WorldWideScience

Sample records for grant-supported population-based research

  1. Managing incidental findings in population based biobank research

    Berge Solberg

    2012-04-01

    Full Text Available With the introduction of whole genome sequencing in medical research, the debate on how to handle incidental findings is becoming omnipresent. Much of the literature on the topic so far, seems to defend the researcher’s duty to inform, the participant’s right to know combined with a thorough informed consent in order to protect and secure high ethical standards in research. In this paper, we argue that this ethical response to incidental findings and whole genome sequencing is appropriate in a clinical context, in what we call therapeutic research. However, we further argue, that it is rather inappropriate in basic research, like the research going on in public health oriented population based biobanks. Our argument is based on two premises: First, in population based biobank research the duties and rights involved are radically different from a clinical based setting. Second, to introduce the ethical framework from the clinical setting into population based basic research, is not only wrong, but it may lead to unethical consequences. A Norwegian population based biobank and the research-ethical debate in Norway on the regulation of whole genome sequencing is used as an illustrative case to demonstrate the pitfalls when approaching the debate on incidental findings in population based biobank research.

  2. Final report for the 1996 DOE grant supporting research at the SLAC/LBNL/LLNL B factory

    Judd, D.; Wright, D.

    1997-01-01

    This final report discusses Department of Energy-supported research funded through Lawrence Livermore National Laboratory (LLNL) which was performed as part of a collaboration between LLNL and Prairie View A and M University to develop part of the BaBar detector at the SLAC B Factory. This work focuses on the Instrumented Flux Return (IFR) subsystem of BaBar and involves a full range of detector development activities: computer simulations of detector performance, creation of reconstruction algorithms, and detector hardware R and D. Lawrence Livermore National Laboratory has a leading role in the IFR subsystem and has established on-site computing and detector facilities to conduct this research. By establishing ties with the existing LLNL Research Collaboration Program and leveraging LLNL resources, the experienced Prairie View group was able to quickly achieve a more prominent role within the BaBar collaboration and make significant contributions to the detector design. In addition, this work provided the first entry point for Historically Black Colleges and Universities into the B Factory collaboration, and created an opportunity to train a new generation of minority students at the premier electron-positron high energy physics facility in the US

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

    Salas Aquiles; Rodriguez Juan; McKeigue Paul; Jacob KS; Krishnamoorthy ES; Huang Yueqin; Guerra Mariella; Gavrilova Svetlana I; Dewey Michael; Arizaga Raul; Albanese Emiliano; Acosta Daisy; Ferri Cleusa P; Prince Martin; Sosa Ana

    2007-01-01

    Abstract Background Latin America, China and India are experiencing unprecedentedly rapid demographic ageing with an increasing number of people with dementia. The 10/66 Dementia Research Group's title refers to the 66% of people with dementia that live in developing countries and the less than one tenth of population-based research carried out in those settings. This paper describes the protocols for the 10/66 population-based and intervention studies that aim to redress this imbalance. Meth...

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

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

    2007-07-20

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

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

    Salas Aquiles

    2007-07-01

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

  6. Population based allele frequencies of disease associated polymorphisms in the Personalized Medicine Research Project.

    Cross, Deanna S; Ivacic, Lynn C; Stefanski, Elisha L; McCarty, Catherine A

    2010-06-17

    There is a lack of knowledge regarding the frequency of disease associated polymorphisms in populations and population attributable risk for many populations remains unknown. Factors that could affect the association of the allele with disease, either positively or negatively, such as race, ethnicity, and gender, may not be possible to determine without population based allele frequencies.Here we used a panel of 51 polymorphisms previously associated with at least one disease and determined the allele frequencies within the entire Personalized Medicine Research Project population based cohort. We compared these allele frequencies to those in dbSNP and other data sources stratified by race. Differences in allele frequencies between self reported race, region of origin, and sex were determined. There were 19544 individuals who self reported a single racial category, 19027 or (97.4%) self reported white Caucasian, and 11205 (57.3%) individuals were female. Of the 11,208 (57%) individuals with an identifiable region of origin 8337 or (74.4%) were German.41 polymorphisms were significantly different between self reported race at the 0.05 level. Stratification of our Caucasian population by self reported region of origin revealed 19 polymorphisms that were significantly different (p = 0.05) between individuals of different origins. Further stratification of the population by gender revealed few significant differences in allele frequencies between the genders. This represents one of the largest population based allele frequency studies to date. Stratification by self reported race and region of origin revealed wide differences in allele frequencies not only by race but also by region of origin within a single racial group. We report allele frequencies for our Asian/Hmong and American Indian populations; these two minority groups are not typically selected for population allele frequency detection. Population wide allele frequencies are important for the design and

  7. Clinical governance and research ethics as barriers to UK low-risk population-based health research?

    Douglas Flora

    2008-11-01

    Full Text Available Abstract Background Since the Helsinki Declaration was introduced in 1964 as a code of practice for clinical research, it has generally been agreed that research governance is also needed in the field of public health and health promotion research. Recently, a range of factors led to the development of more stringent bureaucratic procedures, governing the conduct of low-risk population-based health research in the United Kingdom. Methods Our paper highlights a case study of the application process to medical research ethics committees in the United Kingdom for a study of the promotion of physical activity by health care providers. The case study presented here is an illustration of the challenges in conducting low-risk population-based health research. Results Our mixed-methods approach involved a questionnaire survey of and semi-structured interviews with health professionals (who were all healthy volunteers. Since our study does not involve the participation of either patients or the general population, one would expect the application to the relevant research ethics committees to be a formality. This proved not to be the case! Conclusion Research ethics committees could be counter-productive, rather than protecting the vulnerable in the research process, they can stifle low-risk population-based health research. Research ethics in health services research is first and foremost the responsibility of the researcher(s, and we need to learn to trust health service researchers again. The burden of current research governance regulation to address the perceived ethical problems is neither appropriate nor adequate. Senior researchers/academics need to educate and train students and junior researchers in the area of research ethics, whilst at the same time reducing pressures on them that lead to unethical research, such as commercial funding, inappropriate government interference and the pressure to publish. We propose that non-invasive low

  8. Beliefs and attitudes towards participating in genetic research – a population based cross-sectional study

    Kerath Samantha M

    2013-02-01

    Full Text Available Abstract Background Biobanks have the potential to offer a venue for chronic disease biomarker discovery, which would allow for disease early detection and for identification of carriers of a certain predictor biomarker. To assess the general attitudes towards genetic research and participation in biobanks in the Long Island/Queens area of New York, and what factors would predict a positive view of such research, participants from the NSLIJ hospital system were surveyed. Methods Participants were recruited at six hospital centers in the NSLIJ system during the summers of 2009 and again in 2011 (n = 1,041. Those who opted to participate were given a questionnaire containing 22 questions assessing demographics, lifestyle and attitudes towards genetic research. These questions addressed individual participant’s beliefs about the importance of genetic research, willingness to participate in genetic research themselves, and their views on informed consent issues. Results Respondents took a generally positive view of genetic research in general, as well as their own participation in such research. Those with reservations were most likely to cite concerns over the privacy of their medical and genetic information. Those who were married tended to view genetic research as important, while those in the younger age group viewed it as less important. Prior blood donation of respondents was found to be a predictor of their approval for genetic research. Demographic factors were not found to be predictive of personal willingness to participate in genetic research, or of approval for the opt-out approach to consent. Conclusions While respondents were generally inclined to approve of genetic research, and those who disapproved did not do so based on an underlying moral objection to such research, there is a disconnect between the belief in the importance of genetic research and the willingness of individuals to participate themselves. This indicates a

  9. High hospital research participation and improved colorectal cancer survival outcomes: a population-based study.

    Downing, Amy; Morris, Eva Ja; Corrigan, Neil; Sebag-Montefiore, David; Finan, Paul J; Thomas, James D; Chapman, Michael; Hamilton, Russell; Campbell, Helen; Cameron, David; Kaplan, Richard; Parmar, Mahesh; Stephens, Richard; Seymour, Matt; Gregory, Walter; Selby, Peter

    2017-01-01

    In 2001, the National Institute for Health Research Cancer Research Network (NCRN) was established, leading to a rapid increase in clinical research activity across the English NHS. Using colorectal cancer (CRC) as an example, we test the hypothesis that high, sustained hospital-level participation in interventional clinical trials improves outcomes for all patients with CRC managed in those research-intensive hospitals. Data for patients diagnosed with CRC in England in 2001-2008 (n=209 968) were linked with data on accrual to NCRN CRC studies (n=30 998). Hospital Trusts were categorised by the proportion of patients accrued to interventional studies annually. Multivariable models investigated the relationship between 30-day postoperative mortality and 5-year survival and the level and duration of study participation. Most of the Trusts achieving high participation were district general hospitals and the effects were not limited to cancer 'centres of excellence', although such centres do make substantial contributions. Patients treated in Trusts with high research participation (≥16%) in their year of diagnosis had lower postoperative mortality (presearch participation, with a reduction in postoperative mortality of 1.5% (6.5%-5%, pstudies for all patients with CRC treated in the hospital study participants. Improvement precedes and increases with the level and years of sustained participation. 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/.

  10. The Public Health Exposome: A Population-Based, Exposure Science Approach to Health Disparities Research

    Juarez, Paul D.; Matthews-Juarez, Patricia; Hood, Darryl B.; Im, Wansoo; Levine, Robert S.; Kilbourne, Barbara J.; Langston, Michael A.; Al-Hamdan, Mohammad Z.; Crosson, William L.; Estes, Maurice G.; Estes, Sue M.; Agboto, Vincent K.; Robinson, Paul; Wilson, Sacoby; Lichtveld, Maureen Y.

    2014-01-01

    The lack of progress in reducing health disparities suggests that new approaches are needed if we are to achieve meaningful, equitable, and lasting reductions. Current scientific paradigms do not adequately capture the complexity of the relationships between environment, personal health and population level disparities. The public health exposome is presented as a universal exposure tracking framework for integrating complex relationships between exogenous and endogenous exposures across the lifespan from conception to death. It uses a social-ecological framework that builds on the exposome paradigm for conceptualizing how exogenous exposures “get under the skin”. The public health exposome approach has led our team to develop a taxonomy and bioinformatics infrastructure to integrate health outcomes data with thousands of sources of exogenous exposure, organized in four broad domains: natural, built, social, and policy environments. With the input of a transdisciplinary team, we have borrowed and applied the methods, tools and terms from various disciplines to measure the effects of environmental exposures on personal and population health outcomes and disparities, many of which may not manifest until many years later. As is customary with a paradigm shift, this approach has far reaching implications for research methods and design, analytics, community engagement strategies, and research training. PMID:25514145

  11. The Public Health Exposome: A Population-Based, Exposure Science Approach to Health Disparities Research

    Paul D. Juarez

    2014-12-01

    Full Text Available The lack of progress in reducing health disparities suggests that new approaches are needed if we are to achieve meaningful, equitable, and lasting reductions. Current scientific paradigms do not adequately capture the complexity of the relationships between environment, personal health and population level disparities. The public health exposome is presented as a universal exposure tracking framework for integrating complex relationships between exogenous and endogenous exposures across the lifespan from conception to death. It uses a social-ecological framework that builds on the exposome paradigm for conceptualizing how exogenous exposures “get under the skin”. The public health exposome approach has led our team to develop a taxonomy and bioinformatics infrastructure to integrate health outcomes data with thousands of sources of exogenous exposure, organized in four broad domains: natural, built, social, and policy environments. With the input of a transdisciplinary team, we have borrowed and applied the methods, tools and terms from various disciplines to measure the effects of environmental exposures on personal and population health outcomes and disparities, many of which may not manifest until many years later. As is customary with a paradigm shift, this approach has far reaching implications for research methods and design, analytics, community engagement strategies, and research training.

  12. Diagnostic strategies using physical examination are minimally useful in defining carpal tunnel syndrome in population-based research studies.

    Descatha, A; Dale, A-M; Franzblau, A; Coomes, J; Evanoff, B

    2010-02-01

    We evaluated the utility of physical examination manoeuvres in the prediction of carpal tunnel syndrome (CTS) in a population-based research study. We studied a cohort of 1108 newly employed workers in several industries. Each worker completed a symptom questionnaire, a structured physical examination and nerve conduction study. For each hand, our CTS case definition required both median nerve conduction abnormality and symptoms classified as "classic" or "probable" on a hand diagram. We calculated the positive predictive values and likelihood ratios for physical examination manoeuvres in subjects with and without symptoms. The prevalence of CTS in our cohort was 1.2% for the right hand and 1.0% for the left hand. The likelihood ratios of a positive test for physical provocative tests ranged from 2.0 to 3.3, and those of a negative test from 0.3 to 0.9. The post-test probability of positive testing was study found that physical examination, alone or in combination with symptoms, was not predictive of CTS in a working population. We suggest using specific symptoms as a first-level screening tool, and nerve conduction study as a confirmatory test, as a case definition strategy in research settings.

  13. Adjusting for overdispersion in piecewise exponential regression models to estimate excess mortality rate in population-based research.

    Luque-Fernandez, Miguel Angel; Belot, Aurélien; Quaresma, Manuela; Maringe, Camille; Coleman, Michel P; Rachet, Bernard

    2016-10-01

    In population-based cancer research, piecewise exponential regression models are used to derive adjusted estimates of excess mortality due to cancer using the Poisson generalized linear modelling framework. However, the assumption that the conditional mean and variance of the rate parameter given the set of covariates x i are equal is strong and may fail to account for overdispersion given the variability of the rate parameter (the variance exceeds the mean). Using an empirical example, we aimed to describe simple methods to test and correct for overdispersion. We used a regression-based score test for overdispersion under the relative survival framework and proposed different approaches to correct for overdispersion including a quasi-likelihood, robust standard errors estimation, negative binomial regression and flexible piecewise modelling. All piecewise exponential regression models showed the presence of significant inherent overdispersion (p-value regression modelling, with either a quasi-likelihood or robust standard errors, was the best approach as it deals with both, overdispersion due to model misspecification and true or inherent overdispersion.

  14. 25 CFR 1000.65 - What kinds of activities do planning and negotiation grants support?

    2010-04-01

    ... INDIAN SELF-DETERMINATION AND EDUCATION ACT Other Financial Assistance for Planning and Negotiation... 25 Indians 2 2010-04-01 2010-04-01 false What kinds of activities do planning and negotiation... planning and negotiation grants support? The planning and negotiation grants support activities such as...

  15. Health-Related Lifestyle Factors and Sexual Dysfunction: A Meta-Analysis of Population-Based Research.

    Allen, Mark S; Walter, Emma E

    2018-04-01

    -adjusted models and tests of potential moderators using meta-regression. Limitations include low statistical power in models testing diet, caffeine, and cannabis use as risk factors. Results provide compelling evidence that cigarette smoking, alcohol, and physical activity are important for sexual dysfunction. Insufficient research was available to draw conclusions regarding risk factors for premature ejaculation or for cannabis use as a risk factor. These findings should be of interest to clinicians treating men and women with complaints relating to symptoms of sexual dysfunction. Allen MS, Walter EE. Health-Related Lifestyle Factors and Sexual Dysfunction: A Meta-Analysis of Population-Based Research. J Sex Med 2018;15:458-475. Copyright © 2018 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  16. 36 CFR 1206.90 - Must I acknowledge NHPRC grant support?

    2010-07-01

    ....90 Must I acknowledge NHPRC grant support? Yes, grantee institutions, grant project directors, or grant staff personnel may publish results of any work supported by an NHPRC grant without review by the...

  17. Inpatient treatment of patients with acute idiopathic peripheral facial palsy: A population-based healthcare research study.

    Plumbaum, K; Volk, G F; Boeger, D; Buentzel, J; Esser, D; Steinbrecher, A; Hoffmann, K; Jecker, P; Mueller, A; Radtke, G; Witte, O W; Guntinas-Lichius, O

    2017-12-01

    To determine the inpatient management for patients with acute idiopathic facial palsy (IFP) in Thuringia, Germany. Population-based study. All inpatients with IFP in all hospitals with departments of otolaryngology and neurology in 2012, in the German federal state, Thuringia. Patients' characteristics and treatment were compared between departments, and the probability of recovery was tested. A total of 291 patients were mainly treated in departments of otolaryngology (55%) and neurology (36%). Corticosteroid treatment was the predominant therapy (84.5%). The probability to receive a facial nerve grading (odds ratio [OR=12.939; 95% confidence interval [CI]=3.599 to 46.516), gustatory testing (OR=6.878; CI=1.064 to 44.474) and audiometry (OR=32.505; CI=1.485 to 711.257) was significantly higher in otolaryngology departments, but lower for cranial CT (OR=0.192; CI=0.061 to 0.602), cerebrospinal fluid examination (OR=0.024; CI=0.006 to 0.102). A total of 131 patients (45%) showed a recovery to House-Brackmann grade≤II. A pathological stapedial reflex test (Hazard ratio [HR]=0.416; CI=0.180 to 0.959) was the only independent diagnostic predictor of worse outcome. Prednisolone dose >500 mg (HR=0.579; CI 0.400 to 0.838) and no adjuvant physiotherapy (HR=0.568; CI=0.407 to 0.794) were treatment-related predictors of worse outcome. Inpatient treatment of IFP seems to be highly variable in daily practice, partly depending on the treating discipline and despite the availability of evidence-based guidelines. The population-based recovery rate was worse than reported in clinical trials. © 2017 John Wiley & Sons Ltd.

  18. Evaluation of a research diagnostic algorithm for DSM-5 neurocognitive disorders in a population-based cohort of older adults.

    Eramudugolla, Ranmalee; Mortby, Moyra E; Sachdev, Perminder; Meslin, Chantal; Kumar, Rajeev; Anstey, Kaarin J

    2017-03-04

    There is little information on the application and impact of revised criteria for diagnosing dementia and mild cognitive impairment (MCI), now termed major and mild neurocognitive disorders (NCDs) in the DSM-5. We evaluate a psychometric algorithm for diagnosing DSM-5 NCDs in a community-dwelling sample, and characterize the neuropsychological and functional profile of expert-diagnosed DSM-5 NCDs relative to DSM-IV dementia and International Working Group criteria for MCI. A population-based sample of 1644 adults aged 72-78 years was assessed. Algorithmic diagnostic criteria used detailed neuropsychological data, medical history, longitudinal cognitive performance, and informant interview. Those meeting all criteria for at least one diagnosis had data reviewed by a neurologist (expert diagnosis) who achieved consensus with a psychiatrist for complex cases. The algorithm accurately classified DSM-5 major NCD (area under the curve (AUC) = 0.95, 95% confidence interval (CI) 0.92-0.97), DSM-IV dementia (AUC = 0.91, 95% CI 0.85-0.97), DSM-5 mild NCD (AUC = 0.75, 95% CI 0.70-0.80), and MCI (AUC = 0.76, 95% CI 0.72-0.81) when compared to expert diagnosis. Expert diagnosis of dementia using DSM-5 criteria overlapped with 90% of DSM-IV dementia cases, but resulted in a 127% increase in diagnosis relative to DSM-IV. Additional cases had less severe memory, language impairment, and instrumental activities of daily living (IADL) impairments compared to cases meeting DSM-IV criteria for dementia. DSM-5 mild NCD overlapped with 83% of MCI cases and resulted in a 19% increase in diagnosis. These additional cases had a subtly different neurocognitive profile to MCI cases, including poorer social cognition. DSM-5 NCD criteria can be operationalized in a psychometric algorithm in a population setting. Expert diagnosis using DSM-5 NCD criteria captured most cases with DSM-IV dementia and MCI in our sample, but included many additional cases suggesting that DSM-5

  19. A new framework for the documentation and interpretation of oral food challenges in population-based and clinical research

    Grabenhenrich, L. B.; Reich, Andreas; Bellach, J.; Trendelenburg, V.; Sprikkelman, A. B.; Roberts, G.; Grimshaw, K. E. C.; Sigurdardottir, S; Kowalski, M. L.; Papadopoulos, N. G.; Quirce, S.; Dubakiene, R.; Niggemann, B.; Fernandez-Rivas, M.; Ballmer-Weber, Barbara; van Ree, R.; Schnadt, S.; Mills, E. N. Clare; Keil, T.; Beyer, K.

    Background: The conduct of oral food challenges as the preferred diagnostic standard for food allergy (FA) was harmonized over the last years. However, documentation and interpretation of challenge results, particularly in research settings, are not sufficiently standardized to allow valid

  20. Cardiovascular Disease Burden: Evolving Knowledge of Risk Factors in Myocardial Infarction and Stroke through Population-Based Research and Perspectives in Global Prevention

    GUSTAVO B.F. OLIVEIRA

    2015-08-01

    Full Text Available Current knowledge and research perspectives on the top ranking causes of mortality worldwide, i.e., ischemic heart disease and cerebrovascular diseases have developed rapidly. In fact, until recently, it was considered that only half of the myocardial infarctions were due to traditional risk factors such as hypertension, hypercholesterolemia, smoking and diabetes. In addition, most of the available evidence of incidence, risk factors, and clinical outcomes, if not all of it, was derived from studies conducted in developed countries, which included lower proportion of female individuals and with low ethnic diversity. Recent reports by the WHO have provided striking public health information, i.e., the global burden of cardiovascular mortality for the next decades is expected to predominantly occur among developing countries. Therefore, multi-ethnic population-based research including prospective cohorts and, when appropriate, case-control studies, is warranted. These studies should be specifically designed to ascertain key public health measures such as geographic variations in noncommunicable diseases, diagnosis of traditional and potential newly discovered risk factors, causes of death and disability, and gaps for improvement in healthcare prevention (both primary and secondary and specific treatments. As an example, a multinational, multiethnic population-based cohort study is the Prospective Urban and Rural Epidemiology (PURE study, which is the largest global initiative of 150,000 adults aged 35-70 yrs, looking at environmental, societal and biological influences on obesity and chronic health conditions such as ischemic heart disease, stroke and cancer among urban and rural communities in low-, middle-, and high-income countries, with national, community, household and individual-level data. Implementation of population-based strategies is crucial to optimizing limited health system resources while improving care and cardiovascular morbidity

  1. Increase in Social Activity of Citizens on the Basis of Grant Support of Rural Initiatives

    Bogatchev Alexander I.

    2016-11-01

    Full Text Available The article is devoted to the problems of development of social activity of population. The low activity of local population is now characterized by the following social trends: aloofness from public life, individualism, leading-strings mentality, consumer attitude, legal nihilism. The characteristic of the main reasons for the current situation is given in the article. It is noted that one of the effective tools to attract social investment and development is a grant support for local initiatives, which plays an important role in increasing the social activity of population. This article focuses on the development of grant support in the rural areas at the modern stage. The author analyzed the current status of grant support of rural initiatives in Russia and the Orel region. It is noted that the grant support has great potential, although it is at an early stage of its development. In the conclusion, actions for the development of social activity at the local level are planned.

  2. Creating a sampling frame for population-based veteran research: Representativeness and overlap of VA and Department of Defense databases

    Donna L. Washington, MD, MPH; Su Sun, MPH; Mark Canning, BA

    2010-01-01

    Most veteran research is conducted in Department of Veterans Affairs (VA) healthcare settings, although most veterans obtain healthcare outside the VA. Our objective was to determine the adequacy and relative contributions of Veterans Health Administration (VHA), Veterans Benefits Administration (VBA), and Department of Defense (DOD) administrative databases for representing the U.S. veteran population, using as an example the creation of a sampling frame for the National Survey of Women Vete...

  3. Constructing a population-based research database from routine maternal screening records: a resource for studying alloimmunization in pregnant women.

    Brian K Lee

    Full Text Available BACKGROUND: Although screening for maternal red blood cell antibodies during pregnancy is a standard procedure, the prevalence and clinical consequences of non-anti-D immunization are poorly understood. The objective was to create a national database of maternal antibody screening results that can be linked with population health registers to create a research resource for investigating these issues. STUDY DESIGN AND METHODS: Each birth in the Swedish Medical Birth Register was uniquely identified and linked to the text stored in routine maternal antibody screening records in the time window from 9 months prior to 2 weeks after the delivery date. These text records were subjected to a computerized search for specific antibodies using regular expressions. To illustrate the research potential of the resulting database, selected antibody prevalence rates are presented as tables and figures, and the complete data (from more than 60 specific antibodies presented as online moving graphical displays. RESULTS: More than one million (1,191,761 births with valid screening information from 1982-2002 constitute the study population. Computerized coverage of screening increased steadily over time and varied by region as electronic records were adopted. To ensure data quality, we restricted analysis to birth records in areas and years with a sustained coverage of at least 80%, representing 920,903 births from 572,626 mothers in 17 of the 24 counties in Sweden. During the study period, non-anti-D and anti-D antibodies occurred in 76.8/10,000 and 14.1/10,000 pregnancies respectively, with marked differences between specific antibodies over time. CONCLUSION: This work demonstrates the feasibility of creating a nationally representative research database from the routine maternal antibody screening records from an extended calendar period. By linkage with population registers of maternal and child health, such data are a valuable resource for addressing important

  4. A new framework for the documentation and interpretation of oral food challenges in population-based and clinical research.

    Grabenhenrich, L B; Reich, A; Bellach, J; Trendelenburg, V; Sprikkelman, A B; Roberts, G; Grimshaw, K E C; Sigurdardottir, S; Kowalski, M L; Papadopoulos, N G; Quirce, S; Dubakiene, R; Niggemann, B; Fernández-Rivas, M; Ballmer-Weber, B; van Ree, R; Schnadt, S; Mills, E N C; Keil, T; Beyer, K

    2017-03-01

    The conduct of oral food challenges as the preferred diagnostic standard for food allergy (FA) was harmonized over the last years. However, documentation and interpretation of challenge results, particularly in research settings, are not sufficiently standardized to allow valid comparisons between studies. Our aim was to develop a diagnostic toolbox to capture and report clinical observations in double-blind placebo-controlled food challenges (DBPCFC). A group of experienced allergists, paediatricians, dieticians, epidemiologists and data managers developed generic case report forms and standard operating procedures for DBPCFCs and piloted them in three clinical centres. The follow-up of the EuroPrevall/iFAAM birth cohort and other iFAAM work packages applied these methods. A set of newly developed questionnaire or interview items capture the history of FA. Together with sensitization status, this forms the basis for the decision to perform a DBPCFC, following a standardized decision algorithm. A generic form including details about severity and timing captures signs and symptoms observed during or after the procedures. In contrast to the commonly used dichotomous outcome FA vs no FA, the allergy status is interpreted in multiple categories to reflect the complexity of clinical decision-making. The proposed toolbox sets a standard for improved documentation and harmonized interpretation of DBPCFCs. By a detailed documentation and common terminology for communicating outcomes, these tools hope to reduce the influence of subjective judgment of supervising physicians. All forms are publicly available for further evolution and free use in clinical and research settings. © 2016 The Authors. Allergy Published by John Wiley & Sons Ltd.

  5. Creating a sampling frame for population-based veteran research: representativeness and overlap of VA and Department of Defense databases.

    Washington, Donna L; Sun, Su; Canning, Mark

    2010-01-01

    Most veteran research is conducted in Department of Veterans Affairs (VA) healthcare settings, although most veterans obtain healthcare outside the VA. Our objective was to determine the adequacy and relative contributions of Veterans Health Administration (VHA), Veterans Benefits Administration (VBA), and Department of Defense (DOD) administrative databases for representing the U.S. veteran population, using as an example the creation of a sampling frame for the National Survey of Women Veterans. In 2008, we merged the VHA, VBA, and DOD databases. We identified the number of unique records both overall and from each database. The combined databases yielded 925,946 unique records, representing 51% of the 1,802,000 U.S. women veteran population. The DOD database included 30% of the population (with 8% overlap with other databases). The VHA enrollment database contributed an additional 20% unique women veterans (with 6% overlap with VBA databases). VBA databases contributed an additional 2% unique women veterans (beyond 10% overlap with other databases). Use of VBA and DOD databases substantially expands access to the population of veterans beyond those in VHA databases, regardless of VA use. Adoption of these additional databases would enhance the value and generalizability of a wide range of studies of both male and female veterans.

  6. Understanding the Role of the Immune System in the Development of Cancer: New Opportunities for Population-Based Research.

    Michaud, Dominique S; Houseman, E Andres; Marsit, Carmen J; Nelson, Heather H; Wiencke, John K; Kelsey, Karl T

    2015-12-01

    Understanding the precise role of the immune system in cancer has been hindered by the complexity of the immune response and challenges in measuring immune cell types in health and disease in the context of large epidemiologic studies. In this review, we present the rationale to study immunity in cancer and highlight newly available tools to further elucidate the epidemiologic factors driving individual variation in the immune response in cancer. Here, we summarize key studies that have evaluated the role of immunologic status on risk of cancer, discuss tools that have been used in epidemiologic studies to measure immune status, as well as new evolving methodologies where application to epidemiology is becoming more feasible. We also encourage further development of novel emerging technologies that will continue to enable prospective assessment of the dynamic and complex role played by the immune system in cancer susceptibility. Finally, we summarize characteristics and environmental factors that affect the immune response, as these will need to be considered in epidemiologic settings. Overall, we consider the application of a systems biologic approach and highlight new opportunities to understand the immune response in cancer risk. ©2015 American Association for Cancer Research.

  7. A comparison of stroke severity proxy measures for claims data research: a population-based cohort study.

    Sung, Sheng-Feng; Chen, Solomon Chih-Cheng; Hsieh, Cheng-Yang; Li, Chung-Yi; Lai, Edward Chia-Cheng; Hu, Ya-Han

    2016-04-01

    Confounding by disease severity has been viewed as an intractable problem in claims-based studies. A novel 7-variable stroke severity index (SSI) was designed for estimating stroke severity by using claims data. This study compared the performance of mortality models with various proxy measures of stroke severity, including the SSI, in patients hospitalized for acute ischemic stroke (AIS). Data from the Taiwan National Health Insurance Research Database (NHIRD) were analyzed. Three proxy measures of stroke severity were evaluated: Measure 1, the SSI; Measure 2, intensive care unit admission and length of stay; and Measure 3, surgical operation, mechanical ventilation, hemiplegia or hemiparesis, and residual neurological deficits. We performed logistic regression by including age, sex, vascular risk factors, Charlson comorbidity index, and one of the proxy measures as covariates to predict 30-day and 1-year mortality after AIS. Model discrimination was evaluated using the area under the receiver-operating characteristic curve (AUC). We identified 7551 adult patients with AIS. Models using the SSI (Measure 1) outperformed models using the other proxy measures in predicting 30-day mortality (AUC 0.892 vs 0.851, p < 0.001 for Measure 2; 0.892 vs 0.853, p < 0.001 for Measure 3) and 1-year mortality (AUC 0.816 vs 0.784, p < 0.001 for Measure 2; 0.816 vs 0.782, p < 0.001 for Measure 3). Using the SSI facilitated risk adjustment for stroke severity in mortality models for patients with AIS. The SSI is a viable methodological tool for stroke outcome studies using the NHIRD. Copyright © 2015 John Wiley & Sons, Ltd.

  8. Incidence of fractures among epilepsy patients: a population-based retrospective cohort study in the General Practice Research Database.

    Souverein, Patrick C; Webb, David J; Petri, Hans; Weil, John; Van Staa, Tjeerd P; Egberts, Toine

    2005-02-01

    To compare the incidence of various fractures in a cohort of patients with epilepsy with a reference cohort of patients not having epilepsy. Patients were included in the epilepsy cohort if they had at least one diagnosis of epilepsy in their medical history and had sufficient evidence of "active" epilepsy (use of antiepileptic drugs, diagnoses) after the practice was included in the General Practice Research Database (GPRD). Two reference patients were sampled for each patient with epilepsy from the same practice. Primary outcome was the occurrence of any fracture during follow-up. Poisson regression analysis was used to estimate incidence density ratios (IDRs). The study population comprised 40,485 and 80,970 patients in the epilepsy and reference cohorts, respectively. The median duration of follow-up was approximately 3 years. The overall incidence rate in the epilepsy cohort was 241.9 per 10,000 person-years. This rate was about twice as high as that in reference cohort: age- and sex-adjusted IDR, 1.89 (95% CI, 1.81-1.98). When comparing IDRs among the different groups of fractures, the highest relative-risk estimate was found for hip and femur fractures (adjusted IDR, 2.79; 95% CI, 2.41-3.24). IDRs were consistently elevated across age and sex groups and across fracture subtypes. The overall risk of fractures was nearly twice as high among patients with epilepsy compared with the general population. The relative fracture risk was highest for hip and femur. Further study is necessary to elucidate whether this elevated risk is due to the disease, the use of antiepileptic drugs, or both.

  9. Lansoprazole use and tuberculosis incidence in the United Kingdom Clinical Practice Research Datalink: A population based cohort.

    Yates, Tom A; Tomlinson, Laurie A; Bhaskaran, Krishnan; Langan, Sinead; Thomas, Sara; Smeeth, Liam; Douglas, Ian J

    2017-11-01

    Recent in vitro and animal studies have found the proton pump inhibitor (PPI) lansoprazole to be highly active against Mycobacterium tuberculosis. Omeprazole and pantoprazole have no activity. There is no evidence that, in clinical practice, lansoprazole can treat or prevent incident tuberculosis (TB) disease. We studied a cohort of new users of lansoprazole, omeprazole, or pantoprazole from the United Kingdom Clinical Practice Research Datalink to determine whether lansoprazole users have a lower incidence of TB disease than omeprazole or pantoprazole users. Negative control outcomes of myocardial infarction (MI) and herpes zoster were also studied. Multivariable Cox proportional hazards regression was used to adjust for potential confounding by a wide range of factors. We identified 527,364 lansoprazole initiators and 923,500 omeprazole or pantoprazole initiators. Lansoprazole users had a lower rate of TB disease (n = 86; 10.0 cases per 100,000 person years; 95% confidence interval 8.1-12.4) than omeprazole or pantoprazole users (n = 193; 15.3 cases per 100,000 person years; 95% confidence interval 13.3-17.7), with an adjusted hazard ratio (HR) of 0.68 (0.52-0.89). No association was found with MI (adjusted HR 1.04; 95% confidence interval 1.00-1.08) or herpes zoster (adjusted HR 1.03; 95% confidence interval 1.00-1.06). Limitations of this study are that we could not determine whether TB disease was due to reactivation of latent infection or a result of recent transmission, nor could we determine whether lansoprazole would have a beneficial effect if given to people presenting with TB disease. In this study, use of the commonly prescribed and cheaply available PPI lansoprazole was associated with reduced incidence of TB disease. Given the serious problem of drug resistance and the adverse side effect profiles of many TB drugs, further investigation of lansoprazole as a potential antituberculosis agent is warranted.

  10. Mixing modes in a population-based interview survey: comparison of a sequential and a concurrent mixed-mode design for public health research.

    Mauz, Elvira; von der Lippe, Elena; Allen, Jennifer; Schilling, Ralph; Müters, Stephan; Hoebel, Jens; Schmich, Patrick; Wetzstein, Matthias; Kamtsiuris, Panagiotis; Lange, Cornelia

    2018-01-01

    Population-based surveys currently face the problem of decreasing response rates. Mixed-mode designs are now being implemented more often to account for this, to improve sample composition and to reduce overall costs. This study examines whether a concurrent or sequential mixed-mode design achieves better results on a number of indicators of survey quality. Data were obtained from a population-based health interview survey of adults in Germany that was conducted as a methodological pilot study as part of the German Health Update (GEDA). Participants were randomly allocated to one of two surveys; each of the surveys had a different design. In the concurrent mixed-mode design ( n  = 617) two types of self-administered questionnaires (SAQ-Web and SAQ-Paper) and computer-assisted telephone interviewing were offered simultaneously to the respondents along with the invitation to participate. In the sequential mixed-mode design ( n  = 561), SAQ-Web was initially provided, followed by SAQ-Paper, with an option for a telephone interview being sent out together with the reminders at a later date. Finally, this study compared the response rates, sample composition, health indicators, item non-response, the scope of fieldwork and the costs of both designs. No systematic differences were identified between the two mixed-mode designs in terms of response rates, the socio-demographic characteristics of the achieved samples, or the prevalence rates of the health indicators under study. The sequential design gained a higher rate of online respondents. Very few telephone interviews were conducted for either design. With regard to data quality, the sequential design (which had more online respondents) showed less item non-response. There were minor differences between the designs in terms of their costs. Postage and printing costs were lower in the concurrent design, but labour costs were lower in the sequential design. No differences in health indicators were found between

  11. A new socioeconomic status measure for vaccine research in children using individual housing data: a population-based case-control study

    Rachel Hammer

    2016-09-01

    Full Text Available Abstract Background We recently developed HOUSES, an individual housing-based socioeconomic status (SES measurement for health disparities research. We assessed whether HOUSES was associated with risk of pertussis and pertussis vaccine up-to-date status in children. Methods The study utilized a previous population-based case-control study cohort assembled during the 2004–2005 pertussis outbreak. We collected data on pertussis vaccine status (up-to-date status at the time of the index date. Using a z-score for housing value, actual square footage, and numbers of bedrooms and bathrooms, HOUSES was formulated in continuous variable and categorized into quartiles. Vaccine up-to-date status was compared among subjects with different SES as measured by HOUSES using a chi-square test and logistic regression models. Results Of the 391 eligible pediatric subjects (median age of 13.1 years with male sex of 55 %, 363 (93 % were successfully geocoded to formulate HOUSES index. HOUSES was not associated with the risk of pertussis (p = 0.82. Pertussis vaccine up-to-date statuses were 79, 86, 83, and 94 % for children in the first (the lowest SES, second, third, and fourth quartiles of HOUSES, respectively (p = 0.03. HOUSES as a continuous variable was associated with pertussis vaccine up-to-date status (adjusted OR: 1.15 per increment of one unit of HOUSES, 95 % CI: 1.04–1.27, p = 0.008. Conclusion While HOUSES is not associated with the risk of pertussis, it predicts vaccine up-to-date status among children with different SES. HOUSES may be a useful tool for vaccine delivery research among children.

  12. Myeloid malignancies in the real-world: Occurrence, progression and survival in the UK's population-based Haematological Malignancy Research Network 2004-15.

    Roman, Eve; Smith, Alex; Appleton, Simon; Crouch, Simon; Kelly, Richard; Kinsey, Sally; Cargo, Catherine; Patmore, Russell

    2016-06-01

    Population-based information on cancer incidence, prevalence and outcome are required to inform clinical practice and research; but contemporary data are lacking for many myeloid malignancy subtypes. Set within a socio-demographically representative UK population of ∼4 million, myeloid malignancy data (N=5231 diagnoses) are from an established patient cohort. Information on incidence, survival (relative & overall), transformation/progression, and prevalence is presented for >20 subtypes. The median diagnostic age was 72.4years (InterQuartile Range 61.6-80.2), but there was considerable subtype heterogeneity, particularly among the acute myeloid leukaemias (AML) where medians ranged from 20.3 (IQR 13.9-43.8) for AML 11q23 through to 73.7 (IQR 57.3-79.1) for AML with no recurrent genetic changes. Five-year Relative Survival (RS) estimates varied hugely; from 85% for indolent/treatable conditions like chronic myeloid leukaemia (89.8%, 95% CI 84.0-93.6). With a couple of notable exceptions, males experienced higher rates and worse survival than females: the age-standardized incidence rates of several conditions was 2-4 higher in males than females, and the 5-year RS for all subtypes combined was 48.8% (95% CI 46.5-51.2) and 60.4% (95% CI 57.7-62.9) for males and females respectively. During follow-up (potential minimum 2 years and maximum 11years) myelodysplastic syndrome (MDS) progression to AML ranged from 25% for refractory anaemia with excess blasts through to 5% for refractory anaemia with ring sideroblasts: the median interval between MDS and AML diagnosis was 9.0 months (IQR 4.8-17.4months). The marked incidence and outcome variations seen by subtype, sex and age, confirm the requirement for "real-world" longitudinal data to inform aetiological hypotheses, healthcare planning, and future monitoring of therapeutic change. Several challenges for routine cancer registration were identified, including the need to link more effectively to diagnostic and clinical

  13. Dementia incidence and mortality in middle-income countries, and associations with indicators of cognitive reserve: a 10/66 Dementia Research Group population-based cohort study

    Prince, Martin; Acosta, Daisy; Ferri, Cleusa P; Guerra, Mariella; Huang, Yueqin; Rodriguez, Juan J Llibre; Salas, Aquiles; Sosa, Ana Luisa; Williams, Joseph D; Dewey, Michael E; Acosta, Isaac; Jotheeswaran, Amuthavalli T; Liu, Zhaorui

    2012-01-01

    Summary Background Results of the few cohort studies from countries with low incomes or middle incomes suggest a lower incidence of dementia than in high-income countries. We assessed incidence of dementia according to criteria from the 10/66 Dementia Research Group and Diagnostic and Statistical Manual of Mental Disorders (DSM) IV, the effect of dementia at baseline on mortality, and the independent effects of age, sex, socioeconomic position, and indicators of cognitive reserve. Methods We did a population-based cohort study of all people aged 65 years and older living in urban sites in Cuba, the Dominican Republic, and Venezuela, and rural and urban sites in Peru, Mexico, and China, with ascertainment of incident 10/66 and DSM-IV dementia 3–5 years after cohort inception. We used questionnaires to obtain information about age in years, sex, educational level, literacy, occupational attainment, and number of household assets. We obtained information about mortality from all sites. For participants who had died, we interviewed a friend or relative to ascertain the likelihood that they had dementia before death. Findings 12 887 participants were interviewed at baseline. 11 718 were free of dementia, of whom 8137 (69%) were reinterviewed, contributing 34 718 person-years of follow-up. Incidence for 10/66 dementia varied between 18·2 and 30·4 per 1000 person-years, and were 1·4–2·7 times higher than were those for DSM-IV dementia (9·9–15·7 per 1000 person-years). Mortality hazards were 1·56–5·69 times higher in individuals with dementia at baseline than in those who were dementia-free. Informant reports suggested a high incidence of dementia before death; overall incidence might be 4–19% higher if these data were included. 10/66 dementia incidence was independently associated with increased age (HR 1·67; 95% CI 1·56–1·79), female sex (0·72; 0·61–0·84), and low education (0·89; 0·81–0·97), but not with occupational attainment (1

  14. The descriptive epidemiology of delirium symptoms in a large population-based cohort study: results from the Medical Research Council Cognitive Function and Ageing Study (MRC CFAS).

    Davis, Daniel H J; Barnes, Linda E; Stephan, Blossom C M; MacLullich, Alasdair M J; Meagher, David; Copeland, John; Matthews, Fiona E; Brayne, Carol

    2014-07-28

    In the general population, the epidemiological relationships between delirium and adverse outcomes are not well defined. The aims of this study were to: (1) construct an algorithm for the diagnosis of delirium using the Geriatric Mental State (GMS) examination; (2) test the criterion validity of this algorithm against mortality and dementia risk; (3) report the age-specific prevalence of delirium as determined by this algorithm. Participant and informant data in a randomly weighted subsample of the Cognitive Function and Ageing Study were taken from a standardized assessment battery. The algorithmic definition of delirium was based on the DSM-IV classification. Outcomes were: proportional hazard ratios for death; odds ratios of dementia at 2-year follow-up. Data from 2197 persons (representative of 13,004) were used, median age 77 years, 64% women. Study-defined delirium was associated with a new dementia diagnosis at two years (OR 8.82, 95% CI 2.76 to 28.2) and death (HR 1.28, 95% CI 1.03 to 1.60), even after adjustment for acute illness severity. Similar associations were seen for study-defined subsyndromal delirium. Age-specific prevalence as determined by the algorithm increased with age from 1.8% in the 65-69 year age group to 10.1% in the ≥85 age group (p delirium, age-specific period prevalence ranged from 8.2% (65-69 years) to 36.1% (≥85 years). These results demonstrate the possibility of constructing an algorithmic diagnosis for study-defined delirium using data from the GMS schedule, with predictive criterion validity for mortality and dementia risk. These are the first population-based analyses able to account prospectively for both illness severity and an earlier study diagnosis of dementia.

  15. Chronic diseases among older people and co-resident psychological morbidity: a 10/66 Dementia Research Group population-based survey.

    Honyashiki, Mina; Ferri, Cleusa P; Acosta, Daisy; Guerra, Mariella; Huang, Yueqin; Jacob, K S; Llibre-Rodrigues, Juan J; Salas, Aquiles; Sosa, Ana Luisa; Williams, Joseph; Prince, Martin J

    2011-11-01

    This is the first study to investigate the associations between chronic health conditions of older people and their impact on co-resident psychological morbidity using population-based samples in low and middle income countries (LAMICs). Single-phase cross-sectional catchment area surveys were undertaken in urban sites in Cuba, Dominican Republic and Venezuela, and in rural and urban catchment areas in Mexico, Peru, India and China. All residents aged 65 years and over were interviewed with a co-resident key informant. Exposures were structured clinical diagnoses (10/66 and DSM-IV dementia and ICD-10 depression), self-reported diagnosis (stroke) and physical impairments. Mediating variables were dependence and disability (WHODAS 2.0), and the outcome was co-resident psychological morbidity assessed using SRQ-20. Poisson regression analysis was used to estimate the prevalence ratios (PRs) for the associations between health conditions and psychological morbidity in each site, and meta-analysis was used to pool the estimates. 11,988 pairs comprising a participant and a co-resident informant were included in the analysis. After meta-analysis, independent effects were noted for depression (PR2.11; 95% CI 1.82-2.45), dementia (PR 1.98; 95% CI 1.72-2.28), stroke (PR 1.42; 95% CI 1.17-1.71) and physical impairments (PR 1.17; 95% CI 1.13-1.21). The effects were partly mediated through disability and dependence. The mean population attributable fraction of total chronic conditions was 30.1%. The prevalence of co-resident psychological morbidity is higher among co-residents of older people with chronic conditions. This effect was prominent for, but not confined to, depression and dementia. Attention needs to be directed to chronic conditions.

  16. QTL mapping for combining ability in different population-based ...

    2013-12-13

    Dec 13, 2013 ... ability and for geneticists to research the genetic basis of combining ability. [Li L., Sun C., ... population-based NCII designs by a simulation study. J. Genet. ... combining ability could also be applied to other population- based NCII ... was to estimate how different base populations, sample sizes, heritability ...

  17. The Prevalence, Correlates, Detection and Control of Diabetes among Older People in Low and Middle Income Countries. A 10/66 Dementia Research Group Population-Based Survey.

    Aquiles Salas

    Full Text Available Little is known of the epidemiology of diabetes among older people in low and middle income countries. We aimed to study and compare prevalence, social patterning, correlates, detection, treatment and control of diabetes among older people in Latin America, India, China and Nigeria.Cross-sectional surveys in 13 catchment area sites in nine countries. Diagnosed diabetes was assessed in all sites through self-reported diagnosis. Undiagnosed diabetes was assessed in seven Latin American sites through fasting blood samples (glucose > = 7 mmol/L.Total diabetes prevalence in catchment sites in Cuba (prevalence 24.2%, SMR 116, Puerto Rico (43.4%, 197, and urban (27.0%, 125, and rural Mexico (23.7%, 111 already exceeds that in the USA, while that in Venezuela (20.9%, 100 is similar. Diagnosed diabetes prevalence varied very widely, between low prevalences in sites in rural China (0.9%, rural India (6.6% and Nigeria (6.0%. and 32.1% in Puerto Rico, explained mainly by access to health services. Treatment coverage varied substantially between sites. Diabetes control (40 to 61% of those diagnosed was modest in the Latin American sites where this was studied. Diabetes was independently associated with less education, but more assets. Hypertension, central obesity and hypertriglyceridaemia, but not hypercholesterolaemia were consistently associated with total diabetes.Diabetes prevalence is already high in most sites. Identifying undiagnosed cases is essential to quantify population burden, particularly in least developed settings where diagnosis is uncommon. Metabolic risk factors and associated lifestyles may play an important part in aetiology, but this requires confirmation with longitudinal data. Given the high prevalence among older people, more population research is indicated to quantify the impact of diabetes, and to monitor the effect of prevention and health system strengthening on prevalence, treatment and control.

  18. The Prevalence, Correlates, Detection and Control of Diabetes among Older People in Low and Middle Income Countries. A 10/66 Dementia Research Group Population-Based Survey.

