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Sample records for male population-based simulation

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

    PubMed

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

    2013-01-01

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

  2. Genitourinary health in a population-based cohort of males with Duchenne and Becker muscular dystrophies

    PubMed Central

    Zhu, Yong; Romitti, Paul A.; Conway, Kristin M. Caspers; Kim, Sunkyung; Zhang, Ying; Yang, Michele; Mathews, Katherine D.

    2015-01-01

    Introduction Genitourinary (GU) health among patients with Duchenne and Becker muscular dystrophies (DBMD) has not been explored using population-based data. Methods Medical records of 918 males ascertained by the Muscular Dystrophy Surveillance, Tracking, and Research Network were reviewed for documentation of GU-related hospitalizations and prescribed medications. Percentages of males who received these medical interventions were calculated, hazard ratios (HR) and 95% confidence intervals (CI) were estimated for associations with sociodemographics (study site, race/ethnicity), symptoms (early-versus late-onset, ambulation status, scoliosis), and treatments (respiratory support, steroids). Results Among the 918 males, 81 (9%) had a GU condition; voiding dysfunction (n=40), GU tract infection (n=19), and kidney/ureter calculus (n=9) were most common. A Kaplan-Meier curve produced a cumulative probability of 27%. Cox regression showed GU conditions were more common when males were non-ambulatory (HR=2.7, 95% CI=1.3-5.6). Discussion These findings highlight increased awareness of GU health and multidisciplinary care of DBMD patients. PMID:25297835

  3. Maternal inflammatory bowel disease and hypospadias in male offspring: a population-based study in Denmark

    PubMed Central

    Andersen, Ane Birgitte Telén; Ehrenstein, Vera; Erichsen, Rune; Frøslev, Trine; Sørensen, Henrik Toft

    2016-01-01

    Background The occurrence of inflammatory bowel disease (IBD) and hypospadias has been concurrently increasing, possibly through shared environmental risk factors such as endocrine disrupting compounds. Also, maternal IBD may disturb the normal development of the fetal reproductive tract. However, whether maternal IBD increases the risk of hypospadias in male offspring is unknown. We compared hypospadias risk in sons of mothers with and without IBD. Methods We used Danish nationwide population-based registries to conduct a longitudinal prevalence study including all live-born boys from 1979 through 2009. We computed HRs, as estimates of prevalence ratios (PRs), with 95% CIs for hypospadias, using Cox proportional hazards regression, while adjusting for measured confounding. Results Among 966 038 live-born boys, 4688 (0.5%) had a mother with a history of IBD diagnosis before the relevant childbirth. Among the boys with maternal IBD, 36 (0.8%) were diagnosed with hypospadias any time after birth, whereas 6112 (0.6%) sons of mothers without IBD diagnosis had hypospadias (adjusted PR: 1.20, (95% CI 0.86 to 1.67). Adjusted PRs for maternal Crohn's disease and ulcerative colitis were 1.38 (95% CI 0.83 to 2.29) and 1.10 (95% CI 0.71 to 1.68), respectively. Analyses defining hypospadias diagnosis recorded <6 months postpartum showed similar results. Conclusions We found no convincing evidence of an association between maternal IBD and hypospadias. PMID:27933203

  4. Frequent Users of Pornography. A Population Based Epidemiological Study of Swedish Male Adolescents

    ERIC Educational Resources Information Center

    Svedin, Carl Goran; Akerman, Ingrid; Priebe, Gisela

    2011-01-01

    Frequent use of pornography has not been sufficiently studied before. In a Swedish survey 2015 male students aged 18 years participated. A group of frequent users of pornography (N = 200, 10.5%) were studied with respect to background and psychosocial correlates. The frequent users had a more positive attitude to pornography, were more often…

  5. Validation of population-based disease simulation models: a review of concepts and methods

    PubMed Central

    2010-01-01

    Background Computer simulation models are used increasingly to support public health research and policy, but questions about their quality persist. The purpose of this article is to review the principles and methods for validation of population-based disease simulation models. Methods We developed a comprehensive framework for validating population-based chronic disease simulation models and used this framework in a review of published model validation guidelines. Based on the review, we formulated a set of recommendations for gathering evidence of model credibility. Results Evidence of model credibility derives from examining: 1) the process of model development, 2) the performance of a model, and 3) the quality of decisions based on the model. Many important issues in model validation are insufficiently addressed by current guidelines. These issues include a detailed evaluation of different data sources, graphical representation of models, computer programming, model calibration, between-model comparisons, sensitivity analysis, and predictive validity. The role of external data in model validation depends on the purpose of the model (e.g., decision analysis versus prediction). More research is needed on the methods of comparing the quality of decisions based on different models. Conclusion As the role of simulation modeling in population health is increasing and models are becoming more complex, there is a need for further improvements in model validation methodology and common standards for evaluating model credibility. PMID:21087466

  6. Phylogenetic and population-based approaches to mitogenome variation do not support association with male infertility.

    PubMed

    Gómez-Carballa, Alberto; Pardo-Seco, Jacobo; Martinón-Torres, Federico; Salas, Antonio

    2017-03-01

    Infertility has a complex multifactorial etiology and a high prevalence worldwide. Several studies have pointed to variation in the mitochondrial DNA (mtDNA) molecule as a factor responsible for the different disease phenotypes related to infertility. We analyzed 53 mitogenomes of infertile males from Galicia (northwest Spain), and these haplotypes were meta-analyzed phylogenetically with 43 previously reported from Portugal. Taking advantage of the large amount of information available, we additionally carried out association tests between patient mtDNA single-nucleotide polymorphisms (mtSNPs) and haplogroups against Iberian matched controls retrieved from The 1000 Genomes Project and the literature. Phylogenetic and association analyses did not reveal evidence of association between mtSNPs/haplogroups and infertility. Ratios and patterns in patients of nonsynonymous/synonymous changes, and variation at homoplasmic, heteroplasmic and private variants, fall within expected values for healthy individuals. Moreover, the haplogroup background of patients was variable and fits well with patterns typically observed in healthy western Europeans. We did not find evidence of association of mtSNPs or haplogroups pointing to a role for mtDNA in male infertility. A thorough review of the literature on mtDNA variation and infertility revealed contradictory findings and methodological and theoretical problems that overall undermine previous positive findings.

  7. Frequent users of pornography. A population based epidemiological study of Swedish male adolescents.

    PubMed

    Svedin, Carl Göran; Akerman, Ingrid; Priebe, Gisela

    2011-08-01

    Frequent use of pornography has not been sufficiently studied before. In a Swedish survey 2015 male students aged 18 years participated. A group of frequent users of pornography (N = 200, 10.5%) were studied with respect to background and psychosocial correlates. The frequent users had a more positive attitude to pornography, were more often "turned on" viewing pornography and viewed more often advanced forms of pornography. Frequent use was also associated with many problem behaviours. A multiple logistic regression analysis showed that frequent users of pornography were more likely to be living in a large city, consuming alcohol more often, having greater sexual desire and had more often sold sex than other boys of the same age. High frequent viewing of pornography may be seen as a problematic behaviour that needs more attention from both parents and teachers and also to be addressed in clinical interviews.

  8. Prognostic significance of tumor subtypes in male breast cancer: a population-based study.

    PubMed

    Leone, José Pablo; Leone, Julieta; Zwenger, Ariel Osvaldo; Iturbe, Julián; Vallejo, Carlos Teodoro; Leone, Bernardo Amadeo

    2015-08-01

    Substantial controversy exists about the prognostic role of tumor subtypes in male breast cancer (MaBC). The aim of this study was to analyze the characteristics of each tumor subtype in MaBC and its association with prognosis compared with other factors. We evaluated MaBC patients between 2010 and 2012 with known estrogen receptor, progesterone receptor [together hormone receptor (HR)] status, and human epidermal growth factor receptor 2 (HER2) status reported to the Surveillance, Epidemiology, and End Results program. Patients were classified as: HR-positive/HER2-negative, HR-positive/HER2-positive, HR-negative/HER2-positive, and triple-negative (TN). Univariate and multivariate analyses determined the effect of each variable on overall survival (OS). We included 960 patients. Patient distribution was 84.9 % HR-positive/HER2-negative, 11.6 % HR-positive/HER2-positive, 0.6 % HR-negative/HER2-positive, and 2.9 % TN. TN patients were younger, had higher grade, presented with more advanced stage, were more likely to have mastectomy, and to die of breast cancer (all P < 0.05). Univariate analysis showed that HER2 positivity was associated with shorter OS (hazard ratio 1.90, P = 0.031) and TN patients had worse prognosis (hazard ratio 5.10, P = 0.0004). In multivariate analysis, older patients (hazard ratio 3.10, P = 0.032), those with stage IV (hazard ratio 16.27, P < 0.001) and those with TN tumors (hazard ratio 4.61, P = 0.002) had significantly worse OS. We observed significant differences in patient characteristics according to tumor subtype. HER2-positive and TN represented a small proportion of cases. In addition to age and stage, tumor subtype has clear influence on OS in MaBC.

  9. Prognostic factors in male breast cancer: a population-based study.

    PubMed

    Leone, José Pablo; Zwenger, Ariel Osvaldo; Iturbe, Julián; Leone, Julieta; Leone, Bernardo Amadeo; Vallejo, Carlos Teodoro; Bhargava, Rohit

    2016-04-01

    Prognostic factors in male breast cancer (MaBC) are controversial. The objective of this study was to analyze patient characteristics and prognostic factors in MaBC over the last decade. Using the Surveillance, Epidemiology, and End Results program, we extracted MaBC patients diagnosed between 2003 and 2012. Patient characteristics were compared between tumor grades. We conducted univariate and multivariate analyses to determine the effects of each prognostic variable on overall survival (OS). The study included 2992 patients. The majority had ductal (85 %), ER-positive (95.1 %), and PR-positive (86 %) breast cancer; however, only 12.4 % had grade I tumors. Stage I and II disease represented 73 % of cases. There was a significant association between grade III/IV tumors with ductal histology, ER and PR negativity, advanced stage, receipt of mastectomy and radiotherapy, and breast cancer death (all P < 0.05). ER-positive patients had better OS (hazard ratio 0.69, P = 0.03); however, after 7.5 years, OS rates by ER status were similar. In multivariate analysis, older age, grade III/IV tumors, stage IV disease, no surgery, no radiotherapy, ER-negative tumors, and unmarried patients had significantly shorter OS (all P < 0.05). Over the past decade, MaBC has been diagnosed most frequently with early stages of disease and high rates of ER positivity; however, grade I is uncommon. ER positivity is associated with better prognosis, mainly during the first 5 years after diagnosis. Age at diagnosis, tumor grade, stage, surgery, radiotherapy, ER, and marital status have clear impact on OS in MaBC.

  10. Parenting and risk for mood, anxiety and substance use disorders: a study in population-based male twins

    PubMed Central

    Gardner, Charles O.; Kendler, Kenneth S.; Hettema, John M.

    2013-01-01

    Background Previous studies consistently identified a relationship between parenting behavior and psychopathology. In this study, we extended prior analyses performed in female twins to a large sample of twins from male–male pairs. Methods We used interview data on 2,609 adult male twins from a population-based twin registry. We examined the association between three retrospectively reported parenting dimensions (coldness, protectiveness, and authoritarianism) and lifetime history of seven common psychiatric and substance use disorders. Using univariate structural equation modeling, we also examined the influence of the genetic and environmental factors on parenting. Results Examined individually, coldness was consistently associated with risk for a broad range of adult psychopathology. Averaged odds of psychiatric disorders associated with parenting were increased between 26 and 36 %. When the three parenting dimensions were examined together, coldness remained significant for major depression, phobia, and generalized anxiety disorder. Controlling for other disorders, the associations between the parenting dimensions and psychopathology were non-specific. Twin fitting model demonstrated that modest heritability accounted for parenting, whereas most variance resulted from the non-shared environment. Conclusions Based on our current and prior findings, there is broad similarity in the impact of parenting on adult psychopathology between men and women. PMID:23344783

  11. A Population-Based Comparison of Female and Male Same-Sex Parent and Different-Sex Parent Households.

    PubMed

    Bos, Henny M W; Kuyper, Lisette; Gartrell, Nanette K

    2017-02-15

    This investigation compared Dutch same-sex parent and different-sex parent households on children's psychological well-being, parenting stress, and support in child rearing. It was also assessed whether associations among children's well-being, parenting stress, and support in child rearing were different in the two household types. Data were based on a nationally representative survey (N = 25,250). Matching was used to enhance similarity in background characteristics between both types of families. Parental and child characteristics were matched for 43 female same-sex parent, 52 male same-sex parent, and 95 different-sex parent households with offspring between 5 and 18 years old. No significant differences were found on children's well-being, problems in the parent-child relationship, being worried about the child, or the use of formal and informal support between mothers in same-sex and different-sex parent households or for fathers in same-sex and different-sex parent households. Regarding perceived confidence in child rearing, fathers in same-sex parent households and mothers in different-sex parent households felt less competent than their counterparts. Neither the associations between children's well-being and the predictors (parenting stress variables) nor those between support and the predictors (parenting stress and children's well-being) differed along household type. In this population-based study, the similarity in child outcomes regardless of household type confirms the results of prior investigations based on convenience samples. These findings are pertinent to family therapists, practitioners, court officials, and policymakers who seek information on parenting experiences and child outcomes in female and male same-sex parent families.

  12. The Mortality Penalty of Incarceration: Evidence from a Population-based Case-control Study of Working-age Males.

    PubMed

    Pridemore, William Alex

    2014-06-01

    There is a growing body of research on the effects of incarceration on health, though there are few studies in the sociological literature of the association between incarceration and premature mortality. This study examined the risk of male premature mortality associated with incarceration. Data came from the Izhevsk (Russia) Family Study, a large-scale population-based case-control design. Cases (n = 1,750) were male deaths aged 25 to 54 in Izhevsk between October 2003 and October 2005. Controls (n = 1,750) were selected at random from a city population register. The key independent variable was lifetime prevalence of incarceration. I used logistic regression to estimate mortality odds ratios, controlling for age, hazardous drinking, smoking status, marital status, and education. Seventeen percent of cases and 5 percent of controls had been incarcerated. Men who had been incarcerated were more than twice as likely as those who had not to experience premature mortality (odds ratio = 2.2, 95 percent confidence interval: 1.6-3.0). Relative to cases with no prior incarceration, cases who had been incarcerated were more likely to die from infectious diseases, respiratory diseases, non-alcohol-related accidental poisonings, and homicide. Taken together with other recent research, these results from a rigorous case-control design reveal not only that incarceration has durable effects on illness, but that its consequences extend to a greater risk of early death. I draw on the sociology of health literature on exposure, stress, and social integration to speculate about the reasons for this mortality penalty of incarceration.

  13. Acne scars in 18-year-old male adolescents: a population-based study of prevalence and associated factors*

    PubMed Central

    Lauermann, Fernanda Tcatch; de Almeida Jr., Hiram Larangeira; Duquia, Rodrigo Pereira; de Souza, Paulo Ricardo Martins; Breunig, Juliano de Avelar

    2016-01-01

    Background Acne vulgaris is a pilosebaceous follicle disorder affecting over 85% of adolescents to some degree. It frequently causes psychological distress that may persist into adulthood due to scarring. Little information about post-acne scarring epidemiology is available. Objectives To describe prevalence, distribution patterns and associated factors of acne scarring in young males, drawing on a representative population sample from a southern Brazilian city. Methods A cross-sectional study was undertaken during presentation for military service, which is compulsory for all 18-year-old males. A questionnaire was applied, covering topics like diet, smoking habits, ethnicity, family structure, socio-economic level, as well as specific questions about active acne and resulting scars. Dermatologists conducted the clinical examination. Results A total of 2,201 male adolescents were interviewed and examined. The overall prevalence of acne scarring was 22%. The malar region was the most frequently involved, present in 80% of affected individuals, followed by the frontal region (31.5%), back (17%), anterior chest (8.2%) and mentonian region (6.4%). Correlation between the intensity of clinical acne and the presence of scars was found, but no association was observed with educational level, smoking, ethnicity, obesity or socio-economic status. Conclusions There is a high prevalence of acne scars among this population. This is the first study to ascertain a correlation between acne scarring and factors such as socio-economic status and educational level. The direct relation between acne severity and scarring indicates that prompt and effective treatment is the best way to reduce scarring. PMID:27438194

  14. A population-based longitudinal study of suicide risk in male schizophrenia patients: Proximity to hospital discharge and the moderating effect of premorbid IQ.

    PubMed

    Weiser, Mark; Kapara, Ori; Werbeloff, Nomi; Goldberg, Shira; Fenchel, Daphna; Reichenberg, Abraham; Yoffe, Rinat; Ginat, Keren; Fruchter, Eyal; Davidson, Michael

    2015-12-01

    Suicide is a major cause of death in schizophrenia. Identifying factors which increase the risk of suicide among schizophrenia patients might help focus prevention efforts. This study examined risk of suicide in male schizophrenia patients using population-based data, examining the timing of suicide in relation to the last hospital discharge, and the effect of premorbid IQ on risk of suicide. Data on 930,000 male adolescents from the Israeli military draft board were linked with data from the Israeli Psychiatric Hospitalization Case Registry and vital statistics from the Israeli Ministry of Health. The relationship between premorbid IQ and risk for suicide was examined among 2881 males hospitalized with schizophrenia and compared to a control group of 566,726 males from the same cohort, who were not hospitalized for a psychiatric disorder, using survival analysis methods. Over a mean follow-up period of 9.9 years (SD=5.8, range: 0-22 years), 77/3806 males with schizophrenia died by suicide (a suicide rate of 204.4 per 100,000 person-years). Approximately 48% of the suicides occurred within a year of discharge from the last hospital admission for schizophrenia. Risk of suicide was higher in male schizophrenia patients with high premorbid IQ (HR=4.45, 95% CI=1.37-14.43) compared to those with normal premorbid IQ. These data indicate that male schizophrenia patients with high premorbid IQ are at particularly high risk of suicide, and the time of peak risk is during the first year after the last hospitalization discharge.

  15. [Spatial structure analysis and distribution simulation of Therioaphis trifolii population based on geostatistics and GIS].

    PubMed

    Zhang, Rong; Leng, Yun-fa; Zhu, Meng-meng; Wang, Fang

    2007-11-01

    Based on geographic information system and geostatistics, the spatial structure of Therioaphis trifolii population of different periods in Yuanzhou district of Guyuan City, the southern Ningxia Province, was analyzed. The spatial distribution of Therioaphis trifolii population was also simulated by ordinary Kriging interpretation. The results showed that Therioaphis trifolii population of different periods was correlated spatially in the study area. The semivariograms of Therioaphis trifolii could be described by exponential model, indicating an aggregated spatial arrangement. The spatial variance varied from 34.13%-48.77%, and the range varied from 8.751-12.049 km. The degree and direction of aggregation showed that the trend was increased gradually from southwest to northeast. The dynamic change of Therioaphis trifolii population in different periods could be analyzed intuitively on the simulated maps of the spatial distribution from the two aspects of time and space, The occurrence position and degree of Therioaphis trifolii to a state of certain time could be determined easily.

  16. Population-based HIV prevalence and associated factors in male-to-female transsexuals from Southern Brazil.

    PubMed

    Costa, Angelo Brandelli; Fontanari, Anna Martha Vaitses; Jacinto, Michelle Moraes; da Silva, Dhiordan Cardoso; Lorencetti, Emilaine Karine; da Rosa Filho, Heitor Tomé; Mueller, Andressa; de Garcia, Claudia Garcia; Nardi, Henrique Caetano; Koller, Silvia Helena; Lobato, Maria Inês Rodrigues

    2015-02-01

    This study assessed HIV prevalence and associated factors in 284 male-to-female transsexuals from southern Brazil. Seroprevalence was 25 %. Seroprevalence was higher and associated with older age, residence in the metropolitan area, history of diagnosis of other STDs, and reported history of sex work. The year of diagnosis showed no significant relationship with the prevalence of HIV nor the fact of being in a stable relationship, a history of drug use, years of education, and race/ethnicity. The odds of HIV infection compared with the general Brazilian population was 55.55 (95 % CI 38.39-80.39). Changes in the views of the vulnerable groups to HIV/AIDS in Brazil and efforts in the construction of strategies of prevention and in the guarantee of human rights are required.

  17. Simulation of Population-Based Commuter Exposure to NO2 Using Different Air Pollution Models

    PubMed Central

    Ragettli, Martina S.; Tsai, Ming-Yi; Braun-Fahrländer, Charlotte; de Nazelle, Audrey; Schindler, Christian; Ineichen, Alex; Ducret-Stich, Regina E.; Perez, Laura; Probst-Hensch, Nicole; Künzli, Nino; Phuleria, Harish C.

    2014-01-01

    We simulated commuter routes and long-term exposure to traffic-related air pollution during commute in a representative population sample in Basel (Switzerland), and evaluated three air pollution models with different spatial resolution for estimating commute exposures to nitrogen dioxide (NO2) as a marker of long-term exposure to traffic-related air pollution. Our approach includes spatially and temporally resolved data on actual commuter routes, travel modes and three air pollution models. Annual mean NO2 commuter exposures were similar between models. However, we found more within-city and within-subject variability in annual mean (±SD) NO2 commuter exposure with a high resolution dispersion model (40 ± 7 µg m−3, range: 21–61) than with a dispersion model with a lower resolution (39 ± 5 µg m−3; range: 24–51), and a land use regression model (41 ± 5 µg m−3; range: 24–54). Highest median cumulative exposures were calculated along motorized transport and bicycle routes, and the lowest for walking. For estimating commuter exposure within a city and being interested also in small-scale variability between roads, a model with a high resolution is recommended. For larger scale epidemiological health assessment studies, models with a coarser spatial resolution are likely sufficient, especially when study areas include suburban and rural areas. PMID:24823664

  18. Simulation of population-based commuter exposure to NO₂ using different air pollution models.

    PubMed

    Ragettli, Martina S; Tsai, Ming-Yi; Braun-Fahrländer, Charlotte; de Nazelle, Audrey; Schindler, Christian; Ineichen, Alex; Ducret-Stich, Regina E; Perez, Laura; Probst-Hensch, Nicole; Künzli, Nino; Phuleria, Harish C

    2014-05-12

    We simulated commuter routes and long-term exposure to traffic-related air pollution during commute in a representative population sample in Basel (Switzerland), and evaluated three air pollution models with different spatial resolution for estimating commute exposures to nitrogen dioxide (NO2) as a marker of long-term exposure to traffic-related air pollution. Our approach includes spatially and temporally resolved data on actual commuter routes, travel modes and three air pollution models. Annual mean NO2 commuter exposures were similar between models. However, we found more within-city and within-subject variability in annual mean (±SD) NO2 commuter exposure with a high resolution dispersion model (40 ± 7 µg m(-3), range: 21-61) than with a dispersion model with a lower resolution (39 ± 5 µg m(-3); range: 24-51), and a land use regression model (41 ± 5 µg m(-3); range: 24-54). Highest median cumulative exposures were calculated along motorized transport and bicycle routes, and the lowest for walking. For estimating commuter exposure within a city and being interested also in small-scale variability between roads, a model with a high resolution is recommended. For larger scale epidemiological health assessment studies, models with a coarser spatial resolution are likely sufficient, especially when study areas include suburban and rural areas.

  19. QTL mapping for combining ability in different population-based NCII designs: a simulation study.

    PubMed

    Li, Lanzhi; Sun, Congwei; Chen, Yuan; Dai, Zhijun; Qu, Zhen; Zheng, Xingfei; Yu, Sibin; Mou, Tongmin; Xu, Chenwu; Hu, Zhongli

    2013-12-01

    The NCII design (North Carolina mating design II) has been widely applied in studies of combining ability and heterosis. The objective of our research was to estimate how different base populations, sample sizes, testcross numbers and heritability influence QTL analyses of combining ability and heterosis. A series of Monte Carlo simulation experiments with QTL mapping were then conducted for the base population performance, testcross population phenotypic values and the general combining ability (GCA), specific combining ability (SCA) and Hmp (midparental heterosis) datasets. The results indicated that: (i) increasing the number of testers did not necessarily enhance the QTL detection power for GCA, but it was significantly related to the QTL effect. (ii) The QTLs identified in the base population may be different from those from GCA dataset. Similar phenomena can be seen from QTL detected in SCA and Hmp datasets. (iii) The QTL detection power for GCA ranked in the order of DH(RIL) based > F2 based > BC based NCII design, when the heritability was low. The recombinant inbred lines (RILs) (or DHs) allows more recombination and offers higher mapping resolution than other populations. Further, their testcross progeny can be repeatedly generated and phenotyped. Thus, RIL based (or DH based) NCII design was highly recommend for combining ability QTL analysis. Our results expect to facilitate selecting elite parental lines with high combining ability and for geneticists to research the genetic basis of combining ability.

  20. The impact of childhood parental loss on risk for mood, anxiety and substance use disorders in a population-based sample of male twins.

    PubMed

    Otowa, Takeshi; York, Timothy P; Gardner, Charles O; Kendler, Kenneth S; Hettema, John M

    2014-12-15

    Previous studies have identified the relationship between parental loss and psychopathology later in life. However, this relationship varied depending on the kind of loss, the parent involved, and the type of psychopathology. In the present study, we examined the association between parental loss (any loss, death, and separation) during childhood and lifetime risk for seven common psychiatric and substance use disorders in a sample of 2605 male twins from the Virginia population-based twin registry. Using structural equation modeling (SEM), we also examined the extent to which the influence of parental loss contributes to adult psychopathology. Parental separation was associated with a wide range of adult psychopathology, whereas parental death was specifically associated with phobia and alcohol dependence. Maternal and paternal separations were almost equally associated with most forms of psychopathology. SEM suggested that parental loss accounted for about 10% of the variance of adult psychopathology, of which parental separation had the strongest impacts on risk for depression and drug abuse/dependence (11% of the total variance). Our findings suggest that early parental separation has stronger and wider effects on adult psychopathology than parental death.

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

    ERIC Educational Resources Information Center

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

    2014-01-01

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

  2. Budget Impact Analysis of Switching to Digital Mammography in a Population-Based Breast Cancer Screening Program: A Discrete Event Simulation Model

    PubMed Central

    Comas, Mercè; Arrospide, Arantzazu; Mar, Javier; Sala, Maria; Vilaprinyó, Ester; Hernández, Cristina; Cots, Francesc; Martínez, Juan; Castells, Xavier

    2014-01-01

    Objective To assess the budgetary impact of switching from screen-film mammography to full-field digital mammography in a population-based breast cancer screening program. Methods A discrete-event simulation model was built to reproduce the breast cancer screening process (biennial mammographic screening of women aged 50 to 69 years) combined with the natural history of breast cancer. The simulation started with 100,000 women and, during a 20-year simulation horizon, new women were dynamically entered according to the aging of the Spanish population. Data on screening were obtained from Spanish breast cancer screening programs. Data on the natural history of breast cancer were based on US data adapted to our population. A budget impact analysis comparing digital with screen-film screening mammography was performed in a sample of 2,000 simulation runs. A sensitivity analysis was performed for crucial screening-related parameters. Distinct scenarios for recall and detection rates were compared. Results Statistically significant savings were found for overall costs, treatment costs and the costs of additional tests in the long term. The overall cost saving was 1,115,857€ (95%CI from 932,147 to 1,299,567) in the 10th year and 2,866,124€ (95%CI from 2,492,610 to 3,239,638) in the 20th year, representing 4.5% and 8.1% of the overall cost associated with screen-film mammography. The sensitivity analysis showed net savings in the long term. Conclusions Switching to digital mammography in a population-based breast cancer screening program saves long-term budget expense, in addition to providing technical advantages. Our results were consistent across distinct scenarios representing the different results obtained in European breast cancer screening programs. PMID:24832200

  3. Does Fluoride Affect Serum Testosterone and Androgen Binding Protein with Age-Specificity? A Population-Based Cross-Sectional Study in Chinese Male Farmers.

    PubMed

    Duan, Leizhen; Zhu, Jingyuan; Wang, Keyan; Zhou, Guoyu; Yang, Yuejin; Cui, Liuxin; Huang, Hui; Cheng, Xuemin; Ba, Yue

    2016-12-01

    Many studies have demonstrated that exposure to excess fluoride was associated with a variety of diseases. Little is known about the variation of testosterone (T) levels caused by fluoride exposure. The aim of this study is to explore the association of fluoride exposure and age with serum T and androgen-binding protein (ABP) levels in male farmers. A cross-sectional study was conducted in a county of Henan Province, China, including high fluoride exposure from drinking water villages and control villages. Male farmers aged 18-55 years old who lived in these villages were recruited by cluster sampling and divided into a higher fluoride exposure group (HFG) and a lower fluoride exposure group (LFG) according to the level of urinary fluoride. Levels of T and ABP in serum were measured using chemiluminescence immunoassay (CLIA) and enzyme-linked immunosorbent assay (ELISA) respectively. Markedly lower T levels were observed in male farmers from the HFG than in those from the LFG (t = 2.496, P < 0.05). Furthermore, younger farmers, 18-29 and 30-39 years old, may be the most likely to have lower T levels when exposed to fluoride (P < 0.05). No significant differences were observed in serum ABP levels in all male farmers between the two groups with different fluoride exposure. These results supported that excess fluoride exposure decreased serum T levels of male farmers with age-specificity.

  4. Population-based prevalence of hepatitis B and C virus, HIV, syphilis, gonorrhoea and chlamydia in male injection drug users in Lagos, Nigeria.

    PubMed

    Tun, W; Vu, L; Adebajo, S B; Abiodun, L; Sheehy, M; Karlyn, A; Njab, J; Ahonsi, B; Issa, B K; Idogho, O

    2013-08-01

    There is little research on injecting drug use in Nigeria. We investigated the prevalence of HIV, hepatitis B and C, and sexually transmitted infections (STIs) among male injection drug users (IDUs) in Lagos. Male IDUs (N = 328) were recruited through respondent-driven sampling. Participants completed an interview about their sexual and injecting risk behaviours and were tested for hepatitis B surface antigen (HBV), hepatitis C antibody (HCV), HIV and syphilis, as well as genital chlamydia and gonorrhoea infections. Three-quarters of IDUs (74%) reported injecting drugs in the past one month although most did not share needles (92%) and the majority obtained sterile needles from pharmacists (87%). Estimated HBV, HCV, HIV, syphilis, gonorrhoea and chlamydia prevalences were 7.8%, 7.7%, 0.9%, 1.9%, 0.0%, and 3.7%, respectively. The burden of HIV is presently low among IDUs in Lagos. Changes in accessibility to sterile needles at pharmacists would likely have a deleterious effect on IDUs' health. HBV vaccination and HCV prevention programmes for IDUs are urgently needed.

  5. Influence mechanism of low-dose ionizing radiation on Escherichia coli DH5α population based on plasma theory and system dynamics simulation.

    PubMed

    Sun, Yi; Hu, Dawei; Li, Liang; Jing, Zheng; Wei, Chuanfeng; Zhang, Lantao; Fu, Yuming; Liu, Hong

    2016-01-01

    It remains a mystery why the growth rate of bacteria is higher in low-dose ionizing radiation (LDIR) environment than that in normal environment. In this study, a hypothesis composed of environmental selection and competitive exclusion was firstly proposed from observed phenomena, experimental data and microbial ecology. Then a LDIR environment simulator (LDIRES) was built to cultivate a model organism of bacteria, Escherichia coli (E. coli) DH5α, the accurate response of bacterial population to ionizing radiation intensity variation was measured experimentally, and then the precise relative dosage of ionizing radiation E. coli DH5α population received was calculated by finite element analysis based on drift-diffusion equations of plasma. Finally, a highly valid mathematical model expressing the relationship between E. coli DH5α population and LDIR intensity was developed by system dynamics based on hypotheses, experimental data and microbial ecology. Both experiment and simulation results clearly showed that the E. coli DH5α individuals with greater specific growth rate and lower substrate consumption coefficient would adapt and survive in LDIR environment and those without such adaptability were finally eliminated under the combined effects of ionizing radiation selection and competitive exclusion.

  6. The effect of male teenage passengers on male teenage drivers: findings from a driving simulator study.

    PubMed

    Ouimet, Marie Claude; Pradhan, Anuj K; Simons-Morton, Bruce G; Divekar, Gautam; Mehranian, Hasmik; Fisher, Donald L

    2013-09-01

    Studies have shown that teenage drivers are less attentive, more frequently exhibit risky driving behavior, and have a higher fatal crash risk in the presence of peers. The effects of direct peer pressure and conversation on young drivers have been examined. Little is known about the impact on driving performance of the presence of a non-interacting passenger and subtle modes of peer influence, such as perceived social norms. The goal of this study was to examine if teenagers would engage in more risky driving practices and be less attentive in the presence of a passenger (vs. driving alone) as well as with a risk-accepting (vs. risk-averse) passenger. A confederate portrayed the passenger's characteristics mainly by his non-verbal attitude. The relationship between driver characteristics and driving behavior in the presence of a passenger was also examined. Thirty-six male participants aged 16-17 years old were randomly assigned to drive with a risk-accepting or risk-averse passenger. Main outcomes included speed, headway, gap acceptance, eye glances at hazards, and horizontal eye movement. Driver characteristics such as tolerance of deviance, susceptibility to peer pressure, and self-esteem were measured. Compared to solo driving, the presence of a passenger was associated with significantly fewer eye glances at hazards and a trend for fewer horizontal eye movements. Contrary to the hypothesis, however, Passenger Presence was associated with waiting for a greater number of vehicles to pass before initiating a left turn. Results also showed, contrary to the hypothesis, that participants with the risk-accepting passenger maintained significantly longer headway with the lead vehicle and engaged in more eye glances at hazards than participants with the risk-averse passenger. Finally, when driving with the passenger, earlier initiation of a left turn in a steady stream of oncoming vehicles was significantly associated with higher tolerance of deviance and

  7. The effect of male teenage passengers on male teenage drivers: findings from a driving simulator study

    PubMed Central

    Ouimet, Marie Claude; Pradhan, Anuj K.; Simons-Morton, Bruce G.; Divekar, Gautam; Mehranian, Hasmik; Fisher, Donald L.

    2014-01-01

    Studies have shown that teenage drivers are less attentive, more frequently exhibit risky driving behavior, and have a higher fatal crash risk in the presence of peers. The effects of direct peer pressure and conversation on young drivers have been examined. Little is known about the impact on driving performance of the presence of a non-interacting passenger and subtle modes of peer influence, such as perceived social norms. The goal of this study was to examine if teenagers would engage in more risky driving practices and be less attentive in the presence of a passenger (vs. driving alone) as well as with a risk-accepting (vs. risk-averse) passenger. A confederate portrayed the passenger's characteristics mainly by his non-verbal attitude. The relationship between driver characteristics and driving behavior in the presence of a passenger was also examined. Thirty-six male participants aged 16-17 years old were randomly assigned to drive with a risk-accepting or risk-averse passenger. Main outcomes included speed, headway, gap acceptance, eye glances at hazards, and horizontal eye movement. Driver characteristics such as tolerance of deviance, susceptibility to peer pressure, and self-esteem were measured. Compared to solo driving, the presence of a passenger was associated with significantly fewer eye glances at hazards and a trend for fewer horizontal eye movements. Contrary to the hypothesis, however, passenger presence was associated with a greater number of vehicles before initiating a left turn. Results also showed, contrary to the hypothesis, that participants with the risk-accepting passenger maintained significantly longer headway with the lead vehicle and engaged in more eye glances at hazards than participants with the risk-averse passenger. Finally, when driving with the passenger, earlier initiation of a left turn in a steady stream of oncoming vehicles was significantly associated with higher tolerance of deviance and susceptibility to peer pressure

  8. Peer passenger influences on male adolescent drivers’ visual scanning behavior during simulated driving

    PubMed Central

    Pradhan, Anuj K.; Li, Kaigang; Bingham, C. Raymond; Simons-Morton, Bruce; Ouimet, Marie Claude; Shope, Jean T.

    2014-01-01

    Purpose There is a higher likelihood of crashes and fatalities when an adolescent drives with peer passengers, especially for male drivers and male passengers. Simulated driving of male adolescent drivers with male peer passengers was studied to examine passenger influences on distraction and inattention. Methods Male adolescents drove in a high-fidelity driving simulator with a male confederate who posed either as a risk-accepting or risk-averse passenger. Drivers’ eye-movements were recorded. The visual scanning behavior of the drivers was compared when driving alone versus when driving with a passenger, and when driving with a risk-accepting versus a risk-averse passenger. Results The visual scanning of a driver significantly narrowed horizontally and vertically when driving with a peer passenger. There were no significant differences in the times the drivers’ eyes were off the forward roadway when driving with a passenger versus when driving alone. Some significant correlations were found between personality characteristics and the outcome measures. Conclusions The presence of a male peer passenger was associated with a reduction in the visual scanning range of male adolescent drivers. This reduction could be a result of potential cognitive load imposed on the driver due to the presence of a passenger and the real or perceived normative influences or expectations from the passenger. Implications and contribution The presence of male peer passengers was associated with deficient visual scanning in male adolescent drivers. Such reduced scanning behavior is evident in drivers with high cognitive load. Further investigation of passenger influences on adolescent drivers should include examination of distraction and inattention aspects of passenger influence. PMID:24759440

  9. Testosterone affects song modulation during simulated territorial intrusions in male black redstarts (Phoenicurus ochruros).

    PubMed

    Apfelbeck, Beate; Kiefer, Sarah; Mortega, Kim G; Goymann, Wolfgang; Kipper, Silke

    2012-01-01

    Although it has been suggested that testosterone plays an important role in resource allocation for competitive behavior, details of the interplay between testosterone, territorial aggression and signal plasticity are largely unknown. Therefore, we investigated if testosterone acts specifically on signals that communicate the motivation or ability of individuals to engage in competitive situations in a natural context. We studied the black redstart, a territorial songbird species, during two different life-cycle stages, the early breeding phase in spring and the non-breeding phase in fall. Male territory holders were implanted with the androgen receptor blocker flutamide (Flut) and the aromatase inhibitor letrozole (Let) to inhibit the action of testosterone and its estrogenic metabolites. Controls received a placebo treatment. Three days after implantation birds were challenged with a simulated territorial intrusion (STI). Song was recorded before, during and after the challenge. In spring, both treatment groups increased the number of elements sung in parts of their song in response to the STI. However, Flut/Let-implanted males reacted to the STI with a decreased maximum acoustic frequency of one song part, while placebo-implanted males did not. Instead, placebo-implanted males sang the atonal part of their song with a broader frequency range. Furthermore, placebo-, but not Flut/Let-implanted males, sang shorter songs with shorter pauses between parts in the STIs. During simulated intrusions in fall, when testosterone levels are naturally low in this species, males of both treatment groups sang similar to Flut/Let-implanted males during breeding. The results suggest that song sung during a territorial encounter is of higher competitive value than song sung in an undisturbed situation and may, therefore, convey information about the motivation or quality of the territory holder. We conclude that testosterone facilitates context-dependent changes in song structures

  10. Influences of chemical sympathectomy and simulated weightlessness on male and female rats

    NASA Technical Reports Server (NTRS)

    Woodman, Christopher R.; Stump, Craig S.; Stump, Jane A.; Sebastian, Lisa A.; Rahman, Z.; Tipton, Charles M.

    1991-01-01

    Consideration is given to a study aimed at determining whether the sympathetic nervous system is associated with the changes in maximum oxygen consumption (VO2max), run time, and mechanical efficiency observed during simulated weightlessness in male and female rats. Female and male rats were compared for food consumption, body mass, and body composition in conditions of simulated weightlessness to provide an insight into how these parameters may influence aerobic capacity and exercise performance. It is concluded that chemical sympathectomy and/or a weight-bearing stimulus will attenuate the loss in VO2max associated with simulated weightlessness in rats despite similar changes in body mass and composition. It is noted that the mechanisms remain unclear at this time.

  11. Population-based study on infant mortality.

    PubMed

    Lima, Jaqueline Costa; Mingarelli, Alexandre Marchezoni; Segri, Neuber José; Zavala, Arturo Alejandro Zavala; Takano, Olga Akiko

    2017-03-01

    Although Brazil has reduced social, economic and health indicators disparities in the last decade, intra- and inter-regional differences in child mortality rates (CMR) persist in regions such as the state capital of Mato Grosso. This population-based study aimed to investigate factors associated with child mortality in five cohorts of live births (LB) of mothers living in Cuiabá (MT), Brazil, 2006-2010, through probabilistic linkage in 47,018 LB. We used hierarchical logistic regression analysis. Of the 617 child deaths, 48% occurred in the early neonatal period. CMR ranged from 14.6 to 12.0 deaths per thousand LB. The following remained independently associated with death: mothers without companion (OR = 1.32); low number of prenatal consultations (OR = 1.65); low birthweight (OR = 4.83); prematurity (OR = 3.05); Apgar ≤ 7 at the first minute (OR = 3.19); Apgar ≤ 7 at the fifth minute (OR = 4.95); congenital malformations (OR = 14.91) and male gender (OR = 1.26). CMR has declined in Cuiabá, however, there is need to guide public healthcare policies in the prenatal and perinatal period to reduce early neonatal mortality and further studies to identify the causes of preventable deaths.

  12. Experimental Effects of Injunctive Norms on Simulated Risky Driving Among Teenage Males

    PubMed Central

    Simons-Morton, Bruce G.; Pradhan, Anuj K.; Bingham, C. Raymond; Falk, Emily B.; Li, Kaigang; Ouimet, Marie Claude; Almani, Farideh; Shope, Jean T.

    2014-01-01

    Objective Teenage passengers affect teenage driving performance, possibly by social influence. To examine the effect of social norms on driving behavior, male teenagers were randomly assigned to drive in a simulator with a peer-aged confederate to whom participants were primed to attribute either risk-accepting or risk-averse social norms. It was hypothesized that teenage drivers would engage in more risky driving behavior in the presence of peer passengers than no passengers, and with a risk-accepting compared with a risk-averse passenger. Method 66 male participants aged 16 to18 years holding a provisional driver license were randomized to drive with a risk-accepting or risk-averse passenger in a simulator. Failure to Stop at a red light and percent Time in Red (light) were measured as primary risk-relevant outcomes of interest at 18 intersections, while driving once alone and once with their assigned passenger. Results The effect of passenger presence on risky driving was moderated by passenger type for Failed to Stop in a generalized linear mixed model (OR = 1.84, 95% CI [1.19, 2.86], p < .001), and percent Time in Red in a mixed model (B = 7.71, 95% CI [1.54, 13.87], p < .05). Conclusions Exposure of teenage males to a risk-accepting confederate peer increased teenage males’ risky simulated driving behavior compared with exposure to a risk-averse confederate peer. These results indicate that variability in teenage risky driving could be partially explained by social norms. PMID:24467258

  13. Eyewitness Testimony for a Simulated Juvenile Crime by Male and Female Criminals with Consistent or Inconsistent Gender-Role Characteristics

    ERIC Educational Resources Information Center

    Shapiro, Lauren R.

    2009-01-01

    Eyewitness recall by 60 adolescents and 60 young adults in Experiment 1 and by 64 children and 63 preadolescents in Experiment 2 for a simulated theft in which gender-role characteristics and sex of criminal were manipulated (i.e., masculine male, feminine male, feminine female, masculine female) was investigated. Gender-role flexibility impacted…

  14. Organ doses for reference adult male and female undergoing computed tomography estimated by Monte Carlo simulations

    SciTech Connect

    Lee, Choonsik; Kim, Kwang Pyo; Long, Daniel; Fisher, Ryan; Tien, Chris; Simon, Steven L.; Bouville, Andre; Bolch, Wesley E.

    2011-03-15

    Purpose: To develop a computed tomography (CT) organ dose estimation method designed to readily provide organ doses in a reference adult male and female for different scan ranges to investigate the degree to which existing commercial programs can reasonably match organ doses defined in these more anatomically realistic adult hybrid phantomsMethods: The x-ray fan beam in the SOMATOM Sensation 16 multidetector CT scanner was simulated within the Monte Carlo radiation transport code MCNPX2.6. The simulated CT scanner model was validated through comparison with experimentally measured lateral free-in-air dose profiles and computed tomography dose index (CTDI) values. The reference adult male and female hybrid phantoms were coupled with the established CT scanner model following arm removal to simulate clinical head and other body region scans. A set of organ dose matrices were calculated for a series of consecutive axial scans ranging from the top of the head to the bottom of the phantoms with a beam thickness of 10 mm and the tube potentials of 80, 100, and 120 kVp. The organ doses for head, chest, and abdomen/pelvis examinations were calculated based on the organ dose matrices and compared to those obtained from two commercial programs, CT-EXPO and CTDOSIMETRY. Organ dose calculations were repeated for an adult stylized phantom by using the same simulation method used for the adult hybrid phantom. Results: Comparisons of both lateral free-in-air dose profiles and CTDI values through experimental measurement with the Monte Carlo simulations showed good agreement to within 9%. Organ doses for head, chest, and abdomen/pelvis scans reported in the commercial programs exceeded those from the Monte Carlo calculations in both the hybrid and stylized phantoms in this study, sometimes by orders of magnitude. Conclusions: The organ dose estimation method and dose matrices established in this study readily provides organ doses for a reference adult male and female for different

  15. Male penile propulsion into spiraled spermathecal ducts of female chrysomelid beetles: A numerical simulation approach.

    PubMed

    Filippov, Alexander; Kovalev, Alexander; Matsumura, Yoko; Gorb, Stanislav N

    2015-11-07

    Genital diversification in animals is an interesting evolutionary phenomenon. Sexual selection is the main driving force behind the diversification. However, evolutionary mechanisms that have established and maintained variations in genitalia shape parameters observed in related species are not well understood. Here, for the first time, we used numerical simulations to test the hypothesis that variations in female spermathecal duct shapes among related beetle species mechanically interfere with penile propulsion in varying ways. Our numerical simulations showed that high curvature of the spiraled spermathecal ducts of the female have effects with a threshold-based interaction on male penile insertion. The relative size of spirals observed in the beetle, Cassida rubiginosa, studied here is not small enough to interfere with penile propulsion. But the model revealed that propulsion is impeded by the presence of reverse turns in spermathecal ducts. This type of morphology leads to an increase in the velocity of the propulsion but also to an increase in the propulsion energy cost for males. Our results showed that quantitative differences in spermathecal duct shape can mediate qualitative differences in penile motion. This explains, in part, the mechanism behind origin and maintenance of genital divergence among closely related species in general.

  16. Population bases and the 2011 Census.

    PubMed

    Smallwood, Steve

    2011-01-01

    In an increasingly complex society there are a number of different population definitions that can be relevant for users, beyond the standard definition used in counting the population. This article describes the enumeration base for the 2011 Census and how alternative population outputs may be produced. It provides a background as to how the questions on the questionnaire were decided upon and how population bases can be constructed from the Census. Similarities and differences between the information collected across the three UK Censuses (England and Wales, Scotland and Northern Ireland) are discussed. Finally, issues around estimating the population on alternative bases are presented.

  17. Population-Based Smoking Cessation Strategies

    PubMed Central

    2010-01-01

    Executive Summary Objective The objective of this report was to provide the Ministry of Health Promotion (MHP) with a summary of existing evidence-based reviews of the clinical and economic outcomes of population-based smoking cessation strategies. Background Tobacco use is the leading cause of preventable disease and death in Ontario, linked to approximately 13,000 avoidable premature deaths annually – the vast majority of these are attributable to cancer, cardiovascular disease, and chronic obstructive lung disease. (1) In Ontario, tobacco related health care costs amount to $6.1 billion annually, or about $502 per person (including non-smokers) and account for 1.4% of the provincial domestic product. (2) In 2007, there were approximately 1.7 to 1.9 million smokers in Ontario with two-thirds of these intending to quit in the next six months and one-third wanting to quit within 30 days. (3) In 2007/2008, Ontario invested $15 million in cessation programs, services and training. (4) In June 2009, the Ministry of Health Promotion (MHP) requested that MAS provide a summary of the evidence base surrounding population-based smoking cessation strategies. Project Scope The MAS and the MHP agreed that the project would consist of a clinical and economic summary of the evidence surrounding nine population-based strategies for smoking cessation including: Mass media interventions Telephone counselling Post-secondary smoking cessation programs (colleges/universities) Community-wide stop-smoking contests (i.e. Quit and Win) Community interventions Physician advice to quit Nursing interventions for smoking cessation Hospital-based interventions for smoking cessation Pharmacotherapies for smoking cessation, specifically: Nicotine replacement therapies Antidepressants Anxiolytic drugs Opioid antagonists Clonidine Nicotine receptor partial agonists Reviews examining interventions for Cut Down to Quit (CDTQ) or harm reduction were not included in this review. In addition

  18. The Combined Burden of Cognitive, Executive Function, and Psychosocial Problems in Children with Epilepsy: A Population-Based Study

    ERIC Educational Resources Information Center

    Hoie, B.; Sommerfelt, K.; Waaler, P. E.; Alsaker, F. D.; Skeidsvoll, H.; Mykletun, A.

    2008-01-01

    The combined burden of psychosocial (Achenbach scales), cognitive (Raven matrices), and executive function (EF) problems was studied in a population-based sample of 6- to 12-year-old children with epilepsy (n = 162; 99 males, 63 females) and in an age- and sex-matched control group (n = 107; 62 males, 45 females). Approximately 35% of the children…

  19. The number of life-history stages does not influence the androgen responsiveness to male-male interactions: sedentary and migratory black redstarts (Phoenicurus ochruros) do not elevate testosterone in response to simulated territorial intrusions.

    PubMed

    Villavicencio, C P; Blas, J; Goymann, W

    2014-09-01

    High plasma levels of testosterone at the beginning of the breeding season adjust male physiology for mating and promote territorial behavior in birds. Conversely intra-sexual competition may elicit a temporary increase in circulating testosterone. Male black redstarts (Phoenicurus ochruros) from migratory populations show the expected increase in baseline testosterone during early breeding, but circulating testosterone levels do not change in response to male-male interactions. Because sedentary populations express fewer life-history stages they may be more flexible in timing of life-history stages and more responsive to environmental modulation of hormone concentrations. Therefore, we tested whether the androgen responsiveness to male-male interactions differs between migratory (6 life-history stages) and sedentary black redstarts (3 life-history stages) during early breeding, predicting that in contrast to migratory birds, sedentary birds would modulate testosterone in response to simulated territorial intrusions (STI). In contrast to our prediction, sedentary males did not modulate post-capture testosterone levels in response to simulated territorial intrusions. Males of both populations increased testosterone after an injection of gonadotropin releasing hormone (GnRH), demonstrating that they were capable of increasing testosterone. Interestingly, in sedentary males the GnRH injection elicited a higher testosterone response in STI males than in control males. The two populations did not differ in their behavioral response to the STIs, except that sedentary males spent less time close to the decoy. In combination with previous data from black redstarts and other socially monogamous and biparental birds our current study adds to the growing evidence that current theory regarding hormone-behavior relationship needs to be refined.

  20. Simulating temperature-dependent ecological processes at the sub-continental scale: male gypsy moth flight phenology as an example

    NASA Astrophysics Data System (ADS)

    Régnière, J.; Sharov, Alexei

    We simulated male gypsy moth flight phenology for the location of 1371 weather stations east of 100° W longitude and north of 35° N latitude in North America. The output of these simulations, based on average weather conditions from 1961 to 1990, was submitted to two map-interpolation methods: multiple regression and universal kriging. Multiple regression was found to be as accurate as universal kriging and demands less computing power. A map of the date of peak male gypsy moth flight was generated by universal kriging. This map itself constitutes a useful pest-management planning tool; in addition, the map delineates the potential range of the gypsy moth based on its seasonality at the northern edge of its current distribution in eastern North America. The simulation and map-interpolation methods described in this paper thus constitute an interesting approach to the study and monitoring of the ecological impacts of climate change and shifts in land-use patterns at the sub-continental level.

  1. Prevalence of Hidradenitis Suppurativa (HS): A Population-Based Study in Olmsted County, Minnesota

    PubMed Central

    Shahi, Varun; Alikhan, Ali; Vazquez, Benjamin G.; Weaver, Amy L.; Davis, Mark D.

    2014-01-01

    BACKGROUND/AIMS Hidradenitis suppurativa (HS) is a follicular occlusion disorder occurring in apocrine-rich regions of the skin. Estimates of the prevalence of this disorder have not been population-based. We sought to provide population-based information on the prevalence of HS in Olmsted County, Minnesota as of 1/1/2009. METHODS Rochester Epidemiology Project, a unique infrastructure that combines and makes accessible all medical records in Olmsted County since the 1960s, was used to collect population-based data on the prevalence of HS. RESULTS We identified 178 confirmed cases of HS that included 135 females and 43 males, and estimated the total sex- and age-adjusted prevalence in Olmsted County to be 127.8 per 100,000 or 0.13%. The total prevalence was significantly higher among women than men. CONCLUSION This study represents the first population-based investigation on the prevalence of HS. In this population-based cohort, HS was less prevalent than previous reports have suggested. PMID:25228133

  2. A population-based Habitable Zone perspective

    NASA Astrophysics Data System (ADS)

    Zsom, Andras

    2015-08-01

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

  3. Primary male neuroendocrine adenocarcinoma involving the nipple simulating Merkel cell carcinoma - a diagnostic pitfall.

    PubMed

    Mecca, Patricia; Busam, Klaus

    2008-02-01

    Male breast cancer is a rare entity accounting for < 1% of all breast cancer cases in the United States, but with a rate that has been rising over the last 25 years. Nipple skin/subcutaneous tumors in men are even rarer. Likewise, true neuroendocrine carcinoma of the breast, defined as > 50% of tumor cells staining for either chromogranin or synaptophysin, is not a common entity, usually occurring in older women. We present the case of a 70-year-old man with a slowly growing nipple mass that had enlarged over the previous 1.5 years. The histology consisted of nests, trabeculae and sheets of basaloid cells with rare abortive gland formation and a pushing edge. The case was originally misdiagnosed as a Merkel cell carcinoma, based largely on histologic morphology. Strong staining for synaptophysin (in greater than 50% of cells), CD56, keratins AE1 : AE3 and Cam 5.2, as well as estrogen receptor and progesterone receptor was noted. Myoepithelial cells within in situ areas were identified using stains for calponin and 4A4, supporting a primary mammary duct origin. Additionally, a substantial portion of cells stained for Gross Cystic Disease Fluid Protein-15 (GCDFP-15), confirming some overlap with sweat duct differentiation. To the best of our knowledge, although reported in the male breast, no case of primary nipple neuroendocrine carcinoma in a male patient has been reported in the literature. The gender of the patient and association with the skin of the chest wall probably contributed to the original misdiagnosis of Merkel cell carcinoma in this patient.

  4. Assessment of Male Anthropometric Trends and the Effects on Simulated Heat Stress Responses

    DTIC Science & Technology

    2008-01-01

    by comparing 2004 and 1988 databases. Anthropometric somatotypes were identified and physiological responses of different somatotypes to simulated...databases and identified five primary somatotypes : "tall-fat", "tall-lean", "average", "short-lean" and "short-fat". anthropometry, thermal regulatory

  5. Subdural haemorrhages in infants: population based study

    PubMed Central

    Jayawant, S; Rawlinson, A; Gibbon, F; Price, J; Schulte, J; Sharples, P; Sibert, J R; Kemp, A M

    1998-01-01

    Objectives To identify the incidence, clinical outcome, and associated factors of subdural haemorrhage in children under 2 years of age, and to determine how such cases were investigated and how many were due to child abuse. Design Population based case series. Setting South Wales and south west England. Subjects Children under 2 years of age who had a subdural haemorrhage. We excluded neonates who developed subdural haemorrhage during their stay on a neonatal unit and infants who developed a subdural haemorrhage after infection or neurosurgical intervention. Main outcome measures Incidence and clinical outcome of subdural haemorrhage in infants, the number of cases caused by child abuse, the investigations such children received, and associated risk factors. Results Thirty three children (23 boys and 10 girls) were identified with subdural haemorrhage. The incidence was 12.8/100 000 children/year (95% confidence interval 5.4 to 20.2). Twenty eight cases (85%) were under 1 year of age. The incidence of subdural haemorrhage in children under 1 year of age was 21.0/100 000 children/year and was therefore higher than in the older children. The clinical outcome was poor: nine infants died and 15 had profound disability. Only 22 infants had the basic investigations of a full blood count, coagulation screen, computed tomography or magnetic resonance imaging, skeletal survey or bone scan, and ophthalmological examination. In retrospect, 27 cases (82%) were highly suggestive of abuse. Conclusion Subdural haemorrhage is common in infancy and carries a poor prognosis; three quarters of such infants die or have profound disability. Most cases are due to child abuse, but in a few the cause is unknown. Some children with subdural haemorrhage do not undergo appropriate investigations. We believe the clinical investigation of such children should include a full multidisciplinary social assessment, an ophthalmic examination, a skeletal survey supplemented with a bone scan or a

  6. Walking economy at simulated high altitude in human healthy young male lowlanders

    PubMed Central

    Horiuchi, Masahiro; Handa, Yoko; Abe, Daijiro; Fukuoka, Yoshiyuki

    2016-01-01

    ABSTRACT We measured oxygen consumption during walking per unit distance (Cw) values for 12 human healthy young males at six speeds from 0.667 to 1.639 m s−1 (four min per stage) on a level gradient under normobaric normoxia, moderate hypoxia (15% O2), and severe hypoxia (11% O2). Muscle deoxygenation (HHb) was measured at the vastus lateralis muscle using near-infrared spectroscopy. Economical speed which can minimize the Cw in each individual was calculated from a U-shaped relationship. We found a significantly slower economical speed (ES) under severe hypoxia [1.237 (0.056) m s−1; mean (s.d.)] compared to normoxia [1.334 (0.070) m s−1] and moderate hypoxia [1.314 (0.070) m s−1, P<0.05 respectively] with no differences between normoxia and moderate hypoxia (P>0.05). HHb gradually increased with increasing speed under severe hypoxia, while it did not increase under normoxia and moderate hypoxia. Changes in HHb between standing baseline and the final minute at faster gait speeds were significantly related to individual ES (r=0.393 at 1.250 m s−1, r=0.376 at 1.444 m s−1, and r=0.409 at 1.639 m s−1, P<0.05, respectively). These results suggested that acute severe hypoxia slowed ES by ∼8%, but moderate hypoxia left ES unchanged. PMID:27744292

  7. Effect of potassium depletion in normal males - An Apollo 15 simulation

    NASA Technical Reports Server (NTRS)

    Hyatt, K. H.; Hulley, S. B.; Vogel, J. M.; Spears, C. P.; Johnson, P. C.; Hoffler, G. W.; Rambaut, P. C.; Rummel, J. A.; Huntoon, C.

    1975-01-01

    In the course of Apollo 15, physiologic abnormalities, manifested by ectopic activity on the ECG and unusual alterations in exercise tolerance, occurred in the crew of the Lunar Excursion Module. These were associated with decreases in total body potassium, measured by K-42, of 10% and 15%. The possibility of inadequate potassium (K+) intake existed. A simulation study was performed prior to Apollo 16, corresponding in duration to Apollo 15. Subjects endured the same sleep aberrations and caloric expenditure as the Apollo 15 astronauts. Subjects consumed a diet containing only 15 mEq/d of K+ during the entire 12 days of absolute bedrest. Study implications and reasons for discrepancies between K+ loss measured by balance techniques and K-42 are reviewed.

  8. Effects of simulated weightlessness and sympathectomy on maximum VO2 of male rats

    NASA Technical Reports Server (NTRS)

    Woodman, C. R.; Stump, C. S.; Beaulieu, S. M.; Rahman, Z.; Sebastian, L. A.

    1989-01-01

    The effects of simulated weightlessness (hind-limb suspension) and chemical sympathectomy (by repeated injections with guanethidine sulfate) on the maximum oxygen consumption (VO2 max) of female rats were investigated in rats assigned for 14 days to one of three groups: a head-down hind-limb suspension, a horizontal suspension with hind limbs weight bearing, or the caged control. The VO2 max values were assessed by having rats run on a treadmill enclosed in an airtight chamber. The hind-limb-suspended sympathectomized rats were found to exhibit shorter run times and lower mechanical efficiencies, compared to their presuspension values or the values from saline-injected suspended controls. On the other hand, the suspended sympathectomized rats did not demonstrate a decrease in the VO2 max values that was observed in saline-injected controls.

  9. Effect of potassium depletion in normal males: an Apollo 15 simulation.

    PubMed

    Hyatt, K H; Johnson, P C; Hoffler, G W; Rambaut, P C; Rummel, J A; Hulley, S B; Vogel, J M; Huntoon, C; Spears, C P

    1975-01-01

    In the course of Apollo 15, physiologic abnormalities, manifested by ectopic activity on the ECG and unusual alterations in excerise tolerance, occurred in the crew of the Lunar Excursion Module. These were associated with decreases in total body potassium, measured by 42K, of 10% and 15%. The possibility of inadequate potassium (K plus) intake existed. A simulation study was performed prior to Apollo 16, corresponding in duration to Apollo 15. Subjects endured the same sleep aberrations and caloric expenditure as the Apollo 15 astronauts. Subjects consumed a diet containing only 15 mEq/d of K plus during the entire 12 d of absolute bedrest. ECG was continuously monitored, body fluid compartments and total body K plus were measured at intervals by radionuclide methods, electrolyte balance was determined daily, and excercise and orthostatic tolerances were determined prior to and after bedrest. In spite of decreases in total body K plus measured by 42K of 14.5% and 10.5%, and by potassium balances of 3.3% and 6.5%, respectively, neither of the two subjects developed symptomatic hypokalemia. Minor ECG abnormalities were noted in one subject. Orthostatic and exercise tolerance showed only those changes expected as a result of bedrest. Muscle strength was unaffected. Study implications and reasons for discrepancies between K plus loss measured by balance techniques and 42K are reviewed.

  10. Physiological responses and performance in a simulated trampoline gymnastics competition in elite male gymnasts.

    PubMed

    Jensen, Peter; Scott, Suzanne; Krustrup, Peter; Mohr, Magni

    2013-01-01

    Physiological responses and performance were examined during and after a simulated trampoline competition (STC). Fifteen elite trampoline gymnasts participated, of which eight completed two routines (EX1 and EX2) and a competition final (EX3). Trampoline-specific activities were quantified by video-analysis. Countermovement jump (CMJ) and 20 maximal trampoline jump (20-MTJ) performances were assessed. Heart rate (HR) and quadriceps muscle temperature (Tm) were recorded and venous blood was drawn. A total of 252 ± 16 jumps were performed during the STC. CMJ performance declined (P < 0.05) by 3.8, 5.2 and 4.2% after EX1, EX2 and EX3, respectively, and was 4.8% lower (P < 0.05) than baseline 24 h post-competition. 20-MTJ flight time was ~1% shorter (P < 0.05) for jump 1-10 after EX2 and 24 h post STC. Tm increased (P < 0.05) to ~39°C after the warm-up, but declined (P < 0.05) 1.0 and 0.6ºC before EX2 and EX3, respectively. Peak HR was 95-97% HRmax during EX1-3. Peak blood lactate, plasma K(+) and NH3 were 6.5 ± 0.5, 6.0 ± 0.2 mmol · l(-1) and 92 ± 10 µmol · l(-1), respectively. Plasma CK increased (P < 0.05) by ~50 and 65% 0 and 24 h after STC. In conclusion, a trampoline gymnastic competition includes a high number of repeated explosive and energy demanding jumps, which impairs jump performance during and 24 h post-competition.

  11. The ethical dilemma of population-based medical decision making.

    PubMed

    Kirsner, R S; Federman, D G

    1998-11-01

    Over the past several years, there has been a growing interest in population-based medicine. Some elements in healthcare have used population-based medicine as a technique to decrease healthcare expenditures. However, in their daily practice of medicine, physicians must grapple with the question of whether they incorporate population-based medicine when making decisions for an individual patient. They therefore may encounter an ethical dilemma. Physicians must remember that the physician-patient relationship is of paramount importance and that even well-conducted research may not be applicable to an individual patient.

  12. Difference Verification of Cheek Subcutaneous Fat Thickness of Male and Female Using Near Infrared Ray Spectral Characteristic Simulation of Cheek

    NASA Astrophysics Data System (ADS)

    Nishino, Satoshi; Yasuda, Shun

    The near infrared ray spectral characteristic of a person’s cheeks was simulated in this paper, and it was confirmed that the spectral characteristic of the cheeks part by the near infrared rays was detected at the subcutaneous fat under 2mm of the skin. Therefore, subcutaneous fat has a great influence at the near infrared ray spectral characteristic. Concretely, when subcutaneous fat thickness is thick, the absorbance falls down, and the spectral characteristic around 1200nm is the same for an acute angle, and becomes the spectral characteristic of the female. On the other hand, increasing the water content to simulate the increase in the thickness of the subcutaneous fat, the light absorbance rises, and the acute angle of the spectral characteristic around 1200nm disappears. The 1200nm characteristic becomes that of the male’s spectral characteristic which shows a rounded form. From the discussion above, it could be verified that a difference in the subcutaneous fat thickness is the factor of the difference in the near infrared ray spectral characteristics between that of a male and female cheek.

  13. Passive Range of Motion in a Population-Based Sample of Children with Spastic Cerebral Palsy Who Walk

    ERIC Educational Resources Information Center

    McDowell, Brona C.; Salazar-Torres, Jose J.; Kerr, Claire; Cosgrove, Aidan P.

    2012-01-01

    -While passive range of motion (PROM) is commonly used to inform decisions on therapeutic management, knowledge of PROM of children with spastic cerebral palsy (CP) is limited. A population-based sample of 178 children with spastic CP (110 male; unilateral, n = 94; bilateral, n = 84; age range 4-17 years) and 68 typically developing children (24…

  14. Influence of lunar phases on suicide: the end of a myth? A population-based study.

    PubMed

    Biermann, Teresa; Estel, Dorothee; Sperling, Wolfgang; Bleich, Stefan; Kornhuber, Johannes; Reulbach, Udo

    2005-01-01

    The hypothesis of lunar influence on suicide remains widespread, despite the fact that little scientific evidence to substantiate it. We conducted a population-based study to assess the influence of the lunar phases on suicides according to age, sex, and chosen method. The study included all suicides in Middle Franconia between 1998 and 2003. From a population-based sample of 3351 events, the files of 3054 suicides (1949 males and 1105 females) were complete for the study variables. Data were categorized by lunar phase, sex, age, and chosen method-"violent" vs. "non-violent" acts. No significant relationship was detected between the full, absent, and moon's interphases and suicide incidence. Nevertheless, there was a weak association between the absent moon and choice of a non-violent suicide method in men aged less than the median of 40.2 yrs. There was no evidence of a relationship between suicide and lunar phase. Some explanations for this phenomenon are discussed.

  15. Posture-specific phantoms representing female and male adults in Monte Carlo-based simulations for radiological protection

    NASA Astrophysics Data System (ADS)

    Cassola, V. F.; Kramer, R.; Brayner, C.; Khoury, H. J.

    2010-08-01

    Does the posture of a patient have an effect on the organ and tissue absorbed doses caused by x-ray examinations? This study aims to find the answer to this question, based on Monte Carlo (MC) simulations of commonly performed x-ray examinations using adult phantoms modelled to represent humans in standing as well as in the supine posture. The recently published FASH (female adult mesh) and MASH (male adult mesh) phantoms have the standing posture. In a first step, both phantoms were updated with respect to their anatomy: glandular tissue was separated from adipose tissue in the breasts, visceral fat was separated from subcutaneous fat, cartilage was segmented in ears, nose and around the thyroid, and the mass of the right lung is now 15% greater than the left lung. The updated versions are called FASH2_sta and MASH2_sta (sta = standing). Taking into account the gravitational effects on organ position and fat distribution, supine versions of the FASH2 and the MASH2 phantoms have been developed in this study and called FASH2_sup and MASH2_sup. MC simulations of external whole-body exposure to monoenergetic photons and partial-body exposure to x-rays have been made with the standing and supine FASH2 and MASH2 phantoms. For external whole-body exposure for AP and PA projection with photon energies above 30 keV, the effective dose did not change by more than 5% when the posture changed from standing to supine or vice versa. Apart from that, the supine posture is quite rare in occupational radiation protection from whole-body exposure. However, in the x-ray diagnosis supine posture is frequently used for patients submitted to examinations. Changes of organ absorbed doses up to 60% were found for simulations of chest and abdomen radiographs if the posture changed from standing to supine or vice versa. A further increase of differences between posture-specific organ and tissue absorbed doses with increasing whole-body mass is to be expected.

  16. Population-Based Incidence and Prevalence of Systemic Lupus Erythematosus

    PubMed Central

    Somers, Emily C.; Marder, Wendy; Cagnoli, Patricia; Lewis, Emily E.; DeGuire, Peter; Gordon, Caroline; Helmick, Charles G.; Wang, Lu; Wing, Jeffrey J.; Dhar, J. Patricia; Leisen, James; Shaltis, Diane; McCune, W. Joseph

    2014-01-01

    Objective To estimate the incidence and prevalence of systemic lupus erythematosus (SLE) in a sociodemographically diverse southeastern Michigan source population of 2.4 million people. Methods SLE cases fulfilling the American College of Rheumatology classification criteria (primary case definition) or meeting rheumatologist-judged SLE criteria (secondary definition) and residing in Wayne or Washtenaw Counties during 2002–2004 were included. Case finding was performed from 6 source types, including hospitals and private specialists. Age-standardized rates were computed, and capture–recapture was performed to estimate underascertainment of cases. Results The overall age-adjusted incidence and prevalence (ACR definition) per 100,000 persons were 5.5 (95% confidence interval [95% CI] 5.0–6.1) and 72.8 (95% CI 70.8–74.8). Among females, the incidence was 9.3 per 100,000 persons and the prevalence was 128.7 per 100,000 persons. Only 7 cases were estimated to have been missed by capture–recapture, adjustment for which did not materially affect the rates. SLE prevalence was 2.3-fold higher in black persons than in white persons, and 10-fold higher in females than in males. Among incident cases, the mean ± SD age at diagnosis was 39.3 ± 16.6 years. Black SLE patients had a higher proportion of renal disease and end-stage renal disease (ESRD) (40.5% and 15.3%, respectively) as compared to white SLE patients (18.8% and 4.5%, respectively). Black patients with renal disease were diagnosed as having SLE at younger age than white patients with renal disease (mean ± SD 34.4 ± 14.9 years versus 41.9 ± 21.3 years; P = 0.05). Conclusion SLE prevalence was higher than has been described in most other population-based studies and reached 1 in 537 among black female persons. There were substantial racial disparities in the burden of SLE, with black patients experiencing earlier age at diagnosis, >2-fold increases in SLE incidence and prevalence, and increased

  17. Effect of electromagnetic irradiation produced by 3G mobile phone on male rat reproductive system in a simulated scenario.

    PubMed

    Kumar, Sanjay; Nirala, Jay Prakash; Behari, J; Paulraj, R

    2014-09-01

    Reports of declining male fertility have renewed interest in assessing the role of electromagnetic fields (EMFs). Testicular function is particularly susceptible to the radiation emitted by EMFs. Significant decrease in sperm count, increase in the lipid peroxidation damage in sperm cells, reduction in seminiferous tubules and testicular weight and DNA damage were observed following exposure to EMF in male albino rats. The results suggest that mobile phone exposure adversely affects male fertility.

  18. The use of metabolomics in population-based research.

    PubMed

    Su, L Joseph; Fiehn, Oliver; Maruvada, Padma; Moore, Steven C; O'Keefe, Stephen J; Wishart, David S; Zanetti, Krista A

    2014-11-01

    The NIH has made a significant commitment through the NIH Common Fund's Metabolomics Program to build infrastructure and capacity for metabolomics research, which should accelerate the field. Given this investment, it is the ideal time to start planning strategies to capitalize on the infrastructure being established. An obvious gap in the literature relates to the effective use of metabolomics in large-population studies. Although published reports from population-based studies are beginning to emerge, the number to date remains relatively small. Yet, there is great potential for using metabolomics in population-based studies to evaluate the effects of nutritional, pharmaceutical, and environmental exposures (the "exposome"); conduct risk assessments; predict disease development; and diagnose diseases. Currently, the majority of the metabolomics studies in human populations are in nutrition or nutrition-related fields. This symposium provided a timely venue to highlight the current state-of-science on the use of metabolomics in population-based research. This session provided a forum at which investigators with extensive experience in performing research within large initiatives, multi-investigator grants, and epidemiology consortia could stimulate discussion and ideas for population-based metabolomics research and, in turn, improve knowledge to help devise effective methods of health research.

  19. Establishment of soft tissue norms for the north Indian population based on laymen perception.

    PubMed

    Gupta, Ankur; Garg, Jaishree; Anand, Neelima; Hegde, Manjunath; Parashar, Sandeep

    2014-03-01

    In this study we aimed to determine the soft tissue norms for the North Indian population based on the laymen perception of facial esthetics and to test the hypothesis that there are racial differences in cephalometric measurement between North Indians and White Americans norms. Two sets (Facial frontal and profile photographs) of 170 standardized facial photographs (76 males and 94 females in the age group of 18-28 years) were taken. A panel of judges which consisted of 20 laymen evaluated the photographs on the visual analogue scale to select a sample of 120 subjects (60 males and 60 females), which included individuals with esthetically pleasing appearance. Digital lateral cephalograms were made and anatomic landmarks were identified directly on the digital images. Seventeen soft tissue variables taken from Subtenley's, Holdaway's, Ricketts and Legan's analysis were calculated electronically using the Dolphin (version 9) software package. Most measurements were similar to the white American norms, some differences were noticed in nasal prominence, basic upper lip thickness, and 'H' angle measurements. The independent-sample t test was used to compare the measurement differences of the North Indian men and women. North Indian males have relatively prominent and thicker upper lip, and increased basic upper lip thickness than the females. Lower lip was found to be more protrusive in females than in males.

  20. The burden of hypertension and its risk factors in Malawi: nationwide population-based STEPS survey.

    PubMed

    Msyamboza, Kelias P; Kathyola, Damson; Dzowela, Titha; Bowie, Cameron

    2012-12-01

    Hypertension is the most common cause of cardiovascular diseases, accounting for at least half of haemorrhagic and ischaemic strokes, heart failure and renal failure in sub-Saharan Africa. However, population-based data to inform policies are scarce. Using the WHO STEPwise approach to chronic disease risk factor surveillance, a population-based nationwide survey was conducted on participants aged 25-64 years in Malawi. Detailed findings on the burden of hypertension are presented in this paper. Blood pressure (BP) was measured in 3727 participants. The age-standardised prevalence of hypertension (BP ≥140/90 mmHg) was 33.2% (95% CI 30.9-35.6%). Hypertension was more frequent in males than females (36.9% vs 29.9%), alcohol drinkers than non-drinkers (40.9% vs 31.6%), overweight than non-overweight (41.5% vs 30.7%) and increased with increasing age (21.4% in 25-34 years old vs 59.2% in 55-64 years old). Three-quarters of the participants said they never had their BP measured before and 94.9% of those with hypertension said they were not aware that they had such a medical problem. High prevalence of hypertension and its risk factors calls for the implementation of primary healthcare approaches such as the WHO package for essential non-communicable diseases to promote healthy lifestyles, early detection, treatment and control.

  1. Frequency and impact of recurrent traumatic brain injury in a population-based sample.

    PubMed

    Theadom, Alice; Parmar, Priya; Jones, Kelly; Barker-Collo, Suzanne; Starkey, Nicola J; McPherson, Kathryn M; Ameratunga, Shanthi; Feigin, Valery L

    2015-05-15

    The aim of this study was to determine the frequency, mechanism(s), and impact of recurrent traumatic brain injury (TBI) over a 1-year period. Population-based TBI incidence and 1-year outcomes study with embedded case-control analysis. All participants (adults and children) who experienced a recurrent TBI (more than one) in the 12 months after an index injury and matched controls who sustained one TBI within the same period were enrolled in a population-based TBI incidence and outcomes study. Details of all recurrent TBIs sustained within 12 months of the initial index injury were recorded. Each recurrent TBI case was matched to a case sustaining one TBI based on age (±2 years), gender, and index TBI severity. Cognitive ability, disability, and postconcussion symptoms (PCS) were assessed 1 year after the index injury. Overall, 9.9% (n=72) of TBI cases experienced at least one recurrent TBI within the year after initial index injury. Males, people <35 years of age, and those who had experienced a TBI before their index injury were at highest risk of recurrent TBI. Recurrent TBI cases reported significantly increased PCS at 1 year, compared to the matched controls (n=72) sustaining one TBI. There was no difference in overall cognitive ability and disability between the two groups. People experiencing recurrent TBIs are more likely to experience increased frequency and severity of PCS. Greater public awareness of the potential effects of recurrent brain injury is needed.

  2. Real world epidemiology of myeloproliferative neoplasms: a population based study in Korea 2004-2013.

    PubMed

    Byun, Ja Min; Kim, Young Jin; Youk, Taemi; Yang, John Jeongseok; Yoo, Jongha; Park, Tae Sung

    2017-03-01

    Myeloproliferative neoplasms (MPNs), with an expected increment in number, impose substantial economic and social burdens. To this end, we conducted a nationwide population-based descriptive epidemiology study. We also investigated medical cost associated with MPNs. Prevalence was the highest for essential thrombocythemia (ET) (range 4.1-9.0 per 100,000), followed by polycythemia vera (PV) (range 2.8-5.4 per 100,000) and primary myelofibrosis (PMF) (range 0.5-0.9 per 100,000). ET incurred the highest cumulative total cost at US$35 million and the most frequent hospital visits, while PMF incurred the highest average cost per person at US$5000. The mean hemoglobin level was 16.9 ± 2.2 g/dL for PV males and 15.5 ± 2.7 g/dL for PV females. Further analyses on hemoglobin levels showed the true positive rate of PV from the significantly elevated hemoglobin group (defined as >18.5 g/dL for men and >16.5 g/dL for women) was 3.01% and that of MPNs was 3.1%. Here, we provide the biggest population-based report on MPN epidemiology that can readily be used as a representative Asian data.

