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Sample records for examination survey mortality

  1. Effect of marijuana use on cardiovascular and cerebrovascular mortality: A study using the National Health and Nutrition Examination Survey linked mortality file.

    Science.gov (United States)

    Yankey, Barbara A; Rothenberg, Richard; Strasser, Sheryl; Ramsey-White, Kim; Okosun, Ike S

    2017-11-01

    Background Reports associate marijuana use with cardiovascular emergencies. Studies relating marijuana use to cardiovascular mortality are scarce. Recent advance towards marijuana use legalization emphasizes the importance of understanding relationships between marijuana use and cardiovascular deaths; the primary ranked mortality. Recreational marijuana is primarily smoked; we hypothesize that like cigarette smoking, marijuana use will be associated with increased cardiovascular mortalities. Design The design of this study was based on a mortality follow-up. Method We linked participants aged 20 years and above, who responded to questions on marijuana use during the 2005 US National Health and Nutrition Examination Survey to data from the 2011 public-use linked mortality file of the National Center for Health Statistics, Centers for Disease Control and Prevention. Only participants eligible for mortality follow-up were included. We conducted Cox proportional hazards regression analyses to estimate hazard ratios for hypertension, heart disease, and cerebrovascular mortality due to marijuana use. We controlled for cigarette smoking and other relevant variables. Results Of the 1213 eligible participants 72.5% were presumed to be alive. The total follow-up time was 19,569 person-years. Adjusted hazard ratios for death from hypertension among marijuana users compared to non-marijuana users was 3.42 (95% confidence interval: 1.20-9.79) and for each year of marijuana use was 1.04 (95% confidence interval: 1.00-1.07). Conclusion From our results, marijuana use may increase the risk for hypertension mortality. Increased duration of marijuana use is associated with increased risk of death from hypertension. Recreational marijuana use potentially has cardiovascular adverse effects which needs further investigation.

  2. Actinic skin damage and mortality--the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study.

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    Wei He

    Full Text Available BACKGROUND: Exposure to sunlight may decrease the risk of several diseases through the synthesis of vitamin D, whereas solar radiation is the main cause of some skin and eye diseases. However, to the best of our knowledge, the association of sun-induced skin damage with mortality remains unknown. METHODOLOGY/PRINCIPAL FINDINGS: Subjects were 8472 white participants aged 25-74 years in the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study. Cardiovascular disease mortality, cancer mortality, and all-cause mortality were obtained by either a death certificate or a proxy interview, or both. Actinic skin damage was examined and recorded by the presence and severity (absent, minimal, moderate, or severe of overall actinic skin damage and its components (i.e., fine telangiectasia, solar elastosis, and actinic keratoses. Cox regression and Kaplan-Meier methods were applied to explore the associations. A total of 672 cancer deaths, 1500 cardiovascular disease deaths, and 2969 deaths from all causes were documented through the follow-up between 1971 and 1992. After controlling for potential confounding variables, severe overall actinic skin damage was associated with a 45% higher risk for all-cause mortality (95% CI: 1.22, 1.72; P<0.001, moderate overall skin damage with a 20% higher risk (95% CI: 1.08., 1.32; P<0.001, and minimal overall skin damage with no significant mortality difference, when compared to those with no skin damage. Similar results were obtained for all-cause mortality with fine telangiectasia, solar elastosis, and actinic keratoses. The results were similar for cancer and cardiovascular disease mortality. CONCLUSIONS: The present study gives an indication of an association of actinic skin damage with cardiovascular disease, cancer and all-cause mortality in white subjects. Given the lack of support in the scientific literature and potential unmeasured confounding factors, this finding should be

  3. Serum phosphorus and mortality in the Third National Health and Nutrition Examination Survey (NHANES III): effect modification by fasting.

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    Chang, Alex R; Grams, Morgan E

    2014-10-01

    Serum phosphorus levels have been associated with mortality in some but not all studies. Because dietary intake prior to measurement can affect serum phosphorus levels, we hypothesized that the association between serum phosphorus level and mortality is strongest in those who have fasted longer. Prospective cohort study. Nationally representative sample of 12,984 participants 20 years or older in the Third National Health and Nutrition Examination Survey (1988-1994). Serum phosphorus level, fasting duration (dichotomized as ≥ 12 or fasting duration recorded as time since food or drink other than water was consumed. Individuals fasting 12 or more hours had lower serum phosphorus levels than those fasting less than 12 hours (3.34 vs 3.55 mg/dL; P fasting 12 or more hours (adjusted HR, 1.74; 95% CI, 1.38-2.20; reference, lowest quartile) but not in participants fasting less than 12 hours (adjusted HR, 1.08; 95% CI, 0.89-1.32; P for interaction = 0.002). Relationships were consistent using 8 hours as the fasting cutoff point or cardiovascular mortality as the outcome. Observational study, lack of fibroblast growth factor 23 or intact parathyroid hormone measurements. Fasting but not nonfasting serum phosphorus levels were associated with increased mortality. Risk prognostication based on serum phosphorus may be improved using fasting levels. Copyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  4. Examination of the association between mental health, morbidity, and mortality in late life: findings from longitudinal community surveys.

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    Burns, Richard A; Butterworth, Peter; Browning, Colette; Byles, Julie; Luszcz, Mary; Mitchell, Paul; Shaw, Jonathan; Anstey, Kaarin J

    2015-05-01

    Physical health has been demonstrated to mediate the mental health and mortality risk association. The current study examines an alternative hypothesis that mental health mediates the effect of physical health on mortality risk. Participants (N = 14,019; women = 91%), including eventual decedents (n = 3,752), were aged 70 years and older, and drawn from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project. Participants were observed on two to four occasions, over a 10-year period. Mediation analysis compared the converse mediation of physical and mental health on mortality risk. For men, neither physical nor mental health was associated with mortality risk. For women, poor mental health reported only a small effect on mortality risk (Hazard Risk (HR) = 1.01; p physical health (HR = 1.04; p effects were observed. Mental health effects on mortality were fully attenuated by physical health in men, and partially so in women. Neither mental nor physical health mediated the effect of each other on mortality risk for either gender. We conclude that physical health is a stronger predictor of mortality risk than mental health.

  5. Longitudinal Associations of Leisure-Time Physical Activity and Cancer Mortality in the Third National Health and Nutrition Examination Survey (1986–2006

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    Niyati Parekh

    2012-01-01

    Full Text Available Longitudinal associations between leisure-time physical activity (LTPA and overall cancer mortality were evaluated within the Third National Health and Nutrition Examination Survey (NHANES III; 1988–2006; n=15,535. Mortality status was ascertained using the National Death Index. Self-reported LTPA was divided into inactive, regular low-to-moderate and vigorous activity. A frequency-weighted metabolic equivalents (METS/week variable was also computed. Hazard ratios (HRs and 95% confidence intervals (CI were calculated for overall cancer mortality in the whole sample, by body mass index categories and insulin resistance (IR status. Nonsignificant protective associations were observed for regular low-to-moderate and vigorous activity, and for the highest quartile of METS/week (HRs range: 0.66–0.95. Individuals without IR engaging in regular vigorous activity had a 48% decreased risk of cancer mortality (HR: 0.52; 95% CI: 0.28–0.98 in multivariate analyses. Conversely, nonsignificant positive associations were observed in people with IR. In conclusion, regular vigorous activity may reduce risk of cancer mortality among persons with normal insulin-glucose metabolism in this national sample.

  6. Hemoglobin A1c and Mortality in Older Adults With and Without Diabetes: Results From the National Health and Nutrition Examination Surveys (1988-2011).

    Science.gov (United States)

    Palta, Priya; Huang, Elbert S; Kalyani, Rita R; Golden, Sherita H; Yeh, Hsin-Chieh

    2017-04-01

    Hemoglobin A 1c (HbA 1c ) level has been associated with increased mortality in middle-aged populations. The optimal intensity of glucose control in older adults with diabetes remains uncertain. We sought to estimate the risk of mortality by HbA 1c levels among older adults with and without diabetes. We analyzed data from adults aged ≥65 years ( n = 7,333) from the Third National Health and Nutrition Examination Survey (NHANES III) (1998-1994) and Continuous NHANES (1999-2004) and their linked mortality data (through December 2011). Cox proportional hazards models were used to examine the relationship of HbA 1c with the risk of all-cause and cause-specific (cardiovascular disease [CVD], cancer, and non-CVD/noncancer) mortality, separately for adults with diabetes and without diabetes. Over a median follow-up of 8.9 years, 4,729 participants died (1,262 from CVD, 850 from cancer, and 2,617 from non-CVD/noncancer causes). Compared with those with diagnosed diabetes and an HbA 1c 8.0%. HRs were 1.6 (95% CI 1.02, 2.6) and 1.8 (95% CI 1.3, 2.6) for HbA 1c 8.0-8.9% and ≥9.0%, respectively ( P for trend 6.5% had a 1.3 (95% CI 1.03, 1.8) times greater risk of all-cause mortality compared with participants without diabetes and HbA 1c 5.0-5.6%. An HbA 1c >8.0% was associated with increased risk of all-cause and cause-specific mortality in older adults with diabetes. Our results support the idea that better glycemic control is important for reducing mortality; however, in light of the conflicting evidence base, there is also a need for individualized glycemic targets for older adults with diabetes depending on their demographics, duration of diabetes, and existing comorbidities. © 2017 by the American Diabetes Association.

  7. An examination of the maternal social determinants influencing under-5 mortality in Nigeria: Evidence from the 2013 Nigeria Demographic Health Survey.

    Science.gov (United States)

    Blackstone, Sarah R; Nwaozuru, Ucheoma; Iwelunmor, Juliet

    2017-06-01

    Nigeria is the second largest contributor to child (under-5) mortality in the world, with an average of 128 child deaths per 1000 live births, and is not on track to meet the Millennium Development Goals of reducing childhood mortality rates to 64 per 1000. Data from the 2013 Nigeria Demographic and Health Survey (NDHS) report were analysed to explore the relationship between structural and intermediary maternal characteristics and likelihood of childhood mortality. Binary logistic regressions for the first three reported births were conducted with childhood mortality (e.g. death before 59 months of age) as a dependent variable. Maternal characteristics investigated included age, education, region, antenatal care, and breastfeeding. Significant factors for birth 1 included region of residence, breastfeeding, literacy, wealth, number of children, and antenatal care. For second birth, not breastfeeding and attending antenatal care with a nurse were negatively associated with survival. For third birth, wealth and number of children were positively associated with survival. The results point to some maternal characteristics that may be influential in childhood mortality. However, community and systems level factors should be accounted for in interventions, as maternal characteristics do not offer a full explanation for why children are dying so young in Nigeria.

  8. Race-ethnic differences in the association of genetic loci with HbA1c levels and mortality in U.S. adults: the third National Health and Nutrition Examination Survey (NHANES III).

    Science.gov (United States)

    Grimsby, Jonna L; Porneala, Bianca C; Vassy, Jason L; Yang, Quanhe; Florez, José C; Dupuis, Josée; Liu, Tiebin; Yesupriya, Ajay; Chang, Man-Huei; Ned, Renee M; Dowling, Nicole F; Khoury, Muin J; Meigs, James B

    2012-04-27

    Hemoglobin A1c (HbA1c) levels diagnose diabetes, predict mortality and are associated with ten single nucleotide polymorphisms (SNPs) in white individuals. Genetic associations in other race groups are not known. We tested the hypotheses that there is race-ethnic variation in 1) HbA1c-associated risk allele frequencies (RAFs) for SNPs near SPTA1, HFE, ANK1, HK1, ATP11A, FN3K, TMPRSS6, G6PC2, GCK, MTNR1B; 2) association of SNPs with HbA1c and 3) association of SNPs with mortality. We studied 3,041 non-diabetic individuals in the NHANES (National Health and Nutrition Examination Survey) III. We stratified the analysis by race/ethnicity (NHW: non-Hispanic white; NHB: non-Hispanic black; MA: Mexican American) to calculate RAF, calculated a genotype score by adding risk SNPs, and tested associations with SNPs and the genotype score using an additive genetic model, with type 1 error = 0.05. RAFs varied widely and at six loci race-ethnic differences in RAF were significant (p differed by race-ethnicity (NHW: 10.4, NHB: 11.0, MA: 10.7, p race-ethnic heterogeneity. The combined impact of common HbA1c-associated variants on HbA1c levels varied by race-ethnicity, but did not influence mortality.

  9. Comparison of the fixed ratio and the Z-score of FEV1/FVC in the elderly population: a long-term mortality analysis from the Third National Health and Nutritional Examination Survey.

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    Oh, Dong Kyu; Baek, Seunghee; Lee, Sei Won; Lee, Jae Seung; Lee, Sang-Do; Oh, Yeon-Mok

    2018-01-01

    Despite the ongoing intense debate on the definition of airflow limitation by spirometry in the elderly population, there have only been few studies comparing the fixed ratio and the Z -score of forced expiratory volume in 1 second (FEV 1 )/forced vital capacity (FVC) in terms of long-term mortalities. In this study, we aimed to identify the proper method for accurately defining the airflow limitation in terms of long-term mortality prediction in the elderly population. Data were collected from the Third National Health and Nutrition Examination Survey in the US. Non-Hispanic Caucasians aged 65-80 years were included. The receiver operating characteristic (ROC) curves of both methods were plotted and compared for 10-year all-cause, respiratory, and COPD mortalities. Of 1,331 subjects, the mean age was 71.7 years and 805 (60.5%) were males. For the 10-year all-cause mortality, the area under the curve (AUC) of the fixed ratio was significantly greater than that of the Z -score of FEV 1 /FVC, but both showed poor prediction performance (0.633 vs 0.616, p ratio and the Z -score of FEV 1 /FVC showed comparable prediction performance with greater AUCs (0.784 vs 0.778, p =0.160, and 0.896 vs 0.896, p =0.971, respectively). Interestingly, the conventional cutoff of 0.7 in the fixed ratio was consistently higher than the optimal for the 10-year all-cause, respiratory, and COPD mortalities (0.70 vs 0.69, 0.62, and 0.61, respectively), whereas that of -1.64 in the Z -score of FEV 1 /FVC was consistently lower than the optimal cutoff (-1.64 vs -1.31, -1.47, and -1.41, respectively). In the elderly population, both the fixed ratio and the Z -score of FEV 1 /FVC showed comparable prediction performance for the 10-year respiratory and COPD mortalities. However, the conventional cutoff of neither 0.70 in the fixed ratio nor -1.64 in the Z -score of FEV 1 /FVC was optimal for predicting the long-term mortalities.

  10. National natality and fetal mortality surveys

    International Nuclear Information System (INIS)

    Roney, P.L.

    1980-01-01

    A project is described in which the Epidemiologic Studies Branch, DBE, is cooperating with the National Center for Health Statistics in a National Natality Survey and a National Fetal Mortality Survey of a sample of live births and of late fetal deaths (28 or more weeks gestation) in 1979. Questionnaires will be sent to a sample of mothers who had a live born infant or late fetal death in 1979, to hospitals in which the deliveries took place, to attending physicians, and all other possible sources of health care. The survey will provide quantitative information regarding use of ionizing and nonionizing radiation, including ultrasound, during pregnancy and possible associations between radiation and late fetal mortality. Specifically the study will provide information on the demographic and socioeconomic characteristics of the mothers and complications of pregnancy, labor, and delivery. The physical condition of the infant at birth is also included. This is one of many health surveys conducted routinely by the NCHS under the National Health Survey program

  11. Comparison of the fixed ratio and the Z-score of FEV1/FVC in the elderly population: a long-term mortality analysis from the Third National Health and Nutritional Examination Survey

    Directory of Open Access Journals (Sweden)

    Oh DK

    2018-03-01

    Full Text Available Dong Kyu Oh,1 Seunghee Baek,2 Sei Won Lee,1 Jae Seung Lee,1 Sang-Do Lee,1 Yeon-Mok Oh1 1Department of Pulmonary and Critical Care Medicine, Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; 2Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea Background and objective: Despite the ongoing intense debate on the definition of airflow limitation by spirometry in the elderly population, there have only been few studies comparing the fixed ratio and the Z-score of forced expiratory volume in 1 second (FEV1/forced vital capacity (FVC in terms of long-term mortalities. In this study, we aimed to identify the proper method for accurately defining the airflow limitation in terms of long-term mortality prediction in the elderly population. Methods: Data were collected from the Third National Health and Nutrition Examination Survey in the US. Non-Hispanic Caucasians aged 65–80 years were included. The receiver operating characteristic (ROC curves of both methods were plotted and compared for 10-year all-cause, respiratory, and COPD mortalities. Results: Of 1,331 subjects, the mean age was 71.7 years and 805 (60.5% were males. For the 10-year all-cause mortality, the area under the curve (AUC of the fixed ratio was significantly greater than that of the Z-score of FEV1/FVC, but both showed poor prediction performance (0.633 vs 0.616, p<0.001. For the 10-year respiratory and COPD mortalities, both the fixed ratio and the Z-score of FEV1/FVC showed comparable prediction performance with greater AUCs (0.784 vs 0.778, p=0.160, and 0.896 vs 0.896, p=0.971, respectively. Interestingly, the conventional cutoff of 0.7 in the fixed ratio was consistently higher than the optimal for the 10-year all-cause, respiratory, and COPD mortalities (0.70 vs 0.69, 0.62, and 0.61, respectively

  12. Race-ethnic differences in the association of genetic loci with HbA1c levels and mortality in U.S. adults: the third National Health and Nutrition Examination Survey (NHANES III)

    Science.gov (United States)

    2012-01-01

    Background Hemoglobin A1c (HbA1c) levels diagnose diabetes, predict mortality and are associated with ten single nucleotide polymorphisms (SNPs) in white individuals. Genetic associations in other race groups are not known. We tested the hypotheses that there is race-ethnic variation in 1) HbA1c-associated risk allele frequencies (RAFs) for SNPs near SPTA1, HFE, ANK1, HK1, ATP11A, FN3K, TMPRSS6, G6PC2, GCK, MTNR1B; 2) association of SNPs with HbA1c and 3) association of SNPs with mortality. Methods We studied 3,041 non-diabetic individuals in the NHANES (National Health and Nutrition Examination Survey) III. We stratified the analysis by race/ethnicity (NHW: non-Hispanic white; NHB: non-Hispanic black; MA: Mexican American) to calculate RAF, calculated a genotype score by adding risk SNPs, and tested associations with SNPs and the genotype score using an additive genetic model, with type 1 error = 0.05. Results RAFs varied widely and at six loci race-ethnic differences in RAF were significant (p HbA1c in NHW (β = 0.012 HbA1c increase per risk allele, p = 0.04) and MA (β = 0.021, p = 0.005) but not NHB (β = 0.007, p = 0.39). The genotype score was not associated with mortality in any group (NHW: OR (per risk allele increase in mortality) = 1.07, p = 0.09; NHB: OR = 1.04, p = 0.39; MA: OR = 1.03, p = 0.71). Conclusion At many HbA1c loci in NHANES III there is substantial RAF race-ethnic heterogeneity. The combined impact of common HbA1c-associated variants on HbA1c levels varied by race-ethnicity, but did not influence mortality. PMID:22540250

  13. Prognostic value of fasting versus nonfasting low-density lipoprotein cholesterol levels on long-term mortality: insight from the National Health and Nutrition Examination Survey III (NHANES-III).

    Science.gov (United States)

    Doran, Bethany; Guo, Yu; Xu, Jinfeng; Weintraub, Howard; Mora, Samia; Maron, David J; Bangalore, Sripal

    2014-08-12

    National and international guidelines recommend fasting lipid panel measurement for risk stratification of patients for prevention of cardiovascular events. However, the prognostic value of fasting versus nonfasting low-density lipoprotein cholesterol (LDL-C) is uncertain. Patients enrolled in the National Health and Nutrition Examination Survey III (NHANES-III), a nationally representative cross-sectional survey performed from 1988 to 1994, were stratified on the basis of fasting status (≥8 or fasting and nonfasting cohorts with similar baseline characteristics. The risk of outcomes as a function of LDL-C and fasting status was assessed with the use of receiver operating characteristic curves and bootstrapping methods. The interaction between fasting status and LDL-C was assessed with Cox proportional hazards modeling. Primary outcome was all-cause mortality. Secondary outcome was cardiovascular mortality. One-to-one matching based on propensity score yielded 4299 pairs of fasting and nonfasting individuals. For the primary outcome, fasting LDL-C yielded prognostic value similar to that for nonfasting LDL-C (C statistic=0.59 [95% confidence interval, 0.57-0.61] versus 0.58 [95% confidence interval, 0.56-0.60]; P=0.73), and LDL-C by fasting status interaction term in the Cox proportional hazards model was not significant (Pinteraction=0.11). Similar results were seen for the secondary outcome (fasting versus nonfasting C statistic=0.62 [95% confidence interval, 0.60-0.66] versus 0.62 [95% confidence interval, 0.60-0.66]; P=0.96; Pinteraction=0.34). Nonfasting LDL-C has prognostic value similar to that of fasting LDL-C. National and international agencies should consider reevaluating the recommendation that patients fast before obtaining a lipid panel. © 2014 American Heart Association, Inc.

  14. Race-ethnic differences in the association of genetic loci with HbA1c levels and mortality in U.S. adults: the third National Health and Nutrition Examination Survey (NHANES III

    Directory of Open Access Journals (Sweden)

    Grimsby Jonna L

    2012-04-01

    Full Text Available Abstract Background Hemoglobin A1c (HbA1c levels diagnose diabetes, predict mortality and are associated with ten single nucleotide polymorphisms (SNPs in white individuals. Genetic associations in other race groups are not known. We tested the hypotheses that there is race-ethnic variation in 1 HbA1c-associated risk allele frequencies (RAFs for SNPs near SPTA1, HFE, ANK1, HK1, ATP11A, FN3K, TMPRSS6, G6PC2, GCK, MTNR1B; 2 association of SNPs with HbA1c and 3 association of SNPs with mortality. Methods We studied 3,041 non-diabetic individuals in the NHANES (National Health and Nutrition Examination Survey III. We stratified the analysis by race/ethnicity (NHW: non-Hispanic white; NHB: non-Hispanic black; MA: Mexican American to calculate RAF, calculated a genotype score by adding risk SNPs, and tested associations with SNPs and the genotype score using an additive genetic model, with type 1 error = 0.05. Results RAFs varied widely and at six loci race-ethnic differences in RAF were significant (p ATP11A, the SNP RAF was 54% in NHB, 18% in MA and 14% in NHW (p 1c in NHW (β = 0.012 HbA1c increase per risk allele, p = 0.04 and MA (β = 0.021, p = 0.005 but not NHB (β = 0.007, p = 0.39. The genotype score was not associated with mortality in any group (NHW: OR (per risk allele increase in mortality = 1.07, p = 0.09; NHB: OR = 1.04, p = 0.39; MA: OR = 1.03, p = 0.71. Conclusion At many HbA1c loci in NHANES III there is substantial RAF race-ethnic heterogeneity. The combined impact of common HbA1c-associated variants on HbA1c levels varied by race-ethnicity, but did not influence mortality.

  15. National Health and Nutrition Examination Survey (NHANES)

    Data.gov (United States)

    U.S. Department of Health & Human Services — 1999-2000 forward. The National Health and Nutrition Examination Survey (NHANES) is a program of studies designed to assess the health and nutritional status of...

  16. Examining geographic patterns of mortality: the atlas of mortality in small areas in Spain (1987-1995).

    Science.gov (United States)

    Benach, Joan; Yasui, Yutaka; Borrell, Carme; Rosa, Elisabeth; Pasarín, M Isabel; Benach, Núria; Español, Esther; Martínez, José Miguel; Daponte, Antonio

    2003-06-01

    Small-area mortality atlases have been demonstrated to be a useful tool for both showing general geographical patterns in mortality data and identifying specific high-risk locations. In Spain no study has so far systematically examined geographic patterns of small-area mortality for the main causes of death. This paper presents the main features, contents and potential uses of the Spanish Atlas of Mortality in small areas (1987-1995). Population data for 2,218 small areas were drawn from the 1991 Census. Aggregated mortality data for 14 specific causes of death for the period 1987-1995 were obtained for each small area. Empirical Bayes-model-based estimates of age-adjusted relative risk were displayed in small-area maps for each cause/gender/age group (0-64 or 65 and over) combination using the same range of values (i.e. septiles) and colour schemes. The 'Spanish Atlas of Mortality' includes multiple choropleth (area-shaded) small-area maps and graphs to answer different questions about the data. The atlas is divided into three main sections. Section 1 includes the methods and comments on the main maps. Section 2 presents a two-page layout for each leading cause of death by gender including 1) a large map with relative risk estimates, 2) a map that indicates high- and low-risk small areas, 3) a graph with median and interquartile range of relative risk estimates for 17 large regions of Spain, and 4) relative-risk maps for two age groups. Section 3 provides specific information on the geographical units of analysis, statistical methods and other supplemental maps. The 'Spanish Atlas of Mortality' is a useful tool for examining geographical patterns of mortality risk and identifying specific high-risk areas. Mortality patterns displayed in the atlas may have important implications for research and social/health policy planning purposes.

  17. Engineering surveying theory and examination problems for students

    CERN Document Server

    Schofield, W

    2013-01-01

    Engineering Surveying: Theory and Examination Problems for Students, Volume 1, Third Edition discusses topics concerning engineering surveying techniques and instrumentations. The book is comprised of eight chapters that cover several concerns in engineering survey. Chapter 1 discusses the basic concepts of surveying. Chapter 2 deals with simple and precise leveling, while Chapter 3 covers earthworks. The book also talks about the theodolite and its applications, and then discusses optical distance measurement. Curves, underground and hydrographic surveying, and aspects of dimensional control

  18. An examination of black/white differences in the rate of age-related mortality increase

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    Andrew Fenelon

    2013-09-01

    Full Text Available BACKGROUND The rate of mortality increase with age among adults is typically used as a measure of the rate of functional decline associated with aging or senescence. While black and white populations differ in the level of mortality, mortality also rises less rapidly with age for blacks than for whites, leading to the well-known black/white mortality "crossover". OBJECTIVE This paper investigates black/white differences in the rate of mortality increase with age for major causes of death in order to examine the factors responsible for the black/white crossover. METHODS The analysis considers two explanations for the crossover: selective survival and age misreporting. Mortality is modeled using a Gompertz model for 11 causes of death from ages 50-84 among blacks and whites by sex. RESULTS Mortality increases more rapidly with age for whites than for blacks for nearly all causes of death considered. The all-cause mortality rate of mortality increase is nearly two percentage points higher for whites. The analysis finds evidence for both selective survival and age misreporting, although age misreporting is a more prominent explanation among women. CONCLUSIONS The black/white mortality crossover reflects large differences in the rate of age-related mortality increase. Instead of reflecting the impact of specific causes of death, this pattern exists across many disparate disease conditions, indicating the need for a broad explanation.

  19. Food Habits, Lifestyle Factors and Mortality among Oldest Old Chinese: The Chinese Longitudinal Healthy Longevity Survey (CLHLS).

    Science.gov (United States)

    Shi, Zumin; Zhang, Tuohong; Byles, Julie; Martin, Sean; Avery, Jodie C; Taylor, Anne W

    2015-09-09

    There are few studies reporting the association between lifestyle and mortality among the oldest old in developing countries. We examined the association between food habits, lifestyle factors and all-cause mortality in the oldest old (≥80 years) using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). In 1998/99, 8959 participants aged 80 years and older took part in the baseline survey. Follow-up surveys were conducted every two to three years until 2011. Food habits were assessed using an in-person interview. Deaths were ascertained from family members during follow-up. Cox and Laplace regression were used to assess the association between food habits, lifestyle factors and mortality risk. There were 6626 deaths during 31,926 person-years of follow-up. Type of staple food (rice or wheat) was not associated with mortality. Daily fruit and vegetable intake was inversely associated with a higher mortality risk (hazard ratios (HRs): 0.85 (95% CI (confidence interval) 0.77-0.92), and 0.74 (0.66-0.83) for daily intake of fruit and vegetables, respectively). There was a positive association between intake of salt-preserved vegetables and mortality risk (consumers had about 10% increase of HR for mortality). Fruit and vegetable consumption were inversely, while intake of salt-preserved vegetables positively, associated with mortality risk among the oldest old. Undertaking physical activity is beneficial for the prevention of premature death.

  20. Food Habits, Lifestyle Factors and Mortality among Oldest Old Chinese: The Chinese Longitudinal Healthy Longevity Survey (CLHLS

    Directory of Open Access Journals (Sweden)

    Zumin Shi

    2015-09-01

    Full Text Available There are few studies reporting the association between lifestyle and mortality among the oldest old in developing countries. We examined the association between food habits, lifestyle factors and all-cause mortality in the oldest old (≥80 years using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS. In 1998/99, 8959 participants aged 80 years and older took part in the baseline survey. Follow-up surveys were conducted every two to three years until 2011. Food habits were assessed using an in-person interview. Deaths were ascertained from family members during follow-up. Cox and Laplace regression were used to assess the association between food habits, lifestyle factors and mortality risk. There were 6626 deaths during 31,926 person-years of follow-up. Type of staple food (rice or wheat was not associated with mortality. Daily fruit and vegetable intake was inversely associated with a higher mortality risk (hazard ratios (HRs: 0.85 (95% CI (confidence interval 0.77–0.92, and 0.74 (0.66–0.83 for daily intake of fruit and vegetables, respectively. There was a positive association between intake of salt-preserved vegetables and mortality risk (consumers had about 10% increase of HR for mortality. Fruit and vegetable consumption were inversely, while intake of salt-preserved vegetables positively, associated with mortality risk among the oldest old. Undertaking physical activity is beneficial for the prevention of premature death.

  1. Examining the Challenges of Cadastral Surveying Practice in Zambia

    African Journals Online (AJOL)

    lodging and examination of survey records, cadastral survey standards and regulations. ... African land systems referred to as the 'Evolutionary Theory of Land Rights' (ETLR). The main ... emerge and, once established, to evolve towards individualisation and ..... livelihoods 'What contributions can we make?', DFID, London.

  2. Aviation medical examiner 2012 feedback survey : content analysis of recommendations.

    Science.gov (United States)

    2013-06-01

    The Civil Aerospace Medical Institute (CAMI), as a component of the Office of Aerospace Medicine (OAM), surveyed the population of aviation medical examiners (AMEs), as federal designees, in 2012 to assess their satisfaction with Federal Aviation Adm...

  3. National Health and Nutrition Examination Survey (NHANES), 2009-2010

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Health and Nutrition Examination Survey (NHANES) is a program of studies designed to assess the health and nutritional status of adults and children in...

  4. Socioeconomic Inequality in mortality using 12-year follow-up data from nationally representative surveys in South Korea.

    Science.gov (United States)

    Khang, Young-Ho; Kim, Hye-Ryun

    2016-03-22

    Investigations into socioeconomic inequalities in mortality have rarely used long-term mortality follow-up data from nationally representative samples in Asian countries. A limited subset of indicators for socioeconomic position was employed in prior studies on socioeconomic inequalities in mortality. We examined socioeconomic inequalities in mortality using follow-up 12-year mortality data from nationally representative samples of South Koreans. A total of 10,137 individuals who took part in the 1998 and 2001 Korea National Health and Nutrition Examination Surveys were linked to mortality data from Statistics Korea. Of those individuals, 1,219 (12.1 %) had died as of December 2012. Cox proportional hazard models were used to estimate the relative risks of mortality according to a wide range of socioeconomic position (SEP) indicators after taking into account primary sampling units, stratification, and sample weights. Our analysis showed strong evidence that individuals with disadvantaged SEP indicators had greater all-cause mortality risks than their counterparts. The magnitude of the association varied according to gender, age group, and specific SEP indicators. Cause-specific analyses using equivalized income quintiles showed that the magnitude of mortality inequalities tended to be greater for cardiovascular disease and external causes than for cancer. Inequalities in mortality exist in every aspect of SEP indicators, both genders, and age groups, and four broad causes of deaths. The South Korean economic development, previously described as effective in both economic growth and relatively equitable income distribution, should be scrutinized regarding its impact on socioeconomic mortality inequalities. Policy measures to reduce inequalities in mortality should be implemented in South Korea.

  5. Mortality Factor Survey of Severe Acute Respiratory Syndrome in Taiwan

    Directory of Open Access Journals (Sweden)

    Tei-Chu Liu

    2009-03-01

    Conclusion: The mortality rate of intubation patients was 115 times higher than that of those who did not require intubation. Therefore, special care must be taken with SARS disease with severe infiltration chest X-ray images and respiratory distress. Positive medical treatment should be performed to lower the mortality rate.

  6. Comparing two survey methods for estimating maternal and perinatal mortality in rural Cambodia.

    Science.gov (United States)

    Chandy, Hoeuy; Heng, Yang Van; Samol, Ha; Husum, Hans

    2008-03-01

    We need solid estimates of maternal mortality rates (MMR) to monitor the impact of maternal care programs. Cambodian health authorities and WHO report the MMR in Cambodia at 450 per 100,000 live births. The figure is drawn from surveys where information is obtained by interviewing respondents about the survival of all their adult sisters (sisterhood method). The estimate is statistically imprecise, 95% confidence intervals ranging from 260 to 620/100,000. The MMR estimate is also uncertain due to under-reporting; where 80-90% of women deliver at home maternal fatalities may go undetected especially where mortality is highest, in remote rural areas. The aim of this study was to attain more reliable MMR estimates by using survey methods other than the sisterhood method prior to an intervention targeting obstetric rural emergencies. The study was carried out in rural Northwestern Cambodia where access to health services is poor and poverty, endemic diseases, and land mines are endemic. Two survey methods were applied in two separate sectors: a community-based survey gathering data from public sources and a household survey gathering data direct from primary sources. There was no statistically significant difference between the two survey results for maternal deaths, both types of survey reported mortality rates around the public figure. The household survey reported a significantly higher perinatal mortality rate as compared to the community-based survey, 8.6% versus 5.0%. Also the household survey gave qualitative data important for a better understanding of the many problems faced by mothers giving birth in the remote villages. There are detection failures in both surveys; the failure rate may be as high as 30-40%. PRINCIPLE CONCLUSION: Both survey methods are inaccurate, therefore inappropriate for evaluation of short-term changes of mortality rates. Surveys based on primary informants yield qualitative information about mothers' hardships important for the design

  7. Maternal mortality in Kassala State - Eastern Sudan: community-based study using Reproductive age mortality survey (RAMOS

    Directory of Open Access Journals (Sweden)

    Mohammed Abdalla A

    2011-12-01

    Full Text Available Abstract Background The maternal mortality ratio in Sudan was estimated at 750/100,000 live births. Sudan was one of eleven countries that are responsible for 65% of global maternal deaths according to a recent World Health Organization (WHO estimate. Maternal mortality in Kassala State was high in national demographic surveys. This study was conducted to investigate the causes and contributing factors of maternal deaths and to identify any discrepancies in rates and causes between different areas. Methods A reproductive age mortality survey (RAMOS was conducted to study maternal mortality in Kassala State. Deaths of women of reproductive age (WRA in four purposively selected areas were identified by interviewing key informants in each village followed by verbal autopsy. Results Over a three-year period, 168 maternal deaths were identified among 26,066 WRA. Verbal autopsies were conducted in 148 (88.1% of these cases. Of these, 64 (43.2% were due to pregnancy and childbirth complications. Maternal mortality rates and ratios were 80.6 per 100,000 WRA and 713.6 per 100,000 live births (LB, respectively. There was a wide discrepancy between urban and rural maternal mortality ratios (369 and 872100,000 LB, respectively. Direct obstetric causes were responsible for 58.4% of deaths. Severe anemia (20.3% and acute febrile illness (9.4% were the major indirect causes of maternal death whereas obstetric hemorrhage (15.6%, obstructed labor (14.1% and puerperal sepsis (10.9% were the major obstetric causes. Of the contributing factors, we found delay of referral in 73.4% of cases in spite of a high problem recognition rate (75%. 67.2% of deaths occurred at home, indicating under utilization of health facilities, and transportation problems were found in 54.7% of deaths. There was a high illiteracy rate among the deceased and their husbands (62.5% and 48.4%, respectively. Conclusions Maternal mortality rates and ratios were found to be high, with a wide

  8. Examining mortality among formerly homeless adults enrolled in Housing First: An observational study.

    Science.gov (United States)

    Henwood, Benjamin F; Byrne, Thomas; Scriber, Brynn

    2015-12-04

    Adults who experience prolonged homelessness have mortality rates 3 to 4 times that of the general population. Housing First (HF) is an evidence-based practice that effectively ends chronic homelessness, yet there has been virtually no research on premature mortality among HF enrollees. In the United States, this gap in the literature exists despite research that has suggested chronically homeless adults constitute an aging cohort, with nearly half aged 50 years old or older. This observational study examined mortality among formerly homeless adults in an HF program. We examined death rates and causes of death among HF participants and assessed the timing and predictors of death among HF participants following entry into housing. We also compared mortality rates between HF participants and (a) members of the general population and (b) individuals experiencing homelessness. We supplemented these analyses with a comparison of the causes of death and characteristics of decedents in the HF program with a sample of adults identified as homeless in the same city at the time of death through a formal review process. The majority of decedents in both groups were between the ages of 45 and 64 at their time of death; the average age at death for HF participants was 57, compared to 53 for individuals in the homeless sample. Among those in the HF group, 72% died from natural causes, compared to 49% from the homeless group. This included 21% of HF participants and 7% from the homeless group who died from cancer. Among homeless adults, 40% died from an accident, which was significantly more than the 14% of HF participants who died from an accident. HIV or other infectious diseases contributed to 13% of homeless deaths compared to only 2% of HF participants. Hypothermia contributed to 6% of homeless deaths, which was not a cause of death for HF participants. Results suggest HF participants face excess mortality in comparison to members of the general population and that mortality

  9. Mammography examination in Ghana: preliminary survey of patients' profiles

    International Nuclear Information System (INIS)

    Boadu, M.; Sosu, E.K.; Hasford, F.; Nani, E.K.; Addison, E.K.; Schandorf, C.

    2012-01-01

    Profiles of 1,671 patients undergoing diagnostic mammography examination at three Centres in Accra between May and December 2009 were analysed as preliminary survey to formulate a National Breast Screening Policy for Ghana. Employment category, age, body mass index, clinical history and diagnosis were indices used in the survey. The age profile of the patients ranged from 22 to 90 years, with an average of 51 years, and at 95 % confidence interval, the variance in age was 0.01. The dominant age groups of the patients surveyed were 46 - 50 years (23 %), 41 - 45 years (21 %) and 51 - 55 years (20 %). From the body mass indices, 34 % of the patients were overweight, 49 % were obese, 16 % were of normal weight and only 1 % was under weight. By the clinical history and diagnosis, about 25 % of the cases were attributed to mastalgia (pain in the breast), 4 % already diagnosed of breast cancer, while 45 % were undergoing assessment and evaluation. The probability of an obese individual to develop breast cancer out of the entire population was p = 0.004. The profiles indicated that breast screening awareness programmes should be targeted towards women between ages of 41 - 60 years. (au)

  10. Estimating mortality from external causes using data from retrospective surveys: A validation study in Niakhar (Senegal

    Directory of Open Access Journals (Sweden)

    Gilles Pison

    2018-03-01

    Full Text Available Background: In low- and middle-income countries (LMICs, data on causes of death is often inaccurate or incomplete. In this paper, we test whether adding a few questions about injuries and accidents to mortality questionnaires used in representative household surveys would yield accurate estimates of the extent of mortality due to external causes (accidents, homicides, or suicides. Methods: We conduct a validation study in Niakhar (Senegal, during which we compare reported survey data to high-quality prospective records of deaths collected by a health and demographic surveillance system (HDSS. Results: Survey respondents more frequently list the deaths of their adult siblings who die of external causes than the deaths of those who die from other causes. The specificity of survey data is high, but sensitivity is low. Among reported deaths, less than 60Š of the deaths classified as due to external causes by the HDSS are also classified as such by survey respondents. Survey respondents better report deaths due to road-traffic accidents than deaths from suicides and homicides. Conclusions: Asking questions about deaths resulting from injuries and accidents during surveys might help measure mortality from external causes in LMICs, but the resulting data displays systematic bias in a rural population of Senegal. Future studies should 1 investigate whether similar biases also apply in other settings and 2 test new methods to further improve the accuracy of survey data on mortality from external causes. Contribution: This study helps strengthen the monitoring of sustainable development targets in LMICs by validating a simple approach for the measurement of mortality from external causes.

  11. Location matters: trends in inequalities in child mortality in Indonesia. Evidence from repeated cross-sectional surveys.

    Science.gov (United States)

    Hodge, Andrew; Firth, Sonja; Marthias, Tiara; Jimenez-Soto, Eliana

    2014-01-01

    Considerable improvements in life expectancy and other human development indicators in Indonesia are thought to mask considerable disparities between populations in the country. We examine the existence and extent of these disparities by measuring trends and inequalities in the under-five mortality rate and neonatal mortality rate across wealth, education and geography. Using data from seven waves of the Indonesian Demographic and Health Surveys, direct estimates of under-five and neonatal mortality rates were generated for 1980-2011. Absolute and relative inequalities were measured by rate differences and ratios, and where possible, slope and relative indices of inequality. Disparities were assessed by levels of rural/urban location, island groups, maternal education and household wealth. Declines in national rates of under-five and neonatal mortality have accorded with reductions of absolute inequalities in clusters stratified by wealth, maternal education and rural/urban location. Across these groups, relative inequalities have generally stabilised, with possible increases with respect to mortality across wealth subpopulations. Both relative and absolute inequalities in rates of under-five and neonatal mortality stratified by island divisions have widened. Indonesia has made considerable gains in reducing under-five and neonatal mortality at a national level, with the largest reductions happening before the Asian financial crisis (1997-98) and decentralisation (2000). Hasty implementation of decentralisation reforms may have contributed to a slowdown in mortality rate reduction thereafter. Widening inequities between the most developed provinces of Java-Bali and those of other island groupings should be of particular concern for a country embarking on an ambitious plan for universal health coverage by 2019. A focus on addressing the key supply side barriers to accessing health care and on the social determinants of health in remote and disadvantaged regions will

  12. Location matters: trends in inequalities in child mortality in Indonesia. Evidence from repeated cross-sectional surveys.

    Directory of Open Access Journals (Sweden)

    Andrew Hodge

    Full Text Available Considerable improvements in life expectancy and other human development indicators in Indonesia are thought to mask considerable disparities between populations in the country. We examine the existence and extent of these disparities by measuring trends and inequalities in the under-five mortality rate and neonatal mortality rate across wealth, education and geography.Using data from seven waves of the Indonesian Demographic and Health Surveys, direct estimates of under-five and neonatal mortality rates were generated for 1980-2011. Absolute and relative inequalities were measured by rate differences and ratios, and where possible, slope and relative indices of inequality. Disparities were assessed by levels of rural/urban location, island groups, maternal education and household wealth.Declines in national rates of under-five and neonatal mortality have accorded with reductions of absolute inequalities in clusters stratified by wealth, maternal education and rural/urban location. Across these groups, relative inequalities have generally stabilised, with possible increases with respect to mortality across wealth subpopulations. Both relative and absolute inequalities in rates of under-five and neonatal mortality stratified by island divisions have widened.Indonesia has made considerable gains in reducing under-five and neonatal mortality at a national level, with the largest reductions happening before the Asian financial crisis (1997-98 and decentralisation (2000. Hasty implementation of decentralisation reforms may have contributed to a slowdown in mortality rate reduction thereafter. Widening inequities between the most developed provinces of Java-Bali and those of other island groupings should be of particular concern for a country embarking on an ambitious plan for universal health coverage by 2019. A focus on addressing the key supply side barriers to accessing health care and on the social determinants of health in remote and

  13. Mortality patterns in Vietnam, 2006: Findings from a national verbal autopsy survey

    Directory of Open Access Journals (Sweden)

    Adair Timothy

    2010-03-01

    Full Text Available Abstract Background Accurate nationally representative statistics on total and cause-specific mortality in Vietnam are lacking due to incomplete capture in government reporting systems. This paper presents total and cause-specific mortality results from a national verbal autopsy survey conducted first time in Vietnam in conjunction with the annual population change survey and discusses methodological and logistical challenges associated with the implementation of a nation-wide assessment of mortality based on surveys. Verbal autopsy interviews, using the WHO standard questionnaire, were conducted with close relatives of the 6798 deaths identified in the 2007 population change survey in Vietnam. Data collectors were health staff recruited from the commune health station who undertook 3-day intensive training on VA interview. The Preston-Coale method assessed the level of completeness of mortality reporting from the population change survey. The number of deaths in each age-sex grouping is inflated according to the estimate of completeness to produce an adjusted number of deaths. Underlying causes of death were aggregated to the International Classification of Diseases Mortality Tabulation List 1. Leading causes of death were tabulated by sex for three broad age groups: 0-14 years; 15-59 years; and 60 years and above. Findings Completeness of mortality reporting was 69% for males and 54% for females with substantial regional variation. The use of VA has resulted in 10% of deaths being classified to ill-defined among males, and 15% among females. More ill-defined deaths were reported among the 60 year or above age group. Incomplete death reporting, wide geographical dispersal of deaths, extensive travel between households, and substantial variation in local responses to VA interviews challenged the implementation of a national mortality and cause of death assessment based on surveys. Conclusions Verbal autopsy can be a viable tool to identify cause

  14. Childhood IQ and all-cause mortality before and after age 65: Prospective observational study linking the Scottish Mental Survey 1932 and the Midspan studies

    OpenAIRE

    Hart, C.L.; Taylor, M.D.; Davey Smith, G.; Whalley, L.J.; Starr, J.M.; Hole, D.; Wilson, V.; Deary, I.J.

    2005-01-01

    OBJECTIVES: The objective was to investigate how childhood IQ related to all-cause mortality before and after age 65. DESIGN: The Midspan prospective cohort studies, followed-up for mortality for 25 years, were linked to individuals' childhood IQ from the Scottish Mental Survey 1932. METHODS: The Midspan studies collected data on risk factors for cardiorespiratory disease from a questionnaire and at a screening examination, and were conducted on adults in Scotland in the 1970s. An age 11 IQ f...

  15. Mortality of Stroke and Its Subtypes in China: Results from a Nationwide Population-Based Survey.

    Science.gov (United States)

    Chen, Zhenghong; Jiang, Bin; Ru, Xiaojuan; Sun, Haixin; Sun, Dongling; Liu, Xiangtong; Li, Yichong; Li, Di; Guo, Xiuhua; Wang, Wenzhi

    2017-01-01

    In China, stroke is the leading cause of death and contributes to a heavy disease burden. However, a nationwide population-based survey of the mortality of stroke and its subtypes is lacking for this country. Data derived from the National Epidemiological Survey of Stroke in China, which was a multistage, stratified clustering sampling-designed, cross-sectional survey, were analyzed. Mortality rate analyses were performed for 476,156 participants ≥20 years old from September 1, 2012 to August 31, 2013. Of the 476,156 participants in the investigated population, 364 died of ischemic stroke, 373 of hemorrhagic stroke, and 21 of stroke of undetermined pathological type. The age-standardized mortality rates per 100,000 person-years among those aged ≥20 years were 114.8 for total stroke, 56.5 for ischemic stroke, and 55.8 for hemorrhagic stroke. The age-standardized mortality rates of total stroke, ischemic stroke, and hemorrhagic stroke were all higher in rural areas than those in urban areas. The stroke mortality rate was higher in the northern regions than in the south. An estimated 1.12 million people aged ≥20 years in China died of stroke during the period from September 1, 2012 to August 31, 2013. The burden of stroke in China is still heavy. Greater attention should be paid to improve strategies for preventing stroke. © 2017 S. Karger AG, Basel.

  16. 46 CFR 71.50-3 - Drydock examination, internal structural examination, underwater survey, and alternate hull exam...

    Science.gov (United States)

    2010-10-01

    ..., underwater survey, and alternate hull exam intervals. 71.50-3 Section 71.50-3 Shipping COAST GUARD...-3 Drydock examination, internal structural examination, underwater survey, and alternate hull exam... wooden hulls must undergo two drydock and two internal structural examinations within any five year...

  17. Space-Time Smoothing of Complex Survey Data: Small Area Estimation for Child Mortality.

    Science.gov (United States)

    Mercer, Laina D; Wakefield, Jon; Pantazis, Athena; Lutambi, Angelina M; Masanja, Honorati; Clark, Samuel

    2015-12-01

    Many people living in low and middle-income countries are not covered by civil registration and vital statistics systems. Consequently, a wide variety of other types of data including many household sample surveys are used to estimate health and population indicators. In this paper we combine data from sample surveys and demographic surveillance systems to produce small area estimates of child mortality through time. Small area estimates are necessary to understand geographical heterogeneity in health indicators when full-coverage vital statistics are not available. For this endeavor spatio-temporal smoothing is beneficial to alleviate problems of data sparsity. The use of conventional hierarchical models requires careful thought since the survey weights may need to be considered to alleviate bias due to non-random sampling and non-response. The application that motivated this work is estimation of child mortality rates in five-year time intervals in regions of Tanzania. Data come from Demographic and Health Surveys conducted over the period 1991-2010 and two demographic surveillance system sites. We derive a variance estimator of under five years child mortality that accounts for the complex survey weighting. For our application, the hierarchical models we consider include random effects for area, time and survey and we compare models using a variety of measures including the conditional predictive ordinate (CPO). The method we propose is implemented via the fast and accurate integrated nested Laplace approximation (INLA).

  18. National Health and Nutrition Examination Survey: national youth fitness survey plan, operations, and analysis, 2012.

    Science.gov (United States)

    Borrud, Lori; Chiappa, Michele M; Burt, Vicki L; Gahche, Jaime; Zipf, George; Johnson, Clifford L; Dohrmann, Sylvia M

    2014-04-01

    In October 2008, the federal government issued its first-ever Physical Activity Guidelines for Americans to provide science-based guidance on the types and amounts of physical activity that provide substantial health benefits for Americans (1). Guidelines for children and adolescents recommend 60 minutes or more of aerobic, muscle-strengthening, or bone-strengthening physical activity daily (1). While the number of children in the United States who meet the recommendations in the Physical Activity Guidelines is unknown, the percentage that is physically active in the United States may be declining. No recent national data exist on the fitness levels of children and adolescents. The National Health and Nutrition Examination Survey's (NHANES) National Youth Fitness Survey (NNYFS) was conducted in 2012 and collected data on physical activity and fitness levels for U.S. children and adolescents aged 3-15 years. The objective of NNYFS was to provide national-level estimates of the physical activity and fitness levels of children, based on interview and physical examination data. Results from the survey are intended to contribute to the development of policies and programs to improve youth fitness nationally. The data also may be used in the development of national reference standards for measures of fitness and physical activity. Methods The NNYFS survey design used the design for NHANES, which is a multistage probability sample of the civilian noninstitutionalized resident population of the United States. NNYFS consisted of a household interview and a physical activity and fitness examination in a mobile examination center. A total of 1,640 children and adolescents aged 3-15 were interviewed, and 1,576 were examined. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  19. An algorithm to assess methodological quality of nutrition and mortality cross-sectional surveys: development and application to surveys conducted in Darfur, Sudan.

    Science.gov (United States)

    Prudhon, Claudine; de Radiguès, Xavier; Dale, Nancy; Checchi, Francesco

    2011-11-09

    Nutrition and mortality surveys are the main tools whereby evidence on the health status of populations affected by disasters and armed conflict is quantified and monitored over time. Several reviews have consistently revealed a lack of rigor in many surveys. We describe an algorithm for analyzing nutritional and mortality survey reports to identify a comprehensive range of errors that may result in sampling, response, or measurement biases and score quality. We apply the algorithm to surveys conducted in Darfur, Sudan. We developed an algorithm based on internationally agreed upon methods and best practices. Penalties are attributed for a list of errors, and an overall score is built from the summation of penalties accrued by the survey as a whole. To test the algorithm reproducibility, it was independently applied by three raters on 30 randomly selected survey reports. The algorithm was further applied to more than 100 surveys conducted in Darfur, Sudan. The Intra Class Correlation coefficient was 0.79 for mortality surveys and 0.78 for nutrition surveys. The overall median quality score and range of about 100 surveys conducted in Darfur were 0.60 (0.12-0.93) and 0.675 (0.23-0.86) for mortality and nutrition surveys, respectively. They varied between the organizations conducting the surveys, with no major trend over time. Our study suggests that it is possible to systematically assess quality of surveys and reveals considerable problems with the quality of nutritional and particularly mortality surveys conducted in the Darfur crisis.

  20. Rapid Survey For Measuring The Level And Causes Of Maternal Mortality

    Directory of Open Access Journals (Sweden)

    Kumar Rajesh

    1997-01-01

    Full Text Available Research question: What is the extent of problem of maternal mortality in a given population? Objective: 1. To evolve a rapid survey methodology aimed at measuring maternal mortality ratio. 2. To find out the probable medical causes of maternal deaths and behavioural factors associated with them. Study Design: cross- sectional. Setting: Urban and rural areas of district Mohindergarh, Haryana. Participants: Members of families in which a maternal death had taken place in last 12 months. Sample size: All 275 deaths among women 15-44 years occurring in the district from 1st April 95 to 31st March 96. Study variables: Age, gravida, parity, literacy, caste, land holding, health care facilities, distance from health centers, mode of conveyance. Statistical Analysis: Rates and ratios. Results: Maternal mortality ratio was estimated to be 275 per 100,000 live births (298 rural and 82 urban. Major causes of death were â€" sepsis(30%, haemorrhage (21%, abortion(5%, eclampsia (3% and obstructed labour(3%. Twenty-nine causes of deaths occurred at home and 26% on way to hospital. Out of 59(93.7% cases who could avail medical consultation, 61% arranged it within five hours after onset of symptoms, and 78% availed two, 21% three, and 11% four consulations. The survey was completed in three months at a cost of Rs. 54,000. Recommendations: Such rapid surveys should be carried out periodically (every 4-5 years to monitor the progress in maternal health. Staff of heath deptt. Should be involved in carrying out these surveys. This will not only help in reducing cost of the survey but information about specific problems of maternal mortality in the area can be utilized by health staff for taking appropriate action to improve maternal health care.

  1. Are the Poor Dying Younger in Malaysia? An Examination of the Socioeconomic Gradient in Mortality.

    Science.gov (United States)

    Mariapun, Jeevitha; Hairi, Noran N; Ng, Chiu-Wan

    2016-01-01

    Socioeconomic inequalities in health represent unfairness in the health distribution of a population. Efforts to produce information on mortality distributions in many low and middle income countries (LMICs) are mostly hampered by lack of data disaggregated by socioeconomic groups. In this paper we describe how mortality statistics obtained from multiple data sources were combined to provide an evaluation of the socioeconomic distribution of mortality in Malaysia, a LMIC located in the Asia Pacific region. This study has an ecological design. As a measure of socioeconomic status, we used principal component analysis to construct a socioeconomic index using census data. Districts were ranked according to the standardised median index of households and assigned to each individual in the 5-year mortality data. The mortality indicators of interest were potential years of life lost (PYLL), standardised mortality ratio (SMR), infant mortality rate (IMR) and under-5 mortality rate (U5MR). Both socioeconomic status and mortality outcomes were used compute the concentration index which provided the summary measure of the magnitude of inequality. Socially disadvantaged districts were found to have worse mortality outcomes compared to more advantaged districts. The values of the concentration index for the overall population of the Peninsula are C = -0.1334 (95% CI: -0.1605 to -0.1063) for the PYLL, C = -0.0685 (95% CI: -0.0928 to -0.0441) for the SMR, C = -0.0997 (95% CI: -0.1343 to -0.0652) for the IMR and C = -0.1207 (95% CI: -0.1523 to -0.0891) for the U5MR. Mortality outcomes within ethnic groups were also found to be less favourable among the poor. The findings of this study suggest that socioeconomic inequalities disfavouring the poor exist in Malaysia.

  2. Cancer mortality in women after repeated fluoroscopic examinations of the chest

    International Nuclear Information System (INIS)

    Boice, J.D.; Monson, R.R.; Rosenstein, M.

    1981-01-01

    Among 1,047 women fluoroscopically examined in average of 102 times during pneumothorax therapy for tuberculosis and followed up to 45 years (average . 27 yr), no increase in the total number of cancer deaths occurred when these women were compared to 717 women who received other treatments [relative risk (RR) . 0.8]. However, elevated risks of mortality from stomach cancer (RR . 2.3), rectal cancer (RR . 3.8), breast cancer (RR . 1.2), lung cancer (RR . 1.8), and leukemia (RR . 1.2) were observed, but none was statistically significant and all were based on very small numbers of deaths. These increases were balanced by decreases of genital cancer (RR . 0.2), pancreatic cancer (RR . 0.9), lymphoma (RR . 0.6), and all other cancers (RR . 0.1). Average cumulative absorbed doses were 110 rads for the lungs, 33 rads for the trunk, 13 rads for the active bone marrow, and 7 rads for the stomach. The following upper levels of excess risk could be excluded with 95% confidence: 3.5 deaths/10(6) woman-year (WY)-rad for lung cancer, 4.8 deaths/10(6) WY-rad for lymphoma, and 12 deaths/10(6) WY-rad for leukemia. These findings indicated that the carcinogenic effect of multiple low-dose X-ray exposures was not greater than that currently assumed

  3. Mortality from breast cancer after irradiation during fluoroscopic examinations in patients being treated for tuberculosis

    International Nuclear Information System (INIS)

    Miller, A.B.; Howe, G.R.; Sherman, G.J.; Lindsay, J.P.; Yaffe, M.J.; Dinner, P.J.; Risch, H.A.; Preston, D.L.

    1989-01-01

    The increasing use of mammography to screen asymptomatic women makes it important to know the risk of breast cancer associated with exposure to low levels of ionizing radiation. We examined the mortality from breast cancer in a cohort of 31,710 women who had been treated for tuberculosis at Canadian sanatoriums between 1930 and 1952. A substantial proportion (26.4 percent) had received radiation doses to the breast of 10 cGy or more from repeated fluoroscopic examinations during therapeutic pneumothoraxes. Women exposed to greater than or equal to 10 cGy of radiation had a relative risk of death from breast cancer of 1.36, as compared with those exposed to less than 10 cGy (95 percent confidence interval, 1.11 to 1.67; P = 0.001). The data were most consistent with a linear dose-response relation. The risk was greatest among women who had been exposed to radiation when they were between 10 and 14 years of age; they had a relative risk of 4.5 per gray, and an additive risk of 6.1 per 10(4) person-years per gray. With increasing age at first exposure, there was substantially less excess risk, and the radiation effect appeared to peak approximately 25 to 34 years after the first exposure. Our additive model for lifetime risk predicts that exposure to 1 cGy at the age of 40 increases the number of deaths from breast cancer by 42 per million women. We conclude that the risk of breast cancer associated with radiation decreases sharply with increasing age at exposure and that even a small benefit to women of screening mammography would outweigh any possible risk of radiation-induced breast cancer

  4. A Qualitative Survey Examining the Moral Identities of Young Adults

    Science.gov (United States)

    Onat Kocabiyik, Oya; Kulaksizoglu, Adnan

    2014-01-01

    Moral identity can orient one's behaviors when exhibiting any kind of moral behavior. In this study, the moral identities of young adults are analyzed to a certain extent. For this purpose, the "interpretative phenomenological pattern" and "grounded theory" models are used as qualitative survey models. The study group for…

  5. Mortality and malnutrition among populations living in South Darfur, Sudan: results of 3 surveys, September 2004.

    Science.gov (United States)

    Grandesso, Francesco; Sanderson, Frances; Kruijt, Jenneke; Koene, Ton; Brown, Vincent

    2005-03-23

    Mass violence against civilians in the west of Sudan has resulted in the displacement of more than 1.5 million people (25% of the population of the Darfur region). Most of these people are camped in 142 settlements. There has been increasing international concern about the health status of the displaced population. To perform rapid epidemiological assessments of mortality and nutritional status at 3 sites in South Darfur for relief efforts. In August and September 2004, mortality surveys were conducted among 137,000 internally displaced persons (IDPs) in 3 sites in South Darfur (Kass [n = 900 households], Kalma [n = 893 households], and Muhajiria [n = 900 households]). A nutritional survey was performed concomitantly among children aged 6 to 59 months using weight for height as an index of acute malnutrition (Kass [n = 894], Kalma [n = 888], and Muhajiria [n = 896]). A questionnaire detailing access to food and basic services was administered to a subset of households (n = 210 in each site). Crude and under 5-year mortality rates and nutritional status of IDPs in Kass, Kalma, and Muhajiria, South Darfur. Crude mortality rates, expressed as deaths per 10,000 per day, were 3.2 (95% confidence interval [CI], 2.2-4.1) in Kass, 2.0 (95% CI, 1.3-2.7) in Kalma, and 2.3 (95% CI, 1.2-3.4) in Muhajiria. Under 5-year mortality rates were 5.9 (95% CI, 3.8-8.0) in Kass, 3.5 (95% CI, 1.5-5.7) in Kalma, and 1.0 (95% CI, 0.03-1.9) in Muhajiria. During the period of displacement covered by our survey in Muhajiria, violence was reported to be responsible for 72% of deaths, mainly among young men. Diarrheal disease was reported to cause between 25% and 47% of deaths in camp residents and mainly affected the youngest and oldest age groups. Acute malnutrition was common, affecting 14.1% of the target population in Kass, 23.6% in Kalma, and 10.7% in Muhajiria. This study provides epidemiological evidence of the high rates of mortality and malnutrition among the displaced population in

  6. National Survey on Justification of CT-examinations in Sweden

    Energy Technology Data Exchange (ETDEWEB)

    Almen, Anja; Leitz, Wolfram; Richter, Sven

    2009-02-15

    All examinations in diagnostic radiology shall be justified to avoid unnecessary irradiation of the patients. The objective of the study was to investigate the degree of justification for CT-examinations in Sweden. Referrals for all examinations performed during one day were retrospectively evaluated by a group of physicians. The study was designed and conducted by a project group lead by prof. Haakan Jorulf. The authors of this report have derived the results and conclusions on the basis of the data and are responsible for the content of this report. The principle result was that approximately 20 % of all examinations were not justified. The degree of justification varied strongly with organ examined, moderately with prescriber affiliation and weakly with geographical region. If unjustified examinations could be avoided a large dose reduction for the population would be achieved. This study shows that there is a need for improvements and the authority will continue to work with this issue

  7. National Survey on Justification of CT-examinations in Sweden

    International Nuclear Information System (INIS)

    Almen, Anja; Leitz, Wolfram; Richter, Sven

    2009-02-01

    All examinations in diagnostic radiology shall be justified to avoid unnecessary irradiation of the patients. The objective of the study was to investigate the degree of justification for CT-examinations in Sweden. Referrals for all examinations performed during one day were retrospectively evaluated by a group of physicians. The study was designed and conducted by a project group lead by prof. Haakan Jorulf. The authors of this report have derived the results and conclusions on the basis of the data and are responsible for the content of this report. The principle result was that approximately 20 % of all examinations were not justified. The degree of justification varied strongly with organ examined, moderately with prescriber affiliation and weakly with geographical region. If unjustified examinations could be avoided a large dose reduction for the population would be achieved. This study shows that there is a need for improvements and the authority will continue to work with this issue

  8. Temporal Trends in Geographical Variation in Breast Cancer Mortality in China, 1973–2005: An Analysis of Nationwide Surveys on Cause of Death

    Directory of Open Access Journals (Sweden)

    Changfa Xia

    2016-09-01

    Full Text Available To describe geographical variation in breast cancer mortality over time, we analysed breast cancer mortality data from three retrospective national surveys on causes of death in recent decades in China. We first calculated the age-standardized mortality rate (ASMR for each of the 31 provinces in mainland China stratified by survey period (1973–1975, 1990–1992 and 2004–2005. To test whether the geographical variation in breast cancer mortality changed over time, we then estimated the rate ratio (RR for the aggregated data for seven regions and three economic zones using generalized linear models. Finally, we examined the correlation between mortality rate and several macro-economic measures at the provincial level. We found that the overall ASMR increased from 2.98 per 100,000 in 1973–1975 to 3.08 per 100,000 in 1990–1992, and to 3.85 per 100,000 in 2004–2005. Geographical variation in breast cancer mortality also increased significantly over time at the regional level (p = 0.002 but not at the economic zone (p = 0.089 level, with RR being generally lower for Western China (Northwest and Southwest and higher in Northeast China over the three survey periods. These temporal and spatial trends in breast cancer mortality were found to be correlated with per capita gross domestic product, number of hospitals and health centres’ beds per 10,000 population and number of practicing doctors per 10,000 population, and average number of live births for women aged 15–64. It may be necessary to target public health policies in China to address the widening geographic variation in breast cancer mortality, and to take steps to ensure that the ease of access and the quality of cancer care across the country is improved for all residents.

  9. Temporal Trends in Geographical Variation in Breast Cancer Mortality in China, 1973–2005: An Analysis of Nationwide Surveys on Cause of Death

    Science.gov (United States)

    Xia, Changfa; Kahn, Clare; Wang, Jinfeng; Liao, Yilan; Chen, Wanqing; Yu, Xue Qin

    2016-01-01

    To describe geographical variation in breast cancer mortality over time, we analysed breast cancer mortality data from three retrospective national surveys on causes of death in recent decades in China. We first calculated the age-standardized mortality rate (ASMR) for each of the 31 provinces in mainland China stratified by survey period (1973–1975, 1990–1992 and 2004–2005). To test whether the geographical variation in breast cancer mortality changed over time, we then estimated the rate ratio (RR) for the aggregated data for seven regions and three economic zones using generalized linear models. Finally, we examined the correlation between mortality rate and several macro-economic measures at the provincial level. We found that the overall ASMR increased from 2.98 per 100,000 in 1973–1975 to 3.08 per 100,000 in 1990–1992, and to 3.85 per 100,000 in 2004–2005. Geographical variation in breast cancer mortality also increased significantly over time at the regional level (p = 0.002) but not at the economic zone (p = 0.089) level, with RR being generally lower for Western China (Northwest and Southwest) and higher in Northeast China over the three survey periods. These temporal and spatial trends in breast cancer mortality were found to be correlated with per capita gross domestic product, number of hospitals and health centres’ beds per 10,000 population and number of practicing doctors per 10,000 population, and average number of live births for women aged 15–64. It may be necessary to target public health policies in China to address the widening geographic variation in breast cancer mortality, and to take steps to ensure that the ease of access and the quality of cancer care across the country is improved for all residents. PMID:27690073

  10. Temporal Trends in Geographical Variation in Breast Cancer Mortality in China, 1973-2005: An Analysis of Nationwide Surveys on Cause of Death.

    Science.gov (United States)

    Xia, Changfa; Kahn, Clare; Wang, Jinfeng; Liao, Yilan; Chen, Wanqing; Yu, Xue Qin

    2016-09-28

    To describe geographical variation in breast cancer mortality over time, we analysed breast cancer mortality data from three retrospective national surveys on causes of death in recent decades in China. We first calculated the age-standardized mortality rate (ASMR) for each of the 31 provinces in mainland China stratified by survey period (1973-1975, 1990-1992 and 2004-2005). To test whether the geographical variation in breast cancer mortality changed over time, we then estimated the rate ratio (RR) for the aggregated data for seven regions and three economic zones using generalized linear models. Finally, we examined the correlation between mortality rate and several macro-economic measures at the provincial level. We found that the overall ASMR increased from 2.98 per 100,000 in 1973-1975 to 3.08 per 100,000 in 1990-1992, and to 3.85 per 100,000 in 2004-2005. Geographical variation in breast cancer mortality also increased significantly over time at the regional level ( p = 0.002) but not at the economic zone ( p = 0.089) level, with RR being generally lower for Western China (Northwest and Southwest) and higher in Northeast China over the three survey periods. These temporal and spatial trends in breast cancer mortality were found to be correlated with per capita gross domestic product, number of hospitals and health centres' beds per 10,000 population and number of practicing doctors per 10,000 population, and average number of live births for women aged 15-64. It may be necessary to target public health policies in China to address the widening geographic variation in breast cancer mortality, and to take steps to ensure that the ease of access and the quality of cancer care across the country is improved for all residents.

  11. ABR Core examination preparation: results of a survey of fourth-year radiology residents who took the 2013 examination.

    Science.gov (United States)

    Shetty, Anup S; Grajo, Joseph R; Decker, Summer; Heitkamp, Darel E; DeStigter, Kristen K; Mezwa, Duane G; Deitte, Lori

    2015-01-01

    A survey was administered to fourth-year radiology residents after receiving their results from the first American Board of Radiology (ABR) Core examination in 2013. The purpose was to gather information regarding resources and study strategies to share with program directors and future resident classes. An online survey was distributed to examinees nationwide. The survey included free-response and multiple choice questions that covered examination results, perceived value of enumerated study resources, case-based and didactic teaching conferences, board reviews, study materials for noninterpretive skills, multidisciplinary conference attendance, and free-form comments. Two hundred sixty-six of 1186 residents who took the Core examination responded to the survey. Some resources demonstrated a significant difference in perceived value between residents who passed the examination and residents who failed, including internal board reviews (1.10, P multiple choice questions, audience response, and integration of clinical physics and patient safety topics compared to residents who failed. Radiology residents and residency programs have adapted their preparations for the ABR Core examination in a variety of ways. Certain practices and study tools, including daily conferences and internal board reviews, had greater perceived value by residents who passed the examination than by residents who failed. This survey provides insights that can be used to assess and modify current preparation strategies for the ABR Core examination. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

  12. Increased Cancer Mortality Risk for NASA's ISS Astronauts: The Contribution of Diagnostic Radiological Examinations

    Science.gov (United States)

    Dodge, C.W.; Picco, C. E.; Gonzalez, S. M.; Johnston, S. L.; Van Baalen, M.; Shavers, M.R.

    2009-01-01

    This viewgraph presentation reviews the radiation exposures and risks associated with long-term spaceflight on the International Space Station. NASA's risk model of cancer mortality is also presented.

  13. An algorithm to assess methodological quality of nutrition and mortality cross-sectional surveys: development and application to surveys conducted in Darfur, Sudan

    Directory of Open Access Journals (Sweden)

    Prudhon Claudine

    2011-11-01

    Full Text Available Abstract Background Nutrition and mortality surveys are the main tools whereby evidence on the health status of populations affected by disasters and armed conflict is quantified and monitored over time. Several reviews have consistently revealed a lack of rigor in many surveys. We describe an algorithm for analyzing nutritional and mortality survey reports to identify a comprehensive range of errors that may result in sampling, response, or measurement biases and score quality. We apply the algorithm to surveys conducted in Darfur, Sudan. Methods We developed an algorithm based on internationally agreed upon methods and best practices. Penalties are attributed for a list of errors, and an overall score is built from the summation of penalties accrued by the survey as a whole. To test the algorithm reproducibility, it was independently applied by three raters on 30 randomly selected survey reports. The algorithm was further applied to more than 100 surveys conducted in Darfur, Sudan. Results The Intra Class Correlation coefficient was 0.79 for mortality surveys and 0.78 for nutrition surveys. The overall median quality score and range of about 100 surveys conducted in Darfur were 0.60 (0.12-0.93 and 0.675 (0.23-0.86 for mortality and nutrition surveys, respectively. They varied between the organizations conducting the surveys, with no major trend over time. Conclusion Our study suggests that it is possible to systematically assess quality of surveys and reveals considerable problems with the quality of nutritional and particularly mortality surveys conducted in the Darfur crisis.

  14. Food balance sheet and household budget survey dietary data and mortality patterns in Europe.

    Science.gov (United States)

    Naska, Androniki; Berg, Mari-Anna; Cuadrado, Carmen; Freisling, Heinz; Gedrich, Kurt; Gregoric, Matej; Kelleher, Cecily; Leskova, Emilia; Nelson, Michael; Pace, Lucienne; Remaut, Anne-Marie; Rodrigues, Sara; Sekula, Wlodzimierz; Sjöstrom, Michael; Trygg, Kerstin; Turrini, Aida; Volatier, Jean Luc; Zajkas, Gabor; Trichopoulou, Antonia

    2009-07-01

    Worldwide dietary data for nutrition monitoring and surveillance are commonly derived from food balance sheets (FBS) and household budget surveys (HBS). We have compared food supply from FBS and food availability data from HBS among eighteen European countries and have estimated the extent to which they correlate, focusing on food groups which are comparably captured by FBS and HBS and for which there is epidemiological evidence that they can have a noticeable impact on population mortality. Spearman's correlation coefficient was +0.78 (P 0.05 in some instances). FBS and HBS have their own strengths and weaknesses, but they may complement each other in dietary assessments at the population level.

  15. Collaborative survey of perinatal loss in planned and unplanned home births. Northern Region Perinatal Mortality Survey Coordinating Group.

    Science.gov (United States)

    1996-11-23

    To document the outcome of planned and unplanned births outside hospital. Confidential review of every pregnancy ending in stillbirth or neonatal death in which plans had been made for home delivery, irrespective of where delivery eventually occurred. The review was part of a sustained collaborative survey of all perinatal deaths. Northern Regional Health Authority area. All 558,691 registered births to women normally resident in the former Northern Regional Health Authority area during 1981-94. Perinatal death. The estimated perinatal mortality during 1981-94 among women booked for a home birth was 14 deaths in 2888 births. This was less than half that among all women in the region. Only three of the 14 women delivered outside hospital. Independent review suggested that two of the 14 deaths might have been averted by different management. Both births occurred in hospital, and in only one was management before admission of the mother judged inappropriate. Perinatal loss to the 64 women who booked for hospital delivery but delivered outside and to the 67 women who delivered outside hospital without ever making arrangements to receive professional care during labour accounted for the high perinatal mortality (134 deaths in 3466 deliveries) among all births outside hospital. The perinatal hazard associated with planned home birth in the few women who exercised this option (unplanned delivery outside hospital.

  16. Cancer mortality among women frequently exposed to radiographic examinations for spinal disorders

    NARCIS (Netherlands)

    Ronckers, Cécile M.; Land, Charles E.; Miller, Jeremy S.; Stovall, Marilyn; Lonstein, John E.; Doody, Michele M.

    2010-01-01

    We studied cancer mortality in a cohort of 5,573 women with scoliosis and other spine disorders who were diagnosed between 1912 and 1965 and were exposed to frequent diagnostic X-ray procedures. Patients were identified from medical records in 14 orthopedic medical centers in the United States and

  17. An examination of the association between premature mortality and life expectancy among men in Europe

    DEFF Research Database (Denmark)

    White, Alan; McKee, Martin; de Sousa, Bruno

    2014-01-01

    A feature of the health of men across Europe is their higher rates of premature mortality and shorter life expectancy at birth than women. Following the publication of the first State of Men's Health in Europe report, we sought to explore possible reasons....

  18. Violence and mortality in West Darfur, Sudan (2003-04): epidemiological evidence from four surveys.

    Science.gov (United States)

    Depoortere, Evelyn; Checchi, Francesco; Broillet, France; Gerstl, Sibylle; Minetti, Andrea; Gayraud, Olivia; Briet, Virginie; Pahl, Jennifer; Defourny, Isabelle; Tatay, Mercedes; Brown, Vincent

    Violence in Darfur, Sudan, has rendered more than one million people internally displaced. An epidemiological study of the effect of armed incursions on mortality in Darfur was needed to provide a basis for appropriate assistance to internally displaced people. Between April and June, 2004, we did retrospective cluster surveys among 215?400 internally displaced people in four sites of West Darfur (Zalingei, Murnei, Niertiti, El Geneina). Mortality recall periods covered both the pre-displacement and post-displacement periods in Zalingei, Murnei, and Niertiti, but not in El Geneina. Heads of households provided dates, causes, and places of deaths, and described the family structure. Before arrival at displacement sites, mortality rates (expressed as deaths per 10?000 per day), were 5.9 (95% CI 2.2-14.9) in Zalingei, 9.5 (6.4-14.0) in Murnei, and 7.3 (3.2-15.7) in Niertiti. Violence caused 68-93% of these deaths. People who were killed were mostly adult men (relative risk 29.1-117.9 compared with children younger than 15 years), but included women and children. Most households fled because of direct village attacks. In camps, mortality rates fell but remained above the emergency benchmark, with a peak of 5.6 in El Geneina. Violence persisted even after displacement. Age and sex pyramids of surviving populations were skewed, with a deficit in men. This study, which was done in a difficult setting, provides epidemiological evidence of this conflict's effect on civilians, confirming the serious nature of the crisis, and reinforcing findings from other war contexts.