    Salas, Aquiles; Acosta, Daisy; Ferri, Cleusa P; Guerra, Mariella; Huang, Yueqin; Jacob, K S; Jimenez-Velazquez, Ivonne Z; Llibre Rodriguez, Juan J; Sosa, Ana L; Uwakwe, Richard; Williams, Joseph D; Jotheeswaran, A T; Liu, Zhaorui; Lopez Medina, A M; Salinas-Contreras, Rosa Maria; Prince, Martin J

    2016-01-01

    Little is known of the epidemiology of diabetes among older people in low and middle income countries. We aimed to study and compare prevalence, social patterning, correlates, detection, treatment and control of diabetes among older people in Latin America, India, China and Nigeria. Cross-sectional surveys in 13 catchment area sites in nine countries. Diagnosed diabetes was assessed in all sites through self-reported diagnosis. Undiagnosed diabetes was assessed in seven Latin American sites through fasting blood samples (glucose > = 7 mmol/L). Total diabetes prevalence in catchment sites in Cuba (prevalence 24.2%, SMR 116), Puerto Rico (43.4%, 197), and urban (27.0%, 125), and rural Mexico (23.7%, 111) already exceeds that in the USA, while that in Venezuela (20.9%, 100) is similar. Diagnosed diabetes prevalence varied very widely, between low prevalences in sites in rural China (0.9%), rural India (6.6%) and Nigeria (6.0%). and 32.1% in Puerto Rico, explained mainly by access to health services. Treatment coverage varied substantially between sites. Diabetes control (40 to 61% of those diagnosed) was modest in the Latin American sites where this was studied. Diabetes was independently associated with less education, but more assets. Hypertension, central obesity and hypertriglyceridaemia, but not hypercholesterolaemia were consistently associated with total diabetes. Diabetes prevalence is already high in most sites. Identifying undiagnosed cases is essential to quantify population burden, particularly in least developed settings where diagnosis is uncommon. Metabolic risk factors and associated lifestyles may play an important part in aetiology, but this requires confirmation with longitudinal data. Given the high prevalence among older people, more population research is indicated to quantify the impact of diabetes, and to monitor the effect of prevention and health system strengthening on prevalence, treatment and control.

  19. The Prevalence, Correlates, Detection and Control of Diabetes among Older People in Low and Middle Income Countries. A 10/66 Dementia Research Group Population-Based Survey

    Salas, Aquiles; Acosta, Daisy; Ferri, Cleusa P.; Guerra, Mariella; Huang, Yueqin; Jacob, K. S.; Jimenez-Velazquez, Ivonne Z.; Llibre Rodriguez, Juan J.; Sosa, Ana L.; Uwakwe, Richard; Williams, Joseph D.; Jotheeswaran, A. T.; Liu, Zhaorui; Lopez Medina, A. M.; Salinas-Contreras, Rosa Maria; Prince, Martin J.

    2016-01-01

    Background Little is known of the epidemiology of diabetes among older people in low and middle income countries. We aimed to study and compare prevalence, social patterning, correlates, detection, treatment and control of diabetes among older people in Latin America, India, China and Nigeria. Methods Cross-sectional surveys in 13 catchment area sites in nine countries. Diagnosed diabetes was assessed in all sites through self-reported diagnosis. Undiagnosed diabetes was assessed in seven Latin American sites through fasting blood samples (glucose > = 7mmol/L). Results Total diabetes prevalence in catchment sites in Cuba (prevalence 24.2%, SMR 116), Puerto Rico (43.4%, 197), and urban (27.0%, 125), and rural Mexico (23.7%, 111) already exceeds that in the USA, while that in Venezuela (20.9%, 100) is similar. Diagnosed diabetes prevalence varied very widely, between low prevalences in sites in rural China (0.9%), rural India (6.6%) and Nigeria (6.0%). and 32.1% in Puerto Rico, explained mainly by access to health services. Treatment coverage varied substantially between sites. Diabetes control (40 to 61% of those diagnosed) was modest in the Latin American sites where this was studied. Diabetes was independently associated with less education, but more assets. Hypertension, central obesity and hypertriglyceridaemia, but not hypercholesterolaemia were consistently associated with total diabetes. Conclusions Diabetes prevalence is already high in most sites. Identifying undiagnosed cases is essential to quantify population burden, particularly in least developed settings where diagnosis is uncommon. Metabolic risk factors and associated lifestyles may play an important part in aetiology, but this requires confirmation with longitudinal data. Given the high prevalence among older people, more population research is indicated to quantify the impact of diabetes, and to monitor the effect of prevention and health system strengthening on prevalence, treatment and control

  20. Contribution of chronic diseases to disability in elderly people in countries with low and middle incomes: a 10/66 Dementia Research Group population-based survey.

    Sousa, Renata M; Ferri, Cleusa P; Acosta, Daisy; Albanese, Emiliano; Guerra, Mariella; Huang, Yueqin; Jacob, K S; Jotheeswaran, A T; Rodriguez, Juan J Llibre; Pichardo, Guillermina Rodriguez; Rodriguez, Marina Calvo; Salas, Aquiles; Sosa, Ana Luisa; Williams, Joseph; Zuniga, Tirso; Prince, Martin

    2009-11-28

    Disability in elderly people in countries with low and middle incomes is little studied; according to Global Burden of Disease estimates, visual impairment is the leading contributor to years lived with disability in this population. We aimed to assess the contribution of physical, mental, and cognitive chronic diseases to disability, and the extent to which sociodemographic and health characteristics account for geographical variation in disability. We undertook cross-sectional surveys of residents aged older than 65 years (n=15 022) in 11 sites in seven countries with low and middle incomes (China, India, Cuba, Dominican Republic, Venezuela, Mexico, and Peru). Disability was assessed with the 12-item WHO disability assessment schedule 2.0. Dementia, depression, hypertension, and chronic obstructive pulmonary disease were ascertained by clinical assessment; diabetes, stroke, and heart disease by self-reported diagnosis; and sensory, gastrointestinal, skin, limb, and arthritic disorders by self-reported impairment. Independent contributions to disability scores were assessed by zero-inflated negative binomial regression and Poisson regression to generate population-attributable prevalence fractions (PAPF). In regions other than rural India and Venezuela, dementia made the largest contribution to disability (median PAPF 25.1% [IQR 19.2-43.6]). Other substantial contributors were stroke (11.4% [1.8-21.4]), limb impairment (10.5% [5.7-33.8]), arthritis (9.9% [3.2-34.8]), depression (8.3% [0.5-23.0]), eyesight problems (6.8% [1.7-17.6]), and gastrointestinal impairments (6.5% [0.3-23.1]). Associations with chronic diseases accounted for around two-thirds of prevalent disability. When zero inflation was taken into account, between-site differences in disability scores were largely attributable to compositional differences in health and sociodemographic characteristics. On the basis of empirical research, dementia, not blindness, is overwhelmingly the most important

  1. Metabolomics in Population-Based Research

    Metabolomics is the study of small molecules of both endogenous and exogenous origin, such as metabolic substrates and their products, lipids, small peptides, vitamins and other protein cofactors generated by metabolism, which are downstream from genes.

  2. Population-based screening versus case detection.

    Thomas Ravi

    2002-01-01

    Full Text Available India has a large burden of blindness and population-based screening is a strategy commonly employed to detect disease and prevent morbidity. However, not all diseases are amenable to screening. This communication examines the issue of "population-based screening" versus "case detection" in the Indian scenario. Using the example of glaucoma, it demonstrates that given the poor infrastructure, for a "rare" disease, case detection is more effective than population-based screening.

  3. Population based reference intervals for common blood ...

    Population based reference intervals for common blood haematological and biochemical parameters in the Akuapem north district. K.A Koram, M.M Addae, J.C Ocran, S Adu-amankwah, W.O Rogers, F.K Nkrumah ...

  4. Representativeness in population-based studies

    Drivsholm, Thomas Bo; Eplov, Lene Falgaard; Davidsen, Michael

    2006-01-01

    Decreasing rates of participation in population-based studies increasingly challenge the interpretation of study results, in both analytic and descriptive epidemiology. Consequently, estimates of possible differences between participants and non-participants are increasingly important...... for the interpretation of study results and generalization to the background population....

  5. Gastroesophageal Reflux Disease: A Population Based Study

    Nwokediuko, Sylvester

    2009-01-01

    Background The prevalence of gastroesophageal reflux disease varies in different parts of the world. There are no population based studies in Nigeria. The main objectives of this study were to determine the prevalence and risk factors for gastroesophageal reflux disease in a population of Nigerian medical students. Methods The Carlsson-Dent questionnaire was administered to medical students in the clinical phase of their training at the University of Nigeria, Enugu Campus. Some putative risk ...

  6. Uses of cancer registries for public health and clinical research in Europe: Results of the European Network of Cancer Registries survey among 161 population-based cancer registries during 2010–2012

    Siesling, Sabine; Louwman, W.J.; Kwast, A.; van den Hurk, C.J.G.; O'Callaghan, M.; Rosso, S.; Zanetti, R.; Storm, H.; Comber, H.; Steliarova-Foucher, E.; Coebergh, J.W.W.

    2015-01-01

    Aim To provide insight into cancer registration coverage, data access and use in Europe. This contributes to data and infrastructure harmonisation and will foster a more prominent role of cancer registries (CRs) within public health, clinical policy and cancer research, whether within or outside the

  7. Mapping population-based structural connectomes.

    Zhang, Zhengwu; Descoteaux, Maxime; Zhang, Jingwen; Girard, Gabriel; Chamberland, Maxime; Dunson, David; Srivastava, Anuj; Zhu, Hongtu

    2018-05-15

    Advances in understanding the structural connectomes of human brain require improved approaches for the construction, comparison and integration of high-dimensional whole-brain tractography data from a large number of individuals. This article develops a population-based structural connectome (PSC) mapping framework to address these challenges. PSC simultaneously characterizes a large number of white matter bundles within and across different subjects by registering different subjects' brains based on coarse cortical parcellations, compressing the bundles of each connection, and extracting novel connection weights. A robust tractography algorithm and streamline post-processing techniques, including dilation of gray matter regions, streamline cutting, and outlier streamline removal are applied to improve the robustness of the extracted structural connectomes. The developed PSC framework can be used to reproducibly extract binary networks, weighted networks and streamline-based brain connectomes. We apply the PSC to Human Connectome Project data to illustrate its application in characterizing normal variations and heritability of structural connectomes in healthy subjects. Copyright © 2018 Elsevier Inc. All rights reserved.

  8. "The contribution of chronic diseases to the prevalence of dependence among older people in Latin America, China and India: a 10/66 Dementia Research Group population-based survey"

    Salas Aquiles

    2010-08-01

    Full Text Available Abstract Background The number of older people is set to increase dramatically worldwide. Demographic changes are likely to result in the rise of age-related chronic diseases which largely contribute to years lived with a disability and future dependence. However dependence is much less studied although intrinsically linked to disability. We investigated the prevalence and correlates of dependence among older people from middle income countries. Methods A one-phase cross-sectional survey was carried out at 11 sites in seven countries (urban sites in Cuba, Venezuela, and Dominican Republic, urban and rural sites in Peru, Mexico, China and India. All those aged 65 years and over living in geographically defined catchment areas were eligible. In all, 15,022 interviews were completed with an informant interview for each participant. The full 10/66 Dementia Research Group survey protocol was applied, including ascertainment of depression, dementia, physical impairments and self-reported diagnoses. Dependence was interviewer-rated based on a key informant's responses to a set of open-ended questions on the participant's needs for care. We estimated the prevalence of dependence and the independent contribution of underlying health conditions. Site-specific prevalence ratios were meta-analysed, and population attributable prevalence fractions (PAPF calculated. Results The prevalence of dependence increased with age at all sites, with a tendency for the prevalence to be lower in men than in women. Age-standardised prevalence was lower in all sites than in the USA. Other than in rural China, dementia made the largest independent contribution to dependence, with a median PAPF of 34% (range 23%-59%. Other substantial contributors were limb impairment (9%, 1%-46%, stroke (8%, 2%-17%, and depression (8%, 1%-27%. Conclusion The demographic and health transitions will lead to large and rapid increases in the numbers of dependent older people particularly in

  9. The contribution of chronic diseases to the prevalence of dependence among older people in Latin America, China and India: a 10/66 Dementia Research Group population-based survey.

    Sousa, Renata M; Ferri, Cleusa P; Acosta, Daisy; Guerra, Mariella; Huang, Yueqin; Jacob, Ks; Jotheeswaran, At; Hernandez, Milagros A Guerra; Liu, Zhaorui; Pichardo, Guillermina Rodriguez; Rodriguez, Juan J Llibre; Salas, Aquiles; Sosa, Ana Luisa; Williams, Joseph; Zuniga, Tirso; Prince, Martin

    2010-08-06

    The number of older people is set to increase dramatically worldwide. Demographic changes are likely to result in the rise of age-related chronic diseases which largely contribute to years lived with a disability and future dependence. However dependence is much less studied although intrinsically linked to disability. We investigated the prevalence and correlates of dependence among older people from middle income countries. A one-phase cross-sectional survey was carried out at 11 sites in seven countries (urban sites in Cuba, Venezuela, and Dominican Republic, urban and rural sites in Peru, Mexico, China and India). All those aged 65 years and over living in geographically defined catchment areas were eligible. In all, 15,022 interviews were completed with an informant interview for each participant. The full 10/66 Dementia Research Group survey protocol was applied, including ascertainment of depression, dementia, physical impairments and self-reported diagnoses. Dependence was interviewer-rated based on a key informant's responses to a set of open-ended questions on the participant's needs for care. We estimated the prevalence of dependence and the independent contribution of underlying health conditions. Site-specific prevalence ratios were meta-analysed, and population attributable prevalence fractions (PAPF) calculated. The prevalence of dependence increased with age at all sites, with a tendency for the prevalence to be lower in men than in women. Age-standardised prevalence was lower in all sites than in the USA. Other than in rural China, dementia made the largest independent contribution to dependence, with a median PAPF of 34% (range 23%-59%). Other substantial contributors were limb impairment (9%, 1%-46%), stroke (8%, 2%-17%), and depression (8%, 1%-27%). The demographic and health transitions will lead to large and rapid increases in the numbers of dependent older people particularly in middle income countries (MIC). The prevention and control of

  10. "The contribution of chronic diseases to the prevalence of dependence among older people in Latin America, China and India: a 10/66 Dementia Research Group population-based survey"

    2010-01-01

    Background The number of older people is set to increase dramatically worldwide. Demographic changes are likely to result in the rise of age-related chronic diseases which largely contribute to years lived with a disability and future dependence. However dependence is much less studied although intrinsically linked to disability. We investigated the prevalence and correlates of dependence among older people from middle income countries. Methods A one-phase cross-sectional survey was carried out at 11 sites in seven countries (urban sites in Cuba, Venezuela, and Dominican Republic, urban and rural sites in Peru, Mexico, China and India). All those aged 65 years and over living in geographically defined catchment areas were eligible. In all, 15,022 interviews were completed with an informant interview for each participant. The full 10/66 Dementia Research Group survey protocol was applied, including ascertainment of depression, dementia, physical impairments and self-reported diagnoses. Dependence was interviewer-rated based on a key informant's responses to a set of open-ended questions on the participant's needs for care. We estimated the prevalence of dependence and the independent contribution of underlying health conditions. Site-specific prevalence ratios were meta-analysed, and population attributable prevalence fractions (PAPF) calculated. Results The prevalence of dependence increased with age at all sites, with a tendency for the prevalence to be lower in men than in women. Age-standardised prevalence was lower in all sites than in the USA. Other than in rural China, dementia made the largest independent contribution to dependence, with a median PAPF of 34% (range 23%-59%). Other substantial contributors were limb impairment (9%, 1%-46%), stroke (8%, 2%-17%), and depression (8%, 1%-27%). Conclusion The demographic and health transitions will lead to large and rapid increases in the numbers of dependent older people particularly in middle income countries

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

    Doiron, Dany; Burton, Paul; Marcon, Yannick; Gaye, Amadou; Wolffenbuttel, Bruce H R; Perola, Markus; Stolk, Ronald P; Foco, Luisa; Minelli, Cosetta; Waldenberger, Melanie; Holle, Rolf; Kvaløy, Kirsti; Hillege, Hans L; Tassé, Anne-Marie; Ferretti, Vincent; Fortier, Isabel

    2013-01-01

    ABSTRACTS BACKGROUND: Individual-level data pooling of large population-based studies across research centres in international research projects faces many hurdles. The BioSHaRE (Biobank Standardisation and Harmonisation for Research Excellence in the European Union) project aims to address these

  12. Assessment of military population-based psychological resilience programs.

    Morgan, Brenda J; Bibb, Sandra C Garmon

    2011-09-01

    Active duty service members' (ADSMs) seemingly poor adaptability to traumatic stressors is a risk to force health. Enhancing the psychological resilience of ADSMs has become a key focus of Department of Defense (DoD) leaders and the numbers of military programs for enhancing psychological resilience have increased. The purpose of this article is to describe the results of an assessment conducted to determine comprehensiveness of current psychological resilience building programs that target ADSMs. A modified six-step, population-based needs assessment was used to evaluate resilience programs designed to meet the psychological needs of the ADSM population. The assessment results revealed a gap in published literature regarding program outcomes. DoD leaders may benefit from targeted predictive research that assesses program effectiveness outcomes. The necessity of including preventive, evidence-based interventions in new programs, such as positive emotion interventions shown to enhance psychological resilience in civilian samples, is also recommended.

  13. Febrile seizures: a population-based study

    Juliane S. Dalbem

    2015-11-01

    Full Text Available Objectives: To determine the prevalence of benign febrile seizures of childhood and describe the clinical and epidemiological profile of this population. Methods: This was a population-based, cross-sectional study, carried out in the city of Barra do Bugres, MT, Brazil, from August 2012 to August 2013. Data were collected in two phases. In the first phase, a questionnaire that was previously validated in another Brazilian study was used to identify suspected cases of seizures. In the second phase, a neurological evaluation was performed to confirm diagnosis. Results: The prevalence was 6.4/1000 inhabitants (95% CI: 3.8–10.1. There was no difference between genders. Simple febrile seizures were found in 88.8% of cases. A family history of febrile seizures in first-degree relatives and history of epilepsy was present in 33.3% and 11.1% of patients, respectively. Conclusions: The prevalence of febrile seizures in Midwestern Brazil was lower than that found in other Brazilian regions, probably due to the inclusion only of febrile seizures with motor manifestations and differences in socioeconomic factors among the evaluated areas. Resumo: Objetivos: Estabelecer a prevalência das crises febris e descrever o perfil clínico e epidemiológico dessa população. Métodos: Estudo transversal de base populacional realizado na cidade de Barra do Bugres (MT, no período de agosto de 2012 a agosto de 2013. Os dados foram coletados em duas etapas. Na primeira fase utilizamos um questionário validado previamente em outro estudo brasileiro, para identificação de casos suspeitos de crises epilépticas. Na segunda etapa realizamos a avaliação neuroclínica para confirmação diagnóstica. Resultados: A prevalência de crise febril foi de 6,4/1000 habitantes (IC95% 3,8; 10,1. Não houve diferença entre os sexos. As crises febris simples foram encontradas em 88,8% dos casos. A história familiar de crise febril e epilepsia em parentes de 1° grau esteve

  14. Interleaver Optimization using Population-Based Metaheuristics

    Snášel, V.; Platoš, J.; Krömer, P.; Abraham, A.; Ouddane, N.; Húsek, Dušan

    2010-01-01

    Roč. 20, č. 5 (2010), s. 591-608 ISSN 1210-0552 R&D Projects: GA ČR GA205/09/1079 Grant - others:GA ČR(CZ) GA102/09/1494 Institutional research plan: CEZ:AV0Z10300504 Keywords : turbo codes * global optimization * genetic algorithms * differential evolution * noisy communication channel Subject RIV: IN - Informatics, Computer Science Impact factor: 0.511, year: 2010

  15. Research

    abp

    2014-01-31

    Jan 31, 2014 ... by Hazarika in a population-based study in India. The researcher noted that patients' preference to the private health facilities was due mainly to their dissatisfaction with the services in the public health facilities [11]. Furthermore, the quality of the services in the private health facilities could also be a major ...

  16. Final Report. Research in Theoretical High Energy Physics

    Greensite, Jeffrey P. [San Francisco State Univ., CA (United States); Golterman, Maarten F.L. [San Francisco State Univ., CA (United States)

    2015-04-30

    Grant-supported research in theoretical high-energy physics, conducted in the period 1992-2015 is briefly described, and a full listing of published articles result from those research activities is supplied.

  17. Interim Feed The Future Population Based Assessment of Cambodia

    US Agency for International Development — This is the interim population based survey of Feed the Future in Cambodia for 2015. The data is split into survey modules. Modules A through C includes location...

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

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

    2012-01-01

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

  19. Falls and Depression in Men: A Population-Based Study.

    Stuart, Amanda L; Pasco, Julie A; Jacka, Felice N; Berk, Michael; Williams, Lana J

    2018-01-01

    The link between falls and depression has been researched in the elderly; however, little information is available on this association in younger adults, particularly men. This study sought to investigate the link between major depressive disorder (MDD) and falls in a population-based sample of 952 men (24-97 years). MDD was diagnosed utilizing the Structured Clinical Interview for DSM-IV-TR Research Version, Non-Patient edition, and categorized as 12-month/past/never. Body mass index and gait were measured; falls, smoking status, psychotropic medication use, and alcohol intake were self-reported as part of the Geelong Osteoporosis Study 5-year follow-up assessment. Thirty-four (3.6%) men met criteria for 12-month MDD, and 110 (11.6%) for past MDD. Of the 952 men, 175 (18.4%) reported falling at least once during the past 12 months. Fallers were older (66 [interquartile range: 48-79] vs. 59 [45-72] years, p = .001) and more likely to have uneven gait ( n = 16, 10% vs. n = 31, 4%, p = .003) than nonfallers. Participants with 12-month MDD had more than twice the odds of falling (age-adjusted odds ratio: 2.22, 95% confidence interval [1.03, 4.80]). The odds of falling were not associated with past depression ( p = .4). Further adjustments for psychotropic drug use, gait, body mass index, smoking status, blood pressure, and alcohol did not explain these associations. Given the 2.2-fold greater likelihood of falling associated with depression was not explained by age or psychotropic drug use, further research is warranted.

  20. Perinatal characteristics and breast cancer risk in daughters: a Scandinavian population-based study

    Troisi, R.; Grotmol, T.; Jacobsen, J.; Tretli, S.; Toft-Sørensen, H.; Gissler, M.; Kaaja, R.; Potischman, N.; Ekbom, A.; N. Hoover, R.; Stephansson, O.

    2013-01-01

    The in utero origins of breast cancer are an increasing focus of research. However, the long time period between exposure and disease diagnosis, and the lack of standardized perinatal data collection makes this research challenging. We assessed perinatal factors, as proxies for in utero exposures, and breast cancer risk using pooled, population-based birth and cancer registry data. Birth registries provided information on perinatal exposures. Cases were females born in Norway, Sweden or Denma...

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

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

    2013-11-01

    Young adults' Ecstasy use trajectories have important implications for individual and population-level consequences of Ecstasy use, but little relevant research has been conducted. This study prospectively examines Ecstasy trajectories in a population-based sample. Data are from the Natural History Study of Drug Use, a retrospective/prospective cohort study conducted in Australia. Population screening identified a probability sample of Ecstasy users aged 19-23 years. Complete data for 30 months of follow-up, comprising 4 time intervals, were available for 297 participants (88.4% of sample). Trajectories were derived using cluster analysis based on recent Ecstasy use at each interval. Trajectory predictors were examined using a generalized ordered logit model and included Ecstasy dependence (World Mental Health Composite International Diagnostic Instrument), psychological distress (Hospital Anxiety Depression Scale), aggression (Young Adult Self Report) and contextual factors (e.g. attendance at electronic/dance music events). Three Ecstasy trajectories were identified (low, intermediate and high use). At its peak, the high-use trajectory involved 1-2 days Ecstasy use per week. Decreasing frequency of use was observed for intermediate and high-use trajectories from 12 months, independently of market factors. Intermediate and high-use trajectory membership was predicted by past Ecstasy consumption (>70 pills) and attendance at electronic/dance music events. High-use trajectory members were unlikely to have used Ecstasy for more than 3 years and tended to report consistently positive subjective effects at baseline. Given the social context and temporal course of Ecstasy use, Ecstasy trajectories might be better understood in terms of instrumental rather than addictive drug use patterns. © 2013 Elsevier Ltd. All rights reserved.

  2. Hepatoblastoma incidence in Taiwan: A population-based study

    Giun-Yi Hung

    2018-06-01

    Full Text Available Background: The incidence of hepatoblastoma is not well known in Taiwan. The goal of this study was to investigate the incidence rates of hepatoblastoma by age and sex. Methods: The data of patients with hepatoblastoma diagnosed from 1995 to 2012 were obtained from the population-based Taiwan Cancer Registry. Incidence rates of hepatoblastoma according to sex and age were analyzed. This study employed the published methods of International Agency for Research on Cancer to calculate the age-standardized incidence rates (ASIRs, standard errors, 95% confidence intervals (CIs, and standardized incidence rate ratios (SIRRs. Results: In total, 211 patients were diagnosed with hepatoblastoma during the 18-year study period. The ASIR was 0.76 per million person-years. Hepatoblastoma was predominantly diagnosed in children (n = 184, 87.2%. By contrast, adolescents/adults (n = 10, 4.7% and elderly people (n = 17, 8.1% were rarely affected. The incidence peaked at ages 0–4 years with corresponding ASIR of 7.3 per million person-years. A significant male predilection was only found in children and elderly people, with male-to-female SIRRs of 1.23 and 1.89, respectively. During 1995–2012, the overall incidence of hepatoblastoma significantly increased only in children (annual percent change: 7.4%, 95% CI 3.9%–11.1%, p < 0.05 and specifically in boys (annual percent change: 6.5%, 95% CI 1.9%–11.2%, p < 0.05. Conclusion: Only 27 patients aged ≥ 15 years with hepatoblastoma were identified in this study, the existence of adult hepatoblastoma still requires novel molecular tools to elucidate. The association between the upward trend of hepatoblastoma incidence in boys and increased survival of prematurity in Taiwan warrants further investigations. Keywords: Hepatoblastoma, Incidence, Taiwan

  3. Nationwide and population-based prescription patterns in bipolar disorder

    Kessing, Lars Vedel; Vradi, Eleni; Andersen, Per Kragh

    2016-01-01

    OBJECTIVES: The aim of the present study was to describe prescription patterns and changes in these patterns over the last decade for patients diagnosed with bipolar disorder in mental healthcare, using population-based and nationwide data, and to relate the findings to recommendations from...... international guidelines. METHODS: A population-based, nationwide study was carried out. It included register-based longitudinal data on all patients with a first-ever contact with mental healthcare with a diagnosis of mania/bipolar disorder from the entire Danish population, and all prescription data...

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

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

    BACKGROUND: Although the effectiveness of influenza vaccination in high-risk groups has been proven, vaccine coverage continues to be less than 50% in The Netherlands. To improve vaccination rates, data on the organizational factors, which should be targeted in population-based prevention of

  5. Economic costs of minor depression: a population-based study.

    Cuijpers, P.; Smit, H.F.E.; Oostenbrink, J.; de Graaf, R.; ten Have, M.; Beekman, A.T.F.

    2007-01-01

    Objective: Although the clinical relevance of minor depression has been demonstrated in many studies, the economic costs are not well explored. In this study, we examine the economic costs of minor depression. Method: In a large-scale, population-based study in the Netherlands (n = 5504) the costs

  6. Economic costs of minor depression: a population-based study

    Cuijpers, P.; Smit, H.F.E.; Oostenbrink, J.; Graaf, de R.; Have, M. ten; Beekman, A.T.F.

    2006-01-01

    Objective: Although the clinical relevance of minor depression has been demonstrated in many studies, the economic costs are not well explored. In this study, we examine the economic costs of minor depression. Method: In a large-scale, population-based study in the Netherlands (n ¼ 5504) the costs

  7. Economic costs of minor depression: a population-based study

    Cuijpers, P.; Smit, H.F.E.; Oostenbrink, J.; de Graaf, R.; ten Have, M.; Beekman, A.T.F.

    2006-01-01

    Objective: Although the clinical relevance of minor depression has been demonstrated in many studies, the economic costs are not well explored. In this study, we examine the economic costs of minor depression. Method: In a large-scale, population-based study in the Netherlands (n = 5504) the costs

  8. Economic costs of social phobia: a population-based study.

    Acarturk, C.; Smit, H.F.E.; de Graaf, R.; van Straten, A.; ten Have, M.; Cuijpers, P.

    2009-01-01

    Background: Information about the economic costs of social phobia is scant. In this study, we examine the economic costs of social phobia and subthreshold social phobia. Methods: Data were derived from the Netherlands Mental Health Survey and Incidence Study (NEMESIS) which is a population-based

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

    Lindfors Pirjo L

    2012-11-01

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

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

    2012-01-01

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

  11. Types of Cancer Research

    An infographic from the National Cancer Institute (NCI) describing the four broad categories of cancer research: basic research, clinical research, population-based research, and translational research.

  12. Increased migraine risk in osteoporosis patients: a nationwide population-based study

    Wu, Chieh-Hsin; Zhang, Zi-Hao; Wu, Ming-Kung; Wang, Chiu-Huan; Lu, Ying-Yi; Lin, Chih-Lung

    2016-01-01

    Background Osteoporosis and migraine are both important public health problems and may have overlapping pathophysiological mechanisms. The aim of this study was to use a Taiwanese population-based dataset to assess migraine risk in osteoporosis patients. Methods The Taiwan National Health Insurance Research Database was used to analyse data for 40,672 patients aged ?20?years who had been diagnosed with osteoporosis during 1996?2010. An additional 40,672 age-matched patients without osteoporos...

  13. Population-based study of Hodgkin's lymphoma in Kuwait.

    Alshemmari, S; Sajnani, K P; Refaat, S; Albassami, A

    2011-01-01

    Hodgkin lymphoma (HL) comprises about 25% of all malignant nodal lymphomas worldwide. Incidence of HL has been increasing in many countries around the world, in the western countries in particular. Cancer incidence variations in different ethnic groups in the same country can lead to some important information about the search of etiological factors. Some researchers found an association between ethnicity and increased risk of HL. In this study, we evaluated the epidemiologic and clinical characteristics of patients with HL and the HL subtypes in Kuwait who were diagnosed between 1998 and 2006 and we analyzed the changes in the incidence of HL over time based on age, sex, and ethnicity. The Kuwait Cancer Control Center is a tertiary referral hospital and the only cancer hospital in the entire state of Kuwait. We identified 293 patients who were newly diagnosed with HL by histopathology between January 1, 1998, and December 31, 2006, at the Kuwait Cancer Control Center. Incidence data were crossvalidated with the population-based Cancer Registry of Kuwait. Clinical data were obtained by reviewing the patients' medical records. The median age at diagnosis was 39 years (range, 10-85 years) for patients with cHL and 36 years (range, 14-51 years) for patients with NLPHL. The age-adjusted incidence rate was 2.1 cases (range, 1.2-2.9) per 100,000 people per year in the period between 1998 and 2006. NLPHL and cHL were predominant in men with a male to female ratio of 2:1. However, the mean annual percentage change in HL incidence among Kuwaiti patients and non-Kuwaiti patients per year showed unexplained higher percentage in females both Kuwaiti and non-Kuwaiti. cHL comprised 92.5% of all HL cases and NLPHL comprised 7.5%. Nodular sclerosis was the predominant histologic subtype of cHL (58.9%), whereas mixed cellularity was the second most frequent histologic subtype of cHL, (25.9%). Although the incidence of HL was slightly lower in Kuwait than the worldwide incidence; it

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

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

    2008-01-01

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

  15. A Population-Based Clinical Trial of Irinotecan and Carboplatin

    Derick Lau

    2009-01-01

    Full Text Available Purpose. Phase I trials of anticancer drugs are commonly conducted using the method of modified Fibonacci. We have developed a population-based design for phase I trials of combining anticancer drugs such as irinotecan and carboplatin. Patients and Methods. Intrapatient dose escalation of irinotecan and carboplatin was performed according to a predetermined schema to reach individual dose-limiting toxicity (DLT in 50 patients with solid tumors refractory to previous chemotherapy. The individual toxicity-limiting dose levels were analyzed for normal distribution using the method of Ryan-Joiner and subsequently used to determine a population-based maximum tolerated dose (pMTD. For comparison, a simulation study was performed using the method of modified Fibonacci. Results. The most common dose-limiting toxicities (DLTs included neutropenia (58%, thrombocytopenia (16%, and diarrhea (8%. The frequency of individual toxicity-limiting dose levels of 50 patients approximated a normal distribution. The dose levels associated with individual limiting toxicities ranged from level 1 (irinotecan 100 mg/m2 and carboplatin AUC = 4 mg/mL x min to level 8 (irinotecan 350 mg/m2 and carboplatin AUC = 6. The pMTD was determined to be dose level 3 (150 mg/m2 for irinotecan and AUC = 5 for carboplatin. In contrast, the MTD was determined to be dose level 4 (200 mg/m2 for irinotecan and AUC 5 for carboplatin by modified-Fibonacci simulation. Conclusions. The population-based design of phase I trial allows optimization of dose intensity and derivation of a pMTD. The pMTD has been applied in phase II trial of irinotecan and carboplatin in patients with small-cell lung cancer.

  16. Population-based strategies to control manufacturing epidemics.

    Gorini, Giuseppe

    2017-01-01

    "The multinational corporations producing tobacco, alcohol, soft drinks, and processed foods have a role of vectors in the increase of chronic diseases, so that one can speak of manufacturing epidemics. The main aim of this paper is to conduct a literature review on different approaches in population-based interventions to stem the rise in consumption of unhealthy products. Different approaches were found: • command-and-control regulations: the route is definitely more advanced for tobacco with the implementation of an international treaty, which requires 180 ratifying states to implement a series of tobacco control policies. Similar regulations have been partially adopted to reduce alcohol use and to increase taxes of sugar-sweetened beverages; • multinational corporations in few Countries can voluntarily adopt recommendations on media campaigns and on labelling of soft drinks and processed foods; • in order to reduce salt in foods, many Countries developed voluntary agreements with industries with monitoring systems to assess compliance. Population-based interventions to try to align the interests of multinational corporations with those of public health are described in literature: • the "Health Footprint" programme; • the performance-based regulation which could oblige industry to take responsibility to reduce the harmful consequences of the use of their unhealthy commodities; • the price-cap regulation, usually applied to the utilities sector, would set a cap on the price of the tobacco industry, raising the tobacco taxes by 500 million euros per year. In order to reduce the burden of chronic disease, one of the objectives of the Italian National Prevention Plan, a working group including non-governmental organizations and experts in communication, social marketing, and lifestyles should be organized by the Ministry of Health in order to identify which population-based interventions could be implemented in Italy in next years to stem the rise of

  17. Progression to impaired glucose regulation and diabetes in the population-based Inter99 study

    Engberg, Susanne; Vistisen, Dorte; Lau, Cathrine

    2009-01-01

    Objective: To estimate the progression rates to impaired glucose regulation (impaired fasting glucose or impaired glucose tolerance) and diabetes in the Danish population-based Inter99 study and in a high-risk subpopulation, separately. Research Design and Methods: From a population-based primary...... glucose regulation using the current World Health Organization classification criteria were calculated for the first time in a large European population-based study. The progression rates to diabetes show the same pattern as seen in the few similar European studies....... prevention study, the Inter99 study, 4,615 individuals without diabetes at baseline and with relevant follow-up data were divided into a low- and a high-risk group based on a risk estimate of ischemic heart disease or the presence of risk factors (smoking, hypertension, hypercholesterolemia, obesity...... estimated directly from baseline to 5-year follow-up for all the participants, and from baseline through 1- and 3-, to 5-year follow-up for the high-risk individuals, separately. Results: In the combined low- and high-risk group, 2.1 per 100 person-years progressed from normal glucose tolerance to impaired...

  18. Definitions of medication-overuse headache in population-based studies and their implications on prevalence estimates

    Westergaard, Maria L; Hansen, Ebba Holme; Glümer, Charlotte

    2014-01-01

    Case definitions of medication-overuse headache (MOH) in population-based research have changed over time. This study aims to review MOH prevalence reports with respect to these changes, and to propose a practical case definition for future studies based on the ICHD-3 beta....

  19. Childhood blindness in India: a population based perspective

    Dandona, R; Dandona, L

    2003-01-01

    Aim: To estimate the prevalence and causes of blindness in children in the southern Indian state of Andhra Pradesh. Methods: These data were obtained as part of two population based studies in which 6935 children ≤15 years of age participated. Blindness was defined as presenting distance visual acuity <6/60 in the better eye. Results: The prevalence of childhood blindness was 0.17% (95% confidence interval 0.09 to 0.30). Treatable refractive error caused 33.3% of the blindness, followed by 16.6% due to preventable causes (8.3% each due to vitamin A deficiency and amblyopia after cataract surgery). The major causes of the remaining blindness included congenital eye anomalies (16.7%) and retinal degeneration (16.7%). Conclusion: In the context of Vision 2020, the priorities for action to reduce childhood blindness in India are refractive error, cataract related amblyopia, and corneal diseases. PMID:12598433

  20. A population-based prospective study of optic neuritis

    Soelberg, K; Jarius, S; Skejoe, Hanne Pernille Bro

    2017-01-01

    BACKGROUND: Optic neuritis (ON) is often associated with multiple sclerosis (MS). Early diagnosis is critical to optimal patient management. OBJECTIVE: To estimate the incidence of acute ON and the rates of conversion to MS and antibody-mediated ON. METHOD: Population-based prospective study......-specific incidence was 3.28 (2.44-4.31) per 100,000 person years, 2.02 for men and 4.57 for women. At follow-up, 20 patients met the diagnostic criteria for MS, MRI lesions disseminated in space and time in 17/20 patients. AQP4-IgG was detected in none, MOG-IgG was detected in two patients. CONCLUSION...

  1. Scleroderma prevalence: demographic variations in a population-based sample.

    Bernatsky, S; Joseph, L; Pineau, C A; Belisle, P; Hudson, M; Clarke, A E

    2009-03-15

    To estimate the prevalence of systemic sclerosis (SSc) using population-based administrative data, and to assess the sensitivity of case ascertainment approaches. We ascertained SSc cases from Quebec physician billing and hospitalization databases (covering approximately 7.5 million individuals). Three case definition algorithms were compared, and statistical methods accounting for imperfect case ascertainment were used to estimate SSc prevalence and case ascertainment sensitivity. A hierarchical Bayesian latent class regression model that accounted for possible between-test dependence conditional on disease status estimated the effect of patient characteristics on SSc prevalence and the sensitivity of the 3 ascertainment algorithms. Accounting for error inherent in both the billing and the hospitalization data, we estimated SSc prevalence in 2003 at 74.4 cases per 100,000 women (95% credible interval [95% CrI] 69.3-79.7) and 13.3 cases per 100,000 men (95% CrI 11.1-16.1). Prevalence was higher for older individuals, particularly in urban women (161.2 cases per 100,000, 95% CrI 148.6-175.0). Prevalence was lowest in young men (in rural areas, as low as 2.8 cases per 100,000, 95% CrI 1.4-4.8). In general, no single algorithm was very sensitive, with point estimates for sensitivity ranging from 20-73%. We found marked differences in SSc prevalence according to age, sex, and region. In general, no single case ascertainment approach was very sensitive for SSc. Therefore, using data from multiple sources, with adjustment for the imperfect nature of each, is an important strategy in population-based studies of SSc and similar conditions.

  2. Population-Based Analysis of Histologically Confirmed Melanocytic Proliferations Using Natural Language Processing.

    Lott, Jason P; Boudreau, Denise M; Barnhill, Ray L; Weinstock, Martin A; Knopp, Eleanor; Piepkorn, Michael W; Elder, David E; Knezevich, Steven R; Baer, Andrew; Tosteson, Anna N A; Elmore, Joann G

    2018-01-01

    Population-based information on the distribution of histologic diagnoses associated with skin biopsies is unknown. Electronic medical records (EMRs) enable automated extraction of pathology report data to improve our epidemiologic understanding of skin biopsy outcomes, specifically those of melanocytic origin. To determine population-based frequencies and distribution of histologically confirmed melanocytic lesions. A natural language processing (NLP)-based analysis of EMR pathology reports of adult patients who underwent skin biopsies at a large integrated health care delivery system in the US Pacific Northwest from January 1, 2007, through December 31, 2012. Skin biopsy procedure. The primary outcome was histopathologic diagnosis, obtained using an NLP-based system to process EMR pathology reports. We determined the percentage of diagnoses classified as melanocytic vs nonmelanocytic lesions. Diagnoses classified as melanocytic were further subclassified using the Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis (MPATH-Dx) reporting schema into the following categories: class I (nevi and other benign proliferations such as mildly dysplastic lesions typically requiring no further treatment), class II (moderately dysplastic and other low-risk lesions that may merit narrow reexcision with skin biopsies, performed on 47 529 patients, were examined. Nearly 1 in 4 skin biopsies were of melanocytic lesions (23%; n = 18 715), which were distributed according to MPATH-Dx categories as follows: class I, 83.1% (n = 15 558); class II, 8.3% (n = 1548); class III, 4.5% (n = 842); class IV, 2.2% (n = 405); and class V, 1.9% (n = 362). Approximately one-quarter of skin biopsies resulted in diagnoses of melanocytic proliferations. These data provide the first population-based estimates across the spectrum of melanocytic lesions ranging from benign through dysplastic to malignant. These results may serve as a foundation for future

  3. Unilateral Vocal Fold Paralysis and Risk of Pneumonia: A Nationwide Population-Based Cohort Study.

    Tsai, Ming-Shao; Yang, Yao-Hsu; Liu, Chia-Yen; Lin, Meng-Hung; Chang, Geng-He; Tsai, Yao-Te; Li, Hsueh-Yu; Tsai, Ying-Huang; Hsu, Cheng-Ming

    2018-05-01

    Objective To investigate pneumonia risk among patients with unilateral vocal fold paralysis (UVFP). Study Design Retrospective population-based cohort study. Setting This study used data from the National Health Insurance Research Database of Taiwan, a nationwide population-based database. Subjects and Methods A total of 419 patients newly diagnosed with UVFP between January 1, 1997, and December 31, 2013, were identified from the Longitudinal Health Insurance Database 2000, a nationally representative database of 1 million randomly selected patients. Moreover, 1676 patients without UVFP were matched to patients with UVFP at a 1:4 ratio based on age, sex, socioeconomic status, urbanization level, and site-specific cancers. Patients were followed up until death or the end of the study period (December 31, 2013). The primary outcome was the occurrence of pneumonia. Results The cumulative incidence of pneumonia was significantly higher for patients with UVFP than those without UFVP ( P < .001). The adjusted Cox proportional hazard model showed that UVFP was significantly associated with a higher incidence of pneumonia (hazard ratio, 1.97; 95% CI, 1.35-2.86; P < .001). Subgroup analyses demonstrated that UVFP was an independent risk factor of pneumonia for 4 subgroups: young (18-50 years), older (≥51 years), male, and cancer. Conclusion This is the first nationwide population-based cohort study to investigate the association between UVFP and pneumonia. The findings indicate that UVFP is an independent risk factor of pneumonia. Given the study results, physicians should be aware of the potential for pneumonia occurrence following UVFP.

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

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

    2015-09-01

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

  5. Economic costs of social phobia: a population-based study.

    Acarturk, C; Smit, Filip; de Graaf, R; van Straten, A; Ten Have, M; Cuijpers, P

    2009-06-01

    Information about the economic costs of social phobia is scant. In this study, we examine the economic costs of social phobia and subthreshold social phobia. Data were derived from the Netherlands Mental Health Survey and Incidence Study (NEMESIS) which is a population-based prospective study (n=4,789). Costs related to health service uptake, patients' out-of-pocket expenses, and costs arising from production losses were calculated for the reference year 2003. The costs for people with social phobia were compared with the costs for people with no mental disorder. The annual per capita total costs of social phobia were euro 11,952 (95% CI=7,891-16,013) which is significantly higher than the total costs for people with no mental disorder, euro 2957 (95% CI=2690-3224). When adjusting for mental and somatic co-morbidity, the costs decreased to euro 6,100 (95% CI=2681-9519), or 136 million euro per year per 1 million inhabitants, which was still significantly higher than the costs for people with no mental disorder. The costs of subthreshold social phobia were also significantly higher than the costs for people without any mental disorder, at euro 4,687 (95% CI=2557-6816). The costs presented here are conservative lower estimates because we only included costs related to mental health services. The economic costs associated with social phobia are substantial, and those of subthreshold social phobia approach those of the full-blown disorder.

  6. Population-based absolute risk estimation with survey data

    Kovalchik, Stephanie A.; Pfeiffer, Ruth M.

    2013-01-01

    Absolute risk is the probability that a cause-specific event occurs in a given time interval in the presence of competing events. We present methods to estimate population-based absolute risk from a complex survey cohort that can accommodate multiple exposure-specific competing risks. The hazard function for each event type consists of an individualized relative risk multiplied by a baseline hazard function, which is modeled nonparametrically or parametrically with a piecewise exponential model. An influence method is used to derive a Taylor-linearized variance estimate for the absolute risk estimates. We introduce novel measures of the cause-specific influences that can guide modeling choices for the competing event components of the model. To illustrate our methodology, we build and validate cause-specific absolute risk models for cardiovascular and cancer deaths using data from the National Health and Nutrition Examination Survey. Our applications demonstrate the usefulness of survey-based risk prediction models for predicting health outcomes and quantifying the potential impact of disease prevention programs at the population level. PMID:23686614

  7. Population-Based Study of Trachoma in Guatemala.

    Silva, Juan Carlos; Diaz, Marco Antonio; Maul, Eugenio; Munoz, Beatriz E; West, Sheila K

    2015-01-01

    A prevalence survey for active trachoma in children aged under 10 years and trichiasis in women aged 40 years and older was carried out in four districts in the Sololá region in Guatemala, which is suspected of still having a trachoma problem. Population-based surveys were undertaken in three districts, within 15 randomly selected communities in each district. In addition, in a fourth district that borders the third district chosen, we surveyed the small northern sub-district, by randomly selecting three communities in each community, 100 children aged under 10 years were randomly selected, and all females over 40 years. Five survey teams were trained and standardized. Trachoma was graded using the World Health Organization simplified grading scheme and ocular swabs were taken in cases of clinical follicular or inflammatory trachoma. Prevalence estimates were calculated at district and sub-district level. Trachoma rates at district level varied from 0-5.1%. There were only two sub-districts where active trachoma approached 10% (Nahualá Costa, 8.1%, and Santa Catarina Costa, 7.3%). Trichiasis rates in females aged 40 years and older varied from 0-3%. Trachoma was likely a problem in the past. Trachoma is disappearing in the Sololá region in Guatemala. Health leadership may consider further mapping of villages around the areas with an especially high rate of trachoma and infection, and instituting trichiasis surgery and active trachoma intervention where needed.

  8. Calcium intake by adolescents: a population-based health survey.

    de Assumpção, Daniela; Dias, Marcia Regina Messaggi Gomes; de Azevedo Barros, Marilisa Berti; Fisberg, Regina Mara; de Azevedo Barros Filho, Antonio

    2016-01-01

    To analyze calcium intake in adolescents according to sociodemographic variables, health-related behaviors, morbidities, and body mass index. This was a cross-sectional population-based study, with a two-stage cluster sampling that used data from a survey conducted in Campinas, São Paulo, Brazil, between 2008 and 2009. Food intake was assessed using a 24-hour dietary recall. The study included 913 adolescents aged 10-19 years. Average nutrient intake was significantly lower in the segment with lower education of the head of the family and lower per capita family income, in individuals from other cities or states, those who consumed fruit less than four times a week, those who did not drink milk daily, those who were smokers, and those who reported the occurrence of headaches and dizziness. Higher mean calcium intake was found in individuals that slept less than seven hours a day. The prevalence of calcium intake below the recommendation was 88.6% (95% CI: 85.4-91.2). The results alert to an insufficient calcium intake and suggest that certain subgroups of adolescents need specific strategies to increase the intake of this nutrient. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  9. Calcium intake by adolescents: a population-based health survey

    Daniela de Assumpção

    2016-06-01

    Full Text Available Abstract Objective To analyze calcium intake in adolescents according to sociodemographic variables, health-related behaviors, morbidities, and body mass index. Methods This was a cross-sectional population-based study, with a two-stage cluster sampling that used data from a survey conducted in Campinas, São Paulo, Brazil, between 2008 and 2009. Food intake was assessed using a 24-hour dietary recall. The study included 913 adolescents aged 10-19 years. Results Average nutrient intake was significantly lower in the segment with lower education of the head of the family and lower per capita family income, in individuals from other cities or states, those who consumed fruit less than four times a week, those who did not drink milk daily, those who were smokers, and those who reported the occurrence of headaches and dizziness. Higher mean calcium intake was found in individuals that slept less than seven hours a day. The prevalence of calcium intake below the recommendation was 88.6% (95% CI: 85.4-91.2. Conclusion The results alert to an insufficient calcium intake and suggest that certain subgroups of adolescents need specific strategies to increase the intake of this nutrient.

