; Lucas, C; Fields, B; Hicks, L; Cersovsky, S B

2014-11-01

We investigated a mixed outbreak of Legionnaires' disease (LD) and Pontiac fever (PF) at a military base to identify the outbreak's environmental source as well as known legionellosis risk factors. Base workers with possible legionellosis were interviewed and, if consenting, underwent testing for legionellosis. A retrospective cohort study collected information on occupants of the buildings closest to the outbreak source. We identified 29 confirmed and probable LD and 38 PF cases. All cases were exposed to airborne pathogens from a cooling tower. Occupants of the building closest to the cooling tower were 6·9 [95% confidence interval (CI) 2·2-22·0] and 5·5 (95% CI 2·1-14·5) times more likely to develop LD and PF, respectively, than occupants of the next closest building. Thorough preventive measures and aggressive responses to outbreaks, including searching for PF cases in mixed legionellosis outbreaks, are essential for legionellosis control.

Jiangsu Four Cancers Study: a large case-control study of lung, liver, stomach, and esophageal cancers in Jiangsu Province, China.

PubMed

Zhao, Jin-Kou; Wu, Ming; Kim, Claire H; Jin, Zi-Yi; Zhou, Jin-Yi; Han, Ren-Qiang; Yang, Jie; Zhang, Xiao-Feng; Wang, Xu-Shan; Liu, Ai-Ming; Gu, Xiaoping; Su, Ming; Hu, Xu; Sun, Zheng; Li, Gang; Li, Liming; Mu, Lina; Zhang, Zuo-Feng

2017-07-01

Cancer is a major public health burden both globally and in China. The most common cancer-related deaths in China are attributable to cancers of the lung, liver, stomach, and esophagus. Previous epidemiologic studies on cancer in China have often been limited by small sample sizes, inconsistent measurements, and lack of precise and accurate data. The Jiangsu Four Cancers (JFC) Study is a population-based case-control study carried out in an effort to obtain consistent and high-quality data to investigate the life style, behavioral, environmental, and genetic factors associated with the four major cancers in China. The aim of this paper is to describe the overall design of the JFC Study and report selected findings on the major risk factors for cancers. Epidemiologic data were collected from 2003 to 2010 through in-person interviews using a structured questionnaire and blood samples were drawn. Unconditional logistic regression was used to estimate the associations of putative risk factors with risks of cancers of the lung, liver, stomach, and esophagus. The study included 2871 lung cancer cases, 2018 liver cancer cases, 2969 esophageal cancer cases, 2216 stomach cancer cases, and 8019 community controls. Low educational level, low income level, tobacco smoking, alcohol drinking, and family history of cancer were confirmed as risk factors for these major cancers. The JFC Study is one of the largest case-control studies of cancers in the Chinese population and will serve as a rich resource for future research on the four major cancers in China.

Mixed-Method Quasi-Experimental Study of Outcomes of a Large-Scale Multilevel Economic and Food Security Intervention on HIV Vulnerability in Rural Malawi.

PubMed

Weinhardt, Lance S; Galvao, Loren W; Yan, Alice F; Stevens, Patricia; Mwenyekonde, Thokozani Ng'ombe; Ngui, Emmanuel; Emer, Lindsay; Grande, Katarina M; Mkandawire-Valhmu, Lucy; Watkins, Susan C

2017-03-01

The objective of the Savings, Agriculture, Governance, and Empowerment for Health (SAGE4Health) study was to evaluate the impact of a large-scale multi-level economic and food security intervention on health outcomes and HIV vulnerability in rural Malawi. The study employed a quasi-experimental non-equivalent control group design to compare intervention participants (n = 598) with people participating in unrelated programs in distinct but similar geographical areas (control, n = 301). We conducted participant interviews at baseline, 18-, and 36-months on HIV vulnerability and related health outcomes, food security, and economic vulnerability. Randomly selected households (n = 1002) were interviewed in the intervention and control areas at baseline and 36 months. Compared to the control group, the intervention led to increased HIV testing (OR 1.90; 95 % CI 1.29-2.78) and HIV case finding (OR = 2.13; 95 % CI 1.07-4.22); decreased food insecurity (OR = 0.74; 95 % CI 0.63-0.87), increased nutritional diversity, and improved economic resilience to shocks. Most effects were sustained over a 3-year period. Further, no significant differences in change were found over the 3-year study period on surveys of randomly selected households in the intervention and control areas. Although there were general trends toward improvement in the study area, only intervention participants' outcomes were significantly better. Results indicate the intervention can improve economic and food security and HIV vulnerability through increased testing and case finding. Leveraging the resources of economic development NGOs to deliver locally-developed programs with scientific funding to conduct controlled evaluations has the potential to accelerate the scientific evidence base for the effects of economic development programs on health.

Case Studies of Student Mentoring in Three New York City Community-Based Organizations

ERIC Educational Resources Information Center

Truitt, Brett J.

2012-01-01

This researcher examined three selected New York City community-based organizations' roles in student mentoring and the building of social capital. The methodology included focus group interviews, individual interviews, shadowing, and the collection of archival materials. The data were analyzed through pattern, theme and discrepancy analysis to…

Elementary Preservice Teachers' Mathematical Knowledge for Teaching: Using Situated Case Studies and Educative Experiences to Examine and Improve the Development of MKT in Teacher Education

ERIC Educational Resources Information Center

Johnson, Tracy L.

2011-01-01

This study examined pre-service teachers' development of mathematical knowledge for teaching (MKT) over their final year in a university based teacher education program. This was done through analyzing written reflections, focus group interviews, individual interviews, teaching observations, and post-observation interviews as well as through the…

Biomechanical and psychosocial risk factors for low back pain at work.

PubMed Central

Kerr, M S; Frank, J W; Shannon, H S; Norman, R W; Wells, R P; Neumann, W P; Bombardier, C

2001-01-01

OBJECTIVES: This study determined whether the physical and psychosocial demands of work are associated with low back pain. METHODS: A case-control approach was used. Case subjects (n = 137) reported a new episode of low back pain to their employer, a large automobile manufacturing complex. Control subjects were randomly selected from the study base as cases accrued (n = 179) or were matched to cases by exact job (n = 65). Individual, clinical, and psychosocial variables were assessed by interview. Physical demands were assessed with direct workplace measurements of subjects at their usual jobs. The analysis used multiple logistic regression adjusted for individual characteristics. RESULTS: Self-reported risk factors included a physically demanding job, a poor workplace social environment, inconsistency between job and education level, better job satisfaction, and better coworker support. Low job control showed a borderline association. Physical-measure risk factors included peak lumbar shear force, peak load handled, and cumulative lumbar disc compression. Low body mass index and prior low back pain compensation claims were the only significant individual characteristics. CONCLUSIONS: This study identified specific physical and psychosocial demands of work as independent risk factors for low back pain. PMID:11441733

UK case control study of brain tumours in children, teenagers and young adults: a pilot study.

PubMed

Feltbower, Richard G; Fleming, Sarah J; Picton, Susan V; Alston, Robert D; Morgan, Diana; Achilles, Janice; McKinney, Patricia A; Birch, Jillian M

2014-01-08

Tumours of the central nervous system are the second most common group of childhood cancers in 0-14 year olds (24% of total cancers) and represent a major diagnostic group in 15-24 year olds. The pilot case-control study aimed to establish methodologies for a future comprehensive aetiological investigation among children and young adults. Eligible cases were newly diagnosed with an intracranial tumour of neuroepithelial tissue aged 0-24 years. The pilot recruited patients through Leeds and Manchester Principal Treatment Centres. Controls were drawn from general practice lists. Controls were frequency matched by age and gender. We interviewed 49 cases and 78 controls comprising 85% of the target sample size. Response rates were 52% for cases and 32% for controls. Completion of the questionnaire was successful, with a very small proportion of missing data being reported (5-10%). The age distribution of cases and controls was similar with around three-quarters of interviewed subjects aged 0-14. Half of cases and almost two-thirds of controls reported using a mobile phone with the majority starting between 10-14 years of age. Prevalence of breastfeeding was lower in cases than controls (Odds Ratio 0.4; 95% CI 0.2-1.2), whilst cases were more likely to be delivered by caesarean section (OR 1.6; 95% CI 0.6-4.4). Cases were significantly more likely to have a birthweight > 3.5 kg compared to controls. Cases were also more likely to come from a family with 3 or more siblings than controls (OR 3.0; 95% CI 0.7-13.6). The majority of participants (>80%) were in favour of taking either blood or saliva to aid molecular epidemiological research. Successful methods were established for identifying and recruiting a high proportion of case subjects, exploiting strong links with the clinical teams at the treatment centres. Control procedures proved more difficult to implement. However, working closely with national clinical and professional research networks will enable improved control identification and recruitment, with good prospects for collecting biological samples in the future.

Deliberate self-harm as seen in Kampala, Uganda - a case-control study.

PubMed

Kinyanda, Eugene; Hjelmeland, Heidi; Musisi, Seggane

2004-04-01

A study to investigate deliberate self-harm (DSH) in an African context was undertaken in Uganda. A case-control study in which 100 cases of DSH and 300 controls matched on age and sex were recruited from three general hospitals in Kampala and subjected to a structured interview using a modified version of the European Parasuicide Study Interview Schedule I. Among the cases, 63% were males, with a male to female ratio of 1.7:1 and a peak age range of 20-24 years. Higher educational attainment, higher socio-economic class and poor housing were significantly associated with DSH. District of current residence, district of birth, religion, ethnicity, marital status, number of children, current living arrangement, area of usual residence, employment status of respondent and partner were not significantly associated with DSH. Pesticides and medications, mainly antimalarials and diazepam, were the main methods of DSH used. The most commonly reported psychiatric disorders were adjustment disorder, acute stress reactions and depression. DSH in Uganda appears to predominantly afflict the young. Disturbed interpersonal relationships, poverty and loneliness were important factors in the immediate precipitation of this behaviour. The fact that pesticide poisoning is still the predominantly used method in DSH in this area calls for a review of the legislation that controls the sale and availability of these agricultural chemicals.

[Managerial performance in public health services: a case study in Mato Grosso do Sul, Brazil].

PubMed

Barbieri, Ana Rita; Hortale, Virginia Alonso

2005-01-01

This paper presents part of a doctoral dissertation that developed a theoretical model capable of identifying managerial performance in various administrative levels of a Municipal Health Secretariat. The methodology was a case study of the Municipal Health Secretariat in Campo Grande, capital of the State of Mato Grosso do Sul, Brazil. The theoretical model was based on recent debates emphasizing the need to modernize public administration, with an emphasis on efficacy and efficiency in the organizations as a whole. Some 31 interviews were conducted with the objective of identifying the managers' performance, through questions based on their daily practices in planning, organization, direction, and control. Managers from higher hierarchical levels obtained better results, while those in basic health units generally developed activities and complied with decisions passed down by imposition, with limited capacity to plan, organize, or control activities pertaining to their management sphere. These results stem partially from the charismatic leadership and centralizing administration of the current management in the municipal health system.

Exposure to pesticides as risk factor for non-Hodgkin's lymphoma and hairy cell leukemia: pooled analysis of two Swedish case-control studies.

PubMed

Hardell, Lennart; Eriksson, Mikael; Nordstrom, Marie

2002-05-01

Increased risk for non-Hodgkin's lymphoma (NHL) following exposure to certain pesticides has previously been reported. To further elucidate the importance of phenoxyacetic acids and other pesticides in the etiology of NHL a pooled analysis was performed on two case-control studies, one on NHL and another on hairy cell leukemia (HCL), a rare subtype of NHL. The studies were population based with cases identified from cancer registry and controls from population registry. Data assessment was ascertained by questionnaires supplemented over the telephone by specially trained interviewers. The pooled analysis of NHL and HCL was based on 515 cases and 1141 controls. Increased risks in univariate analysis were found for subjects exposed to herbicides (OR 1.75, CI 95% 1.26-2.42), insecticides (OR 1.43, CI 95% 1.08-1.87), fungicides (OR 3.11, CI 95% 1.56-6.27) and impregnating agents (OR 1.48, CI 95% 1.11-1.96). Among herbicides, significant associations were found for glyphosate (OR 3.04, CI 95% 1.08-8.52) and 4-chloro-2-methyl phenoxyacetic acid (MCPA) (OR 2.62, CI 95% 1.40-4.88). For several categories of pesticides the highest risk was found for exposure during the latest decades before diagnosis. However, in multivariate analyses the only significantly increased risk was for a heterogeneous category of other herbicides than above.

Exposure to residential electric and magnetic fields and risk of childhood leukemia.

PubMed

London, S J; Thomas, D C; Bowman, J D; Sobel, E; Cheng, T C; Peters, J M

1991-11-01

The relation between exposure to electric and magnetic fields in the home, as assessed by measurements, wiring configuration, and self-reported appliance use, and risk of leukemia was investigated in a case-control study among children from birth to age 10 years in Los Angeles County, California. Cases were ascertained through a population-based tumor registry from 1980 to 1987. Controls were drawn from friends and by random digit dialing. Interviews were obtained from 232 cases and 232 controls. Available for analysis were measurements of the magnetic field in the child's bedroom over 24 hours or longer (164 cases and 144 controls), spot measurements of magnetic and electric fields (140 cases and 109 controls), and wiring configuration (219 cases and 207 controls). No clear associations between leukemia risk and measured magnetic or electric fields were seen. An association between the Denver Wertheimer-Leeper wiring configuration and childhood leukemia risk was observed (odds ratio for very high relative to very low current and underground configuration combined = 2.15, 95% confidence interval 1.08-4.28; p for trend = 0.008) and was not substantially altered by adjustment for potential confounding factors. Cases were more likely than controls to report use of several appliances that produce high electric and magnetic fields. Our results support an association between childhood leukemia risk and wiring configuration, but not direct measurements of electric and magnetic fields.

Curriculum Evaluation in Online Education: The Case of Teacher Candidates Preparing Online for Public Personnel Selection Examination

ERIC Educational Resources Information Center

Karacaoglu, Ömer Cem

2018-01-01

The aim of the present study is to evaluate the efficiency of an online curriculum based on the views of lecturers and students enrolled in the program. The study is mainly based on survey method. In order to collect qualitative data, interviews forms developed by the researcher were used. The reliability and validity of the interview forms were…

Sitting occupations are an independent risk factor for Ischemic stroke in North Indian population.

PubMed

Kumar, A; Prasad, M; Kathuria, P

2014-10-01

Stroke is a multi-factorial disease and is influenced by complex environmental interactions. The purpose of this case-control study was to determine the relationship of sitting occupations with ischemic stroke in the North Indian population. In a hospital-based case-control study, age- and sex-matched controls were recruited from the outpatient department and the neurology ward of All India Institute of Medical Sciences, New Delhi. Occupation along with other demographic and risk factor variables was measured in-person interview in standardized case record form. The multivariate logistic regression model was used to estimate the odds ratio associated with ischemic stroke. Two hundred and twenty-four people post-stroke and 224 control participants were recruited from the period of February 2009 to February 2012. Mean age of cases and controls was 53.47 ± 14 and 52.92 ± 13.4, respectively. The occupations which involve sitting at work were independently associated with the risk of ischemic stroke after adjustment for demographic and risk factor variables (OR 2.2, 95% CI 1.12-3.8). The result of this study has shown an independent association between the sitting occupations and ischemic stroke in North Indian population. The present study supports the workplace health initiative to implement workplace physical activity policy and encourages employee to reduce the amount of time they spend sitting throughout the day.

Sociodemographic differences among HIV-positive and HIV-negative recently pregnant women in Mexico City: A case-control study.

PubMed

Aguilar-Zapata, Daniel; Piñeirúa-Menéndez, Alicia; Volkow-Fernández, Patricia; Rodríguez-Zulueta, Patricia; Ramos-Alamillo, Ubaldo; Cabrera-López, Teresita; Martin-Onraet, Alexandra

2017-07-01

National HIV preventive programs in Mexico focus on high-risk groups that do not consider women, apart from prenatal screening. Nonetheless, the epidemic in women is growing, and there is a need to better understand sociodemographic factors in women living with HIV (WLH). We performed a case-control study in Mexico City, including HIV+ and HIV- women with a recent pregnancy to compare their sociodemographic characteristics and describe the circumstances of diagnosis in HIV+ women, as well as prenatal screening frequency in both groups. Fifty cases and 102 controls were interviewed. HIV+ women were more frequently the only economic support of the family (20% vs 0%, P < .0001). Thirty-eight percent of cases had their first pregnancy at ≤18 years, versus 16% of controls (odds ratio 2.47, 95% confidence interval 1.07-5.72, P = .03); 16% of cases had lived in the street; 6% reported transactional sex, versus none of the controls (P < .0001). In the multivariate analysis, there was strong evidence of an association between HIV infection and age at the time of the interview, history of sexually transmitted diseases, substance abuse, history of violence, and civil status. Only 6% of controls were tested for HIV during prenatal follow-up. WLH in this study faced important social vulnerability. Targeting women living in these social contexts might increase early diagnosis and could tailor HIV prevention strategies. Prenatal coverage needs to be improved and should represent a national priority.

Reduced Allergy and Immunoglobulin E among Adults with Intra-cranial Meningioma Compared to Controls

PubMed Central

Wiemels, Joseph L.; Wrensch, Margaret; Sison, Jennette D.; Zhou, Mi; Bondy, Melissa; Calvocoressi, Lisa; Black, Peter M.; Yu, Herbert; Schildkraut, Joellen M.; Claus, Elizabeth B.

2012-01-01

Meningioma, the most frequent tumor in the central nervous system, has few recognized risk factors. We explored the role of allergies in a population-based case-control consortium study of meningioma in five geographic areas. We also studied serum levels of a marker of atopic allergy (IgE) in a subset of study participants, a first for a study on meningioma. Participants (N = 1,065) with surgically resected, pathologically confirmed meningioma and controls (N = 634) selected via random-digit dialing were recruited and interviewed. Cases were less likely than controls to report history of physician-diagnosed allergy [odds ratio (OR) = 0.64; 95% confidence interval (95% CI): 0.51 – 0.80]. Also, cases (N = 295) had lower total serum IgE than controls [N = 192; OR = 0.85, 95% CI: 0.75–0.98 for each unit of Ln(IgE)]. Similar to glioma and cancers at several other sites, meningioma appears to have an inverse relationship with history of allergies and a biomarker of atopic allergy. Since some common opposing predisposition or developmental processes for allergy and meningioma may exist, further research into immune processes that can affect the incidence and natural history of meningioma is warranted. PMID:21520030

Stress and psychiatric disorder in healthcare professionals and hospital staff.

PubMed

Weinberg, A; Creed, F

2000-02-12

Previous studies of stress in healthcare staff have indicated a probable high prevalence of distress. Whether this distress can be attributed to the stressful nature of the work situation is not clear. No previous study has used a detailed interview method to ascertain the link between stress in and outside of work and anxiety and depressive disorders. Doctors, nurses, and administrative and ancillary staff were screened using the general health questionnaire (GHQ). High scorers (GHQ>4) and matched individuals with low GHQ scores were interviewed by means of the clinical interview schedule to ascertain definite anxiety and depressive disorders (cases). Cases and controls, matched for age, sex, and occupational group were interviewed with the life events and difficulties schedule classification and an objective measure of work stress to find out the amount of stress at work and outside of work. Sociodemographic and stress variables were entered into a logistic-regression analysis to find out the variables associated with anxiety and depressive disorders. 64 cases and 64 controls were matched. Cases and controls did not differ on demographic variables but cases were less likely to have a confidant (odds ratio 0.09 [95% CI 0.01-0.79]) and more likely to have had a previous episode of psychiatric disorder (3.07 [1.10-8.57]). Cases and controls worked similar hours and had similar responsibility but cases had a greater number of objective stressful situations both in and out of work (severe event or substantial difficulty in and out of work-45 cases vs 18 controls 6.05 [2.81-13.00], p<0.001; severe chronic difficulty outside of work-27 vs 8, 5.12 [2.09-12.46], p<0.001). Cases had significantly more objective work problems than controls (median 6 vs 4, z=3.81, p<0.001). The logistic-regression analyses indicated that even after the effects of personal vulnerability to psychiatric disorder and ongoing social stress outside of work had been taken into account, stressful situations at work contributed to anxiety and depressive disorders. Both stress at work and outside of work contribute to the anxiety and depressive disorders experienced by healthcare staff. Our findings suggest that the best way to decrease the prevalence of these disorders is individual treatment, which may focus on personal difficulties outside of work, combined with organisational attempts to reduce work stress. The latter may involve more assistance for staff who have a conflict between their managerial role and clinical role.

Probiotic and prebiotic use in patients with inflammatory bowel disease: a case-control study.

PubMed

Hedin, Charlotte R H; Mullard, Miriam; Sharratt, Elizabeth; Jansen, Clare; Sanderson, Jeremy D; Shirlaw, Penelope; Howe, Leslie C; Djemal, Serpil; Stagg, Andrew J; Lindsay, James O; Whelan, Kevin

2010-12-01

The use of complementary and alternative medicine in inflammatory bowel disease (IBD) has been extensively studied. However, the use of probiotics and prebiotics is poorly documented, despite evidence of efficacy of particular probiotic strains in specific forms of IBD. A case-control study comprising interviewer-administered questionnaires was conducted in IBD patients and healthy controls. Data regarding use and knowledge of probiotics and prebiotics, demographic, and clinical information were collected. In total, 334 participants (234 IBD, 100 controls) were interviewed. Significantly more IBD patients than controls had ever used probiotics to manage their health (Crohn's disease [CD] 43%, ulcerative colitis [UC] 51%, controls 21%, P < 0.001). Prebiotic use was negligible. On logistic regression analysis, having UC (odds ratio [OR] 4.30, 95% confidence interval [CI] 2.27-8.12) or CD (OR 3.05, 95% CI 1.66-5.60) were the strongest predictors of probiotic use. Within IBD patients the strongest predictor of probiotic use was current steroid use (OR 2.4, 95% CI 1.11-5.18). IBD patients had greater probiotic knowledge scores than controls (P = 0.003), although 20% of IBD probiotic users could not provide a definition of a probiotic. Less than half of IBD probiotic users discussed probiotic use with healthcare professionals, with commercial advertising being the primary source of information. Patients with IBD use probiotics to manage their health but frequently choose strains without evidence of efficacy in IBD. Patients rely on nonclinical sources of information and often do not disclose probiotic use to healthcare professionals. Conventional healthcare providers should inquire about probiotic use among their patients and offer evidence-based advice. Copyright © 2010 Crohn's & Colitis Foundation of America, Inc.

Cases for the Net Generation: An Empirical Examination of Students' Attitude toward Multimedia Case Studies

ERIC Educational Resources Information Center

Sheppard, Michael; Vibert, Conor

2016-01-01

Case studies have been an important tool in business, legal, and medical education for generations of students. Traditional text-based cases tend to be self-contained and structured in such a way as to teach a particular concept. The multimedia cases introduced in this study feature unscripted web-hosted video interviews with business owners and…

Novel ways to explore surgical interventions in randomised controlled trials: applying case study methodology in the operating theatre.

PubMed

Blencowe, Natalie S; Blazeby, Jane M; Donovan, Jenny L; Mills, Nicola

2015-12-28

Multi-centre randomised controlled trials (RCTs) in surgery are challenging. It is particularly difficult to establish standards of surgery and ensure that interventions are delivered as intended. This study developed and tested methods for identifying the key components of surgical interventions and standardising interventions within RCTs. Qualitative case studies of surgical interventions were undertaken within the internal pilot phase of a surgical RCT for obesity (the By-Band study). Each case study involved video data capture and non-participant observation of gastric bypass surgery in the operating theatre and interviews with surgeons. Methods were developed to transcribe and synchronise data from video recordings with observational data to identify key intervention components, which were then explored in the interviews with surgeons. Eight qualitative case studies were undertaken. A novel combination of video data capture, observation and interview data identified variations in intervention delivery between surgeons and centres. Although surgeons agreed that the most critical intervention component was the size and shape of the gastric pouch, there was no consensus regarding other aspects of the procedure. They conceded that evidence about the 'best way' to perform bypass was lacking and, combined with the pragmatic nature of the By-Band study, agreed that strict standardisation of bypass might not be required. This study has developed and tested methods for understanding how surgical interventions are designed and delivered delivered in RCTs. Applying these methods more widely may help identify key components of interventions to be delivered by surgeons in trials, enabling monitoring of key components and adherence to the protocol. These methods are now being tested in the context of other surgical RCTs. Current Controlled Trials ISRCTN00786323 , 05/09/2011.

The long term impact of cataract surgery on quality of life, activities and poverty: results from a six year longitudinal study in Bangladesh and the Philippines.

PubMed

Danquah, Lisa; Kuper, Hannah; Eusebio, Cristina; Rashid, Mamunur Akm; Bowen, Liza; Foster, Allen; Polack, Sarah

2014-01-01

Cataract surgery has been shown to improve quality of life and household economy in the short term. However, it is unclear whether these benefits are sustained over time. This study aims to assess the six year impact of cataract surgery on health related quality of life (HRQoL), daily activities and economic poverty in Bangladesh and The Philippines. This was a longitudinal study. At baseline people aged ≥50 years with visual impairment due to cataract ('cases') and age-, sex-matched controls without visual impairment were interviewed about vision specific and generic HRQoL, daily activities and economic indicators (household per capita expenditure, assets and self-rated wealth). Cases were offered free or subsidised cataract surgery. Cases and controls were re-interviewed approximately one and six years later. At baseline across the two countries there were 455 cases and 443 controls. Fifty percent of cases attended for surgery. Response rates at six years were 47% for operated cases and 53% for controls. At baseline cases had poorer health and vision related QoL, were less likely to undertake productive activities, more likely to receive assistance with activities and were poorer compared to controls (p<0.05). One year after surgery there were significant increases in HRQoL, participation and time spent in productive activities and per capita expenditure and reduction in assistance with activities so that the operated cases were similar to controls. These increases were still evident after six years with the exception that time spent on productive activities decreased among both cases and controls. Cataract causing visual loss is associated with reduced HRQoL and economic poverty among older adults in low-income countries. Cataract surgery improves the HRQoL of the individual and economy of the household. The findings of this study suggest these benefits are sustained in the long term.

Preliminary investigation into application of problem-based learning in the practical teaching of diagnostics

PubMed Central

Rui, Zeng; Rong-Zheng, Yue; Hong-Yu, Qiu; Jing, Zeng; Xue-Hong, Wan; Chuan, Zuo

2015-01-01

Background Problem-based learning (PBL) is a pedagogical approach based on problems. Specifically, it is a student-centered, problem-oriented teaching method that is conducted through group discussions. The aim of our study is to explore the effects of PBL in diagnostic teaching for Chinese medical students. Methods A prospective, randomized controlled trial was conducted. Eighty junior clinical medical students were randomly divided into two groups. Forty students were allocated to a PBL group and another 40 students were allocated to a control group using the traditional teaching method. Their scores in the practice skills examination, ability to write and analyze medical records, and results on the stage test and behavior observation scale were compared. A questionnaire was administered in the PBL group after class. Results There were no significant differences in scores for writing medical records, content of interviewing, physical examination skills, and stage test between the two groups. However, compared with the control group, the PBL group had significantly higher scores on case analysis, interviewing skills, and behavioral observation scales. Conclusion The questionnaire survey revealed that PBL could improve interest in learning, cultivate an ability to study independently, improve communication and analytical skills, and good team cooperation spirit. However, there were some shortcomings in systematization of imparting knowledge. PBL has an obvious advantage in teaching with regard to diagnostic practice. PMID:25848334

Effectiveness and cost of quick diagnostic tests to determine tetanus immunity in patients with a wound in French emergency departments.

PubMed

N'Diaye, Dieynaba S; Schwarzinger, Michaël; Obach, Dorothée; Poissy, Julien; Matheron, Sophie; Casalino, Enrique; Yazdanpanah, Yazdan

2014-11-19

Tétanos Quick Stick® (TQS) is a test for tetanus immunity screening for wounded patients in emergency departments (EDs), but represents additional costs compared with a medical interview on vaccination history. The study objective was to assess the effectiveness and cost of the TQS in French EDs. We performed a model-based analysis that simulates screening of tetanus immunity and risk of tetanus based on prophylaxis administration. Strategies compared were: i) diagnosis of tetanus immunity by "TQS"; ii) "Medical Interview" (current practice). The study population was 1,658,000 French adults seeking ED care for a wound in 2012. Model parameters were estimated based on French national surveillance data, and published literature. Outcome measures were number of tetanus cases, life years gained and costs (2012 €) from a societal perspective. Use of TQS had negligible impact on health outcomes (0.02 tetanus cases/year in France vs. 0.41 for "Medical Interview"), but resulted in a decrease in annual costs of €2,203,000 (-42%). Base case and sub-group analysis showed that with the same effectiveness, the average cost per patient was: €13 with "Medical Interview" vs. €11.7 with TQS for the overall cohort; €28.9 with "Medical Interview" vs. €21 with "TQS" for tetanus-prone wounds; €15 with "Medical Interview" vs. €14.1 with "TQS" for patients aged ≥65 years; and €6.2 with "Medical Interview" vs. €7.8 with "TQS" for non-tetanus-prone wounds. Use of TQS is as effective and less costly than "Medical Interview" when applied in ED to wounded patients with tetanus-prone wounds or aged ≥65 years. However, it is more expensive in patients with non-tetanus-prone wounds.

Risk factors for squamous cell carcinoma of the penis--population-based case-control study in Denmark.

PubMed

Madsen, Birgitte Schütt; van den Brule, Adriaan J C; Jensen, Helle Lone; Wohlfahrt, Jan; Frisch, Morten

2008-10-01

Few etiologic studies of squamous cell carcinoma (SCC) of the penis have been carried out in populations where childhood circumcision is rare. A total of 71 patients with invasive (n=53) or in situ (n=18) penile SCC, 86 prostate cancer controls, and 103 population controls were interviewed in a population-based case-control study in Denmark. For 37 penile SCC patients, tissue samples were PCR examined for human papillomavirus (HPV) DNA. Overall, 65% of PCR-examined penile SCCs were high-risk HPV-positive, most of which (22 of 24; 92%) were due to HPV16. Penile SCC risk was positively associated with measures of early and high sexual activity, including lifetime number of female sex partners, number of female sex partners before age 20, age at first intercourse, penile-oral sex, a history of anogenital warts, and never having used condoms. Histories of phimosis and priapism at least 5 years before diagnosis were also significant risk factors, whereas alcohol abstinence was associated with reduced risk. Our study confirms sexually transmitted HPV16 infection and phimosis as major risk factors for penile SCC and suggests that penile-oral sex may be an important means of viral transmission. The association with priapism was unexpected and needs replication.

Occupational exposure to pesticides and lymphoid neoplasms among men: results of a French case-control study

PubMed Central

Orsi, Laurent; Delabre, Laurene; Monnereau, Alain; Delval, Philippe; Berthou, Christian; Fenaux, Pierre; Marit, Gerald; Soubeyran, Pierre; Huguet, Francoise; Milpied, Noel; Leporrier, Michel; Hemon, Denis; Troussard, Xavier; Clavel, Jacqueline

2009-01-01

Objectives Investigating the relationship between occupational exposure to pesticides and the risk of lymphoid neoplasms (LN) in men. Methods A hospital-based case-control study was conducted in six centres in France between 2000 and 2004. The cases were incident cases with a diagnosis of lymphoid neoplasm aged 18 to 75 years. During the same period, controls of the same age and gender as the cases were recruited in the same hospital, mainly in the orthopaedic and rheumatological departments. Exposures to pesticides were evaluated through specific interviews and case-by-case expert reviews. Four hundred and ninety-one cases (244 cases of non-Hodgkin’s lymphoma (NHL), 87 of Hodgkin’s lymphoma (HL), 104 of lymphoproliferative syndromes (LPS) and 56 of multiple myeloma (MM) cases) and 456 controls were included in the analyses. The odds ratios (OR) and 95% confidence intervals (95% CI) were estimated using unconditional logistic regressions. Results Positive associations between HL and occupational exposure to triazole fungicides and urea herbicides were observed (OR=8.4 [2.2–32.4], 10.8 [2.4–48.1] respectively). Exposure to insecticides, fungicides and herbicides were linked to a three-fold increases in MM risk (OR=2.8 [1.2–6.5], 3.2 [1.4–7.2], 2.9 [1.3–6.5]). For LPS subtypes, associations restricted to hairy-cell leukaemia (HCL) were evidenced for exposure to organochlorine insecticides, phenoxy herbicides and triazine herbicides (OR=4.9 [1.1–21.2], 4.1 [1.1–15.5], 5.1 [1.4–19.3]), although based on small numbers. Lastly, despite the increased odds ratios for organochlorine and organophosphate insecticides, carbamate fungicides and triazine herbicides, no significant associations were evidenced for NHL. Conclusions The results, based on case-by-case expert review of occupation-specific questionnaires, support the hypothesis that occupational pesticide exposures may be involved in HL, MM and HCL and do not rule out a role in NHL. The analyses identified specific pesticides that deserve further investigation and the findings were consistent with those of previous studies. PMID:19017688

Involving Employers in Training: Case Studies. Research and Evaluation Report Series 97-J.

ERIC Educational Resources Information Center

Isbell, Kellie; Trutko, John W.; Barnow, Burt S.; Nightengale, Demetra; Pindus, Nancy

This document contains in-depth descriptions and assessments of 17 exemplary employer-based training (EBT) programs that were studied as part of an examination of EBT programs. The case studies are based on site visits to each firm, during which interviews were conducted with company management, supervisors of workers in training, individuals…

Asthma, chronic bronchitis, and exposure to irritant agents in occupational domestic cleaning: a nested case-control study.

PubMed

Medina-Ramón, M; Zock, J P; Kogevinas, M; Sunyer, J; Torralba, Y; Borrell, A; Burgos, F; Antó, J M

2005-09-01

Women employed in domestic cleaning are at increased risk for symptoms of obstructive lung disease, but the agents responsible are unknown. To investigate common tasks and products in occupational domestic cleaning in relation to respiratory morbidity. Case-control study in domestic cleaning women nested within a large population based survey of women aged 30-65 years; 160 domestic cleaning women with asthma symptoms, chronic bronchitis symptoms, or both and 386 without a history of respiratory symptoms were identified. Detailed exposures were evaluated for 40 cases who reported still having symptoms at the recruitment interview, and 155 controls who reported not having symptoms. All tasks performed and products used when cleaning houses were determined in a face-to-face interview. Lung function, methacholine challenge, and serum IgE testing were performed. Personal exposure measurements of airborne chlorine and ammonia were performed in a subsample. Associations between asthma, chronic bronchitis, and cleaning exposures were evaluated using multiple logistic regression analysis. Airborne chlorine (median level 0-0.4 ppm) and ammonia (0.6-6.4 ppm) were detectable during occupational domestic cleaning activities. Cases used bleach more frequently than controls; adjusted odds ratio (OR) for intermediate exposure was 3.3 (95% CI 0.9 to 11) and for high exposure 4.9 (1.5 to 15). Other independent associations included accidental inhalation of vapours and gases from cleaning agents and washing dishes. These associations were more pronounced for cases with asthma symptoms than for those with symptoms of chronic bronchitis, but were not related to sensitisation to common allergens. Asthma symptoms in domestic cleaning women are associated with exposure to bleach and possibly other irritant agents. The public health impact of the use of irritant cleaning products could be widespread since the use of these products is common both in the workplace and at home.

Online Collaborative Learning in a Project-Based Learning Environment in Taiwan: A Case Study on Undergraduate Students' Perspectives

ERIC Educational Resources Information Center

Zhang, Ke; Peng, Shiang Wuu; Hung, Jui-long

2009-01-01

This case study investigated undergraduate students' first experience in online collaborative learning in a project-based learning (PBL) environment in Taiwan. Data were collected through interviews of 48 students, instructor's field notes, researchers' online observations, students' online discourse, and group artifacts. The findings revealed…

Faith and Moral Development: A Case Study of a Jail Faith-Based Correctional Education Program

ERIC Educational Resources Information Center

Swanson, Karen

2009-01-01

Increasingly, faith-based programs have provided curriculum in correctional facilities to meet the challenge of rehabilitating offenders. To attempt to identify the impact of such instruction, this qualitative case study examines the faith and moral development of the participants in one such program. Through interviews, observations, document…

Evaluating risk factors for protein-energy malnutrition in children under the age of six years: a case-control study from Iran

PubMed Central

Sharghi, Afshan; Kamran, Aziz; Faridan, Mohammad

2011-01-01

Introduction: Protein-energy malnutrition is one of the most important public health problems in Iran. It not only accounts for more than half of child mortality but can also produce somatic and mental impairment in survivors. The main aim of this study was to identify risk factors for protein-energy malnutrition in children under 6 years of age in Namin city. Methods: This was a population-based, multicenter case-control study. Seventy-six children with malnutrition and 76 children without malnutrition were randomly recruited for case and control groups. The prevalence of risk factors in the two groups was compared. Data were gathered from a health center database and interviews with mothers and health workers. The Wilcoxon signed-rank test and logistic regression were used for data analysis. Results: Female gender, poverty, short maternal height, and use of unhygienic latrines in the home were significantly associated with childhood malnutrition (P < 0.05). Conclusion: The results of this study indicate four main factors (poverty, small maternal height, female gender, and absence of hygienic latrines in the home) as underlying factors in malnutrition of children under the age of 6 years. PMID:21887115

Response rates in case-control studies of cancer by era of fieldwork and by characteristics of study design.

PubMed

Xu, Mengting; Richardson, Lesley; Campbell, Sally; Pintos, Javier; Siemiatycki, Jack

2018-04-09

The purpose of this study was to describe time trends in response rates in case-control studies of cancer and identify study design factors that influence response rate. We reviewed 370 case-control studies of cancer published in 12 journals during indicator years in each of the last four decades. We estimated time trends of response rates and reasons for nonresponse in each of the following types of study subjects: cases, medical source controls, and population controls. We also estimated response rates according to characteristics of study context. Median response rates among cases and population controls were between 75% and 80% in the 1970s. Between 1971 and 2010, study response rates declined by 0.31% per year for cases and 0.78% for population controls. Only a minority of studies reported reasons for nonparticipation; subject refusal was the most common reported reason. Studies conducted in North America had lower median response rates than studies conducted in Europe. In-person and telephone interviews elicited higher response rates than mail questionnaires. Response rates from case-control studies of cancer have declined, and this could threaten the validity of results derived from these studies. Copyright © 2018 Elsevier Inc. All rights reserved.

Environmental and occupational risk factors for progressive supranuclear palsy: Case-control study.

PubMed

Litvan, Irene; Lees, Peter S J; Cunningham, Christopher R; Rai, Shesh N; Cambon, Alexander C; Standaert, David G; Marras, Connie; Juncos, Jorge; Riley, David; Reich, Stephen; Hall, Deborah; Kluger, Benzi; Bordelon, Yvette; Shprecher, David R

2016-05-01

The cause of progressive supranuclear palsy (PSP) is largely unknown. Based on evidence for impaired mitochondrial activity in PSP, we hypothesized that the disease may be related to exposure to environmental toxins, some of which are mitochondrial inhibitors. This multicenter case-control study included 284 incident PSP cases of 350 cases and 284 age-, sex-, and race-matched controls primarily from the same geographical areas. All subjects were administered standardized interviews to obtain data on demographics, residential history, and lifetime occupational history. An industrial hygienist and a toxicologist unaware of case status assessed occupational histories to estimate past exposure to metals, pesticides, organic solvents, and other chemicals. Cases and controls were similar on demographic factors. In unadjusted analyses, PSP was associated with lower education, lower income, more smoking pack-years, more years of drinking well water, more years living on a farm, more years living 1 mile from an agricultural region, more transportation jobs, and more jobs with exposure to metals in general. However, in adjusted models, only more years of drinking well water was significantly associated with PSP. There was an inverse association with having a college degree. We did not find evidence for a specific causative chemical exposure; higher number of years of drinking well water is a risk factor for PSP. This result remained significant after adjusting for income, smoking, education and occupational exposures. This is the first case-control study to demonstrate PSP is associated with environmental factors. © 2016 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder Society.

Pleural mesothelioma and occupational and non-occupational asbestos exposure: a case-control study with quantitative risk assessment.

PubMed

Ferrante, Daniela; Mirabelli, Dario; Tunesi, Sara; Terracini, Benedetto; Magnani, Corrado

2016-03-01

Casale Monferrato (north west Italy) is an area with an exceptionally high incidence of mesothelioma caused by asbestos contamination at work and in the general environment from the asbestos-cement Eternit plant that was operational until 1986. The purpose of this study was to quantify the association between pleural malignant mesothelioma (PMM) and asbestos cumulative exposure using individual assessment of environmental and domestic exposure, as well as of occupational exposure. This population-based case-control study included cases of PMM diagnosed between January 2001 and June 2006 among residents in the Casale Monferrato Local Health Authority. Population controls were randomly sampled, matched by age and sex to cases. Cumulative exposure was estimated to account for the lifelong exposure history. Analyses were conducted using unconditional logistic regression models adjusting for gender, age at diagnosis and type of interview (direct or proxy respondents). 200 PMM cases of 223 eligible cases (89.7%) and 348 (63%) of 552 eligible controls accepted to be interviewed. ORs increased with cumulative exposure index (p<0.0001) from 4.4 (CI 95% 1.7 to 11.3) (<1 f/mL-years) to 62.1 (CI 95% 22.2 to 173.2) (≥10 f/mL-years). Among subjects never occupationally exposed, corresponding ORs were 3.8 (CI 95% 1.3 to 11.1) and 23.3 (CI 95% 2.9 to 186.9) (reference: background level of asbestos exposure). ORs of about 2, statistically significant, were observed for domestic exposure and for living in houses near buildings with large asbestos cement parts. Risk of PMM increased with cumulative asbestos exposure and also in analyses limited to subjects non-occupationally exposed. Our results also provide indication of risk associated with common sources of environmental exposure and are highly relevant for the evaluation of residual risk after the cessation of asbestos industrial use. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Lung Cancer Risk Among Hairdressers: A Pooled Analysis of Case-Control Studies Conducted Between 1985 and 2010

PubMed Central

Olsson, Ann C.; Xu, Yiwen; Schüz, Joachim; Vlaanderen, Jelle; Kromhout, Hans; Vermeulen, Roel; Peters, Susan; Stücker, Isabelle; Guida, Florence; Brüske, Irene; Wichmann, Heinz-Erich; Consonni, Dario; Landi, Maria Teresa; Caporaso, Neil; Tse, Lap Ah; Yu, Ignatius Tak-sun; Siemiatycki, Jack; Richardson, Lesley; Mirabelli, Dario; Richiardi, Lorenzo; Simonato, Lorenzo; Gustavsson, Per; Plato, Nils; Jöckel, Karl-Heinz; Ahrens, Wolfgang; Pohlabeln, Hermann; Tardón, Adonina; Zaridze, David; Marcus, Michael W.; ‘t Mannetje, Andrea; Pearce, Neil; McLaughlin, John; Demers, Paul; Szeszenia-Dabrowska, Neonila; Lissowska, Jolanta; Rudnai, Peter; Fabianova, Eleonora; Dumitru, Rodica Stanescu; Bencko, Vladimir; Foretova, Lenka; Janout, Vladimir; Boffetta, Paolo; Fortes, Cristina; Bueno-de-Mesquita, Bas; Kendzia, Benjamin; Behrens, Thomas; Pesch, Beate; Brüning, Thomas; Straif, Kurt

2013-01-01

Increased lung cancer risks among hairdressers were observed in large registry-based cohort studies from Scandinavia, but these studies could not adjust for smoking. Our objective was to evaluate the lung cancer risk among hairdressers while adjusting for smoking and other confounders in a pooled database of 16 case-control studies conducted in Europe, Canada, China, and New Zealand between 1985 and 2010 (the Pooled Analysis of Case-Control Studies on the Joint Effects of Occupational Carcinogens in the Development of Lung Cancer). Lifetime occupational and smoking information was collected through interviews with 19,369 cases of lung cancer and 23,674 matched population or hospital controls. Overall, 170 cases and 167 controls had ever worked as hairdresser or barber. The odds ratios for lung cancer in women were 1.65 (95% confidence interval (CI): 1.16, 2.35) without adjustment for smoking and 1.12 (95% CI: 0.75, 1.68) with adjustment for smoking; however, women employed before 1954 also experienced an increased lung cancer risk after adjustment for smoking (odds ratio = 2.66, 95% CI: 1.09, 6.47). The odds ratios in male hairdressers/barbers were generally not elevated, except for an increased odds ratio for adenocarcinoma in long-term barbers (odds ratio = 2.20, 95% CI: 1.02, 4.77). Our results suggest that the increased lung cancer risks among hairdressers are due to their smoking behavior; single elevated risk estimates should be interpreted with caution and need replication in other studies. PMID:24068200

The Association Between Neurocysticercosis and Hippocampal Atrophy is Related to Age

PubMed Central

Del Brutto, Oscar H.; Issa, Naoum P.; Salgado, Perla; Del Brutto, Victor J.; Zambrano, Mauricio; Lama, Julio; García, Héctor H.

2017-01-01

Neurocysticercosis (NCC) has been associated with hippocampal atrophy, but the prevalence and pathogenic mechanisms implicated in this relationship are unknown. Using a population-based, case–control study design, residents in a rural village (Atahualpa) aged ≥ 40 years with calcified NCC were identified as cases and paired to NCC-free individuals (control subjects) matched by age, sex, and level of education. Cases and control subjects underwent magnetic resonance imaging for hippocampal rating according to the Scheltens' scale for medial temporal atrophy and were interviewed to identify those with a clinical seizure disorder. The prevalence of hippocampal atrophy was compared between cases and control subjects by the use of the McNemar's test for correlated proportions. Seventy-five individuals with calcified NCC and their matched control subjects were included in the analysis. Hippocampal atrophy was noted in 26 (34.7%) cases and nine (12%) control subjects (odds ratio: 4.4; 95% confidence interval: 1.6–14.9, P < 0.0021). Stratification of pairs according to tertiles of age revealed an age-related trend in this association, which became significant only in those aged ≥ 68 years (P = 0.027). Only five cases and one control had recurrent seizures (P = 0.221); three of these five cases had hippocampal atrophy, and the single control subject had normal hippocampi. This study confirms an association between NCC and hippocampal atrophy, and shows that this association is stronger in older age groups. This suggests that NCC-related hippocampal atrophy takes a long time to develop. PMID:28077750

Smoking and adult glioma: a population-based case-control study in China.

PubMed

Hou, Lei; Jiang, Jingmei; Liu, Boqi; Han, Wei; Wu, Yanping; Zou, Xiaonong; Nasca, Philip C; Xue, Fang; Chen, Yuanli; Zhang, Biao; Pang, Haiyu; Wang, Yuyan; Wang, Zixing; Li, Junyao

2016-01-01

Smoking increases the risk of numerous cancers; however, an association of smoking with adult gliomas has not been found in a population. This case-control study included 4556 glioma cases (ICD-9 code 191.0-191.9) aged ≥ 30 years and 9112 controls from a national survey of smoking and mortality in China in 1989-1991. Controls from 325 255 surviving spouses of all-cause deaths were randomly assigned to cases in each of 103 areas according to sex and age groups at a ratio of 2:1. Smoking information was ascertained retrospectively by interviewing surviving spouses. After adjustment for confounders, smoking increased the risk of glioma deaths by 11% (odds ratio [OR] = 1.11; 95% confidence interval [CI]: 1.03-1.21). Compared with non-smokers; the increased risk was 9% (OR = 1.09; 95% CI: 0.99-1.20) in men and 16% (OR = 1.16; 95% CI: 1.00-1.36) in women. The risk increased with age and doses. For individuals aged ≥ 50 years, smoking was associated with higher risk of glioma death by 25% (OR = 1.25; 95% CI: 1.15-1.38); this increased risk for smokers who smoked ≥ 20 cigarettes daily for ≥ 30 years was 53% (OR = 1.53; 95% CI: 1.34-1.74). There were similar findings in both men and women and with either pathology-based or non-pathology-based comparisons. This study indicates that smoking is associated with glioma deaths in the Chinese population. Long-term heavy smoking could be a factor for risk stratification in individuals attending brain tumor clinics. © The Author(s) 2015. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Soya food intake and risk of endometrial cancer among Chinese women in Shanghai: population based case-control study

PubMed Central

Xu, Wang Hong; Zheng, Wei; Xiang, Yong Bing; Ruan, Zhi Xian; Cheng, Jia Rong; Dai, Qi; Gao, Yu Tang; Shu, Xiao Ou

2004-01-01

Objective To evaluate the association of intake of soya food, a rich source of phytoestrogens, with the risk of endometrial cancer. Design Population based case-control study, with detailed information on usual soya food intake over the past five years collected by face to face interview using a food frequency questionnaire. Setting Urban Shanghai, China. Participants 832 incident cases of endometrial cancer in women aged of 30 to 69 years diagnosed during 1997-2001 and identified from the Shanghai Cancer Registry; 846 control women frequency matched to cases on age and randomly selected from the Shanghai Residential Registry. Main outcome measures Odds ratios for risk of endometrial cancer in women with different intakes of soya foods. Results Regular consumption of soya foods, measured as amount of either soya protein or soya isoflavones, was inversely associated with the risk of endometrial cancer. Compared with women with the lowest quarter of intake, the adjusted odds ratio of endometrial cancer was reduced from 0.93 to 0.85 and 0.67 with increasing quarter of soya protein intake (P for trend 0.01). A similar inverse association was observed for soya isoflavones and soya fibre intake. The inverse association seemed to be more pronounced among women with high body mass index and waist:hip ratio. Conclusion Regular intake of soya foods is associated with a reduced risk of endometrial cancer. PMID:15136343

Hospital-Based Case-Control Study of MDS Subtypes and Benzene Exposure in Shanghai

PubMed Central

Copley, G. Bruce; Schnatter, A. Robert; Armstrong, Thomas W.; Irons, Richard D.; Chen, Min; Wang, Xiao Qin; Kerzic, Patrick

2017-01-01

Objective: Due to the sparse data on benzene exposure and myelodysplastic syndrome (MDS) subtypes, we studied this relationship in patients from 29 hospitals in Shanghai, China. Methods: We recruited 604 cases of MDS and 1193 controls matched on age, sex, and admission date. We interviewed subjects for information on workplace and lifestyle exposures, and developed semi-quantitative exposure estimates. Results: Benzene exposure showed a direct exposure–response pattern with refractory cytopenia with multilineage dysplasia, a less certain association with refractory cytopenia with unilineage dysplasia, and no association with other MDS subtypes. A different pattern was observed with farm residence and smoking, which was primarily related to refractory anemias. Conclusions: This research demonstrates the importance of MDS subtype specification for more robust etiologic insights. Our data suggests that subtypes with non-erythroid dysplasia are associated with benzene exposure. PMID:28146040

Relationship between female sexual difficulties and mental health in patients referred to two public and private settings in Tehran, Iran.

PubMed

Azar, Mahyar; Noohi, Sima; Shafiee Kandjani, Ali Reza

2007-09-01

Sexual difficulty has various effects on patients suffering from this condition that can impact on interpersonal and marital relationships. Sexual function may be adversely affected by stress of any kind and emotional disorders. There have been limited studies focusing on the mental health of those suffering from this problem. To determine the relationship between sexual difficulties and mental health in female patients seeking help in psychiatric clinics. The study was based on the case-control design methodology in which the case group consisted of 165 outpatients of two psychiatric clinics, who were diagnosed with different mental disorders such as depression, anxiety, phobia, aggression, and somatic complaints (33 subjects for each type of disorder). The 33 subjects in the control group were chosen among the patients' relatives and visitors who had no history of either seeking psychiatric help or taking psychiatric drugs. The subjects of both case and control groups were selected based on a convenience sampling method. Moreover, the data were collected based on two techniques of "interview" and "questionnaire;" the latter was of three different subcategories, each dealt with demographic characteristics, sexual difficulties, and a Symptom Check-List-90-Revised. Assessing female sexual difficulties associated with mental health and differences between women with and without psychiatric problems. The obtained results indicated that there was a significant difference between the prevalence of sexual difficulties (e.g., sexual desire and orgasm disorders) in the case group and that of the control group. It was also revealed that there was a significant difference between the depressed, aggressive, as well as those with somatic complaints, and their control group counterparts. In Iran, sexual difficulties seem to be more frequent in those seeking psychiatric help in clinics than in those within the normal population.

Medical exposures in youth and the frequency of narcolepsy with cataplexy: a population-based case-control study in genetically predisposed people

PubMed Central

Koepsell, Thomas D.; Longstreth, William T.; Ton, Thanh G. N.

2012-01-01

SUMMARY Epidemiological observations suggest that exposures in youth may trigger narcolepsy in genetically predisposed individuals. In this population-based case–control study, we sought to identify all prevalent cases of narcolepsy with cataplexy aged 18–50 years as of 1 July 2001, in King County, Washington. The 45 eligible cases who were DQB1*0602-positive were compared with 95 controls with this allele, identified through random-digit dialing and buccal smears. Cases and controls were interviewed in person about physician-diagnosed infectious and non-infectious illnesses, immunizations, head trauma and parasomnias or psychiatric problems during youth. Narcolepsy with cataplexy was more frequent in African-Americans and in poorer households. Adjusting for these factors, the condition was 5.4-fold more common [95% confidence interval (CI) = 1.5–19.1] among people reporting a physician-diagnosed strep throat before the age of 21 years. No other significant associations with childhood diseases, immunizations or head trauma were found. However, prevalence was increased 16.3-fold (95% CI = 6.1–44.1) in subjects who reported having had ‘night terrors’. Strep throat may be related to narcolepsy with cataplexy in genetically susceptible individuals. The association with night terrors could simply reflect early symptoms of narcolepsy, or they could be a prodromal sign of disturbed sleep physiology. keywords epidemiology, head injuries, immunization, narcolepsy, night terrors, streptococcal infections PMID:19732319

Sodium intake, salt taste and gastric cancer risk according to Helicobacter pylori infection, smoking, histological type and tumor site in China.

PubMed

Zhong, Chen; Li, Kai-Nan; Bi, Jing-Wang; Wang, Bao-Cheng

2012-01-01

The risk factors mostly strongly associated with gastric cancer are gastric bacteria Helicobacter pylori and diet. Using a case-control study among residents in Jinan, we examined the association between the salt taste and gastric cancer according to H. pylori infection, smoking and histological type as well as tumor site. This population-based case-control study included 207 cases and 410 controls. Data on potential risk factors of gastric cancer were obtained by interview of cases and controls with a questionnaire, salt taste preference was measured for all subjects, and IgG antibodies to H. pylori were applied to assess infection. Risk measures were determined using unconditional logistic regression. The proportions of salt taste at intervals of 1.8-7.2 g/L and ≥ 7.2 g/L were significantly higher in cases than controls, with ORs of 1.56 (1.23-3.64) and 2.03 (2.12- 4.11), respectively, subjects with high salt intake having an elevated risk for gastric cancer when infected with H. pylori. Significant modification by smoking and tumor site was observed across the different measures of salt intake, the highest salt taste showed higher cancer risk in ever smokers or with non-cardia cancers. Our study supports the view that high intake of sodium is an important dietary risk factor for gastric cancer, with a synergistic effect found between salt and H.pylori and smoking, dependent on the tumor site.

Indoor residential radon exposure and risk of childhood acute myeloid leukaemia.

PubMed

Steinbuch, M; Weinberg, C R; Buckley, J D; Robison, L L; Sandler, D P

1999-11-01

Exposure to radon has been identified as a risk factor for lung cancer in uranium miners, but evidence of adverse health effects due to indoor radon exposure is inconsistent. Ecological studies have suggested a correlation between indoor radon levels and leukaemia incidence. We evaluated the risk associated with indoor residential radon exposure within a larger interview-based case-control study of risk factors for childhood acute myeloid leukaemia (AML). A total of 173 cases and 254 controls met the eligibility criteria, and information was collected through telephone interviews with parents and analysis of alpha-track radon detectors placed in the home for a period of 1 year. No association was observed between radon exposure and risk of AML, with adjusted odds ratios of 1.2 (95% confidence interval (CI) 0.7-1.8) for 37-100 Bq m(-3) and 1.1 (95% CI 0.6-2.0) for > 100 Bq m(-3) compared with < 37 Bq m(-3). Although there was an inverse association between radon level and AML risk among children < 2 years at diagnosis, among children > or = 2 years, AML risk was increased among those with higher radon exposure. The observed association after age 2 is most likely due to chance. Overall, there was no association between residential radon and risk of childhood AML.

Developing and pretesting case studies in dental and dental hygiene education: using the diffusion of innovations model.

PubMed

Cragun, Deborah L; DeBate, Rita DiGioacchino; Severson, Herbert H; Shaw, Tracy; Christiansen, Steve; Koerber, Anne; Tomar, Scott L; Brown, Kelli McCormack; Tedesco, Lisa A; Hendricson, William D

2012-05-01

Case-based learning offers exposure to clinical situations that health professions students may not encounter in their training. The purposes of this study were to apply the Diffusion of Innovations conceptual framework to 1) identify characteristics of case studies that would increase their adoption among dental and dental hygiene faculty members and 2) develop and pretest interactive web-based case studies on sensitive oral-systemic health issues. The formative study spanned two phases using mixed methods (Phase 1: eight focus groups and four interviews; Phase 2: ten interviews and satisfaction surveys). Triangulation of quantitative and qualitative data revealed the following positive attributes of the developed case studies: relative advantage of active learning and modeling; compatibility with a variety of courses; observability of case-related knowledge and skills; independent learning; and modifiability for use with other oral-systemic health issues. These positive attributes are expected to increase the likelihood that dental and dental hygiene faculty members will adopt the developed case study once it is available for use. The themes identified in this study could be applied to the development of future case studies and may provide broader insight that might prove useful for exploring differences in case study use across dental and dental hygiene curricula.

Prior medical conditions and medication use and risk of non-Hodgkin lymphoma in Connecticut United States women.

PubMed

Zhang, Yawei; Holford, Theodore R; Leaderer, Brian; Zahm, Shelia Hoar; Boyle, Peter; Morton, Lindsay McOmber; Zhang, Bing; Zou, Kaiyong; Flynn, Stuart; Tallini, Giovanni; Owens, Patricia H; Zheng, Tongzhang

2004-05-01

To further investigate the role of prior medical conditions and medication use in the etiology of non-Hodgkin lymphoma (NHL), we analyzed the data from a population-based case-control study of NHL in Connecticut women. A total of 601 histologically confirmed incident cases of NHL and 717 population-based controls were included in this study. In-person interviews were administered using standardized, structured questionnaires to collect information on medical conditions and medication use. An increased risk was found among women who had a history of autoimmune disorders (such as rheumatoid arthritis, lupus erythematosus, Sjogren's syndrome, and multiple sclerosis), anemia, eczema, or psoriasis. An increased risk was also observed among women who had used steroidal anti-inflammatory drugs and tranquilizers. A reduced risk was found for women who had scarlet fever or who had used estrogen replacement therapy, aspirin, medications for non-insulin dependent diabetes, HMG-CoA reductase inhibitors, or beta-adrenergic blocking agents. Risk associated with past medical history appeared to vary based on NHL subtypes, but the results were based on small number of exposed subjects. A relationship between certain prior medical conditions and medication use and risk of NHL was observed in this study. Further studies are warranted to confirm our findings.

Can social capital help explain enrolment (or lack thereof) in community-based health insurance? Results of an exploratory mixed methods study from Senegal.

PubMed

Mladovsky, Philipa; Soors, Werner; Ndiaye, Pascal; Ndiaye, Alfred; Criel, Bart

2014-01-01

CBHI has achieved low population coverage in West Africa and elsewhere. Studies which seek to explain this point to inequitable enrolment, adverse selection, lack of trust in scheme management and information and low quality of health care. Interventions to address these problems have been proposed yet enrolment rates remain low. This exploratory study proposes that an under-researched determinant of CBHI enrolment is social capital. Fieldwork comprising a household survey and qualitative interviews was conducted in Senegal in 2009. Levels of bonding and bridging social capital among 720 members and non-members of CBHI across three case study schemes are compared. The results of the logistic regression suggest that, controlling for age and gender, in all three case studies members were significantly more likely than non-members to be enrolled in another community association, to have borrowed money from sources other than friends and relatives and to report having control over all community decisions affecting daily life. In two case studies, having privileged social relationships was also positively correlated with enrolment. After controlling for additional socioeconomic and health variables, the results for borrowing money remained significant. Additionally, in two case studies, reporting having control over community decisions and believing that the community would cooperate in an emergency were significantly positively correlated with enrolment. The results suggest that CBHI members had greater bridging social capital which provided them with solidarity, risk pooling, financial protection and financial credit. Qualitative interviews with 109 individuals selected from the household survey confirm this interpretation. The results ostensibly suggest that CBHI schemes should build on bridging social capital to increase coverage, for example by enrolling households through community associations. However, this may be unadvisable from an equity perspective. It is concluded that since enrolment in CBHI was less common not only among the poor, but also among those with less social capital and less power, strategies should focus on removing social as well as financial barriers to  financial protection from the cost of ill health. Copyright © 2013 Elsevier Ltd. All rights reserved.

Nutrition knowledge, food label use, and food intake patterns among Latinas with and without type 2 diabetes.

PubMed

Fitzgerald, Nurgül; Damio, Grace; Segura-Pérez, Sofia; Pérez-Escamilla, Rafael

2008-06-01

To examine the associations of nutrition knowledge, food label use, and food intake patterns among Latinas with and without diagnosed diabetes. This was a case-control study. A convenience sample of 201 (100 cases with diagnosed type 2 diabetes, 101 controls without diagnosed diabetes) nonpregnant, nonbreastfeeding Latinas without severe health conditions, aged 35 to 60 years were interviewed by bicultural interviewers. Diverse community-based recruitment methods were used. Independent samples t test, Mann-Whitney U, and chi(2) tests, and multivariate logistic regression were performed. Food labels self-efficacy and stage of change, and average nutrition knowledge scores were similar between cases and controls (P>0.05). Within the diabetes group, nutrition knowledge was greater among those who had seen a registered dietitian or a diabetes educator (P=0.020). Cases reported consuming artificially sweetened desserts and beverages more frequently than controls (P<0.001). Pooled sample cross-sectional analyses showed that nutrition knowledge was positively related to food label use, which in turn was related to a more healthful food intake pattern (P<0.05). After adjusting for likely confounders, socioeconomic status (SES) was positively related to nutrition knowledge (P=0.001) and intakes of fruits, vegetables, and meats (P

Does Motivational Interviewing (MI) Work with Nonaddicted Clients? A Controlled Study Measuring the Effects of a Brief Training in MI on Client Outcomes

ERIC Educational Resources Information Center

Young, Tabitha L.; Gutierrez, Daniel; Hagedorn, W. Bryce

2013-01-01

This study investigated the relationships between motivational interviewing (MI) and client symptoms, attendance, and satisfaction. Seventy-nine clients attending a university-based counseling center were purposefully assigned to treatment or control conditions. Statistical analyses revealed client symptoms in both groups improved. However,…

Quality Control for Interviews to Obtain Dietary Recalls from Children for Research Studies

PubMed Central

SHAFFER, NICOLE M.; THOMPSON, WILLIAM O.; BAGLIO, MICHELLE L.; GUINN, CAROLINE H.; FRYE, FRANCESCA H. A.

2005-01-01

Quality control is an important aspect of a study because the quality of data collected provides a foundation for the conclusions drawn from the study. For studies that include interviews, establishing quality control for interviews is critical in ascertaining whether interviews are conducted according to protocol. Despite the importance of quality control for interviews, few studies adequately document the quality control procedures used during data collection. This article reviews quality control for interviews and describes methods and results of quality control for interviews from two of our studies regarding the accuracy of children's dietary recalls; the focus is on quality control regarding interviewer performance during the interview, and examples are provided from studies with children. For our two studies, every interview was audio recorded and transcribed. The audio recording and typed transcript from one interview conducted by each research dietitian either weekly or daily were randomly selected and reviewed by another research dietitian, who completed a standardized quality control for interviews checklist. Major strengths of the methods of quality control for interviews in our two studies include: (a) interviews obtained for data collection were randomly selected for quality control for interviews, and (b) quality control for interviews was assessed on a regular basis throughout data collection. The methods of quality control for interviews described may help researchers design appropriate methods of quality control for interviews for future studies. PMID:15389417

Using Problem-Based Learning Software with At-Risk Students: A Case Study

ERIC Educational Resources Information Center

Samsonov, Pavel; Pedersen, Susan; Hill, Christine L.

2006-01-01

In an extension of research examining student-centered pedagogy, the present case study examined how at-risk students used Alien Rescue, a problem-based learning (PBL) software program for middle school science. Twenty-nine participants were observed and interviewed over the twelve class days in which they were engaged in Alien Rescue. Students'…

Association of tobacco use and other determinants with pregnancy outcomes: a multicentre hospital-based case-control study in Karachi, Pakistan.

PubMed

Rozi, Shafquat; Butt, Zahid Ahmad; Zahid, Nida; Wasim, Saba; Shafique, Kashif

2016-09-20

The study aimed to identify the effects of maternal tobacco consumption during pregnancy and other factors on birth outcomes and obstetric complications in Karachi, Pakistan. A multicentre hospital-based case-control study. Four leading maternity hospitals of Karachi. A random sample of 1275 women coming to the gynaecology and obstetric department of selected hospitals for delivery was interviewed within 48 hours of delivery from wards. Cases were women with adverse birth outcomes and obstetric complications, while controls were women who had normal uncomplicated delivery. Adverse birth outcomes (preterm delivery, low birth weight, stillbirth, low Apgar score) and obstetric complications (antepartum haemorrhage, caesarean section, etc). Final multiple logistic regression analysis revealed that with every 1 year increase in age the odds of being a case was 1.03 times as compared with being a control. Tobacco use (adjusted OR (aOR): 2.24; 95% CI 1.56 to 3.23), having no slits in the kitchen (proxy indicator for indoor air pollution) (aOR=1.90; 95% CI 1.05 to 3.43), gravidity (aOR=0.83; 95% CI 0.73 to 0.93), non-booked hospital cases (aOR=1.87; 95% CI 1.38 to 2.74), history of stillbirth (aOR=4.06; 95% CI 2.36 to 6.97), miscarriages (aOR=1.91; 95% CI 1.27 to 2.85) and preterm delivery (aOR=6.04; 95% CI 2.52 to 14.48) were significantly associated with being a case as compared with control. This study suggests that women who had adverse pregnancy outcomes were more likely to have exposure to tobacco, previous history of adverse birth outcomes and were non-booked cases. Engagement of stakeholders in tobacco control for providing health education, incorporating tobacco use in women in the tobacco control policy and designing interventions for tobacco use cessation is warranted. Prenatal care and health education might help in preventing such adverse events. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Health information system model for monitoring treatment and surveillance for leprosy patients in indonesia (case study in Pekalongan District, Central Java, Indonesia).