  19. The contribution of unimproved water and toilet facilities to pregnancy-related mortality in Afghanistan: analysis of the Afghan Mortality Survey.

    Science.gov (United States)

    Gon, Giorgia; Monzon-Llamas, Laura; Benova, Lenka; Willey, Barbara; Campbell, Oona M R

    2014-12-01

    To estimate the effect of unimproved household water and toilet facilities on pregnancy-related mortality in Afghanistan. The data source was a population-based cross-sectional study, the Afghan Mortality Survey 2010. Descriptive, univariate and multivariate logistic regression analyses were carried out, comparing 69 pregnancy-related deaths (cases) and 15386 surviving women (non-cases) who had a live birth or stillbirth between 2007 and 2010. After adjusting for confounders, households with unimproved water access had 1.91 the odds of pregnancy-related mortality [95% confidence interval (CI) 1.11-3.30] compared to households with improved water access. We also found an association between unimproved toilet facilities and pregnancy-related mortality (OR = 2.25; 95% CI 0.71-7.19; P-value = 0.169), but it was not statistically significant. Unimproved household water access was an important risk factor for pregnancy-related mortality in Afghanistan. However, we were unable to discern whether unimproved water source is a marker of unhygienic environments or socio-economic position. There was weak evidence for the association between unimproved toilet facilities and pregnancy-related mortality; this association requires confirmation from larger studies. © 2014 John Wiley & Sons Ltd.

  20. Serum Phosphorus Concentrations in the Third National Health and Nutrition Examination Survey (NHANES III)

    Science.gov (United States)

    de Boer, Ian H.; Rue, Tessa C.; Kestenbaum, Bryan

    2011-01-01

    Background Higher serum phosphorus concentrations within the normal laboratory range have been associated with cardiovascular events and mortality in large prospective cohort studies of individuals with and without kidney disease. Reasons for interindividual variation in steady-state serum phosphorus concentrations are largely unknown. Study Design Cross-sectional study. Setting & Participants 15,513 participants in the Third National Health and Nutrition Examination Survey. Predictors Demographic data, dietary intake measured by means of 24-hour dietary recall and food-frequency questionnaire, and established cardiovascular risk factors. Outcome & Measurements Serum phosphorus concentration. Results Mean serum phosphorus concentrations were significantly greater in women (+0.16 mg/dL versus men; P phosphorus and phosphorus-rich foods were associated only weakly with circulating serum phosphorus concentrations, if at all. Higher serum phosphorus levels were associated with lower calculated Framingham coronary heart disease risk scores, which are based on traditional atherosclerosis risk factors. In aggregate, demographic, nutritional, cardiovascular, and kidney function variables explained only 12% of the variation in circulating serum phosphorus concentrations. Limitations Results may differ with advanced kidney disease. Conclusions Serum phosphorus concentration is weakly related to dietary phosphorus and not related to a diverse array of phosphorus-rich foods in the general population. Factors determining serum phosphorus concentration are largely unknown. Previously observed associations of serum phosphorus concentrations with cardiovascular events are unlikely to be a result of differences in dietary intake or traditional cardiovascular risk factors. PMID:18992979

  1. Examining the medical blogosphere: an online survey of medical bloggers.

    Science.gov (United States)

    Kovic, Ivor; Lulic, Ileana; Brumini, Gordana

    2008-09-23

    Blogs are the major contributors to the large increase of new websites created each year. Most blogs allow readers to leave comments and, in this way, generate both conversation and encourage collaboration. Despite their popularity, however, little is known about blogs or their creators. To contribute to a better understanding of the medical blogosphere by investigating the characteristics of medical bloggers and their blogs, including bloggers' Internet and blogging habits, their motivations for blogging, and whether or not they follow practices associated with journalism. We approached 197 medical bloggers of English-language medical blogs which provided direct contact information, with posts published within the past month. The survey included 37 items designed to evaluate data about Internet and blogging habits, blog characteristics, blogging motivations, and, finally, the demographic data of bloggers. Pearson's Chi-Square test was used to assess the significance of an association between 2 categorical variables. Spearman's rank correlation coefficient was utilized to reveal the relationship between participants' ages, as well as the number of maintained blogs, and their motivation for blogging. The Mann-Whitney U test was employed to reveal relationships between practices associated with journalism and participants' characteristics like gender and pseudonym use. A total of 80 (42%) of 197 eligible participants responded. The majority of responding bloggers were white (75%), highly educated (71% with a Masters degree or doctorate), male (59%), residents of the United States (72%), between the ages of 30 and 49 (58%), and working in the healthcare industry (67%). Most of them were experienced bloggers, with 23% (18/80) blogging for 4 or more years, 38% (30/80) for 2 or 3 years, 32% (26/80) for about a year, and only 7% (6/80) for 6 months or less. Those who received attention from the news media numbered 66% (53/80). When it comes to best practices associated

  2. Causes of death in Prader-Willi syndrome: Prader-Willi Syndrome Association (USA) 40-year mortality survey.

    Science.gov (United States)

    Butler, Merlin G; Manzardo, Ann M; Heinemann, Janalee; Loker, Carolyn; Loker, James

    2017-06-01

    Prader-Willi syndrome (PWS) is a rare, complex, neurodevelopmental genetic disorder that is associated with hyperphagia and morbid obesity in humans and leads to a shortened life expectancy. This report summarizes the primary causes of death and evaluates mortality trends in a large cohort of individuals with PWS. The US Prader-Willi Syndrome Association (PWSA (USA)) syndrome-specific database of death reports was collected through a cursory bereavement program for PWSA (USA) families using a brief survey created in 1999. Causes of death were descriptively characterized and statistically examined using Cox proportional hazards. A total of 486 deaths were reported (263 males, 217 females, 6 unknown) between 1973 and 2015, with mean age of 29.5 ± 16 years (2 months-67 years); 70% occurred in adulthood. Respiratory failure was the most common cause, accounting for 31% of all deaths. Males were at increased risk for presumed hyperphagia-related accidents/injuries and cardiopulmonary factors compared to females. PWS maternal disomy 15 genetic subtype showed an increased risk of death from cardiopulmonary factors compared to the deletion subtype. These findings highlight the heightened vulnerability to obesity and hyperphagia-related mortality in PWS. Future research is needed to address critical vulnerabilities such as gender and genetic subtype in the cause of death in PWS.Genet Med advance online publication 17 November 2016.

  3. Association between changes in lifestyle and all-cause mortality: the Health and Lifestyle Survey.

    OpenAIRE

    White, J.; Greene, G.; Kivimaki, M.; Batty, G. D.

    2018-01-01

    BACKGROUND: To examine the combined influence of changes in physical activity, diet, smoking and alcohol consumption on all-cause mortality. METHODS: Health behaviours were assessed in 1984/1985 and 1991/1992 in 8123 adults from the UK (4666 women, median age 41.0 years). An unhealthy lifestyle score was calculated, allocating one point for smoking, fruits and vegetables 21 units of alcohol (men) per week. RESULTS: There were 2003 deaths over a median follow-up of 6.6 years (IQR 5.9-7.2) foll...

  4. Mortality among twins and singletons in sub-Saharan Africa between 1995 and 2014: a pooled analysis of data from 90 Demographic and Health Surveys in 30 countries.

    Science.gov (United States)

    Monden, Christiaan W S; Smits, Jeroen

    2017-07-01

    Sub-Saharan Africa has the world's highest under-5 and neonatal mortality rates as well as the highest naturally occurring twin rates. Twin pregnancies carry high risk for children and mothers. Under-5 mortality has declined in sub-Saharan Africa over the last decades. It is unknown whether twins have shared in this reduction. We pooled data from 90 Demographic and Health Surveys for 30 sub-Saharan Africa countries on births reported between 1995 and 2014. We used information on 1 685 110 singleton and 56 597 twin livebirths to compute trends in mortality rates for singletons and twins. We examined whether the twin-singleton rate ratio can be attributed to biological, socioeconomic, care-related factors, or birth size, and estimated the mortality burden among sub-Saharan African twins. Under-5 mortality among twins has declined from 327·7 (95% CI 312·0-343·5) per 1000 livebirths in 1995-2001 to 213·0 (196·7-229·2) in 2009-14. This decline of 35·0% was much less steep than the 50·6% reduction among singletons (from 128·6 [95% CI 126·4-130·8] per 1000 livebirths in 1995-2001 to 63·5 [61·6-65·3] in 2009-14). Twins account for an increasing share of under-5 deaths in sub-Saharan Africa: currently 10·7% of under-5 mortality and 15·1% of neonatal mortality. We estimated that about 315 000 twins (uncertainty interval 289 000-343 000) die in sub-Saharan African each year. Excess twin mortality cannot be explained by common risk factors for under-5 mortality, including birthweight. The difference with singletons was especially stark for neonatal mortality (rate ratio 5·0, 95% CI 4·5-5·6). 51·7% of women pregnant with twins reported receiving medical assistance at birth. The fate of twins in sub-Saharan Africa is lagging behind that of singletons. An alarming one-fifth of twins in the region dies before age 5 years, three times the mortality rate among singletons. Twins account for a substantial and growing share of under-5 and neonatal

  5. A survey of collection development for United States Medical Licensing Examination (USMLE) and National Board Dental Examination (NBDE) preparation material.

    Science.gov (United States)

    Hendrix, Dean; Hasman, Linda

    2008-07-01

    The research sought to ascertain medical and dental libraries' collection development policies, evaluation methods, purchase decisions, and issues that relate to print and electronic United States Medical Licensing Examination (USMLE) and National Board Dental Examination (NBDE) preparation materials. The investigators surveyed librarians supporting American Association of Medical Colleges (AAMC)-accredited medical schools (n = 58/125) on the USMLE and librarians supporting American Dental Association (ADA)-accredited dental schools (n = 23/56) on the NBDE. The investigators analyzed the data by cross-tabulating and filtering the results using EFM Continuum web survey software. Investigators also surveyed print and electronic USMLE and NBDE preparation materials from 2004-2007 to determine the number of publications and existence of reviews. A majority of responding AAMC libraries (62%, n = 58) provide at least 1 electronic or online USMLE preparation resource and buy an average of 11.6 print USMLE titles annually. Due to a paucity of NBDE print and electronic resources, ADA libraries bought significantly fewer print resources, and only 1 subscribed to an electronic resource. The most often reported evaluation methods for both populations were feedback from medical or dental students, feedback from medical or dental faculty, and online trials. Some AAMC (10%, n = 58) and ADA libraries (39%, n = 23) libraries reported that no evaluation of these materials occured at their libraries. From 2004-2007, publishers produced 45 USMLE preparation resources (total n = 546) to every 1 NBDE preparation resource (total n = 12). Users' needs, institutional missions and goals, financial status, and official collection policies most often underlie decisions to collect or not collect examination preparation materials. Evaluating the quality of examination preparation materials can be problematic due to lack of published reviews, lack of usability testing by libraries, and

  6. Survey of malignant tumor incidence and mortality characteristics among the residents in Fuqing from 2007 to 2009

    International Nuclear Information System (INIS)

    Chen Tiehui; Peng Xian'e; Hu Zhijian; Xue Feng; Zeng Zhichang; Zhang Xiuxia; Shi Xishun; Xue Changgao; Sun Quanfu; Zhou Tianshu

    2014-01-01

    Objective: To investigate distribution characteristics of malignant tumor incidence and mortality among the local residents before the operation of Fuqing nuclear power plant, in Fujian province. Methods: A retrospective survey of malignant tumor incidence and mortality in Fuqing residents from 2007 to 2009 was carried out. The incidence and mortality distribution characteristics of total malignant tumors and main malignant tumors associated with nuclear radiation was analyzed. Results: The annual malignant tumors incidence and mortality rates were 148.65/10"5 and 114.96/10"5, respectively. Liver cancer, stomach cancer, lung cancer, esophagus cancer and colorectal cancer ranked the top five. Leukemia incidence and mortality rates were 3.77/10"5 and 2.61/10"5, respectively. Thyroid cancer incidence and mortality rates were 6.95/10"5 and 0.46/10"5, respectively. Conclusions: Esophageal carcinoma and lung cancer are the main malignant tumors in Fuqing city before the operation of the nuclear power plant. Leukemia incidence and mortality rates are both lower in Fuqing city than the national average level, but thyroid cancer incidence and mortality rates are both higher than the national average level. Surveillance of malignant tumors and death causes should proceeding continuously in Fuqing city, in order to evaluate the operation of nuclear power plant on local population health. (authors)

  7. Neonatal mortality in East Africa and West Africa: a geographic analysis of district-level demographic and health survey data

    Directory of Open Access Journals (Sweden)

    Sue C. Grady

    2017-05-01

    Full Text Available Under-five child mortality declined 47% since 2000 following the implementation of the United Nation’s (UN Millennium Development Goals. To further reduce under-five child mortality, the UN’s Sustainable Development Goals (SDGs will focus on interventions to address neonatal mortality, a major contributor of under-five mortality. The African region has the highest neonatal mortality rate (28.0 per 1000 live births, followed by that of the Eastern Mediterranean (26.6 and South-East Asia (24.3. This study used the Demographic and Health Survey Birth Recode data (http://dhsprogram.com/data/File-Types-and-Names.cfm to identify high-risk districts and countries for neonatal mortality in two sub-regions of Africa – East Africa and West Africa. Geographically weighted Poisson regression models were estimated to capture the spatially varying relationships between neonatal mortality and dimensions of potential need i care around the time of delivery, ii maternal education, and iii women’s empowerment. In East Africa, neonatal mortality was significantly associated with home births, mothers without an education and mothers whose husbands decided on contraceptive practices, controlling for rural residency. In West Africa, neonatal mortality was also significantly associated with home births, mothers with a primary education and mothers who did not want or plan their last child. Importantly, neonatal mortality associated with home deliveries were explained by maternal exposure to unprotected water sources in East Africa and older maternal age and female sex of infants in West Africa. Future SDG-interventions may target these dimensions of need in priority high-risk districts and countries, to further reduce the burden of neonatal mortality in Africa.

  8. National health and nutrition examination survey: plan and operations, 1999-2010.

    Science.gov (United States)

    Zipf, George; Chiappa, Michele; Porter, Kathryn S; Ostchega, Yechiam; Lewis, Brenda G; Dostal, Jennifer

    2013-08-01

    Background-Starting in 1999, the National Health and Nutrition Examination Survey (NHANES) became a continuous, ongoing annual survey of the noninstitutionalized civilian resident population of the United States. A continuous survey allowed content to change to meet emerging needs. Objective-This report describes how NHANES for 1999-2010 was designed and implemented. NHANES is a national survey designed to provide national estimates on various health-related topics. Methods-The survey used in-person face-to-face interviews and physical examinations for data collection. Approximately 5,000 people per year participated in NHANES. The 5,000 people surveyed each year are representative of the entire U.S. population. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  9. Prevalence and Determinants of Diabetic Nephropathy in Korea: Korea National Health and Nutrition Examination Survey

    Directory of Open Access Journals (Sweden)

    Jae Hee Ahn

    2014-04-01

    Full Text Available BackgroundDiabetic nephropathy is a leading cause of end stage renal disease and is associated with an increased risk of cardiovascular mortality. It manifests as albuminuria or impaired glomerular filtration rate (GFR, and the prevalence of diabetic nephropathy varies with ethnicity. The prevalence of diabetic nephropathy and its determinants in Korean adults have not previously been studied at the national level. This cross-sectional study was undertaken to ascertain the prevalence and determinants of albuminuria and chronic kidney disease (CKD in Korean patients with diabetes.MethodsThe Korea National Health and Nutrition Examination Survey (KNHANES V, conducted in 2011, was used to define albuminuria (n=4,652, and the dataset of KNHANES IV-V (2008-2011 was used to define CKD (n=21,521. Selected samples were weighted to represent the entire civilian population in Korea. Albuminuria was defined as a spot urine albumin/creatinine ratio >30 mg/g. CKD was defined as a GFR <60 mL/min/1.73 m2.ResultsAmong subjects with diabetes, 26.7% had albuminuria, and 8.6% had CKD. Diabetes was associated with an approximate 2.5-fold increased risk of albuminuria, with virtually no difference between new-onset and previously diagnosed diabetes. Only systolic blood pressure was significantly associated with albuminuria, and old age, high serum triglyceride levels, and previous cardiovascular disease (CVD were related with CKD in subjects with diabetes.ConclusionKorean subjects with diabetes had a higher prevalence of albuminuria and CKD than those without diabetes. Blood pressure was associated with albuminuria, and age, triglyceride level, and previous CVD were independent determinants of CKD in subjects with diabetes.

  10. Evaluation of fifteen epidemiologic studies examining the lung cancer mortality of underground miners

    International Nuclear Information System (INIS)

    1985-01-01

    A group of 15 epidemiologic studies was identified in which researchers reported excess lung cancer deaths among underground miners who worked in mines where radon (10043922) progeny were present. Several other studies demonstrated a dose response relationship existing between radon progeny exposure and mortality from lung cancer. Two recent studies indicated excess numbers of cases of lung cancer deaths resulting from mean cumulative radon progeny exposures below 100 Working Level Months (WLM). In the mining environment exposure can also occur to other substances such as arsenic (1332214), diesel exhaust, smoking, chromium (7440473), nickel (7440020), and radiation, which can affect the lung cancer risk resulting from exposure to radon progeny. Not much was available in the literature which deals with the results of these combined exposures except the finding that a combined exposure to radon progeny and cigarette smoke resulted in a higher risk than exposure to either substance alone. X-ray surveillance and sputum cytology appeared to be ineffective in preventing radon progeny induced lung cancers in individual miners. There does not appear to be any particular association between one specific lung cancer cell type and radon progeny exposure

  11. Endosonography-related mortality and morbidity for pulmonary indications: a nationwide survey in the Netherlands.

    Science.gov (United States)

    von Bartheld, Martin B; Annema, Jouke T

    2015-12-01

    Endosonography is being implemented rapidly in pulmonary medicine for the diagnosis and staging of lung cancer, the assessment of sarcoidosis, and the assessment of mediastinal lesions. Although serious adverse events (SAEs) have been described, safety data outside cohort studies are scarce. To assess the SAE and mortality rate of EUS-guided FNA (EUS-FNA) and endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) for mediastinal and/or hilar analysis. Nationwide, retrospective survey by using questionnaires. All hospitals in the Netherlands. All patients undergoing EUS-FNA and EBUS-TBNA for intrathoracic analysis in the period 1999 to 2011. EUS-FNA and EBUS-TBNA. Occurrence of fatal outcomes and SAEs. Detailed information was obtained for each reported case, and all cases were reviewed independently by 2 investigators, including identification of risk factors. All 89 hospitals (100%) responded. An estimated 14,075 EUS-FNA and 2675 EBUS procedures were performed. Seven patients died after endosonography (5 EUS-FNA, 2 EBUS [mortality rate 0.04%]). All fatalities occurred in patients of poor performance status (American Society of Anesthesiologists Physical Status Classification System score of III/IV). Twenty-five SAEs were reported (22 EUS-FNA, 3 EBUS [SAE rate of 0.15%; EUS-FNA 0.16%, EBUS 0.11%]). SAEs were mostly (64%) of infectious origin. No specific risk factors for infectious adverse events could be identified. Retrospective study, possible recall bias, overrepresentation of EUS-FNA cases. Endosonography appears to be a safe technique for the analysis of mediastinal and/or hilar lesions. Poor performance status is a risk factor for fatal outcomes. Mediastinitis and/or mediastinal abscess formation is rare but is a potential and dangerous adverse event of endosonography. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  12. Job characteristics in relation to the prevalence of myocardial infarction in the US Health Examination Survey (HES) and the Health and Nutrition Examination Survey (HANES).

    Science.gov (United States)

    Karasek, R A; Theorell, T; Schwartz, J E; Schnall, P L; Pieper, C F; Michela, J L

    1988-08-01

    Associations between psychosocial job characteristics and past myocardial infarction (MI) prevalence for employed males were tested with the Health Examination Survey (HES) 1960-61, N = 2,409, and the Health and Nutrition Examination Survey (HANES) 1971-75, N = 2,424. A new estimation method is used which imputes to census occupation codes, job characteristic information from national surveys of job characteristics (US Department of Labor, Quality of Employment Surveys). Controlling for age, we find that employed males with jobs which are simultaneously low in decision latitude and high in psychological work load (a multiplicative product term isolating 20 per cent of the population) have a higher prevalence of myocardial infarction in both data bases. In a logistic regression analysis, using job measures adjusted for demographic factors and controlling for age, race, education, systolic blood pressure, serum cholesterol, smoking (HANES only), and physical exertion, we find a low decision latitude/high psychological demand multiplicative product term associated with MI in both data bases. Additional multiple logistic regressions show that low decision latitude is associated with increased prevalence of MI in both the HES and the HANES. Psychological workload and physical exertion are significant only in the HANES.

  13. The Danish Health Examination Survey 2007-2008 (DANHES 2007-2008)

    DEFF Research Database (Denmark)

    Eriksen, Louise; Grønbæk, Morten; Helge, Jørn Wulff

    2011-01-01

    AIMS: The Danish Health Examination Survey (DANHES 2007-2008) was carried out by the National Institute of Public Health, University of Southern Denmark, in 13 Danish municipalities in 2007-2008. The focus of the survey was diet, smoking, alcohol, and physical activity. The aim of the survey......, and living conditions, and a supplementary food frequency questionnaire. The health examination contained measurements of blood pressure, resting heart rate, height, weight, fat percentage, waist and hip circumference, blood and hair samples, spirometry, bone mineral density, physical performance, muscle...

  14. Three days in October of 1630: detailed examination of mortality during an early modern plague epidemic in Venice.

    Science.gov (United States)

    Ell, S R

    1989-01-01

    The epidemiology of medieval and early modern European plague remains highly controversial. It now seems likely that the epidemiology was not uniform throughout either the geographic or temporal boundaries of the plague in Western Europe. The Venetian plague of 1630 was extensively documented; day-by-day records were kept, and each mortality in the city was recorded in a set format. The days 23-25 October 1630, representing a period when mortality was beginning to increase sharply, are examined. In all, 1,163 deaths were recorded. They show a large preponderance of women; a mean age of 28, but a majority of cases clumped between ages 0 and 25 years; and an unequal sex ratio among children. Further, there was an identifiable smallpox epidemic raging simultaneously with plague, and more than one-quarter of all the deaths in this period of high mortality were clearly due to nonplague causes. Deaths due to wounds and associated with violence were prominent in one parish, which suggests that in times of plague the breakdown in the normal machinery of government, in everyday patterns of life, and possibly of mental well being resulted in an even more exaggerated death toll. These factors--violence, accidents, and other epidemics--have never been so definitively tied to a European plague epidemic. In addition, there are hints that plague has a marked proclivity to kill pregnant women--their deaths far outnumber those anticipated--and that plague was very localized at a given moment within Venice itself, even during times of peak mortality.

  15. Modelling the incidence and mortality of psychotic disorders: data from the second Australian national survey of psychosis.

    Science.gov (United States)

    Saha, Sukanta; Whiteford, Harvey; McGrath, John

    2014-04-01

    The aim of this study was to model estimates related to (a) the incidence of psychotic disorders and (b) the mortality associated with these disorders based on a large, population-based prevalence study. Data were drawn from the second national survey of adults with psychotic disorders conducted in seven Australian catchment areas during March to December 2010. To generate incidence rate estimates, we identified recent onset cases recruited as part of the prevalence study and then imputed population-based incidence rates using a set of conservative assumptions. Similarly, for mortality rates, we identified individuals who had died after being identified as 'screen-positive' for psychosis, but prior to full clinical assessment. Using a set of conservative assumptions, we then used these estimates to infer population-based mortality rates. Based on our models, we estimated that the incidence rate for psychotic disorders was 28 cases per 100,000 population. The rate estimates were significantly higher in males than females, with an overall male:female ratio of 1.57:1. Incidence rate estimates peaked in the youngest age group (18-24 years). The adjusted mortality rate estimated during the whole period of observation was 12.5 per 1000 persons, with a standardised mortality ratio of 5.5. Using treated prevalence data and observed deaths with appropriate algorithms, we were able to impute incidence and mortality rates for psychotic disorders consistent with the published literature. While the second national survey of psychotic disorders was not designed to identify mortality, our estimates provide a stark reminder of the increased mortality associated with these disorders.

  16. Bisphenol-A and Sleep Adequacy among Adults in the National Health and Nutrition Examination Surveys

    Science.gov (United States)

    Beydoun, Hind A.; Beydoun, May A.; Jeng, Hueiwang Anna; Zonderman, Alan B.; Eid, Shaker M.

    2016-01-01

    Study Objectives: To evaluate bisphenol-A (BPA) level and its relationship to sleep adequacy in a nationally representative sample of U.S. adults. Methods: A population-based cross-sectional study was conducted using 2005–2010 National Health and Nutrition Examination Survey whereby data were collected using in-person interviews, physical examination and laboratory testing. BPA level was measured in urine samples and analyzed as loge-transformed variable and in quartiles ( 8 h); (Bisphenol-A and sleep adequacy among adults in the National Health and Nutrition Examination Surveys. SLEEP 2016;39(2):467–476. PMID:26446109

  17. Diabetes mellitus and mortality from all-causes, cancer, cardiovascular and respiratory disease: evidence from the Health Survey for England and Scottish Health Survey cohorts.

    Science.gov (United States)

    Gordon-Dseagu, Vanessa L Z; Shelton, Nicola; Mindell, Jennifer

    2014-01-01

    Diabetes mellitus is associated with differing rates of all-cause and cause-specific mortality compared with the general population; although the strength of these associations requires further investigation. The effects of confounding factors, such as overweight and obesity and the presence of co-morbid cardiovascular disease (CVD), upon such associations also remain unclear. There is thus a need for studies which utilise data from nationally-representative samples to explore these associations further. A cohort study of 204,533 participants aged 16+ years (7,199 with diabetes) from the Health Survey for England (HSE) (1994-2008) and Scottish Health Survey (SHeS) (1995, 1998 and 2003) linked with UK mortality records. Odds ratios (ORs) of all-cause and cause-specific mortality and 95% confidence intervals were estimated using logistic and multinomial logistic regression. There were 20,051 deaths (1,814 among those with diabetes). Adjusted (age, sex, and smoking status) ORs for all-cause mortality among those with diabetes was 1.68 (95%CI 1.57-1.79). Cause-specific mortality ORs were: cancer 1.26 (1.13-1.42), respiratory diseases 1.25 (1.08-1.46), CVD 1.96 (1.80-2.14) and 'other' causes 2.06 (1.84-2.30). These were not attenuated significantly after adjustment for generalised and/or central adiposity and other confounding factors. The odds of mortality differed between those with and without comorbid CVD at baseline; the ORs for the latter group were substantially increased. In addition to the excess in CVD and all-cause mortality among those with diabetes, there is also increased mortality from cancer, respiratory diseases, and 'other' causes. This increase in mortality is independent of obesity and a range of other confounding factors. With falling CVD incidence and mortality, the raised risks of respiratory and cancer deaths in people with diabetes will become more important and require increased health care provision. Copyright © 2014 Elsevier Inc. All rights

  18. Intelligence and all-cause mortality in the 6-Day Sample of the Scottish Mental Survey 1947 and their siblings: testing the contribution of family background.

    Science.gov (United States)

    Iveson, Matthew H; Cukic, Iva; Der, Geoff; Batty, G David; Deary, Ian J

    2018-02-01

    Higher early-life intelligence is associated with a reduced risk of mortality in adulthood, though this association is apparently hardly attenuated when accounting for early-life socio-economic status (SES). However, the use of proxy measures of SES means that residual confounding may underestimate this attenuation. In the present study, the potential confounding effect of early-life SES was instead accounted for by examining the intelligence-mortality association within families. The association between early-life intelligence and mortality in adulthood was assessed in 727 members of the 6-Day Sample of the Scottish Mental Survey 1947 and, for the first time, 1580 of their younger siblings. These individuals were born between 1936 and 1958, and were followed up into later life, with deaths recorded up to 2015. Cox regression was used to estimate the relative risk of mortality associated with higher IQ scores after adjusting for shared family factors. A standard-deviation advantage in IQ score was associated with a significantly reduced mortality risk [hazard ratio = 0.76, p family factors [hazard ratio = 0.79, p = 0.002, 95% CI (0.68-0.92)]. Although somewhat conservative, adjusting for all variance shared by a family avoids any potential residual confounding of the intelligence-mortality association arising from the use of proxy measures of early-life SES. The present study demonstrates that the longevity associated with higher early-life intelligence cannot be explained by early-life SES or within-family factors. © The Author 2017; Published by Oxford University Press on behalf of the International Epidemiological Association

  19. Indicators to examine quality of large scale survey data: an example through district level household and facility survey.

    Directory of Open Access Journals (Sweden)

    Kakoli Borkotoky

    Full Text Available BACKGROUND: Large scale surveys are the main source of data pertaining to all the social and demographic indicators, hence its quality is also of great concern. In this paper, we discuss the indicators used to examine the quality of data. We focus on age misreporting, incompleteness and inconsistency of information; and skipping of questions on reproductive and sexual health related issues. In order to observe the practical consequences of errors in a survey; the District Level Household and Facility Survey (DLHS-3 is used as an example dataset. METHODS: Whipple's and Myer's indices are used to identify age misreporting. Age displacements are identified by estimating downward and upward transfers for women from bordering age groups of the eligible age range. Skipping pattern is examined by recording the responses to the questions which precede the sections on birth history, immunization, and reproductive and sexual health. RESULTS: The study observed errors in age reporting, in all the states, but the extent of misreporting differs by state and individual characteristics. Illiteracy, rural residence and poor economic condition are the major factors that lead to age misreporting. Female were excluded from the eligible age group, to reduce the duration of interview. The study further observed that respondents tend to skip questions on HIV/RTI and other questions which follow a set of questions. CONCLUSION: The study concludes that age misreporting, inconsistency and incomplete response are three sources of error that need to be considered carefully before drawing conclusions from any survey. DLHS-3 also suffers from age misreporting, particularly for female in the reproductive ages. In view of the coverage of the survey, it may not be possible to control age misreporting completely, but some extra effort to probe a better answer may help in improving the quality of data in the survey.

  20. Prevalence of overweight and obesity in Portugal: Results from the First Portuguese Health Examination Survey (INSEF 2015).

    Science.gov (United States)

    Gaio, Vânia; Antunes, Liliana; Namorado, Sónia; Barreto, Marta; Gil, Ana; Kyslaya, Irina; Rodrigues, Ana Paula; Santos, Ana; Bøhler, Linn; Castilho, Emília; Vargas, Patrícia; do Carmo, Isabel; Nunes, Baltazar; Dias, Carlos Matias

    Obesity is recognised as a serious public health issue, due to its associated morbidity and mortality. This study aimed at estimating the prevalence of overweight and obesity in the Portuguese population through direct measurements obtained by the 1st National Health Examination Survey (INSEF 2015) and to identify its associated sociodemographic factors. INSEF was a nationally representative cross-sectional prevalence study conducted on 4911 Portuguese adults aged 25-74 years, in 2015. Height and weight were measured according to the European Health Examination Survey procedures. Poisson regression was used to estimate the adjusted prevalence ratios of overweight and obesity according to age, marital status, occupational activity, education, urbanization of living area and smoking status. Overall prevalences of overweight and obesity were 39.1% and 28.6%, respectively. The prevalence of overweight was higher among men (45.5% vs 33.2%) while the prevalence of obesity was higher among women (32% vs 25%). The sociodemographic factors associated with overweight and obesity were age, marital status and education. Smoking status was associated with overweight and obesity but only in women. INSEF suggests that a high prevalences of overweight and obesity are found in older individuals, married, with lower education levels and non-smoking women. Public health interventions are urgently required for obesity prevention, namely throughout health literacy strategies. Copyright © 2017 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  1. The relationship between maternal education and mortality among women giving birth in health care institutions: Analysis of the cross sectional WHO Global Survey on Maternal and Perinatal Health

    Directory of Open Access Journals (Sweden)

    Gülmezoglu A Metin

    2011-07-01

    Full Text Available Abstract Background Approximately one-third of a million women die each year from pregnancy-related conditions. Three-quarters of these deaths are considered avoidable. Millennium Development Goal five calls for a reduction in maternal mortality and the establishment of universal access to high quality reproductive health care. There is evidence of a relationship between lower levels of maternal education and higher maternal mortality. This study examines the relationship between maternal education and maternal mortality among women giving birth in health care institutions and investigates the association of maternal age, marital status, parity, institutional capacity and state-level investment in health care with these relationships. Methods Cross-sectional information was collected on 287,035 inpatients giving birth in 373 health care institutions in 24 countries in Africa, Asia and Latin America, between 2004-2005 (in Africa and Latin America and 2007-2008 (in Asia as part of the WHO Global Survey on Maternal and Perinatal Health. Analyses investigated associations between indicators measured at the individual, institutional and country level and maternal mortality during the intrapartum period: from admission to, until discharge from, the institution where women gave birth. There were 363 maternal deaths. Results In the adjusted models, women with no education had 2.7 times and those with between one and six years of education had twice the risk of maternal mortality of women with more than 12 years of education. Institutional capacity was not associated with maternal mortality in the adjusted model. Those not married or cohabiting had almost twice the risk of death of those who were. There was a significantly higher risk of death among those aged over 35 (compared with those aged between 20 and 25 years, those with higher numbers of previous births and lower levels of state investment in health care. There were also additional effects

  2. Survey of Forensic Document Examination Habit Areas: Degree of Use and Discriminatory Power

    Energy Technology Data Exchange (ETDEWEB)

    G Sperry; PA Manzolillo; RC Hanlan; RJ Muehlberger

    1999-09-07

    Beginning in 1998, the Pacific Northwest National Laboratory (PNL), US Postal Inspection Service Forensic Laboratory (USPIS), and the Data Fusion Laboratory, Drexel University (DFL) have been collaborating on a large scale research project ''Handwriting Individuality--Moving From Art to Science''. In April 1998 a survey was distributed to the community of forensic document examiners (FDEs) requesting input on the habit areas used and their utility in distinguishing handwriting. The information obtained from this survey was intended to provide the data necessary to select the criteria and begin the evaluation of the handwriting samples currently in the project. Preliminary results of the survey were made available to the community at the American Society of Questioned Document Examiners (ASQDE) meeting in August 1998 and the American Academy of Forensic Sciences (AAFS) meeting in February 1999. This report provides final documentation of the survey and its results. This survey has two objectives: (1) to compile a list of handwriting features and characteristics used by professional forensic document examiners in the examination and comparison of handwriting and (2) to gather information about the significance of these features and characteristics. These objectives are met by having the FDEs provide an indication of their experience in the frequency of habit area evaluation and the utility of the habit area for discrimination.

  3. The Role of Empowerment in the Association between a Woman's Educational Status and Infant Mortality in Ethiopia: Secondary Analysis of Demographic and Health Surveys.

    Science.gov (United States)

    Alemayehu, Yibeltal Kiflie; Theall, Katherine; Lemma, Wuleta; Hajito, Kifle Woldemichael; Tushune, Kora

    2015-10-01

    Socioeconomic status at national, sub-national, household, and individual levels explains a significant portion of variation in infant mortality. Women's education is among the major determinants of infant mortality. The mechanism through which a woman's own educational status, over her husband's as well as household characteristics, influences infant mortality has not been well studied in developing countries. The objective of this study was to explore the role of woman's empowerment and household wealth in the association between a woman's educational status and infant mortality. The association between a woman's educational status and infant death, and the role of woman's empowerment and household wealth in this relationship, were examined among married women in Ethiopia through a secondary, serial cross-sectional analysis utilizing data on birth history of married women from three rounds of the Ethiopian Demographic and Health Survey. Univariate, bivariate, and multivariate analyses were conducted to examine the association between woman's education and infant death, and the possible mediation or moderation roles of woman empowerment and household wealth. Female education and empowerment were inversely associated with infant death. The results indicated mediation by empowerment in the education-infant death association, and effect modification by household wealth. Both empowerment and education had strongest inverse association with infant death among women from the richest households. The findings suggest an important role of female empowerment in the education-infant death relation, and the complexity of these factors according to household wealth. Woman empowerment programs may prove effective as a shorter term intervention in reducing infant mortality.

  4. The BRACELET Study: surveys of mortality in UK neonatal and paediatric intensive care trials

    Directory of Open Access Journals (Sweden)

    Platt Martin

    2010-05-01

    Full Text Available Abstract Background The subject of death and bereavement in the context of randomised controlled trials in neonatal or paediatric intensive care is under-researched. The objectives of this phase of the Bereavement and RAndomised ControlLEd Trials (BRACELET Study were to determine trial activity in UK neonatal and paediatric intensive care (2002-06; numbers of deaths before hospital discharge; and variation in mortality across intensive care units and trials and to determine whether bereavement support policies were available within trials. These are essential prerequisites to considering the implications of future policies and practice subsequent to bereavement following a child's enrolment in a trial. Methods The units survey involved neonatal units providing level 2 or 3 care, and paediatric units providing level II care or above; the trials survey involved trials where allocation was randomized and interventions were delivered to intensive care patients, or to parents but designed to affect patient outcomes. Results Information was available from 191/220 (87% neonatal units (149 level 2 or 3 care; and 28/32 (88% paediatric units. 90/177 (51% eligible responding units participated in one or more trial (76 neonatal, 14 paediatric and 54 neonatal units and 6 paediatric units witnessed at least one death. 50 trials were identified (36 neonatal, 14 paediatric. 3,137 babies were enrolled in neonatal trials, 210 children in paediatric trials. Deaths ranged 0-278 (median [IQR interquartile range] 2 [1, 14.5] per neonatal trial, 0-4 (median [IQR] 1 [0, 2.5] per paediatric trial. 534 (16% participants died post-enrolment: 522 (17% in neonatal trials, 12 (6% in paediatric trials. Trial participants ranged 1-236 (median [IQR] 21.5 [8, 39.8] per neonatal unit, 1-53 (median [IQR] 11.5 [2.3, 33.8] per paediatric unit. Deaths ranged 0-37 (median [IQR] 3.5 [0.3, 8.8] per neonatal unit, 0-7 (median [IQR] 0.5 [0, 1.8] per paediatric unit. Three trials had a

  5. A review of methodology and analysis of nutrition and mortality surveys conducted in humanitarian emergencies from October 1993 to April 2004

    Directory of Open Access Journals (Sweden)

    Spiegel Paul B

    2007-06-01

    Full Text Available Abstract Background Malnutrition prevalence and mortality rates are increasingly used as essential indicators to assess the severity of a crisis, to follow trends, and to guide decision-making, including allocation of funds. Although consensus has slowly developed on the methodology to accurately measure these indicators, errors in the application of the survey methodology and analysis have persisted. The aim of this study was to identify common methodological weaknesses in nutrition and mortality surveys and to provide practical recommendations for improvement. Methods Nutrition (N = 368 and crude mortality rate (CMR; N = 158 surveys conducted by 33 non-governmental organisations and United Nations agencies in 17 countries from October 1993 to April 2004 were analysed for sampling validity, precision, quality of measurement and calculation according to several criteria. Results One hundred and thirty (35.3% nutrition surveys and 5 (3.2% CMR surveys met the criteria for quality. Quality of surveys varied significantly depending on the agency. The proportion of nutrition surveys that met criteria for quality rose significantly from 1993 to 2004; there was no improvement for mortality surveys during this period. Conclusion Significant errors and imprecision in the methodology and reporting of nutrition and mortality surveys were identified. While there was an improvement in the quality of nutrition surveys over the years, the quality of mortality surveys remained poor. Recent initiatives aimed at standardising nutrition and mortality survey quality should be strengthened. There are still a number of methodological issues in nutrition and mortality surveys in humanitarian emergencies that need further study.

  6. Testing survey-based methods for rapid monitoring of child mortality, with implications for summary birth history data.

    Science.gov (United States)

    Brady, Eoghan; Hill, Kenneth

    2017-01-01

    Under-five mortality estimates are increasingly used in low and middle income countries to target interventions and measure performance against global development goals. Two new methods to rapidly estimate under-5 mortality based on Summary Birth Histories (SBH) were described in a previous paper and tested with data available. This analysis tests the methods using data appropriate to each method from 5 countries that lack vital registration systems. SBH data are collected across many countries through censuses and surveys, and indirect methods often rely upon their quality to estimate mortality rates. The Birth History Imputation method imputes data from a recent Full Birth History (FBH) onto the birth, death and age distribution of the SBH to produce estimates based on the resulting distribution of child mortality. DHS FBHs and MICS SBHs are used for all five countries. In the implementation, 43 of 70 estimates are within 20% of validation estimates (61%). Mean Absolute Relative Error is 17.7.%. 1 of 7 countries produces acceptable estimates. The Cohort Change method considers the differences in births and deaths between repeated Summary Birth Histories at 1 or 2-year intervals to estimate the mortality rate in that period. SBHs are taken from Brazil's PNAD Surveys 2004-2011 and validated against IGME estimates. 2 of 10 estimates are within 10% of validation estimates. Mean absolute relative error is greater than 100%. Appropriate testing of these new methods demonstrates that they do not produce sufficiently good estimates based on the data available. We conclude this is due to the poor quality of most SBH data included in the study. This has wider implications for the next round of censuses and future household surveys across many low- and middle- income countries.

  7. Perception survey on the introduction of clinical performance examination as part of the national nursing licensing examination in Korea

    Directory of Open Access Journals (Sweden)

    Su Jin Shin

    2017-10-01

    Full Text Available Purpose The purpose of this study was to analyze opinions about the action plan for implementation of clinical performance exam as part of the national nursing licensing examination and presents the expected effects of the performance exam and aspects to consider regarding its implementation. Methods This study used a mixed-methods design. Quantitative data were collected by a questionnaire survey, while qualitative data were collected by focus group interviews with experts. The survey targeted 200 nursing professors and clinical nurses with more than 5 years of work experience, and the focus group interviews were conducted with 28 of professors, clinical instructors, and nurses at hospitals. Results First, nursing professors and clinical specialists agreed that the current written tests have limitations in evaluating examinees’ ability, and that the introduction of a clinical performance exam will yield positive results. Clinical performance exam is necessary to evaluate and improve nurses’ work ability, which means that the implementation of a performance exam is advisable if its credibility and validity can be verified. Second, most respondents chose direct performance exams using simulators or standardized patients as the most suitable format of the test. Conclusion In conclusion, the current national nursing licensing exam is somewhat limited in its ability to identify competent nurses. Thus, the time has come for us to seriously consider the introduction of a performance exam. The prerequisites for successfully implementing clinical performance exam as part of the national nursing licensing exam are a professional training process and forming a consortium to standardize practical training.

  8. The physical examination content of the Japanese National Health and Nutrition Survey: temporal changes.

    Science.gov (United States)

    Tanaka, Hisako; Imai, Shino; Nakade, Makiko; Imai, Eri; Takimoto, Hidemi

    2016-12-01

    Survey items of the Japan National Nutrition Survey (J-NNS) have changed over time. Several papers on dietary surveys have been published; however, to date, there are no in-depth papers regarding physical examinations. Therefore, we investigated changes in the survey items in the physical examinations performed in the J-NNS and the National Health and Nutrition Survey (NHNS), with the aim of incorporating useful data for future policy decisions. We summarized the description of physical examinations and marshalled the changes of survey items from the J-NNS and NHNS from 1946 to 2012. The physical examination is roughly classified into the following six components: some are relevant to anthropometric measurements, clinical measurements, physical symptoms, blood tests, lifestyle and medication by interview, and others. Items related to nutritional deficiency, such as anaemia and tendon reflex disappearance, and body weight measurements were collected during the early period, according to the instructions of the General Headquarters. From 1989, blood tests and measurement of physical activity were added, and serum total protein, total cholesterol, triglycerides, HDL-cholesterol, blood glucose, red blood corpuscles and haemoglobin measurements have been performed continuously for more than 20 years. This is the first report on the items of physical examination in the J-NNS and NHNS. Our research results provide basic information for the utilization of the J-NNS and NHNS, to researchers, clinicians or policy makers. Monitoring the current state correctly is essential for national health promotion, and also for improvement of the investigation methods to apply country-by-country comparisons.

  9. Cancer mortality and incidence survey around the Aube's low- and medium-activity radioactive waste storage site

    International Nuclear Information System (INIS)

    2010-01-01

    This report presents the main results of a survey performed in 2010 to describe the health status of the population around the Aube's low- and medium-activity radioactive waste storage site. The aim of this survey was to determine whether the frequencies of death and hospitalization on account of cancer are different for this population (15 km around the site) with respect to two reference populations (the population of the Champagne-Ardennes region and the French metropolitan population). Results of mortality, hospitalization, and lung cancer are presented under the form of maps and tables giving global data or data for males, females, adults, or children

  10. Using quantile regression to examine the effects of inequality across the mortality distribution in the U.S. counties

    Science.gov (United States)

    Yang, Tse-Chuan; Chen, Vivian Yi-Ju; Shoff, Carla; Matthews, Stephen A.

    2012-01-01

    The U.S. has experienced a resurgence of income inequality in the past decades. The evidence regarding the mortality implications of this phenomenon has been mixed. This study employs a rarely used method in mortality research, quantile regression (QR), to provide insight into the ongoing debate of whether income inequality is a determinant of mortality and to investigate the varying relationship between inequality and mortality throughout the mortality distribution. Analyzing a U.S. dataset where the five-year (1998–2002) average mortality rates were combined with other county-level covariates, we found that the association between inequality and mortality was not constant throughout the mortality distribution and the impact of inequality on mortality steadily increased until the 80th percentile. When accounting for all potential confounders, inequality was significantly and positively related to mortality; however, this inequality–mortality relationship did not hold across the mortality distribution. A series of Wald tests confirmed this varying inequality–mortality relationship, especially between the lower and upper tails. The large variation in the estimated coefficients of the Gini index suggested that inequality had the greatest influence on those counties with a mortality rate of roughly 9.95 deaths per 1000 population (80th percentile) compared to any other counties. Furthermore, our results suggest that the traditional analytic methods that focus on mean or median value of the dependent variable can be, at most, applied to a narrow 20 percent of observations. This study demonstrates the value of QR. Our findings provide some insight as to why the existing evidence for the inequality–mortality relationship is mixed and suggest that analytical issues may play a role in clarifying whether inequality is a robust determinant of population health. PMID:22497847

  11. Estimating survival probabilities by exposure levels: utilizing vital statistics and complex survey data with mortality follow-up.

    Science.gov (United States)

    Landsman, V; Lou, W Y W; Graubard, B I

    2015-05-20

    We present a two-step approach for estimating hazard rates and, consequently, survival probabilities, by levels of general categorical exposure. The resulting estimator utilizes three sources of data: vital statistics data and census data are used at the first step to estimate the overall hazard rate for a given combination of gender and age group, and cohort data constructed from a nationally representative complex survey with linked mortality records, are used at the second step to divide the overall hazard rate by exposure levels. We present an explicit expression for the resulting estimator and consider two methods for variance estimation that account for complex multistage sample design: (1) the leaving-one-out jackknife method, and (2) the Taylor linearization method, which provides an analytic formula for the variance estimator. The methods are illustrated with smoking and all-cause mortality data from the US National Health Interview Survey Linked Mortality Files, and the proposed estimator is compared with a previously studied crude hazard rate estimator that uses survey data only. The advantages of a two-step approach and possible extensions of the proposed estimator are discussed. Copyright © 2015 John Wiley & Sons, Ltd.

  12. Child mortality in the Democratic Republic of Congo: cross-sectional evidence of the effect of geographic location and prolonged conflict from a national household survey.

    Science.gov (United States)

    Kandala, Ngianga-Bakwin; Mandungu, Tumwaka P; Mbela, Kisumbula; Nzita, Kikhela P D; Kalambayi, Banza B; Kayembe, Kalambayi P; Emina, Jacques B O

    2014-03-20

    The child mortality rate is a good indicator of development. High levels of infectious diseases and high child mortality make the Democratic Republic of Congo (DRC) one of the most challenging environments for health development in Sub-Saharan Africa (SSA). Recent conflicts in the eastern part of the country and bad governance have compounded the problem. This study aimed to examine province-level geographic variation in under-five mortality (U5M), accounting for individual- and household-level risk factors including environmental factors such as conflict. Our analysis used the nationally representative cross-sectional household sample of 8,992 children under five in the 2007 DRC Demographic and Health Survey. In the survey year, 1,005 deaths among this group were observed. Information on U5M was aggregated to the 11 provinces, and a Bayesian geo-additive discrete-time survival mixed model was used to map the geographic distribution of under-five mortality rates (U5MRs) at the province level, accounting for observable and unobservable risk factors. The overall U5MR was 159 per 1,000 live births. Significant associations with risk of U5M were found for conflict area of the DRC, and the lowest in the conflict area of North Kivu. This study reveals clear geographic patterns in rates of U5M in the DRC and shows the potential role of individual child, household and environmental factors, which are unexplained by the ongoing conflict. The displacement of mothers to safer areas may explain the lower U5MR observed at the epicentre of the conflict in North Kivu, compared with rates in conflict-free areas. Overall, the U5M maps point to a lack of progress towards the Millennium Development Goal of reducing U5M by half by 2015.

  13. The impact of prenatal care quality on neonatal, infant and child mortality in Zimbabwe: evidence from the demographic and health surveys.

    Science.gov (United States)

    Makate, Marshall; Makate, Clifton

    2017-04-01

    The impact of the quality of prenatal care on child mortality outcomes has received less attention in sub-Saharan Africa. This study endeavoured to explore the effect of the quality of prenatal care and its individual components on neonatal, infant and under-five mortality. The empirical analysis uses data from the three most recent waves of the nationally representative Demographic and Health Survey for Zimbabwe conducted in 1999, 2005/06 and 2010/11. The results indicate that a one-unit increase in the quality of prenatal care lowers the prospect of neonatal, infant and under-five mortality by approximately 42.33, 30.86 and 28.65%, respectively. These findings remained roughly the same even after adjusting for potential mediating factors. Examining the effect of individual prenatal care components on child mortality revealed that women who receive information on possible complications arising during pregnancy are less liable to experience a neonatal death. Similarly, women who had blood pressure checks and tetanus immunizations were less likely to experience an infant or under-five death. We did not find any statistically meaningful impact on child mortality outcomes of blood and urine sample checks, iron tablet consumption, and the receipt of malarial tablets. Overall, our results suggest the need for public health policymakers to focus on ensuring high-quality prenatal care to enhance the survival prospects of Zimbabwe's infants. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. An examination of responses to surveys among Filipino-Australian migrants.

    Science.gov (United States)

    Maneze, Della; Everett, Bronwyn; DiGiacomo, Michelle; Davidson, Patricia M; Salamonson, Yenna

    2016-11-18

    Background Surveys are frequently used to collect data. Although paper surveys are commonly used, online surveys are gaining in popularity, with the inclusion of open-ended questions (OEQs) allowing respondents to freely express their views. Little is known about how Filipino-Australian migrants respond to surveys. There is some concern about the usefulness of OEQs administered to culturally and linguistically diverse migrants, who may have limited capacity to articulate their thoughts in writing. Aim To examine the responses of Filipino-Australian migrants to a survey. Discussion A total of 552 respondents were recruited, of whom 428 (78%) completed the questionnaire online. The overall response rate to the OEQs was 69%, with higher completion rates among those given a paper-based questionnaire and those with university educations. Conclusion Filipino migrants with functional English language skills responded well to the online survey. Paper-based administration elicited more OEQ responses, which is attributed to greater interaction between participants and researchers. Those with university educations may have more capacity to express themselves in English and were therefore more likely to complete the OEQs. Implications for practice The high response rate obtained in this study suggests that among Filipino-Australian migrants who rated their English language skills and educational level highly, the translation of OEQs may not be necessary. This has important implications for resources in research. Face-to-face interaction between participants and researchers is an important strategy for increasing the rates of response to OEQs.

  15. The value of the physical examination in clinical practice: an international survey.

    Science.gov (United States)

    Elder, Andrew T; McManus, I Chris; Patrick, Alan; Nair, Kichu; Vaughan, Louella; Dacre, Jane

    2017-12-01

    A structured online survey was used to establish the views of 2,684 practising clinicians of all ages in multiple countries about the value of the physical examination in the contemporary practice of internal medicine. 70% felt that physical examination was 'almost always valuable' in acute general medical referrals. 66% of trainees felt that they were never observed by a consultant when undertaking physical examination and 31% that consultants never demonstrated their use of the physical examination to them. Auscultation for pulmonary wheezes and crackles were the two signs most likely to be rated as frequently used and useful, with the character of the jugular venous waveform most likely to be rated as -infrequently used and not useful. Physicians in contemporary hospital general medical practice continue to value the contribution of the physical examination to assessment of outpatients and inpatients, but, in the opinion of trainees, teaching and demonstration could be improved. © Royal College of Physicians 2017. All rights reserved.

  16. Using Health Extension Workers for Monitoring Child Mortality in Real-Time: Validation against Household Survey Data in Rural Ethiopia.

    Directory of Open Access Journals (Sweden)

    Agbessi Amouzou

    Full Text Available Ethiopia has scaled up its community-based programs over the past decade by training and deploying health extension workers (HEWs in rural communities throughout the country. Consequently, child mortality has declined substantially, placing Ethiopia among the few countries that have achieved the United Nations' fourth Millennium Development Goal. As Ethiopia continues its efforts, results must be assessed regularly to provide timely feedback for improvement and to generate further support for programs. More specifically the expansion of HEWs at the community level provides a unique opportunity to build a system for real-time monitoring of births and deaths, linked to a civil registration and vital statistics system that Ethiopia is also developing. We tested the accuracy and completeness of births and deaths reported by trained HEWs for monitoring child mortality over 15 -month periods.HEWs were trained in 93 randomly selected rural kebeles in Jimma and West Hararghe zones of the Oromia region to report births and deaths over a 15-month period from January, 2012 to March, 2013. Completeness of number of births and deaths, age distribution of deaths, and accuracy of resulting under-five, infant, and neonatal mortality rates were assessed against data from a large household survey with full birth history from women aged 15-49. Although, in general HEWs, were able to accurately report events that they identified, the completeness of number of births and deaths reported over twelve-month periods was very low and variable across the two zones. Compared to household survey estimates, HEWs reported only about 30% of births and 21% of under-five deaths occurring in their communities over a twelve-month period. The under-five mortality rate was under-estimated by around 30%, infant mortality rate by 23% and neonatal mortality by 17%. HEWs reported disproportionately higher number of deaths among the very young infants than among the older children

  17. Occupation and lung cancer mortality in a nationally representative U.S. Cohort: The National Health Interview Survey (NHIS).

    Science.gov (United States)

    Lee, David J; Fleming, Lora E; Leblanc, William G; Arheart, Kristopher L; Chung-Bridges, Katherine; Christ, Sharon L; Caban, Alberto J; Pitman, Terry

    2006-08-01

    The objective of this study was to assess the risk of lung cancer mortality in a nationally representative sample of U.S. workers by occupation. National Death Index linkage identified 1812 lung cancer deaths among 143,863 workers who participated in the 1987, 1988, and 1990-1994 National Health Interview Surveys. Current and former smoking status was predictive of lung cancer mortality (hazard ratio [HR] = 15.1 and 3.8, respectively). Occupations with significantly higher risk for age- and smoking-adjusted lung cancer mortality included heating/air/refrigeration mechanics (HR = 3.0); not specified mechanics and repairers (HR = 2.8); financial records processing occupations (HR = 1.8); freight, stock, and materials handlers (HR = 1.5); and precision production occupations (HR = 1.4). Although tobacco use continues to be the single most important risk factor for lung cancer mortality, occupational exposure to lung carcinogens should be targeted as well to further reduce the burden of lung cancer.

  18. Examining national trends in worker health with the National Health Interview Survey.

    Science.gov (United States)

    Luckhaupt, Sara E; Sestito, John P

    2013-12-01

    To describe data from the National Health Interview Survey (NHIS), both the annual core survey and periodic occupational health supplements (OHSs), available for examining national trends in worker health. The NHIS is an annual in-person household survey with a cross-sectional multistage clustered sample design to produce nationally representative health data. The 2010 NHIS included an OHS. Prevalence rates of various health conditions and health behaviors among workers based on multiple years of NHIS core data are available. In addition, the 2010 NHIS-OHS data provide prevalence rates of selected health conditions, work organization factors, and occupational exposures among US workers by industry and occupation. The publicly available NHIS data can be used to identify areas of concern for various industries and for benchmarking data from specific worker groups against national averages.

  19. Mini-mental state examination as a predictor of mortality among older people referred to secondary mental healthcare.

    Science.gov (United States)

    Su, Yu-Ping; Chang, Chin-Kuo; Hayes, Richard D; Perera, Gayan; Broadbent, Matthew; To, David; Hotopf, Matthew; Stewart, Robert

    2014-01-01

    Lower levels of cognitive function have been found to be associated with higher mortality in older people, particularly in dementia, but the association in people with other mental disorders is still inconclusive. Data were analysed from a large mental health case register serving a geographic catchment of 1.23 million residents, and associations were investigated between cognitive function measured by the Mini-Mental State Examination (MMSE) and survival in patients aged 65 years old and over. Cox regressions were carried out, adjusting for age, gender, psychiatric diagnosis, ethnicity, marital status, and area-level socioeconomic index. A total of 6,704 subjects were involved, including 3,368 of them having a dementia diagnosis and 3,336 of them with depression or other diagnoses. Descriptive outcomes by Kaplan-Meier curves showed significant differences between those with normal and impaired cognitive function (MMSE scoremental health services regardless of a dementia diagnosis. Causal pathways between this exposure and outcome (for example, suboptimal healthcare) need further investigation.

  20. Education and adult cause-specific mortality--examining the impact of family factors shared by 871 367 Norwegian siblings

    DEFF Research Database (Denmark)

    Næss, Oyvind; Hoff, Dominic A; Lawlor, Debbie

    2012-01-01

    To estimate the impact family factors shared by siblings has on the association between length of education and cause-specific mortality in adulthood.......To estimate the impact family factors shared by siblings has on the association between length of education and cause-specific mortality in adulthood....

  1. Factors Associated with Hemorrhoids in Korean Adults: Korean National Health and Nutrition Examination Survey

    OpenAIRE

    Lee, Jong-Hyun; Kim, Hyo-Eun; Kang, Ji-Hun; Shin, Jin-Young; Song, Yun-Mi

    2014-01-01

    Background Although hemorrhoids are one of the most common anal diseases among Koreans, risk factors for hemorrhoids have not been well identified. Methods We analyzed the data from the 4th Korean National Health and Nutrition Examination Survey (KNHANES) between 2007 and 2009. Study subjects were 17,228 participants of KNHANES who were aged 19 years or older. Logistic regression analysis was conducted to evaluate associations between hemorrhoids and probable risk factors. Results Overall pre...

  2. Mapping hardwood mortality for the early detection of P. ramorum: an assessment of aerial surveys and object-oriented image analysis

    Science.gov (United States)

    Erik Haunreiter; Zhanfeng Liu; Jeff Mai; Zachary Heath; Lisa Fischer

    2008-01-01

    Effective monitoring and identification of areas of hardwood mortality is a critical component in the management of sudden oak death (SOD). From 2001 to 2005, aerial surveys covering 13.5 million acres in California were conducted to map and monitor hardwood mortality for the early detection of Phytophthora ramorum, the pathogen responsible for SOD....

  3. [Estimating child mortality using the previous child technique, with data from health centers and household surveys: methodological aspects].

    Science.gov (United States)

    Aguirre, A; Hill, A G

    1988-01-01

    2 trials of the previous child or preceding birth technique in Bamako, Mali, and Lima, Peru, gave very promising results for measurement of infant and early child mortality using data on survivorship of the 2 most recent births. In the Peruvian study, another technique was tested in which each woman was asked about her last 3 births. The preceding birth technique described by Brass and Macrae has rapidly been adopted as a simple means of estimating recent trends in early childhood mortality. The questions formulated and the analysis of results are direct when the mothers are visited at the time of birth or soon after. Several technical aspects of the method believed to introduce unforeseen biases have now been studied and found to be relatively unimportant. But the problems arising when the data come from a nonrepresentative fraction of the total fertile-aged population have not been resolved. The analysis based on data from 5 maternity centers including 1 hospital in Bamako, Mali, indicated some practical problems and the information obtained showed the kinds of subtle biases that can result from the effects of selection. The study in Lima tested 2 abbreviated methods for obtaining recent early childhood mortality estimates in countries with deficient vital registration. The basic idea was that a few simple questions added to household surveys on immunization or diarrheal disease control for example could produce improved child mortality estimates. The mortality estimates in Peru were based on 2 distinct sources of information in the questionnaire. All women were asked their total number of live born children and the number still alive at the time of the interview. The proportion of deaths was converted into a measure of child survival using a life table. Then each woman was asked for a brief history of the 3 most recent live births. Dates of birth and death were noted in month and year of occurrence. The interviews took only slightly longer than the basic survey

  4. Trends in the nursing doctoral comprehensive examination process: a national survey.

    Science.gov (United States)

    Mawn, Barbara E; Goldberg, Shari

    2012-01-01

    The doctoral comprehensive or qualifying examination (CE/QE) is a traditional rite of passage into the community of scholars for the nursing profession. This exploratory, descriptive cross-sectional study examined trends in the process, timing, and methodology of comprehensive and qualifying examinations in nursing doctoral programs in the United States. Administrators from 45 schools responded to an online survey from 27 states across the country (37% response rate). Participants reported wide variations in the process. The most common method of implementation was the written take-home test (47%), two thirds of which had a subsequent oral examination. Eleven survey respondents (24%) reported using a form of the traditional written, timed, on-site examination; however, only 4 of these also followed up with an oral defense. Nine schools (20%) moved to a requirement for a written publishable paper; three schools consider the written proposal and its defense as the CE/QE. Approximately half had changed their policy in the past 5 years. With the increase in nursing doctor of philosophy programs over the past decade, information is needed to facilitate the development of methods to achieve program outcomes. An understanding of national CE/QE trends can provide a starting point for discussion and allow innovative ideas to meet the need of individual programs. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. A preliminary survey of avian mortality on power lines in the ...

    African Journals Online (AJOL)

    Collisions were more common than electrocutions, apparently killing 88% of the birds found on distribution lines. Large terrestrial birds were the most numerous victims, with large numbers of Blue Cranes Anthropoides paradiseus and Denham's Bustards Neotis denhami killed. In comparison with mortality rates from the ...

  6. Trends and social differentials in child mortality in Rwanda 1990-2010: results from three demographic and health surveys.

    Science.gov (United States)

    Musafili, Aimable; Essén, Birgitta; Baribwira, Cyprien; Binagwaho, Agnes; Persson, Lars-Åke; Selling, Katarina Ekholm

    2015-09-01

    Rwanda has embarked on ambitious programmes to provide equitable health services and reduce mortality in childhood. Evidence from other countries indicates that advances in child survival often have come at the expense of increasing inequity. Our aims were to analyse trends and social differentials in mortality before the age of 5 years in Rwanda from 1990 to 2010. We performed secondary analyses of data from three Demographic and Health Surveys conducted in 2000, 2005 and 2010 in Rwanda. These surveys included 34 790 children born between 1990 and 2010 to women aged 15-49 years. The main outcome measures were neonatal mortality rates (NMR) and under-5 mortality rates (U5MR) over time, and in relation to mother's educational level, urban or rural residence and household wealth. Generalised linear mixed effects models and a mixed effects Cox model (frailty model) were used, with adjustments for confounders and cluster sampling method. Mortality rates in Rwanda peaked in 1994 at the time of the genocide (NMR 60/1000 live births, 95% CI 51 to 65; U5MR 238/1000 live births, 95% CI 226 to 251). The 1990s and the first half of the 2000s were characterised by a marked rural/urban divide and inequity in child survival between maternal groups with different levels of education. Towards the end of the study period (2005-2010) NMR had been reduced to 26/1000 (95% CI 23 to 29) and U5MR to 65/1000 (95% CI 61 to 70), with little or no difference between urban and rural areas, and household wealth groups, while children of women with no education still had significantly higher U5MR. Recent reductions in child mortality in Rwanda have concurred with improved social equity in child survival. Current challenges include the prevention of newborn deaths. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  7. Factors Associated with Participation, Active Refusals and Reasons for Not Taking Part in a Mortality Followback Survey Evaluating End-of-Life Care.

    Directory of Open Access Journals (Sweden)

    Natalia Calanzani

    Full Text Available Examination of factors independently associated with participation in mortality followback surveys is rare, even though these surveys are frequently used to evaluate end-of-life care. We aimed to identify factors associated with 1 participation versus non-participation and 2 provision of an active refusal versus a silent refusal; and systematically examine reasons for refusal in a population-based mortality followback survey.Postal survey about the end-of-life care received by 1516 people who died from cancer (aged ≥18, identified through death registrations in London, England (response rate 39.3%. The informant of death (a relative in 95.3% of cases was contacted 4-10 months after the patient died. We used multivariate logistic regression to identify factors associated with participation/active refusals and content analysis to examine refusal reasons provided by 205 nonparticipants.The odds of partaking were higher for patients aged 90+ (AOR 3.48, 95%CI: 1.52-8.00, ref: 20-49yrs and female informants (AOR 1.70, 95%CI: 1.33-2.16. Odds were lower for hospital deaths (AOR 0.62, 95%CI: 0.46-0.84, ref: home and proxies other than spouses/partners (AORs 0.28 to 0.57. Proxies of patients born overseas were less likely to provide an active refusal (AOR 0.49; 95% CI: 0.32-0.77. Refusal reasons were often multidimensional, most commonly study-related (36.0%, proxy-related and grief-related (25.1% each. One limitation of this analysis is the large number of nonparticipants who did not provide reasons for refusal (715/920.Our survey better reached proxies of older patients while those dying in hospitals were underrepresented. Proxy characteristics played a role, with higher participation from women and spouses/partners. More information is needed about the care received by underrepresented groups. Study design improvements may guide future questionnaire development and help develop strategies to increase response rates.

  8. Factors Associated with Participation, Active Refusals and Reasons for Not Taking Part in a Mortality Followback Survey Evaluating End-of-Life Care

    Science.gov (United States)

    Calanzani, Natalia; Higginson, Irene J; Koffman, Jonathan; Gomes, Barbara

    2016-01-01

    Background Examination of factors independently associated with participation in mortality followback surveys is rare, even though these surveys are frequently used to evaluate end-of-life care. We aimed to identify factors associated with 1) participation versus non-participation and 2) provision of an active refusal versus a silent refusal; and systematically examine reasons for refusal in a population-based mortality followback survey. Methods Postal survey about the end-of-life care received by 1516 people who died from cancer (aged ≥18), identified through death registrations in London, England (response rate 39.3%). The informant of death (a relative in 95.3% of cases) was contacted 4–10 months after the patient died. We used multivariate logistic regression to identify factors associated with participation/active refusals and content analysis to examine refusal reasons provided by 205 nonparticipants. Findings The odds of partaking were higher for patients aged 90+ (AOR 3.48, 95%CI: 1.52–8.00, ref: 20–49yrs) and female informants (AOR 1.70, 95%CI: 1.33–2.16). Odds were lower for hospital deaths (AOR 0.62, 95%CI: 0.46–0.84, ref: home) and proxies other than spouses/partners (AORs 0.28 to 0.57). Proxies of patients born overseas were less likely to provide an active refusal (AOR 0.49; 95% CI: 0.32–0.77). Refusal reasons were often multidimensional, most commonly study-related (36.0%), proxy-related and grief-related (25.1% each). One limitation of this analysis is the large number of nonparticipants who did not provide reasons for refusal (715/920). Conclusions Our survey better reached proxies of older patients while those dying in hospitals were underrepresented. Proxy characteristics played a role, with higher participation from women and spouses/partners. More information is needed about the care received by underrepresented groups. Study design improvements may guide future questionnaire development and help develop strategies to increase

  9. One in Five Maternal Deaths in Bangladesh Associated with Acute Jaundice: Results from a National Maternal Mortality Survey.

    Science.gov (United States)

    Shah, Rupal; Nahar, Quamrun; Gurley, Emily S

    2016-03-01

    We estimated the proportion of maternal deaths in Bangladesh associated with acute onset of jaundice. We used verbal autopsy data from a nationally representative maternal mortality survey to calculate the proportion of maternal deaths associated with jaundice and compared it to previously published estimates. Of all maternal deaths between 2008 and 2010, 23% were associated with jaundice, compared with 19% from 1998 to 2001. Approximately one of five maternal deaths was preceded by jaundice, unchanged in 10 years. Our findings highlight the need to better understand the etiology of these maternal deaths in Bangladesh. © The American Society of Tropical Medicine and Hygiene.

  10. Collaborative survey of perinatal loss in planned and unplanned home births. Northern Region Perinatal Mortality Survey Coordinating Group.

    OpenAIRE

    1996-01-01

    OBJECTIVE: To document the outcome of planned and unplanned births outside hospital. DESIGN: Confidential review of every pregnancy ending in stillbirth or neonatal death in which plans had been made for home delivery, irrespective of where delivery eventually occurred. The review was part of a sustained collaborative survey of all perinatal deaths. SETTING: Northern Regional Health Authority area. SUBJECTS: All 558,691 registered births to women normally resident in the former Northern Regio...

  11. Examining the Factors Related to Mortality Aamongst One Year Old and Younger Children in Yazd City During 2011 to 2013 Period

    Directory of Open Access Journals (Sweden)

    Abbas Askari Nodoushan

    2015-06-01

    Materials and Methods: This descriptive-analytical study was conducted using control-test group method. All recorded cases of mortality for children in Yazd city during the first year of their life were included in statistical population, while for each case of mortality two cases of living children were examined as control group. The data were collected by direct visits on healthcare centers in the city and examining case files for children. Obtained data were analyzed using SPSS 20 software package. Results: 116 mortality cases were examined in total which included 41.4% boys and 58.6% girls. Some variables such as type of marriage between parents, mother and father’s education level, type of labor and number of previous pregnancies were significantly related to children’s mortality rate. Conclusion: suggest that paying specific attention to infants at the time of birth, improving knowledge level amongst mothers and families, providing standard level healthcare prior to pregnancy and after that, and also developing programs which aim for improving economic-social and cultural status amongst women and men would be effective on reducing children mortality rates.

  12. Mortality of centrarchid fishes in the Potomac drainage: survey results and overview of potential contributing factors.

    Science.gov (United States)

    Blazer, V S; Iwanowicz, L R; Starliper, C E; Iwanowicz, D D; Barbash, P; Hedrick, J D; Reeser, S J; Mullican, J E; Zaugg, S D; Burkhardt, M R; Kelble, J

    2010-09-01

    Skin lesions and spring mortality events of smallmouth bass Micropterus dolomieu and selected other species were first noted in the South Branch of the Potomac River in 2002. Since that year morbidity and mortality have also been observed in the Shenandoah and Monocacy rivers. Despite much research, no single pathogen, parasite, or chemical cause for the lesions and mortality has been identified. Numerous parasites, most commonly trematode metacercariae and myxozoans; the bacterial pathogens Aeromonas hydrophila, Aeromonas salmonicida, and Flavobacterium columnare; and largemouth bass virus have all been observed. None have been consistently isolated or observed at all sites, however, nor has any consistent microscopic pathology of the lesions been observed. A variety of histological changes associated with exposure to environmental contaminants or stressors, including intersex (testicular oocytes), high numbers of macrophage aggregates, oxidative damage, gill lesions, and epidermal papillomas, were observed. The findings indicate that selected sensitive species may be stressed by multiple factors and constantly close to the threshold between a sustainable (healthy) and nonsustainable (unhealthy) condition. Fish health is often used as an indicator of aquatic ecosystem health, and these findings raise concerns about environmental degradation within the Potomac River drainage. Unfortunately, while much information has been gained from the studies conducted to date, due to the multiple state jurisdictions involved, competing interests, and other issues, there has been no coordinated approach to identifying and mitigating the stressors. This synthesis emphasizes the need for multiyear, interdisciplinary, integrative research to identify the underlying stressors and possible management actions to enhance ecosystem health.

  13. Trends in malnutrition and mortality in Darfur, Sudan, between 2004 and 2008: a meta-analysis of publicly available surveys.

    Science.gov (United States)

    Nielsen, Jens; Prudhon, Claudine; de Radigues, Xavier

    2011-08-01

    The humanitarian response to the crisis in Darfur is the largest humanitarian operation in the world. To investigate the evolution of the conditions of the affected population, we analysed trends in malnutrition and mortality, the most widely accepted indicators for assessing the degree of severity of a crisis. We did a meta-analysis of 164 publicly available surveys taking into account changes in the contextual situation and humanitarian aid; type of population [residents and internally displaced persons (IDPs)]; and seasonal variations. Data on global acute malnutrition (GAM), severe acute malnutrition (SAM), crude death rate (CDR) and under-five death rate (U5DR) were analysed using a random effect model. GAM and SAM decreased by 16% and 28%, respectively, in 2004-05, whereas CDR dropped by 44-75% per year depending on state and type of population and U5DR decreased by an overall 50% yearly. Both security and the humanitarian contexts became increasingly complex after 2005, but levels of malnutrition stabilized in North and South Darfur. In West Darfur, GAM remained stable but SAM tended to increase for IDPs, although mortality rates remained constant. Mortality increased slightly for residents in South Darfur after 2005, even though nutritional status was stable. GAM, SAM, CDR and U5DR fluctuated markedly with seasons. A meta-analysis of myriads of surveys permitted us to draw an overall picture of the situation in Darfur and to identify some of its influencing factors. The large humanitarian operation, which gained momentum through 2004-05, was able to contain the crisis despite huge difficulties, but did not compensate for seasonal variations. The situation has remained fragile with some negative patterns tending to emerge. It is crucial that the humanitarian situation continues to be closely monitored.

  14. Nationwide survey of dental radiographic examination and estimation of collective effective dose in Japan, 1999

    International Nuclear Information System (INIS)

    Iwai, Kazuo; Satomi, Chieko; Kawashima, Shoji; Hashimoto, Koji; Nishizawa, Kanae; Maruyama, Takashi

    2005-01-01

    A nationwide survey of dental X-ray examination in Japan was performed in 1999, and the effective exposure dose due to the dental X-ray examination was estimated. In Japan, most dental X-ray equipment are used at a tube voltage of 60 kV and a tube current of 10 mA. Dental film in speed group D is most frequently used for dental X ray examination. Fifty percent or more of dental clinics processed the films automatically. Seventy-five percent of dental clinics performed dental X-ray examinations in a separate X-ray room. The number of dental X-ray examinations in 1999 in Japan was estimated to be 82,301,000 for intra-oral radiography and 12,336,000 for panoramic radiography. The collective effective exposure dose in 1999 was estimated at 905.5 man·Sv, for intra-oral radiography and 128.9 man·Sv for panoramic radiography. (author)

  15. Breast Ultrasound Examination with Video Monitor System: A Satisfaction Survey among Patients

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Jung Kyu; Kim, Hyun Cheol; Yang, Dal Mo [East-West Neo Medical Center, Kyung-Hee University, Seoul (Korea, Republic of)

    2010-03-15

    The purpose of this study is to assess the patients satisfaction with a newly established video-monitor system and the associated basic items for performing breast ultrasound exams by conducting a survey among the patients. 349 patients were invited to take the survey and they had undergone breast ultrasound examination once during the 3 months after the monitor system has been introduced. The questionnaire was composed of 8 questions, 4 of which were about the basic items such as age, gender and the reason of their taking the breast ultrasound exam, their preference for the gender of the examiner and the desired length of time for the examination. The other 4 question were about their satisfaction with the video monitor. The patients were divided into two groups according to the purposes of taking the exams, which were screening or diagnostic purposes. The results were compared between these 2 groups. The satisfaction with the video monitor system was assessed by using a scoring system that ranged from 1 to 5. For the total patients, the screening group was composed of 124 patients and the diagnostic group was composed of 225. The reasons why the patients wanted to take the examinations in the diagnostic group varied. The questionnaire about the preference of the gender of the examiner showed that 81.5% in the screening group and 79.1% in the diagnostic group preferred a woman doctor. The required, suitable time for the breast ultrasound examination was 5 to 10 minutes or 10 to 15 minutes for about 70% of the patients. The mean satisfaction score for the video monitor system was as high as 3.95 point. The portion of patients in each group who answered over 3 points for their satisfaction with the monitor system was 88.7% and 94.2%, respectively. Our study showed that patients preferred 5-15 minutes for the length of the examination time and a female examiner. We also confirmed high patient satisfaction with the video monitor system

  16. Breast Ultrasound Examination with Video Monitor System: A Satisfaction Survey among Patients

    International Nuclear Information System (INIS)

    Ryu, Jung Kyu; Kim, Hyun Cheol; Yang, Dal Mo

    2010-01-01

    The purpose of this study is to assess the patients satisfaction with a newly established video-monitor system and the associated basic items for performing breast ultrasound exams by conducting a survey among the patients. 349 patients were invited to take the survey and they had undergone breast ultrasound examination once during the 3 months after the monitor system has been introduced. The questionnaire was composed of 8 questions, 4 of which were about the basic items such as age, gender and the reason of their taking the breast ultrasound exam, their preference for the gender of the examiner and the desired length of time for the examination. The other 4 question were about their satisfaction with the video monitor. The patients were divided into two groups according to the purposes of taking the exams, which were screening or diagnostic purposes. The results were compared between these 2 groups. The satisfaction with the video monitor system was assessed by using a scoring system that ranged from 1 to 5. For the total patients, the screening group was composed of 124 patients and the diagnostic group was composed of 225. The reasons why the patients wanted to take the examinations in the diagnostic group varied. The questionnaire about the preference of the gender of the examiner showed that 81.5% in the screening group and 79.1% in the diagnostic group preferred a woman doctor. The required, suitable time for the breast ultrasound examination was 5 to 10 minutes or 10 to 15 minutes for about 70% of the patients. The mean satisfaction score for the video monitor system was as high as 3.95 point. The portion of patients in each group who answered over 3 points for their satisfaction with the monitor system was 88.7% and 94.2%, respectively. Our study showed that patients preferred 5-15 minutes for the length of the examination time and a female examiner. We also confirmed high patient satisfaction with the video monitor system

  17. The U.S. National Health and Nutrition Examination Survey and human exposure to environmental chemicals.

    Science.gov (United States)

    Calafat, Antonia M

    2012-02-01

    Researchers are increasingly interested in using human biomonitoring - the measurement of chemicals, their metabolites or specific reaction products in biological specimens/body fluids - for investigating exposure to environmental chemicals. General population human biomonitoring programs are useful for investigating human exposure to environmental chemicals and an important tool for integrating environment and health. One of these programs, the National Health and Nutrition Examination Survey (NHANES), conducted in the United States is designed to collect data on the health and nutritional status of the noninstitutionalized, civilian U.S. population. NHANES includes a physical examination, collecting a detailed medical history, and collecting biological specimens (i.e., blood and urine). These biological specimens can be used to assess exposure to environmental chemicals. NHANES human biomonitoring data can be used to establish reference ranges for selected chemicals, provide exposure data for risk assessment, and monitor exposure trends. Published by Elsevier GmbH.