  10. Population-based contracting (population health): part II.

    Jacofsky, D J

    2017-11-01

    Modern healthcare contracting is shifting the responsibility for improving quality, enhancing community health and controlling the total cost of care for patient populations from payers to providers. Population-based contracting involves capitated risk taken across an entire population, such that any included services within the contract are paid for by the risk-bearing entity throughout the term of the agreement. Under such contracts, a risk-bearing entity, which may be a provider group, a hospital or another payer, administers the contract and assumes risk for contractually defined services. These contracts can be structured in various ways, from professional fee capitation to full global per member per month diagnosis-based risk. The entity contracting with the payer must have downstream network contracts to provide the care and facilities that it has agreed to provide. Population health is a very powerful model to reduce waste and costs. It requires a deep understanding of the nuances of such contracting and the appropriate infrastructure to manage both networks and risk. Cite this article: Bone Joint J 2017;99-B:1431-4. ©2017 The British Editorial Society of Bone & Joint Surgery.

  11. Anxiety disorders in young people: a population-based study

    Thaíse Campos Mondin

    2013-12-01

    Full Text Available Objective: To assess the prevalence of anxiety disorders and associated factors in young adults. Methods: Cross-sectional population-based study of individuals between the ages of 18 and 24 years randomly selected from 89 census-based sectors to ensure an adequate sample size. Household selection within the sectors was performed according to a systematic sampling process. Anxiety disorders were assessed using the Mini International Neuropsychiatric Interview (MINI. The final sample comprised 1,560 young adults. Results: Of the participants who were diagnosed with anxiety disorders, 12.3% had agoraphobia, 9.7% had generalised anxiety disorder, 4.0% had social phobia, 3.3% had obsessive-compulsive disorder, 2.5% had panic disorder, and 2.1% had post-traumatic stress disorder; only 23.8% had received any previous treatment. Anxiety disorders were associated with sex, socioeconomic status, psychiatric problems in parents, alcohol abuse, and tobacco use. Conclusions: The identification of factors associated with anxiety disorders in young people enables us to develop intervention strategies. Anxiety disorders are not only highly prevalent but are also associated with significant functional impairment, significant reductions in quality of life, lower productivity, and higher rates of comorbidities.

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

    Anoop Shankar

    2010-07-01

    Full Text Available Anoop Shankar1, Kristine E Lee2, Barbara EK Klein2, Paul Muntner3, Peter C Brazy4, Karen J Cruickshanks2,5, F Javier Nieto5, Lorraine G Danforth2, Carla R Schubert2,5, Michael Y Tsai6, Ronald Klein21Department of Community Medicine, West Virginia University School of Medicine, Morgantown, WV, USA; 2Department of Ophthalmology and Visual Sciences, 4Department of Medicine, 5Department of Population Health Sciences, University of Wisconsin, School of Medicine and Public Health, Madison, WI, USA; 3Department of Community Medicine, Mount Sinai School of Medicine, NY, USA; 6Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USABackground: Glomerular filtration rate (GFR-estimating equations are used to determine the prevalence of chronic kidney disease (CKD in population-based studies. However, it has been suggested that since the commonly used GFR equations were originally developed from samples of patients with CKD, they underestimate GFR in healthy populations. Few studies have made side-by-side comparisons of the effect of various estimating equations on the prevalence estimates of CKD in a general population sample.Patients and methods: We examined a population-based sample comprising adults from Wisconsin (age, 43–86 years; 56% women. We compared the prevalence of CKD, defined as a GFR of <60 mL/min per 1.73 m2 estimated from serum creatinine, by applying various commonly used equations including the modification of diet in renal disease (MDRD equation, Cockcroft–Gault (CG equation, and the Mayo equation. We compared the performance of these equations against the CKD definition of cystatin C >1.23 mg/L.Results: We found that the prevalence of CKD varied widely among different GFR equations. Although the prevalence of CKD was 17.2% with the MDRD equation and 16.5% with the CG equation, it was only 4.8% with the Mayo equation. Only 24% of those identified to have GFR in the range of 50–59 mL/min per 1

  13. Sexuality after a cancer diagnosis: A population-based study.

    Jackson, Sarah E; Wardle, Jane; Steptoe, Andrew; Fisher, Abigail

    2016-12-15

    This study explored differences in sexual activity, function, and concerns between cancer survivors and cancer-free controls in a population-based study. The data were from 2982 men and 3708 women who were 50 years old or older and were participating in the English Longitudinal Study of Ageing. Sexual well-being was assessed with the Sexual Relationships and Activities Questionnaire, and cancer diagnoses were self-reported. There were no differences between cancer survivors and controls in levels of sexual activity (76.0% vs 78.5% for men and 58.2% vs 55.5% for women) or sexual function. Men and women with cancer diagnoses were more dissatisfied with their sex lives than controls (age-adjusted percentages: 30.9% vs 19.8% for men [P = .023] and 18.2% vs 11.8% for women [P = .034]), and women with cancer were more concerned about levels of sexual desire (10.2% vs 7.1%; P = .006). Women diagnosed sexual desire (14.8% vs 7.1%; P = .007) and orgasmic experience (17.6% vs 7.1%; P = .042) than controls, but there were no differences in men. Self-reports of sexual activity and functioning in older people with cancer are broadly comparable to age-matched, cancer-free controls. There is a need to identify the causes of sexual dissatisfaction among long-term cancer survivors despite apparently normal levels of sexual activity and function for their age. The development of interventions addressing low sexual desire and problems with sexual functioning in women is also important and may be particularly relevant for cancer survivors after treatment. Cancer 2016;122:3883-3891. © 2016 American Cancer Society. © 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

  14. [Population-based study of diabetic retinopathy in Wolfsburg].

    Hesse, L; Grüsser, M; Hoffstadt, K; Jörgens, V; Hartmann, P; Kroll, P

    2001-11-01

    Since November 1997 the complete documentation of an ophthalmological examination of diabetics has been annually subsidized by the Volkswagen Corporation Health Maintenance Organization (VW-HMO). The results of an annual ophthalmological examination were recorded in a standardised history sheet developed by the Initiative Group for Early Detection of Diabetic Eye Diseases. These data included visual acuity, intraocular pressure, lens status and a description of fundus abnormalities. Within 26 months ophthalmological examinations of 2,801 patients were completed which represented 4.5% of all VW-HMO insured patients. On average, patients suffered from diabetes for 9.6 years (SD +/- 8.3), artificial intraocular lenses were present in 357 eyes (6.4%) and 1,216 eyes (12.0%) were diagnosed with cataract or posterior capsule opacification impairing visual acuity. Out of 263 patients younger than 40 years old, 18.8% had a mild or moderate and 3.3% a severe non-proliferative diabetic retinopathy (NPDR). A proliferative diabetic retinopathy (PDR) was found in 2.2% of the younger patients. Of 2,228 patients aged 40 years and older, 11.9% had a mild or moderate and 2.6% a severe NPDR. In 0.9% of this group PDR was diagnosed. An annual ophthalmological screening based on a survey sheet of the Initiative Group was successfully introduced. For the first time a population-based evaluation on the prevalence of diabetic retinopathy was carried out for inhabitants of a German city. The prevalence of PDR was found to be lower than previously published in comparable studied.

  15. Predictors of fibromyalgia: a population-based twin cohort study.

    Markkula, Ritva A; Kalso, Eija A; Kaprio, Jaakko A

    2016-01-15

    Fibromyalgia (FM) is a pain syndrome, the mechanisms and predictors of which are still unclear. We have earlier validated a set of FM-symptom questions for detecting possible FM in an epidemiological survey and thereby identified a cluster with "possible FM". This study explores prospectively predictors for membership of that FM-symptom cluster. A population-based sample of 8343 subjects of the older Finnish Twin Cohort replied to health questionnaires in 1975, 1981, and 1990. Their answers to the set of FM-symptom questions in 1990 classified them in three latent classes (LC): LC1 with no or few symptoms, LC2 with some symptoms, and LC3 with many FM symptoms. We analysed putative predictors for these symptom classes using baseline (1975 and 1981) data on regional pain, headache, migraine, sleeping, body mass index (BMI), physical activity, smoking, and zygosity, adjusted for age, gender, and education. Those with a high likelihood of having fibromyalgia at baseline were excluded from the analysis. In the final multivariate regression model, regional pain, sleeping problems, and overweight were all predictors for membership in the class with many FM symptoms. The strongest non-genetic predictor was frequent headache (OR 8.6, CI 95% 3.8-19.2), followed by persistent back pain (OR 4.7, CI 95% 3.3-6.7) and persistent neck pain (OR 3.3, CI 95% 1.8-6.0). Regional pain, frequent headache, and persistent back or neck pain, sleeping problems, and overweight are predictors for having a cluster of symptoms consistent with fibromyalgia.

  16. Sleep apnea and risk of vertigo: A nationwide population-based cohort study.

    Tsai, Ming-Shao; Lee, Li-Ang; Tsai, Yao-Te; Yang, Yao-Hsu; Liu, Chia-Yen; Lin, Meng-Hung; Hsu, Cheng-Ming; Chen, Chin-Kuo; Li, Hsueh-Yu

    2018-03-01

    To investigate the risk of vertigo in patients with sleep apnea. Retrospective cohort study. This study used data from the National Health Insurance Research Database of Taiwan, a population-based database. A total of 5,025 patients who were newly diagnosed with sleep apnea between January 1, 1997, and December 31, 2012, were identified from the Longitudinal Health Insurance Database 2000, a nationally representative database of 1 million randomly selected patients. Moreover, 20,100 patients without sleep apnea were matched at a 1:4 ratio by age, sex, socioeconomic status, and urbanization level. Patients were followed up until death or the end of the study period (December 31, 2013). The primary outcome was the occurrence of vertigo. Patients with sleep apnea had a significantly higher cumulative incidence of vertigo than those without sleep apnea (P vertigo (hazard ratio, 1.71; 95% confidence interval [CI], 1.48-1.97; P diabetes mellitus, hypertension, stroke, and obesity. Sleep apnea was demonstrated to be an independent risk factor for vertigo. This is the first nationwide population-based cohort study to investigate the association between sleep apnea and vertigo. The findings strongly support that sleep apnea is an independent risk factor for vertigo. Based on the study results, physicians should be aware of potential vertigo occurrence following sleep apnea. 4. Laryngoscope, 128:763-768, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  17. Preventable trauma deaths: from panel review to population based-studies

    Vesconi Sergio

    2006-04-01

    Full Text Available Abstract Preventable trauma deaths are defined as deaths which could be avoided if optimal care has been delivered. Studies on preventable trauma deaths have been accomplished initially with panel reviews of pre-hospital and hospital charts. However, several investigators questioned the reliability and validity of this method because of low reproducibility of implicit judgments when they are made by different experts. Nevertheless, number of studies were published all around the world and ultimately gained some credibility, particularly in regions where comparisons were made before and after trauma system implementation with a resultant fall in mortality. During the last decade of century the method of comparing observed survival with probability of survival calculated from large trauma registries has obtained popularity. Preventable trauma deaths were identified as deaths occurred notwithstanding a high calculated probability of survival. In recent years, preventable trauma deaths studies have been replaced by population-based studies, which use databases representative of overall population, therefore with high epidemiologic value. These databases contain readily available information which carry out the advantage of objectivity and large numbers. Nowadays, population-based researches provide the strongest evidence regarding the effectiveness of trauma systems and trauma centers on patient outcomes.

  18. A population-based study of glioblastoma multiforme

    Paszat, Lawrence; Laperriere, Normand; Groome, Patti; Schulze, Karleen; Mackillop, William; Holowaty, Eric

    2001-01-01

    Purpose: To describe (1) the use of surgery and radiotherapy (RT) in the treatment of patients with glioblastoma (GBM) in Ontario, (2) survival, and (3) proportion of survival time spent in the hospital after diagnosis. Methods and Materials: We performed a population-based cohort study of all Ontario Cancer Registry (OCR) cases of GBM diagnosed between 1982 and 1994. We linked OCR records, hospital files containing surgical procedure codes from the Canadian Institute for Health Information, and province-wide RT records. We studied the odds of treatment using multivariate logistic regression. We expressed the time spent in the hospital as the mean number of days per case, and as a proportion of the interval between diagnosis and death, or 24 months following diagnosis, whichever came first. We used the life-table method and Cox proportional hazards regression to describe survival. Results: The proportion of patients with GBM undergoing any surgery directed at the tumor varied with age (p<0.0001) and region of residence (p<0.0001). The proportion undergoing RT varied with age (p<0.0001), region of residence (p<0.0001), and year of diagnosis (p=0.01). RT dose ≥53.5 Gy varied with age (p<0.0001), region of residence (p<0.0001), and year of diagnosis (p=0.0002). Median survival was 11 months among patients receiving RT and 3 months among those not receiving RT. The percentage of survival time spent in the hospital was similar among those who received from 49.5 to <53.5 Gy, compared to ≥53.5 Gy. Overall survival and the adjusted relative risk of death varied with age and region of residence. Conclusion: We observed practice variation in the treatment of patients with GBM according to age, region of residence, and year of diagnosis. Survival did not increase during the study period. The variation in RT dose between those receiving from 49.5 to <53.5 Gy compared to ≥53.5 Gy was not paralleled by variation in survival between regions where one or the other of the

  19. Primary intramedullary spinal cord lymphoma: a population-based study.

    Yang, Wuyang; Garzon-Muvdi, Tomas; Braileanu, Maria; Porras, Jose L; Caplan, Justin M; Rong, Xiaoming; Huang, Judy; Jallo, George I

    2017-03-01

    Primary intramedullary spinal cord lymphoma (PISCL) is a rare diagnosis with poorly understood disease progression. Clarification of the factors associated with survival in PISCL patients is warranted. We conducted a population-based cohort study utilizing prospectively collected data from the Surveillance, Epidemiology, and End Results (SEER) database. Patients with histological diagnosis of primary lymphoma in spinal cord (C72.0) from 1973 to 2012 in the SEER database were included. Multivariable survival analysis between patient, lesion characteristics, and PISCL-related death was performed to adjust for confounding factors. We included 346 PISCL patients in our study. Average age was 56.5 ± 17.8 years, with 62.7% being male. Racial distribution of these patients was white (87.6%), black (8.0%), and other (4.3%). More than half (55.8%) of patients were married. The most prevalent histology of PISCL was diffuse B-cell (46.2%), and the majority (55.2%) were low stage (Ann Arbor stage I/II). Most patients (67.9%) received radiation therapy. Average survival interval of patients with PISCL-related death (n=135, 39.0%) was 27.8 months. General cumulative survival probability at 1 year, 2 years, and 5 years was 73.8%, 67.9%, and 63.1%, respectively. Multivariable accelerated failure time (AFT) regression showed follicular lymphoma (HR:0.25, P=.008) and more recent diagnosis (HR:0.96, P<.001) was positively associated with PISCL-related survival. Conversely, nonwhite race (HR:1.69, P=.046), older age (HR:1.02, P<.001), unmarried status (HR:2.14, P<.001), and higher stage (HR:1.54, P=.022) were negatively associated with survival. Age, race, marital status, tumor histology, tumor stage, and year of diagnosis were associated with survival of PISCL. While most PISCL-related deaths occur within a 1-year period, subsequent slow progression was observed after the first year of survival. © The Author(s) 2016. Published by Oxford University Press on behalf of the Society for

  20. Intergenerational teen pregnancy: a population-based cohort study.

    Liu, Ning; Vigod, Simone N; Farrugia, M Michèle; Urquia, Marcelo L; Ray, Joel G

    2018-05-22

    To estimate the intergenerational association in teenage pregnancy, and whether there is a coupling tendency between a mother and daughter in how their teen pregnancies end, such as an induced abortion (IA) vs. a livebirth. Population-based cohort study. Ontario, Canada. 15,097 mothers and their 16,177 daughters. Generalized estimating equations generated adjusted odds ratios (aOR) of a daughter experiencing a teen pregnancy in relation to the number of teen pregnancies her mother had. Multinomial logistic regression estimated the odds that a teen pregnancy ended with IA among both mother and daughter. All models were adjusted for maternal age and world region of origin, the daughter's socio-demographic characteristics and comorbidities, mother-daughter cohabitation, and neighborhood-level teen pregnancy rate. Teen pregnancy in the daughter, between ages 15-19 years, and also the nature of the daughter's teen pregnancy, categorized as i) no teen pregnancy, ii) at least one teen pregnancy, all exclusively ending with a livebirth, and iii) at least one teen pregnancy, with at least one teen pregnancy ending with an IA. The proportion of daughters having a teen pregnancy among those whose mother had 0, 1, 2, or ≥ 3 teen pregnancies was 16.3%, 24.9%, 33.5% and 36.3%, respectively. The aOR of a daughter having a teen pregnancy was 1.42 (95% CI 1.25-1.61) if her mother had 1, 1.97 (95% CI 1.71-2.26) if she had 2, and 2.17 (95% CI 1.84-2.56) if her mother had ≥ 3 teen pregnancies, relative to none. If a mother had ≥ 1 teen pregnancy ending with IA, then her daughter had an aOR of 2.12 (95% CI 1.76-2.56) for having a teen pregnancy also ending with IA; whereas, if a mother had ≥ 1 teen pregnancy, all ending with a livebirth, then her daughter had an aOR of 1.73 (95% CI 1.46-2.05) for that same outcome. There is a strong intergenerational occurrence of teenage pregnancy between a mother and daughter, including a coupling tendency in how the pregnancy ends. This

  1. Elevated incidence rates of diabetes in Peru: report from PERUDIAB, a national urban population-based longitudinal study

    Seclen, Segundo Nicolas; Rosas, Moises Ernesto; Arias, Arturo Jaime; Medina, Cecilia Alexandra

    2017-01-01

    Objective A recent report from a non-nationally representative, geographically diverse sample in four separate communities in Peru suggests an unusually high diabetes incidence. We aimed to estimate the national diabetes incidence rate using PERUDIAB, a probabilistic, national urban population-based longitudinal study. Research design and methods 662 subjects without diabetes, selected by multistage, cluster, random sampling of households, representing the 24 administrative and the 3 (coast, ...

  2. Familial risk of epilepsy: a population-based study

    Peljto, Anna L.; Barker-Cummings, Christie; Vasoli, Vincent M.; Leibson, Cynthia L.; Hauser, W. Allen; Buchhalter, Jeffrey R.

    2014-01-01

    Almost all previous studies of familial risk of epilepsy have had potentially serious methodological limitations. Our goal was to address these limitations and provide more rigorous estimates of familial risk in a population-based study. We used the unique resources of the Rochester Epidemiology Project to identify all 660 Rochester, Minnesota residents born in 1920 or later with incidence of epilepsy from 1935–94 (probands) and their 2439 first-degree relatives who resided in Olmsted County. We assessed incidence of epilepsy in relatives by comprehensive review of the relatives’ medical records, and estimated age-specific cumulative incidence and standardized incidence ratios for epilepsy in relatives compared with the general population, according to proband and relative characteristics. Among relatives of all probands, cumulative incidence of epilepsy to age 40 was 4.7%, and risk was increased 3.3-fold (95% confidence interval 2.75–5.99) compared with population incidence. Risk was increased to the greatest extent in relatives of probands with idiopathic generalized epilepsies (standardized incidence ratio 6.0) and epilepsies associated with intellectual or motor disability presumed present from birth, which we denoted ‘prenatal/developmental cause’ (standardized incidence ratio 4.3). Among relatives of probands with epilepsy without identified cause (including epilepsies classified as ‘idiopathic’ or ‘unknown cause’), risk was significantly increased for epilepsy of prenatal/developmental cause (standardized incidence ratio 4.1). Similarly, among relatives of probands with prenatal/developmental cause, risk was significantly increased for epilepsies without identified cause (standardized incidence ratio 3.8). In relatives of probands with generalized epilepsy, standardized incidence ratios were 8.3 (95% confidence interval 2.93–15.31) for generalized epilepsy and 2.5 (95% confidence interval 0.92–4.00) for focal epilepsy. In relatives of

  3. Longitudinal population-based studies of affective disorders: Where to from here?

    Beard John R

    2008-09-01

    Full Text Available Abstract Background Longitudinal, population-based, research is important if we are to better characterize the lifetime patterns and determinants of affective disorders. While studies of this type are becoming increasingly prevalent, there has been little discussion about the limitations of the methods commonly used. Methods Discussion paper including a brief review of key prospective population-based studies as the basis for a critical appraisal of current approaches. Results We identified a number of common methodological weaknesses that restrict the potential of longitudinal research to characterize the diversity, prognosis, and determinants of affective disorders over time. Most studies using comprehensive diagnostic instruments have either been of relatively brief duration, or have suffered from long periods between waves. Most etiologic research has focused on first onset diagnoses, although these may be relatively uncommon after early adulthood and the burden of mental disorders falls more heavily on individuals with recurring disorders. Analysis has tended to be based on changes in diagnostic status rather than anges in symptom levels, limiting study power. Diagnoses have generally been treated as homogeneous entities and few studies have explored whether diagnostic subtypes such as atypical depression vary in their etiology or prognosis. Little research has considered whether there are distinct trajectories of symptoms over time and most has focused on individual disorders such as depression, rather than considering the relationship over time between symptoms of different affective disorders. There has also been limited longitudinal research on factors in the physical or social environment that may influence the onset, recurrence or chronicity of symptoms. Conclusion Many important, and in some respects quite basic, questions remain about the trajectory of depression and anxiety disorders over the life course and the factors that

  4. Population-based imaging biobanks as source of big data.

    Gatidis, Sergios; Heber, Sophia D; Storz, Corinna; Bamberg, Fabian

    2017-06-01

    Advances of computational sciences over the last decades have enabled the introduction of novel methodological approaches in biomedical research. Acquiring extensive and comprehensive data about a research subject and subsequently extracting significant information has opened new possibilities in gaining insight into biological and medical processes. This so-called big data approach has recently found entrance into medical imaging and numerous epidemiological studies have been implementing advanced imaging to identify imaging biomarkers that provide information about physiological processes, including normal development and aging but also on the development of pathological disease states. The purpose of this article is to present existing epidemiological imaging studies and to discuss opportunities, methodological and organizational aspects, and challenges that population imaging poses to the field of big data research.

  5. A nationwide population-based study of low vision and blindness in South Korea.

    Park, Shin Hae; Lee, Ji Sung; Heo, Hwan; Suh, Young-Woo; Kim, Seung-Hyun; Lim, Key Hwan; Moon, Nam Ju; Lee, Sung Jin; Park, Song Hee; Baek, Seung-Hee

    2014-12-18

    To investigate the prevalence and associated risk factors of low vision and blindness in the Korean population. This cross-sectional, population-based study examined the ophthalmologic data of 22,135 Koreans aged ≥5 years from the fifth Korea National Health and Nutrition Examination Survey (KNHANES V, 2010-2012). According to the World Health Organization criteria, blindness was defined as visual acuity (VA) less than 20/400 in the better-seeing eye, and low vision as VA of 20/60 or worse but 20/400 or better in the better-seeing eye. The prevalence rates were calculated from either presenting VA (PVA) or best-corrected VA (BCVA). Multivariate regression analysis was conducted for adults aged ≥20 years. The overall prevalence rates of PVA-defined low vision and blindness were 4.98% and 0.26%, respectively, and those of BCVA-defined low vision and blindness were 0.46% and 0.05%, respectively. Prevalence increased rapidly above the age of 70 years. For subjects aged ≥70 years, the population-weighted prevalence rates of low vision, based on PVA and BCVA, were 12.85% and 3.87%, respectively, and the corresponding rates of blindness were 0.49% and 0.42%, respectively. The presenting vision problems were significantly associated with age (younger adults or elderly subjects), female sex, low educational level, and lowest household income, whereas the best-corrected vision problems were associated with age ≥ 70 years, a low educational level, and rural residence. This population-based study provides useful information for planning optimal public eye health care services in South Korea. Copyright 2015 The Association for Research in Vision and Ophthalmology, Inc.

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

    Chieh-Hsin Wu

    Full Text Available The aims of this study were to investigate the risk of hip fracture and contributing factors in patients with erectile dysfunction(ED. This population-based study was performed using the Taiwan National Health Insurance Research Database. The analysis included 4636 patients aged ≥ 40 years who had been diagnosed with ED (International Classification of Diseases, Ninth Revision, Clinical Modification codes 302.72, 607.84 during 1996-2010. The control group included 18,544 randomly selected age-matched patients without ED (1:4 ratio. The association between ED and hip fracture risk was estimated using a Cox proportional hazard regression model. During the follow-up period, 59 (1.27% patients in the ED group and 140 (0.75% patients in the non-ED group developed hip fracture. After adjusting for covariates, the overall incidence of hip fracture was 3.74-times higher in the ED group than in the non-ED group (2.03 vs. 0.50 per 1000 person-years, respectively. The difference in the overall incidence of hip fracture was largest during the 3-year follow-up period (hazard ratio = 7.85; 95% confidence interval = 2.94-20.96; P <0.0001. To the best of our knowledge, this nationwide population-based study is the first to investigate the relationship between ED and subsequent hip fracture in an Asian population. The results showed that ED patients had a higher risk of developing hip fracture. Patients with ED, particularly those aged 40-59 years, should undergo bone mineral density examinations as early as possible and should take measures to reduce the risk of falls.

  7. Osteoporosis-related fracture case definitions for population-based administrative data

    Lix Lisa M

    2012-05-01

    Full Text Available Abstract Background Population-based administrative data have been used to study osteoporosis-related fracture risk factors and outcomes, but there has been limited research about the validity of these data for ascertaining fracture cases. The objectives of this study were to: (a compare fracture incidence estimates from administrative data with estimates from population-based clinically-validated data, and (b test for differences in incidence estimates from multiple administrative data case definitions. Methods Thirty-five case definitions for incident fractures of the hip, wrist, humerus, and clinical vertebrae were constructed using diagnosis codes in hospital data and diagnosis and service codes in physician billing data from Manitoba, Canada. Clinically-validated fractures were identified from the Canadian Multicentre Osteoporosis Study (CaMos. Generalized linear models were used to test for differences in incidence estimates. Results For hip fracture, sex-specific differences were observed in the magnitude of under- and over-ascertainment of administrative data case definitions when compared with CaMos data. The length of the fracture-free period to ascertain incident cases had a variable effect on over-ascertainment across fracture sites, as did the use of imaging, fixation, or repair service codes. Case definitions based on hospital data resulted in under-ascertainment of incident clinical vertebral fractures. There were no significant differences in trend estimates for wrist, humerus, and clinical vertebral case definitions. Conclusions The validity of administrative data for estimating fracture incidence depends on the site and features of the case definition.

  8. Viewing the body after bereavement due to suicide: a population-based survey in Sweden.

    Pernilla Omerov

    Full Text Available BACKGROUND: Research on the assumed, positive and negative, psychological effects of viewing the body after a suicide loss is sparse. We hypothesized that suicide-bereaved parents that viewed their childs body in a formal setting seldom regretted the experience, and that viewing the body was associated with lower levels of psychological morbidity two to five years after the loss. METHODS AND FINDINGS: We identified 915 suicide-bereaved parents by linkage of nationwide population-based registries and collected data by a questionnaire. The outcome measures included the Patient Health Questionnaire (PHQ-9. In total, 666 (73% parents participated. Of the 460 parents (69% that viewed the body, 96% answered that they did not regret the experience. The viewing was associated with a higher risk of reliving the child's death through nightmares (RR 1.61, 95% CI 1.13 to 2.32 and intrusive memories (RR 1.20, 95% CI 1.04 to 1.38, but not with anxiety (RR 1.02, 95% CI 0.74 to 1.40 and depression (RR 1.25, 95% CI 0.85 to 1.83. One limitation of our study is that we lack data on the informants' personality and coping strategies. CONCLUSIONS: In this Swedish population-based survey of suicide-bereaved parents, we found that by and large everyone that had viewed their deceased child in a formal setting did not report regretting the viewing when asked two to five years after the loss. Our findings suggest that most bereaved parents are capable of deciding if they want to view the body or not. Officials may assist by giving careful information about the child's appearance and other details concerning the viewing, thus facilitating mental preparation for the bereaved person. This is the first large-scale study on the effects of viewing the body after a suicide and additional studies are needed before clinical recommendations can be made.

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

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

    2013-10-01

    The aim of the current study was to examine sleep patterns and rates of insomnia in a population-based study of adolescents aged 16-19 years. Gender differences in sleep patterns and insomnia, as well as a comparison of insomnia rates according to DSM-IV, DSM-V and quantitative criteria for insomnia (Behav. Res. Ther., 41, 2003, 427), were explored. We used a large population-based study in Hordaland county in Norway, conducted in 2012. The sample included 10,220 adolescents aged 16-18 years (54% girls). Self-reported sleep measurements included bedtime, rise time, time in bed, sleep duration, sleep efficiency, sleep onset latency, wake after sleep onset, rate and frequency and duration of difficulties initiating and maintaining sleep and rate and frequency of tiredness and sleepiness. The adolescents reported short sleep duration on weekdays (mean 6:25 hours), resulting in a sleep deficiency of about 2 h. A majority of the adolescents (65%) reported sleep onset latency exceeding 30 min. Girls reported longer sleep onset latency and a higher rate of insomnia than boys, while boys reported later bedtimes and a larger weekday-weekend discrepancy on several sleep parameters. Insomnia prevalence rates ranged from a total prevalence of 23.8 (DSM-IV criteria), 18.5 (DSM-V criteria) and 13.6% (quantitative criteria for insomnia). We conclude that short sleep duration, long sleep onset latency and insomnia were prevalent in adolescents. This warrants attention as a public health concern in this age group. © 2013 European Sleep Research Society.

  10. The interrelation between premenstrual syndrome and major depression: Results from a population-based sample

    Weiss Carine

    2011-10-01

    Full Text Available Abstract Background Research about the relationship between premenstrual syndrome (PMS and major depression is limited. This study examined the relationship between moderate to severe PMS and major depression in a population-based sample of women of reproductive age. The objectives of the study were to assess the association between premenstrual syndrome and major depression, to analyse how PMS and major depression differ and to characterise the group of women who report both PMS and major depression. Methods Data were obtained from the Swiss Health Survey 2007. Included in the analysis was data from women under the age of 55 without hysterectomy and who answered the questions on PMS symptoms. The population-based sample consisted of 3518 women. Weighted prevalence rates were calculated and relative risk ratios for PMS, major depression and women who reported both PMS and major depression, were calculated with logistic multinominal logit regression. Results The prevalence of major depression was 11.3% in women screening positive for moderate PMS and 24.6% in women screening positive for severe PMS. Compared to women without any of these conditions, women who reported moderate to severe alcohol consumption had a lower risk for PMS. Women reporting use of antidepressants, and use of oral contraceptives had a higher risk for major depression compared to women without any of these conditions. Women reporting work dissatisfaction had a higher risk for PMS. A higher relative risk to report both PMS and major depression compared to women without PMS or major depression was related to factors such as high psychological distress, low mastery, psychotropic drug consumption, and low self-rated health. Conclusions The results suggested that women who suffer from both PMS and major depression are more impaired compared to women with only one disorder. The results further indicated that PMS and major depression are different disorders that can, however, co-occur.

  11. Sleep in later life: a population-based approach

    J.F. van den Berg (Julia)

    2008-01-01

    textabstractThis dissertation includes six epidemiological studies of sleep in a normal elderly population. The research was conducted within the setting of the Rotterdam Study, a large prospective cohort study of community-dwelling inhabitants of a district of Rotterdam, aged 55 and over. A total

  12. Population-based treatment and outcomes of Stage I uterine serous carcinoma

    Putten, L.J.M. van der; Hoskins, P.; Tinker, A.; Lim, P.; Aquino-Parsons, C.; Kwon, J.S.

    2014-01-01

    OBJECTIVE: Uterine serous carcinoma (USC) is a rare type of endometrial cancer that often recurs in patients with Stage I disease. Our objective was to evaluate treatment and outcomes in Stage I USC in the context of a population-based study. METHODS: This was a population-based retrospective cohort

  13. Cardiovascular Disease Risk in a Large, Population-Based Cohort of Breast Cancer Survivors

    Boekel, Naomi B.; Schaapveld, Michael; Gietema, Jourik A.; Russell, Nicola S.; Poortmans, Philip; Theuws, Jacqueline C. M.; Schinagl, Dominic A. X.; Rietveld, Derek H. F.; Versteegh, Michel I. M.; Visser, Otto; Rutgers, Emiel J. T.; Aleman, Berthe M. P.; van Leeuwen, Flora E.

    2016-01-01

    Purpose: To conduct a large, population-based study on cardiovascular disease (CVD) in breast cancer (BC) survivors treated in 1989 or later. Methods and Materials: A large, population-based cohort comprising 70,230 surgically treated stage I to III BC patients diagnosed before age 75 years between

  14. Crowdfunding for cardiovascular research.

    Krittanawong, Chayakrit; Zhang, HongJu Janet; Aydar, Mehmet; Wang, Zhen; Sun, Tao

    2018-01-01

    The competition for public cardiovascular research grants has recently increased. Independent researchers are facing increasing competition for public research grant support and ultimately may need to seek alternative funding sources. Crowdfunding, a financing method of raising funds online by pooling together small donations from the online community to support a specific initiative, seems to have significant potential. However, the feasibility of crowdfunding for cardiovascular research remains unknown. Here, we performed exploratory data analysis of the feasibility of online crowdfunding in cardiovascular research. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Physical multimorbidity and loneliness: A population-based study.

    Andrew Stickley

    Full Text Available Multimorbidity has been linked to a variety of negative outcomes although as yet, there has been little research on its association with loneliness. This study examined the association between physical multimorbidity (≥ 2 physical diseases and loneliness in the general population and its potential mediators. Data came from the Adult Psychiatric Morbidity Survey 2007 (N = 7403, aged ≥16 years. Information was obtained on 20 doctor diagnosed physical conditions that were present in the previous year. An item from the Social Functioning Questionnaire (SFQ was used to obtain information on loneliness. Multivariable logistic regression analysis was used to examine associations. An increasing number of physical diseases was associated with higher odds for loneliness. Compared to no physical diseases, the odds ratio (OR (95% confidence interval: CI for loneliness increased from 1.34 (1.13-1.59 to 2.82 (2.11-3.78 between one and ≥5 physical diseases. This association was particularly strong in the youngest age group (i.e. 16-44 years. The loneliness-physical multimorbidity association was significantly mediated by stressful life events (% mediated 11.1%-30.5%, anxiety (30.2%, and depression (15.4%. Physical multimorbidity is associated with increased odds for loneliness. Prospective research is now needed to further elucidate this association and the factors that underlie it.

  16. Physical multimorbidity and loneliness: A population-based study.

    Stickley, Andrew; Koyanagi, Ai

    2018-01-01

    Multimorbidity has been linked to a variety of negative outcomes although as yet, there has been little research on its association with loneliness. This study examined the association between physical multimorbidity (≥ 2 physical diseases) and loneliness in the general population and its potential mediators. Data came from the Adult Psychiatric Morbidity Survey 2007 (N = 7403, aged ≥16 years). Information was obtained on 20 doctor diagnosed physical conditions that were present in the previous year. An item from the Social Functioning Questionnaire (SFQ) was used to obtain information on loneliness. Multivariable logistic regression analysis was used to examine associations. An increasing number of physical diseases was associated with higher odds for loneliness. Compared to no physical diseases, the odds ratio (OR) (95% confidence interval: CI) for loneliness increased from 1.34 (1.13-1.59) to 2.82 (2.11-3.78) between one and ≥5 physical diseases. This association was particularly strong in the youngest age group (i.e. 16-44 years). The loneliness-physical multimorbidity association was significantly mediated by stressful life events (% mediated 11.1%-30.5%), anxiety (30.2%), and depression (15.4%). Physical multimorbidity is associated with increased odds for loneliness. Prospective research is now needed to further elucidate this association and the factors that underlie it.

  17. Population-based initiatives in college mental health: students helping students to overcome obstacles.

    Kirsch, Daniel J; Pinder-Amaker, Stephanie L; Morse, Charles; Ellison, Marsha L; Doerfler, Leonard A; Riba, Michelle B

    2014-12-01

    College students' need for mental health care has increased dramatically, leaving campus counseling and mental health centers struggling to meet the demand. This has led to the investigation and development of extra-center, population-based interventions. Student-to-student support programs are but one example. Students themselves are a plentiful, often-untapped resource that extends the reach of mental health services on campus. Student-to-student programs capitalize on students' natural inclination to assist their peers. A brief review of the prevalence and effects of mental disorders in the college population is provided, followed by a broad overview of the range of peer-to-peer programs that can be available on college campuses. Two innovative programs are highlighted: (1) a hospital- and community-based program, the College Mental Health Program (CMHP) at McLean Hospital, and 2) the Student Support Network (SSN) at Worcester Polytechnic Institute. The subsequent section reviews the literature on peer-to-peer programs for students with serious and persistent mental illness for which there is a small but generally positive body of research. This lack of an empirical basis in college mental health leads the authors to argue for development of broad practice-research networks.

  18. Trends in population-based studies of human genetics in infectious diseases.

    Rowell, Jessica L; Dowling, Nicole F; Yu, Wei; Yesupriya, Ajay; Zhang, Lyna; Gwinn, Marta

    2012-01-01

    Pathogen genetics is already a mainstay of public health investigation and control efforts; now advances in technology make it possible to investigate the role of human genetic variation in the epidemiology of infectious diseases. To describe trends in this field, we analyzed articles that were published from 2001 through 2010 and indexed by the HuGE Navigator, a curated online database of PubMed abstracts in human genome epidemiology. We extracted the principal findings from all meta-analyses and genome-wide association studies (GWAS) with an infectious disease-related outcome. Finally, we compared the representation of diseases in HuGE Navigator with their contributions to morbidity worldwide. We identified 3,730 articles on infectious diseases, including 27 meta-analyses and 23 GWAS. The number published each year increased from 148 in 2001 to 543 in 2010 but remained a small fraction (about 7%) of all studies in human genome epidemiology. Most articles were by authors from developed countries, but the percentage by authors from resource-limited countries increased from 9% to 25% during the period studied. The most commonly studied diseases were HIV/AIDS, tuberculosis, hepatitis B infection, hepatitis C infection, sepsis, and malaria. As genomic research methods become more affordable and accessible, population-based research on infectious diseases will be able to examine the role of variation in human as well as pathogen genomes. This approach offers new opportunities for understanding infectious disease susceptibility, severity, treatment, control, and prevention.

  19. Abstracts and research accomplishments of university coal research projects

    1991-06-01

    The Principal Investigators of the grants supported by the University Coal Research Program were requested to submit abstracts and highlight accomplishments of their projects in time for distribution at a grantees conference. This book is a compilation of the material received in response to the request. Abstracts discuss the following area: coal science, coal surface science, reaction chemistry, advanced process concepts, engineering fundamentals and thermodynamics, environmental science

  20. Abstracts and research accomplishments of university coal research projects

    1991-06-01

    The Principal Investigators of the grants supported by the University Coal Research Program were requested to submit abstracts and highlight accomplishments of their projects in time for distribution at a grantees conference. This book is a compilation of the material received in response to the request. Abstracts discuss the following area: coal science, coal surface science, reaction chemistry, advanced process concepts, engineering fundamentals and thermodynamics, environmental science.

  1. Neighborhood social capital is associated with participation in health checks of a general population: a multilevel analysis of a population-based lifestyle intervention- the Inter99 study.

    Bender, Anne Mette; Kawachi, Ichiro; Jørgensen, Torben; Pisinger, Charlotta

    2015-07-22

    Participation in population-based preventive health check has declined over the past decades. More research is needed to determine factors enhancing participation. The objective of this study was to examine the association between two measures of neighborhood level social capital on participation in the health check phase of a population-based lifestyle intervention. The study population comprised 12,568 residents of 73 Danish neighborhoods in the intervention group of a large population-based lifestyle intervention study - the Inter99. Two measures of social capital were applied; informal socializing and voting turnout. In a multilevel analysis only adjusting for age and sex, a higher level of neighborhood social capital was associated with higher probability of participating in the health check. Inclusion of both individual socioeconomic position and neighborhood deprivation in the model attenuated the coefficients for informal socializing, while voting turnout became non-significant. Higher level of neighborhood social capital was associated with higher probability of participating in the health check phase of a population-based lifestyle intervention. Most of the association between neighborhood social capital and participation in preventive health checks can be explained by differences in individual socioeconomic position and level of neighborhood deprivation. Nonetheless, there seems to be some residual association between social capital and health check participation, suggesting that activating social relations in the community may be an avenue for boosting participation rates in population-based health checks. ClinicalTrials.gov (registration no. NCT00289237 ).

  2. Symptoms of anxiety and depression in childhood and use of MDMA: prospective, population based study

    Huizink, A.C.; Ferdinand, R.F.; Ende, J. van den; Verhulst, F.C.

    2006-01-01

    Objective To investigate whether using ecstasy (3,4-methylenedioxymethamphetamine, MDMA) is preceded by symptoms of behavioural and emotional problems in childhood and early adolescence. Design Prospective, longitudinal, population based study. Setting The Dutch province of

  3. Symptoms of anxiety and depression in childhood and use of MDMA: prospective, population based study

    A.C. Huizink (Anja); R.F. Ferdinand (Robert); J. van der Ende (Jan); F.C. Verhulst (Frank)

    2006-01-01

    textabstractOBJECTIVE: To investigate whether using ecstasy (3,4-methylenedioxymethamphetamine, MDMA) is preceded by symptoms of behavioural and emotional problems in childhood and early adolescence. DESIGN: Prospective, longitudinal, population based study SETTING: The Dutch

  4. Spironolactone and risk of upper gastrointestinal events: population based case-control study

    K.M.C. Verhamme (Katia); G. Mosis (Georgio); B.H.Ch. Stricker (Bruno); M.C.J.M. Sturkenboom (Miriam); J.P. Dieleman (Jeanne)

    2006-01-01

    textabstractOBJECTIVE: To confirm and quantify any association between spironolactone and upper gastrointestinal bleeding and ulcers. DESIGN: Population based case-control study. SETTING: A primary care information database in the Netherlands. PARTICIPANTS: All people on the

  5. Large Population-Based Study Reveals Disparities in Myeloma Precursor Disease | Center for Cancer Research

    Multiple myeloma (MM) is a cancer of plasma cells, which are antibody-producing white blood cells. Patients with MM have a characteristic excess of monoclonal antibodies, so called M proteins, in their serum, urine, or both and plasma cell infiltration into their bone marrow at multiple sites. African Americans are more than twice as likely as whites to develop MM, but the reason for this higher prevalence is not entirely clear. Since MM is nearly always preceded by the premalignant condition monoclonal gammopathy of undetermined significance (MGUS), Ola Landgren, M.D., Ph.D., a Senior Investigator in CCR’s Lymphoid Malignancies Branch, and colleagues from NCI’s Division of Cancer Epidemiology and Genetics, the Mayo Clinic, and the Centers for Disease Control and Prevention (CDC), wanted to determine whether there were also disparities in MGUS prevalence or in biomarkers associated with a high risk of MGUS progression to MM.

  6. Family Aggregation and Heritability of ESRD in Taiwan: A Population-Based Study.

    Wu, Hsin Hsu; Kuo, Chang Fu; Li, I Jung; Weng, Cheng Hao; Lee, Cheng Chia; Tu, Kun Hua; Liu, Shou Hsuan; Chen, Yung Chang; Yang, Chih Wei; Luo, Shue Fen; See, Lai Chu; Yu, Kuang Hui; Huang, Lu Hsiang; Zhang, Weiya; Doherty, Michael; Tian, Ya Chung

    2017-11-01

    Aggregation of end-stage renal disease (ESRD) has been observed in families of European origin, as well as those of African origin. However, it is not well documented if this disease aggregates in Asian families. Furthermore, the contribution of genetic factors and shared environmental factors to family aggregation remains unclear. Population-based cross-sectional cohort study. All 23,422,955 individuals registered in the Taiwan National Health Insurance Research Database in 2013. Among these, 47.45%, 57.45%, 47.29%, and 1.51% had a known parent, child, sibling, or twin, respectively. We identified 87,849 patients who had a diagnosis of ESRD. Family history of ESRD. ESRD and heritability defined as the proportion of phenotypic variance attributable to genetic factors. Having an affected first-degree relative with ESRD was associated with an adjusted relative risk of 2.46 (95% CI, 2.32-2.62). Relative risks were 96.38 (95% CI, 48.3-192.34) for twins of patients with ESRD, 2.15 (95% CI, 2.02-2.29) for parents, 2.78 (95% CI, 2.53-3.05) for offspring, 4.96 (95% CI, 4.19-5.88) for siblings, and 1.66 (95% CI, 1.54-1.78) for spouses without genetic similarities. Heritability in this study was 31.1% to 11.4% for shared environmental factors and 57.5% for nonshared environmental factors. This was a registry database study and we did not have detailed information about clinical findings or the definite causes of ESRD. This whole population-based family study in Asia confirmed, in a Taiwanese population, that a family history of ESRD is a strong risk factor for this disease. Moderate heritability was noted and environmental factors were related to disease. Family history of ESRD is an important piece of clinical information. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  7. Quality is the key for emerging issues of population-based colonoscopy screening

    Jin Young Yoon

    2018-01-01

    Full Text Available Colonoscopy is currently regarded as the gold standard and preferred method of screening for colorectal cancer (CRC. However, the benefit of colonoscopy screening may be blunted by low participation rates in population-based screening programs. Harmful effects of population-based colonoscopy screening may include complications induced by colonoscopy itself and by sedation, psychosocial distress, potential over-diagnosis, and socioeconomic burden. In addition, harmful effects of colonoscopy may increase with age and comorbidities. As the risk of adverse events in population-based colonoscopy screening may offset the benefit, the adverse events should be managed and monitored. To adopt population-based colonoscopy screening, consensus on the risks and benefits should be developed, focusing on potential harm, patient preference, socioeconomic considerations, and quality improvement of colonoscopy, as well as efficacy for CRC prevention. As suboptimal colonoscopy quality is a major pitfall of population-based screening, adequate training and regulation of screening colonoscopists should be the first step in minimizing variations in quality. Gastroenterologists should promote quality improvement, auditing, and training for colonoscopy in a population-based screening program.

  8. The Contemporary Incidence and Sequelae of Rhabdomyolysis Following Extirpative Renal Surgery: A Population Based Analysis.

    Gelpi-Hammerschmidt, Francisco; Tinay, Ilker; Allard, Christopher B; Su, Li-Ming; Preston, Mark A; Trinh, Quoc-Dien; Kibel, Adam S; Wang, Ye; Chung, Benjamin I; Chang, Steven L

    2016-02-01

    We evaluate the contemporary incidence and consequences of postoperative rhabdomyolysis after extirpative renal surgery. We conducted a population based, retrospective cohort study of patients who underwent extirpative renal surgery with a diagnosis of a renal mass or renal cell carcinoma in the United States between 2004 and 2013. Regression analysis was performed to evaluate 90-day mortality (Clavien grade V), nonfatal major complications (Clavien grade III-IV), hospital readmission rates, direct costs and length of stay. The final weighted cohort included 310,880 open, 174,283 laparoscopic and 69,880 robotic extirpative renal surgery cases during the 10-year study period, with 745 (0.001%) experiencing postoperative rhabdomyolysis. The presence of postoperative rhabdomyolysis led to a significantly higher incidence of 90-day nonfatal major complications (34.7% vs 7.3%, p rhabdomyolysis (incidence risk ratio 1.83, 95% CI 1.56-2.15, p rhabdomyolysis (vs laparoscopic approach, OR 2.43, p rhabdomyolysis (p rhabdomyolysis developing. Our study confirms that postoperative rhabdomyolysis is an uncommon complication among patients undergoing extirpative renal surgery, but has a potentially detrimental impact on surgical morbidity, mortality and costs. Male gender, comorbidities, obesity, prolonged surgery (more than 5 hours) and a robotic approach appear to place patients at higher risk for postoperative rhabdomyolysis. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  9. Childhood vaccine refusal and hesitancy intentions in Croatia: insights from a population-based study.

    Repalust, Anja; Šević, Sandra; Rihtar, Stanko; Štulhofer, Aleksandar

    2017-10-01

    Considering that programmatic data suggest a recent rise in vaccine refusal in Croatia, this study, first of its kind in Southeast Europe, aimed to estimate the prevalence, and sociodemographic, and sociocultural determinants of childhood vaccine refusal and hesitancy (CVRH) intentions among Croatian adults. Multi-stage stratified population-based survey included 1000 individuals aged 18-88 years (M age  = 47.7, SD = 17.8), of whom 51.7% were women. The outcome, a categorical indicator, distinguished among individuals who would approve vaccinating their children (vaccine accepting), those who would approve some but not all vaccines (vaccine hesitant), and those who would refuse vaccination (vaccine refusing). A sizeable minority of participants was characterized by childhood vaccine refusal (10.6%) and hesitancy intentions (19.5%). In a multivariate assessment controlling for parenthood, the odds of vaccine hesitancy were significantly increased by a younger age (AOR = 1.96-3.03, p Croatia. Following the social contagion model, future research should move beyond individual-level approach and take into account social interaction and social network effects.