PubMed

Rachmani, Enny; Kurniadi, Arif; Hsu, Chien Yeh

2013-01-01

After India and Brazil, Indonesia has the third highest incidence/prevalence of leprosy in the world. Every year thousands of new cases and case with grade-2 disability are reported and, while the recovery rate lingers only 80-90 %. Therefore, more than 10 % of leprosy patients drop out of treatment and can be a source of new infections in the community. Our research was aimed at determining apparent difficulties in the leprosy control program as well as how a health information system (HIS) could assist the Indonesian leprosy control program. We used qualitative method with deep interview and observation of document. One of the difficulties which the Indonesian leprosy control program faces is discontinuity of patient's data due to rotating staff as well as the treatment monitoring and queries patients which should be monitored after treatment has ceased. Technology implementation is feasible through short message service (sms) reminders and web base applications. The leprosy control program urgently needs to implement continuous monitoring and recording of patients because of the particular characteristics of this contagious disease.

Crossing boundaries: family physicians' struggles to protect their private lives.

PubMed

Miedema, Baukje; Easley, Julie; Fortin, Pierrette; Hamilton, Ryan; Tatemichi, Sue

2009-03-01

To explore the tensions between professional and personal boundaries and how they affect the work and private lives of family physicians. Qualitative case study using semistructured interviews. Province of New Brunswick. Forty-eight family physicians from across the province. A collective case-study approach was developed, with 24 cases of 2 individuals per case. Cases were selected based on sex, location (urban or rural), language (French or English), and number of years since medical school graduation (< 10 years, 10 to 20 years, or > 20 years). Physicians were interviewed in either French or English. Participants were recruited using the College of Physicians and Surgeons of New Brunswick's physician directory. Based on the rates of response and participation, some cases were overrepresented, while others were not completed. All interviews were audiotaped, transcribed verbatim, and analyzed thematically using a categorical aggregation approach. A coding scheme for the thematic analysis was developed by the research team before the interviews were transcribed. Almost all of the family physicians interviewed discussed how their profession negatively affected their personal lives. Many struggled with issues such as heavy workloads, the adverse effects of their profession on their family lives, and the trespassing of patients onto their personal lives in small towns and rural communities. Some physicians had developed strategies to balance their personal lives with their professional demands; however, this often meant reducing work hours or terminating certain shifts, such as those in the emergency department or after-hours clinics. Family physicians struggle to keep their profession from intruding too much into their private lives. These struggles are important to acknowledge and address in order to avoid physician burnout and premature retirement from clinical practice.

Crossing boundaries

PubMed Central

Miedema, Baukje; Easley, Julie; Fortin, Pierrette; Hamilton, Ryan; Tatemichi, Sue

2009-01-01

ABSTRACT OBJECTIVE To explore the tensions between professional and personal boundaries and how they affect the work and private lives of family physicians. DESIGN Qualitative case study using semistructured interviews. SETTING Province of New Brunswick. PARTICIPANTS Forty-eight family physicians from across the province. METHODS A collective case-study approach was developed, with 24 cases of 2 individuals per case. Cases were selected based on sex, location (urban or rural), language (French or English), and number of years since medical school graduation (< 10 years, 10 to 20 years, or > 20 years). Physicians were interviewed in either French or English. Participants were recruited using the College of Physicians and Surgeons of New Brunswick’s physician directory. Based on the rates of response and participation, some cases were overrepresented, while others were not completed. All interviews were audiotaped, transcribed verbatim, and analyzed thematically using a categorical aggregation approach. A coding scheme for the thematic analysis was developed by the research team before the interviews were transcribed. MAIN FINDINGS Almost all of the family physicians interviewed discussed how their profession negatively affected their personal lives. Many struggled with issues such as heavy workloads, the adverse effects of their profession on their family lives, and the trespassing of patients onto their personal lives in small towns and rural communities. Some physicians had developed strategies to balance their personal lives with their professional demands; however, this often meant reducing work hours or terminating certain shifts, such as those in the emergency department or after-hours clinics. CONCLUSION Family physicians struggle to keep their profession from intruding too much into their private lives. These struggles are important to acknowledge and address in order to avoid physician burnout and premature retirement from clinical practice. PMID:19282540

Acute nonlymphocytic leukemia and residential exposure to power frequency magnetic fields

DOE Office of Scientific and Technical Information (OSTI.GOV)

Severson, R.K.

1986-01-01

A population-based case-control study of adult acute nonlymphocytic leukemia (ANLL) and residential exposure to power frequency magnetic fields was conducted in King, Pierce and Snohomish Counties in Washington state. Of 164 cases who were diagnosed from January 1, 1981 through December 31, 1984, 114 were interviewed. Controls were selected from the study area on the basis of random digit dialing and frequency matched to the cases by age and sex. Analyses were undertaken to evaluate whether exposure to high levels of power frequency magnetic fields in the residence were associated with an increased risk of ANLL. Neither the directly measuredmore » magnetic fields nor the surrogate values based on the wiring configurations were associated with ANLL. Additional analyses suggested that persons with prior allergies were at decreased risk of acute myelocytic leukemia (AML). Also, persons with prior autoimmune diseases were at increased risk of AML. The increase in AML risk in rheumatoid arthritics was of borderline statistical significance. Finally, cigarette smoking was associated with an increased risk of AML. The risk of AML increased significantly with the number of years of cigarette smoking.« less

Impact of Repeated Questioning on Interviewers: Learning From a Forensic Interview Training Project.

PubMed

Duron, Jacquelynn F; Cheung, Monit

2016-01-01

Forensic interviewers have a difficult job with high risk for career burnout and secondary trauma. Few studies have addressed how new forensic interviewers or trainees experience repeated questioning and multiple interviews. This study simulated the process of training new forensic interviewers through the creation of two interview videos in which social work graduate students participated as actors portraying the roles of interviewer and child. These films served as instructional aids preparing graduate social work students for professional child welfare roles while promoting research-based approaches to interviewing children about sexual abuse allegations. Qualitative data from two cohorts of student actors were collected to analyze interviewers' perspectives on repeated questioning and interviews in child sexual abuse cases. Two themes were extracted from the subjects' experiences: "It is emotionally taxing" and "Navigating the interviewer role is unexpectedly complex." Exposure to repeated questions and multiple interviews affected the performance and confidence of the interviewers.

Personality as a risk factor in large bowel cancer: data from the Melbourne Colorectal Cancer Study.

PubMed

Kune, G A; Kune, S; Watson, L F; Bahnson, C B

1991-02-01

In a case control study which formed one arm of a large, population-based investigation of colorectal cancer incidence, aetiology and survival. 'The Melbourne Colorectal Cancer Study', among others, 22 psychosocially orientated questions were asked by personal interview of 637 histologically confirmed new cases of colorectal cancer and 714 age/sex frequency matched community controls, from Melbourne (population 2.81 million). Self-reported childhood or adult life 'unhappiness' was statistically significantly more common among the cancer cases, while 'unhappiness with retirement' was similarly distributed among cases and controls. Questions which were formulated to test a particular personality profile as a cancer risk, and which included the elements of denial and repression of anger and of other negative emotions, a commitment to prevailing social norms resulting in the external appearance of a 'nice' or 'good' person, a suppression of reactions which may offend others and the avoidance of conflict, showed a statistically significant discrimination between cases and controls. The risk of colorectal cancer with respect to this model was independent of the previously found risk factors of diet, beer intake, and family history of colorectal cancer, and was also independent of other potential confounding factors of socioeconomic level, marital status, religion and country of birth. Although the results must be interpreted with caution, the data are consistent with the hypothesis that this personality type may play a role in the clinical expression of colorectal cancer and merits further study.

Informing the design of a randomised controlled trial of an exercise-based programme for long term stroke survivors: lessons from a before-and-after case series study

PubMed Central

2013-01-01

Background To inform the design of a randomised controlled trial (RCT) of an exercise-based programme for long term stroke survivors, we conducted a mixed methods before-and-after case series with assessment at three time points. We evaluated Action for Rehabilitation from Neurological Injury (ARNI), a personalised, functionally-focussed programme. It was delivered through 24 hours of one-to-one training by an Exercise Professional (EP), plus at least 2 hours weekly unsupervised exercise, over 12- 14 weeks. Assessment was by patient-rated questionnaires addressing function, physical activity, confidence, fatigue and health-related quality of life; objective assessment of gait quality and speed; qualitative individual interviews conducted with participants. Data were collected at baseline, 3 months and 6 months. Fidelity and acceptability was assessed by participant interviews, audit of participant and EP records, and observation of training. Findings Four of six enrolled participants completed the exercise programme. Quantitative data demonstrated little change across the sample, but marked changes on some measures for some individuals. Qualitative interviews suggested that small benefits in physical outcomes could be of great psychological significance to participants. Participant-reported fatigue levels commonly increased, and non-completers said they found the programme too demanding. Most key components of the intervention were delivered, but there were several potentially important departures from intervention fidelity. Discussion The study provided data and experience that are helping to inform the design of an RCT of this intervention. It suggested the need for a broader recruitment strategy; indicated areas that could be explored in more depth in the qualitative component of the trial; and highlighted issues that should be addressed to enhance and evaluate fidelity, particularly in the preparation and monitoring of intervention providers. The experience illustrates the value of even small sample before-and-after studies in the development of trials of complex interventions. PMID:23941470

Sleep bruxism and myofascial temporomandibular disorders

PubMed Central

Raphael, Karen G.; Sirois, David A.; Janal, Malvin N.; Wigren, Pia E.; Dubrovsky, Boris; Nemelivsky, Lena V.; Klausner, Jack J.; Krieger, Ana C.; Lavigne, Gilles J.

2015-01-01

Background Many dentists believe that sleep bruxism (SB) is a pathogenic factor in myofascial temporomandibular disorder (TMD), but almost all supportive data rely on patients’ self-reports rather than on direct observation. Methods The authors administered a structured self-report interview to determine whether a large and well-characterized sample of patients with myofascial TMD (124 women) experienced SB more often than did matched control participants (46 women). The authors then used data from a two-night laboratory-based polysomnographic (PSG) study to determine whether the case participants exhibited more SB than the control participants. Results The results of independent sample t tests and χ2 analyses showed that, although self-reported rates of SB were significantly higher in case participants (55.3 percent) than in control participants (15.2 percent), PSG-based measures showed much lower and statistically similar rates of SB in the two groups (9.7 percent and 10.9 percent, respectively). Grinding noises were common in both case participants (59.7 percent) and control participants (78.3 percent). Conclusions Most case participants did not exhibit SB, and the common belief that SB is a sufficient explanation for myofascial TMD should be abandoned. Clinical Implications Although other reasons to consider treating SB may exist, misplaced concern about SB’s sustaining or exacerbating a chronic myofascial TMD condition should not be used to justify SB treatment. PMID:23115152

Three Cases of Adolescent Childbearing Decision-Making: The Importance of Ambivalence

ERIC Educational Resources Information Center

Bender, Soley S.

2008-01-01

Limited information is available about the childbearing decision-making experience by the pregnant adolescent. The purpose of this case study was to explore this experience with three pregnant teenagers. The study is based on nine qualitative interviews. Within-case descriptions applying the theoretical model of decision-making regarding unwanted…

Comparing dietary patterns of depressed patients versus healthy people in a case control protocol

PubMed Central

Khosravi, Maryam; Sotoudeh, Gity; Raisi, Firoozeh; Majdzadeh, Reza; Foroughifar, Tahereh

2014-01-01

Introduction Major depressive disorder is the leading cause of disability around the world. Because of the high rate of medication discontinuation by patients and the risk of recurrence, factors such as nutrition could be useful for the prevention or treatment of depression. The relationship between depression and dietary patterns has been reported in a few studies but with controversial results. Therefore, we have decided to study the possible effects of cultural, social, racial, geographic and environmental conditions on this relationship in an Iranian population. Methods and analysis In our case control protocol, 110 cases and 220 controls will be individually matched based on age, sex and area of residence. New cases of depression, based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), will be recruited from two psychiatric clinics in Tehran. Interviewers will then go to each patient's home and invite qualified individuals to participate in the study as controls. Food intakes of all participants will be obtained by semiquantitative food frequency questionnaires covering the past year; these will be transformed into actual food intake (g/day). Dietary patterns will be determined by the principal components method. Conditional logistic regression, as a multivariate analysis, will be used for assessing the relationship between dietary patterns and depression, taking into consideration the potential role of different variables. The results may help to identify differences in dietary patterns between depressed and healthy people. Ethics and dissemination The study protocol has been approved by ethics committee of Tehran University of Medical Sciences. At the beginning of the study, a written informed consent form will be signed and dated by subjects and investigators. The results will be published in due time. PMID:24525387

Lifelong vegetarianism and breast cancer risk: a large multicentre case control study in India.

PubMed

Gathani, Toral; Barnes, Isobel; Ali, Raghib; Arumugham, Rajkumar; Chacko, Raju; Digumarti, Raghunadharao; Jivarajani, Parimal; Kannan, Ravi; Loknatha, Dasappa; Malhotra, Hemant; Mathew, Beela S

2017-01-18

The lower incidence of breast cancer in Asian populations where the intake of animal products is lower than that of Western populations has led some to suggest that a vegetarian diet might reduce breast cancer risk. Between 2011 and 2014 we conducted a multicentre hospital based case-control study in eight cancer centres in India. Eligible cases were women aged 30-70 years, with newly diagnosed invasive breast cancer (ICD10 C50). Controls were frequency matched to the cases by age and region of residence and chosen from the accompanying attendants of the patients with cancer or those patients in the general hospital without cancer. Information about dietary, lifestyle, reproductive and socio-demographic factors were collected using an interviewer administered structured questionnaire. Multivariate logistic regression models were used to estimate the odds ratio (OR) and 95% confidence intervals for the risk of breast cancer in relation to lifelong vegetarianism, adjusting for known risk factors for the disease. The study included 2101 cases and 2255 controls. The mean age at recruitment was similar in cases (49.7 years (SE 9.7)) and controls (49.8 years (SE 9.1)). About a quarter of the population were lifelong vegetarians and the rates varied significantly by region. On multivariate analysis, with adjustment for known risk factors for the disease, the risk of breast cancer was not decreased in lifelong vegetarians (OR 1.09 (95% CI 0.93-1.29)). Lifelong exposure to a vegetarian diet appears to have little, if any effect on the risk of breast cancer.

A blueprint-based case study analysis of nutrition services provided in a midterm care facility for the elderly.

PubMed

Paquet, Catherine; St-Arnaud-Mckenzie, Danielle; Ferland, Guylaine; Dubé, Laurette

2003-03-01

Ensuring nutritionally adequate food intake in institutions is a complex and important challenge for dietitians. To tackle this problem, we argue that dietitians need to adopt a systematic, integrative, and patient-centered approach to identify and manage more effectively organizational determinants of the quality of food intake under their control. In this study, we introduce such an approach, the blueprint-based case study, that we applied in the context of a midterm care facility for elderly patients. Data gathered through interviews and field observations were used to develop, from the perspective of key patient encounters, detailed representations of the food, nutrition, and nursing activities necessary to ensure adequate food intake. These service "blueprints" were developed to illustrate all activities that might potentially impact on the nutritional, sensory, functional, and social quality of patients' meals. They were also used as roadmaps to develop a case study analysis in which critical areas were identified and opportunities for improvement put forth, while considering services' resources and priorities. By providing a precise, objective, yet comprehensive mapping of the service operations and management, the blueprint-based case study approach represents a valuable tool to determine the optimal allocation of resources to insure nutritionally adequate food intake to patients.

Breast Cancer Risk Factors among Ugandan Women at a Tertiary Hospital: A Case-Control Study

PubMed Central

Galukande, Moses; Wabinga, Henry; Mirembe, Florence; Karamagi, Charles; Asea, Alexzander

2016-01-01

Background Although East Africa, like other countries in sub-Saharan Africa, has a lower incidence of breast cancer than high-income countries, the disease rate is rising steeply in Africa; it has nearly tripled in the past few decades in Uganda. There is a paucity of studies that have examined the relation between reproductive factors and breast cancer risk factors in Ugandan women. Objective To determine breast cancer risk factors among indigenous Ugandan women. Methods This is a hospital-based unmatched case-control study. Interviews were conducted between 2011 and 2012 using structured questionnaires. Patients with histologyproven breast cancer were recruited over a 2-year period. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results A total of 350 women were recruited; 113 were cases and 237 were controls. The mean age was 47.5 years (SD 14) for the cases and 45.5 years (SD 14.1) for the controls. The odds of breast cancer risk seemed lower for those who breastfed (adjusted OR = 0.04; 95% CI: 0.01, 0.18). There was no significance for early age at first full-term birth (adjusted OR = 1.96; 95% CI: 0.97, 3.96; p = 0.061), and urban residence carried no increased odds of breast cancer either (p = 0.201). Conclusion Breastfeeding seems to be associated with reduced odds of breast cancer. PMID:27104645

Professional Learning in Rural Practice: A Sociomaterial Analysis

ERIC Educational Resources Information Center

Slade, Bonnie

2013-01-01

Purpose: This paper aims to examine the professional learning of rural police officers. Design/methodology/approach: This qualitative case study involved interviews and focus groups with 34 police officers in Northern Scotland. The interviews and focus groups were transcribed and analysed, drawing on practice-based and sociomaterial learning…

Diet, cigarettes and alcohol in laryngeal cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Freudenheim, J.L.; Graham, S.; Byers, T.E.

Diet and other risk factors for cancer of the larynx were examined in a case-control study among white males in Western New York, conducted in 1975-1985. Incident, pathologically-confirmed cases and age- and neighborhood-matched controls were interviewed to determine usual diet, and lifetime use of tobacco and alcohol. Because response rates were low for both cases and controls, this cannot be considered a population-based study. A strong association of risk with cigarette but not pipe and cigar smoking was found. Beer and hard liquor but not wine were associated with increased risk. After control for cigarettes, alcohol and education, the uppermore » quartile odds ratio for fat was 2.40, while the odds ratio for high intake of carotenoids was 0.51. There was effect modification by smoking. Carotenoids were most negatively associated with risk among lighter smokers; dietary fat was most positively associated with risk among heavier smokers. Total calories, protein, and retinol were associated with increased risk; there was no relationship between laryngeal cancer and vitamins C and E or carbohydrate. This study again demonstrates the strong association between tobacco and alcohol and laryngeal cancer and also suggests that diets low in carotenoids and high fat may increase risk.« less

Dietary vitamin A and lung cancer: results of a case-control study among chemical workers.

PubMed

Bond, G G; Thompson, F E; Cook, R R

1987-01-01

A nested case-control study conducted among a cohort of chemical manufacturing employees provided an opportunity to test the hypothesis that lung cancer risk is inversely related to dietary intake of vitamin A. Eligible for study were 308 former male employees who had died of lung cancer between 1940 and 1980. Two control groups, one a decedent and the other a "living" series, were individually matched to the cases one-for-one. Interviews were completed with 734 subjects or their next-of-kin and included a food frequency list. A vitamin A index was developed for each subject based on the frequency of consumption of 29 food items. After adjustment for a number of potentially confounding variables (e.g., smoking, educational level, and use of vitamin supplements), there was evidence that vitamin A intake was inversely associated with lung cancer risk. The effect was most pronounced in the comparisons with the "living" controls and appeared strongest among cigarette smokers. Subjects in the lowest tertile of vitamin A intake had approximately twice the risk of lung cancer as those in the highest. Analyses of an index of carotenoids and of individual food items suggested that plant sources of vitamin A may play a more important role in producing the effect than do animal sources.

Exploring the use of Motivational Interviewing with a disengaged primary-aged child

PubMed Central

Cryer, Sarah; Atkinson, Cathy

2015-01-01

Research suggests motivational interviewing (MI) techniques are both widely-used by educational psychologists (EPs) and effective in supporting young people of secondary age. To date, there has been no published research investigating the use of MI with primary-aged children. This study details the use of a short MI-based intervention with a primary-aged pupil identified as disengaged. A case-based approach was employed, using pupil and teacher interviews and observational fieldnotes to assess the usefulness of the intervention. Data were analysed using thematic analysis and the intervention checked for adherence to the MI spirit and principles. Here the process, structure and outcomes of the intervention are exemplified through an illustrative case study with a nine-year-old boy. Results indicate that the adapted intervention had a significant impact on learning motivation and classroom behaviour. The implications of the findings are discussed in relation to the use of school-based therapeutic interventions by EPs. PMID:26339113

Enhancement of medication recall using medication pictures and lists in telephone interviews.

PubMed

Kimmel, Stephen E; Lewis, James D; Jaskowiak, Jane; Kishel, Lori; Hennessy, Sean

2003-01-01

To determine the effect of reading medication lists and providing medication pictures on recall of non-aspirin non-steroidal anti-inflammatory drugs (NANSAIDs) during telephone interviews in a case-control study. After a series of indication-specific questions, a list of all available NANSAIDs was read to study participants and a series of pictures was reviewed when available. Recall was defined as enhanced if a participant recalled NANSAID use only after the memory aids. Among the 1484 participants who reported NANSAID use, 94 (6.3%) recalled their NANSAID use only after the memory aids. Several groups demonstrated enhanced recall following the memory aids: men (odds ratio (OR): 1.73; 95% confidence interval (CI): 1.11, 2.69), users of non-prescription versus prescription NANSAIDs (OR 2.28; 95% CI: 1.21, 4.30), those using > 2 other medications (OR 1.69; 95% CI: 1.06, 2.69), those who did not have all of their medication containers available during the interview (OR 1.58; 95% CI: 1.03, 2.42) and cases versus controls (OR 1.90; 95% CI: 1.11, 3.28). The reading of medication names with the availability of medication photographs enhanced recall by approximately 6%. The use of this type of memory aid may reduce recall bias in case-control studies that rely on medication recall, depending on the overall prevalence of medication use and the effect size of the drug on the outcome.

Relationships between undergraduates' argumentation skills, conceptual quality of problem solutions, and problem solving strategies in introductory physics

NASA Astrophysics Data System (ADS)

Rebello, Carina M.

This study explored the effects of alternative forms of argumentation on undergraduates' physics solutions in introductory calculus-based physics. A two-phase concurrent mixed methods design was employed to investigate relationships between undergraduates' written argumentation abilities, conceptual quality of problem solutions, as well as approaches and strategies for solving argumentative physics problems across multiple physics topics. Participants were assigned via stratified sampling to one of three conditions (control, guided construct, or guided evaluate) based on gender and pre-test scores on a conceptual instrument. The guided construct and guided evaluate groups received tasks and prompts drawn from literature to facilitate argument construction or evaluation. Using a multiple case study design, with each condition serving as a case, interviews were conducted consisting of a think-aloud problem solving session paired with a semi-structured interview. The analysis of problem solving strategies was guided by the theoretical framework on epistemic games adapted by Tuminaro and Redish (2007). This study provides empirical evidence that integration of written argumentation into physics problems can potentially improve the conceptual quality of solutions, expand their repertoire of problem solving strategies and show promise for addressing the gender gap in physics. The study suggests further avenues for research in this area and implications for designing and implementing argumentation tasks in introductory college physics.

Biological Basis for Chemoprevention of Ovarian Cancer

DTIC Science & Technology

2003-10-01

birth control pill use are strongly protective. To achieve a better understanding of the etiology of ovarian cancer, which can then be translated into effective prevention strategies, we have initiated a case-control study that considers genetic susceptibility, epidemiologic risk factors and acquired genetic alterations. Subjects are interviewed in their homes and about 650 cases and 650 controls have been accrued thus far. Blood and cancer samples have been collected and molecular analyses of genetic polymorphisms (BRCA1/2, progesterone receptor) have been performed. An

Biological Basis for Chemoprevention of Ovarian Cancer

DTIC Science & Technology

2004-10-01

birth control pill use are strongly protective. To achieve a better understanding of the etiology of ovarian cancer, which can then be translated into effective prevention strategies, we have initiated a case-control study that considers genetic susceptibility, epidemiologic risk factors and acquired genetic alterations. Subjects are interviewed in their homes and about 750 cases and 750 controls have been accrued thus far. Blood and cancer samples have been collected and molecular analyses of genetic polymorphisms (BRCA1/2, progesterone receptor, vitamin D receptor,

Use of fertility drugs and risk of endometrial cancer in an Italian case-control study.

PubMed

Parazzini, Fabio; Pelucchi, Claudio; Talamini, Renato; Montella, Maurizio; La Vecchia, Carlo

2010-11-01

The objective of this study was to analyse time-related aspects of the use of fertility drugs related to the risk of endometrial cancer using data from a case-control study conducted between 1992 and 2006 in Italy. The study included 454 cases (median age, 60 years; range, 18-79) with incident, histologically confirmed endometrial cancer and 908 female controls (median age, 61 years; range 19-79) admitted to the same network of hospitals as cases for a wide spectrum of acute, non-neoplastic conditions. Controls were frequency matched to cases with a 2:1 ratio for age and study centre. Information was collected by trained interviewers using a structured questionnaire. We calculated odds ratios (ORs) and the corresponding 95% confidence intervals (CI) using conditional logistic regression models adjusted for major relevant covariates. The OR of endometrial cancer for ever use of fertility drugs was 3.26 (95% CI, 1.07-9.95). The risk was higher for duration of use 12 months or more (OR=6.10; 95% CI, 0.96-38.6), time since last use 25 years or less before the interview (OR=5.30; 95% CI, 1.12-25.1), and for age at first use less than 30 years (OR=5.14; 95% CI, 1.13-23.4). The association was apparently stronger in ever-gravid (OR=6.50; 95% CI, 1.10-38.3) than in nulligravid (OR=2.83; 95% CI, 0.32-25.0) women. Our data support earlier findings of an increase in risk of endometrial cancer with duration of use of fertility drugs.

Road traffic and childhood leukemia: the ESCALE study (SFCE).

PubMed

Amigou, Alicia; Sermage-Faure, Claire; Orsi, Laurent; Leverger, Guy; Baruchel, André; Bertrand, Yves; Nelken, Brigitte; Robert, Alain; Michel, Gérard; Margueritte, Geneviève; Perel, Yves; Mechinaud, Françoise; Bordigoni, Pierre; Hémon, Denis; Clavel, Jacqueline

2011-04-01

Traffic is a source of environmental exposures, including benzene, which may be related to childhood leukemia. A national registry-based case-control study [ESCALE (Etude Sur les Cancers et les Leucémies de l'Enfant, Study on Environmental and Genetic Risk Factors of Childhood Cancers and Leukemia)] carried out in France was used to assess the effect of exposure to road traffic exhaust fumes on the risk of childhood leukemia. Over the study period, 2003-2004, 763 cases and 1,681 controls < 15 years old were included, and the controls were frequency matched with the cases on age and sex. The ESCALE data were collected by a standardized telephone interview of the mothers. Various indicators of exposure to traffic and pollution were determined using the geocoded addresses at the time of diagnosis for the cases and of interview for the controls. Indicators of the distance from, and density of, main roads and traffic nitrogen dioxide (NO(2)) concentrations derived from traffic emission data were used. Odds ratios (ORs) were estimated using unconditional regression models adjusted for potential confounders. Acute leukemia (AL) was significantly associated with estimates of traffic NO(2) concentration at the place of residence > 27.7 µg/m(3) compared with NO(2) concentration < 21.9 µg/m(3) [OR=1.2; confidence interval (CI), 1.0-1.5] and with the presence of a heavy-traffic road within 500 m compared with the absence of a heavy-traffic road in the same area (OR=2.0; 95% CI, 1.0-3.6). There was a significant association between AL and a high density of heavy-traffic roads within 500 m compared with the reference category with no heavy-traffic road within 500 m (OR=2.2; 95% CI, 1.1-4.2), with a significant positive linear trend of the association of AL with the total length of heavy-traffic road within 500 m. This study supports the hypothesis that living close to heavy-traffic roads may increase the risk of childhood leukemia.

Occupation and leukemia: a population-based case-control study in Iowa and Minnesota.

PubMed

Blair, A; Zheng, T; Linos, A; Stewart, P A; Zhang, Y W; Cantor, K P

2001-07-01

Studies have suggested that risk of leukemia may be associated with occupational or industrial exposures and risk may vary by the histological type of the disease. A population-based case-control study was conducted in Iowa and Minnesota to evaluate the association between various occupations, industries, and occupational exposures and leukemia risk. A total of 513 cases and 1,087 controls was included in the study. A lifetime occupational history and other risk factor information were collected through in-person interviews, and a job-exposure matrix was used to assess possible risks associated with specific exposures. A significantly increased risk of leukemia was observed among agricultural service industries and among nursing and healthcare workers. Janitors, cleaners, and light truck drivers also experienced increased risk. Those employed in plumbing, heating and air conditioning industries, and sales of nondurable goods (such as paints and varnishes) had an increased risk. Printers, painters, and workers in the food and metal industries had a nonsignificantly increased risk of leukemia. Analyses by specific exposures and histology of leukemia showed that risk of leukemia associated with occupational or industrial exposures may vary by histological type of the disease. An increased risk of leukemia among workers employed in agricultural industries, nursing and healthcare workers, and in a few occupations with possible exposure to solvents is consistent with earlier studies. Associations of risk with occupations not observed previously deserve further assessment. Published 2001 Wiley-Liss, Inc.

Dietary and other risk factors in the aetiology of cholelithiasis: a case control study.

PubMed

Linos, A D; Daras, V; Linos, D A; Kekis, V; Tsoukas, M M; Golematis, V

1989-10-01

We studied the effect of dietary factors and a variety of other risk factors on the development of cholelithiasis through a case control study. The study involved 96 cases and 118 age and sex matched controls. All cases and controls were interviewed with regard to a variety of risk factors and frequency of consumption of over 100 food items. Analysis was done both by chi square and a multiple logistic regression model. From all the dietary factors the only ones that showed a positive statistically significantly (p less than 0.05) association was consumption of animal fat as expressed by eating all visible fat on the meat and using butter on the table. Interestingly high consumption of olive oil had a negative (protective) association with the disease. A negative association was also found with smoking and holding a job demanding hard labor.

Dietary and Other Risk Factors in The Aetiology of Cholelithiasis: A Case Control Study

PubMed Central

Daras, V.; Linos, D. A.; Kekis, V.; Tsoukas, M. M.; Golematis, V.

1989-01-01

We studied the effect of dietary factors and a variety of other risk factors on the development of cholelithiasis through a case control study. The study involved 96 cases and 118 age and sex matched controls. All cases and controls were interviewed with regard to a variety of risk factors and frequency of consumption of over 100 food items. Analysis was done both by chi square and a multiple logistic regression model. From all the dietry factors the only ones that showed a positive statistically signficantly (p<0.05) association was consumption of animal fat as expressed by eating all visible fat on the meat and using butter on the table. Interestingly high consumption of olive oil had a negative (protective) association with the disease. A negative association was also found with smoking and holding a job demanding hard labor. PMID:2487388

Case Studies of the Development of Science Teachers' Practices of Socio-Scientific Issue (SSI)-Based Teaching through a Professional Development Program

ERIC Educational Resources Information Center

Pitiporntapin, Sasithep; Srisakuna, Suchada

2017-01-01

This research aimed to assess three case studies of in-service science teachers regarding their practices of socio-scientific issue (SSI)-based teaching as they participated in a specially developed professional development (PD) program. Data were collected throughout the PD program from group discussions, observations, interviews, and the review…

Driving following Kava Use and Road Traffic Injuries: A Population-Based Case-Control Study in Fiji (TRIP 14)

PubMed Central

Wainiqolo, Iris; Kafoa, Berlin; Kool, Bridget; Robinson, Elizabeth; Herman, Josephine; McCaig, Eddie; Ameratunga, Shanthi

2016-01-01

Objective To investigate the association between kava use and the risk of four-wheeled motor vehicle crashes in Fiji. Kava is a traditional beverage commonly consumed in many Pacific Island Countries. Herbal anxiolytics containing smaller doses of kava are more widely available. Methods Data for this population-based case-control study were collected from drivers of ‘case’ vehicles involved in serious injury-involved crashes (where at least one road user was killed or admitted to hospital for 12 hours or more) and ‘control’ vehicles representative of ‘driving time’ in the study base. Structured interviewer administered questionnaires collected self-reported participant data on demographic characteristics and a range of risk factors including kava use and potential confounders. Unconditional logistic regression models estimated odds ratios relating to the association between kava use and injury-involved crash risk. Findings Overall, 23% and 4% of drivers of case and control vehicles, respectively, reported consuming kava in the 12 hours prior to the crash or road survey. After controlling for assessed confounders, driving following kava use was associated with a four-fold increase in the odds of crash involvement (Odds ratio: 4.70; 95% CI: 1.90–11.63). The related population attributable risk was 18.37% (95% CI: 13.77–22.72). Acknowledging limited statistical power, we did not find a significant interaction in this association with concurrent alcohol use. Conclusion In this study conducted in a setting where recreational kava consumption is common, driving following the use of kava was associated with a significant excess of serious-injury involved road crashes. The precautionary principle would suggest road safety strategies should explicitly recommend avoiding driving following kava use, particularly in communities where recreational use is common. PMID:26930404

Inter-Regional, Epidemiological Study of Childhood Cancer (IRESCC): case-control study in children with germ cell tumors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Johnston, H.E.; Mann, J.R.; Williams, J.

In 1980-1983 members of IRESCC interviewed parents of 555 children with newly diagnosed cancer on topics of possible etiological significance. Identical questions were asked of the parents of 1100 control children chosen from hospital admissions and general practitioner lists. Medical information was confirmed whenever possible by cross-checking with NHS records. Data for the 41 children with germ cell tumors and their 82 controls are reported here. The cases had more major congenital malformations than controls, including one neural tube defect. More case than control mothers and fathers reported occupational exposure to chemicals. Nine close relatives of cases had multiple primarymore » tumors, which were often benign or of low-grade malignancy, compared with 1 hospital control and 3 general practitioner control relatives. Cases and controls differed with respect to birth weight and paternal age. No case-control differences were shown for: birth rank, maternal age, chronic illnesses and smoking, mothers reproductive histories and oral contraceptive usage. In index pregnancies there were no case-control differences for maternal illness, infections, alcohol intake and X-ray and ultrasound exposure. There was no difference between cases and controls for the frequency of twinning the families.« less

Investigation of occupational and environmental causes of respiratory cancers (ICARE): a multicenter, population-based case-control study in France.

PubMed

Luce, Danièle; Stücker, Isabelle

2011-12-14

Occupational causes of respiratory cancers need to be further investigated: the role of occupational exposures in the aetiology of head and neck cancers remains largely unknown, and there are still substantial uncertainties for a number of suspected lung carcinogens. The main objective of the study is to examine occupational risk factors for lung and head and neck cancers. ICARE is a multi-center, population-based case-control study, which included a group of 2926 lung cancer cases, a group of 2415 head and neck cancer cases, and a common control group of 3555 subjects. Incident cases were identified in collaboration with cancer registries, in 10 geographical areas. The control group was a random sample of the population of these areas, with a distribution by sex and age comparable to that of the cases, and a distribution by socioeconomic status comparable to that of the population. Subjects were interviewed face to face, using a standardized questionnaire collecting particularly information on tobacco and alcohol consumption, residential history and a detailed description of occupational history. Biological samples were also collected from study subjects. The main occupational exposures of interest are asbestos, man-made mineral fibers, formaldehyde, polycyclic aromatic hydrocarbons, chromium and nickel compounds, arsenic, wood dust, textile dust, solvents, strong acids, cutting fluids, silica, diesel fumes, welding fumes. The complete list of exposures of interest includes more than 60 substances. Occupational exposure assessment will use several complementary methods: case-by-case evaluation of exposure by experts; development and use of algorithms to assess exposure from the questionnaires; application of job-exposure matrices. The large number of subjects should allow to uncover exposures associated with moderate increase in risks, and to evaluate risks associated with infrequent or widely dispersed exposures. It will be possible to study joint effects of exposure to different occupational risk factors, to examine the interactions between occupational exposures, tobacco smoking, alcohol drinking, and genetic risk factors, and to estimate the proportion of respiratory cancers attributable to occupational exposures in France. In addition, information on many non-occupational risk factors is available, and the study will provide an excellent framework for numerous studies in various fields.

Occupational risk factors for mycosis fungoides: a European multicenter case-control study.

PubMed

Morales-Suárez-Varela, Maria M; Olsen, Jorn; Johansen, Preben; Kaerlev, Linda; Guénel, Pascal; Arveux, Patrick; Wingren, Gun; Hardell, Lennart; Ahrens, Wolfgang; Stang, Andreas; Llopis, Agustin; Merletti, Franco; Aurrekoetxea, Juan Jose; Masala, Giovanna

2004-03-01

Mycosis fungoides (MF) is a rare disease with an unknown etiology. Its distribution suggests that occupational exposures may play a role. In the present study, we searched for occupational factors associated with MF. A European multicenter case-control study on seven rare cancers, including MF, was conducted from 1995 to 1997. Patients between 35 and 69 years of age diagnosed with MF (n = 134) were identified and their diagnoses were checked by a reference pathologist who classified 83 cases as definitive, 35 cases as possible, and 16 cases as not histologically verified. Of the 118 histologically verified cases, 104 were interviewed, of which 76 were definitive cases. As controls, we selected population controls and colon cancer controls to serve all seven case groups. Altogether, 833 colon cancer controls and 2071 population controls were interviewed. The response rate was 91.5% for cases (76 of the 83 definitive cases), and 66.6% for controls. A high risk of MF for men was observed in the industries of other non-metallic mineral products (Odds Ratio [OR] 5.3, 95% confidence interval [CI] = 1.7-16.2) and of wholesale trade (OR 3.6, 95% CI = 1.3-10.5). A high risk was found for female employees in the sector of pulp paper manufacture (OR 14.4, 95% CI = 2.2-95.1). The male occupations with the highest risks were glass formers, potters, and ceramics workers (OR 17.9, 95% CI = 5.4-59.4) and technical salesmen (OR 8.6, 95% CI = 2.4-30.8). For women, the occupations associated with the highest risks were government executives (OR 4.8, 95% CI = 1.0-22.6) and railway and road vehicles loaders (OR 3.9, 95% CI = 1.0-14.0). The results suggest that some occupational factors are associated with MF. Working as glass formers, pottery, and ceramics workers carried the highest risk, and these findings deserve further attention and replication. Females working in the paper and pulp industries may also be exposed to carcinogens of relevance to MF.

Reduced Risk of Barrett's Esophagus in Statin Users: Case-Control Study and Meta-Analysis.

PubMed

Beales, Ian L P; Dearman, Leanne; Vardi, Inna; Loke, Yoon

2016-01-01

Use of statins has been associated with a reduced incidence of esophageal adenocarcinoma in population-based studies. However there are few studies examining statin use and the development of Barrett's esophagus. The purpose of this study was to examine the association between statin use and the presence of Barrett's esophagus in patients having their first gastroscopy. We have performed a case-control study comparing statin use between patients with, and without, an incident diagnosis of non-dysplastic Barrett's esophagus. Male Barrett's cases (134) were compared to 268 male age-matched controls in each of two control groups (erosive gastro-esophageal reflux and dyspepsia without significant upper gastrointestinal disease). Risk factor and drug exposure were established using standardised interviews. Logistic regression was used to compare statin exposure and correct for confounding factors. We performed a meta-analysis pooling our results with three other case-control studies. Regular statin use was associated with a significantly lower incidence of Barrett's esophagus compared to the combined control groups [adjusted OR 0.62 (95 % confidence intervals 0.37-0.93)]. This effect was more marked in combined statin plus aspirin users [adjusted OR 0.43 (95 % CI 0.21-0.89)]. The inverse association between statin or statin plus aspirin use and risk of Barrett's was significantly greater with longer duration of use. Meta-analysis of pooled data (1098 Barrett's, 2085 controls) showed that statin use was significantly associated with a reduced risk of Barrett's esophagus [pooled adjusted OR 0.63 (95 % CI 0.51-0.77)]. Statin use is associated with a reduced incidence of a new diagnosis of Barrett's esophagus.

Risk Factors of Congenital Heart Diseases: A Case-Control Study inNorthwest Iran.

PubMed

Naghavi-Behzad, Mohammad; Alizadeh, Mahasti; Azami, Saber; Foroughifar, Shirin; Ghasempour-Dabbaghi, Khazar; Karzad, Nazila; Ahadi, Hamid-Reza; Naghavi-Behzad, Ali

2013-01-01

Congenital heart diseases are of immense importance and also a high prevalence. Contributing factors to developing these defects have not been abundantly studied. Therefore, the current study was conducted aiming at determining the effective factors on Congenital Heart Disease (CHD) in newborn infants of Northwest Iran. A case-control study was carried out in North-West of Iran from 2002 to 2012 and a total of 473 infants entered the study. Required data were obtained through check lists completed by the information of hospital records and interview with mothers of 267 newborn infants with CHD together with medical records of mothers as the case group, and 206 medical records of healthy infants at the same period all together with those of their mothers as the control group. The obtained data were statistically analyzed using descriptive statistical methods, T-test, Spearman's correlation coefficient, and Multi-variable Logistic Regression Model (OR with 95% CI), using SPSS.19. In the present study, P value less than 0.05 was considered statistically significant. Based on the results of univariable analyses, the number of previous cesarean sections, past medical history of diseases, gestational age (GA), fetal weight at birth, diastolic blood pressure, fetal heart rate, pulse rate, fetal hemoglobin and hematocrit levels, and fetal head circumference at birth have significant relationship with incidence of congenital abnormalities (P<0.05). Family history, past cesarean sections history, past medical history and GA had significant relationship with CHD incidence. Based on the results of present study, in order to control and reduce the cases of CHD, it is crucial to make proper decisions and implement policies for reducing cesarean cases, lowering consanguineous marriages, providing proper pre-marriage counseling, prompt treatment of mothers' illnesses, improving pregnancy health care and mothers' health status for the purpose of better well-being of newborn infants.

The Role of Well Control Training in Developing Safe Onshore and Offshore Oil Drilling Operations

ERIC Educational Resources Information Center

Abulhassn, Aber

2016-01-01

This research investigates the role of the International Well Control Forum (IWCF) Rotary Drilling Well Control Training Program in developing safe oil drilling operations from the perspective of onshore and offshore drilling crews. The research methodology is a qualitative case study. A total of 40 IWCF candidates were interviewed, with 10 from…

Indiana State University: Documentation of the Teachers for a New Era Learning Network. Case Study

ERIC Educational Resources Information Center

Academy for Educational Development, 2009

2009-01-01

The Academy for Educational Development (AED) sent a research team to Indiana State University (ISU) on November 11-12, 2008 to conduct interviews with individuals who play important roles in the university's teacher preparation program. Based upon the nine case studies, the AED research team will prepare a cross-case study that will document and…

RISK AND PROTECTIVE FACTORS FOR GASTRIC METAPLASIA AND CANCER: A HOSPITAL-BASED CASE-CONTROL STUDY IN ECUADOR.

PubMed

Salvador, Iván; Mercado, Andrés; Bravo, Gabriela Liliana; Baldeón, Manuel; Fornasini, Marco

2015-09-01

worldwide, stomach cancer is the fifth most frequent cancer, with 952 000 new cases diagnosed in 2012. Ecuador currently holds the 15th place of countries with the highest incidence of stomach cancer for both sexes. the objective of this study was to evaluate risk and protective factors for gastric cancer/metaplasia. a hospital-based case-control study was conducted in Quito, Ecuador. Cases were defined as patients with histological confirmation of gastric cancer (N = 60) or incomplete gastric metaplasia (N = 53). Controls were defined as patients free of gastric cancer or premalignant lesions (N = 144). All participants were personally interviewed using a structured questionnaire to collect data about dietary habits, lifestyle and medical history. risk factors significantly associated to the presence of gastric cancer/metaplasia were the consumption of reheated foods at least 3 times per week (AOR: 4.57; CI: 2.2 - 9.5) and adding salt to more than 50% of foods (AOR: 1.32; CI: 1.04 - 1.67). Protective factors for gastric cancer/metaplasia were the use of non-steroidal anti-inflammatory drugs (AOR: 0.39; CI 0.19 - 0.83), age less than 58 years old (AOR: 0.38; CI: 0.18 - 0.79) and have received treatment for H. Pylori infection (AOR: 0.33; CI: 0.16 - 0.71). this study reports for the first time, the risk and protective factors associated with gastric cancer and metaplasia in Ecuador. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Hot food and beverage consumption and the risk of esophageal squamous cell carcinoma: A case-control study in a northwest area in China.

PubMed

Tai, Wei-Ping; Nie, Guo-Ji; Chen, Meng-Jie; Yaz, Tajigul Yiminni; Guli, Arzi; Wuxur, Arzigul; Huang, Qing-Qing; Lin, Zhi-Gang; Wu, Jing

2017-12-01

This study was trying to investigate the association of hot food and beverage consumption and the risk of esophageal squamous cell carcinoma in Hotan, a northwest area of China with high risk of esophageal squmous cell carcinoma. A population-based case-control study was designed. For the study, 167 patients diagnosed with esophageal squamous cell carcinoma were selected from Hotan during 2014 to 2015, and 167 community-based controls were selected from the same area, matched with age and sex. Information involved of temperature of food and beverage intake was obtained by face-to-face interview. Logistic regression analyses were performed to investigate the association between temperature of food and beverage intake and the risk of esophageal squamous cell carcinoma. The temperature of the food and beverage consumed by the esophageal squamous cell carcinoma patients was significantly higher than the controls. High temperature of tea, water, and food intake significantly increased the risk of esophageal squamous cell carcinoma by more than 2-fold, with adjusted odds ratio 2.23 (1.45-2.90), 2.13 (1.53-2.66), and 2.98 (1.89-4.12). Intake of food and beverage with high temperature was positively associated with the incidence of esophageal squamous cell carcinoma in Northwestern China. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Assessment of Semi-Structured Clinical Interview for Mobile Phone Addiction Disorder.

PubMed

Alavi, Seyyed Salman; Mohammadi, Mohammad Reza; Jannatifard, Fereshteh; Mohammadi Kalhori, Soroush; Sepahbodi, Ghazal; BabaReisi, Mohammad; Sajedi, Sahar; Farshchi, Mojtaba; KhodaKarami, Rasul; Hatami Kasvaee, Vahid

2016-04-01

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) classified mobile phone addiction disorder under "impulse control disorder not elsewhere classified". This study surveyed the diagnostic criteria of DSM-IV-TR for the diagnosis of mobile phone addiction in correspondence with Iranian society and culture. Two hundred fifty students of Tehran universities were entered into this descriptive-analytical and cross-sectional study. Quota sampling method was used. At first, semi- structured clinical interview (based on DSM-IV-TR) was performed for all the cases, and another specialist reevaluated the interviews. Data were analyzed using content validity, inter-scorer reliability (Kappa coefficient) and test-retest via SPSS18 software. The content validity of the semi- structured clinical interview matched the DSM-IV-TR criteria for behavioral addiction. Moreover, their content was appropriate, and two items, including "SMS pathological use" and "High monthly cost of using the mobile phone" were added to promote its validity. Internal reliability (Kappa) and test-retest reliability were 0.55 and r = 0.4 (p<0. 01) respectively. The results of this study revealed that semi- structured diagnostic criteria of DSM-IV-TR are valid and reliable for diagnosing mobile phone addiction, and this instrument is an effective tool to diagnose this disorder.

Feasibility of including cellular telephone numbers in random digit dialing for epidemiologic case-control studies.

PubMed

Voigt, Lynda F; Schwartz, Stephen M; Doody, David R; Lee, Spencer C; Li, Christopher I

2011-01-01

The usefulness of landline random digit dialing (RDD) in epidemiologic studies is threatened by the rapid increase in households with only cellular telephone service. This study assessed the feasibility of including cellular telephone numbers in RDD and differences between young adults with landline telephones and those with only cellular telephones. Between 2008 and 2009, a total of 9,023 cellular telephone numbers were called and 43.8% were successfully screened; 248 men and 249 women who resided in 3 Washington State counties, were 20-44 years of age, and used only cellular telephones were interviewed. They were compared with 332 men and 526 women with landline telephones interviewed as controls for 2 case-control studies conducted in parallel with cellular telephone interviewing. Cellular-only users were more likely to be college educated and less likely to have fathered/birthed a child than were their landline counterparts. Male cellular-only users were less likely to be obese and more likely to exercise, to be Hispanic, and to have lower incomes, while female cellular-only users were more likely to be single than landline respondents. Including cellular telephone numbers in RDD is feasible and should be incorporated into epidemiologic studies that rely on this method to ascertain subjects, although low screening rates could hamper the representativeness of such a sample.

Case-control study of urinary bladder cancer in metropolitan Nagoya.

PubMed

Ohno, Y; Aoki, K; Obata, K; Morrison, A S

1985-12-01

We conducted a population-based case-control study of patients with bladder cancer and of controls drawn randomly from the general population of Metropolitan Nagoya and interviewed both groups. The incidence rates of bladder cancer were 2.42 and 7.05/100,000 for females and males, respectively. The analysis, based on 293 patients and 589 controls who were frequency matched for age, sex, and residence, provided the following major findings. Age-adjusted relative risks of 1.89 (1.15-3.10) and 3.53 (1.71-7.27) were found in male and female cigarette smokers, respectively. Significant relative risk was also found in males who drank cocoa. Elevated risk with a dose-response relationship was observed among women who used hair dye and who smoke, but this risk was insignificant, with the disappearance of a dose-response relationship, when it was adjusted for smoking. Age- and smoking-adjusted relative risk of coffee drinking was insignificant with no dose-response relationship. Relative risk of artificial sweetener use was below 1 with adjustment for age and smoking. Intake of alcoholic beverages and cola was insignificantly associated. Reduced risk of significance was suggested for the intake of black tea and matcha (powdered green tea) in females and of fruit juice in males.

Multiple Case Study of STEM in School-Based Agricultural Education

ERIC Educational Resources Information Center

Stubbs, Eric A.; Myers, Brian E.

2015-01-01

This multiple case study investigated the integration of science, technology, engineering, and mathematics (STEM) in three Florida high school agriculture programs. Observations, interviews, documents, and artifacts provided qualitative data that indicated the types of STEM knowledge taught. Variables of interest included student and teacher…

Mesothelioma associated with the shipbuilding industry in coastal Virginia.

PubMed

Tagnon, I; Blot, W J; Stroube, R B; Day, N E; Morris, L E; Peace, B B; Fraumeni, J F

1980-11-01

A case-control study was undertaken to clarify reasons for a four-fold increased incidence of mesothelioma discovered among white males in coastal Tidewater, Va., from 1972 to 1978. Sixty-one cases were identified. Interviews with next of kin revealed that the excess was linked to employment in area shipyards. Three-fourths of the cases had been employed in the shipbuilding industry, nearly all beginning employment prior to 1950. Most were career employees, but an increased risk was also found among those who worked only temporarily, mainly during World War II, and were reportedly exposed to asbestos. More of the cases than controls were pipecoverers or pipefitters, but cases were reported to work in a variety of shipyard trades. Few of the mesothelioma cases were heavy smokers, a trend that may be related in part to the competing risks for fatal diseases caused by the interactions of smoking and asbestos exposure. Information obtained by interview for five of the six white females diagnosed with mesothelioma revealed that the husband of four had been employed in the shipbuilding industry.

Developing Student Teachers' Critical Thinking and Professional Values: A Case Study of a Teacher Educator in Singapore

ERIC Educational Resources Information Center

Low, Ee Ling; Hui, Chenri; Cai, Li

2017-01-01

This paper explores how thinking and values in student teachers are cultivated in the Singapore context, via a case study of a teacher educator selected based on having won excellence in teaching commendation awards. The study adopts a qualitative case study methodology (i.e., interviews with the teacher educator and her student teachers) and uses…

[The transgenerational transmission of traumatic experiences of the Second World War over three generations--a psychoanalytical perspective].

PubMed

Silke, Wiegand-Grefe; Möller, Birgit

2012-01-01

The paper presents some reflections on the transgenerational transmission of traumatic experiences of war and in particular bombing during Second World War. These theoretical considerations are based on a case study (family interview) deriving from the research project "Kriegskindheit im Hamburger Feuersturm" additionally illustrated and complemented with impressions based on interviews with three generations in context of the project.

Using Getting To Outcomes to facilitate the use of an evidence-based practice in VA homeless programs: a cluster-randomized trial of an implementation support strategy.

PubMed

Chinman, Matthew; McCarthy, Sharon; Hannah, Gordon; Byrne, Thomas Hugh; Smelson, David A

2017-03-09

Incorporating evidence-based integrated treatment for dual disorders into typical care settings has been challenging, especially among those serving Veterans who are homeless. This paper presents an evaluation of an effort to incorporate an evidence-based, dual disorder treatment called Maintaining Independence and Sobriety Through Systems Integration, Outreach, and Networking-Veterans Edition (MISSION-Vet) into case management teams serving Veterans who are homeless, using an implementation strategy called Getting To Outcomes (GTO). This Hybrid Type III, cluster-randomized controlled trial assessed the impact of GTO over and above MISSION-Vet Implementation as Usual (IU). Both conditions received standard MISSION-Vet training and manuals. The GTO group received an implementation manual, training, technical assistance, and data feedback. The study occurred in teams at three large VA Medical Centers over 2 years. Within each team, existing sub-teams (case managers and Veterans they serve) were the clusters randomly assigned. The trial assessed MISSION-Vet services delivered and collected via administrative data and implementation barriers and facilitators, via semi-structured interview. No case managers in the IU group initiated MISSION-Vet while 68% in the GTO group did. Seven percent of Veterans with case managers in the GTO group received at least one MISSION-Vet session. Most case managers appreciated the MISSION-Vet materials and felt the GTO planning meetings supported using MISSION-Vet. Case manager interviews also showed that MISSION-Vet could be confusing; there was little involvement from leadership after their initial agreement to participate; the data feedback system had a number of difficulties; and case managers did not have the resources to implement all aspects of MISSION-Vet. This project shows that GTO-like support can help launch new practices but that multiple implementation facilitators are needed for successful execution of a complex evidence-based program like MISSION-Vet. ClinicalTrials.gov NCT01430741.

What is an adequate sample size? Operationalising data saturation for theory-based interview studies.

PubMed

Francis, Jill J; Johnston, Marie; Robertson, Clare; Glidewell, Liz; Entwistle, Vikki; Eccles, Martin P; Grimshaw, Jeremy M

2010-12-01

In interview studies, sample size is often justified by interviewing participants until reaching 'data saturation'. However, there is no agreed method of establishing this. We propose principles for deciding saturation in theory-based interview studies (where conceptual categories are pre-established by existing theory). First, specify a minimum sample size for initial analysis (initial analysis sample). Second, specify how many more interviews will be conducted without new ideas emerging (stopping criterion). We demonstrate these principles in two studies, based on the theory of planned behaviour, designed to identify three belief categories (Behavioural, Normative and Control), using an initial analysis sample of 10 and stopping criterion of 3. Study 1 (retrospective analysis of existing data) identified 84 shared beliefs of 14 general medical practitioners about managing patients with sore throat without prescribing antibiotics. The criterion for saturation was achieved for Normative beliefs but not for other beliefs or studywise saturation. In Study 2 (prospective analysis), 17 relatives of people with Paget's disease of the bone reported 44 shared beliefs about taking genetic testing. Studywise data saturation was achieved at interview 17. We propose specification of these principles for reporting data saturation in theory-based interview studies. The principles may be adaptable for other types of studies.

Maternal Risk Factors for Fetal Alcohol Spectrum Disorders in a Province in Italy*

PubMed Central

Ceccanti, Mauro; Fiorentino, Daniela; Coriale, Giovanna; Kalberg, Wendy O.; Buckley, David; Hoyme, H. Eugene; Gossage, J. Phillip; Robinson, Luther K.; Manning, Melanie; Romeo, Marina; Hasken, Julie M.; Tabachnick, Barbara; Blankenship, Jason

2016-01-01

Background Maternal risk factors for fetal alcohol spectrum disorders (FASD) in Italy and Mediterranean cultures need clarification, as there are few studies and most are plagued by inaccurate reporting of antenatal alcohol use. Methods Maternal interviews (n=905) were carried out in a population-based study of the prevalence and characteristics of FASD in the Lazio region of Italy which provided data for multivariate case control comparisons and multiple correlation models. Results Case control findings from interviews seven years post-partum indicate that mothers of children with FASD are significantly more likely than randomly-selected controls or community mothers to: be shorter; have higher body mass indexes (BMI); be married to a man with legal problems; report more drinking three months pre-pregnancy; engage in more current drinking and drinking alone; and have alcohol problems in her family. Logistic regression analysis of multiple candidate predictors of a FASD diagnosis indicates that alcohol problems in the child’s family is the most significant risk factor, making a diagnosis within the continuum of FASD 9 times more likely (95% C.I. = 1.6 to 50.7). Sequential multiple regression analysis of the child’s neuropsychological performance also identifies alcohol problems in the child’s family as the only significant maternal risk variable (p<.001) when controlling for other potential risk factors. Conclusions Underreporting of prenatal alcohol use has been demonstrated among Italian and other Mediterranean antenatal samples, and it was suspected in this sample. Nevertheless, several significant maternal risk factors for FASD have been identified. PMID:25456331

Maternal risk factors for fetal alcohol spectrum disorders in a province in Italy.

PubMed

Ceccanti, Mauro; Fiorentino, Daniela; Coriale, Giovanna; Kalberg, Wendy O; Buckley, David; Hoyme, H Eugene; Gossage, J Phillip; Robinson, Luther K; Manning, Melanie; Romeo, Marina; Hasken, Julie M; Tabachnick, Barbara; Blankenship, Jason; May, Philip A

2014-12-01

Maternal risk factors for fetal alcohol spectrum disorders (FASD) in Italy and Mediterranean cultures need clarification, as there are few studies and most are plagued by inaccurate reporting of antenatal alcohol use. Maternal interviews (n = 905) were carried out in a population-based study of the prevalence and characteristics of FASD in the Lazio region of Italy which provided data for multivariate case control comparisons and multiple correlation models. Case control findings from interviews seven years post-partum indicate that mothers of children with FASD are significantly more likely than randomly-selected controls or community mothers to: be shorter; have higher body mass indexes (BMI); be married to a man with legal problems; report more drinking three months pre-pregnancy; engage in more current drinking and drinking alone; and have alcohol problems in her family. Logistic regression analysis of multiple candidate predictors of a FASD diagnosis indicates that alcohol problems in the child's family is the most significant risk factor, making a diagnosis within the continuum of FASD 9 times more likely (95%C.I. = 1.6 to 50.7). Sequential multiple regression analysis of the child's neuropsychological performance also identifies alcohol problems in the child's family as the only significant maternal risk variable (p < .001) when controlling for other potential risk factors. Underreporting of prenatal alcohol use has been demonstrated among Italian and other Mediterranean antenatal samples, and it was suspected in this sample. Nevertheless, several significant maternal risk factors for FASD have been identified. Copyright © 2014. Published by Elsevier Ireland Ltd.

Occupation and keratinocyte cancer risk: a population-based case-control study.

PubMed

Marehbian, Josh; Colt, Joanne S; Baris, Dalsu; Stewart, Patricia; Stukel, Therese A; Spencer, Steven K; Karagas, Margaret R

2007-10-01

The aim of our study was to identify occupations associated with increased risk of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). We conducted a population-based case-control study of BCC and SCC in New Hampshire. Cases (n = 599 BCC, n = 290 SCC) and controls (n = 524) completed a self-administered residence and work history questionnaire and personal interview regarding major risk factors for skin cancer. Reported jobs were coded using the Standardized Occupational Classification system (SOC). Odds ratios (ORs) and confidence intervals (CIs) for BCC and SCC were calculated for men and women separately using unconditional logistic regression models taking into account age, education, skin reaction to sun, history of painful sunburns, time spent outdoors, and for SCC, smoking. Among men, we observed elevated risks of both BCC and SCC among groundskeepers and gardeners, except farm (SOC 5622). We also found that garage and service station-related occupations (SOCs 873) and to some extent food/beverage preparation/service occupations (SOC 521) were associated with BCC risk among men. Women in health services occupations (SOC 523) had elevated risks for both tumors, especially for BCC. Additionally, administrative support (SOC 46/47) occupations were related to BCC risk among women. Other occupations were associated with excess risks, but without consistent trends by duration of employment. We observed several occupations associated with elevated BCC and SCC risk. These results resemble reported findings for cutaneous melanoma and are generally consistent with the few available studies on keratinocyte cancers.

Infection prevention and control in home nursing: case study of four organisations in Australia.

PubMed

Felemban, Ohood; St John, Winsome; Shaban, Ramon Zenel

2015-09-01

The aim of this case study was to explore the environmental challenges nurses experience with infection control practice, and the strategies they use to overcome those challenges. An exploratory case study was conducted in four home visiting nursing organisations in southeast Queensland, Australia, using data triangulation (document review, individual interviews, and focus groups). Data were analysed using a framework approach to identify themes. Three major infection prevention and control challenges were experienced in the community context. The first challenge is the nature of the work environment, including: poor cleanliness in clients' home environments, pets or vermin, inadequate hand-washing facilities, and a lack of appropriate storage space for clinical materials. The second challenge occurs when nurses lack access to appropriate infection control equipment, including wound-management materials and sharps containers. The third challenge is dealing with clients' poor personal hygiene and health status. Participants addressed these issues by offering assistance, using clean surfaces at clients' homes, applying an alcohol-based hand rub, providing client education, and reducing the cost of purchasing equipment for clients. It is imperative that policy is developed to support nurses' decision making and practices as they address infection control challenges in the community environment. Ensuring staff are well-supported with resources, education, policy, and guidelines to address these challenges is important for the delivery of safe and high-quality care in community settings.

"Give Us the Words": Protestant Faith Leaders and Sexuality Education in Their Churches

ERIC Educational Resources Information Center

Hach, Alexa; Roberts-Dobie, Susan

2016-01-01

A small sample of faith leaders from the USA's three largest Mainline Protestant denominations (American Baptist, Evangelical Lutheran Church of America and Methodist) were interviewed as part of a case study regarding sexuality education in their churches. The interview schedule, based on a previous Alan Guttmacher Institute designed…

Cannabis use and cancer of the head and neck: case-control study.

PubMed

Aldington, Sarah; Harwood, Matire; Cox, Brian; Weatherall, Mark; Beckert, Lutz; Hansell, Anna; Pritchard, Alison; Robinson, Geoffrey; Beasley, Richard

2008-03-01

To investigate whether cannabis smoking increases the risk of head and neck cancer. Case-control study. Cases of head and neck cancer < or =55 years identified from hospital databases and the Cancer Registry, and controls randomly selected from the electoral roll completed interviewer-administered questionnaires. Logistic regression was used to estimate the relative risk of head and neck cancer. There were 75 cases and 319 controls. An increased risk of cancer was found with increasing tobacco use, alcohol consumption, and decreased income but not increasing cannabis use. The highest tertile of cannabis use (>8.3 joint years) was associated with a nonsignificant increased risk of cancer (relative risk = 1.6, 95% confidence interval, 0.5-5.2) after adjustment for confounding variables. Cannabis use did not increase the risk of head and neck cancer; however, because of the limited power and duration of use studied, a small or longer-term effect cannot be excluded.

Adolescent depression, family psychopathology and parent/child relations: a case control study.

PubMed

Séguin, Monique; Manion, Ian; Cloutier, Paula; McEvoy, Lisa; Cappelli, Mario

2003-02-01

The objective of this study was to investigate family psychopathology and relationships between family members. Three groups of adolescents were interviewed: 1) currently depressed adolescents who have at least one parent who had/or is still experiencing a mood disorder, 2) currently depressed adolescents whose parents were never diagnosed with a mood disorder, 3) never-depressed control adolescents. Personal interview data was obtained from the proband, their parent(s) and one sibling. Findings suggest that parental psychopathology, parent-child relations and life events are all relevant factors in adolescent depression and should be considered in combination for assessment, prevention and intervention efforts.

Childhood infectious diseases and risk of leukaemia in an adult population.

PubMed

Parodi, Stefano; Crosignani, Paolo; Miligi, Lucia; Nanni, Oriana; Ramazzotti, Valerio; Rodella, Stefania; Costantini, Adele Seniori; Tumino, Rosario; Vindigni, Carla; Vineis, Paolo; Stagnaro, Emanuele

2013-10-15

Our study is aimed at investigating the association between common childhood infectious diseases (measles, chickenpox, rubella, mumps and pertussis) and the risk of developing leukaemia in an adult population. A reanalysis of a large population-based case-control study was carried out. Original data included 1,771 controls and 649 leukaemia cases from 11 Italian areas. To contain recall bias, the analysis was restricted to subjects directly interviewed and with a good quality interview (1,165 controls and 312 cases). Odds ratios (ORs) and their related 95% confidence intervals (95% CIs) were estimated by unconditional polychotomous logistic regression model adjusting for age, gender and occupational and lifestyle exposures. A protective effect of at least one infection (OR = 0.66, 95% CI: 0.45-0.97), measles (OR = 0.57, 95% CI: 0.39-0.82) and pertussis (OR = 0.66, 95% CI: 0.45-0.98) was observed for chronic lymphoid leukaemia (CLL). The number of infections was strongly inversely associated with the risk of CLL (p = 0.002, test for trend). With regard to the other types of leukaemia, only a protective effect of pertussis was observed for AML (OR = 0.52, 95% CI: 0.32-0.87). Our results pointed out a protective role of childhood infectious diseases on the risk of CLL in adults. Although a specific antioncogenic effect of some infectious disease, especially measles, cannot be ruled out, the observed decrease of risk with increasing number of infections suggests that a more general "hygiene hypothesis" could be the most likely explanation of the detected association. The protective role of pertussis remains to be elucidated. Copyright © 2013 UICC.