  18. Relationship between anthropometric parameters and open angle glaucoma: The Korea National Health and Nutrition Examination Survey.

    Directory of Open Access Journals (Sweden)

    Jae Yeun Lee

    Full Text Available To evaluate the relationships between open-angle glaucoma (OAG and various anthropometric measurements.Korea National Health and Nutrition Examination Survey (KNHANES, a population-based cross-sectional study using a complex, stratified, multistage, probability-cluster survey.A total of 5,255 participants including 247 glaucoma patients, aged ≥ 19 years were included from the KNHANES V database. Glaucoma diagnosis was based on International Society of Geographical and Epidemiological Ophthalmology criteria. Various anthropometric data regarding obesity were analyzed including body mass index (BMI, total body fat mass, total body muscle mass (lean body mass, non-bone lean body mass, and appendicular skeletal muscle (ASM mass, and waist circumference (WC. The differences in OAG prevalence with respect to anthropometric parameter quartiles were examined.In males, the multivariate general linear model adjusted for age, alcohol, smoking, exercise, systemic hypertension, diabetes, and intraocular pressure (IOP showed the quartiles for the anthropometric parameters BMI, fat mass/weight ratio and fat mass/muscle mass ratio were negatively associated with OAG. However, muscle mass parameter/BMI ratio was significantly positively associated with OAG (P for trend<0.05. In females, height and fat mass/BMI showed a significant relationship with the risk of OAG. (P value<0.05.In the present study, high fat mass was associated with low OAG risk. Body composition seemed to affect the prevalence of OAG, but further evaluation is needed.

  19. Diabetes, vestibular dysfunction, and falls: analyses from the National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Agrawal, Yuri; Carey, John P; Della Santina, Charles C; Schubert, Michael C; Minor, Lloyd B

    2010-12-01

    Patients with diabetes are at increased risk both for falls and for vestibular dysfunction, a known risk factor for falls. Our aims were 1) to further characterize the vestibular dysfunction present in patients with diabetes and 2) to evaluate for an independent effect of vestibular dysfunction on fall risk among patients with diabetes. National cross-sectional survey. Ambulatory examination centers. Adults from the United States aged 40 years and older who participated in the 2001-2004 National Health and Nutrition Examination Survey (n = 5,86). Diagnosis of diabetes, peripheral neuropathy, and retinopathy. Vestibular function measured by the modified Romberg Test of Standing Balance on Firm and Compliant Support Surfaces and history of falling in the previous 12 months. We observed a higher prevalence of vestibular dysfunction in patients with diabetes with longer duration of disease, greater serum hemoglobin A1c levels and other diabetes-related complications, suggestive of a dose-response relationship between diabetes mellitus severity and vestibular dysfunction. We also noted that vestibular dysfunction independently increased the odds of falling more than 2-fold among patients with diabetes (odds ratio, 2.3; 95% confidence interval, 1.1-5.1), even after adjusting for peripheral neuropathy and retinopathy. Moreover, we found that including vestibular dysfunction, peripheral neuropathy, and retinopathy in multivariate models eliminated the significant association between diabetes and fall risk. Vestibular dysfunction may represent a newly recognized diabetes-related complication, which acts as a mediator of the effect of diabetes mellitus on fall risk.

  20. Relationship between anthropometric parameters and open angle glaucoma: The Korea National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Lee, Jae Yeun; Kim, Tae-Woo; Kim, Hyun Tae; Lee, Mi Yeon; Min, Hye Won; Won, Yu Sam; Kwon, Hyun Seok; Park, Ki Ho; Kim, Joon Mo

    2017-01-01

    To evaluate the relationships between open-angle glaucoma (OAG) and various anthropometric measurements. Korea National Health and Nutrition Examination Survey (KNHANES), a population-based cross-sectional study using a complex, stratified, multistage, probability-cluster survey. A total of 5,255 participants including 247 glaucoma patients, aged ≥ 19 years were included from the KNHANES V database. Glaucoma diagnosis was based on International Society of Geographical and Epidemiological Ophthalmology criteria. Various anthropometric data regarding obesity were analyzed including body mass index (BMI), total body fat mass, total body muscle mass (lean body mass, non-bone lean body mass, and appendicular skeletal muscle (ASM) mass), and waist circumference (WC). The differences in OAG prevalence with respect to anthropometric parameter quartiles were examined. In males, the multivariate general linear model adjusted for age, alcohol, smoking, exercise, systemic hypertension, diabetes, and intraocular pressure (IOP) showed the quartiles for the anthropometric parameters BMI, fat mass/weight ratio and fat mass/muscle mass ratio were negatively associated with OAG. However, muscle mass parameter/BMI ratio was significantly positively associated with OAG (P for trend<0.05). In females, height and fat mass/BMI showed a significant relationship with the risk of OAG. (P value<0.05). In the present study, high fat mass was associated with low OAG risk. Body composition seemed to affect the prevalence of OAG, but further evaluation is needed.

  1. [Physical activity: results of the German Health Interview and Examination Survey for Adults (DEGS1)].

    Science.gov (United States)

    Krug, S; Jordan, S; Mensink, G B M; Müters, S; Finger, J; Lampert, T

    2013-05-01

    Regular physical activity can have a positive effect on health at any age. Today's lifestyles, however, can often be characterised as sedentary. Therefore, the promotion of physical activity and sports has become an integral part of public health measures. The representative data of adults aged 18 to 79 years in Germany obtained from the "German Health Interview and Examination Survey for Adults" (DEGS1) provide an overview of self-estimated current physical activity behaviour. The results show that one third of the adult population claims to pay close attention to reaching a sufficient level of physical activity and one fourth participates in sports for at least 2 h/week on a regular basis. Thus, the percentage of adults regularly engaged in sports has increased compared to the previous "German National Health Interview and Examination Survey 1998". Still, four out of five adults do not achieve at least 2.5 h/week of moderate-intensity physical activity as recommended by the World Health Organisation. Consequently, future individual-level and population-level interventions should focus on target group-specific measures while continuing to promote regular physical activity in all segments of the population. An English full-text version of this article is available at SpringerLink as supplemental.

  2. Examining the association between male circumcision and sexual function: evidence from a British probability survey.

    Science.gov (United States)

    Homfray, Virginia; Tanton, Clare; Mitchell, Kirstin R; Miller, Robert F; Field, Nigel; Macdowall, Wendy; Wellings, Kaye; Sonnenberg, Pam; Johnson, Anne M; Mercer, Catherine H

    2015-07-17

    Despite biological advantages of male circumcision in reducing HIV/sexually transmitted infection acquisition, concern is often expressed that it may reduce sexual enjoyment and function. We examine the association between circumcision and sexual function among sexually active men in Britain using data from Britain's third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Natsal-3 asked about circumcision and included a validated measure of sexual function, the Natsal-SF, which takes into account not only sexual difficulties but also the relationship context and overall level of satisfaction. A stratified probability survey of 6293 men and 8869 women aged 16-74 years, resident in Britain, undertaken 2010-2012, using computer-assisted face-to-face interviewing with computer-assisted self-interview for the more sensitive questions. Logistic regression was used to calculate odds ratios (ORs) to examine the association between reporting male circumcision and aspects of sexual function among sexually active men (n = 4816). The prevalence of male circumcision in Britain was 20.7% [95% confidence interval (CI): 19.3-21.8]. There was no association between male circumcision and, being in the lowest quintile of scores for the Natsal-SF, an indicator of poorer sexual function (adjusted OR: 0.95, 95% CI: 0.76-1.18). Circumcised men were as likely as uncircumcised men to report the specific sexual difficulties asked about in Natsal-3, except that a larger proportion of circumcised men reported erectile difficulties. This association was of borderline statistical significance after adjusting for age and relationship status (adjusted OR: 1.27, 95% CI: 0.99-1.63). Data from a large, nationally representative British survey suggest that circumcision is not associated with men's overall sexual function at a population level.

  3. Survey of patient doses from conventional diagnostic radiographic examinations in Syria

    International Nuclear Information System (INIS)

    Kharita, M. H.; Khedr, M. S.; Wannus, K. M.

    2010-01-01

    The aim of this study is to evaluate radiation doses received by adult patients undergoing eight routine common types of X-ray examination in Syria. These types cover chest PA, lumbar spine PA, lumbar spine LAT, urography, abdomen, pelvis and hip, head and shoulder. This work consisted of measurements for 926 X-ray examinations for patients in 26 governmental hospitals. The mean and third quartile of the dose area product (DAP) to each patient per examination have been measured. The corresponding average effective doses have been computed from the DAP measurement for each examination using NRPP X-Dose software. Comparison of the results was done with those from similar surveys published by the United Nation Scientific Committee on the Effects of Atomic Radiation (UNSCEAR, 2000, 2007). The present measurements will provide a useful baseline to establish, for the first time, national diagnostic reference levels. These results can be used in the future to evaluate the collective dose to the population from medical exposure and the radiation risks from the various radiological procedures. (authors)

  4. The FRCR 2B examination: a survey of candidate perceptions and experiences

    International Nuclear Information System (INIS)

    Yeung, A.; Booth, T.C.; Jacob, K.; McCoubrie, P.; McKnight, L.

    2011-01-01

    Aim: To survey the views of recent candidates of the Fellowship of the Royal College of Radiologists (FRCR) 2B examination with reference to assessment validity, reliability, and acceptability. Materials and methods: One thousand, two hundred and four UK radiology trainees and consultants were invited to complete an automated internet questionnaire regarding their experiences and perceptions of the FRCR 2B examination. The questionnaire was informed by a review of the literature. Eligible participants were candidates who had taken the examination within the previous 3 years. Results: Four hundred and ninety-seven out of 1204 (41%) responses were received; of which 258/497 (52% of respondents) were eligible for inclusion into the study. The rapid reporting component is perceived to be significantly fairer than the oral section (82 versus 70% agree; p < 0.001). The oral component fared poorly in perceived performance-reducing anxiety levels but well in questions relating to validity and reliability. Female candidates are more likely to find the FRCR 2B unfair (p = 0.01) and experience performance-reducing anxiety (p < 0.001) than males. No gender differences were observed in first-time pass rates (p = 0.6). Candidate first language did not affect anxiety levels (p = 0.9) or first-time pass rates (p = 0.06). Only 12% of candidates agreed that the oral examination should move to an objective structured clinical format. Conclusion: Candidates score the FRCR 2B examination well in test validity with little desire for change to the oral examination format. Efforts to help reduce anxiety levels in the oral component would improve perceived fairness.

  5. Survey of rainbow trout mortality in cage culture farms in Hasanloo Dam, west Azerbaijan province

    Directory of Open Access Journals (Sweden)

    amin Khodadadi

    2014-08-01

    Full Text Available In late June 2013, because of sudden and unjustified increase in mortality of apparent healthy fish in Hasanloo dam cage culture, random sampling was convicted from a live dying and dead fishes. Forty fishes (20 alive and 20 dead fishes from two cage with the weight of 200-300 gr were sampled. Samples were sent to private factor laboratory ice pieces for evolution. Some physicochemical parameters of Hasanloo dam water including nitrite, nitrate, ammonium, soluble solid materials, temperature, dissolved oxygen and pH was measured.  To investing the probability of bacterial, fungal and parasitic discover outbreaks sample were taken from the kidney, gills and skin of fish. The result of different investing revealed the presence of algal bloom, oxygen shortage, executive problems and fishing net fountain obstruction due to accumulation of planktons and suspended material. Because of increase in light intensity, nutritive substances level, warming of water temperature and static suability of water hydrological status, algal blooming had occurred in Hasanloo dam that not only destroyed the gills of fish but also created competition for soluble oxygen at night with some phytoplankton species causing hypoxia and death of salmon in the breeding farm. The result of general bacterial cutler was negative and mild secondary infection with S aprolegnia species was detected in PGYEA culture. The result of liver histopathology indicated the presence of hepatic ceroidosis because of non-standard diets with high levels of carbohydrates. Gill blade inflammation and hyperplasia was the observed. Due to high amounts of ionized ammonia among culture nets resolving from summer mortality syndrome.

  6. Child Odors and Parenting: A Survey Examination of the Role of Odor in Child-Rearing.

    Science.gov (United States)

    Okamoto, Masako; Shirasu, Mika; Fujita, Rei; Hirasawa, Yukei; Touhara, Kazushige

    2016-01-01

    Parental caregiving is critical for the survival of our young and continuation of our species. In humans, visual and auditory signals from offspring have been shown to be potent facilitators of parenting. However, whether odors emitted by our young also influence human parenting remains unclear. To explore this, we conducted a series of questionnaire surveys targeting parents with children under 6 years old. First, we collected episodes on experiencing odors/sniffing various parts of a child's body (n = 507). The prevalence of experiencing events described in those episodes was examined in a separate survey (n = 384). Based on those results, the Child Odor in Parenting scale (COPs) was developed, and subsequently used in the main survey (n = 888). We found COPs to have adequate content validity, concurrent validity, and reliability. Responses to the COPs demonstrated that parents, especially mothers with infants, are aware of odors from their offspring, and actively seek them in daily child-rearing. The factor structure and content of the COPs items indicated that child odors have both affective and instrumental roles. Affective experiences induce loving feeling and affectionate sniffing, while instrumental experiences pertain to specific hygienic needs. The head was the most frequent source of affective experiences, and the child's bottom of instrumental. Each was experienced by more than 90% of the mothers with a child below 1 year of age. Affective experiences significantly declined as the child grew older, possibly associated with the decline of physical proximity between parents and child. This age-related decline was not prominent for instrumental experiences, except for the bottom, which significantly declined after 3 years of age. The present findings suggest that child odors play roles in human parenting, and that their nature and significance change during the course of a child's development.

  7. Child Odors and Parenting: A Survey Examination of the Role of Odor in Child-Rearing.

    Directory of Open Access Journals (Sweden)

    Masako Okamoto

    Full Text Available Parental caregiving is critical for the survival of our young and continuation of our species. In humans, visual and auditory signals from offspring have been shown to be potent facilitators of parenting. However, whether odors emitted by our young also influence human parenting remains unclear. To explore this, we conducted a series of questionnaire surveys targeting parents with children under 6 years old. First, we collected episodes on experiencing odors/sniffing various parts of a child's body (n = 507. The prevalence of experiencing events described in those episodes was examined in a separate survey (n = 384. Based on those results, the Child Odor in Parenting scale (COPs was developed, and subsequently used in the main survey (n = 888. We found COPs to have adequate content validity, concurrent validity, and reliability. Responses to the COPs demonstrated that parents, especially mothers with infants, are aware of odors from their offspring, and actively seek them in daily child-rearing. The factor structure and content of the COPs items indicated that child odors have both affective and instrumental roles. Affective experiences induce loving feeling and affectionate sniffing, while instrumental experiences pertain to specific hygienic needs. The head was the most frequent source of affective experiences, and the child's bottom of instrumental. Each was experienced by more than 90% of the mothers with a child below 1 year of age. Affective experiences significantly declined as the child grew older, possibly associated with the decline of physical proximity between parents and child. This age-related decline was not prominent for instrumental experiences, except for the bottom, which significantly declined after 3 years of age. The present findings suggest that child odors play roles in human parenting, and that their nature and significance change during the course of a child's development.

  8. Misery loves company? A meta-regression examining aggregate unemployment rates and the unemployment-mortality association.

    Science.gov (United States)

    Roelfs, David J; Shor, Eran; Blank, Aharon; Schwartz, Joseph E

    2015-05-01

    Individual-level unemployment has been consistently linked to poor health and higher mortality, but some scholars have suggested that the negative effect of job loss may be lower during times and in places where aggregate unemployment rates are high. We review three logics associated with this moderation hypothesis: health selection, social isolation, and unemployment stigma. We then test whether aggregate unemployment rates moderate the individual-level association between unemployment and all-cause mortality. We use six meta-regression models (each using a different measure of the aggregate unemployment rate) based on 62 relative all-cause mortality risk estimates from 36 studies (from 15 nations). We find that the magnitude of the individual-level unemployment-mortality association is approximately the same during periods of high and low aggregate-level unemployment. Model coefficients (exponentiated) were 1.01 for the crude unemployment rate (P = .27), 0.94 for the change in unemployment rate from the previous year (P = .46), 1.01 for the deviation of the unemployment rate from the 5-year running average (P = .87), 1.01 for the deviation of the unemployment rate from the 10-year running average (P = .73), 1.01 for the deviation of the unemployment rate from the overall average (measured as a continuous variable; P = .61), and showed no variation across unemployment levels when the deviation of the unemployment rate from the overall average was measured categorically. Heterogeneity between studies was significant (P unemployment experiences change when macroeconomic conditions change. Efforts to ameliorate the negative social and economic consequences of unemployment should continue to focus on the individual and should be maintained regardless of periodic changes in macroeconomic conditions. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Mortality followup through 1977 of the white underground uranium miners cohort examined by the US Public Health Service

    International Nuclear Information System (INIS)

    Roscoe, R.J.; Waxweiler, R.; Archer, V.

    1983-01-01

    This report extends through 1977 the mortality follow-up of the US Public Health Service cohort of 3362 male uranium miners. The last report on this cohort followed the miners through 1974. The data were analyzed using the lifetable analysis system developed by the National Institute for Occupational Safety and Health (NIOSH). The mean exposure to radon daughters was 821 working level months (WLM); mean period of observation was 19 years. The following significantly elevated standard mortality ratios (SMRs) were calculated: lung cancer (482), certain nonmalignant respiratory disease (NMRD) (499), accidents (331), tuberculosis (409), alcoholism (273), chronic and unspecified nephritis and renal sclerosis (262), rheumatic fever (1093) and certain heart disease (171). The SMR for all causes of death was 158. The main reason for this overall increase in mortality was excess deaths from lung cancer, accidents and NMRD. However, lung cancer was seen to be dropping in the last 3 year period, NMRD appeared to have peaked in 1975 and accidents continued a decline begun in the late 1950s. NIOSH's primary interest in this cohort concerns radiation-induced lung cancer, especially at low WLM levels. Ongoing research includes consideration of WLM dose data and smoking data

  10. Cadmium exposure and cardiovascular disease in the 2005 Korea National Health and Nutrition Examination Survey

    International Nuclear Information System (INIS)

    Lee, Mi-Sun; Park, Sung Kyun; Hu, Howard; Lee, Sundong

    2011-01-01

    Background: Limited epidemiologic data are available concerning the cardiovascular effects of cadmium exposure, although recent studies suggest associations with myocardial infarction and peripheral arterial disease. We examined the associations of cadmium exposure with cardiovascular disease in nationally representative general Korean adults. Methods: We used cross-sectional data on blood cadmium and self-reported diagnoses of ischemic heart disease (IHD), stroke, and hypertension in a sub-sample of 1908 adults, aged 20 years and older, who participated in the 2005 Korea National Health and Nutrition Examination Survey (KNHANES). We used survey logistic regression models accounting for the complex sampling design to estimate the odds ratios (OR), adjusting for age, education, income, alcohol, smoking, body mass index, waist circumference, family history of hypertension, blood pressure, and blood lead. Results: The geometric mean of blood cadmium was 1.53 μg/L. After adjusting for potential confounders, an interquartile range (IQR) increase in blood cadmium (0.91 μg/L) was found to be associated with an increased risk for IHD (OR 2.1, 95% confidence interval (CI) 1.3-3.4). An IQR increase in blood cadmium was found to be associated with an elevated risk for hypertension only among men (OR 1.4, 95% CI 1.1-1.8) but not among women. No association was observed with stroke in both genders. Conclusions: These findings suggest that cadmium in blood may be associated with an increased risk for IHD and hypertension in the general Korean adult population.

  11. Cadmium exposure and cardiovascular disease in the 2005 Korea National Health and Nutrition Examination Survey

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Mi-Sun [Department of Environmental Health, Harvard School of Public Health, Boston, MA (United States); Park, Sung Kyun; Hu, Howard [Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI (United States); Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI (United States); Lee, Sundong, E-mail: sdlee@sangji.ac.kr [Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI (United States); Department of Preventive Medicine, School of Oriental Medicine, Sangji University, Wonju, Kangwon (Korea, Republic of)

    2011-01-15

    Background: Limited epidemiologic data are available concerning the cardiovascular effects of cadmium exposure, although recent studies suggest associations with myocardial infarction and peripheral arterial disease. We examined the associations of cadmium exposure with cardiovascular disease in nationally representative general Korean adults. Methods: We used cross-sectional data on blood cadmium and self-reported diagnoses of ischemic heart disease (IHD), stroke, and hypertension in a sub-sample of 1908 adults, aged 20 years and older, who participated in the 2005 Korea National Health and Nutrition Examination Survey (KNHANES). We used survey logistic regression models accounting for the complex sampling design to estimate the odds ratios (OR), adjusting for age, education, income, alcohol, smoking, body mass index, waist circumference, family history of hypertension, blood pressure, and blood lead. Results: The geometric mean of blood cadmium was 1.53 {mu}g/L. After adjusting for potential confounders, an interquartile range (IQR) increase in blood cadmium (0.91 {mu}g/L) was found to be associated with an increased risk for IHD (OR 2.1, 95% confidence interval (CI) 1.3-3.4). An IQR increase in blood cadmium was found to be associated with an elevated risk for hypertension only among men (OR 1.4, 95% CI 1.1-1.8) but not among women. No association was observed with stroke in both genders. Conclusions: These findings suggest that cadmium in blood may be associated with an increased risk for IHD and hypertension in the general Korean adult population.

  12. Survey of image quality and radiographic technique of pediatric chest examinations performed in Latin America

    International Nuclear Information System (INIS)

    Khoury, H.; Mora, P.; Defaz, M.Y.; Blanco, S.; Leyton, F.; Benavente, T.; Ortiz Lopez, P.; Ramirez, R.

    2008-01-01

    This work presents the results of a survey of entrance surface air kerma values (K e ), image quality and radiographic exposure parameters used in pediatric chest examinations performed in Latin America. This study is part of the activities of the IAEA Regional Project RLA/9/057 whose objective is to optimize the radiological protection of patients in diagnostic and interventional radiology, nuclear medicine and radiotherapy. The survey was performed in nine hospitals in Argentina (1), Brazil (4), Chile (1), Costa Rica (1), Peru (1) and Ecuador (1). The study group consisted of 462 pediatric patients (Group I- from two days to one year, Group II- from four to six years of age) undergoing chest PA/AP examinations. At the time of the examination the exposure parameters (kVp, mAs, focal-spot-to-film distance, etc.) and patient information (gender, height, weight and age) were recorded. The radiographic image quality was evaluated by the local radiologist based on the European Guidelines on Quality Criteria for Diagnostic Radiographic Images in Pediatrics. The results showed that the exposure parameters used on newborn patients were in the majority outside the 60-65kV range recommended by the European Guidelines for a good radiographic practice. In the case of examinations of patients with age between 4 to 6 years, 80% were performed with a peak tube voltage within the 60-80 kV range, as recommended by the European Guidelines. It was found that none of countries fully comply with the European Guidelines on Quality Criteria and those criteria No. 2 and No. 3 (reproduction of the chest without rotation) received the lowest scores. Probably this occurs because there are no proper patient immobilization devices. The Ke values, for both patient groups, showed a wide dispersion, ranged from 10 μGy to 160μGy for the newborn patients and from 20μGy to 240μGy for infant patients. It is possible to conclude that, in the participating Latin American countries on this project

  13. Factors associated with mortality of myxedema coma: report of eight cases and literature survey.

    Science.gov (United States)

    Yamamoto, T; Fukuyama, J; Fujiyoshi, A

    1999-12-01

    High-dose thyroid hormone replacement has been recommended for treatment of myxedema coma (MC) while questions of safety of the therapy and of efficacy of low-dose thyroid hormone replacement have not been systematically addressed. We treated 8 patients with MC in a period of 18 years, the first 3 with high-dose intravenous injections of levotriiodothyronine (LT3) and the other 5 patients with a smaller amount of either LT3 or levothyroxine (LT4). Two of the first 3 patients died of pneumonia and the other 5 recovered despite pulmonary abnormalities at the outset. To find factors associated with fatal outcome after treatment, the MEDLINE database was searched for MC cases with data of thyroid hormone replacement and outcome within 1 month of therapy. Clinical data for our 5 patients and 82 cases from the MEDLINE search were pooled and factors associated with mortality were sought among age, gender, presence of cardiac or pulmonary complications, and doses of thyroid hormone by multiple logistic regression analysis. It revealed that greater age, cardiac complications, and high-dose thyroid hormone replacement (LT4 > or = 500 microg/d or LT3 > or = 75 microg/d) were significantly associated with a fatal outcome within 1 month of treatment. Elderly MC patients can be treated with low-dose hormone replacement. A bolus of 500 microg LT4, especially by mouth or via nasogastric tube, appears to be tolerated by younger patients (< 55 years) without cardiac complication. The conclusion remains to be confirmed in more patients.

  14. Using threshold regression to analyze survival data from complex surveys: With application to mortality linked NHANES III Phase II genetic data.

    Science.gov (United States)

    Li, Yan; Xiao, Tao; Liao, Dandan; Lee, Mei-Ling Ting

    2018-03-30

    The Cox proportional hazards (PH) model is a common statistical technique used for analyzing time-to-event data. The assumption of PH, however, is not always appropriate in real applications. In cases where the assumption is not tenable, threshold regression (TR) and other survival methods, which do not require the PH assumption, are available and widely used. These alternative methods generally assume that the study data constitute simple random samples. In particular, TR has not been studied in the setting of complex surveys that involve (1) differential selection probabilities of study subjects and (2) intracluster correlations induced by multistage cluster sampling. In this paper, we extend TR procedures to account for complex sampling designs. The pseudo-maximum likelihood estimation technique is applied to estimate the TR model parameters. Computationally efficient Taylor linearization variance estimators that consider both the intracluster correlation and the differential selection probabilities are developed. The proposed methods are evaluated by using simulation experiments with various complex designs and illustrated empirically by using mortality-linked Third National Health and Nutrition Examination Survey Phase II genetic data. Copyright © 2017 John Wiley & Sons, Ltd.

  15. Neighborhood Racial Diversity and Metabolic Syndrome: 2003-2008 National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Li, Kelin; Wen, Ming; Fan, Jessie X

    2018-03-30

    This study investigated the independent association between neighborhood racial/ethnic diversity and metabolic syndrome among US adults, and focused on how this association differed across individual and neighborhood characteristics (i.e., race/ethnicity, sex, age, urbanity, neighborhood poverty). Objectively-measured biomarker data from 2003 to 2008 National Health and Nutrition Examination Survey were linked to census-tract profiles from 2000 decennial census (N = 10,122). Multilevel random intercept logistic regression models were estimated to examine the contextual effects of tract-level racial/ethnic diversity on individual risks of metabolic syndrome. Overall, more than 20% of the study population were identified as having metabolic syndrome, although the prevalence also varied across demographic subgroups and specific biomarkers. Multilevel analyses showed that increased racial/ethnic diversity within a census tract was associated with decreased likelihood of having metabolic syndrome (OR 0.71, 95% CI 0.52-0.96), particularly among female (OR 0.64; 95% CI 0.43-0.96), young adults (OR 0.60; 95% CI 0.39-0.93), and residents living in urban (OR 0.67; 95% CI 0.48-0.93) or poverty neighborhoods (OR 0.54; 95% CI 0.31-0.95). The findings point to the potential benefits of neighborhood racial/ethnic diversity on individual health risks.

  16. Bisphenol-A and Sleep Adequacy among Adults in the National Health and Nutrition Examination Surveys.

    Science.gov (United States)

    Beydoun, Hind A; Beydoun, May A; Jeng, Hueiwang Anna; Zonderman, Alan B; Eid, Shaker M

    2016-02-01

    To evaluate bisphenol-A (BPA) level and its relationship to sleep adequacy in a nationally representative sample of U.S. adults. A population-based cross-sectional study was conducted using 2005-2010 National Health and Nutrition Examination Survey whereby data were collected using in-person interviews, physical examination and laboratory testing. BPA level was measured in urine samples and analyzed as loge-transformed variable and in quartiles (Sleep adequacy was operationalized with three questions: "How much sleep do you usually get at night on weekdays or workdays?", "Have you ever told a doctor or other health professionals that you have trouble sleeping?" and "Have you ever been told by a doctor or other health professional that you have a sleep disorder?" Sleep duration was further categorized as ( 8 h); (sleep duration defined, in hours, as a continuous variable, a dichotomous variable (≥ 6, sleep problems and diagnosis with sleep disorders were not significantly associated with loge-transformed BPA level in fully adjusted models. Loge-transformed BPA level may be associated with fewer hours of sleep among U.S. adults, with implications for prevention. Further research involving diverse populations are needed to confirm these study findings. © 2016 Associated Professional Sleep Societies, LLC.

  17. Sexual orientation measurement and chronic disease disparities: National Health and Nutrition Examination Survey, 2009-2014.

    Science.gov (United States)

    Patterson, Joanne G; Jabson, Jennifer M

    2018-02-01

    To examine chronic disease disparities by sexual orientation measurement among sexual minorities. We pooled data from the 2009-2014 National Health and Nutrition Examination Survey to examine differences in chronic disease prevalence between heterosexual and sexual minority people as defined by sexual identity, lifetime sexual behavior, 12-month sexual behavior, and concordance of lifetime sexual behavior and sexual identity. Self-identified lesbian women reported greater odds of asthma (adjusted odds ratio [aOR], 3.19; 95% confidence intervals [CI], 1.37-7.47) and chronic bronchitis (aOR, 2.64; 95% CI, 1.21-5.72) than self-identified heterosexual women. Self-identified sexual minority women with a history of same-sex sexual behavior reported greater odds of arthritis (aOR, 1.67; 95% CI, 1.02-2.74). Compared with heterosexual men, gay men reported greater odds of chronic bronchitis when sexual orientation was defined by sexual identity (aOR, 4.68; 95% CI, 1.90-11.56) or 12-month sexual behavior (aOR, 3.22; 95% CI, 1.27-8.20), as did bisexual men defined by lifetime sexual behavior (aOR, 2.36; 95% CI, 1.14-4.89). Bisexual men reported greater odds of asthma when measured by lifetime sexual behavior (aOR, 1.90; 95% CI, 1.12-3.19), as did self-identified heterosexual men with a history of same-sex sexual behavior (aOR, 2.21; 95% CI, 1.10-4.46). How we define sexual orientation influences our understanding of chronic disease prevalence. Capturing subgroups of sexual minority people in health surveillance is essential for identifying groups most at risk and developing targeted interventions to reduce chronic disease disparities. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Melanoma awareness and prevalence of dermoscopic examination among internet users: a cross-sectional survey

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    Grazyna Kaminska-Winciorek

    2016-12-01

    Full Text Available Introduction : Melanoma presents the greater threat to health the later the disease is detected and treated, although treatment results can be improved by the widespread use of dermoscopy. However, scarce data are available concerning the awareness of dermoscopy and the frequency of its performance in the non-patient population. Aim: To assess the awareness of melanoma detection by dermoscopic examination among the audience of a scientific website. Material and methods : Respondents were invited to participate in an online cross-sectional survey. They were asked to complete an online questionnaire designed by the authors. The preliminary analysis of 5,154 collected forms and the exclusion of incomplete forms yielded 4,919 fully completed questionnaires; the resulting database was analyzed statistically using logistic regression with the R software program (95% CI. Results: Less than two-fifths (39.2% of respondents reported ever having sought the advice of a medical professional (dermatologist or other specialist, and 25.4% of the respondents had undergone dermoscopy at least once in their life. Furthermore, approximately one-tenth of respondents (10.7% were not aware of this detection tool. The study respondents gained knowledge about dermoscopic examination from television and magazines. The performance of dermoscopy was more increasingly associated with inhabitants of larger locales, the use of higher-SPF sunscreens, and greater awareness of the relationship between the risk of melanoma and sunburn. Conclusions : Awareness of melanoma and sun care varied within the analyzed population. A subset of individuals at high risk of melanoma was identified. This group included those who engaged in risky sun exposure behaviors and who had never been examined by dermoscopy.

  19. Association between physical activity and kidney function: National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Hawkins, Marquis S; Sevick, Mary Ann; Richardson, Caroline R; Fried, Linda F; Arena, Vincent C; Kriska, Andrea M

    2011-08-01

    Chronic kidney disease is a condition characterized by the deterioration of the kidney's ability to remove waste products from the body. Although treatments to slow the progression of the disease are available, chronic kidney disease may eventually lead to a complete loss of kidney function. Previous studies have shown that physical activities of moderate intensity may have renal benefits. Few studies have examined the effects of total movement on kidney function. The purpose of this study was to determine the association between time spent at all levels of physical activity intensity and sedentary behavior and kidney function. Data were obtained from the 2003-2004 and 2005-2006 National Health and Nutrition Examination Survey, a cross-sectional study of a complex, multistage probability sample of the US population. Physical activity was assessed using an accelerometer and questionnaire. Glomerular filtration rate (eGFR) was estimated using the Modification of Diet in Renal Disease study formula. To assess linear associations between levels of physical activity and sedentary behavior with log-transformed estimated GFR (eGFR), linear regression was used. In general, physical activity (light and total) was related to log eGFR in females and males. For females, the association between light and total physical activity with log eGFR was consistent regardless of diabetes status. For males, the association between light and total physical activity and log eGFR was only significant in males without diabetes. When examining the association between physical activity, measured objectively with an accelerometer, and kidney function, total and light physical activities were found to be positively associated with kidney function.

  20. Reliability and prevalence of physical performance examination assessing mobility and balance in older persons in the US: data from the Third National Health and Nutrition Examination Survey.

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    Ostchega, Y; Harris, T B; Hirsch, R; Parsons, V L; Kington, R; Katzoff, M

    2000-09-01

    This report provides reliability and prevalence estimates by sex, age, and race/ethnicity of an observed physical performance examination (PPE) assessing mobility and balance. The Third National Health and Nutrition Examination Survey (NHANES III) 1988-1994. A cross-sectional nationally representative survey. All persons aged 60 and older (n = 5,403) who performed the PPE either in the mobile examination center (MEC) or in the home during NHANES III (conducted 1988-1994). The PPE included timed chair stand, full tandem stand, and timed 8-foot walk. Timed chair stand and 8-foot timed walk were reliable measurements (Intraclass Correlations > 0.5). Women were significantly slower (P physically limited than men.

  1. A Novel Survey to Examine the Relationship Between Health IT Adoption and Nurse-Physician Communication

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    Pfeifer, Eric; Manojlovich, Milisa; Adler-Milstein, Julia

    2016-01-01

    Summary Background As EHR adoption in US hospitals becomes ubiquitous, a wide range of IT options are theoretically available to facilitate physician-nurse communication, but we know little about the adoption rate of specific technologies or the impact of their use. Objectives To measure adoption of hardware, software, and telephony relevant to nurse-physician communication in US hospitals. To assess the relationship between non-IT communication practices and hardware, software, and telephony adoption. To identify hospital characteristics associated with greater adoption of hardware, software, telephony, and non-IT communication practices. Methods We conducted a survey of 105 hospitals in the National Nursing Practice Network. The survey captured adoption of hardware, software, and telephony to support nurse-physician communication, along with non-IT communication practices. We calculated descriptive statistics and then created four indices, one for each category, by scoring degree of adoption of technologies or practices within each category. Next, we examined correlations between the three technology indices and the non-IT communication practices index. We used multivariate OLS regression to assess whether certain types of hospitals had higher index scores. Results The majority of hospitals surveyed have a range of hardware, software, and telephony tools available to support nurse-physician communication; we found substantial heterogeneity across hospitals in non-IT communication practices. More intensive non-IT communication was associated with greater adoption of software (r=0.31, p=0.01), but was not correlated with hardware or telephony. Medium-sized hospitals had lower adoption of software (r =-1.14,p=0.04) in comparison to small hospitals, while federally-owned hospitals had lower software (r=-2.57, p=0.02) and hardware adoption (r=-1.63, p=0.01). Conclusions The positive relationship between non-IT communication and level of software adoption suggests that

  2. Intraoperative cardiac arrest and mortality in trauma patients. A 14-yr survey from a Brazilian tertiary teaching hospital.

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    Marcelo T O Carlucci

    Full Text Available BACKGROUND: Little information on the factors influencing intraoperative cardiac arrest and its outcomes in trauma patients is available. This survey evaluated the associated factors and outcomes of intraoperative cardiac arrest in trauma patients in a Brazilian teaching hospital between 1996 and 2009. METHODS: Cardiac arrest during anesthesia in trauma patients was identified from an anesthesia database. The data collected included patient demographics, ASA physical status classification, anesthesia provider information, type of surgery, surgical areas and outcome. All intraoperative cardiac arrests and deaths in trauma patients were reviewed and grouped by associated factors and also analyzed as totally anesthesia-related, partially anesthesia-related, totally surgery-related or totally trauma patient condition-related. FINDINGS: Fifty-one cardiac arrests and 42 deaths occurred during anesthesia in trauma patients. They were associated with male patients (P<0.001 and young adults (18-35 years (P=0.04 with ASA physical status IV or V (P<0.001 undergoing gastroenterological or multiclinical surgeries (P<0.001. Motor vehicle crashes and violence were the main causes of trauma (P<0.001. Uncontrolled hemorrhage or head injury were the most significant associated factors of intraoperative cardiac arrest and mortality (P<0.001. All cardiac arrests and deaths reported were totally related to trauma patient condition. CONCLUSIONS: Intraoperative cardiac arrest and mortality incidence was highest in male trauma patients at a younger age with poor clinical condition, mainly related to uncontrolled hemorrhage and head injury, resulted from motor vehicle accidents and violence.

  3. Life course socioeconomic position, alcohol drinking patterns in midlife, and cardiovascular mortality: Analysis of Norwegian population-based health surveys.

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    Eirik Degerud

    2018-01-01

    Full Text Available Socioeconomically disadvantaged groups tend to experience more harm from the same level of exposure to alcohol as advantaged groups. Alcohol has multiple biological effects on the cardiovascular system, both potentially harmful and protective. We investigated whether the diverging relationships between alcohol drinking patterns and cardiovascular disease (CVD mortality differed by life course socioeconomic position (SEP.From 3 cohorts (the Counties Studies, the Cohort of Norway, and the Age 40 Program, 1987-2003 containing data from population-based cardiovascular health surveys in Norway, we included participants with self-reported information on alcohol consumption frequency (n = 207,394 and binge drinking episodes (≥5 units per occasion, n = 32,616. We also used data from national registries obtained by linkage. Hazard ratio (HR with 95% confidence intervals (CIs for CVD mortality was estimated using Cox models, including alcohol, life course SEP, age, gender, smoking, physical activity, body mass index (BMI, systolic blood pressure, heart rate, triglycerides, diabetes, history of CVD, and family history of coronary heart disease (CHD. Analyses were performed in the overall sample and stratified by high, middle, and low strata of life course SEP. A total of 8,435 CVD deaths occurred during the mean 17 years of follow-up. Compared to infrequent consumption (mortality (HR = 0.78, 95% CI 0.72, 0.84 overall. HRs for the high, middle, and low strata of SEP were 0.66 (95% CI 0.58, 0.76, 0.87 (95% CI 0.78, 0.97, and 0.79 (95% CI 0.64, 0.98, respectively, compared with infrequent users in each stratum. HRs for effect modification were 1.30 (95% CI 1.10, 1.54, p = 0.002; middle versus high, 1.23 (95% CI 0.96, 1.58, p = 0.10; low versus high, and 0.96 (95% CI 0.76, 1.21, p = 0.73; low versus middle. In the group with data on binge drinking, 2

  4. Lung function and metabolic syndrome: Findings of National Health and Nutrition Examination Survey 2007–2010*

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    FORD, Earl S.; CUNNINGHAM, Timothy J.; MERCADO, Carla I.

    2015-01-01

    Background Considerable uncertainty remains about obstructive lung function (OLF) in adults with metabolic syndrome (MetS). The aim of the present study was to examine pulmonary function status in adults with and without MetS. Methods We used data from 3109 participants aged ≥20 years of the National Health and Nutrition Examination Survey 2007–2010. Subjects’ MetS status was established on the basis of the 2009 harmonizing definition. Participants received spirometry. Results After age adjustment, 79.3% (SE 1.1) of participants with MetS had normal lung function, 8.7% (0.9) had restrictive lung function (RLF), 7.1% (0.8) had mild OLF, and 4.8% (0.6) had moderate OLF or worse. Among participants without MetS, these estimates were 78.7% (1.2), 3.9% (0.6), 10.9% (1.1), and 6.4% (0.8), respectively. After multiple adjustment, participants with MetS were more likely to have RLF (adjusted prevalence ratio [aPR] 2.20; 95% confidence interval [CI] 1.67, 2.90) and less likely to have any OLF (aPR 0.73; 95% CI 0.62, 0.86) than those without MetS. Furthermore, participants with MetS had lower mean levels of forced expiratory volume in one second (FEV1), FEV1 % predicted, forced vital capacity (FVC), and FVC % predicted, but a higher FEV1/FVC ratio than participants without MetS. Mean levels of FEV1, FEV1 % predicted, FVC, and FVC % predicted declined significantly, but not the FEV1/FVC ratio, as the number of components increased. Conclusions Compared with adults without MetS, spirometry is more likely to show a restrictive pattern and less likely to show an obstructive pattern among adults with MetS. PMID:26677470

  5. A survey on respiratory diseases of atomic bomb survivors using chest X-ray examination

    International Nuclear Information System (INIS)

    Komatsubara, Naoka; Isobe, Takeshi; Nakamura, Kenji

    1994-01-01

    Chest X-ray films, taken from 48,160 A-bomb survivors aged 40 years or more during a 5-year period 1988-1992, were reviewed. Abnormal X-ray findings were obtained in 26.7% for men and 18.2% for women. The incidence of necessary detailed examination was 2.6%. Of these A-bomb survivors, 93.7% participated in it. Pulmonary fibrosis, chronic emphysema, and pulmonary cyst yielded higher prevalence per population of 100,000 in men, irrespective of exposure distance. In comparing with the results obtained during a 5-year period 1981-1985, the detection rate of primary lung cancer was not different from that in the present 5-year survey. For active pulmonary tuberculosis, pulmonary fibrosis, and chronic emphysema, however, the prevalence tended to decrease. Primary lung cancer and pulmonary fibrosis were more frequently detected with aging in both men and women. This was independent of exposure distance. (N.K.)

  6. Examination of the long-term stability of radiation survey meters and electronic pocket dosemeters

    International Nuclear Information System (INIS)

    Chida, K.; Nishimura, Y.; Sato, Y.; Endo, A.; Sakamoto, M.; Hoshi, C.; Zuguchi, M.

    2008-01-01

    To describe the stability of radiation survey meters (RSMs) and electronic pocket dosemeters (EPDs), we examined 28 EPDs and 24 RSMs: 12 used NaI(Tl) scintillation RSMs and 12 used Geiger-Muller (GM) RSMs. We used simple methods for the relative calibration of the 24 RSMs and 28 EPDs. The RSM and EPD measurements were compared with a calibrated RSM and EPD (reference: traceable from the national standard of exposure) using a homemade measurement device to maintain the reproducibility of the measurements with reference radiation sources (i.e. 137 Cs, 90 Sr and 67 Ga). The response of RSMs and EPDs, especially after prolonged use, should be checked periodically. In particular, GMRSMs that have been in use for many years have very low sensitivity and poor reproducibility. Our simple method for the relative calibration of RSMs and EPDs was shown to be effective for quality assurance purposes in checking RSMs and EPDs. We recommend regular checks and calibration for sustained performance of RSMs and EPDs. (authors)

  7. Diet quality on meatless days: National Health and Nutrition Examination Survey (NHANES), 2007-2012.

    Science.gov (United States)

    Conrad, Zach; Karlsen, Micaela; Chui, Kenneth; Jahns, Lisa

    2017-06-01

    To compare diet quality scores between adult non-meat eaters and meat eaters, and to compare the consumption of diet components across quintiles of diet quality. Cross-sectional analysis. The Healthy Eating Index-2010 (HEI-2010) and Alternative Healthy Eating Index-2010 (AHEI-2010) were used to assess mean diet quality. Differences in consumption of diet components between quintiles of diet quality were tested using post hoc Wald tests and z tests. The National Health and Nutrition Examination Survey (NHANES), 2007-2012. The sample consisted of 16810 respondents aged≥18 years, including 280 individuals who reported not consuming meat, poultry, game birds or seafood on two non-consecutive days of dietary recall. Dietary data were obtained from one dietary recall per individual. Non-meat eaters had substantially greater HEI-2010 and AHEI-2010 scores than meat eaters (Pempty calories and unsaturated:saturated fatty acids. Mean consumption across AHEI-2010 quintiles demonstrated different (Pempty calories, and increased consumption of nuts and legumes, PUFA and vegetables, as a way to improve overall dietary quality.

  8. Comparison of Health Examination Survey Methods in Brazil, Chile, Colombia, Mexico, England, Scotland, and the United States.

    Science.gov (United States)

    Mindell, Jennifer S; Moody, Alison; Vecino-Ortiz, Andres I; Alfaro, Tania; Frenz, Patricia; Scholes, Shaun; Gonzalez, Silvia A; Margozzini, Paula; de Oliveira, Cesar; Sanchez Romero, Luz Maria; Alvarado, Andres; Cabrera, Sebastián; Sarmiento, Olga L; Triana, Camilo A; Barquera, Simón

    2017-09-15

    Comparability of population surveys across countries is key to appraising trends in population health. Achieving this requires deep understanding of the methods used in these surveys to examine the extent to which the measurements are comparable. In this study, we obtained detailed protocols of 8 nationally representative surveys from 2007-2013 from Brazil, Chile, Colombia, Mexico, the United Kingdom (England and Scotland), and the United States-countries that that differ in economic and inequity indicators. Data were collected on sampling frame, sample selection procedures, recruitment, data collection methods, content of interview and examination modules, and measurement protocols. We also assessed their adherence to the World Health Organization's "STEPwise Approach to Surveillance" framework for population health surveys. The surveys, which included half a million participants, were highly comparable on sampling methodology, survey questions, and anthropometric measurements. Heterogeneity was found for physical activity questionnaires and biological samples collection. The common age range included by the surveys was adults aged 18-64 years. The methods used in these surveys were similar enough to enable comparative analyses of the data across the 7 countries. This comparability is crucial in assessing and comparing national and subgroup population health, and to assisting the transfer of research and policy knowledge across countries. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. A Longitudinal Study of the Mini-Mental State Examination in Late Nonagenarians and Its Relationship with Dementia, Mortality, and Education.

    Science.gov (United States)

    Skoog, Johan; Backman, Kristoffer; Ribbe, Mats; Falk, Hanna; Gudmundsson, Pia; Thorvaldsson, Valgeir; Borjesson-Hanson, Anne; Ostling, Svante; Johansson, Boo; Skoog, Ingmar

    2017-06-01

    To examine level of and change in cognitive status using the Mini-Mental State Examination (MMSE) in relation to dementia, mortality, education, and sex in late nonagenarians. Three-year longitudinal study with examinations at ages 97, 99, and 100. Trained psychiatric research nurses examined participants at their place of living. A representative population-based sample of 97-year-old Swedes (N = 591; 107 men, 484 women) living in Gothenburg, Sweden. A Swedish version of the MMSE was used to measure cognitive status. Geriatric psychiatrists diagnosed dementia according to the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised. Mixed models were fitted to the data to model the longitudinal relationship between MMSE score and explanatory variables. Individuals with dementia between age 97 and 100 had lower mean MMSE scores than those without dementia. Those who died during the 3-year follow-up had lower MMSE scores than those who survived. MMSE scores at baseline did not differ between those without dementia and those who developed dementia during the 3-year follow-up. Participants with more education had higher MMSE scores, but there was no association between education and linear change. MMSE score is associated with dementia and subsequent mortality even in very old individuals, although the preclinical phase of dementia may be short in older age. Level of education is positively associated with MMSE score but not rate of decline in individuals approaching age 100. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  10. Using an External Exposome Framework to Examine Pregnancy-Related Morbidities and Mortalities: Implications for Health Disparities Research

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    Tonny J. Oyana

    2015-12-01

    Full Text Available Objective: We have conducted a study to assess the role of environment on the burden of maternal morbidities and mortalities among women using an external exposome approach for the purpose of developing targeted public health interventions to decrease disparities. Methods: We identified counties in the 48 contiguous USA where observed low birthweight (LBW rates were higher than expected during a five-year study period. The identification was conducted using a retrospective space-time analysis scan for statistically significant clusters with high or low rates by a Discrete Poisson Model. Results: We observed statistically significant associations of LBW rate with a set of predictive variables. However, in one of the two spatiotemporal models we discovered LBW to be associated with five predictive variables (teen birth rate, adult obesity, uninsured adults, physically unhealthy days, and percent of adults who smoke in two counties situated in Alabama after adjusting for location changes. Counties with higher than expected LBW rates were similarly associated with two environmental variables (ozone and fine particulate matter. Conclusions: The county-level predictive measures of LBW offer new insights into spatiotemporal patterns relative to key contributory factors. An external framework provides a promising place-based approach for identifying “hotspots” with implications for designing targeted interventions and control measures to reduce and eliminate health disparities.

  11. Mortality, Morbidity and Health-Seeking Behaviour during the Ebola Epidemic 2014-2015 in Monrovia Results from a Mobile Phone Survey.

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    Anna Kuehne

    2016-08-01

    Full Text Available Between March 2014 and July 2015 at least 10,500 Ebola cases including more than 4,800 deaths occurred in Liberia, the majority in Monrovia. However, official numbers may have underestimated the size of the outbreak. Closure of health facilities and mistrust in existing structures may have additionally impacted on all-cause morbidity and mortality. To quantify mortality and morbidity and describe health-seeking behaviour in Monrovia, Médecins sans Frontières (MSF conducted a mobile phone survey from December 2014 to March 2015. We drew a random sample of households in Monrovia and conducted structured mobile phone interviews, covering morbidity, mortality and health-seeking behaviour from 14 May 2014 until the day of the survey. We defined an Ebola-related death as any death meeting the Liberian Ebola case definition. We calculated all-cause and Ebola-specific mortality rates. The sample consisted of 6,813 household members in 905 households. We estimated a crude mortality rate (CMR of 0.33/10,000 persons/day (95%CI:0.25-0.43 and an Ebola-specific mortality rate of 0.06/10,000 persons/day (95%-CI:0.03-0.11. During the recall period, 17 Ebola cases were reported including those who died. In the 30 days prior to the survey 277 household members were reported sick; malaria accounted for 54% (150/277. Of the sick household members, 43% (122/276 did not visit any health care facility. The mobile phone-based survey was found to be a feasible and acceptable alternative method when data collection in the community is impossible. CMR was estimated well below the emergency threshold of 1/10,000 persons/day. Non-Ebola-related mortality in Monrovia was not higher than previous national estimates of mortality for Liberia. However, excess mortality directly resulting from Ebola did occur in the population. Importantly, the small proportion of sick household members presenting to official health facilities when sick might pose a challenge for future outbreak

  12. An Infectious Disease and Mortality Survey in a Population of Free-Ranging African Wild Dogs and Sympatric Domestic Dogs

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    G. Flacke

    2013-01-01

    Full Text Available Disease can cause declines in wildlife populations and significantly threaten their survival. Recent expansion of human and domestic animal populations has made wildlife more susceptible to transmission of pathogens from domestic animal hosts. We conducted a pathogen surveillance and mortality survey for the population of African wild dogs (Lycaon pictus in KwaZulu-Natal (KZN, South Africa, from January 2006–February 2007. Samples were obtained from 24 wild dogs for canine distemper virus (CDV and canine parvovirus (CPV serological testing. Data were collected on the presence of CDV, CPV, and rabies virus in the KZN domestic dog (Canis familiaris population from 2004–06. The presence of these pathogens was confirmed in domestic dogs throughout KZN. Wild dogs exhibited 0% and 4.2% prevalence for CDV and CPV antibodies, respectively. In 2006 the largest wild dog pack in KZN was reduced from 26 individuals to a single animal; disease due to rabies virus was considered the most probable cause. This study provides evidence that CDV, CPV and rabies are potential threats to African wild dog conservation in KZN. The most economical and practical way to protect wild dogs from canine pathogens may be via vaccination of sympatric domestic dogs; however, such programmes are currently limited.

  13. Maternal complications and perinatal mortality: findings of the World Health Organization Multicountry Survey on Maternal and Newborn Health.

    Science.gov (United States)

    Vogel, J P; Souza, J P; Mori, R; Morisaki, N; Lumbiganon, P; Laopaiboon, M; Ortiz-Panozo, E; Hernandez, B; Pérez-Cuevas, R; Roy, M; Mittal, S; Cecatti, J G; Tunçalp, Ö; Gülmezoglu, A M

    2014-03-01

    We aimed to determine the prevalence and risks of late fetal deaths (LFDs) and early neonatal deaths (ENDs) in women with medical and obstetric complications. Secondary analysis of the WHO Multicountry Survey on Maternal and Newborn Health (WHOMCS). A total of 359 participating facilities in 29 countries. A total of 308 392 singleton deliveries. We reported on perinatal indicators and determined risks of perinatal death in the presence of severe maternal complications (haemorrhagic, infectious, and hypertensive disorders, and other medical conditions). Fresh and macerated LFDs (defined as stillbirths ≥ 1000 g and/or ≥28 weeks of gestation) and ENDs. The LFD rate was 17.7 per 1000 births; 64.8% were fresh stillbirths. The END rate was 8.4 per 1000 liveborns; 67.1% occurred by day 3 of life. Maternal complications were present in 22.9, 27.7, and 21.2% [corrected] of macerated LFDs, fresh LFDs, and ENDs, respectively. The risks of all three perinatal mortality outcomes were significantly increased with placental abruption, ruptured uterus, systemic infections/sepsis, pre-eclampsia, eclampsia, and severe anaemia. Preventing intrapartum-related perinatal deaths requires a comprehensive approach to quality intrapartum care, beyond the provision of caesarean section. Early identification and management of women with complications could improve maternal and perinatal outcomes. © 2014 RCOG The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

  14. Factors Associated with Hemorrhoids in Korean Adults: Korean National Health and Nutrition Examination Survey

    Science.gov (United States)

    Lee, Jong-Hyun; Kim, Hyo-Eun; Kang, Ji-Hun

    2014-01-01

    Background Although hemorrhoids are one of the most common anal diseases among Koreans, risk factors for hemorrhoids have not been well identified. Methods We analyzed the data from the 4th Korean National Health and Nutrition Examination Survey (KNHANES) between 2007 and 2009. Study subjects were 17,228 participants of KNHANES who were aged 19 years or older. Logistic regression analysis was conducted to evaluate associations between hemorrhoids and probable risk factors. Results Overall prevalence of hemorrhoids among study subjects was 14.4%, being more prevalent among women (15.7%) than among men (13.0%). Obesity and abdominal obesity were associated with a higher risk of hemorrhoids with odds ratio (OR) (95% confidence intervals, 95% CI) of 1.13 (1.01 to 1.26) and 1.16 (1.04 to 1.30), respectively. Both self-reported depression (OR, 1.83; 95% CI, 1.62 to 2.08) and physician diagnosed depression (OR, 1.71; 95% CI, 1.35 to 2.17) were associated with significantly higher risk of hemorrhoids. No regular walking (OR, 1.11; 95% CI, 1.00 to 1.23) and experience of pregnancy (OR, 1.62; 95% CI, 1.17 to 2.25) for women were also associated with higher risk of hemorrhoids. However, educational level, alcohol consumption, physical activities, diabetes mellitus, hypertension, fiber, fat intake, and energy intake were not associated with a risk of hemorrhoids. Low quality of life assessed with EuroQol-5 Dimension and EuroQol-Visual Analogue Scale was significantly associated with hemorrhoids. Conclusion This nationwide cross-sectional study of Korean adults suggests that obesity, abdominal obesity, depression, and past pregnancy may be risk factors for hemorrhoids and hemorrhoids affect quality of life negatively. PMID:25309703

  15. Thyroid hormones and electrocardiographic parameters: findings from the third national health and nutrition examination survey.

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    Yiyi Zhang

    Full Text Available Altered thyroid status exerts a major effect on the heart. Individuals with hypo- or hyperthyroidism showed various changes in electrocardiograms. However, little is known about how variations in thyroid hormone levels within the normal range affect electrical activities of the heart in the general population.We conducted a cross-sectional analysis of 5,990 men and women from the Third National Health and Nutrition Examination Survey. Serum total T4 was measured by immunoassay and TSH was measured by chemiluminescent assay. We categorized T4 and TSH into 7 groups with cut-offs at the 5(th, 20(th, 40(th, 60(th, 80(th, and 95(th percentiles of the weighted population distribution. Electrocardiographic parameters were measured from the standard 12-lead electrocardiogram. We found a positive linear association between serum total T4 level and heart rate in men, and a U-shape association between T4 and PR interval in men and women. TSH level was positively associated with QRS interval in men, while a U-shape association between TSH and QRS was observed in women. No clear graded association between thyroid hormones and corrected QT or JT was found, except that men in the highest category of T4 levels appeared to have longer corrected QT and JT, and men in the lowest category of T4 appeared to have shorter corrected QT and JT.Variation in thyroid hormone levels in the general population, even within the normal range, was associated with various ECG changes.

  16. Study of radiation dosimetry for child in dentistry, 1. Examination survey on radiation dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Tateno, H; Shinji, H; Higaki, M; Kanno, M; Higashi, T [Kanagawa Dental Coll., Yokosuka (Japan)

    1980-09-01

    Patients in pedodontics usually do not appropriately report the symptoms of their own disease because of their immaturity. For this reason X-ray inspection plays a big part in diagnosis. It is considered that radiation injury for children is generally more severe than that for adults under the same exposure dose. Therefore it is necessary to detect the effective minimum exposure dose as accurately as possible for protection. The exposure dose was surveyed by use of TLD combined with the 6-films technique for children (child intraoral technique) currently used in the dental clinic. First, the reliability of TLD, the effect of scattered rays and indicator dependence etc. were tested. Second, the distribution of exposure dose in the intraoral technique for children was examined by water phantom. The following results were obtained. 1. It was necessary to select the stabilized TLD as the measuring values were comparatively scattered. 2. Measuring of the effect of scattered rays showed that it was the least in use of Pb, value of which was 101 for air dose 100. This indicated that Pb was the best for scatter protection. 3. For the indicator dependence it was unnecessary to adjust the glancing angle in case it was below 60 degrees. 4. TLD showed a stable result even in the increased time of exposure, and at the same time there was no error with the electric timer. 5. The result of the basic experiment of water phantom required further investigation as to the overlapped exposure in treatment of child patients with much smaller dental arches where the irradiation field was bigger than in that of adult patients with larger dental arches.

  17. Lung function and metabolic syndrome: Findings of National Health and Nutrition Examination Survey 2007–2010.

    Science.gov (United States)

    Ford, Earl S; Cunningham, Timothy J; Mercado, Carla I

    2014-11-01

    Considerable uncertainty remains about obstructive lung function( OLF) in adults with metabolic syndrome (MetS). The aim of the present study was to examine pulmonary function status in adults with and without MetS. We used data from 3109 participants aged ≥20 years of the National Health and Nutrition Examination Survey 2007-2010. Subjects'MetS status was established on the basis of the 2009 harmonizing definition. Participants received spirometry. After age adjustment, 79.3% (SE 1.1) of participants with MetS had normal lung function, 8.7% (0.9) had restrictive lung function (RLF), 7.1% (0.8) had mild OLF, and 4.8% (0.6) had moderate OLF or worse. Among participants without MetS, these estimates were 78.7% (1.2), 3.9% (0.6), 10.9%(1.1), and 6.4% (0.8), respectively. After multiple adjustment, participants with MetS were more likely to have RLF (adjusted prevalence ratio [aPR] 2.20; 95% confidence interval [CI] 1.67, 2.90) and less likely to have any OLF (aPR 0.73; 95% CI 0.62, 0.86) than those without MetS. Furthermore, participants with MetS had lower mean levels of forced expiratory volume in one second (FEV1), FEV1 % predicted, forced vital capacity (FVC), and FVC % predicted, but a higher FEV1/FVC ratio than participants without MetS. Mean levels of FEV1, FEV1 % predicted, FVC, and FVC % predicted declined significantly, but not the FEV1/FVC ratio, as the number of components increased. Compared with adults without MetS, spirometry is more likely to show a restrictive pattern and less likely to show an obstructive pattern among adults with MetS. 2014 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  18. A two-stage cluster sampling method using gridded population data, a GIS, and Google EarthTM imagery in a population-based mortality survey in Iraq

    Directory of Open Access Journals (Sweden)

    Galway LP

    2012-04-01

    Full Text Available Abstract Background Mortality estimates can measure and monitor the impacts of conflict on a population, guide humanitarian efforts, and help to better understand the public health impacts of conflict. Vital statistics registration and surveillance systems are rarely functional in conflict settings, posing a challenge of estimating mortality using retrospective population-based surveys. Results We present a two-stage cluster sampling method for application in population-based mortality surveys. The sampling method utilizes gridded population data and a geographic information system (GIS to select clusters in the first sampling stage and Google Earth TM imagery and sampling grids to select households in the second sampling stage. The sampling method is implemented in a household mortality study in Iraq in 2011. Factors affecting feasibility and methodological quality are described. Conclusion Sampling is a challenge in retrospective population-based mortality studies and alternatives that improve on the conventional approaches are needed. The sampling strategy presented here was designed to generate a representative sample of the Iraqi population while reducing the potential for bias and considering the context specific challenges of the study setting. This sampling strategy, or variations on it, are adaptable and should be considered and tested in other conflict settings.

  19. Preliminary mortality survey from 1973 to 1977 of Japanese radiological technologists and analyses of the association of mortality with cumulative doses

    International Nuclear Information System (INIS)

    Aoyama, Takashi; Ishizaka, Masatsuna; Yamamoto, Yoichi; Kano, Eiichi; Nikaido, Osamu.

    1981-01-01

    The Japan Association of Radiologic Technologists reported that, from 1941 to 1978, 395 deaths occurred among Japanese radiological technologists who belong to the association. Using these data, Sakka, Kitabatake and colleagues, and the present authors studied mortality and cause of death among these technologists for 11 years from 1955 to 1965, for 7 years from 1966 to 1972, and for 5 years from 1973 to 1977, respectively. In general, the number of cancer deaths in the three studies was less than expected. However, Kitabatake et al. and the present authors found that deaths from skin cancer were significantly more frequent than expected. The present authors recently estimated the cumulative doses of radiation exposure for the majority of deaths (268 out of 395). The mean dose of radiation related to cancer deaths was then compared with that for non-cancer deaths. Also the proportional mortality ratios for cancers were observed in relation to the estimated dose level. In the present study, however, statistical tests to assess for the relationship between mortality and dose of radiation exposure showed no correlation, for the majority of deaths from cancer. (author)

  20. Self-reported exposure to pesticides and radiation related to pregnancy outcome--results from National Natality and Fetal Mortality Surveys

    International Nuclear Information System (INIS)

    Savitz, D.A.; Whelan, E.A.; Kleckner, R.C.

    1989-01-01

    Although fetal development is known to be sensitive to environmental agents, relatively little epidemiologic research has addressed this concern. Effects on pregnancy outcome of self-reported parental exposure to pesticides and to radiation were examined using data from the National Natality and Fetal Mortality Surveys, large national probability samples of live births and stillbirths occurring in 1980. In case-control analyses, maternal exposure to pesticides at home or work was associated with increased risk of stillbirth (odds ratios (ORs) = 1.5-1.6). Paternal pesticide exposure was associated with stillbirth (ORs = 1.2-1.4) and delivery of small-for-gestational-age infants (ORs = 1.4-2.0). A small increased risk of stillbirth (OR = 1.3) was found in relation to either parent's reported exposure to radiation. In spite of limitations in the quality of exposure data and the possibility of biased recall related to pregnancy outcome, associations of reported pesticide exposure to either parent with risk of stillbirth and small-for-gestational-age infants warrant further evaluation

  1. Assessing the Contribution of Unstable Employment to Mortality in Posttransition Russia: Prospective Individual-Level Analyses From the Russian Longitudinal Monitoring Survey

    Science.gov (United States)

    Bobak, Martin

    2009-01-01

    Objectives. We used the Russia Longitudinal Monitoring Survey (RLMS) to investigate associations between employment, socioeconomic position, and mortality. Methods. Data were from working-age respondents in 8 rounds (1994–2003) of the RLMS. We measured associations between education, occupation, unemployment, and insecure employment and mortality with Cox proportional hazards analyses. Results. Of 4465 men and 4158 women who were currently employed, 251 men and 34 women died. A third of employed respondents experienced wage arrears, and 10% experienced compulsory leave and payment in consumer goods. Insecure employment, more common among the less-educated and manual workers, fluctuated with macroeconomic measures. Mortality was significantly associated with payment in consumer goods among men (hazard ratio [HR] = 1.46; 95% confidence interval [CI] = 1.03, 2.07), compulsory unpaid leave among women (HR = 3.79; 95% CI = 1.82, 7.88), and male unemployment (HR = 1.88; 95% CI = 1.38, 2.55). Associations with death within 1 year of entry were generally somewhat stronger than the association with mortality over the whole study period. Conclusions. Unemployment and job insecurity predicted mortality, suggesting that they contributed to Russia's high mortality during the transition from communism. PMID:19696378

  2. Examining Student Attitudes in Introductory Physics via the Math Attitude and Expectations Survey (MAX)

    Science.gov (United States)

    Hemingway, Deborah; Eichenlaub, Mark; Losert, Wolfgang; Redish, Edward F.

    2017-01-01

    Student often face difficulties with using math in science, and this exploratory project seeks to address the underlying mechanisms that lead to these difficulties. This mixed-methods project includes the creation of two novel assessment surveys, the Mathematical Epistemic Games Survey (MEGS) and the Math Attitude and Expectations Survey (MAX). The MAX, a 30-question Likert-scale survey, focuses on the attitudes towards using mathematics of the students in a reformed introductory physics course for the life sciences (IPLS) which is part of the National Experiment in Undergraduate Education (NEXUS/Physics) developed at the University of Maryland (UMD). Preliminary results from the MAX are discussed with specific attention given to students' attitudes towards math and physics, opinions about interdisciplinarity, and the usefulness of physics in academic settings as well as in professional biological research and modern medicine settings.

  3. Preclinical QSP Modeling in the Pharmaceutical Industry: An IQ Consortium Survey Examining the Current Landscape

    Science.gov (United States)

    Wu, Fan; Bansal, Loveleena; Bradshaw‐Pierce, Erica; Chan, Jason R.; Liederer, Bianca M.; Mettetal, Jerome T.; Schroeder, Patricia; Schuck, Edgar; Tsai, Alice; Xu, Christine; Chimalakonda, Anjaneya; Le, Kha; Penney, Mark; Topp, Brian; Yamada, Akihiro

    2018-01-01

    A cross‐industry survey was conducted to assess the landscape of preclinical quantitative systems pharmacology (QSP) modeling within pharmaceutical companies. This article presents the survey results, which provide insights on the current state of preclinical QSP modeling in addition to future opportunities. Our results call attention to the need for an aligned definition and consistent terminology around QSP, yet highlight the broad applicability and benefits preclinical QSP modeling is currently delivering. PMID:29349875

  4. Relationship between alcohol consumption and age at menopause: The Korea National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Choi, Jeong In; Han, Kyung-do; Lee, Dae Woo; Kim, Min Jeong; Shin, Yeon Joo; Lee, Hae Nam

    2017-08-01

    We used data from the 2011-2014 Korean National Health and Nutrition Examination Surveys (KNHANES) to investigate whether the age at menopause is related to alcohol consumption in South Korean women. This was a cross-sectional study of the data for 940 women who became menopausal within the 3 years preceding the KNHANES. The numbers of nondrinkers, mild to moderate drinkers, and heavy drinkers in this group were 345 (34.7%), 573 (62.2%), and 22 (3%). Body mass index (BMI), smoking, and exercise were adjusted in model 1 and age was additionally adjusted in model 2. The mean ages at menopause were 51.6 ± 0.2, 50.8 ± 0.1, and 50.4 ± 0.5 years (p = 0.0025) in model 1 and 51.7 ± 0.2, 51.1 ± 0.1, and 50.1 ± 0.5 years (p = 0.0018) in model 2 for nondrinkers, mild to moderate drinkers, and heavy drinkers, respectively. BMI, smoking, exercise, educational level, income, duration of menopause, age at menarche, age at first delivery, and gravidity were adjusted in model 3, and the respective mean ages at menopause were 51.3 ± 0.2, 50.7 ± 0.2, and 50.1 ± 0.8 years (p = 0.0402). The population was classified into groups using the Alcohol Use Disorders Identification Test (AUDIT) scores of menopause according to AUDIT score were 51.3 ± 0.1, 50.5 ± 0.3, and 50.4 ± 0.4 years (p = 0.0222, model 1), 51.4 ± 0.1, 50.8 ± 0.3, and 50.8 ± 0.3 years (p = 0.0261, model 2), and 51.1 ± 0.1, 50.6 ± 0.4, and 49.5 ± 0.6 years (p = 0.0241, model 3) respectively. In Korean women, alcohol consumption was associated with younger age at menopause. A higher AUDIT score was also related to younger age at menopause. Copyright © 2017. Published by Elsevier B.V.

  5. Pulmonary Impairment in Tuberculosis Survivors: The Korean National Health and Nutrition Examination Survey 2008-2012.

    Science.gov (United States)

    Jung, Jae-Woo; Choi, Jae-Chol; Shin, Jong-Wook; Kim, Jae-Yeol; Choi, Byoung-Whui; Park, In-Won

    2015-01-01

    Pulmonary tuberculosis (TB) can affect lung function, but studies regarding long-term follow-up in patients with no sequelae on chest X-ray (CXR) have not been performed. We evaluated lung functional impairment and persistent respiratory symptoms in those with prior pulmonary TB and those with prior pulmonary TB with no residual sequelae on CXR, and determined risk factors for airflow obstruction. We used data from adults aged ≥ 40 years from the annual Korean National Health and Nutrition Examination Surveys conducted between 2008 and 2012. P values for comparisons were adjusted for age, sex, and smoking status. In total of 14,967 adults, 822 subjects (5.5%) had diagnosed and treated pulmonary TB (mean 29.0 years ago). The FVC% (84.9 vs. 92.6), FEV1% (83.4 vs. 92.4), and FEV1/FVC% (73.4 vs. 77.9) were significantly decreased in subjects with prior pulmonary TB compared to those without (p pulmonary TB (296, 2.3%) had significantly lower FEV1% (90.9 vs. 93.4, p = 0.001) and FEV1/FVC% (76.6 vs. 78.4, p pulmonary TB as well as subjects with no sequalae on CXR were more likely to experience cough and physical activity limitations due to pulmonary symptoms than those without prior pulmonary TB (p pulmonary TB (OR, 2.314; 95% CI, 1.922-2.785), along with age, male, asthma, and smoking mount was risk factor for airflow obstruction. In subjects with prior pulmonary tuberculosis, inactive TB lesion on chest x-ray (OR, 2.300; 95% CI, 1.606-3.294) were risk factors of airflow obstruction. In addition to subjects with inactive TB lesion on CXR, subjects with no sequelae on CXR can show impaired pulmonary function and respiratory symptoms. Prior TB is a risk factor for airflow obstruction and that the risk is more important when they have inactive lesions on chest X-ray. Hence, the patients with treated TB should need to have regular follow-up of lung function and stop smoking for early detection and prevention of the chronic airway disease.

  6. The influence of the social and cultural environment on maternal mortality in Nigeria: Evidence from the 2013 demographic and health survey.

    Directory of Open Access Journals (Sweden)

    Oluwatosin Ariyo

    Full Text Available Reducing maternal mortality remains a priority for global health. One in five maternal deaths, globally, are from Nigeria.This study aimed to assess the sociocultural correlates of maternal mortality in Nigeria.We conducted a retrospective analysis of nationally representative data from the 2013 Nigeria Demographic and Health Survey. The analysis was based on responses from the core women's questionnaire. Maternal mortality was categorized as 'yes' for any death while pregnant, during delivery or two months after delivery (as reported by the sibling, and 'no' for deaths of other or unknown causes. Multilevel logistic regression analysis was conducted to test for association between maternal mortality and predictor variables of sociocultural status (educational attainment, community women's education, region, type of residence, religion, and women's empowerment.Region, Religion, and the level of community women's education were independently associated with maternal mortality. Women in the North West were more than twice as likely to report maternal mortality (OR: 2.14; 95% CI: 1.42-3.23 compared to those in the North Central region. Muslim women were 52% more likely to report maternal deaths (OR: 1.52; 95% CI: 1.10-2.11 compared to Christian women. Respondents living in communities where a significant proportion of women have at least secondary schooling were 33% less likely to report that their sisters died of pregnancy-related causes (OR: 0.67; 95% CI: 0.48-0.95.Efforts to reduce maternal mortality should implement tailored programs that address barriers to health-seeking behavior influenced by cultural beliefs and attitudes, and low educational attainment. Strategies to improve women's agency should be at the core of these programs; they are essential for reducing maternal mortality and achieving sustainable development goals towards gender equality. Future studies should develop empirically evaluated measures which assess, and further

  7. From Ethnography to Items: A Mixed Methods Approach to Developing a Survey to Examine Graduate Engineering Student Retention

    Science.gov (United States)

    Crede, Erin; Borrego, Maura

    2013-01-01

    As part of a sequential exploratory mixed methods study, 9 months of ethnographically guided observations and interviews were used to develop a survey examining graduate engineering student retention. Findings from the ethnographic fieldwork yielded several themes, including international diversity, research group organization and climate,…

  8. Examining the Cultural Validity of Fear Survey Schedule for Children: The Contemporary Fears of Turkish Children and Adolescents

    Science.gov (United States)

    Serim-Yildiz, Begum; Erdur-Baker, Ozgur

    2013-01-01

    The authors examined the cultural validity of Fear Survey Schedule for Children (FSSC-AM) developed by J. J. Burnham (2005) with Turkish children. The relationships between demographic variables and the level of fear were also tested. Three independent data sets were used. The first data set comprised 676 participants (321 women and 355 men) and…

  9. Sexting, Risk Behavior, and Mental Health in Adolescents: An Examination of 2015 Pennsylvania Youth Risk Behavior Survey Data

    Science.gov (United States)

    Frankel, Anne S.; Bass, Sarah Bauerle; Patterson, Freda; Dai, Ting; Brown, Deanna

    2018-01-01

    Background: Sexting, the sharing of sexually suggestive photos, may be a gateway behavior to early sexual activity and increase the likelihood of social ostracism. Methods: Youth Risk Behavior Survey (N = 6021) data from 2015 among Pennsylvania 9th-12th grade students were used to examine associations between consensual and nonconsensual sexting…

  10. Quantifying the impact of rising food prices on child mortality in India: a cross-district statistical analysis of the District Level Household Survey.