  10. Predictors of autopsy following stillbirth in Queensland, Australia: A population-based study.

    Ibiebele, Ibinabo; Boyle, Frances M; Horey, Dell; Lourie, Rohan; Wilson, Patricia; Coory, Michael; Flenady, Vicki

    2017-02-01

    Accurate determination of causes of stillbirth is critical to effective prevention. Autopsy remains the gold standard investigation for stillbirth; however, with low autopsy rates many stillbirths are likely to be 'unexplored' rather than 'unexplained'. To determine factors associated with autopsy following stillbirth. Routinely collected population-based data on all singleton stillbirths of at least 400 g birthweight or 20 weeks gestation in Queensland between July 2000 and December 2011 were examined. Adjusted odds ratios (aOR, 99% CI) were calculated accounting for sociodemographic, pregnancy and medical factors. Of interest was initially unexplained stillbirth on the death certificate; analysis was stratified by gestational age group (autopsy performed. Initially unexplained stillbirth was associated with decreased odds of autopsy at late gestation (28-36 weeks, aOR 0.63 (99% CI 0.42-0.93); ≥37 weeks, aOR 0.53 (99% CI 0.35-0.81)) as was intrapartum stillbirth (autopsy following stillbirth. Pregnancy factors are associated with stillbirth autopsy. These findings have implications for development of appropriate information for parents and education of clinical staff. Further research is needed into factors influencing autopsy following stillbirth. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  11. Estimated ventricle size using Evans index: reference values from a population-based sample.

    Jaraj, D; Rabiei, K; Marlow, T; Jensen, C; Skoog, I; Wikkelsø, C

    2017-03-01

    Evans index is an estimate of ventricular size used in the diagnosis of idiopathic normal-pressure hydrocephalus (iNPH). Values >0.3 are considered pathological and are required by guidelines for the diagnosis of iNPH. However, there are no previous epidemiological studies on Evans index, and normal values in adults are thus not precisely known. We examined a representative sample to obtain reference values and descriptive data on Evans index. A population-based sample (n = 1235) of men and women aged ≥70 years was examined. The sample comprised people living in private households and residential care, systematically selected from the Swedish population register. Neuropsychiatric examinations, including head computed tomography, were performed between 1986 and 2000. Evans index ranged from 0.11 to 0.46. The mean value in the total sample was 0.28 (SD, 0.04) and 20.6% (n = 255) had values >0.3. Among men aged ≥80 years, the mean value of Evans index was 0.3 (SD, 0.03). Individuals with dementia had a mean value of Evans index of 0.31 (SD, 0.05) and those with radiological signs of iNPH had a mean value of 0.36 (SD, 0.04). A substantial number of subjects had ventricular enlargement according to current criteria. Clinicians and researchers need to be aware of the range of values among older individuals. © 2017 EAN.

  12. EpiReumaPt: how to perform a national population based study – a practical guide

    Nélia Gouveia

    2015-04-01

    Full Text Available Background: The aim of this article was to describe and discuss several strategies and standard operating procedures undertaken in the EpiReumaPt study – which was the first Portuguese, national, cross-sectional population-based study of Rheumatic and Musculoskeletal Diseases (RMD. Methods: The technical procedures, legal issues, management and practical questions were studied, analyzed and discussed with relevant stakeholders. During the 1st phase of EpiReumaPt the coordination team and Centro de Estudos de Sondagens e Opinião (CESOP worked to recruit and interview 10,661 subjects. The 2nd phase involved the participation of a multidisciplinary team, several local authorities, a specialized vehicle (“mobile unit” and a specific software program for the clinical appointments. The development of specific recruitment strategies improved the participation rate. Blood samples were collected and sent to Biobanco-IMM and to a central lab for immediate measurements. In the 3rd phase the RMD diagnosis were validated by a team of three experienced rheumatologists - clinical data, imaging and lab test results were revised according to previously published classification criteria. Conclusion: EpiReumaPt was a nationwide project successfully conducted, which followed critical logistic/coordination and research strategies. EpiReumaPt methodology and coordination could be used as an example for other epidemiologic endeavors and public health policies.

  13. Mental health differences between German gay and bisexual men and population-based controls.

    Sattler, Frank A; Franke, Gabriele H; Christiansen, Hanna

    2017-07-21

    International studies have revealed that gay and bisexual men present more mental health problems than the general male population. Furthermore, there is evidence that minority stress predicts mental health problems in gay and bisexual men. The aim of the present study is to provide initial data on mental health differences in Germany and to analyze the effect of minority stress. Mental health data on n = 1903 German gay and bisexual men and n = 958 men from a population-based sample were assessed using a shortened version of the SCL-90-S. The mental health of the two samples was compared. Furthermore, a linear regression was conducted for the gay and bisexual sample: mental health was used as the criterion and minority stressors as predictors. As compared to our population sample, gay and bisexual men demonstrated more mental health problems with a moderate effect size. In the regression, minority stress predicted mental health problems in the gay and bisexual sample. We observed pronounced mental health differences between gay and bisexual men versus the population sample. These differences could be at least partly due to the minority stress gay and bisexual men face. Research should focus on how to reduce and cope with minority stress.

  14. Recipient Age and Mortality Risk after Liver Transplantation: A Population-Based Cohort Study.

    Chen, Hsiu-Pin; Tsai, Yung-Fong; Lin, Jr-Rung; Liu, Fu-Chao; Yu, Huang-Ping

    2016-01-01

    The aim of the present large population-based cohort study is to explore the risk factors of age-related mortality in liver transplant recipients in Taiwan. Basic information and data on medical comorbidities for 2938 patients who received liver transplants between July 1, 1998, and December 31, 2012, were extracted from the National Health Insurance Research Database on the basis of ICD-9-codes. Mortality risks were analyzed after adjusting for preoperative comorbidities and compared among age cohorts. All patients were followed up until the study endpoint or death. This study finally included 2588 adults and 350 children [2068 (70.4%) male and 870 (29.6%) female patients]. The median age at transplantation was 52 (interquartile range, 43-58) years. Recipients were categorized into the following age cohorts: recipients (≥60 years), especially dialysis patients, have a higher mortality rate, possibly because they have more medical comorbidities. Our findings should make clinicians aware of the need for better risk stratification among elderly liver transplantation candidates.

  15. Long-term survival among Hodgkin's lymphoma patients with gastrointestinal cancer: a population-based study

    Youn, P.; Li, H.; Milano, M. T.; Stovall, M.; Constine, L. S.; Travis, L. B.

    2013-01-01

    Background The increased risk of gastrointestinal (GI) cancers after Hodgkin's lymphoma (HL) is well established. However, no large population-based study has described the actuarial survival after subsequent GI cancers in HL survivors (HL-GI). Patients and methods For 209 patients with HL-GI cancers (105 colon, 35 stomach, 30 pancreas, 21 rectum, and 18 esophagus) and 484 165 patients with first primary GI cancers (GI-1), actuarial survival was compared, accounting for age, gender, race, GI cancer stage, radiation for HL, and other variables. Results Though survival of HL patients who developed localized stage colon cancer was similar to that of the GI-1 group, overall survival (OS) of HL patients with regional or distant stage colon cancer was reduced [hazard ratio, (HR) = 1.46, P = 0.01]. The HL survivors with regional or distant stage colon cancer in the transverse segment had an especially high risk of mortality (HR: 2.7, P = 0.001 for OS). For localized stomach cancer, OS was inferior among HL survivors (HR = 3.46, P = 0.006). Conclusions The HL patients who develop GI cancer experience significantly reduced survival compared with patients with a first primary GI cancer. Further research is needed to explain the inferior survival of HL patients and to define selection criteria for cancer screening in HL survivors. PMID:22855552

  16. Inverse Association of Parkinson Disease With Systemic Lupus Erythematosus: A Nationwide Population-based Study.

    Liu, Feng-Cheng; Huang, Wen-Yen; Lin, Te-Yu; Shen, Chih-Hao; Chou, Yu-Ching; Lin, Cheng-Li; Lin, Kuen-Tze; Kao, Chia-Hung

    2015-11-01

    The effects of the inflammatory mediators involved in systemic lupus erythematous (SLE) on subsequent Parkinson disease have been reported, but no relevant studies have focused on the association between the 2 diseases. This nationwide population-based study evaluated the risk of Parkinson disease in patients with SLE.We identified 12,817 patients in the Taiwan National Health Insurance database diagnosed with SLE between 2000 and 2010 and compared the incidence rate of Parkinson disease among these patients with that among 51,268 randomly selected age and sex-matched non-SLE patients. A Cox multivariable proportional-hazards model was used to evaluate the risk factors of Parkinson disease in the SLE cohort.We observed an inverse association between a diagnosis of SLE and the risk of subsequent Parkinson disease, with the crude hazard ratio (HR) being 0.60 (95% confidence interval 0.45-0.79) and adjusted HR being 0.68 (95% confidence interval 0.51-0.90). The cumulative incidence of Parkinson disease was 0.83% lower in the SLE cohort than in the non-SLE cohort. The adjusted HR of Parkinson disease decreased as the follow-up duration increased and was decreased among older lupus patients with comorbidity.We determined that patients with SLE had a decreased risk of subsequent Parkinson disease. Further research is required to elucidate the underlying mechanism.

  17. Psychiatric morbidity in the community: A population based-study from Kerala.

    Shaji, K S; Raju, D; Sathesh, V; Krishnakumar, P; Punnoose, Varghese P; Kiran, P S; Mini, B S; Kumar, Shibu; Anish, P K; Kaimal, Ganga G; Gupthan, Lekshmy; Sumesh, T P; Nikhil, U G; Cyriac, Nisha; Vinod, M D; Kumar, R Prasad; Chandran, Ramesh; Rejani, P P; Amrutha, R; Mahesh; Anand, T N

    2017-01-01

    Estimates of psychiatric morbidity in the community will help service development. Participation of trained nonspecialist health-care providers will facilitate scaling up of services in resource-limited settings. This study aimed to estimate the prevalence of priority mental health problems in populations served by the District Mental Health Program (DMHP). This is a population-based cross-sectional survey. We did stratified cluster sampling of households in five districts of Kerala. Trained Accredited Social Health Activists (ASHAs) identified people who had symptoms suggestive of schizophrenia or bipolar disorder. Clinicians evaluated the information collected by the ASHAs and designated individuals as probable cases of psychosis or noncases. Screening instruments such as General Health Questionnaire-12, CAGE questionnaire, and Everyday Abilities Scale for India were used for identifying common mental disorders (CMDs), clinically significant alcohol-related problems, and functional impairment. We found 12.43% of the adult population affected by mental health conditions. We found CMD as most common with a prevalence of 9%. The prevalence of psychosis was 0.71%, clinically significant alcohol-related problems was 1.46%, and dementia and other cognitive impairments was 1.26%. We found informant-based case finding to be useful in the identification of psychosis. Mental health problems are common. Nonspecialist health-care providers can be trained to identify psychiatric morbidity in the community. Their participation will help in narrowing the treatment gap. Embedding operational research to DMHP will make scaling up more efficient.

  18. Medical risk factors associated with cholangiocarcinoma in Taiwan: a population-based case-control study.

    Jeffrey S Chang

    Full Text Available BACKGROUND: Cholangiocarcinoma, including intra- and extrahepatic cholangiocarcinoma, is a rare but highly lethal cancer. Despite effort in finding the risk factors of cholangiocarcinoma, the causes of most cholangiocarcinoma remain unknown. This study utilized a population-based case-control design using data from the National Health Insurance Research Database (NHIRD of Taiwan to assess the medical conditions associated with cholangiocarcinoma. METHODS: 5,157 incident cases of cholangiocarcinoma diagnosed during 2004 to 2008 and 20,628 controls matched to the cases on sex, age, and time of diagnosis (reference date for the controls were identified from the NHIRD. Medical risk factors were ascertained from the NHIRD for each individual. Conditional logistic regression was performed to evaluate the association between cholangiocarcinoma and each medical risk factor. RESULTS: The results showed that factors associated with an increased risk of cholangiocarcinoma included cholangitis, cholelithiasis, cholecystitis, cirrhosis of liver, alcoholic liver disease, chronic non-alcoholic liver disease, hepatitis B, hepatitis C, diabetes, chronic pancreatitis, inflammatory bowel disease, and peptic ulcer. In addition, sex and age differences were observed. CONCLUSIONS: This study confirms the association between cholangiocarcinoma and several less established risk factors, including diabetes, inflammatory bowel disease, hepatitis B, hepatitis C, and peptic ulcer (proxy for the presence of Helicobacter Pylori. Future studies should focus on finding additional environmental and genetic causes of cholangiocarcinoma.

  19. A Population-Based Cohort Study on Peripheral Arterial Disease in Patients with Schizophrenia.

    Wen-Yu Hsu

    Full Text Available Peripheral arterial disease (PAD is considered the leading cause of atherosclerotic cardiovascular morbidity. Several risk factors of PAD have been observed in patients with schizophrenia. Therefore, we hypothesize that the incidence of PAD is higher in the schizophrenia population than in the general population.The patients in this population-based cohort study were selected from the Taiwanese National Health Insurance Research Database on the basis of the claims data from 2000 to 2011. We compared the incidence of PAD between schizophrenia and nonschizophrenia cohorts. Cox proportional hazard regression models were employed for analyzing the risk of PAD after adjustment for sex, age, and comorbidities.The adjusted hazard ratio (HR for PAD in the schizophrenia cohort was 1.26-fold higher than that in the nonschizophrenia cohort. Furthermore, patients with schizophrenia using atypical antipsychotics exhibited a high adjusted HR for PAD.Compared with the general population, the risk of PAD is higher among patients with schizophrenia. Early diagnosis and intervention can mitigate complications resulting from cardiovascular diseases and lower mortality.

  20. Impact of preoperative chronic renal failure on liver transplantation: a population-based cohort study

    Chung, Peter Chi-Ho; Chen, Hsiu-Pin; Lin, Jr-Rung; Liu, Fu-Chao; Yu, Huang-Ping

    2016-01-01

    Purpose The purpose of this study was to assess whether preoperative chronic renal failure (CRF) affects the rates of postoperative complications and survival after liver transplantation. Methods This population-based retrospective cohort study included 2,931 recipients of liver transplantation performed between 1998 and 2012, enrolled from the Taiwan National Health Insurance Research Database. Patients were divided into two groups, based on the presence or absence of preoperative CRF. Results The overall estimated survival rate of liver transplantation recipients (LTRs) with preoperative CRF was significantly lower than that of patients without preoperative CRF (P=0.0085). There was no significant difference between the groups in terms of duration of intensive care unit stay, total hospital stay, bacteremia, postoperative bleeding, and pneumonia during hospitalization. Long-term adverse effects, including cerebrovascular disease and coronary heart disease, were not different between patients with versus without CRF. Conclusion These findings suggest that LTRs with preoperative CRF have a higher rate of mortality. PMID:28008264

  1. Sleep and academic performance in later adolescence: results from a large population-based study.

    Hysing, Mari; Harvey, Allison G; Linton, Steven J; Askeland, Kristin G; Sivertsen, Børge

    2016-06-01

    The aim of the current study was to assess the association between sleep duration and sleep patterns and academic performance in 16-19 year-old adolescents using registry-based academic grades. A large population-based study from Norway conducted in 2012, the youth@hordaland-survey, surveyed 7798 adolescents aged 16-19 years (53.5% girls). The survey was linked with objective outcome data on school performance. Self-reported sleep measures provided information on sleep duration, sleep efficiency, sleep deficit and bedtime differences between weekday and weekend. School performance [grade point average (GPA)] was obtained from official administrative registries. Most sleep parameters were associated with increased risk for poor school performance. After adjusting for sociodemographic information, short sleep duration and sleep deficit were the sleep measures with the highest odds of poor GPA (lowest quartile). Weekday bedtime was associated significantly with GPA, with adolescents going to bed between 22:00 and 23:00 hours having the best GPA. Also, delayed sleep schedule during weekends was associated with poor academic performance. The associations were somewhat reduced after additional adjustment for non-attendance at school, but remained significant in the fully adjusted models. In conclusion, the demonstrated relationship between sleep problems and poor academic performance suggests that careful assessment of sleep is warranted when adolescents are underperforming at school. Future studies are needed on the association between impaired sleep in adolescence and later functioning in adulthood. © 2016 European Sleep Research Society.

  2. Background and Data Configuration Process of a Nationwide Population-Based Study Using the Korean National Health Insurance System

    Sun Ok Song

    2014-10-01

    Full Text Available BackgroundThe National Health Insurance Service (NHIS recently signed an agreement to provide limited open access to the databases within the Korean Diabetes Association for the benefit of Korean subjects with diabetes. Here, we present the history, structure, contents, and way to use data procurement in the Korean National Health Insurance (NHI system for the benefit of Korean researchers.MethodsThe NHIS in Korea is a single-payer program and is mandatory for all residents in Korea. The three main healthcare programs of the NHI, Medical Aid, and long-term care insurance (LTCI provide 100% coverage for the Korean population. The NHIS in Korea has adopted a fee-for-service system to pay health providers. Researchers can obtain health information from the four databases of the insured that contain data on health insurance claims, health check-ups and LTCI.ResultsMetabolic disease as chronic disease is increasing with aging society. NHIS data is based on mandatory, serial population data, so, this might show the time course of disease and predict some disease progress, and also be used in primary and secondary prevention of disease after data mining.ConclusionThe NHIS database represents the entire Korean population and can be used as a population-based database. The integrated information technology of the NHIS database makes it a world-leading population-based epidemiology and disease research platform.

  3. Adverse childhood experiences, gender, and HIV risk behaviors: Results from a population-based sample

    Lin Fang

    2016-12-01

    Full Text Available Recent HIV research suggested assessing adverse childhood experiences (ACEs as contributing factors of HIV risk behaviors. However, studies often focused on a single type of adverse experience and very few utilized population-based data. This population study examined the associations between ACE (individual and cumulative ACE score and HIV risk behaviors. We analyzed the 2012 Behavioral Risk Factor Surveillance Survey (BRFSS from 5 states. The sample consisted of 39,434 adults. Eight types of ACEs that included different types of child abuse and household dysfunctions before the age of 18 were measured. A cumulative score of ACEs was also computed. Logistic regression estimated of the association between ACEs and HIV risk behaviors using odds ratio (OR with 95% confidence intervals (CIs for males and females separately. We found that ACEs were positively associated with HIV risk behaviors overall, but the associations differed between males and females in a few instances. While the cumulative ACE score was associated with HIV risk behaviors in a stepwise manner, the pattern varied by gender. For males, the odds of HIV risk increased at a significant level as long as they experienced one ACE, whereas for females, the odds did not increase until they experienced three or more ACEs. Future research should further investigate the gender-specific associations between ACEs and HIV risk behaviors. As childhood adversities are prevalent among general population, and such experiences are associated with increased risk behaviors for HIV transmission, service providers can benefit from the principles of trauma-informed practice.

  4. Prescription pattern of Chinese herbal products for heart failure in Taiwan: A population-based study.

    Tsai, Ming-Yen; Hu, Wen-Long; Lin, Che-Chen; Lee, Yi-Chiao; Chen, Shih-Yu; Hung, Yu-Chiang; Chen, Yung-Hsiang

    2017-02-01

    Certain Chinese herbal products (CHPs) may protect against the progression of heart failure (HF). However, there is a lack of research regarding the use of CHPs in patients with HF. The aims of this study were to analyze CHPs usage patterns in patients with HF and to identify the frequency and combination of CHPs most commonly used for HF. This retrospective, nationwide, population-based cohort study was conducted using a randomly sampled cohort of one million patients selected from the National Health Insurance Research Database (NHIRD) for the years 2000-2010 in Taiwan. CHP use and the top ten most frequently prescribed formulae and single herbs for treating HF were assessed, including total formulae number and average and frequency of prescriptions. Demographic characteristics, including sex and age at diagnosis of HF, were examined, together with existing comorbidities. The cohort included 19,988 newly diagnosed AD patients, who were given CHP treatment for HF between 2000 and 2010. Among them, female patients (53.3%) and those over 65years old (63.9%) were more likely to use CM. After adjusting for demographic factors, HF patients suffering from coronary artery disease (CAD) were more likely to seek traditional Chinese medicine (TCM) treatment than those with non-TCM users (57.6% vs. 52.6%). Zhi-Gan-Cao-Tang (4.07%) and Danshen (5.13%) were the most frequent formula CHP and single CHP prescribed by TCM practitioners for treating HF, respectively. Most people with HF who consumed CHPs used CHPs to supplement Yang-Qi, nourish the Ying-blood, and strengthen the heart spirit as complementary medicines to relieve HF-related symptoms, in addition to using standard anti-HF treatments. Further large-scale, randomized clinical trials are warranted in order to determine the effectiveness and safety of these herbal medicines. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. Risk of Nongenitourinary Cancers in Patients With Spinal Cord Injury: A Population-based Cohort Study.

    Kao, Chia-Hong; Sun, Li-Min; Chen, Yueh-Sheng; Lin, Cheng-Li; Liang, Ji-An; Kao, Chia-Hung; Weng, Ming-Wei

    2016-01-01

    Little information is available regarding the risk of nongenitourinary (GU) cancers in patients with spinal cord injury (SCI). The authors conducted a nationwide population-based study to investigate whether a higher risk of non-GU cancer is seen among patients with SCI.Data retrieved from the National Health Insurance Research Database of Taiwan were used in this study. A total of 41,900 patients diagnosed with SCI between 2000 and 2011 were identified from the National Health Insurance Research Database and comprised the SCI cohort. Each of these patients was randomly frequency matched with 4 people from the general population (without SCI) according to age, sex, comorbidities, and index year. Cox proportional hazards regression analysis was used to calculate adjusted hazard ratios and 95% confidence intervals and determine how SCI affected non-GU cancer risk.No significant difference in overall non-GU cancer risk was observed between the SCI and control groups. The patients with SCI exhibited a significantly higher risk of developing esophageal, liver, and hematologic malignancies compared with those without SCI. By contrast, the SCI cohort had a significantly lower risk of colorectal cancer compared with the non-SCI cohort (adjusted hazard ratio = 0.80, 95% confidence interval = 0.69-0.93). Additional stratified analyses by sex, age, and follow-up duration revealed various correlations between SCI and non-GU cancer risk.The patients with SCI exhibited higher risk of esophageal, liver, and hematologic malignancies but a lower risk of colorectal cancer compared with those without SCI. The diverse patterns of cancer risk among the patients with SCI may be related to the complications of chronic SCI.

  6. Research

    abp

    15 juin 2015 ... Résultats: Les pathologies gastroduodénales étaient plus fréquentes chez les patients de plus ... mode de transmission interhumain principalement oral-oral. ..... infection in preschool children: a population-based study from.

  7. Research

    ebutamanya

    2014-08-16

    Aug 16, 2014 ... Methods: In a population-based survey between January and. May 2012, we ... Socio-demographical, clinical and biological data were collected during ... The Pan African Medical Journal - ISSN 1937-8688. This is ... data come from nephrology departments in specialized hospitals in big .... perspectives.

  8. Metabolic profile at first-time schizophrenia diagnosis: a population-based cross-sectional study

    Horsdal HT

    2017-02-01

    Full Text Available Henriette Thisted Horsdal,1,2 Michael Eriksen Benros,2,3 Ole Köhler-Forsberg,2–4 Jesper Krogh,3 Christiane Gasse1,2,5 1National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus BSS, Aarhus University, Aarhus, 2The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, 3Faculty of Health Sciences, Mental Health Centre Copenhagen, University of Copenhagen, Copenhagen, 4Psychosis Research Unit, Aarhus University Hospital, Risskov, 5Centre for Integrated Register-Based Research, Aarhus University, Aarhus, Denmark Objective: Schizophrenia and/or antipsychotic drug use are associated with metabolic abnormalities; however, knowledge regarding metabolic status and physician’s monitoring of metabolic status at first schizophrenia diagnosis is sparse. We assessed the prevalence of monitoring for metabolic blood abnormalities and characterized the metabolic profiles in people with a first-time schizophrenia diagnosis. Methods: This is a population-based cross-sectional study including all adults born in Denmark after January 1, 1955, with their first schizophrenia diagnosis between 2000 and 2012 in the Central Denmark Region. Information on metabolic parameters was obtained from a clinical laboratory information system. Associations were calculated using Wilcoxon rank-sum tests, chi-square tests, logistic regression, and Spearman’s correlation coefficients. Results: A total of 2,452 people with a first-time schizophrenia diagnosis were identified, of whom 1,040 (42.4% were monitored for metabolic abnormalities. Among those monitored, 58.4% had an abnormal lipid profile and 13.8% had an abnormal glucose profile. People who had previously filled prescription(s for antipsychotic drugs were more likely to present an abnormal lipid measure (65.7% vs 46.8%, P<0.001 and abnormal glucose profile (16.4% vs 10.1%, P=0.01. Conclusion: Metabolic abnormalities are common at first

  9. Postoperative adverse outcomes in intellectually disabled surgical patients: a nationwide population-based study.

    Jui-An Lin

    Full Text Available BACKGROUND: Intellectually disabled patients have various comorbidities, but their risks of adverse surgical outcomes have not been examined. This study assesses pre-existing comorbidities, adjusted risks of postoperative major morbidities and mortality in intellectually disabled surgical patients. METHODS: A nationwide population-based study was conducted in patients who underwent inpatient major surgery in Taiwan between 2004 and 2007. Four controls for each patient were randomly selected from the National Health Insurance Research Database. Preoperative major comorbidities, postoperative major complications and 30-day in-hospital mortality were compared between patients with and without intellectual disability. Use of medical services also was analyzed. Adjusted odds ratios using multivariate logistic regression analyses with 95% confidence intervals were applied to verify intellectual disability's impact. RESULTS: Controls were compared with 3983 surgical patients with intellectual disability. Risks for postoperative major complications were increased in patients with intellectual disability, including acute renal failure (odds ratio 3.81, 95% confidence interval 2.28 to 6.37, pneumonia (odds ratio 2.01, 1.61 to 2.49, postoperative bleeding (odds ratio 1.35, 1.09 to 1.68 and septicemia (odds ratio 2.43, 1.85 to 3.21 without significant differences in overall mortality. Disability severity was positively correlated with postoperative septicemia risk. Medical service use was also significantly higher in surgical patients with intellectual disability. CONCLUSION: Intellectual disability significantly increases the risk of overall major complications after major surgery. Our findings show a need for integrated and revised protocols for postoperative management to improve care for intellectually disabled surgical patients.

  10. Relationship of zolpidem and cancer risk: a Taiwanese population-based cohort study.

    Kao, Chia-Hung; Sun, Li-Min; Liang, Ji-An; Chang, Shih-Ni; Sung, Fung-Chang; Muo, Chih-Hsin

    2012-05-01

    To evaluate the relationship between the use of zolpidem and subsequent cancer risk in Taiwanese patients. We used data from the National Health Insurance system of Taiwan to investigate whether use of zolpidem was related to cancer risk. For the study cohort, we identified 14,950 patients who had received a first prescription for zolpidem from January 1, 1998, through December 31, 2000. For each zolpidem user, we selected randomly 4 comparison patients without a history of using zolpidem who were frequency-matched by sex, age, and year of the index date. Incidence rates of all cancers and selected site-specific cancers were measured by the end of 2009, and related hazard ratios (HRs) and 95% confidence intervals (CIs) of the cancer were measured as well. The risk of developing any cancer was greater in patients using zolpidem than in nonusers (HR, 1.68; 95% CI, 1.55-1.82). The stratified analysis showed that the overall HR for high-dosage zolpidem (≥300 mg/y) was 2.38. The site-specific cancer risk was the highest for oral cancer (HR, 2.36; 95% CI, 1.57-3.56), followed by kidney cancer, esophageal cancer, breast cancer, liver cancer, lung cancer, and bladder cancer (HR, 1.60; 95% CI, 1.06-2.41). Men were at higher risk than women. This population-based study revealed some unexpected findings, suggesting that the use of zolpidem may be associated with an increased risk of subsequent cancer. Further large-scale and in-depth investigations in this area are warranted. Copyright © 2012 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  11. Attitudes towards suicide in urban and rural China: a population based, cross-sectional study.

    Zou, Yaming; Leung, Ricky; Lin, Shao; Yang, Mingan; Lu, Tao; Li, Xianyun; Gu, Jing; Hao, Chun; Dong, Guanghui; Hao, Yuantao

    2016-05-26

    Suicide intervention programs have been guided by findings that attitude towards suicide and suicidal behavior may be causally linked. These findings also make it imperative to identify the factors that influence attitudes towards suicide. However, there has been little research on attitudes towards suicide among the general population, especially in low-income and middle-income countries. This population-based, cross-sectional study investigated the associated factors of attitudes towards suicide among a representative sample of urban and rural adult residents in China. A multi-stage, stratified random sampling approach was implemented to select participants. Data were collected by a survey using the Scale of Public Attitudes about Suicide (SPAS). The survey also collected some socio-demographic factors and suicidal history of participants. Statistical tests were conducted to identify associated factors that account for variations in attitudes towards suicide. The residents in China generally hold a neutral attitude towards suicide. Attitudes towards suicide among Chinese residents were associated with age, duration of formal education, marital status, job and suicidal ideation. Different attitudinal subscales seemed not to share the same risk factors. However, gender, ethnicity, religious belief, housing style and economic status might not influence residents' attitudes towards suicide. Attitudes towards suicide among Chinese urban and rural residents generally had no statistical difference with one notable exception: opinions on whether or not suicides and suicide attempts are different phenomena. Age, duration of formal education, marital status, job and suicidal ideation seem to have an impact on attitudes towards suicide among residents. Urban and rural residents have similar attitudes towards suicide with the only statistically significance difference being their opinions on whether or not suicides and suicide attempts are different phenomena.

  12. The relationship between waterpipe smoking and body weight: population-based findings from Syria.

    Ward, Kenneth D; Ahn, SangNam; Mzayek, Fawaz; Al Ali, Radwan; Rastam, Samer; Asfar, Taghrid; Fouad, Fouad; Maziak, Wasim

    2015-01-01

    Cigarette smoking has well known effects on body weight, with current smokers weighing less than never-smokers, and cessation producing weight gain. Use of waterpipe (or "hookah") is increasing in many parts of the world but its effects on body weight are not known. We compared body mass index (BMI) among 2,536 adults (age ≥ 18 years old), who were never, former, current nondaily, or current daily waterpipe smokers, drawn from 2 representative, population-based household surveys of adults in Aleppo, Syria. Overall, 84.1% (n = 2,134) never-smoked waterpipe, 4.6% (n = 116) were former smokers, 9.9% (n = 251) were current nondaily smokers, and 1.4% (n = 35) were current daily smokers. Mean BMI of the sample was 30.2 kg/m(2) (SD = 6.3). Adjusted for cigarette smoking, number of chronic diseases, age, gender, income, and marital status, daily waterpipe users were 2.26 BMI units greater than never-smokers (beta = 2.26, 95% CI = 0.79-3.72), and had nearly threefold odds of being obese (odds ratio = 2.87, 95% CI = 1.06-7.76). Nondaily and former waterpipe users were similar to never-smokers in terms of BMI and obesity risk. Results indicate that daily waterpipe users, compared to never-users, have higher BMI, translating into 6 extra kilograms of weight on average, and are 3 times as likely to be obese. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. Chronic Musculoskeletal Disabilities following Snake Envenoming in Sri Lanka: A Population-Based Study.

    Subashini Jayawardana

    2016-11-01

    Full Text Available Snakebite is a major public health problem in agricultural communities in the tropics leading to acute local and systemic impairments with resultant disabilities. Snakebite related long-term musculoskeletal disabilities have been a neglected area of research. We conducted a population-based, cross-sectional study in an agricultural community to describe the chronic musculoskeletal disabilities of snake envenoming.A sample representative of residents of a single district in a region of high incidence of snake envenoming was recruited to identify ever snakebite victims. They were evaluated for chronic musculoskeletal disabilities that had developed immediately or within four weeks after the snakebite and persisted over three months. In-depth interviews, validated musculoskeletal functional assessment criteria and specialists' examinations were utilised. Among the 816 victims, 26 (3.2%, 95% confidence interval: 2.2-4.6% had musculoskeletal disabilities, persisting on average for 13.4 years (SD = 14.4. The disabilities were mostly in lower limbs (61.5% and ranged from swelling (34.6%, muscle wasting (46.1%, reduced motion (61.5%, reduced muscle power (50%, impaired balance (26.9%, chronic non-healing ulcers (3.85%, abnormal gait (3.85%, fixed deformities (19.2% to amputations (15.4%. Based on disability patterns, six snakebite-related musculoskeletal syndromes were recognised. The offending snakes causing disabilities were cobra (30.8%, Russell's viper (26.9% and hump-nosed viper (7.7%. Cobra bites manifested muscle wasting (87.5%, reduced muscle power (87.5%, joint stiffness (62.5% and deformities (37.5% while viper bites manifested impaired balance (42.8%, pain (71.4% and swelling (71.4%.Snakebite envenoming is associated with considerable long-term musculoskeletal disabilities. Facilities for specialized care and rehabilitation need to be established in high risk areas.

  14. Prevalence and predictors of premenstrual syndrome and premenstrual dysphoric disorder in a population-based sample.

    Tschudin, Sibil; Bertea, Paola Coda; Zemp, Elisabeth

    2010-12-01

    The study aimed at assessing the prevalence of premenstrual symptoms and of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) in a population-based sample of women of the entire reproductive age range, as well as to analyse predictors of PMS and PMDD in terms of socio-demographic, health status and health behavioural factors. A set of questions on PMS-based on the premenstrual syndrome screening tool developed by Steiner et al., translated into German and piloted-was integrated into the written questionnaire of the 2007 Swiss Health Survey. Weighted prevalence rates and multivariable regression analysis for the outcome variables PMS and PMDD were calculated. A total of 3,913 women aged 15 to 54 years answered the questions on PMS symptoms, and 3,522 of them additionally answered the questions on interference of PMS with life. Ninety one percent of the participants reported at least one symptom, 10.3% had PMS and 3.1% fulfilled the criteria for PMDD. The prevalence of PMS was higher in non-married women, in women aged 35-44 years and in women of the Italian-speaking region of Switzerland. Both PMS and PMDD were strongly associated with poor physical health and psychological distress. Socio-cultural factors seem to determine the prevalence, perception and handling of PMS. Considering the association with poor physical health and high psychological distress, a broader underlying vulnerability in women qualifying for PMDD must be assumed and should be taken into account in clinical management as well as in future research in this field.

  15. Chronic headache and comorbidities: a two-phase, population-based, cross-sectional study.

    da Silva, Ariovaldo; Costa, Esther Coelho; Gomes, João Bosco; Leite, Frederico Motta; Gomez, Rodrigo Santiago; Vasconcelos, Luiz Paulo; Krymchantowski, Abouch; Moreira, Pedro; Teixeira, Antonio Lucio

    2010-09-01

    Studies using resources of a public family health program to estimate the prevalence of chronic daily headaches (CDH) are lacking. To estimate the 1-year prevalence of CDH, as well as the presence of associated psychiatric and temporomandibular disorders (TMD) comorbidities, on the entire population of a city representative of the rural area of Brazil. This was a cross-sectional, population-based, 2-phase study. In the first phase, health agents interviewed all individuals older than 10 years, in a rural area of Brazil. In the second stage, all individuals who reported headaches on 4 or more days per week were then evaluated by a multidisciplinary team. CDH were classified according to the second edition of the International Classification of Headache Disorders (ICHD-2). Medication overuse headache was diagnosed, as per the ICHD-2, after detoxification trials. Psychiatric comorbidities and TMD were diagnosed based on the DSM-IV and on the Research Diagnostic Criteria for Temporomandibular Disorders criteria, respectively. A total of 1631 subjects participated in the direct interviews. Of them, 57 (3.6%) had CDH. Chronic migraine was the most common of the CDH (21, 36.8%). Chronic tension-type headache (10, 17.5%), medication overuse headache (13, 22.8%) and probable medication overuse headache (10, 17.5%) were also common. Psychiatric disorders were observed in 38 (67.3%) of the CDH subjects. TMD were seen in 33 (58.1)% of them. The prevalence of CDH in the rural area of Brazil is similar to what has been reported in previous studies. A significant proportion of them have psychiatric comorbidities and/or TMD. In this sample, comorbidities were as frequent as reported in convenience samples from tertiary headache centers.

  16. [Static Retinal Vessel Analysis in Population-based Study SHIP-Trend].

    Theophil, Constanze; Jürgens, Clemens; Großjohann, Rico; Kempin, Robert; Ittermann, Till; Nauck, Matthias; Völzke, Henry; Tost, Frank H W

    2017-08-24

    Background Interdisciplinary investigations of possible connections between general diseases and ophthalmological changes are difficult to perform in the clinical environment. But they are gaining in importance as a result of the age-related increase in chronic diseases. The collection of health-related parameters in the Study of Health in Pomerania (SHIP) project allows to derive conclusions for the general population. Methods The population-based SHIP trend study was conducted between 2008 and 2012 in Greifswald. The baseline cohort included 4420 subjects (response 50.1%) at the age of 20 to 84 years. The pre-existence of arterial hypertension, diabetes mellitus and smoking status were questioned in a standardized questionnaire, the blood pressure and the HbA 1c were determined by the laboratory. The vascular diameter of retinal arterioles and venules were determined by means of non-mydriatic fundus images and the retinal arterial (CRAE) and venous equivalent (CRVE) were calculated therefrom. The association of diabetes mellitus, HbA 1c , smoking status and blood pressure with the retinal vascular parameters was tested for age and sex with linear regression models. Results In 3218 subjects with evaluable standardized fundus photographs, significant associations of elevated HbA 1c (> 6.5%), smoking status and systolic and diastolic blood pressure were found with the retinal vessel widths CRAE and CRVE. Anamnestic diabetes mellitus, on the other hand, was not associated with any of the vascular parameters. Conclusion This research study reveals a relevant correlation between general diseases and the retinal blood flow in the eye. Therefore, general diseases can induce ophthalmological changes and eye examination can provide information for the assessment of general diseases. Georg Thieme Verlag KG Stuttgart · New York.

  17. Population-Based Trachoma Mapping in Six Evaluation Units of Papua New Guinea.

    Ko, Robert; Macleod, Colin; Pahau, David; Sokana, Oliver; Keys, Drew; Burnett, Anthea; Willis, Rebecca; Wabulembo, Geoffrey; Garap, Jambi; Solomon, Anthony W

    2016-01-01

    We sought to determine the prevalence of trachomatous inflammation - follicular (TF) in children aged 1-9 years, and trachomatous trichiasis (TT) in those aged ≥15 years, in suspected trachoma-endemic areas of Papua New Guinea (PNG). We carried out six population-based prevalence surveys using the protocol developed as part of the Global Trachoma Mapping Project. A total of 19,013 individuals were sampled for inclusion, with 15,641 (82.3%) consenting to participate. Four evaluation units had prevalences of TF in children ≥10%, above which threshold the World Health Organization (WHO) recommends mass drug administration (MDA) of azithromycin for at least three years; Western Province (South Fly/Daru) 11.2% (95% confidence interval, CI, 6.9-17.0%), Southern Highlands (East) 12.2% (95% CI 9.6-15.0%), Southern Highlands (West) 11.7% (95% CI 8.5-15.3%), and West New Britain 11.4% (95% CI 8.7-13.9%). TF prevalence was 5.0-9.9% in Madang (9.4%, 95% CI 6.1-13.0%) and National Capital District (6.0%. 95% CI 3.2-9.1%) where consideration of a single round of MDA is warranted. Cases of TT were not found outside West New Britain, in which four cases were seen, generating an estimated population-level prevalence of TT in adults of 0.10% (95% CI 0.00-0.40%) for West New Britain, below the WHO elimination threshold of 0.2% of those aged ≥15 years. Trachoma is a public health issue in PNG. However, other than in West New Britain, there are few data to support the idea that trachoma is a cause of blindness in PNG. Further research is needed to understand the stimulus for the active trachoma phenotype in these populations.

  18. When and where do hip fractures occur? A population-based study.

    Leavy, B; Åberg, A C; Melhus, H; Mallmin, H; Michaëlsson, K; Byberg, L

    2013-09-01

    We investigated the effects of socio-demographic and health factors on timing and location of hip fracture among 484 subjects. Time of fracture varied between community dwellers and residential care facility dwellers, and in relation to subjects' psychotropic drug status. Indoor hip fracture incidence increased on snow-covered days. This paper aims to describe the timing and whereabouts of hip fracture cases in a population-based setting and to relate these factors with residential and health status, seasonal variation, and snow-covered ground. We consecutively included 484 incident hip fracture events (age ≥50 years) admitted to a Swedish orthopedic department during a 1-year period. Data concerning socio-demographic details, fall location, time of fracture, comorbidity, and medications were collected from in-patient medical records and through patient or caregiver interviews. The expected peak in fracture occurrence during daytime was observed among community dwellers but not among subjects living in residential care. Hip fracture was twice as likely to occur during nighttime hours among psychotropic drug users (adjusted odds ratio (Adj. OR), 2.20; 95% confidence interval (CI), 1.12-4.30) compared to those not receiving these medications. Subjects without dementia, taking psychotropic drugs, were also more likely to fracture during nighttime hours (Adj. OR, 2.91; 95% CI, 1.40-6.0). We observed an increase in indoor hip fracture incidence on snow-covered days among community dwellers (incidence rate ratio, 1.34; 95% CI, 1.02-1.74). We observed only a weak seasonal trend in hip fracture incidence, based on month, among community dwellers who fractured indoors. Special attention and possibly fall-preventive efforts should be directed not only toward those living in residential care facilities but also toward community-dwelling subjects taking psychotropic drugs since these groups have a higher incidence of nighttime hip fracture. Further research aiming to explain

  19. Association of prior HPV vaccination with reduced preterm birth: A population based study.

    Lawton, Beverley; Howe, Anna S; Turner, Nikki; Filoche, Sara; Slatter, Tania; Devenish, Celia; Hung, Noelyn Anne

    2018-01-02

    Emerging evidence suggests that HPV infection is associated with negative pregnancy outcomes such as preterm birth (PTB), and pre-eclampsia. We aimed to determine if prior HPV vaccination reduced adverse pregnancy outcomes. A New Zealand population-based retrospective study linking first pregnancy outcome data (2008-2014 n = 35,646) with prior quadrivalent HPV vaccination status. Primary outcomes were likelihood (odds ratios, ORs) of PTB, pre-eclampsia, and stillbirth. Exposure groups were based on HPV vaccination. Adjusted ORs were calculated for each outcome, controlling for mother's age at delivery, ethnicity, socioeconomic status, health board region at time of delivery, and body mass index and smoking status at time of registration with maternity care provider. Mother's mean age at delivery was 19 (SD 2.1) years. Of 34,994 the pregnancies included in the final study analyses 62.3% of women were unvaccinated, 11.0% vaccinated with one or two doses and 27.7% vaccinated with three doses prior to pregnancy. PTB (OR: 0.87; CI 0.78, 0.96)) was significantly lower for women who previously received the HPV vaccine. A dose response effect was found with each successive dose received decreasing the likelihood of PTB. No associations between the vaccinated and unvaccinated groups were shown for pre-eclampsia or stillbirth. Prior receipt of the quadrivalent HPV vaccine was associated with a significant reduction in PTB (13%); suggesting that HPV vaccination may be effective in reducing PTB. The potential global public health impact is considerable and there is urgency to undertake further research to replicate and explore these findings. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Relationship between neighborhood socioeconomic status and venous thromboembolism: results from a population-based study.

    Kort, D; van Rein, N; van der Meer, F J M; Vermaas, H W; Wiersma, N; Cannegieter, S C; Lijfering, W M

    2017-12-01

    Essentials Literature on socioeconomic status (SES) and incidence of venous thromboembolism (VTE) is scarce. We assessed neighborhood SES with VTE risk in a population of over 1.4 million inhabitants. Higher neighborhood SES was associated with lower incidence of VTE. These findings are helpful to inform policy and resource allocation in health systems. Background The association between socioeconomic status and arterial cardiovascular disease is well established. However, despite its high burden of disability-adjusted life years, little research has been carried out to determine whether socioeconomic status is associated with venous thromboembolism. Objective To determine if neighborhood socioeconomic status is associated with venous thromboembolism in a population-based study from the Netherlands. Methods We identified all patients aged 15 years and older with a first event of venous thromboembolism from inhabitants who lived in the urban districts of The Hague, Leiden and Utrecht in the Netherlands in 2008-2012. Neighborhood socioeconomic status was based on the status score, which combines educational level, income and unemployment on a four-digit postal code level. Incidence rate ratios of venous thromboembolism were calculated for different levels of neighborhood socioeconomic status, with adjustments for age and sex. Results A total of 7373 patients with a first venous thromboembolism (median age 61 years; 50% deep vein thrombosis) were identified among more than 1.4 million inhabitants. Higher neighborhood SES was associated with lower incidence of VTE. In the two highest status score groups (i.e. the 95-99th and > 99th percentile), the adjusted incidence rate ratios were 0.91 (95% confidence interval [CI], 0.84-1.00) and 0.80 (95% CI, 0.69-0.93), respectively, compared with the reference status score group (i.e. 30-70th percentile). Conclusions High neighborhood socioeconomic status is associated with a lower risk of first venous thromboembolism. © 2017

  1. Fibromyalgia and Risk of Dementia-A Nationwide, Population-Based, Cohort Study.

    Tzeng, Nian-Sheng; Chung, Chi-Hsiang; Liu, Feng-Cheng; Chiu, Yu-Hsiang; Chang, Hsin-An; Yeh, Chin-Bin; Huang, San-Yuan; Lu, Ru-Band; Yeh, Hui-Wen; Kao, Yu-Chen; Chiang, Wei-Shan; Tsao, Chang-Hui; Wu, Yung-Fu; Chou, Yu-Ching; Lin, Fu-Huang; Chien, Wu-Chien

    2018-02-01

    Fibromyalgia is a syndrome of chronic pain and other symptoms and is associated with patient discomfort and other diseases. This nationwide matched-cohort population-based study aimed to investigate the association between fibromyalgia and the risk of developing dementia, and to clarify the association between fibromyalgia and dementia. A total of 41,612 patients of age ≥50 years with newly diagnosed fibromyalgia between January 1, and December 31, 2000 were selected from the National Health Insurance Research Database of Taiwan, along with 124,836 controls matched for sex and age. After adjusting for any confounding factors, Fine and Gray competing risk analysis was used to compare the risk of developing dementia during the 10 years of follow-up. Of the study subjects, 1,704 from 41,612 fibromyalgia patients (21.23 per 1,000 person-years) developed dementia when compared to 4,419 from 124,836 controls (18.94 per 1,000 person-years). Fine and Gray competing risk analysis revealed that the study subjects were more likely to develop dementia (hazard ratio: 2.29, 95% CI: 2.16-2.42; P dementia in this study. The study subjects with fibromyalgia had a 2.77-fold risk of dementia in comparison to the control group. Therefore, further studies are needed to elucidate the underlying mechanisms of the association between fibromyalgia and the risk of dementia. Copyright © 2018 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  2. Comparative effectiveness of prostate cancer surgical treatments: a population based analysis of postoperative outcomes.

    Lowrance, William T; Elkin, Elena B; Jacks, Lindsay M; Yee, David S; Jang, Thomas L; Laudone, Vincent P; Guillonneau, Bertrand D; Scardino, Peter T; Eastham, James A

    2010-04-01

    Enthusiasm for laparoscopic surgical approaches to prostate cancer treatment has grown despite limited evidence of improved outcomes compared with open radical prostatectomy. We compared laparoscopic prostatectomy with or without robotic assistance vs open radical prostatectomy in terms of postoperative outcomes and subsequent cancer directed therapy. Using a population based cancer registry linked with Medicare claims we identified men 66 years old or older with localized prostate cancer who underwent radical prostatectomy from 2003 to 2005. Outcome measures were general medical/surgical complications and mortality within 90 days after surgery, genitourinary/bowel complications within 365 days, radiation therapy and/or androgen deprivation therapy within 365 days and length of hospital stay. Of the 5,923 men 18% underwent laparoscopic radical prostatectomy. Adjusting for patient and tumor characteristics, there were no differences in the rate of general medical/surgical complications (OR 0.93 95% CI 0.77-1.14) or genitourinary/bowel complications (OR 0.96 95% CI 0.76-1.22), or in postoperative radiation and/or androgen deprivation (OR 0.80 95% CI 0.60-1.08). Laparoscopic prostatectomy was associated with a 35% shorter hospital stay (p <0.0001) and a lower bladder neck/urethral obstruction rate (OR 0.74, 95% CI 0.58-0.94). In laparoscopic cases surgeon volume was inversely associated with hospital stay and the odds of any genitourinary/bowel complication. Laparoscopic prostatectomy and open radical prostatectomy have similar rates of postoperative morbidity and additional treatment. Men considering prostate cancer surgery should understand the expected benefits and risks of each technique to facilitate decision making and set realistic expectations. Copyright (c) 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  3. Childhood hunger and depressive symptoms in adulthood: Findings from a population-based study.

