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Sample records for adults prospective cohort

  1. Functional prognosis of dizziness in older adults in primary care: a prospective cohort study.

    NARCIS (Netherlands)

    Dros, J.; Maarsingh, O.R.; Beem, L.; Horst, H.E. van der; Riet, G. ter; Schellevis, F.G.; Weert, H.C.P.M. van

    2012-01-01

    Objectives: To investigate the 6-month functional prognosis of dizziness in older adults in primary care, to identify important predictors of dizziness-related impairment, and to construct a score to assist risk prediction. Design: Prospective cohort study with 6-month follow-up. Setting: Twenty-fou

  2. Functional prognosis of dizziness in older adults in primary care: a prospective cohort study.

    OpenAIRE

    Dros, J.; Maarsingh, O.R.; Beem, L.; van der Horst, H.E.; Riet, G. ter; Schellevis, F G; van Weert, H.C.P.M.

    2012-01-01

    Objectives: To investigate the 6-month functional prognosis of dizziness in older adults in primary care, to identify important predictors of dizziness-related impairment, and to construct a score to assist risk prediction. Design: Prospective cohort study with 6-month follow-up. Setting: Twenty-four primary care practices in the Netherlands. Participants: Four hundred seventeen older adults (mean age 78.5, range 65–95, 74% female) presenting consecutively to primary care with dizziness. Meas...

  3. Incidence of asthma and mortality in a cohort of young adults: a 7-year prospective study

    OpenAIRE

    Bugianio Massimilian; Cazzoletti Lucia; Locatelli Francesca; Marco Roberto; Carosso Aurelia; Marinoni Alessandra

    2005-01-01

    Abstract Background Few longitudinal data exist on the incidence of asthma in young adults and on the overall mortality risk due to asthma. A 7-year follow-up prospective study was performed to assess the incidence of asthma and mortality from all causes in a cohort of young adults. Methods The life status of a cohort of 6031 subjects, aged 20–44 years, who replied to a respiratory screening questionnaire between 1991 and 1992, was ascertained in 1999. A new questionnaire investigating the hi...

  4. Major dietary patterns and risk of frailty in older adults: a prospective cohort study

    OpenAIRE

    León-Muñoz, Luz M.; García-Esquinas, Esther; López-García, Esther; Banegas, José R; Rodríguez-Artalejo, Fernando

    2015-01-01

    Background There is emerging evidence of the role of certain nutrients as risk factors for frailty. However, people eat food, rather than nutrients, and no previous study has examined the association between dietary patterns empirically derived from food consumption and the risk of frailty in older adults. Methods This is a prospective cohort study of 1,872 non-institutionalized individuals aged ≥60 years recruited between 2008 and 2010. At baseline, food consumption was obtained with a valid...

  5. Incidence of Dengue Virus Infection in Adults and Children in a Prospective Longitudinal Cohort in the Philippines.

    OpenAIRE

    Maria Theresa Alera; Anon Srikiatkhachorn; John Mark Velasco; Tac-An, Ilya A.; Catherine B Lago; Hannah E Clapham; Stefan Fernandez; Levy, Jens W; Butsaya Thaisomboonsuk; Chonticha Klungthong; Macareo, Louis R.; Ananda Nisalak; Laura Hermann; Daisy Villa; In-Kyu Yoon

    2016-01-01

    The mean age of dengue has been increasing in some but not all countries. We sought to determine the incidence of dengue virus (DENV) infection in adults and children in a prospective cohort study in the Philippines where dengue is hyperendemic.A prospective cohort of subjects ≥6 months old in Cebu City, Philippines, underwent active community-based surveillance for acute febrile illnesses by weekly contact. Fever history within the prior seven days was evaluated with an acute illness visit f...

  6. Incidence of Dengue Virus Infection in Adults and Children in a Prospective Longitudinal Cohort in the Philippines

    OpenAIRE

    Maria Theresa Alera; Anon Srikiatkhachorn; John Mark Velasco; Ilya A Tac-An; Lago, Catherine B.; Clapham, Hannah E; Stefan Fernandez; Levy, Jens W.; Butsaya Thaisomboonsuk; Chonticha Klungthong; Macareo, Louis R.; Ananda Nisalak; Laura Hermann; Daisy Villa; In-Kyu Yoon

    2016-01-01

    Background The mean age of dengue has been increasing in some but not all countries. We sought to determine the incidence of dengue virus (DENV) infection in adults and children in a prospective cohort study in the Philippines where dengue is hyperendemic. Methodology/Principal Findings A prospective cohort of subjects ≥6 months old in Cebu City, Philippines, underwent active community-based surveillance for acute febrile illnesses by weekly contact. Fever history within the prior seven days ...

  7. Incidence of asthma and mortality in a cohort of young adults: a 7-year prospective study

    Directory of Open Access Journals (Sweden)

    Bugianio Massimilian

    2005-08-01

    Full Text Available Abstract Background Few longitudinal data exist on the incidence of asthma in young adults and on the overall mortality risk due to asthma. A 7-year follow-up prospective study was performed to assess the incidence of asthma and mortality from all causes in a cohort of young adults. Methods The life status of a cohort of 6031 subjects, aged 20–44 years, who replied to a respiratory screening questionnaire between 1991 and 1992, was ascertained in 1999. A new questionnaire investigating the history of asthma was subsequently sent to the 5236 subjects who were still alive and residents in the areas of the study. 3880 subjects (74% replied to the second questionnaire. Results The incidence of adult-onset asthma was 15.3/10,000/year (95%CI:11.2–20.8. The presence of asthma-like symptoms (IRR:4.17; 95%CI:2.20–7.87 and allergic rhinitis (IRR:3.30; 95%CI:1.71–6.36 at baseline were independent predictors of the onset of asthma, which was more frequent in women (IRR:2.32; 95%CI:1.16–4.67 and increased in the younger generations. The subjects who reported asthma attacks or nocturnal asthma symptoms at baseline had an excess mortality risk from all causes (SMR = 2.05; 95%CI:1.06–3.58 in the subsequent seven years. The excess mortality was mainly due to causes not related to respiratory diseases. Conclusion Asthma occurrence is a relevant public health problem even in young adults. The likelihood of developing adult onset asthma is significantly higher in people suffering from allergic rhinitis, in women and in more recent generations. The presence of asthma attacks and nocturnal symptoms seems to be associated with a potential excess risk of all causes mortality.

  8. Computer use and stress, sleep disturbances, and symptoms of depression among young adults – a prospective cohort study

    OpenAIRE

    Thomée Sara; Härenstam Annika; Hagberg Mats

    2012-01-01

    Abstract Background We have previously studied prospective associations between computer use and mental health symptoms in a selected young adult population. The purpose of this study was to investigate if high computer use is a prospective risk factor for developing mental health symptoms in a population-based sample of young adults. Methods The study group was a cohort of young adults (n = 4163), 20–24 years old, who responded to a questionnaire at baseline and 1-year follow-up. Exposure va...

  9. Opium use and mortality in Golestan Cohort Study: prospective cohort study of 50 000 adults in Iran

    OpenAIRE

    Khademi, Hooman; Malekzadeh, Reza; Pourshams, Akram; Jafari, Elham; Salahi, Rasool; Semnani, Shahryar; Abaie, Behrooz; Islami, Farhad; Nasseri-Moghaddam, Siavosh; Etemadi, Arash; Byrnes, Graham; Abnet, Christian C.; Dawsey, Sanford M.; Day, Nicholas E; Pharoah, Paul D

    2012-01-01

    Objectives To investigate the association between opium use and subsequent risk of death. Design Prospective cohort study. Setting The Golestan Cohort Study in north-eastern Iran collected detailed validated data on opium use and other exposures at baseline. Participants were enrolled between January 2004 and June 2008 and were followed to May 2011, with a follow-up success rate of over 99%. Participants 50 045 participants aged 40-75 at baseline. Main outcomes Mortality, all cause and major ...

  10. Functional outcome in older adults with joint pain and comorbidity: design of a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Dekker Joost

    2011-10-01

    Full Text Available Abstract Background Joint pain is a highly prevalent condition in the older population. Only a minority of the older adults consult the general practitioner for joint pain, and during consultation joint pain is often poorly recognized and treated, especially when other co-existing chronic conditions are involved. Therefore, older adults with joint pain and comorbidity may have a higher risk of poor functional outcome and decreased quality of life (QoL, and possibly need more attention in primary care. The main purpose of the study is to explore functioning in older adults with joint pain and comorbidity, in terms of mobility, functional independence and participation and to identify possible predictors of poor functional outcome. The study will also identify predictors of decreased QoL. The results will be used to develop prediction models for the early identification of subgroups at high risk of poor functional outcome and decreased QoL. This may contribute to better targeting of treatment and to more effective health care in this population. Methods/Design The study has been designed as a prospective cohort study, with measurements at baseline and after 6, 12 and 18 months. For the recruitment of 450 patients, 25 general practices will be approached. Patients are eligible for participation if they are 65 years or older, have at least two chronic conditions and report joint pain on most days. Data will be collected using various methods (i.e. questionnaires, physical tests, patient interviews and focus groups. We will measure different aspects of functioning (e.g. mobility, functional independence and participation and QoL. Other measurements concern possible predictors of functioning and QoL (e.g. pain, co-existing chronic conditions, markers for frailty, physical performance, psychological factors, environmental factors and individual factors. Furthermore, health care utilization, health care needs and the meaning and impact of joint pain

  11. Mobile phone use and stress, sleep disturbances, and symptoms of depression among young adults - a prospective cohort study

    OpenAIRE

    Hagberg Mats; Härenstam Annika; Thomée Sara

    2011-01-01

    Abstract Background Because of the quick development and widespread use of mobile phones, and their vast effect on communication and interactions, it is important to study possible negative health effects of mobile phone exposure. The overall aim of this study was to investigate whether there are associations between psychosocial aspects of mobile phone use and mental health symptoms in a prospective cohort of young adults. Methods The study group consisted of young adults 20-24 years old (n ...

  12. Clinical and hepatic evaluation in adult dengue patients: a prospective two-month cohort study

    Directory of Open Access Journals (Sweden)

    Ricardo Tristão-Sá

    2012-12-01

    Full Text Available INTRODUCTION: To analyze the liver dysfunction and evolution of signs and symptoms in adult dengue patients during a two-month follow-up period. METHODS: A prospective cohort study was conducted in Campos dos Goytacazes, Rio de Janeiro, Brazil, from January to July, 2008. The evolution of laboratory and clinical manifestations of 90 adult dengue patients was evaluated in five scheduled visits within a two-month follow-up period. Twenty controls were enrolled for the analysis of liver function. Patients with hepatitis B, hepatitis C, those known to be human immunodeficiency virus (HIV seropositive and pregnant women were excluded from the study. RESULTS: At the end of the second month following diagnosis, we observed that symptoms persisted in 33.3% (30/90 of dengue patients. We also observed that, 57.7% (15/26 of the symptoms persisted at the end of the second month. The most persistent symptoms were arthralgia, fatigue, weakness, adynamia, anorexia, taste alteration, and hair loss. Prior dengue virus (DENV infection did not predispose patients to a longer duration of symptoms. Among hepatic functions, transaminases had the most remarkable elevation and in some cases remained elevated up to the second month after the disease onset. Alanine aminotransferase (ALT levels overcame aspartate aminotransferase (AST during the convalescent period. Male patients were more severely affected than females. CONCLUSIONS: Dengue fever may present a wide number of symptoms and elevated liver transaminases at the end of the second month.

  13. Arthritis in adults with community-acquired bacterial meningitis: a prospective cohort study

    NARCIS (Netherlands)

    M. Weisfelt; D. van de Beek; L. Spanjaard; J. de Gans

    2006-01-01

    Background: Although the coexistence of bacterial meningitis and arthritis has been noted in several studies, it remains unclear how often both conditions occur simultaneously. Methods: We evaluated the presence of arthritis in a prospective nationwide cohort of 696 episodes of community-acquired ba

  14. Disability in young people and adults after head injury: 12-14 year follow up of a prospective cohort

    OpenAIRE

    McMillan, T.; Teasdale, G; Stewart, Van E.

    2012-01-01

    Background: There is a need to establish how long term outcome evolves after head injury (HI) and factors related to this, to inform opportunities for intervention. Objective: To determine late outcome in adults 12-14 years after hospital admission for HI and to examine relationships between injury, early and late factors and disability. Methods: A prospective cohort with HI, whose outcome was reported previously at 1 and 5-7 years after injury were followed up after 12-14 years. P...

  15. Diabetes and Cause-Specific Mortality in a Prospective Cohort of One Million U.S. Adults

    OpenAIRE

    Campbell, Peter T.; Newton, Christina C.; Patel, Alpa V.; Jacobs, Eric J.; Gapstur, Susan M.

    2012-01-01

    OBJECTIVE Diabetes is a major predictor of death from heart disease and stroke; its impact on nonvascular mortality, including specific cancers, is less understood. We examined the association of diabetes with cause-specific mortality, including deaths from specific cancers. RESEARCH DESIGN AND METHODS A prospective cohort of 1,053,831 U.S. adults, without cancer at baseline, enrolled in the Cancer Prevention Study-II in 1982 and was followed for mortality until December 2008. At baseline, pa...

  16. Factors related to the mobility of hospitalized older adults: A prospective cohort study.

    Science.gov (United States)

    Zisberg, Anna; Syn-Hershko, Anat

    2016-01-01

    A low ambulation rate is common even among acutely ill hospitalized older adults. This prospective observational study conducted among 769 older adults (≥70) hospitalized in acute-care units tested the relationship of satisfaction with hospital environment, sleep-medication consumption, and in-hospital caloric intake to mobility levels during hospitalization on 3 consecutive hospitalization days. Approximately 20% of the patients did not walk, 30% walked only in their room, and 50% mobilized outside their room. A multinomial-logistic regression, controlling for potential intervening factors, showed that sleep-medication avoidance (AOR = 1.99; p walking outside the room from non-walking patients. Satisfaction with the physical environment was lower in the non-mobile group than in the other two. Results suggest that hospital environment, sleep-medication consumption, and caloric intake during hospitalization need to be addressed in attempts to improve in-hospital mobility in older adults. PMID:26597674

  17. Prospective associations between childhood low-level lead exposure and adult mental health problems: the Port Pirie cohort study.

    Science.gov (United States)

    McFarlane, Alexander C; Searle, Amelia K; Van Hooff, Miranda; Baghurst, Peter A; Sawyer, Michael G; Galletly, Cherrie; Sim, Malcolm R; Clark, Levina S

    2013-12-01

    Low-level environmental lead exposure during childhood is associated with poorer emotional/behavioural functioning in later childhood and adolescence. Scarce research has examined whether these apparent effects persist into adulthood. This study is the first to examine prospective associations between lead exposure across early childhood and several common adult mental health problems. Childhood data (including blood lead concentrations) and adult data (from mental health questionnaires and psychiatric interviews) were available for 210 participants (44% males, mean age=26.3 years) from the Port Pirie cohort study (1979-1982 birth cohort). Participants had a mean childhood (to 7 years) average blood lead concentration of 17.2μg/dL. Among females, childhood blood lead showed small significant positive associations with lifetime diagnoses of drug and alcohol abuse and social phobia, and with anxiety, somatic and antisocial personality problems. For example: for a 10μg/dL blood lead increase, females were 2.84 times (95% CI 1.10, 7.30) more likely to have an alcohol abuse diagnosis. However, adjustment for childhood covariates - particularly stimulation within the home environment - rendered these associations non-significant. No significant or sizeable unadjusted or adjusted associations were seen for males. The associations between early lead exposure and emotional/behavioural functioning in children might persist into adulthood, at least for females. However, it is unclear whether such results arise from residual confounding, or other mechanisms. Interventions that focus on improving the childhood home environment may have a long-term positive impact on adult mental health outcomes. However, more prospective research using large and representative samples is needed to substantiate these results. PMID:23958641

  18. Incidence of Dengue Virus Infection in Adults and Children in a Prospective Longitudinal Cohort in the Philippines.

    Directory of Open Access Journals (Sweden)

    Maria Theresa Alera

    2016-02-01

    Full Text Available The mean age of dengue has been increasing in some but not all countries. We sought to determine the incidence of dengue virus (DENV infection in adults and children in a prospective cohort study in the Philippines where dengue is hyperendemic.A prospective cohort of subjects ≥6 months old in Cebu City, Philippines, underwent active community-based surveillance for acute febrile illnesses by weekly contact. Fever history within the prior seven days was evaluated with an acute illness visit followed by 2, 5, and 8-day, and 3-week convalescent visits. Blood was collected at the acute and 3-week visits. Scheduled visits took place at enrolment and 12 months that included blood collections. Acute samples were tested by DENV PCR and acute/convalescent samples by DENV IgM/IgG ELISA to identify symptomatic infections. Enrolment and 12-month samples were tested by DENV hemagglutination inhibition (HAI assay to identify subclinical infections. Of 1,008 enrolled subjects, 854 completed all study activities at 12 months per-protocol undergoing 868 person-years of surveillance. The incidence of symptomatic and subclinical infections was 1.62 and 7.03 per 100 person-years, respectively. However, in subjects >15 years old, only one symptomatic infection occurred whereas 27 subclinical infections were identified. DENV HAI seroprevalence increased sharply with age with baseline multitypic HAIs associated with fewer symptomatic infections. Using a catalytic model, the historical infection rate among dengue naïve individuals was estimated to be high at 11-22%/year.In this hyperendemic area with high seroprevalence of multitypic DENV HAIs in adults, symptomatic dengue rarely occurred in individuals older than 15 years. Our findings demonstrate that dengue is primarily a pediatric disease in areas with high force of infection. However, the average age of dengue could increase if force of infection decreases over time, as is occurring in some hyperendemic

  19. Association between body mass index and mortality in a prospective cohort of Chinese adults.

    Science.gov (United States)

    Sun, Hao; Ren, Xiaoxia; Chen, Zhichao; Li, Chunsheng; Chen, Shuohua; Wu, Shouling; Chen, Youren; Yang, Xinchun

    2016-08-01

    Obesity is associated with an increased risk of diabetes mellitus, hypertension, and coronary artery disease; however, the relation between body mass index (BMI) and the risk of all-cause mortality is controversial. We prospectively examined the relationship between BMI and all-cause mortality in 123,384 Chinese men and women who participated in the Kailuan health examination study from 2006 to 2007 and 2008 to 2009. Cases included 6218 deaths (5770 men and 448 women) that occurred during a mean follow-up period of 7.39 years. Relative risk was adjusted for factors such as age, serum lipid levels (ie, triglyceride, high-density lipoprotein, and low-density lipoprotein cholesterol), history of smoking and drinking, and physical activity, as well as a medical history of hypertension, diabetes, myocardial infarction, and stroke. Within the cohort, the lowest risk of all-cause mortality was seen among persons with a BMI of 24 to 28 kg/m in male, and the risk was elevated among persons with BMI levels lower or higher than that range. Moreover, all-cause mortality was greatest in the group with a BMI of <18.5 kg/m. In contrast, in female, a high BMI was associated with increased mortality, and a BMI of <18.5 kg/m was associated with the lowest risk. Further, a U-shaped association was seen between BMI and the risk of death from any cause among men and women, even after adjusting for confounding factors. In conclusion, underweight was associated with a substantially increased risk of all-cause mortality in males. The excess risk of all-cause mortality with a high BMI, however, was seen among females. PMID:27512844

  20. Computer use and stress, sleep disturbances, and symptoms of depression among young adults – a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Thomée Sara

    2012-10-01

    Full Text Available Abstract Background We have previously studied prospective associations between computer use and mental health symptoms in a selected young adult population. The purpose of this study was to investigate if high computer use is a prospective risk factor for developing mental health symptoms in a population-based sample of young adults. Methods The study group was a cohort of young adults (n = 4163, 20–24 years old, who responded to a questionnaire at baseline and 1-year follow-up. Exposure variables included time spent on computer use (CU in general, email/chat use, computer gaming, CU without breaks, and CU at night causing lost sleep. Mental health outcomes included perceived stress, sleep disturbances, symptoms of depression, and reduced performance due to stress, depressed mood, or tiredness. Prevalence ratios (PRs were calculated for prospective associations between exposure variables at baseline and mental health outcomes (new cases at 1-year follow-up for the men and women separately. Results Both high and medium computer use compared to low computer use at baseline were associated with sleep disturbances in the men at follow-up. High email/chat use was negatively associated with perceived stress, but positively associated with reported sleep disturbances for the men. For the women, high email/chat use was (positively associated with several mental health outcomes, while medium computer gaming was associated with symptoms of depression, and CU without breaks with most mental health outcomes. CU causing lost sleep was associated with mental health outcomes for both men and women. Conclusions Time spent on general computer use was prospectively associated with sleep disturbances and reduced performance for the men. For the women, using the computer without breaks was a risk factor for several mental health outcomes. Some associations were enhanced in interaction with mobile phone use. Using the computer at night and consequently losing

  1. Dietary fat intake and subsequent weight change in adults: results from the European Prospective Investigation into Cancer and Nutrition cohorts

    DEFF Research Database (Denmark)

    Forouhi, Nita G; Sharp, Stephen J; Du, Huaidong; van der A, Daphne L; Halkjaer, Jytte; Schulze, Matthias B; Tjønneland, Anne; Overvad, Kim; Jakobsen, Marianne Uhre; Boeing, Heiner; Buijsse, Brian; Palli, Domenico; Masala, Giovanna; Feskens, Edith J M; Sørensen, Thorkild I A; Wareham, Nicholas J

    2009-01-01

    weight divided by duration of follow-up). DESIGN: We analyzed data from 89,432 men and women from 6 cohorts of the EPIC (European Prospective Investigation into Cancer and Nutrition) study. Using country-specific food-frequency questionnaires, we examined the association between baseline fat intake...

  2. Incidence of hypertension in a prospective cohort study of adults from Porto, Portugal

    Directory of Open Access Journals (Sweden)

    Pereira Marta

    2012-11-01

    Full Text Available Abstract Background During the past 30 years, Portugal has been described as one of the countries with highest median blood pressure levels in Europe, but the incidence of hypertension is unknown. The aim of this study was to estimate the incidence of hypertension, according to socio-demographic characteristics and lifestyles. Methods A population-based cohort of randomly selected dwellers from Porto, Portugal, aged ≥18 years, was assembled in 1999–2003 (EPIPorto study and 796 hypertension-free individuals (62.6% women were reassessed after a median of 3.8 years. Hypertension was defined as blood pressure ≥140/90 mmHg and/or antihypertensive drug therapy. Incidence rate ratios (IRR were estimated using Poisson regression. Results The overall incidence rate was 47.3 [95% confidence interval (95% CI: 40.5-55.5] per 1000 person-years. Among women, the incidence was 43.4 (35.6-53.1 and among men 52.7 (41.3-68.0 per 1000 person-years. The incidence was lower in women up to 60 years and much higher among women above 60 (110.0 vs. 64.4 per 1000 person-years among men, p for age-sex interaction=0.032. Participants with higher education had a lower risk of becoming hypertensive (≥13 years vs. ≤4 years: RR=0.70, 95% CI, 0.46-1.08, p for linear trend Conclusions In this urban Portuguese population the incidence rate of hypertension was high, with new cases occurring predominantly among older subjects, the less educated and those with overweight-obesity. Despite recent progresses in blood pressure related outcomes, the risk of hypertension remains higher in Portugal than in other developed countries.

  3. Predictors of changes in physical activity in a prospective cohort study of the Danish adult population

    DEFF Research Database (Denmark)

    Zimmermann, Esther; Ekholm, Ola; Grønbaek, Morten;

    2008-01-01

    AIM: To investigate predictors of changes in physical activity, in a prospective population-based study. METHODS: Data were from the Danish Health Interview Surveys in 1994 and 2000, and included persons between 16 and 64 years of age who answered the questions on physical activity and various...... interval (CI) 1.24-3.48, and OR 2.23, 95% CI 1.34-3.71), poor self-rated health (OR 2.11, 95% CI 1.25-3.58, and OR 1.75, 95% CI 1.10-2.80), and believing that one's own effort has no effect on health (OR 1.86, 95% CI 1.20-2.88, and OR 1.63, 95% CI 1.00-2.65). For men, further predictors for physical...... inactivity were obesity as compared to normal weight (OR 2.10, 95% CI 1.11-3.98), and being unmarried as compared to being married (OR 2.22, 95% CI 1.40-3.51). The only predictor for becoming physically active among initially sedentary respondents was meeting often with family (p=0.011). CONCLUSIONS: Our...

  4. Healthcare Resource Utilisation Associated with Herpes Zoster in a Prospective Cohort of Older Australian Adults

    Science.gov (United States)

    Karki, Surendra; Newall, Anthony T.; MacIntyre, C. Raina; Heywood, Anita E.; McIntyre, Peter; Banks, Emily; Liu, Bette

    2016-01-01

    Background Herpes zoster (HZ) is a common condition that increases in incidence with older age but vaccines are available to prevent the disease. However, there are limited data estimating the health system burden attributable to herpes zoster by age. Methods In this study, we quantified excess healthcare resource usage associated with HZ during the acute/sub-acute period of disease (21days before to 90 days after onset) in 5952 cases and an equal number of controls matched on age, sex, and prior healthcare resource usage. Estimates were adjusted for potential confounders in multivariable regression models. Using population-based estimates of HZ incidence, we calculated the age-specific excess number of health service usage events attributable to HZ in the population. Results Per HZ case, there was an average of 0.06 (95% CI 0.04–0.08) excess hospitalisations, 1.61 (95% CI 1.51–1.69) excess general practitioner visits, 1.96 (95% CI 1.86–2.15) excess prescriptions filled and 0.11 (95% CI 0.09–0.13) excess emergency department visits. The average number of healthcare resource use events, and the estimated excess per 100,000 population increased with increasing age but were similar for men and women, except for higher rates of hospitalisation in men. The excess annual HZ associated burden of hospitalisations was highest in adults ≥80 years (N = 2244, 95%CI 1719–2767); GP visits was highest in those 60–69 years (N = 50567, 95%CI 39958–61105), prescriptions and ED visits were highest in 70–79 years (N = 50524, 95%CI 40634–60471 and N = 2891, 95%CI 2319–3449 respectively). Conclusions This study provides important data to establish the healthcare utilisation associated with HZ against which detailed cost-effectiveness analyses of HZ immunisation in older adults can be conducted. PMID:27483007

  5. Retention in Care of Adult HIV Patients Initiating Antiretroviral Therapy in Tigray, Ethiopia: A Prospective Observational Cohort Study

    OpenAIRE

    Bucciardini, Raffaella; Fragola, Vincenzo; Abegaz, Teshome; Lucattini, Stefano; Halifom, Atakilt; Tadesse, Eskedar; Berhe, Micheal; Pugliese, Katherina; Binelli, Andrea; De Castro, Paola; Terlizzi, Roberta; Fucili, Luca; Di Gregorio, Massimiliano; Mirra, Marco; Olivieri, Erika

    2015-01-01

    Introduction Although Ethiopia has been scaling up the antiretroviral therapy (ART) services, low retention in care of patients remains one of the main obstacles to treatment success. We report data on retention in care and its associated determinants in Tigray, Ethiopia. Methods We used data from the CASA project, a prospective observational and multi-site study of a cohort of HIV-infected patients who initiated ART for the first time in Tigray. Four participating health facilities (HFs) loc...

  6. A prospective cohort study of latent tuberculosis in adult close contacts of active pulmonary tuberculosis patients in Korea

    Science.gov (United States)

    Park, Sun Hyo; Lee, Seung Jun; Cho, Yu Ji; Jeong, Yi Yeong; Kim, Ho Cheol; Lee, Jong Deog; Kim, Hee Jin; Menzies, Dick

    2016-01-01

    Background/Aims: The objective of this prospective study was to evaluate the diagnosis and treatment of latent tuberculosis infection (LTBI) in adult close contacts of active pulmonary tuberculosis (TB) patients in Korea. Methods: Adult close contacts of active pulmonary TB patients were recruited at a regional tertiary hospital in Korea. The participants were tested for LTBI using the tuberculin skin test (TST) and/or QuantiFERON-TB Gold (QFT-G) test. LTBI patients, who consented to treatment, were randomly assigned to receive isoniazid for 9 months (9INH) or rifampin for 4 months (4RIF). Results: We examined 189 adult close contacts (> 18 years) of 107 active pulmonary TB patients. The TST and QFT-G were positive (≥ 10 mm) in 75/183 (39.7%) and 45/118 (38.1%) tested participants, respectively. Among 88 TST or QFT-G positive LTBI participants, 45 participants were randomly assigned to receive 4RIF (n = 21) or 9INH (n = 24), respectively. The average treatment duration for the 4RIF and 9INH groups was 3.3 ± 1.3 and 6.1 ± 2.7 months, respectively. Treatment was completed in 25 participants (4RIF, n = 16; 9INH, n = 9). LTBI participants who accepted treatment were more likely to be women and have more cavitary lesions on the chest radiographs of index cases and positive TST and QFT-G results compared to those who refused treatment. Conclusions: About 40% of adult close contacts of active pulmonary TB patients had LTBI; about 50% of these LTBI participants agreed to treatment. PMID:27052266

  7. The influence of housing characteristics on leisure-time sitting. A prospective cohort study in Danish adults

    DEFF Research Database (Denmark)

    Saidj, Madina; Jørgensen, Torben; Jacobsen, Rikke Kart; Linneberg, Allan; Aadahl, Mette

    2015-01-01

    OBJECTIVE: Built environmental attributes have been studied in relation to domestic time spent sedentary. An indoor behaviour has thus been linked to an outdoor setting. Yet, attributes of the actual domestic environment may also influence the time spent sedentary at home. Therefore, the aim was to...... household size), moderate-to-vigorous physical activity (MVPA) and socio-demographic factors. Leisure-time sitting was self-reported at baseline and 5-year follow-up. Multiple linear regression was used to assess cross-sectional and prospective associations. RESULTS: At baseline habitat surface area and...... housing characteristics. CONCLUSIONS: Habitat type, habitat surface area and household size were associated with leisure-time sitting in adults, while especially household size was a predictor of leisure-time sitting five years later. The findings highlight the importance of home-environmental attributes...

  8. Risk factors for medial meniscal pathology on knee MRI in older U.S. adults: A multicenter prospective cohort study

    Science.gov (United States)

    Englund, Martin; Felson, David T.; Guermazi, Ali; Roemer, Frank W.; Wang, Ke; Crema, Michel D.; Lynch, John A.; Sharma, Leena; Segal, Neil A; Lewis, Cora E.; Nevitt, Michael C.

    2016-01-01

    Objectives Knee trauma is a known cause of meniscal tear. However, meniscal pathology where the aetiology is often unclear is a frequent finding on knee magnetic resonance imaging (MRI).Our objective was to investigate potential risk factors for medial meniscal lesions or extrusion in middle-aged and elderly persons. Methods Prospective cohort study using population-based subjects from Birmingham, Alabama and Iowa City, Iowa, United States (the Multicenter Osteoarthritis Study (MOST)). We studied 644 men and women aged 50 to 79 years with or at high risk of knee osteoarthritis (Kellgren and Lawrence grade 0 to 2) but with normal medial meniscal status at baseline. We scored paired baseline and 30-month 1.0T knee MRIs for meniscal lesions and extrusion (pathology) and evaluated the following systemic, knee-specific, and compartment-specific potential risk factors: age, sex, body mass index, bony enlargement of finger joints, knee trauma, leg-length inequality, and knee alignment. Results Of 791 knees, 77 (9.7%) had medial meniscal pathology at 30-months follow-up. Sixty-one of these 77 knees (81%) had no report of trauma during follow-up. Including all potential risk factors in the multivariable model, the adjusted odds ratio (OR) for medial meniscal pathology was 4.14 (95% confidence interval 2.06, 8.31) for knee trauma during follow-up, 1.64 (1.00, 2.70) for ≥5 bony enlargements of finger joints (vs. ≤4), and 2.00 (1.18, 3.40) for varus alignment (vs. not varus) at baseline exam. Further, obesity was a risk factor for the development of meniscal extrusion, OR 3.04 (1.04, 8.93) but not for meniscal lesions, OR 1.15 (0.52, 2.54). Conclusions Apart from knee trauma, possible generalised osteoarthritis, expressed as multiple bony enlargements of finger joints, varus alignment, and obesity are risk factors for medial meniscal pathology. PMID:21646417

  9. Fruit and Vegetable Consumption and Changes in Anthropometric Variables in Adult Populations: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

    OpenAIRE

    Schwingshackl, Lukas; Hoffmann, Georg; Kalle-Uhlmann, Tamara; Arregui, Maria; Buijsse, Brian; Boeing, Heiner

    2015-01-01

    Background Randomized controlled trials provide conflicting results on the effects of increased fruit and vegetable consumption on changes in body weight. We aimed to perform a systematic review and meta-analysis of prospective cohort studies on fruit and vegetable consumption in relation to changes in anthropometric measures. Methods PubMed and EMBASE were searched up to July 2015 for prospective studies reporting on habitual fruit and/or vegetable consumption in relation to changes in body ...

  10. Understanding the Relationship between Type 2 Diabetes Mellitus and Falls in Older Adults: A Prospective Cohort Study

    OpenAIRE

    Tine Roman de Mettelinge; Dirk Cambier; Patrick Calders; Nele Van Den Noortgate; Kim Delbaere

    2013-01-01

    Background: Older adults with type 2 Diabetes Mellitus are at increased risk of falling. The current study aims to identify risk factors that mediate the relationship between diabetes and falls. Methods: 199 older adults (104 with diabetes and 95 healthy controls) underwent a medical screening. Gait (GAITRite (R)), balance (AccuGait (R) force plate), grip strength (Jamar (R)), and cognitive status (Mini-Mental State Examination and Clock Drawing Test) were assessed. Falls were prospectivel...

  11. The Developmental Mental-Disorder Histories of Adults With Posttraumatic Stress Disorder: A Prospective Longitudinal Birth Cohort Study

    OpenAIRE

    Koenen, Karestan C.; Moffitt, Terrie E; Caspi, Avshalom; Gregory, Alice; Harrington, HonaLee; Poulton, Richie

    2008-01-01

    Clinical and epidemiologic studies have established that posttraumatic stress disorder (PTSD) is highly comorbid with other mental disorders. However, such studies have largely relied on adults' retrospective reports to ascertain comorbidity. The authors examined the developmental mental health histories of adults with PTSD using data on mental disorders assessed across the first 3 decades of life among members of the longitudinal Dunedin Multidisciplinary Health and Development Study; 100% o...

  12. Prospective longitudinal study of frailty transitions in a community-dwelling cohort of older adults with cognitive impairment

    OpenAIRE

    Chong, Mei Sian; Tay, Laura; Chan, Mark; Lim, Wee Shiong; Ye, Ruijing; Tan, Eng King; Ding, Yew Yoong

    2015-01-01

    Background Frailty and cognitive impairment are seemingly distinct syndromes, but have a shared vulnerability to stress in older adults, resulting in poorer outcomes. Although there has been recent interest in cognitive frailty, frailty transitions in relation to cognitive deterioration in older adults with cognitive impairment have not yet been well studied. We thus aim to study frailty transitions and change in cognitive status over 1-year follow-up among subjects with cognitive impairment ...

  13. High rate of pneumococcal bacteremia in a prospective cohort of older children and adults in an area of high HIV prevalence in rural western Kenya

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    Oundo Joseph

    2010-06-01

    Full Text Available Abstract Background Although causing substantial morbidity, the burden of pneumococcal disease among older children and adults in Africa, particularly in rural settings, is not well-characterized. We evaluated pneumococcal bacteremia among 21,000 persons ≥5 years old in a prospective cohort as part of population-based infectious disease surveillance in rural western Kenya from October 2006-September 2008. Methods Blood cultures were done on patients meeting pre-defined criteria - severe acute respiratory illness (SARI, fever, and admission for any reason at a referral health facility within 5 kilometers of all 33 villages where surveillance took place. Serotyping of Streptococcus pneumoniae was done by latex agglutination and quellung reaction and antibiotic susceptibility testing was done using broth microdilution. We extrapolated incidence rates based on persons with compatible illnesses in the surveillance population who were not cultured. We estimated rates among HIV-infected persons based on community HIV prevalence. We projected the national burden of pneumococcal bacteremia cases based on these rates. Results Among 1,301 blood cultures among persons ≥5 years, 52 (4% yielded pneumococcus, which was the most common bacteria isolated. The yield was higher among those ≥18 years than 5-17 years (6.9% versus 1.6%, p 95%. The crude rate of pneumococcal bacteremia was 129/100,000 person-years, and the adjusted rate was 419/100,000 person-years. Nineteen (61% of 31 patients with HIV results were HIV-positive. The adjusted rate among HIV-infected persons was 2,399/100,000 person-years (Rate ratio versus HIV-negative adults, 19.7, 95% CI 12.4-31.1. We project 58,483 cases of pneumococcal bacteremia will occur in Kenyan adults in 2010. Conclusions Pneumococcal bacteremia rates were high among persons ≥5 years old, particularly among HIV-infected persons. Ongoing surveillance will document if expanded use of highly-active antiretroviral

  14. Determinants in adolescence for adult sickness absence in women and men : a 26-year follow-up of a prospective population based cohort (Northern Swedish cohort)

    OpenAIRE

    Mittendorfer-Rutz Ellenor; Hensing Gunnel; Westerlund Hugo; Backheden Magnus; Hammarström Anne

    2013-01-01

    Abstract Background To date little is known regarding how factors measured in adolescence predict sickness absence in adulthood, and whether different patterns of factors exist for women and men that could contribute to an explanation of adult gender differences in sickness absence. Methods All pupils in the last year of compulsory school in the municipality of Luleå with complete information from surveys (questionnaires) in 1981 and 1983 (compulsory and upper-secondary schooling; 16 and 18 y...

  15. Minimum incidence of adult invasive pneumococcal disease in Blantyre, Malawi an urban african setting: a hospital based prospective cohort study.

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    Naor Bar-Zeev

    Full Text Available Invasive pneumococcal disease causes substantial morbidity and mortality in Africa. Evaluating population level indirect impact on adult disease of pneumococcal conjugate vaccine (PCV programmes in infants requires baseline population incidence rates but these are often lacking in areas with limited disease surveillance. We used hospital based blood culture and cerebrospinal fluid surveillance to calculate minimal incidence of invasive pneumococcal disease in the adult (≥15 years old population of Blantyre, a rapidly growing urban centre in southern Malawi, in the period preceding vaccine introduction. Invasive pneumococcal disease incidence in Blantyre district was high, mean 58.1 (95% confidence interval (CI: 53.7, 62.7 per 100,000 person years and peaking among 35 to 40 year olds at 108.8 (95%CI: 89.0, 131.7 mirroring the population age prevalence of HIV infection. For pneumococcal bacteraemia in urban Blantyre, mean incidence was 60.6 (95% CI: 55.2, 66.5 per 100,000 person years, peaking among 35 to 40 year olds at 114.8 (95%CI: 90.3, 143.9. We suspected that our surveillance may under-ascertain the true burden of disease, so we used location data from bacteraemic subjects and projected population estimates to calculate local sub-district incidence, then examined the impact of community level socio-demographic covariates as possible predictors of local sub-district incidence of pneumococcal and non-pneumococcal pathogenic bacteraemia. Geographic heterogeneity in incidence was marked with localised hotspots but ward level covariates apart from prison were not associated with pneumococcal bacteraemia incidence. Modelling suggests that the current sentinel surveillance system under-ascertains the true burden of disease. We outline a number of challenges to surveillance for pneumococcal disease in our low-resource setting. Subsequent surveillance in the vaccine era will have to account for geographic heterogeneity when evaluating population

  16. Minimum incidence of adult invasive pneumococcal disease in Blantyre, Malawi an urban african setting: a hospital based prospective cohort study.

    Science.gov (United States)

    Bar-Zeev, Naor; Mtunthama, Neema; Gordon, Stephen B; Mwafulirwa, Gershom; French, Neil

    2015-01-01

    Invasive pneumococcal disease causes substantial morbidity and mortality in Africa. Evaluating population level indirect impact on adult disease of pneumococcal conjugate vaccine (PCV) programmes in infants requires baseline population incidence rates but these are often lacking in areas with limited disease surveillance. We used hospital based blood culture and cerebrospinal fluid surveillance to calculate minimal incidence of invasive pneumococcal disease in the adult (≥15 years old) population of Blantyre, a rapidly growing urban centre in southern Malawi, in the period preceding vaccine introduction. Invasive pneumococcal disease incidence in Blantyre district was high, mean 58.1 (95% confidence interval (CI): 53.7, 62.7) per 100,000 person years and peaking among 35 to 40 year olds at 108.8 (95%CI: 89.0, 131.7) mirroring the population age prevalence of HIV infection. For pneumococcal bacteraemia in urban Blantyre, mean incidence was 60.6 (95% CI: 55.2, 66.5) per 100,000 person years, peaking among 35 to 40 year olds at 114.8 (95%CI: 90.3, 143.9). We suspected that our surveillance may under-ascertain the true burden of disease, so we used location data from bacteraemic subjects and projected population estimates to calculate local sub-district incidence, then examined the impact of community level socio-demographic covariates as possible predictors of local sub-district incidence of pneumococcal and non-pneumococcal pathogenic bacteraemia. Geographic heterogeneity in incidence was marked with localised hotspots but ward level covariates apart from prison were not associated with pneumococcal bacteraemia incidence. Modelling suggests that the current sentinel surveillance system under-ascertains the true burden of disease. We outline a number of challenges to surveillance for pneumococcal disease in our low-resource setting. Subsequent surveillance in the vaccine era will have to account for geographic heterogeneity when evaluating population level indirect

  17. Incident and Risk Factor of Diabetes Mellitus in Adults at Bogor. Prospective Cohort Study Risk Factors Non Comunicable Diseases

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    Anna Maria Sirait

    2015-11-01

    Full Text Available Background: Diabetes mellitus (DM is a chronic progressive disease that can lead to various complications in other organs and becoming a serious public health problem. This analysis aimed to determine the incidence of diabetes, pre-diabetes and risk factors that influence the occurrence of DM. Methods: Respondents who did not have DM at baseline Cohort Study of Non-Communicable Diseases in 2011 were followed until 2013. They were interviewed with questionnaires, had physical examination (measuring height, weight, waist circumference, blood pressure and laboratory tests (fasting blood glucose, cholesterol, HDL, LDL and triglycerides in accordance with procedures. Respondents were said to suffer from diabetes if the fasting blood glucose levels ≥ 126 mg/dL or blood glucose levels after loading 75 g glucose ≥ 200 mg/dL and was diagnosed diabetes by health professionals. Pre diabetes categorized into impaired fasting glucose (IFG when fasting blood glucose levels (100–125 mg/dl and impared glucose tolerance (IGT when plasma glucose levels two hours after loading 75 g glucose 140–199 mg/dl. Result:Beseline respondents in 2011, was not suffering from diabetes and underwent a complete laboratory examination to follow-up in 2013 amounted to 1313 people. The incidence of diabetes is 3.5% and pre diabetes 18.4%. Multivariate logistic regression analysis demonstrated that central obesity (RR = 3.98; 95% CI: 1.86 to 8.55, Impaired Glucose Tolerance (RR = 3.49; 95% CI: 1.82 to 6.68, fasting blood sugar (RR = 3.35; 95% CI: 1.59 to 7.07, history of parental diabetes (RR = 2.41; 95% CI: 1.06 to 5.50, hypertension (RR = 1.88; 95% CI: 1.0 to 3.55 were risk factors that have a significant relationship with the occurrence of DM. Respondents with IFG and IGT has been changes into DM respectively by 13.5%; 10.4% after 2 years. Conclusion:the factor that most contribute to diabetes and IGT are central obesity, tasting blood glucose level

  18. Widespread pain and depression are key modifiable risk factors associated with reduced social participation in older adults: A prospective cohort study in primary care.

    OpenAIRE

    Wilkie, R.; Blagojevic-Bucknall, M; Belcher, J.; Chew-Graham, C.; Lacey, RJ; McBeth, J

    2016-01-01

    In older adults, reduced social participation increases the risk of poor health-related quality of life, increased levels of inflammatory markers and cardiovascular disease, and increased mortality. Older adults frequently present to primary care, which offers the potential to deliver interventions at the point of care to increase social participation. The aim of this prospective study was to identify the key modifiable exposures that were associated with reduced social participation in a pri...

  19. Adult physical, sexual, and emotional abuse and postpartum depression, a population based, prospective study of 53,065 women in the Norwegian Mother and Child Cohort Study

    OpenAIRE

    Sørbø, Marie Flem; Grimstad, Hilde; Bjørngaard, Johan Håkon; Lukasse, Mirjam; Schei, Berit

    2014-01-01

    Background Postpartum depression (PPD) has detrimental consequences to the women, their infants and families. The aim of the present study was to assess the association between adult abuse and PPD. Methods This study was based on data from 53,065 pregnant women in the Norwegian Mother and Child Cohort Study (MoBa), conducted by the Norwegian Institute of Public Health. Women were recruited through a postal invitation in relation to a routine ultra-sound invitation at week 18 of gestation. Exp...

  20. Combined early and adult life risk factor associations for mid-life obesity in a prospective birth cohort: assessing potential public health impact

    Science.gov (United States)

    Pinto Pereira, Snehal M; van Veldhoven, Karin; Li, Leah; Power, Chris

    2016-01-01

    Objective The combined effect of life-course influences on obesity development and thus their potential public health impact is unclear. We evaluated combined associations and predicted probabilities for early and adult life risk factors with central and general obesity in mid-adulthood. Setting 1958 British birth cohort. Participants 4629 males and 4670 females with data on waist circumference. Outcome measures 45 year obesity measured via waist circumference, waist–hip ratio (WHR) and BMI. Results At 45 years, approximately a third of the population were centrally obese and a quarter were generally obese. Three factors (parental overweight, maternal smoking during pregnancy and adult inactivity) were consistently associated with central and general obesity. Predicted probabilities for waist obesity increased from those with none to all three risk factors (0.15–0.33 in men; 0.19–0.39 in women (ptrend<0.001)), with a similar trend for general obesity. Additional factors (adult smoking, low fibre and heavy alcohol consumption) were associated with WHR obesity, although varying by gender. Prevalence of risk factors was higher in manual than non-manual groups: for example, in men 38% versus 25%, respectively, had ≥2 risk factors for waist and general obesity. Conclusions Early-life and adult factors that are amenable to change are highly prevalent and accumulate in association with central and general obesity in mid-adulthood. The increase in probabilities for mid-adult obesity associated with cumulative levels of risk factors suggests the potential for public health impact. PMID:27072572

  1. The health and social situation of the mother during pregnancy and global quality of life of the child as an adult. Results from the prospective Copenhagen Perinatal Cohort 1959-1961

    Directory of Open Access Journals (Sweden)

    Søren Ventegodt

    2005-01-01

    Full Text Available A prospective cohort study (Copenhagen Perinatal Birth Cohort 1959-61 of 7,222 persons was used in order to explore the association between the social and health situation during pregnancy and the global quality of life (QOL of the adult child 31-33 years later. Two sets of questionnaires were used with one filled out by physicians during pregnancy and one filled out by the adult children 31-33 years later. The questionnaires included mother's situation during pregnancy and global QOL of the child at follow-up: Well-being, life satisfaction, happiness, fulfilment of needs, experience of life’s temporal and spatial domains, expression of life’s potentials and objective measures. The only indicators to have clear connections with a reduced quality of life were the cases of mother's with syphilis (8.5%, mother's congenital malformations (8.8%, low social group (6.9% and failing contraception (3.8%. The results obtained repudiate the common notion and hypothesis that the mother's situation during pregnancy is highly important for the quality of life that the child experience as an adult. This suggest that the aspects important for quality of life later on are not found solely in early conditions, but instead more dependent on later attitude towards life of that specific person.

  2. Tinned Fruit Consumption and Mortality in Three Prospective Cohorts

    OpenAIRE

    Aasheim, Erlend T.; Sharp, Stephen J.; Appleby, Paul N.; Shipley, Martin J.; Lentjes, Marleen A.H.; Kay-Tee Khaw; Eric Brunner; Key, Tim J.; Wareham, Nicholas J

    2015-01-01

    Dietary recommendations to promote health include fresh, frozen and tinned fruit, but few studies have examined the health benefits of tinned fruit. We therefore studied the association between tinned fruit consumption and mortality. We followed up participants from three prospective cohorts in the United Kingdom: 22,421 participants from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk cohort (1993-2012), 52,625 participants from the EPIC-Oxford cohort (1993-20...

  3. Longitudinal analysis of QuantiFERON-TB Gold In-Tube in children with adult household tuberculosis contact in South Africa: a prospective cohort study.

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    Maunank Shah

    Full Text Available BACKGROUND: QuantiFERON-TB Gold In Tube (QFT-GIT is a tool for detecting M. tuberculosis infection. However, interpretation and utility of serial QFT-GIT testing of pediatric tuberculosis (TB contacts is not well understood. We compared TB prevalence between baseline and 6 months follow-up using QFT-GIT and tuberculin skin testing (TST in children who were household contacts of adults with pulmonary TB in South Africa, and explored factors associated with QFT-GIT conversions and reversions. METHOD: Prospective study with six month longitudinal follow-up. RESULTS: Among 270 enrolled pediatric contacts, 196 (73% underwent 6-month follow-up testing. The 6-month prevalence estimate of MTB infection in pediatric contacts increased significantly from a baseline of 29% (79/270, 95%CI [24-35] to 38% (103/270, 95% CI [32-44], p10 years (AOR 8.9 95%CI [1.1-72] and baseline TST positivity ≥5 mm (AOR 5.2 95%CI [1.2-23] were associated with QFT-GIT conversion. Among 62 children with a positive baseline QFT-GIT, 9 (15% reverted to negative; female gender (AOR 18.5 95%CI [1.1-321]; p = 0.04] was associated with reversion, while children with baseline positive TST were less likely to have QFT-GIT reversion (AOR 0.01 95%CI [0.001-0.24]. CONCLUSION: Among pediatric contacts of adult household TB cases in South Africa, prevalence estimates of TB infection increased significantly from baseline to 6 months. Conversions and reversions occurred among pediatric TB contacts using QFT-GIT, but QFT-GIT conversion rates were less influenced by thresholds used for conversions than were TST conversion rates.

  4. Predictive Validity of the American College of Cardiology/American Heart Association Pooled Cohort Equations in Predicting All-Cause and Cardiovascular Disease-Specific Mortality in a National Prospective Cohort Study of Adults in the United States.

    Science.gov (United States)

    Loprinzi, Paul D; Addoh, Ovuokerie

    2016-06-01

    The predictive validity of the Pooled Cohort risk (PCR) equations for cardiovascular disease (CVD)-specific and all-cause mortality among a national sample of US adults has yet to be evaluated, which was this study's purpose. Data from the 1999-2010 National Health and Nutrition Examination Survey were used, with participants followed up through December 31, 2011, to ascertain mortality status via the National Death Index probabilistic algorithm. The analyzed sample included 11,171 CVD-free adults (40-79 years of age). The 10-year risk of a first atherosclerotic cardiovascular disease (ASCVD) event was determined from the PCR equations. For the entire sample encompassing 849,202 person-months, we found an incidence rate of 1.00 (95% CI, 0.93-1.07) all-cause deaths per 1000 person-months and an incidence rate of 0.15 (95% CI, 0.12-0.17) CVD-specific deaths per 1000 person-months. The unweighted median follow-up duration was 72 months. For nearly all analyses (unadjusted and adjusted models with ASCVD expressed as a continuous variable as well as dichotomized at 7.5% and 20%), the ASCVD risk score was significantly associated with all-cause and CVD-specific mortality (P<.05). In the adjusted model, the increased all-cause mortality risk ranged from 47% to 77% based on an ASCVD risk of 20% or higher and 7.5% or higher, respectively. Those with an ASCVD score of 7.5% or higher had a 3-fold increased risk of CVD-specific mortality. The 10-year predicted risk of a first ASCVD event via the PCR equations was associated with all-cause and CVD-specific mortality among those free of CVD at baseline. In this American adult sample, the PCR equations provide evidence of predictive validity. PMID:27180122

  5. Pre-existing type 2 diabetes and risk of lung cancer: a report from two prospective cohort studies of 133 024 Chinese adults in urban Shanghai

    OpenAIRE

    Yang, Wan-Shui; Yang, Yang; YANG, Gong; Chow, Wong-Ho; Li, Hong-Lan; Gao, Yu-Tang; Ji, Bu-Tian; Rothman, Nat; Zheng, Wei; Shu, Xiao-Ou; Xiang, Yong-Bing

    2014-01-01

    Objectives Observational studies of type 2 diabetes (T2D) and lung cancer risk are limited and controversial. We thus examined the association between T2D and risk of incident lung cancer using a cohort design. Setting Data from two ongoing population-based cohorts (the Shanghai Men's Health Study, SMHS, 2002–2006 and the Shanghai Women's Health Study, SWHS, 1996–2000) were used. Cox proportional-hazards regression models with T2D as a time-varying exposure were modelled to estimate HRs and 9...

  6. Relationship of serum methotrexate concentration in high-dose methotrexate chemotherapy to prognosis and tolerability: A prospective cohort study in chinese adults with osteosarcoma

    OpenAIRE

    Lin, Feng; Juan, Yue; Zheng, Shui-er; Shen, Zan; Tang, Li-Na; Hui ZHAO; Yao, Yang

    2009-01-01

    Background: Cancer that originates in the bone, termed primary bone cancer, is rare. Osteosarcoma (OS) occurs primarily in growing bone tissue and is more prevalent in children and adolescents. OS in adults is rare, with 3 to 5 cases per million population per year worldwide. There are limited data on treatment-related prognosis and adverse reactions in adults reported in the literature.

  7. Comparative Long-Term Effectiveness of a Monotherapy with Five Antiepileptic Drugs for Focal Epilepsy in Adult Patients: A Prospective Cohort Study

    OpenAIRE

    Zeng, Qing-Yi; Fan, Tian-Tian; Zhu, Pan; He, Ru-Qian; Bao, Yi-Xin; Zheng, Rong-Yuan; Xu, Hui-Qin

    2015-01-01

    Objective To evaluate and compare long-term effectiveness of five antiepileptic drugs (AEDs) for monotherapy of adult patients with focal epilepsy in routine clinical practice. Methods Adult patients with focal epilepsy, who were prescribed with carbamazepine (CBZ), valproate (VPA), lamotrigine (LTG), topiramate (TPM), or oxcarbazepine (OXC) as monotherapy, during the period from January 2004 to June 2012 registered in Wenzhou Epilepsy Follow Up Registry Database (WEFURD), were included in th...

  8. Prospective Memory Training in Older Adults.

    Science.gov (United States)

    Schmidt, Iris W.; Berg, Ina J.; Deelman, Betto G.

    2001-01-01

    Twenty adults received training in prospective memory; 23 who received training in reducing worries about forgetfulness and 22 controls formed a comparison group. Results of a telephone task and a prospective categorization task revealed significant but small effects for the prospective memory group. After 3 months, the comparison group's…

  9. Adherence to and effectiveness of an individually tailored home-based exercise program for frail older adults, driven by mobility monitoring : design of a prospective cohort study

    NARCIS (Netherlands)

    Geraedts, Hilde A. E.; Zijlstra, Wiebren; Zhang, Wei; Bulstra, Sjoerd; Stevens, Martin

    2014-01-01

    Background: With the number of older adults in society rising, frailty becomes an increasingly prevalent health condition. Regular physical activity can prevent functional decline and reduce frailty symptoms. In particular, home-based exercise programs can be beneficial in reducing frailty of older

  10. Hyperglycemia in bacterial meningitis: a prospective cohort study

    NARCIS (Netherlands)

    E.S. Schut; W.F. Westendorp; J. de Gans; N.D. Kruyt; L. Spanjaard; J.B. Reitsma; D. van de Beek

    2009-01-01

    ABSTRACT: BACKGROUND: Hyperglycemia has been associated with unfavorable outcome in several disorders, but few data are available in bacterial meningitis. We assessed the incidence and significance of hyperglycemia in adults with bacterial meningitis. METHODS: We collected data prospectively between

  11. Liver elasticity measurement before and after biliary drainage in patients with obstructive jaundice: a prospective cohort studya prospective cohort study

    OpenAIRE

    Kubo, Kimitoshi; Kawakami, Hiroshi; Kuwatani, Masaki; Nishida, Mutsumi; Kawakubo, Kazumichi; Kawahata, Shuhei; Taya, Yoko; Kubota, Yoshimasa; Amano, Toraji; Shirato, Hiroki; Sakamoto, Naoya

    2016-01-01

    Background Obstructive jaundice has been reported to influence liver elasticity, independent of liver fibrosis. The aim of our prospective study was to evaluate the changes in liver elasticity, before and after biliary drainage, in patients with obstructive jaundice, and to evaluate the correlation between elasticity measures and serum markers of liver fibrosis. Methods This is a prospective cohort study of 20 patients with obstructive jaundice. Liver elasticity was assessed by Transient Elas...

  12. Investing in Prospective Cohorts for Etiologic Study of Occupational Exposures

    Science.gov (United States)

    Prospective cohorts have played a major role in understanding the role of diet, physical activity, medical conditions, and genes in the development of many diseases, but have not been widely used in the study of occupational exposures. Studies in agriculture are an exception. W...

  13. Determinants of depression in chronic stroke : A prospective cohort study

    NARCIS (Netherlands)

    van de Port, Ingrid G. L.; Kwakkel, Gert; Bruin, Margje; Lindeman, Eline

    2007-01-01

    Purpose. The aim of the study was to identify factors that are significantly related to depression in chronic stroke patients. Methods. Prospective cohort study of stroke patients admitted for rehabilitation. A total of 165 first ever stroke patients over 18 years of age were assessed at one and thr

  14. Impact of musculoskeletal pain on insomnia onset: a prospective cohort study

    OpenAIRE

    Tang, Nicole K. Y.; McBeth, John; Jordan, Kelvin P; Blagojevic-Bucknall, Milisa; Croft, Peter; Wilkie, Ross

    2014-01-01

    Objective. Pain, the most common manifestation of rheumatological conditions, is highly prevalent among older adults, with worse health outcomes found in those with co-morbid insomnia. Proactive prevention of insomnia may reduce the overall disease burden of pain and rheumatological conditions. To inform such development, this study examined the role of pain, physical limitation and reduced social participation in predicting and mediating insomnia onset. Methods. A prospective cohort study wa...

  15. Abnormal vital signs are strong predictors for intensive care unit admission and in-hospital mortality in adults triaged in the emergency department - a prospective cohort study

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    Barfod Charlotte

    2012-04-01

    Full Text Available Abstract Background Assessment and treatment of the acutely ill patient have improved by introducing systematic assessment and accelerated protocols for specific patient groups. Triage systems are widely used, but few studies have investigated the ability of the triage systems in predicting outcome in the unselected acute population. The aim of this study was to quantify the association between the main component of the Hillerød Acute Process Triage (HAPT system and the outcome measures; Admission to Intensive Care Unit (ICU and in-hospital mortality, and to identify the vital signs, scored and categorized at admission, that are most strongly associated with the outcome measures. Methods The HAPT system is a minor modification of the Swedish Adaptive Process Triage (ADAPT and ranks patients into five level colour-coded triage categories. Each patient is assigned a triage category for the two main descriptors; vital signs, Tvitals, and presenting complaint, Tcomplaint. The more urgent of the two determines the final triage category, Tfinal. We retrieved 6279 unique adult patients admitted through the Emergency Department (ED from the Acute Admission Database. We performed regression analysis to evaluate the association between the covariates and the outcome measures. Results The covariates, Tvitals, Tcomplaint and Tfinal were all significantly associated with ICU admission and in-hospital mortality, the odds increasing with the urgency of the triage category. The vital signs best predicting in-hospital mortality were saturation of peripheral oxygen (SpO2, respiratory rate (RR, systolic blood pressure (BP and Glasgow Coma Score (GCS. Not only the type, but also the number of abnormal vital signs, were predictive for adverse outcome. The presenting complaints associated with the highest in-hospital mortality were 'dyspnoea' (11.5% and 'altered level of consciousness' (10.6%. More than half of the patients had a Tcomplaint more urgent than Tvitals

  16. Adult outcomes of teen mothers across birth cohorts

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    Anne Driscoll

    2014-04-01

    Full Text Available Background: Teen and young adult mothers have lower socioeconomic status than older mothers. Objective: This study analyzes the socioeconomic status (SES of teen, young adult, and older adult mothers across four five-year birth cohorts from 1956 to 1975 who were teens from 1971 to 1994. Methods: Data were pooled from the 1995, 2002, and 2006-2010 National Survey of Family Growth (NSFG. Mothers were categorized by age at first birth and by their birth cohorts. The SES (education, single motherhood, poverty, employment of teen, young adult, and older mothers was compared across cohorts and within cohorts. Results: Among teen mothers, the odds of fulltime employment improved across birth cohorts and the odds of educational attainment beyond high school did not vary. Their odds of single motherhood and living in poverty increased across cohorts. The odds of higher education and single motherhood increased across birth cohorts for young adult mothers as did the odds of living in poverty, even if working fulltime. Among older adult mothers, educational attainment and the odds of single motherhood rose for recent cohorts. Conclusions: Comparisons between teen mothers and both young adult and all adult mothers within cohorts suggest that gaps in single motherhood and poverty between teen and adult mothers have widened over time, to the detriment of teen mothers. Teen mothers have become more likely to be single and poor than in the past and compared to older mothers.

  17. Cohort Profile: Golestan Hepatitis B Cohort Study- A Prospective Long Term Study in Northern Iran ​

    OpenAIRE

    Poustchi, Hossein; Katoonizadeh, Aezam; Ostovaneh, Mohammad Reza; Moossavi, Shirin; Sharafkhah, Maryam; Esmaili, Saeed; Pourshams, Akram; Mohamadkhani, Ashraf; Besharat, Sima; Merat, Shahin; Mohamadnejad, Mehdi; George, Jacob; Malekzadeh, Reza

    2014-01-01

    Hepatitis B virus (HBV) infection is the most common cause of end stage liver disease in Iran and in Golestan province. Large-scale population-based prospective cohort studies with long term follow-up are the method of choice to accurately understand the natural course of HBV infection. To date, several studies of HBV epidemiology, natural history, progression to cirrhosis and association with HCC have been reported from other countries. However, few of these are prospective and fewer still a...

  18. The influence of statin exposure on inflammatory markers in patients with early bacterial infection: pilot prospective cohort study

    OpenAIRE

    Shankar-Hari, Manu; Donnelly, Antonia; Pinto, Ruxandra; Salih, Zaid; McKenzie, Cathrine; Terblanche, Marius; Adhikari, Neill KJ

    2014-01-01

    Background In the context of infection, progressive illness resulting in acute organ dysfunction is thought to be secondary to inflammatory response. Our aims were to determine risk factors for progressive illness following infection in a low-risk hospitalised cohort, including the impact of prior stain therapy. Methods We performed a prospective observational cohort study on two adult acute medical wards of a single tertiary academic hospital. We screened drug prescription charts of all adul...

  19. Migraine and Cognitive Decline Among Women: Prospective Cohort Study

    OpenAIRE

    Rist, Pamela Marie; Kang, Jae Hee Hee; Buring, Julie Elizabeth; Glymour, Maria Lee; Grodstein, Francine; Kurth, Tobias

    2012-01-01

    Objective: To evaluate the association between migraine and cognitive decline among women. Design Prospective cohort study. Setting Women’s Health Study, United States. Participants 6349 women aged 65 or older enrolled in the Women’s Health Study who provided information about migraine status at baseline and participated in cognitive testing during follow-up. Participants were classified into four groups: no history of migraine, migraine with aura, migraine without aura, and past history of m...

  20. Risk factors for seabather's eruption: a prospective cohort study.

    OpenAIRE

    Kumar, S.; Hlady, W. G.; Malecki, J M

    1997-01-01

    OBJECTIVE: A prospective cohort study was performed to identify risk factors for seabather's eruption. METHODS: Study participants were recruited at four beaches in Palm Beach County, Florida, during three weekends of May and June 1993. Participants were interviewed by telephone after 48 hours regarding medical history, beach activities, development of rashes, and use of possible preventive measures. RESULTS: Seabather's eruption, defined by the occurrence of a rash within two days of exposur...

  1. Adult outcomes of teen mothers across birth cohorts

    OpenAIRE

    Anne Driscoll

    2014-01-01

    Background: Teen and young adult mothers have lower socioeconomic status than older mothers. Objective: This study analyzes the socioeconomic status (SES) of teen, young adult, and older adult mothers across four five-year birth cohorts from 1956 to 1975 who were teens from 1971 to 1994. Methods: Data were pooled from the 1995, 2002, and 2006-2010 National Survey of Family Growth (NSFG). Mothers were categorized by age at first birth and by their birth cohorts. The SES (education, singl...

  2. Sleep-disordered breathing and mortality: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Naresh M Punjabi

    2009-08-01

    Full Text Available BACKGROUND: Sleep-disordered breathing is a common condition associated with adverse health outcomes including hypertension and cardiovascular disease. The overall objective of this study was to determine whether sleep-disordered breathing and its sequelae of intermittent hypoxemia and recurrent arousals are associated with mortality in a community sample of adults aged 40 years or older. METHODS AND FINDINGS: We prospectively examined whether sleep-disordered breathing was associated with an increased risk of death from any cause in 6,441 men and women participating in the Sleep Heart Health Study. Sleep-disordered breathing was assessed with the apnea-hypopnea index (AHI based on an in-home polysomnogram. Survival analysis and proportional hazards regression models were used to calculate hazard ratios for mortality after adjusting for age, sex, race, smoking status, body mass index, and prevalent medical conditions. The average follow-up period for the cohort was 8.2 y during which 1,047 participants (587 men and 460 women died. Compared to those without sleep-disordered breathing (AHI: or=30.0 events/h sleep-disordered breathing were 0.93 (95% CI: 0.80-1.08, 1.17 (95% CI: 0.97-1.42, and 1.46 (95% CI: 1.14-1.86, respectively. Stratified analyses by sex and age showed that the increased risk of death associated with severe sleep-disordered breathing was statistically significant in men aged 40-70 y (hazard ratio: 2.09; 95% CI: 1.31-3.33. Measures of sleep-related intermittent hypoxemia, but not sleep fragmentation, were independently associated with all-cause mortality. Coronary artery disease-related mortality associated with sleep-disordered breathing showed a pattern of association similar to all-cause mortality. CONCLUSIONS: Sleep-disordered breathing is associated with all-cause mortality and specifically that due to coronary artery disease, particularly in men aged 40-70 y with severe sleep-disordered breathing. Please see later in the

  3. Leisure time computer use and overweight development in young adults – a prospective study

    OpenAIRE

    Thomée, Sara; Lissner, Lauren; Hagberg, Mats; Grimby-Ekman, Anna

    2015-01-01

    Background The prevalence of overweight among Swedish young adults has nearly doubled since the 1980s. The weight increase has been paralleled by the increased use of computers at work, at school, and at leisure time. The aim was to examine leisure time computer use for gaming, and for emailing/chatting, in relation to overweight development in young adults. Methods A prospective cohort study with Swedish young adults (20–24 years at baseline) who responded to a questionnaire at baseline (n =...

  4. Cohort profile: golestan hepatitis B cohort study- a prospective long term study in northern iran ​.

    Science.gov (United States)

    Poustchi, Hossein; Katoonizadeh, Aezam; Ostovaneh, Mohammad Reza; Moossavi, Shirin; Sharafkhah, Maryam; Esmaili, Saeed; Pourshams, Akram; Mohamadkhani, Ashraf; Besharat, Sima; Merat, Shahin; Mohamadnejad, Mehdi; George, Jacob; Malekzadeh, Reza

    2014-10-01

    Hepatitis B virus (HBV) infection is the most common cause of end stage liver disease in Iran and in Golestan province. Large-scale population-based prospective cohort studies with long term follow-up are the method of choice to accurately understand the natural course of HBV infection. To date, several studies of HBV epidemiology, natural history, progression to cirrhosis and association with HCC have been reported from other countries. However, few of these are prospective and fewer still are population-based. Moreover, the underlying molecular mechanisms and immunogenetic determinants of the outcome of HBV infection especially in low and middle income countries remains largely unknown. Therefore, the hepatitis B cohort study (HBCS), nested as part of the Golestan Cohort Study (GCS), Golestan, Iran was established in 2008 with the objective to prospectively investigate the natural course of chronic hepatitis B with reference to its epidemiology, viral/host genetic interactions, clinical features and outcome in the Middle East where genotype D HBV accounts for >90% of infections. In 2008, a baseline measurement of HBV surface antigen (HBsAg) was performed on stored serum samples of all GCS participants. A sub-cohort of 3,505 individuals were found to be HBsAg positive and were enrolled in the Golestan HBCS. In 2011, all first degree relatives of HBsAg positive subjects including their children and spouses were invited for HBV serology screening and those who were positive for HBsAg were also included in the Golestan HBCS. PMID:25349681

  5. Aboriginal birth cohort (ABC): a prospective cohort study of early life determinants of adiposity and associated risk factors among Aboriginal people in Canada

    OpenAIRE

    Wahi, Gita; Wilson, Julie; Miller, Ruby; Anglin, Rebecca; McDonald, Sarah; Morrison, Katherine M; Teo, Koon K; Anand, Sonia S

    2013-01-01

    Background Aboriginal people living in Canada have a high prevalence of obesity, type 2 diabetes, and cardiovascular disease (CVD). To better understand the pre and postnatal influences on the development of adiposity and related cardio-metabolic factors in adult Aboriginal people, we will recruit and follow prospectively Aboriginal pregnant mothers and their children – the Aboriginal Birth Cohort (ABC) study. Methods/design We aim to recruit 300 Aboriginal pregnant mothers and their newborns...