    Science.gov (United States)

    Fledderjohann, Jasmine; Vellakkal, Sukumar; Khan, Zaky; Ebrahim, Shah; Stuckler, David

    2016-04-01

    Rates of child malnutrition and mortality in India remain high. We tested the hypothesis that rising food prices are contributing to India's slow progress in improving childhood survival. Using rounds 2 and 3 (2002-08) of the Indian District Level Household Survey, we calculated neonatal, infant and under-five mortality rates in 364 districts, and merged these with district-level food price data from the National Sample Survey Office. Multivariate models were estimated, stratified into 27 less deprived states and territories and 8 deprived states ('Empowered Action Groups'). Between 2002 and 2008, the real price of food in India rose by 11.7%. A 1% increase in total food prices was associated with a 0.49% increase in neonatal (95% confidence interval (CI): 0.13% to 0.85%), but not infant or under-five mortality rates. Disaggregating by type of food and level of deprivation, in the eight deprived states, we found an elevation in neonatal mortality rates of 0.33% for each 1% increase in the price of meat (95% CI: 0.06% to 0.60%) and 0.10% for a 1% increase in dairy (95% CI: 0.01% to 0.20%). We also detected an adverse association of the price of dairy with infant (b = 0.09%; 95% CI: 0.01% to 0.16%) and under-five mortality rates (b = 0.10%; 95% CI: 0.03% to 0.17%). These associations were not detected in less deprived states and territories. Rising food prices, particularly of high-protein meat and dairy products, were associated with worse child mortality outcomes. These adverse associations were concentrated in the most deprived states. © The Author 2016. Published by Oxford University Press on behalf of the International Epidemiological Association.

  11. Examining the Reliability and Validity of a Turkish Version of the Community of Inquiry Survey

    Science.gov (United States)

    Olpak, Yusuf Ziya; Kiliç Çakmak, Ebru

    2018-01-01

    The aim of this study was to describe the validity and reliability of a Turkish language version of the CoI survey developed by Arbaugh et al. (2008). Data were obtained from 1150 students enrolled in online courses in various departments in three Turkish state universities. The data were randomly divided into two parts: the first part was…

  12. Examining the Reliability and Validity of the Effective Behavior Support Self-Assessment Survey

    Science.gov (United States)

    Solomon, Benjamin G.; Tobin, Kevin G.; Schutte, Gregory M.

    2015-01-01

    The Effective Behavior Support Self-Assessment Survey (SAS; Sugai, Horner, & Todd, 2003) is designed to measure perceived Positive Behavior Interventions and Supports (PBIS) implementation and identify priorities for improvement. Despite its longevity, little published research exists documenting its reliability or validity for these purposes.…

  13. A Survey Study Examining Teachers' Perceptions in Teaching Refugee and Immigrant Students

    Science.gov (United States)

    Kurbegovic, Dajana

    2016-01-01

    There is limited research around best practices in working with refugee and immigrant students. Since teachers spend the majority of the school day with students, their insights about how best to serve these populations of children and adolescents is critical. This dissertation study conducted an online survey study with 139 elementary school…

  14. Examining Stress in Graduate Assistants: Combining Qualitative and Quantitative Survey Methods

    Science.gov (United States)

    Mazzola, Joseph J.; Walker, Erin J.; Shockley, Kristen M.; Spector, Paul E.

    2011-01-01

    The aim of this study was to employ qualitative and quantitative survey methods in a concurrent mixed model design to assess stressors and strains in graduate assistants. The stressors most frequently reported qualitatively were work overload, interpersonal conflict, and organizational constraints; the most frequently reported psychological…

  15. Examining impacts of allergic diseases on psychological problems and tobacco use in Korean adolescents: the 2008-2011 Korean National Health and Nutrition Examination Survey.

    Directory of Open Access Journals (Sweden)

    Yoon Hong Chun

    Full Text Available Asthma during adolescence can induce social, psychological, and behavioral problems. We examined the impact of asthma and other allergic diseases on psychological symptoms and health risk behaviors among South Korean adolescents.In this population-based cross-sectional study, 3192 adolescents (10-18 years of age participating in the 2008-2011 Korean National Health and Nutrition Examination Survey were enrolled. Psychological problems associated with clinically diagnosed asthma, allergic rhinitis, and atopic dermatitis were assessed using questionnaires and surveys. Data was analyzed using logistic regression to determine the association of depression with allergic disease while controlling for age, sex, body mass index, smoking experience, and alcohol use.Asthma and atopic dermatitis were associated with a higher prevalence of depression (17.2% and 13%, respectively. After adjusting for the covariates, asthma patients were approximately two times as likely to have depression as non-allergic participants (odds ratio, 1.81; 95% confidence interval, 1.22-2.68. Psychosocial stress significantly increased in the following order: no allergy, any allergy without asthma, asthma only, and asthma with any allergy (p for linear trend = 0.01. The asthma without other allergies group showed the highest prevalence of cigarette smoking (p = 0.007.In this study, asthma with or without other allergies was significantly related to increases in depression, psychosocial stress, and smoking experience. Thus, care should be taken to adjust treatment to account for the psychological symptoms and health risk behaviors common among asthmatic adolescents.

  16. Impaired glucose metabolism among those with and without diagnosed diabetes and mortality: a cohort study using Health Survey for England data.

    Directory of Open Access Journals (Sweden)

    Vanessa L Z Gordon-Dseagu

    Full Text Available The extent that controlled diabetes impacts upon mortality, compared with uncontrolled diabetes, and how pre-diabetes alters mortality risk remain issues requiring clarification.We carried out a cohort study of 22,106 Health Survey for England participants with a HbA1C measurement linked with UK mortality records. We estimated hazard ratios (HRs of all-cause, cancer and cardiovascular disease (CVD mortality and 95% confidence intervals (CI using Cox regression.Average follow-up time was seven years and there were 1,509 deaths within the sample. Compared with the non-diabetic and normoglycaemic group (HbA1C <5.7% [<39 mmol/mol] and did not indicate diabetes, undiagnosed diabetes (HbA1C ≥6.5% [≥48 mmol/mol] and did not indicate diabetes inferred an increased risk of mortality for all-causes (HR 1.40, 1.09-1.80 and CVD (1.99, 1.35-2.94, as did uncontrolled diabetes (diagnosed diabetes and HbA1C ≥6.5% [≥48 mmol/mol] and diabetes with moderately raised HbA1C (diagnosed diabetes and HbA1C 5.7-<6.5% [39-<48 mmol/mol]. Those with controlled diabetes (diagnosed diabetes and HbA<5.7% [<39 mmol/mol] had an increased HR in relation to mortality from CVD only. Pre-diabetes (those who did not indicate diagnosed diabetes and HbA1C 5.7-<6.5% [39-<48 mmol/mol] was not associated with increased mortality, and raised HbA1C did not appear to have a statistically significant impact upon cancer mortality. Adjustment for BMI and socioeconomic status had a limited impact upon our results. We also found women had a higher all-cause and CVD mortality risk compared with men.We found higher rates of all-cause and CVD mortality among those with raised HbA1C, but not for those with pre-diabetes, compared with those without diabetes. This excess differed by sex and diabetes status. The large number of deaths from cancer and CVD globally suggests that controlling blood glucose levels and policies to prevent hyperglycaemia should be considered public health priorities.

  17. Anxiety and Depressive Symptoms as Predictors of All-Cause Mortality among People with Insulin-Naïve Type 2 Diabetes: 17-Year Follow-Up of the Second Nord-Trøndelag Health Survey (HUNT2, Norway.

    Directory of Open Access Journals (Sweden)

    Marjolein M Iversen

    Full Text Available To examine whether elevated anxiety and/or depressive symptoms are related to all-cause mortality in people with Type 2 diabetes, not using insulin.948 participants in the community-wide Nord-Trøndelag Health Survey conducted during 1995-97 completed the Hospital Anxiety and Depression Scale with subscales of anxiety (HADS-A and depression (HADS-D. Elevated symptoms were defined as HADS-A or HADS-D ≥8. Participants with type 2 diabetes, not using insulin, were followed until November 21, 2012 or death. Cox regression analyses were used to estimate associations between baseline elevated anxiety symptoms, elevated depressive symptoms and mortality, adjusting for sociodemographic factors, HbA1c, cardiovascular disease and microvascular complications.At baseline, 8% (n = 77/948 reported elevated anxiety symptoms, 9% (n = 87/948 elevated depressive symptoms and 10% (n = 93/948 reported both. After a mean follow-up of 12 years (SD 5.1, range 0-17, 541 participants (57% had died. Participants with elevated anxiety symptoms only had a decreased mortality risk (unadjusted HR 0.66, 95% CI 0.46-0.96. Adjustment for HbA1c attenuated this relation (HR 0.73, 95% CI 0.50-1.07. Those with elevated depression symptoms alone had an increased mortality risk (fully adjusted model HR 1.39, 95% CI 1.05-1.84. Having both elevated anxiety and depressive symptoms was not associated with increased mortality risk (adjusted HR 1.30, 95% CI 0.96-1.74.Elevated depressive symptoms were associated with excess mortality risk in people with Type 2 diabetes not using insulin. No significant association with mortality was found among people with elevated anxiety symptoms. Having both elevated anxiety and depressive symptoms was not associated with mortality. The hypothesis that elevated levels of anxiety symptoms leads to behavior that counteracts the adverse health effects of Type 2 diabetes needs further investigation.

  18. Assessment of distribution and abundance estimates for Mariana swiftlets (Aerodramus bartschi) via examination of survey methods

    Science.gov (United States)

    Johnson, Nathan C.; Haig, Susan M.; Mosher, Stephen M.

    2018-01-01

    We described past and present distribution and abundance data to evaluate the status of the endangered Mariana Swiftlet (Aerodramus bartschi), a little-known echolocating cave swiftlet that currently inhabits 3 of 5 formerly occupied islands in the Mariana archipelago. We then evaluated the survey methods used to attain these estimates via fieldwork carried out on an introduced population of Mariana Swiftlets on the island of O'ahu, Hawaiian Islands, to derive better methods for future surveys. We estimate the range-wide population of Mariana Swiftlets to be 5,704 individuals occurring in 15 caves on Saipan, Aguiguan, and Guam in the Marianas; and 142 individuals occupying one tunnel on O'ahu. We further confirm that swiftlets have been extirpated from Rota and Tinian and have declined on Aguiguan. Swiftlets have remained relatively stable on Guam and Saipan in recent years. Our assessment of survey methods used for Mariana Swiftlets suggests overestimates depending on the technique used. We suggest the use of night vision technology and other changes to more accurately reflect their distribution, abundance, and status.

  19. Evaluating the quality, clinical relevance, and resident perception of the radiation oncology in-training examination: A national survey.

    Science.gov (United States)

    Kim, Hyun; Bar Ad, Voichita; McAna, John; Dicker, Adam P

    2016-01-01

    The yearly radiation oncology in-training examination (ITE) by the American College of Radiology is a widely used, norm-referenced educational assessment, with high test reliability and psychometric performance. We distributed a national survey to evaluate the academic radiation oncology community's perception of the ITE. In June 2014, a 7-question online survey was distributed via e-mail to current radiation oncology residents, program directors, and attending physicians who had completed residency in the past 5 years or junior attendings. Survey questions were designed on a 5-point Likert scale. Sign test was performed with P ≤ .05 considered statistically different from neutral. Thirty-one program directors (33.3%), 114 junior attendings (35.4%), and 225 residents (41.2%) responded. Junior attendings and program directors reported that the ITE directly contributed to their preparation for the American Board of Radiology written certification (P = .050 and .004, respectively). Residents did not perceive the examination as an accurate assessment of relevant clinical and scientific knowledge (P ITE. Although the current examination allows limited feedback, establishing a venue for individualized feedback may allow continual and timely improvement of the ITE. Adopting a criterion-referenced examination may further increase resident investment in and utilization of this valuable learning tool. Copyright © 2016 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

  20. Comorbidities in obstructive lung disease in Korea: data from the fourth and fifth Korean National Health and Nutrition Examination Survey

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    Park HJ

    2015-08-01

    Full Text Available Hee Jin Park, Ah Young Leem, Sang Hoon Lee, Ju Han Song, Moo Suk Park, Young Sam Kim, Se Kyu Kim, Joon Chang, Kyung Soo Chung Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Institute of Chest Disease, Yonsei University College of Medicine, Seoul, South Korea Background: Comorbidities can occur frequently in patients with chronic obstructive pulmonary disease (COPD and can influence mortality and morbidity independently. It is increasingly recognized that many patients with COPD have comorbidities that have a major impact on their quality of life and survival. Therefore, we investigated the prevalence of comorbidities in Korean COPD populations. Methods: We used data obtained in the 6 years of the fourth and fifth Korean National Health and Nutrition Examination Survey (KNHANES IV and V. Among 50,405 subjects, 16,151 subjects aged ≥40 years who performed spirometry adequately were included in this study. Airway obstruction was defined as forced expiratory volume in 1 second/forced vital capacity <0.7, and the Global Initiative For Chronic Obstructive Lung Disease stage was used to evaluate the severity of airway obstruction. Statistical analyses were performed using SAS 9.2. Results: Among the 16,151 subjects (43.2% male, 56.8% female; mean age: 57.1 years for men and 57.2 years for women, 13.1% had obstructive lung function; 11.3%, restrictive lung function; and 75.6%, normal lung function. Among individuals with obstructive lung function, 45.3%, 49.4%, and 5.3% had mild, moderate, and severe and very severe airflow limitation. The prevalence of hypertension, diabetes mellitus (DM, underweight, and hypertriglyceridemia was higher in the obstructive lung function group than in the normal lung function group (49.6% vs 35.2%; 16.8% vs 10.5%; 3.3% vs 1.3%; 19.7% vs 17.0%. According to the severity of airway obstruction, hypertension and underweight were more common as severity increased

  1. Survey on th incidence of homeless pulmonary tuberculosis infection rate through chest x-ray examination

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Young; Shin, Sung Rae [Dept. of Nursing, Sahmyook University, Seoul (Korea, Republic of); Ryu, Young Hwan [Dept. of Radiology, Seoul Medical Center, Seoul (Korea, Republic of); Lim, Hwan Yeal [Dept. of Medical Business Administration, U1 University, Yeongdong (Korea, Republic of)

    2017-02-15

    This study, Seoul City shelter, you are trying to seek medical cooperation and cure rate increase proposal Yu fndings’s current situation and tuberculosis of homeless tuberculosis. Inspector, and has a total 591 people is targeted to implement an interview after acquiring utilization agreement in studies conducted chest X-ray photography. Of the interview questions, three or more protons, it is determined that the TB symptomatic conducted sputum examination, chest X-ray examination confrms the physician radiology, when sputum examination primarily chromatic fndings the double implemented and conducted by requesting the ship inspection also said inspection sputum acid-fast bacteria if it is true one, respectively. confrmed case result of checking whether there is a difference due to risk factors (Jb) at the chi square black, it was found that there is no statistically significant difference at 95% confidence level. (χ{sup 2}=0.276, p>0.05), suspected case (Ac, Ae) results of examining whether there is a difference due to risk factors in chi square black, that there is a statistically significant difference at 99% confidence level is I found (χ{sup 2}=9.414, p<0.01). The nature of the homeless tuberculosis screening and directed to the distance homeless specifc location are likely to evaluate the actual incidence low and aggressive or management needs, the rationale is allowed insufficient reality is. Through this research, future, for tuberculosis high risk tuberculosis patient, such as homeless to expand the tuberculosis screening of infectious tuberculosis patients in private medical institutions, and one-stop service that chest X-ray examination and sputum examination is carried out at the same time introduced immediately to prevent the inspection and examination, cure, and should establish a foundation that can be up to post administration.

  2. Survey on th incidence of homeless pulmonary tuberculosis infection rate through chest x-ray examination

    International Nuclear Information System (INIS)

    Kim, Mi Young; Shin, Sung Rae; Ryu, Young Hwan; Lim, Hwan Yeal

    2017-01-01

    This study, Seoul City shelter, you are trying to seek medical cooperation and cure rate increase proposal Yu fndings’s current situation and tuberculosis of homeless tuberculosis. Inspector, and has a total 591 people is targeted to implement an interview after acquiring utilization agreement in studies conducted chest X-ray photography. Of the interview questions, three or more protons, it is determined that the TB symptomatic conducted sputum examination, chest X-ray examination confrms the physician radiology, when sputum examination primarily chromatic fndings the double implemented and conducted by requesting the ship inspection also said inspection sputum acid-fast bacteria if it is true one, respectively. confrmed case result of checking whether there is a difference due to risk factors (Jb) at the chi square black, it was found that there is no statistically significant difference at 95% confidence level. (χ 2 =0.276, p>0.05), suspected case (Ac, Ae) results of examining whether there is a difference due to risk factors in chi square black, that there is a statistically significant difference at 99% confidence level is I found (χ 2 =9.414, p<0.01). The nature of the homeless tuberculosis screening and directed to the distance homeless specifc location are likely to evaluate the actual incidence low and aggressive or management needs, the rationale is allowed insufficient reality is. Through this research, future, for tuberculosis high risk tuberculosis patient, such as homeless to expand the tuberculosis screening of infectious tuberculosis patients in private medical institutions, and one-stop service that chest X-ray examination and sputum examination is carried out at the same time introduced immediately to prevent the inspection and examination, cure, and should establish a foundation that can be up to post administration

  3. Chaperone use during intimate examinations in primary care: postal survey of family physicians

    Directory of Open Access Journals (Sweden)

    Upshur Ross EG

    2005-12-01

    Full Text Available Abstract Background Physicians have long been advised to have a third party present during certain parts of a physical examination; however, little is known about the frequency of chaperone use for those specific intimate examinations regularly performed in primary care. We aimed to determine the frequency of chaperone use among family physicians across a variety of intimate physical examinations for both male and female patients, and also to identify the factors associated with chaperone use. Methods Questionnaires were mailed to a randomly selected sample of 500 Ontario members of the College of Family Physicians of Canada. Participants were asked about their use of chaperones when performing a variety of intimate examinations, namely female pelvic, breast, and rectal exams and male genital and rectal exams. Results 276 of 500 were returned (56%, of which 257 were useable. Chaperones were more commonly used with female patients than with males (t = 9.09 [df = 249], p Conclusion Clinical practice concerning the use of chaperones during intimate exams continues to be discordant with the recommendations of medical associations and medico-legal societies. Chaperones are used by only a minority of Ontario family physicians. Chaperone use is higher for examinations of female patients than of male patients and is highest for female pelvic exams. The availability of a nurse in the clinic to act as a chaperone is associated with more frequent use of chaperones.

  4. Examining Multiple Sources of Differential Item Functioning on the Clinician & Group CAHPS® Survey

    Science.gov (United States)

    Rodriguez, Hector P; Crane, Paul K

    2011-01-01

    Objective To evaluate psychometric properties of a widely used patient experience survey. Data Sources English-language responses to the Clinician & Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS®) survey (n = 12,244) from a 2008 quality improvement initiative involving eight southern California medical groups. Methods We used an iterative hybrid ordinal logistic regression/item response theory differential item functioning (DIF) algorithm to identify items with DIF related to patient sociodemographic characteristics, duration of the physician–patient relationship, number of physician visits, and self-rated physical and mental health. We accounted for all sources of DIF and determined its cumulative impact. Principal Findings The upper end of the CG-CAHPS® performance range is measured with low precision. With sensitive settings, some items were found to have DIF. However, overall DIF impact was negligible, as 0.14 percent of participants had salient DIF impact. Latinos who spoke predominantly English at home had the highest prevalence of salient DIF impact at 0.26 percent. Conclusions The CG-CAHPS® functions similarly across commercially insured respondents from diverse backgrounds. Consequently, previously documented racial and ethnic group differences likely reflect true differences rather than measurement bias. The impact of low precision at the upper end of the scale should be clarified. PMID:22092021

  5. Seroprevalence of herpes simplex virus 2 among Hispanics in the USA: National Health and Nutrition Examination Survey, 2007-2008.

    Science.gov (United States)

    Molina, M; Romaguera, R A; Valentine, J; Tao, G

    2011-07-01

    To examine the seroprevalence of herpes simplex virus type 2 (HSV-2) among Hispanics in the USA, we used the cross-sectional, nationally representative National Health and Nutrition Examination Survey to compare the seroprevalence of HSV-2 between Hispanic persons of Mexican heritage and non-Mexican heritage aged 14-44 years, from survey years 2007-2008. The overall HSV-2 seroprevalence among Hispanics aged 14-44 years was 17.5% (95% confidence interval [CI], 15.2, 20.1) in the USA. HSV-2 seroprevalence was significantly lower among Mexican Americans than among other Hispanics (11.7% vs. 27.8%, P heritage and non-Mexican heritage suggested that targeting specific subgroups of Hispanics for preventive interventions may be a strategy to reduce the transmission of HSV-2 and HIV among Hispanics in the USA.

  6. Hypertension Among US Adults by Disability Status and Type, National Health and Nutrition Examination Survey, 2001–2010

    OpenAIRE

    Stevens, Alissa; Courtney-Long, Elizabeth; Gillespie, Cathleen; Armour, Brian S.

    2014-01-01

    The prevalence of hypertension among people with disabilities is not well understood. We combined data from the 2001–2010 National Health and Nutrition Examination Survey to obtain estimates of hypertension prevalence by disability status and type (cognitive, hearing, vision, or mobility limitation) and assess the association between disability and hypertension. Overall, 34% of adults with disabilities had hypertension compared with 27% of adults without disabilities; adults with mobility lim...

  7. A patient dose survey for femoral arteriogram diagnostic radiographic examinations using a dose-area product meter

    International Nuclear Information System (INIS)

    Thwaites, J.H.; Rafferty, M.W.; Gray, N.; Black, J.; Stock, B.

    1996-01-01

    A patient dose survey was carried out for femoral arteriogram procedures at the Sir Charles Gairdner Hospital. The procedure involves fluoroscopy to the pelvic region to locate a guide wire and catheter, followed by a series of radiographs extending from the pelvic area to the feet to form a collage image of the entire arterial system. Radiographs are taken whilst a bolus of contrast media is injected into the arterial system. A dose-area product meter was used to determine the dose-area product delivered to patients. Radiographic and patient details were logged with dose-area product for each part of each procedure. Mean energy imparted, mean effective dose and effective dose equivalent are calculated for the examinations. Calculated effective doses are shown to produce results consistent with those of other authors. We present a method for dealing with a complex radiographic procedure including multiple radiographs and fluoroscopy in an attempt to provide a simple way of calculating effective dose from which a general risk factor can be determined. The effective dose varies considerably from examination to examination due to the large range in the number of radiographs taken in any one procedure. A useful index can be obtained by logging the number of radiographs in each region, and fluoroscopy time, from which the effective dose may be easily calculated. These measurements extend a continuing survey of doses for common diagnostic radiographic examinations which previously included the simple examinations: lumbar spine, abdoment and pelvis. (author)

  8. Survey of post-irradiation examinations made of mixed carbide fuels

    International Nuclear Information System (INIS)

    Coquerelle, M.

    1997-01-01

    Post-irradiation examinations on mixed carbide, nitride and carbonitride fuels irradiated in fast flux reactors Rapsodie and DFR were carried out during the seventies and early eighties. In this report, emphasis was put on the fission gas release, cladding carburization and head-end gaseous oxidation process of these fuels, in particular, of mixed carbides. (author). 8 refs, 16 figs, 3 tabs

  9. Time trends and inequalities of under-five mortality in Nepal: a secondary data analysis of four demographic and health surveys between 1996 and 2011.

    Directory of Open Access Journals (Sweden)

    Chandrashekhar T Sreeramareddy

    Full Text Available BACKGROUND: Inequalities in progress towards achievement of Millennium Development Goal four (MDG-4 reflect unequal access to child health services. OBJECTIVE: To examine the time trends, socio-economic and regional inequalities of under-five mortality rate (U5MR in Nepal. METHODS: We analyzed the data from complete birth histories of four Nepal Demographic and Health Surveys (NDHS done in the years 1996, 2001, 2006 and 2011. For each livebirth, we computed survival period from birth until either fifth birthday or the survey date. Using direct methods i.e. by constructing life tables, we calculated yearly U5MRs from 1991 to 2010. Projections were made for the years 2011 to 2015. For each NDHS, U5MRs were calculated according to child's sex, mother's education, household wealth index, rural/urban residence, development regions and ecological zones. Inequalities were calculated as rate difference, rate ratio, population attributable risk and hazard ratio. RESULTS: Yearly U5MR (per 1000 live births had decreased from 157.3 (95% CIs 178.0-138.9 in 1991 to 43.2 (95% CIs 59.1-31.5 in 2010 i.e. 114.1 reduction in absolute risk. Projected U5MR for the year 2015 was 54.33. U5MRs had decreased in absolute terms in all sub groups but relative inequalities had reduced for gender and rural/urban residence only. Wide inequalities existed by wealth and education and increased between 1996 and 2011. For lowest wealth quintile (as compared to highest quintile hazard ratio (HR increased from 1.37 (95% CIs 1.27, 1.49 to 2.54 ( 95% CIs 2.25, 2.86 and for mothers having no education (as compared to higher education HR increased from 2.55 (95% CIs 1.95, 3.33 to 3.75 (95% CIs 3.17, 4.44. Changes in regional inequities were marginal and irregular. CONCLUSIONS: Nepal is most likely to achieve MDG-4 but eductional and wealth inequalities may widen further. National health policies should address to reduce inequalities in U5MR through 'inclusive policies'.

  10. A Survey of Digital Rectal Examination Training in Canadian Medical Schools

    Directory of Open Access Journals (Sweden)

    Alysha Nensi

    2012-01-01

    Full Text Available BACKGROUND: The digital rectal examination (DRE is important for the diagnosis of a variety of gastrointestinal, urological and gynecological disorders. However, it appears that Canadian medical students may not be adequately taught nor provided the opportunity to practice their skills often enough. The present study was an analysis of the current practices in DRE teaching and evaluation in undergraduate medicine programs across Canada.

  11. Iron status and reproduction in US women: National Health and Nutrition Examination Survey, 1999-2006.

    Directory of Open Access Journals (Sweden)

    Elizabeth M Miller

    Full Text Available Women experience significant changes in iron status throughout their reproductive lifespans. While this is evident in regions with high rates of malnutrition and infectious disease, the extent of reproductive-related changes is less well known in countries with low rates of iron deficiency anemia, such as the United States. The goal of this study is determine the relationship between women's reproductive variables (pregnancy, parity, currently breastfeeding, regular menstruation, hormonal contraceptive use, and age at menarche and iron status (hemoglobin, ferritin, transferrin receptor, and % transferrin saturation using an anthropological framework for interpreting the results. Data from women aged 18-49 were taken from the 1999-2006 US NHANES, a nationally representative cross-sectional sample of US women. Using multiple imputation and complex survey statistics, women's reproductive variables were regressed against indicators of iron status. Pregnant women had significantly poorer iron status, by most indicators, than non-pregnant women. All biomarkers demonstrated significantly lower iron levels with increasing parity. Women who were having regular periods had iron indicators that suggested decreased iron levels, while women who used hormonal contraceptives had iron indicators that suggested increased iron levels. Despite relatively good iron status and widespread availability of iron-rich foods in the US, women still exhibit patterns of iron depletion across several reproductive variables of interest. These results contribute to an ecological approach to iron status that seeks to understand variation in iron status, with the hopes that appropriate, population-specific recommendations can be developed to improve women's health.

  12. Results of a questionnaire survey on window setting and FOV on CT images of examinations

    International Nuclear Information System (INIS)

    Anzui, Maya; Asano, Kazushige; Goto, Takahiro; Sekitani, Toshinori; Tsujioka, Katsumi; Kawaguchi, Daisuke; Narumi, Tatsuki

    2008-01-01

    The use of CT as a general examination has spread widely and is even used in small institutions. However, it is difficult to determine the current situation of each institution. Therefore, we employed a questionnaire to investigate the current situation of a variety of institutions. From the results of the questionnaire, we determined that the window setting was difficult for beginner technologists. In addition, in many institutions, radiological technologists did not always use the same display field of view (FOV) for the same patient. From this questionnaire, we were able to determine the present conditions in each institution. We consider these results very useful. (author)

  13. A survey on respiratory diseases of atomic bomb survivors using chest X-ray examination

    International Nuclear Information System (INIS)

    Sasaki, Hideo; Noma, Koji; Ito, Chikako; Mitsuyama, Toyofumi; Kamitsuna, Akimitsu; Nishimoto, Yukio; Katsuta, Shizutomo.

    1986-01-01

    From April 1981 through March 1986, 39,363 A-bomb survivors older than 50 years of age underwent chest X-ray examination. The incidence of abnormal findings was higher in men (28 %) than in women (13 %). The most common disease was old pulmonary tuberculosis in both men and women. The incidence of pulmonary fibrosis was remarkably high in survivors exposed directly to A-bomb radiation, when compared with controls. There was no data suggesting the relationship between the incidence of respiratory disease and exposure status such as the distance from ground zero. (Namekawa, K.)

  14. We need studies of the mortality effect of vitamin A supplementation, not surveys of vitamin A deficiency

    DEFF Research Database (Denmark)

    Benn, Christine Stabell

    2017-01-01

    It is usually acknowledged that high‐dose vitamin A supplementation (VAS) provides no sustained improvement in vitamin A status, and that the effect of VAS on mortality is more likely linked to its immunomodulating effects. Nonetheless, it is widely assumed that we can deduce something about...

  15. Patient dose surveys for radiological examinations in Dutch hospitals between 1993 and 2000

    International Nuclear Information System (INIS)

    Spoelstra, F.M.; Geleijns, J.; Broerse, J.J.; Teeuwisse, W.M.; Zweers, D.

    2001-01-01

    Our inventory studies on radiation dose to patients in Dutch hospitals are reviewed and compared with current European guidelines on patient dose and reference dose values of the NRPB. Between the years 1993 and 2000 doses were measured and effective dose was assessed at 14 hospitals for paediatric radiography, at 18 hospitals for PA chest radiography, at 10 respectively 9 hospitals for barium meal and barium enema examinations and at 18 hospitals for CT scans of the brain, chest (including high resolution CT of the chest), abdomen and lumbar spine in The Netherlands. Effective doses varied from 1 μSv (AP chest radiograph premature) to 26 mSv (CT abdomen scan). Doses were in general well below the reference dose values, with the exception of CT where the dose length product often exceeded reference levels. Interhospital variations were considerable, the largest range was observed for PA chest examinations, i.e.a ratio of 27 between maximum and minimum effective dose. (author)

  16. Familial concordance of metabolic syndrome in Korean population--Korean National Health and Nutrition Examination Survey 2005.

    Science.gov (United States)

    Lee, Myung Ha; Kim, Hyeon Chang; Thomas, G Neil; Ahn, Song Vogue; Hur, Nam Wook; Choi, Dong Phil; Suh, Il

    2011-09-01

    To investigate the familial concordance of metabolic syndrome and its components in a nationally representative survey in Korean. We used data from the Korean National Health and Nutrition Examination Survey (KNHANES), a nationwide survey examining the general health and nutritional status of the Korean people. We enrolled 1641 married couples and 1527 parents-1342 offspring. Prevalence of the metabolic syndrome was 17.1% for husbands, 11.7% for wives, 14.3% for parents, and 7.2% for offspring. After adjustment for age, there were strong positive correlations between family members for the metabolic variables. Compared with husbands whose wives did not have metabolic syndrome, adjusted odds ratio in husbands whose wives had metabolic syndrome was 1.43 (95% CI: 1.10-1.87) for the risk of having metabolic syndrome. Similarly, wives whose husbands had metabolic syndrome had 1.41 (95% CI: 1.08-1.84) times higher risk of having metabolic syndrome. Compared with children whose parents did not have metabolic syndrome, adjusted odds ratio in children with at least one parent with the metabolic syndrome was 2.56 (95% CI: 1.09-5.98) for the metabolic syndrome. Our study revealed that there is significant familial concordance for metabolic syndrome and its components in Korean families. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  17. Social Aspects of Education Integration (Based on Survey Findings on Uniform State Examination and Education Affordability

    Directory of Open Access Journals (Sweden)

    Nataliya V. Kolacheva

    2017-12-01

    Full Text Available Introduction: the purpose of this article is to study the opinion of interested and non-professional segment of society regarding the Uniform State Exam on mathematics and affordability of higher education in Russia. The authors checked the hypothesis of interconnection between social opinion and changes in the exam procedure, economic and socio-demographic situation, educational system reformation and integration of educational space in the RF and other countries. Materials and Methods: we studied the survey data of students in Togliatti State University, their parents or legal representatives between 2009–2016. We processed the results by methods of probability assessment with the help of complex features reflecting possibilities of the applicants admitted to higher educational institutions and social affordability of higher education. Results: we theoretically grounded and developed the method of social opinion study about the Uniform State Exam and affordability of higher education in the region. Dynamics of social opinion was studied with the help of adapted probability rates describing either quantitative or qualitative features of social processes. We studied and analyzed scientific papers devoted to the attitude of society to secondary school final exams, admission to higher education institutions, and social mobility of the applicants and determined theoretical background of education space integration with the education sy stems of other countries. Discussion and Conclusions: the research showed that even in the region with visible economic and socio-demographic problems the concerned part of society gradually understands that the Uniform State Exam serves to keep education quality in the country making it more affordable. The results of the study may be useful to specialists in the field of education, as well as int eresting to the general public.

  18. Successful linking of the Society of Thoracic Surgeons Database to Social Security data to examine the accuracy of Society of Thoracic Surgeons mortality data.

    Science.gov (United States)

    Jacobs, Jeffrey P; O'Brien, Sean M; Shahian, David M; Edwards, Fred H; Badhwar, Vinay; Dokholyan, Rachel S; Sanchez, Juan A; Morales, David L; Prager, Richard L; Wright, Cameron D; Puskas, John D; Gammie, James S; Haan, Constance K; George, Kristopher M; Sheng, Shubin; Peterson, Eric D; Shewan, Cynthia M; Han, Jane M; Bongiorno, Phillip A; Yohe, Courtney; Williams, William G; Mayer, John E; Grover, Frederick L

    2013-04-01

    The Society of Thoracic Surgeons Adult Cardiac Surgery Database has been linked to the Social Security Death Master File to verify "life status" and evaluate long-term surgical outcomes. The objective of this study is explore practical applications of the linkage of the Society of Thoracic Surgeons Adult Cardiac Surgery Database to Social Securtiy Death Master File, including the use of the Social Securtiy Death Master File to examine the accuracy of the Society of Thoracic Surgeons 30-day mortality data. On January 1, 2008, the Society of Thoracic Surgeons Adult Cardiac Surgery Database began collecting Social Security numbers in its new version 2.61. This study includes all Society of Thoracic Surgeons Adult Cardiac Surgery Database records for operations with nonmissing Social Security numbers between January 1, 2008, and December 31, 2010, inclusive. To match records between the Society of Thoracic Surgeons Adult Cardiac Surgery Database and the Social Security Death Master File, we used a combined probabilistic and deterministic matching rule with reported high sensitivity and nearly perfect specificity. Between January 1, 2008, and December 31, 2010, the Society of Thoracic Surgeons Adult Cardiac Surgery Database collected data for 870,406 operations. Social Security numbers were available for 541,953 operations and unavailable for 328,453 operations. According to the Society of Thoracic Surgeons Adult Cardiac Surgery Database, the 30-day mortality rate was 17,757/541,953 = 3.3%. Linkage to the Social Security Death Master File identified 16,565 cases of suspected 30-day deaths (3.1%). Of these, 14,983 were recorded as 30-day deaths in the Society of Thoracic Surgeons database (relative sensitivity = 90.4%). Relative sensitivity was 98.8% (12,863/13,014) for suspected 30-day deaths occurring before discharge and 59.7% (2120/3551) for suspected 30-day deaths occurring after discharge. Linkage to the Social Security Death Master File confirms the accuracy of

  19. Allostatic load as a predictor of all-cause and cause-specific mortality in the general population: Evidence from the Scottish Health Survey.

    Science.gov (United States)

    Robertson, Tony; Beveridge, Gayle; Bromley, Catherine

    2017-01-01

    Allostatic load is a multiple biomarker measure of physiological 'wear and tear' that has shown some promise as marker of overall physiological health, but its power as a risk predictor for mortality and morbidity is less well known. This study has used data from the 2003 Scottish Health Survey (SHeS) (nationally representative sample of Scottish population) linked to mortality records to assess how well allostatic load predicts all-cause and cause-specific mortality. From the sample, data from 4,488 men and women were available with mortality status at 5 and 9.5 (rounded to 10) years after sampling in 2003. Cox proportional hazard models estimated the risk of death (all-cause and the five major causes of death in the population) according to allostatic load score. Multiple imputation was used to address missing values in the dataset. Analyses were also adjusted for potential confounders (sex, age and deprivation). There were 258 and 618 deaths over the 5-year and 10-year follow-up period, respectively. In the fully-adjusted model, higher allostatic load (poorer physiological 'health') was not associated with an increased risk of all-cause mortality after 5 years (HR = 1.07, 95% CI 0.94 to 1.22; p = 0.269), but it was after 10 years (HR = 1.08, 95% CI 1.01 to 1.16; p = 0.026). Allostatic load was not associated with specific causes of death over the same follow-up period. In conclusions, greater physiological wear and tear across multiple physiological systems, as measured by allostatic load, is associated with an increased risk of death, but may not be as useful as a predictor for specific causes of death.

  20. Clinical survey of blood dyscrasias among Hiroshima A-bomb survivors by periodical health examination, (6)

    International Nuclear Information System (INIS)

    Abe, Tsutomu; Dohy, Hiroo; Okita, Hajime

    1980-01-01

    Serum ferritin was determined in A-bomb survivors, and its significance was evaluated. A low-ferritin group included many of the females under the age of 50, who mostly had iron deficient anemia. A high-ferritin group included many older-aged A-bomb survivors who had secondary anemia due to hemochromatosis, paroxismal nocturnal hemoglobinuria (PNH), and multiple myeloma. Secondary anemia due to hemochromatosis, PNH, leukemia, and sideroblastic anemia was detected in those who were old and had underlying moderate or severe anemia with a high ferritin level. As the results of this investigation, blood examination combined with serum ferritin determination is valuable for diagnosis of anemia and detection of underlying diseases. (Ueda, J.)

  1. The practice of optometry: National Board of Examiners in Optometry survey of optometric patients.

    Science.gov (United States)

    Soroka, Mort; Krumholz, David; Bennett, Amy

    2006-09-01

    A study commissioned by the National Board of Examiners in Optometry was designed to obtain information about patients seen in general practice. Providers completed an encounter form for patients seen during a 2-day sample. Data were obtained from 11,012 patients in rural, urban, and suburban environments from a diverse population of 480 optometrists representative of profession-wide practitioners in terms of geographic distribution and practice settings. Although practitioners were selected randomly, the response rate among those who were invited to participate was only 17.7%. Optometrists who specialized and did not classify themselves as general practitioners were excluded from the study. The study provides insights into the most common diagnostic and therapeutic procedures performed, medications prescribed, and referrals made in general practices. Seventy-one percent of all examinations were categorized as comprehensive, approximately 13% were because of disease, and 11% were for contact lens care. Almost 17% of all patients received a formal visual field test (Goldmann or automated). Refractive error was the most prevalent diagnosis, reflective of the ocular problems found in the general population, and systemic conditions were the second largest category. Although 12% of all patients were referred to an ophthalmologist for further care, other types of referrals were infrequent. Referrals to a primary care physician, laboratory, and imaging or for refractive surgery accounted for only 8% of all referrals. Ocular disease treatment was found to be an integral part of the optometrist's practice. Prescribing topical medications, both legend and "over-the-counter," was a primary treatment option. The most common medications prescribed were for glaucoma, with antibiotics, anti-inflammatory and anti-allergy drops making up the remainder, in descending order.

  2. A case law survey of the Personality Assessment Inventory: examining its role in civil and criminal trials.

    Science.gov (United States)

    Mullen, Kacy L; Edens, John F

    2008-05-01

    Although professional surveys suggest that the Personality Assessment Inventory (PAI; Morey, 1991) is a popular instrument among forensic and correctional psychologists, relatively little is known about the specific types of legal cases in which it is applied, the particular types of questions it is used to address, or the extent to which its admissibility has been at issue in court cases. Using a comprehensive legal database, we surveyed all published U.S., Canadian, European, and Australian criminal and civil cases in which the PAI was administered. The PAI appears to be introduced by examiners in a wide variety of civil (e.g., child custody, personal injury) and criminal (e.g., insanity, competence) cases to aid in the assessment of a broad range of psychopathology. Additionally, the PAI seems to be used frequently to assess questions concerning potential dissimulation and response styles. Surprisingly, the admissibility of the PAI into evidence was never at issue in any of the cases reviewed.

  3. The relationships between pesticide metabolites and neurobehavioral test performance in the third National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Krieg, Edward F

    2013-01-01

    Regression analysis was used to estimate and test for relationships between urinary pesticide metabolites and neurobehavioral test performance in adults, 20 to 59 years old, participating in the third National Health and Nutrition Examination Survey. The 12 pesticide metabolites included 2 naphthols, 8 phenols, a phenoxyacetic acid, and a pyridinol. The 3 neurobehavioral tests included in the survey were simple reaction time, symbol-digit substitution, and serial digit learning. As the 2,4-dichlorophenol, 2,5-dichlorophenol, and the pentachlorophenol concentrations increased, performance on the serial digit learning test improved. As the 2,5-dichlorophenol concentration increased, performance on the symbol-digit substitution test improved. At low concentrations, the parent compounds of these metabolites may act at acetylcholine and γ-aminobutyric acid synapses in the central nervous system to improve neurobehavioral test performance.

  4. A survey of 165 sporotrichosis cases examined in Nagasaki prefecture from 1951 to 2012.

    Science.gov (United States)

    Takenaka, Motoi; Yoshizaki, Asako; Utani, Atushi; Nishimoto, Katsutaro

    2014-05-01

    A total of 165 sporotrichosis cases occurring in Nagasaki prefecture, and examined at Nagasaki University Hospital, were evaluated. Both males and females were equally affected, with no significant differences in the affected body regions. Lesions were frequently seen on the face (49 cases, 29.5%) and upper limbs (101 cases, 60.9%). The localised cutaneous type of sporotrichosis (105 cases, 62.9%) was much more frequent than the lymphocutaneous type (62 cases, 37.1%). The infection rate in patients over 50 years of age was 73.1%. The most frequent occupation among the patients was farming (52 cases, 37.4%), and 34 patients had a history of injury. Regarding the geographical distribution of sporotrichosis, 48 cases occurred in the Shimabara peninsula (31.2%) and this is much higher than expected for the population size. Before 1994, almost all sporotrichosis cases (112 cases, 96.5%) were treated with potassium iodide (KI). After 1995, the number of patients treated with KI decreased (nine cases, 23.1%), and itraconazole (ITZ) was used in 21 cases (59.0%) and terbinafine in six cases (15.3%). The time between ITZ and KI treatment and cure was 13.8 weeks and 12.5 weeks, respectively. All 116 cases, for which the outcome was known, were cured or improved. © 2013 Blackwell Verlag GmbH.

  5. Examination of the equivalence of self-report survey-based paper-and-pencil and internet data collection methods.

    Science.gov (United States)

    Weigold, Arne; Weigold, Ingrid K; Russell, Elizabeth J

    2013-03-01

    Self-report survey-based data collection is increasingly carried out using the Internet, as opposed to the traditional paper-and-pencil method. However, previous research on the equivalence of these methods has yielded inconsistent findings. This may be due to methodological and statistical issues present in much of the literature, such as nonequivalent samples in different conditions due to recruitment, participant self-selection to conditions, and data collection procedures, as well as incomplete or inappropriate statistical procedures for examining equivalence. We conducted 2 studies examining the equivalence of paper-and-pencil and Internet data collection that accounted for these issues. In both studies, we used measures of personality, social desirability, and computer self-efficacy, and, in Study 2, we used personal growth initiative to assess quantitative equivalence (i.e., mean equivalence), qualitative equivalence (i.e., internal consistency and intercorrelations), and auxiliary equivalence (i.e., response rates, missing data, completion time, and comfort completing questionnaires using paper-and-pencil and the Internet). Study 1 investigated the effects of completing surveys via paper-and-pencil or the Internet in both traditional (i.e., lab) and natural (i.e., take-home) settings. Results indicated equivalence across conditions, except for auxiliary equivalence aspects of missing data and completion time. Study 2 examined mailed paper-and-pencil and Internet surveys without contact between experimenter and participants. Results indicated equivalence between conditions, except for auxiliary equivalence aspects of response rate for providing an address and completion time. Overall, the findings show that paper-and-pencil and Internet data collection methods are generally equivalent, particularly for quantitative and qualitative equivalence, with nonequivalence only for some aspects of auxiliary equivalence. PsycINFO Database Record (c) 2013 APA, all

  6. The associations between smoking and occupational categories: the Korea National Health and Nutrition Examination Survey from 2008 to 2010.

    Science.gov (United States)

    Kim, Sungroul; Kim, Junhyoung

    2015-03-01

    The implementation of smoke-free policies for workplaces and their impacts have been far from satisfactory. We investigated smoking prevalence in various occupations using data (n = 9283) from the Korea National Health and Nutrition Examination Survey collected from 2008 to 2010. Young adults who were working in the occupation categories of "service and sales," "skilled agricultural, fishery, and forest workers," and "crafts and machine operation" for men and "service and sales" for women showed 1.8 to 7.1 and 3.7 times higher (P Korea, and evidence supporting the improvement of prevention by the concomitant reduction of risk factors. © 2012 APJPH.

  7. Mortality disparities among groups participating in an East Africa surveying expedition: the Herbert Henry Austin expedition of 1900-1901.

    Science.gov (United States)

    Imperato, Pascal James; Imperato, Gavin H; Imperato, Austin C

    2013-10-01

    In the late nineteenth and early twentieth centuries, a number of European expeditions traveled to the region of Lake Rudolf, now largely in northern Kenya. Although diverse in intent, many of these were undertaken in the interests of furthering colonial territorial claims. In 1900-1901, Major Herbert Henry Austin led a British expedition down to the lake from Khartoum in the north. Of the 62 African, Arab, and European members of this expedition, only 18 (29 %) arrived at its final destination at Lake Baringo in Kenya. Because of a confluence of adverse climatic, social, and political conditions, the expedition ran short of food supplies when it arrived at the northern end of the lake in April 1901. For the next 4 months, the members of the expedition struggled down the west side of the lake and beyond. The greatest mortality (91 %) occurred among the 32 African transport drivers who were the most marginally nourished at the outset of the trip. The lowest mortality among the Africans on the expedition (15 %) occurred among the members of the Tenth Sudanese Rifles Battalion, who had an excellent nutritional status at the start of the expedition. Major Austin himself suffered from severe scurvy with retinal hemorrhages which left him partially blind in his right eye. An analysis of the mortality rates among the groups that participated in this expedition was undertaken. This revealed that poor nutritional status at the start of the trip was predictive of death from starvation.

  8. The interaction between individualism and wellbeing in predicting mortality: Survey of Health Ageing and Retirement in Europe.

    Science.gov (United States)

    Okely, Judith A; Weiss, Alexander; Gale, Catharine R

    2018-02-01

    The link between greater wellbeing and longevity is well documented. The aim of the current study was to test whether this association is consistent across individualistic and collectivistic cultures. The sample consisted of 13,596 participants from 11 European countries, each of which was assigned an individualism score according to Hofstede et al.'s (Cultures and organizations: software of the mind, McGraw Hill, New York, 2010) cultural dimension of individualism. We tested whether individualism moderated the cross-sectional association between wellbeing and self-rated health or the longitudinal association between wellbeing and mortality risk. Our analysis revealed a significant interaction between individualism and wellbeing such that the association between wellbeing and self-rated health or risk of mortality from cardiovascular disease was stronger in more individualistic countries. However, the interaction between wellbeing and individualism was not significant in analysis predicting all-cause mortality. Further prospective studies are needed to confirm our finding and to explore the factors responsible for this culturally dependent effect.

  9. Clinical survey of blood dyscrasias among Hiroshima A-bomb survivors by the periodical health examination

    International Nuclear Information System (INIS)

    Taketomi, Yoshinori; Kamada, Nanao; Uchino, Haruto; Takahashi, Hiroshi; Ohkita, Takeshi

    1976-01-01

    For investigation of delayed effects on atomic bomb survivors, age, the association with exposure conditions, and individual pathological conditions were examined on 200 survivors for whom hypoplastic anemia was suspected in a year, April 1, 1972-March 31, 1973. Anemia was prevalent among the aged: in the females (170 cases) the incidence according to age was 1.2% in those aged 29 or below, 8.8% in those aged between 30 and 39, 12.4% in those aged between 40 and 49, 21.2% in those aged between 50 and 59, 28.8% in those aged between 60 and 69, and 24.1% aged between 70 and 79. In the males (30 cases) it was 73.3% in those aged 60 or above. The incidence according to exposure distance in the females was 4.1% in the group of 0.9km or less, 36.5% in the group of 1.9km or less, and 41.8% in the group of 2km or more, and the incidence in the males was 43.3% in the group of 1.9km or less. Anemia was not necessarily frequent among the short-distance victims. As for the distribution of hemoglobin, anemia with 10g/dl or less was found in 18%, and a white blood cell count of less than 3000 was rather infrequent (12%). Although, according to age, the amount of hemoglobin showed a slight increase in the subjects aged 70 or above, there was no significant difference. Neither of the values showed any particular decrease in relation to exposure diatance. Up to present, however, anemia has not been improved in many of the subjects in whom a mean of more than 10 years has elapsed. In addition to senile anemia, iron deficiency anemia and posthemorrhagic anemia represented most cases. There were 22 cases of hypoplastic anemia, of which three were aplastic. The exposure distance in these three cases was 1.3km, 1.5km, and 2.5km, but its relation to the incidence was not found because of the small number. (Kanao, K.)

  10. Examining the impact of introducing ICD-MM on observed trends in maternal mortality rates in the UK 2003-13.

    Science.gov (United States)

    Knight, Marian; Nair, Manisha; Brocklehurst, Peter; Kenyon, Sara; Neilson, James; Shakespeare, Judy; Tuffnell, Derek; Kurinczuk, Jennifer J

    2016-07-20

    The causes of maternal death are now classified internationally according to ICD-MM. One significant change with the introduction of ICD-MM in 2012 was the reclassification of maternal suicide from the indirect group to the direct group. This has led to concerns about the impact of this reclassification on calculated mortality rates. The aim of this analysis was to examine the trends in maternal deaths in the UK over the past 10 years, and to investigate the impact of reclassification using ICD-MM on the observed rates. Data about all maternal deaths between 2003-13 in the UK were included in this analysis. Data about maternal deaths occurring prior to 2009 were obtained from previously published reports. The deaths of women from 2009-13 during or after pregnancy were identified through the MBRRACE-UK Confidential Enquiry into Maternal Deaths. The underlying causes of maternal death were reclassified from a disease-based system to ICD-MM. Maternal mortality rates with 95 % confidence intervals were calculated using national data on the number of maternities as the denominator. Rate ratios with 95 % CI were calculated to compare the change in rates of maternal death as per ICD-MM relative to the old classification system. There was a decrease in the maternal death rate between 2003-05 and 2011-13 (rate ratio (RR) 0.65; 95 % CI 0.54-0.77 comparing 2003-5 with 2011-13; p = 0.005 for trend over time). The direct maternal death rate calculated using the old classification decreased with a RR of 0.47 (95 % CI 0.34-0.63) when comparing 2011-13 with 2003-05; p = 0.005 for trend over time. Reclassification using ICD-MM made little material difference to the observed trend in direct maternal death rates, RR = 0.51 (95 % CI 0.39-0.68) when comparing 2003-5 with 2011-13; p = 0.005 for trend over time. The impact of reclassifying maternal deaths according to ICD-MM in the UK was minimal. However, such reclassification raises awareness of maternal suicides

  11. Physical activity and depression symptoms among pregnant women from the National Health and Nutrition Examination Survey 2005-2006.

    Science.gov (United States)

    Loprinzi, Paul D; Fitzgerald, Elizabeth M; Cardinal, Bradley J

    2012-03-01

    To examine the association between objectively measured physical activity and depression symptoms among a nationally representative sample of pregnant women to provide a more accurate understanding of the relationship between physical activity and depression symptoms. We employed a cross-sectional study design. Data from the National Health and Nutrition Examination Survey 2005-2006 were used for this study. One-hundred and forty-one pregnant women wore an ActiGraph accelerometer for 7 days and completed the Patient Health Questionnaire-9 to assess depression status. More than 19% of the participants experienced some depression symptoms, and compared to their counterparts not having depression symptoms, they were less physically active. An inverse association was found between physical activity and depression symptoms among pregnant women. When feasible, nurses are encouraged to help facilitate physical activity among pregnant women, assuming an uncomplicated pregnancy. © 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  12. Association between psoriasis and leisure-time physical activity: findings from the National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Do, Young Kyung; Lakhani, Naheed; Malhotra, Rahul; Halstater, Brian; Theng, Colin; Østbye, Truls

    2015-02-01

    Despite evidence that physical activity can reduce the cardiometabolic risk of patients with psoriasis, these patients may engage in less physical activity than those without psoriasis. The aim of this study was to examine the association of the extent of psoriatic skin lesions with the likelihood of participating in leisure-time moderate to vigorous physical activity (MVPA) and metabolic equivalent task (MET)-minutes of MVPA amongst those who participated. The National Health and Nutrition Examination Survey (NHANES) is a population-based survey among U.S. adults. A total of 6549 persons aged 20-59 years responded to the 2003-2006 NHANES dermatology questionnaires, which asked about participation in leisure-time MVPA and MET-minutes of MVPA amongst those who participated. Compared with individuals without psoriasis, those with psoriasis were less likely to have engaged in leisure MVPA in the past 30 days, although this association was not statistically significant. Amongst those who participated in leisure-time MVPA, MET-minutes of leisure-time MVPA were lower on average for patients currently having few to extensive cutaneous lesions (but not for those currently having little or no psoriatic patches), relative to individuals never diagnosed with psoriasis by approximately 30%. Clinicians should encourage patients with psoriasis, especially those with more severe disease, to be more physically active; they should help identify and address possible psychological and physical barriers to their patients' physical activity. © 2014 Japanese Dermatological Association.

  13. A patient dose survey or femoral arteriogram diagnostic radiographic examinations using a dose-area product meter

    International Nuclear Information System (INIS)

    Thwaites, J.H.; Rafferty, M.W.; Gray, N.; Black, J.; Stock, B.

    1996-01-01

    We present a method for dealing with a complex radiographic procedure (which involves multiple radiographs and fluoroscopy) in an attempt to provide a simple way of calculating effective dose from which a general risk factor can be determined. A useful index of harm can be obtained by recording the number of radiographs in each region, and the fluoroscopy time, from which the effective dose may be easily calculated. A patient dose survey was carried out using a PTW diamentor for femoral arteriogram procedures in a large teaching hospital. The procedure involves fluoroscopy to the pelvic region to locate a guide wire and catheter, followed by a series of radiographs extending from the pelvic area to the feet to form a collage image of the entire arterial system. Radiographs are taken whilst a bolus of contrast media is injected into the arterial system. The measurements extend a continuing survey of doses for common diagnostic radiographic examinations which have previously included the simple examinations of lumbar spine, abdomen and pelvis. (Author)

  14. The Association between Food Insecurity and Obesity in Children-The National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Kaur, Jasbir; Lamb, Molly M; Ogden, Cynthia L

    2015-05-01

    Food insecurity can put children at greater risk of obesity because of altered food choices and nonuniform consumption patterns. We examined the association between obesity and both child-level food insecurity and personal food insecurity in US children. Data from 9,701 participants in the National Health and Nutrition Examination Survey, 2001-2010, aged 2 to 11 years were analyzed. Child-level food insecurity was assessed with the US Department of Agriculture's Food Security Survey Module based on eight child-specific questions. Personal food insecurity was assessed with five additional questions. Obesity was defined, using physical measurements, as body mass index (calculated as kg/m²) greater than or equal to the age- and sex-specific 95th percentile of the Centers for Disease Control and Prevention growth charts. Logistic regressions adjusted for sex, race/ethnic group, poverty level, and survey year were conducted to describe associations between obesity and food insecurity. Obesity was significantly associated with personal food insecurity for children aged 6 to 11 years (odds ratio=1.81; 95% CI 1.33 to 2.48), but not in children aged 2 to 5 years (odds ratio=0.88; 95% CI 0.51 to 1.51). Child-level food insecurity was not associated with obesity among 2- to 5-year-olds or 6- to 11-year-olds. Personal food insecurity is associated with an increased risk of obesity only in children aged 6 to 11 years. Personal food-insecurity measures may give different results than aggregate food-insecurity measures in children. Published by Elsevier Inc.

  15. Improving the quality of adult mortality data collected in demographic surveys: validation study of a new siblings' survival questionnaire in Niakhar, Senegal.

    Science.gov (United States)

    Helleringer, Stéphane; Pison, Gilles; Masquelier, Bruno; Kanté, Almamy Malick; Douillot, Laetitia; Duthé, Géraldine; Sokhna, Cheikh; Delaunay, Valérie

    2014-05-01

    In countries with limited vital registration, adult mortality is frequently estimated using siblings' survival histories (SSHs) collected during Demographic and Health Surveys (DHS). These data are affected by reporting errors. We developed a new SSH questionnaire, the siblings' survival calendar (SSC). It incorporates supplementary interviewing techniques to limit omissions of siblings and uses an event history calendar to improve reports of dates and ages. We hypothesized that the SSC would improve the quality of adult mortality data. We conducted a retrospective validation study among the population of the Niakhar Health and Demographic Surveillance System in Senegal. We randomly assigned men and women aged 15-59 y to an interview with either the DHS questionnaire or the SSC. We compared SSHs collected in each group to prospective data on adult mortality collected in Niakhar. The SSC reduced respondents' tendency to round reports of dates and ages to the nearest multiple of five or ten ("heaping"). The SSC also had higher sensitivity in recording adult female deaths: among respondents whose sister(s) had died at an adult age in the past 15 y, 89.6% reported an adult female death during SSC interviews versus 75.6% in DHS interviews (p = 0.027). The specificity of the SSC was similar to that of the DHS questionnaire, i.e., it did not increase the number of false reports of deaths. However, the SSC did not improve the reporting of adult deaths among the brothers of respondents. Study limitations include sample selectivity, limited external validity, and multiple testing. The SSC has the potential to collect more accurate SSHs than the questionnaire used in DHS. Further research is needed to assess the effects of the SSC on estimates of adult mortality rates. Additional validation studies should be conducted in different social and epidemiological settings. Controlled-Trials.com ISRCTN06849961

  16. Improving the Quality of Adult Mortality Data Collected in Demographic Surveys: Validation Study of a New Siblings' Survival Questionnaire in Niakhar, Senegal

    Science.gov (United States)

    Helleringer, Stéphane; Pison, Gilles; Masquelier, Bruno; Kanté, Almamy Malick; Douillot, Laetitia; Duthé, Géraldine; Sokhna, Cheikh; Delaunay, Valérie

    2014-01-01

    Background In countries with limited vital registration, adult mortality is frequently estimated using siblings' survival histories (SSHs) collected during Demographic and Health Surveys (DHS). These data are affected by reporting errors. We developed a new SSH questionnaire, the siblings' survival calendar (SSC). It incorporates supplementary interviewing techniques to limit omissions of siblings and uses an event history calendar to improve reports of dates and ages. We hypothesized that the SSC would improve the quality of adult mortality data. Methods and Findings We conducted a retrospective validation study among the population of the Niakhar Health and Demographic Surveillance System in Senegal. We randomly assigned men and women aged 15–59 y to an interview with either the DHS questionnaire or the SSC. We compared SSHs collected in each group to prospective data on adult mortality collected in Niakhar. The SSC reduced respondents' tendency to round reports of dates and ages to the nearest multiple of five or ten (“heaping”). The SSC also had higher sensitivity in recording adult female deaths: among respondents whose sister(s) had died at an adult age in the past 15 y, 89.6% reported an adult female death during SSC interviews versus 75.6% in DHS interviews (p = 0.027). The specificity of the SSC was similar to that of the DHS questionnaire, i.e., it did not increase the number of false reports of deaths. However, the SSC did not improve the reporting of adult deaths among the brothers of respondents. Study limitations include sample selectivity, limited external validity, and multiple testing. Conclusions The SSC has the potential to collect more accurate SSHs than the questionnaire used in DHS. Further research is needed to assess the effects of the SSC on estimates of adult mortality rates. Additional validation studies should be conducted in different social and epidemiological settings. Trial Registration Controlled-Trials.com ISRCTN06849961

  17. The linear relationship between the Vulnerable Elders Survey-13 score and mortality in an Asian population of community-dwelling older persons.

    Science.gov (United States)

    Wang, Jye; Lin, Wender; Chang, Ling-Hui

    2018-01-01

    The Vulnerable Elders Survey-13 (VES-13) has been used as a screening tool to identify vulnerable community-dwelling older persons for more in-depth assessment and targeted interventions. Although many studies supported its use in different populations, few have addressed Asian populations. The optimal scaling system for the VES-13 in predicting health outcomes also has not been adequately tested. This study (1) assesses the applicability of the VES-13 to predict the mortality of community-dwelling older persons in Taiwan, (2) identifies the best scaling system for the VES-13 in predicting mortality using generalized additive models (GAMs), and (3) determines whether including covariates, such as socio-demographic factors and common geriatric syndromes, improves model fitting. This retrospective longitudinal cohort study analyzed the data of 2184 community-dwelling persons 65 years old or older from the 2003 wave of the national-wide Taiwan Longitudinal Study on Aging. Cox proportional hazards models and Generalized Additive Models (GAMs) were used. The VES-13 significantly predicted the mortality of Taiwan's community-dwelling elders. A one-point increase in the VES-13 score raised the risk of death by 26% (hazard ratio, 1.26; 95% confidence interval, 1.21-1.32). The hazard ratio of death increased linearly with each additional VES-13 score point, suggesting that using a continuous scale is appropriate. Inclusion of socio-demographic factors and geriatric syndromes improved the model-fitting. The VES-13 is appropriate for an Asian population. VES-13 scores linearly predict the mortality of this population. Adjusting the weighting of the physical activity items may improve the performance of the VES-13. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Social vulnerability as a predictor of mortality and disability: cross-country differences in the survey of health, aging, and retirement in Europe (SHARE).

    Science.gov (United States)

    Wallace, Lindsay M K; Theou, Olga; Pena, Fernando; Rockwood, Kenneth; Andrew, Melissa K

    2015-06-01

    Social factors are important for health; the concept of social vulnerability considers them holistically and can be quantified using a social vulnerability index (SVI). Investigate the SVI in relation to mortality and disability, independent of frailty, in middle-aged and older European adults, and examine how this relationship differs across countries. 18,289 community-dwelling participants 50 years and older from SHARE wave 1 (2004) were included in our sample. A 32-item SVI and a 57-item frailty index were calculated for individuals as the proportion of deficits present out of the total number considered. Countries were grouped based on their social model: Nordic (Denmark, Netherlands, Sweden), Continental (France, Austria, Belgium, Germany) and Mediterranean (Greece, Italy, Spain). Outcome measures were 5-year mortality and disability (≥1 dependency with activities of daily living) at wave 4 (2011-2012). High social vulnerability (highest quartile) predicted mortality (HR = 1.25, 95 % CI 1.07-1.45), and disability (OR = 1.36, 95 % CI 1.15-1.62) after controlling for age, sex, baseline disability and frailty level. When analyses were split by social model, social vulnerability remained a significant predictor of mortality for Continental (HR = 1.36, CI 1.05-1.77) and Mediterranean (HR = 1.33, CI 1.03-1.72) countries, but not the Nordic (HR = 1.02, CI 0.76-1.37) countries; the same pattern was observed for disability (Nordic OR = 1.06, CI 0.72-1.55; Continental OR = 1.53, CI 1.20-1.96; Mediterranean OR = 1.58, CI 1.13-2.23). Social vulnerability was a significant predictor of mortality and disability, though when controlling for frailty, this relationship varied by the social model of the country.

  19. Obstetric transition in the World Health Organization Multicountry Survey on Maternal and Newborn Health: exploring pathways for maternal mortality reduction

    Directory of Open Access Journals (Sweden)

    Solange da Cruz Chaves

    2015-05-01

    Full Text Available OBJECTIVE: To test whether the proposed features of the Obstetric Transition Model-a theoretical framework that may explain gradual changes that countries experience as they eliminate avoidable maternal mortality-are observed in a large, multicountry, maternal and perinatal health database; and to discuss the dynamic process of maternal mortality reduction using this model as a theoretical framework. METHODS: This was a secondary analysis of a cross-sectional study by the World Health Organization that collected information on more than 300 000 women who delivered in 359 health facilities in 29 countries in Africa, Asia, Latin America, and the Middle East, during a 2-4-month period in 2010-2011. The ratios of Potentially Life-Threatening Conditions, Severe Maternal Outcomes, Maternal Near Miss, and Maternal Death were estimated and stratified by stages of obstetric transition. The characteristics of each stage are defined. RESULTS: Data from 314 623 women showed that female fertility, indirectly estimated by parity, was higher in countries at a lower obstetric transition stage, ranging from a mean of 3 children in Stage II to 1.8 children in Stage IV. Medicalization increased with obstetric transition stage. In Stage IV, women had 2.4 times the cesarean deliveries (15.3% in Stage II and 36.7% in Stage IV and 2.6 times the labor inductions (7.1% in Stage II and 18.8% in Stage IV as women in Stage II. The mean age of primiparous women also increased with stage. The occurrence of uterine rupture had a decreasing trend, dropping by 5.2 times, from 178 to 34 cases per 100 000 live births, as a country transitioned from Stage II to IV. CONCLUSIONS: This analysis supports the concept of obstetric transition using multicountry data. The Obstetric Transition Model could provide justification for customizing strategies for reducing maternal mortality according to a country's stage in the obstetric transition.

  20. Socioeconomic disparities in secondhand smoke exposure among US never-smoking adults: the National Health and Nutrition Examination Survey 1988-2010.

    Science.gov (United States)

    Gan, Wen Qi; Mannino, David M; Jemal, Ahmedin

    2015-11-01

    Secondhand smoke (SHS) is a leading preventable cause of illness, disability and mortality. There is a lack of quantitative analyses on socioeconomic disparities in SHS; especially, it is not known how socioeconomic disparities have changed in the past two decades in the USA. To examine socioeconomic disparities and long-term temporal trends in SHS exposure among US never-smoking adults aged ≥20 years. 15 376 participants from the National Health and Nutrition Examination Survey (NHANES) 1999-2010 were included in the analysis of socioeconomic disparities; additional 8195 participants from NHANES III 1988-1994 were included in the temporal trend analysis. SHS exposure was assessed using self-reported exposure in the home and workplace as well as using serum cotinine concentrations ≥0.05 ng/mL. Individual socioeconomic status (SES) was assessed using poverty-to-income ratio. During the period 1999-2010, 6% and 14% of participants reported SHS exposure in the home and workplace, respectively; 40% had serum cotinine-indicated SHS exposure. Individual SES was strongly associated with SHS exposure in a dose-response fashion; participants in the lowest SES group were 2-3 times more likely to be exposed to SHS compared with those in the highest SES group. During the period 1988-2010, the prevalence declined over 60% for the three types of SHS exposure. However, for cotinine-indicated exposure, the magnitudes of the declines were smaller for lower SES groups compared with higher SES groups, leading to widening socioeconomic disparities in SHS exposure. SHS exposure is still widespread among US never-smoking adults, and socioeconomic disparities for cotinine-indicated exposure have substantially increased in the past two decades. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  1. Radiation doses to patients in medical diagnostic x-ray examinations in New Zealand: a 1983-84 survey

    International Nuclear Information System (INIS)

    Williamson, B.D.P.; Poletti, J.L.; Cartwright, P.H.; Le Heron, J.C.

    1993-06-01

    A survey of doses to patients undergoing diagnostic x-ray examinations was performed in 1983-84. Developments since 1983-84 were reviewed and estimates made of the frequency of x-ray examinations, and doses to patients, as at 1992. The collective effective dose from general medical diagnostic radiology in 1983-84 was estimated to have been about 443 μSv per capita per annum. The figure excluded computed tomography which was estimated to have contributed about 5.6 μSv per capita per annum and mammography gave 0.3 μSv per annum. The total per capital effective dose from all medical diag over the whole period from 1983-84 to 1992. The highest dose examinations in 1983-84 were the fluoroscopic procedures barium enema and meal. Over the whole period 1983-84 to 1992 the genetically significant dose (GSD) to the population of New Zealand from medical diagnostic radiology was estimated to have been in the range 200-250 μSv per capita per annum. The two opposing tendencies noted for effective dose, viz, the fall in frequency of some examination types and the rise of Computed tomography, acted also upon this dose index. 43 refs., tabs., figs., ills

  2. Diagnostic reference levels for common computed tomography (CT) examinations: results from the first Nigerian nationwide dose survey.

    Science.gov (United States)

    Ekpo, Ernest U; Adejoh, Thomas; Akwo, Judith D; Emeka, Owujekwe C; Modu, Ali A; Abba, Mohammed; Adesina, Kudirat A; Omiyi, David O; Chiegwu, Uche H

    2018-01-29

    To explore doses from common adult computed tomography (CT) examinations and propose national diagnostic reference levels (nDRLs) for Nigeria. This retrospective study was approved by the Nnamdi Azikiwe University and University Teaching Hospital Institutional Review Boards (IRB: NAUTH/CS/66/Vol8/84) and involved dose surveys of adult CT examinations across the six geographical regions of Nigeria and Abuja from January 2016 to August 2017. Dose data of adult head, chest and abdomen/pelvis CT examinations were extracted from patient folders. The median, 75th and 25th percentile CT dose index volume (CTDI vol ) and dose-length-product (DLP) were computed for each of these procedures. Effective doses (E) for these examinations were estimated using the k conversion factor as described in the ICRP publication 103 (E DLP  =  k × DLP ). The proposed 75th percentile CTDI vol for head, chest, and abdomen/pelvis are 61 mGy, 17 mGy, and 20 mGy, respectively. The corresponding DLPs are 1310 mGy.cm, 735 mGy.cm, and 1486 mGy.cm respectively. The effective doses were 2.75 mSv (head), 10.29 mSv (chest), and 22.29 mSv (abdomen/pelvis). Findings demonstrate wide dose variations within and across centres in Nigeria. The results also show CTDI vol comparable to international standards, but considerably higher DLP and effective doses.

  3. Cross-national comparison of sex differences in health and mortality in Denmark, Japan and the US

    DEFF Research Database (Denmark)

    Oksuzyan, Anna; Crimmins, Eileen; Saito, Yasuhiko

    2010-01-01

    The present study aims to compare the direction and magnitude of sex differences in mortality and major health dimensions across Denmark, Japan and the US. The Human Mortality Database was used to examine sex differences in age-specific mortality rates. The Danish twin surveys, the Danish 1905-Co...

  4. Association between Chronic Laryngitis and Particulate Matter Based on the Korea National Health and Nutrition Examination Survey 2008-2012.

    Directory of Open Access Journals (Sweden)

    Young-Hoon Joo

    Full Text Available Chronic laryngitis (CL has been described as chronic inflammation of the larynx. CL have various causes such as long-term smoking, acid reflux, voice overuse, bronchitis, allergies, pneumonia, excessive exposure to toxic chemicals and complications from the flu or a chronic cold. However, the prevalence of CL and role of air pollution in the etiology is uncertain.The aim of this study was to investigate the relationship between CL and particulate matter with aerodynamic diameter less than 10 μm (PM10 in South Korea using data from the Korea National Health and Nutrition Examination Surveys (KNHANES during 2008-2012.KNHANES is a cross-sectional survey of the civilian, non-institutionalized population of South Korea (n = 21,116. A field survey team that included an otolaryngologist moved with a mobile examination unit and performed interviews and physical examinations. The mean annual concentrations of ambient PM10, SO2, O3, NO2, and CO levels in Korea were determined from monitoring station data. Multiple logistic regression was used to examine the relationship of air pollution to CL.Among the population ≥ 19 years of age, the weighted prevalence of CL was 3.37 ± 0.30% (95% confidence interval, 2.79-3.95%. CL was more prevalent in men, current smokers, and those with lower household income and prevalence increased with age. A significant decrease over time was observed in the prevalence of CL (P for trend = 0.0049 and the annual average concentrations of PM10 (P for trend < 0.0001 from 2008 to 2012. In a multivariate model, the factors associated with CL included PM10 (odds ratio [OR], 1.378, p = 0.0457, age (OR, 1.020, p<0.0001, sex (OR, 0.734, p = 0.0179, and smoking status (OR, 1.438, p = 0.0054.Elevated PM10 exposures could be associated with increased risk of CL in South Koreans. Further epidemiological and experimental studies are necessary to clarify the impact of chronic PM10 exposure on CL.

  5. Sitting Time and Obesity or Abdominal Obesity in Older South Koreans: Korean National Health and Nutrition Examination Survey 2013.

    Science.gov (United States)

    Sohn, Minsung; Cho, Kyung-Hwan; Han, Kyung-Do; Choi, Mankyu; Kim, Yang-Hyun

    2017-01-01

    We examined relationships between sitting time and obesity or abdominal obesity according to sex and socioeconomic status in elderly people. We analyzed data from the Korean National Health and Nutrition Examination Survey 2013, and 1565 participants were included in the study. Multivariate logistic regression analysis was used to examine relationships between sitting time and obesity or abdominal obesity according to sex and socioeconomic status. Sitting time was positively correlated with body mass index in men and women and waist circumference in men. When considering socioeconomic factors, men who sat for 5 hours or longer and fell within the lowest income were more likely to have obesity and abdominal obesity relative to men who sat for 5 hours or shorter and earned higher incomes (odds ratio [95% confidence interval] = 1.80 [1.14-2.84] and 1.63 [1.02-2.61] respectively), and women who sat for 5 hours or longer and fell within the lowest educational level were more likely to have obesity relative to women who sat for 5 hours or less and were educated to a higher level (1.24 [1.01-1.85]). Strategies to reduce sedentary behavior would help to prevent obesity in older men who earn low incomes and women with lower levels of educational attainment.

  6. Food Insecurity and Depression Among Adults With Diabetes: Results From the National Health and Nutrition Examination Survey (NHANES).

    Science.gov (United States)

    Montgomery, Joshua; Lu, Juan; Ratliff, Scott; Mezuk, Briana

    2017-06-01

    Purpose While both food insecurity and depression have been linked to risk of type 2 diabetes, little is known about the relationship between food insecurity and depression among adults with diabetes. Research Design and Methods Cross-sectional analyses of the National Health and Nutrition Examination Survey (2011-2014), a nationally representative, population-based survey. Analytic sample was limited to adults aged ≥20 with diabetes determined by either fasting plasma glucose (≥126 mg/dL) or self-report (n = 1724) and adults age ≥20 with prediabetes determined by fasting plasma glucose (100-125 mg/dL) or self-report (n = 2004). Food insecurity was measured using the US Food Security Survey Module. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9). Logistic regression was used to assess the relationship between food insecurity and depression while accounting for sociodemographic characteristics and health behaviors. Results Approximately 10% of individuals with diabetes and 8.5% of individuals with prediabetes had severe food insecurity in the past year; an additional 20.3% of individuals with diabetes and 14.3% of those with prediabetes had mild food insecurity. Among individuals with diabetes, both mild and severe food insecurity were associated with elevated odds of depression These relationships were similar in magnitude among individuals with prediabetes. Conclusions Food insecurity is significantly associated with depressive symptoms in people with diabetes and prediabetes. Results point to the need to address economic issues in conjunction with psychosocial issues for comprehensive diabetes care.