Spinal cord injury and women's sexual life: case-control study.

PubMed

Merghati-Khoei, E; Emami-Razavi, S H; Bakhtiyari, M; Lamyian, M; Hajmirzaei, S; Ton-Tab Haghighi, S; Korte, J E; Maasoumi, R

2017-03-01

Study design :This is a case-control study. The objective of this study was to estimate the magnitude of association between spinal cord injury (SCI) and women's quality of sexual life and sexual function. This study was conducted in the Brain and Spinal Cord Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran. From the referral university-based clinics, we used simple random sampling to recruit 62 women: 31 women with SCI and 31 women without SCI. Socio-demographic and reproductive traits questionnaire, Sexual Quality of life-Female (SQOL-F), Female Sexual Function Index (FSFI) and Spinal Cord Independence Measure (SCIM) were completed using telephone and face-to-face interviews in the cases and controls. After univariate analyses, multivariate linear and proportional odds regression models were conducted to investigate the relation between SCI and women's quality of sexual life, as well as sexual function. The mean age of cases and controls was 35.42±6.51 and 33.77±4.02 years. Most women were high school-educated and housewives. Adjusting for probable confounders, the proportional odds regression model showed a significant relationship between the spinal cord injury (AOR=4.2, 95% CI: 1.8-9.2), non-college-educated (AOR=3.1, 95% CI: 1.2-5.9) and employed (AOR=1.8, 95% CI: 1.1-1.8) variables and being in one of the moderate or poor quality of life classes. Scores of SQOL-F and FSFI domains, except satisfaction, were significantly worse in cases versus controls (P<0.001). Although our participants showed low sexual dysfunction, they tended to report moderate to poor quality of sexual life. Our findings support the implication that sexual rehabilitation must be provided for women with SCI soon after injury.

Parental smoking, socioeconomic factors, and risk of invasive meningococcal disease in children: a population based case-control study

PubMed Central

Kriz, P; Bobak, M; Kriz, B

2000-01-01

AIMS—To investigate the effects of parental smoking, socioeconomic characteristics, and indoor environment on the risk of invasive meningococcal disease in children.
METHODS—Population based case-control study. A total of 68 incident cases of invasive meningococcal disease in children less than 15 years old were compared with 135 controls selected from the same school and matched for year of birth, sex, and place of residence. Information on exposures was obtained in interviews with parents.
RESULTS—Invasive meningococcal disease was strongly associated with parental smoking; rate ratios adjusted for socioeconomic factors were 3.5 (95% confidence interval 1.4-8.7) for smoking of mother, 3.2 (1.5-6.9) for smoking of father, and 2.7 (1.3-5.4) for every 20 cigarettes smoked at home on an average day. The risk of the disease was strongly inversely related to maternal education and, less strongly, to ownership of a car and of a weekend house, father's education, crowding, and the number of siblings, but these associations were reduced or eliminated in multivariate models. The type of heating and cooking (used as proxies for indoor air pollution) were not associated with the disease.
CONCLUSION—The risk of invasive meningococcal disease in children is strongly influenced by parental smoking and unfavourable socioeconomic circumstances.

 PMID:10906015

The business case for provider participation in clinical trials research: an application to the National Cancer Institute's community clinical oncology program.

PubMed

Song, Paula H; Reiter, Kristin L; Weiner, Bryan J; Minasian, Lori; McAlearney, Ann Scheck

2013-01-01

Provider-based research networks (PBRNs) make clinical trials available in community-based practice settings, where most people receive their care, but provider participation requires both financial and in-kind contributions. The aim of this study was to explore whether providers believe there is a business case for participating in PBRNs and what factors contribute to the business case. We use a multiple case study methodology approach to examine the National Cancer Institute's community clinical oncology program, a long-standing federally funded PBRN. Interviews with 41 key informants across five sites, selected on the basis of organizational maturity, were conducted using a semistructured interview guide. We analyzed interview transcripts using an iterative, deductive process to identify themes and subthemes in the data. We found that a business case for provider participation in PBRNs may exist if both direct and indirect financial benefits are identified and included in the analysis and if the time horizon is long enough to allow those benefits to be realized. We identified specific direct and indirect financial benefits that were perceived as important contributors to the business case and the perceived length of time required for a positive return to accrue. As the lack of a business case may result in provider reluctance to participate in PBRNs, knowledge of the benefits we identified may be crucial to encouraging and sustaining participation, thereby preserving patient access to innovative community-based treatments. The results are also relevant to federally funded PBRNs outside of oncology or to providers considering participation in any clinical trials research.

Pedagogical Content Knowledge: A Case Study of ESL Teacher Educator

ERIC Educational Resources Information Center

Liu, Siping

2013-01-01

This single-case study focuses on the pedagogical content knowledge (PCK) of a university faculty member teaching Second Language Acquisition to elementary teacher candidates. The research questions address the pattern and development of PCK for ESL teaching. Based on data from classroom observation, interviews and document review, the study finds…

A School Council's Experience with School Improvement: A Saskatchewan Case Study

ERIC Educational Resources Information Center

Preston, Jane P.

2012-01-01

Based on a qualitative case study conducted within one Saskatchewan (Canada) rural community, the purpose of this article is to describe the challenges a school council faced when supporting a school improvement plan. The primary data for the study were 35 semi-structured individual interviews conducted with school council members, teachers, and…

Physical Activity Promotion in General Practices of Barcelona: A Case Study

ERIC Educational Resources Information Center

Puig Ribera, Anna; McKenna, Jim; Riddoch, Chris

2006-01-01

This case study aimed to generate explanations for the lack of integration of physical activity (PA) promotion in general practices of Barcelona, the capital of Catalonia. This explanatory study adopted a qualitative approach, based on three techniques; focus groups (n = 3), semi-structured (n = 25) and short individual interviews (n = 5). These…

Factors Affecting Pre-Service Teachers' Participation in Asynchronous Discussion: The Case of Iran

ERIC Educational Resources Information Center

Ebrahimi, Alice; Faghih, Esmail; Marandi, Seyyedeh Susan

2016-01-01

This study reports on a qualitative small-scale exploratory study which examined the factors influencing 32 Iranian pre-service language teachers' participation in online asynchronous text-based discussion forums. By adopting a multiple case study design and analysing data gathered through semi-structured interviews and participants' online…

Sustaining Latina Student Organizations: An Exploratory Instrumental Case Study

ERIC Educational Resources Information Center

Castellanos, Michelle

2016-01-01

Utilizing the exploratory case study methodology, the author examines the conditions that support and limit a Latina-based student organization at a predominately White institution of higher education. Seven organizational structures were found to influence the organization's ability to advance its aims, from interviews, documents, observations,…

Mediating Meaning for Individuals with Down Syndrome: A Phenomenological Case Study

ERIC Educational Resources Information Center

McCullough, Michelle J.

2012-01-01

The current phenomenological case study, based in part on Vygotsky's sociocultural theory, set out to examine the lived experiences of individuals sharing and mediating meaningful communication with individuals who have Down syndrome. To accomplish this, the researcher interviewed several categories of caregivers who regularly interact with…

The oral microbiota in patients with pancreatic cancer, patients with IPMNs, and controls: a pilot study.

PubMed

Olson, Sara H; Satagopan, Jaya; Xu, Youming; Ling, Lilan; Leong, Siok; Orlow, Irene; Saldia, Amethyst; Li, Peter; Nunes, Pamela; Madonia, Vincent; Allen, Peter J; O'Reilly, Eileen; Pamer, Eric; Kurtz, Robert C

2017-09-01

Poor oral health appears to be a risk factor for pancreatic cancer, possibly implicating the oral microbiota. In this pilot study, we evaluated the characteristics of the oral microbiota in patients with pancreatic ductal adenocarcinoma (PDAC), intraductal papillary mucinous neoplasms (IPMN), and healthy controls. Forty newly diagnosed PDAC patients, 39 IPMN patients, and 58 controls, excluding current smokers and users of antibiotics, provided saliva samples. Common oral bacterial species were comprehensively surveyed by sequencing of the 16S rRNA microbial genes. We obtained measures of diversity and the mean relative proportions of individual taxa. We explored the degree to which these measures differed according to respondent characteristics based on individual interviews. PDAC cases did not differ in diversity measures from either controls or IPMN cases. PDAC cases had higher mean relative proportions of Firmicutes and related taxa, while controls had higher mean relative proportions of Proteobacteria and related taxa. Results were generally similar when comparing PDAC to IPMN cases. Among IPMNs and controls combined, younger individuals had higher levels of several taxa within the Proteobacteria. The only other variable consistently related to mean relative proportions was mouthwash use, with taxa within Firmicutes more common among users. While there were no differences in diversity of the oral microbiota among these groups, there were differences in the mean relative proportions of some taxa. Characteristics of the oral microbiota are not associated with most measures of oral health.

Cross-border-assisted reproduction: a qualitative account of UK travellers' experiences.

PubMed

Hudson, Nicky; Culley, Lorraine; Blyth, Eric; Norton, Wendy; Pacey, Allan; Rapport, Frances

2016-06-01

Surveys on patients' experiences of cross-border fertility treatment have reported a range of positive and challenging features. However, the number of such studies is limited, and there is no detailed qualitative account of the experiences of UK patients who travel overseas for fertility treatment. The present study used a cross-sectional, qualitative design and in-depth interviews. Fifty-one participants (41 women and 10 men, representing 41 treatment 'cases') participated in semi-structured interviews. The experiences reported were broadly positive with a large proportion of participants (39 cases, 95%) citing a favourable overall experience with only two cases (5%) reporting a more negative experience. Thematic analysis revealed 6 major categories and 20 sub-categories, which described the positive and challenging aspects of cross-border fertility travel. The positive aspects were represented by the categories: 'access', 'control' and 'care and respect'. The more challenging aspects were categorized as 'logistics and coordination of care', 'uncertainty' and 'cultural dissonance'. The study confirms findings from others that despite some challenges, there is a relatively high level of patient satisfaction with cross-border treatment with participants able to extend the boundaries of their fertility-seeking trajectories and in some cases, regain a sense of control over their treatment.

The impact of science teachers' epistemological beliefs on authentic inquiry: A multiple-case study

NASA Astrophysics Data System (ADS)

Jackson, Dionne Bennett

The purpose of this study was to examine how science teachers' epistemological beliefs impacted their use of authentic inquiry in science instruction. Participants in this multiple-case study included a total of four teachers who represented the middle, secondary and post-secondary levels. Based on the results of the pilot study conducted with a secondary science teacher, adjustments were made to the interview questions and observation protocol. Data collection for the study included semi-structured interviews, direct observations of instructional techniques, and the collection of artifacts. The cross case analysis revealed that the cases epistemological beliefs were mostly Transitional and the method of instruction used most was Discussion. Two of the cases exhibited consistent beliefs and instructional practices, whereas the other two exhibited beliefs beyond their instruction. The findings of this study support the literature on the influence of contextual factors and professional development on teacher beliefs and practice. The findings support and contradict literature relevant to the consistency of teacher beliefs with instruction. This study's findings revealed that the use of reform-based instruction, or Authentic Inquiry, does not occur when science teachers do not have the beliefs and experiences necessary to implement this form of instruction.

Effect of using an audience response system on learning environment, motivation and long-term retention, during case-discussions in a large group of undergraduate veterinary clinical pharmacology students.

PubMed

Doucet, Michèle; Vrins, André; Harvey, Denis

2009-12-01

Teaching methods that provide an opportunity for individual engagement and focussed feedback are required to create an active learning environment for case-based teaching in large groups. A prospective observational controlled study was conducted to evaluate whether the use of an audience response system (ARS) would promote an active learning environment during case-based discussions in large groups, have an impact on student motivation and improve long-term retention. Group A (N = 83) participated in large group case discussions where student participation was voluntary, while for group B (N = 86) an ARS was used. Data collection methods included student and teacher surveys, student focus group interviews, independent observations and 1-year post-course testing. Results indicated that the use of an ARS provided an active learning environment during case-based discussions in large groups by favouring engagement, observation and critical reflection and by increasing student and teacher motivation. Although final exam results were significantly improved in group B, long-term retention was not significantly different between groups. It was concluded that ARS use significantly improved the learning experience associated with case-based discussions in a large group of undergraduate students.

Adolescent depression: social network and family climate--a case-control study.

PubMed

Olsson, G I; Nordström, M L; Arinell, H; von Knorring, A L

1999-02-01

In a study of a total high-school population, 2300 students aged 16-17 years were screened for depression (BDI, CES-DC). Those with a self-evaluation indicating depression, together with controls matched for sex, age, and class were interviewed (DICA-R-A). The 177 pairs, where both individuals were interviewed and the control had no lifetime diagnosis of depression, were analysed in the form of paired differences for psychosocial factors and compared within diagnostic groups. The psychosocial factors were measured with the ISSI subscales and six attitude questions about family climate (KSP). Adolescents with an episode of major depression during part of the last year did not differ from their controls. Those with long-lasting depressive symptoms, i.e. dysthymia with or without episodes of major depression, had a more limited social interaction and were not satisfied with it. They also evaluated their family climate and attachment network as being more inadequate than did their controls. Depressed adolescents with comorbid conduct disorder had a more negative evaluation of availability and adequacy of both social interaction and attachment network than their controls. This group had a very negative view of their family climate. Since this is a case-control study conclusions cannot be drawn about cause and effect.

Working smarter on cold cases: identifying factors associated with successful cold case investigations.

PubMed

Davis, Robert C; Jensen, Carl J; Burgette, Lane; Burnett, Kathryn

2014-03-01

Cold case squads have garnered much attention; however, they have yet to undergo significant empirical scrutiny. In the present study, the authors interviewed investigators and reviewed 189 solved and unsolved cold cases in Washington, D.C., to determine whether there are factors that can predict cold case solvability. In the interviews, new information from witnesses or information from new witnesses was cited as the most prevalent reason for case clearance. The case reviews determined that there were factors in each of the following domains that predicted whether cases would be solved during cold case investigations: Crime Context, Initial Investigation Results, Basis for Opening Cold Case, and Cold Case Investigator Actions. The results suggest that it is possible to prioritize cold case work based on the likelihood of investigations leading to clearances. © 2014 American Academy of Forensic Sciences.

Do non-communicable diseases such as hypertension and diabetes associate with primary open-angle glaucoma? Insights from a case-control study in Nepal.

PubMed

Shakya-Vaidya, Suraj; Aryal, Umesh Raj; Upadhyay, Madan; Krettek, Alexandra

2013-11-04

Non-communicable diseases (NCDs) such as hypertension and diabetes are rapidly emerging public health problems worldwide, and they associate with primary open-angle glaucoma (POAG). POAG is the most common cause of irreversible blindness. The most effective ways to prevent glaucoma blindness involve identifying high-risk populations and conducting routine screening for early case detection. This study investigated whether POAG associates with hypertension and diabetes in a Nepalese population. To explore the history of systemic illness, our hospital-based case-control study used non-random consecutive sampling in the general eye clinics in three hospitals across Nepal to enroll patients newly diagnosed with POAG and controls without POAG. The study protocol included history taking, ocular examination, and interviews with 173 POAG cases and 510 controls. Data analysis comprised descriptive and inferential statistics. Descriptive statistics computed the percentage, mean, and standard deviation (SD); inferential statistics used McNemar's test to measure associations between diseases. POAG affected males more frequently than females. The odds of members of the Gurung ethnic group having POAG were 2.05 times higher than for other ethnic groups. Hypertension and diabetes were strongly associated with POAG. The overall odds of POAG increased 2.72-fold among hypertensive and 3.50-fold among diabetic patients. POAG associates significantly with hypertension and diabetes in Nepal. Thus, periodic glaucoma screening for hypertension and diabetes patients in addition to opportunistic screening at eye clinics may aid in detecting more POAG cases at an early stage and hence in reducing avoidable blindness.

A case-control study of Nocardia mastitis in Nova Scotia dairy herds

PubMed Central

Ferns, Lyn; Dohoo, Ian; Donald, Alan

1991-01-01

A case-control study was conducted to identify herd production, housing, and hygienic and therapeutic factors associated with a diagnosis of Nocardia mastitis in dairy herds in Nova Scotia. The data were collected by on-farm interviews with owners of 54 case and 54 control herds. Logistic regression was used to study risk factors. The use of dry cow products containing neomycin, including two specific dry cow products, was strongly associated with a diagnosis of Nocardia mastitis in a herd. Other factors which increased the risk of Nocardia mastitis were higher levels of production, larger herd size, and a large percentage of cows treated with dry cow products. These results are compared to results from a similar study carried out in Ontario. PMID:17423896

Occupational risk factors for Wilms' tumor

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bunin, G.; Kramer, S.; Nass, C.

A matched case-control study of Wilms' tumor investigated parental occupational risk factors. Cases diagnosed in 1970-1983 were identified through a population-based tumor registry and hospital registries in the Greater Philadelphia area. Controls were selected by random digit dialing and were matched to cases on race, birth date (+/- 3 years), and the area code and exchange of the case's telephone number at diagnosis. Parents of 100 matched pairs were interviewed by telephone. Parents of patients and controls were generally similar in demographic characteristics, except that mothers differed in religion. Published schemes were used to group jobs into clusters of similarmore » exposures and to determine exposures from industry and job title. Analyses were done for preconception, pregnancy, and postnatal time periods. More case than control fathers had jobs in a cluster that includes machinists and welders (odds ratios (ORs) = 4.0-5.7, p less than or equal to 0.04). Paternal exposures to lead, silver, tin, and iron (some exposures of this cluster) were associated with Wilms' tumor in some analyses, with moderate odds ratios (ORs = 1.5-3.4). In general, the highest odds ratios were found for the preconception period among the genetic (prezygotic) cases. No maternal job clusters or exposures gave significantly elevated odds ratios. These results support a previous finding that lead is a risk factor, but not radiation, hydrocarbon, or boron exposures.« less

The prevalence of ADHD in a population-based sample

PubMed Central

Rowland, Andrew S.; Skipper, Betty J.; Umbach, David M.; Rabiner, David L.; Campbell, Richard A.; Naftel, A. Jack; Sandler, Dale P.

2014-01-01

Objective Few studies of ADHD prevalence have used population-based samples, multiple informants, and DSM-IV criteria. In addition, children who are asymptomatic while receiving ADHD mediction often have been misclassified. Therefore, we conducted a population-based study to estimate the prevalence of ADHD in elementary school children using DSM-IV critera. Methods We screened 7587 children for ADHD. Teachers of 81% of the children completed a DSM-IV checklist. We then interviewed parents using a structured interview (DISC). Of these, 72% participated. Parent and teacher ratings were combined to determine ADHD status. We also estimated the proportion of cases attributable to other conditions. Results Overall, 15.5% of our sample (95% confidence interval (C.I.) 14.6%-16.4%) met DSM-IV-TR criteria for ADHD. Over 40% of cases reported no previous diagnosis. With additional information, other conditions explained about 9% of cases. Conclusions The prevalence of ADHD in this population-based sample was higher than the 3-7% commonly reported. To compare study results, the methods used to implement the DSM criteria need to be standardized. PMID:24336124

Social phobia and other psychiatric problems in children with strabismus.

PubMed

Cumurcu, Tongabay; Cumurcu, Birgul Elbozan; Ozcan, Ozlem; Demirel, Soner; Duz, Cem; Porgalı, Esra; Doganay, Selim

2011-06-01

To investigate the rate of social phobia, anxiety, depression, and other psychiatric problems in children with strabismus. Prospective, cross-sectional, case-control study. Forty-two children with strabismus and 47 control subjects 8-13 years of age were enrolled in this study. After the ophthalmologist's examination, all cases were assessed by a psychiatrist based on the structured interview technique of Schedule for Affective Disorders and Schizophrenia for School-Aged Children-Present and Lifetime Version (Kiddie-SADS-PL). The Screen for Child Anxiety Related Emotional Disorders (SCARED) was administered to each subject to evaluate social phobia. All participants completed the Children's Depression Inventory (CDI). Age as well as sex and income were comparable between the strabismus patients and control groups. Social phobia was diagnosed in 8 (19.04%) of the 42 strabismic children and in 1 (2.12%) of the control subjects. The CDI and SCARED (total score, social phobia, separation anxiety) scores of strabismus patients were significantly higher than the control group (p = 0.001, p = 0.004, p = 0.0001, p = 0.05, respectively). A relationship between strabismus in children and social phobia, depression, and anxiety on a symptom basis was underlined by our data. Copyright © 2011. Published by Elsevier Inc.

Vehicle year and the risk of car crash injury

PubMed Central

Blows, S; Ivers, R; Woodward, M; Connor, J; Ameratunga, S; Norton, R

2003-01-01

Objective: To quantify the association between vehicle age and risk of car crash injury. Design and setting: Data from a population based case-control study conducted in the Auckland region in 1998/99 was used to examine the adjusted risk of car crash injury or death due to vehicle age, after controlling for a range of known confounders. Cases were all cars involved in crashes in which at least one occupant was hospitalized or killed anywhere in the Auckland region, and controls were randomly selected cars on Auckland roads. The drivers of the 571 case vehicles and 588 control vehicles completed a structured interview. Main outcome measure: Hospitalisation or death of a vehicle occupant due to car crash injury. Results: Vehicles constructed before 1984 had significantly greater chance of being involved in an injury crash than those constructed after 1994 (odds ratio 2.88, 95% confidence interval (CI) 1.20 to 6.91), after adjustment for potential confounders. There was also a trend for increasing crash risk with each one year increase in vehicle age after adjustment for potential confounders (odds ratio 1.05, 95% CI 0.99 to 1.11; p = 0.09). Conclusion: This study quantifies the increased risk of car crash injury associated with older vehicle year and confirms this as an important public health issue. PMID:14693899

Vehicle year and the risk of car crash injury.

PubMed

Blows, S; Ivers, R Q; Woodward, M; Connor, J; Ameratunga, S; Norton, R

2003-12-01

To quantify the association between vehicle age and risk of car crash injury. Data from a population based case-control study conducted in the Auckland region in 1998/99 was used to examine the adjusted risk of car crash injury or death due to vehicle age, after controlling for a range of known confounders. Cases were all cars involved in crashes in which at least one occupant was hospitalized or killed anywhere in the Auckland region, and controls were randomly selected cars on Auckland roads. The drivers of the 571 case vehicles and 588 control vehicles completed a structured interview. Hospitalisation or death of a vehicle occupant due to car crash injury. Vehicles constructed before 1984 had significantly greater chance of being involved in an injury crash than those constructed after 1994 (odds ratio 2.88, 95% confidence interval (CI) 1.20 to 6.91), after adjustment for potential confounders. There was also a trend for increasing crash risk with each one year increase in vehicle age after adjustment for potential confounders (odds ratio 1.05, 95% CI 0.99 to 1.11; p = 0.09). This study quantifies the increased risk of car crash injury associated with older vehicle year and confirms this as an important public health issue.

Campuses Respond to Violent Tragedy. American Council on Education Series on Higher Education.

ERIC Educational Resources Information Center

Siegel, Dorothy G.

This book presents 10 case studies of how universities and colleges respond to violent tragedies, both on- and off-campus, and offers suggestions for institutions to prepare themselves to deal with such crises. Each case study of a specific case of violence or other tragedy was based on interviews with the participants and reports on the specific…

[Assessment of laboratory diagnostic network in the implementation of the Program for Viral Hepatitis Prevention and Control in São Paulo State, Brazil, 1997-2012].

PubMed

Marques, Cristiano Corrêa de Azevedo; Carvalheiro, José da Rocha

2017-01-01

to assess the performance of the diagnostic network in the implementation process of the Program for Viral Hepatitis Prevention and Control in São Paulo State, Brazil, from 1997 to 2012. evaluation study based on documentary research and structured interviews, combined with a historical series analysis of indicators developed to assess the implementation process of the program, using data from the Department of the Brazilian National Health System. from 1997 to 2012, the serology, biopsy and molecular biology diagnostic networks showed an increase in the coefficients of coverage of 7.4, 7.3, and 62.0 times, respectively, with an increase in cases detection and treatment access. despite the effective implementation of the diagnostic network, there is a need to review the search strategy for new cases, and access to liver biopsy, still insufficient to the program demand.

Prenatal and Perinatal Morbidity in Children with Tic Disorders: A Mainstream School-based Population Study in Central Spain.

PubMed

Cubo, Esther; Hortigüela, Montesclaros; Jorge-Roldan, Sandra; Ciciliani, Selva Esther; Lopez, Patricia; Velasco, Leticia; Sastre, Emilio; Ausin, Vanesa; Delgado, Vanesa; Saez, Sara; Gabriel-Galán, José Trejo; Macarrón, Jesús

2014-01-01

While current research suggests that genetic factors confer the greatest risk for the development of tic disorders, studies of environmental factors are relatively few, with a lack of consistent risk factors across studies. Our aim is to analyze the association of tic disorders with exposure to prenatal and perinatal morbidity. This was a nested case-control study design. Cases and controls were selected and identified from a mainstream, school-based sample. The diagnosis of tic disorders was assigned by a movement disorder neurologist using 'Diagnostic and statistical manual of mental disorders, 4th edition, text revision' criteria, and neuropsychiatric comorbidities were screened using the Spanish computerized version of the Diagnostic Interview Schedule for Children Predictive Scale. Information regarding the exposure to pre-perinatal risk factors was collected by a retrospective review of the birth certificates. Logistic regression analyses were then performed to test the association of tic disorders with pre-perinatal risk factors. Out of 407 participants, complete pre-perinatal data were available in 153 children (64 with tics and 89 without tics). After adjusting for family history of tics, neonatal respiratory distress syndrome, body mass index, prenatal infection, and coexisting comorbid neuropsychiatric disturbances, tic disorders were associated with prenatal exposure to tobacco (odds ratio [OR] = 3.07, 95% confidence interval [CI] 1.24-7.60, p = 0.007), and cesarean section (OR = 5.78, 95% CI 1.60-20.91, p = 0.01). This nested case-control study of children with tic disorders demonstrates higher adjusted odds for tics in children with exposure to cesarean delivery and maternal smoking. Longitudinal, population-based samples are required to confirm these results.

Validity of Criteria-Based Content Analysis (CBCA) at Trial in Free-Narrative Interviews

ERIC Educational Resources Information Center

Roma, Paolo; San Martini, Pietro; Sabatello, Ugo; Tatarelli, Roberto; Ferracuti, Stefano

2011-01-01

Objective: The reliability of child witness testimony in sexual abuse cases is often controversial, and few tools are available. Criteria-Based Content Analysis (CBCA) is a widely used instrument for evaluating psychological credibility in cases of suspected child sexual abuse. Only few studies have evaluated CBCA scores in children suspected of…

Associations of Epstein-Barr Virus DNA in PBMCs and the Subtypes with Breast Cancer Risk

PubMed Central

Zhang, Wei; Wang, Min-Yi; Wei, Xue-Ling; Lin, Ying; Su, Feng-Xi; Xie, Xiao-Ming; Tang, Lu-Ying; Ren, Ze-Fang

2017-01-01

Objective: Epstein-Barr virus (EBV) has been found to be implicated in the development of breast cancer. The purpose of the present study was to identify the associations of EBV DNA and the subtypes in peripheral blood mononuclear cells (PBMCs) with the risk of breast cancer. Material and Methods: A case-control study with 671 breast cancer cases and 859 age-matched controls was conducted in Guangzhou, China. Face-to-face interviews were performed and blood samples were collected immediately after admission to the hospital for patients or after the interview for controls. EBV DNA in PBMCs and the subtypes were detected using Polymerase Chain Reaction (PCR) and restricted fragment length polymorphisms (RFLP). IgA antibodies against EBV VCA-p18 and EBNA-1 were examined using commercial enzyme-linked immunosorbent assay kits. Unconditional logistic regression analysis was applied to evaluate the associations of the DNA positivity and subtypes of EBV with the risk of breast cancer. Results: Among the 1530 subjects, 164 cases (24.4 %) and 206 controls (24.0 %) were positive for EBV DNA in PBMCs and no significant difference occurred between cases and controls. The presence of EBV DNA was related to the positivity of EBV IgA antibodies. Of the DNA positive samples, 71 cases and 109 controls for F/f subtype and 58 cases and 112 controls for C/D subtype were successfully obtained. The D subtype was associated with an increased breast cancer risk compared with the C subtype [OR (95% CI): 2.86 (1.25~6.53)]. We did not find an association of the F/f polymorphism with breast cancer risk. Conclusions: The present study suggested that the presence of EBV DNA in PBMCs may not be an appropriate biomarker for breast cancer risk. The subtype D of EBV was likely to be related to breast tumorigenesis. PMID:28928885

Night shift work and chronic lymphocytic leukemia in the MCC-Spain case-control study.

PubMed

Costas, Laura; Benavente, Yolanda; Olmedo-Requena, Rocío; Casabonne, Delphine; Robles, Claudia; Gonzalez-Barca, Eva-Maria; de la Banda, Esmeralda; Alonso, Esther; Aymerich, Marta; Tardón, Adonina; Marcos-Gragera, Rafael; Gimeno-Vázquez, Eva; Gómez-Acebo, Inés; Papantoniou, Kyriaki; Castaño-Vinyals, Gemma; Aragonés, Nuria; Pollán, Marina; Kogevinas, Manolis; de Sanjosé, Silvia

2016-11-01

Chronic lymphocytic leukemia (CLL) has few known modifiable risk factors. Recently, circadian disruption has been proposed as a potential contributor to lymphoid neoplasms' etiology. Serum melatonin levels have been found to be significantly lower in CLL subjects compared with healthy controls, and also, CLL prognosis has been related to alterations in the circadian molecular signaling. We performed the first investigation of an association between night shift work and CLL in 321 incident CLL cases and 1728 population-based controls in five areas of Spain. Participants were interviewed face-to-face by trained interviewers to collect information on sociodemographic factors, familial, medical and occupational history, including work shifts and other lifestyle factors. We used logistic regression models adjusted for potential confounders to estimate odds ratios (OR) and 95% confidence intervals (CI). Seventy-nine cases (25%) and 339 controls (20%) had performed night work. Overall, working in night shifts was not associated with CLL (OR = 1.06; 95% CI = 0.78-1.45, compared with day work). However, long-term night shift (>20 years) was positively associated with CLL (OR(tertile 3 vs . day-work)  = 1.77; 95% = 1.14-2.74), although no linear trend was observed (P trend = 0.18). This association was observed among those with rotating (OR(tertile 3 vs . day-work)  = 2.29; 95% CI = 1.33-3.92; P trend = 0.07), but not permanent night shifts (OR(tertile 3 vs . day-work) = 1.16; 95% CI = 0.60-2.25; P trend = 0.86). The association between CLL and long-term rotating night shift warrants further investigation. © 2016 UICC.

Targeting imported malaria through social networks: a potential strategy for malaria elimination in Swaziland.

PubMed

Koita, Kadiatou; Novotny, Joseph; Kunene, Simon; Zulu, Zulizile; Ntshalintshali, Nyasatu; Gandhi, Monica; Gosling, Roland

2013-06-27

Swaziland has made great progress towards its goal of malaria elimination by 2015. However, malaria importation from neighbouring high-endemic Mozambique through Swaziland's eastern border remains a major factor that could prevent elimination from being achieved. In order to reach elimination, Swaziland must rapidly identify and treat imported malaria cases before onward transmission occurs. A nationwide formative assessment was conducted over eight weeks to determine if the imported cases of malaria identified by the Swaziland National Malaria Control Programme could be linked to broader social networks and to explore methods to access these networks. Using a structured format, interviews were carried out with malaria surveillance agents (6), health providers (10), previously identified imported malaria cases (19) and people belonging to the networks identified through these interviews (25). Most imported malaria cases were Mozambicans (63%, 12/19) making a living in Swaziland and sustaining their families in Mozambique. The majority of imported cases (73%, 14/19) were labourers and self-employed contractors who travelled frequently to Mozambique to visit their families and conduct business. Social networks of imported cases with similar travel patterns were identified through these interviews. Nearly all imported cases (89%, 17/19) were willing to share contact information to enable network members to be interviewed. Interviews of network members and key informants revealed common congregation points, such as the urban market places in Manzini and Malkerns, as well as certain bus stations, where people with similar travel patterns and malaria risk behaviours could be located and tested for malaria. This study demonstrated that imported cases of malaria belonged to networks of people with similar travel patterns. This study may provide novel methods for screening high-risk groups of travellers using both snowball sampling and time-location sampling of networks to identify and treat additional malaria cases. Implementation of a proactive screening programme of importation networks may help Swaziland halt transmission and achieve malaria elimination by 2015.

Personality Disorders in Hypochondriasis: A Comparison to Panic Disorder and Healthy Controls.

PubMed

Weck, Florian; Nagel, Laura Carlotta; Richtberg, Samantha; Neng, Julia M B

2017-08-01

Previous studies found high prevalence rates of personality disorders (PDs) in patients with hypochondriasis; however, assessment was often based only on questionnaires. In the current study, a sample of 68 patients with hypochondriasis was compared to 31 patients with panic disorder and to 94 healthy controls. Participants were investigated with the Structured Clinical Interview for DSM-IV Personality Disorders questionnaire (SCID-II questionnaire) and the SCID-II interview. Based on the cut-off scores of the SCID-II questionnaire, we found a prevalence rate of 45.6% for PD in patients with hypochondriasis. In comparison to healthy controls, patients with hypochondriasis showed characteristics of paranoid, borderline, avoidant, and dependent PDs in the dimensional assessment significantly more often. However, no significant differences were found between the clinical samples. Based on the SCID-II interview, only 2.9% of the patients with hypochondriasis fulfilled the criteria for a PD. These results suggest that PDs are not a specific characteristic of hypochondriasis.

The influence of environmental conditions on safety management in hospitals: a qualitative study.

PubMed

Alingh, Carien W; van Wijngaarden, Jeroen D H; Huijsman, Robbert; Paauwe, Jaap

2018-05-02

Hospitals are confronted with increasing safety demands from a diverse set of stakeholders, including governmental organisations, professional associations, health insurance companies, patient associations and the media. However, little is known about the effects of these institutional and competitive pressures on hospital safety management. Previous research has shown that organisations generally shape their safety management approach along the lines of control- or commitment-based management. Using a heuristic framework, based on the contextually-based human resource theory, we analysed how environmental pressures affect the safety management approach used by hospitals. A qualitative study was conducted into hospital care in the Netherlands. Five hospitals were selected for participation, based on organisational characteristics as well as variation in their reputation for patient safety. We interviewed hospital managers and staff with a central role in safety management. A total of 43 semi-structured interviews were conducted with 48 respondents. The heuristic framework was used as an initial model for analysing the data, though new codes emerged from the data as well. In order to ensure safe care delivery, institutional and competitive stakeholders often impose detailed safety requirements, strong forces for compliance and growing demands for accountability. As a consequence, hospitals experience a decrease in the room to manoeuvre. Hence, organisations increasingly choose a control-based management approach to make sure that safety demands are met. In contrast, in case of more abstract safety demands and an organisational culture which favours patient safety, hospitals generally experience more leeway. This often results in a stronger focus on commitment-based management. Institutional and competitive conditions as well as strategic choices that hospitals make have resulted in various combinations of control- and commitment-based safety management. A balanced approach is required. A strong focus on control-based management generates extrinsic motivation in employees but may, at the same time, undermine or even diminish intrinsic motivation to work on patient safety. Emphasising commitment-based management may, in contrast, strengthen intrinsic motivation but increases the risk of priorities being set elsewhere. Currently, external pressures frequently lead to the adoption of control-based management. A balanced approach requires a shift towards more trust-based safety demands.

Case-control study on uveal melanoma (RIFA): rational and design

PubMed Central

Schmidt-Pokrzywniak, Andrea; Jöckel, Karl-Heinz; Bornfeld, Norbert; Stang, Andreas

2004-01-01

Background Although a rare disease, uveal melanoma is the most common primary intraocular malignancy in adults, with an incidence rate of up to 1.0 per 100,000 persons per year in Europe. Only a few consistent risk factors have been identified for this disease. We present the study design of an ongoing incident case-control study on uveal melanoma (acronym: RIFA study) that focuses on radiofrequency radiation as transmitted by radio sets and wireless telephones, occupational risk factors, phenotypical characteristics, and UV radiation. Methods/Design We conduct a case-control study to identify the role of different exposures in the development of uveal melanoma. The cases of uveal melanoma were identified at the Division of Ophthalmology, University of Essen, a referral centre for tumours of the eye. We recruit three control groups: population controls, controls sampled from those ophthalmologists who referred cases to the Division of Ophthalmology, University of Duisburg-Essen, and sibling controls. For each case the controls are matched on sex and age (five year groups), except for sibling controls. The data are collected from the study participants by short self-administered questionnaire and by telephone interview. During and at the end of the field phase, the data are quality-checked. To estimate the effect of exposures on uveal melanoma risk, we will use conditional logistic regression that accounts for the matching factors and allows to control for potential confounding. PMID:15318944

Risk Factors for Stillbirth: Findings from a Population-Based Case-Control Study, Haryana, India.

PubMed

Neogi, Sutapa Bandyopadhyay; Negandhi, Preeti; Chopra, Sapna; Das, Ankan Mukherjee; Zodpey, Sanjay; Gupta, Ravi Kant; Gupta, Rakesh

2016-01-01

Stillbirth is a prevalent adverse outcome of pregnancy in India despite efforts to improve care of women during pregnancy. Risk factors for stillbirths include sociodemographic factors, medical complications during pregnancy, intake of harmful drugs, and complications during delivery. The objective of the study was to examine the risk factors for stillbirth with a focus on sex selection drugs (SSDs). A population-based case-control study was undertaken in Haryana. Cases of stillbirths were identified from the Maternal Infant Death Review System portal of Haryana state for the months of August-September 2014. A consecutive birth from the same geographical area as the case was selected as the control. The sample size was 325 per group. Mothers were interviewed using a validated tool. Bivariate analyses and logistic regression were conducted to examine the association between risk factors and stillbirth. Attributable risk proportions (ARP) and population attributable risk proportions (PARP) were estimated. The sociodemographic profiles of the cases and controls were similar. History of intake of SSDs [adjusted odds ratio (OR) 2.6, 95% confidence interval (CI) 1.5, 4.5] emerged as a risk factor. Other significant factors were preterm <37 weeks (OR 3.5, 95% CI 2.1, 6.0), history of previous stillbirths (OR 4.0, 95% CI 2.1, 7.8), and complications during labour (OR 3.3, 95% CI 2.1, 5.3). Estimates of the ARP and PARP for intake of SSDs were 0.60 (95% CI 0.32, 0.77) and 0.1 (95% CI -0.13, 0.28), respectively. SSDs could be attributed as a risk factor in a fifth of the cases of stillbirths. The number needed to harm for the use of SSDs in causing adverse effect of stillbirths was 5, suggesting thereby that for every five mothers exposed to SSDs, one would have stillbirth. Greater efforts are required to inform people about the harmful effects of SSD consumption during pregnancy. © 2015 John Wiley & Sons Ltd.

Perceptions of Primary Care-Based Breastfeeding Promotion Interventions: Qualitative Analysis of Randomized Controlled Trial Participant Interviews

PubMed Central

Bonuck, Karen; Barnett, Josephine; Lischewski-Goel, Jennifer

2012-01-01

Abstract Objective This study examined women's perceptions and reported effects of routine, primary care-based interventions to increase breastfeeding. Subjects and Methods A subsample (n=67) of participants in randomized controlled trials (RCTs) completed semistructured exit interviews at 6 months postpartum. RCT arms included the following: (a) routine pre-/postnatal lactation consultant (LC) support (LC group); (b) electronic prompts (EP) guiding providers to discuss breastfeeding during prenatal care visits (EP group); (c) a combined intervention (LC+EP group); and (d) controls. Interview transcripts were coded and analyzed in MAX.qda. Results Key findings included the following: (1) Brief, non-directive assessment of feeding via postpartum interviews focused attention upon feeding practices. When coupled with breastfeeding promotion interventions, interviews promoted breastfeeding. (2) The EP and LC interventions were complementary: EPs influenced initiation, while LCs helped overcome barriers and sustain breastfeeding. (3) Prenatal intent to feed both breastmilk and formula was associated with the greatest receptivity to study messages. Conclusions Findings underscore the need for interventions across the continuum of care. Trained LCs in prenatal/postpartum settings and prenatal care providers play important complementary roles that, when coupled with brief telephone feeding assessments, may improve breastfeeding rates. PMID:22621223

Perceptions of primary care-based breastfeeding promotion interventions: qualitative analysis of randomized controlled trial participant interviews.

PubMed

Andaya, Elise; Bonuck, Karen; Barnett, Josephine; Lischewski-Goel, Jennifer

2012-12-01

This study examined women's perceptions and reported effects of routine, primary care-based interventions to increase breastfeeding. A subsample (n=67) of participants in randomized controlled trials (RCTs) completed semistructured exit interviews at 6 months postpartum. RCT arms included the following: (a) routine pre-/postnatal lactation consultant (LC) support (LC group); (b) electronic prompts (EP) guiding providers to discuss breastfeeding during prenatal care visits (EP group); (c) a combined intervention (LC+EP group); and (d) controls. Interview transcripts were coded and analyzed in MAX.qda. Key findings included the following: (1) Brief, non-directive assessment of feeding via postpartum interviews focused attention upon feeding practices. When coupled with breastfeeding promotion interventions, interviews promoted breastfeeding. (2) The EP and LC interventions were complementary: EPs influenced initiation, while LCs helped overcome barriers and sustain breastfeeding. (3) Prenatal intent to feed both breastmilk and formula was associated with the greatest receptivity to study messages. Findings underscore the need for interventions across the continuum of care. Trained LCs in prenatal/postpartum settings and prenatal care providers play important complementary roles that, when coupled with brief telephone feeding assessments, may improve breastfeeding rates.

Mental disorders and suicide in Japan: a nation-wide psychological autopsy case-control study.

PubMed

Hirokawa, Seiko; Kawakami, Norito; Matsumoto, Toshihiko; Inagaki, Akiko; Eguchi, Nozomi; Tsuchiya, Masao; Katsumata, Yotaro; Akazawa, Masato; Kameyama, Akiko; Tachimori, Hisateru; Takeshima, Tadashi

2012-10-01

The purpose of the present nationwide psychological autopsy case-control study is to identify the association between mental disorders and suicide in Japan, adjusting for physical conditions. A semi-structured interview was conducted of the closest family members of 49 suicide completers and 145 gender-, age-, and municipality-matched living controls. The interview included sections of socio-demographic characteristics, physical conditions, and a psychiatric interview producing DSM-IV diagnoses of mental disorders prior to suicide (or at survey). We compared prevalences of mental disorders between the two groups, using conditional logistic regression. A significantly higher proportion with any mental disorder was found in the suicide group (65.3%) compared to the control group (4.8%) (p=0.003, odds ratio [OR]=7.5). The population attributable risk proportion associated with mental disorder was 0.24. Mood disorder, particularly major depressive disorder, was the most strongly associated with suicide (p<0.001). Anxiety disorder, alcohol-related disorder, and brief psychotic disorder were also significantly associated with suicide (p<0.05). These patterns were unchanged after adjusting for serious chronic physical conditions. The present study had some limitations, such as small sample size, sampling bias and information bias. Most mental disorders, particularly mood disorder, were significantly associated with a greater risk of suicide in Japan, independent of physical conditions. Mental disorders are a major target of suicide prevention programs in Japan. Copyright © 2012 Elsevier B.V. All rights reserved.

A case-control study of Parkinson's disease and tobacco use: gene-tobacco interactions.

PubMed

De Palma, Giuseppe; Dick, Finlay D; Calzetti, Stefano; Scott, Neil W; Prescott, Gordon J; Osborne, Aileen; Haites, Neva; Mozzoni, Paola; Negrotti, Anna; Scaglioni, Augusto; Mutti, Antonio

2010-05-15

A case-control study of genetic, environmental, and occupational risk factors for Parkinson's disease (PD) was carried out in five European countries (Italy, Malta, Romania, Scotland, and Sweden) to explore the possible contribution of interactions among host and environmental factors in sporadic PD. Whereas smoking habits confirmed its negative association with PD, a possible modulatory role of genetic polymorphisms was investigated to obtain further mechanistic insights. We recruited 767 cases of PD and 1989 age-matched and gender-matched controls. Participants completed an interviewer-administered questionnaire including the history of smoking habits. The polymorphisms of genes involved either in metabolism of compounds contained in tobacco smoke (CYP2D6, CYP1B1, GSTM1, GSTT1, GSTM3, GSTP1, NQO1, SOD2, EPHX and NAT2) or in dopaminergic neurotransmission (MAOA, MAOB, DAT1 and DRD2) were characterized by PCR based methods on genomic DNA. We found evidence of statistically significant gene-tobacco interaction for GSTM1, NAT2, and GSTP1, the negative association between tobacco smoking and PD being significantly enhanced in subjects expressing GSTM1-1 activity, in NAT2 fast acetylators, and in those with the GSTP1*B*C haplotype. Owing to the retrospective design of the study, these results require confirmation. (c) 2010 Movement Disorder Society.

Occupational risk factors have to be considered in the definition of high-risk lung cancer populations.

PubMed

Wild, P; Gonzalez, M; Bourgkard, E; Courouble, N; Clément-Duchêne, C; Martinet, Y; Févotte, J; Paris, C

2012-03-27

The aim of this study was to compute attributable fractions (AF) to occupational factors in an area in North-Eastern France with high lung cancer rates and a past of mining and steel industry. A population-based case-control study among males aged 40-79 was conducted, including confirmed primary lung cancer cases from all hospitals of the study region. Controls were stratified by broad age-classes, district and socioeconomic classes. Detailed occupational and personal risk factors were obtained in face-to-face interviews. Cumulative occupational exposure indices were obtained from the questionnaires. Attributable fractions were computed from multiple unconditional logistic regression models. A total of 246 cases and 531 controls were included. The odds ratios (ORs) adjusted on cumulative smoking and family history of lung cancer increased significantly with the cumulative exposure indices to asbestos, polycyclic aromatic hydrocarbons and crystalline silica, and with exposure to diesel motor exhaust. The AF for occupational factors exceeded 50%, the most important contributor being crystalline silica and asbestos. These AFs are higher than most published figures. This can be because of the highly industrialised area or methods for exposure assessments. Occupational factors are important risk factors and should not be forgotten when defining high-risk lung cancer populations.

Acceptance of routine or case-based inquiry for intimate partner violence: a mixed method study.

PubMed

Stöckl, Heidi; Hertlein, Linda; Himsl, Isabelle; Ditsch, Nina; Blume, Carolin; Hasbargen, Uwe; Friese, Klaus; Stöckl, Doris

2013-03-26

The prevalence and detrimental health effects of intimate partner violence have resulted in international discussions and recommendations that health care professionals should screen women for intimate partner violence during general and antenatal health care visits. Due to the lack of discussion on routine or case-based inquiry for intimate partner violence during antenatal care in Germany, this study seeks to explore its acceptability among pregnant German women. A mixed methods approach was used, utilizing a self-administered survey on the acceptability of routine or case-based inquiry for intimate partner violence in a university hospital's maternity ward in Munich and in-depth interviews with seven women who experienced violence during pregnancy. Of the 401 women who participated in the survey, 92 percent were in favor of routine or case-based inquiry for intimate partner violence during antenatal care. Acceptance of routine or case-based inquiry for intimate partner violence during antenatal care was significantly associated with women's experiences of child sexual abuse, being young, less educated, single or divorced and smoking during pregnancy. Open-ended survey questions and in-depth interviews stressed adequate training for screening, sufficient time and provision of referral information as important conditions for routine or case-based inquiry for intimate partner violence. Women in this study showed an overwhelming support for routine or case-based screening for intimate partner violence in antenatal care in Germany. Until adequate training is in place to allow providers to inquire for intimate partner violence in a professional manner, this study recommends that health care providers are made aware of the prevalence and health consequences of violence during pregnancy.

Acceptance of routine or case-based inquiry for intimate partner violence: a mixed method study

PubMed Central

2013-01-01

Background The prevalence and detrimental health effects of intimate partner violence have resulted in international discussions and recommendations that health care professionals should screen women for intimate partner violence during general and antenatal health care visits. Due to the lack of discussion on routine or case-based inquiry for intimate partner violence during antenatal care in Germany, this study seeks to explore its acceptability among pregnant German women. Methods A mixed methods approach was used, utilizing a self-administered survey on the acceptability of routine or case-based inquiry for intimate partner violence in a university hospital’s maternity ward in Munich and in-depth interviews with seven women who experienced violence during pregnancy. Results Of the 401 women who participated in the survey, 92 percent were in favor of routine or case-based inquiry for intimate partner violence during antenatal care. Acceptance of routine or case-based inquiry for intimate partner violence during antenatal care was significantly associated with women’s experiences of child sexual abuse, being young, less educated, single or divorced and smoking during pregnancy. Open-ended survey questions and in-depth interviews stressed adequate training for screening, sufficient time and provision of referral information as important conditions for routine or case-based inquiry for intimate partner violence. Conclusions Women in this study showed an overwhelming support for routine or case-based screening for intimate partner violence in antenatal care in Germany. Until adequate training is in place to allow providers to inquire for intimate partner violence in a professional manner, this study recommends that health care providers are made aware of the prevalence and health consequences of violence during pregnancy. PMID:23531127

Macronutrients, vitamins and minerals intake and risk of esophageal squamous cell carcinoma: a case-control study in Iran

PubMed Central

2011-01-01

Background Although Iran is a high-risk region for esophageal squamous cell carcinoma (ESCC), dietary factors that may contribute to this high incidence have not been thoroughly studied. The aim of this study was to evaluate the effect of macronutrients, vitamins and minerals on the risk of ESCC. Methods In this hospital-based case-control study, 47 cases with incident ESCC and 96 controls were interviewed and usual dietary intakes were collected using a validated food frequency questionnaire. Data were modeled through unconditional multiple logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI), controlling for age, sex, gastrointestinal reflux, body mass index, smoking history (status, intensity and duration), physical activity, and education. Results ESCC cases consumed significantly more hot foods and beverages and fried and barbecued meals, compared to the controls (p < 0.05). After adjusting for potential confounders, the risk of ESCC increased significantly in the highest tertiles of saturated fat [OR:2.88,95%CI:1.15-3.08], cholesterol [OR:1.53, 95%CI: 1.41-4.13], discretionary calorie [OR:1.51, 95%CI: 1.06-3.84], sodium [OR:1.49,95%CI:1.12-2.89] and total fat intakes [OR:1.48, 95%CI:1.09-3.04]. In contrast, being in the highest tertile of carbohydrate, dietary fiber and (n-3) fatty acid intake reduced the ESCC risk by 78%, 71% and 68%, respectively. The most cancer-protective effect was observed for the combination of high folate and vitamin E intakes (OR: 0.02, 95%CI: 0.00-0.87; p < 0.001). Controls consumed 623.5 times higher selenium, 5.48 times as much β-carotene and 1.98 times as much α-tocopherol as the amount ESCC cases consumed. Conclusion This study suggests that high intake of nutrients primarily found in plant-based foods is associated with a reduced esophageal cancer risk. Some nutrients such as folate, vitamin E and selenium might play major roles in the etiology of ESCC and their status may eventually be used as an epidemiological marker for esophageal cancer in Iran, and perhaps other high-risk regions. PMID:22185224

Developing Interview Skills and Visual Literacy: A New Model of Engagement for Academic Libraries

ERIC Educational Resources Information Center

Denda, Kayo

2015-01-01

This case study presents a cocurricular initiative at the Margery Somers Foster Center at Rutgers University Libraries in New Brunswick, NJ. The initiative resulted in an interview workshop for the course Knowledge and Power, a "mission course" of the Douglass Residential College. This discussion-based workshop uses visual and multimedia…

Outbreak of Escherichia coli 0157:H7 related to animal contact at a petting zoo

PubMed Central

Warshawsky, Bryna; Gutmanis, Iris; Henry, Bonnie; Dow, Joanne; Reffle, Jim; Pollett, Graham; Ahmed, Rafiq; Aldom, John; Alves, David; Chagla, Abdul; Ciebin, Bruce; Kolbe, Faron; Jamieson, Frances; Rodgers, Frank

2002-01-01

OBJECTIVE: To determine the cause of an outbreak of Escherichia coli 0157:H7 related to animal exposures so that further transmission could be prevented. DESIGN: Description of laboratory investigations and a case control study. SETTING: Agricultural pavilion at an annual fair in Ontario. POPULATION: People with laboratory evidence of E coli 0157:H7 (seven people) and others with diarrhea (155 people) who called the health unit following a media release were interviewed. Animals that were accessed most frequently by the public in the agriculture pavilion were tested for E coli 0157:H7. In the case control study, a case was defined as someone with laboratory confirmed E coli 0157:H7, or someone who developed severe or bloody diarrhea two to eight days after attending the agricultural pavilion at the fair (61 people). A convenience sample of people who attended the agricultural pavilion but did not develop diarrhea was selected as the control group (89 people). INTERVENTIONS: Human and animal E coli 0157:H7 specimens were subtyped. Cases and controls were interviewed using a standardized questionnaire. RESULTS: Subtyping of the seven human isolates of E coli 0157:H7 revealed five that were of an extremely uncommon phage type. Three samples from goats and one from sheep at the petting zoo in the agricultural pavilion were of this same phage type. The case control study also implicated goats (odds ratio [OR] 3.65; 95% CI 1.63 to 8.52) and sheep (OR 2.94; 95% CI 1.33 to 6.57) from the petting zoo. CONCLUSIONS: Results of this investigation suggest strongly that the goats and sheep from the petting zoo were the source of this outbreak of E coli 0157:H7. PMID:18159389

Power and control in the legal system: from marriage/relationship to divorce and custody.

PubMed

Watson, Laurel B; Ancis, Julie R

2013-02-01

The purpose of this study was to examine the ways in which abuse that occurred during marriage/relationship continued within divorce and custody-related legal proceedings. Twenty-seven women participated in semistructured interviews. Interviews were analyzed utilizing a grounded theory approach in order to inductively arrive at a theory explaining how abuse dynamics may continue during legal proceedings. Participants identified child support litigation, custody and visitation battles, intimidation/harassment, deliberately prolonging the case, manipulating finances, and distortions of information as methods by which their exes sought to maintain power and control. Counseling implications are described.

Breast Cancer Risk Factors among Ugandan Women at a Tertiary Hospital: A Case-Control Study.

PubMed

Galukande, Moses; Wabinga, Henry; Mirembe, Florence; Karamagi, Charles; Asea, Alexzander

2016-01-01

Although East Africa, like other countries in sub-Saharan Africa, has a lower incidence of breast cancer than high-income countries, the disease rate is rising steeply in Africa; it has nearly tripled in the past few decades in Uganda. There is a paucity of studies that have examined the relation between reproductive factors and breast cancer risk factors in Ugandan women. To determine breast cancer risk factors among indigenous Ugandan women. This is a hospital-based unmatched case-control study. Interviews were conducted between 2011 and 2012 using structured questionnaires. Patients with histology-proven breast cancer were recruited over a 2-year period. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). A total of 350 women were recruited; 113 were cases and 237 were controls. The mean age was 47.5 years (SD 14) for the cases and 45.5 years (SD 14.1) for the controls. The odds of breast cancer risk seemed lower for those who breastfed (adjusted OR = 0.04; 95% CI: 0.01, 0.18). There was no significance for early age at first full-term birth (adjusted OR = 1.96; 95% CI: 0.97, 3.96; p = 0.061), and urban residence carried no increased odds of breast cancer either (p = 0.201). Breastfeeding seems to be associated with reduced odds of breast cancer. © 2016 The Author(s) Published by S. Karger AG, Basel.

A Case Study of a Collaborative Speech-Language Pathologist

ERIC Educational Resources Information Center

Ritzman, Mitzi J.; Sanger, Dixie; Coufal, Kathy L.

2006-01-01

This study explored how a school-based speech-language pathologist implemented a classroom-based service delivery model that focused on collaborative practices in classroom settings. The study used ethnographic observations and interviews with 1 speech-language pathologist to provide insights into how she implemented collaborative consultation and…

Smoke-free workplace ballot campaigns: case studies from Missouri and lessons for policy and media advocacy.

PubMed

Bach, Laura E; Shelton, Sarah C; Moreland-Russell, Sarah; Israel, Kendre

2013-01-01

To assess the key components of smoke-free campaigns that may have influenced voting outcomes in three communities. Community case studies with content analysis of tobacco-related newspaper articles. Three semiurban Missouri communities. One hundred eighty-one articles referencing tobacco published during the campaigns and five key informant interviews. Articles were coded for type, community referenced, tobacco control position, source of quotations, use of evidence, and frame. Semistructured interviews with key informants collected additional information. Descriptive statistics were utilized to examine media coverage in each community. Key themes and events for each campaign were identified from qualitative interviews. The only community that failed to pass its initiative had the highest proportion of letters to the editor (81.1%), anti-tobacco control articles (34.2%), use of a rights frame (28.8%), no evidence used (36.9%), no neighboring communities with policies, strong Tea Party presence, and no support from the chamber of commerce. Across all communities, more articles incorporating health frames were pro-tobacco control (70.7%) and more articles with a rights frame were anti-tobacco control (62.0%), compared to other positions. Several factors can influence the policy process. Tobacco control policy advocates facing strong opposition should consider the many factors (demographics, proximity to other adopting localities, politics) driving the debate and use media as an avenue to influence the discussion, connect with the public and policymakers, and mobilize proponents.

Stakeholders' perceptions of transferability criteria for health promotion interventions: a case study.

PubMed

Trompette, Justine; Kivits, Joëlle; Minary, Laetitia; Cambon, Linda; Alla, François

2014-11-04

The effects of health promotion interventions are the result not only of the interventions themselves, but also of the contexts in which they unfold. The objective of this study was to analyze, through stakeholders' discourse, the characteristics of an intervention that can influence its outcomes. This case study was based on semi-structured interviews with health promotion stakeholders involved in a regional program (PRALIMAP). General hypotheses on transferability and on how the intervention is presumed to produce its effects were used to construct an interview guide. Interviews were analyzed using thematic coding. Twenty-three stakeholders were interviewed. Results showed stakeholders made few references to population and environment characteristics. Three themes emerged as significant for the stakeholders: implementation modalities and methodology, modalities used to mobilize actors; and transferability-promoting factors and barriers. Our work contributes to a better understanding not only of transferability factors, but also of stakeholders' perceptions of them, which are just as important, because those perceptions themselves are a factor in mobilization of actors, implementation, and transferability.

Scaffolding Online Historical Inquiry Tasks: A Case Study of Two Secondary School Classrooms

ERIC Educational Resources Information Center

Li, Dong Dong; Lim, Cher Ping

2008-01-01

This paper examines the different dimensions of scaffolding for online historical inquiry based on a case study of two secondary-two history classes from a neighborhood school in Singapore. The data collected for the study include video and screen captures, focus group interview, digital artifacts, and students' survey. Using sample transcripts…

The Influence of Academic Values on Scholarly Publication and Communication Practices. Research and Occasional Paper Series: CSHE.13.06

ERIC Educational Resources Information Center

Harley, Diane; Earl-Novell, Sarah; Arter, Jennifer; Lawrence, Shannon; King, C. Judson

2006-01-01

This study reports on five disciplinary case studies that explore academic value systems as they influence publishing behavior and attitudes of University of California, Berkeley faculty. The case studies are based on direct interviews with relevant stakeholders--faculty, advancement reviewers, librarians, and editors--in five fields: chemical…

Academic Staff's Perspectives upon Student Plagiarism: A Case Study at a University in Hong Kong

ERIC Educational Resources Information Center

Li, Yongyan

2015-01-01

Much of the previous research concerning student plagiarism has been conducted in Anglo-American settings. The present paper reports a case study of academic staff's perspectives upon student plagiarism at a university in Hong Kong. Based on interviews with 16 instructors, the study focused on the teachers' views and pedagogical practices,…

Medication Use in Pregnancy in Relation to the Risk of Isolated Clubfoot in Offspring

PubMed Central

Werler, Martha M.; Yazdy, Mahsa M.; Kasser, James R.; Mahan, Susan T.; Meyer, Robert E.; Anderka, Marlene; Druschel, Charlotte M.; Mitchell, Allen A.

2014-01-01

Clubfoot, a common major structural malformation, develops early in gestation. Epidemiologic studies have identified higher risks among boys, first-born children, and babies with a family history of clubfoot, but studies of risks associated with maternal exposures are lacking. We conducted the first large-scale, population-based, case-control study of clubfoot with detailed information on maternal medication use in pregnancy. Study subjects were ascertained from birth defect registries in Massachusetts, New York, and North Carolina during 2007–2011. Cases were 646 mothers of children with clubfoot without other major structural malformations (i.e., isolated clubfoot); controls were mothers of 2,037 children born without major malformations. Mothers were interviewed within 12 months of delivery about medication use, including product, timing, and frequency. Odds ratios were estimated for exposure to 27 medications in pregnancy months 2–4 after adjustment for study site, infant sex, first-born status, body mass index (weight (kg)/height (m)2), and smoking. Odds ratios were less than 1.20 for 14 of the medications; of the remainder, most odds ratios were only slightly elevated (range, 1.21–1.66), with wide confidence intervals. The use of antiviral drugs was more common in clubfoot cases than in controls (odds ratio = 4.22, 95% confidence interval: 1.52, 11.73). Most of these results are new findings and require confirmation in other studies. PMID:24824985

Sounds of Silence: Race and Emergent Counter-Narratives of Art Teacher Identity

ERIC Educational Resources Information Center

Kraehe, Amelia M.

2015-01-01

This article presents case studies of two Black preservice art teachers and their racialized experiences in art teacher education. Drawing from a critical race theory perspective, their stories are conceptualized as emergent counternarratives of becoming an art teacher. The case studies are based on interviews from an ethnographic investigation of…

Playing the Literacy Game: A Case Study in Adult Education

ERIC Educational Resources Information Center

Kambouri, Maria; Thomas, Siobhan; Mellar, Harvey

2006-01-01

Runner is a high-quality educational game designed by the University for Industry (UfI/"learndirect") to attract young adults who find learning in formal educational contexts difficult. A case study evaluation of this novel application of an adventure game genre to literacy learning is discussed, based on observations and interviews in…

The Relationships between Organizational Culture and Environmental Scanning: A Case Study.

ERIC Educational Resources Information Center

Miller, Jerry P.

1994-01-01

Based on interview and survey data from 220 upper- and middle-level managers within a Fortune 500 manufacturing firm, this case study describes how differences in organizational values influence the frequency with which decision makers use oral, written, and electronic sources of information for environmental scanning. (91 references) (LRW)

The Crisis Response to a School-Based Hostage Event: A Case Study

ERIC Educational Resources Information Center

Crepeau-Hobson, Franci; Summers, Laura L.

2011-01-01

During the past two decades there has been increased public, professional, and legislative interest in school crisis prevention and intervention. It is recommended that comprehensive crisis teams be established at the school, district, and community levels. A case study was conducted in which interviews were utilized to facilitate an increased…

Epiphany? A Case Study of Learner-Centredness in Educational Supervision

ERIC Educational Resources Information Center

Talbot, Martin

2009-01-01

Graduate medical trainees in the UK appreciate mentors who demonstrate learner-centredness as modelled by Rogers. This case study was undertaken to examine how, in one instance, learner-centred may be supervision within the tight confines of a formal, competency-based programme of training. Four formal interviews (in 18 months), were analysed to…

Demographic profile of families and children in the Study to Explore Early Development (SEED): Case-control study of autism spectrum disorder

PubMed Central

DiGuiseppi, Carolyn G.; Daniels, Julie L.; Fallin, Daniele M.; Rosenberg, Steven A.; Schieve, Laura A.; Thomas, Kathleen C.; Windham, Gayle C.; Goss, Cynthia W.; Soke, Gnakub N.; Currie, Dustin W.; Singer, Alison B.; Lee, Li-Ching; Bernal, Pilar; Croen, Lisa A.; Miller, Lisa A.; Pinto-Martin, Jennifer A.; Young, Lisa M.; Schendel, Diana E.

2016-01-01

Background The Study to Explore Early Development (SEED) is designed to enhance knowledge of autism spectrum disorder characteristics and etiologies. Objective This paper describes the demographic profile of enrolled families and examines sociodemographic differences between children with autism spectrum disorder and children with other developmental problems or who are typically developing. Methods This multi-site case-control study used health, education, and birth certificate records to identify and enroll children aged 2–5 years into one of three groups: 1) cases (children with autism spectrum disorder), 2) developmental delay or disorder controls, or 3) general population controls. Study group classification was based on sampling source, prior diagnoses, and study screening tests and developmental evaluations. The child's primary caregiver provided demographic characteristics through a telephone (or occasionally face-to-face) interview. Groups were compared using ANOVA, chi-squared test, or multinomial logistic regression as appropriate. Results Of 2768 study children, sizeable proportions were born to mothers of non-White race (31.7%), Hispanic ethnicity (11.4%), and foreign birth (17.6%); 33.0% of households had incomes below the US median. The autism spectrum disorder and population control groups differed significantly on nearly all sociodemographic parameters. In contrast, the autism spectrum disorder and developmental delay or disorder groups had generally similar sociodemographic characteristics. Conclusions SEED enrolled a sociodemographically diverse sample, which will allow further, in-depth exploration of sociodemographic differences between study groups and provide novel opportunities to explore sociodemographic influences on etiologic risk factor associations with autism spectrum disorder and phenotypic subtypes. PMID:26917104

Demographic profile of families and children in the Study to Explore Early Development (SEED): Case-control study of autism spectrum disorder.