  6. Healthy Eating and Risks of Total and Cause-Specific Death among Low-Income Populations of African-Americans and Other Adults in the Southeastern United States: A Prospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Danxia Yu

    2015-05-01

    Full Text Available A healthy diet, as defined by the US Dietary Guidelines for Americans (DGA, has been associated with lower morbidity and mortality from major chronic diseases in studies conducted in predominantly non-Hispanic white individuals. It is unknown whether this association can be extrapolated to African-Americans and low-income populations.We examined the associations of adherence to the DGA with total and cause-specific mortality in the Southern Community Cohort Study, a prospective study that recruited 84,735 American adults, aged 40-79 y, from 12 southeastern US states during 2002-2009, mostly through community health centers that serve low-income populations. The present analysis included 50,434 African-Americans, 24,054 white individuals, and 3,084 individuals of other racial/ethnic groups, among whom 42,759 participants had an annual household income less than US$15,000. Usual dietary intakes were assessed using a validated food frequency questionnaire at baseline. Adherence to the DGA was measured by the Healthy Eating Index (HEI, 2010 and 2005 editions (HEI-2010 and HEI-2005, respectively. During a mean follow-up of 6.2 y, 6,906 deaths were identified, including 2,244 from cardiovascular disease, 1,794 from cancer, and 2,550 from other diseases. A higher HEI-2010 score was associated with lower risks of disease death, with adjusted hazard ratios (HRs of 0.80 (95% CI, 0.73-0.86 for all-disease mortality, 0.81 (95% CI, 0.70-0.94 for cardiovascular disease mortality, 0.81 (95% CI, 0.69-0.95 for cancer mortality, and 0.77 (95% CI, 0.67-0.88 for other disease mortality, when comparing the highest quintile with the lowest (all p-values for trend 0.50. Several component scores in the HEI-2010, including whole grains, dairy, seafood and plant proteins, and ratio of unsaturated to saturated fatty acids, showed significant inverse associations with total mortality. HEI-2005 score was also associated with lower disease mortality, with a HR of 0.86 (95

  7. Think Tank on Metabolomics and Prospective Cohorts: How to Leverage Resources

    Science.gov (United States)

    This Think Tank identified resources that can be used collaboratively across prospective cohorts; developed strategies to leverage resources for advancing the use of metabolomics in prospective cohort studies; identified the best strategies for performing analyses using metabolomics data across multiple studies; and, established a collaborative group that will identify and tackle research projects that cannot be effectively investigated by one independent group.

  8. Cohort Profile: Sympathetic activity and Ambulatory Blood Pressure in Africans (SABPA) prospective cohort study.

    Science.gov (United States)

    Malan, Leoné; Hamer, Mark; Frasure-Smith, Nancy; Steyn, Hendrik S; Malan, Nicolaas T

    2015-12-01

    Adapting to an over-demanding stressful urban environment may exhaust the psychophysiological resources to cope with these demands, and lead to sympathetic nervous system dysfunction. The evidence that an urban-dwelling lifestyle may be detrimental to the cardiometabolic health of Africans motivated the design of the Sympathetic activity and Ambulatory Blood Pressure in African Prospective cohort study. We aimed to determine neural mechanistic pathways involved in emotional distress and vascular remodelling. The baseline sample included 409 teachers representing a bi-ethnic sex cohort from South Africa. The study was conducted in 2008-09 and repeated after 3-year follow-up in 2011-12, with an 87.8% successful follow-up rate. Seasonal changes were avoided and extensive clinical assessments were performed in a well-controlled setting. Data collection included sociodemographics, lifestyle habits, psychosocial battery and genetic analysis, mental stress responses mimicking daily life stress (blood pressure and haemostatic, cardiometabolic, endothelial and stress hormones). Target organ damage was assessed in the brain, heart, kidney, blood vessels and retina. A unique highly phenotyped cohort is presented that can address the role of a hyperactive sympathetic nervous system and neural response pathways contributing to the burden of cardiometabolic diseases in Africans. PMID:25344943

  9. Asthma and Panic in Young Adults: A 20-Year Prospective Community Study

    OpenAIRE

    Hasler, Gregor; Gergen, Peter J; Kleinbaum, David G.; Ajdacic, Vladeta; Gamma, Alex; Eich, Dominique; Rössler, Wulf; Angst, Jules

    2005-01-01

    Rationale: Psychologic factors are increasingly recognized to influence the onset and course of asthma. Previous cross-sectional community-based studies have provided evidence for a relatively specific association between asthma and panic. Objectives: To examine concurrent and longitudinal associations between asthma and panic in young adults. Measurements and Main Results: Prospective community-based cohort study of young adults (n = 591) followed between ages 19 and 40. Information was deri...

  10. Cytomegalovirus Infection and the Risk of Mortality and Frailty in Older Women: A Prospective Observational Cohort Study

    OpenAIRE

    Wang, George C.; Kao, Wen Hong L.; Murakami, Peter; Xue, Qian-Li; Chiou, Roger B.; Detrick, Barbara; McDyer, John F.; Richard D Semba; Casolaro, Vincenzo; Walston, Jeremy D.; Fried, Linda P.

    2010-01-01

    Cytomegalovirus (CMV), a prevalent pathogen, causes severe disease in immunocompromised humans. However, present understanding is limited regarding the long-term clinical effect of persistent CMV infection in immunocompetent adults. The authors conducted a prospective observational cohort study (1992–2002) of 635 community-dwelling women in Baltimore, Maryland, aged 70–79 years in the Women's Health and Aging Studies to examine the effect of CMV infection on the risk of frailty, a common geri...

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

    Science.gov (United States)

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

    2016-06-01

    Previous studies have shown a relationship between osteoporosis and increased mortality risk. However, none of these studies performed a concomitant evaluation of the parathyroid hormone (PTH)-calcium-vitamin D axis and bone mass to accurately determine the contribution of each of these parameters to survival in older subjects. Thus, we sought to investigate the association between bone parameters and mortality in a longitudinal, prospective, population-based cohort of 839 elderly subjects. Clinical data (including history of fractures and cardiovascular events) were assessed using a specific questionnaire. Laboratory exams, including serum 25OHD and PTH, were also performed. Bone mineral density (BMD) at the lumbar spine and hip were evaluated using DXA. All analyses were performed at baseline (2005 to 2007). Mortality was recorded during follow-up. Multivariate Cox proportional regression was used to compute hazard ratios for all-cause and cardiovascular mortality. Over a mean 4.06 ± 1.07 years, there were 132 (15.7%) deaths. These individuals were compared to 707 subjects who were alive at the end of the coverage period for mortality data collection. In a multivariate Cox proportional hazards model, age (HR 1.32; 95% CI, 1.13 to 1.55; p = 0.001, for each 5-year increase), male gender (HR 1.90; 95% CI, 1.30 to 2.79; p = 0.001), recurrent falls (more than two in the previous year; HR 1.65; 95% CI, 1.06 to 2.56; p = 0.026), diabetes mellitus (HR 2.17; 95% CI, 1.46 to 3.21; p 49 pg/mL) were at a higher risk of cardiovascular death (HR 3.09; 95% CI, 1.36 to 6.99; p = 0.007) compared with the subjects in the lowest quartile (Mineral Research. PMID:26814375

  12. Cohort profile: Lifelines DEEP, a prospective, general population cohort study in the northern Netherlands: study design and baseline characteristics

    OpenAIRE

    Tigchelaar, E.F.; Zhernakova, A; Dekens, J.A.M.; Hermes, G.D.A.; Baranska, A.; Mujagic, Z.; M.A. Swertz; Munoz, A.M.; Deelen, P.; Cenit, M. C.; Franke, L; Scholtens, S.; Stolk, R.P.; Wijmenga, C; Feskens, E.J.M.

    2015-01-01

    Purpose: There is a critical need for population-based prospective cohort studies because they follow individuals before the onset of disease, allowing for studies that can identify biomarkers and disease-modifying effects, and thereby contributing to systems epidemiology. Participants: This paper describes the design and baseline characteristics of an intensively examined subpopulation of the LifeLines cohort in the Netherlands. In this unique subcohort, LifeLines DEEP, we included 1539 part...

  13. Biomarkers in differentiating clinical dengue cases: A prospective cohort study

    Directory of Open Access Journals (Sweden)

    Gary Kim Kuan Low

    2015-12-01

    Full Text Available Objective: To evaluate five biomarkers (neopterin, vascular endothelial growth factor-A, thrombomodulin, soluble vascular cell adhesion molecule 1 and pentraxin 3 in differentiating clinical dengue cases. Methods: A prospective cohort study was conducted whereby the blood samples were obtained at day of presentation and the final diagnosis were obtained at the end of patients’ follow-up. All patients included in the study were 15 years old or older, not pregnant, not infected by dengue previously and did not have cancer, autoimmune or haematological disorder. Median test was performed to compare the biomarker levels. A subgroup Mann-Whitney U test was analysed between severe dengue and non-severe dengue cases. Monte Carlo method was used to estimate the 2-tailed probability (P value for independent variables with unequal number of patients. Results: All biomarkers except thrombomodulin has P value < 0.001 in differentiating among the healthy subjects, non-dengue fever, dengue without warning signs and dengue with warning signs/severe dengue. Subgroup analysis for all the biomarkers between severe dengue and non-severe dengue cases was not statistically significant except vascular endothelial growth factor-A (P < 0.05. Conclusions: Certain biomarkers were able to differentiate the clinical dengue cases. This could be potentially useful in classifying and determining the severity of dengue infected patients in the hospital.

  14. Prospective cohort study of comprehensive prevention to gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Hai-Qiang Guo; Peng Guan; Hai-Long Shi; Xuan Zhang; Bao-Sen Zhou; Yuan Yuan

    2003-01-01

    AIM: To evaluate the preliminary effects of comprehensive prevention of gastric cancer in Zhuanghe County epidemiologically.METHODS: Stratified sampling and cluster sampling were applied to define the intervention group and the control group. The prospective cohort study was used for evaluating the effect of preventing gastric cancer. The relative risk (RR)and attributable risk percent (AR %) of intervention on gastric cancer death were calculated. Potential years of life lost (PLYY) of the disease was analyzed, and the RR and AR %of PYLL were calculated. Survival analysis was applied among the screened patients.RESULTS: In the first 4 years after intervening, the relative risk (RR) of intervention on death was 0.5059 (95 % CI:0.3462~0.7392,P<0.05) with significance statistically. AR %of the intervention on death was 49.41%. The RR of intervention on cumulative PYLL was 0.6778 (95 % CI:0.5604~0.8198,P<0.05) with statistic significance. AR %of the intervention on cumulative PYLL was 30.32 %. The four-year survival rate of the screened patients was 0.6751(95 % CI: 0.5298~0.9047).CONCLUSION: The initiative intervention results showed that the intervention approach used in the trial was effective, it reduced mortality and increased survival rate, and alleviated the adverse effect of gastric cancer on the health and life of screened population.

  15. Employment Trajectories After Spinal Cord Injury : Results From a 5-Year Prospective Cohort Study

    NARCIS (Netherlands)

    Ferdiana, Astri; Post, Marcel W.; Hoekstra, Trynke; van der Woude, Luccas H.; van der Klink, Jac J.; Bultmann, Ute

    2014-01-01

    Objectives: To identify different employment trajectories in individuals with spinal cord injury (SCI) after discharge from initial rehabilitation and to determine predictors of different trajectories from demographic, injury, functional, and psychological characteristics. Design: Prospective cohort

  16. Adherence to chemoprophylaxis and Plasmodium falciparum anti-circumsporozoite seroconversion in a prospective cohort study of Dutch short-term travelers

    NARCIS (Netherlands)

    Belderok, S.M.; Hoek, A.; Roeffen, W.F.; Sauerwein, R.; Sonder, G.J.

    2013-01-01

    BACKGROUND: We conducted a prospective study in a cohort of short-term travelers assessing the incidence rate of anti-circumsporozoite seroconversion, adherence to chemoprophylaxis, symptoms of malaria during travel, and malaria treatment abroad. METHODS: Adults were recruited from the travel clinic

  17. Use and Safety of Anthroposophic Medications for Acute Respiratory and Ear Infections: A Prospective Cohort Study

    OpenAIRE

    Hamre, Harald J.; Anja Glockmann; Michael Fischer; Riley, David S.; Erik Baars; Helmut Kiene

    2007-01-01

    Objective: Anthroposophic medications (AMED) are widely used, but safety data on AMED from large prospective studies are sparse. The objective of this analysis was to determine the frequency of adverse drug reactions (ADR) to AMED in outpatients using AMED for acute respiratory and ear infections.Methods: A prospective four-week observational cohort study was conducted in 21 primary care practices in Europe and the U.S.A. The cohort comprised 715 consecutive outpatients aged 1 month, treated ...

  18. Dietary fiber intake and mortality among survivors of myocardial infarction: prospective cohort study

    OpenAIRE

    Li, Shanshan; Flint, Alan; Pai, Jennifer K.; Forman, John P.; Hu, Frank B.; Willett, Walter C.; Rexrode, Kathryn M.; Mukamal, Kenneth J; Rimm, Eric B

    2014-01-01

    Objective To evaluate the associations of dietary fiber after myocardial infarction (MI) and changes in dietary fiber intake from before to after MI with all cause and cardiovascular mortality. Design Prospective cohort study. Setting Two large prospective cohort studies of US women and men with repeated dietary measurements: the Nurses’ Health Study and the Health Professionals Follow-Up Study. Participants 2258 women and 1840 men who were free of cardiovascular disease, stroke, or cancer at...

  19. Dietary fiber intake and mortality among survivors of myocardial infarction: prospective cohort study

    OpenAIRE

    Li, Shanshan; Flint, Alan; Pai, Jennifer K.; Forman, John P.; Hu, Frank B.; Willett, Walter C.; Rexrode, Kathryn M.; Mukamal, Kenneth J; Rimm, Eric B

    2014-01-01

    Objective: To evaluate the associations of dietary fiber after myocardial infarction (MI) and changes in dietary fiber intake from before to after MI with all cause and cardiovascular mortality. Design: Prospective cohort study. Setting: Two large prospective cohort studies of US women and men with repeated dietary measurements: the Nurses’ Health Study and the Health Professionals Follow-Up Study. Participants: 2258 women and 1840 men who were free of cardiovascular disease, stroke, or cance...

  20. Exposure to Radiofrequency Electromagnetic Fields and Sleep Quality: A Prospective Cohort Study

    OpenAIRE

    Mohler, Evelyn; Frei, Patrizia; Fröhlich, Jürg; Braun-Fahrländer, Charlotte; Röösli, Martin; ,

    2012-01-01

    Background There is persistent public concern about sleep disturbances due to radiofrequency electromagnetic field (RF-EMF) exposure. The aim of this prospective cohort study was to investigate whether sleep quality is affected by mobile phone use or by other RF-EMF sources in the everyday environment. Methods We conducted a prospective cohort study with 955 study participants aged between 30 and 60 years. Sleep quality and daytime sleepiness was assessed by means of standardized questionnair...

  1. The WISTAH hand study: A prospective cohort study of distal upper extremity musculoskeletal disorders

    OpenAIRE

    Garg Arun; Hegmann Kurt T; Wertsch Jacqueline J; Kapellusch Jay; Thiese Matthew S; Bloswick Donald; Merryweather Andrew; Sesek Richard; Deckow-Schaefer Gwen; Foster James; Wood Eric; Kendall Richard; Sheng Xiaoming; Holubkov Richard

    2012-01-01

    Abstract Background Few prospective cohort studies of distal upper extremity musculoskeletal disorders have been performed. Past studies have provided somewhat conflicting evidence for occupational risk factors and have largely reported data without adjustments for many personal and psychosocial factors. Methods/design A multi-center prospective cohort study was incepted to quantify risk factors for distal upper extremity musculoskeletal disorders and potentially develop improved methods for ...

  2. Differences in kinetic variables between injured and noninjured novice runners : A prospective cohort study

    NARCIS (Netherlands)

    Bredeweg, Steef W.; Kluitenberg, Bas; Bessem, Bram; Buist, Ida

    2013-01-01

    Objectives: This prospective study examined differences in kinetic variables between injured and noninjured novice female and male runners and their potential contribution to RRIs. Design: A prospective cohort study. Methods: At baseline vertical ground reaction forces were assessed with an instrume

  3. Genomic landscape of the individual host response and outcomes in sepsis: a prospective cohort study

    Science.gov (United States)

    Davenport, Emma E; Burnham, Katie L; Radhakrishnan, Jayachandran; Humburg, Peter; Hutton, Paula; Mills, Tara C; Rautanen, Anna; Gordon, Anthony C; Garrard, Christopher; Hill, Adrian V S; Hinds, Charles J; Knight, Julian C

    2016-01-01

    Summary Background Effective targeted therapy for sepsis requires an understanding of the heterogeneity in the individual host response to infection. We investigated this heterogeneity by defining interindividual variation in the transcriptome of patients with sepsis and related this to outcome and genetic diversity. Methods We assayed peripheral blood leucocyte global gene expression for a prospective discovery cohort of 265 adult patients admitted to UK intensive care units with sepsis due to community-acquired pneumonia and evidence of organ dysfunction. We then validated our findings in a replication cohort consisting of a further 106 patients. We mapped genomic determinants of variation in gene transcription between patients as expression quantitative trait loci (eQTL). Findings We discovered that following admission to intensive care, transcriptomic analysis of peripheral blood leucocytes defines two distinct sepsis response signatures (SRS1 and SRS2). The presence of SRS1 (detected in 108 [41%] patients in discovery cohort) identifies individuals with an immunosuppressed phenotype that included features of endotoxin tolerance, T-cell exhaustion, and downregulation of human leucocyte antigen (HLA) class II. SRS1 was associated with higher 14 day mortality than was SRS2 (discovery cohort hazard ratio (HR) 2·4, 95% CI 1·3–4·5, p=0·005; validation cohort HR 2·8, 95% CI 1·5–5·1, p=0·0007). We found that a predictive set of seven genes enabled the classification of patients as SRS1 or SRS2. We identified cis-acting and trans-acting eQTL for key immune and metabolic response genes and sepsis response networks. Sepsis eQTL were enriched in endotoxin-induced epigenetic marks and modulated the individual host response to sepsis, including effects specific to SRS group. We identified regulatory genetic variants involving key mediators of gene networks implicated in the hypoxic response and the switch to glycolysis that occurs in sepsis, including HIF1α and

  4. A prospective cohort study of health behavior profiles after age 50 and mortality risk

    Directory of Open Access Journals (Sweden)

    Shaw Benjamin A

    2012-09-01

    Full Text Available Abstract Background This study examines the mortality risk associated with distinct combinations of multiple risk behaviors in middle-aged and older adults, and assesses whether the mortality risks of certain health behaviors are moderated by the presence of other risk behaviors. Methods Data for this prospective cohort study are from the Health and Retirement Study (HRS, a nationwide sample of adults older than 50 years. Baseline data are from respondents (n = 19,662 to the 1998 wave of the HRS. Twelve distinct health behavior profiles were created, based on each respondent’s smoking, physical activity, and alcohol use status in 1998. Mortality risk was estimated through 2008 using Cox regression. Results Smoking was associated with elevated risk for mortality within all behavioral profiles, but risk was greatest when combined with heavy drinking, both for middle-aged (ages 51–65 and older (ages 66+ adults. Profiles that included physical inactivity were also associated with increased mortality risk in both age groups. However, the impact of inactivity was clearly evident only among non-smokers; among smokers, the risk of inactivity was less evident, and seemingly overshadowed by the risk of smoking. Moderate drinking was protective relative to abstinence among non-smokers, and relative to heavy drinking among smokers. Conclusions In both middle-aged and older adults, multiple unhealthy behaviors increase mortality risk. However, the level of risk varies across unique combinations of unhealthy behaviors. These findings highlight the role that lifestyle improvements could play in promoting healthy aging, and provide insight into which behavioral combinations should receive top priority for intervention.

  5. Association of sarcopenic obesity with the risk of all-cause mortality: A meta-analysis of prospective cohort studies.

    Science.gov (United States)

    Tian, Simiao; Xu, Yang

    2016-02-01

    Many prospective studies have investigated the relationship between sarcopenic obesity (SO) and risk of mortality. However, the results have been controversial. The aim of the present study was to evaluate the association between SO and all-cause mortality in adults by a meta-analysis of prospective cohort studies. A systematic literature search was carried out through electronic databases up to September 2014. A total of nine articles with 12 prospective cohort studies, including 35 287 participants and 14 306 deaths, were included in the meta-analysis. Overall, compared with healthy subjects, subjects with SO had a significant increased risk of all-cause mortality (pooled HR 1.24, 95% CI 1.12-1.37, P < 0.001), with significant heterogeneity among studies (I(2)  = 53.18%, P = 0.0188), but no indication for publication bias (P = 0.7373). Heterogeneity became low and no longer significant in the subgroup analyses by three SO definitions. More importantly, SO, defined by mid-arm muscle circumference and muscle strength criteria, significantly increased the risk of mortality (HR 1.46, 95% CI 1.23-1.73 and 1.23, 1.09-1.38, respectively). The risk of all-cause mortality did not appreciably change considering the geography (USA cohorts and non-USA cohorts) or the duration of follow up (≥10 years and <10 years). However, the risk estimate was only significant in men (HR 1.23, 95% CI 1.08-1.41, P = 0.0017), not in women (HR 1.16, P = 0.1332). The results of the present study show that subjects with SO are associated with a 24% increase risk of all-cause mortality, compared with those without SO, in particular in men; the significant association was found independent of geographical location and duration of follow up. PMID:26271226

  6. Predicting reading and spelling disorders: a 4-year prospective cohort study.

    OpenAIRE

    Bigozzi, Lucia; Tarchi, Christian; Caudek, Corrado; Pinto, Giuliana

    2016-01-01

    In this 4-year prospective cohort study, children with a reading and spelling disorder, children with a spelling impairment, and children without a reading and/or spelling disorder (control group) in a transparent orthography were identified in third grade, and their emergent literacy performances in kindergarten compared retrospectively. Six hundred and forty-two Italian children participated. This cohort was followed from the last year of kindergarten to third grade. In kindergarten, the ch...

  7. The impact of universal newborn hearing screening on longterm literacy outcomes: A prospective cohort study

    OpenAIRE

    Pimperton, H; Blythe, H.; Kreppner, J.; Mahon, H. M.; Stevenson, J.; Terletski, E.; Worsfold, S.; Yuen, H M; Kennedy, C

    2016-01-01

    Objective: To determine whether the benefits of universal newborn hearing screening (UNHS) seen at age 8 years persist through the second decade. Design: Prospective cohort study of a population sample of children with permanent childhood hearing impairment (PCHI) followed up for 17 years since birth in periods with (or without) UNHS. Setting: Birth cohort of 100 000 in southern England. Participants: 114 teenagers aged 13–19 years, 76 with PCHI and 38 with normal hearing. All had previously ...

  8. Early determinants of physical activity in adolescence: prospective birth cohort study.

    OpenAIRE

    Hallal, P. C.; Wells, J. C.; Reichert, F. F.; Anselmi, L; Victora, C G

    2006-01-01

    OBJECTIVE: To examine the effects of early social, anthropometric, and behavioural variables on physical activity in adolescence. DESIGN: Prospective birth cohort study. SETTING: Pelotas, southern Brazil. PARTICIPANTS: 4453 adolescents aged 10-12 years participating in the Pelotas 1993 birth cohort study (follow-up rate 87.5%). MAIN OUTCOME MEASURES: Sedentary lifestyle (< 300 minutes of physical activity per week) and median physical activity score (minutes per week). RESULTS: The prevalence...

  9. Dietary Flavonoid Intake and Esophageal Cancer Risk in the European Prospective Investigation into Cancer and Nutrition Cohort

    DEFF Research Database (Denmark)

    Vermeulen, Esther; Zamora-Ros, Raul; Duell, Eric J.; Lujan-Barroso, Leila; Boeing, Heiner; Aleksandrova, Krasimira; Bas Bueno-de-Mesquita, H.; Scalbert, Augustin; Romieu, Isabelle; Fedirko, Veronika; Touillaud, Marina; Fagherazzi, Guy; Perquier, Florence; Molina-Montes, Esther; Chirlaque, Maria-Dolores; Vicente Argüelles, Marcial; Amiano, Pilar; Barricarte, Aurelio; Pala, Valeria; Mattiello, Amalia; Saieva, Calogero; Tumino, Rosario; Ricceri, Fulvio; Trichopoulou, Antonia; Vasilopoulou, Effie; Ziara, Gianna; Crowe, Francesca L.; Khaw, Kay-Thee; Wareham, Nicholas J.; Lukanova, Annekatrin; Grote, Verena A.; Tjønneland, Anne; Halkjær, Jytte; Bredsdorff, Lea; Overvad, Kim; Siersema, Peter D.; Peeters, Petra H. M.; May, Anne M.; Weiderpass, Elisabete; Skeie, Guri; Hjartåker, Anette; Landberg, Rikard; Johansson, Ingegerd; Sonestedt, Emily; Ericson, Ulrika; Riboli, Elio; Gonzalez, Carlos A.

    2013-01-01

    We prospectively investigated dietary flavonoid intake and esophageal cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The study included 477,312 adult subjects from 10 European countries. At baseline, country-specific validated dietary questionnaires...... flavonoid intake was inversely associated with esophageal cancer risk (hazard ratio (HR) (log2) = 0.87, 95% confidence interval (CI): 0.78, 0.98) but not in multivariable models (HR (log2) = 0.97, 95% CI: 0.86, 1.10). After covariate adjustment, no statistically significant association was found between any...... flavonoid subclass and esophageal cancer, EAC, or ESCC. However, among current smokers, flavonols were statistically significantly associated with a reduced esophageal cancer risk (HR (log2) = 0.72, 95% CI: 0.56, 0.94), whereas total flavonoids, flavanols, and flavan-3-ol monomers tended to be inversely...

  10. Nutrition and dietary intake and their association with mortality and hospitalisation in adults with chronic kidney disease treated with haemodialysis: protocol for DIET-HD, a prospective multinational cohort study

    NARCIS (Netherlands)

    Palmer, S.C.; Ruospo, M.; Campbell, K.L.; Garcia Larsen, V.; Saglimbene, V.; Natale, P.; Gargano, L.; Craig, J.C.; Johnson, D.W.; Tonelli, M.; Knight, J.; Bednarek-Skublewska, A.; Celia, E.; Castillo, D. Del; Dulawa, J.; Ecder, T.; Fabricius, E.; Frazao, J.M.; Gelfman, R.; Hoischen, S.H.; Schon, S.; Stroumza, P.; Timofte, D.; Torok, M.; Hegbrant, J.; Wollheim, C.; Frantzen, L.; Strippoli, G.F.; Steiner, K.

    2015-01-01

    INTRODUCTION: Adults with end-stage kidney disease (ESKD) treated with haemodialysis experience mortality of between 15% and 20% each year. Effective interventions that improve health outcomes for long-term dialysis patients remain unproven. Novel and testable determinants of health in dialysis are

  11. HIV incidence among men who have sex with men in Beijing: a prospective cohort study

    OpenAIRE

    Li, Dongliang; Li, Shuming; Liu, Yingjie; Gao, Yanjie; Yu, Mingrun; Yang, Xueying; Li, Qingchun; Jiang, Shulin; Zhou, Zhenhai; Zhang, Zheng; Yan, Li; Jiang, Guiyan; Xiao, Dong; Pan, Stephen W.; Luo, Fengji

    2012-01-01

    Objectives (1) To assess the HIV incidence rate among men who have sex with men (MSM) in a large cohort study in Beijing, China and (2) to identify sociodemographic and behavioural risk factors of HIV seroconversion among MSM in Beijing, China. Design A prospective cohort study. Setting Baseline and follow-up visits were conducted among MSM in Beijing, China. Participants A cohort of 797 HIV-seronegative MSM was recruited from August to December 2009, with follow-up occurring after 6 and 12 m...

  12. Physical activity and risk of Amyotrophic Lateral Sclerosis in a prospective cohort study

    OpenAIRE

    Gallo, V; Vanacore, N; Bueno-de-Mesquita, HB; Vermeulen, R.; Brayne, C.; Pearce, N.; Wark, PA; Ward, HA; P. Ferrari; Jenab, M; Andersen, PM; P. Wennberg; Wareham, N.; Katzke, V; Kaaks, R

    2016-01-01

    Previous case–control studies have suggested a possible increased risk of Amyotrophic Lateral Sclerosis (ALS) with physical activity (PA), but this association has never been studied in prospective cohort studies. We therefore assessed the association between PA and risk of death from ALS in the European Prospective Investigation into Cancer and Nutrition. A total of 472,100 individuals were included in the analysis, yielding 219 ALS deaths. At recruitment, information on PA was collected tho...

  13. Self-rated health and mortality in individuals with diabetes mellitus: prospective cohort study

    OpenAIRE

    Wennberg, Patrik; Rolandsson, Olov; Jerden, Lars; Boeing, Heiner; Sluik, Diewertje; Kaaks, Rudolf; Teucher, Birgit; Spijkerman, Annemieke; de Mesquita, Bas Bueno; Dethlefsen, Claus; Nilsson, Peter; Noethlings, Ute

    2012-01-01

    Objectives: To investigate whether low self-rated health (SRH) is associated with increased mortality in individuals with diabetes. Design: Population-based prospective cohort study. Setting: Enrolment took place between 1992 and 2000 in four centres (Bilthoven, Heidelberg, Potsdam, Umea) in a subcohort nested in the European Prospective Investigation into Cancer and Nutrition. Participants: 3257 individuals (mean +/- SD age was 55.8 +/- 7.6 years and 42% women) with confirmed diagnosis of di...

  14. Anatomy of Health Effects of Mediterranean Diet: Greek EPIC Prospective Cohort Study

    OpenAIRE

    Trichopoulou, Antonia; Bamia, Christina; Trichopoulos, Dimitrios

    2009-01-01

    Objective: To investigate the relative importance of the individual components of the Mediterranean diet in generating the inverse association of increased adherence to this diet and overall mortality. Design: Prospective cohort study. Setting: Greek segment of the European Prospective Investigation into Cancer and nutrition (EPIC). Participants: 23 349 men and women, not previously diagnosed with cancer, coronary heart disease, or diabetes, with documented survival status until June 2008 an...

  15. Prospective Memory Training in older adults

    NARCIS (Netherlands)

    Schmidt, I.W.; Berg, I.J.; Deelman, B.G.

    2001-01-01

    This study evaluates the results of a training program for prospective remembering. The goal of the training was to improve prospective memory by associating cues from the retrieval situation with the to be remembered information. The training group consisted of 20 participants, aged between 45 and

  16. Variation in the gene coding for the M5 Muscarinic receptor (CHRM5 influences cigarette dose but is not associated with dependence to drugs of addiction: evidence from a prospective population based cohort study of young adults

    Directory of Open Access Journals (Sweden)

    Olsson Craig A

    2007-07-01

    Full Text Available Abstract Background The mesolimbic structures of the brain are important in the anticipation and perception of reward. Moreover, many drugs of addiction elicit their response in these structures. The M5 muscarinic receptor (M5R is expressed in dopamine-containing neurones of the substantia nigra pars compacta and ventral tegmental area, and regulates the release of mesolimbic dopamine. Mice lacking M5R show a substantial reduction in both reward and withdrawal responses to morphine and cocaine. The CHRM5, the gene that codes for the M5R, is a strong biological candidate for a role in human addiction. We screened the coding and core promoter sequences of CHRM5 using denaturing high performance liquid chromatography to identify common polymorphisms. Additional polymorphisms within the coding and core promoter regions that were identified through dbSNP were validated in the test population. We investigated whether these polymorphisms influence substance dependence and dose in a cohort of 1947 young Australians. Results Analysis was performed on 815 participants of European ancestry who were interviewed at wave 8 of the cohort study and provided DNA. We observed a 26.8% increase in cigarette consumption in carriers of the rs7162140 T-allele, equating to 20.1 cigarettes per week (p=0.01. Carriers of the rs7162140 T-allele were also found to have nearly a 3-fold increased risk of developing cannabis dependence (OR=2.9 (95%CI 1.1-7.4; p=0.03. Conclusion Our data suggest that variation within the CHRM5 locus may play an important role in tobacco and cannabis but not alcohol addiction in European ancestry populations. This is the first study to show an association between CHRM5 and substance use in humans. These data support the further investigation of this gene as a risk factor in substance use and dependence.

  17. Association of blood lead concentrations with mortality in older women: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Muldoon Susan B

    2009-04-01

    Full Text Available Abstract Background Blood lead concentrations have been associated with increased risk of cardiovascular, cancer, and all-cause mortality in adults in general population and occupational cohorts. We aimed to determine the association between blood lead, all cause and cause specific mortality in elderly, community residing women. Methods Prospective cohort study of 533 women aged 65–87 years enrolled in the Study of Osteoporotic Fractures at 2 US research centers (Baltimore, MD; Monongahela Valley, PA from 1986–1988. Blood lead concentrations were determined by atomic absorption spectrometry. Using blood lead concentration categorized as Results Mean blood lead concentration was 5.3 ± 2.3 μg/dL (range 1–21 [0.25 ± 0.11 μmol/L (range 0.05–1.008]. After 12.0 ± 3 years of > 95% complete follow-up, 123 (23% women who died had slightly higher mean (± SD blood lead 5.56 (± 3 μg/dL [0.27(± 0.14 μmol/L] than survivors: 5.17(± 2.0 [0.25(± 0.1 μmol/L] (p = 0.09. Women with blood lead concentrations ≥ 8 μg/dL (0.384 μmol/L, had 59% increased risk of multivariate adjusted all cause mortality (Hazard Ratio [HR], 1.59; 95% confidence interval [CI], 1.02–2.49 (p = 0.041 especially coronary heart disease (CHD mortality (HR = 3.08 [CI], (1.23–7.70(p = 0.016, compared to women with blood lead concentrations Conclusion Women with blood lead concentrations of ≥ 8 μg/dL (0.384 μmol/L, experienced increased mortality, in particular from CHD as compared to those with lower blood lead concentrations.

  18. Increased mortality associated with HTLV-II infection in blood donors: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Smith James W

    2004-03-01

    Full Text Available Abstract Background HTLV-I is associated with adult T-cell leukemia, and both HTLV-I and -II are associated with HTLV-associated myelopathy/tropical spastic paraparesis (HAM/TSP. Several published reports suggest that HTLV-I may lead to decreased survival, but HTLV-II has not previously been associated with mortality. Results We examined deaths among 138 HTLV-I, 358 HTLV-II, and 759 uninfected controls enrolled in a prospective cohort study of U.S. blood donors followed biannually since 1992. Proportional hazards models yielded hazard ratios (HRs for the association between mortality and HTLV infection, controlling for sex, race/ethnicity, age, income, educational level, blood center, smoking, injection drug use history, alcohol intake, hepatitis C status and autologous donation. After a median follow-up of 8.6 years, there were 45 confirmed subject deaths. HTLV-I infection did not convey a statistically significant excess risk of mortality (unadjusted HR 1.9, 95%CI 0.8–4.4; adjusted HR 1.9, 95%CI 0.8–4.6. HTLV-II was associated with death in both the unadjusted model (HR 2.8, 95%CI 1.5–5.5 and in the adjusted model (HR 2.3, 95%CI 1.1–4.9. No single cause of death appeared responsible for the HTLV-II effect. Conclusions After adjusting for known and potential confounders, HTLV-II infection is associated with increased mortality among healthy blood donors. If replicated in other cohorts, this finding has implications for both HTLV pathogenesis and counseling of infected persons.

  19. Incidence of chronic obstructive pulmonary disease in a cohort of young adults according to the presence of chronic cough and phlegm

    NARCIS (Netherlands)

    de Marco, Roberto; Accordini, Simone; Cerveri, Isa; Corsico, Angelo; Anto, Josep M.; Kunzli, Nino; Janson, Christer; Sunyer, Jordi; Jarvis, Deborah; Chinn, Susan; Vermeire, Paul; Svanes, Cecilie; Ackermann-Liebrich, Ursula; Gislason, Thorarinn; Heinrich, Joachim; Leynaert, Benedicte; Neukirch, Francoise; Schouten, Jan P.; Wjst, Matthias; Burney, Peter

    2007-01-01

    Rationale: The few prospective studies aimed at assessing the incidence of chronic obstructive pulmonary disease (COPD) in relation to the presence of chronic cough/phlegm have produced contrasting results. Objectives: To assess the incidence of COPD in a cohort of young adults and to test whether c

  20. Development in Children with Achondroplasia: A Prospective Clinical Cohort Study

    Science.gov (United States)

    Ireland, Penelope J.; Donaghey, Samantha; McGill, James; Zankl, Andreas; Ware, Robert S.; Pacey, Verity; Ault, Jenny; Savarirayan, Ravi; Sillence, David; Thompson, Elizabeth; Townshend, Sharron; Johnston, Leanne M.

    2012-01-01

    Aim: Achondroplasia is characterized by delays in the development of communication and motor skills. While previously reported developmental profiles exist across gross motor, fine motor, feeding, and communication skills, there has been no prospective study of development across multiple areas simultaneously. Method: This Australasian…

  1. Lung cancer stage at diagnosis: Individual associations in the prospective VITamins and lifestyle (VITAL cohort

    Directory of Open Access Journals (Sweden)

    Au David H

    2011-06-01

    Full Text Available Abstract Background Lung cancer is the leading cause of cancer death in the United States. Identifying factors associated with stage of diagnosis can improve our understanding of biologic and behavioral pathways of lung cancer development and detection. We used data from a prospective cohort study to evaluate associations of demographic, health history, and health behaviors with early versus late stage at diagnosis of non-small cell lung cancer (NSCLC. Methods We calculated odds ratios (ORs for the association of patient-level characteristics with advanced stage of diagnosis for NSCLC. The OR's were then adjusted for age, gender, race/ethnicity, smoking status, income, education, chronic obstructive pulmonary disease, and a comorbidity index. Results We identified 612 cases of NSCLC among 77,719 adults, aged 50 to 76 years from Washington State recruited in 2000-2002, with followup through December 2007. In univariate analyses, subjects who quit smoking Conclusions Smoking status, education, and a screening activity were associated with stage at diagnosis of NSCLC. These results may guide future studies of the underlying mechanisms that influence how NSCLC is detected and diagnosed.

  2. Predictors of red blood cell transfusion after cardiac surgery: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Camila Takao Lopes

    2015-12-01

    Full Text Available Abstract OBJECTIVE To identify predictors of red blood cell transfusion (RBCT after cardiac surgery. METHOD A prospective cohort study performed with 323 adults after cardiac surgery, from April to December of 2013. A data collection instrument was constructed by the researchers containing factors associated with excessive bleeding after cardiac surgery, as found in the literature, for investigation in the immediate postoperative period. The relationship between risk factors and the outcome was assessed by univariate analysis and logistic regression. RESULTS The factors associated with RBCT in the immediate postoperative period included lower height and weight, decreased platelet count, lower hemoglobin level, higher prevalence of platelet count <150x10 3/mm3, lower volume of protamine, longer duration of anesthesia, higher prevalence of intraoperative RBCT, lower body temperature, higher heart rate and higher positive end-expiratory pressure. The independent predictor was weight <66.5Kg. CONCLUSION Factors associated with RBCT in the immediate postoperative period of cardiac surgery were found. The independent predictor was weight.

  3. Salt intake, cured meat consumption, refrigerator use and stomach cancer incidence: A prospective cohort study (Netherlands)

    NARCIS (Netherlands)

    Brandt, P.A. van den; Botterweck, A.A.M.; Goldbohm, R.A.

    2003-01-01

    Objective: Many case-control studies have reported that salt and cured meat intake are positively, and refrigerator use is inversely, associated with stomach cancer risk. In the current prospective study these associations were evaluated. Methods: The Netherlands Cohort Study consisted of 120,852 me

  4. Work-site musculoskeletal pain risk estimates by trained observers - a prospective cohort study

    NARCIS (Netherlands)

    Coenen, P.; Kingma, I.; Boot, C.R.L.; Douwes, M.; Bongers, P.M.; Dieën, J.H. van

    2012-01-01

    Work-related musculoskeletal pain (MSP) risk assessments by trained observers are often used in ergonomic practice; however, the validity may be questionable. We investigated the predictive value of work-site MSP risk estimates in a prospective cohort study of 1745 workers. Trained observers estimat

  5. 75 FR 9902 - Proposed Collection; Comment Request; The Agricultural Health Study: A Prospective Cohort Study...

    Science.gov (United States)

    2010-03-04

    ... history information for respondents enrolled in the Agriculture Health Study. This represents a request to... Health Study: A Prospective Cohort Study of Cancer and Other Disease Among Men and Women in Agriculture... Disease Among Men and Women in Agriculture (NCI) (OMB : 0925-0406). Type of Information Collection...

  6. Predicting Dyslexia in a Transparent Orthography from Grade 1 Literacy Skills: A Prospective Cohort Study

    Science.gov (United States)

    Bigozzi, Lucia; Tarchi, Christian; Pinto, Giuliana; Accorti Gamannossi, Beatrice

    2016-01-01

    We conducted this prospective cohort study to explore the predictability of dyslexia from 1st-grade literacy skills in Italian students. We followed 407 Italian students in primary school from the 1st through the 3rd grades. Students were diagnosed with dyslexia in the 3rd grade. We retrospectively tested participants' 1st-grade performance in…

  7. Soccer injuries and recovery in dutch male amateur soccer players: Results of a prospective cohort study

    NARCIS (Netherlands)

    Beijsterveldt, A.M. van; Steffen, K.; Stubbe, J.H.; Frederiks, J.E.; Port, I.G.L. van de; Backx, F.J.G.

    2014-01-01

    OBJECTIVE:: To describe characteristics of outdoor soccer injury and recovery among Dutch soccer players. DESIGN:: Prospective cohort study. SETTING:: The 2009-2010 competitive season (33 weeks). PARTICIPANTS:: Four hundred fifty-six Dutch male soccer players of 23 amateur teams. MAIN OUTCOME MEASUR

  8. Adverse drug reactions to tocolytic treatment for preterm labour : prospective cohort study

    NARCIS (Netherlands)

    de Heus, R.; Mol, B.W.; Erwich, J.J.H.M.; van Geijn, H.P.; Gyselaers, W.J.; Hanssens, M.; Harmark, L.; van Holsbeke, C.D.; Duvekot, J.J.; Schobben, F.F.A.M.; Wolf, Hans; Visser, G.H.A.

    2009-01-01

    Objective To evaluate the incidence of serious maternal complications after the use of various tocolytic drugs for the treatment of preterm labour in routine clinical situations. Design Prospective cohort study. Setting 28 hospitals in the Netherlands and Belgium. Participants 1920 consecutive women

  9. Adverse drug reactions to tocolytic treatment for preterm labour: prospective cohort study

    NARCIS (Netherlands)

    R. de Heus; B.W. Mol; J.J.H.M. Erwich; H.P. van Geijn; W.J. Gyselaers; M. Hanssens; L. Härmark; C.D. van Holsbeke; J.J. Duvekot; F.F.A.M. Schobben; H. Wolf; G.H.A. Visser

    2009-01-01

    Objective To evaluate the incidence of serious maternal complications after the use of various tocolytic drugs for the treatment of preterm labour in routine clinical situations. Design Prospective cohort study. Setting 28 hospitals in the Netherlands and Belgium. Participants 1920 consecutive women

  10. Adverse drug reactions to tocolytic treatment for preterm labour: prospective cohort study

    NARCIS (Netherlands)

    Heus, R.; Mol, B.W.; Erwich, J.J.; Geijn, van H.; Gyselaers, W.J.; Hanssens, M.; Harmark, L.; Holsbeke, van C.D.; Duvekot, J.J.; Schobben, F.F.; Wolf, de H.; Visser, G.H.A.

    2009-01-01

    OBJECTIVE: To evaluate the incidence of serious maternal complications after the use of various tocolytic drugs for the treatment of preterm labour in routine clinical situations. DESIGN: Prospective cohort study. SETTING: 28 hospitals in the Netherlands and Belgium. PARTICIPANTS: 1920 consecutive w

  11. THE MAIN DIRECTIONS OF PROSPECTIVE COHORT STUDY OF POPULATION LIVING AROUND THE SEMIPALATINSK NUCLEAR TEST SITE

    OpenAIRE

    ZHUNUSSOVA T.; Grosche, B; Apsalikov, K.; BELIKHINA T.; Pivina, L.; Muldagaliev, T.

    2014-01-01

    In the paper we have presented the possibilities of prospective cohort study of health status in the radiation exposed population living around the Semipalatinsk nuclear test site. It was substantiated the necessity of international cooperation of scientists from Kazakhstan, Europe, Japan and the United States for long-term study of radiation effects for the people and the environment.

  12. Pre-diagnostic alcohol consumption and postmenopausal breast cancer survival: a prospective patient cohort study

    NARCIS (Netherlands)

    Vrieling, A.; Buck, K.; Heinz, J.; Obi, N.; Benner, A.; Flesch-Janys, D.; Chang-Claude, J.

    2012-01-01

    Study results on the association of alcohol consumption with breast cancer survival are inconsistent, partly due to the use of different survival outcomes. We assessed the association of pre-diagnostic alcohol consumption with survival and recurrence in a prospective cohort study in Germany includin

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

    Science.gov (United States)

    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…

  14. Susceptibility to deterioration of mobility long-term after stroke: a prospective cohort study.

    NARCIS (Netherlands)

    Port, I.G. van de; Kwakkel, G.; Wijk, I. van; Lindeman, E.

    2006-01-01

    BACKGROUND AND PURPOSE: The aim of the present study was to identify clinical determinants able to predict which individuals are susceptible to deterioration of mobility from 1 to 3 years after stroke. METHODS: Prospective cohort study of stroke patients consecutively admitted for inpatient rehabili

  15. Predictive factors of postpartum fatigue: a prospective cohort study among working women

    NARCIS (Netherlands)

    Bakker, M.; Beek, A.J. van der; Hendriksen, I.J.M.; Bruinvels, D.J.; Poppel, M.N. van

    2014-01-01

    Objectives The aim of this study was to investigate which prepartum determinants contribute to the development of postpartum (PP) fatigue among working women in the Netherlands. Methods A prospective cohort study in 15 Dutch companies was conducted to measure different potential predictors using sel

  16. Asymptomatic spontaneous cerebral emboli and mood in a cohort of older people: a prospective study.

    NARCIS (Netherlands)

    Oude Voshaar, R.C.; Purandare, N.; Hardicre, J.; McCollum, C.N.; Burns, A.

    2007-01-01

    OBJECTIVE: To examine whether asymptomatic spontaneous cerebral emboli (SCE) predicts subsequent depression in older people. METHODS: Prospective cohort study with 2.5 years of follow-up including 96 nondepressed older subjects in primary care. Presence of SCE was measured at baseline by transcrania

  17. Psychosocial work environment and antidepressant medication: a prospective cohort study

    DEFF Research Database (Denmark)

    Bonde, Jens Peter; Munch-Hansen, T.; Wieclaw, J.;

    2009-01-01

    antidepressant medication. METHODS: Information on all antidepressant drugs (AD) purchased at pharmacies from 1995 through 2006 was obtained for a cohort of 21,129 Danish public service workers that participated in work climate surveys carried out during the period 2002-2005. Individual self-reports of...... alone. None of the measured psychosocial work environment factors were consistently related to prescription of antidepressant drugs during the follow-up period. CONCLUSION: The study does not indicate that a poor psychosocial work environment among public service employees is related to prescription of...... antidepressant pharmaceuticals. These findings need cautious interpretation because of lacking individual exposure assessments Udgivelsesdato: 2009...

  18. Recall Bias in Childhood Atopic Diseases Among Adults in The Odense Adolescence Cohort Study

    DEFF Research Database (Denmark)

    Mortz, Charlotte G; Andersen, Klaus E; Bindslev-Jensen, Carsten

    2015-01-01

    Atopic dermatitis (AD) is a common disease in childhood and an important risk factor for the later development of other atopic diseases. Many publications on childhood AD use questionnaires based on information obtained in adulthood, which introduce the possibility of recall bias. In a prospective...... cohort study, recall bias was evaluated in 1,501 unselected schoolchildren (mean age 14 years) evaluated for the first time in 1995 with a standardized questionnaire combined with a clinical examination and repeated in 2010. The lifetime prevalence of AD was 34.1% including data obtained both during...... school age and 15 years later, compared with 23.6% including data only from adulthood. The most important factors for remembering having had AD in childhood were: (i) long duration of dermatitis in childhood; (ii) adult hand eczema; and (iii) concomitant atopic disease. Recall bias for childhood AD...

  19. Locoregional first recurrence after mastectomy: prospective cohort studies with and without immediate chemotherapy

    International Nuclear Information System (INIS)

    Purpose: To evaluate prospectively the impact of combination chemotherapy in the combined modality treatment of isolated first locoregional recurrence (LRR) following mastectomy for breast cancer. Methods and Materials: Between 1979 and 1989, 120 chemotherapy-naive women with isolated LRR as first failure after mastectomy were prospectively identified, uniformly staged, and systematically followed. Treatment consisted of excision if feasible, radical locoregional radiotherapy, and a hormonal maneuver (unless estrogen receptor negative). The initial chemotherapy cohort also received 8 cycles of doxorubicin and cyclophosphamide. This was compared to a subsequent control cohort. Results: For all patients, the 10-year actuarial relapse-free survival ± 95% confidence interval was 42.1 ± 9.2%, and overall survival was 56.8 ± 9.1%. No difference was seen in locoregional control between cohorts. At 5 years, distant recurrence-free survival for chemotherapy and control cohort respectively was 75.4 ± 10.8% and 60.7 ±12.5% (p = 0.33) and overall survival was 81.9% ± 9.6 and 74.3% ± 11.2 (p = 0.24). Univariate analysis showed no prognostic importance for any imbalance between cohorts. Cox modeling confirmed that complete resection was strongly associated with fewer LRR (hazard ratio [HR] 0.32, p = 0.001) and also with better overall survival (HR 1.82, p = 0.019). Chemotherapy produced a substantial reduction in risk of death (HR 0.72 CI 0.421-1.235, p = 0.23). Conclusions: In this prospective but nonrandomized study of treatment for first LRR, the risk of death in the later control cohort was 1.39 times the risk in the chemotherapy cohort but failed to reach statistical significance. The results justify further study

  20. Exposure to traffic and lung function in adults: a general population cohort study

    OpenAIRE

    Carlsen, Hanne Krage; Modig, Lars; Levinsson, Anna; Kim, Jeong-Lim; Toren, Kjell; Nyberg, Fredrik; Olin, Anna-Carin

    2015-01-01

    Objectives: To investigate the association between living near dense traffic and lung function in a cohort of adults from a single urban region. Design: Cross-sectional results from a cohort study. Setting: The adult-onset asthma and exhaled nitric oxide (ADONIX) cohort, sampled during 2001-2008 in Gothenburg, Sweden. Exposure was expressed as the distance from participants' residential address to the nearest road with dense traffic (>10 000 vehicles per day) or very dense traffic (>30 ...

  1. Estimating bias from loss to follow-up in a prospective cohort study of bicycle crash injuries

    Science.gov (United States)

    Tin Tin, Sandar; Woodward, Alistair; Ameratunga, Shanthi

    2014-01-01

    Background Loss to follow-up, if related to exposures, confounders and outcomes of interest, may bias association estimates. We estimated the magnitude and direction of such bias in a prospective cohort study of crash injury among cyclists. Methods The Taupo Bicycle Study involved 2590 adult cyclists recruited from New Zealand's largest cycling event in 2006 and followed over a median period of 4.6 years through linkage to four administrative databases. We resurveyed the participants in 2009 and excluded three participants who died prior to the resurvey. We compared baseline characteristics and crash outcomes of the baseline (2006) and follow-up (those who responded in 2009) cohorts by ratios of relative frequencies and estimated potential bias from loss to follow-up on seven exposure-outcome associations of interest by ratios of HRs. Results Of the 2587 cyclists in the baseline cohort, 1526 (60%) responded to the follow-up survey. The responders were older, more educated and more socioeconomically advantaged. They were more experienced cyclists who often rode in a bunch, off-road or in the dark, but were less likely to engage in other risky cycling behaviours. Additionally, they experienced bicycle crashes more frequently during follow-up. The selection bias ranged between −10% and +9% for selected associations. Conclusions Loss to follow-up was differential by demographic, cycling and behavioural risk characteristics as well as crash outcomes, but did not substantially bias association estimates of primary research interest. PMID:24336816

  2. Intake of nitrate and nitrite and the risk of gastric cancer: a prospective cohort study.

    OpenAIRE

    Loon, A.J.M. van; Botterweck, A.A.M.; Goldbohm, R. A.; Brants, H.A.M.; van Klaveren, J.D.; van den Brandt, P.A.

    1998-01-01

    The association between the intake of nitrate or nitrite and gastric cancer risk was investigated in a prospective cohort study started in 1986 in the Netherlands, of 120,852 men and women aged 55-69 years. At baseline, data on dietary intake, smoking habits and other covariates were collected by means of a self-administered questionnaire. For data analysis, a case-cohort approach was used, in which the person-years at risk were estimated from a randomly selected subcohort (1688 men and 1812 ...

  3. Sex differences in obesity incidence: 20‐year prospective cohort in South Africa

    OpenAIRE

    Lundeen, E. A.; Norris, S. A.; Adair, L. S.; Richter, L.M.; Stein, A.D.

    2015-01-01

    Summary Background Prospective data spanning childhood and adolescence are needed to better understand obesity incidence among children and to identify important periods for intervention. Objective To describe gender differences in overweight and obesity from infancy to late adolescence in a South African cohort. Methods We analysed body mass index at 1–2 years, 4–8 years, 11–12 years, 13–15 years and 16–18 years among 1172 participants in the South African Birth‐to‐Twenty cohort. Results Amo...

  4. Utility of Hippocrates’ prognostic aphorism to predict death in the modern era: prospective cohort study

    OpenAIRE

    St. John, Philip D.; Montgomery, Patrick R

    2014-01-01

    Objective To determine if one of Hippocrates’ aphorisms, identifying good cognition and good appetite as two prognostic factors, predicts death in community living older adults in the modern era. Design Secondary analysis of an existing population based cohort study. Setting Manitoba Study of Health and Aging. Participants 1751 community living adults aged more than 65 enrolled in the Manitoba Study of Health and Aging in 1991 and followed over five years. Main outcome measure Time to death. ...

  5. Psychosocial work environment and antidepressant medication: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Westergaard-Nielsen Niels

    2009-07-01

    Full Text Available Abstract Background Adverse psychosocial work environments may lead to impaired mental health, but it is still a matter of conjecture if demonstrated associations are causal or biased. We aimed at verifying whether poor psychosocial working climate is related to increase of redeemed subscription of antidepressant medication. Methods Information on all antidepressant drugs (AD purchased at pharmacies from 1995 through 2006 was obtained for a cohort of 21,129 Danish public service workers that participated in work climate surveys carried out during the period 2002–2005. Individual self-reports of psychosocial factors at work including satisfaction with the work climate and dimensions of the job strain model were obtained by self-administered questionnaires (response rate 77,2%. Each employee was assigned the average score value for all employees at his/her managerial work unit [1094 units with an average of 18 employees (range 3–120]. The risk of first-time AD prescription during follow-up was examined according to level of satisfaction and psychosocial strain by Cox regression with adjustment for gender, age, marital status, occupational status and calendar year of the survey. Results The proportion of employees that received at least one prescription of ADs from 1995 through 2006 was 11.9% and prescriptions rose steadily from 1.50% in 1996 to the highest level 6.47% in 2006. ADs were prescribed more frequent among women, middle aged, employees with low occupational status and those living alone. None of the measured psychosocial work environment factors were consistently related to prescription of antidepressant drugs during the follow-up period. Conclusion The study does not indicate that a poor psychosocial work environment among public service employees is related to prescription of antidepressant pharmaceuticals. These findings need cautious interpretation because of lacking individual exposure assessments.

  6. Testosterone deficiency and quality of life in Australasian testicular cancer survivors: a prospective cohort study.

    Science.gov (United States)

    O'Carrigan, B; Fournier, M; Olver, I N; Stockler, M R; Whitford, H; Toner, G C; Thomson, D B; Davis, I D; Hanning, F; Singhal, N; Underhill, C; Clingan, P; McDonald, A; Boland, A; Grimison, P

    2014-08-01

    This is the first prospective study in a contemporary Australian/New Zealand population to determine the prevalence of testosterone deficiency in testicular cancer survivors at 12 months from treatment, and any association with poorer quality of life. Hormone assays from 54 evaluable patients in a prospective cohort study revealed biochemical hypogonadism in 18 patients (33%) and low-normal testosterone in 13 patients (24%). We found no association between testosterone levels and quality of life (all P > 0.05). Hypogonadal patients should be considered for testosterone replacement to prevent long-term morbidity. PMID:25081047

  7. Complex prospective memory in adults with attention deficit hyperactivity disorder.

    Directory of Open Access Journals (Sweden)

    Anselm B M Fuermaier

    Full Text Available OBJECTIVES: Attention deficit hyperactivity disorder (ADHD in adults has been associated with disturbances of attention and executive functions. Furthermore, impairments of verbal and figural retrospective memory were reported. However, little is known about the effects of ADHD on prospective memory, the execution of delayed intentions in the future. METHODS: The present study compared the performance of 45 adult patients with ADHD not treated with stimulant medication with the performance of 45 matched healthy individuals on a paradigm of complex prospective memory which measured task planning, plan recall, self-initiation and execution. Furthermore, the contribution of other cognitive functions to prospective memory functioning was assessed, including measures of attention, executive functions and memory. RESULTS: A large-scale impairment could be observed in task planning abilities in patients with ADHD. Only negligible to small effects were found for plan recall, self-initiation and execution. Inhibition was identified to contribute significantly to performance on task planning. CONCLUSIONS: The present findings suggest that four cognitive components contribute to the performance of prospective memory. Impairments of prospective memory mainly emerged from deficient planning abilities in adults with ADHD. Implications on behavioral based intervention strategies are discussed.

  8. Adult Education in Malta: Challenges and Prospects

    Science.gov (United States)

    Mayo, Peter

    2012-01-01

    Lifelong learning has long been a topic of discussion in Malta but, as this article shows, barriers to participation continue to exist. This article outlines the historical and economic changes that have led Malta to its present situation where adult education largely focuses on employment skills. Although available through a variety of channels,…

  9. Contaminated small drinking water supplies and risk of infectious intestinal disease: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Helen L Risebro

    Full Text Available BACKGROUND: This study sought to identify whether elevated risk of infectious intestinal disease (IID exists in contaminated small water supply consumers compared with consumers drinking from small supplies complying with current standards and whether this effect is modified by age. METHODOLOGY AND PRINCIPAL FINDINGS: A prospective cohort study of 611 individuals receiving small supplies in England was conducted. Water supplies received sanitary inspection and examination for indicator bacteria and participants maintained a daily record of IID. Regression modeling with generalized estimating equations that included interaction terms between age and indicators of fecal pollution was performed. Crude IID prevalence was 9 · 3 days with symptoms/1000 person days (95%CI: 8 · 4, 10 · 1 and incidence was 3 · 2 episodes/1000 person days (95%CI, 2 · 7, 3 · 7 or 1 · 2 episodes per person year. Although there was no overall association between IID risk and indicator presence, there was strong interaction between age and indicator presence. In children under ten, relative risk (RR of IID in those drinking from enterococci contaminated supplies was 4.8 (95%CI: 1.5, 15.3 for incidence and 8.9 (95%CI: 2.8, 27.5 for prevalence. In those aged 10 to 59, IID risk was lower but not statistically significant. CONCLUSIONS: Contaminated small water supplies pose a substantial risk of IID to young children who live in homes reliant on these supplies. By contrast older children and adults do not appear to be at increased risk. Health care professionals with responsibility for children living in homes provided by very small water supplies should make parents aware of the risk.

  10. Prospective surveillance and molecular characterization of seasonal influenza in a university cohort in Singapore.

    Directory of Open Access Journals (Sweden)

    Ramandeep Kaur Virk

    Full Text Available BACKGROUND: Southeast Asia is believed to be a potential locus for the emergence of novel influenza strains, and therefore accurate sentinel surveillance in the region is critical. Limited information exists on sentinel surveillance of influenza-like illness (ILI in young adults in Singapore in a University campus setting. The objective of the present study was to determine the proportion of ILI caused by influenza A and B viruses in a university cohort in Singapore. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a prospective surveillance study from May through October 2007, at the National University of Singapore (NUS. Basic demographic information and nasopharyngeal swabs were collected from students and staff with ILI. Reverse-transcriptase PCR (RT-PCR and viral isolation were employed to detect influenza viruses. Sequencing of hemagglutinin (HA and neuraminidase (NA genes of some representative isolates was also performed. Overall proportions of influenza A and B virus infections were 47/266 (18% and 9/266 (3% respectively. The predominant subtype was A/H3N2 (55% and the rest were A/H1N1 (45%. The overall sensitivity difference for detection of influenza A viruses using RT-PCR and viral isolation was 53%. Phylogenetic analyses of HA and NA gene sequences of Singapore strains showed identities higher than 98% within both the genes. The strains were more similar to strains included in the WHO vaccine recommendation for the following year (2008. Genetic markers of oseltamivir resistance were not detected in any of the sequenced Singapore isolates. CONCLUSIONS/SIGNIFICANCE: HA and NA gene sequences of Singapore strains were similar to vaccine strains for the upcoming influenza season. No drug resistance was found. Sentinel surveillance on university campuses should make use of molecular methods to better detect emerging and re-emerging influenza viral threats.

  11. Living with diabetes: rationale, study design and baseline characteristics for an Australian prospective cohort study

    Directory of Open Access Journals (Sweden)

    Donald Maria

    2012-01-01

    Full Text Available Abstract Background Diabetes mellitus is a major global public health threat. In Australia, as elsewhere, it is responsible for a sizeable portion of the overall burden of disease, and significant costs. The psychological and social impact of diabetes on individuals with the disease can be severe, and if not adequately addressed, can lead to the worsening of the overall disease picture. The Living With Diabetes Study aims to contribute to a holistic understanding of the psychological and social aspects of diabetes mellitus. Methods/Design The Living With Diabetes Study is a 5-year prospective cohort study, based in Queensland, Australia. The first wave of data, which was collected via a mailed self-report survey, was gathered in 2008, with annual collections thereafter. Measurements include: demographic, lifestyle, health and disease characteristics; quality of life (EQ-5D, ADDQoL; emotional well-being (CES-D, LOT-R, ESSI; disease self-management (PAM; and health-care utilisation and patient-assessed quality of care (PACIC. 29% of the 14,439 adults who were invited to participate in the study agreed to do so, yielding a sample size of 3,951 people. Discussion The data collected by the Living With Diabetes Study provides a good representation of Australians with diabetes to follow over time in order to better understand the natural course of the illness. The study has potential to further illuminate, and give a comprehensive picture of the psychosocial implications of living with diabetes. Data collection is ongoing.

  12. Association between Sleep Duration and Cancer Risk: A Meta-Analysis of Prospective Cohort Studies

    OpenAIRE

    Yan Lu; Nong Tian; Jie Yin; Yuhua Shi; Zhenping Huang

    2013-01-01

    BACKGROUND: Sleep duration has been shown to play an important role in the development of cancer. However, the results have been inconsistent. A meta-analysis with prospective cohort studies was performed to clarify the association between short or long sleep duration and cancer risk. METHODS: PubMed and Embase databases were searched for eligible publications. Pooled relative risk (RR) with 95% confidence interval (CI) was calculated using random- or fixed- model. RESULTS: A total of 10 pros...

  13. Recreational Physical Activity and the Risk of Preeclampsia: A Prospective Cohort of Norwegian Women

    OpenAIRE

    2008-01-01

    Previous case-control studies suggest that recreational physical activity protects against preeclampsia. Using a prospective design, the authors estimated the risk of preeclampsia for pregnant women according to level of physical activity, taking other variables that influence risk into consideration. The data set comprised 59,573 pregnancies from the Norwegian Mother and Child Cohort Study (1999–2006). Information on physical activity and other exposures was extracted from questionnaire resp...

  14. Program specific admission testing and dropout for sports science students: a prospective cohort study

    DEFF Research Database (Denmark)

    O'Neill, Lotte; Christensen, Mette Krogh; Vonsild, Maria Cecilie;

    2014-01-01

    admission strategy was also independently associated with dropout for sports science students in a university setting. The study design was a prospective cohort study with a 2 year follow-up. The population was 449 sports science students admitted to a university in the years 2002-2007. The analysis was......-based admission. This result may fit with elements of previous dropout theory, student-environment fit theory and perhaps also with self-efficacy theory....

  15. Sensibility and taste alterations after impacted lower third molar extractions. A prospective cohort study

    OpenAIRE

    Ridaura-Ruiz, Lourdes; Figueiredo, Rui; Valmaseda-Castellón, Eduard; Berini-Aytés, Leonardo; Gay-Escoda, Cosme

    2012-01-01

    Objectives: To determine the incidence, severity and duration of lingual tactile and gustatory function impairments after lower third molar removal. Study Design: Prospective cohort study with intra-subject measures of 16 patients undergoing lower third molar extractions. Sensibility and gustatory functions were evaluated in each subject preoperatively, one week and one month after the extraction, using Semmes-Weinstein monofilaments and 5 different concentrations of NaCl, respectively. Addit...

  16. The relationship between water intake and foetal growth and preterm delivery in a prospective cohort study

    OpenAIRE

    Wright J Michael; Hoffman Caroline S; Savitz David A

    2010-01-01

    Abstract Background Interpretation of previous associations between water intake and adverse birth outcomes is challenging given that amount and type of water consumed can be non-specific markers of exposure or underlying behavioural characteristics. We examined the relationship between water intake measures and adverse birth outcomes in participants from three study sites in the United States. Methods Using a prospective cohort study, we examined daily intake of bottled, cold tap, total tap,...

  17. Smoking during pregnancy and risk of abnormal glucose tolerance: a prospective cohort study

    OpenAIRE

    Haskins Amy E; Bertone-Johnson Elizabeth R; Pekow Penelope; Carbone Elena; Fortner Renée T; Chasan-Taber Lisa

    2010-01-01

    Abstract Background Disturbances in glucose metabolism during pregnancy are associated with negative sequalae for both mother and infant. The association between smoking and abnormal glucose tolerance (AGT) remains controversial. Therefore, the aim of this study was to examine the relationship between smoking prior to and during pregnancy and risk of AGT. Methods We utilized data from a prospective cohort of 1,006 Hispanic (predominantly Puerto Rican) prenatal care patients in Western Massach...

  18. Prospective cohort study of predictors of incident low back pain in nurses.

    OpenAIRE

    Smedley, J.; Egger, P.; Cooper, C.; Coggon, D

    1997-01-01

    OBJECTIVE: To assess the impact of handling patients and indicators of individual susceptibility on risk of low back pain in nurses. DESIGN: Prospective cohort study with follow up by repeated self administered every three months over two years. SETTING: NHS university hospital trust. SUBJECTS: 961 female nurses who had been free from low back pain for at least one month at the time of completing a baseline questionnaire. MAIN OUTCOME MEASURES: Incidence of new low back pain during follow up ...

  19. Speed of updating online evidence based point of care summaries: prospective cohort analysis

    OpenAIRE

    Banzi, Rita; Cinquini, Michela; Liberati, Alessandro; Moschetti, Ivan; Pecoraro, Valentina; Tagliabue, Ludovica; Moja, Lorenzo

    2011-01-01

    Objective To evaluate the ability of international point of care information summaries to update evidence relevant to medical practice. Design Prospective cohort bibliometric analysis. Setting Top five point of care information summaries (Clinical Evidence, EBMGuidelines, eMedicine, Dynamed, UpToDate) ranked for coverage of medical conditions, editorial quality, and evidence based methodology. Main outcome measures From June 2009 to May 2010 we measured the incidence of research findings rela...

  20. Peer Victimization During Adolescence and Risk for Anxiety Disorders in Adulthood: A Prospective Cohort Study

    OpenAIRE

    Stapinski, Lexine A; Bowes, Lucy; Wolke, Dieter; Pearson, Rebecca M.; Mahedy, Liam; Button, Katherine S; Lewis, Glyn; Araya, Ricardo

    2014-01-01

    Background Peer victimization is ubiquitous across schools and cultures, and has been suggested as one developmental pathway to anxiety disorders. However, there is a dearth of prospective studies examining this relationship. The purpose of this cohort study was to examine the association between peer victimization during adolescence and subsequent anxiety diagnoses in adulthood. A secondary aim was to investigate whether victimization increases risk for severe anxiety presentations involving...