  7. A National Survey Examining Manuscript Dissertation Formats Among Nursing PhD Programs in the United States.

    Science.gov (United States)

    Graves, Janessa M; Postma, Julie; Katz, Janet R; Kehoe, Leanne; Swalling, Eileen; Barbosa-Leiker, Celestina

    2018-03-08

    Among research-focused nursing doctoral (PhD) programs in the United States, the traditional dissertation format has recently given way to a series of publication-ready manuscripts, often bookended by introduction and conclusion chapters. To help programs make decisions about the use of these formats, this study undertook a national survey of programs offering PhDs in nursing. The purpose of this study was to explore the advantages and disadvantages of the traditional format versus manuscript option for dissertations among nursing PhD programs in the United States. Cross-sectional census survey of U.S. nursing PhD programs. A web-based survey was administered to all U.S. nursing PhD programs. Respondents indicated formats offered, factors contributing to decisions of which formats to offer, and lessons learned. Descriptive statistics and inductive content analyses were used for analysis. Of 121 eligible institutions, 79 provided eligible responses (66.7%). The majority (59%) offered both formats; 11% offered the manuscript option only, and 24% offered the traditional format only. Faculty support (or lack thereof) contributed to adoption (or not) of the manuscript option. Respondents' approaches to the manuscript option (e.g., number of papers) and advice are summarized. Manuscript option dissertations are commonly offered and provide benefits to students and faculty; however, thoughtful implementation is critical. Programs need to agree upon clear expectations and have graduate school support (e.g., formatting). Faculty need mentorship in advising manuscript option students who choose to use this format, and the time and support. Finally, students need additional writing skills that could be provided through coursework or via individual work with mentors. As nursing education continues to expand further into doctoral research, programs must examine dissertation formats in order to both prepare future nurse scholars and disseminate nursing research that is critical

  8. Hypertension Among US Adults by Disability Status and Type, National Health and Nutrition Examination Survey, 2001–2010

    Science.gov (United States)

    Courtney-Long, Elizabeth; Gillespie, Cathleen; Armour, Brian S.

    2014-01-01

    The prevalence of hypertension among people with disabilities is not well understood. We combined data from the 2001–2010 National Health and Nutrition Examination Survey to obtain estimates of hypertension prevalence by disability status and type (cognitive, hearing, vision, or mobility limitation) and assess the association between disability and hypertension. Overall, 34% of adults with disabilities had hypertension compared with 27% of adults without disabilities; adults with mobility limitations were more likely to have hypertension than adults without disabilities (adjusted prevalence ratio: 1.23; 95% confidence interval: 1.16–1.32). Our results suggest that adults living with disabilities are an important subpopulation to include in hypertension reporting and intervention efforts. PMID:25121351

  9. Hypertension among US adults by disability status and type, National Health and Nutrition Examination Survey, 2001-2010.

    Science.gov (United States)

    Stevens, Alissa; Courtney-Long, Elizabeth; Gillespie, Cathleen; Armour, Brian S

    2014-08-14

    The prevalence of hypertension among people with disabilities is not well understood. We combined data from the 2001-2010 National Health and Nutrition Examination Survey to obtain estimates of hypertension prevalence by disability status and type (cognitive, hearing, vision, or mobility limitation) and assess the association between disability and hypertension. Overall, 34% of adults with disabilities had hypertension compared with 27% of adults without disabilities; adults with mobility limitations were more likely to have hypertension than adults without disabilities (adjusted prevalence ratio: 1.23; 95% confidence interval: 1.16-1.32). Our results suggest that adults living with disabilities are an important subpopulation to include in hypertension reporting and intervention efforts.

  10. Serum Lipid Levels in Relation to Consumption of Yogurt: The 2012 Korea National Health and Nutrition Examination Survey

    Science.gov (United States)

    Seo, Bong-Kyung; Kim, Nam-Eun; Park, Kyong-Min; Park, Kye-Yeung; Park, Hoon-Ki

    2017-01-01

    Background The purpose of this study was to evaluate serum lipid levels in Korean adults after consumption of different types of yogurt. Methods Study subjects were 3,038 individuals (≥19 years of age) who participated in the 2012 Korean National Health and Nutrition Examination Survey. Yogurt intake was assessed with a food frequency questionnaire by using the 24-hour recall method. We conducted complex samples general linear analysis with adjustment for covariates. Results The serum triglyceride levels in the group consuming viscous yogurt were lower than those in the group consuming non-viscous yogurt. Conclusion Consumption of viscous yogurt is associated with low serum triglyceride levels in Korean adults. PMID:29026484

  11. Examining Agencies' Satisfaction with Electronic Record Management Systems in e-Government: A Large-Scale Survey Study

    Science.gov (United States)

    Hsu, Fang-Ming; Hu, Paul Jen-Hwa; Chen, Hsinchun; Hu, Han-Fen

    While e-government is propelling and maturing steadily, advanced technological capabilities alone cannot guarantee agencies’ realizing the full benefits of the enabling computer-based systems. This study analyzes information systems in e-government settings by examining agencies’ satisfaction with an electronic record management system (ERMS). Specifically, we investigate key satisfaction determinants that include regulatory compliance, job relevance, and satisfaction with support services for using the ERMS. We test our model and the hypotheses in it, using a large-scale survey that involves a total of 1,652 government agencies in Taiwan. Our results show significant effects of regulatory compliance on job relevance and satisfaction with support services, which in turn determine government agencies’ satisfaction with an ERMS. Our data exhibit a reasonably good fit to our model, which can explain a significant portion of the variance in agencies’ satisfaction with an ERMS. Our findings have several important implications to research and practice, which are also discussed.

  12. Risk of mental health problems in adolescents skipping meals: The Korean National Health and Nutrition Examination Survey 2010 to 2012.

    Science.gov (United States)

    Lee, Gyungjoo; Han, Kyungdo; Kim, Hyunju

    Adolescents frequently skip meals, doing so even more than once per day. This is associated with more mental health problems. This study identified mental health problems' associations with skipping meals and the frequency thereof among adolescents. This cross-sectional population-based study used a data set of 1,413 adolescents from the 2010 to 2012 Korean National Health and Nutrition Examination Survey. Hierarchical multivariable logistic regression was conducted to determine the risk of mental health problems, including stress, depressive mood, and suicidal ideation in relation to skipping meals and the frequency thereof per day. Breakfast skipping significantly increased the risks of stress and depressive mood. Stress, depressive mood, and suicidal ideation were significantly prevalent as the daily frequency of skipping meals increased. Specific strategies should be developed at government or school level to decrease the frequency of skipping meals per day, associated with serious mental health problems in adolescents. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Mortality and ST resolution in patients admitted with STEMI: the MOMI survey of emergency service experience in a complex urban area.

    Science.gov (United States)

    Grieco, Niccolò; Sesana, Giovanni; Corrada, Elena; Ieva, Francesca; Paganoni, Annamaria; Marzegalli, Maurizio

    2012-09-01

    Since 2001, the urban area of Milan has been operating a network among 23 cardiac care units, the 118 dispatch centre (national free number for medical emergencies), and the county government health agency called Group for Prehospital Cardiac Emergency. In order to monitor the network activity, time to treatment, and clinical outcome, a periodic survey, called MOMI(2), was repeated two or three times a year. Each survey lasted 30 days and was repeated in comparable periods. Data were stratified for hospital admission mode. We collected data concerning 708 consecutive ST-elevation myocardial infarction (STEMI) patients (male 72.6%; mean age 64.4 years). In these six surveys, we observed a high rate of primary percutaneous coronary intervention (73.2%) and a mortality rate of 6.3%. Using advanced statistical models, we identified age, Killip class, and the symptom onset-to-balloon time as most relevant prognostic factors. Nonparametric test showed that the modality of hospital admittance was the most critical determinant of door-to-balloon time. 12-lead ECG tele-transmission and activation of a fast track directly to the catheterization laboratory are easy action to reduce time to treatment. The experience of the Milan network for cardiac emergency shows how a network coordinating the community, rescue units, and hospitals in a complex urban area and making use of medical technology contributes to the health care of patients with STEMI.

  14. Partners in immunization: 2010 survey examining differences among H1N1 vaccine providers in Washington state.

    Science.gov (United States)

    Seib, Katherine; Gleason, Cindy; Richards, Jennifer L; Chamberlain, Allison; Andrews, Tracey; Watson, Lin; Whitney, Ellen; Hinman, Alan R; Omer, Saad B

    2013-01-01

    Emergency response involving mass vaccination requires the involvement of traditional vaccine providers as well as other health-care providers, including pharmacists, obstetricians, and health-care providers at correctional facilities. We explored differences in provider experiences administering pandemic vaccine during a public health emergency. We conducted a cross-sectional survey of H1N1 vaccine providers in Washington State, examining topics regarding pandemic vaccine administration, participation in preparedness activities, and communication with public health agencies. We also examined differences among provider types in responses received (n=619, 80.9% response rate). Compared with other types of vaccine providers (e.g., family practitioners, obstetricians, and specialists), pharmacists reported higher patient volumes as well as higher patient-to-practitioner ratios, indicating a broad capacity for community reach. Pharmacists and correctional health-care providers reported lower staff coverage with seasonal and H1N1 vaccines. Compared with other vaccine providers, pharmacists were also more likely to report relying on public health information from federal sources. They were less likely to report relying on local health departments (LHDs) for pandemic-related information, but indicated a desire to be included in LHD communications and plans. While all provider types indicated a high willingness to respond to a public health emergency, pharmacists were less likely to have participated in training, actual emergency response, or surge capacity initiatives. No obstetricians reported participating in surge capacity initiatives. Results from this survey suggest that efforts to increase communication and interaction between public health agencies and pharmacy, obstetric, and correctional health-care vaccine providers may improve future preparedness and emergency response capability and reach.

  15. Use of the National Board of Medical Examiners® Comprehensive Basic Science Exam: survey results of US medical schools.

    Science.gov (United States)

    Wright, William S; Baston, Kirk

    2017-01-01

    The National Board of Medical Examiners ® (NBME) Comprehensive Basic Science Exam (CBSE) is a subject exam offered to US medical schools, where it has been used for external validation of student preparedness for the United States Medical Licensing Examination ® (USMLE) Step 1 in new schools and schools undergoing curricular reform. Information regarding the actual use of the NBME CBSE is limited. Therefore, the aim of the survey was to determine the scope and utilization of the NBME CBSE by US medical schools. A survey was sent in May 2016 to curriculum leadership of the 139 US medical schools listed on the Liaison Committee on Medical Education (LCME ® ) website with provisional or full accreditation as of February 29, 2016. Responses were received from 53 schools (38% response rate). A series of different follow-up questions were asked if respondents stated "yes" or "no" to the initial question "Does your institution administer the NBME CBSE prior to the USMLE Step 1?". A total of 37 schools (70%) administered the NBME CBSE. In all, 36 of the 37 schools responded to follow-up questions. Of 36 schools, 13 schools (36%) used the NBME CBSE for curriculum modification. Six schools (17%) used the NBME CBSE for formative assessment for a course, and five schools (14%) used the NBME CBSE for summative assessment for a course. A total of 28 schools (78%) used the NBME CBSE for identifying students performing below expectations and providing targeted intervention strategies. In all, 24 schools (67%) of the 36 responding schools administering the NBME CBSE administered the test once prior to the administration of the USMLE Step 1, whereas 10 (28%) schools administered the NBME CBSE two or more times prior to the administration of the USMLE Step 1. Our data suggest that the NBME CBSE is administered by many US medical schools. However, the objective, timing, and number of exams administered vary greatly among schools.

  16. Family Consumer Behaviors, Adolescent Prediabetes and Diabetes in the National Health and Nutrition Examination Survey (2007-2010).

    Science.gov (United States)

    Nagarajan, Sairaman; Khokhar, Aditi; Holmes, Danielle Sweetnam; Chandwani, Sheenu

    2017-01-01

    Prediabetes or diabetes (characterized by hemoglobin A1c [HbA1c] levels ≥ 5.7 gm%) has been associated with numerous long-term complications. Family consumer behaviors are important risk factors that lead to impaired glucose tolerance or diabetes. However, few studies have studied the association between the family consumer environment and prediabetes and diabetes in adolescents. The aim of this study was to examine the association between family consumer behaviors (healthy food availability and supermarket spending) and adolescent prediabetes and diabetes (ClinicalTrials.gov identifier #NCT03136289.) Methods: Data from a nationwide survey conducted by the Centers for Disease Control and Prevention (National Health and Nutrition Examination Survey [NHANES] 2007-2010 data) were used for these analyses. Adolescents aged 12-19 years were selected for this study. Bivariate analyses and logistic regression models assessed the relationship between family consumer behaviors and the prevalence of adolescent prediabetes and diabetes. Multivariable models adjusted for age, gender, ethnicity, physical activity, education, income, and household size. A total of 2520 adolescents were eligible for this study. Adolescents with healthier household food availability had negative odds (odds ratio [OR] = 0.74, 95% confidence interval [CI], 0.55-1.00), as did higher log supermarket spending (OR = 0.69; 95% CI, 0.57-0.85). Interaction models demonstrated that adolescent females had more negative odds of prediabetes/diabetes for both healthier food availability (OR = 0.79, 95% CI, 0.39-1.29) and for greater log supermarket spending (OR = 0.69, 95% CI, 0.57-0.85). This study shows that both healthy food availability and an increase in supermarket spending were associated with a decreased adjusted prevalence of prediabetes and diabetes in adolescents, with a greater effect in females. These results suggest the need for policy and dietary interventions targeting the consumer

  17. Use of the National Board of Medical Examiners® Comprehensive Basic Science Exam: survey results of US medical schools

    Directory of Open Access Journals (Sweden)

    Wright WS

    2017-06-01

    Full Text Available William S Wright,1 Kirk Baston2 1Department of Biomedical Sciences, 2Department of Pathology, University of South Carolina School of Medicine Greenville, Greenville, SC, USA Purpose: The National Board of Medical Examiners® (NBME Comprehensive Basic Science Exam (CBSE is a subject exam offered to US medical schools, where it has been used for external validation of student preparedness for the United States Medical Licensing Examination® (USMLE Step 1 in new schools and schools undergoing curricular reform. Information regarding the actual use of the NBME CBSE is limited. Therefore, the aim of the survey was to determine the scope and utilization of the NBME CBSE by US medical schools.Methods: A survey was sent in May 2016 to curriculum leadership of the 139 US medical schools listed on the Liaison Committee on Medical Education (LCME® website with provisional or full accreditation as of February 29, 2016. Responses were received from 53 schools (38% response rate. A series of different follow-up questions were asked if respondents stated “yes” or “no” to the initial question “Does your institution administer the NBME CBSE prior to the USMLE Step 1?”.Results: A total of 37 schools (70% administered the NBME CBSE. In all, 36 of the 37 schools responded to follow-up questions. Of 36 schools, 13 schools (36% used the NBME CBSE for curriculum modification. Six schools (17% used the NBME CBSE for formative assessment for a course, and five schools (14% used the NBME CBSE for summative assessment for a course. A total of 28 schools (78% used the NBME CBSE for identifying students performing below expectations and providing targeted intervention strategies. In all, 24 schools (67% of the 36 responding schools administering the NBME CBSE administered the test once prior to the administration of the USMLE Step 1, whereas 10 (28% schools administered the NBME CBSE two or more times prior to the administration of the USMLE Step 1.Conclusion

  18. Livestock Ownership Among Rural Households and Child Morbidity and Mortality: An Analysis of Demographic Health Survey Data from 30 Sub-Saharan African Countries (2005-2015).

    Science.gov (United States)

    Kaur, Maneet; Graham, Jay P; Eisenberg, Joseph N S

    2017-03-01

    AbstractChildren living in homes with livestock may have both an increased risk of enteric infections and improved access to food, and therefore improved nutritional status. Few studies, however, have characterized these relationships in tandem. This study investigated the association between child health and household ownership of livestock. A cross-sectional study was performed using data from Demographic and Health Surveys conducted in 30 sub-Saharan African countries with 215,971 rural children under 5 years of age from 2005 to 2015. Logistic regression was performed for each country to estimate the relationship between a log 2 increase in the number of livestock owned by the household and three child-health outcomes: 2-week prevalence of diarrhea, stunting, and all-cause mortality. Results for each country were combined using meta-analyses. Most countries (22 of 30) displayed an odds ratio (OR) less than 1 for child stunting associated with livestock (pooled OR = 0.97; 95% confidence interval [CI] = 0.95, 0.99). The results for diarrhea were more even with 14 countries displaying ORs greater than 1 and 10 displaying ORs less than 1. Most countries (22 of 30) displayed an OR greater than 1 for child mortality (pooled OR = 1.04; 95% CI = 1.02, 1.06). All meta-analyses displayed significant heterogeneity by country. Our analysis is consistent with the theory that livestock may have a dual role as protective against stunting, an indicator of chronic malnutrition, and a risk factor for all-cause mortality in children, which may be linked to acute infections. The heterogeneity by country, however, indicates more data are needed on specific household livestock management practices.

  19. Sedentary behavior and residual-specific mortality

    OpenAIRE

    Paul D. Loprinzi; Meghan K. Edwards; Eveleen Sng; Ovuokerie Addoh

    2016-01-01

    Background: The purpose of this study was to examine the association of accelerometer-assessed sedentary behavior and residual-specific mortality. Methods: Data from the 2003-2006 National Health and Nutrition Examination Survey (NHANES) were used (N = 5536), with follow-up through 2011. Sedentary behavior was objectively measured over 7 days via accelerometry. Results: When expressing sedentary behavior as a 60 min/day increase, the hazard ratio across the models ranged from 1.07-1.40 (P < 0...

  20. Class relations and all-cause mortality: a test of Wright's social class scheme using the Barcelona 2000 Health Interview Survey.

    Science.gov (United States)

    Muntaner, Carles; Borrell, Carme; Solà, Judit; Marí-Dell'Olmo, Marc; Chung, Haejoo; Rodríguez-Sanz, Maica; Benach, Joan; Rocha, Kátia B; Ng, Edwin

    2011-01-01

    The aim of this study is to test the effects of neo-Marxian social class and potential mediators such as labor market position, work organization, material deprivation, and health behaviors on all-cause mortality. The authors use longitudinal data from the Barcelona 2000 Health Interview Survey (N=7526), with follow-up interviews through the municipal census in 2008 (95.97% response rate). Using data on relations of property, organizational power, and education, the study groups social classes according to Wright's scheme: capitalists, petit bourgeoisie, managers, supervisors, and skilled, semi-skilled, and unskilled workers. Findings indicate that social class, measured as relations of control over productive assets, is an important predictor of mortality among working-class men but not women. Workers (hazard ratio = 1.60; 95% confidence interval, 1.10-2.35) but also managers and small employers had a higher risk of death compared with capitalists. The extensive use of conventional gradient measures of social stratification has neglected sociological measures of social class conceptualized as relations of control over productive assets. This concept is capable of explaining how social inequalities are generated. To confirm the protective effect of the capitalist class position and the "contradictory class location hypothesis," additional efforts are needed to properly measure class among low-level supervisors, capitalists, managers, and small employers.

  1. Teaching musculoskeletal examination skills to UK medical students: a comparative survey of Rheumatology and Orthopaedic education practice.

    Science.gov (United States)

    Blake, Tim

    2014-03-28

    Specialists in Rheumatology and Orthopaedics are frequently involved in undergraduate teaching of musculoskeletal (MSK) examination skills. Students often report that specialty-led teaching is inconsistent, confusing and bears little resemblance to the curricula. The Gait, Arms, Legs and Spine (GALS) is a MSK screening tool that provides a standardised approach to examination despite it being fraught with disapproval and low uptake. Recent studies would appear to support innovative instructional methods of engaging learners such as patient educators and interactive small group teaching. This comparative cross-sectional survey evaluates the current state of undergraduate teaching in Rheumatology and Orthopaedics, including preferred teaching methods, attitudes towards GALS, and barriers to effective teaching. An electronic questionnaire was sent to specialist trainees and Consultants in the East and West Midlands region, representing 5 UK medical schools. Descriptive statistical data analysis was performed. There were 76 respondents representing 5 medical schools. There was a request for newer teaching methodologies to be used: multi-media computer-assisted learning (35.5%), audio-visual aids (31.6%), role-playing (19.7%), and social media (3.9%). It is evident that GALS is under-utilised with 50% of clinicians not using GALS in their teaching. There is a genuine desire for clinical educators to improve their teaching ability, collaborate more with curriculum planners, and feel valued by institutions. There remains a call for implementing a standardised approach to MSK clinical teaching to supersede GALS.

  2. Associations Between Periodontitis and Chronic Obstructive Pulmonary Disease: The 2010 to 2012 Korean National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Chung, Jae Ho; Hwang, Hee-Jin; Kim, Sun-Hyun; Kim, Tae Ho

    2016-08-01

    The aim of this study is to examine whether oral hygiene and self-care, particularly in periodontal health, are associated with chronic obstructive pulmonary disease (COPD) in the Korean population. Data from the Korean National Health and Nutrition Examination Survey from 2010 to 2012 were used to assess the community periodontal index (CPI) of 5,878 participants (normal lung function: n = 5,181; obstructive spirometric pattern: n = 697) aged ≥40 years, who underwent spirometry. Participants with COPD brushed their teeth less frequently and used the following less frequently: 1) dental floss and/or interdental brush; 2) mouthwash; and 3) electric toothbrush (P periodontitis in patients with COPD (58.1%) was significantly higher than in those without COPD (34.0%, P periodontal severity. Periodontitis (CPI 3 and 4) was associated in males with COPD after adjustment for: 1) age; 2) income; 3) education; 4) smoking; 5) alcohol consumption; 6) exercise; 7) body mass index; 8) toothbrushing frequency; 9) diabetes mellitus; and 10) number of teeth (CPI 3: relative risk [RR] = 1.38, 95% confidence interval [CI] = 1.12 to 2.05; CPI 4: RR = 1.23, 95% CI = 1.06 to 1.56). Findings of this cross-sectional study suggest that COPD in males may be associated with severe periodontitis and indicates the importance of promoting dental care in patients with COPD.

  3. Prevalence of Diabetes and Relationship with Socioeconomic Status in the Thai Population: National Health Examination Survey, 2004–2014

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    Wichai Aekplakorn

    2018-01-01

    Full Text Available Objective. To determine the prevalence and trend of diabetes, related glycemic control, and influential socioeconomic (SES factors in the Thai population aged ≥20 years during 2004–2014. Methods. Data from the Thai National Health Examination Survey 2004, 2009, and 2014 were used. Age-adjusted prevalence was calculated, and the associations of education levels with prevalence of diabetes and glycemic control were examined using logistic regression. Results. Age-adjusted prevalence of diabetes increased from 7.7% in 2004 to 7.8% in 2009 and 9.9% in 2014 (8.9% among men and 10.8% among women. Proportions of undiagnosed diabetes were slightly decreased but remained high in 2014 (51.2% for men and 41.3% for women. Diabetes prevalence was higher among those with primary education in both sexes; however, undiagnosed diabetes was higher among women with secondary and university educations. The percentages of those treated and controlled slightly improved among men (45.9% but not among women (36.4%. Unmet glycemic control was also higher among women with secondary education levels and among men with university-level educations. Conclusions. Epidemic diabetes continues to grow in the Thai population, particularly in individuals with lower educational attainment. Measures to detect new cases and strengthen glycemic control should be scaled up.

  4. Diabetes, Triglyceride Levels, and Other Risk Factors for Glaucoma in the National Health and Nutrition Examination Survey 2005-2008.

    Science.gov (United States)

    Ko, Fang; Boland, Michael V; Gupta, Priya; Gadkaree, Shekhar K; Vitale, Susan; Guallar, Eliseo; Zhao, Di; Friedman, David S

    2016-04-01

    To determine risk factors for glaucoma in a population-based study in the United States. Participants age 40 and older from the National Health and Nutrition Examination Survey underwent questionnaires, physical examination, laboratory tests, and vision tests including fundus imaging. Glaucoma was determined based on expert grading of fundus photographs. Regression modeling of glaucoma risk factors was performed. Participants with glaucoma (172) were older (mean age 68.1 [95% confidence interval (CI) 65.6-70.7] vs. 56.4 years [95% CI 55.6-57.2, P glucose, insulin dependence, body mass index, cholesterol levels, diastolic hypertension, systolic hypotension, obstructive sleep apnea, and marijuana were not associated with glaucoma. Multivariable modeling showed associations between glaucoma and older age (odds ratio [OR] 1.09 per year, 95% CI 1.04-1.14), black race (OR 4.40, 95% CI 1.71-11.30), and poverty (OR 3.39, 95% CI 1.73-6.66). Diabetes was no longer associated with glaucoma after adjustment for triglyceride levels. Sex, education, insurance status, body mass index, blood pressure, obstructive sleep apnea, and smoking were not associated with glaucoma. People who are older, of black race, and with lower income levels have a higher prevalence of glaucoma. A novel association between diabetes, triglyceride levels, and glaucoma is also identified.

  5. Relationship between dietary quality, tinnitus and hearing level: data from the national health and nutrition examination survey, 1999-2002.

    Science.gov (United States)

    Spankovich, Christopher; Bishop, Charles; Johnson, Mary Frances; Elkins, Alex; Su, Dan; Lobarinas, Edward; Le Prell, Colleen G

    2017-10-01

    To examine the relationship between the healthy eating index (HEI), a measure of dietary quality based on United States Department of Agriculture recommendations and report of tinnitus. This cross-sectional analysis was based on HEI data and report of tinnitus. Data for adults between 20 and 69 years of age were drawn from the National Health and Nutrition Examination Survey (NHANES), 1999-2002. The NHANES is a programme of studies, to assess the health and nutritional status of adults and children in the United States. Two thousand one hundred and seventy-six participants were included in the analytic sample. Of the sample, 21.1% reported tinnitus within the past year and 11.7% reported persistent tinnitus, defined as tinnitus experienced at least monthly or greater. Controlling for age, sex, race/ethnicity, diabetes, noise exposure and smoking status, we found that with healthier diet (poorer vs. better HEI) there was decreased odds of reported persistent tinnitus [odds ratio (OR); 0.67; 95% confidence interval (CI) 0.45-0.98; p = 0.03]. The current findings support a possible relationship between healthier diet quality and reported persistent tinnitus.

  6. Relationship between socioeconomic status and type 2 diabetes: results from Korea National Health and Nutrition Examination Survey (KNHANES) 2010–2012

    OpenAIRE

    Hwang, Jongnam; Shon, Changwoo

    2014-01-01

    Objective To examine the relationship between socioeconomic status (SES) and type 2 diabetes using the Korea National Health and Nutrition Examination Survey (KNHANES) 2010–2012. Design A pooled sample cross-sectional study. Setting A nationally representative population survey data. Participants A total of 14 330 individuals who participated in the KNHANES 2010–2012 were included in our analysis. Primary outcome Prevalence of type 2 diabetes. Results The relationship between SES and type 2 d...

  7. Clinical survey of blood dyscrasias among Hiroshima A-bomb survivors by the periodical health examination, (3)

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    Taketomi, Y; Abe, T; Kamada, N; Kuramoto, A; Takahashi, H [Hiroshima Univ. (Japan). Research Inst. for Nuclear Medicine and Biology

    1978-04-01

    The actual condition of polycythemia in atomic bomb survivors was evaluated laying stress on the results of general clinical examinations in Hiroshima A-bomb Survivors Health Control Clinic in 1973. Of 40,410 subjects examined in 1973 (male 15,390; female 25,020), 218 males and 220 females, 438 in total, excluding the patients with cardiopulmonary diseases, satisfied the criteria for polycythemia that males show higher values over 17.1 g/dl of Hb and 51.5% of Ht and females over 15.2 g/dl of Hb and 46.0% of Ht. The incidence of this disease was higher in younger males but it increased with age in females. However, there was no correlationship between the incidence of this disease and the distance from the epicenter. Further, 10 males and 8 females, 18 in total, of these patients satisfied the Komiya's criteria for polycythemia (RBC 6,000,000, Ht 50% in males, and RBC 5,500,000, Ht>50% in females) in 1973 or before, and one of them was diagnosed as polycythemia vera by the present examination (1977). This survey was made on 40,410 subjects, one of which was diagnosed as polycythemia vera. Because of a lower incidence of polycythemia than that of leukemia, it was difficult to give an accurate diagnosis and it was also hard to evaluate the incidence of this disease in atomic bomb survivors comparing with that in healthy people. It is therefore required to pile up the data year after year. In various blood diseases such as chronic myelogenic leukemia and acute leukemia, the foregoing state of myeloid proliferation was sometimes observed preceding the onset of these blood diseases. Therefore, the 18 cases at least which satisfied the Komiya's criteria should be followed up carefully.

  8. Obesity as a Potential Risk Factor for Blepharoptosis: The Korea National Health and Nutrition Examination Survey 2008-2010.

    Directory of Open Access Journals (Sweden)

    Ji-Sun Paik

    Full Text Available To examine obesity parameters as potential risk factors associated with blepharoptosis in a representative Korean population.We analyzed the Korea National Health and Nutrition Examination Survey (KNHANES, conducted between 2008 and 2010. 10,285 Korean adults (4,441 men and 5,844 women aged 40 years or older was enrolled. We compared body mass index (BMI, waist circumference (WC and percentage body fat (BF, according to the severity of blepharoptosis. Multiple logistic regression analysis was conducted to examine the associations of each obesity parameter with blepharoptosis.The overall prevalence of age-related blepharoptosis was 14.8 % in South Korea. There were significant and graded associations between increasing blepharoptosis severity and the mean value of obesity parameters (P for trend < 0.05. As marginal reflex distance 1 (MRD1 decreased, the prevalence of general obesity and overweight status increased (P for trend=0.121 in men and < 0.001 in women; the prevalence of abdominal obesity increased (P for trend < 0.001 for both genders; the prevalence of highest quartile of percentage BF increased (P for trend ≤0.001 for both genders. Blepharoptosis was significantly associated with general obesity in women (adjusted odds ratio (aOR, 2.14; 95% confidence intervals (CI, 1.32-3.47; and with the highest quartile of percentage BF in men (aOR, 2.01; 95% CI, 1.34-2.97 and in women (aOR, 1.52; 95% CI, 1.06-2.3317, after adjusting for age, smoking exercise, drinking alcohol, total energy intake, fat intake, total cholesterol, and high density lipoprotein cholesterol, diabetes, hypertension, and family history of eye disease.The etiology of age-related blepharoptosis may be multifactorial and is unclear. Our results suggest that obesity parameters such as BMI, WC and percentage BF might be potential risk factors for age-related blepharoptosis in a representative Korean population.

  9. Clinical survey of blood dyscrasias among Hiroshima A-bomb survivors by the periodical health examination, (3)

    International Nuclear Information System (INIS)

    Taketomi, Yoshinori; Abe, Tsutomu; Kamada, Nanao; Kuramoto, Atsushi; Takahashi, Hiroshi

    1978-01-01

    The actual condition of polycythemia in atomic bomb survivors was evaluated laying stress on the results of general clinical examinations in Hiroshima A-bomb Survivors Health Control Clinic in 1973. Of 40,410 subjects examined in 1973 (male 15,390; female 25,020), 218 males and 220 females, 438 in total, excluding the patients with cardiopulmonary diseases, satisfied the criteria for polycythemia that males show higher values over 17.1 g/dl of Hb and 51.5% of Ht and females over 15.2 g/dl of Hb and 46.0% of Ht. The incidence of this disease was higher in younger males but it increased with age in females. However, there was no correlationship between the incidence of this disease and the distance from the epicenter. Further, 10 males and 8 females, 18 in total, of these patients satisfied the Komiya's criteria for polycythemia (RBC 6,000,000, Ht 50% in males, and RBC 5,500,000, Ht>50% in females) in 1973 or before, and one of them was diagnosed as polycythemia vera by the present examination (1977). This survey was made on 40,410 subjects, one of which was diagnosed as polycythemia vera. Because of a lower incidence of polycythemia than that of leukemia, it was difficult to give an accurate diagnosis and it was also hard to evaluate the incidence of this disease in atomic bomb survivors comparing with that in healthy people. It is therefore required to pile up the data year after year. In various blood diseases such as chronic myelogenic leukemia and acute leukemia, the foregoing state of myeloid proliferation was sometimes observed preceding the onset of these blood diseases. Therefore, the 18 cases at least which satisfied the Komiya's criteria should be followed up carefully. (Ueda, J.)

  10. Ethnic differences in the nutrient intake adequacy of premenopausal US women: results from the Third National Health Examination Survey.

    Science.gov (United States)

    Arab, Lenore; Carriquiry, Alicia; Steck-Scott, Susan; Gaudet, Mia M

    2003-08-01

    To examine the adequacy of dietary intake of calcium; folate; and vitamins C, D, E, B-6, and B-12 in premenopausal US women of differing ethnicity. Analyses of single and duplicate 24-hour recalls were conducted to determine dietary intake during the Third National Health and Nutrition Examination Survey. Three thousand five hundred eighty-five randomly selected women aged 20 to 50 years from across the United States who were not pregnant or lactating were examined between 1988 and 1994. Usual nutrient intake distributions were estimated using the Iowa State University method for adjustment of the distribution. The Estimated Average Requirement cut-point method was used to determine the proportion of women with inadequate intake for each nutrient in each ethnic group. More than 75% of women irrespective of ethnic group had usual intakes of calcium lower than the new Adequate Intake. More than 90% of the women had inadequate intakes of folate and vitamin E from food sources alone. More than half of smokers had inadequate intakes of vitamin C. Intakes of vitamins B-6 and B-12 were low in less than 10% of these women. This article provides evidence that a high proportion of premenopausal US women are underconsuming a variety of nutrients. Dietary intakes alone are not currently adequate to meet the new recommended intakes. Nutritional supplement use is widespread and effective, but does not eliminate the concerns for at-risk populations. Awareness of the general inadequacies in intakes of vitamin E and folic acid at large, and in many women vitamin C as well, can help direct individual dietary recommendations and place the emphasis in group counseling on nutrients that are of widespread concern. In addition, foods rich in vitamins B-6 and of general nutritional benefit should be emphasized among African American women in the United States as a substantial proportion of this group is still showing inadequate intakes from foods.

  11. Cognitive impairment and mortality among nonagenarians

    DEFF Research Database (Denmark)

    Andersen, Kjeld; Nybo, Hanne; Gaist, David

    2002-01-01

    Cognitive impairment has been associated with increased mortality. Most studies, however, have only included small numbers, if at all, of the very old. In a large nationwide survey of all Danes born in 1905 and still alive in 1998, where the baseline examination was conducted, we examined...... the impact of cognitive impairment on mortality over a 2-year period. No cognitive impairment was defined as a score of 24-30 points on the Mini Mental State Examination, mild cognitive impairment was defined as a score of 18-23 points, and severe impairment was defined as a score of 0-17 points. Cox...... regression analysis was applied to adjust for a number of known and suspected factors known or suspected of being associated with cognition and mortality (e.g. sociodemographic factors, sex, smoking, alcohol consumption, depressive symptoms, and physical abilities), and yielded hazard ratios (95% confidence...

  12. Infant Mortality

    Science.gov (United States)

    ... After hours (404) 639-2888 Contact Media Infant Mortality Recommend on Facebook Tweet Share Compartir On This ... differences in rates among population groups. About Infant Mortality Infant mortality is the death of an infant ...

  13. Depression among people with type 2 diabetes mellitus, US National Health and Nutrition Examination Survey (NHANES), 2005-2012.

    Science.gov (United States)

    Wang, Yiting; Lopez, Janice M S; Bolge, Susan C; Zhu, Vivienne J; Stang, Paul E

    2016-04-05

    Depression in people with diabetes can result in increased risk for diabetes-related complications. The prevalence of depression has been estimated to be 17.6 % in people with type 2 diabetes mellitus (T2DM), based on studies published between 1980 and 2005. There is a lack of more recent estimates of depression prevalence among the US general T2DM population. The present study used the US National Health and Nutrition Examination Survey (NHANES) 2005-2012 data to provide an updated, population-based estimate for the prevalence of depression in people with T2DM. NHANES is a cross-sectional survey of a nationally representative sample of the civilian, non-institutionalized US population. Starting from 2005, the Patient Health Questionnaire (PHQ-9) was included to measure signs and symptoms of depression. We defined PHQ-9 total scores ≥ 10 as clinically relevant depression (CRD), and ≥ 15 as clinically significant depression (CSD). Self-reported current antidepressant use was also combined to estimate overall burden of depression. Predictors of CRD and CSD were investigated using survey logistic regression models. A total of 2182 participants with T2DM were identified. The overall prevalence of CRD and CSD among people with T2DM is 10.6 % (95 % confidence interval (CI) 8.9-12.2 %), and 4.2 % (95 % CI 3.4-5.1 %), respectively. The combined burden of depressive symptoms and antidepressants may be as high as 25.4 % (95 % CI 23.0-27.9 %). Significant predictors of CRD include age (younger than 65), sex (women), income (lower than 130 % of poverty level), education (below college), smoking (current or former smoker), body mass index (≥30 kg/m(2)), sleep problems, hospitalization in the past year, and total cholesterol (≥200 mg/dl). Significant predictors of CSD also include physical activity (below guideline) and cardiovascular diseases. The prevalence of CRD and CSD among people with T2DM in the US may be lower than in earlier studies, however, the burden of

  14. Signal functions for emergency obstetric care as an intervention for reducing maternal mortality: a survey of public and private health facilities in Lusaka District, Zambia.

    Science.gov (United States)

    Tembo, Tannia; Chongwe, Gershom; Vwalika, Bellington; Sitali, Lungowe

    2017-09-06

    Zambia's maternal mortality ratio was estimated at 398/100,000 live births in 2014. Successful aversion of deaths is dependent on availability and usability of signal functions for emergency obstetric and neonatal care. Evidence of availability, usability and quality of signal functions in urban settings in Zambia is minimal as previous research has evaluated their distribution in rural settings. This survey evaluated the availability and usability of signal functions in private and public health facilities in Lusaka District of Zambia. A descriptive cross sectional study was conducted between November 2014 and February 2015 at 35 public and private health facilities. The Service Availability and Readiness Assessment tool was adapted and administered to overall in-charges, hospital administrators or maternity ward supervisors at health facilities providing maternal and newborn health services. The survey quantified infrastructure, human resources, equipment, essential drugs and supplies and used the UN process indicators to determine availability, accessibility and quality of signal functions. Data on deliveries and complications were collected from registers for periods between June 2013 and May 2014. Of the 35 (25.7% private and 74.2% public) health facilities assessed, only 22 (62.8%) were staffed 24 h a day, 7 days a week and had provided obstetric care 3 months prior to the survey. Pre-eclampsia/ eclampsia and obstructed labor accounted for most direct complications while postpartum hemorrhage was the leading cause of maternal deaths. Overall, 3 (8.6%) and 5 (14.3%) of the health facilities had provided Basic and Comprehensive EmONC services, respectively. All facilities obtained blood products from the only blood bank at a government referral hospital. The UN process indicators can be adequately used to monitor progress towards maternal mortality reduction. Lusaka district had an unmet need for BEmONC as health facilities fell below the minimum UN standard

  15. Association of vegetables and fruits consumption with sarcopenia in older adults: the Fourth Korea National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Kim, Jinhee; Lee, Yunhwan; Kye, Seunghee; Chung, Yoon-Sok; Kim, Kwang-Min

    2015-01-01

    several studies have found nutrients, including antioxidants, to be associated with sarcopenia. However, whether specific foods, such as vegetables and fruits, are associated with sarcopenia has not been studied. to examine the association of the frequency of vegetables and fruits consumption with sarcopenia in older people. this study used cross-sectional data from the Fourth Korea National Health and Nutrition Examination Survey in 2008-09. Subjects were community-dwelling 823 men and 1,089 women aged ≥65 years. Frequency of food group consumption was obtained by using the food frequency questionnaire. Body composition was measured with the dual-energy X-ray absorptiometry and sarcopenia was defined as appendicular lean mass adjusted for height and fat mass. Logistic regression was used to assess the association of the frequency of food group consumption with sarcopenia, controlling for sociodemographics and health-related variables. dietary intake of vegetables, fruits and both vegetables and fruits was associated with a significantly reduced risk of sarcopenia after controlling for covariates in men (P = 0.026 for trend, P = 0.012 for trend, P = 0.003 for trend, respectively). Men in the highest quintile, compared with those in the lowest quintile, of vegetables [odds ratio (OR) = 0.48; 95% confidence interval (CI): 0.24-0.95], fruits (OR = 0.30; 95% CI: 0.13-0.70) and vegetables and fruits consumption (OR = 0.32; 95% CI: 0.16-0.67) demonstrated a lower risk of sarcopenia. In women, high consumption of fruits demonstrated a lower risk of sarcopenia (OR = 0.39; 95% CI: 0.18-0.83). frequent vegetables and fruits consumption was inversely associated with sarcopenia in older adults. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. Who Is Food Insecure? Implications for Targeted Recruitment and Outreach, National Health and Nutrition Examination Survey, 2005–2010

    Science.gov (United States)

    Leonard, Tammy; Xuan, Lei; Amory, Richard; Higashi, Robin T.; Nguyen, Oanh Kieu; Pezzia, Carla; Swales, Stephanie

    2016-01-01

    Introduction Food insecurity is negatively associated with health; however, health needs may differ among people participating in food assistance programs. Our objectives were to characterize differences in health among people receiving different types of food assistance and summarize strategies for targeted recruitment and outreach of various food insecure populations. Methods We examined health status, behaviors, and health care access associated with food insecurity and receipt of food assistance among US adults aged 20 years or older using data from participants (N = 16,934) of the National Health and Nutrition Examination Survey from 2005 through 2010. Results Food insecurity affected 19.3% of US adults (95% confidence interval, 17.9%–20.7%). People who were food insecure reported poorer health and less health care access than those who were food secure (P food insecure, 58.0% received no assistance, 20.3% received only Supplemental Nutrition Assistance Program (SNAP) benefits, 9.7% received only food bank assistance, and 12.0% received both SNAP and food bank assistance. We observed an inverse relationship between receipt of food assistance and health and health behaviors among the food insecure. Receipt of both (SNAP and food bank assistance) was associated with the poorest health; receiving no assistance was associated with the best health. For example, functional limitations were twice as prevalent among people receiving both types of food assistance than among those receiving none. Conclusion Receipt of food assistance is an overlooked factor associated with health and has the potential to shape future chronic disease prevention efforts among the food insecure. PMID:27736055

  17. Sarcopenia and Hearing Loss in Older Koreans: Findings from the Korea National Health and Nutrition Examination Survey (KNHANES 2010.

    Directory of Open Access Journals (Sweden)

    Jieun Lee

    Full Text Available Age-related hearing impairment (ARHI is becoming a more significant issue as geriatric population increases. Sarcopenia in older people is known to have a diverse health problem in various circumstances in recent studies. We assessed whether the decrease in muscle mass is related to ARHI. We used the 2010 data of the Korea National Health and Nutrition Examination Survey (KNHANES to examine the associations between sarcopenia and ARHI. A total number of participants was 1,622 including 746 males and 876 females aged 60 years or older. Muscle mass was assessed as an appendicular skeletal muscle mass, and hearing loss was defined as the pure-tone averages (PTA of test frequencies 0.5, 1, 2, 4 kHz at a threshold of 40 dB or higher in worse hearing side of the ear. Among 1,622 participants, 298 men and 256 women had hearing loss. Appendicular muscle mass (ASM, expressed as kg, was categorized in tertiles. In female population, after adjusting for age, smoking, drinking, amount of exercise, total body fat, education level, income level, and tinnitus, the odds ratio (OR for hearing loss was 1.57 (95% confidence interval (CI = 0.92-2.68 in the middle tertile and 1.79 (1.03-3.08 in the lowest tertile, compared with the highest tertile. P for trend in this model was 0.036. Controlling further for hypertension, diabetes mellitus, chronic kidney disease, and three types of noise exposure did not change the association. Larger muscle mass is associated with lower prevalence of hearing loss in elderly Korean females.

  18. Normal range albuminuria and metabolic syndrome in South Korea: the 2011-2012 Korean National Health and Nutrition Examination Survey.

    Directory of Open Access Journals (Sweden)

    Si-Young Park

    Full Text Available It is well-known that there is a close relationship between metabolic syndrome (MetS and microalbuminuria. However, some recent studies have found that even normal range albuminuria was associated with MetS and cardiometabolic risk factors. The purpose of this study is to analyze the relationship between MetS and normal range albuminuria and to calculate the cutoff value for albuminuria that correlates with MetS in the representative fraction of Korean population.Data were obtained from the 2011-2012 Korea National Health and Nutrition Examination Survey and included 9,650 subjects aged ≥ 19 years. We measured metabolic parameters: fasting blood glucose, waist circumference, blood pressure, and lipids, and albumin-to-creatinine ratio (ACR. The optimal ACR cutoff points for MetS were examined by the receiver operating characteristic curve. Multivariate logistic regression was used to obtain the prevalence of MetS and its components according to the ACR levels.The first cutoff value of ACR were 4.8 mg/g for subjects with ≥ 3 components of MetS. There was a graded association between ACR and prevalence of MetS and its components. If ACR was <4 mg/g, there was no significant increase in the prevalence of MetS or its components. From the ACR level of 4-5 mg/g, the prevalence of MetS significantly increased after adjusting for age, sex, body mass index, smoking, alcohol intake, exercise, and medications for diabetes mellitus and hypertension (odds ratio; 95% confidence intervals = 1.416; 1.041-1.926.Albuminuria within the normal range (around 5 mg/g was associated with prevalence of MetS in the Korean population.

  19. Acculturation and the prevalence of diabetes in US Latino Adults, National Health and Nutrition Examination Survey 2007-2010.

    Science.gov (United States)

    O'Brien, Matthew J; Alos, Victor A; Davey, Adam; Bueno, Angeli; Whitaker, Robert C

    2014-10-09

    US Latinos are growing at the fastest rate of any racial/ethnic group in the United States and have the highest lifetime risk of diabetes. Acculturation may increase the risk of diabetes among all Latinos, but this hypothesis has not been studied in a nationally representative sample. The objective of this study was to test the hypothesis that acculturation was associated with an increased risk of diabetes in such a sample. We conducted a cross-sectional analysis including 3,165 Latino participants in the 2007-2010 National Health and Nutrition Examination Survey. Participants with doctor-diagnosed diabetes and participants without diagnosed diabetes who had glycated hemoglobin (HbA1C) values of 6.5% or higher were classified as having diabetes. An acculturation score, ranging from 0 (lowest) to 3 (highest), was calculated by giving 1 point for each of 3 characteristics: being born in the United States, speaking predominantly English, and living in the United States for 20 years or more. Logistic regression was used to determine the association between acculturation and diabetes. The prevalence of diabetes among Latinos in our sample was 12.4%. After adjusting for sociodemographic factors, the likelihood of diabetes (95% confidence interval [CI]) increased with level of acculturation- 1.71 (95% CI, 1.31-2.23), 1.63 (95% CI, 1.11-2.39), and 2.05 (95% CI, 1.27-3.29) for scores of 1, 2, and 3, respectively. This association persisted after further adjustment for body mass index (BMI), total dietary calories, and physical inactivity. Acculturation was associated with a higher risk of diabetes among US Latinos, and this risk was only partly explained by BMI and weight-related behaviors. Future research should examine the bio-behavioral mechanisms that underlie the relationship between acculturation and diabetes in Latinos.

  20. Low pulmonary function in individuals with impaired fasting glucose: the 2007-2009 Korea national health and nutrition examination survey.

    Science.gov (United States)

    Lee, Yun Jeong; Kim, Na Kyung; Yang, Ju Yean; Noh, Jung Hyun; Lee, Sung-Soon; Ko, Kyung Soo; Rhee, Byoung Doo; Kim, Dong-Jun

    2013-01-01

    To investigate the association between fasting plasma glucose level and pulmonary function. Nutritional information, pulmonary function data, and laboratory test data from 9,223 subjects from the fourth Korea National Health and Nutrition Examination Survey were examined. The participants were divided into five groups according to fasting plasma glucose (FPG) level: normal fasting glucose (NFG)1, FPG fasting glucose (IFG)1: FPG 100-109 mg/dl; IFG2, FPG 110-125 mg/dl; and diabetes, FPG ≥126 mg/dl and/or current anti-diabetes medications. After adjustment for several variables, the percentage of predicted forced vital capacity(FVC%) decreased with increasing fasting plasma glucose level in both sexes[men: (mean ± SEM) 92.0±0.3 in NFG1; 91.9±0.3 in NFG2; 92.0±0.4 in IFG1; 90.2±0.7 in IFG2; and 89.9±0.5 in diabetes, P = 0.004; women: 93.7±0.3 in NFG1; 93.7±0.3 in NFG2; 93.1±0.5 in IFG1; 91.1±0.9 in IFG2; and 90.7±0.6 in diabetes, P<0.001]. A logistic regression analysis found that IFG2 and diabetes were independently associated with the lowest quintile of predicted FVC% (IFG2: odds ratio [95%CI], 1.50 [1.18-1.89], P = 0.001; diabetes: 1.56 [1.30-1.88], P<0.001) using NFG1 as a control. The current data suggest that forced vital capacity may begin to decrease in the higher range of IFG.

  1. Volatile Organic Compounds and Pulmonary Function in the Third National Health and Nutrition Examination Survey, 1988–1994

    Science.gov (United States)

    Elliott, Leslie; Longnecker, Matthew P.; Kissling, Grace E.; London, Stephanie J.

    2006-01-01

    Background Volatile organic compounds (VOCs) are present in much higher concentrations indoors, where people spend most of their time, than outdoors and may have adverse health effects. VOCs have been associated with respiratory symptoms, but few studies address objective respiratory end points such as pulmonary function. Blood levels of VOCs may be more indicative of personal exposures than are air concentrations; no studies have addressed their relationship with respiratory outcomes. Objective We examined whether concentrations of 11 VOCs that were commonly identified in blood from a sample of the U.S. population were associated with pulmonary function. Methods We used data from 953 adult participants (20–59 years of age) in the Third National Health and Nutrition Examination Survey (1988–1994) who had VOC blood measures as well as pulmonary function measures. Linear regression models were used to evaluate the relationship between 11 VOCs and measures of pulmonary function. Results After adjustment for smoking, only 1,4-dichlorobenzene (1,4-DCB) was associated with reduced pulmonary function. Participants in the highest decile of 1,4-DCB concentration had decrements of −153 mL [95% confidence interval (CI), −297 to −8] in forced expiratory volume in 1 sec and −346 mL/sec (95% CI, −667 to −24) in maximum mid-expiratory flow rate, compared with participants in the lowest decile. Conclusions Exposure to 1,4-DCB, a VOC related to the use of air fresheners, toilet bowl deodorants, and mothballs, at levels found in the U.S. general population, may result in reduced pulmonary function. This common exposure may have long-term adverse effects on respiratory health. PMID:16882527

  2. Volatile organic compounds and pulmonary function in the Third National Health and Nutrition Examination Survey, 1988-1994.

    Science.gov (United States)

    Elliott, Leslie; Longnecker, Matthew P; Kissling, Grace E; London, Stephanie J

    2006-08-01

    Volatile organic compounds (VOCs) are present in much higher concentrations indoors, where people spend most of their time, than outdoors and may have adverse health effects. VOCs have been associated with respiratory symptoms, but few studies address objective respiratory end points such as pulmonary function. Blood levels of VOCs may be more indicative of personal exposures than are air concentrations; no studies have addressed their relationship with respiratory outcomes. We examined whether concentrations of 11 VOCs that were commonly identified in blood from a sample of the U.S. population were associated with pulmonary function. We used data from 953 adult participants (20-59 years of age) in the Third National Health and Nutrition Examination Survey (1988-1994) who had VOC blood measures as well as pulmonary function measures. Linear regression models were used to evaluate the relationship between 11 VOCs and measures of pulmonary function. After adjustment for smoking, only 1,4-dichlorobenzene (1,4-DCB) was associated with reduced pulmonary function. Participants in the highest decile of 1,4-DCB concentration had decrements of -153 mL [95% confidence interval (CI) , -297 to -8] in forced expiratory volume in 1 sec and -346 mL/sec (95% CI, -667 to -24) in maximum mid-expiratory flow rate, compared with participants in the lowest decile. Exposure to 1,4-DCB, a VOC related to the use of air fresheners, toilet bowl deodorants, and mothballs, at levels found in the U.S. general population, may result in reduced pulmonary function. This common exposure may have long-term adverse effects on respiratory health.

  3. Diabetes Screening in US Women With a History of Gestational Diabetes, National Health and Nutrition Examination Survey, 2007-2012.

    Science.gov (United States)

    Man, Bernice; Turyk, Mary E; Kominiarek, Michelle A; Xia, Yinglin; Gerber, Ben S

    2016-09-08

    Women with a history of gestational diabetes mellitus (GDM) are at increased risk for developing type 2 diabetes mellitus. We examined individual, socioeconomic, and health care use characteristics of women with a history of GDM and the association of those characteristics with diabetes screening, and we estimated their rates of undiagnosed prediabetes and diabetes. Using 3 cycles of the National Health and Nutrition Examination Survey (2007-2008, 2009-2010, and 2011-2012), we identified 284 women with a history of GDM who were eligible for diabetes screening. Screening status was defined by self-report of having had a blood test for diabetes within the prior 3 years. Undiagnosed prediabetes and diabetes were assessed by hemoglobin A1c measurement. Among women with a history of GDM, 67% reported diabetes screening within the prior 3 years. Weighted bivariate analyses showed screened women differed from unscreened women in measured body mass index (BMI) category (P = .01) and number of health visits in the prior year (P = .001). In multivariable analysis, screening was associated with a greater number of health visits in the prior year (1 visit vs 0 visits, adjusted odds ratio [AOR], 1.91; 95% confidence interval [CI], 0.71-5.18; 2 or 3 visits, AOR, 7.05; and ≥4 visits, AOR, 5.83). Overall, 24.4% (95% CI, 18.3%-31.7%) of women had undiagnosed prediabetes and 6.5% (95% CI, 3.7%-11.3%) had undiagnosed diabetes. More health visits in the prior year was associated with receiving diabetes screening. Fewer opportunities for screening may delay early detection, clinical management, and prevention of diabetes. Prediabetes in women with a history of GDM may be underrecognized and inadequately treated.

  4. Association between dental pain and depression in Korean adults using the Korean National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Yang, S E; Park, Y G; Han, K; Min, J A; Kim, S Y

    2016-01-01

    The purpose of this study was to evaluate the relationships between the prevalence of depression and dental pain using a well characterised, nationally representative, population-based study. This study analysed data from the 2012 Korea National Health and Nutrition Examination Survey (n = 4886). Oral health status was assessed using the oral health questionnaire, and oral examination was performed by trained dentists. Depression was defined as the participant having been diagnosed as depression during the previous year. Logistic regression was applied to estimate adjusted odds ratios (AOR) and 95% confidence intervals (CI), controlling for a range of covariates. Results demonstrated that participants included in 'root canal treatment is necessary' showed higher prevalence of self-reported dental pain; in particular, participants with depression presented more dental pain than those without depression. After adjusting for sociodemographic factors, self-reported dental pain increased in participants with depression. The AOR (95% CI) for having self-reported dental pain was 1·58 (1·08-2·33) in dentists' diagnosis of no dental pain/depression group, 1·62 (1·32-1·98) in dentists' diagnosis of dental pain/no depression group and 2·84 (1·10-7·37) in dentists' diagnosis of dental pain/depression group. It was concluded that depression was associated with dental pain after adjustment for potential confounders in Korean adults. Thus, dentists should consider the possible presence of psychopathology when treating patients with dental pain. © 2015 John Wiley & Sons Ltd.

  5. Evaluation of the acceptability of Peer Physical Examination (PPE) in medical and osteopathic students: a cross sectional survey.

    Science.gov (United States)

    Consorti, Fabrizio; Mancuso, Rosaria; Piccolo, Annalisa; Consorti, Giacomo; Zurlo, Joseph

    2013-08-22

    Peer physical examination (PPE) is a method of training in medical and osteopathic curricula. The aim of this study was to compare the acceptability of PPE in two classes of medical and osteopathic students after their first experience, to obtain comparative information useful for an understanding of the different professional approaches. The leading hypothesis was that osteopathic students enter the curriculum with a more positive attitude to bodily contact.As a secondary aim, this study validated the new version of a questionnaire to assess the acceptability of PPE. A new version of a previously validated questionnaire and an instrument from the literature (the Examining Fellow Student [EFS] questionnaire) were used for a cross-sectional survey in a class of 129 3rd year medical students and in two parallel classes of 1st year osteopathic students (total of 112 students). The mean score of the new questionnaire was significantly higher for the osteopathic students than for the medical students (53.4 ± 6.3 vs. 43.4 ± 8.9; p student. The EFS mean score also showed a significant difference between the osteopathic and medical students (30.76 ± 2.9 vs. 27.85 ± 4.3; p accounting for 62.8% of the variance. Criterion validity was assessed by correlation with the EFS (Pearson's r coefficient = 0.61). Reliability was expressed in terms of Cronbach's alpha coefficient, which equals 0.86. These quantitative results are consistent with previous qualitative research on the process of embodiment both in medicine and osteopathy. The new questionnaire proved to be valid and reliable. The objective assessment of the acceptability of PPE is a way to determine differences in students' attitudes towards contact with the body and can be used for counselling students regarding career choice. This study can also highlight differences between students from different professions and serve as a basis for reflection for improved mutual interprofessional understanding and future

  6. A Sustained Decline in Postmenopausal Hormone Use: Results From the National Health and Nutrition Examination Survey, 1999–2010

    Science.gov (United States)

    Sprague, Brian L.; Trentham-Dietz, Amy; Cronin, Kathleen A.

    2012-01-01

    Objective Short-term declines in postmenopausal hormone use were observed following the Women’s Health Initiative trial results in 2002. While concerns about the trial’s generalizability have been expressed, long-term trends in hormone use in a nationally representative sample have not been reported. We sought to evaluate national trends in the prevalence of hormone use, and assess variation by type of formulation and patient characteristics. Methods We examined postmenopausal hormone use during 1999–2010 using cross-sectional data on 10,107 women aged 40 years and older in the National Health and Nutrition Examination Survey. Results In 1999–2000, the prevalence of oral postmenopausal hormone use was 22.4% (95% CI: 19.0, 25.8) overall, 16.8% (95% CI: 14.2, 19.3) for estrogen only, and 5.2% (95% CI: 3.6, 6.8) for estrogen plus progestin. A sharp decline in use of all formulations occurred in 2003–2004, when the overall prevalence dropped to 11.9% (95% CI: 9.6, 14.2). This decline was initially limited to non-Hispanic whites; use among non-Hispanic blacks and Hispanics did not decline substantially until 2005–2006. Hormone use continued to decline through 2009–2010 across all patient demographic groups, with the current prevalence now at 4.7% (95% CI: 3.3, 6.1) overall, 2.9% (95% CI: 2.1, 3.7) for estrogen only, and 1.5% (95% CI: 0.5, 2.5) for estrogen plus progestin. Patient characteristics currently associated with hormone use include history of hysterectomy, non-Hispanic white race or ethnicity, and income. Conclusions Postmenopausal hormone use in the United States has declined in a sustained fashion to very low levels across a wide variety of patient subgroups. PMID:22914469

  7. Dyslipidemia and Food Security in Low-Income US Adolescents: National Health and Nutrition Examination Survey, 2003-2010.

    Science.gov (United States)

    Tester, June M; Laraia, Barbara A; Leung, Cindy W; Mietus-Snyder, Michele L

    2016-02-11

    Low levels of food security are associated with dyslipidemia and chronic disease in adults, particularly in women. There is a gap in knowledge about the relationship between food security among youth and dyslipidemia and chronic disease. We investigated the relationship between food security status and dyslipidemia among low-income adolescents. We analyzed data from adolescents aged 12 to 18 years (N = 1,072) from households with incomes at or below 200% of the federal poverty level from the National Health and Nutrition Examination Survey (NHANES) 2003-2010. We used logistic regression to examine the relationship between household food security status and the odds of having abnormalities with fasting total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), serum triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), TG/HDL-C ratio, and apolipoprotein B (Apo B). Models included age, sex, race/ethnicity, smoking status, partnered status in the household, and maternal education, with additional adjustment for adiposity. Household food security status was not associated with elevated TC or LDL-C. Adolescents with marginal food security were more likely than food-secure peers to have elevated TGs (odds ratio [OR] = 1.86; 95% confidence interval [CI], 1.14-3.05), TG/HDL-C ratio (OR = 1.74; 95% CI, 1.11-2.82), and Apo B (OR = 1.98; 95% CI, 1.17-3.36). Female adolescents with marginal food security had greater odds than male adolescents of having low HDL-C (OR = 2.69; 95% CI, 1.14-6.37). No elevated odds of dyslipidemia were found for adolescents with low or very low food security. Adjustment for adiposity did not attenuate estimates. In this nationally representative sample, low-income adolescents living in households with marginal food security had increased odds of having a pattern consistent with atherogenic dyslipidemia, which represents a cardiometabolic burden above their risk from adiposity alone.

  8. Applying the ACSM Preparticipation Screening Algorithm to U.S. Adults: National Health and Nutrition Examination Survey 2001-2004.

    Science.gov (United States)

    Whitfield, Geoffrey P; Riebe, Deborah; Magal, Meir; Liguori, Gary

    2017-10-01

    For most people, the benefits of physical activity far outweigh the risks. Research has suggested that exercise preparticipation questionnaires might refer an unwarranted number of adults for medical evaluation before exercise initiation, creating a potential barrier to adoption. The new American College of Sports Medicine (ACSM) prescreening algorithm relies on current exercise participation; history and symptoms of cardiovascular, metabolic, or renal disease; and desired exercise intensity to determine referral status. Our purpose was to compare the referral proportion of the ACSM algorithm to that of previous screening tools using a representative sample of U.S. adults. On the basis of responses to health questionnaires from the 2001-2004 National Health and Nutrition Examination Survey, we calculated the proportion of adults 40 yr or older who would be referred for medical clearance before exercise participation based on the ACSM algorithm. Results were stratified by age and sex and compared with previous results for the ACSM/American Heart Association Preparticipation Questionnaire and the Physical Activity Readiness Questionnaire. On the basis of the ACSM algorithm, 2.6% of adults would be referred only before beginning vigorous exercise and 54.2% of respondents would be referred before beginning any exercise. Men were more frequently referred before vigorous exercise, and women were more frequently referred before any exercise. Referral was more common with increasing age. The ACSM algorithm referred a smaller proportion of adults for preparticipation medical clearance than the previously examined questionnaires. Although additional validation is needed to determine whether the algorithm correctly identifies those at risk for cardiovascular complications, the revised ACSM algorithm referred fewer respondents than other screening tools. A lower referral proportion may mitigate an important barrier of medical clearance from exercise participation.

  9. Total physical activity volume, physical activity intensity, and metabolic syndrome: 1999-2004 National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Churilla, James R; Fitzhugh, Eugene C

    2012-02-01

    This study examined the association of total physical activity volume (TPAV) and physical activity (PA) from three domains [leisure-time physical activity (LTPA), domestic, transportation] with metabolic syndrome. We also investigated the relationship between LTPA intensity and metabolic syndrome risk. Sample included adults who participated in the 1999-2004 National Health and Nutrition Examination Survey. Physical activity measures were created for TPAV, LTPA, domestic PA, and transportational PA. For each, a six-level measure based upon no PA (level 1) and quintiles (levels 2-6) of metabolic equivalents (MET)·min·wk(-1) was created. A three-level variable associated with the current Department of Health and Human Services (DHHS) PA recommendation was also created. SAS and SUDAAN were used for the statistical analysis. Adults reporting the greatest volume of TPAV and LTPA were found to be 36% [odds ratio (OR) 0.64; 95% confidence interval (CI) 0.49-0.83] and 42% (OR 0.58; 95% CI 0.43-0.77), respectively, less likely to have metabolic syndrome. Domestic and transportational PA provided no specific level of protection from metabolic syndrome. Those reporting a TPAV that met the DHHS PA recommendation were found to be 33% (OR 0.67; 95%; CI 0.55-0.83) less likely to have metabolic syndrome compared to their sedentary counterparts. Adults reporting engaging in only vigorous-intensity LTPA were found to be 37% (OR 0.63; 95 CI 0.42-0.96) to 56% (OR 0.44; 95% CI 0.29-0.67) less likely to have metabolic syndrome. Volume, intensity, and domain of PA may all play important roles in reducing the prevalence and risk of metabolic syndrome.

  10. ?Look at the Whole Me?: A Mixed-Methods Examination of Black Infant Mortality in the US through Women?s Lived Experiences and Community Context

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    Wallace, Maeve E.; Green, Carmen; Richardson, Lisa; Theall, Katherine; Crear-Perry, Joia

    2017-01-01

    In the US, the non-Hispanic Black infant mortality rate exceeds the rate among non-Hispanic Whites by more than two-fold. To explore factors underlying this persistent disparity, we employed a mixed methods approach with concurrent quantitative and qualitative data collection and analysis. Eighteen women participated in interviews about their experience of infant loss. Several common themes emerged across interviews, grouped by domain: individual experiences (trauma, grieving and counseling; ...

  11. Learning healthcare needs when the body speaks: Insights from a 2016 Vietnamese survey on general physical examinations

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    Quan-Hoang Vuong

    2017-03-01

    Full Text Available Background: General health examinations (GHEs help Vietnamese detect early signs of illness and serve to be an important part of preventive medicine. Having GHEs can help reduce risks of poverty due to prolonged medical treatments in Vietnam, as 70% patients without health insurance face financial burdens caused by expensive treatments. Aims & Objectives: Does owning a medicine cabinet or having practical first-aid knowledge and skills have effects on people’s attitude towards GHEs? Materials & Methods: Analysis is performed on a 2,068-observation dataset, collected from a survey towards GHEs propensity collected in Hanoi and its vicinities. The methods of baseline-categorical logit model and ordinary least square are used to estimate the probabilities. Results: (1 There exist differences in the tendency of attending GHEs between those with and without a family medicine cabinet, and knowledge of using basic medical equipment; (2 The factors of age, gender, job and marital status are also proven related to body mass index (BMI. Conclusion: People who have common medical tools in the family and medical skills are likely to have GHEs more often. The likelihood of being over-weight is higher when people become older, especially among women.

  12. Learning healthcare needs when the body speaks: Insights from a 2016 Vietnamese survey on general physical examinations

    Directory of Open Access Journals (Sweden)

    Quan-Hoang Vuong

    2017-03-01

    Full Text Available Background: General health examinations (GHEs help Vietnamese detect early signs of illness and serve to be an important part of preventive medicine. Having GHEs can help reduce risks of poverty due to prolonged medical treatments in Vietnam, as 70% patients without health insurance face financial burdens caused by expensive treatments. Aims & Objectives: Does owning a medicine cabinet or having practical first-aid knowledge and skills have effects on people’s attitude towards GHEs? Materials & Methods: Analysis is performed on a 2,068-observation dataset, collected from a survey towards GHEs propensity collected in Hanoi and its vicinities. The methods of baseline-categorical logit model and ordinary least square are used to estimate the probabilities. Results: (1 There exist differences in the tendency of attending GHEs between those with and without a family medicine cabinet, and knowledge of using basic medical equipment; (2 The factors of age, gender, job and marital status are also proven related to body mass index (BMI. Conclusion: People who have common medical tools in the family and medical skills are likely to have GHEs more often. The likelihood of being over-weight is higher when people become older, especially among women.

  13. Type 2 diabetes mellitus unawareness, prevalence, trends and risk factors: National Health and Nutrition Examination Survey (NHANES) 1999-2010.

    Science.gov (United States)

    Zhang, Nana; Yang, Xin; Zhu, Xiaolin; Zhao, Bin; Huang, Tianyi; Ji, Qiuhe

    2017-04-01

    Objectives To determine whether the associations with key risk factors in patients with diagnosed and undiagnosed type 2 diabetes mellitus (T2DM) are different using data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2010. Methods The study analysed the prevalence and association with risk factors of undiagnosed and diagnosed T2DM using a regression model and a multinomial logistic regression model. Data from the NHANES 1999-2010 were used for the analyses. Results The study analysed data from 10 570 individuals. The overall prevalence of diagnosed and undiagnosed T2DM increased significantly from 1999 to 2010. The prevalence of undiagnosed T2DM was significantly higher in non-Hispanic whites, in individuals 130-159 mg/dl) or very high (≥220 mg/dl) non-high-density lipoprotein cholesterol levels compared with diagnosed T2DM. Body mass index, low economic status or low educational level had no effect on T2DM diagnosis rates. Though diagnosed T2DM was associated with favourable diet/carbohydrate intake behavioural changes, it had no effect on physical activity levels. Conclusion The overall T2DM prevalence increased between 1999 and 2010, particularly for undiagnosed T2DM in patients that were formerly classified as low risk.

  14. Systemic Comorbidities of Dry Eye Syndrome: The Korean National Health and Nutrition Examination Survey V, 2010 to 2012.

    Science.gov (United States)

    Roh, Hyun Cheol; Lee, Jimmy K; Kim, Martha; Oh, Jong-Hyun; Chang, Min-Wook; Chuck, Roy S; Park, Choul Yong

    2016-02-01

    To identify systemic comorbidities in patients with dry eye syndrome in South Korea. From 2010 to 2012, 17,364 participants aged 20 or older were randomly included in the nationwide Korean National Health and Nutrition Examination Survey V. The prevalence of dry eye syndrome and demographics of these patients were investigated. We performed conditional logistic regression analyses based on age, sex, residential area, education level, occupation type, and household income level to obtain the odds ratio for each systemic comorbidity among subjects with and without dry eye syndrome. The prevalence of dry eye syndrome in this study was 10.4%. Age [adjusted odds ratio (AOR): 1.02], female gender (AOR: 3.01), and indoor occupation (AOR: 1.30) were associated with a higher prevalence of dry eye syndrome and found to be less prevalent in those residing in rural areas (AOR: 0.73) and with lower education levels (AOR: 0.66-0.99). With regard to systemic comorbidities, dyslipidemia (AOR: 1.63), degenerative arthritis (AOR: 1.56), rheumatoid arthritis (AOR: 1.44), thyroid disease (AOR: 1.79), and renal failure (AOR: 2.56) were associated with a significantly higher prevalence of dry eye syndrome. We found that patients with dry eye syndrome have a higher prevalence of several systemic comorbidities. A more comprehensive therapeutic approach considering the effect of systemic medication may be necessary in these patients.

  15. Type 2 diabetes mellitus unawareness, prevalence, trends and risk factors: National Health and Nutrition Examination Survey (NHANES) 1999–2010

    Science.gov (United States)

    Zhang, Nana; Yang, Xin; Zhu, Xiaolin; Zhao, Bin; Huang, Tianyi

    2017-01-01

    Objectives To determine whether the associations with key risk factors in patients with diagnosed and undiagnosed type 2 diabetes mellitus (T2DM) are different using data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2010. Methods The study analysed the prevalence and association with risk factors of undiagnosed and diagnosed T2DM using a regression model and a multinomial logistic regression model. Data from the NHANES 1999–2010 were used for the analyses. Results The study analysed data from 10 570 individuals. The overall prevalence of diagnosed and undiagnosed T2DM increased significantly from 1999 to 2010. The prevalence of undiagnosed T2DM was significantly higher in non-Hispanic whites, in individuals educational level had no effect on T2DM diagnosis rates. Though diagnosed T2DM was associated with favourable diet/carbohydrate intake behavioural changes, it had no effect on physical activity levels. Conclusion The overall T2DM prevalence increased between 1999 and 2010, particularly for undiagnosed T2DM in patients that were formerly classified as low risk. PMID:28415936

  16. The Association of Metabolic Syndrome with Diabetic Retinopathy: The Korean National Health and Nutrition Examination Survey 2008-2012.

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    Tai Kyong Kim

    Full Text Available To explore gender differences and associations between metabolic syndrome (MetS and its components, and diabetic retinopathy (DR in Korean adults aged 40 years and older with diabetes.We analyzed data from the Korean National Health and Nutrition Examination Surveys (2008-2012. In total, 2,576 type 2 diabetic participants, aged 40 and older, were evaluated. Seven standard retinal fundus photographs were obtained after pupil dilation in both eyes. DR was graded using the modified Airlie House classification system. Vision-threatening diabetic retinopathy (VTDR included proliferative diabetic retinopathy and clinically significant macular edema. MetS was defined according to the Joint Interim Statement, proposed in 2009, by the International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute. Multivariate logistic regression analysis was used to assess the relationship between MetS and its individual components with DR and VTDR.After controlling for confounders, MetS was not associated with DR in men or women. Moreover, the risk for DR or VTDR did not increase with increasing MetS components. However, high waist circumference was significantly inversely associated with VTDR (adjusted odds ratio = 0.36; 95% confidence interval = 0.14-0.93 only in men.MetS was not associated with DR or VTDR in a Korean diabetic population. However, among MetS components, it seems that abdominal obesity was inversely associated with VTDR in Korean diabetic men.

  17. Association Between Chewing Difficulty and Symptoms of Depression in Adults: Results from the Korea National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Shin, Hye-Sun; Ahn, Yong-Soon; Lim, Do-Seon

    2016-12-01

    To assess the association between chewing difficulty and symptoms of depression in a representative sample of the Korean population. Cross-sectional. Korea National Health and Nutrition Examination Survey (KNHANES). KNHANES participants (N = 5,158). Chewing difficulty was assessed according to the self-reported presence of chewing problems using a structured questionnaire. Symptoms of depression were defined as having feelings of sadness or depression consecutively over 2 weeks during the last 12 months. Multivariable logistic regression analysis was used to determine the adjusted odds ratios (AORs) and 95% confidence intervals (CIs) of the associations between chewing difficulty and symptoms of depression, adjusted for age; sex; monthly household income; education; number of teeth; number of decayed, missing, or filled permanent teeth; periodontitis; state of dentition; tooth brushing frequency; regular dental visits; smoking status; alcohol consumption; hypertension; diabetes mellitus; and obesity. The interaction effects between chewing difficulty and confounders were evaluated, and age- and sex-stratified analyses were performed. There was a significant positive association between chewing difficulty and symptoms of depression in the fully adjusted model (AOR = 1.86, 95% CI = 1.48-2.33). The strength of the association was highest in men aged 60 and older (AOR = 3.28, 95% CI = 1.54-7.00). Chewing difficulty was independently associated with symptoms of depression in a representative sample of Korean adults. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  18. Association Between Serum Antibodies to Periodontal Bacteria and Rheumatoid Factor in the Third National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Goh, Charlene E; Kopp, Jacob; Papapanou, Panos N; Molitor, Jerry A; Demmer, Ryan T

    2016-10-01

    Alterations in the microbiome, including the periodontal microbiome, may be a risk factor for rheumatoid arthritis (RA). Most studies that have analyzed this association are relatively small, focus primarily on a single periodontal pathogen (Porphyromonas gingivalis), and are not population based. This study was undertaken to investigate the association between elevated serum levels of IgG antibodies to 19 periodontal species and the prevalence of rheumatoid factor (RF) in a large nationally representative sample of adults. The Third National Health and Nutrition Examination Survey (NHANES-III) is a cross-sectional sample of the noninstitutionalized US population (n = 33,994). Our study population included all dentate participants who were 60 years and older, did not have RA as defined by a modified version of the American College of Rheumatology 1987 criteria, and had complete data for both serum IgG antibodies against periodontal bacteria and serum RF antibody titer (n = 2,461). Adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) summarizing the relationship between the 19 periodontal serum IgG antibodies and RF seropositivity ranged from 0.53 (95% CI 0.29-0.97) to 1.27 (95% CI 0.79-2.06), and 17 of the 19 observed ORs were periodontal bacteria are mostly unassociated with RF seropositivity in the nationally representative NHANES-III. Elevated levels of antibodies to P intermedia and C ochracea are associated with lower odds of RF seropositivity. © 2016, American College of Rheumatology.

  19. Examining the Cervical Screening Behaviour of Women Aged 50 or above and Its Predicting Factors: A Population-Based Survey.