PubMed

DiGuiseppi, Carolyn G; Daniels, Julie L; Fallin, Daniele M; Rosenberg, Steven A; Schieve, Laura A; Thomas, Kathleen C; Windham, Gayle C; Goss, Cynthia W; Soke, Gnakub N; Currie, Dustin W; Singer, Alison B; Lee, Li-Ching; Bernal, Pilar; Croen, Lisa A; Miller, Lisa A; Pinto-Martin, Jennifer A; Young, Lisa M; Schendel, Diana E

2016-07-01

The Study to Explore Early Development (SEED) is designed to enhance knowledge of autism spectrum disorder characteristics and etiologies. This paper describes the demographic profile of enrolled families and examines sociodemographic differences between children with autism spectrum disorder and children with other developmental problems or who are typically developing. This multi-site case-control study used health, education, and birth certificate records to identify and enroll children aged 2-5 years into one of three groups: 1) cases (children with autism spectrum disorder), 2) developmental delay or disorder controls, or 3) general population controls. Study group classification was based on sampling source, prior diagnoses, and study screening tests and developmental evaluations. The child's primary caregiver provided demographic characteristics through a telephone (or occasionally face-to-face) interview. Groups were compared using ANOVA, chi-squared test, or multinomial logistic regression as appropriate. Of 2768 study children, sizeable proportions were born to mothers of non-White race (31.7%), Hispanic ethnicity (11.4%), and foreign birth (17.6%); 33.0% of households had incomes below the US median. The autism spectrum disorder and population control groups differed significantly on nearly all sociodemographic parameters. In contrast, the autism spectrum disorder and developmental delay or disorder groups had generally similar sociodemographic characteristics. SEED enrolled a sociodemographically diverse sample, which will allow further, in-depth exploration of sociodemographic differences between study groups and provide novel opportunities to explore sociodemographic influences on etiologic risk factor associations with autism spectrum disorder and phenotypic subtypes. Copyright © 2016 Elsevier Inc. All rights reserved.

Occupational exposure to solvents, metals and welding fumes and risk of Parkinson's disease.

PubMed

van der Mark, Marianne; Vermeulen, Roel; Nijssen, Peter C G; Mulleners, Wim M; Sas, Antonetta M G; van Laar, Teus; Huss, Anke; Kromhout, Hans

2015-06-01

The aim of this study was to investigate the potential association between occupational exposure to solvents, metals and/or welding fumes and risk of developing Parkinson's disease (PD). Data of a hospital based case-control study including 444 PD patients and 876 age and sex matched controls was used. Occupational histories and lifestyle information of cases and controls were collected in a structured telephone interview. Exposures to aromatic solvents, chlorinated solvents and metals were estimated by linking the ALOHA+ job-exposure matrix to the occupational histories. Exposure to welding fumes was estimated using self-reported information on welding activities. No statistically significant associations with any of the studied metal and solvent exposures were found. However, for self-reported welding activities we observed non-statistically significant reduced risk estimates (third tertile cumulative exposure: OR = 0.51 (95% CI: 0.21-1.24)). The results of our study did not provide support for an increased chance on developing PD after occupational exposure to aromatic solvents, chlorinated solvents or exposure to metals. The results showed reduced risk estimates for welding, which is in line with previous research, but no clear explanation for these findings is available. Copyright © 2015 Elsevier Ltd. All rights reserved.

Exposure to diesel and gasoline engine emissions and the risk of lung cancer.

PubMed

Parent, Marie-Elise; Rousseau, Marie-Claude; Boffetta, Paolo; Cohen, Aaron; Siemiatycki, Jack

2007-01-01

Pollution from motor vehicles constitutes a major environmental health problem. The present paper describes associations between diesel and gasoline engine emissions and lung cancer, as evidenced in a 1979-1985 population-based case-control study in Montreal, Canada. Cases were 857 male lung cancer patients. Controls were 533 population controls and 1,349 patients with other cancer types. Subjects were interviewed to obtain a detailed lifetime job history and relevant data on potential confounders. Industrial hygienists translated each job description into indices of exposure to several agents, including engine emissions. There was no evidence of excess risks of lung cancer with exposure to gasoline exhaust. For diesel engine emissions, results differed by control group. When cancer controls were considered, there was no excess risk. When population controls were studied, the odds ratios, after adjustments for potential confounders, were 1.2 (95% confidence interval: 0.8, 1.8) for any exposure and 1.6 (95% confidence interval: 0.9, 2.8) for substantial exposure. Confidence intervals between risk estimates derived from the two control groups overlapped considerably. These results provide some limited support for the hypothesis of an excess lung cancer risk due to diesel exhaust but no support for an increase in risk due to gasoline exhaust.

Night shift work, chronotype and prostate cancer risk in the MCC-Spain case-control study.

PubMed

Papantoniou, Kyriaki; Castaño-Vinyals, Gemma; Espinosa, Ana; Aragonés, Nuria; Pérez-Gómez, Beatriz; Burgos, Javier; Gómez-Acebo, Inés; Llorca, Javier; Peiró, Rosana; Jimenez-Moleón, Jose Juan; Arredondo, Francisco; Tardón, Adonina; Pollan, Marina; Kogevinas, Manolis

2015-09-01

Night shift work has been classified as a probable human carcinogen based on experimental studies and limited human evidence on breast cancer. Evidence on other common cancers, such as prostate cancer, is scarce. Chronotype is an individual characteristic that may relate to night work adaptation. We evaluated night shift work with relation to prostate cancer, taking into account chronotype and disease severity in a population based case-control study in Spain. We included 1,095 prostate cancer cases and 1,388 randomly selected population controls. We collected detailed information on shift schedules (permanent vs. rotating, time schedules, duration, frequency), using lifetime occupational history. Sociodemographic and lifestyle factors were assessed by face-to-face interviews and chronotype through a validated questionnaire. We used unconditional logistic regression analysis adjusting for potential confounders. Subjects who had worked at least for one year in night shift work had a slightly higher prostate cancer risk [Odds Ratio (OR) 1.14; 95%CI 0.94, 1.37] compared with never night workers; this risk increased with longer duration of exposure (≥ 28 years: OR 1.37; 95%CI 1.05, 1.81; p-trend = 0.047). Risks were more pronounced for high risk tumors [D'Amico classification, Relative Risk Ratio (RRR) 1.40; 95%CI 1.05, 1.86], particularly among subjects with longer duration of exposure (≥28 years: RRR 1.63; 95%CI 1.08, 2.45; p-trend = 0.027). Overall risk was higher among subjects with an evening chronotype, but also increased in morning chronotypes after long-term night work. In this large population based study, we found an association between night shift work and prostate cancer particularly for tumors with worse prognosis. © 2014 UICC.

Family members of older persons with multi-morbidity and their experiences of case managers in Sweden: an interpretive phenomenological approach.

PubMed

Hjelm, Markus; Holmgren, Ann-Charlotte; Willman, Ania; Bohman, Doris; Holst, Göran

2015-01-01

Family members of older persons (75+) with multi-morbidity are likely to benefit from utilising case management services performed by case managers. However, research has not yet explored their experiences of case managers. The aim of the study was to deepen the understanding of the importance of case managers to family members of older persons (75+) with multi-morbidity. The study design was based on an interpretive phenomenological approach. Data were collected through individual interviews with 16 family members in Sweden. The interviews were analysed by means of an interpretive phenomenological approach. The findings revealed one overarching theme: "Helps to fulfil my unmet needs", based on three sub-themes: (1) "Helps me feel secure - Experiencing a trusting relationship", (2) "Confirms and strengthens me - Challenging my sense of being alone" and (3) "Being my personal guide - Increasing my competence". The findings indicate that case managers were able to fulfil unmet needs of family members. The latter recognised the importance of case managers providing them with professional services tailored to their individual needs. The findings can contribute to the improvement of case management models not only for older persons but also for their family members.

Caught between Cultures: Case Study of an "Out of School" Ethnic Minority Student in Hong Kong

ERIC Educational Resources Information Center

Bhowmik, Miron Kumar; Kennedy, Kerry J.

2017-01-01

This paper reports a case study on Maneesha Rai, a Nepalese girl living in Hong Kong and an "out of school" student. Based on in-depth interviews, a case was constructed of her previous school days and current "out of school" days. These provided a vivid picture of her life and several themes were created using schema analysis…

The posttraumatic stress disorder project in Brazil: neuropsychological, structural and molecular neuroimaging studies in victims of urban violence.

PubMed

Bressan, Rodrigo A; Quarantini, Lucas C; Andreoli, Sérgio B; Araújo, Celia; Breen, Gerome; Guindalini, Camila; Hoexter, Marcelo; Jackowski, Andrea P; Jorge, Miguel R; Lacerda, Acioly L T; Lara, Diogo R; Malta, Stella; Moriyama, Tais S; Quintana, Maria I; Ribeiro, Wagner S; Ruiz, Juliana; Schoedl, Aline F; Shih, Ming C; Figueira, Ivan; Koenen, Karestan C; Mello, Marcelo F; Mari, Jair J

2009-06-01

Life trauma is highly prevalent in the general population and posttraumatic stress disorder is among the most prevalent psychiatric consequences of trauma exposure. Brazil has a unique environment to conduct translational research about psychological trauma and posttraumatic stress disorder, since urban violence became a Brazilian phenomenon, being particularly related to the rapid population growth of its cities. This research involves three case-control studies: a neuropsychological, a structural neuroimaging and a molecular neuroimaging study, each focusing on different objectives but providing complementary information. First, it aims to examine cognitive functioning of PTSD subjects and its relationships with symptomatology. The second objective is to evaluate neurostructural integrity of orbitofrontal cortex and hippocampus in PTSD subjects. The third aim is to evaluate if patients with PTSD have decreased dopamine transporter density in the basal ganglia as compared to resilient controls subjects. This paper shows the research rationale and design for these three case-control studies. Cases and controls will be identified through an epidemiologic survey conducted in the city of São Paulo. Subjects exposed to traumatic life experiences resulting in posttraumatic stress disorder (cases) will be compared to resilient victims of traumatic life experiences without PTSD (controls) aiming to identify biological variables that might protect or predispose to PTSD. In the neuropsychological case-control study, 100 patients with PTSD, will be compared with 100 victims of trauma without posttraumatic stress disorder, age- and sex-matched controls. Similarly, 50 cases and 50 controls will be enrolled for the structural study and 25 cases and 25 controls in the functional neuroimaging study. All individuals from the three studies will complete psychometrics and a structured clinical interview (the Structured Clinical Interview for DSM-IV and the Clinician-Administered PTSD Scale, Beck Anxiety Inventory, Beck Depression Inventory, Global Assessment of Function, The Social Adjustment Scale, Medical Outcomes Study 36-Item Short-Form Health Survey, Early Trauma Inventory, Clinical global Impressions, and Peritraumatic Dissociative Experiences Questionnaire). A broad neuropsychological battery will be administered for all participants of the neuropsychological study. Magnetic resonance scans will be performed to acquire structural neuroimaging data. Single photon emission computerized tomography with [(99m)Tc]-TRODAT-1 brain scans will be performed to evaluate dopamine transporters. This study protocol will be informative for researchers and clinicians interested in considering, designing and/or conducting translational research in the field of trauma and posttraumatic stress disorder.

The home environment and asthma symptoms in childhood: two population based case-control studies 13 years apart

PubMed Central

Butland, B. K.; Strachan, D. P.; Anderson, H. R.

1997-01-01

BACKGROUND: Prevalence surveys of asthma and/or wheezing among all children aged between 7 1/2 and 8 1/2 attending state and private schools in the London Borough of Croydon were conducted in February 1978 and February 1991. Two population based case-control studies drawn from the survey responders were used to investigate the association between childhood wheeze and characteristics of the home environment and to assess whether changes in these characteristics between 1978 and 1991 may have contributed to an increase in the population prevalence of wheeze among school children. METHODS: Information on exposure to potential indoor environmental risk factors was obtained from parents by home interview and compared between cases-that is, children with frequent (> or = 5) or in-frequent (1-4) attacks of asthma or wheezing in the past 12 months- and controls, with adjustment for study. Changes in exposure over time were assessed by comparing control groups. RESULTS: Between 1978 and 1991 the population prevalence odds of wheeze increased by 20% (OR 1.20; 95% CI 1.04 to 1.39). Change in parental smoking, gas cooking, pet ownership, and central heating did not appear to explain the rise. Use of non-feather pillows was positively associated with childhood wheeze even after adjusting for other risk factors and after re-coding from non-feather to feather cases thought to have changed pillow in response to symptoms (OR 1.54; 95% CI 1.13 to 2.10). The proportion of control children reportedly using non-feather pillows was 44% in 1978 and 67% in 1991. CONCLUSIONS: Increased use of non-feather pillows was the only domestic indoor exposure studied which appeared to explain a modest rise in prevalence of wheeze from 1978 to 1991. Our analysis attempts to address behavioural change in response to the child's symptoms but an artifact arising from lifelong avoidance of feather bedding in atopic families cannot be entirely discounted. 


 PMID:9246133

Risk of venous thromboembolism in association with factor V leiden in cancer patients - The EDITH case-control study.

PubMed

Heraudeau, Adeline; Delluc, Aurélien; Le Henaff, Mickaël; Lacut, Karine; Leroyer, Christophe; Desrues, Benoit; Couturaud, Francis; Tromeur, Cécile

2018-01-01

Cancer and factor V Leiden mutation are both risk factors for venous thromboembolism (VTE). Cancer critically increases the thrombotic risk whereas Factor V Leiden is the most common pro-thrombotic mutation. The impact of the factor V Leiden on the risk of VTE in cancer patients remains uncertain. To assess the impact of factor V Leiden mutation in cancer-associated thrombosis. The EDITH hospital-based case-control study enrolled 182 patients with cancer and VTE as well as 182 control patients with cancer, matched for gender, age and cancer location, between 2000 and 2012, in the University Hospital of Brest. All cases and controls were genotyped for the factor V Leiden mutation and interviewed with a standardized questionnaire. Twenty one of 182 (11.5%) patients with cancer-associated thrombosis carried the factor V Leiden mutation and 4 of 182 (2.2%) controls with cancer but no venous thrombosis. In multivariate analysis including cancer stage and family history of VTE, cancer patients with factor V Leiden mutation had a seven-fold increased risk of venous thromboembolism (adjusted odds ratio [OR], 7.04; 95% CI, 2.01-24.63). The pro-thrombotic Factor V Leiden mutation was found to be an independent additional risk factor for venous thromboembolism in cancer patients and might therefore be considered in the individual thrombotic risk assessment.

Case Histories of Six Consumers and Their Families in Cash and Counseling

PubMed Central

San Antonio, Patricia M; Simon-Rusinowitz, Lori; Loughlin, Dawn; Eckert, J Kevin; Mahoney, Kevin J

2007-01-01

Objective To examine how the lives of consumers and their caregivers were affected by making choices and controlling their own resources with the cash option, this paper focuses on six case studies from the Cash and Counseling Demonstration Program. Data Sources Twenty-one consumers, caregivers, and state consultants were interviewed about their experiences in the program. Study Design The data come from a larger study of over 200 interviews conducted from June 2000 to August 2004. Interview data were analyzed for themes about caregiving and program satisfaction. Principal Findings Cash and Counseling benefited consumers and caregivers by allowing consumers increased continuity and reliability of care, increased ability to set hours of care, more satisfaction with how caregiving is offered and more satisfaction with the quality of care. Conclusions The cash option allowed consumers to create, schedule, and manage their own model of care. Some consumers faced challenges in the program with paperwork, accounting, worries about receiving care, and some ineffective state consultants who could have been more helpful. PMID:17244296

Experiences of Community-Living Older Adults Receiving Integrated Care Based on the Chronic Care Model: A Qualitative Study

PubMed Central

Spoorenberg, Sophie L. W.; Wynia, Klaske; Fokkens, Andrea S.; Slotman, Karin; Kremer, Hubertus P. H.; Reijneveld, Sijmen A.

2015-01-01

Background Integrated care models aim to solve the problem of fragmented and poorly coordinated care in current healthcare systems. These models aim to be patient-centered by providing continuous and coordinated care and by considering the needs and preferences of patients. The objective of this study was to evaluate the opinions and experiences of community-living older adults with regard to integrated care and support, along with the extent to which it meets their health and social needs. Methods Semi-structured interviews were conducted with 23 older adults receiving integrated care and support through “Embrace,” an integrated care model for community-living older adults that is based on the Chronic Care Model and a population health management model. Embrace is currently fully operational in the northern region of the Netherlands. Data analysis was based on the grounded theory approach. Results Responses of participants concerned two focus areas: 1) Experiences with aging, with the themes “Struggling with health,” “Increasing dependency,” “Decreasing social interaction,” “Loss of control,” and “Fears;” and 2) Experiences with Embrace, with the themes “Relationship with the case manager,” “Interactions,” and “Feeling in control, safe, and secure”. The prospect of becoming dependent and losing control was a key concept in the lives of the older adults interviewed. Embrace reinforced the participants’ ability to stay in control, even if they were dependent on others. Furthermore, participants felt safe and secure, in contrast to the fears of increasing dependency within the standard care system. Conclusion The results indicate that integrated care and support provided through Embrace met the health and social needs of older adults, who were coping with the consequences of aging. PMID:26489096

Experiences of Community-Living Older Adults Receiving Integrated Care Based on the Chronic Care Model: A Qualitative Study.

PubMed

Spoorenberg, Sophie L W; Wynia, Klaske; Fokkens, Andrea S; Slotman, Karin; Kremer, Hubertus P H; Reijneveld, Sijmen A

2015-01-01

Integrated care models aim to solve the problem of fragmented and poorly coordinated care in current healthcare systems. These models aim to be patient-centered by providing continuous and coordinated care and by considering the needs and preferences of patients. The objective of this study was to evaluate the opinions and experiences of community-living older adults with regard to integrated care and support, along with the extent to which it meets their health and social needs. Semi-structured interviews were conducted with 23 older adults receiving integrated care and support through "Embrace," an integrated care model for community-living older adults that is based on the Chronic Care Model and a population health management model. Embrace is currently fully operational in the northern region of the Netherlands. Data analysis was based on the grounded theory approach. Responses of participants concerned two focus areas: 1) Experiences with aging, with the themes "Struggling with health," "Increasing dependency," "Decreasing social interaction," "Loss of control," and "Fears;" and 2) Experiences with Embrace, with the themes "Relationship with the case manager," "Interactions," and "Feeling in control, safe, and secure". The prospect of becoming dependent and losing control was a key concept in the lives of the older adults interviewed. Embrace reinforced the participants' ability to stay in control, even if they were dependent on others. Furthermore, participants felt safe and secure, in contrast to the fears of increasing dependency within the standard care system. The results indicate that integrated care and support provided through Embrace met the health and social needs of older adults, who were coping with the consequences of aging.

A randomized trial of tailoring and motivational interviewing to promote fruit and vegetable consumption for cancer prevention and control.

PubMed

Campbell, Marci Kramish; Carr, Carol; Devellis, Brenda; Switzer, Boyd; Biddle, Andrea; Amamoo, M Ahinee; Walsh, Joan; Zhou, Bingqing; Sandler, Robert

2009-10-01

Healthful dietary patterns, including eating fruits and vegetables (F&V) and avoiding obesity, may decrease the risk of cancer and other chronic diseases. In addition to promoting health for the general population, a cancer diagnosis may provide a "teachable moment," facilitating the adoption of more healthful eating habits and leading to lower risk of chronic disease and better overall health. This study was designed to test the effectiveness of two health communication interventions in increasing F&V consumption and physical activity in a sample of older adults (average age of 66 years), including both colorectal cancer (CRC) survivors and noncolorectal cancer-affected (N-CRC) individuals. CRC survivors and N-CRC individuals were recruited from a population-based case-control study and randomly assigned to four conditions using a 2 x 2 design. We tested two different methods of communicating and promoting health behavior change alone or in combination: tailored print communication (TPC) and brief telephone-based motivational interviewing (TMI). A significant increase in F&V consumption was found for the combined intervention group in the entire sample (p < 0.05). When stratified by cancer survivor status, the effect was concentrated in the N-CRC subset (p < 0.01) versus CRC survivors. The combined intervention was also found to be most cost-effective for the N-CRC group, with TPC more cost-effective than TMI. For physical activity, none of the interventions produced statistically significant improvements. This study indicates that combining tailoring and motivational interviewing may be an effective and cost-effective method for promoting dietary behavior change among older healthy adults. More research is needed to identify the optimal dose and timing for intervention strategies to promote dietary and physical activity change among both CRC survivors and the general population.

The Business Case for Provider Participation in Clinical Trials Research: An Application to the National Cancer Institute's Community Clinical Oncology Program

PubMed Central

Song, Paula H.; Reiter, Kristin L.; Weiner, Bryan J.; Minasian, Lori; McAlearney, Ann Scheck

2012-01-01

Background Provider-based research networks (PBRNs) make clinical trials available in community-based practice settings, where most people receive their care, but provider participation requires both financial and in-kind contributions. Purpose This study explores whether providers believe there is a business case for participating in PBRNs and what factors contribute to the business case. Methodology/Approach We use a multiple case study methodology approach to examine the National Cancer Institute's Community Clinical Oncology Program, a longstanding federally funded PBRN. Interviews with 41 key informants across five sites, selected on the basis of organizational maturity, were conducted using a semi-structured interview guide. We analyzed interview transcripts using an iterative, deductive process to identify themes and subthemes in the data. Findings We found that a business case for provider participation in PBRNs may exist if both direct and indirect financial benefits are identified and included in the analysis, and if the time horizon is long enough to allow those benefits to be realized. We identified specific direct and indirect financial benefits that were perceived as important contributors to the business case and the perceived length of time required for a positive return to accrue. Practice Implications As the lack of a business case may result in provider reluctance to participate in PBRNs, knowledge of the benefits we identified may be crucial to encouraging and sustaining participation, thereby preserving patient access to innovative community-based treatments. The results are also relevant to federally-funded PBRNs outside of oncology or to providers considering participation in any clinical trials research. PMID:23044836

Does Exposure to Agricultural Chemicals Increase the Risk of Prostate Cancer among Farmers?

PubMed Central

Parent, Marie-Élise; Désy, Marie; Siemiatycki, Jack

2009-01-01

Several studies suggest that farmers may be at increased risk of prostate cancer. The present analysis, based on a large population-based case-control study conducted among men in the Montreal area in the early 1980’s, aim at identifying occupational chemicals which may be responsible for such increases. The original study enrolled 449 prostate cancer cases, nearly 4,000 patients with other cancers, as well as 533 population controls. Subjects were interviewed about their occupation histories, and a team of industrial hygienists assigned their past exposures using a checklist of some 300 chemicals. The present analysis was restricted to a study base of men who had worked as farmers earlier in their lives. There were a total of 49 men with prostate cancers, 127 with other cancers and 56 population controls. We created a pool of 183 controls combining the patients with cancers at sites other than the prostate and the population controls. We then estimated the odds ratio for prostate cancer associated with exposure to each of 10 agricultural chemicals, i.e., pesticides, arsenic compounds, acetic acid, gasoline engine emissions, diesel engine emissions, polycyclic aromatic hydrocarbons from petroleum, lubricating oils and greases, alkanes with ≥18 carbons, solvents, and mononuclear aromatic hydrocarbons. Based on a model adjusting for age, ethnicity, education, and respondent status, there was evidence of a two-fold excess risk of prostate cancer among farmers with substantial exposure to pesticides [odds ratio (OR)=2.3, 95% confidence interval (CI) 1.1–5.1], as compared to unexposed farmers. There was some suggestion, based on few subjects, of increased risks among farmers ever exposed to diesel engine emissions (OR=5.7, 95% CI 1.2–26.5). The results for pesticides are particularly noteworthy in the light of findings from previous studies. Suggestions of trends for elevated risks were noted with other agricultural chemicals, but these are largely novel and need further confirmation in larger samples. PMID:19753293

Herpes zoster vaccine effectiveness and manifestations of herpes zoster and associated pain by vaccination status.

PubMed

Marin, Mona; Yawn, Barbara P; Hales, Craig M; Wollan, Peter C; Bialek, Stephanie R; Zhang, John; Kurland, Marge J; Harpaz, Rafael

2015-01-01

Options for managing herpes zoster (HZ)-related pain and complications have limited effectiveness, making HZ prevention through vaccination an important strategy. Limited data are available on HZ vaccine effectiveness against confirmed HZ and manifestations of HZ among vaccinated persons. We conducted a matched case-control study to assess HZ vaccine effectiveness for prevention of HZ and other HZ-related outcomes and a cohort study of persons with HZ to compare HZ-related outcomes by vaccination status. Cases were identified through active surveillance among persons age ≥ 60 years with HZ onset and health-care encounters during 2010-2011 in Southeastern Minnesota. Controls were age- and sex-matched to cases. Data were collected by medical record review and from participants via interviews and daily pain diaries. 266 HZ case-patients and 362 matched controls were enrolled in the vaccine effectiveness studies and 303 case-patients in the cohort study of HZ characteristics by vaccination status. Vaccination was associated with 54% (95% CI:32%-69%) reduction in HZ incidence, 58% (95% CI:31%-75%) reduction in HZ prodromal symptoms, and 70% (95% CI:33%-87%) reduction in medically-attended prodrome. HZ vaccine was statistically significant effective at preventing postherpetic neuralgia (PHN) measured at 30 d after rash onset, 61% (95% CI: 22%-80%). Among persons who developed HZ, no differences were found by vaccination status in severity or duration of HZ pain after rash onset. In this population-based study, HZ vaccination was associated with >50% reduction in HZ, HZ prodrome, and medically-attended prodrome.

Herpes zoster vaccine effectiveness and manifestations of herpes zoster and associated pain by vaccination status

PubMed Central

Marin, Mona; Yawn, Barbara P; Hales, Craig M; Wollan, Peter C; Bialek, Stephanie R; Zhang, John; Kurland, Marge J; Harpaz, Rafael

2015-01-01

Options for managing herpes zoster (HZ)-related pain and complications have limited effectiveness, making HZ prevention through vaccination an important strategy. Limited data are available on HZ vaccine effectiveness against confirmed HZ and manifestations of HZ among vaccinated persons. We conducted a matched case-control study to assess HZ vaccine effectiveness for prevention of HZ and other HZ-related outcomes and a cohort study of persons with HZ to compare HZ-related outcomes by vaccination status. Cases were identified through active surveillance among persons age ≥60 years with HZ onset and health-care encounters during 2010-2011 in Southeastern Minnesota. Controls were age- and sex-matched to cases. Data were collected by medical record review and from participants via interviews and daily pain diaries. 266 HZ case-patients and 362 matched controls were enrolled in the vaccine effectiveness studies and 303 case-patients in the cohort study of HZ characteristics by vaccination status. Vaccination was associated with 54% (95% CI:32%-69%) reduction in HZ incidence, 58% (95% CI:31%-75%) reduction in HZ prodromal symptoms, and 70% (95% CI:33%-87%) reduction in medically-attended prodrome. HZ vaccine was statistically significant effective at preventing postherpetic neuralgia (PHN) measured at 30 d after rash onset, 61% (95% CI: 22%-80%). Among persons who developed HZ, no differences were found by vaccination status in severity or duration of HZ pain after rash onset. In this population-based study, HZ vaccination was associated with >50% reduction in HZ, HZ prodrome, and medically-attended prodrome. PMID:25806911

Multidisciplinary Responses to the Sexual Victimization of Children: Use of Control Phone Calls.

PubMed

Canavan, J William; Borowski, Christine; Essex, Stacy; Perkowski, Stefan

2017-10-01

This descriptive study addresses the question of the value of one-party consent phone calls regarding the sexual victimization of children. The authors reviewed 4 years of experience with children between the ages of 3 and 18 years selected for the control phone calls after a forensic interview by the New York State Police forensic interviewer. The forensic interviewer identified appropriate cases for control phone calls considering New York State law, the child's capacity to make the call, the presence of another person to make the call and a supportive residence. The control phone call process has been extremely effective forensically. Offenders choose to avoid trial by taking a plea bargain thereby dramatically speeding up the criminal judicial and family court processes. An additional outcome of the control phone call is the alleged offender's own words saved the child from the trauma of testifying in court. The control phone call reduced the need for children to repeat their stories to various interviewers. A successful control phone call gives the child a sense of vindication. This technique is the only technique that preserves the actual communication pattern between the alleged victim and the alleged offender. This can be of great value to the mental health professionals working with both the child and the alleged offender. Cautions must be considered regarding potential serious adverse effects on the child. The multidisciplinary team members must work together in the control phone call. The descriptive nature of this study did not allow the authors adequate demographic data, a subject that should be addressed in future prospective study.

Interviewing with or without the partner present?--an underexposed dilemma between ethics and methodology in nursing research.

PubMed

Norlyk, Annelise; Haahr, Anita; Hall, Elisabeth

2016-04-01

To discuss ethical and methodological challenges related to in-depth interviews with patients and partners when interviewed together or separately. Increased interest in exploring illness phenomena from both patients' and partners' perspectives has emerged. The decision about how to collect data is challenging. Patients and partners can be interviewed separately or together; in both scenarios researchers face complex questions of methodology and ethics. This paper contributes to the ongoing debate on individual or joint interviewing and the effect of absence/presence of the partner on data collection. Discussion paper that draws on data from three phenomenological studies. Referring to three cases from our phenomenological studies, we discuss the different types of ethical and methodological dilemmas faced when undertaking joint and separate interviews with couples. Furthermore, we discuss how the unexpected presence of the partner potentially influences the data gathered from the patient. The cases demonstrate the interrelatedness of ethics and methodology in studies based on in-depth interviews with couples. Nurse researchers may be caught up in a dilemma between ethical concerns and methodological considerations. We argue that the presence of the partner during an interview session might influence the data and favour expressions of shared rather than individual experiences of the phenomenon studied. Furthermore, we argue that ethical concerns must be given higher priority than methodology when interviewing couples. An increased awareness of the tension between ethical and methodological challenges in joint or individual interviewing with patients and partners is necessary, as this issue is underexposed. © 2015 John Wiley & Sons Ltd.

The economic burden of a Salmonella Thompson outbreak caused by smoked salmon in the Netherlands, 2012-2013.

PubMed

Suijkerbuijk, Anita W M; Bouwknegt, Martijn; Mangen, Marie-Josee J; de Wit, G Ardine; van Pelt, Wilfrid; Bijkerk, Paul; Friesema, Ingrid H M

2017-04-01

In 2012, the Netherlands experienced the most extensive food-related outbreak of Salmonella ever recorded. It was caused by smoked salmon contaminated with Salmonella Thompson during processing. In total, 1149 cases of salmonellosis were laboratory confirmed and reported to RIVM. Twenty percent of cases was hospitalised and four cases were reported to be fatal. The purpose of this study was to estimate total costs of the Salmonella Thompson outbreak. Data from a case-control study were used to estimate the cost-of-illness of reported cases (i.e. healthcare costs, patient costs and production losses). Outbreak control costs were estimated based on interviews with staff from health authorities. Using the Dutch foodborne disease burden and cost-of-illness model, we estimated the number of underestimated cases and the associated cost-of-illness. The estimated number of cases, including reported and underestimated cases was 21 123. Adjusted for underestimation, the total cost-of-illness would be €6.8 million (95% CI €2.5-€16.7 million) with productivity losses being the main cost driver. Adding outbreak control costs, the total outbreak costs are estimated at €7.5 million. In the Netherlands, measures are taken to reduce salmonella concentrations in food, but detection of contamination during food processing remains difficult. As shown, Salmonella outbreaks have the potential for a relatively high disease and economic burden for society. Early warning and close cooperation between the industry, health authorities and laboratories is essential for rapid detection, control of outbreaks, and to reduce disease and economic burden. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Assessment of Semi-Structured Clinical Interview for Mobile Phone Addiction Disorder

PubMed Central

Alavi, Seyyed Salman; Jannatifard, Fereshteh; Mohammadi Kalhori, Soroush; Sepahbodi, Ghazal; BabaReisi, Mohammad; Sajedi, Sahar; Farshchi, Mojtaba; KhodaKarami, Rasul; Hatami Kasvaee, Vahid

2016-01-01

Objective: The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) classified mobile phone addiction disorder under “impulse control disorder not elsewhere classified”. This study surveyed the diagnostic criteria of DSM-IV-TR for the diagnosis of mobile phone addiction in correspondence with Iranian society and culture. Method: Two hundred fifty students of Tehran universities were entered into this descriptive-analytical and cross-sectional study. Quota sampling method was used. At first, semi- structured clinical interview (based on DSM-IV-TR) was performed for all the cases, and another specialist reevaluated the interviews. Data were analyzed using content validity, inter-scorer reliability (Kappa coefficient) and test-retest via SPSS18 software. Results: The content validity of the semi- structured clinical interview matched the DSM–IV-TR criteria for behavioral addiction. Moreover, their content was appropriate, and two items, including “SMS pathological use” and “High monthly cost of using the mobile phone” were added to promote its validity. Internal reliability (Kappa) and test–retest reliability were 0.55 and r = 0.4 (p<0. 01) respectively. Conclusion: The results of this study revealed that semi- structured diagnostic criteria of DSM-IV-TR are valid and reliable for diagnosing mobile phone addiction, and this instrument is an effective tool to diagnose this disorder. PMID:27437008

Outlining a Population “at Risk” of Parkinson's Disease: Evidence from a Case-Control Study

PubMed Central

Schirinzi, Tommaso; Martella, Giuseppina; D'Elia, Alessio; Di Lazzaro, Giulia; Imbriani, Paola; Madeo, Graziella; Monaco, Leonardo; Maltese, Marta

2016-01-01

The multifactorial pathogenesis of Parkinson's Disease (PD) requires a careful identification of populations “at risk” of developing the disease. In this case-control study we analyzed a large Italian population, in an attempt to outline general criteria to define a population “at risk” of PD. We enrolled 300 PD patients and 300 controls, gender and age matched, from the same urban geographical area. All subjects were interviewed on demographics, family history of PD, occupational and environmental toxicants exposure, smoking status, and alcohol consumption. A sample of 65 patients and 65 controls also underwent serum dosing of iron, copper, mercury, and manganese by means of Inductively Coupled-Plasma-Mass-Spectrometry (ICP-MS). Positive family history, toxicants exposure, non-current-smoker, and alcohol nonconsumer status occurred as significant risk factors in our population. The number of concurring risk factors overlapping in the same subject impressively increased the overall risk. No significant differences were measured in the metal serum levels. Our findings indicate that combination of three to four concurrent PD-risk factors defines a condition “at risk” of PD. A simple stratification, based on these questionnaires, might be of help in identifying subjects suitable for neuroprotective strategies. PMID:27651975

Determinants of delayed care seeking for TB suggestive symptoms in Seru district, Oromiya region, Ethiopia: a community based unmatched case-control study.

PubMed

Yirgu, Robel; Lemessa, Firaol; Hirpa, Selamawit; Alemayehu, Abraham; Klinkenberg, Eveline

2017-04-20

Early tuberculosis (TB) case finding and adequate chemotherapy are essential for interrupting disease transmission and preventing complications due to delayed care seeking. This study was undertaken in order to provide insights into the magnitude and determinants of patient delay. The study was conducted in rural Seru district, employing a population based unmatched case-control study design. The WHO standardized TB screening tool was used to identify presumptive TB cases among the district population ages > 15 years. Presumptive TB cases who sought care in a health facility more than 14 days after the onset of symptoms were considered cases while those who sought care within the first 14 days were classified as controls. A structured interview questionnaire was used to capture socio demographic characteristics and health care service utilization related data from the study participants. A multiple binary logistic regression model was used to identify any factor associated with patient care seeking delay. A total of 9,782 individuals were screened, of which 980 (10%, 95% CI; 9.4-10.5%) presumptive TB cases were identified. From these cases 358 (76%, 95% CI; 75.6%-76.4%) sought care within the first 14 days of the onset of symptoms with a median patient delay of 15 days, IQR (5-30 days). The most common TB suggestive symptom mentioned by the participants was night sweat 754 (76.4%) while the least common was a history of contact with a confirmed TB case in the past one year 207 (21.1%). Individuals in the 45-54 age range had lower odds of delay (AOR 0.31, 95%CI 0.15, 0.61) as compared to those 15-24 years old. First TB treatment episode (AOR16.2, 95% CI 9.94, 26.26) and limited access to either traditional or modern modes of transportation (AOR 2.62, 95% CI 1.25, 5.49) were independently associated with patient care delay. Increasing community awareness about the risks of delayed care seeking and the importance of accessing health services close to the community can help decrease patient care delay.

Exploring Situational Awareness in Diagnostic Errors in Primary Care

PubMed Central

Singh, Hardeep; Giardina, Traber Davis; Petersen, Laura A.; Smith, Michael; Wilson, Lindsey; Dismukes, Key; Bhagwath, Gayathri; Thomas, Eric J.

2013-01-01

Objective Diagnostic errors in primary care are harmful but poorly studied. To facilitate understanding of diagnostic errors in real-world primary care settings using electronic health records (EHRs), this study explored the use of the Situational Awareness (SA) framework from aviation human factors research. Methods A mixed-methods study was conducted involving reviews of EHR data followed by semi-structured interviews of selected providers from two institutions in the US. The study population included 380 consecutive patients with colorectal and lung cancers diagnosed between February 2008 and January 2009. Using a pre-tested data collection instrument, trained physicians identified diagnostic errors, defined as lack of timely action on one or more established indications for diagnostic work-up for lung and colorectal cancers. Twenty-six providers involved in cases with and without errors were interviewed. Interviews probed for providers' lack of SA and how this may have influenced the diagnostic process. Results Of 254 cases meeting inclusion criteria, errors were found in 30 (32.6%) of 92 lung cancer cases and 56 (33.5%) of 167 colorectal cancer cases. Analysis of interviews related to error cases revealed evidence of lack of one of four levels of SA applicable to primary care practice: information perception, information comprehension, forecasting future events, and choosing appropriate action based on the first three levels. In cases without error, the application of the SA framework provided insight into processes involved in attention management. Conclusions A framework of SA can help analyze and understand diagnostic errors in primary care settings that use EHRs. PMID:21890757

Sugary food and beverage consumption and epithelial ovarian cancer risk: a population-based case–control study

PubMed Central

2013-01-01

Background Ovarian cancer is the deadliest gynecologic cancer in the US. The consumption of refined sugars has increased dramatically over the past few decades, accounting for almost 15% of total energy intake. Yet, there is limited evidence on how sugar consumption affects ovarian cancer risk. Methods We evaluated ovarian cancer risk in relation to sugary foods and beverages, and total and added sugar intakes in a population-based case–control study. Cases were women with newly diagnosed epithelial ovarian cancer, older than 21 years, able to speak English or Spanish, and residents of six counties in New Jersey. Controls met same criteria as cases, but were ineligible if they had both ovaries removed. A total of 205 cases and 390 controls completed a phone interview, food frequency questionnaire, and self-recorded waist and hip measurements. Based on dietary data, we computed the number of servings of dessert foods, non-dessert foods, sugary drinks and total sugary foods and drinks for each participant. Total and added sugar intakes (grams/day) were also calculated. Multiple logistic regression models were used to estimate odds ratios and 95% confidence intervals for food and drink groups and total and added sugar intakes, while adjusting for major risk factors. Results We did not find evidence of an association between consumption of sugary foods and beverages and risk, although there was a suggestion of increased risk associated with sugary drink intake (servings per 1,000 kcal; OR=1.63, 95% CI: 0.94-2.83). Conclusions Overall, we found little indication that sugar intake played a major role on ovarian cancer development. PMID:23442818

An updated review of case-control studies of lung cancer and indoor radon-Is indoor radon the risk factor for lung cancer?

PubMed

Sheen, Seungsoo; Lee, Keu Sung; Chung, Wou Young; Nam, Saeil; Kang, Dae Ryong

2016-01-01

Lung cancer is a leading cause of cancer-related death in the world. Smoking is definitely the most important risk factor for lung cancer. Radon ((222)Rn) is a natural gas produced from radium ((226)Ra) in the decay series of uranium ((238)U). Radon exposure is the second most common cause of lung cancer and the first risk factor for lung cancer in never-smokers. Case-control studies have provided epidemiological evidence of the causative relationship between indoor radon exposure and lung cancer. Twenty-four case-control study papers were found by our search strategy from the PubMed database. Among them, seven studies showed that indoor radon has a statistically significant association with lung cancer. The studies performed in radon-prone areas showed a more positive association between radon and lung cancer. Reviewed papers had inconsistent results on the dose-response relationship between indoor radon and lung cancer risk. Further refined case-control studies will be required to evaluate the relationship between radon and lung cancer. Sufficient study sample size, proper interview methods, valid and precise indoor radon measurement, wide range of indoor radon, and appropriate control of confounders such as smoking status should be considered in further case-control studies.

Artificial sweeteners and absence of bladder cancer risk in Copenhagen.

PubMed

Møller-Jensen, O; Knudsen, J B; Sørensen, B L; Clemmesen, J

1983-11-15

During the years 1979 to 1981 a population-based case-control study of bladder cancer including papillomas was performed in Greater Copenhagen. After exclusions some 388 patients (290 males; 98 females) and an age- and sex-matched group of 787 controls (592 males; 195 females) remained for analysis. Controls were selected at random from the general population of the study area. All persons were interviewed concerning use of artificial sweeteners in addition to their exposure to a number of other known or suspected risk factors for bladder cancer. Fifty-five male bladder cancer patients (19.4%) and 150 controls (25.7%) had at some time used artificial sweeteners regularly. Among females 27.1% of cases and 25.9% of controls regularly used sweeteners. In neither sex was the relative risk significantly increased in users compared with non-users of artificial sweeteners. The relative risk of 0.78 in the two sexes combined was not significantly different from 1.0 (95% C.I.: 0.58-1.05). There was no indication of a regular increase in risk with increasing daily consumption of table-top sweeteners nor was there any indication of an increase in risk with a duration of regular use of artificial sweeteners. Taking into account a possible latency period between first regular use and bladder cancer development did not change the finding of an absence of association between use of artificial sweeteners and the risk of bladder cancer. Neither saccharine nor cyclamate users had an increased risk of bladder cancer. This population-based case-control investigation provides further evidence that it is highly unlikely that the consumption of artificial sweeteners has contributed to current bladder cancer rates in man.

New Insights into the Compulsion to Use Tobacco from an Adolescent Case-Series

ERIC Educational Resources Information Center

DiFranza, Joseph R.; Ursprung, W. W. Sanouri; Carson, Alisha

2010-01-01

Nicotine addiction is the most common preventable cause of premature death presenting during adolescence. No prior study has described the onset of this condition based on case histories. We used trained personnel to conduct individual semi-structured interviews to obtain case histories from 50 adolescent and young adult current and former…

Postoperative infections traced to contamination of an intravenous anesthetic, propofol.

PubMed

Bennett, S N; McNeil, M M; Bland, L A; Arduino, M J; Villarino, M E; Perrotta, D M; Burwen, D R; Welbel, S F; Pegues, D A; Stroud, L

1995-07-20

Between June 1990 and February 1993, the Centers for Disease Control and Prevention conducted investigations at seven hospitals because of unusual outbreaks of bloodstream infections, surgical-site infections, and acute febrile episodes after surgical procedures. We conducted case-control or cohort studies, or both, to identify risk factors. A case patient was defined as any patient who had an organism-specific infection or acute febrile episode after a surgical procedure during the study period in that hospital. The investigations also included reviews of procedures, cultures, and microbiologic studies of infecting, contaminating, and colonizing strains. Sixty-two case patients were identified, 49 (79 percent) of whom underwent surgery during an epidemic period. Postoperative complications were more frequent during the epidemic period than before it. Only exposure to propofol, a lipid-based anesthetic agent, was significantly associated with the postoperative complications at all seven hospitals. In six of the outbreaks, an etiologic agent (Staphylococcus aureus, Candida albicans, Moraxella osloensis, Enterobacter agglomerans, or Serratia marcescens) was identified, and the same strains were isolated from the case patients. Although cultures of unopened containers of propofol were negative, at two hospitals cultures of propofol from syringes currently in use were positive. At one hospital, the recovered organism was identical to the organism isolated from the case patients. Interviews with and observation of anesthesiology personnel documented a wide variety of lapses in aseptic techniques. With the increasing use of lipid-based medications, which support rapid bacterial growth at room temperature, strict aseptic techniques are essential during the handling of these agents to prevent extrinsic contamination and dangerous infectious complications.

Implementation of case studies in undergraduate didactic nursing courses: a qualitative study.

PubMed

Dutra, Danette K

2013-07-04

The implementation of unfolding scenario-based case studies in the didactic classroom is associated with learner-centered education. The utilization of learner-centered pedagogies, such as case studies, removes the focus from the instructor and instead places it on the student. Learner-centered pedagogies are believed to improve students' levels of cognition. The purpose of this study was to examine how nurse educators are implementing the pedagogies of case studies in their undergraduate didactic courses. The goal was to examine, document, report, and, ultimately, implement the strategies. Purposeful sampling was utilized in this qualitative, multisite-designed study. For each of the four participants, three separate site visits were completed. Observations and post-observational interviews took place at each site visit. Transcribed data from interviews, observations, and course documents were imported into the computer program Nvivo8. Repetitive comparative analysis was utilized to complete the data coding process. The guiding research question of this study sought to investigate the implementation strategies of case studies in didactic nursing courses. The implementation of case studies by the participants reflected two primary patterns: Formal Implementation (FI) and Informal Implementation (II) of case studies. The FI of case studies was further divided into two subcategories: Formal Implementation of case studies used Inside the Classroom setting (FIIC) and Formal Implementation of cases studies used Outside of the Classroom (FIOC). Results of this investigation have led to an increased understanding of implementation strategies of unfolding scenario-based case studies in undergraduate nursing didactic courses. Data collected were rich in the description of specific methodologies for utilization of case studies and may serve as a resource for faculty in development of creative strategies to enhance the didactic classroom experience.

Implementation of case studies in undergraduate didactic nursing courses: a qualitative study

PubMed Central

2013-01-01

Background The implementation of unfolding scenario-based case studies in the didactic classroom is associated with learner-centered education. The utilization of learner-centered pedagogies, such as case studies, removes the focus from the instructor and instead places it on the student. Learner-centered pedagogies are believed to improve students’ levels of cognition. The purpose of this study was to examine how nurse educators are implementing the pedagogies of case studies in their undergraduate didactic courses. The goal was to examine, document, report, and, ultimately, implement the strategies. Methods Purposeful sampling was utilized in this qualitative, multisite-designed study. For each of the four participants, three separate site visits were completed. Observations and post-observational interviews took place at each site visit. Transcribed data from interviews, observations, and course documents were imported into the computer program Nvivo8. Repetitive comparative analysis was utilized to complete the data coding process. Results The guiding research question of this study sought to investigate the implementation strategies of case studies in didactic nursing courses. The implementation of case studies by the participants reflected two primary patterns: Formal Implementation (FI) and Informal Implementation (II) of case studies. The FI of case studies was further divided into two subcategories: Formal Implementation of case studies used Inside the Classroom setting (FIIC) and Formal Implementation of cases studies used Outside of the Classroom (FIOC). Conclusion Results of this investigation have led to an increased understanding of implementation strategies of unfolding scenario-based case studies in undergraduate nursing didactic courses. Data collected were rich in the description of specific methodologies for utilization of case studies and may serve as a resource for faculty in development of creative strategies to enhance the didactic classroom experience. PMID:23826925

Medical History, Medication Use, and Risk of Nasopharyngeal Carcinoma.

PubMed

Xiao, Xiling; Zhang, Zhe; Chang, Ellen T; Liu, Zhiwei; Liu, Qing; Cai, Yonglin; Chen, Guomin; Huang, Qi-Hong; Xie, Shang-Hang; Cao, Su-Mei; Shao, Jian-Yong; Jia, Wei-Hua; Zheng, Yuming; Liao, Jian; Chen, Yufeng; Lin, Longde; Ernberg, Ingemar; Huang, Guangwu; Zeng, Yi; Zeng, Yi-Xin; Adami, Hans-Olov; Ye, Weimin

2018-04-26

Because persistent inflammation may render the nasopharyngeal mucosa susceptible to carcinogenesis, chronic ear/nose/throat (ENT) disease and its treatment might influence the risk of nasopharyngeal carcinoma (NPC). Existing evidence is, however, inconclusive and often based on methodologically suboptimal epidemiologic studies. In a population-based case-control study in southern China, we enrolled 2532 NPC cases and 2597 controls aged 20-74 years from 2010 to 2014. Odds ratios were estimated for associations between NPC risk and history of ENT and related medications. Any history of chronic ENT disease was associated with a 34% increased risk of NPC. Similarly, use of nasal drops or aspirin was associated with approximately doubled risk of NPC. However, in secondary analyses restricted to chronic ENT diseases and related medication use at least 5 years prior to diagnosis/interview, most results were statistically non-significant, except a history of uncured ENT diseases, untreated nasal polyps, and earlier age at first diagnosis of ENT disease and first or most recent aspirin use. Overall, these findings suggest that ENT disease and related drug use are most likely early indications rather than causes of NPC, although the possibility of a modestly increased NPC risk associated with these diseases and related drugs cannot be excluded.

Fluoride in drinking water and risk of hip fracture in the UK: a case-control study.

PubMed

Hillier, S; Cooper, C; Kellingray, S; Russell, G; Hughes, H; Coggon, D

2000-01-22

Although the benefits of water fluoridation for dental health are widely accepted, concerns remain about possible adverse effects, particularly effects on bone. Several investigators have suggested increased rates of hip fracture in places with high concentrations of fluoride in drinking water, but this finding has not been consistent, possibly because of unrecognised confounding effects. We did a case-control study of men and women aged 50 years and older from the English county of Cleveland, and compared patients with hip fracture with community controls. Current addresses were ascertained for all participants; for those who agreed to an interview and who passed a mental test, more detailed information was obtained about lifetime residential history and exposure to other known and suspected risk factors for hip fracture. Exposures to fluoride in water were estimated from the residential histories and from information provided by water suppliers. Analysis was by logistic regression. 914 cases and 1196 controls were identified, of whom 514 and 527, respectively, were interviewed. Among those interviewed, hip fracture was strongly associated with low body-mass index (p for trend <0.001) and physical inactivity (p for trend <0.001). Estimated average lifetime exposure to fluoride in drinking water ranged from 0.15 to 1.79 ppm. Current residence in Hartlepool was a good indicator for high lifetime exposure to fluoride. After adjustment for potential confounders, the odds ratio associated with an average lifetime exposure to fluoride > or =0.9 ppm was 1.0 [95% CI 0.7-1.5]. There is a low risk of hip fracture for people ingesting fluoride in drinking water at concentrations of about 1 ppm. This low risk should not be a reason for withholding fluoridation of water supplies.

Risk factors associated with sporadic salmonellosis in adults: a case-control study.

PubMed

Ziehm, D; Dreesman, J; Campe, A; Kreienbrock, L; Pulz, M

2013-02-01

In order to identify and assess recent risk factors for sporadic human infections with Salmonella enterica, we conducted a case-control study in Lower Saxony, Germany. The data collection was based on standardized telephone interviews with 1017 cases and 346 controls aged >14 years. Odds ratios were calculated in single-factor and multi-factor analyses for Salmonella cases and two different control groups, i.e. population controls and controls with rotavirus infection. Multi-factor analysis revealed associations between sporadic Salmonella infections for two exposures by both sets of controls: consumption of raw ground pork [adjusted odds ratio (aOR) 2·38, 95% confidence interval (CI) 1·27-4·44] and foreign travel (aOR 2·12, 95% CI 1·00-4·52). Other exposures included consumption of food items containing eggs (aOR 1·43, 95% CI 0·80-2·54), consumption of chicken meat (aOR 1·77, 95% CI 1·26-2·50), outdoor meals/barbecues (aOR 3·96, 95% CI 1·41-11·12) and taking gastric acidity inhibitors (aOR 2·42, 95% CI 1·19-4·92), all were significantly associated with respect to one of the two control groups. The impact of consuming food items containing eggs or chicken meat was lower than expected from the literature. This might be a consequence of Salmonella control programmes as well as increased public awareness of eggs and chicken products being a risk factor for salmonellosis. Efforts to reduce Salmonella infections due to raw pork products should be intensified.

Does the 'Teddy Bear Hospital' enhance preschool children's knowledge? A pilot study with a pre/post-case control design in Germany.

PubMed

Leonhardt, Corinna; Margraf-Stiksrud, Jutta; Badners, Larissa; Szerencsi, Andrea; Maier, Rolf F

2014-10-01

The 'Teddy Bear Hospital' is a medical students' project, which has been increasingly established in many countries. To evaluate this concept, we examined the effects of a German Teddy Bear Hospital on children's knowledge relating to their body, health and disease. Using a quasi-experimental pre/post design, we examined 131 preschool children from 14 German kindergartens with pictorial interview-based scales. The analysis of covariance revealed that the children who visited the Teddy Bear Hospital had a significantly better knowledge concerning their body, health and disease than the children from the control group. This German Teddy Bear Hospital is a good health education vehicle for preschool children. © The Author(s) 2013.

Creating Synergies: Local Government Facilitating Learning and Development through Partnerships--Support Document

ERIC Educational Resources Information Center

Waterhouse, Peter; Virgona, Crina; Brown, Richard

2006-01-01

This research sought to document and better understand four evolving learning communities in Victoria. It was based upon an earlier study by the Victorian Local Governance Association (VLGA) (Snelling, 2003). The study was qualitative in nature, based on face-to-face interviews and case studies. This supporting document provides the literature…

Thirty Years of School Based Curriculum Development: A Case Study.

ERIC Educational Resources Information Center

Ben-Peretz, Miriam; Dor, Ben Zion

A study of one school's involvement in school-based curriculum development (SBCD) for nearly 30 years provided researchers with information on the factors affecting the success of SBCD programs. The school studied serves 3,500 students in 12 grades at several sites in an Israeli city. Following interviews with faculty members, the researchers…

First case-control study of zoonotic brucellosis in Gafsa district, Southwest Tunisia.

PubMed

Khamassi Khbou, Médiha; Htira, Samaher; Harabech, Kaouther; Benzarti, M'hammed

2018-06-01

A case-control study was conducted, aimed to describe the clinical human brucellosis (CHB) pattern during 2015 in the Gafsa region (Southwest Tunisia) and to investigate the main risk factors involved in the disease occurrence. One hundred and four CHB cases were notified in 2015 in Gafsa district. All CHB cases that own ruminants were contacted, but only 32 accepted to participate in a matched case-control study. Thirty-two and thirty-one CHB cases and controls, respectively, were included in the study. The subjects were interviewed using a structured questionnaire. A total of 662 domestic ruminants (cattle, sheep and goats) belonging to cases and controls, were screened using the Rose Bengal Test, as recommended by the World Organisation of Animal Health. During 2015, the incidence of CHB was estimated to 30.8 per 100,000 inhabitants affecting mainly males aged between 30 and 39 years. The overall animal seropositivity to Brucella , was 21 and 1.9% in case and control farms, respectively (p < 0.0001). Only five risk factors were found to be significant: overall animal seropositivity (OR = 65.2; 95%CI: 13.3-318.7); handling aborted females (OR = 43.1; 95%CI: 8.3-222.7); presence of male ruminants in the herds (OR = 18.5; 95%CI: 5.18-66); owning seropositive goats (OR = 18.3; 95%CI: 2.4-137.6), owning seropositive sheep (OR = 9.66; 95%CI: 2.9-31.5) and history of abortion during the previous year in the herd (OR = 4.6; 95%CI: 1.3-12.6). Vaccination of animals against brucellosis was associated with lower odds of human brucellosis (OR = 0.03; 95%CI: 0.004-0.2). Raw milk and derivatives consumption was not a risk factor of human brucellosis. Based on this study, ruminants' vaccination coverage should be increased by enhancing the number of vaccinated animals and systematically including male ruminants in Tunisia. Comprehensive education programmes targeting both farmers and general population should be implemented.

A new structured interview for children with autism spectrum disorder based on the DSM-IV.

PubMed

Hansakunachai, Tippawan; Roongpraiwan, Rawiwan; Sombuntham, Tasnawat; Limprasert, Pornprot; Ruangdaraganon, Nichara

2014-08-01

Autism spectrum disorder (ASD) is a common neurodevelopmental disorder in children. The clinical spectrum of ASD includes autism, childhood disintegrative disorder Asperger syndrome and pervasive developmental disorder not otherwise specified (PDD-NOS). Although the DSM-IVcriteria are well acceptedforASD diagnosis, there are some known limitations for clinicians. The most important issue is lack'ofspecific age-appropriate items in each domain. Thus, the DSM-IVneeds some modifications in order to be appropriate for clinical use. To develop a structured interview for children based on the DSM-IVdiagnostic criteria ofautism and PDD-NOS. MATERIAL ANDMETHOD: From June 2006 to December 2008, 140 Thai children, 121 boys and 19 girls, already diagnosed with ASD, were recruited through the child development clinics of Ramathibodi and Thammasat University Hospitals in Thailand. A 26-item structured interview was developed with scoring according to the DSM-IVdiagnostic criteria for autism andPDD- NOS. To test the accuracy of the structured interview and its reliability, 32 children with ASD were selected and interviewed by four clinicians using the new instrument. One clinician interviewed the parents or caregivers, while three others independently took notes and observed the play behavior of the children. All items from the structured interview as scored by each clinician were compared using inter-rater agreement statistics (Kappa). All of the original 140 patients were then clinically diagnosed again using the structured interview and the results were compared with the initial diagnoses. Ofthe 140patients originally diagnosed with ASD, 110 and 30patients were finally diagnosed with the new interview as having autism and PDD-NOS, respectively. The initial diagnoses from 15 cases (10.7%) were changed according to the structured interview Inter-rater reliability among the four clinicians showed a good level ofagreement (Kappa = 0.897) with statistical significance (p<0.001). The authors only compared the items in the structured interview between the autism and PDD-NOSgroups from 105 cases aged 2-5 years (79 cases with autism and 26 cases with PDD-NOS) because there were only 4 cases with PDD-NOS in the other age groups. Highly significant differences (p<0.001) in clinical items between patients with autism and patients with PDD-NOS from the final diagnoses were noted in 6 of 8 items in the category of restricted, repetitive and stereotyped patterns ofbehavior, interests and activities, which were more common in the autism group than the PDD-NOS group. In addition, the autism group had higher frequencies of using finger-pointing to indicate interest rather than verbalization, and idiosyncratic language, than the PDD-NOS group. The newly developed structured interview for Thai children with ASD had a high level ofinterrater reliability between four clinicians. However, most children tested using this structured interview were 2-5years ofage, and the study did not include non-autistic groups. The application ofthis structured interview needs further study with a wider variety ofcases, such as ASD cases from different age groups, children with delayed development and normal children.

LOST TO FOLLOW-UP: FAILURE TO ENGAGE CHILDREN IN CARE IN THE FIRST THREE MONTHS OF DIAGNOSIS

PubMed Central

Gillespie, Susan L.; Homedes, Nuria; Selwyn, Beatrice J.; Ross, Michael W.; Anabwani, Gabriel; Schutze, Gordon; Kline, Mark W.

2016-01-01

Loss to follow-up (LTFU) is a critical factor in determining clinical outcomes in HIV treatment programs. Identifying modifiable factors of LTFU is fundamental for designing effective patient retention interventions. We analyzed factors contributing to children LTFU from a treatment program to identify those that can be modified. A case-control study involving 313 children was used to compare the sociodemographic and clinical characteristics of children LTFU (cases) with those remaining in care (controls) at a large pediatric HIV care setting in Botswana. We traced children through caregiver contacts and those we found, we conducted structured interviews with patients’ caregivers. Children < 5 years were nearly twice as likely as older children to be LTFU (57·8% versus 30·9%, p<0·01). Approximately half (47·6%, n=51) of LTFU patients failed to further engage in care after just one clinic visit, as compared to less than 1% (n=2) in the control group (p<0·01). Children LTFU were more likely than controls to have advanced disease, greater immunosuppression, and not to be receiving ART. Among interviewed patient caregivers, psychosocial factors (e.g. stigma, religious beliefs, child rebellion, disclosure of HIV status) were characteristic of patients LTFU, but not of controls. Socioeconomic factors (e.g. lack of transportation, school-related activities, forgetting appointments) were cited predominantly by the controls. Pediatric patients and their caregivers need to be targeted and engaged at their initial clinic visit, with special attention to children <5 years. Possible interventions include providing psychosocial support for issues that deter patients from engaging with the clinic. Collaboration with community-based organizations focused on reducing stigma may be useful in addressing these complex issues. PMID:27160542

Pilot study: evaluation of the use of the convergent interview technique in understanding the perception of surgical design and simulation.

PubMed

Logan, Heather; Wolfaardt, Johan; Boulanger, Pierre; Hodgetts, Bill; Seikaly, Hadi

2013-06-19

It is important to understand the perceived value of surgical design and simulation (SDS) amongst surgeons, as this will influence its implementation in clinical settings. The purpose of the present study was to examine the application of the convergent interview technique in the field of surgical design and simulation and evaluate whether the technique would uncover new perceptions of virtual surgical planning (VSP) and medical models not discovered by other qualitative case-based techniques. Five surgeons were asked to participate in the study. Each participant was interviewed following the convergent interview technique. After each interview, the interviewer interpreted the information by seeking agreements and disagreements among the interviewees in order to understand the key concepts in the field of SDS. Fifteen important issues were extracted from the convergent interviews. In general, the convergent interview was an effective technique in collecting information about the perception of clinicians. The study identified three areas where the technique could be improved upon for future studies in the SDS field.

Pilot study: evaluation of the use of the convergent interview technique in understanding the perception of surgical design and simulation

PubMed Central

2013-01-01

Background It is important to understand the perceived value of surgical design and simulation (SDS) amongst surgeons, as this will influence its implementation in clinical settings. The purpose of the present study was to examine the application of the convergent interview technique in the field of surgical design and simulation and evaluate whether the technique would uncover new perceptions of virtual surgical planning (VSP) and medical models not discovered by other qualitative case-based techniques. Methods Five surgeons were asked to participate in the study. Each participant was interviewed following the convergent interview technique. After each interview, the interviewer interpreted the information by seeking agreements and disagreements among the interviewees in order to understand the key concepts in the field of SDS. Results Fifteen important issues were extracted from the convergent interviews. Conclusion In general, the convergent interview was an effective technique in collecting information about the perception of clinicians. The study identified three areas where the technique could be improved upon for future studies in the SDS field. PMID:23782771

Creating an Institutional Identity out of "Differences": A Case Study of Multicultural Organizational Change.

ERIC Educational Resources Information Center

Bensimon, Estela Mara

This case study examines the efforts of one small private liberal arts college to exchange a monocultural organizational structure for one that is grounded in the racial, ethnic, and cultural diversity of the student body. The paper is based on interviews with faculty, administrators, students, and trustees and provides a detailed description of…

Design Principles for the Blend in Blended Learning: A Collective Case Study

ERIC Educational Resources Information Center

Lai, Ming; Lam, Kwok Man; Lim, Cher Ping

2016-01-01

This paper reports on a collective case study of three blended courses taught by different instructors in a higher education institution, with the purpose of identifying the different types of blend and how the blend supports student learning. Based on the instructors' and students' interviews, and document analysis of course outlines, two major…

Neo-Democracy in Educational Policy-Making: A Critical Case Study of Neoliberal Reform in Massachusetts

ERIC Educational Resources Information Center

Piazza, Peter

2017-01-01

This paper explores changes to the educational policy-making arena through case study analysis of a Massachusetts law passed in 2012 that limits seniority-based job protections for public K-12 teachers. I use data from interviews with policy stakeholders, observations of public meetings, and policy artifacts to explore struggles over democratic…

Nitrate in drinking water and bladder cancer risk in Spain.

PubMed

Espejo-Herrera, Nadia; Cantor, Kenneth P; Malats, Nuria; Silverman, Debra T; Tardón, Adonina; García-Closas, Reina; Serra, Consol; Kogevinas, Manolis; Villanueva, Cristina M

2015-02-01

Nitrate is a widespread contaminant in drinking water and ingested nitrate under conditions resulting in endogenous nitrosation is suspected to be carcinogenic. However, the suggested association between nitrate in drinking water and bladder cancer remains inconsistent. We evaluated the long-term exposure to drinking water nitrate as a risk factor for bladder cancer, considering endogenous nitrosation modifiers and other covariables. We conducted a hospital-based case-control study of bladder cancer in Spain (1998-2001). Residential histories and water consumption information were ascertained through personal interviews. Historical nitrate levels (1940-2000) were estimated in study municipalities based on monitoring records and water source. Residential histories of study subjects were linked with nitrate estimates by year and municipality to calculate individual exposure from age 18 to recruitment. We calculated odds ratios (OR) and 95% confidence intervals (CI) for bladder cancer among 531 cases and 556 controls with reliable interviews and nitrate exposure information covering at least 70% of years from age 18 to interview. Average residential levels ranged from 2.1mg/L to 12.0mg/L among regions. Adjusted OR (95%CI) for average residential levels relative to ≤ 5 mg/L were 1.2 (0.7-2.0) for >5-10mg/L and 1.1 (0.6-1.9) for >10mg/L. The OR for subjects with longest exposure duration (>20 years) to highest levels (>9.5mg/L) was 1.4 (0.9-2.3). Stratification by intake of vitamin C, vitamin E, meat, and gastric ulcer diagnosis did not modify these results. A non-significant negative association was found with waterborne ingested nitrate with an OR of 0.7 (0.4-1.0) for >8 vs. ≤ 4 mg/day. Adjustment for several covariables showed similar results to crude analyses. Bladder cancer risk was inconsistently associated with chronic exposure to drinking water nitrate at levels below the current regulatory limit. Elevated risk is suggested only among subjects with longest exposure duration to the highest levels. No evidence of interaction with endogenous nitrosation modifiers was observed. Copyright © 2014 Elsevier Inc. All rights reserved.