    Stickley, Andrew; Leinsalu, Mall

    2018-01-15

    Several studies have linked childhood hunger to an increased risk for later depression. However, as yet, there has been little research on this relation in adults of all ages or whether there are sex differences in this association. The current study examined these issues using data from a national population-based sample. Data were analyzed from 5095 adults aged 25-84 collected during the Estonian Health Interview Survey 2006. Information was obtained on the frequency of going to bed hungry in childhood and on depressive symptoms using the Emotional State Questionnaire (EST-Q). Logistic regression analysis was used to examine the association between hunger and depression while controlling for other demographic, socioeconomic and health-related variables. In a fully adjusted model, going to bed hungry in childhood either sometimes or often was associated with significantly increased odds for depressive symptoms. When the analysis was stratified by sex the association was more evident in men where any frequency of childhood hunger was linked to adult depression while only women who had experienced hunger often had higher odds for depressive symptoms in the final model. Data on childhood hunger were retrospectively reported and may have been affected by recall bias. We also lacked information on potentially relevant variables such as other childhood adversities that might have been important for the observed associations. Childhood hunger is associated with an increased risk for depressive symptoms among adults. Preventing hunger in childhood may be important for mental health across the life course. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Prevalence of depression: Comparisons of different depression definitions in population-based samples of older adults.

    Sjöberg, Linnea; Karlsson, Björn; Atti, Anna-Rita; Skoog, Ingmar; Fratiglioni, Laura; Wang, Hui-Xin

    2017-10-15

    Depression prevalence in older adults varies largely across studies, which probably reflects methodological rather than true differences. This study aims to explore whether and to what extent the prevalence of depression varies when using different diagnostic criteria and rating scales, and various samples of older adults. A population-based sample of 3353 individuals aged 60-104 years from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K) were examined in 2001-2004. Point prevalence of depression was estimated by: 1) diagnostic criteria, ICD-10 and DSM-IV-TR/DSM-5; 2) rating scales, MADRS and GDS-15; and 3) self-report. Depression prevalence in sub-samples by dementia status, living place, and socio-demographics were compared. The prevalence of any depression (including all severity grades) was 4.2% (moderate/severe: 1.6%) for ICD-10 and 9.3% (major: 2.1%) for DSM-IV-TR; 10.6% for MADRS and 9.2% for GDS-15; and 9.1% for self-report. Depression prevalence was lower in the dementia-free sample as compared to the total population. Furthermore, having poor physical function, or not having a partner were independently associated with higher depression prevalence, across most of the depression definitions. The response rate was 73.3% and this may have resulted in an underestimation of depression. Depression prevalence was similar across all depression definitions except for ICD-10, showing much lower figures. However, independent of the definition used, depression prevalence varies greatly by dementia status, physical functioning, and marital status. These findings may be useful for clinicians when assessing depression in older adults and for researchers when exploring and comparing depression prevalence across studies. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Psychiatric morbidity in the community: A population based-study from Kerala

    Shaji, K. S.; Raju, D.; Sathesh, V; Krishnakumar, P.; Punnoose, Varghese P.; Kiran, P. S; Mini, B. S.; Kumar, Shibu; Anish, P. K; Kaimal, Ganga G.; Gupthan, Lekshmy; Sumesh, T. P.; Nikhil, U. G; Cyriac, Nisha; Vinod, M. D.; Kumar, R. Prasad; Chandran, Ramesh; Rejani, P. P; Amrutha, R; Mahesh; Anand, TN

    2017-01-01

    Background: Estimates of psychiatric morbidity in the community will help service development. Participation of trained nonspecialist health-care providers will facilitate scaling up of services in resource-limited settings. Aims: This study aimed to estimate the prevalence of priority mental health problems in populations served by the District Mental Health Program (DMHP). Settings and Design: This is a population-based cross-sectional survey. Materials and Methods: We did stratified cluster sampling of households in five districts of Kerala. Trained Accredited Social Health Activists (ASHAs) identified people who had symptoms suggestive of schizophrenia or bipolar disorder. Clinicians evaluated the information collected by the ASHAs and designated individuals as probable cases of psychosis or noncases. Screening instruments such as General Health Questionnaire-12, CAGE questionnaire, and Everyday Abilities Scale for India were used for identifying common mental disorders (CMDs), clinically significant alcohol-related problems, and functional impairment. Results: We found 12.43% of the adult population affected by mental health conditions. We found CMD as most common with a prevalence of 9%. The prevalence of psychosis was 0.71%, clinically significant alcohol-related problems was 1.46%, and dementia and other cognitive impairments was 1.26%. We found informant-based case finding to be useful in the identification of psychosis. Conclusions: Mental health problems are common. Nonspecialist health-care providers can be trained to identify psychiatric morbidity in the community. Their participation will help in narrowing the treatment gap. Embedding operational research to DMHP will make scaling up more efficient. PMID:28827860

  6. Relationship between Polycystic Ovarian Syndrome and Subsequent Gestational Diabetes Mellitus: A Nationwide Population-Based Study.

    Mei-Lien Pan

    Full Text Available This nationwide population-based study aims to explore the relationship between polycystic ovarian syndrome (PCOS and subsequent gestational diabetes mellitus (GDM.Data from 1998-2012 Taiwan National Health Insurance Research Database were used for this study. ICD9-CM codes 256.4X and 648.X were used separately for the diagnoses of PCOS and GDM, which were further confirmed by records of blood tests or ultrasonography to ensure the accuracy of the diagnoses. Women diagnosed at 45 years of age, and those diagnosed with overt diabetes mellitus or GDM prior to PCOS were excluded. During pregnancy, each woman with a previous diagnosis of PCOS was age-matched to 10 women without PCOS. Odds ratios (ORs for risk of GDM were calculated by logistic regression analysis with adjustment for economic status and co-morbidities.Among 7,629 eligible women with a valid PCOS diagnosis, 3,109 (42.87% had subsequent pregnancies. GDM occurred frequently among women with a history of PCOS as compared to those without PCOS (20.46% vs. 10.54%, p0.05. If not used after conception, OHAs did not reduce the risk of GDM (adjusted OR = 1.20; 95% CI:0.88-1.62.A history of PCOS is a significant and independent risk factor for development of GDM. Medication for PCOS or pre-pregnancy use of OHAs does not reduce the risk of GDM. When at-risk women become pregnant, they require closer surveillance for maternal and fetal well-being, and should follow a strict diet and adhere to weight gain control to avoid obstetric complications due to GDM.

  7. Cancer risk in patients with alopecia areata: a nationwide population-based matched cohort study.

    Chen, Chih-Chiang; Chang, Yun-Ting; Liu, Han-Nan; Chen, Yi-Ju

    2018-05-01

    Alopecia areata (AA) is an organ-specific autoimmune disorder. Defective immune system related disorders are prone to increase the risk of cancer formation. However, the association among AA and variety of cancer types had never been studied. A nationwide population-based matched cohort study was conducted to evaluate the cancer risk in patients with AA. Records from Taiwan National Health Insurance Research Database were analyzed. Cases of AA from 1997 to 2013 and cancers registered in the catastrophic illness profile from the same time period were collected. The standard incidence ratio (SIR) of each cancer was calculated. In total, 2099 cancers among 162,499 patients with AA and without prior cancers were identified. The overall cancer risks in AA patients were slightly decreased, especially among male subjects (SIR: 0.89). Refer to individual cancer, the cancer risk of nonmelanoma skin cancer (NMSC) (SIR: 0.59), upper GI cancer (SIR: 0.70), liver cancer (SIR: 0.82), uterine, and cervix cancer (SIR: 0.84) were significantly lower in patients with AA. In contrast, AA patients were inclined to have lymphoma, breast cancer, kidney, and urinary bladder cancer with the SIR of 1.55, 2.93, and 2.95, respectively. Age stratified analyses revealed female AA patients younger than 50 years old have even higher risk of breast cancer (SIR: 3.37). Further sensitivity analysis showed similar results after excluding major autoimmune disorders. Cancer risk in AA patients is organ specific, and it is not associated with the underlying autoimmune disorders in patients with AA. © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  8. Economic burden of cancer across the European Union: a population-based cost analysis.

    Luengo-Fernandez, Ramon; Leal, Jose; Gray, Alastair; Sullivan, Richard

    2013-11-01

    In 2008, 2·45 million people were diagnosed with cancer and 1·23 million died because of cancer in the 27 countries of the European Union (EU). We aimed to estimate the economic burden of cancer in the EU. In a population-based cost analysis, we evaluated the cost of all cancers and also those associated with breast, colorectal, lung, and prostate cancers. We obtained country-specific aggregate data for morbidity, mortality, and health-care resource use from international and national sources. We estimated health-care costs from expenditure on care in the primary, outpatient, emergency, and inpatient settings, and also drugs. Additionally, we estimated the costs of unpaid care provided by relatives or friends of patients (ie, informal care), lost earnings after premature death, and costs associated with individuals who temporarily or permanently left employment because of illness. Cancer cost the EU €126 billion in 2009, with health care accounting for €51·0 billion (40%). Across the EU, the health-care costs of cancer were equivalent to €102 per citizen, but varied substantially from €16 per person in Bulgaria to €184 per person in Luxembourg. Productivity losses because of early death cost €42·6 billion and lost working days €9·43 billion. Informal care cost €23·2 billion. Lung cancer had the highest economic cost (€18·8 billion, 15% of overall cancer costs), followed by breast cancer (€15·0 billion, 12%), colorectal cancer (€13·1 billion, 10%), and prostate cancer (€8·43 billion, 7%). Our results show wide differences between countries, the reasons for which need further investigation. These data contribute to public health and policy intelligence, which is required to deliver affordable cancer care systems and inform effective public research funds allocation. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. A population-based study of homicide deaths in Ontario, Canada using linked death records.

    Lachaud, James; Donnelly, Peter D; Henry, David; Kornas, Kathy; Calzavara, Andrew; Bornbaum, Catherine; Rosella, Laura

    2017-07-24

    Homicide - a lethal expression of violence - has garnered little attention from public health researchers and health policy makers, despite the fact that homicides are a cause of preventable and premature death. Identifying populations at risk and the upstream determinants of homicide are important for addressing inequalities that hinder population health. This population-based study investigates the public health significance of homicides in Ontario, Canada, over the period of 1999-2012. We quantified the relative burden of homicides by comparing the socioeconomic gradient in homicides with the leading causes of death, cardiovascular disease (CVD) and neoplasm, and estimated the potential years of life lost (PYLL) due to homicide. We linked vital statistics from the Office of the Registrar General Deaths register (ORG-D) with Census and administrative data for all Ontario residents. We extracted all homicide, neoplasm, and cardiovascular deaths from 1999 to 2012, using International Classification of Diseases codes. For socioeconomic status (SES), we used two dimensions of the Ontario Marginalization Index (ON-Marg): material deprivation and residential instability. Trends were summarized across deprivation indices using age-specific rates, rate ratios, and PYLL. Young males, 15-29 years old, were the main victims of homicide with a rate of 3.85 [IC 95%: 3.56; 4.13] per 100,000 population and experienced an upward trend over the study period. The socioeconomic neighbourhood gradient was substantial and higher than the gradient for both cardiovascular and neoplasms. Finally, the PYLL due to homicide were 63,512 and 24,066 years for males and females, respectively. Homicides are an important cause of death among young males, and populations living in disadvantaged neighbourhoods. Our findings raise concerns about the burden of homicides in the Canadian population and the importance of addressing social determinants to address these premature deaths.

  10. The Association Between Barium Examination and Subsequent Appendicitis: A Nationwide Population-Based Study.

    Li, Hao-Ming; Yeh, Lee-Ren; Huang, Ying-Kai; Lin, Cheng-Li; Kao, Chia-Hung

    2017-01-01

    The incidence and association between appendicitis and barium examination (BE) remain unclear. Such potential risk may be omitted. We conducted a longitudinal, nationwide, population-based cohort study to investigate the association between BE and appendicitis risk. From the Taiwan National Health Insurance Research Database, a total of 24,885 patients who underwent BE between January 1, 2000 and December 31, 2010 were enrolled in a BE cohort; an additional 98,384 subjects without BE exposure were selected as a non-BE cohort, matched by age, sex, and index date. The cumulative incidences of subsequent appendicitis in the BE and non-BE cohorts were assessed using the Kaplan-Meier curves and log-rank test. Cox proportional hazards regression analyses were employed to calculate the appendicitis risk between the groups. The cumulative incidence of appendicitis was higher in the BE cohort than in the non-BE cohort (P = .001). The overall incidence rates of appendicitis for the BE and non-BE cohorts were 1.19 and 0.80 per 1000 person-years, respectively. After adjustment for sex, age, and comorbidities, the risk of appendicitis was higher in the BE cohort (adjusted hazard ratio = 1.46, 95% confidence interval = 1.23-1.73) compared with the non-BE cohort, especially in the first 2 months (adjusted hazard ratio = 9.72, 95% confidence interval = 4.65-20.3). BE was associated with an increased, time-dependent appendicitis risk. Clinicians should be aware of this potential risk to avoid delayed diagnoses. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. The relationship between economic conditions and postpartum depression in Taiwan: a nationwide population-based study.

    Chang, Fung-Wei; Lee, Wen-Ying; Liu, Yueh-Ping; Yang, Jing-Jung; Chen, Shu-Pin; Cheng, Kuan-Chen; Lin, Yan-Cen; Ho, Te-Wei; Chiu, Feng-Hsiang; Hsu, Ren-Jun; Liu, Jui-Ming

    2016-11-01

    Understanding mothers' economic conditions and postpartum depression (PPD) is important for determining how they will take care of themselves and their infants during the postnatal period, especially for low-income families. This study examined the relationship between economic conditions and PPD to elucidate the effect of economic contraction on PPD. Our population-based nationwide study used 2000-2013 the National Health Insurance Research Database of Taiwan. A total of 1240 newly diagnosed PPD patients were recruited. We used the database of the Directorate General of Budget, Accounting, and Statistics of Executive Yuan of Taiwan for national economic indicators. The correlation between economic indicators and PPD was examined. The PPD incidence was positively correlated with yearly unemployment rate, consumer price index, and gross domestic product. During the great recession of 2008-2009, PPD was positively correlated with inflation rate. Consumer price index had a positive correlation with PPD incidence per month when comparing PPD in 2010 with the economic indicators during the great recession. As this retrospective study evaluated macroeconomic indicators, it is unclear whether the macroeconomic indicators' effect on PPD totally reflects the effect of true personal economic status on PPD. There was a significant association between PPD and economic conditions. This study shows that mothers' familial environment plays an important role in the development of PPD. The impact of the worldwide economic downturn of the great recession on women is persistent. This useful finding may give health policy planners a hint of early discovering and dealing with PPD when worldwide economic downturn. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. Cigarette smoking, nicotine dependence and anxiety disorders: a systematic review of population-based, epidemiological studies

    Moylan Steven

    2012-10-01

    Full Text Available Abstract Background Multiple studies have demonstrated that rates of smoking and nicotine dependence are increased in individuals with anxiety disorders. However, significant variability exists in the epidemiological literature exploring this relationship, including study design (cross-sectional versus prospective, the population assessed (random sample versus clinical population and diagnostic instrument utilized. Methods We undertook a systematic review of population-based observational studies that utilized recognized structured clinical diagnostic criteria (Diagnostic and Statistical Manual of Mental Disorders (DSM or International Classification of Diseases (ICD for anxiety disorder diagnosis to investigate the relationship between cigarette smoking, nicotine dependence and anxiety disorders. Results In total, 47 studies met the predefined inclusion criteria, with 12 studies providing prospective information and 5 studies providing quasiprospective information. The available evidence suggests that some baseline anxiety disorders are a risk factor for initiation of smoking and nicotine dependence, although the evidence is heterogeneous and many studies did not control for the effect of comorbid substance use disorders. The identified evidence however appeared to more consistently support cigarette smoking and nicotine dependence as being a risk factor for development of some anxiety disorders (for example, panic disorder, generalized anxiety disorder, although these findings were not replicated in all studies. A number of inconsistencies in the literature were identified. Conclusions Although many studies have demonstrated increased rates of smoking and nicotine dependence in individuals with anxiety disorders, there is a limited and heterogeneous literature that has prospectively examined this relationship in population studies using validated diagnostic criteria. The most consistent evidence supports smoking and nicotine dependence as

  13. Population-based reference values for bone mineral density in young men

    Høiberg, M; Nielsen, Torben Leo; Wraae, K

    2007-01-01

    -energy X-ray absorptiometry (DXA) equipment. METHODS: The aim of the present study was 1) to establish population-based reference values for BMD in young men and 2) to study subgroups based on variables with suspected impact on bone metabolism. We included 783 young Caucasian men aged 20 to 30 years...... in the Odense Androgen Study (OAS). RESULTS: Peak BMD was attained within the third decade. Obesity (BMI > 30 kg/m2) was associated with higher BMD. Abuse of anabolic steroids as well as chronic illness was associated with lower BMD. Our population-based reference values for BMD of the total hip (1.078 +/- 0...

  14. Increased incidence of peptic ulcer disease in central serous chorioretinopathy patients: a population-based retrospective cohort study.

    Chen, San-Ni; Lian, Iebin; Chen, Yi-Chiao; Ho, Jau-Der

    2015-02-01

    To investigate peptic ulcer disease and other possible risk factors in patients with central serous chorioretinopathy (CSR) using a population-based database. In this population-based retrospective cohort study, longitudinal data from the Taiwan National Health Insurance Research Database were analyzed. The study cohort comprised 835 patients with CSR and the control cohort comprised 4175 patients without CSR from January 2000 to December 2009. Conditional logistic regression was applied to examine the association of peptic ulcer disease and other possible risk factors for CSR, and stratified Cox regression models were applied to examine whether patients with CSR have an increased chance of peptic ulcer disease and hypertension development. The identifiable risk factors for CSR included peptic ulcer disease (adjusted odd ratio: 1.39, P = 0.001) and higher monthly income (adjusted odd ratio: 1.30, P = 0.006). Patients with CSR also had a significantly higher chance of developing peptic ulcer disease after the diagnosis of CSR (adjusted odd ratio: 1.43, P = 0.009). Peptic ulcer disease and higher monthly income are independent risk factors for CSR. Whereas, patients with CSR also had increased risk for peptic ulcer development.

  15. Association between obesity and suicide in woman, but not in man: a population-based study of young adults.

    Branco, Jerônimo Costa; Motta, Janaína; Wiener, Carolina; Oses, Jean Pierre; Pedrotti Moreira, Fernanda; Spessato, Barbara; Dias, Luciano; da Silva, Ricardo

    2017-03-01

    The relationship between obesity and suicide risk is still unclear with controversial research results. The aim of this study is to investigate the relationship between obesity and suicide risk for men and women in a population-based study of young adults. This is a cross-sectional population-based study that identified young adults between 18 and 35 years of age. Suicide risk was investigated through the structured clinical interview Mini. Weight and height were assessed, and participants were classified as normal-weight body mass index (BMI obese (BMI > 30). The prevalence of obesity was of 19.9% of the total sample (n = 1953). Obesity was more prevalent among women and participants between 27 and 35 years of age. Suicide risk was present in 13.0% of the sample and more prevalent among women. In our study we found an association between obesity and suicide risk for women, but not for men. Obesity was associated with a higher prevalence of suicide risk in women. Given the strength of the relationship between BMI and suicide, identifying the mechanisms associated with obesity, especially for women, can lead to new insights into the prevention of suicide risk.

  16. Lower bone turnover markers in metabolic syndrome and diabetes: the population-based Study of Health in Pomerania.

    Lerchbaum, E; Schwetz, V; Nauck, M; Völzke, H; Wallaschofski, H; Hannemann, A

    2015-05-01

    Accumulating evidence demonstrates an important interaction between bone and energy metabolism. We aimed to study the associations of three bone turnover markers (BTM: osteocalcin, beta-crosslaps, procollagen type 1 N-terminal propeptide) as well as of 25-hydroxyvitamin D and parathyroid hormone with metabolic syndrome (MetS) or type 2 diabetes mellitus (T2DM) in a large population-based cohort. This cross-sectional study comprised 2671 adult men and women participating in the first follow-up of the population-based Study of Health in Pomerania (SHIP-1). Multivariable logistic regression analyses were performed to assess sex-specific associations between the BTMs, 25-hydroxyvitamin D or parathyroid hormone and metabolic disease. All models were adjusted for age, body mass index, smoking status, physical activity, estimated glomerular filtration rate and month of blood sampling. The models for women were further adjusted for menopausal status. Higher BTM or 25-hydroxyvitamin D concentrations were associated with significantly lower odds for metabolic disease, while there was no association between parathyroid hormone and MetS or T2DM. Our results contribute to the accumulating evidence of a cross-sectional association between high BTM or 25-hydroxyvitamin D concentrations and a lower prevalence of MetS or T2DM. Further research is necessary to evaluate the mechanisms underlying these results. Copyright © 2015 Elsevier B.V. All rights reserved.

  17. Prevalence of cerebral palsy in Uganda: a population-based study.

    Kakooza-Mwesige, Angelina; Andrews, Carin; Peterson, Stefan; Wabwire Mangen, Fred; Eliasson, Ann Christin; Forssberg, Hans

    2017-12-01

    Few population-based studies of cerebral palsy have been done in low-income and middle-income countries. We aimed to examine cerebral palsy prevalence and subtypes, functional impairments, and presumed time of injury in children in Uganda. In this population-based study, we used a nested, three-stage, cross-sectional method (Iganga-Mayuge Health and Demographic Surveillance System [HDSS]) to screen for cerebral palsy in children aged 2-17 years in a rural eastern Uganda district. A specialist team confirmed the diagnosis and determined the subtype, motor function (according to the Gross Motor Function Classification System [GMFCS]), and possible time of brain injury for each child. Triangulation and interviews with key village informants were used to identify additional cases of suspected cerebral palsy. We estimated crude and adjusted cerebral palsy prevalence. We did χ 2 analyses to examine differences between the group screened at stage 1 and the entire population and regression analyses to investigate associations between the number of cases and age, GMFCS level, subtype, and time of injury. We used data from the March 1, 2015, to June 30, 2015, surveillance round of the Iganga-Mayuge HDSS. 31 756 children were screened for cerebral palsy, which was confirmed in 86 (19%) of 442 children who screened positive in the first screening stage. The crude cerebral palsy prevalence was 2·7 (95% CI 2·2-3·3) per 1000 children, and prevalence increased to 2·9 (2·4-3·6) per 1000 children after adjustment for attrition. The prevalence was lower in older (8-17 years) than in younger (cerebral palsy was the most common subtype (45 [46%] of 97 children) followed by bilateral cerebral palsy (39 [40%] of 97 children). 14 (27%) of 51 children aged 2-7 years had severe cerebral palsy (GMFCS levels 4-5) compared with only five (12%) of 42 children aged 8-17 years. Few children (two [2%] of 97) diagnosed with cerebral palsy were born preterm. Post-neonatal events were the

  18. A population based statistical model for daily geometric variations in the thorax

    Szeto, Yenny Z.; Witte, Marnix G.; van Herk, Marcel; Sonke, Jan-Jakob

    2017-01-01

    To develop a population based statistical model of the systematic interfraction geometric variations between the planning CT and first treatment week of lung cancer patients for inclusion as uncertainty term in future probabilistic planning. Deformable image registrations between the planning CT and

  19. A UK population-based study of the relationship between mental disorder and victimisation

    Hart, C.; Vet, R. de; Moran, P.; Hatch, S.L.; Dean, K.

    2012-01-01

    PURPOSE: To establish the prevalence of victimisation in a UK population-based sample and to investigate the association between mental disorder and victimisation in both cross-sectional and prospective manner, whilst adjusting for potential confounds. METHODS: Data from the National Child

  20. Sickness benefit claims due to mental disorders in Brazil : associations in a population-based study

    Barbosa-Branco, Anadergh; Bultmann, Ute; Steenstra, Ivan

    2012-01-01

    This study aims to determine the prevalence and duration of sickness benefit claims due to mental disorders and their association with economic activity, sex, age, work-relatedness and income replacement using a population-based study of sickness benefit claims (> 15 days) due to mental disorders in

  1. Harmonising measures of knee and hip osteoarthritis in population-based cohort studies

    Leyland, K M; Gates, L S; Nevitt, M

    2018-01-01

    OBJECTIVE: Population-based osteoarthritis (OA) cohorts provide vital data on risk factors and outcomes of OA, however the methods to define OA vary between cohorts. We aimed to provide recommendations for combining knee and hip OA data in extant and future population cohort studies, in order to ...

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

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

  3. Mortality in myasthenia gravis: A nationwide population-based follow-up study in Denmark

    Hansen, Julie S; Danielsen, Ditte H; Somnier, Finn E

    2016-01-01

    INTRODUCTION: In previous studies of myasthenia gravis (MG), increased mortality has been reported. The aim of this study was to estimate mortality in patients with acetylcholine receptor antibody-positive (AChR-Ab-seropositive) MG in a nationwide population-based, long-term follow-up study...

  4. Sex differences in subjective and actigraphic sleep measures: A population-based study of elderly persons

    Berg, J.F. van den; Miedema, H.M.E.; Tulen, J.H.M.; Hofman, A.; Neven, A.K.; Tiemeier, H.

    2009-01-01

    Study Objectives: To investigate and explain sex differences in subjective and actigraphic sleep parameters in community-dwelling elderly persons. Design: Cross-sectional study. Setting: The study was embedded in the Rotterdam Study, a population-based study. Participants: Nine hundred fifty-six

  5. Regular exercise, anxiety, depression and personality: a population-based study

    de Moor, M. H. M.; Beem, A. L.; Stubbe, J. H.; Boomsma, D. I.; de Geus, E. J. C.

    2006-01-01

    To examine whether regular exercise is associated with anxiety, depression and personality in a large population-based sample as a function of gender and age. The sample consisted of adolescent and adult twins and their families (N=19,288) who participated in the study on lifestyle and health from

  6. Phenotyping asthma, rhinitis and eczema in MeDALL population-based birth cohorts

    Garcia-Aymerich, J; Benet, M; Saeys, Y

    2015-01-01

    at 4 years and 14 585 at 8 years from seven European population-based birth cohorts (MeDALL project). At each age period, children were grouped, using partitioning cluster analysis, according to the distribution of 23 variables covering symptoms 'ever' and 'in the last 12 months', doctor diagnosis, age...

  7. Estrogen use and early onset Alzheimer's disease: a population-based study

    A.J.C. Slooter (Arjen); J.B. Bronzova (Juliana); J.C.M. Witteman (Jacqueline); C.M. van Duijn (Cornelia); C. van Broeckhoven (Christine); A. Hofman (Albert)

    1999-01-01

    textabstractEstrogen use may be protective for Alzheimer's disease with late onset. However, the effects on early onset Alzheimer's disease are unclear. This issue was studied in a population based setting. For each female patient, a female control was matched on age (within 5

  8. Epidemiology of Haemophilus influenzae bacteremia: A multi-national population-based assessment

    Laupland, Kevin B; Schønheyder, Henrik C; Østergaard, Christian

    2011-01-01

    OBJECTIVES: Haemophilus influenzae is an important cause of invasive infection but contemporary data in non-selected populations is limited. METHODS: Population-based surveillance for Haemophilus influenzae bacteremia was conducted in seven regions in Australia, Canada, and Denmark during 2000-20...

  9. Epidemiology of multiple congenital anomalies in Europe: A EUROCAT population-based registry study

    Calzolari, Elisa; Barisic, Ingeborg; Loane, Maria

    2014-01-01

    BACKGROUND: This study describes the prevalence, associated anomalies, and demographic characteristics of cases of multiple congenital anomalies (MCA) in 19 population-based European registries (EUROCAT) covering 959,446 births in 2004 and 2010. METHODS: EUROCAT implemented a computer algorithm f...

  10. Paper 3: EUROCAT data quality indicators for population-based registries of congenital anomalies

    Loane, Maria; Dolk, Helen; Garne, Ester

    2011-01-01

    The European Surveillance of Congenital Anomalies (EUROCAT) network of population-based congenital anomaly registries is an important source of epidemiologic information on congenital anomalies in Europe covering live births, fetal deaths from 20 weeks gestation, and terminations of pregnancy for...

  11. Parity and 11-Year Serum Thyrotropin and Thyroid Autoantibody Change: A Longitudinal Population-Based Study

    Bjergved, Lena; Carlé, Allan; Jørgensen, Torben

    2016-01-01

    thyrotropin (TSH), as well as change in thyroid peroxidase autoantibody (TPOAb) status. A random sample of 4649 people aged 18-65 years participated in a population-based study in the period 1997-1998. In the study presented here, 1749 non-pregnant women with no history of thyroid disease were included who...

  12. Acute hospital, community, and indirect costs of stroke associated with atrial fibrillation: population-based study.

    Hannon, Niamh

    2014-10-30

    No economic data from population-based studies exist on acute or late hospital, community, and indirect costs of stroke associated with atrial fibrillation (AF-stroke). Such data are essential for policy development, service planning, and cost-effectiveness analysis of new therapeutic agents.

  13. The evaluation of a population based diffusion tensor image atlas using a ground truth method

    Van Hecke, Wim; Leemans, Alexander; D'Agostino, Emiliano; De Backer, Steve; Vandervliet, Evert; Parizel, Paul M.; Sijbers, Jan

    2008-03-01

    Purpose: Voxel based morphometry (VBM) is increasingly being used to detect diffusion tensor (DT) image abnormalities in patients for different pathologies. An important requisite for these VBM studies is the use of a high-dimensional, non-rigid coregistration technique, which is able to align both the spatial and the orientational information. Recent studies furthermore indicate that high-dimensional DT information should be included during coregistration for an optimal alignment. In this context, a population based DTI atlas is created that preserves the orientational DT information robustly and contains a minimal bias towards any specific individual data set. Methods: A ground truth evaluation method is developed using a single subject DT image that is deformed with 20 deformation fields. Thereafter, an atlas is constructed based on these 20 resulting images. Thereby, the non-rigid coregistration algorithm is based on a viscous fluid model and on mutual information. The fractional anisotropy (FA) maps as well as the DT elements are used as DT image information during the coregistration algorithm, in order to minimize the orientational alignment inaccuracies. Results: The population based DT atlas is compared with the ground truth image using accuracy and precision measures of spatial and orientational dependent metrics. Results indicate that the population based atlas preserves the orientational information in a robust way. Conclusion: A subject independent population based DT atlas is constructed and evaluated with a ground truth method. This atlas contains all available orientational information and can be used in future VBM studies as a reference system.

  14. Socioeconomic differences in children’s television viewing trajectory: A population-based prospective cohort study

    Yang-Huang, J. (Junwen); A. van Grieken (Amy); H.A. Moll (Henriëtte); V.W.V. Jaddoe (Vincent); A.I. Wijtzes (Anne); H. Raat (Hein)

    2017-01-01

    textabstractWe aimed to evaluate the association between family socioeconomic status and repeatedly measured child television viewing time from early childhood to the school period. We analyzed data on 3,561 Dutch children from the Generation R Study, a population-based study in the Netherlands.

  15. Adaptive list sequential sampling method for population-based observational studies

    Hof, Michel H.; Ravelli, Anita C. J.; Zwinderman, Aeilko H.

    2014-01-01

    In population-based observational studies, non-participation and delayed response to the invitation to participate are complications that often arise during the recruitment of a sample. When both are not properly dealt with, the composition of the sample can be different from the desired

  16. Prevalence and prognosis of synchronous colorectal cancer: a Dutch population-based study

    Mulder, S.F.; Kranse, R.; Damhuis, R.A.; Wilt, J.H. de; Ouwendijk, R.J.; Kuipers, E.J.; Leerdam, M.E. van

    2011-01-01

    BACKGROUND: A noticeable proportion of colorectal cancer (CRC) patients are diagnosed with synchronous CRC. Large population-based studies on the incidence, risk factors and prognosis of synchronous CRC are, however, scarce, and are needed for better determination of risks of synchronous CRC in

  17. A review of population-based studies on hypertension in Ghana ...

    Background: Hypertension is becoming a common health problem worldwide with increasing life expectancy and increasing prevalence of risk factors. Epidemiological data on hypertension in Ghana is necessary to guide policy and develop effective interventions. Methods: A review of population-based studies on ...

  18. Evaluation of two population-based input functions for quantitative neurological FDG PET studies

    Eberl, S.; Anayat, A.R.; Fulton, R.R.; Hooper, P.K.; Fulham, M.J.

    1997-01-01

    The conventional measurement of the regional cerebral metabolic rate of glucose (rCMRGlc) with fluorodexoyglucose (FDG) and positron emission tomography (PET) requires arterial or arterialised-venous (a-v) blood sampling at frequent intervals to obtain the plasma input function (IF). We evaluated the accuracy of rCMRGlc measurements using population-based IFs that were calibrated with two a-v blood samples. Population-based IFs were derived from: (1) the average of a-v IFs from 26 patients (Standard IF) and (2) a published model of FDG plasma concentration (Feng IF). Values for rCMRGlc calculated from the population-based IFs were compared with values obtained with IFs derived from frequent a-v blood sampling in 20 non-diabetic and six diabetic patients. Values for rCMRGlc calculated with the different IFs were highly correlated for both patient groups (r≥0.992) and root mean square residuals about the regression line were less than 0.24 mg/min/100 g. The Feng IF tended to underestimate high rCMRGlc. Both population-based IFs simplify the measurement of rCMRGlc with minimal loss in accuracy and require only two a-v blood samples for calibration. The reduced blood sampling requirements markedly reduce radiation exposure to the blood sampler. (orig.)

  19. Population-based reference values for bone mineral density in young men

    Høiberg, M; Nielsen, T L; Wraae, Kristian

    2007-01-01

    Population-based reference values for peak bone mass density in Danish men. BMD of total hip (1.078 +/- 0,14 g/cm2) differed significantly from values from National Health and Nutrition Examination Survey III and of total lumbar spine ((1.073 +/- 0.125 g/cm2) differed significantly from Hologic...

  20. Recurrent bacteraemia: A 10-year regional population-based study of clinical and microbiological risk factors

    Jensen, U.S.; Knudsen, J.D.; Andersen, Christian Østergaard

    2010-01-01

    Background: A population-based nested case-control study was conducted in order to characterize patient factors and microbial species associated with recurrent bacteraemia. Methods: All patients with bacteraemia in a Danish region during 1996-2006 were investigated. Recurrence was defined based o...

  1. Development of a "Myeloma Risk Score" using a population-based registry on paraproteinemia and myeloma

    Ong, F; Hermans, J; Noordijk, E M; De Kieviet, W; Seelen, P J; Wijermans, P W; Kluin-Nelemans, J C

    1997-01-01

    Diagnostic systems for monoclonal gammopathies use bone marrow and X-ray examinations to exclude multiple myeloma (MM). Data from a population-based registry of unselected patients with paraproteinemia indicate that these tests are often done only when MM is suspected. We used 441 randomly selected

  2. Pneumococcal serotypes and mortality following invasive pneumococcal disease: a population-based cohort study

    Harboe, Zitta B; Thomsen, Reimar W; Riis, Anders

    2009-01-01

    BACKGROUND: Pneumococcal disease is a leading cause of morbidity and mortality worldwide. The aim of this study was to investigate the association between specific pneumococcal serotypes and mortality from invasive pneumococcal disease (IPD). METHODS AND FINDINGS: In a nationwide population-based...

  3. Recurrence risk of low Apgar score among term singletons: a population-based cohort study

    Ensing, Sabine; Schaaf, Jelle M.; Abu-Hanna, Ameen; Mol, Ben W. J.; Ravelli, Anita C. J.

    2014-01-01

    To examine the risk of recurrence of low Apgar score in a subsequent term singleton pregnancy. Population-based cohort study. The Netherlands. A total of 190,725 women with two subsequent singleton term live births between 1999 and 2007. We calculated the recurrence risk of low Apgar score after

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

    Chung, Kuo-Hsuan; Lin, Herng-Ching

    2010-01-01

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

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

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

    2013-01-01

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

  6. Suicide risk in relation to level of urbanicity - a population-based linkage study

    Qin, Ping

    2005-01-01

    BACKGROUND: The extent to which the high suicide rate in urban areas is influenced by exposures to risk factors for suicide other than urbanicity remains unknown. This population-based study aims to investigate suicide risk in relation to the level of urbanicity in the context of other factors...

  7. Sensor, a population-based cohort study on gastroenteritis in the Netherlands: incidence and etiology.

    Wit, M.A.S. de; Koopmans, M.P.G.; Kortbeek, L.M.; Wannet, W.J.B.; Vinje, J; Leusden, F. van; Bartelds, A.I.M.; Duynhoven, Y.T.H.P. van

    2001-01-01

    A prospective population-based cohort study with a nested case- control study was conducted to estimate the incidence of gastroenteritis and the associated pathogens in the general Dutch population. Follow-up of two consecutive cohorts was performed by weekly reporting cards from december 1998 to

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

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

    2014-01-01

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

  9. Emotional development in children with tics : a longitudinal population-based study

    Hoekstra, P. J.; Lundervold, A. J.; Lie, S. A.; Gillberg, C.; Plessen, Kerstin J.

    Children with tics often experience accompanying problems that may have more impact on their well being and quality of life than the tics themselves. The present study investigates characteristics and the course of associated problems. In a population-based follow-up study, we investigated the

  10. Chronic comorbidities in children with type 1 diabetes : a population-based cohort study

    Fazelifarsani, Soulmaz; Souverein, Patrick C|info:eu-repo/dai/nl/243074948; van der Vorst, Marja M J; Knibbe, Catherijne A J; de Boer, Anthonius|info:eu-repo/dai/nl/075097346; Mantel-Teeuwisse, Aukje K|info:eu-repo/dai/nl/266775098

    OBJECTIVE: To determine the incidence of chronic comorbidities among children with type 1 diabetes (T1D) and to compare incidences with a group of children without diabetes. DESIGN: Population-based cohort study. SETTING: Dutch PHARMO database (1998-2010). PATIENTS: All patients (<19 years old) with

  11. Population-based metagenomics analysis reveals markers for gut microbiome composition and diversity

    Zhernakova, A.; Kurilshikov, Alexander; Bonder, Marc Jan; Feskens, E.J.M.

    2016-01-01

    Deep sequencing of the gut microbiomes of 1135 participants from a Dutch population-based cohort shows relations between the microbiome and 126 exogenous and intrinsic host factors, including 31 intrinsic factors, 12 diseases, 19 drug groups, 4 smoking categories, and 60 dietary factors. These

  12. Retesting with the TRUE Test in a population-based twin cohort with hand eczema

    Lerbaek, Anne; Kyvik, Kirsten Ohm; Menné, Torkil

    2007-01-01

    Population-based studies on contact allergy with retesting of individuals are infrequently performed. Variable degrees of persistence are reported when individuals with contact allergy are retested with years in between. The patch test results of 270 individuals tested in 2005-2006 are presented ...

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

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

    2013-01-01

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

  14. A review of population-based studies on hypertension in ghana

    Addo, J.; Agyemang, C.; Smeeth, L.; de-Graft Aikins, A.; Edusei, A. K.; Ogedegbe, O.

    2012-01-01

    Hypertension is becoming a common health problem worldwide with increasing life expectancy and increasing prevalence of risk factors. Epidemiological data on hypertension in Ghana is necessary to guide policy and develop effective interventions. A review of population-based studies on hypertension

  15. Development of Population-Based Resilience Measures in the Primary School Setting

    Sun, Jing; Stewart, Donald

    2007-01-01

    Purpose: The purpose of the population-based study in the paper is to report on progress in formulating instruments to measure children's resilience and associated protective factors in family, primary school and community contexts. Design/methodology/approach: In this paper a total of 2,794 students, 1,558 parents/caregivers, and 465 staff were…

  16. CardioBengo study protocol: a population based cardiovascular longitudinal study in Bengo Province, Angola

    João M. Pedro

    2016-03-01

    Full Text Available Abstract Background Cardiovascular diseases and other non-communicable diseases are major causes of morbidity and mortality, responsible for 38 million deaths in 2012, 75 % occurring in low- and middle-income countries. Most of these countries are facing a period of epidemiological transition, being confronted with an increased burden of non-communicable diseases, which challenge health systems mainly designed to deal with infectious diseases. With the adoption of the World Health Organization “Global Action Plan for the Prevention and Control of non-communicable diseases, 2013–2020”, the national dimension of risk factors for non-communicable diseases must be reported on a regular basis. Angola has no national surveillance system for non-communicable diseases, and periodic population-based studies can help to overcome this lack of information. CardioBengo will collect information on risk factors, awareness rates and prevalence of symptoms relevant to cardiovascular diseases, to assist decision makers in the implementation of prevention and treatment policies and programs. Methods CardioBengo is designed as a research structure that comprises a cross-sectional component, providing baseline information and the assembling of a cohort to follow-up the dynamics of cardiovascular diseases risk factors in the catchment area of the Dande Health and Demographic Surveillance System of the Health Research Centre of Angola, in Bengo Province, Angola. The World Health Organization STEPwise approach to surveillance questionnaires and procedures will be used to collect information on a representative sex-age stratified sample, aged between 15 and 64 years old. Discussion CardioBengo will recruit the first population cohort in Angola designed to evaluate cardiovascular diseases risk factors. Using the structures in place of the Dande Health and Demographic Surveillance System and a reliable methodology that generates comparable results with other

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

    Zeidan RK

    2016-03-01

    Full Text Available Rouba Karen Zeidan,1 Rita Farah,2 Mirna N Chahine,3 Roland Asmar,3 Hassan Hosseini,4,5 Pascale Salameh,6,7 Atul Pathak8 1Doctoral School of Biology Health and Biotechnologies, Toulouse III University, Toulouse, 2Doctoral School of Life and Health Sciences, Paris-Est University, Creteil, France; 3Foundation-Medical Research Institutes, F-MRI®, Beirut, Lebanon; 4Department of Neurology, Henri Mondor Hospital AP-HP, 5EA 4391, Nerve Excitability and Therapeutics, Université Paris-Est, Creteil, France; 6School of Pharmacy, Lebanese American University, Byblos, 7Laboratory of Clinical and Epidemiology Research, Faculty of Pharmacy, Lebanese University, Hadath, Lebanon; 8Department of Cardiovascular Medicine, Hypertension, Risk Factors and Heart Failure Unit, Clinique Pasteur, Toulouse, France Background: Lebanon is experiencing a growing epidemic of coronary heart diseases (CHDs, as most low- and middle-income countries currently are. However, this growth can be attenuated if effective preventive strategies are adopted. Purpose: To provide the first national population-based prevalence of CHD and to describe the profile of Lebanese adults with prevalent CHD. Methods: We carried out a cross-sectional study using a multistage cluster sample across Lebanon. We interviewed residents aged 40 years and older using a questionnaire that captured the presence of CHDs and their risk factors (RFs. Results: Our study showed that 13.4% of the Lebanese population aged ≥40 years suffer from a prevalent CHD. CHD seemed to appear more prematurely than in developed countries, and males seemed to be more subject to CHD than females until a certain age. CHD was associated with older age, male sex, a lower economic situation, hypercholesterolemia, hypertension, having a family history of premature cardiovascular diseases, and suffering from diabetes. However, smoking and waist circumference did not seem to have an independent effect on CHD, but rather an effect

  18. CardioBengo study protocol: a population based cardiovascular longitudinal study in Bengo Province, Angola.

    Pedro, João M; Rosário, Edite; Brito, Miguel; Barros, Henrique

    2016-03-01

    Cardiovascular diseases and other non-communicable diseases are major causes of morbidity and mortality, responsible for 38 million deaths in 2012, 75 % occurring in low- and middle-income countries. Most of these countries are facing a period of epidemiological transition, being confronted with an increased burden of non-communicable diseases, which challenge health systems mainly designed to deal with infectious diseases. With the adoption of the World Health Organization "Global Action Plan for the Prevention and Control of non-communicable diseases, 2013-2020", the national dimension of risk factors for non-communicable diseases must be reported on a regular basis. Angola has no national surveillance system for non-communicable diseases, and periodic population-based studies can help to overcome this lack of information. CardioBengo will collect information on risk factors, awareness rates and prevalence of symptoms relevant to cardiovascular diseases, to assist decision makers in the implementation of prevention and treatment policies and programs. CardioBengo is designed as a research structure that comprises a cross-sectional component, providing baseline information and the assembling of a cohort to follow-up the dynamics of cardiovascular diseases risk factors in the catchment area of the Dande Health and Demographic Surveillance System of the Health Research Centre of Angola, in Bengo Province, Angola. The World Health Organization STEPwise approach to surveillance questionnaires and procedures will be used to collect information on a representative sex-age stratified sample, aged between 15 and 64 years old. CardioBengo will recruit the first population cohort in Angola designed to evaluate cardiovascular diseases risk factors. Using the structures in place of the Dande Health and Demographic Surveillance System and a reliable methodology that generates comparable results with other regions and countries, this study will constitute a useful tool for

  19. Residual Motion and Duty Time in Respiratory Gating Radiotherapy Using Individualized or Population-Based Windows

    Fuji, Hiroshi; Asada, Yoshihiro; Numano, Masumi; Yamashita, Haruo; Nishimura, Tetsuo; Hashimoto, Takayuki; Harada, Hideyuki; Asakura, Hirofumi; Murayama, Shigeyuki

    2009-01-01

    Purpose: The efficiency and precision of respiratory gated radiation therapy for tumors is affected by variations in respiration-induced tumor motion. We evaluated the use of individualized and population-based parameters for such treatment. Methods and Materials: External respiratory signal records and images of respiration-induced tumor motion were obtained from 42 patients undergoing respiratory gated radiation therapy for liver tumors. Gating window widths were calculated for each patient, with 2, 4, and 10 mm of residual motion, and the mean was defined as the population-based window width. Residual motions based on population-based and predefined window widths were compared. Duty times based on whole treatment sessions, at various window levels, were calculated. The window level giving the longest duty time was defined as the individualized most efficient level (MEL). MELs were also calculated based on the first 10 breathing cycles. The duty times for population-based MELs (defined as mean MELs) and individualized MELs were compared. Results: Tracks of respiration-induced tumor motion ranged from 3 to 50 mm. Half of the patients had larger actual residual motions than the assigned residual motions. Duty times were greater when based on individualized, rather than population-based, window widths. The MELs established during whole treatment sessions for 2 mm and 4 mm of residual motion gave significantly increased duty times, whereas those calculated using the first 10 breathing cycles showed only marginal increases. Conclusions: Using individualized window widths and levels provided more precise and efficient respiratory gated radiation therapy. However, methods for predicting individualized window levels before treatment remain to be explored.

  20. Productivity losses in chronic obstructive pulmonary disease: a population-based survey.

    Erdal, Marta; Johannessen, Ane; Askildsen, Jan Erik; Eagan, Tomas; Gulsvik, Amund; Grønseth, Rune

    2014-01-01

    We aimed to estimate incremental productivity losses (sick leave and disability) of spirometry-defined chronic obstructive pulmonary disease (COPD) in a population-based sample and in hospital-recruited patients with COPD. Furthermore, we examined predictors of productivity losses by multivariate analyses. We performed four quarterly telephone interviews of 53 and 107 population-based patients with COPD and controls, as well as 102 hospital-recruited patients with COPD below retirement age. Information was gathered regarding annual productivity loss, exacerbations of respiratory symptoms and comorbidities. Incremental productivity losses were estimated by multivariate quantile median regression according to the human capital approach, adjusting for sex, age, smoking habits, education and lung function. Main effect variables were COPD/control status, number of comorbidities and exacerbations of respiratory symptoms. Altogether 55%, 87% and 31% of population-based COPD cases, controls and hospital patients, respectively, had a paid job at baseline. The annual incremental productivity losses were 5.8 (95% CI 1.4 to 10.1) and 330.6 (95% CI 327.8 to 333.3) days, comparing population-recruited and hospital-recruited patients with COPD to controls, respectively. There were significantly higher productivity losses associated with female sex and less education. Additional adjustments for comorbidities, exacerbations and FEV1% predicted explained all productivity losses in the population-based sample, as well as nearly 40% of the productivity losses in hospital-recruited patients. Annual incremental productivity losses were more than 50 times higher in hospital-recruited patients with COPD than that of population-recruited patients with COPD. To ensure a precise estimation of societal burden, studies on patients with COPD should be population-based.

  1. Evaluation of a complex, population-based injury claims management intervention for improving injury outcomes: study protocol

    Collie, Alex; Gabbe, Belinda; Fitzharris, Michael

    2015-01-01

    Introduction Injuries resulting from road traffic crashes are a substantial cause of disability and death worldwide. Injured persons receiving compensation have poorer recovery and return to work than those with non-compensable injury. Case or claims management is a critical component of injury compensation systems, and there is now evidence that claims management can have powerful positive impacts on recovery, but can also impede recovery or exacerbate mental health concerns in some injured people. This study seeks to evaluate the impact of a population-based injury claims management intervention in the State of Victoria, Australia, on the health of those injured in motor vehicle crashes, their experience of the compensation process, and the financial viability of the compensation system. Methods and analysis Evaluation of this complex intervention involves a series of linked but stand-alone research projects to assess the anticipated process changes, impacts and outcomes of the intervention over a 5-year time frame. Linkage and analysis of routine administrative and health system data is supplemented with a series of primary studies collecting new information. Additionally, a series of ‘action’ research projects will be undertaken to inform the implementation of the intervention. A program logic model designed by the state government Transport Accident Commission in conjunction with the research team provides the evaluation framework. Ethics and dissemination Relatively few studies have comprehensively examined the impact of compensation system processes on the health of injured persons, their satisfaction with systems processes, and impacts on the financial performance of the compensation scheme itself. The wholesale, population-based transformation of an injury claims management model is a rare opportunity to document impacts of system-level policy change on outcomes of injured persons. Findings will contribute to the evidence base of information on the

  2. Academic Achievement in Adults with a History of Childhood Attention-Deficit/Hyperactivity Disorder: A Population-Based Prospective Study.