  3. The Effect of Age on Fracture Risk: A Population-Based Cohort Study

    PubMed Central

    Chikritzhs, Tanya

    2016-01-01

    Aim. To precisely estimate the effect of age on the risk of fracture hospitalisation among the Western Australia population over the life course. Methods. This population-based cohort study used hospital data on fractures for the period January 1991 to January 2013 among Western Australians born between 1915 and 1990. Results. The average incidence rates (per 10,000 person-years) of fracture hospitalisation (95% confidence interval) were 50.12 (49.90, 50.35), 55.14 (54.82, 55.48), and 45.02 (44.71, 45.32) for both males and females, males only, and females only, respectively. The age-specific rate of fracture hospitalisation (in natural logarithm form) in adults (>18 years) was well predicted by age at its 1st, 2nd, and 3rd power in males with an adjusted R-squared of 0.98 and p < 0.001. For females, the trend was also well predicted by its 1st and 2nd powers (the 3rd power term of age was removed due to its p value > 0.8) with an adjusted R-squared of 0.99 and p < 0.001. Conclusions. Overall trends in age and gender specific risk of fracture among the Western Australian population were similar to estimates reported from previous studies. The trend in fracture hospitalisation risk over the life course can be almost fully explained by age. PMID:27340566

  4. Trend analysis of cancer incidence in Japan using data from selected population-based cancer registries.

    PubMed

    Katanoda, Kota; Ajiki, Wakiko; Matsuda, Tomohiro; Nishino, Yoshikazu; Shibata, Akiko; Fujita, Manabu; Tsukuma, Hideaki; Ioka, Akiko; Soda, Midori; Sobue, Tomotaka

    2012-02-01

    Population-based cancer registries are operated by over 80% of prefectures in Japan. However, only a limited proportion of the registries can provide long-term incidence data. Here, we aimed to establish a method for monitoring cancer incidence trends in Japan using data from selected prefectures. Based on the availability of long-term (≥ 20 years) high-quality data, we collected incidence data from five prefectures (Miyagi, Yamagata, Fukui, Osaka, and Nagasaki), which included an annual average of 54,539 primary cancer cases diagnosed between 1985 and 2004. Cancer mortality data for 1995-2004 were obtained from the vital statistics. Representativeness and homogeneity of the trends were examined by funnel plot analysis of log-linear regression coefficients calculated for the most recent 10 years of data (1995-2004) of age-standardized rates (ASR). The ASR of incidence for five prefectures in total (5-pref total) showed a significant decrease, with an annual percent change (APC) of -1.0 (95% confidence interval [CI] -1.4: -0.6) for males and -0.4 (95% CI -0.8: -0.1) for females. Excluding data from Osaka (4-pref total) reversed the decreasing trend; the corresponding APC was +0.4 (95% CI -0.2: +1.0) for males and +0.7 (95% CI +0.5: +0.9) for females. The APCs for the ASR of mortality for the 4-pref total (males, -1.5; females, -1.3) were more representative of nationwide data (males, -1.4 [95% CI -1.7: -1.2]; females, -1.1 [95% CI -1.4: -0.9]) than those for the 5-pref total (males, -1.7; females, -1.4). We conclude that using data from Miyagi, Yamagata, Fukui, and Nagasaki prefectures, with continuous monitoring of the representativeness of the data, is a provisionally relevant way to evaluate cancer incidence trends in Japan.

  5. Changing roles of population-based cancer registries in Australia.

    PubMed

    Roder, David; Creighton, Nicola; Baker, Deborah; Walton, Richard; Aranda, Sanchia; Currow, David

    2015-09-01

    Registries have key roles in cancer incidence, mortality and survival monitoring and in showing disparities across the population. Incidence monitoring began in New South Wales in 1972 and other jurisdictions soon followed. Registry data are used to evaluate outcomes of preventive, screening, treatment and support services. They have shown decreases in cancer incidence following interventions and have been used for workforce and other infrastructure planning. Crude markers of optimal radiotherapy and chemotherapy exist and registry data are used to show shortfalls against these markers. The data are also used to investigate cancer clusters and environmental concerns. Survival data are used to assess service performance and interval cancer data are used in screening accreditation. Registries enable determination of risk of multiple primary cancers. Clinical quality registries are used for clinical quality improvement. Population-based cancer registries and linked administrative data complement clinical registries by providing high-level system-wide data. The USA Commission on Cancer has long used registries for quality assurance and service accreditation. Increasingly population-based registry data in Australia are linked with administrative data on service delivery to assess system performance. Addition oftumour stage and otherprognostic indicators is important forthese analyses and is facilitated by the roll-out of structured pathology reporting. Data linkage with administrative data, following checks on the quality of these data, enables assessment of patterns of care and other performance indicators for health-system monitoring. Australian cancer registries have evolved and increasingly are contributing to broader information networks for health system management.

  6. Population-based case-control association studies.

    PubMed

    Hancock, Dana B; Scott, William K

    2012-07-01

    This unit provides an overview of the design and analysis of population-based case-control studies of genetic risk factors for complex disease. Considerations specific to genetic studies are emphasized. The unit reviews basic study designs differentiating case-control studies from others, presents different genetic association strategies (candidate gene, genome-wide association, and high-throughput sequencing), introduces basic methods of statistical analysis for case-control data and approaches to combining case-control studies, and discusses measures of association and impact. Admixed populations, controlling for confounding (including population stratification), consideration of multiple loci and environmental risk factors, and complementary analyses of haplotypes, genes, and pathways are briefly discussed. Readers are referred to basic texts on epidemiology for more details on general conduct of case-control studies.

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

    PubMed Central

    2015-01-01

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

  8. On estimation of time-dependent attributable fraction from population-based case-control studies.

    PubMed

    Zhao, Wei; Chen, Ying Qing; Hsu, Li

    2017-01-18

    Population attributable fraction (PAF) is widely used to quantify the disease burden associated with a modifiable exposure in a population. It has been extended to a time-varying measure that provides additional information on when and how the exposure's impact varies over time for cohort studies. However, there is no estimation procedure for PAF using data that are collected from population-based case-control studies, which, because of time and cost efficiency, are commonly used for studying genetic and environmental risk factors of disease incidences. In this article, we show that time-varying PAF is identifiable from a case-control study and develop a novel estimator of PAF. Our estimator combines odds ratio estimates from logistic regression models and density estimates of the risk factor distribution conditional on failure times in cases from a kernel smoother. The proposed estimator is shown to be consistent and asymptotically normal with asymptotic variance that can be estimated empirically from the data. Simulation studies demonstrate that the proposed estimator performs well in finite sample sizes. Finally, the method is illustrated by a population-based case-control study of colorectal cancer.

  9. Prevalence of auditory hallucinations in Norwegian adolescents: Results from a population-based study

    PubMed Central

    Kompus, Kristiina; Løberg, Else-Marie; Posserud, Maj-Britt; Lundervold, Astri Johansen

    2015-01-01

    Knowing the prevalence and characteristics of auditory verbal hallucinations (AVH) in adolescents is important for estimations of need for mental health care and assessment of psychosis risk. In this report we assess the prevalence of AVH in a population-based sample of 16–19 years old Norwegian adolescents (n = 9,646, 46.4% male) using two items assessing AVH (from the extended Launay-Slade Hallucination Scale). The prevalence of hearing a voice speaking thoughts aloud was 10.6%. The prevalence of being troubled by voices was 5.3%, showing that negative emotionality about AVH is less frequent than the experience of hearing voices. Female respondents had slightly increased risk for being troubled by voices than males (odds ratio = 1.3), while age did not modulate prevalence. This AVH prevalence is in line with earlier reports in smaller samples of adolescents and indicates that AVH are not uncommon in this period of life. Further longitudinal studies are needed to investigate the value of AVH in predicting psychiatric disorder. PMID:25968251

  10. Prevalence and correlates of coronary heart disease: first population-based study in Lebanon

    PubMed Central

    Zeidan, Rouba Karen; Farah, Rita; Chahine, Mirna N; Asmar, Roland; Hosseini, Hassan; Salameh, Pascale; Pathak, Atul

    2016-01-01

    Background Lebanon is experiencing a growing epidemic of coronary heart diseases (CHDs), as most low- and middle-income countries currently are. However, this growth can be attenuated if effective preventive strategies are adopted. Purpose To provide the first national population-based prevalence of CHD and to describe the profile of Lebanese adults with prevalent CHD. Methods We carried out a cross-sectional study using a multistage cluster sample across Lebanon. We interviewed residents aged 40 years and older using a questionnaire that captured the presence of CHDs and their risk factors (RFs). Results Our study showed that 13.4% of the Lebanese population aged ≥40 years suffer from a prevalent CHD. CHD seemed to appear more prematurely than in developed countries, and males seemed to be more subject to CHD than females until a certain age. CHD was associated with older age, male sex, a lower economic situation, hypercholesterolemia, hypertension, having a family history of premature cardiovascular diseases, and suffering from diabetes. However, smoking and waist circumference did not seem to have an independent effect on CHD, but rather an effect mediated by biological RFs. Conclusion This is the first nationwide endeavor conducted in Lebanon to assess the prevalence of CHD. This study also confirms the relevance of the classic RFs of CHD and their applicability to the Lebanese population, thus allowing for prevention strategies. PMID:27051290

  11. Epidemiology for primary brain tumors: a nationwide population-based study.

    PubMed

    Darlix, Amélie; Zouaoui, Sonia; Rigau, Valérie; Bessaoud, Faiza; Figarella-Branger, Dominique; Mathieu-Daudé, Hélène; Trétarre, Brigitte; Bauchet, Fabienne; Duffau, Hugues; Taillandier, Luc; Bauchet, Luc

    2017-02-01

    Primary central nervous system tumors (PCNST) are rare tumors responsible for high mortality and morbidity. Their epidemiology is poorly known, and clinical data are scarcely analyzed at a national level. In this study, we aimed at providing descriptive epidemiological data and incidence rates for all histological subtypes of PCNST according to the WHO classification. We conducted a nationwide population-based study of all newly diagnosed and histologically confirmed PCNST in France, between 2006 and 2011. A total of 57,816 patients were included: male 46.4%, median age at diagnosis 56 years old (range 0-99). For all newly diagnosed PCNST with histological confirmation the crude incidence rate was 15.5/10(5) per 100,000 person-years. To enable international comparisons, standardized rates were calculated: 14.1/10(5) (population of reference: USA), 14.5/10(5) (population of reference: Europe), and 12.0/10(5) (population of reference: world). 23.4% of samples were cryopreserved. Resection was performed in 79.1% of cases. Results are detailed (incidence rate, sex ratio, median age at diagnosis, number of cryopreserved samples, and type of surgery) for each of the 143 histological subtypes of PCNST, including all rare tumors. For example, incidence rates (population of reference: USA) were 0.018/10(5) for anaplastic gangliogliomas, 0.054/10(5) for malignant meningiomas, and 0.036/10(5) for hemangiopericytomas. Our study is the first to describe incidence rates and epidemiological data for all histological subtypes of PCNST, including rare tumors, at a national level. Its methodology ensures the exhaustiveness of the data collection for histologically-proven cases. Histological population-based studies have many perspectives in the field of clinical epidemiology and research.

  12. Epidemiological study of prostate cancer (EPICAP): a population-based case–control study in France

    PubMed Central

    2014-01-01

    Background Prostate cancer is the most common cancer in male in most Western countries, including France. Despite a significant morbidity and mortality to a lesser extent, the etiology of prostate cancer remains largely unknown. Indeed, the only well-established risk factors to date are age, ethnicity and a family history of prostate cancer. We present, here, the rationale and design of the EPIdemiological study of Prostate CAncer (EPICAP), a population-based case–control study specifically designed to investigate the role of environmental and genetic factors in prostate cancer. The EPICAP study will particularly focused on the role of circadian disruption, chronic inflammation, hormonal and metabolic factors in the occurrence of prostate cancer. Methods/Design EPICAP is a population-based case–control study conducted in the département of Hérault in France. Eligible cases are all cases of prostate cancers newly diagnosed in 2012-2013 in men less than 75 years old and residing in the département of Hérault at the time of diagnosis. Controls are men of the same age as the cases and living in the département of Hérault, recruited in the general population. The sample will include a total of 1000 incident cases of prostate cancer and 1000 population-based controls over a 3-year period (2012-2014). The cases and controls are face-to-face interviewed using a standardized computed assisted questionnaire. The questions focus primarily on usual socio-demographic characteristics, personal and family medical history, lifestyle, leisure activities, residential and occupational history. Anthropometric measures and biological samples are also collected for cases and controls. Discussion The EPICAP study aims to answer key questions in prostate cancer etiology: (1) role of circadian disruption through the study of working hours, chronotype and duration/quality of sleep, (2) role of chronic inflammation and anti-inflammatory drugs, (3) role of hormonal and metabolic

  13. Scalable Entity-Based Modeling of Population-Based Systems, Final LDRD Report

    SciTech Connect

    Cleary, A J; Smith, S G; Vassilevska, T K; Jefferson, D R

    2005-01-27

    The goal of this project has been to develop tools, capabilities and expertise in the modeling of complex population-based systems via scalable entity-based modeling (EBM). Our initial focal application domain has been the dynamics of large populations exposed to disease-causing agents, a topic of interest to the Department of Homeland Security in the context of bioterrorism. In the academic community, discrete simulation technology based on individual entities has shown initial success, but the technology has not been scaled to the problem sizes or computational resources of LLNL. Our developmental emphasis has been on the extension of this technology to parallel computers and maturation of the technology from an academic to a lab setting.

  14. Estimating glomerular filtration rate in a population-based study

    PubMed Central

    Shankar, Anoop; Lee, Kristine E; Klein, Barbara EK; Muntner, Paul; Brazy, Peter C; Cruickshanks, Karen J; Nieto, F Javier; Danforth, Lorraine G; Schubert, Carla R; Tsai, Michael Y; Klein, Ronald

    2010-01-01

    Background: Glomerular filtration rate (GFR)-estimating equations are used to determine the prevalence of chronic kidney disease (CKD) in population-based studies. However, it has been suggested that since the commonly used GFR equations were originally developed from samples of patients with CKD, they underestimate GFR in healthy populations. Few studies have made side-by-side comparisons of the effect of various estimating equations on the prevalence estimates of CKD in a general population sample. Patients and methods: We examined a population-based sample comprising adults from Wisconsin (age, 43–86 years; 56% women). We compared the prevalence of CKD, defined as a GFR of <60 mL/min per 1.73 m2 estimated from serum creatinine, by applying various commonly used equations including the modification of diet in renal disease (MDRD) equation, Cockcroft–Gault (CG) equation, and the Mayo equation. We compared the performance of these equations against the CKD definition of cystatin C >1.23 mg/L. Results: We found that the prevalence of CKD varied widely among different GFR equations. Although the prevalence of CKD was 17.2% with the MDRD equation and 16.5% with the CG equation, it was only 4.8% with the Mayo equation. Only 24% of those identified to have GFR in the range of 50–59 mL/min per 1.73 m2 by the MDRD equation had cystatin C levels >1.23 mg/L; their mean cystatin C level was only 1 mg/L (interquartile range, 0.9–1.2 mg/L). This finding was similar for the CG equation. For the Mayo equation, 62.8% of those patients with GFR in the range of 50–59 mL/min per 1.73 m2 had cystatin C levels >1.23 mg/L; their mean cystatin C level was 1.3 mg/L (interquartile range, 1.2–1.5 mg/L). The MDRD and CG equations showed a false-positive rate of >10%. Discussion: We found that the MDRD and CG equations, the current standard to estimate GFR, appeared to overestimate the prevalence of CKD in a general population sample. PMID:20730018

  15. Population-based prevention of influenza in Dutch general practice.

    PubMed Central

    Hak, E; Hermens, R P; van Essen, G A; Kuyvenhoven, M M; de Melker, R A

    1997-01-01

    BACKGROUND: Although the effectiveness of influenza vaccination in high-risk groups has been proven, vaccine coverage continues to be less than 50% in The Netherlands. To improve vaccination rates, data on the organizational factors, which should be targeted in population-based prevention of influenza, is essential. AIM: To assess the organizational factors in Dutch general practice, which were associated with the influenza vaccination rate in 1994. METHOD: A retrospective questionnaire study was undertaken in 1586 of the 4758 Dutch general practices, which were randomly selected. A total of 1251 (79%) practices returned a questionnaire. The items verified were practice profile, urbanization, delegation index, use of computer-based patient records, influenza vaccination characteristics and influenza vaccination rate. RESULTS: No differences were found with regard to the percentage of single-handed practices (65%), practices situated in urban area (38%), practices with a pharmacy (12%), patients insured by the National Health Service (59%) and use of computer-based patient records (57%) when compared with national statistics. The mean overall influenza vaccination rate was 9.0% (SD 4.0%). Using a logistic regression analysis, a high vaccination rate (> or = 9%) was associated with the use of personal reminders (odds ratio (OR) 1.7, 1.3-2.2), monitoring patient compliance (OR 1.8, 1.3-2.4), marking risk patients in computer-based patient records (OR 1.3, 1.0-1.6), a small number of patients per full-time practice assistant (OR 1.5, 1.1-1.9), urban areas (OR 1.6, 1.3-2.1) and single-handed practices (OR 1.5, 1.1-1.9). CONCLUSION: Improvement of vaccination rates in high-risk patients may be achievable by promoting the use of personal reminders and computer-based patient records, as well as monitoring patient compliance. In addition, the role of practice assistants with regard to preventive activities should be developed further. Practices situated in rural areas and

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

    PubMed

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

    2016-02-01

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

  17. Psoriasis and dyslipidaemia: a population-based study.

    PubMed

    Dreiher, Jacob; Weitzman, Dahlia; Davidovici, Batya; Shapiro, Jonathan; Cohen, Arnon D

    2008-01-01

    Previous reports demonstrated an association between psoriasis and the metabolic syndrome. The aim of this study was to elucidate the association between psoriasis and dyslipidaemia. A cross-sectional study was performed utilizing a population-based database. Psoriasis patients were compared with enrollees without psoriasis regarding the prevalence of dyslipidaemia and lipid levels. Comparison of lipid levels was performed on a "low-risk" subset of subjects without diabetes, hypertension and cardiovascular disease. The study included 10,669 psoriasis patients and 22,996 subjects without psoriasis. The prevalence of dyslipidaemia was significantly higher in psoriasis patients (odds ratio (OR) = 1.48, 95% confidence interval (CI) 1.40-1.55). The association remained significant after controlling for confounders (OR = 1.19, 95% CI 1.12-1.26, p < 0.001). In multivariate analysis of the "low-risk" subset, triglyceride levels were higher in psoriasis patients and high-density lipoprotein cholesterol levels were lower. This study supports previous reports of an association between psoriasis and lipid abnormalities.

  18. Optimal inverse functions created via population-based optimization.

    PubMed

    Jennings, Alan L; Ordóñez, Raúl

    2014-06-01

    Finding optimal inputs for a multiple-input, single-output system is taxing for a system operator. Population-based optimization is used to create sets of functions that produce a locally optimal input based on a desired output. An operator or higher level planner could use one of the functions in real time. For the optimization, each agent in the population uses the cost and output gradients to take steps lowering the cost while maintaining their current output. When an agent reaches an optimal input for its current output, additional agents are generated in the output gradient directions. The new agents then settle to the local optima for the new output values. The set of associated optimal points forms an inverse function, via spline interpolation, from a desired output to an optimal input. In this manner, multiple locally optimal functions can be created. These functions are naturally clustered in input and output spaces allowing for a continuous inverse function. The operator selects the best cluster over the anticipated range of desired outputs and adjusts the set point (desired output) while maintaining optimality. This reduces the demand from controlling multiple inputs, to controlling a single set point with no loss in performance. Results are demonstrated on a sample set of functions and on a robot control problem.

  19. Stress and dysmenorrhoea: a population based prospective study

    PubMed Central

    Wang, L; Wang, X; Wang, W; Chen, C; Ronnennberg, A; Guang, W; Huang, A; Fang, Z; Zang, T; Wang, L; Xu, X

    2004-01-01

    Background: Dysmenorrhoea is the most common gynaecological disorder in women of reproductive age. Despite the association between stress and pregnancy outcomes, few studies have examined the possible link between stress and dysmenorrhoea. Aims and Methods: Using a population based cohort of Chinese women, the independent effect of women's perceived stress in the preceding menstrual cycle on the incidence of dysmenorrhoea in the subsequent cycle was investigated prospectively. The analysis included 1160 prospectively observed menstrual cycles from 388 healthy, nulliparous, newly married women who intended to conceive. The perception of stress and the occurrence of dysmenorrhoea in each menstrual cycle were determined from daily diaries recorded by the women. Results: After adjustment for important covariates, the risk of dysmenorrhoea was more than twice as great among women with high stress compared to those with low stress in the preceding cycle (OR = 2.4; 95% CI 1.4 to 4.3). The risk of dysmenorrhoea was greatest among women with both high stress and a history of dysmenorrhoea compared to women with low stress and no history of dysmenorrhoea (OR = 10.4, 95% CI 4.9 to 22.3). Stress in the follicular phase of the preceding cycles had a stronger association with dysmenorrhoea than stress in the luteal phase of the preceding cycles. Conclusion: This study shows a significant association between stress and the incidence of dysmenorrhoea, which is even stronger among women with a history of dysmenorrhoea. PMID:15550609

  20. Unbiased methods for population-based association studies.

    PubMed

    Devlin, B; Roeder, K; Bacanu, S A

    2001-12-01

    Large, population-based samples and large-scale genotyping are being used to evaluate disease/gene associations. A substantial drawback to such samples is the fact that population substructure can induce spurious associations between genes and disease. We review two methods, called genomic control (GC) and structured association (SA), that obviate many of the concerns about population substructure by using the features of the genomes present in the sample to correct for stratification. The GC approach exploits the fact that population substructure generates "over dispersion" of statistics used to assess association. By testing multiple polymorphisms throughout the genome, only some of which are pertinent to the disease of interest, the degree of overdispersion generated by population substructure can be estimated and taken into account. The SA approach assumes that the sampled population, although heterogeneous, is composed of subpopulations that are themselves homogeneous. By using multiple polymorphisms throughout the genome, this "latent class method" estimates the probability sampled individuals derive from each of these latent subpopulations. GC has the advantage of robustness, simplicity, and wide applicability, even to experimental designs such as DNA pooling. SA is a bit more complicated but has the advantage of greater power in some realistic settings, such as admixed populations or when association varies widely across subpopulations. It, too, is widely applicable. Both also have weaknesses, as elaborated in our review.

  1. Central poststroke pain: a population-based study.

    PubMed

    Klit, Henriette; Finnerup, Nanna Brix; Andersen, Grethe; Jensen, Troels Staehelin

    2011-04-01

    Central poststroke pain (CPSP) is a specific pain condition arising as a direct consequence of a cerebrovascular lesion. There is limited knowledge about the epidemiology and clinical characteristics of this often neglected but important consequence of stroke. In this population-based study, a questionnaire was sent out to all (n=964) stroke patients identified through the Danish National Indicator Project Stroke Database in Aarhus County, Denmark, between March 2004 and February 2005. All surviving patients who fulfilled 4 questionnaire criteria for possible CPSP (n=51) were selected for further clinical examination, and their pain was classified by using stringent and well-defined criteria and a detailed, standardized clinical examination. The minimum prevalence of definite or probable CPSP in this population is 7.3% and the prevalence of CPSP-like dysesthesia or pain is 8.6%. Pinprick hyperalgesia was present in 57%, cold allodynia in 40%, and brush-evoked dysesthesia in 51% of patients with CPSP. Because of its negative impact on quality of life and rehabilitation, pain is an important symptom to assess in stroke survivors.

  2. Sex ratio of congenital abnormalities in the function of maternal age: a population-based study.

    PubMed

    Csermely, Gyula; Urbán, Robert; Czeizel, Andrew E; Veszprémi, Béla

    2015-05-01

    Maternal age effect is well-known in the origin of numerical chromosomal aberrations and some isolated congenital abnormalities (CAs). The sex ratio (SR), i.e. number of males divided by the number of males and females together, of most CAs deviates from the SR of newborn population (0.51). The objective of this analysis was to evaluate the possible association of maternal age with the SR of isolated CAs in a population-based large dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities, 1980-1996. First, SR of 24 CA entities/groups was estimated in 21,494 patients with isolated CA. In the next step SR of different maternal age groups was compared to the mean SR of the given CA-groups. The SR of four CA-groups showed some deviation in certain maternal age groups. Cases with anencephaly had female excess in young mothers (<25 years). Cases with skull's CAs particularly craniosynostosis had a male excess in cases born to women over 30 years. Two other CA groups (cleft lip ± palate and valvar pulmonic stenosis within the group of right-sided obstructive defect of heart) had significant deviation in SR of certain maternal age groups from the mean SR, but these deviations were not harmonized with joining age groups and thus were considered as a chance effect due to multiple testing. In conclusion, our study did not suggest that in general SR of isolated CAs might be modified by certain maternal age groups with some exception such as anencephaly and craniosynostosis.

  3. A Comparison of Objective and Subjective Stress in Homogeneous Male and Female Teams in a Mars Simulation

    NASA Astrophysics Data System (ADS)

    Bishop, S.; Sundaresan, A.

    Introduction The role of stress and its impact on coping performance motivation behavior cognitive functioning and psychological well-being has become a key focus for long duration missions Since all extreme environments are characterized by significant physical demands e g skiing climbing EVAs as well as inescapable environmental characteristics e g imminent danger noise isolation confinement loss of normal sensory stimuli an examination of the impact of prolong stress in analogue environments should provide insight into developing effective support and countermeasures for long duration space crews The presence of even low levels of chronic stressors if not met with functional adaptation and or countermeasures has been shown to produce subjective symptoms of stress persistent performance incompetence accelerated fatiguability altered mood states increased rate of infections and decrements in attention and cognitive Gender has been shown to cut across both individual factors and group factors including response to stress and ways of coping Generally men and women differ in many arenas such as interaction and communication styles need for affiliation responses to crowding privacy and confined spaces Men and women in homogeneous groups interact in significantly different ways than those in mixed groups Therefore differences between genders on subjective and objective responses to stress are of interest The Mars Society Utah Desert Simulation MDRS facility provides a unique opportunity to examine the interaction of

  4. Counseling Males.

    ERIC Educational Resources Information Center

    Scher, Murray, Ed.

    1981-01-01

    Contains 16 articles about counseling males including: (1) gender role conflict; (2) sex-role development; (3) counseling adolescent, adult, and gay males; (4) teenage fathers; (5) female therapists and male clients; (6) career development; (7) hypermasculinity; (8) counseling physically abusive men, uncoupling men; (9) group therapy, men's…

  5. Increasing incidence of cataract surgery: Population-based study

    PubMed Central

    Gollogly, Heidrun E.; Hodge, David O.; St. Sauver, Jennifer L.; Erie, Jay C.

    2015-01-01

    PURPOSE To estimate the incidence of cataract surgery in a defined population and to determine longitudinal cataract surgery patterns. SETTING Mayo Clinic, Rochester, Minnesota, USA. DESIGN Cohort study. METHODS Rochester Epidemiology Project (REP) databases were used to identify all incident cataract surgeries in Olmsted County, Minnesota, between January 1, 2005, and December 31, 2011. Age-specific and sex-specific incidence rates were calculated and adjusted to the 2010 United States white population. Data were merged with previous REP data (1980 to 2004) to assess temporal trends in cataract surgery. Change in the incidence over time was assessed by fitting generalized linear models assuming a Poisson error structure. The probability of second-eye cataract surgery was calculated using the Kaplan-Meier method. RESULTS Included were 8012 cataract surgeries from 2005 through 2011. During this time, incident cataract surgery significantly increased (P < .001), peaking in 2011 with a rate of 1100 per 100 000 (95% confidence interval, 1050–1160). The probability of second-eye surgery 3, 12, and 24 months after first-eye surgery was 60%, 76%, and 86%, respectively, a significant increase compared with the same intervals in the previous 7 years (1998 to 2004) (P < .001). When merged with 1980 to 2004 REP data, incident cataract surgery steadily increased over the past 3 decades (P < .001). CONCLUSION Incident cataract surgery steadily increased over the past 32 years and has not leveled off, as reported in Swedish population-based series. Second-eye surgery was performed sooner and more frequently, with 60% of residents having second-eye surgery within 3-months of first-eye surgery. PMID:23820302

  6. Medullary carcinoma of the large intestine: a population based analysis.

    PubMed

    Thirunavukarasu, Pragatheeshwar; Sathaiah, Magesh; Singla, Smit; Sukumar, Shyam; Karunamurthy, Arivarasan; Pragatheeshwar, Kothai Divya; Lee, Kenneth K W; Zeh, Herbert; Kane, Kevin M; Bartlett, David L

    2010-10-01

    Medullary carcinoma (MC) of the colorectum is a relatively new histological type of adenocarcinoma characterized by poor glandular differentiation and intraepithelial lymphocytic infiltrate. To date, there has been no epidemiological study of this rare tumor type, which has now been incorporated as a separate entity in the World Health Organization (WHO) classification of colorectal cancers. We used the population-based registries of the Surveillance, Epidemiology and End Results (SEER) database to identify all cases of colorectal MC between 1973 and 2006 and compared them to poorly and undifferentiated colonic adenocarcinomas (PDA and UDA, respectively). We observed that MCs were rare tumors, constituting approximately 5-8 cases for every 10,000 colon cancers diagnosed, with a mean annual incidence of 3.47 (+/-0.75) per 10 million population. Mean age at diagnosis was 69.3 (+/-12.5) years, with incidence increasing with age. MCs were twice as common in females, who presented at a later age, with a lower stage and a trend towards favorable prognosis. MCs were extremely rare among African-Americans. MCs were most common in the proximal colon (74%), where they present at a later age than the sigmoid colon. There were no cases reliably identified in the rectum or appendix. Serum carcinoembryonic antigen levels (CEA) were elevated prior to first course of treatment in 40% of the patients. MCs were more commonly poorly differentiated (72%), with 22% being undifferentiated. MCs commonly presented with Stage II disease, with 10% presenting with metastases. Only one patient presented with N2b disease (>7 positive nodes). Early outcome analyses showed that MCs have 1- and 2-year relative survival rates of 92.7 and 73.8% respectively. Although MCs showed a trend towards better early overall survival, undifferentiated MCs present more commonly with Stage III, with comparatively worse early outcomes.

  7. Distributions of personal VOC exposures: a population-based analysis.

    PubMed

    Jia, Chunrong; D'Souza, Jennifer; Batterman, Stuart

    2008-10-01

    Information regarding the distribution of volatile organic compound (VOC) concentrations and exposures is scarce, and there have been few, if any, studies using population-based samples from which representative estimates can be derived. This study characterizes distributions of personal exposures to ten different VOCs in the U.S. measured in the 1999--2000 National Health and Nutrition Examination Survey (NHANES). Personal VOC exposures were collected for 669 individuals over 2-3 days, and measurements were weighted to derive national-level statistics. Four common exposure sources were identified using factor analyses: gasoline vapor and vehicle exhaust, methyl tert-butyl ether (MBTE) as a gasoline additive, tap water disinfection products, and household cleaning products. Benzene, toluene, ethyl benzene, xylenes chloroform, and tetrachloroethene were fit to log-normal distributions with reasonably good agreement to observations. 1,4-Dichlorobenzene and trichloroethene were fit to Pareto distributions, and MTBE to Weibull distribution, but agreement was poor. However, distributions that attempt to match all of the VOC exposure data can lead to incorrect conclusions regarding the level and frequency of the higher exposures. Maximum Gumbel distributions gave generally good fits to extrema, however, they could not fully represent the highest exposures of the NHANES measurements. The analysis suggests that complete models for the distribution of VOC exposures require an approach that combines standard and extreme value distributions, and that carefully identifies outliers. This is the first study to provide national-level and representative statistics regarding the VOC exposures, and its results have important implications for risk assessment and probabilistic analyses.

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

    PubMed

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

    2013-11-01

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

  9. Stratification of ALS patients' survival: a population-based study.

    PubMed

    Marin, Benoît; Couratier, Philippe; Arcuti, Simona; Copetti, Massimiliano; Fontana, Andrea; Nicol, Marie; Raymondeau, Marie; Logroscino, Giancarlo; Preux, Pierre Marie

    2016-01-01

    The natural history of amyotrophic lateral sclerosis (ALS) and patient risk stratification are areas of considerable research interest. We aimed (1) to describe the survival of a representative cohort of French ALS patients, and (2) to identify covariates associated with various patterns of survival using a risk classification analysis. ALS patients recruited in the FRALim register (2000-2013) were included. Time-to-death analyses were performed using Kaplan-Meier method and Cox model. A recursive partitioning and amalgamation (RECPAM) algorithm analysis identified subgroups of patients with different patterns of survival. Among 322 patients, median survival times were 26.2 and 15.6 months from time of onset and of diagnosis, respectively. Four groups of patients were identified, depending on their baseline characteristics and survival (1) ALSFRS-R slope >0.46/month and definite or probable ALS (median survival time (MST) 10.6 months); (2) ALSFRS-R slope >0.46/month and possible or probable laboratory-supported ALS (MST: 18.1 months); (3) ALSFRS-R slope ≤0.46/month and definite or probable ALS (MST: 22.5 months), and (4) ALSFRS-R slope ≤0.46/month and possible or probable laboratory-supported ALS (MST: 37.6 months). Median survival time is among the shortest ever reported by a worldwide population-based study. This is probably related to the age structure of the patients (the oldest identified to date), driven by the underlying population (30 % of subjects older than 60 years). Further research in the field of risk stratification could help physicians better anticipate prognosis of ALS patients, and help improve the design of randomized controlled trials.

  10. Recurrence of hyperemesis gravidarum across generations: population based cohort study

    PubMed Central

    Skjærven, Rolv; Grjibovski, Andrej M; Gunnes, Nina; Vangen, Siri; Magnus, Per

    2010-01-01

    Objective To estimate the risk of hyperemesis gravidarum (hyperemesis) according to whether the daughters and sons under study were born after pregnancies complicated by hyperemesis. Design Population based cohort study. Setting Registry data from Norway. Participants Linked generational data from the medical birth registry of Norway (1967-2006): 544 087 units of mother and childbearing daughter and 399 777 units of mother and child producing son. Main outcome measure Hyperemesis in daughters in mother and childbearing daughter units and hyperemesis in female partners of sons in mother and child producing son units. Results Daughters who were born after a pregnancy complicated by hyperemesis had a 3% risk of having hyperemesis in their own pregnancy, while women who were born after an unaffected pregnancy had a risk of 1.1% (unadjusted odds ratio 2.9, 95% confidence interval 2.4 to 3.6). Female partners of sons who were born after pregnancies complicated by hyperemesis had a risk of 1.2% (1.0, 0.7 to 1.6). Daughters born after a pregnancy not complicated by hyperemesis had an increased risk of the condition if the mother had hyperemesis in a previous or subsequent pregnancy (3.2 (1.6 to 6.4) if hyperemesis had occurred in one of the mother’s previous pregnancies and 3.7 (1.5 to 9.1) if it had occurred in a later pregnancy). Adjustment for maternal age at childbirth, period of birth, and parity did not change the estimates. Restrictions to firstborns did not influence the results. Conclusions Hyperemesis gravidarum is more strongly influenced by the maternal genotype than the fetal genotype, though environmental influences along the maternal line cannot be excluded as contributing factors. PMID:21030362

  11. Calculated organ doses using Monte Carlo simulations in a reference male phantom undergoing HDR brachytherapy applied to localized prostate carcinoma

    SciTech Connect

    Candela-Juan, Cristian; Perez-Calatayud, Jose; Ballester, Facundo; Rivard, Mark J.

    2013-03-15

    Purpose: The aim of this study was to obtain equivalent doses in radiosensitive organs (aside from the bladder and rectum) when applying high-dose-rate (HDR) brachytherapy to a localized prostate carcinoma using {sup 60}Co or {sup 192}Ir sources. These data are compared with results in a water phantom and with expected values in an infinite water medium. A comparison with reported values from proton therapy and intensity-modulated radiation therapy (IMRT) is also provided. Methods: Monte Carlo simulations in Geant4 were performed using a voxelized phantom described in International Commission on Radiological Protection (ICRP) Publication 110, which reproduces masses and shapes from an adult reference man defined in ICRP Publication 89. Point sources of {sup 60}Co or {sup 192}Ir with photon energy spectra corresponding to those exiting their capsules were placed in the center of the prostate, and equivalent doses per clinical absorbed dose in this target organ were obtained in several radiosensitive organs. Values were corrected to account for clinical circumstances with the source located at various positions with differing dwell times throughout the prostate. This was repeated for a homogeneous water phantom. Results: For the nearest organs considered (bladder, rectum, testes, small intestine, and colon), equivalent doses given by {sup 60}Co source were smaller (8%-19%) than from {sup 192}Ir. However, as the distance increases, the more penetrating gamma rays produced by {sup 60}Co deliver higher organ equivalent doses. The overall result is that effective dose per clinical absorbed dose from a {sup 60}Co source (11.1 mSv/Gy) is lower than from a {sup 192}Ir source (13.2 mSv/Gy). On the other hand, equivalent doses were the same in the tissue and the homogeneous water phantom for those soft tissues closer to the prostate than about 30 cm. As the distance increased, the differences of photoelectric effect in water and soft tissue, and appearance of other materials

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

    PubMed Central

    2012-01-01

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

  13. Prevalence of microcephaly in Europe: population based study

    PubMed Central

    Rankin, Judith; Garne, Ester; Loane, Maria; Greenlees, Ruth; Addor, Marie-Claude; Arriola, Larraitz; Barisic, Ingeborg; Bergman, Jorieke E H; Csaky-Szunyogh, Melinda; Dias, Carlos; Draper, Elizabeth S; Gatt, Miriam; Khoshnood, Babak; Klungsoyr, Kari; Kurinczuk, Jennifer J; Lynch, Catherine; McDonnell, Robert; Nelen, Vera; Neville, Amanda J; O’Mahony, Mary T; Pierini, Anna; Randrianaivo, Hanitra; Rissmann, Anke; Tucker, David; Verellen-Dumoulin, Christine; de Walle, Hermien E K; Wellesley, Diana; Wiesel, Awi; Dolk, Helen

    2016-01-01

    Objectives To provide contemporary estimates of the prevalence of microcephaly in Europe, determine if the diagnosis of microcephaly is consistent across Europe, and evaluate whether changes in prevalence would be detected using the current European surveillance performed by EUROCAT (the European Surveillance of Congenital Anomalies). Design Questionnaire and population based observational study. Setting 24 EUROCAT registries covering 570 000 births annually in 15 countries. Participants Cases of microcephaly not associated with a genetic condition among live births, fetal deaths from 20 weeks’ gestation, and terminations of pregnancy for fetal anomaly at any gestation. Main outcome measures Prevalence of microcephaly (1 Jan 2003-31 Dec 2012) analysed with random effects Poisson regression models to account for heterogeneity across registries. Results 16 registries responded to the questionnaire, of which 44% (7/16) used the EUROCAT definition of microcephaly (a reduction in the size of the brain with a skull circumference more than 3 SD below the mean for sex, age, and ethnic origin), 19% (3/16) used a 2 SD cut off, 31% (5/16) were reliant on the criteria used by individual clinicians, and one changed criteria between 2003 and 2012. Prevalence of microcephaly in Europe was 1.53 (95% confidence interval 1.16 to 1.96) per 10 000 births, with registries varying from 0.4 (0.2 to 0.7) to 4.3 (3.6 to 5.0) per 10 000 (χ2=338, df=23, I2=93%). Registries with a 3 SD cut off reported a prevalence of 1.74 per 10 000 (0.86 to 2.93) compared with those with the less stringent 2 SD cut off of 1.21 per 10 000 (0.21 to 2.93). The prevalence of microcephaly would need to increase in one year by over 35% in Europe or by over 300% in a single registry to reach statistical significance (P<0.01). Conclusions EUROCAT could detect increases in the prevalence of microcephaly from the Zika virus of a similar magnitude to those observed in Brazil. Because of the rarity

  14. A national population-based assessment of 2007–2008 election-related violence in Kenya

    PubMed Central

    2014-01-01

    Background Following the contested national elections in 2007, violence occurred throughout Kenya. The objective of this study was to assess the prevalence, characteristics, and health consequences of the 2007–2008 election-related violence. Methods A cross-sectional, national, population-based cluster survey of 956 Kenyan adults aged ≥ 18 years was conducted in Kenya in September 2011 utilizing a two-stage 90 x 10 cluster sample design and structured interviews and questionnaires. Prevalence of all forms of violence surrounding the 2007 election period, symptoms of major depressive disorder (MDD) and posttraumatic stress disorder (PTSD), and morbidity related to sexual and physical violence were assessed. Results Of 956 households surveyed, 916 households participated (response rate 95.8%). Compared to pre-election, election-related sexual violence incidents/1000 persons/year increased over 60-fold (39.1-2370.1; p < .001) with a concurrent 37-fold increase in opportunistic sexual violence (5.2-183.1; p < .001). Physical and other human rights violations increased 80-fold (25.0-1987.1; p < .001) compared to pre-election. Overall, 50% of households reported at least one physical or sexual violation. Households reporting violence were more likely to report violence among female household members (66.6% vs. 58.1%; p = .04) or among the Luhya ethnic group (17.0% vs. 13.8%; p = 0.03). The most common perpetrators of election-related sexual violence were reported to be affiliated with government or political groups (1670.5 incidents/1000 persons per year); the Kalenjin ethnic group for physical violations (54.6%). Over thirty percent of respondents met MDD and PTSD symptom criteria; however, symptoms of MDD (females, 63.3%; males, 36.7%; p = .01) and suicidal ideation (females, 68.5%; males, 31.5%; p = .04) were more common among females. Substance abuse was more common among males (males, 71.2%; females, 28.8%; p < .001). Conclusion On a

  15. Population-based sexual behavior surveys in China: Liuzhou compared with other prefectural cities.

    PubMed

    Huang, Yingying; Abler, Laurie; Pan, Suiming; Henderson, Gail E; Wang, Xin; Yao, Xingliang; Parish, William L

    2014-02-01

    Sexual behaviors in China are rapidly changing; simultaneously, sexually transmitted infections (STI)/HIV prevalence is increasing in the general population. To investigate these major shifts, we examined sexual behaviors and self-reported STI in one prefectural city in southern China, Liuzhou, and compared it to other prefectural cities throughout China. We used adults age 18-39 from two sets of population-based surveys that paralleled each other in both content and method. The first set was the Liuzhou survey conducted in 2008 (n = 398). The second set consisted of two national surveys collected in 2006 and 2010 (n = 2,186). Liuzhou respondents reported more active social and sexual behaviors than their national counterparts, including more socializing, dancing, drinking excessively, sexual activity among never married men and women, purchasing commercial sex among men, one-night stands among men, multiple sexual partnerships and self-reported STI among both men and women. Women in Liuzhou reported greater sexual risk behavior than their national counterparts, although overall they reported less than their male counterparts; they were also more likely to have had an abortion than women in other prefectural cities. Our findings provide a comprehensive overview of the sexual context of Liuzhou among the general population, which may help explain the greater STI/HIV prevalence in Liuzhou.

  16. The association between intelligence and telomere length: a longitudinal population based study.

    PubMed

    Kingma, Eva M; de Jonge, Peter; van der Harst, Pim; Ormel, Johan; Rosmalen, Judith G M

    2012-01-01

    Low intelligence has been associated with poor health and mortality, but underlying mechanisms remain obscure. We hypothesized that low intelligence is associated with accelerated biological ageing as reflected by telomere length; we suggested potential mediation of this association by unhealthy behaviors and low socioeconomic position. The study was performed in a longitudinal population-based cohort study of 895 participants (46.8% males). Intelligence was measured with the Generalized Aptitude-Test Battery at mean age 52.8 years (33-79 years, SD=11.3). Leukocyte telomere length was measured by PCR. Lifestyle and socioeconomic factors were assessed using written self-report measures. Linear regression analyses, adjusted for age, sex, and telomere length measured at the first assessment wave (T1), showed that low intelligence was associated with shorter leukocyte telomere length at approximately 2 years follow-up (beta= .081, t=2.160, p= .031). Nearly 40% of this association was explained by an unhealthy lifestyle, while low socioeconomic position did not add any significant mediation. Low intelligence may be a risk factor for accelerated biological ageing, thereby providing an explanation for its association with poor health and mortality.

  17. Population-based sexual behavior surveys in China: Liuzhou compared with other prefectural cities

    PubMed Central

    Yingying, Huang; Abler, Laurie; Suiming, Pan; Henderson, Gail E.; Xin, Wang; Xingliang, Yao; Parish, William L.

    2013-01-01

    Sexual behaviors in China are rapidly changing; simultaneously, STI/HIV prevalence is increasing in the general population. To investigate these major shifts, we examined sexual behaviors and self-reported sexually transmitted infections (STI) in one prefectural city in southern China, Liuzhou, and compared it to other prefectural cities throughout China. We used adults age 18-39 from two sets of population-based surveys that paralleled each other in both content and method. The first set was the Liuzhou survey conducted in 2008 (n=398). The second set consisted of two national surveys collected in 2006 and 2010 (n=2186). Liuzhou respondents reported more active social and sexual behaviors than their national counterparts, including more socializing, dancing, drinking excessively, sexual activity among never married men and women, purchasing commercial sex among men, one-night stands among men, multiple sexual partnerships and self-reported STI among both men and women. Women in Liuzhou reported greater sexual risk behavior than their national counterparts, although overall they reported less than their male counterparts; they were also more likely to have had an abortion than women in other prefectural cities. Our findings provide a comprehensive overview of the sexual context of Liuzhou among the general population, which may help explain the greater STI/HIV prevalence in Liuzhou. PMID:24174289

  18. Major congenital anomalies in babies born with Down syndrome: a EUROCAT population-based registry study.

    PubMed

    Morris, Joan K; Garne, Ester; Wellesley, Diana; Addor, Marie-Claude; Arriola, Larraitz; Barisic, Ingeborg; Beres, Judit; Bianchi, Fabrizio; Budd, Judith; Dias, Carlos Matias; Gatt, Miriam; Klungsoyr, Kari; Khoshnood, Babak; Latos-Bielenska, Anna; Mullaney, Carmel; Nelen, Vera; Neville, Amanda J; O'Mahony, Mary; Queisser-Luft, Annette; Randrianaivo, Hanitra; Rankin, Judith; Rissmann, Anke; Rounding, Cath; Sipek, Antonin; Stoianova, Sylvia; Tucker, David; de Walle, Hermien; Yevtushok, Lyubov; Loane, Maria; Dolk, Helen

    2014-12-01

    Previous studies have shown that over 40% of babies with Down syndrome have a major cardiac anomaly and are more likely to have other major congenital anomalies. Since 2000, many countries in Europe have introduced national antenatal screening programs for Down syndrome. This study aimed to determine if the introduction of these screening programs and the subsequent termination of prenatally detected pregnancies were associated with any decline in the prevalence of additional anomalies in babies born with Down syndrome. The study sample consisted of 7,044 live births and fetal deaths with Down syndrome registered in 28 European population-based congenital anomaly registries covering seven million births during 2000-2010. Overall, 43.6% (95% CI: 42.4-44.7%) of births with Down syndrome had a cardiac anomaly and 15.0% (14.2-15.8%) had a non-cardiac anomaly. Female babies with Down syndrome were significantly more likely to have a cardiac anomaly compared to male babies (47.6% compared with 40.4%, P < 0.001) and significantly less likely to have a non-cardiac anomaly (12.9% compared with 16.7%, P < 0.001). The prevalence of cardiac and non-cardiac congenital anomalies in babies with Down syndrome has remained constant, suggesting that population screening for Down syndrome and subsequent terminations has not influenced the prevalence of specific congenital anomalies in these babies.

  19. Insomnia and the Risk of Atrial Fibrillation: A Population-Based Cohort Study

    PubMed Central

    Lee, Hsiu-Hao; Chen, Yueh-Chung; Chen, Jien-Jiun; Lo, Shih-Hsiang; Guo, Yue-Liang; Hu, Hsiao-Yun

    2017-01-01

    Background Although advancements in the treatment of atrial fibrillation have improved patient prognosis for this persistent condition, interest in atrial fibrillation development is growing. Of note is the fact that additional attention is being focused on the accompanying effect of insomnia. The aim of the study was to investigate the effects of insomnia on the risk of atrial fibrillation development. Methods This was a nationwide population-based retrospective cohort study using data from the Taiwan National health Insurance Research Database. We analyzed 64,421 insomnia cases and 128,842 matched controls without insomnia from January 1, 2000, to December 31, 2010. A Cox regression model was used to estimate the adjusted hazard ratios (HRs) and 95% confidence intervals (CI) for atrial fibrillation development. Results During the follow-up period, the incidence of atrial fibrillation development was significantly higher in the insomnia cases than in the comparison cohort (2.6% vs. 2.3%, p < 0.001). Insomnia was associated with an increased risk of atrial fibrillation (HR = 1.08, 95% CI: 1.01-1.14). Males, those > 65 years of age, and patients with peripheral artery disease who have insomnia had a higher rate of atrial fibrillation development. Conclusions The findings of this nationwide analysis support the hypothesis that insomnia is associated with a significant risk of atrial fibrillation development. PMID:28344420

  20. Prevalence of different forms of child maltreatment among Taiwanese adolescents: a population-based study.

    PubMed

    Feng, Jui-Ying; Chang, Yi-Ting; Chang, Hsin-Yi; Fetzer, Susan; Wang, Jung-Der

    2015-04-01

    Reported cases of child maltreatment are increasing in Taiwan. Yet, comprehensive epidemiological characteristics of adolescents' exposure over the wide spectrum of violence are still lacking. The purpose of this study was to estimate the prevalence and magnitude of child maltreatment among Taiwanese adolescents. A population-based study was conducted with 5,276 adolescents aged 12-18 from 35 schools in 17 cities and townships to determine the prevalence of five forms of child maltreatment in Taiwan. A total of 5,236 adolescents completed anonymous, self-report, structured questionnaires. Most adolescents (91%, n=4,788) experienced at least one form of maltreatment with 83% (n=4,347) exposed during the previous year. Violence exposure was the most common type of child maltreatment experienced, followed by psychological abuse, physical abuse, neglect, and sexual abuse. Adolescents reported an average of 7.4 (SD=5.87) victimizations over their lifetime and 4.8 (SD=4.82) victimizations during the past year. Females reported a higher rate of neglect, while males reported a higher rate of sexual abuse. Most of the sexual abuse perpetrators were known by their victims. Adolescents' victimization and polyvictimization from child maltreatment in Taiwan deserves a review and modification of national control and prevention policies.

  1. Passive-aggressive (negativistic) personality disorder: a population-based twin study.

    PubMed

    Czajkowski, Nikolai; Kendler, Kenneth S; Jacobson, Kristen C; Tambs, Kristian; Røysamb, Espen; Reichborn-Kjennerud, Ted

    2008-02-01

    The objective of this study was to investigate the familial aggregation of passive aggressive personality disorder (PAPD), and explore issues regarding PAPD raised by the DSM-IV Personality Disorder Work Group. Two thousand seven hundred and ninety-four Norwegian twins from the population-based Norwegian Institute of Public Health Twin Panel were interviewed with the Structured Interview for DSM-IV Personality (SIDP-IV). Because of the rarity of the twins meeting full diagnostic criteria for PAPD a dimensional representation of the disorder was used for the analyses. Overlap with other axis II disorders was assessed by polychoric correlations, while familial aggregation was explored by structural equation twin models. Overlap was highest with paranoid (r = 0.52) and borderline personality disorder (r = 0.53), and lowest with schizoid (r = 0.26). Significant familial aggregation was found for PAPD. The twin correlations and parameter estimates in the full model indicated genetic and shared environmental effects for females, and only shared environmental effects for males, but the prevalence of endorsed PAPD criteria in this community sample was too low to permit us to conclude with confidence regarding the relative influence of genetic and shared environmental factors on the familial aggregation of PAPD.

  2. Incidence and outcome of subarachnoid haemorrhage: a retrospective population based study

    PubMed Central

    Pobereskin, L

    2001-01-01

    OBJECTIVES—The purpose was to define the incidence and case fatality rates of subarachnoid haemorrhage in the population of Devon and Cornwall.
METHODS—A retrospective population based design was employed with multiple overlapping methods of case ascertainment. A strict definition of subarachnoid haemorrhage was used. Age and sex specific incidence rates and relative risks for death at different time intervals are calculated.
RESULTS—Eight hundred cases of first ever subarachnoid haemorrhage were identified; 77% of cases were verified by CT, 22% by necropsy, and 1% by lumbar puncture. The incidence rates are higher than those previously reported in the United Kingdom. The age standardised incidence rate (/100 000 person-years) for females was 11.9 (95% confidence interval (95% CI) 9.5-15.0), for males 7.4 (5.4-10.0), and the total rate was 9.7 (7.5-12.6). The case fatality rates at 24 hours, 1 week, and 30 days were 21 (18-24)%, 37 (33-41)%, and 44 (40-49)% respectively. The relative risk for death at 30days for those over 60 years:under 60 years was 2.95 (2.18-3.97).
CONCLUSION—The incidence of subarachnoid haemorrhage in the United Kingdom is higher than previously reported. Three quarters of the mortality occurs within 3days.

 PMID:11181855

  3. Occupations and lung cancer: a population-based case-control study in British Columbia.

    PubMed

    Yenugadhati, Nagarajkumar; Birkett, Nicholas J; Momoli, Franco; Krewski, Daniel

    2009-01-01

    An investigation based on a large population-based case-control study in British Columbia, Canada, was conducted to identify high-risk occupations for lung cancer by histological subtypes. Subjects were 14,755 male incident cancer cases for whom lifetime occupational histories and information on smoking and relevant covariates were collected. Occupational associations for 2998 lung cancer cases, including histological subtypes, were assessed by logistic regression using other cancer cases, excluding smoking-related cancers, as controls. An excess risk of lung cancer was found among workers in metal processing, bakers, and ship deck crew for all histological subtypes, and construction workers, chefs and cooks, and medical workers for specific histological subtypes. Occupational associations that are unique to histological subtypes of lung cancer were identified. Owing to a scarcity of literature in this area, future research needs to focus on confirming these histological associations, and identifying the risk from key exposures found within these occupations (e.g., medical radiation, electromagnetic fields, and cooking fumes).

  4. Genocide Exposure and Subsequent Suicide Risk: A Population-Based Study

    PubMed Central

    Levine, Stephen Z.; Levav, Itzhak; Yoffe, Rinat; Becher, Yifat; Pugachova, Inna

    2016-01-01

    The association between periods of genocide-related exposures and suicide risk remains unknown. Our study tests that association using a national population-based study design. The source population comprised of all persons born during1922-1945 in Nazi-occupied or dominated European nations, that immigrated to Israel by 1965, were identified in the Population Register (N = 220,665), and followed up for suicide to 2014, totaling 16,953,602 person-years. The population was disaggregated to compare a trauma gradient among groups that immigrated before (indirect, n = 20,612, 9%); during (partial direct, n = 17,037, 8%); or after (full direct, n = 183,016, 83%) exposure to the Nazi era. Also, the direct exposure groups were examined regarding pre- or post-natal exposure periods. Cox regression models were used to compute Hazard Ratios (HR) of suicide risk to compare the exposure groups, adjusting for confounding by gender, residential SES and history of psychiatric hospitalization. In the total population, only the partial direct exposure subgroup was at greater risk compared to the indirect exposure group (HR = 1.73, 95% CI, 1.10, 2.73; P < .05). That effect replicated in six sensitivity analyses. In addition, sensitivity analyses showed that exposure at ages 13 plus among females, and follow-up by years since immigration were associated with a greater risk; whereas in utero exposure among persons with no psychiatric hospitalization and early postnatal exposure among males were at a reduced risk. Tentative mechanisms impute biopsychosocial vulnerability and natural selection during early critical periods among males, and feelings of guilt and entrapment or defeat among females. PMID:26901411

  5. HIV testing in national population-based surveys: experience from the Demographic and Health Surveys.

    PubMed Central

    Mishra, Vinod; Vaessen, Martin; Boerma, J. Ties; Arnold, Fred; Way, Ann; Barrere, Bernard; Cross, Anne; Hong, Rathavuth; Sangha, Jasbir

    2006-01-01

    OBJECTIVES: To describe the methods used in the Demographic and Health Surveys (DHS) to collect nationally representative data on the prevalence of human immunodeficiency virus (HIV) and assess the value of such data to country HIV surveillance systems. METHODS: During 2001-04, national samples of adult women and men in Burkina Faso, Cameroon, Dominican Republic, Ghana, Mali, Kenya, United Republic of Tanzania and Zambia were tested for HIV. Dried blood spot samples were collected for HIV testing, following internationally accepted ethical standards. The results for each country are presented by age, sex, and urban versus rural residence. To estimate the effects of non-response, HIV prevalence among non-responding males and females was predicted using multivariate statistical models for those who were tested, with a common set of predictor variables. RESULTS: Rates of HIV testing varied from 70% among Kenyan men to 92% among women in Burkina Faso and Cameroon. Despite large differences in HIV prevalence between the surveys (1-16%), fairly consistent patterns of HIV infection were observed by age, sex and urban versus rural residence, with considerably higher rates in urban areas and in women, especially at younger ages. Analysis of non-response bias indicates that although predicted HIV prevalence tended to be higher in non-tested males and females than in those tested, the overall effects of non-response on the observed national estimates of HIV prevalence are insignificant. CONCLUSIONS: Population-based surveys can provide reliable, direct estimates of national and regional HIV seroprevalence among men and women irrespective of pregnancy status. Survey data greatly enhance surveillance systems and the accuracy of national estimates in generalized epidemics. PMID:16878227

  6. Vitreous haemorrhage: a population-based study of the incidence and risk factors in Taiwan

    PubMed Central

    Wang, Ching-Yu; Cheang, Wai-Man; Hwang, De-Kuang; Lin, Ching-Heng

    2017-01-01

    AIM To report the epidemiology and incidence of vitreous hemorrhage and to evaluate risk factors for patients with vitreous hemorrhage (VH) in Taiwan. METHODS A retrospective population-based study. Analyzing a sample of one million subjects from all enrollees of the Taiwan Health Insurance programme. All data were obtained from the Taiwan Health Insurance Research Database, which contained patient sex, date of birth, all records of clinical visits and hospitalizations, and diagnosis codes as included in the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The main outcome measures were the incidence and risk factors of VH. RESULT From 2001 to 2010, the database claim 4379 newly diagnosed cases were identified with VH. The average incidence of VH in Taiwan was 4.8 cases per ten-thousand person-years generally and increased with time especially in subjects who aged between 40 and 59y and when the VH was associated with proliferative diabetic retinopathies or retinal vein occlusions. A definitely upward trends in the incidence of VH from 2001 to 2010 were noted (P-value for increasing trend <0.001). Univariate Cox's regression analysis pointed out that older age (for 40-59, P<0.001, HR=9.39; for ≥60, P<0.001, HR=11.39), male gender (P=0.03, HR=1.07) and subjects who had been prescribed anti-coagulation drug included aspirin, warfarin and clopidogrel (P<0.001, HR=2.20) were significant risk factors for suffering from VH. CONCLUSION The incidence of VH is estimated being 4.8 cases per 10 000 person-years in Taiwan. Age, male gender and having been prescribed anti-coagulation drugs are associated with the incidence of VH. PMID:28393040

  7. The Association Between Peptic Ulcer Disease and Ischemic Stroke: A Population-Based Longitudinal Study.

    PubMed

    Cheng, Tain-Junn; Guo, How-Ran; Chang, Chia-Yu; Weng, Shih-Feng; Li, Pi-I; Wang, Jhi-Joung; Wu, Wen-Shiann

    2016-05-01

    Stroke is a common cause of death worldwide, but about 30% of ischemic stroke (IS) patients have no identifiable contributing risk factors. Because peptic ulcer disease (PUD) and vascular events share some common risk factors, we conducted a population-based study to evaluate the association between PUD and IS.We followed up a representative sample of 1 million residents of Taiwan using the National Health Insurance Research Database from 1997 to 2011. We defined patients who received medications for PUD and had related diagnosis codes as the PUD group, and a reference group matched by age and sex was sampled from those who did not have PUD. We also collected data on medical history and monthly income. The events of IS occurred after enrollment were compared between the 2 groups. The data were analyzed using Cox proportional hazard models at the 2-tailed significant level of 0.05.The PUD group had higher income and prevalence of hypertension, diabetes mellitus (DM), heart disease, and hyperlipidemia. They also had a higher risk of developing IS with an adjusted hazard ratio of 1.31 (95% confidence interval: 1.20-1.41). Other independent risk factors included male sex, older age, lower income, and co-morbidity of hypertension, diabetes mellitus (DM), and heart disease.PUD is a risk factor for IS, independent of conventional risk factors such as male sex, older age, lower income, and co-morbidity of hypertension, DM, and heart disease. Prevention strategies taking into account PUD should be developed and evaluated.

  8. Cancer incidence and incidence rates in Japan in 2008: a study of 25 population-based cancer registries for the Monitoring of Cancer Incidence in Japan (MCIJ) project.

    PubMed

    Matsuda, Ayako; Matsuda, Tomohiro; Shibata, Akiko; Katanoda, Kota; Sobue, Tomotaka; Nishimoto, Hiroshi

    2014-04-01

    The Japan Cancer Surveillance Research Group aimed to estimate the cancer incidence in Japan in 2008 based on data collected from 25 of 34 population-based cancer registries, as part of the Monitoring of Cancer Incidence in Japan project. The incidence in Japan for 2008 was estimated to be 749 767 (C00-C96). Stomach cancer and breast cancer were the leading types of cancer in males and females, respectively.

  9. Cancer incidence and incidence rates in Japan in 2009: a study of 32 population-based cancer registries for the Monitoring of Cancer Incidence in Japan (MCIJ) project.

    PubMed

    Hori, Megumi; Matsuda, Tomohiro; Shibata, Akiko; Katanoda, Kota; Sobue, Tomotaka; Nishimoto, Hiroshi

    2015-09-01

    The Japan Cancer Surveillance Research Group aimed to estimate the cancer incidence in Japan in 2009 based on data collected from 32 of 37 population-based cancer registries, as part of the Monitoring of Cancer Incidence in Japan (MCIJ) project. The incidence of only primary invasive cancer in Japan for 2009 was estimated to be 775 601. Stomach cancer and breast cancer were the leading types of cancer in males and females, respectively.

  10. Sexual offender recidivism among a population-based prison sample.

    PubMed

    Rettenberger, Martin; Briken, Peer; Turner, Daniel; Eher, Reinhard

    2015-04-01

    The present study examines recidivism rates in sexual offenders using officially registered reconvictions in a representative data set of N = 1,115 male sexual offenders from Austria. In general, results indicate that most sexual offenders do not reoffend sexually after release from prison. More detailed, within the first 5 years after release, the sexual recidivism rate was 6% for the total sample, 4% for the rapist subgroup, and 8% for the child molester subgroup. The findings confirmed previous studies about sex offender recidivism which have shown that first-time sexual offenders are significantly less likely to sexually reoffend than those with previous sexual convictions. With regard to the relationship between age and sexual recidivism, the results challenged the traditional assumption of a clear linear function between age and recidivism. Taken together, compared with previous studies, the recidivism rates found in the present investigation are substantially lower than previous research has indicated.

  11. Self medication with antibiotics in Yogyakarta City Indonesia: a cross sectional population-based survey

    PubMed Central

    2011-01-01

    Background Self medication with antibiotics has become an important factor driving antibiotic resistance. This study investigated the period prevalence, patterns of use, and socio-demographic factors associated with self medication with antibiotics in Yogyakarta City Indonesia. This cross-sectional population-based survey used a pre-tested questionnaire which was self-administered to randomly selected respondents (over 18 years old) in Yogyakarta City Indonesia in 2010 (N = 625). Descriptive statistics, chi-square and logistic regression were applied. Results A total of 559 questionnaires were analyzed (response rate = 90%). The period prevalence of self medication with antibiotics during the month prior to the study was 7.3%. Amoxicillin was the most popular (77%) antibiotic for self medication besides ampicilline, fradiomisin-gramisidin, tetracycline, and ciprofloxacin to treat the following symptoms: the common-cold including cough and sore throat, headache, and other minor symptoms; with the length of use was mostly less than five days. Doctors or pharmacists were the most common source of information about antibiotics for self medication (52%). Antibiotics were usually purchased without prescription in pharmacies (64%) and the cost of the purchases was commonly less than US $1 (30%). Previous experience was reported to be the main reason for using non-prescribed antibiotics (54%). There were no socio-demographic variables significantly associated with the actual practice of using non-prescribed antibiotics. However, gender, health insurance, and marital status were significantly associated with the intent to self medicate with antibiotics (P < 0.05). Being male (Odds Ratio = 1.7 (1.2 - 2.6)) and having no health insurance (Odds Ratio = 1.5 (1.0 -2.3)) is associated with the intent to self medicate with antibiotics. Conclusions This study is the first population-based study of self-medication with antibiotics among the Indonesian population. Usage of non

  12. Heterosexual Male Carriers Could Explain Persistence of Homosexuality in Men: Individual-Based Simulations of an X-Linked Inheritance Model.

    PubMed

    Chaladze, Giorgi

    2016-10-01

    Homosexuality has been documented throughout history and is found in almost all human cultures. Twin studies suggest that homosexuality is to some extent heritable. However, from an evolutionary perspective, this poses a problem: Male homosexuals tend to have on average five times fewer children than heterosexual males, so how can a phenomenon associated with low reproductive success be maintained at relatively stable frequencies? Recent findings of increased maternal fecundity of male homosexuals suggest that the genes responsible for homosexuality in males increase fecundity in the females who carry them. Can an increase in maternal fecundity compensate for the fecundity reduction in homosexual men and produce a stable polymorphism? In the current study, this problem was addressed with an individual-based modeling (IBM) approach. IBM suggests that male homosexuality can be maintained in a population at low and stable frequencies if roughly more than half of the females and half of the males are carriers of genes that predispose the male to homosexuality.

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  14. Universal Screening for Emotional and Behavioral Problems: Fitting a Population-Based Model

    ERIC Educational Resources Information Center

    Schanding, G. Thomas, Jr.; Nowell, Kerri P.

    2013-01-01

    Schools have begun to adopt a population-based method to conceptualizing assessment and intervention of students; however, little empirical evidence has been gathered to support this shift in service delivery. The present study examined the fit of a population-based model in identifying students' behavioral and emotional functioning using a…

  15. A Population Based Study on Hepatitis B Virus in Northern Iran, Amol

    PubMed Central

    Keyvani, Hossein; Sohrabi, Masoudreza; Zamani, Farhad; Poustchi, Hossein; Ashrafi, Hossein; Saeedian, Fatemeh; Mooadi, Mansooreh; Motamed, Nima; Ajdarkosh, Hossein; Khonsari, Mahmoodreza; Hemmasi, Gholamreza; Ameli, Mitra; Kabir, Ali; Khodadost, Mahmoud

    2014-01-01

    Background: Viral hepatitis is a major health problem worldwide. Change in transmission patterns of hepatitis B makes it necessary to re-evaluate its prevalence and risk factors. Objectives: We aimed to determine the prevalence of HBV infection and its related risk factors in Amol city, Northern Iran. Patients and Methods: As a population based study, a cluster sampling approach was used and 6146 individuals from the general population of urban and rural areas of Amol, Iran, from both genders and different ages were enrolled. Inclusion criteria were willingness to participate in the study, being a lifelong resident in Amol city or its surrounding areas with Iranian nationality. Ten milliliters (10 mL) of blood was taken from each study subject and checked regarding hepatitis B markers including HbsAg, HBsAb and HBcAb using a third generation ELISA. The prevalence of HBV infections and its potential risk factors were recorded. Results: The prevalence of HBsAg, HBsAb and HBcAb were estimated as 0.9%, 30.7% and 10.5%, respectively. The mean age of all participants was 43.9 (95% CI: 43.4, 44.3) in females and 55.6 in (n = 3472) males. In our study, there was a significant association between family history of hepatitis, rural residency and presence of HBsAg. There was also a positive correlation between HBcAb and family history of hepatitis, history of other types of hepatic diseases, history of tattooing, traditional phlebotomy, male gender and age. In backward logistic regression, a significant association was found between history of hepatitis in first-degree family members (OR = 13.35; 95% CI: 6.26, 28.47) and place of residence (OR = 2.32; 95% CI: 1.27, 4.22) with presence of HBsAg. There was also a positive correlation between history of hepatitis among first-degree family members (OR = 2.49; 95% CI: 1.52, 4.08), history of tattooing (OR = 2.13; 95% CI: 1.33, 3.42), history of previous hepatitis (OR = 1.87; 95% CI: 1.06, 3.28), male sex (OR = 1.36; 95% CI: 1

  16. High-Resolution Association Mapping of Quantitative Trait Loci: A Population-Based Approach

    PubMed Central

    Fan, Ruzong; Jung, Jeesun; Jin, Lei

    2006-01-01

    In this article, population-based regression models are proposed for high-resolution linkage disequilibrium mapping of quantitative trait loci (QTL). Two regression models, the “genotype effect model” and the “additive effect model,” are proposed to model the association between the markers and the trait locus. The marker can be either diallelic or multiallelic. If only one marker is used, the method is similar to a classical setting by Nielsen and Weir, and the additive effect model is equivalent to the haplotype trend regression (HTR) method by Zaykin et al. If two/multiple marker data with phase ambiguity are used in the analysis, the proposed models can be used to analyze the data directly. By analytical formulas, we show that the genotype effect model can be used to model the additive and dominance effects simultaneously; the additive effect model takes care of the additive effect only. On the basis of the two models, F-test statistics are proposed to test association between the QTL and markers. By a simulation study, we show that the two models have reasonable type I error rates for a data set of moderate sample size. The noncentrality parameter approximations of F-test statistics are derived to make power calculation and comparison. By a simulation study, it is found that the noncentrality parameter approximations of F-test statistics work very well. Using the noncentrality parameter approximations, we compare the power of the two models with that of the HTR. In addition, a simulation study is performed to make a comparison on the basis of the haplotype frequencies of 10 SNPs of angiotensin-1 converting enzyme (ACE) genes. PMID:16172503

  17. Condoms - male

    MedlinePlus

    Prophylactics; Rubbers; Male condoms; Contraceptive - condom; Contraception - condom; Barrier method - condom ... rubber Polyurethane Condoms are the only method of birth control for men that are not permanent. They can ...

  18. A population-based examination of the role of years of education, age of onset, and sex on the course of schizophrenia.

    PubMed

    Levine, Stephen Z; Rabinowitz, Jonathan

    2009-06-30

    This article examines how premorbid years of education and age of onset relate to the course of schizophrenia in a population-based cohort. All first and subsequent cases who were hospitalized with schizophrenia (1988-92, followed up until 1996) and completed their formal education at least 1 year before hospitalization (n=2135) were extracted from the Israeli National Psychiatric Hospitalization Registry. Results, based on hierarchical moderated regression models showed that age of onset predicted the course with greater consistency and magnitude than years of education. Years of education predicted the age of first hospitalization among males. Years of education and age of first hospitalization significantly interacted to predict the length of first stay and average number of days hospitalized over the course for males. The interaction showed that for males less education predicted poorer hospitalization outcomes if an earlier onset occurred. Together, the results suggest that less educated, early onset males are at higher risk of a poorer course.

  19. Familial clustering of ALS in a population-based resource

    PubMed Central

    Gibson, Summer B.; Figueroa, Karla P.; Bromberg, Mark B.; Cannon-Albright, Lisa

    2014-01-01

    Objective: To determine the extent of an inherited contribution to amyotrophic lateral sclerosis (ALS) mortality. Methods: Death certificates (DCs) from 1904 to 2009 were analyzed from patients with at least 3 generations recorded in the Utah Population Database, a genealogic and medical database of more than 2 million Utah residents. Among probands whose DCs listed ALS, the relative risk (RR) of death with ALS was determined among spouses and first- through fifth-degree relatives, using birth year-, sex-, and birthplace-matched cohorts. Results: Eight hundred seventy-three patients with ALS met the inclusion criteria. Among 3,531 deceased first-degree relatives of probands, the RR of dying with ALS was increased compared with control cohorts (RR = 4.91, 95% confidence interval 3.36, 6.94). The RR of dying with ALS was also increased among 9,386 deceased second-degree relatives (RR = 2.85, 95% confidence interval 2.06, 3.84). The RR of dying with ALS was not increased among third- through fifth-degree relatives. More affected first-degree relatives were male (p = 0.014). No cases of conjugal ALS were observed. Conclusions: This study is suggestive of familial clustering in excess of expected for ALS. Our results confirm the results of prior studies of familial ALS, suggesting applicability of our findings to other mixed European populations. Furthermore, this work expands on previous studies by quantifying the RR of ALS among more distant relatives. The use of mortality data obtained from DCs reduces the ascertainment and recall bias of many previous studies. Finally, the excess of ALS among second-degree relatives and lack of conjugal ALS are strongly supportive of a genetic contribution. PMID:24306004

  20. The Haematological Malignancy Research Network (HMRN): a new information strategy for population based epidemiology and health service research.

    PubMed

    Smith, Alexandra; Roman, Eve; Howell, Debra; Jones, Richard; Patmore, Russell; Jack, Andrew

    2010-03-01

    The Haematological Malignancy Research Network (HMRN) was established in 2004 to provide robust generalizable data to inform clinical practice and research. It comprises an ongoing population-based cohort of patients newly diagnosed by a single integrated haematopathology laboratory in two adjacent UK Cancer Networks (population 3.6 million). With an emphasis on primary-source data, prognostic factors, sequential treatment/response history, and socio-demographic details are recorded to clinical trial standards. Data on 8131 patients diagnosed over the 4 years 2004-08 are examined here using the latest World Health Organization classification. HMRN captures all diagnoses (adult and paediatric) and the diagnostic age ranged from 4 weeks to 99 years (median 70.4 years). In line with published estimates, first-line clinical trial entry varied widely by disease subtype and age, falling from 59.5% in those aged <15 years to 1.9% in those aged over 75 years - underscoring the need for contextual population-based treatment and response data of the type collected by HMRN. The critical importance of incorporating molecular and prognostic markers into comparative survival analyses is illustrated with reference to diffuse-large B-cell lymphoma, acute myeloid leukaemia and myeloma. With respect to aetiology, several descriptive factors are highlighted and discussed, including the unexplained male predominance evident for most subtypes across all ages.

  1. Sun Exposure Prevalence and Associated Skin Health Habits: Results from the Austrian Population-Based UVSkinRisk Survey.

    PubMed

    Haluza, Daniela; Simic, Stana; Moshammer, Hanns

    2016-01-19

    Recreational sun exposure accounts for a large number of acute and chronic dermatological diseases, including skin cancer. This study aimed at estimating the one-year prevalence of sun exposure and skin health-associated knowledge and attitudes among Austrian citizens. The population-based UVSkinRisk survey investigated a representative sample of Austrian adults using a structured questionnaire. In total, 1500 study subjects (median age 33.0 years, 50.5% females) participated in this questionnaire survey. Among study participants, prevalence of sun exposure was 47%, with slightly higher rates in males (48%) compared to females (46%). Younger age, lower professional category, darker skin type, motives to tan, sunbed use, sunburn, and outdoor sport activity increased the odds for prevalent sun exposure. This is the first population-based study evaluating the prevailing sun exposure and recreational habits influencing skin health among Austrian citizens. Despite public media campaigns educating on the harmful effects of sunlight exposure, we found a high prevalence of self-reported sunlight exposure. The results suggest that multifaceted socio-cultural characteristics stimulate recreational sun exposure and tanning habits. Communicating individualized Public (Skin) Health messages might be the key to prevent photo-induced skin health hazards in light-skinned populations. The practical and theoretical implications of these findings are discussed.

  2. Sun Exposure Prevalence and Associated Skin Health Habits: Results from the Austrian Population-Based UVSkinRisk Survey

    PubMed Central

    Haluza, Daniela; Simic, Stana; Moshammer, Hanns

    2016-01-01

    Recreational sun exposure accounts for a large number of acute and chronic dermatological diseases, including skin cancer. This study aimed at estimating the one-year prevalence of sun exposure and skin health-associated knowledge and attitudes among Austrian citizens. The population-based UVSkinRisk survey investigated a representative sample of Austrian adults using a structured questionnaire. In total, 1500 study subjects (median age 33.0 years, 50.5% females) participated in this questionnaire survey. Among study participants, prevalence of sun exposure was 47%, with slightly higher rates in males (48%) compared to females (46%). Younger age, lower professional category, darker skin type, motives to tan, sunbed use, sunburn, and outdoor sport activity increased the odds for prevalent sun exposure. This is the first population-based study evaluating the prevailing sun exposure and recreational habits influencing skin health among Austrian citizens. Despite public media campaigns educating on the harmful effects of sunlight exposure, we found a high prevalence of self-reported sunlight exposure. The results suggest that multifaceted socio-cultural characteristics stimulate recreational sun exposure and tanning habits. Communicating individualized Public (Skin) Health messages might be the key to prevent photo-induced skin health hazards in light-skinned populations. The practical and theoretical implications of these findings are discussed. PMID:26797627

  3. Perceived health in a population based sample of victims of the 1956 polio epidemic in the Netherlands

    PubMed Central

    Nollet, F; Ivanyi, B; Beelen, A; de Haan, R J; Lankhorst, G; de Visser, M

    2002-01-01

    Objective: To investigate perceived health and its relation to residual paresis from polio, late onset neuromuscular symptoms following poliomyelitis (LSP), and sex, in a population based sample of polio survivors. Methods: 350 subjects traced from the notification records of the Dutch 1956 polio epidemic received a mailed questionnaire on residual polio paresis and new neuromuscular symptoms. Perceived health was measured using the Nottingham health profile. Respondents with new muscle weakness and new neuromuscular symptoms were considered as cases with LSP. Results: Health problems were perceived by 151 of the 260 respondents. Respondents with residual paresis had significantly more health problems than clinically recovered respondents for the Nottingham health profile category of physical mobility. The perceived health of respondents with LSP (45.5%) was significantly worse than that of respondents without LSP for all the health profile categories. Among the respondents with LSP, health status did not differ between those with residual paresis and those who had recovered, except for physical mobility. Female respondents with LSP reported worse health status than male respondents with regard to physical mobility and social isolation. Conclusions: In this population based sample, health problems were frequently reported. They were mainly related to late onset neuromuscular symptoms following poliomyelitis, which were perceived by a substantial proportion of all polio survivors—not only subjects with polio residuals but also individuals who (subjectively) had recovered from polio. PMID:12438472

  4. Associating optical measurements of MEO and GEO objects using Population-Based Meta-Heuristic methods

    NASA Astrophysics Data System (ADS)

    Zittersteijn, M.; Vananti, A.; Schildknecht, T.; Dolado Perez, J. C.; Martinot, V.