  1. Risk of Pre-Eclampsia in First and Subsequent Pregnancies: Prospective Cohort Study

    OpenAIRE

    Cnattingius, Sven; Toh, Sengwee; Hernández-Díaz, Sonia

    2009-01-01

    Objective: To investigate whether pre-eclampsia is more common in first pregnancies solely because fewer affected women, who presumably have a higher risk of recurrence, go on to have subsequent pregnancies. Design: Prospective cohort study. Setting: Swedish Medical Birth Register. Participants: 763 795 primiparous mothers who had their first births in Sweden, 1987-2004. Main outcome measures: Pre-eclampsia. Results: The risk of pre-eclampsia was 4.1% in the first pregnancy and 1.7% in later ...

  2. Adverse drug reactions to tocolytic treatment for preterm labour: Prospective cohort study

    OpenAIRE

    Heus, R.; Mol, B. W.; Erwich, J.J.H.M.; van Geijn, H.P.; Gyselaers, W.J.; Hanssens, M.; Harmark, L.; van Holsbeke, C.D.; Duvekot, J.J.; Schobben, F.F.A.M.; Wolf, Hans; Visser, G. H. A.

    2009-01-01

    textabstractObjective To evaluate the incidence of serious maternal complications after the use of various tocolytic drugs for the treatment of preterm labour in routine clinical situations. Design Prospective cohort study. Setting 28 hospitals in the Netherlands and Belgium. Participants 1920 consecutive women treated with tocolytics for threatened preterm labour. Main outcome measures Maternal adverse events (those suspected of being causally related to treatment were considered adverse dru...

  3. Prognostic role of Helicobacter pylori infection in acute coronary syndrome: a prospective cohort study

    OpenAIRE

    Eskandarian, Rahimeh; Madani, M; R. Ghorbani; Shiyasi, M; Momeni, B.; Hajifathalian, K

    2012-01-01

    Abstract In a prospective cohort study, we evaluated the effect of Helicobacter pylori seropositivity on the risk of future adverse cardiovascular outcomes among patients with acute coronary syndrome (ACS). In 433 patients, IgA and IgG antibodies to H pylori, along with classic risk factors, including hypertension, diabetes, hyperlipidaemia, smoking and family history of coronary artery disease (CAD) were determined. Short-and long-term follow-up information on adverse outcomes, defined as re...

  4. The Effect of Adenotonsillectomy on Pediatric Nocturnal Enuresis: a Prospective Cohort Study

    OpenAIRE

    Mohammad Saeed Ahmadi; Shahriar Amirhassani; Jalal Poorolajal

    2013-01-01

    Introduction: Sleep disorder caused by adenotonsillar hypertrophy has been implicated as a cause of primary and secondary nocturnal enuresis in children. This study was conducted to investigate the effect of adenotonsillectomy on enuresis in children with adenotonsillar hypertrophy. Materials and Methods: This prospective cohort study was conducted in Hamadan City in Western Iran, from April 2010 to December 2011. Ninety-seven children aged 3 to 12 years with adenotonsillar hypertrophy who we...

  5. Job Strain and Cognitive Decline: A Prospective Study of the Framingham Offspring Cohort

    OpenAIRE

    W Agbenyikey; R Karasek; Cifuentes, M.; PA Wolf; Seshadri, S.; Taylor JA; AS Beiser; Au, R.

    2015-01-01

    Background: Workplace stress is known to be related with many behavioral and disease outcomes. However, little is known about its prospective relationship with measures of cognitive decline.Objective: To investigate the association of job strain, psychological demands and job control on cognitive decline.Methods: Participants from Framingham Offspring cohort (n=1429), were assessed on job strain, and received neuropsychological assessment approximately 15 years and 21 years afterwards.Results...

  6. Association between dietary patterns and coronary heart disease: a meta-analysis of prospective cohort studies

    OpenAIRE

    Hou, Lina; LI Fei; Wang, Yuanyuan; Ou, Zejin; Xu, Dingli; Tan, Wanlong; Dai, Meng

    2015-01-01

    The associations of dietary patterns with coronary heart disease (CHD) risk remain unclear. Thereby, a meta-analysis was conducted to examine potential relations between dietary patterns and CHD. PubMed and EMBASE databases were searched up to March 2014 for eligible prospective cohort studies regarding the relationships between common dietary patterns and CHD. Random-effects models were applied to calculate the summary relative risk estimates (SRRE) for the highest versus the lowest category...

  7. Evans Syndrome in Children: Long-Term Outcome in a Prospective French National Observational Cohort

    OpenAIRE

    Aladjidi, Nathalie; Fernandes, Helder; Leblanc, Thierry; Vareliette, Amélie; Rieux-Laucat, Frédéric; Bertrand, Yves; Chambost, Hervé; Pasquet, Marlène; Mazingue, Françoise; Guitton, Corinne; Pellier, Isabelle; Roqueplan-Bellmann, Françoise; Armari-Alla, Corinne; Thomas, Caroline; Marie-Cardine, Aude

    2015-01-01

    Evans syndrome (ES) is a rare autoimmune disorder whose long-term outcome is not well known. In France, a collaborative pediatric network set up via the National Rare Disease Plan now provides comprehensive clinical data in children with this disease. Patients aged less than 18 years at the initial presentation of autoimmune cytopenia have been prospectively included into a national observational cohort since 2004. The definition of ES was restricted to the simultaneous or sequential associat...

  8. Nutritional status predicts preterm death in older people : a prospective cohort study

    OpenAIRE

    Söderström, Lisa; Rosenblad, Andreas; Adolfsson, Eva Thors; Saletti, Anja; Bergkvist, Leif

    2014-01-01

    Background & aims: There is an association between malnutrition and mortality. However, it is uncertain whether this association is independent of confounders. The aim of the present study was to examine whether nutritional status, defined according to the three categories in the full Mini Nutritional Assessment (MNA) instrument, is an independent predictor of preterm death in people 65 years and older. Methods: This prospective cohort study included individuals aged >= 65 years who we...

  9. Gestational influenza and risk of hypomania in young adulthood: prospective birth cohort study

    OpenAIRE

    Anderson, Jana J; Hoath, Sean; Zammit, Stanley; Meyer, Thomas D.; Pell, Jill P.; Mackay, Daniel; Smith, Daniel J

    2016-01-01

    BACKGROUND: Previous studies have suggested a possible link between exposure to influenza in utero and bipolar disorder in adulthood. Using data from a prospective birth cohort, we aimed to test for an association between exposure to gestational influenza and the experience of hypomania assessed in early adulthood.METHODS: We used data on 2957 participants from the Avon Longitudinal Study of Parents and Children (ALSPAC). The two main outcomes of interest were hypomania, assessed using the Hy...

  10. Maternal use of oral contraceptives and risk of birth defects in Denmark: prospective, nationwide cohort study

    OpenAIRE

    Charlton, Brittany M; Mølgaard-Nielsen, Ditte; Svanström, Henrik; Wohlfahrt, Jan; Pasternak, Björn; Melbye, Mads

    2016-01-01

    Study question Is oral contraceptive use around the time of pregnancy onset associated with an increased risk of major birth defects? Methods: In a prospective observational cohort study, data on oral contraceptive use and major birth defects were collected among 880 694 live births from Danish registries between 1997 and 2011. We conservatively assumed that oral contraceptive exposure lasted up to the most recently filled prescription. The main outcome measure was the number of major birth d...

  11. Diabetes and pancreatic cancer survival: a prospective cohort-based study

    OpenAIRE

    Toriola, A T; Stolzenberg-Solomon, R; Dalidowitz, L; Linehan, D; Colditz, G

    2014-01-01

    Background: Diabetes is a risk factor for pancreatic cancer but its association with survival from pancreatic cancer is poorly understood. Our objective was to investigate the association of diabetes with survival among pancreatic cancer patients in a prospective cohort-based study where diabetes history was ascertained before pancreatic cancer diagnosis. Methods: We evaluated survival by baseline (1993–2001) self-reported diabetes history (n=62) among 504 participants that developed exocrine...

  12. Widow Inheritance and HIV Prevalence in Bondo District, Kenya: Baseline Results from a Prospective Cohort Study

    OpenAIRE

    Agot, Kawango E; Vander Stoep, Ann; Tracy, Melissa; Obare, Billy A.; Bukusi, Elizabeth A.; Ndinya-Achola, Jeckoniah O; Moses, Stephen; Weiss, Noel S.

    2010-01-01

    Background Widow Inheritance is a widespread cultural practice in sub-Saharan Africa that has been postulated as contributing to risk of HIV transmission. We present baseline results from a study designed to investigate the association between widow inheritance and HIV acquisition. Methods and Findings We performed a cross-sectional analysis of baseline data from a prospective cohort study to investigate if widow inheritance is a risk practice for HIV infection. Study participants were 1,987 ...

  13. Intrinsic risk factors for acute ankle injuries among male soccer players : a prospective cohort study

    OpenAIRE

    Engebretsen, Anders Hauge; Myklebust, Grethe; Holme, Ingar Morten K.; Engebretsen, Lars; Bahr, Roald

    2009-01-01

    This prospective cohort study was conducted to identify risk factors for acute ankle injuries among male soccer players. A total of 508 players representing 31 amateur teams were tested during the 2004 pre-season through a questionnaire on previous injury and function score (foot and ankle outcome score; FAOS), functional tests (balance tests on the floor and a balance mat) and a clinical examination of the ankle. Generalized estimating equations were used in univariate analyses to identify c...

  14. Adherence to healthy lifestyle and risk of gestational diabetes mellitus: prospective cohort study

    OpenAIRE

    Zhang, Cuilin; Tobias, Deirdre K; Chavarro, Jorge E; Bao, Wei; Wang, Dong; Ley, Sylvia H; Hu, Frank B

    2014-01-01

    Objective: To quantify the association between a combination of healthy lifestyle factors before pregnancy (healthy body weight, healthy diet, regular exercise, and not smoking) and the risk of gestational diabetes. Design: Prospective cohort study. Setting: Nurses’ Health Study II, United States. Participants: 20 136 singleton live births in 14 437 women without chronic disease. Main outcome measure Self reported incident gestational diabetes diagnosed by a physician, validated by medical re...

  15. Iron intake, haemoglobin and risk of gestational diabetes: a prospective cohort study

    OpenAIRE

    Helin, Annika; Kinnunen, Tarja Inkeri; Raitanen, Jani; Ahonen, Suvi; Virtanen, Suvi M.; Luoto, Riitta

    2012-01-01

    Objective To investigate the possible association between total daily iron intake during pregnancy, haemoglobin in early pregnancy and the risk of gestational diabetes mellitus (GDM) in women at increased risk of GDM. Design A prospective cohort study (based on a cluster-randomised controlled trial, where the intervention and the usual care groups were combined). Setting Primary healthcare maternity clinics in 14 municipalities in south-western Finland. Participants 399 Pregnant women who wer...

  16. Adherence to healthy lifestyle and risk of gestational diabetes mellitus: prospective cohort study

    OpenAIRE

    Zhang, Cuilin; Tobias, Deirdre K; Chavarro, Jorge E; Bao, Wei; Wang, Dong; Ley, Sylvia H; Hu, Frank B

    2014-01-01

    Objective To quantify the association between a combination of healthy lifestyle factors before pregnancy (healthy body weight, healthy diet, regular exercise, and not smoking) and the risk of gestational diabetes. Design Prospective cohort study. Setting Nurses’ Health Study II, United States. Participants 20 136 singleton live births in 14 437 women without chronic disease. Main outcome measure Self reported incident gestational diabetes diagnosed by a physician, validated by medical record...

  17. Body mass index and obstetric outcomes in Saudi Arabia: a prospective cohort study

    OpenAIRE

    El-Gilany, Abdel-Hady; Hammad, Sabry

    2010-01-01

    BACKGROUND AND OBJECTIVES: We examined the effect of body mass index in early pregnancy on pregnancy outcome since no study in Saudi Arabia has addressed this question. METHODS: This prospective cohort study involved women registered for antenatal care during the first month of pregnancy at primary health care centers in Al-Hassa, Saudi Arabia. Data was collected from records and by direct interview. RESULTS: The study included 787 women. Compared to normal weight women (n=307), overweight (n...

  18. Workplace bullying, sleep problems and leisure-time physical activity: a prospective cohort study

    DEFF Research Database (Denmark)

    Hansen, Åse Marie; Gullander, Maria; Hogh, Annie;

    2015-01-01

    OBJECTIVES: Workplace bullying is a potent stressor that may increase sleep problems. Since physical fitness improves resilience to stress, it seems plausible that recreational physical activities may moderate the association between bullying and sleep. The study aimed to examine prospectively...... whether (i) bullying increases the risk of sleep problems, and (ii) the association between bullying and sleep problems is moderated by leisure-time physical activity (LTPA). METHODS: The study sample comprised a cohort of public and private sector employees, who were enrolled into the Work Bullying and...... Harassment (WBH) cohort (N=3278) or the Psychosocial Risk Factors for Stress and Mental Disease (PRISME) cohort (N=4455). We measured workplace bullying using one question that was preceded by a definition of bullying. We used the Karolinska sleep questionnaire to assess sleep problems. The number of hours...

  19. Hyperhomocysteinemia predicts renal function decline: a prospective study in hypertensive adults.

    Science.gov (United States)

    Xie, Di; Yuan, Yan; Guo, Jiangnan; Yang, Shenglin; Xu, Xin; Wang, Qin; Li, Youbao; Qin, Xianhui; Tang, Genfu; Huo, Yong; Deng, Guangpu; Wu, Shengjie; Wang, Binyan; Zhang, Qin; Wang, Xiaobin; Fang, Pu; Wang, Hong; Xu, Xiping; Hou, Fanfan

    2015-01-01

    Hyper-homocysteinemia (HHcy) is associated with microalbuminuria and glomerular injury in general and diabetic populations. However, HHcy's role in hypertensive patients was not studied. We investigated whether HHcy is an independent risk factor for renal function decline and development of chronic kidney disease (CKD) in hypertensive men and women. This was a community-based prospective cohort study of 2,387 hypertensive adults without CKD at baseline, with a mean follow-up of 4.4 years. Baseline and follow-up levels of plasma Hcy, folate, vitamin B12, blood pressure and other pertinent covariables were obtained. CKD was defined as an estimated glomerular filtration rate (eGFR) 1 ml/min/per 1.73 m(2)/year. There was a graded association between Hcy tertiles and eGFR decline. Subjects in the 3(rd) tertile of Hcy levels had an accelerated rate of eGFR decline and an increased risk of incident CKD, as compared with those in the 1st tertile, after adjusting for age, gender, baseline diabetes, SBP, BMI, smoking, dyslipidemia, eGFR, folate and vitamin B12 levels. In conclusion, in this prospective cohort of Chinese hypertensive adults, elevated baseline plasma Hcy can serve as an independent biomarker to predict renal function decline and incident CKD. PMID:26553372

  20. Addiction Treatment Experience among a Cohort of Street-Involved Youths and Young Adults

    Science.gov (United States)

    Wong, Jellena; Marshall, Brandon D. L.; Kerr, Thomas; Lai, Calvin; Wood, Evan

    2009-01-01

    Very little is known about the accessibility and potential barriers to addiction treatment among street youths and young adults. We sought to examine the prevalence and correlates of enrollment in addiction treatment among a cohort of street-involved youths and young adults in Vancouver, Canada. Street-involved youths and young adults who use…

  1. Seasonal incidence of medically attended respiratory syncytial virus infection in a community cohort of adults ≥50 years old.

    Directory of Open Access Journals (Sweden)

    David L McClure

    Full Text Available BACKGROUND: Diagnostic testing for respiratory syncytial virus (RSV is not routinely performed in adults. We estimated medically attended RSV seasonal incidence in a community cohort of adults ≥50 years old during four influenza seasons (2006-07 through 2009-10. METHODS: Patients seeking care for acute respiratory illness (ARI were prospectively enrolled and tested for RSV by multiplex RT-PCR. Results from enrolled patients were used to estimate projected cases among non-enrolled patients with ARI. The seasonal incidence of medically attended RSV was the sum of actual and projected cases divided by the community cohort denominator. Since each enrollment period did not include the entire RSV season, incidence estimates were adjusted to account for the statewide proportion of RSV occurring outside the study enrollment period. RESULTS: There were 16,088 to 17,694 adults in the cohort each season and 164 RSV cases in all 4 seasons. The overall seasonal incidence of medically attended RSV was 154 episodes (95% CI, 132-180 per 10,000 persons; the incidence was highest in 2007-08 (179 and lowest in 2006-07 (110. Among persons 50-59, 60-69, and ≥70 years old, RSV incidence was 124 (95% CI, 99-156, 147 (95% CI, 110-196, and 199 (95% CI, 153-258, respectively. CONCLUSIONS: The incidence of medically attended RSV increased with age and was similar during four seasons.

  2. Investigation of bias due to loss of participants in a Dutch multicentre prospective spinal cord injury cohort study

    OpenAIRE

    De Groot,, P.A.J.; Haisma, J.A.; Post, M.W.; Asbeck, van, F.W.A.; Woude, van der, C.J.

    2009-01-01

    OBJECTIVE: To determine bias due to loss of participants (attrition bias) in a prospective cohort study. DESIGN: A multi-centre prospective cohort study. SUBJECTS: A total of 225 individuals with a spinal cord injury from 8 Dutch rehabilitation centres. METHODS: Participants were considered non-participants when no information was collected at the measurement one year after discharge from inpatient rehabilitation. Using bivariate tests participants and non-participants were compared regarding...

  3. A prospective cohort study comparing early opioid requirement between Chinese from Hong Kong and Caucasian Australians after major abdominal surgery

    DEFF Research Database (Denmark)

    Konstantatos, A H; Imberger, G; Angliss, M;

    2012-01-01

    The relationship between ethnicity and early opioid consumption is not well understood. Our prospective cohort study tested whether Chinese patients in Hong Kong require less opioid after major abdominal surgery compared with Caucasian patients in Australia.......The relationship between ethnicity and early opioid consumption is not well understood. Our prospective cohort study tested whether Chinese patients in Hong Kong require less opioid after major abdominal surgery compared with Caucasian patients in Australia....

  4. Burden of cancer in a large consortium of prospective cohorts in Europe

    OpenAIRE

    Tsilidis, KK; Papadimitriou, N; Capothanassi, D; Bamia, C.; Benetou, V; Jenab, M; Freisling, H; Kee, F.; Nelen, A; O'Doherty, MG; Scott, A.; Soerjomataram, I; Tjønneland, A; May, AM; Ramón Quirós, J

    2016-01-01

    Disability-adjusted life-years (DALYs) are an indicator of mortality, morbidity, and disability. We calculated DALYs for cancer in middle-aged and older adults participating in the Consortium on Health and Ageing Network of Cohorts in Europe and the United States (CHANCES) consortium.A total of 90 199 participants from five European cohorts with 10 455 incident cancers and 4399 deaths were included in this study. DALYs were calculated as the sum of the years of life lost because of premature ...

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

    Science.gov (United States)

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

    2015-01-01

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

  6. Weekly miscarriage rates in a community-based prospective cohort study in rural western Kenya

    Science.gov (United States)

    Dellicour, Stephanie; Aol, George; Ouma, Peter; Yan, Nicole; Bigogo, Godfrey; Hamel, Mary J; Burton, Deron C; Oneko, Martina; Breiman, Robert F; Slutsker, Laurence; Feikin, Daniel; Kariuki, Simon; Odhiambo, Frank; Stergachis, Andreas; Laserson, Kayla F; ter Kuile, Feiko O; Desai, Meghna

    2016-01-01

    Objective Information on adverse pregnancy outcomes is important to monitor the impact of public health interventions. Miscarriage is a challenging end point to ascertain and there is scarce information on its rate in low-income countries. The objective was to estimate the background rate and cumulative probability of miscarriage in rural western Kenya. Design This was a population-based prospective cohort. Participants and setting Women of childbearing age were followed prospectively to identify pregnancies and ascertain their outcomes in Siaya County, western Kenya. The cohort study was carried out in 33 adjacent villages under health and demographic surveillance. Outcome measure Miscarriage. Results Between 2011 and 2013, among 5536 women of childbearing age, 1453 pregnancies were detected and 1134 were included in the analysis. The cumulative probability was 18.9%. The weekly miscarriage rate declined steadily with increasing gestation until approximately 20 weeks. Known risk factors for miscarriage such as maternal age, gravidity, occupation, household wealth and HIV infection were confirmed. Conclusions This is the first report of weekly miscarriage rates in a rural African setting in the context of high HIV and malaria prevalence. Future studies should consider the involvement of community health workers to identify the pregnancy cohort of early gestation for better data on the actual number of pregnancies and the assessment of miscarriage. PMID:27084287

  7. A Prospective Cohort Evaluation of a Robotic, Auto-Navigating Operating Microscope

    Science.gov (United States)

    Bohl, Michael A; Oppenlander, Mark E

    2016-01-01

    The unique challenges inherent to microneurosurgery demand that we stay on the forefront of new surgical technologies. Many believe the next major technological advance in neurosurgery will be the widespread application of image-guided robotics in the operating room. We evaluated a novel technology for image-guided robotic auto-navigation of the operating microscope in a prospectively enrolled cohort of patients. Twenty patients were prospectively enrolled for analysis. Data were collected on the extent of resection, operative time, estimated blood loss, time taken to set up the new software, and complications encountered. Software accuracy, reliability, and usefulness in the case were subjectively evaluated. The most commonly  treated pathologies were cavernous malformation (n = 5), arteriovenous malformation (n = 4), and meningioma (n = 4). The time to set up the new software interface before the start of the operation was robotic interface to be accurate, reliable, and useful. The new technology was significantly more useful in deeper lesions. The addition of image-guided robotic auto-positioning features to the operating microscope has a great potential to advance the field of neurosurgery. This study is the first prospective evaluation of such a technology in a patient cohort. The results suggest that the newest robotic auto-positioning technology has the potential to improve the neurosurgeon's efficiency and efficacy, thereby positively impacting patient safety and surgical outcomes, especially in cases involving deep-seated lesions. PMID:27493844

  8. Physical activity and risk of Amyotrophic Lateral Sclerosis in a prospective cohort study.

    Science.gov (United States)

    Gallo, Valentina; Vanacore, Nicola; Bueno-de-Mesquita, H Bas; Vermeulen, Roel; Brayne, Carol; Pearce, Neil; Wark, Petra A; Ward, Heather A; Ferrari, Pietro; Jenab, Mazda; Andersen, Peter M; Wennberg, Patrik; Wareham, Nicholas; Katzke, Verena; Kaaks, Rudolf; Weiderpass, Elisabete; Peeters, Petra H; Mattiello, Amalia; Pala, Valeria; Barricante, Aurelio; Chirlaque, Maria-Dolores; Travier, Noémie; Travis, Ruth C; Sanchez, Maria-Jose; Pessah-Rasmussen, Hélène; Petersson, Jesper; Tjønneland, Anne; Tumino, Rosario; Quiros, Jose Ramon; Trichopoulou, Antonia; Kyrozis, Andreas; Oikonomidou, Despoina; Masala, Giovanna; Sacerdote, Carlotta; Arriola, Larraitz; Boeing, Heiner; Vigl, Matthaeus; Claver-Chapelon, Francoise; Middleton, Lefkos; Riboli, Elio; Vineis, Paolo

    2016-03-01

    Previous case-control studies have suggested a possible increased risk of Amyotrophic Lateral Sclerosis (ALS) with physical activity (PA), but this association has never been studied in prospective cohort studies. We therefore assessed the association between PA and risk of death from ALS in the European Prospective Investigation into Cancer and Nutrition. A total of 472,100 individuals were included in the analysis, yielding 219 ALS deaths. At recruitment, information on PA was collected thorough standardised questionnaires. Total PA was expressed by the Cambridge Physical Activity Index (CPAI) and analysed in relation to ALS mortality, using Cox hazard models. Interactions with age, sex, and anthropometric measures were assessed. Total PA was weakly inversely associated with ALS mortality with a borderline statistically significant trend across categories (p = 0.042), with those physically active being 33 % less likely to die from ALS compared to those inactive: HR = 0.67 (95 % CI 0.42-1.06). Anthropometric measures, sex, and age did not modify the association with CPAI. The present study shows a slightly decreased-not increased like in case-control studies-risk of dying from ALS in those with high levels of total PA at enrolment. This association does not appear confounded by age, gender, anthropometry, smoking, and education. Ours was the first prospective cohort study on ALS and physical activity. PMID:26968841

  9. A Prospective Cohort Evaluation of a Robotic, Auto-Navigating Operating Microscope.

    Science.gov (United States)

    Bohl, Michael A; Oppenlander, Mark E; Spetzler, Robert

    2016-01-01

    The unique challenges inherent to microneurosurgery demand that we stay on the forefront of new surgical technologies. Many believe the next major technological advance in neurosurgery will be the widespread application of image-guided robotics in the operating room. We evaluated a novel technology for image-guided robotic auto-navigation of the operating microscope in a prospectively enrolled cohort of patients. Twenty patients were prospectively enrolled for analysis. Data were collected on the extent of resection, operative time, estimated blood loss, time taken to set up the new software, and complications encountered. Software accuracy, reliability, and usefulness in the case were subjectively evaluated. The most commonly  treated pathologies were cavernous malformation (n = 5), arteriovenous malformation (n = 4), and meningioma (n = 4). The time to set up the new software interface before the start of the operation was robotic interface to be accurate, reliable, and useful. The new technology was significantly more useful in deeper lesions. The addition of image-guided robotic auto-positioning features to the operating microscope has a great potential to advance the field of neurosurgery. This study is the first prospective evaluation of such a technology in a patient cohort. The results suggest that the newest robotic auto-positioning technology has the potential to improve the neurosurgeon's efficiency and efficacy, thereby positively impacting patient safety and surgical outcomes, especially in cases involving deep-seated lesions. PMID:27493844

  10. Prospective Memory in Young and Older Adults: The Effects of Ongoing-Task Load

    OpenAIRE

    Smith, Rebekah E.; Horn, Sebastian S.; Bayen, Ute J.

    2011-01-01

    Prospective memory involves remembering to perform intended actions in the future. Previous work with the multinomial model of event-based prospective memory indicated that adult age-related differences in prospective-memory performance were due to the prospective (not the retrospective) component of the task (Smith & Bayen, 2006). However, ongoing-task performance was also lower in older adults in that study. In the current study with young and older adults, the difficulty of the ongoing tas...

  11. Fetal and life course origins of serum lipids in mid-adulthood: results from a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Gustafsson Per E

    2010-08-01

    Full Text Available Abstract Background During the past two decades, the hypothesis of fetal origins of adult disease has received considerable attention. However, critique has also been raised regarding the failure to take the explanatory role of accumulation of other exposures into consideration, despite the wealth of evidence that social circumstances during the life course impact on health in adulthood. The aim of the present prospective cohort study was to examine the contributions of birth weight and life course exposures (cumulative socioeconomic disadvantage and adversity to dyslipidemia and serum lipids in mid-adulthood. Methods A cohort (effective n = 824, 77% was prospectively examined with respect to self-reported socioeconomic status as well as stressors (e.g., financial strain, low decision latitude, separation, death or illness of a close one, unemployment at the ages of 16, 21, 30 and 43 years; summarized in cumulative socioeconomic disadvantage and cumulative adversity. Information on birth weight was collected from birth records. Participants were assessed for serum lipids (total cholesterol, low- and high-density lipoprotein cholesterol and triglycerides, apolipoproteins (A1 and B and height and weight (for the calculation of body mass index, BMI at age 43. Current health behavior (alcohol consumption, smoking and snuff use was reported at age 43. Results Cumulative life course exposures were related to several outcomes; mainly explained by cumulative socioeconomic disadvantage in the total sample (independently of current health behaviors but attenuated by current BMI and also by cumulative adversity in women (partly explained by current health behavior but not by BMI. Birth weight was related only to triglycerides in women, independently of life course exposures, health behaviors and BMI. No significant association of either exposure was observed in men. Conclusions Social circumstances during the life course seem to be of greater importance

  12. Predicting Reading and Spelling Disorders: A 4-Year Prospective Cohort Study

    Science.gov (United States)

    Bigozzi, Lucia; Tarchi, Christian; Caudek, Corrado; Pinto, Giuliana

    2016-01-01

    In this 4-year prospective cohort study, children with a reading and spelling disorder, children with a spelling impairment, and children without a reading and/or spelling disorder (control group) in a transparent orthography were identified in third grade, and their emergent literacy performances in kindergarten compared retrospectively. Six hundred and forty-two Italian children participated. This cohort was followed from the last year of kindergarten to third grade. In kindergarten, the children were assessed in phonological awareness, conceptual knowledge of writing systems and textual competence. In third grade, 18 children with a reading and spelling impairment and 13 children with a spelling impairment were identified. Overall, conceptual knowledge of the writing system was the only statistically significant predictor of the clinical samples. No differences were found between the two clinical samples. PMID:27014145

  13. Self-report of healthcare utilization among community-dwelling older persons: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Marlies T van Dalen

    Full Text Available BACKGROUND: Self-reported data are often used for estimates on healthcare utilization in cost-effectiveness studies. OBJECTIVE: To analyze older adults' self-report of healthcare utilization compared to data obtained from the general practitioners' (GP electronic medical record (EMR and to study the differences in healthcare utilization between those who completed the study, those who did not respond, and those lost to follow-up. METHODS: A prospective cohort study was conducted among community-dwelling persons aged 70 years and above, without dementia and not living in a nursing home. Self-reporting questionnaires were compared to healthcare utilization data extracted from the EMR at the GP-office. RESULTS: Overall, 790 persons completed questionnaires at baseline, median age 75 years (IQR 72-80, 55.8% had no disabilities in (instrumental activities of daily living. Correlations between self-report data and EMR data on healthcare utilization were substantial for 'hospitalizations' and 'GP home visits' at 12 months intraclass correlation coefficient 0.63 (95% CI; 0.58-0.68. Compared to the EMR, self-reported healthcare utilization was generally slightly over-reported. Non-respondents received more GP home visits (p<0.05. Of the participants who died or were institutionalized 62.2% received 2 or more home visits (p<0.001 and 18.9% had 2 or more hospital admissions (p<0.001 versus respectively 18.6% and 3.9% of the participants who completed the study. Of the participants lost to follow-up for other reasons 33.0% received 2 or more home visits (p<0.01 versus 18.6 of the participants who completed the study. CONCLUSIONS: Self-report of hospitalizations and GP home visits in a broadly 'healthy' community-dwelling older population seems adequate and efficient. However, as people become older and more functionally impaired, collecting healthcare utilization data from the EMR should be considered to avoid measurement bias, particularly if the data will

  14. Mortality from suicide and other external cause injuries in China: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Duan Xiufang

    2011-01-01

    Full Text Available Abstract Background Premature death from suicide is a leading cause of death worldwide. However, the pattern and risk factors for suicide and other external cause injuries are not well understood. This study investigates mortality from suicide and other injuries and associated risk factors in China. Methods A prospective cohort study of 169,871 Chinese adults aged 40 years and older was conducted. Mortality due to suicide or other external cause injuries was recorded. Results Mortality from all external causes was 58.7/100,000 (72.3 in men and 44.4 in women: 14.1/100,000 (14.2 in men and 14.2 in women for suicide and 44.6/100,000 (58.1 in men and 30.2 in women for other external cause injuries. Transport accidents (17.2/100,000 overall, 23.4 in men and 10.8 in women, accidental poisoning (7.5/100,000 overall, 10.2 in men and 4.8 in women, and accidental falls (5.7/100,000 overall, 6.5 in men and 5.0 in women were the three leading causes of death from other external cause injuries in China. In the multivariable analysis, male sex (relative risk [RR] 1.56, 95% confidence interval [CI] 1.03-2.38, age 70 years and older (2.27, 1.29-3.98, living in north China (1.68, 1.20-2.36 and rural residence (2.82, 1.76-4.51 were associated with increased mortality from suicide. Male sex (RR 2.50, 95% CI 1.95-3.20, age 60-69 years (1.93, 1.45-2.58 and 70 years and older (3.58, 2.58-4.97, rural residence (2.29, 1.77-2.96, and having no education (1.56, 1.00-2.43 were associated with increased mortality from other external cause injuries, while overweight (0.60, 0.43-0.83 was associated with decreased risk of mortality from other external cause injuries. Conclusions External cause mortality has become a major public health problem in China. Developing an integrated national program for the prevention of mortality due to external cause injuries in China is warranted.

  15. Diarrhoea in a large prospective cohort of European travellers to resource-limited destinations

    Directory of Open Access Journals (Sweden)

    Pitzurra Raffaela

    2010-08-01

    Full Text Available Abstract Background Incidence rates of travellers' diarrhoea (TD need to be updated and risk factors are insufficiently known. Methods Between July 2006 and January 2008 adult customers of our Centre for Travel Health travelling to a resource-limited country for the duration of 1 to 8 weeks were invited to participate in a prospective cohort study. They received one questionnaire pre-travel and a second one immediately post-travel. First two-week incidence rates were calculated for TD episodes and a risk assessment was made including demographic and travel-related variables, medical history and behavioural factors. Results Among the 3100 persons recruited, 2800 could be investigated, resulting in a participation rate of 89.2%. The first two-weeks incidence for classic TD was 26.2% (95%CI 24.5-27.8. The highest rates were found for Central Africa (29.6%, 95% CI 12.4-46.8, the Indian subcontinent (26.3%, 95%CI 2.3-30.2 and West Africa (21.5%, 95%CI 14.9-28.1. Median TD duration was 2 days (range 1-90. The majority treated TD with loperamide (57.6%, while a small proportion used probiotics (23.0% and antibiotics (6.8%. Multiple logistic regression analysis on any TD to determine risk factors showed that a resolved diarrhoeal episode experienced in the 4 months pre-travel (OR 2.03, 95%CI 1.59-2.54, antidepressive comedication (OR 2.11, 95%CI 1.17-3.80, allergic asthma (OR 1.67, 95%CI 1.10-2.54, and reporting TD-independent fever (OR 6.56, 95%CI 3.06-14.04 were the most prominent risk factors of TD. Conclusions TD remains a frequent travel disease, but there is a decreasing trend in the incidence rate. Patients with a history of allergic asthma, pre-travel diarrhoea, or of TD-independent fever were more likely to develop TD while abroad.

  16. Eurythmy therapy in chronic disease: a four-year prospective cohort study

    Directory of Open Access Journals (Sweden)

    Willich Stefan N

    2007-04-01

    Full Text Available Abstract Background Many patients with chronic diseases use complementary therapies, often provided by their physicians. In Germany, several physician-provided complementary therapies have been reimbursed by health insurance companies as part of health benefit programs. In most of these therapies, the patient has a predominantly passive role. In eurythmy therapy, however, patients actively exercise specific movements with the hands, the feet or the whole body. The purpose of this study was to describe clinical outcomes in patients practising eurythmy therapy exercises for chronic diseases. Methods In conjunction with a health benefit program, 419 outpatients from 94 medical practices in Germany, referred to 118 eurythmy therapists, participated in a prospective cohort study. Main outcomes were disease severity (Disease and Symptom Scores, physicians' and patients' assessment on numerical rating scales 0–10 and quality of life (adults: SF-36, children aged 8–16: KINDL, children 1–7: KITA. Disease Score was documented after 0, 6 and 12 months, other outcomes after 0, 3, 6, 12, 18, 24, and (SF-36 and Symptom Score 48 months. Results Most common indications were mental disorders (31.7% of patients; primarily depression, fatigue, and childhood emotional disorder and musculoskeletal diseases (23.4%. Median disease duration at baseline was 3.0 years (interquartile range 1.0–8.5. Median number of eurythmy therapy sessions was 12 (interquartile range 10–19, median therapy duration was 119 days (84–188. All outcomes improved significantly between baseline and all subsequent follow-ups (exceptions: KITA Psychosoma in first three months and KINDL. Improvements from baseline to 12 months were: Disease Score from mean (standard deviation 6.65 (1.81 to 3.19 (2.27 (p Adverse reactions to eurythmy therapy occurred in 3.1% (13/419 of patients. No patient stopped eurythmy therapy due to adverse reactions. Conclusion Patients practising eurythmy therapy

  17. Anxiety disorders and inflammation in a large adult cohort

    NARCIS (Netherlands)

    Vogelzangs, N.; Beekman, A. T. F.; de Jonge, P.; Penninx, Brenda

    2013-01-01

    Although anxiety disorders, like depression, are increasingly being associated with metabolic and cardiovascular burden, in contrast with depression, the role of inflammation in anxiety has sparsely been examined. This large cohort study examines the association between anxiety disorders and anxiety

  18. HIV burden in men who have sex with men: a prospective cohort study 2007–2012

    OpenAIRE

    Zhongwei Jia; Xiaojie Huang; Hao Wu; Tong Zhang; Ning Li; Peipei Ding; Yixuan Sun; Zhiying Liu; Feili Wei; Hongwei Zhang; Yanmei Jiao; Yunxia Ji; Yonghong Zhang; Caiping Guo; Wei Li

    2015-01-01

    We conducted a prospective cohort study among HIV-negative MSM aged 18 years or older between 2007 and 2012 in Beijing, China to measure the rates of incident HIV and identify risk factors for infection. Among 5,800 participants evaluated at enrollment, we identified 486 prevalent cases of HIV (8.4%). Among the 3,625 enrollees who were HIV-negative at enrollment and completed at least one follow-up interview, we identified 440 incident cases of HIV in the follow up period: this constituted an...

  19. Atosiban vs. ritodrine as a tocolytic in external cephalic version at term: a prospective cohort study

    OpenAIRE

    Burgos, Jorge; Eguiguren, Nekane; Quintana, Eider; Cobos, Patricia; del Mar Centeno, Maria; Larrieta, Rosa; Fernández-Llebrez, Luis

    2009-01-01

    Objective: To compare the success rate of external cephalic version (ECV) at term using ritodrine or atosiban as a tocolytic agent. Study design: Prospective cohort study with a sample of 236 pregnant women with a breech presentation at term, from November 2006 to March 2008. Data have been analyzed from the moment the cephalic version is performed until the time of delivery. Results: ECV success rate using ritodrine as a tocolytic agent was 56.8% compared to 31.4% with atosiban. Ritodrine ...

  20. Duration of pregnancy in relation to seafood intake during early and mid pregnancy: prospective cohort

    DEFF Research Database (Denmark)

    Olsen, S. F; Osterdal, M. L; Salvig, J. D;

    2006-01-01

    We examined the association between exposure to seafood intake during two periods of pregnancy on the one hand and risks of preterm delivery and postterm delivery on the other. In a prospective cohort of 8729 pregnant Danish women, we assessed frequency of fish meals during the first and second.......34 (0.12-0.95), respectively, in zero fish consumers. All analyses were adjusted for potential confounding by factors such as maternal smoking, height, and prepregnant weight. We conclude that never consuming fish in the first two trimesters of pregnancy was an extremely strong risk factor for preterm...

  1. Increased traffic exposure and negative birth outcomes: a prospective cohort in Australia

    OpenAIRE

    Wilson Lee-Ann; Seow W Kim; Plonka Kathryn; Barnett Adrian G; Hansen Craig

    2011-01-01

    Abstract Background Pregnant women exposed to traffic pollution have an increased risk of negative birth outcomes. We aimed to investigate the size of this risk using a prospective cohort of 970 mothers and newborns in Logan, Queensland. Methods We examined two measures of traffic: distance to nearest road and number of roads around the home. To examine the effect of distance we used the number of roads around the home in radii from 50 to 500 metres. We examined three road types: freeways, hi...

  2. Potato intake and incidence of hypertension: results from three prospective US cohort studies

    OpenAIRE

    Borgi, Lea; Rimm, Eric B; Willett, Walter C.; Forman, John P.

    2016-01-01

    Objective To determine whether higher intake of baked or boiled potatoes, French fries, or potato chips is associated with incidence of hypertension. Design Prospective longitudinal cohort studies. Setting Healthcare providers in the United States. Participants 62 175 women in Nurses’ Health Study, 88 475 women in Nurses’ Health Study II, and 36 803 men in Health Professionals Follow-up Study who were non-hypertensive at baseline. Main outcome measure Incident cases of hypertension (self repo...

  3. Estimated Phytanic Acid Intake and Prostate Cancer Risk: a Prospective Cohort Study

    OpenAIRE

    Wright, Margaret E.; Bowen, Phyllis; Virtamo, Jarmo; Albanes, Demetrius; Gann, Peter H.

    2012-01-01

    Phytanic acid is a saturated fatty acid found predominantly in red meat and dairy products and may contribute to increases in prostate cancer risk that are observed with higher intakes of these foods. We constructed a novel summary measure of phytanic acid intake and prospectively examined its association with prostate cancer risk in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study – a cohort of Finnish male smokers ages 50–69 years. Diet was assessed at baseline in 27,111 particip...

  4. Alcohol consumption and later risk of hospitalization with psychiatric disorders: prospective cohort study

    DEFF Research Database (Denmark)

    Flensborg-Madsen, Trine; Becker, Ulrik; Grønbæk, Morten;

    2011-01-01

    hospital with a psychiatric disorder. The prospective cohort study, the Copenhagen City Heart Study (n=18,146), was used, containing three updated sets of alcohol intake and lifestyle covariates and up to 26 years follow-up. Alcohol intake was measured by self-report while psychiatric disorders were.......31-3.04) compared to women drinking below the sensible drinking limits. For men, the risk functions were slightly U-shaped; thus, a weekly low or moderate alcohol intake seemed to have a protective effect towards developing psychiatric disorders. The findings suggest sex differences in the association between...

  5. Oral health changes in an adult Norwegian population : a cohort analytical approach

    NARCIS (Netherlands)

    Holst, D; Schuller, A A

    2000-01-01

    OBJECTIVES: The purpose of this analysis was to study temporal variation in oral health in an adult population. The cohort analysis comprised 1) estimation of longitudinal, cross-sectional, and time-lag differences in caries and treatment experience of the adult population in Trøndelag from 1973 to

  6. Methylmercury Exposure and Incident Diabetes in U.S. Men and Women in Two Prospective Cohorts

    DEFF Research Database (Denmark)

    Mozaffarian, Dariush; Shi, Peilin; Morris, J Steven; Grandjean, Philippe; Siscovick, David S; Spiegelman, Donna; Hu, Frank B

    2013-01-01

    were compared, and in analyses stratified by fish or omega-3 consumption, BMI, and age.CONCLUSIONSThese findings from two separate large prospective cohorts do not support adverse effects of methylmercury on development of diabetes in men or women at usual levels of exposure seen in these populations.......OBJECTIVEEmerging in vitro and animal evidence suggests that methylmercury could increase type 2 diabetes, but little evidence exists in humans. We aimed to prospectively determine associations of mercury exposure, as assessed by biomarker measurement, with incident diabetes.RESEARCH DESIGN AND...... toenail mercury was 1.32 μg/g in men and 0.76 μg/g in women, corresponding to exposures ∼3.5-fold and twofold higher than the U.S. Environmental Protection Agency reference dose. In multivariable analyses, toenail mercury concentrations were not associated with higher incidence of diabetes in women, men...

  7. Incidence of obesity and its modifiable risk factors in Chinese adults aged 35-74 years: a prospective cohort study%我国35~74岁成人肥胖发病率及其可控危险因素的前瞻性队列随访研究

    Institute of Scientific and Technical Information of China (English)

    李建新; 樊森; 李莹; 陈纪春; 曹杰; 黄建凤; 赵连成; 刘小清; 俞玲

    2014-01-01

    目的 了解我国成人肥胖的发病率,并探讨肥胖相关可控危险因素.方法 以1998年中国心血管流行病学多中心协作研究和2000年中国心血管健康多中心合作研究的27 020名35 ~ 74岁成人的调查作为基线,进行平均7.9年的前瞻性随访,收集肥胖及其相关危险因素指标;以BMI (kg/m2) 24.0~27.9作为超重,≥28.0作为肥胖,分别计算超重和肥胖的发病率;采用多因素logistic回归分析,调整性别、年龄、南北方、城乡等基线相关因素后,计算各危险因素对于肥胖发病的相对危险度.结果 我国35 ~ 74岁成人肥胖年发病率为6.97‰,女性(7.74‰)高于男性(6.10‰),北方(9.29‰)高于南方(5.10‰),农村(7.28‰)高于城市(6.52‰),超重年发病率为24.83‰.多因素调整后,与高中(12年教育)以下学历人群相比,高中及以上学历人群肥胖发病风险降低18%;中等收入人群肥胖发病相对风险是低收入人群的1.28倍;与从事中-重度体力工作人员相比,从事轻度体力工作和非在岗(家务劳动和退休)人员发病风险分别增加32%和63%;常饮牛奶和食用中等量水果,分别可以降低38%和19%的肥胖发病,而食用较多红肉可增加肥胖发病风险,常饮花茶者肥胖发病相对风险是不饮茶者的1.34倍.结论 我国35~ 74岁成人肥胖发病率达6.97‰.为了预防与控制肥胖流行,应提倡健康的生活方式,适当增加体力活动,鼓励喝牛奶,适量食用水果,减少红肉的摄入和花茶的饮用,尤其是在低学历和中等收入人群中.%Objective To examine the incidence of obesity and its modifiable risk factors in Chinese adults aged 35-74 years.Methods A total of 27 020 participants aged 35 to 74 years from two prospective cohort studies in China were followed up in the years of 2007 and 2008.Obesity and overweight were defined as body mass index ≥28.0,and 24.0-27.9 kg/m2,respectively.Relative risks of obesity for risk

  8. Diet and risk of diverticular disease in Oxford cohort of European Prospective Investigation into Cancer and Nutrition (EPIC): prospective study of British vegetarians and non-vegetarians.

    OpenAIRE

    Crowe, FL; Appleby, PN; Allen, NE; Key, TJ

    2011-01-01

    Objective: To examine the associations of a vegetarian diet and dietary fibre intake with risk of diverticular disease. Design: Prospective cohort study. Setting: The EPIC-Oxford study, a cohort of mainly health conscious participants recuited from around the United Kingdom. Participants: 47033 men and women living in England or Scotland of whom 15459 (33%) reported consuming a vegetarian diet. Main outcome measures: Diet group was assessed at baseline; intake of dietary fibre was...

  9. Adverse childhood experiences and prescription drug use in a cohort study of adult HMO patients

    Directory of Open Access Journals (Sweden)

    Dube Shanta R

    2008-06-01

    Full Text Available Abstract Background Prescription drugs account for approximately 11% of national health expenditures. Prior research on adverse childhood experiences (ACEs, which include common forms of child maltreatment and related traumatic stressors, has linked them to numerous health problems. However, data about the relationship of these experiences to prescription drug use are scarce. Method We used the ACE Score (an integer count of 8 different categories of ACEs as a measure of cumulative exposure to traumatic stress during childhood. We prospectively assessed the relationship of the Score to prescription drug use in a cohort of 15,033 adult HMO patients (mean follow-up: 6.1 years and assessed mediation of this relationship by documented ACE-related health and social problems. Results Nearly 1.2 million prescriptions were recorded; prescriptions rates increased in a graded fashion as the ACE Score increased (p for trend Conclusion ACEs substantially increase the number of prescriptions and classes of drugs used for as long as 7 or 8 decades after their occurrence. The increases in prescription drug use were largely mediated by documented ACE-related health and social problems.

  10. Impact of psychosocial factors on cardiovascular morbimortality: a prospective cohort study

    OpenAIRE

    Mejía-Lancheros, Cília; Estruch, Ramón; Martínez-González, Miguel A.; Salas-Salvadó, Jordi; Castañer, Olga; Corella, Dolores; Arós, Fernando; Gómez-Gracia, Enrique; Fiol, Miquel; Lapetra, José; Serra-Majem, Lluís; Pintó, Xavier; Ros, Emilio; Diéz-Espino, Javier; Basora, Josep

    2014-01-01

    © 2014 Mejía-Lancheros et al.; licensee BioMed Central Ltd. Background: Whilst it is well known that psychosocial determinants may contribute to cardiovascular diseases (CVD), data from specific groups are scarce. The present study aims to determine the contribution of psychosocial determinants in increasing the risk of cardiovascular events (myocardial infarction and stroke), and death from CVD, in a high risk adult population.Methods: Longitudinal prospective study of 7263 patients (57.5% w...

  11. Identification of asthma clusters in two independent Korean adult asthma cohorts.

    Science.gov (United States)

    Kim, Tae-Bum; Jang, An-Soo; Kwon, Hyouk-Soo; Park, Jong-Sook; Chang, Yoon-Seok; Cho, Sang-Heon; Choi, Byoung Whui; Park, Jung-Won; Nam, Dong-Ho; Yoon, Ho-Joo; Cho, Young-Joo; Moon, Hee-Bom; Cho, You Sook; Park, Choon-Sik

    2013-06-01

    Asthma is a heterogeneous airway disease with various clinical phenotypes. It is crucial to clearly identify clinical phenotypes to achieve better asthma management. We used cluster analysis to classify the clinical groups of 724 asthmatic patients from the Cohort for Reality and Evolution of Adult Asthma in Korea (COREA), and in 1843 subjects from another independent Korean asthma cohort of Soonchunhyang University Asthma Genome Research Centre (SCH) (Bucheon, Republic of Korea). Hierarchical cluster analysis was performed by Ward's method, followed by κ-means cluster analysis. Cluster analysis of the COREA cohort indicated four asthma subtypes: 1) smoking asthma; 2) severe obstructive asthma; 3) early-onset atopic asthma; and 4) late-onset mild asthma. An independent cluster analysis of the SCH cohort also indicated four clusters that were similar to the COREA clusters. Our results indicate that adult Korean asthma patients can be classified into four distinct clusters. PMID:23060627

  12. Infant milk feeding influences adult bone health: a prospective study from birth to 32 years.

    Directory of Open Access Journals (Sweden)

    Satu Pirilä

    Full Text Available BACKGROUND: Peak bone mass, attained by early adulthood, is influenced by genetic and life-style factors. Early infant feeding and duration of breastfeeding in particular, associate with several health-related parameters in childhood. The aim of this study was to examine whether the effects of early infant feeding extend to peak bone mass and other bone health characteristics at adult age. METHODS AND FINDINGS: A cohort of 158 adults (76 males born in Helsinki, Finland, 1975, prospectively followed up from birth, underwent physical examination and bone densitometry to study bone area, bone mineral content (BMC, and bone mineral density (BMD at 32 years of age. Life-style factors relevant for bone health were recorded. For data analysis the cohort was divided into three equal-size groups according to the total duration of breastfeeding (BF: Short (≤3 months, Intermediate and Prolonged (≥7 months BF groups. In males short BF is associated with higher bone area, BMC, and BMD compared to longer BF. Males in the Short BF group had on average 4.7% higher whole body BMD than males in the Prolonged BF group. In multivariate analysis, after controlling for multiple confounding factors, the influence of BF duration on adult bone characteristics persisted in males. Differences between the three feeding groups were observed in lumbar spine bone area and BMC, and whole body BMD (MANCOVA; p = 0.025, p = 0.013, and p = 0.048, respectively, favoring the Short BF group. In women no differences were observed. CONCLUSIONS: In men, early infant milk feeding may have a significant impact on adult bone health. A potential explanation is that the calcium and phosphate contents were strikingly higher in formula milk and commercial cow milk/cow milk dilutions as opposed to human milk. Our novel finding merits further studies to determine means to ensure optimal bone mass development in infants with prolonged breastfeeding.

  13. Prospective and Episodic Memory in Relation to Hippocampal Volume in Adults with Spina Bifida Myelomeningocele

    OpenAIRE

    Treble-Barna, Amery; Juranek, Jenifer; Stuebing, Karla K.; CIRINO, PAUL T.; Dennis, Maureen; Fletcher, Jack M.

    2014-01-01

    The present study examined prospective and episodic memory in relation to age, functional independence, and hippocampal volume in younger to middle-aged adults with spina bifida myelomeningocele (SBM) and typically developing (TD) adults. Prospective and episodic memory, as well as hippocampal volume, were reduced in adults with SBM relative to TD adults. Neither memory performance nor hippocampal volume showed greater decrements in older adults. Lower hippocampal volume was associated with r...

  14. Use and Safety of Anthroposophic Medications for Acute Respiratory and Ear Infections: A Prospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Harald J. Hamre

    2007-01-01

    Full Text Available Objective: Anthroposophic medications (AMED are widely used, but safety data on AMED from large prospective studies are sparse. The objective of this analysis was to determine the frequency of adverse drug reactions (ADR to AMED in outpatients using AMED for acute respiratory and ear infections.Methods: A prospective four-week observational cohort study was conducted in 21 primary care practices in Europe and the U.S.A. The cohort comprised 715 consecutive outpatients aged 1 month, treated by anthroposophic physicians for acute otitis and respiratory infections. Physicians’ prescription data and patient reports of adverse events were analyzed. Main outcome measures were use of AMED and ADR to AMED.Results: Two patients had confirmed ADR to AMED: 1 swelling and redness at the injection site after subcutaneous injections of Prunus spinosa 5%, 2 sleeplessness after intake of Pneumodoron® 2 liquid. These ADR lasted one and two days respectively; both subsided after dose reduction; none were unexpected; none were serious. The frequency of confirmed ADR to AMED was 0.61% (2/327 of all different AMED used, 0.28% (2/715 of patients, and 0.004% (3/73,443 of applications.Conclusion: In this prospective study, anthroposophic medications used by primary care patients with acute respiratory or ear infections were well tolerated.Abbreviations: A-: anthroposophy; ADR: adverse drug reactions; AE: adverse events; AM: anthroposophic medicine; AMED: AM medication; C-: conventional; ENE-patients: eligible, not enrolled patients; IIPCOS: International Primary Care Outcomes Study

  15. Exposure to Greenness and Mortality in a Nationwide Prospective Cohort Study of Women

    Science.gov (United States)

    James, Peter; Hart, Jaime E.; Banay, Rachel F.; Laden, Francine

    2016-01-01

    Background: Green, natural environments may ameliorate adverse environmental exposures (e.g., air pollution, noise, and extreme heat), increase physical activity and social engagement, and lower stress. Objectives: We aimed to examine the prospective association between residential greenness and mortality. Methods: Using data from the U.S.-based Nurses’ Health Study prospective cohort, we defined cumulative average time-varying seasonal greenness surrounding each participant’s address using satellite imagery [Normalized Difference Vegetation Index (NDVI)]. We followed 108,630 women and observed 8,604 deaths between 2000 and 2008. Results: In models adjusted for mortality risk factors (age, race/ethnicity, smoking, and individual- and area-level socioeconomic status), women living in the highest quintile of cumulative average greenness (accounting for changes in residence during follow-up) in the 250-m area around their home had a 12% lower rate of all-cause nonaccidental mortality [95% confidence interval (CI); 0.82, 0.94] than those in the lowest quintile. The results were consistent for the 1,250-m area, although the relationship was slightly attenuated. These associations were strongest for respiratory and cancer mortality. The findings from a mediation analysis suggested that the association between greenness and mortality may be at least partly mediated by physical activity, particulate matter social engagement, and depression. Conclusions: Higher levels of green vegetation were associated with decreased mortality. Policies to increase vegetation may provide opportunities for physical activity, reduce harmful exposures, increase social engagement, and improve mental health. Planting vegetation may mitigate the effects of climate change; in addition, evidence of an association between vegetation and lower mortality rates suggests it also might be used to improve health. Citation: James P, Hart JE, Banay RF, Laden F. 2016. Exposure to greenness and mortality

  16. Sexual orientation and diurnal cortisol patterns in a cohort of U.S. young adults

    Science.gov (United States)

    Austin, S. Bryn; Rosario, Margaret; McLaughlin, Katie A.; Roberts, Andrea L.; Gordon, Allegra R.; Sarda, Vishnudas; Missmer, Stacey; Anatale-Tardiff, Laura; Scherer, Emily A.

    2016-01-01

    Sexual minorities in the United States are at elevated risk of bullying, discrimination, and violence victimization, all stressors that have been linked to psychological and behavioral stress responses including depressive and anxious symptoms and substance use. Acute and chronic stressors may also elicit physiologic stress responses, including changes in the regulation of the hypothalamic-pituitary-adrenocortical (HPA) axis. Few studies, however, have examined the relationship between minority sexual orientation and diurnal cortisol patterns. The present study included 1670 young adults ages 18–32 years (69% female, 31% male) from the Growing Up Today Study, a prospective cohort of U.S. youth. Participants provided five saliva samples over one day to estimate diurnal cortisol patterns. Sexual orientation groups included: completely heterosexual with no same-sex partners (referent), completely heterosexual with same-sex partners/mostly heterosexual, and gay/lesbian/bisexual. Covariates included perceived stress and stressful life events in the past month. Sex-stratified multilevel models of log-transformed cortisol values were used to model diurnal cortisol patterns, and generalized estimating equations were used to model area under the curve (AUC), both with respect to ground (AUCg) and increase (AUCi). Among females, sexual minorities reported significantly more stressful life events in the past month than their heterosexual counterparts. In adjusted multilevel models, sexual orientation was not significantly associated with diurnal cortisol patterns or with AUCg or AUCi in either females or males. There were no significant interactions between sexual orientation and stressful life events. Time-varying negative mood was significantly associated with higher cortisol levels across the day for both female and male participants, after adjusting for all covariates. This study from a large cohort of U.S. young adults did not detect a relationship between sexual

  17. Sexual orientation and diurnal cortisol patterns in a cohort of U.S. young adults.

    Science.gov (United States)

    Austin, S Bryn; Rosario, Margaret; McLaughlin, Katie A; Roberts, Andrea L; Gordon, Allegra R; Sarda, Vishnudas; Missmer, Stacey; Anatale-Tardiff, Laura; Scherer, Emily A

    2016-07-01

    Sexual minorities in the United States are at elevated risk of bullying, discrimination, and violence victimization, all stressors that have been linked to psychological and behavioral stress responses including depressive and anxious symptoms and substance use. Acute and chronic stressors may also elicit physiologic stress responses, including changes in the regulation of the hypothalamic-pituitary-adrenocortical (HPA) axis. Few studies, however, have examined the relationship between minority sexual orientation and diurnal cortisol patterns. The present study included 1670 young adults ages 18-32 years (69% female, 31% male) from the Growing Up Today Study, a prospective cohort of U.S. youth. Participants provided five saliva samples over one day to estimate diurnal cortisol patterns. Sexual orientation groups included: completely heterosexual with no same-sex partners (referent), completely heterosexual with same-sex partners/mostly heterosexual, and gay/lesbian/bisexual. Covariates included perceived stress and stressful life events in the past month. Sex-stratified multilevel models of log-transformed cortisol values were used to model diurnal cortisol patterns, and generalized estimating equations were used to model area under the curve (AUC), both with respect to ground (AUCg) and increase (AUCi). Among females, sexual minorities reported significantly more stressful life events in the past month than their heterosexual counterparts. In adjusted multilevel models, sexual orientation was not significantly associated with diurnal cortisol patterns or with AUCg or AUCi in either females or males. There were no significant interactions between sexual orientation and stressful life events. Time-varying negative mood was significantly associated with higher cortisol levels across the day for both female and male participants, after adjusting for all covariates. This study from a large cohort of U.S. young adults did not detect a relationship between sexual

  18. Use of angiotensin receptor blockers and risk of dementia in a predominantly male population: prospective cohort analysis

    OpenAIRE

    Li, Nien-Chen; Lee, Austin; Whitmer, Rachel A.; Kivipelto, Miia; Lawler, Elizabeth; Kazis, Lewis E; Wolozin, Benjamin

    2010-01-01

    Objective To investigate whether angiotensin receptor blockers protect against Alzheimer’s disease and dementia or reduce the progression of both diseases. Design Prospective cohort analysis. Setting Administrative database of the US Veteran Affairs, 2002-6. Population 819 491 predominantly male participants (98%) aged 65 or more with cardiovascular disease. Main outcome measures Time to incident Alzheimer’s disease or dementia in three cohorts (angiotensin receptor blockers, lisinopril, and ...

  19. Psychosocial factors and their predictive value in chiropractic patients with low back pain: a prospective inception cohort study

    OpenAIRE

    Breen Alan C; Langworthy Jennifer M

    2007-01-01

    Abstract Background Being able to estimate the likelihood of poor recovery from episodes of back pain is important for care. Studies of psychosocial factors in inception cohorts in general practice and occupational populations have begun to make inroads to these problems. However, no studies have yet investigated this in chiropractic patients. Methods A prospective inception cohort study of patients presenting to a UK chiropractic practice for new episodes of non-specific low back pain (LBP) ...

  20. A Clinical Algorithm to Identify HIV Patients at High Risk for Incident Active Tuberculosis: A Prospective 5-Year Cohort Study.

    Directory of Open Access Journals (Sweden)

    Susan Shin-Jung Lee

    Full Text Available Predicting the risk of tuberculosis (TB in people living with HIV (PLHIV using a single test is currently not possible. We aimed to develop and validate a clinical algorithm, using baseline CD4 cell counts, HIV viral load (pVL, and interferon-gamma release assay (IGRA, to identify PLHIV who are at high risk for incident active TB in low-to-moderate TB burden settings where highly active antiretroviral therapy (HAART is routinely provided.A prospective, 5-year, cohort study of adult PLHIV was conducted from 2006 to 2012 in two hospitals in Taiwan. HAART was initiated based on contemporary guidelines (CD4 count < = 350/μL. Cox regression was used to identify the predictors of active TB and to construct the algorithm. The validation cohorts included 1455 HIV-infected individuals from previous published studies. Area under the receiver operating characteristic (ROC curve was calculated.Seventeen of 772 participants developed active TB during a median follow-up period of 5.21 years. Baseline CD4 < 350/μL or pVL ≥ 100,000/mL was a predictor of active TB (adjusted HR 4.87, 95% CI 1.49-15.90, P = 0.009. A positive baseline IGRA predicted TB in patients with baseline CD4 ≥ 350/μL and pVL < 100,000/mL (adjusted HR 6.09, 95% CI 1.52-24.40, P = 0.01. Compared with an IGRA-alone strategy, the algorithm improved the sensitivity from 37.5% to 76.5%, the negative predictive value from 98.5% to 99.2%. Compared with an untargeted strategy, the algorithm spared 468 (60.6% from unnecessary TB preventive treatment. Area under the ROC curve was 0.692 (95% CI: 0.587-0.798 for the study cohort and 0.792 (95% CI: 0.776-0.808 and 0.766 in the 2 validation cohorts.A validated algorithm incorporating the baseline CD4 cell count, HIV viral load, and IGRA status can be used to guide targeted TB preventive treatment in PLHIV in low-to-moderate TB burden settings where HAART is routinely provided to all PLHIV. The implementation of this algorithm will avoid unnecessary

  1. Association between sleep duration and cancer risk: a meta-analysis of prospective cohort studies.

    Directory of Open Access Journals (Sweden)

    Yan Lu

    Full Text Available BACKGROUND: Sleep duration has been shown to play an important role in the development of cancer. However, the results have been inconsistent. A meta-analysis with prospective cohort studies was performed to clarify the association between short or long sleep duration and cancer risk. METHODS: PubMed and Embase databases were searched for eligible publications. Pooled relative risk (RR with 95% confidence interval (CI was calculated using random- or fixed- model. RESULTS: A total of 10 prospective studies (8392 incident cases and 555678 participants were included in the meta-analysis. Neither short nor long sleep duration was statistically associated with increased risk of cancer (short sleep duration: RR=1.05, 95%CI=0.90-1.24, p=0.523; long sleep duration: RR=0.92, 95%CI=0.76-1.12, p=0.415. In the subgroup by cancer type, long sleep duration was positively associated with colorectal cancer (RR=1.29, 95%CI=1.09-1.52, p=0.003. CONCLUSION: The present meta-analysis suggested that neither short nor long sleep duration was significantly associated with risk of cancer, although long sleep duration increased risk of with colorectal cancer. Large-scale well-design prospective studies are required to be conducted to further investigate the observed association.

  2. Anxiety disorders and inflammation in a large adult cohort

    OpenAIRE

    Vogelzangs, N.; Beekman, A.T.F.; de Jonge, P.; Penninx, Brenda

    2013-01-01

    Although anxiety disorders, like depression, are increasingly being associated with metabolic and cardiovascular burden, in contrast with depression, the role of inflammation in anxiety has sparsely been examined. This large cohort study examines the association between anxiety disorders and anxiety characteristics with several inflammatory markers. For this purpose, persons (18-65 years) with a current (N = 1273) or remitted (N = 459) anxiety disorder (generalized anxiety disorder, social ph...

  3. Birth weight and later life adherence to unhealthy lifestyles in predicting type 2 diabetes: prospective cohort study

    OpenAIRE

    Li, Yanping; Ley, Sylvia H; Tobias, Deirdre K; Chiuve, Stephanie E.; VanderWeele, Tyler J; Rich-Edwards, Janet W.; Curhan, Gary C.; Willett, Walter C.; JoAnn E Manson; Hu, Frank B.; Qi, Lu

    2015-01-01

    Objectives To prospectively assess the joint association of birth weight and established lifestyle risk factors in adulthood with incident type 2 diabetes and to quantitatively decompose the attributing effects to birth weight only, to adulthood lifestyle only, and to their interaction. Design: Prospective cohort study. Setting: Health Professionals Follow-up Study (1986-2010), Nurses’ Health Study (1980-2010), and Nurses’ Health Study II (1991-2011). Participants: 149 794 men and women witho...

  4. Social and psychological predictors of onset of anxiety disorders: results from a large prospective cohort study

    DEFF Research Database (Denmark)

    Flensborg-Madsen, Trine; Tolstrup, Janne Schurmann; Sørensen, Holger Jelling;

    2012-01-01

    PURPOSE: The vast majority of studies investigating the association between social and psychological factors and anxiety disorders have been cross-sectional, making it difficult to draw causal conclusions. The purpose of the study was to investigate in a prospective longitudinal study whether...... social and psychological factors are associated with the later risk of being admitted to a hospital and receive a diagnosis of anxiety disorders. METHOD: The study population comprised 4,497 members of The Copenhagen Perinatal Cohort (CPC) who in 1993 answered a mailed questionnaire containing questions...... on a range of social and psychological factors. In 2007, the study population was linked to The Danish Hospital Discharge Register and the Danish Psychiatric Central Register to obtain information on registration with anxiety disorders. Multiple Cox regression analysis was used to analyze the risk of...

  5. Maternal thyroid function and the outcome of external cephalic version: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    van der Donk Riet W

    2011-01-01

    Full Text Available Abstract Background To investigate the relation between maternal thyroid function and the outcome of external cephalic version (ECV in breech presentation. Methods Prospective cohort study in 141 women (≥ 35 weeks gestation with a singleton fetus in breech. Blood samples for assessing thyroid function were taken prior to ECV. Main outcome measure was the relation between maternal thyroid function and ECV outcome indicated by post ECV ultrasound. Results ECV success rate was 77/141 (55%, 41/48 (85% in multipara and 36/93 (39% in primipara. Women with a failed ECV attempt had significantly higher TSH concentrations than women with a successful ECV (p Conclusions Higher TSH levels increase the risk of ECV failure. Trial registration number ClinicalTrials.gov: NCT00516555

  6. SLE disease patterns in a Danish population-based lupus cohort: an 8-year prospective study

    DEFF Research Database (Denmark)

    Laustrup, H; Voss, A; Green, A;

    2009-01-01

    In 1995 all systemic lupus erythematosus (SLE) patients in the county of Funen were retrieved from four separate and independent sources as part of an 8-year prospective study to determine the pattern of disease activity and damage accumulation in a community based lupus cohort of predominantly...... Scandinavian ancestry. Incident cases were subsequently identified by surveillance of these sources. Established and new cases underwent annual, structured interviews, clinical examination and blood sampling. The Systemic Lupus Erythematosus Diseases Activity Index SLEDAI and Systemic Lupus International...... Collaborating Clinics SLICC scores were calculated. Flares were defined as modified - SLEDAI >/= 4.The annual flare rate in definite SLE (D-SLE) was 0.21 (95%CI 0.18-0.24) versus 0.03 (95%CI 0.01-0.07) in incomplete SLE (I-SLE). Forty-three per cent of the entire study population had no disease exacerbations...

  7. Beverage preference and risk of alcohol-use disorders: a Danish prospective cohort study

    DEFF Research Database (Denmark)

    Flensborg-Madsen, Trine; Knop, Joachim; Mortensen, Erik Lykke; Becker, Ulrik; Makhija, Nita; Sher, Leo; Grønbaek, Morten

    2008-01-01

    women or men. CONCLUSIONS: Individuals who include wine when they drink alcohol have lower risks of AUD, independent of the total amount of alcohol consumed. The most likely explanation of these results is that lifestyle factors and personal characteristics are associated with beverage preference.......OBJECTIVE: The purpose of this study was to examine whether preferred type of alcoholic beverage influences the later risk of alcohol-use disorders (AUD). METHOD: A prospective cohort study was used, comprising three updated measures of alcohol intake and covariates, and 26 years of follow-up data...... on 18,146 individuals from the Copenhagen City Heart Study, Denmark. The study population was linked to three different registers to detect AUD registrations. RESULTS: For both genders, wine drinking was associated with lower risk of AUD irrespective of the weekly amount of alcohol consumed. Women...

  8. Self reported stress and risk of breast cancer: prospective cohort study

    DEFF Research Database (Denmark)

    Nielsen, Naja Rod; Zhang, Zuo-Feng; Kristensen, Tage S;

    2005-01-01

    OBJECTIVE: To assess the relation between self reported intensity and frequency of stress and first time incidence of primary breast cancer. DESIGN: Prospective cohort study with 18 years of follow-up. SETTING: Copenhagen City heart study, Denmark. PARTICIPANTS: The 6689 women participating in the...... Copenhagen City heart study were asked about their perceived level of stress at baseline in 1981-3. These women were followed until 1999 in the Danish nationwide cancer registry, with < 0.1% loss to follow-up. MAIN OUTCOME MEASURE: First time incidence of primary breast cancer. RESULTS: During follow-up 251...... women were diagnosed with breast cancer. After adjustment for confounders, women with high levels of stress had a hazard ratio of 0.60 (95% confidence interval 0.37 to 0.97) for breast cancer compared with women with low levels of stress. Furthermore, for each increase in stress level on a six point...