The 10/66 Dementia Research Group's fully operationalised DSM-IV dementia computerized diagnostic algorithm, compared with the 10/66 dementia algorithm and a clinician diagnosis: a population validation study

PubMed Central

Prince, Martin J; de Rodriguez, Juan Llibre; Noriega, L; Lopez, A; Acosta, Daisy; Albanese, Emiliano; Arizaga, Raul; Copeland, John RM; Dewey, Michael; Ferri, Cleusa P; Guerra, Mariella; Huang, Yueqin; Jacob, KS; Krishnamoorthy, ES; McKeigue, Paul; Sousa, Renata; Stewart, Robert J; Salas, Aquiles; Sosa, Ana Luisa; Uwakwa, Richard

2008-01-01

Background The criterion for dementia implicit in DSM-IV is widely used in research but not fully operationalised. The 10/66 Dementia Research Group sought to do this using assessments from their one phase dementia diagnostic research interview, and to validate the resulting algorithm in a population-based study in Cuba. Methods The criterion was operationalised as a computerised algorithm, applying clinical principles, based upon the 10/66 cognitive tests, clinical interview and informant reports; the Community Screening Instrument for Dementia, the CERAD 10 word list learning and animal naming tests, the Geriatric Mental State, and the History and Aetiology Schedule – Dementia Diagnosis and Subtype. This was validated in Cuba against a local clinician DSM-IV diagnosis and the 10/66 dementia diagnosis (originally calibrated probabilistically against clinician DSM-IV diagnoses in the 10/66 pilot study). Results The DSM-IV sub-criteria were plausibly distributed among clinically diagnosed dementia cases and controls. The clinician diagnoses agreed better with 10/66 dementia diagnosis than with the more conservative computerized DSM-IV algorithm. The DSM-IV algorithm was particularly likely to miss less severe dementia cases. Those with a 10/66 dementia diagnosis who did not meet the DSM-IV criterion were less cognitively and functionally impaired compared with the DSMIV confirmed cases, but still grossly impaired compared with those free of dementia. Conclusion The DSM-IV criterion, strictly applied, defines a narrow category of unambiguous dementia characterized by marked impairment. It may be specific but incompletely sensitive to clinically relevant cases. The 10/66 dementia diagnosis defines a broader category that may be more sensitive, identifying genuine cases beyond those defined by our DSM-IV algorithm, with relevance to the estimation of the population burden of this disorder. PMID:18577205

Passive Smoking and Breast Cancer Risk among Non-Smoking Women: A Case-Control Study in China.

PubMed

Li, Bin; Wang, Lian; Lu, Min-Shan; Mo, Xiong-Fei; Lin, Fang-Yu; Ho, Suzanne C; Zhang, Cai-Xia

2015-01-01

The role of passive smoking on breast cancer risk was unclear. This study aimed to evaluate the association between passive smoking and breast cancer risk among Chinese women. A hospital-based case-control study, including 877 breast cancer cases and 890 controls, frequency-matched by age and residence, was conducted. A structured questionnaire was used to collect information on passive smoking history through face-to-face interview by trained interviewers. Unconditional logistic regression models were used to estimate the association between passive smoking and breast cancer risk. A positive association between any passive smoking exposure and breast cancer risk was observed. Compared with women who were never exposed to passive smoking, women who were ever exposed had a higher breast cancer risk, with the adjusted odds ratio (OR) and 95% confidence interval (CI) of 1.35 (1.11-1.65). Similar result was found on home passive smoking exposure and breast cancer risk, but not on workplace passive smoking exposure. Women who were ever exposed to tobacco smoke at home had a higher risk of breast cancer compared with never exposed women, with the adjusted OR (95% CI) of 1.30 (1.05-1.61). Home passive smoking exposure showed significant dose-response relationships with breast cancer risk in smoker-years, cigarettes/day and total pack-years (Ptrend=0.003, 0.006 and 0.009, respectively). An increased total smoker-years of any passive exposure significantly elevated the risk of breast cancer (Ptrend<0.001). Positive associations and dose-response relationships were found among postmenopausal women and all subtypes of estrogen receptor (ER) and progesterone receptor (PR) status of breast cancer. Passive smoking was associated with an increased risk of breast cancer among non-smoking Chinese women. A stronger positive association with breast cancer risk was seen mainly among postmenopausal women.

Passive Smoking and Breast Cancer Risk among Non-Smoking Women: A Case-Control Study in China

PubMed Central

Li, Bin; Wang, Lian; Lu, Min-Shan; Mo, Xiong-Fei; Lin, Fang-Yu; Ho, Suzanne C.; Zhang, Cai-Xia

2015-01-01

Background The role of passive smoking on breast cancer risk was unclear. This study aimed to evaluate the association between passive smoking and breast cancer risk among Chinese women. Methods/Principal Findings A hospital-based case-control study, including 877 breast cancer cases and 890 controls, frequency-matched by age and residence, was conducted. A structured questionnaire was used to collect information on passive smoking history through face-to-face interview by trained interviewers. Unconditional logistic regression models were used to estimate the association between passive smoking and breast cancer risk. A positive association between any passive smoking exposure and breast cancer risk was observed. Compared with women who were never exposed to passive smoking, women who were ever exposed had a higher breast cancer risk, with the adjusted odds ratio (OR) and 95% confidence interval (CI) of 1.35 (1.11-1.65). Similar result was found on home passive smoking exposure and breast cancer risk, but not on workplace passive smoking exposure. Women who were ever exposed to tobacco smoke at home had a higher risk of breast cancer compared with never exposed women, with the adjusted OR (95% CI) of 1.30 (1.05-1.61). Home passive smoking exposure showed significant dose-response relationships with breast cancer risk in smoker-years, cigarettes/day and total pack-years (P trend=0.003, 0.006 and 0.009, respectively). An increased total smoker-years of any passive exposure significantly elevated the risk of breast cancer (P trend<0.001). Positive associations and dose-response relationships were found among postmenopausal women and all subtypes of estrogen receptor (ER) and progesterone receptor (PR) status of breast cancer. Conclusions Passive smoking was associated with an increased risk of breast cancer among non-smoking Chinese women. A stronger positive association with breast cancer risk was seen mainly among postmenopausal women. PMID:25915759

Enterprise architecture availability analysis using fault trees and stakeholder interviews

NASA Astrophysics Data System (ADS)

Närman, Per; Franke, Ulrik; König, Johan; Buschle, Markus; Ekstedt, Mathias

2014-01-01

The availability of enterprise information systems is a key concern for many organisations. This article describes a method for availability analysis based on Fault Tree Analysis and constructs from the ArchiMate enterprise architecture (EA) language. To test the quality of the method, several case-studies within the banking and electrical utility industries were performed. Input data were collected through stakeholder interviews. The results from the case studies were compared with availability of log data to determine the accuracy of the method's predictions. In the five cases where accurate log data were available, the yearly downtime estimates were within eight hours from the actual downtimes. The cost of performing the analysis was low; no case study required more than 20 man-hours of work, making the method ideal for practitioners with an interest in obtaining rapid availability estimates of their enterprise information systems.

Predictors of provider- initiated HIV testing and counseling refusal by outpatient department clients in Wolaita zone, Southern Ethiopia: a case control study.

PubMed

Facha, Wolde; Kassahun, Wondewosen; Workicho, Abdulhalik

2016-08-12

Despite different strategies designed to rapidly identify HIV infected individuals, majority of HIV-infected people are unaware of their sero-status in developing countries. The objective of this study was to assess predictors of provider-initiated HIV testing and counseling (PITC) refusal by outpatient department (OPD) clients in Wolaita zone, Southern Ethiopia. Facility based unmatched case control study was conducted on outpatient department clients in randomly selected seven health facilities in Wolaita zone, Southern Ethiopia in February 2012. A total of 291 participants (97 cases and 194 controls) were included in our study. Cases were patients who refused HIV test while controls were patients who tested for HIV after provider-initiated HIV testing and counseling (PITC) recommendation by outpatient department (OPD) clinicians. We used both quantitative and qualitative methods of data collection. Pretested interviewer administered questionnaires were used to collect quantitative data by trained nurses, and in-depth interview with 14 OPD clinicians was conducted by principal investigator to supplement quantitative findings. Bivariate and multivariate analyses were done to identify independent predictors of provider-initiated HIV testing and counseling refusal by OPD clients. Study participants who had stigmatizing attitude [AOR = 6.09, (95 % CI: 1.70, 21.76)], who had perceived risk for HIV infection [AOR = 5.23, (95 % CI: 2.22, 12.32)], who did not perceive the benefits of provider-initiated HIV testing and counseling [AOR = 4.64, (95 % CI: 1.79, 12.01)], who did not get minimum recommended pretest information from their providers [AOR = 2.98, (95 % CI: 1.06, 8.35)], who ever not heard of provider-initiated HIV testing and counseling service [AOR = 2.41, (95 % CI: 1.14, 5.09)], and who were from urban area [AOR = 2.40, (95 % CI = 1.26, 4.57)] were more likely to refuse provider-initiated HIV testing and counseling service than their counterparts. Knowledge on HIV/AIDS, attitude towards people living with HIV/AIDS and perceived risk for HIV infection by clients were the major barriers for provider-initiated HIV testing and counseling acceptance. Health professionals working at outpatient department should give due attention to overcome these barriers so as to enhance HIV testing acceptance by their clients.

Disrespect, harassment, and abuse: all in a day's work for family physicians.

PubMed

Miedema, Baukje; Easley, Julie; Fortin, Pierrette; Hamilton, Ryan; Tatemichi, Sue

2009-03-01

To examine harassment and abusive encounters between family physicians and their patients or colleagues in the workplace. Qualitative case study using semistructured interviews. Province of New Brunswick. Forty-eight family physicians from across the province. A collective case-study approach was developed, with 24 cases of 2 individuals per case. Cases were selected based on sex, location (urban or rural), language (French or English), and number of years since medical school graduation (< 10 years, 10 to 20 years, or > 20 years). Physicians were interviewed in either French or English. Participants were recruited using the College of Physicians and Surgeons of New Brunswick's physician directory. Based on the rates of response and participation, some cases were overrepresented, while others were not completed. All interviews were audiotaped, transcribed verbatim, and analyzed thematically using a categorical aggregation approach. A coding scheme for the thematic analysis was developed by the research team before the interviews were transcribed. Although the original intent of this study was to examine the work environment of family physicians in light of the increasing number of women entering the profession, harassment and abusive encounters in the workplace emerged as a main theme. These encounters ranged from minor to severe. Minor abusive encounters included disrespectful behaviour and verbal threats by patients, their families, and occasionally colleagues. More severe forms of harassment involved physical threats, physical encounters, and stalking. Demanding patients, such as heavy drug users, were often seen as threatening. Location of practice, years in practice, and sex of the physician seemed to affect abusive encounters--young, female, rural physicians appeared to experience such encounters most often. Abusive encounters in the workplace are concerning. It is essential to address these issues of workplace harassment and abuse in order to protect physician safety and avoid workplace dissatisfaction. Abusive encounters might push family physicians to leave clinical practice prematurely or refuse to work in higher-risk environments, such as emergency departments or rural areas.

Disrespect, harassment, and abuse

PubMed Central

Miedema, Baukje; Easley, Julie; Fortin, Pierrette; Hamilton, Ryan; Tatemichi, Sue

2009-01-01

ABSTRACT OBJECTIVE To examine harassment and abusive encounters between family physicians and their patients or colleagues in the workplace. DESIGN Qualitative case study using semistructured interviews. SETTING Province of New Brunswick. PARTICIPANTS Forty-eight family physicians from across the province. METHODS A collective case-study approach was developed, with 24 cases of 2 individuals per case. Cases were selected based on sex, location (urban or rural), language (French or English), and number of years since medical school graduation (< 10 years, 10 to 20 years, or > 20 years). Physicians were interviewed in either French or English. Participants were recruited using the College of Physicians and Surgeons of New Brunswick’s physician directory. Based on the rates of response and participation, some cases were overrepresented, while others were not completed. All interviews were audiotaped, transcribed verbatim, and analyzed thematically using a categorical aggregation approach. A coding scheme for the thematic analysis was developed by the research team before the interviews were transcribed. MAIN FINDINGS Although the original intent of this study was to examine the work environment of family physicians in light of the increasing number of women entering the profession, harassment and abusive encounters in the workplace emerged as a main theme. These encounters ranged from minor to severe. Minor abusive encounters included disrespectful behaviour and verbal threats by patients, their families, and occasionally colleagues. More severe forms of harassment involved physical threats, physical encounters, and stalking. Demanding patients, such as heavy drug users, were often seen as threatening. Location of practice, years in practice, and sex of the physician seemed to affect abusive encounters—young, female, rural physicians appeared to experience such encounters most often. CONCLUSION Abusive encounters in the workplace are concerning. It is essential to address these issues of workplace harassment and abuse in order to protect physician safety and avoid workplace dissatisfaction. Abusive encounters might push family physicians to leave clinical practice prematurely or refuse to work in higher-risk environments, such as emergency departments or rural areas. PMID:19282539

Driver sleepiness and risk of motor vehicle crash injuries: a population-based case control study in Fiji (TRIP 12).

PubMed

Herman, Josephine; Kafoa, Berlin; Wainiqolo, Iris; Robinson, Elizabeth; McCaig, Eddie; Connor, Jennie; Jackson, Rod; Ameratunga, Shanthi

2014-03-01

Published studies investigating the role of driver sleepiness in road crashes in low and middle-income countries have largely focused on heavy vehicles. We investigated the contribution of driver sleepiness to four-wheel motor vehicle crashes in Fiji, a middle-income Pacific Island country. The population-based case control study included 131 motor vehicles involved in crashes where at least one person died or was hospitalised (cases) and 752 motor vehicles identified in roadside surveys (controls). An interviewer-administered questionnaire completed by drivers or proxies collected information on potential risks for crashes including sleepiness while driving, and factors that may influence the quantity or quality of sleep. Following adjustment for confounders, there was an almost six-fold increase in the odds of injury-involved crashes for vehicles driven by people who were not fully alert or sleepy (OR 5.7, 95%CI: 2.7, 12.3), or those who reported less than 6 h of sleep during the previous 24 h (OR 5.9, 95%CI: 1.7, 20.9). The population attributable risk for crashes associated with driving while not fully alert or sleepy was 34%, and driving after less than 6 h sleep in the previous 24 h was 9%. Driving by people reporting symptoms suggestive of obstructive sleep apnoea was not significantly associated with crash risk. Driver sleepiness is an important contributor to injury-involved four-wheel motor vehicle crashes in Fiji, highlighting the need for evidence-based strategies to address this poorly characterised risk factor for car crashes in less resourced settings. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Socio-economic status and lifestyle factors are associated with achalasia risk: A population-based case-control study

PubMed Central

Coleman, Helen G; Gray, Ronan T; Lau, Kar W; McCaughey, Conall; Coyle, Peter V; Murray, Liam J; Johnston, Brian T

2016-01-01

AIM: To evaluate the association between various lifestyle factors and achalasia risk. METHODS: A population-based case-control study was conducted in Northern Ireland, including n = 151 achalasia cases and n = 117 age- and sex-matched controls. Lifestyle factors were assessed via a face-to-face structured interview. The association between achalasia and lifestyle factors was assessed by unconditional logistic regression, to produce odds ratios (OR) and 95% confidence interval (CI). RESULTS: Individuals who had low-class occupations were at the highest risk of achalasia (OR = 1.88, 95%CI: 1.02-3.45), inferring that high-class occupation holders have a reduced risk of achalasia. A history of foreign travel, a lifestyle factor linked to upper socio-economic class, was also associated with a reduced risk of achalasia (OR = 0.59, 95%CI: 0.35-0.99). Smoking and alcohol consumption carried significantly reduced risks of achalasia, even after adjustment for socio-economic status. The presence of pets in the house was associated with a two-fold increased risk of achalasia (OR = 2.00, 95%CI: 1.17-3.42). No childhood household factors were associated with achalasia risk. CONCLUSION: Achalasia is a disease of inequality, and individuals from low socio-economic backgrounds are at highest risk. This does not appear to be due to corresponding alcohol and smoking behaviours. An observed positive association between pet ownership and achalasia risk suggests an interaction between endotoxin and viral infection exposure in achalasia aetiology. PMID:27099443

Integration of health technology assessment recommendations into organizational and clinical practice: A case study in Catalonia.

PubMed

Gagnon, Marie-Pierre; Sánchez, Emília; Pons, Joan M V

2006-01-01

Evaluating the impact of recommendations based upon health technology assessment (HTA) represents a challenge for both HTA agencies and healthcare policy makers. This research sought to understand factors affecting the uptake of HTA recommendations to support decision making with respect to the introduction of three health technologies. Using a multidimensional framework, based upon a combination of theoretical models, a case study was conducted. A total of twenty-eight semistructured interviews were done with physicians from fifteen hospitals and other stakeholders in Catalonia. Interview content was analyzed iteratively and classified according to theoretical dimensions and contextual factors. At the sociopolitical level, factors related to the organization and financing of the health system were found to affect the utilization of HTA recommendations. At the healthcare organization level, existing collaborations between the hospital and the HTA agency favored the integration of recommendations into practices. Formalism in the organization also influenced the utilization of HTA recommendations. At the professional level, the high degree of autonomy of specialists, the importance of peers and collegial control, and the definition of professional roles and responsibilities influenced physicians' willingness to integrate HTA recommendations into their practice. This study offers a comprehensive framework to understand the complex dynamics that affect adoption of health technologies in organizational and professional practices. The findings suggest some avenues to promote the integration of HTA recommendations into practices and, thus, increase the utilization of scientific evidence to support decision making in health care.

Mindfulness-based lifestyle programs for the self-management of Parkinson's disease in Australia.

PubMed

Vandenberg, Brooke E; Advocat, Jenny; Hassed, Craig; Hester, Jennifer; Enticott, Joanne; Russell, Grant

2018-04-11

Despite emerging evidence suggesting positive outcomes of mindfulness training for the self-management of other neurodegenerative diseases, limited research has explored its effect on the self-management of Parkinson's disease (PD). We aimed to characterize the experiences of individuals participating in a facilitated, group mindfulness-based lifestyle program for community living adults with Stage 2 PD and explore how the program influenced beliefs about self-management of their disease. Our longitudinal qualitative study was embedded within a randomized controlled trial exploring the impact of a 6-week mindfulness-based lifestyle program on patient-reported function. The study was set in Melbourne, Australia in 2012-2013. We conducted semi-structured interviews with participants before, immediately after, and 6 months following participation in the program. Sixteen participants were interviewed prior to commencing the program. Of these, 12 were interviewed shortly after its conclusion, and 9 interviewed at 6 months. Prior to the program, participants felt a lack of control over their illness. A desire for control and a need for alternative tools for managing the progression of PD motivated many to engage with the program. Following the program, where participants experienced an increase in mindfulness, many became more accepting of disease progression and reported improved social relationships and self-confidence in managing their disease. Mindfulness-based lifestyle programs have the potential for increasing both participants' sense of control over their reactions to disease symptoms as well as social connectedness. Community-based mindfulness training may provide participants with tools for self-managing a number of the consequences of Stage 2 PD.

Cellular phones, cordless phones, and the risks of glioma and meningioma (Interphone Study Group, Germany).

PubMed

Schüz, Joachim; Böhler, Eva; Berg, Gabriele; Schlehofer, Brigitte; Hettinger, Iris; Schlaefer, Klaus; Wahrendorf, Jürgen; Kunna-Grass, Katharina; Blettner, Maria

2006-03-15

The widespread use of cellular telephones has generated concern about possible adverse health effects, particularly brain tumors. In this population-based case-control study carried out in three regions of Germany, all incident cases of glioma and meningioma among patients aged 30-69 years were ascertained during 2000-2003. Controls matched on age, gender, and region were randomly drawn from population registries. In total, 366 glioma cases, 381 meningioma cases, and 1,494 controls were interviewed. Overall use of a cellular phone was not associated with brain tumor risk; the respective odds ratios were 0.98 (95% confidence interval (CI): 0.74, 1.29) for glioma and 0.84 (95% CI: 0.62, 1.13) for meningioma. Among persons who had used cellular phones for 10 or more years, increased risk was found for glioma (odds ratio = 2.20, 95% CI: 0.94, 5.11) but not for meningioma (odds ratio = 1.09, 95% CI: 0.35, 3.37). No excess of temporal glioma (p = 0.41) or meningioma (p = 0.43) was observed in cellular phone users as compared with nonusers. Cordless phone use was not related to either glioma risk or meningioma risk. In conclusion, no overall increased risk of glioma or meningioma was observed among these cellular phone users; however, for long-term cellular phone users, results need to be confirmed before firm conclusions can be drawn.

Evolving epidemiology of Nipah virus infection in Bangladesh: evidence from outbreaks during 2010–2011

PubMed Central

CHAKRABORTY, A.; SAZZAD, H. M. S.; HOSSAIN, M. J.; ISLAM, M. S.; PARVEEN, S.; HUSAIN, M.; BANU, S. S.; PODDER, G.; AFROJ, S.; ROLLIN, P. E.; DASZAK, P.; LUBY, S. P.; RAHMAN, M.; GURLEY, E. S.

2015-01-01

SUMMARY Drinking raw date palm sap is the primary route of Nipah virus (NiV) transmission from bats to people in Bangladesh; subsequent person-to-person transmission is common. During December 2010 to March 2011, we investigated NiV epidemiology by interviewing cases using structured questionnaires, in-depth interviews, and group discussions to collect clinical and exposure histories. We conducted a case-control study to identify risk factors for transmission. We identified 43 cases; 23 were laboratory-confirmed and 20 probable. Thirty-eight (88%) cases died. Drinking raw date palm sap and contact with an infected person were major risk factors; one healthcare worker was infected and for another case transmission apparently occurred through contact with a corpse. In absence of these risk factors, apparent routes of transmission included drinking fermented date palm sap. For the first time, a case was detected in eastern Bangladesh. Identification of new epidemiological characteristics emphasizes the importance of continued NiV surveillance and case investigation. PMID:26122675

Evolving epidemiology of Nipah virus infection in Bangladesh: evidence from outbreaks during 2010-2011.

PubMed

Chakraborty, A; Sazzad, H M S; Hossain, M J; Islam, M S; Parveen, S; Husain, M; Banu, S S; Podder, G; Afroj, S; Rollin, P E; Daszak, P; Luby, S P; Rahman, M; Gurley, E S

2016-01-01

Drinking raw date palm sap is the primary route of Nipah virus (NiV) transmission from bats to people in Bangladesh; subsequent person-to-person transmission is common. During December 2010 to March 2011, we investigated NiV epidemiology by interviewing cases using structured questionnaires, in-depth interviews, and group discussions to collect clinical and exposure histories. We conducted a case-control study to identify risk factors for transmission. We identified 43 cases; 23 were laboratory-confirmed and 20 probable. Thirty-eight (88%) cases died. Drinking raw date palm sap and contact with an infected person were major risk factors; one healthcare worker was infected and for another case transmission apparently occurred through contact with a corpse. In absence of these risk factors, apparent routes of transmission included drinking fermented date palm sap. For the first time, a case was detected in eastern Bangladesh. Identification of new epidemiological characteristics emphasizes the importance of continued NiV surveillance and case investigation.

Increased risk of malignant mesothelioma of the pleura after residential or domestic exposure to asbestos: a case-control study in Casale Monferrato, Italy.

PubMed Central

Magnani, C; Dalmasso, P; Biggeri, A; Ivaldi, C; Mirabelli, D; Terracini, B

2001-01-01

The association of malignant mesothelioma (MM) and nonoccupational asbestos exposure is currently debated. Our study investigates environmental and domestic asbestos exposure in the city where the largest Italian asbestos cement (AC) factory was located. This population-based case-control study included pleural MM (histologically diagnosed) incidents in the area in 1987-1993, matched by age and sex to two controls (four if younger than 60). Diagnoses were confirmed by a panel of five pathologists. We interviewed 102 cases and 273 controls in 1993-1995, out of 116 and 330 eligible subjects. Information was checked and completed on the basis of factory and Town Office files. We adjusted analyses for occupational exposure in the AC industry. In the town there were no other relevant industrial sources of asbestos exposure. Twenty-three cases and 20 controls lived with an AC worker [odds ratio (OR) = 4.5; 95% confidence interval (CI), 1.8-11.1)]. The risk was higher for the offspring of AC workers (OR = 7.4; 95% CI, 1.9-28.1). Subjects attending grammar school in Casale also showed an increased risk (OR = 3.3; 95% CI, 1.4-7.7). Living in Casale was associated with a very high risk (after selecting out AC workers: OR = 20.6; 95% CI, 6.2-68.6), with spatial trend with increasing distance from the AC factory. The present work confirms the association of environmental asbestos exposure and pleural MM, controlling for other sources of asbestos exposure, and suggests that environmental exposure caused a greater risk than domestic exposure. PMID:11673120

Dealing with chaos and complexity: the reality of interviewing children and families in their own homes.

PubMed

MacDonald, Kath; Greggans, Alison

2008-12-01

The aim of this paper is to share our experiences of dealing with chaos and complexity in interview situations in the home with children and young people. We highlight dilemmas relevant to dealing with multiple interruptions, building a rapport, consent and confidentiality. Furthermore, we discuss issues regarding the locus of power and control and offer some solutions based on our experiences. Creating a safe environment is essential for qualitative research. Participants are more likely to open up and communicate if they feel safe, comfortable and relaxed. We conclude that interviewing parents and their children with cystic fibrosis in their own homes, is chaotic and appears to threaten the rigour of data collection processes. Limited attention or print space is paid to this issue, with published articles frequently sanitising the messiness of real world qualitative research. Position paper. In this position paper, we use two case studies to illustrate ethical and pragmatic challenges of interviewing out in the field. These case studies, typical of families we encountered, help emphasise the concerns we had in balancing researcher-participant rapport with the quality of the research process. Dealing with perceived chaos is hard in reality, but capturing it is part of the complexity of qualitative enquiry. The context is interdependent with children's perceived reality, because they communicate with others through their environment. This paper gives researchers an insight into the tensions of operating out in the field and helps raise the importance of the environmental 'chaos' in revealing significant issues relevant to peoples daily lives. Knowing that unexpected chaos is part and parcel of qualitative research, will equip researchers with skills fundamental for balancing the well being of all those involved with the quality of the research process.

Cross-sectional survey of treatment practices for urethritis at pharmacies, private clinics and government health facilities in coastal Kenya: many missed opportunities for HIV prevention.

PubMed

Mugo, Peter M; Duncan, Sarah; Mwaniki, Samuel W; Thiong'o, Alexander N; Gichuru, Evanson; Okuku, Haile Selassie; van der Elst, Elise M; Smith, Adrian D; Graham, Susan M; Sanders, Eduard J

2013-11-01

While bacterial sexually transmitted infections (STIs) are important cofactors for HIV transmission, STI control has received little attention in recent years. The aim of this study was to assess STI treatment and HIV testing referral practices among health providers in Kenya. In 2011 we assessed quality of case management for male urethritis at pharmacies, private clinics and government health facilities in coastal Kenya using simulated visits at pharmacies and interviews at pharmacies and health facilities. Quality was assessed using Ministry of Health guidelines. Twenty (77%) of 26 pharmacies, 20 (91%) of 22 private clinics and all four government facilities in the study area took part. The median (IQR) number of adult urethritis cases per week was 5 (2-10) at pharmacies, 3 (1-3) at private clinics and 5 (2-17) at government facilities. During simulated visits, 10% of pharmacies prescribed recommended antibiotics at recommended dosages and durations and, during interviews, 28% of pharmacies and 27% of health facilities prescribed recommended antibiotics at recommended dosages and durations. Most regimens were quinolone-based. HIV testing was recommended during 10% of simulated visits, 20% of pharmacy interviews and 25% of health facility interviews. In an area of high STI burden, most men with urethritis seek care at pharmacies and private clinics. Most providers do not comply with national guidelines and very few recommend HIV testing. In order to reduce the STI burden and mitigate HIV transmission, there is an urgent need for innovative dissemination of up-to-date guidelines and inclusion of all health providers in HIV/STI programmes.

Maternal hypertension, medication use, and hypospadias in the National Birth Defects Prevention Study.

PubMed

Van Zutphen, Alissa R; Werler, Martha M; Browne, Marilyn M; Romitti, Paul A; Bell, Erin M; McNutt, Louise-Anne; Druschel, Charlotte M; Mitchell, Allen A

2014-02-01

To investigate whether antihypertensive classes and specific medications in early pregnancy increase the risk of severe hypospadias and to assess prior associations detected for late-treated and untreated hypertension in the National Birth Defects Prevention Study. Using telephone interviews from mothers of 2,131 children with severe hypospadias and 5,129 nonmalformed male control children for 1997-2009 births in a population-based case-control study, we estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs) with multivariable logistic regression. We adjusted P values to account for multiple testing. Forty-eight (2.3%) case and 70 (1.4%) control mothers reported early pregnancy antihypertensive treatment, 45 (2.1%) case and 31 (0.6%) control mothers reported late treatment, and 315 (14.8%) case and 394 (7.7%) control mothers reported untreated hypertension. Selective β-blockers, centrally acting agents, renin-angiotensin system-acting agents, diuretics, and specific medications, methyldopa and atenolol, were not associated with hypospadias. Nonselective β-blockers (adjusted OR 3.22, 95% CI 1.47-7.05) were associated with hypospadias; however, P values adjusted for multiple testing were not statistically significant. We confirmed prior findings for associations between hypospadias and untreated hypertension (adjusted OR 2.09, 95% CI 1.76-2.48) and late initiation of treatment (adjusted OR 3.98, 95% CI 2.41-6.55). The increased risks would translate to severe hypospadias prevalences of 11.5, 17.7, and 21.9 per 10,000 births for women with untreated hypertension, nonselective β-blocker use, and late initiation of treatment, respectively. Our study suggests a relationship between hypospadias and the severity of hypertension. II.

“I Wasted 3 Years, Thinking It’s Not a Problem”: Patient and Health System Delays in Diagnosis of Leprosy in India: A Mixed-Methods Study

PubMed Central

Govindarajulu, Srinivas; Isaakidis, Petros; Shewade, Hemant Deepak; Rokade, Vasudev; Singh, Rajbir; Kamble, Sanjeev

2017-01-01

Background Worldwide, leprosy is one of the major causes of preventable disability. India contributes to 60% of global leprosy burden. With increasing numbers of leprosy with grade 2 disability (visible disability) at diagnosis, we aimed to determine risk factors associated with grade 2 disability among new cases and explore patients and providers’ perspectives into reasons for late presentation. Methodology/Principal Findings This was an explanatory mixed-methods study where the quantitative component, a matched case-control design, was followed by a qualitative component. A total of 70 cases (grade 2 disability) and 140 controls (grade 0) matched for age and sex were randomly sampled from new patients registered between January 2013-January 2015 in three districts of Maharashtra (Mumbai, Thane and Amaravati) and interviewed using a structured close ended questionnaire. Eight public health care providers involved in leprosy care and 7 leprosy patients were purposively selected (maximum variation sampling) and interviewed using a structured open-ended interview schedule. Among cases, overall median (IQR) diagnosis delay in months was 17.9(7–30); patient and health system delay was 7(4–16.5) and 5.5(0.9–12.5) respectively; this was significantly higher than the delay in controls. Reasons for delayed presentation identified by the quantitative and qualitative data were: poor awareness of leprosy symptoms, first health care provider visited being private practitioners who were not aware about provision of free leprosy treatment at public health care facilities, reduced engagement and capacity of the general health care system in leprosy control. Conclusions Raising awareness in communities and health care providers regarding early leprosy symptoms, engagement of private health care provider in early leprosy diagnosis and increasing capacity of general health system staff, especially targeting high endemic areas that are hotspots for leprosy transmission may help in reducing diagnosis delays. PMID:28081131

"I Wasted 3 Years, Thinking It's Not a Problem": Patient and Health System Delays in Diagnosis of Leprosy in India: A Mixed-Methods Study.

PubMed

Muthuvel, Thirumugam; Govindarajulu, Srinivas; Isaakidis, Petros; Shewade, Hemant Deepak; Rokade, Vasudev; Singh, Rajbir; Kamble, Sanjeev

2017-01-01

Worldwide, leprosy is one of the major causes of preventable disability. India contributes to 60% of global leprosy burden. With increasing numbers of leprosy with grade 2 disability (visible disability) at diagnosis, we aimed to determine risk factors associated with grade 2 disability among new cases and explore patients and providers' perspectives into reasons for late presentation. This was an explanatory mixed-methods study where the quantitative component, a matched case-control design, was followed by a qualitative component. A total of 70 cases (grade 2 disability) and 140 controls (grade 0) matched for age and sex were randomly sampled from new patients registered between January 2013-January 2015 in three districts of Maharashtra (Mumbai, Thane and Amaravati) and interviewed using a structured close ended questionnaire. Eight public health care providers involved in leprosy care and 7 leprosy patients were purposively selected (maximum variation sampling) and interviewed using a structured open-ended interview schedule. Among cases, overall median (IQR) diagnosis delay in months was 17.9(7-30); patient and health system delay was 7(4-16.5) and 5.5(0.9-12.5) respectively; this was significantly higher than the delay in controls. Reasons for delayed presentation identified by the quantitative and qualitative data were: poor awareness of leprosy symptoms, first health care provider visited being private practitioners who were not aware about provision of free leprosy treatment at public health care facilities, reduced engagement and capacity of the general health care system in leprosy control. Raising awareness in communities and health care providers regarding early leprosy symptoms, engagement of private health care provider in early leprosy diagnosis and increasing capacity of general health system staff, especially targeting high endemic areas that are hotspots for leprosy transmission may help in reducing diagnosis delays.

Listening to a personal music player is associated with fewer but more serious injuries among snowboarders in a terrain park: a case-control study.

PubMed

Russell, Kelly; Meeuwisse, Willem; Nettel-Aguirre, Alberto; Emery, Carolyn A; Gushue, Shantel; Wishart, Jillian; Romanow, Nicole; Rowe, Brian H; Goulet, Claude; Hagel, Brent E

2015-01-01

Some snowboarders listen to music on a personal music player and the objective was to determine if listening to music was associated with injury in a terrain park. A case-control study was conducted at a terrain park in Alberta, Canada during the 2008-2009 and 2009-2010 winter seasons. Cases were snowboarders who were injured in the terrain park and presented to either the ski patrol and/or a nearby emergency department (ED). Demographic, environmental and injury characteristics were collected from standardised ski patrol Accident Report Forms, ED medical records and telephone interviews. Controls were uninjured snowboarders using the same terrain park and were interviewed as they approached the lift-line on randomly selected days and times. Multivariable logistic regression determined if listening to music was associated with the odds of snowboard injury. Overall, 333 injured cases and 1261 non-injured controls were enrolled; 69 (21%) cases and 425 (34%) controls were listening to music. Snowboarders listening to music had significantly lower odds of injury compared with those not listening to music (adjusted odds ratio (OR) 0.68; 95% CI 0.48 to 0.98). Snowboarders listening to music had significantly higher odds of presenting to the ED versus ski patrol only compared with those not listening to music (adjusted OR 2.09; 95% CI 1.07 to 4.05). While listening to music decreased the odds of any injury in the terrain park, it increased the odds of an injury resulting in ED presentation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Six ways problem-based learning cases can sabotage patient-centered medical education.

PubMed

MacLeod, Anna

2011-07-01

Problem-based learning (PBL) cases tell a story of a medical encounter; however, the version of the story is typically very biomedical in focus. The patient and her or his experience of the situation are rarely the focus of the case despite a prevalent discourse of patient-centeredness in contemporary medical education. This report describes a qualitative study that explored the question, "How does PBL teach medical students about what matters in medicine?" The qualitative study, culminating in 2008, involved three data collection strategies: (1) a discourse analysis of a set of PBL cases from 2005 to 2006, (2) observation of a PBL tutorial group, and (3) semistructured, in-depth, open-ended interviews with medical educators and medical students. In this report, using data gathered from 67 PBL cases, 26 hours of observation, and 14 interviews, the author describes six specific ways in which PBL cases-if not thoughtfully conceptualized and authored-can serve to overlook social considerations, thereby undermining a patient-centered approach. These comprise the detective case, the shape-shifting patient, the voiceless PBL person, the joke name, the disembodied PBL person, and the stereotypical PBL person. PBL cases constitute an important component of undergraduate medical education. Thoughtful authoring of PBL cases has the potential to reinforce, rather than undermine, principles of patient-centeredness.

Dietary factors and gastric cancer risk. A case-control study in Spain.

PubMed

Ramón, J M; Serra, L; Cerdó, C; Oromí, J

1993-03-01

Evidence supports that gastric cancer has an environmental etiology, of which diet appears to be the most important component. The authors examined the effect of diet on the risk of gastric cancer. A case-control study of dietary factors and gastric cancer was conducted between September 1986 and March 1989 in the Barcelona metropolitan area, Spain. One hundred seventeen cases with histologically confirmed diagnosis of gastric adenocarcinoma were matched by age, gender, and whether they possessed a telephone to 234 community controls. One hundred eighty-eight (80.3%) controls were selected by random-digit telephone dialing and 46 (19.7%) by neighborhood of residence. Information about frequency and amount of consumption of 89 food items in one year was gathered by using a questionnaire, and cases and controls were interviewed in their homes by trained interviewers. Unconditional logistic regression was used for the analysis. Gastric cancer risk rose with increasing intake of smoked and pickled foods (OR 3.67 for upper tertile) and salt (OR 2.11 for upper quartile). Intake of citrus fruits (OR 0.47 for upper tertile) and raw-green vegetables (OR 0.56 for upper quartile) appeared to be protective. Gastric cancer risk was not associated with intake of cereals, rice, total vegetables, and fruits as a whole. These data suggest that high intake of salt and smoked and pickled food may be associated with a high risk of gastric cancer, and this association could be due to intragastric formation of nitrosamines. The negative association with citric and green vegetables consumption to be associated with the inhibition of nitrosation process.

Comparison of electronic data capture (EDC) with the standard data capture method for clinical trial data.

PubMed

Walther, Brigitte; Hossin, Safayet; Townend, John; Abernethy, Neil; Parker, David; Jeffries, David

2011-01-01

Traditionally, clinical research studies rely on collecting data with case report forms, which are subsequently entered into a database to create electronic records. Although well established, this method is time-consuming and error-prone. This study compares four electronic data capture (EDC) methods with the conventional approach with respect to duration of data capture and accuracy. It was performed in a West African setting, where clinical trials involve data collection from urban, rural and often remote locations. Three types of commonly available EDC tools were assessed in face-to-face interviews; netbook, PDA, and tablet PC. EDC performance during telephone interviews via mobile phone was evaluated as a fourth method. The Graeco Latin square study design allowed comparison of all four methods to standard paper-based recording followed by data double entry while controlling simultaneously for possible confounding factors such as interview order, interviewer and interviewee. Over a study period of three weeks the error rates decreased considerably for all EDC methods. In the last week of the study the data accuracy for the netbook (5.1%, CI95%: 3.5-7.2%) and the tablet PC (5.2%, CI95%: 3.7-7.4%) was not significantly different from the accuracy of the conventional paper-based method (3.6%, CI95%: 2.2-5.5%), but error rates for the PDA (7.9%, CI95%: 6.0-10.5%) and telephone (6.3%, CI95% 4.6-8.6%) remained significantly higher. While EDC-interviews take slightly longer, data become readily available after download, making EDC more time effective. Free text and date fields were associated with higher error rates than numerical, single select and skip fields. EDC solutions have the potential to produce similar data accuracy compared to paper-based methods. Given the considerable reduction in the time from data collection to database lock, EDC holds the promise to reduce research-associated costs. However, the successful implementation of EDC requires adjustment of work processes and reallocation of resources.

Comparison of Electronic Data Capture (EDC) with the Standard Data Capture Method for Clinical Trial Data

PubMed Central

Walther, Brigitte; Hossin, Safayet; Townend, John; Abernethy, Neil; Parker, David; Jeffries, David

2011-01-01

Background Traditionally, clinical research studies rely on collecting data with case report forms, which are subsequently entered into a database to create electronic records. Although well established, this method is time-consuming and error-prone. This study compares four electronic data capture (EDC) methods with the conventional approach with respect to duration of data capture and accuracy. It was performed in a West African setting, where clinical trials involve data collection from urban, rural and often remote locations. Methodology/Principal Findings Three types of commonly available EDC tools were assessed in face-to-face interviews; netbook, PDA, and tablet PC. EDC performance during telephone interviews via mobile phone was evaluated as a fourth method. The Graeco Latin square study design allowed comparison of all four methods to standard paper-based recording followed by data double entry while controlling simultaneously for possible confounding factors such as interview order, interviewer and interviewee. Over a study period of three weeks the error rates decreased considerably for all EDC methods. In the last week of the study the data accuracy for the netbook (5.1%, CI95%: 3.5–7.2%) and the tablet PC (5.2%, CI95%: 3.7–7.4%) was not significantly different from the accuracy of the conventional paper-based method (3.6%, CI95%: 2.2–5.5%), but error rates for the PDA (7.9%, CI95%: 6.0–10.5%) and telephone (6.3%, CI95% 4.6–8.6%) remained significantly higher. While EDC-interviews take slightly longer, data become readily available after download, making EDC more time effective. Free text and date fields were associated with higher error rates than numerical, single select and skip fields. Conclusions EDC solutions have the potential to produce similar data accuracy compared to paper-based methods. Given the considerable reduction in the time from data collection to database lock, EDC holds the promise to reduce research-associated costs. However, the successful implementation of EDC requires adjustment of work processes and reallocation of resources. PMID:21966505

Virtual reality job interview training and 6-month employment outcomes for individuals with schizophrenia seeking employment.

PubMed

Smith, Matthew J; Fleming, Michael F; Wright, Michael A; Roberts, Andrea G; Humm, Laura Boteler; Olsen, Dale; Bell, Morris D

2015-08-01

Individuals with schizophrenia have low employment rates and the job interview presents a critical barrier for them to obtain employment. Virtual reality training has demonstrated efficacy at improving interview skills and employment outcomes among multiple clinical populations. However, the effects of this training on individuals with schizophrenia are unknown. This study evaluated the efficacy of virtual reality job interview training (VR-JIT) at improving job interview skills and employment outcomes among individuals with schizophrenia in a small randomized controlled trial (n=21 VR-JIT trainees, n=11 waitlist controls). Trainees completed up to 10h of virtual interviews using VR-JIT, while controls received services as usual. Primary outcome measures included two pre-test and two post-test video-recorded role-play interviews scored by blinded raters with expertise in human resources and self-reported interviewing self-confidence. Six-month follow-up data on employment outcomes were collected. Trainees reported that the intervention was easy-to-use, helpful, and prepared them for future interviews. Trainees demonstrated increased role-play scores between pre-test and post-test while controls did not (p=0.001). After accounting for neurocognition and months since prior employment, trainees had greater odds of receiving a job offer by 6month follow-up compared to controls (OR: 8.73, p=0.04) and more training was associated with fewer weeks until receiving a job offer (r=-0.63, p<0.001). Results suggest that VR-JIT is acceptable to trainees and may be efficacious for improving job interview skills in individuals with schizophrenia. Moreover, trainees had greater odds of receiving a job offer by 6-month follow-up. Future studies could evaluate the effectiveness of VR-JIT within community-based services. Copyright © 2015 Elsevier B.V. All rights reserved.

A Tale of Two Methods: Chart and Interview Methods for Identifying Delirium

PubMed Central

Saczynski, Jane S.; Kosar, Cyrus M.; Xu, Guoquan; Puelle, Margaret R.; Schmitt, Eva; Jones, Richard N.; Marcantonio, Edward R.; Wong, Bonnie; Isaza, Ilean; Inouye, Sharon K.

2014-01-01

Background Interview and chart-based methods for identifying delirium have been validated. However, relative strengths and limitations of each method have not been described, nor has a combined approach (using both interviews and chart), been systematically examined. Objectives To compare chart and interview-based methods for identification of delirium. Design, Setting and Participants Participants were 300 patients aged 70+ undergoing major elective surgery (majority were orthopedic surgery) interviewed daily during hospitalization for delirium using the Confusion Assessment Method (CAM; interview-based method) and whose medical charts were reviewed for delirium using a validated chart-review method (chart-based method). We examined rate of agreement on the two methods and patient characteristics of those identified using each approach. Predictive validity for clinical outcomes (length of stay, postoperative complications, discharge disposition) was compared. In the absence of a gold-standard, predictive value could not be calculated. Results The cumulative incidence of delirium was 23% (n= 68) by the interview-based method, 12% (n=35) by the chart-based method and 27% (n=82) by the combined approach. Overall agreement was 80%; kappa was 0.30. The methods differed in detection of psychomotor features and time of onset. The chart-based method missed delirium in CAM-identified patients laacking features of psychomotor agitation or inappropriate behavior. The CAM-based method missed chart-identified cases occurring during the night shift. The combined method had high predictive validity for all clinical outcomes. Conclusions Interview and chart-based methods have specific strengths for identification of delirium. A combined approach captures the largest number and the broadest range of delirium cases. PMID:24512042

What to give the patient who has everything? A qualitative study of prescribing for multimorbidity in primary care.

PubMed

Sinnott, Carol; Hugh, Sheena Mc; Boyce, Maria B; Bradley, Colin P

2015-03-01

Using clinical guidelines in the management of patients with multimorbidity can lead to the prescription of multiple and sometimes conflicting medications. To explore how GPs make decisions when prescribing for multimorbid patients, with a view to informing intervention design. In-depth qualitative interviews incorporating chart-stimulated recall with purposively sampled GPs in the Republic of Ireland. Grounded theory analysis with iterative theory development. Twenty GPs were interviewed about 51 multimorbid cases. In these cases, GPs integrated information from multiple sources including the patient, specialists, and evidence-based medicine. Difficulties arose when recommendations or preferences conflicted, to which GPs responded by 'satisficing': accepting care that they deemed satisfactory and sufficient for a particular patient. Satisficing was manifest as relaxing targets for disease control, negotiating compromise with the patient, or making 'best guesses' about the most appropriate course of action to take. In multimorbid patients perceived as stable, GPs preferred to 'maintain the status quo' rather than rationalise medications, even in cases with significant polypharmacy. Proactive changes in medications were facilitated by continuity of care, sufficient consultation time, and open lines of communication with the patient, other healthcare professionals, and other GPs. GPs respond to conflicts in the management of multimorbid patients by making compromises between patient-centred and evidence-based care. These findings will be used to inform interventions that aim to care in multimorbidity. © British Journal of General Practice 2015.

Outbreak of Salmonella enterica serotype I 4,5,12:i:- infections: the challenges of hypothesis generation and microwave cooking.

PubMed

Mody, R K; Meyer, S; Trees, E; White, P L; Nguyen, T; Sowadsky, R; Henao, O L; Lafon, P C; Austin, J; Azzam, I; Griffin, P M; Tauxe, R V; Smith, K; Williams, I T

2014-05-01

We investigated an outbreak of 396 Salmonella enterica serotype I 4,5,12:i:- infections to determine the source. After 7 weeks of extensive hypothesis-generation interviews, no refined hypothesis was formed. Nevertheless, a case-control study was initiated. Subsequently, an iterative hypothesis-generation approach used by a single interviewing team identified brand A not-ready-to-eat frozen pot pies as a likely vehicle. The case-control study, modified to assess this new hypothesis, along with product testing indicated that the turkey variety of pot pies was responsible. Review of product labels identified inconsistent language regarding preparation, and the cooking instructions included undefined microwave wattage categories. Surveys found that most patients did not follow the product's cooking instructions and did not know their oven's wattage. The manufacturer voluntarily recalled pot pies and improved the product's cooking instructions. This investigation highlights the value of careful hypothesis-generation and the risks posed by frozen not-ready-to-eat microwavable foods.

International public health research involving interpreters: a case study from Bangladesh

PubMed Central

Pitchforth, Emma; van Teijlingen, Edwin

2005-01-01

Background Cross-cultural and international research are important components of public health research, but the challenges of language barriers and working with interpreters are often overlooked, particularly in the case of qualitative research. Methods A case-study approach was used to explore experiences of working with an interpreter in Bangladesh as part of a research project investigating women's experiences of emergency obstetric care. The case study Data from the researcher's field notes provided evidence of experiences in working with an interpreter and show how the model of interviewing was adapted over time to give a more active role to the interpreter. The advantages of a more active role were increased rapport and "flow" in interviews. The disadvantages included reduced control from the researcher's perspective. Some tensions between the researcher and interpreter remained hard to overcome, irrespective of the model used. Independent transcription and translation of the interviews also raised questions around accuracy in translation. Conclusion The issues examined in this case study have broader implications for public health research. Further work is needed in three areas: 1) developing effective relationships with interpreters; 2) the impact of the interpreter on the research process; and 3) the accuracy of the translation and level of analysis needed in any specific public health research. Finally, this paper highlights the importance to authors of reflecting on the potential impact of translation and interpretation on the research process when disseminating their research. PMID:15985161

Ovarian cysts and breast cancer: results from the Women's Contraceptive and Reproductive Experiences Study.

PubMed

Knight, Julia A; Lesosky, Maia; Blackmore, Kristina M; Voigt, Lynda F; Holt, Victoria L; Bernstein, Leslie; Marchbanks, Polly A; Burkman, Ronald T; Daling, Janet R; Whittemore, Alice S

2008-05-01

A diagnosis of ovarian cysts is likely an indicator of hormonal milieu and thus may be related to breast cancer risk. Recent studies have reported an inverse relationship between prior ovarian cyst diagnosis and breast cancer risk. We evaluated this relationship in the Women's Contraceptive and Reproductive Experiences (CARE) Study, a population-based case-control study conducted in Atlanta, Detroit, Philadelphia, Los Angeles, and Seattle. Cases had first primary invasive breast cancer diagnosed between 1994 and 1998 at ages 35-64 years. African American women were over-sampled. Controls were identified through random digit dialling and were frequency matched to cases on centre, race, and five-year age group. A total of 4575 cases and 4682 controls were interviewed. We used unconditional logistic regression adjusted for age and study centre within racial groups to estimate the odds ratio (OR) and 95% confidence interval (CI) for the relationship between prior ovarian cysts and breast cancer. Ovarian cyst diagnosis was associated with a significantly reduced risk among Caucasians (OR=0.85, 95% CI 0.76-0.96) and among African Americans (OR=0.68, 95% CI 0.57-0.81). The association in Caucasians was not significant within subgroups defined by menopausal status, hormone use, or gynecological surgery while the OR estimates in African Americans were consistently lower and frequently significant. These data are consistent with the previously reported inverse association between ovarian cysts and breast cancer, but the evidence for a relationship was stronger in African Americans than Caucasians. Additional studies are required to determine the specific cyst type(s) responsible for the observed relationship.

Culture, risk factors and suicide in rural China: a psychological autopsy case control study.

PubMed

Zhang, J; Conwell, Y; Zhou, L; Jiang, C

2004-12-01

Previous research on sociocultural factors for Chinese suicide have been basically limited to single case studies or qualitative research with ethnographic methodology. The current study examines the major risk factors and some cultural uniqueness related to Chinese rural suicide using a quantitative design. This is a case control study with 66 completed suicides and 66 living controls obtained from psychological autopsy interviews in rural China. Both bivariate analyses and the multiple regression model have found that the Chinese rural suicide patterns are basically similar to those in most other cultures in the world: strong predictors of rural Chinese suicide are the psychopathological, psychological, and physical health variables, followed by social support and negative and stressful life events. Other significant correlates include lower education, poverty, religion, and family disputes. Culture has an important impact on suicide patterns in a society.

Culture, risk factors and suicide in rural China: a psychological autopsy case control study

PubMed Central

Zhang, J.; Conwell, Y.; Zhou, L.; Jiang, C.

2009-01-01

Objective Previous research on sociocultural factors for Chinese suicide have been basically limited to single case studies or qualitative research with ethnographic methodology. The current study examines the major risk factors and some cultural uniqueness related to Chinese rural suicide using a quantitative design. Method This is a case control study with 66 completed suicides and 66 living controls obtained from psychological autopsy interviews in rural China. Results Both bivariate analyses and the multiple regression model have found that the Chinese rural suicide patterns are basically similar to those in most other cultures in the world: strong predictors of rural Chinese suicide are the psychopathological, psychological, and physical health variables, followed by social support and negative and stressful life events. Other significant correlates include lower education, poverty, religion, and family disputes. Conclusion Culture has an important impact on suicide patterns in a society. PMID:15521827

Case histories of six consumers and their families in Cash and Counseling.

PubMed

San Antonio, Patricia M; Simon-Rusinowitz, Lori; Loughlin, Dawn; Eckert, J Kevin; Mahoney, Kevin J

2007-02-01

To examine how the lives of consumers and their caregivers were affected by making choices and controlling their own resources with the cash option, this paper focuses on six case studies from the Cash and Counseling Demonstration Program. Twenty-one consumers, caregivers, and state consultants were interviewed about their experiences in the program. The data come from a larger study of over 200 interviews conducted from June 2000 to August 2004. Interview data were analyzed for themes about caregiving and program satisfaction. Cash and Counseling benefited consumers and caregivers by allowing consumers increased continuity and reliability of care, increased ability to set hours of care, more satisfaction with how caregiving is offered and more satisfaction with the quality of care. The cash option allowed consumers to create, schedule, and manage their own model of care. Some consumers faced challenges in the program with paperwork, accounting, worries about receiving care, and some ineffective state consultants who could have been more helpful.

Evaluation of inciting causes, alternative targets, and risk factors associated with redirected aggression in cats.

PubMed

Amat, Marta; Manteca, Xavier; Brech, Susana Le; Ruiz de la Torre, José Luís; Mariotti, Valentina M; Fatjó, Jaume

2008-08-15

To identify inciting causes, alternative targets, and risk factors associated with redirected aggression in cats. Case-control study. 19 cats with a history of redirected aggression and 64 cats with no such history. Medical records were reviewed to identify cats evaluated for problems with redirected aggression (case cats), in which the primary inciting stimulus and alternative target of aggression were clearly identifiable. Data obtained from the records and from follow-up interviews included details about the cats and incidents of redirected aggression. Owners of control cats were interviewed via telephone to obtain similar information on their cats. 22 incidents of redirected aggression were reported for the 19 case cats. In 95% of those incidents, loud noises or interactions with other cats were identified as the inciting stimuli. Case cats most commonly redirected their aggression toward the owner, followed by another cat living in the same household. Compared with control cats, case cats were more likely to have a sound phobia but were less likely to be outdoor cats. In addition, case cats were more likely to be from small households (

Use of tanning devices and risk of basal cell and squamous cell skin cancers.

PubMed

Karagas, Margaret R; Stannard, Virginia A; Mott, Leila A; Slattery, Mary Jo; Spencer, Steven K; Weinstock, Martin A

2002-02-06

Use of artificial tanning devices that emit UV radiation, such as tanning lamps and tanning beds, has become increasingly popular in the United States. Although an excess risk of nonmelanoma skin cancers might be predicted from this exposure, little epidemiologic data exist. We conducted a population-based, case-control study that included 603 basal cell carcinoma (BCC) case patients, 293 squamous cell carcinoma (SCC) case patients, and 540 control subjects. Study participants were interviewed in person to obtain information on tanning device use, sun exposure history, sun sensitivity, and other risk factors for skin cancer. Overall, any use of tanning devices was associated with odds ratios of 2.5 (95% confidence interval [CI] = 1.7 to 3.8) for SCC and 1.5 (95% CI = 1.1 to 2.1) for BCC. Adjustment for history of sunburns, sunbathing, and sun exposure did not affect our results. Our findings suggest that the use of tanning devices may contribute to the incidence of nonmelanoma skin cancers. They highlight the need to further evaluate the potential risks of BCC and SCC that are associated with tanning lamp exposure and the appropriate public health response.

The Biographical Personality Interview (BPI)--a new approach to the assessment of premorbid personality in psychiatric research. Part I: Development of the instrument.

PubMed

von Zerssen, D; Pössl, J; Hecht, H; Black, C; Garczynski, E; Barthelmes, H

1998-01-01

The Biographical Personality Interview (BPI) is a research instrument for the retrospective assessment of premorbid personality traits of psychiatric patients. Its construction is based on results of a series of investigations in which biographical data from psychiatric case notes were analysed with respect to premorbid personality traits. In order to avoid methodological shortcomings of the utilisation of clinical records, an interview technique was developed. It is applied by two independent, specially trained investigators who are kept "blind" regarding any clinical data of the subject under study. One of them has to conduct the interview of a clinically remitted patient and to provide an interview protocol, the other one has to rate personality traits from that protocol along a large series of purely descriptive items. Sum scores for six personality structures ("types") are calculated and the case is then assigned to the intra-individually dominating personality type according to the highest of these scores.

Association of Serum Retinol-Binding Protein 4 Concentration With Risk for and Prognosis of Amyotrophic Lateral Sclerosis.

PubMed

Rosenbohm, Angela; Nagel, Gabriele; Peter, Raphael S; Brehme, Torben; Koenig, Wolfgang; Dupuis, Luc; Rothenbacher, Dietrich; Ludolph, Albert C

2018-05-01

Knowledge about the metabolic states of patients with amyotrophic lateral sclerosis (ALS) may provide a therapeutic approach. To investigate the association between the onset and prognosis of ALS and serum retinol-binding protein 4 (RBP4) concentration as a biomarker for insulin resistance and vitamin A metabolism. Case-control design for risk factors of ALS; cohort design for prognostic factors within ALS cases. Between October 1, 2010, and June 30, 2014, a population-based case-control study with randomly selected controls was established based on the ALS Registry Swabia in southern Germany, with a target population of 8.4 million inhabitants. Response rates were 64.8% among the cases and 18.7% among the controls. The dates of analysis were April 2016 to May 2017. Serum samples were measured for RBP4. Information on covariates was assessed by an interview-based standardized questionnaire. Main outcomes and measures were adjusted odds ratios for risk of ALS associated with serum RBP4 concentration, as well as time to death associated with RBP4 concentration at baseline in ALS cases only. Conditional logistic regression was applied to calculate multivariable odds ratios for risk of ALS. Survival models were used in cases only to appraise their prognostic value. Data from 289 patients with ALS (mean [SD] age, 65.7 [10.5] years; 172 [59.5%] male) and 504 controls (mean [SD] age, 66.3 [9.8] years; 299 [59.3%] male) were included in the case-control study. Compared with controls, ALS cases were characterized by lower body mass index, less educational attainment, smoking, light occupational work intensity, and self-reported diabetes. The median serum RBP4 concentration was lower in ALS cases than in controls (54.0 vs 59.5 mg/L). In the multivariable model, increasing RBP4 concentration was associated with reduced odds for ALS (top vs bottom quartile odds ratio, 0.36; 95% CI, 0.22-0.59; P for trend <.001), which persisted after further adjustment for renal function and for leptin and adiponectin. Among 279 ALS cases during a median follow-up of 14.5 months, 104 died (mean [SD] age, 68.9 [10.3] years; 56 [53.9%] male). In this ALS cohort, an inverse association was found between serum RBP4 concentration as a continuous measure and survival. RBP4 was inversely related to risk for and prognosis of ALS, suggesting that vitamin A metabolism or impaired insulin signaling could be involved. Further research, including a prospective design and other biological markers, is necessary to clarify the role of insulin resistance in the pathogenesis of ALS.

No role for human papillomavirus infection in oral cancers in a region in southern India.

PubMed

Laprise, Claudie; Madathil, Sreenath A; Allison, Paul; Abraham, Priya; Raghavendran, Anantharam; Shahul, Hameed P; ThekkePurakkal, Akhil-Soman; Castonguay, Geneviève; Coutlée, François; Schlecht, Nicolas F; Rousseau, Marie-Claude; Franco, Eduardo L; Nicolau, Belinda

2016-02-15

Oral cancer is a major public health issue in India with ∼ 77,000 new cases and 52,000 deaths yearly. Paan chewing, tobacco and alcohol use are strong risk factors for this cancer in India. Human papillomaviruses (HPVs) are also related to a subset of head and neck cancers (HNCs). We examined the association between oral HPV and oral cancer in a sample of Indian subjects participating in a hospital-based case-control study. We recruited incident oral cancer cases (N = 350) and controls frequency-matched by age and sex (N = 371) from two main referral hospitals in Kerala, South India. Sociodemographic and behavioral data were collected by interviews. Epithelial cells were sampled using Oral CDx® brushes from the oral cancer site and the normal mucosa. Detection and genotyping of 36 HPV genotypes were done using a polymerase chain reaction protocol. Data collection procedures were performed by qualified dentists via a detailed protocol with strict quality control, including independent HPV testing in India and Canada. HPV DNA was detected in none of the cases or controls. Associations between oral cancer and risk factors usually associated with HPV infection, such as oral sex and number of lifetime sexual partners, were examined by logistic regression and were not associated with oral cancer. Lack of a role for HPV infection in this study may reflect cultural or religious characteristics specific to this region in India that are not conducive to oral HPV transmission. A nationwide representative prevalence study is needed to investigate HPV prevalence variability among Indian regions. © 2015 UICC.

Differences in risk factors for 2nd and 3rd degree hypospadias in the National Birth Defects Prevention Study

PubMed Central

in 't Woud, Sander Groen; van Rooij, Iris A.L.M.; van Gelder, Marleen M.H.J.; Olney, Richard S.; Carmichael, Suzan L.; Roeleveld, Nel; Reefhuis, Jennita

2015-01-01

Background Hypospadias is a frequent birth defect with three phenotypic subtypes. With data from the National Birth Defects Prevention Study, a large, multi-state, population-based, case-control study, we compared risk factors for second and third degree hypospadias. Methods A wide variety of data on maternal and pregnancy-related risk factors for isolated second and third degree hypospadias was collected via computer-assisted telephone interviews to identify potential etiological differences between the two phenotypes. Logistic regression was used to calculate odds ratios including a random effect by study center. Results In total, 1547 second degree cases, 389 third degree cases, and 5183 male controls were included in our study. Third degree cases were more likely to have a non-Hispanic black or Asian/Pacific Islander mother, be delivered preterm, have a low birth weight, be small for gestational age, and be conceived with fertility treatments than second degree cases and controls. Associations with both second and third degree hypospadias were observed for maternal age, family history, parity, plurality, and hypertension during pregnancy. Risk estimates were generally higher for third degree hypospadias except for family history. Conclusions Most risk factors were associated with both or neither phenotype. Therefore, it is likely that the underlying mechanism is at least partly similar for both phenotypes. However, some associations were different between 2nd and 3rd degree hypospadias, and went in opposite directions for second and third degree hypospadias for Asian/Pacific Islander mothers. Effect estimates for subtypes of hypospadias may be over- or underestimated in studies without stratification by phenotype. PMID:25181604

Concept Mapping and Misconceptions: A Study of High-School Students' Understandings of Acids and Bases.

ERIC Educational Resources Information Center

Ross, Bertram; And Others

1991-01-01

An investigation of students understandings of acids and bases using concept maps, multiple-choice tests, and clinical interviews is described. The methodology and resulting analysis are illustrated with two abbreviated case studies selected from the study. Discussion of concept mapping points to how it starkly represents gaps in the understanding…

The Implementation and Evaluation of an Instructional Design Based on the Interdisciplinary Approach: Conscious Consumer Education

ERIC Educational Resources Information Center

Karakus, Memet; Uyar, Melis Yesilpinar

2018-01-01

The aim of this study was to implement and evaluate the instructional design prepared as consumer-oriented and based upon interdisciplinary curriculum. In this study, case study approach, which is one of the qualitative research patterns, was employed. Observations, interviews and document analysis were used to collect data. For analyzing the…

Managing School-Based Curriculum Innovations: A Hong Kong Case Study

ERIC Educational Resources Information Center

Law, Edmond H. F.; Wan, Sally W. Y.; Galton, Maurice; Lee, John C. K.

2010-01-01

This study was originally designed to explore the impact of a distributed approach to developing curriculum leadership among schoolteachers. Previous papers have focused on reporting evidence of teacher learning in the process of engaging teachers in various types of curriculum decision-making in an innovation project based on interview data. This…

Religious Tolerance and Understanding in the French Education System

ERIC Educational Resources Information Center

Ferrara, Carol

2012-01-01

This research is based on an interview and survey-based case study of an Islamic "lycee", a Catholic "lycee", and two public "lycees" in the Ile-de-France region of France. The study investigated whether students in private schools receiving some form of education about religion tend to be more tolerant and…

Approaches to Measuring and Understanding Employer Training Expenditure: Support Document

ERIC Educational Resources Information Center

Smith, Andrew; Burke, Gerald; Long, Michael; Dumbrell, Tom

2008-01-01

This support document was produced by the authors based on their research for the report "Approaches to Measuring and Understanding Employer Training Expenditure," and is an added resource for further information. As outlined in the report, the research for this study was based on interviews and case studies, analysis of other research…

State Initiatives on Industry-Based Skill Standards and Credentials.