    Voigt, Robert G; Katusic, Slavica K; Colligan, Robert C; Killian, Jill M; Weaver, Amy L; Barbaresi, William J

    2017-01-01

    Previous research on the developmental course of attention-deficit/hyperactivity disorder (ADHD) is limited by biased clinic-referred samples and other methodological problems. Thus, questions about adult academic outcomes associated with childhood ADHD remain unanswered. Thus, the objective of this study was to describe academic outcomes in adulthood among incident cases of research-identified childhood ADHD versus non-ADHD referents from a population-based birth cohort. Young adults with research-identified childhood ADHD (N = 232; mean age 27.0 yr; 72.0% men) and referents (N = 335; mean age 28.6 yr; 62.7% men) from a 1976 to 1982 birth cohort (N = 5699) were invited to participate in a followup study and were administered an academic achievement battery consisting of the basic reading component of the Woodcock-Johnson III Tests of Achievement (WJ-III) and the arithmetic subtest of the Wide Range Achievement Test-Third Edition (WRAT-3). Outcomes were compared between the 2 groups using linear regression models, adjusted for age, sex, and comorbid learning disability status. Childhood ADHD cases scored from 3 to 5 grade equivalents lower on all academic tests compared with referents, with mean (SD) standard scores of 95.7 (8.4) versus 101.8 (8.1) in basic reading; 95.0 (9.3) versus 101.9 (8.5) in letterword identification; 98.2 (8.6) versus 103.2 (9.2) in passage comprehension; 95.7 (9.1) versus 100.9 (9.0) in word attack; and 87.8 (12.9) versus 98.0 (12.0) in arithmetic. This is the first prospective, population-based study of adult academic outcomes of childhood ADHD. Our data provide evidence that childhood onset ADHD is associated with long-term underachievement in reading and math that may negatively impact ultimate educational attainment and occupational functioning in adulthood.

  3. International incidence of childhood cancer, 2001-10: a population-based registry study.

    Steliarova-Foucher, Eva; Colombet, Murielle; Ries, Lynn A G; Moreno, Florencia; Dolya, Anastasia; Bray, Freddie; Hesseling, Peter; Shin, Hee Young; Stiller, Charles A

    2017-06-01

    Cancer is a major cause of death in children worldwide, and the recorded incidence tends to increase with time. Internationally comparable data on childhood cancer incidence in the past two decades are scarce. This study aimed to provide internationally comparable local data on the incidence of childhood cancer to promote research of causes and implementation of childhood cancer control. This population-based registry study, devised by the International Agency for Research on Cancer in collaboration with the International Association of Cancer Registries, collected data on all malignancies and non-malignant neoplasms of the CNS diagnosed before age 20 years in populations covered by high-quality cancer registries with complete data for 2001-10. Incidence rates per million person-years for the 0-14 years and 0-19 years age groups were age-adjusted using the world standard population to provide age-standardised incidence rates (WSRs), using the age-specific incidence rates (ASR) for individual age groups (0-4 years, 5-9 years, 10-14 years, and 15-19 years). All rates were reported for 19 geographical areas or ethnicities by sex, age group, and cancer type. The regional WSRs for children aged 0-14 years were compared with comparable data obtained in the 1980s. Of 532 invited cancer registries, 153 registries from 62 countries, departments, and territories met quality standards, and contributed data for the entire decade of 2001-10. 385 509 incident cases in children aged 0-19 years occurring in 2·64 billion person-years were included. The overall WSR was 140·6 per million person-years in children aged 0-14 years (based on 284 649 cases), and the most common cancers were leukaemia (WSR 46·4), followed by CNS tumours (WSR 28·2), and lymphomas (WSR 15·2). In children aged 15-19 years (based on 100 860 cases), the ASR was 185·3 per million person-years, the most common being lymphomas (ASR 41·8) and the group of epithelial tumours and melanoma (ASR 39·5

  4. The reliability of assigning individuals to cognitive states using the Mini Mental-State Examination: a population-based prospective cohort study

    Marioni, Riccardo E.; Chatfield, Mark; Brayne, Carol; Matthews, Fiona E.; Med Res Council

    2011-01-01

    Abstract Background Previous investigations of test re-test reliability of the Mini-Mental State Examination (MMSE) have used correlations and statistics such as Cronbach's α to assess consistency. In practice, the MMSE is usually used to group individuals into cognitive states. The reliability of this grouping (state based approach) has not been fully explored. Methods MMSE data were collected on a subset of 2,275 older participants (≥ 65 years) from the population-based Medical Research Cou...

  5. Characteristics of traditional Chinese medicine use for children with allergic rhinitis: a nationwide population-based study.

    Yen, Hung-Rong; Liang, Kai-Li; Huang, Tzu-Ping; Fan, Ji-Yu; Chang, Tung-Ti; Sun, Mao-Feng

    2015-04-01

    Allergic rhinitis (AR) is a common allergic disorder in children, some of whom seek complementary treatments, including acupuncture and Chinese herbs. Little, however, is known about the treatment of pediatric AR with traditional Chinese medicine (TCM). To characterize TCM use in pediatric AR, we conducted a nationwide population-based study. We screened one million randomly sampled beneficiaries of the National Health Insurance Program in Taiwan from 2002 to 2010 to identify children herb was Chan-Tui (Periostracum cicadae; 13.78%). Regarding syndrome differentiation (ZHENG) according to TCM theory, prescriptions for the Cold Syndrome exceeded those for the Hot Syndrome throughout the year in Taiwan. We found that approximately two-thirds of pediatric AR patients were prescribed TCM treatments in Taiwan. Further research is warranted to examine the efficacy and safety of TCM for pediatric AR patients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. Monitoring the introduction of pneumococcal conjugate vaccines into West Africa: design and implementation of a population-based surveillance system.

    Grant A Mackenzie

    2012-01-01

    Full Text Available Routine use of pneumococcal conjugate vaccines (PCVs in developing countries is expected to lead to a significant reduction in childhood deaths. However, PCVs have been associated with replacement disease with non-vaccine serotypes. We established a population-based surveillance system to document the direct and indirect impact of PCVs on the incidence of invasive pneumococcal disease (IPD and radiological pneumonia in those aged 2 months and older in The Gambia, and to monitor changes in serotype-specific IPD. Here we describe how this surveillance system was set up and is being operated as a partnership between the Medical Research Council Unit and the Gambian Government. This surveillance system is expected to provide crucial information for immunisation policy and serves as a potential model for those introducing routine PCV vaccination in diverse settings.

  7. Benign Paroxysmal Positional Vertigo after Dental Procedures: A Population-Based Case-Control Study.

    Tzu-Pu Chang

    Full Text Available Benign paroxysmal positional vertigo (BPPV, the most common type of vertigo in the general population, is thought to be caused by dislodgement of otoliths from otolithic organs into the semicircular canals. In most cases, however, the cause behind the otolith dislodgement is unknown. Dental procedures, one of the most common medical treatments, are considered to be a possible cause of BPPV, although this has yet to be proven. This study is the first nationwide population-based case-control study conducted to investigate the correlation between BPPV and dental manipulation.Patients diagnosed with BPPV between January 1, 2007 and December 31, 2012 were recruited from the National Health Insurance Research Database in Taiwan. We further identified those who had undergone dental procedures within 1 month and within 3 months before the first diagnosis date of BPPV. We also identified the comorbidities of the patients with BPPV, including head trauma, osteoporosis, migraine, hypertension, diabetes, hyperlipidemia and stroke. These variables were then compared to those in age- and gender-matched controls.In total, 768 patients with BPPV and 1536 age- and gender-matched controls were recruited. In the BPPV group, 9.2% of the patients had undergone dental procedures within 1 month before the diagnosis of BPPV. In contrast, only 5.5% of the controls had undergone dental treatment within 1 month before the date at which they were identified (P = 0.001. After adjustments for demographic factors and comorbidities, recent exposure to dental procedures was positively associated with BPPV (adjusted odds ratio 1.77; 95% confidence interval 1.27-2.47. This association was still significant if we expanded the time period from 1 month to 3 months (adjusted odds ratio 1.77; 95% confidence interval 1.39-2.26.Our results demonstrated a correlation between dental procedures and BPPV. The specialists who treat patients with BPPV should consider dental procedures to be a

  8. Benign Paroxysmal Positional Vertigo after Dental Procedures: A Population-Based Case-Control Study.

    Chang, Tzu-Pu; Lin, Yueh-Wen; Sung, Pi-Yu; Chuang, Hsun-Yang; Chung, Hsien-Yang; Liao, Wen-Ling

    2016-01-01

    Benign paroxysmal positional vertigo (BPPV), the most common type of vertigo in the general population, is thought to be caused by dislodgement of otoliths from otolithic organs into the semicircular canals. In most cases, however, the cause behind the otolith dislodgement is unknown. Dental procedures, one of the most common medical treatments, are considered to be a possible cause of BPPV, although this has yet to be proven. This study is the first nationwide population-based case-control study conducted to investigate the correlation between BPPV and dental manipulation. Patients diagnosed with BPPV between January 1, 2007 and December 31, 2012 were recruited from the National Health Insurance Research Database in Taiwan. We further identified those who had undergone dental procedures within 1 month and within 3 months before the first diagnosis date of BPPV. We also identified the comorbidities of the patients with BPPV, including head trauma, osteoporosis, migraine, hypertension, diabetes, hyperlipidemia and stroke. These variables were then compared to those in age- and gender-matched controls. In total, 768 patients with BPPV and 1536 age- and gender-matched controls were recruited. In the BPPV group, 9.2% of the patients had undergone dental procedures within 1 month before the diagnosis of BPPV. In contrast, only 5.5% of the controls had undergone dental treatment within 1 month before the date at which they were identified (P = 0.001). After adjustments for demographic factors and comorbidities, recent exposure to dental procedures was positively associated with BPPV (adjusted odds ratio 1.77; 95% confidence interval 1.27-2.47). This association was still significant if we expanded the time period from 1 month to 3 months (adjusted odds ratio 1.77; 95% confidence interval 1.39-2.26). Our results demonstrated a correlation between dental procedures and BPPV. The specialists who treat patients with BPPV should consider dental procedures to be a risk factor

  9. Intergenerational abortion tendency between mothers and teenage daughters: a population-based cohort study.

    Liu, Ning; Farrugia, M Michèle; Vigod, Simone N; Urquia, Marcelo L; Ray, Joel G

    2018-01-29

    A teenage woman's sexual health practices may be influenced by her mother's experience. We evaluated whether there is an intergenerational tendency for induced abortion between mothers and their teenage daughters. We conducted a retrospective population-based cohort study involving daughters born in Ontario between 1992 and 1999. We evaluated the daughters' data for induced abortions between age 12 years and their 20th birthday. We assessed each mother's history of induced abortion for the period from 4 years before her daughter's birth to 12 years after (i.e., when her daughter turned 12 years of age). We used Cox proportional hazard models to estimate a daughter's risk of having an induced abortion in relation to the mother's history of the same procedure. We adjusted hazard ratios (HRs) for maternal age and world region of origin, mental or physical health problems in the daughter, mother- daughter cohabitation, neighbourhood-level rate of teen induced abortion, rural or urban residence, and income quintile. A total of 431 623 daughters were included in the analysis. The cumulative probability of teen induced abortion was 10.1% (95% confidence interval [CI] 9.8%-10.4%) among daughters whose mother had an induced abortion, and 4.2% (95% CI 4.1%-4.3%) among daughters whose mother had no induced abortion, for an adjusted HR of 1.94 (95% CI 1.86-2.01). The adjusted HR of a teenaged daughter having an induced abortion in relation to number of maternal induced abortions was 1.77 (95% CI 1.69-1.85) with 1 maternal abortion, 2.04 (95% CI 1.91-2.18) with 2 maternal abortions, 2.39 (95% CI 2.19-2.62) with 3 maternal abortions and 2.54 (95% CI 2.33-2.77) with 4 or more maternal abortions, relative to none. We found that the risk of teen induced abortion was higher among daughters whose mother had had an induced abortion. Future research should explore the mechanisms for intergenerational induced abortion. © 2018 Joule Inc. or its licensors.

  10. The association between paternal and adolescent depressive symptoms: evidence from two population-based cohorts.

    Lewis, Gemma; Neary, Martha; Polek, Ela; Flouri, Eirini; Lewis, Glyn

    2017-12-01

    Incidence of depression increases markedly around age 13 years, and nearly three-quarters of adults report that their mental health problems started in adolescence. Although maternal depression is a risk factor for adolescent depression, evidence about the association between paternal and adolescent depression is inconclusive, and many studies have methodological limitations. We aimed to assess the association between paternal and adolescent depressive symptoms in two large population-based cohort studies. We used data for two-parent families from two representative prospective cohorts in Ireland (Growing up in Ireland [GUI]) and the UK (Millennium Cohort Study [MCS]). Parental depressive symptoms were measured with the Centre for Epidemiological Studies Depression Scale in the GUI cohort when children were 9 years old, and the Kessler six-item psychological distress scale in the MCS cohort when children were 7 years old. Adolescent depressive symptoms were measured with the Short Mood and Feelings Questionnaire (SMFQ) at age 13 years in the GUI cohort and age 14 years in the MCS cohort. We analysed data using linear regression models, before and after adjustment for confounders, in both multiply imputed and complete case samples. There were 6070 families in GUI and 7768 in MCS. After all adjustments, a 1 SD (three-point) increase in paternal depressive symptoms was associated with an increase of 0·24 SMFQ points (95% CI 0·03-0·45; p=0·023) in the GUI cohort and 0·18 SMFQ points (0·01-0·36; p=0·041) in the MCS cohort. This association was independent of, and not different in magnitude to, the association between maternal and adolescent depressive symptoms (Wald test p=0·435 in the GUI cohort and 0·470 in the MCS cohort). Our results show an association between depressive symptoms in fathers and depressive symptoms in their adolescent offspring. These findings support the involvement of fathers as well as mothers in early interventions to reduce the

  11. Refugee maternal and perinatal health in Ontario, Canada: a retrospective population-based study

    Shakya, Yogendra; Gagnon, Anita J; Cole, Donald C; Rashid, Meb; Blake, Jennifer; Dastoori, Parisa; Moineddin, Rahim; Ray, Joel G; Urquia, Marcelo L

    2018-01-01

    Objectives Immigrants are thought to be healthier than their native-born counterparts, but less is known about the health of refugees or forced migrants. Previous studies often equate refugee status with immigration status or country of birth (COB) and none have compared refugee to non-refugee immigrants from the same COB. Herein, we examined whether: (1) a refugee mother experiences greater odds of adverse maternal and perinatal health outcomes compared with a similar non-refugee mother from the same COB and (2) refugee and non-refugee immigrants differ from Canadian-born mothers for maternal and perinatal outcomes. Design This is a retrospective population-based database study. We implemented two cohort designs: (1) 1:1 matching of refugees to non-refugee immigrants on COB, year and age at arrival (±5 years) and (2) an unmatched design using all data. Setting and participants Refugee immigrant mothers (n=34 233), non-refugee immigrant mothers (n=243 439) and Canadian-born mothers (n=615 394) eligible for universal healthcare insurance who had a hospital birth in Ontario, Canada, between 2002 and 2014. Primary outcomes Numerous adverse maternal and perinatal health outcomes. Results Refugees differed from non-refugee immigrants most notably for HIV, with respective rates of 0.39% and 0.20% and an adjusted OR (AOR) of 1.82 (95% CI 1.19 to 2.79). Other elevated outcomes included caesarean section (AOR 1.04, 95% CI 1.00 to 1.08) and moderate preterm birth (AOR 1.08, 95% CI 0.99 to 1.17). For the majority of outcomes, refugee and non-refugee immigrants experienced similar AORs when compared with Canadian-born mothers. Conclusions Refugee status was associated with a few adverse maternal and perinatal health outcomes, but the associations were not strong except for HIV. The definition of refugee status used herein may not sensitively identify refugees at highest risk. Future research would benefit from further refining refugee status based on migration

  12. The population-based Occupational and Environmental Health Prospective Cohort Study (AMIGO) in The Netherlands.

    Slottje, Pauline; Yzermans, C Joris; Korevaar, Joke C; Hooiveld, Mariëtte; Vermeulen, Roel C H

    2014-11-26

    Occupational and environmental exposures remain important modifiable risk factors of public health. Existing cohort studies are often limited by the level of detail of data collected on these factors and health. It is also often assumed that the more healthy group is over-represented in cohort studies, which is of concern for their external validity. In this cohort profile, we describe how we set up the population-based Occupational and Environmental Health Cohort Study (AMIGO) to longitudinally study occupational and environmental determinants of diseases and well-being from a multidisciplinary and life course point of view. Reviewed by the Medical Ethics Research Committee of the University Medical Center Utrecht (protocol 10-268/C). All cohort members participate voluntarily and gave informed consent prior to their inclusion. 14,829 adult cohort members (16% of those invited) consented and filled in the online baseline questionnaire. Determinants include chemical, biological, physical (eg, electromagnetic fields), and psychosocial factors. Priority health outcomes include cancer, neurological, cardiovascular and respiratory diseases and non-specific symptoms. Owing to the recruitment strategy via general practitioners of an established network, we also collect longitudinal data registered in their electronic medical records including symptoms, diagnosis and treatments. Besides the advantage of health outcomes that cannot be easily captured longitudinally by other means, this created a unique opportunity to assess health-related participation bias by comparing general practitioner-registered prevalence rates in the cohort and its source population. We found no indications of such a systematic bias. The major assets of the AMIGO approach are its detailed occupational and environmental determinants in combination with the longitudinal health data registered in general practice besides linkage to cancer and mortality registries and self-reported health. We are now

  13. Association of Tic Disorders and Enterovirus Infection: A Nationwide Population-Based Study.

    Tsai, Ching-Shu; Yang, Yao-Hsu; Huang, Kuo-You; Lee, Yena; McIntyre, Roger S; Chen, Vincent Chin-Hung

    2016-04-01

    There has been growing interest in the association between infectious disease and mental disorders, but an association between enterovirus (EV) infection and tic disorders has not been sufficiently explored. Herein, we aim to investigate the association between EV infection and incidence of tic disorders in a nationwide population-based sample using Taiwan's National Health Insurance Research Database. We identified individuals aged ≤18 years prior to 2005 with an inpatient diagnosis of EV infection and/or history of EV infection. Tic disorder was operationalized using International Classification of Disease, Revision 9, Clinical Modification (ICD-9-CM) codes 307.20-307.23. A total of 47,998 individuals with history of EV infection were compared to 47,998 sex-, age-, and urbanization-matched controls on incidence of tic disorders. The mean ± standard deviation follow-up period for all subjects was 9.7 ± 3.6 years; the mean latency period between initial EV infection and incident diagnosis of tic disorder diagnosis was 5.4 ± 2.8 years. EV infection was significantly associated with greater incidence of tic disorders (hazard ratio [HR] = 1.24, 95% CI: 1.07-1.45). When subgrouped on the basis of central nervous system (CNS) involvement, EV infection with CNS involvement was not significantly associated with greater incidence of tic disorders when compared to controls (HR = 1.25, 95% CI: 0.64-2.43); EV infection without CNS involvement was significantly associated greater incidence of tic disorders when compared to controls (HR = 1.24, 95% CI: 1.07-1.45). In addition, hospitalization for an EV infection did not increase the hazard for greater incidence of tic disorders (HR = 1.32, 95% CI: 1.04-1.67 with hospitalization and 1.22, 95% CI: 1.04-1.44 without hospitalization). EV infection is temporally associated with incidence of tic disorders. Our observations add to the growing body of literature implicating immune-inflammatory system in

  14. Migration and risk of HIV acquisition in Rakai, Uganda: a population-based cohort study.

    Olawore, Oluwasolape; Tobian, Aaron A R; Kagaayi, Joseph; Bazaale, Jeremiah M; Nantume, Betty; Kigozi, Grace; Nankinga, Justine; Nalugoda, Fred; Nakigozi, Gertrude; Kigozi, Godfrey; Gray, Ronald H; Wawer, Maria J; Ssekubugu, Robert; Santelli, John S; Reynolds, Steven J; Chang, Larry W; Serwadda, David; Grabowski, Mary K

    2018-04-01

    In sub-Saharan Africa, migrants typically have higher HIV prevalence than non-migrants; however, whether HIV acquisition typically precedes or follows migration is unknown. We aimed to investigate the risk of HIV after migration in Rakai District, Uganda. In a prospective population-based cohort of HIV-negative participants aged 15-49 years in Rakai, Uganda, between April 6, 1999, and Jan 30, 2015, we assessed the association between migration and HIV acquisition. Individuals were classified as recent in-migrants (≤2 years in community), non-recent in-migrants (>2 years in community), or permanent residents with no migration history. The primary outcome was incident HIV infection. We used Poisson regression to estimate incidence rate ratios (IRRs) of HIV associated with residence status with adjustment for demographics, sexual behaviours, and time. Data were also stratified and analysed within three periods (1999-2004, 2005-11, and 2011-15) in relation to the introduction of combination HIV prevention (CHP; pre-CHP, early CHP, and late CHP). Among 26 995 HIV-negative people who participated in the Rakai Community Cohort Study survey, 15 187 (56%) contributed one or more follow-up visits (89 292 person-years of follow-up) and were included in our final analysis. 4451 (29%) were ever in-migrants and 10 736 (71%) were permanent residents. 841 incident HIV events occurred, including 243 (29%) among in-migrants. HIV incidence per 100 person-years was significantly increased among recent in-migrants compared with permanent residents, for both women (1·92, 95% CI 1·52-2·43 vs 0·93, 0·84-1·04; IRR adjusted for demographics 1·75, 95% CI 1·33-2·33) and men (1·52, 0·99-2·33 vs 0·84, 0·74-0·94; 1·74, 1·12-2·71), but not among non-recent in-migrants (IRR adjusted for demographics 0·94, 95% CI 0·74-1·19 for women and 1·28, 0·94-1·74 for men). Between the pre-CHP and late-CHP periods, HIV incidence declined among permanent resident men (p

  15. Family meals and eating practices among mothers in Santos, Brazil: A population-based study.

    Sato, Priscila de Morais; Lourenço, Bárbara Hatzlhoffer; Trude, Angela Cristina Bizzotto; Unsain, Ramiro Fernandez; Pereira, Patrícia Rocha; Martins, Paula Andrea; Scagliusi, Fernanda Baeza

    2016-08-01

    This study investigates family meals among mothers and explores associations between eating with family and sociodemographic characteristics, body mass index, and eating practices. A population-based cross-sectional study, using complex cluster-sampling, was conducted in the city of Santos, Brazil with 439 mothers. Frequency of family meals was assessed by asking if mothers did or did not usually have a) breakfast, b) lunch, and c) dinner with family. Linear regression analyses were conducted for the number of meals eaten with family per day and each of the potential explanatory variables, adjusting for the mother's age. Poisson regression with robust variance was used to analyze each factor associated with eating with family as classified categorically: a) sharing meals with family, b) not eating any meals with family. Only 16.4% (n = 72) of participants did not eat any meals with family. From the 83.6% (n = 367) of mothers that had at least one family meal per day, 69.70% (n = 306) ate dinner with their families. Mothers aged ≥40 years reported significantly fewer meals eaten with family compared to mothers aged 30-39 years (β: -0.26, p = 0.04). Having family meals was 54% more prevalent among mothers with ≥12 years of education (PR for no meals eaten with family: 0.54, 95% CI: 0.30; 0.96, p = 0.03), when compared to mothers with less than nine years of education. Eating no meals with family was 85% more prevalent among mothers who reported that eating was one of the biggest pleasures in their lives (PR: 1.85, 95% CI: 1.21; 2.82, p = 0.004). We suggest the need for further research investigating the effects of family meals on mothers' health through nutritional and phenomenological approaches. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Burden of diabetes mellitus estimated with a longitudinal population-based study using administrative databases.

    Luciana Scalone

    Full Text Available OBJECTIVE: To assess the epidemiologic and economic burden of diabetes mellitus (DM from a longitudinal population-based study. RESEARCH DESIGN AND METHODS: Lombardy Region includes 9.9 million individuals. Its DM population was identified through a data warehouse (DENALI, which matches with a probabilistic linkage demographic, clinical and economic data of different Healthcare Administrative databases. All individuals, who, during the year 2000 had an hospital discharge with a IDC-9 CM code 250.XX, and/or two consecutive prescriptions of drugs for diabetes (ATC code A10XXXX within one year, and/or an exemption from co-payment healthcare costs specific for DM, were selected and followed up to 9 years. We calculated prevalence, mortality and healthcare costs (hospitalizations, drugs and outpatient examinations/visits from the National Health Service's perspective. RESULTS: We identified 312,223 eligible subjects. The study population (51% male had a mean age of 66 (from 0.03 to 105.12 years at the index date. Prevalence ranged from 0.4% among subjects aged ≤45 years to 10.1% among those >85 years old. Overall 43.4 deaths per 1,000 patients per year were estimated, significantly (p<0.001 higher in men than women. Overall, 3,315€/patient-year were spent on average: hospitalizations were the cost driver (54.2% of total cost. Drugs contributed to 31.5%, outpatient claims represented 14.3% of total costs. Thirty-five percent of hospital costs were attributable to cerebro-/cardiovascular reasons, 6% to other complications of DM, and 4% to DM as a main diagnosis. Cardiovascular drugs contributed to 33.5% of total drug costs, 21.8% was attributable to class A (16.7% to class A10 and 4.3% to class B (2.4% to class B01 drugs. CONCLUSIONS: Merging different administrative databases can provide with many data from large populations observed for long time periods. DENALI shows to be an efficient instrument to obtain accurate estimates of burden of

  17. Intergenerational abortion tendency between mothers and teenage daughters: a population-based cohort study

    Liu, Ning; Farrugia, M. Michèle; Vigod, Simone N.; Urquia, Marcelo L.; Ray, Joel G.

    2018-01-01

    BACKGROUND: A teenage woman’s sexual health practices may be influenced by her mother’s experience. We evaluated whether there is an intergenerational tendency for induced abortion between mothers and their teenage daughters. METHODS: We conducted a retrospective population-based cohort study involving daughters born in Ontario between 1992 and 1999. We evaluated the daughters’ data for induced abortions between age 12 years and their 20th birthday. We assessed each mother’s history of induced abortion for the period from 4 years before her daughter’s birth to 12 years after (i.e., when her daughter turned 12 years of age). We used Cox proportional hazard models to estimate a daughter’s risk of having an induced abortion in relation to the mother’s history of the same procedure. We adjusted hazard ratios (HRs) for maternal age and world region of origin, mental or physical health problems in the daughter, mother– daughter cohabitation, neighbourhood-level rate of teen induced abortion, rural or urban residence, and income quintile. RESULTS: A total of 431 623 daughters were included in the analysis. The cumulative probability of teen induced abortion was 10.1% (95% confidence interval [CI] 9.8%–10.4%) among daughters whose mother had an induced abortion, and 4.2% (95% CI 4.1%–4.3%) among daughters whose mother had no induced abortion, for an adjusted HR of 1.94 (95% CI 1.86–2.01). The adjusted HR of a teenaged daughter having an induced abortion in relation to number of maternal induced abortions was 1.77 (95% CI 1.69–1.85) with 1 maternal abortion, 2.04 (95% CI 1.91–2.18) with 2 maternal abortions, 2.39 (95% CI 2.19–2.62) with 3 maternal abortions and 2.54 (95% CI 2.33–2.77) with 4 or more maternal abortions, relative to none. INTERPRETATION: We found that the risk of teen induced abortion was higher among daughters whose mother had had an induced abortion. Future research should explore the mechanisms for intergenerational induced

  18. Secondary depression in severe anxiety disorders: a population-based cohort study in Denmark

    Meier, Sandra M; Petersen, Liselotte; Mattheisen, Manuel; Mors, Ole; Mortensen, Preben B; Laursen, Thomas M

    2016-01-01

    Summary Background Depression and anxiety disorders are highly comorbid conditions and a worldwide disease burden; however, large-scale studies delineating their association are scarce. In this retrospective study, we aimed to assess the effect of severe anxiety disorders on the risk and course of depression. Methods We did a population-based cohort study with prospectively gathered data in Denmark using data from three Danish population registers: The Danish Civil Registration System, the Danish Psychiatric Central Register, and the Danish National Hospital Registry. We selected the cohort from people born in Denmark between Jan 1, 1955, and Dec 31, 2002, who we followed up from Jan 1, 1994, to Dec 31, 2012. The cohort was restricted to individuals with known parents. First, we investigated the effect of specific anxiety diagnoses on risk of single depressive episodes and recurrent depressive disorder. Second, we investigated the effect of comorbid anxiety on risk of readmission for depression, adjusting for sex, age, calendar year, parental age, place at residence at time of birth, and the interaction of age with sex. Findings We included 3 380 059 individuals in our study cohort. The adjusted incidence rate ratio (IRR) for single depressive episodes was 3·0 (95% CI 2·8–3·1, pdepressive disorder was 5·0 (4·8–5·2) in patients with severe anxiety disorders compared with the general population. Compared with control individuals, the offspring of parents with anxiety disorders were more likely to be diagnosed with single depressive episodes (1·9, 1·8–2·0) or recurrent depressive disorder (2·1, 1·9–2·2). Comorbid anxiety increased the readmission rates in both patients with single depressive episodes and patients with recurrent depressive disorder. Interpretation Severe anxiety constitutes a significant risk factor for depression. Focusing on specific anxiety disorders might help to identify individuals at risk of depression, thereby providing new

  19. Splenectomy and risk of renal and perinephric abscesses: A population-based cohort study in Taiwan.

    Lai, Shih-Wei; Lin, Hsien-Feng; Lin, Cheng-Li; Liao, Kuan-Fu

    2016-08-01

    Little epidemiological research is available on the relationship between splenectomy and renal and perinephric abscesses. The purpose of the study was to examine this issue in Taiwan.We conducted a population-based retrospective cohort study using the hospitalization dataset of the Taiwan National Health Insurance Program. A total of 16,426 participants aged 20 and older who were newly diagnosed with splenectomy from 1998 to 2010 were assigned to the splenectomy group, whereas 65,653 sex-matched, age-matched, and comorbidity-matched, randomly selected participants without splenectomy were assigned to the nonsplenectomy group. The incidence of renal and perinephric abscesses at the end of 2011 was measured in both groups. The multivariable Cox proportional hazards regression model was used to measure the hazard ratio (HR) and 95% confidence interval (CI) for risk of renal and perinephric abscesses associated with splenectomy and other comorbidities including cystic kidney disease, diabetes mellitus, urinary tract infection, and urolithiasis.The overall incidence rate of renal and perinephric abscesses was 2.14-fold greater in the splenectomy group than that in the nonsplenectomy group (2.24 per 10,000 person-years vs 1.05 per 10,000 person-years, 95% CI 2.02, 2.28). After controlling for sex, age, cystic kidney disease, diabetes mellitus, urinary tract infection, and urolithiasis, the multivariable regression analysis demonstrated that the adjusted HR of renal and perinephric abscesses was 2.24 for the splenectomy group (95 % CI 1.30, 3.88), when compared with the nonsplenectomy group. In further analysis, the adjusted HR markedly increased to 7.69 for those comorbid with splenectomy and diabetes mellitus (95% CI 3.31, 17.9).Splenectomy is associated with renal and perinephric abscesses, particularly comorbid with diabetes mellitus. In view of its potential morbidity and mortality, clinicians should consider the possibility of renal and perinephric abscesses when

  20. Long-term oxygen therapy in COPD patients: population-based cohort study on mortality

    Pavlov N

    2018-03-01

    Full Text Available Nikolay Pavlov,1 Alan Gary Haynes,2,3 Armin Stucki,4 Peter Jüni,5 Sebastian Robert Ott1 1Department of Pulmonary Medicine, University Hospital (Inselspital, University of Bern, Bern, Switzerland; 2CTU Bern, University of Bern, Bern, Switzerland; 3Institute of Social and Preventive Medicine (ISPM, University of Bern, Bern, Switzerland; 4Department of Internal Medicine, Spital Thun, Thun, Switzerland; 5Applied Health Research Centre, Li Ka Shing Knowledge Institute of St Michael’s Hospital, Department of Medicine, University of Toronto, Toronto, ON, Canada Purpose: Chronic obstructive pulmonary disease (COPD is the fourth leading cause of death worldwide and is associated with a growing and substantial socioeconomic burden. Long-term oxygen therapy (LTOT, recommended by current treatment guidelines for COPD patients with severe chronic hypoxemia, has shown to reduce mortality in this population. The aim of our study was to assess the standardized mortality ratios of incident and prevalent LTOT users and to identify predictors of mortality. Patients and methods: We conducted a 2-year follow-up population-based cohort study comprising all COPD patients receiving LTOT in the canton of Bern, Switzerland. Comparing age- and sex-adjusted standardized mortality ratios, we examined associations between all-cause mortality and patient characteristics at baseline. To avoid immortal time bias, data for incident (receiving LTOT <6 months and prevalent users were analyzed separately. Results: At baseline, 475 patients (20% incident users, n=93 were receiving LTOT because of COPD (48/100,000 inhabitants. Mortality of incident and prevalent LTOT users was 41% versus 27%, respectively, p<0.007, and standardized mortality ratios were 8.02 (95% CI: 5.64–11.41 versus 5.90 (95% CI: 4.79–7.25, respectively. Type 2 respiratory failure was associated with higher standardized mortality ratios among incident LTOT users (60.57, 95% CI: 11.82–310.45, p=0

  1. Association between selective serotonin reuptake inhibitors and upper gastrointestinal bleeding: population based case-control study

    de Abajo, Francisco José; Rodríguez, Luis Alberto García; Montero, Dolores

    1999-01-01

    Objective To examine the association between selective serotonin reuptake inhibitors and risk of upper gastrointestinal bleeding. Design Population based case-control study. Setting General practices included in the UK general practice research database. Subjects 1651 incident cases of upper gastrointestinal bleeding and 248 cases of ulcer perforation among patients aged 40 to 79 years between April 1993 and September 1997, and 10 000 controls matched for age, sex, and year that the case was identified. Interventions Review of computer profiles for all potential cases, and an internal validation study to confirm the accuracy of the diagnosis on the basis of the computerised information. Main outcome measures Current use of selective serotonin reuptake inhibitors or other antidepressants within 30 days before the index date. Results Current exposure to selective serotonin reuptake inhibitors was identified in 3.1% (52 of 1651) of patients with upper gastrointestinal bleeding but only 1.0% (95 of 10 000) of controls, giving an adjusted rate ratio of 3.0 (95% confidence interval 2.1 to 4.4). This effect measure was not modified by sex, age, dose, or treatment duration. A crude incidence of 1 case per 8000 prescriptions was estimated. A small association was found with non-selective serotonin reuptake inhibitors (relative risk 1.4, 1.1 to 1.9) but not with antidepressants lacking this inhibitory effect. None of the groups of antidepressants was associated with ulcer perforation. The concurrent use of selective serotonin reuptake inhibitors with non-steroidal anti-inflammatory drugs increased the risk of upper gastrointestinal bleeding beyond the sum of their independent effects (15.6, 6.6 to 36.6). A smaller interaction was also found between selective serotonin reuptake inhibitors and low dose aspirin (7.2, 3.1 to 17.1). Conclusions Selective serotonin reuptake inhibitors increase the risk of upper gastrointestinal bleeding. The absolute effect is, however

  2. Health-Related Quality of Life in Cervical Cancer Survivors: A Population-Based Survey

    Korfage, Ida J.; Essink-Bot, Marie-Louise; Mols, Floortje; Poll-Franse, Lonneke van de; Kruitwagen, Roy; Ballegooijen, Marjolein van

    2009-01-01

    Purpose: In a population-based sample of cervical cancer survivors, health-related quality of life (HRQoL) was assessed 2-10 years postdiagnosis. Methods and Materials: All patients given a diagnosis of cervical cancer in 1995-2003 in the Eindhoven region, The Netherlands, and alive after Jan 2006 were identified through the cancer registry. Generic HRQoL (36-Item Short-Form Health Survey, EQ-5D), cervical cancer-specific HRQoL (European Organization for Research and Treatment of Cancer Quality-of-Life questionnaire cervical cancer module), and anxiety (6-item State Trait Anxiety Inventory) were assessed and compared with a reference population (n = 349). Data for tumor characteristics at diagnosis and disease progression were available. Results: A total of 291 women responded (69%), with a mean age of 53 ± 13 (SD) years (range, 31-88 years). Treatment had consisted of surgery (n = 195) or a combination of therapies (n = 75); one woman had not been treated. Of all women, 85% were clinically disease free, 2% had a recurrence/metastasis, and in 13%, this was unknown. After controlling for background characteristics (age, education, job and marital status, having children, and country of birth), generic HRQoL scale scores were similar to the reference population, except for worse mental health in survivors. The most frequent symptoms were crampy pain in the abdomen or belly (17%), urinary leakage (15%), menopausal symptoms (18%), and problems with sexual activity. Compared with the 6-10-year survivors, more sexual worry and worse body image were reported by the 2-5-year survivors. Compared with surgery only, especially primary radiotherapy was associated with an increased frequency of treatment-related side effects, also after controlling for age and disease stage at diagnosis and follow-up. Conclusions: Most cervical cancer survivors were coping well, although their mental health was worse than in the reference population. Even after 2-10 years, radiotherapy was

  3. Population-based multicase-control study in common tumors in Spain (MCC-Spain): rationale and study design.

    Castaño-Vinyals, Gemma; Aragonés, Nuria; Pérez-Gómez, Beatriz; Martín, Vicente; Llorca, Javier; Moreno, Victor; Altzibar, Jone M; Ardanaz, Eva; de Sanjosé, Sílvia; Jiménez-Moleón, José Juan; Tardón, Adonina; Alguacil, Juan; Peiró, Rosana; Marcos-Gragera, Rafael; Navarro, Carmen; Pollán, Marina; Kogevinas, Manolis

    2015-01-01

    We present the protocol of a large population-based case-control study of 5 common tumors in Spain (MCC-Spain) that evaluates environmental exposures and genetic factors. Between 2008-2013, 10,183 persons aged 20-85 years were enrolled in 23 hospitals and primary care centres in 12 Spanish provinces including 1,115 cases of a new diagnosis of prostate cancer, 1,750 of breast cancer, 2,171 of colorectal cancer, 492 of gastro-oesophageal cancer, 554 cases of chronic lymphocytic leukaemia (CLL) and 4,101 population-based controls matched by frequency to cases by age, sex and region of residence. Participation rates ranged from 57% (stomach cancer) to 87% (CLL cases) and from 30% to 77% in controls. Participants completed a face-to-face computerized interview on sociodemographic factors, environmental exposures, occupation, medication, lifestyle, and personal and family medical history. In addition, participants completed a self-administered food-frequency questionnaire and telephone interviews. Blood samples were collected from 76% of participants while saliva samples were collected in CLL cases and participants refusing blood extractions. Clinical information was recorded for cases and paraffin blocks and/or fresh tumor samples are available in most collaborating hospitals. Genotyping was done through an exome array enriched with genetic markers in specific pathways. Multiple analyses are planned to assess the association of environmental, personal and genetic risk factors for each tumor and to identify pleiotropic effects. This study, conducted within the Spanish Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), is a unique initiative to evaluate etiological factors for common cancers and will promote cancer research and prevention in Spain. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  4. The Impact of a Population-Based Screening Program on Income- and Immigration-Related Disparities in Colorectal Cancer Screening.

    Kiran, Tara; Glazier, Richard H; Moineddin, Rahim; Gu, Sumei; Wilton, Andrew S; Paszat, Lawrence

    2017-09-01

    Background: A population-based program promoting the Fecal Occult Blood Test (FOBT) for colorectal cancer screening was introduced in 2008 in Ontario, Canada, where opportunistic screening with colonoscopy had been increasing in frequency. We evaluated the impact of the program on income and immigration-related disparities in screening. Methods: We used linked administrative data to calculate colorectal cancer screening rates for eligible Ontarians in each year between 2001/02 ( n = 2,852,619) and 2013/14 ( n = 4,139,304). We quantified disparities using an "inequality ratio" of screening rates in the most disadvantaged group relative to the most advantaged group. We performed segmented logistic regression analyses stratified by screening modality and adjusted for age, sex, rurality, comorbidity, and morbidity. Results: Between 2001/02 and 2013/14, the income and immigration inequality ratios narrowed from 0.74 to 0.80 and 0.55 to 0.69, respectively. Before the screening program, the income inequality ratio was widening by 1% per year (95% CI 1% to 1%); in the year it was introduced, it narrowed by 4% (95% CI 2% to 7%) and in the years following, it remained stable [0% decrease (95% CI 1% decrease to 0% decrease) per year]. Results were similar for immigration-related disparities. After program introduction, disparities in receiving FOBT were narrowing at a faster rate while disparities in receiving colonoscopy were widening at a slower rate. Conclusions: Introduction of a population-based screening program promoting FOBT for colorectal cancer was associated with only modest improvements in immigration and income-related disparities. Impact: Reducing immigration and income-related disparities should be a focus for future research and policy work. Disparities in Ontario seem to be driven by a higher uptake of colonoscopy among more advantaged groups. Cancer Epidemiol Biomarkers Prev; 26(9); 1401-10. ©2017 AACR . ©2017 American Association for Cancer Research.

  5. Association between risk factors and detection of cutaneous melanoma in the setting of a population-based skin cancer screening.

    Hübner, Joachim; Waldmann, Annika; Eisemann, Nora; Noftz, Maria; Geller, Alan C; Weinstock, Martin A; Volkmer, Beate; Greinert, Rüdiger; Breitbart, Eckhard W; Katalinic, Alexander

    2017-07-07

    Early detection is considered to improve the prognosis of cutaneous melanoma. The value of population-based screening for melanoma, however, is still controversial. The aim of this study was to evaluate the predictive power of established risk factors in the setting of a population-based screening and to provide empirical evidence for potential risk stratifications. We reanalyzed data (including age, sex, risk factors, and screening results) of 354 635 participants in the Skin Cancer Research to provide Evidence for Effectiveness of Screening in Northern Germany project conducted in the German state of Schleswig-Holstein (2003-2004). In multivariable analysis, atypical nevi [odds ratio (OR): 17.4; 95% confidence interval (CI): 14.4-20.1], personal history of melanoma (OR: 5.3; 95% CI: 3.6-7.6), and multiple (≥40) common nevi (OR: 1.3; 95% CI: 1.1-1.6) were associated with an increased risk of melanoma detection. Family history and congenital nevi were not significantly associated with melanoma detection in the Skin Cancer Research to provide Evidence for Effectiveness of Screening in Northern Germany population. The effects of several risk-adapted screening strategies were evaluated. Hypothesizing a screening of individuals aged more than or equal to 35 years, irrespective of risk factors (age approach), the number needed to screen is 559 (95% CI: 514-612), whereas a screening of adults (aged ≥20) with at least one risk factor (risk approach) leads to an number needed to screen of 178 (95% CI: 163-196). Converted into one screen-detected melanoma, the number of missed melanomas is 0.15 (95% CI: 0.12-0.18) with the age approach and 0.22 (95% CI: 0.19-0.26) with the risk approach. The results indicate that focusing on individuals at high risk for melanoma may improve the cost-effectiveness and the benefit-to-harm balance of melanoma screening programs.

  6. Using Smartphones and Health Apps to Change and Manage Health Behaviors: A Population-Based Survey.

    Ernsting, Clemens; Dombrowski, Stephan U; Oedekoven, Monika; O Sullivan, Julie L; Kanzler, Melanie; Kuhlmey, Adelheid; Gellert, Paul

    2017-04-05

    Chronic conditions are an increasing challenge for individuals and the health care system. Smartphones and health apps are potentially promising tools to change health-related behaviors and manage chronic conditions. The aim of this study was to explore (1) the extent of smartphone and health app use, (2) sociodemographic, medical, and behavioral correlates of smartphone and health app use, and (3) associations of the use of apps and app characteristics with actual health behaviors. A population-based survey (N=4144) among Germans, aged 35 years and older, was conducted. Sociodemographics, presence of chronic conditions, health behaviors, quality of life, and health literacy, as well as the use of the Internet, smartphone, and health apps were assessed by questionnaire at home visit. Binary logistic regression models were applied. It was found that 61.25% (2538/4144) of participants used a smartphone. Compared with nonusers, smartphone users were younger, did more research on the Internet, were more likely to work full-time and more likely to have a university degree, engaged more in physical activity, and less in low fat diet, and had a higher health-related quality of life and health literacy. Among smartphone users, 20.53% (521/2538) used health apps. App users were younger, less likely to be native German speakers, did more research on the Internet, were more likely to report chronic conditions, engaged more in physical activity, and low fat diet, and were more health literate compared with nonusers who had a smartphone. Health apps focused on smoking cessation (232/521, 44.5%), healthy diet (201/521, 38.6%), and weight loss (121/521, 23.2%). The most common app characteristics were planning (264/521, 50.7%), reminding (188/521, 36.1%), prompting motivation (179/521 34.4%), and the provision of information (175/521, 33.6%). Significant associations were found between planning and the health behavior physical activity, between feedback or monitoring and physical

  7. Incidence of hand eczema in a population-based twin cohort

    Lerbaek, A; Kyvik, Kirsten Ohm; Ravn, H

    2007-01-01

    BACKGROUND: Population-based studies on the incidence of hand eczema are sparse. OBJECTIVES: The aim of this prospective follow-up study was to determine the incidence rate of hand eczema in a population-based twin cohort. Secondly, the role of genetic factors and other potential risk factors...... for hand eczema was investigated. METHODS: A questionnaire on self-reported hand eczema was answered by 5610 and 4128 twin individuals in 1996 and 2005, respectively. Data were analysed in a Poisson regression analysis. RESULTS: The crude incidence rate was 8.8 cases per 1000 person-years (95% confidence...... with an increased risk, whereas no association with age, sex, smoking or alcohol was found...

  8. Cataract surgery in a population-based cohort of patients with type 1 diabetes

    Grauslund, Jakob; Green, Anders; Sjølie, Anne K

    2011-01-01

    .05-3.40) were the only statistically significant predictors of cataract surgery. Duration of diabetes, gender, glycaemic regulation, proteinuria, smoking, blood pressure and level of retinopathy were not associated with cataract surgery. Conclusion: Type 1 diabetes is associated with a high long-term incidence......ABSTRACT. Purpose: To estimate the long-term cumulative incidence of cataract surgery and associated risk factors in a 25-year follow-up of a population-based cohort of patients with type 1 diabetes. Methods: Based on insulin prescriptions, a population-based cohort of 727 patients with type 1...... of surgery were 59.3 and 42 years, respectively. Cataract surgery in the cohort took place approximately 20 years earlier compared to non-diabetic persons. In a multivariate regression analysis, baseline age [hazard ratio (HR) 1.89 per 10 years, 95% CI 1.46-2.27] and maculopathy (HR 1.89, 95% CI 1...

  9. Rationale for and protocol of a multi-national population-based bacteremia surveillance collaborative

    Church Deirdre L

    2009-07-01

    Full Text Available Abstract Background Bloodstream infections are frequent causes of human illness and cause major morbidity and death. In order to best define the epidemiology of these infections and to track changes in occurrence, adverse outcome, and resistance rates over time, population based methodologies are optimal. However, few population-based surveillance systems exist worldwide, and because of differences in methodology inter-regional comparisons are limited. In this report we describe the rationale and propose first practical steps for developing an international collaborative approach to the epidemiologic study and surveillance for bacteremia. Findings The founding collaborative participants represent six regions in four countries in three continents with a combined annual surveillance population of more than 8 million residents. Conclusion Future studies from this collaborative should lead to a better understanding of the epidemiology of bloodstream infections.

  10. Neighborhood deprivation is strongly associated with participation in a population-based health check

    Bender, Anne Mette; Kawachi, Ichiro; Jørgensen, Torben

    2015-01-01

    BACKGROUND: We sought to examine whether neighborhood deprivation is associated with participation in a large population-based health check. Such analyses will help answer the question whether health checks, which are designed to meet the needs of residents in deprived neighborhoods, may increase...... participation and prove to be more effective in preventing disease. In Europe, no study has previously looked at the association between neighborhood deprivation and participation in a population-based health check. METHODS: The study population comprised 12,768 persons invited for a health check including...... screening for ischemic heart disease and lifestyle counseling. The study population was randomly drawn from a population of 179,097 persons living in 73 neighborhoods in Denmark. Data on neighborhood deprivation (percentage with basic education, with low income and not in work) and individual socioeconomic...