  9. Coffee consumption during pregnancy and the risk of hyperkinetic disorder and ADHD: a prospective cohort study

    DEFF Research Database (Denmark)

    Linnet, Karen Markussen; Wisborg, Kirsten; Secher, Niels Jørgen;

    2008-01-01

    Aim: Based on hypotheses from experimental studies, we studied the association between intrauterine exposure to coffee and the risk of clinically verified hyperkinetic disorder and attention-deficit hyperactivity disorder (ADHD). Methods: A cohort study with prospectively collected data from...... 88 children with hyperkinetic disorder and ADHD. Information about coffee consumption during pregnancy was obtained at 16 weeks of gestation from self-administrated questionnaires. Potential confounding factors were evaluated using Cox regression analyses. Results: We found that intrauterine exposure...... to 10 or more cups of coffee per day was associated with a threefold increased risk of hyperkinetic disorder and ADHD. After adjustments for a number of confounding factors, the risk decreased and became statistically insignificant (RR 2.3, 95% CI 0.9-5.9). Conclusion: Prenatal exposure to high levels...

  10. Residential Radon Exposure and Skin Cancer Incidence in a Prospective Danish Cohort

    DEFF Research Database (Denmark)

    Brauner, Elvira Vaclavik; Loft, Steffen; Sørensen, Mette;

    2015-01-01

    Background Although exposure to UV radiation is the major risk factor for skin cancer, theoretical models suggest that radon exposure can contribute to risk, and this is supported by ecological studies. We sought to confirm or refute an association between long-term exposure to residential radon...... and the risk for malignant melanoma (MM) and non-melanoma skin cancer (NMSC) using a prospective cohort design and long-term residential radon exposure. Methods During 1993-1997, we recruited 57,053 Danish persons and collected baseline information. We traced and geocoded all residential addresses of...... exposure may contribute to development of basal cell carcinoma of the skin. We cannot exclude confounding from sunlight and cannot conclude on causality, as the relationship was stronger amongst persons living in apartments and nonexistent amongst those living in single detached homes....

  11. Accuracy of prognosis estimates by four palliative care teams: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Costantini Massimo

    2002-03-01

    Full Text Available Abstract Background Prognosis estimates are used to access services, but are often inaccurate. This study aimed to determine the accuracy of giving a prognosis range. Methods and measurements A prospective cohort study in four multi-professional palliative care teams in England collected data on 275 consecutive cancer referrals who died. Prognosis estimates (minimum – maximum at referral, patient characteristics, were recorded by staff, and later compared with actual survival. Results Minimum survival estimates ranged Conclusions Offering a prognosis range has higher levels of accuracy (about double than traditional estimates, but is still very often inaccurate, except very close to death. Where possible clinicians should discuss scenarios with patients, rather than giving a prognosis range.

  12. Job Strain and Cognitive Decline: A Prospective Study of the Framingham Offspring Cohort

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    W Agbenyikey

    2015-03-01

    Full Text Available Background: Workplace stress is known to be related with many behavioral and disease outcomes. However, little is known about its prospective relationship with measures of cognitive decline.Objective: To investigate the association of job strain, psychological demands and job control on cognitive decline.Methods: Participants from Framingham Offspring cohort (n=1429, were assessed on job strain, and received neuropsychological assessment approximately 15 years and 21 years afterwards.Results: High job strain and low control were associated with decline in verbal learning and memory. Job strain was associated with decline in word recognition skills. Active job and passive job predicted decline in verbal learning and memory relative to low strain jobs in the younger subgroup. Active job and demands were positively associated with abstract reasoning skills.Conclusions: Job strain and job control may influence decline in cognitive performance.

  13. Suicide attempts in a prospective cohort of patients with schizophrenia treated with sertindole or risperidone.

    Science.gov (United States)

    Crocq, M A; Naber, D; Lader, M H; Thibaut, F; Drici, M; Everitt, B; Hall, G C; Le Jeunne, C; Mittoux, A; Peuskens, J; Priori, S; Sturkenboom, M; Thomas, S H L; Tanghøj, P; Toumi, M; Mann, R; Moore, N D

    2010-12-01

    The incidence of suicide attempts (fatal and non-fatal) was analysed in a prospective cohort of patients with schizophrenia randomly assigned to sertindole (4905 patients) or risperidone (4904 patients) in a parallel-group open-label study with blinded classification of outcomes (the sertindole cohort prospective study--SCoP). The total exposure was 6978 and 7975 patient-years in the sertindole and risperidone groups, respectively. Suicide mortality in the study was low (0.21 and 0.28 per 100 patients per year with sertindole and risperidone, respectively). The majority (84%) of suicide attempts occurred within the first year of treatment. Cox's proportional hazards model analysis of the time to the first suicide attempt, reported by treating psychiatrists and blindly reviewed by an independent expert group according to the Columbia Classification Algorithm of Suicide Assessment (both defining suicide attempts by association of suicidal act and intent to die), showed a lower risk of suicide attempt for sertindole-treated patients than for risperidone-treated patients. The effect was statistically significant with both evaluation methods during the first year of randomized treatment (hazard ratios [95% CI]: 0.5 [0.31-0.82], p=0.006; and 0.57 [0.35-0.92], p=0.02, respectively). With classification by an independent safety committee using a broader definition including all incidences of intentional self-harm, also those without clear suicidal intent, the results were not significant. A history of previous suicide attempts was significantly associated with attempted suicides in both treatment groups. PMID:20926264

  14. Smoking during pregnancy and risk of abnormal glucose tolerance: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Haskins Amy E

    2010-09-01

    Full Text Available Abstract Background Disturbances in glucose metabolism during pregnancy are associated with negative sequalae for both mother and infant. The association between smoking and abnormal glucose tolerance (AGT remains controversial. Therefore, the aim of this study was to examine the relationship between smoking prior to and during pregnancy and risk of AGT. Methods We utilized data from a prospective cohort of 1,006 Hispanic (predominantly Puerto Rican prenatal care patients in Western Massachusetts. Women reported pre- and early pregnancy smoking at recruitment (mean = 15 weeks and mid pregnancy smoking at a second interview (mean = 28 weeks. AGT was defined as > 135 mg/dL on the routine 1-hour glucose tolerance test (1-hr OGTT. We used multivariable regression to assess the effect of pre, early, and mid-pregnancy smoking on risk of AGT and screening plasma glucose value from the 1-hr OGTT. Results In age-adjusted models, women who smoked > 0-9 cigarettes/day in pre-pregnancy had an increased risk of AGT (OR = 1.90; 95% CI 1.02-3.55 compared to non-smokers; this was attenuated in multivariable models. Smoking in early (OR = 0.48; 95% CI 0.21-1.10 and mid pregnancy (OR = 0.38; 95% CI 0.13-1.11 were not associated with AGT in multivariable models. Smoking during early and mid pregnancy were independently associated with lower glucose screening values, while smoking in pre-pregnancy was not. Conclusions In this prospective cohort of Hispanic women, we did not observe an association between smoking prior to or during pregnancy and risk of AGT. Findings from this study, although based on small numbers of cases, extend prior research to the Hispanic population.

  15. Exposure to radiofrequency electromagnetic fields and sleep quality: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Evelyn Mohler

    Full Text Available BACKGROUND: There is persistent public concern about sleep disturbances due to radiofrequency electromagnetic field (RF-EMF exposure. The aim of this prospective cohort study was to investigate whether sleep quality is affected by mobile phone use or by other RF-EMF sources in the everyday environment. METHODS: We conducted a prospective cohort study with 955 study participants aged between 30 and 60 years. Sleep quality and daytime sleepiness was assessed by means of standardized questionnaires in May 2008 (baseline and May 2009 (follow-up. We also asked about mobile and cordless phone use and asked study participants for consent to obtain their mobile phone connection data from the mobile phone operators. Exposure to environmental RF-EMF was computed for each study participant using a previously developed and validated prediction model. In a nested sample of 119 study participants, RF-EMF exposure was measured in the bedroom and data on sleep behavior was collected by means of actigraphy during two weeks. Data were analyzed using multivariable regression models adjusted for relevant confounders. RESULTS: In the longitudinal analyses neither operator-recorded nor self-reported mobile phone use was associated with sleep disturbances or daytime sleepiness. Also, exposure to environmental RF-EMF did not affect self-reported sleep quality. The results from the longitudinal analyses were confirmed in the nested sleep study with objectively recorded exposure and measured sleep behavior data. CONCLUSIONS: We did not find evidence for adverse effects on sleep quality from RF-EMF exposure in our everyday environment.

  16. Adult Lifespan Cognitive Variability in the Cross-Sectional Cam-CAN Cohort

    OpenAIRE

    Emma Green; Shafto, Meredith A.; Fiona E Matthews; Cam-CAN,; White, Simon R.

    2015-01-01

    This study examines variability across the age span in cognitive performance in a cross-sectional, population-based, adult lifespan cohort from the Cambridge Centre for Ageing and Neuroscience (Cam-CAN) study (n = 2680). A key question we highlight is whether using measures that are designed to detect age-related cognitive pathology may not be sensitive to, or reflective of, individual variability among younger adults. We present three issues that contribute to the debate for and against age-...

  17. Time-based prospective memory in adults with developmental dyslexia.

    Science.gov (United States)

    Smith-Spark, James H; Zięcik, Adam P; Sterling, Christopher

    2016-01-01

    Prospective memory (PM) is memory for delayed intentions. Despite its importance to everyday life, the few studies on PM function in adults with dyslexia which exist have relied on self-report measures. To determine whether self-reported PM deficits can be measured objectively, laboratory-based PM tasks were administered to 24 adults with dyslexia and 25 age- and IQ-matched adults without dyslexia. Self-report data indicated that people with dyslexia felt that time-based PM (TBPM; requiring responses at certain times in the future) was most problematic for them and so this form of PM was the focus of investigation. Whilst performing the ongoing task from which they were required to break out every 3 min to make a PM-related response, the participants were allowed to make clock checks whenever they wished. The cognitive demands made on ongoing behaviour were manipulated to determine whether loading executive resources had a mediating role in dyslexia-related deficits in PM, resulting in three tasks with varying working memory load. A semi-naturalistic TBPM task was also administered, in which the participants were asked to remind the experimenter to save a data file 40 min after being given this instruction. Dyslexia-related differences were found across all three computerized tasks, regardless of cognitive load. The adults with dyslexia made fewer correct PM responses and also fewer clock checks. On the semi-naturalistic task, the participants with dyslexia were less likely to remember to remind the experimenter to save the file. This is the first study to document PM deficits in dyslexia using objective measures of performance. Since TBPM impairments were found under more naturalistic conditions as well as on computerized tasks, the results have implications for workplace support for adults with dyslexia. PMID:26649894

  18. HIV burden in men who have sex with men: a prospective cohort study 2007-2012

    Science.gov (United States)

    Jia, Zhongwei; Huang, Xiaojie; Wu, Hao; Zhang, Tong; Li, Ning; Ding, Peipei; Sun, Yixuan; Liu, Zhiying; Wei, Feili; Zhang, Hongwei; Jiao, Yanmei; Ji, Yunxia; Zhang, Yonghong; Guo, Caiping; Li, Wei; Mou, Danlei; Xia, Wei; Li, Zhen; Chen, Dexi; Yan, Huiping; Chen, Xinyue; Zhao, Jinkou; Meyers, Kathrine; Cohen, Ted; Mayer, Kenneth; Salomon, Joshua A.; Lu, Zuhong; Dye, Christopher

    2015-07-01

    We conducted a prospective cohort study among HIV-negative MSM aged 18 years or older between 2007 and 2012 in Beijing, China to measure the rates of incident HIV and identify risk factors for infection. Among 5,800 participants evaluated at enrollment, we identified 486 prevalent cases of HIV (8.4%). Among the 3,625 enrollees who were HIV-negative at enrollment and completed at least one follow-up interview, we identified 440 incident cases of HIV in the follow up period: this constituted an HIV incidence rate of 7.1 per 100 person-years (95% CI: 6.4-7.7). Early treatment of syphilis may have significantly reduced risk of HIV infection (RR: 1.45, 95% CI: 1.11-1.93), while MSM presenting perfect compliance in the cohort did not show reduction in HIV infection. Our study suggested that HIV incidence has been remained high in this sample of Chinese MSM during the intensive preventive intervention, suggesting that we need to find new strategies to prevent HIV infection in this population.

  19. Progression of carotid intima media thickness after radiotherapy: A long-term prospective cohort study

    International Nuclear Information System (INIS)

    Background and purpose: Carotid artery vasculopathy is a long-term complication of radiotherapy (RT) of the neck. We investigated the change in carotid intima media thickness (IMT) and the incidence of ischemic stroke in the first 7 years after radiotherapy (RT) of the neck. Materials and methods: A multicentre prospective cohort study among patients treated for Head and Neck Cancer (HNC) assessed carotid IMT at baseline (before RT) and after a median of 7 years follow-up. We also screened for cerebrovascular risk factors and events. Results: 48 patients underwent IMT measurement at baseline and follow-up (median age 61 years, range 29–87). Mean IMT of the irradiated common carotid arteries was 0.64 mm at baseline and 0.74 mm at follow-up (p = 0.002). Mean delta IMT in the irradiated and non-irradiated common carotid arteries were 0.11 and 0.02 mm (p = 0.03). Incidence rate of stroke in our cohort, compared to the Dutch population was 8.9 versus 1.5 per 1.000 person years. Conclusions: IMT in irradiated carotid arteries was significantly increased in the first 7 years after RT. The incidence rate of stroke was six fold increased. Patients treated with RT for HNC have sustained risk for developing atherosclerosis of the carotid arteries and future stroke

  20. HIV incidence among men who have sex with men in Beijing: a prospective cohort study

    Science.gov (United States)

    Li, Dongliang; Li, Shuming; Liu, Yingjie; Gao, Yanjie; Yu, Mingrun; Yang, Xueying; Li, Qingchun; Jiang, Shulin; Zhou, Zhenhai; Zhang, Zheng; Yan, Li; Jiang, Guiyan; Xiao, Dong; Pan, Stephen W; Luo, Fengji; Ruan, Yuhua; Shao, Yiming

    2012-01-01

    Objectives (1) To assess the HIV incidence rate among men who have sex with men (MSM) in a large cohort study in Beijing, China and (2) to identify sociodemographic and behavioural risk factors of HIV seroconversion among MSM in Beijing, China. Design A prospective cohort study. Setting Baseline and follow-up visits were conducted among MSM in Beijing, China. Participants A cohort of 797 HIV-seronegative MSM was recruited from August to December 2009, with follow-up occurring after 6 and 12 months. Primary and secondary outcome measures At baseline and follow-up visits, participants reported sociodemographic and sexual behaviour information, and were tested for HIV, herpes simplex virus-2 (HSV-2) and syphilis with whole blood specimens. Cox regression analysis was used to identify factors associated with HIV seroconversion. Results Most study participants (86.8%) were retained by the 12-month follow-up. The HIV, HSV-2 and syphilis incidence rates were 8.09 (95% CI 6.92 to 9.26), 5.92 (95% CI 5.44 to 6.40) and 8.06 (95% CI 7.56 to 8.56) cases per 100 person-years, respectively. HIV seroconversion was significantly associated with being 1 male sex partner in the past 6 months, and being syphilis positive or HSV-2 positive. Conclusions The HIV incidence among MSM in Beijing is serious. Interventions and treatment of sexually transmitted diseases (STD) should be combined with HIV control and prevention measures among MSM. PMID:23166133

  1. Long-term lifestyle and dietary habits in relation to cardiovascular mortality and life expectancy: a prospective cohort study

    NARCIS (Netherlands)

    Streppel, M.T.

    2009-01-01

    Introduction: In prospective cohort studies, information on lifestyle and dietary habits is generally only assessed at the baseline examination, assuming that these habits are relatively constant over the entire study period. Repeated measures can take into account changes in these habits, reduce me

  2. A prospective cohort study of depression in pregnancy, prevalence and risk factors in a multi-ethnic population

    OpenAIRE

    Shakeel, Nilam; Eberhard-Gran, Malin; Sletner, Line; Slinning, Kari; Martinsen, Egil W; Holme, Ingar; Anne K. Jenum

    2015-01-01

    Background Depression in pregnancy increases the risk of complications for mother and child. Few studies are done in ethnic minorities. We wanted to identify the prevalence of depression in pregnancy and associations with ethnicity and other risk factors. Method Population-based, prospective cohort of 749 pregnant women (59% ethnic minorities) attending primary antenatal care during early pregnancy in...

  3. Course, Diagnosis, and Treatment of Depressive Symptomatology in Workers Following a Workplace Injury : A Prospective Cohort Study

    NARCIS (Netherlands)

    Franche, Renee-Louise; Carnide, Nancy; Hogg-Johnson, Sheilah; Cote, Pierre; Breslin, F. Curtis; Bultmann, Ute; Severin, Colette N.; Krause, Niklas

    2009-01-01

    Objectives: To estimate prevalence, incidence, and course of depressive symptoms and prevalence of mental health treatment following a workplace injury, and to estimate the association between depressive symptoms and return-to-work (RTW) trajectories. Method: In a prospective cohort study, workers f

  4. Dietary carbohydrates, glycemic index, glycemic load, and endometrial cancer risk within the European prospective investigation into cancer and nutrition cohort

    NARCIS (Netherlands)

    Cust, Anne E.; Slimani, Nadia; Kaaks, Rudolf; van Bakel, Marit; Biessy, Carine; Ferrari, Pietro; Laville, Martine; Tjonneland, Anne; Olsen, Anja; Overvad, Kim; Lajous, Martin; Clavel-Chapelon, Francoise; Boutron-Ruault, Marie-Christine; Linseisen, Jakob; Rohrmann, Sabine; Noethlings, Ute; Boeing, Heiner; Palli, Domenico; Sieri, Sabina; Panico, Salvatore; Tumino, Rosario; Sacerdote, Carlotta; Skeie, Guri; Engeset, Dagrun; Gram, Inger Torhild; Quiros, J. Ramon; Jakszyn, Paula; Sanchez, Maria Jose; Larranaga, Nerea; Navarro, Carmen; Ardanaz, Eva; Wirfalt, Elisabet; Berglund, Goran; Lundin, Eva; Hallmans, Goeran; Bueno-de-Mesquita, H. Bas; Du, Huaidong; Peeters, Petra H. M.; Bingham, Shelia; Khaw, Kay-Tee; Allen, Naomi E.; Key, Timothy J.; Jenab, Mazda; Riboli, Elio

    2007-01-01

    The associations of dietary total carbohydrates, overall glycemic index, total dietary glycemic load, total sugars, total starch, and total fiber with endometrial cancer risk were analyzed among 288,428 women in the European Prospective Investigation into Cancer and Nutrition cohort (1992-2004), inc

  5. Micronutrient levels and supplement intake in pregnancy after bariatric surgery: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Roland Devlieger

    Full Text Available Studies report frequent micronutrient deficiencies after bariatric surgery, but less is known about micronutrient levels of pregnant women after bariatric surgery.To prospectively evaluate micronutrient levels and supplement intake in pregnancy following bariatric surgery.A multicenter prospective cohort study including women with restrictive or malabsorptive types of bariatric surgery. Nutritional deficiencies, together with supplement intake, were screened during pregnancy.The total population included 18 women in the restrictive and 31 in the malabsorptive group. Most micronutrients were depleted and declined significantly during pregnancy. The proportion of women with low vitamin A and B-1 levels increased to respectively 58 and 17% at delivery (P = 0.005 and 0.002. The proportion of women with vitamin D deficiency decreased from 14% at trimester 1 to 6% at delivery (P = 0.030. Mild anemia was found in respectively 22 and 40% of the women at trimester 1 and delivery. In the first trimester, most women took a multivitamin (57.1%. In the second and third trimester, the majority took additional supplements (69.4 and 73.5%. No associations were found between supplement intake and micronutrient deficiencies.Pregnant women with bariatric surgery show frequent low micronutrient levels. Supplementation partially normalizes low levels of micronutrients.

  6. mHealth Intervention to Improve Diabetes Risk Behaviors in India: A Prospective, Parallel Group Cohort Study

    Science.gov (United States)

    Spring, Bonnie; Saligram, Nalini; Davé, Raj; Gowda, Arun; Blais, Linelle; Arora, Monika; Ranjani, Harish; Ganda, Om; Hedeker, Donald; Reddy, Sethu; Ramalingam, Sandhya

    2016-01-01

    Background In low/middle income countries like India, diabetes is prevalent and health care access limited. Most adults have a mobile phone, creating potential for mHealth interventions to improve public health. To examine the feasibility and initial evidence of effectiveness of mDiabetes, a text messaging program to improve diabetes risk behaviors, a global nonprofit organization (Arogya World) implemented mDiabetes among one million Indian adults. Objective A prospective, parallel cohort design was applied to examine whether mDiabetes improved fruit, vegetable, and fat intakes and exercise. Methods Intervention participants were randomly selected from the one million Nokia subscribers who elected to opt in to mDiabetes. Control group participants were randomly selected from non-Nokia mobile phone subscribers. mDiabetes participants received 56 text messages in their choice of 12 languages over 6 months; control participants received no contact. Messages were designed to motivate improvement in diabetes risk behaviors and increase awareness about the causes and complications of diabetes. Participant health behaviors (exercise and fruit, vegetable, and fat intake) were assessed between 2012 and 2013 via telephone surveys by blinded assessors at baseline and 6 months later. Data were cleaned and analyzed in 2014 and 2015. Results 982 participants in the intervention group and 943 in the control group consented to take the phone survey at baselne. At the end of the 6-month period, 611 (62.22%) in the intervention and 632 (67.02%) in the control group completed the follow-up telephone survey. Participants receiving texts demonstrated greater improvement in a health behavior composite score over 6 months, compared with those who received no messages F(1, 1238) = 30.181, Phttps://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=367946&isReview=true (Archived by WebCite at http://www.webcitation.org/6j5ptaJgF) PMID:27496271

  7. Intake of coffee and tea and risk of ovarian cancer: a prospective cohort study.

    Science.gov (United States)

    Silvera, Stephanie A N; Jain, Meera; Howe, Geoffrey R; Miller, Anthony B; Rohan, Thomas E

    2007-01-01

    There is some evidence from case-control studies that coffee consumption might be positively associated with ovarian cancer risk, whereas the epidemiologic evidence regarding tea consumption and ovarian cancer is inconsistent. To date, there have been few prospective studies of these associations. Therefore, we examined ovarian cancer risk in association with both coffee and tea intake in a prospective cohort study of 49,613 Canadian women enrolled in the National Breast Screening Study (NBSS) who completed a self-administered food frequency questionnaire between 1980 and 1985. Linkages to national mortality and cancer databases yielded data on deaths and cancer incidence, with follow-up ending between 1998 and 2000. Data from the food frequency questionnaire were used to estimate daily intake of coffee and tea. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between categories of coffee and tea intake and ovarian cancer risk. During a mean 16.4 years of follow-up, we observed 264 incident ovarian cancer cases. Tea intake was not associated with ovarian cancer risk in our study population. In contrast, a borderline positive association was observed among women who drank > 4 cups coffee/day compared to women who did not drink coffee (HR = 1.62, 95% CI = 0.95-2.75, P(trend) = 0.06). Given the pervasive use of these beverages, the associations between coffee and tea consumption and ovarian cancer risk warrant investigation in further prospective studies. PMID:17571963

  8. Gastro esophageal reflux disease is associated with absence from work: Results from a prospective cohort study

    Institute of Scientific and Technical Information of China (English)

    Andreas Leodolter; Marc Nocon; Michael Kulig; Stefan N Willich; Peter Malfertheiner; Joachim Labenz

    2005-01-01

    AIM: To study the association of gastro-esophageal reflux disease (GERD) with the absence from work and to estimate the extent of loss in gross domestic product due to inability to work.METHODS: Analysis was based on the prospectively gathered data of a large European cohort study involving 6 215 symptomatic GERD patients (ProGERD). Among these patients, 2 871 were initially employed. The calculation of the loss of gross domestic product was based on the assumption that the prevalence of GERD was about 15% in Germany. According to the German Federal Statistical Office, the mean gross wage of employees was 150 ∈/d in 2002.RESULTS: The data of 2 078 employed patients who were prospectively followed up for over 2 years were analyzed. At study entry, the patients reported a mean of 1.8 d per year of inability to work. During the prospective follow-up under routine clinical care, the proportion of patients reporting days with inability to work decreased from 14% to 6% and the mean number of days per year with inability to work decreased to 0.9 d. Assuming a prevalence of troublesome GERD of 15% in the employed German population, the loss of gross domestic product amounted to 668 million ∈/year in Germany.CONCLUSION: GERD causes a relevant impairment on the national economics by absence from work. The presented data demonstrate the importance of GERD,not only for patients and health insurance companies,but also for the community at large.

  9. The Source of Adult Age Differences in Event-Based Prospective Memory: A Multinomial Modeling Approach

    Science.gov (United States)

    Smith, Rebekah E.; Bayen, Ute J.

    2006-01-01

    Event-based prospective memory involves remembering to perform an action in response to a particular future event. Normal younger and older adults performed event-based prospective memory tasks in 2 experiments. The authors applied a formal multinomial processing tree model of prospective memory (Smith & Bayen, 2004) to disentangle age differences…

  10. Anterior cruciate ligament injury in elite football: a prospective three-cohort study.

    Science.gov (United States)

    Waldén, Markus; Hägglund, Martin; Magnusson, Henrik; Ekstrand, Jan

    2011-01-01

    Anterior cruciate ligament (ACL) injury causes long lay-off time and is often complicated with subsequent new knee injury and osteoarthritis. Female gender is associated with an increased ACL injury risk, but few studies have adjusted for gender-related differences in age although female players are often younger when sustaining their ACL injury. The objective of this three-cohort study was to describe ACL injury characteristics in teams from the Swedish men's and women's first leagues and from several European men's professional first leagues. Over a varying number of seasons from 2001 to 2009, 57 clubs (2,329 players) were followed prospectively and during this period 78 ACL injuries occurred (five partial). Mean age at ACL injury was lower in women compared to men (20.6 ± 2.2 vs. 25.2 ± 4.5 years, P = 0.0002). Using a Cox regression, the female-to-male hazard ratio (HR) was 2.6 (95% CI 1.4-4.6) in all three cohorts studied and 2.6 (95% CI 1.3-5.3) in the Swedish cohorts; adjusted for age, the HR was reduced to 2.4 (95% CI 1.3-4.2) and 2.1 (95% CI 1.0-4.2), respectively. Match play was associated with a higher ACL injury risk with a match-to-training ratio of 20.8 (95% CI 12.4-34.8) and 45 ACL injuries (58%) occurred due to non-contact mechanisms. Hamstrings grafts were used more often in Sweden than in Europe (67 vs. 34%, P = 0.028), and there were no differences in time to return to play after ACL reconstruction between the cohorts or different grafts. In conclusion, this study showed that the ACL injury incidence in female elite footballers was more than doubled compared to their male counterparts, but also that they were significantly younger at ACL injury than males. These findings suggest that future preventive research primarily should address the young female football player. PMID:20532869

  11. Stress and survival after cancer: A prospective study of a Finnish population-based cohort

    DEFF Research Database (Denmark)

    Saito-Nakaya, K.; Bidstrup, P. E.; Nakaya, N.;

    2012-01-01

    Stress has been suggested to reduce survival after cancer, but the results of previous studies have been contradictory. We investigated the hypothesis in a national cohort of adults in Finland. Of those who completed the Stressful Life Events scale and the Stress of Daily Activities scale, 1470 and...... score was 0.99 (95% CI, 0.95-1.03). Further, the HR was 0.92 (95% CI, 0.69-1.22) for severe daily stress. Overall, the results of the current study do not support the hypothesis that stress reduces cancer survival. (C) 2011 Elsevier Ltd. All rights reserved....... 1882, respectively, later had cancer and were included in the analysis, covering 23 years of follow-up between 1982 and 2004. In Cox regression analysis, the multivariate hazard ratio (HR) was 0.99 (95% confidence interval [CI], 0.96-1.01) for total number of life events and the HR for the life change...

  12. Hereditary Angioedema in Swedish Adults: Report From the National Cohort.

    Science.gov (United States)

    Nordenfelt, Patrik; Nilsson, Mats; Björkander, Janne; Mallbris, Lotus; Lindfors, Anders; Wahlgren, Carl-Fredrik

    2016-04-12

    Hereditary angioedema (HAE) is rare, disabling and sometimes life-threatening. The aim of this study is to describe its prevalence, symptomatology and treatment in Sweden. A total of 146 patients were identified; 110 adults and 36 children with HAE type I (n = 136) or II (n = 10), giving a minimal HAE prevalence of 1.54/100,000. All patients received a written questionnaire followed by a structured telephone interview. This report focuses on the 102 adults who responded. Females reported 19 attacks in the previous year vs. 9 for males (p < 0.01), and females reported 10 days of sick leave vs. 4 days for males (p < 0.05). For all treated acute attacks, plasma-derived C1-inhibitor concentrate (pdC1INH) (used in 27% of patients) had a good effect. For maintenance treatment, 43% used attenuated androgens and 8% used pdC1INH, which reduced their attack rate by more than 50%. In conclusion, the minimal HAE prevalence in Sweden was 1.54/100,000. HAE affected females more severely. Attenuated androgens and pdC1INH had a good effect on preventing attacks. PMID:26540175

  13. Premature birth and insulin resistance in infancy: A prospective cohort study

    Science.gov (United States)

    Payal, Vikas; Jora, Rakesh; Sharma, Pramod; Gupta, Pradeep Kumar; Gupta, Mukesh

    2016-01-01

    Objective: This study was done to determine the role of prematurity and other variables to predict insulin sensitivity in infancy. Subjects and Methods: In this prospective study, 36 preterm appropriate for gestational age (AGA), 11 preterm small for gestational age (SGA), and 17 term SGA included as study cohort and 36 term AGA as control cohort. Detailed anthropometry assessment was performed at birth, 3, 6, and 9 months and at 9 months, fasting plasma glucose and serum insulin was done. Insulin resistance was determined by using homeostasis model assessment version 2. Results: It is found that preterm AGA (mean difference 0.617, 95% confidence interval [CI]; 0.43–0.80, P = 0.0001), preterm SGA (mean difference 0.764, 95% CI; 0.44–1.09, P = 0.0001), and term AGA (mean difference 0.725, 95% CI; 0.49–0.96, P = 0.0001) group had significantly higher insulin resistance than control. There was no significant difference in between preterm SGA and preterm AGA (mean difference 0.147 95% CI; −0.13–0.42, P = 0.927). In multiple regression models, SGA status (β =0.505) was more significant predictor of insulin resistance index than gestational age (β = −0.481), weight-for-length (β =0.315), and ponderal index (β = −0.194). Conclusion: Preterm birth is a risk factor for the future development of insulin resistance which may develop as early as infancy. PMID:27366716

  14. Risk Factors for HIV Acquisition in a Prospective Nairobi-Based Female Sex Worker Cohort.

    Science.gov (United States)

    McKinnon, Lyle R; Izulla, Preston; Nagelkerke, Nico; Munyao, Julius; Wanjiru, Tabitha; Shaw, Souradet Y; Gichuki, Richard; Kariuki, Cecilia; Muriuki, Festus; Musyoki, Helgar; Gakii, Gloria; Gelmon, Lawrence; Kaul, Rupert; Kimani, Joshua

    2015-12-01

    With two million new HIV infections annually, ongoing investigations of risk factors for HIV acquisition is critical to guide ongoing HIV prevention efforts. We conducted a prospective cohort analysis of HIV uninfected female sex workers enrolled at an HIV prevention clinic in Nairobi (n = 1640). In the initially HIV uninfected cohort (70 %), we observed 34 HIV infections during 1514 person-years of follow-up, i.e. an annual incidence of 2.2 % (95 % CI 1.6-3.1 %). In multivariable Cox Proportional Hazard analysis, HIV acquisition was associated with a shorter baseline duration of sex work (aHR 0.76, 95 % CI 0.63-0.91), minimum charge/sex act (aHR 2.74, 0.82-9.15, for low vs. intermediate; aHR 5.70, 1.96-16.59, for high vs. intermediate), N. gonorrhoeae infection (aAHR 5.89, 95 % CI 2.03-17.08), sex with casual clients during menses (aHR 6.19, 95 % CI 2.58-14.84), Depo Provera use (aHR 5.12, 95 % CI 1.98-13.22), and estimated number of annual unprotected regular partner contacts (aHR 1.004, 95 % CI 1.001-1.006). Risk profiling based on baseline predictors suggested that substantial heterogeneity in HIV risk is evident, even within a key population. These data highlight several risk factors for HIV acquisition that could help to re-focus HIV prevention messages. PMID:26091706

  15. Airborne exposures and risk of gastric cancer: a prospective cohort study.

    Science.gov (United States)

    Sjödahl, Krister; Jansson, Catarina; Bergdahl, Ingvar A; Adami, Johanna; Boffetta, Paolo; Lagergren, Jesper

    2007-05-01

    There is an unexplained male predominance among patients with gastric cancer, and many carcinogens are found in male-dominated dusty occupations. However, the relation between occupational exposures and risk of gastric cancer remains unclear. To investigate whether airborne occupational exposures might influence the risk of noncardia gastric cancer, we used a large, prospective cohort study of male Swedish construction workers. These workers were, during the period 1971-1993, regularly invited to health examinations by a nationwide occupational health service organization. Data on job titles and other variables were collected through self-administered questionnaires and forms completed by the health organization's staff. Industrial hygienists assessed 12 specific airborne occupational exposures for 200 job titles. Gastric cancer, death or emigration occurring during follow-up in 1971-2002 were identified by linkage to the Swedish registers of Cancer, Causes of Death and Total Population, respectively. Incidence rate ratios (IRR) and 95% confidence intervals (CI), adjusted for attained age, tobacco smoking, calendar period and body mass, were derived from Cox regression. Among 256,357 cohort members, contributing 5,378,012 person-years at risk, 948 noncardia gastric cancers were identified. Increased risk of this tumor was found among workers exposed to cement dust (IRR 1.5 [95% CI 1.1-2.1]), quartz dust (IRR 1.3 [95% CI 1.0-1.7]) and diesel exhaust (IRR 1.4 [95% CI 1.1-1.9]). Dose-response relations were observed for these exposures. No consistent positive associations were found regarding exposure to asbestos, asphalt fumes, concrete dust, epoxy resins, isocyanates, metal fumes, mineral fibers, organic solvents or wood dust. In conclusion, this study provides some support to the hypothesis that specific airborne exposures increase the risk of noncardia gastric cancer. PMID:17266028

  16. The impact of universal newborn hearing screening on long-term literacy outcomes: a prospective cohort study

    OpenAIRE

    Kennedy, Colin R.; Pimperton, Hannah; Blythe, Hazel I.; Kreppner, Jana; Mahon, Merle; Peacock, Janet L; Stevenson, Jim; Terlektsi, Emmanouela; Worsfold, Sarah; Yuen, Ho Ming

    2016-01-01

    Objective To determine whether the benefits of universal newborn hearing screening (UNHS) seen at age 8 years persist through the second decade. Design Prospective cohort study of a population sample of children with permanent childhood hearing impairment (PCHI) followed up for 17 years since birth in periods with (or without) UNHS. Setting Birth cohort of 100 000 in southern England. Participants 114 teenagers aged 13–19 years, 76 with PCHI and 38 with normal hearing. All had previously thei...

  17. Prospective longitudinal cohort study on cumulative 5-year delivery and adoption rates among 1338 couples initiating infertility treatment

    DEFF Research Database (Denmark)

    Pinborg, A; Hougaard, C O; Andersen, Anders Nyboe;

    2009-01-01

    BACKGROUND The objective was to assess crude 5-year delivery rates after assisted reproductive technology (ART) treatment, intrauterine inseminations (IUI), spontaneous conceptions (SC) and adoptions in a large infertile cohort. METHODS A prospective longitudinal survey comprised 1338 infertile...... couples starting public infertility programmes offering IUIs and three free ART cycles during 2000-2001. The cohort was cross-linked with the National Medical Birth Register to obtain delivery rates for all 1338 couples. More detailed data were available from 817 women responding to a 5-year follow...

  18. Mortality in sickle cell anemia in Africa: a prospective cohort study in Tanzania.

    Directory of Open Access Journals (Sweden)

    Julie Makani

    Full Text Available BACKGROUND: The World Health Organization has declared Sickle Cell Anemia (SCA a public health priority. There are 300,000 births/year, over 75% in Africa, with estimates suggesting that 6 million Africans will be living with SCA if average survival reaches half the African norm. Countries such as United States of America and United Kingdom have reduced SCA mortality from 3 to 0.13 per 100 person years of observation (PYO, with interventions such as newborn screening, prevention of infections and comprehensive care, but implementation of interventions in African countries has been hindered by lack of locally appropriate information. The objective of this study was to determine the incidence and factors associated with death from SCA in Dar-es-Salaam. METHODS AND FINDINGS: A hospital-based cohort study was conducted, with prospective surveillance of 1,725 SCA patients recruited from 2004 to 2009, with 209 (12% lost to follow up, while 86 died. The mortality rate was 1.9 (95%CI 1.5, 2.9 per 100 PYO, highest under 5-years old [7.3 (4.8-11.0], adjusting for dates of birth and study enrollment. Independent risk factors, at enrollment to the cohort, predicting death were low hemoglobin (<5 g/dL [3.8 (1.8-8.2; p = 0.001] and high total bilirubin (≥102 µmol/L [1.7 (1.0-2.9; p = 0.044] as determined by logistic regression. CONCLUSIONS: Mortality in SCA in Africa is high, with the most vulnerable period being under 5-years old. This is most likely an underestimate, as this was a hospital cohort and may not have captured SCA individuals with severe disease who died in early childhood, those with mild disease who are undiagnosed or do not utilize services at health facilities. Prompt and effective treatment for anemia in SCA is recommended as it is likely to improve survival. Further research is required to determine the etiology, pathophysiology and the most appropriate strategies for management of anemia in SCA.

  19. Relationship between body image disturbance and incidence of depression: the SUN prospective cohort

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    López Celeste

    2009-01-01

    Full Text Available Abstract Background Body image disturbance is an increasing problem in Western societies and is associated with a number of mental health outcomes including anorexia, bulimia, body dysmorphia, and depression. The aim of this study was to assess the association between body image disturbance and the incidence of depression. Methods This study included 10,286 participants from a dynamic prospective cohort of Spanish university graduates, who were followed-up for a median period of 4.2 years (Seguimiento Universidad de Navarra – the SUN study. The key characteristic of the study is the permanently open recruitment that started in 1999. The baseline questionnaire included information about body mass index (BMI and the nine figure schemes that were used to assess body size perception. These variables were grouped according to recommended classifications and the difference between BMI and body size perception was considered as a proxy of body image disturbance. A subject was classified as an incident case of depression if he/she was initially free of depression and reported a physician-made diagnosis of depression and/or the use of antidepressant medication in at least one of the follow-up questionnaires. The association between body image disturbance and the incidence of depression was estimated by calculating the multivariable adjusted Odds Ratio (OR and its 95% Confidence Interval (95% CI, using logistic regression models. Results The cumulative incidence of depression during follow-up in the cohort was 4.8%. Men who underestimated their body size had a high percentage of overweight and obesity (50.1% and 12.6%, respectively, whereas women who overestimated their body size had a high percentage of underweight (87.6%. The underestimation exhibited a negative association with the incidence of depression among women (OR: 0.72, 95% CI: 0.54 – 0.95, but this effect disappeared after adjusting for possible confounding variables. The proportion of

  20. The spectrum of intermediate syndrome following acute organophosphate poisoning: a prospective cohort study from Sri Lanka.

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    Pradeepa Jayawardane

    2008-07-01

    Full Text Available BACKGROUND: Intermediate syndrome (IMS is a major cause of death from respiratory failure following acute organophosphate poisoning. The objective of this study was to determine repetitive nerve stimulation (RNS predictors of IMS that would assist in patient management and clinical research. METHODS AND FINDINGS: Seventy-eight consenting symptomatic patients with organophosphate poisoning were assessed prospectively with daily physical examination and RNS. RNS was done on the right and left median and ulnar nerves at 1, 3, 10, 15, 20, and 30 Hz. The study was conducted as a prospective observational cohort study in the Central Province, Sri Lanka. IMS was diagnosed in ten out of 78 patients using a priori clinical diagnostic criteria, and five of them developed respiratory failure. All ten patients showed progressive RNS changes correlating with the severity of IMS. A decrement-increment was observed at intermediate and high frequencies preceding the onset of clinical signs of IMS. As the patient developed clinical signs of IMS, decrement-increment was progressively noted at low and intermediate frequencies and a combination of decrement-increment and repetitive fade or severe decrement was noted at high frequencies. Severe decrement preceded respiratory failure in four patients. Thirty patients developed forme fruste IMS with less severe weakness not progressing to respiratory failure whose RNS was characterized by decrement-increment or a combination of decrement-increment and repetitive fade but never severe decrements. CONCLUSIONS: Characteristic changes in RNS, preceding the development of IMS, help to identify a subgroup of patients at high risk of developing respiratory failure. The forme fruste IMS with the characteristic early changes on RNS indicates that IMS is a spectrum disorder. RNS changes are objective and precede the diagnosis and complications of IMS. Thus they may be useful in clinical management and research.

  1. Risk factors for shunt malfunction in pediatric hydrocephalus: a multicenter prospective cohort study.

    Science.gov (United States)

    Riva-Cambrin, Jay; Kestle, John R W; Holubkov, Richard; Butler, Jerry; Kulkarni, Abhaya V; Drake, James; Whitehead, William E; Wellons, John C; Shannon, Chevis N; Tamber, Mandeep S; Limbrick, David D; Rozzelle, Curtis; Browd, Samuel R; Simon, Tamara D

    2016-04-01

    OBJECT The rate of CSF shunt failure remains unacceptably high. The Hydrocephalus Clinical Research Network (HCRN) conducted a comprehensive prospective observational study of hydrocephalus management, the aim of which was to isolate specific risk factors for shunt failure. METHODS The study followed all first-time shunt insertions in children younger than 19 years at 6 HCRN centers. The HCRN Investigator Committee selected, a priori, 21 variables to be examined, including clinical, radiographic, and shunt design variables. Shunt failure was defined as shunt revision, subsequent endoscopic third ventriculostomy, or shunt infection. Important a priori-defined risk factors as well as those significant in univariate analyses were then tested for independence using multivariate Cox proportional hazard modeling. RESULTS A total of 1036 children underwent initial CSF shunt placement between April 2008 and December 2011. Of these, 344 patients experienced shunt failure, including 265 malfunctions and 79 infections. The mean and median length of follow-up for the entire cohort was 400 days and 264 days, respectively. The Cox model found that age younger than 6 months at first shunt placement (HR 1.6 [95% CI 1.1-2.1]), a cardiac comorbidity (HR 1.4 [95% CI 1.0-2.1]), and endoscopic placement (HR 1.9 [95% CI 1.2-2.9]) were independently associated with reduced shunt survival. The following had no independent associations with shunt survival: etiology, payer, center, valve design, valve programmability, the use of ultrasound or stereotactic guidance, and surgeon experience and volume. CONCLUSIONS This is the largest prospective study reported on children with CSF shunts for hydrocephalus. It confirms that a young age and the use of the endoscope are risk factors for first shunt failure and that valve type has no impact. A new risk factor-an existing cardiac comorbidity-was also associated with shunt failure. PMID:26636251

  2. Calcium intake and breast cancer risk: meta-analysis of prospective cohort studies.

    Science.gov (United States)

    Hidayat, Khemayanto; Chen, Guo-Chong; Zhang, Ru; Du, Xuan; Zou, Sheng-Yi; Shi, Bi-Min; Qin, Li-Qiang

    2016-07-01

    Findings from observational studies have suggested a possible relation between Ca and breast cancer risk. However, the results of these studies are inconclusive, and the dose-response relationship between Ca intake and risk of breast cancer remains to be determined. A meta-analysis of prospective studies was conducted to address these issues. PubMed and Embase databases were searched for relevant studies concerning the association between Ca intake and breast cancer up to March 2016. The summary relative risks (RR) with 95 % CI were calculated with a random-effects model. The final analysis included eleven prospective cohort studies involving 26 606 cases and 872 895 participants. The overall RR of breast cancer for high v. low intake of Ca was 0·92 (95 % CI 0·85, 0·99), with moderate heterogeneity (P=0·026, I 2=44·2 %). In the subgroup analysis, the inverse association appeared stronger for premenopausal breast cancer (RR 0·75; 95 % CI 0·59, 0·96) than for postmenopausal breast cancer (RR 0·94; 95 % CI 0·87, 1·01). Dose-response analysis revealed that each 300 mg/d increase in Ca intake was associated with 2 % (RR 0·98; 95 % CI 0·96, 0·99), 8 % (RR 0·92; 95 % CI 0·87, 0·98) and 2 % (RR 0·98; 95 % CI 0·97, 0·99) reduction in the risk of total, premenopausal and postmenopausal breast cancer, respectively. Our findings suggest an inverse dose-response association between Ca intake and risk of breast cancer. PMID:27170091

  3. Recombinant Hepatitis B Vaccine Adjuvanted With AS04 in Dialysis Patients: A Prospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Fabrizio Fabrizi

    2015-11-01

    Full Text Available Background/Aims: Patients undergoing maintenance dialysis have an unsatisfactory response to vaccination, including to hepatitis B vaccine. A recombinant HB vaccine containing a new adjuvant system AS04 (HBV-AS04 has been recently developed; a few data exist on the immunogenicity and safety of HBV-AS04 among patients undergoing regular dialysis. All hepatitis B virus-seronegative patients with undetectable antibody against HBsAg undergoing maintenance dialysis at two units were prospectively included. Methods: Patients received four 20-mcg doses of HBV-AS04 by intramuscular route (deltoid muscle at months 0,1,2, and 3. Anti-HB surface antibody concentrations were measured at intervals of 1, 2, 3, 4, and 12 months. Univariate and multivariate analyses determined which parameters predicted immunologic response to HBV-AS04 vaccine. Results: 102 patients were enrolled and 91 completed the study. At completion of the vaccination schedule, using per-protocol analysis, 76 of 91 (84% had antibody titers ≥10 mIU/mL with anti-HBs geometric antibody concentrations (GMCs of 385.25 mIU/mL. The sero-protection rate at month 12 was 84% (48/57 with lower GMCs (62.74 mIU/mL, PPConclusions: HBV-AS04 vaccine was highly immunogenic in our cohort of patients on maintenance dialysis even if a significant number of non-responders is still present. Prospective studies with HBV-AS04 on larger study groups and with longer follow-ups are under way.

  4. Leisure-time physical activity in pregnancy and risk of postpartum depression: a prospective study in a large national birth cohort

    DEFF Research Database (Denmark)

    Strøm, Marin; Mortensen, Erik L; Halldorson, Thórhallur I;

    2009-01-01

    OBJECTIVE: To explore the association between physical activity during pregnancy and postpartum depression (PPD) in a large, prospective cohort. METHOD: Exposure information from the Danish National Birth Cohort, a large, prospective cohort with information on more than 100,000 pregnancies (1996......-2002), was linked to the Danish Psychiatric Central Register and the Danish Register for Medicinal Product Statistics for data on clinically identified cases of depression up to 1 year postpartum. A total of 70,866 women from the Danish National Birth Cohort were included in the analyses. Duration, frequency...... activity, against postpartum depression requiring antidepressant therapy. No protective effect could be detected on PPD leading to hospitalization....

  5. Predicting mortality with biomarkers: a population-based prospective cohort study for elderly Costa Ricans

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    Rosero-Bixby Luis

    2012-06-01

    Full Text Available Abstract Background Little is known about adult health and mortality relationships outside high-income nations, partly because few datasets have contained biomarker data in representative populations. Our objective is to determine the prognostic value of biomarkers with respect to total and cardiovascular mortality in an elderly population of a middle-income country, as well as the extent to which they mediate the effects of age and sex on mortality. Methods This is a prospective population-based study in a nationally representative sample of elderly Costa Ricans. Baseline interviews occurred mostly in 2005 and mortality follow-up went through December 2010. Sample size after excluding observations with missing values: 2,313 individuals and 564 deaths. Main outcome: prospective death rate ratios for 22 baseline biomarkers, which were estimated with hazard regression models. Results Biomarkers significantly predict future death above and beyond demographic and self-reported health conditions. The studied biomarkers account for almost half of the effect of age on mortality. However, the sex gap in mortality became several times wider after controlling for biomarkers. The most powerful predictors were simple physical tests: handgrip strength, pulmonary peak flow, and walking speed. Three blood tests also predicted prospective mortality: C-reactive protein (CRP, glycated hemoglobin (HbA1c, and dehydroepiandrosterone sulfate (DHEAS. Strikingly, high blood pressure (BP and high total cholesterol showed little or no predictive power. Anthropometric measures also failed to show significant mortality effects. Conclusions This study adds to the growing evidence that blood markers for CRP, HbA1c, and DHEAS, along with organ-specific functional reserve indicators (handgrip, walking speed, and pulmonary peak flow, are valuable tools for identifying vulnerable elderly. The results also highlight the need to better understand an anomaly noted previously in

  6. Fruit Intake and Abdominal Aortic Calcification in Elderly Women: A Prospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Nicola P. Bondonno

    2016-03-01

    Full Text Available Cardiovascular disease (CVD is the leading cause of death worldwide. There is a consistent inverse relationship between fruit intake with CVD events and mortality in cross-sectional and prospective observational studies, but the relationship of fruit intake with measurements of atherosclerosis in humans is less clear. Nutritional effects on abdominal aortic calcification (AAC, a marker for subclinical intimal and medial atherosclerotic vascular disease, have not been studied previously. The aim of this study was to examine the cross-sectional relationship of total and individual fruit (apple, pear, orange and other citrus, and banana intake with AAC, scored between 0 and 24. The current study assessed baseline data for a cohort of 1052 women over 70 years of age who completed both a food frequency questionnaire assessing fruit intake, and underwent AAC measurement using dual energy X-ray absorptiometry. AAC scores were significantly negatively correlated with total fruit and apple intakes (p < 0.05, but not with pear, orange or banana intakes (p > 0.25. In multivariable-adjusted logistic regression, each standard deviation (SD; 50 g/day increase in apple intake was associated with a 24% lower odds of having severe AAC (AAC score >5 (odd ratio OR: 0.76 (0.62, 0.93, p = 0.009. Total and other individual fruit intake were not associated with increased odds of having severe AAC. Apple but not total or other fruit intake is independently negatively associated with AAC in older women.

  7. Testing the sexually abused-sexual abuser hypothesis: A prospective longitudinal birth cohort study.

    Science.gov (United States)

    Leach, Chelsea; Stewart, Anna; Smallbone, Stephen

    2016-01-01

    The sexually abused-sexual abuser hypothesis posits that persons, especially males, who are sexually abused as children are at particular risk of sexually abusing others later in life. We tested this hypothesis by prospectively examining associations between maltreatment and offending in a birth cohort of 38,282 males with a maltreatment history and/or at least one finalized offense. We examined these associations within the context of the wider birth population. Proportionally few boys were the subject of official notifications for sexual abuse (14.8% of maltreated boys, and 1.4% of the birth population); proportionally very few of these sexually abused boys (3%) went on to become sexual offenders; and, contrary to findings typically reported in retrospective clinical studies, proportionally few sexual offenders (4%) had a confirmed history of sexual abuse. Poly-victimization (exposure to multiple types of maltreatment) was significantly associated with sexual offending, violent offending, and general (nonsexual, nonviolent) offending. We found no specific association between sexual abuse and sexual offending, and nor did we find any association between sexual abuse and sexual offending specifically within the poly-victimized group. The total number of sexual abuse notifications did make a small unique contribution to the variance in sexual offending compared to other offending. Implications concerning maltreated boys and male sexual offenders are discussed. PMID:26615777

  8. The Impact of Parental Personality on Birth Outcomes: A Prospective Cohort Study

    Science.gov (United States)

    Morisaki, Naho; Fujiwara, Takeo; Horikawa, Reiko

    2016-01-01

    Objective To investigate the effect of parental personality on birth outcomes. Design Prospective cohort study. Setting 727 pregnant women and 579 spouses receiving antenatal care at a single-center in rural Tokyo, Japan during 2010–2013. Methods We measured the association between maternal effect of parental personality traits assessed by the Cloninger’s Temperament and Character Inventory on birth outcomes, using multiple regression and adjusting for demographics. Results Maternal self-transcendence personality was inversely associated with gestational age [-0.26 (95% confidence interval (CI): -0.51 to -0.01) weeks per unit] and positively associated with preterm birth [odds ratio (OR) 2.60 (95% CI: 1.00 to 6.75) per unit], while paternal self-transcendence personality was positively associated with gestational age [0.31 (95% CI: 0.07 to 0.55) weeks per unit]. Maternal reward dependence was positively associated with fetal growth [0.30 (95% CI: 0.02 to 0.59) per unit]. Other maternal and paternal personality traits associated with adverse maternal behavior, such as novelty seeking, harm avoidance and self-directedness, were not associated with birth outcomes. Conclusion We found that specific parental personality traits can be associated with birth outcomes. PMID:27331908

  9. Multiyear prospective study of intestinal parasitism in a cohort of Peace Corps volunteers in Guatemala.

    Science.gov (United States)

    Herwaldt, B L; de Arroyave, K R; Wahlquist, S P; de Merida, A M; Lopez, A S; Juranek, D D

    2001-01-01

    We conducted a prospective, longitudinal study in a cohort of 36 Peace Corps volunteers (PCVs) in Guatemala to study the incidence and natural history of intestinal parasitic infections during the PCVs' >2-year overseas stay. PCVs collected stool specimens at least monthly and when ill with gastrointestinal symptoms. Of the 1,168 specimens tested, 453 (38.8%) were positive for at least one parasite and 48 (4.1%) were positive for a pathogenic parasite. A median interval of 187 days (range, 14 to 752 days) elapsed before the first documented parasitic infection, and the median intervals from arrival until subsequent infections (e.g., second or third) were >300 days. The PCVs had 116 episodes of infection with 11 parasites, including up to 4 episodes per PCV with specific nonpathogens and Blastocystis hominis. The incidence, in episodes per 100 person-years, was highest for B. hominis (65), followed by Entamoeba coli (31), Cryptosporidium parvum (17), and Entamoeba hartmanni (17). The PCVs' B. hominis episodes lasted 6,809 person-days (28.7% of the 23,689 person-days in the study), the E. coli episodes lasted 2,055 person-days (8.7%), and each of the other types of episodes lasted 2-year stay in Guatemala suggests that PCVs repeatedly had fecal exposures and thus were at risk for infections with both parasitic and nonparasitic pathogens throughout their overseas service. PMID:11136744

  10. Generic quality of life assessment in dementia patients: a prospective cohort study

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    Müller Friedemann

    2010-06-01

    Full Text Available Abstract Background Quality of life (QoL is increasingly used to characterize the impact of disease and the efficacy of interventions. Methods Prospective cohort study in patients' and proxies' homes with137 patients with dementia (age 52 to 88; Mini-Mental Status Examination (MMSE 3 to 28 and their proxies (age 43 to 90. MMSE, Behave-AD, Geriatric Depression Scale (GDS, and Bayer-ADL scale (B-ADL, and the Euroqol (EQ-5D; patient self-rating, proxy self-rating, and proxy-rating of patient. Results B-ADL impairment and Behave-AD total score increased with dementia severity (Kruskal-Wallis p Conclusion Proxies' assessment of the patients' QoL is related to the proxies' health, and the difference of patient's and proxie's QoL-rating is correlated with dementia severity even in mild dementia stages. QOL measures use ratings of the individual to assess the impact of symptoms and disorders on everyday life. In dementia patients, however, this impact is not captured since patients' and proxies' self-assessment of their own QoL do not reflect severity of disease whatsoever. Patients' and proxies' influencing variables render the score obtained with generic quality of life assessment meaningless in capturing the impact of dementia. Decisions on initiation or discontinuation of treatment or allocation of other resources for patients with dementia therefore need not depend on generic assessment of quality of life.

  11. Coffee prevents proximal colorectal adenomas in Japanese men: a prospective cohort study.

    Science.gov (United States)

    Nakamura, Tomiyo; Ishikawa, Hideki; Mutoh, Michihiro; Wakabayashi, Keiji; Kawano, Atsuko; Sakai, Toshiyuki; Matsuura, Nariaki

    2016-09-01

    This prospective cohort study aimed to show that coffee prevents the recurrence of colorectal tumors (adenomas, precursors of colorectal cancer, and early-stage colorectal cancers) as well as colorectal cancer. The present study included 307 patients who participated in a clinical study that required endoscopy to remove a colorectal tumor. The amount of coffee consumed by the patients at study inclusion and the frequency of colorectal tumors, as detected by colonoscopy over the subsequent 4 years, were assessed. Coffee consumption was determined using a diet survey that included 3-consecutive-day food records. The risk of colorectal tumor recurrence was significantly lower (odds ratio=0.21; 95% confidence interval, 0.06-0.74) in patients who consumed more than three cups of coffee per day compared with those who consumed no coffee. No correlation was observed between the examined factors, including green tea and black tea intake and the amount of caffeine consumed. In subanalysis divided by the tumor location within the colorectum, the odds ratio of colorectal tumor recurrence in the proximal colon showed a tendency toward reduction as coffee consumption increased; however, increased coffee consumption significantly increased colorectal tumor recurrence in the distal colon. We showed that high coffee consumption reduced the overall occurrence of colorectal tumors, affected by the reduction in the proximal colon. PMID:26291025

  12. A historical prospective cohort study of carotid artery stenosis after radiotherapy for head and neck malignancies

    International Nuclear Information System (INIS)

    Purpose: To determine carotid artery stenosis incidence after radiotherapy for head-and-neck neoplasms. Methods and Materials: This historical prospective cohort study comprised 44 head-and-neck cancer survivors who received unilateral neck radiotherapy between 1974 and 1999. They underwent bilateral carotid duplex ultrasonography to detect carotid artery stenosis. Results: The incidence of significant carotid stenosis (8 of 44 [18%]) in the irradiated neck was higher than that in the contralateral unirradiated neck (3 of 44 [7%]), although this difference was not statistically significant (p = 0.13). The rate of significant carotid stenosis events increased as the time after radiotherapy increased. The risk of ipsilateral carotid artery stenosis was higher in patients who had undergone a neck dissection vs. those who had not. Patients with significant ipsilateral stenosis also tended to be older than those without significant stenosis. No other patient or treatment variables correlated with risk of carotid artery stenosis. Conclusions: For long-term survivors after neck dissection and irradiation, especially those who are symptomatic, ultrasonographic carotid artery screening should be considered

  13. Prognostic role of Helicobacter pylori infection in acute coronary syndrome: a prospective cohort study.

    Science.gov (United States)

    Eskandarian, R; Ghorbani, R; Shiyasi, M; Momeni, B; Hajifathalian, K; Madani, M

    2012-04-01

    In a prospective cohort study, we evaluated the effect of Helicobacter pylori seropositivity on the risk of future adverse cardiovascular outcomes among patients with acute coronary syndrome (ACS). In 433 patients, IgA and IgG antibodies to H pylori, along with classic risk factors, including hypertension, diabetes, hyperlipidaemia, smoking and family history of coronary artery disease (CAD) were determined. Short and long-term follow-up information on adverse outcomes, defined as recurrence of unstable angina, myocardial infarction, coronary angioplasty, coronary artery bypass graft surgery, and sudden cardiac death was obtained. None of the classic CAD risk factors correlated with incidence of either short- or long-term outcomes. Seropositivity for H pylori was significantly associated with risk of short-term adverse outcomes, and independently predicted their incidence in multivariate regression (R = 3.05, p < 0.001). Results failed to show such an association between H pylori seropositivity and long-term adverse outcomes. H pylori infection may affect short-term prognosis in patients with ACS. Randomised trials are needed to evaluate the role of H pylori eradication in these patients. PMID:22555636

  14. Low Back Pain in Student Nurses: Literature Review and Prospective Cohort Study.

    Science.gov (United States)

    Menzel, Nancy; Feng, Du; Doolen, Jessica

    2016-01-01

    There is consensus that registered nurses worldwide have a high prevalence of work-related musculoskeletal disorders, particularly of the back. Patient handling activities such as lifting present the highest risk of injury, activities that begin in nursing school. A literature review identified 21 studies of back pain in nursing students, indicating a wide range of prevalence rates. A prospective cohort study of nursing students in a United States baccalaureate program followed 119 students who completed the Nordic Musculoskeletal Questionnaire upon beginning the 16 month upper division major and then a year later. There was no statistically significant change in low back pain prevalence over time. While nursing students have intermittent and brief exposure to patient handling activities, nursing schools must nevertheless protect them before they enter the high risk profession of nursing by teaching evidence-based safe patient handling techniques, empowering students to refuse unsafe manual lifts, and ensuring that the clinical settings with which they affiliate have adequate mechanical equipment available. PMID:27176750

  15. Perceived stress and risk of colorectal cancer in men and women: a prospective cohort study

    DEFF Research Database (Denmark)

    Nielsen, N R; Kristensen, T S; Strandberg-Larsen, Katrine;

    2008-01-01

    OBJECTIVE: We aim to assess the relationship between stress and risk of primary colorectal cancer in men and women. DESIGN: A prospective cohort study. SETTING: The Copenhagen City Heart Study, Denmark. SUBJECTS: A total of 6488 women and 5426 men were included in the study. The participants were...... asked about intensity and frequency of stress at baseline in 1981-1983 and were followed until the end of 2000 in the Danish Cancer Registry. Less than 0.1% was lost to follow-up. MAIN OUTCOME MEASURES: First time incidence of primary colorectal cancer. RESULTS: During follow-up 162 women and 166 men...... were diagnosed with colorectal cancer. Women with moderate and high stress intensity had a hazard ratio of 0.60 (95% CI: 0.37-0.98) and 0.52 (0.23-1.14) for colorectal cancer, respectively, compared to women with no stress. For colon cancer, a one-unit increase on a seven-point stress-score was...

  16. Increased traffic exposure and negative birth outcomes: a prospective cohort in Australia

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    Wilson Lee-Ann

    2011-04-01

    Full Text Available Abstract Background Pregnant women exposed to traffic pollution have an increased risk of negative birth outcomes. We aimed to investigate the size of this risk using a prospective cohort of 970 mothers and newborns in Logan, Queensland. Methods We examined two measures of traffic: distance to nearest road and number of roads around the home. To examine the effect of distance we used the number of roads around the home in radii from 50 to 500 metres. We examined three road types: freeways, highways and main roads. Results There were no associations with distance to road. A greater number of freeways and main roads around the home were associated with a shorter gestation time. There were no negative impacts on birth weight, birth length or head circumference after adjusting for gestation. The negative effects on gestation were largely due to main roads within 400 metres of the home. For every 10 extra main roads within 400 metres of the home, gestation time was reduced by 1.1% (95% CI: -1.7, -0.5; p-value = 0.001. Conclusions Our results add weight to the association between exposure to traffic and reduced gestation time. This effect may be due to the chemical toxins in traffic pollutants, or because of disturbed sleep due to traffic noise.

  17. Evans syndrome in children. Long-term outcome in a prospective French national observational cohort.

    Directory of Open Access Journals (Sweden)

    Nathalie eAladjidi

    2015-09-01

    Full Text Available Evans syndrome (ES is a rare autoimmune disorder whose long-term follow-up characteristics are unknown. Patients under 18 at the time of diagnosis of a first autoimmune cytopenia have been included since 2004 in a national prospective observational cohort. In 2014, 156 children diagnosed between 1981 and 2014 with ES, were analyzed. The median age at initial cytopenia was 5.4 (0.2-17.2 years old. For 85 sequential cases, the median delay between the episodes of AIHA and ITP was 2.4 years (0.1–16.3. The median follow-up since ES diagnosis was 6.5 years (0.1-28.8. ES revealed underlying diseases in 10% of children; in 60% of patients, various associated immune manifestations were observed, and ES remained primary in 30%. Five-year ITP and AIHA relapse-free survival were respectively 25% and 61%. In all, 69% of children required one or more than one second-line immune treatment and 15 patients (10% died at a median age of 14.3 years (1.7-28.1.This national work provides the first consistent clinical description for ES and underscores the high percentage of associated immune manifestations, the long-term complications, and treatment toxicities. Current challenges include the identification of underlying genetic immune dysregulations and better characterization of subgroups of patients and of second-line therapy strategies.

  18. Incomplete functional recovery after delirium in elderly people: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Freter Susan H

    2005-03-01

    Full Text Available Abstract Background Delirium often has a poor outcome, but why some people have incomplete recovery is not well understood. Our objective was to identify factors associated with short-term (by discharge and long-term (by 6 month incomplete recovery of function following delirium. Methods In a prospective cohort study of elderly patients with delirium seen by geriatric medicine services, function was assessed at baseline, at hospital discharge and at six months. Results Of 77 patients, vital and functional status at 6 months was known for 71, of whom 21 (30% had died. Incomplete functional recovery, defined as ≥10 point decline in the Barthel Index, compared to pre-morbid status, was present in 27 (54% of the 50 survivors. Factors associated with death or loss of function at hospital discharge were frailty, absence of agitation (hypoactive delirium, a cardiac cause and poor recognition of delirium by the treating service. Frailty, causes other than medications, and poor recognition of delirium by the treating service were associated with death or poor functional recovery at 6 months. Conclusion Pre-existing frailty, cardiac cause of delirium, and poor early recognition by treating physicians are associated with worse outcomes. Many physicians view the adverse outcomes of delirium as intractable. While in some measure this might be true, more skilled care is a potential remedy within their grasp.

  19. Biomarkers in differentiating clinical dengue cases:A prospective cohort study

    Institute of Scientific and Technical Information of China (English)

    Gary Kim Kuan Low; Seng Chiew Gan; Shu Cheow Ho

    2015-01-01

    Objective:To evaluate five biomarkers (neopterin, vascular endothelial growth factor-A, thrombomodulin, soluble vascular cell adhesion molecule 1 and pentraxin 3) in differentiating clinical dengue cases. Methods:A prospective cohort study was conducted whereby the blood samples were obtained at day of presentation and the final diagnosis were obtained at the end of patients’ follow-up. All patients included in the study were 15 years old or older, not pregnant, not infected by dengue previously and did not have cancer, autoimmune or haematological disorder. Median test was performed to compare the biomarker levels. A subgroup Mann-WhitneyU test was analysed between severe dengue and non-severe dengue cases. Monte Carlo method was used to estimate the 2-tailed probability (P) value for independent variables with unequal number of patients. Results: All biomarkers except thrombomodulin hasPvalue < 0.001 in differentiating among the healthy subjects, non-dengue fever, dengue without warning signs and dengue with warning signs/severe dengue. Subgroup analysis for all the biomarkers between severe dengue and non-severe dengue cases was not statistically significant except vascular endothelial growth factor-A (P < 0.05). Conclusions: Certain biomarkers were able to differentiate the clinical dengue cases. This could be potentially useful in classifying and determining the severity of dengue infected patients in the hospital.

  20. A prospective cohort study of the use of domiciliary intravenous antibiotics in bronchiectasis

    Science.gov (United States)

    Bedi, Pallavi; Sidhu, Manjit K; Donaldson, Lucienne S; Chalmers, James D; Smith, Maeve P; Turnbull, Kim; Pentland, Joanna L; Scott, Jenny; Hill, Adam T

    2014-01-01

    Background: We introduced domiciliary intravenous (IV) antibiotic therapy in patients with bronchiectasis to promote patient-centred domiciliary treatment instead of hospital inpatient treatment. Aim: To assess the efficacy and safety of domiciliary IV antibiotic therapy in patients with non-cystic fibrosis bronchiectasis. Methods: In this prospective study conducted over 5 years, we assessed patients’ eligibility for receiving domiciliary treatment. All patients received 14 days of IV antibiotic therapy and were monitored at baseline/day 7/day 14. We assessed the treatment outcome, morbidity, mortality and 30-day readmission rates. Results: A total of 116 patients received 196 courses of IV antibiotics. Eighty courses were delivered as inpatient treatment, 32 as early supported discharge (ESD) and 84 as domiciliary therapy. There was significant clinical and quality of life improvement in all groups, with resolution of infection in 76% in the inpatient group, 80% in the ESD group and 80% in the domiciliary group. Morbidity was recorded in 13.8% in the inpatient group, 9.4% in the ESD group and 14.2% in the domiciliary IV group. No mortality was recorded in either group. Thirty-day readmission rates were 13.8% in the inpatient group, 12.5% in the ESD group and 14.2% in the domiciliary group. Total bed days saved was 1443. Conclusion: Domiciliary IV antibiotic therapy in bronchiectasis is clinically effective and was safe in our cohort of patients. PMID:25340361

  1. Porous high-density polyethylene in facial reconstruction and revision rhinoplasty: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Mohammadi Shabahang

    2012-05-01

    Full Text Available Abstract Introduction Initial methods which used human tissues as reconstruction materials caused different problems including rejection, limited shapes and infection. In 1970s, PHDPE (Medpor® was introduced by its exclusive advantageous including no donor site morbidity, easily shaped and the minimal foreign body reaction. Hereby, we report our experience of using Medpor® in facial reconstruction especially in frontal reconstruction and orbital rim with a large sample size. Methods This study was a prospective cohort study. Surgical techniques included using Medpor® in reconstruction of lamina papiracea (LP (15 patients, frontal bone (15 patients, orbital rim (18 patients and open rhinoplasty (8 patients. All interventions on LP were performed by endoscopic procedures. All frontal operations were carried out by bicoronal incision. In orbital defects, we used subciliary incision. Results From all 56 patients, 1 case had primitive neuroectodermal tumor (PNET of maxillary sinus. In that case, reconstruction of inferior orbital rim was not successful and extrusion was occurred after radiotherapy. In rhinoplasty and other experiences no extrusion or infection were detected within the next 1 to 3 years of follow up. There were not any palpable and visible irregularities under the skin in our experiences. Conclusions In this study the patients did not experience any complications during the follow up periods and the satisfaction was remarkable. Gathering these data gives rise to future review studies which can provide more organized evidences for replacing classic reconstructive methods by the presented material.