ERIC Educational Resources Information Center

Ganzglass, Evelyn; Simon, Martin

A study examined state initiatives for industry-based skill standards and credentials. Officials in 19 states were interviewed, case studies of programs in 3 states (Georgia, Pennsylvania, and Texas) were conducted, and focus group discussions were held with 25 individuals. State skill standards were generally found to be tied to broader efforts…

The Impact of Preservice Teachers' Experiences in a Video-Enhanced Training Program on Their Teaching: A Case Study in Physical Education

ERIC Educational Resources Information Center

Gaudin, Cyrille; Chaliès, Sébastien; Amathieu, Jérôme

2018-01-01

This case study documents the influence of preservice teachers' experiences in a Video-Enhanced Training Program (VETP) on their teaching. The conceptual framework of this VETP comes from a research program in cultural anthropology based on Wittgenstein's analytical philosophy. Influence was identified during self-confrontation interviews with…

The Cultural and Intercultural Identities of Transnational English Teachers: Two Case Studies from the Americas

ERIC Educational Resources Information Center

Menard-Warwick, Julia

2008-01-01

This article presents case studies of two long-time English language teachers: a California English as a second language instructor originally from Brazil, and a Chilean English as a foreign language teacher who worked for many years in the United States before returning home. Based on interview and classroom observation data, this research…

Using Educational Neuroscience and Psychology to Teach Science. Part 1: A Case Study Review of Cognitive Load Theory (CLT) and Cognitive Acceleration through Science Education (CASE)

ERIC Educational Resources Information Center

Jenkins, Rebecca Torrance

2017-01-01

This article is the first of a two-part series that explores science teachers' and their pupils' experiences of using different pedagogical approaches based on understandings of how brains learn. For this case-study research, nine science teachers were interviewed and four teachers self-selected to trial a pedagogical approach, new to them, from…

Family members of older persons with multi-morbidity and their experiences of case managers in Sweden: an interpretive phenomenological approach

PubMed Central

Hjelm, Markus; Holmgren, Ann-Charlotte; Willman, Ania; Bohman, Doris; Holst, Göran

2015-01-01

Background Family members of older persons (75+) with multi-morbidity are likely to benefit from utilising case management services performed by case managers. However, research has not yet explored their experiences of case managers. Objectives The aim of the study was to deepen the understanding of the importance of case managers to family members of older persons (75+) with multi-morbidity. Design The study design was based on an interpretive phenomenological approach. Method Data were collected through individual interviews with 16 family members in Sweden. The interviews were analysed by means of an interpretive phenomenological approach. Results The findings revealed one overarching theme: “Helps to fulfil my unmet needs”, based on three sub-themes: (1) “Helps me feel secure – Experiencing a trusting relationship”, (2) “Confirms and strengthens me – Challenging my sense of being alone” and (3) “Being my personal guide – Increasing my competence”. Conclusion and discussion The findings indicate that case managers were able to fulfil unmet needs of family members. The latter recognised the importance of case managers providing them with professional services tailored to their individual needs. The findings can contribute to the improvement of case management models not only for older persons but also for their family members. PMID:25918497

Facilitators and barriers to employment among veterans with spinal cord injury receiving 12 months of evidence-based supported employment services.

PubMed

Cotner, Bridget A; Njoh, Eni N; Trainor, John K; O'Connor, Danielle R; Barnett, Scott D; Ottomanelli, Lisa

2015-01-01

Return to work is associated with positive rehabilitation outcomes for persons with spinal cord injury (SCI); however, more research is needed on vocational support for persons with disabilities seeking employment. The association between facilitators and barriers of employment and employment outcome was examined among Veterans with SCI who participated in an evidence-based supported employment (EBSE) program. Using a mixed-methods, nested case-control design, data on facilitators and barriers to employment were extracted from qualitative interviews and quantitative measures administered in person to 34 Veterans with SCI who completed 12 months of an EBSE program. Participants who did (case) and did not (control) obtain competitive employment were matched on time since SCI. Facilitators and barriers to employment were compared between the groups. Self-report measures administered at baseline were examined; there were no statistically significant factors that predicted employment outcomes after 12 months of EBSE program participation. Qualitative interview data revealed program-specific facilitators and Veteran characteristics that were associated with employment outcomes. Qualitative data illustrate how the integration of the vocational rehabilitation specialist on the medical team is helpful for addressing identified disability-specific barriers, including practical matters such as transportation and caregiving schedules, to facilitate employment outcomes.

Facilitators and Barriers to Employment Among Veterans with Spinal Cord Injury Receiving 12 Months of Evidence-Based Supported Employment Services

PubMed Central

Njoh, Eni N.; Trainor, John K.; O’Connor, Danielle R.; Barnett, Scott D.; Ottomanelli, Lisa

2015-01-01

Background: Return to work is associated with positive rehabilitation outcomes for persons with spinal cord injury (SCI); however, more research is needed on vocational support for persons with disabilities seeking employment. Objective: The association between facilitators and barriers of employment and employment outcome was examined among Veterans with SCI who participated in an evidence-based supported employment (EBSE) program. Methods: Using a mixed-methods, nested case-control design, data on facilitators and barriers to employment were extracted from qualitative interviews and quantitative measures administered in person to 34 Veterans with SCI who completed 12 months of an EBSE program. Participants who did (case) and did not (control) obtain competitive employment were matched on time since SCI. Facilitators and barriers to employment were compared between the groups. Results: Self-report measures administered at baseline were examined; there were no statistically significant factors that predicted employment outcomes after 12 months of EBSE program participation. Qualitative interview data revealed program-specific facilitators and Veteran characteristics that were associated with employment outcomes. Conclusions: Qualitative data illustrate how the integration of the vocational rehabilitation specialist on the medical team is helpful for addressing identified disability-specific barriers, including practical matters such as transportation and caregiving schedules, to facilitate employment outcomes. PMID:25762857

Antiperspirant use as a risk factor for breast cancer in Iraq.

PubMed

Fakri, S; Al-Azzawi, A; Al-Tawil, N

2006-01-01

Some internet communications have addressed the link between antiperspirant use and breast cancer. We studied the possible association between the use of antiperspirants and some other factors with the development of breast cancer in Al-Kadhmia teaching hospital. Thus, 54 cases of breast cancer and 50 controls were interviewed. We found 82.0% of the controls used antiperspirants compared with 51.8% of cases (P< 0.05). The use of antiperspirants had no association with the risk of breast cancer, while family history and oral contraceptives use were found to be associated.

[Public control and equity of access to hospitals under non-State public administration].

PubMed

Carneiro Junior, Nivaldo; Elias, Paulo Eduardo

2006-10-01

To analyze social health organizations in the light of public control and the guarantee of equity of access to health services. Utilizing the case study technique, two social health organizations in the metropolitan region of São Paulo were selected. The analytical categories were equity of access and public control, and these were based on interviews with key informants and technical-administrative reports. It was observed that the overall funding and administrative control of the social health organizations are functions of the state administrator. The presence of a local administrator is important for ensuring equity of access. Public control is expressed through supervisory actions, by means of accounting and financial procedures. Equity of access and public control are not taken into consideration in the administration of these organizations. The central question lies in the capacity of the public authorities to have a presence in implementing this model at the local level, thereby ensuring equity of access and taking public control into consideration.

Probiotic Beverage with Soy Isoflavone Consumption for Breast Cancer Prevention: A Case-control Study

PubMed Central

Toi, Masakazu; Hirota, Saya; Tomotaki, Ai; Sato, Nobuaki; Hozumi, Yasuo; Anan, Keisei; Nagashima, Takeshi; Tokuda, Yutaka; Masuda, Norikazu; Ohsumi, Shozo; Ohno, Shinji; Takahashi, Masato; Hayashi, Hironori; Yamamoto, Seiichiro; Ohashi, Yasuo

2013-01-01

The purpose of this study is to evaluate how beverages containing Lactobacillus casei Shirota (BLS) and soy isoflavone consumption since adolescence affected the incidence of breast cancer. In a population-based case-control study, three hundred and six cases with breast cancer and 662 controls aged 40 to 55 were matched for age and residential area and included in the analyses. Diet, lifestyle and other breast cancer risk factors were investigated using the self-administered questionnaire and interview. Odds ratios (ORs) of BLS and soy isoflavone consumption for breast cancer incidence were independently and jointly estimated using a conditional logistic regression. The ORs of BLS consumption (≥ four times a week against < four times a week) was 0.65 and statistically significant (p = 0.048). The analysis of association between soy consumption and breast cancer incidence showed the more the isoflavone consumption is, the lower the odds of breast cancer becomes. Adjusted ORs for breast cancer in the second, the third and the fourth quartiles of soy consumption against the first quartile were 0.76, 0.53 and 0.48, respectively (trend test, p = 0.0002). The BLS-isoflavone interaction was not statistically significant; however, a biological interaction was suggested. Regular consumption of BLS and isoflavones since adolescence was inversely associated with the incidence of breast cancer in Japanese women. PMID:23966890

Frequency of soy food consumption and serum isoflavone concentrations among Chinese women in Shanghai.

PubMed

Frankenfeld, Cara L; Lampe, Johanna W; Shannon, Jackilen; Gao, Dao L; Ray, Roberta M; Prunty, Joann; Kalhorn, Thomas F; Wähälä, Kristiina; Patterson, Ruth E; Thomas, David B

2004-09-01

The food-frequency questionnaire (FFQ) can be an efficient tool to evaluate dietary intake in large, population-based studies, especially for specific foods. The objective of this study was to validate the assessment of soy and isoflavone (daidzein and genistein) intakes, measured by an FFQ, by comparing intakes with serum isoflavone concentrations. Soy and isoflavone intakes and serum isoflavone concentrations were determined as part of a case-control study of dietary factors and risks of benign breast disease and breast cancer. The FFQ, administered during an in-person interview, included six soy-specific line items. Blood was drawn within one week of FFQ completion. In total, 1823 women living in Shanghai, People's Republic of China. In this population, soybean milk, fresh bean curd and other bean foods were eaten once per week, and fermented bean curd, fried bean curd puff and soybeans were eaten less than once per week. A significant linear trend (P<0.01) in serum isoflavone concentrations across increasing categories of soy and isoflavone intakes was observed, indicating that soy and isoflavone intakes, measured by the FFQ, well distinguished serum isoflavone concentrations. Linear trends were also observed in both case and control groups in stratified analyses, suggesting little differential bias by case-control status. The results suggest that the FFQ provides a useful marker of soy food consumption and isoflavone exposure in this population.

Retrospective Correlates for Bulimia Nervosa: A Matched Case-Control Study.

PubMed

Gonçalves, Sónia; Machado, Barbara C; Martins, Carla; Hoek, Hans W; Machado, Paulo P P

2016-05-01

There have been few studies investigating the risk factors for bulimia nervosa (BN), and most have been in Anglo-Saxon countries. This study aimed to (i) replicate the uncontested retrospective correlates for BN and clarify the role of factors with inconsistent findings and (ii) evaluate the strength of these factors in a different culture. A case-control design was used to compare 60 women who met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for BN to 60 healthy controls and 60 participants with other psychiatric disorders. Retrospective correlates were assessed by interviewing each person with the Oxford Risk Factor Interview. The primary retrospective correlates identified from the comparison of BN participants to healthy controls were general high maternal expectations, negative attitudes about parental weight and obesity in childhood and adolescence. Compared with participants with other psychiatric disorders, those with BN also reported higher rates of childhood obesity, deliberate self-harm, family conflicts, general high maternal expectations and feeling fat in childhood. The common findings across cultures suggest that, at least, individuals subjectively experience a number of similar factors that increase risk for developing BN. In addition, the difference regarding self-harm is notable. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

Improving childhood malaria treatment and referral practices by training patent medicine vendors in rural south-east Nigeria

PubMed Central

2009-01-01

Background Malaria remains a major cause of morbidity and mortality among children under five years of age in Nigeria. Most of the early treatments for fever and malaria occur through self-medication with anti-malarials bought over-the-counter (OTC) from untrained drug vendors. Self-medication through drug vendors can be ineffective, with increased risks of drug toxicity and development of drug resistance. Global malaria control initiatives highlights the potential role of drug vendors to improve access to early effective malaria treatment, which underscores the need for interventions to improve treatment obtained from these outlets. This study aimed to determine the feasibility and impact of training rural drug vendors on community-based malaria treatment and advice with referral of severe cases to a health facility. Methods A drug vendor-training programme was carried out between 2003 and 2005 in Ugwuogo-Nike, a rural community in south-east Nigeria. A total of 16 drug vendors were trained and monitored for eight months. The programme was evaluated to measure changes in drug vendor practice and knowledge using exit interviews. In addition, home visits were conducted to measure compliance with referral. Results The intervention achieved major improvements in drug selling and referral practices and knowledge. Exit interviews confirmed significant increases in appropriate anti-malarial drug dispensing, correct history questions asked and advice given. Improvements in malaria knowledge was established and 80% compliance with referred cases was observed during the study period, Conclusion The remarkable change in knowledge and practices observed indicates that training of drug vendors, as a means of communication in the community, is feasible and strongly supports their inclusion in control strategies aimed at improving prompt effective treatment of malaria with referral of severe cases. PMID:19930561

Improving childhood malaria treatment and referral practices by training patent medicine vendors in rural south-east Nigeria.

PubMed

Okeke, Theodora A; Uzochukwu, Benjamin S C

2009-11-20

Malaria remains a major cause of morbidity and mortality among children under five years of age in Nigeria. Most of the early treatments for fever and malaria occur through self-medication with anti-malarials bought over-the-counter (OTC) from untrained drug vendors. Self-medication through drug vendors can be ineffective, with increased risks of drug toxicity and development of drug resistance. Global malaria control initiatives highlights the potential role of drug vendors to improve access to early effective malaria treatment, which underscores the need for interventions to improve treatment obtained from these outlets. This study aimed to determine the feasibility and impact of training rural drug vendors on community-based malaria treatment and advice with referral of severe cases to a health facility. A drug vendor-training programme was carried out between 2003 and 2005 in Ugwuogo-Nike, a rural community in south-east Nigeria. A total of 16 drug vendors were trained and monitored for eight months. The programme was evaluated to measure changes in drug vendor practice and knowledge using exit interviews. In addition, home visits were conducted to measure compliance with referral. The intervention achieved major improvements in drug selling and referral practices and knowledge. Exit interviews confirmed significant increases in appropriate anti-malarial drug dispensing, correct history questions asked and advice given. Improvements in malaria knowledge was established and 80% compliance with referred cases was observed during the study period, The remarkable change in knowledge and practices observed indicates that training of drug vendors, as a means of communication in the community, is feasible and strongly supports their inclusion in control strategies aimed at improving prompt effective treatment of malaria with referral of severe cases.

Atopic conditions and brain tumor risk in children and adolescents--an international case-control study (CEFALO).

PubMed

Shu, X; Prochazka, M; Lannering, B; Schüz, J; Röösli, M; Tynes, T; Kuehni, C E; Andersen, T V; Infanger, D; Schmidt, L S; Poulsen, A H; Klaeboe, L; Eggen, T; Feychting, M

2014-04-01

A number of epidemiological studies indicate an inverse association between atopy and brain tumors in adults, particularly gliomas. We investigated the association between atopic disorders and intracranial brain tumors in children and adolescents, using international collaborative CEFALO data. CEFALO is a population-based case-control study conducted in Denmark, Norway, Sweden, and Switzerland, including all children and adolescents in the age range 7-19 years diagnosed with a primary brain tumor between 2004 and 2008. Two controls per case were randomly selected from population registers matched on age, sex, and geographic region. Information about atopic conditions and potential confounders was collected through personal interviews. In total, 352 cases (83%) and 646 controls (71%) participated in the study. For all brain tumors combined, there was no association between ever having had an atopic disorder and brain tumor risk [odds ratio 1.03; 95% confidence interval (CI) 0.70-1.34]. The OR was 0.76 (95% CI 0.53-1.11) for a current atopic condition (in the year before diagnosis) and 1.22 (95% CI 0.86-1.74) for an atopic condition in the past. Similar results were observed for glioma. There was no association between atopic conditions and risk of all brain tumors combined or of glioma in particular. Stratification on current or past atopic conditions suggested the possibility of reverse causality, but may also the result of random variation because of small numbers in subgroups. In addition, an ongoing tumor treatment may affect the manifestation of atopic conditions, which could possibly affect recall when reporting about a history of atopic diseases. Only a few studies on atopic conditions and pediatric brain tumors are currently available, and the evidence is conflicting.

Exposure to welding fumes increases lung cancer risk among light smokers but not among heavy smokers: evidence from two case-control studies in Montreal.

PubMed

Vallières, Eric; Pintos, Javier; Lavoué, Jérôme; Parent, Marie-Élise; Rachet, Bernard; Siemiatycki, Jack

2012-08-01

We investigated relationships between occupational exposure to gas and arc welding fumes and the risk of lung cancer among workers exposed to these agents throughout the spectrum of industries. Two population-based case-control studies were conducted in Montreal. Study I (1979-1986) included 857 cases and 1066 controls, and Study II (1996-2001) comprised 736 cases and 894 controls. Detailed job histories were obtained by interview and evaluated by an expert team of chemist-hygienists to estimate degree of exposure to approximately 300 substances for each job. Gas and arc welding fumes were among the agents evaluated. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) of lung cancer using logistic regression, adjusting for smoking history and other covariates. The two studies provided similar results, so a pooled analysis was conducted. Among all subjects, no significant association was found between lung cancer and gas welding fumes (OR = 1.1; 95% CI = 0.9-1.4) or arc welding fumes (OR = 1.0; 95% CI = 0.8-1.2). However, when restricting attention to light smokers, there was an increased risk of lung cancer in relation to gas welding fumes (OR = 2.9; 95% CI = 1.7-4.8) and arc welding fumes (OR = 2.3; 95% CI = 1.3-3.8), with even higher OR estimates among workers with the highest cumulative exposures. In conclusion, there was no detectable excess risk of lung cancer due to welding fumes among moderate to heavy smokers; but among light smokers we found an excess risk related to both types of welding fumes.

Prevalence, correlates, comorbidities, and suicidal tendencies of premenstrual dysphoric disorder in a nationwide sample of Korean women.

PubMed

Hong, Jin Pyo; Park, Subin; Wang, Hee-Ryung; Chang, Sung Man; Sohn, Jee Hoon; Jeon, Hong Jin; Lee, Hae Woo; Cho, Seong-Jin; Kim, Byung-Soo; Bae, Jae Nam; Cho, Maeng Je

2012-12-01

We examined the prevalence, correlates, comorbidities, and suicidal tendencies of premenstrual dysphoric disorder (PMDD) according to the DSM-IV criteria in a nationwide sample of Korean women. A total of 2,499 women aged 18-64 years participated in this study. Diagnostic assessments were based on the Korean version of the Composite International Diagnostic Interview (CIDI) 2.1 and its 12-month PMDD diagnostic module, which were administered by lay interviewers. The frequencies of DSM-IV psychiatric disorders, insomnia, and suicidal tendency were analyzed among PMDD cases and compared with non-PMDD cases, and both odds ratios and significance levels were calculated. The 12-month prevalence rate of DSM-IV-diagnosed PMDD was 2.4 %. Among subjects with PMDD, 59.3 % had at least one psychiatric illness; in comparison, the control frequency was 21.8 %. Associations between PMDD and alcohol abuse/dependence, major depressive disorder, post-traumatic stress disorder, social phobia, specific phobia, somatoform disorder, insomnia, and suicidality were overwhelmingly positive and significant (p < 0.05), after controlling for age. Physical illness and being underweight were associated with increased risks of PMDD (p < 0.05). PMDD was prevalent in the nationwide sample of Korean women and was frequently associated with other psychiatric disorders, insomnia, and suicidality, suggesting the need to detect and treat women who experience PMDD.

Assigning exposure to pesticides and solvents from self-reports collected by a computer assisted personal interview and expert assessment of job codes: the UK Adult Brain Tumour Study.

PubMed

Hepworth, S J; Bolton, A; Parslow, R C; van Tongeren, M; Muir, K R; McKinney, P A

2006-04-01

To compare assignment of occupational pesticide and solvent exposure using self-reported data collected by a computer assisted personal interview (CAPI) with exposure based on expert assessment of job codes. To discuss the advantages and disadvantages of using a CAPI to collect individual occupational exposure data. Between 2001 and 2004, 1495 participants were interviewed using a CAPI for a case-control study of adult brain tumours and acoustic neuromas. Two types of occupational data were collected: (1) a full history, including job title from which a job code was assigned from the Standard Occupational Classification; and (2) specific details on pesticide and solvent exposure reported by participants. Study members' experiences of using the CAPI were recorded and advantages and disadvantages summarised. Of 7192 jobs recorded, the prevalence of self-reported exposure was 1.3% for pesticides and 11.5% for solvents. Comparing this with exposure expertly assessed from job titles showed 53.6% and 45.8% concordance for pesticides and solvents respectively. Advantages of the CAPI include no data entry stage, automatic input validation, and a reduction in interviewer bias. Disadvantages include an adverse effect on study implementation as a consequence of resources required for programming and difficulties encountered with data management prior to analysis. Different methods of exposure assessment derive different exposure levels for pesticide and solvent exposure at work. Agreement between self-reported and expert assessment of exposure was greater for pesticides compared to solvents. The advantages of using a CAPI for the collection of complex data outweigh the disadvantages for interviewers and data quality but using such a method requires extra resources at the study outset.

It Takes a Toll on Pre-Service Teachers and Programs: Case Studies of Teacher Candidates Who Withdrew from a Teacher Education Program

ERIC Educational Resources Information Center

Lin, Pei-Ying; Childs, Ruth A.; Zhang, Jingshun

2016-01-01

Previous studies have examined patterns of withdrawal from initial teacher education (ITE) programs and have found that pre-service teachers are more likely to withdraw if they are male or older than the typical pre-service teacher. This study presents case studies based on semi-structured interviews with older male pre-service teachers who…

The Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) Study Protocol

PubMed Central

Woo, Daniel; Rosand, Jonathan; Kidwell, Chelsea; McCauley, Jacob L.; Osborne, Jennifer; Brown, Mark W.; West, Sandra E.; Rademacher, Eric W.; Waddy, Salina; Roberts, Jamie N.; Koch, Sebastian; Gonzales, Nicole R.; Sung, Gene; Kittner, Steven J.; Birnbaum, Lee; Frankel, Michael; Daniel Testai, Fernando; Hall, Christiana E.; Elkind, Mitchell S. V.; Flaherty, Matthew; Coull, Bruce; Chong, Ji Y.; Warwick, Tanya; Malkoff, Marc; James, Michael L.; Ali, Latisha K.; Worrall, Bradford B.; Jones, Floyd; Watson, Tiffany; Leonard, Anne; Martinez, Rebecca; Sacco, Ralph I; Langefeld, Carl D.

2013-01-01

Background and Purpose Epidemiologic studies of intracerebral hemorrhage (ICH) have consistently demonstrated variation in incidence, location, age at presentation, and outcomes among non-Hispanic white, black, and Hispanic populations. We report here the design and methods for this large, prospective, multi-center case-control study of ICH. Methods The ERICH study is a multi-center, prospective case-control study of ICH. Cases are identified by hot-pursuit and enrolled using standard phenotype and risk factor information and include neuroimaging and blood sample collection. Controls are centrally identified by random digit dialing to match cases by age (+/−5 years), race, ethnicity, gender and metropolitan region. Results As of March 22, 2013, 1,655 cases of ICH had been recruited into the study which is 101.5% of the target for that date and 851 controls had been recruited which is 67.2% of the target for that date (1,267 controls) for a total of 2,506 subjects which is 86.5% of the target for that date (2,897 subjects). Of the 1,655 cases enrolled, 1,640 cases had the case interview entered into the database of which 628 (38%) were non-Hispanic black, 458 (28%) were non-Hispanic white and 554 (34%) were Hispanic. Of the 1,197 cases with imaging submitted, 876 (73.2%) had a 24 hour follow-up CT available In addition to CT imaging, 607 cases have had MRI evaluation. Conclusion The ERICH study is a large, case-control study of ICH with particular emphasis on recruitment of minority populations for the identification of genetic and epidemiologic risk factors for ICH and outcomes after ICH. PMID:24021679

Cancer registries in four provinces in Turkey: a case study

PubMed Central

2012-01-01

Background The burden of cancer affects all countries; while high-income countries have the capacity and resources to establish comprehensive cancer control programs, low and middle-income countries have limited resources to develop such programs. This paper examines factors associated with the development of cancer registries in four provinces in Turkey. It looks at the progress made by these registries, the challenges they faced, and the lessons learned. Other countries with similar resources can benefit from the lessons identified in this case study. Methods A mix of qualitative case study methods including key informant interviews, document review and questionnaires was used. Results This case study showed that surveillance systems that accurately report current cancer-related data are essential components of a country’s comprehensive cancer control program. At the initial stages, Turkey established one cancer registry with international support, which was used as a model for other registries. The Ministry of Health recognized the value of the registry data and its contribution to the country’s cancer control program and is supporting sustainability of these registries as a result. Conclusions This study demonstrates how Turkey was able to use resources from multiple sources to enhance its population based cancer registry system in four provinces. With renewed international interest in non-communicable diseases and cancer following the 2011 UN high-level meeting on NCDs, low- and middle- income countries can benefit from Turkey’s experience. Other countries can utilize lessons learned from Turkey as they address cancer burden and establish their own registries. PMID:23110989

Sociodemographic differences among HIV-positive and HIV-negative recently pregnant women in Mexico City

PubMed Central

Aguilar-Zapata, Daniel; Piñeirúa-Menéndez, Alicia; Volkow-Fernández, Patricia; Rodríguez-Zulueta, Patricia; Ramos-Alamillo, Ubaldo; Cabrera-López, Teresita; Martin-Onraet, Alexandra

2017-01-01

Abstract National HIV preventive programs in Mexico focus on high-risk groups that do not consider women, apart from prenatal screening. Nonetheless, the epidemic in women is growing, and there is a need to better understand sociodemographic factors in women living with HIV (WLH). We performed a case–control study in Mexico City, including HIV+ and HIV− women with a recent pregnancy to compare their sociodemographic characteristics and describe the circumstances of diagnosis in HIV+ women, as well as prenatal screening frequency in both groups. Fifty cases and 102 controls were interviewed. HIV+ women were more frequently the only economic support of the family (20% vs 0%, P < .0001). Thirty-eight percent of cases had their first pregnancy at ≤18 years, versus 16% of controls (odds ratio 2.47, 95% confidence interval 1.07–5.72, P = .03); 16% of cases had lived in the street; 6% reported transactional sex, versus none of the controls (P < .0001). In the multivariate analysis, there was strong evidence of an association between HIV infection and age at the time of the interview, history of sexually transmitted diseases, substance abuse, history of violence, and civil status. Only 6% of controls were tested for HIV during prenatal follow-up. WLH in this study faced important social vulnerability. Targeting women living in these social contexts might increase early diagnosis and could tailor HIV prevention strategies. Prenatal coverage needs to be improved and should represent a national priority. PMID:28682879

Lived experience of economic and political trends related to globalization.

PubMed

Cushon, Jennifer A; Muhajarine, Nazeem; Labonte, Ronald

2010-01-01

A multi-method case study examined how the economic and political processes of globalization have influenced the determinants of health among low-income children in Saskatoon, Saskatchewan, Canada. This paper presents the results from the qualitative interview component of the case study. The purpose of the interviews was to uncover the lived experience of low-income families and their children in Saskatoon with regards to political and economic trends related to globalization, an important addition to the usual globalization and health research that relies primarily on cross-country regressions in which the personal impacts remain hidden. In-depth phenomenological interviews with 26 low-income parents of young children (aged zero to five) who were residents of Saskatoon. A combination of volunteer and criterion sampling was used. Interview questions were open-ended and based upon an analytical framework. Analysis proceeded through immersion in the data, a process of open coding, and finally through a process of selective coding. The larger case study and interviews indicate that globalization has largely not been benefiting low-income parents with young children. Low-income families with young children were struggling to survive, despite the tremendous economic growth occurring in Saskatchewan and Saskatoon at the time of the interviews. This often led to participants expressing a sense of helplessness, despair, isolation, and/or anger. Respondents' experiences suggest that globalization-related changes in social conditions and public policies and programs have great potential to negatively affect family health through either psychosocial effects in individuals and/or decreased levels of social cohesion in the community.

A Case-Control Study on Intimate Partner Violence during Pregnancy and Low Birth Weight, Southeast Ethiopia

PubMed Central

Demelash, Habtamu; Nigatu, Dabere; Gashaw, Ketema

2015-01-01

Introduction. Violence against women has serious consequences for their reproductive and sexual health including birth outcomes. In Ethiopia, though the average parity of pregnant women is much higher than in other African countries, the link between intimate partner violence with low birth weight is unknown. Objective. The aim of this study was to examine the association between intimate partner violence and low birth weight among pregnant women. Method. Hospital based case-control study was conducted among 387 mothers (129 cases and 258 controls). Anthropometric measurements were taken both from mothers and their live births. The association between intimate partner violence and birth weight was computed through bivariable and multivariable logistic regression analyses and statistical significance was declared at P < 0.05. Result. Out of 387 interviewed mothers, 100 (25.8%) had experienced intimate partner violence during their index pregnancy period. Relatively more mothers of low birth weight infants were abused (48%) compared with controls (16.4%). Those mothers who suffered acts of any type of intimate partner violence during pregnancy were three times more likely to have a newborn with low birth weight (95% CI; (1.57 to 7.18)). The association between overall intimate partner violence and LBW was adjusted for potential confounder variables. Conclusion. This research result gives insight for health professional about the importance of screening for intimate partner violence during pregnancy. Health care providers should consider violence in their practice and try to identify women at risk. PMID:26798345

Action and Organizational Learning in an Elevator Company

ERIC Educational Resources Information Center

De Loo, Ivo

2006-01-01

Purpose: To highlight the relevance of management control in action learning programs that aim to foster organizational learning. Design/methodology/approach: Literature review plus case study. The latter consists of archival analysis and multiple interviews. Findings: When action learning programs are built around singular learning experiences,…

Development of Evidence-Based Health Policy Documents in Developing Countries: A Case of Iran

PubMed Central

Imani-Nasab, Mohammad Hasan; Seyedin, Hesam; Majdzadeh, Reza; Yazdizadeh, Bahareh; Salehi, Masoud

2014-01-01

Background: Evidence-based policy documents that are well developed by senior civil servants and are timely available can reduce the barriers to evidence utilization by health policy makers. This study examined the barriers and facilitators in developing evidence-based health policy documents from the perspective of their producers in a developing country. Methods: In a qualitative study with a framework analysis approach, we conducted semi-structured interviews using purposive and snowball sampling. A qualitative analysis software (MAXQDA-10) was used to apply the codes and manage the data. This study was theory-based and the results were compared to exploratory studies about the factors influencing evidence-based health policymaking. Results: 18 codes and three main themes of behavioral, normative, and control beliefs were identified. Factors that influence the development of evidence-based policy documents were identified by the participants: behavioral beliefs included quality of policy documents, use of resources, knowledge and innovation, being time-consuming and contextualization; normative beliefs included policy authorities, policymakers, policy administrators, and co-workers; and control beliefs included recruitment policy, performance management, empowerment, management stability, physical environment, access to evidence, policy making process, and effect of other factors. Conclusion: Most of the cited barriers to the development of evidence-based policy were related to control beliefs, i.e. barriers at the organizational and health system levels. This study identified the factors that influence the development of evidence-based policy documents based on the components of the theory of planned behavior. But in exploratory studies on evidence utilization by health policymakers, the identified factors were only related to control behaviors. This suggests that the theoretical approach may be preferable to the exploratory approach in identifying the barriers and facilitators of a behavior. PMID:24762343

Development of evidence-based health policy documents in developing countries: a case of Iran.

PubMed

Imani-Nasab, Mohammad Hasan; Seyedin, Hesam; Majdzadeh, Reza; Yazdizadeh, Bahareh; Salehi, Masoud

2014-02-07

Evidence-based policy documents that are well developed by senior civil servants and are timely available can reduce the barriers to evidence utilization by health policy makers. This study examined the barriers and facilitators in developing evidence-based health policy documents from the perspective of their producers in a developing country. In a qualitative study with a framework analysis approach, we conducted semi-structured interviews using purposive and snowball sampling. A qualitative analysis software (MAXQDA-10) was used to apply the codes and manage the data. This study was theory-based and the results were compared to exploratory studies about the factors influencing evidence-based health policy-making. 18 codes and three main themes of behavioral, normative, and control beliefs were identified. Factors that influence the development of evidence-based policy documents were identified by the participants: behavioral beliefs included quality of policy documents, use of resources, knowledge and innovation, being time-consuming and contextualization; normative beliefs included policy authorities, policymakers, policy administrators, and co-workers; and control beliefs included recruitment policy, performance management, empowerment, management stability, physical environment, access to evidence, policy making process, and effect of other factors. Most of the cited barriers to the development of evidence-based policy were related to control beliefs, i.e. barriers at the organizational and health system levels. This study identified the factors that influence the development of evidence-based policy documents based on the components of the theory of planned behavior. But in exploratory studies on evidence utilization by health policymakers, the identified factors were only related to control behaviors. This suggests that the theoretical approach may be preferable to the exploratory approach in identifying the barriers and facilitators of a behavior.

Case Series: Mental Health Needs and Perspectives of Rural Children Reared by Parents Who Abuse Methamphetamine

ERIC Educational Resources Information Center

Ostler, Teresa; Haight, Wendy; Black, James; Choi, Ga-Young; Kingery, Linda; Sheridan, Kathryn

2007-01-01

Objective: This case-based, mixed-methods study was undertaken to understand the perspectives and mental health needs of rural children exposed to parental methamphetamine abuse. Method: Participants were 23 children involved with a state child protective agency because of parental methamphetamine abuse. A semistructured interview provided…

Case Study of a Gifted and Talented Catholic Dominican Nun

ERIC Educational Resources Information Center

Lavin, Angela

2017-01-01

The case of a gifted and talented Catholic Dominican nun is described and analysed in the context of Renzulli's Three-Ring Conception of Giftedness and Gagne's Differentiated Model of Giftedness and Talent. Using qualitative methods, semi-structured interviews of relevant individuals were conducted and analysed. Based on the conclusions of this…

Cluster of cases of severe acute respiratory syndrome among Toronto healthcare workers after implementation of infection control precautions: a case series.

PubMed

Ofner-Agostini, Marianna; Gravel, Denise; McDonald, L Clifford; Lem, Marcus; Sarwal, Shelley; McGeer, Allison; Green, Karen; Vearncombe, Mary; Roth, Virginia; Paton, Shirley; Loeb, Mark; Simor, Andrew

2006-05-01

To review the severe acute respiratory syndrome (SARS) infection control practices, the types of exposure to patients with SARS, and the activities associated with treatment of such patients among healthcare workers (HCWs) who developed SARS in Toronto, Canada, after SARS-specific infection control precautions had been implemented. A retrospective review of work logs and patient assignments, detailed review of medical records of patients with SARS, and comprehensive telephone-based interviews of HCWs who met the case definition for SARS after implementation of infection control precautions. Seventeen HCWs from 6 hospitals developed disease that met the case definition for SARS after implementation of infection control precautions. These HCWs had a mean age (+/-SD) of 39+/-2.3 years. Two HCWs were not interviewed because of illness. Of the remaining 15, only 9 (60%) reported that they had received formal infection control training. Thirteen HCWs (87%) were unsure of proper order in which personal protective equipment should be donned and doffed. Six HCWs (40%) reused items (eg, stethoscopes, goggles, and cleaning equipment) elsewhere on the ward after initial use in a room in which a patient with SARS was staying. Use of masks, gowns, gloves, and eyewear was inconsistent among HCWs. Eight (54%) reported that they were aware of a breach in infection control precautions. HCWs reported fatigue due to an increased number and length of shifts; participants worked a median of 10 shifts during the 10 days before onset of symptoms. Seven HCWs were involved in the intubation of a patient with SARS. One HCW died, and the remaining 16 recovered. Multiple factors were likely responsible for SARS in these HCWs, including the performance of high-risk patient care procedures, inconsistent use of personal protective equipment, fatigue, and lack of adequate infection control training.

Paternal occupation and birth defects: findings from the National Birth Defects Prevention Study.

PubMed

Desrosiers, Tania A; Herring, Amy H; Shapira, Stuart K; Hooiveld, Mariëtte; Luben, Tom J; Herdt-Losavio, Michele L; Lin, Shao; Olshan, Andrew F

2012-08-01

Several epidemiological studies have suggested that certain paternal occupations may be associated with an increased prevalence of birth defects in offspring. Using data from the National Birth Defects Prevention Study, the authors investigated the association between paternal occupation and birth defects in a case-control study of cases comprising over 60 different types of birth defects (n=9998) and non-malformed controls (n=4066) with dates of delivery between 1997 and 2004. Using paternal occupational histories reported by mothers via telephone interview, jobs were systematically classified into 63 groups based on shared exposure profiles within occupation and industry. Data were analysed using bayesian logistic regression with a hierarchical prior for dependent shrinkage to stabilise estimation with sparse data. Several occupations were associated with an increased prevalence of various birth defect categories, including mathematical, physical and computer scientists; artists; photographers and photo processors; food service workers; landscapers and groundskeepers; hairdressers and cosmetologists; office and administrative support workers; sawmill workers; petroleum and gas workers; chemical workers; printers; material moving equipment operators; and motor vehicle operators. Findings from this study might be used to identify specific occupations worthy of further investigation and to generate hypotheses about chemical or physical exposures common to such occupations.

Teacher Mathematical Literacy: Case Study of Junior High School Teachers in Pasaman

NASA Astrophysics Data System (ADS)

Ahmad, D.; Suherman, S.; Maulana, H.

2018-04-01

The aim of this paper was to examine the ability of junior high school mathematics teachers to solve mathematical literacy base Problems (PISA and PISA-like problems) for the case Pasaman regency. The data was collected by interviews and test. As the results of this study, teacher ability in solving mathematical literacy base problems for level 1 until 3 has been good, but for level 4 or above is still low. It is caused by teacher knowledge about mathematical literacy still few.

Fragility fractures and bone mineral density in HIV positive women: a case-control population-based study.

PubMed

Prior, J; Burdge, D; Maan, E; Milner, R; Hankins, C; Klein, M; Walmsley, S

2007-10-01

This Canadian study of bone health showed that HIV+ women were more likely to have had fragility fractures (OR 1.7) but had BMD values that were not different than women from a national population-based cohort. Given that 17.5 million women globally are HIV-infected and living longer on anti-retroviral therapy (ART+), it is essential to determine whether they are at risk for osteoporosis as is currently assumed. Assessment of osteoporosis risk factors and lifetime low-trauma (fragility) fracture history used a common interviewer-administered questionnaire and phantom-adjusted bone mineral density (BMD). This study compared HIV+ Canadian women with age- and region-matched control women (1:3) from a national population-based study of osteoporosis. One hundred and thirty-eight HIV+ women (100 ART+, 38 ART-) were compared with 402 controls. There were no differences in age (37.7 vs. 38.0 years), BMI (25.0 vs. 26.2), family history of osteoporosis, exercise history, alcohol or calcium intakes, age at menarche, oral contraceptive use or parity. HIV+ cases included more Aboriginal and Black women (12.5% and 16.2 vs. 2% and 1%, respectively), smoked and used injection drugs (53%) more, were more often treated with glucocorticoids, had oligomenorrhea, and reported 10-kg weight cycling. Significantly more HIV+ women reported lifetime fragility fractures (26.1% vs. 17.3; OR 1.7, 95% CI 1.1, 2.6). HIV+ and control women did not differ in BMD: spine 1.0 +/- 0.12 vs.1.0 +/- 0.14 g/cm(2) (diff. 0.0, 95% CI -0.27, 0.27) or total femur 0.91 +/- 0.15 vs. 0.93 +/- 0.12 g/cm(2) (diff 0.02, 95% CI +0.005, -0.045). HIV+ women reported significantly more past osteoporotic fractures than population-based controls despite normal BMD. Research is needed to assess bone microarchitecture and develop a reliable fracture risk assessment tool for HIV+ women.

Higher dietary intakes of choline and betaine are associated with a lower risk of primary liver cancer: a case-control study.

PubMed

Zhou, Rui-Fen; Chen, Xiao-Lin; Zhou, Zhong-Guo; Zhang, Yao-Jun; Lan, Qiu-Ye; Liao, Gong-Cheng; Chen, Yu-Ming; Zhu, Hui-Lian

2017-04-06

The dietary intake of methyl donors is favorably associated with many diseases, but the findings regarding primary liver cancer (PLC) risk are limited. This study investigated the association between the intake of choline, betaine and methionine and PLC risk in adults. This 1:1 matched case-control study enrolled 644 hospital-based PLC patients and 644 community-based controls who were matched by sex and age, in Guangzhou, China. An interviewer-administered questionnaire and a food-frequency questionnaire were used to collect general information and dietary intake information. Conditional logistic regression showed a significantly inverse association between total choline and betaine intakes and PLC risk. The multivariable-adjusted odds ratios (ORs) and their 95% confidence intervals (CIs) for PLC for the top (vs. bottom) tertile were 0.34 (0.24-0.49; P -trend  < 0.001) for total choline and 0.67 (0.48-0.93; P -trend  = 0.011) for betaine. No significant association was observed between the intake of methionine and PLC risk (P > 0.05). For individual choline compounds, higher consumptions of free choline, glycerophosphocholine, phosphocholine, phosphatidylcholine and sphingomyelin were associated with a lower PLC risk (all P-trend < 0.05). The studied associations were not significantly modified by the folate intake (P-interactions: 0.488-0.890). Our findings suggest that higher choline and betaine intakes may be associated with a lower risk of PLC.

The association between urban tree cover and gun assault: A case-control and case-crossover study

Treesearch

Michelle C. Kondo; Eugenia C. South; Charles C. Branas; Therese S. Richmond; Douglas J. Wiebe

2017-01-01

Green space and vegetation may play a protective role against urban violence. We investigated whether being near urban tree cover during outdoor activities was related to being assaulted with a gun. We conducted geographic information systems–assisted interviews with boys andmen aged 10–24 years in Philadelphia, Pennsylvania, including 135 patients who had been shot...

Contact screening and chemoprophylaxis in India's Revised Tuberculosis Control Programme: a situational analysis.

PubMed

Banu Rekha, V V; Jagarajamma, K; Wares, F; Chandrasekaran, V; Swaminathan, S

2009-12-01

India's Revised National Tuberculosis Control Programme (RNTCP) recommends screening of all household contacts of smear-positive pulmonary tuberculosis (PTB) cases for tuberculosis (TB) disease, and 6-month isoniazid preventive therapy (IPT) for asymptomatic children aged <6 years. To assess the implementation of child contact screening and IPT administration under the RNTCP. A cross-sectional study conducted in four randomly selected TB units (TUs), two in an urban (Chennai City) and two in a rural (Vellore District) area of Tamil Nadu, South India, from July to September 2008. The study involved the perusal of TB treatment cards of source cases (new or retreatment smear-positive PTB patients started on treatment), interview of source cases and focus group discussions (FGDs) among health care workers. Interviews of 253 PTB patients revealed that of 220 contacts aged <14 years, only 31 (14%) had been screened for TB, and that of 84 household children aged <6 years, only 16 (19%) had been initiated on IPT. The treatment cards of source cases lacked documentation of contact details. FGDs revealed greater TB awareness among urban health care workers, but a lack of detailed knowledge about procedures. Provision for documentation using a separate IPT card and focused training may help improve the implementation of contact screening and IPT.

Instructors' Experiences of Web Based Synchronous Communication using Two Way Audio and Direct Messaging

ERIC Educational Resources Information Center

Murphy, Elizabeth; Ciszewska-Carr, Justyna

2007-01-01

This paper reports on an exploratory case study designed to gain insight into instructors' experiences with web based synchronous communication using two way audio and direct messaging. We conducted semi-structured interviews with eight instructors who used "Elluminate Live" in their web based, asynchronous courses in Education, Nursing,…

Risk Factors for Influenza A(H1N1)pdm09 among Students, Beijing, China

PubMed Central

Zheng, Yang; Duan, Wei; Yang, Peng; Zhang, Yi; Wang, Xiaoli; Zhang, Li; Liyanage, Surabhi S.

2013-01-01

To identify risk factors associated with influenza A(H1N1)pdm09 among students in Beijing, China, we conducted a case–control study. Participants (304 case-patients and 608 controls, age range 6–19 years) were interviewed by using a standardized questionnaire. We found that in addition to vaccination, nonpharmaceutical interventions appeared to be protective. PMID:23347500

A case study examination of structure and function in a state health department chronic disease unit.

PubMed

Alongi, Jeanne

2015-04-01

I explored the structural and operational practices of the chronic disease prevention and control unit of a state health department and proposed a conceptual model of structure, function, and effectiveness for future study. My exploratory case study examined 7 elements of organizational structure and practice. My interviews with staff and external stakeholders of a single chronic disease unit yielded quantitative and qualitative data that I coded by perspective, process, relationship, and activity. I analyzed these for patterns and emerging themes. Chi-square analysis revealed significant correlations among collaboration with goal ambiguity, political support, and responsiveness, and evidence-based decisions with goal ambiguity and responsiveness. Although my study design did not permit conclusions about causality, my findings suggested that some elements of the model might facilitate effectiveness for chronic disease units and should be studied further. My findings might have important implications for identifying levers around which capacity can be built that may strengthen effectiveness.

A Case Study Examination of Structure and Function in a State Health Department Chronic Disease Unit

PubMed Central

2015-01-01

Objectives. I explored the structural and operational practices of the chronic disease prevention and control unit of a state health department and proposed a conceptual model of structure, function, and effectiveness for future study. Methods. My exploratory case study examined 7 elements of organizational structure and practice. My interviews with staff and external stakeholders of a single chronic disease unit yielded quantitative and qualitative data that I coded by perspective, process, relationship, and activity. I analyzed these for patterns and emerging themes. Results. Chi-square analysis revealed significant correlations among collaboration with goal ambiguity, political support, and responsiveness, and evidence-based decisions with goal ambiguity and responsiveness. Conclusions. Although my study design did not permit conclusions about causality, my findings suggested that some elements of the model might facilitate effectiveness for chronic disease units and should be studied further. My findings might have important implications for identifying levers around which capacity can be built that may strengthen effectiveness. PMID:25689211

Effectiveness of Implementation of Electronic Malaria Information System as the National Malaria Surveillance System in Thailand

PubMed Central

2016-01-01

Background In moving toward malaria elimination, one strategy is to implement an active surveillance system for effective case management. Thailand has developed and implemented the electronic Malaria Information System (eMIS) capturing individualized electronic records of suspected or confirmed malaria cases. Objective The main purpose of this study was to determine how well the eMIS improves the quality of Thailand’s malaria surveillance system. In particular, the focus of the study was to evaluate the effectiveness of the eMIS in terms of the system users’ perception and the system outcomes (ie, quality of data) regarding the management of malaria patients. Methods A mixed-methods technique was used with the framework based on system effectiveness attributes: data quality, timeliness, simplicity, acceptability, flexibility, stability, and usefulness. Three methods were utilized: data records review, survey of system users, and in-depth interviews with key stakeholders. From the two highest endemic provinces, paper forms matching electronic records of 4455 noninfected and 784 malaria-infected cases were reviewed. Web-based anonymous questionnaires were distributed to all 129 eMIS data entry staff throughout Thailand, and semistructured interviews were conducted with 12 management-level officers. Results The eMIS is well accepted by system users at both management and operational levels. The data quality has enabled malaria personnel to perform more effective prevention and control activities. There is evidence of practices resulting in inconsistencies and logical errors in data reporting. Critical data elements were mostly completed, except for a few related to certain dates and area classifications. Timeliness in reporting a case to the system was acceptable with a delay of 3-4 days. The evaluation of quantitative and qualitative data confirmed that the eMIS has high levels of simplicity, acceptability, stability, and flexibility. Conclusions Overall, the system implemented has achieved its objective. The results of the study suggested that the eMIS helps improve the quality of Thailand’s malaria surveillance system. As the national malaria surveillance system, the eMIS’s functionalities have provided the malaria staff working at the point of care with close-to-real-time case management data quality, covering case detection, case investigation, drug compliance, and follow-up visits. Such features has led to an improvement in the quality of the malaria control program; the government officials now have quicker access to both individual and aggregated data to promptly react to possible outbreak. The eMIS thus plays one of the key roles in moving toward the national goal of malaria elimination by the next decade. PMID:27227156

International public health research involving interpreters: a case study from Bangladesh.

PubMed

Pitchforth, Emma; van Teijlingen, Edwin

2005-06-28

Cross-cultural and international research are important components of public health research, but the challenges of language barriers and working with interpreters are often overlooked, particularly in the case of qualitative research. A case-study approach was used to explore experiences of working with an interpreter in Bangladesh as part of a research project investigating women's experiences of emergency obstetric care. Data from the researcher's field notes provided evidence of experiences in working with an interpreter and show how the model of interviewing was adapted over time to give a more active role to the interpreter. The advantages of a more active role were increased rapport and "flow" in interviews. The disadvantages included reduced control from the researcher's perspective. Some tensions between the researcher and interpreter remained hard to overcome, irrespective of the model used. Independent transcription and translation of the interviews also raised questions around accuracy in translation. The issues examined in this case study have broader implications for public health research. Further work is needed in three areas: 1) developing effective relationships with interpreters; 2) the impact of the interpreter on the research process; and 3) the accuracy of the translation and level of analysis needed in any specific public health research. Finally, this paper highlights the importance to authors of reflecting on the potential impact of translation and interpretation on the research process when disseminating their research.

In Search of a New Paradigm for Higher Education: A Case Analysis of Faculty Experiences in the First Year of a New University.

ERIC Educational Resources Information Center

Gonzalez, Kenneth P.

This study examined the experiences of faculty members in the first year of a new university. Twelve faculty at the new institution were interviewed and observed during the 1995-96 academic year. The analysis presented in this paper is based on one particular interview. Overall, six concrete universals were found during the analysis: (1) the…

Assessing the Risk of Oral Cancer associated with Gutka and Other Smokeless Tobacco Products: A Case-control Study.

PubMed

Awan, K H; Hussain, Q A; Patil, Shankargouda; Maralingannavar, Mahesh

2016-09-01

Tobacco and tobacco-related products have been attributed to be causative factors for oral cancer. Newer, chewable, and commercially available smokeless tobacco (ST) products, such as gutka pose further threat in this direction. The aim of the study was to evaluate the risk of oral cancer associated with gutka and other ST products. A case-control study of 134 cases and 134 controls, over a period of 6 months (July-December 2014), was carried out at the Baqai University, Karachi, Pakistan. An interview-based questionnaire was used to collect data on sociodemographic characteristics, oral hygiene practices and type, duration, and frequency of use of tobacco-related products. Data were analyzed using the Pearson's chi-square (χ 2 ) test with the level of significance set as p < 0.05. Gutka showed the highest odds ratio toward developing oral cancer ratio among all the tobacco-related products [odds ratio (OR) 5.54; 95% CI 2.83-10.83; p < 0.001)]. Participants who consumed other ST products also showed 2 to 4 times higher odds ratio of developing oral cancer than compared to those who did not consume these products. The study provided strong evidence that gutka and other ST products are independent risk factors for oral cancer. This study highlights the strong association of different types of ST and oral cancer. This results in identification of high-risk groups for targeted screening for potential oral cancer lesions.

Outbreak of haemolytic uraemic syndrome in Norway caused by stx2-positive Escherichia coli O103:H25 traced to cured mutton sausages

PubMed Central

Schimmer, Barbara; Nygard, Karin; Eriksen, Hanne-Merete; Lassen, Jørgen; Lindstedt, Bjørn-Arne; Brandal, Lin T; Kapperud, Georg; Aavitsland, Preben

2008-01-01

Background On 20–21 February 2006, six cases of diarrhoea-associated haemolytic uraemic syndrome (HUS) were reported by paediatricians to the Norwegian Institute of Public Health. We initiated an investigation to identify the etiologic agent and determine the source of the outbreak in order to implement control measures. Methods A case was defined as a child with diarrhoea-associated HUS or any person with an infection with the outbreak strain of E. coli O103 (defined by the multi-locus variable number tandem repeats analysis (MLVA) profile) both with illness onset after January 1st 2006 in Norway. After initial hypotheses-generating interviews, we performed a case-control study with the first fifteen cases and three controls for each case matched by age, sex and municipality. Suspected food items were sampled, and any E. coli O103 strains were typed by MLVA. Results Between 20 February and 6 April 2006, 17 cases were identified, of which 10 children developed HUS, including one fatal case. After pilot interviews, a matched case-control study was performed indicating an association between a traditional cured sausage (odds ratio 19.4 (95% CI: 2.4–156)) and STEC infection. E. coli O103:H25 identical to the outbreak strain defined by MLVA profile was found in the product and traced back to contaminated mutton. Conclusion We report an outbreak caused by a rare STEC variant (O103:H25, stx2-positive). More than half of the diagnosed patients developed HUS, indicating that the causative organism is particularly virulent. Small ruminants continue to be important reservoirs for human-pathogen STEC. Improved slaughtering hygiene and good manufacturing practices for cured sausage products are needed to minimise the possibility of STEC surviving through the entire sausage production process. PMID:18387178

Stillbirth Collaborative Research Network: design, methods and recruitment experience.

PubMed

Parker, Corette B; Hogue, Carol J R; Koch, Matthew A; Willinger, Marian; Reddy, Uma M; Thorsten, Vanessa R; Dudley, Donald J; Silver, Robert M; Coustan, Donald; Saade, George R; Conway, Deborah; Varner, Michael W; Stoll, Barbara; Pinar, Halit; Bukowski, Radek; Carpenter, Marshall; Goldenberg, Robert

2011-09-01

The Stillbirth Collaborative Research Network (SCRN) has conducted a multisite, population-based, case-control study, with prospective enrollment of stillbirths and livebirths at the time of delivery. This paper describes the general design, methods and recruitment experience. The SCRN attempted to enroll all stillbirths and a representative sample of livebirths occurring to residents of pre-defined geographical catchment areas delivering at 59 hospitals associated with five clinical sites. Livebirths <32 weeks gestation and women of African descent were oversampled. The recruitment hospitals were chosen to ensure access to at least 90% of all stillbirths and livebirths to residents of the catchment areas. Participants underwent a standardised protocol including maternal interview, medical record abstraction, placental pathology, biospecimen testing and, in stillbirths, post-mortem examination. Recruitment began in March 2006 and was completed in September 2008 with 663 women with a stillbirth and 1932 women with a livebirth enrolled, representing 69% and 63%, respectively, of the women identified. Additional surveillance for stillbirths continued until June 2009 and a follow-up of the case-control study participants was completed in December 2009. Among consenting women, there were high consent rates for the various study components. For the women with stillbirths, 95% agreed to a maternal interview, chart abstraction and a placental pathological examination; 91% of the women with a livebirth agreed to all of these components. Additionally, 84% of the women with stillbirths agreed to a fetal post-mortem examination. This comprehensive study is poised to systematically study a wide range of potential causes of, and risk factors for, stillbirths and to better understand the scope and incidence of the problem. © 2011 Blackwell Publishing Ltd.

Modeling and Control of Airport Queueing Dynamics under Severe Flow Restrictions

NASA Technical Reports Server (NTRS)

Carr, Francis; Evans, Antony; Clarke, John-Paul; Deron, Eric

2003-01-01

Based on field observations and interviews with controllers at BOS and EWR, we identify the closure of local departure fixes as the most severe class of airport departure restrictions. A set of simple queueing dynamics and traffic rules are developed to model departure traffic under such restrictions. The validity of the proposed model is tested via Monte Carlo simulation against 10 hours of actual operations data collected during a case-study at EWR on June 29,2000. In general, the model successfully reproduces the aggregate departure congestion. An analysis of the average error over 40 simulation runs indicates that flow-rate restrictions also significantly impact departure traffic; work is underway to capture these effects. Several applications and what-if scenarios are discussed for future evaluation using the calibrated model.

Leadership Strategies for Maintaining Profitability in a Volatile Crude Oil Market

NASA Astrophysics Data System (ADS)

Braimoh, Lucky Anderson

Volatile crude oil prices significantly affect the profitability of crude oil firms. The purpose of this single case study was to explore strategies some crude oil and gas business leaders used to remain profitable during periods of crude oil price volatility. The target population comprised 8 crude oil and gas business leaders located in Calgary, Canada, whose company remained profitable despite crude oil price volatility. The transformational leadership theory formed the conceptual framework for the study. Data were collected through the use of semistructured face-to-face interviews, company reports, and field notes. Data analysis involved a modified Van Kamm method, which included descriptive coding, a sequential review of the interview transcripts, and member checking. Based on methodological triangulation and thematic analysis, 5 themes emerged from the study, including communication and engagement; motivation and empowerment; measurement, monitoring, and control; self-awareness and humility; and efficiency and optimization. The implications for social change include the potential for crude oil and gas companies in Calgary, Canada to manage production costs, ensure earnings and profitability, and thus improve the socioeconomic well-being of Calgary indigenes through improved employment opportunities.

Older persons' definitions and explanations of elder abuse in the Netherlands.

PubMed

Mysyuk, Yuliya; Westendorp, Rudi G J; Lindenberg, Jolanda

2016-01-01

In this article we explore older persons' definitions of and explanations for elder abuse in the Netherlands by means of interviews with older persons. A qualitative study was conducted based on semistructured interviews with 35 older persons who had no experience with abuse. Our findings show that older persons participating in our study define elder abuse foremost as physical violence that is performed intentionally. The study participants explain elder abuse as a result of the dependency and vulnerability of older persons, of changing norms and values, and of changes in the position of older persons in society, which result in disrespect toward older persons and a lack of social control and responsibility. The older persons' explanations for the occurrence of abuse mainly focus on societal changes; older persons seem to regard elder abuse primarily as a societal problem. This understanding of, and explanation for, elder abuse may influence their detection and reporting behavior, as they may tend to acknowledge only severe cases of intentional physical violence that leave clear and therefore physically detectable evidence.

Regular Chinese Green Tea Consumption Is Protective for Diabetic Retinopathy: A Clinic-Based Case-Control Study

PubMed Central

Ma, Qinghua; Chen, Dandan; Sun, Hong-Peng; Yan, Ning; Xu, Yong; Pan, Chen-Wei

2015-01-01

Objective. To determine the association between regular Chinese green tea consumption and the risk of diabetic retinopathy (DR) in diabetic patients in China. Methods. 100 DR patients and 100 age-sex-matched diabetic controls without retinopathy were recruited in a clinic-based, case-control study. DR was defined from retinal photographs and detailed information on Chinese green tea consumption of the participants was collected through a face-to-face interview. Results. The crude odds ratio [OR] of Chinese green tea consumption for DR was 0.49 (95% confidence interval: 0.26–0.90). When stratified by sex, the protective effect of Chinese green tea consumption on DR was statistically significant in women (P = 0.01) but not in men (P = 0.63). After adjusting for age, sex, and other confounders, DR was significantly associated with Chinese green tea consumption (OR = 0.48; P = 0.04), higher systolic blood pressure (OR = 1.02; P = 0.05), longer duration of diabetes (OR = 1.07; P = 0.02), and the presence of family history of diabetes (OR = 2.35; P = 0.04). Conclusions. Diabetic patients who had regularly drunk Chinese green tea every week for at least one year in their lives had a DR risk reduction of about 50% compared with those who had not. Regular Chinese green tea consumption may be a novel approach for the prevention of DR. PMID:26539551

Regular Chinese Green Tea Consumption is Protective for Diabetic Retinopathy: A Clinic-Based Case-Control Study.

PubMed

Ma, Qinghua; Chen, Dandan; Sun, Hong-Peng; Yan, Ning; Xu, Yong; Pan, Chen-Wei

2015-01-01

To determine the association between regular Chinese green tea consumption and the risk of diabetic retinopathy (DR) in diabetic patients in China. 100 DR patients and 100 age-sex-matched diabetic controls without retinopathy were recruited in a clinic-based, case-control study. DR was defined from retinal photographs and detailed information on Chinese green tea consumption of the participants was collected through a face-to-face interview. The crude odds ratio [OR] of Chinese green tea consumption for DR was 0.49 (95% confidence interval: 0.26-0.90). When stratified by sex, the protective effect of Chinese green tea consumption on DR was statistically significant in women (P = 0.01) but not in men (P = 0.63). After adjusting for age, sex, and other confounders, DR was significantly associated with Chinese green tea consumption (OR = 0.48; P = 0.04), higher systolic blood pressure (OR = 1.02; P = 0.05), longer duration of diabetes (OR = 1.07; P = 0.02), and the presence of family history of diabetes (OR = 2.35; P = 0.04). Diabetic patients who had regularly drunk Chinese green tea every week for at least one year in their lives had a DR risk reduction of about 50% compared with those who had not. Regular Chinese green tea consumption may be a novel approach for the prevention of DR.

[PHARMAGRIPS: structured pharmaceutical counseling in the self-medication of the common cold. A randomised controlled study (RCT)].

PubMed

Laven, Anna; Schäfer, Julia; Läer, Stephanie

2014-06-01

Many minor ailments are treated in Germany by self-medication. Most drugs dispensed by pharmacy staff are those for the common cold, general pain and gastrointestinal disorders. Whilst pharmacists express their need for further training in counseling on side effects, interactions and contraindications, they tend to receive feedback from patients to the effect that the drugs used have not worked. From July to October 2013 we carried out a prospective, single-blind, quasi-randomised controlled study on the effect of training on structured pharmaceutical advice in self-medication of the common cold (PHARMAGRIPS Study). Using a controlled, interventional study design we investigated whether it is possible to improve the pharmaceutical counseling in self-medication within a short time, by using an appropriate teaching method. The counseling should be made in a systematic way and refer to evidence-based content in order to avoid incorrect advice. We enrolled 86 pharmacists and assigned them randomly into the study protocol. Of those, 56 completed the study as planned and were analysed. In this study, we reviewed the structure of the average pharmaceutical consultation and added evidence-based content from the Cochrane Reviews on common cold. We then integrated this structured consultation in a methodical modem training program consisting of e-learning and live classes which we evaluated scientifically. For this purpose, we conducted telephone interviews with the participating pharmacists by using standardized case report forms. The case report forms contained the questions that the participants were supposed to ask. For every question asked, the participant received a certain amount of points, 18 in total. The training was stated to be successful at the primary endpoint when an improvement of at least 3.5 out of 18 points was achieved on average. The secondary endpoints were related to various aspects of the interview process (medical history, limits of self-medication, evidence-based drug selection and integration of customer input in the consultation interaction). The training group improved in the primary endpoint by an average of 5.93 points (p < 0.001) and compared to the control group significantly in all secondary endpoints, with one participant managing to achieve the full score. The participants recognized the importance and practical relevance of the exercise in a short time and were able to implement even integrate complex content in their consultations and to give the customer appropriate advice.

Population-Based Case-Control Study of Recreational Drug Use and Testis Cancer Risk Confirms Association between Marijuana Use and Non-Seminoma Risk

PubMed Central

Lacson, John Charles A.; Carroll, Joshua D.; Tuazon, Ellenie; Castelao, Esteban J.; Bernstein, Leslie; Cortessis, Victoria K.

2013-01-01

Background Testicular germ cell tumor (TGCT) incidence increased steadily in recent decades, but causes remain elusive. Germ cell function may be influenced by cannabinoids, and two prior epidemiologic studies report that use of marijuana may be associated with non-seminomatous TGCT. Here we evaluate the relationship between TGCTs and exposure to marijuana and other recreational drugs using a population-based case-control study. Methods 163 TGCT cases diagnosed in Los Angeles County from December 1986 to April 1991 were enrolled with 292 controls matched on age, race/ethnicity and neighborhood. Participants were asked about drug use by structured in-person interview. Odds ratios and 95% confidence intervals were estimated using conditional logistic regression, adjusted for history of cryptorchidism; education; religiosity; and reported use of marijuana, cocaine and amyl nitrite. Results Compared to never use, ever use of marijuana had two-fold increased risk (OR=1.94, 95%CI: 1.02–3.68) while ever use of cocaine was negatively associated with TGCT (OR=0.54, 95%CI: 0.32–0.91). Stratification on tumor histology revealed a specific association of marijuana use with non-seminoma and mixed histology tumors (OR=2.42, 95%CI: 1.08–5.42). Conclusions We observed a specific association of marijuana use with risk of non-seminoma and mixed tumors. This is the first report of a negative association between cocaine use and TGCT risk. Results warrant mechanistic studies of marijuana’s effect on the endocannabinoid system and TGCT risk, and caution that recreational and therapeutic cannabinoids by young men may confer malignant potential to testicular germ cells. PMID:22965656

Risk of multiple myeloma following medication use and medical conditions: a case-control study in Connecticut women.

PubMed

Landgren, Ola; Zhang, Yawei; Zahm, Sheila Hoar; Inskip, Peter; Zheng, Tongzhang; Baris, Dalsu

2006-12-01

Certain commonly used drugs and medical conditions characterized by chronic immune dysfunction and/or antigen stimulation have been suggested to affect important pathways in multiple myeloma tumor cell growth and survival. We conducted a population-based case-control study to investigate the role of medical history in the etiology of multiple myeloma among Connecticut women. A total of 179 incident multiple myeloma cases (21-84 years, diagnosed 1996-2002) and 691 population-based controls was included in this study. Information on medical conditions, medications, and medical radiation was obtained by in-person interviews. We calculated odds ratios (OR) as measures of relative risks using logistic regression models. A reduced multiple myeloma risk was found among women who had used antilipid statin therapy [OR, 0.4; 95% confidence interval (95% CI), 0.2-0.8] or estrogen replacement therapy (OR, 0.6; 95% CI, 0.4-0.99) or who had a medical history of allergy (OR, 0.4; 95% CI, 0.3-0.7), scarlet fever (OR, 0.5; 95% CI, 0.2-0.9), or bursitis (OR, 0.4; 95% CI, 0.2-0.7). An increased risk of multiple myeloma was found among women who used prednisone (OR, 5.1; 95% CI, 1.8-14.4), insulin (OR, 3.1; 95% CI, 1.1-9.0), or gout medication (OR, 6.7; 95% CI, 1.2-38.0). If our results are confirmed, mechanistic studies examining how prior use of insulin, prednisone, and, perhaps, gout medication might promote increased occurrence of multiple myeloma and how antilipid statins, estrogen replacement therapy, and certain medical conditions might protect against multiple myeloma may provide insights to the as yet unknown etiology of multiple myeloma.