    2016-11-01

    Currently several thousands of objects are being tracked in the MEO and GEO regions through optical means. The problem faced in this framework is that of Multiple Target Tracking (MTT). The MTT problem quickly becomes an NP-hard combinatorial optimization problem. This means that the effort required to solve the MTT problem increases exponentially with the number of tracked objects. In an attempt to find an approximate solution of sufficient quality, several Population-Based Meta-Heuristic (PBMH) algorithms are implemented and tested on simulated optical measurements. These first results show that one of the tested algorithms, namely the Elitist Genetic Algorithm (EGA), consistently displays the desired behavior of finding good approximate solutions before reaching the optimum. The results further suggest that the algorithm possesses a polynomial time complexity, as the computation times are consistent with a polynomial model. With the advent of improved sensors and a heightened interest in the problem of space debris, it is expected that the number of tracked objects will grow by an order of magnitude in the near future. This research aims to provide a method that can treat the association and orbit determination problems simultaneously, and is able to efficiently process large data sets with minimal manual intervention.

  5. Population-based metaheuristic optimization in neutron optics and shielding design

    NASA Astrophysics Data System (ADS)

    DiJulio, D. D.; Björgvinsdóttir, H.; Zendler, C.; Bentley, P. M.

    2016-11-01

    Population-based metaheuristic algorithms are powerful tools in the design of neutron scattering instruments and the use of these types of algorithms for this purpose is becoming more and more commonplace. Today there exists a wide range of algorithms to choose from when designing an instrument and it is not always initially clear which may provide the best performance. Furthermore, due to the nature of these types of algorithms, the final solution found for a specific design scenario cannot always be guaranteed to be the global optimum. Therefore, to explore the potential benefits and differences between the varieties of these algorithms available, when applied to such design scenarios, we have carried out a detailed study of some commonly used algorithms. For this purpose, we have developed a new general optimization software package which combines a number of common metaheuristic algorithms within a single user interface and is designed specifically with neutronic calculations in mind. The algorithms included in the software are implementations of Particle-Swarm Optimization (PSO), Differential Evolution (DE), Artificial Bee Colony (ABC), and a Genetic Algorithm (GA). The software has been used to optimize the design of several problems in neutron optics and shielding, coupled with Monte-Carlo simulations, in order to evaluate the performance of the various algorithms. Generally, the performance of the algorithms depended on the specific scenarios, however it was found that DE provided the best average solutions in all scenarios investigated in this work.

  6. Refractory Hypertension: Determination of Prevalence, Risk Factors and Comorbidities in a Large, Population-Based Cohort

    PubMed Central

    Calhoun, David A.; Booth, John N.; Oparil, Suzanne; Irvin, Marguerite R.; Shimbo, Daichi; Lackland, Daniel T.; Howard, George; Safford, Monika M.; Muntner, Paul

    2014-01-01

    Refractory hypertension is an extreme phenotype of antihypertensive treatment failure. Participants in the REasons for Geographic And Racial Differences in Stroke (REGARDS) Study, a large (n=30,239), population-based cohort were evaluated to determine the prevalence of refractory hypertension and associated cardiovascular risk factors and comorbidities. Refractory hypertension was defined as uncontrolled blood pressure (systolic/diastolic ≥ 140/90 mm Hg) on ≥ 5 antihypertensive drug classes. Participants with resistant hypertension (systolic/diastolic ≥140/90 mm Hg on ≥ 3 or<140/90 mm Hg on ≥ 4 antihypertensive classes) and all treated hypertensive participants served as comparator groups. Of 14,809 REGARDS participants receiving antihypertensive treatment, 78 (0.5%) had refractory hypertension. The prevalence of refractory hypertension was 3.6% among participants with resistant hypertension(n=2,144) and 41.7% among participants on 5 or more antihypertensive drug classes. Among all hypertensive participants, African American race, male gender, living in the stroke belt or buckle, higher body mass index, lower heart rate, reduced estimated glomerular filtration rate, albuminuria, diabetes and history of stroke and coronary heart disease were associated with refractory hypertension. Compared to resistant hypertension, prevalence ratios for refractory hypertension were increased for African Americans (3.00, 95% CI 1.68 – 5.37) and those with albuminuria (2.22, 95% CI 1.40 – 3.52) and diabetes (2.09, 95% CI 1.32 – 3.31). The median 10-year Framingham risk for coronary heart disease and stroke was higher among participants with refractory hypertension compared to either comparator group. These data indicate that while resistant hypertension is relatively common among treated hypertensive patients, true antihypertensive treatment failure is rare. PMID:24324035

  7. Refractory hypertension: determination of prevalence, risk factors, and comorbidities in a large, population-based cohort.

    PubMed

    Calhoun, David A; Booth, John N; Oparil, Suzanne; Irvin, Marguerite R; Shimbo, Daichi; Lackland, Daniel T; Howard, George; Safford, Monika M; Muntner, Paul

    2014-03-01

    Refractory hypertension is an extreme phenotype of antihypertensive treatment failure. Participants in the REasons for Geographic And Racial Differences in Stroke (REGARDS) Study, a large (n=30 239), population-based cohort were evaluated to determine the prevalence of refractory hypertension and associated cardiovascular risk factors and comorbidities. Refractory hypertension was defined as uncontrolled blood pressure (systolic/diastolic, ≥140/90 mm Hg) on ≥5 antihypertensive drug classes. Participants with resistant hypertension (systolic/diastolic, ≥140/90 mm Hg on ≥3 or <140/90 mm Hg on ≥4 antihypertensive classes) and all participants treated for hypertension served as comparator groups. Of 14 809 REGARDS participants receiving antihypertensive treatment, 78 (0.5%) had refractory hypertension. The prevalence of refractory hypertension was 3.6% among participants with resistant hypertension (n=2144) and 41.7% among participants on ≥5 antihypertensive drug classes. Among all participants with hypertension, black race, male sex, living in the stroke belt or buckle, higher body mass index, lower heart rate, reduced estimated glomerular filtration rate, albuminuria, diabetes mellitus, and history of stroke and coronary heart disease were associated with refractory hypertension. Compared with resistant hypertension, prevalence ratios for refractory hypertension were increased for blacks (3.00; 95% confidence interval, 1.68-5.37) and those with albuminuria (2.22; 95% confidence interval, 1.40-3.52) and diabetes mellitus (2.09; 95% confidence interval, 1.32-3.31). The median 10-year Framingham risk for coronary heart disease and stroke was higher among participants with refractory hypertension when compared with those with either comparator group. These data indicate that although resistant hypertension is relatively common among treated patients with hypertension, true antihypertensive treatment failure is rare.

  8. The changing face of thyroid cancer in a population-based cohort.

    PubMed

    Pathak, K Alok; Leslie, William D; Klonisch, Thomas C; Nason, Richard W

    2013-08-01

    In North America, the incidence of thyroid cancer is increasing by over 6% per year. We studied the trends and factors influencing thyroid cancer incidence, its clinical presentation, and treatment outcome during 1970-2010 in a population-based cohort of 2306 consecutive thyroid cancers in Canada, that was followed up for a median period of 10.5 years. Disease-specific survival (DSS) and disease-free survival were estimated by the Kaplan-Meier method and the independent influence of various prognostic factors was evaluated by Cox proportional hazard models. Cumulative incidence of deaths resulting from thyroid cancer was calculated by competing risk analysis. A P-value <0.05 was considered to indicate statistical significance. The age standardized incidence of thyroid cancer by direct method increased from 2.52/100,000 (1970) to 9.37/100,000 (2010). Age at diagnosis, gender distribution, tumor size, and initial tumor stage did not change significantly during this period. The proportion of papillary thyroid cancers increased significantly (P < 0.001) from 58% (1970-1980) to 85.9% (2000-2010) while that of anaplastic cancer fell from 5.7% to 2.1% (P < 0.001). Ten-year DSS improved from 85.4% to 95.6%, and was adversely influenced by anaplastic histology (hazard ratio [HR] = 8.7; P < 0.001), male gender (HR = 1.8; P = 0.001), TNM stage IV (HR = 8.4; P = 0.001), incomplete surgical resection (HR = 2.4; P = 0.002), and age at diagnosis (HR = 1.05 per year; P < 0.001). There was a 373% increase in the incidence of thyroid cancer in Manitoba with a marked improvement in the thyroid cancer-specific survival that was independent of changes in patient demographics, tumor stage, or treatment practices, and is largely attributed to the declining proportion of anaplastic thyroid cancers.

  9. Predictors of Death among Patients Who Completed Tuberculosis Treatment: A Population-Based Cohort Study

    PubMed Central

    Millet, Juan-Pablo; Orcau, Angels; Rius, Cristina; Casals, Marti; de Olalla, Patricia Garcia; Moreno, Antonio; Nelson, Jeanne L.; Caylà, Joan A.

    2011-01-01

    Background Mortality among patients who complete tuberculosis (TB) treatment is still high among vulnerable populations. The objective of the study was to identify the probability of death and its predictive factors in a cohort of successfully treated TB patients. Methods A population-based retrospective longitudinal study was performed in Barcelona, Spain. All patients who successfully completed TB treatment with culture-confirmation and available drug susceptibility testing between 1995–1997 were retrospectively followed-up until December 31, 2005 by the Barcelona TB Control Program. Socio-demographic, clinical, microbiological and treatment variables were examined. Mortality, TB Program and AIDS registries were reviewed. Kaplan-Meier and a Cox regression methods with time-dependent covariates were used for the survival analysis, calculating the hazard ratio (HR) with 95% confidence intervals (CI). Results Among the 762 included patients, the median age was 36 years, 520 (68.2%) were male, 178 (23.4%) HIV-infected, and 208 (27.3%) were alcohol abusers. Of the 134 (17.6%) injecting drug users (IDU), 123 (91.8%) were HIV-infected. A total of 30 (3.9%) recurrences and 173 deaths (22.7%) occurred (mortality rate: 3.4/100 person-years of follow-up). The predictors of death were: age between 41–60 years old (HR: 3.5; CI:2.1–5.7), age greater than 60 years (HR: 14.6; CI:8.9–24), alcohol abuse (HR: 1.7; CI:1.2–2.4) and HIV-infected IDU (HR: 7.9; CI:4.7–13.3). Conclusions The mortality rate among TB patients who completed treatment is associated with vulnerable populations such as the elderly, alcohol abusers, and HIV-infected IDU. We therefore need to fight against poverty, and promote and develop interventions and social policies directed towards these populations to improve their survival. PMID:21980423

  10. Incidence and Mortality of Obstructive Lung Disease in Rheumatoid Arthritis: A Population-Based Study

    PubMed Central

    Nannini, Carlotta; Medina-Velasquez, Yimy F.; Achenbach, Sara J.; Crowson, Cynthia S.; Ryu, Jay H.; Vassallo, Robert; Gabriel, Sherine E.; Matteson, Eric L.; Bongartz, Tim

    2014-01-01

    OBJECTIVE Pulmonary disease represents an important extra-articular manifestation of rheumatoid arthritis (RA). While the association of RA and interstitial lung disease is widely acknowledged, obstructive lung disease (OLD) in RA is less well understood. We therefore aimed to assess incidence, risk factors and mortality of OLD in patients with RA. METHODS We examined a population-based incident cohort of patients with RA and a comparison cohort of individuals without RA. OLD was defined using a strict composite criterion. Cox-proportional hazards models were used to compare OLD incidence between the RA and comparator cohort, to investigate risk factors and to explore the impact of OLD on patient survival. RESULTS 594 patients with RA and 596 subjects without RA were followed for a mean of 16.3 and 19.4 years, respectively. The lifetime risk of developing OLD was 9.6% for RA patients and 6.2% for subjects without RA; hazard ratio (HR) 1.54 (95% CI 1.01 to 2.34). The risk of developing OLD was higher among male patients, current or former smokers and for individuals with more severe RA. Survival of RA patients diagnosed with OLD was worse compared to those without OLD (HR 2.09, 95% CI 1.47 to 2.97). CONCLUSION Patients with RA are at higher risk of developing OLD, which is significantly associated with premature mortality. Effective diagnostic and therapeutic strategies to detect and manage OLD in patients with RA may help to improve survivorship in these patients. PMID:23436637

  11. Dementia is associated with open-angle glaucoma: a population-based study

    PubMed Central

    Chung, S-D; Ho, J-D; Chen, C-H; Lin, H-C; Tsai, M-C; Sheu, J-J

    2015-01-01

    Purpose Previous epidemiologic studies that focused on the association between open-angle glaucoma (OAG) and dementia showed inconsistent results. In the present study, we explored the association between OAG and dementia in an ethnic Chinese (ie, Taiwanese) population using a population-based data set. Methods We retrieved data on study subjects for this case-control study from the Longitudinal Health Insurance Database 2000. We identified 7770 patients who had a diagnosis of dementia as cases, and 7770 subjects matched in terms of sex and age, which were randomly extracted as controls. A conditional logistic regression conditioned on age group, sex, and index year was used to assess the association of dementia with previously diagnosed OAG among the sampled patients. Results Of 15 540 patients, 1.70% had prior OAG, including 2.02% of the dementia group and 1.38% of the controls. After adjusting for patient socioeconomic characteristics and comorbid medical disorders, dementia patients were more likely to have had prior OAG than controls (odds ratio (OR): 1.44; 95% confidence interval (CI): 1.12–1.85; P<0.01). In addition, female dementia patients were more likely to have had prior OAG than controls (OR: 1.93; 95% CI: 1.35–2.77; P<0.001), whereas no statistical difference in prior OAG between male dementia patients and controls was found. Conclusions Female dementia patients were associated with a higher proportion of prior OAG than were the controls. PMID:26160529

  12. Occupational Chronic Obstructive Pulmonary Disease in a Danish Population-Based Study.

    PubMed

    Würtz, Else Toft; Schlünssen, Vivi; Malling, Tine Halsen; Hansen, Jens Georg; Omland, Øyvind

    2015-08-01

    The aim was to explore the impact of occupation on chronic obstructive pulmonary disease (COPD) in a cross-sectional population-based study among subjects aged 45 to 84 years. In a stratified sampling 89 general practitioners practices (GPP) in Denmark recruited 3106 males and 1636 females through the Danish Civil Registration System. COPD was defined by spirometry by the 2.5(th)-centile Lower Limit of Normal of FEV1 and FEV1/FVC. Information about smoking, occupational exposure and the respective occupations were obtained from questionnaires. Occupations followed the Danish adaptation of The International Standard Classification of Occupations, revision 1988 (DISCO-88). Exposure to vapour, gas, dust (organic and inorganic), and fume (VGDF) in each occupation (yes/no) was evaluated by two independent specialist in occupational medicine. Exposures were divided in no, low, medium, and high exposure as 0, < 5, 5-14, and ≥ 15 years in the job, respectively. Data was analysed by a mixed random effect logistic regression model. The age-standardised COPD study prevalence was 5.0%. Of 372 DISCO-88 codes 72 were identified with relevant exposure to VGDF. 46% of the participants reported at least one occupation with VGDF exposure. Adjusted for smoking, age, sex, and GPP a dose-dependent association of COPD was found among workers in jobs with high organic dust exposure, with OR 1.56 (95% CI 1.09-2.24). Restricted to agriculture the OR was 1.59 (95% CI: 1.08-2.33). No association was observed for workers in jobs with inorganic dust, fume/gas, or vapour exposures. In summary, occupational organic dust exposure was associated to the prevalence of COPD.

  13. HLA Associations and Risk of Posttransplant Lymphoproliferative Disorder in a Danish Population-Based Cohort

    PubMed Central

    Vase, Maja Ølholm; Maksten, Eva Futtrup; Strandhave, Charlotte; Søndergaard, Esben; Bendix, Knud; Hamilton-Dutoit, Stephen; Andersen, Claus; Møller, Michael Boe; Sørensen, Søren Schwartz; Kampmann, Jan; Eiskjær, Hans; Iversen, Martin; Weinreich, Ilse Duus; Møller, Bjarne; Jespersen, Bente; d'Amore, Francesco

    2015-01-01

    Background Posttransplant lymphoproliferative disorder (PTLD) is a feared complication to organ transplantation, associated with substantial morbidity and inferior survival. Risk factors for PTLD include T cell–depleting induction therapy and primary infection or reactivation of Epstein-Barr virus. Possible associations between certain HLA types and the risk of developing PTLD have been reported by other investigators; however, results are conflicting. Methods We conducted a retrospective, population-based study on 4295 Danish solid organ transplant patients from the Scandiatransplant database. Having identified 93 PTLD patients in the cohort, we investigated the association of HLA types with PTLD, Epstein-Barr virus status and time to PTLD onset. The outcomes survival and PTLD were evaluated using Cox regression; mismatching, and the PTLD-specific mortality were evaluated in a competing risk analysis. Results Risk of PTLD was associated with male sex (odds ratio, 1.70; 95% confidence interval, 1.07-2.71), and, in women, HLA-DR13 conferred an increased risk (odds ratio, 3.22; 95% confidence interval, 1.41-7.31). In multivariate analysis, HLA-B45 and HLA-DR13 remained independent predictive factors of PTLD. Mismatching in the B locus was associated with a reduced risk of PTLD (P < 0.001). Overall survival was poor after a PTLD diagnosis and was significantly worse than that in the remaining transplant cohort (P < 0.001). Conclusions Our data indicate risk-modifying HLA associations, which can be clinically useful after transplantation in personalized monitoring schemes. Given the strong linkage disequilibrium in the HLA region, the associations must be interpreted carefully. The large size, virtually complete ascertainment of cases and no loss to follow-up remain important strengths of the study. PMID:27500227

  14. A Population Based Twin Study of DSM-5 Maladaptive Personality Domains.

    PubMed

    South, Susan C; Krueger, Robert F; Knudsen, Gun Peggy; Ystrom, Eivind; Czajkowski, Nikolai; Aggen, Steven H; Neale, Michael C; Gillespie, Nathan A; Kendler, Kenneth S; Reichborn-Kjennerud, Ted

    2016-10-31

    Personality disorders (PDs) can be partly captured by dimensional traits, a viewpoint reflected in the most recent Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) Alternative (Section III) Model for PD classification. The current study adds to the literature on the Alternative Model by examining the magnitude of genetic and environmental influences on 6 domains of maladaptive personality: negative emotionality, detachment, antagonism, disinhibition, compulsivity, and psychoticism. In a large, population-based sample (N = 2,293) of Norwegian male and female twin pairs, we investigated (a) if the domains demonstrated measurement invariance across gender at the phenotypic level, meaning that the relationships between the items and the latent factor were equivalent in men and women; and (b) if genetic and environmental influences on variation in these domains were equivalent across gender. Multiple group confirmatory factor modeling provided evidence that all 6 domain scale measurement models were gender-invariant. The best fitting biometric model for 4 of the 6 domains (negative emotionality, detachment, disinhibition, and compulsivity) was one in which genetic and environmental influences could be set invariant across gender. Evidence for sex differences in psychoticism was mixed, but the only clear evidence for quantitative sex differences was for the antagonism scale, with greater genetic influences found for men than women. Genetic influences across domains were moderate overall (19-37%), in line with previous research using symptom-based measures of PDs. This study adds to the very limited knowledge currently existing on the etiology of maladaptive personality traits. (PsycINFO Database Record

  15. The Prevalence and Causes of Primary Infertility in Iran: A Population-Based Study

    PubMed Central

    Kazemijaliseh, Hadigheh; Tehrani, Fahimeh Ramezani; Behboudi-Gandevani, Samira; Hosseinpanah, Farhad; Khalili, Davood; Azizi, Fereidoun

    2015-01-01

    Background: Primary infertility is a health issue among women over the world. The aim of this study was to investigate the prevalence and causes of primary infertility based on a population-based study in an urban area of Iran. Materials and Methods: In a cross-sectional study, a total of 1067 married women who participated in the Tehran Lipid and Glucose Study were randomly selected using systematic random sampling. Unmarried women, those with unwilling pregnancy and duration of marriage below one year were excluded from the study. Data was collected by using validated ad-hoc questionnaires. Descriptive and inferential statistics were used for data analysis. Results: The mean (SD) of age and marriage age of the studied women were 40.3 (9.3) and 20.6 (4.49) years, respectively; the overall prevalence of lifetime primary infertility among couples was 17.3% (185/1067). Ovulatory disorder (39.7%) and male factors (29.1%) were the main causes of primary infertility. In addition, 31 (17%) of the women were diagnosed with more than one cause. According to the logistic regression analysis, primary infertility was independently related to the old age of women (OR: 1.37; 95% CI: 1.14–13.63, P.value: 0.001), higher BMI (OR: 1.95; 95% CI: 1.87–4.14, P.value: 0.003), active smoking (OR: 1.47; 95% CI: 1.38–3.53, P.value: 0.012) and higher educational level (OR: 2.23; 95% CI: 1.12–5.53, P.value: 0.03). Conclusion: The prevalence of primary infertility in Iran was higher than the worldwide trends of infertility, indicating that understanding such risks help healthcare providers and policy makers to design and implement interventions to slow down this trend. PMID:26153187

  16. Male contraception.

    PubMed

    Wang, Christina; Swerdloff, Ronald S

    2002-04-01

    Currently approved male-directed contraceptive methods include condoms and vas occlusion. Vas occlusion is very effective but is intended to be non-reversible. Condoms have a relatively high failure rate, at least partially due to compliance problems and are not accepted by many couples. The only other male-oriented methods in clinical trials utilize the administration of testosterone alone or its combination with another gonadotropin-suppressing agent such as a progestin or a gonadotropin-releasing hormone antagonist. Studies published in the 1990s demonstrated that a testosterone-containing hormonal contraceptive method suppressed spermatogenesis to azoospermia in most men and severe oligozoospermia in the remaining. The contraceptive efficacy after treatment with testosterone alone was comparable to that of female hormonal methods. Having proven that reversible male contraception is a reality, present trials are attempting to identify the best androgen delivery system and the most effective androgen plus progestin preparation. It is likely that the first marketed male hormonal contraceptive method will be a long-acting (injectable or implant) combination of an androgen plus a progestin. Research is continuing to identify other target areas for male contraceptive development, including agents with post-testicular and epididymal sites of action.

  17. Population based model of human embryonic stem cell (hESC) differentiation during endoderm induction.

    PubMed

    Task, Keith; Jaramillo, Maria; Banerjee, Ipsita

    2012-01-01

    The mechanisms by which human embryonic stem cells (hESC) differentiate to endodermal lineage have not been extensively studied. Mathematical models can aid in the identification of mechanistic information. In this work we use a population-based modeling approach to understand the mechanism of endoderm induction in hESC, performed experimentally with exposure to Activin A and Activin A supplemented with growth factors (basic fibroblast growth factor (FGF2) and bone morphogenetic protein 4 (BMP4)). The differentiating cell population is analyzed daily for cellular growth, cell death, and expression of the endoderm proteins Sox17 and CXCR4. The stochastic model starts with a population of undifferentiated cells, wherefrom it evolves in time by assigning each cell a propensity to proliferate, die and differentiate using certain user defined rules. Twelve alternate mechanisms which might describe the observed dynamics were simulated, and an ensemble parameter estimation was performed on each mechanism. A comparison of the quality of agreement of experimental data with simulations for several competing mechanisms led to the identification of one which adequately describes the observed dynamics under both induction conditions. The results indicate that hESC commitment to endoderm occurs through an intermediate mesendoderm germ layer which further differentiates into mesoderm and endoderm, and that during induction proliferation of the endoderm germ layer is promoted. Furthermore, our model suggests that CXCR4 is expressed in mesendoderm and endoderm, but is not expressed in mesoderm. Comparison between the two induction conditions indicates that supplementing FGF2 and BMP4 to Activin A enhances the kinetics of differentiation than Activin A alone. This mechanistic information can aid in the derivation of functional, mature cells from their progenitors. While applied to initial endoderm commitment of hESC, the model is general enough to be applicable either to a system of

  18. Childhood Predictors of Male Criminality: A Prospective Population-Based Follow-up Study from Age 8 to Late Adolescence

    ERIC Educational Resources Information Center

    Sourander, Andre; Elonheimo, Henrik; Niemela, Solja; Nuutila, Ari-Matti; Helenius, Hans; Sillanmaki, Lauri; Piha, Jorma; Tamminen, Tuula; Kumpulainen, Kirsti; Moilanen, Irma; Almqvist, Frederik

    2006-01-01

    Objective: To study childhood predictors for late adolescence criminality. Method: The follow-up sample included 2,713 Finnish boys born in 1981. Information about the 8-year-old boys' problem behavior was obtained from parents, teachers, and the children themselves. The follow-up information about criminal offenses was based on the national…

  19. Population-Based Study of Incidence of Acute Abdominal Aortic Aneurysms With Projected Impact of Screening Strategy

    PubMed Central

    Howard, Dominic P J; Banerjee, Amitava; Fairhead, Jack F; Handa, Ashok; Silver, Louise E; Rothwell, Peter M

    2015-01-01

    Background Current abdominal aortic aneurysm (AAA) screening in men age 65 might have limited impact on overall AAA death rates if incidence is moving to older ages. Up-to-date population-based studies of age-specific incidence, risk factors, and outcome of acute AAA are needed to inform screening policy. Methods and Results In a prospective, population-based study (Oxfordshire, UK, 2002–2014), the incidence and outcome of acute AAA events were determined. Based on population projections and current incidence trends, the impact of screening strategies in the UK was estimated. Over the 12-year period, 103 incident acute AAA events occurred in the study population of 92 728. Incidence/100 000/year was 55 in men ages 65 to 74 years, but increased to 112 at 75 to 85 and 298 at ≥85, with 66.0% of all events occurring at age ≥75 years. Incidence at ages 65 to 74 was highest in male smokers (274), with 96.4% of events in men <75 years occurring in ever-smokers. Extrapolating rates to the UK population, using trial evidence of screening efficacy, the current UK screening program would prevent 5.6% of aneurysm-related deaths (315 200 scans/year: 1426/death prevented, 121/year-of-life saved). Screening only male smokers age 65 and then all men at age 75 would prevent 21.1% of deaths (247 900 scans/year; 297/death prevented, 34/year-of-life saved). By 2030, 91.0% of deaths will occur at age ≥75, 61.6% at ≥85, and 28.6% in women. Conclusions Given that two thirds of acute AAA occurred at ≥75 years of age, screening older age groups should be considered. Screening nonsmokers at age 65 is likely to have very little impact on AAA event rates. PMID:26289347

  20. Combining family- and population-based imputation data for association analysis of rare and common variants in large pedigrees.

    PubMed

    Saad, Mohamad; Wijsman, Ellen M

    2014-11-01

    In the last two decades, complex traits have become the main focus of genetic studies. The hypothesis that both rare and common variants are associated with complex traits is increasingly being discussed. Family-based association studies using relatively large pedigrees are suitable for both rare and common variant identification. Because of the high cost of sequencing technologies, imputation methods are important for increasing the amount of information at low cost. A recent family-based imputation method, Genotype Imputation Given Inheritance (GIGI), is able to handle large pedigrees and accurately impute rare variants, but does less well for common variants where population-based methods perform better. Here, we propose a flexible approach to combine imputation data from both family- and population-based methods. We also extend the Sequence Kernel Association Test for Rare and Common variants (SKAT-RC), originally proposed for data from unrelated subjects, to family data in order to make use of such imputed data. We call this extension "famSKAT-RC." We compare the performance of famSKAT-RC and several other existing burden and kernel association tests. In simulated pedigree sequence data, our results show an increase of imputation accuracy from use of our combining approach. Also, they show an increase of power of the association tests with this approach over the use of either family- or population-based imputation methods alone, in the context of rare and common variants. Moreover, our results show better performance of famSKAT-RC compared to the other considered tests, in most scenarios investigated here.

  1. Male circumcision.

    PubMed

    2012-09-01

    Male circumcision consists of the surgical removal of some, or all, of the foreskin (or prepuce) from the penis. It is one of the most common procedures in the world. In the United States, the procedure is commonly performed during the newborn period. In 2007, the American Academy of Pediatrics (AAP) convened a multidisciplinary workgroup of AAP members and other stakeholders to evaluate the evidence regarding male circumcision and update the AAP's 1999 recommendations in this area. The Task Force included AAP representatives from specialty areas as well as members of the AAP Board of Directors and liaisons representing the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, and the Centers for Disease Control and Prevention. The Task Force members identified selected topics relevant to male circumcision and conducted a critical review of peer-reviewed literature by using the American Heart Association's template for evidence evaluation. Evaluation of current evidence indicates that the health benefits of newborn male circumcision outweigh the risks; furthermore, the benefits of newborn male circumcision justify access to this procedure for families who choose it. Specific benefits from male circumcision were identified for the prevention of urinary tract infections, acquisition of HIV, transmission of some sexually transmitted infections, and penile cancer. Male circumcision does not appear to adversely affect penile sexual function/sensitivity or sexual satisfaction. It is imperative that those providing circumcision are adequately trained and that both sterile techniques and effective pain management are used. Significant acute complications are rare. In general, untrained providers who perform circumcisions have more complications than well-trained providers who perform the procedure, regardless of whether the former are physicians, nurses, or traditional religious providers. Parents are entitled to factually correct

  2. Public assistance, drug testing, and the law: the limits of population-based legal analysis.

    PubMed

    Player, Candice T

    2014-01-01

    In Populations, Public Health and the Law, legal scholar Wendy Parmet urges courts to embrace population-based legal analysis, a public health inspired approach to legal reasoning. Parmet contends that population-based legal analysis offers a way to analyze legal issues--not unlike law and economics--as well as a set of values from which to critique contemporary legal discourse. Population-based analysis has been warmly embraced by the health law community as a bold new way of analyzing legal issues. Still, population-based analysis is not without its problems. At times, Parmet claims too much territory for the population perspective. Moreover, Parmet urges courts to recognize population health as an important norm in legal reasoning. What should we do when the insights of public health and conventional legal reasoning conflict? Still in its infancy, population-based analysis offers little in the way of answers to these questions. This Article applies population-based legal analysis to the constitutional problems that arise when states condition public assistance benefits on passing a drug test, thereby highlighting the strengths of the population perspective and exposing its weaknesses.

  3. The impact of truncation and missing family links in population-based registers on familial risk estimates.

    PubMed

    Leu, Monica; Czene, Kamila; Reilly, Marie

    2007-12-15

    Family history information is often incomplete in population-based disease registers because of truncation and/or missing family links. In this study, the authors simulated complete populations of related individuals with realistic age, family structure, and incidence rates. After mimicking the realities of register-based data, such as left truncation of family history and missing family links due to death, the authors explored recovery of familial association parameters from standard epidemiologic models. Truncation of family history produced almost no bias for a familial risk of 2 and 50 years of follow-up, but it had a dramatic impact when the familial risk was 10. The age distribution of disease and the magnitude of background incidence rates also affected family history loss and thus the magnitude of bias. One can safeguard against bias by starting follow-up later, with the number of registration years to be ignored in the analysis depending on the value of familial risk. The missing familial links due to death had no effect, except when there was differential mortality for cases with and without a family history of disease. In summary, truncation, and to a lesser extent missing family links, induces bias in familial risk estimates from population-based registers.

  4. [Male contraception].

    PubMed

    Demery, A

    1987-05-01

    Except for condoms, male contraception is very slightly utilized in France. Several male experimental methods are under study. A synthetic luteinizing hormone-releasing hormone (LHRH) analog has been used successfully in women and offers promise in men of blocking LHRH and thus blocking spermatogenesis. Several nonsteroid substances such an hypertensives and adrenaline would suppress follicle stimulating hormone and luteinizing hormone release, but are too toxic for use. The combination of 40 mcg ethinyl estradiol and 20 mg of methyltestosterone inhibits gonadotropin release and produces azoospermia in men, but at the risk of loss of libido, constant gynecomastia, and testicular atrophy. Several combinations of androgens and progestins have been evaluated. Percutaneous testosterone and medroxyprogesterone acetate appears to be the most effective, with good metabolic tolerance and maintenance of libido and sexual performance. Injections of inhibine, a testicular factor that controls secretion of follicle stimulating hormone by feedback, offer promise of suppressing spermatogenesis without affecting other systems. Numerous substances are known to inhibit spermatogenesis but are to toxic for use or entail an unacceptable loss of libido. Gossypol has been employed as a contraceptive by the Chinese for its action in inhibiting protein synthesis, but it is known to have serious secondary effects. Among male methods currently in use, the condom had a Pearl index of .4-1.6 in the most recent British studies. Coitus interruptus can seriously interfere with sexual pleasure and has a failure rate of 25-30%. Vasectomy is safe, effective, and easy to perform, but is not a reversible method. The combination of 20 mg of medroxyprogesterone acetate in 2 daily doses and 100 mg of testosterone applied in an abdominal spray has given very promising results in 2 small studies in France and merits further development and diffusion.

  5. The changing face of thyroid cancer in a population-based cohort

    PubMed Central

    Alok Pathak, K; Leslie, William D; Klonisch, Thomas C; Nason, Richard W

    2013-01-01

    Abstract In North America, the incidence of thyroid cancer is increasing by over 6% per year. We studied the trends and factors influencing thyroid cancer incidence, its clinical presentation, and treatment outcome during 1970–2010 in a population-based cohort of 2306 consecutive thyroid cancers in Canada, that was followed up for a median period of 10.5 years. Disease-specific survival (DSS) and disease-free survival were estimated by the Kaplan–Meier method and the independent influence of various prognostic factors was evaluated by Cox proportional hazard models. Cumulative incidence of deaths resulting from thyroid cancer was calculated by competing risk analysis. A P-value <0.05 was considered to indicate statistical significance. The age standardized incidence of thyroid cancer by direct method increased from 2.52/100,000 (1970) to 9.37/100,000 (2010). Age at diagnosis, gender distribution, tumor size, and initial tumor stage did not change significantly during this period. The proportion of papillary thyroid cancers increased significantly (P < 0.001) from 58% (1970–1980) to 85.9% (2000–2010) while that of anaplastic cancer fell from 5.7% to 2.1% (P < 0.001). Ten-year DSS improved from 85.4% to 95.6%, and was adversely influenced by anaplastic histology (hazard ratio [HR] = 8.7; P < 0.001), male gender (HR = 1.8; P = 0.001), TNM stage IV (HR = 8.4; P = 0.001), incomplete surgical resection (HR = 2.4; P = 0.002), and age at diagnosis (HR = 1.05 per year; P < 0.001). There was a 373% increase in the incidence of thyroid cancer in Manitoba with a marked improvement in the thyroid cancer-specific survival that was independent of changes in patient demographics, tumor stage, or treatment practices, and is largely attributed to the declining proportion of anaplastic thyroid cancers. This article shows there is an increase in the incidence of thyroid cancers of all sizes in a population cohort in Canada. The improvement in thyroid

  6. Establishment of a Population-based Registry of Inflammatory Bowel Diseases in Fars Province, Iran.

    PubMed

    Taghavi, Seyed Alireza; Bagheri Lankarani, Kamran; Moini, Maryam; Hamidpour, Laleh; Ardebili, Maryam; Mansoorabadi, Zahra

    2012-04-01

    BACKGROUND Inflammatory bowel diseases (IBD) are debilitating diseases that lead to a variety of problems in a patient's daily life and are a huge burden for the health care system. Since this group of diseases are multifactorial and complex, long-term longitudinal studies are clearly needed to understand them better. A population-based registry (IBD-FaR) has been established in Fars, a southern Iranian province, with the intent to create a reliable data source. This registry will be of considerable help in future planning of health care resources necessary to deal with IBD and to enable investigators to test their theories on the origin and/or treatment of IBD. METHODS This registry is managed by both the Gastroenterohepatology Research Center and Health Policy Research Center at Shiraz University of Medical Sciences. A governing committee is responsible for decisions regarding budget allocations and use of data. The designed questionnaire includes a consent form, basic history data, risk factors, related procedures, medical therapy, and follow-up data. The establishment process has two parallel phases: in the first phase, data is collected from numerous sources, including annual hospital discharge data, referral from university affiliated physicians and private practices, pathologic reports, death certificates, self-referral, and insurance system data. In the interview, the questionnaire is completed and blood samples are taken. The gathered data are entered in a custom-designed, computerized data base. In the second phase, annual follow up interviews will be conducted. New IBD patients are also being registered. This phase will continue indefinitely, in order to include new incident cases. RESULTS Briefly, from May 2011 until December 2011, there were 188 patients [94 (50%) females and 94 (50%) males] diagnosed with IBD who were registered in IBD-FaR. Patients' age range was between 15 and 80 years. A total of 164 (87.2%) patients out of 188 were registered as

  7. Factors Predicting Reversion from Mild Cognitive Impairment to Normal Cognitive Functioning: A Population-Based Study

    PubMed Central

    Sachdev, Perminder S.; Lipnicki, Darren M.; Crawford, John; Reppermund, Simone; Kochan, Nicole A.; Trollor, Julian N.; Wen, Wei; Draper, Brian; Slavin, Melissa J.; Kang, Kristan; Lux, Ora; Mather, Karen A.; Brodaty, Henry; Team, Ageing Study

    2013-01-01

    Introduction Mild cognitive impairment (MCI) is associated with an increased risk of developing dementia. However, many individuals diagnosed with MCI are found to have reverted to normal cognition on follow-up. This study investigated factors predicting or associated with reversion from MCI to normal cognition. Methods Our analyses considered 223 participants (48.9% male) aged 71–89 years, drawn from the prospective, population-based Sydney Memory and Ageing Study. All were diagnosed with MCI at baseline and subsequently classified with either normal cognition or repeat diagnosis of MCI after two years (a further 11 participants who progressed from MCI to dementia were excluded). Associations with reversion were investigated for (1) baseline factors that included diagnostic features, personality, neuroimaging, sociodemographics, lifestyle, and physical and mental health; (2) longitudinal change in potentially modifiable factors. Results There were 66 reverters to normal cognition and 157 non-reverters (stable MCI). Regression analyses identified diagnostic features as most predictive of prognosis, with reversion less likely in participants with multiple-domain MCI (p = 0.011), a moderately or severely impaired cognitive domain (p = 0.002 and p = 0.006), or an informant-based memory complaint (p = 0.031). Reversion was also less likely for participants with arthritis (p = 0.037), but more likely for participants with higher complex mental activity (p = 0.003), greater openness to experience (p = 0.041), better vision (p = 0.014), better smelling ability (p = 0.040), or larger combined volume of the left hippocampus and left amygdala (p<0.040). Reversion was also associated with a larger drop in diastolic blood pressure between baseline and follow-up (p = 0.026). Discussion Numerous factors are associated with reversion from MCI to normal cognition. Assessing these factors could facilitate more accurate prognosis of

  8. Prenatal Exposure to Maternal Bereavement and Childbirths in the Offspring: A Population-Based Cohort Study

    PubMed Central

    Plana-Ripoll, Oleguer; Olsen, Jørn; Andersen, Per Kragh; Gómez, Guadalupe; Cnattingius, Sven; Li, Jiong

    2014-01-01

    Introduction The decline in birth rates is a concern in public health. Fertility is partly determined before birth by the intrauterine environment and prenatal exposure to maternal stress could, through hormonal disturbance, play a role. There has been such evidence from animal studies but not from humans. We aimed to examine the association between prenatal stress due to maternal bereavement following the death of a relative and childbirths in the offspring. Materials and Methods This population-based cohort study included all subjects born in Denmark after 1968 and in Sweden after 1973 and follow-up started at the age of 12 years. Subjects were categorized as exposed if their mothers lost a close relative during pregnancy or the year before and unexposed otherwise. The main outcomes were age at first child and age-specific mean numbers of childbirths. Data was analyzed using Cox Proportional Hazards models stratified by gender and adjusted for several covariates. Subanalyses were performed considering the type of relative deceased and timing of bereavement. Results A total of 4,121,596 subjects were followed-up until up to 41 years of age. Of these subjects, 93,635 (2.3%) were exposed and 981,989 (23.8%) had at least one child during follow-up time. Compared to unexposed, the hazard ratio (HR) [95% confidence interval] of having at least one child for exposed males and females were 0.98 [0.96–1.01] and 1.01 [0.98–1.03], respectively. We found a slightly reduced probability of having children in females born to mothers who lost a parent with HR = 0.97 [0.94–0.99] and increased probability in females born to mothers who lost another child (HR = 1.09 [1.04–1.14]), the spouse (HR = 1.29 [1.12–1.48]) or a sibling (HR = 1.13 [1.01–1.27]). Conclusions Our results suggested no overall association between prenatal exposure to maternal stress and having a child in early adulthood but a longer time of follow-up is necessary in order to reach a

  9. Age, sex, and road-use patterns of motor vehicular trauma in Rhode Island: A population-based hospital emergency department study

    SciTech Connect

    Rockett, I.R.H.; Lieberman, E.S.; Hollinshead, W.H.; Putnam, S.L.; Thode, H.C. Brigham and Women's Hospital, Boston, MA Brookhaven National Laboratory, Upton, NY )

    1990-12-01

    Population-based hospital emergency department data on motor vehicle traffic trauma in Rhode Island, 1984-85, are analyzed by age, sex, and road-use status. Annualized rates of overall and severe trauma were 1,195 cases (95% confidence interval (CI) = 1,164, 1,225) and 102 cases (95% CI = 94, 111) per 100,000 population, respectively. Overall and severe rates peaked at ages 15-24 years. Male rate excesses were most pronounced for motorcycle and pedal cycle trauma.

  10. Role of comorbidity on outcome of head and neck cancer: a population-based study in Thuringia, Germany.

    PubMed

    Göllnitz, Irene; Inhestern, Johanna; Wendt, Thomas G; Buentzel, Jens; Esser, Dirk; Böger, Daniel; Mueller, Andreas H; Piesold, Jörn-Uwe; Schultze-Mosgau, Stefan; Eigendorff, Ekkehard; Schlattmann, Peter; Guntinas-Lichius, Orlando

    2016-11-01

    To examine the impact of comorbidity on overall survival (OS) in a population-based study of patients with head and neck cancer who were treated between 2009 and 2011. Data of 1094 patients with primary head and neck carcinomas without distant metastasis from the Thuringian cancer registries were evaluated concerning the influence of patient's characteristics and comorbidity on OS. Data on comorbidity prior to head and neck cancer diagnosis was adapted to the Charlson Comorbidity (CCI), age-adjusted CCI (ACCI), head and neck CCI (HNCCI), simplified comorbidity score (SCS), and to the Adult Comorbidity Evaluation-27 (ACE-27). Most patients were male (80%; median age: 60 years; 50% stage IV tumors). Smoking, alcohol abuse, and anemia were registered for 38%, 33%, and 23% of the patients, respectively. Predominant therapy was surgery + radiochemotherapy (30%), surgery (29%), and surgery + radiotherapy (21%). Mean CCI, ACCI, HNCCI, SCS and ACE-27 were 1.0 ± 1.5, 2.6 ± 2.1, 0.6 ± 0.8, 4.4 ± 4.2, and 0.9 ± 0.9, respectively. Median follow-up was 25.7 months. Multivariable analyses showed that higher age, higher UICC stage, no therapy, including surgery or radiotherapy, alcohol abuse, and anemia, higher comorbidity were independent risk factors for worse OS (all P < 0.05). According to the discriminatory power analysis none of the five comorbidity scores was superior to the other scores to prognosticate OS. This population-based study showed that comorbidity is frequent in German patients with head and neck cancer and is an important risk factor for poor OS. Comorbidity should be routinely assessed and taken into account in prospective clinical trials.

  11. Adrenocortical carcinoma in children: first population-based clinicopathological study with long-term follow-up.

    PubMed

    Kerkhofs, T M A; Ettaieb, M H T; Verhoeven, R H A; Kaspers, G J L; Tissing, W J E; Loeffen, J; Van den Heuvel-Eibrink, M M; De Krijger, R R; Haak, H R

    2014-12-01

    Adrenocortical carcinoma (ACC) is rare in both adult and pediatric populations. Literature suggests significant differences between children and adults in presentation, histological properties and outcome. The aim of this first nationwide study on pediatric ACC was to describe the incidence, presentation, pathological characteristics, treatment and survival in The Netherlands. All ACC patients aged <20 years at diagnosis and registered in the population-based Netherlands Cancer Registry between 1993 and 2010 were included. Clinical data were extracted from medical records. Archival histological slides were collected via the Dutch Pathology Registry (PALGA). We compared our findings to all clinical studies on pediatric ACC that were found on PubMed. Based on the results, 12 patients were identified: 8 females and 4 males. The median age was 4.1 years (range 1.1-18.6). The population-based age-standardized incidence rate for patients <20 years was 0.18 per million person-years. Autonomous hormonal secretion was present in 10 patients. Seven patients were aged ≤4 years at diagnosis, 5 presented with localized disease and 2 with locally advanced disease. Five patients were aged ≥5 years, 3 presented with distant metastases and 1 with locally advanced disease. For all patients, histological examination displayed malignant characteristics. All patients aged ≤4 years at diagnosis survived; the median follow-up was 97 months (57-179 months). All patients aged ≥5 years died; the median survival was 6 months (0-38 months). Pediatric ACC is extremely rare in the Western world. The clinical outcome was remarkably better in patients aged ≤4 years. This is in accordance with less advanced stage of disease at presentation, yet contrasts with the presence of adverse histological characteristics. Clinical management in advanced disease is adapted from adult practice in the absence of evidence regarding pediatric ACC.

  12. PSYCHOPATHOLOGY IN THE AFTERMATH OF THE HAITI EARTHQUAKE: A POPULATION-BASED STUDY OF POSTTRAUMATIC STRESS DISORDER AND MAJOR DEPRESSION

    PubMed Central

    Cerdá, Magdalena; Paczkowski, Magdalena; Galea, Sandro; Nemethy, Kevin; Péan, Claude; Desvarieux, Moïse

    2013-01-01

    Background In the first population-based study of psychopathology conducted in Haiti, we documented earthquake-related experiences associated with risk for posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) 2–4 months following the 2010 Haiti earthquake. Methods A population-based survey was conducted of 1,323 survivors randomly selected from the general nondisplaced community, internally displaced persons camps, and a community clinic. Respondents were from the Nazon area of Port-au-Prince, ~20 miles from the epicenter. Results Respondents (90.5%) reported at least one relative/close friend injured/killed, 93% saw dead bodies, and 20.9% lost their job post-earthquake. The prevalence of PTSD (24.6%) and MDD (28.3%) was high. History of violent trauma was associated with risk of PTSD and MDD (adjusted odds ratio [AOR] 1.4, 95% confidence interval [CI], 1.0–1.9; AOR, 1.7, 95% CI 1.3, 2.2, respectively). Low social support (AOR, 1.7, 95% CI 1.2, 2.3; AOR 1.4, 95% CI 1.0, 1.9, respectively) increased risk of PTSD and MDD among women. Suffering damage to the home increased risk of MDD in males (AOR 2.8, 95% CI 1.5, 5.5). Associations between being trapped in rubble, major damage to house, job loss, and PTSD; and participation in rescue/recovery, friends/family injured/killed, and MDD varied based on prior history of violent trauma. Conclusions Addressing mental health in a post-earthquake setting such as Haiti will require focusing resources on screening and treatment of identified vulnerable groups while targeting improvement of post-earthquake living conditions. Investment in sources of social support for women may make help mitigate the vulnerability of women to PTSD and MDD. PMID:23124841

  13. Male catheterization.

    PubMed

    Hadfield-Law, L

    2001-10-01

    The insertion of catheters into male emergency patients is fairly common practice and is associated with a worryingly high rate of infection. Everyday pressures within the department, along with the added stress of resuscitation can result in inappropriately trained or skilled staff undertaking this procedure. The issue of gender and whether female nurses should catheterize male patients may also affect this vulnerable group of patients. Acquiring the psychomotor skills of inserting a urethral catheter is only one part of preparation for practice. Emergency nurses must know when and when not to resort to catheterization. Choosing the type and size of catheter requires careful judgment. What will you do if insertion proves difficult? Prevention of infection is of paramount importance and there are an increasing number of evidence-based sources of information, which are crucial to formulating procedures and informing every day practice. In the pressured surroundings of A&E departments, it is easy to ignore the vulnerability of men requiring catheterization, both from a physical and psychological point of view. Making the effort to explain the procedure, listen to questions and concerns and record relevant details in the notes, will take only a few extra moments. There is no doubt that urinary catheterization is not without complications. It is associated with significant morbidity and occasionally, mortality.

  14. Long-Term Prediction of the Demand of Colonoscopies Generated by a Population-Based Colorectal Cancer Screening Program

    PubMed Central

    Mendivil, Joan; Andreu, Montserrat; Hernández, Cristina; Castells, Xavier

    2016-01-01

    Objective To estimate the long-term need for colonoscopies after a positive fecal immunochemical test (FIT) and post-polypectomy surveillance in the context of a population-based colorectal cancer (CRC) screening program. Methods A discrete-event simulation model was built to reproduce the process of CRC screening and post-polypectomy surveillance following European guidelines in a population of 100,000 men and women aged 50–69 years over a 20-year period. Screening consisted of biennial FIT and colonoscopy in participants with positive results. The model was mainly fed using data from the first and second rounds of a Spanish program (2010–2013). Data on post-polypectomy surveillance results were obtained from the literature. A probabilistic multivariate sensitivity analysis was performed on the effect of participation, FIT positivity, and adherence to surveillance colonoscopies. The main outcome variables were the number of colonoscopies after a positive FIT, surveillance colonoscopies, and the overall number of colonoscopies. Results An average yearly number of 1,200 colonoscopies after a positive FIT were predicted per 100,000 inhabitants with a slight increase to 1,400 at the end of the 20-year period. Surveillance colonoscopies increased to an average of 1,000 per 100,000 inhabitants in the long-term, showing certain stabilization in the last years of the 20-year simulation horizon. The results were highly sensitive to FIT positivity. Conclusions Implementing a population-based CRC screening program will increase the demand for colonoscopies, which is expected to double in 20 years, mainly due to an increase in surveillance colonoscopies. PMID:27732635

  15. Gastric cancer burden of last 40 years in North China (Hebei Province): A population-based study.

    PubMed

    Liang, Di; Liang, Suoyuan; Jin, Jing; Li, Daojuan; Shi, Jin; He, Yutong

    2017-01-01

    Gastric cancer (GC) is the second leading cause of cancer death in China. It is well known that Cixian in Hebei Province is one of the highest risk areas of GC in China and worldwide. This study aims to accurate assessment of GC burden and trend in high-risk area (Hebei Province) from 1973 to 2013. The authors analyzed GC data from 21 population-based cancer registries which represented 15.25% of the entire population of Hebei Province. The collected data were stratified by 5-year age groups, gender, and area. Mortality of GC was extracted from national death surveys from 1973 to 1975, 1990 to 1992, 2004 to 2005, and 2011 to 2013. Trend analysis (1988-2013) in a high-risk area (Cixian) used the Joinpoint Model. The age-period-cohort model was used to estimate the effects of age, period, and birth cohort in GC incidence in Cixian from 1988 to 2013. The crude incidence of GC in 2011 to 2013 was 40.37/100,000 (57.53/100,000 in males and 22.55/100,000 in females). The corresponding age-standardized rate by world age-standard population was 32.18/100,000 (48.87/100,000 in males and 17.53/100,000 in females), which was 2.66-fold (2.81-fold in male and 2.34-fold in female) higher than that in the world (12.1/100,000, 17.4/100,000 in males and 7.5/100,000 in females). Males in rural areas had the highest incidence, with an age-standardized rate of 70.51/100,000. Gastric cardia cancer was primary anatomical subsite which accounting for 59.59% in GC, followed by gastric corpus (13.92%), gastric antrum (11.43%), gastric fundus (4.99%), and overlapping lesion of gastric (4.17%). The age-standardized rate of mortality from GC displayed a significant downward trend (P = 0.019) in Hebei Province from the 1990s (31.44/100,000) to the 2010s (24.63/100,000). In Cixian, the incidence of GC rose from 1988 (38.25/100,000) to 2009 (65.11/100,000). Cixian, where population-based screening of upper gastrointestinal cancer was performed, experienced the increasing rate of GC from 2000

  16. Cancer incidence in North West Algeria (Mascara) 2000-2010: results from a population-based cancer registry

    PubMed Central

    Benarba, Bachir; Meddah, Boumedienne; Hamdani, Houria

    2014-01-01

    Cancer is a leading cause of death worldwide accounting for 7.4 million deaths. Cancer has become a major public health concern in Algeria. The aim of the present study was to estimate cancer incidence in Mascara Province based on the population-based cancer registry. We analyzed data from the cancer registry of Mascara covering all cancer cases diagnosed by all methods and included in the registry from 1st January 2000 to 31st December 2010. The results are presented as incidence rates of cases by site, sex, age, and crude rate. Age-standardized rates per 100,000 person-years (ASRs) were calculated, using the direct method of standardization to the world population. A total of 1875 cases of invasive cancer were recorded. The mean age of diagnosis for all cancers was 52.66 ± 0.5 in men and 59.18 ± 0.6 in women. The ASR for all cancers in females was 27.8 per 100,000, and that for males was 23.6 per 100,000. The most important finding of the present study was the high incidence of liver cancer among males and females in Mascara. Among females, breast cancer was the most frequently reported followed by Cervix uteri, liver and colon. The most frequent cancer types in males were lung, colon, esophagus and stomach and liver. Cancer incidence in Mascara province was lower than that reported in other national and regional registries. Findings of the present study revealed high incidence of liver cancer in the province, the highest in Algeria, suggesting high prevalence of risk factors. PMID:26417294

  17. Statin use and its effect on all-cause mortality of melanoma patients: a population-based Dutch cohort study

    PubMed Central

    Livingstone, Elisabeth; Hollestein, Loes M; van Herk-Sukel, Myrthe P P; van de Poll-Franse, Lonneke; Joosse, Arjen; Schilling, Bastian; Nijsten, Tamar; Schadendorf, Dirk; de Vries, Esther

    2014-01-01

    Preclinical data showed anticancer effects of statins in melanoma, but meta-analyses could not demonstrate a reduced melanoma incidence in statin users. Rather than preventing occurrence, statins might reduce growth and metastatic spread of melanomas and ultimately improve survival. In this population-based study, we investigated the relationship between statin use and survival of melanoma patients. Patients ≥18 years who were diagnosed with cutaneous melanoma (Breslow thickness >1 mm) and registered in the Eindhoven Cancer Registry and in PHARMO Database Network between 1 January 1998 and 31 December 2010 were eligible. The hazard ratio (HR) of all-cause mortality was calculated by employing adjusted time-dependent and time-fixed Cox proportional hazard models. Disease-specific survival was estimated by means of 3-year relative survival rates (RSR). A control cohort of randomly selected patients using statins from PHARMO Database Network matched on age and gender was used to compare RSR of statin users to the general population. After melanoma diagnosis, 171 of 709 patients used statins. Use of statins showed a nonsignificantly decreased hazard of death (adjusted HR 0.76, 95% confidence interval [CI] 0.50–1.61). After stratification for gender, male but not female statin users showed a favorable outcome compared to nonusers (HR 0.57, 95% CI 0.32–0.99; HR 1.22, 95% CI 0.62–2.38, respectively). Three-year RSR for male statin users tended to be higher than for nonusers (91% vs. 80.5%, P = 0.06), no differences were observed in women (87.1% vs. 92.5%, P = 0.76). Statin use was not associated with an improved survival of melanoma patients. The trend for better survival of male in contrast to female statin users warrants further research. PMID:24935402

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

  19. HIV/AIDS Misconceptions among Latinos: Findings from a Population-Based Survey of California Adults

    ERIC Educational Resources Information Center

    Ritieni, Assunta; Moskowitz, Joel; Tholandi, Maya

    2008-01-01

    Misconceptions about HIV/AIDS among Latino adults (N=454) in California were examined using data from a population-based telephone survey conducted in 2000. Common misconceptions concerning modes of HIV transmission included transmission via mosquito or animal bite (64.1%), public facilities (48.3%), or kissing someone on the cheek (24.8%). A…

  20. Epilepsy Among Children and Adolescents with Autism Spectrum Disorders: A Population-Based Study

    ERIC Educational Resources Information Center

    Jokiranta, Elina; Sourander, Andre; Suominen, Auli; Timonen-Soivio, Laura; Brown, Alan S.; Sillanpää, Matti

    2014-01-01

    The present population-based study examines associations between epilepsy and autism spectrum disorders (ASD). The cohort includes register data of 4,705 children born between 1987 and 2005 and diagnosed as cases of childhood autism, Asperger's syndrome or pervasive developmental disorders--not otherwise specified. Each case was matched to four…

  1. Probabilistic estimation of residential air exchange rates for population-based human exposure modeling

    EPA Science Inventory

    Residential air exchange rates (AERs) are a key determinant in the infiltration of ambient air pollution indoors. Population-based human exposure models using probabilistic approaches to estimate personal exposure to air pollutants have relied on input distributions from AER meas...

  2. Methods of Suicide among Cancer Patients: A Nationwide Population-Based Study

    ERIC Educational Resources Information Center

    Chung, Kuo-Hsuan; Lin, Herng-Ching

    2010-01-01

    A 3-year nationwide population-based data set was used to explore methods of suicide (violent vs. nonviolent) and possible contributing factors among cancer patients in Taiwan. A total of 1,065 cancer inpatients who committed suicide were included as our study sample. The regression shows that those who had genitourinary cancer were 0.55 times (p…

  3. Sexually Transmitted Diseases and Risk Behaviors among California Farmworkers: Results from a Population-Based Survey

    ERIC Educational Resources Information Center

    Brammeier, Monique; Chow, Joan M.; Samuel, Michael C.; Organista, Kurt C.; Miller, Jamie; Bolan, Gail

    2008-01-01

    Context: The prevalence of sexually transmitted diseases and associated risk behaviors among California farmworkers is not well described. Purpose: To estimate the prevalence of sexually transmitted diseases (STDs) and associated risk behaviors among California farmworkers. Methods: Cross-sectional analysis of population-based survey data from 6…

  4. Psychological Abuse between Parents: Associations with Child Maltreatment from a Population-Based Sample

    ERIC Educational Resources Information Center

    Chang, Jen Jen; Theodore, Adrea D.; Martin, Sandra L.; Runyan, Desmond K.

    2008-01-01

    Objective: This study examined the association between partner psychological abuse and child maltreatment perpetration. Methods: This cross-sectional study examined a population-based sample of mothers with children aged 0-17 years in North and South Carolina (n = 1,149). Mothers were asked about the occurrence of potentially neglectful or abusive…

  5. Mortality in Adults with Moderate to Profound Intellectual Disability: A Population-Based Study

    ERIC Educational Resources Information Center

    Tyrer, F.; Smith, L. K.; McGrother, C. W.

    2007-01-01

    Background: People with intellectual disability (ID) experience a variety of health inequalities compared with the general population including higher mortality rates. This is the first UK population-based study to measure the extent of excess mortality in people with ID compared with the general population. Method: Indirectly standardized…

  6. Long-Term Benefits of Full-Day Kindergarten: A Longitudinal Population-Based Study

    ERIC Educational Resources Information Center

    Brownell, M. D.; Nickel, N. C.; Chateau, D.; Martens, P. J.; Taylor, C.; Crockett, L.; Katz, A.; Sarkar, J.; Burland, E.; Goh, C. Y.

    2015-01-01

    In the first longitudinal, population-based study of full-day kindergarten (FDK) outcomes beyond primary school in Canada, we used linked administrative data to follow 15 kindergarten cohorts (n ranging from 112 to 736) up to grade 9. Provincial assessments conducted in grades 3, 7, and 8 and course marks and credits earned in grade 9 were…

  7. A Population-Based Study of Preschoolers' Food Neophobia and Its Associations with Food Preferences

    ERIC Educational Resources Information Center

    Russell, Catherine Georgina; Worsley, Anthony

    2008-01-01

    Objective: This cross-sectional study was designed to investigate the relationships between food preferences, food neophobia, and children's characteristics among a population-based sample of preschoolers. Design: A parent-report questionnaire. Setting: Child-care centers, kindergartens, playgroups, day nurseries, and swimming centers. Subjects:…

  8. Risk of fragility fracture among patients with sarcoidosis: a population-based study 1976-2013.

    PubMed

    Ungprasert, P; Crowson, C S; Matteson, E L

    2017-02-16

    Incidence of fragility fracture of a population-based cohort of 345 patients with sarcoidosis was compared with age and sex-matched comparators. The incidence of fragility fracture was higher among patients with sarcoidosis with hazard ratio (HR) of 2.18.

  9. Understanding Disabled Childhoods: What Can We Learn from Population-Based Studies?

    ERIC Educational Resources Information Center

    Emerson, Eric

    2012-01-01

    This article illustrates the potential value of undertaking secondary analyses of large-scale population-based survey data to better inform our understanding of disabled childhoods. It is argued that while such approaches can never address the lived experience of growing up with disability, they can provide valuable insights into the ways in which…

  10. Associated Medical Disorders and Disabilities in Children with Autistic Disorder: A Population-Based Study

    ERIC Educational Resources Information Center

    Kielinen, Marko; Rantala, Heikki; Timonen, Eija; Linna, Sirkka-Liisa; Moilanen, Irma

    2004-01-01

    A population-based survey was conducted among 152,732 Finnish children and adolescents aged under 16 years and living in northern Finland. Diagnoses and associated medical conditions were derived from the hospital and institutional records of this area. One hundred and eighty-seven children with DSM-IV autistic disorder were identified. Associated…

  11. Relationship Status among Parents of Children with Autism Spectrum Disorders: A Population-Based Study

    ERIC Educational Resources Information Center

    Freedman, Brian H.; Kalb, Luther G.; Zablotsky, Benjamin; Stuart, Elizabeth A.

    2012-01-01

    Despite speculation about an 80% divorce rate among parents of children with an Autism Spectrum Disorder (ASD), very little empirical and no epidemiological research has addressed the issue of separation and divorce among this population. Data for this study was taken from the 2007 National Survey of Children's Health, a population-based,…

  12. Evaluating Nicotine Replacement Therapy and Stage-Based Therapies in a Population-Based Effectiveness Trial

    ERIC Educational Resources Information Center

    Velicer, Wayne F.; Friedman, Robert H.; Fava, Joseph L.; Gulliver, Suzy B.; Keller, Stefan; Sun, Xiaowu; Ramelson, Harley; Prochaska, James O.

    2006-01-01

    Pharmacological interventions for smoking cessation are typically evaluated using volunteer samples (efficacy trials) but should also be evaluated in population-based trials (effectiveness trials). Nicotine replacement therapy (NRT) alone and in combination with behavioral interventions was evaluated on a population of smokers from a New England…

  13. Paediatric cancer stage in population-based cancer registries: the Toronto consensus principles and guidelines.

    PubMed

    Gupta, Sumit; Aitken, Joanne F; Bartels, Ute; Brierley, James; Dolendo, Mae; Friedrich, Paola; Fuentes-Alabi, Soad; Garrido, Claudia P; Gatta, Gemma; Gospodarowicz, Mary; Gross, Thomas; Howard, Scott C; Molyneux, Elizabeth; Moreno, Florencia; Pole, Jason D; Pritchard-Jones, Kathy; Ramirez, Oscar; Ries, Lynn A G; Rodriguez-Galindo, Carlos; Shin, Hee Young; Steliarova-Foucher, Eva; Sung, Lillian; Supriyadi, Eddy; Swaminathan, Rajaraman; Torode, Julie; Vora, Tushar; Kutluk, Tezer; Frazier, A Lindsay

    2016-04-01

    Population-based cancer registries generate estimates of incidence and survival that are essential for cancer surveillance, research, and control strategies. Although data on cancer stage allow meaningful assessments of changes in cancer incidence and outcomes, stage is not recorded by most population-based cancer registries. The main method of staging adult cancers is the TNM classification. The criteria for staging paediatric cancers, however, vary by diagnosis, have evolved over time, and sometimes vary by cooperative trial group. Consistency in the collection of staging data has therefore been challenging for population-based cancer registries. We assembled key experts and stakeholders (oncologists, cancer registrars, epidemiologists) and used a modified Delphi approach to establish principles for paediatric cancer stage collection. In this Review, we make recommendations on which staging systems should be adopted by population-based cancer registries for the major childhood cancers, including adaptations for low-income countries. Wide adoption of these guidelines in registries will ease international comparative incidence and outcome studies.

  14. Big data for population-based cancer research: the integrated cancer information and surveillance system.

    PubMed

    Meyer, Anne-Marie; Olshan, Andrew F; Green, Laura; Meyer, Adrian; Wheeler, Stephanie B; Basch, Ethan; Carpenter, William R

    2014-01-01

    The Integrated Cancer Information and Surveillance System (ICISS) facilitates population-based cancer research by developing extensive information technology systems that can link and manage large data sets. Taking an interdisciplinary 'team science' approach, ICISS has developed data, systems, and methods that allow researchers to better leverage the power of big data to improve population health.

  15. A Population-Based Longitudinal Study of Depression in Children with Developmental Disabilities in Manitoba

    ERIC Educational Resources Information Center

    Shooshtari, Shahin; Brownell, Marni; Dik, Natalia; Chateau, Dan; Yu, C. T.; Mills, Rosemary S. L.; Burchill, Charles A.; Wetzel, Monika

    2014-01-01

    In this population-based study, prevalence of depression was estimated and compared between children with and without developmental disability (DD). Twelve years of administrative data were linked to identify a cohort of children with DD living in the Canadian province of Manitoba. Children in the study cohort were matched with children without DD…

  16. Understanding Risk and Protective Factors for Child Maltreatment: The Value of Integrated, Population-Based Data

    ERIC Educational Resources Information Center

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

    2013-01-01

    In this article, we argue for expanded efforts to integrate administrative data systems as a "practical strategy" for developing a richer understanding of child abuse and neglect. Although the study of child maltreatment is often critiqued for being atheoretical, we believe that a more pressing concern is the absence of population-based and…

  17. The role of area-level deprivation and gender in participation in population-based faecal immunochemical test (FIT) colorectal cancer screening.

    PubMed

    Clarke, Nicholas; McNamara, Deirdre; Kearney, Patricia M; O'Morain, Colm A; Shearer, Nikki; Sharp, Linda

    2016-12-01

    This study aimed to investigate the effects of sex and deprivation on participation in a population-based faecal immunochemical test (FIT) colorectal cancer screening programme. The study population included 9785 individuals invited to participate in two rounds of a population-based biennial FIT-based screening programme, in a relatively deprived area of Dublin, Ireland. Explanatory variables included in the analysis were sex, deprivation category of area of residence and age (at end of screening). The primary outcome variable modelled was participation status in both rounds combined (with "participation" defined as having taken part in either or both rounds of screening). Poisson regression with a log link and robust error variance was used to estimate relative risks (RR) for participation. As a sensitivity analysis, data were stratified by screening round. In both the univariable and multivariable models deprivation was strongly associated with participation. Increasing affluence was associated with higher participation; participation was 26% higher in people resident in the most affluent compared to the most deprived areas (multivariable RR=1.26: 95% CI 1.21-1.30). Participation was significantly lower in males (multivariable RR=0.96: 95%CI 0.95-0.97) and generally increased with increasing age (trend per age group, multivariable RR=1.02: 95%CI, 1.01-1.02). No significant interactions between the explanatory variables were found. The effects of deprivation and sex were similar by screening round. Deprivation and male gender are independently associated with lower uptake of population-based FIT colorectal cancer screening, even in a relatively deprived setting. Development of evidence-based interventions to increase uptake in these disadvantaged groups is urgently required.

  18. Sexually antagonistic selection in human male homosexuality.

    PubMed

    Camperio Ciani, Andrea; Cermelli, Paolo; Zanzotto, Giovanni

    2008-06-18

    Several lines of evidence indicate the existence of genetic factors influencing male homosexuality and bisexuality. In spite of its relatively low frequency, the stable permanence in all human populations of this apparently detrimental trait constitutes a puzzling 'Darwinian paradox'. Furthermore, several studies have pointed out relevant asymmetries in the distribution of both male homosexuality and of female fecundity in the parental lines of homosexual vs. heterosexual males. A number of hypotheses have attempted to give an evolutionary explanation for the long-standing persistence of this trait, and for its asymmetric distribution in family lines; however a satisfactory understanding of the population genetics of male homosexuality is lacking at present. We perform a systematic mathematical analysis of the propagation and equilibrium of the putative genetic factors for male homosexuality in the population, based on the selection equation for one or two diallelic loci and Bayesian statistics for pedigree investigation. We show that only the two-locus genetic model with at least one locus on the X chromosome, and in which gene expression is sexually antagonistic (increasing female fitness but decreasing male fitness), accounts for all known empirical data. Our results help clarify the basic evolutionary dynamics of male homosexuality, establishing this as a clearly ascertained sexually antagonistic human trait.

  19. Sexually Antagonistic Selection in Human Male Homosexuality

    PubMed Central

    Camperio Ciani, Andrea; Cermelli, Paolo; Zanzotto, Giovanni

    2008-01-01

    Several lines of evidence indicate the existence of genetic factors influencing male homosexuality and bisexuality. In spite of its relatively low frequency, the stable permanence in all human populations of this apparently detrimental trait constitutes a puzzling ‘Darwinian paradox’. Furthermore, several studies have pointed out relevant asymmetries in the distribution of both male homosexuality and of female fecundity in the parental lines of homosexual vs. heterosexual males. A number of hypotheses have attempted to give an evolutionary explanation for the long-standing persistence of this trait, and for its asymmetric distribution in family lines; however a satisfactory understanding of the population genetics of male homosexuality is lacking at present. We perform a systematic mathematical analysis of the propagation and equilibrium of the putative genetic factors for male homosexuality in the population, based on the selection equation for one or two diallelic loci and Bayesian statistics for pedigree investigation. We show that only the two-locus genetic model with at least one locus on the X chromosome, and in which gene expression is sexually antagonistic (increasing female fitness but decreasing male fitness), accounts for all known empirical data. Our results help clarify the basic evolutionary dynamics of male homosexuality, establishing this as a clearly ascertained sexually antagonistic human trait. PMID:18560521

  20. Factors Associated with Disability in Rural Bangladesh: Bangladesh Population-Based Diabetes and Eye Study (BPDES)

    PubMed Central

    Islam, Fakir M. Amirul; Bhowmik, Jahar L.; Islam, Silvia Z.; Renzaho, Andre M. N.; Hiller, Janet E.

    2016-01-01

    Background To assess factors associated with disability in a rural district of Bangladesh. Methods Using a population-based systematic sampling technique, data were collected from 3104 adults aged ≥ 30 years from the Banshgram union of Narail district. Data collected included an interviewer administered questionnaire to report physical disabilities including impairment that prevents engagement with paid work, visual, hearing, and mobility as well as mental disabilities. Socio-demographic and anthropometric factors including educational attainment and body mass index, as well as clinical factors such as blood pressure, and fasting blood glucose were also collected. Binary and multinomial logistic regression techniques were used to explore the association of various socio-demographic and clinical factors with disability. Results The mean (SD), minimum and maximum ages of the participants were 51 (12), 30 and 89 years. Of total participants, 65% were female. The prevalence of disability varied from 29.1% for visual impairment (highest) to 16.5% for hearing, 14.7% for movement difficulties and 1.6% (lowest) for any other disability that prevented engagement with paid work. Overall, the prevalence of a single disability was 28.6% and that of two or more disabilities was 14.7%. Older age, gender (female), lower socio-economic status (SES), and hypertension were associated with a higher prevalence of most of the disability components. The prevalence of hearing problems (24.5% vs. 13.3%, p<0.001) and movement difficulties (24.9% vs. 13.0%, p<0.001) was significantly higher among lower-income participants than their higher-income counterparts after controlling for age. Prevalence of visual impairment (54.6% vs. 9.2%, p<0.001), hearing (32.2% vs. 6.7%, p<0.001) and movement difficulties (29.2% vs. 5.5%, p<0.001) were significantly higher in people of aged 60 years or older than those aged 30–34 years. After multivariate adjustment, the prevalence of single disability

  1. Simulation of the migration and transformation of petroleum pollutants in the soils of the Loess plateau: a case study in the Maling oil field of northwestern China.

    PubMed

    Pan, Feng; Ma, Jinzhu; Wang, Yunquan; Zhang, Yali; Chen, Lihua; Edmunds, W Mike

    2013-10-01

    We developed a coupled water-oil simulation model to simulate the migration and transformation of petroleum-derived contaminants in the soil of the Xifeng oil field. To do so, we used the HYDRUS-2D model, which simulates the diffusion, adsorption or desorption, and microbial degradation of petroleum-derived hydrocarbons in the soil-water system. The saturated soil hydraulic conductivity of petroleum-derived pollutants was 0.05 cm day(-1), which is about 1 to 2 % of the soil moisture permeability coefficient. Our numerical simulation results show that spilled crude oil was mainly concentrated in the surface horizons of the soil. The organic pollutant concentration tended to be highest nearest to the pollution source. The pollutant migration was generally concentrated within the top 20 to 30 cm of the soil, with the maximum concentration in the top 5 cm of the soil. With passing time, the pollutant accumulation increased and the adsorption and degradation functions reached a dynamic balance with the input rate at depths greater than 30 cm below the soil surface. The oil-derived pollutants totaled 50 to 100 mg kg(-1) under the dynamic balance condition, which occurred after 20 to 30 years. The petroleum-derived pollutant concentration in the loess soil was inversely correlated with the horizontal distance from the oil well, and the concentration decreased greatly at a distance greater than 40 m from the well.

  2. [Male contraception].

    PubMed

    Demoulin, A

    1984-04-01

    Among the reasons why male hormonal contraception has lagged behind female methods are the necessity of preserving virility, the fact that spermatogenesis is a continuous process, the need to control secondary effects and toxicity, and the requirement that modes of administration be acceptable to both partners. Among currently available reversible mehtods, withdrawal is undoubtedly the most ancient. It is still widespread but cannot be recommended because of its limited effectiveness. The condom is used by about 10% of couples worldwide as a principal or temporary method, but its inter-ference with sensation has limited its acceptance. Condoms are nevertheless highly effective when used with a spermicide. Various androgens are currently under investigation. High doses of testosterone can induce azoospermia without affecting libido but their side effects may be serious. The use of combinations of steroids permits doses to be reduced and offers promise for the future. The combination of oral medroxyprogesterone acetate and percutaneous testosterone is one of the better approaches; the combination is effective and nontoxic but has the disadvantage of percutaneous administration. Gossypol, a pigment extracted from the cotton plant, has been used as a contraceptive in China with a reported efficacy of 99.89%, recovery of fertility within 3 months, and no effect on future fertility. However, its toxicity appears to be significant in the animal and its reversibility is uncertain. A search is on for analogs which would preserve the contraceptive effects while eliminating toxic effects. Several gonadotropin releasing hormone (GnRH) analogs under investigation for their interference with spermatogenesis have given promising results. Several chemicals tested for contraceptive effects have had unacceptably high toxicity. Chinese investigators have reported good results with various physical methods of interfering with sperm production, but their reversibility and innocuity

  3. Mental health indicators fifty years later: A population-based study of men with histories of child sexual abuse.

    PubMed

    Easton, Scott D; Kong, Jooyoung

    2017-01-01

    Childhood sexual abuse (CSA) is a widely acknowledged trauma that affects a substantial number of boys/men and has the potential to undermine mental health across the lifespan. Despite the topic's importance, few studies have examined the long-term effects of CSA on mental health in middle and late life for men. Most empirical studies on the effects of CSA have been conducted with women, non-probability samples, and samples of young or emerging adults with inadequate control variables. Based on complex trauma theory, the current study investigated: a) the effect of CSA on mental health outcomes (depressive symptoms, somatic symptom severity, hostility) in late life for men, and b) the moderating effects of childhood adversities and masculine norms in the relationship between CSA and the three mental health outcomes. Using a population-based sample from the 2004-2005 Wisconsin Longitudinal Study, multivariate analyses found that CSA was positively related to both depressive and somatic symptoms and increased the likelihood of hostility for men who reported a history of CSA. Both childhood adversities and masculine norms were positively related to the three outcomes for the entire sample. Among CSA survivors, childhood adversities exerted a moderating effect in terms of depressive symptoms. Mental health practitioners should include CSA and childhood adversities in assessment and treatment with men. To more fully understand the effects of CSA, future studies are needed that use longitudinal designs, compare male and female survivors, and examine protective mechanisms such as social support.

  4. No increases in the rate of undescended testis in Hungary during the last 50 years: A population-based study.

    PubMed

    Mavrogenis, Stelios; Ács, Nándor; Czeizel, Andrew E

    2015-08-01

    Undescended testis (cryptorchidism) is a common structural birth defect, i.e. congenital abnormality of the male genital organs and increasing trend in its birth prevalence was reported in some countries. The aim of this study was to analyze the recorded annual birth prevalence of isolated undescended testis (IUT) in the population-based large dataset of the Hungarian Congenital Abnormality Registry for the period between 1962 and 2011, i.e. during the last 50 years. Cases with IUT reported after births were evaluated, and their annual rate per 1000 live-births was calculated. The rates of cases with IUT were compared with the so-called true rate of IUT measured in a previous clinical-epidemiological study based on the personal examination of 10,203 newborn infants. The birth prevalence of cases with recorded IUT in Hungary was lower than expected based on the true rate of IUT. Thus the two waves in the rate of IUT were connected with the different completeness of reporting. In conclusion the birth prevalence of cases with IUT in Hungary did not indicate a real increasing trend during the last 50 years.