  2. Prognosis of acute low back pain: design of a prospective inception cohort study

    Directory of Open Access Journals (Sweden)

    York John

    2006-06-01

    Full Text Available Abstract Background Clinical guidelines generally portray acute low back pain as a benign and self-limiting condition. However, evidence about the clinical course of acute low back pain is contradictory and the risk of subsequently developing chronic low back pain remains uncertain. There are few high quality prognosis studies and none that have measured pain, disability and return to work over a 12 month period. This study aims to provide the first estimates of the one year prognosis of acute low back pain (pain of less than 2 weeks duration in patients consulting primary care practitioners. A secondary aim is to identify factors that are associated with the prognosis of low back pain. Methods/Design The study is a prospective inception cohort study. Consecutive patients consulting general medical practitioners, physiotherapists and chiropractors in the Sydney metropolitan region will complete a baseline questionnaire regarding their back pain. Subsequently these patients will be followed up by telephone 6 weeks, 3 months and 12 months after the initial consultation. Patients will be considered to have recovered from the episode of back pain if they have no pain and no limitation of activity, and have returned to pre-injury work status. Life tables will be generated to determine the one year prognosis of acute low back pain. Prognostic factors will be assessed using Cox regression. Discussion This study will provide the first estimates of the one year prognosis of acute low back pain in a representative sample of primary care patients.

  3. Community paediatric respiratory infection surveillance study protocol: a feasibility, prospective inception cohort study

    Science.gov (United States)

    Anderson, Emma C; Ingle, Suzanne Marie; Muir, Peter; Beck, Charles; Finn, Adam; Leeming, John Peter; Cabral, Christie; Kesten, Joanna May; Hay, Alastair D

    2016-01-01

    Introduction Paediatric respiratory tract infections (RTIs) are common reasons for primary care consultations and antibiotic prescribing. Locally relevant syndromic and microbiological surveillance information has the potential to improve the care of children with RTIs by normalising illness (parents) and reducing uncertainty (clinicians). Currently, most RTI studies are conducted at the point of healthcare service consultation, leaving the community burden, microbiology, symptom duration and proportion consulting largely unknown. This study seeks to establish the feasibility of (mainly online) participant recruitment and retention, and the acceptability/comparability of parent versus nurse-collected microbiological sampling, to inform the design of a future surveillance intervention study. Evidence regarding consultation rates and symptom duration is also sought. Methods and analysis A community-based, feasibility prospective inception cohort study, recruiting children aged ≥3 months and rates. Feasibility will be assessed using recruitment and retention rates, data completeness; and acceptability by quantitative survey and qualitative interviews. Symptomatic parent and nurse swab pairs will be compared for microbe isolation. PMID:27580839

  4. Level of education and risk of heart failure: a prospective cohort study with echocardiography evaluation

    DEFF Research Database (Denmark)

    Mogelvang, Rasmus; Heitmann, Merete; Prescott, Eva;

    2011-01-01

    Aims With increasing socioeconomic disparity in cardiovascular risk factors, there is a need to assess the role of socioeconomic factors in chronic heart failure (CHF) and to what extent this is caused by modifiable risk factors. Methods and results In a prospective cohort of 18 616 men and women...... without known myocardial infarction or CHF examined in 1976–78, 1981–83, 1991–94, and 2001–03 in the Copenhagen City Heart Study, we studied the effect of education on CHF incidence. During a median follow-up of 21 years (range 0–31), 2190 participants were admitted to hospital for CHF. Age......-adjusted hazard ratio (HR) for intermediary (8–10 years) and high level of education (>10 years) with low (<8 years) as reference was 0.69 (0.62–0.78) and 0.52 (0.43–0.63), respectively, with similar associations in men and women. After adjusting for updated cardiovascular risk factors, corresponding HRs were 0...

  5. Plasma YKL-40 and CHI3L1 in systemic inflammation and sepsis—Experience from two prospective cohorts

    DEFF Research Database (Denmark)

    Kornblit, Brian; Hellemann, Dorthe; Munthe-Fog, Lea;

    2013-01-01

    YKL-40, derived from the CHI3L1 gene, has been associated with outcome of infectious and inflammatory diseases. We hypothesized that plasma YKL-40 concentrations and CHI3L1 genotype could be used as prognostic biomarkers in the assessment of systemic inflammatory response syndrome (SIRS) and sepsis....... The objective of the study was to assess the prognostic value of plasma YKL-40 and CHI3L1 genotype in patients with SIRS and sepsis. Plasma YKL-40 and CHI3L1 genotype (rs4950928) were analyzed at time of admission to intensive care units (ICU), in two prospective cohorts of consecutive SIRS patients...... (cohort 1, n=272; cohort 2, n=502). The plasma YKL-40 cut-off for predicting survival was determined in cohort 1 by receiver operator characteristic analyses and validated in cohort 2. In cohort 1 patients with plasma YKL-40 ≤505ng/ml (area under the curve 0.64 (95% confidence interval (CI) 0.57-0.70), p...

  6. Do we at all need surgery to treat thrombosed external hemorrhoids? Results of a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Ole Gebbensleben

    2009-06-01

    Full Text Available Ole Gebbensleben1, York Hilger2, Henning Rohde31Park-Klinik Berlin-Weissensee, Berlin, Germany; 2Institut für Biostatistik, Freiburg im Breisgau, Germany; 3Praxis für Endoskopie und Proktologie, Berlin, GermanyBackground: It is unknown whether surgery is the gold standard for therapy of thrombosed external hemorrhoids (TEH.Methods: A prospective cohort study of 72 adults with TEH was conducted: no surgery, no sitz baths but gentle dry cleaning with smooth toilet paper after defecation. Follow-up information was collected six months after admission by questionnaire.Results: Despite our strict conservative management policy 62.5% (45/72 of patients (95% confidence interval [CI]: 51.0–74.0 described themselves as “healed” or “ameliorated”, and 61.1% (44/72, 95% CI: 49.6–72.6 found our management policy as “valuable to test” or “impracticable”. 13.9% (10/72, 95% CI: 5.7–22.1 of patients suspected to have recurrences. 4.2% did not know. Twenty-two of the 48 responding patients reported symptoms such as itching (18.8%, soiling (12.5%, pricking (10.4%, or a sore bottom (8.3% once a month (59.1%, 13/22, once a week (27.3%, 6/22, or every day (13.6%, 3/22. Conclusions: The dictum that surgery is the gold standard for therapy for TEH should be checked by randomized controlled trials.Keywords: hemorrhoids, acute hemorrhoidal disease, thrombosed external hemorrhoid, perianal thrombosis, conservative therapy, surgery

  7. Effect of door-to-antibiotic time on mortality of patients with sepsis in emergency department: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Mohammad Jalili

    2013-07-01

    Full Text Available Sepsis constitutes an important cause of hospital admission with a high mortality rate. Appropriate antibiotic therapy is the cornerstone of therapy in patients with sepsis. Although numerous studies have recommended early antibiotic initiation in severe sepsis or septic shock stages of sepsis syndrome, its role in treatment of patients with sepsis who have not entered these stages remains to be investigated. The purpose of this study is to investigate the effect of door-to-antibiotic time in sepsis patients with various degrees of severity. This is a longitudinal prospective cohort study on adult patients admitted with sepsis to the emergency department. Sepsis was defined as presence of at least two criteria of systemic inflammatory response syndrome and procalcitonin levels ≥ 2μg/l. Severity of sepsis was determined using the APACHE II (Acute Physiology and Chronic Health Evaluation II scoring system. Time to antibiotic administration was recorded and its relationship with mortality was assessed. A total of 145 patients were eligible for enrollment. The mean age was 60.4 years and the mean APACHE score was 13.7. The overall in-hospital mortality was 21.4%, and the mean length of stay in hospital was 211.9 hours. The mean door-to-antibiotic time for our patients was 104.4 minutes. Antibiotic administration time and mortality in patients with APACHE scores of 21 or higher (P=0.05 were significantly related; whereas such a relationship was not observed for patients with APACHE scores of 11- 20 (P=0.46. We observed early antibiotic initiation for patients in sepsis phase with higher severity scores was associated with significant improvement in survival rate.

  8. Socioeconomic and demographic factors are associated with dietary patterns in a cohort of young Brazilian adults

    OpenAIRE

    Arruda, Soraia Pinheiro Machado; da Silva, Antônio Augusto Moura; Kac, Gilberto; Goldani, Marcelo Zubaran; Bettiol, Heloisa; Barbieri, Marco Antônio

    2014-01-01

    Background The aim of the present study was to identify the main dietary patterns among young adults and to investigate the association of socioeconomic and demographic factors, and social mobility with dietary patterns. Methods Data from the fourth follow-up of the 1978/79 Ribeirão Preto birth cohort study, Brazil, were used. A total of 2,061 young adults, whose mothers gave sociodemographic information at birth in 1978–79, provided sociodemographic and dietary data through a validated food ...

  9. Social capital, the miniaturisation of community, traditionalism and first time acute myocardial infarction: A prospective cohort study in southern Sweden.

    OpenAIRE

    Ali, Sadiq Mohammad; Merlo, Juan; Rosvall, Maria; Lithman, Thor; Lindström, Martin

    2006-01-01

    This longitudinal study investigates the impact of social participation, trust and the combinations of social participation and trust on the incidence of first time acute myocardial infarction (AMI) in the population of Scania, southern Sweden. It is based on the cross-sectional 2000 public-health survey in Scania with a 59% participation rate and 13,604 participants, and prospective morbidity/mortality data collected for three years (January 2000-December 2002). The study cohort was followed...

  10. Long-term lifestyle and dietary habits in relation to cardiovascular mortality and life expectancy: a prospective cohort study

    OpenAIRE

    Streppel, M T

    2009-01-01

    Introduction: In prospective cohort studies, information on lifestyle and dietary habits is generally only assessed at the baseline examination, assuming that these habits are relatively constant over the entire study period. Repeated measures can take into account changes in these habits, reduce measurement error due to a reduction in within-subject variation, and can give more insight into the etiology of diseases. The main objective of this thesis is to assess the relationships of recent a...

  11. Objectively measured physical activity and sedentary time:cross-sectional and prospective associations with adiposity in the Millennium Cohort Study

    OpenAIRE

    Griffiths, Lucy J; Sera, Francesco; Cortina-Borja, Mario; Law, Catherine; Ness, Andy R.; Dezateux, Carol

    2016-01-01

    OBJECTIVE: To examine whether physical activity (PA) and sedentary time (ST) in primary school-aged children are associated with adiposity at the start of secondary school, and whether these associations differ by sex or ethnic group.DESIGN: Nationally representative prospective cohort study.SETTING: Children born across the UK, between 2000 and 2002.PARTICIPANTS: 6497 singleton children.OUTCOME MEASURES: Measures of adiposity (body mass index (BMI), fat mass index (FMI) and fat free mass ind...

  12. Do Dietary Trajectories between Infancy and Toddlerhood Influence IQ in Childhood and Adolescence? Results from a Prospective Birth Cohort Study

    OpenAIRE

    Smithers, Lisa G.; Golley, Rebecca K.; Mittinty, Murthy N; Brazionis, Laima; Northstone, Kate; Emmett, Pauline; John W. Lynch

    2013-01-01

    Objective We examined whether trajectories of dietary patterns from 6 to 24 months of age are associated with intelligence quotient (IQ) in childhood and adolescence. Methods Participants were children enrolled in a prospective UK birth cohort (n = 7652) who had IQ measured at age 8 and/or 15 years. Dietary patterns were previously extracted from questionnaires when children were aged 6, 15 and 24 months using principal component analysis. Dietary trajectories were generated by combining scor...

  13. Risk factors for suicidal thoughts in adolescence-a prospective cohort study: the Young-HUNT study

    OpenAIRE

    Strandheim, Arve; Bjerkeset, Ottar; Gunnell, David; Bjørnelv, Sigrid; Holmen, Turid Lingaas; Bentzen, Niels

    2014-01-01

    Objectives: Examining the associations between health and lifestyle factors recorded in the participants’ early teens and development of suicidal thoughts recorded 4 years later. Design: Population-based prospective cohort study. Settings: All students in the two relevant year classes in Nord-Trøndelag County were invited, 80% attended both waves of data collection. Participants: 2399 secondary school students who participated in the Young-HUNT1 study in 1995–1997 (13–15 yea...

  14. Prognostic Role of Ventricular Ectopic Beats in Systemic Sclerosis: A Prospective Cohort Study Shows ECG Indexes Predicting the Worse Outcome

    OpenAIRE

    De Luca, Giacomo; Bosello, Silvia Laura; Gabrielli, Francesca Augusta; Berardi, Giorgia; Parisi, Federico; Rucco, Manuela; Canestrari, Giovanni; Loperfido, Francesco; Galiuto, Leonarda; Crea, Filippo; Ferraccioli, Gianfranco

    2016-01-01

    Background Arrhythmias are frequent in Systemic Sclerosis (SSc) and portend a bad prognosis, accounting alone for 6% of total deaths. Many of these patients die suddenly, thus prevention and intensified risk-stratification represent unmet medical needs. The major goal of this study was the definition of ECG indexes of poor prognosis. Methods We performed a prospective cohort study to define the role of 24h-ECG-Holter as an additional risk-stratification technique in the identification of SSc-...

  15. Predictive Factors of Postoperative Pain and Postoperative Anxiety in Children Undergoing Elective Circumcision: A Prospective Cohort Study

    OpenAIRE

    Zavras, Nick; Tsamoudaki, Stella; Ntomi, Vasileia; Yiannopoulos, Ioannis; Christianakis, Efstratios; Pikoulis, Emmanuel

    2015-01-01

    Background Although circumcision for phimosis in children is a minor surgical procedure, it is followed by pain and carries the risk of increased postoperative anxiety. This study examined predictive factors of postoperative pain and anxiety in children undergoing circumcision. Methods We conducted a prospective cohort study of children scheduled for elective circumcision. Circumcision was performed applying one of the following surgical techniques: sutureless prepuceplasty (SP), preputial pl...

  16. Accelerated fetal growth prior to diagnosis of gestational diabetes mellitus:A prospective cohort study of nulliparous women

    OpenAIRE

    Sovio, Ulla; Murphy, Helen; Smith, Gordon C. S.

    2016-01-01

    OBJECTIVE: To determine whether fetal overgrowth precedes the diagnosis of gestational diabetes mellitus (GDM) and to quantify the interrelationships among fetal overgrowth, GDM, and maternal obesity. RESEARCH DESIGN AND METHODS: We conducted a prospective cohort study of unselected nulliparous women and performed ultrasonic measurement of the fetal abdominal circumference (AC) and head circumference (HC) at 20 and 28 weeks of gestational age (wkGA). Exposures were diagnosis of GDM ≥28 wkGA a...

  17. Strategies for recruiting Hispanic women into a prospective cohort study of modifiable risk factors for gestational diabetes mellitus

    OpenAIRE

    Hastings Valerie; Fortner Renée T; Chasan-Taber Lisa; Markenson Glenn

    2009-01-01

    Abstract Background The purpose of this article was to describe effective strategies for recruitment of Hispanic women into a prospective cohort study of modifiable risk factors for gestational diabetes mellitus (GDM). Although Hispanic women have two to four times the risk of developing GDM compared with non-Hispanic white women, few GDM prevention studies have included Hispanic women. Methods The study was conducted in the ambulatory obstetrical practices of Baystate Medical Center located ...

  18. Gallbladder disease and use of transdermal versus oral hormone replacement therapy in postmenopausal women: prospective cohort study

    OpenAIRE

    Liu, Bette; Beral, Valerie; Balkwill, Angela; Green, Jane; Sweetland, Siân; Reeves, Gillian

    2008-01-01

    Objective To determine whether transdermal compared with oral use of hormone replacement therapy reduces the risk of gallbladder disease in postmenopausal women. Design Prospective cohort study (Million Women Study). Setting Women registered with the National Health Service (NHS) in England and Scotland. Participants 1 001 391 postmenopausal women (mean age 56) recruited between 1996 and 2001 from NHS breast screening centres and followed by record linkage to routinely collected NHS hospital ...

  19. Evaluation of the impact of breast milk expression in early postpartum period on breastfeeding duration: a prospective cohort study

    OpenAIRE

    Jiang, Beiqi; Hua, Jing; Wang, Yijing; Fu, Yun; Zhuang, Zhigang; Zhu, Liping

    2015-01-01

    Background Breast milk expression (breast pumping) has become prevalent as an important dimension of breastfeeding behavior. It is, however, not clear whether increasing breast milk expression contributes to extend the duration of breastfeeding. The objective of the present study was to evaluate the impact of breast milk expression in early postpartum period on breastfeeding duration amongst mothers of healthy term infants. Methods A prospective cohort study had been conducted from March to J...

  20. Growth of human immunodeficiency type 1-infected and unifected children : a prospective cohort study in Kigali, Rwanda, 1988 to 1993

    OpenAIRE

    Lepage, P; Msellati, Philippe; Hitimana, D.G.; Bazubagira, A.; Van Goethem, C.; Simonon, A.; Karita, E.; Dequae-Merchadou, L.; Van de Perre, P; DABIS, F.

    1996-01-01

    To compare the anthropometric characteristics of children with an without HIV-1 infection. In a prospective cohort study of 218 children born to HIV-1 seropositive mothers and 218 children born to HIV-1 seronegative mothers in Kigali, Rwanda, 3 groups were compared : infected children (n = 46), uninfected children born to seropositive mothers (n = 140), and uninfected children born to seronegative mothers (n = 207). Weight, height and head circumference were measured at birth, every 3 months ...

  1. Ozone Nucleolysis for Management of Pain and Disability in Prolapsed Lumber Intervertebral Disc: A Prospective Cohort Study

    OpenAIRE

    Das, G.; Ray, S; Ishwarari, S.; Roy, M.; Ghosh, P.(Variable Energy Cyclotron Centre, Kolkata, India)

    2009-01-01

    The prevalence rate of low back pain in a number of studies ranged from 22% to 65% in one year, and lifetime prevalence ranged from 11% to 84%. Over the years many percutaneous minimally invasive therapeutic modalities have evolved. Intradiscal oxygen-ozone therapy has also showed promising results. We undertook a prospective cohort study to evaluate the therapeutic outcome of oxygen-ozone therapy on patients with lumber disc herniation in the Indian population.

  2. Reproductive factors and risk of mortality in the European Prospective Investigation into Cancer and Nutrition; a cohort study

    OpenAIRE

    Merritt, Melissa A; Riboli, Elio; Murphy, Neil; Kadi, Mai; Tjønneland, Anne; Olsen, Anja; Overvad, Kim; Dossus, Laure; Dartois, Laureen; Clavel-Chapelon, Françoise; Fortner, Renée T.; Katzke, Verena A; Boeing, Heiner; Trichopoulou, Antonia; Lagiou, Pagona

    2015-01-01

    Background: Reproductive events are associated with important physiologic changes, yet little is known about how reproductive factors influence long-term health in women. Our objective was to assess the relation of reproductive characteristics with all-cause and cause-specific mortality risk. Methods: The analysis was performed within the European Investigation into Cancer and Nutrition prospective cohort study, which enrolled >500,000 women and men from 1992 to 2000, who were residing in a g...

  3. Alcohol and Exercise Affect Declining Kidney Function in Healthy Males Regardless of Obesity: A Prospective Cohort Study

    OpenAIRE

    Kanda, Eiichiro; Muneyuki, Toshitaka; Suwa, Kaname; Nakajima, Kei

    2015-01-01

    Background Although lifestyle is associated with metabolic syndrome and cardiovascular diseases, there has been no sufficient evidence of lifestyles on incident chronic kidney disease (CKD). The purpose of this prospective cohort study is to investigate the effects of lifestyles on kidney function in healthy people. Methods A total of 7473 healthy people were enrolled in this Saitama Cardiometabolic Disease and Organ Impairment Study, Japan. Data on alcohol consumption, exercise frequency, an...

  4. High sensitivity cardiac troponin and the under-diagnosis of myocardial infarction in women:Prospective cohort study

    OpenAIRE

    Shah, Anoop S V; Griffiths, Megan; Lee, Kuan Ken; McAllister, David A; Hunter, Amanda L; Ferry, Amy V; Cruikshank, Anne; Reid, Alan; Stoddart, Mary; Strachan, Fiona; Walker, Simon; Collinson, Paul O; Apple, Fred S.; Gray, Alasdair J; Fox, Keith A. A.

    2015-01-01

    OBJECTIVE: To evaluate the diagnosis of myocardial infarction using a high sensitivity troponin I assay and sex specific diagnostic thresholds in men and women with suspected acute coronary syndrome. DESIGN: Prospective cohort study. SETTING: Regional cardiac centre, United Kingdom. PARTICIPANTS: Consecutive patients with suspected acute coronary syndrome (n = 1126, 46% women). Two cardiologists independently adjudicated the diagnosis of myocardial infarction by using a high sensitivity tropo...

  5. The appraisal of chronic stress and the development of the metabolic syndrome: a systematic review of prospective cohort studies

    OpenAIRE

    Bergmann, N; Gyntelberg, F; Faber, J

    2014-01-01

    Chronic psychosocial stress has been proposed as a risk factor for the development of the metabolic syndrome (MES). This review gives a systematic overview of prospective cohort studies investigating chronic psychosocial stress as a risk factor for incident MES and the individual elements of MES. Thirty-nine studies were included. An association between chronic psychosocial stress and the development of MES was generally supported. Regarding the four elements of MES: i) weight gain: the prosp...

  6. Women’s preferences and mode of delivery in public and private hospitals: a prospective cohort study

    OpenAIRE

    Mazzoni, Agustina; Althabe, Fernando; Gutierrez, Laura; Gibbons, Luz; Liu, Nancy H; Bonotti, Ana María; Izbizky, Gustavo H.; Ferrary, Marta; Viergue, Nora; Vigil, Silvia I.; Zalazar Denett, Gabriela; Belizán, José M

    2016-01-01

    Background Rates of caesarean section have steadily increased in most middle- and high-income countries over the last few decades without medical justification. Maternal request is one of the frequently cited non-medical factors contributing to this trend. The objectives of this study were to assess pregnant women’s preferences regarding mode of delivery and to compare actual caesarean section rates in the public and private sectors. Methods A prospective cohort study was conducted in two pub...

  7. Staying well in an unstable world of work : Prospective cohort study of the determinants of employee well-being

    OpenAIRE

    PAHKIN, Krista

    2015-01-01

    The overarching aim of the thesis was to identify work-related and personal factors which support employee well-being during working career and organizational restructuring. The empirical part of this thesis was based on a prospective cohort study of employees in the Finnish forest industry. Data included responses to questionnaires (N up to 4279) and records from organizational and national registers, all collected between 1986 and 2009. The data covered a period of stable growth, strong int...

  8. Maternal near misses from two referral hospitals in Uganda: a prospective cohort study on incidence, determinants and prognostic factors

    OpenAIRE

    Nakimuli, Annettee; Nakubulwa, Sarah; Kakaire, Othman; Osinde, Michael O; Mbalinda, Scovia N; Nabirye, Rose C; Kakande, Nelson; Kaye, Dan K

    2016-01-01

    Background Maternal near misses occur more often than maternal deaths and could enable more comprehensive analysis of risk factors, short-term outcomes and prognostic factors of complications during pregnancy and childbirth. The study determined the incidence, determinants and prognostic factors of severe maternal outcomes (near miss or maternal death) in two referral hospitals in Uganda. Methods A prospective cohort study was conducted between March 1, 2013 and February 28, 2014, where cases...

  9. Bio-psycho-socio-demographic and Obstetric Predictors of Postpartum Depression in Pregnancy: A prospective Cohort Study

    OpenAIRE

    Abdollahi, Fatemeh; Rohani, Samad; Sazlina, Ghazali Shariff; Zarghami, Mehran; Azhar, Md Zain; Lye, Munn Sann; Rezaiee Abhari, Farideh; Majidi, Zohreh; Mozafari, Soghra

    2014-01-01

    Objective: There are various attempts to confirm variables that could predict postpartum depression in advance. This study determined antenatal risk factors for postpartum depression in women at risk of developing this disorder. Methods: A prospective cohort study was conducted with 2279 eligible women who attended at Mazandaran province’ primary health centers from 32-42 weeks of pregnancy to eighth postpartum weeks. The women were screened for symptoms of depression using the Iranian versio...

  10. Past and recent abuse is associated with early cessation of breast feeding: results from a large prospective cohort in Norway.

    OpenAIRE

    Sørbø, Marie Flem; Lukasse, Mirjam; Brantsæter, Anne Lise; Grimstad, Hilde

    2015-01-01

    Objective: Breast feeding provides a wide range of health benefits for both infants and mothers. Few studies have examined the impact of past and recent abuse of women on breastfeeding behaviour. The aims of our study were to examine whether exposure to past and recent emotional, sexual or physical abuse was associated with early breastfeeding cessation, and to assess whether a potential association differed for known and unknown perpetrators. Design: Prospective cohort study. Set...

  11. Risk factors for self-reported arm lymphedema among female breast cancer survivors: a prospective cohort study

    OpenAIRE

    Togawa, Kayo; Ma, Huiyan; Sullivan-Halley, Jane; Neuhouser, Marian L.; Imayama, Ikuyo; Baumgartner, Kathy B.; Smith, Ashley Wilder; Alfano, Catherine M.; McTiernan, Anne; Ballard-Barbash, Rachel; Bernstein, Leslie

    2014-01-01

    Introduction Lymphedema is a potentially debilitating condition that occurs among breast cancer survivors. This study examines the incidence of self-reported lymphedema, timing of lymphedema onset, and associations between sociodemographic, clinical and lifestyle factors and lymphedema risk across racial-ethnic groups using data from a multicenter, multiethnic prospective cohort study of breast cancer survivors, the Health, Eating, Activity and Lifestyle Study. Methods A total of 666 women di...

  12. Dairy consumption and calcium intake and risk of breast cancer in a prospective cohort: The Norwegian Women and Cancer study

    OpenAIRE

    Hjartaker, A; Engeset, Dagrun; Lund, Eiliv; Thoresen, Magne

    2010-01-01

    Objective To study the association between consumption of dairy products and calcium intake and risk of breast cancer risk according to menopausal status. Methods In a population-based prospective cohort study of 64,904 Norwegian women followed from 1996/1999 through 2006, we examined total dairy consumption and consumption of various dairy products in relation to pre- and postmenopausal breast cancer risk. We also examined breast cancer in relation to calcium intake and to milk consumption d...

  13. The incidence and health burden of earaches attributable to recreational swimming in natural waters: a prospective cohort study

    OpenAIRE

    Wade, Timothy J.; Sams, Elizabeth A.; Beach, Michael J.; Collier, Sarah A.; Dufour, Alfred P

    2013-01-01

    Background Earaches and outer ear infections are commonly associated with swimming. In this study, we estimated the excess risk and health burden of earaches due to swimming in natural fresh and marine waters using results from a survey of over 50,000 beachgoers at nine beaches across the United States. Methods Prospective cohort studies were conducted at four freshwater and five marine sites in the United States and Puerto Rico. Beach visitors were enrolled on summer weekends and holidays. T...

  14. Sickness absence and disability pension due to otoaudiological diagnoses: risk of premature death – a nationwide prospective cohort study

    OpenAIRE

    Friberg, Emilie; Rosenhall, Ulf; Alexanderson, Kristina

    2014-01-01

    Background It is estimated that hearing difficulties will be one of the top ten leading burdens of disease by 2030. Knowledge of mortality among individuals on sick leave or disability pension due to hearing diagnoses is virtually non-existent. We aimed prospectively to examine the associations of diagnosis-specific sick leave and disability pension due to different otoaudiological diagnoses with risks of all-cause and cause-specific mortality. Methods A cohort, based on Swedish registry data...

  15. Assessment of cosmetic outcome of oncoplastic breast conservation surgery in women with early breast cancer: A prospective cohort study

    OpenAIRE

    G Adimulam; Challa, V R; Dhar, A.; S Chumber; V Seenu; Srivastava, A.

    2014-01-01

    Background: The aim of this study was to assess the cosmetic outcome of patients undergoing oncoplastic breast conserving surgery in Indian population. Materials and Methods: A prospective cohort of 35 patients who were eligible for breast conservation surgery was included in the study from year 2007 to 2009. Patients with central quadrant tumors were excluded from the study. A double - blind cosmetic assessment was done by a plastic surgeon and a senior nurse not involved in the management o...

  16. Sarcopenia, but not sarcopenic obesity, predicts mortality for older old men: A 3-year prospective cohort study

    OpenAIRE

    Li-Kuo Liu, MD; Liang-Yu Chen, MD; Kuo-Ping Yeh, MD; Ming-Hsien Lin, MD; An-Chun Hwang, MD; Li-Ning Peng, MD; Liang-Kung Chen, MD, PhD

    2014-01-01

    Background: The prognostic significance of sarcopenia and sarcopenic obesity (SO) among older people remains controversial. The main aim of this study was to evaluate the mortality risk of sarcopenia and SO among men aged 75 years and older in Taiwan. Methods: This prospective cohort study recruited all residents of the Banciao Veterans Home, a veterans retirement community in Taipei City in northern Taiwan. For all study participants, the demographic profile, comorbid medical conditions, ...

  17. Elevation of Serum Aminotransferase Levels and Future Risk of Death from External Causes: A Prospective Cohort Study in Korea

    OpenAIRE

    Sohn, Jungwoo; Kang, Dae Ryong; Kim, Hyeon Chang; Cho, Jaelim; Choi, Yoon Jung; Kim, Changsoo; Suh, Il

    2015-01-01

    Purpose The association between liver enzymes and death from external causes has not been examined. We investigated the association between serum aminotransferase levels and external-cause mortality in a large prospective cohort study. Materials and Methods A total of 142322 subjects of 35-59 years of age who completed baseline examinations in 1990 and 1992 were enrolled. Mortalities were identified using death certificates. Serum alanine aminotransferase (ALT) and aspartate aminotransferase ...

  18. Design and implementation of the canadian kidney disease cohort study (CKDCS): A prospective observational study of incident hemodialysis patients

    OpenAIRE

    Opgenorth Dawn; Cembrowski George; Holmes Daniel; Zimmerman Deborah; Chan Christopher; Gill John; Klarenbach Scott; Hemmelgarn Brenda; Thadhani Ravi; Bello Aminu K; Sibrian Rafael; Karkhaneh Mohammad; Tiv Sophanny; Wiebe Natasha; Tonelli Marcello

    2011-01-01

    Abstract Background Many nephrology observational studies use renal registries, which have well known limitations. The Canadian Kidney Disease Cohort Study (CKDCS) is a large prospective observational study of patients commencing hemodialysis in five Canadian centers. This study focuses on delineating potentially reversible determinants of adverse outcomes that occur in patients receiving dialysis for end-stage renal disease (ESRD). Methods/Design The CKDCS collects information on risk factor...

  19. Failure to reduce drinking and driving in France: a 6-year prospective study in the GAZEL cohort.

    OpenAIRE

    Constant, Aymery; Lafont, Sylviane; Chiron, Mireille; Zins, Marie; Lagarde, Emmanuel; Messiah, Antoine

    2010-01-01

    AIM: An unprecedented decline in alcohol consumption and road mortality has been observed recently in France, but it is still unclear whether or not these changes affected driving while alcohol-intoxicated (DWI). The objective of the study was to estimate prospectively trends of excessive speed on the roads, alcohol consumption and DWI between 2001 and 2007 in a large cohort of experienced drivers. METHODS: Participants were current employees or recent retirees of the French national electric...

  20. Traffic-Related Air Pollution and Asthma Onset in Children: A Prospective Cohort Study with Individual Exposure Measurement

    OpenAIRE

    Jerrett, Michael; Shankardass, Ketan; Berhane, Kiros; Gauderman, W James; Künzli, Nino; Avol, Edward; Gilliland, Frank; Lurmann, Fred; Molitor, Jassy N.; Molitor, John T.; Thomas, Duncan C; Peters, John; McCONNELL, ROB

    2008-01-01

    Background The question of whether air pollution contributes to asthma onset remains unresolved. Objectives In this study, we assessed the association between asthma onset in children and traffic-related air pollution. Methods We selected a sample of 217 children from participants in the Southern California Children’s Health Study, a prospective cohort designed to investigate associations between air pollution and respiratory health in children 10–18 years of age. Individual covariates and ne...

  1. A comparison of health outcomes in older versus younger adults following a road traffic crash injury: a cohort study.

    Directory of Open Access Journals (Sweden)

    Bamini Gopinath

    Full Text Available Given the aging demographics of most developed countries, understanding the public health impact of mild/moderate road traffic crash injuries in older adults is important. We aimed to determine whether health outcomes (pain severity and quality of life measures over 24 months differ significantly between older (65+ and younger adults (18-64.Prospective cohort study of 364, 284 and 252 participants with mild/moderate injury following a vehicle collision at baseline, 12 and 24 months, respectively. A telephone-administered questionnaire obtained information on socio-economic, pre- and post-injury psychological and heath characteristics.At baseline, there were 55 (15.1% and 309 (84.9% participants aged ≥65 and 18-64 years, respectively. At 12- and 24-month follow-up, older compared to younger participants who had sustained a mild/moderate musculoskeletal injury had lower physical functioning (3.9-units lower Short Form-12 Physical Composite Score, multivariable-adjusted p = 0.03 at both examinations. After multivariable adjustment, older (n = 45 versus younger (n = 207 participants had lower self-perceived health status (8.1-units lower European Quality of Life-5 Dimensions Visual Acuity Scale scores at 24 months, p = 0.03, 24 months later.Older compared to younger participants who sustained a mild/moderate injury following a road-traffic crash demonstrated poorer physical functioning and general health at 24 months.

  2. Incidence and Risk Factors of Serious Adverse Events during Antituberculous Treatment in Rwanda: A Prospective Cohort Study

    Science.gov (United States)

    Lorent, Natalie; Sebatunzi, Osee; Mukeshimana, Gloria; Van den Ende, Jef; Clerinx, Joannes

    2011-01-01

    Background Tuberculosis (TB) and TB-human immunodeficiency virus infection (HIV) coinfection is a major public health concern in resource-limited settings. Although TB treatment is challenging in HIV-infected patients because of treatment interactions, immunopathological reactions, and concurrent infections, few prospective studies have addressed this in sub-Saharan Africa. In this study we aimed to determine incidence, causes of, and risk factors for serious adverse events among patients on first-line antituberculous treatment, as well as its impact on antituberculous treatment outcome. Methods and findings Prospective observational cohort study of adults treated for TB at the Internal Medicine department of the Kigali University Hospital from May 2008 through August 2009. Of 263 patients enrolled, 253 were retained for analysis: median age 35 (Interquartile range, IQR 28–40), 55% male, 66% HIV-positive with a median CD4 count 104 cells/mm3 (IQR 44–248 cells/mm3). Forty percent had pulmonary TB, 43% extrapulmonary TB and 17% a mixed form. Sixty-four (26%) developed a serious adverse event; 58/167 (35%) HIV-infected vs. 6/86 (7%) HIV-uninfected individuals. Commonest events were concurrent infection (n = 32), drug-induced hepatitis (n = 24) and paradoxical reactions/TB-IRIS (n = 23). HIV-infection (adjusted Hazard Ratio, aHR 3.4, 95% Confidence Interval, CI 1.4–8.7) and extrapulmonary TB (aHR 2, 95%CI 1.1–3.7) were associated with an increased risk of serious adverse events. For TB/HIV co-infected patients, extrapulmonary TB (aHR 2.0, 95%CI 1.1–3.9) and CD4 count <100 cells/mm3 at TB diagnosis (aHR 1.7, 95%CI 1.0–2.9) were independent predictors. Adverse events were associated with an almost two-fold higher risk of unsuccessful treatment outcome at 6 months (HR 1.89, 95%CI 1.3–3.0). Conclusion Adverse events frequently complicate the course of antituberculous treatment and worsen treatment outcome, particularly in patients with

  3. Incidence and risk factors of serious adverse events during antituberculous treatment in Rwanda: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Natalie Lorent

    Full Text Available BACKGROUND: Tuberculosis (TB and TB-human immunodeficiency virus infection (HIV coinfection is a major public health concern in resource-limited settings. Although TB treatment is challenging in HIV-infected patients because of treatment interactions, immunopathological reactions, and concurrent infections, few prospective studies have addressed this in sub-Saharan Africa. In this study we aimed to determine incidence, causes of, and risk factors for serious adverse events among patients on first-line antituberculous treatment, as well as its impact on antituberculous treatment outcome. METHODS AND FINDINGS: Prospective observational cohort study of adults treated for TB at the Internal Medicine department of the Kigali University Hospital from May 2008 through August 2009. Of 263 patients enrolled, 253 were retained for analysis: median age 35 (Interquartile range, IQR 28-40, 55% male, 66% HIV-positive with a median CD4 count 104 cells/mm(3 (IQR 44-248 cells/mm(3. Forty percent had pulmonary TB, 43% extrapulmonary TB and 17% a mixed form. Sixty-four (26% developed a serious adverse event; 58/167 (35% HIV-infected vs. 6/86 (7% HIV-uninfected individuals. Commonest events were concurrent infection (n = 32, drug-induced hepatitis (n = 24 and paradoxical reactions/TB-IRIS (n = 23. HIV-infection (adjusted Hazard Ratio, aHR 3.4, 95% Confidence Interval, CI 1.4-8.7 and extrapulmonary TB (aHR 2, 95%CI 1.1-3.7 were associated with an increased risk of serious adverse events. For TB/HIV co-infected patients, extrapulmonary TB (aHR 2.0, 95%CI 1.1-3.9 and CD4 count <100 cells/mm3 at TB diagnosis (aHR 1.7, 95%CI 1.0-2.9 were independent predictors. Adverse events were associated with an almost two-fold higher risk of unsuccessful treatment outcome at 6 months (HR 1.89, 95%CI 1.3-3.0. CONCLUSION: Adverse events frequently complicate the course of antituberculous treatment and worsen treatment outcome, particularly in patients with extrapulmonary

  4. Dietary flavonoid intake and the risk of stroke: a dose-response meta-analysis of prospective cohort studies

    Science.gov (United States)

    Tang, Zhenyu; Li, Min; Zhang, Xiaowei; Hou, Wenshang

    2016-01-01

    Objective To clarify and quantify the potential association between intake of flavonoids and risk of stroke. Design Meta-analysis of prospective cohort studies. Data source Studies published before January 2016 identified through electronic searches using PubMed, Embase and the Cochrane Library. Eligibility criteria for selecting studies Prospective cohort studies with relative risks and 95% CIs for stroke according to intake of flavonoids (assessed as dietary intake). Results The meta-analysis yielded 11 prospective cohort studies involving 356 627 participants and more than 5154 stroke cases. The pooled estimate of the multivariate relative risk of stroke for the highest compared with the lowest dietary flavonoid intake was 0.89 (95% CI 0.82 to 0.97; p=0.006). Dose-response analysis indicated that the summary relative risk of stroke for an increase of 100 mg flavonoids consumed per day was 0.91 (95% CI 0.77 to 1.08) without heterogeneity among studies (I2=0%). Stratifying by follow-up duration, the relative risk of stroke for flavonoid intake was 0.89 (95% CI 0.81 to 0.99) in studies with more than 10 years of follow-up. Conclusions Results from this meta-analysis suggest that higher dietary flavonoid intake may moderately lower the risk of stroke. PMID:27279473

  5. Prospective observational cohort study of Health Related Quality of Life (HRQOL, chronic foot problems and their determinants in gout: a research protocol

    Directory of Open Access Journals (Sweden)

    Chandratre Priyanka

    2012-11-01

    Full Text Available Abstract Background Gout is the commonest inflammatory arthritis affecting around 1.4% of adults in Europe. It is predominantly managed in primary care and classically affects the joints of the foot, particularly the first metatarsophalangeal joint. Gout related factors (including disease characteristics and treatment as well as comorbid chronic disease are associated with poor Health Related Quality of Life (HRQOL yet to date there is limited evidence concerning gout in a community setting. Existing epidemiological studies are limited by their cross-sectional design, selection of secondary care patients with atypical disease and the use of generic tools to measure HRQOL. This 3 year primary care-based prospective observational cohort study will describe the spectrum of HRQOL in community dwelling patients with gout, associated factors, predictors of poor outcome, and prevalence and incidence of foot problems in gout patients. Methods Adults aged ≥ 18 years diagnosed with gout or prescribed colchicine or allopurinol in the preceding 2 years will be identified through Read codes and mailed a series of self-completion postal questionnaires over a 3-year period. Consenting participants will have their general practice medical records reviewed. Discussion This is the first prospective cohort study of HRQOL in patients with gout in primary care in the UK. The combination of survey data and medical record review will allow an in-depth understanding of factors that are associated with and lead to poor HRQOL and foot problems in gout. Identification of these factors will improve the management of this prevalent, yet under-treated, condition in primary care.

  6. Association between adult otitis media and nasopharyngeal cancer: A nationwide population-based cohort study

    International Nuclear Information System (INIS)

    Purpose: To determine whether the diagnosis of otitis media (OM) in adults is associated with an increased risk for the subsequent development of nasopharyngeal cancer (NPC) using a nationwide population-based retrospective study. Methods and materials: We selected 13,513 adult patients that had been previously diagnosed with OM between 2000 and 2005 from the Taiwan Longitudinal Health Insurance Database 2000 as the study cohort, and randomly extracted the data of 135,130 participants matched by sex, age, and baseline year for the comparison cohort. The follow-up period was terminated upon developing NPC, withdrawal from the national health insurance system, or the end of 2009. Cumulative incidences and hazard ratios (HRs) of NPC development were determined. Results: The subsequent NPC incidence rates in the OM and comparison cohorts were 6.41 and 0.58 per 10 000 person-years, respectively (adjusted HR, 11.04; 95% CI, 7.68–5.87; P < 0.0001). The NPC risk for males was significantly higher than that for females (adjusted HR = 3.24; 95% CI, 2.16–4.85). In both female and male patients, the diagnosis of OM was associated with a significantly increased risk for NPC (adjusted HR, 11.91 vs. 10.78, respectively). Among the OM cohort, 62 participants were subsequently diagnosed with NPC, with 71% of them occurring within 1 year following the diagnosis of OM. However, even after 5-year follow-up, the OM cohort still displayed a higher risk for NPC (adjusted HR = 2.50). Stratified by the frequency of OM episodes, more than one episode per year had a significantly greater risk of developing NPC, compared with the comparison cohort (HR = 29.22; 95% CI, 20.19–42.27). Conclusion: We found that adult OM is a warning sign for the development of NPC in Taiwan, with approximately an 11-fold higher risk for adult OM patients. We recommend that OM patients undergo follow-up examinations for at least 5 years. To extrapolate our findings, further studies are warranted in other

  7. Comparison of two different approaches for the analysis of data from a prospective cohort study: an application to work related risk factors for low back pain

    OpenAIRE

    Hoogendoorn, W.E.; Bongers, P.M.; Vet, van der, Paul E.; Twisk, J.W.R.; Mechelen, Van; Bouter, L M

    2002-01-01

    Aims: To compare the results of a traditional approach using standard regression for the analysis of data from a prospective cohort study with the results of generalised estimating equations (GEE) analysis.

  8. Cannabis and Anxiety and Depression in Young Adults: A Large Prospective Study

    Science.gov (United States)

    Hayatbakhsh, Mohammad R.; Najman, Jake M.; Jamrozik, Konrad; Mamun, Abdullah A.; Alati, Rosa; Bor, William

    2007-01-01

    Objective: To examine whether age of first use or frequency of use of cannabis is associated with anxiety and depression (AD) in young adults, independent of known potential confounders, including the use of other illicit drugs. Method: A cohort of 3,239 Australian young adults was followed from birth to the age of 21 when data on AD were obtained…

  9. Consequences of gestational diabetes in an urban hospital in Viet Nam: a prospective cohort study.

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    Jane E Hirst

    Full Text Available BACKGROUND: Gestational diabetes mellitus (GDM is increasing and is a risk for type 2 diabetes. Evidence supporting screening comes mostly from high-income countries. We aimed to determine prevalence and outcomes in urban Viet Nam. We compared the proposed International Association of the Diabetes and Pregnancy Study Groups (IADPSG criterion, requiring one positive value on the 75-g glucose tolerance test, to the 2010 American Diabetes Association (ADA criterion, requiring two positive values. METHODS AND FINDINGS: We conducted a prospective cohort study in Ho Chi Minh City, Viet Nam. Study participants were 2,772 women undergoing routine prenatal care who underwent a 75-g glucose tolerance test and interview around 28 (range 24-32 wk. GDM diagnosed by the ADA criterion was treated by local protocol. Women with GDM by the IADPSG criterion but not the ADA criterion were termed "borderline" and received standard care. 2,702 women (97.5% of cohort were followed until discharge after delivery. GDM was diagnosed in 164 participants (6.1% by the ADA criterion, 550 (20.3% by the IADPSG criterion. Mean body mass index was 20.45 kg/m(2 in women with out GDM, 21.10 in women with borderline GDM, and 21.81 in women with GDM, p<0.001. Women with GDM and borderline GDM were more likely to deliver preterm, with adjusted odds ratios (aORs of 1.49 (95% CI 1.16-1.91 and 1.52 (1.03-2.24, respectively. They were more likely to have clinical neonatal hypoglycaemia, aORs of 4.94 (3.41-7.14 and 3.34 (1.41-7.89, respectively. For large for gestational age, the aORs were 1.16 (0.93-1.45 and 1.31 (0.96-1.79, respectively. There was no significant difference in large for gestational age, death, severe birth trauma, or maternal morbidity between the groups. Women with GDM underwent more labour inductions, aOR 1.51 (1.08-2.11. CONCLUSIONS: Choice of criterion greatly affects GDM prevalence in Viet Nam. Women with GDM by the IADPSG criterion were at risk of preterm delivery

  10. Rapid, easy, and cheap randomization: prospective evaluation in a study cohort

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    Parker Melissa J

    2012-06-01

    Full Text Available Abstract Background When planning a randomized controlled trial (RCT, investigators must select randomization and allocation procedures based upon a variety of factors. While third party randomization is cited as being among the most desirable randomization processes, many third party randomization procedures are neither feasible nor cost-effective for small RCTs, including pilot RCTs. In this study we present our experience with a third party randomization and allocation procedure that utilizes current technology to achieve randomization in a rapid, reliable, and cost-effective manner. Methods This method was developed by the investigators for use in a small 48-participant parallel group RCT with four study arms. As a nested study, the reliability of this randomization procedure was prospectively evaluated in this cohort. The primary outcome of this nested study was the proportion of subjects for whom allocation information was obtained by the Research Assistant within 15 min of the initial participant randomization request. A secondary outcome was the average time for communicating participant group assignment back to the Research Assistant. Descriptive information regarding any failed attempts at participant randomization as well as costs attributable to use of this method were also recorded. Statistical analyses included the calculation of simple proportions and descriptive statistics. Results Forty-eight participants were successfully randomized and group allocation instruction was received for 46 (96% within 15 min of the Research Assistant placing the initial randomization request. Time elapsed in minutes until receipt of participant allocation instruction was Mean (SD 3.1 +/− 3.6; Median (IQR 2 (2,3; Range (1–20 for the entire cohort of 48. For the two participants for whom group allocation information was not received by the Research Assistant within the 15-min pass threshold, this information was obtained following a second

  11. Direct Medical Costs for Patients with Type 2 Diabetes and Related Complications: A Prospective Cohort Study Based on the Korean National Diabetes Program

    OpenAIRE

    Kim, Tae Ho; Chun, Ki Hong; Kim, Hae Jin; Han, Seung Jin; Kim, Dae Jung; Kwak, Jiyeong; Kim, Young Seol; Woo, Jeong Taek; Park, Yongsoo; Nam, Moonsuk; Baik, Sei Hyun; Ahn, Kyu Jeung; Lee, Kwan Woo

    2012-01-01

    We analyzed the direct medical costs for Korean patients with type 2 diabetes according to the type of complications and the number of microvascular complications. We analyzed costs for type 2 diabetes and associated complications in 3,125 patients. These data were obtained from the Korean National Diabetes Program (KNDP), a large, ongoing, prospective cohort study that began in 2005. The cost data were prospectively collected, using an electronic database, for the KNDP cohort at six hospital...

  12. Chlamydia trachomatis prevalence in undocumented migrants undergoing voluntary termination of pregnancy: a prospective cohort study

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    Irion Olivier

    2008-11-01

    Full Text Available Abstract Background Chlamydia trachomatis infection (CTI is the most frequent sexual transmitted disease (STI in Switzerland but its prevalence in undocumented migrants is unknown. We aimed to compare CTI prevalence among undocumented migrants undergoing termination of pregnancy (ToP to the prevalence among women with residency permit. Methods This prospective cohort study included all pregnant, undocumented women presenting from March 2005 to October 2006 to the University hospital for ToP. The control group consisted of a systematic sample of pregnant women with legal residency permit coming to the same hospital during the same time period for ToP Results One hundred seventy five undocumented women and 208 women with residency permit (controls were included in the study. Mean ages were 28.0 y (SD 5.5 and 28.2 y (SD 7.5, respectively (p = 0.77. Undocumented women came primarily from Latin-America (78%. Frequently, they lacked contraception (23%, controls 15%, OR 1.8, 95% CI 1.04;2.9. Thirteen percent of undocumented migrants were found to have CTI (compared to 4.4% of controls; OR 3.2, 95% CI 1.4;7.3. Conclusion This population of undocumented, pregnant migrants consisted primarily of young, Latino-American women. Compared to control women, undocumented migrants showed higher prevalence rates of genital CTI, which indicates that health professionals should consider systematic screening for STI in this population. There is a need to design programs providing better access to treatment and education and to increase migrants' awareness of the importance of contraception and transmission of STI.

  13. Perinatal mortality in rural Burkina Faso: a prospective community-based cohort study

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    Diallo Abdoulaye

    2010-08-01

    Full Text Available Abstract Background There is a scarcity of reliable data on perinatal mortality (PNM in Sub-Saharan Africa. The PROMISE-EBF trial, during which we promoted exclusive breastfeeding, gave us the opportunity to describe the epidemiology of PNM in Banfora Health District, South-West in Burkina Faso. Study objectives To measure the perinatal mortality rate (PNMR in the PROMISE-EBF cohort in Banfora Health District and to identify potential risk factors for perinatal death. Methods We used data collected prospectively during the PROMISE-EBF-trial to estimate the stillbirth rate (SBR and early neonatal mortality rate (ENMR. We used binomial regression with generalized estimating equations to identify potential risk factors for perinatal death. Results 895 pregnant women were enrolled for data collection in the EBF trial and followed-up to 7 days after birth. The PNMR, the SBR and the ENMR, were 79 per 1000 (95% CI: 59-99, 54 per 1000 (95% CI: 38-69 and 27 per 1000 (95% CI: 9-44, respectively. In a multivariable analysis, nulliparous women (RR = 2.90, 95% CI: 1.6-5.0, primiparae mothers (RR = 2.20, 95% CI: 1.2-3.9, twins (RR = 4.0, 95% CI: 2.3-6.9 and giving birth during the dry season (RR = 2.1 95% CI: 1.3-3.3 were factors associated with increased risk of perinatal death. There was no evidence that risk of perinatal death differed between deliveries at home and at a health centre Conclusion Our study observed the highest PNMR ever reported in Burkina. There is an urgent need for sustainable interventions to improve maternal and newborn health in the country.

  14. Injuries in Professional Male Soccer Players in the Netherlands: A Prospective Cohort Study

    Science.gov (United States)

    Stubbe, Janine H.; van Beijsterveldt, Anne-Marie M. C.; van der Knaap, Sissi; Stege, Jasper; Verhagen, Evert A.; van Mechelen, Willem; Backx, Frank J. G.

    2015-01-01

    Context: Injuries are a major adverse event in a soccer player's career. Reducing injury incidence requires a thorough knowledge of the epidemiology of soccer injuries. Objective: To investigate the incidence and characteristics of injuries in the Dutch premier soccer league. Design: Cohort study. Setting: The Dutch premier soccer league. Patients or Other Participants: During the 2009–2010 soccer season, a total of 217 professional soccer players from 8 teams were prospectively followed. Main Outcome Measure(s): The medical staff recorded time-loss injuries, including information on injuries (ie, type, body part, duration) and exposure data for training sessions and matches. Results: A total of 286 injuries were recorded, affecting 62.7% of the players. The overall injury incidence was 6.2 injuries per 1000 player-hours, 2.8 in training sessions and 32.8 in matches. Most of the recorded injuries were acute (68.5%). Eight percent of the injuries were classified as recurrent. Injuries were most likely to be located in the lower extremities (82.9%). Injury time loss ranged from 1 to 752 days, with a median of 8 days. Knee injuries had the greatest consequences in terms of days of absence from soccer play (on average, 45 days). The most common diagnosis was muscle/tendon injury of the lower extremities (32.9%). Conclusions: Injury risk in the Dutch premier soccer league is high, especially during matches. Preventive measures should focus on the most common diagnoses, namely, muscle/tendon injuries of the lower extremities. PMID:25531144

  15. Body mass index and obstetric outcomes in pregnant in Saudi Arabia: a prospective cohort study

    International Nuclear Information System (INIS)

    We examined the effect of body mass index in early pregnancy on pregnancy outcome since no study in Saudi Arabia has addressed this question.This prospective cohort study involved women registered for antenatal care during the first month of pregnancy at primary health care centers in Al-Hassa, Saudi Arabia. Data was collected from records and by direct interview. The study included 787 women. Compared to normal weight women (n=307), overweight (n=187) and obese (n=226) women were at increased risk for pregnancy-induced hypertension (RR=4.9 [95% CI 1.6-11.1] and 6.1 [95% CI 2.1-17.8], respectively), gestational diabetes (RR=4.4 [95% CI 1.2-16.3] and 8.6 [95% CI 2.6-28.8]), preeclamptic toxemia (RR=3.8 [95% CI 1.1-14.6] and 5.9 [95% CI 1.7-20.4]), urinary tract infections (RR=1.4 [95% CI 0.5-3.9] and 3.7 [95% CI 1.7-6.2]), and cesarean delivery (RR=2.0 [95% CI 1.3-3.0] in obese women). Neonates born to obese women had an increased risk for postdate pregnancy (RR=3.7 [95% CI 1.2-11.6]), macrosomia (RR=6.8 [95% CI 1.5-30.7]), low 1-minute Apgar score (RR=1.9 [95% CI 1.1-3.6]), and admission to neonatal care units (RR=2.1 [95% CI 1.2-2.7]). On the other hand, low birth weight was less frequent among obese women (RR=0.5 [95% CI 0.3-0.9]) while the risk was high among underweight women (RR=2.3 [95% CI 1.4-3.8]). Even with adequate prenatal care, overweight and obesity can adversely affect pregnancy outcomes (Author).

  16. Advance care planning in patients with brain tumours: A prospective cohort study

    Directory of Open Access Journals (Sweden)

    Krystal Song

    2015-08-01

    Full Text Available Objectives: To assess and understand the awareness and experience of brain tumour (BT patients in discussing Advance Care Planning (ACP, to identify main symptoms experienced, physical and functional status perceived quality of life, and level of coping. Methods: A prospective cohort study with an initial open-ended questionnaire followed by semi-structured interview questions regarding ACP with 18 patients diagnosed with BT (WHO Grade I-IV, metastatic BT in hospital and community. Standardized assessments measured coping strategies, and quality of life (QoL. Interview transcripts regarding ACP discussions were analyzed, coded and interpreted using qualitative analytic techniques for thematic analyses. Results: Participants' mean age was 51 years (range 22-65 years, female (61%; median time since BT diagnosis was 1.5 years and just over half (56% had glioblastoma multiforme (GBM. Fatigue was the most common symptom reported by 83% of participants. Overall, participants indicated good QoL and used more problem-focused coping strategies including ‘acceptance’ and ‘positive reframing’. Thematic analyses indicated that participants had limited awareness and understanding of ACP, variable views on appropriate timing of ACP discussions and change of decisions over illness trajectory. Most felt able to discuss ACP and preferred dedicated sessions by a trained health professional. Conclusion: This study highlights the importance of providing timely information regarding ACP to BT patients during the course of their disease. Established ACP discussions have an important role in enhancing patient autonomy and to guide delivery of end-of-life care. The demonstrated low uptake of ACP in this pilot study shows need for improved awareness in clinical practice for timely ACP discussions and multifaceted interventions system-wide in implementing ACP

  17. Carbohydrate Intake, Glycemic Index, Glycemic Load, and Stroke: A Meta-analysis of Prospective Cohort Studies.

    Science.gov (United States)

    Cai, Xianlei; Wang, Chen; Wang, Shan; Cao, Gaoyang; Jin, Chao; Yu, Jiawei; Li, Xiuyang; Yan, Jing; Wang, Fudi; Yu, Wei; Ding, Fang

    2015-07-01

    The objective of this study was to investigate associations between carbohydrate intake/glycemic index (GI)/glycemic load (GL) and stroke risk. A literature search of MEDLINE, Embase, Web of Science, and CBM databases was performed to retrieve eligible studies published up to March 2014. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were used to evaluate the strength of this association. Publication bias was assessed by the Egger's regression asymmetry test and Begg's rank correlation test with Begg's funnel plot. All analyses were conducted using software STATA 12.0 (StataCorp LP, College Station, TX) and SAS version 9.1 (SAS Institute Inc, Cary, NC). We identified 7 prospective studies that met the inclusion criteria and processed data from cohort studies to update available evidence. There were 25 independent estimates and 225 000 participants free of diabetes from 6 different countries; 3046 stroke events were included; and the follow-up range was 5 to 18 years. High GI was not associated with risk of stroke events (pooled RR = 1.10; 95% CI: 0.99-1.21); GL was a risk factor for stroke (pooled RR = 1.19; 95% CI: 1.05-1.36). There was no significant association between high carbohydrate intake and stroke risk (RR = 1.12; 95% CI: 0.93-1.35). A daily high GL diet is the risk factor of stroke event, and further researches need to verify the meta-analyses results and study associated mechanisms. PMID:25593213

  18. Pressure ulcer incidence in Dutch and German nursing homes: design of a prospective multicenter cohort study

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    Lohrmann Christa

    2011-04-01

    Full Text Available Abstract Background Pressure ulcers are a common and serious health care problem in all health care settings. Results from annual national pressure ulcer prevalence surveys in the Netherlands and Germany reveal large differences in prevalence rates between both countries over the past ten years, especially in nursing homes. When examining differences in prevalence and incidence rates, it is important to take into account all factors associated with the development of pressure ulcers. Numerous studies have identified patient related factors, as well as nursing related interventions as risk factors for the development of pressure ulcers. Next to these more process oriented factors, also structural factors such as staffing levels and staff quality play a role in the development of pressure ulcers. This study has been designed to investigate the incidence of pressure ulcers in nursing homes in the Netherlands and Germany and to identify patient related factors, nursing related factors and structural factors associated with pressure ulcer development. The present article describes the protocol for this study. Methods/design A prospective multicenter study is designed in which a cohort of newly admitted nursing home residents in 10 Dutch and 11 German nursing homes will be followed for a period of 12 weeks. Data will be collected by research assistants using questionnaires on four different levels: resident, staff, ward, and nursing home. Discussion The results of the study will provide information on the incidence of pressure ulcers in Dutch and German nursing homes. Furthermore, information will be gathered on the influence of patient related factors, nursing related factors and structural factors on the incidence of pressure ulcers. The present article describes the study design and addresses the study's strengths and weaknesses.

  19. "Burnout in Medical Oncology Fellows: a Prospective Multicenter Cohort Study in Brazilian Institutions".

    Science.gov (United States)

    Cubero, Daniel I G; Fumis, Renata Rego Lins; de Sá, Thiago Hérick; Dettino, Aldo; Costa, Felipe Osório; Van Eyll, Brigitte M R H Adam; Beato, Carlos; Peria, Fernanda Maris; Mota, Augusto; Altino, José; Azevedo, Sérgio Jobim; da Rocha Filho, Duílio Reis; Moura, Melba; Lessa, Álvaro Edson Ramos; Del Giglio, Auro

    2016-09-01

    Burnout syndrome is a common occurrence among oncologists. Doctors enrolled in residency programs in clinical oncology are exposed to similar risk factors; however, few data are available in this population. This study assessed the occurrence of burnout and associated factors among first-year residents at Brazilian institutions. The present prospective, multicenter, cohort study was conducted with doctors enrolled in residency programs in clinical oncology at Brazilian institutions affiliated with the public health system. The participants answered a sociodemographic questionnaire, the Maslach Burnout Inventory (MBI), Lipp's Stress Inventory, and the Beck Depression Inventory (BDI), upon admission to the program and 6 and 12 months later. Of 37 eligible residency programs in 2009, 11 (30.6 %) agreed to participate in the study. Fifty-four residents, representing 100 % of new admissions to the participating institutions, were included. Most of the participants met the criteria for severe burnout upon admission to the residency programs (emotional exhaustion in 49.0 % and depersonalization in 64.7 %). The scores on MBI domains emotional exhaustion and depersonalization increased significantly (p < 0.01) during the first year of residency, and the prevalence of burnout increased to 88 % at the end of that first year. The present study found a high prevalence of burnout among doctors enrolled in residency programs in clinical oncology at Brazilian institutions. A large fraction of the participants met the criteria for burnout syndrome upon admission to the program, which suggests that the problem began during the course of the previous residency program in internal medicine. PMID:25952940

  20. Current asthma control predicts future risk of asthma exacerbation: a 12-month prospective cohort study

    Institute of Scientific and Technical Information of China (English)

    WEI Hua-hua; ZHOU Ting; WANG Lan; ZHANG Hong-ping; FU Juan-juan; WANG Lei; JI Yu-lin; WANG Gang

    2012-01-01

    Background The performance of asthma control test (ACT) at baseline for predicting future risk of asthma exacerbation has not been previously demonstrated.This study was designed to explore the ability of the baseline ACT score to predict future risk of asthma exacerbation during a 12-month follow-up.Methods This post hoc analysis included data from a 12-month prospective cohort study in patients with asthma (n=290).The time to the first asthma exacerbation was analyzed and the association between baseline ACT scores and future risk of asthma exacerbation was calculated as adjusted odds ratio (OR) using Logistic regression models.Further,sensitivity and specificity were estimated at each cut-point of ACT scores for predicting asthma exacerbations.Results The subjects were divided into three groups,which were uncontrolled (U,n=128),partly-controlled (PC,n=111),and well controlled (C,n=51) asthma.After adjustment,the decreased ACT scores at baseline in the U and PC groups were associated with an increased probability of asthma exacerbations (OR 3.65 and OR 5.75,respectively),unplanned visits (OR 8.03 and OR 8.21,respectively) and emergency visits (OR 20.00 and OR 22.60,respectively) over a 12-month follow-up period.The time to the first asthma exacerbation was shorter in the groups with U and PC asthma (all P<0.05).The baseline ACT of 20 identified as the cut-point for screening the patients at high risk of asthma exacerbations had an increased sensitivity of over 90.0% but a lower specificity of about 30.0%.Conclusion Our findings indicate that the baseline ACT score with a high sensitivity could rule out patients at low risk of asthma exacerbations and oredict future risk of asthma exacerbations in clinical practice.

  1. Combined Antirelapse Therapy in Patients with Schizoaffective Disorder: A Prospective Cohort Study

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    Zhanna R. Gardanova

    2016-06-01

    Full Text Available Background: In most studies, patients with schizoaffective disorder (SAD are often combined into one group along with schizophrenia patients or less commonly with those suffering from affective disorders, which makes it difficult to obtain data about the peculiarities of SAD treatment. Articles dedicated to SAD treatment in the interictal period are rare. Methods and Results: The prospective cohort study was conducted from 2011 to 2015. The study involved 86 patients diagnosed with SAD according to ICD-10. Patients received neuroleptics (NLs as antirelapse therapy for 2 years (NL therapy; then mood stabilizers (MSs were added to the antirelapse treatment (NL+MS therapy. The results of this combined therapy with MSs were evaluated after 2 years of treatment. Our results suggest that the use of combination therapy that includes antipsychotics and MSs leads to maintenance of a higher quality remission. Remission becomes more prolonged and affective swings less pronounced, resulting in improved quality of life in SAD patients. Improving the quality of remission can be attributed to the following characteristics of the combined therapy: a the use of lower doses of neuroleptics; b a reduction in the frequency and severity of mood swings; and c an increase in patient compliance. Conclusion: The use of combined pharmacotherapy including antipsychotics and MSs produces a longer, high-quality remission. The inclusion of MSs in the scheme of treatment increases the patient adherence to a medication regimen. The use of MSs in combination therapy reduces affective fluctuations, thereby increasing the probability of maintaining remission with complete symptom relief.

  2. Predictors of environmental lead exposure among pregnant women – a prospective cohort study in Poland

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    Kinga Polańska

    2014-03-01

    Full Text Available Blood lead levels (BLL in women of child-bearing age have been decreasing in recent decades, but still remains a concern for long-term effects of child psychomotor development. The aim of the study was to characterize lead exposure among Polish pregnant women and assess the relationship between BLL and selected socio-demographic, economic and lifestyle factors. The study population consisted of 594 pregnant women who had been the subjects of the prospective Polish Mother and Child Cohort Study (REPRO_PL. The women were interviewed three times during pregnancy (once in each trimester. Lead concentration in the blood collected during the second trimester of pregnancy was analyzed using graphite furnace atomic absorption spectrometry (GF-AAS, or inductively coupled plasma mass spectrometry (ICP-MS. Active and passive smoking was analyzed by the cotinine level in saliva using liquid chromatography with tandem mass spectrometry (LC-MS/MS. The lead level in the blood ranged from 0.3 – 5.7 μg/dL, with a geometric mean (GM of 1.1 μg/dL (GSD }0.2 μg/dL. Statistically significant associations were found between BLL and factors such as maternal age (β=0.01; p=0.02, education (β=0.08; p=0.04 and prepregnancy BMI (β=0.1; p=0.001. Additionally, BLL increased with increasing cotinine level in saliva (β=0.02; p=0.06 and decreased with the increasing distance from the copper smelter (β=-0.1; p=0.009. Public health interventions, especially in regions with a higher level of exposure to lead, among women with lower SES and among smokers, are still reasonable.

  3. Risk factors for preterm birth in an international prospective cohort of nulliparous women.

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    Gustaaf Albert Dekker

    Full Text Available OBJECTIVES: To identify risk factors for spontaneous preterm birth (birth <37 weeks gestation with intact membranes (SPTB-IM and SPTB after prelabour rupture of the membranes (SPTB-PPROM for nulliparous pregnant women. DESIGN: Prospective international multicentre cohort. PARTICIPANTS: 3234 healthy nulliparous women with a singleton pregnancy, follow up was complete in 3184 of participants (98.5%. RESULTS: Of the 3184 women, 156 (4.9% had their pregnancy complicated by SPTB; 96 (3.0% and 60 (1.9% in the SPTB-IM and SPTB-PPROM categories, respectively. Independent risk factors for SPTB-IM were shorter cervical length, abnormal uterine Doppler flow, use of marijuana pre-pregnancy, lack of overall feeling of well being, being of Caucasian ethnicity, having a mother with diabetes and/or a history of preeclampsia, and a family history of low birth weight babies. Independent risk factors for SPTB-PPROM were shorter cervical length, short stature, participant's not being the first born in the family, longer time to conceive, not waking up at night, hormonal fertility treatment (excluding clomiphene, mild hypertension, family history of recurrent gestational diabetes, and maternal family history of any miscarriage (risk reduction. Low BMI (<20 nearly doubled the risk for SPTB-PPROM (odds ratio 2.64; 95% CI 1.07-6.51. The area under the receiver operating characteristics curve (AUC, after internal validation, was 0.69 for SPTB-IM and 0.79 for SPTB-PPROM. CONCLUSION: The ability to predict PTB in healthy nulliparous women using clinical characteristics is modest. The dissimilarity of risk factors for SPTB-IM compared with SPTB-PPROM indicates different pathophysiological pathways underlie these distinct phenotypes. TRIAL REGISTRATION: ACTR.org.au ACTRN12607000551493.