  11. Primary mucinous carcinoma of the skin: a population-based study

    Breiting, L.; Dahlstrom, K.; Breiting, V.

    2008-01-01

    Background Primary mucinous carcinoma of the skin (PMCS) is a rare malignant tumor deriving from the sweat glands. It is typically located on the head and is often mistaken for a metastasis from a more common primary tumor of the breast or gastrointestinal tract. We present the first population......-based study of PMCS. Materials and methods Data on PMCS was obtained from the Danish Cancer Registry, which has recorded incident cases of cancer on a nationwide basis since 1943. We extracted all patients diagnosed 1978-2003 with PMCS. Results Fifteen cases of PMCS have been registered during the study...... or PMCS related deaths were reported. Conclusion PMCS is a rare, slow-growing tumor which rarely metastasizes and is associated with low mortality. The age-standardized incidence rate, based on data from a population-based cancer registry of high quality and validity, is less than 0.1 per million. However...

  12. Population-based imaging and radiomics. Rational and perspective of the German National Cohort MRI study

    Schlett, C.L.; Weckbach, S.; Hendel, T.

    2016-01-01

    The MRI study within the German National Cohort, a large-scale, population-based, longitudinal study in Germany, comprises comprehensive characterization and phenotyping of a total of 30 000 participants using 3-Tesla whole-body MR imaging. A multi-centric study design was established together with dedicated core facilities for e.g. managing incidental findings or providing quality assurance. As such, the study represents a unique opportunity to substantially impact imaging-based risk stratification leading to personalized and precision medicine. Supported by the developments in the field of computational science, the newly developing scientific field of radiomics has large potential for the future. In the present article we provide an overview on population-based imaging and Radiomics and conceptualize the rationale and design of the MRI study within the German National Cohort.

  13. Benign Paroxysmal Positional Vertigo after Dental Procedures: A Population-Based Case-Control Study

    Chang, Tzu-Pu; Lin, Yueh-Wen; Sung, Pi-Yu; Chuang, Hsun-Yang; Chung, Hsien-Yang; Liao, Wen-Ling

    2016-01-01

    Background Benign paroxysmal positional vertigo (BPPV), the most common type of vertigo in the general population, is thought to be caused by dislodgement of otoliths from otolithic organs into the semicircular canals. In most cases, however, the cause behind the otolith dislodgement is unknown. Dental procedures, one of the most common medical treatments, are considered to be a possible cause of BPPV, although this has yet to be proven. This study is the first nationwide population-based cas...

  14. Method for mapping population-based case-control studies: an application using generalized additive models

    Aschengrau Ann

    2006-06-01

    Full Text Available Abstract Background Mapping spatial distributions of disease occurrence and risk can serve as a useful tool for identifying exposures of public health concern. Disease registry data are often mapped by town or county of diagnosis and contain limited data on covariates. These maps often possess poor spatial resolution, the potential for spatial confounding, and the inability to consider latency. Population-based case-control studies can provide detailed information on residential history and covariates. Results Generalized additive models (GAMs provide a useful framework for mapping point-based epidemiologic data. Smoothing on location while controlling for covariates produces adjusted maps. We generate maps of odds ratios using the entire study area as a reference. We smooth using a locally weighted regression smoother (loess, a method that combines the advantages of nearest neighbor and kernel methods. We choose an optimal degree of smoothing by minimizing Akaike's Information Criterion. We use a deviance-based test to assess the overall importance of location in the model and pointwise permutation tests to locate regions of significantly increased or decreased risk. The method is illustrated with synthetic data and data from a population-based case-control study, using S-Plus and ArcView software. Conclusion Our goal is to develop practical methods for mapping population-based case-control and cohort studies. The method described here performs well for our synthetic data, reproducing important features of the data and adequately controlling the covariate. When applied to the population-based case-control data set, the method suggests spatial confounding and identifies statistically significant areas of increased and decreased odds ratios.

  15. Demographic factors associated with knowledge of colorectal cancer symptoms in a UK population-based survey.

    Yardley, C.; Glover, C.; Allen-Mersh, T. G.

    2000-01-01

    Greater public awareness of colorectal cancer symptoms might result in earlier presentation with improved cure by available treatments, but little is known about the extent of public knowledge of colorectal cancer symptoms. We asked a sample of the general population about knowledge of colorectal cancer symptoms and assessed demographic characteristics associated with differences in knowledge. A population-based telephone enquiry into knowledge of colorectal cancer-associated symptoms was con...

  16. EpiReumaPt: how to perform a national population based study - a practical guide

    Gouveia, Nélia; Rodrigues, Ana M.; Ramiro, Sofia; Machado, Pedro; Da Costa, Leonor Pereira; Mourão, Ana Filipa; Silva, Inês; Rego, Tânia; Laires, Pedro; André, Rui; Mauricio, Luís; Romeu, José Carlos; Tavares, Viviana; Cerol, Jorge; Canhão, Helena

    2015-01-01

    BACKGROUND: The aim of this article was to describe and discuss several strategies and standard operating procedures undertaken in the EpiReumaPt study - which was the first Portuguese, national, cross-sectional population-based study of Rheumatic and Musculoskeletal Diseases (RMD). METHODS: The technical procedures, legal issues, management and practical questions were studied, analyzed and discussed with relevant stakeholders. During the 1st phase of EpiReumaPt the coordination team and Cen...

  17. Racial disparities in incidence and outcome in multiple myeloma: a population-based study

    Waxman, Adam J.; Mink, Pamela J.; Devesa, Susan S.; Anderson, William F.; Weiss, Brendan M.; Kristinsson, Sigurdur Y.; McGlynn, Katherine A.; Landgren, Ola

    2010-01-01

    Multiple myeloma (MM) is the most common hematologic malignancy in blacks. Some prior studies suggest inferior survival in blacks; others suggest similar survival. Using the original 9 Surveillance, Epidemiology, and End Results registries, we conducted a large-scale population-based study including 5798 black and 28 939 white MM patients diagnosed 1973-2005, followed through 2006. Age-adjusted incidence rates, disease-specific survival, and relative survival rates were calculated by race, ag...

  18. Shifting the lens: the introduction of population-based funding in Alberta.

    Smith, Neale; Church, John

    2008-01-01

    This paper offers a detailed historical description of the development of Alberta's population-based funding model for Regional Health Authorities (RHAs). It focuses on key political factors that may have facilitated this transition--in particular, the role of institutions, organized interests, and ideas and values. Understanding the politics of policy change as exemplified in this case can be useful in assessing future prospects for health system reform in Canada and laying the groundwork for further comparative study.

  19. Factors Associated with Remission of Eczema in Children: a Population-based Follow-up Study.

    von Kobyletzki, Laura; Bornehag, Carl-Gustaf; Breeze, Elizabeth; Larsson, Malin; Boman Lindström, Cecilia; Svensson, Åke

    2014-01-01

    The aim of this study was to analyse factors associated with remission of atopic dermatitis (AD) in childhood. A population-based AD cohort of 894 children aged 1-3 years from a cross-sectional baseline study in 2000 was followed up in 2005. The association between remission, background, health, lifestyle, and environmental variables was estimated with crude and multivariable logistic regression. At follow-up, 52% of the children had remission. Independent factors at baseline predicting remis...

  20. Fetal size monitoring and birth-weight prediction: a new population-based approach.

    Gjessing, H K; Grøttum, P; Økland, I; Eik-Nes, S H

    2017-04-01

    To develop a complete, population-based system for ultrasound-based fetal size monitoring and birth-weight prediction for use in the second and third trimesters of pregnancy. Using 31 516 ultrasound examinations from a population-based Norwegian clinical database, we constructed fetal size charts for biparietal diameter, femur length and abdominal circumference from 24 to 42 weeks' gestation. A reference curve of median birth weight for gestational age was estimated using 45 037 birth weights. We determined how individual deviations from the expected ultrasound measures predicted individual percentage deviations from expected birth weight. The predictive quality was assessed by explained variance of birth weight and receiver-operating characteristics curves for prediction of small-for-gestational age. A curve for intrauterine estimated fetal weight was constructed. Charts were smoothed using the gamlss non-linear regression method. The population-based approach, using bias-free ultrasound gestational age, produces stable estimates of size-for-age and weight-for-age curves in the range 24-42 weeks' gestation. There is a close correspondence between percentage deviations and percentiles of birth weight by gestational age, making it easy to convert between the two. The variance of birth weight that can be 'explained' by ultrasound increases from 8% at 20 weeks up to 67% around term. Intrauterine estimated fetal weight is 0-106 g higher than median birth weight in the preterm period. The new population-based birth-weight prediction model provides a simple summary measure, the 'percentage birth-weight deviation', to be used for fetal size monitoring throughout the third trimester. Predictive quality of the model can be measured directly from the population data. The model computes both median observed birth weight and intrauterine estimated fetal weight. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2016 ISUOG. Published by John

  1. Dietary patterns associated with fall-related fracture in elderly Japanese: a population based prospective study

    Monma, Yasutake; Niu, Kaijun; Iwasaki, Koh; Tomita, Naoki; Nakaya, Naoki; Hozawa, Atsushi; Kuriyama, Shinichi; Takayama, Shin; Seki, Takashi; Takeda, Takashi; Yaegashi, Nobuo; Ebihara, Satoru; Arai, Hiroyuki; Nagatomi, Ryoichi; Tsuji, Ichiro

    2010-01-01

    Abstract Background Diet is considered an important factor for bone health, but is composed of a wide variety of foods containing complex combinations of nutrients. Therefore we investigated the relationship between dietary patterns and fall-related fractures in the elderly. Methods We designed a population-based prospective survey of 1178 elderly people in Japan in 2002. Dietary intake was assessed with a 75-item food frequency questionnaire (FFQ), from which dietary patterns were created by...

  2. Profiles of sedentary and non-sedentary young men ? a population-based MOPO study

    Pyky, Riitta; Jauho, Anna-Maiju; Ahola, Riikka; Ik?heimo, Tiina M.; Koivumaa-Honkanen, Heli; M?ntysaari, Matti; J?ms?, Timo; Korpelainen, Raija

    2015-01-01

    Background Sedentary behavior is associated with poor well-being in youth with adverse trajectories spanning to adulthood. Still, its determinants are poorly known. Our aim was to profile sedentary and non-sedentary young men and to clarify their differences in a population-based setting. Methods A total of 616 men (mean age 17.9, SD 0.6) attending compulsory conscription for military service completed a questionnaire on health, health behavior, socioeconomic situation and media use. They und...

  3. Population-based study on use of chemotherapy in men with castration resistant prostate cancer

    Lissbrant, Ingela Franck; Garmo, Hans; Widmark, Anders; Stattin, P?r

    2013-01-01

    Background. Chemotherapy prolongs life and relieves symptoms in men with castration resistant prostate cancer (CRPC). There is limited information on a population level on the use of chemotherapy for CRPC. Material and methods. To assess the use of chemotherapy in men with CRPC we conducted a register-based nationwide population-based study in Prostate Cancer data Base Sweden (PCBaSe) and a nationwide in-patient drug register (SALT database) between May 2009 and December 2010. We assumed that...

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

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

    2007-12-01

    Birth defects surveillance systems collect population-based birth defects data from multiple sources to track trends in prevalence, identify risk factors, refer affected families to services, and evaluate prevention efforts. Strong state and federal public health and legal mandates are in place to govern the collection and use of these data. Despite the prima facie appeal of "opt-in" and similar strategies to those who view data collection as a threat to privacy, the use of these strategies in lieu of population-based surveillance can severely limit the ability of public health agencies to accurately access the health status of a group within a defined geographical area. With the need for population-based data central to their mission, birth defects programs around the country take their data stewardship role seriously, recognizing both moral and legal obligations to protect the data by employing numerous safeguards. Birth defects surveillance systems are shaped by the needs of the community they are designed to serve, with the goal of preventing birth defects or alleviating the burdens associated with them. (c) 2007 Wiley-Liss, Inc.

  5. Invitation strategies and coverage in the population-based cancer screening programmes in the European Union.

    Vale, Diama B; Anttila, Ahti; Ponti, Antonio; Senore, Carlo; Sankaranaryanan, Rengaswamy; Ronco, Guglielmo; Segnan, Nereo; Tomatis, Mariano; Žakelj, Maja P; Elfström, Klara M; Lönnberg, Stefan; Dillner, Joakim; Basu, Partha

    2018-03-21

    The aim of this study was to describe the compliance of the population-based cancer screening programmes in the European Union Member States to the invitation strategies enumerated in the European Guidelines and the impact of such strategies on the invitational coverage. Experts in screening programme monitoring from the respective countries provided data. Coverage by invitation was calculated as the proportion of individuals in the target age range receiving a screening invitation over the total number of annualized eligible population. The invitation strategies of 30 breasts, 25 cervical and 27 colorectal national or regional population-based screening programmes are described. Individual mail invitations are sent by 28 breasts, 20 cervical and 25 colorectal screening programmes. Faecal occult blood test kits are sent by post in 17 of the colorectal cancer screening programmes. The majority of programmes claimed to have a population registry, although some use health insurance data as the database for sending invitations. At least 95% invitation coverage was reached by 16 breast, six cervical and five colorectal screening programmes. Majority of the programmes comply with the invitation strategies enumerated in the European guidelines, although there is still scope for improvements. Coverage by invitation is below the desirable level in many population-based cancer screening programmes in European Union.

  6. A population-based job exposure matrix for power-frequency magnetic fields.

    Bowman, Joseph D; Touchstone, Jennifer A; Yost, Michael G

    2007-09-01

    A population-based job exposure matrix (JEM) was developed to assess personal exposures to power-frequency magnetic fields (MF) for epidemiologic studies. The JEM compiled 2,317 MF measurements taken on or near workers by 10 studies in the United States, Sweden, New Zealand, Finland, and Italy. A database was assembled from the original data for six studies plus summary statistics grouped by occupation from four other published studies. The job descriptions were coded into the 1980 Standard Occupational Classification system (SOC) and then translated to the 1980 job categories of the U.S. Bureau of the Census (BOC). For each job category, the JEM database calculated the arithmetic mean, standard deviation, geometric mean, and geometric standard deviation of the workday-average MF magnitude from the combined data. Analysis of variance demonstrated that the combining of MF data from the different sources was justified, and that the homogeneity of MF exposures in the SOC occupations was comparable to JEMs for solvents and particulates. BOC occupation accounted for 30% of the MF variance (p job variance to the total of within- and between-job variances) was 88%. Jobs lacking data had their exposures inferred from measurements on similar occupations. The JEM provided MF exposures for 97% of the person-months in a population-based case-control study and 95% of the jobs on death certificates in a registry study covering 22 states. Therefore, we expect this JEM to be useful in other population-based epidemiologic studies.

  7. The use of customised versus population-based birthweight standards in predicting perinatal mortality.

    Zhang, X; Platt, R W; Cnattingius, S; Joseph, K S; Kramer, M S

    2007-04-01

    The objective of this study was to critically examine potential artifacts and biases underlying the use of 'customised' standards of birthweight for gestational age (GA). Population-based cohort study. Sweden. A total of 782,303 singletons > or =28 weeks of gestation born in 1992-2001 to Nordic mothers with complete data on birthweight; GA; and maternal age, parity, height, and pre-pregnancy weight. We compared perinatal mortality in four groups of infants based on the following classification of small for gestational age (SGA): non-SGA based on either population-based or customised standards (the reference group), SGA based on the population-based standard only, SGA based on the customised standard only, and SGA according to both standards. We used graphical methods to compare GA-specific birthweight cutoffs for SGA using the two standards and also used logistic regression to control for differences in GA and maternal pre-pregnancy body mass index (BMI) in the four groups. Perinatal mortality, including stillbirth and neonatal death. Customisation led to a large artifactual increase in the proportion of SGA infants born preterm. Adjustment for differences in GA and maternal BMI markedly reduced the excess risk among infants classified as SGA by customised standards only. The large increase in perinatal mortality risk among infants classified as SGA based on customised standards is largely an artifact due to inclusion of more preterm births.

  8. Epidemiology of Pediatric Traumatic Spinal Cord Injury in a Population-Based Cohort, 1998-2012.

    Saunders, Lee L; Selassie, Anbesaw; Cao, Yue; Zebracki, Kathy; Vogel, Lawrence C

    2015-01-01

    Traumatic spinal cord injury (SCI) that occurs in children and adolescents who are still developing represents a different challenge than SCI in adults. However, information on the epidemiology and incidence of SCI in a population-based cohort is lacking. To describe the epidemiology of pediatric SCI in a population-based cohort in the United States and to assess trend in incidence over a 15-year period (1998-2012). Children and adolescents (0-21 years) with SCI were identified through the South Carolina SCI Surveillance Registry using hospital discharge records from 1998 to 2012. Overall age-adjusted incidence rates were calculated for each year, and incidence rates were stratified by age, gender, and race. The overall age-adjusted incidence rate was 26.9 per million population, and there was a trend (P = .0583) toward decreasing incidence of pediatric SCI. When stratified by race, there was a significant decrease in incidence among Whites(P = .0052) but not among non-Whites. Younger participants were more likely to be female, to be injured through sports, and to be more likely to have concomitant traumatic brain injury. Since 1998, the proportion of older pediatric patients (16-22 years) with SCI has increased, as has the proportion of non-White patients. Although there was an overall trend toward decreasing incidence in this population-based cohort, when stratified by race, this trend only occurred in the White population.

  9. An Improved Real-Coded Population-Based Extremal Optimization Method for Continuous Unconstrained Optimization Problems

    Guo-Qiang Zeng

    2014-01-01

    Full Text Available As a novel evolutionary optimization method, extremal optimization (EO has been successfully applied to a variety of combinatorial optimization problems. However, the applications of EO in continuous optimization problems are relatively rare. This paper proposes an improved real-coded population-based EO method (IRPEO for continuous unconstrained optimization problems. The key operations of IRPEO include generation of real-coded random initial population, evaluation of individual and population fitness, selection of bad elements according to power-law probability distribution, generation of new population based on uniform random mutation, and updating the population by accepting the new population unconditionally. The experimental results on 10 benchmark test functions with the dimension N=30 have shown that IRPEO is competitive or even better than the recently reported various genetic algorithm (GA versions with different mutation operations in terms of simplicity, effectiveness, and efficiency. Furthermore, the superiority of IRPEO to other evolutionary algorithms such as original population-based EO, particle swarm optimization (PSO, and the hybrid PSO-EO is also demonstrated by the experimental results on some benchmark functions.

  10. Stages of development and injury patterns in the early years: a population-based analysis

    Simpson Kelly

    2006-07-01

    Full Text Available Abstract Background In Canada, there are many formal public health programs under development that aim to prevent injuries in the early years (e.g. 0–6. There are paradoxically no population-based studies that have examined patterns of injury by developmental stage among these young children. This represents a gap in the Canadian biomedical literature. The current population-based analysis explores external causes and consequences of injuries experienced by young children who present to the emergency department for assessment and treatment. This provides objective evidence about prevention priorities to be considered in anticipatory counseling and public health planning. Methods Four complete years of data (1999–2002; n = 5876 cases were reviewed from the Kingston sites of the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP, an ongoing injury surveillance initiative. Epidemiological analyses were used to characterize injury patterns within and across age groups (0–6 years that corresponded to normative developmental stages. Results The average annual rate of emergency department-attended childhood injury was 107 per 1000 (95% CI 91–123, with boys experiencing higher annual rates of injury than girls (122 vs. 91 per 1000; p Conclusion This population-based injury surveillance analysis provides a strong evidence-base to inform and enhance anticipatory counseling and other public health efforts aimed at the prevention of childhood injury during the early years.

  11. Perinatal risk factors in offenders with severe personality disorder: a population-based investigation.

    Fazel, Seena; Bakiyeva, Liliya; Cnattingius, Sven; Grann, Martin; Hultman, Christina M; Lichtenstein, Paul; Geddes, John R

    2012-10-01

    Although perinatal factors are associated with the development of several psychiatric disorders, it is unknown whether these factors are linked with personality disorder. Cases of personality disorder were drawn from a national registry of all forensic psychiatric evaluations (n = 150). Two control groups were used: (1) A sample of forensic evaluations without any psychiatric disorder (n = 97) allowing for a nested case-control investigation; and (2) A population-based sample matched by age and gender with no history of psychiatric hospitalization (n = 1498). Prematurity (personality disorder, both in the nested and the population-based case-control comparisons with adjusted odds ratios (OR) for this risk factor ranging from 2 to 4. Asphyxia (adjusted OR = 2.4, 95% CI: 1.4-4.1) and complicated delivery (adjusted OR = 1.5, 1.0-2.1) were associated with personality disorder in the population-based study, and the former remained significant in multivariate models. Overall, perinatal complications were found to be associated with a later diagnosis of personality disorder in this selected sample. As with other psychiatric disorders where such associations have been demonstrated, changes during the perinatal period may lead to abnormal brain development and function.

  12. Prevalence of Latent Mycobacterium Tuberculosis Infection (LTBI) in Saudi Arabia; Population based survey.

    Balkhy, Hanan H; El Beltagy, Kamel; El-Saed, Aiman; Aljasir, Badr; Althaqafi, Abdulhakeem; Alothman, Adel F; Alshalaan, Mohammad; Al-Jahdali, Hamdan

    2017-07-01

    The annual risk of tuberculosis infection (ARTI) data in Saudi Arabia has not been updated since 1993. To estimate the prevalence of latent TB infection (LTBI) and ARTI in a population-based sample in Saudi Arabia using Tuberculin skin test (TST) and QuantiFERON TB Gold in tube (QFT-GIT) test. A population-based cross sectional study was conducted between July 2010 and March 2013. Participants were randomly selected from the population served by the primary healthcare centers of the Ministry of National Guard Health Affairs in Riyadh, Jeddah, Alhassa and Dammam, Saudi Arabia. A total of 1369 participants were included. The overall prevalence of LTBI was similar using TST and QFT-GIT (9.3% and 9.1% respectively, p=0.872) but stratified prevalence rates were variable in all sociodemographic groups except marital status. Additionally, the prevalence rates of LTBI using either test alone showed significant differences by several sociodemographic and behavioral characteristics. The overall ARTI was 0.36% using TST and 0.35% using QFT-GIT. We are reporting much lower estimates for the prevalence of LTBI and the ARTI in a population-based sample in Saudi Arabia relative to the data that have been used for more than two decades. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

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

    Villagra, Victor G

    2009-04-01

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

  14. Infertility experience and health differentials - a population-based comparative study on infertile and non-infertile women (the HUNT Study)

    Rostad, Berit; Schmidt, Lone; Sundby, Johanne

    2014-01-01

    between infertility and health and life satisfaction. DESIGN: Cross-sectional population-based health study, conducted between 2006 and 2008. SETTING: All women in a county in Norway were invited. The current material is restricted to women aged 20-49 years. POPULATION: A total of 9200 women participated......OBJECTIVE: Studies suggest that health complaints, distress and poor life satisfaction are associated with infertility experience. Research on health consequences of infertility experience in women has relied heavily on clinic-based samples. This population-based study investigates the association....... METHODS: Health measures were compared between women with infertility experience (infertile women) and women without infertility experience (non-infertile women). Disparities in health and life satisfaction among the infertile women were assessed. MAIN OUTCOME MEASURES: Self-reported health, functional...

  15. The Oslo Health Study: The impact of self-selection in a large, population-based survey

    Bjertness Espen

    2004-05-01

    Full Text Available Abstract Background Research on health equity which mainly utilises population-based surveys, may be hampered by serious selection bias due to a considerable number of invitees declining to participate. Sufficient information from all the non-responders is rarely available to quantify this bias. Predictors of attendance, magnitude and direction of non-response bias in prevalence estimates and association measures, are investigated based on information from all 40 888 invitees to the Oslo Health Study. Methods The analyses were based on linkage between public registers in Statistics Norway and the Oslo Health Study, a population-based survey conducted in 2000/2001 inviting all citizens aged 30, 40, 45, 59–60 and 75–76 years. Attendance was 46%. Weighted analyses, logistic regression and sensitivity analyses are performed to evaluate possible selection bias. Results The response rate was positively associated with age, educational attendance, total income, female gender, married, born in a Western county, living in the outer city residential regions and not receiving disability benefit. However, self-rated health, smoking, BMI and mental health (HCSL in the attendees differed only slightly from estimated prevalence values in the target population when weighted by the inverse of the probability of attendance. Observed values differed only moderately provided that the non-attending individuals differed from those attending by no more than 50%. Even though persons receiving disability benefit had lower attendance, the associations between disability and education, residential region and marital status were found to be unbiased. The association between country of birth and disability benefit was somewhat more evident among attendees. Conclusions Self-selection according to sociodemographic variables had little impact on prevalence estimates. As indicated by disability benefit, unhealthy persons attended to a lesser degree than healthy individuals

  16. The Oslo Health Study: The impact of self-selection in a large, population-based survey

    Søgaard, Anne Johanne; Selmer, Randi; Bjertness, Espen; Thelle, Dag

    2004-01-01

    Background Research on health equity which mainly utilises population-based surveys, may be hampered by serious selection bias due to a considerable number of invitees declining to participate. Sufficient information from all the non-responders is rarely available to quantify this bias. Predictors of attendance, magnitude and direction of non-response bias in prevalence estimates and association measures, are investigated based on information from all 40 888 invitees to the Oslo Health Study. Methods The analyses were based on linkage between public registers in Statistics Norway and the Oslo Health Study, a population-based survey conducted in 2000/2001 inviting all citizens aged 30, 40, 45, 59–60 and 75–76 years. Attendance was 46%. Weighted analyses, logistic regression and sensitivity analyses are performed to evaluate possible selection bias. Results The response rate was positively associated with age, educational attendance, total income, female gender, married, born in a Western county, living in the outer city residential regions and not receiving disability benefit. However, self-rated health, smoking, BMI and mental health (HCSL) in the attendees differed only slightly from estimated prevalence values in the target population when weighted by the inverse of the probability of attendance. Observed values differed only moderately provided that the non-attending individuals differed from those attending by no more than 50%. Even though persons receiving disability benefit had lower attendance, the associations between disability and education, residential region and marital status were found to be unbiased. The association between country of birth and disability benefit was somewhat more evident among attendees. Conclusions Self-selection according to sociodemographic variables had little impact on prevalence estimates. As indicated by disability benefit, unhealthy persons attended to a lesser degree than healthy individuals, but social inequality in

  17. Association of Barrett's esophagus with type II Diabetes Mellitus: results from a large population-based case-control study.

    Iyer, Prasad G; Borah, Bijan J; Heien, Herbert C; Das, Ananya; Cooper, Gregory S; Chak, Amitabh

    2013-09-01

    Central obesity could increase the risk for Barrett's esophagus (BE) and esophageal adenocarcinoma by mechanical and/or metabolic mechanisms, such as hyperinsulinemia. We performed an epidemiologic study to determine whether prior type 2 diabetes mellitus (DM2) is associated with BE. We performed a population-based case-control study using the General Practice Research Database, a UK primary care database that contains information on more than 8 million subjects, to identify cases of BE (using previously validated codes; n = 14,245) and matched controls without BE (by age, sex, enrollment date, duration of follow-up evaluation, and practice region by incidence density sampling; n = 70,361). We assessed the association of a prior diagnosis of DM2 with BE using conditional univariate and multivariable regression analysis. Confounders assessed included smoking, obesity measured by body mass index (BMI), and gastroesophageal reflux disease. BE cases were more likely than controls to have smoked (52.4% vs 49.9%), have a higher mean BMI (27.2 vs 26.9), and a higher prevalence of DM2 than controls (5.8% vs 5.3%). On multivariable analysis, DM2 was associated with a 49% increase in the risk of BE, independent of other known risk factors (odds ratio, 1.49; 95% confidence interval, 1.16-1.91). This association was stronger in women than men. Results remained stable with sensitivity analyses. In a large population-based case-control study, DM2 was a risk factor for BE, independent of obesity (as measured by BMI) and other risk factors (smoking and gastroesophageal reflux disease). These data suggest that metabolic pathways related to DM2 should be explored in BE pathogenesis and esophageal carcinogenesis. Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.

  18. Risk of lung cancer in patients with gastro-esophageal reflux disease: a population-based cohort study

    Chi-Kuei Hsu

    2016-12-01

    Full Text Available This large-scale, controlled cohort study estimated the risks of lung cancer in patients with gastro-esophageal reflux disease (GERD in Taiwan. We conducted this population-based study using data from the National Health Insurance Research Database of Taiwan during the period from 1997 to 2010. Patients with GERD were diagnosed using endoscopy, and controls were matched to patients with GERD at a ratio of 1:4. We identified 15,412 patients with GERD and 60,957 controls. Compared with the controls, the patients with GERD had higher rates of osteoporosis, diabetes mellitus, asthma, chronic obstructive pulmonary disease, pneumonia, bronchiectasis, depression, anxiety, hypertension, dyslipidemia, chronic liver disease, congestive heart failure, atrial fibrillation, stroke, chronic kidney disease, and coronary artery disease (all P < .05. A total of 85 patients had lung cancer among patients with GERD during the follow-up of 42,555 person-years, and the rate of lung cancer was 0.0020 per person-year. By contrast, 232 patients had lung cancer among patients without GERD during the follow-up of 175,319 person-years, and the rate of lung cancer was 0.0013 per person-year. By using stepwise Cox regression model, the overall incidence of lung cancer remained significantly higher in the patients with GERD than in the controls (hazard ratio, 1.53; 95% CI [1.19–1.98]. The cumulative incidence of lung cancer was higher in the patients with GERD than in the controls (P = .0012. In conclusion, our large population-based cohort study provides evidence that GERD may increase the risk of lung cancer in Asians.

  19. Risk of erectile dysfunction in transfusion-naive thalassemia men: a nationwide population-based retrospective cohort study.

    Chen, Yu-Guang; Lin, Te-Yu; Lin, Cheng-Li; Dai, Ming-Shen; Ho, Ching-Liang; Kao, Chia-Hung

    2015-04-01

    Based on the mechanism of pathophysiology, thalassemia major or transfusion-dependent thalassemia patients may have an increased risk of developing organic erectile dysfunction resulting from hypogonadism. However, there have been few studies investigating the association between erectile dysfunction and transfusion-naive thalassemia populations. We constructed a population-based cohort study to elucidate the association between transfusion-naive thalassemia populations and organic erectile dysfunction. This nationwide population-based cohort study involved analyzing data from 1998 to 2010 obtained from the Taiwanese National Health Insurance Research Database, with a follow-up period extending to the end of 2011. We identified men with transfusion-naive thalassemia and selected a comparison cohort that was frequency-matched with these according to age, and year of diagnosis thalassemia at a ratio of 1 thalassemia man to 4 control men. We analyzed the risks for transfusion-naive thalassemia men and organic erectile dysfunction by using Cox proportional hazards regression models. In this study, 588 transfusion-naive thalassemia men and 2337 controls were included. Total 12 patients were identified within the thalassaemia group and 10 within the control group. The overall risks for developing organic erectile dysfunction were 4.56-fold in patients with transfusion-naive thalassemia men compared with the comparison cohort after we adjusted for age and comorbidities. Our long-term cohort study results showed that in transfusion-naive thalassemia men, there was a higher risk for the development of organic erectile dysfunction, particularly in those patients with comorbidities.

  20. All-Cause Mortality in a Population-Based Type 1 diabetes Cohort in the U.S. Virgin Islands

    Washington, Raynard E.; Orchard, Trevor J.; Arena, Vincent C.; LaPorte, Ronald E.; Secrest, Aaron M.; Tull, Eugene S.

    2014-01-01

    Objective Type 1 diabetes remains a significant source of premature mortality; however, its burden has not been assessed in the U.S. Virgin Islands (USVI). As such, the objective of this study was to estimate type 1 diabetes mortality in a population-based registry sample in the USVI. Research Design and Methods We report overall and 20-year mortality in the USVI Childhood (<19 years old) Diabetes Registry Cohort diagnosed 1979-2005. Recent data for non-Hispanic blacks from the Allegheny County, PA population-based type 1 diabetes registry were used to compare mortality in the USVI to the contiguous US. Results As of December 31, 2010, the vital status of 94 of 103 total cases was confirmed (91.3%) with mean diabetes duration 16.8 ± 7.0 years. No deaths were observed in the 2000-2005 cohort. The overall mortality rates for those diagnosed 1979-1989 and 1990-1999 were 1852 and 782 per 100,000 person-years, respectively. Overall cumulative survival for USVI was 98% (95% CI: 97-99) at 10 years, 92% (95% CI: 89-95) at 15 years and 73% (95% CI: 66-80) at 20 years. The overall SMR for non-Hispanic blacks in the USVI was 5.8 (95% CI 2.7-8.8). Overall mortality and cumulative survival for non-Hispanic blacks did not differ between the USVI and Allegheny County, PA. Conclusions This study, as the first type 1 diabetes mortality follow-up in the USVI, confirmed previous findings of poor disease outcomes in racial/ethnic minorities with type 1 diabetes. PMID:24439208

  1. Optical Coherence Tomography in the UK Biobank Study - Rapid Automated Analysis of Retinal Thickness for Large Population-Based Studies.

    Pearse A Keane

    Full Text Available To describe an approach to the use of optical coherence tomography (OCT imaging in large, population-based studies, including methods for OCT image acquisition, storage, and the remote, rapid, automated analysis of retinal thickness.In UK Biobank, OCT images were acquired between 2009 and 2010 using a commercially available "spectral domain" OCT device (3D OCT-1000, Topcon. Images were obtained using a raster scan protocol, 6 mm x 6 mm in area, and consisting of 128 B-scans. OCT image sets were stored on UK Biobank servers in a central repository, adjacent to high performance computers. Rapid, automated analysis of retinal thickness was performed using custom image segmentation software developed by the Topcon Advanced Biomedical Imaging Laboratory (TABIL. This software employs dual-scale gradient information to allow for automated segmentation of nine intraretinal boundaries in a rapid fashion.67,321 participants (134,642 eyes in UK Biobank underwent OCT imaging of both eyes as part of the ocular module. 134,611 images were successfully processed with 31 images failing segmentation analysis due to corrupted OCT files or withdrawal of subject consent for UKBB study participation. Average time taken to call up an image from the database and complete segmentation analysis was approximately 120 seconds per data set per login, and analysis of the entire dataset was completed in approximately 28 days.We report an approach to the rapid, automated measurement of retinal thickness from nearly 140,000 OCT image sets from the UK Biobank. In the near future, these measurements will be publically available for utilization by researchers around the world, and thus for correlation with the wealth of other data collected in UK Biobank. The automated analysis approaches we describe may be of utility for future large population-based epidemiological studies, clinical trials, and screening programs that employ OCT imaging.

  2. Incidence of Enuresis and Encopresis Among Children with Attention Deficit Hyperactivity Disorder in a Population-Based Birth Cohort

    Mellon, Michael W.; Natchev, Brooke E.; Katusic, Slavica K.; Colligan, Robert C.; Weaver, Amy L.; Voigt, Robert G.; Barbaresi, William J.

    2013-01-01

    OBJECTIVE This study reports the incidence of enuresis and encopresis among children with attention-deficit/hyperactivity disorder (AD/HD) versus those without AD/HD. METHOD Subjects included 358 (74.5% male) children with research-identified AD/HD from a 1976-1982 population-based birth cohort (N = 5718) and 729 (75.2% male) non-AD/HD control subjects from the same birth cohort, matched by gender and age. All subjects were retrospectively followed from birth until a diagnosis of enuresis or encopresis was made or last follow-up prior to 18 years of age. The complete medical record for each subject was reviewed to obtain information on age of initial diagnosis of an elimination disorder, frequency and duration of symptoms, identification of exclusionary criteria specified by DSM-IV, with confirmation of the diagnosis by expert consensus. RESULTS Children with AD/HD were 2.1 (95% CI, 1.3-3.4; p = 0.002) times more likely to meet DSM-IV criteria for enuresis than non-AD/HD controls; they were 1.8 (95% CI, 1.2 – 2.7; p = 0.006) times more likely to do so than non-AD/HD controls when less stringent criteria for a diagnosis of enuresis were employed. Though not significant, children with AD/HD were 1.8 (95% CI, 0.7-4.6; p = 0.23) times more likely to meet criteria for encopresis than non-AD/HD controls. The relative risk was 2.0 (95% CI, 1.0-4.1; p = 0.05) when a less stringent definition for encopresis was utilized. CONCLUSIONS The results of this population-based study demonstrate that children with AD/HD are more likely than their peers without AD/HD to develop enuresis with a similar trend for encopresis. PMID:23680296

  3. EUROCOURSE recipe for cancer surveillance by visible population-based cancer RegisTrees in Europe: From roots to fruits.

    Coebergh, Jan Willem; van den Hurk, Corina; Louwman, Marieke; Comber, Harry; Rosso, Stefano; Zanetti, Roberto; Sacchetto, Lidia; Storm, Hans; van Veen, Evert-Ben; Siesling, Sabine; van den Eijnden-van Raaij, Janny

    2015-06-01

    Currently about 160 population-based cancer registries (CRs) in Europe have extensive experience in generating valid information on variation in cancer risk and survival with time and place. Most CRs cover all cancers, but some are confined to specific cancers or to children. They cover 15-55% of the populations in all of the larger member states of the European Union (EU), except the United Kingdom (UK), and 100% coverage in 80% of those with populations below 20 million. The EU FP 7 EUROCOURSE project, which operated in 2009-2013, explored the essential role of CRs in cancer research and public health, and also focused attention on their programme owners (POs) and stakeholders (e.g. cancer societies, oncological professionals, cancer patient groups, and planners, providers and evaluators of cancer care and mass screening). Generally, all CRs depended on their regional and/or national oncological context and were increasingly involved in population-based studies of quality of cancer care, long-term prognosis and quality of life, one third being very active. Within the public health domain, CRs, in addition to describing the variety of environmental and lifestyle-related cancer epidemics, have also contributed actively to aetiologic research by a European databases that showed wide discrepancies in cancer risk and survival across the EU, and in more depth by follow-up of cohorts and recruitment for case-control studies. CRs were also actively contributing to independent evaluation of mass screening as an intervention which affects quality of care and cancer mortality. The potential of CRs for clinical evaluation has grown substantially through interaction with clinical stakeholders and more incidentally biobanks, also with greater involvement of patient groups - with a special focus on elderly patients who generally do not take part in clinical trials. Whereas 25-35% of CRs are active in a range of cancer research areas, the rest have a low profile and usually

  4. Active recruitment and limited participant-load related to high participation in large population-based biobank studies

    van Zon, Sander K. R.; Scholtens, Salome; Reijneveld, Sijmen A.; Smidt, Nynke; Bultmann, Ute

    2016-01-01

    Objectives: Insight into baseline participation rates and their determinants is crucial for designing future population-based biobank studies. We therefore conducted a systematic review and meta-analysis of baseline participation rates and their determinants in large longitudinal population-based

  5. The long-term effect of a population-based life-style intervention on smoking and alcohol consumption

    Baumann, Sophie; Toft, Ulla Marie Nørgaard; Aadahl, Mette

    2015-01-01

    AIMS: To examine whether improvements in smoking and alcohol consumption throughout the 5-year course of a population-based multi-factorial life-style intervention were sustained 5 years after its discontinuation. DESIGN: Population-based randomized controlled trial. SETTING: Suburbs of Copenhage...

  6. Risk factors for pneumonia among patients with Parkinson's disease: a Taiwan nationwide population-based study

    Chang YP

    2016-04-01

    Full Text Available Yang-Pei Chang,1 Chih-Jen Yang,2 Kai-Fang Hu,3 A-Ching Chao,4 Yu-Han Chang,5 Kun-Pin Hsieh,6 Jui-Hsiu Tsai,7 Pei-Shan Ho,8,9 Shen-Yang Lim101Department of Neurology, 2Department of Internal Medicine, 3Department of Dentistry, Kaohsiung Municipal Ta-Tung Hospital, 4Department of Neurology, College of Medicine, 5Department of Management, Kaohsiung Municipal Ta-Tung Hospital, 6School of Pharmacy, College of Pharmacy, 7Department of Psychiatry, Kaohsiung Municipal Ta-Tung Hospital, 8Faculty of Dental Hygiene, College of Dental Medicine, Kaohsiung Medical University, 9Cancer Center, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan, Republic of China; 10Faculty of Medicine, University of Malaya, Kuala lumpur, MalaysiaObjective: Pneumonia is the leading cause of death in patients with Parkinson’s disease (PD. However, few studies have been performed to explore the risk factors for pneumonia development in patients with PD.Methods: We conducted a nationwide population-based cohort study of patients with PD to identify the risk factors for these patients developing pneumonia. Participants with newly diagnosed PD between 2000 and 2009 were enrolled from the 2000–2010 National Health Insurance Research Database in Taiwan. We compared patients with PD with an incidence of hospitalization with pneumonia vs those without, and Cox proportional hazard models were used to estimate the risk of pneumonia.Results: Of the 2,001 enrolled patients (mean follow-up duration 5.8 years, range: 2.7–14.7 years, 381 (19.0% had an incidence of hospitalization with pneumonia during the study period. Multivariate Cox proportional hazards analysis identified older age group (≥80 years of age, hazard ratio [HR] =3.15 [95% confidence interval 2.32–4.28], male sex (HR =1.59 [1.29–1.96], certain geographic regions (northern, HR =1.36 [1.04–1.78], southern and eastern, HR =1.40 [1.05–1.88], rural areas (HR =1.34 [1.05–1.72], chronic heart

  7. Prediction of critical illness in elderly outpatients using elder risk assessment: a population-based study

    Biehl M

    2016-06-01

    Full Text Available Michelle Biehl,1 Paul Y Takahashi,2 Stephen S Cha,3 Rajeev Chaudhry,2 Ognjen Gajic,1 Bjorg Thorsteinsdottir2 1Division of Pulmonary and Critical Care Medicine, Department of Medicine, 2Division of Primary Care Internal Medicine, 3Health Sciences Research, Mayo Clinic, Rochester, MN, USA Rationale: Identifying patients at high risk of critical illness is necessary for the development and testing of strategies to prevent critical illness. The aim of this study was to determine the relationship between high elder risk assessment (ERA score and critical illness requiring intensive care and to see if the ERA can be used as a prediction tool to identify elderly patients at the primary care visit who are at high risk of critical illness. Methods: A population-based historical cohort study was conducted in elderly patients (age >65 years identified at the time of primary care visit in Rochester, MN, USA. Predictors including age, previous hospital days, and comorbid health conditions were identified from routine administrative data available in the electronic medical record. The main outcome was critical illness, defined as sepsis, need for mechanical ventilation, or death within 2 years of initial visit. Patients with an ERA score of 16 were considered to be at high risk. The discrimination of the ERA score was assessed using area under the receiver operating characteristic curve. Results: Of the 13,457 eligible patients, 9,872 gave consent for medical record review and had full information on intensive care unit utilization. The mean age was 75.8 years (standard deviation ±7.6 years, and 58% were female, 94% were Caucasian, 62% were married, and 13% were living in nursing homes. In the overall group, 417 patients (4.2% suffered from critical illness. In the 1,134 patients with ERA >16, 154 (14% suffered from critical illness. An ERA score ≥16 predicted critical illness (odds ratio 6.35; 95% confidence interval 3.51–11.48. The area under the

  8. Population-based cancer survival in the United States: Data, quality control, and statistical methods.

    Allemani, Claudia; Harewood, Rhea; Johnson, Christopher J; Carreira, Helena; Spika, Devon; Bonaventure, Audrey; Ward, Kevin; Weir, Hannah K; Coleman, Michel P

    2017-12-15

    Robust comparisons of population-based cancer survival estimates require tight adherence to the study protocol, standardized quality control, appropriate life tables of background mortality, and centralized analysis. The CONCORD program established worldwide surveillance of population-based cancer survival in 2015, analyzing individual data on 26 million patients (including 10 million US patients) diagnosed between 1995 and 2009 with 1 of 10 common malignancies. In this Cancer supplement, we analyzed data from 37 state cancer registries that participated in the second cycle of the CONCORD program (CONCORD-2), covering approximately 80% of the US population. Data quality checks were performed in 3 consecutive phases: protocol adherence, exclusions, and editorial checks. One-, 3-, and 5-year age-standardized net survival was estimated using the Pohar Perme estimator and state- and race-specific life tables of all-cause mortality for each year. The cohort approach was adopted for patients diagnosed between 2001 and 2003, and the complete approach for patients diagnosed between 2004 and 2009. Articles in this supplement report population coverage, data quality indicators, and age-standardized 5-year net survival by state, race, and stage at diagnosis. Examples of tables, bar charts, and funnel plots are provided in this article. Population-based cancer survival is a key measure of the overall effectiveness of services in providing equitable health care. The high quality of US cancer registry data, 80% population coverage, and use of an unbiased net survival estimator ensure that the survival trends reported in this supplement are robustly comparable by race and state. The results can be used by policymakers to identify and address inequities in cancer survival in each state and for the United States nationally. Cancer 2017;123:4982-93. Published 2017. This article is a U.S. Government work and is in the public domain in the USA. Published 2017. This article is a U

  9. The National Women's Health Study: assembly and description of a population-based reproductive cohort

    Prior Susan

    2004-08-01

    Full Text Available Abstract Background Miscarriage is a common event but is remarkably difficult to measure in epidemiological studies. Few large-scale population-based studies have been conducted in the UK. Methods This was a population-based two-stage postal survey of reproductive histories of adult women living in the United Kingdom in 2001, sampled from the electronic electoral roll. In Stage 1 a short "screening" questionnaire was sent to over 60,000 randomly selected women in order to identify those aged 55 and under who had ever been pregnant or ever attempted to achieve a pregnancy, from whom a brief reproductive history was requested. Stage 2 involved a more lengthy questionnaire requesting detailed information on every pregnancy (and fertility problems, and questions relating to socio-demographic, behavioural and other factors for the most recent pregnancy in order to examine risk factors for miscarriage. Data on stillbirth, multiple birth and maternal age are compared to national data in order to assess response bias. Results The response rate was 49% for Stage 1 and 73% for the more targeted Stage 2. A total of 26,050 questionnaires were returned in Stage 1. Of the 17,748 women who were eligible on the grounds of age, 27% reported that they had never been pregnant and had never attempted to conceive a child. The remaining 13,035 women reported a total of 30,661 pregnancies. Comparison of key reproductive indicators (stillbirth and multiple birth rates and maternal age at first birth with national statistics showed that the data look remarkably similar to the general population. Conclusions This study has enabled the assembly of a large population-based dataset of women's reproductive histories which appears unbiased compared to the general UK population and which will enable investigation of hard-to-measure outcomes such as miscarriage and infertility.

  10. Etiology and management of esophageal food impaction: a population based study.

    Gretarsdottir, Helga M; Jonasson, Jon Gunnlaugur; Björnsson, Einar S

    2015-05-01

    Esophageal food impaction (FI) is a common clinical problem with limited information on incidence. Previous population based studies are lacking. The incidence, main etiological factors, recurrence and outcome of FI was determined in the present study in a population based setting. This was a study of consecutive adult patients who presented with FI from 2008 to 2013 at the National University Hospital of Iceland. The mean crude incidence rate of FI was calculated. Retrospective analysis was undertaken on relevant clinical data such as type of bolus, management, complications, recurrence rate, risk factors for recurrence, and outcome. Overall 308 patients had endoscopically confirmed FI, males 199/308 (65%), median age 62 years. The mean crude incidence was 25 per 100,000 inhabitants per year. The types of FI was meat (68%), fish (12%), vegetable (4%) and other food/objects (16%). Causes for the FI included: esophageal strictures (45%), hiatal hernia (22%), eosinophilic esophagitis (EoE) (16%) and esophageal carcinoma (2%). Recurrence appeared in 21%, in which 24/48 (50%) had EoE vs. 40/260 (15%) in others (p = 0.0001). The removal of the foreign body was successful in 98% of the cases during the first endoscopy. Endoscopic associated complications included four (1.3%) aspirations, one (0.3%) esophageal perforation and one Boerhaave syndrome at presentation (both had EoE). The incidence of FI is the highest reported to date. EoE was strongly associated with recurrence of FI. In a population based setting endoscopy is a safe and effective procedure for removing FI.