  5. What is past is prologue: A population-based case-control study of repeat victimization, premature mortality, and homicide.

    PubMed

    Pridemore, William Alex; Berg, Mark T

    2017-04-01

    We examined risk of male premature mortality associated with recent criminal victimization. Prior victimization is among the most consistent predictors of future risk but the explanation of repeat victimization remains elusive. Two general perspectives frame this debate. According to the state-dependence perspective, repeat victimization is forged through intervening processes connecting an initial with a subsequent violent victimization. According to the risk-heterogeneity perspective, this association is spurious because all victimization events for a person result from underlying individual traits. Research on health outcomes and premature mortality provides related, but often overlooked, conceptual assumptions about the co-occurring health burden of preventable injuries and disease. We extend and apply each of these perspectives in the current study to assess the nature and sources of repeat violent victimization. Data were from the Izhevsk (Russia) Family Study, a large-scale population-based case-control study. Cases (n = 1750) were all male deaths aged 25-54 living in Izhevsk between October 2003 and October 2005. Controls (n = 1750) were randomly selected from a city population register. Key independent variables were prior year prevalence of violent, property, and residential victimization. We used logistic regression to estimate mortality odds ratios. Results provided evidence for state dependence. We found that (i) after controlling for indicators of risk heterogeneity men who had been victims of violence (but not property or residential crime) within the past year were 2.6 times more likely than those who had not to die prematurely; and (ii) the only type of death for which risk was higher was homicide. Aggr. Behav. 43:176-189, 2017. © 2016 Wiley Periodicals, Inc.

  6. Tobacco-related cancers in India: A review of incidence reported from population-based cancer registries

    PubMed Central

    Asthana, Smita; Patil, Rakshit S.; Labani, Satyanarayana

    2016-01-01

    Background: Tobacco related cancers (TRC) account for major share of all cancers and updated of incidence data are helpful in policy changes. The aim was to present an update of TRCs on age-adjusted incidence data and corresponding lifetime risk of developing TRC for different regions of the country. Methods: The data for this study were obtained from published reports of 25 population-based cancer registries (PBCRs) in India. The PBCRs in different parts of India were divided into seven regions such as North, South, Central, Northeast, West, Rural West, and East. Data indicators such as age-adjusted rates (AARs) of incidence and the cumulative risks of TRCs up to the age of 64 years for each of the 10 TRC sites of either sex in each of 25 registries were obtained from the National Cancer Registry Programme reports. Results: Among all TRCs, esophagus, lung, hypopharynx, and mouth are the leading sites for both males and females. Males in Northeast region had the highest risk 1 in 27 of developing esophageal cancer, 1 in 67 for cancer of lungs and hypopharynx, followed by 1 in 143 for both mouth and tongue cancers. Females also had the highest risk of esophagus and lungs (1 in 63 female) and cancer of mouth (1 in 250) in Northeast region. Proportion of TRC in comparison of all cancer ranged from 11–25% for men and 3–18% for women. Conclusions: Proportion of TRC in relation to all cancers was still high in different registries of India including the Northeast region. PMID:27688608

  7. Prevalence of physical violence against children in Haiti: A national population-based cross-sectional survey.

    PubMed

    Flynn-O'Brien, Katherine T; Rivara, Frederick P; Weiss, Noel S; Lea, Veronica A; Marcelin, Louis H; Vertefeuille, John; Mercy, James A

    2016-01-01

    Although physical violence against children is common worldwide, there are no national estimates in Haiti. To establish baseline national estimates, a three-stage clustered sampling design was utilized to administer a population-based household survey about victimization due to physical violence to 13-24 year old Haitians (n=2,916), including those residing in camps or settlements. Descriptive statistics and weighted analysis techniques were used to estimate national lifetime prevalence and characteristics of physical violence against children. About two-thirds of respondents reported having experienced physical violence during childhood (67.0%; 95% CI 63.4-70.4), the percentage being similar in males and females. More than one-third of 13-17 year old respondents were victimized in the 12 months prior to survey administration (37.8%; 95% CI 33.6-42.1). The majority of violence was committed by parents and teachers; and the perceived intent was often punishment or discipline. While virtually all (98.8%; 95% CI 98.0-99.3) victims of childhood physical violence were punched, kicked, whipped or beaten; 11.0% (95% CI 9.2-13.2) were subject to abuse by a knife or other weapon. Injuries sustained from violence varied by victim gender and perpetrator, with twice as many females (9.6%; 95% CI 7.1-12.7) than males (4.0%; 95% CI 2.6-6.1) sustaining permanent injury or disfigurement by a family member or caregiver (p-value<.001). Our findings suggest that physical violence against children in Haiti is common, and may lead to severe injury. Characterization of the frequency and nature of this violence provides baseline estimates to inform interventions.

  8. Gender and Regional Differences in Sleep Quality and Insomnia: A General Population-based Study in Hunan Province of China

    PubMed Central

    Tang, Jinsong; Liao, Yanhui; Kelly, Brian C.; Xie, Liqin; Xiang, Yu-Tao; Qi, Chang; Pan, Chen; Hao, Wei; Liu, Tieqiao; Zhang, Fengyu; Chen, Xiaogang

    2017-01-01

    Insomnia and the inability to sleep affect people’s health and well-being. However, its systematic estimates of prevalence and distribution in the general population in China are still lacking. A population-based cluster sampling survey was conducted in the rural and urban areas of Hunan, China. Subjects (n = 26,851) were sampled from the general population, with a follow-up using the Pittsburgh Sleep Quality Index (PSQI) for interview to assess quality of sleep and Insomnia (PSQI score >5). While the overall prevalence of insomnia was 26.6%, and little difference was found between males (26.3%) and females (27.0%); the mean PSQI score was 4.26 (±2.67), and significant higher in females (4.32 ± 2.70) than males (4.21 ± 2.64, p = 0.003). Individuals in the rural areas tended to report a higher PSQI score (4.45 ± 2.81) than urban residents did (4.18 ± 2.60) (p < 0.001) and the estimates of prevalence of insomnia was 29.4% in the rural areas, significant higher than 25.5% in the urban areas (p < 0.001). Multiple logistic regression analysis showed that female gender, older age, higher level of education, being unmarried, living in the rural area, cigarette smoking and alcohol drinking were associated with insomnia. Our study may provide important information for general and mental health research. PMID:28262807

  9. Parallel genetic algorithm with population-based sampling approach to discrete optimization under uncertainty

    NASA Astrophysics Data System (ADS)

    Subramanian, Nithya

    Optimization under uncertainty accounts for design variables and external parameters or factors with probabilistic distributions instead of fixed deterministic values; it enables problem formulations that might maximize or minimize an expected value while satisfying constraints using probabilities. For discrete optimization under uncertainty, a Monte Carlo Sampling (MCS) approach enables high-accuracy estimation of expectations but it also results in high computational expense. The Genetic Algorithm (GA) with a Population-Based Sampling (PBS) technique enables optimization under uncertainty with discrete variables at a lower computational expense than using Monte Carlo sampling for every fitness evaluation. Population-Based Sampling uses fewer samples in the exploratory phase of the GA and a larger number of samples when `good designs' start emerging over the generations. This sampling technique therefore reduces the computational effort spent on `poor designs' found in the initial phase of the algorithm. Parallel computation evaluates the expected value of the objective and constraints in parallel to facilitate reduced wall-clock time. A customized stopping criterion is also developed for the GA with Population-Based Sampling. The stopping criterion requires that the design with the minimum expected fitness value to have at least 99% constraint satisfaction and to have accumulated at least 10,000 samples. The average change in expected fitness values in the last ten consecutive generations is also monitored. The optimization of composite laminates using ply orientation angle as a discrete variable provides an example to demonstrate further developments of the GA with Population-Based Sampling for discrete optimization under uncertainty. The focus problem aims to reduce the expected weight of the composite laminate while treating the laminate's fiber volume fraction and externally applied loads as uncertain quantities following normal distributions. Construction of

  10. A common modality of action of simulated space stresses on the oxidative metabolism of ethylmorphine, aniline and p-nitroanisole by male rat liver.

    NASA Technical Reports Server (NTRS)

    Furner, R. L.; Neville, E. D.; Talarico, K. S.; Feller, D. D.

    1972-01-01

    High gravity, cold and starvation elicited similar responses in male Simonson rats. These responses included a decreased rate in body weight gain, increased metabolism of aniline and p-nitroanisole, and no consistent pattern of change in the metabolism of ethylmorphine. Cold and starvation increased the amount of hepatic cytochrome P-450, while hypobaric-hyperoxia caused no change in any of the parameters measured. When 1% acetone was given to the rats in their drinking water, the effects on drug metabolism were similar to those produced by food restriction in that the metabolism of aniline and p-nitroanisole was increased, and the metabolism of ethylmorphine unchanged. The type I binding spectrum of acetone suggests that it is either a substrate, inhibitor, or both for hepatitic oxidative enzymes.

  11. Nocturnal illumination maintains reproductive function and simulates the period-lengthening effect of constant light in the mature male Djungarian hamster (Phodopus sungorus)

    NASA Technical Reports Server (NTRS)

    Ferraro, J. S.

    1990-01-01

    Mature male Djungarian hamsters (Phodopus sungorus) were placed in individual light-tight, sound attenuated chambers and exposed to one of four lighting conditions for a duration of approximately seven weeks. The four lighting conditions were: constant light (LL); constant dark (DD); feedback lighting (LDFB; a condition that illuminates the cage in response to locomotor activity); or a feedback lighting neighbor control (LDFB NC; the animal receives the same light pattern as a paired animal in feedback lighting, but has no control over it). Exposure of hamsters to LL or LDFB produced significantly and similarly longer free-running periods of the locomotor activity rhythm than exposure of animals to DD. Hamsters exposed to LDFB NC did not free-run or entrain, but rather displayed "relative coordination". The paired testes and sex accessory glands weights suggest that in the Djungarian hamster, LL and LDFB exposed animals maintained reproductive function, whereas DD exposed animals did not. Animals exposed to LDFB NC had intermediate paired testes weights. Since several previous studies have demonstrated that short pulses of light, which are coincident with the subjective night, are photostimulatory, it is not surprising that LDFB maintained reproductive function in the mature Djungarian hamster. Feedback lighting, however, has been shown to be an insufficient stimulus to maintain reproductive function of mature male and female Syrian hamsters, and to the reproductive maturation of immature Djungarian hamsters. The results suggest that there may be slight, but significant differences in the way these two species interpret photoperiod, as well as a developmental change in the photoperiodic response of Djungarian hamsters.

  12. Comparison of conversion coefficients for equivalent dose in terms of air kerma for photons using a male adult voxel simulator in sitting and standing posture with geometry of irradiation antero-posterior

    NASA Astrophysics Data System (ADS)

    Galeano, D. C.; Cavalcante, F. R.; Carvalho, A. B.; Hunt, J.

    2014-02-01

    The dose conversion coefficient (DCC) is important to quantify and assess effective doses associated with medical, professional and public exposures. The calculation of DCCs using anthropomorphic simulators and radiation transport codes is justified since in-vivo measurement of effective dose is extremely difficult and not practical for occupational dosimetry. DCCs have been published by the ICRP using simulators in a standing posture, which is not always applicable to all exposure scenarios, providing an inaccurate dose estimation. The aim of this work was to calculate DCCs for equivalent dose in terms of air kerma (H/Kair) using the Visual Monte Carlo (VMC) code and the VOXTISS8 adult male voxel simulator in sitting and standing postures. In both postures, the simulator was irradiated by a plane source of monoenergetic photons in antero-posterior (AP) geometry. The photon energy ranged from 15 keV to 2 MeV. The DCCs for both postures were compared and the DCCs for the standing simulator were higher. For certain organs, the difference of DCCs were more significant, as in gonads (48% higher), bladder (16% higher) and colon (11% higher). As these organs are positioned in the abdominal region, the posture of the anthropomorphic simulator modifies the form in which the radiation is transported and how the energy is deposited. It was also noted that the average percentage difference of conversion coefficients was 33% for the bone marrow, 11% for the skin, 13% for the bone surface and 31% for the muscle. For other organs, the percentage difference of the DCCs for both postures was not relevant (less than 5%) due to no anatomical changes in the organs of the head, chest and upper abdomen. We can conclude that is important to obtain DCCs using different postures from those present in the scientific literature.

  13. Diets and selected lifestyle practices of self-defined adult vegetarians from a population-based sample suggest they are more 'health conscious'

    PubMed

    Bedford, Jennifer L; Barr, Susan I

    2005-04-13

    BACKGROUND: Few population-based studies of vegetarians have been published. Thus we compared self-reported vegetarians to non-vegetarians in a representative sample of British Columbia (BC) adults, weighted to reflect the BC population. METHODS: Questionnaires, 24-hr recalls and anthropometric measures were completed during in-person interviews with 1817 community-dwelling residents, 19-84 years, recruited using a population-based health registry. Vegetarian status was self-defined. ANOVA with age as a covariate was used to analyze continuous variables, and chi-square was used for categorical variables. Supplement intakes were compared using the Mann-Whitney test. RESULTS: Approximately 6% (n = 106) stated that they were vegetarian, and most did not adhere rigidly to a flesh-free diet. Vegetarians were more likely female (71% vs. 49%), single, of low-income status, and tended to be younger. Female vegetarians had lower BMI than non-vegetarians (23.1 +/- 0.7 (mean +/- SE) vs. 25.7 +/- 0.2 kg/m2), and also had lower waist circumference (75.0 +/- 1.5 vs. 79.8 +/- 0.5 cm). Male vegetarians and non-vegetarians had similar BMI (25.9 +/- 0.8 vs. 26.7 +/- 0.2 kg/m2) and waist circumference (92.5 +/- 2.3 vs. 91.7 +/- 0.4 cm). Female vegetarians were more physically active (69% vs. 42% active >/=4/wk) while male vegetarians were more likely to use nutritive supplements (71% vs. 51%). Energy intakes were similar, but vegetarians reported higher % energy as carbohydrate (56% vs. 50%), and lower % protein (men only; 13% vs. 17%) or % fat (women only; 27% vs. 33%). Vegetarians had higher fiber, magnesium and potassium intakes. For several other nutrients, differences by vegetarian status differed by gender. The prevalence of inadequate magnesium intake (% below Estimated Average Requirement) was lower in vegetarians than non-vegetarians (15% vs. 34%). Female vegetarians also had a lower prevalence of inadequate thiamin, folate, vitamin B6 and C intakes. Vegetarians were more

  14. An overview of population-based algorithms for multi-objective optimisation

    NASA Astrophysics Data System (ADS)

    Giagkiozis, Ioannis; Purshouse, Robin C.; Fleming, Peter J.

    2015-07-01

    In this work we present an overview of the most prominent population-based algorithms and the methodologies used to extend them to multiple objective problems. Although not exact in the mathematical sense, it has long been recognised that population-based multi-objective optimisation techniques for real-world applications are immensely valuable and versatile. These techniques are usually employed when exact optimisation methods are not easily applicable or simply when, due to sheer complexity, such techniques could potentially be very costly. Another advantage is that since a population of decision vectors is considered in each generation these algorithms are implicitly parallelisable and can generate an approximation of the entire Pareto front at each iteration. A critique of their capabilities is also provided.

  15. Population-based surveillance for bacterial meningitis in the Dominican Republic: implications for control by vaccination.

    PubMed

    Gomez, E; Peguero, M; Sanchez, J; Castellanos, P L; Feris, J; Peña, C; Brudzinski-LaClaire, L; Levine, O S

    2000-12-01

    Quantifying the local burden of disease is an important step towards the introduction of new vaccines, such as Haemophilus influenzae type b (Hib) conjugate vaccine. We adapted a generic protocol developed by the World Health Organization for population-based surveillance of bacterial meningitis. All hospitals that admit paediatric patients with meningitis in the National District, Dominican Republic were included in the system and standard laboratory methods were used. The system identified 111 cases of confirmed bacterial meningitis. Hib was the leading cause of bacterial meningitis, followed by group B streptococcus, S. pneumoniae, and N. meningitidis. Unlike hospital-based case series, this population-based system was able to calculate incidence rates. The incidence of Hib meningitis was 13 cases per 100,000 children < 5 years old. The data from this study were used by the Ministry of Health to support the introduction of routine Hib vaccination and will be used to monitor its effectiveness.

  16. Estimating and modeling the cure fraction in population-based cancer survival analysis.

    PubMed

    Lambert, Paul C; Thompson, John R; Weston, Claire L; Dickman, Paul W

    2007-07-01

    In population-based cancer studies, cure is said to occur when the mortality (hazard) rate in the diseased group of individuals returns to the same level as that expected in the general population. The cure fraction (the proportion of patients cured of disease) is of interest to patients and is a useful measure to monitor trends in survival of curable disease. There are 2 main types of cure fraction model, the mixture cure fraction model and the non-mixture cure fraction model, with most previous work concentrating on the mixture cure fraction model. In this paper, we extend the parametric non-mixture cure fraction model to incorporate background mortality, thus providing estimates of the cure fraction in population-based cancer studies. We compare the estimates of relative survival and the cure fraction between the 2 types of model and also investigate the importance of modeling the ancillary parameters in the selected parametric distribution for both types of model.

  17. Population-Based Assessment of Exposure to Risk Behaviors in Motion Pictures.

    PubMed

    Sargent, James D; Worth, Keilah A; Beach, Michael; Gerrard, Meg; Heatherton, Todd F

    2008-01-01

    The aim of most population-based studies of media is to relate a specific exposure to an outcome of interest. A research program has been developed that evaluates exposure to different components of movies in an attempt of assess the association of such exposure with the adoption of substance use during adolescence. To assess exposure to movie substance use, one must measure both viewing time and content. In developing the exposure measure, the study team was interested in circumventing a common problem in exposure measurement, where measures often conflate exposure to media with attention to media. Our aim in this paper is to present a validated measure of exposure to entertainment media, the Beach method, which combines recognition of a movie title with content analysis of the movie for substance use, to generate population based measures of exposure to substance use in this form of entertainment.

  18. Statistical genetics with application to population-based study design: a primer for clinicians.

    PubMed

    Beyene, Joseph; Pare, Guillaume

    2014-02-01

    With the completion of the entire human genome sequence and remarkable advances in genotyping technologies, there has been an increased interest in the application of genetics and genomics in biomedical research over the last decade. Large-scale population-based genetic association studies have now become routine and their application to several multifactorial diseases such as cardiovascular disorders has led to the identification of a number of novel susceptibility genes. However, to be able to interpret results from such studies, clinicians need to have a basic understanding of unique concepts and issues related to this fast-moving area of research. In this primer, we provide a broad overview of design, analysis, and methodological issues with a focus on population-based study design.

  19. Population-based surveillance for bacterial meningitis in the Dominican Republic: implications for control by vaccination.

    PubMed Central

    Gomez, E.; Peguero, M.; Sanchez, J.; Castellanos, P. L.; Feris, J.; Peña, C.; Brudzinski-LaClaire, L.; Levine, O. S.

    2000-01-01

    Quantifying the local burden of disease is an important step towards the introduction of new vaccines, such as Haemophilus influenzae type b (Hib) conjugate vaccine. We adapted a generic protocol developed by the World Health Organization for population-based surveillance of bacterial meningitis. All hospitals that admit paediatric patients with meningitis in the National District, Dominican Republic were included in the system and standard laboratory methods were used. The system identified 111 cases of confirmed bacterial meningitis. Hib was the leading cause of bacterial meningitis, followed by group B streptococcus, S. pneumoniae, and N. meningitidis. Unlike hospital-based case series, this population-based system was able to calculate incidence rates. The incidence of Hib meningitis was 13 cases per 100,000 children < 5 years old. The data from this study were used by the Ministry of Health to support the introduction of routine Hib vaccination and will be used to monitor its effectiveness. PMID:11218205

  20. Disease management to population-based health: steps in the right direction?

    PubMed

    Sprague, Lisa

    2003-05-16

    This issue brief reviews the evolution of the disease management model and the ways it relates to care coordination and case management approaches. It also looks at examples of population-based disease management programs operating in both the private and public sectors and reviews the evidence of their success. Finally, the paper considers the policy implications of adapting this model to a Medicare fee-for-service population.

  1. Hand, hip and knee osteoarthritis in a Norwegian population-based study - The MUST protocol

    PubMed Central

    2013-01-01

    Background Knowledge about the prevalence and consequences of osteoarthritis (OA) in the Norwegian population is limited. This study has been designed to gain a greater understanding of musculoskeletal pain in the general population with a focus on clinically and radiologically confirmed OA, as well as risk factors, consequences, and management of OA. Methods/Design The Musculoskeletal pain in Ullensaker STudy (MUST) has been designed as an observational study comprising a population-based postal survey and a comprehensive clinical examination of a sub-sample with self-reported OA (MUST OA cohort). All inhabitants in Ullensaker municipality, Norway, aged 40 to 79 years receive the initial population-based postal survey questionnaire with questions about life style, general health, musculoskeletal pain, self-reported OA, comorbidities, health care utilisation, medication use, and functional ability. Participants who self-report OA in their hip, knee and/or hand joints are asked to attend a comprehensive clinical examination at Diakonhjemmet Hospital, Oslo, including a comprehensive medical examination, performance-based functional tests, different imaging modalities, cardiovascular assessment, blood and urine samples, and a number of patient-reported questionnaires including five OA disease specific instruments. Data will be merged with six national data registries. A subsample of those who receive the questionnaire has previously participated in postal surveys conducted in 1990, 1994, and 2004 with data on musculoskeletal pain and functional ability in addition to demographic characteristics and a number of health related factors. This subsample constitutes a population based cohort with 20 years follow-up. Discussion This protocol describes the design of an observational population-based study that will involve the collection of data from a postal survey on musculoskeletal pain, and a comprehensive clinical examination on those with self-reported hand, hip and

  2. Medical male circumcision coverage in Rakai, Uganda.

    PubMed

    Kong, Xiangrong; Kigozi, Godfrey; Ssekasanvu, Joseph; Nalugoda, Fred; Nakigozi, Gertrude; Chang, Larry W; Latkin, Carl; Serwadda, David; Wawer, Maria J; Gray, Ronald H

    2017-03-13

    We assessed medical male circumcision (MMC) scale-up in Rakai, Uganda using population-based surveys during 2007-2014. MMC coverage increased from 28.5 to 52.0%. Coverage was initially lower in 15-19-year-olds but increased in 2014, was higher in married men and in trading communities, and lowest in the sexually inactive. Coverage did not vary by self-perceived risk of HIV or HIV serostatus. Increasing generalized coverage suggested that MMC became normative, but coverage falls short of WHO/Joint United Nations Programme on HIV and AIDS (UNAIDS) 80% targets, indicating the need for demand generation.

  3. An obesity/cardiometabolic risk reduction disease management program: a population-based approach.

    PubMed

    Villagra, Victor G

    2009-04-01

    Obesity is a critical health concern that has captured the attention of public and private healthcare payers who are interested in controlling costs and mitigating the long-term economic consequences of the obesity epidemic. Population-based approaches to obesity management have been proposed that take advantage of a chronic care model (CCM), including patient self-care, the use of community-based resources, and the realization of care continuity through ongoing communications with patients, information technology, and public policy changes. Payer-sponsored disease management programs represent an important conduit to delivering population-based care founded on similar CCM concepts. Disease management is founded on population-based disease identification, evidence-based care protocols, and collaborative practices between clinicians. While substantial clinician training, technology infrastructure commitments, and financial support at the payer level will be needed for the success of disease management programs in obesity and cardiometabolic risk reduction, these barriers can be overcome with the proper commitment. Disease management programs represent an important tool to combat the growing societal risks of overweight and obesity.

  4. Defining Sickle Cell Disease Mortality Using a Population-Based Surveillance System, 2004 through 2008

    PubMed Central

    Paulukonis, Susan T.; Eckman, James R.; Snyder, Angela B.; Hagar, Ward; Feuchtbaum, Lisa B.; Zhou, Mei; Grant, Althea M.

    2016-01-01

    Objective Population-based surveillance data from California and Georgia for years 2004 through 2008 were linked to state death record files to determine the all-cause death rate among 12,143 patients identified with sickle cell disease (SCD). Methods All-cause death rates, by age, among these SCD patients were compared with all-cause death rates among both African Americans and the total population in the two states. All-cause death rates were also compared with death rates for SCD derived from publicly available death records: the compressed mortality files and multiple cause of death files. Results Of 12,143 patients identified with SCD, 615 patients died. The all-cause mortality rate for the SCD population was lower than the all-cause mortality rate among African Americans and similar to the total population all-cause mortality rates from birth through age 4 years, but the rate was higher among those with SCD than both the African American and total population rates from ages 5 through 74 years. The count of deceased patients identified by using population-based surveillance data (n=615) was more than twice as high as the count identified in compressed mortality files using SCD as the underlying cause of death alone (n=297). Conclusion Accurate assessment of all-cause mortality and age at death requires long-term surveillance via population-based registries of patients with accurately diagnosed SCD. PMID:26957672

  5. Collection, use, and protection of population-based birth defects surveillance data in the united states.

    PubMed

    Mai, Cara T; Law, David J; Mason, Craig A; McDowell, Bradley D; Meyer, Robert E; Musa, Debra

    2007-12-01

    Birth defects surveillance systems collect population-based birth defects data from multiple sources to track trends in prevalence, identify risk factors, refer affected families to services, and evaluate prevention efforts. Strong state and federal public health and legal mandates are in place to govern the collection and use of these data. Despite the prima facie appeal of "opt-in" and similar strategies to those who view data collection as a threat to privacy, the use of these strategies in lieu of population-based surveillance can severely limit the ability of public health agencies to accurately access the health status of a group within a defined geographical area. With the need for population-based data central to their mission, birth defects programs around the country take their data stewardship role seriously, recognizing both moral and legal obligations to protect the data by employing numerous safeguards. Birth defects surveillance systems are shaped by the needs of the community they are designed to serve, with the goal of preventing birth defects or alleviating the burdens associated with them.

  6. Population-based public health interventions: innovations in practice, teaching, and management. Part II.

    PubMed

    Keller, Linda Olson; Strohschein, Susan; Schaffer, Marjorie A; Lia-Hoagberg, Betty

    2004-01-01

    The Intervention Wheel is a population-based practice model that encompasses three levels of practice (community, systems, and individual/family) and 17 public health interventions. Each intervention and practice level contributes to improving population health. The Intervention Wheel, previously known as the Public Health Intervention Model, was originally introduced in 1998 by the Minnesota Department of Health, Section of Public Health Nursing (PHN). The model has been widely disseminated and used throughout the United States since that time. The evidence supporting the Intervention Wheel was recently subjected to a rigorous critique by regional and national experts. This critical process, which involved hundreds of public health nurses, resulted in a more robust Intervention Wheel and established the validity of the model. The critique also produced basic steps and best practices for each of the 17 interventions. Part I describes the Intervention Wheel, defines population-based practice, and details the recommended modifications and validation process. Part II provides examples of the innovative ways that the Intervention Wheel is being used in public health/PHN practice, education, and administration. The two articles provide a foundation and vision for population-based PHN practice and direction for improving population health.

  7. Population-based public health interventions: practice-based and evidence-supported. Part I.

    PubMed

    Keller, Linda Olson; Strohschein, Susan; Lia-Hoagberg, Betty; Schaffer, Marjorie A

    2004-01-01

    The Intervention Wheel is a population-based practice model that encompasses three levels of practice (community, systems, and individual/family) and 17 public health interventions. Each intervention and practice level contributes to improving population health. The Intervention Wheel, previously known as the Public Health Intervention Model, was originally introduced in 1998 by the Minnesota Department of Health, Section of Public Health Nursing. The model has been widely disseminated and used throughout the United States since that time. The evidence supporting the Intervention Wheel was recently subjected to a rigorous critique by regional and national experts. This critical process, which involved hundreds of public health nurses, resulted in a more robust Intervention Wheel and established the validity of the model. The critique also produced basic steps and best practices for each of the 17 interventions. Part I describes the Intervention Wheel, defines population-based practice, and details the recommended modifications and validation process. Part II provides examples of the innovative ways that the Intervention Wheel is being used in public health/public health nursing practice, education, and administration. The two articles provide a foundation and vision for population-based public health nursing practice and direction for improving population health.

  8. Cancer risk in close relatives of women with early-onset breast cancer – a population-based incidence study

    PubMed Central

    Olsen, J H; Seersholm, N; Boice Jr, J D; Kjær, S Krüger; Jr, J F Fraumeni

    1999-01-01

    Inherited susceptibility to breast cancer is associated with an early onset and bilateral disease. The extent of familial risks has not, however, been fully assessed in population-based incidence studies. The purpose of the study was to quantify the risks for cancers of the breast, ovary and other sites of close relatives of women in whom breast cancer was diagnosed at an early age. Records collected between 1943 and 1990 at the Danish Cancer Registry were searched, and 2860 women were found in whom breast cancer was diagnosed before age 40. Population registers and parish records were used to identify 14 973 parents, siblings and offspring of these women. Cancer occurrence through to 31 December 1993 was determined within the Cancer Registry's files and compared with national incidence rates. Women with early-onset breast cancer were at a nearly fourfold increased risk of developing a new cancer later in life (268 observed vs 68.9 expected). The excess risk was most evident for second cancer of the breast (181 vs 24.5) and for ovarian cancer (20 vs 3.3). For mothers and sisters, risks for cancers of the breast and ovary were significantly increased by two- to threefold. Bilateral breast cancer and breast–ovarian cancer were very strong predictors of familial risks, with one in four female relatives predicted to develop breast and/or ovarian cancer by age 75. Mothers had a slightly increased risk of colon cancer, but not endometrial cancer. The risk for breast cancer was also increased among fathers (standardized incidence ratio 2.5; 95% CI 0.5–7.4) and especially brothers (29; 7.7–74), although based on small numbers. The risk for prostatic cancer was unremarkable. In this large population-based survey, the first-degree relatives of women who developed breast cancer before age 40 were prone to ovarian cancer as well as male and female breast cancer, but not other tumours that may share susceptibility genes with breast cancer. © 1999 Cancer Research Campaign

  9. Assessment of uncertainties in the lung activity measurement of low-energy photon emitters using Monte Carlo simulation of ICRP male thorax voxel phantom.

    PubMed

    Nadar, M Y; Akar, D K; Rao, D D; Kulkarni, M S; Pradeepkumar, K S

    2015-12-01

    Assessment of intake due to long-lived actinides by inhalation pathway is carried out by lung monitoring of the radiation workers inside totally shielded steel room using sensitive detection systems such as Phoswich and an array of HPGe detectors. In this paper, uncertainties in the lung activity estimation due to positional errors, chest wall thickness (CWT) and detector background variation are evaluated. First, calibration factors (CFs) of Phoswich and an array of three HPGe detectors are estimated by incorporating ICRP male thorax voxel phantom and detectors in Monte Carlo code 'FLUKA'. CFs are estimated for the uniform source distribution in lungs of the phantom for various photon energies. The variation in the CFs for positional errors of ±0.5, 1 and 1.5 cm in horizontal and vertical direction along the chest are studied. The positional errors are also evaluated by resizing the voxel phantom. Combined uncertainties are estimated at different energies using the uncertainties due to CWT, detector positioning, detector background variation of an uncontaminated adult person and counting statistics in the form of scattering factors (SFs). SFs are found to decrease with increase in energy. With HPGe array, highest SF of 1.84 is found at 18 keV. It reduces to 1.36 at 238 keV.

  10. Male to male transmission of supernumerary nipples.

    PubMed

    Tsukahara, M; Uchida, M; Uchino, S; Fujisawa, R; Kamei, T; Itoh, T

    1997-03-17

    We report on a father and his son with supernumerary nipples. No male-to-male transmission has previously been described with this trait. This observation confirms that this trait is inherited in an autosomal dominant fashion.

  11. Reliability of hypothalamic–pituitary–adrenal axis assessment methods for use in population-based studies

    PubMed Central

    Wand, Gary S.; Malhotra, Saurabh; Kamel, Ihab; Horton, Karen

    2013-01-01

    Population-based studies have been hampered in exploring hypothalamic–pituitary–adrenal axis (HPA) activity as a potential explanatory link between stress-related and metabolic disorders due to their lack of incorporation of reliable measures of chronic cortisol exposure. The purpose of this review is to summarize current literature on the reliability of HPA axis measures and to discuss the feasibility of performing them in population-based studies. We identified articles through PubMed using search terms related to cortisol, HPA axis, adrenal imaging, and reliability. The diurnal salivary cortisol curve (generated from multiple salivary samples from awakening to midnight) and 11 p.m. salivary cortisol had the highest between-visit reliabilities (r = 0.63–0.84 and 0.78, respectively). The cortisol awakening response and dexamethasone-suppressed cortisol had the next highest between-visit reliabilities (r = 0.33–0.67 and 0.42–0.66, respectively). Based on our own data, the inter-reader reliability (rs) of adrenal gland volume from non-contrast CT was 0.67–0.71 for the left and 0.47–0.70 for the right adrenal glands. While a single 8 a.m. salivary cortisol is one of the easiest measures to perform, it had the lowest between-visit reliability (R = 0.18–0.47). Based on the current literature, use of sampling multiple salivary cortisol measures across the diurnal curve (with awakening cortisol), dexamethasone-suppressed cortisol, and adrenal gland volume are measures of HPA axis tone with similar between-visit reliabilities which likely reflect chronic cortisol burden and are feasible to perform in population-based studies. PMID:21533585

  12. Measuring stress before and during pregnancy: a review of population-based studies of obstetric outcomes.

    PubMed

    Witt, Whitney P; Litzelman, Kristin; Cheng, Erika R; Wakeel, Fathima; Barker, Emily S

    2014-01-01

    Mounting evidence from clinic and convenience samples suggests that stress is an important predictor of adverse obstetric outcomes. Using a proposed theoretical framework, this review identified and synthesized the population-based literature on the measurement of stress prior to and during pregnancy in relation to obstetric outcomes. Population-based, peer-reviewed empirical articles that examined stress prior to or during pregnancy in relation to obstetric outcomes were identified in the PubMed and PsycInfo databases. Articles were evaluated to determine the domain(s) of stress (environmental, psychological, and/or biological), period(s) of stress (preconception and/or pregnancy), and strength of the association between stress and obstetric outcomes. Thirteen studies were evaluated. The identified studies were all conducted in developed countries. The majority of studies examined stress only during pregnancy (n = 10); three examined stress during both the preconception and pregnancy periods (n = 3). Most studies examined the environmental domain (e.g. life events) only (n = 9), two studies examined the psychological domain only, and two studies examined both. No study incorporated a biological measure of stress. Environmental stressors before and during pregnancy were associated with worse obstetric outcomes, although some conflicting findings exist. Few population-based studies have examined stress before or during pregnancy in relation to obstetric outcomes. Although considerable variation exists in the measurement of stress across studies, environmental stress increased the risk for poor obstetric outcomes. Additional work using a lifecourse approach is needed to fill the existing gaps in the literature and to develop a more comprehensive understanding of the mechanisms by which stress impacts obstetric outcomes.

  13. Models of population-based analyses for data collected from large extended families.

    PubMed

    Wang, Wenyu; Lee, Elisa T; Howard, Barbara V; Fabsitz, Richard R; Devereux, Richard B; MacCluer, Jean W; Laston, Sandra; Comuzzie, Anthony G; Shara, Nawar M; Welty, Thomas K

    2010-12-01

    Large studies of extended families usually collect valuable phenotypic data that may have scientific value for purposes other than testing genetic hypotheses if the families were not selected in a biased manner. These purposes include assessing population-based associations of diseases with risk factors/covariates and estimating population characteristics such as disease prevalence and incidence. Relatedness among participants however, violates the traditional assumption of independent observations in these classic analyses. The commonly used adjustment method for relatedness in population-based analyses is to use marginal models, in which clusters (families) are assumed to be independent (unrelated) with a simple and identical covariance (family) structure such as those called independent, exchangeable and unstructured covariance structures. However, using these simple covariance structures may not be optimally appropriate for outcomes collected from large extended families, and may under- or over-estimate the variances of estimators and thus lead to uncertainty in inferences. Moreover, the assumption that families are unrelated with an identical family structure in a marginal model may not be satisfied for family studies with large extended families. The aim of this paper is to propose models incorporating marginal models approaches with a covariance structure for assessing population-based associations of diseases with their risk factors/covariates and estimating population characteristics for epidemiological studies while adjusting for the complicated relatedness among outcomes (continuous/categorical, normally/non-normally distributed) collected from large extended families. We also discuss theoretical issues of the proposed models and show that the proposed models and covariance structure are appropriate for and capable of achieving the aim.

  14. National nephrectomy registries: Reviewing the need for population-based data.

    PubMed

    Pearson, John; Williamson, Timothy; Ischia, Joseph; Bolton, Damien M; Frydenberg, Mark; Lawrentschuk, Nathan

    2015-09-01

    Nephrectomy is the cornerstone therapy for renal cell carcinoma (RCC) and continued refinement of the procedure through research may enhance patient outcomes. A national nephrectomy registry may provide the key information needed to assess the procedure at a national level. The aim of this study was to review nephrectomy data available at a population-based level in Australia and to benchmark these data against data from the rest of the world as an examination of the national nephrectomy registry model. A PubMed search identified records pertaining to RCC nephrectomy in Australia. A similar search identified records relating to established nephrectomy registries internationally and other surgical registries of clinical importance. These records were reviewed to address the stated aims of this article. Population-based data within Australia for nephrectomy were lacking. Key issues identified were the difficulty in benchmarking outcomes and no ongoing monitoring of trends. The care centralization debate, which questions whether small-volume centers provide comparable outcomes to high-volume centers, is ongoing. Patterns of adherence and the effectiveness of existing protocols are uncertain. A review of established international registries demonstrated that the registry model can effectively address issues comparable to those identified in the Australian literature. A national nephrectomy registry could address deficiencies identified in a given nation's nephrectomy field. The model is supported by evidence from international examples and will provide the population-based data needed for studies. Scope exists for possible integration with other registries to develop a more encompassing urological or surgical registry. Need remains for further exploration of the feasibility and practicalities of initiating such a registry including a minimum data set, outcome indicators, and auditing of data.

  15. Population-based disease management under fee-for-service Medicare.

    PubMed

    Foote, Sandra M

    2003-01-01

    Medicare policymakers are considering testing population-based disease management (PDM) programs under fee-for-service (FFS) Medicare as a way to improve health and cost outcomes for selected subgroups of chronically ill beneficiaries. This paper provides a brief overview of how PDM programs are evolving in the private sector and describes how they differ from other approaches already being tested in Medicare disease management demonstrations. It also discusses some key opportunities and issues to be considered in adapting PDM programs for testing in the FFS Medicare context.

  16. Suicide by people in a community justice pathway: population-based nested case–control study

    PubMed Central

    King, Carlene; Senior, Jane; Webb, Roger T.; Millar, Tim; Piper, Mary; Pearsall, Alison; Humber, Naomi; Appleby, Louis; Shaw, Jenny

    2015-01-01

    The elevated risk of suicide in prison and after release is a well-recognised and serious problem. Despite this, evidence concerning community-based offenders' suicide risk is sparse. We conducted a population-based nested case–control study of all people in a community justice pathway in England and Wales. Our data show 13% of general population suicides were in community justice pathways before death. Suicide risks were highest among individuals receiving police cautions, and those having recent, or impending prosecution for sexual offences. Findings have implications for the training and practice of clinicians identifying and assessing suicidality, and offering support to those at elevated risk. PMID:26159602

  17. [Population-based cohorts. Example of the Gazel and Constances cohorts].

    PubMed

    Goldberg, Marcel; Zins, Marie

    2013-02-01

    Population-based cohorts focus on the causes of diseases, especially multifactorial diseases. Some are very large, and prospectively collect personal, lifestyle, occupational and environmental data over several decades. All include biobanks. "Generalist" cohorts cover a large field of diseases and risk factors. Two examples are presented here The Gazel cohort was composed of 20,000 subjects aged 35-50 at enrolment andfollowed-up for 25 years, resulting in about 200 publications. The Constances cohort, created in 2012, aims to include a representative sample of 200,000 adults aged 18-69 at enrolment.

  18. Radiology Education in the Era of Population-based Medicine in the United States.

    PubMed

    Slanetz, Priscilla J; Mullins, Mark E

    2016-07-01

    Over the past several decades, the practice of radiology has undergone substantial change primarily related to advances in imaging technology, changes in the infrastructure of healthcare delivery, and evolution of reimbursement systems. Yet to a large extent, the educational system has not substantially changed. In this perspective, we discuss the need for radiology education to adapt and address these essential systems-based skills (business, quality, informatics, leadership, population-based medicine, and interprofessional teamwork) to ensure that future radiology graduates will thrive in this evolving healthcare environment.

  19. Investigating Measures of Social Context on 2 Population-Based Health Surveys, Hawaii, 2010-2012.

    PubMed

    Pobutsky, Ann M; Baker, Kathleen Kromer; Reyes-Salvail, Florentina

    2015-12-17

    Measures from the Social Context Module of the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System were used on 2 population-based health surveys in Hawaii to explicate the role of the nonmedical and social determinants of health; these measures were also compared with conventional socioeconomic status (SES) variables. Results showed that the self-reported SES vulnerabilities of food and housing insecurity are both linked to demographic factors and physical and mental health status and significant when controlling for the conventional measures of SES. The social context module indicators should be increasingly used so results can inform appropriate interventions for vulnerable populations.

  20. Heritability of Autism Spectrum Disorder in a UK Population-Based Twin Sample

    PubMed Central

    Colvert, Emma; Tick, Beata; McEwen, Fiona; Stewart, Catherine; Curran, Sarah R.; Woodhouse, Emma; Gillan, Nicola; Hallett, Victoria; Lietz, Stephanie; Garnett, Tracy; Ronald, Angelica; Plomin, Robert; Rijsdijk, Frühling; Happé, Francesca; Bolton, Patrick

    2016-01-01

    IMPORTANCE Most evidence to date highlights the importance of genetic influences on the liability to autism and related traits. However, most of these findings are derived from clinically ascertained samples, possibly missing individuals with subtler manifestations, and obtained estimates may not be representative of the population. OBJECTIVES To establish the relative contributions of genetic and environmental factors in liability to autism spectrum disorder (ASD) and a broader autism phenotype in a large population-based twin sample and to ascertain the genetic/environmental relationship between dimensional trait measures and categorical diagnostic constructs of ASD. DESIGN, SETTING, AND PARTICIPANTS We used data from the population-based cohort Twins Early Development Study, which included all twin pairs born in England and Wales from January 1, 1994, through December 31, 1996. We performed joint continuous-ordinal liability threshold model fitting using the full information maximum likelihood method to estimate genetic and environmental parameters of covariance. Twin pairs underwent the following assessments: the Childhood Autism Spectrum Test (CAST) (6423 pairs; mean age, 7.9 years), the Development and Well-being Assessment (DAWBA) (359 pairs; mean age, 10.3 years), the Autism Diagnostic Observation Schedule (ADOS) (203 pairs; mean age, 13.2 years), the Autism Diagnostic Interview–Revised (ADI-R) (205 pairs; mean age, 13.2 years), and a best-estimate diagnosis (207 pairs). MAIN OUTCOMES AND MEASURES Participants underwent screening using a population-based measure of autistic traits (CAST assessment), structured diagnostic assessments (DAWBA, ADI-R, and ADOS), and a best-estimate diagnosis. RESULTS On all ASD measures, correlations among monozygotic twins (range, 0.77-0.99) were significantly higher than those for dizygotic twins (range, 0.22-0.65), giving heritability estimates of 56% to 95%. The covariance of CAST and ASD diagnostic status (DAWBA, ADOS

  1. The protocols for the 10/66 dementia research group population-based research programme

    PubMed Central

    Prince, Martin; Ferri, Cleusa P; Acosta, Daisy; Albanese, Emiliano; Arizaga, Raul; Dewey, Michael; Gavrilova, Svetlana I; Guerra, Mariella; Huang, Yueqin; Jacob, KS; Krishnamoorthy, ES; McKeigue, Paul; Rodriguez, Juan Llibre; Salas, Aquiles; Sosa, Ana Luisa; Sousa, Renata MM; Stewart, Robert; Uwakwe, Richard

    2007-01-01

    Background Latin America, China and India are experiencing unprecedentedly rapid demographic ageing with an increasing number of people with dementia. The 10/66 Dementia Research Group's title refers to the 66% of people with dementia that live in developing countries and the less than one tenth of population-based research carried out in those settings. This paper describes the protocols for the 10/66 population-based and intervention studies that aim to redress this imbalance. Methods/design Cross-sectional comprehensive one phase surveys have been conducted of all residents aged 65 and over of geographically defined catchment areas in ten low and middle income countries (India, China, Nigeria, Cuba, Dominican Republic, Brazil, Venezuela, Mexico, Peru and Argentina), with a sample size of between 1000 and 3000 (generally 2000). Each of the studies uses the same core minimum data set with cross-culturally validated assessments (dementia diagnosis and subtypes, mental disorders, physical health, anthropometry, demographics, extensive non communicable disease risk factor questionnaires, disability/functioning, health service utilisation, care arrangements and caregiver strain). Nested within the population based studies is a randomised controlled trial of a caregiver intervention for people with dementia and their families (ISRCTN41039907; ISRCTN41062011; ISRCTN95135433; ISRCTN66355402; ISRCTN93378627; ISRCTN94921815). A follow up of 2.5 to 3.5 years will be conducted in 7 countries (China, Cuba, Dominican Republic, Venezuela, Mexico, Peru and Argentina) to assess risk factors for incident dementia, stroke and all cause and cause-specific mortality; verbal autopsy will be used to identify causes of death. Discussion The 10/66 DRG baseline population-based studies are nearly complete. The incidence phase will be completed in 2009. All investigators are committed to establish an anonymised file sharing archive with monitored public access. Our aim is to create an

  2. A population-based descriptive study of housefire deaths in North Carolina.

    PubMed Central

    Patetta, M J; Cole, T B

    1990-01-01

    We report a population-based study of housefire deaths in North Carolina in 1985 using data obtained from fire investigators and the North Carolina medical examiner system. The crude death rate was 3.2 per 100,000 population; age-specific death rates were highest for ages 75-84 years. Death rates for Whites were one-third as high as death rates for other races. Of those decedents tested for alcohol, 56 percent had blood alcohol levels greater than or equal to 22 mmol/L. Most fatal fires were caused by heating units or cigarettes. PMID:2382752

  3. Time trend of multiple myeloma and associated secondary primary malignancies in Asian patients: a Taiwan population-based study.

    PubMed

    Tzeng, Huey-En; Lin, Cheng-Li; Tsai, Chun-Hao; Tang, Chih-Hsin; Hwang, Wen-Li; Cheng, Ya-Wen; Sung, Fung-Chang; Chung, Chi-Jung

    2013-01-01

    Studies involving second malignancies in patients with multiple myeloma are limited for the Asian population. Using data from population-based insurance claims, we assessed the risk of developing secondary malignancies after multiple myeloma, in particular hematologic malignancies. A retrospective cohort study was conducted in 3970 patients with newly diagnosed multiple myeloma from the registry of catastrophic illnesses between 1997 and 2009. A total of 15880 subjects without multiple myeloma were randomly selected as comparisons from the insured population, frequency-matched based on gender, age, and the date of diagnosis. The incidence of secondary malignancies was ascertained through cross-referencing with the National Cancer Registry System. The Cox proportional hazards model was used for analyses. The incidence of multiple myeloma in the insured population increased annually. The overall incidence of secondary malignancy was lower in the multiple myeloma cohort than in the comparison cohort (93.6 vs. 104.5 per 10,000 person-years, IRR = 0.90, 95% CI = 0.78-1.04). The incidence of hematologic malignancies was 11-fold greater for multiple myeloma patients (47.2 vs. 4.09 per 10,000 person-years) with an adjusted HR of 13.0 (95% CI = 7.79-21.6) compared with the comparison cohort. The relative risk of secondary malignancy was also strong for myeloid leukemia (21.2 vs. 1.36 per 10,000 person-years). Gender- and age-specific analysis for secondary hematologic malignancies showed that males and patients with multiple myeloma <60 years of age had a higher risk of secondary malignancy than females and patients with multiple myeloma >60 years of age. In conclusion, patients with multiple myeloma, especially younger patients, are at a high risk of hematologic malignancies.

  4. Drinking water mutagenicity and urinary tract cancers: a population-based case-control study in Finland.

    PubMed

    Koivusalo, M; Hakulinen, T; Vartiainen, T; Pukkala, E; Jaakkola, J J; Tuomisto, J

    1998-10-01

    The detection of mutagenic and carcinogenic chlorination by-products in chlorinated drinking water has raised concern in many countries over the potential health effects of long-term exposure to these products. The relation between estimated exposure to historical drinking water mutagenicity and cancer was studied in Finland by using a population-based case-control study comprising 732 bladder cancer cases, 703 kidney cancer cases, and 914 controls. The cases were obtained from the nationwide Finnish Cancer Registry for the years 1991-1992. The controls, frequency matched by age and sex, were randomly selected from the national population registry. Information on past drinking water sources and confounding factors was acquired through a questionnaire. Historical exposure to drinking water mutagenicity was estimated by using information on past residence, past water source, and historical data on water quality and treatment. Odds ratios were calculated for an increase of 3,000 net revertants per liter (net rev/liter) in average exposure from 1950 to 1987, adjusting for age, sex, socioeconomic status, and smoking in logistic regression models. A small, statistically significant, exposure-related excess risk was found for kidney cancer for men (odds ratio = 1.49, 95 percent confidence interval (CI) 1.05-2.13) for 3,000 net rev/liter exposure level. For women, the association remained nonsignificant, with a lower odds ratio of 1.08 (95% CI 0.69-1.68). For bladder cancer, the odds ratio for both men and women was 1.22 (95% CI 0.92-1.62) for 3,000 net rev/liter exposure. However, a higher odds ratio of 2.59 (95% CI 1.13-5.94) for 3,000 net rev/liter exposure was observed for male nonsmokers.

  5. Prevalence of erectile dysfunction and possible risk factors among men of South-Western Nigeria: a population based study

    PubMed Central

    Oyelade, Bolaji Oyetunde; Jemilohun, Abiodun Christopher; Aderibigbe, Sunday Adedeji

    2016-01-01

    Introduction Erectile dysfunction (ED) is currently one of the most common sexual dysfunctions worldwide but it is usually underestimated because it is not a life threatening condition. The associated stigma makes men who have it to suffer in silence. This study was conducted to determine the prevalence of erectile dysfunction and the possible associated risk factors among Nigerian men. Methods The study was a descriptive cross-sectional population based survey among men aged 30-80 years in Ogbomoso, South-west, Nigeria. A multistage random sampling method was used. The instrument used was the International Index of Erectile Function Questionnaire-5 (IIEF-5). Unadjusted odds ratios of possible risk factors were calculated by univariate analyses. Binary logistic regression analysis was used to eliminate the effect of possible confounders on the risk factors to get the adjusted odds ratios. Results The general prevalence of ED in this study was 58.9%. Sixty-seven (47.2%), 16 (11.3%) and 59(41.5%) respondents had mild, moderate and severe ED respectively. Age, hypertension, use of anti-hypertensive drugs, diabetes mellitus and heart disease all had significant unadjusted associations with ED, but their adjusted associations were not statistically significant. Diabetes mellitus maintained a positive statistically significant relationship with ED after adjustment for potential confounders [OR= 8.31(95% CI 1.02 - 67.65), P= 0.048]. Conclusion The prevalence of ED is high among south-western Nigeria male adults. Physicians, especially primary care ones, need to pay more attention to the sexual history of their patients in order to diagnose and manage ED more frequently. PMID:27642462

  6. Erosive tooth wear among 12-year-old schoolchildren: a population-based cross-sectional study in Montevideo, Uruguay.

    PubMed

    Alvarez Loureiro, Licet; Fabruccini Fager, Anunzziatta; Alves, Luana Severo; Alvarez Vaz, Ramón; Maltz, Marisa

    2015-01-01

    The aim of this study was to assess the prevalence, extent, severity, intraoral distribution and risk indicators for erosive tooth wear (ETW) among 12-year-old schoolchildren from Montevideo, Uruguay. A population-based, cross-sectional survey was conducted using a representative sample of 1,136 12-year-old schoolchildren attending public and private schools. Parents answered questions on socioeconomic status and general health. Schoolchildren answered questions on dietary and oral hygiene habits. Two calibrated examiners recorded ETW on permanent teeth according to the Basic Erosive Wear Examination (BEWE) score system. Logistic regression models were performed to assess the association between the predictor variables and the prevalence of ETW (overall and severe ETW). Odds ratios (OR) and the respective 95% confidence intervals (CI) were estimated. The prevalence of ETW was 52.9%, being mild erosion (BEWE = 1) in the vast majority of cases (48.5%). Severe erosion (BEWE ≥2) was detected in 4.4% of schoolchildren. The overall prevalence of ETW differed significantly between categories of gender and socioeconomic status, but only between gender in the severe ETW analysis. The overall extent of ETW was significantly different between categories of gender, socioeconomic status, and swish before swallow. The extent of severe ETW differed between categories of swish before swallow and brushing frequency. In the logistic regression analysis, no association was found between the studied variables and the overall prevalence of ETW. Males were more likely to have severe ETW than females (OR = 3.22, 95% CI = 1.50-6.89). ETW may be considered a public health problem among 12-year-old-Uruguayan schoolchildren.

  7. Outcome of Community-Acquired Staphylococcus aureus Bacteraemia in Patients with Diabetes: A Historical Population-Based Cohort Study

    PubMed Central

    Smit, Jesper; Thomsen, Reimar Wernich; Schønheyder, Henrik Carl; Nielsen, Henrik; Frøslev, Trine; Søgaard, Mette

    2016-01-01

    Background Patients with diabetes (DM) experience increased risk of Staphylococcus aureus bacteraemia (SAB), but the prognostic impact of diabetes in patients with SAB remain unclear. Therefore, we investigated 30-day all-cause mortality in patients with and without DM. Methods Population-based medical databases were used to conduct a cohort study of all adult patients with community-acquired SAB in Northern Denmark, 2000–2011. Using Cox proportional hazards regression, we computed hazard ratios as estimates of 30-day mortality rate ratios (MRRs) among patients with and without DM. We further investigated whether the prognostic impact of DM differed among patients with and without recent preadmission healthcare contacts (within 30 days of the current hospitalization) and by age, sex, marital status, level of comorbidity, and DM-related characteristics (e.g., duration of DM and presence of DM complications). Results Among 2638 SAB patients, 713 (27.0%) had DM. Thirty-day cumulative mortality was 25.8% in patients with DM and 24.3% in patients without DM, for an adjusted MRR (aMRR) of 1.01 (95% confidence interval (CI), 0.84–1.20). In analyses with and without recent healthcare contacts, the corresponding aMRRs were 0.84 (95% CI, 0.62–1.14) and 1.13 (95% CI, 0.91–1.41), respectively. Compared to patients without DM, the aMRR was 0.94 (95% CI, 0.74–1.20) for male patients with DM and 1.13 (95% CI, 0.87–1.47) for female patients with DM. The prognostic influence of DM on mortality did not differ notably with age, level of comorbidity, or characteristics of patients with DM. Conclusion Patients with DM and community-acquired SAB did not experience higher 30-day mortality than patients without DM. PMID:27082873

  8. Anti-depressant medication use and C-reactive protein: results from two population-based studies.

    PubMed

    Hamer, Mark; Batty, G D; Marmot, Michael G; Singh-Manoux, Archana; Kivimäki, Mika

    2011-01-01

    The use of anti-depressant medication has been linked to cardiovascular disease (CVD). We examined the association between anti-depressant medication use and a marker of low grade systemic inflammation as a potential pathway linking anti-depressant use and CVD in two population based studies. Data were collected in a representative sample of 8131 community dwelling adults (aged 47.4±15.9 years, 46.7% male) from the Scottish Health Surveys (SHS). The use of anti-depressant medication was coded according to the British National Formulary and blood was drawn for the measurement of C-reactive protein (CRP). In a second study, we attempted to replicate our findings using longitudinal data from the Whitehall II study (n=4584, aged 55.5±5.9 years, mean follow-up 5.5 years). Antidepressants were used in 5.6% of the SHS sample, with selective serotonin reuptake inhibitors (SSRIs) being the most common. There was a higher risk of elevated CRP (>3 mg/L) in users of tricyclic antidepressant (TCA) medication (multivariate adjusted odds ratio (OR)=1.52, 95% CI, 1.07-2.15), but not in SSRI users (multivariate adjusted OR=1.07, 95% CI, 0.81-1.42). A longitudinal association between any antidepressant use and subsequent CRP was confirmed in the Whitehall cohort. In summary, the use of anti-depressants was associated with elevated levels of systemic inflammation independently from the symptoms of mental illness and cardiovascular co-morbidity. This might be a potential mechanism through which antidepressant medication increases CVD risk. Further data are required to explore the effects of dosage and duration of antidepressant treatment.

  9. Selective Nonresponse Bias in Population-Based Survey Estimates of Drug Use Behaviors in the United States

    PubMed Central

    McCabe, Sean Esteban; West, Brady T.

    2015-01-01

    Purpose There is a trend of decreasing response rates in population surveys, and selective nonresponse represents a major source of potential bias in population-based survey estimates of drug use behaviors, especially estimates based on longitudinal designs. Methods This study compared baseline substance use behaviors among initial respondents who did respond (n = 34,653) and did not respond (n = 8,440) to a 3-year follow-up interview in a prospective study of the general U.S. adult population. Differences in nonresponse rates were assessed as a function of past-year drug use behaviors both before and after adjustment for socio-demographic differences potentially associated with these behaviors, and the effects of interactions of the socio-demographic characteristics with the drug use behaviors were assessed in multivariate logistic regression models for response at the 3-year follow-up. Results Weighted and unweighted nonresponse rates varied between alcohol users and users of other drugs such as cocaine and marijuana, with rates of nonresponse being higher in the latter drug categories. There were also significant differences in nonresponse rates as a function of frequency of use and demographics. More specifically, being married tends to reduce the probability of non-response, while higher age, being male, being Asian or Hispanic, and having lower education all substantially increase the probability of nonresponse at Wave 2, even after controlling for relevant covariates. Conclusions This study provides the substance abuse field with a methodology that users of longitudinal data can apply to test the sensitivity of their inferences to assumptions about attrition patterns. PMID:26373776

  10. Incidence of herpes zoster and post-herpetic neuralgia in Italy: Results from a 3-years population-based study

    PubMed Central

    Iannazzo, Stefania

    2017-01-01

    ABSTRACT Herpes Zoster (HZ) and its main complication, post-herpetic neuralgia (PHN), represent important public health issues because of their relevant burden among older adults. However, data on the epidemiology of HZ and PHN in Italy are very limited. A population-based study was performed by seeking for cases of HZ and PHN, occurred in the period 2013-2015, in the clinical charts of 56 General Practitioners working in 4 Italian Regions (Liguria, Puglia, Toscana and Veneto). The main objective of the study was to estimate the incidence of HZ and the proportion of PHN (at 1 and 3 mo from the onset of HZ; PHN1 and PHN3) among people aged ≥ 50 y. Overall, 598 cases of HZ were identified over 93,146 person-years of observation, thus corresponding to an overall incidence of 6.42 (IC95%: 5.93 – 6.95) HZ cases per 1,000 person-years. The incidence of HZ increased with age and was higher in female than in male. In total, 22.7%, 12.7%, and 2.4% of HZ cases suffered PHN at 1 and 3 mo and 1 y from the onset of acute episode. The proportions of these complications significantly increased with age, with the peak occurring in people aged ≥ 85 y. Four per cent of patients suffered ophthalmic zoster. The study provided an update of the epidemiological burden of HZ and PHN in Italy, confirming the relevant burden of the disease in the elderly population. The study was funded by the Italian Ministry of Health, Center for Disease Prevention and Control (CCM) in 2013. PMID:27925843

  11. Undiagnosed hypertension in a rural district in Bangladesh: The Bangladesh Population-based Diabetes and Eye Study (BPDES).

    PubMed

    Islam, F M A; Bhuiyan, A; Chakrabarti, R; Rahman, M A; Kanagasingam, Y; Hiller, J E

    2016-04-01

    Hypertension is mainly asymptomatic and remains undiagnosed until the disease progresses. The objective of the study was to determine the prevalence of and risk factors for hypertension in rural Bangladesh. Using a population-based cluster random sampling strategy, 3096 adults aged ⩾30 years were recruited from a rural district in Bangladesh. Data collected included two blood pressure (BP) measurements, fasting blood glucose, socio-demographic and anthropometric measurements. Hypertension was defined as systolic BP (SBP) ⩾140 mm Hg or diastolic BP (DBP) ⩾90 mm Hg or self-reported diagnosed hypertension. Logistic regression techniques were used for data analyses. The crude prevalence of hypertension was 40% (95% confidence interval (CI) 38-42%) of which 82% were previously undiagnosed. People from lower socio-economic status (SES) had a significantly higher percentage of undiagnosed hypertension compared with people with higher SES (P<0.001). There was no significant gender difference in severity of hypertension. Males with higher education level compared with no education had a higher prevalence of hypertension (odds ratio 2.34, 95% CI 1.49-3.69). Older age and waist circumference in both genders, and diabetes, lack of physical activity in females were found to be associated with higher prevalence of hypertension. Our research suggests the prevalence of undiagnosed hypertension was higher in the rural area in Bangladesh than that reported from the rural area in neighbouring India and China. Lower SES was associated with a higher risk of undiagnosed hypertension. Public health programs at the grass-roots level must emphasise the provision of primary care and preventive services in managing this non-communicable disease.

  12. "Healthy Men" and High Mortality: Contributions from a Population-Based Study for the Gender Paradox Discussion

    PubMed Central

    Bastos, Tássia Fraga; Canesqui, Ana Maria; Barros, Marilisa Berti de Azevedo

    2015-01-01

    Background Inequalities between men and women in morbidity and mortality show a contrast, which has been called gender paradox. Most studies evaluating this paradox were conducted in high-income countries and, until now, few investigations have been performed in Brazil. This study aims to estimate the magnitude of inequalities between adult men and women in several dimensions: demographic and socioeconomic, health behaviors, morbidity, use of health services and mortality. Methods The data were obtained from population-based household survey carried out in Campinas (Campinas Health Survey 2008/09) corresponding to 957 people, and data from the Mortality Information System (MIS) between 2009 and 2011. Prevalences and prevalence ratios were analyzed in order to verify the differences between men and women regarding socioeconomic and demographic variables, health behaviors, morbidities and consultations in the last two weeks. Mortality rates and the ratio between coefficients considering the underlying causes of death were calculated. Results Women had a greater disadvantage in socioeconomic indicators, chronic diseases diagnosed by a health professional and referred health problems as well as make more use of health services, while men presented higher frequency of most unhealthy behaviors and excessive mortality for all causes investigated. Conclusions The findings contribute to the discussion of gender paradox and demonstrate the need to employ health actions that consider the differences between men and women in the various health dimensions analyzed. The premature male mortality from preventable causes was outstanding, making clear the need for more effective prevention and health promotion directed to this segment of the population. PMID:26641245

  13. Sleep apnea and the subsequent risk of Parkinson’s disease: a 3-year nationwide population-based study

    PubMed Central

    Chou, Ping-Song; Lai, Chiou-Lian; Chou, Yii-Her; Chang, Wei-Pin

    2017-01-01

    Purpose Sleep apnea (SA)-induced chronic intermittent hypoxia increases oxidative stress and inflammation, which may contribute to the pathophysiology of Parkinson’s disease (PD). This study evaluated the risk of PD following SA diagnosis. Patients and methods This was a 3-year nationwide population-based matched cohort study using claims data from the National Health Insurance Research Database (NHIRD), Taiwan. We analyzed 1,944 patients diagnosed as having SA between 1997 and 2005 and a matched cohort of 9,720 non-SA patients from the NHIRD. Patients with a history of PD were excluded. Each patient was followed up for 3 years to evaluate subsequent PD development. Results Of the 11,664 patients, 17 (0.9%) and 38 (0.4%) from the SA and matched non-SA cohorts, respectively, were subsequently diagnosed as having PD during follow-up. After adjustments for potential confounders, the SA cohort had a 1.85-fold higher risk of PD than the non-SA cohort (95% confidence interval [CI] =1.02–3.35; P=0.042). After age and sex stratification, PD development was independently associated with SA only in men (adjusted hazard ratio [HR], 2.26; 95% CI =1.11–4.63; P<0.05) and in patients aged ≥60 years (adjusted HR, 1.93; 95% CI =1.01–3.71; P<0.05). Conclusion Our study suggests that patients with SA are at an increased longitudinal risk of PD. Furthermore, age and male sex are independently associated with the risk of PD.

  14. Impact of malocclusion on oral health-related quality of life among Brazilian preschool children: a population-based study.

    PubMed

    Carvalho, Anita Cruz; Paiva, Saul Martins; Viegas, Claudia Marina; Scarpelli, Ana Carolina; Ferreira, Fernanda Morais; Pordeus, Isabela Almeida

    2013-01-01

    The purpose of the present study was to evaluate the impact of malocclusion on Oral Health-Related Quality of Life (OHRQoL) of children and their families. A population-based cross-sectional study was carried out in Belo Horizonte, MG, Brazil. A representative sample of 1069 male and female preschoolers aged 60 to 71 months was randomly selected from public and private preschools and daycare centers. Data were collected using the B-ECOHIS. In addition, a questionnaire addressing socioeconomic and demographic data was self-administered by the parents/guardians. The criteria used to diagnose malocclusion were based on Foster and Hamilton (1969), Graboswki et al. (2007) and Oliveira et al. (2008). Descriptive, univariate and multiple Poison logistic regression analyses were carried out. The prevalence of malocclusion was observed in 46.2% of the children and deep overbite was the most prevalent type of malocclusion (19.7%), followed by posterior crossbite (13.1%), accentuated overjet (10.5%), anterior open bite (7.9%) and anterior crossbite (6.7%). The impact of malocclusion on OHRQoL was 32.7% among the children and 27.1% among the families. In Poisson multiple regression model adjusted for socioeconomic status, no significant association was found between malocclusion and OHRQoL of the children (PR=1.09, 95% CI: 0.96-1.24) and their families (PR=1.11, 95% CI: 0.94-1.31). It is concluded that children with malocclusion in this sample did not have a negative impact on their OHRQoL and of their families.

  15. Increased risk of chronic osteomyelitis after hip replacement: a retrospective population-based cohort study in an Asian population.

    PubMed

    Hung, D-Z; Tien, N; Lin, C-L; Lee, Y-R; Wang, C C N; Chen, J-J; Lim, Y-P

    2017-04-01

    The correlation between hip replacement (Hip-Repl) and chronic osteomyelitis (COM) has not been studied in Asian populations. Thus, we assessed Hip-Repl-related risk of developing COM via a population-based, nationwide, retrospective cohort study. The Hip-Repl cohort was obtained from Taiwan's Longitudinal Health Insurance Database 2000, and included patients who underwent Hip-Repl between 2000 and 2010; the control cohort was also selected from this database. Patients with a history of COM were excluded in both cohorts. We used univariate and multivariate Cox proportional hazards regression models to calculate the adjusted hazard ratios (aHRs) by age, sex, and comorbidities for developing COM. A total of 5349 patients who received a Hip-Repl and 10,372 matched controls were enrolled. In the Hip-Repl group, the risk for COM was 4.18-fold [95 % confidence interval (CI) = 2.24-7.80] higher than that in the control group after adjustment. For patients aged ≤65 years, the risk was 10.0-fold higher (95 % CI = 2.89-34.6). Furthermore, the risk was higher in the Hip-Repl cohort than in the non-Hip-Repl cohort, for both patients without comorbidity (aHR = 16.5, 95 % CI = 2.07-132.3) and those with comorbidity (aHR = 3.49, 95 % CI = 1.78-6.83). The impact of Hip-Repl on the risk for COM was greater among patients not using immunosuppressive drugs, and occurred during the first postoperative year. Patients who received Hip-Repl have an increased risk of developing COM. This risk was higher among males and patients aged 65 years or younger, and during the first postoperative year.

  16. Temporal trends in ankyloglossia and frenotomy in British Columbia, Canada, 2004-2013: a population-based study

    PubMed Central

    Joseph, K.S.; Kinniburgh, Brooke; Metcalfe, Amy; Razaz, Neda; Sabr, Yasser; Lisonkova, Sarka

    2016-01-01

    Background: Routine surveillance of congenital anomalies has shown recent increases in ankyloglossia (tongue-tie) in British Columbia, Canada. We examined the temporal trends in ankyloglossia and its surgical treatment (frenotomy). Methods: We conducted a population-based cohort study involving all live births in British Columbia from Apr. 1, 2004, to Mar. 31, 2014, with data obtained from the province's Perinatal Data Registry. Spatiotemporal trends in ankyloglossia and frenotomy, and associations with maternal and infant characteristics, were quantified using logistic regression analysis. Results: There were 459 445 live births and 3022 cases of ankyloglossia between 2004 and 2013. The population incidence of ankyloglossia increased by 70% (rate ratio 1.70, 95% confidence interval [CI] 1.44-2.01), from 5.0 per 1000 live births in 2004 to 8.4 per 1000 in 2013. During the same period, the population rate of frenotomy increased by 89% (95% CI 52%-134%), from 2.8 per 1000 live births in 2004 to 5.3 per 1000 in 2013. The 2 regional health authorities with the lowest population rates of frenotomy (1.5 and 1.8 per 1000 live births) had the lowest rates of ankyloglossia and the lowest rates of frenotomy among cases with ankyloglossia, whereas the 2 regional health authorities with the highest population rates of frenotomy (5.2 and 5.3 per 1000 live births) had high rates of ankyloglossia and the highest rates of frenotomy among cases of ankyloglossia. Nulliparity, multiple birth, male infant sex, birth weight and year were independently associated with ankyloglossia. Interpretation: Large temporal increases and substantial spatial variations in ankyloglossia and frenotomy rates were observed that may indicate a diagnostic suspicion bias and increasing use of a potentially unnecessary surgical procedure among infants. PMID:27280112

  17. Same-Sex Couples' Decisions and Experiences of Marriage in the Context of Minority Stress: Interviews From a Population-Based Longitudinal Study.

    PubMed

    Rostosky, Sharon S; Riggle, Ellen D B; Rothblum, Esther D; Balsam, Kimberly F

    2016-08-01

    In the emerging context of marriage equality, it is important to explore the reasons for and experience of marriage for long-term same-sex couples, including the role of minority stress. In Wave 3 of the population-based, longitudinal CUPPLES Study we interviewed 21 long-term same-sex couples (14 female, 7 male) who resided in 12 different states and who were legally married. Couple members ranged in age from 37 to 84 and reported being together as a couple from 15 to 41 years. Seven couples lived in states that did not recognize their marriage at the time of the interview. Legal protection and social validation emerged as the two primary domains that captured couples' lived experiences of marriage. Minority stress experiences emerged in the narratives in the context of couples' long-term commitment, the availability of civil marriage, and couples' participation in activist efforts on behalf of marriage equality for themselves and others.

  18. Let’s Get Physical: Sexual Orientation Disparities in Physical Activity, Sports Involvement, and Obesity Among a Population-Based Sample of Adolescents

    PubMed Central

    Poteat, V. Paul

    2015-01-01

    Objectives. We examined sexual orientation disparities in physical activity, sports involvement, and obesity among a population-based adolescent sample. Methods. We analyzed data from the 2012 Dane County Youth Assessment for 13 933 students in grades 9 through 12 in 22 Wisconsin high schools. We conducted logistic regressions to examine sexual orientation disparities in physical activity, sports involvement, and body mass index among male and female adolescents. Results. When we accounted for several covariates, compared with heterosexual females, sexual minority females were less likely to participate in team sports (adjusted odds ratio [AOR] = 0.44; 95% confidence interval [CI] = 0.37, 0.53) and more likely to be overweight (AOR = 1.28; 95% CI = 1.02, 1.62) or obese (AOR = 1.88; 95% CI = 1.43, 2.48). Sexual minority males were less likely than heterosexual males to be physically active (AOR = 0.62; 95% CI = 0.46, 0.83) or to participate in team sports (AOR = 0.26; 95% CI = 0.20, 0.32), but the 2 groups did not differ in their risk of obesity. Conclusions. Sexual orientation health disparities in physical activity and obesity are evident during adolescence. Culturally affirming research, interventions, and policies are needed for sexual minority youths. PMID:26180946

  19. Hand grip strength is associated with forced expiratory volume in 1 second among subjects with COPD: report from a population-based cohort study

    PubMed Central

    Strandkvist, Viktor Johansson; Backman, Helena; Röding, Jenny; Stridsman, Caroline; Lindberg, Anne

    2016-01-01

    Background Cardiovascular diseases and skeletal muscle dysfunction are common comorbidities in COPD. Hand grip strength (HGS) is related to general muscle strength and is associated with cardiovascular disease and all-cause mortality, while the results from small selected COPD populations are contradictory. The aim of this population-based study was to compare HGS among the subjects with and without COPD, to evaluate HGS in relation to COPD severity, and to evaluate the impact of heart disease. Subjects and methods Data were collected from the Obstructive Lung disease in Northern Sweden COPD study, where the subjects with and without COPD have been invited to annual examinations since 2005. In 2009–2010, 441 subjects with COPD (postbronchodilator forced expiratory volume in 1 second [FEV1]/vital capacity <0.70) and 570 without COPD participated in structured interviews, spirometry, and measurements of HGS. Results The mean HGS was similar when comparing subjects with and without COPD, but those with heart disease had lower HGS than those without. When compared by Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades, the subjects with GOLD 3–4 had lower HGS than those without COPD in both sexes (females 21.4 kg vs 26.9 kg, P=0.010; males 41.5 kg vs 46.3 kg, P=0.038), and the difference persisted also when adjusted for confounders. Among the subjects with COPD, HGS was associated with FEV1% of predicted value but not heart disease when adjusted for height, age, sex, and smoking habits, and the pattern was similar among males and females. Conclusion In this population-based study, the subjects with GOLD 3–4 had lower HGS than the subjects without COPD. Among those with COPD, HGS was associated with FEV1% of predicted value but not heart disease, and the pattern was similar in both sexes. PMID:27785009

  20. Health service utilisation for anogenital warts in Ontario, Canada prior to the human papillomavirus (HPV) vaccine programme introduction: a retrospective longitudinal population-based study

    PubMed Central

    Guerra, Fiona M; Rosella, Laura C; Dunn, Sheila; Wilson, Sarah E; Chen, Cynthia; Deeks, Shelley L

    2016-01-01

    Objective Trends in occurrence of anogenital warts (AGWs) can provide early evidence of human papillomavirus (HPV) vaccination programme impact on preventing HPV infection and HPV-induced lesions. The objective of this study was to provide a baseline of AGW epidemiology in Ontario prior to the introduction of the publicly-funded school-based HPV vaccination programme in September 2007. Setting and participants As a retrospective longitudinal population-based study, we used health administrative data as a proxy to estimate incident AGWs and total health service utilisation (HSU) for AGWs for all Ontario residents 15 years and older with valid health cards between 1 April 2003 and 31 March 2007. Outcome measures The outcome of interest was AGW healthcare utilisation identified using the International Classification of Diseases, 10th revision (ICD-10) diagnostic code for AGWs, as well as an algorithm for identifying AGW physician office visits in a database with a unique system of diagnostic and procedural codes. An AGW case was considered incident if preceded by 12 months without HSU for AGWs. Time trends by age group and sex were analysed. Results Between fiscal years 2003 and 2006, we identified 123 247 health service visits for AGWs by 51 436 Ontario residents 15 years and older. Incident AGWs peaked in females and males in the 21–23 year age group, at 3.74 per 1000 and 2.81 per 1000, respectively. HSU for AGWs peaked in females and males within the 21–23 year age group, at 9.34 per 1000 and 7.22 per 1000, respectively. Conclusions To the best of our knowledge, this is the first population-based study of AGW incidence and HSU in Ontario. The sex and age distribution of individuals with incident and prevalent AGWs in Ontario was similar to that of other provinces before HPV vaccine programme implementation in Canada. PMID:26966057

  1. Prevalence and risk factors of chlamydia infection in Hong Kong: A population-based geospatial household survey and testing

    PubMed Central

    Wong, William Chi Wai; Wong, Ngai Sze; Parish, William L.; Miu, Heidi Yin Hai; Yang, Li-Gang; Emch, Michael; Ho, King Man; Fong, Francois Yeung; Tucker, Joseph D.