Raw garlic consumption as a protective factor for lung cancer, a population-based case-control study in a Chinese population

PubMed Central

Jin, Zi-Yi; Wu, Ming; Han, Ren-Qiang; Zhang, Xiao-Feng; Wang, Xu-Shan; Liu, Ai-Ming; Zhou, Jin-Yi; Lu, Qing-Yi; Zhang, Zuo-Feng; Zhao, Jin-Kou

2013-01-01

Protective effect of garlic on the development of cancer has been reported in vitro and in vivo experimental studies, however, few human epidemiological studies have evaluated the relationship. A population-based case-control study has been conducted in a Chinese population from 2003 to 2010, with the aim to explore the association between raw garlic consumption and lung cancer. Epidemiological data were collected by face-to-face interviews using a standard questionnaire among 1,424 lung cancer cases and 4,543 healthy controls. Unconditional logistic regression was employed to estimate adjusted odds ratios (OR) and their 95% confidence intervals (CIs), and to evaluate ratio of odds ratios (ROR) for multiplicative interactions between raw garlic consumption and other risk factors. After adjusting for potential confounding factors, raw garlic consumption of ≥ 2 times per week is inversely associated with lung cancer (OR = 0.56, 95% CI = 0.44-0.72) with a monotonic dose-response relationship (p for trend <0.001). Furthermore, strong interactions at either additive and/or multiplicative scales were observed between raw garlic consumption and tobacco smoking (Synergy Index (SI) = 0.70, 95% CI = 0.57-0.85; and ROR = 0.78, 95% CI = 0.67-0.90), as well as high-temperature cooking oil fume (ROR = 0.77, 95% CI = 0.59-1.00). In conclusion, protective association between intake of raw garlic and lung cancer has been observed with a dose-response pattern, suggesting that garlic may potentially serve as a chemopreventive agent for lung cancer. Effective components in garlic in lung cancer chemoprevention warrant further in-depth investigation. PMID:23658367

Serial murder in America: case studies of seven offenders.

PubMed

Beasley, James O

2004-01-01

This article summarizes and compares information on seven interviewed serial killers in an ongoing project designed to study similarities and differences among these individuals. The aim of this article is to increase our collective knowledge of the dynamics of serial murder by examining the perpetrators' backgrounds, as well as the unique ways in which they view themselves and the world around them. Although qualitative interview research alone is not sufficient to fully understand such behavior, it is useful in many ways. Some of the information discussed based on the seven offenders interviewed is compared with broader epidemiological studies, and the strengths and limitations of each type of research are discussed. Published in 2004 by John Wiley & Sons, Ltd.

Family history of cancer and the risk of bladder cancer: A case-control study from Italy.

PubMed

Turati, Federica; Bosetti, Cristina; Polesel, Jerry; Serraino, Diego; Montella, Maurizio; Libra, Massimo; Facchini, Gaetano; Ferraroni, Monica; Tavani, Alessandra; La Vecchia, Carlo; Negri, Eva

2017-06-01

A family history of bladder cancer has been associated with the risk of bladder cancer, but quantification of the excess risk in different populations is still a relevant issue. Further, the role of a family history of other cancers on the risk of bladder cancer remains unclear. We analyzed data from an Italian case-control study, including 690 bladder cancer cases and 665 hospital controls. Odds ratios (ORs) were estimated through unconditional logistic regression models, adjusted for sex, age, study center, year of interview and further for education, smoking and sibling's number. The OR for family history of bladder cancer was 2.13 (95% confidence intervals (95%CIs) 1.02-4.49) from the model with partial adjustment, and 1.99 (95%CI 0.91-4.32) after additional adjustment for smoking and siblings' number, based on 23 cases (3.3%) and 11 controls (1.7%) with a family history of bladder cancer. The fully adjusted OR was 3.77 when the relative was diagnosed at age below 65years. Smokers with a family history of bladder cancer had a four-fold increased risk compared to non-smokers without a family history. Bladder cancer risk was significantly increased among subjects with a family history of hemolymphopoietic cancers (OR=2.97, 95%CI 1.35-6.55). Family history of cancer at other sites showed no significant association with bladder cancer risk. This study confirms an approximately two-fold increased risk of bladder cancer for family history of bladder cancer, and indicates a possible familial clustering of bladder cancer with cancers of the hemolymphopoietic system. Copyright © 2017 Elsevier Ltd. All rights reserved.

A case-control study to examine the association between breastfeeding during late pregnancy and risk of a small-for-gestational-age birth in Lima, Peru.

PubMed

Pareja, Rossina G; Marquis, Grace S; Penny, Mary E; Dixon, Philip M

2015-04-01

Excessive demands on maternal nutritional status may be a risk factor for poor birth outcomes. This study examined the association between breastfeeding during late pregnancy (≥ 28 weeks) and the risk of having a small-for-gestational-age (SGA) newborn, using a matched case-control design (78 SGA cases: birthweight <10th percentile for gestational age; 150 non-SGA controls: 50th percentile

Industrial Guidelines for Undertaking a Hard-Core Employment Program: An Analytic Case Study of the Experience of an Urban Industrial Organization.

ERIC Educational Resources Information Center

Feifer, Irwin; And Others

Based on an analytically evaluative case study of a New York City furniture department store's experiences with a Manpower Administration contract, this report deals with the development and progress of the program as analyzed by one investigator through interviews with almost all of the participants in the program. As a result of the study,…

Is there an association between bruxism and intestinal parasitic infestation in children?

PubMed

Díaz-Serrano, Kranya Victoria; da Silva, Carolina Brunelli Alvares; de Albuquerque, Sérgio; Pereira Saraiva, Maria da Conceição; Nelson-Filho, Paulo

2008-01-01

Multiple factors have been considered in the etiology of bruxism in pediatric patients, among which are infestations by intestinal parasites suggested by some authors. No empirical evidence exists, however, of such association. Therefore, this study's purpose was to investigate the existence of an association between bruxism and intestinal parasitic infestation in children. Fifty-seven 6- to 11-year-olds (30 cases and 27 controls) who had not used anthelminthics 2 months before the baseline examination were enrolled in the study. A diagnosis of bruxism was based on an intraoral clinical examination performed by a single trained examiner and on the parent/guardian's report of any perceived parafunctional habits (questionnaire-based interview). Bruxism cases were defined as those children with a report of currently perceived habits of eccentric or centric bruxism (tooth-grinding and tooth-clenching, respectively) combined with clinical evidence of nonphysiologic wear facets. The volunteers were required to collect 3 fecal samples (1 every 2 to 3 days). Parasitologic analysis was performed using the spontaneous sedimentation method. Data gathered from the intraoral clinical examination, questionnaire, and parasitologic analysis were tabulated and submitted to statistical analysis using the chi-square test and student's t test. Intestinal parasitic infestation was observed in 30% (N=9) of cases and 41% (N=11) of controls, but no statistically significant association was observed (P=.40). This study's findings do not support the existence of an association between intestinal parasitic infestation and bruxism among the evaluated pediatric population.

Black tobacco, wine and mate in oropharyngeal cancer. A case-control study from Uruguay.

PubMed

De Stefani, E; Correa, P; Oreggia, F; Deneo-Pellegrini, H; Fernandez, G; Zavala, D; Carzoglio, J; Leiva, J; Fontham, E; Rivero, S

1988-01-01

A case-control study of oral and pharyngeal cancer involving interviews with 108 cases and 286 controls was carried out in the University Hospital of Montevideo, Uruguay. The study was restricted to males and cases afflicted with lip, salivary gland and nasopharyngeal cancer were excluded. Point estimates of RR associated with smoking variables, alcohol variables, nutritional items and ingestion of hot infusions of the herb Ilex paraguariensis ('Mate') were obtained by logistic regression analysis. Dark tobacco smokers showed a RR 3.4 times higher than light tobacco users and heavy drinkers of wine displayed an OR of 17.2. Mate exposure showed a significant dose-response, after adjustment for age, tobacco and alcohol intake, with a fivefold increase in risk for heavy consumers. Joint exposure to black tobacco and wine displayed very high risks and no significant interactions were observed. The results suggest that the high rates of oropharyngeal cancer could be explained by the multiplicative effect of black tobacco smoking, wine drinking and mate ingestion.

Risk Factors for Human Immunodeficiency Virus Infection among Brazilian Blood Donors; a Multicenter Case-Control Study Using Audio Computer-Assisted Structured-Interviews

PubMed Central

de Almeida-Neto, Cesar; Goncalez, Thelma T.; Birch, Rebecca Jeffries; de Carvalho, Silvia Maia F.; Capuani, Ligia; Leão, Silvana Carneiro; Miranda, Carolina; Rocha, Pedro Capuani; Carneiro-Proietti, Anna Barbara; Johnson, Bryce R.; Wright, David J.; Murphy, Edward L.; Custer, Brian

2013-01-01

Background Although risk factors for HIV infection are known, it is important for blood centers to understand local epidemiology and disease transmission patterns. Current risk factors for HIV infection in blood donors in Brazil were assessed. Methods A case-control study was conducted at large public blood centers located in four major cities between April 2009 – March 2011. Cases were persons whose donations were confirmed positive by enzyme immunoassays followed by Western Blot confirmation. Audio computer-assisted structured-interviews (ACASI) were completed by all cases and controls. Multivariable logistic regression was used to estimate adjusted odds ratios (AORs) and associated 95% confidence intervals (CIs). Results There were 341 cases, including 47 with recently-acquired infection, and 791 controls. Disclosed risk factors for both females and males were sex with an HIV-positive person (adjusted odds ratio (AOR) 11.3, 95% CI [4.1, 31.7]) and being an IVDU or sexual partner of an IVDU (AOR 4.65 [1.8, 11.7]). For female blood donors, additional risk factors were having male sex partners who also are MSM (AOR 13.5 [3.1, 59.8]), and having unprotected sex with multiple sexual partners (AOR 5.19 [2.1, 12.9]). The primary risk factor for male blood donors was MSM activity (AOR 21.6 [8.8, 52.9.]). Behaviors associated with recently-acquired HIV were being a MSM or sex partner of MSM (13.82, [4.7, 40.3]), and IVDU (11.47, [3.0, 43.2]). Conclusion Risk factors in blood donors parallel those in the general population in Brazil. Identified risk factors suggest that donor compliance with selection procedures at the participating blood centers is inadequate. PMID:23517235

Gall bladder cancer and the role of dietary and lifestyle factors: a case-control study in a North Indian population.

PubMed

Panda, Dipanjan; Sharma, Atul; Shukla, Nootan K; Jaiswal, Richa; Dwivedi, Sadanand; Raina, Vinod; Mohanti, Bidhu K; Deo, Surya V; Patra, Somdatta

2013-09-01

Most patients with gall bladder cancer (GBC) present in the advanced stage with a poor response to therapy. Prevention or early detection is the best way to prevent death, but this requires identification of susceptible subgroups. Keeping this in mind, this study was carried out to evaluate the association between selected demographic, lifestyle, and dietary factors and GBC. A hospital-based case-control study was carried out at the All India Institute of Medical Sciences (New Delhi, India). Cases were defined as newly registered confirmed primary GBC patients. Controls were defined as healthy relatives of patients other than that of GBC. Data were collected from February 2008 to October 2009 using a semistructured interview schedule from both cases and controls. Analysis was carried out using SPSS version 15 and Epi-Info version 6. Factors found to be significant in the bivariate analysis were entered in a multivariate logistic regression analysis. A total of 122 cases and 122 controls were included in the study. There was no significant difference in age (P=0.06) and sex (P=0.66) between the cases and the controls. In the bivariate analysis, factors found to be significantly associated with GBC were illiteracy [odds ratio (OR) 8.00, P=0.000], lower socioeconomic status (OR 2.45, P=0.000), parity more than 3 (OR 9.06, P=0.000), age at first pregnancy less than 20 years (OR 2.03, P=0.018), and the use of nonliquefied petroleum gas cooking fuel (OR 4.17, P=0.000). Higher vitamin C intake had a protective effect (OR 0.33, P=0.004). In the multivariate analysis, education, intake of vitamin C, parity, and type of fuel used were significant factors. The risk factors for GBC that have been identified in the present study delineate a high-risk population group that can be targeted for preventive measures including improvement in socioeconomic status, education and lifestyle, and dietary intervention, and avoidance of the use of nonliquefied petroleum gas as cooking fuel.

An account of the Ebola virus disease outbreak in Nigeria: implications and lessons learnt.

PubMed

Otu, Akaninyene; Ameh, Soter; Osifo-Dawodu, Egbe; Alade, Enoma; Ekuri, Susan; Idris, Jide

2017-07-10

The 2014 Ebola virus disease (EVD) outbreak remains unprecedented both in the number of cases, deaths and geographic scope. The first case of EVD was confirmed in Lagos Nigeria on 23 July 2014 and spread to involve 19 laboratory-confirmed EVD cases. The EVD cases were not limited to Lagos State as Rivers State recorded 2 confirmed cases of EVD with 1 out of the 2 dying. Swift implementation of public health measures were sufficient to forestall a country -wide spread of this dreaded disease. This exploratory formative research describes the events of the Nigeria Ebola crisis in 2014. This research was implemented through key informant in-depth interviews involving 15 stakeholders in the EVD outbreak in Nigeria by a team of two or three interviewers. Most of the interviews were conducted face-to-face at the various offices of the respondents and others were via the telephone. The interviews which lasted an hour on average were conducted in English, digitally recorded and notes were also taken. This study elucidated the public health response to the Ebola outbreak led by Lagos State Government in conjunction with the Federal Ministry of Health. The principal strategy was an incident management approach which saw them identify and successfully follow up 894 contacts. The infected EVD cases were quarantined and treated. The Nigerian private sector and international organizations made significant contributions to the control efforts. Public health enlightenment programmes using multimodal communication strategies were rapidly deployed. Water and sanitary facilities were provided in many public schools in Lagos. The 2014 Ebola outbreak in Nigeria was effectively controlled using the incident management approach with massive support provided by the private sector and international community. Eight of the confirmed cases of EVD in Nigeria eventually died (case fatality rate of 42.1%) and twelve were nursed back to good health. On October 20 2014 Nigeria was declared fee of EVD by the World Health Organization. The Nigerian EVD experience provides valuable insights to guide reforms of African health systems in preparation for future infectious diseases outbreaks.

Using Standardized Diagnostic Instruments to Classify Children with Autism in the Study to Explore Early Development

ERIC Educational Resources Information Center

Wiggins, Lisa D.; Reynolds, Ann; Rice, Catherine E.; Moody, Eric J.; Bernal, Pilar; Blaskey, Lisa; Rosenberg, Steven A.; Lee, Li-Ching; Levy, Susan E.

2015-01-01

The Study to Explore Early Development (SEED) is a multi-site case-control study designed to explore the relationship between autism spectrum disorder (ASD) phenotypes and etiologies. The goals of this paper are to (1) describe the SEED algorithm that uses the Autism Diagnostic Interview-Revised (ADI-R) and Autism Diagnostic Observation Schedule…

Marijuana use and car crash injury.

PubMed

Blows, Stephanie; Ivers, Rebecca Q; Connor, Jennie; Ameratunga, Shanthi; Woodward, Mark; Norton, Robyn

2005-05-01

To investigate the relationship between marijuana use prior to driving, habitual marijuana use and car crash injury. Population based case-control study in Auckland, New Zealand. Case vehicles were all cars involved in crashes in which at least one occupant was hospitalized or killed anywhere in the Auckland region, and control vehicles were a random sample of cars driving on Auckland roads. The drivers of 571 case and 588 control vehicles completed a structured interview. Self reported marijuana use in the 3 hours prior to the crash/survey and habitual marijuana use over the previous 12 months were recorded, along with a range of other variables potentially related to crash risk. The main outcome measure was hospitalization or death of a vehicle occupant due to car crash injury. Acute marijuana use was significantly associated with car crash injury, after controlling for the confounders age, gender, ethnicity, education level, passenger carriage, driving exposure and time of day (OR 3.9, 95% CI 1.2-12.9). However, after adjustment for these confounders plus other risky driving at the time of the crash (blood alcohol concentration, seat-belt use, travelling speed and sleepiness score), the effect of acute marijuana intake was no longer significant (OR 0.8, 95% CI 0.2-3.3). There was a strong significant association between habitual use and car crash injury after adjustment for all the above confounders plus acute use prior to driving (OR 9.5, 95% CI 2.8-32.3). This population-based case-control study indicates that habitual use of marijuana is strongly associated with car crash injury. The nature of the relationship between marijuana use and risk-taking is unclear and needs further research. The prevalence of marijuana use in this driving population was low, and acute use was associated with habitual marijuana use, suggesting that intervention strategies may be more effective if they are targeted towards high use groups.

A Case Study of a Volunteer-Based Literacy Class with Adults with Developmental Disabilities

ERIC Educational Resources Information Center

Lynch, Jacqueline

2013-01-01

The purpose of this study was to examine participants' perspectives on how a volunteer-based adult literacy class supports the learning of adults with developmental/intellectual disabilities. Interviews were conducted with four tutors, three adult learners, and two coordinators and observations of the class occurred over a 6-month period during…

Parental Perceptions on Childrens' Out-of-School Physical Activity and Family-Based Physical Activity

ERIC Educational Resources Information Center

Noonan, Robert J.; Boddy, Lynne M.; Fairclough, Stuart J.; Knowles, Zoe R.

2017-01-01

This study explored parents' physical activity (PA) knowledge and perceptions of children's out-of-school PA to formatively contribute to a family-based intervention design. Eleven telephone interviews were conducted with parents of children aged 10-11 years. Child and parent data were triangulated and family case studies were written. Most…

Prostate cancer, benign prostatic hyperplasia and physical activity in Shanghai, China.

PubMed

Lacey, J V; Deng, J; Dosemeci, M; Gao, Y T; Mostofi, F K; Sesterhenn, I A; Xie, T; Hsing, A W

2001-04-01

Studies suggest that increased levels of physical activity might decrease the risk of prostate cancer. We ascertained lifetime measures of activity in a population-based case-control study of prostate cancer in Shanghai, China to investigate physical activity in a population where the incidence of prostate cancer is low but rising. In all, 238 men with prostate cancer, diagnosed 1993-1995, were identified through a rapid reporting system. A second group of 206 men with benign prostatic hyperplasia (BPH) was matched to prostate cancer cases, and 471 age-matched and population-based controls were identified from urban Shanghai. Through personal interviews, we ascertained all daily, occupational, and recreational activities at ages 20-29, ages 40-49, and in 1988 to generate hours spent sleeping, sitting, in moderate activity, and in vigorous activity. Time spent per week in different activities was converted to metabolic equivalents (MET-h) and energy expended. Time spent in, MET-h of, and energy expended in physical activities were not consistently related to either prostate cancer or BPH when compared to controls. Few men reported regular vigorous activity. Occupational activity, based on an energy expenditure index using job titles, was suggestively associated with a decreased risk of BPH, but not associated with prostate cancer. Associations did not vary according to age or stage of prostate cancer at diagnosis. Our results, based on regular physical activity, occupational activity, hours in activities, MET-h, and energy expended, did not support a protective role of physical activity in prostate cancer or BPH for men in a low-risk population.

Socialization and the Acquisition of Professional Discourse: A Case Study in the PR Industry

ERIC Educational Resources Information Center

Bremner, Stephen

2012-01-01

This article tracks the socialization of a Chinese intern into a Hong Kong PR company and considers the factors that enabled her to move toward acquiring the discourse of the profession. Taking a case study approach, the research is based on a detailed daily journal written by the intern during her internship, and two interviews. Over the 3-month…

Leadership in Education Abroad Office: A Case Study Based on the Interactional Framework of Leadership and the Transformational-Transactional Leadership Theory

ERIC Educational Resources Information Center

Deng, Jie

2017-01-01

This case study explored the unique context and dynamics of leadership in an education abroad office. The focus was on how leadership took place in the synergistic interactions among the leader, the followers, and specific situations in such an office. Interviews, observations, and document review were used to collect data. Hughes, Ginnett, and…

Association of HLA-DRB1 alleles and neuropsychological function in autism.

PubMed

Chien, Yi-Ling; Wu, Yu-Yu; Chen, Chia-Hsiang; Gau, Susan Shur-Fen; Huang, Yu-Shu; Chien, Wei-Hsien; Hu, Fu-Chang; Chao, Yu-Lin

2012-02-01

Evidence suggests an association between autism and immune dysfunction. The associations between human lymphocyte antigen (HLA)-A2, B44, DRβ1*04 (DR4), C4B, and haplotype B44-SC30-DR4 and autism have been reported in western countries but there is a lack of such information in Asian population. This study aimed to assess the association between HLA-DRB1 allele frequencies and the clinical phenomenology of autism. The sample included 141 participants (male, 87.2%), who were diagnosed with autistic disorder based on clinical assessments and structured interviews using the Chinese version of the Autism Diagnostic Interview-Revised, and 156 healthy controls (male, 38.6%). The HLA-DRB1 alleles were determined by sequencing-based typing method. A subsample of patients (n=39) were assessed for intelligence and neuropsychological functions. The results showed that the pattern of DRB1 allele frequencies was significantly different between patients with autism and the controls (P=0.047). After adjusting for sex by haplotype regression, the frequencies of DR4, DR11, and DR14 were significantly different between patients with autism and healthy controls. In addition, patients with autism and DR4, DR11, or DR14 had different performance on intelligence and neuropsychology tests. Despite a relatively small sample size and a case-control association design, the findings suggest HLA-DRB1 gene might be associated with autism in Han Chinese. The true functional variants associated with autism in our samples remain to be further clarified. It warrants a replication study of a larger family sample and to validate the HLA genetic association with autism and its influence on neuropsychological function.

Long term effects of self-determination theory and motivational interviewing in a web-based physical activity intervention: randomized controlled trial.

PubMed

Friederichs, Stijn A H; Oenema, Anke; Bolman, Catherine; Lechner, Lilian

2015-08-18

Our main objective in the current study was to evaluate the long-term effectiveness (12 months from baseline) of I Move (a web-based computer tailored physical activity intervention, based on self-determination theory and motivational interviewing). To this end, we compared I Move to a web-based computer tailored physical activity intervention based on traditional health behavior theories (Active Plus), and to a no-intervention control group. As a secondary objective, the present study aimed to identify participant characteristics that moderate the long term effects of I Move and Active Plus. A randomized controlled trial was conducted, comparing three research conditions: 1) the I Move condition, participants in this condition received I Move; 2) the Active Plus condition, participants in this condition received Active Plus; 3) the control condition; participants in this condition received no intervention and were placed on a waiting list. Main outcome measures were weekly minutes of moderate to vigorous physical activity and weekly days with minimal 30 min of physical activity. All measurements were taken by web-based questionnaires via the study website. Intervention effects were analyzed using multilevel linear regression analyses. At 12 months from baseline, I Move was found to be effective in increasing weekly minutes of moderate to vigorous physical activity (ES = .13), while Active Plus was not. In contrast, Active Plus was found to be effective in increasing weekly days with ≥ 30 min PA at 12 months (ES = .11), while I Move was not. No moderators of the effects of I Move were found. The results suggest that web-based computer tailored physical activity interventions might best include elements based on both self-determination theory/motivational interviewing and traditional health behavioral theories. To be more precise, it is arguable that the focus of the theoretical foundations, used in new web-based PA interventions should depend on the intended program outcome. In order to draw firm conclusions, however, more research on the effects of self-determination theory and motivational interviewing in web-based physical activity promotion is needed. Dutch Trial Register NTR4129.

Risk factors for the occurrence of sporadic Salmonella enterica serotype enteritidis infections in children in France: a national case-control study.

PubMed Central

Delarocque-Astagneau, E.; Desenclos, J. C.; Bouvet, P.; Grimont, P. A.

1998-01-01

To determine risk factors associated with the occurrence of sporadic cases of Salmonella enteritidis infections among children in France, we conducted a matched case-control study. Cases were identified between 1 March and 30 September 1995. One hundred and five pairs of cases and controls matched for age and place of residence were interviewed. In the 1-5 years age group, illness was associated with the consumption of raw eggs or undercooked egg-containing foods (OR 2.4, 95% CI 1.2-4.8). Storing eggs more than 2 weeks after purchase was associated with Salmonella enteritidis infection (OR 3.8, 95% CI 1.4-10.2), particularly during the summer period (OR 6.0, 95% CI 1.3-26.8). Cases were more likely to report a case of diarrhoea in the household 10-3 days before the onset of symptoms, particularly in the age group < or = 1 year (P = 0.01). This study confirms the link between eggs and the occurrence of sporadic cases of Salmonella enteritidis among children, highlights the potential role of prolonged egg storage and underlines the role of person-to-person transmission in infants. PMID:10030705

A first-line nurse manager's goal-profile.

PubMed

Johansson, Gunilla; Pörn, Ingmar; Theorell, Töres; Gustafsson, Barbro

2007-01-01

The aim of this case study was to acquire understanding concerning the first-line nurse manager's goal-profile, i.e. prioritization of goals in her work as a first-line nurse manager, through use of an action-theoretic and confirmatory theory. The first-line nurse manager's pivotal role regarding quality of care and development in relation to on-going changes in the health care sector is stressed by many researchers and the transition from nurse to manager is described as a demanding challenge for the first-line nurse manager. The case study described in this paper concerns a first-line nurse manager in an actual working environment in care of older people. Data collection comprised interviews, observations, a job description and policy documents. A hermeneutic interpretation was used for data analysis. The results showed that the first-line nurse manager had three goals in her goal-profile, in the following order of priority: (i) a nurse goal that she had strongly accepted and in which she had excellent control, (ii) an administrator goal that she had accepted and in which she had control, (iii) a leadership goal that she had not accepted and in which she did not have control. Both the administrator and leadership goals were based on her job description, but the nurse goal was a personally chosen goal based on her own self-relation/goal-fulfillment. The first-line nurse manager's prioritized self-identity, based on successful realization of goals in her goal-profile, was decisive in the manifestation of her work. This study contributes to a new understanding of the first-line nurse manager's self-identity related to work in terms of goal acceptance and goal control of prioritized goals. This action-theoretic approach could be a valuable 'key' for understanding leadership (or lack of leadership) in clinical practice.

Independent and joint exposure to passive smoking and cooking oil fumes on oral cancer in Chinese women: a hospital-based case-control study.

PubMed

He, Baochang; Chen, Fa; Yan, Lingjun; Huang, Jiangfeng; Liu, Fangping; Qiu, Yu; Lin, Lisong; Zhang, Zuofeng; Cai, Lin

2016-10-01

Passive smoking and COF exposure are independent risk factors for oral cancer in Chinese women, with the multiplicative interactions from combined exposures. Avoiding exposure to environmental tobacco smoke and COF may contribute to the prevention of oral cancer in Chinese women. To evaluate the independent and joint effects of passive smoking and cooking oil fumes (COF) on oral cancer in Chinese women. A case-control study was performed including 238 female patients with pathologically confirmed oral cancer and 470 controls as age-matched controls. Face-to-face interviews were conducted based on a structured questionnaire. The effects of passive smoking and COF exposure were analyzed using non-conditional logistic regression models. Passive smoking significantly increased the risk of oral cancer in Chinese women: adjusted ORs were 2.12 (95% CI = 1.11-4.07) for those only exposed before age 18, 1.52 (95% CI = 1.01-2.31) for those only exposed after age 18, and 2.38 (95% CI = 1.47-3.85) for those both exposed before and after age 18. In addition, COF exposure was significantly associated with a risk of oral cancer (adjusted ORs were 1.69 (95% CI = 1.03-2.78) for light exposure and 2.06 (95% CI = 1.21-3.50) for heavy exposure). Furthermore, there was a significantly multiplicative interaction between passive smoking and COF for oral cancer.

A sham case-control study of effectiveness of DTP-Hib-hepatitis B vaccine against rotavirus acute gastroenteritis in Kenya

PubMed Central

2014-01-01

Background In many GAVI-eligible countries, effectiveness of new vaccines will be evaluated by case-control methodology. To inform the design and assess selection bias of a future case-control study of rotavirus vaccine effectiveness (VE) in western Kenya, we performed a sham case-control study evaluating VE of pentavalent vaccine (DTP-Hib-HepB) against rotavirus acute gastroenteritis (AGE). Methods From ongoing rotavirus surveillance, we defined cases as children 12 weeks to 23 months old with EIA-confirmed rotavirus AGE. We enrolled one community-based and two hospital-based control groups. We collected vaccination status from cards at enrollment, or later in homes, and evaluated VE by logistic regression. Results We enrolled 91 cases (64 inpatient, 27 outpatient), 252 non-rotavirus AGE facility-based controls (unmatched), 203 non-AGE facility-based controls (age-matched) and 271 community controls (age-matched). Documented receipt of 3 pentavalent doses was 77% among cases and ranged from 81-86% among controls. One percent of cases and 0-2% of controls had no pentavalent doses. The adjusted odds ratio of three versus zero doses for being a case was 3.27 (95% CI 0.01-1010) for community controls and 0.69 (95% CI 0.06-7.75) for non-rotavirus hospital-based AGE controls, translating to VE of -227% and 31%, respectively, with wide confidence intervals. (No facility-based non-AGE controls were unvaccinated.) Similar results were found for ≥2 pentavalent doses and for severe rotavirus AGE. Conclusions The study showed that it is feasible to carry out a real case control in the study area, but this needs to be done as soon as the vaccine is introduced to capture the real impact. Sham case-control or pilot studies before vaccine introduction can be useful in designing case-control VE studies. PMID:24517198

A sham case-control study of effectiveness of DTP-Hib-hepatitis B vaccine against rotavirus acute gastroenteritis in Kenya.

PubMed

Khagayi, Sammy; Tate, Jacqueline E; Onkoba, Reuben; Parashar, Umesh; Odhiambo, Frank; Burton, Deron; Laserson, Kayla; Feikin, Daniel R

2014-02-11

In many GAVI-eligible countries, effectiveness of new vaccines will be evaluated by case-control methodology. To inform the design and assess selection bias of a future case-control study of rotavirus vaccine effectiveness (VE) in western Kenya, we performed a sham case-control study evaluating VE of pentavalent vaccine (DTP-Hib-HepB) against rotavirus acute gastroenteritis (AGE). From ongoing rotavirus surveillance, we defined cases as children 12 weeks to 23 months old with EIA-confirmed rotavirus AGE. We enrolled one community-based and two hospital-based control groups. We collected vaccination status from cards at enrollment, or later in homes, and evaluated VE by logistic regression. We enrolled 91 cases (64 inpatient, 27 outpatient), 252 non-rotavirus AGE facility-based controls (unmatched), 203 non-AGE facility-based controls (age-matched) and 271 community controls (age-matched). Documented receipt of 3 pentavalent doses was 77% among cases and ranged from 81-86% among controls. One percent of cases and 0-2% of controls had no pentavalent doses. The adjusted odds ratio of three versus zero doses for being a case was 3.27 (95% CI 0.01-1010) for community controls and 0.69 (95% CI 0.06-7.75) for non-rotavirus hospital-based AGE controls, translating to VE of -227% and 31%, respectively, with wide confidence intervals. (No facility-based non-AGE controls were unvaccinated.) Similar results were found for ≥2 pentavalent doses and for severe rotavirus AGE. The study showed that it is feasible to carry out a real case control in the study area, but this needs to be done as soon as the vaccine is introduced to capture the real impact. Sham case-control or pilot studies before vaccine introduction can be useful in designing case-control VE studies.

The impact of using standardized patients in psychiatric cases on the levels of motivation and perceived learning of the nursing students.

PubMed

Sarikoc, Gamze; Ozcan, Celale Tangul; Elcin, Melih

2017-04-01

The use of standardized patients is not very common in psychiatric nursing education and there has been no study conducted in Turkey. This study evaluated the impact of using standardized patients in psychiatric cases on the levels of motivation and perceived learning of the nursing students. This manuscript addressed the quantitative aspect of a doctoral thesis study in which both quantitative and qualitative methods were used. A pre-test and post-test were employed in the quantitative analysis in a randomized and controlled study design. The motivation scores, and interim and post-test scores for perceived learning were higher in the experimental group compared to pre-test scores and the scores of the control group. The students in the experimental group reported that they felt more competent about practical training in clinical psychiatry, as well as in performing interviews with patients having mental problems, and reported less anxiety about performing an interview when compared to students in the control group. It is considered that the inclusion of standardized patient methodology in the nursing education curriculum in order to improve the knowledge level and skills of students would be beneficial in the training of mental health nurses. Copyright © 2017 Elsevier Ltd. All rights reserved.

Adapting qualitative research strategies to technology savvy adolescents.

PubMed

Mason, Deanna Marie; Ide, Bette

2014-05-01

To adapt research strategies involving adolescents in a grounded theory qualitative research study by conducting email rather than face-to-face interviews. Adolescent culture relies heavily on text-based communication and teens prefer interactions mediated through technology. Traditional qualitative research strategies need to be rethought when working with adolescents. Adapting interviewing strategies to electronic environments is timely and relevant for researching adolescents. Twenty three adolescents (aged 16-21) were interviewed by email. A letter of invitation was distributed. Potential participants emailed the researcher to convey interest in participating. If the inclusion criteria were met, email interviews were initiated. Participants controlled the interviews through their rate of response to interview questions. A grounded theory methodology was employed. Initial contact with participants reiterated confidentiality and the ability to withdraw from the study at any time. Interviews began with the collection of demographic information and a broad opening based on a semi-structured interview guide. All data were permissible, including text, photos, music, videos or outside media, for example YouTube. The participant was allowed to give direction to the interview after initial questions were posed. Email interviews continued until saturation was reached in the data. Participants were enthusiastic about email interviewing. Attrition did not occur. Email interviewing gave participants more control over the research, decreased power differentials between the adolescent and researcher, allowed the study to be adapted to cultural, linguistic and developmental needs, and maintained confidentiality. As participants said that email communication was slow and they preferred instant messaging, replication in faster-paced media is recommended. Repetition in face-to-face settings is warranted to evaluate how technology may have influenced the findings. Implications for practice/research Adolescents' use of the internet and their preference for textbased communication makes a compelling support for modifying traditional face-to-face qualitative investigations to reflect these changing contextual conditions.

Occupational risk factors for urothelial carcinoma: agent-specific results from a case-control study in Germany. MURC Study Group. Multicenter Urothelial and Renal Cancer.

PubMed

Pesch, B; Haerting, J; Ranft, U; Klimpel, A; Oelschlägel, B; Schill, W

2000-04-01

This multicentre population-based case-control study was conducted to estimate the urothelial cancer risk for occupational exposure to aromatic amines, polycyclic aromatic hydrocarbons (PAH), and chlorinated hydrocarbons besides other suspected risk factors. In a population-based multicentre study, 1035 incident urothelial cancer cases and 4298 controls matched for region, sex, and age were interviewed between 1991 and 1995 for their occupational history and lifestyle habits. Exposure to the agents under study was self-assessed as well as expert-rated with two job-exposure matrices and a job task-exposure matrix. Conditional logistic regression was used to calculate smoking adjusted odds ratios (OR) and to control for study centre and age. Urothelial cancer risk following exposure to aromatic amines was only slightly elevated. Among males, substantial exposures to PAH as well as to chlorinated solvents and their corresponding occupational settings were associated with significantly elevated risks after adjustment for smoking (PAH exposure, assessed with a job-exposure matrix: OR = 1.6, 95% CI: 1.1-2.3, exposure to chlorinated solvents, assessed with a job task-exposure matrix: OR = 1.8, 95% CI: 1.2-2.6). Metal degreasing showed an elevated urothelial cancer risk among males (OR = 2.3, 95% CI: 1.4-3.8). In females also, exposure to chlorinated solvents indicated a urothelial cancer risk. Because of small numbers the risk evaluation for females should be treated with caution. Occupational exposure to aromatic amines could not be shown to be as strong a risk factor for urothelial carcinomas as in the past. A possible explanation for this finding is the reduction in exposure over the last 50 years. Our results strengthen the evidence that PAH may have a carcinogenic potential for the urothelium. Furthermore, our results indicate a urothelial cancer risk for the use of chlorinated solvents.

Maternal autoimmune disease and birth defects in the National Birth Defects Prevention Study.

PubMed

Howley, Meredith M; Browne, Marilyn L; Van Zutphen, Alissa R; Richardson, Sandra D; Blossom, Sarah J; Broussard, Cheryl S; Carmichael, Suzan L; Druschel, Charlotte M

2016-11-01

Little is known about the association between maternal autoimmune disease or its treatment and the risk of birth defects. We examined these associations using data from the National Birth Defects Prevention Study, a multi-site, population-based, case-control study. Analyses included 25,116 case and 9897 unaffected control infants with estimated delivery dates between 1997 and 2009. Information on autoimmune disease, medication use, and other pregnancy exposures was collected by means of telephone interview. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for birth defects with five or more exposed cases; crude ORs and exact 95% CIs were estimated for birth defects with three to four exposed cases. Autoimmune disease was reported by 373 mothers (279 case and 94 control mothers). The majority of birth defects evaluated were not associated with autoimmune disease; however, a statistically significant association between maternal autoimmune disease and encephalocele was observed (OR, 4.64; 95% CI, 1.95-11.04). Eighty-two mothers with autoimmune disease used an immune modifying/suppressing medication during pregnancy; this was associated with encephalocele (OR, 7.26; 95% CI, 1.37-24.61) and atrial septal defects (OR, 3.01; 95% CI, 1.16-7.80). Our findings suggest maternal autoimmune disease and treatment are not associated with the majority of birth defects, but may be associated with some defects, particularly encephalocele. Given the low prevalence of individual autoimmune diseases and the rare use of specific medications, we were unable to examine associations of specific autoimmune diseases and medications with birth defects. Other studies are needed to confirm these findings. Birth Defects Research (Part A) 106:950-962, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Inquiry-based Science Instruction in High School Biology Courses: A Multiple Case Study

NASA Astrophysics Data System (ADS)

Aso, Eze

A lack of research exists about how secondary school science teachers use inquiry-based instruction to improve student learning. The purpose of this qualitative study was to explore how science teachers used inquiry-based instruction to improve student learning in high school biology courses. The conceptual framework was based on Banchi and Bell's model of increasing levels of complexity for inquiry-based instruction. A multiple case study research design was conducted of biology programs at 3 high schools in an urban school district in the northeastern region of the United States. Participants included 2 biology teachers from each of the 3 high schools. Data were collected from individual interviews with biology teachers, observations of lessons in biology, and documents related to state standards, assessments, and professional development. The first level of data analysis involved coding and categorizing the interview and observation data. A content analysis was used for the documents. The second level of data analysis involved examining data across all sources and all cases for themes and discrepancies. According to study findings, biology teachers used confirmation, structure, and guided inquiry to improve student learning. However, they found open inquiry challenging and frustrating to implement because professional development about scaffolding of instruction over time was needed, and students' reading and writing skills needed to improve. This study contributes to positive social change by providing educators and researchers with a deeper understanding about how to scaffold levels of inquiry-based science instruction in order to help students become scientifically literate citizens.

A psychological autopsy study of suicide among Inuit in Nunavut: methodological and ethical considerations, feasibility and acceptability

PubMed Central

Chachamovich, Eduardo; Haggarty, Jack; Cargo, Margaret; Hicks, Jack; Kirmayer, Laurence J.; Turecki, Gustavo

2013-01-01

Introduction The increasing global prevalence of suicide has made it a major public health concern. Research designed to retrospectively study suicide cases is now being conducted in populations around the world. This field of research is especially crucial in Aboriginal populations, as they often have higher suicide rates than the rest of the country. Objective This article presents the methodological aspects of the first psychological autopsy study on suicide among Inuit in Nunavut. Qaujivallianiq Inuusirijauvalauqtunik (Learning from lives that have been lived) is a large case-control study, including all 120 cases of suicide by Inuit that occurred in Nunavut between 1 January 2003 and 31 December 2006. The article describes the research design, ethical considerations and strategies used to adapt the psychological autopsy method to Nunavut Inuit. Specifically, we present local social and cultural issues; data collection procedures; and the acceptability, reliability and validity of the method. Method A retrospective case-control study using the psychological autopsy approach was carried out in 22 communities in Nunavut. A total of 498 individuals were directly interviewed, and medical and correctional charts were also reviewed. Results The psychological autopsy method was well received by participants as they appreciated the opportunity to discuss the loss of a family member or friend by suicide. During interviews, informants readily identified symptoms of psychiatric disorders, although culture-specific rather than clinical explanations were sometimes provided. Results suggest that the psychological autopsy method can be effectively used in Inuit populations. PMID:23539438

A psychological autopsy study of suicide among Inuit in Nunavut: methodological and ethical considerations, feasibility and acceptability.

PubMed

Chachamovich, Eduardo; Haggarty, Jack; Cargo, Margaret; Hicks, Jack; Kirmayer, Laurence J; Turecki, Gustavo

2013-01-01

The increasing global prevalence of suicide has made it a major public health concern. Research designed to retrospectively study suicide cases is now being conducted in populations around the world. This field of research is especially crucial in Aboriginal populations, as they often have higher suicide rates than the rest of the country. This article presents the methodological aspects of the first psychological autopsy study on suicide among Inuit in Nunavut. Qaujivallianiq Inuusirijauvalauqtunik (Learning from lives that have been lived) is a large case-control study, including all 120 cases of suicide by Inuit that occurred in Nunavut between 1 January 2003 and 31 December 2006. The article describes the research design, ethical considerations and strategies used to adapt the psychological autopsy method to Nunavut Inuit. Specifically, we present local social and cultural issues; data collection procedures; and the acceptability, reliability and validity of the method. A retrospective case-control study using the psychological autopsy approach was carried out in 22 communities in Nunavut. A total of 498 individuals were directly interviewed, and medical and correctional charts were also reviewed. The psychological autopsy method was well received by participants as they appreciated the opportunity to discuss the loss of a family member or friend by suicide. During interviews, informants readily identified symptoms of psychiatric disorders, although culture-specific rather than clinical explanations were sometimes provided. Results suggest that the psychological autopsy method can be effectively used in Inuit populations.

Breast Cancer Risk and Ovariectomy, Hysterectomy, and Tubal Sterilization in the Women's Contraceptive and Reproductive Experiences Study

PubMed Central

Press, David J.; Sullivan-Halley, Jane; Ursin, Giske; Deapen, Dennis; McDonald, Jill A.; Strom, Brian L.; Norman, Sandra A.; Simon, Michael S.; Marchbanks, Polly A.; Folger, Suzanne G.; Liff, Jonathan M.; Burkman, Ronald T.; Malone, Kathleen E.; Weiss, Linda K.; Spirtas, Robert; Bernstein, Leslie

2011-01-01

Removal or impairment of ovaries before menopause may affect a woman's breast cancer risk by altering her cumulative exposure to ovarian hormones. The Women's Contraceptive and Reproductive Experiences Study, a population-based, multicenter case-control study of incident invasive breast cancer, recruited women aged 35–64 years (4,490 cases and 4,611 controls) who provided data on ovariectomy, hysterectomy, and tubal sterilization during in-person interviews. Controls were frequency-matched to cases by age, race, and study site. Unconditional logistic regression analysis was used. Women who had not undergone premenopausal reproductive surgery were the referent group. Bilateral ovariectomy was associated with reduced breast cancer risk overall (odds ratio (OR) = 0.59, 95% confidence interval (CI): 0.50, 0.69) and among women <45 years of age (ORs ranged from 0.31 to 0.52), but not among those who were older at surgery. It was also associated with a reduced risk for estrogen and progesterone receptor–positive tumors (OR = 0.63, 95% CI: 0.52, 0.75) but not receptor-negative tumors. Hysterectomy with ovarian conservation (OR = 0.83, 95% CI: 0.72, 0.96) and hysterectomy with partial ovary removal (OR = 0.73, 95% CI: 0.59, 0.91) were also associated with lower risk. No association with breast cancer risk was observed with tubal sterilization only or partial ovariectomy without hysterectomy. Reproductive organ surgeries may alter ovarian hormone levels, thereby affecting breast cancer risk. PMID:21109566

Breast cancer risk and ovariectomy, hysterectomy, and tubal sterilization in the women's contraceptive and reproductive experiences study.

PubMed

Press, David J; Sullivan-Halley, Jane; Ursin, Giske; Deapen, Dennis; McDonald, Jill A; Strom, Brian L; Norman, Sandra A; Simon, Michael S; Marchbanks, Polly A; Folger, Suzanne G; Liff, Jonathan M; Burkman, Ronald T; Malone, Kathleen E; Weiss, Linda K; Spirtas, Robert; Bernstein, Leslie

2011-01-01

Removal or impairment of ovaries before menopause may affect a woman's breast cancer risk by altering her cumulative exposure to ovarian hormones. The Women's Contraceptive and Reproductive Experiences Study, a population-based, multicenter case-control study of incident invasive breast cancer, recruited women aged 35-64 years (4,490 cases and 4,611 controls) who provided data on ovariectomy, hysterectomy, and tubal sterilization during in-person interviews. Controls were frequency-matched to cases by age, race, and study site. Unconditional logistic regression analysis was used. Women who had not undergone premenopausal reproductive surgery were the referent group. Bilateral ovariectomy was associated with reduced breast cancer risk overall (odds ratio (OR) = 0.59, 95% confidence interval (CI): 0.50, 0.69) and among women <45 years of age (ORs ranged from 0.31 to 0.52), but not among those who were older at surgery. It was also associated with a reduced risk for estrogen and progesterone receptor-positive tumors (OR = 0.63, 95% CI: 0.52, 0.75) but not receptor-negative tumors. Hysterectomy with ovarian conservation (OR = 0.83, 95% CI: 0.72, 0.96) and hysterectomy with partial ovary removal (OR = 0.73, 95% CI: 0.59, 0.91) were also associated with lower risk. No association with breast cancer risk was observed with tubal sterilization only or partial ovariectomy without hysterectomy. Reproductive organ surgeries may alter ovarian hormone levels, thereby affecting breast cancer risk.

Prostatitis, other genitourinary infections and prostate cancer: results from a population-based case-control study.

PubMed

Boehm, Katharina; Valdivieso, Roger; Meskawi, Malek; Larcher, Alessandro; Schiffmann, Jonas; Sun, Maxine; Graefen, Markus; Saad, Fred; Parent, Marie-Élise; Karakiewicz, Pierre I

2016-03-01

We relied on a population-based case-control study (PROtEuS) to examine a potential association between the presence of histologically confirmed prostate cancer (PCa) and history of genitourinary infections, e.g., prostatitis, urethritis, orchitis and epididymitis. Cases were 1933 men with incident PCa, diagnosed across Montreal hospitals between 2005 and 2009. Population controls were 1994 men from the same residential area and age distribution. In-person interviews collected information about socio-demographic characteristics, lifestyle and medical history, e.g., self-reported history of several genitourinary infections, as well as on PCa screening. Logistic regression analyses tested overall and grade-specific associations, including subgroup analyses with frequent PSA testing. After multivariable adjustment, prostatitis was associated with an increased risk of any PCa (OR 1.81 [1.44-2.27]), but not urethritis (OR 1.05 [0.84-1.30]), orchitis (OR 1.28 [0.92-1.78]) or epididymitis (OR 0.98 [0.57-1.68]). The association between prostatitis and PCa was more pronounced for low-grade PCa (Gleason ≤ 6: OR 2.11 [1.61-2.77]; Gleason ≥ 7: OR 1.59 [1.22-2.07]). Adjusting for frequency of physician visits, PSA testing frequency or restricting analyses to frequently screened subjects did not affect these results. Prostatitis was associated with an increased probability for detecting PCa even after adjustment for frequency of PSA testing and physician visits, but not urethritis, orchitis or epididymitis. These considerations may be helpful in clinical risk stratification of individuals in whom the risk of PCa is pertinent.

Automobile industry occupations and bladder cancer: a population-based case-control study in southeastern Michigan, USA.

PubMed

Kobrosly, R W; Meliker, J R; Nriagu, J O

2009-10-01

To determine whether employees in the automobile industry in Michigan are at elevated risk of urinary bladder cancer. The authors conducted a population-based case-control study including 418 cases and 571 controls. History of employment within the automobile industry was coded according to the US Census Bureau Index of Occupations. Logistic regression analyses were adjusted for age at interview, cigarette smoking status, and highest education level, and used to assess associations between bladder cancer and (1) ever working in particular occupations within the automobile industry; and (2) usual occupation - defined as occupation of longest duration for each subject. Ever having worked in the automobile industry and usual employment within the industry exhibited elevated non-significant risks for bladder cancer among assembly line workers, painters and foremen. A higher risk was seen for those who worked for 20 or more years on the assembly line (OR = 2.10, 95% CI 1.15 to 3.80). Statistical interaction between usual employment on the assembly line and smoking status (>5 pack-years) was demonstrated (OR = 6.19, 95% CI 2.69 to 14.24). Among workers on the assembly line for at least 20 years, we observed an approximately twofold risk for bladder cancer. Heavy smokers working on the assembly line experience a sixfold risk for bladder cancer. Further research is necessary to verify this finding, identify the exposures that might be contributing to bladder cancer on the assembly line, and examine whether those exposures continue to persist in today's workplace.

Case-control study on analgesics and nephropathy (SAN): protocol

PubMed Central

Heinemann, Lothar AJ; Garbe, Edeltraut; Lewis, Michael; van der Woude, Fokko; Graf, Helmut

2005-01-01

Background The association between intake of non-phenacetin-containing analgesics and the occurrence of chronic renal failure is still controversially discussed. A new epidemiologic study was planned and conducted in Germany and Austria. Methods/design The objective of the international, multicenter case-control study was to evaluate the association between end-stage renal disease (ESRD) and use of non-phenacetin-containing analgesics with particular emphasis on combined formulations. A targeted sample of 1000 new (incident) dialysis patients, aged less than 50 years, was planned to recruit between January 1, 2001 and December 31, 2004. The age limit was chosen to avoid contamination of the study population with phenacetin-containing analgesics to the extent possible. Four control subjects per ESRD case, matched by age, sex, and region were selected from the population living in the region the case came from. Lifetime exposure to analgesics and potential renal risk factors were recorded in a single face-to-face interview. A set of aids was introduced to reinforce the memory of study participants. A standardized, pre-tested interview questionnaire (participants), a medical documentation sheet (physicians in dialysis centres), a logbook for all activities (dialysis centres) were used to collect the necessary data. Quality management consisted of the standardized procedures, (re-) training and supervision of interviewers, regular checks of all incoming data for completeness and plausibility. The study is scientifically independent and governed by a international Scientific Advisory Committee that bridged the gap between the sponsoring companies and the investigators. Also other advisory groups assisted the managing committee of the study. All relevant German and Austrian nephrological associations supported the study, and the study design was carefully reviewed and approved by the Kidney Foundation of Germany. Discussion The study is expected to answer the main research question by end 2005. There is however a high potential for various biases that we tried to address with adequate measure. One limitation however cannot be overcome: The methodologically needed age-limitation of the study will make it not easy to generalize the results to age groups over 50 years. It might be suggested to repeat the study for persons over 50 years in 10 years when contamination with phenacetin use early in life is likely to be outgrown. PMID:16086834

Lack of genetic association between the phospholipase A2 gene and bipolar mood disorder in a European multicentre case-control study.

PubMed

Dikeos, Dimitris G; Papadimitriou, George N; Souery, Daniel; Del-Favero, Jurgen; Massat, Isabelle; Blackwood, Douglas; Cichon, Sven; Daskalopoulou, Eugenia; Ivezic, Sladjana; Kaneva, Radka; Karadima, Georgia; Lorenzi, Cristina; Milanova, Vihra; Muir, Walter; Nöthen, Markus; Oruc, Lilijana; Rietschel, Marcella; Serretti, Alessandro; Van Broeckhoven, Christine; Soldatos, Constantin R; Stefanis, Costas N; Mendlewicz, Julien

2006-08-01

The possible association between phospholipase A2 gene and bipolar mood disorder was examined in 557 bipolar patients and 725 controls (all personally interviewed), recruited from seven countries (Belgium, Bulgaria, Croatia, Germany, Greece, Italy, and UK). The frequencies of the eight alleles that were identified did not differ between patients and control individuals in the whole population, while the power to detect an association based on our sample was relatively high. Some differences were noted among the various ethnic groups, but no significant trends existed, suggesting that population stratification by country may not be responsible for a type II error. On the basis of these results, mutations of the phospholipase A2 gene, at least in the region close to the polymorphism examined between exons 1 and 2, are not involved in the pathogenesis of bipolar mood disorder.

The Connotations of "Botho Philosophy" and Its Potential Contribution towards Environmental Conservation: The Case of Tlokoeng Community in Lesotho

ERIC Educational Resources Information Center

Mokuku, Tšepo

2017-01-01

This paper explores innovative environmental education strategies to conserve biodiversity in a rural-based context, in Lesotho. A case study approach was employed to investigate the community's conception of botho philosophy and how it might promote nature conservation. Focus Group Interviews were conducted with 105 participants. The responses…

Integrating Entrepreneurship Education across University-Wide Curricula: The Case of Two Public Universities in Tanzania

ERIC Educational Resources Information Center

Kalimasi, Perpetua Joseph; Herman, Chaya

2016-01-01

This qualitative case study explores the integration of entrepreneurship education (EE) across the curricula in two public universities in Tanzania. Based on Shapero's model of the entrepreneurial event, the feasibility and desirability of EE in the selected universities are analysed. In-depth interviews and document analysis were used for data…

Providing Better Education Services to the Poor: Accountability and Context in the Case of Guatemalan Decentralization

ERIC Educational Resources Information Center

Gershberg, Alec Ian; Meade, Ben; Andersson, Sven

2009-01-01

We explore how two community-based reform models align with the World Bank's "World Development Report 2004" accountability framework. Using a qualitative case study of rural Guatemalan primary schools, we examine local governance through interviews with a range of stakeholders. While both reforms appear appropriate according to the…

Factors Related to Suicide in LGBT Populations.

PubMed

Skerrett, Delaney Michael; Kõlves, Kairi; De Leo, Diego

2016-09-01

There is evidence of heightened vulnerability to nonfatal suicidal behaviors among LGBT populations yet a paucity of studies into fatal behaviors. The specific aim of this article was to identify factors related to suicide in LGBT individuals in Australia. The psychological autopsy (PA) method with a matched case-control study design was used. PA interviews were conducted with 27 next-of-kin of an LGBT person that had died by suicide. Three living LGBT controls per suicide case, matched by age and gender, were also interviewed. The key factors relating to suicide in LGBT people were a lack of acceptance by family and self (reflected in higher internalized homophobia and shame), negative feelings about own sexuality/gender, and dissatisfaction with appearance. LGBT people who died by suicide also tended to go through coming out milestones 2 years earlier than controls. There was a higher prevalence of aggressive behaviors and a more predominant history of physical and sexual abuse. Additionally, there was greater incidence of depression and anxiety and alcohol and substance use disorders. Specific predictive factors for suicide in LGBT populations in Australia were identified, including significantly poorer mental health outcomes and more violence across an array of measures.

Newborn Survival Case Study in Rwanda - Bottleneck Analysis and Projections in Key Maternal and Child Mortality Rates Using Lives Saved Tool (LiST).

PubMed

Khurmi, Manpreet Singh; Sayinzoga, Felix; Berhe, Atakilt; Bucyana, Tatien; Mwali, Assumpta Kayinamura; Manzi, Emmanuel; Muthu, Maharajan

2017-01-01

The Newborn Survival Case study in Rwanda provides an analysis of the newborn health and survival situation in the country. It reviews evidence-based interventions and coverage levels already implemented in the country; identifies key issues and bottlenecks in service delivery and uptake of services by community/beneficiaries, and provides key recommendations aimed at faster reduction in newborn mortality rate. This study utilized mixed method research including qualitative and quantitative analyses of various maternal and newborn health programs implemented in the country. This included interviewing key stakeholders at each level, field visits and also interviewing beneficiaries for assessment of uptake of services. Monitoring systems such as Health Management Information Systems (HMIS), maternal and newborn death audits were reviewed and data analyzed to aid these analyses. Policies, protocols, various guidelines and tools for monitoring are already in place however, implementation of these remains a challenge e.g. infection control practices to reduce deaths due to sepsis. Although existing staff are quite knowledgeable and are highly motivated, however, shortage of health personnel especially doctors in an issue. New facilities are being operationalized e.g. at Gisenyi, however, the existing facilities needs expansion. It is essential to implement high impact evidence based interventions but coverage levels need to be significantly high in order to achieve higher reduction in newborn mortality rate. Equity approach should be considered in planning so that the services are better implemented and the poor and needy can get the benefits of public health programs.

Forensic Interviews for Child Sexual Abuse Allegations: An Investigation into the Effects of Animal-Assisted Intervention on Stress Biomarkers.

PubMed

Krause-Parello, Cheryl A; Gulick, Elsie E

2015-01-01

The use of therapy animals during forensic interviews for child sexual abuse allegations is a recommendation by the Therapy Animals Supporting Kids Program to help ease children's discomfort during the forensic interview process. Based on this recommendation, this study incorporated a certified therapy canine into the forensic interview process for child sexual abuse allegations. This study investigated changes in salivary cortisol, immunoglobulin A, blood pressure, and heart rate as a result of forensic interview phenomenon (e.g., outcry) incorporating animal-assisted intervention versus a control condition in children (N = 42) interviewed for alleged child sexual abuse. The results supported significantly greater heart rate values for the control group (n = 23) who experienced sexual contact and/or indecency than the experience of aggravated sexual assault compared to no difference in HR for the intervention group (n = 19). The results suggest that the presence of the canine in the forensic interview may have acted as a buffer or safeguard for the children when disclosing details of sexual abuse. In the intervention group, children's HR was lower at the start of the forensic interview compared to the control group. Finding an effect of having a certified handler-canine team available during the forensic interview on physiological measures of stress has real-world value for children, child welfare personnel, and clinical therapists. It is suggested that animal-assisted intervention be expanded to children facing other types of trauma and to treatment programs for child survivors of sexual abuse.

A community-based health education analysis of an infectous disease control program in Nigeria.

PubMed

Adeyanju, O M

1987-01-01

This descriptive study utilized the strategy of primary health care in program development-especially a community-based health education intervention approach-in the control of guinea-worm in rural communities of Nigeria. Two closely related rural communities in two states served as target groups. Committee system approach, nominal group process, interview methods, audio-visual aids, and health care volunteer trainingship were the educational strategies employed in a control and experimental set up. The PRECEDE model was applied in the analysis. Results show a significant control action on guinea-worm infestation in the experimental community and a tremendous achievement in preventive health education interventions through organized community participation/involvement and ultimate self-reliance and individual responsibility. A positive increase in health knowledge and attitude examined through interview method, and observable changes in health behavior were noticed. Wells were provided, drinking water treated, while personal and community health promotion strategies were encouraged by all. The study has shown the effectiveness/efficacy of a community-based effort facilitated by a health educator.

Occupation and lung cancer in Shanghai: a case-control study.

PubMed Central

Levin, L I; Zheng, W; Blot, W J; Gao, Y T; Fraumeni, J F

1988-01-01

Occupation was evaluated as a potential risk factor for lung cancer as part of a large population based case-control study conducted in the ten urban districts of Shanghai. A total of 733 newly diagnosed cases of male lung cancer and 760 controls selected from the general population was interviewed to obtain lifetime occupational histories and information on smoking and other factors. Of the approximately 25 major industrial titles examined, significantly raised risks, adjusted for smoking, were found for employment in agricultural production (odds ratio (OR) = 1.6, 95% confidence interval (CI) = 1.0-2.6). A concomitant increase was detected for farmers (OR = 1.6, 95% CI = 1.0-2.5) when 35 major occupational titles were examined. There was a 70% excess among workers in the chemical industry (OR = 1.7, 95% CI = 0.9-3.1) and a significant decrease among textile industry workers (OR = 0.7, 95% CI = 0.5-1.0). Raised risks of 30% to 80% were associated with reported job exposures to wood and coal dusts, smoke from burning fuels, and chemical fumes. Employment categories were also examined for 672 cases and 735 controls among women, but small numbers in many of the industrial and occupational categories precluded detailed analyses. The largest excess risk among women (OR = 5.1, 95% CI 1.3-23.5) was among glass products workers. Although cigarette smoking was the dominant cause of lung cancer among men and a significant risk factor among women in Shanghai, these findings suggest the importance of certain workplace exposures and offer leads to occupational carcinogens. PMID:3395581

Prolonged labour as indication for emergency caesarean section: a quality assurance analysis by criterion-based audit at two Tanzanian rural hospitals.

PubMed

Maaløe, N; Sorensen, B L; Onesmo, R; Secher, N J; Bygbjerg, I C

2012-04-01

To audit the quality of obstetric management preceding emergency caesarean sections for prolonged labour. A quality assurance analysis of a retrospective criterion-based audit supplemented by in-depth interviews with hospital staff. Two Tanzanian rural mission hospitals. Audit of 144 cases of women undergoing caesarean sections for prolonged labour; in addition, eight staff members were interviewed. Criteria of realistic best practice were established, and the case files were audited and compared with these. Hospital staff were interviewed about what they felt might be the causes for the audit findings. Prevalence of suboptimal management and themes emerging from an analysis of the transcripts. Suboptimal management was identified in most cases. Non-invasive interventions to potentially avoid operative delivery were inadequately used. When deciding on caesarean section, in 26% of the cases labour was not prolonged, and in 16% the membranes were still intact. Of the women with genuine prolonged labour, caesarean sections were performed with a fully dilated cervix in 36% of the cases. Vacuum extraction was not considered. Amongst the hospital staff interviewed, the awareness of evidence-based guidelines was poor. Word of mouth, personal experience, and fear, especially of HIV transmission, influenced management decisions. The lack of use and awareness of evidence-based guidelines led to misinterpretation of clinical signs, fear of simple interventions, and an excessive rate of emergency caesarean sections. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

Pregnancy-related maternal risk factors of attention-deficit hyperactivity disorder: a case-control study.

PubMed

Amiri, Shahrokh; Malek, Ayyoub; Sadegfard, Majid; Abdi, Salman

2012-01-01

Background. The etiology of attention-deficit hyperactivity disorder (ADHD) is complex.This study was conducted to evaluate the pregnancy-related maternal risk factors of ADHD. Methods. 164 ADHD children attending to Child and Adolescent Psychiatric Clinics compared with 166 normal children selected in a random-cluster method from primary schools. ADHD rating scale and clinical interview based on Schedule for Affective disorders and Schizophrenia for School-Aged Children (K-SADS) were used to diagnose ADHD cases and to select the control group. Results. The mean maternal age at pregnancy, duration of pregnancy, and the mean paternal age were alike in two groups. The ADHD children's mothers compared with those of control group had higher frequencies of somatic diseases, psychiatric disorders, and alcohol and cigarette exposure during the pregnancies (P < 0.01). Also birth by cesarean section was more common among mothers of ADHD children (P < 0.001). These factors plus trauma to the abdomen during pregnancy were significantly predictors of ADHD in children. Conclusions. Some pregnancy-related maternal factors may be considered as environmental risk factors for ADHD. Each of these factors considered in our study as a risk factor needs to be tested and confirmed through next methodologically appropriate researches in this field.

Context-Based Pedagogy: A Framework From Experience.

PubMed

Kantar, Lina D

2016-07-01

Attempts to transform teaching practice are inadvertently subjected to several hurdles, mostly attributed to the lack of a guiding framework. This study aimed at unraveling the conceptual underpinnings of the context-based pedagogy, being perceived the pedagogy that prepares professionals for future practice. Through focus group interviews, data were collected from 16 nursing students who had case studies as the main instructional format in three major courses. The participants were divided into three focus groups, and interview questions were based on three educational parameters: the learning environment, instructional format, and instructional process. Initial findings revealed an array of classroom activities that characterize each parameter. An in-depth analysis of these activities converged on four concepts: (a) dynamic learning environment, (b) realism, (c) thinking dispositions, and (d) professional formation. These concepts improvise a beginning framework for educators and curriculum leaders that can be used to integrate cases in the curriculum and to facilitate the contextualization of knowledge. [J Nurs Educ. 2016;55(7):391-395.]. Copyright 2016, SLACK Incorporated.

Deep venous thrombosis associated with corporate air travel.

PubMed

Dimberg, L A; Mundt, K A; Sulsky, S I; Liese, B H

2001-01-01

Deep venous thrombosis (DVT) is commonly seen among bedridden and postoperative patients. Its association with travel may also make DVT an occupational health risk to otherwise healthy business travelers. We estimated the incidence of and risk factors for DVT among 8,189 World Bank employees and a subset of 4,951 international business travelers. Occurrence of DVT between 1995 and 1998 was determined using 1) medical insurance claims; 2) Workers' Compensation claims; and 3) intra-office E-mail solicitation followed by interview. For each insurance claim case, 10 controls were randomly selected from among World Bank employees insured during the same month and year as the case's claim was filed, and case-control analyses were performed to identify potential predictors or risk factors for DVT. Thirty individuals filed claims for DVT of the legs (annual incidence rate: 0.9 per 1,000 employees); three of these claims were filed within 30 days after a travel mission. Two employees reported DVT as a Workers' Compensation injury, and five staff with verified DVT participated in interviews. After controlling for age and gender, no association with any travel-related covariate was seen. Results of analyses considering all thrombophlebitis and thromboembolism followed the same pattern. The average annual incidence of DVT occurring within 30 days of mission among traveling staff ranged from 0.10 per 1,000 to 0.25 per 1,000 travelers, depending on the case-finding method. No association between DVT and travel was observed after adjustment for gender and age. These results, however, are preliminary, and due to the rarity of DVT, based on small numbers.

Tumor-based case-control studies of infection and cancer: muddling the when and where of molecular epidemiology.

PubMed

Engels, Eric A; Wacholder, Sholom; Katki, Hormuzd A; Chaturvedi, Anil K

2014-10-01

We describe the "tumor-based case-control" study as a type of epidemiologic study used to evaluate associations between infectious agents and cancer. These studies assess exposure using diseased tissues from affected individuals (i.e., evaluating tumor tissue for cancer cases), but they must utilize nondiseased tissues to assess control subjects, who do not have the disease of interest. This approach can lead to exposure misclassification in two ways. First, concerning the "when" of exposure assessment, retrospective assessment of tissues may not accurately measure exposure at the key earlier time point (i.e., during the etiologic window). Second, concerning the "where" of exposure assessment, use of different tissues in cases and controls can have different accuracy for detecting the exposure (i.e., differential exposure misclassification). We present an example concerning the association of human papillomavirus with various cancers, where tumor-based case-control studies likely overestimate risk associated with infection. In another example, we illustrate how tumor-based case-control studies of Helicobacter pylori and gastric cancer underestimate risk. Tumor-based case-control studies can demonstrate infection within tumor cells, providing qualitative information about disease etiology. However, measures of association calculated in tumor-based case-control studies are prone to over- or underestimating the relationship between infections and subsequent cancer risk. ©2014 American Association for Cancer Research.