    Science.gov (United States)

    Chan, Carmen W H; Choi, Kai Chow; Wong, Rosa S; Chow, Ka Ming; So, Winnie K W; Leung, Doris Y P; Lam, Wendy W T; Goggins, William

    2016-12-02

    Under-screening may increase the risk of cervical cancer in middle-aged women. This study aimed to investigate cervical cancer screening behaviour and its predictors among women aged 50 years or above. A population-based sample of 959 women was recruited by telephone from domestic households in Hong Kong, using random methods, and a structured questionnaire developed to survey participants. Multivariable logistic regressions were performed to examine the factors independently associated with cervical screening behaviour. Nearly half the sample (48%) had never had a cervical smear test. Multivariable analyses showed that age, educational level, marital status, family history of cancer, smoking status, use of complementary therapy, recommendation from health professionals, and believing that regular visits to a doctor or a Chinese herbalist were good for their health were predictors of cervical screening behaviour. Misconceptions concerned with menopause may reduce women's perceived susceptibility to cervical cancer, especially if they are 50 or above, and exert a negative effect on their screening behaviour. Healthcare professionals should actively approach these high-risk groups-older unmarried women, smokers, those less educated and who are generally not much concerned with their health.

  20. Examining the Cervical Screening Behaviour of Women Aged 50 or above and Its Predicting Factors: A Population-Based Survey

    Directory of Open Access Journals (Sweden)

    Carmen W. H. Chan

    2016-12-01

    Full Text Available Under-screening may increase the risk of cervical cancer in middle-aged women. This study aimed to investigate cervical cancer screening behaviour and its predictors among women aged 50 years or above. A population-based sample of 959 women was recruited by telephone from domestic households in Hong Kong, using random methods, and a structured questionnaire developed to survey participants. Multivariable logistic regressions were performed to examine the factors independently associated with cervical screening behaviour. Nearly half the sample (48% had never had a cervical smear test. Multivariable analyses showed that age, educational level, marital status, family history of cancer, smoking status, use of complementary therapy, recommendation from health professionals, and believing that regular visits to a doctor or a Chinese herbalist were good for their health were predictors of cervical screening behaviour. Misconceptions concerned with menopause may reduce women’s perceived susceptibility to cervical cancer, especially if they are 50 or above, and exert a negative effect on their screening behaviour. Healthcare professionals should actively approach these high-risk groups–older unmarried women, smokers, those less educated and who are generally not much concerned with their health.

  1. Physical Activity Level of Korean Adults with Chronic Diseases: The Korean National Health and Nutritional Examination Survey, 2010-2012.

    Science.gov (United States)

    Jin, Ho-Seong; An, Ah-Reum; Choi, Ho-Chun; Lee, Sang-Hyun; Shin, Dong-Heon; Oh, Seung-Min; Seo, Young-Gyun; Cho, Be-Long

    2015-11-01

    Proper physical activities are known to be helpful in the prevention and management of chronic diseases. However, the physical activity level of patients with chronic diseases is low. Therefore, this study aimed to investigate the physical activity compliance of patients with hypertension, diabetes, and dyslipidemia in Korea. This study analyzed the 2010-2012 Fifth Korean National Health and Nutrition Examination Survey data. We included 13,873 individuals in the analysis. The level of physical activity compliance was measured by performing multivariate logistic regression analyses. In the univariate analysis, the subjects with hypertension or diabetes tended to comply with the physical activity guidelines less faithfully than their healthy counterparts. The proportion of subjects with hypertension who were insufficiently physically active was 65.4% among the men and 75.8% among the women. For diabetes, the proportions were 66.7% and 76.8%, respectively. No significant difference was found between the subjects with dyslipidemia and their healthy counterparts. In the multivariate logistic regression analysis, no significant difference in physical activity compliance was observed between the subjects with hypertension, diabetes, or dyslipidemia and their healthy counterparts for both sexes. The patients with hypertension or diabetes tended to have lower physical activity prevlaence than their healthy counterparts. However, for dyslipidemia, no significant difference was found between the two groups. Given the significance of physical activities in the management of chronic diseases, the physical activities of these patients need to be improved.

  2. Participation in Types of Physical Activities Among US Adults--National Health and Nutrition Examination Survey 1999-2006.

    Science.gov (United States)

    Dai, Shifan; Carroll, Dianna D; Watson, Kathleen B; Paul, Prabasaj; Carlson, Susan A; Fulton, Janet E

    2015-06-01

    Information on specific types of physical activities in which US adults participate is important for community and program development to promote physical activity. Prevalence of participation and average time spent for 33 leisure-time aerobic activities and 10 activity categories were calculated using self-reported data from 22,545 participants aged ≥ 18 years in the National Health and Nutrition Examination Survey 1999-2006. Overall, 38% of US adults reported no leisure-time physical activities, and 43% reported 1 or 2 activities in the past 30 days. Walking was the most frequently reported activity for both men (29%) and women (38%). Among walkers, the average time spent walking was 198 minutes/week for men and 152 minutes/week for women. The most reported activities for men after walking were bicycling and yard work, and for women were aerobics and dance. For most activity categories, participation was lower among adults aged ≥ 65 years than among younger adults, and among Mexican Americans and non-Hispanic blacks than among non-Hispanic whites. Participation in most categories increased with increasing educational attainment. Participation in physical activity differs by types of activities and demographic characteristics. Physical activity promotion programs should take these differences into account when developing intervention strategies.

  3. Association of meal frequency with metabolic syndrome in Korean adults: from the Korea National Health and Nutrition Examination Survey (KNHANES).

    Science.gov (United States)

    Jung, Chan-Hee; Lee, Ji Sung; Ahn, Hee Jung; Choi, Jin-Sun; Noh, Min Young; Lee, Ji Jeung; Lee, Eun Young; Lim, Jeong Hyun; Lee, Young Ran; Yoon, So Yoon; Kim, Chong Hwa; Cho, Dong-Hyeok; Choi, Young Sik; Choi, Kyung Mook

    2017-01-01

    Although previous studies have established a close relationship between caloric intake and metabolic syndrome, there is limited research exploring the impact of meal frequency adjusted by caloric intake on metabolic syndrome (MetS). To evaluate the association of meal frequency and MetS after adjusting for confounding factors including caloric intake in Korean men and women. We analyzed the national representative data of a total 12,389 adults (5171 men, 7218 women) from the Korean National Health and Nutrition Examination Survey (KNHANES) 2010-2012. Subjects were categorized as eating 3 meals/day (MF3) or 2 or fewer meals/day (MF ≤ 2). Daily caloric intake was calculated using CAN-Pro 4.0 (The Korean Nutrition Society, Seoul, Korea). The prevalence of components of MetS differed significantly according to meal frequency in both men and women. In an unadjusted analysis, the prevalence of MetS in women was significantly higher in the MF3 group than the MF ≤ 2 group (27.5% vs. 17.8%, P  meal frequency did not affect the risk of metabolic syndrome in women after adjusting for confounding factors including caloric intake (OR = 1.09, 95%, CI = 0.90-1.31). This study suggests that lower meal frequency adjusted for caloric intake, physical activity, age, smoking, alcohol, income, and education may be associated with increased risk of MetS in Korean men.

  4. The Prevalence of "Drinking and Biking" and Associated Risk Factors: The Korea National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Hwang, Se Hwan; Ahn, Ma Rhip; Han, Kyung Do; Lee, Jung Ho

    2017-09-01

    With the steady rise of health and environmental awareness, the number of bicyclists is increasing. However, there are few epidemiologic studies on bicycling under the influence (BUI). The aim of this study was to determine the prevalence of BUI and the associated risk factors in a representative Korean population. The data of 4,833 adult bicyclists who participated in the Korean National Health and Nutrition Examination Survey (2010-2012) were analyzed. Among the 4,833 participants investigated in this study, 586 (12.1%) had experienced BUI. As participants' age increased, so did the prevalence of BUI (P < 0.001), with the participants who were aged 60-69 showing the highest prevalence of BUI (19.6%). With regard to BUI and drinking habits, the likelihood of being a heavy or high-risk drinker increased with the frequency of BUI (P < 0.001). In addition, there was a positive relationship between the frequency of BUI and alcohol use disorder identification score level. Finally, those who had previous experiences of BUI were significantly more likely to drive and ride motorcycles under the influence (P < 0.001). In conclusion, the prevalence of BUI was 12.1% and several associated risk factors for BUI were elucidated in this study. The development of specific preventive strategies and educational programs aimed at deterring individuals at a high risk of engaging in BUI is expected to reduce the number of alcohol-related bicycle injuries. © 2017 The Korean Academy of Medical Sciences.

  5. Implication of Sarcopenia and Sarcopenic Obesity on Lung Function in Healthy Elderly: Using Korean National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Moon, Ji Hyun; Kong, Mi Hee; Kim, Hyeon Ju

    2015-11-01

    Previous studies have demonstrated a positive association between obesity and decreased lung function. However, the effect of muscle and fat has not been fully assessed, especially in a healthy elderly population. In this study, we evaluated the impact of low muscle mass (LMM) and LMM with obesity on pulmonary impairment in healthy elderly subjects. Our study used data from the Korea National Health and Nutrition Examination Survey from 2008 to 2011. Men and women aged 65 yr or older were included. Muscle mass was measured by dual-energy X-ray absorptiometry. LMM was defined as two standard deviations below the sex-specific mean for young healthy adults. Obesity was defined as body mass index ≥ 25 kg/m(2). The prevalence of LMM in individuals aged over 65 was 11.9%. LMM and pulmonary function (forced vital capacity and forced expiratory volume in 1 second) were independently associated after adjusting for age, sex, body mass index, smoking status, alcohol consumption, and frequency of exercise. LMM with obesity was also related to a decrease in pulmonary function. This study revealed that LMM is an independent risk factor of decreased pulmonary function in healthy Korean men and women over 65 yr of age.

  6. Cardiovascular health metrics and accelerometer-measured physical activity levels: National Health and Nutrition Examination Survey, 2003-2006.

    Science.gov (United States)

    Barreira, Tiago V; Harrington, Deirdre M; Katzmarzyk, Peter T

    2014-01-01

    To determine whether relationships exist between accelerometer-measured moderate-to-vigorous physical activity (MVPA) and other cardiovascular (CV) health metrics in a large sample. Data from the 2003-2006 National Health and Nutrition Examination Survey (NHANES) collected from January 1, 2003, through December 31, 2006, were used. Overall, 3454 nonpregnant adults 20 years or older who fasted for 6 hours or longer, with valid accelerometer data and with CV health metrics, were included in the study. Blood pressure (BP), body mass index (BMI), smoking status, diet, fasting plasma glucose level, and total cholesterol level were defined as ideal, intermediate, and poor on the basis of American Heart Association criteria. Results were weighted to account for sampling design, oversampling, and nonresponse. Significant increasing linear trends in mean daily MVPA were observed across CV health levels for BMI, BP, and fasting plasma glucose (Pphysical activity in the overall definition of ideal CV health. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  7. Factors Affecting Examination Attrition: Does Academic Support Help? A Survey of ACN203S (Cost Accounting and Control) Students at Unisa

    Science.gov (United States)

    Tladi, Lerato Sonia

    2013-01-01

    This study sought to determine the attributing and contributing factors to examination absence as well as whether the academic and social support available to students had a role to play in discouraging or reducing absence from examinations using results from a quantitative survey of ACN203S (Cost Accounting and Control) students who were admitted…

  8. Sleep duration, nap habits, and mortality in older persons.

    Science.gov (United States)

    Cohen-Mansfield, Jiska; Perach, Rotem

    2012-07-01

    To examine the effect of nighttime sleep duration on mortality and the effect modification of daytime napping on the relationship between nighttime sleep duration and mortality in older persons. Prospective survey with 20-yr mortality follow-up. The Cross-Sectional and Longitudinal Aging Study, a multidimensional assessment of a stratified random sample of the older Jewish population in Israel conducted between 1989-1992. There were 1,166 self-respondent, community-dwelling participants age 75-94 yr (mean, 83.40, standard deviation, 5.30). Nighttime sleep duration, napping, functioning (activities of daily living, instrumental activities of daily living, Orientation Memory Concentration Test), health, and mortality. Duration of nighttime sleep of more than 9 hr was significantly related to increased mortality in comparison with sleeping 7-9 hr (hazard ratio [HR] = 1.31, P habits, and mortality in older persons. SLEEP 2012;35(7):1003-1009.

  9. Prevalence and Risk Factors of Chronic Otitis Media: The Korean National Health and Nutrition Examination Survey 2010–2012

    Science.gov (United States)

    Park, Mina; Lee, Ji Sung; Lee, Jun Ho; Oh, Seung Ha; Park, Moo Kyun

    2015-01-01

    Background The performance of nationwide studies of chronic otitis media (COM) in adults has been insufficient in Korea. We evaluated the prevalence and risk factors of COM in Korea. Methods This study was conducted using data from the fifth Korean National Health and Nutrition Examination Survey (n = 23,621). After excluding the subjects under 20 year old and suffered from cancers, 16,063 patients were evaluated for COM. Participants underwent a medical interview, physical examination, endoscopic examination, and blood and urine test. COM was diagnosed by trained residents in the Department of Otorhinolaryngology using an ear, nose, and throat questionnaire and otoendoscopy findings. Data on the presence and absence of COM were collected. Multivariate logistic regression analyses were performed to identify its risk factors. Results Of the 16,063 participants aged above 20 year old, the weighted prevalence of COM was 3.8%. In the multivariate analyses, the following factors showed high odds ratios (ORs) for COM: pulmonary tuberculosis (adjusted OR, 1.78; 95% confidence interval [CI], 1.06-3.01), chronic rhinosinusitis (adjusted OR, 1.87; 95% CI, 1.17-2.98), mild hearing impairment (adjusted OR, 1.95; 95% CI, 1.34-2.85), moderate hearing impairment (adjusted OR, 4.00; 95% CI, 2.21-7.22), tinnitus (adjusted OR, 1.82; 95% CI, 1.34-2.49), increased hearing thresholds in pure tone audiometry in the right ear (adjusted OR, 1.02; 95% CI, 1.01-1.03), and left ear (adjusted OR, 1.03; 95% CI, 1.02-1.04). The following factors showed low odds ratios for COM: hepatitis B (adjusted OR, 0.28; 95% CI, 0.08-0.94) and rhinitis (adjusted OR, 0.60; 95% CI, 0.42-0.88). In addition, high levels of vitamin D, lead, and cadmium, EQ-5D index; and low red blood cell counts were associated with development of COM (Student’s t-test, P < 0.01). Conclusions Our population-based study showed that COM is not rare in Korea, and its development may be associated with various host and

  10. Tree Mortality

    Science.gov (United States)

    Mark J. Ambrose

    2012-01-01

    Tree mortality is a natural process in all forest ecosystems. However, extremely high mortality also can be an indicator of forest health issues. On a regional scale, high mortality levels may indicate widespread insect or disease problems. High mortality may also occur if a large proportion of the forest in a particular region is made up of older, senescent stands....

  11. Mortality follow-up through 1977 of the white underground uranium miners cohort examined by the United States Public Health Service

    International Nuclear Information System (INIS)

    Waxweiler, R.J.; Roscoe, R.J.; Archer, V.E.; Thun, M.J.; Wagoner, J.K.; Lundin, F.E. Jr.

    1981-01-01

    Substantial excesses of lung cancer have been noted among miners in the Joachimsthal mines, lead-zinc miners in Sweden, fluorspar miners in Canada, iron miners in Sweden, and metal and uranium miners in the United States. The latter prospective cohort has also been shown to be at an excess risk of death due to tuberculosis, nonmalignant respiratory disease, and accidents when followed through September 30, 1974. This report extends the followup of this cohort of miners through December 31, 1977 and expands the mortality analysis to investigate more cause-specific categories

  12. The spectrum of adult congenital heart disease in Europe: morbidity and mortality in a 5 year follow-up period - The Euro Heart Survey on adult congenital heart disease

    NARCIS (Netherlands)

    Engelfriet, Peter; Boersma, Eric; Oechslin, Erwin; Tijssen, Jan; Gatzoulis, Michael A.; Thilén, Ulf; Kaemmerer, Harald; Moons, Philip; Meijboom, Folkert; Popelová, Jana; Laforest, Valérie; Hirsch, Rafael; Daliento, Luciano; Thaulow, Erik; Mulder, Barbara

    2005-01-01

    Aims To describe clinical and demographic characteristics at baseline of a European cohort of adults with congenital heart disease (CHD) and to assess mortality and morbidity in a 5 year follow-up period. Methods and results Data collected as part of the Euro Heart Survey on adult CHD was analysed.

  13. Association of Individual and Neighborhood Factors with Home Food Availability: Evidence from the National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Chai, Weiwen; Fan, Jessie X; Wen, Ming

    2018-05-01

    Accumulating evidence suggests the important role of the home food environment in an individual's dietary intake. This study examined the associations of individual and neighborhood-level factors with the availability of healthy and unhealthy foods in the home using a nationally representative sample from the 2007 to 2008 and 2009 to 2010 National Health and Nutrition Examination Surveys (NHANES). A cross-sectional study design was used with NHANES merged with the 2000 census data. Food availability was measured through self-report questionnaire regarding the frequency of foods or drinks available in the home. The analysis included 8,975 participants aged 19 to 65 years. Associations of individual and neighborhood factors with home food availability (always or most of the time available) were assessed using logistic regression modeling accounting for NHANES' complex survey design and weights. Individual-level and neighborhood-level factors were simultaneously included in the analysis. Family income-to-needs ratio was positively associated with the availability of dark green vegetables (odds ratio [OR]=1.07; 95% CI=1.00 to 1.13), fat-free or low-fat milk (OR=1.16; 95% CI=1.07 to 1.25), and salty snacks (OR=1.12; 95% CI=1.04 to 1.20) in the home. College graduates were more likely to have fruits (OR=1.96, 95% CI=1.48 to 2.60), vegetables (OR=1.48; 95% CI=1.16 to 1.88), and fat-free or low-fat milk (OR=1.81; 95% CI=1.55 to 2.12) and less likely to have salty snacks (OR=0.77; 95% CI=0.63 to 0.95) and sugary drinks (OR=0.46, 95% CI=0.37 to 0.57) available compared with non-college graduates. Tract socioeconomic status (SES) scores were positively associated with fruit (OR=1.15; 95% CI=1.02 to 1.29), vegetable (OR=1.14; 95% CI=1.03 to 1.26), and fat-free or low-fat milk (OR=1.25; 95% CI=1.10 to 1.42) availability. Urban residents were associated with greater availability of fruits (OR=1.47; 95% CI=1.05 to 2.08) and fat-free or low-fat milk (OR=1.33; 95% CI=1.02 to 1

  14. Loneliness, health and mortality

    DEFF Research Database (Denmark)

    Henriksen, J; Larsen, E R; Mattisson, C

    2017-01-01

    Aims.: Literature suggests an association between loneliness and mortality for both males and females. Yet, the linkage of loneliness to mortality is not thoroughly examined, and need to be replicated with a long follow-up time. This study assessed the association between loneliness and mortality...... not been previously reported. If replicated, our results indicate that loneliness may have differential physical implications in some subgroups. Future studies are needed to further investigate the influence of gender on the relationship....

  15. Parity and increased risk of insulin resistance in postmenopausal women: the 2010 Korean National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Kim, Jin Hwi; Lee, Sung Jong

    2017-07-01

    The objective of this study was to assess the association between parity and insulin resistance in nondiabetic, postmenopausal women. This cross-sectional study was conducted using data from the 2010 Korean National Health and Nutrition Examination Survey administered by the Korean Ministry of Health and Welfare. A total of 1,243 nondiabetic postmenopausal women were included in this study and subdivided into three groups according to parity (1-2, 3-4, and ≥5 live births). Insulin resistance was measured using the homeostasis model assessment of insulin resistance (HOMA-IR) index. The relationship between parity and insulin resistance was investigated using analysis of covariance. HOMA-IR showed a positive relationship with parity. Mean HOMA-IR (geometric mean and 95% CI) increased according to increasing parity group (1-2, 3-4, and ≥5 live births) after adjustment for age, smoking, alcohol consumption, exercise, education, income, and body mass index as follows: 2.1 (2.0-2.2) insulin resistance was accompanied by obesity. The mean parity of the obese and insulin-resistant group was significantly higher than that of the nonobese insulin-sensitive group (3.6 ± 0.1 vs 3.2 ± 0.1, P = 0.047). Our study provides the first evidence that parity is significantly associated with insulin resistance in nondiabetic postmenopausal women. Further prospective longitudinal studies are needed to confirm the impact of parity on insulin resistance.

  16. Timing of Introduction of Complementary Foods to US Infants, National Health and Nutrition Examination Survey 2009-2014.

    Science.gov (United States)

    Barrera, Chloe M; Hamner, Heather C; Perrine, Cria G; Scanlon, Kelley S

    2018-03-01

    Although there has been inconsistency in recommendations regarding the optimal time for introducing complementary foods, most experts agree that introduction should not occur before 4 months. Despite recommendations, studies suggest that 20% to 40% of US infants are introduced to foods at younger than 4 months. Previous studies focused on the introduction of solid foods and are not nationally representative. Our aims were to provide a nationally representative estimate of the timing of introduction of complementary foods and to describe predictors of early (introduction. We conducted a cross-sectional analysis of 2009-2014 National Health and Nutrition Examination Survey data. The study included 1,482 children aged 6 to 36 months. Timing of first introduction to complementary foods (anything other than breast milk or formula) was analyzed. Prevalence estimates of first introduction to complementary foods are presented by month. Logistic regression was used to assess characteristics associated with early (introduction. In this sample, 16.3% of US infants were introduced to complementary foods at introduction varied by breastfeeding status; race/Hispanic origin; Special Supplemental Nutrition Program for Women, Infants, and Children participation; and maternal age. In adjusted analyses, only breastfeeding status remained significant; infants who never breastfed or stopped at introduction in this nationally representative sample than previous studies that included only solids. However, many young children were still introduced to complementary foods earlier than recommended. Strategies to support caregivers to adhere to infant feeding guidelines may be needed. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  17. Relationship between Regional Body Fat Distribution and Diabetes Mellitus: 2008 to 2010 Korean National Health and Nutrition Examination Surveys

    Directory of Open Access Journals (Sweden)

    Soo In Choi

    2017-01-01

    Full Text Available BackgroundThe aim of this study was to investigate the association between regional body fat distribution, especially leg fat mass, and the prevalence of diabetes mellitus (DM in adult populations.MethodsA total of 3,181 men and 3,827 postmenopausal women aged 50 years or older were analyzed based on Korea National Health and Nutrition Examination Surveys (2008 to 2010. Body compositions including muscle mass and regional fat mass were measured using dual-energy X-ray absorptiometry.ResultsThe odds ratios (ORs for DM was higher with increasing truncal fat mass and arm fat mass, while it was lower with increasing leg fat mass. In a partial correlation analysis adjusted for age, leg fat mass was negatively associated with glycosylated hemoglobin in both sexes and fasting glucose in women. Leg fat mass was positively correlated with appendicular skeletal muscle mass and homeostasis model assessment of β cell. In addition, after adjusting for confounding factors, the OR for DM decreased gradually with increasing leg fat mass quartiles in both genders. When we subdivided the participants into four groups based on the median values of leg fat mass and leg muscle mass, higher leg fat mass significantly lowered the risk of DM even though they have smaller leg muscle mass in both genders (P<0.001.ConclusionThe relationship between fat mass and the prevalence of DM is different according to regional body fat distribution. Higher leg fat mass was associated with a lower risk of DM in Korean populations. Maintaining leg fat mass may be important in preventing impaired glucose tolerance.

  18. Association between Body Weight Changes and Menstrual Irregularity: The Korea National Health and Nutrition Examination Survey 2010 to 2012.

    Science.gov (United States)

    Ko, Kyung Min; Han, Kyungdo; Chung, Youn Jee; Yoon, Kun Ho; Park, Yong Gyu; Lee, Seung Hwan

    2017-06-01

    Menstrual irregularity is an indicator of endocrine disorders and reproductive health status. It is associated with various diseases and medical conditions, including obesity and underweight. We aimed to assess the association between body weight changes and menstrual irregularity in Korean women. A total of 4,621 women 19 to 54 years of age who participated in the 2010 to 2012 Korea National Health and Nutrition Examination Survey were included in this study. Self-reported questionnaires were used to collect medical information assessing menstrual health status and body weight changes. Odds ratios (ORs) and 95% confidence interval (CI) were calculated to evaluate the association between body weight changes and menstrual irregularity. Significantly higher ORs (95% CI) were observed in the association between menstrual irregularity and both weight loss (OR, 1.74; 95% CI, 1.22 to 2.48) and weight gain (OR, 1.45; 95% CI, 1.13 to 1.86) after adjusting for age, body mass index, current smoking, heavy alcohol drinking, regular exercise, calorie intake, education, income, metabolic syndrome, age of menarche, parity, and stress perception. Of note, significant associations were only observed in subjects with obesity and abdominal obesity, but not in non-obese or non-abdominally obese subjects. U-shaped patterns were demonstrated in both obese and abdominally obese subjects, indicating that greater changes in body weight are associated with higher odds of menstrual irregularity. We found a U-shaped pattern of association between body weight changes and menstrual irregularity among obese women in the general Korean population. This result indicates that not only proper weight management but also changes in body weight may influence the regulation of the menstrual cycle. Copyright © 2017 Korean Endocrine Society

  19. An Examination of Growing Trends in Land Tenure and Conservation Practice Adoption: Results from a Farmer Survey in Iowa

    Science.gov (United States)

    Varble, Sarah; Secchi, Silvia; Druschke, Caroline Gottschalk

    2016-02-01

    Tenants and part-owners are farming an increasing number of acres in the United States, while full-owners are farming fewer acres. This shift in ownership is a potential cause for concern because some previous research indicated that tenant and part-owner farmers were less likely to adopt conservation practices than farmers who owned the land they farmed. If that trend persists, ownership changes would signal a national drop in conservation adoption. Here we examine this issue using a survey of agricultural operators in the Clear Creek watershed in Iowa, a state with intensive agricultural production. We compare adoption of conservation practices, and preferences for conservation information sources and communication channels, between farmers who rent some portion of the land they farm (tenants and part-owners) and farmers who own all of the land they farm (full-owners). We find that renters are more likely to practice conservation tillage than full-owners, though they are less likely to rotate crops. In addition, renters report using federal government employees (specifically, Natural Resource Conservation Service and Farm Service Agency) as their primary sources of conservation information, while full-owners most frequently rely on neighbors, friends, and County Extension. These findings are significant for conservation policy because, unlike some past research, they indicate that renters are not resistant to all types of conservation practices, echoing recent studies finding an increase in conservation adoption among non-full-owners. Our results emphasize the importance of government conservation communication and can inform outreach efforts by helping tailor effective, targeted conservation strategies for owners and renters.

  20. Diet and food insufficiency among Hispanic youths: acculturation and socioeconomic factors in the third National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Mazur, Robert E; Marquis, Grace S; Jensen, Helen H

    2003-12-01

    Low socioeconomic status is associated with poor diet, food insufficiency, and poor child health. Hispanic households have disproportionately low incomes. Acculturation-related changes may augment the effects of poverty on children's diet and health. The goal was to determine the associations that acculturation, measured by parents' language use, and income have with dietary intakes and food insufficiency among Hispanic youths. Data on 2985 Hispanic youths aged 4-16 y were from the third National Health and Nutrition Examination Survey (1988-1994). Nutrient intake data were from one 24-h dietary recall. The analysis was controlled for demographic, socioeconomic, and program variables. Parents' exclusive use of Spanish was associated in bivariate analyses with differences in intakes of energy, protein, sodium, and folate and in percentages of energy from fat and saturated fat. When other factors were controlled for, less acculturation was associated with differences in intakes of energy and sodium and in percentages of energy from fat and saturated fat. Individuals in poorer households had higher intakes of energy, protein, sodium, and some micronutrients. Although not significant for all indicators of food insufficiency, consistent patterns showed that household food insufficiency decreased with less acculturation (odds ratio: 0.4; 95% CI: 0.2, 0.7 for adult meal size reduced) and increased with low income [odds ratio: 5.9 (3.0, 11.7) for not enough food and 5.4 (2.2, 13.4) for child meal size reduced]. Both acculturation and poverty have roles in children's diets and in household food insufficiency. Culturally specific public health and nutrition education should complement efforts to improve the financial security of low-income households.

  1. Poor Adherence to US Dietary Guidelines for Children and Adolescents in the National Health and Nutrition Examination Survey Population.

    Science.gov (United States)

    Banfield, Emilyn C; Liu, Yan; Davis, Jennifer S; Chang, Shine; Frazier-Wood, Alexis C

    2016-01-01

    Poor diet quality in childhood and adolescence is associated with adverse health outcomes throughout life, yet the dietary habits of American children and how they change across childhood and adolescence are unknown. This study sought to describe diet quality among children and adolescents by assessing adherence to the 2010 Dietary Guidelines for Americans (DGA) and to determine whether any differences in adherence occurred across childhood. We employed a cross-sectional design using data from the National Health and Nutrition Examination Survey (NHANES). Of 9,280 children aged 4 to 18 years who participated in NHANES from 2005 to 2010, those with insufficient data on dietary recall (n=852) or who were pregnant or lactating during the time of interview (n=38) were excluded from the final study sample (n=8,390). We measured adherence to the DGA using the Healthy Eating Index 2010 (HEI-2010) and stratified participants into three age groups (4 to 8, 9 to 13, and 14 to 18 years of age). We analyzed each of 12 HEI-2010 components and total HEI-2010 score. The youngest children had the highest overall diet quality due to significantly greater scores for total fruit, whole fruit, dairy, and whole grains. These children also had the highest scores for sodium, refined grains, and empty calories. Total HEI-2010 scores ranged from 43.59 to 52.11 out of 100, much lower than the minimum score of 80 that is thought to indicate a diet associated with good health. Overall, children and adolescents are failing to meet the DGA and may be at an increased risk of chronic diseases throughout life. By analyzing which food groups show differences between age groups, we provide data that can inform the development of dietary interventions to promote specific food groups targeting specific ages and improve diet quality among children and adolescents. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  2. Prevalence of Glaucoma in the United States: The 2005–2008 National Health and Nutrition Examination Survey

    Science.gov (United States)

    Gupta, Priya; Zhao, Di; Guallar, Eliseo; Ko, Fang; Boland, Michael V.; Friedman, David S.

    2016-01-01

    Purpose To estimate the prevalence of glaucoma in the US population based on optic nerve head photography, to estimate the prevalence of glaucoma awareness, and to identify demographic and ocular risk factors for being unaware of having glaucoma. Methods The study included 5746 men and women 40 years of age and older participating in the National Health and Nutrition Examination Survey (NHANES) 2005–2008. Each participant had 45° photographs of the macula and optic disc of both eyes. Fundus photographs were first graded by a reading center, and those with a cup-to-disc ratio (CDR) ≥ 0.6 were regraded by three glaucoma specialists to determine the presence or absence of glaucoma. Analyses were performed using NHANES weights to account for the complex multistage probability sampling design. Results The estimated overall prevalence of glaucoma in the US civilian, noninstitutionalized population 40 years of age and older was 2.1% (95% confidence interval [CI], 1.7%–2.6%). Glaucoma affected 2.9 million individuals, including 1.4 million women; 1.5 million men; 2.3 million people 60 years of age and older; and 0.9 million blacks, Mexican Americans, and people of other races. The prevalence of glaucoma was highest in non-Hispanic blacks, followed by non-Hispanic whites, Mexican Americans, and others. Over half of participants with glaucoma were unaware that they had the disease. Conclusions The prevalence of glaucoma based on optic nerve fundus photography assessment in the general US population 40 years of age and older was 2.1%. Approximately half of glaucoma cases were previously undiagnosed. Studies to determine whether and how to identify undiagnosed glaucoma are an important next step. PMID:27168366

  3. Association between Body Weight Changes and Menstrual Irregularity: The Korea National Health and Nutrition Examination Survey 2010 to 2012

    Directory of Open Access Journals (Sweden)

    Kyung Min Ko

    2017-06-01

    Full Text Available BackgroundMenstrual irregularity is an indicator of endocrine disorders and reproductive health status. It is associated with various diseases and medical conditions, including obesity and underweight. We aimed to assess the association between body weight changes and menstrual irregularity in Korean women.MethodsA total of 4,621 women 19 to 54 years of age who participated in the 2010 to 2012 Korea National Health and Nutrition Examination Survey were included in this study. Self-reported questionnaires were used to collect medical information assessing menstrual health status and body weight changes. Odds ratios (ORs and 95% confidence interval (CI were calculated to evaluate the association between body weight changes and menstrual irregularity.ResultsSignificantly higher ORs (95% CI were observed in the association between menstrual irregularity and both weight loss (OR, 1.74; 95% CI, 1.22 to 2.48 and weight gain (OR, 1.45; 95% CI, 1.13 to 1.86 after adjusting for age, body mass index, current smoking, heavy alcohol drinking, regular exercise, calorie intake, education, income, metabolic syndrome, age of menarche, parity, and stress perception. Of note, significant associations were only observed in subjects with obesity and abdominal obesity, but not in non-obese or non-abdominally obese subjects. U-shaped patterns were demonstrated in both obese and abdominally obese subjects, indicating that greater changes in body weight are associated with higher odds of menstrual irregularity.ConclusionWe found a U-shaped pattern of association between body weight changes and menstrual irregularity among obese women in the general Korean population. This result indicates that not only proper weight management but also changes in body weight may influence the regulation of the menstrual cycle.

  4. Age-Related Imbalance Is Associated With Slower Walking Speed: An Analysis From the National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Xie, Yanjun J; Liu, Elizabeth Y; Anson, Eric R; Agrawal, Yuri

    Walking speed is an important dimension of gait function and is known to decline with age. Gait function is a process of dynamic balance and motor control that relies on multiple sensory inputs (eg, visual, proprioceptive, and vestibular) and motor outputs. These sensory and motor physiologic systems also play a role in static postural control, which has been shown to decline with age. In this study, we evaluated whether imbalance that occurs as part of healthy aging is associated with slower walking speed in a nationally representative sample of older adults. We performed a cross-sectional analysis of the previously collected 1999 to 2002 National Health and Nutrition Examination Survey (NHANES) data to evaluate whether age-related imbalance is associated with slower walking speed in older adults aged 50 to 85 years (n = 2116). Balance was assessed on a pass/fail basis during a challenging postural task-condition 4 of the modified Romberg Test-and walking speed was determined using a 20-ft (6.10 m) timed walk. Multivariable linear regression was used to evaluate the association between imbalance and walking speed, adjusting for demographic and health-related covariates. A structural equation model was developed to estimate the extent to which imbalance mediates the association between age and slower walking speed. In the unadjusted regression model, inability to perform the NHANES balance task was significantly associated with 0.10 m/s slower walking speed (95% confidence interval: -0.13 to -0.07; P imbalance mediates 12.2% of the association between age and slower walking speed in older adults. In a nationally representative sample, age-related balance limitation was associated with slower walking speed. Balance impairment may lead to walking speed declines. In addition, reduced static postural control and dynamic walking speed that occur with aging may share common etiologic origins, including the decline in visual, proprioceptive, and vestibular sensory and

  5. Obesity and Insulin Resistance Screening Tools in American Adolescents: National Health and Nutrition Examination Survey (NHANES) 1999 to 2010.

    Science.gov (United States)

    Lee, Joey A; Laurson, Kelly R

    2016-08-01

    To identify which feasible obesity and insulin resistance (IR) screening tools are most strongly associated in adolescents by using a nationally representative sample. Adolescents aged 12.0 to 18.9 years who were participating in the National Health and Nutrition Examination Survey (NHANES) (n=3584) and who were measured for height, weight, waist circumference (WC), triceps and subscapular skinfold thickness, glycated hemoglobin, fasting glucose (FG) and fasting insulin (FI) level were included. Adolescents were split by gender and grouped by body mass index (BMI) percentile. Age- and gender-specific classifications were constructed for each obesity screening tool measure to account for growth and maturation. General linear models were used to establish groups objectively for analysis based on when IR began to increase. Additional general linear models were used to identify when IR significantly increased for each IR measure as obesity group increased and to identify the variance accounted for among each obesity-IR screening tool relationship. As the obesity group increased, homeostasis model assessment-insulin resistance (HOMA-IR) and FI significantly increased, while FG increased only (above the referent) in groups with BMI percentiles ≥95.0, and glycated hemoglobin level did not vary across obesity groups. The most strongly associated screening tools were WC and FI in boys (R(2)=0.253) and girls (R(2)=0.257). FI had the strongest association with all of the obesity measures. BMI associations were slightly weaker than WC in each in relation to IR. Our findings show that WC and FI are the most strongly associated obesity and IR screening tool measures in adolescents. These feasible screening tools should be utilized in screening practices for at-risk adolescents. Copyright © 2015 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  6. The Relationship between Metabolically Obese Non-Obese Weight and Stroke: The Korea National Health and Nutrition Examination Survey.

    Directory of Open Access Journals (Sweden)

    Young-Gyun Seo

    Full Text Available Both metabolic syndrome (MetS and obesity increase the risk of stroke. However, few studies have compared the risks of stroke associated with metabolically obese non-obese weight (MONW and metabolically healthy obesity (MHO. This study aimed to compare the prevalence of stroke in MONW and MHO individuals.A total of 25,744 subjects aged ≥40 years were selected from the 2007-2014 Korean National Health and Nutrition Examination Survey. MetS was defined using 2001 National Cholesterol Education Program/Adult Treatment Panel III and 2005 American Heart Association/National Heart, Lung, and Blood Institute criteria. Non-obese weight and obesity were defined as a body mass index (BMI <25 kg/m2 and ≥25 kg/m2, respectively. MONW was defined as meeting the MetS criteria with a BMI <25 kg/m2 and MHO was defined as not meeting the MetS criteria with a BMI ≥25 kg/m2.Women with MONW had a higher prevalence of stroke than those with MHO (odds ratio [OR] = 2.27, 95% confidence interval [CI]: 1.45-3.57. The prevalence of stroke increased as the number of MetS components increased. The ORs for MONW with 3, 4, and 5 MetS components were 1.95 (95% CI: 1.19-3.21, 2.49 (95% CI: 1.46-4.24 and 2.74 (95% CI: 1.39-5.40, respectively.Our study findings may better emphasize the risk of stroke among more lean but unhealthy individuals, who appear healthy but may be suffering from MetS. These findings also highlight the need for stroke risk factor assessment in non-obese weight individuals.

  7. Electronic Health Record Data Versus the National Health and Nutrition Examination Survey (NHANES): A Comparison of Overweight and Obesity Rates.

    Science.gov (United States)

    Funk, Luke M; Shan, Ying; Voils, Corrine I; Kloke, John; Hanrahan, Lawrence P

    2017-06-01

    Estimating population-level obesity rates is important for informing policy and targeting treatment. The current gold standard for obesity measurement in the United States-the National Health and Nutrition Examination Survey (NHANES)-samples health system-level measurement. To assess the feasibility of using body mass index (BMI) data from the electronic health record (EHR) to assess rates of overweight and obesity and compare these rates to national NHANES estimates. Using outpatient data from 42 clinics, we studied 388,762 patients in a large health system with at least 1 primary care visit in 2011-2012. We compared crude and adjusted overweight and obesity rates by age category and ethnicity (white, black, Hispanic, Other) between EHR and NHANES participants. Adjusted overweight (BMI≥25) and obesity rates were calculated by a 2-step process. Step 1 accounted for missing BMI data using inverse probability weighting, whereas step 2 included a poststratification correction to adjust the EHR population to a nationally representative sample. Adjusted rates of obesity (BMI≥30) for EHR patients were 37.3% [95% confidence interval (95% CI), 37.1-37.5] compared with 35.1% (95% CI, 32.3-38.1) for NHANES patients. Among the 16 different obesity class, ethnicity, and sex strata that were compared between EHR and NHANES patients, 14 (87.5%) contained similar obesity estimates (ie, overlapping 95% CIs). EHRs may be an ideal tool for identifying and targeting patients with obesity for implementation of public health and/or individual level interventions.

  8. Sarcopenia exacerbates obesity-associated insulin resistance and dysglycemia: findings from the National Health and Nutrition Examination Survey III.

    Directory of Open Access Journals (Sweden)

    Preethi Srikanthan

    2010-05-01

    Full Text Available Sarcopenia often co-exists with obesity, and may have additive effects on insulin resistance. Sarcopenic obese individuals could be at increased risk for type 2 diabetes. We performed a study to determine whether sarcopenia is associated with impairment in insulin sensitivity and glucose homeostasis in obese and non-obese individuals.We performed a cross-sectional analysis of National Health and Nutrition Examination Survey III data utilizing subjects of 20 years or older, non-pregnant (N = 14,528. Sarcopenia was identified from bioelectrical impedance measurement of muscle mass. Obesity was identified from body mass index. Outcomes were homeostasis model assessment of insulin resistance (HOMA IR, glycosylated hemoglobin level (HbA1C, and prevalence of pre-diabetes (6.0≤ HbA1C<6.5 and not on medication and type 2 diabetes. Covariates in multiple regression were age, educational level, ethnicity and sex.Sarcopenia was associated with insulin resistance in non-obese (HOMA IR ratio 1.39, 95% confidence interval (CI 1.26 to 1.52 and obese individuals (HOMA-IR ratio 1.16, 95% CI 1.12 to 1.18. Sarcopenia was associated with dysglycemia in obese individuals (HbA1C ratio 1.021, 95% CI 1.011 to 1.043 but not in non-obese individuals. Associations were stronger in those under 60 years of age. We acknowledge that the cross-sectional study design limits our ability to draw causal inferences.Sarcopenia, independent of obesity, is associated with adverse glucose metabolism, and the association is strongest in individuals under 60 years of age, which suggests that low muscle mass may be an early predictor of diabetes susceptibility. Given the increasing prevalence of obesity, further research is urgently needed to develop interventions to prevent sarcopenic obesity and its metabolic consequences.

  9. Sleep disordered breathing and depression among U.S. adults: National Health and Nutrition Examination Survey, 2005-2008.

    Science.gov (United States)

    Wheaton, Anne G; Perry, Geraldine S; Chapman, Daniel P; Croft, Janet B

    2012-04-01

    To determine if symptoms of sleep disordered breathing (SDB) are associated with depression symptomology in a national sample. National Health and Nutrition Examination Survey. U.S., 2005-2008. 9,714 adults (≥ 18 years). Respondents were asked about frequency of snoring and snorting, gasping, or stopping breathing while asleep and completed the PHQ-9 (a 9-item depression screener). Odds ratios (OR) and 95% confidence intervals (CI) for SDB symptom-associated probable major depression (defined as a PHQ-9 score ≥ 10) were obtained from sex-specific logistic regression analyses adjusted for body mass index, age, race/ethnicity, and education. Among men, 6.0% reported physician-diagnosed sleep apnea, 37.2% snored ≥ 5 nights/week, 7.1% snorted/stopped breathing ≥ 5 nights/week, and 5.0% had PHQ-9 scores ≥ 10. Among women, 3.1% reported sleep apnea, 22.4% snored ≥ 5 nights/week, 4.3% snorted/stopped breathing ≥ 5 nights/week, and 8.4% had PHQ-9 scores ≥ 10. Sleep apnea was associated with probable major depression (OR = 2.4; 95% CI: 1.5, 3.6 among men; OR = 5.2; 95% CI: 2.7, 9.9 among women). Snoring was not associated with depression symptoms in men or women. Snorting/stopping breathing ≥ 5 nights/week compared to never was strongly associated with probable major depression in men (OR = 3.1; 95% CI: 1.8, 5.2) and women (OR = 3.0; 95% CI: 1.6, 5.4). Frequent snorting/stopping breathing was associated with probable major depression by the PHQ-9 in a national sample of adults. Additional research may be needed to determine whether regular screening for these conditions by mental health professionals and sleep specialists should be recommended.

  10. Deterministic modeling of the exposure of individual participants in the National Health and Nutrition Examination Survey (NHANES) to polychlorinated biphenyls.

    Science.gov (United States)

    Wood, Stephen A; Armitage, James M; Binnington, Matthew J; Wania, Frank

    2016-09-14

    A population's exposure to persistent organic pollutants, e.g., polychlorinated biphenyls (PCBs), is typically assessed through national biomonitoring programs, such as the United States National Health and Nutrition Examination Survey (NHANES). To complement statistical methods, we use a deterministic modeling approach to establish mechanistic links between human contaminant concentrations and factors (e.g. age, diet, lipid mass) deemed responsible for the often considerable variability in these concentrations. Lifetime exposures to four PCB congeners in 6128 participants from NHANES 1999-2004 are simulated using the ACC-Human model supplied with individualized input parameters obtained from NHANES questionnaires (e.g., birth year, sex, body mass index, dietary composition, reproductive behavior). Modeled and measured geometric mean PCB-153 concentrations in NHANES participants of 13.3 and 22.0 ng g -1 lipid, respectively, agree remarkably well, although lower model-measurement agreement for air, water, and food suggests that this is partially due to fortuitous error cancellation. The model also reproduces trends in the measured data with key factors such as age, parity and sex. On an individual level, 62% of all modeled concentrations are within a factor of three of their corresponding measured values (Spearman r s = 0.44). However, the model attributes more of the inter-individual variability to differences in dietary lipid intake than is indicated by the measured data. While the model succeeds in predicting levels and trends on the population level, the accuracy of individual-specific predictions would need to be improved for refined exposure characterization in epidemiological studies.

  11. Helping veterans achieve work: A Veterans Health Administration nationwide survey examining effective job development practices in the community.

    Science.gov (United States)

    Kukla, Marina; McGuire, Alan B; Strasburger, Amy M; Belanger, Elizabeth; Bakken, Shana K

    2018-06-01

    Veterans Health Administration vocational services assist veterans with mental illness to acquire jobs; one major component of these services is job development. The purpose of this study was to characterize the nature of effective job development practices and to examine perceptions and intensity of job development services. A national mixed-methods online survey of 233 Veterans Health Administration vocational providers collected data regarding frequency of employer contacts, perceptions of job development ease/difficulty, and effective job development practices when dealing with employers. Qualitative responses elucidating effective practices were analyzed using content analysis. Vocational providers had a modest number of job development employer contacts across 2 weeks (M = 11.0, SD = 10.6) and fewer were face-to-face (M = 7.6, SD = 8.4). Over 70% of participants perceived job development to be difficult. Six major themes emerged regarding effective job development practices with employers: using an employer-focused approach; utilizing a targeted marketing strategy; engaging in preparation and follow-up; going about the employer interaction with genuineness, resilience, and a strong interpersonal orientation; serving as an advocate for veterans and educator of employers; utilizing specific employer-tailored strategies, such as arranging a one-on-one meeting with a decision maker and touring the business, individualizing a prescripted sales pitch, connecting on a personal level, and engaging in ongoing communication to solidify the working relationship. Respondents highlight several potentially effective job development strategies; tools and resources may be developed around these strategies to bolster job development implementation and allow opportunities for fruitful employer interactions. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  12. Association between sleep quality and C-reactive protein: results from national health and nutrition examination survey, 2005-2008.

    Directory of Open Access Journals (Sweden)

    Rong Liu

    Full Text Available OBJECTIVE: Our objective was to explore the association between poor sleep quality and hs_CRP in an adult U.S. population. METHODS: This study focused on 9,317 participants in the National Health and Nutrition Examination Survey (NHANES from 2005-2008 who were aged 20-85 years, completed a sleep disorder questionnaire, and had available information on serum hs_CRP. Sleep quality was classified into three categories (good, moderate, poor based on the responses of participants to the NHANES sleep disorder questionnaire. High CRP was defined as hs-CRP >1 md/dL. Linear regression model was applied to investigate the association between poor sleep quality and log-transformed hs_CRP. And logistic regression model was fitted to evaluate the association between sleep quality and the risk of high CRP. RESULTS: Females were more likely to report poor sleep quality than males (26% vs. 19%, p<0.0001. Each sleep disorder was significantly associated with increased hs_CRP and correlative to other sleep disorders. In fully-adjusted linear regression model, poor sleep quality was significantly associated with elevated hs_CRP (log transformed among the overall sample and in females only (β = 0.10, se = 0.03, p<0.01 and β = 0.13, se = 0.04, p<0.01, respectively. In fully-adjusted logistics regression model, poor sleep quality was linked with risk of high CRP(OR: 1.42, 95%CI: 1.15-1.76 in overall sample and OR: 1.59, 95%CI: 1.18-2.14 in females, respectively. CONCLUSION: We found that poor sleep quality was independently associated with elevated hs_CRP in females but not in males in a U.S. adult population.

  13. Physical activity patterns and socioeconomic position: the German National Health Interview and Examination Survey 1998 (GNHIES98).

    Science.gov (United States)

    Finger, Jonas D; Tylleskär, Thorkild; Lampert, Thomas; Mensink, Gert B M

    2012-12-15

    We investigated the associations between education and leisure-time, occupational, sedentary and total physical-activity levels based on data from the German National Health Interview and Examination Survey 1998 (GNHIES98). The roles of income level, occupational status and other mediating variables for these associations were also examined. The total study sample of the GNHIES98 comprised 7,124 participants between the ages of 18 and 79. Complete information was available for 6,800 persons on leisure-time, sedentary and total physical-activity outcomes and for 3,809 persons in regular employment on occupational activity outcomes. The associations between educational level and physical activity (occupational, sedentary, leisure-time and total physical activity) were analysed separately for men and women using multivariate logistic regression analysis. Odds ratios (OR) of educational level on physical-activity outcomes were calculated and adjusted for age, region, occupation, income and other mediating variables. After adjusting for age and region, a higher education level was associated with more leisure-time activity - with an OR of 1.6 (95% CI, 1.3-2.0) for men with secondary education and 2.1 (1.7-2.7) for men with tertiary education compared to men with primary education. The corresponding ORs for women were 1.3 (1.1-1.6) and 1.7 (1.2-2.4), respectively. Higher education was associated with a lower level of vigorous work activity: an OR of 6.9 (4.6-10.3) for men with secondary education and 18.6 (12.0-27.3) for men with primary education compared to men with tertiary education. The corresponding ORs for women were 2.8 (2.0-4.0) and 5.8 (4.0-8.5), respectively. Higher education was also associated with a lower level of total activity: an OR of 2.9 (2.2-3.8) for men with secondary education and 4.3 (3.3-5.6) for men with tertiary education compared to men with primary education. The corresponding ORs for women were 1.6 (1.2-2.0) and 1.6 (1.2-2.1), respectively

  14. Dyslipidemia and Food Security in Low-Income US Adolescents: National Health and Nutrition Examination Survey, 2003–2010

    Science.gov (United States)

    Laraia, Barbara A.; Leung, Cindy W.; Mietus-Snyder, Michele L.

    2016-01-01

    Introduction Low levels of food security are associated with dyslipidemia and chronic disease in adults, particularly in women. There is a gap in knowledge about the relationship between food security among youth and dyslipidemia and chronic disease. We investigated the relationship between food security status and dyslipidemia among low-income adolescents. Methods We analyzed data from adolescents aged 12 to 18 years (N = 1,072) from households with incomes at or below 200% of the federal poverty level from the National Health and Nutrition Examination Survey (NHANES) 2003–2010. We used logistic regression to examine the relationship between household food security status and the odds of having abnormalities with fasting total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), serum triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), TG/HDL-C ratio, and apolipoprotein B (Apo B). Models included age, sex, race/ethnicity, smoking status, partnered status in the household, and maternal education, with additional adjustment for adiposity. Results Household food security status was not associated with elevated TC or LDL-C. Adolescents with marginal food security were more likely than food-secure peers to have elevated TGs (odds ratio [OR] = 1.86; 95% confidence interval [CI], 1.14–3.05), TG/HDL-C ratio (OR = 1.74; 95% CI, 1.11–2.82), and Apo B (OR = 1.98; 95% CI, 1.17–3.36). Female adolescents with marginal food security had greater odds than male adolescents of having low HDL-C (OR = 2.69; 95% CI, 1.14–6.37). No elevated odds of dyslipidemia were found for adolescents with low or very low food security. Adjustment for adiposity did not attenuate estimates. Conclusion In this nationally representative sample, low-income adolescents living in households with marginal food security had increased odds of having a pattern consistent with atherogenic dyslipidemia, which represents a cardiometabolic burden above their risk from adiposity

  15. Association between Sarcopenia and Dipstick Proteinuria in the Elderly Population: The Korea National Health and Nutrition Examination Surveys 2009–2011

    OpenAIRE

    Hwang, Duna; Cho, Mi-Ryung; Choi, Minyong; Lee, Sang Hyun; Park, Youngmin

    2017-01-01

    Background Sarcopenia and proteinuria are significant health difficulties in the elderly; however, few studies have investigated their relationship. In this study, we investigated the association between sarcopenia and proteinuria in Korean subjects over 60 years old. Methods We included data from the Korean National Health and Nutrition Examination Survey, a cross-sectional, nationally representative survey conducted from 2009 to 2011 (n=4,008). Sarcopenia was defined using appendicular skel...

  16. Studies of the mortality of A-bomb survivors: report 7. Mortality, 1950-1978: part II. Mortality from causes other than cancer and mortality in early entrants

    International Nuclear Information System (INIS)

    Kato, H.; Brown, C.C.; Hoel, D.G.; Shull, W.J.

    1982-01-01

    Deaths in the Radiation Effects Research Foundation (REFR) Life Span Study (LSS) sample have been determined for the 4 years 1975-1978, and mortality examined for the 28 years since 1950. An analysis of cancer mortality is presented separately. In this report, we examine whether mortality from causes other than cancer is also increased or whether a nonspecific acceleration of aging occurs. 1. Cumulative mortality from causes other than cancer, estimated by the life table method, does not increase with radiation dose in either city, in either sex, or in any of the five different age-at-the-time-of-bomb groups. 2. No specific cause of death, other than cancer, exhibits a significant relationship with A-bomb exposure. Thus there is still no evidence of a nonspecific acceleration of aging due to radiation in this cohort. 3. Mortality before the LSS sample was established has been reanalyzed using three supplementary mortality surveys to determine the magnitude of the possible bias from the exclusion of deaths prior to 1950. It is unlikely that such a bias seriously affects the interpretation of the radiation effects observed in the cohort after 1950. 4. No excess of deaths from leukemia or other malignant tumors is observed among early entrants into these cities in this cohort

  17. Neonatal tetanus mortality in coastal Kenya

    DEFF Research Database (Denmark)

    Bjerregaard, P; Steinglass, R; Mutie, D M

    1993-01-01

    In a house-to-house survey in Kilifi District, Kenya, mothers of 2556 liveborn children were interviewed about neonatal mortality, especially from neonatal tetanus (NNT). The crude birth rate was 60.5 per 1000 population, the neonatal mortality rate 21.1 and the NNT mortality rate 3.1 per 1000 li...... indicates that over the past decade the surveyed area has greatly reduced neonatal and NNT mortality. Possible strategies for accelerated NNT control have been identified by the survey....

  18. Preclinical Pharmacokinetic/Pharmacodynamic Modeling and Simulation in the Pharmaceutical Industry: An IQ Consortium Survey Examining the Current Landscape

    OpenAIRE

    Schuck, Edgar; Bohnert, Tonika; Chakravarty, Arijit; Damian-Iordache, Valeriu; Gibson, Christopher; Hsu, Cheng-Pang; Heimbach, Tycho; Krishnatry, Anu Shilpa; Liederer, Bianca M; Lin, Jing; Maurer, Tristan; Mettetal, Jerome T; Mudra, Daniel R; Nijsen, Marjoleen JMA; Raybon, Joseph

    2015-01-01

    The application of modeling and simulation techniques is increasingly common in preclinical stages of the drug discovery and development process. A survey focusing on preclinical pharmacokinetic/pharmacodynamics (PK/PD) analysis was conducted across pharmaceutical companies that are members of the International Consortium for Quality and Innovation in Pharmaceutical Development. Based on survey responses, ~68% of companies use preclinical PK/PD analysis in all therapeutic areas indicating its...

  19. Development of a Survey to Examine the Factors that Motivate Secondary Education Teachers' Use of Problem-based Learning (PBL)

    Science.gov (United States)

    Lao, Huei-Chen

    In this quantitative study, a survey was developed and administered to middle and high school teachers to examine what factors motivated them to implement problem-based learning (PBL). Using Expectancy-Value Theory by Eccles et al. (1983) and Self-Determination Theory by Ryan and Deci (2000b) as the theoretical framework, this instrument measured respondents' perceived competence, support for autonomy and relatedness, and value and cost they placed on implementing PBL. Data analyses indicated that the instrument had good reliability. A 3-factor structure was established by exploratory factor analysis which confirmed the construct validity of the instrument. Value of PBL to teachers and their students was the most dominant factor that motivated teachers to implement it. The second most important factor was their self-efficacy and anxiety about failing this pedagogy, and the third factor was teachers' perceived autonomy, and support from schools and colleagues. Regression models showed the predictive power of the factors on teachers' intention to implement PBL, with their perceptions of the value of PBL being the strongest predictor. Results also indicate that teachers with PBL experience perceived significantly higher levels of competence and support from peers, and placed a higher level of value and perceived less cost in implementing PBL than teachers who had not implemented PBL. Teachers' formal training in PBL played a significant role in positively influencing their perceptions of competence and the value of PBL, and reduced their perceived cost of implementing PBL. This, in turn, enhanced teachers' intention of practicing PBL. For teachers who had previously taught with PBL, their responses to two open-ended questions in this instrument corresponded with the theoretical framework of this study and triangulated well with the quantitative data. These teachers highly valued PBL and they recognized the challenges associated with its implementation. These teachers

  20. Association between socioeconomic status and oral health behaviors: The 2008-2010 Korea national health and nutrition examination survey.

    Science.gov (United States)

    Park, Jun-Beom; Han, Kyungdo; Park, Yong-Gyu; Ko, Youngkyung

    2016-10-01

    Socioeconomic status (SES) has been reported to be associated with oral health behavior. Therefore, the present study was conducted to assess the relationship between SES and oral health behaviors in a large sample of the Korean population. Data from the Korea National Health and Nutrition Examination Survey, which was conducted between 2008 and 2010 by the Division of Chronic Disease Surveillance under the Korea Centers for Disease Control and Prevention and the Korean Ministry of Health and Welfare, were used in the present study. Daily tooth brushing frequency and the use of secondary oral products according to demographic variables and anthropometric characteristics of the participants were assessed. Multivariate logistic regression analyses were used to analyze the associations between daily tooth brushing frequency and the use of secondary oral products, and SES, urban/rural residence, body mass index (BMI), alcohol intake and smoking. An association between SES and tooth brushing frequency and the use of secondary oral products was detected after adjustment. Following adjustment for age, gender, BMI, smoking, drinking, exercise, energy intake, fat intake, periodontal treatment needs and education or income, the adjusted odds ratios and 95% confidence intervals (CI) of tooth brushing ≥3 per day in the highest income group were 1.264 (95% CI, 1.094-1.460) and 2.686 (95% CI, 2.286-3.155) for highest education level group. The adjusted odds ratios for the use of secondary oral products in the highest income and highest education groups were 1.835 (95% CI, 1.559-2.161) and 5.736 (95% CI, 4.734-6.951), respectively, after adjustment for age, gender, smoking, BMI, exercise, calorie intake, periodontal treatment requirements or income. The present study demonstrated an association between SES and oral health behaviors in a large sample of the Korean population. Within the limits of the present study, income and education were suggested as potential risk indicators

  1. Sugary soda consumption and albuminuria: results from the National Health and Nutrition Examination Survey, 1999-2004.

    Directory of Open Access Journals (Sweden)

    David A Shoham

    Full Text Available BACKGROUND: End-stage renal disease rates rose following widespread introduction of high fructose corn syrup in the American diet, supporting speculation that fructose harms the kidney. Sugar-sweetened soda is a primary source of fructose. We therefore hypothesized that sugary soda consumption was associated with albuminuria, a sensitive marker for kidney disease. METHODOLOGY/PRINCIPAL FINDINGS: Design was a cross-sectional analysis. Data were drawn from the National Health and Nutrition Examination Survey (NHANES, 1999-2004. The setting was a representative United States population sample. Participants included adults 20 years and older with no history of diabetes mellitus (n = 12,601; after exclusions for missing outcome and covariate information (n = 3,243, the analysis dataset consisted of 9,358 subjects. Exposure was consumption of two or more sugary soft drinks, based on 24-hour dietary recall. The main outcome measure was Albuminuria, defined by albumin to creatinine ratio cutpoints of >17 mg/g (males and >25 mg/g (females. Logistic regression adjusted for confounders (diet soda, age, race-ethnicity, gender, poverty. Interactions between age, race-ethnicity, gender, and overweight-obesity were explored. Further analysis adjusted for potential mediators: energy intake, basal metabolic rate, obesity, hypertension, lipids, serum uric acid, smoking, energy expenditure, and glycohemoglobin. Alternative soda intake definitions and cola consumption were employed. RESULTS: Weighted albuminuria prevalence was 11%, and 17% consumed 2+ sugary soft drinks/day. The confounder-adjusted odds ratio for sugary soda was 1.40 (95% confidence interval: 1.13, 1.74. Associations were modified by gender (p = 0.008 and overweight-obesity (p = 0.014. Among women, the OR was 1.86 (95% CI: 1.37, 2.53; the OR among males was not significant. In the group with body mass under 25 kg/m(2, OR = 2.15 (95% confidence interval: 1.42, 3.25. Adjustment for potential

  2. Exposure to DDT and diabetic nephropathy among Mexican Americans in the 1999-2004 National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Everett, Charles J; Thompson, Olivia M; Dismuke, Clara E

    2017-03-01

    Concentrations of the pesticide DDT (dichlorodiphenyltrichloroethane) and its metabolite DDE (dichlorodiphenyldichloroethylene), in the blood of Mexican Americans, were evaluated to determine their relationships with diabetes and diabetic nephropathy. The data were derived from the National Health and Nutrition Examination Survey (NHANES) 1999-2004 (unweighted N = 1,411, population estimate = 13,760,609). The sample included teens, 12-19 years old, which accounted for 19.8% of the data. The time of the study overlapped the banning of DDT in Mexico in the year 2000, and those participants born in Mexico were exposed to DDT before they immigrated to the US. We sought to better understand the relationship of DDT with diabetes in a race/ethnicity group prone to develop diabetes and exposed to DDT. In this study, nephropathy was defined as urinary albumin to creatinine ratio >30 mg/g, representing microalbuminuria and macroalbuminuria, and total diabetes was defined as diagnosed and undiagnosed diabetes (glycohemoglobin, A1c ≥ 6.5%). The proportion with the isomer p,p'-DDT >0.086 ng/g (above the maximum limit of detection) was 13.3% for Mexican Americans born in the US, and 36.9% for those born in Mexico. Levels of p,p'-DDT >0.086 ng/g were associated with total diabetes with nephropathy (odds ratio = 4.42, 95% CI 2.23-8.76), and with total diabetes without nephropathy (odds ratio = 2.02, 95% CI 1.19-3.44). The third quartile of p,p'-DDE (2.99-7.67 ng/g) and the fourth quartile of p,p'-DDE (≥7.68 ng/g) were associated with diabetic nephropathy and had odds ratios of 5.32 (95% CI 1.05-26.87) and 14.95 (95% CI 2.96-75.48) compared to less than the median, respectively, whereas p,p'-DDE was not associated with total diabetes without nephropathy. The findings of this study differ from those of a prior investigation of the general adult US population in that there were more associations found with the Mexican Americans sample. Published by Elsevier Ltd.

  3. Cigarette Smoking in Persons Living with Hepatitis C: The National Health and Nutrition Examination Survey (NHANES), 1999-2014.

    Science.gov (United States)

    Kim, Ryung S; Weinberger, Andrea H; Chander, Geetanjali; Sulkowski, Mark S; Norton, Brianna; Shuter, Jonathan

    2018-06-01

    Cigarette smoking is common in persons living with hepatitis C (hepatitis C+), but national statistics on this harmful practice are lacking. A better understanding of smoking behaviors in hepatitis C+ individuals may help in the development of targeted treatment strategies. We extracted data from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2014. Hepatitis C+ were compared with hepatitis C- adults in the entire sample and in the subset of current smokers. Measures included demographics, current smoking, cigarettes/day, nicotine dependence, other tobacco use, substance use, and medical and psychiatric comorbidities. Complete smoking and hepatitis C virus (HCV) data were available for 39,472 (90.1%) of 43,793 adult participants in NHANES during the study years. Hepatitis C+ smoked at almost triple the rate of hepatitis C- adults (62.4% vs 22.9%), with no significant difference between hepatitis C+ men and women (64.5% vs 58.2%). Hepatitis C+ smokers were more likely to smoke daily than hepatitis C- smokers (87.5% vs 80.0%), but had similar levels of nicotine dependence. Hepatitis C+ smokers were more likely to be older (mean age: 47.1 vs 41.5 years), male (69.4% vs 54.4%), Black (21.2% vs 12.1%), less educated (any college: 31.8% vs 42.9%), poor (mean family monthly poverty index: 1.80 vs 2.47), uninsured (43.9% vs 30.4%), use drugs (cocaine: 11.1% vs 3.2%; heroin: 4.0% vs 0.6%), and be depressed (33.2% vs 13.5%). Multivariate analyses revealed significant associations of both hepatitis C infection and cigarette smoking with current depression and hypertension. There is a cigarette smoking epidemic embedded within the hepatitis C epidemic in the United States. The sociodemographic profile of hepatitis C+ smokers suggests that the implementation of effective tobacco treatment will be challenging. Thoughtful treatment strategies that are mindful of the unique characteristics of this group are needed. Copyright © 2018 Elsevier

  4. Prevalence of Elevated Cardiovascular Risks in Young Adults: A Cross-sectional Analysis of National Health and Nutrition Examination Surveys.

    Science.gov (United States)

    Patel, Krishna K; Taksler, Glen B; Hu, Bo; Rothberg, Michael B

    2017-06-20

    The 2013 cholesterol management guidelines from the American College of Cardiology and American Heart Association (ACC/AHA) recommend lipid screening in all adults older than 20 years to identify those at increased risk for atherosclerotic cardiovascular disease (ASCVD). Statins may be considered for patients with elevated 10-year risk (>5%) or a low-density lipoprotein cholesterol (LDL-C) level of 4.92 mmol/L (190 mg/dL) or greater. To describe the prevalence of elevated ASCVD risk among nondiabetic adults younger than 50 years. Cross-sectional. NHANES (National Health and Nutrition Examination Survey), 1999 to 2000 through 2011 to 2012. Adults aged 30 to 49 years without known ASCVD or diabetes. 10-year ASCVD risk was estimated by using the 2013 ACC/AHA ASCVD risk calculator. Participants were subdivided by age, sex, and history of smoking and hypertension. The percentages of adults in each subgroup with a 10-year ASCVD risk greater than 5% and of those with an LDL-C level of 4.92 mmol/L (190 mg/dL) or greater were estimated. Low-prevalence subgroups were defined as those in which a greater than 1% prevalence of elevated cardiovascular risk could be ruled out (that is, the upper 95% confidence bound for prevalence was ≤1%). Overall, 9608 NHANES participants representing 67.9 million adults were included, with approximately half (47.12%, representing 32 million adults) in low-prevalence subgroups. In the absence of smoking or hypertension, 0.09% (95% CI, 0.02% to 0.35%) of adult men younger than 40 years and 0.04% (CI, 0.0% to 0.26%) of adult women younger than 50 years had an elevated risk. Among other subgroups, 0% to 75.9% of participants had an increased risk. Overall, 2.9% (CI, 2.3% to 3.5%) had an LDL-C level of 4.92 mmol/L (190 mg/dL) or greater. No information was available regarding cardiovascular outcomes. In the absence of risk factors, the prevalence of increased ASCVD risk is low among women younger than 50 and men younger than 40 years. None.

  5. Psoriasis and the Risk of Depression in the US Population: National Health and Nutrition Examination Survey 2009-2012.

    Science.gov (United States)

    Cohen, Brandon E; Martires, Kathryn J; Ho, Roger S

    2016-01-01

    Psoriasis is a risk factor for depression. Depression may also trigger or exacerbate psoriasis. The relationship between psoriasis and depression, however, remains to be fully explored. To investigate the association between psoriasis and major depression in the US population. Population-based study using participants in the National Health and Nutrition Examination Survey from 2009 through 2012. Diagnosis of major depression based on the Patient Health Questionnaire-9. We identified 351 (2.8%) cases of psoriasis and 968 (7.8%) cases of major depression among 12,382 US citizens included in our study. Fifty-eight (16.5%) patients with psoriasis met criteria for a diagnosis of major depression. The mean (SD) Patient Health Questionnaire-9 score was significantly higher among patients with a history of psoriasis than those without psoriasis (4.54 [5.7] vs 3.22 [4.3], P < .001). Psoriasis was significantly associated with major depression, even after adjustment for sex, age, race, body mass index, physical activity, smoking history, alcohol use, history of myocardial infarction (MI), history of stroke, and history of diabetes mellitus (OR, 2.09 [95% CI, 1.41-3.11], P < .001). Interaction term analyses involving patients with a history of both psoriasis and a cardiovascular event, specifically MI or stroke, did not reveal a synergistically increased risk of major depression (psoriasis and MI: OR, 1.09 [95% CI, 0.28-3.60], P = .91; psoriasis and stroke: OR, 0.67 [95% CI, 0.12-3.66], P = .63). In adjusted multivariable models, the risk of major depression was not significantly different between patients with limited vs extensive psoriasis (OR, 0.66 [95% CI, 0.18-2.44], P = .53). Self-reported history of psoriasis was independently associated with major depression as assessed by a validated screening tool, even when controlling for comorbidities. History of cardiovascular event did not modify the risk of major depression for patients with psoriasis. The severity

  6. Web based health surveys: Using a Two Step Heckman model to examine their potential for population health analysis.

    Science.gov (United States)

    Morrissey, Karyn; Kinderman, Peter; Pontin, Eleanor; Tai, Sara; Schwannauer, Mathias

    2016-08-01

    In June 2011 the BBC Lab UK carried out a web-based survey on the causes of mental distress. The 'Stress Test' was launched on 'All in the Mind' a BBC Radio 4 programme and the test's URL was publicised on radio and TV broadcasts, and made available via BBC web pages and social media. Given the large amount of data created, over 32,800 participants, with corresponding diagnosis, demographic and socioeconomic characteristics; the dataset are potentially an important source of data for population based research on depression and anxiety. However, as respondents self-selected to participate in the online survey, the survey may comprise a non-random sample. It may be only individuals that listen to BBC Radio 4 and/or use their website that participated in the survey. In this instance using the Stress Test data for wider population based research may create sample selection bias. Focusing on the depression component of the Stress Test, this paper presents an easy-to-use method, the Two Step Probit Selection Model, to detect and statistically correct selection bias in the Stress Test. Using a Two Step Probit Selection Model; this paper did not find a statistically significant selection on unobserved factors for participants of the Stress Test. That is, survey participants who accessed and completed an online survey are not systematically different from non-participants on the variables of substantive interest. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Occupational mortality

    DEFF Research Database (Denmark)

    Lynge, Elsebeth

    2011-01-01

    -1975 revealed a considerable social class gradient in male mortality where university teachers and farmers had a 40% lower mortality and waiters and seamen had an about 100% higher mortality than the average for economically active men. The social class gradient was less steep for women. A similar pattern...

  8. Association between Nutrition Label Reading and Nutrient Intake in Korean Adults: Korea National Health and Nutritional Examination Survey, 2007-2009 (KNHANES IV)

    OpenAIRE

    Kim, Min-Gyou; Oh, Seung-Won; Han, Na-Rae; Song, Dong-Ju; Um, Jae-Yean; Bae, Su-Hyun; Kwon, Hyuktae; Lee, Cheol-Min; Joh, Hee-Kyung; Hong, Sung-woo

    2014-01-01

    Background Nutrition labels provide various information on the nutrient contents of food. However, despite the recent increase in the interest in dietary intake and expansion of related policies, studies on the association between nutrition label reading and dietary intake are lacking in Korea. Methods This study analyzed the 2007-2009 KNHANES (Korean National Health and Nutrition Examination Survey) data. To examine macronutrients and micronutrients intake according to nutrition label readin...

  9. Body Fat Percentile Curves for Korean Children and Adolescents: A Data from the Korea National Health and Nutrition Examination Survey 2009-2010

    OpenAIRE

    Kim, Kirang; Yun, Sung Ha; Jang, Myoung Jin; Oh, Kyung Won

    2013-01-01

    A valid assessment of obesity in children and adolescents is important due to significant change in body composition during growth. This study aimed to develop percentile curves of body fat and fat free mass using the Lambda, Mu, and Sigma method, and to examine the relationship among body mass index (BMI), fat mass and fat free mass in Korean children and adolescents, using the Korea National Health and Nutrition Examination Survey (KNHANES) 2009-2010. The study subjects were 834 for boys an...

  10. Food Security and Cardiovascular Disease Risk Among Adults in the United States: Findings From the National Health and Nutrition Examination Survey, 2003?2008

    OpenAIRE

    Ford, Earl S.

    2013-01-01

    Introduction Little is known about the relationship between food security status and predicted 10-year cardiovascular disease risk. The objective of this study was to examine the associations between food security status and cardiovascular disease risk factors and predicted 10-year risk in a national sample of US adults. Methods A cross-sectional analysis using data from 10,455 adults aged 20 years or older from the National Health and Nutrition Examination Survey 2003?2008 was conducted. Fou...

  11. Patient-reported mental and physical health outcomes are independent predictors of one-year mortality and cardiac events across cardiac diagnoses. Findings from the national DenHeart survey."

    DEFF Research Database (Denmark)

    Berg, Selina Kikkenborg; Thorup, Charlotte Brun; Borregaard, Britt

    2018-01-01

    -reported outcomes at hospital discharge as a predictor of mortality and cardiac events. Design: A cross-sectional survey with register follow-up. Methods: Participants: All patients discharged from April 2013 to April 2014 from five national heart centres in Denmark. Main outcomes: Patient-reported outcomes......Aims: Patient-reported quality of life and anxiety/depression scores provide important prognostic information independently of traditional clinical data. The aims of this study were to describe: (a) mortality and cardiac events one year after hospital discharge across cardiac diagnoses; (b) patient...

  12. Association between periodontitis and mortality in stages 3-5 chronic kidney disease: NHANES III and linked mortality study.

    Science.gov (United States)

    Sharma, Praveen; Dietrich, Thomas; Ferro, Charles J; Cockwell, Paul; Chapple, Iain L C

    2016-02-01

    Periodontitis may add to the systemic inflammatory burden in individuals with chronic kidney disease (CKD), thereby contributing to an increased mortality rate. This study aimed to determine the association between periodontitis and mortality rate (all-cause and cardiovascular disease-related) in individuals with stage 3-5 CKD, hitherto referred to as "CKD". Survival analysis was carried out using the Third National Health and Nutrition Examination Survey (NHANES III) and linked mortality data. Cox proportional hazards regression was employed to assess the association between periodontitis and mortality, in individuals with CKD. This association was compared with the association between mortality and traditional risk factors in CKD mortality (diabetes, hypertension and smoking). Of the 13,784 participants eligible for analysis in NHANES III, 861 (6%) had CKD. The median follow-up for this cohort was 14.3 years. Adjusting for confounders, the 10-year all-cause mortality rate for individuals with CKD increased from 32% (95% CI: 29-35%) to 41% (36-47%) with the addition of periodontitis. For diabetes, the 10-year all-cause mortality rate increased to 43% (38-49%). There is a strong, association between periodontitis and increased mortality in individuals with CKD. Sources of chronic systemic inflammation (including periodontitis) may be important contributors to mortality in patients with CKD. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Development of a Survey to Examine the Factors That Motivate Secondary Education Teachers' Use of Problem-Based Learning (PBL)

    Science.gov (United States)

    Lao, Huei-Chen

    2016-01-01

    In this quantitative study, a survey was developed and administered to middle and high school teachers to examine what factors motivated them to implement problem-based learning (PBL). Using Expectancy-Value Theory by Eccles et al. (1983) and Self-Determination Theory by Ryan and Deci (2000b) as the theoretical framework, this instrument measured…

  14. A Profile of Puerto Rican Health in the United States: Data from the Hispanic Health and Nutrition Examination Survey 1982-84.