    2017-01-01

    Background Chlamydia causes infertility and increases risk of HIV infection, and population-based studies provide essential information for effective infection control and prevention. This study examined Chlamydia trachomatis prevalence and risk factors among a representative sample of 18-49-year-old residents in Hong Kong. Methods Census boundary map of 412 constituency areas was used as primary sampling units to construct the sampling frame and, residential buildings and units were randomly selected using geospatial modelling. A questionnaire on sexual practice and health was conducted, and polymerase chain reaction was used to test the urine for genital chlamydial infection. Invitation letters were sent to the selected households and a team of interviewers were sent to recruit one subject per household. Prevalence data was weighted according to the 2011 census and risk factors identified through logistic regression. Results Among 881 participants (response rate of 24.5%), the overall Chlamydia trachomatis prevalence was low at 1.4% (95%CI 0.8–2.5%) but sexually active young (18–26 years) women had relatively high prevalence (5.8%, 95%CI 1.7–18.2%) in Hong Kong. A unique U-shape disease burden was observed with peaks in younger and older (40–49 years) women. Amongst the sexually active women, the risk factors of Chlamydia trachomatis infection were: younger age (aOR = 25.4, 95% CI 2.81–230); living alone (aOR = 8.99, 95% CI 1.46–55.40); and, among all the sexually active participants, males (including the male partners of the female participants) who had travelled out of Hong Kong in the previous 12 months had higher risks of infection (aOR = 5.35; 95% CI 1.25–22.8). A core-peripheral geographical distribution of Chlamydia trachomatis prevalence was also observed. Conclusion Young and older sexually active women in Hong Kong have high prevalence of chlamydia. Routine screening for sexually active women and young men should be considered. Further

  2. The burden of headache disorders in Pakistan: methodology of a population-based nationwide study, and questionnaire validation

    PubMed Central

    2013-01-01

    Background Large geographical gaps in our knowledge of the prevalence and burden of headache disorders include Pakistan, a country with major problems of poverty, illiteracy and security. We report implementation in this country of standard methods developed by Lifting The Burden (LTB) for population-based burden-of-headache studies. Methods We surveyed six locations from the four provinces: Lahore and Multan (Punjab), Karachi and Sukkur (Sindh), Abbottabad (Khyber Pakhtunkhwa) and Gwadar (Baluchistan). We randomly selected rural and urban households in each, which were visited by trained non-medical interviewers from the same locations. One randomly selected adult member (18–65 years) of each household was interviewed using LTB’s structured questionnaire translated into Urdu, the national language. Validation was performed among patients and accompanying attendants in three (urban and rural) medical facilities. After responding to the questionnaire, these participants were re-interviewed and diagnosed by a neurologist (gold standard). Results The survey was completed by 4,223 respondents (1,957 [46.3%] male, 2,266 [53.7%] female, 1,443 [34.2%] urban, 2,780 [65.8%] rural, mean age 34.4 ± 11.0 years). The participation rate was 89.5%. There were 180 participants (46.1% male, 53.9% female, 41.7% urban, 58.3% rural, mean age 39.4 ± 14.2 years) in the validation sample, of whom 147 (81.7%) reported headache in the last year. The questionnaire was 100% sensitive in screening for headache and for headache on ≥15 days/month, and showed good agreement with the gold-standard diagnoses (kappa = 0.77). It was relatively insensitive for TTH. The questionnaire’s default diagnosis of probable MOH when medication overuse accompanied headache on ≥15 days/month was not supported by evidence of causation in most cases seen by the neurologist. In public-health terms, precise diagnosis in these cases matters less than reliably detecting the coexistence of

  3. Association between Daily Hydrogen Sulfide Exposure and Incidence of Emergency Hospital Visits: A Population-Based Study

    PubMed Central

    Finnbjornsdottir, Ragnhildur Gudrun; Carlsen, Hanne Krage; Thorsteinsson, Throstur; Oudin, Anna; Lund, Sigrun Helga; Gislason, Thorarinn; Rafnsson, Vilhjalmur

    2016-01-01

    Background The adverse health effects of high concentrations of hydrogen sulfide (H2S) exposure are well known, though the possible effects of low concentrations have not been thoroughly studied. The aim was to study short-term associations between modelled ambient low-level concentrations of intermittent hydrogen sulfide (H2S) and emergency hospital visits with heart diseases (HD), respiratory diseases, and stroke as primary diagnosis. Methods The study is population-based, using data from patient-, and population-registers from the only acute care institution in the Reykjavik capital area, between 1 January, 2007 and 30 June, 2014. The study population was individuals (≥18yr) living in the Reykjavik capital area. The H2S emission originates from a geothermal power plant in the vicinity. A model was used to estimate H2S exposure in different sections of the area. A generalized linear model assuming Poisson distribution was used to investigate the association between emergency hospital visits and H2S exposure. Distributed lag models were adjusted for seasonality, gender, age, traffic zones, and other relevant factors. Lag days from 0 to 4 were considered. Results The total number of emergency hospital visits was 32961 with a mean age of 70 years. In fully adjusted un-stratified models, H2S concentrations exceeding 7.00μg/m3 were associated with increases in emergency hospital visits with HD as primary diagnosis at lag 0 risk ratio (RR): 1.067; 95% confidence interval (CI): 1.024–1.111, lag 2 RR: 1.049; 95%CI: 1.005–1.095, and lag 4 RR: 1.046; 95%CI: 1.004–1.089. Among males an association was found between H2S concentrations exceeding 7.00μg/m3, and HD at lag 0 RR: 1.087; 95%CI: 1.032–1.146 and lag 4 RR: 1080; 95%CI: 1.025–1.138; and among those 73 years and older at lag 0 RR: 1.075; 95%CI: 1.014–1.140 and lag 3 RR: 1.072; 95%CI: 1.009–1.139. No associations were found with other diseases. Conclusions The study showed an association between

  4. Cardiovascular disease and diagnosis of amyotrophic lateral sclerosis: A population based study.

    PubMed

    Kioumourtzoglou, Marianthi-Anna; Seals, Ryan M; Gredal, Ole; Mittleman, Murray A; Hansen, Johnni; Weisskopf, Marc G

    Amyotrophic lateral sclerosis (ALS) is a rapidly fatal neurodegenerative disease of unknown etiology. We investigated the association between ALS diagnosis and prior cardiovascular disease (CVD), and CVD-specific, hospital admissions in the Danish population. We conducted a population based nested case-control study, including 3182 Danish residents diagnosed with ALS at age ≥20 years (1982-2009) and 100 randomly selected controls for each case, matched on age, gender and vital status. We estimated odds ratios (OR) associated with CVD, and CVD-specific hospital admissions, adjusting for socioeconomic and marital status, region of residence and past diabetes and obesity diagnoses. The estimated adjusted OR for any CVD admission at least three years prior to the date of ALS diagnosis was 1.15 (95% CI 1.04-1.27). Our results varied across cause-specific admissions; for atherosclerosis the OR was 1.36 (95% CI 1.02-1.80) and for ischemic heart disease 1.14 (95% CI 0.99-1.31), while we observed no association with hypertensive and cerebrovascular diseases. Adjusting for or stratifying by COPD status, a cigarette-smoking correlate, did not change our results. In conclusion, in our population based study we found evidence for a moderately elevated association with CVD that was stronger for specific conditions, such as atherosclerosis. Our findings may have important implications for ALS pathogenesis.

  5. Primary gastrointestinal non-Hodgkin's lymphoma in a population-based registry.

    PubMed Central

    Otter, R.; Bieger, R.; Kluin, P. M.; Hermans, J.; Willemze, R.

    1989-01-01

    In a population-based registry of 580 patients with non-Hodgkin's lymphoma (NHL) 54 patients had a primary gastric lymphoma, 42 an intestinal, 113 a primary extranodal lymphoma localised elsewhere than in the gastrointestinal tract and 371 a primary nodal NHL. Histological specimens were reviewed by a panel of pathologists and classified according to the Kiel classification and the International Working Formulation. The 4-year survival rates for primary gastric, intestinal, other extranodal and nodal NHL ranged from 50 to 60%; the 4-year recurrence-free survival rates were 50%, 35%, 19% and 19%, respectively. Among patients with localised intermediate-grade disease survival for those with gastric NHL was better than for those with intestinal lymphoma. Because it is population-based, our study cohort was not subjected to exclusion due to age, performance scale, etc. and therefore provides a more realistic picture of the occurrence and presentation of as well as prognosis for lymphoma in the population. PMID:2803951

  6. Hodgkin's disease in Asians: incidence patterns and risk factors in population-based data.

    PubMed

    Glaser, Sally L; Hsu, Joe L

    2002-03-01

    Hodgkin's disease (HD) has been reported to be rare in Asians. Data sparseness has hindered studies exploring the relative contributions of environment and heredity to HD etiology, and individual risk factors have never been studied in an Asian population. With the most recent, uniformly collected population-based data from the US and Asia, we compared HD incidence rates in Chinese, Japanese, Filipinos, and Asian Indians in the US and in Asia. HD incidence rates were quite low in all Asian subgroups, but approximately double in US Asians as in native Asians. In both, rates were lower for Japanese and Chinese than for Filipinos and Asian Indians. A modest young-adult rate peak occurred for most US Asian groups, but not for any population in Asia. In data from a population-based case-control study of HD in San Francisco area women, young-adult Asian cases, like young-adult cases of other racial/ethnic groups, had childhood social environments indicative of less early contact with children. Given environmental and lifestyle differences between the US and Asia, the consistently low rates of HD in Asians suggest genetic resistance to disease development, possibly associated with HLA type. International and inter-ethnic differences, and risk factor patterns in case-control data, implicate environmental influences in the etiology of HD.

  7. Newly Diagnosed Anemia Increases Risk of Parkinson's disease: A Population-Based Cohort Study.

    PubMed

    Hong, Chien Tai; Huang, Yao Hsien; Liu, Hung Yi; Chiou, Hung-Yi; Chan, Lung; Chien, Li-Nien

    2016-07-14

    Anemia and low hemoglobin have been identified to increase Parkinson's disease (PD) risk. This population-based cohort study investigated PD risk in newly diagnosed anemic patients by using data from the Taiwan National Health Insurance Research Database. All newly diagnosed anemic patients (n = 86,334) without a history of stroke, neurodegenerative diseases, traumatic brain injury, major operations, or blood loss diseases were enrolled. A cohort of nonanemic controls, 1:1 matched with anemic patients on the basis of the demographics and pre-existing medical conditions, was also included. Competing risk analysis was used to evaluate PD risk in anemic patients compared with that in their matched controls. The adjusted hazard ratio (aHR) of PD risk in the anemic patients was 1.36 (95% confidence interval [CI]: 1.22-1.52, p < 0.001). Iron deficiency anemia (IDA) patients tended to exhibit a higher PD risk (aHR: 1.49; 95% CI: 1.24-1.79, p < 0.001). Furthermore, Iron supplement did not significantly affect the PD risk: the aHRs for PD risk were 1.32 (95% CI: 1.07-1.63, p < 0.01) and 1.86 (95% CI: 1.46-2.35, p < 0.001) in IDA patients with and without iron supplementation, respectively. The population-based cohort study indicated newly diagnosed anemia increases PD risk.

  8. Direct medical costs associated with Parkinson's disease: a population-based study.

    PubMed

    Leibson, Cynthia L; Long, Kirsten Hall; Maraganore, Demetrius M; Bower, James H; Ransom, Jeanine E; O'Brien, Peter C; Rocca, Walter A

    2006-11-01

    The objective was to provide population-based estimates of incremental medical costs associated with Parkinson's disease (PD) from onset forward. All Olmsted County, Minnesota, residents with confirmed PD onset from 1987 through 1995 (n = 92) and one age- and sex-matched non-PD referent subject per case were identified with retrospective record review and followed in provider-linked billing data for direct medical costs (excluding outpatient pharmaceutical costs) from 1 year before index (i.e., year of symptom onset) through 10 years after index. Costs for each referent subject were subtracted from those for his/her matched case. Tests for statistical significance used Wilcoxon signed ranks. Preindex costs were similar [median difference in annual costs (MD) = -3 dollars; P = 0.59]. One year post index, PD subjects exhibited borderline significantly higher costs compared to referent subjects (MD = 581 dollars; P = 0.052); the difference diminished over 5 years (MD = 118 dollars; P = 0.82). By 5 to 10 years, however, PD subjects exhibited significantly higher costs (MD = 1,146 dollars; P = 0.01). Over the full 10 years, excess costs were concentrated among PD subjects without rest tremor (MD = 2,261 dollars, P < 0.01, for those without tremor and -229 dollars, P = 0.99, for those with tremor). These population-based estimates of PD-associated direct medical costs from onset forward can uniquely inform policy decisions and cost-effectiveness research.

  9. Is Statin Use Associated With Tendon Rupture? A Population-Based Retrospective Cohort Analysis.

    PubMed

    Contractor, Tahmeed; Beri, Abhimanyu; Gardiner, Joseph C; Tang, Xiaoqin; Dwamena, Francesca C

    2015-01-01

    Previous case reports and small studies have suggested that 3-hydroxy-3-methylglutaryl-CoA reductase inhibitors (HMG-CoA-Is) may increase the risk of tendon rupture. We conducted a population-based retrospective cohort evaluation to better assess this relationship. From approximately 800,000 enrollees of a private insurance database, those who were aged ≤64 years with at least 1 year of continuous enrollment were selected. Exposure was defined as initiation of HMG-CoA-I after the beginning of the study period. Each exposed person was matched with 2 controls of similar age and gender. Baseline characteristics, including known risk factors for tendon rupture, were compared between exposed and control cohorts with fidelity to the study's matched design. After adjusting for differences in follow-up and baseline characteristics, incidence rate ratios for tendon rupture was assessed in HMG-CoA-I users and nonusers. A total of 34,749 exposed patients were matched with 69,498 controls. There was no difference in the occurrence of tendon ruptures in HMG-CoA-I users versus nonusers. The results remained unchanged after adjustment for age and gender. In conclusion, this population-based retrospective cohort evaluation suggests that use of HMG-CoA-Is as a group are not associated with tendon rupture.

  10. Smoldering multiple myeloma risk factors for progression: a Danish population-based cohort study.

    PubMed

    Sørrig, Rasmus; Klausen, Tobias W; Salomo, Morten; Vangsted, Annette J; Østergaard, Brian; Gregersen, Henrik; Frølund, Ulf Christian; Andersen, Niels F; Helleberg, Carsten; Andersen, Kristian T; Pedersen, Robert S; Pedersen, Per; Abildgaard, Niels; Gimsing, Peter

    2016-09-01

    Several risk scores for disease progression in patients with smoldering multiple myeloma (SMM) have been proposed; however, all have been developed using single-center registries. To examine risk factors for time to progression (TTP) to multiple myeloma (MM) for SMM, we analyzed a nationwide population-based cohort of 321 patients with newly diagnosed SMM registered within the Danish Multiple Myeloma Registry between 2005 and 2014. Significant univariable risk factors for TTP were selected for multivariable Cox regression analyses. We found that both an M-protein ≥30 g/L and immunoparesis significantly influenced TTP (HR 2.7, 95%CI (1.5;4.7), P = 0.001, and HR 3.3, 95%CI (1.4;7.8), P = 0.002, respectively). High free light chain (FLC) ratio did not significantly influence TTP in our cohort. Therefore, our data do not support recent IMWG proposal of identifying patients with FLC ratio above 100 as having ultra high-risk of transformation to MM. Using only immunoparesis and M-protein ≥30 g/L, we created a scoring system to identify low-, intermediate-, and high-risk SMM. This first population-based study of patients with SMM confirms that an M-protein ≥30 g/L and immunoparesis remain important risk factors for progression to MM.

  11. Prevalence of Parkinson's disease in Baskale, Turkey: a population based study.

    PubMed

    Durmus, Hacer; Gokalp, Mehmet A; Hanagasi, Hasmet A

    2015-03-01

    Parkinson's disease (PD) is the second most common neurodegenerative disease, and its prevalence rate varies between 15 and 250/100.000. The data on the prevalence of PD in Turkey are limited. In this study, we aimed to estimate the prevalence of PD in Baskale, Turkey. The study area is a rural small area in the eastern part Turkey, with a population of 26.991 inhabitants. The first stage of the study was undertaken between February and October 2011. Field workers performed a door to door population screening for the cardinal symptoms of PD and identified cases were reevaluated by an experienced movement disorders specialist. In this population based study, 19 PD patients were identified in the screened population, indicating that the estimated age standardized prevalence of PD in Turkey was 202/100.000. This study is the first large population based study for identifying prevalence of PD in Turkey. Our prevalence rate is slightly lower than those of European countries, which may be caused by ethnical differences or environmental factors.

  12. Immunosurveillance and the evaluation of national immunization programmes: a population-based approach.

    PubMed Central

    De Melker, H. E.; Conyn-van Spaendonck, M. A.

    1998-01-01

    Mass vaccination can change the epidemiological dynamics of infectious diseases. It may result in a limited persistence of natural and vaccine-induced immunity and a higher mean age of infection, which may lead to a greater risk of complications. The epidemiological situation should be monitored and immunosurveillance based on the assessment of specific antibodies against vaccine-preventable diseases in human serum is one of the tools. In order to estimate the immunity of the Dutch population reliably, a large-scale, population-based, collection of serum samples was established (8359 sera in a nation-wide sampling and 1589 sera from municipalities with low vaccine coverage). In contrast to collecting residual sera from laboratories, this approach gains extensive information by means of a questionnaire regarding the determinants of the immune status and the risk factors for the transmission of infectious diseases in general. The population-based approach gives a better guarantee that the data are representative than collecting sera from laboratories does. PMID:10030714

  13. Comprehensive population-based genome sequencing provides insight into hematopoietic regulatory mechanisms

    PubMed Central

    Guo, Michael H.; Nandakumar, Satish K.; Ulirsch, Jacob C.; Zekavat, Seyedeh M.; Buenrostro, Jason D.; Natarajan, Pradeep; Salem, Rany M.; Chiarle, Roberto; Mitt, Mario; Kals, Mart; Pärn, Kalle; Fischer, Krista; Milani, Lili; Mägi, Reedik; Palta, Priit; Gabriel, Stacey B.; Metspalu, Andres; Lander, Eric S.; Kathiresan, Sekar; Hirschhorn, Joel N.; Esko, Tõnu; Sankaran, Vijay G.

    2017-01-01

    Genetic variants affecting hematopoiesis can influence commonly measured blood cell traits. To identify factors that affect hematopoiesis, we performed association studies for blood cell traits in the population-based Estonian Biobank using high-coverage whole-genome sequencing (WGS) in 2,284 samples and SNP genotyping in an additional 14,904 samples. Using up to 7,134 samples with available phenotype data, our analyses identified 17 associations across 14 blood cell traits. Integration of WGS-based fine-mapping and complementary epigenomic datasets provided evidence for causal mechanisms at several loci, including at a previously undiscovered basophil count-associated locus near the master hematopoietic transcription factor CEBPA. The fine-mapped variant at this basophil count association near CEBPA overlapped an enhancer active in common myeloid progenitors and influenced its activity. In situ perturbation of this enhancer by CRISPR/Cas9 mutagenesis in hematopoietic stem and progenitor cells demonstrated that it is necessary for and specifically regulates CEBPA expression during basophil differentiation. We additionally identified basophil count-associated variation at another more pleiotropic myeloid enhancer near GATA2, highlighting regulatory mechanisms for ordered expression of master hematopoietic regulators during lineage specification. Our study illustrates how population-based genetic studies can provide key insights into poorly understood cell differentiation processes of considerable physiologic relevance. PMID:28031487

  14. The potential and limitations of data from population-based state cancer registries.

    PubMed

    Izquierdo, J N; Schoenbach, V J

    2000-05-01

    Cancer incidence varies markedly among states because of population heterogeneity regarding risk, genetic, and demographic factors. Population-based cancer registries are essential to monitoring cancer trends and control. The Centers for Disease Control and Prevention and the North American Association of Central Cancer Registries, through the National Program of Cancer Registries, are helping state registries generate more and better data nationwide. The National Program of Cancer Registries has supported the enhancement of 36 registries and the creation of 13 new registries in 45 states, 3 territories, and the District of Columbia, providing national standards for completeness, timeliness, and quality; financial support; and technical assistance. Users must be aware of diverse issues that influence collection and interpretation of cancer registry data, such as multiple cancer diagnoses, duplicate reports, reporting delays, misclassification of race/ethnicity, and pitfalls in estimations of cancer incidence rates. Attention to these issues and intense use of the available data for cancer surveillance will enable maximum societal benefit from the emerging network of population-based state cancer registries.

  15. Survival rate of breast cancer patients in Malaysia: a population-based study.

    PubMed

    Abdullah, Nor Aini; Wan Mahiyuddin, Wan Rozita; Muhammad, Nor Asiah; Ali, Zainudin Mohamad; Ibrahim, Lailanor; Ibrahim Tamim, Nor Saleha; Mustafa, Amal Nasir; Kamaluddin, Muhammad Amir

    2013-01-01

    Breast cancer is the most common cancer among Malaysian women. Other than hospital-based results, there are no documented population-based survival rates of Malaysian women for breast cancers. This population- based retrospective cohort study was therefore conducted. Data were obtained from Health Informatics Centre, Ministry of Health Malaysia, National Cancer Registry and National Registration Department for the period from 1st Jan 2000 to 31st December 2005. Cases were captured by ICD-10 and linked to death certificates to identify the status. Only complete data were analysed. Survival time was calculated from the estimated date of diagnosis to the date of death or date of loss to follow-up. Observed survival rates were estimated by Kaplan- Meier method using SPSS Statistical Software version 17. A total of 10,230 complete data sets were analysed. The mean age at diagnosis was 50.6 years old. The overall 5-year survival rate was 49% with median survival time of 68.1 months. Indian women had a higher survival rate of 54% compared to Chinese women (49%) and Malays (45%). The overall 5-year survival rate of breast cancer patient among Malaysian women was still low for the cohort of 2000 to 2005 as compared to survival rates in developed nations. Therefore, it is necessary to enhance the strategies for early detection and intervention.

  16. Statin Use Reduces Prostate Cancer All-Cause Mortality: A Nationwide Population-Based Cohort Study.

    PubMed

    Sun, Li-Min; Lin, Ming-Chia; Lin, Cheng-Li; Chang, Shih-Ni; Liang, Ji-An; Lin, I-Ching; Kao, Chia-Hung

    2015-09-01

    Studies have suggested that statin use is related to cancer risk and prostate cancer mortality. We conducted a population-based cohort study to determine whether using statins in prostate cancer patients is associated with reduced all-cause mortality rates. Data were obtained from the Taiwan National Health Insurance Research Database. The study cohort comprised 5179 patients diagnosed with prostate cancer who used statins for at least 6 months between January 1, 1998 and December 31, 2010. To form a comparison group, each patient was randomly frequency-matched (according to age and index date) with a prostate cancer patient who did not use any type of statin-based drugs during the study period. The study endpoint was mortality. The hazard ratio (HR) and 95% confidence interval (CI) were estimated using Cox regression models. Among prostate cancer patients, statin use was associated with significantly decreased all-cause mortality (adjusted HR = 0.65; 95% CI = 0.60-0.71). This phenomenon was observed among various types of statin, age groups, and treatment methods. Analyzing the defined daily dose of statins indicated that both low- and high-dose groups exhibited significantly decreased death rates compared with nonusers, suggesting a dose-response relationship. The results of this population-based cohort study suggest that using statins reduces all-cause mortality among prostate cancer patients, and a dose-response relationship may exist.

  17. The contribution of chromosomal abnormalities to congenital heart defects: a population-based study.

    PubMed

    Hartman, Robert J; Rasmussen, Sonja A; Botto, Lorenzo D; Riehle-Colarusso, Tiffany; Martin, Christa L; Cragan, Janet D; Shin, Mikyong; Correa, Adolfo

    2011-12-01

    We aimed to assess the frequency of chromosomal abnormalities among infants with congenital heart defects (CHDs) in an analysis of population-based surveillance data. We reviewed data from the Metropolitan Atlanta Congenital Defects Program, a population-based birth-defects surveillance system, to assess the frequency of chromosomal abnormalities among live-born infants and fetal deaths with CHDs delivered from January 1, 1994, to December 31, 2005. Among 4430 infants with CHDs, 547 (12.3%) had a chromosomal abnormality. CHDs most likely to be associated with a chromosomal abnormality were interrupted aortic arch (type B and not otherwise specified; 69.2%), atrioventricular septal defect (67.2%), and double-outlet right ventricle (33.3%). The most common chromosomal abnormalities observed were trisomy 21 (52.8%), trisomy 18 (12.8%), 22q11.2 deletion (12.2%), and trisomy 13 (5.7%). In conclusion, in our study, approximately 1 in 8 infants with a CHD had a chromosomal abnormality. Clinicians should have a low threshold at which to obtain testing for chromosomal abnormalities in infants with CHDs, especially those with certain types of CHDs. Use of new technologies that have become recently available (e.g., chromosomal microarray) may increase the identified contribution of chromosomal abnormalities even further.

  18. Posterior segment eye disease in sub-Saharan Africa: review of recent population-based studies

    PubMed Central

    Bastawrous, Andrew; Burgess, Philip I; Mahdi, Abdull M; Kyari, Fatima; Burton, Matthew J; Kuper, Hannah

    2014-01-01

    Objective To assess the burden of posterior segment eye diseases (PSEDs) in sub-Saharan Africa (SSA). Methods We reviewed published population-based data from SSA and other relevant populations on the leading PSED, specifically glaucoma, diabetic retinopathy and age-related macular degeneration, as causes of blindness and visual impairment in adults. Data were extracted from population-based studies conducted in SSA and elsewhere where relevant. Results PSEDs, when grouped or as individual diseases, are a major contributor to blindness and visual impairment in SSA. PSED, grouped together, was usually the second leading cause of blindness after cataract, ranging as a proportion of blindness from 13 to 37%. Conclusions PSEDs are likely to grow in importance as causes of visual impairment and blindness in SSA in the coming years as populations grow, age and become more urban in lifestyle. African-based cohort studies are required to help estimate present and future needs and plan services to prevent avoidable blindness. PMID:24479434

  19. Male Reproductive System

    MedlinePlus

    ... Old Feeding Your 1- to 2-Year-Old Male Reproductive System KidsHealth > For Parents > Male Reproductive System Print A ... understand your son's reproductive health. continue About the Male Reproductive System Most species have two sexes: male and female. ...

  20. Power comparison between population-based case–control studies and family-based transmission–disequilibrium tests: An empirical study

    PubMed Central

    Haldar, Tanushree; Ghosh, Saurabh

    2011-01-01

    BACKGROUND: There are two major classes of genetic association analyses: population based and family based. Population-based case–control studies have been the method of choice due to the ease of data collection. However, population stratification is one of the major limitations of case–control studies, while family-based studies are protected against stratification. In this study, we carry out extensive simulations under different disease models (both Mendelian as well as complex) to evaluate the relative powers of the two approaches in detecting association. MATERIALS AND METHODS: The power comparisons are based on a case–control design comprising 200 cases and 200 controls versus a Transmission Disequilibrium Test (TDT) or Pedigree Disequilibrium Test (PDT) design with 200 informative trios. We perform the allele-level test for case–control studies, which is based on the difference of allele frequencies at a single nucleotide polymorphism (SNP) between unrelated cases and controls. The TDT and the PDT are based on preferential allelic transmissions at a SNP from heterozygous parents to the affected offspring. We considered five disease modes of inheritance: (i) recessive with complete penetrance (ii) dominant with complete penetrance and (iii), (iv) and (v) complex diseases with varying levels of penetrances and phenocopies. RESULTS: We find that while the TDT/PDT design with 200 informative trios is in general more powerful than a case–control design with 200 cases and 200 controls (except when the heterozygosity at the marker locus is high), it may be necessary to sample a very large number of trios to obtain the requisite number of informative families. CONCLUSION: The current study provides insights into power comparisons between population-based and family-based association studies. PMID:21747584

  1. Organochlorine Pesticides and Risk of Endometriosis: Findings from a Population-Based Case–Control Study

    PubMed Central

    De Roos, Anneclaire J.; Thompson, Mary Lou; Sathyanarayana, Sheela; Scholes, Delia; Barr, Dana Boyd; Holt, Victoria L.

    2013-01-01

    Background: Endometriosis is considered an estrogen-dependent disease. Persistent environmental chemicals that exhibit hormonal properties, such as organochlorine pesticides (OCPs), may affect endometriosis risk. Objective: We investigated endometriosis risk in relation to environmental exposure to OCPs. Methods: We conducted the present analyses using data from the Women’s Risk of Endometriosis (WREN) study, a population-based case–control study of endometriosis conducted among 18- to 49-year-old female enrollees of a large health care system in western Washington State. OCP concentrations were measured in sera from surgically confirmed endometriosis cases (n = 248) first diagnosed between 1996 and 2001 and from population-based controls (n = 538). We estimated odds ratios (OR) and 95% CIs using unconditional logistic regression, adjusting for age, reference date year, serum lipids, education, race/ethnicity, smoking, and alcohol intake. Results: Our data suggested increased endometriosis risk associated with serum concentrations of β-hexachlorocyclohexane (HCH) (third vs. lowest quartile: OR = 1.7; 95% CI: 1.0, 2.8; highest vs. lowest quartile OR = 1.3; 95% CI: 0.8, 2.4) and mirex (highest vs. lowest category: OR = 1.5; 95% CI: 1.0, 2.2). The association between serum β-HCH concentrations and endometriosis was stronger in analyses restricting cases to those with ovarian endometriosis (third vs. lowest quartile: OR = 2.5; 95% CI: 1.5, 5.2; highest vs. lowest quartile: OR = 2.5; 95% CI: 1.1, 5.3). Conclusions: In our case–control study of women enrolled in a large health care system in the U.S. Pacific Northwest, serum concentrations of β-HCH and mirex were positively associated with endometriosis. Extensive past use of environmentally persistent OCPs in the United States or present use in other countries may affect the health of reproductive-age women. Citation: Upson K, De Roos AJ, Thompson ML, Sathyanarayana S, Scholes D, Barr DB, Holt VL. 2013

  2. Systemic inflammation in chronic obstructive pulmonary disease: a population-based study

    PubMed Central

    2010-01-01

    Background Elevated circulating levels of several inflammatory biomarkers have been described in selected patient populations with COPD, although less is known about their population-based distribution. The aims of this study were to compare the levels of several systemic biomarkers between stable COPD patients and healthy subjects from a population-based sample, and to assess their distribution according to clinical variables. Methods This is a cross-sectional study design of participants in the EPI-SCAN study (40-80 years of age). Subjects with any other condition associated with an inflammatory process were excluded. COPD was defined as a post-bronchodilator FEV1/FVC < 0.70. The reference group was made of non-COPD subjects without respiratory symptoms, associated diseases or prescription of medication. Subjects were evaluated with quality-of-life questionnaires, spirometry and 6-minute walk tests. Serum C-reactive protein (CRP), tumor necrosis factor (TNF)-α, interleukins (IL-6 and IL-8), alpha1-antitrypsin, fibrinogen, albumin and nitrites/nitrates (NOx) were measured. Results We compared 324 COPD patients and 110 reference subjects. After adjusting for gender, age, BMI and tobacco consumption, COPD patients showed higher levels of CRP (0.477 ± 0.023 vs. 0.376 ± 0.041 log mg/L, p = 0.049), TNF-α (13.12 ± 0.59 vs. 10.47 ± 1.06 pg/mL, p = 0.033), IL-8 (7.56 ± 0.63 vs. 3.57 ± 1.13 pg/ml; p = 0.033) and NOx (1.42 ± 0.01 vs. 1.36 ± 0.02 log nmol/l; p = 0.048) than controls. In COPD patients, serum concentrations of some biomarkers were related to severity and their exercise tolerance was related to serum concentrations of CRP, IL-6, IL-8, fibrinogen and albumin. Conclusions Our results provide population-based evidence that COPD is independently associated with low-grade systemic inflammation, with a different inflammatory pattern than that observed in healthy subjects. PMID:20500811

  3. Aortic Valve Calcification and the Risk of dementia: A Population-Based Study.

    PubMed

    Wolters, Frank J; Bos, Daniel; Vernooij, Meike W; Franco, Oscar H; Hofman, Albert; Koudstaal, Peter J; van der Lugt, Aad; Ikram, M Arfan

    2017-01-01

    The association of aortic valve calcification (AVC) with dementia remains unknown. In 2,428 non-demented participants from the population-based Rotterdam Study, we investigated the association of CT-assessed AVC with risk of dementia and cognitive decline. AVC was present in 33.1% of the population. During a median follow-up of 9.3 years, 160 participants developed dementia. We found no association between presence of AVC and risk of all-cause dementia [hazard ratio (HR): 0.89 (95% confidence interval (CI):0.63;1.26)]. Presence of AVC was not associated with cognitive decline on any of the cognitive tests, nor with a measure of global cognition.

  4. Waiting time disparities in breast cancer diagnosis and treatment: a population-based study in France.

    PubMed

    Molinié, F; Leux, C; Delafosse, P; Ayrault-Piault, S; Arveux, P; Woronoff, A S; Guizard, A V; Velten, M; Ganry, O; Bara, S; Daubisse-Marliac, L; Tretarre, B

    2013-10-01

    Waiting times are key indicators of a health's system performance, but are not routinely available in France. We studied waiting times for diagnosis and treatment according to patients' characteristics, tumours' characteristics and medical management options in a sample of 1494 breast cancers recorded in population-based registries. The median waiting time from the first imaging detection to the treatment initiation was 34 days. Older age, co-morbidity, smaller size of tumour, detection by organised screening, biopsy, increasing number of specimens removed, multidisciplinary consulting meetings and surgery as initial treatment were related to increased waiting times in multivariate models. Many of these factors were related to good practices guidelines. However, the strong influence of organised screening programme and the disparity of waiting times according to geographical areas were of concern. Better scheduling of diagnostic tests and treatment propositions should improve waiting times in the management of breast cancer in France.

  5. A population-based twin study of parentally reported tactile and auditory defensiveness in young children.

    PubMed

    Goldsmith, H H; Van Hulle, C A; Arneson, C L; Schreiber, J E; Gernsbacher, M A

    2006-06-01

    Some adults and children exhibit defensive behaviors to tactile or auditory stimulation. These symptoms occur not only in subsets of children with ADHD, autism, and Fragile X syndrome, but also in the apparent absence of accompanying disorders. Relatively little research explores the correlates and antecedents of sensory defensiveness. Using a population-based sample of 1,394 toddler-aged twins, mothers reported on tactile and auditory defensiveness, temperament, and behavior problems. The incidence of defensive symptoms was widely distributed, with some accumulation of cases in the extreme range. Girls were overrepresented in the extreme tactile defensiveness group. Both auditory and tactile defensiveness were modestly associated with fearful temperament and anxiety, but they were relatively distinct from other common dimensions of childhood behavioral dysfunction. Twin correlations for the full range of scores and concordance rates for the extremes suggested moderate genetic influences, with some indication that the tactile domain might be more heritable than the auditory domain.

  6. Epilepsy among children and adolescents with autism spectrum disorders: a population-based study.

    PubMed

    Jokiranta, Elina; Sourander, Andre; Suominen, Auli; Timonen-Soivio, Laura; Brown, Alan S; Sillanpää, Matti

    2014-10-01

    The present population-based study examines associations between epilepsy and autism spectrum disorders (ASD). The cohort includes register data of 4,705 children born between 1987 and 2005 and diagnosed as cases of childhood autism, Asperger's syndrome or pervasive developmental disorders--not otherwise specified. Each case was matched to four controls by gender, date of birth, place of birth, and residence in Finland. Epilepsy was associated with ASD regardless of the subgroup after adjusting for covariates. The associations were stronger among cases with intellectual disability, especially among females. Epilepsy's age at onset was similar between the cases and controls regardless of the ASD subgroup. These findings emphasize the importance to examine the neurodevelopmental pathways in ASD, epilepsy and intellectual disability.

  7. Population-based p16 and HPV positivity rates in oropharyngeal cancer in Southeast Scotland.

    PubMed

    Wells, L A R; Junor, E J; Conn, B; Pattle, S; Cuschieri, K

    2015-10-01

    We assessed a population-based cohort of patients diagnosed with oropharyngeal squamous cell carcinoma in Southeast Scotland over 13 months. p16 and human papilloma virus (HPV) expression were determined, and correlated with stage, treatment, smoking and alcohol history, and disease outcomes. Retrospective analysis was performed on 60 patients. p16 immunohistochemistry and HPV genotyping were performed on formalin-fixed paraffin-embedded tissues. HPV infection (as defined by p16 positivity and/or HPV PCR positivity) was identified in 57% of samples, while dual positives were detected in 45% of cases. HPV16 was most prevalent of the HPV types and was associated with 90% of positive samples. Cause-specific 1-year and 2-year survivals were 82.5% and 78.2%, respectively. The p16-positive and HPV-positive groups demonstrated significantly increased cause-specific survival in comparison with their negative counterparts.

  8. [Visual, hearing, and physical disability: prevalence and associated factors in a population-based study].

    PubMed

    Castro, Shamyr Sulyvan de; César, Chester Luiz Galvão; Carandina, Luana; Barros, Marilisa Berti Azevedo; Alves, Maria Cecília Goi Porto; Goldbaum, Moises

    2008-08-01

    The aim of this study was to describe the prevalence of disabilities according to demographic and socioeconomic characteristics, as well as to determine the main causes. The research used data from two population-based health surveys in São Paulo State, Brazil, in 2002 and 2003, designed with complex sampling techniques. Interviewees that reported disabilities comprised the study sample, according to the database variables. Prevalence of any disability was 110.8; visual disability, 62; hearing disability, 44; and physical disability, 13.3. Prevalence rates for disabilities varied according to age, gender, and schooling. Prevalence of hearing and physical disability was higher among men. The principal cause of disabilities was the disease itself. External causes were also one of the causative factors in disabilities. Disabilities increased with age and were more prevalent among women and persons with less schooling, and the principal causes were diseases and injuries.

  9. Reported Hearing Impairment in Essential Tremor: A Population-Based Case-Control Study

    PubMed Central

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

    2008-01-01

    In a population-based sample, we determined whether a larger proportion of essential tremor (ET) cases reported hearing impairment compared with controls. Ninety-six (38.7%) of 248 ET cases versus 1,371 (29.4%) of 4,669 controls (p = 0.002) reported hearing impairment. In a logistic regression analysis adjusted for age, gender, educational level, depressive symptoms, and dementia, participants who reported hearing impairment were 30% more likely to suffer from ET than were controls (odds ratio 1.3; 95% confidence interval 1.01–1.7; p = 0.04). ET seemed to be associated with reported hearing impairment. The basis for this finding, which has been noted in several studies, deserves further exploration. PMID:18073494

  10. Challenges of cardiac image analysis in large-scale population-based studies.

    PubMed

    Medrano-Gracia, Pau; Cowan, Brett R; Suinesiaputra, Avan; Young, Alistair A

    2015-03-01

    Large-scale population-based imaging studies of preclinical and clinical heart disease are becoming possible due to the advent of standardized robust non-invasive imaging methods and infrastructure for big data analysis. This gives an exciting opportunity to gain new information about the development and progression of heart disease across population groups. However, the large amount of image data and prohibitive time required for image analysis present challenges for obtaining useful derived data from the images. Automated analysis tools for cardiac image analysis are only now becoming available. This paper reviews the challenges and possible solutions to the analysis of big imaging data in population studies. We also highlight the potential of recent large epidemiological studies using cardiac imaging to discover new knowledge on heart health and well-being.

  11. Marital distress and DSM-IV psychiatric disorders in a population-based national survey.

    PubMed

    Whisman, Mark A

    2007-08-01

    The associations between marital distress and Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) Axis I psychiatric disorders were evaluated in a United States population-based survey of married individuals in which there was no upper age exclusionary criterion (N = 2,213). Marital distress was associated with (a) broad-band classifications of anxiety, mood, and substance use disorders and (b) all narrow-band classifications of specific disorders except for panic disorder, with the strongest associations obtained between marital distress and bipolar disorder, alcohol use disorders, and generalized anxiety disorder. The association between marital distress and major depressive disorder increased in magnitude with increasing age; there was no evidence that the association between marital distress and other psychiatric disorders was moderated by gender or age. Results support continued research on the association between couple functioning and mental health.

  12. Occupation and thyroid cancer: a population-based case-control study in Connecticut

    PubMed Central

    Ba, Yue; Huang, Huang; Lerro, Catherine C.; Li, Shuzhen; Zhao, Nan; Li, Anqi; Ma, Shuangge; Udelsman, Robert; Zhang, Yawei

    2016-01-01

    Objective The study aims to explore the associations between various occupations and thyroid cancer risk. Methods A population-based case-control study involving 462 histologically confirmed incident cases and 498 controls was conducted in Connecticut in 2010–2011. Results A significantly increased risk of thyroid cancer, particularly papillary microcarcinoma, was observed for those working as the healthcare practitioners and technical workers, health diagnosing and treating practitioners and registered nurses. Those working in building and grounds cleaning, maintenance occupations, pest control, retail sales, and customer service also had increased risk for papillary thyroid cancer. Subjects who worked as cooks, janitors, cleaners, and customer service representatives were at an increased risk of papillary thyroid cancer with tumor size >1 cm. Conclusions Certain occupations were associated with an increased risk of thyroid cancer, with some tumor size and subtype specificity. PMID:26949881

  13. Chemical exposures and Parkinson's disease: a population-based case-control study.

    PubMed

    Frigerio, Roberta; Sanft, Kevin R; Grossardt, Brandon R; Peterson, Brett J; Elbaz, Alexis; Bower, James H; Ahlskog, J Eric; de Andrade, Mariza; Maraganore, Demetrius M; Rocca, Walter A

    2006-10-01

    The putative association between pesticide exposures and Parkinson's disease (PD) remains controversial. We identified all subjects who developed PD in Olmsted County, Minnesota, from 1976 through 1995, and matched them by age (+/- 1 year) and sex to general population controls. We assessed exposures to chemical products by means of telephone interview with cases, controls, or their proxies (149 cases; 129 controls). Exposure to pesticides related or unrelated to farming was associated with PD in men (odds ratio, 2.4; 95% confidence interval, 1.1-5.4; P = 0.04). The association remained significant after adjustment for education or smoking. Analyses for the other six categories of industrial and household chemicals were all nonsignificant. This population-based study suggests a link between pesticides use and PD that is restricted to men. Pesticides may interact with other genetic or nongenetic factors that are different in men and women.

  14. Health: Policy or Law? A Population-Based Analysis of the Supreme Court's ACA Cases.

    PubMed

    Parmet, Wendy E

    2016-08-16

    This essay argues that it matters for the fate of health policies challenged in court whether courts consider health merely as a policy goal that must be subordinate to law, or as a legal norm warranting legal weight and consideration. Applying population-based legal analysis, this article demonstrates that courts have traditionally treated health as a legal norm. However, this norm appears to have weakened in recent years, a trend evident in the Supreme Court's first two decisions concerning the Affordable Care Act, NFIB v. Sebelius and Burwell v. Hobby Lobby However, in its more recent Affordable Care Act decision, King v. Burwell, the health legal norm is once again evident. Whether the Court will continue to treat health as a legal norm will prove critical to the deference and weight it grants health policies in the future.

  15. A Population-Based Twin Study of Parentally Reported Tactile and Auditory Defensiveness in Young Children

    PubMed Central

    Goldsmith, H. H.; Van Hulle, C. A.; Arneson, C. L.; Schreiber, J. E.; Gernsbacher, M. A.

    2015-01-01

    Some adults and children exhibit defensive behaviors to tactile or auditory stimulation. These symptoms occur not only in subsets of children with ADHD, autism, and Fragile X syndrome, but also in the apparent absence of accompanying disorders. Relatively little research explores the correlates and antecedents of sensory defensiveness. Using a population-based sample of 1,394 toddler-aged twins, mothers reported on tactile and auditory defensiveness, temperament, and behavior problems. The incidence of defensive symptoms was widely distributed, with some accumulation of cases in the extreme range. Girls were overrepresented in the extreme tactile defensiveness group. Both auditory and tactile defensiveness were modestly associated with fearful temperament and anxiety, but they were relatively distinct from other common dimensions of childhood behavioral dysfunction. Twin correlations for the full range of scores and concordance rates for the extremes suggested moderate genetic influences, with some indication that the tactile domain might be more heritable than the auditory domain. PMID:16649001

  16. Long-term benefits of full-day kindergarten: a longitudinal population-based study.

    PubMed

    Brownell, M D; Nickel, N C; Chateau, D; Martens, P J; Taylor, C; Crockett, L; Katz, A; Sarkar, J; Burland, E; Goh, C Y

    2015-02-01

    In the first longitudinal, population-based study of full-day kindergarten (FDK) outcomes beyond primary school in Canada, we used linked administrative data to follow 15 kindergarten cohorts (n ranging from 112 to 736) up to grade 9. Provincial assessments conducted in grades 3, 7, and 8 and course marks and credits earned in grade 9 were compared between FDK and half-day kindergarten (HDK) students in both targeted and universal FDK programmes. Propensity score matched cohort and stepped-wedge designs allowed for stronger causal inferences than previous research on FDK. We found limited long-term benefits of FDK, specific to the type of programme, outcomes examined, and subpopulations. FDK programmes targeted at low-income areas showed long-term improvements in numeracy for lower income girls. Our results suggest that expectations for wide-ranging long-term academic benefits of FDK are unwarranted.

  17. [A population-based case control study of primary liver cancer in Fusui].

    PubMed

    Zhang, M D

    1993-02-01

    A population-based case control study of primary liver cancer (PLC) was undertaken in Fusui County, Guangxi Autonomous Region. Ninety-nine PLC cases and 99 age-sex-matched controls were surveyed for their general conditions, life style features, dietary habits, types of drinking water and family history. Cases and controls were well distributed in nationality, education, marital status and annual income per person. Conditional logistic regression results showed that HBV infection, drinking pond-ditch water, family history and total alcohol intake were the risk factors of PLC with the relative risks 5.330 (2.502-11.35), 3.703 (1.251-10.96), 2.881 (1.289-6.441), 1.002 (1.000-1.004), respectively. And antibody of HBV surface antigen is protective factor with the relative risk of 0.418 (0.210-0.834).

  18. [Population-based breast cancer screening: certainties, controversies, and future perspectives].

    PubMed

    Apesteguía Ciriza, Luis; Pina Insausti, Luis Javier

    2014-01-01

    Population-based breast cancer screening programs based on mammography must maintain a high level of quality, so the results must be constantly monitored. Although most authors consider that these programs have decreased the mortality due to breast cancer by about 30%, others claim that the mortality has decreased by only about 12% due to errors in the randomization of patients, because the rate of advanced tumors has hardly decreased and because adjuvant treatment also improves survival. Other criticisms focus on overdiagnosis and overtreatment. We believe that despite the unquestionable value of mammographic screening, we should be open to certain changes such as the stratification of patients by their level of risk and the introduction of complementary techniques like tomosynthesis, ultrasonography, and magnetic resonance imaging in selected cases.

  19. Transferring HIS data to population-based cancer registries - concept and first implementations.

    PubMed

    Breil, Bernhard; Dugas, Martin

    2009-01-01

    Cancer is the second leading cause of death worldwide and in focus of epidemiological research. In Germany the cancer registration law stipulates an electronic report to the population-based cancer registry (PBCR). In this context the Comprehensive Cancer Centre Münster (CCCM) required a new concept to support the obligation to register cancer diseases. We analysed Hospital Information System (HIS) data structures related to cancer documentation and PBCR documents. Our main idea was to export available data items from the HIS and to convert them into the import format of the PBCR. We analysed HIS data and developed an XML-based converter to support an electronic reporting procedure. Using available HIS data can avoid redundant data entry and supports information workflow within the CCCM. HIS data can provide a secondary use beyond clinical routine in form of reporting, quality assurance and clinical research.

  20. Stroke Risk After Non-Stroke ED Dizziness Presentations: A Population-Based Cohort Study

    PubMed Central

    Kerber, Kevin A.; Zahuranec, Darin B.; Brown, Devin L.; Meurer, William J.; Burke, James F.; Smith, Melinda A.; Lisabeth, Lynda D.; Fendrick, A. Mark; McLaughlin, Thomas; Morgenstern, Lewis B.

    2014-01-01

    Objective Acute stroke is a serious concern in Emergency Department (ED) dizziness presentations. Prior studies, however, suggest that stroke is actually an unlikely cause of these presentations. Lacking are data on short- and long-term follow-up from population-based studies to establish stroke risk after presumed non-stroke ED dizziness presentations. Methods From 5/8/2011 to 5/7/2012, patients ≥ 45 years of age presenting to EDs in Nueces County, Texas, with dizziness, vertigo, or imbalance were identified, excluding those with stroke as the initial diagnosis. Stroke events after the ED presentation up to 10/2/2012 were determined using the Brain Attack Surveillance in Corpus Christi (BASIC) study, which uses rigorous surveillance and neurologist validation. Cumulative stroke risk was calculated using Kaplan-Meier estimates. Results 1,245 patients were followed for a median of 347 days (IQR 230- 436 days). Median age was 61.9 years (IQR, 53.8-74.0 years). After the ED visit, fifteen patients (1.2%) had a stroke. Stroke risk was 0.48% (95% CI, 0.22%-1.07%) at 2 days; 0.48% (95% CI, 0.22%-1.07%) at 7 days; 0.56% (95% CI, 0.27%-1.18%) at 30 days; 0.56% (95% CI, 0.27%-1.18%) at 90 days; and 1.42% (95% CI, 0.85%-2.36%) at 12 months. Interpretation Using rigorous case ascertainment and outcome assessment in a population-based design, we found that the risk of stroke after presumed non-stroke ED dizziness presentations is very low, supporting a non-stroke etiology to the overwhelming majority of original events. High-risk subgroups likely exist, however, because most of the 90-day stroke risk occurred within 2-days. Vascular risk stratification was insufficient to identify these cases. PMID:24788511

  1. Bowel Obstruction in Elderly Ovarian Cancer Patients: A Population-Based Study

    PubMed Central

    Mooney, Stephen J.; Winner, Megan; Hershman, Dawn L.; Wright, Jason D.; Feingold, Daniel L.; Allendorf, John D.; Neugut, Alfred I.

    2013-01-01

    PURPOSE Bowel obstruction is a common pre-terminal event in abdominal/pelvic cancer that has mainly been described in small single-institution studies. We used a large, population-based database to investigate the incidence, management, and outcomes of obstruction in ovarian cancer patients. PATIENTS AND METHODS We identified patients with stages IC-IV ovarian cancer, aged 65 years or older, in the Surveillance, Epidemiology and End Results (SEER)-Medicare database diagnosed between January 1, 1991 and December 31, 2005. We modeled predictors of inpatient hospitalization for bowel obstruction after cancer diagnosis, categorized management of obstruction, and analyzed the associations between treatment for obstruction and outcomes. RESULTS Of 8607 women with ovarian cancer, 1518 (17.6%) were hospitalized for obstruction subsequent to cancer diagnosis. Obstruction at cancer diagnosis (HR=2.17, 95% CI: 1.86–2.52) and mucinous tumor histology (HR=1.45, 95% CI: 1.15–1.83) were associated with increased risk of subsequent obstruction. Surgical management of obstruction was associated with lower 30-day mortality (13.4% in women managed surgically vs. 20.2% in women managed non-surgically), but equivalent survival after 30 days and equivalent rates of post-obstruction chemotherapy. Median post-obstruction survival was 382 days in women with obstructions of adhesive origin and 93 days in others. CONCLUSION In this large-scale, population-based assessment of patients with advanced ovarian cancer, nearly 20% of women developed bowel obstruction after cancer diagnosis. While obstruction due to adhesions did not signal the end of life, all other obstructions were pre-terminal events for the majority of patients regardless of treatment. PMID:23274561

  2. The epidemiology of functional gastrointestinal disorders in Mexico: a population-based study.

    PubMed

    López-Colombo, Aurelio; Morgan, Douglas; Bravo-González, Dalia; Montiel-Jarquín, Alvaro; Méndez-Martínez, Socorro; Schmulson, Max

    2012-01-01

    Aims. The frequency of functional gastrointestinal disorders (FGIDs) in the general population of Mexico is unknown. Methods. To determine the prevalence of FGIDs, associated depression, and health care utilization, a population-based sampling strategy was used to select 500 households in the State of Tlaxcala, in central Mexico. Household interviews were conducted by two trained physicians using the Rome II Modular Questionnaire, a health-care and medication used questionnaire and the CES-D depression scale. Results. The most common FGIDs were IBS: 16.0% (95% CI: 12.9-19.5); functional bloating: 10.8% (8.2-13.9); unspecified functional bowel disorder: 10.6% (8.0-13.6); and functional constipation (FC): 7.4% (5.3-10.1). Uninvestigated heartburn was common: 19.6% (16.2-23.4). All FGIDs were equally prevalent among both genders, except for IBS (P = 0.001), IBS-C (P < 0.001), IBS-A/M (P = 0.049), and FC (P = 0.039) which were more frequent in women. Subjects with FGIDs reported higher frequencies of medical visits: 34.6 versus 16.8%; use of medications: 40.7 versus 21.6%; (both P < 0.001); and reported depression: 26.7 versus 6.7%, (P < 0.001). Conclusion. In this first population-based study of FGIDs in Mexico, heartburn, IBS, functional distension, and FC were common. Only IBS, IBS-C, IBS-A/M, and FC were more frequent in women. Finally, FGIDs in Mexico had an increased burden of health care utilization and depression.

  3. Violence against children in humanitarian settings: A literature review of population-based approaches.

    PubMed

    Stark, Lindsay; Landis, Debbie

    2016-03-01

    Children in humanitarian settings are thought to experience increased exposure to violence, which can impair their physical, emotional, and social development. Violence against children has important economic and social consequences for nations as a whole. The purpose of this review is to examine population-based approaches measuring violence against children in humanitarian settings. The authors reviewed prevalence studies of violence against children in humanitarian contexts appearing in peer-reviewed journals within the past twenty years. A Boolean search procedure was conducted in October 2014 of the electronic databases PubMed/Medline and PsychInfo. If abstracts contained evidence of the study's four primary themes--violence, children, humanitarian contexts and population-based measurement--a full document review was undertaken to confirm relevance. Out of 2634 identified articles, 22 met the final inclusion criteria. Across studies, there was varying quality and no standardization in measurement approach. Nine out of 22 studies demonstrated a relationship between conflict exposure and adverse health or mental health outcomes. Among studies that compared rates of violence between boys and girls, boys reported higher rates of physical violence, while girls reported higher rates of sexual violence. Children in infancy and early childhood were found to be among the most under-researched. Ultimately, the body of evidence in this review offers an incomplete picture regarding the prevalence, nature and impact of violence against children in emergencies, demonstrating a weak evidence base for some of the basic assumptions underpinning humanitarian practice. The development of standardized approaches to more rigorously measure violence against children is urgently needed in order to understand trends of violence against children in humanitarian contexts, and to promote children's healthy development and well-being.

  4. Racial and Ethnic Disparities in Oncotype DX Test Receipt in a Statewide Population-Based Study.

    PubMed

    Davis, Brigette A; Aminawung, Jenerius A; Abu-Khalaf, Maysa M; Evans, Suzanne B; Su, Kevin; Mehta, Rajni; Wang, Shi-Yi; Gross, Cary P

    2017-03-01

    Background: Racial disparities have been reported in breast cancer care, yet little is known about disparities in access to gene expression profiling (GEP) tests. Given the impact of GEP test results, such as those of Oncotype DX (ODx), on treatment decision-making for hormone receptor-positive (HR+) breast cancer, it is particularly important to assess disparities in its use. Methods: We conducted a retrospective population-based study of 8,784 patients diagnosed with breast cancer in Connecticut during 2011 through 2013. We assessed the association between race, ethnicity, and ODx receipt among women with HR+ breast cancer for whom NCCN does and does not recommend ODx testing, using bivariate and multivariate logistic analyses. Results: We identified 5,294 women who met study inclusion criteria: 83.8% were white, 6.3% black, and 7.4% Hispanic. Overall, 50.9% (n=4,131) of women in the guideline-recommended group received ODx testing compared with 18.5% (n=1,163) in the nonrecommended group. More white women received the ODx test compared with black and Hispanic women in the recommended and nonrecommended groups (51.4% vs 44.6% and 47.7%; and 21.2% vs 9.0% and 9.7%, respectively). After adjusting for tumor and clinical characteristics, we observed significantly lower ODx use among black (odds ratio [OR], 0.64; 95% CI, 0.47-0.88) and Hispanic women (OR, 0.59; 95% CI, 0.45-0.77) compared with white women in the recommended group and in the guideline-discordant group (blacks: OR, 0.39; 95% CI, 0.20-0.78, and Hispanics: OR, 0.44; 95% CI, 0.23-0.85). Conclusions: In this population-based study, we identified racial disparities in ODx testing. Disparities in access to innovative cancer care technologies may further exacerbate existing disparities in breast cancer outcomes.

  5. Childhood cancer survival in Finland (1953-2010): a nation-wide population-based study.

    PubMed

    Madanat-Harjuoja, L M; Pokhrel, A; Kivivuori, S M; Saarinen-Pihkala, U M

    2014-11-01

    Population based survival studies are critical in monitoring changes in anticancer therapy, evaluating effectiveness of new treatments as well as identifying possibilities for further improvement. The previous report on cancer survival in Finland covered patients diagnosed in 1953-1995. Data on survival in the European and Nordic pediatric populations have been published with follow-up ending in 2002. We describe population-based survival of childhood cancer patients (n = 8270, age 0-14 years) in Finland overall and by disease category with follow-up extending from 1953 to 2010 and focusing on the modern treatment era. Data were collected from the Finnish Cancer Registry. Age-standardised observed survival proportions (rates) were calculated using the actuarial (or life-table) method. Trends in observed survival rates were studied over six diagnostic periods: 1953-1960, 1961-1970, 1971-1980, 1981-1990, 1991-2000 and 2001-2010. The overall 5-year survival reached 82.1% (95% CI 80.0-84.2) in the most recent period. In most diagnostic categories, the biggest leap in survival was seen between 1961-1970 and 1981-1990, after which slight improvements occurred between 1981-1990 and 1991-2000, with no significant increase thereafter. In analyses by diagnostic group, positive trends in survival over the last three decades were seen for leukemia (p = 0.000), non-Hodgkin's lymphoma (p = 0.002) and CNS tumours (p = 0.02). Although survival of childhood cancer patients overall has significantly improved from 1953 to 2000, improvement thereafter has been marginal. Future treatment efforts should be directed at bone tumours, soft-tissue sarcoma, neuroblastoma and malignant brain tumours as well as high-risk leukemia.

  6. Hip Fracture in People with Erectile Dysfunction: A Nationwide Population-Based Cohort Study

    PubMed Central

    Wu, Chieh-Hsin; Tung, Yi-Ching; Lin, Tzu-Kang; Chai, Chee-Yin; Su, Yu-Feng; Tsai, Tai-Hsin; Tsai, Cheng-Yu; Lu, Ying-Yi; Lin, Chih-Lung

    2016-01-01

    The aims of this study were to investigate the risk of hip fracture and contributing factors in patients with erectile dysfunction(ED). This population-based study was performed using the Taiwan National Health Insurance Research Database. The analysis included4636 patients aged ≥ 40 years who had been diagnosed with ED (International Classification of Diseases, Ninth Revision, Clinical Modification codes 302.72, 607.84) during 1996–2010. The control group included 18,544 randomly selected age-matched patients without ED (1:4 ratio). The association between ED and hip fracture risk was estimated using a Cox proportional hazard regression model. During the follow-up period, 59 (1.27%) patients in the ED group and 140 (0.75%) patients in the non-ED group developed hip fracture. After adjusting for covariates, the overall incidence of hip fracture was 3.74-times higher in the ED group than in the non-ED group (2.03 vs. 0.50 per 1000 person-years, respectively). The difference in the overall incidence of hip fracture was largest during the 3-year follow-up period (hazard ratio = 7.85; 95% confidence interval = 2.94–20.96; P <0.0001). To the best of our knowledge, this nationwide population-based study is the first to investigate the relationship between ED and subsequent hip fracture in an Asian population. The results showed that ED patients had a higher risk of developing hip fracture. Patients with ED, particularly those aged 40–59 years, should undergo bone mineral density examinations as early as possible and should take measures to reduce the risk of falls. PMID:27078254

  7. Acute gastroenteritis in Hong Kong: a population-based telephone survey.

    PubMed

    Ho, S C; Chau, P H; Fung, P K; Sham, A; Nelson, E A; Sung, J

    2010-07-01

    A population-based telephone survey of acute gastroenteritis (AG) was conducted in Hong Kong from August 2006 to July 2007. Study subjects were recruited through random digit-dialing with recruitments evenly distributed weekly over the 1-year period. In total, 3743 completed questionnaires were obtained. An AG episode is defined as diarrhoea >or=3 times or any vomiting in a 24-h period during the 4 weeks prior to interview, in the absence of known non-infectious causes. The prevalence of AG reporting was 7%. An overall rate of 0.91 (95% CI 0.81-1.01) episodes per person-year was observed with women having a slightly higher rate (0.94, 95% CI 0.79-1.08) than men (0.88, 95% CI 0.73-1.04). The mean duration of illness was 3.6 days (S.D.=5.52). Thirty-nine percent consulted a physician, 1.9% submitted a stool sample for testing, and 2.6% were admitted to hospital. Of the subjects aged >or=15 years, significantly more of those with AG reported eating raw oysters (OR 2.4, 95% CI 1.3-4.4), buffet meals (OR 1.8, 95% CI 1.3-2.5), and partially cooked beef (OR 1.8, 95% CI 1.2-2.7) in the previous 4 weeks compared to the subjects who did not report AG. AG subjects were also more likely to have had hot pot, salad, partially cooked or raw egg or fish, sushi, sashimi, and 'snacks bought at roadside' in the previous 4 weeks. This first population-based study on the disease burden of AG in Asia showed that the prevalence of AG in Hong Kong is comparable to that experienced in the West. The study also revealed some 'risky' eating practices that are more prevalent in those affected with AG.

  8. Socioeconomic differences in childhood injury: a population based epidemiologic study in Ontario, Canada

    PubMed Central

    Faelker, T.; Pickett, W.; Brison, R.

    2000-01-01

    Objective—To determine whether risks for childhood injury vary according to socioeconomic gradients. Design—Population based, retrospective study. The percentage of individuals living below the poverty line (described ecologically using census data) was the primary measure of socioeconomic status. Setting—Catchment area of a tertiary medical centre that provides emergency services to all area residents. Area residents aged 0–19 years during 1996 were included. Observations—Injuries that occurred during 1996 were identified by an emergency department based surveillance system. The study population was divided into socioeconomic grades based upon percentages of area residents living below the poverty line. Multiple Poisson regression analyses were used to quantify associations and assess the statistical significance of trends. Results—5894 childhood injuries were identified among 35 380 eligible children; 985 children with missing socioeconomic data were excluded. A consistent relation between poverty and injury was evident. Children in the highest grade (indicating higher poverty levels) experienced injury rates that were 1.67 (95% confidence interval 1.48 to 1.89) higher than those in the lowest grade (adjusted relative risk for grades 1-V: 1.00,1.10,1.22,1.42, 1.67; ptrend<0.001). These patterns were observed within age/sex strata; for home, recreational, and fall injuries; and for injuries of minor and moderate severities. Conclusions—Socioeconomic differences in childhood injury parallel mortality and morbidity gradients identified in adult populations. This study confirms that this health gradient is observable in a population of children using emergency department data. Given the population based nature of this study, these findings are likely to be reflected in other settings. The results suggest the need for targeted injury prevention efforts among children from economically disadvantaged populations, although the exact requirements of the

  9. Suicide after release from prison - a population-based cohort study from Sweden

    PubMed Central

    Haglund, Axel; Tidemalm, Dag; Jokinen, Jussi; Långström, Niklas; Liechtenstein, Paul; Fazel, Seena; Runeson, Bo

    2015-01-01

    Objective Released prisoners have high suicide rates compared with the general population, but little is known about risk factors and possible causal pathways. We conducted a population-based cohort study to investigate rates and risk factors for suicide in people previously imprisoned. Methods We identified individuals released from prison in Sweden between January 1, 2005 and December 31, 2009 through linkage of national population-based registers. Released prisoners were followed from the day of release until death, emigration, new incarceration, or December 31, 2009. Survival analyses were conducted to compare incidence rates and psychiatric morbidity with non-convicted population controls matched on gender and year of birth. Results We identified 38,995 releases among 26,953 prisoners (7.6% females) during 2005-2009. Overall, 127 suicides occurred, accounting for 14% of all deaths after release (n=920). The mean suicide rate was 204 per 100,000 person years yielding an incidence rate ratio of 18.2 (95% CI 13.9-23.8) compared with general population controls. Previous substance use disorder (Hazard Ratio [HR]=2.1, 1.4-3.2), suicide attempt (HR=2.5, 1.7-3.7), and being born in Sweden vs. abroad (HR=2.1, 1.2-3.6) were independent risk factors for suicide after release. Conclusions Released prisoners are at high suicide risk and with a slightly different pattern of psychiatric risk factors for suicide compared with the general population. Results suggest appropriate allocation of resources to facilitate transition to life outside prison and increased attention to prisoners with both a previous suicide attempt and substance use disorder. PMID:25373114

  10. Organization of population-based cancer control programs: Europe and the world.

    PubMed

    Otter, Renée; Qiao, You-Lin; Burton, Robert; Samiei, Massoud; Parkin, Max; Trapido, Edward; Weller, David; Magrath, Ian; Sutcliffe, Simon

    2009-01-01

    As cancer is to a large extent avoidable and treatable, a cancer control program should be able to reduce mortality and morbidity and improve the quality of life of cancer patients and their families. However, the extent to which the goals of a cancer control program can be achieved will depend on the resource constraints a country faces. Such population-based cancer control plans should prioritize effective interventions and programs that are beneficial to the largest part of the population, and should include activities devoted to prevention, screening and early detection, treatment, palliation and end-of-life care, and rehabilitation. In order to develop a successful cancer control program, leadership and the relevant stakeholders, including patient organizations, need to be identified early on in the process so that all partners can take ownership and responsibility for the program. Various tools have been developed to aid them in the planning and implementation process. However, countries developing a national cancer control program would benefit from a discussion of different models for planning and delivery of population-based cancer control in settings with differing levels of resource commitment, in order to determine how best to proceed given their current level of commitment, political engagement and resources. As the priority assigned to different components of cancer control will differ depending on available resources and the burden and pattern of cancer, it is important to consider the relative roles of prevention, early detection, diagnosis, treatment, rehabilitation and palliative care in a cancer control program, as well as how to align available resources to meet prioritized needs. Experiences from countries with differing levels of resources are presented and serve to illustrate the difficulties in developing and implementing cancer control programs, as well as the innovative strategies that are being used to maximize available resources and

  11. Juvenile Huntington's disease: a population-based study using the General Practice Research Database

    PubMed Central

    Douglas, Ian; Evans, Stephen; Rawlins, Michael D; Smeeth, Liam; Tabrizi, Sarah J; Wexler, Nancy S

    2013-01-01

    Background The juvenile form of Huntington's disease (HD) is a rare disorder. There are no population-based estimates of either its incidence or prevalence in any population in the world. The present study was undertaken to estimate the frequency of juvenile HD in the UK and to examine the range of pharmacological treatments used in its management. Method The records of individuals under the age of 21 who had recorded diagnoses of HD were retrieved from the General Practice Research Database from 1990 through 2010. From these data estimates of incidence and prevalence were made as well as the specific treatments used in the treatment of its physical and psychological manifestations. Results 12 incident and 21 prevalent patients with juvenile HD were identified. The 21 prevalent cases included the 12 incident cases. The minimum population-based estimate of incidence is 0.70 (95% CI 0.36 to 1.22) per million patient-years. The minimum estimate of prevalence is 6.77/million (95% CI 5.60 to 8.12) per million patient-years. Patients were most frequently prescribed antidepressants, hypnotics, antipsychotics and treatments for motor abnormalities. Conclusions In the UK, juvenile HD is an extremely rare and complex disorder. The prescribing data demonstrate that the clinical management of juvenile HD is undertaken with no formal evidence base for the efficacy or safety of the treatments used. Research into the safety and efficacy of appropriate therapies is urgently required to offset the haphazard nature of prescribing. Multinational collaboration will be necessary to enrol sufficient numbers. Exploratory studies, though, should begin now. PMID:23558730

  12. Infective Endocarditis and Cancer Risk: A Population-Based Cohort Study.

    PubMed

    Sun, Li-Min; Wu, Jung-Nan; Lin, Cheng-Li; Day, Jen-Der; Liang, Ji-An; Liou, Li-Ren; Kao, Chia-Hung

    2016-03-01

    This study investigated the possible relationship between endocarditis and overall and individual cancer risk among study participants in Taiwan.We used data from the National Health Insurance program of Taiwan to conduct a population-based, observational, and retrospective cohort study. The case group consisted of 14,534 patients who were diagnosed with endocarditis between January 1, 2000 and December 31, 2010. For the control group, 4 patients without endocarditis were frequency matched to each endocarditis patient according to age, sex, and index year. Competing risks regression analysis was conducted to determine the effect of endocarditis on cancer risk.A large difference was noted in Charlson comorbidity index between endocarditis and nonendocarditis patients. In patients with endocarditis, the risk for developing overall cancer was significant and 119% higher than in patients without endocarditis (adjusted subhazard ratio = 2.19, 95% confidence interval = 1.98-2.42). Regarding individual cancers, in addition to head and neck, uterus, female breast and hematological malignancies, the risks of developing colorectal cancer, and some digestive tract cancers were significantly higher. Additional analyses determined that the association of cancer with endocarditis is stronger within the 1st 5 years after endocarditis diagnosis.This population-based cohort study found that patients with endocarditis are at a higher risk for colorectal cancer and other cancers in Taiwan. The risk was even higher within the 1st 5 years after endocarditis diagnosis. It suggested that endocarditis is an early marker of colorectal cancer and other cancers. The underlying mechanisms must still be explored and may account for a shared risk factor of infection in both endocarditis and malignancy.

  13. Data harmonization and federated analysis of population-based studies: the BioSHaRE project

    PubMed Central

    2013-01-01

    Abstracts Background Individual-level data pooling of large population-based studies across research centres in international research projects faces many hurdles. The BioSHaRE (Biobank Standardisation and Harmonisation for Research Excellence in the European Union) project aims to address these issues by building a collaborative group of investigators and developing tools for data harmonization, database integration and federated data analyses. Methods Eight population-based studies in six European countries were recruited to participate in the BioSHaRE project. Through workshops, teleconferences and electronic communications, participating investigators identified a set of 96 variables targeted for harmonization to answer research questions of interest. Using each study’s questionnaires, standard operating procedures, and data dictionaries, harmonization potential was assessed. Whenever harmonization was deemed possible, processing algorithms were developed and implemented in an open-source software infrastructure to transform study-specific data into the target (i.e. harmonized) format. Harmonized datasets located on server in each research centres across Europe were interconnected through a federated database system to perform statistical analysis. Results Retrospective harmonization led to the generation of common format variables for 73% of matches considered (96 targeted variables across 8 studies). Authenticated investigators can now perform complex statistical analyses of harmonized datasets stored on distributed servers without actually sharing individual-level data using the DataSHIELD method. Conclusion New Internet-based networking technologies and database management systems are providing the means to support collaborative, multi-center research in an efficient and secure manner. The results from this pilot project show that, given a strong collaborative relationship between participating studies, it is possible to seamlessly co

  14. Sleep patterns and insomnia among adolescents: a population-based study.

    PubMed

    Hysing, Mari; Pallesen, Ståle; Stormark, Kjell M; Lundervold, Astri J; Sivertsen, Børge

    2013-10-01

    The aim of the current study was to examine sleep patterns and rates of insomnia in a population-based study of adolescents aged 16-19 years. Gender differences in sleep patterns and insomnia, as well as a comparison of insomnia rates according to DSM-IV, DSM-V and quantitative criteria for insomnia (Behav. Res. Ther., 41, 2003, 427), were explored. We used a large population-based study in Hordaland county in Norway, conducted in 2012. The sample included 10,220 adolescents aged 16-18 years (54% girls). Self-reported sleep measurements included bedtime, rise time, time in bed, sleep duration, sleep efficiency, sleep onset latency, wake after sleep onset, rate and frequency and duration of difficulties initiating and maintaining sleep and rate and frequency of tiredness and sleepiness. The adolescents reported short sleep duration on weekdays (mean 6:25 hours), resulting in a sleep deficiency of about 2 h. A majority of the adolescents (65%) reported sleep onset latency exceeding 30 min. Girls reported longer sleep onset latency and a higher rate of insomnia than boys, while boys reported later bedtimes and a larger weekday-weekend discrepancy on several sleep parameters. Insomnia prevalence rates ranged from a total prevalence of 23.8 (DSM-IV criteria), 18.5 (DSM-V criteria) and 13.6% (quantitative criteria for insomnia). We conclude that short sleep duration, long sleep onset latency and insomnia were prevalent in adolescents. This warrants attention as a public health concern in this age group.

  15. A systematic review of economic evaluations of population-based sodium reduction interventions

    PubMed Central

    Hope, Silvia F.; Webster, Jacqui; Trieu, Kathy; Pillay, Arti; Ieremia, Merina; Bell, Colin; Snowdon, Wendy; Neal, Bruce; Moodie, Marj

    2017-01-01

    Objective To summarise evidence describing the cost-effectiveness of population-based interventions targeting sodium reduction. Methods A systematic search of published and grey literature databases and websites was conducted using specified key words. Characteristics of identified economic evaluations were recorded, and included studies were appraised for reporting quality using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Results Twenty studies met the study inclusion criteria and received a full paper review. Fourteen studies were identified as full economic evaluations in that they included both costs and benefits associated with an intervention measured against a comparator. Most studies were modelling exercises based on scenarios for achieving salt reduction and assumed effects on health outcomes. All 14 studies concluded that their specified intervention(s) targeting reductions in population sodium consumption were cost-effective, and in the majority of cases, were cost saving. Just over half the studies (8/14) were assessed as being of ‘excellent’ reporting quality, five studies fell into the ‘very good’ quality category and one into the ‘good’ category. All of the identified evaluations were based on modelling, whereby inputs for all the key parameters including the effect size were either drawn from published datasets, existing literature or based on expert advice. Conclusion Despite a clear increase in evaluations of salt reduction programs in recent years, this review identified relatively few economic evaluations of population salt reduction interventions. None of the studies were based on actual implementation of intervention(s) and the associated collection of new empirical data. The studies universally showed that population-based salt reduction strategies are likely to be cost effective or cost saving. However, given the reliance on modelling, there is a need for the effectiveness of new

  16. Population based study of rates of multiple pregnancies in Denmark, 1980-94.

    PubMed Central

    Westergaard, T.; Wohlfahrt, J.; Aaby, P.; Melbye, M.

    1997-01-01

    OBJECTIVE: To study trends in multiple pregnancies not explained by changes in maternal age and parity patterns. DESIGN: Trends in population based figures for multiple pregnancies in Denmark studied from complete national records on parity history and vital status. POPULATION: 497,979 Danish women and 803,019 pregnancies, 1980-94. MAIN OUTCOME MEASURES: National rates of multiple pregnancies, infant mortality, and stillbirths controlled for maternal age and parity. Special emphasis on primiparous women > or = 30 years of age, who are most likely to undergo fertility treatment. RESULTS: The national incidence of multiple pregnancies increased 1.7-fold during 1980-94, the increase primarily in 1989-94 and almost exclusively in primiparous women aged > or = 30 years, for whom the adjusted population based twinning rate increased 2.7-fold and the triplet rate 9.1-fold. During 1989-94, the adjusted yearly increase in multiple pregnancies for these women was 19% (95% confidence interval 16% to 21%) and in dizygotic twin pregnancies 25% (21% to 28%). The proportion of multiple births among infant deaths in primiparous women > or = 30 years increased from 11.5% to 26.9% during the study period. The total infant mortality, however, did not increase for these women because of a simultaneous significant decrease in infant mortality among singletons. CONCLUSIONS: A relatively small group of women has drastically changed the overall national rates of multiple pregnancies. The introduction of new treatments to enhance fertility has probably caused these changes and has also affected the otherwise decreasing trend in infant mortality. Consequently, the resources, both economical and otherwise, associated with these treatments go well beyond those invested in specific fertility enhancing treatments. PMID:9080993

  17. ALS and the Military: A Population-Based Study in the Danish Registries

    PubMed Central

    Seals, Ryan M.; Kioumourtzoglou, Marianthi-Anna; Gredal, Ole; Hansen, Johnni; Weisskopf, Marc G.

    2016-01-01

    Background Prior studies have suggested that military service may be associated with the development of amyotrophic lateral sclerosis. We conducted a population-based case-control study in Denmark to assess whether occupation in the Danish military is associated with an increased risk of developing amyotrophic lateral sclerosis. Methods There were 3,650 incident cases of amyotrophic lateral sclerosis recorded in the Danish National Patient Registry between 1982 and 2009. Each case was matched to 100 age- and sex-matched population controls alive and free of amyotrophic lateral sclerosis on the date of the case diagnosis. Comprehensive occupational history was obtained from the Danish Pension Fund database, which began in 1964. Results 2.4% (n=8,922) of controls had a history of employment in the military prior to the index date. Military employees overall had an elevated rate of ALS (OR=1.3; 95% CI: 1.1-1.6). A ten-year increase in years employed by the military was associated with an odds ratio of 1.2 (95% CI: 1.0-1.4), and all quartiles of time employed were elevated. There was little suggestion of a pattern across calendar year of first employment, but there was some evidence that increasing age at first employment was associated with increased ALS rates. Rates were highest in the decade immediately following the end of employment (OR=1.6; 95% CI: 1.2-2.2). Conclusions In this large population-based case-control study, employment by the military is associated with increased rates of ALS. These findings are consistent with earlier findings that military service or employment may entail exposure to risk factors for ALS. PMID:26583610

  18. New population based reference values for spinal mobility measures based on the NHANES 2009–10

    PubMed Central

    Assassi, Shervin; Weisman, Michael H.; Lee, MinJae; Savage, Laurie; Diekman, Laura; Graham, Tiffany A.; Rahbar, Mohammad H.; Schall, Joan I.; Gensler, Lianne S.; Deodhar, Atul A.; Clegg, Daniel O.; Colbert, Robert A.; Reveille, John D.