  4. Quality of care in elder emergency department patients with pneumonia: a prospective cohort study

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    Martin Daniel R

    2008-04-01

    Full Text Available Abstract Background The goals of the study were to assess the relationship between age and processes of care in emergency department (ED patients admitted with pneumonia and to identify independent predictors of failure to meet recommended quality care measures. Methods This was a prospective cohort study of a pre-existing database undertaken at a university hospital ED in the Midwest. ED patients ≥18 years of age requiring admission for pneumonia, with no documented use of antibiotics in the 24 hours prior to ED presentation were included. Compliance with Pneumonia National Quality Measures was assessed including ED antibiotic administration, antibiotics within 4 hours, oxygenation assessment, and obtaining of blood cultures. Odds ratios were calculated for elders and non-elders. Logistic regression was used to identify independent predictors of process failure. Results One thousand, three hundred seventy patients met inclusion criteria, of which 560 were aged ≥65 years. In multiple variable logistic regression analysis, age ≥65 years was independently associated with receiving antibiotics in the ED (odds ratio [OR] = 2.03, 95% CI 1.28–3.21 and assessment of oxygenation (OR = 2.10, 95% CI, 1.18–3.32. Age had no significant impact on odds of receiving antibiotics within four hours of presentation (OR 1.10, 95% CI 0.84–1.43 or having blood cultures drawn (OR 1.02, 95%CI 0.78–1.32. Certain other patient characteristics were also independently associated with process failure. Conclusion Elderly patients admitted from the ED with pneumonia are more likely to receive antibiotics while in the ED and to have oxygenation assessed in the ED than younger patients. The independent association of certain patient characteristics with process failure provides an opportunity to further increase compliance with recommended quality measures in admitted patients diagnosed with pneumonia.

  5. Anthroposophic therapy for chronic depression: a four-year prospective cohort study

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    Willich Stefan N

    2006-12-01

    Full Text Available Abstract Background Depressive disorders are common, cause considerable disability, and do not always respond to standard therapy (psychotherapy, antidepressants. Anthroposophic treatment for depression differs from ordinary treatment in the use of artistic and physical therapies and special medication. We studied clinical outcomes of anthroposophic therapy for depression. Methods 97 outpatients from 42 medical practices in Germany participated in a prospective cohort study. Patients were aged 20–69 years and were referred to anthroposophic therapies (art, eurythmy movement exercises, or rhythmical massage or started physician-provided anthroposophic therapy (counselling, medication for depression: depressed mood, at least two of six further depressive symptoms, minimum duration six months, Center for Epidemiological Studies Depression Scale, German version (CES-D, range 0–60 points of at least 24 points. Outcomes were CES-D (primary outcome and SF-36 after 3, 6, 12, 18, 24, and 48 months. Data were collected from July 1998 to March 2005. Results Median number of art/eurythmy/massage sessions was 14 (interquartile range 12–22, median therapy duration was 137 (91–212 days. All outcomes improved significantly between baseline and all subsequent follow-ups. Improvements from baseline to 12 months were: CES-D from mean (standard deviation 34.77 (8.21 to 19.55 (13.12 (p Conclusion In outpatients with chronic depression, anthroposophic therapies were followed by long-term clinical improvement. Although the pre-post design of the present study does not allow for conclusions about comparative effectiveness, study findings suggest that the anthroposophic approach, with its recourse to non-verbal and artistic exercising therapies can be useful for patients motivated for such therapies.

  6. Association of Group B Streptococcus Colonization and Bovine Exposure: A Prospective Cross-Sectional Cohort Study

    Science.gov (United States)

    Manning, Shannon D.; Springman, A. Cody; Million, Amber D.; Milton, Nicole R.; McNamara, Sara E.; Somsel, Patricia A.; Bartlett, Paul; Davies, H. Dele

    2010-01-01

    Background While Group B Streptococcus (GBS) human colonization and infection has long been suspected as originating from cows, several investigators have suggested that ongoing interspecies GBS transmission is unlikely due to genotyping data demonstrating that human and bovine-derived GBS strains represent mostly distinct populations. The possibility of ongoing transmission between humans and their livestock has not been systematically examined. Methodology/Principal Findings To examine ongoing interspecies transmission, we conducted a prospective cross-sectional cohort study of 68 families and their livestock. Stool specimens were collected from 154 people and 115 livestock; GBS was detected in 19 (12.3%) humans and 2 (1.7%) animals (bovine and sheep). Application of multilocus sequence typing (MLST) identified 8 sequence types (STs or clones), with STs 1 and 23 predominating. There were 11 families in which two members submitted stools and at least one had GBS colonization. In 3 of these families, both members (consisting of couples) were colonized, yielding a co-colonization rate of 27% (95% CI: 7%–61%). Two of these couples had strains with identical MLST, capsule (cps) genotype, susceptibility, and RAPD profiles. One couple co-colonized with ST-1 (cps5) strains also had a bovine colonized with the identical strain type. On multivariate analysis of questionnaire data, cattle exposure was a predictor of GBS colonization, with each unit increase in days of cattle exposure increasing the odds of colonization by 20% (P = 0.02). These results support interspecies transmission with additional evidence for transmission provided by the epidemiological association with cattle exposure. Conclusions/Significance Although GBS uncommonly colonizes livestock stools, increased frequency of cattle exposure was significantly associated with human colonization and one couple shared the same GBS strains as their bovine suggesting intraspecies transmission. These results

  7. Antimicrobial resistance predicts death in Tanzanian children with bloodstream infections: a prospective cohort study

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    Msangi Viola

    2007-05-01

    Full Text Available Abstract Background Bloodstream infection is a common cause of hospitalization, morbidity and death in children. The impact of antimicrobial resistance and HIV infection on outcome is not firmly established. Methods We assessed the incidence of bloodstream infection and risk factors for fatal outcome in a prospective cohort study of 1828 consecutive admissions of children aged zero to seven years with signs of systemic infection. Blood was obtained for culture, malaria microscopy, HIV antibody test and, when necessary, HIV PCR. We recorded data on clinical features, underlying diseases, antimicrobial drug use and patients' outcome. Results The incidence of laboratory-confirmed bloodstream infection was 13.9% (255/1828 of admissions, despite two thirds of the study population having received antimicrobial therapy prior to blood culture. The most frequent isolates were klebsiella, salmonellae, Escherichia coli, enterococci and Staphylococcus aureus. Furthermore, 21.6% had malaria and 16.8% HIV infection. One third (34.9% of the children with laboratory-confirmed bloodstream infection died. The mortality rate from Gram-negative bloodstream infection (43.5% was more than double that of malaria (20.2% and Gram-positive bloodstream infection (16.7%. Significant risk factors for death by logistic regression modeling were inappropriate treatment due to antimicrobial resistance, HIV infection, other underlying infectious diseases, malnutrition and bloodstream infection caused by Enterobacteriaceae, other Gram-negatives and candida. Conclusion Bloodstream infection was less common than malaria, but caused more deaths. The frequent use of antimicrobials prior to blood culture may have hampered the detection of organisms susceptible to commonly used antimicrobials, including pneumococci, and thus the study probably underestimates the incidence of bloodstream infection. The finding that antimicrobial resistance, HIV-infection and malnutrition predict fatal

  8. Calprotectin and lactoferrin faecal levels in patients with Clostridium difficile infection (CDI: a prospective cohort study.

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    Andrew Swale

    Full Text Available Measurement of both calprotectin and lactoferrin in faeces has successfully been used to discriminate between functional and inflammatory bowel conditions, but evidence is limited for Clostridium difficile infection (CDI. We prospectively recruited a cohort of 164 CDI cases and 52 controls with antibiotic-associated diarrhoea (AAD. Information on disease severity, duration of symptoms, 30-day mortality and 90-day recurrence as markers of complicated CDI were recorded. Specimens were subject to microbiological culture and PCR-ribotyping. Levels of faecal calprotectin (FC and lactoferrin (FL were measured by ELISA. Statistical analysis was conducted using percentile categorisation. ROC curve analysis was employed to determine optimal cut-off values. Both markers were highly correlated with each other (r2 = 0.74 and elevated in cases compared to controls (p0.85, although we observed a large amount of variability across both groups. The optimal case-control cut-off point was 148 mg/kg for FC and 8.1 ng/µl for FL. Median values for FL in CDI cases were significantly greater in patients suffering from severe disease compared to non-severe disease (104.6 vs. 40.1 ng/µl, p = 0.02, but were not significant for FC (969.3 vs. 512.7 mg/kg, p = 0.09. Neither marker was associated with 90-day recurrence, prolonged CDI symptoms, positive culture results and colonisation by ribotype 027. Both FC and FL distinguished between CDI cases and AAD controls. Although FL was associated with disease severity in CDI patients, this showed high inter-individual variability and was an isolated finding. Thus, FC and FL are unlikely to be useful as biomarkers of complicated CDI disease.

  9. A prospective cohort study among new Chinese coal miners: the early pattern of lung function change

    Energy Technology Data Exchange (ETDEWEB)

    Wang, M.L.; Wu, Z.E.; Du, Q.G.; Petsonk, E.L.; Peng, K.L.; Li, Y.D.; Li, S.K.; Han, G.H.; Atffield, M.D. [NIOSH, Morgantown, WV (United States)

    2005-11-01

    The early pattern of lung function changes in 317 newly hired Chinese underground coal miners was compared to 132 referents. This three year prospective cohort study involved a pre-employment and 15 follow up health surveys, including a questionnaire and spirometry tests. Twice a month, total and respirable dust area sampling was done. The authors used a two stage analysis and a linear mixed effects model approach to analyse the longitudinal spirometry data, and to investigate the changes in forced expiratory volume in 1 second (FEV1) over time, controlling for age, height, pack years of smoking, mean respirable dust concentration, the room temperature during testing, and the group x time interaction terms. Results: FEV1 change over time in new miners is non-linear. New miners experience initial rapid FEV1 declines, primarily during the first year of mining, little change during the second year, and partial recovery during the third year. Both linear and quadratic time trends in FEV1 change are highly significant. Smoking miners lost more FEV1 than non-smokers. Referents, all age less than 20 years, showed continued lung growth, whereas the miners who were under age 20 exhibited a decline in FEV1. Conclusion: Dust and smoking affect lung function in young, newly hired Chinese coal miners. FEV1 change over the first three years of employment is non-linear. The findings have implications for both methods and interpretation of medical screening in coal mining and other dusty work: during the first several years of employment more frequent testing may be desirable, and caution is required in interpreting early FEV1 declines.

  10. A hinged external fixator for complex elbow dislocations: A multicenter prospective cohort study

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    Verleisdonk Egbert JMM

    2011-06-01

    Full Text Available Abstract Background Elbow dislocations can be classified as simple or complex. Simple dislocations are characterized by the absence of fractures, while complex dislocations are associated with fractures of the radial head, olecranon, or coronoid process. The majority of patients with these complex dislocations are treated with open reduction and internal fixation (ORIF, or arthroplasty in case of a non-reconstructable radial head fracture. If the elbow joint remains unstable after fracture fixation, a hinged elbow fixator can be applied. The fixator provides stability to the elbow joint, and allows for early mobilization. The latter may be important for preventing stiffness of the joint. The aim of this study is to determine the effect of early mobilization with a hinged external elbow fixator on clinical outcome in patients with complex elbow dislocations with residual instability following fracture fixation. Methods/Design The design of the study will be a multicenter prospective cohort study of 30 patients who have sustained a complex elbow dislocation and are treated with a hinged elbow fixator following fracture fixation because of residual instability. Early active motion exercises within the limits of pain will be started immediately after surgery under supervision of a physical therapist. Outcome will be evaluated at regular intervals over the subsequent 12 months. The primary outcome is the Quick Disabilities of the Arm, Shoulder, and Hand score. The secondary outcome measures are the Mayo Elbow Performance Index, Oxford Elbow Score, pain level at both sides, range of motion of the elbow joint at both sides, radiographic healing of the fractures and formation of periarticular ossifications, rate of secondary interventions and complications, and health-related quality of life (Short-Form 36. Discussion The outcome of this study will yield quantitative data on the functional outcome in patients with a complex elbow dislocation and who are

  11. A prospective cohort study on the association between coffee drinking and risk of non-gallstone-related acute pancreatitis.

    Science.gov (United States)

    Oskarsson, Viktor; Sadr-Azodi, Omid; Orsini, Nicola; Wolk, Alicja

    2016-05-01

    Only one previous study has examined the association between coffee consumption and risk of acute pancreatitis, and it found a reduced risk for alcohol-related episodes among high consumers of coffee. Therefore, we examined (1) the association between coffee consumption and risk of non-gallstone-related acute pancreatitis and (2) whether this association was modified by alcohol intake. Data were obtained from two prospective cohorts, the Cohort of Swedish Men and the Swedish Mammography Cohort, including 76 731 men and women (born 1914-1952). Coffee consumption was assessed at baseline with a FFQ, and the cohorts were followed up between 1998 and 2012 via linkage to national health registries. Hazard ratios were estimated using Cox models, with adjustment for potential confounding factors. During 1 035 881 person-years of total follow-up, 383 cases (246 in men and 137 in women) of incident non-gallstone-related acute pancreatitis were identified. Overall, and irrespective of whether a categorical or a continuous exposure model was used, we observed no association between coffee consumption and risk of non-gallstone-related acute pancreatitis (e.g. the multivariable-adjusted hazard ratio for each 1 cup/d increase in coffee consumption was 0·97; 95 % CI 0·92, 1·03). There was no evidence of effect modification by alcohol intake (P interaction=0·77). In conclusion, coffee consumption was not associated with risk of non-gallstone-related acute pancreatitis in this large prospective cohort study. Because of the limited number of epidemiological studies and their conflicting results, further research is needed to elucidate this potential association. PMID:26987519

  12. Following young people with perinatal HIV infection from adolescence into adulthood: the protocol for PHACS AMP Up, a prospective cohort study

    Science.gov (United States)

    Tassiopoulos, Katherine; Patel, Kunjal; Alperen, Julie; Kacanek, Deborah; Ellis, Angela; Berman, Claire; Allison, Susannah M; Hazra, Rohan; Barr, Emily; Cantos, Krystal; Siminski, Suzanne; Massagli, Michael; Bauermeister, Jose; Siddiqui, Danish Q; Puga, Ana; Van Dyke, Russell; Seage, George R

    2016-01-01

    Introduction The first generation of adolescents born with HIV infection has reached young adulthood due to advances in treatment. It is important to continue follow-up of these individuals to assess their long-term medical, behavioural and mental health and ability to successfully transition to adulthood while coping with a chronic, potentially stigmatising condition. To accomplish this, and to maintain their interest in long-term research participation, we need to accommodate the changing lifestyles and interests of young adult study participants while ensuring valid data collection. We report the protocol for Pediatric HIV/AIDS Cohort Study (PHACS) Adolescent Master Protocol (AMP) Up, a prospective cohort study enrolling young adult participants for long-term follow-up. Methods and analysis AMP Up is recruiting 850 young men and women 18 years of age and older—600 perinatally HIV-infected and a comparison group of 250 perinatally HIV-exposed, uninfected—at 14 clinical research sites in the USA and Puerto Rico. Recruitment began in April 2014 and is ongoing, with 305 participants currently enrolled. Planned follow-up is ≥6 years. Data are collected with a flexible hybrid of online and in-person methods. Outcomes include: transition to adult clinical care and retention in care; end-organ diseases; malignancies; metabolic complications; sexually transmitted infections; reproductive health; mental health and neurocognitive functioning; adherence to antiretroviral treatment; sexual behaviour and substance use; hearing and language impairments; and employment and educational achievement. Ethics and dissemination The study received ethical approval from the Harvard T.H. Chan School of Public Health's institutional review board (IRB), and from the IRBs of each clinical research site. All participants provide written informed consent; for cognitively impaired individuals with legally authorised representatives, legal guardian permission and participant assent

  13. Effects of depressive symptoms and coronary heart disease and their interactive associations on mortality in middle-aged adults: the Whitehall II cohort study. : Depression and mortality by CHD status

    OpenAIRE

    Nabi, Hermann; Shipley, Martin ,; Vahtera, Jussi; Hall, Martica; Korkeila, Jyrki; Marmot, Michael; Kivimäki, Mika; Singh-Manoux, Archana

    2010-01-01

    BACKGROUND: Depression and mortality have been studied separately in patients with coronary heart disease (CHD) and in populations healthy at study inception. This does not allow comparisons across risk-factor groups based on the cross-classification of depression and CHD status. OBJECTIVE: To examine effects of depressive symptoms and CHD and their interactive associations on mortality in middle-aged adults followed over 5.6years. DESIGN AND SETTING: A prospective population-based cohort stu...

  14. Allergic conditions and risk of hematological malignancies in adults: a cohort study

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    Schwartzbaum Judith

    2004-11-01

    Full Text Available Abstract Background Two contradictory hypotheses have been proposed to explain the relationship between allergic conditions and malignancies, the immune surveillance hypothesis and the antigenic stimulation hypothesis. The former advocates that allergic conditions may be protective against development of cancer, whereas the latter proposes an increased risk. This relationship has been studied in several case-control studies, but only in a few cohort studies. Methods The association between allergic conditions and risk of developing leukemia, Hodgkin's disease, non-Hodgkin's lymphoma and myeloma was investigated in a cohort of 16,539 Swedish twins born 1886–1925. Prospectively collected, self-reported information about allergic conditions such as asthma, hay fever or eczema was obtained through questionnaires administered in 1967. The cohort was followed 1969–99 and cancer incidence was ascertained from the Swedish Cancer Registry. Results Hives and asthma tended to increase the risk of leukemia (relative risk [RR] = 2.1, 95% Confidence Interval [CI] 1.0–4.5 and RR = 1.6, 95% CI 0.8–3.5, respectively. There was also an indication of an increased risk of non-Hodgkin's lymphoma associated with eczema during childhood (RR = 2.3, 95% CI 1.0–5.3. Conclusion In contrast to most previous studies, our results do not indicate a protective effect of allergic conditions on the risk of developing hematological malignancies. Rather, they suggest that allergic conditions might increase the risk of some hematological malignancies.

  15. Effect of dietary fatty acid intake on prospective weight change in the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition

    DEFF Research Database (Denmark)

    Nimptsch, Katharina; Berg-Beckhoff, Gabi; Linseisen, Jakob

    2010-01-01

    . RESULTS: Stearic acid intake was linearly associated with weight gain (P <0.01) in men and women. Linear associations also existed for ALA and arachidonic acid intake, significantly so in women. In multinomial models, women in the highest tertile of ALA and stearic acid intake showed increased OR (95 % CI......OBJECTIVE: To evaluate the association between fatty acid (alpha-linolenic acid (ALA), EPA, DHA, palmitic, stearic, oleic, linoleic and arachidonic acids) intake and prospective weight change in the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition. DESIGN...... categorised into four groups (weight loss, or =2.5 to or =7.5%/5 years). Energy-adjusted dietary fatty acid intake data were estimated from the FFQ completed at baseline. Multivariate linear regression models as well as multinomial logistic regression analyses (carbohydrate replacement models) were conducted...

  16. Incidence, severity, aetiology and type of neck injury in men's amateur rugby union: a prospective cohort study

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    Pollard Henry P

    2010-07-01

    Full Text Available Abstract Background There is a paucity of epidemiological data on neck injury in amateur rugby union populations. The objective of this study was to determine the incidence, severity, aetiology and type of neck injury in Australian men's amateur rugby union. Methods Data was collected from a cohort of 262 participants from two Australian amateur men's rugby union clubs via a prospective cohort study design. A modified version of the Rugby Union Injury Report Form for Games and Training was used by the clubs physiotherapist or chiropractor in data collection. Results The participants sustained 90 (eight recurrent neck injuries. Exposure time was calculated at 31143.8 hours of play (12863.8 hours of match time and 18280 hours of training. Incidence of neck injury was 2.9 injuries/1000 player-hours (95%CI: 2.3, 3.6. As a consequence 69.3% neck injuries were minor, 17% mild, 6.8% moderate and 6.8% severe. Neck compression was the most frequent aetiology and was weakly associated with severity. Cervical facet injury was the most frequent neck injury type. Conclusions This is the first prospective cohort study in an amateur men's rugby union population since the inception of professionalism that presents injury rate, severity, aetiology and injury type data for neck injury. Current epidemiological data should be sought when evaluating the risks associated with rugby union football.

  17. Maternal adiposity as an independent risk factor for pre-eclampsia: a meta-analysis of prospective cohort studies.

    Science.gov (United States)

    Wang, Z; Wang, P; Liu, H; He, X; Zhang, J; Yan, H; Xu, D; Wang, B

    2013-06-01

    Studies investigating the association between maternal adiposity and risk of pre-eclampsia showed contradictory results. Therefore, we performed a meta-analysis of prospective cohort studies to estimate the effect of maternal adiposity on pre-eclampsia. We reviewed 1,286 abstracts and finally included 29 prospective cohort studies with 1,980,761 participants and 67,075 pre-eclampsia events. We pooled data with a random-effects model, and obtained risk estimates for five predetermined bodyweight groups: low, normal-weight (reference), overweight, obese and severely obese. In the cohort studies that unadjusted for pre-eclampsia risk factors, the pooled unadjusted relative risks (RR) with 95% confidence intervals (95%CI) for pre-eclampsia of overweight, obese and severely obese women were 1.58 (95% CI 1.44-1.72, P multiparas women. In conclusion, overweight or obese pregnant women have a substantially increased risk of pre-eclampsia, and maternal adiposity is an independent risk factor of pre-eclampsia. PMID:23530552

  18. Post-GED-Credential College Prospects for Adults with Special Needs

    Science.gov (United States)

    Patterson, Margaret Becker

    2014-01-01

    Many adults with special needs, who did not finish high school, complete a GED® credential to go to college. As they prepare to transition, they may encounter barriers and likely require supports to succeed in college. The purpose of this qualitative research paper is to describe the college prospects of transitioning adults with a GED credential…

  19. Epidemiology and clinical outcome of virus-positive respiratory samples in ventilated patients: a prospective cohort study.

    OpenAIRE

    Daubin, Cédric; Parienti, Jean-Jacques; Vincent, Sophie; Vabret, Astrid; du Cheyron, Damien; Ramakers, Michel; Freymuth, François; Charbonneau, Pierre

    2006-01-01

    INTRODUCTION: Respiratory viruses are a major cause of respiratory tract infections. The prevalence of a virus-positive respiratory sample and its significance in patients requiring mechanical ventilation remain unknown. METHODS: We conducted a cohort study in all consecutive adults ventilated for more than 48 hours admitted to a 22-bed medical intensive care unit during a 12-month period. Respiratory samples at the time of intubation were assessed by culture, by indirect immunofluorescence a...

  20. A prospective study of symptoms, function, and medication use during acute illness in nursing home residents: design, rationale and cohort description

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    Liu Sophia

    2010-07-01

    Full Text Available Abstract Background Nursing home residents are at high risk for developing acute illnesses. Compared with community dwelling adults, nursing home residents are often more frail, prone to multiple medical problems and symptoms, and are at higher risk for adverse outcomes from acute illnesses. In addition, because of polypharmacy and the high burden of chronic disease, nursing home residents are particularly vulnerable to disruptions in transitions of care such as medication interruptions in the setting of acute illness. In order to better estimate the effect of acute illness on nursing home residents, we have initiated a prospective cohort which will allow us to observe patterns of acute illnesses and the consequence of acute illnesses, including symptoms and function, among nursing home residents. We also aim to examine the patterns of medication interruption, and identify patient, provider and environmental factors that influence continuity of medication prescribing at different points of care transition. Methods This is a prospective cohort of nursing home residents residing in two nursing homes in a metropolitan area. Baseline characteristics including age, gender, race, and comorbid conditions are recorded. Participants are followed longitudinally for a planned period of 3 years. We record acute illness incidence and characteristics, and measure symptoms including depression, pain, withdrawal symptoms, and function using standardized scales. Results 76 nursing home residents have been followed for a median of 666 days to date. At baseline, mean age of residents was 74.4 (± 11.9; 32% were female; 59% were white. The most common chronic conditions were dementia (41%, depression (38%, congestive heart failure (25% and chronic obstructive lung disease (27%. Mean pain score was 4.7 (± 3.6 on a scale of 0 to 10; Geriatric Depression Scale (GDS-15 score was 5.2 (± 4.4. During follow up, 138 acute illness episodes were identified, for an

  1. Characteristics, therapy and outcome in an unselected and prospectively registered cohort of pancreatic cancer patients

    DEFF Research Database (Denmark)

    Bjerregaard, J K; Mortensen, Michael Bau; Schønnemann, K R;

    2012-01-01

    Pancreatic cancer (PC) is associated with a dismal prognosis. Few studies have examined characteristics and outcome in an unselected population-based cohort of PC patients. Therefore, we investigated patient baseline characteristics, therapy choices and survival in a complete cohort of patients...

  2. Smoking behaviors in a community-based cohort of HIV-infected indigent adults

    OpenAIRE

    Vijayaraghavan, M.; Penko, J; Vittinghoff, E.; Bangsberg, DR; Miaskowski, C; Kushel, MB

    2014-01-01

    We conducted a longitudinal study of a community-based cohort of HIV-infected indigent adults to examine smoking behaviors and factors associated with quitting. We assessed "hardcore" smoking behaviors associated with a low probability of quitting. Of the 296 participants, 218 were current smokers (73.6 %). The prevalence of "hardcore" smoking was high: 59.6 % smoked ≥15 cigarettes per day, and 67.3 % were daily smokers. During the study interval, 20.6 % made at least one quit attempt. Of the...

  3. Determinants of pregnant women's compliance with alcohol guidelines: a prospective cohort study

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    Anderson Amy E

    2012-09-01

    Full Text Available Abstract Background In 2009, Australian alcohol guidelines for pregnancy changed from low to no alcohol intake. Previous research found a high proportion of pregnant Australian women drank during pregnancy; however, there has been limited investigation of whether pregnant women comply with 2009 alcohol guidelines. The purpose of this study was to provide an assessment of pregnant women’s compliance with 2009 Australian alcohol guidelines and identify predictors of such compliance, including previous drinking behaviour. Methods Cross-sectional analysis of prospective data from the 1973–1978 cohort of the Australian Longitudinal Study on Women’s Health was conducted. Women aged 30–36 years who were pregnant at the 2009 survey and had data on alcohol use were included (n = 837. Compliance with 2009 alcohol guidelines for pregnancy was defined as no alcohol intake. Predictors of compliance were analysed using multivariate logistic regression, controlling for area of residence, in three separate models to account for multicollinearity between measures of previous alcohol intake (compliance with 2001 guidelines; frequency and quantity; bingeing. Private health insurance, household income, and illicit drug use were entered into all models and retained if significant. Results 72% of pregnant women did not comply with the 2009 alcohol guidelines and 82% of these women drank less than seven drinks per week, with no more than one or two drinks per drinking day. The odds of complying with abstinence increased by a factor of 3.48 (95% CI 2.39-5.05 for women who previously complied with the 2001 alcohol guidelines and decreased by a factor of 0.19 (95% CI 0.08-0.66 if household incomes were $36,400 or more. In other models the odds of complying were lower for women who consumed alcohol before pregnancy at least weekly (OR = 0.40, 95% CI 0.25-0.63 or binged (OR ≥ 0.18, 95% CI 0.10-0.31 and were higher for those who abstained (OR

  4. Procalcitonin levels in acute exacerbation of COPD admitted in ICU: a prospective cohort study

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    Daubin, Cédric; Parienti, Jean-Jacques; Vabret, Astrid; Ramakers, Michel; Fradin, Sabine; Terzi, Nicolas; Freymuth, François; Charbonneau, Pierre; du Cheyron, Damien

    2008-01-01

    Background Antibiotics are recommended for severe acute exacerbation of chronic obstructive pulmonary disease (AECOPD) admitted to intensive care units (ICU). Serum procalcitonin (PCT) could be a useful tool for selecting patients with a lower probability of developing bacterial infection, but its measurement has not been investigated in this population. Methods We conducted a single center prospective cohort study in consecutive COPD patients admitted to the ICU for AECOPD between September 2005 and September 2006. Sputum samples or tracheal aspirates were tested for the presence of bacteria and viruses. PCT levels were measured at the time of admittance, six hours, and 24 hours using a sensitive immunoassay. Results Thirty nine AECOPD patients were included, 31 of which (79%) required a ventilator support at admission. The median [25%–75% interquartile range] PCT level, assessed in 35/39 patients, was: 0.096 μg/L [IQR, 0.065 to 0.178] at the time of admission, 0.113 μg/L [IQR, 0.074 to 0.548] at six hours, and 0.137 μg/L [IQR, 0.088 to 0.252] at 24 hours. The highest PCT (PCTmax) levels were less than 0.1 μg/L in 14/35 (40%) patients and more than 0.25 μg/L in 10/35 (29%) patients, suggesting low and high probability of bacterial infection, respectively. Five species of bacteria and nine species of viruses were detected in 12/39 (31%) patients. Among the four patients positive for Pseudomonas aeruginosa, one had a PCTmax less than 0.25 μg/L and three had a PCTmax less than 0.1 μg/L. The one patient positive for Haemophilus influenzae had a PCTmax more than 0.25 μg/L. The presence or absence of viruses did not influence PCT at time of admission (0.068 vs 0.098 μg/L respectively, P = 0.80). Conclusion The likelihood of bacterial infection is low among COPD patients admitted to ICU for AECOPD (40% with PCT procalcitonin-based therapeutic strategy in critically ill COPD patients. PMID:18947382

  5. Sex effects on short-term complications after hip fracture: a prospective cohort study

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    Ekström W

    2015-08-01

    Full Text Available Wilhelmina Ekström,1 Bodil Samuelsson,2 Sari Ponzer,3 Tommy Cederholm,4,5 Karl-Göran Thorngren,6 Margareta Hedström7 1Department of Molecular Medicine and Surgery, Section of Orthopaedics and Sports Medicine, Karolinska Institutet, Karolinska University Hospital, Solna, 2Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, 3Department of Clinical Science and Education, Section of Orthopaedics, Karolinska Institutet, Södersjukhuset, Stockholm, 4Department of Public Health and Caring Sciences, 5Department of Geriatrics, Uppsala University, Uppsala University Hospital, Uppsala, 6Department of Clinical Sciences, Lund, Orthopaedics, Lund University, Lund, 7Department of Orthopaedics, Institute of Clinical Science, Intervention and Technology (CLINTEC, Karolinska University Hospital, Huddinge, Stockholm, Sweden Objectives: To evaluate potential sex differences and other factors associated with complications within 4 months after a hip fracture.Methods: A total of 1,915 patients ≥65 years (480 men with hip fracture were consecutively included in a prospective multicenter cohort study. A review of medical records and patient interviews according to a study protocol based on the Standardized Audit of Hip Fractures in Europe (SAHFE, RIKSHÖFT was performed. Sex differences in comorbidity according to the American Society of Anesthesiologists score and complications 4 months after a hip fracture were registered. Multivariate logistic regression analysis was performed to identify factors related to complications.Results: Male sex was associated with worse general health according to the American Society of Anesthesiologists classification (P=0.005 and with more comorbidities (P<0.001. Male sex emerged as a risk factor for developing pneumonia (P<0.001, and additionally, 18% of the men suffered from cardiac complications compared with 13% of the females (P=0.018. Female sex was predisposed for urinary tract infections, 30% vs 23

  6. Program specific admission testing and dropout for sports science students: a prospective cohort study.

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    Lotte Dyhrberg O'Neill

    2014-09-01

    Full Text Available Recent research in medical education suggests that program specific admission testing could have a protective effect against early dropout. Little is known about the effect of program specific admission testing on dropout in other areas of higher education. The aim of this paper was to examine if admission strategy was also independently associated with dropout for sports science students in a university setting. The study design was a prospective cohort study with a 2 year follow-up. The population was 449 sports science students admitted to a university in the years 2002-2007. The analysis used was multivariate logistic regression and the predictors examined were: admission group (grade-based or admission tested as well as educational and socio-demographic variables. The outcome was dropout within 2 years of study start. Admission testing offered superior protection against dropout compared to grade-based admission. This result may fit with elements of previous dropout theory, student-environment fit theory and perhaps also with self-efficacy theory. Nyere forskning inden for medicinsk uddannelse indikerer at uddannelsesspecifikke optagelsesprøver kan have en beskyttende effekt i forhold til tidligt studiefrafald, men for andre universitetsuddannelser end Medicin synes denne sammenhæng endnu ikke at være blevet grundigt belyst. Formålet med dette studie var derfor at undersøge, om optagelsesprøver også beskyttede mod tidligt frafald blandt idrætsstuderende på universitetet. Studiedesignet var et prospektivt kohortestudie med to års opfølgning. Populationen var 449 idrætsstuderende, som blev optaget på Syddansk Universitet i årene 2002-2007. Data blev analyseret med multivariat logistisk regression, og følgende typer af prædiktorer for frafald blev undersøgt: Optagelseskvote (kvote 1 eller kvote 2 udprøvede, andre uddannelsesrelaterede variable samt udvalgte socio-demografiske variable. Effektmålet var studiestatus (frafaldet

  7. Procalcitonin levels in acute exacerbation of COPD admitted in ICU: a prospective cohort study

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    Freymuth François

    2008-10-01

    Full Text Available Abstract Background Antibiotics are recommended for severe acute exacerbation of chronic obstructive pulmonary disease (AECOPD admitted to intensive care units (ICU. Serum procalcitonin (PCT could be a useful tool for selecting patients with a lower probability of developing bacterial infection, but its measurement has not been investigated in this population. Methods We conducted a single center prospective cohort study in consecutive COPD patients admitted to the ICU for AECOPD between September 2005 and September 2006. Sputum samples or tracheal aspirates were tested for the presence of bacteria and viruses. PCT levels were measured at the time of admittance, six hours, and 24 hours using a sensitive immunoassay. Results Thirty nine AECOPD patients were included, 31 of which (79% required a ventilator support at admission. The median [25%–75% interquartile range] PCT level, assessed in 35/39 patients, was: 0.096 μg/L [IQR, 0.065 to 0.178] at the time of admission, 0.113 μg/L [IQR, 0.074 to 0.548] at six hours, and 0.137 μg/L [IQR, 0.088 to 0.252] at 24 hours. The highest PCT (PCTmax levels were less than 0.1 μg/L in 14/35 (40% patients and more than 0.25 μg/L in 10/35 (29% patients, suggesting low and high probability of bacterial infection, respectively. Five species of bacteria and nine species of viruses were detected in 12/39 (31% patients. Among the four patients positive for Pseudomonas aeruginosa, one had a PCTmax less than 0.25 μg/L and three had a PCTmax less than 0.1 μg/L. The one patient positive for Haemophilus influenzae had a PCTmax more than 0.25 μg/L. The presence or absence of viruses did not influence PCT at time of admission (0.068 vs 0.098 μg/L respectively, P = 0.80. Conclusion The likelihood of bacterial infection is low among COPD patients admitted to ICU for AECOPD (40% with PCT

  8. Consequences of maternal complications in women's lives in the first postpartum year: a prospective cohort study.

    Science.gov (United States)

    Iyengar, Kirti; Yadav, Ranjana; Sen, Swapnaleen

    2012-06-01

    Maternal complications are common during and following childbirth. However, little information is available on the psychological, social and economic consequences of maternal complications on women's lives, especially in a rural setting. A prospective cohort study was conducted in southern Rajasthan, India, among rural women who had a severe or less-severe, or no complication at the time of delivery or in the immediate postpartum period. In total, 1,542 women, representing 93% of all women who delivered in the field area over a 15-month period and were examined in the first week postpartum by nurse-midwives, were followed up to 12 months to record maternal and child survival. Of them, a subset of 430 women was followed up at 6-8 weeks and 12 months to capture data on the physical, psychological, social, or economic consequences. Women with severe maternal complications around the time of delivery and in the immediate postpartum period experienced an increased risk of mortality and morbidity in the first postpartum year: 2.8% of the women with severe complications died within one year compared to none with uncomplicated delivery. Women with severe complications also had higher rates of perinatal mortality [adjusted odds ratio (AOR)=3.98, confidence interval (CI) 1.96-8.1, p=0.000] and mortality of babies aged eight days to 12 months (AOR=3.14, CI 1.4-7.06, p=0.004). Compared to women in the uncomplicated group, women with severe complications were at a higher risk of depression at eight weeks and 12 months with perceived physical symptoms, had a greater difficulty in completing daily household work, and had important financial repercussions. The results suggest that women with severe complications at the time of delivery need to be provided regular follow-up services for their physical and psychological problems till about 12 months after childbirth. They also might benefit from financial support during several months in the postpartum period to prevent severe

  9. The Netherlands study of depression in older persons (NESDO; a prospective cohort study

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    Comijs Hannie C

    2011-12-01

    Full Text Available Abstract Background To study late-life depression and its unfavourable course and co morbidities in The Netherlands. Methods We designed the Netherlands Study of Depression in Older Persons (NESDO, a multi-site naturalistic prospective cohort study which makes it possible to examine the determinants, the course and the consequences of depressive disorders in older persons over a period of six years, and to compare these with those of depression earlier in adulthood. Results From 2007 until 2010, the NESDO consortium has recruited 510 depressed and non depressed older persons (≥ 60 years at 5 locations throughout the Netherlands. Depressed persons were recruited from both mental health care institutes and general practices in order to include persons with late-life depression in various developmental and severity stages. Non-depressed persons were recruited from general practices. The baseline assessment included written questionnaires, interviews, a medical examination, cognitive tests and collection of blood and saliva samples. Information was gathered about mental health outcomes and demographic, psychosocial, biological, cognitive and genetic determinants. The baseline NESDO sample consists of 378 depressed (according to DSM-IV criteria and 132 non-depressed persons aged 60 through 93 years. 95% had a major depression and 26.5% had dysthymia. Mean age of onset of the depressive disorder was around 49 year. For 33.1% of the depressed persons it was their first episode. 41.0% of the depressed persons had a co morbid anxiety disorder. Follow up assessments are currently going on with 6 monthly written questionnaires and face-to-face interviews after 2 and 6 years. Conclusions The NESDO sample offers the opportunity to study the neurobiological, psychosocial and physical determinants of depression and its long-term course in older persons. Since largely similar measures were used as in the Netherlands Study of Depression and Anxiety (NESDA; age

  10. A prediction rule for shoulder pain related sick leave: a prospective cohort study

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    van der Heijden Geert JMG

    2006-12-01

    Full Text Available Abstract Background Shoulder pain is common in primary care, and has an unfavourable outcome in many patients. Information about predictors of shoulder pain related sick leave in workers is scarce and inconsistent. The objective was to develop a clinical prediction rule for calculating the risk of shoulder pain related sick leave for individual workers, during the 6 months following first consultation in general practice. Methods A prospective cohort study with 6 months follow-up was conducted among 350 workers with a new episode of shoulder pain. Potential predictors included the results of a physical examination, sociodemographic variables, disease characteristics (duration of symptoms, sick leave in the 2 months prior to consultation, pain intensity, disability, comorbidity, physical activity, physical work load, psychological factors, and the psychosocial work environment. The main outcome measure was sick leave during 6 months following first consultation in general practice. Results Response rate to the follow-up questionnaire at 6 months was 85%. During the 6 months after first consultation 30% (89/298 of the workers reported sick leave. 16% (47 reported 10 days sick leave or more. Sick leave during this period was predicted in a multivariable model by a longer duration of sick leave prior to consultation, more shoulder pain, a perceived cause of strain or overuse during regular activities, and co-existing psychological complaints. The discriminative ability of the prediction model was satisfactory with an area under the curve of 0.70 (95% CI 0.64–0.76. Conclusion Although 30% of all workers with shoulder pain reported sick leave during follow-up, the duration of sick leave was limited to a few days in most workers. We developed a prediction rule and a score chart that can be used by general practitioners and occupational health care providers to calculate the absolute risk of sick leave in individual workers with shoulder pain, which

  11. Screening for vulnerability in older cancer patients: the ONCODAGE Prospective Multicenter Cohort Study.

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    Pierre Soubeyran

    Full Text Available Geriatric Assessment is an appropriate method for identifying older cancer patients at risk of life-threatening events during therapy. Yet, it is underused in practice, mainly because it is time- and resource-consuming. This study aims to identify the best screening tool to identify older cancer patients requiring geriatric assessment by comparing the performance of two short assessment tools the G8 and the Vulnerable Elders Survey (VES-13.The diagnostic accuracy of the G8 and the (VES-13 were evaluated in a prospective cohort study of 1674 cancer patients accrued before treatment in 23 health care facilities. 1435 were eligible and evaluable. Outcome measures were multidimensional geriatric assessment (MGA, sensitivity (primary, specificity, negative and positive predictive values and likelihood ratios of the G8 and VES-13, and predictive factors of 1-year survival rate.Patient median age was 78.2 years (70-98 with a majority of females (69.8%, various types of cancer including 53.9% breast, and 75.8% Performance Status 0-1. Impaired MGA, G8, and VES-13 were 80.2%, 68.4%, and 60.2%, respectively. Mean time to complete G8 or VES-13 was about five minutes. Reproducibility of the two questionnaires was good. G8 appeared more sensitive (76.5% versus 68.7%, P =  0.0046 whereas VES-13 was more specific (74.3% versus 64.4%, P<0.0001. Abnormal G8 score (HR = 2.72, advanced stage (HR = 3.30, male sex (HR = 2.69 and poor Performance Status (HR = 3.28 were independent prognostic factors of 1-year survival.With good sensitivity and independent prognostic value on 1-year survival, the G8 questionnaire is currently one of the best screening tools available to identify older cancer patients requiring geriatric assessment, and we believe it should be implemented broadly in daily practice. Continuous research efforts should be pursued to refine the selection process of older cancer patients before potentially life-threatening therapy.

  12. Evans Syndrome in Children: Long-Term Outcome in a Prospective French National Observational Cohort.

    Science.gov (United States)

    Aladjidi, Nathalie; Fernandes, Helder; Leblanc, Thierry; Vareliette, Amélie; Rieux-Laucat, Frédéric; Bertrand, Yves; Chambost, Hervé; Pasquet, Marlène; Mazingue, Françoise; Guitton, Corinne; Pellier, Isabelle; Roqueplan-Bellmann, Françoise; Armari-Alla, Corinne; Thomas, Caroline; Marie-Cardine, Aude; Lejars, Odile; Fouyssac, Fanny; Bayart, Sophie; Lutz, Patrick; Piguet, Christophe; Jeziorski, Eric; Rohrlich, Pierre; Lemoine, Philippe; Bodet, Damien; Paillard, Catherine; Couillault, Gérard; Millot, Frédéric; Fischer, Alain; Pérel, Yves; Leverger, Guy

    2015-01-01

    Evans syndrome (ES) is a rare autoimmune disorder whose long-term outcome is not well known. In France, a collaborative pediatric network set up via the National Rare Disease Plan now provides comprehensive clinical data in children with this disease. Patients aged less than 18 years at the initial presentation of autoimmune cytopenia have been prospectively included into a national observational cohort since 2004. The definition of ES was restricted to the simultaneous or sequential association of autoimmune hemolytic anemia (AIHA) and immune thrombocytopenic purpura (ITP). Cases were deemed secondary if associated with a primitive immunodeficiency or systemic lupus erythematosus. In December 2014, we analyzed the data pertaining to 156 children from 26 centers with ES whose diagnosis was made between 1981 and 2014. Median age (range) at the onset of cytopenia was 5.4 years (0.2-17.2). In 85 sequential cases, the time lapse between the first episodes of AIHA and ITP was 2.4 years (0.1-16.3). The follow-up period as from ES diagnosis was 6.5 years (0.1-28.8). ES was secondary, revealing another underlying disease, in 10% of cases; various associated immune manifestations (mainly lymphoproliferation, other autoimmune diseases, and hypogammaglobulinemia) were observed in 60% of cases; and ES remained primary in 30% of cases. Five-year ITP and AIHA relapse-free survival were 25 and 61%, respectively. Overall, 69% of children required one or more second-line immune treatments, and 15 patients (10%) died at the age of 14.3 years (1.7-28.1). To our knowledge, this is the first consistent long-term clinical description of this rare syndrome. It underscores the high rate of associated immune manifestations and the burden of long-term complications and treatment toxicity. Future challenges include (1) the identification of the underlying genetic defects inducing immune dysregulation and (2) the need to better characterize patient subgroups and second

  13. Risk factors for venous thromboembolism in 1.3 million pregnancies: a nationwide prospective cohort.

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    Rie Adser Virkus

    Full Text Available OBJECTIVE: To quantify risk factors for venous thromboembolism during pregnancy and the puerperal period. DESIGN: In a nationwide prospective cohort study we followed pregnant and puerperal women in Denmark from 1995 to 2009 for venous thromboembolism. Information on risk factors and confounders was retrieved from national registries. The diagnosis of venous thromboembolism was confirmed through medical charts. We calculated adjusted incidence rates per 10,000 women years and used Poisson regression to estimate effects during pregnancy and the puerperal period. RESULTS: We studied 1,297,037 pregnancies and related puerperal periods, during which there were 748 venous thromboembolisms. The incidence rate for venous thromboembolism during a pregnancy with and without hospitalization for hyperemesis was 15.2/10,000 yr and 6.3/10,000 yr, respectively, (adjusted rate ratio: 2.5 (95%-confidence interval; 1.4-4.5. The incidence rate among women with multiple pregnancies was 18.2/10,000 yr and 6.3/10,000 yr in singletons (adjusted rate ratio: 2.8 (1.9-4.2. Increased risk was found with hospitalization during pregnancy or the puerperal period with incidence rates of 42.1/10.000 and 54.7/10.000, respectively, (rate ratios: 12.2 (8.7-17 and 5.9 (4.0-8.8. Women hospitalized with infections during pregnancy had incidence rates of 25.9/10,000 yr and 29.3/10,000 yr during pregnancy and the puerperal period, respectively, and of 62.7/10,000 yr if hospitalized with infection in the puerperal period. Puerperal venous thromboembolism was associated with hospitalization for preeclampsia and intrauterine growth restriction/fetal death with incidence rates of 45.8/10,000 yr and 18.3/10,000 yr, respectively (rate ratio: 5.0 (3.1-7.8 and 1.9 (0.9-4.4. Additionally puerperal venous thromboembolism was associated with obesity, elective and acute caesarean sections and major postpartum bleeding with incidence rates of 25.5/10,000 yr, 23.2/10,000 yr, 34.0/10,000 yr and 20

  14. Factors associated with exclusive breastfeeding of preterm infants. Results from a prospective national cohort study.

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    Ragnhild Maastrup

    Full Text Available BACKGROUND AND AIM: Evidence-based knowledge of how to guide the mothers of preterm infants in breastfeeding establishment is contradictive or sparse. The aim was to investigate the associations between pre-specified clinical practices for facilitating breastfeeding, and exclusive breastfeeding at discharge as well as adequate duration thereof. METHODS: A prospective survey based on questionnaires was conducted with a Danish national cohort, comprised of 1,221 mothers and their 1,488 preterm infants with a gestational age of 24-36 weeks. Adjusted for covariates, the pre-specified clinical practices were analysed by multiple logistic regression analyses. RESULTS: At discharge 68% of the preterm infants were exclusively breastfed and 17% partially. Test-weighing the infant, and minimizing the use of a pacifier, showed a protective effect to exclusive breastfeeding at discharge (OR 0.6 (95% CI 0.4-0.8 and 0.4 (95% CI 0.3-0.6, respectively. The use of nipple shields (OR 2.3 (95% CI 1.6-3.2 and the initiation of breast milk expression later than 48 hours postpartum (OR 4.9 (95% CI 1.9-12.6 were associated with failure of exclusive breastfeeding at discharge. The clinical practices associated with an inadequate breastfeeding duration were the initiation of breast milk expression at 12-24 hours (OR 1.6 (95% CI 1.0-2.4 and 24-48 hours (OR 1.8 (95% CI 1.0-3.1 vs. before six hours postpartum, and the use of nipple shields (OR 1.4 (95% CI 1.1-1.9. CONCLUSION: Early initiation of breast milk pumping before 12 hours postpartum may increase breastfeeding rates, and it seems that the use of nipple shields should be restricted. The use of test-weighing and minimizing the use of a pacifier may promote the establishment of exclusive breastfeeding, but more research is needed regarding adequate support to the mother when test-weighing is ceased, as more of these mothers ceased exclusive breastfeeding at an early stage after discharge.

  15. Transmission of Multidrug-Resistant and Drug-Susceptible Tuberculosis within Households: A Prospective Cohort Study

    Science.gov (United States)

    Grandjean, Louis; Gilman, Robert H.; Martin, Laura; Soto, Esther; Castro, Beatriz; Lopez, Sonia; Coronel, Jorge; Castillo, Edith; Alarcon, Valentina; Lopez, Virginia; San Miguel, Angela; Quispe, Neyda; Asencios, Luis; Dye, Christopher; Moore, David A. J.

    2015-01-01

    Background The “fitness” of an infectious pathogen is defined as the ability of the pathogen to survive, reproduce, be transmitted, and cause disease. The fitness of multidrug-resistant tuberculosis (MDRTB) relative to drug-susceptible tuberculosis is cited as one of the most important determinants of MDRTB spread and epidemic size. To estimate the relative fitness of drug-resistant tuberculosis cases, we compared the incidence of tuberculosis disease among the household contacts of MDRTB index patients to that among the contacts of drug-susceptible index patients. Methods and Findings This 3-y (2010–2013) prospective cohort household follow-up study in South Lima and Callao, Peru, measured the incidence of tuberculosis disease among 1,055 household contacts of 213 MDRTB index cases and 2,362 household contacts of 487 drug-susceptible index cases. A total of 35/1,055 (3.3%) household contacts of 213 MDRTB index cases developed tuberculosis disease, while 114/2,362 (4.8%) household contacts of 487 drug-susceptible index patients developed tuberculosis disease. The total follow-up time for drug-susceptible tuberculosis contacts was 2,620 person-years, while the total follow-up time for MDRTB contacts was 1,425 person-years. Using multivariate Cox regression to adjust for confounding variables including contact HIV status, contact age, socio-economic status, and index case sputum smear grade, the hazard ratio for tuberculosis disease among MDRTB household contacts was found to be half that for drug-susceptible contacts (hazard ratio 0.56, 95% CI 0.34–0.90, p = 0.017). The inference of transmission in this study was limited by the lack of genotyping data for household contacts. Capturing incident disease only among household contacts may also limit the extrapolation of these findings to the community setting. Conclusions The low relative fitness of MDRTB estimated by this study improves the chances of controlling drug-resistant tuberculosis. However, fitter

  16. Transmission of Multidrug-Resistant and Drug-Susceptible Tuberculosis within Households: A Prospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Louis Grandjean

    2015-06-01

    Full Text Available The "fitness" of an infectious pathogen is defined as the ability of the pathogen to survive, reproduce, be transmitted, and cause disease. The fitness of multidrug-resistant tuberculosis (MDRTB relative to drug-susceptible tuberculosis is cited as one of the most important determinants of MDRTB spread and epidemic size. To estimate the relative fitness of drug-resistant tuberculosis cases, we compared the incidence of tuberculosis disease among the household contacts of MDRTB index patients to that among the contacts of drug-susceptible index patients.This 3-y (2010-2013 prospective cohort household follow-up study in South Lima and Callao, Peru, measured the incidence of tuberculosis disease among 1,055 household contacts of 213 MDRTB index cases and 2,362 household contacts of 487 drug-susceptible index cases. A total of 35/1,055 (3.3% household contacts of 213 MDRTB index cases developed tuberculosis disease, while 114/2,362 (4.8% household contacts of 487 drug-susceptible index patients developed tuberculosis disease. The total follow-up time for drug-susceptible tuberculosis contacts was 2,620 person-years, while the total follow-up time for MDRTB contacts was 1,425 person-years. Using multivariate Cox regression to adjust for confounding variables including contact HIV status, contact age, socio-economic status, and index case sputum smear grade, the hazard ratio for tuberculosis disease among MDRTB household contacts was found to be half that for drug-susceptible contacts (hazard ratio 0.56, 95% CI 0.34-0.90, p = 0.017. The inference of transmission in this study was limited by the lack of genotyping data for household contacts. Capturing incident disease only among household contacts may also limit the extrapolation of these findings to the community setting.The low relative fitness of MDRTB estimated by this study improves the chances of controlling drug-resistant tuberculosis. However, fitter multidrug-resistant strains that emerge

  17. Local excision of ciliary body tumors:a long-term prospective cohort study in China

    Institute of Scientific and Technical Information of China (English)

    WEI Wen-bin; YANG Wen-li; HU Shi-min; LI Bin

    2008-01-01

    Background Ciliary body tumors are usually difficult to diagnose and treat in early stages.However,treatment of such tumors has trended toward ocular conservation instead of enucleation.Local excision of ciliary body tumors has become effective with the development of the modern vitrectomy,but long-term outcomes are still not clear.Therefore,we reported the outcome of locally excised ciliary body tumors after long-term follow-up.Methods Twenty-two patients (22 eyes),who had been diagnosed with ciliary body tumors in Beijing Tongren Hospital from January 1996 to June 2001,were enrolled in this prospective cohort study.Localized lamellar sclera-ciliary excisions were performed.In some cases,vitrectomies,scleral graft transplantations,and further excisions of the anterior choroid were performed.Diagnoses were confirmed by histopathologic examination.Patients were followed from five to eleven years after surgery.Their visual acuity,intraocular pressure and local recurrence were recorded with descriptive percentages.Results After surgery,all patients maintained normal eyeball appearances.Six patients maintained circular pupils.The final best corrected visual acuities (BCVA) varied from 0.02-1.00,including 18 patients (81.82%) who had BCVA equal to or better than that before surgery.Fifteen patients (68.18%) had BCVA better than 0.3.Only two patients had intraocular pressure (IOP) of less than 10 mmHg and the other patients maintained normal IOP.Nine cases (40.91%) were given confirmed diagnosis of malignant melanoma,four (18.18%) of melanocytoma,six (27.27%) of nonpigmented ciliary epithelial adenoma,two (9.09%) of neurofibroma,and one (4.55%) of neurinoma.Twenty patients (90.91%) had no recurrence during the follow-up period.In one case melanocytoma recurred seven years after surgery and enucleation was performed.One patient,whose operation removed a malignant melanoma with a diameter of 16 mm,died of hepatic metastasis five years after the operation.Conclusion For

  18. Adult mental health consequences of peer bullying and maltreatment in childhood: two cohorts in two countries

    Science.gov (United States)

    Lereya, Suzet Tanya; Copeland, William E; Costello, E Jane; Wolke, Dieter

    2015-01-01

    Summary Background The adult mental health consequences of childhood maltreatment are well documented. Maltreatment by peers (ie, bullying) has also been shown to have long-term adverse effects. We aimed to determine whether these effects are just due to being exposed to both maltreatment and bullying or whether bullying has a unique effect. Methods We used data from the Avon Longitudinal Study of Parents and Children in the UK (ALSPAC) and the Great Smoky Mountains Study in the USA (GSMS) longitudinal studies. In ALSPAC, maltreatment was assessed as physical, emotional, or sexual abuse, or severe maladaptive parenting (or both) between ages 8 weeks and 8·6 years, as reported by the mother in questionnaires, and being bullied was assessed with child reports at 8, 10, and 13 years using the previously validated Bullying and Friendship Interview Schedule. In GSMS, both maltreatment and bullying were repeatedly assessed with annual parent and child interviews between ages 9 and 16 years. To identify the association between maltreatment, being bullied, and mental health problems, binary logistic regression analyses were run. The primary outcome variable was overall mental health problem (any anxiety, depression, or self-harm or suicidality). Findings 4026 children from the ALSPAC cohort and 1420 children from the GSMS cohort provided information about bullying victimisation, maltreatment, and overall mental health problems. The ALSPAC study started in 1991 and the GSMS cohort enrolled participants from 1993. Compared with children who were not maltreated or bullied, children who were only maltreated were at increased risk for depression in young adulthood in models adjusted for sex and family hardships according to the GSMS cohort (odds ratio [OR] 4·1, 95% CI 1·5–11·7). According to the ALSPAC cohort, those who were only being maltreated were not at increased risk for any mental health problem compared with children who were not maltreated or bullied. By contrast

  19. Association of total daily physical activity with disability in community-dwelling older persons: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Shah Raj C

    2012-10-01

    Full Text Available Abstract Background Based on findings primarily using self-report measures, physical activity has been recommended to reduce disability in old age. Collecting objective measures of total daily physical activity in community-dwelling older adults is uncommon, but might enhance the understanding of the relationship of physical activity and disability. We examined whether greater total daily physical activity was associated with less report of disability in the elderly. Methods Data were from the Rush Memory and Aging Project, a longitudinal prospective cohort study of common, age-related, chronic conditions. Total daily physical activity was measured in community-dwelling participants with an average age of 82 using actigraphy for approximately 9 days. Disability was measured via self-reported basic activities of daily living (ADL. The odds ratio and 95% Confidence Interval (CI were determined for the baseline association of total daily physical activity and ADL disability using a logistic regression model adjusted for age, education level, gender and self-report physical activity. In participants without initial report of ADL disability, the hazard ratio and 95% CI were determined for the relationship of baseline total daily physical activity and the development of ADL disability using a discrete time Cox proportional hazard model adjusted for demographics and self-report physical activity. Results In 870 participants, the mean total daily physical activity was 2. 9 × 105 counts/day (range in 105 counts/day = 0.16, 13. 6 and the mean hours/week of self-reported physical activity was 3.2 (SD = 3.6. At baseline, 718 (82.5% participants reported being independent in all ADLs. At baseline, total daily physical activity was protective against disability (OR per 105 counts/day difference = 0.55; 95% CI = 0.47, 0.65. Of the participants without baseline disability, 584 were followed for 3.4 years on average. Each 105 counts/day additional total

  20. Prospective Safety Surveillance of GH-Deficient Adults: Comparison of GH-Treated vs Untreated Patients.

    OpenAIRE

    Hartman, Mark L.; Xu, Rong; Crowe, Brenda J; Robison, Leslie L.; Erfurth, Eva Marie; Kleinberg, David L; Zimmermann, Alan G.; Woodmansee, Whitney W.; Cutler, Gordon B.; Chipman, John J; Melmed, Shlomo

    2013-01-01

    Context: In clinical practice, the safety profile of GH replacement therapy for GH-deficient adults compared with no replacement therapy is unknown. Objective: The objective of this study was to compare adverse events (AEs) in GH-deficient adults who were GH-treated with those in GH-deficient adults who did not receive GH replacement. Design and Setting: This was a prospective observational study in the setting of US clinical practices. Patients and Outcome Measures: AEs were compared between...

  1. Are neck flexion, neck rotation, and sitting at work risk factors for neck pain? Results of a prospective cohort study

    OpenAIRE

    Ariens, G.A.M.; Bongers, P M; Douwes, M; Miedema, M.C.; Hoogendoorn, W.E.; Van der Wal; Bouter, L M; Mechelen, van, J.B.

    2001-01-01

    OBJECTIVE—To study the relation between neck pain and work related neck flexion, neck rotation, and sitting.
METHODS—A prospective cohort study was performed with a follow up of 3 years among 1334 workers from 34 companies. Work related physical load was assessed by analysing objectively measured exposure data (video recordings) of neck flexion, neck rotation, and sitting posture. Neck pain was assessed by a questionnaire. Adjustments were made for various physical factors that were related o...

  2. Severity of gentamicin's nephrotoxic effect on patients with infective endocarditis: a prospective observational cohort study of 373 patients

    DEFF Research Database (Denmark)

    Buchholtz, Kristine; Larsen, Carsten T; Hassager, Christian;

    2009-01-01

    mortality in patients with IE. METHODS: A prospective observational cohort study was performed at 2 tertiary university hospitals in Copenhagen from October 2002 through October 2007; 373 consecutive patients with IE were included. A total of 287 (77%) of the patients received gentamicin treatment (median...... duration, 14 days); dosage was adjusted according to daily serum creatinine and trough serum gentamicin levels. Kidney function was determined by estimated endogenous creatinine clearance (EECC). Statistical correlation between gentamicin and EECC change was analyzed, and the association between mortality...

  3. Does the Benefit on Survival from Leisure Time Physical Activity Depend on Physical Activity at Work? A Prospective Cohort Study

    OpenAIRE

    Andreas Holtermann; Jacob Louis Marott; Finn Gyntelberg; Karen Søgaard; Poul Suadicani; Ole Steen Mortensen; Eva Prescott; Peter Schnohr

    2013-01-01

    PURPOSE: To investigate if persons with high physical activity at work have the same benefits from leisure time physical activity as persons with sedentary work. METHODS: In the Copenhagen City Heart Study, a prospective cohort of 7,411 males and 8,916 females aged 25-66 years without known cardiovascular disease at entry in 1976-78, 1981-83, 1991-94, or 2001-03, the authors analyzed with sex-stratified multivariate Cox proportional hazards regression the association between leisure time phys...

  4. Residential Exposure to 50 Hz Magnetic Fields and the Association with Miscarriage Risk: A 2-Year Prospective Cohort Study

    OpenAIRE

    Qiang Wang; Zhaojin Cao; Yingli Qu; Xiaowu Peng; Shu Guo; Li Chen

    2013-01-01

    OBJECTIVE: The hypothesis of whether exposure to extremely low-frequency magnetic fields (ELF-MF) may increase miscarriage risk is controversial. A 2-year prospective cohort study was designed to study the association between exposure to 50 Hz magnetic fields (MF) and the miscarriage risk for women residing in the area of the Pearl-River Delta of China. METHOD: Two towns with densely distributed power supply constructions were selected as the study sites. From 2010 to 2012, 552 women in the r...

  5. Changes in water and beverage intake and long-term weight changes: results from three prospective cohort studies

    OpenAIRE

    Pan, An; Malik, Vasanti S; Hao, Tao; Willett, Walter C.; Mozaffarian, Dariush; Hu, Frank B.

    2013-01-01

    Objective: To examine the long-term relationship between changes in water and beverage intake and weight change. Subjects Prospective cohort studies of 50 013 women aged 40-64 in the Nurses’ Health Study (NHS, 1986-2006), 52 987 women aged 27-44 in the NHS II (1991-2007), and 21 988 men aged 40-64 in the Health Professionals Follow-up Study (1986-2006) without obesity and chronic diseases at baseline. Measures We assessed the association of weight change within each 4-year interval with chang...

  6. Changes in water and beverage intake and long-term weight changes: results from three prospective cohort studies

    OpenAIRE

    Pan, An; Malik, Vasanti S; Hao, Tao; Willett, Walter C.; Mozaffarian, Dariush; Hu, Frank B.

    2013-01-01

    Objective To examine the long-term relationship between changes in water and beverage intake and weight change. Subjects Prospective cohort studies of 50 013 women aged 40-64 in the Nurses’ Health Study (NHS, 1986-2006), 52 987 women aged 27-44 in the NHS II (1991-2007), and 21 988 men aged 40-64 in the Health Professionals Follow-up Study (1986-2006) without obesity and chronic diseases at baseline. Measures We assessed the association of weight change within each 4-year interval with change...

  7. Maternal Dietary Patterns during Pregnancy in Relation to Offspring Forearm Fractures: Prospective Study from the Danish National Birth Cohort

    Science.gov (United States)

    Petersen, Sesilje B.; Rasmussen, Morten A.; Olsen, Sjurdur F.; Vestergaard, Peter; Mølgaard, Christian; Halldorsson, Thorhallur I.; Strøm, Marin

    2015-01-01

    Limited evidence exists for an association between maternal diet during pregnancy and offspring bone health. In a prospective study, we examined the association between dietary patterns in mid-pregnancy and offspring forearm fractures. In total, 101,042 pregnancies were recruited to the Danish National Birth Cohort (DNBC) during 1996–2002. Maternal diet was collected by a food frequency questionnaire. Associations were analyzed between seven dietary patterns extracted by principal component analysis and offspring first occurrence of any forearm fracture diagnosis, extracted from the Danish National Patient Register, between time of birth and end of follow-up (sweetened soft drinks, which was positively associated with offspring forearm fractures (p = 0.02). In the large prospective DNBC high mid-pregnancy consumption of Western diet and artificially sweetened soft drinks, respectively, indicated positive associations with offspring forearm fractures, which provides interesting hypotheses for future research. PMID:25849947

  8. Maternal adiposity prior to pregnancy is associated with ADHD symptoms in offspring: evidence from three prospective pregnancy cohorts

    DEFF Research Database (Denmark)

    Rodriguez, A; Miettunen, J.; Henriksen, Tine Brink;

    2007-01-01

    included pre-pregnancy overweight or obesity and a high ADHD symptom score in offspring, ORs ranged between 1.37 (95% CI: 1.07, 1.75) and 1.89 (95% CI: 1.13, 3.15) adjusted for gestational age, birth weight, weight gain, pregnancy smoking, maternal age, maternal education, child gender, family structure......Objectives:We examine whether pregnancy weight (pre-pregnancy body mass index (BMI) and/or weight gain) is related to core symptoms of attention deficit hyperactivity disorder (ADHD) in school-age offspring.Design:Follow-up of prospective pregnancy cohorts from Sweden, Denmark and Finland within...... the Nordic Network on ADHD.Methods:Maternal pregnancy and delivery data were collected prospectively. Teachers rated inattention and hyperactivity symptoms in offspring. High scores were defined as at least one core symptom rated as 'severe' and two as 'present' (approximately 10% of children scored...

  9. Acupuncture in Premenopausal Women With Hypoactive Sexual Desire Disorder: A Prospective Cohort Pilot Study

    Directory of Open Access Journals (Sweden)

    Susan H. Oakley, MD, FACOG

    2016-09-01

    Conclusion: In this cohort of premenopausal women with HSDD, 5 weeks of acupuncture therapy was associated with significant improvements in sexual function, particularly desire. This supports a role for acupuncture as a therapeutic option for women with low desire.

  10. Survival with treated and well-controlled blood pressure: findings from a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Debbie A Lawlor

    Full Text Available AIM: To compare survival and incident cardiovascular disease between normotensive, untreated hypertensive, treated and poorly-controlled hypertensive and treated and well-controlled hypertensive adults. METHODS AND RESULTS: Data from the British Regional Heart Study (men and British Women's Heart and Health Study (women were used (N = 6476. Blood pressure and treatment were assessed at baseline (1998-2001 when participants were aged 60-79 years and participants were followed up for a median of 8 years. Date and cause of death were obtained from death certificates and non-fatal cardiovascular disease events were obtained from repeat detailed medical record reviews. Of the whole cohort 52% of women and 49% of men had untreated hypertension and a further 22% and 18%, respectively, had poorly treated hypertension. Just 3% of women and 4% of men had treated and well controlled hypertension and 23% and 29%, respectively, were normotensive. Compared to normotensive individuals, incident cardiovascular disease (fatal and non-fatal was increased in those with poorly-controlled hypertension (Hazard Ratio (HR: 1.88; 95%CI: 1.53, 2.30, those with untreated hypertension (HR 1.46; 95%CI 1.22, 1.75 and those who were well-controlled hypertension (HR 1.38; 95%CI 0.94, 2.03. Adjustment for baseline differences in mean blood pressure between the groups resulted in attenuation of the increased risk in the poorly-controlled (1.52 (1.18, 1.97 and untreated groups (1.21 (0.97, 1.52, but did not change the association in the well-controlled group. All-cause mortality was also increased in all three hypertension groups but estimates were imprecise with wide confidence intervals. CONCLUSIONS: Half of women and men aged 60-79 in Britain had untreated hypertension and only a very small proportion of those with diagnosed and treated hypertension were well controlled. Those with hypertension, irrespective of whether this was treated and controlled or not, were at

  11. Childhood IQ and risk of bipolar disorder in adulthood: prospective birth cohort study

    OpenAIRE

    Smith, Daniel J; Anderson, Jana; Zammit, Stanley; Meyer, Thomas D; Pell, Jill P; MacKay, Daniel

    2015-01-01

    Background: Intellectual ability may be an endophenotypic marker for bipolar disorder. Aims: Within a large birth cohort, we aimed to assess whether childhood IQ (including both verbal IQ (VIQ) and performance IQ (PIQ) subscales) was predictive of lifetime features of bipolar disorder assessed in young adulthood. Method: We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a large UK birth cohort, to test for an association between measures of childhood IQ a...