    Science.gov (United States)

    Munoz, Eric; And Others

    The health conditions and health status of Hispanic Americans will assume increased importance as their population increases. The goal of this book of charts is to present data from the Hispanic Health and Nutrition Examination Survey (HHANES) on Puerto Ricans. The Puerto Rican HHANES sampling procedure is a multi-stage probability sample of…

  15. Brief Alcohol Intervention by Newly Trained Workers Versus Leaflets: Comparison of Effect in Older Heavy Drinkers Identified in a Population Health Examination Survey: A Randomized Controlled Trial

    DEFF Research Database (Denmark)

    Hansen, Anders Blædel Gottlieb; Becker, Ulrik; Nielsen, Anette Søgaard

    2011-01-01

    Aims: To test if a brief motivational intervention (BMI) in a non-treatment seeking population of heavy drinkers results in a reduced alcohol intake. Methods: Screening of 12,364 participants in a Danish health examination survey led to 1026 heavy drinkers of whom 772 were included and randomized...

  16. Dietary vitamin C intake protects against COPD: the Korea National Health and Nutrition Examination Survey in 2012

    Directory of Open Access Journals (Sweden)

    Park HJ

    2016-10-01

    Full Text Available Hye Jung Park,1 Min Kwang Byun,1 Hyung Jung Kim,1 Jae Yeol Kim,2 Yu-Il Kim,3 Kwang-Ha Yoo,4 Eun Mi Chun,5 Ji Ye Jung,6 Sang Haak Lee,7 Chul Min Ahn1 On behalf of the Korean Smoking Cessation Study Group 1Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 2Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, 3Department of Internal Medicine, Chonnam National University Hospital, Gwangju, 4Department of Internal Medicine, Konkuk University School of Medicine, 5Department of Internal Medicine, Ewha Womans University School of Medicine, 6Division of Pulmonology, Department of Internal Medicine, Institute of Chest Disease, Severance Hospital, Yonsei University College of Medicine, 7Division of Pulmonology, Critical Care and Sleep Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea Background: Vitamin C, as an antioxidant, has recently been suggested to provide protection against COPD; however, only few national cohort studies have investigated these effects. We aimed to confirm the protective effects of vitamin C against COPD in Korean patients. Patients and methods: We analyzed the data of 3,283 adults aged ≥40 years (representing 23,541,704 subjects who underwent pulmonary function tests and responded to questionnaires on smoking history and vitamin C intake, with stratification variables and sampling weight designated by the Korea 2012 National Health and Nutrition Examination Survey. Results: Among all the subjects, 512 (representing 3,459,679 subjects; 15.6% were diagnosed as having COPD based on pulmonary function test results. Male gender, old age, residence in suburban/rural regions, low household income, low educational level, an occupation in agriculture or fisheries, and heavy smoking were significantly associated with COPD. Low intake of nutrients, including potassium, vitamin A, carotene, retinol

  17. Double-Checking the Race Box: Examining Inconsistency between Survey Measures of Observed and Self-Reported Race

    Science.gov (United States)

    Saperstein, Aliya

    2006-01-01

    Social constructivist theories of race suggest no two measures of race will capture the same information, but the degree of "error" this creates for quantitative research on inequality is unclear. Using unique data from the General Social Survey, I find observed and self-reported measures of race yield substantively different results when used to…

  18. Testing the Invariance of the National Health and Nutrition Examination Survey's Sexual Behavior Questionnaire Across Gender, Ethnicity/Race, and Generation.

    Science.gov (United States)

    Zhou, Anne Q; Hsueh, Loretta; Roesch, Scott C; Vaughn, Allison A; Sotelo, Frank L; Lindsay, Suzanne; Klonoff, Elizabeth A

    2016-02-01

    Federal and state policies are based on data from surveys that examine sexual-related cognitions and behaviors through self-reports of attitudes and actions. No study has yet examined their factorial invariance--specifically, whether the relationship between items assessing sexual behavior and their underlying construct differ depending on gender, ethnicity/race, or age. This study examined the factor structure of four items from the sexual behavior questionnaire part of the National Health and Nutrition Examination Survey (NHANES). As NHANES provided different versions of the survey per gender, invariance was tested across gender to determine whether subsequent tests across ethnicity/race and generation could be done across gender. Items were not invariant across gender groups so data files for women and men were not collapsed. Across ethnicity/race for both genders, and across generation for women, items were configurally invariant, and exhibited metric invariance across Latino/Latina and Black participants for both genders. Across generation for men, the configural invariance model could not be identified so the baseline models were examined. The four item one factor model fit well for the Millennial and GenerationX groups but was a poor fit for the baby boomer and silent generation groups, suggesting that gender moderated the invariance across generation. Thus, comparisons between ethnic/racial and generational groups should not be made between the genders or even within gender. Findings highlight the need for programs and interventions that promote a more inclusive definition of "having had sex."

  19. Mortality among twins and singletons in sub-Saharan Africa between 1995 and 2014: a pooled analysis of data from 90 Demographic and Health Surveys in 30 countries

    NARCIS (Netherlands)

    Monden, C.W.S.; Smits, J.P.J.M.; Monden, C.

    2017-01-01

    BACKGROUND - Sub-Saharan Africa has the world's highest under-5 and neonatal mortality rates as well as the highest naturally occurring twin rates. Twin pregnancies carry high risk for children and mothers. Under-5 mortality has declined in sub-Saharan Africa over the last decades. It is unknown

  20. Population-wide weight loss and regain in relation to diabetes burden and cardiovascular mortality in Cuba 1980-2010: repeated cross sectional surveys and ecological comparison of secular trends.

    Science.gov (United States)

    Franco, Manuel; Bilal, Usama; Orduñez, Pedro; Benet, Mikhail; Morejón, Alain; Caballero, Benjamín; Kennelly, Joan F; Cooper, Richard S

    2013-04-09

    To evaluate the associations between population-wide loss and gain in weight with diabetes prevalence, incidence, and mortality, as well as cardiovascular and cancer mortality trends, in Cuba over a 30 year interval. Repeated cross sectional surveys and ecological comparison of secular trends. Cuba and the province of Cienfuegos, from 1980 to 2010. Measurements in Cienfuegos included a representative sample of 1657, 1351, 1667, and 1492 adults in 1991, 1995, 2001, and 2010, respectively. National surveys included a representative sample of 14 304, 22 851, and 8031 participants in 1995, 2001, and 2010, respectively. Changes in smoking, daily energy intake, physical activity, and body weight were tracked from 1980 to 2010 using national and regional surveys. Data for diabetes prevalence and incidence were obtained from national population based registries. Mortality trends were modelled using national vital statistics. Rapid declines in diabetes and heart disease accompanied an average population-wide loss of 5.5 kg in weight, driven by an economic crisis in the mid-1990s. A rebound in population weight followed in 1995 (33.5% prevalence of overweight and obesity) and exceeded pre-crisis levels by 2010 (52.9% prevalence). The population-wide increase in weight was immediately followed by a 116% increase in diabetes prevalence and 140% increase in diabetes incidence. Six years into the weight rebound phase, diabetes mortality increased by 49% (from 9.3 deaths per 10 000 people in 2002 to 13.9 deaths per 10 000 people in 2010). A deceleration in the rate of decline in mortality from coronary heart disease was also observed. In relation to the Cuban experience in 1980-2010, there is an association at the population level between weight reduction and death from diabetes and cardiovascular disease; the opposite effect on the diabetes and cardiovascular burden was seen on population-wide weight gain.

  1. A frequency survey of radiological examinations carried out in National Health Service hospitals in Great Britain in 1977 for diagnostic purposes

    International Nuclear Information System (INIS)

    Kendall, G.M.; Darby, S.C.; Harries, S.V.; Rae, S.

    1980-06-01

    Medical irradiation is the largest man-made contributor to the radiation dose received by the population of Great Britain, and diagnostic radiology is the most important component of medical irradiation. The work described here is a survey of the numbers and types of radiological examinations carried out in National Health Service hospitals in Great Britain in 1977. The overall level of diagnostic radiology in Great Britain as a whole is reported and separate estimates for England, Wales and Scotland are given. Discussion of topics such as the frequency of particular types of examination, the number of films per examination and the use of gonad shields is included, and the results of the present survey are compared with those of the last national survey which was carried out in 1957. Also reported is an estimate of the amount of radiology undertaken outside the Health Service. The findings will be combined with estimates of gonadal doses from the different examinations and child expectancy data to estimate the genetically significant dose to the population of Great Britain. (author)

  2. Menopause, postmenopausal hormone use and serum uric acid levels in US women - The Third National Health and Nutrition Examination Survey

    NARCIS (Netherlands)

    A.E. Elisabeth (Elisabeth); H.K. Choi (Hyon)

    2008-01-01

    textabstractIntroduction: Despite the substantial prevalence of gout in the ageing female population, female hormonal influence has not been comprehensively examined. We evaluated and quantified the potential independent association between menopause, postmenopausal hormone use and serum uric acid

  3. Caesarean section and mortality

    African Journals Online (AJOL)

    Hawkins JL, Gibbs CP, Orleans M, et al. Obstetric anesthesia work force survey, versus 1992. Anesthesiology. 1981;1997(87):135–43. 2. Bert CJ, Atrash HK, Koonin KM, et al. Pregnacy related mortality in the. United States, 1987–1990. Obstet Gynecol. 1996;88:161–7. Received: 10-08-2015 Accepted: 14-08-2015.

  4. Empowered? Examining self-disconnection in a postal survey of electricity prepayment meter consumers in New Zealand

    International Nuclear Information System (INIS)

    O'Sullivan, Kimberley C.; Howden-Chapman, Philippa L.; Fougere, Geoffrey M.; Hales, Simon; Stanley, James

    2013-01-01

    Prepayment metering is an electricity payment method often used by low-income consumers. Fuel poverty is an important public health problem in New Zealand, and is likely to be a particular problem for those using prepayment metering. This paper details a nationwide postal survey of consumers undertaken with the support of three major electricity retailers, which investigated the advantages and disadvantages of using prepayment metering from a consumer perspective. The study surveyed a total pool of 359 randomly selected consumers across the three companies, a response rate of 48%. The study found that while almost all respondents felt the benefits of using prepayment outweighed the risks of running out of credit or ‘self-disconnection’, 53% of respondents experienced self-disconnection in the past year. Of concern, over a third of respondents experiencing self-disconnection were without electricity for more than 12 h. The frequency of self-disconnection was also high, with 17% of those disconnecting reporting six or more events in the past year. Government intervention could reduce the risks and disadvantages involved with using prepayment metering, which could then support initiatives aimed at reducing fuel poverty. - Highlights: ► Results of a national postal survey of New Zealand electricity prepayment users. ► Self-disconnection is an extreme outcome of fuel poverty. ► 53% of respondents experienced self-disconnection in the past year. ► Self-disconnection is problematic, lasting 12 or more hours for 38% of those who disconnected. ► Government policies could minimise health effects and capture benefits of prepayment metering.

  5. Risk factors for mortality during the 2002 landslides in Chuuk, Federated States of Micronesia.

    Science.gov (United States)

    Sanchez, Carlos; Lee, Tze-San; Young, Stacy; Batts, Dahna; Benjamin, Jefferson; Malilay, Josephine

    2009-10-01

    This study examines health effects resulting from landslides in Chuuk during Tropical Storm Chata'an in July 2002, and suggests strategies to prevent future mortality. In August 2002, we conducted a cross-sectional survey to identify risk factors for mortality during landslides, which included 52 survivors and 40 surrogates for 43 decedents to identify risk factors for death. Findings suggest that 1) females had a higher mortality rate from this event than males, and 2) children aged 5-14 years had a 10-fold increase in mortality when compared with annual mortality rates from all causes. Awareness of landslides occurring elsewhere and knowledge of natural warning signs were significantly associated with lower risks of death; being outside during landslides was not associated with reduced mortality. In Chuuk, improving communication systems during tropical storms and increasing knowledge of natural warnings can reduce the risk for mortality during landslides.

  6. Use of structured musculoskeletal examination routines in undergraduate medical education and postgraduate clinical practice - a UK survey.

    Science.gov (United States)

    Baker, Kenneth F; Jandial, Sharmila; Thompson, Ben; Walker, David; Taylor, Ken; Foster, Helen E

    2016-10-21

    Structured examination routines have been developed as educational resources for musculoskeletal clinical skills teaching, including Gait-Arms-Legs-Spine (GALS), Regional Examination of the Musculoskeletal System (REMS) and paediatric GALS (pGALS). In this study, we aimed to assess the awareness and use of these examination routines in undergraduate medical teaching in UK medical schools and UK postgraduate clinical practice. Electronic questionnaires were distributed to adult and paediatric musculoskeletal teaching leads at UK medical schools and current UK doctors in training. Responses were received from 67 tutors representing teaching at 22/33 [67 %] of all UK medical schools, and 70 trainee doctors across a range of postgraduate training specialities. There was widespread adoption, at responding medical schools, of the adult examination routines within musculoskeletal teaching (GALS: 14/16 [88 %]; REMS: 12/16 [75 %]) and assessment (GALS: 13/16 [81 %]; REMS: 12/16 [75 %]). More trainees were aware of GALS (64/70 [91 %]) than REMS (14/67 [21 %]). Of the 39 trainees who used GALS in their clinical practice, 35/39 [90 %] reported that it had improved their confidence in musculoskeletal examination. Of the 17/22 responding medical schools that included paediatric musculoskeletal examination within their curricula, 15/17 [88 %] used the pGALS approach and this was included within student assessment at 4 medical schools. We demonstrate the widespread adoption of these examination routines in undergraduate education and significant uptake in postgraduate clinical practice. Further study is required to understand their impact upon clinical performance.

  7. Mortality of young offenders: a national register-based follow-up study of 15- to 19-year-old Finnish delinquents referred for forensic psychiatric examination between 1980 and 2010.

    Science.gov (United States)

    Lindberg, Nina; Miettunen, Jouko; Heiskala, Anni; Kaltiala-Heino, Riittakerttu

    2017-01-01

    The mortality rate of young offenders is high. Furthermore, mortality in young offenders is associated with psychiatric and substance use disorders. The primary aim of this national register-based follow-up study was to investigate the mortality rate of Finnish delinquents who underwent a forensic psychiatric examination between 1980 and 2010. As delinquency is not a solid entity, we further aimed to compare the risk of premature death among different subgroups of the delinquents; violent versus non-violent offenders, offenders with alcohol use disorders versus those with no such diagnoses, offenders with schizophrenia spectrum disorders versus conduct- and personality-disordered offenders, under-aged versus young adult offenders, and, finally, boys versus girls. We collected the forensic psychiatric examination reports of all 15- to 19-year-old offenders who were born in Finland and had undergone the examination between 1.1.1980 and 31.12.2010 (n = 606) from the archives of the National Institute of Health and Welfare and retrospectively reviewed them. For each delinquent, four age-, gender- and place of birth-matched controls were randomly selected from the Central Population Register (n = 2424). The delinquents and their controls were followed until the end of 2015. The median follow-up time was 23.9 years (interquartile range 15.3-29.5). We obtained the mortality data from the causes of death register. Deaths attributable to a disease or an occupational disease were considered natural, and those attributable to an accident, suicide or homicide were considered unnatural. By the end of the follow-up period, 22.1% (n = 134) of the delinquents and 3.4% (n = 82) of their controls had died (OR 8.11, 95% CI 6.05-10.86, p delinquents and 3.7% (n = 81) of the controls had died (OR 7.38, 95% CI 5.46-9.95, p delinquents' risk of unnatural death was almost 11-fold, of natural death more than twofold, and of unclear death more than fourfold compared to that of

  8. A comparison of prevalence estimates for selected health indicators and chronic diseases or conditions from the Behavioral Risk Factor Surveillance System, the National Health Interview Survey, and the National Health and Nutrition Examination Survey, 2007-2008.

    Science.gov (United States)

    Li, Chaoyang; Balluz, Lina S; Ford, Earl S; Okoro, Catherine A; Zhao, Guixiang; Pierannunzi, Carol

    2012-06-01

    To compare the prevalence estimates of selected health indicators and chronic diseases or conditions among three national health surveys in the United States. Data from adults aged 18 years or older who participated in the Behavioral Risk Factor Surveillance System (BRFSS) in 2007 and 2008 (n=807,524), the National Health Interview Survey (NHIS) in 2007 and 2008 (n=44,262), and the National Health and Nutrition Examination Survey (NHANES) during 2007 and 2008 (n=5871) were analyzed. The prevalence estimates of current smoking, obesity, hypertension, and no health insurance were similar across the three surveys, with absolute differences ranging from 0.7% to 3.9% (relative differences: 2.3% to 20.2%). The prevalence estimate of poor or fair health from BRFSS was similar to that from NHANES, but higher than that from NHIS. The prevalence estimates of diabetes, coronary heart disease, and stroke were similar across the three surveys, with absolute differences ranging from 0.0% to 0.8% (relative differences: 0.2% to 17.1%). While the BRFSS continues to provide invaluable health information at state and local level, it is reassuring to observe consistency in the prevalence estimates of key health indicators of similar caliber between BRFSS and other national surveys. Published by Elsevier Inc.

  9. A survey of front-line paramedics examining the professional relationship between paramedics and physician medical oversight.

    Science.gov (United States)

    Foerster, Christopher R; Tavares, Walter; Virkkunen, Ilkka; Kämäräinen, Antti

    2018-03-01

    Paramedicine is often dependent on physician medical directors and their associated programs for direction and oversight. A positive relationship between paramedics and their oversight physicians promotes safety and quality care while a strained or ineffective one may threaten these goals. The objective of this study was to explore and understand the professional relationship between paramedics and physician medical oversight as viewed by front-line paramedics. All active front-line paramedics from four municipal paramedic services involving three medical oversight groups in Ontario were invited to complete an online survey. Five hundred and four paramedics were invited to participate in the study, with 242 completing the survey (48% response rate); 66% male, 76% primary care paramedics with an average of 13 (SD=9) years of experience. Paramedics had neutral or positive perceptions regarding their autonomy, opportunities to interact with their medical director, and medical director understanding of the prehospital setting. Paramedics perceived medical directives as rigid and ambiguous. A significant amount of respondents reported a perception of having provided suboptimal patient care due to fear of legal or disciplinary consequences. Issues of a lack of support for critical thinking and a lack of trust between paramedics and medical oversight groups were often raised. Paramedic perceptions of physician medical oversight were mixed. Concerning areas identified were perceptions of ambiguous written directives and concerns related to the level of trust and support for critical thinking. These perceptions may have implications for the system of care and should be explored further.

  10. Promoting Sustainability through EMS Application: A Survey Examining the Critical Factors about EMAS Registration in Italian Organizations

    Directory of Open Access Journals (Sweden)

    Roberto Merli

    2016-02-01

    Full Text Available One of the tools set by the European Community (EC to reduce the environmental impact of firms is EMAS Regulation (Regulation (EC No 1221/2009, setting up an Environmental Management System (EMS, which aims for a continuous improvement of environmental performances. Italy has the highest number of certified organization among all European Member States, accounting for over one thousand registrations. The paper presents the result of a survey conducted through a questionnaire about EMAS implementation and targeted to all Italian registered organizations. Of nearly 1000 organizations, over 500 answers were collected. The main goal is to understand how organizations experience the scheme, focusing on main drivers for its adoption, main difficulties encountered, and perceived benefits. In particular, survey results contribute to define a reflection on the difficulties regarding EMAS diffusion among European companies. Aspects identified as critical can lead to a contraction of registration requests, especially those formulated by SMEs, which constitute the majority of Italian companies. Moreover, perceived difficulties might affect the firms’ willingness to renew EMAS registration. Data provided by the Italian Institute for Environmental Protection and Research (ISPRA recently highlighted the increasing rate of firms who decide to withdraw from registration. This study offers interesting inputs related to main critical issues in EMAS implementation, which can be the baseline for future research on companies that abandon the certification scheme, in order to provide suggestions for the improvement of its effectiveness both for national and communitarian institutions.

  11. Estimated Trans-Lamina Cribrosa Pressure Differences in Low-Teen and High-Teen Intraocular Pressure Normal Tension Glaucoma: The Korean National Health and Nutrition Examination Survey

    OpenAIRE

    Lee, Si Hyung; Kwak, Seung Woo; Kang, Eun Min; Kim, Gyu Ah; Lee, Sang Yeop; Bae, Hyoung Won; Seong, Gong Je; Kim, Chan Yun

    2016-01-01

    Background To investigate the association between estimated trans-lamina cribrosa pressure difference (TLCPD) and prevalence of normal tension glaucoma (NTG) with low-teen and high-teen intraocular pressure (IOP) using a population-based study design. Methods A total of 12,743 adults (? 40 years of age) who participated in the Korean National Health and Nutrition Examination Survey (KNHANES) from 2009 to 2012 were included. Using a previously developed formula, cerebrospinal fluid pressure (C...

  12. The present conditions of interpretation and findings report in UGI series examination (The Japanese society gastrointestinal imaging report group performed questionary survey)

    International Nuclear Information System (INIS)

    Sato, Shinsuke; Aoki, Ryosuke; Yoshida, Takashi; Nishikawa, Takashi; Takahashi, Nobuyuki; Ishimoto, Yuji

    2008-01-01

    The Japanese society gastrointestinal imaging report group performed questionary survey to relate to interpretation of radiogram of radiological technologist and findings report in upper GI series examination for 599 national institutions. Response rate was 27%, and many of answers were the institutions where surgical treatment was possible. Additional radiography examining by radiological technologist depending on the situation and, it was recognized a doctor furthermore, institutions more than 70% made findings report after examination, and, as for the mention methods of findings report, there was difference in mention contents, and character by examination classification. It seemed the mention methods that we unified were difficult nationwide, and, however, as for the making of the findings report which used diagnosis flow chart, it was thought with possibility in future by enlightenment active. (author)

  13. The ADOPT-LC score: a novel predictive index of in-hospital mortality of cirrhotic patients following surgical procedures, based on a national survey.

    Science.gov (United States)

    Sato, Masaya; Tateishi, Ryosuke; Yasunaga, Hideo; Horiguchi, Hiromasa; Matsui, Hiroki; Yoshida, Haruhiko; Fushimi, Kiyohide; Koike, Kazuhiko

    2017-03-01

    We aimed to develop a model for predicting in-hospital mortality of cirrhotic patients following major surgical procedures using a large sample of patients derived from a Japanese nationwide administrative database. We enrolled 2197 cirrhotic patients who underwent elective (n = 1973) or emergency (n = 224) surgery. We analyzed the risk factors for postoperative mortality and established a scoring system for predicting postoperative mortality in cirrhotic patients using a split-sample method. In-hospital mortality rates following elective or emergency surgery were 4.7% and 20.5%, respectively. In multivariate analysis, patient age, Child-Pugh (CP) class, Charlson Comorbidity Index (CCI), and duration of anesthesia in elective surgery were significantly associated with in-hospital mortality. In emergency surgery, CP class and duration of anesthesia were significant factors. Based on multivariate analysis in the training set (n = 987), the Adequate Operative Treatment for Liver Cirrhosis (ADOPT-LC) score that used patient age, CP class, CCI, and duration of anesthesia to predict in-hospital mortality following elective surgery was developed. This scoring system was validated in the testing set (n = 986) and produced an area under the curve of 0.881. We also developed iOS/Android apps to calculate ADOPT-LC scores to allow easy access to the current evidence in daily clinical practice. Patient age, CP class, CCI, and duration of anesthesia were identified as important risk factors for predicting postoperative mortality in cirrhotic patients. The ADOPT-LC score effectively predicts in-hospital mortality following elective surgery and may assist decisions regarding surgical procedures in cirrhotic patients based on a quantitative risk assessment. © 2016 The Authors Hepatology Research published by John Wiley & Sons Australia, Ltd on behalf of Japan Society of Hepatology.

  14. Associations between maternal experiences of intimate partner violence and child nutrition and mortality: findings from Demographic and Health Surveys in Egypt, Honduras, Kenya, Malawi and Rwanda.

    Science.gov (United States)

    Rico, Emily; Fenn, Bridget; Abramsky, Tanya; Watts, Charlotte

    2011-04-01

    If effective interventions are to be used to address child mortality and malnutrition, then it is important that we understand the different pathways operating within the framework of child health. More attention needs to be given to understanding the contribution of social influences such as intimate partner violence (IPV). To investigate the relationship between maternal exposure to IPV and child mortality and malnutrition using data from five developing countries. Population data from Egypt, Honduras, Kenya, Malawi and Rwanda were analysed. Logistic regression analysis was used to generate odds ratios of the associations between several categories of maternal exposure to IPV since the age of 15 and three child outcomes: under-2-year-old (U2) mortality and moderate and severe stunting (Honduras) to 46.2% (Kenya). For child stunting, prevalence ranged from 25.4% (Egypt) to 58.0% (Malawi) and for U2 mortality from 3.6% (Honduras) to 15.2% (Rwanda). In Kenya, maternal exposure to IPV was associated with higher U2 mortality (adjusted odds ratio (OR)=1.42, 95% CI 1.18 to 1.71) and child stunting (adjusted OR=1.36, 95% CI 1.16 to 1.61). In Malawi and Honduras, marginal associations were observed between IPV and severe stunting and U2 mortality, respectively, with strength of associations varying by type of violence. The relationship between IPV and U2 mortality and stunting in Kenya, Honduras and Malawi suggests that, in these countries, IPV plays a role in child malnutrition and mortality. This contributes to a growing body of evidence that broader public health benefits may be incurred if efforts to address IPV are incorporated into a wider range of maternal and child health programmes; however, the authors highlight the need for more research that can establish temporality, use data collected on the basis of the study's objectives, and further explore the causal framework of this relationship using more advanced statistical analysis.

  15. Examining the infrared variable star population discovered in the Small Magellanic Cloud using the SAGE-SMC survey

    Energy Technology Data Exchange (ETDEWEB)

    Polsdofer, Elizabeth; Marengo, M. [Iowa State University, Department of Physics and Astronomy, 12 Physics Hall, Ames, Iowa 50011 (United States); Seale, J.; Sewiło, M. [The Johns Hopkins University, Department of Physics and Astronomy, 366 Bloomberg Center, 3400 N. Charles Street, Baltimore, MD 21218 (United States); Vijh, U. P.; Terrazas, M. [Ritter Astrophysical Research Center, University of Toledo, Toledo, OH 43606 (United States); Meixner, M., E-mail: empolsdofer@gmail.com [Space Telescope Science Institute, 3700 San Martin Dr., Baltimore, MD 21218 (United States)

    2015-02-01

    We present our study on the infrared variability of point sources in the Small Magellanic Cloud (SMC). We use the data from the Spitzer Space Telescope Legacy Program “Surveying the Agents of Galaxy Evolution in the Tidally Stripped, Low Metallicity Small Magellanic Cloud” (SAGE-SMC) and the “Spitzer Survey of the Small Magellanic Cloud” (S{sup 3}MC) survey, over three different epochs, separated by several months to 3 years. Variability in the thermal infrared is identified using a combination of Spitzer’s InfraRed Array Camera 3.6, 4.5, 5.8, and 8.0 μm bands, and the Multiband Imaging Photometer for Spitzer 24 μm band. An error-weighted flux difference between each pair of three epochs (“variability index”) is used to assess the variability of each source. A visual source inspection is used to validate the photometry and image quality. Out of ∼2 million sources in the SAGE-SMC catalog, 814 meet our variability criteria. We matched the list of variable star candidates to the catalogs of SMC sources classified with other methods, available in the literature. Carbon-rich Asymptotic Giant Branch (AGB) stars make up the majority (61%) of our variable sources, with about a third of all of our sources being classified as extreme AGB stars. We find a small, but significant population of oxygen-rich (O-rich) AGB (8.6%), Red Supergiant (2.8%), and Red Giant Branch (<1%) stars. Other matches to the literature include Cepheid variable stars (8.6%), early type stars (2.8%), Young-stellar objects (5.8%), and background galaxies (1.2%). We found a candidate OH maser star, SSTISAGE1C J005212.88-730852.8, which is a variable O-rich AGB star, and would be the first OH/IR star in the SMC, if confirmed. We measured the infrared variability of a rare RV Tau variable (a post-AGB star) that has recently left the AGB phase. 59 variable stars from our list remain unclassified.

  16. Examining the infrared variable star population discovered in the Small Magellanic Cloud using the SAGE-SMC survey

    International Nuclear Information System (INIS)

    Polsdofer, Elizabeth; Marengo, M.; Seale, J.; Sewiło, M.; Vijh, U. P.; Terrazas, M.; Meixner, M.

    2015-01-01

    We present our study on the infrared variability of point sources in the Small Magellanic Cloud (SMC). We use the data from the Spitzer Space Telescope Legacy Program “Surveying the Agents of Galaxy Evolution in the Tidally Stripped, Low Metallicity Small Magellanic Cloud” (SAGE-SMC) and the “Spitzer Survey of the Small Magellanic Cloud” (S 3 MC) survey, over three different epochs, separated by several months to 3 years. Variability in the thermal infrared is identified using a combination of Spitzer’s InfraRed Array Camera 3.6, 4.5, 5.8, and 8.0 μm bands, and the Multiband Imaging Photometer for Spitzer 24 μm band. An error-weighted flux difference between each pair of three epochs (“variability index”) is used to assess the variability of each source. A visual source inspection is used to validate the photometry and image quality. Out of ∼2 million sources in the SAGE-SMC catalog, 814 meet our variability criteria. We matched the list of variable star candidates to the catalogs of SMC sources classified with other methods, available in the literature. Carbon-rich Asymptotic Giant Branch (AGB) stars make up the majority (61%) of our variable sources, with about a third of all of our sources being classified as extreme AGB stars. We find a small, but significant population of oxygen-rich (O-rich) AGB (8.6%), Red Supergiant (2.8%), and Red Giant Branch (<1%) stars. Other matches to the literature include Cepheid variable stars (8.6%), early type stars (2.8%), Young-stellar objects (5.8%), and background galaxies (1.2%). We found a candidate OH maser star, SSTISAGE1C J005212.88-730852.8, which is a variable O-rich AGB star, and would be the first OH/IR star in the SMC, if confirmed. We measured the infrared variability of a rare RV Tau variable (a post-AGB star) that has recently left the AGB phase. 59 variable stars from our list remain unclassified.

  17. Educational disparities in quality of diabetes care in a universal health insurance system: evidence from the 2005 Korea National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Do, Young Kyung; Eggleston, Karen N

    2011-08-01

    To investigate educational disparities in the care process and health outcomes among patients with diabetes in the context of South Korea's universal health insurance system. Bivariate and multiple regression analyses of data from a cross-sectional health survey. A nationally representative and population-based survey, the 2005 Korea National Health and Nutrition Examination Survey. Respondents aged 40 or older who self-reported prior diagnosis with diabetes (n= 1418). Seven measures of the care process and health outcomes, namely (i) receiving medical treatment for diabetes, (ii) ever received diabetes education, (iii) received dilated eye examination in the past year, (iv) received microalbuminuria test in the past year, (v) having activity limitation due to diabetes, (vi) poor self-rated health and (vii) self-rated health on a visual analog scale. Except for receiving medical care for diabetes, overall process quality was low, with only 25% having ever received diabetes education, 39% having received a dilated eye examination in the past year and 51% having received a microalbuminuria test in the past year. Lower education level was associated with both poorer care processes and poorer health outcomes, whereas lower income level was only associated with poorer health outcomes. While South Korea's universal health insurance system may have succeeded in substantially reducing financial barriers related to diabetes care, the quality of diabetes care is low overall and varies by education level. System-level quality improvement efforts are required to address the weaknesses of the health system, thereby mitigating educational disparities in diabetes care quality.

  18. Clinical survey of blood dyscrasias among Hiroshima a-bomb survivors by the periodical health examination, 5

    International Nuclear Information System (INIS)

    Taketomi, Yoshinori; Abe, Tsutomu; Okita, Hajime; Kamada, Nanao; Kuramoto, Atsushi

    1980-01-01

    Certain blood examinations were performed on a-bomb survivors having anemia more than moderate stage (the hemoglobin value under 9.0 g/dl), who were found out by the periodical health examination performed in Hiroshima-A-bomb Survivors Health Control Clinic during the latter period of the fiscal year 1975. The total number of a-bomb survivors who received the periodical health examination was 50,973, and the number of survivors whose hemoglobin value was under 9.0 g/dl was 201 (0.39%). The incidence of such anemia was high in women. There was not a relationship between this anemia and the exposure distance from the hypocenter. The incidence of this anemia was high in young a-bomb survivors, and more than 50% of a-bomb survivors having this anemia was under the age of 50. Iron-deficiency anemia was found in 88% of a-bomb survivors, and the course of their anemia ran in many years in many a-bomb survivors. (Tsunoda, M.)

  19. Clinical survey of blood dyscrasias among Hiroshima A-bomb survivors by the periodical health examination, 2

    International Nuclear Information System (INIS)

    Taketomi, Yoshinori; Kamada, Nanao; Takahashi, Hiroshi; Ohkita, Takeshi; Ito, Chikako.

    1976-01-01

    An actual condition of anemia in A-bomb survivors was discussed from the periodical health examination of the fiscal years 1972 and 1973. Under 11.5 g/dl of hemoglobin was determined as anemia. An actual number of cases with anemia in both fiscal years was nearly the same, but ratio of anemia to the total number of recipient of periodical health examination increased 1.9% in the fiscal year 1973. 35.3% of the subjects with anemia in both fiscal years was the same persons. In the following examination of 478 subjects with under 10.0 g/dl of hemoglobin, in the fiscal year 1972, 96 subjects (20.1%) still showed under 10.0 g/dl of hemoglobin in the fiscal year 1975. Characteristics of anemia were that hypochromic anemia was comparatively frequent in the young, and normochromic anemia was frequent in the aged. In the former, marked decrease of value of iron in serum was recognized, and in the latter, fall of hematopoiesis by old age and secondary anemia were recognized. Marked relationship between exposure distance and anemia in each group was not recognized. 17.9% of cases with moderate anemia showed positive in stool guaiac test and 8.9% and past history of duodenal or peptic ulcer. (Kanao, N.)

  20. Birth spacing, sibling rivalry and child mortality in India.

    Science.gov (United States)

    Whitworth, Alison; Stephenson, Rob

    2002-12-01

    The detrimental impact of short preceding birth intervals on infant and early childhood mortality is well documented in demographic literature, although the pathways of influence within the relationship remain an area of debate. This paper examines the impact of the length of the preceding birth interval on under-two mortality in India, and examines the pathways through which short preceding birth intervals may lead to an increased risk of mortality. Three mortality periods are examined: neonatal, early post neonatal and late post-neonatal and toddler, using the 1992 Indian National Family Health Survey. A multilevel modelling approach is used to account for the hierarchical nature of the data. The determinants of infants following a short or long birth interval are also examined. The results show that short preceding birth intervals (sibling rivalry is a pathway through which short birth intervals influence mortality, with the death of the previous sibling removing the competition for scarce resources, and resulting in lower risks of mortality than if the previous sibling was still alive. The greatest risks of an infant following a short birth interval are among those whose previous sibling died, high parities, those with young mothers, and those whose previous sibling was breastfed for a short duration. Copyright 2002 Elsevier Science Ltd.

  1. Inequity of healthcare utilization on mammography examination and Pap smear screening in Thailand: Analysis of a population-based household survey.

    Directory of Open Access Journals (Sweden)

    Sukanya Chongthawonsatid

    Full Text Available Healthcare in Thailand is not equally distributed, and not all people can equally access healthcare resources even if they are covered by health insurance. To examine factors associated with the utilization of mammography examination for breast cancer and Pap smear screening for cervical cancer, data from the national reproductive health survey conducted by the National Statistical Office of Thailand in 2009 was examined. The survey was carried out on 15,074,126 women aged 30-59 years. The results showed that the wealthier respondents had more mammograms than did the lower-income groups. The concentration index was 0.144. The data on Pap smears for cervical cancer also showed that the wealthier respondents were more likely to have had a Pap smear than their lower-income counterparts. The concentration index was 0.054. Determinants of mammography examination were education, followed by health welfare and wealth index, whereas the determinants of Pap smear screening were wealth index, followed by health welfare and education. The government should support greater education for women because education was associated with socioeconomic status and wealth. There should be an increase in the number of screening campaigns, mobile clinics, and low-cost mammograms and continued support for accessibility to mammograms, especially in rural areas and low-income communities.

  2. Air ingress and graphite burning in HTRs: A survey on analytical examinations performed with the code React/Thermix

    International Nuclear Information System (INIS)

    Moormann, R.

    1995-05-01

    Analyses on air ingress in the pebble bed reactors PNP-500, THTR-300, HTR-Modul, AVR-II and AVR process heat plant are outlined; in addition, some results for the VHTR with block type fuel are given. Air ingress requires primary circuit depressurization and large leak(s) to reactor buildings and environment and belongs therefore to highly hypothetical events in the sense of classical safety analysis. One accident class examined is air ingress with forced flow by emergency cooling: For this case, the range of mass flow/air content in cooling gas has been evaluated, in which safe core cool down is possible resp. long term core burning occurs; for highest available emergency cooling flow, a safe cool down of the THTR-300, which has no reactor building, is possible for up to 20 vol-% of air in the cooling gas, wheras low flow allows only for about 5 vol-%. If the amount of available air is restricted to the content of a reactor building, as is examined for the PNP-500, relevant consequences have not to be expected; this remains also true for forced convection flow, if burning of CO, formed by graphite oxidation, within the building is considered. For the second accident class examined, air ingress with natural convection flow by chimney draught as studied for the HTR-Modul and some other concepts, the time span until significant fission product release begins has been determined; in case, that the bottom reflector is hot at accident start (> 600 C) and therefore consumes most of the ingressing oxygen, this time span is at least several hours and leak tightening counter measures may be possible. (orig./HP)

  3. Survey of parasites in threatened stocks of coho salmon (Oncorhynchus kisutch) in Oregon by examination of wet tissues and histology.

    Science.gov (United States)

    Ferguson, Jayde A; St-Hilaire, Sophie; Peterson, Tracy S; Rodnick, Kenneth J; Kent, Michael L

    2011-12-01

    We are conducting studies on the impacts of parasites on Oregon coastal coho salmon (Oncorhynchus kistuch). An essential first step is documenting the geographic distribution of infections, which may be accomplished by using different methods for parasite detection. Thus, the objectives of the current study were to (1) identify parasite species infecting these stocks of coho salmon and document their prevalence, density, and geographic distribution; (2) assess the pathology of these infections; and (3) for the first time, determine the sensitivity and specificity of histology for detecting parasites compared with examining wet preparations for muscle and gill infections. We examined 576 fry, parr, and smolt coho salmon in total by histology. The muscle and gills of 219 of these fish also were examined by wet preparation. Fish were collected from 10 different locations in 2006-2007. We identified 21 different species of parasites in these fish. Some parasites, such as Nanophyetus salmincola and Myxobolus insidiosus, were common across all fish life stages from most basins. Other parasites, such as Apophallus sp., were more common in underyearling fish than smolts and had a more restricted geographic distribution. Additional parasites commonly observed were as follows: Sanguinicola sp., Trichodina truttae , Epistylis sp., Capriniana piscium, and unidentified metacercariae in gills; Myxobolus sp. in brain; Myxidium salvelini and Chloromyxum majori in kidney; Pseudocapillaria salvelini and adult digenean spp. in the intestine. Only a few parasites, such as the unidentified gill metacercariae, elicted overt pathologic changes. Histology had generally poor sensitivity for detecting parasites; however, it had relatively good specificity. We recommend using both methods for studies or monitoring programs requiring a comprehensive assessment of parasite identification, enumeration, and parasite-related pathology.

  4. Clinical survey of blood dyscrasias among Hiroshima A-bomb survivors by the periodical health examination, (9)

    International Nuclear Information System (INIS)

    Dohy, Hiroo; Taketomi, Yoshinori; Oguma, Nobuo; Takamatsu, Yumiko; Kamada, Nanao

    1984-01-01

    Of 195,146 A-bomb survivors undergoing the periodic health examination, 607 in whom anemia was confirmed were investigated. Iron deficiency anemia was seen in 77.3% of the survivors (mostly consisting of women under the age of 54 years). There was no significant difference in other types of anemia between men and women. Renal anemia was frequent in survivors aged between 60 and 80 years. Refractory anemia was frequent in survivors older than those with renal anemia. The white blood cell count and platelet count were within the normal range in three types of anemia. (Namekawa, K.)

  5. Survey on the frequency of typical X-Ray examinations and estimation of associated population doses in the Republic of Macedonia

    International Nuclear Information System (INIS)

    Gershan, V.; Stikova, E.

    2013-01-01

    Purpose: Medical X-ray exposures have been the largest man-made source of population exposure to ionizing radiation in developed countries for many years. It is therefore important for radiation protection and health care authorities in each country to regularly assess the magnitude and the distribution of this large and increasing source of population exposure. The purpose of this paper is to present results from the survey on the number of typical X-ray examination procedures in the Republic of Macedonia for 2010, the distribution of examination procedures by type per modality for adults and pediatric patients, the annual frequency per 1000 population and the collective effective dose per 1000 population from the X-ray examination procedures performed in the Republic of Macedonia in 2010. Materials and methods: In the beginning of 2011, a survey was initiated in the Republic of Macedonia for collecting data on the number of typical X-ray examination procedures conducted in 2010 as a basis for estimating frequency of these procedures and associated population doses. The survey was initiated within a Dose Data Med project launched by the European Commission to study population doses from medical exposures within the Union. The Republic of Macedonia was invited to participate in this project as a test country. Typical X-ray examination procedures encompass those that are recognized to be the most important for the total population dose, referred to as TOP20 X-ray procedures. The survey was based on a specific questionnaire being prepared and distributed to the 87 X-ray departments in the Republic of Macedonia intended to cover the data for the year of 2010. The data was collected and summarized. Based on data gathered, the total number of examination procedures, annual frequency and their distribution by modality were calculated. Thereafter, the annual collective effective dose per 1000 population for each examination procedure in the TOP20 group and collective

  6. Relations among obesity, family socioeconomic status, oral health behaviors, and dental caries in adolescents: the 2010-2012 Korea National Health and nutrition examination survey.

    Science.gov (United States)

    Kim, Jin Ah; Choi, Hayon Michelle; Seo, Yunhee; Kang, Dae Ryong

    2018-06-22

    The purpose of this study was to examine the relationships among obesity, family socioeconomic status, oral health behaviors, and dental caries and to identify possible differences in factors related with dental caries according to gender among a representative sample of Korean adolescents. Data were obtained from the Korean National Health and Nutrition Examination Survey, which was conducted between 2010 and 2012. This nationally representative cross-sectional survey included approximately 10,000 individuals, including adolescents, each year as a survey sample, and collected information on socioeconomic status, health-related behaviors, quality of life, healthcare utilization, anthropometric measures, biochemical and clinical profiles for non-communicable diseases, and dietary intake via three component surveys (health interview, health examination, and nutrition survey). The health interview and health examination were conducted by trained staff members. A total of 1646 adolescents of ages 13 to 18 years old were included in this study; there were 879 males and 767 females. Data were analyzed by t-test, X 2 -test, and univariate and multivariate logistic regression analyses using SAS 9.4 and 'R' statistical software for Windows to account for the complex sampling design. In males, significant associations between family income and dental caries on permanent teeth were noted after adjusting for confounding variables; the odds ratios and 95% confidence intervals thereof were 0.43(0.24-0.76), 0.41(0.24-0.70), and 0.28(0.16-0.49) for low-middle, middle-high, and high family income, respectively. Smoking experience showed a significant association with dental caries on permanent teeth in females. Oral health behaviors, such as tooth brushing frequency, were associated with dental caries in only male adolescents. There was no association between obesity and dental caries on permanent teeth in either male or female adolescents. The present study demonstrated that

  7. Mortality and kidnapping estimates for the Yazidi population in the area of Mount Sinjar, Iraq, in August 2014: A retrospective household survey.

    Science.gov (United States)

    Cetorelli, Valeria; Sasson, Isaac; Shabila, Nazar; Burnham, Gilbert

    2017-05-01

    In August 2014, the so-called Islamic State of Iraq and Syria (ISIS) attacked the Yazidi religious minority living in the area of Mount Sinjar in Nineveh governorate, Iraq. We conducted a retrospective household survey to estimate the number and demographic profile of Yazidis killed and kidnapped. The survey covered the displaced Yazidi population from Sinjar residing in camps in the Kurdistan Region of Iraq. Fieldwork took place between 4 November and 25 December, 2015. A systematic random sample of 1,300 in-camp households were interviewed about the current household composition and any killings and kidnappings of household members by ISIS. Of the 1,300 interviewed households, 988 were Yazidi from Sinjar. Yazidi households contained 6,572 living residents at the time of the survey; 43 killings and 83 kidnappings of household members were reported. We calculated the probability of being killed and kidnapped by dividing the number of reported killings and kidnappings by the number of sampled Yazidis at risk, adjusting for sampling design. To obtain the overall toll of killings and kidnappings, those probabilities were multiplied by the total Yazidi population living in Sinjar at the time of the ISIS attack, estimated at roughly 400,000 by the United Nations and Kurdish officials. The demographic profile of those killed and kidnapped was examined, distinguishing between children and adults and females and males. We estimated that 2.5% of the Yazidi population was either killed or kidnapped over the course of a few days in August 2014, amounting to 9,900 (95% CI 7,000-13,900) people in total. An estimated 3,100 (95% CI 2,100-4,400) Yazidis were killed, with nearly half of them executed-either shot, beheaded, or burned alive-while the rest died on Mount Sinjar from starvation, dehydration, or injuries during the ISIS siege. The estimated number kidnapped is 6,800 (95% CI 4,200-10,800). Escapees recounted the abuses they had suffered, including forced religious

  8. Mortality and kidnapping estimates for the Yazidi population in the area of Mount Sinjar, Iraq, in August 2014: A retrospective household survey.

    Directory of Open Access Journals (Sweden)

    Valeria Cetorelli

    2017-05-01

    Full Text Available In August 2014, the so-called Islamic State of Iraq and Syria (ISIS attacked the Yazidi religious minority living in the area of Mount Sinjar in Nineveh governorate, Iraq. We conducted a retrospective household survey to estimate the number and demographic profile of Yazidis killed and kidnapped.The survey covered the displaced Yazidi population from Sinjar residing in camps in the Kurdistan Region of Iraq. Fieldwork took place between 4 November and 25 December, 2015. A systematic random sample of 1,300 in-camp households were interviewed about the current household composition and any killings and kidnappings of household members by ISIS. Of the 1,300 interviewed households, 988 were Yazidi from Sinjar. Yazidi households contained 6,572 living residents at the time of the survey; 43 killings and 83 kidnappings of household members were reported. We calculated the probability of being killed and kidnapped by dividing the number of reported killings and kidnappings by the number of sampled Yazidis at risk, adjusting for sampling design. To obtain the overall toll of killings and kidnappings, those probabilities were multiplied by the total Yazidi population living in Sinjar at the time of the ISIS attack, estimated at roughly 400,000 by the United Nations and Kurdish officials. The demographic profile of those killed and kidnapped was examined, distinguishing between children and adults and females and males. We estimated that 2.5% of the Yazidi population was either killed or kidnapped over the course of a few days in August 2014, amounting to 9,900 (95% CI 7,000-13,900 people in total. An estimated 3,100 (95% CI 2,100-4,400 Yazidis were killed, with nearly half of them executed-either shot, beheaded, or burned alive-while the rest died on Mount Sinjar from starvation, dehydration, or injuries during the ISIS siege. The estimated number kidnapped is 6,800 (95% CI 4,200-10,800. Escapees recounted the abuses they had suffered, including forced

  9. Examination of cross contamination risks between hospitals by external medical staff via cross-sectional intercept survey of hand hygiene

    Directory of Open Access Journals (Sweden)

    Schiffers, Hank

    2014-08-01

    Full Text Available [english] Introduction: Work in hospitals is supported by contributions of life sciences industry representatives (IR in various ways of fields. Close contact between them, caretakers and patients is unavoidable, even in situations where hygiene is critical.The present study investigates whether IR display comparable levels of and methicillin-resistant (MRSA contamination after being exposed to a shared environment for a minimum of 4 hours.Material and methods: An anonymous survey to sample a group of healthcare professionals for traces of fingertip contamination was performed. We used dip slides ( and MRSA to evaluate professionals at the medical exhibition MEDICA. After applying exclusion criteria 298 participants remained valid, they consisted of 208 industry representatives, 49 nurses and 41 physicians.Results: IR where engaged in hospitals, operating rooms and outpatient clinics (82%, 41.8%, 51.9% respectively. 65.9% of IR (vs. 48.8% physicians and 40.8% nurses carried a microbiological burden ≥10 CFU (colony forming units. Neither (≥10 CFU in IR (40.9% did show statistical differences in contamination patterns in comparison to physicians (43.9%, p=0.346 and nurses (36.7%, p=0.878 nor did MRSA (physicians p=0.579, nurses p=0.908. We were unable to differentiate transient from pre-existing permanent colonization.Conclusion: Exposure to the same environment may result in similar hand contamination patterns of IR when compared caregivers. This supports the concern that industry representatives can cause cross infection between hospitals and hygiene sensitive areas like operation room, intensive care unit and central sterilization units particularly. Further study is required to clarify whether pre-existing bacterial colonization is an influencing factor and how industry is taking care of this to create a safe working environment for their employees, the customers and ultimately the patients.

  10. Hostility, drinking pattern and mortality

    DEFF Research Database (Denmark)

    Boyle, Stephen H; Mortensen, Laust Hvas; Grønbaek, Morten

    2008-01-01

    This study examined the association of hostility to drinking pattern and whether this association mediated the relation of hostility to mortality.......This study examined the association of hostility to drinking pattern and whether this association mediated the relation of hostility to mortality....

  11. Estimated mortality on HIV treatment among active patients and patients lost to follow-up in 4 provinces of Zambia: Findings from a multistage sampling-based survey.

    Directory of Open Access Journals (Sweden)

    Charles B Holmes

    2018-01-01

    Full Text Available Survival represents the single most important indicator of successful HIV treatment. Routine monitoring fails to capture most deaths. As a result, both regional assessments of the impact of HIV services and identification of hotspots for improvement efforts are limited. We sought to assess true mortality on treatment, characterize the extent under-reporting of mortality in routine health information systems in Zambia, and identify drivers of mortality across sites and over time using a multistage, regionally representative sampling approach.We enumerated all HIV infected adults on antiretroviral therapy (ART who visited any one of 64 facilities across 4 provinces in Zambia during the 24-month period from 1 August 2013 to 31 July 2015. We identified a probability sample of patients who were lost to follow-up through selecting facilities probability proportional to size and then a simple random sample of lost patients. Outcomes among patients lost to follow-up were incorporated into survival analysis and multivariate regression through probability weights. Of 165,464 individuals (64% female, median age 39 years (IQR 33-46, median CD4 201 cells/mm3 (IQR 111-312, the 2-year cumulative incidence of mortality increased from 1.9% (95% CI 1.7%-2.0% to a corrected rate of 7.0% (95% CI 5.7%-8.4% (all ART users and from 2.1% (95% CI 1.8%-2.4% to 8.3% (95% CI 6.1%-10.7% (new ART users. Revised provincial mortality rates ranged from 3-9 times higher than naïve rates for new ART users and were lowest in Lusaka Province (4.6 per 100 person-years and highest in Western Province (8.7 per 100 person-years after correction. Corrected mortality rates varied markedly by clinic, with an IQR of 3.5 to 7.5 deaths per 100 person-years and a high of 13.4 deaths per 100 person-years among new ART users, even after adjustment for clinical (e.g., pretherapy CD4 and contextual (e.g., province and clinic size factors. Mortality rates (all ART users were highest year 1 after

  12. Nationwide survey on pediatric CT among children of public health and school nurses to examine a possibility for a follow-up study on radiation effects

    International Nuclear Information System (INIS)

    Ono, K.; Ban, N.; Ojima, M.; Yoshinaga, S.; Akahane, K.; Fujii, K.; Toyota, M.; Hamada, F.; Kouriyama, C.; Akiba, S.; Kunugita, N.; Shimada, Y.; Kai, M.

    2011-01-01

    A nationwide survey was conducted in Japan on paediatric CT among children of public health and school nurses to examine a possibility for a follow-up study on radiation effects. A survey questionnaire was sent out to 3173 public primary and junior high schools and 317 public health centres during October to December in 2009. According to the collected responses, 410 (16.2 %) children received the CT scans and the total number of CT scans was 585. Most of respondents expressed a high interest in radiation health effects and an intent to participate in the epidemiological study that will follow-up the health conditions of children. This study provides information to discuss the feasibility of the epidemiological study on health effects in children who received CT scans. (authors)

  13. Coffee, alcohol, smoking, physical activity and QT interval duration: results from the Third National Health and Nutrition Examination Survey.

    Directory of Open Access Journals (Sweden)

    Yiyi Zhang

    2011-02-01

    Full Text Available Abnormalities in the electrocardiographic QT interval duration have been associated with an increased risk of ventricular arrhythmias and sudden cardiac death. However, there is substantial uncertainty about the effect of modifiable factors such as coffee intake, cigarette smoking, alcohol consumption, and physical activity on QT interval duration.We studied 7795 men and women from the Third National Health and Nutrition Survey (NHANES III, 1988-1994. Baseline QT interval was measured from the standard 12-lead electrocardiogram. Coffee and tea intake, alcohol consumption, leisure-time physical activities over the past month, and lifetime smoking habits were determined using validated questionnaires during the home interview.In the fully adjusted model, the average differences in QT interval comparing participants drinking ≥6 cups/day to those who did not drink any were -1.2 ms (95% CI -4.4 to 2.0 for coffee, and -2.0 ms (-11.2 to 7.3 for tea, respectively. The average differences in QT interval duration comparing current to never smokers was 1.2 ms (-0.6 to 2.9 while the average difference in QT interval duration comparing participants drinking ≥7 drinks/week to non-drinkers was 1.8 ms (-0.5 to 4.0. The age, race/ethnicity, and RR-interval adjusted differences in average QT interval duration comparing men with binge drinking episodes to non-drinkers or drinkers without binge drinking were 2.8 ms (0.4 to 5.3 and 4.0 ms (1.6 to 6.4, respectively. The corresponding differences in women were 1.1 (-2.9 to 5.2 and 1.7 ms (-2.3 to 5.7. Finally, the average differences in QT interval comparing the highest vs. the lowest categories of total physical activity was -0.8 ms (-3.0 to 1.4.Binge drinking was associated with longer QT interval in men but not in women. QT interval duration was not associated with other modifiable factors including coffee and tea intake, smoking, and physical activity.

  14. Coffee, alcohol, smoking, physical activity and QT interval duration: results from the Third National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Zhang, Yiyi; Post, Wendy S; Dalal, Darshan; Blasco-Colmenares, Elena; Tomaselli, Gordon F; Guallar, Eliseo

    2011-02-28

    Abnormalities in the electrocardiographic QT interval duration have been associated with an increased risk of ventricular arrhythmias and sudden cardiac death. However, there is substantial uncertainty about the effect of modifiable factors such as coffee intake, cigarette smoking, alcohol consumption, and physical activity on QT interval duration. We studied 7795 men and women from the Third National Health and Nutrition Survey (NHANES III, 1988-1994). Baseline QT interval was measured from the standard 12-lead electrocardiogram. Coffee and tea intake, alcohol consumption, leisure-time physical activities over the past month, and lifetime smoking habits were determined using validated questionnaires during the home interview. In the fully adjusted model, the average differences in QT interval comparing participants drinking ≥6 cups/day to those who did not drink any were -1.2 ms (95% CI -4.4 to 2.0) for coffee, and -2.0 ms (-11.2 to 7.3) for tea, respectively. The average differences in QT interval duration comparing current to never smokers was 1.2 ms (-0.6 to 2.9) while the average difference in QT interval duration comparing participants drinking ≥7 drinks/week to non-drinkers was 1.8 ms (-0.5 to 4.0). The age, race/ethnicity, and RR-interval adjusted differences in average QT interval duration comparing men with binge drinking episodes to non-drinkers or drinkers without binge drinking were 2.8 ms (0.4 to 5.3) and 4.0 ms (1.6 to 6.4), respectively. The corresponding differences in women were 1.1 (-2.9 to 5.2) and 1.7 ms (-2.3 to 5.7). Finally, the average differences in QT interval comparing the highest vs. the lowest categories of total physical activity was -0.8 ms (-3.0 to 1.4). Binge drinking was associated with longer QT interval in men but not in women. QT interval duration was not associated with other modifiable factors including coffee and tea intake, smoking, and physical activity.

  15. Temporal changes in predicted risk of type 2 diabetes in Germany: findings from the German Health Interview and Examination Surveys 1997–1999 and 2008–2011

    Science.gov (United States)

    Paprott, Rebecca; Mensink, Gert B M; Schulze, Matthias B; Thiele, Silke; Mühlenbruch, Kristin; Scheidt-Nave, Christa; Heidemann, Christin

    2017-01-01

    Objective Over time, prevalence changes in individual diabetes risk factors have been observed for Germany and other European countries. We aimed to investigate the temporal change of a summary measure of type 2 diabetes risk in Germany. Design Comparison of data from two cross-sectional surveys that are about 12 years apart. Setting Two nationwide health examination surveys representative for the non-institutionalised population aged 18–79 years in Germany. Participants The study included participants without diagnosed diabetes from the national health examination surveys in 1997–1999 (n=6457) and 2008–2011 (n=6095). Outcome measures Predicted 5-year type 2 diabetes risk was calculated using the German Diabetes Risk Score (GDRS), which considers information on age, anthropometry, lifestyle factors, hypertension and family history of diabetes. Results Between the two survey periods, the overall age- and sex-standardised predicted 5-year risk of type 2 diabetes decreased by 27% from 1.5% (95% CI 1.4% to 1.6%) to 1.1% (1.0% to 1.2%). The decrease in red meat intake and waist circumference had the highest impact on the overall decrease in diabetes risk. In stratified analyses, diabetes risk decreased among both sexes and within strata of age and body mass index. Diabetes risk also decreased among highly educated persons, but remained unchanged among persons with a middle or low educational level. Conclusions Monitoring type 2 diabetes risk by a summary measure such as the GDRS could essentially contribute to interpret the dynamics in diabetes epidemiology. PMID:28694339

  16. Temporal changes in predicted risk of type 2 diabetes in Germany: findings from the German Health Interview and Examination Surveys 1997-1999 and 2008-2011.

    Science.gov (United States)

    Paprott, Rebecca; Mensink, Gert B M; Schulze, Matthias B; Thiele, Silke; Mühlenbruch, Kristin; Scheidt-Nave, Christa; Heidemann, Christin

    2017-07-09

    Over time, prevalence changes in individual diabetes risk factors have been observed for Germany and other European countries. We aimed to investigate the temporal change of a summary measure of type 2 diabetes risk in Germany. Comparison of data from two cross-sectional surveys that are about 12 years apart. Two nationwide health examination surveys representative for the non-institutionalised population aged 18-79 years in Germany. The study included participants without diagnosed diabetes from the national health examination surveys in 1997-1999 (n=6457) and 2008-2011 (n=6095). Predicted 5-year type 2 diabetes risk was calculated using the German Diabetes Risk Score (GDRS), which considers information on age, anthropometry, lifestyle factors, hypertension and family history of diabetes. Between the two survey periods, the overall age- and sex-standardised predicted 5-year risk of type 2 diabetes decreased by 27% from 1.5% (95% CI 1.4% to 1.6%) to 1.1% (1.0% to 1.2%). The decrease in red meat intake and waist circumference had the highest impact on the overall decrease in diabetes risk. In stratified analyses, diabetes risk decreased among both sexes and within strata of age and body mass index. Diabetes risk also decreased among highly educated persons, but remained unchanged among persons with a middle or low educational level. Monitoring type 2 diabetes risk by a summary measure such as the GDRS could essentially contribute to interpret the dynamics in diabetes epidemiology. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. Molecular survey and microscopic examination of Hepatozoon Miller, 1908 (Apicomplexa: Adeleorina) in lacertid lizards from the western Mediterranean.

    Science.gov (United States)

    Maia, João P M C; Perera, Ana; Harris, D James

    2012-12-01

    The genus Hepatozoon Miller, 1908 (Apicomplexa: Adeleorina) is composed of intracellular haemogregarine parasites that are widely distributed among all tetrapod groups. The present study combines microscopic and molecular data on haemogregarine parasites from lizards in the western Mediterranean. We screened tissue samples and examined blood smears for the presence of species of Hepatozoon from four lizards, namely Algyroides marchi Valverde, endemic to Southeast Spain, Podarcis bocagei Seoane from Spain and Portugal, P hispanica Steindachner from Spain, and P lilfordi Günther from Cabrera, Balearic Islands (Spain). Our results show that prevalence and intensity of Hepatozoon parasites vary between and within lizard species from different regions. Algyroides marchi and P bocagei from Spain had the lowest values, whereas P hispanica had the highest. Phylogeny based on 18S rRNA gene sequences indicates that most of the new Hepatozoon sequences are part of a clade exclusive from North African and Iberian lizards, except for a single P bocagei isolate that is found related to another clade including isolates from other reptile host species and rodents. Interestingly, isolates from Algyroides form a distinct monophyletic subgroup, which could be a signal of strict host-specificity within this host genus.

  18. Relationship between prosthodontic status and nutritional intake in the elderly in Korea: National Health and Nutrition Examination Survey (NHANES IV).

    Science.gov (United States)

    Choi, Y K; Park, D Y; Kim, Y

    2014-11-01

    Many health issues have been reported to be associated with poor nutritional status. We sought to examine the association between nutritional intake and oral health status in elderly people. The association between perceived disability in mastication and prosthodontic status was analysed using multiple logistic regression. Multiple linear regression was used to analyse the association between prosthodontic status and nutritional intake. The elderly subjects with partial or full dentures reported chewing difficulties 1.62-fold more frequently (95% CI: 1.06-2.49) than those with natural teeth or a fixed prosthesis after adjusting for gender, TMD (temporomandibular disorder), household income and education level. Additionally, daily nutritional intakes of energy, protein, fat, ash, calcium, phosphorus and thiamine were decreased significantly in elderly with partial or full dentures compared with those with no prosthesis or with a fixed prosthesis (P oral health status and perceived disability in mastication are associated with dietary imbalances in the elderly. We suggest that the evaluation of patients' nutritional status should be considered as a part of an overall plan for dental hygiene care. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Clinical survey of blood dyscrasias among Hiroshima A-bomb survivors by the periodical health examination, (4)

    Energy Technology Data Exchange (ETDEWEB)

    Taketomi, Y; Abe, T; Kamada, N; Kuramoto, A; Takahashi, H [Hiroshima Univ. (Japan). Research Inst. for Nuclear Medicine and Biology

    1978-09-01

    Status of leukopenia in a-bomb survivors was studied on 202 cases in which leukopenia (white cell count of below 3900) was recognized during successive 3 years in the periodical health examination of the fiscal years from 1973 to 1975. A white cell count of below 3900 was recogenized in about 4% of the total subjects of the year, and the half overlapped in other years. Incidence of leukopenia was higher in the aged, and there was not a marked difference according to the distance from the explosion center. As to a relationship to anemia, hemoglobin amount of below 11.5 g/dl was recognized in 98 of 202 cases, and aplastic anemia was recognized in 3 cases under medical treatment. Concerning a relationship to other disease, chronic liver dysfunction was recognized in 33 of 202 cases, and anemia, in 14 cases. As to classification of leukocyte, abnormality (neutrocytopenia, lymphocytosis) was not recognized in 70 of 202 cases. About a relationship to anemia and liver dysfunction in cases of lymphocytic abnormality, the incidence of lymphocytic abnormality was higher in cases of liver dysfunction (23 of 33 cases of chronic liver dysfunction, 69.7%), and there was not difference between cases of anemia alone and cases without anemia and liver dysfunction (54 of 84 cases, 64.3%). The incidence of lymphocytic abnormality was higher in cases of liver dysfunction and cases without anemia.

  20. Clinical survey of blood dyscrasias among Hiroshima A-bomb survivors by the periodical health examination, (4)

    International Nuclear Information System (INIS)

    Taketomi, Yoshinori; Abe, Tsutomu; Kamada, Nanao; Kuramoto, Atsushi; Takahashi, Hiroshi

    1978-01-01

    Status of leukopenia in a-bomb survivors was studied on 202 cases in which leukopenia (white cell count of below 3900) was recognized during successive 3 years in the periodical health examination of the fiscal years from 1973 to 1975. A white cell count of below 3900 was recogenized in about 4% of the total subjects of the year, and the half overlapped in other years. Incidence of leukopenia was higher in the aged, and there was not a marked difference according to the distance from the explosion center. As to a relationship to anemia, hemoglobin amount of below 11.5 g/dl was recognized in 98 of 202 cases, and aplastic anemia was recognized in 3 cases under medical treatment. Concerning a relationship to other disease, chronic liver dysfunction was recognized in 33 of 202 cases, and anemia, in 14 cases. As to classification of leukocyte, abnormality (neutrocytopenia, lymphocytosis) was not recognized in 70 of 202 cases. About a relationship to anemia and liver dysfunction in cases of lymphocytic abnormality, the incidence of lymphocytic abnormality was higher in cases of liver dysfunction (23 of 33 cases of chronic liver dysfunction, 69.7%), and there was not difference between cases of anemia alone and cases without anemia and liver dysfunction (54 of 84 cases, 64.3%). The incidence of lymphocytic abnormality was higher in cases of liver dysfunction and cases without anemia. (Tsunoda, M.)

  1. Comorbid anxiety disorders alter the association between cardiovascular diseases and depression: the German National Health Interview and Examination Survey.

    Science.gov (United States)

    Tully, Phillip J; Baune, Bernhard T

    2014-05-01

    This study aims to examine whether specific anxiety disorder comorbidity alters the purported association between depression and specific cardiovascular diseases (CVDs). In 4,181 representative German participants of the general population, 12-month prevalence of psychiatric disorders was assessed through the Composite International Diagnostic Interview and CVDs by physician verified diagnosis. Adjusting for conventional risk factors logistic regression analyzed the association between CVDs (peripheral vascular disease (PVD), hypertension, cerebrovascular disease and heart disease) and combinations of comorbidity between depression and anxiety disorder types (panic disorder, specific phobia, social phobia and generalized anxiety). There were 770 cases of hypertension (18.4 %), 763 cases of cerebrovascular disease (18.2 %), 748 cases of PVD (17.9 %), and 1,087 cases of CVD (26.0 %). In adjusted analyses phobia comorbid with depression was associated with cerebrovascular disease (odds ratio (OR) 1.61; 95 % confidence interval (CI) 1.04-2.50) as was panic disorder (OR 2.89; 95 % CI 1.47-5.69). PVD was significantly associated with panic disorder (adjusted OR 2.97; 95 % CI 1.55-5.69). Panic disorder was associated with CVDs (adjusted OR 2.28; 95 % CI 1.09-4.77) as was phobia (adjusted OR 1.35; 95 % CI 1.04-1.78). Classification of anxiety and depression according to comorbidity groups showed discrete effects for panic disorder and specific phobia with CVDs, independent from covariates and depression.

  2. Factors associated with health-related quality of life in Koreans aged over 50 Years: the fourth and fifth Korea National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Kwon, Kyoung Min; Lee, Jung Soo; Jeon, Na Eun; Kim, Yeo Hyung

    2017-12-16

    To evaluate and analyse the factors associated with health-related quality of life (HR-QoL) in the Korean population aged 50 years and older. We used data obtained from the fourth and fifth Korea National Health and Nutrition Examination Survey (KNHANES IV-V) 2007-2012, a national, cross-sectional health examination and survey, for which representative data on the health, nutritional status, and physical activities of the Korean general population are collected by the Korea Centres for Disease Control and Prevention (KCDC). The sampling protocol for the KNHANES was designed to involve a complex, stratified, multistage probability cluster survey of a representative sample of the noninstitutionalized civilian population in South Korea using a cross-sectional design. The association between HR-QoL and socio-economic factors and medical comorbidities in adults aged 50 years and older was investigated using data from the KNHANES IV-V from 2007 to 2012 (n = 17,937). The EuroQol 5-Dimension Questionnaire (EQ-5D) was used to evaluate HR-QoL, and the factors associated with HR-QoL were analysed after adjusting for socio-economic and demographic factors, anthropometric measurements and clinical comorbidities. Health status declined with ageing, and low socio-economic status had negative associations with health status. Gender had no association with health status. Among chronic medical conditions, arthritis and depression had significant associations with health status in older people when stratified by age and gender (P < 0.05). These findings suggest that older people may value the ability to perform daily activities, which may mean that it is necessary to pay more attention to the factors associated with musculoskeletal pain and emotional distress, as well as socio-economic status or chronic diseases. The Korea National Health and Nutrition Examination Survey (KNHNES) is not a clinical trial registry, but the national health survey conducted by the Government of the

  3. Female circumcision and child mortality in urban Somalia.

    Science.gov (United States)

    Mohamud, O A

    1991-01-01

    In Somalia, a demographer analyzed urban data obtained from the Family Health Survey to examine the effect female circumcision has on child mortality and the mechanism of that effect. Girls undergo female circumcision between 5-12 years old in Somalia. Since sunni circumcision (removal of the clitoral prepuce and tip of the clitoris) and clitoridectomy (removal of the entire clitoris) did not affect child mortality, he used them as the reference group. Infibulation (entire removal of the clitoris and of the labia minora and majora with the remains of the labia majora being sewn together allowing only a small opening for passage of urine) did affect child mortality. Female children who underwent infibulation and whose mothers most likely also underwent infibulation experienced higher mortality (13-72%) than those from other circumcised mothers. Female mortality exceeded male mortality indicating possible son preference. Mothers with clitoridectomy or infibulation had significantly higher infant mortality than those with sunni circumcision with the strongest effects during the neonatal period (95% and 42% higher mortality, respectively; p=.01). The effect of female circumcision on child mortality decreased with increased child's age. This higher than expected mortality among women with clitoridectomy may have been because women with infibulation had more stillbirths which were not counted as births. The exposed vagina of clitoridectomized women is more likely to be infected resulting in high risk of stillbirths and premature births than the closed vagina of infibulated women. The researcher suggested that the policies promoting education and consciousness raising may eventually eradicate female circumcision. This longterm campaign should use mass media, senior women of high status, and respected religious leaders. Legislation prohibiting this practice would only drive it underground under unsanitary conditions. Demographers should no longer ignore female circumcision

  4. Mortality and Causes of Death in Patients with Sporadic Inclusion Body Myositis: Survey Study Based on the Clinical Experience of Specialists in Australia, Europe and the USA

    NARCIS (Netherlands)

    Price, Mark A.; Barghout, Victoria; Benveniste, Olivier; Christopher-Stine, Lisa; Corbett, Alastair; de Visser, Marianne; Hilton-Jones, David; Kissel, John T.; Lloyd, Thomas E.; Lundberg, Ingrid E.; Mastaglia, Francis; Mozaffar, Tahseen; Needham, Merrilee; Schmidt, Jens; Sivakumar, Kumaraswamy; DeMuro, Carla; Tseng, Brian S.

    2016-01-01

    There is a paucity of data on mortality and causes of death (CoDs) in patients with sporadic inclusion body myositis (sIBM), a rare, progressive, degenerative, inflammatory myopathy that typically affects those aged over 50 years. Based on patient records and expertise of clinical specialists, this

  5. The burden of mortality of obesity at middle and old age is small: a life table analysis of the US Health and Retirement Survey

    NARCIS (Netherlands)

    Reuser, M.; Bonneux, L.G.A.; Willekens, F.J.C.

    2008-01-01

    The evidence of effect of overweight and obesity on mortality at middle and old age is conflicting. The increased relative risk of cardiovascular disease and diabetes for overweight and obese individuals compared to normal weight is well documented, but the absolute risk of cardiovascular death has

  6. The burden of mortality of obesity at middle and old age is small. A life table analysis of the US Health and Retirement Survey

    NARCIS (Netherlands)

    Reuser, Mieke; Bonneux, Luc; Willekens, Frans

    The evidence of effect of overweight and obesity on mortality at middle and old age is conflicting. The increased relative risk of cardiovascular disease and diabetes for overweight and obese individuals compared to normal weight is well documented, but the absolute risk of cardiovascular death has

  7. Light-Intensity Physical Activity and All-Cause Mortality.

    Science.gov (United States)

    Loprinzi, Paul D

    2017-07-01

    Research demonstrates that moderate-to-vigorous physical activity (MVPA) is associated with a reduced risk of all-cause mortality. Few studies have examined the effects of light-intensity physical activity on mortality. Therefore, the purpose of this study was to examine the association between objectively measured light-intensity physical activity and all-cause mortality risk. Longitudinal. National Health and Nutrition Examination Survey 2003-2006 with follow-up through December 31, 2011. Five thousand five hundred seventy-five U.S. adults. Participants wore an accelerometer for at least 4 days and completed questionnaires to assess sociodemographics and chronic disease information, with blood samples taken to assess biological markers. Follow-up mortality status was assessed via death certificate data from the National Death Index. Cox proportional hazard model. After adjusting for accelerometer-determined MVPA, age, gender, race-ethnicity, cotinine, weight status, poverty level, C-reactive protein, and comorbid illness, for every 60-minute increase in accelerometer-determined light-intensity physical activity, participants had a 16% reduced hazard of all-cause mortality (hazard ratio = .84; 95% confidence interval: .78-.91; p physical activity was inversely associated with all-cause mortality risk, independent of age, MVPA, and other potential confounders. In addition to MVPA, promotion of light-intensity physical activity is warranted.

  8. Irish neonatal mortality statistics for 2004 and over the past 17 years: how do we compare internationally?

    LENUS (Irish Health Repository)

    Fleming, P

    2012-02-01

    In the past 17 years neonatal mortality survey has provided important data on the trends in deaths of all live born infants born in Southern Ireland who are greater than 500 g birth weight and who die within the first 28 days of life. The aims of this study were to report neonatal mortality data for Southern Ireland for 2004, to examine trends in neonatal mortality over the past 17 years and compare Irish Neonatal Mortality rates to other countries around the world. The neonatal mortality rate for 2004 was 2.9\\/1000 with a corrected NMR of 1.9\\/1000. The response rate to the survey was 100%. Prematurity is now the leading cause of neonatal mortality representing a change from previous years. Deaths related to asphyxia have remained largely unchanged. When compared to international figures Ireland compares favourably to other countries around the world.

  9. The relationship between physical activity level and selected cardiovascular risk factors and mortality of males ≥ 50 years in Poland – The results of follow-up of participants of National Multicenter Health Survey WOBASZ

    Directory of Open Access Journals (Sweden)

    Janusz Śmigielski

    2016-08-01

    Full Text Available Objectives: The role of leisure-time physical activity in reducing all-cause and cardiovascular mortality is well explored. The knowledge on occupational and commuting physical activity continues to be ambiguous and misleading. The aim of the study is to assess the influence of different kinds of physical activity on cardiovascular mortality risk in men. Material and Methods: Data analysis on physical activity level and other selected cardiovascular risk factors acquired from 3577 men in the age between 50–80 years who participated in the National Multicenter Health Survey WOBASZ (Wieloośrodkowe Ogólnopolskie Badanie Stanu Zdrowia, Poland (2003–2005 was linked with male mortality in 2004–2009. Data about causes of deaths were obtained from the Central Statistical Office and the Population Electronic Register. Results: Among males aged 50–59 years, the strongest risk factor was living in large settlements and provincial capitals as a place of residence and the most protective factor was occupational physical activity. In the age group 60–69 years and 70–80 years, the strongest protective effect was observed for leisure-time physical activity. In men aged between 70–80 years (unlike in the 50–59 years age group, the protective effect of large settlements and provincial capitals as a place of residence was noted. Conclusions: Occupational physical activity significantly reduced cardiovascular mortality in men aged 50–69 years, while for leisure-time activity the positive effect was observed in age group 60–69 years and 70–80 years. On the other hand, for the inhabitants of large settlements and provincial capitals, significantly higher risk of cardiovascular mortality in the age group 50–69 years and lower risk in the age group ≥ 70 years was noted, both in comparison with smaller places of residence.

  10. Survey of image quality and patient dose in simple radiographic examinations: establishing guidance levels and comparison with international standards

    International Nuclear Information System (INIS)

    Manatrakul, N.; Bunsoong, T.; Krisanachinda, A.; Suwanpradit, P.; Rungruengthanakit, P.; Kanchart, S.; Chaiwong, Rajikorn; Tsapakig, V.A.