    2014-01-01

    Objective To report population based percentile reference values for selected spinal mobility measures in a nationally representative sample of 5103 U.S. adults ages 20–69 years examined in the 2009–10 U.S. National Health and Nutrition Examination Survey (NHANES). Methods Occiput-to-Wall Distance (OWD), Thoracic Expansion (TE), and Anterior Lumbar Flexion (ALF – modified Schober test) were measured by trained examiners in a standardized fashion. TE was measured at the xyphosternal level while the lower reference point for ALF was a line marked at the level of the superior margin of the lateral iliac crests. We report reference values based on the 95th percentile of OWD and 5th percentile of TE and ALF measurements, as well as other summary statistics for these measures in the study population. Results An OWD of more than zero was present in 3.8 % of participants while 8.8% of participants had out of range values for TE based the commonly used threshold of 2.5 cm. The 95th percentile of OWD measurement was zero while the 5th percentile measurements for TE and ALF were 1.9 and 2 cm, respectively. The spinal measures were significantly associated with gender, age, ethnicity, height, and body mass index. Exclusion of individuals with severe obesity (BMI > 35) changed the proposed reference values for TE and ALF to 2.2 and 1.9 cm, respectively. Conclusion We verified the reference value of zero for OWD. Using the reported population based percentile values, new reference values for TE and the ALF can be derived. PMID:24782356

  19. Survival of patients with a new diagnosis of heart failure: a population based study

    PubMed Central

    Cowie, M; Wood, D; Coats, A; Thompson, S; Suresh, V; Poole-Wilson, P; Sutton, G

    2000-01-01

    OBJECTIVE—To describe the survival of a population based cohort of patients with incident (new) heart failure and the clinical features associated with mortality.
DESIGN—A population based observational study.
SETTING—Population of 151 000 served by 82 general practitioners in west London.
PATIENTS—New cases of heart failure were identified by daily surveillance of acute hospital admissions to the local district general hospital, and by general practitioner referral of all suspected new cases of heart failure to a rapid access clinic.
INTERVENTIONS—All patients with suspected heart failure underwent clinical assessment, and chest radiography, ECG, and echocardiogram were performed. A panel of three cardiologists reviewed all the data and determined whether the definition of heart failure had been met. Patients were subsequently managed by the general practitioner in consultation with the local cardiologist or admitting physician.
MAIN OUTCOME MEASURES—Death, overall and from cardiovascular causes.
RESULTS—There were 90 deaths (83 cardiovascular deaths) in the cohort of 220 patients with incident heart failure over a median follow up of 16 months. Survival was 81% at one month, 75% at three months, 70% at six months, 62% at 12 months, and 57% at 18 months. Lower systolic blood pressure, higher serum creatinine concentration, and greater extent of crackles on auscultation of the lungs were independently predictive of cardiovascular mortality (all p < 0.001).
CONCLUSIONS—In patients with new heart failure, mortality is high in the first few weeks after diagnosis. Simple clinical features can identify a group of patients at especially high risk of death.


Keywords: heart failure; prognosis; survival; epidemiology PMID:10768897

  20. The interrelation between premenstrual syndrome and major depression: Results from a population-based sample

    PubMed Central

    2011-01-01

    Background Research about the relationship between premenstrual syndrome (PMS) and major depression is limited. This study examined the relationship between moderate to severe PMS and major depression in a population-based sample of women of reproductive age. The objectives of the study were to assess the association between premenstrual syndrome and major depression, to analyse how PMS and major depression differ and to characterise the group of women who report both PMS and major depression. Methods Data were obtained from the Swiss Health Survey 2007. Included in the analysis was data from women under the age of 55 without hysterectomy and who answered the questions on PMS symptoms. The population-based sample consisted of 3518 women. Weighted prevalence rates were calculated and relative risk ratios for PMS, major depression and women who reported both PMS and major depression, were calculated with logistic multinominal logit regression. Results The prevalence of major depression was 11.3% in women screening positive for moderate PMS and 24.6% in women screening positive for severe PMS. Compared to women without any of these conditions, women who reported moderate to severe alcohol consumption had a lower risk for PMS. Women reporting use of antidepressants, and use of oral contraceptives had a higher risk for major depression compared to women without any of these conditions. Women reporting work dissatisfaction had a higher risk for PMS. A higher relative risk to report both PMS and major depression compared to women without PMS or major depression was related to factors such as high psychological distress, low mastery, psychotropic drug consumption, and low self-rated health. Conclusions The results suggested that women who suffer from both PMS and major depression are more impaired compared to women with only one disorder. The results further indicated that PMS and major depression are different disorders that can, however, co-occur. PMID:21992230

  1. Preoperative risk score predicting 90-day mortality after liver resection in a population-based study.

    PubMed

    Chang, Chun-Ming; Yin, Wen-Yao; Su, Yu-Chieh; Wei, Chang-Kao; Lee, Cheng-Hung; Juang, Shiun-Yang; Chen, Yi-Ting; Chen, Jin-Cherng; Lee, Ching-Chih

    2014-09-01

    The impact of important preexisting comorbidities, such as liver and renal disease, on the outcome of liver resection remains unclear. Identification of patients at risk of mortality will aid in improving preoperative preparations. The purpose of this study is to develop and validate a population-based score based on available preoperative and predictable parameters predicting 90-day mortality after liver resection using data from a hepatitis endemic country.We identified 13,159 patients who underwent liver resection between 2002 and 2006 in the Taiwan National Health Insurance Research Database. In a randomly selected half of the total patients, multivariate logistic regression analysis was used to develop a prediction score for estimating the risk of 90-day mortality by patient demographics, preoperative liver disease and comorbidities, indication for surgery, and procedure type. The score was validated with the remaining half of the patients.Overall 90-day mortality was 3.9%. Predictive characteristics included in the model were age, preexisting cirrhosis-related complications, ischemic heart disease, heart failure, cerebrovascular disease, renal disease, malignancy, and procedure type. Four risk groups were stratified by mortality scores of 1.1%, 2.2%, 7.7%, and 15%. Preexisting renal disease and cirrhosis-related complications were the strongest predictors. The score discriminated well in both the derivation and validation sets with c-statistics of 0.75 and 0.75, respectively.This population-based score could identify patients at risk of 90-day mortality before liver resection. Preexisting renal disease and cirrhosis-related complications had the strongest influence on mortality. This score enables preoperative risk stratification, decision-making, quality assessment, and counseling for individual patients.

  2. Area-level poverty and preterm birth risk: A population-based multilevel analysis

    PubMed Central

    DeFranco, Emily A; Lian, Min; Muglia, Louis A; Schootman, Mario

    2008-01-01

    Background Preterm birth is a complex disease with etiologic influences from a variety of social, environmental, hormonal, genetic, and other factors. The purpose of this study was to utilize a large population-based birth registry to estimate the independent effect of county-level poverty on preterm birth risk. To accomplish this, we used a multilevel logistic regression approach to account for multiple co-existent individual-level variables and county-level poverty rate. Methods Population-based study utilizing Missouri's birth certificate database (1989–1997). We conducted a multilevel logistic regression analysis to estimate the effect of county-level poverty on PTB risk. Of 634,994 births nested within 115 counties in Missouri, two levels were considered. Individual-level variables included demographics factors, prenatal care, health-related behavioral risk factors, and medical risk factors. The area-level variable included the percentage of the population within each county living below the poverty line (US census data, 1990). Counties were divided into quartiles of poverty; the first quartile (lowest rate of poverty) was the reference group. Results PTB < 35 weeks occurred in 24,490 pregnancies (3.9%). The rate of PTB < 35 weeks was 2.8% in counties within the lowest quartile of poverty and increased through the 4th quartile (4.9%), p < 0.0001. High county-level poverty was significantly associated with PTB risk. PTB risk (< 35 weeks) was increased for women who resided in counties within the highest quartile of poverty, adjusted odds ratio (adjOR) 1.18 (95% CI 1.03, 1.35), with a similar effect at earlier gestational ages (< 32 weeks), adjOR 1.27 (95% CI 1.06, 1.52). Conclusion Women residing in socioeconomically deprived areas are at increased risk of preterm birth, above other underlying risk factors. Although the risk increase is modest, it affects a large number of pregnancies. PMID:18793437

  3. Increased risk of herpes zoster in children with cancer: A nationwide population-based cohort study.

    PubMed

    Lin, Hsiao-Chuan; Chao, Yu-Hua; Wu, Kang-Hsi; Yen, Ting-Yu; Hsu, Yu-Lung; Hsieh, Tsung-Hsueh; Wei, Hsiu-Mei; Wu, Jhong-Lin; Muo, Chih-Hsin; Hwang, Kao-Pin; Peng, Ching-Tien; Lin, Cheng-Chieh; Li, Tsai-Chung

    2016-07-01

    Herpes zoster is rare in healthy children, but immunocompromised persons have an increased risk of herpes zoster and severe diseases. Considering the very limited information on herpes zoster in children with cancer, we performed a nationwide population-based cohort study to estimate the incidence of herpes zoster in children with cancer and to explore the association between the 2 diseases.Data were obtained from the National Health Research Institutes Database in Taiwan. A total of 4432 children with newly diagnosed cancer between 2000 and 2007 were identified as the cancer cohort, and 17,653 children without cancer frequency-matched by sex and age at entry were considered the noncancer cohort. The association between herpes zoster and childhood cancer was determined.Children with cancer had a higher risk of herpes zoster. The incidence rate of herpes zoster was higher in the cancer cohort than in the noncancer cohort (20.7 vs 2.4 per 10,000 person-years; IRR = 8.6; 95% CI = 4.8-15.6). The cumulative incidence was significantly higher in the cancer cohort (P < 0.0001). Leukemia, lymphoma, and solid tumor were all associated with the increased risk, and leukemia had the highest magnitude of strength of association.This nationwide population-based cohort study demonstrated that children with cancer were associated with an increased risk of herpes zoster. In addition to early antiviral treatment, vaccination with heat-treated zoster vaccine or adjuvanted subunit vaccine could be an appropriate policy to decrease the incidence in children with cancer.

  4. Cost burden of type 2 diabetes in Germany: results from the population-based KORA studies

    PubMed Central

    Ulrich, Susanne; Holle, Rolf; Wacker, Margarethe; Stark, Renee; Icks, Andrea; Thorand, Barbara; Peters, Annette

    2016-01-01

    Objective To examine the impact of type 2 diabetes on direct and indirect costs and to describe the effect of relevant diabetes-related factors, such as type of treatment or glycaemic control on direct costs. Design Bottom-up excess cost analysis from a societal perspective based on population-based survey data. Participants 9160 observations from 6803 individuals aged 31–96 years (9.6% with type 2 diabetes) from the population-based KORA (Cooperative Health Research in the Region of Augsburg) studies in Southern Germany. Outcome measures Healthcare usage, productivity losses, and resulting direct and indirect costs. Methods Information on diabetes status, biomedical/sociodemographic variables, medical history and on healthcare usage and productivity losses was assessed in standardised interviews and examinations. Healthcare usage and productivity losses were costed with reference to unit prices and excess costs of type 2 diabetes were calculated using generalised linear models. Results Individuals with type 2 diabetes had 1.81 (95% CI 1.56 to 2.11) times higher direct (€3352 vs €1849) and 2.07 (1.51 to 2.84) times higher indirect (€4103 vs €1981) annual costs than those without diabetes. Cardiovascular complications, a long diabetes duration and treatment with insulin were significantly associated with increased direct costs; however, glycaemic control was only weakly insignificantly associated with costs. Conclusions This study illustrates the substantial direct and indirect societal cost burden of type 2 diabetes in Germany. Strong effort is needed to optimise care to avoid progression of the disease and costly complications. PMID:27872118

  5. A Nationwide Population-Based Cohort Study of Migraine and Organic-Psychogenic Erectile Dysfunction

    PubMed Central

    Wu, Szu-Hsien; Chuang, Eric; Chuang, Tien-Yow; Lin, Cheng-Li; Lin, Ming-Chia; Yen, Der-Jen; Kao, Chia-Hung

    2016-01-01

    Abstract As chronic illnesses and chronic pain are related to erectile dysfunction (ED), migraine as a prevalent chronic disorder affecting lots of people all over the world may negatively affect quality of life as well as sexual function. However, a large-scale population-based study of erectile dysfunction and other different comorbidities in patients with migraine is quite limited. This cohort longitudinal study aimed to estimate the association between migraine and ED using a nationwide population-based database in Taiwan. The data used for this cohort study were retrieved from the Longitudinal Health Insurance Database 2000 in Taiwan. We identified 5015 patients with migraine and frequency matched 20,060 controls without migraine from 2000 to 2011. The occurrence of ED was followed up until the end of 2011. We used Cox proportional hazard regression models to analyze the risks of ED. The overall incidence of ED was 1.78-fold greater in the migraine cohort than in the comparison cohort (23.3 vs 10.5 per 10,000 person-years; 95% confidence interval [CI] = 1.31–2.41). Furthermore, patients with migraine were 1.75-fold more likely to develop organic ED (95% CI = 1.27–2.41) than were the comparison cohort. The migraine patients with anxiety had a 3.6-fold higher HR of having been diagnosed with ED than the comparison cohort without anxiety (95% CI, 2.10–6.18). The results support that patients with migraine have a higher incidence of being diagnosed with ED, particularly in the patient with the comorbidity of anxiety. PMID:26962838

  6. Lung Cancer Prognosis Before and After Recurrence in a Population-Based Setting

    PubMed Central

    Consonni, Dario; Pierobon, Mariaelena; Rubagotti, Maurizia; Rotunno, Melissa; Goldstein, Alisa; Goldin, Lynn; Lubin, Jay; Wacholder, Sholom; Caporaso, Neil E.; Bertazzi, Pier Alberto; Tucker, Margaret A.; Pesatori, Angela C.

    2015-01-01

    Background: Population-based estimates of absolute risk of lung cancer recurrence, and of mortality rates after recurrence, can inform clinical management. Methods: We evaluated prognostic factors for recurrences and survival in 2098 lung cancer case patients from the general population of Lombardy, Italy, from 2002 to 2005. We conducted survival analyses and estimated absolute risks separately for stage IA to IIIA surgically treated and stage IIIB to IV non–surgically treated patients. Results: Absolute risk of metastases exceeded that of local recurrence in every stage and cell type, highlighting the systemic threat of lung cancer. In stage I, the probability of dying within the first year after diagnosis was 2.7%, but it was 48.3% within first year after recurrence; in stage IV, the probabilities were 57.3% and 80.6%, respectively. Over half the patients died within one year of first metastasis. Although in stages IA to IB about one-third of patients had a recurrence, stage IIA patients had a recurrence risk (61.2%) similar to stage IIB (57.9%) and IIIA (62.8%) patients. Risk of brain metastases in stage IA to IIIA surgically treated non–small cell lung cancer patients increased with increasing tumor grade. Absolute risk of recurrence was virtually identical in adenocarcinoma and squamous cell carcinoma patients. Conclusions: This population-based study provides clinically useful estimates of risks of lung cancer recurrence and mortality that are applicable to the general population. These data highlight the need for more effective adjuvant treatments overall and within specific subgroups. The estimated risks of various endpoints are useful for designing clinical trials, whose power depends on absolute numbers of events. PMID:25802059

  7. Case definitions for use in population-based surveillance of periodontitis.

    PubMed

    Page, Roy C; Eke, Paul I

    2007-07-01

    Many definitions of periodontitis have been used in the literature for population-based studies, but there is no accepted standard. In early epidemiologic studies, the two major periodontal diseases, gingivitis and periodontitis, were combined and considered to be a continuum. National United States surveys were conducted in 1960 to 1962, 1971 to 1974, 1981, 1985 to 1986, 1988 to 1994, and 1999 to 2000. The case definitions and protocols used in the six national surveys reflect a continuing evolution and improvement over time. Generally, the clinical diagnosis of periodontitis is based on measures of probing depth (PD), clinical attachment level (CAL), the radiographic pattern and extent of alveolar bone loss, gingival inflammation measured as bleeding on probing, or a combination of these measures. Several other patient characteristics are considered, and several factors, such as age, can affect measurements of PD and CAL. Accuracy and reproducibility of measurements of PD and CAL are important because case definitions for periodontitis are based largely on either or both measurements, and relatively small changes in these values can result in large changes in disease prevalence. The classification currently accepted by the American Academy of Periodontology (AAP) was devised by the 1999 International Workshop for a Classification of Periodontal Diseases and Conditions. However, in 2003 the Centers for Disease Control and Prevention and the AAP appointed a working group to develop further standardized clinical case definitions for population-based studies of periodontitis. This classification defines severe periodontitis and moderate periodontitis in terms of PD and CAL to enhance case definitions and further demonstrates the importance of thresholds of PD and CAL and the number of affected sites when determining prevalence.

  8. Correlation between systemic lupus erythematosus and malignancies: a cross-sectional population-based study.

    PubMed

    Azrielant, Shir; Tiosano, Shmuel; Watad, Abdulla; Mahroum, Naim; Whitby, Aaron; Comaneshter, Doron; Cohen, Arnon D; Amital, Howard

    2017-01-14

    Autoimmune conditions reflect dysregulation of the immune system; this may be of clinical significance in the development of several malignancies. Previous studies show an association between systemic lupus erythematosus (SLE) and the development of malignancies; however, their investigations into the development of specific malignancies are inconsistent, and their external validity may be questionable. The main objective of this study is to investigate the association between the presence of SLE and various malignancies, in a large-scale population-based study. Data for this study was collected from Clalit Health Services, the largest state-mandated health service organization in Israel. All adult members diagnosed with SLE were included (n = 5018) and their age and sex-matched controls (n = 25,090), creating a cross-sectional population-based study. Medical records of all subjects were analyzed for documentation of malignancies. Logistic regression models were built separately for each malignant condition, controlling for age, gender, BMI, smoking, and socioeconomic status. Diagnosis of malignancy (of any type) was more prevalent in the SLE population (odds ratio [OR] 3.35, 95% confidence interval [CI] 3.02-3.72). SLE diagnosis was also found to be independently associated with higher proportions of non-Hodgkin lymphoma (OR 3.02, 95% CI 2.72-3.33), Hodgkin lymphoma (OR 2.43, 95% CI 1.88-2.99), multiple myeloma (OR 2.57, 95% CI 1.85-3.28), cervix uteri malignancies (OR 1.65, 95% CI 1.10-2.20), and genital organ malignancies (OR 2.32, 95% CI 1.42-3.22), after adjustment for confounding variables. The presence of an SLE diagnosis was found to be independently associated with higher proportions of malignancies, particularly hematologic malignancies. These findings should be considered while treating SLE patients, and possibly supplement their screening routine.

  9. Risk factors of admission for acute colonic diverticulitis in a population-based cohort study: The North Trondelag Health Study, Norway

    PubMed Central

    Jamal Talabani, Aras; Lydersen, Stian; Ness-Jensen, Eivind; Endreseth, Birger Henning; Edna, Tom-Harald

    2016-01-01

    AIM To assess risk factors of hospital admission for acute colonic diverticulitis. METHODS The study was conducted as part of the second wave of the population-based North Trondelag Health Study (HUNT2), performed in North Trondelag County, Norway, 1995 to 1997. The study consisted of 42570 participants (65.1% from HUNT2) who were followed up from 1998 to 2012. Of these, 22436 (52.7%) were females. The cases were defined as those 358 participants admitted with acute colonic diverticulitis during follow-up. The remaining participants were used as controls. Univariable and multivariable Cox regression analyses was used for each sex separately after multiple imputation to calculate HR. RESULTS Multivariable Cox regression analyses showed that increasing age increased the risk of admission for acute colonic diverticulitis: Comparing with ages < 50 years, females with age 50-70 years had HR = 3.42, P < 0.001 and age > 70 years, HR = 6.19, P < 0.001. In males the corresponding values were HR = 1.85, P = 0.004 and 2.56, P < 0.001. In patients with obesity (body mass index ≥ 30) the HR = 2.06, P < 0.001 in females and HR = 2.58, P < 0.001 in males. In females, present (HR = 2.11, P < 0.001) or previous (HR = 1.65, P = 0.007) cigarette smoking increased the risk of admission. In males, breathlessness (HR = 2.57, P < 0.001) and living in rural areas (HR = 1.74, P = 0.007) increased the risk. Level of education, physical activity, constipation and type of bread eaten showed no association with admission for acute colonic diverticulitis. CONCLUSION The risk of hospital admission for acute colonic diverticulitis increased with increasing age, in obese individuals, in ever cigarette smoking females and in males living in rural areas. PMID:28082819

  10. Implications of incomplete registration of deaths on long-term survival estimates from population-based cancer registries.

    PubMed

    Brenner, Hermann; Hakulinen, Timo

    2009-07-15

    International comparison of population-based cancer survival is a key component of monitoring progress against cancer. Its validity depends to an unknown degree on completeness of ascertainment of deaths in the cancer registries involved which may vary according to legal and administrative circumstances. The aim of this study was to assess the impact of incomplete registration of deaths through various mechanisms on the validity of long-term absolute and relative survival estimates. For that purpose, we simulated underascertainment of deaths through linkage failure of registry data with death certificates with probabilities between 0.1 and 5%, and underascertainment of deaths by unregistered annual emigration with probabilities between 0.05 and 2%, using data from the Finnish Cancer Registry. The expected impact on estimates of 5-, 10- and 15-year absolute and relative survival was assessed. We demonstrate that even modest levels of under-registration of deaths may lead to severe overestimation of long-term survival estimates, ranging from 0 to 31 percent units in the scenarios assessed. In general, relative survival is much more affected than absolute survival, and potential problems are much larger for relative survival estimates in older compared with younger patients. Potential overestimation strongly increases with length of follow-up, and this increase is particularly pronounced for under-registration of deaths because of unrecorded emigration. Every effort should be made in cancer registry based survival analyses to ascertain deaths with close to 100% completeness. When such completeness cannot be achieved, long-term relative survival estimates and their comparison across populations must be interpreted with much caution.

  11. Trends with corticosteroid use in males with Duchenne muscular dystrophy born 1982-2001.

    PubMed

    Fox, Deborah J; Kumar, Anil; West, Nancy A; DiRienzo, A Gregory; James, Katherine A; Oleszek, Joyce

    2015-01-01

    This study examines trends in corticosteroid use for males with Duchenne muscular dystrophy by birth year, race/ethnicity, and knowledge of Duchenne muscular dystrophy family history. Firstborn males (n = 521) selected from a population-based surveillance system of Duchenne muscular dystrophy were analyzed using Kaplan Meier and regression methods. Comparing males born 1982 to 1986 with males born 1997 to 2001, steroid use increased from 54% to 72% and mean age at steroid initiation decreased from 8.2 to 7.1 years. Hispanics and non-Hispanic Black males used steroids less frequently and delayed initiation compared to white males. Compared to males without a Duchenne muscular dystrophy family history, males with known family history were half as likely to use steroids. Duration of steroid use increased over time and age at initiation decreased. Racial/ethnic disparities exist for steroid use and should be addressed to improve outcome and quality of life for boys with Duchenne muscular dystrophy.

  12. Male pattern baldness (image)

    MedlinePlus

    Male pattern baldness is a sex-linked characteristic that is passed from mother to child. A man can more accurately predict his chances of developing male pattern baldness by observing his mother's father than by looking ...

  13. Risk factors for pneumonia among patients with Parkinson’s disease: a Taiwan nationwide population-based study

    PubMed Central

    Chang, Yang-Pei; Yang, Chih-Jen; Hu, Kai-Fang; Chao, A-Ching; Chang, Yu-Han; Hsieh, Kun-Pin; Tsai, Jui-Hsiu; Ho, Pei-Shan; Lim, Shen-Yang

    2016-01-01

    Objective Pneumonia is the leading cause of death in patients with Parkinson’s disease (PD). However, few studies have been performed to explore the risk factors for pneumonia development in patients with PD. Methods We conducted a nationwide population-based cohort study of patients with PD to identify the risk factors for these patients developing pneumonia. Participants with newly diagnosed PD between 2000 and 2009 were enrolled from the 2000–2010 National Health Insurance Research Database in Taiwan. We compared patients with PD with an incidence of hospitalization with pneumonia vs those without, and Cox proportional hazard models were used to estimate the risk of pneumonia. Results Of the 2,001 enrolled patients (mean follow-up duration 5.8 years, range: 2.7–14.7 years), 381 (19.0%) had an incidence of hospitalization with pneumonia during the study period. Multivariate Cox proportional hazards analysis identified older age group (≥80 years of age, hazard ratio [HR] =3.15 [95% confidence interval 2.32–4.28]), male sex (HR =1.59 [1.29–1.96]), certain geographic regions (northern, HR =1.36 [1.04–1.78], southern and eastern, HR =1.40 [1.05–1.88]), rural areas (HR =1.34 [1.05–1.72]), chronic heart failure (HR =1.53 [1.02–2.29]), and chronic kidney disease (HR =1.39 [1.03–1.90]) as risk factors for hospitalization with pneumonia in patients with PD. However, treatment for dental caries was a protective factor (HR =0.80 [0.64–0.99]). Conclusion The results of this study highlight risk factors that are associated with hospitalization with pneumonia, and, for the first time, suggest a link between treated dental caries and a diminished risk of hospitalization with pneumonia in patients with PD. PMID:27175081

  14. Occupation and Bladder Cancer in a Population-Based Case-control Study in Northern New England

    PubMed Central

    Colt, Joanne S.; Karagas, Margaret R.; Schwenn, Molly; Baris, Dalsu; Johnson, Alison; Stewart, Patricia; Verrill, Castine; Moore, Lee E.; Lubin, Jay; Ward, Mary H.; Samanic, Claudine; Rothman, Nathaniel; Cantor, Kenneth P.; Beane Freeman, Laura E.; Schned, Alan; Cherala, Sai; Silverman, Debra T.

    2010-01-01

    Objectives We used data from a large, population-based case-control study in New England to examine relationships between occupation, industry, and bladder cancer risk. Methods Lifetime occupational histories were obtained by personal interview from 1,158 patients newly diagnosed with urothelial carcinoma of the bladder between 2001 and 2004 among residents of Maine, New Hampshire, and Vermont, and from 1,402 population controls selected from Department of Motor Vehicle records (ages 30 to 64 years) or Medicare beneficiary records (65 to 79 years). Unconditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for demographic factors, smoking, and employment in high-risk occupations other than the one being analyzed. Results Male precision metalworkers and metalworking/plasticworking machine operators had significantly elevated risks and significant trends in risk with duration of employment (precision metalworkers: OR=2.2; CI: 1.4, 3.4, Ptrend =0.0065; metalworking/plasticworking machine operators: OR=1.6; CI: 1.01, 2.6, Ptrend=0.047). Other occupations/industries for which risk increased significantly with duration of employment included: for men, textile machine operators, mechanics/repairers, automobile mechanics, plumbers, computer systems analysts, information clerks, and landscape and horticultural services industry workers; and for women, service occupations, health services, cleaning and building services, management-related occupations, electronic components and accessories manufacturing, and transportation equipment manufacturing. Men reporting use of metalworking fluids (MWF) had a significantly elevated bladder cancer risk (OR=1.7; 95% CI: 1.1, 2.5), Conclusions Our findings for metalworkers and for MWF exposure support the hypothesis that some component(s) of MWF may be carcinogenic to the bladder in humans. Our results also corroborate many other previously-reported associations between bladder

  15. Furthering the understanding of olfaction, prevalence of loss of smell and risk factors: a population-based survey (OLFACAT study)

    PubMed Central

    Mullol, Joaquim; Alobid, Isam; Mariño-Sánchez, Franklin; Quintó, Llorenç; de Haro, Josep; Bernal-Sprekelsen, Manuel; Valero, Antonio; Picado, Cèsar; Marin, Concepció

    2012-01-01

    Objectives To investigate olfaction in general population, prevalence of olfactory dysfunction and related risk factors. Design Cross-sectional population-based survey, distributing four microencapsulated odorants (rose, banana, musk and gas) and two self-administered questionnaires (odour description; epidemiology/health status). Setting The survey was distributed to general population through a bilingual (Catalan, Spanish) newspaper in Catalonia (Spain), on December 2003. Participants Newspaper readers of all ages and gender; 9348 surveys were analysed from the 10 783 returned. Main outcome measures Characteristics of surveyed population, olfaction by age and gender, smell self-perception and smell impairment risk factors. Terms normosmia, hyposmia and anosmia were used when participants detected, recognised or identified all four, one to three or none of the odours, respectively. Results Survey profile was a 43-year-old woman with medium–high educational level, living in a city. Olfaction was considered normal in 80.6% (detection), 56% (recognition/memory) and 50.7% (identification). Prevalence of smell dysfunction was 19.4% for detection (0.3% anosmia, 19.1% hyposmia), 43.5% for recognition (0.2% anosmia, 43.3% hyposmia) and 48.8% for identification (0.8% anosmia, 48% hyposmia). Olfaction was worse (p<0.0001) in men than in women through all ages. There was a significant age-related smell detection decline however smell recognition and identification increased up to fourth decade and declined after the sixth decade of life. Risk factors for anosmia were: male gender, loss of smell history and poor olfactory self-perception for detection; low educational level, poor self-perception and pregnancy for recognition; and older age, poor self-perception and history of head trauma and loss of smell for identification. Smoking and exposure to noxious substances were mild protective factors for smell recognition. Conclusions Sense of smell in women is better than in

  16. Risks of Treated Insomnia, Anxiety, and Depression in Health Care-Seeking Physicians: A Nationwide Population-Based Study.

    PubMed

    Huang, Charles Lung-Cheng; Weng, Shih-Feng; Wang, Jhi-Joung; Hsu, Ya-Wen; Wu, Ming-Ping

    2015-09-01

    High occupational stress and burnout among physicians can lead to sleep problems, anxiety, depression, and even suicide. Even so, the actual risk for these behavioral health problems in health care-seeking physicians has been seldom explored. The aim of this study was to determine whether physicians have higher odds of treated insomnia, anxiety, and depression than the normal population.This is a nationwide population-based case-control study using the National Health Insurance Research Database in Taiwan for the years 2007 to 2011. Physicians were obtained from the Registry for Medical Personnel in 2009. Hospital physicians who had at least 3 coded ambulatory care claims or 1 inpatient claim with a principal diagnosis of insomnia, anxiety, or depression were identified. A total of 15,150 physicians and 45,450 matched controls were enrolled. Odd ratios (ORs) of insomnia, anxiety, and depression between physicians and their control counterparts were measured.The adjusted ORs for treated insomnia, anxiety, and depression among all studied physicians were 2.028 (95% confidence interval [CI], 1.892-2.175), 1.103 (95% CI, 1.020-1.193), and 0.716 (95% CI, 0.630-0.813), respectively. All specialties of physicians had significantly higher ORs for treated insomnia; among the highest was the emergency specialty. The adjusted ORs for treated anxiety among male and female physicians were 1.136 (95% CI, 1.039-1.242) and 0.827 (95% CI, 0.686-0.997), respectively. Among specialties, psychiatry and "others" had significantly higher risks of anxiety. Obstetrics and gynecology and surgery specialties had significantly lower risks of anxiety. The adjusted ORs for treated depression among physicians in age groups 35 to 50 years and >50 years were 0.560 (95% CI, 0.459-0.683) and 0.770 (95% CI, 0.619-0.959), respectively. Those in the psychiatry specialty had significantly higher risks of depression; internal and surgery specialties had significant lower risks of depression

  17. Subsequent mortality after hyperglycemic crisis episode in the non-elderly: a national population-based cohort study.

    PubMed

    Kao, Yuan; Hsu, Chien-Chin; Weng, Shih-Feng; Lin, Hung-Jung; Wang, Jhi-Joung; Su, Shih-Bin; Huang, Chien-Cheng; Guo, How-Ran

    2016-01-01

    Hyperglycemic crisis episodes (HCEs)-diabetic ketoacidosis and the hyperosmolar hyperglycemic state-are the most serious acute metabolic complications of diabetes. We aimed to investigate the subsequent mortality after HCE in the non-elderly diabetic which is still unclear. This retrospective national population-based cohort study reviewed, in Taiwan's National Health Insurance Research Database, data from 23,079 non-elder patients (≤65 years) with new-onset diabetes between 2000 and 2002: 7693 patients with HCE and 15,386 patients without HCE (1:2). Both groups were compared, and follow-up prognoses were done until 2011. One thousand eighty-five (14.1%) patients with HCE and 725 (4.71%) patients without HCE died (P < 0.0001) during follow-up. Incidence rate ratios (IRR) of mortality were 3.24 times higher in patients with HCE than in patients without HCE (P < 0.0001). Individual analysis of diabetic ketoacidosis and hyperosmolar hyperglycemic state also showed the similar result with combination of both. After stratification by age, mortality was significant higher in the middle age (40-64 years) [IRR 3.29; 95% confidence interval (CI) 2.98-3.64] and young adult (18-39 years) (IRR 3.91; 95% CI 3.28-4.66), but not in the pediatric subgroup (<18 years) (IRR 1.28; 95% CI 0.21-7.64). The mortality risk was highest in the first month (IRR 54.43; 95% CI 27.98-105.89), and still high after 8 years (IRR 2.05; 95% CI 1.55-2.71). After adjusting for age, gender, and selected comorbidities, the mortality hazard ratio for patients with HCE was still four times higher than for patients without HCE. Moreover, older age, male gender, stroke, cancer, chronic obstructive pulmonary disease, congestive heart failure, and liver disease were independent mortality predictors. HCE significantly increases the subsequent mortality risk in the non-elderly with diabetes. Strategies for prevention and control of comorbidities are needed as soon as possible.

  18. The influence of non-response in a population-based cohort study on type 2 diabetes evaluated by the Swedish Prescribed Drug Register.

    PubMed

    Eriksson, Anna-Karin; Ekbom, Anders; Hilding, Agneta; Ostenson, Claes-Göran

    2012-03-01

    Bias due to non-response in observational studies may lead to false risk estimates. We evaluated potential selective non-response in Stockholm Diabetes Prevention Program (SDPP) using a population-based drug register. A cohort of 12,952 men and 19,416 women, aged 35-56 years, was screened for diabetes and family history of diabetes (FHD). Response rate: 79% in men and 85% in women. Of the 4,209 men and 6,916 women that were invited, 70 and 68% participated in a baseline health examination including oral glucose tolerance test. A follow-up was performed in 79% of male and 70% of female baseline participants. We used data from the prescription register to estimate absolute risks and ORs for drug-treated diabetes in the non-response/non-participation groups. At both screening and baseline steps absolute risks of drug-treated diabetes were equal in non-participants and participants. Adjusted ORs were 0.9-1.0. At follow-up, absolute risks were higher among non-participants than participants, men 6.2/4.4% and women 2.6/1.6%, adjusted ORs 1.4 (0.9-2.3) and 1.5 (0.9-2.4), suggesting selective non-participation. Further analyses of FHD, smoking, physical activity, socioeconomic position and psychological distress demonstrated no previous false risk estimates for type 2 diabetes. However, for body mass index, there were indications of overestimation in women. We conclude that bias from non-response was not present at screening or baseline steps, suggesting that diabetes prevalence and risks may be estimated from a population-based cohort study with high attendance rate such as the SDPP. However, follow-up data should be treated with some caution, since the sample may have become biased.

  19. Second primary neoplasms in survivors of Wilms' tumour--a population-based cohort study from the British Childhood Cancer Survivor Study.

    PubMed

    Taylor, Aliki J; Winter, David L; Pritchard-Jones, Kathy; Stiller, Charles A; Frobisher, Clare; Lancashire, Emma R; Reulen, Raoul C; Hawkins, Mike M

    2008-05-01

    A British population-based cohort study was carried out to determine the risk of second primary neoplasms in survivors of Wilms' tumour. The cohort was obtained from the British Childhood Cancer Survivor Study, a population-based cohort study of treatment toxicities in 18,044 individuals diagnosed with childhood cancer, at an age of less than 15 years, between 1940 and 1991 in Britain. There were 1,441 Wilms' tumour survivors in the cohort: 732 males (50.8%) and 709 females (49.2%). Total follow-up from 5-year survival was 27,841 person years, mean follow-up of 19.3 years per survivor. There were 81 second primary neoplasms, including 52 solid neoplasms, 3 acute myeloid leukaemias and 26 basal cell carcinomas. Thirty-five of the 39 solid neoplasms that developed in the thoracic, abdominal or pelvic region occurred within irradiated tissue. The standardised incidence ratio for all solid second primary neoplasms was 6.7 (95% CI: 5.0-8.8). Cumulative incidence for all solid second primary neoplasms by ages 30, 40 and 50 years was 2.3% (1.4-3.5%), 6.8% (4.6-9.5%) and 12.2% (7.3-18.4%). The overall risk of second primary neoplasms in survivors of Wilms' tumour treated between 1940 and 1991 was substantial, and solid second tumours tended to develop in the irradiated tissue. Continued follow-up of these survivors is important to monitor such late effects of treatment. It is also important to evaluate the risk of second primary neoplasms following more recent lower radiation dose treatment practices.

  20. Population-based study of risk factors for severe maternal morbidity

    PubMed Central

    Gray, Kristen E; Wallace, Erin R; Nelson, Kailey R; Reed, Susan D; Schiff, Melissa A

    2012-01-01

    Summary Background Severe maternal morbidity (SMM) is a serious health condition potentially resulting in death without immediate medical attention, including organ failure, obstetric shock, and elcampsia. SMM affects 20,000 US women every year; however, few population-based studies have examined SMM risk factors. Methods We conducted a population-based case-control study linking birth certificate and hospital discharge data from Washington State (1987–2008), identifying 9,485 women with an antepartum, intrapartum, or postpartum SMM with ≥3-day hospitalization or transfer from another facility and 41,112 random controls. Maternal age, race, smoking during pregnancy, parity, preexisting medical condition, multiple birth, prior cesarean delivery, and BMI were assessed as risk factors with logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI), adjusted for education and delivery payer source. Results Older women [35–39: OR 1.65 CI 1.52, 1.79; 40+: OR 2.48 CI 2.16, 2.81], non-white women [Black: OR 1.82 CI 1.64, 2.01; American Indian: OR 1.52 CI 1.32, 1.73; Asian/Pacific Islander: OR 1.30 CI 1.19, 1.41; Hispanic: OR 1.17 CI 1.07, 1.27], and women at parity extremes [OR 1.83 CI 1.72, 1.95, nulliparous; OR 1.34 CI 1.23, 1.45, parity 3+] were at greater risk of SMM. Women with a preexisting medical condition [OR 2.10 CI 1.88, 2.33], a multiple birth [OR 2.54 CI 2.26, 2.82], and a prior cesarean delivery [OR 2.08 CI 1.93, 2.23] were also at increased risk. Conclusion The risk factors identified are not modifiable at the individual level; therefore, provider and system-level factors may be the most appropriate target for preventing SMM. PMID:23061686

  1. Longitudinal population-based studies of affective disorders: Where to from here?

    PubMed Central

    Beard, John R; Galea, Sandro; Vlahov, David

    2008-01-01

    Background Longitudinal, population-based, research is important if we are to better characterize the lifetime patterns and determinants of affective disorders. While studies of this type are becoming increasingly prevalent, there has been little discussion about the limitations of the methods commonly used. Methods Discussion paper including a brief review of key prospective population-based studies as the basis for a critical appraisal of current approaches. Results We identified a number of common methodological weaknesses that restrict the potential of longitudinal research to characterize the diversity, prognosis, and determinants of affective disorders over time. Most studies using comprehensive diagnostic instruments have either been of relatively brief duration, or have suffered from long periods between waves. Most etiologic research has focused on first onset diagnoses, although these may be relatively uncommon after early adulthood and the burden of mental disorders falls more heavily on individuals with recurring disorders. Analysis has tended to be based on changes in diagnostic status rather than anges in symptom levels, limiting study power. Diagnoses have generally been treated as homogeneous entities and few studies have explored whether diagnostic subtypes such as atypical depression vary in their etiology or prognosis. Little research has considered whether there are distinct trajectories of symptoms over time and most has focused on individual disorders such as depression, rather than considering the relationship over time between symptoms of different affective disorders. There has also been limited longitudinal research on factors in the physical or social environment that may influence the onset, recurrence or chronicity of symptoms. Conclusion Many important, and in some respects quite basic, questions remain about the trajectory of depression and anxiety disorders over the life course and the factors that influence their incidence

  2. The relation between exercise and glaucoma in a South Korean population-based sample

    PubMed Central

    Lin, Shuai-Chun; Wang, Sophia Y.; Pasquale, Louis R.; Singh, Kuldev; Lin, Shan C.

    2017-01-01

    Purpose To investigate the association between exercise and glaucoma in a South Korean population-based sample. Design Population-based, cross-sectional study. Participants A total of 11,246 subjects, 40 years and older who underwent health care assessment as part of the 2008–2011 Korean National Health and Nutrition Examination Survey. Methods Variables regarding the duration (total minutes per week), frequency (days per week), and intensity of exercise (vigorous, moderate exercise and walking) as well as glaucoma prevalence were ascertained for 11,246 survey participants. Demographic, comorbidity, and health-related behavior information was obtained via interview. Multivariable logistic regression analyses were performed to determine the association between the exercise-related parameters and odds of a glaucoma diagnosis. Main outcome measure(s) Glaucoma defined by International Society for Geographical and Epidemiological Ophthalmology criteria. Results Overall, 336 (2.7%) subjects met diagnostic criteria for glaucomatous disease. After adjustment for potential confounding variables, subjects engaged in vigorous exercise 7 days per week had higher odds of having glaucoma compared with those exercising 3 days per week (Odds Ratio [OR] 3.33, 95% confidence interval [CI] 1.16–9.54). High intensity of exercise, as categorized by the guidelines of the American College of Sports Medicine (ACSM), was also associated with greater glaucoma prevalence compared with moderate intensity of exercise (OR 1.55, 95% CI 1.03–2.33). There was no association between other exercise parameters including frequency of moderate exercise, walking, muscle strength exercise, flexibility training, or total minutes of exercise per week, and the prevalence of glaucoma. In sub-analyses stratifying by gender, the association between frequency of vigorous exercise 7 days per week and glaucoma diagnosis remained significant in men (OR 6.05, 95% CI 1.67–21.94) but not in women (OR 0.96 95

  3. Perceived weight discrimination in England: a population-based study of adults aged ⩾50 years

    PubMed Central

    Jackson, S E; Steptoe, A; Beeken, R J; Croker, H; Wardle, J

    2015-01-01

    Background: Despite a wealth of experimental studies on weight bias, little is known about weight discrimination at the population level. This study examined the prevalence and socio-demographic correlates of perceived weight discrimination in a large population-based sample of older adults. Methods: Data were from 5307 adults in the English Longitudinal Study of Ageing; a population-based cohort of men and women aged ⩾50 years. Weight discrimination was reported for five domains (less respect/courtesy; treated as less clever; poorer treatment in medical settings; poorer service in restaurants/stores; threatened/harassed) at wave 5 (2010–2011). Height and weight were measured at wave 4 (2008–2009). We used logistic regression to test the odds of weight discrimination in relation to weight status, age, sex, wealth, education and marital status. Results: Perceived weight discrimination in any domain was reported by 4.6% of participants, ranging from 0.8% in the normal-weight participants through 0.9, 6.7, 24.2 and 35.1% in individuals who were overweight or met criteria for class I, II and III obesity. Overall, and in each situation, odds of perceived weight discrimination were higher in younger and less wealthy individuals. There was no interaction between weight status and any socio-demographic variable. Relative to normal-weight participants, odds ratios for any perceived weight discrimination were 1.13 (95% confidence interval 0.53–2.40) in those who were overweight, 8.86 (4.65–16.88) in those with class I obesity, 35.06 (18.30–67.16) in class II obese and 56.43 (27.72–114.87) in class III obese. Conclusions: Our results indicate that rates of perceived weight discrimination are comparatively low in individuals who are overweight or have class I obesity, but for those with class II/III obesity, >10% had experienced discrimination in each domain, and >20% had been treated with less respect or courtesy. These findings have implications for public

  4. Population-Based Biomonitoring of Exposure to Organophosphate and Pyrethroid Pesticides in New York City

    PubMed Central

    Jacobson, J. Bryan; Kass, Daniel; Barr, Dana Boyd; Davis, Mark; Calafat, Antonia M.; Aldous, Kenneth M.

    2013-01-01

    Background: Organophosphates and pyrethroids are the most common classes of insecticides used in the United States. Widespread use of these compounds to control building infestations in New York City (NYC) may have caused higher exposure than in less-urban settings. Objectives: The objectives of our study were to estimate pesticide exposure reference values for NYC and identify demographic and behavioral characteristics that predict exposures. Methods: The NYC Health and Nutrition Examination Survey was a population-based, cross-sectional study conducted in 2004 among adults ≥ 20 years of age. It measured urinary concentrations of organophosphate metabolites [dimethylphosphate (DMP), dimethylthiophosphate (DMTP), dimethyldithiophosphate, diethylphosphate, diethylthiophosphate, and diethyldithiophosphate] in 883 participants, and pyrethroid metabolites [3-phenoxybenzoic acid (3-PBA), trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane-1-carboxylic acid (trans-DCCA), 4-fluoro-3-phenoxybenzoic acid, and cis-3-(2,2-dibromovinyl)-2,2-dimethylcyclopropane-1-carboxylic acid] in 1,452 participants. We used multivariable linear regression to estimate least-squares geometric mean total dialkylphospate (ΣDAP) and 3-PBA concentrations across categories of predictors. Results: The dimethyl organophosphate metabolites had the highest 95th percentile concentrations (87.4 μg/L and 74.7 μg/L for DMP and DMTP, respectively). The highest 95th percentiles among pyrethroid metabolites were measured for 3-PBA and trans-DCCA (5.23 μg/L and 5.94 μg/L, respectively). Concentrations of ΣDAP increased with increasing age, non-Hispanic white or black compared with Hispanic race/ethnicity, professional pesticide use, and increasing frequency of fruit consumption; they decreased with non-green vegetable consumption. Absolute differences in geometric mean urinary 3-PBA concentrations across categories of predictors were too small to be meaningful. Conclusion: Estimates of exposure to

  5. Insomnia Symptoms Are Not Associated with Dyslipidemia: A Population-Based Study

    PubMed Central

    Vozoris, Nicholas T.

    2016-01-01

    Study Objectives: The purpose of this study was to examine whether or not insomnia symptoms were associated with measured dyslipidemia. Methods: This was a population-based multiyear cross-sectional study, using data from 2005–2008 United States National Health and Nutrition Examination Surveys. Survey participants ages 20 y and older self-reported the frequency of difficulty falling asleep, prolonged nocturnal awakening, and undesired early morning awakening over the preceding month. One-time venipuncture was performed and a low-density lipoprotein cholesterol (LDL-C) of ≥ 160 mg/ dL, triglycerides of ≥ 200 mg/dL, and a high-density lipoprotein cholesterol (HDL-C) of < 40 mg/dL denoted dyslipidemia. Descriptive statistics and multiple logistic regression were used. Results: Data on LDL-C, triglycerides, and HDL-C was available for 4,635, 4,757, and 9,798 individuals, respectively. There were no significant associations between having any insomnia symptom at least five times in the past month and high LDL-C (odds ratio [OR] 1.20, 95% confidence interval [CI] 0.92–1.55) or low HDL-C (OR 0.92, 95% CI 0.82–1.04) in unadjusted analyses, or with high triglycerides after adjusting for covariates (OR 1.03, 95% CI 0.78–1.37). Recipients of sleeping pills who also had insomnia symptoms had significantly increased adjusted odds of elevated LDL-C (OR 2.18, 95% CI 1.14–4.15). Conclusions: Insomnia symptoms were generally not associated with dyslipidemia, but receipt of sleeping pills in the setting of insomnia was associated with elevated LDL-C. Further research is needed to confirm a possible link between sleeping pill use and dyslipidemia and to delineate if an association with atherosclerosis exists with specific types of sleeping pills or with all sedative medications more broadly. Citation: Vozoris NT. Insomnia symptoms are not associated with dyslipidemia: a population-based study. SLEEP 2016;39(3):551–558. PMID:26612387

  6. Ambient Fine Particulate Matter and Mortality among Survivors of Myocardial Infarction: Population-Based Cohort Study

    PubMed Central

    Chen, Hong; Burnett, Richard T.; Copes, Ray; Kwong, Jeffrey C.; Villeneuve, Paul J.; Goldberg, Mark S.; Brook, Robert D.; van Donkelaar, Aaron; Jerrett, Michael; Martin, Randall V.; Brook, Jeffrey R.; Kopp, Alexander; Tu, Jack V.

    2016-01-01

    Background: Survivors of acute myocardial infarction (AMI) are at increased risk of dying within several hours to days following exposure to elevated levels of ambient air pollution. Little is known, however, about the influence of long-term (months to years) air pollution exposure on survival after AMI. Objective: We conducted a population-based cohort study to determine the impact of long-term exposure to fine particulate matter ≤ 2.5 μm in diameter (PM2.5) on post-AMI survival. Methods: We assembled a cohort of 8,873 AMI patients who were admitted to 1 of 86 hospital corporations across Ontario, Canada in 1999–2001. Mortality follow-up for this cohort extended through 2011. Cumulative time-weighted exposures to PM2.5 were derived from satellite observations based on participants’ annual residences during follow-up. We used standard and multilevel spatial random-effects Cox proportional hazards models and adjusted for potential confounders. Results: Between 1999 and 2011, we identified 4,016 nonaccidental deaths, of which 2,147 were from any cardiovascular disease, 1,650 from ischemic heart disease, and 675 from AMI. For each 10-μg/m3 increase in PM2.5, the adjusted hazard ratio (HR10) of nonaccidental mortality was 1.22 [95% confidence interval (CI): 1.03, 1.45]. The association with PM2.5 was robust to sensitivity analyses and appeared stronger for cardiovascular-related mortality: ischemic heart (HR10 = 1.43; 95% CI: 1.12, 1.83) and AMI (HR10 = 1.64; 95% CI: 1.13, 2.40). We estimated that 12.4% of nonaccidental deaths (or 497 deaths) could have been averted if the lowest measured concentration in an urban area (4 μg/m3) had been achieved at all locations over the course of the study. Conclusions: Long-term air pollution exposure adversely affects the survival of AMI patients. Citation: Chen H, Burnett RT, Copes R, Kwong JC, Villeneuve PJ, Goldberg MS, Brook RD, van Donkelaar A, Jerrett M, Martin RV, Brook JR, Kopp A, Tu JV. 2016. Ambient fine

  7. Population-Based Incidence Rates of Diarrheal Disease Associated with Norovirus, Sapovirus, and Astrovirus in Kenya

    PubMed Central

    Shioda, Kayoko; Cosmas, Leonard; Audi, Allan; Gregoricus, Nicole; Vinjé, Jan; Parashar, Umesh D.; Montgomery, Joel M.; Feikin, Daniel R.; Breiman, Robert F.; Hall, Aron J.

    2016-01-01

    Background Diarrheal diseases remain a major cause of mortality in Africa and worldwide. While the burden of rotavirus is well described, population-based rates of disease caused by norovirus, sapovirus, and astrovirus are lacking, particularly in developing countries. Methods Data on diarrhea cases were collected through a population-based surveillance platform including healthcare encounters and household visits in Kenya. We analyzed data from June 2007 to October 2008 in Lwak, a rural site in western Kenya, and from October 2006 to February 2009 in Kibera, an urban slum. Stool specimens from diarrhea cases of all ages who visited study clinics were tested for norovirus, sapovirus, and astrovirus by RT-PCR. Results Of 334 stool specimens from Lwak and 524 from Kibera, 85 (25%) and 159 (30%) were positive for norovirus, 13 (4%) and 31 (6%) for sapovirus, and 28 (8%) and 18 (3%) for astrovirus, respectively. Among norovirus-positive specimens, genogroup II predominated in both sites, detected in 74 (87%) in Lwak and 140 (88%) in Kibera. The adjusted community incidence per 100,000 person-years was the highest for norovirus (Lwak: 9,635; Kibera: 4,116), followed by astrovirus (Lwak: 3,051; Kibera: 440) and sapovirus (Lwak: 1,445; Kibera: 879). For all viruses, the adjusted incidence was higher among children aged <5 years (norovirus: 22,225 in Lwak and 17,511 in Kibera; sapovirus: 5,556 in Lwak and 4,378 in Kibera; astrovirus: 11,113 in Lwak and 2,814 in Kibera) compared to cases aged ≥5 years. Conclusion Although limited by a lack of controls, this is the first study to estimate the outpatient and community incidence rates of norovirus, sapovirus, and astrovirus across the age spectrum in Kenya, suggesting a substantial disease burden imposed by these viruses. By applying adjusted rates, we estimate approximately 2.8–3.3 million, 0.45–0.54 million, and 0.77–0.95 million people become ill with norovirus, sapovirus, and astrovirus, respectively, every year in

  8. Deriving stage at diagnosis from multiple population-based sources: colorectal and lung cancer in England

    PubMed Central

    Benitez-Majano, S; Fowler, H; Maringe, C; Di Girolamo, C; Rachet, B

    2016-01-01

    Background: Stage at diagnosis is a strong predictor of cancer survival. Differences in stage distributions and stage-specific management help explain geographic differences in cancer outcomes. Stage information is thus essential to improve policies for cancer control. Despite recent progress, stage information is often incomplete. Data collection methods and definition of stage categories are rarely reported. These inconsistencies may result in assigning conflicting stage for single tumours and confound the interpretation of international comparisons and temporal trends of stage-specific cancer outcomes. We propose an algorithm that uses multiple routine, population-based data sources to obtain the most complete and reliable stage information possible. Methods: Our hierarchical approach derives a single stage category per tumour prioritising information deemed of best quality from multiple data sets and various individual components of tumour stage. It incorporates rules from the Union for International Cancer Control TNM classification of malignant tumours. The algorithm is illustrated for colorectal and lung cancer in England. We linked the cancer-specific Clinical Audit data (collected from clinical multi-disciplinary teams) to national cancer registry data. We prioritise stage variables from the Clinical Audit and added information from the registry when needed. We compared stage distribution and stage-specific net survival using two sets of definitions of summary stage with contrasting levels of assumptions for dealing with missing individual TNM components. This exercise extends a previous algorithm we developed for international comparisons of stage-specific survival. Results: Between 2008 and 2012, 163 915 primary colorectal cancer cases and 168 158 primary lung cancer cases were diagnosed in adults in England. Using the most restrictive definition of summary stage (valid information on all individual TNM components), colorectal cancer stage

  9. Bile acids in a multicenter, population-based case-control study of stillbirth

    PubMed Central

    Silver, Robert M.; Parker, Corette B.; Goldenberg, Robert; Reddy, Uma M.; Dudley, Donald J.; Saade, George R.; Hogue, Carol J. Rowland; Coustan, Donald; Varner, Michael W.; Koch, Matthew A.; Conway, Deborah; Bukowski, Radek; Pinar, Halit; Stoll, Barbara; Moore, Janet; Willinger, Marian

    2015-01-01

    OBJECTIVE We sought to compare bile acids in women with and without stillbirth in a population-based study. STUDY DESIGN The Stillbirth Collaborative Research Network conducted a multisite, population-based case-control study of stillbirth (fetal deaths ≥20 weeks). Maternal sera were obtained at the time of enrollment and frozen at −80° until assay for bile acids. RESULTS Assays were performed in 581 women with stillbirth and 1546 women with live births. Bile acid levels were slightly higher in women with stillbirth (geometric mean [95% confidence interval {CI}] = 3.2 [3.0–3.5]) compared to live births (2.9 [2.7–3.1], P = .0327). However, the difference was not significant after adjustment for baseline risk factors for stillbirth. The proportion of women with elevated levels (≥10 or ≥40 μmol/L) was similar in stillbirths and live births. Results were similar when the analysis was limited to subsets of stillbirths and live births. In women with stillbirths not associated with fetal anomalies or obstetric complications bile acid levels were higher than in women with term live births (geometric mean [95% CI] = 3.4 [3.0–3.8] vs 2.9 [2.7–3.0], P = .0152, unadjusted; P = .06, adjusted). However, a similar proportion of women in both groups had levels ≥10 mmol/L (10.7 vs 7.2%; odds ratio [OR], 1.54; 95% CI, 0.97–2.44; adjusted OR, 1.29; 95% CI, 0.78–2.15) and ≥40 μmol/L (1.7 vs 0.7%; OR, 2.58; 95% CI, 0.85–7.84; adjusted OR, 2.28; 95% CI, 0.79–6.56). CONCLUSION Our data do not support testing for bile acids in cases of stillbirth in the absence of clinical evidence of intrahepatic cholestasis of pregnancy. PMID:24215860

  10. A Swedish Population-Based Multivariate Twin Study of Externalizing Disorders

    PubMed Central

    Lönn, Sara Larsson; Maes, Hermine H.; Lichtenstein, Paul; Sundquist, Jan; Sundquist, Kristina

    2015-01-01

    In epidemiological and twin populations, prior interview studies have identified an externalizing spectrum of disorders. Could this be detected utilizing objective registry data? In 20,603 twin pairs from the Swedish Twin Registry, we obtained information from national medical, criminal and pharmacy records on drug abuse (DA), criminal behavior (CB) and alcohol use disorders (AUD). Multivariate twin modeling was performed with the OpenMx package. A common pathway model with quantitative but not qualitative sex effects fit best with twin resemblance for the latent liability to externalizing syndromes due to both genetic and shared environmental factors. Heritability of the liability was higher in females (76 vs. 62 %) while shared environmental influences were considerably stronger in males (23 vs. 3 %). In both sexes, this latent liability was most strongly indexed by DA and least by CB. All three syndromes had specific genetic influences (especially CB and AUD in males, and CB in females) and specific shared environmental effects (especially DA and CB in males, and AUD in females). For DA, CB and AUD in men, and DA and AUD in women, at least 75 % of the genetic risk arose through the common factor. The best fit model assumed that genetic and environmental influences on these externalizing syndromes in males and females were the same. We identified, in registry data, a highly heritable externalizing spectrum. DA, CB and AUD share substantial genetic and modest to moderate shared environmental influences. The nature of the externalizing spectrum differed meaningfully between the sexes. PMID:26494460

  11. A Swedish Population-Based Multivariate Twin Study of Externalizing Disorders.

    PubMed

    Kendler, Kenneth S; Lönn, Sara Larsson; Maes, Hermine H; Lichtenstein, Paul; Sundquist, Jan; Sundquist, Kristina

    2016-03-01

    In epidemiological and twin populations, prior interview studies have identified an externalizing spectrum of disorders. Could this be detected utilizing objective registry data? In 20,603 twin pairs from the Swedish Twin Registry, we obtained information from national medical, criminal and pharmacy records on drug abuse (DA), criminal behavior (CB) and alcohol use disorders (AUD). Multivariate twin modeling was performed with the OpenMx package. A common pathway model with quantitative but not qualitative sex effects fit best with twin resemblance for the latent liability to externalizing syndromes due to both genetic and shared environmental factors. Heritability of the liability was higher in females (76 vs. 62%) while shared environmental influences were considerably stronger in males (23 vs. 3%). In both sexes, this latent liability was most strongly indexed by DA and least by CB. All three syndromes had specific genetic influences (especially CB and AUD in males, and CB in females) and specific shared environmental effects (especially DA and CB in males, and AUD in females). For DA, CB and AUD in men, and DA and AUD in women, at least 75% of the genetic risk arose through the common factor. The best fit model assumed that genetic and environmental influences on these externalizing syndromes in males and females were the same. We identified, in registry data, a highly heritable externalizing spectrum. DA, CB and AUD share substantial genetic and modest to moderate shared environmental influences. The nature of the externalizing spectrum differed meaningfully between the sexes.

  12. Workplace exacerbation of asthma symptoms: findings from a population-based study in Maine.

    PubMed

    Henneberger, Paul K; Deprez, Ronald D; Asdigian, Nancy; Oliver, L Christine; Derk, Susan; Goe, Sandra K

    2003-12-01

    In this population-based study of asthma in the State of Maine, the authors investigated how often asthma symptoms were exacerbated in the workplace. Participants from 5 hospital service areas in Maine completed a telephone questionnaire. Of 474 adult participants (18-65 yr of age) employed during the preceding year and for whom information on occupation and industry was available, 64 (13.5%) were identified with current asthma, including 28 (5.9%) with current physician-diagnosed asthma and 36 (7.6%) who met criteria for symptoms consistent with asthma. Jobs were identified a priori as "high-risk" or "low-risk" for asthma. Of the 64 asthma cases, 16 (25%) reported that their coughing or wheezing worsened at work. Among the symptom-based cases, the percentage with workplace exacerbation of asthma was elevated for high-risk jobs (7/14 = 50%) vs. low-risk jobs (3/22 = 13.6%) (p = 0.03). No similar elevation was observed for individuals with current physician-diagnosed asthma, which might have resulted, in part, from a healthy worker effect.

  13. Eating behavior and childhood overweight among population-based elementary schoolchildren in Japan.

    PubMed

    Ochiai, Hirotaka; Shirasawa, Takako; Nishimura, Rimei; Morimoto, Aya; Shimada, Naoki; Ohtsu, Tadahiro; Hashimoto, Masayasu; Hoshino, Hiromi; Tajima, Naoko; Kokaze, Akatsuki

    2012-04-01

    This study investigated the relationship between eating behavior and childhood overweight among population-based elementary schoolchildren in Japan. Data was collected from fourth graders (9 or 10 years of age) from Ina Town, Saitama Prefecture, Japan from 1999 to 2009. Information about subjects' sex, age, and lifestyle, including eating behaviors (eating until full and chewing thoroughly), was obtained using a self-administered questionnaire, and height and weight were measured directly. Overweight was determined according to the definition established by the International Obesity Task Force. Data from 4027 subjects (2079 boys and 1948 girls) were analyzed. Chewing thoroughly was associated with a significantly decreased odds ratio (OR) for being overweight, whereas eating until full significantly increased the OR for being overweight (OR: 1.50, 95% confidence interval: 1.16-1.94) among boys. However, eating until full was not associated with a significantly increased OR for being overweight among the group that reported chewing thoroughly, whereas it was associated with a significantly increased OR for being overweight (2.02, 1.38-2.94) among boys who did not chew thoroughly. In conclusion, eating until full or not chewing thoroughly was associated with being overweight among elementary schoolchildren. Results of this study suggest that chewing thoroughly may be an avenue to explore childhood overweight prevention efforts.

  14. Sleep duration and overweight among elementary schoolchildren: a population-based study in Japan.

    PubMed

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

    2012-01-01

    Although a number of studies have investigated the relationship of sleep duration to overweight and obesity, studies conducted among population-based elementary schoolchildren have been limited in Japan. The aim of the present study was to investigate the relationship between sleep duration and overweight among elementary schoolchildren in Japan. The study subjects were all fourth-grade schoolchildren (9 or 10 years of age) in Ina-town, Saitama Prefecture, Japan from 1999 to 2008. Information concerning each subject's sex, age, and lifestyle was obtained using a self-administered questionnaire, while measurements of his or her height and weight were carried out. Childhood overweight was determined according to the definition established by the International Obesity Task Force. Data from 3,433 children were analyzed. In logistic regression analysis, a statistically significant dose-response relationship was observed between sleep duration and overweight among boys (p for trend = 0.014) but not among girls (p for trend = 0.149). Short sleep duration was associated with childhood overweight, and the sex difference in the association was observed. These findings suggested that it is important to consider sleep duration as part of any program to prevent overweight among elementary schoolchildren, especially among boys.

  15. The LIFE Child study: a population-based perinatal and pediatric cohort in Germany.

    PubMed

    Poulain, Tanja; Baber, Ronny; Vogel, Mandy; Pietzner, Diana; Kirsten, Toralf; Jurkutat, Anne; Hiemisch, Andreas; Hilbert, Anja; Kratzsch, Jürgen; Thiery, Joachim; Fuchs, Michael; Hirsch, Christian; Rauscher, Franziska G; Loeffler, Markus; Körner, Antje; Nüchter, Matthias; Kiess, Wieland

    2017-01-31

    The LIFE Child study is a large population-based longitudinal childhood cohort study conducted in the city of Leipzig, Germany. As a part of LIFE, a research project conducted at the Leipzig Research Center for Civilization Diseases, it aims to monitor healthy child development from birth to adulthood and to understand the development of lifestyle diseases such as obesity. The study consists of three interrelated cohorts; the birth cohort, the health cohort, and the obesity cohort. Depending on age and cohort, the comprehensive study program comprises different medical, psychological, and sociodemographic assessments as well as the collection of biological samples. Optimal data acquisition, process management, and data analysis are guaranteed by a professional team of physicians, certified study assistants, quality managers, scientists and statisticians. Due to the high popularity of the study, more than 3000 children have already participated until the end of 2015, and two-thirds of them participate continuously. The large quantity of acquired data allows LIFE Child to gain profound knowledge on the development of children growing up in the twenty-first century. This article reports the number of available and analyzable data and demonstrates the high relevance and potential of the study.

  16. Dementia is associated with iron-deficiency anemia in females: a population-based study.

    PubMed

    Chung, Shiu-Dong; Sheu, Jau-Jiuan; Kao, Li-Ting; Lin, Herng-Ching; Kang, Jiunn-Horng

    2014-11-15

    Cognitive derangement and neurological symptoms are observed in patients with anemia. Although it is still controversial, a few studies suggested that anemia may increase the risk of dementia. This study aimed to explore the association between iron-deficiency anemia (IDA) and dementia in a population-based case-control study. We retrieved our study sample from the Taiwan Longitudinal Health Insurance Database 2000. We extracted 8300 subjects with a diagnosis of dementia and 8300 age- and gender-matched controls. The results showed that there was a significant difference in the prevalence of prior IDA between cases and controls (6.0% vs. 3.8%, p<0.001). The conditional logistic regression analysis suggested that the odds ratio (OR) of prior IDA for cases was 1.36 (95% CI: 1.07-1.74) compared to controls after adjusting for subjects' monthly income, geographic location, urbanization level, hyperlipidemia, diabetes, hypertension, and alcohol abuse. Among female subjects, the adjusted OR of prior IDA for cases was as high as 2.00 (95% CI: 1.42-2.80) compared to controls. However, in men-no increased odds of prior IDA were observed, compared to controls. We concluded that women with dementia had a higher prevalence of prior IDA, compared to controls.

  17. Physical Trauma and Amyotrophic Lateral Sclerosis: A Population-Based Study Using Danish National Registries

    PubMed Central

    Seals, Ryan M.; Hansen, Johnni; Gredal, Ole; Weisskopf, Marc G.

    2016-01-01

    Prior studies have suggested that physical trauma might be associated with the development of amyotrophic lateral sclerosis (ALS). We conducted a population-based, individually matched case-control study in Denmark to assess whether hospitalization for trauma is associated with a higher risk of developing ALS. There were 3,650 incident cases of ALS in the Danish National Patient Register from 1982 to 2009. We used risk-set sampling to match each case to 100 age- and sex-matched population controls alive on the date of the case's diagnosis. Odds ratios and 95% confidence intervals were calculated using a conditional logistic regression model. History of trauma diagnosis was also obtained from the Danish Patient Register. When traumas in the 5 years prior to the index date were excluded, there was a borderline association between any trauma and ALS (odds ratio (OR) = 1.09, 95% confidence interval (CI): 0.99, 1.19). A first trauma before age 55 years was associated with ALS (OR = 1.22, 95% CI: 1.08, 1.37), whereas first traumas at older ages were not (OR = 0.97, 95% CI: 0.85, 1.10). Our data suggest that physical trauma at earlier ages is associated with ALS risk. Age at first trauma could help explain discrepancies in results of past studies of trauma and ALS. PMID:26825926

  18. Prevalence of chronic kidney disease in population-based studies: Systematic review

    PubMed Central

    Zhang, Qiu-Li; Rothenbacher, Dietrich

    2008-01-01

    Background Chronic kidney disease (CKD) is becoming a major public health problem worldwide. This article reviews the published evidence of prevalence of CKD in population-based study samples that used the standardized definition from the Kidney Disease Outcomes Quality Initiative of the National Kidney Foundation (K/DOQI) practice guideline, and particularly focus on performance of serum-creatinine based equations for GFR estimation. We provide a summary of available data about the burden of CKD in various populations. Methods We performed a systematic review of available published data in MEDLINE. A combination of various keywords relevant to CKD was used in this research. Related data of included studies were extracted in a systematic way. Results A total of 26 studies were included in this review. The studies were conducted in different populations, and the number of study participants ranged from 237 to 65181. The median prevalence of CKD was 7.2% in persons aged 30 years or older. In persons aged 64 years or older prevalence of CKD varied from 23.4% to 35.8%. Importantly, the prevalence of CKD strongly depended on which estimating equations were used. The Modification of Diet in Renal Disease Study (MDRD) equation was likely to be preferred in recent epidemiological studies compared to the adjusted Cockcroft-Gault (CG) equation. Conclusion Worldwide, CKD is becoming a common disease in the general population. Accurately detecting CKD in special groups remains inadequate, particularly among elderly persons, females or other ethnic groups such as Asians. PMID:18405348

  19. Impact of preoperative chronic renal failure on liver transplantation: a population-based cohort study

    PubMed Central

    Chung, Peter Chi-Ho; Chen, Hsiu-Pin; Lin, Jr-Rung; Liu, Fu-Chao; Yu, Huang-Ping

    2016-01-01

    Purpose The purpose of this study was to assess whether preoperative chronic renal failure (CRF) affects the rates of postoperative complications and survival after liver transplantation. Methods This population-based retrospective cohort study included 2,931 recipients of liver transplantation performed between 1998 and 2012, enrolled from the Taiwan National Health Insurance Research Database. Patients were divided into two groups, based on the presence or absence of preoperative CRF. Results The overall estimated survival rate of liver transplantation recipients (LTRs) with preoperative CRF was significantly lower than that of patients without preoperative CRF (P=0.0085). There was no significant difference between the groups in terms of duration of intensive care unit stay, total hospital stay, bacteremia, postoperative bleeding, and pneumonia during hospitalization. Long-term adverse effects, including cerebrovascular disease and coronary heart disease, were not different between patients with versus without CRF. Conclusion These findings suggest that LTRs with preoperative CRF have a higher rate of mortality. PMID:28008264

  20. [Obesity in adults: a population based study in a small town in South of Brazil, 2005].

    PubMed

    Sarturi, Juliana Barbosa; das Neves, Janaina; Peres, Karen Glazer

    2010-01-01

    Changes in nutritional pattern in Brazilian population have been observed mainly in relation to obesity increase. This study aims to estimate the prevalence of obesity and associated factors in adult population in Santo Angelo, Rio Grande do Sul State, 2005. A cross sectional study was carried out involving adult subjects from 20 to 59 years old (n=434), of both sexes. People with Body Mass Index equal to or higher than 30 kg/m(2) were considered obese. A questionnaire was applied to collect data related to socioeconomic, demographic, and behavioral conditions. The multiple logistic regression analysis was performed to identify the associated factors. The response rate was 95.0% and the prevalence of obesity was equal to 16.6% (CI 95% 13.120.1). Presence of obesity was positively associated with lack of physical activity, none feeding habits care, and some individuals that mentioned current health problems regardless of sex. The prevalence of obesity found was similar to other Brazilian population based studies. The results may support planning and implementing prevention actions as well as obesity control in adult population taking into account the relevant details of a small size town.

  1. Osteoporosis in adult patients with atopic dermatitis: A nationwide population-based study.

    PubMed

    Wu, Ching-Ying; Lu, Ying-Yi; Lu, Chun-Ching; Su, Yu-Feng; Tsai, Tai-Hsin; Wu, Chieh-Hsin

    2017-01-01

    The aim of this study was to investigate osteoporosis risk in atopic dermatitis (AD) patients. This study included patients in the Taiwan National Health Insurance Research dataset. The population-based study included all patients aged 20-49 years who had been diagnosed with AD during 1996-2010. In total, 35,229 age and gender-matched patients without AD in a 1:1 ratio were randomly selected as the non-AD group. Cox proportional-hazards regression and Kaplan-Meier analyses were used to measure the hazard ratios and the cumulative incidences of osteoporosis, respectively. During the follow-up period, 360(1.02%) AD patients and 127(0.36%) non-AD patients developed osteoporosis. The overall incidence of osteoporosis was4.72-fold greater in the AD patients compared to the non-AD patients (1.82 vs. 0.24 per 1,000 person-years, respectively) after adjusting for potential confounding factors. Osteoporosis risk factors included female gender, age, advanced Charlson Comorbidity Index, depression and use of corticosteroids. The dataset analysis showed that AD was significantly associated with subsequent risk of osteoporosis.

  2. Sinonasal Cancer and Occupational Exposure in a Population-Based Registry

    PubMed Central

    Mensi, Carolina; Sieno, Claudia; Riboldi, Luciano; Bertazzi, Pier Alberto

    2013-01-01

    We examined occupational exposures among subjects with sinonasal cancer (SNC) recorded in a population-based registry in the Lombardy Region, the most populated and industrialized Italian region. The registry collects complete clinical information and exposure to carcinogens regarding all SNC cases occurring in the population of the region. In the period 2008–2011, we recorded 210 SNC cases (137 men, 73 women). The most frequent occupational exposures were to wood (44 cases, 21.0%) and leather dust (29 cases, 13.8%), especially among men: 39 cases (28.5%) to wood and 23 cases (16.8%) to leather dust. Exposure to other agents was infrequent (<2%). Among 62 subjects with adenocarcinoma, 50% had been exposed to wood dust and 30.7% to leather dust. The proportions were around 10% in subjects with squamous cell carcinoma and about 20% for tumors with another histology. The age-standardized rates (×100,000 person-years) were 0.7 in men and 0.3 in women. Complete collection of cases and their occupational history through a specialized cancer registry is fundamental to accurately monitor SNC occurrence in a population and to uncover exposure to carcinogens in different industrial sectors, even those not considered as posing a high risk of SNC, and also in extraoccupational settings. PMID:24082884

  3. Monoclonal gammopathy of undetermined significance and risk of infections: a population-based study.

    PubMed

    Kristinsson, Sigurdur Y; Tang, Min; Pfeiffer, Ruth M; Björkholm, Magnus; Goldin, Lynn R; Blimark, Cecilie; Mellqvist, Ulf-Henrik; Wahlin, Anders; Turesson, Ingemar; Landgren, Ola

    2012-06-01

    No comprehensive evaluation has been made to assess the risk of viral and bacterial infections among patients with monoclonal gammopathy of undetermined significance. Using population-based data from Sweden, we estimated risk of infections among 5,326 monoclonal gammopathy of undetermined significance patients compared to 20,161 matched controls. Patients with monoclonal gammopathy of undetermined significance had a 2-fold increased risk (P<0.05) of developing any infection at 5- and 10-year follow up. More specifically, patients with monoclonal gammopathy of undetermined significance had an increased risk (P<0.05) of bacterial (pneumonia, osteomyelitis, septicemia, pyelonephritis, cellulitis, endocarditis, and meningitis), and viral (influenza and herpes zoster) infections. Patients with monoclonal gammopathy of undetermined significance with M-protein concentrations over 2.5 g/dL at diagnosis had highest risks of infections. However, the risk was also increased (P<0.05) among those with concentrations below 0.5 g/dL. Patients with monoclonal gammopathy of undetermined significance who developed infections had no excess risk of developing multiple myeloma, Waldenström macroglobulinemia or related malignancy. Our findings provide novel insights into the mechanisms behind infections in patients with plasma cell dyscrasias, and may have clinical implications.

  4. The association between childhood physical abuse and dyslexia: findings from a population-based study.

    PubMed

    Fuller-Thomson, Esme; Hooper, Stephen R

    2015-05-01

    The objective of this study was to determine the relationship between a history of dyslexia and childhood physical abuse in a large population-based epidemiological sample. It was hypothesized that the prevalence of dyslexia would be significantly higher in individuals who reported a childhood history of physical abuse in comparison to those who did not report such a history. A secondary analysis examined data from respondents 18 years and older from the Saskatchewan and Manitoba sample of the 2005 Canadian Community Health Survey (CCHS). There were 13,640 respondents ages 18 and older. Due to missing data, the final sample size was 13,054 respondents. One third (34.8%) of respondents who reported they had been physically abused during their childhood or adolescence also reported being diagnosed with dyslexia in comparison with 7.2% of those who did not report being physically abused (p < .001). Initial adjustments for sociodemographic variables produced an odds ratio (OR) for dyslexia that was more than 7 times higher (OR = 7.09; 95% confidence interval [CI] = [4.42, 11.35]) for those who had reported being physically abused in comparison with their peers who did not report such a history; with additional adjustments for other adverse childhood experiences, these odds decreased only slightly to 6.09 times higher (95% CI = [3.58, 10.35]). Further research is needed to understand the mechanism linking physical abuse and dyslexia.

  5. The effects of climate factors on scabies. A 14-year population-based study in Taiwan

    PubMed Central

    Liu, Jui-Ming; Wang, Hsiao-Wei; Chang, Fung-Wei; Liu, Yueh-Ping; Chiu, Feng-Hsiang; Lin, Yi-Chun; Cheng, Kuan-Chen; Hsu, Ren-Jun

    2016-01-01

    Scabies is a common infectious disease and can cause severe outbreaks if not controlled quickly. Besides personal contact history, environmental factors are also important. This study analyzed the effects of environmental climate factors on the incidence of scabies in Taiwan. We conducted a 14-year nationwide population-based study: a total of 14,883 patients with scabies infestation were enrolled. Monthly climate data were collected from Taiwan’s Central Weather Bureau, including data on temperature, relative humidity, total rainfall, total rain days, and total sunshine hours. The linear relationships between these climate factors and scabies infestations or other risk factors were examined by Pearson’s correlation analysis. Overall, the incidence of scabies was negatively correlated with temperature (γ = −0.152, p < 0.001), while being positively correlated with humidity (γ = 0.192, p < 0.001). This useful information may provide evidence for lowering humidity at nursing facilities, hospitals, and military camps with scabies infestations, which may help to reduce its spread and prevent outbreaks. PMID:27905271

  6. Cognitive functioning in children with internalising, externalising and dysregulation problems: a population-based study.