  12. Excess Medical Care Costs Associated with Physical Inactivity among Korean Adults: Retrospective Cohort Study.

    Science.gov (United States)

    Min, Jin-Young; Min, Kyoung-Bok

    2016-01-01

    Physical inactivity is a major risk factor for chronic diseases and premature death. The increased health risks associated with physical inactivity may also generate a heavier economic burden to society. We estimated the direct medical costs attributable to physical inactivity among adults using data from the 2002-2010 Korean National Health Insurance Service-National Sample Cohort. A total of 68,556 adults whose reported physical activity status did not change during the study period was included for this study. Propensity scores for inactive adults were used to match 23,645 inactive groups with 23,645 active groups who had similar propensity scores. We compared medical expenditures between the two groups using generalized linear models with a gamma distribution and a log link. Direct medical costs were based on the reimbursement records of all medical facilities from 2005 to 2010. The average total medical costs for inactive individuals were $1110.5, which was estimated to be 11.7% higher than the costs for physically active individuals. With respect to specific diseases, the medical costs of inactive people were significantly higher than those of active people, accounting for approximately 8.7% to 25.3% of the excess burden. Physical inactivity is associated with considerable medical care expenditures per capita among Korean adults. PMID:26797622

  13. Time Spent Walking and Risk of Diabetes in Japanese Adults: The Japan Public Health Center-Based Prospective Diabetes Study

    OpenAIRE

    Yusuke Kabeya

    2016-01-01

    Background: The association between time spent walking and risk of diabetes was investigated in a Japanese population-based cohort. Methods: Data from the Japan Public Health Center-based Prospective Diabetes cohort were analyzed. The surveys of diabetes were performed at baseline and at the 5-year follow-up. Time spent walking per day was assessed using a self-reported questionnaire (

  14. Impact of Atopy on Asthma and Allergic Rhinitis in the Cohort for Reality and Evolution of Adult Asthma in Korea

    OpenAIRE

    Jang, An-Soo; Kim, Sang-Heon; Kim, Tae-Bum; Park, Heung-Woo; Kim, Sae-Hoon; Chang, Yoon-Seok; Lee, Jae Hyun; Cho, You Sook; Park, Jung Won; Nahm, Dong-Ho; Cho, Young-Joo; Cho, Sang-Heon; Yoon, Ho Joo; Choi, Byoung-Whui; Moon, Hee-Bom

    2012-01-01

    Purpose Atopy is an important cause of asthma. Few data on the prevalence of atopy or comparisons with clinical characteristics of asthma in Korean patients have been published. We evaluated the effects of atopy on clinical profiles and airway inflammation in Korean asthmatics. Methods We retrospectively enrolled 1,492 asthmatics from the Cohort for Reality and Evolution of Adult Asthma in Korea (COREA) cohort who had undergone skin prick tests for aeroallergens. The patients' clinical charac...

  15. Unmet need and psychological distress predict emergency department visits in community-dwelling elderly women: a prospective cohort study

    OpenAIRE

    Quail Jacqueline M; Wolfson Christina; Lippman Abby

    2011-01-01

    Abstract Background Unmet need to perform activities of daily living (ADL) is associated with increased use of urgent health services by the elderly. However, the reported associations may be confounded by psychological distress. We examine the independent effects of unmet need and psychological distress upon emergency department (ED) visits. Methods We conducted a prospective study of randomly selected community-dwelling adults aged ≥ 75. We report here the results for women only (n = 530). ...

  16. Air pollution exposure estimation using dispersion modelling and continuous monitoring data in a prospective birth cohort study in the Netherlands

    Directory of Open Access Journals (Sweden)

    Van den Hooven Edith H

    2012-02-01

    Full Text Available Abstract Previous studies suggest that pregnant women and children are particularly vulnerable to the adverse effects of air pollution. A prospective cohort study in pregnant women and their children enables identification of the specific effects and critical periods. This paper describes the design of air pollution exposure assessment for participants of the Generation R Study, a population-based prospective cohort study from early pregnancy onwards in 9778 women in the Netherlands. Individual exposures to PM10 and NO2 levels at the home address were estimated for mothers and children, using a combination of advanced dispersion modelling and continuous monitoring data, taking into account the spatial and temporal variation in air pollution concentrations. Full residential history was considered. We observed substantial spatial and temporal variation in air pollution exposure levels. The Generation R Study provides unique possibilities to examine effects of short- and long-term air pollution exposure on various maternal and childhood outcomes and to identify potential critical windows of exposure.

  17. Short-Term Outcomes of Endoscopic Submucosal Dissection in Patients with Early Gastric Cancer: A Prospective Multicenter Cohort Study

    Science.gov (United States)

    Choi, Il Ju; Lee, Na Rae; Kim, Sang Gyun; Lee, Wan Sik; Park, Seun Ja; Kim, Jae J.; Lee, Jun Haeng; Kwon, Jin-Won; Park, Seung-Hee; You, Ji Hye; Kim, Ji Hyun; Lim, Chul-Hyun; Cho, Joo Young; Kim, Gwang Ha; Lee, Yong Chan; Jung, Hwoon-Yong; Kim, Ji Young; Chun, Hoon Jai; Seol, Sang-Yong

    2016-01-01

    Background/Aims Endoscopic submucosal dissection (ESD) is an effective treatment for early gastric cancer (EGC) that has demonstrated a minimal risk of lymph node metastasis in retrospective studies. We sought to prospectively evaluate the short-term outcomes of ESD treatment in EGCs. Methods A prospective multicenter cohort study of neoplasms 3 cm or less in diameter at endoscopic size evaluation was performed in 12 Korean ESD study group-related university hospitals and the National Cancer Center. Resected specimens were evaluated by the central pathologic review board. Results A patient cohort (n=712) with a total of 737 EGCs was analyzed. The margin-freeen bloc resection rate was 97.3%, and curative resection of 640 lesions (86.8%) was achieved. Lower curative resection rates were associated with lesions 2 to 3 cm in size prior to ESD compared with lesions 2 cm or less in size (78.6% vs 88.1%, respectively, p=0.009). Significant factors associated with noncurative resection were moderately or poorly differentiated histological type, posterior wall tumor location, tumor size larger than 3 cm, ulceration, and submucosal invasion. Delayed bleeding occurred in 49 patients (6.9%), and 12 patients (1.7%) exhibited perforations. Conclusions ESD is an effective treatment with a high curative resection rate for EGCs that meets relatively conservative pre-ESD indications. Long-term survival outcomes should be evaluated in follow-up studies. PMID:27172929

  18. A prospective investigation of neurodevelopmental risk factors for adult antisocial behavior combining official arrest records and self-reports.

    Science.gov (United States)

    Paradis, Angela D; Fitzmaurice, Garrett M; Koenen, Karestan C; Buka, Stephen L

    2015-09-01

    Neurodevelopmental deficits are postulated to play an important role in the etiology of persistent antisocial behavior (ASB). Yet it remains uncertain as to which particular deficits are most closely associated with ASB. We seek to advance this understanding using prospectively collected data from a birth cohort in which multiple indices of neurodevelopmental functioning and ASB were assessed. Participants (n = 2776) were members of the Providence, Rhode Island cohort of the Collaborative Perinatal Project. Information on demographic and neurodevelopmental variables was collected from pregnancy through age 7. When all offspring had reached 33 years of age an adult criminal record check was conducted. A subset of subjects also self-reported on their engagement in serious ASB. Bivariate logistic regression was used to examine the relationship between each neurodevelopmental factor and adult ASB and test whether associations varied depending on how ASB was ascertained. After controlling for background and contextual characteristics, maternal smoking during pregnancy, lower childhood verbal and performance IQ, and age 7 aggressive/impulsive behavior all significantly increased the odds of adult ASB. Associations were not modified by sex and did not depend on how ASB was assessed. However, while both males and Black participants were more likely to engage in ASB than their respective female and White counterparts, relationships were significantly stronger for official records than for self-reports. Results point to a particular subset of early neurodevelopmental risks for antisocial outcomes in adulthood. Findings also suggest that prior contradictory results are not due to the use of official records versus self-reported outcomes. PMID:26050211

  19. The Age Prospective Memory Paradox: Young Adults May Not Give Their Best Outside of the Lab

    OpenAIRE

    Aberle, Ingo; Peter G Rendell; Rose, Nathan S.; McDaniel, Mark A.; Kliegel, Matthias

    2010-01-01

    Previous research has identified the age prospective memory paradox of age-related declines in laboratory settings in contrast to age benefits in naturalistic settings. Various factors are assumed to account for this paradox, yet empirical evidence on this issue is scarce. In 2 experiments, the present study examined the effect of task setting in a laboratory task and the effect of motivation in a naturalistic task on prospective memory performance in young and older adults. For the laborator...

  20. Assessing nonresponse bias at follow-up in a large prospective cohort of relatively young and mobile military service members

    Directory of Open Access Journals (Sweden)

    Hooper Tomoko

    2010-10-01

    Full Text Available Abstract Background Nonresponse bias in a longitudinal study could affect the magnitude and direction of measures of association. We identified sociodemographic, behavioral, military, and health-related predictors of response to the first follow-up questionnaire in a large military cohort and assessed the extent to which nonresponse biased measures of association. Methods Data are from the baseline and first follow-up survey of the Millennium Cohort Study. Seventy-six thousand, seven hundred and seventy-five eligible individuals completed the baseline survey and were presumed alive at the time of follow-up; of these, 54,960 (71.6% completed the first follow-up survey. Logistic regression models were used to calculate inverse probability weights using propensity scores. Results Characteristics associated with a greater probability of response included female gender, older age, higher education level, officer rank, active-duty status, and a self-reported history of military exposures. Ever smokers, those with a history of chronic alcohol consumption or a major depressive disorder, and those separated from the military at follow-up had a lower probability of response. Nonresponse to the follow-up questionnaire did not result in appreciable bias; bias was greatest in subgroups with small numbers. Conclusions These findings suggest that prospective analyses from this cohort are not substantially biased by non-response at the first follow-up assessment.

  1. Multiple medication use in older patients in post-acute transitional care: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Runganga M

    2014-09-01

    Full Text Available Maureen Runganga,1,2 Nancye M Peel,2 Ruth E Hubbard2,3 1The Prince Charles Hospital, Chermside, QLD, Australia; 2Centre for Research in Geriatric Medicine, The University of Queensland School of Medicine, QLD, Australia; 3Princess Alexandra Hospital, Woolloongabba, QLD, Australia Background: Older adults with a range of comorbidities are often prescribed multiple medications, which may impact on their function and cognition and increase the potential for drug interactions and adverse events. Aims: This study investigated the extent of polypharmacy and potentially inappropriate medications in patients receiving post-discharge transitional home care and explored the associations of polypharmacy with patient characteristics, functional outcomes, and frailty.Methods: A prospective observational study was conducted of 351 patients discharged home from hospital with support from six Transition Care Program (TCP sites in two states of Australia. A comprehensive geriatric assessment was conducted at TCP admission and discharge using the interRAI Home Care assessment tool, with frailty measured using an index of 57 accumulated deficits. Medications from hospital discharge summaries were coded using the World Health Organization Anatomical Therapeutic Chemical Classification System. Results: Polypharmacy (5–9 drugs was observed in 46.7% and hyperpolypharmacy (≥10 drugs in 39.2% of patients. Increasing numbers of medications were associated with greater number of comorbid conditions, a higher prevalence of diabetes mellitus, coronary heart disease, chronic obstructive pulmonary disease, dizziness, and dyspnea and increased frailty. At discharge from the program, the non-polypharmacy group (<5 drugs had improved outcomes in Activities of Daily Living, Instrumental Activities of Daily Living and fewer falls, which was mediated because of lower levels of frailty. The commonest drugs were analgesics (56.8% and antiulcer drugs (52.7%. The commonest

  2. High local unemployment and increased mortality in Danish adults; results from a prospective multilevel study

    OpenAIRE

    Osler, M; Christensen, U; Lund, R; Gamborg, M; Godtfredsen, N; Prescott, E

    2003-01-01

    Methods: Prospective cohort study with record linkage to mortality and unemployment registers. Data were pooled data from two population studies conducted in Copenhagen, Denmark. The association between unemployment at parish level and mortality was examined in Cox proportional hazard analysis. A total of 15 980 men and women, aged 20–67 years and employed at 1 January 1980, were studied. All-cause mortality was followed from January 1981 to December 1998.

  3. A Prospective Analysis of Airborne Metal Exposures and Risk of Parkinson Disease in the Nurses’ Health Study Cohort

    Science.gov (United States)

    Fitzgerald, Kathryn; Roberts, Andrea L.; Hart, Jaime E.; Weisskopf, Marc G.; Schwarzschild, Michael A.; Ascherio, Alberto; Laden, Francine

    2014-01-01

    Background: Exposure to metals has been implicated in the pathogenesis of Parkinson disease (PD). Objectives: We sought to examine in a large prospective study of female nurses whether exposure to airborne metals was associated with risk of PD. Methods: We linked the U.S. Environmental Protection Agency (EPA)’s Air Toxics tract-level data with the Nurses’ Health Study, a prospective cohort of female nurses. Over the course of 18 years of follow-up from 1990 through 2008, we identified 425 incident cases of PD. We examined the association of risk of PD with the following metals that were part of the first U.S. EPA collections in 1990, 1996, and 1999: arsenic, antimony, cadmium, chromium, lead, manganese, mercury, and nickel. To estimate hazard ratios (HRs) and 95% CIs, we used the Cox proportional hazards model, adjusting for age, smoking, and population density. Results: In adjusted models, the HR for the highest compared with the lowest quartile of each metal ranged from 0.78 (95% CI: 0.59, 1.04) for chromium to 1.33 (95% CI: 0.98, 1.79) for mercury. Conclusions: Overall, we found limited evidence for the association between adulthood ambient exposure to metals and risk of PD. The results for mercury need to be confirmed in future studies. Citation: Palacios N, Fitzgerald K, Roberts AL, Hart JE, Weisskopf MG, Schwarzschild MA, Ascherio A, Laden F. 2014. A prospective analysis of airborne metal exposures and risk of Parkinson disease in the Nurses’ Health Study Cohort. Environ Health Perspect 122:933–938; http://dx.doi.org/10.1289/ehp.1307218 PMID:24905870

  4. Impact of route to diagnosis on treatment intent and 1-year survival in patients diagnosed with oesophagogastric cancer in England: a prospective cohort study

    OpenAIRE

    Palser, Thomas R; Cromwell, David A; Hardwick, Richard H; Riley, Stuart A; Greenaway, Kimberley; van der Meulen, Jan H P; ,

    2013-01-01

    Objective To investigate the relationship between the route to diagnosis, patient characteristics, treatment intent and 1 -year survival among patients with oesophagogastric (O-G) cancer. Setting Cohort study in 142 English NHS trusts and 30 cancer networks. Participants Patients diagnosed with O-G cancer between October 2007 and June 2009. Design Prospective cohort study. Route to diagnosis defined as general practitioner (GP) referral—urgent (suspected cancer) or non-urgent, hospital consul...

  5. The Clinical Research Center for Depression Study: Baseline Characteristics of a Korean Long-Term Hospital-Based Observational Collaborative Prospective Cohort Study

    OpenAIRE

    Kim, Tae-Suk; Jeong, Seung Hee; Kim, Jung-Bum; Lee, Min-Soo; Kim, Jae-Min; Yim, Hyeon-Woo; Jun, Tae-Youn

    2010-01-01

    Objective The Clinical Research Center for Depression (CRESCEND) study is a 9-year observational collaborative prospective cohort study for the clinical outcomes in participants with depressive disorders in Korea. In this study, we examined the baseline characteristics of the depressive participants as the hospital-based cohort. Methods Participants were assessed using various instruments including the Clinical Global Impression scale, 17-item Hamilton Depression Rating Scale (HDRS-17), Hamil...

  6. Baseline self reported functional health and vulnerability to post-traumatic stress disorder after combat deployment: prospective US military cohort study

    OpenAIRE

    LeardMann, Cynthia A; Tyler C. Smith; Smith, Besa; Wells, Timothy S; Ryan, Margaret A. K.

    2009-01-01

    Objective To determine if baseline functional health status, as measured by SF-36 (veterans), predicts new onset symptoms or diagnosis of post-traumatic stress disorder among deployed US military personnel with combat exposure. Design Prospective cohort analysis. Setting Millennium Cohort. Participants Combat deployed members who completed baseline (2001-3) and follow-up (2004-6) questionnaires. Self reported and electronic data used to examine the relation between functional health and post-...

  7. Excess Medical Care Costs Associated with Physical Inactivity among Korean Adults: Retrospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Jin-Young Min

    2016-01-01

    Full Text Available Physical inactivity is a major risk factor for chronic diseases and premature death. The increased health risks associated with physical inactivity may also generate a heavier economic burden to society. We estimated the direct medical costs attributable to physical inactivity among adultsusing data from the 2002–2010 Korean National Health Insurance Service-National Sample Cohort. A total of 68,556 adults whose reported physical activity status did not change during the study period was included for this study. Propensity scores for inactive adults were used to match 23,645 inactive groups with 23,645 active groups who had similar propensity scores. We compared medical expenditures between the two groups using generalized linear models with a gamma distribution and a log link. Direct medical costs were based on the reimbursement records of all medical facilities from 2005 to 2010. The average total medical costs for inactive individuals were $1110.5, which was estimated to be 11.7% higher than the costs for physically active individuals. With respect to specific diseases, the medical costs of inactive people were significantly higher than those of active people, accounting for approximately 8.7% to 25.3% of the excess burden. Physical inactivity is associated with considerable medical care expenditures per capita among Korean adults.

  8. Protein, iron, and meat consumption and risk for rheumatoid arthritis: a prospective cohort study

    OpenAIRE

    Benito-Garcia, Elizabeth; Mandl, Lisa A.; Feskanich, Diane; Hu, Frank B; Karlson, Elizabeth Wood

    2007-01-01

    A recent prospective study showed that higher consumption of red meat and total protein was associated with increased risk for inflammatory polyarthritis. We therefore prospectively examined the relationship between diet (in particular, protein, iron, and corresponding food sources) and incident rheumatoid arthritis (RA) among 82,063 women in the Nurses' Health Study. From 1980 to 2002, 546 incident cases of RA were confirmed by a connective tissue disease screening questionnaire and medical ...

  9. When Distraction Holds Relevance: A Prospective Memory Benefit for Older Adults

    Directory of Open Access Journals (Sweden)

    Joana S. Lourenço

    2015-06-01

    Full Text Available Evidence is accumulating to show that age-related increases in susceptibility to distracting information can benefit older more than young adults in several cognitive tasks. Here we focus on prospective memory (i.e., remembering to carry out future intentions and examine the effect of presenting distracting information that is intention-related as a function of age. Young and older adults performed an ongoing 1-back working memory task to a rapid stream of pictures superimposed with to-be-ignored letter strings. Participants were additionally instructed to respond to target pictures (namely, animals and, for half of the participants, some strings prior to the targets were intention-related words (i.e., animals. Results showed that presenting intention-related distracting information during the ongoing task was particularly advantageous for target detection in older compared to young adults. Moreover, a prospective memory benefit was observed even for older adults who showed no explicit memory for the target distracter words. We speculate that intention-related distracter information enhanced the accessibility of the prospective memory task and suggest that when distracting information holds relevance to intentions it can serve a compensatory role in prospective remembering in older adults.

  10. Lurasidone adjunctive with lithium or valproate for bipolar depression: A placebo-controlled trial utilizing prospective and retrospective enrolment cohorts.

    Science.gov (United States)

    Suppes, Trisha; Kroger, Hans; Pikalov, Andrei; Loebel, Antony

    2016-07-01

    In this study, designed to evaluate the efficacy of lurasidone as adjunctive therapy with lithium or valproate, patients with bipolar I depression were randomized to 6 weeks of double-blind treatment with lurasidone (N = 180) or placebo (N = 176), added to background treatment with lithium or valproate. All patients were treated with lithium or valproate for a minimum of 4 weeks prior to screening. This was confirmed either by prospective treatment after study enrolment (run-in cohort), or retrospectively, with blood levels of lithium and valproate at screening (non-run-in cohort). Primary and key secondary endpoints were change from baseline to week 6 on the Montgomery-Åsberg Depression Rating Scale (MADRS) and depression severity score on the Clinical Global Impressions scale for use in bipolar illness (CGI-BP-S), respectively. Treatment with lurasidone was associated with non-significant improvement at week 6 vs. placebo for the MADRS total score (-11.8 vs -10.4; P = 0.176), and the CGI-BP-S score (-1.36 vs -1.13; P = 0.095). Significant separation from placebo was observed from weeks 2-5 for the MADRS and weeks 3-5 for the CGI-BP-S. Improvement in the placebo-subtracted MADRS total score was notably larger at week 6 for the non-run-in cohort compared to the run-in cohort (LS mean difference in endpoint change scores, -4.6; P = 0.009). Adverse events most frequently reported for lurasidone were akathisia, somnolence, and extrapyramidal side effects. In conclusion, lurasidone adjunctive with lithium or valproate demonstrated significant improvement in depressive symptoms based on the MADRS from weeks 2-5 but not at the primary week 6 endpoint. PMID:27089521

  11. A prospective cohort study on vegetable and fruit consumption and stomach cancer risk in the netherlands

    NARCIS (Netherlands)

    Botterweck, A.A.M.; Brandt, P.A. van den; Goldbohm, R.A.

    1998-01-01

    The association between vegetable and fruit consumption and stomach cancer risk was investigated in the Netherlands Cohort Study among 120,852 men and women aged 55-69 years at the start in September 1986. Analyses were based on 282 incident stomach cancer cases after 6.3 years of follow-up. Age- an

  12. Vegetable and fruit consumption and risks of colon and rectal cancer in a prospective cohort study

    NARCIS (Netherlands)

    Voorrips, L.E.; Goldbohm, R.A.; Poppel, G. van; Sturmans, F.; Hermus, R.J.J.; Brandt, P.A. van den

    2000-01-01

    The relation between vegetable and fruit consumption and colorectal cancer risk was comprehensively assessed in the Netherlands Cohort Study on Diet and Cancer using a validated 150-item food frequency questionnaire. After 6.3 years of follow-up (1986-1992), over 1,000 incident cases of colorectal c

  13. Prognostic factors in breast-conserving therapy : a prospective population-based cohort study

    NARCIS (Netherlands)

    Jobsen, Jan Jacobus

    2010-01-01

    A large cohort study on breast cancer was started that included patients treated with breastconserving therapy, from the early start of this treatment in the Twente – Achterhoek region, till today, with more than 3.800 breast-conserving treatments. Recruitment is still continuing. In chapter 2, on f

  14. Reactivity to Exclusion Prospectively Predicts Social Anxiety Symptoms in Young Adults

    OpenAIRE

    Levinson, Cheri A.; Langer, Julia K.; Rodebaugh, Thomas L.

    2013-01-01

    Peer victimization leads to negative outcomes such as increased anxiety and depression. The prospective relationship between peer victimization and social anxiety in children and adolescents is well established, and adults with social anxiety disorder (SAD) are more likely than individuals with other anxiety disorders to report a history of teasing. However, a crucial bridge between these findings (peer victimization in young adults) is missing. We manipulated perceptions of peer exclusion in...

  15. When Distraction Holds Relevance: A Prospective Memory Benefit for Older Adults

    OpenAIRE

    Lourenço, Joana S.; Maylor, Elizabeth A

    2015-01-01

    Evidence is accumulating to show that age-related increases in susceptibility to distracting information can benefit older more than young adults in several cognitive tasks. Here we focus on prospective memory (i.e., remembering to carry out future intentions) and examine the effect of presenting distracting information that is intention-related as a function of age. Young and older adults performed an ongoing 1-back working memory task to a rapid stream of pictures superimposed with to-be-...

  16. Retention in care, resource utilization, and costs for adults receiving antiretroviral therapy in Zambia: a retrospective cohort study

    OpenAIRE

    Scott, Callie A.; Iyer, Hari S.; McCoy, Kelly; Moyo, Crispin; Long, Lawrence; Bruce A. Larson; Rosen, Sydney

    2014-01-01

    Background Of the estimated 800,000 adults living with HIV in Zambia in 2011, roughly half were receiving antiretroviral therapy (ART). As treatment scale up continues, information on the care provided to patients after initiating ART can help guide decision-making. We estimated retention in care, the quantity of resources utilized, and costs for a retrospective cohort of adults initiating ART under routine clinical conditions in Zambia. Methods Data on resource utilization (antiretroviral [A...

  17. Low health literacy predicts decline in physical function among older adults: findings from the LitCog cohort study

    OpenAIRE

    Smith, Samuel G.; O'Conor, Rachel; Curtis, Laura M.; Waite, Katie; Deary, Ian J; Paasche-Orlow, Michael; Wolf, Michael S.

    2015-01-01

    BACKGROUND: Limited health literacy is associated with worse physical function in cross-sectional studies. We aimed to determine if health literacy is a risk factor for decline in physical function among older adults.METHODS: A longitudinal cohort of 529 community-dwelling American adults aged 55-74 years were recruited from an academic general internal medicine clinic and federally qualified health centres in 2008-2011. Health literacy (Newest Vital Sign), age, gender, race, education, chron...

  18. The Epidemiology, Virology and Clinical Findings of Dengue Virus Infections in a Cohort of Indonesian Adults in Western Java.

    Directory of Open Access Journals (Sweden)

    Herman Kosasih

    2016-02-01

    Full Text Available Dengue has emerged as one of the most important infectious diseases in the last five decades. Evidence indicates the expansion of dengue virus endemic areas and consequently the exponential increase of dengue virus infections across the subtropics. The clinical manifestations of dengue virus infection include sudden fever, rash, headache, myalgia and in more serious cases, spontaneous bleeding. These manifestations occur in children as well as in adults. Defining the epidemiology of dengue in a given area is critical to understanding the disease and devising effective public health strategies.Here, we report the results from a prospective cohort study of 4380 adults in West Java, Indonesia, from 2000-2004 and 2006-2009. A total of 2167 febrile episodes were documented and dengue virus infections were confirmed by RT-PCR or serology in 268 cases (12.4%. The proportion ranged from 7.6 to 41.8% each year. The overall incidence rate of symptomatic dengue virus infections was 17.3 cases/1,000 person years and between September 2006 and April 2008 asymptomatic infections were 2.6 times more frequent than symptomatic infections. According to the 1997 WHO classification guidelines, there were 210 dengue fever cases, 53 dengue hemorrhagic fever cases (including one dengue shock syndrome case and five unclassified cases. Evidence for sequential dengue virus infections was seen in six subjects. All four dengue virus serotypes circulated most years. Inapparent dengue virus infections were predominantly associated with DENV-4 infections.Dengue virus was responsible for a significant percentage of febrile illnesses in an adult population in West Java, Indonesia, and this percentage varied from year to year. The observed incidence rate during the study period was 43 times higher than the reported national or provincial rates during the same time period. A wide range of clinical severity was observed with most infections resulting in asymptomatic disease. The

  19. Fried meat intake is a risk factor for lung adenocarcinoma in a prospective cohort of Chinese men and women in Singapore

    OpenAIRE

    Butler, Lesley M.; Montague, Julia A.; Koh, Woon-Puay; Wang, Renwei; Yu, Mimi C.; Yuan, Jian-Min

    2013-01-01

    Probable human carcinogens are generated during Chinese-style high-temperature cooking of meat and have been detected in the ambient air and on the meat surface. Although the inhalation of these compounds is an established risk factor for lung cancer, exposure via fried meat consumption has not yet been prospectively evaluated as a risk factor. The relationship between fried meat intake and lung cancer risk was investigated using data from a prospective cohort study among Chinese in Singapore...

  20. Prospects for Adult Literacy in a Period of Economic Austerity.

    Science.gov (United States)

    Limage, Leslie J.

    1988-01-01

    Evaluates the outlook for adult literacy during the ongoing international economic crisis. Describes liberal, conservative, and socialist views on relationships among education, poverty, and governmental policies. Examines the piecemeal approach in the United States, mass campaigns in Vietnam, and limited target group efforts in Brazil. Includes…

  1. The system of continuing education for adults in Russia: problems and development prospects

    OpenAIRE

    Fevralskaya Maria Aleksandrovna

    2015-01-01

    The article reveals the features of the system of continuing education in the Russian Federation in the beginning of the XXI century. The author pays special attention to the issue of the inclusion of adults in educational activities. The problems and possible prospects of continuing education in Russia are underlined.

  2. The Role of Shifting, Updating, and Inhibition in Prospective Memory Performance in Young and Older Adults

    Science.gov (United States)

    Schnitzspahn, Katharina M.; Stahl, Christoph; Zeintl, Melanie; Kaller, Christoph P.; Kliegel, Matthias

    2013-01-01

    Prospective memory performance shows a decline in late adulthood. The present article examines the role of 3 main executive function facets (i.e., shifting, updating, and inhibition) as possible developmental mechanisms associated with these age effects. One hundred seventy-five young and 110 older adults performed a battery of cognitive tests…

  3. Prospective study of falls and risk factors for falls in adults with advanced cancer.

    LENUS (Irish Health Repository)

    Stone, Carol A

    2012-06-10

    Retrospective studies of inpatients with cancer suggest that a cancer diagnosis confers a high risk of falls. In adults with advanced cancer, we aimed to prospectively document the incidence of falls, identify the risk factors, and determine if falls in this population occur predominantly in older patients.

  4. Adverse events in childhood and chronic widespread pain in adult life: Results from the 1958 British Birth Cohort Study.

    Science.gov (United States)

    Jones, Gareth T; Power, Chris; Macfarlane, Gary J

    2009-05-01

    Chronic widespread pain (CWP) is a common and frequently disabling condition. Several studies have shown that early life adversity is associated with CWP in later life; however, the majority are retrospective and suffer from potential recall bias. Using data from the 1958 British Birth Cohort Study, the aim of the current study was to examine, prospectively, the relationship between childhood physical and psychological adversity and CWP in adulthood. At 7 yrs data were collected, by parental report, on physically traumatic events (hospitalisation following a road traffic accident, or for surgery); and factors indicating poor social and psychological environment (periods in local authority care, death of a parent; or parental divorce, alcoholism, or financial hardship). CWP was assessed at 45 yrs using self-completion questionnaires. The relationship between childhood events and CWP was examined using Poisson regression. 7571 individuals provided pain data at 45 yrs (71.5%). There was no association between childhood surgery and CWP in adulthood (relative risk: 1.0; 95%CI: 0.9-1.1). However, children who had been hospitalised following a road traffic accident experienced a significant increase in the risk of future CWP (1.5; 1.05-2.1). Children who had resided in institutional care also experienced an increase in the risk of CWP (1.7; 1.3-2.4) as did those who experienced maternal death (2.0; 1.08-3.7) and familial financial hardship (1.6; 1.3-1.9). Further these associations were not explained by adult psychological distress or social class. To prevent long-term consequences of adverse childhood events, future research should study the mechanisms, in particular the biological mechanisms, underlying these relationships. PMID:19304391

  5. Anterior cruciate ligament injury in elite football : a prospective three-cohort study.

    OpenAIRE

    Waldén, Markus; Hägglund, Martin; Magnusson, Henrik; Ekstrand, Jan

    2011-01-01

    Anterior cruciate ligament (ACL) injury causes long lay-off time and is often complicated with subsequent new knee injury and osteoarthritis. Female gender is associated with an increased ACL injury risk, but few studies have adjusted for gender-related differences in age although female players are often younger when sustaining their ACL injury. The objective of this three-cohort study was to describe ACL injury characteristics in teams from the Swedish men's and women's first leagues and fr...

  6. Maternal Dietary Patterns and Fetal Growth: A Large Prospective Cohort Study in China

    OpenAIRE

    Min-Shan Lu; Qiao-Zhu Chen; Jian-Rong He; Xue-Ling Wei; Jin-Hua Lu; Sheng-Hui Li; Xing-Xuan Wen; Fan-Fan Chan; Nian-Nian Chen; Lan Qiu; Wei-Bi Mai; Rui-Fang Zhang; Cui-Yue Hu; Hui-Min Xia; Xiu Qiu

    2016-01-01

    There was limited evidence revealing the association of Chinese maternal dietary patterns with fetal growth. We aimed to examine the relationship of maternal dietary patterns during pregnancy to neonatal birth weight and birth weight for gestational age in a Chinese population. A total of 6954 mother-child pairs were included from the Born in Guangzhou Cohort Study. Maternal diet during pregnancy was assessed using a self-administered food frequency questionnaire. Cluster analysis was used to...

  7. Food Insecurity and Children’s Mental Health: A Prospective Birth Cohort Study

    OpenAIRE

    Melchior, Maria; Chastang, Jean-François; Falissard, Bruno; Galéra, Cédric; Tremblay, Richard E.; Sylvana M Côté; Boivin, Michel

    2012-01-01

    Food insecurity (which can be defined as inadequate access to sufficient, safe, and nutritious food that meets individuals’ dietary needs) is concurrently associated with children’s psychological difficulties. However, the predictive role of food insecurity with regard to specific types of children’s mental health symptoms has not previously been studied. We used data from the Longitudinal Study of Child Development in Québec, LSCDQ, a representative birth cohort study of children born in the...

  8. Physical activity and risk for breast cancer a prospective cohort study among Swedish twins.

    Science.gov (United States)

    Moradi, Tahereh; Adami, Hans-Olov; Ekbom, Anders; Wedrén, Sara; Terry, Paul; Floderus, Birgitta; Lichtenstein, Paul

    2002-07-01

    The epidemiologic association between physical activity and breast cancer has been corroborated in many studies. Some inconsistencies remain, possibly due to variation in life periods for exposure assessment, confounding and undetected effect modification. In our cohort study, we address some of these questions by taking into account physical activity in different periods of life and by investigating effect modification by birth cohort and body mass index (BMI). Altogether 9,539 same-sex twin women aged 42-70 years who answered a questionnaire about their work and leisure-time physical exercise from ages 25 to 50 during 1967 and 1970 were included in our cohort. During follow-up, 506 breast cancer cases occurred through 1997. We used multivariate Cox models to estimate relative risk (RR) with 95% confidence interval (CI). We found no associations between physical activity and breast cancer overall. Women born between 1901 and 1917 (aged 51-70 at baseline) who reported regular leisure-time activity had a borderline significant 40% lower risk compared with those who reported no activity (RR 0.6; 95% CI 0.4-1.0; test for trend, p = 0.07). This association appeared to be confined to women with a low BMI after the age of 50 and to women with a high BMI during the premenopausal period. We found no evidence that work activity reduces risk for breast cancer. The importance of physical activity for breast cancer risk seems to depend on birth cohort. The association may be limited to normal-weight postmenopausal women and overweight premenopausal women. PMID:12115590

  9. Behavioural and Psychiatric Symptoms in People with Dementia Admitted to the Acute Hospital: Prospective Cohort Study

    OpenAIRE

    Sampson, E L; White, N.; Leurent, B.; Scott, S; Lord, K; Round, J; Jones, L.

    2014-01-01

    BACKGROUND: Dementia is common in older people admitted to acute hospitals. There are concerns about the quality of care they receive. Behavioural and psychiatric symptoms of dementia (BPSD) seem to be particularly challenging for hospital staff. AIMS To define the prevalence of BPSD and explore their clinical associations. METHOD: Longitudinal cohort study of 230 people with dementia, aged over 70, admitted to hospital for acute medical illness, and assessed for BPSD at admission and every 4...

  10. Prospective Cohort Study of Type 2 Diabetes and the Risk of Parkinson's Disease

    OpenAIRE

    Smith, Ashley; Logroscino, Giancarlo; Driver, Jane A.; Buring, Julie Elizabeth; Gaziano, John Michael; Kurth, Tobias

    2008-01-01

    OBJECTIVE—To evaluate the association between type 2 diabetes and newly reported Parkinson's disease. RESEARCH DESIGN AND METHODS—Our study included 21,841 participants in the Physicians’ Health Study, a cohort of U.S. male physicians. Diabetes and Parkinson's disease were self-reported via questionnaire. We used time-varying Cox regression to calculate adjusted relative risk (RR) for Parkinson's disease. RESULTS—Over 23 years, 556 individuals with Parkinson's disease were identified. Subject...

  11. Predictors of breastfeeding duration among women in Kuwait: results of a prospective cohort study

    OpenAIRE

    Manal Dashti; Scott, Jane A.; Edwards, Christine A.; Mona Al-Sughayer

    2014-01-01

    The purposes of this paper are to report the prevalence of breastfeeding to six months among women in Kuwait and to determine the factors that are associated with the duration of breastfeeding. A cohort of 373 women recruited from maternity wards in four hospitals in Kuwait city were followed from birth to 26 weeks postpartum. The association of any and full breastfeeding duration and predictor variables were explored using multivariate Cox’s proportional hazards models. At six months, 39% o...

  12. Physical work environment risk factors for long term sickness absence: prospective findings among a cohort of 5357 employees in Denmark

    DEFF Research Database (Denmark)

    Lund, Thomas; Labriola, Merete; Christensen, Karl Bang;

    2006-01-01

    OBJECTIVES: To examine the effects of physical work environment on long term sickness absence and to investigate interaction between physical and psychosocial risk factors. DESIGN AND SETTING: Prospective cohort study of long term sickness absence among employees in Denmark. PARTICIPANTS: 5357...... employees interviewed in 2000 about their physical work environment, and various covariates were followed for 18 months in a national sickness absence register. Outcome measurements Cox regression analysis was performed to assess risk estimates for physical risk factors in the work environment and onset of...... environment risk factors among female employees (P<0.05). CONCLUSION: Uncomfortable working positions, lifting or carrying loads, and pushing or pulling loads increased the risk of onset of long term sickness absence. The study shows a potential for reducing long term sickness absence through modifying work...

  13. Early identification of struggling in medical education: a prospective cohort study of the validity of tutor judgments

    DEFF Research Database (Denmark)

    O'Neill, Lotte; Mørcke, Anne Mette; Eika, Berit

    2015-01-01

    controlling for grades obtained in preceeding exams. Lack of participation, lack of commitment, poor academic performance, poor social interactions and general signs of distress were the main indicators of struggling identified. Teachers’ informal judgements of in-class behavior may be an untapped source of...... early diagnosis of struggling in medical school based on informal teacher judgements of in-class behavior. The study design was a prospective cohort study and the outcome/truth criteria were anatomy failure and medical school drop out. Six weeks into a anatomy course, anatomy tutors attemted to identify...... signs of struggling. By week six, the tutors were able to detect approximately ¼-1/3 of the students who eventually failed or dropped out, and for ¾ of the strugglers they identified, they were correct in their judgments. Informal tutor judgements showed incremental validity for both outcomes when...

  14. Does leisure time physical activity in early pregnancy protect against pre-eclampsia? Prospective cohort in Danish women

    DEFF Research Database (Denmark)

    Østerdal, M L; Strøm, M; Klemmensen, A K; Knudsen, V K; Juhl, M; Halldorsson, T I; Andersen, Anne-Marie Nybo; Magnus, P; Olsen, S F

    2008-01-01

    OBJECTIVE: To examine the association between physical activity in early pregnancy and risk of pre-eclampsia. DESIGN: Prospective cohort. SETTING: Denmark. POPULATION: A total of 85,139 pregnant Danish women, recruited between 1996 and 2002. METHODS: The authors assessed leisure time physical...... activity in first trimester by a telephone interview and categorised women a priori into seven groups: 0 (reference), 1-44, 45-74, 75-149, 150-269, 270-419 and 420+ minutes/week. Pre-eclampsia diagnoses were extracted from the Danish National Patient Registry. A number of potential confounders were...... adjusted for by logistic regression. MAIN OUTCOME MEASURES: Pre-eclampsia and severe pre-eclampsia. RESULTS: The two highest physical activity levels were associated with increased risk of severe pre-eclampsia compared with the nonexercising group, with adjusted odds ratios of 1.65 (95% CI: 1.11-2.43) and...

  15. Rapid improvements in pain and quality of life are sustained after surgery for spinal metastases in a large prospective cohort

    DEFF Research Database (Denmark)

    Choi, David; Fox, Zoe; Albert, Todd;

    2016-01-01

    spinal metastases by analysing the largest reported surgical series of patients with epidural spinal metastases. Methods A prospective cohort study of 922 consecutive patients with spinal metastases who underwent surgery, from the Global Spine Tumour Study Group database. Pre- and post-operative EQ-5D...... who survived up to 2 years after surgery. In specialised spine centres, the technical intra-operative complication rate of surgery was low, however almost a quarter of patients experienced post-operative systemic adverse events. Conclusion Surgical treatment for spinal metastases produces rapid pain......Introduction Metastatic spinal cancer is a common condition that may lead to spinal instability, pain and paralysis. In the 1980s, surgery was discouraged because results showed worse neurological outcomes and pain compared with radiotherapy alone. However, with the advent of modern imaging and...

  16. Healthy Lifestyle and Risk of Cancer in the European Prospective Investigation Into Cancer and Nutrition Cohort Study

    DEFF Research Database (Denmark)

    McKenzie, Fiona; Biessy, Carine; Ferrari, Pietro;

    2016-01-01

    It has been estimated that at least a third of the most common cancers are related to lifestyle and as such are preventable. Key modifiable lifestyle factors have been individually associated with cancer risk; however, less is known about the combined effects of these factors.This study generated a...... healthy lifestyle index score (HLIS) to investigate the joint effect of modifiable factors on the risk of overall cancers, alcohol-related cancers, tobacco-related cancers, obesity-related cancers, and reproductive-related cancers. The study included 391,608 men and women from the multinational European...... Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The HLIS was constructed from 5 factors assessed at baseline (diet, physical activity, smoking, alcohol consumption, and anthropometry) by assigning scores of 0 to 4 to categories of each factor, for which higher values indicate healthier...

  17. The validity of student tutors’ judgments in early detection of struggling in medical school. A prospective cohort study

    DEFF Research Database (Denmark)

    O'Neill, Lotte; Mørcke, Anne Mette; Eika, Berit

    2016-01-01

    early diagnosis of struggling in medical school based on informal teacher judgements of in-class behavior. The study design was a prospective cohort study and the outcomes/truth criteria were anatomy failure and medical school drop out. Six weeks into an anatomy course, student tutors attempted to...... students for signs of struggling. By week six, the student tutors were able to detect approximately 1/4–1/3 of the students who eventually failed or dropped out, and for ¾ of the strugglers they identified, they were correct in their judgments. Informal student tutor’s judgements showed incremental......-class behavior may be an untapped source of information in the early identification of struggling medical students with added value above and beyond formal testing....

  18. Dietary fiber intake and risk of colorectal cancer: A pooled analysis of prospective cohort studies

    NARCIS (Netherlands)

    Park, Y.; Hunter, D.J.; Spiegelman, D.; Bergkvist, L.; Berrino, F.; Brandt, P.A. van den; Buring, J.E.; Colditz, G.A.; Freudenheim, J.L.; Fuchs, C.S.; Giovannucci, E.; Goldbohm, R.A.; Graham, S.; Harnack, L.; Hartman, A.M.; Jacobs, D.R.; Kato, I.; Krogh, V.; Leitzmann, M.F.; McCullough, M.L.; Miller, A.B.; Pietinen, P.; Rohan, T.E.; Schatzkin, A.; Willett, W.C.; Wolk, A.; Zeleniuch-Jacquotte, A.; Zhang, S.M.; Smith-Warner, S.A.

    2005-01-01

    Context: Inconsistent findings from observational studies have continued the controversy over the effects of dietary fiber on colorectal cancer. Objective: To evaluate the association between dietary fiber intake and risk of colorectal cancer. Design, Setting, and Participants: From 13 prospective c

  19. Prenatal, Perinatal, and Neonatal Risk Factors for Specific Language Impairment: A Prospective Pregnancy Cohort Study

    Science.gov (United States)

    Whitehouse, Andrew J. O.; Shelton, W. M. R.; Ing, Caleb; Newnham, John P.

    2014-01-01

    Purpose: Although genetic factors are known to play a causal role in specific language impairment (SLI), environmental factors may also be important. This study examined whether there are prenatal, perinatal, and neonatal factors that are associated with childhood SLI. Method: Participants were members of the Raine Study, a prospective cohort…

  20. A Prospective Cohort Study on Radiation-induced Hypothyroidism : Development of an NTCP Model

    NARCIS (Netherlands)

    Boomsma, Marjolein J.; Bijl, Hendrik P.; Christianen, Miranda E. M. C.; Beetz, Ivo; Chouvalova, Olga; Steenbakkers, Roel J. H. M.; van der Laan, Bernard F. A. M.; Wolffenbuttel, Bruce H. R.; Oosting, Sjoukje F.; Schilstra, Cornelis; Langendijk, Johannes A.

    2012-01-01

    Purpose: To establish a multivariate normal tissue complication probability (NTCP) model for radiation-induced hypothyroidism. Methods and Materials: The thyroid-stimulating hormone (TSH) level of 105 patients treated with (chemo-) radiation therapy for head-and-neck cancer was prospectively measure

  1. Antioxidants, oxidative stress, and cardiovascular diseases : cross-cultural comparisons and prospective cohort studies

    NARCIS (Netherlands)

    Buijsse, B.

    2008-01-01

    Background: Antioxidants in plant foods have been proposed to reduce the risk of cardiovascular diseases (CVD) by reducing oxidative stress. The objective was to confirm prospective studies on CVD and traditional antioxidants (beta-carotene, alpha-tocopherol), and to investigate emerging antioxidant

  2. Stressful life events and leukocyte telomere attrition in adulthood : a prospective population-based cohort study

    NARCIS (Netherlands)

    van Ockenburg, S. L.; Bos, E. H.; de Jonge, P.; van der Harst, P.; Gans, R. O. B.; Rosmalen, J. G. M.

    2015-01-01

    Background. Telomere attrition might be one of the mechanisms through which psychosocial stress leads to somatic disease. To date it is unknown if exposure to adverse life events in adulthood is associated with telomere shortening prospectively. In the current study we investigated whether life even

  3. Food assistance is associated with improved body mass index, food security and attendance at clinic in an HIV program in central Haiti: a prospective observational cohort study

    Directory of Open Access Journals (Sweden)

    Ivers Louise C

    2010-08-01

    Full Text Available Abstract Background Few data are available to guide programmatic solutions to the overlapping problems of undernutrition and HIV infection. We evaluated the impact of food assistance on patient outcomes in a comprehensive HIV program in central Haiti in a prospective observational cohort study. Methods Adults with HIV infection were eligible for monthly food rations if they had any one of: tuberculosis, body mass index (BMI 2, CD4 cell count 3 (in the prior 3 months or severe socio-economic conditions. A total of 600 individuals (300 eligible and 300 ineligible for food assistance were interviewed before rations were distributed, at 6 months and at 12 months. Data collected included demographics, BMI and food insecurity score (range 0 - 20. Results At 6- and 12-month time-points, 488 and 340 subjects were eligible for analysis. Multivariable analysis demonstrated that at 6 months, food security significantly improved in those who received food assistance versus who did not (-3.55 vs -0.16; P Conclusions Food assistance was associated with improved food security, increased BMI, and improved adherence to clinic visits at 6 and 12 months among people living with HIV in Haiti and should be part of routine care where HIV and food insecurity overlap.

  4. Cardiac comorbidity in head and neck cancer patients and its influence on cancer treatment selection and mortality: a prospective cohort study.

    Science.gov (United States)

    Simeoni, Roland; Breitenstein, Kerstin; Eßer, Dirk; Guntinas-Lichius, Orlando

    2016-09-01

    Comorbidity assessment and a profound cardiac examination were implemented into pre-treatment diagnostics to analyze their influence on head and neck squamous cell carcinoma (HNSCC) therapy selection and short-term mortality. Comorbidity was measured prospectively in 49 HNSCC patients using standard indices between 2012 and 2013. Cardiac examinations included electrocardiogram, echocardiography, and bicycle ergometry. Most patients had stage IV tumors (61 %), smoked (61 %), and showed alcohol abuse (57 %); 38 patients (78 %) received a multimodal therapy; 65 % had an adult comorbidity evaluation 27 index ≥2, 59 % a Charlson comorbidity index (CCI) ≥4, and 12 % a revised cardiac risk index (RCRI) ≥2. Additional cardiac examinations revealed moderate to severe cardiovascular pathologies in 32 % of the patients and led to recommendations for additional therapy in 4 patients (8 %) necessary only after cancer treatment. RCRI was associated with CCI and cardiac examinations (p = 0.009, p = 0.030). Chemotherapy, stroke history, and RCRI ≥2 were risk factors for early mortality within first 2 years after cancer therapy (p = 0.037; p = 0.012; p = 0.015). Although one-third of a strongly smoking and drinking patient cohort had relevant cardiac morbidity, extended unselected cardiac diagnostics had only low impact on HNSCC therapy selection. The risk of early mortality after HNSCC cancer treatment seems to be sufficiently reflected by the RCRI. PMID:26581475

  5. Adult Lifespan Cognitive Variability in the Cross-Sectional Cam-CAN Cohort

    Directory of Open Access Journals (Sweden)

    Emma Green

    2015-12-01

    Full Text Available This study examines variability across the age span in cognitive performance in a cross-sectional, population-based, adult lifespan cohort from the Cambridge Centre for Ageing and Neuroscience (Cam-CAN study (n = 2680. A key question we highlight is whether using measures that are designed to detect age-related cognitive pathology may not be sensitive to, or reflective of, individual variability among younger adults. We present three issues that contribute to the debate for and against age-related increases in variability. Firstly, the need to formally define measures of central tendency and measures of variability. Secondly, in addition to the commonly addressed location-confounding (adjusting for covariates there may exist changes in measures of variability due to confounder sub-groups. Finally, that increases in spread may be a result of floor or ceiling effects; where the measure is not sensitive enough at all ages. From the Cam-CAN study, a large population-based dataset, we demonstrate the existence of variability-confounding for the immediate episodic memory task; and show that increasing variance with age in our general cognitive measures is driven by a ceiling effect in younger age groups.

  6. Adult Lifespan Cognitive Variability in the Cross-Sectional Cam-CAN Cohort.

    Science.gov (United States)

    Green, Emma; Shafto, Meredith A; Matthews, Fiona E; White, Simon R

    2015-12-01

    This study examines variability across the age span in cognitive performance in a cross-sectional, population-based, adult lifespan cohort from the Cambridge Centre for Ageing and Neuroscience (Cam-CAN) study (n = 2680). A key question we highlight is whether using measures that are designed to detect age-related cognitive pathology may not be sensitive to, or reflective of, individual variability among younger adults. We present three issues that contribute to the debate for and against age-related increases in variability. Firstly, the need to formally define measures of central tendency and measures of variability. Secondly, in addition to the commonly addressed location-confounding (adjusting for covariates) there may exist changes in measures of variability due to confounder sub-groups. Finally, that increases in spread may be a result of floor or ceiling effects; where the measure is not sensitive enough at all ages. From the Cam-CAN study, a large population-based dataset, we demonstrate the existence of variability-confounding for the immediate episodic memory task; and show that increasing variance with age in our general cognitive measures is driven by a ceiling effect in younger age groups. PMID:26690191

  7. The Norwegian Offender Mental Health and Addiction Study - Design and Implementation of a National Survey and Prospective Cohort Study.

    Science.gov (United States)

    Bukten, Anne; Lund, Ingunn Olea; Rognli, Eline Borger; Stavseth, Marianne Riksheim; Lobmaier, Philipp; Skurtveit, Svetlana; Clausen, Thomas; Kunøe, Nikolaj

    2015-01-01

    The Norwegian prison inmates are burdened by problems before they enter prison. Few studies have managed to assess this burden and relate it to what occurs for the inmates once they leave the prison. The Norwegian Offender Mental Health and Addiction (NorMA) study is a large-scale longitudinal cohort study that combines national survey and registry data in order to understand mental health, substance use, and criminal activity before, during, and after custody among prisoners in Norway. The main goal of the study is to describe the criminal and health-related trajectories based on both survey and registry linkage information. Data were collected from 1,499 inmates in Norwegian prison facilities during 2013-2014. Of these, 741 inmates provided a valid personal identification number and constitute a cohort that will be examined retrospectively and prospectively, along with data from nationwide Norwegian registries. This study describes the design, procedures, and implementation of the ongoing NorMA study and provides an outline of the initial data. PMID:26648732

  8. The Norwegian Offender Mental Health and Addiction Study – Design and Implementation of a National Survey and Prospective Cohort Study

    Science.gov (United States)

    Bukten, Anne; Lund, Ingunn Olea; Rognli, Eline Borger; Stavseth, Marianne Riksheim; Lobmaier, Philipp; Skurtveit, Svetlana; Clausen, Thomas; Kunøe, Nikolaj

    2015-01-01

    The Norwegian prison inmates are burdened by problems before they enter prison. Few studies have managed to assess this burden and relate it to what occurs for the inmates once they leave the prison. The Norwegian Offender Mental Health and Addiction (NorMA) study is a large-scale longitudinal cohort study that combines national survey and registry data in order to understand mental health, substance use, and criminal activity before, during, and after custody among prisoners in Norway. The main goal of the study is to describe the criminal and health-related trajectories based on both survey and registry linkage information. Data were collected from 1,499 inmates in Norwegian prison facilities during 2013–2014. Of these, 741 inmates provided a valid personal identification number and constitute a cohort that will be examined retrospectively and prospectively, along with data from nationwide Norwegian registries. This study describes the design, procedures, and implementation of the ongoing NorMA study and provides an outline of the initial data. PMID:26648732

  9. The Stroke Outcomes Study 2 (SOS2: a prospective, analytic cohort study of depressive symptoms after stroke

    Directory of Open Access Journals (Sweden)

    Hewison Jenny

    2009-06-01

    Full Text Available Abstract Background Mood disorder is recognised as an important and common problem after stroke but little is known about the longer term effects of mood on functional outcomes. This protocol paper describes the Stroke Outcomes Study 2 (SOS2, a research study conducted in two large acute NHS Trusts in the North of England, which was designed to investigate the impact of early depressive symptoms on outcomes after an acute stroke. Methods and design SOS2 was a prospective cohort study that aimed to recruit patients in the first few weeks after a stroke, and to follow them up at regular intervals for one year thereafter in order to describe the trajectory of psychological symptoms and study their impact on physical functional recovery. Measures of mood and function were completed at baseline (approximately 3 weeks and at four follow-up time-points: approximately 9, 13, 26 and 52 weeks after the index stroke. Discussion Recruiting patients to research studies soon after an acute stroke is difficult. Mortality following stroke is approximately 30% and in the region of half the patients that survive the initial event are significantly disabled. Together these factors reduced the number of patients available to participate in SOS2 but once recruited to the study the drop-out rate was relatively low. During the recruitment period over 6000 admissions for stroke or query stroke were screened for eligibility. A cohort of 592 study participants was finally achieved.

  10. Flavonoid and lignan intake and pancreatic cancer risk in the European prospective investigation into cancer and nutrition cohort.

    Science.gov (United States)

    Molina-Montes, Esther; Sánchez, María-José; Zamora-Ros, Raul; Bueno-de-Mesquita, H B As; Wark, Petra A; Obon-Santacana, Mireia; Kühn, Tilman; Katzke, Verena; Travis, Ruth C; Ye, Weimin; Sund, Malin; Naccarati, Alessio; Mattiello, Amalia; Krogh, Vittorio; Martorana, Caterina; Masala, Giovanna; Amiano, Pilar; Huerta, José-María; Barricarte, Aurelio; Quirós, José-Ramón; Weiderpass, Elisabete; Angell Åsli, Lene; Skeie, Guri; Ericson, Ulrika; Sonestedt, Emily; Peeters, Petra H; Romieu, Isabelle; Scalbert, Augustin; Overvad, Kim; Clemens, Matthias; Boeing, Heiner; Trichopoulou, Antonia; Peppa, Eleni; Vidalis, Pavlos; Khaw, Kay-Tee; Wareham, Nick; Olsen, Anja; Tjønneland, Anne; Boutroun-Rualt, Marie-Christine; Clavel-Chapelon, Françoise; Cross, Amanda J; Lu, Yunxia; Riboli, Elio; Duell, Eric J

    2016-10-01

    Despite the potential cancer preventive effects of flavonoids and lignans, their ability to reduce pancreatic cancer risk has not been demonstrated in epidemiological studies. Our aim was to examine the association between dietary intakes of flavonoids and lignans and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. A total of 865 exocrine pancreatic cancer cases occurred after 11.3 years of follow-up of 477,309 cohort members. Dietary flavonoid and lignan intake was estimated through validated dietary questionnaires and the US Department of Agriculture (USDA) and Phenol Explorer databases. Hazard ratios (HR) and 95% confidence intervals (CIs) were calculated using age, sex and center-stratified Cox proportional hazards models, adjusted for energy intake, body mass index (BMI), smoking, alcohol and diabetes status. Our results showed that neither overall dietary intake of flavonoids nor of lignans were associated with pancreatic cancer risk (multivariable-adjusted HR for a doubling of intake = 1.03, 95% CI: 0.95-1.11 and 1.02; 95% CI: 0.89-1.17, respectively). Statistically significant associations were also not observed by flavonoid subclasses. An inverse association between intake of flavanones and pancreatic cancer risk was apparent, without reaching statistical significance, in microscopically confirmed cases (HR for a doubling of intake = 0.96, 95% CI: 0.91-1.00). In conclusion, we did not observe an association between intake of flavonoids, flavonoid subclasses or lignans and pancreatic cancer risk in the EPIC cohort. PMID:27184434

  11. Academic Achievement in Primary School in Offspring Born to Mothers With Type 1 Diabetes (the EPICOM Study): A Register-Based Prospective Cohort Study

    DEFF Research Database (Denmark)

    Knorr, Sine; Clausen, Tine D; Vlachová, Zuzana;

    2015-01-01

    OBJECTIVE: This study examined the effect of maternal pregestational type 1 diabetes on offspring primary school performance. RESEARCH DESIGN AND METHODS: We performed a prospective combined clinical and register-based cohort study comparing primary school performance in offspring (n = 707) of wo...

  12. Foot pronation is not associated with increased injury risk in novice runners wearing a neutral shoe : a 1-year prospective cohort study

    NARCIS (Netherlands)

    Nielsen, Rasmus Oestergaard; Buist, Ida; Parner, Erik Thorlund; Nohr, Ellen Aagaard; Sorensen, Henrik; Lind, Martin; Rasmussen, Sten

    2014-01-01

    Objective To investigate if running distance to first running-related injury varies between foot postures in novice runners wearing neutral shoes. Design A 1-year epidemiological observational prospective cohort study. Setting Denmark. Participants A total of 927 novice runners equivalent to 1854 fe

  13. Predictors of postherpetic neuralgia in patients with herpes zoster: a pooled analysis of prospective cohort studies from North and Latin America and Asia

    Directory of Open Access Journals (Sweden)

    Kosuke Kawai

    2015-05-01

    Conclusions: In addition to older age and severe acute pain, this study suggests that impaired physical and social functioning from acute zoster pain may play a role in the development of PHN in this prospective cohort study of HZ patients from North and Latin America and Asia.

  14. The Effect of Moderate and Excessive Alcohol Use on the Course and Outcome of Patients With Bipolar Disorders : A Prospective Cohort Study

    NARCIS (Netherlands)

    van Zaane, J.; van den Brink, W.; Draisma, S.; Smit, J. H.; Nolen, W. A.

    2010-01-01

    Objective: Comorbid alcohol use disorders (AUDs) arc frequently associated with negative effects on course and outcome of bipolar disorder This prospective cohort study assessed the effect of actual alcohol use (no, moderate, and excessive) on the course and outcome of patients with bipolar disorder

  15. Diet, Screen Time, Physical Activity, and Childhood Overweight in the General Population and in High Risk Subgroups: Prospective Analyses in the PIAMA Birth Cohort.

    NARCIS (Netherlands)

    Wijga, A.H.; Scholtens, S.; Bemelmans, W.J.E.; Kerkhof, M.; Koppelman, G.H.; Brunekreef, B.; Smit, H.A.

    2010-01-01

    Objective. To prospectively identify behavioral risk factors for childhood overweight and to assess their relevance in high risk sub groups (children of mothers with overweight or low education). Methods. In the PIAMA birth cohort (n = 3963), questionnaire data were obtained at ages 5 and 7 on "scre

  16. Prospective cohort study on surgical wounds comparing a polyhexanide-containing biocellulose dressing with a dialkyl-carbamoyl-chloride-containing hydrophobic dressing

    DEFF Research Database (Denmark)

    Nielsen, Anna Marie; Andriessen, Anneke

    2012-01-01

    Postsurgery dressing changes in diabetic foot amputation wounds and surgical wounds healing by secondary intention are often conducted in the operating room under general anesthesia. A prospective comparative cohort study was performed in 60 patients (n = 60: n = 30/n = 30) with secondary...

  17. Evaluating the Predictive Impact of an Emergent Literacy Model on Dyslexia in Italian Children: A Four-Year Prospective Cohort Study

    Science.gov (United States)

    Bigozzi, Lucia; Tarchi, Christian; Pezzica, Sara; Pinto, Giuliana

    2016-01-01

    The strong differences in manifestation, prevalence, and incidence in dyslexia across languages invite studies in specific writing systems. In particular, the question of the role played by emergent literacy in opaque and transparent writing systems remains a fraught one. This research project tested, through a 4-year prospective cohort study, an…

  18. Predictive accuracy of Edinburgh Postnatal Depression Scale assessment during pregnancy for the risk of developing postpartum depressive symptoms : a prospective cohort study

    NARCIS (Netherlands)

    Meijer, J. L.; Beijers, C.; van Pampus, M. G.; Verbeek, T.; Stolk, R. P.; Milgrom, J.; Bockting, C. L. H.; Burger, H.

    2014-01-01

    ObjectiveTo investigate whether the 10-item Edinburgh Postnatal Depression Scale (EPDS) administered antenatally is accurate in predicting postpartum depressive symptoms, and whether a two-item EPDS has similar predictive accuracy. DesignProspective cohort study. SettingObstetric care in the Netherl

  19. Maternal Risk Exposure and Adult Daughters' Health, Schooling, and Employment: A Constructed Cohort Analysis of 50 Developing Countries.

    Science.gov (United States)

    Li, Qingfeng; Tsui, Amy O

    2016-06-01

    This study analyzes the relationships between maternal risk factors present at the time of daughters' births-namely, young mother, high parity, and short preceding birth interval-and their subsequent adult developmental, reproductive, and socioeconomic outcomes. Pseudo-cohorts are constructed using female respondent data from 189 cross-sectional rounds of Demographic and Health Surveys conducted in 50 developing countries between 1986 and 2013. Generalized linear models are estimated to test the relationships and calculate cohort-level outcome proportions with the systematic elimination of the three maternal risk factors. The simulation exercise for the full sample of 2,546 pseudo-cohorts shows that the combined elimination of risk exposures is associated with lower mean proportions of adult daughters experiencing child mortality, having a small infant at birth, and having a low body mass index. Among sub-Saharan African cohorts, the estimated changes are larger, particularly for years of schooling. The pseudo-cohort approach can enable longitudinal testing of life course hypotheses using large-scale, standardized, repeated cross-sectional data and with considerable resource efficiency. PMID:27154342

  20. A prospective evaluation of early detection biomarkers for ovarian cancer in the European EPIC cohort

    DEFF Research Database (Denmark)

    Terry, Kathryn L; Schock, Helena; Fortner, Renée T; Hüsing, Anika; Fichorova, Raina N; Yamamoto, Hidemi S; Vitonis, Allison F; Johnson, Theron; Overvad, Kim; Tjønneland, Anne; Boutron-Ruault, Marie-Christine; Mesrine, Sylvie; Severi, Gianluca; Dossus, Laure; Rinaldi, Sabina; Boeing, Heiner; Benetou, Vassiliki; Lagiou, Pagona; Trichopoulou, Antonia; Krogh, Vittorio; Kuhn, Elisabetta; Panico, Salvatore; Bueno-de-Mesquita, H Bas; Onland-Moret, N Charlotte; Peeters, Petra H; Gram, Inger Torhild; Weiderpass, Elisabete; Duell, Eric J; Sanchez, Maria-Jose; Ardanaz, Eva; Etxezarreta, Nerea; Navarro, Carmen; Idahl, Annika; Lundin, Eva; Jirström, Karin; Manjer, Jonas; Wareham, Nicholas J; Khaw, Kay-Tee; Smith Byrne, Karl; Travis, Ruth C; Gunter, Marc J; Merritt, Melissa A; Riboli, Elio; Cramer, Daniel; Kaaks, Rudolf

    2016-01-01

    source of information to evaluate early detection biomarkers. Here we evaluate the most promising ovarian cancer screening biomarkers in prospectively collected samples from the European Prospective Investigation into Cancer and Nutrition (EPIC) study. EXPERIMENTAL DESIGN: We measured CA125, HE4, CA72......PURPOSE: About 60% of ovarian cancers are diagnosed at late stage, when 5-year survival is less than 30% in contrast to 90% for local disease. This has prompted search for early detection biomarkers. For initial testing, specimens taken months or years before ovarian cancer diagnosis are the best.......4 and CA15.3 in 810 invasive epithelial ovarian cancer cases and 1,939 controls. We calculated the sensitivity at 95% and 98% specificity as well as Area under the Receiver Operator Curve (C-statistic) for each marker individually and in combination. Additionally, we evaluated marker performance by...

  1. Maternal Dietary Patterns during Pregnancy in Relation to Offspring Forearm Fractures: Prospective Study from the Danish National Birth Cohort

    Directory of Open Access Journals (Sweden)

    Sesilje B. Petersen

    2015-04-01

    Full Text Available Limited evidence exists for an association between maternal diet during pregnancy and offspring bone health. In a prospective study, we examined the association between dietary patterns in mid-pregnancy and offspring forearm fractures. In total, 101,042 pregnancies were recruited to the Danish National Birth Cohort (DNBC during 1996–2002. Maternal diet was collected by a food frequency questionnaire. Associations were analyzed between seven dietary patterns extracted by principal component analysis and offspring first occurrence of any forearm fracture diagnosis, extracted from the Danish National Patient Register, between time of birth and end of follow-up (<16 year (n = 53,922. In multivariable Cox regression models, offspring of mothers in the fourth vs. first quintile of the Western pattern had a significant increased risk (Hazard ratio, 95% confidence interval: 1.11, 1.01–1.23 of fractures, and there was a borderline significant positive trend (p = 0.06. The other dietary patterns showed no associations and neither did supplementary analyses of macro- and micronutrients or single food groups, except for the intake of artificially sweetened soft drinks, which was positively associated with offspring forearm fractures (p = 0.02. In the large prospective DNBC high mid-pregnancy consumption of Western diet and artificially sweetened soft drinks, respectively, indicated positive associations with offspring forearm fractures, which provides interesting hypotheses for future research.

  2. Incidence of neuralgic amyotrophy (Parsonage Turner syndrome in a primary care setting--a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Nens van Alfen

    Full Text Available Neuralgic amyotrophy is considered a rare peripheral nervous system disorder but in practice seems grossly under recognized, which negatively affects care for these patients. In this study we prospectively counted the one-year incidence rate of classic neuralgic amyotrophy in a primary care setting.In a prospective cohort study during the year 2012 we registered all new cases of neck, shoulder or arm complaints from two large primary care centers serving a population of 14,118. Prior to study, general practitioners received a short training on how to diagnose classic neuralgic amyotrophy. Neuralgic amyotrophy was defined according to published criteria irrespective of family history. Only patients with a classic phenotype were counted as definite cases. After inclusion, patients with suspected neuralgic amyotrophy who had not yet seen a neurologist were offered neurologic evaluation for diagnostic confirmation.Of the 492 patients identified with new onset neck, shoulder or arm complaints, 34 were suspected of having neuralgic amyotrophy. After neurologic evaluation the diagnosis was confirmed in 14 patients. This amounts to a one-year incidence rate for classic neuralgic amyotrophy of 1 per 1000.Our findings suggest that neuralgic amyotrophy is 30-50 times more common than previously thought. Unawareness of the disorder and its clinical presentation seems the most likely explanation for this difference. An incidence rate of 1 per 1000 and the long-term sequelae many patients suffer warrant more vigilance in diagnosing the disorder, to pave the way for timely treatment and prevent complications.

  3. Dietary iron and haem iron intake and risk of endometrial cancer: a prospective cohort study

    OpenAIRE

    Kabat, G C; Miller, A B; M Jain; Rohan, T E

    2007-01-01

    We used data from a large cohort study of Canadian women to assess the association of meat intake and dietary intake of iron and haem iron with risk of endometrial cancer. Among 34 148 women with an intact uterus at baseline and followed for a mean of 16.4 years, we identified 426 incident endometrial cancer cases. Data from a food frequency questionnaire administered at baseline were used to calculate intake of all meats, red meat, total dietary iron, iron from meat, haem iron, and non-haem ...

  4. Habitual intake of flavonoid subclasses and risk of colorectal cancer in 2 large prospective cohorts12

    OpenAIRE

    Nimptsch, K; Zhang, X; CASSIDY, A; Song, M; O'Reilly, EJ; Lin, JH; Pischon, T.; Rimm, EB; Willett, WC; Fuchs, CS; Ogino, S; Chan, AT; Giovannucci, EL; Wu, K

    2016-01-01

    BACKGROUND: Flavonoids inhibit the growth of colon cancer cells in vitro. In a secondary analysis of a randomized controlled trial, the Polyp Prevention Trial, a higher intake of one subclass, flavonols, was statistically significantly associated with a reduced risk of recurrent advanced adenoma. Most previous prospective studies on colorectal cancer evaluated only a limited number of flavonoid subclasses and intake ranges, yielding inconsistent results. OBJECTIVE: In this study, we examined...

  5. Prevalence and structural correlates of gender based violence among a prospective cohort of female sex workers

    OpenAIRE

    Shannon, Kate; Kerr, T.; Strathdee, S.A.; Shoveller, J; Montaner, J S; Tyndall, M W

    2009-01-01

    Objective To examine the prevalence and structural correlates of gender based violence against female sex workers in an environment of criminalised prostitution. Design Prospective observational study. Setting Vancouver, Canada during 2006-8. Participants Female sex workers 14 years of age or older (inclusive of transgender women) who used illicit drugs (excluding marijuana) and engaged in street level sex work. Main outcome measure Self reported gender based violence. Results Of 267 female s...