    2008-01-01

    Purpose: To investigate image quality and patient dose for commonly radiographic examinations in Thailand, to establish national reference or guidance levels (GL) and compare with international standards, as part of an International Atomic Energy Agency (IAEA) project on Radiation Protection of Patients and Medical Exposure Control (RAS/9/034 and RAS/9/047). Materials and Methods: Film reject rate analysis, image quality and patient dose assessment before and after Quality Control (QC) implementation were investigated in 8 X-ray machines in 4 hospitals. Air kerma (in mGy) at 1 meter focus-detector-distance for different kVp settings for each X-ray machines were measured using an ionization chamber under standardized condition. The entrance skin air kerma (ESAK) for Chest PA, Lumbar spine AP, Lumbar spine LAT, Pelvis AP, Abdomen AP, Skull AP and Skull LAT were calculated for at least 10 adult patients of average body mass (60 to 80 kg) for each projection. The obtained values were compared with international standards. Results: The highest film rejection rate reduction recorded after corrective actions from 9.15% to 6.8%. Mean ESAK values were less than international standards both before and after QC implementation in all projections but Chest PA projection. Maximum ESAK in Chest PA projection before corrective action was 0.55 mGy which was higher than the IAEA GL of 0.2 mGy. However, it was reduced to 0.25 mGy after QC tests on X- ray machine and using high kilovoltage (kV) technique. Conclusion: Proposed national GL of Thailand were obtained by estimating the 3rd quartile of the whole sample: Chest PA: 0.1 mGy, Lumbar Spine AP: 2.1 mGy, Lumbar Spine LAT: 6.3 mGy, Pelvis AP: 1.8 mGy, Abdomen: 1.5 mGy, Skull PA: 1.3 mGy and Skull LAT: 0.9 mGy. (author)

  11. The Association between Education and Mortality for Adults with Intellectual Disability.

    Science.gov (United States)

    Landes, Scott D

    2017-03-01

    Although the relationship between education and mortality is well documented in the general population, it has not been examined for adults with intellectual disability. Informed by fundamental cause theory, I explore the association between education and mortality in a sample of 4,241 adults with intellectual disability from the 1986-2009 National Health Interview Survey with Linked Mortality Files through 2011. Cox regression models were utilized to analyze the predictive effect of education on mortality risk while taking into account birth cohort differences. Increased education was associated with lower mortality risk for adults with intellectual disability, and this relationship strengthened in later birth cohorts who had greater access to the public education system. Comparison with a sample of 21,205 adults without intellectual disability demonstrates that the association between education and mortality risk was not as robust for adults with intellectual disability and highlights the ongoing socioeconomic challenges faced by this population.

  12. Role of Age and Acculturation in Diet Quality Among Mexican Americans - Findings From the National Health and Nutrition Examination Survey, 1999-2012.

    Science.gov (United States)

    Yoshida, Yilin; Scribner, Richard; Chen, Liwei; Broyles, Stephanie; Phillippi, Stephen; Tseng, Tung-Sung

    2017-07-20

    Age and acculturation may play a role in diet quality among Mexican Americans. This study examined diet quality in Mexican Americans by age and whether acculturation influences diet quality across different age groups, using data from the National Health and Nutrition Examination Survey (NHANES). Diet quality, measured by the Healthy Eating Index 2010, improved with age except in categories of dairy, sodium, and refined grains. More acculturation was associated with lower scores in overall diet quality and categories of vegetables, fruits, and sodium and empty calories across almost all ages, but higher scores in grain categories, especially in younger groups. A diet rich in fruits and vegetables but low in fat and sodium should be promoted among more acculturated Mexican Americans, and whole-grain foods should be promoted among young but less acculturated Mexican Americans.

  13. Associations Among Oral Hygiene Behavior and Hypertension Prevalence and Control: The 2008 to 2010 Korea National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Choi, Hye Min; Han, Kyungdo; Park, Yong-Gyu; Park, Jun-Beom

    2015-07-01

    Recently, a positive association has been reported between hypertension and periodontitis. The authors hypothesized that oral hygiene promotion activities could have an effect on hypertension prevention or the degree of hypertension control. Therefore, this study examines the relationship between oral hygiene behaviors and hypertension using data from a nationally representative survey, the Korea National Health and Nutrition Examination Survey (KNHANES). Using data from the KNHANES (2008 to 2010), 19,560 adults with complete data sets were included. The authors analyzed the relationship of the prevalence and control rate of hypertension and numerous variables, including oral hygiene behavior. As the frequency of toothbrushing increased, the prevalence of hypertension decreased in multivariate analysis after adjusting for various factors, including the presence of periodontitis. In a subgroup analysis, this relationship was also observed in individuals without periodontitis. In particular, systolic blood pressure levels progressively decreased as the frequency of toothbrushing and the number of secondary oral products used increased. The adjusted odds ratio of hypertension prevalence was 1.195 (95% confidence interval 1.033 to 1.383) for individuals who brushed their teeth hardly ever or once daily compared with those who brushed after every meal. Individuals with poor oral hygiene behavior are more likely to have a higher prevalence of hypertension, even before periodontitis is shown. Oral hygiene behavior may be considered an independent risk indicator for hypertension, and maintaining good oral hygiene may help to prevent and control hypertension.

  14. Effects of exercise on glycemic control in type 2 diabetes mellitus in Koreans: the fifth Korea National Health and Nutrition Examination Survey (KNHANES V).

    Science.gov (United States)

    Park, Ji-Hye; Lee, Young-Eun

    2015-11-01

    [Purpose] The aim of this study was to investigate the effect of exercise on glycemic control using data from fifth Korea National Health and Nutrition Examination Survey and to provide appropriate exercise guidelines for patients with type 2 diabetes mellitus in Korea. [Subjects and Methods] We selected 1,328 patients from the fifth Korea National Health and Nutrition Examination Survey database who had type 2 diabetes and ranged in age from 30 to 90 years. Statistical analyses included χ(2) tests, multiple linear regression, and logistic regression. [Results] Factors found to be significantly related to glycemic control included income level, physical activity based on intensity of aerobic exercise, use of diabetes medicine, presence of hypertension, duration of diabetes, and waist circumference. In addition, engaging in combined low- and moderate-intensity aerobic exercise when adjusted for resistance exercise was found to lower the risk of glycemic control failure. [Conclusion] Patients with type 2 diabetes mellitus in Korea should engage in combined low- and moderate-intensity aerobic exercise such as walking for 30 minutes or more five times a week. Physical activity is likely to improve glycemic control and thus prevent the acute and chronic complications of diabetes mellitus.

  15. Predictors of exclusive breastfeeding across three time points in Bangladesh: an examination of the 2007, 2011 and 2014 Demographic and Health Survey.

    Science.gov (United States)

    Blackstone, Sarah R; Sanghvi, Tina

    2018-05-01

    The objective of this study was to explore predictors of exclusive breastfeeding (EBF) in Bangladesh using data from 2007, 2011 and 2014, specifically focusing on potential reasons why rates of EBF changed over those time periods. Data on mother/infant pairs with infants <6 months of age were examined at the three time points using the Bangladesh Demographic and Health Survey. The EBF prevalence, changes in EBF since the previous survey and determinants of EBF at each time period were examined using t-tests, χ2 and multilevel logistic regression. The prevalence of EBF was 42.5, 65 and 59.4% in 2007, 2011 and 2014, respectively. The age of the child was significantly associated with EBF across all time points. The largest changes in EBF occurred in the 3- to 5-month age group. Predictors of EBF in this specific age group were similar to overall predictors (e.g. age of the child and region). Participation of the mother in household decisions was a significant predictor in 2014. EBF prevalence in Bangladesh increased between 2007 and 2011 and then decreased between 2011 and 2014. The increase in 2011 may have been the result of widespread initiatives to promote EBF in that time frame. Due to the unexplained decrease in EBF between 2011 and 2014, there is still a need for interventions such as peer counselling, antenatal education and community awareness to promote EBF.

  16. Working hours and depressive symptomatology among full-time employees: Results from the fourth Korean National Health and Nutrition Examination Survey (2007-2009).

    Science.gov (United States)

    Kim, Inah; Kim, Hyunjoo; Lim, Sinye; Lee, Mira; Bahk, Jinwook; June, Kyung Ja; Kim, Soyeon; Chang, Won Joon

    2013-09-01

    This study aimed to examine the distribution of working hours and the association between working hours and depressive symptomatology using representative data from a national, population-based survey. Data came from the fourth Korean National Health and Nutrition Examination Survey (2007-2009), which employed a systematic, stratified cluster-sampling method. We used logistic regression procedures to estimate the importance of weekly working hours as a predictor of depressive symptomatology. The prevalence of depressive symptomatology was 10.2%. The work week, which averaged 48.3 hours for the sample as a whole, was longer for men (49.8 hours) than women (45.3 hours), and 12.1% of respondents were engaged in shift work. In logistic regression analyses, compared to those working hours per week, the odds ratios (OR) of working hours as a predictor of depressive symptomatology were 1.19 [95% confidence interval (95% CI) 0.77-1.85] for those working 52-59 hours per week and 1.62 (95% CI 1.20-2.18) for those working ≥ 60 hours per week, after adjustment for demographic characteristics, health behaviors, socioeconomic status, employment status, and work schedules. It showed a positive dose-response relationship between working hours and depressive symptomatology (P = 0.0059). Working hours in Korea are long. There is an association between working hours and depressive symptomatology, and there seems be a trend in working hours and depressive symptomatology.

  17. A cross-national examination of differences in classification of lifetime alcohol use disorder between DSM-IV and DSM-5: Findings from the World Mental Health Survey

    Science.gov (United States)

    Slade, Tim; Chiu, Wai-Tat; Glantz, Meyer; Kessler, Ronald C.; Lago, Luise; Sampson, Nancy; Al-Hamzawi, Ali; Florescu, Silvia; Moskalewicz, Jacek; Murphy, Sam; Navarro-Mateu, Fernando; de Galvis, Yolanda Torres; Viana, Maria Carmen; Xavier, Miguel; Degenhardt, Louisa

    2016-01-01

    Aims To examine the diagnostic overlap in DSM-IV and DSM-5 alcohol use disorder (AUD) and determine the clinical correlates of changing diagnostic status across the two classification systems. Design DSM-IV and DSM-5 definitions of AUD were compared using cross-national community survey data. Setting Nine low-, middle- and high-income countries. Participants/Cases 31,367 respondents to surveys in the World Health Organization World Mental Health Survey Initiative. Measures Composite International Diagnostic Interview, version 3.0 was used to derive DSM-IV and DSM-5 lifetime diagnoses of AUD. Clinical characteristics, also assessed in the surveys, included lifetime DSM-IV anxiety, mood and drug use disorders, lifetime suicidal ideation, plan and attempt, general functional impairment and psychological distress. Findings Compared to DSM-IV AUD (12.3%, SE=0.3%), the DSM-5 definition yielded slightly lower prevalence estimates (10.8%, SE=0.2%). Almost one third (n=802) of all DSM-IV Abuse cases switched to sub-threshold according to DSM-5 and one quarter (n=467) of all DSM-IV diagnostic orphans switched to mild AUD according to DSM-5. New cases of DSM-5 AUD were largely similar to those who maintained their AUD across both classifications. Similarly, new DSM-5 non-cases were similar to those who were sub-threshold across both classifications. The exception to this was with regards to the prevalence of any lifetime drug use disorder. Conclusions In this large cross-national community sample, the prevalence of DSM-5 lifetime AUD was only slightly lower than the prevalence of DSM-IV lifetime AUD. Nonetheless there was considerable diagnostic switching, with a large number of people inconsistently identified across the two DSM classifications. PMID:27426631

  18. Associations between Food Security Status and Dietary Inflammatory Potential within Lower-Income Adults from the United States National Health and Nutrition Examination Survey, Cycles 2007 to 2014.

    Science.gov (United States)

    Bergmans, Rachel S; Palta, Mari; Robert, Stephanie A; Berger, Lawrence M; Ehrenthal, Deborah B; Malecki, Kristen M

    2018-06-01

    Evidence suggests both that chronic inflammation mediates the association of food insecurity with adverse health outcomes and that diet may be a significant source of inflammation among food insecure individuals. To examine whether food security status is associated with dietary inflammatory potential. Cross-sectional data came from the National Health and Nutrition Examination Survey (NHANES), cycles 2007 to 2014 (n=10,630). The analysis sample is representative of noninstitutionalized US adults with an income-to-poverty ratio ≤3.00. Dietary Inflammatory Index (DII) score, calculated using the average of two 24-hour dietary recalls, was the main outcome measure. Type III F tests or χ 2 tests compared population characteristics by food security status, defined using the US Food Security Survey Module. Multivariable linear regression was used to estimate the association between food security status and the DII score and moderation by demographic factors. Survey weighting procedures accounted for the effects of stratification and clustering used in the NHANES study design. When accounting for socioeconomic status, demographic factors, and health status, DII score was higher at greater levels of food insecurity (P=0.0033). Those with very low food security had a 0.31 (95% CI=0.12 to 0.49) higher DII score than those with high food security. Age moderated the association between food security status and DII score (interaction P=0.0103), where the magnitude of the association between DII score and severity of food insecurity was higher for those >65 years than for younger age groups. Food security status may be associated with dietary inflammatory potential, which is hypothesized to play a role in multiple chronic health conditions. Further research is needed to determine the causal nature of this relationship and evaluate how best to implement programs designed to address health disparities within food insecure populations. Copyright © 2018 Academy of Nutrition and

  19. Hypertension and age at onset of natural menopause in Korean postmenopausal women: Results from the Korea National Health and Nutrition Examination Survey (2008-2013).

    Science.gov (United States)

    Lim, Hee-Sook; Kim, Tae-Hee; Lee, Hae-Hyeog; Park, Yoon-Hyung; Kim, Jun-Mo; Lee, Bo-Ra

    2016-08-01

    Menopause is a natural phenomenon of aging, although the timing and management of menopause can significantly affect a woman's quality of life. It is therefore important to identify measures to ensure a healthy menopause. We set out to investigate the association between hypertension and early menopause in Korean women. This cross-sectional study was based on 2008-2013 data from the Korea National Health and Nutrition Examination Survey (KNHANES). Of the 53,829 participants surveyed, 13,584 women were selected. We analyzed the contents of the health interview, health examination, and nutrition survey. The main outcome was defined based on hazard ratios (HR) to identify the effects of hypertension on age at onset of menopause. Among postmenopausal women (n=6650), the mean age at onset of menopause was 50.4 years. Premenopausal hypertension was statistically significantly associated with age at menopause, oral contraceptive usage, household income, education level, occupation, marital status and smoking and drinking habits. With lower age at diagnosis of hypertension, HRs for menopause tended to be higher, and hypertension diagnosed before age 40 years conferred a statistically significantly higher HR (Model 1, HR=2.32, 95% CI=1.87-2.88; Model 2, HR=2.31, 95% CI=1.86-2.86; Model 3, HR=2.23, 95% CI=1.80-2.77; Model 4, HR=2.00, 95% CI=1.52-2.63). Premature menopause is strongly associated with lifestyle factors, in combination with incomplete management of chronic diseases. Our findings support the hypothesis that younger age at diagnosis of hypertension is associated with younger age at onset of menopause in Korean women. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. Mortality and Causes of Death in Patients with Sporadic Inclusion Body Myositis: Survey Study Based on the Clinical Experience of Specialists in Australia, Europe and the USA

    Science.gov (United States)

    Price, Mark A.; Barghout, Victoria; Benveniste, Olivier; Christopher-Stine, Lisa; Corbett, Alastair; de Visser, Marianne; Hilton-Jones, David; Kissel, John T.; Lloyd, Thomas E.; Lundberg, Ingrid E.; Mastaglia, Francis; Mozaffar, Tahseen; Needham, Merrilee; Schmidt, Jens; Sivakumar, Kumaraswamy; DeMuro, Carla; Tseng, Brian S.

    2016-01-01

    Background: There is a paucity of data on mortality and causes of death (CoDs) in patients with sporadic inclusion body myositis (sIBM), a rare, progressive, degenerative, inflammatory myopathy that typically affects those aged over 50 years. Objective: Based on patient records and expertise of clinical specialists, this study used questionnaires to evaluate physicians’ views on clinical characteristics of sIBM that may impact on premature mortality and CoDs in these patients. Methods: Thirteen physicians from seven countries completed two questionnaires online between December 20, 2012 and January 15, 2013. Responses to the first questionnaire were collated and presented in the second questionnaire to seek elaboration and identify consensus. Results: All 13 physicians completed both questionnaires, providing responses based on 585 living and 149 deceased patients under their care. Patients were reported to have experienced dysphagia (60.2%) and injurious falls (44.3%) during their disease. Over half of physicians reported that a subset of their patients with sIBM had a shortened lifespan (8/13), and agreed that bulbar dysfunction/dysphagia/oropharyngeal involvement (12/13), early-onset disease (8/13), severe symptoms (8/13), and falls (7/13) impacted lifespan. Factors related to sIBM were reported as CoDs in 40% of deceased patients. Oropharyngeal muscle dysfunction was ranked as the leading feature of sIBM that could contribute to death. The risk of premature mortality was higher than the age-matched comparison population. Conclusions: In the absence of data from traditional sources, this study suggests that features of sIBM may contribute to premature mortality and may be used to inform future studies. PMID:27854208

  1. What are patient factors associated with the quality of diabetes care?: results from the Korean National Health and Nutrition Examination Survey

    Directory of Open Access Journals (Sweden)

    Ko Ki

    2012-08-01

    Full Text Available Abstract Background Recently there has been a growing interest in healthcare quality control in Korea. We examined the association between patient factors and quality indicators of diabetic care among Korean adults with diabetes. Methods We obtained a sample of 335 adults aged 20 or older diagnosed with diabetes from the 2005 Korean National Health and Nutrition Examination Survey. Patient factors were divided into two categories: socioeconomic position and health-related factors. Quality indicators for diabetes care were defined as receiving preventive care services for diabetes complications (e.g., fundus examination, microalbuminuria examination, diabetes education and diabetes-related clinical outcomes (e.g., HbA1c, blood pressure, LDL-cholesterol. We performed multiple logistic regression analyses for each quality indicator. Results We found that people with lower education levels or shorter duration of diabetes illness were less likely to receive preventive care services for diabetes complications. Women or people with longer duration of diabetes were less likely to reach the glycemic target. Obese diabetic patients were less likely to accomplish adequate control of blood pressure and LDL-cholesterol. Conclusions Several factors of patients with diabetes, such as education level, duration of illness, gender, and obesity grade are associated with the quality of diabetes care. These findings can help inform policy makers about subpopulations at risk in developing a public health strategy in the future.

  2. Cancer mortality

    International Nuclear Information System (INIS)

    Kato, H.

    1986-01-01

    The Radiation Effects Research Foundation (RERF) and its predecessor, the Atomic Bomb Casualty Commission (ABCC), have conducted mortality surveillance on a fixed sample, the Life Span Study (LSS), of 82,000 atomic bomb survivors and 27,000 nonexposed residents of Hiroshima and Nagasaki since 1950. The results of the most recent analysis of the LSS are summarized

  3. Dietary Approaches to Stop Hypertension Diet, Weight Status, and Blood Pressure among Children and Adolescents: National Health and Nutrition Examination Surveys 2003-2012.

    Science.gov (United States)

    Cohen, Juliana F W; Lehnerd, Megan E; Houser, Robert F; Rimm, Eric B

    2017-09-01

    The Dietary Approaches to Stop Hypertension (DASH) diet is associated with lower blood pressure and reduced risk of cardiovascular disease among adults, but little is known about accordance with this dietary pattern or health benefits among children and adolescents. The objectives were to evaluate accordance with the DASH diet, differences over time, and the association with health attributes among a nationally representative sample of US children and adolescents. Cross-sectional data from the 2003-2012 National Health and Nutrition Examination Surveys (NHANES) were analyzed. Data from 9,793 individuals aged 8 to 18 years were examined. DASH accordance was estimated based on nine nutrient targets: total fat, saturated fat, protein, cholesterol, fiber, calcium, magnesium, potassium, and sodium; possible score range is 0 to 9. Accordance with the DASH diet across time was examined comparing the 2011-2012 to 2003-2004 NHANES surveys. The association between DASH score and weight status was examined using multinomial logistic regression, and the associations with waist circumference, systolic blood pressure, and diastolic blood pressure were examined using multivariable linear regression. Accordance with the DASH diet was low across the age groups, with a range of mean DASH scores from 1.48 to 2.14. There were no significant changes across time. DASH score was inversely associated with systolic blood pressure (mm Hg) among 14- to 18-year-olds (β=-.46; 95% CI -.83 to -.09) among the larger sample of participants who completed at least one dietary recall, but no significant differences were seen in other age categories. In the subsample of participants with both dietary recalls, a significant inverse association was seen between DASH score and systolic blood pressure for 11- to 13-year-olds (β=-.57; 95% CI -1.02 to -.12). There were no significant associations between this dietary pattern and weight status, waist circumference, or diastolic blood pressure. Few US

  4. Socio-economic determinants of mortality in Bangladesh.

    Science.gov (United States)

    Kabir, M; Howlader, A A

    1980-01-01

    Infant mortality in Bangladesh is 1 of the highest in Asian countries. There are several reasons why infant mortality is still high in Bangladesh. A large number of births occur prematurely, or there is poor handling by birth attendants leading to injury and infection. In addition, there is a gross shortage of maternity clinics, trained midwives, and other paramedical personnel in the country. The children are generally born in the most unhygienic of conditions. Malnutrition is a common factor. In recent years, the study of socioeconomic differentials of infant and child mortality has occupied an important position in demographic research. Given the limited data available to measure many variables which could have an effect on mortality as measured here by infant mortality, the analysis has been essentially confined to an analysis of differences in infant mortality by various socioeconomic characteristics. The factors and relative contributions of the combined effects of medical services, general socioeconomic and environmental factors need to be examined. Mortality can be seen in this context as a final consequence of the interactions between health, work, and income. Due to lack of data availability, very little work has been done on this. The World Fertility Survey has given a unique opportunity to researchers to explore this field more comprehensively.

  5. Radiologists' knowledge and perceptions of the impact of contrast-induced nephropathy and its risk factors when performing computed tomography examinations: A survey of European radiologists

    International Nuclear Information System (INIS)

    Reddan, Donal; Fishman, Elliot K.

    2008-01-01

    Background: The past decade has seen a proliferation in the number of CT procedures. As increasing numbers of elderly patients with multiple comorbidities undergo contrast media (CM)-enhanced procedures, more patients are at risk for contrast-induced nephropathy (CIN). Objectives: To understand whether radiologists are sufficiently aware of the incidence, impact and risk factors of CIN, and whether they are taking sufficient measures to prevent CIN among patients undergoing CT. Materials and methods: A telephone or online survey was conducted in 2005 with 509 radiologists from 10 European countries. Participants had a minimum of 3 years' experience and performed at least 50 CT scans per week. Results: Most (88%) radiologists believed that CIN is an important issue. While 45% identify that a patient is experiencing CIN when the serum creatinine level increases >25% (0.5 mg/dL) from baseline within 48 h, the remainder used criteria that might lead to significant under-diagnosis. Most (72%) radiologists believed that CIN is associated with increased morbidity; 56% did not believe that it is associated with increased mortality. Most respondents agreed that pre-existing renal impairment (97%), dehydration (90%) and diabetes (89%) were risk factors for CIN; however, 26%, 30% and 46%, respectively, did not identify advanced age, CM dose or congestive cardiac failure as risk factors. Only 7% of radiologists thought they were always made aware of CIN associated with their cases and 28% never consulted a nephrologist to discuss patients at risk of CIN or who had developed CIN. Conclusion: There is highly variable awareness of the definition, impact and risk factors for CIN among European radiologists. Data regarding the importance of CIN in CT are limited. Improved efforts are required to better educate radiologists and referring physicians and to institute appropriate protocols to identify at-risk patients and prevent CIN

  6. Radiologists' knowledge and perceptions of the impact of contrast-induced nephropathy and its risk factors when performing computed tomography examinations: A survey of European radiologists

    Energy Technology Data Exchange (ETDEWEB)

    Reddan, Donal [University College Galway Hospitals, Unit 7, Merlin Park Hospital, Galway (Ireland)], E-mail: donal.reddan@mailn.hse.ie; Fishman, Elliot K. [Johns Hopkins Hospital, Baltimore, MD (United States)

    2008-05-15

    Background: The past decade has seen a proliferation in the number of CT procedures. As increasing numbers of elderly patients with multiple comorbidities undergo contrast media (CM)-enhanced procedures, more patients are at risk for contrast-induced nephropathy (CIN). Objectives: To understand whether radiologists are sufficiently aware of the incidence, impact and risk factors of CIN, and whether they are taking sufficient measures to prevent CIN among patients undergoing CT. Materials and methods: A telephone or online survey was conducted in 2005 with 509 radiologists from 10 European countries. Participants had a minimum of 3 years' experience and performed at least 50 CT scans per week. Results: Most (88%) radiologists believed that CIN is an important issue. While 45% identify that a patient is experiencing CIN when the serum creatinine level increases >25% (0.5 mg/dL) from baseline within 48 h, the remainder used criteria that might lead to significant under-diagnosis. Most (72%) radiologists believed that CIN is associated with increased morbidity; 56% did not believe that it is associated with increased mortality. Most respondents agreed that pre-existing renal impairment (97%), dehydration (90%) and diabetes (89%) were risk factors for CIN; however, 26%, 30% and 46%, respectively, did not identify advanced age, CM dose or congestive cardiac failure as risk factors. Only 7% of radiologists thought they were always made aware of CIN associated with their cases and 28% never consulted a nephrologist to discuss patients at risk of CIN or who had developed CIN. Conclusion: There is highly variable awareness of the definition, impact and risk factors for CIN among European radiologists. Data regarding the importance of CIN in CT are limited. Improved efforts are required to better educate radiologists and referring physicians and to institute appropriate protocols to identify at-risk patients and prevent CIN.

  7. Prevalence and cardiovascular risk profile of chronic kidney disease in Italy: results of the 2008-12 National Health Examination Survey.

    Science.gov (United States)

    De Nicola, Luca; Donfrancesco, Chiara; Minutolo, Roberto; Lo Noce, Cinzia; Palmieri, Luigi; De Curtis, Amalia; Iacoviello, Licia; Zoccali, Carmine; Gesualdo, Loreto; Conte, Giuseppe; Vanuzzo, Diego; Giampaoli, Simona

    2015-05-01

    National surveys in countries outside Europe have reported a high prevalence (11-13%) of chronic kidney disease (CKD). Studies in Europe have provided a variable prevalence likely due to differences in study design, including age and extent of geographic areas, equation used to evaluate estimated glomerular filtration rate (eGFR) and CKD stages examined. The 2008-12 National Health Examination Survey in Italy randomly extracted samples from the general population aged 35-79 years, stratified by age and gender, from the resident list of each Italian region (440 persons/1.5 million of residents). We estimated the prevalence of CKD by means of urinary albumin : creatinine ratio and eGFR (CKD-EPI equation-enzymatic assay of serum creatinine). Cardiovascular (CV) risk profile was also evaluated. Three thousand eight hundred and forty-eight men and 3704 women were examined. In the whole population, mean age was 57 ± 12 and 56 ± 12 years in men and women, respectively; hypertension was prevalent in men and women, respectively (56 and 43%) and the same held true for overweight (48 and 33%), obesity (26 and 27%), diabetes (14 and 9%) and smoking (21 and 18%), whereas CV disease was less frequent (9 and 6%). Overall, the prevalence of CKD (95% confidence interval) was 7.05% (6.48-7.65). Early stages constituted 59% of the CKD population [Stage G1-2 A2-3: 4.16% (3.71-4.61) and Stage G3-5: 2.89% (2.51-3.26)]. At multivariate regression analysis, age, obesity, hypertension, diabetes, CV disease and smoking were all independent correlates of CKD. CKD has a relatively lower prevalence in Italy, in particular for advanced stages, when compared with similar national surveys outside Europe. This occurs despite older age and unfavourable CV risk profile of the whole population. © The Author 2014. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  8. Validation of the German Diabetes Risk Score among the general adult population: findings from the German Health Interview and Examination Surveys

    Science.gov (United States)

    Paprott, Rebecca; Mühlenbruch, Kristin; Mensink, Gert B M; Thiele, Silke; Schulze, Matthias B; Scheidt-Nave, Christa; Heidemann, Christin

    2016-01-01

    Objective To evaluate the German Diabetes Risk Score (GDRS) among the general adult German population for prediction of incident type 2 diabetes and detection of prevalent undiagnosed diabetes. Methods The longitudinal sample for prediction of incident diagnosed type 2 diabetes included 3625 persons who participated both in the examination survey in 1997–1999 and the examination survey in 2008–2011. Incident diagnosed type 2 diabetes was defined as first-time physician diagnosis or antidiabetic medication during 5 years of follow-up excluding potential incident type 1 and gestational diabetes. The cross-sectional sample for detection of prevalent undiagnosed diabetes included 6048 participants without diagnosed diabetes of the examination survey in 2008–2011. Prevalent undiagnosed diabetes was defined as glycated haemoglobin ≥6.5% (48 mmol/mol). We assessed discrimination as area under the receiver operating characteristic curve (ROC-AUC (95% CI)) and calibration through calibration plots. Results In longitudinal analyses, 82 subjects with incident diagnosed type 2 diabetes were identified after 5 years of follow-up. For prediction of incident diagnosed diabetes, the GDRS yielded an ROC-AUC of 0.87 (0.83 to 0.90). Calibration plots indicated excellent prediction for low diabetes risk and overestimation for intermediate and high diabetes risk. When considering the entire follow-up period of 11.9 years (ROC-AUC: 0.84 (0.82 to 0.86)) and including incident undiagnosed diabetes (ROC-AUC: 0.81 (0.78 to 0.84)), discrimination decreased somewhat. A previously simplified paper version of the GDRS yielded a similar predictive ability (ROC-AUC: 0.86 (0.82 to 0.89)). In cross-sectional analyses, 128 subjects with undiagnosed diabetes were identified. For detection of prevalent undiagnosed diabetes, the ROC-AUC was 0.84 (0.81 to 0.86). Again, the simplified version yielded a similar result (ROC-AUC: 0.83 (0.80 to 0.86)). Conclusions The GDRS might be applied

  9. [A survey carried out among Italian physicians regarding non-required clinical examinations, treatments and procedures in the current clinical practice: results and considerations.

    Science.gov (United States)

    Vernero, Sandra; Giustetto, Guido

    2017-01-01

    A survey addressed to all Italian physicians regarding how they behave when a patient asks them to prescribe non-required clinical examinations, treatments and procedures has been carried out for the first time. The survey - realized during the last months of the year 2015 thanks to the collaboration between Slow Medicine and the National Federation of Associations of Doctors, Surgeons and Dentists - is based on a questionnaire given to the America physicians by the ABIM Foundation in 2014. The Italian survey results cannot be compared with the American ones because different approaches were used. 4,263 physicians started to fill in the questionnaire and 3,688 completed it. The results suggest that the physicians that answered the questions are highly aware of the over-usage of diagnostic tests and treatments, and among the main reasons they cite the need of safety and then the fear of legal consequences. Most of the physicians who answered the questions believe to be responsible for giving patients accurate information in order to avoid non-required practices, and that the physician is the right person with the most suitable role to face the problem. Among the most important and useful tools to reduce the prescription of non-required examinations and treatments, physicians indicate the possibility to have much more time available to discuss the different options with their patients, to arrange the evidence-based information material for the patients, and to explain the reform on the physician's responsibility (recently approved as law). Therefore, it stands out the opportunity to apply provisions aimed at providing the patients with more accurate information and at improving the relationship between the physician and the patient by ensuring on the one hand more availability of dedicated time and on the other hand the training of the physicians on scientific topics as well as on topics concerning communication and shared decisions. The communication can be

  10. Effect change of obesity on diabetes depending on measurement: self-reported body mas index from 2012 Community Health Survey vs. directly measured from the Korea National Health and Nutrition Examination Survey

    Directory of Open Access Journals (Sweden)

    Kyuhyun Yoon

    2015-01-01

    Full Text Available OBJECTIVES: Obesity is a well-recognized risk factor for type 2 diabetes mellitus (DM among young and middle-aged adults in South Korea. To elaborate on the association between obesity and Diabetes mellitus (DM, subjective data from self-reporting survey or objective data from health examination is generally used. This study was conducted to validate the change of association from using these different measurements. METHODS: Community Health Survey data and Korea National Health and Nutrition Examination Survey data, as subjective and objective data respectively, were used. Population, resident in Seoul and over 45 aged, were selected for the study and the association between obesity and DM were defined by using multivariate logistic regression model. RESULTS: In subjective data, DM prevalence was 12.4% (male, 14.7; female, 10.6 and obesity prevalence was 26.0% (male, 29.2; female, 23.4. Whereas, in objective data, DM prevalence was 15.0% (male, 17.8; female, 12.9, and obese population was 32.4% (male, 34.4; female, 30.8. Based on the effect of obesity on DM prevalence from each data, using objective data increased the impact of obesity. Difference of relative risk of obesity between from subjective data and from objective was bigger in female than male and statistically significant. CONCLUSIONS: The differences of association pattern between subjective and objective data were found, due to higher obesity prevalence in objective data, and discrepancies of socio-economic status. These discrepancies could be inevitable Therefore we have to face them proactively, and understand the different aspect of various variables from different measurement.

  11. A Methodological Approach to Assessing the Health Impact of Environmental Chemical Mixtures: PCBs and Hypertension in the National Health and Nutrition Examination Survey

    Directory of Open Access Journals (Sweden)

    Paul White

    2011-11-01

    Full Text Available We describe an approach to examine the association between exposure to chemical mixtures and a health outcome, using as our case study polychlorinated biphenyls (PCBs and hypertension. The association between serum PCB and hypertension among participants in the 1999–2004 National Health and Nutrition Examination Survey was examined. First, unconditional multivariate logistic regression was used to estimate odds ratios and associated 95% confidence intervals. Next, correlation and multicollinearity among PCB congeners was evaluated, and clustering analyses performed to determine groups of related congeners. Finally, a weighted sum was constructed to represent the relative importance of each congener in relation to hypertension risk. PCB serum concentrations varied by demographic characteristics, and were on average higher among those with hypertension. Logistic regression results showed mixed findings by congener and class. Further analyses identified groupings of correlated PCBs. Using a weighted sum approach to equalize different ranges and potencies, PCBs 66, 101, 118, 128 and 187 were significantly associated with increased risk of hypertension. Epidemiologic data were used to demonstrate an approach to evaluating the association between a complex environmental exposure and health outcome. The complexity of analyzing a large number of related exposures, where each may have different potency and range, are addressed in the context of the association between hypertension risk and exposure to PCBs.

  12. The effect of Medicaid adult vision coverage on the likelihood of appropriate correction of distance vision: Evidence from the National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Lipton, Brandy J; Decker, Sandra L

    2016-02-01

    Medicaid is the main public health insurance program for individuals with low income in the United States. Some state Medicaid programs cover preventive eye care services and vision correction, while others cover emergency eye care only. Similar to other optional benefits, states may add and drop adult vision benefits over time. This article examines whether providing adult vision benefits is associated with an increase in the percentage of low-income individuals with appropriately corrected distance vision as measured during an eye exam. We estimate the effect of Medicaid vision coverage on the likelihood of having appropriately corrected distance vision using examination data from the 2001-2008 National Health and Nutrition Examination Survey. We compare vision outcomes for Medicaid beneficiaries (n = 712) and other low income adults not enrolled in Medicaid (n = 4786) before and after changes to state vision coverage policies. Between 29 and 33 states provided Medicaid adult vision benefits during 2001-2008, depending on the year. Our findings imply that Medicaid adult vision coverage is associated with a significant increase in the percentage of Medicaid beneficiaries with appropriately corrected distance vision of up to 10 percentage points. Providing vision coverage to adults on Medicaid significantly increases the likelihood of appropriate correction of distance vision. Further research on the impact of vision coverage on related functional outcomes and the effects of Medicaid coverage of other services may be appropriate. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Prevalence of Perceived Dysphonia and Its Correlation With the Prevalence of Clinically Diagnosed Laryngeal Disorders: The Korea National Health and Nutrition Examination Surveys 2010-2012.

    Science.gov (United States)

    Byeon, Haewon

    2015-10-01

    This study investigated the prevalence of perceived dysphonia and its correlation with the prevalence of clinically diagnosed laryngeal disorders. Subjects were 8713 non-institutionalized civilian adults over the age of 19 (3810 men and 4912 women) who completed the laryngeal examination of the fifth Korea National Health and Nutrition Examination Survey. A Poisson regression was used to examine the association between perceived dysphonia and laryngeal disorders. Adjusting for covariates (age, sex, education level, income, occupation, alcohol drinking, and self-reported health status), those with perceived voice problems were 4.8 times (OR=4.75, 95% CI, 3.77-5.99) more likely to have laryngeal disorders than those without voice problems. In particular, the vocal fold pathology correlated with perceived dysphonia was: vocal fold nodules (OR=5.32, 95% CI, 3.43-8.26), vocal polyps (OR=3.73, 95% CI, 1.57-8.86), vocal cysts (OR=11.97, 95% CI, 1.97-72.72), Reinke's edema (OR=9.27, 95% CI, 4.77-18.00), laryngeal paralysis (OR=3.58, 95% CI, 1.56-8.26), laryngeal granulomas (OR=4.31, 95% CI, 1.01-18.80), epiglottic cyst (OR=2.94, 95% CI, 1.21-7.13), and laryngitis (OR=4.07, 95% CI, 2.91-5.69). People with self-perceived dysphonia had a high risk of laryngeal disorders. © The Author(s) 2015.

  14. Socioeconomic status, food security, and dental caries in US children: mediation analyses of data from the National Health and Nutrition Examination Survey, 2007-2008.

    Science.gov (United States)

    Chi, Donald L; Masterson, Erin E; Carle, Adam C; Mancl, Lloyd A; Coldwell, Susan E

    2014-05-01

    We examined associations of household socioeconomic status (SES) and food security with children's oral health outcomes. We analyzed 2007 and 2008 US National Health and Nutrition Examination Survey data for children aged 5 to 17 years (n = 2206) to examine the relationship between food security and untreated dental caries and to assess whether food security mediates the SES-caries relationship. About 20.1% of children had untreated caries. Most households had full food security (62%); 13% had marginal, 17% had low, and 8% had very low food security. Higher SES was associated with significantly lower caries prevalence (prevalence ratio [PR] = 0.77; 95% confidence interval = 0.63, 0.94; P = .01). Children from households with low or very low food security had significantly higher caries prevalence (PR = 2.00 and PR = 1.70, respectively) than did children living in fully food-secure households. Caries prevalence did not differ among children from fully and marginally food-secure households (P = .17). Food insecurity did not appear to mediate the SES-caries relationship. Interventions and policies to ensure food security may help address the US pediatric caries epidemic.

  15. Mortality Implications of Mortality Plateaus

    DEFF Research Database (Denmark)

    Missov, T. I.; Vaupel, J. W.

    2015-01-01

    This article aims to describe in a unified framework all plateau-generating random effects models in terms of (i) plausible distributions for the hazard (baseline mortality) and the random effect (unobserved heterogeneity, frailty) as well as (ii) the impact of frailty on the baseline hazard...

  16. Continuing study of mortality in Hanford workers

    International Nuclear Information System (INIS)

    Marks, S.; Gilbert, E.S.

    1979-10-01

    The mortality of workers at the Hanford Plant in southeastern Washington who have been exposed to penetrating external ionizing radiation is studied. Deaths are analyzed statistically and compared to standardized mortality ratios. Cancer deaths in particular are examined

  17. Multilevel model to estimate county-level untreated dental caries among US children aged 6-9years using the National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Lin, Mei; Zhang, Xingyou; Holt, James B; Robison, Valerie; Li, Chien-Hsun; Griffin, Susan O

    2018-06-01

    Because conducting population-based oral health screening is resource intensive, oral health data at small-area levels (e.g., county-level) are not commonly available. We applied the multilevel logistic regression and poststratification method to estimate county-level prevalence of untreated dental caries among children aged 6-9years in the United States using data from the National Health and Nutrition Examination Survey (NHANES) 2005-2010 linked with various area-level data at census tract, county and state levels. We validated model-based national estimates against direct estimates from NHANES. We also compared model-based estimates with direct estimates from select State Oral Health Surveys (SOHS) at state and county levels. The model with individual-level covariates only and the model with individual-, census tract- and county-level covariates explained 7.2% and 96.3% respectively of overall county-level variation in untreated caries. Model-based county-level prevalence estimates ranged from 4.9% to 65.2% with median of 22.1%. The model-based national estimate (19.9%) matched the NHANES direct estimate (19.8%). We found significantly positive correlations between model-based estimates for 8-year-olds and direct estimates from the third-grade State Oral Health Surveys (SOHS) at state level for 34 states (Pearson coefficient: 0.54, P=0.001) and SOHS estimates at county level for 53 New York counties (Pearson coefficient: 0.38, P=0.006). This methodology could be a useful tool to characterize county-level disparities in untreated dental caries among children aged 6-9years and complement oral health surveillance to inform public health programs especially when local-level data are not available although the lack of external validation due to data unavailability should be acknowledged. Published by Elsevier Inc.

  18. Iron deficiency is associated with food insecurity in pregnant females in the United States: National Health and Nutrition Examination Survey 1999-2010.

    Science.gov (United States)

    Park, Clara Y; Eicher-Miller, Heather A

    2014-12-01

    Food-insecure pregnant females may be at greater risk of iron deficiency (ID) because nutrition needs increase and more resources are needed to secure food during pregnancy. This may result in a higher risk of infant low birth weight and possibly cognitive impairment in the neonate. The relationships of food insecurity and poverty income ratio (PIR) with iron intake and ID among pregnant females in the United States were investigated using National Health and Nutrition Examination Survey 1999-2010 data (n=1,045). Food security status was classified using the US Food Security Survey Module. One 24-hour dietary recall and a 30-day supplement recall were used to assess iron intake. Ferritin, soluble transferrin receptor, or total body iron classified ID. Difference of supplement intake prevalence, difference in mean iron intake, and association of ID and food security status or PIR were assessed using χ(2) analysis, Student t test, and logistic regression analysis (adjusted for age, race, survey year, PIR/food security status, education, parity, trimester, smoking, C-reactive protein level, and health insurance coverage), respectively. Mean dietary iron intake was similar among groups. Mean supplemental and total iron intake were lower, whereas odds of ID, classified by ferritin status, were 2.90 times higher for food-insecure pregnant females compared with food-secure pregnant females. Other indicators of ID were not associated with food security status. PIR was not associated with iron intake or ID. Food insecurity status may be a better indicator compared with income status to identify populations at whom to direct interventions aimed at improving access and education regarding iron-rich foods and supplements. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  19. Asthma management practices in adults--findings from the German Health Update (GEDA) 2010 and the German National Health Interview and Examination Survey (DEGS1) 2008-2011.

    Science.gov (United States)

    Steppuhn, Henriette; Langen, Ute; Mueters, Stephan; Dahm, Stefan; Knopf, Hildtraud; Keil, Thomas; Scheidt-Nave, Christa

    2016-01-01

    In Germany, population-wide data on adherence to national asthma management guidelines are lacking, and performance measures (PM) for quality assurance in asthma care are systematically monitored for patients with German national asthma disease management program (DMP) enrollment only. We used national health survey data to assess variation in asthma care PM with respect to patient characteristics and care context, including DMP enrollment. Among adults 18-79 years with self-reported physician-diagnosed asthma in the past 12 months identified from a recent German National Health Interview Survey (GEDA 2010: N = 1096) and the German National Health interview and Examination Survey 2008-2011 (DEGS1: N = 333), variation in asthma care PM was analyzed using logistic regression analysis. Overall, 38.4% (95% confidence interval: 32.5-44.6%) of adults with asthma were on current inhaled corticosteroid therapy. Regarding non-drug asthma management, low coverage was observed for inhaler technique monitoring (35.2%; 31.2-39.3%) and for provision of an asthma management plan (27.3%; 24.2-30.7%), particularly among those with low education. Specific PM were more complete among persons with than without asthma DMP enrollment (adjusted odds ratios ranging up to 10.19; 5.23-19.86), even if asthma patients were regularly followed in a different care context. Guideline adherence appears to be suboptimal, particularly with respect to PM related to patient counseling. Barriers to the translation of recommendations into practice need to be identified and continuous monitoring of asthma care PM at the population level needs to be established.

  20. The traditional Korean dietary pattern is associated with decreased risk of metabolic syndrome: findings from the Korean National Health and Nutrition Examination Survey, 1998-2009.

    Science.gov (United States)

    Lee, Kyung Won; Cho, Mi Sook

    2014-01-01

    The traditional Korean diet has several healthy components, including abundant vegetables, fermented foods, a variety of foodstuffs, and a balance of animal and vegetable food intake. Although the traditional Korean diet has many healthy components, few studies have been conducted on the health advantages of the Korean dietary pattern. This study is intended to clarify the relationship between Korean dietary patterns and chronic diseases using the Integrated Korean Dietary Pattern Score (I-KDPS). I-KDPS is an index for measuring Korean dietary patterns based on traditional Korean meals and reflects the complex and multifaceted characteristics of Korean food culture. I-KDPS is composed of seven items to measure the level of balance and adequacy of Korean food consumption, with a maximum score of 60. When I-KDPS was applied to the Korean National Health and Nutrition Examination Survey (1998-2009), a nationwide survey, I-KDPS was closely related to the risk of metabolic syndrome. Even though there were a few differences among the years surveyed, the risk of metabolic syndrome, obesity, hypertension, and hypertriglyceridemia significantly decreased as I-KDPS increased. These results indicate that risk of diseases, including metabolic syndrome, decreases in individuals adhering to traditional Korean dietary patterns in adequate levels and those who eat a balanced diet. The result of this study shows that the traditional Korean table setting, which comprises side dishes, including seasoned vegetables, grilled dishes, and fermented products with cooked rice (bap), soup (guk), and kimchi, contains traits that help prevent metabolic syndrome. I-KDPS coupled with the basic study of the healthfulness of the Korean dietary lifestyle is expected to help establish a foundation for continuous development of health promoting Korean foods and dietary culture.

  1. Total Blood Mercury Levels and Depression among Adults in the United States: National Health and Nutrition Examination Survey 2005–2008

    Science.gov (United States)

    Ng, Tsz Hin H.; Mossey, Jana M.; Lee, Brian K.

    2013-01-01

    Background Mercury is a neurotoxicant linked with psychiatric symptoms at high levels of exposure. However, it is unclear whether an association is present at the low exposure levels in the US adult population. Materials and Methods Cross-sectional associations of total blood mercury and depression were assessed in 6,911 adults age ≥20 in the National Health and Nutrition Examination Survey (NHANES), 2005–2008. The Patient Health Questionnaire-9 was used to assess depression (high likelihood of a depressive spectrum disorder diagnosis; score 5–27). Results Unadjusted survey weighted logistic regression suggested that higher total blood mercury was associated with lower odds of depression (Odds Ratio  = 0.49, 95% Confidence Interval: 0.36–0.65, comparing the highest and lowest mercury quintiles). This association largely disappeared after adjustment for sociodemographic variables (income-poverty ratio, education, marital status). However, in age-stratified analyses, this inverse relationship remained in older adults (age ≥40) even after adjustment for sociodemographic variables. Simulation analyses adjusting for expected confounding effects of fish intake suggested that the inverse relationship among older adults may be plausibly attributed to residual confounding (Odds Ratio  = 0.75, 95% Confidence Interval: 0.50–1.12, comparing the highest and lowest mercury quintiles). Conclusions Higher total blood mercury was not associated with increased odds of depression. The lower odds of depression in older adults with higher total blood mercury may be due to residual confounding. PMID:24244482

  2. Prevalence of gluten-free diet adherence among individuals without celiac disease in the USA: results from the Continuous National Health and Nutrition Examination Survey 2009-2010.

    Science.gov (United States)

    DiGiacomo, Daniel V; Tennyson, Christina A; Green, Peter H; Demmer, Ryan T

    2013-08-01

    Clinical inference suggests the prevalence of non-celiac gluten sensitivity is substantially higher than that of celiac disease in the USA. Unfortunately, there are currently no data supporting these claims. The authors analyzed nationally representative data to estimate the prevalence of adherence to a gluten-free diet among participants without celiac disease and also to characterize the demographics and general health status of these participants. The Continuous National Health and Nutrition Examination Survey (NHANES) 2009-2010 enrolled 7762 individuals representing the civilian, non-institutionalized, US population free of celiac disease. Participants responded to interviewer administered questionnaires regarding current adherence to a gluten-free diet. Prevalence estimates were computed using SAS survey procedures. There were 49 individuals who reported current adherence to a gluten-free diet reflecting a weighted prevalence of 0.548% (95% CI 0.206-0.889). The prevalence of a gluten-free diet was higher in females (0.58%) than males (0.37%), although this was not statistically significant (p = 0.34). Participants reporting a gluten-free diet were older (46.6 vs. 40.5 years, p = 0.005), had higher high-density lipoprotein, lower iron and lower body mass index. The estimated national prevalence of non-celiac gluten sensitivity is 0.548%, approximately half that of celiac disease. Future studies are merited in order to better understand the population burden of non-celiac gluten sensitivity.

  3. Paediatric advance care planning survey: a cross-sectional examination of congruence and discordance between adolescents with HIV/AIDS and their families.

    Science.gov (United States)

    Lyon, Maureen E; Dallas, Ronald H; Garvie, Patricia A; Wilkins, Megan L; Garcia, Ana; Cheng, Yao Iris; Wang, Jichuan

    2017-09-21

    To identify patient-reported paediatric advance care planning (pACP) needs of adolescents living with HIV and to examine the congruence with their family's perception of their needs. A cross-sectional survey among six paediatric hospital-based outpatient HIV specialty clinics. Participants included 48 adolescent/family dyads (n=96 participants) within a larger study facilitating pACP. The main outcome measure was the Lyon Advance Care Planning Survey - Adolescent and Surrogate Versions-Revised. Adolescents' mean age was 18 years (range ≥14-congruence in pACP needs within adolescent/family dyads. There was substantial congruence in that being free from pain (PABAK=0.83), and understanding your treatment choices (PABAK=0.92) were very important or important. There was discordance about being off machines that extend life (PABAK=0.08) and when is the best time to bring up EOL decisions (PABAK=0.32). Areas of discordance were associated with life-sustaining choices and when to have the EOL conversation. Targeted, adolescent/family-centred, evidence-based pACP interventions are needed to improve family understanding of youth's EOL wishes. NCT01289444; Results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  4. Associations Between Reported Dietary Sodium Intake and Osteoporosis in Korean Postmenopausal Women: The 2008-2011 Korea National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Kim, Yunmi; Kim, Hyun-Young; Kim, Jung Hwan

    2017-07-01

    Osteoporosis is prevalent among postmenopausal women, and increasing evidence has linked salt intake with this disease. In this article, we explored the association between dietary sodium intake and osteoporosis in Korean postmenopausal women. We analyzed data for 3635 postmenopausal women extracted from the 2008-2011 Korea National Health and Nutrition Examination Survey. We found that 1542 participants (42.4%) have osteoporosis. The adjusted prevalence rates of osteoporosis at the lumbar spine were significantly higher in participants who consumed ≥4001 mg of salt than those who consumed ≤2000 mg. At the femoral neck, rates were significantly higher for those who consumed ≥5001 mg compared with those who consumed ≤4000 mg. Participants with a higher sodium intake showed a significantly higher odds ratio of developing lumbar and femoral neck osteoporosis, compared with those with a lower intake. Our results suggest that excessive daily sodium intake is associated with a higher osteoporosis prevalence in Korean postmenopausal women.

  5. Prevalence of and Factors Associated with Sarcopenia in Korean Cancer Survivors: Based on Data Obtained by the Korea National Health and Nutrition Examination Survey (KNHANES) 2008-2011.

    Science.gov (United States)

    Kim, Eun Young; Kim, Kirang; Kim, Young Saing; Ahn, Hee Kyung; Jeong, Yu Mi; Kim, Jeong Ho; Choi, Won-Jun

    2017-04-01

    Using a representative dataset from the Korea National Health and Nutrition Examination Survey (KNHANES) from 2008 to 2011, we analyzed anthropometric and dual-energy X-ray absorptiometry (DXA)-determined body composition findings for 493 cancer survivors (mean age a61.1 ± 12.6 years; 35.7% male). A much higher proportion of men (30.1%) than women (0.6%) met the criteria of sarcopenia. Subjects with a history of lung cancer, genitourinary cancer, or gastric cancer were prone to develop sarcopenia (31.6%, 26.3%, and 21.4%, respectively). Furthermore, sarcopenia was more prevalent among elderly (≥65 years; P sarcopenia was significantly associated with male gender (odds ratio [OR], 68.14; 95% CI, 15.52-299.13), a BMI of sarcopenia in Korean cancer survivors.

  6. Survey of radionuclide emissions from coal-fired power plants and examination of impacts from a proposed circulating fluidized bed boiler power plant

    International Nuclear Information System (INIS)

    Steiner, C.P.; Militana, L.M.; Harvey, K.A.; Kinsey, G.D.

    1995-01-01

    This paper presents the results of a literature survey that examined radionuclide emissions from coal-fired power plants. Literature references from both the US and foreign countries are presented. Emphasis is placed on references from the US because the radionuclide emissions from coal-fired power plants are related to radionuclide concentrations in the coal, which vary widely throughout the world. The radionuclides were identified and quantified for various existing power plants reported in the literature. Applicable radionuclide emissions criteria discovered in the literature search were then applied to a proposed circulating fluidized bed boiler power plant. Based upon the derived radionuclide emission rates applied to the proposed power plant, an air quality modeling analysis was performed. The estimated ambient concentrations were compared to the most relevant existing regulatory ambient levels for radionuclides

  7. Addressing catch mechanisms in gillnets improves modeling of selectivity and estimates of mortality rates: a case study using survey data on an endangered stock of Arctic char

    DEFF Research Database (Denmark)

    Jonsson, T.; Setzer, M.; Pope, John George

    2013-01-01

    Estimation of fish stock size distributions from survey data requires knowledge about gear selectivity. However, selectivity models rest on assumptions that seldom are analyzed. Departures from these can lead to misinterpretations and biased management recommendations. Here, we use survey data...... and asymmetric, with poor model fits. Removing potentially nonmeshed fish had the greatest positive effect on model fit, resulting in much narrower and less asymmetric selection curves, while attempting to take nonisometric growth into account, by using girth rather than length, improved model fit...

  8. Evaluation of general practitioners' assessment of overweight among children attending the five-year preventive child health examination: a cross-sectional survey.

    Science.gov (United States)

    Andersen, Merethe Kousgaard; Christensen, Bo; Obel, Carsten; Søndergaard, Jens

    2012-09-01

    To evaluate general practitioners' (GPs') assessment of potential overweight among children attending the five-year preventive child health examination (PCHE) by comparing their assessment of the children's weight-for-stature with overweight defined by body mass index (BMI) according to paediatric standard definitions. A cross-sectional survey. Data were obtained from a questionnaire survey of children's health in general and their growth in particular. The five-year preventive child health examination (PCHE) in general practice in the Central Denmark Region. Children attending the five-year PCHE in general practice, regardless of their weight status. Paediatric standard definitions for childhood overweight based on BMI were used as the gold standard for categorizing weight-for-stature. Identification of overweight was analysed with regard to sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the GPs' assessment of weight-for-stature. A total of 165 GPs conducted 1138 PCHEs. GPs assessed that 171 children had a weight-for-stature above normal. Use of the Danish Standards (DS), i.e. the Danish national growth charts for BMI, as the gold standard yielded a sensitivity of 70.1% (95% CI 62.0-77.3) and a specificity of 92.4% (95% CI 90.6-93.9). The sensitivity was influenced by the GPs' use of BMI and the presence of previous notes regarding abnormal weight development. At the five-year PCHE almost one-third of overweight children were assessed to be normal weight by GPs. Use of BMI and presence of notes on abnormal weight in medical records were positively associated with a higher identification. Hence, utilization of medical record data and BMI charts may refine GPs' assessment of childhood overweight.

  9. Changes in daily activity patterns with age in U.S. men and women: National Health and Nutrition Examination Survey 2003-04 and 2005-06.

    Science.gov (United States)

    Martin, Kathryn R; Koster, Annemarie; Murphy, Rachel A; Van Domelen, Dane R; Hung, Ming-yang; Brychta, Robert J; Chen, Kong Y; Harris, Tamara B

    2014-07-01

    To compare daily and hourly activity patterns according to sex and age. Cross-sectional, observational. Nationally representative community sample: National Health and Nutrition Examination Survey (NHANES) 2003-04 and 2005-06. Individuals (n = 5,788) aged 20 and older with 4 or more valid days of monitor wear-time, no missing data on valid wear-time minutes, and covariates. Activity was examined as average counts per minute (CPM) during wear-time; percentage of time spent in nonsedentary activity; and time (minutes) spent in sedentary (physical activity (MVPA (≥ 760)). Analyses accounted for survey design, adjusted for covariates, and were sex specific. In adjusted models, men spent slightly more time (~1-2%) in nonsedentary activity than women aged 20 to 34, with levels converging at age 35 to 59, although the difference was not significant. Women aged 60 and older spent significantly more time (~3-4%) in nonsedentary activity than men, despite similarly achieved average CPM. With increasing age, all nonsedentary activity decreased in men; light activity remained constant in women (~30%). Older men had fewer CPM at night (~20), more daytime sedentary minutes (~3), fewer daytime light physical activity minutes (~4), and more MVPA minutes (~1) until early evening than older women. Although sex differences in average CPM declined with age, differences in nonsedentary activity time emerged as men increased sedentary behavior and reduced MVPA time. Maintained levels of light-intensity activity suggest that women continue engaging in common daily activities into older age more than men. Findings may help inform the development of behavioral interventions to increase intensity and overall activity levels, particularly in older adults. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  10. Novel exposure biomarkers of N,N-diethyl-m-toluamide (DEET): Data from the 2007-2010 National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Calafat, Antonia M; Baker, Samuel E; Wong, Lee-Yang; Bishop, Amanda M; Morales-A, Pilar; Valentin-Blasini, Liza

    2016-01-01

    N,N-diethyl-m-toluamide (DEET) is a widely used insect repellent in the United States. To assess exposure to DEET in a representative sample of persons 6years and older in the U.S. general population from the 2007-2010 National Health and Nutrition Examination Survey. We analyzed 5348 urine samples by using online solid-phase extraction coupled to isotope dilution-high-performance liquid chromatography-tandem mass spectrometry. We used regression models to examine associations of various demographic parameters with urinary concentrations of DEET biomarkers. We detected DEET in ~3% of samples and at concentration ranges (>0.08μg/L-45.1μg/L) much lower than those of 3-(diethylcarbamoyl)benzoic acid (DCBA) (>0.48μg/L-30,400μg/L) and N,N-diethyl-3-hydroxymethylbenzamide (DHMB) (>0.09μg/L-332μg/L). DCBA was the most frequently detected metabolite (~84%). Regardless of survey cycle and the person's race/ethnicity or income, adjusted geometric mean concentrations of DCBA were higher in May-Sep than in Oct-Apr. Furthermore, non-Hispanic whites in the warm season were more likely than in the colder months [adjusted odds ratio (OR)=10.83; 95% confidence interval (CI), 3.28-35.79] and more likely than non-Hispanic blacks (OR=3.45; 95% CI, 1.51-7.87) to have DCBA concentrations above the 95th percentile. The general U.S. population, including school-age children, is exposed to DEET. However, reliance on DEET as the sole urinary biomarker would likely underestimate the prevalence of exposure. Instead, oxidative metabolites of DEET are the most adequate exposure biomarkers. Differences by season of the year based on demographic variables including race/ethnicity likely reflect different lifestyle uses of DEET-containing products. Published by Elsevier Ltd.

  11. Evaluation of socioeconomic status as a risk factor of pterygium using the Korean National Health and Nutrition Examination Survey 2010 to 2011: A STROBE-compliant article.

    Science.gov (United States)

    Lee, Young Bok; Kim, Su Young; Park, Yong Gyu; Han, Kyung Do; Kim, Jin-Wou; Chae, Hiun Suk; Lee, Young Chun

    2017-03-01

    Pterygium is a common conjunctival disorder. The socioeconomic risk factors of pterygium have not been systematically evaluated in Korea. The study investigated risk factors of pterygium considering socioeconomic status.Participants were 9839 adults aged 19 to 74 years, who underwent ophthalmic slit-lamp examinations as part of the Korean National Health and Nutrition Examination Survey 2010 to 2011. Pterygium was diagnosed as a growth of fibrovascular tissue over the cornea. The socioeconomic risk factors were analyzed in association with the presence of pterygium. Multiple logistic regression analysis was used to evaluate the odds ratios for differences in socioeconomic status.The presence of pterygium was associated with diabetes mellitus, hypertension, metabolic syndrome, and sun exposure time (>5 h/d). The blood level of 25-hydroxyvitamin D was higher in the pterygium group than in the control group, but both groups were deficient in 25-hydroxyvitamin D compared with the normal reference level. Pterygium was almost 3 times as frequent among persons who worked outdoors, such as skilled agricultural, forestry, and fishery workers, than among those who worked indoors (odds ratio 3.061, 95% confidence interval 1.946-4.813). Low educational status and longer working hours were also significantly associated with pterygium.This study used a nationwide population-based survey conducted by the Korean Centers for Disease Control and Prevention to reveal that pterygium is associated with low socioeconomic status. Efforts should be made to reduce the risk of pterygium by changing modifiable risk factors, especially among people with low socioeconomic status.

  12. Gender differences in the associations between urinary bisphenol A and body composition among American children: The National Health and Nutrition Examination Survey, 2003–2006

    Directory of Open Access Journals (Sweden)

    Ji Li

    2017-05-01

    Full Text Available Background: As an endocrine disruptor, bisphenol A (BPA exposure has been implicated as a potential risk factor in childhood obesity, which is defined using percentiles of body mass index for age. We aimed to examine the associations between BPA exposure, reflected by urinary BPA concentration, and body composition in American children. Methods: Data of 1860 children aged 8–19 years who participated in the 2003–2006 National Health and Nutrition Examination Survey (NHANES were analyzed in this study. Urinary BPA concentration (ng/mL was used to indicate BPA status in the body. Body composition was measured by dual-energy X-ray absorptiometry (DXA. Multivariate linear regression models were fitted using survey procedures to investigate the associations between urinary BPA level and body composition separately for boys and girls. Results: After adjusting for demographic and lifestyle covariates, higher quartiled and log-transformed urinary BPA levels were significantly associated with elevated lean body mass index (LBMI z-scores in boys (p < 0.05, and significantly associated with elevated fat mass index (FMI z-scores in girls (p < 0.05. Lower urinary BPA concentration was associated with lower percentage of trunk fat in girls (compared to 1st quartile, 2nd-quartile: β = 2.85, 95% CI, 0.92–4.78; 3rd-quartile: β = 2.57, 95% CI, 0.28–4.85; 4th-quartile: β = 2.79, 95% CI, 0.44–5.14; all p < 0.05. Such patterns were not observed in boys. Conclusions: Higher BPA levels may be associated with elevated LBM in boys, but not in girls, while higher BPA levels may be associated with elevated FM in girls, but not in boys.

  13. [Trend survey of ocular infections with bacteria at Toyama University Hospital over the past six years--from the standpoint of laboratory examination].

    Science.gov (United States)

    Kubota, Tomomi; Hayashi, Shirou; Niimi, Hideki; Kitajima, Isao

    2012-07-01

    Specimens of bacterial ocular infections are frequently received in the clinical laboratory. However, a comprehensive trend survey of ocular infections with bacteria is very rare. Our objective is to understand the current tendency of ocular infections with bacteria in patients at Toyama University Hospital from the standpoint of laboratory examination. We studied 263 cases of ocular infection with bacteria diagnosed at Toyama University Hospital from January 2006 to December 2011. 123 were male and 140 were female, with a mean age of 61.2(0-98) years. Specimens were subjected to direct microscopy and culture. Cultures were positive in 174(66.2%) patients. The most common bacterial isolate was Staphylococcus (28.1%), followed by Corynebacterium (19.3%), Streptococcus (9.3%), and Propionibacterium (8.6%). MRSA accounted for 18.8% of all S. aureus isolates, and has increased in recent years. The number of bacteria detected was larger in March, June, July, August, and October. Age distribution indicated that around 70% of bacterial isolates were detected from patients over 60 years old. The most common specimen of ocular infections with bacteria was eye discharge (detection rate; 87.8%), followed by corneal scraping(41%), aqueous humor (19%), and vitreous body (27%). Nearly 80% of bacterial isolates were detected from patients with keratitis, endophthalmitis, dacryocystitis, and conjunctivitis. As for the disease specific detection rate, endophthalmitis was very low (38.3%). The detection rate by years indicated that the way doctors pick up the specimens greatly affects the detection rate. Based on this survey, we need close cooperation with medical doctors concerning laboratory examination in ocular infection with bacteria, and we must improve the detection sensitivity of specimens from patients with endophthalmitis.

  14. Accelerometer-Derived Pattern of Sedentary and Physical Activity Time in Persons with Mobility Disability: National Health and Nutrition Examination Survey 2003 to 2006.

    Science.gov (United States)

    Manns, Patricia; Ezeugwu, Victor; Armijo-Olivo, Susan; Vallance, Jeff; Healy, Genevieve N

    2015-07-01

    To describe objectively determined sedentary and activity outcomes (volume and pattern) and their associations with cardiometabolic risk biomarkers in individuals with and without mobility disability. Cross-sectional. Population based. Community-dwelling older adults (≥60) living in the United States who were participants in the 2003 to 2004 or 2005 to 2006 National Health and Nutrition Examination Survey. Participants were classified as with or without mobility disability according to responses to self-reported questions about ability to walk, climb stairs, and/or use of ambulatory aids. Accelerometer-derived sedentary and activity variables for volume (time in sedentary (activity and pattern (number of breaks from sedentary time, duration of sedentary bouts, duration of activity bouts). Survey-weighted regression models, adjusted for age, sex, ethnicity, education, and smoking, were used to examine the associations between pattern of activity and cardiometabolic health risk factors (blood pressure, waist circumference, high-density lipoprotein cholesterol). Of the 2,017 participants, 547 were classified as having a mobility disability. Participants with mobility disability had more sedentary time and less active time than those without. Sedentary bouts were longer and active bouts shorter in those with disability. The total number of sedentary breaks (transitions from sedentary to nonsedentary) differed between groups after adjustment for total sedentary time. Fewer breaks, longer sedentary bouts, and shorter activity bouts were associated with higher average waist circumference regardless of disability status. This study provides rationale for the development and testing of interventions to change the pattern of activity (e.g., include more breaks and longer activity bout durations) in older adults with mobility disability. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

  15. Association between secondhand smoke exposure and blood lead and cadmium concentration in community dwelling women: the fifth Korea National Health and Nutrition Examination Survey (2010-2012).

    Science.gov (United States)

    Jung, Se Young; Kim, Suyeon; Lee, Kiheon; Kim, Ju Young; Bae, Woo Kyung; Lee, Keehyuck; Han, Jong-Soo; Kim, Sarah

    2015-07-16

    To assess the association between secondhand smoke exposure and blood lead and cadmium concentration in women in South Korea. Population-based cross-sectional study. South Korea (Korea National Health and Nutrition Examination Survey V). 1490 non-smoking women who took part in the fifth Korea National Health and Nutrition Examination Survey (2010-2012), in which blood levels of lead and cadmium were measured. The primary outcome was blood levels of lead and cadmium in accordance with the duration of secondhand smoke exposure. The adjusted mean level of blood cadmium in women who were never exposed to secondhand smoke was 1.21 (0.02) µg/L. Among women who were exposed less than 1 h/day, the mean cadmium level was 1.13 (0.03) µg/L, and for those exposed for more than 1 h, the mean level was 1.46 (0.06) µg/L. In particular, there was a significant association between duration of secondhand smoke exposure at the workplace and blood cadmium concentration. The adjusted mean level of blood cadmium concentration in the never exposed women's group was less than that in the 1 h and more exposed group, and the 1 h and more at workplace exposed group: 1.20, 1.24 and 1.50 µg/L, respectively. We could not find any association between lead concentration in the blood and secondhand smoke exposure status. This study showed that exposure to secondhand smoke and blood cadmium levels are associated. Especially, there was a significant association at the workplace. Therefore, social and political efforts for reducing the exposure to secondhand smoke at the workplace are needed in order to promote a healthier working environment for women. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  16. Detection of fatigue damage of high and medium pressure rotor by X-ray diffraction method. Survey and research of nondestructive examination of thermal power generation facilities

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Tatsuo; Suesada, Yasuhiko; Nishioka, Noriaki; Goto, Toru; Ito, Hitomi; Kadoya, Yoshikuni

    1987-03-25

    In recent years, the existing thermal power generation facilities have been required to be operated in securing dependability from the standpoints of the operating conditions which have been getting severer and the demands to use them for longer periods, accordingly it is hoped to establish the diagnostic technology of aged deterioration by the non-destructive examination method for the facilities. In the beginning of 1959 the Kansai Electric Power Co. surveyed the current situation of this technology at various thermal power generation turbine facilities and discovered that concerning the diagnostic technology of aged deterioration by the non-destructive examination method, there remained many matters untouched in the basic research field. The company consequently started a survey and research jointly with Mitsubishi Heavy Industries in the first half of 1959. This report summarizes the research on the detection of aged deterioration due to thermal fatigue of Cr-Mo-V rotor material by the X-ray diffraction method which was conducted during the full fiscal year of 1984 and the first half of FY 1985 as a part of the above joint research. With respect to the conditions for the detection method of thermal fatigue damages of dummy grooves of the high and medium pressure rotor by the application of the X-ray diffraction method, it is preferred to measure a diffraction strength curve of the diffraction surface by using a Co tube as X-ray tube and it is also desirable to use a position sensitive proportional counter tube for X-ray detector. (5 figs, 6 refs)

  17. The association between long working hours and the metabolic syndrome: evidences from the 5th Korean National Health and Nutrition Examination Survey of 2010 and 2012.

    Science.gov (United States)

    Jeong, Jae Uk; Jeon, Man Joong; Sakong, Joon

    2014-01-01

    This study was conducted in order to evaluate the association between the working hours of Korean employees and the metabolic syndrome and the effects of long working hours on metabolic syndrome based on the 5th Korean National Health and Nutrition Examination Survey (2010-2012). Based on the 5th Korean National Health and Nutrition Examination Survey (2010-2012), 4,456 Korean employees without shift work, aged over 15, who work 30 hours or more per week were targeted in this study. The association between the general characteristics, including age, smoking, alcohol drinking, exercise, and the metabolic syndrome criteria defined by International Diabetes Federation (IDF) and weekly working hours were analyzed. In addition, the association between weekly working hours and the metabolic syndrome of the subjects stratified by gender was analyzed through multiple logistic regression analyses and generalized linear mixed model after adjusting the general characteristics. In the results of stratified analysis by gender, in male subjects, in comparison with the 30-39 weekly working hours group, there were no significant adjusted odds ratios to the other working hours groups. In female subjects, in comparison with the 30-39 weekly working hours group, there were no significant adjusted odds ratios to the other working hours groups. In addition, no trend associations were observed among weekly working hour groups in both stratified genders. No significant differences in prevalence of metabolic syndrome of the subjects stratified by gender were found according to weekly increasing working hours. However, due to some limitations of this study, further prospective studies may be necessary for verification.

  18. A novel use of structural equation models to examine factors associated with prediabetes among adults aged 50 years and older: National Health and Nutrition Examination Survey 2001-2006.

    Science.gov (United States)

    Bardenheier, Barbara H; Bullard, Kai McKeever; Caspersen, Carl J; Cheng, Yiling J; Gregg, Edward W; Geiss, Linda S

    2013-09-01

    To use structural modeling to test a hypothesized model of causal pathways related with prediabetes among older adults in the U.S. Cross-sectional study of 2,230 older adults (≥ 50 years) without diabetes included in the morning fasting sample of the 2001-2006 National Health and Nutrition Examination Surveys. Demographic data included age, income, marital status, race/ethnicity, and education. Behavioral data included physical activity (metabolic equivalent hours per week for vigorous or moderate muscle strengthening, walking/biking, and house/yard work), and poor diet (refined grains, red meat, added sugars, solid fats, and high-fat dairy). Structural-equation modeling was performed to examine the interrelationships among these variables with family history of diabetes, high blood pressure, BMI, large waist (waist circumference: women, ≥ 35 inches; men, ≥ 40 inches), triglycerides ≥ 200 mg/dL, and total and HDL (≥ 60 mg/dL) cholesterol. After dropping BMI and total cholesterol, our best-fit model included three single factors: socioeconomic position (SEP), physical activity, and poor diet. Large waist had the strongest direct effect on prediabetes (0.279), followed by male sex (0.270), SEP (-0.157), high blood pressure (0.122), family history of diabetes (0.070), and age (0.033). Physical activity had direct effects on HDL (0.137), triglycerides (-0.136), high blood pressure (-0.132), and large waist (-0.067); poor diet had direct effects on large waist (0.146) and triglycerides (0.148). Our results confirmed that, while including factors known to be associated with high risk of developing prediabetes, large waist circumference had the strongest direct effect. The direct effect of SEP on prediabetes suggests mediation by some unmeasured factor(s).

  19. Sex differentials in mortality.

    Science.gov (United States)

    1970-06-01

    The questions leing considered are whether a higher female than male mortality rate exists in Ceylon, India, and Pakistan, and whether this sex differential can account for the observed high male sex ratios. There is a choice between explaining the recorded masculinity of the Indian population by assuming that the subordinate position of women caused their omission from the census or that it caused their unrecorded death in childhood. The 1951 census report of India states that there is a traditional fondness for male issues in most parts of the country and a corresponding dislike for female children. However, a life table for India applied to the 1951 census gave a higher average female age at death 34.7 years as opposed to 33.5 years for male. Other estimates for India and Pakistan for the period 1951-1961 give 37.8 years for life expectancy for males and 36.98 for females. In 1953 the female death rate in Ceylon was over 80% higher than that of the males in the most reproductive ages, 20-29. In 1963 the female excess mortality at the same ages was still 25%, and in the age group 30-34 almost a 1/3 higher. In India the female death rate at ages 15-44 was 38% higher than that of the males in the 1958-1959 survey and as much as 174% higher in the Khanna rural survey, 1956-1960. In Pakistan a Population growth Estimate experiment conducted during 1962-1965 on a national probability sample has shown that in the ages 15-44 the female death rate was 75% higher than that of the males. High maternal mortality was the major reason. In addition, female mortality among young children over age 1 year was 24% higher in 1965 and 1963. There was little difference between the rates of mortality of the 2 sexes at age 45 and above. Recent trends in Ceylon show considerable improvement in maternal mortality which has reduced by 22% the ratio of female to male mortality at age 15-44. Also the ratio at ages 1-9 fell by 8%. to .1 of a year for every calendar year to 1980.

  20. Frozen yogurt and ice cream were less healthy than yogurt, and adding toppings reduced their nutrition value: evidence from 1999-2014 National Health and Nutrition Examination Survey.

    Science.gov (United States)

    An, Ruopeng; Jiang, Ning

    2017-06-01

    It was hypothesized that frozen yogurt and ice cream would be less healthy than yogurt. We examined daily energy and nutrient intake from yogurt, frozen yogurt, and ice cream among US adults. In-person 24-hour dietary recall data (n=6453) came from the 1999-2014 National Health and Nutrition Examination Survey. Regression analyses were performed to examine the differences in energy/nutrient intake from frozen yogurt and ice cream (with/without toppings) in comparison to yogurt. Approximately 5.3%, 0.9%, and 14.3% of US adults consumed yogurt, frozen yogurt, and ice cream on any given day, respectively. Among frozen yogurt and ice cream consumers, 29.7% and 14.8% added toppings to their consumption, respectively. Compared with yogurt, frozen yogurt consumption with and without toppings was associated with increased daily energy intake by 214.6 and 97.9kj, respectively; whereas ice cream consumption with and without toppings was associated with increased daily energy intake by 427.2 and 343.5kj, respectively. Compared with yogurt, frozen yogurt consumption was associated with a decreased intake of most vitamins/minerals under examination, but increased intake of sugar, total/saturated fat, cholesterol, fiber, and iron. Adding toppings to frozen yogurt further increased total and saturated fat intake. Compared with yogurt, ice cream consumption was associated with a decreased intake of multiple micronutrients, but increased intake of sugar, total/saturated fat, cholesterol, fiber, vitamins A and E, and iron. Adding toppings to ice cream further increased sugar intake. In conclusion, frozen yogurt and ice cream were less healthy than yogurt, and adding toppings made them even less desirable. Copyright © 2017 Elsevier Inc. All rights reserved.