    PubMed

    Blanken, Laura M E; White, Tonya; Mous, Sabine E; Basten, Maartje; Muetzel, Ryan L; Jaddoe, Vincent W V; Wals, Marjolein; van der Ende, Jan; Verhulst, Frank C; Tiemeier, Henning

    2017-04-01

    Psychiatric symptoms in childhood are closely related to neurocognitive deficits. However, it is unclear whether internalising and externalising symptoms are associated with general or distinct cognitive problems. We examined the relation between different types of psychiatric symptoms and neurocognitive functioning in a population-based sample of 1177 school-aged children. Internalising and externalising behaviour was studied both continuously and categorically. For continuous, variable-centred analyses, broadband scores of internalising and externalising symptoms were used. However, these measures are strongly correlated, which may prevent identification of distinct cognitive patterns. To distinguish groups of children with relatively homogeneous symptom patterns, a latent profile analysis of symptoms at age 6 yielded four exclusive groups of children: a class of children with predominantly internalising symptoms, a class with externalising symptoms, a class with co-occurring internalising and externalising symptoms, that resembles the CBCL dysregulation profile and a class with no problems. Five domains of neurocognitive ability were tested: attention/executive functioning, language, memory and learning, sensorimotor functioning, and visuospatial processing. Consistently, these two different modelling approaches demonstrated that children with internalising and externalising symptoms show distinct cognitive profiles. Children with more externalising symptoms performed lower in the attention/executive functioning domain, while children with more internalising symptoms showed impairment in verbal fluency and memory. In the most severely affected class of children with internalising and externalising symptoms, we found specific impairment in the sensorimotor domain. This study illustrates the specific interrelation of internalising and externalising symptoms and cognition in young children.

  7. Education, occupation, leisure activities, and brain reserve: a population-based study.

    PubMed

    Foubert-Samier, Alexandra; Catheline, Gwenaelle; Amieva, Hélène; Dilharreguy, Bixente; Helmer, Catherine; Allard, Michèle; Dartigues, Jean-François

    2012-02-01

    The influence of education, occupation, and leisure activities on the passive and active components of reserve capacity remains unclear. We used the voxel-based morphometry (VBM) technique in a population-based sample of 331 nondemented people in order to investigate the relationship between these factors and the cerebral volume (a marker of brain reserve). The results showed a positive and significant association between education, occupation, and leisure activities and the cognitive performances on Isaac's set test. Among these factors, only education was significantly associated with a cerebral volume including gray and white matter (p = 0.01). In voxel-based morphometry analyses, the difference in gray matter volume was located in the temporoparietal lobes and in the orbitofrontal lobes bilaterally (a p-value corrected <0.05 by false discovery rate [FDR]). Although smaller, the education-related difference in white matter volume appeared in areas connected to the education-related difference in gray matter volume. Education, occupation attainment, and leisure activities were found to contribute differently to reserve capacity. Education could play a role in the constitution of cerebral reserve capacity.

  8. Firearm and Nonfirearm Homicide in 5 South African Cities: A Retrospective Population-Based Study

    PubMed Central

    Thompson, Mary Lou; Myers, Jonathan E.

    2014-01-01

    Objective. We assessed the effectiveness of South Africa’s Firearm Control Act (FCA), passed in 2000, on firearm homicide rates compared with rates of nonfirearm homicide across 5 South African cities from 2001 to 2005. Methods. We conducted a retrospective population-based study of 37 067 firearm and nonfirearm homicide cases. Generalized linear models helped estimate and compare time trends of firearm and nonfirearm homicides, adjusting for age, sex, race, day of week, city, year of death, and population size. Results. There was a statistically significant decreasing trend regarding firearm homicides from 2001, with an adjusted year-on-year homicide rate ratio of 0.864 (95% confidence interval [CI] = 0.848, 0.880), representing a decrease of 13.6% per annum. The year-on-year decrease in nonfirearm homicide rates was also significant, but considerably lower at 0.976 (95% CI = 0.954, 0.997). Results suggest that 4585 (95% CI = 4427, 4723) lives were saved across 5 cities from 2001 to 2005 because of the FCA. Conclusions. Strength, timing and consistent decline suggest stricter gun control mediated by the FCA accounted for a significant decrease in homicide overall, and firearm homicide in particular, during the study period. PMID:24432917

  9. Sexual violence, mood disorders and suicide risk: a population-based study.

    PubMed

    Mondin, Thaíse Campos; Cardoso, Taiane de Azevedo; Jansen, Karen; Konradt, Caroline Elizabeth; Zaltron, Rosana Ferrazza; Behenck, Monalisa de Oliveira; de Mattos, Luciano Dias; da Silva, Ricardo Azevedo

    2016-03-01

    This article seeks to analyze the association between sexual violence, manic and depressive episodes, and suicide risk among young adults. This is a cross-sectional population-based study carried out with young people between 18 and 24 years of age in a town in southern Brazil. The sample was selected through clusters. The prevalence of sexual violence, manic, depressive and mixed episodes and suicide risk were evaluated, as well as the association between them. The chi-square test and Poisson regression were used for statistical analysis. The study sample comprised 1,560 subjects. Among these, 3.1% had suffered sexual violence at some point in their life. The prevalence of depressive, mixed episodes, and (hypo)manic episodes were 10%, 2.4% and 2.3%, respectively. Suicide risk had a prevalence of 8.6% in the total sample. Young people who have suffered sexual violence are more likely to be subject to mood changes or suicide risk than those who have not (p < 0.05), except for the occurrence of (hypo)manic episodes. These results revealed a strong association between sexual violence and depressive and mixed episodes and suicide risk.

  10. Comprehensive, Population-Based Sensitivity Analysis of a Two-Mass Vocal Fold Model

    PubMed Central

    Robertson, Daniel; Zañartu, Matías; Cook, Douglas

    2016-01-01

    Previous vocal fold modeling studies have generally focused on generating detailed data regarding a narrow subset of possible model configurations. These studies can be interpreted to be the investigation of a single subject under one or more vocal conditions. In this study, a broad population-based sensitivity analysis is employed to examine the behavior of a virtual population of subjects and to identify trends between virtual individuals as opposed to investigating a single subject or model instance. Four different sensitivity analysis techniques were used in accomplishing this task. Influential relationships between model input parameters and model outputs were identified, and an exploration of the model’s parameter space was conducted. Results indicate that the behavior of the selected two-mass model is largely dominated by complex interactions, and that few input-output pairs have a consistent effect on the model. Results from the analysis can be used to increase the efficiency of optimization routines of reduced-order models used to investigate voice abnormalities. Results also demonstrate the types of challenges and difficulties to be expected when applying sensitivity analyses to more complex vocal fold models. Such challenges are discussed and recommendations are made for future studies. PMID:26845452

  11. Paper 3: EUROCAT data quality indicators for population-based registries of congenital anomalies.

    PubMed

    Loane, Maria; Dolk, Helen; Garne, Ester; Greenlees, Ruth

    2011-03-01

    The European Surveillance of Congenital Anomalies (EUROCAT) network of population-based congenital anomaly registries is an important source of epidemiologic information on congenital anomalies in Europe covering live births, fetal deaths from 20 weeks gestation, and terminations of pregnancy for fetal anomaly. EUROCAT's policy is to strive for high-quality data, while ensuring consistency and transparency across all member registries. A set of 30 data quality indicators (DQIs) was developed to assess five key elements of data quality: completeness of case ascertainment, accuracy of diagnosis, completeness of information on EUROCAT variables, timeliness of data transmission, and availability of population denominator information. This article describes each of the individual DQIs and presents the output for each registry as well as the EUROCAT (unweighted) average, for 29 full member registries for 2004-2008. This information is also available on the EUROCAT website for previous years. The EUROCAT DQIs allow registries to evaluate their performance in relation to other registries and allows appropriate interpretations to be made of the data collected. The DQIs provide direction for improving data collection and ascertainment, and they allow annual assessment for monitoring continuous improvement. The DQI are constantly reviewed and refined to best document registry procedures and processes regarding data collection, to ensure appropriateness of DQI, and to ensure transparency so that the data collected can make a substantial and useful contribution to epidemiologic research on congenital anomalies.

  12. Chromosomal Abnormalities among Offspring of Childhood-Cancer Survivors in Denmark: A Population-Based Study

    PubMed Central

    Winther, Jeanette Falck; Boice Jr., John D.; Mulvihill, John J.; Stovall, Marilyn; Frederiksen, Kirsten; Tawn, E. Janet; Olsen, Jørgen H.

    2004-01-01

    Ionizing radiation and many cancer drugs have the potential to produce germ-cell mutations that might lead to genetic disease in the next generation. In a population-based study, we identified, from records in the Danish Cancer Registry, 4,676 children treated for cancer. Their 6,441 siblings provided a comparison cohort. The results of a search of the Central Population Register identified 2,630 live-born offspring of the survivors and 5,504 live-born offspring of their siblings. The occurrence of abnormal karyotypes diagnosed in these offspring and also in any pregnancies terminated following prenatal diagnosis of a chromosome abnormality was determined from the Danish Cytogenetic Registry. After exclusion of hereditary cases and inclusion of the prenatal cases, after correction for expected viability, the adjusted proportion of live-born children in survivor families with abnormal karyotypes (5.5/2,631.5 [0.21%]) was the same as that among the comparison sibling families (11.8/5,505.8 [0.21%]). There were no significant differences in the occurrence of Down syndrome (relative risk [RR]=1.07; 95% CI 0.16–5.47) or Turner syndrome (RR=1.32; 95% CI 0.17–7.96) among the children of cancer survivors, compared with the children of their siblings. These reassuring results are of importance to the survivors, to their families, and to genetic counselors. PMID:15106125

  13. Copy Number Variations in a Population-Based Study of Charcot-Marie-Tooth Disease

    PubMed Central

    Høyer, Helle; Braathen, Geir J.; Eek, Anette K.; Nordang, Gry B. N.; Skjelbred, Camilla F.; Russell, Michael B.

    2015-01-01

    Copy number variations (CNVs) are important in relation to diversity and evolution but can sometimes cause disease. The most common genetic cause of the inherited peripheral neuropathy Charcot-Marie-Tooth disease is the PMP22 duplication; otherwise, CNVs have been considered rare. We investigated CNVs in a population-based sample of Charcot-Marie-Tooth (CMT) families. The 81 CMT families had previously been screened for the PMP22 duplication and point mutations in 51 peripheral neuropathy genes, and a genetic cause was identified in 37 CMT families (46%). Index patients from the 44 CMT families with an unknown genetic diagnosis were analysed by whole-genome array comparative genomic hybridization to investigate the entire genome for larger CNVs and multiplex ligation-dependent probe amplification to detect smaller intragenomic CNVs in MFN2 and MPZ. One patient had the pathogenic PMP22 duplication not detected by previous methods. Three patients had potentially pathogenic CNVs in the CNTNAP2, LAMA2, or SEMA5A, that is, genes related to neuromuscular or neurodevelopmental disease. Genotype and phenotype correlation indicated likely pathogenicity for the LAMA2 CNV, whereas the CNTNAP2 and SEMA5A CNVs remained potentially pathogenic. Except the PMP22 duplication, disease causing CNVs are rare but may cause CMT in about 1% (95% CI 0–7%) of the Norwegian CMT families. PMID:25648254

  14. Haemorrhoids are associated with erectile dysfunction: a population-based study.

    PubMed

    Keller, J J; Lin, H-C

    2012-12-01

    Haemorrhoids are associated with regional vascular abnormalities and rectal pain, which are hypothesized to increase the risk of erectile dysfunction (ED); however, few studies have investigated the association between ED and haemorrhoids. This case-control study aimed to estimate the association between haemorrhoids and ED by using a population-based data in Taiwan. We identified 6,310 patients with ED as cases and randomly selected 31,550 controls. Conditional logistic regression was performed to compute the odds ratio (OR) for having been previously diagnosed with haemorrhoids between cases and controls. The results show that haemorrhoids were found to be present among 1,572 (24.9%) cases and 4,491 (14.20%) controls. The OR for prior haemorrhoids among cases was 1.90 (95% CI = 1.78-2.03) when compared with controls after adjusting for monthly income, geographical location, hypertension, diabetes, coronary heart disease, hyperlipidemia, obesity and alcohol abuse/alcohol dependence syndrome. Younger cases demonstrated a higher risk for prior haemorrhoids when compared with controls. In particular, the adjusted OR among cases <30 years old was 3.71 (95% CI = 2.74-5.02) when compared with controls. We concluded that there was an association between ED and a prior diagnosis of haemorrhoids.

  15. Treatment profile and complications associated with cryotherapy for localized prostate cancer: A population-based study

    PubMed Central

    Roberts, Calpurnyia B.; Jang, Thomas L.; Shao, Yu-Hsuan; Kabadi, Shaum; Moore, Dirk F.; Lu-Yao, Grace L.

    2011-01-01

    The aim of this study was to assess the treatment patterns and 3 to 12-month complication rates associated with receiving prostate cryotherapy in a population-based study. Men > 65 years diagnosed with incident localized prostate cancer in Surveillance Epidemiology End Results (SEER) - Medicare linked database from 2004 to 2005 were identified. A total of 21,344 men were included in the study, of which 380 were treated initially with cryotherapy. Recipients of cryotherapy versus aggressive forms of prostate therapy (i.e. radical prostatectomy or radiation therapy) were more likely to be older, have one co-morbidity, low income, live in the South, and be diagnosed with indolent cancer. Complication rates increased from 3 to 12 months following cryotherapy. By the twelfth month, the rates for urinary incontinence, lower urinary tract obstruction, erectile dysfunction, and bowel bleeding reached 9.8%, 28.7%, 20.1%, and 3.3%, respectively. Diagnoses of hydronephrosis, urinary fistula, or bowel fistula were not evident. The rates of corrective invasive procedures for lower urinary tract obstruction and erectile dysfunction were both <2.9% by the twelfth month. Overall, complications post cryotherapy were modest; however, diagnoses for lower urinary tract obstruction and erectile dysfunction were common. PMID:21519347

  16. A genome-wide association study of neuroticism in a population-based sample.

    PubMed

    Calboli, Federico C F; Tozzi, Federica; Galwey, Nicholas W; Antoniades, Athos; Mooser, Vincent; Preisig, Martin; Vollenweider, Peter; Waterworth, Dawn; Waeber, Gerard; Johnson, Michael R; Muglia, Pierandrea; Balding, David J

    2010-07-09

    Neuroticism is a moderately heritable personality trait considered to be a risk factor for developing major depression, anxiety disorders and dementia. We performed a genome-wide association study in 2,235 participants drawn from a population-based study of neuroticism, making this the largest association study for neuroticism to date. Neuroticism was measured by the Eysenck Personality Questionnaire. After Quality Control, we analysed 430,000 autosomal SNPs together with an additional 1.2 million SNPs imputed with high quality from the Hap Map CEU samples. We found a very small effect of population stratification, corrected using one principal component, and some cryptic kinship that required no correction. NKAIN2 showed suggestive evidence of association with neuroticism as a main effect (p < 10(-6)) and GPC6 showed suggestive evidence for interaction with age (p approximately = 10(-7)). We found support for one previously-reported association (PDE4D), but failed to replicate other recent reports. These results suggest common SNP variation does not strongly influence neuroticism. Our study was powered to detect almost all SNPs explaining at least 2% of heritability, and so our results effectively exclude the existence of loci having a major effect on neuroticism.

  17. Coronary Angioplasty and Cancer Risk: A Population-Based Cohort Study in Sweden

    SciTech Connect

    Lambe, M. Hall, P.; Granath, F.; Azodi, O. Sadr; Nilsson, T.

    2005-01-15

    Background. Percutaneous transluminal coronary angioplasty (PTCA) has become the reperfusion method of choice in patients with coronary artery disease. This sometimes complicated and lengthy procedure is performed using fluoroscopy and cineradiography or digital imaging, which may result in considerable exposure to ionizing radiation. Possible cancer risks in PTCA patients have been discussed, but never before examined in a population-based setting. Objective. To assess the cancer risks following PTCA. Methods. A cohort study was carried out based on nationwide registration of all coronary angioplasty procedures in Sweden between 1989 and 1998. The study encompassed a total of 23,097 PTCA patients followed up for cancer outcomes in the Swedish Cancer Register until December 31, 2000. The mean and median follow-up times were 4.8 and 4.5 years, respectively. The main outcome measures were standardized incidence ratios of cancer. Results. Except for a transient excess of lung cancers, observed number of cancers in patients who had undergone coronary angioplasty did not differ from those expected in the general population. If anything, the overall cancer risk was lower in the PTCA group (SIR 0.94; 95% CI 0.88-0.99). In particular, no increased risks were detected for leukemias or thyroid cancer. Conclusion. There was no indication of increased risks of leukemia or cancers overall in PTCA patients.

  18. Stereotypical hand movements in 144 subjects with Rett syndrome from the population-based Australian database.

    PubMed

    Carter, Philippa; Downs, Jenny; Bebbington, Ami; Williams, Simon; Jacoby, Peter; Kaufmann, Walter E; Leonard, Helen

    2010-02-15

    Stereotypic hand movements are a feature of Rett Syndrome but few studies have observed their nature systematically. Video data in familiar settings were obtained on subjects (n = 144) identified from an Australian population-based database. Hand stereotypies were demonstrated by most subjects (94.4%), 15 categories were observed and midline wringing was seen in approximately 60% of subjects. There was a median of two stereotypies per subject but this number decreased with age. Clapping and mouthing of hands were more prevalent in girls younger than 8 years and wringing was more prevalent in women 19 years or older. Clapping was commoner in those with p.R306C and early truncating mutations, and much rarer in those with p.R106W, p.R270X, p.R168X, and p.R255X. Stereotypies tended to be less frequent in those with more severe mutations. Otherwise, there were no clear relationships between our categories of stereotypies and mutation. Approximately a quarter each had predominantly right and left handed stereotypies and for the remaining half, no clear laterality was seen. Results were similar for all cases and when restricted to those with a pathogenic mutation. Hand stereotypies changed with increasing age but limited relationships with MECP2 mutations were identified.

  19. Reptiles, amphibians, and human Salmonella infection: a population-based, case-control study.

    PubMed

    Mermin, Jonathan; Hutwagner, Lori; Vugia, Duc; Shallow, Sue; Daily, Pamela; Bender, Jeffrey; Koehler, Jane; Marcus, Ruthanne; Angulo, Frederick J

    2004-04-15

    To estimate the burden of reptile- and amphibian-associated Salmonella infections, we conducted 2 case-control studies of human salmonellosis occurring during 1996-1997. The studies took place at 5 Foodborne Diseases Active Surveillance Network (FoodNet) surveillance areas: all of Minnesota and Oregon and selected counties in California, Connecticut, and Georgia. The first study included 463 patients with serogroup B or D Salmonella infection and 7618 population-based controls. The second study involved 38 patients with non-serogroup B or D Salmonella infection and 1429 controls from California only. Patients and controls were interviewed about contact with reptiles and amphibians. Reptile and amphibian contact was associated both with infection with serogroup B or D Salmonella (multivariable odds ratio [OR], 1.6; 95% confidence interval [CI], 1.1-2.2; P<.009) and with infection with non-serogroup B or D Salmonella (OR, 4.2; CI, 1.8-9.7; P<.001). The population attributable fraction for reptile or amphibian contact was 6% for all sporadic Salmonella infections and 11% among persons <21 years old. These data suggest that reptile and amphibian exposure is associated with approximately 74,000 Salmonella infections annually in the United States.

  20. Childhood gender-typed behavior and adolescent sexual orientation: A longitudinal population-based study.

    PubMed

    Li, Gu; Kung, Karson T F; Hines, Melissa

    2017-04-01

    Lesbian and gay individuals have been reported to show more interest in other-sex, and/or less interest in same-sex, toys, playmates, and activities in childhood than heterosexual counterparts. Yet, most of the relevant evidence comes from retrospective studies or from prospective studies of clinically referred, extremely gender nonconforming children. In addition, findings are mixed regarding the relation between childhood gender-typed behavior and the later sexual orientation spectrum from exclusively heterosexual to exclusively lesbian/gay. The current study drew a sample (2,428 girls and 2,169 boys) from a population-based longitudinal study, and found that the levels of gender-typed behavior at ages 3.5 and 4.75 years, although less so at age 2.5 years, significantly and consistently predicted adolescents' sexual orientation at age 15 years, both when sexual orientation was conceptualized as 2 groups or as a spectrum. In addition, within-individual change in gender-typed behavior during the preschool years significantly related to adolescent sexual orientation, especially in boys. These results suggest that the factors contributing to the link between childhood gender-typed behavior and sexual orientation emerge during early development. Some of those factors are likely to be nonsocial, because nonheterosexual individuals appear to diverge from gender norms regardless of social encouragement to conform to gender roles. (PsycINFO Database Record

  1. Community violence and mental health among Iraqi women, a population-based study

    PubMed Central

    Al-Nuaimi, Maha A.

    2013-01-01

    Background: The recent events in Iraq following the 2003 war render Iraq as a country with a high level of all types of violence. Exposure to violence, as a witness or a victim, is related to a number of longer term emotional, behavioral and social problems. Objectives: To investigate the impact of witnessing and experiencing community violence and tragedy as a factor contributing to mental health disorders among Iraqi women in the city of Mosul. Methods: A population-based cross-sectional study of 500 women were selected by a multi-stage random sampling technique. Four catchment areas of primary health centers of Mosul city were selected. Community violence with nine commonly associated social, economic, emotional, physical and mental health symptoms were recorded by questionnaire. Results: The study revealed that all the participating women had a history of exposure to at least one type of community violence within the last twelve months. A mainstream consequence of exposure to community violence was transportation difficulties, loss of husband's job, and family displacement. More than half of the women were classified as having severe emotional disturbances that may evolve to mental health problems in future. Conclusion: Women are bearing the consequences of the violence in Iraq. National commitment and action needs to be taken to curb the violence which is hugely affecting the people of Iraq. Treatment programs targeted at promoting emotional resilience may be effective at preventing mental health problems. PMID:25003060

  2. Review of the Cervical Cancer Burden and Population-Based Cervical Cancer Screening in China.

    PubMed

    Di, Jiangli; Rutherford, Shannon; Chu, Cordia

    2015-01-01

    Cervical cancer continues to be a serious public health problem in the developing world, including China. Because of its large population with geographical and socioeconomic inequities, China has a high burden of cervical cancer and important disparities among different regions. In this review, we first present an overview of the cervical cancer incidence and mortality over time, and focus on diversity and disparity in access to care for various subpopulations across geographical regions and socioeconomic strata in China. Then, we describe population-based cervical cancer screening in China, and in particular implementation of the National Cervical Cancer Screening Program in Rural Areas (NACCSPRA) and the challenges that this program faces. These include low screening coverage, shortage of qualified health care personnel and limited funds. To improve prevention of cervical cancer and obtain better cancer outcomes, the Chinese government needs to urgently consider the following key factors: reducing disparities in health care access, collecting accurate and broadly representative data in cancer registries, expanding target population size and increasing allocation of government funding for training of personnel, improving health education for women, enhancing quality control of screening services and improving a system to increase follow up for women with positive results.

  3. Multiple myeloma and infections: a population-based study on 9253 multiple myeloma patients.

    PubMed

    Blimark, Cecilie; Holmberg, Erik; Mellqvist, Ulf-Henrik; Landgren, Ola; Björkholm, Magnus; Hultcrantz, Malin; Kjellander, Christian; Turesson, Ingemar; Kristinsson, Sigurdur Y

    2015-01-01

    Infections are a major cause of morbidity and mortality in patients with multiple myeloma. To estimate the risk of bacterial and viral infections in multiple myeloma patients, we used population-based data from Sweden to identify all multiple myeloma patients (n=9253) diagnosed from 1988 to 2004 with follow up to 2007 and 34,931 matched controls. Cox proportional hazard models were used to estimate the risk of infections. Overall, multiple myeloma patients had a 7-fold (hazard ratio =7.1; 95% confidence interval = 6.8-7.4) risk of developing any infection compared to matched controls. The increased risk of developing a bacterial infection was 7-fold (7.1; 6.8-7.4), and for viral infections 10-fold (10.0; 8.9-11.4). Multiple myeloma patients diagnosed in the more recent calendar periods had significantly higher risk of infections compared to controls (P<0.001). At one year of follow up, infection was the underlying cause in 22% of deaths in multiple myeloma patients. Mortality due to infections remained constant during the study period. Our findings confirm that infections represent a major threat to multiple myeloma patients. The effect on infectious complications due to novel drugs introduced in the treatment of multiple myeloma needs to be established and trials on prophylactic measures are needed.

  4. Does Intracerebral Hemorrhage Mimic Benign Dizziness Presentations? A Population Based Study

    PubMed Central

    Kerber, Kevin A.; Burke, James F.; Brown, Devin L.; Meurer, William J.; Smith, Melinda A.; Lisabeth, Lynda D.; Morgenstern, Lewis B.; Zahuranec, Darin B.

    2012-01-01

    Objective A principal reason to order a head computerized tomography (CT) scan for dizziness patients is to exclude stroke. Since CT imaging is substantially limited in assessing for any acute lesions other than hemorrhage, the most important stroke syndrome adequately evaluated by CT is intracerebral hemorrhage (ICH). We used a population-based stroke database to assess the frequency with which ICH might mimic a benign dizziness presentation. Methods The Brain Attack Surveillance in Corpus Christi (BASIC) project was used to identify cases of ICH from January 1, 2000, to December 26, 2007. The hospital records of ICH cases with a National Institutes of Health Stroke Scale (NIHSS) of < 2 were abstracted for more detailed information. Cases were classified as benign dizziness presentations when isolated dizziness and a normal general neurological examination were documented. Results Of 595 ICH cases, only 2.2% (13 of 595) had dizziness as the primary presenting symptom and an NIHSS < 2. No case mimicked a benign dizziness presentation. Only one case had isolated dizziness symptoms but this patient had dysmetria documented on the exam. All other cases had either focal or global neurological symptoms or exam abnormalities. Conclusions This study provides further support for the notion that ICH is highly unlikely to mimic a benign dizziness presentation. Coupled with the limitations of CT to show acute ischemia in the posterior fossa, these results suggest that screening for ICH may not be necessary in benign appearing dizziness presentations, though more research is needed. PMID:21245473

  5. Dementia is not inevitable: a population-based study of Danish centenarians.

    PubMed

    Andersen-Ranberg, K; Vasegaard, L; Jeune, B

    2001-05-01

    The authors evaluated the prevalence of dementia in centenarians. In this population-based survey, persons living in Denmark who turned 100 during the period April 1, 1995--May 31, 1996 (N = 276) were interviewed and examined at their residences. Additional health information was retrieved from medical files, including the National Discharge Registry. A participation rate was 75%, and no differences were found between participants and nonparticipants regarding sex and type of housing. The prevalence of mild to severe dementia in centenarians was 51%; 37% had no signs of dementia. Among the 105 demented centenarians, 13 (12%) had diseases (vitamin B12 and folic acid deficiencies, hypothyroidism, Parkinson's disease) that could contribute to a dementia diagnosis. Of the remaining 92 demented participants, 46 (50%) had 1 one or more cerebro- or cardiovascular diseases known to be risk factors in the development of dementia. The prevalence of these risk factors was the same in demented and nondemented participants, whereas hypertension was significantly more frequent in nondemented than demented participants. Dementia is common but not inevitable in centenarians. Cerebro- and cardiovascular diseases are equally common in demented and nondemented persons.

  6. Osteoporosis in adult patients with atopic dermatitis: A nationwide population-based study

    PubMed Central

    Lu, Chun-Ching; Su, Yu-Feng; Tsai, Tai-Hsin; Wu, Chieh-Hsin

    2017-01-01

    The aim of this study was to investigate osteoporosis risk in atopic dermatitis (AD) patients. This study included patients in the Taiwan National Health Insurance Research dataset. The population-based study included all patients aged 20–49 years who had been diagnosed with AD during 1996–2010. In total, 35,229 age and gender-matched patients without AD in a 1:1 ratio were randomly selected as the non-AD group. Cox proportional-hazards regression and Kaplan–Meier analyses were used to measure the hazard ratios and the cumulative incidences of osteoporosis, respectively. During the follow-up period, 360(1.02%) AD patients and 127(0.36%) non-AD patients developed osteoporosis. The overall incidence of osteoporosis was4.72-fold greater in the AD patients compared to the non-AD patients (1.82 vs. 0.24 per 1,000 person-years, respectively) after adjusting for potential confounding factors. Osteoporosis risk factors included female gender, age, advanced Charlson Comorbidity Index, depression and use of corticosteroids. The dataset analysis showed that AD was significantly associated with subsequent risk of osteoporosis. PMID:28207767

  7. Neurofibromatosis and childhood leukaemia/lymphoma: a population-based UKCCSG study.

    PubMed Central

    Stiller, C. A.; Chessells, J. M.; Fitchett, M.

    1994-01-01

    There is a well-known raised risk of leukaemia in children with neurofibromatosis type 1 (NF-1). We carried out the first detailed population-based study of leukaemia and non-Hodgkin lymphoma (NHL) associated with NF-1 in order to estimate the risk and elucidate the relationship between these conditions. Over the 17 year study period there were five cases of chronic myelomonocytic leukaemia (CMML) in patients with NF-1 (relative risk 221; 95% CI 71-514), 12 cases of acute lymphoblastic leukaemia (ALL) (relative risk 5.4; 95% CI 2.8-9.4) and five cases of NHL (relative risk 10.0; 95% CI 3.3-23.4). Marrow cytogenetics could be reviewed for seven patients. Specific abnormalities found were monosomy 21 in a child with CMML and 7p+, 17p- in a child with ALL. No abnormalities were reported of 17q, which includes the NF1 gene. CMML occurred predominantly in boys, who also had a family history of NF-1. ALL and NHL were more often found in children with no previous family history. PMID:7947106

  8. Cohort Profile: The Japanese Population-based Osteoporosis (JPOS) Cohort Study.

    PubMed

    Iki, Masayuki; Tamaki, Junko; Sato, Yuho; Morita, Akemi; Ikeda, Yukihiro; Kajita, Etsuko; Nishino, Harumi; Akiba, Takashi; Matsumoto, Toshio; Kagamimori, Sadanobu; Kagawa, Yoshiko; Yoneshima, Hideo; Matsukura, Tomoharu; Yamagami, Takashi; Kitagawa, Jun

    2015-04-01

    The Japanese Population-based Osteoporosis (JPOS) Cohort Study was launched in 1996 to produce a reference database of areal bone mineral density (aBMD) by dual energy X-ray absorptiometry (DXA) and bone turnover markers in the Japanese female population and to determine risk factors for osteoporotic fractures. At baseline, 3984 women aged 15 to 79 years were randomly selected to provide representative bone status data and aBMD values for the diagnosis of osteoporosis. Follow-up surveys were conducted in 1999, 2002, 2006 and 2011/12 to determine changes in aBMD and identify incident morphometry-confirmed vertebral fractures and clinical fractures. These outcomes were obtained from 2174 women who participated in at least one follow-up survey. JPOS is a unique resource of individual-level bone health information with radiological and biological archives that include DXA images, and serum, plasma and DNA for future analyses with emerging radiological and biological techniques. The JPOS dataset is not freely available, but new collaborations are encouraged. Potential collaborators are invited to contact the Secretary General (M.I.) at the administrative office of the JPOS Study Group.

  9. Adult Prevalence of Epilepsy in Spain: EPIBERIA, a Population-Based Study

    PubMed Central

    Serrano-Castro, Pedro J.; Mauri-Llerda, Jose Angel; Hernández-Ramos, Francisco José; Sánchez-Alvarez, Juan Carlos; Parejo-Carbonell, Beatriz; Quiroga-Subirana, Pablo; Vázquez-Gutierrez, Fernando; Santos-Lasaosa, Sonia; Mendez-Lucena, Carolina; Redondo-Verge, Luis; Tejero-Juste, Carlos; Morandeira-Rivas, Clara; Sancho-Rieger, Jerónimo; Matías-Guiu, Jorge

    2015-01-01

    Background. This study assesses the lifetime and active prevalence of epilepsy in Spain in people older than 18 years. Methods. EPIBERIA is a population-based epidemiological study of epilepsy prevalence using data from three representative Spanish regions (health districts in Zaragoza, Almería, and Seville) between 2012 and 2013. The study consisted of two phases: screening and confirmation. Participants completed a previously validated questionnaire (EPIBERIA questionnaire) over the telephone. Results. A total of 1741 valid questionnaires were obtained, including 261 (14.99%) raising a suspicion of epilepsy. Of these suspected cases, 216 (82.75%) agreed to participate in phase 2. Of the phase 2 participants, 22 met the International League Against Epilepsy's diagnostic criteria for epilepsy. The estimated lifetime prevalence, adjusted by age and sex per 1,000 people, was 14.87 (95% CI: 9.8–21.9). Active prevalence was 5.79 (95% CI: 2.8–10.6). No significant age, sex, or regional differences in prevalence were detected. Conclusions. EPIBERIA provides the most accurate estimate of epilepsy prevalence in the Mediterranean region based on its original methodology and its adherence to ILAE recommendations. We highlight that the lifetime prevalence and inactive epilepsy prevalence figures observed here were compared to other epidemiological studies. PMID:26783554

  10. Lung Cancer and Occupation in a Population-based Case-Control Study

    PubMed Central

    Consonni, Dario; De Matteis, Sara; Lubin, Jay H.; Wacholder, Sholom; Tucker, Margaret; Pesatori, Angela Cecilia; Caporaso, Neil E.; Bertazzi, Pier Alberto; Landi, Maria Teresa

    2010-01-01

    The authors examined the relation between occupation and lung cancer in the large, population-based Environment And Genetics in Lung cancer Etiology (EAGLE) case-control study. In 2002–2005 in the Lombardy region of northern Italy, 2,100 incident lung cancer cases and 2,120 randomly selected population controls were enrolled. Lifetime occupational histories (industry and job title) were coded by using standard international classifications and were translated into occupations known (list A) or suspected (list B) to be associated with lung cancer. Smoking-adjusted odds ratios and 95% confidence intervals were calculated with logistic regression. For men, an increased risk was found for list A (177 exposed cases and 100 controls; odds ratio = 1.74, 95% confidence interval: 1.27, 2.38) and most occupations therein. No overall excess was found for list B with the exception of filling station attendants and bus and truck drivers (men) and launderers and dry cleaners (women). The authors estimated that 4.9% (95% confidence interval: 2.0, 7.8) of lung cancers in men were attributable to occupation. Among those in other occupations, risk excesses were found for metal workers, barbers and hairdressers, and other motor vehicle drivers. These results indicate that past exposure to occupational carcinogens remains an important determinant of lung cancer occurrence. PMID:20047975

  11. Metformin use and survival from lung cancer: A population-based cohort study.

    PubMed

    Menamin, Úna C Mc; Cardwell, Chris R; Hughes, Carmel M; Murray, Liam M

    2016-04-01

    Preclinical evidence suggests that metformin, a widely prescribed anti-diabetic drug, may inhibit lung cancer progression. We investigated whether metformin use was associated with decreased risk of cancer-specific mortality in lung cancer patients. This study included newly diagnosed lung cancer patients (identified from English National Cancer Data Repository, 1998-2009) with type 2 diabetes (based on UK Clinical Practice Research Datalink prescriptions and diagnosis records). Lung cancer deaths occurring up to 2012 were identified using Office of National Statistics mortality data and the association between metformin use (before and after diagnosis) and risk of lung cancer-specific mortality was calculated using Cox regression models. In analysis of 533 patients, we found a weak non-significant reduction in lung cancer-specific mortality with metformin use after diagnosis (adjusted HR, 0.86; 95% CI, 0.68-1.09). No association was evident for metformin use before diagnosis and cancer-specific mortality in analysis of 1350 patients (adjusted HR, 0.97; 95% CI, 0.86, 1.11). Associations were similar by duration of use. In addition, after adjustment for potential confounders, there was little evidence of an association between the use of other anti-diabetic medications (either before or after diagnosis) and lung cancer-specific mortality; including sulfonylureas, insulin or other anti-diabetic medications (such as thiazolidinediones). Overall, the results from this population-based study provide little evidence of a protective association between metformin use and cancer mortality in lung cancer patients.

  12. Estimating the personal cure rate of cancer patients using population-based grouped cancer survival data.

    PubMed

    Binbing Yu; Tiwari, Ram C; Feuer, Eric J

    2011-06-01

    Cancer patients are subject to multiple competing risks of death and may die from causes other than the cancer diagnosed. The probability of not dying from the cancer diagnosed, which is one of the patients' main concerns, is sometimes called the 'personal cure' rate. Two approaches of modelling competing-risk survival data, namely the cause-specific hazards approach and the mixture model approach, have been used to model competing-risk survival data. In this article, we first show the connection and differences between crude cause-specific survival in the presence of other causes and net survival in the absence of other causes. The mixture survival model is extended to population-based grouped survival data to estimate the personal cure rate. Using the colorectal cancer survival data from the Surveillance, Epidemiology and End Results Programme, we estimate the probabilities of dying from colorectal cancer, heart disease, and other causes by age at diagnosis, race and American Joint Committee on Cancer stage.

  13. Population-based survival-cure analysis of ER-negative breast cancer.

    PubMed

    Huang, Lan; Johnson, Karen A; Mariotto, Angela B; Dignam, James J; Feuer, Eric J

    2010-08-01

    This study investigated the trends over time in age and stage specific population-based survival of estrogen receptor negative (ER-) breast cancer patients by examining the fraction of cured patients and the median survival time for uncured patients. Cause-specific survival data from the Surveillance, Epidemiology, and End Results program for cases diagnosed during 1992-1998 were used in mixed survival cure models to evaluate the cure fraction and the extension in survival for uncured patients. Survival trends were compared with adjuvant chemotherapy data available from an overlapping patterns-of-care study. For stage II N+ disease, the largest increase in cure fraction was 44-60% (P = 0.0257) for women aged >or=70 in contrast to a 7-8% point increase for women aged <50 or 50-69 (P = 0.056 and 0.038, respectively). For women with stage III disease, the increases in the cure fraction were not statistically significant, although women aged 50-69 had a 10% point increase (P = 0.103). Increases in cure fraction correspond with increases in the use of adjuvant chemotherapy, particularly for the oldest age group. In this article, for the first time, we estimate the cure fraction for ER- patients. We notice that at age >o5r=70, the accelerated increase in cure fraction from 1992 to 1998 for women with stage II N+ compared with stage III suggests a selective benefit for chemotherapy in the lower stage group.

  14. Population-based screening for anemia using first-time blood donors

    PubMed Central

    Mast, Alan E.; Steele, Whitney R.; Johnson, Bryce; Wright, David J.; Cable, Ritchard G.; Carey, Patricia; Gottschall, Jerome L.; Kiss, Joseph E.; Simon, Toby L.; Murphy, Edward L.

    2012-01-01

    Background Anemia is an important public health concern. Data from population-based surveys such as the National Health and Nutrition Examination Survey (NHANES) are the gold standard, but are obtained infrequently and include only small samples from certain minority groups. Objectives We assessed whether readily available databases of blood donor hemoglobin values could be used as a surrogate for population hemoglobin values from NHANES. Design Blood donor venous and fingerstick hemoglobin values were compared to 10,254 NHANES 2005-2008 venous hemoglobin values using demographically stratified analyses and ANOVA. Fingerstick hemoglobins or hematocrits were converted to venous hemoglobin estimates using regression analysis. Results Venous hemoglobin values from 1,609 first time donors correlated extremely well with NHANES data across different age, gender and demographic groups. Cigarette smoking increased hemoglobin by 0.26 to 0.59 g/dL depending on intensity. Converted fingerstick hemoglobin from 36,793 first time donors agreed well with NHANES hemoglobin (weighted mean hemoglobin of 15.53 g/dL for donors and 15.73 g/dL for NHANES) with similar variation in mean hemoglobin by age. However, compared to NHANES, the larger donor dataset showed reduced differences in mean hemoglobin between Blacks and other races/ethnicities. Conclusions Overall, first-time donor fingerstick hemoglobins approximate U.S. population data and represent a readily available public health resource for ongoing anemia surveillance. PMID:22460662

  15. Intensive care outcomes in bone marrow transplant recipients: a population-based cohort analysis

    PubMed Central

    Scales, Damon C; Thiruchelvam, Deva; Kiss, Alexander; Sibbald, William J; Redelmeier, Donald A

    2008-01-01

    Introduction Intensive care unit (ICU) admission for bone marrow transplant recipients immediately following transplantation is an ominous event, yet the survival of these patients with subsequent ICU admissions is unknown. Our objective was to determine the long-term outcome of bone marrow transplant recipients admitted to an ICU during subsequent hospitalizations. Methods We conducted a population-based cohort analysis of all adult bone marrow transplant recipients who received subsequent ICU care in Ontario, Canada from 1 January 1992 to 31 March 2002. The primary endpoint was mortality at 1 year. Results A total of 2,653 patients received bone marrow transplantation; 504 of which received ICU care during a subsequent hospitalization. Patients receiving any major procedure during their ICU stay had higher 1-year mortality than those patients who received no ICU procedure (87% versus 44%, P < 0.0001). Death rates at 1 year were highest for those receiving mechanical ventilation (87%), pulmonary artery catheterization (91%), or hemodialysis (94%). In combination, the strongest independent predictors of death at 1 year were mechanical ventilation (odds ratio, 7.4; 95% confidence interval, 4.8 to 11.4) and hemodialysis (odds ratio, 8.7; 95% confidence interval, 2.1 to 36.7), yet no combination of procedures uniformly predicted 100% mortality. Conclusion The prognosis of bone marrow transplant recipients receiving ICU care during subsequent hospitalizations is very poor but should not be considered futile. PMID:18547422

  16. Incidence of Lower Urinary Tract Symptoms in a Population-Based Study of Men and Women

    PubMed Central

    Maserejian, Nancy N.; Chen, Shan; Chiu, Gretchen R.; Wager, Carrie G.; Kupelian, Varant; Araujo, Andre B.; McKinlay, John B.

    2013-01-01

    Objectives To report the incidence of lower urinary tract symptoms (LUTS) in a racially/ethnically and age-diverse U.S. population-based sample of men and women. Methods We conducted a prospective cohort study with 5-year follow-up. A stratified 2-stage cluster random sampling method was used to recruit 5,502 Boston residents aged 30–79 years of black, Hispanic, or white race/ethnicity; 4,144 individuals (1,610 men; 2,534 women) completed follow-up. The American Urological Association Symptom Index (AUASI) was used to define moderate-to-severe LUTS. Results Among the 3,301 men and women with no or mild LUTS at baseline, the 5-year incidence of moderate-to-severe LUTS (AUASI≥8) was 11.4% overall, and higher for women than men (13.9% vs. 8.5%, P=0.02). Although the incidence increased with age (P<0.001), it had a plateau among women between ages 50–70 years of age and then doubled to 35.0% among women ≥70 years. White men had a distinctly lower incidence (7%), compared to all other sex/race sub-groups (13%). Conclusions Approximately one in ten adults had newly developed LUTS at 5-year follow-up, with differences by sex and race/ethnicity, indicating greater occurrence of urological problems among black and Hispanic participants or women. PMID:23876577

  17. Level of neurotoxic metals in amyotrophic lateral sclerosis: A population-based case-control study.

    PubMed

    Bocca, Beatrice; Forte, Giovanni; Oggiano, Riccardo; Clemente, Simonetta; Asara, Yolande; Peruzzu, Angela; Farace, Cristiano; Pala, Salvatore; Fois, Alessandro Giuseppe; Pirina, Pietro; Madeddu, Roberto

    2015-12-15

    The association between exposure to toxic metals and amyotrophic lateral sclerosis (ALS) was explored in a population-based case-control study in the Sardinia island (Italy), a region characterized by elevated rates of ALS cases. In 34 patients with ALS (mean age, 62 ± 10 years) and 30 controls (mean age, 65 ± 11 years), Al, Cd, Hg, Mn and Pb were determined in blood, hair and urine by sector field inductively coupled mass spectrometry. Results indicated that, in blood, concentrations of Al (p=0.045) and Pb were higher (p=0.026) in ALS patients than in control subjects. In hair, a depletion of Al (p=0.006) and Mn (p=0.032) concentrations in ALS subjects respect to controls was found. In urine, no significant differences between cases and controls were observed. Thus, some metals seemed to be associated with ALS degeneration, but a definitive conclusion is still far considering the multiple risk factors (genetic mutations, environmental toxicants and stressors) involved in the disease. Finally, the interpretation that deregulated metal concentrations can be a consequence of the degenerative process, rather than a cause, is also valid.

  18. Predicting successful aging in a population-based sample of georgia centenarians.

    PubMed

    Arnold, Jonathan; Dai, Jianliang; Nahapetyan, Lusine; Arte, Ankit; Johnson, Mary Ann; Hausman, Dorothy; Rodgers, Willard L; Hensley, Robert; Martin, Peter; Macdonald, Maurice; Davey, Adam; Siegler, Ilene C; Jazwinski, S Michal; Poon, Leonard W

    2010-01-01

    Used a population-based sample (Georgia Centenarian Study, GCS), to determine proportions of centenarians reaching 100 years as (1) survivors (43%) of chronic diseases first experienced between 0-80 years of age, (2) delayers (36%) with chronic diseases first experienced between 80-98 years of age, or (3) escapers (17%) with chronic diseases only at 98 years of age or older. Diseases fall into two morbidity profiles of 11 chronic diseases; one including cardiovascular disease, cancer, anemia, and osteoporosis, and another including dementia. Centenarians at risk for cancer in their lifetime tended to be escapers (73%), while those at risk for cardiovascular disease tended to be survivors (24%), delayers (39%), or escapers (32%). Approximately half (43%) of the centenarians did not experience dementia. Psychiatric disorders were positively associated with dementia, but prevalence of depression, anxiety, and psychoses did not differ significantly between centenarians and an octogenarian control group. However, centenarians were higher on the Geriatric Depression Scale (GDS) than octogenarians. Consistent with our model of developmental adaptation in aging, distal life events contribute to predicting survivorship outcome in which health status as survivor, delayer, or escaper appears as adaptation variables late in life.

  19. History of depression and risk of hyperemesis gravidarum: a population-based cohort study.

    PubMed

    Kjeldgaard, Helena Kames; Eberhard-Gran, Malin; Benth, Jūratė Šaltytė; Nordeng, Hedvig; Vikanes, Åse Vigdis

    2017-01-07

    Hyperemesis gravidarum (HG) is a pregnancy condition characterised by debilitating nausea and vomiting. HG has been associated with depression during pregnancy but the direction of the association remains unclear. The aim of this study was to assess whether previous depression is associated with HG. This is a population-based pregnancy cohort study using data from The Norwegian Mother and Child Cohort Study. The study reviewed 731 pregnancies with HG and 81,055 pregnancies without. Logistic regression analyses were performed to examine the association between a lifetime history of depression and hyperemesis gravidarum. Odds ratios were adjusted for symptoms of current depression, maternal age, parity, body mass index, smoking, sex of the child, education and pelvic girdle pain. A lifetime history of depression was associated with higher odds for hyperemesis gravidarum (aOR = 1.49, 95% CI (1.23; 1.79)). Two thirds of women with hyperemesis gravidarum had neither a history of depression nor symptoms of current depression, and 1.2% of women with a history of depression developed HG. A lifetime history of depression increased the risk of HG. However, given the fact that only 1.2% of women with a history of depression developed HG and that the majority of women with HG had no symptoms of depression, depression does not seem to be a main driver in the aetiology of HG.

  20. Association between Gastroesophageal Reflux Disease and Appendicitis: A Population-Based Case-Control Study.

    PubMed

    Kao, Li-Ting; Tsai, Ming-Chieh; Lin, Herng-Ching; Lee, Cha-Ze

    2016-03-02

    Appendicitis and gastroesophageal reflux disease (GERD) are both prevalent diseases and might share similar pathological mechanisms. The aim of this study was to investigate the association between GERD and appendicitis using a large population-based dataset. This study used administrative claims data from the Taiwan Longitudinal Health Insurance Database 2005. We identified 7113 patients with appendicitis as cases, and 28452 matched patients without appendicitis as controls. This study revealed that GERD was found in 359 (5.05%) cases and 728 (2.56%) controls (p < 0.001). Conditional logistic regression shows that the adjusted odds ratio (OR) of GERD for cases was 2.05 (95% confidence interval (CI): 1.08~2.33) compared to controls. The adjusted ORs of prior GERD for patients aged 18~39, 40~59, and ≥60 years with appendicitis were 1.96 (95% CI: 1.56~2.47), 2.36 (95% CI: 1.94~2.88), and 1.71 (95% CI: 1.31~2.22) than controls, respectively. We concluded that patients with appendicitis had higher odds of prior GERD than those without appendicitis regardless of age group.

  1. Inverse Association of Parkinson Disease With Systemic Lupus Erythematosus: A Nationwide Population-based Study.

    PubMed

    Liu, Feng-Cheng; Huang, Wen-Yen; Lin, Te-Yu; Shen, Chih-Hao; Chou, Yu-Ching; Lin, Cheng-Li; Lin, Kuen-Tze; Kao, Chia-Hung

    2015-11-01

    The effects of the inflammatory mediators involved in systemic lupus erythematous (SLE) on subsequent Parkinson disease have been reported, but no relevant studies have focused on the association between the 2 diseases. This nationwide population-based study evaluated the risk of Parkinson disease in patients with SLE.We identified 12,817 patients in the Taiwan National Health Insurance database diagnosed with SLE between 2000 and 2010 and compared the incidence rate of Parkinson disease among these patients with that among 51,268 randomly selected age and sex-matched non-SLE patients. A Cox multivariable proportional-hazards model was used to evaluate the risk factors of Parkinson disease in the SLE cohort.We observed an inverse association between a diagnosis of SLE and the risk of subsequent Parkinson disease, with the crude hazard ratio (HR) being 0.60 (95% confidence interval 0.45-0.79) and adjusted HR being 0.68 (95% confidence interval 0.51-0.90). The cumulative incidence of Parkinson disease was 0.83% lower in the SLE cohort than in the non-SLE cohort. The adjusted HR of Parkinson disease decreased as the follow-up duration increased and was decreased among older lupus patients with comorbidity.We determined that patients with SLE had a decreased risk of subsequent Parkinson disease. Further research is required to elucidate the underlying mechanism.

  2. The Urban-Rural Gradient In Asthma: A Population-Based Study in Northern Europe

    PubMed Central

    Timm, Signe; Frydenberg, Morten; Janson, Christer; Campbell, Brittany; Forsberg, Bertil; Gislason, Thorarinn; Holm, Mathias; Jogi, Rain; Omenaas, Ernst; Sigsgaard, Torben; Svanes, Cecilie; Schlünssen, Vivi

    2015-01-01

    The early life environment appears to have a persistent impact on asthma risk. We hypothesize that environmental factors related to rural life mediate lower asthma prevalence in rural populations, and aimed to investigate an urban-rural gradient, assessed by place of upbringing, for asthma. The population-based Respiratory Health In Northern Europe (RHINE) study includes subjects from Denmark, Norway, Sweden, Iceland and Estonia born 1945–1973. The present analysis encompasses questionnaire data on 11,123 RHINE subjects. Six categories of place of upbringing were defined: farm with livestock, farm without livestock, village in rural area, small town, city suburb and inner city. The association of place of upbringing with asthma onset was analysed with Cox regression adjusted for relevant confounders. Subjects growing up on livestock farms had less asthma (8%) than subjects growing up in inner cities (11%) (hazard ratio 0.72 95% CI 0.57–0.91), and a significant urban-rural gradient was observed across six urbanisation levels (p = 0.02). An urban-rural gradient was only evident among women, smokers and for late-onset asthma. Analyses on wheeze and place of upbringing revealed similar results. In conclusion, this study suggests a protective effect of livestock farm upbringing on asthma development and an urban-rural gradient in a Northern European population. PMID:26729146

  3. A population-based study of quantitative sensory testing in adolescents with and without chronic pain.

    PubMed

    Tham, See Wan; Palermo, Tonya M; Holley, Amy Lewandowski; Zhou, Chuan; Stubhaug, Audun; Furberg, Anne-Sofie; Nielsen, Christopher Sivert

    2016-12-01

    Quantitative sensory testing (QST) has been used to characterize pain sensitivity in individuals with and without pain conditions. Research remains limited in pediatric populations, hindering the ability to expand the utility of QST toward its potential application in clinical settings and clinical predictive value. The aims of this study were to examine pain sensitivity using QST in adolescents with chronic pain compared to adolescents without chronic pain and identify predictors of pain sensitivity. A population-based study conducted from 2010 to 2011 provided data on 941 adolescents, 197 were classified as having chronic pain and 744 were classified without chronic pain. Self-reported data on pain characteristics, psychological functioning, and QST responses were examined. The findings revealed lower pressure pain threshold and tolerance on the trapezius (P's = 0.03) in adolescents with chronic pain compared to adolescents without chronic pain, but no differences on heat or cold-pressor pain tasks. Female sex (P's = 0.02) and poorer psychological functioning (P's = 0.02) emerged as significant predictors of greater pain sensitivity across all pain modalities. Exploratory analyses revealed several associations between clinical pain characteristics and QST responses within the chronic pain cohort. Findings from this large pediatric sample provide comprehensive data that could serve as normative data on QST responses in adolescents with and without chronic pain. These findings lay the groundwork toward developing future QST research and study protocols in pediatric populations, taking into consideration sex and psychological distress.

  4. Noise Annoyance in Urban Children: A Cross-Sectional Population-Based Study

    PubMed Central

    Grelat, Natacha; Houot, Hélène; Pujol, Sophie; Levain, Jean-Pierre; Defrance, Jérôme; Mariet, Anne-Sophie; Mauny, Frédéric

    2016-01-01

    Acoustical and non-acoustical factors influencing noise annoyance in adults have been well-documented in recent years; however, similar knowledge is lacking in children. The aim of this study was to quantify the annoyance caused by chronic ambient noise at home in children and to assess the relationship between these children′s noise annoyance level and individual and contextual factors in the surrounding urban area. A cross sectional population-based study was conducted including 517 children attending primary school in a European city. Noise annoyance was measured using a self-report questionnaire adapted for children. Six noise exposure level indicators were built at different locations at increasing distances from the child′s bedroom window using a validated strategic noise map. Multilevel logistic models were constructed to investigate factors associated with noise annoyance in children. Noise indicators in front of the child′s bedroom (p ≤ 0.01), family residential satisfaction (p ≤ 0.03) and socioeconomic characteristics of the individuals and their neighbourhood (p ≤ 0.05) remained associated with child annoyance. These findings illustrate the complex relationships between our environment, how we may perceive it, social factors and health. Better understanding of these relationships will undoubtedly allow us to more effectively quantify the actual effect of noise on human health. PMID:27801858

  5. Population-based worksite obesity management interventions: a qualitative case study.

    PubMed

    Romney, Martha C; Thomson, Erin; Kash, Kathryn

    2011-06-01

    Due to the increased prevalence of obesity and associated direct and indirect costs to employers, weight management programs have become an integral component of employer and insurer benefits plans. The programs vary in foci, scope, breadth, and implementation. The aim of this study was to explore promising employer-sponsored population-based obesity management programs. A case study that utilized a telephonic semi-structured questionnaire was conducted with small and large organizations located in different regions of the United States that had been recruited to participate. Eight employers and 1 health care advocacy coalition who met the inclusion criteria were interviewed about features of their weight management programs. The case study revealed a number of themes consistent with reports in the literature and reflecting cited best practices. Key findings include confirmation that weight management is a significant component of the wellness strategy in all participating organizations because employers are invested in population health programs and cost savings. Based upon their experience and knowledge, occupational health specialists are responsible for designing, implementing, managing, and evaluating employee health programs. Almost all employers utilize electronic media as a prominent component of wellness and disease management initiatives. Experience has shown that incentives-both financial and nonmonetary-are effective motivators for employee engagement and outcomes. However, while employers report success, favorable outcomes have been difficult to quantify.

  6. The association between ALS and population density: A population based study.

    PubMed

    Scott, Kirsten M; Abhinav, Kumar; Wijesekera, Lokesh; Ganesalingam, Jeban; Goldstein, Laura H; Janssen, Anna; Dougherty, Andrew; Willey, Emma; Stanton, Biba R; Turner, Martin R; Ampong, Mary-Ann; Sakel, Mohammed; Orrell, Richard; Howard, Robin; Shaw, Christopher E; Nigel Leigh, P; Al-Chalabi, Ammar

    2010-10-01

    We aimed to assess whether rural residence is associated with amyotrophic lateral sclerosis in the south-east of England using a population based register. Previous studies in different populations have produced contradictory findings. Residence defined by London borough or non-metropolitan district at time of diagnosis was recorded for each incident case in the South-East England ALS Register between 1995 and 2005. Each of the 26 boroughs or districts of the catchment area of the register was classified according to population density. Age- and sex-adjusted incidence of ALS was calculated for each region and the relationship with population density tested by linear regression, thereby controlling for the underlying population structure. We found that population density in region of residence at diagnosis explained 25% of the variance in ALS rates (r = 0.5, p < 0.01). Thus, in this cohort in the south-east of England, people with ALS were more likely to be resident in areas of high population density at diagnosis.

  7. Cortical thickness and prosocial behavior in school-age children: A population-based MRI study.

    PubMed

    Thijssen, Sandra; Wildeboer, Andrea; Muetzel, Ryan L; Bakermans-Kranenburg, Marian J; El Marroun, Hanan; Hofman, Albert; Jaddoe, Vincent W V; van der Lugt, Aad; Verhulst, Frank C; Tiemeier, Henning; van IJzendoorn, Marinus H; White, Tonya

    2015-01-01

    Prosocial behavior plays an important role in establishing and maintaining relationships with others and thus may have important developmental implications. This study examines the association between cortical thickness and prosocial behavior in a population-based sample of 6- to 9-year-old children. The present study was embedded within the Generation R Study. Magnetic resonance scans were acquired from 464 children whose parents had completed the prosocial scale of the Strengths and Difficulties Questionnaire. To study the association between cortical thickness and prosocial behavior, we performed whole-brain surface-based analyses. Prosocial behavior was related to a thicker cortex in a cluster that covers part of the left superior frontal and rostral middle frontal cortex (p < .001). Gender moderated the association between prosocial behavior and cortical thickness in a cluster including the right rostral middle frontal and superior frontal cortex (p < .001) as well as in a cluster covering the right superior parietal cortex, cuneus, and precuneus (p < .001). Our results suggest that prosocial behavior is associated with cortical thickness in regions related to theory of mind (superior frontal cortex, rostral middle frontal cortex cuneus, and precuneus) and inhibitory control (superior frontal and rostral middle frontal cortex).

  8. Emotional development in children with tics: a longitudinal population-based study.

    PubMed

    Hoekstra, P J; Lundervold, A J; Lie, S A; Gillberg, C; Plessen, Kerstin J

    2013-03-01

    Children with tics often experience accompanying problems that may have more impact on their well being and quality of life than the tics themselves. The present study investigates characteristics and the course of associated problems. In a population-based follow-up study, we investigated the developmental trajectory of children with and without tics when they were 7-9 years old. Parents and teachers completed the strengths and difficulties questionnaire (SDQ) when the children were 7-9 years (wave 1) and 4 years later (wave 2). Using strict criteria, we identified 38 children with tics in the cohort of 4,025 children (0.94% of the total cohort) with a preponderance of boys (78.9%). 22 children (57.9%) in the group with tics had only motor tics, and 16 (42.1%) had both motor and vocal tics. Children with tics had significantly higher parent- and teacher-rated SDQ total difficulty scores and subscale scores in both waves. Children with tics experienced an increase in emotional problems and in peer problems between the first and the second wave. This study in a general population indicates that the presence of tics is associated with a range of internalizing and externalizing difficulties, as well as problems in peer relationships. Moreover, our study indicates that emotional and peer problems tend to increase over time in the group of children with tics.

  9. A Population-Based Study of the Fractionation of Postlumpectomy Breast Radiation Therapy

    SciTech Connect

    Ashworth, Allison; Kong, Weidong; Whelan, Timothy; Mackillop, William J.

    2013-05-01

    Purpose: The optimal fractionation schedule of post lumpectomy radiation therapy remains controversial. The objective of this study was to describe the fractionation of post-lumpectomy radiation therapy (RT) in Ontario, before and after the seminal Ontario Clinical Oncology Group (OCOG) trial, which showed the equivalence of 16- and 25-fraction schedules. Methods and Materials: This was a retrospective cohort study conducted by linking electronic treatment records to a population-based cancer registry. The study population included all patients who underwent lumpectomy for invasive breast cancer in Ontario, Canada, between 1984 and 2008. Results: Over the study period, 41,747 breast cancer patients received post lumpectomy radiation therapy to the breast only. Both 16- and 25-fraction schedules were commonly used throughout the study period. In the early 1980s, shorter fractionation schedules were used in >80% of cases. Between 1985 and 1995, the proportion of patients treated with shorter fractionation decreased to 48%. After completion of the OCOG trial, shorter fractionation schemes were once again widely adopted across Ontario, and are currently used in about 71% of cases; however, large intercenter variations in fractionation persisted. Conclusions: The use of shorter schedules of post lumpectomy RT in Ontario increased after completion of the OCOG trial, but the trial had a less normative effect on practice than expected.

  10. Comprehensive population-based determination of pediatric multiple sclerosis health care costs

    PubMed Central

    Wright, Melissa A.; Korgenski, E. Kent; Bardsley, Tyler; Bonkowsky, Joshua L.

    2016-01-01

    Objective: To determine the health care costs associated with pediatric multiple sclerosis (MS). Methods: We performed a retrospective analysis of all patients with MS 18 years of age or younger who were diagnosed or treated between 2002 and 2012 in a population-based cohort. Demographics and health care costs were extracted from the Intermountain Healthcare Enterprise Data Warehouse. Patients were divided into high-cost (>84th percentile) and low-cost groups and differences in health care utilization between the groups were analyzed. Results: Fifty-seven pediatric patients with MS were identified. Health care costs for the cohort totaled more than $1.5 million over the 10-year period, with the top 16th percentile of patients contributing nearly two-thirds. Outpatient visits represented the majority of health care encounters and expenditures, accounting for 83.1% of total costs. Costs per encounter were highest for inpatient stays, averaging $2,924 per stay. Conclusions: The burden of health care expenses for pediatric patients with MS is significant. Expenditures related to outpatient visits were the largest contributor to costs, but inpatient stays were the most costly per encounter. A small proportion of patients incurred the bulk of costs and spent significantly more time receiving care compared to the majority of patients. Avoidance of inpatient treatment and efficient outpatient management are potential areas for health care cost reduction and improvement in care. PMID:28018945

  11. Hyperlipidemia Is Associated with Chronic Urticaria: A Population-Based Study

    PubMed Central

    Wang, Kuo-Hsien; Chen, Chao-Hung

    2016-01-01

    The etiology of chronic urticaria (CU) is diverse, with chronic infections and inflammation being reported as considerable contributing factors. Although the prevalence of metabolic syndrome was found to be significantly elevated in patients with CU, no one has specifically estimated the effects on CU following hyperlipidemia. This study aimed to examine the association between hyperlipidemia and CU using a population-based dataset in Taiwan. This study included 9798 adults with CU as cases and 9798 sex- and age-matched controls. These patients were examined for whether they had received a prior diagnosis of hyperlipidemia. We used conditional logistic regression analyses to calculate the odds ratio (OR) and its corresponding 95% confidence interval (CI) for having been previously diagnosed with hyperlipidemia between cases and controls. In total, 7066 (36.1%) patients had received a prior diagnosis of hyperlipidemia, including 4287 (43.8%) among CU cases and 2779 (28.4%) among controls. The conditional logistic regression revealed that the OR of prior hyperlipidemia for cases was 1.97 (95% CI: 1.85~2.09) compared to the controls. Furthermore, compared to patients without CU, patients with CU independently experienced a 1.65-fold (95% CI = 1.55~1.76; p<0.001) increased risk of having a prior hyperlipidemia diagnosis, after adjustments were made. We concluded that CU was associated with having received a prior diagnosis of hyperlipidemia. PMID:26964045

  12. Overweight and Weight Gain Predict Psoriasis Development in a Population-based Cohort.

    PubMed

    Danielsen, Kjersti; Wilsgaard, Tom; Olsen, Anne Olaug; Furberg, Anne-Sofie

    2017-03-10

    Overweight is a proposed risk factor for psoriasis. How-ever, evidence from prospective studies is limited. The aim of this study was to investigate the association be-tween overweight, weight gain and risk of psoriasis, and potential synergism with smoking, within a population-based cohort including 8,752 individuals followed from 1994 up to 2008. There was a 32% increased odds of psoriasis from a body mass index (BMI) of 27 kg/m2, in multi-variable logistic regression analysis, further increasing to 43% at BMI 28 kg/m2, and to 71% at BMI ≥ 30 kg/m2 in non-smokers. There was a dose-response association between weight gain from age 25 years, with up to 90% higher odds of psoriasis from middle age, independent of weight category. There was no indication of a synergism between overweight and smoking, and no interaction with sex. Overweight and weight gain represent modifiable risk factors that may be targets for primary prevention of psoriasis.

  13. Incidence of hidradenitis suppurativa and associated factors: a population-based study of Olmsted County, Minnesota.

    PubMed

    Vazquez, Benjamin G; Alikhan, Ali; Weaver, Amy L; Wetter, David A; Davis, Mark D

    2013-01-01

    There are no population-based incidence studies of hidradenitis suppurativa (HS). Using the medical record linkage system of the Rochester Epidemiology Project, we sought to determine the incidence of the disease, as well as other associations and characteristics, among HS patients diagnosed in Olmsted County, Minnesota, between 1968 and 2008. Incidence was estimated using the decennial census data for the county. Logistic regression models were fit to evaluate associations between patient characteristics and disease severity. A total of 268 incident cases were identified, with an overall annual age- and sex-adjusted incidence of 6.0 per 100,000. Age-adjusted incidence was significantly higher in women compared with men (8.2 (95% confidence interval (CI), 7.0-9.3) vs. 3.8 (95% CI, 3.0-4.7). The highest incidence was among young women aged 20-29 years (18.4 per 100,000). The incidence has risen over the past four decades, particularly among women. Women were more likely to have axillary and upper anterior torso involvement, whereas men were more likely to have perineal or perianal disease. In addition, 54.9% (140/255) patients were obese; 70.2% were current or former smokers; 42.9% carried a diagnosis of depression; 36.2% carried a diagnosis of acne; and 6% had pilonidal disease. Smoking and gender were significantly associated with more severe disease.

  14. Association between gallbladder stone disease and prostate cancer: A nationwide population-based study

    PubMed Central

    Chen, Chien-Hua; Lin, Cheng-Li; Kao, Chia-Hung

    2016-01-01

    Objectives Chronic inflammation and abnormal cholesterol metabolism are involved in the pathogenesis of gallbladder stone disease (GSD) and that of prostate cancer in experimental studies. We assessed the association between GSD and prostate cancer in this population-based study. Results The cumulative incidence of prostate cancer (log-rank test: P <.001) and the risk of prostate cancer (1.64 vs 1.14 per 10 000 person-y, adjusted hazard ratio [aHR] = 1.30, 95% confidence interval [CI] = 1.22-1.39) were greater in the patients with GSD than in those without GSD. Furthermore, the risk of prostate cancer increased with the time of follow-up after a diagnosis of GSD, particularly after 9 years of follow-up (aHR = 1.95, 95% CI = 1.74-2.19). Materials and Methods We identified 9496 patients who were diagnosed with GSD between 1998 and 2011 from Taiwan's Longitudinal Health Insurance Database 2000 as the study cohort. We randomly selected 37 983 controls from the non-GSD population and used frequency matching by age, sex, and index year for the control cohort. All patient cases were followed until the end of 2011 to measure the incidence of prostate cancer. Conclusion GSD is associated with an increased risk of prostate cancer, and the risk increases with the time of follow-up after a diagnosis of GSD. PMID:27147576

  15. Population-based survey of taeniasis along the United States-Mexico border.

    PubMed

    Barton Behravesh, C; Mayberry, L F; Bristol, J R; Cardenas, V M; Mena, K D; Martínez-Ocaña, J; Flisser, A; Snowden, K F

    2008-06-01

    Taenia solium and T. saginata are zoonotic tapeworms of substantial medical and economic importance. Although human taeniasis is widely recognised as an endemic problem in Mexico, its presence in the United States is poorly understood. The first population-based study to estimate the prevalence of human infection with Taenia tapeworms along the Texas-Mexico border has recently been conducted. Households were interviewed in the Texan city of El Paso and in the neighbouring Ciudad Juárez, in Mexico. Faecal samples from household members were then checked for Taenia eggs by flotation and/or for Taenia copro-antigens in an ELISA. The overall prevalence of taeniasis in this border region was found to be 3% but, compared with the residents of Juárez, El Paso residents were 8.6-fold more likely to be tapeworm carriers. The interviews revealed some important differences between the two study sites, particularly the more frequent use of anthelminthic drugs on the Mexican side of the border. These findings have implications in terms of the planning of effective health-education campaigns to decrease the prevalence of taeniasis in the human populations along the Texas-Mexico border.

  16. Patients with Epididymo-Orchitis and Meteorological Impact in Taiwan: A Nationwide Population-Based Study

    PubMed Central

    Liu, Jui-Ming; Chang, Ying-Hsu; Ho, Te-Wei; Chang, Fung-Wei; Pang, See-Tong

    2017-01-01

    Background. Epididymo-orchitis is a common infectious disease among men, especially men aged 20 to 39 years. The aim of this study was to analyze possible associations of various meteorological indicators on the incidence of epididymo-orchitis in Taiwan. Methods and Materials. This nationwide population-based study collected data on cases of epididymo-orchitis that were newly diagnosed from 2001 to 2013 in Taiwan. Monthly meteorological indicators, including average temperatures, humidity, rainfall, total rain days, and sunshine hours, were collected from the Central Weather Bureau of Taiwan. Data for a total of 7,233 patients with epididymo-orchitis were collected for this study. Results. The monthly incidence of epididymo-orchitis was positively correlated with temperature, rainfall, and sunshine hours. The average monthly temperature had a linear correlation with the incidence of epididymo-orchitis (ß = 0.11). The monthly average temperature is significantly related, with a positive linear correlation, to the incidence of epididymo-orchitis in Taiwan. Conclusion. This finding may constitute useful information in terms of helping physicians to distinguish between patients with epididymo-orchitis and testicular torsion in hot or cold weather. PMID:28316630

  17. Population-based initiatives in college mental health: students helping students to overcome obstacles.

    PubMed

    Kirsch, Daniel J; Pinder-Amaker, Stephanie L; Morse, Charles; Ellison, Marsha L; Doerfler, Leonard A; Riba, Michelle B

    2014-12-01

    College students' need for mental health care has increased dramatically, leaving campus counseling and mental health centers struggling to meet the demand. This has led to the investigation and development of extra-center, population-based interventions. Student-to-student support programs are but one example. Students themselves are a plentiful, often-untapped resource that extends the reach of mental health services on campus. Student-to-student programs capitalize on students' natural inclination to assist their peers. A brief review of the prevalence and effects of mental disorders in the college population is provided, followed by a broad overview of the range of peer-to-peer programs that can be available on college campuses. Two innovative programs are highlighted: (1) a hospital- and community-based program, the College Mental Health Program (CMHP) at McLean Hospital, and 2) the Student Support Network (SSN) at Worcester Polytechnic Institute. The subsequent section reviews the literature on peer-to-peer programs for students with serious and persistent mental illness for which there is a small but generally positive body of research. This lack of an empirical basis in college mental health leads the authors to argue for development of broad practice-research networks.

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

    PubMed

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

    2010-08-01

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

  19. New evidence of risk factors for community-acquired pneumonia: a population-based study.

    PubMed

    Almirall, J; Bolíbar, I; Serra-Prat, M; Roig, J; Hospital, I; Carandell, E; Agustí, M; Ayuso, P; Estela, A; Torres, A

    2008-06-01

    The aim of the present study was to identify risk factors for community-acquired pneumonia (CAP), with special emphasis on modifiable risk factors and those applicable to the general population. A population-based, case-control study was conducted, with a target population of 859,033 inhabitants aged >14 yrs. A total of 1,336 patients with confirmed CAP were matched to control subjects by age, sex and primary centre over 1 yr. In the univariate analysis, outstanding risk factors were passive smoking in never-smokers aged >65 yrs, heavy alcohol intake, contact with pets, households with >10 people, contact with children, interventions on the upper airways and poor dental health. Risky treatments included amiodarone, N-acetylcysteine and oral steroids. Influenza and pneumococcal vaccine, and visiting the dentist were protective factors. Multivariable analysis confirmed cigarette smoking, usual contact with children, sudden changes of temperature at work, inhalation therapy (particularly containing steroids and using plastic pear-spacers), oxygen therapy, asthma and chronic bronchitis as independent risk factors. Interventions for reducing community-acquired pneumonia should integrate health habits and lifestyle factors related to household, work and community, together with individual clinical conditions, comorbidities and oral or inhaled regular treatments. Prevention would include vaccination, dental hygiene and avoidance of upper respiratory colonisation.

  20. A population-based study of familial Alzheimer disease: Linkage to chromosomes 14, 19, and 21

    SciTech Connect

    Duijn, C.M. van; Hofman, A.; Hendriks, L.; Cruts, M.; Van Broeckhoven, C.; Backhovens, H.; Wehnert, A. |; Farrer, L.A.

    1994-10-01

    Linkage of Alzheimer disease (AD) to DNA markers on chromosomes 14, 19, and 21 was studied in 10 families in which the disease was apparently inherited as an autosomal dominant trait. Families were derived from a Dutch population-based epidemiologic study of early-onset AD. Although in all probands the onset of AD was at or before age 65 years, the mean age at onset was after age 65 years in four families (referred to as {open_quotes}LOAD{close_quotes}). Among the six families with early-onset AD (referred to as {open_quotes}EOAD,{close_quotes} i.e., mean age of onset of AD of relatives was at or before age 65 years), conclusive linkage to 14q24.3 was found in one family with a very early onset (around 47 years), while linkage to the same region was excluded in two other families. For the LOAD families, predominantly negative lod scores were obtained, and the overall lod score excluded linkage to chromosome 14. The results with markers on chromosome 19 and chromosome 21 were not conclusive for EOAD and LOAD. The findings of our study confirm genetic heterogeneity within familial EOAD. 50 refs., 7 figs., 2 tabs.

  1. Full dates (day, month, year) should be used in population-based cancer survival studies.

    PubMed

    Woods, Laura M; Rachet, Bernard; Ellis, Libby; Coleman, Michel P

    2012-10-01

    Accurate survival estimates are essential for monitoring cancer survival trends, for health care planning and for resource allocation. To obtain precise estimates of survival, full dates (day, month and year) rather than partial dates (month and year) are required. In some jurisdictions, however, cancer registries are constrained from providing full dates on the grounds of confidentiality. The bias resulting from the use of partial dates in the estimation and comparison of survival makes it impossible to determine precisely the differences in the risk of death from cancer between population groups or in successive calendar periods. Important operational arguments also exist against the use of incomplete dates for survival analysis, including increased workload for cancer registry staff and the introduction of avoidable complexity for quality control of survival data. Cancer survival is one of the most widely known outputs produced by population-based cancer registries, and it is a crucial metric for the comparative effectiveness of health services. The bodies that set data access guidelines must take a more balanced view of the risks and benefits of using full dates for the estimation of cancer survival.

  2. Association of mitochondrial DNA haplogroups and vascular complications of diabetes mellitus: A population-based study.

    PubMed

    Martikainen, Mika H; Rönnemaa, Tapani; Majamaa, Kari

    2015-07-01

    We investigated whether mitochondrial (mtDNA) haplogroups and maternal family history of diabetes mellitus were associated with vascular diabetes mellitus complications in a population-based cohort of 299 Finnish diabetes mellitus patients with disease onset in young adult age. We found that haplogroup U was more prevalent among patients with no vascular diabetes mellitus complications than among those with at least one complication (p = 0.038). Haplogroup U was also more prevalent among the patients who reported maternal family history of diabetes mellitus than among those who did not (p = 0.0013). Furthermore, haplogroup U was more prevalent among patients with maternal family history of diabetes mellitus but no vascular diabetes mellitus complications than among those with at least one vascular diabetes mellitus complication but no maternal family history of diabetes mellitus (p = 0.0003 for difference). These findings suggest that different mtDNA-related factors may influence the risk of diabetes mellitus per se and the risk of vascular diabetes mellitus complications. Further studies are, however, warranted to replicate and elaborate on these results.

  3. Pathological femoral fracture caused by primary bone tumour: a population-based study.

    PubMed

    Godley, K; Watts, A C; Robb, J E

    2011-02-01

    This population-based study aimed to analyse the demographic, clinical and histological features of patients with a malignant primary bone tumour of the femur presenting with a pathological fracture. Eighty-four patients were identified from a prospectively gathered national tumour database between 1960 and 2004. Demographic data, presenting features, tumour location, histological diagnosis, treatment, local recurrence, metastasis and survival data were gathered. An estimate of the annual incidence was obtained using population data from the General Register Office and was 0.4 per million population per annum. The mean age was 56 years (range 4-87 years) with a bimodal distribution and 46% were men or boys. Forty-one percent of patients presented with a history of trauma. The average duration of symptoms before presentation was 1-3 months. The most common histological diagnoses were osteosarcoma (14 patients) and Paget's sarcoma (12 patients). The local recurrence rate was 38% and the overall five-year survival was 22%. The prognosis was made worse by local tumour recurrence, the development of metastasis and age at diagnosis greater than 21 years. Limb salvage surgery did not alter the prognosis. Patients who present with pathological fracture of a primary malignant bone tumour, carry a poor prognosis in all tumour types and no improvement in survival was identified over the period of the study.

  4. Risk factors for child maltreatment in an Australian population-based birth cohort.

    PubMed

    Doidge, James C; Higgins, Daryl J; Delfabbro, Paul; Segal, Leonie

    2017-02-01

    Child maltreatment and other adverse childhood experiences adversely influence population health and socioeconomic outcomes. Knowledge of the risk factors for child maltreatment can be used to identify children at risk and may represent opportunities for prevention. We examined a range of possible child, parent and family risk factors for child maltreatment in a prospective 27-year population-based birth cohort of 2443 Australians. Physical abuse, sexual abuse, emotional abuse, neglect and witnessing of domestic violence were recorded retrospectively in early adulthood. Potential risk factors were collected prospectively during childhood or reported retrospectively. Associations were estimated using bivariate and multivariate logistic regressions and combined into cumulative risk scores. Higher levels of economic disadvantage, poor parental mental health and substance use, and social instability were strongly associated with increased risk of child maltreatment. Indicators of child health displayed mixed associations and infant temperament was uncorrelated to maltreatment. Some differences were observed across types of maltreatment but risk profiles were generally similar. In multivariate analyses, nine independent risk factors were identified, including some that are potentially modifiable: economic disadvantage and parental substance use problems. Risk of maltreatment increased exponentially with the number of risk factors experienced, with prevalence of maltreatment in the highest risk groups exceeding 80%. A cumulative risk score based on the independent risk factors allowed identification of individuals at very high risk of maltreatment, while a score that incorporated all significant risk and protective factors provided better identification of low-risk individuals.