  6. Brain computer tomography in critically ill patients -- a prospective cohort study

    OpenAIRE

    Purmer Ilse M; van Iperen Erik P; Beenen Ludo F M; Kuiper Michael J; Binnekade Jan M; Vandertop Peter W; Schultz Marcus J; Horn Janneke

    2012-01-01

    Abstract Background Brain computer tomography (brain CT) is an important imaging tool in patients with intracranial disorders. In ICU patients, a brain CT implies an intrahospital transport which has inherent risks. The proceeds and consequences of a brain CT in a critically ill patient should outweigh these risks. The aim of this study was to critically evaluate the diagnostic and therapeutic yield of brain CT in ICU patients. Methods In a prospective observational study data were collected ...

  7. Factors associated with anxiety in critically ill patients: A prospective observational cohort study

    OpenAIRE

    Castillo, M. I.; Cooke, M.; Macfarlane, B; Aitken, L. M.

    2016-01-01

    Background: Anxiety is an unpleasant emotion that most intensive care patients experience. This emotion is an important issue in intensive care settings because of its prevalence, adverse effects and severity. Little is known about the factors associated with state and trait anxiety during critical illness. Objectives: To describe the patterns of state anxiety reported by intensive care patients, and identify factors associated with state and trait anxiety. Design: Prospective observ...

  8. Smoking, Alcohol, and Betel Quid and Oral Cancer: A Prospective Cohort Study

    OpenAIRE

    Shih-An Liu; Fun-Jou Chen; Shang-Heng Wu; Rong-San Jiang; Wen-Jiun Lin

    2011-01-01

    We aimed to investigate the association between smoking, alcoholic consumption, and betel quid chewing with oral cancer in a prospective manner. All male patients age ≥18 years who visited our clinic received an oral mucosa inspection. Basic data including personal habits were also obtained. A multivariate logistic regression model was utilized to determine relevant risk factors for developing oral cavity cancer. A total of 10,657 participants were enrolled in this study. Abnormal findings we...

  9. Intensive care acquired infection is an independent risk factor for hospital mortality: a prospective cohort study

    OpenAIRE

    Ylipalosaari, Pekka; Ala-Kokko, Tero I; Laurila, Jouko; Ohtonen, Pasi; Syrjälä, Hannu

    2006-01-01

    Introduction The aim of this study was to elucidate the impact of intensive care unit (ICU)-acquired infection on hospital mortality. Methods Patients with a longer than 48 hour stay in a mixed 10 bed ICU in a tertiary-level teaching hospital were prospectively enrolled between May 2002 and June 2003. Risk factors for hospital mortality were analyzed with a logistic regression model. Results Of 335 patients, 80 developed ICU-acquired infection. Among the patients with ICU-acquired infections,...

  10. Adult-onset Still's disease: current challenges and future prospects

    Directory of Open Access Journals (Sweden)

    Siddiqui M

    2016-03-01

    Full Text Available Mariam Siddiqui,1 Michael S Putman,2 Anisha B Dua,11Department of Rheumatology, 2Department of Internal Medicine, The University of Chicago Medical Center, Chicago, IL, USA Abstract: Adult-onset Still's disease (AOSD – a multi-systemic inflammatory condition characterized by high fevers, polyarthritis, an evanescent rash, and pharyngitis – has been a challenging condition to diagnose expediently and treat effectively. Questions remain regarding the underlying pathophysiology and etiology of AOSD. Pathognomonic diagnostic tests and reliable biomarkers remain undiscovered. Over the past decade, important progress has been made. Diagnostic criteria employing glycosylated ferritin have improved specificity. More important, novel biologic therapies have offered important clues to AOSD's underlying pathophysiology. Cytokine-specific biologic therapies have been instrumental in providing more effective treatment for disease refractory to conventional treatment. While IL-1 therapy has demonstrated efficacy in refractory disease, novel therapies targeting IL-6 and IL-18 show great promise and are currently under investigation. Keywords: adult-onset Still's disease, biomarkers, therapeutics

  11. Racial Variations in Radiation-Induced Skin Toxicity Severity: Data From a Prospective Cohort Receiving Postmastectomy Radiation

    Energy Technology Data Exchange (ETDEWEB)

    Wright, Jean L., E-mail: jwrigh71@jhmi.edu [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland (United States); Takita, Cristiane [Department of Radiation Oncology, University of Miami Sylvester Comprehensive Cancer Center, Miami, Florida (United States); Reis, Isildinha M. [Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida (United States); Department of Public Health Sciences, University of Miami, Miami, Florida (United States); Zhao, Wei; Lee, Eunkyung [Department of Public Health Sciences, University of Miami, Miami, Florida (United States); Hu, Jennifer J. [Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida (United States); Department of Public Health Sciences, University of Miami, Miami, Florida (United States)

    2014-10-01

    Purpose: Radiation-induced skin toxicity is one of the most symptomatic side effects of postmastectomy radiation therapy (PMRT). We sought to determine whether the severity of acute skin toxicity was greater in black patients in a prospective cohort receiving PMRT and to identify other predictors of more severe skin toxicity. Methods and Materials: We evaluated the first 110 patients in an ongoing prospective study assessing radiation-induced skin toxicity in patients receiving PMRT. We recorded patient demographics, body mass index (BMI), and disease and treatment characteristics. Logistic regression analyses were conducted to evaluate the effect of potential predictors on the risk of skin toxicity. Results: A total of 23.6% respondents self-identified as black, 5.5% as non-Hispanic white, 69.1% as Hispanic white, and 1.8% as other; 57% were postmenopausal, and 70.9% had BMI of >25. Median chest wall dose was 50 Gy, and mastectomy scar dose was 60 Gy. Most patients, 95.5%, were treated with a 0.5-cm bolus throughout treatment. There were no significant differences in patient characteristics in black versus non-black patients. At RT completion, moist desquamation was more common in black patients (73.1% vs 47.6%, respectively, P=.023), in postmenopausal patients (63.5% vs 40.4%, respectively, P=.016), and in those with BMI of ≥25 (60.3% vs 37.5%, respectively, P=.030). On multivariate analysis, the effects of black race (odds ratio [OR] = 7.46, P=.031), BMI ≥25 (OR = 2.95, P=.043) and postmenopausal status (OR = 8.26, P=.004) remained significant risk factors for moist desquamation. Conclusions: In this prospectively followed, racially diverse cohort of breast cancer patients receiving PMRT delivered in a uniform fashion, including the routine use of chest wall boost and bolus, black race, higher BMI, and postmenopausal status emerged as significant predictors of moist desquamation. There was a high frequency of moist desquamation, particularly in those

  12. Racial Variations in Radiation-Induced Skin Toxicity Severity: Data From a Prospective Cohort Receiving Postmastectomy Radiation

    International Nuclear Information System (INIS)

    Purpose: Radiation-induced skin toxicity is one of the most symptomatic side effects of postmastectomy radiation therapy (PMRT). We sought to determine whether the severity of acute skin toxicity was greater in black patients in a prospective cohort receiving PMRT and to identify other predictors of more severe skin toxicity. Methods and Materials: We evaluated the first 110 patients in an ongoing prospective study assessing radiation-induced skin toxicity in patients receiving PMRT. We recorded patient demographics, body mass index (BMI), and disease and treatment characteristics. Logistic regression analyses were conducted to evaluate the effect of potential predictors on the risk of skin toxicity. Results: A total of 23.6% respondents self-identified as black, 5.5% as non-Hispanic white, 69.1% as Hispanic white, and 1.8% as other; 57% were postmenopausal, and 70.9% had BMI of >25. Median chest wall dose was 50 Gy, and mastectomy scar dose was 60 Gy. Most patients, 95.5%, were treated with a 0.5-cm bolus throughout treatment. There were no significant differences in patient characteristics in black versus non-black patients. At RT completion, moist desquamation was more common in black patients (73.1% vs 47.6%, respectively, P=.023), in postmenopausal patients (63.5% vs 40.4%, respectively, P=.016), and in those with BMI of ≥25 (60.3% vs 37.5%, respectively, P=.030). On multivariate analysis, the effects of black race (odds ratio [OR] = 7.46, P=.031), BMI ≥25 (OR = 2.95, P=.043) and postmenopausal status (OR = 8.26, P=.004) remained significant risk factors for moist desquamation. Conclusions: In this prospectively followed, racially diverse cohort of breast cancer patients receiving PMRT delivered in a uniform fashion, including the routine use of chest wall boost and bolus, black race, higher BMI, and postmenopausal status emerged as significant predictors of moist desquamation. There was a high frequency of moist desquamation, particularly in those

  13. Trends in U.S. Adult Chronic Disease Mortality, 1960–1999: Age, Period, and Cohort Variations

    OpenAIRE

    Yang, Yang

    2008-01-01

    In this paper, I examine temporal changes in U.S. adult mortality by chronic disease cause of death and by sex over a 40-year period in the second half of the twentieth century. I apply age-period-cohort (APC) analyses that combine conventional approaches and a new method of model estimation to simultaneously account for age, period, and cohort variations in mortality rates for four leading causes of deaths, including heart disease, stroke, lung cancer, and breast cancer. The results show tha...

  14. Road traffic noise and incident myocardial infarction: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Mette Sørensen

    Full Text Available BACKGROUND: Both road traffic noise and ambient air pollution have been associated with risk for ischemic heart disease, but only few inconsistent studies include both exposures. METHODS: In a population-based cohort of 57 053 people aged 50 to 64 years at enrolment in 1993-1997, we identified 1600 cases of first-ever MI between enrolment and 2006. The mean follow-up time was 9.8 years. Exposure to road traffic noise and air pollution from 1988 to 2006 was estimated for all cohort members from residential address history. Associations between exposure to road traffic noise and incident MI were analysed in a Cox regression model with adjustment for air pollution (NO(x and other potential confounders: age, sex, education, lifestyle confounders, railway and airport noise. RESULTS: We found that residential exposure to road traffic noise (L(den was significantly associated with MI, with an incidence rate ratio IRR of 1.12 per 10 dB for both of the two exposure windows: yearly exposure at the time of diagnosis (95% confidence interval (CI: 1.02-1.22 and 5-years time-weighted mean (95% CI: 1.02-1.23 preceding the diagnosis. Visualizing of the results using restricted cubic splines showed a linear dose-response relationship. CONCLUSIONS: Exposure to long-term residential road traffic noise was associated with a higher risk for MI, in a dose-dependent manner.

  15. Prospective clinical trial of hepatitis B vaccination in adults with and without type-2 diabetes mellitus

    Science.gov (United States)

    Van Der Meeren, Olivier; Peterson, James T.; Dionne, Marc; Beasley, Richard; Ebeling, Peter R.; Ferguson, Murdo; Nissen, Michael D.; Rheault, Paul; Simpson, Richard W.; De Ridder, Marc; Crasta, Priya D.; Miller, Jacqueline M.; Trofa, Andrew F.

    2016-01-01

    ABSTRACT  Objective: Patients with diabetes mellitus are at increased risk for hepatitis B virus (HBV) infection and its complications. HBV vaccination is recommended for adults with diabetes in the United States and other countries. However, few studies have assessed safety and immunogenicity of hepatitis B vaccine in such patients. We assessed the safety and immunogenicity of recombinant hepatitis B vaccine in subjects with and without diabetes mellitus. Methods: Prospective, multi-country controlled study in 21 centers (www.clinicaltrials.gov NCT01627340). Four hundred and sixteen participants with Type-2 diabetes and 258 controls matched for age and body mass index (BMI) (2:1 ratio) received 3-doses of HBV vaccine (Engerix-B™, GSK Vaccines, Belgium) according to a 0, 1, 6 months schedule. Antibodies were measured against HBV surface antigen and expressed as seroprotection rates (anti-HBs ≥10mIU/mL) and geometric mean concentration (GMC). Results: The median age and BMI in patients with diabetes and controls (according-to-protocol cohort) were 54 y and 32.1 kg/m2, and 53 y and 30.8 kg/m2, respectively. Seroprotection rates (GMCs) one month post-dose-3 were 75.4% (147.6 mIU/mL) and 82.0% (384.2 mIU/mL) in patients with diabetes and controls, respectively. Age-stratified seroprotection rates for patients with diabetes were 88.5% (20–39 years), 81.2% (40–49 years), 83.2% (50–59 years), and 58.2% (≥60 years). The overall safety profile of hepatitis B vaccine was similar between groups. Conclusions: Hepatitis B vaccine is immunogenic in patients with diabetes and has a similar safety profile to vaccination in healthy controls. Because increasing age was generally associated with a reduction in seroprotection rates, hepatitis B vaccine should be administered as soon as possible after the diagnosis of diabetes. PMID:27123743

  16. The effect of alcohol advertising, marketing and portrayal on drinking behaviour in young people: systematic review of prospective cohort studies

    Directory of Open Access Journals (Sweden)

    Foxcroft David R

    2009-02-01

    Full Text Available Abstract Background The effect of alcohol portrayals and advertising on the drinking behaviour of young people is a matter of much debate. We evaluated the relationship between exposure to alcohol advertising, marketing and portrayal on subsequent drinking behaviour in young people by systematic review of cohort (longitudinal studies. Methods studies were identified in October 2006 by searches of electronic databases, with no date restriction, supplemented with hand searches of reference lists of retrieved articles. Cohort studies that evaluated exposure to advertising or marketing or alcohol portrayals and drinking at baseline and assessed drinking behaviour at follow-up in young people were selected and reviewed. Results seven cohort studies that followed up more than 13,000 young people aged 10 to 26 years old were reviewed. The studies evaluated a range of different alcohol advertisement and marketing exposures including print and broadcast media. Two studies measured the hours of TV and music video viewing. All measured drinking behaviour using a variety of outcome measures. Two studies evaluated drinkers and non-drinkers separately. Baseline non-drinkers were significantly more likely to have become a drinker at follow-up with greater exposure to alcohol advertisements. There was little difference in drinking frequency at follow-up in baseline drinkers. In studies that included drinkers and non-drinkers, increased exposure at baseline led to significant increased risk of drinking at follow-up. The strength of the relationship varied between studies but effect sizes were generally modest. All studies controlled for age and gender, however potential confounding factors adjusted for in analyses varied from study to study. Important risk factors such as peer drinking and parental attitudes and behaviour were not adequately accounted for in some studies. Conclusion data from prospective cohort studies suggest there is an association between

  17. Occurrence of aflatoxin M1 in urines from rural and urban adult cohorts in Bangladesh.

    Science.gov (United States)

    Ali, Nurshad; Hossain, Khaled; Blaszkewicz, Meinolf; Rahman, Mashiur; Mohanto, Nayan Chandra; Alim, Abdul; Degen, Gisela H

    2016-07-01

    Aflatoxins are important mycotoxins produced by Aspergillus flavus and A. parasiticus, moulds which contaminate mainly grains and nuts, especially in hot and humid climate. Presence of aflatoxin B1 (AFB1), the most toxic one and a potent hepatocarcinogen, has been reported in food and feed in Bangladesh and raised concerns about mycotoxin exposure in the population. Biomonitoring provides the best approach to assess human exposure from various sources and by all routes. Part of the ingested AFB1 is converted in the body to aflatoxin M1 (AFM1), a metabolite that has served as biomarker of AFB1 exposure, as it is excreted in urine, and thus enables non-invasive sampling, a relevant aspect in field studies. This investigation measured the AFM1 concentration in urines collected from adult residents of a rural (n = 52) and an urban (n = 43) area in the Rajshahi district of Bangladesh. The urinary levels of AFM1 were determined by enzyme-linked immunosorbent assay. AFM1 was detected in 46 % of all urine samples at a range of 31-348 pg/mL. The median and mean concentration of AFM1 in urine was 61 and 80 ± 60 pg/mL, respectively. A significant difference (p < 0.05) was found at the mean level of AFM1 between the rural (99 ± 71 pg/mL) and urban (54 ± 15 pg/mL) cohort. Urinary AFM1 levels did not show significant correlations with food frequency data or age, gender and body mass index of the participants. Among them, the highest mean AFM1 level (101 ± 71 pg/mL) was observed in the 50-60 years age group. In conclusion, detection frequency and urinary AFM1 levels in the Bangladeshi adults support concerns regarding their dietary exposure to AFB1. These first data warrant further biomarker-based studies in children and in cohorts of other parts of the country. PMID:26391179

  18. SENILE DEGENERATIVE CHANGES IN ADULT LUMBAR SPINE! - A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Garjesh Singh

    2015-11-01

    Full Text Available : BACKGROUND: Low back pain (LBP is a common presenting complaint affecting mostly middle aged and older person and traditionally considered as ageing process, but now-a-days large number of younger people are also affected by this debilitating chronic disorder. The cause of early onset of degenerative spine disease is multifactorial, but genetical predisposition plays very important role. AIMS AND OBJECTIVE: To find out association between genetic predisposition and degenerative spine disease in adult patients and to assess the pattern of MRI findings of various degenerative diseases in lumbo-sacral spine. MATERIAL AND METHOD: The present cross-sectional study had been performed among 100 selected patients in 1yr period, who presented with chief complaint of chronic low back pain. After taking detailed clinical and professional history, MRI of lumbosacral spine had been performed. Total 100 patients were divided in two groups on the basis of genetical predisposition. Prevalence and spectrum of degenerative changes were compared between both groups. RESULTS: Hundred patients of 20 to 35-year age had been selected with mean age of 27yr. Out of 100 patients; 47 were male and 53 were female. The most common degenerative findings were desiccation of disc (95% followed by disc bulge, herniation, spinal canal stenosis, ligamentum flavum hypertrophy, facet joint hypertrophy and modic changes. L4-L5 and L5- S1 were the most commonly involved spinal levels for any degenerative pathology. CONCLUSION: Good association is seen between early onset of degenerative spine disease and genetical predisposition in patients who have history of similar type degenerative spine disease in one or more first degree relatives in comparison to those patients who do not have any genetical predisposition. So it can be concluded that heredity play important role in early onset of degenerative spine disease in adults.

  19. Changes in oral microflora after full-mouth tooth extraction : A prospective cohort study

    NARCIS (Netherlands)

    de Waal, Yvonne C M; Winkel, Edwin G; Raangs, Gerwin C; van der Vusse, Marleen L; Rossen, John W A; van Winkelhoff, Arie Jan

    2014-01-01

    AIM: The aim of the study was to evaluate the effect of full-mouth tooth extraction on the oral microflora, with emphasis on the presence and load of Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis. MATERIAL AND METHODS: Adult patients (n = 30), with moderate to advanced periodont

  20. Diet in the Aetiology of Ulcerative Colitis: A European Prospective Cohort Study

    DEFF Research Database (Denmark)

    Hart, Andrew R; Luben, Robert; Olsen, Anja;

    2008-01-01

    Background/Aims: The causes of ulcerative colitis are unknown, although it is plausible that dietary factors are involved. Case-control studies of diet and ulcerative colitis are subject to recall biases. The aim of this study was to examine the prospective relationship between the intake of...... was supplied and the subjects were followed up for the development of ulcerative colitis. Each incident case was matched with four controls and dietary variables were divided into quartiles. Results: A total of 139 subjects with incident ulcerative colitis were identified. No dietary associations were...

  1. Prepregnancy low-carbohydrate dietary pattern and risk of gestational diabetes mellitus: a prospective cohort study

    DEFF Research Database (Denmark)

    Bao, Wei; Bowers, Katherine; Tobias, Deirdre K;

    2014-01-01

    BACKGROUND: Low-carbohydrate diets (LCDs) have been vastly popular for weight loss. The association between a low-carbohydrate dietary pattern and risk of gestational diabetes mellitus (GDM) remains unknown. OBJECTIVE: We aimed to prospectively examine the association of 3 prepregnancy low...... age, parity, family history of diabetes, physical activity, or overweight status. CONCLUSIONS: A prepregnancy low-carbohydrate dietary pattern with high protein and fat from animal-food sources is positively associated with GDM risk, whereas a prepregnancy low-carbohydrate dietary pattern with high...

  2. Preadmission quality of life can predict mortality in intensive care unit—A prospective cohort study

    DEFF Research Database (Denmark)

    Bukan, Ramin I; Møller, Ann M; Henning, Mattias A S;

    2014-01-01

    quality of life, assessed by SF-36 and SF-12, is as good at predicting ICU, 30-, and 90-day mortality as APACHE II in patients admitted to the ICU for longer than 24 hours. This indicates that estimated preadmission quality of life, potentially available in the pre-ICU setting, could aid decision making......PURPOSE: We sought to investigate whether preadmission quality of life could act as a predictor of mortality among patients admitted to the intensive care unit (ICU). MATERIALS AND METHODS: This is a prospective observational study of all patients above the age of 18 years admitted to the ICU with...

  3. Lower Injury Rates for Newcomers to Professional Soccer : a Prospective Cohort Study over Nine Consecutive Seasons

    OpenAIRE

    Kristenson, Karolina; Waldén, Markus; Ekstrand, Jan; Hägglund, Martin

    2013-01-01

    Background: No study has investigated whether newcomers to professional soccer have a different injury rate than established players.                      Purpose: The primary objective was to investigate whether being a newcomer to professional soccer influences injury rates. The secondary objective was to evaluate whether playing position and player age influence injury rates.                      Study Design: Cohort study; Level of evidence, 2.                      Methods: Twenty-six soc...

  4. A Prospective Cohort Study on Radiation-induced Hypothyroidism: Development of an NTCP Model

    Energy Technology Data Exchange (ETDEWEB)

    Boomsma, Marjolein J.; Bijl, Hendrik P.; Christianen, Miranda E.M.C.; Beetz, Ivo; Chouvalova, Olga; Steenbakkers, Roel J.H.M. [Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen (Netherlands); Laan, Bernard F.A.M. van der [Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Groningen (Netherlands); Wolffenbuttel, Bruce H.R. [Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen (Netherlands); Oosting, Sjoukje F. [Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen (Netherlands); Schilstra, Cornelis [Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen (Netherlands); Langendijk, Johannes A., E-mail: j.a.langendijk@umcg.nl [Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen (Netherlands)

    2012-11-01

    Purpose: To establish a multivariate normal tissue complication probability (NTCP) model for radiation-induced hypothyroidism. Methods and Materials: The thyroid-stimulating hormone (TSH) level of 105 patients treated with (chemo-) radiation therapy for head-and-neck cancer was prospectively measured during a median follow-up of 2.5 years. Hypothyroidism was defined as elevated serum TSH with decreased or normal free thyroxin (T4). A multivariate logistic regression model with bootstrapping was used to determine the most important prognostic variables for radiation-induced hypothyroidism. Results: Thirty-five patients (33%) developed primary hypothyroidism within 2 years after radiation therapy. An NTCP model based on 2 variables, including the mean thyroid gland dose and the thyroid gland volume, was most predictive for radiation-induced hypothyroidism. NTCP values increased with higher mean thyroid gland dose (odds ratio [OR]: 1.064/Gy) and decreased with higher thyroid gland volume (OR: 0.826/cm{sup 3}). Model performance was good with an area under the curve (AUC) of 0.85. Conclusions: This is the first prospective study resulting in an NTCP model for radiation-induced hypothyroidism. The probability of hypothyroidism rises with increasing dose to the thyroid gland, whereas it reduces with increasing thyroid gland volume.

  5. A Prospective Cohort Study on Radiation-induced Hypothyroidism: Development of an NTCP Model

    International Nuclear Information System (INIS)

    Purpose: To establish a multivariate normal tissue complication probability (NTCP) model for radiation-induced hypothyroidism. Methods and Materials: The thyroid-stimulating hormone (TSH) level of 105 patients treated with (chemo-) radiation therapy for head-and-neck cancer was prospectively measured during a median follow-up of 2.5 years. Hypothyroidism was defined as elevated serum TSH with decreased or normal free thyroxin (T4). A multivariate logistic regression model with bootstrapping was used to determine the most important prognostic variables for radiation-induced hypothyroidism. Results: Thirty-five patients (33%) developed primary hypothyroidism within 2 years after radiation therapy. An NTCP model based on 2 variables, including the mean thyroid gland dose and the thyroid gland volume, was most predictive for radiation-induced hypothyroidism. NTCP values increased with higher mean thyroid gland dose (odds ratio [OR]: 1.064/Gy) and decreased with higher thyroid gland volume (OR: 0.826/cm3). Model performance was good with an area under the curve (AUC) of 0.85. Conclusions: This is the first prospective study resulting in an NTCP model for radiation-induced hypothyroidism. The probability of hypothyroidism rises with increasing dose to the thyroid gland, whereas it reduces with increasing thyroid gland volume.

  6. Adult human neural stem cell therapeutics: Currentdevelopmental status and prospect

    Institute of Scientific and Technical Information of China (English)

    Hyun Nam; Kee-Hang Lee; Do-Hyun Nam; Kyeung Min Joo

    2015-01-01

    Over the past two decades, regenerative therapies usingstem cell technologies have been developed for variousneurological diseases. Although stem cell therapy is anattractive option to reverse neural tissue damage and torecover neurological deficits, it is still under developmentso as not to show significant treatment effects in clinicalsettings. In this review, we discuss the scientific andclinical basics of adult neural stem cells (aNSCs), andtheir current developmental status as cell therapeuticsfor neurological disease. Compared with other typesof stem cells, aNSCs have clinical advantages, suchas limited proliferation, inborn differentiation potentialinto functional neural cells, and no ethical issues. Inspite of the merits of aNSCs, difficulties in the isolationfrom the normal brain, and in the in vitro expansion,have blocked preclinical and clinical study using aNSCs.However, several groups have recently developed noveltechniques to isolate and expand aNSCs from normaladult brains, and showed successful applications ofaNSCs to neurological diseases. With new technologiesfor aNSCs and their clinical strengths, previous hurdlesin stem cell therapies for neurological diseases could beovercome, to realize clinically efficacious regenerativestem cell therapeutics.

  7. Apoptosis-Related Gene Expression in an Adult Cohort with Crimean-Congo Hemorrhagic Fever.

    Science.gov (United States)

    Guler, Nil; Eroglu, Cafer; Yilmaz, Hava; Karadag, Adil; Alacam, Hasan; Sunbul, Mustafa; Fletcher, Tom E; Leblebicioglu, Hakan

    2016-01-01

    Crimean-Congo Hemorrhagic Fever (CCHF) is a life threatening acute viral infection characterized by fever, bleeding, leukopenia and thrombocytopenia. It is a major emerging infectious diseases threat, but its pathogenesis remains poorly understood and few data exist for the role of apoptosis in acute infection. We aimed to assess apoptotic gene expression in leukocytes in a cross-sectional cohort study of adults with CCHF. Twenty participants with CCHF and 10 healthy controls were recruited at a tertiary CCHF unit in Turkey; at admission baseline blood tests were collected and total RNA was isolated. The RealTime ready Human Apoptosis Panel was used for real-time PCR, detecting differences in gene expression. Participants had CCHF severity grading scores (SGS) with low risk score (10 out of 20) and intermediate or high risk scores (10 out of 20) for mortality. Five of 20 participants had a fatal outcome. Gene expression analysis showed modulation of pro-apoptotic and anti-apoptotic genes that facilitate apoptosis in the CCHF patient group. Dominant extrinsic pathway activation, mostly related with TNF family members was observed. Severe and fatal cases suggest additional intrinsic pathway activation. The clinical significance of relative gene expression is not clear, and larger longitudinal studies with simultaneous measurement of host and viral factors are recommended. PMID:27304063

  8. Clinical and inflammatory characteristics of the European U-BIOPRED adult severe asthma cohort.

    Science.gov (United States)

    Shaw, Dominick E; Sousa, Ana R; Fowler, Stephen J; Fleming, Louise J; Roberts, Graham; Corfield, Julie; Pandis, Ioannis; Bansal, Aruna T; Bel, Elisabeth H; Auffray, Charles; Compton, Chris H; Bisgaard, Hans; Bucchioni, Enrica; Caruso, Massimo; Chanez, Pascal; Dahlén, Barbro; Dahlen, Sven-Erik; Dyson, Kerry; Frey, Urs; Geiser, Thomas; Gerhardsson de Verdier, Maria; Gibeon, David; Guo, Yi-Ke; Hashimoto, Simone; Hedlin, Gunilla; Jeyasingham, Elizabeth; Hekking, Pieter-Paul W; Higenbottam, Tim; Horváth, Ildikó; Knox, Alan J; Krug, Norbert; Erpenbeck, Veit J; Larsson, Lars X; Lazarinis, Nikos; Matthews, John G; Middelveld, Roelinde; Montuschi, Paolo; Musial, Jacek; Myles, David; Pahus, Laurie; Sandström, Thomas; Seibold, Wolfgang; Singer, Florian; Strandberg, Karin; Vestbo, Jorgen; Vissing, Nadja; von Garnier, Christophe; Adcock, Ian M; Wagers, Scott; Rowe, Anthony; Howarth, Peter; Wagener, Ariane H; Djukanovic, Ratko; Sterk, Peter J; Chung, Kian Fan

    2015-11-01

    U-BIOPRED is a European Union consortium of 20 academic institutions, 11 pharmaceutical companies and six patient organisations with the objective of improving the understanding of asthma disease mechanisms using a systems biology approach.This cross-sectional assessment of adults with severe asthma, mild/moderate asthma and healthy controls from 11 European countries consisted of analyses of patient-reported outcomes, lung function, blood and airway inflammatory measurements.Patients with severe asthma (nonsmokers, n=311; smokers/ex-smokers, n=110) had more symptoms and exacerbations compared to patients with mild/moderate disease (n=88) (2.5 exacerbations versus 0.4 in the preceding 12 months; pgastro-oesophageal reflux with lower lung function. Sputum eosinophil count was higher in severe asthma compared to mild/moderate asthma (median count 2.99% versus 1.05%; p=0.004) despite treatment with higher doses of inhaled and/or oral corticosteroids.Consistent with other severe asthma cohorts, U-BIOPRED is characterised by poor symptom control, increased comorbidity and airway inflammation, despite high levels of treatment. It is well suited to identify asthma phenotypes using the array of "omic" datasets that are at the core of this systems medicine approach. PMID:26357963

  9. PRIORITIES IN CONCEPT OF CARDIOVASCULAR RISK FACTORS IN IRRADIATED PATIENTS AT DISTANT PERIOD AFTER CHERNOBYL NUCLEAR DISASTER BASED ON PROSPECTIVE COHORT DATA

    Directory of Open Access Journals (Sweden)

    R. G. Oganov

    2016-01-01

    Full Text Available Aim. To study pathogenetic mechanisms and cardiovascular risk factors prospective cohort study in liquidators of consequences of Chernobyl Nuclear Disaster 13-20 years after an accident.Material and methods. 409 irradiated patients and 224 control patients comparable on the age and gender were involved into two-stage cohort prospective study with 4,5years period of observation. Database included results of standard questionnaires, social and demographic description, education, family status, smoking and alcohol habits, anthropometry, fasting lipids and glucose, blood pressure, ECG, arrhythmias on ECG monitoring, heart rhythm variability, Echocardiography, thyroid ultrasound image, spirometry, transesophageal electrophysiological study of heart conduction system, exercise tests, functional class of ischemic heart disease, stage of arterial hypertension, fatal/nonfatal end-points, as well as neurologist, endocrinologist and cardiologist conclusions. Totally 267 variables were included in the analysis.Results. Spectrum of active cardiovascular risk factors in cohort of irradiated patients was entirely different from this in control patients. Determinative value for irradiated patients was related with night hypersympathetic activity, ANDS syndrome (Autonomic Nervous Dysfunction on hyperSympathetic type and less related with decreased airway conductance in small bronchial tubes.Conclusion. Comparative prospective cohort study in liquidators of consequences of Chernobyl Nuclear Disaster 13-20 years after an accident revealed highly significant new and permanently acting cardiovascular risk factors. These data let to work out appropriate approaches to therapy and prevention of cardiovascular diseases.

  10. Multiple medication use in older patients in post-acute transitional care: a prospective cohort study

    OpenAIRE

    Runganga M; Peel NM; Hubbard RE

    2014-01-01

    Maureen Runganga,1,2 Nancye M Peel,2 Ruth E Hubbard2,3 1The Prince Charles Hospital, Chermside, QLD, Australia; 2Centre for Research in Geriatric Medicine, The University of Queensland School of Medicine, QLD, Australia; 3Princess Alexandra Hospital, Woolloongabba, QLD, Australia Background: Older adults with a range of comorbidities are often prescribed multiple medications, which may impact on their function and cognition and increase the potential for drug interactions and adverse events...

  11. Survival with Treated and Well-Controlled Blood Pressure: Findings from a Prospective Cohort Study

    OpenAIRE

    Debbie A. Lawlor; Kim, Lois; Morris, Richard; Amuzu, Antoinette; Whincup, Peter; Ebrahim, Shah

    2011-01-01

    Aim To compare survival and incident cardiovascular disease between normotensive, untreated hypertensive, treated and poorly-controlled hypertensive and treated and well-controlled hypertensive adults. Methods and Results Data from the British Regional Heart Study (men) and British Women's Heart and Health Study (women) were used (N = 6476). Blood pressure and treatment were assessed at baseline (1998–2001) when participants were aged 60–79 years and participants were followed up for a median...

  12. The relationship of primary health care use with persistence of insomnia: a prospective cohort study

    OpenAIRE

    Hayward Richard A; Jordan Kelvin P; Croft Peter

    2012-01-01

    Abstract Background Prevalence of insomnia symptoms in the general population is high. Insomnia is linked with high health care use and within primary care there are a number of treatment options available. The objective of this study was to determine the association of persistence and remission of insomnia with primary health care using a longitudinal study. Methods A postal survey of registered adult (over 18 years) populations of five UK general practices, repeated after 1 year, linked to ...

  13. Self-Reports of Increased Prospective and Retrospective Memory Problems in Adults with Developmental Dyslexia.

    Science.gov (United States)

    Smith-Spark, James H; Zięcik, Adam P; Sterling, Christopher

    2016-08-01

    Short-term and working memory problems in dyslexia are well-documented, but other memory domains have received little empirical scrutiny, despite some evidence to suggest that they might be impaired. Prospective memory is memory for delayed intentions, whilst retrospective memory relates to memory for personally experienced past events. To gain an understanding of subjective everyday memory experience, a self-report measure designed to tap prospective and retrospective memory was administered to 28 adults with dyslexia and 26 IQ-matched adults without dyslexia. Adults with dyslexia reported experiencing significantly more frequent problems with memory than the adults without dyslexia. Group differences were found across seven out of the eight questionnaire scales. Further to these analyses, the participants' own ratings were compared with proxy ratings provided by close associates. The perception of poorer memory abilities in the participants did not differ between respondent types. The self-reported difficulties are, thus, unlikely to be the result of lowered self-esteem or metacognitive awareness. More frequent difficulties with both types of memory would seem, therefore, to be experienced by adults with dyslexia in everyday life. Further laboratory-based research is recommended to explore both memory domains in dyslexia and to identify the cognitive mechanisms by which these problems occur. Copyright © 2016 John Wiley & Sons, Ltd. PMID:27121331

  14. Reactivity to exclusion prospectively predicts social anxiety symptoms in young adults.

    Science.gov (United States)

    Levinson, Cheri A; Langer, Julia K; Rodebaugh, Thomas L

    2013-09-01

    Peer victimization leads to negative outcomes such as increased anxiety and depression. The prospective relationship between peer victimization and social anxiety in children and adolescents is well established, and adults with social anxiety disorder (SAD) are more likely than individuals with other anxiety disorders to report a history of teasing. However, a crucial bridge between these findings (peer victimization in young adults) is missing. We manipulated perceptions of peer exclusion in a young adult sample (N=108) using the Cyberball Ostracism Task. Reactivity to exclusion prospectively predicted social anxiety symptoms at a 2-month follow-up, whereas self-reported teasing during high school and current relational victimization did not. This research suggests that reactions to peer victimization may be a worthwhile target for clinical interventions in young adults. Targeting how young adults react to stressful social interactions such as exclusion may help prevent the development of SAD. Future research should test if reactivity to exclusion plays a role in the relationship between other disorders (e.g., depression) and peer victimization. PMID:23768673

  15. Seven-day mortality can be predicted in medical patients by blood pressure, age, respiratory rate, loss of independence, and peripheral oxygen saturation (the PARIS score: a prospective cohort study with external validation.

    Directory of Open Access Journals (Sweden)

    Mikkel Brabrand

    Full Text Available Most existing risk stratification systems predicting mortality in emergency departments or admission units are complex in clinical use or have not been validated to a level where use is considered appropriate. We aimed to develop and validate a simple system that predicts seven-day mortality of acutely admitted medical patients using routinely collected variables obtained within the first minutes after arrival.This observational prospective cohort study used three independent cohorts at the medical admission units at a regional teaching hospital and a tertiary university hospital and included all adult (≥ 15 years patients. Multivariable logistic regression analysis was used to identify the clinical variables that best predicted the endpoint. From this, we developed a simplified model that can be calculated without specialized tools or loss of predictive ability. The outcome was defined as seven-day all-cause mortality. 76 patients (2.5% met the endpoint in the development cohort, 57 (2.0% in the first validation cohort, and 111 (4.3% in the second. Systolic blood Pressure, Age, Respiratory rate, loss of Independence, and peripheral oxygen Saturation were associated with the endpoint (full model. Based on this, we developed a simple score (range 0-5, ie, the PARIS score, by dichotomizing the variables. The ability to identify patients at increased risk (discriminatory power and calibration was excellent for all three cohorts using both models. For patients with a PARIS score ≥ 3, sensitivity was 62.5-74.0%, specificity 85.9-91.1%, positive predictive value 11.2-17.5%, and negative predictive value 98.3-99.3%. Patients with a score ≤ 1 had a low mortality (≤ 1%; with 2, intermediate mortality (2-5%; and ≥ 3, high mortality (≥ 10%.Seven-day mortality can be predicted upon admission with high sensitivity and specificity and excellent negative predictive values.

  16. Psychosocial risk factors and heart failure hospitalization: a prospective cohort study

    DEFF Research Database (Denmark)

    Rod, Naja Hulvej; Andersen, Ingelise; Prescott, Eva

    2011-01-01

    Prospective studies on the role of psychosocial factors in heart failure development are virtually nonexistent. The authors aimed to address the effect of psychosocial factors on the risk of heart failure hospitalization in men and women free of cardiovascular disease. In 1991-1993, the 8...... population reported some degree of vital exhaustion. The vital exhaustion score was associated with a higher risk of heart failure in a dose-response manner (P <0.002), with high vital exhaustion being associated with a 2-fold higher risk of heart failure in both men (hazard ratio = 1.93, 95% confidence...... population, even a modestly higher risk of heart failure associated with vital exhaustion may be of importance in the planning of future preventive strategies for heart failure....

  17. Sociodemographic status, stress, and risk of prostate cancer. A prospective cohort study

    DEFF Research Database (Denmark)

    Nielsen, Naja Rod; Kristensen, Tage S; Zhang, Zuo-Feng;

    2007-01-01

    PURPOSE: The social gradient in prostate cancer incidence observed in several studies may be a result of differential access to prostate cancer screening. We aim to assess if socioeconomic status, stress, and marital status are associated with prostate cancer risk in a population with free access...... to health care. METHODS: The 5,496 men who participated in the Copenhagen City Heart Study were asked about their income, educational level, stress level, and marital status during 1981-1983. These men were prospectively followed up in the Danish Cancer Registry until the end of 2002 and fewer than 0...... prostate cancer risk according to stress (HR = 0.99; 95% CI: 0.90-1.09) or marital status. CONCLUSION: In a racially homogeneous population of Caucasians with free access to health care, we found no evidence of a relation between sociodemographic variables or stress and subsequent risk of prostate cancer....

  18. Self-reported stress and risk of endometrial cancer: a prospective cohort study

    DEFF Research Database (Denmark)

    Nielsen, Naja Rod; Strandberg-Larsen, Katrine; Grønbaek, Morten;

    2007-01-01

    OBJECTIVES: To assess a possible relationship between perceived stress and first-time incidence of primary endometrial cancer. Psychological stress may affect the synthesis and metabolism of estrogens and thereby be related to risk of endometrial cancer. METHODS: The 6760 women participating in the...... Copenhagen City Heart Study were asked about their stress level at baseline from 1981 to 1983. These women were prospectively followed up in the Danish nationwide cancer registry until 2000 and <0.1% were lost to follow-up. Cox proportional hazard models were used to analyze data. RESULTS: During follow......-up, 72 women were diagnosed with endometrial cancer. For each increase in stress level on a 7-point stress scale, there was a lower risk of primary endometrial cancer (hazard ratio (HR) = 0.88; 95% confidence interval (CI), 0.76-1.01). This inverse association was particularly strong in women who...

  19. Travel style is a major risk factor for diarrhoea in India: a prospective cohort study.

    Science.gov (United States)

    Schindler, V M; Jaeger, V K; Held, L; Hatz, C; Bühler, S

    2015-07-01

    Although some studies suggested specific foods/beverages as risk factors for travellers' diarrhoea (TD), details of transmission remain unclear. We assessed the influence of travel style (luxury/middle-class versus backpacking) on TD risk. TD attack rates were compared in a prospective study among travellers to India at the University of Zurich's Travel Clinic. Information on consumption of foods/beverages was collected. Seventy-one luxury/middle-class travellers and 21 backpackers completed the study; overall 37% suffered from TD (62% backpackers, 30% luxury/middle-class travellers, OR 4.43, p 0.022). Travel style rather than the consumption of specific foods/beverages appears to be a risk factor for TD development. PMID:25882361

  20. Work Disability among Employees with Diabetes: Latent Class Analysis of Risk Factors in Three Prospective Cohort Studies.

    Directory of Open Access Journals (Sweden)

    Marianna Virtanen

    Full Text Available Studies of work disability in diabetes have examined diabetes as a homogeneous disease. We sought to identify subgroups among persons with diabetes based on potential risk factors for work disability.Participants were 2,445 employees with diabetes from three prospective cohorts (the Finnish Public Sector study, the GAZEL study, and the Whitehall II study. Work disability was ascertained via linkage to registers of sickness absence and disability pensions during a follow-up of 4 years. Study-specific latent class analysis was used to identify subgroups according to prevalent comorbid disease and health-risk behaviours. Study-specific associations with work disability at follow-up were pooled using fixed-effects meta-analysis.Separate latent class analyses for men and women in each cohort supported a two-class solution with one subgroup (total n = 1,086; 44.4% having high prevalence of chronic somatic diseases, psychological symptoms, obesity, physical inactivity and abstinence from alcohol and the other subgroup (total n = 1,359; 55.6% low prevalence of these factors. In the adjusted meta-analyses, participants in the 'high-risk' group had more work disability days (pooled rate ratio = 1.66, 95% CI 1.38-1.99 and more work disability episodes (pooled rate ratio = 1.33, 95% CI 1.21-1.46. These associations were similar in men and women, younger and older participants, and across occupational groups.Diabetes is not a homogeneous disease in terms of work disability risk. Approximately half of people with diabetes are assigned to a subgroup characterised by clustering of comorbid health conditions, obesity, physical inactivity, abstinence of alcohol, and associated high risk of work disability; the other half to a subgroup characterised by a more favourable risk profile.

  1. The high burden of infant deaths in rural Burkina Faso: a prospective community-based cohort study

    Directory of Open Access Journals (Sweden)

    Diallo Abdoulaye

    2012-09-01

    Full Text Available Abstract Background Infant mortality rates (IMR remain high in many sub-Saharan African countries, especially in rural settings where access to health services may be limited. Studies in such communities can provide relevant data on the burden of and risk factors for infant death. We measured IMR and explored risk factors for infant death in a cohort of children born in Banfora Health District, a rural area in South-West Burkina Faso. Methods A prospective community-based cohort study was nested within the PROMISE-EBF trial (NCT00397150 in 24 villages of the study area. Maternal and infant baseline characteristics were collected at recruitment and after birth, respectively. Home visits were conducted at weeks 3, 6, 12, 24 and 52 after birth. Descriptive statistics were calculated using robust standard errors to account for cluster sampling. Cox multivariable regression was used to investigate potential risk factors for infant death. Results Among the 866 live born children included in the study there were 98 infant deaths, yielding an IMR of 113 per 1000 live births (95% CI: 89–143. Over 75% of infant deaths had occurred by 6 months of age and the post neonatal infant mortality rate was 67 per 1000 live births (95% CI: 51–88. Infections (35% and preterm births complications (23% were the most common probable causes of death by 6 months. Multivariable analyses identified maternal history of child death, polygyny, twin births and poor anthropometric z-scores at week-3 as factors associated with increased risk of infant death. Conclusions We observed a very high IMR in a rural area of Burkina Faso, a country where 75% of the population lives in rural settings. Community-based health interventions targeting mothers and children at high risk are urgently needed to reduce the high burden of infant deaths in these areas.

  2. Telomere length in white blood cell DNA and lung cancer: a pooled analysis of three prospective cohorts.

    Science.gov (United States)

    Seow, Wei Jie; Cawthon, Richard M; Purdue, Mark P; Hu, Wei; Gao, Yu-Tang; Huang, Wen-Yi; Weinstein, Stephanie J; Ji, Bu-Tian; Virtamo, Jarmo; Hosgood, H Dean; Bassig, Bryan A; Shu, Xiao-Ou; Cai, Qiuyin; Xiang, Yong-Bing; Min, Shen; Chow, Wong-Ho; Berndt, Sonja I; Kim, Christopher; Lim, Unhee; Albanes, Demetrius; Caporaso, Neil E; Chanock, Stephen; Zheng, Wei; Rothman, Nathaniel; Lan, Qing

    2014-08-01

    We investigated the relationship between telomere length and lung cancer in a pooled analysis from three prospective cohort studies: the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial, conducted among men and women in the United States, and previously published data from the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Trial conducted among male smokers in Finland, and the Shanghai Women's Health Study (SWHS), which is comprised primarily of never-smokers. The pooled population included 847 cases and 847 controls matched by study, age, and sex. Leukocyte telomere length was measured by a monochrome multiplex qPCR assay. We used conditional logistic regression models to calculate ORs and their 95% confidence intervals (CI) for the association between telomere length and lung cancer risk, adjusted for age and pack-years of smoking. Longer telomere length was associated with increased lung cancer risk in the pooled analysis [OR (95% CI) by quartile: 1.00; 1.24 (0.90-1.71); 1.27 (0.91-1.78); and 1.86 (1.33-2.62); P trend = 0.000022]. Findings were consistent across the three cohorts and strongest for subjects with very long telomere length, i.e., lung cancer risks for telomere length [OR (95% CI)] in the upper half of the fourth quartile were 2.41 (1.28-4.52), 2.16 (1.11-4.23), and 3.02(1.39-6.58) for the PLCO trial, the ATBC trial, and the SWHS, respectively. In addition, the association persisted among cases diagnosed more than 6 years after blood collection and was particularly evident for female adenocarcinoma cases. Telomere length in white blood cell DNA may be a biomarker of future increased risk of lung cancer in diverse populations. PMID:24853549

  3. Greater maternal weight gain during pregnancy predicts a large but lean fetal phenotype: a prospective cohort study.

    Science.gov (United States)

    Hure, Alexis Jayne; Collins, Clare Elizabeth; Giles, Warwick Bruce; Paul, Jonathan Winter; Smith, Roger

    2012-10-01

    The objective of this study is to describe the fetal phenotype in utero and its associations with maternal pre-pregnancy weight and gestational weight gain. This prospective longitudinal cohort included 179 Australian women with singleton pregnancies. Serial ultrasound measurements were performed at 19, 25, 30 and 36 (±1) weeks gestation and maternal anthropometry were collected concurrently. The ultrasound scans included the standard fetal biometry of head circumference, biparietal diameter, abdominal circumference, and femur length, and body composition at the abdomen and mid-thigh, including fat and lean mass cross-sectional areas. Maternal gestational weight gain was compared to current clinical guidelines. The participants had an average of 3.7 ± 0.8 scans and birth data were available for 165 neonates. Fifty four per cent of the cohort gained weight in excess of current recommendations, according to pre-pregnancy body mass index (BMI). Maternal gestational weight positively predicted fetal abdominal circumference (P 0.029) and lean abdominal mass area (P 0.046) in linear mixed model regression analysis, adjusted for known and potential confounders. At any pre-pregnancy BMI gaining weight above the current recommendations resulted in a larger fetus according to standard biometry, because of significantly larger lean muscle mass at the abdomen (P 0.024) and not due to an increase in fat mass (P 0.463). We have demonstrated the importance of maternal weight gain, independent of pre-pregnancy BMI, to support the growth of a large but lean fetus. Prenatal counselling should focus on achieving a healthy BMI prior to conception so that gestational weight gain restrictions can be minimised. PMID:22052171

  4. Neck circumference predicts renal function decline in overweight women: A community-based prospective cohort study.

    Science.gov (United States)

    Yoon, Chang-Yun; Park, Jung Tak; Jhee, Jong Hyun; Kee, Youn Kyung; Seo, Changhwan; Lee, Misol; Cha, Min-Uk; Jung, Su-Young; Park, Seohyun; Yun, Hae-Ryong; Kwon, Young Eun; Oh, Hyung Jung; Han, Seung Hyeok; Yoo, Tae-Hyun; Kang, Shin-Wook

    2016-09-01

    Chronic kidney disease (CKD) is characterized by increased risks of morbidity and mortality. Upper-body subcutaneous fat, which is commonly estimated from the neck circumference (NC), was revealed to be the main reservoir of circulating nonesterified fatty acids in overweight patients. Despite a close association between NC and metabolic complications, the relationship of NC with renal function has not been fully investigated. In this study, the impact of NC on the development of incident CKD was elucidated.The data were retrieved from the Korean Genome and Epidemiology Study cohort. The subjects were followed at 2-year intervals from 2003 to 2011. Overweight was defined as a body mass index of ≥23 kg/m. A total of 4298 cohort subjects were screened. After exclusion, 2268 overweight subjects were included for the final analysis. The primary end point was incident CKD, which was defined as a composite of estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m or the development of proteinuria.The mean patient age was 36.3 ± 3.0 years, and 1285 (56.7%) were men. They were divided into 2 groups according to the median NC in male and female subjects, separately. In both sexes, hypertension (men, P < 0.001; women, P = 0.009) and diabetes (men, P = 0.002; women, P < 0.001) were significantly more prevalent in the big NC group than in the small NC group. In contrast, eGFR was significantly lower only in male subjects of the big NC group (P < 0.001), whereas it was comparable between the small and big NC groups (P = 0.167). In multivariate Cox proportional hazards regression analysis, NC values were independently associated with incident CKD development in female subjects after adjusting for multiple confounding factors (per 1 cm increase, hazard ratio [95% confidence interval] = 1.159 [1.024-1.310], P = 0.019) but not in male subjects.NC is independently associated with the development of CKD in overweight female subjects, suggesting

  5. Aromas of Salvia species enhance everyday prospective memory performance in healthy young adults

    OpenAIRE

    2014-01-01

    Research has previously demonstrated that aromas of both Salvia officinalis and Salvia lavandulaefolia are capable of modulating aspects of retrospective memory, attention and mood. This study is the first to report the potential for these aromas to enhance everyday prospective memory performance in healthy young adults. In an independent groups design, three conditions, Salvia officinalis aroma, Saliva lavandulaefolia aroma and no aroma were employed with 45 healthy volunteers in each cond...

  6. Post-breeding prospecting trips of adult Sandwich Terns Thalasseus sandvicensis

    OpenAIRE

    Fijn, Ruben; Wolf, Pim; Courtens, Wouter; Verstraete, Hilbran; Stienen,Eric; Iliszko, Lech; Poot, Martin

    2014-01-01

    Multiple tracking methods (colour-rings, plumage-markings and GPS-loggers) revealed that adult Sandwich Terns Thalasseus sandvicensis from the Netherlands showed prospecting behaviour in other colonies within Northwest Europe. Birds were recorded from a few kilometres to over 850 km away and in different countries around the Southern North Sea. Our data suggest large-scale connectivity between Northwest European Sandwich Tern colonies. Such connectivity is potentially of great importance when...

  7. Post-breeding prospecting trips of adult Sandwich Terns Thalasseus sandvicensis

    OpenAIRE

    Fijn, R.C.; P. Wolf; Courtens, W; Verstraete, H.; Stienen, E.W.M.; Iliszko, L.; Poot, M.J.M.

    2014-01-01

    Capsule Multiple tracking methods (colour-rings, plumage-markings and GPS-loggers) revealed that adult Sandwich Terns Thalasseus sandvicensis from the Netherlands showed prospecting behaviour in other colonies within Northwest Europe. Birds were recorded from a few kilometres to over 850 km away and in different countries around the Southern North Sea. Our data suggest large-scale connectivity between Northwest European Sandwich Tern colonies. Such connectivity is potentially of great importa...

  8. Quality of care after acute coronary syndromes in a prospective cohort with reasons for non-prescription of recommended medications.

    Directory of Open Access Journals (Sweden)

    Reto Auer

    Full Text Available Adherence to guidelines is associated with improved outcomes of patients with acute coronary syndrome (ACS. Clinical registries developed to assess quality of care at discharge often do not collect the reasons for non-prescription for proven efficacious preventive medication in Continental Europe. In a prospective cohort of patients hospitalized for an ACS, we aimed at measuring the rate of recommended treatment at discharge, using pre-specified quality indicators recommended in cardiologic guidelines and including systematic collection of reasons for non-prescription for preventive medications.In a prospective cohort with 1260 patients hospitalized for ACS, we measured the rate of recommended treatment at discharge in 4 academic centers in Switzerland. Performance measures for medication at discharge were pre-specified according to guidelines, systematically collected for all patients and included in a centralized database.Six hundred and eighty eight patients(54.6% were discharged with a main diagnosis of STEMI, 491(39% of NSTEMI and 81(6.4% of unstable angina. Mean age was 64 years and 21.3% were women. 94.6% were prescribed angiotensin converting enzyme inhibitors/angiotensin II receptor blockers at discharge when only considering raw prescription rates, but increased to 99.5% when including reasons non-prescription. For statins, rates increased from 98% to 98.6% when including reasons for non-prescription and for beta-blockers, from 82% to 93%. For aspirin, rates further increased from 99.4% to 100% and from to 99.8% to 100% for P2Y12 inhibitors.We found a very high adherence to ACS guidelines for drug prescriptions at discharge when including reasons for non-prescription to drug therapy. For beta-blockers, prescription rates were suboptimal, even after taking into account reason for non-prescription. In an era of improving quality of care to achieve 100% prescription rates at discharge unless contra-indicated, pre-specification of reasons

  9. Prevalence rate, predictors and long-term course of probable posttraumatic stress disorder after major trauma: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Haagsma Juanita A

    2012-12-01

    Full Text Available Abstract Background Among trauma patients relatively high prevalence rates of posttraumatic stress disorder (PTSD have been found. To identify opportunities for prevention and early treatment, predictors and course of PTSD need to be investigated. Long-term follow-up studies of injury patients may help gain more insight into the course of PTSD and subgroups at risk for PTSD. The aim of our long-term prospective cohort study was to assess the prevalence rate and predictors, including pre-hospital trauma care (assistance of physician staffed Emergency Medical Services (EMS at the scene of the accident, of probable PTSD in a sample of major trauma patients at one and two years after injury. The second aim was to assess the long-term course of probable PTSD following injury. Methods A prospective cohort study was conducted of 332 major trauma patients with an Injury Severity Score (ISS of 16 or higher. We used data from the hospital trauma registry and self-assessment surveys that included the Impact of Event Scale (IES to measure probable PTSD symptoms. An IES-score of 35 or higher was used as indication for the presence of probable PTSD. Results One year after injury measurements of 226 major trauma patients were obtained (response rate 68%. Of these patients 23% had an IES-score of 35 or higher, indicating probable PTSD. At two years after trauma the prevalence rate of probable PTSD was 20%. Female gender and co-morbid disease were strong predictors of probable PTSD one year following injury, whereas minor to moderate head injury and injury of the extremities (AIS less than 3 were strong predictors of this disorder at two year follow-up. Of the patients with probable PTSD at one year follow-up 79% had persistent PTSD symptoms a year later. Conclusions Up to two years after injury probable PTSD is highly prevalent in a population of patients with major trauma. The majority of patients suffered from prolonged effects of PTSD, underlining the

  10. Prevalence rate, predictors and long-term course of probable posttraumatic stress disorder after major trauma: a prospective cohort study

    Science.gov (United States)

    2012-01-01

    Background Among trauma patients relatively high prevalence rates of posttraumatic stress disorder (PTSD) have been found. To identify opportunities for prevention and early treatment, predictors and course of PTSD need to be investigated. Long-term follow-up studies of injury patients may help gain more insight into the course of PTSD and subgroups at risk for PTSD. The aim of our long-term prospective cohort study was to assess the prevalence rate and predictors, including pre-hospital trauma care (assistance of physician staffed Emergency Medical Services (EMS) at the scene of the accident), of probable PTSD in a sample of major trauma patients at one and two years after injury. The second aim was to assess the long-term course of probable PTSD following injury. Methods A prospective cohort study was conducted of 332 major trauma patients with an Injury Severity Score (ISS) of 16 or higher. We used data from the hospital trauma registry and self-assessment surveys that included the Impact of Event Scale (IES) to measure probable PTSD symptoms. An IES-score of 35 or higher was used as indication for the presence of probable PTSD. Results One year after injury measurements of 226 major trauma patients were obtained (response rate 68%). Of these patients 23% had an IES-score of 35 or higher, indicating probable PTSD. At two years after trauma the prevalence rate of probable PTSD was 20%. Female gender and co-morbid disease were strong predictors of probable PTSD one year following injury, whereas minor to moderate head injury and injury of the extremities (AIS less than 3) were strong predictors of this disorder at two year follow-up. Of the patients with probable PTSD at one year follow-up 79% had persistent PTSD symptoms a year later. Conclusions Up to two years after injury probable PTSD is highly prevalent in a population of patients with major trauma. The majority of patients suffered from prolonged effects of PTSD, underlining the importance of prevention

  11. Early detection and prediction of cardiotoxicity after radiation therapy for breast cancer: the BACCARAT prospective cohort study

    International Nuclear Information System (INIS)

    Radiotherapy (RT) for breast cancer presents a benefit in terms of reducing local recurrence and deaths resulting from breast cancer but it can lead to secondary effects due to the presence of neighboring cardiac normal tissues within the irradiation field. Breast RT has been shown to be associated with long-term increased risk of heart failure, coronary artery disease, myocardial infarction and finally cardiovascular death more than 10 years after RT. However, there is still a lack of knowledge for early cardiotoxicity induced by breast RT that can appear long before the onset of clinically significant cardiac events. Based on a 2-year follow-up prospective cohort of patients treated with breast RT, the BACCARAT (BreAst Cancer and CArdiotoxicity Induced by RAdioTherapy) study aims to enhance knowledge on detection and prediction of early subclinical cardiac dysfunction and lesions induced by breast RT and on biological mechanisms potentially involved, based on functional and anatomical cardiac imaging combined with simultaneous assessment of multiple circulating biomarkers and accurate heart dosimetry. BACCARAT study consists in a monocentric prospective cohort study that will finally include 120 women treated with adjuvant 3D CRT for breast cancer, and followed for 2 years after RT. Women aged 50 to 70 years, treated for breast cancer and for whom adjuvant 3D CRT is indicated, without chemotherapy are eligible for the study. Baseline (before RT) and follow-up data include measurements of functional myocardial dysfunction including strain and strain rate based on 2D-speckle tracking echocardiography, anatomical coronary lesions including description of plaques in segments of coronary arteries based on Coronary computed tomography angiography, and a wide panel of circulating biomarkers. The absorbed dose is evaluated for the whole heart and its substructures, in particular the coronary arteries. Analysis on occurrence and evolution of subclinical cardiac lesions

  12. Hemodialysis outcomes in a global sample of children and young adult hemodialysis patients: the PICCOLO MONDO cohort

    OpenAIRE

    Ferris, Maria; Gibson, Keisha; Plattner, Brett; Gipson, Debbie S.; Kotanko, Peter; Marcelli, Daniele; Marelli, Cristina; Etter, Michael; Carioni, Paola; von Gersdorff, Gero; Xu, Xiaoqi; Kooman, Jeroen P.; Xiao, Qingqing; van der Sande, Frank M.; Power, Albert

    2016-01-01

    Background The aim of this study was to describe the experience of pediatric and young adult hemodialysis (HD) patients from a global cohort. Methods The Pediatric Investigation and Close Collaborative Consortium for Ongoing Life Outcomes for MONitoring Dialysis Outcomes (PICCOLO MONDO) study provided de-identified electronic information of 3244 patients, ages 0–30 years from 2000 to 2012 in four regions: Asia, Europe, North America and South America. The study sample was categorized into ped...

  13. Cancer Risk Associated with Insulin Glargine among Adult Type 2 Diabetes Patients – A Nationwide Cohort Study

    OpenAIRE

    Chang, Chia-Hsuin; Toh, Sengwee; Lin, Jou-Wei; Chen, Shu-Ting; Kuo, Chuei-Wen; Chuang, Lee-Ming; Lai, Mei-Shu

    2011-01-01

    Background Preclinical and observational studies raise the concern about the safety of insulin glargine in terms of cancer initiation and promotion. This study is designed to examine cancer incidence associated with use of insulin glargine vs. intermediate/long-acting human insulin (HI). Methodology A retrospective cohort study using the Taiwan National Health Insurance claims database was conducted to identify adult patients with type 2 diabetes mellitus and without a history of cancer who i...

  14. Predictors of attendance to group exercise: a cohort study of older adults in long-term care facilities

    OpenAIRE

    Finnegan, Susanne; Bruce, Julie; Lamb, Sarah E; Griffiths, Frances

    2015-01-01

    Background The benefits of regular exercise and physical activity are well known. Those living in long-term care are often frail, but have the potential to benefit from physical activity; yet are less likely to be offered exercise. Promoting exercise within residential and nursing homes may reduce health risks associated with inactivity in this population. The aim of this cohort study is to identify predictors of attendance at physiotherapy led exercise groups offered to older adults residing...

  15. Childbirth and symptoms of postpartum depression and anxiety: a prospective birth cohort study.

    Science.gov (United States)

    Bell, A F; Carter, C S; Davis, J M; Golding, J; Adejumo, O; Pyra, M; Connelly, J J; Rubin, L H

    2016-04-01

    We investigated associations between aspects of childbirth and elevated postpartum symptoms of depression and anxiety. We employed secondary analysis of perinatal data (N = 4657-4946) from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. Multivariable logistic regression models (adjusted for covariates) examined predictors of elevated symptoms of postpartum depression and anxiety. Predictors included the following: type of delivery (normal physiological vs. interventive non-physiological), immediate postpartum complications, and maternal perception of the recent birth experience. The Edinburgh Postnatal Depression Scale assessed elevated symptoms of depression (score ≥ 13), and the Crown-Crisp Experiential Index assessed elevated symptoms of anxiety (score ≥ 9) at 2 and 8 months after delivery. A more negative perception of the recent birth experience was associated with elevated symptoms of anxiety at 2 months [odds ratio (OR) 1.52, 95 % confidence interval (CI) 1.25-1.85] and 8 months (OR 1.30, 95 % CI 1.06-1.60) postpartum but was not associated with elevated symptoms of depression at either time point. Type of delivery (physiological vs. non-physiological) and immediate postpartum complications were not associated with elevated symptoms of depression or anxiety. Our findings suggest that improving women's childbirth experience may decrease the likelihood of postpartum anxiety, but not postpartum depression. PMID:26202722

  16. Predictors of Breastfeeding Duration among Women in Kuwait: Results of a Prospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Manal Dashti

    2014-02-01

    Full Text Available The purposes of this paper are to report the prevalence of breastfeeding to six months among women in Kuwait and to determine the factors that are associated with the duration of breastfeeding. A cohort of 373 women recruited from maternity wards in four hospitals in Kuwait city were followed from birth to 26 weeks postpartum. The association of any and full breastfeeding duration and predictor variables were explored using multivariate Cox’s proportional hazards models. At six months, 39% of all infants were receiving some breast milk and only 2% of infants had been fully breastfed to 26 weeks. Women born in other Arab countries were less likely to discontinue breastfeeding than women born in Kuwait. Other factors positively associated with breastfeeding duration were level of maternal education, higher parity, infant being demand fed in hospital and a preference for breastfeeding on the part of the infant’s father and maternal grandmother. The introduction of a pacifier before four weeks of age and the mother intending to return to work by six months were negatively associated with duration. These findings present a number of opportunities for prolonging breastfeeding duration in Kuwait.

  17. Milk consumption during pregnancy is associated with increased infant size at birth: prospective cohort study

    DEFF Research Database (Denmark)

    Olsen, Sjurdur F; Halldorsson, Thorhallur I; Willett, Walter C;

    2007-01-01

    BACKGROUND: Cow milk contains many potentially growth-promoting factors. OBJECTIVE: The objective was to examine whether milk consumption during pregnancy is associated with greater infant size at birth. DESIGN: During 1996-2002, the Danish National Birth Cohort collected data on midpregnancy diet......'s socioeconomic status The analyses included data from 50,117 mother-infant pairs. RESULTS: Mean (+/-SD) consumption of milk was 3.1 +/- 2.0 glasses/d. Milk consumption was inversely associated with the risk of small-for gestational age (SGA) birth and directly with both large-for-gestational age (LGA) birth and...... < 0.001) for abdominal circumference (0.52 cm; 0.35, 0.69 cm), placental weight (26 g; 15, 38 g), birth length (increment: 0.31 cm; 0.15, 0.46 cm), and head circumference (0.13 cm; 0.04, 0.25 cm). Birth weight was related to intake of protein, but not of fat, derived from milk. CONCLUSION: Milk intake...

  18. Discordant Treatment Responses to Combination Antiretroviral Therapy in Rwanda: A Prospective Cohort Study

    Science.gov (United States)

    Kayigamba, Felix R.; Franke, Molly F.; Bakker, Mirjam I.; Rodriguez, Carly A.; Bagiruwigize, Emmanuel; Wit, Ferdinand WNM; Rich, Michael L.; Schim van der Loeff, Maarten F.

    2016-01-01

    Introduction Some antiretroviral therapy naïve patients starting combination antiretroviral therapy (cART) experience a limited CD4 count rise despite virological suppression, or vice versa. We assessed the prevalence and determinants of discordant treatment responses in a Rwandan cohort. Methods A discordant immunological cART response was defined as an increase of health facilities in two regions in Rwanda. Results Among 382 patients with an undetectable VL at 12 months, 112 (29%) had a CD4 rise of travel to the clinic were independent determinants of an immunological discordant response, but sex, baseline CD4 count, body mass index and WHO HIV clinical stage were not. Among 326 patients with a CD4 rise of ≥100 cells/mm3, 56 (17%) had a detectable viral load at 12 months. Male sex was associated with a virological discordant treatment response (P = 0.05), but age, baseline CD4 count, BMI, WHO HIV clinical stage, and travel time to the clinic were not. Conclusions Discordant treatment responses were common in cART-naïve HIV patients in Rwanda. Small CD4 increases could be misinterpreted as a (virological) treatment failure and lead to unnecessary treatment changes. PMID:27438000

  19. Early dissemination of bevacizumab for advanced colorectal cancer: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Fouad Mona N

    2011-08-01

    Full Text Available Abstract Background We describe early dissemination patterns for first-line bevacizumab given for metastatic colorectal cancer treatment. Methods We analyzed patient surveys and medical records for a population-based cohort with metastatic colorectal cancer treated in multiple regions and health systems in the United States (US. Eligible patients were diagnosed with metastatic colorectal cancer and initiated first-line chemotherapy after US Food & Drug Administration (FDA bevacizumab approval in February 2004. First-line bevacizumab therapy was defined as receiving bevacizumab within 8 weeks of starting chemotherapy for metastatic colorectal cancer. We evaluated factors associated with first-line bevacizumab treatment using logistic regression. Results Among 355 patients, 31% received first-line bevacizumab in the two years after FDA approval, including 26% of men, 41% of women, and 16% of those ≥ 75 years. Use rose sharply within 6 months after FDA approval, then plateaued. 20% of patients received bevacizumab in combination with irinotecan; 53% received it with oxaliplatin. Men were less likely than women to receive bevacizumab (adjusted OR 0.55; 95% CI 0.32-0.93; p = 0.026. Patients ≥ 75 years were less likely to receive bevacizumab than patients Conclusions One-third of eligible metastatic colorectal cancer patients received first-line bevacizumab shortly after FDA approval. Most patients did not receive bevacizumab as part of the regimen used in the pivotal study leading to FDA approval.

  20. Gestational diabetes as a risk factor for pancreatic cancer: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Calderon R

    2007-08-01

    Full Text Available Abstract Background Diabetes is known to be associated with cancer of the pancreas, though there is some debate as to whether it is a cause or a consequence of the disease. We investigated the incidence of pancreatic cancer in a cohort of 37926 Israeli women followed for 28–40 years for whom information on diabetes had been collected at the time they gave birth, in 1964–1976, in Jerusalem. There were 54 cases of pancreatic cancer ascertained from the Israel Cancer Registry during follow-up. Methods We used Cox proportional hazards models to adjust for age at baseline and explore effects of other risk factors, including ethnic groups, preeclampsia, birth order and birth weight of offspring. Results We observed no cases of pancreatic cancer in the women with insulin dependent diabetes; however, there were five cases in the women with gestational diabetes. The interval between the record of diabetes in pregnancy and the diagnosis of pancreatic cancer ranged from 14–35 years. Women with a history of gestational diabetes showed a relative risk of pancreatic cancer of 7.1 (95% confidence interval, 2.8–18.0. Conclusion We conclude that gestational diabetes is strongly related to the risk of cancer of the pancreas in women in this population, and that gestational diabetes can precede cancer diagnosis by many years.