Thyrotoxicosis outbreak linked to consumption of minced beef and chorizo: Minas, Uruguay, 2003-2004.

PubMed

Conrey, E J; Lindner, C; Estivariz, C; Pereira, M; Welsh, J; Vignolo, J; Fishbein, D; Kettel Khan, L; Grummer-Strawn, L

2008-11-01

Thyrotoxicosis is produced by excessive quantities of thyroid hormone. Its most common causes involve inflammation of the thyroid gland. Much more rarely, thyrotoxicosis is due to exogenous intake of thyroid hormones or iodide compounds. Few outbreaks are documented. In 2003 to early 2004, doctors in Minas, Uruguay noted a sharp increase in the incidence of thyrotoxicosis in a neighbourhood, with multiple cases within families. The objective of this study was to identify the source of the outbreak. A case-control study was conducted following surveillance and environmental inspection. Case patients were symptomatic residents of Minas with documented thyroid-stimulating hormone concentrations <0.1 microUI/ml or <0.49 microUI/ml and elevated free triiodothyronine or free thyroxine. Control subjects were frequency matched with case patients by barrio of residence and age. Case patients, control subjects and persons who prepared and purchased household food were interviewed using a standard questionnaire. Odds ratios adjusted (AOR) for age and gender were calculated by logistic regression in SUDAAN to account for neighbourhood and family clustering. Fifty-nine case patients aged 9-74 years (median 39 years) were identified. Of the 56 interviewed, 52% were women and 71% resided in one barrio. Case patients were more likely than control subjects to eat minced beef at least weekly and purchase it from Butcher A [AOR 6.1; 95% confidence interval (CI) 2.61-14.46], and were more likely to eat chorizo at least weekly and purchase it from Butcher B (AOR 11.6; 95% CI 1.30-102.27). One beef supplier selling meat cuts containing thyroid gland was identified. The most likely cause of this outbreak of thyrotoxicosis was consumption of minced beef and chorizo contaminated with thyroid gland. Tight regulation and oversight of slaughter, processing, and sales of meat and meat products are imperative for prevention of future outbreaks.

Randomized trial of supplementary interviewing techniques to enhance recall of sexual partners in contact interviews.

PubMed

Brewer, Devon D; Potterat, John J; Muth, Stephen Q; Malone, Patricia Z; Montoya, Pamela; Green, David L; Rogers, Helen L; Cox, Patricia A

2005-03-01

People with multiple sex partners tend to forget a significant proportion when recalling them. Randomized trial of supplementary interviewing techniques during routine partner notification contact interviews for chlamydia, gonorrhea, and syphilis in Colorado Springs, CO. Cases with multiple sex partners in the last 3 months (n = 123) participated. Interviewers prompted nonspecifically and read back the list of elicited partners after cases recalled partners on their own. We then randomly assigned cases to receive 1 of 3 sets of recall cues: (1) an experimental set of cues consisting of locations where people meet partners, role relationships, network ties, and first letters of names; (2) another experimental set including common first names; and (3) control cues referring to individual characteristics (e.g., physical appearance). Nonspecific prompting and reading back the list each increased the number of additional partners elicited and located by 3% to 5% on average. On average, the combined location/role/letter/network cues elicited more additional partners (0.57) than did the first-name (0.29) and individual characteristics (0.28) cues. The location and first-name cues were the most effective in eliciting located partners. The supplementary techniques increased the number of new cases found by 12% and, importantly, identified branches of the sexual network that would not otherwise have been discovered. Elicitation of sex partners can be enhanced in contact interviews with simple interviewing techniques, resulting in improved network ascertainment and sexually transmitted disease case finding.

A discriminant analysis prediction model of non-syndromic cleft lip with or without cleft palate based on risk factors.

PubMed

Li, Huixia; Luo, Miyang; Luo, Jiayou; Zheng, Jianfei; Zeng, Rong; Du, Qiyun; Fang, Junqun; Ouyang, Na

2016-11-23

A risk prediction model of non-syndromic cleft lip with or without cleft palate (NSCL/P) was established by a discriminant analysis to predict the individual risk of NSCL/P in pregnant women. A hospital-based case-control study was conducted with 113 cases of NSCL/P and 226 controls without NSCL/P. The cases and the controls were obtained from 52 birth defects' surveillance hospitals in Hunan Province, China. A questionnaire was administered in person to collect the variables relevant to NSCL/P by face to face interviews. Logistic regression models were used to analyze the influencing factors of NSCL/P, and a stepwise Fisher discriminant analysis was subsequently used to construct the prediction model. In the univariate analysis, 13 influencing factors were related to NSCL/P, of which the following 8 influencing factors as predictors determined the discriminant prediction model: family income, maternal occupational hazards exposure, premarital medical examination, housing renovation, milk/soymilk intake in the first trimester of pregnancy, paternal occupational hazards exposure, paternal strong tea drinking, and family history of NSCL/P. The model had statistical significance (lambda = 0.772, chi-square = 86.044, df = 8, P < 0.001). Self-verification showed that 83.8 % of the participants were correctly predicted to be NSCL/P cases or controls with a sensitivity of 74.3 % and a specificity of 88.5 %. The area under the receiver operating characteristic curve (AUC) was 0.846. The prediction model that was established using the risk factors of NSCL/P can be useful for predicting the risk of NSCL/P. Further research is needed to improve the model, and confirm the validity and reliability of the model.

The relationship between temperament and character in conversion disorder and comorbid depression.

PubMed

Erten, Evrim; Yenilmez, Yelda; Fistikci, Nurhan; Saatcioglu, Omer

2013-05-01

The aim of this study was to compare conversion disorder patients with healthy controls in terms of temperament and character, and to determine the effect of these characteristics on comorbid depression, based on the idea that conversion disorder patients may have distinctive temperament and character qualities. The study involved 58 patients diagnosed with conversion disorder, based on the DSM-IV diagnostic criteria, under observation at the Bakırköy Psychiatric and Neurological Disorders Outpatient Center, Istanbul. The patients were interviewed with a Structured Clinical Interview (SCID-I) and 57 healthy volunteers, matched for age, sex and education level, were interviewed with a Structured Clinical Interview for people without a psychiatric disorder (SCID-I/NP). All the participants completed a sociodemographic form, the Hamilton Depression Rating Scale, the Hamilton Anxiety Scale and the Temperament and Character Inventory. The conversion disorder patients displayed more harm avoidance (P<.001), more impulsivity (P<.01) and more sentimentality (P<.01) than the healthy controls, but were less persistent (P<.05). In terms of character qualities, conversion disorder patients had high self-transcendence (P<.05), but were inadequate in terms of self-directedness (P<.001) and took on less responsibility (P<.05) than the healthy controls. Conversion disorder patients are significantly different from healthy controls on temperament and character measures of harm avoidance, persistence, self-transcendence and self-directedness. Copyright © 2013 Elsevier Inc. All rights reserved.

Moses' Black Wife: A Case Study Analysis of Secondary School Students' Arts-Based Projects

ERIC Educational Resources Information Center

Reingold, Matt

2014-01-01

Practitioner research was conducted on Grade 10 students' arts-based projects of Numbers 12 in order to assess the value of using the arts in Jewish secondary schools. Based on interview transcripts, projects, and written statements, three themes emerged that demonstrated why teachers should use the arts in their classes. The arts provided…

Student Perceptions of Learning in a Web-Based Tutorial.

ERIC Educational Resources Information Center

Brescia, William; McAuley, Sean

This case study used both quantitative and qualitative methods to investigate students' perceptions of learning using a Web-based tutorial. Students participated in a Web-based tutorial to learn basic HTML as part of a graduate-level Web design course. Four of five students agreed to participate in the survey and interviews. After completing the…

Community-acquired Legionnaires' Disease in a Newly Constructed Apartment Building.

PubMed

Ryu, Sukhyun; Yang, Kyungho; Chun, Byung Chul

2017-07-01

Legionnaires' disease (LD) is a severe type of pneumonia caused by inhalation of aerosols contaminated with Legionella . On September 22, 2016, a single case of LD was reported from a newly built apartment building in Gyeonggi province. This article describes an epidemiologic investigation of LD and identification of the possible source of infection. To identify the source of LD, we interviewed the patient's husband using a questionnaire based on the Legionella management guidelines from the Korea Centers for Disease Control and Prevention. Water samples from the site were collected and analyzed. An epidemiological investigation of the residents and visitors in the apartment building was conducted for 14 days before the index patient's symptoms first appeared to 14 days after the implementation of environmental control measures. Legionella pneumophila serogroup 1 was isolated from the heated-water samples from the patient's residence and the basement of the apartment complex. Thirty-two suspected cases were reported from the apartment building during the surveillance period, yet all were confirmed negative based on urinary antigen tests. The likely source of infection was the building's potable water, particularly heated water. Further study of effective monitoring systems in heated potable water should be considered.

Technology Integration in the Schools of Guyana: A Case Study

ERIC Educational Resources Information Center

MacKinnon, Gregory; MacKinnon, Paula

2010-01-01

The following study examines the implementation of learning technologies in Guyana, South America. Specifically, the study addresses the impact of using interactive radio instruction for teaching mathematics and SuccessMaker software for enhancing literacy skills. The research results were based on surveys, interviews, classroom observations, and…

Evading Equity: Principal Autonomy under the Bloomberg-Klein Market Regime

ERIC Educational Resources Information Center

Lewis-Durham, Tiffanie C.

2015-01-01

Using New York City schools as a case study, this study draws on interview data from principals, district consultants and administrators, and principal's union representatives to explore the relationship between market-based reform and colorblindness in educational policy. The study is informed by colorblindness theory, which explores the subtle…

The effect of force feedback on student reasoning about gravity, mass, force and motion

NASA Astrophysics Data System (ADS)

Bussell, Linda

The purpose of this study was to examine whether force feedback within a computer simulation had an effect on reasoning by fifth grade students about gravity, mass, force, and motion, concepts which can be difficult for learners to grasp. Few studies have been done on cognitive learning and haptic feedback, particularly with young learners, but there is an extensive base of literature on children's conceptions of science and a number of studies focus specifically on children's conceptions of force and motion. This case study used a computer-based paddleball simulation with guided inquiry as the primary stimulus. Within the simulation, the learner could adjust the mass of the ball and the gravitational force. The experimental group used the simulation with visual and force feedback; the control group used the simulation with visual feedback but without force feedback. The proposition was that there would be differences in reasoning between the experimental and control groups, with force feedback being helpful with concepts that are more obvious when felt. Participants were 34 fifth-grade students from three schools. Students completed a modal (visual, auditory, and haptic) learning preference assessment and a pretest. The sessions, including participant experimentation and interviews, were audio recorded and observed. The interviews were followed by a written posttest. These data were analyzed to determine whether there were differences based on treatment, learning style, demographics, prior gaming experience, force feedback experience, or prior knowledge. Work with the simulation, regardless of group, was found to increase students' understanding of key concepts. The experimental group appeared to benefit from the supplementary help that force feedback provided. Those in the experimental group scored higher on the posttest than those in the control group. The greatest difference between mean group scores was on a question concerning the effects of increased gravitational force.

Integration of DNA sample collection into a multi-site birth defects case-control study.

PubMed

Rasmussen, Sonja A; Lammer, Edward J; Shaw, Gary M; Finnell, Richard H; McGehee, Robert E; Gallagher, Margaret; Romitti, Paul A; Murray, Jeffrey C

2002-10-01

Advances in quantitative analysis and molecular genotyping have provided unprecedented opportunities to add biological sampling and genetic information to epidemiologic studies. The purpose of this article is to describe the incorporation of DNA sample collection into the National Birth Defects Prevention Study (NBDPS), an ongoing case-control study in an eight-state consortium with a primary goal to identify risk factors for birth defects. Babies with birth defects are identified through birth defects surveillance systems in the eight participating centers. Cases are infants with one or more of over 30 major birth defects. Controls are infants without defects from the same geographic area. Epidemiologic information is collected through an hour-long interview with mothers of both cases and controls. We added the collection of buccal cytobrush DNA samples for case-infants, control-infants, and their parents to this study. We describe here the methods by which the samples have been collected and processed, establishment of a centralized resource for DNA banking, and quality control, database management, access, informed consent, and confidentiality issues. Biological sampling and genetic analyses are important components to epidemiologic studies of birth defects aimed at identifying risk factors. The DNA specimens collected in this study can be used for detection of mutations, study of polymorphic variants that confer differential susceptibility to teratogens, and examination of interactions among genetic risk factors. Information on the methods used and issues faced by the NBDPS may be of value to others considering the addition of DNA sampling to epidemiologic studies.

What is the Effect of Case-Based Learning on the Academic Achievement of Students on the Topic of "Biochemical Oxygen Demand?"

NASA Astrophysics Data System (ADS)

Günter, Tuğçe; Alpat, Sibel Kılınç

2017-11-01

The purpose of this study was to investigate the effect of the case-based learning (CBL) method used in "biochemical oxygen demand (BOD)," which is a topic taught in the environmental chemistry course, at Dokuz Eylul University, on the academic achievement and opinions of students. The research had a quasi-experimental design and the study group consisted of 4th and 5th grade students (N = 18) attending the Chemistry Teaching Program in a university in Izmir. The "Biochemical Oxygen Demand Achievement Test (BODAT)" and the structured interview form were used as data collection tools. The results of BODAT post-test showed the higher increase in the achievement scores of the experimental group may be an indication of the effectiveness of the CBL method in improving academic achievement in the relevant topic. In addition, the experimental and control group students had positive opinions regarding the method, the scenario, and the material. The students found the method, the scenario, and the material to be interesting, understandable/instructional, relatable with everyday life, suitable for the topic, and enhancing active participation.

Colorectal Cancer and Long-Term Exposure to Trihalomethanes in Drinking Water: A Multicenter Case–Control Study in Spain and Italy

PubMed Central

Villanueva, Cristina M.; Gracia-Lavedan, Esther; Bosetti, Cristina; Righi, Elena; Molina, Antonio José; Martín, Vicente; Boldo, Elena; Aragonés, Nuria; Perez-Gomez, Beatriz; Pollan, Marina; Acebo, Ines Gomez; Altzibar, Jone M.; Zabala, Ana Jiménez; Ardanaz, Eva; Peiró, Rosana; Tardón, Adonina; Chirlaque, Maria Dolores; Tavani, Alessandra; Polesel, Jerry; Serraino, Diego; Pisa, Federica; Castaño-Vinyals, Gemma; Espinosa, Ana; Espejo-Herrera, Nadia; Palau, Margarita; Moreno, Victor; La Vecchia, Carlo; Aggazzotti, Gabriella; Nieuwenhuijsen, Mark J; Kogevinas, Manolis

2016-01-01

Background: Evidence on the association between colorectal cancer and exposure to disinfection by-products in drinking water is inconsistent. Objectives: We assessed long-term exposure to trihalomethanes (THMs), the most prevalent group of chlorination by-products, to evaluate the association with colorectal cancer. Methods: A multicenter case–control study was conducted in Spain and Italy in 2008–2013. Hospital-based incident cases and population-based (Spain) and hospital-based (Italy) controls were interviewed to ascertain residential histories, type of water consumed in each residence, frequency and duration of showering/bathing, and major recognized risk factors for colorectal cancer. We estimated adjusted odds ratios (OR) for colorectal cancer in association with quartiles of estimated average lifetime THM concentrations in each participant’s residential tap water (micrograms/liter; from age 18 to 2 years before the interview) and estimated average lifetime THM ingestion from drinking residential tap water (micrograms/day). Results: We analyzed 2,047 cases and 3,718 controls. Median values (ranges) for average lifetime residential tap water concentrations of total THMs, chloroform, and brominated THMs were 30 (0–174), 17 (0–63), and 9 (0–145) μg/L, respectively. Total THM concentration in residential tap water was not associated with colorectal cancer (OR = 0.92, 95% CI: 0.66, 1.28 for highest vs. lowest quartile), but chloroform concentrations were inversely associated (OR = 0.31, 95% CI: 0.24, 0.41 for highest vs. lowest quartile). Brominated THM concentrations showed a positive association among men in the highest versus the lowest quartile (OR = 1.43, 95% CI: 0.83, 2.46). Patterns of association were similar for estimated average THM ingestion through residential water consumption. Conclusions: We did not find clear evidence of an association between detailed estimates of lifetime total THM exposure and colorectal cancer in our large case–control study population. Negative associations with chloroform concentrations and ingestion suggest differences among specific THMs, but these findings should be confirmed in other study populations. Citation: Villanueva CM, Gracia-Lavedan E, Bosetti C, Righi E, Molina AJ, Martín V, Boldo E, Aragonés N, Perez-Gomez B, Pollan M, Gomez Acebo I, Altzibar JM, Jiménez Zabala A, Ardanaz E, Peiró R, Tardón A, Chirlaque MD, Tavani A, Polesel J, Serraino D, Pisa F, Castaño-Vinyals G, Espinosa A, Espejo-Herrera N, Palau M, Moreno V, La Vecchia C, Aggazzotti G, Nieuwenhuijsen MJ, Kogevinas M. 2017. Colorectal cancer and long-term exposure to trihalomethanes in drinking water: a multicenter case–––control study in Spain and Italy. Environ Health Perspect 125:56–65; http://dx.doi.org/10.1289/EHP155 PMID:27383820

Nurse Case Managers' Experiences on Case Management for Long-term Hospitalization in Korea.

PubMed

Oh, Jinjoo; Oh, Seieun

2017-12-01

The implementation of case management for long-term hospitalization use has been approved for controlling medical cost increases in other countries. But, introduction of the case management in Korea has created issues that hinder its effective operation. This qualitative study aimed to obtain further understanding of the issues surrounding the management of Medical Aid beneficiaries' use of long-term hospitalization from the case managers' perspectives and to provide suggestions for successful case management. Thematic analysis was employed to analyze the data. Medical Aid case managers with 3 or more years of case management experience were recruited from urban, suburban, and rural regions. Data were collected through in-depth interviews: 12 nurse case managers participated in focus group interviews and 11 participated in individual one-on-one interviews. Four major themes emerged: on-site obstacles that hinder work progress; going in an opposite direction; ambiguous position of case managers; and work-related emotions. Eleven subthemes were discovered: chasing potential candidates; becoming an enemy; discharging patients who have nowhere to go; welfare-centered national policies increasing medical costs; Medical Aid Program that encourages hospitalization; misuse of hospitalization; feeling limited; working without authority; fulfilling the expected role; fretting about social criticism; and feeling neglected and unprotected. The findings highlight the complexity and ambiguity of the issues faced by case managers. Successful management of Medical Aid resources requires the orchestrated efforts and collaboration of multiple stakeholders. More systematized support and resources for nurse case managers are essential to fully implement this nursing innovation in Korea. Copyright © 2017. Published by Elsevier B.V.

Prenatal and perinatal risk factors and testicular cancer: a hospital-based case-control study.

PubMed

Sonke, Gabe S; Chang, Shine; Strom, Sara S; Sweeney, Anne M; Annegers, J Fred; Sigurdson, Alice J

2007-01-01

Some evidence exists to support the hypothesis that elevated levels of circulating maternal estrogens during early pregnancy may increase risk of testicular germ cell cancer. However, the results from studies evaluating maternal factors have been mixed. We evaluated maternal factors, particularly those associated with excess estrogen levels, as risk factors for testicular cancer. We conducted a hospital-based case-control study at The University of Texas M. D. Anderson Cancer Center in Houston, Texas of 144 testicular cancer patients diagnosed between 1990 and 1996 and 86 friend controls matched to cases on age, race, and state of residence. Risk factor data about the mother, the son, and the pregnancy were obtained from the mothers by telephone interviews and from the sons by self-administered questionnaires. Extreme nausea during the first trimester of pregnancy was associated with an elevated risk of testicular cancer [odds ratio (OR) = 2.0; 95% confidence interval (CI) = 1.0-3.9]. Adjustment for potential confounders slightly lowered this risk (OR = 1.8; 95% CI = 0.9-3.8). Risks were modestly increased for other factors that are proxy measures for maternal estrogens, including preterm delivery (OR = 2.2; 95% CI = 0.4-12.9), birth weight <3000 g (OR = 2.4: 95% CI = 0.7-8.1), and birth weight >4000 g (OR = 1.7; 95% CI = 0.9-3.2), albeit nonsignificantly so. Our finding that severe nausea was associated with increased testicular cancer risk adds evidence to support the in utero estrogen exposure hypothesis because nausea early in pregnancy is related to rising levels of circulating estrogens. For other factors, which are less direct measures of maternal estrogens, the modest associations found indicate a suggestive pattern in support of the excess estrogen hypothesis.

Childhood acute respiratory infections and household environment in an Eastern Indonesian urban setting.

PubMed

Shibata, Tomoyuki; Wilson, James L; Watson, Lindsey M; LeDuc, Alyse; Meng, Can; Ansariadi; La Ane, Ruslan; Manyullei, Syamsuar; Maidin, Alimin

2014-11-25

This pilot study evaluated the potential effect of household environmental factors such as income, maternal characteristics, and indoor air pollution on children's respiratory status in an Eastern Indonesian community. Household data were collected from cross-sectional (n = 461 participants) and preliminary childhood case-control surveys (pneumonia cases = 31 diagnosed within three months at a local health clinic; controls = 30). Particulate matter (PM2.5 and PM10) was measured in living rooms, kitchens, children's bedrooms, and outside areas in close proximity once during the case-control household interviews (55 homes) and once per hour from 6 a.m. to midnight in 11 homes. The household survey showed that children were 1.98 times (p = 0.02) more likely to have coughing symptoms indicating respiratory infection, if mothers were not the primary caregivers. More children exhibited coughing if they were not exclusively breastfed (OR = 2.18; p = 0.06) or there was a possibility that their mothers were exposed to environmental tobacco smoke during pregnancy (OR = 2.05; p = 0.08). This study suggests that household incomes and mother's education have an indirect effect on childhood pneumonia and respiratory illness. The concentrations of PM2.5 and PM10 ranged from 0.5 to 35.7 µg/m3 and 7.7 to 575.7 µg/m3, respectively, based on grab samples. PM was significantly different between the case and control groups (p < 0.01). The study also suggests that ambient air may dilute indoor pollution, but also introduces pollution into the home from the community environment. Effective intervention programs need to be developed that consider multiple direct and indirect risk factors to protect children.

Childhood Acute Respiratory Infections and Household Environment in an Eastern Indonesian Urban Setting

PubMed Central

Shibata, Tomoyuki; Wilson, James L.; Watson, Lindsey M.; LeDuc, Alyse; Meng, Can; Ansariadi; La Ane, Ruslan; Manyullei, Syamsuar; Maidin, Alimin

2014-01-01

This pilot study evaluated the potential effect of household environmental factors such as income, maternal characteristics, and indoor air pollution on children’s respiratory status in an Eastern Indonesian community. Household data were collected from cross-sectional (n = 461 participants) and preliminary childhood case-control surveys (pneumonia cases = 31 diagnosed within three months at a local health clinic; controls = 30). Particulate matter (PM2.5 and PM10) was measured in living rooms, kitchens, children’s bedrooms, and outside areas in close proximity once during the case-control household interviews (55 homes) and once per hour from 6 a.m. to midnight in 11 homes. The household survey showed that children were 1.98 times (p = 0.02) more likely to have coughing symptoms indicating respiratory infection, if mothers were not the primary caregivers. More children exhibited coughing if they were not exclusively breastfed (OR = 2.18; p = 0.06) or there was a possibility that their mothers were exposed to environmental tobacco smoke during pregnancy (OR = 2.05; p = 0.08). This study suggests that household incomes and mother’s education have an indirect effect on childhood pneumonia and respiratory illness. The concentrations of PM2.5 and PM10 ranged from 0.5 to 35.7 µg/m3 and 7.7 to 575.7 µg/m3, respectively, based on grab samples. PM was significantly different between the case and control groups (p < 0.01). The study also suggests that ambient air may dilute indoor pollution, but also introduces pollution into the home from the community environment. Effective intervention programs need to be developed that consider multiple direct and indirect risk factors to protect children. PMID:25429685

Salt taste preference, sodium intake and gastric cancer in China.

PubMed

Zhang, Zhiyong; Zhang, Xiefu

2011-01-01

The risk factors mostly strongly associated with gastric cancer are gastric bacteria Helicobacter pylori and diet. By using a case-control study among residents in China, we examined the association between sodium intake, presence of H,pylori, and gastric cancer risk. A population-based case-control study including 235 cases and 410 controls were used. Potential risk factors of gastric cancer were interview for cases and controls by questionnaire, salt taste preference was measured for all subjects, and IgG antibodies to H,pylori was used for H.pylori infection. Risk measures were calculated using unconditional logistic regression. H.pylori infection and smoking increased the risk of gastric cancer, with the OR(95%CI) of 1.91(1.32-2.79) and 1.47(1.05- 2.05), respectively. Dietary sodium intake independently increased the risk of gastric cancer. Participants with the highest sodium intake(>5g/day) had a high gastric cancer risk [OR(95%CI)= 3.78(1.74-5.44)]. Participants with the salt taste preference at 7.3g/L and ≥ 14.6g/L showed higher risk of gastric cancer [OR(95%) for 7.3g/L and ≥ 14.6g/L were 5.36(2.72-10.97) and 4.75(2.43-8.85), respectively]. A significantly interaction was found between salt taste preference and H.pylori infection (p=0.037). Salt taste preference was significantly correlated with sodium intake (Correlation coefficient=0.46, p< 0.001). Salt taste preference test could be a simple way to evaluate an inherited characteristic of sodium intake, and our study confirms the gastric cancer is associated with sodium intake and H.pylori.

An Outbreak of Cryptosporidium parvum across England & Scotland Associated with Consumption of Fresh Pre-Cut Salad Leaves, May 2012

PubMed Central

McKerr, Caoimhe; Adak, Goutam K.; Nichols, Gordon; Gorton, Russell; Chalmers, Rachel M.; Kafatos, George; Cosford, Paul; Charlett, Andre; Reacher, Mark; Pollock, Kevin G.; Alexander, Claire L.; Morton, Stephen

2015-01-01

Background We report a widespread foodborne outbreak of Cryptosporidium parvum in England and Scotland in May 2012. Cases were more common in female adults, and had no history of foreign travel. Over 300 excess cases were identified during the period of the outbreak. Speciation and microbiological typing revealed the outbreak strain to be C. parvum gp60 subtype IIaA15G2R1. Methods Hypothesis generation questionnaires were administered and an unmatched case control study was undertaken to test the hypotheses raised. Cases and controls were interviewed by telephone. Controls were selected using sequential digit dialling. Information was gathered on demographics, foods consumed and retailers where foods were purchased. Results Seventy-four laboratory confirmed cases and 74 controls were included in analyses. Infection was found to be strongly associated with the consumption of pre-cut mixed salad leaves sold by a single retailer. This is the largest documented outbreak of cryptosporidiosis attributed to a food vehicle. PMID:26017538

An Outbreak of Cryptosporidium parvum across England & Scotland Associated with Consumption of Fresh Pre-Cut Salad Leaves, May 2012.

PubMed

McKerr, Caoimhe; Adak, Goutam K; Nichols, Gordon; Gorton, Russell; Chalmers, Rachel M; Kafatos, George; Cosford, Paul; Charlett, Andre; Reacher, Mark; Pollock, Kevin G; Alexander, Claire L; Morton, Stephen

2015-01-01

We report a widespread foodborne outbreak of Cryptosporidium parvum in England and Scotland in May 2012. Cases were more common in female adults, and had no history of foreign travel. Over 300 excess cases were identified during the period of the outbreak. Speciation and microbiological typing revealed the outbreak strain to be C. parvum gp60 subtype IIaA15G2R1. Hypothesis generation questionnaires were administered and an unmatched case control study was undertaken to test the hypotheses raised. Cases and controls were interviewed by telephone. Controls were selected using sequential digit dialling. Information was gathered on demographics, foods consumed and retailers where foods were purchased. Seventy-four laboratory confirmed cases and 74 controls were included in analyses. Infection was found to be strongly associated with the consumption of pre-cut mixed salad leaves sold by a single retailer. This is the largest documented outbreak of cryptosporidiosis attributed to a food vehicle.

Planning for long-duration space exploration: Interviews with NASA subject matter experts

NASA Astrophysics Data System (ADS)

McIntosh, Tristan; Mulhearn, Tyler; Gibson, Carter; Mumford, Michael D.; Yammarino, Francis J.; Connelly, Shane; Day, Eric A.; Vessey, William B.

2016-12-01

Planning is critical to organizations, especially for those involved in pursuing technologic, scientific, and innovative ventures. Examination of planning processes is particularly important in high-stake and high-risk environments. In the present study, to highlight the significance of planning in the context of long-duration space missions, 11 current and former National Aeronautics and Space Administration (NASA) personnel were interviewed to gain a better understanding of astronaut and Mission Control leadership in preparing for and carrying out space missions. Interviewees focused their responses on perceptions of leadership and thoughts on how long-duration spaceflight leadership should be different from current and short-term spaceflight. Notes from these interviews were content coded and qualitatively analyzed. We found that cognitive planning skills and case-based reasoning were among the variables that were most highly rated for being critical to the success of long-duration space missions. Moreover, qualitative analyses revealed new considerations for long-duration space missions, such as granting greater autonomy to crewmembers and the need for more near-term forecasting. The implications of these findings for understanding the planning processes and necessary characteristics of individuals tasked with planning are discussed.

Sexual dysfunction, mood, anxiety, and personality disorders in female patients with fibromyalgia.

PubMed

Kayhan, Fatih; Küçük, Adem; Satan, Yılmaz; İlgün, Erdem; Arslan, Şevket; İlik, Faik

2016-01-01

We aimed to investigate the current prevalence of sexual dysfunction (SD), mood, anxiety, and personality disorders in female patients with fibromyalgia (FM). This case-control study involved 96 patients with FM and 94 healthy women. The SD diagnosis was based on a psychiatric interview in accordance with the Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria. Mood and anxiety disorders were diagnosed using the Structured Clinical Interview. Personality disorders were diagnosed according to the Structured Clinical Interview for DSM, Revised Third Edition Personality Disorders. Fifty of the 96 patients (52.1%) suffered from SD. The most common SD was lack of sexual desire (n=36, 37.5%) and arousal disorder (n=10, 10.4%). Of the 96 patients, 45 (46.9%) had a mood or anxiety disorder and 13 (13.5%) had a personality disorder. The most common mood, anxiety, and personality disorders were major depression (26%), generalized anxiety disorder (8.3%), and histrionic personality disorder (10.4%). SD, mood, and anxiety disorders are frequently observed in female patients with FM. Pain plays a greater role in the development of SD in female patients with FM.

The professional clothing bank as evidence-based practice.

PubMed

Bishop, SueZanne Monique

2015-01-01

Little research exists linking interview-appropriate attire to improved employment outcomes for women. Thus, it appears that the professional clothing bank has not been investigated as evidence-based practice. To provide preliminary evidence for clothing banks, in this article the author synthesizes findings from existing research on the provision of a professional clothing bank as a means for offering interview-appropriate attire to poor women in job readiness programming. For context, job readiness programs are explored and a case study of one program operating a professional clothing bank is presented. Finally, preliminary considerations for planning and implementing clothing banks based on this literature review are given.

A Framework for NGO-Military Collaboration

DTIC Science & Technology

2013-12-13

from scholarly literature and inductively from case studies and practitioner interviews , I theorize that the efficacy of NGO-military collaboration...studies and practitioner interviews , I theorize that the efficacy of NGO-military collaboration varies with the type of NGO (INGO or LNGO) and the...scholarly literature on NGO-military interactions, and inductively from illustrative case studies from both civilian and military sources and interviews

Perceptions and experiences underlying self-management and reporting of symptoms in teens with asthma

PubMed Central

Mammen, Jennifer R.; Rhee, Hyekyun; Norton, Sally A.; Butz, Arlene M.

2016-01-01

Background Teens often have inadequate asthma self-management and control. However, little is known of their perceptions of or rationales for self-management behaviors. Objectives To explore how teens self-manage asthma, including experiences, perceptions, responses to and reporting of symptoms. Methods A case-based, qualitative-descriptive design was used. Data were collected from minority and non-minority teens with controlled and uncontrolled asthma and their respective parents (N=28). There were four data-collection points, including: (1) a primary teen interview; (2) parent interview; (3) two-week self-management voice-diary; and (4) follow-up teen interview, incorporating symptom-response card-sorting to map symptoms and associated self-management responses. Seventy data sources were included in the analysis. Results Teens thought of their asthma symptoms as normal or unusual relative to their personal baseline symptom pattern; Those with uncontrolled asthma normalized higher levels of asthma symptoms than their counterparts with controlled asthma. Second, teens’ decisions to treat symptoms of asthma with rescue medication were based on perceived benefits, burdens and accessibility of treatment balanced against perceived normalcy of symptoms. Teens with uncontrolled asthma had substantially higher treatment thresholds and delayed responses to symptoms compared to controlled peers. Third, teens never reported perceived normal symptoms of asthma to parents or providers, who were thus only aware of unusual or visible/audible symptoms. Conclusions Teen’s perceptions of symptoms and understanding of what is normal is the basis for self-management decisions. Improving self-management will likely entail modifying perceptions of symptoms and benefits/burdens of treatment to achieve healthier self-management patterns. PMID:27337035

Perceptions and experiences underlying self-management and reporting of symptoms in teens with asthma.

PubMed

Mammen, Jennifer R; Rhee, Hyekyun; Norton, Sally A; Butz, Arlene M

2017-03-01

Teens often have inadequate asthma self-management and control. However, little is known of their perceptions of or rationales for self-management behaviors. To explore how teens self-manage asthma, including experiences, perceptions, responses to and reporting of symptoms. A case-based, qualitative-descriptive design was used. Data were collected from minority and non-minority teens with controlled and uncontrolled asthma and their respective parents (N = 28). There were four data-collection points, including: (1) a primary teen interview; (2) parent interview; (3) 2-week self-management voice-diary; and (4) follow-up teen interview, incorporating symptom-response card-sorting to map symptoms and associated self-management responses. Seventy data sources were included in the analysis. Teens thought of their asthma symptoms as normal or unusual relative to their personal baseline symptom pattern; Those with uncontrolled asthma normalized higher levels of asthma symptoms than their counterparts with controlled asthma. Second, teens' decisions to treat symptoms of asthma with rescue medication were based on perceived benefits, burdens and accessibility of treatment balanced against perceived normalcy of symptoms. Teens with uncontrolled asthma had substantially higher treatment thresholds and delayed responses to symptoms compared to controlled peers. Third, teens never reported perceived normal symptoms of asthma to parents or providers, who were thus only aware of unusual or visible/audible symptoms. Teen's perceptions of symptoms and understanding of what is normal is the basis for self-management decisions. Improving self-management will likely entail modifying perceptions of symptoms and benefits/burdens of treatment to achieve healthier self-management patterns.

[Psychiatric comorbidities of psoriasis: pilot study].

PubMed

Parafianowicz, Katarzyna; Sicińska, Justyna; Moran, Anna; Szumański, Jakub; Staniszewski, Krzysztof; Rudnicka, Lidia; Kokoszka, Andrzej

2010-01-01

There are some reports about the relatively frequent occurrence of depression in the case of psoriasis and some hypothesis about interactions between those two diseases. However there are no studies verifying those hypothesis based on reliable structured psychiatric interviews according to the current diagnostic criteria of mental disorders. The aim of the study was to compare the frequency of depression in patients suffering from psoriasis and from other chronic skin diseases with the use of a structured questionnaire for the diagnosis of the main mental disorders Mini International Neuropsychiatric Interview. 32 consecutive outpatients (9 males and 23 females), age M = 43.9 with psoriasis were examined by a team of dermatologists, psychiatrists and a psychologist using a standard set of methods. In addition, 32 patients with other chronically occurring skin diseases, including 11 males and 21 females, age M = 31.6, were also examined and formed the control group. RESULTS; The point prevalence of mental disorders was significantly higher in the psoriatic group--20 (62.5%) versus 5 (15.62%) in the control group (p < 0.001). In all of the cases, affective disorders were diagnosed. Mild anxiety disorders were additionally found in 10 psoriatic patients (31.25%) and in 2 controls (6.25%) (p < 0.001). The level of depression was much higher in the study group than in the control group, both in the Beck Depression Inventory (M = 15.28, SD = 8.72 versus M = 8.13, SD = 6.31, p < 0.001 respectively) and in the Hamilton Rating Scale for Depression (M = 9.63, SD = 5.71 versus M = 5.09, SD = 4.26, p < 0.001 respectively). The neurotic symptoms measured by the Symptoms Check List-II by Aleksandrowicz were also significantly more intense in the psoriatic group (M = 54.37; SD = 40.99) than in the control group (M = 35.28; SD 23.96) (F = 8.55, p < 0.005). The results imply the need for the careful examination of the mental state of patients with psoriasis in order to offer and provide treatment of any concomitant psychiatric conditions.

Life after stoma creation.

PubMed

Danielsen, Anne Kjærgaard

2013-10-01

Stoma creation is a surgical operation where the surgeon makes an artificial opening on the abdomen from where the bowel is taken out. It is a radical treatment with permanent physical signs of bodily change. In general, it leads to loss of a central and personal physical function, as well as an alteration in the bodily design. Research in the field may provide additional information about central elements when adapting to life with a stoma. There are currently no studies that adequately focus on the relationship between health-related quality of life and stoma construction in a Danish context, neither for temporary or permanent construction, nor in relation to the importance of stoma handling. The overall objective of the study was to investigate health-related quality of life related to stoma creation and patient education. Methodologically, the project was implemented as a mixed methods study in which qualitative interview studies and two systematic literature reviews identified interventions, which were subsequently tested in a clinical case/control study. Finally the case/control study was made subject to an economic analysis. The project is based on 6 papers reporting the results. ARTICLE 1: Impact of a temporary stoma on patients everyday-lives: feelings of uncertainty while waiting for closure of the stoma. The study included 7 participants who were interviewed in focus groups. The results indicated that patients experienced a high degree of uncertainty in connection with the stoma being temporary. At the same time, participants had a strong need to control both their physical appearance and their changed bodily functions. Participants opted for education programs involving teachers with a stoma. ARTICLE 2: Learning to live with a Permanent Intestinal Ostomy: Impact on everyday life and Educational Needs. The study included 15 participants who were interviewed in groups related to whether they were treated for cancer or non-cancer. The results showed that participants often experienced the stoma as a taboo, and emotions related to stigma were identified. In addition, participants were influenced by the stoma in various ways, and the stoma imposed some restrictions on the participants. Participants pointed at group-based education, as well as the involvement of teachers who had a stoma. ARTICLE 3: Spouses of patients with a stoma lack information and support and are restricted in their social and sexual life: a systematic review. The study included 6 articles based on quantitative and qualitative data showing that spouses were affected in several ways by the construction of the stoma. The results pointed at spouses not being informed and supported sufficiently by neither enterostoma therapists or surgeons. ARTICLE 4: Patient education has a positive effect in patients with a stoma - a systematic review The study included 7 studies, all with quantitative results. They showed that patient education had a positive impact in several areas including shorter hospital stay, less time until proficiency in stoma management is reached, an increase in quality of life, increased knowledge about the stoma, and increased self-efficacy. ARTICLE 5: Health-related quality of life increases when patients with a stoma attend patient education - a case/control study. The study included 50 participants shortly after stoma creation. The results showed that the disease-specific quality of life was significantly increased in the intervention group, while generic health-related quality of life was positively affected in different dimensions in both groups. ARTICLE 6: Decreased costs with patient education after stoma creation. The study was an economic analysis based on participants in Article 5. The results indicated that there were fewer unplanned re-admissions related to the stoma, and that patients in the intervention group did not visit the general practitioner as much as patients in the control group. Furthermore, we found that the average cost per patient did not increase when establishing a patient education program. The thesis concludes that patient education has a positive impact on patients' quality of life, and that costs are reduced. At the same time, it is concluded that living with a stoma is a complex situation, which also involves spouses and close relatives, and that patient education must be based on multiple interventions that are not all explored in this project.

Risk factors for syphilis in women: case-control study

PubMed Central

de Macêdo, Vilma Costa; de Lira, Pedro Israel Cabral; de Frias, Paulo Germano; Romaguera, Luciana Maria Delgado; Caires, Silvana de Fátima Ferreira; Ximenes, Ricardo Arraes de Alencar

2017-01-01

ABSTRACT OBJECTIVE To determine the sociodemographic, behavioral, and health care factors related to the occurrence of syphilis in women treated at public maternity hospitals. METHODS This is a case-control study (239 cases and 322 controls) with women admitted to seven maternity hospitals in the municipality of Recife, Brazil, from July 2013 to July 2014. Eligible women were recruited after the result of the VDRL (Venereal Disease Research Laboratory) under any titration. The selection of cases and controls was based on the result of the serology for syphilis using ELISA (enzyme-linked immunosorbent assay). The independent variables were grouped into: sociodemographic, behavioral, clinical and obstetric history, and health care in prenatal care and maternity hospital. Information was obtained by interview, during hospitalization, with the application of a questionnaire. Odds ratios and 95% confidence intervals were estimated using logistic regression to identify the predicting factors of the variable to be explained. RESULTS The logistic regression analysis identified as determinant factors for gestational syphilis: education level of incomplete basic education or illiterate (OR = 2.02), lack of access to telephone (OR = 2.4), catholic religion (OR = 1.70 ), four or more pregnancies (OR = 2.2), three or more sexual partners in the last year (OR = 3.1), use of illicit drugs before the age of 18 (OR = 3.0), and use of illicit drugs by the current partner (OR = 1.7). Only one to three prenatal appointments (OR = 3.5) and a previous history of sexually transmitted infection (OR = 9.7) were also identified as determinant factors. CONCLUSIONS Sociodemographic, behavioral, and health care factors are associated with the occurrence of syphilis in women and should be taken into account in the elaboration of universal strategies aimed at the prevention and control of syphilis, but with a focus on situations of greater vulnerability. PMID:28832758

Communication of scientific uncertainty: international case studies on the development of folate and vitamin D Dietary Reference Values.

PubMed

Brown, Kerry A; de Wit, Liesbeth; Timotijevic, Lada; Sonne, Anne-Mette; Lähteenmäki, Liisa; Brito Garcia, Noé; Jeruszka-Bielak, Marta; Sicińska, Ewa; Moore, Alana N; Lawrence, Mark; Raats, Monique M

2015-06-01

Transparent evidence-based decision making has been promoted worldwide to engender trust in science and policy making. Yet, little attention has been given to transparency implementation. The degree of transparency (focused on how uncertain evidence was handled) during the development of folate and vitamin D Dietary Reference Values was explored in three a priori defined areas: (i) value request; (ii) evidence evaluation; and (iii) final values. Qualitative case studies (semi-structured interviews and desk research). A common protocol was used for data collection, interview thematic analysis and reporting. Results were coordinated via cross-case synthesis. Australia and New Zealand, Netherlands, Nordic countries, Poland, Spain and UK. Twenty-one interviews were conducted in six case studies. Transparency of process was not universally observed across countries or areas of the recommendation setting process. Transparency practices were most commonly seen surrounding the request to develop reference values (e.g. access to risk manager/assessor problem formulation discussions) and evidence evaluation (e.g. disclosure of risk assessor data sourcing/evaluation protocols). Fewer transparency practices were observed to assist with handling uncertainty in the evidence base during the development of quantitative reference values. Implementation of transparency policies may be limited by a lack of dedicated resources and best practice procedures, particularly to assist with the latter stages of reference value development. Challenges remain regarding the best practice for transparently communicating the influence of uncertain evidence on the final reference values. Resolving this issue may assist the evolution of nutrition risk assessment and better inform the recommendation setting process.

Occupational exposure to lead and lung cancer: results from two case-control studies in Montreal, Canada.

PubMed

Wynant, Willy; Siemiatycki, Jack; Parent, Marie-Élise; Rousseau, Marie-Claude

2013-03-01

We investigated the association between workplace lead exposure and lung cancer risk, separately for organic lead and for inorganic lead, from either engine emissions or from other sources. Two population-based case-control studies were carried out in Montreal (1979-1986 and 1996-2002) to investigate occupational factors in relation to lung cancer among 1593 men with histologically confirmed incident lung cancer, and 1426 controls from the general population. Interviews elicited information on sociodemographic characteristics, lifetime smoking and occupational history. Chemists translated each job into potential chemical exposures. Cumulative indices of exposure were derived and classified into non-substantial and substantial exposure. ORs adjusted for several potential confounders including smoking, and 95% CIs were estimated by logistic regression. Lifetime prevalences of exposure in Study I were 3% for organic lead, 40% for inorganic lead from engine emissions and 17% for inorganic lead from other sources; corresponding prevalences in Study II were 4%, 19% and 16%, respectively. No associations were observed when comparing ever to never exposed subjects in pooled analyses (organic lead, OR=1.39, 95% CI 0.77 to 2.52; inorganic lead from engine emissions: OR=0.89, 95% CI 0.72 to 1.09; inorganic lead from other sources: OR=0.99, 95% CI 0.76 to 1.29). Nor were these exposures associated with lung cancer in subjects with substantial cumulative exposure. In this large study, using a blinded expert-based assessment of lifetime occupational exposure and adjustment for several potential confounders, we observed no increased risk of lung cancer with exposure to lead compounds.

The association of temporomandibular disorder pain with history of head and neck injury in adolescents.

PubMed

Fischer, Dena J; Mueller, Beth A; Critchlow, Cathy W; LeResche, Linda

2006-01-01

To evaluate the risk of self-reported temporomandibular disorder (TMD) pain among adolescents in relation to previous head and/or neck injury. 3,101 enrollees (11 to 17 years of age) of a nonprofit integrated health-care system were interviewed by telephone. Two hundred four cases with self-reported TMD pain and 194 controls without self-reported TMD pain frequency-matched to the cases by age and gender completed standardized in-person interviews and physical examinations in which reports of previous head/neck injuries were recorded. Odds ratio (OR) estimates and 95% confidence intervals (CIs) of the relative risks of TMD pain associated with prior head and/or neck injuries were calculated using logistic regression. A greater proportion of subjects reporting TMD pain (36%) than controls (25%) had a history of head and/or neck injuries (OR = 1.8, 95% CI, 1.1-2.8). In a separate analysis, the presence of TMD based upon the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) was assessed in relation to prior head and/or neck injury. Cases reporting TMD pain and meeting the RDC/TMD criteria for myofascial pain and/or arthralgia or arthritis were 2.0 (CI, 1.0-3.8) times more likely to have had a prior head injury than were controls with neither self-reported nor RDC/TMD pain diagnoses. The results suggest a modest association of prior head injuries with both self-reported and clinically diagnosed TMD pain in adolescents.

Pregnant womens' concerns when invited to a randomized trial: a qualitative case control study.

PubMed

Oude Rengerink, Katrien; Logtenberg, Sabine; Hooft, Lotty; Bossuyt, Patrick M; Mol, Ben Willem

2015-09-04

Pregnant women were excluded from clinical trials until the 1990s, but the Food and Drug Administration nowadays allows--and even encourages--responsible inclusion of pregnant women in trials with adequate safety monitoring. Still, randomized trials in pregnant women face specific enrolment challenges. Previous studies have focused on barriers to trial participation in studies that had failed to recruit sufficient participants. Our aim was to identify barriers and motivators for participation in a range of clinical trials being conducted in the Netherlands, regardless of recruitment performance. We performed a qualitative case control study in women who had been asked in 2010 to participate in one of eight clinical trials during pregnancy or shortly after giving birth. Both participants and non-participants of these clinical trials were invited for a face-to-face interview that addressed motives for participation and non-participation. We started the interview in an open fashion, asking the women for their main motive for participation or non-participation. When no new information emerged in this open part, we continued with a semi-structured interview, guided by a topic list. Transcripts of the interviews were analysed using a constant-comparative approach. Two researchers identified barriers and facilitators for participation, conjoined into main themes. Of 28 women invited for the interview, 21 agreed to be interviewed (12 participants and 9 non-participants). For 5 of the 12 participants, contribution to scientific research was their main motive, while 5 had participated because the intervention seemed favorable and was not available outside the trial. Key motives for non-participation (n = 9) were a negative association or a dislike of the intervention, either because it might do harm (n = 6) or for practical reasons (n = 3). Combining the open and topic list guided interviews we constructed seven main themes that influence the pregnant women's decision to participate: external influence, research and healthcare, perception own situation, study design, intervention, information and counselling, and uncertainty. Among seven main themes that influence pregnant women's decision to participate, uncertainty about scientific research or the intervention was reported to be of considerable importance. Measures should be taken to habituate pregnant women more to scientific research, and further evaluation of opt-out consent deserves attention.

77 FR 12598 - Notice Correction; A Multi-Center International Hospital-Based Case-Control Study of Lymphoma in...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Notice Correction; A Multi-Center International Hospital-Based Case-Control Study of Lymphoma in Asia (AsiaLymph) (NCI) The Federal... project titled, ``A multi-center international hospital-based case-control study of lymphoma in Asia (Asia...

lmplementing lifestyle change through phone-based motivational interviewing in rural-based women with previous gestational diabetes mellitus.

PubMed

Reinhardt, Judith A; van der Ploeg, Hidde P; Grzegrzulka, Richard; Timperley, Jennifer G

2012-04-01

Substantial numbers of women with past gestational diabetes mellitus (GDM) develop type 2 diabetes mellitus (T2DM). In northern New South Wales 23% of women attending diabetes services between 2007 and 2010 with T2DM previously had GDM. This study investigated whether phone-based lifestyle education using motivational interviewing resulted in positive lifestyle change post GDM for women in a large rural area. Thirty-eight women were recruited to this pilot study following GDM diagnosis and randomly allocated to either the control or intervention group. Following baseline assessment, the intervention group received a 6-month phone-based motivational interviewing program, and access to usual care. The control group received usual care only. Measures were collected at baseline (6 weeks postnatal), and at 6 months follow-up. Outcome measures included body mass index, diet, and physical activity. At follow-up, the intervention group compared to the control group significantly reduced total fat intake by -19 g/d (95%CI: -37 to -1), total carbohydrate intake by -42 g/d (95%CI: -82 to -1), and glycaemic load by -26 units (95%CI: -48 to -4). These women also increased leisure physical activity compared to the control group by 11 min/d (95%CI: 1 to 22); no significant change in total physical activity levels occurred. At follow-up, body mass index in the intervention group improved by -1.5 kg/m2 (95%CI: -2.8 to -0.1) compared to the control group. The intervention group showed positive trends across lifestyle variables compared to the control group. Further large-scale research on the effectiveness of phone-based lifestyle counselling following GDM is warranted.

Burnout and psychiatric morbidity among medical students entering clinical training: a three year prospective questionnaire and interview-based study.

PubMed

Dahlin, Marie E; Runeson, Bo

2007-04-12

Mental distress among medical students is often reported. Burnout has not been studied frequently and studies using interviewer-rated diagnoses as outcomes are rarely employed. The objective of this prospective study of medical students was to examine clinically significant psychiatric morbidity and burnout at 3rd year of medical school, considering personality and study conditions measured at 1st year. Questionnaires were sent to 127 first year medical students who were then followed-up at 3rd year of medical school. Eighty-one of 3rd year respondents participated in a diagnostic interview. Personality (HP5-i) and Performance-based self-esteem (PBSE-scale) were assessed at first year, Study conditions (HESI), Burnout (OLBI), Depression (MDI) at 1st and 3rd years. Diagnostic interviews (MINI) were used at 3rd year to assess psychiatric morbidity. High and low burnout at 3rd year was defined by cluster analysis. Logistic regressions were used to identify predictors of high burnout and psychiatric morbidity, controlling for gender. 98 (77%) responded on both occasions, 80 (63%) of these were interviewed. High burnout was predicted by Impulsivity trait, Depressive symptoms at 1st year and Financial concerns at 1st year. When controlling for 3rd year study conditions, Impulsivity and concurrent Workload remained. Of the interviewed sample 21 (27%) had a psychiatric diagnosis, 6 of whom had sought help. Unadjusted analyses showed that psychiatric morbidity was predicted by high Performance-based self-esteem, Disengagement and Depression at 1st year, only the later remained significant in the adjusted analysis. Psychiatric morbidity is common in medical students but few seek help. Burnout has individual as well as environmental explanations and to avoid it, organisational as well as individual interventions may be needed. Early signs of depressive symptoms in medical students may be important to address. Students should be encouraged to seek help and adequate facilities should be available.

Case Study of Mental Skills Training for a Taekwondo Olympian

PubMed Central

Lim, TaeHee

2016-01-01

Abstract The purpose of this study was to identify the effect of systematic mental skills training (MST) for a taekwondo gold medallist. Based on MST of other sports, this programme was designed for a single subject who competed in the Olympics. The Korean test of performance strategies, Sport Attributional Style in Korean Athletes, and a few sessions of interviews were applied to investigate the effect of MST. The pre and post-test mean scores of both the Korean test of performance strategies and Sport Attributional Style in Korean Athletes were compared. Interviews recorded the athlete’s psychological characteristics. Excluding the ‘activation’ variable, all of the psychological skills, e.g. self-talk (4.25–5), emotional control (3.75–4.5), automaticity (3.75–4.25), goal setting (4.5–5), imagery (4.25–5), negative thinking (3.25–4.75), anxiety management (4.5–5), and physical and mental condition (4.5–5) improved. MST is believed to have helped the athlete succeed. PMID:28149361

The prevalence of foot problems in older women: a cause for concern.

PubMed

Dawson, Jill; Thorogood, Margaret; Marks, Sally-Anne; Juszczak, Ed; Dodd, Chris; Lavis, Grahame; Fitzpatrick, Ray

2002-06-01

Painful feet are an extremely common problem amongst older women. Such problems increase the risk of falls and hamper mobility. The aetiology of painful and deformed feet is poorly understood. Data were obtained during a pilot case-control study about past high heel usage in women, in relation to osteoarthritis of the knee. A total of 127 women aged 50-70 were interviewed (31 cases, 96 controls); case-control sets were matched for age. The following information was obtained about footwear: (1) age when first wore shoes with heels 1, 2 and 3 inches high; (2) height of heels worn for work; (3) maximum height of heels worn regularly for work, going out socially and for dancing, in 10-year age bands. Information about work-related activities and lifetime occupational history was gathered using a Life-Grid. The interview included a foot inspection. Foot problems, particularly foot arthritis, affected considerably more cases than controls (45 per cent versus 16 per cent, p = 0.001) and was considered a confounder. Cases were therefore excluded from subsequent analyses. Amongst controls, the prevalence of any foot problems was very high (83 per cent). All women had regularly worn one inch heels and few (8 per cent) had never worn 2 inch heels. Foot problems were significantly associated with a history of wearing relatively lower heels. Few work activities were related to foot problems; regular lifting was associated with foot pain (p = 0.03). Most women in this age-group have been exposed to high-heeled shoes over many years, making aetiological research difficult in this area. Foot pain and deformities are widespread. The relationship between footwear, occupational activities and foot problems is a complex one that deserves considerably more research.

A feasibility study of dementia communication training based on the VERA framework for pre-registration nurses: Part II impact on student experience.

PubMed

Naughton, Corina; Beard, Chloe; Tzouvara, Vasiliki; Pegram, Anne; Verity, Rebecca; Eley, Rhiannon; Hingley, David

2018-04-01

People living with dementia have complex communication needs, especially during acute hospital admissions. The VERA framework (validation, emotion, reassurance, activity) was designed to promote person centred communication between student nurses and people living with dementia, but there is limited evaluation of its impact. To measure the impact of dementia communication training (based on VERA) plus older adult unit (OAU) placement on students' ability to recognise opportunities for person centred (PC) communication compared to OAU placement alone. A control pre-post-study design was used. Dementia communication training plus follow-up during OAU placement was delivered to 51 students (5 OAU, two hospitals) while 66 students (7 OAUs, five hospitals) acted as controls. The primary outcome was students' ability to recognise PC communication assessed using case vignettes. Data were collected using electronic survey and focus group interviews. Data analysis used independent non-parametric Mann-Whitney U test and thematic analysis. In total 52 students (response rate 40%) completed surveys at the end of placements (38 intervention, 14 control group students). In the intervention group, participants were significantly more likely to identify PC responses with a mean score of 10.5 (SD 3.0) compared with 7.5 (SD 3.0) in the control group (p = 0.006). In focus group interviews (n = 19 students), the main themes were connecting with patients, VERA in practice, communication challenges, and learning environment. VERA was described as a flexible approach that added to participants' communication toolkit. The learning environment, complexity of patients and organisational resources were important contextual factors. The VERA framework has potential as a foundation level dementia communication training intervention, but it requires more rigorous testing. Nursing can lead the way in developing and embedding evidence-based, interdisciplinary dementia communication training in preregistration curricula. Copyright © 2018 Elsevier Ltd. All rights reserved.

Common mental disorders associated with tuberculosis: a matched case-control study.

PubMed

de Araújo, Gleide Santos; Pereira, Susan Martins; dos Santos, Darci Neves; Marinho, Jamocyr Moura; Rodrigues, Laura Cunha; Barreto, Mauricio Lima

2014-01-01

Despite the availability of treatment and a vaccine, tuberculosis continues to be a public health problem worldwide. Mental disorders might contribute to the burden of the disease. The objective of this study was to investigate the association between common mental disorders and tuberculosis. A matched case-control study was conducted. The study population included symptomatic respiratory patients who attended three referral hospitals and six community clinics in the city of Salvador, Brazil. A doctor's diagnosis defined potential cases and controls. Cases were newly diagnosed tuberculosis cases, and controls were symptomatic respiratory patients for whom tuberculosis was excluded as a diagnosis by the attending physician. Cases and controls were ascertained in the same clinic. Data collection occurred between August 2008 and April 2010. The study instruments included a structured interview, a self-reporting questionnaire for the identification of common mental disorders, and a questionnaire for alcoholism. An univariate analysis included descriptive procedures (with chi-square statistics), and a multivariate analysis used conditional logistic regression. The mean age of the cases was 38 years, and 61% of the cases were males. After adjusting for potential confounders, the odds of tuberculosis were significantly higher in patients diagnosed with a common mental disorder (OR: 1.34; 95% CI 1.05-1.70). There appears to be a positive and independent association between common mental disorders and tuberculosis; further epidemiological studies are required to increase our understanding of the possible biological and social mechanisms responsible for this association. Independent of the direction of the association, this finding has implications for the provision of care for mental disorders and for tuberculosis.

Design, methodological issues and participation in a multiple sclerosis case-control study.

PubMed

Williamson, D M; Marrie, R A; Ashley-Koch, A; Schiffer, R; Trottier, J; Wagner, L

2012-09-01

This study was conducted to determine whether the risk of developing multiple sclerosis (MS) was associated with certain environmental exposures or genetic factors previously reported to influence MS risk. This paper describes the methodological issues, study design and characteristics of the study population. Individuals with definite MS were identified from a prevalence study conducted in three geographic areas. The target number of cases was not reached, so an additional study area was added. Identifying clinic controls was inefficient, so controls were recruited using random digit dialing. All study participants completed a detailed questionnaire regarding environmental exposures using computer-assisted telephone interviewing, and blood was collected for genetic analysis. In total, 276 cases and 590 controls participated, but participation rates were low, ranging from 28.4% to 38.9%. Only one-third (33.6%) of individuals identified in the prevalence study agreed to participate in the case-control study. Cases were more likely to be non-Hispanic white and older than their source populations as identified in the preceding prevalence study (P < 0.05). Most participants provided a blood sample for genotyping (91%; n = 789). Epidemiological studies play a key role in identifying genetic and environmental factors that are associated with complex diseases like MS. Methodological issues arise in every study, and investigators need to be able to detect, respond to and correct problems in a timely and scientifically valid manner. © 2011 John Wiley & Sons A/S.

Pre-licensed driving experience and car crash involvement during the learner and restricted, licence stages of graduated driver licensing: Findings from the New Zealand drivers study.

PubMed

Begg, Dorothy J; Langley, John D; Brookland, Rebecca L; Ameratunga, Shanthi; Gulliver, Pauline

2014-01-01

The aim of this study was to determine whether pre-licence driving experiences, that is driving before beginning the licensing process, increased or decreased crash risk as a car driver, during the learner or the restricted licence stages of the graduated driver licensing system (GDLS). Study participants were 15-24 year old members of the New Zealand Drivers Study (NZDS) - a prospective cohort study of newly licensed car drivers. The interview stages of the NZDS are linked to, the three licensing stages of the GDLS: learner, restricted and full. Baseline demographic (age, ethnicity, residential location, deprivation), personality (impulsivity, sensation seeking, aggression) and, behavioural data, (including pre-licensed driving behaviour), were obtained at the learner licence interview. Data on distance driven and crashes that occurred at the learner licence and restricted licence stages, were reported at the restricted and full licence interviews, respectively. Crash data were also obtained from police traffic crash report files and this was combined with the self-reported crash data. The analysis of the learner licence stage crashes, when only supervised driving is allowed, was based on the participants who had passed the restricted licence test and undertaken the NZDS, restricted licence interview (n=2358). The analysis of the restricted licence stage crashes, when unsupervised driving is first allowed, was based on those who had passed the full licence test and completed the full licence interview (n=1428). After controlling for a range of demographic, personality, behavioural variables and distance driven, Poisson regression showed that the only pre-licence driving behaviour that showed a consistent relationship with subsequent crashes was on-road car driving which was associated with an increased risk of being the driver in a car crash during the learner licence period. This research showed that pre-licensed driving did not reduce crash risk among learner or restricted licensed drivers, and in some cases (such as on-road car driving) may have increased risk. Young people should be discouraged from the illegal behaviour of driving a car on-road before licensing. Copyright © 2013 Elsevier Ltd. All rights reserved.

"Making the Difficult Choice": Understanding Georgia's Test-Based Grade Retention Policy in Reading

ERIC Educational Resources Information Center

Huddleston, Andrew P.

2015-01-01

The author uses Bourdieu's concepts of field, capital, and habitus to analyze how students, parents, teachers, and administrators are responding to Georgia's test-based grade retention policy in reading at one Georgia elementary school. In this multiple case study, the author interviewed, observed, and collected documents regarding ten fifth…

Not Funding the Evidence-Based Model in Ohio

ERIC Educational Resources Information Center

Edlefson, Carla

2010-01-01

The purpose of this descriptive case study was to describe the implementation of Ohio's version of the Evidence-Based Model (OEBM) state school finance system in 2009. Data sources included state budget documents and analyses as well as interviews with local school officials. The new system was responsive to three policy objectives ordered by the…

Implementing Curriculum-Based Learning Portfolio: A Case Study in Taiwan

ERIC Educational Resources Information Center

Chen, Shu-Chin Susan; Cheng, Yu-Pay

2011-01-01

The main purpose of this descriptive research is to examine and document the development of a curriculum-based learning portfolio model for children in a preschool for three-six-year-olds in Taiwan. Data collection methods adopted include classroom observation, in-depth interviews, questionnaires and documentation. Participants include a preschool…

Teleworking and Gender.

ERIC Educational Resources Information Center

Huws, Ursula; And Others

This report details a survey of 188 teleworkers throughout Europe that was supplemented by face-to-face interviews with 9 teleworkers in the United Kingdom, Sweden, and the Netherlands. The group of male and female home-based translators was chosen for two reasons: most surveys and case studies of teleworking have been company based and unable to…

Children's Agentive Orientations in Play-Based and Academically Focused Preschools in Hong Kong

ERIC Educational Resources Information Center

Cheng Pui-Wah, Doris; Reunamo, Jyrki; Cooper, Paul; Liu, Karen; Vong, Keang-ieng Peggy

2015-01-01

The article describes a comparative case study on children's agentive orientations in two Hong Kong preschools, one is play-based and the other is academically focused. Agentive orientations were measured using Reunamo's interview tool, which focuses on children's uses of accommodative and agentive orientations in everyday situations. The findings…

Implementation of Evidence-Based Employment Services in Specialty Mental Health

PubMed Central

Hamilton, Alison B; Cohen, Amy N; Glover, Dawn L; Whelan, Fiona; Chemerinski, Eran; McNagny, Kirk P; Mullins, Deborah; Reist, Christopher; Schubert, Max; Young, Alexander S

2013-01-01

Objective. Study a quality improvement approach for implementing evidence-based employment services at specialty mental health clinics. Data Sources/Study Setting. Semistructured interviews with clinicians and administrators before, during, and after implementation. Qualitative field notes, structured baseline and follow-up interviews with patients, semistructured interviews with patients after implementation, and administrative data. Study Design. Site-level controlled trial at four implementation and four control sites. Hybrid implementation–effectiveness study with mixed methods intervention evaluation design. Data Collection/Extraction Methods. Site visits, in-person and telephone interviews, patient surveys, patient self-assessment. A total of 801 patients completed baseline surveys and 53 clinicians and other clinical key stakeholders completed longitudinal qualitative interviews. Principal Findings. At baseline, sites varied in the availability, utilization, and quality of supported employment. Each site needed quality improvement for this service, though for differing reasons, with some needing development of the service itself and others needing increased service capacity. Improvements in knowledge, attitudes, beliefs, and referral behaviors were evident in mid- and postimplementation interviews, though some barriers persisted. Half of patients expressed an interest in working at baseline. Patients at implementation sites were 2.3 times more likely to receive employment services during the study year. Those who had a service visit were more likely to be employed at follow-up than those who did not. Conclusions. Studies of implementation and effectiveness require mixed methods to both enhance implementation in real time and provide context for interpretation of complex results. In this study, a quality improvement approach resulted in superior patient-level outcomes and improved clinician knowledge, attitudes, and behaviors, in the context of substantial variation among sites. PMID:24138608