  5. Planning for Serious Illness by the General Public: A Population-Based Survey

    PubMed Central

    Quinlan, Elizabeth; Venne, Rosemary; Hunter, Paulette; Surtees, Doug

    2013-01-01

    Background. While rates of advance care documentation amongst the general public remain low, there is increasing recognition of the value of informal planning to address patient preferences in serious illness. Objectives. To determine the associations between personal attributes and formal and informal planning for serious illness across age groups. Methods. This population-based, online survey was conducted in Saskatchewan, Canada, in April, 2012, using a nonclinical sample of 827 adults ranging from 18 to 88 years of age and representative of age, sex, and regional distribution of the province. Associations between key predictor variables and planning for serious illness were assessed using binary logistic regression. Results. While 16.6% of respondents had completed a written living will or advance care plan, half reported having conversations about their treatment wishes or states of health in which they would find it unacceptable to live. Lawyers were the most frequently cited source of assistance for those who had prepared advance care plans. Personal experiences with funeral planning significantly increased the likelihood of activities designed to plan for serious illness. Conclusions. Strategies designed to increase the rate of planning for future serious illness amongst the general public must account for personal readiness. PMID:25025030

  6. Sleep and academic performance in later adolescence: results from a large population-based study.

    PubMed

    Hysing, Mari; Harvey, Allison G; Linton, Steven J; Askeland, Kristin G; Sivertsen, Børge

    2016-06-01

    The aim of the current study was to assess the association between sleep duration and sleep patterns and academic performance in 16-19 year-old adolescents using registry-based academic grades. A large population-based study from Norway conducted in 2012, the youth@hordaland-survey, surveyed 7798 adolescents aged 16-19 years (53.5% girls). The survey was linked with objective outcome data on school performance. Self-reported sleep measures provided information on sleep duration, sleep efficiency, sleep deficit and bedtime differences between weekday and weekend. School performance [grade point average (GPA)] was obtained from official administrative registries. Most sleep parameters were associated with increased risk for poor school performance. After adjusting for sociodemographic information, short sleep duration and sleep deficit were the sleep measures with the highest odds of poor GPA (lowest quartile). Weekday bedtime was associated significantly with GPA, with adolescents going to bed between 22:00 and 23:00 hours having the best GPA. Also, delayed sleep schedule during weekends was associated with poor academic performance. The associations were somewhat reduced after additional adjustment for non-attendance at school, but remained significant in the fully adjusted models. In conclusion, the demonstrated relationship between sleep problems and poor academic performance suggests that careful assessment of sleep is warranted when adolescents are underperforming at school. Future studies are needed on the association between impaired sleep in adolescence and later functioning in adulthood.

  7. Prevalence of exposure to suicide: A meta-analysis of population-based studies.

    PubMed

    Andriessen, Karl; Rahman, Bayzidur; Draper, Brian; Dudley, Michael; Mitchell, Philip B

    2017-05-01

    Those exposed to suicide are at increased risk of adverse outcomes including mental illness, impaired social functioning, and fatal and non-fatal suicidal behavior. However, it is unclear how many people are exposed to suicide in the general community. This first meta-analysis of population-based studies aimed to provide pooled estimates of past-year and lifetime prevalence of exposure to suicide among family, friends/peers, and all relationships. In addition, the study examined prevalence of exposure to suicide by age group: adolescents and adults. Systematic searches of the literature in Embase, Medline and PsycINFO identified eighteen studies that were included in the analysis. Pooled past-year prevalence was 4.31% (CI: 2.50 to 6.58) and life-time prevalence 21.83% (CI: 16.32 to 27.90). Both past-year and lifetime prevalences of exposure to suicide among friends and peers were significantly higher than the prevalence of exposure within families; there were no differences in the prevalence of exposure to suicide between adolescents and adults. Heterogeneity was highly significant. Future research should be conducted with large national representative samples and use standardised assessment instruments. Given the increased risks of adverse outcomes among those exposed to suicide, the high rate of exposure to suicide reported here has important ramifications for public health and mental health service delivery.

  8. Patients with Epididymo-Orchitis and Meteorological Impact in Taiwan: A Nationwide Population-Based Study.

    PubMed

    Liu, Jui-Ming; Chang, Ying-Hsu; Ho, Te-Wei; Chang, Fung-Wei; Pang, See-Tong; Hsu, Ren-Jun; Lin, Po-Hung

    2017-01-01

    Background. Epididymo-orchitis is a common infectious disease among men, especially men aged 20 to 39 years. The aim of this study was to analyze possible associations of various meteorological indicators on the incidence of epididymo-orchitis in Taiwan. Methods and Materials. This nationwide population-based study collected data on cases of epididymo-orchitis that were newly diagnosed from 2001 to 2013 in Taiwan. Monthly meteorological indicators, including average temperatures, humidity, rainfall, total rain days, and sunshine hours, were collected from the Central Weather Bureau of Taiwan. Data for a total of 7,233 patients with epididymo-orchitis were collected for this study. Results. The monthly incidence of epididymo-orchitis was positively correlated with temperature, rainfall, and sunshine hours. The average monthly temperature had a linear correlation with the incidence of epididymo-orchitis (ß = 0.11). The monthly average temperature is significantly related, with a positive linear correlation, to the incidence of epididymo-orchitis in Taiwan. Conclusion. This finding may constitute useful information in terms of helping physicians to distinguish between patients with epididymo-orchitis and testicular torsion in hot or cold weather.

  9. Incidence of Stroke and Transient Ischemic Attack in Croatia: A Population Based Study.

    PubMed

    Kadojić, Dragutin; Demarin, Vida; Dikanović, Marinko; Lusić, Ivo; Tuskan-Mohar, Lidija; Trkanjec, Zlatko; Mihaljević, Ivan; Kadojić, Mira; Bitunjac, Milan; Vranjes, Zeljko

    2015-09-01

    The aim of this population based neuroepidemiological study was to establish the real incidence rates of acute cerebrovascular disease (CVD): stroke and transient ischemic attack (TIA) in the Republic of Croatia. Multicentric study included 89 501 persons of all ages in four regional centres in Croatia: Zagreb, Osijek + Slavonski Brod, Rijeka and Split. The following incidence rates of stroke, expressed at population of 100 000, have been established: Zagreb 290.52, Osijek + Slavonski Brod 302.14, Rijeka 219.65, Split 195.82. Incidence rate of stroke for the Republic of Croatia is 251.39. The following incidence rates of TIA, expressed at population of 100,000, have been established: Zagreb 87.15, Osijek + Slavonski Brod 156.53, Rijeka 90.11, Split 59.10. Incidence rate of TIA for the Republic of Croatia is 100.55. In the continental part of Croatia (Zagreb, Osijek + Slavonski Brod) incidence rate of stroke is higher by 45%, while incidence rate of TIA is higher by 82% than in the coastal part of Croatia, probably due to different lifestyle and environmental factors. The study has shown relatively high incidence rates of acute CVD (stroke and TIA) in the Republic of Croatia, which proves that CVD are a great public health problem.

  10. Population-based learning of load balancing policies for a distributed computer system

    NASA Technical Reports Server (NTRS)

    Mehra, Pankaj; Wah, Benjamin W.

    1993-01-01

    Effective load-balancing policies use dynamic resource information to schedule tasks in a distributed computer system. We present a novel method for automatically learning such policies. At each site in our system, we use a comparator neural network to predict the relative speedup of an incoming task using only the resource-utilization patterns obtained prior to the task's arrival. Outputs of these comparator networks are broadcast periodically over the distributed system, and the resource schedulers at each site use these values to determine the best site for executing an incoming task. The delays incurred in propagating workload information and tasks from one site to another, as well as the dynamic and unpredictable nature of workloads in multiprogrammed multiprocessors, may cause the workload pattern at the time of execution to differ from patterns prevailing at the times of load-index computation and decision making. Our load-balancing policy accommodates this uncertainty by using certain tunable parameters. We present a population-based machine-learning algorithm that adjusts these parameters in order to achieve high average speedups with respect to local execution. Our results show that our load-balancing policy, when combined with the comparator neural network for workload characterization, is effective in exploiting idle resources in a distributed computer system.

  11. Correlation of anxiety and depression symptoms in patients with restless legs syndrome: a population based survey

    PubMed Central

    Sevim, S; Dogu, O; Kaleagasi, H; Aral, M; Metin, O; Camdeviren, H

    2004-01-01

    Background and objectives: Restless legs syndrome (RLS) is an important and common cause of insomnia, and previous studies indicate that psychiatric wellbeing may be impaired among RLS patients. We aimed to investigate the interaction between anxiety/depression and RLS in a population based survey. Methods: Data were drawn from the Mersin University Neuro-Epidemiology Project, a representative community sample of adults aged over 17 years residing in Mersin (n = 3234). Subjects found to be positive for RLS (n = 103) were evaluated for symptoms of anxiety and depression using the Hamilton Anxiety and Depression Scales and compared with the same number of contemporaneous control subjects. Results: Significantly greater anxiety and depression symptoms were observed among patients with RLS than in the control subjects. Our data also seem to provide initial evidence of a correlation between the severity of RLS and of anxiety and depression symptoms (r = 0.21, p = 0.03 and r = 0.201, p = 0.04 respectively). Conclusions: Assessment of psychiatric status of RLS patients can be helpful and sometimes necessary to determine additional features and treatment strategies of this bothering condition. Further studies are needed to replicate our findings using longitudinal data. PMID:14742594

  12. Population-based 3D genome structure analysis reveals driving forces in spatial genome organization

    PubMed Central

    Li, Wenyuan; Kalhor, Reza; Dai, Chao; Hao, Shengli; Gong, Ke; Zhou, Yonggang; Li, Haochen; Zhou, Xianghong Jasmine; Le Gros, Mark A.; Larabell, Carolyn A.; Chen, Lin; Alber, Frank

    2016-01-01

    Conformation capture technologies (e.g., Hi-C) chart physical interactions between chromatin regions on a genome-wide scale. However, the structural variability of the genome between cells poses a great challenge to interpreting ensemble-averaged Hi-C data, particularly for long-range and interchromosomal interactions. Here, we present a probabilistic approach for deconvoluting Hi-C data into a model population of distinct diploid 3D genome structures, which facilitates the detection of chromatin interactions likely to co-occur in individual cells. Our approach incorporates the stochastic nature of chromosome conformations and allows a detailed analysis of alternative chromatin structure states. For example, we predict and experimentally confirm the presence of large centromere clusters with distinct chromosome compositions varying between individual cells. The stability of these clusters varies greatly with their chromosome identities. We show that these chromosome-specific clusters can play a key role in the overall chromosome positioning in the nucleus and stabilizing specific chromatin interactions. By explicitly considering genome structural variability, our population-based method provides an important tool for revealing novel insights into the key factors shaping the spatial genome organization. PMID:26951677

  13. Prevalence and outcome of asymptomatic carotid stenosis: a population-based ultrasonographic study.

    PubMed

    Mineva, P P; Manchev, I C; Hadjiev, D I

    2002-07-01

    The aims of this epidemiological population-based cohort study were to examine the prevalence and outcomes of asymptomatic carotid stenosis (ACS) detected by duplex scanning and its relations to other vascular risk factors. A total of 500 volunteers, 200 men and 300 women, without signs and symptoms of cerebrovascular disease, aged 50-79 years, were enrolled in the study. The prevalence of ACS of 50% or greater was 6.4%. Only severe carotid stenosis was detected in 0.4% of the subjects examined. Significant relationships between ACS and coronary heart disease (CHD) [odds ratio (OR)=8.00], peripheral arterial disease (PAD) (OR=3.66), cigarette smoking in men (OR=4.39) and obesity in women (OR=0.31) were found. The biennial incidence rate of cerebral ischaemic events was 9.4%. A progression of ACS was revealed in 14% and a regression in 6.25% of the subjects. The patients with progressing ACS to more than 70% diameter reduction reached the end-points. Follow-up with repeated duplex scans in patients with advancing ACS of 50% or greater, especially smokers with CHD and PAD, is recommended.

  14. Post-transplant lymphoproliferative disorder following kidney transplantation: a population-based cohort study.

    PubMed

    Maksten, Eva Futtrup; Vase, Maja Ølholm; Kampmann, Jan; d'Amore, Francesco; Møller, Michael Boe; Strandhave, Charlotte; Bendix, Knud; Bistrup, Claus; Thiesson, Helle Charlotte; Søndergaard, Esben; Hamilton-Dutoit, Stephen; Jespersen, Bente

    2016-04-01

    Post-transplant lymphoproliferative disorder (PTLD) incidence is difficult to determine, mainly because both early and other lesions may go unrecognized and unregistered. Few studies have included systematic pathology review to maximize case identification and decide more accurately PTLD frequency after long-term post-transplantation follow-up. A retrospective population-based cohort study including all kidney transplant recipients at two Danish centres (1990-2011; population covered 3.1 million; 2175 transplantations in 1906 patients). Pathology reports were reviewed for all patient biopsies to identify possible PTLDs. Candidate PTLDs underwent histopathological review and classification. Seventy PTLD cases were identified in 2175 transplantations (3.2%). The incidence rate (IR) after first transplantation was 5.4 cases per 1000 patient-years (95% CI: 4.0-7.3). Most PTLDs were monomorphic (58.5%), or early lesions (21.5%). Excluding early lesions and patients <18 years, IR was 3.7 (95% CI: 2.9-5.5). Ten patients with PTLD were retransplanted, 2 developing further PTLDs. Post-transplant patient survival was inferior in patients with PTLD, while death-censored graft survival was not. Using registry data together with extensive pathological review and long follow-up, a rather high incidence of PTLD was found.

  15. Hepatitis C virus infection and risk of cancer: a population-based cohort study

    PubMed Central

    Omland, Lars Haukali; Farkas, Dora Körmendiné; Jepsen, Peter; Obel, Niels; Pedersen, Lars

    2010-01-01

    Background: Hepatitis C virus (HCV) infection is associated with an increased risk of primary liver cancer; however, 5- and 10-year risk estimates are needed. The association of HCV with non-Hodgkin lymphoma (NHL) is uncertain and the association with other cancers is unknown. Method: We conducted a nationwide, population-based cohort study of 4,349 HCV-infected patients in Denmark, computing standardized incidence ratios (SIR) of cancer incidence in HCV infected patients compared with cancer incidence of the general population. We calculated 5- and 10-year risks of developing cancer, stratifying our analyses based on the presence of HIV coinfection and cirrhosis. Results: We recorded an increased risk of primary liver cancer (SIR: 76.63 [95% CI: 51.69–109.40]), NHL (SIR: 1.89 [95% CI: 0.39–5.52]), and several smoking- and alcohol-related cancers in HCV infected patients without HIV coinfection. HCV-infected patients without HIV coinfection had a 6.3% (95% CI: 4.6%–8.7%) risk of developing cancer and 2.0% (95% CI: 1.1%–3.8%) risk of developing primary liver cancer within 10 years. Conclusion: We confirmed the association of HCV infection with primary liver cancer and NHL. We also observed an association between HCV infection and alcohol- and smoking-related cancers. PMID:20865115

  16. Prevalence of depressive symptoms and associated developmental disorders in preschool children: a population-based study.

    PubMed

    Fuhrmann, Pia; Equit, Monika; Schmidt, Karin; von Gontard, Alexander

    2014-04-01

    Depression is an incapacitating disorder, which is often overlooked in preschool children. The aim of this study was to analyse the prevalence of depressive symptoms and co-occurring risk factors in a large, population-based sample of preschool children. All 653 children (of a total of 731) in a defined geographical area were assessed during the school-entry exam by community care paediatricians. In addition to clinical appraisal, parents filled out the Preschool Feelings Checklist, a 16-item screening instrument with good psychometric properties. The mean age was 6.2 years (range 5.0-7.6 years) and the sample included 344 boys and 305 girls. The prevalence of depressive symptoms of clinical relevance (total score ≥3) was 5.7% (37). There were no differences between boys and girls, and between younger (<6 years) and older (>6 years) children. Depressive symptoms were associated with parental separation and comorbid behavioural problems, but especially with developmental motor and speech problems and disorders. Migration to Germany had no influence. Depressive symptoms are common in preschool children and associated with developmental problems. Depression should be considered in children with speech and motor problems who are at special risk. Early detection and treatment are recommended.

  17. Hepatitis B prevalence and incidence in Greenland: a population-based cohort study.

    PubMed

    Børresen, Malene Landbo; Andersson, Mikael; Wohlfahrt, Jan; Melbye, Mads; Biggar, Robert J; Ladefoged, Karin; Panum, Inge; Koch, Anders

    2015-03-15

    Greenland remains a highly endemic area for hepatitis B virus (HBV) infection. This is in sharp contrast to other modern societies, such as Denmark. To address this discrepancy, we investigated the natural history of HBV infection in Greenland by estimating the age-specific incidence of HBV infection, the proportion of chronic carriers, and the rates of hepatitis B surface antigen seroclearance. In total, 8,879 Greenlanders (16% of the population) from population-based surveys conducted in 1987 and 1998 were followed through March 2010. Data on HBV status were supplemented by HBV test results from all available HBV registries in Greenland to determine changes in HBV status over time. Incidence rates of HBV infection and hepatitis B surface antigen seroclearance were estimated after taking into account interval censoring. The incidence of HBV infection in 5-14-year-old subjects was less than 1 per 100 person-years and peaked at 5 per 100 person-years in persons 15-24 years of age. Overall, 17.5% of persons infected in adulthood were estimated to become chronic carriers. HBV is primarily transmitted in adolescence and adulthood in Greenland. In contrast to what is observed in most other populations, HBV-infected adults in Greenland have a high risk of progressing to chronic HBV carriage. This phenomenon might explain how the high rate of infection is maintained in Greenland.

  18. Isotretinoin Use and the Risk of Inflammatory Bowel Disease: A Population-Based Cohort Study

    PubMed Central

    Alhusayen, Raed O.; Juurlink, David N.; Mamdani, Muhammad M.; Morrow, Richard L.; Shear, Neil H.; Dormuth, Colin R.

    2013-01-01

    Limited evidence suggests that isotretinoin may be associated with inflammatory bowel disease (IBD). To explore this association, we conducted a retrospective population-based cohort study in British Columbia, Canada, among participants who were newly treated with isotretinoin or topical acne medications. The entire population of untreated provincial residents aged 12–29 years served as the reference group. During the 12-year study period, we identified 46,922 participants treated with isotretinoin, 184,824 treated with a topical acne medication, and 1,526,946 untreated individuals. Compared with untreated individuals, we observed no significant association between isotretinoin use and IBD (rate ratio (RR) 1.14; 95% confidence interval (CI) 0.92–1.41). As expected, we found no association with topical acne medications (RR 1.11; 95% CI 0.99–1.24). In prespecified secondary analyses, isotretinoin was associated with IBD among individuals aged 12–19 years (RR 1.39; 95% CI 1.03–1.87) and topical acne medications were associated with ulcerative colitis (RR 1.19; 95% CI 1.00–1.42). Our primary analyses found no association between isotretinoin and IBD. In prespecified secondary analyses, some evidence was found of associations with isotretinoin as well as topical acne medications, suggesting a possible association between IBD and acne itself. Additional research is needed to explore this possibility. PMID:23096714

  19. Predictors of Colorectal Cancer Survival in Golestan, Iran: A Population-based Study

    PubMed Central

    Aryaie, Mohammad; Roshandel, Gholamreza; Semnani, Shahryar; Asadi-Lari, Mohsen; Aarabi, Mohsen; Vakili, Mohammad Ali; Kazemnejhad, Vahideh; Sedaghat, Seyed Mehdi

    2013-01-01

    OBJECTIVES We aimed to investigate factors associated with colorectal cancer survival in Golestan, Iran. METHODS We used a population based cancer registry to recruit study subjects. All patients registered since 2004 were contacted and data were collected using structured questionnaires and trained interviewers. All the existing evidences to determine the stage of the cancer were also collected. The time from first diagnosis to death was compared in patients according to their stage of cancer using the Kaplan-Meir method. A Cox proportional hazard model was built to examine their survival experience by taking into account other covariates. RESULTS Out of a total of 345 subjects, 227 were traced. Median age of the subjects was 54 and more than 42% were under 50 years old. We found 132 deaths among these patients, 5 of which were non-colorectal related deaths. The median survival time for the entire cohort was 3.56 years. A borderline significant difference in survival experience was detected for ethnicity (log rank test, p=0.053). Using Cox proportional hazard modeling, only cancer stage remained significantly associated with time of death in the final model. CONCLUSIONS Colorectal cancer occurs at a younger age among people living in Golestan province. A very young age at presentation and what appears to be a high proportion of patients presenting with late stage in this area suggest this population might benefit substantially from early diagnoses by introducing age adapted screening programs. PMID:23807907

  20. Population-Based Analysis of Invasive Nontypeable Pneumococci Reveals That Most Have Defective Capsule Synthesis Genes

    PubMed Central

    Sherwood, Logan K.; Nahm, Moon H.; Beall, Bernard

    2014-01-01

    Since nasopharyngeal carriage of pneumococcus precedes invasive pneumococcal disease, characteristics of carriage isolates could be incorrectly assumed to reflect those of invasive isolates. While most pneumococci express a capsular polysaccharide, nontypeable pneumococci are sometimes isolated. Carriage nontypeables tend to encode novel surface proteins in place of a capsular polysaccharide synthetic locus, the cps locus. In contrast, capsular polysaccharide is believed to be indispensable for invasive pneumococcal disease, and nontypeables from population-based invasive pneumococcal disease surveillance have not been extensively characterized. We received 14,328 invasive pneumococcal isolates through the Active Bacterial Core surveillance program during 2006–2009. Isolates that were nontypeable by Quellung serotyping were characterized by PCR serotyping, sequence analyses of the cps locus, and multilocus sequence typing. Eighty-eight isolates were Quellung-nontypeable (0.61%). Of these, 79 (89.8%) contained cps loci. Twenty-two nontypeables exhibited serotype 8 cps loci with defects, primarily within wchA. Six of the remaining nine isolates contained previously-described aliB homologs in place of cps loci. Multilocus sequence typing revealed that most nontypeables that lacked capsular biosynthetic genes were related to established non-encapsulated lineages. Thus, invasive pneumococcal disease caused by nontypeable pneumococcus remains rare in the United States, and while carriage nontypeables lacking cps loci are frequently isolated, such nontypeable are extremely rare in invasive pneumococcal disease. Most invasive nontypeable pneumococci possess defective cps locus genes, with an over-representation of defective serotype 8 cps variants. PMID:24831650

  1. Association between psychiatric disorders and osteoarthritis: a nationwide longitudinal population-based study

    PubMed Central

    Huang, Shih-Wei; Wang, Wei-Te; Lin, Li-Fong; Liao, Chun-De; Liou, Tsan-Hon; Lin, Hui-Wen

    2016-01-01

    Abstract Although the association between depressive disorders and osteoarthritis (OA) has been studied, the association of other psychiatric disorders with OA remains unclear. Here, we investigated whether psychiatric disorders are risk factors for OA. The data were obtained from the Longitudinal Health Insurance Database 2005 of Taiwan. We collected the ambulatory care claim records of patients who were diagnosed with psychiatric disorders according to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes between January 1, 2004 and December 31, 2008. The prevalence and adjusted hazard ratios (HRs) of osteoarthritis among patients with psychiatric disorders and the control cohort were estimated. Of 74,393 patients with psychiatric disorders, 16,261 developed OA during the 7-year follow-up period. The crude HR for OA was 1.44 (95% confidence interval [CI], 1.39–1.49), which was higher than that of the control cohort. The adjusted HR for OA was 1.42 (95% CI, 1.39–1.42) among patients with psychiatric disorders during the 7-year follow-up period. Further analysis revealed that affective psychoses, neurotic illnesses or personality disorders, alcohol and drug dependence or abuse, and other mental disorders were risk factors for OA. This large-scale longitudinal population-based study revealed that affective psychoses, personality disorders, and alcohol and drug dependence or abuse are risk factors for OA. PMID:27368019

  2. Atypical antipsychotic drugs and risk of ischaemic stroke: population based retrospective cohort study

    PubMed Central

    Gill, Sudeep S; Rochon, Paula A; Herrmann, Nathan; Lee, Philip E; Sykora, Kathy; Gunraj, Nadia; Normand, Sharon-Lise T; Gurwitz, Jerry H; Marras, Connie; Wodchis, Walter P; Mamdani, Muhammad

    2005-01-01

    Objective To compare the incidence of admissions to hospital for stroke among older adults with dementia receiving atypical or typical antipsychotics. Design Population based retrospective cohort study. Setting Ontario, Canada. Patients 32 710 older adults (≤ 65 years) with dementia (17 845 dispensed an atypical antipsychotic and 14 865 dispensed a typical antipsychotic). Main outcome measures Admission to hospital with the most responsible diagnosis (single most important condition responsible for the patient's admission) of ischaemic stroke. Observation of patients until they were either admitted to hospital with ischaemic stroke, stopped taking antipsychotics, died, or the study ended. Results After adjustment for potential confounders, participants receiving atypical antipsychotics showed no significant increase in risk of ischaemic stroke compared with those receiving typical antipsychotics (adjusted hazard ratio 1.01, 95% confidence interval 0.81 to 1.26). This finding was consistent in a series of subgroup analyses, including ones of individual atypical antipsychotic drugs (risperidone, olanzapine, and quetiapine) and selected subpopulations of the main cohorts. Conclusion Older adults with dementia who take atypical antipsychotics have a similar risk of ischaemic stroke to those taking typical antipsychotics. PMID:15668211

  3. Congenital Adrenal Hyperplasia, Polycystic Ovary Syndrome and criminal behavior: A Swedish population based study.

    PubMed

    Ohlsson Gotby, Agnes; Nordenström, Anna; Falhammar, Henrik; Nordenskjöld, Agneta; Linden Hirschberg, Angelica; Frisén, Louise; Landén, Mikael; Lichtenstein, Paul

    2015-10-30

    Both prenatal and circulating testosterone and other androgens have been suggested to influence the individual's propensity to commit crime, but empirical evidence is limited and inconsistent. Congenital Adrenal Hyperplasia (CAH) and Polycystic Ovary Syndrome (PCOS) are both hyperandrogenic conditions but with an important difference; whereas subjects with CAH are exposed to high concentrations of androgens in utero, women with PCOS are subjected to high androgens in adulthood. Comparing these groups can therefore yield important insights of androgenic effects on behavior. In the current study, information on medical diagnoses and convicted crimes were gathered from Swedish population-based registers. The associations between diagnoses of CAH or PCOS and any crime, violent crime or sex crime were estimated with conditional logistic regression. Results showed that CAH in women and men did not predict criminality, whereas an increased risk for any crime and violent crime was found in PCOS women. Our findings indicate that female hyperandrogenism in adulthood, but not prenatal hyperandrogenism, is associated with risk for criminal behavior. Further research into hyperandrogenic conditions holds opportunities to deepen our understanding of the etiology of crime and psychopathology.

  4. Increased risk of essential tremor in migraine: A population-based retrospective cohort study

    PubMed Central

    Lau, Chi-Ieong; Lin, Che-Chen; Chen, Hsuan-Ju; Wang, Han-Cheng; Chen, Wei-Hung

    2017-01-01

    Purpose To examine the long-term risk of essential tremor (ET) in migraine. Methods Using population-based administrative data from a subset of the National Health Insurance Research Database (NHIRD) of Taiwan, we identified 22,696 newly diagnosed migraineurs (mean age 44.5 years) and a matched migraine-free cohort of 90,784 individuals in the period 2000–2008. Multivariable Cox proportional hazards regression analysis was conducted for assessing the ET risk for the migraine cohort compared to the migraine-free cohort. Results After adjusting for covariates, the migraine cohort had a 1.83-fold increased risk (95% CI 1.50–2.23) of subsequent ET in comparison to the migraine-free cohort (8.97 vs. 4.81 per 10,000 person-years). In the subgroup analysis, patients with migraine were associated with higher risks of ET, regardless of gender, age or the existence of comorbidities. Conclusion Our findings demonstrated an association between migraine and ET, suggesting a possible shared pathophysiology underpinning both disorders. PMID:28288163

  5. The ethics of feedback of HIV test results in population-based surveys of HIV infection.

    PubMed

    Maher, Dermot

    2013-12-01

    Population-based disease prevalence surveys raise ethical questions, including whether participants should be routinely told their test results. Ethical guidelines call for informing survey participants of any clinically relevant finding to enable appropriate management. However, in anonymous surveys of human immunodeficiency virus (HIV) infection, participants can "opt out" of being given their test results or are offered the chance to undergo voluntary HIV testing in local counselling and testing services. This is aimed at minimizing survey participation bias. Those who opt out of being given their HIV test results and who do not seek their results miss the opportunity to receive life-saving antiretroviral therapy. The justification for HIV surveys without routine feedback of results to participants is based on a public health utility argument: that the benefits of more rigorous survey methods - reduced participation bias - outweigh the benefits to individuals of knowing their HIV status. However, people with HIV infection have a strong immediate interest in knowing their HIV status. In consideration of the ethical value of showing respect for people and thereby alleviating suffering, an argument based on public health utility is not an appropriate justification. In anonymous HIV surveys as well as other prevalence surveys of treatable conditions in any setting, participation should be on the basis of routine individual feedback of results as an integral part of fully informed participation. Ensuring that surveys are ethically sound may stimulate participation, increase a broader uptake of HIV testing and reduce stigmatization of people who are HIV-positive.

  6. Lung cancer and occupation in a population-based case-control study.

    PubMed

    Consonni, Dario; De Matteis, Sara; Lubin, Jay H; Wacholder, Sholom; Tucker, Margaret; Pesatori, Angela Cecilia; Caporaso, Neil E; Bertazzi, Pier Alberto; Landi, Maria Teresa

    2010-02-01

    The authors examined the relation between occupation and lung cancer in the large, population-based Environment And Genetics in Lung cancer Etiology (EAGLE) case-control study. In 2002-2005 in the Lombardy region of northern Italy, 2,100 incident lung cancer cases and 2,120 randomly selected population controls were enrolled. Lifetime occupational histories (industry and job title) were coded by using standard international classifications and were translated into occupations known (list A) or suspected (list B) to be associated with lung cancer. Smoking-adjusted odds ratios and 95% confidence intervals were calculated with logistic regression. For men, an increased risk was found for list A (177 exposed cases and 100 controls; odds ratio = 1.74, 95% confidence interval: 1.27, 2.38) and most occupations therein. No overall excess was found for list B with the exception of filling station attendants and bus and truck drivers (men) and launderers and dry cleaners (women). The authors estimated that 4.9% (95% confidence interval: 2.0, 7.8) of lung cancers in men were attributable to occupation. Among those in other occupations, risk excesses were found for metal workers, barbers and hairdressers, and other motor vehicle drivers. These results indicate that past exposure to occupational carcinogens remains an important determinant of lung cancer occurrence.

  7. Socioeconomic, remoteness and sex differences in life expectancy in New South Wales, Australia, 2001–2012: a population-based study

    PubMed Central

    Stephens, Alexandre S; Gupta, Leena; Thackway, Sarah; Broome, Richard A

    2017-01-01

    Objectives Despite being one of the healthiest countries in the world, Australia displays substantial mortality differentials by socioeconomic disadvantage, remoteness and sex. In this study, we examined how these mortality differentials translated to differences in life expectancy between 2001 and 2012. Design and setting Population-based study using mortality and estimated residential population data from Australia's largest state, New South Wales (NSW), between 2001 and 2012. Age-group-specific death rates by socioeconomic disadvantage quintile, remoteness (major cities vs regional and remote areas), sex and year were estimated via Poisson regression, and inputted into life table calculations to estimate life expectancy. Results Life expectancy decreased with increasing socioeconomic disadvantage in males and females. The disparity between the most and least socioeconomically deprived quintiles was 3.77 years in males and 2.39 years in females in 2012. Differences in life expectancy by socioeconomic disadvantage were mostly stable over time. Gender gaps in life expectancy ranged from 3.50 to 4.93 years (in 2012), increased with increasing socioeconomic disadvantage and decreased by ∼1 year for all quintiles between 2001 and 2012. Overall, life expectancy varied little by remoteness, but was 1.8 years higher in major cities compared to regional/remote areas in the most socioeconomically deprived regions in 2012. Conclusions Socioeconomic disadvantage and sex were strongly associated with life expectancy. The disparity in life expectancy across the socioeconomic spectrum was larger in males and was stable over time. In contrast, gender gaps reduced for all quintiles between 2001 and 2012, and a remoteness effect was evident in 2012, but only for those living in the most deprived areas. PMID:28073794

  8. Serious transport accidents in adults with ADHD, and the effect of medication: A population based study

    PubMed Central

    Chang, Zheng; Lichtenstein, Paul; D’Onofrio, Brian M.; Sjölander, Arvid; Larsson, Henrik

    2013-01-01

    Importance Studies have shown that Attention-deficit/hyperactivity disorder (ADHD) is associated with transport accidents, but the magnitude of the association remains unclear. Importantly, it is also unclear whether ADHD medication reduces this risk. Objective First, to estimate the association between ADHD and the risk of serious transport accidents. Second, to explore the extent to which ADHD medication influences this risk among ADHD patients. Design, Setting, and Participants 17,408 patients with a diagnosis of ADHD were followed from 2006 to 2009 for serious transport accidents in Swedish national registers. The association between ADHD and accidents was estimated with Cox regression. To study the effect of ADHD medication, we used stratified Cox regression to compare the risk of accidents during medication period with the risk during non-medication period within the same patients. Main Outcome and Measure Serious transport accident, identified as admission to an emergency hospital care or death due to transport accident. Results Compared with individuals without ADHD, male ADHD patients (adjusted hazard ratio [HR] =1.47, 95% confidence interval [CI] 1.32–1.63) and female ADHD patients (HR=1.45, 95% CI 1.24–1.71) had increased risk of serious transport accidents. In male ADHD patients, ADHD medication was associated with a 58% risk reduction (HR=0.42, 95% CI 0.23–0.75), but there was no significant association in female patients. Estimates of the population attributable fractions suggested that 41% – 49% of the accidents in male patients with ADHD could have been avoided if they had been on treatment the entire follow-up. Conclusions and Relevance ADHD is associated with an increased risk of serious transport accidents, and this risk seems to be possibly reduced by ADHD medication, at least among male ADHD patients. This should lead to increased awareness of the association between serious transport accidents and ADHD medication among clinicians and

  9. Use of BPPV processes in Emergency Department Dizziness Presentations: A Population-Based Study

    PubMed Central

    Kerber, Kevin A.; Burke, James F.; Skolarus, Lesli E.; Meurer, William J.; Callaghan, Brian C.; Brown, Devin L.; Lisabeth, Lynda D.; McLaughlin, Thomas J.; Fendrick, A. Mark; Morgenstern, Lewis B.

    2013-01-01

    Objective A common cause of dizziness, benign paroxysmal positional vertigo (BPPV), is effectively diagnosed and cured with the Dix-Hallpike test (DHT) and the canalith repositioning maneuver (CRM). We aimed to describe the use of these processes in Emergency Departments (ED), to assess for trends in use over time, and to determine provider level variability in use. Design Prospective population-based surveillance study Setting EDs in Nueces County, Texas, January 15, 2008 to January 14, 2011 Subjects and Methods Adult patients discharged from EDs with dizziness, vertigo, or imbalance documented at triage. Clinical information was abstracted from source documents. A hierarchical logistic regression model adjusting for patient and provider characteristics was used to estimate trends in DHT use and provider level variability. Results 3,522 visits for dizziness were identified. A DHT was documented in 137 visits (3.9%). A CRM was documented in 8 visits (0.2%). Among patients diagnosed with BPPV, a DHT was documented in only 21.8% (34 of 156) and a CRM in 3.9% (6 of 156). In the hierarchical model (c statistic = 0.93), DHT was less likely to be used over time (odds ratio, 0.97, 95% CI [0.95, 0.99]) and the provider level explained 50% (ICC, 0.50) of the variance in the probability of DHT use. Conclusion BPPV is seldom examined for, and when diagnosed, infrequently treated in this ED population. DHT use is decreasing over time, and varies substantially by provider. Implementation research focused on BPPV care may be an opportunity to optimize management in ED dizziness presentations. PMID:23264119

  10. Symptom profile of persons self-reporting whiplash: a Norwegian population-based study (HUNT 2)

    PubMed Central

    Mykletun, Arnstein; Nilsen, Tom Ivar Lund

    2009-01-01

    The aetiology of chronic whiplash associated disorder (WAD) is unclear and the condition has been perceived both as a chronic pain disorder, based on the injury to the neck, and as a functional somatic disorder. Based on the hypothesis that chronic WAD should be perceived as a functional somatic syndrome, we compared the symptom profile of persons with chronic WAD with the profile of persons with a functional somatic disorder, and with the profile of persons with an organic pain disorder. A sample of 55,046 persons participating in a Norwegian population-based health study (HUNT 2) was divided into four study groups: chronic WAD, fibromyalgia, rheumatoid arthritis, and controls (none of these disorders). Symptoms were categorized as pain and stiffness, cardiopulmonary and gastrointestinal symptoms, and mental disorders. Odds ratios (ORs) with 95% confidence intervals (CIs) from logistic regression were used to compare the prevalence of symptoms among the groups. The chronic WAD group had a significantly higher prevalence of symptoms from all body parts, across organ systems and also mental symptoms, compared to the control group. The fibromyalgia group had an even higher prevalence of all symptoms, while the rheumatoid arthritis group showed an increase in the prevalence of particularly pain and stiffness symptoms and also a minor increase in the prevalence of other symptoms compared to the control group. We conclude that this study provide evidence in favour of the hypothesis that chronic WAD should be perceived as a functional somatic syndrome. Persons with chronic WAD had a symptom profile more similar to people with a functional somatic disorder than an organic pain disorder, consisting of a wide array of symptoms, not only predominantly pain symptoms. PMID:19669172

  11. Virtual colleagues, virtually colleagues—physicians’ use of Twitter: a population-based observational study

    PubMed Central

    Brynolf, Anne; Johansson, Stefan; Appelgren, Ester; Lynoe, Niels; Edstedt Bonamy, Anna-Karin

    2013-01-01

    Objective To investigate potential violations of patient confidentiality or other breaches of medical ethics committed by physicians and medical students active on the social networking site Twitter. Design Population-based cross-sectional observational study. Setting The social networking site Twitter (Swedish-speaking users, n=298819). Population Physicians and medical students (Swedish-speaking users, n=237) active on the social networking site Twitter between July 2007 and March 2012. Main outcome measure Postings that reflect unprofessional behaviour and ethical breaches among physicians and medical students. Results In all, 237 Twitter accounts were established as held by physicians and medical students and a total of 13 780 tweets were analysed by content. In all, 276 (1.9%) tweets were labelled as ‘unprofessional’. Among these, 26 (0.2%) tweets written by 15 (6.3%) physicians and medical students included information that could violate patient privacy. No information on the personal ID number or names was disclosed, but parts of the patient documentation or otherwise specific indicatory information on patients were found. Unprofessional tweets were more common among users writing under a pseudonym and among medical students. Conclusions In this study of physicians and medical students on Twitter, we observed potential violations of patient privacy and other breaches of medical ethics. Our findings underline that every physician and medical student has to consider his or her presence on social networking sites. It remains to be investigated if the introduction of social networking site guidelines for medical professionals will improve awareness. PMID:23883885

  12. Simultaneous resection of primary colorectal cancer and synchronous liver metastases: a population-based study

    PubMed Central

    Nanji, Sulaiman; Mackillop, William J.; Wei, Xuejiao; Booth, Christopher M.

    2017-01-01

    Background Simultaneous resection of primary colorectal cancer (CRC) and synchronous liver metastases (LM) is gaining interest. We describe management and outcomes of patients undergoing simultaneous resection in the general population. Methods All patients with CRC who underwent surgical resection of LM between 2002 and 2009 were identified using the population-based Ontario Cancer Registry and linked electronic treatment records. Synchronous disease was defined as having resection of CRCLM within 12 weeks of surgery for the primary tumour. Results During the study period, 1310 patients underwent resection of CRCLM. Of these, 226 (17%) patients had synchronous disease; 100 (44%) had a simultaneous resection and 126 (56%) had a staged resection. For the simultaneous and the staged groups, the mean number of liver lesions resected was 1.6 and 2.3, respectively (p < 0.001); the mean size of the largest lesion was 3.1 and 4.8 cm, respectively (p < 0.001); and the major hepatic resection rate was 21% and 79%, respectively (p < 0.001). Postoperative mortality for simultaneous cases at 90 days was less than 5%. Five-year overall survival and cancer-specific survival for patients with simultaneous resection was 36% (95% confidence interval [CI] 26%–45%) and 37% (95% CI 25%–50%), respectively. Simultaneous resections are common in the general population. A more conservative approach is being adopted for simultaneous resections by limiting the extent of liver resection. Postoperative mortality and long-term survival in this patient population is similar to that reported in other contemporary series. Conclusion Compared with a staged approach, patients undergoing simultaneous resections had fewer and smaller liver metastases and underwent less aggressive resections. One-third of these patients achieved long-term survival. PMID:28234215

  13. Effect of cataract surgery volume constraints on recently graduated ophthalmologists: a population-based cohort study

    PubMed Central

    Campbell, Robert J.; El-Defrawy, Sherif R.; Bell, Chaim M.; Gill, Sudeep S.; Hooper, Philip L.; Whitehead, Marlo; Campbell, Erica de L.P.; Nesdole, Robert; Warder, Daniel; ten Hove, Martin

    2017-01-01

    BACKGROUND: Across Canada, graduates from several medical and surgical specialties have recently had difficulty securing practice opportunities, especially in specialties dependent on limited resources such as ophthalmology. We aimed to investigate whether resource constraints in the health care system have a greater impact on the volume of cataract surgery performed by recent graduates than on established physicians. METHODS: We used population-based administrative data from Ontario for the period Jan. 1, 1994, to June 30, 2013, to compare health services provided by recent graduates and established ophthalmologists. The primary outcome was volume of cataract surgery, a resource-intensive service for which volume is controlled by the province. RESULTS: When cataract surgery volume in Ontario entered a period of government-mandated zero growth in 2007, the mean number of cataract operations performed by recent graduates dropped significantly (−46.37 operations/quarter, 95% confidence interval [CI] −62.73 to −30.00 operations/quarter), whereas the mean rate for established ophthalmologists remained stable (+5.89 operations/quarter, 95% CI 95% CI −1.47 to +13.24 operations/quarter). Decreases in service provision among recent graduates did not occur for services without volume control. The proportion of recent graduates providing exclusively cataract surgery increased over the study period, and recent graduates in this group were 5.24 times (95% CI 2.15 to 12.76 times) more likely to fall within the lowest quartile for cataract surgical volume during the period of zero growth in provincial cataract volume (2007–2013) than in the preceding period (1996–2006). INTERPRETATION: Recent ophthalmology graduates performed many fewer cataract surgery procedures after volume controls were implemented in Ontario. Integrated initiatives involving multiple stakeholders are needed to address the issues facing recently graduated physicians in Canada. PMID:27920012

  14. Estimating the burden of shigellosis in Thailand: 36-month population-based surveillance study.

    PubMed Central

    Chompook, Pornthip; Samosornsuk, Seksun; von Seidlein, Lorenz; Jitsanguansuk, Supot; Sirima, Nunta; Sudjai, Sanit; Mangjit, Prasitchai; Kim, Deok Ryun; Wheeler, Jeremy G.; Todd, Jim; Lee, Hyejon; Ali, Mohammad; Clemens, John; Tapchaisri, Pramuan; Chaicumpa, Wanpen

    2005-01-01

    OBJECTIVE: To estimate incidence of shigellosis in the Kaengkhoi district, Saraburi Province, Thailand. METHODS: Population-based surveillance of shigellosis based in treatment centres. The detected rates of treated shigellosis were corrected for the number of cases missed due to the low sensitivity of microbiological culture methods and participants' use of health-care providers not participating in the study. FINDINGS: The overall uncorrected incidence of shigellosis was 0.6/1000 population per year (95% confidence interval (CI) = 0.5-0.8). The unadjusted incidence of treated shigellosis was highest among children less than 5 years old (4/1000 children per year; 95% CI = 3-6) and significantly lower among people aged > 5 years (0.3/1000 population per year; 95% CI = 0.2-0.5; P < 0.001). Adjusting for cases likely to be missed as a result of culture and surveillance methods increased estimates approximately five times. The majority of Shigella isolates (122/146; 84%) were S. sonnei; the rest were S. flexneri. Of the 22 S. flexneri isolates, the three most frequently encountered serotypes were 2a (36%), 1b (23%) and 3b (28%). A total of 90-95% of S. sonnei and S. flexneri isolates were resistant to tetracycline and co-trimoxazole. In contrast to S. sonnei isolates, more than 90% of the S. flexneri isolates were also resistant to ampicillin and chloramphenicol (P < 0.0001). CONCLUSION: Estimates of incidence of Shigella infection in the community are 10-fold to 100-fold greater than those found from routine government surveillance. The high prevalence of Shigella strains resistant to multiple antibiotics adds urgency to the development of a vaccine to protect against shigellosis in this region of Thailand. PMID:16283050

  15. Emergency department use by people with HIV in Ontario: a population-based cohort study

    PubMed Central

    Ng, Ryan; Kendall, Claire E.; Burchell, Ann N.; Bayoumi, Ahmed M.; Loutfy, Mona R.; Raboud, Janet; Glazier, Richard H.; Rourke, Sean; Antoniou, Tony

    2016-01-01

    Background: Emergency department use may reflect poor access to primary care. Our objective was to compare rates and causes of emergency department use between adults living with and without HIV. Methods: We conducted a population-based study involving Ontario residents living with and without HIV between Apr. 1, 2011, and Mar. 31, 2012. We frequency matched adults with HIV to 4 HIV-negative people by age, sex and census division, and used random-effects negative binomial regression to compare rates of emergency department use. We classified visits as low urgency or high urgency, and also examined visits for ambulatory care sensitive conditions. Hospital admission following an emergency department visit was a secondary outcome. Results: We identified 14 534 people with HIV and 58 136 HIV-negative individuals. Rates of emergency department use were higher among people with HIV (67.3 v. 31.2 visits per 100 person-years; adjusted rate ratio 1.58, 95% confidence interval [CI] 1.51-1.65). Similar results were observed for low-urgency visits. With the exception of hypertension, visit rates for ambulatory care sensitive conditions were higher among people with HIV. People with HIV were also more likely than HIV-negative individuals to be admitted to hospital following an emergency department visit (adjusted odds ratio 1.55, 95% CI 1.43-1.69). Interpretation: Compared with HIV-negative individuals, people with HIV had high rates of emergency department use, including potentially avoidable visits. These findings strongly support the need for comprehensive care for people with HIV. PMID:27398370

  16. Risk of Cancer in Patients with Iron Deficiency Anemia: A Nationwide Population-Based Study

    PubMed Central

    Hu, Yu-Wen; Hu, Li-Yu; Yeh, Chiu-Mei; Teng, Chung-Jen; Kuan, Ai-Seon; Chen, San-Chi; Chen, Tzeng-Ji; Liu, Chia-Jen

    2015-01-01

    Objective This study evaluated the risk of cancer among patients with iron deficiency anemia (IDA) by using a nationwide population-based data set. Method Patients newly diagnosed with IDA and without antecedent cancer between 2000 and 2010 were recruited from the Taiwan National Health Insurance Research Database. The standardized incidence ratios (SIRs) of cancer types among patients with IDA were calculated. Results Patients with IDA exhibited an increased overall cancer risk (SIR: 2.15). Subgroup analysis showed that patients of both sexes and in all age groups had an increased SIR. After we excluded patients diagnosed with cancer within the first and first 5 years of IDA diagnosis, the SIRs remained significantly elevated at 1.43 and 1.30, respectively. In addition, the risks of pancreatic (SIR: 2.31), kidney (SIR: 2.23), liver (SIR: 1.94), and bladder cancers (SIR: 1.74) remained significantly increased after exclusion of patients diagnosed with cancer within 5 years after IDA diagnosis. Conclusion The overall cancer risk was significantly elevated among patients with IDA. After we excluded patients diagnosed with IDA and cancer within 1 and 5 years, the SIRs remained significantly elevated compared with those of the general population. The increased risk of cancer was not confined to gastrointestinal cancer when the SIRs of pancreatic, kidney, liver, and bladder cancers significantly increased after exclusion of patients diagnosed with IDA and cancer within the first 5 years. This finding may be caused by immune activities altered by IDA. Further study is necessary to determine the association between IDA and cancer risk. PMID:25781632

  17. Family meals and eating practices among mothers in Santos, Brazil: A population-based study.

    PubMed

    Sato, Priscila de Morais; Lourenço, Bárbara Hatzlhoffer; Trude, Angela Cristina Bizzotto; Unsain, Ramiro Fernandez; Pereira, Patrícia Rocha; Martins, Paula Andrea; Scagliusi, Fernanda Baeza

    2016-08-01

    This study investigates family meals among mothers and explores associations between eating with family and sociodemographic characteristics, body mass index, and eating practices. A population-based cross-sectional study, using complex cluster-sampling, was conducted in the city of Santos, Brazil with 439 mothers. Frequency of family meals was assessed by asking if mothers did or did not usually have a) breakfast, b) lunch, and c) dinner with family. Linear regression analyses were conducted for the number of meals eaten with family per day and each of the potential explanatory variables, adjusting for the mother's age. Poisson regression with robust variance was used to analyze each factor associated with eating with family as classified categorically: a) sharing meals with family, b) not eating any meals with family. Only 16.4% (n = 72) of participants did not eat any meals with family. From the 83.6% (n = 367) of mothers that had at least one family meal per day, 69.70% (n = 306) ate dinner with their families. Mothers aged ≥40 years reported significantly fewer meals eaten with family compared to mothers aged 30-39 years (β: -0.26, p = 0.04). Having family meals was 54% more prevalent among mothers with ≥12 years of education (PR for no meals eaten with family: 0.54, 95% CI: 0.30; 0.96, p = 0.03), when compared to mothers with less than nine years of education. Eating no meals with family was 85% more prevalent among mothers who reported that eating was one of the biggest pleasures in their lives (PR: 1.85, 95% CI: 1.21; 2.82, p = 0.004). We suggest the need for further research investigating the effects of family meals on mothers' health through nutritional and phenomenological approaches.

  18. Population-based analysis of Alzheimer’s disease risk alleles implicates genetic interactions

    PubMed Central

    Ebbert, Mark T. W.; Ridge, Perry G.; Wilson, Andrew R.; Sharp, Aaron R.; Bailey, Matthew; Norton, Maria C.; Tschanz, JoAnn T.; Munger, Ronald G.; Corcoran, Christopher D.; Kauwe, John S. K.

    2013-01-01

    Background Reported odds ratios and population attributable fractions (PAF) for late-onset Alzheimer’s disease (LOAD) risk loci (BIN1, ABCA7, CR1, MS4A4E, CD2AP, PICALM, MS4A6A, CD33, and CLU) come from clinically ascertained samples. Little is known about the combined PAF for these LOAD risk alleles and the utility of these combined markers for case-control prediction. Here we evaluate these loci in a large population-based sample to estimate PAF and explore the effects of additive and non-additive interactions on LOAD status prediction performance. Methods 2,419 samples from the Cache County Memory Study were genotyped for APOE and nine LOAD risk loci from AlzGene.org. We used logistic regression and ROC analysis to assess the LOAD status prediction performance of these loci using additive and non-additive models, and compared ORs and PAFs between AlzGene.org and Cache County. Results Odds ratios were comparable between Cache County and AlzGene.org when identical SNPs were genotyped. PAFs from AlzGene.org ranged from 2.25–37%; those from Cache County ranged from 0.05–20%. Including non-APOE alleles significantly improved LOAD status prediction performance (AUC = 0.80) over APOE alone (AUC = 0.78) when not constrained to an additive relationship (p < 0.03). We identified potential allelic interactions (p-values uncorrected): CD33-MS4A4E (Synergy Factor = 5.31; p < 0.003) and CLU-MS4A4E (SF = 3.81; p < 0.016). Conclusions While non-additive interactions between loci significantly improve diagnostic ability, the improvement does not reach the desired sensitivity or specificity for clinical use. Nevertheless, these results suggest that understanding gene-gene interactions may be important in resolving Alzheimer’s disease etiology. PMID:23954108

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    2011-01-01

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

  1. A Bayesian Approach to Identifying New Risk Factors for Dementia: A Nationwide Population-Based Study.

    PubMed

    Wen, Yen-Hsia; Wu, Shihn-Sheng; Lin, Chun-Hung Richard; Tsai, Jui-Hsiu; Yang, Pinchen; Chang, Yang-Pei; Tseng, Kuan-Hua

    2016-05-01

    Dementia is one of the most disabling and burdensome health conditions worldwide. In this study, we identified new potential risk factors for dementia from nationwide longitudinal population-based data by using Bayesian statistics.We first tested the consistency of the results obtained using Bayesian statistics with those obtained using classical frequentist probability for 4 recognized risk factors for dementia, namely severe head injury, depression, diabetes mellitus, and vascular diseases. Then, we used Bayesian statistics to verify 2 new potential risk factors for dementia, namely hearing loss and senile cataract, determined from the Taiwan's National Health Insurance Research Database.We included a total of 6546 (6.0%) patients diagnosed with dementia. We observed older age, female sex, and lower income as independent risk factors for dementia. Moreover, we verified the 4 recognized risk factors for dementia in the older Taiwanese population; their odds ratios (ORs) ranged from 3.469 to 1.207. Furthermore, we observed that hearing loss (OR = 1.577) and senile cataract (OR = 1.549) were associated with an increased risk of dementia.We found that the results obtained using Bayesian statistics for assessing risk factors for dementia, such as head injury, depression, DM, and vascular diseases, were consistent with those obtained using classical frequentist probability. Moreover, hearing loss and senile cataract were found to be potential risk factors for dementia in the older Taiwanese population. Bayesian statistics could help clinicians explore other potential risk factors for dementia and for developing appropriate treatment strategies for these patients.

  2. Long-term air pollution exposure and diabetes in a population-based Swiss cohort.

    PubMed

    Eze, Ikenna C; Schaffner, Emmanuel; Fischer, Evelyn; Schikowski, Tamara; Adam, Martin; Imboden, Medea; Tsai, Ming; Carballo, David; von Eckardstein, Arnold; Künzli, Nino; Schindler, Christian; Probst-Hensch, Nicole

    2014-09-01

    Air pollution is an important risk factor for global burden of disease. There has been recent interest in its possible role in the etiology of diabetes mellitus. Experimental evidence is suggestive, but epidemiological evidence is limited and mixed. We therefore explored the association between air pollution and prevalent diabetes, in a population-based Swiss cohort. We did cross-sectional analyses of 6392 participants of the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults [SAPALDIA], aged between 29 and 73 years. We used estimates of average individual home outdoor PM10 [particulate matter <10μm in diameter] and NO2 [nitrogen dioxide] exposure over the 10 years preceding the survey. Their association with diabetes was modeled using mixed logistic regression models, including participants' study area as random effect, with incremental adjustment for confounders. There were 315 cases of diabetes (prevalence: 5.5% [95% confidence interval (CI): 2.8, 7.2%]). Both PM10 and NO2 were associated with prevalent diabetes with respective odds ratios of 1.40 [95% CI: 1.17, 1.67] and 1.19 [95% CI: 1.03, 1.38] per 10μg/m(3) increase in the average home outdoor level. Associations with PM10 were generally stronger than with NO2, even in the two-pollutant model. There was some indication that beta blockers mitigated the effect of PM10. The associations remained stable across different sensitivity analyses. Our study adds to the evidence that long term air pollution exposure is associated with diabetes mellitus. PM10 appears to be a useful marker of aspects of air pollution relevant for diabetes. This association can be observed at concentrations below air quality guidelines.

  3. Apgar-score in children prenatally exposed to antiepileptic drugs: a population-based cohort study

    PubMed Central

    Christensen, Jakob; Pedersen, Henrik Søndergaard; Kjaersgaard, Maiken Ina Siegismund; Parner, Erik Thorlund; Vestergaard, Mogens; Sørensen, Merete Juul; Olsen, Jørn; Bech, Bodil Hammer; Pedersen, Lars Henning

    2015-01-01

    Objectives It is unknown if prenatal exposure to antiepileptic drugs (AEDs) increases the risk of low Apgar score in offspring. Setting Population-based study using health registers in Denmark. Participants We identified all 677 021 singletons born in Denmark from 1997 to 2008 and linked the Apgar score from the Medical Birth Register with information on the women's prescriptions for AEDs during pregnancy from the Danish Register of Medicinal Product Statistics. We used the Danish National Hospital Registry to identify mothers diagnosed with epilepsy before birth of the child. Results were adjusted for smoking and maternal age. Results Among 2906 children exposed to AEDs, 55 (1.9%) were born with an Apgar score ≤7 as compared with 8797 (1.3%) children among 674 115 pregnancies unexposed to AEDs (adjusted relative risk (aRR)=1.41 (95% CI 1.07 to 1.85). When analyses were restricted to the 2215 children born of mothers with epilepsy, the aRR of having a low Apgar score associated with AED exposure was 1.34 (95% CI 0.90 to 2.01) When assessing individual AEDs, we found increased, unadjusted RR for exposure to carbamazepine (RR=1.86 (95% CI 1.01 to 3.42)), valproic acid (RR=1.85 (95% CI 1.04 to 3.30)) and topiramate (RR=2.97 (95% CI 1.26 to 7.01)) when compared to unexposed children. Conclusions Prenatal exposure to AEDs was associated with increased risk of being born with a low Apgar score, but the absolute risk of a low Apgar score was <2%. Risk associated with individual AEDs indicate that the increased risk is not a class effect, but that there may be particularly high risks of a low Apgar score associated with certain AEDs. PMID:26359281

  4. Cardiovascular Events in Patients with Atherothrombotic Disease: A Population-Based Longitudinal Study in Taiwan

    PubMed Central

    Lee, Wen-Hsien; Hsu, Po-Chao; Chu, Chun-Yuan; Su, Ho-Ming; Lee, Chee-Siong; Yen, Hsueh-Wei; Lin, Tsung-Hsien; Voon, Wen-Chol; Lai, Wen-Ter; Sheu, Sheng-Hsiung

    2014-01-01

    Background Atherothrombotic diseases including cerebrovascular disease (CVD), coronary artery disease (CAD), and peripheral arterial disease (PAD), contribute to the major causes of death in the world. Although several studies showed the association between polyvascular disease and poor cardiovascular (CV) outcomes in Asian population, there was no large-scale study to validate this relationship in this population. Methods and Results This retrospective cohort study included patients with a diagnosis of CVD, CAD, or PAD from the database contained in the Taiwan National Health Insurance Bureau during 2001–2004. A total of 19954 patients were enrolled in this study. The atherothrombotic disease score was defined according to the number of atherothrombotic disease. The study endpoints included acute coronary syndrome (ACS), all strokes, vascular procedures, in hospital mortality, and so on. The event rate of ischemic stroke (18.2%) was higher than that of acute myocardial infarction (5.7%) in our patients (P = 0.0006). In the multivariate Cox regression analyses, the adjusted hazard ratios (HRs) of each increment of atherothrombotic disease score in predicting ACS, all strokes, vascular procedures, and in hospital mortality were 1.41, 1.66, 1.30, and 1.14, respectively (P≦0.0169). Conclusions This large population-based longitudinal study in patients with atherothrombotic disease demonstrated the risk of subsequent ischemic stroke was higher than that of subsequent AMI. In addition, the subsequent adverse CV events including ACS, all stroke, vascular procedures, and in hospital mortality were progressively increased as the increase of atherothrombotic disease score. PMID:24647769

  5. Posttraumatic stress disorder across two generations: concordance and mechanisms in a population-based sample

    PubMed Central

    Roberts, Andrea L.; Galea, Sandro; Austin, S. Bryn; Cerda, Magdalena; Wright, Rosalind J.; Rich-Edwards, Janet W.; Koenen, Karestan C.

    2012-01-01

    Background Research conducted using small samples of persons exposed to extreme stressors has documented an association between parental and offspring posttraumatic stress disorder (PTSD), but it is unknown whether this association exists in the general population and whether trauma exposure mediates this association. We sought to determine whether mothers’ posttraumatic stress symptoms were associated with PTSD in their young adult children and whether this association was mediated by higher trauma exposure in children of women with PTSD. Methods Using data from a cohort of mothers (n=6924) and a cohort of their children (n=8453), we calculated risk ratios (RR) for child’s PTSD and examined mediation by trauma exposure. Results Mother’s lifetime posttraumatic stress symptoms were associated with child’s PTSD in dose-response fashion (mother’s 1 to 3 symptoms, child’s RR=1.2; mother’s 4-5 symptoms, RR=1.3; mother’s 6-7 symptoms, RR=1.6, compared to children of mothers with no symptoms, p<0.001 for each). Mother’s lifetime symptoms were also associated with child’s trauma exposure in dose-response fashion. Elevated exposure to trauma substantially mediated elevated risk for PTSD in children of women with symptoms (mediation proportion, 74%, p<0.001). Conclusions Intergenerational association of PTSD is clearly present in a large population-based sample. Children of women who had PTSD were more likely than children of women without PTSD to experience traumatic events; this suggests, in part, why the disorder is associated across generations. Health care providers who treat mothers with PTSD should be aware of the higher risk for trauma exposure and PTSD in their children. PMID:22521146

  6. Maternal Exposure to Methotrexate and Birth Defects: a Population-Based Study

    PubMed Central

    Dawson, April L.; Riehle-Colarusso, Tiffany; Reefhuis, Jennita; Arena, J. Fernando

    2015-01-01

    Methotrexate is an anti-folate medication that is associated with increased risk of multiple birth defects. Using data from the National Birth Defects Prevention Study, a case-control study of major birth defects in the United States, we examined mothers exposed to methotrexate. The study population included mothers of live-born infants without major birth defects (controls) and mothers of fetuses or infants with a major birth defect (cases), with expected dates of delivery between October 1997 and December 2009. Mothers of cases and controls were asked detailed questions concerning pregnancy history, demographic information, and exposures in a telephone interview. Approximately 0.06% (n=16/27,623) of case and 0.04% (n=4/10,113) of control mothers reported exposure to methotrexate between three months prior to conception through the end of pregnancy. Of the 16 case infants, 11 (68.8%) had a congenital heart defect (CHD). The observed CHDs included atrial septal defects, tetralogy of Fallot, valvar pulmonary stenosis, ventricular septal defects (VSDs), and total anomalous pulmonary venous return. One case infant had microtia in addition to a VSD and another had VACTER association. Exposed cases without a CHD had one of the following birth defects: cleft palate, hypospadias, congenital diaphragmatic hernia, or craniosynostosis. Based on a limited number of methotrexate-exposed mothers, our findings support recent case reports suggesting an association between early pregnancy exposure to methotrexate and CHDs. Because of the rarity of maternal periconceptional exposure to methotrexate, long-term, population-based case-control studies are needed to confirm these findings and better evaluate the association between methotrexate and birth defects. PMID:24898111

  7. Radiotherapy and Survival in Prostate Cancer Patients: A Population-Based Study

    SciTech Connect

    Zhou, Esther H. Ellis, Rodney J.; Cherullo, Edward; Colussi, Valdir; Xu Fang; Chen Weidong; Gupta, Sanjay; Whalen, Christopher C.; Bodner, Donald; Resnick, Martin I.; Rimm, Alfred A.

    2009-01-01

    Purpose: To investigate the association of overall and disease-specific survival with the five standard treatment modalities for prostate cancer (CaP): radical prostatectomy (RP), brachytherapy (BT), external beam radiotherapy, androgen deprivation therapy, and no treatment (NT) within 6 months after CaP diagnosis. Methods and Materials: The study population included 10,179 men aged 65 years and older with incident CaP diagnosed between 1999 and 2001. Using the linked Ohio Cancer Incidence Surveillance System, Medicare, and death certificate files, overall and disease-specific survival through 2005 among the five clinically accepted therapies were analyzed. Results: Disease-specific survival rates were 92.3% and 23.9% for patients with localized vs. distant disease at 7 years, respectively. Controlling for age, race, comorbidities, stage, and Gleason score, results from the Cox multiple regression models indicated that the risk of CaP-specific death was significantly reduced in patients receiving RP or BT, compared with NT. For localized disease, compared with NT, in the monotherapy cohort, RP and BT were associated with reduced hazard ratios (HR) of 0.25 and 0.45 (95% confidence intervals 0.13-0.48 and 0.23-0.87, respectively), whereas in the combination therapy cohort, HR were 0.40 (0.17-0.94) and 0.46 (0.27-0.80), respectively. Conclusions: The present population-based study indicates that RP and BT are associated with improved survival outcomes. Further studies are warranted to improve clinical determinates in the selection of appropriate management of CaP and to improve predictive modeling for which patient subsets may benefit most from definitive therapy vs. conservative management and/or observation.

  8. Mothers' birth weight and survival of their offspring: population based study.

    PubMed Central

    Skjaerven, R.; Wilcox, A. J.; Oyen, N.; Magnus, P.

    1997-01-01

    OBJECTIVE: To test the hypothesis that a baby's survival is related to the mother's birth weight. DESIGN: Population based dataset for two generations. SETTING: Population registry in Norway. SUBJECTS: All birth records for women born in Norway since 1967 were linked to births during 1981-94, thereby forming 105104 mother-offspring units. MAIN OUTCOME MEASURES: Perinatal mortality specific for weight for offspring in groups of maternal birth weight (with 500 g categories in both). RESULTS: A mother's birth weight was strongly associated with the weight of her baby. Maternal birth weight was associated with perinatal survival of her baby only for mothers with birth weights under 2000 g. These mothers were more likely to lose a baby in the perinatal period (odds ratio 2.3, 95% confidence interval 1.4 to 3.7). Among mothers with a birth weight over 2000 g there was no overall association between mother's weight and infant survival. There was, however, a strong interaction between mother's birth weight, infant birth weight, and infant survival. Mortality among small babies was much higher for those whose mothers had been large at birth. For example, babies weighing 2500-2999 g had a threefold higher mortality if their mother's birth weight had been high (> or = 4000 g) than if the mother had been small (2500-2999 g). CONCLUSION: Mothers who weighed less than 2000 g at birth have a higher risk of losing their own babies. For mothers who weighed > or = 2000 g their birth weight provides a benchmark for judging the growth of their offspring. Babies who are small relative to their mother's birth weight are at increased risk of mortality. PMID:9161309

  9. Early Cognitive Deficits in Type 2 Diabetes: A Population-Based Study

    PubMed Central

    Marseglia, Anna; Fratiglioni, Laura; Laukka, Erika J.; Santoni, Giola; Pedersen, Nancy L.; Bäckman, Lars; Xu, Weili

    2016-01-01

    Evidence links type 2 diabetes to dementia risk. However, our knowledge on the initial cognitive deficits in diabetic individuals and the factors that might promote such deficits is still limited. This study aimed to identify the cognitive domains initially impaired by diabetes and the factors that play a role in this first stage. Within the population-based Swedish National Study on Aging and Care–Kungsholmen, 2305 cognitively intact participants aged ≥60 y were identified. Attention/working memory, perceptual speed, category fluency, letter fluency, semantic memory, and episodic memory were assessed. Diabetes (controlled and uncontrolled) and prediabetes were ascertained by clinicians, who also collected information on vascular disorders (hypertension, heart diseases, and stroke) and vascular risk factors (VRFs, including smoking and overweight/obesity). Data were analyzed with linear regression models. Overall, 196 participants (8.5%) had diabetes, of which 144 (73.5%) had elevated glycaemia (uncontrolled diabetes); 571 (24.8%) persons had prediabetes. In addition, diabetes, mainly uncontrolled, was related to lower performance in perceptual speed (β – 1.10 [95% CI – 1.98, – 0.23]), category fluency (β – 1.27 [95% CI – 2.52, – 0.03]), and digit span forward (β – 0.35 [95% CI – 0.54, – 0.17]). Critically, these associations were present only among APOE ɛ4 non–carriers. The associations of diabetes with perceptual speed and category fluency were present only among participants with VRFs or vascular disorders. Diabetes, especially uncontrolled diabetes, is associated with poorer performance in perceptual speed, category fluency, and attention/primary memory. VRFs, vascular disorders, and APOE status play a role in these associations. PMID:27314527

  10. Heterogeneity of nutritional habits of Lithuanian ethnolinguistic groups: population-based study

    PubMed Central

    Audronė, Jakaitienė; Donatas, Austys; Neringa, Burokienė; Vytautas, Kasiulevičius; Rimantas, Stukas; Vaidutis, Kučinskas

    2016-01-01

    Background. Lithuania is a Northern European country consisting of two main ethnolinguistic groups: Samogitians and Highlanders. The objective of the paper is to investigate differences in nutritional habits of 18–65-year-old Lithuanians living in different ethnolinguistic regions. Materials and methods. A representative, population-based, random sample of the 18–65-year-old ethnic Lithuanian population was interviewed from 17 December 2008 to 20 May 2013. Lithuanians living in their ethnolinguistic region for at least three generations were included (n = 1,133). We analysed responses to 12 questions about nutritional habits of respondents. For the univariate analysis, we applied the chi-squared test. For the clusterisation of the survey questions, we employed a multiple correspondence analysis (MCA). Results. Comparing Samogitians’ and Highlanders’ responses according to their gender, education, and place of residence, we observed more often significant differences (p < 0.05) for the urban population, respondents without higher education, and women. The nutrition of Highlanders was more consistent with national and WHO nutritional recommendations. Significant differences were obtained in the consumption of fish (p = 1.9 · 10–12), milk (p = 1.8 · 10–4) and grain products (p = 0.01). MCA revealed that all questions fall into three groups with a different composition for Samogitians and Highlanders. We failed to demonstrate the impact of different nutritional habits on the body mass index. Conclusions. According to the univariate and multivariate analysis, the nutritional habits of Lithuanian ethnolinguistic regions are heterogeneous. Dependency on an ethnolinguistic region might be considered an important factor for the preparation of appropriate health and nutrition education and disease prevention programmes. The issue of excess weight remains equally important for both ethnolinguistic groups. PMID:28356793

  11. Physical comorbidities in men with mood and anxiety disorders: a population-based study

    PubMed Central

    2013-01-01

    Background The mind-body nexus has been a topic of growing interest. Further data are however required to understand the specific relationship between mood and anxiety disorders and individual physical health conditions, and to verify whether these psychiatric disorders are linked to overall medical burden. Methods This study examined data collected from 942 men, 20 to 97 years old, participating in the Geelong Osteoporosis Study. A lifetime history of mood and anxiety disorders was identified using the Structured Clinical Interview for DSM-IV-TR Research Version, Non-patient edition (SCID-I/NP). The presence of medical conditions (lifetime) was self-reported and confirmed by medical records, medication use or clinical data. Anthropometric measurements and socioeconomic status (SES) were determined and information on medication use and lifestyle was obtained via questionnaire. Logistic regression models were used to test the associations. Results After adjustment for age, socioeconomic status, and health risk factors (body mass index, physical activity and smoking), mood disorders were associated with gastro oesophageal reflux disease (GORD), recurrent headaches, blackouts and/or epilepsy, liver disorders and pulmonary disease in older people, whilst anxiety disorders were significantly associated with thyroid, GORD and other gastrointestinal disorders, and psoriasis. Increased odds of high medical burden were associated with both mood and anxiety disorders. Conclusions Our study provides further population-based evidence supporting the link between mental and physical illness in men. Understanding these associations is not only necessary for individual management, but also to inform the delivery of health promotion messages and health care. PMID:23618390

  12. Population-based medical and disease management: an evaluation of cost and quality.

    PubMed

    Wise, Christopher G; Bahl, Vinita; Mitchell, Rita; West, Brady T; Carli, Thomas

    2006-02-01

    Reports by the Institute of Medicine and the Health Care Financing Administration have emphasized that the integration of medical care delivery, evidence-based medicine, and chronic care disease management may play a significant role in improving the quality of care and reducing medical care costs. The specific aim of this project is to assess the impact of an integrated set of care coordination tools and chronic disease management interventions on utilization, cost, and quality of care for a population of beneficiaries who have complementary health coverage through a plan designed to apply proactive medical and disease management processes. The utilization of health care services by the study population was compared to another population from the same geographic service area and covered by a traditional fee-for-service indemnity insurance plan that provided few medical or disease management services. Evaluation of the difference in utilization was based on the difference in the cost per-member-per-month (PMPM) in a 1-year measurement period, after adjusting for differences in fee schedules, case-mix and healthcare benefit design. After adjustments for both case-mix and benefit differences, the study group is $63 PMPM less costly than the comparison population for all members. Cost differences are largest in the 55-64 and 65 and above age groups. The study group is $115 PMPM lower than the comparison population for the age category of 65 years and older, after adjustments for case-mix and benefits. Health Plan Employer and Data Information Set (HEDIS)-based quality outcomes are near the 90th percentile for most indications. The cost outcomes of a population served by proactive, population-based disease management and complex care management, compared to an unmanaged population, demonstrates the potential of coordinated medical and disease management programs. Further studies utilizing appropriate methodologies would be beneficial.

  13. Dietary Pattern and Risk of Hodgkin Lymphoma in a Population-Based Case-Control Study

    PubMed Central

    Epstein, Mara M.; Chang, Ellen T.; Zhang, Yawei; Fung, Teresa T.; Batista, Julie L.; Ambinder, Richard F.; Zheng, Tongzhang; Mueller, Nancy E.; Birmann, Brenda M.

    2015-01-01

    Classic Hodgkin lymphoma (cHL) has few known modifiable risk factors, and the relationship between diet and cHL risk is unclear. We performed the first investigation of an association between dietary pattern and cHL risk in 435 cHL cases and 563 population-based controls from Massachusetts and Connecticut (1997–2000) who completed baseline diet questionnaires. We identified 4 major dietary patterns (“vegetable,” “high meat,” “fruit/low-fat dairy,” “desserts/sweets”) using principal components analysis. We computed multivariable odds ratios and 95% confidence intervals for associations of dietary pattern score (quartiles) with younger-adult (age <50 years), older-adult (age ≥50 years), and overall cHL risk. Secondary analyses examined associations by histological subtype and tumor Epstein-Barr virus (EBV) status. A diet high in desserts/sweets was associated with younger-adult (odds ratio(quartile 4 vs. quartile 1) = 1.60, 95% confidence interval: 1.05, 2.45; Ptrend = 0.008) and EBV-negative, younger-adult (odds ratio = 2.11, 95% confidence interval: 1.31, 3.41; Ptrend = 0.007) cHL risk. A high meat diet was associated with older-adult (odds ratio = 3.34, 95% confidence interval: 1.02, 10.91; Ptrend = 0.04) and EBV-negative, older-adult (odds ratio = 4.64, 95% confidence interval: 1.03, 20.86; Ptrend = 0.04) cHL risk. Other dietary patterns were not clearly associated with cHL. We report the first evidence for a role of dietary pattern in cHL etiology. Diets featuring high intake of meat or desserts and sweets may increase cHL risk. PMID:26182945

  14. Excess weight and abdominal obesity in postmenopausal Brazilian women: a population-based study

    PubMed Central

    2013-01-01

    Background The menopause is associated with a tendency to gain weight. Several alterations in fat deposits occur, leading to changes in the distribution of body fat. There are strong indications that, in middle age, obesity is associated with increased mortality. This study set out to determine the factors associated with the prevalence of overweight and abdominal obesity in postmenopausal women in a population-based study in Brazil. Methods The sample included 456 women, aged 45–69 years, residing in the urban area of Maringa, Parana. Systematic sampling, with a probability proportional to the size of the census sector, was performed. Behavioral, economic, and sociodemographic data were collected, and body mass index (BMI) and waist circumference (WC) were determined. Results According to BMI criteria (≥25.0 kg/m2), 72.6% of the women were overweight, and according to WC (≥88 cm), 63.6% had abdominal obesity. Based on logistic regression analysis, the factors that were most closely associated with overweight were: having three or more children (odds ratio (OR): 1.78; 95% confidence interval (CI): 1.06–3.00); and not taking hormone replacement therapy (OR: 1.69; 95% CI: 1.06–2.63). The prevalence of abdominal obesity was positively associated with greater parity (OR: 1.34, 95% CI: 1.05–1.72) and age older than 65 years (OR: 1.50; 95% CI: 1.03–2.19). Conclusions This study found that the prevalences of overweight and abdominal obesity were higher for postmenopausal women who had three or more children. Age over 65 years was also a risk factor for abdominal obesity and no use of hormonal replacement therapy was a risk factor for overweight. PMID:24228934

  15. Inappropriate asthma therapy—a tale of two countries: a parallel population-based cohort study

    PubMed Central

    Belhassen, Manon; Nibber, Anjan; Van Ganse, Eric; Ryan, Dermot; Langlois, Carole; Appiagyei, Francis; Skinner, Derek; Laforest, Laurent; Soriano, Joan B; Price, David

    2016-01-01

    Against recurrent controversies around the safety of short- and long-acting β2-agonists (SABA and LABA), and the National Review of Asthma Deaths inquiry in the United Kingdom, we investigated the prevalence of inappropriate therapy in asthma. Our study aimed to determine the prevalence of inappropriate use of asthma therapy in the United Kingdom and in France. Two interval, parallel, population-based cohorts (2007 and 2013) were developed in each cou