  11. Injuries in Aleppo, Syria; first population-based estimates and characterization of predominant types

    Maziak Wasim

    2006-03-01

    Full Text Available Abstract Background Despite the growing burden of injuries worldwide, Syria and many other Arab countries still lack population-based estimates of different types of injuries. This study aims toprovide first population-based estimates of major injuries in Syria and characterize groups at increased risk. Methods An interviewer-administered population-based survey of adults 18–65 years residing in Aleppo, Syria was conducted in 2004. The study sample involved 2038 household representatives in Aleppo (45.2% men, mean age 35.3 ± 12.1, response rate 86%. We inquired about participants self-reported injuries in the past year that required medical attention as well as injuries among their household members. When reported, injuries were further assessed according to type, place, and outcome. Results Overall, there was 153 self-reported injuries in the past year (77.3 per 1000 adult respondents, 93.1 per 1000 in men and 64.4 per 1000 in women, p = 0.02. Other than gender, injuries differed by age (the older age group being least affected, and place of occurrence, as men were more likely to sustain traffic injuries and be injured outside the home. Injuries were reported among 236 household members (21.0 per 1000, and were slightly more frequent in children than adults (22.0 per 1000 for children, and 19.7 per 1000 for adults, p = 0.2. Traffic injuries, falls, and poisoning (food were by far the most common types of injury experienced by participants as well as their household members. Falls and traffic injuries seem to have caused most morbidity for the injured, while burns, although not frequently reported, were associated with an unfavorable outcome in the majority of cases. Conclusion This information provides baseline information about the burden of different injuries in Syria, and the sociodemographic factors related to them.

  12. Congenital anomalies in children with cerebral palsy: a population-based record linkage study

    Rankin, Judith; Cans, Christine; Garne, Ester

    2009-01-01

    Aim Our aim was to determine the proportion of children with cerebral palsy (CP) who have a congenital anomaly (CA) in three regions (Isère Region, French Alps; Funen County, Denmark; Northern Region, England) where population-based CP and CA registries exist, and to classify the children according...... to CA subtype. Method Data for children born between 1991 and 1999 were linked using electronic matching of cases. All potential matches were checked manually by each centre and verified as true matches. Results A total of 1104 children with CP were born during the study period (663 males, 441 females...

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

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

    2015-12-17

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

  14. Food protein-induced enterocolitis syndrome in Australia: A population-based study, 2012-2014.

    Mehr, Sam; Frith, Katie; Barnes, Elizabeth H; Campbell, Dianne E

    2017-11-01

    Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated gastrointestinal allergic disorder. Large population-based FPIES studies are lacking. We sought to determine the incidence and clinical characteristics of FPIES in Australian infants. An Australia-wide survey (2012-2014) was undertaken through the Australian Paediatric Surveillance Unit, with monthly notification of new cases of acute FPIES in infants aged less than 24 months by 1400 participating pediatricians. Two hundred thirty infants with FPIES were identified. The incidence of FPIES in Australian infants (disease and FPIES to fruits, vegetables, or both. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  15. A population-based Bayesian approach to the minimal model of glucose and insulin homeostasis

    Andersen, Kim Emil; Højbjerre, Malene

    2005-01-01

    -posed estimation problem, where the reconstruction most often has been done by non-linear least squares techniques separately for each entity. The minmal model was originally specified for a single individual and does not combine several individuals with the advantage of estimating the metabolic portrait...... to a population-based model. The estimation of the parameters are efficiently implemented in a Bayesian approach where posterior inference is made through the use of Markov chain Monte Carlo techniques. Hereby we obtain a powerful and flexible modelling framework for regularizing the ill-posed estimation problem...

  16. Use of fertility drugs and risk of ovarian cancer: Danish population based cohort study

    Jensen, Allan; Sharif, Heidi; Frederiksen, Kirsten; Kj?r, Susanne Kr?ger

    2009-01-01

    Objective To examine the effects of fertility drugs on overall risk of ovarian cancer using data from a large cohort of infertile women. Design Population based cohort study. Setting Danish hospitals and private fertility clinics. Participants 54?362 women with infertility problems referred to all Danish fertility clinics during 1963-98. The median age at first evaluation of infertility was 30 years (range 16-55 years), and the median age at the end of follow-up was 47 (range 18-81) years. In...

  17. Falls in very old people: the population-based Umeå 85+ Study in Sweden

    von Heideken Wågert, Petra; Gustafson, Yngve; Kallin, Kristina; Jensen, Jane; Lundin-Olsson, Lillemor

    2009-01-01

    Artikkelen omhandler en studie hvor hensikten var å beskrive forekomst av fall og fallrelaterte skader, og å identifisere predisponerende faktorer for fall hos eldre 85 år og eldre. The aim of this study was to describe incidences of falls and fall-related injuries, and to identify predisposing factors for falls in very old people in a prospective population-based follow-up study for falls. The study is part of the Umeå 85+ Study which includes half of the population aged 85, and the total...

  18. Perinatal Advantages and Disadvantages of Being Underweight before Pregnancy: A Population-Based Study.

    Trojner Bregar, Andreja; Blickstein, Isaac; Bržan Šimenc, Gabrijela; Janša, Vid; Verdenik, Ivan; Lučovnik, Miha; Tul, Nataša

    2017-01-01

    To evaluate the advantages and disadvantages of being underweight before pregnancy. Cohort study of a large population-based dataset of singleton births was used to compare maternal and neonatal outcomes of pre-gravid underweight body mass index (BMI 4,000 g, less cesarean births and a lower incidence of gestational diabetes and hypertensive disorders. A tradeoff exists between the advantages of being lean before pregnancy in terms of less maternal morbidity in return for gaining a more advanced gestational age and higher birth weight. © 2016 S. Karger AG, Basel.

  19. Fertility rates and perinatal outcomes of adolescent pregnancies: a retrospective population-based study

    Souza, Maria de Lourdes de; Lynn, Fiona Ann; Johnston, Linda; Tavares, Eduardo Cardoso Teixeira; Brüggemann, Odaléa Maria; Botelho, Lúcio José

    2017-01-01

    ABSTRACT Objective: analyze trends in fertility rates and associations with perinatal outcomes for adolescents in Santa Catarina, Brazil. Methods: a population-based study covering 2006 to 2013 was carried out to evaluate associations between perinatal outcomes and age groups, using odds ratios, and Chi-squared tests. Results: differences in the fertility rate among female adolescents across regions and time period were observed, ranging from 40.9 to 72.0 per 1,000 in mothers aged 15-19 ye...

  20. Autoimmune and immunogenetic profile of patients with optic neuritis in a population-based cohort

    Soelberg, K.; Nilsson, A. C.; Nielsen, C.

    2018-01-01

    Background: Optic neuritis (ON) is an inflammatory optic neuropathy, where the genetic and autoimmune dependency remains poorly characterized. Objective: To investigate autoimmune and immunogenetic aspects of ON. Method: In a prospective population-based cohort 51 patients with ON were included...... antibodies. Coexisting neural autoantibodies were detected in two patients and in 12 patients other systemic autoantibodies were found. Four (8%) had other autoimmune disorders. A family history of autoimmunity was observed in 12 (24%) and of demyelinating disease in six patients (12%). In MS-ON patients...

  1. MMAS vs. Population-based EA on a family of dynamic fitness functions

    Lissovoi, Andrei; Witt, Carsten

    2014-01-01

    We study the behavior of a population-based EA and the Max-Min Ant System (MMAS) on a family of deterministically-changing fitness functions, where, in order to find the global optimum, the algorithms have to find specific local optima within each of a series of phases. In particular, we prove...... a Maze function extended over a finite alphabet of μ symbols, whereas population size μ-1 is not sufficient. Furthermore, we show that MMAS does not require additional modifications to track the optimum of the finite-alphabet Maze functions, and, using a novel drift statement to simplify the analysis...

  2. MMAS Versus Population-Based EA on a Family of Dynamic Fitness Functions

    Lissovoi, Andrei; Witt, Carsten

    2015-01-01

    We study the behavior of a population-based EA and the Max–Min Ant System (MMAS) on a family of deterministically-changing fitness functions, where, in order to find the global optimum, the algorithms have to find specific local optima within each of a series of phases. In particular, we prove...... function extended over a finite alphabet of μ symbols, whereas population size μ−1 is not sufficient. Furthermore, we show that MMAS does not require additional modifications to track the optimum of the finite-alphabet Maze functions, and, using a novel drift statement to simplify the analysis, reduce...

  3. Screening for autistic spectrum disorder at the 18-month developmental assessment: a population-based study

    VanDenHeuvel, A.; Fitzgerald, M.; Greiner, Birgit A.; Perry, Ivan J.

    2007-01-01

    VanDenHeuvel A, Fitzgerald M, Greiner B, Perry IJ. Screening for autistic spectrum disorder at the 18-month developmental assessment: a population-based study. Ir Med J. 2007;100(8):565-7. The objectives of this study were to assess the feasibility of administering the CHecklist for Autism in Toddlers (CHAT) at the 18-month developmental check, estimate the prevalence of screening positive for autism at the first and second administrations of the CHAT and estimate the prevalence of diagnos...

  4. Variables associated with olfactory disorders in adults: A U.S. population-based analysis

    Julia Noel

    2017-03-01

    Full Text Available Objective: Olfactory dysfunction is known to have significant social, psychological, and safety implications. Despite increasingly recognized prevalence, potential risk factors for olfactory loss have been arbitrarily documented and knowledge is limited in scale. The aim of this study is to identify potential demographic and exposure variables correlating with olfactory dysfunction. Methods: Cross-sectional analysis of the 2011–2012 and 2013–2014 editions of the National Health Examination and Nutrition Survey was performed. The utilized survey reports from a nationally representative sample of about 5000 persons each year located in counties across the United States. There is an interview and physical examination component which includes demographic, socioeconomic, dietary, and health-related questions as well as medical, dental, physiologic measurements, and laboratory tests. 3594 adult respondents from 2011 to 2012 and 3708 respondents from 2013 to 2014 were identified from the above population-based database. The frequency of self-reported disorders as well as performance on odor identification testing was determined in relation to demographic factors, occupational or environmental exposures, and urinary levels of environmental and industrial compounds. Results: In both subjective and objective analysis, smell disorders were significantly more common with increasing age. While the non-Hispanic Black and non-Hispanic Asian populations were less likely to report subjective olfactory loss, they, along with Hispanics, performed more poorly on odor identification than Caucasians. Those with limited education had a decreased prevalence of hyposmia. Women outperformed men on smell testing. Those reporting exposure to vapors were more likely to experience olfactory dysfunction, and urinary levels of manganese, 2-Thioxothiazolidine-4-carboxylic acid, and 2-Aminothiazoline-4-carboxylic acid were lower among respondents with subjective smell

  5. Risk for Arterial and Venous Thrombosis in Patients With Myeloproliferative Neoplasms: A Population-Based Cohort Study.

    Hultcrantz, Malin; Björkholm, Magnus; Dickman, Paul W; Landgren, Ola; Derolf, Åsa R; Kristinsson, Sigurdur Y; Andersson, Therese M L

    2018-03-06

    Patients with myeloproliferative neoplasms (MPNs) are reported to be at increased risk for thrombotic events. However, no population-based study has estimated this excess risk compared with matched control participants. To assess risk for arterial and venous thrombosis in patients with MPNs compared with matched control participants. Matched cohort study. Population-based setting in Sweden from 1987 to 2009, with follow-up to 2010. 9429 patients with MPNs and 35 820 matched control participants. The primary outcomes were rates of arterial and venous thrombosis. Flexible parametric models were used to calculate hazard ratios (HRs) and cumulative incidence with 95% CIs. The HRs for arterial thrombosis among patients with MPNs compared with control participants at 3 months, 1 year, and 5 years were 3.0 (95% CI, 2.7 to 3.4), 2.0 (CI, 1.8 to 2.2), and 1.5 (CI, 1.4 to 1.6), respectively. The corresponding HRs for venous thrombosis were 9.7 (CI, 7.8 to 12.0), 4.7 (CI, 4.0 to 5.4), and 3.2 (CI, 2.9 to 3.6). The rate was significantly elevated across all age groups and was similar among MPN subtypes. The 5-year cumulative incidence of thrombosis in patients with MPNs showed an initial rapid increase followed by gentler increases during follow-up. The HR for venous thrombosis decreased during more recent calendar periods. No information on individual laboratory results or treatment. Patients with MPNs across all age groups have a significantly increased rate of arterial and venous thrombosis compared with matched control participants, with the highest rates at and shortly after diagnosis. Decreases in the rate of venous thrombosis over time likely reflect advances in clinical management. The Cancer Research Foundations of Radiumhemmet, Blodcancerfonden, the Swedish Research Council, the regional agreement on medical training and clinical research between Stockholm County Council and Karolinska Institutet, the Adolf H. Lundin Charitable Foundation, and Memorial Sloan

  6. Somatic symptom profiles in the general population: a latent class analysis in a Danish population-based health survey

    Eliasen M

    2017-08-01

    Full Text Available Marie Eliasen,1 Torben Jørgensen,1–3 Andreas Schröder,4 Thomas Meinertz Dantoft,1 Per Fink,4 Chalotte Heinsvig Poulsen,1,5 Nanna Borup Johansen,1 Lene Falgaard Eplov,5 Sine Skovbjerg,1 Svend Kreiner2 1Research Centre for Prevention and Health, Centre for Health, The Capital Region of Denmark, Glostrup, 2Department of Public Health, University of Copenhagen, Copenhagen, 3Department of Clinical Medicine, Aalborg University, Aalborg, 4Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus C, 5Mental Health Centre Copenhagen, The Capital Region of Denmark, Hellerup, Denmark Purpose: The aim of this study was to identify and describe somatic symptom profiles in the general adult population in order to enable further epidemiological research within multiple somatic symptoms.Methods: Information on 19 self-reported common somatic symptoms was achieved from a population-based questionnaire survey of 36,163 randomly selected adults in the Capital Region of Denmark (55.4% women. The participants stated whether they had been considerably bothered by each symptom within 14 days prior to answering the questionnaire. We used latent class analysis to identify the somatic symptom profiles. The profiles were further described by their association with age, sex, chronic disease, and self-perceived health.Results: We identified 10 different somatic symptom profiles defined by number, type, and site of the symptoms. The majority of the population (74.0% had a profile characterized by no considerable bothering symptoms, while a minor group of 3.9% had profiles defined by a high risk of multiple somatic symptoms. The remaining profiles were more likely to be characterized by a few specific symptoms. The profiles could further be described by their associations with age, sex, chronic disease, and self-perceived health.Conclusion: The identified somatic symptom profiles could be distinguished by number, type, and site of

  7. The association between social capital and loneliness in different age groups: a population-based study in Western Finland.

    Nyqvist, Fredrica; Victor, Christina R; Forsman, Anna K; Cattan, Mima

    2016-07-11

    Previous studies of loneliness have largely focused on establishing risk factors in specific age groups such as in later life or in young people. Researchers have paid less attention to the link between social capital and loneliness across different age groups. The aim of this study was to examine the association between social capital and experienced loneliness in different age groups in a Finnish setting. The data originates from a population-based cross-sectional survey conducted among 4618 people aged 15-80 in Western Finland in 2011. The response rate was 46.2 %. The association between social capital, measured by frequency of social contacts, participation in organisational activities, trust and sense of belonging to the neighbourhood and loneliness was tested by logistic regression analyses stratified by four age groups. Frequent loneliness (defined as experienced often or sometimes) was higher among younger people (39.5 %) compared to older people (27.3 %). Low levels of trust were linked to loneliness in all four age groups. The association between other aspects of social capital and loneliness varied across age groups. Frequent loneliness is common among the general adult population and could be seen as a public health issue. Our findings imply that low social capital, especially in terms of low trust, may be a risk factor for loneliness. However, further research is needed to assess the influence of poor health and reverse causality as explanations for the findings.

  8. High blood pressure: prevalence and adherence to guidelines in a population-based cohort.

    Walther, Diana; Curjuric, Ivan; Dratva, Julia; Schaffner, Emmanuel; Quinto, Carlos; Rochat, Thierry; Gaspoz, Jean-Michel; Burdet, Luc; Bridevaux, Pierre-Olivier; Pons, Marco; Gerbase, Margaret W; Schindler, Christian; Probst-Hensch, Nicole

    2016-01-01

    High blood pressure, the single leading health risk factor worldwide, contributes greatly to morbidity and mortality. This study aimed to add to the understanding of diagnosed and undiagnosed high blood pressure in Switzerland and to evaluate adherence to hypertension guidelines. Included were 3962 participants from the first (2001-2003) and second (2010-2011) follow-ups of the population-based Swiss Cohort Study on Air Pollution and Lung and Heart Disease in Adults. High blood pressure was defined as blood pressure ≥140/90 mm Hg and the prevalence of doctor-diagnosed hypertension was based on questionnaire information. High blood pressure was found in 34.9% of subjects, 49.1% of whom were unaware of this condition; 30.0% had doctor-diagnosed hypertension and, although 82.1% of these received drug treatments, in only 40.8% was blood pressure controlled (<140/90 mm Hg). Substantial first-line beta-blocker use and nonadherence to comorbidity-specific prescription guidelines were observed and remained mostly unexplained. Age-adjusted rates of unawareness and uncontrolled hypertension were more than 20% higher than in the USA. There is room for improvement in managing hypertension in Switzerland. Population-based observational studies are essential for identifying and evaluating unmet needs in healthcare; however, to pinpoint the underlying causes it is imperative to facilitate linkage of cohort data to medical records.

  9. Population-based differences in treatment outcome following anticancer drug therapies.

    Ma, Brigette By; Hui, Edwin P; Mok, Tony Sk

    2010-01-01

    Population-based differences in toxicity and clinical outcome following treatment with anticancer drugs have an important effect on oncology practice and drug development. These differences arise from complex interactions between biological and environmental factors, which include genetic diversity affecting drug metabolism and the expression of drug targets, variations in tumour biology and host physiology, socioeconomic disparities, and regional preferences in treatment standards. Some well-known examples include the high prevalence of activating epidermal growth factor receptor (EGFR) mutations in pulmonary adenocarcinoma among northeast (China, Japan, Korea) and parts of southeast Asia (excluding India) non-smokers, which predict sensitivity to EGFR kinase inhibitors, and the sharp contrast between Japan and the west in the management and survival outcome of gastric cancer. This review is a critical overview of population-based differences in the four most prevalent cancers in the world: lung, breast, colorectal, and stomach cancer. Particular attention is given to the clinical relevance of such knowledge in terms of the individualisation of drug therapy and in the design of clinical trials. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

  10. Population-based characteristics of fatal and hospital admissions for poisoning in Fiji: TRIP Project-11

    Peiris-John, Roshini; Kafoa, Berlin; Wainiqolo, Iris; Reddy, Ravi Krishnan; McCaig, Eddie; Ameratunga, Shanthi N

    2013-01-01

    This study investigated the incidence and characteristics of poisoning fatalities and hospital admissions among indigenous Fijians and Indians in Viti Levu, Fiji. Individuals with a mechanism of injury classified as poisoning were identified using the Fiji injury surveillance in hospitals system, a population-based registry established for 12 months in Viti Levu, and analysed using population-based denominators. The mean annual rates of fatalities and hospitalisations were 2.3 and 26.0 per 100 000, respectively. Over two-thirds of poisonings occurred among people of Indian ethnicity. Most intentional poisoning admissions occurred among women (58.3%) and in 15–29-year-old individuals (73.8%). Unintentional poisoning admission rates were highest among Indian boys aged 0–14 years. While over 75% of events occurred at home, the substances involved were not systematically identified. The findings indicate the need for a strategy that addresses the differing contexts across age group, gender and ethnicity, and a lead agency responsible for implementing and monitoring its effectiveness. PMID:23353079

  11. Age-specific association of migraine with cryptogenic TIA and stroke: Population-based study.

    Li, Linxin; Schulz, Ursula G; Kuker, Wilhelm; Rothwell, Peter M

    2015-10-27

    To determine whether there is an association between previous migraine and cryptogenic TIA or ischemic stroke at older ages. We determined the age-specific associations of history of migraine and Trial of Org 10172 in Acute Stroke Treatment (TOAST) subtype of TIA and ischemic stroke in a population-based cohort study (Oxford Vascular Study; 2002-2012). Among 1,810 eligible patients with TIA or ischemic stroke, 668 (36.9%) had cryptogenic events, of whom 187 (28.0%) had previous migraine. Migraine was more commonly associated with cryptogenic events than with those of known etiology (odds ratio [OR] 1.73, 95% confidence interval [CI] 1.38-2.16, p TIA or stratified by sex or vascular territory of event. In this population-based study of stroke etiology stratified by age, migraine was most strongly associated with cryptogenic TIA and ischemic stroke, particularly at older ages, suggesting a causal role or a shared etiology. © 2015 American Academy of Neurology.

  12. Low frequency of defective mismatch repair in a population-based series of upper urothelial carcinoma

    Ericson, Kajsa M; Isinger, Anna P; Isfoss, Björn L; Nilbert, Mef C

    2005-01-01

    Upper urothelial cancer (UUC), i.e. transitional cell carcinomas of the renal pelvis and the ureter, occur at an increased frequency in patients with hereditary nonpolyposis colorectal cancer (HNPCC). Defective mismatch repair (MMR) specifically characterizes HNPCC-associated tumors, but also occurs in subsets of some sporadic tumors, e.g. in gastrointestinal cancer and endometrial cancer. We assessed the contribution of defective MMR to the development of UUC in a population-based series from the southern Swedish Cancer Registry, through microsatellite instability (MSI) analysis and immunohistochemical evaluation of expression of the MMR proteins MLH1, PMS2, MSH2, and MSH6. A MSI-high phenotype was identified in 9/216 (4%) successfully analyzed patients and a MSI-low phenotype in 5/216 (2%). Loss of MMR protein immunostaining was found in 11/216 (5%) tumors, and affected most commonly MSH2 and MSH6. This population-based series indicates that somatic MMR inactivation is a minor pathway in the development of UUC, but tumors that display defective MMR are, based on the immunohistochemical expression pattern, likely to be associated with HNPCC

  13. Low frequency of defective mismatch repair in a population-based series of upper urothelial carcinoma

    Isfoss Björn L

    2005-03-01

    Full Text Available Abstract Background Upper urothelial cancer (UUC, i.e. transitional cell carcinomas of the renal pelvis and the ureter, occur at an increased frequency in patients with hereditary nonpolyposis colorectal cancer (HNPCC. Defective mismatch repair (MMR specifically characterizes HNPCC-associated tumors, but also occurs in subsets of some sporadic tumors, e.g. in gastrointestinal cancer and endometrial cancer. Methods We assessed the contribution of defective MMR to the development of UUC in a population-based series from the southern Swedish Cancer Registry, through microsatellite instability (MSI analysis and immunohistochemical evaluation of expression of the MMR proteins MLH1, PMS2, MSH2, and MSH6. Results A MSI-high phenotype was identified in 9/216 (4% successfully analyzed patients and a MSI-low phenotype in 5/216 (2%. Loss of MMR protein immunostaining was found in 11/216 (5% tumors, and affected most commonly MSH2 and MSH6. Conclusion This population-based series indicates that somatic MMR inactivation is a minor pathway in the development of UUC, but tumors that display defective MMR are, based on the immunohistochemical expression pattern, likely to be associated with HNPCC.

  14. Low frequency of defective mismatch repair in a population-based series of upper urothelial carcinoma

    Ericson, Kajsa M; Isinger, Anna P [Departments of Oncology, University Hospital, Lund (Sweden); Isfoss, Björn L [Departments of Pathology, University Hospital, Lund (Sweden); Nilbert, Mef C [Departments of Oncology, University Hospital, Lund (Sweden)

    2005-01-01

    Upper urothelial cancer (UUC), i.e. transitional cell carcinomas of the renal pelvis and the ureter, occur at an increased frequency in patients with hereditary nonpolyposis colorectal cancer (HNPCC). Defective mismatch repair (MMR) specifically characterizes HNPCC-associated tumors, but also occurs in subsets of some sporadic tumors, e.g. in gastrointestinal cancer and endometrial cancer. We assessed the contribution of defective MMR to the development of UUC in a population-based series from the southern Swedish Cancer Registry, through microsatellite instability (MSI) analysis and immunohistochemical evaluation of expression of the MMR proteins MLH1, PMS2, MSH2, and MSH6. A MSI-high phenotype was identified in 9/216 (4%) successfully analyzed patients and a MSI-low phenotype in 5/216 (2%). Loss of MMR protein immunostaining was found in 11/216 (5%) tumors, and affected most commonly MSH2 and MSH6. This population-based series indicates that somatic MMR inactivation is a minor pathway in the development of UUC, but tumors that display defective MMR are, based on the immunohistochemical expression pattern, likely to be associated with HNPCC.

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

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

    2013-01-01

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

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

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

    2017-09-01

    Population attributable fraction (PAF) is widely used to quantify the disease burden associated with a modifiable exposure in a population. It has been extended to a time-varying measure that provides additional information on when and how the exposure's impact varies over time for cohort studies. However, there is no estimation procedure for PAF using data that are collected from population-based case-control studies, which, because of time and cost efficiency, are commonly used for studying genetic and environmental risk factors of disease incidences. In this article, we show that time-varying PAF is identifiable from a case-control study and develop a novel estimator of PAF. Our estimator combines odds ratio estimates from logistic regression models and density estimates of the risk factor distribution conditional on failure times in cases from a kernel smoother. The proposed estimator is shown to be consistent and asymptotically normal with asymptotic variance that can be estimated empirically from the data. Simulation studies demonstrate that the proposed estimator performs well in finite sample sizes. Finally, the method is illustrated by a population-based case-control study of colorectal cancer. © 2017, The International Biometric Society.

  17. Determinants of change in polypharmacy status in Switzerland: the population-based CoLaus study.

    Abolhassani, Nazanin; Castioni, Julien; Marques-Vidal, Pedro; Vollenweider, Peter; Waeber, Gérard

    2017-09-01

    This study aimed to assess the prevalence, the change, and the determinants of change in polypharmacy in a population-based sample. Baseline (2003-2006) and follow-up (2009-2012) data are from 4679 participants aged between 35 and 75 years (53.5% women, mean age 52.6 ± 10.6 years) from the population of Lausanne, Switzerland. Polypharmacy was defined by the regular use of ≥5 drugs. Four categories of change were defined: never (no polypharmacy at baseline and follow-up), initiating (no polypharmacy at baseline but at follow-up), maintaining, or quitting. Polypharmacy increased from 7.7% at baseline to 15.3% at follow-up. Cardiovascular drugs were the most prescribed medicines at baseline and follow-up. Gender, age, obesity, smoking, previously diagnosed hypertension, or diabetes or dyslipidemia were significantly and independently associated with initiating and maintaining polypharmacy. In a population-based sample, prevalence of polypharmacy doubled over a 5.6-year period. The main determinants of initiating polypharmacy were age, overweight and obesity, smoking status, and previously diagnosed cardiovascular risk factors.

  18. Assessment of fracture risk: value of random population-based samples--the Geelong Osteoporosis Study.

    Henry, M J; Pasco, J A; Seeman, E; Nicholson, G C; Sanders, K M; Kotowicz, M A

    2001-01-01

    Fracture risk is determined by bone mineral density (BMD). The T-score, a measure of fracture risk, is the position of an individual's BMD in relation to a reference range. The aim of this study was to determine the magnitude of change in the T-score when different sampling techniques were used to produce the reference range. Reference ranges were derived from three samples, drawn from the same region: (1) an age-stratified population-based random sample, (2) unselected volunteers, and (3) a selected healthy subset of the population-based sample with no diseases or drugs known to affect bone. T-scores were calculated using the three reference ranges for a cohort of women who had sustained a fracture and as a group had a low mean BMD (ages 35-72 yr; n = 484). For most comparisons, the T-scores for the fracture cohort were more negative using the population reference range. The difference in T-scores reached 1.0 SD. The proportion of the fracture cohort classified as having osteoporosis at the spine was 26, 14, and 23% when the population, volunteer, and healthy reference ranges were applied, respectively. The use of inappropriate reference ranges results in substantial changes to T-scores and may lead to inappropriate management.

  19. Design of PREVENCION: a population-based study of cardiovascular disease in Peru.

    Medina-Lezama, Josefina; Chirinos, Julio A; Zea Díaz, Humberto; Morey, Oscar; Bolanos, Juan F; Munoz-Atahualpa, Edgar; Chirinos-Pacheco, Julio

    2005-11-02

    Latin America is undergoing the epidemiologic transition that occurred earlier in developed countries, and is likely to face a gigantic epidemic of heart disease in the next few years unless urgent action is taken. The first essential component of any effective cardiovascular disease (CVD) control program is to establish reliable estimates of cardiovascular disease-related morbidity and mortality. However, such data from population-based studies in Latin America are still lacking. In this paper, we present the design and operation of PREVENCION (Estudio Peruano de Prevalencia de Enfermedades Cardiovasculares, for Peruvian Study of the Prevalence of Cardiovascular diseases). PREVENCION is an ongoing population-based study on a representative sample of the civilian non-institutionalized population of the second largest city in Peru. Its population is comparable to the rest of the Peruvian urban population and closely resembles other Latin American populations in countries such as Bolivia and Ecuador. Our study will contribute to the enormous task of understanding and preventing CVD in Latin America.

  20. Factors associated with quality of life in active childhood epilepsy: a population-based study.

    Reilly, Colin; Atkinson, Patricia; Das, Krishna B; Chin, Richard F M; Aylett, Sarah E; Burch, Victoria; Gillberg, Christopher; Scott, Rod C; Neville, Brian G R

    2015-05-01

    Improving health-related quality of life (HRQOL), rather than just reducing seizures, should be the principal goal in comprehensive management of childhood epilepsy. There is a lack of population-based data on predictors of HRQOL in childhood epilepsy. The Children with Epilepsy in Sussex Schools (CHESS) study is a prospective, population-based study involving school-aged children (5-15 years) with active epilepsy (on one or more AED and/or had a seizure in the last year) in a defined geographical area in the UK. Eighty-five of 115 (74% of eligible population) children underwent comprehensive psychological assessment including measures of cognition, behaviour, and motor functioning. Parents of the children completed the Quality of Life in Childhood Epilepsy (QOLCE).Clinical data on eligible children was extracted using a standardised pro forma. Linear regression analysis was undertaken to identify factors significantly associated with total Quality of Life in this population. Factors independently significantly associated (p QOLCE scores were seizures before 24 months, cognitive impairment (IQ QOLCE when children with IQ < 50 were excluded from analysis. The majority of factors associated with parent reported HRQOL in active childhood epilepsy are related to neurobehavioural and/or psychosocial aspects of the condition. Copyright © 2015 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  1. Occupational risk factors for brain cancer: a population-based case-control study in Iowa.

    Zheng, T; Cantor, K P; Zhang, Y; Keim, S; Lynch, C F

    2001-04-01

    A number of occupations and industries have been inconsistently associated with the risk of brain cancer. To further explore possible relationships, we conducted a population-based case-control study of brain glioma in the state of Iowa, involving 375 histologically confirmed incident cases and 2434 population-based controls. Among men, the industries and/or occupations that had a significantly increased risk for employment of more than 10 years included roofing, siding, and sheet metalworking; newspaper work; rubber and plastics products, particularly tires and inner tubes; miscellaneous manufacturing industries; wholesale trade of durable goods, grain, and field beans; cleaning and building service occupations; miscellaneous mechanics and repairers; and janitors and cleaners. Subjects who worked in plumbing, heating, and air conditioning; electrical services; gasoline service stations; and military occupations also experienced a significantly increased risk. Among women, significant excess risk was observed for occupations in agricultural services and farming, apparel and textile products, electrical and electronic equipment manufacturing, various retail sales, record-keeping, and restaurant service. Workers in industries with a potential for gasoline or motor exhaust exposures experienced a non-significant excess risk of brain glioma.

  2. USING THE POPULATION-BASED INCREMENTAL LEARNING ALGORITHM WITH COMPUTER SIMULATION: SOME APPLICATIONS

    J. Bekker

    2012-01-01

    Full Text Available

    ENGLISH ABSTRACT: The integration of the population-based incremental learning (PBIL algorithm with computer simulation shows how this particular combination can be applied to find good solutions to combinatorial optimisation problems. Two illustrative examples are used: the classical inventory problem of finding a reorder point and reorder quantity that minimises costs while achieving a required service level (a stochastic problem; and the signal timing of a complex traffic intersection. Any traffic control system must be designed to minimise the duration of interruptions at intersections while maximising traffic throughput. The duration of the phases of traffic lights is of primary importance in this regard.

    AFRIKAANSE OPSOMMING: Die integrasie van die population-based incremental learning (PBIL algoritme met rekenaarsimulasie word bespreek, en daar word getoon hoe hierdie spesifieke kombinasie aangewend kan word om goeie oplossings vir kombinatoriese optimeringsprobleme te vind. Twee voorbeelde dien as illustrasie: die klassieke voorraadprobleem waarin ’n herbestelvlak en herbestelhoeveelheid bepaal moet word om koste te minimeer maar nogtans ’n vasgestelde diensvlak te handhaaf (’n stochastiese probleem; en die bepaling van die seintye van ’n komplekse verkeerskruising. Enige verkeerbeheerstelsel moet ontwerp word om die duur van die vloeionderbrekings by verkeerskruisings te minimeer en verkeerdeurset te maksimeer. Die tydsduur van die fases van verkeersligte is dus baie belangrik.

  3. A Population-Based Study of the Incidence of Acute Spinal Cord Infarction.

    Qureshi, Adnan I; Afzal, Mohammad Rauf; Suri, M Fareed K

    2017-06-01

    There is a paucity of reliable data regarding incidence of acute spinal cord infarction in population-based studies. To determine the incidence of acute spinal cord infarction using a population-based design. Medical records and neuroimaging data of all patients with acute spinal cord infarction from Stearns and Benton Counties, Minnesota, between January 1, 2010 and May 31, 2014 were reviewed. Patients with a first-time diagnosis of spinal cord infarction were categorized as primary or secondary depending upon underlying etiology identified. We calculated the incidences of primary and secondary spinal cord infarction adjusted for age and sex based on the 2010 US census (189,093 resident populations). The age- and sex-adjusted incidence of spinal cord infarction was 3.1 [95% confidence interval (CI) 1.6-7.2] per100,000 person-years. The age- and sex-adjusted incidence of primary and secondary spinal cord infarction was 1.5 [95% CI 0.6-3.6] and 1.6 [95% CI 0.6-3.6] per 100,000 person-years, respectively. The age-adjusted incidences among men and women were 1.5 [95%CI 0.6-3.7] and 4.6 [95% CI 2.2-8.7] per 100,000 person-years, respectively. No case fatality was observed at one month. We provide incidence rates for acute spinal cord infarction to assist in future studies and resource allocation.

  4. Child Maltreatment Among Singletons and Multiple Births in Japan: A Population-Based Study.

    Yokoyama, Yoshie; Oda, Terumi; Nagai, Noriyo; Sugimoto, Masako; Mizukami, Kenji

    2015-12-01

    The occurrence of multiple births has been recognized as a risk factor for child maltreatment. However, few population-based studies have examined the relationship between multiple births and child maltreatment. This study aimed to evaluate the degree of risk of child maltreatment among singletons and multiple births in Japan and to identify factors associated with increased risk. Using population-based data, we analyzed the database of records on child maltreatment and medical checkups for infants aged 1.5 years filed at Nishinomiya City Public Health Center between April 2007 and March 2011. To protect personal information, the data were transferred to anonymized electronic files for analysis. After adjusting by logistic regression for each associated factor and gestation number, multiples themselves were not associated with the risk of child maltreatment. However, compared with singletons, multiples had a significantly higher rate of risk factors for child maltreatment, including low birth weight and neural abnormality. Moreover, compared with mothers of singleton, mothers of twins had a significantly higher rate of poor health, which is a risk factor of child maltreatment. Multiples were not associated with the risk of child maltreatment. However, compared with singletons, multiples and their mothers had a significantly higher rate of risk factors of child maltreatment.

  5. Evaluation of a population-based approach to familial colorectal cancer.

    Parfrey, P S; Dicks, E; Parfrey, O; McNicholas, P J; Noseworthy, H; Woods, M O; Negriin, C; Green, J

    2017-05-01

    As Newfoundland has the highest rate of familial colorectal cancer (CRC) in the world, we started a population-based clinic to provide colonoscopic and Lynch syndrome (LS) screening recommendations to families of CRC patients based on family risk. Of 1091 incident patients 51% provided a family history. Seventy-two percent of families were at low or intermediate-low risk of CRC and colonoscopic screening recommendations were provided by letter. Twenty-eight percent were at high and intermediate-high risk and were referred to the genetic counsellor, but only 30% (N = 48) were interviewed by study end. Colonoscopy was recommended more frequently than every 5 years in 35% of families. Lower family risk was associated with older age of proband but the frequency of screening colonoscopy recommendations varied across all age groups, driven by variability in family history. Twenty-four percent had a high MMR predict score for a Lynch syndrome mutation, and 23% fulfilled the Provincial Program criteria for LS screening. A population-based approach in the provision of colonoscopic screening recommendations to families at risk of CRC was limited by the relatively low response rate. A family history first approach to the identification of LS families was inefficient. © 2016 The Authors. Clinical Genetics published by John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Population-based dietary approaches for the prevention of noncommunicable diseases.

    Somasundaram, Noel P; Kalupahana, Nishan Sudheera

    2016-04-01

    As the incidence of noncommunicable diseases such as diabetes continues to rise at an alarming rate in South-East Asia, it is imperative that urgent and population-wide strategies are adopted. The most important contributors to the rise in noncommunicable disease are a rise in mean caloric intake and a decrease in physical activity. The evidence for population-based dietary approaches to counter these factors is reviewed. Several structural and cohesive interdepartmental coordination efforts are required for effective implementation of prevention strategies. Since low- and middle-income countries may lack the frameworks for effective and integrated multi-stakeholder intervention, implementation of population-based dietary and physical-activity approaches may be delayed and may be too late for effective prevention in current at-risk cohorts. Evidence-based strategies to decrease energy intake and increase physical activity are now well established and their urgent adoption by Member States of the World Health Organization South-East Asia Region is essential. In the context of Sri Lanka, for example, it is recommended that the most effective and easy-to-implement interventions would be media campaigns, restrictions on advertisement of unhealthy foods, taxation of unhealthy foods, subsidies for production of healthy foods, and laws on nutrition labelling that introduce colour coding of packaged foods.

  7. Moderate alcohol consumption may protect against overt autoimmune hypothyroidism: a population-based casecontrol study

    Carl, Allan; Pedersen, Inge Blow; Knudsen, Nils

    2012-01-01

    OBJECTIVE: Alcohol consumption is an important protective risk factor for many autoimmune diseases. We wished to study the association between alcohol consumption and autoimmune hypothyroidism. DESIGN: Population-based, case-control study, 1997-2001, Denmark. METHODS: Patients with newly diagnose......, or region of inhabitancy. CONCLUSIONS: Alcohol consumption seems to confer considerable protection against development of overt autoimmune hypothyroidism irrespective of sex and type of alcohol consumed.......OBJECTIVE: Alcohol consumption is an important protective risk factor for many autoimmune diseases. We wished to study the association between alcohol consumption and autoimmune hypothyroidism. DESIGN: Population-based, case-control study, 1997-2001, Denmark. METHODS: Patients with newly diagnosed...... of alcohol per week were as follows: 0 units/week, 1.98 (1.21-3.33); 11-20 units/week, 0.41 (0.20-0.83); and ≥21 units/week, 0.90 (0.41-2.00). Similar results were found for maximum previous alcohol consumption during a calendar year. No interaction was found with type of alcohol consumed (wine vs beer), sex...

  8. Does geography influence the treatment and outcomes of colorectal cancer? A population-based analysis.

    Helewa, Ramzi M; Turner, Donna; Wirtzfeld, Debrah; Park, Jason; Hochman, David; Czaykowski, Piotr; Singh, Harminder; Shu, Emma; Xue, Lin; McKay, Andrew

    2013-06-17

    The Canadian province of Manitoba covers a large geographical area but only has one major urban center, Winnipeg. We sought to determine if regional differences existed in the quality of colorectal cancer care in a publicly funded health care system. This was a population-based historical cohort analysis of the treatment and outcomes of Manitobans diagnosed with colorectal cancer between 2004 and 2006. Administrative databases were utilized to assess quality of care using published quality indicators. A total of 2,086 patients were diagnosed with stage I to IV colorectal cancer and 42.2% lived outside of Winnipeg. Patients from North Manitoba had a lower odds of undergoing major surgery after controlling for other confounders (odds ratio (OR): 0.48, 95% confidence interval (CI): 0.26 to 0.90). No geographic differences existed in the quality measures of 30-day operative mortality, consultations with oncologists, surveillance colonoscopy, and 5-year survival. However, there was a trend towards lower survival in North Manitoba. We found minimal differences by geography. However, overall compliance with quality measures is low and there are concerning trends in North Manitoba. This study is one of the few to evaluate population-based benchmarks for colorectal cancer therapy in Canada.

  9. The International Adoption Project: population-based surveillance of Minnesota parents who adopted children internationally.

    Hellerstedt, Wendy L; Madsen, Nikki J; Gunnar, Megan R; Grotevant, Harold D; Lee, Richard M; Johnson, Dana E

    2008-03-01

    To conduct the first population-based surveillance in the United States of parents who adopted children from countries outside of the United States. A 556-item survey was mailed to 2,977 parents who finalized an international adoption in Minnesota between January 1990 and December 1998; 1,834 (62%) parents returned a survey. Eighty-eight percent of the parents reported transracial adoptions (97% of the parents were white); 57% of the adopted children were Asian; 60% were female; and on average, the children were 18 months-old at the time of placement. Only 15% of the parents reported household annual incomes less than $50,000 and 71% reported they had college educations. Sixty-one percent traveled to their child's country of birth prior to the adoption. Almost three-quarters involved their children in experiences related to their birth countries and 98% would recommend international adoption. Three-quarters of the parents believe that parental leave was an issue for them as they adopted. This is the first population-based survey of U.S. parents who have adopted internationally. The adoptive parents were socioeconomically different than birth parents in Minnesota and their families are most likely to be transracial. Because international adoption has become more prevalent, it is important to understand the strengths and needs of families that are created through this unique form of migration.

  10. Cost effectiveness of population based BRCA1 founder mutation testing in Sephardi Jewish women.

    Patel, Shreeya; Legood, Rosa; Evans, D Gareth; Turnbull, Clare; Antoniou, Antonis C; Menon, Usha; Jacobs, Ian; Manchanda, Ranjit

    2018-04-01

    Population-based BRCA1/BRCA2 founder-mutation testing has been demonstrated as cost effective compared with family history based testing in Ashkenazi Jewish women. However, only 1 of the 3 Ashkenazi Jewish BRCA1/BRCA2 founder mutations (185delAG[c.68_69delAG]), 5382insC[c.5266dupC]), and 6174delT[c.5946delT]) is found in the Sephardi Jewish population (185delAG[c.68_69delAG]), and the overall prevalence of BRCA mutations in the Sephardi Jewish population is accordingly lower (0.7% compared with 2.5% in the Ashkenazi Jewish population). Cost-effectiveness analyses of BRCA testing have not previously been performed at these lower BRCA prevalence levels seen in the Sephardi Jewish population. Here we present a cost-effectiveness analysis for UK and US populations comparing population testing with clinical criteria/family history-based testing in Sephardi Jewish women. A Markov model was built comparing the lifetime costs and effects of population-based BRCA1 testing, with testing using family history-based clinical criteria in Sephardi Jewish women aged ≥30 years. BRCA1 carriers identified were offered magnetic resonance imaging/mammograms and risk-reducing surgery. Costs are reported at 2015 prices. Outcomes include breast cancer, ovarian cancer, and excess deaths from heart disease. All costs and outcomes are discounted at 3.5%. The time horizon is lifetime, and perspective is payer. The incremental cost-effectiveness ratio per quality-adjusted life-year was calculated. Parameter uncertainty was evaluated through 1-way and probabilistic sensitivity analysis. Population testing resulted in gain in life expectancy of 12 months (quality-adjusted life-year = 1.00). The baseline discounted incremental cost-effectiveness ratio for UK population-based testing was £67.04/quality-adjusted life-year and for US population was $308.42/quality-adjusted life-year. Results were robust in the 1-way sensitivity analysis. The probabilistic sensitivity analysis showed 100% of

  11. Clinical Epidemiology Unit - overview of research areas

    Clinical Epidemiology Unit (CEU) conducts etiologic research with potential clinical and public health applications, and leads studies evaluating population-based early detection and cancer prevention strategies

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

    Chou PS

    2017-03-01

    Full Text Available Ping-Song Chou,1 Chiou-Lian Lai,1–3 Yii-Her Chou,4,5,* Wei-Pin Chang6,* 1Department of Neurology, Kaohsiung Medical University Hospital, 2Department of Neurology, Faculty of Medicine, College of Medicine, 3Department of Neurology, Kaohsiung Municipal Hsiao-Kang Hospital, 4Department of Urology, Faculty of Medicine, College of Medicine, 5Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 6School of Health Care Administration, Taipei Medical University, Taipei City, Taiwan *These authors contributed equally to this work Purpose: Sleep apnea (SA-induced chronic intermittent hypoxia increases oxidative stress and inflammation, which may contribute to the pathophysiology of Parkinson’s disease (PD. This study evaluated the risk of PD following SA diagnosis.Patients and methods: This was a 3-year nationwide population-based matched cohort study using claims data from the National Health Insurance Research Database (NHIRD, Taiwan. We analyzed 1,944 patients diagnosed as having SA between 1997 and 2005 and a matched cohort of 9,720 non-SA patients from the NHIRD. Patients with a history of PD were excluded. Each patient was followed up for 3 years to evaluate subsequent PD development.Results: Of the 11,664 patients, 17 (0.9% and 38 (0.4% from the SA and matched non-SA cohorts, respectively, were subsequently diagnosed as having PD during follow-up. After adjustments for potential confounders, the SA cohort had a 1.85-fold higher risk of PD than the non-SA cohort (95% confidence interval [CI] =1.02–3.35; P=0.042. After age and sex stratification, PD development was independently associated with SA only in men (adjusted hazard ratio [HR], 2.26; 95% CI =1.11–4.63; P<0.05 and in patients aged ≥60 years (adjusted HR, 1.93; 95% CI =1.01–3.71; P<0.05.Conclusion: Our study suggests that patients with SA are at an increased longitudinal risk of PD. Furthermore, age and male sex are independently

  13. The epidemiology of neck pain: what we have learned from our population-based studies

    Côté, Pierre; Cassidy, J. David; Carroll, Linda

    2003-01-01

    Background: There are few population-based studies on the epidemiology of neck pain in the general population. Purpose: To synthesize the findings of two large population-based studies of the epidemiology of neck pain and whiplash-associated disorders from the province of Saskatchewan, Canada. Study Design and Methods: We conducted two population-based cohort studies of neck pain and its related disability in Saskatchewan, Canada. First, the Saskatchewan Health and Back Pain Survey was designed to determine the prevalence and factors associated with neck pain in randomly selected adults. Second, we conducted a cohort study of the incidence and prognosis of whiplash and studied whether a change in the insurance system from tort to no-fault was related to a reduction in the number of whiplash claims and faster recovery. Results: In 1995, the six-month prevalence of neck pain was 54.2% and 4.6% of adults experienced disabling neck pain in the previous six-months. Neck pain was associated with education, comorbidities, smoking, self-reported general health and a history of neck injury in a motor vehicle collision. The incidence of treated and/or compensated whiplash injury was estimated at 834/100,000 adults in 1994, and dropped by 28% to 598/100,000 adults in 1995, after tort reform. Compared to tort, the median time-to-recovery was more than 230 days faster under no-fault. The strongest predictors of recovery were age, gender, education, injury severity, lawyer involvement and type of initial care provider. Conclusion: Neck pain is a public health problem. The incidence and prognosis of whiplash injuries are greatly influenced by compensation for pain and suffering, legal factors, injury severity and sociodemographic characteristics. Overall, neck pain is a multifaceted disabling problem that deserves more attention. When treating patients with neck pain, clinicians need to recognize that it is more than a physical problem and that its prognosis is influenced by

  14. HIV incidence from the first population-based cohort study in India.

    Dandona, Lalit; Kumar, G Anil; Lakshmi, Vemu; Ahmed, G Md Mushtaq; Akbar, Mohammed; Ramgopal, Sri P; Sudha, Talasila; Alary, Michel; Dandona, Rakhi

    2013-07-17

    Understanding about who acquires new HIV infection and the determinants of why some persons get infected and others do not is fundamental to controlling HIV in the population. We assess HIV incidence and its associations in the population of a high HIV burden district in Andhra Pradesh state in southern India by a population-based longitudinal cohort study. We re-surveyed a population-based cohort of 12,617 adults in Guntur district of Andhra Pradesh for which we had reported a baseline HIV prevalence of 1.72% (rural 1.64%, urban 1.89%) among the 15-49 years age group in 2004-2005. We conducted interviews to assess risk behaviour and performed HIV testing again in 2010-2011. We assessed the rate of new HIV infection and its associations using multiple logistic regression. The participation rate in the follow-up was 74.9% and 63.9% of the baseline rural and urban samples, respectively. Over a mean follow-up of 5.63 years, the incidence of HIV was 1.26 per 1000 person-years (95% CI 0.83-1.69), after adjusting for slight compositional bias in the follow-up sample. The incidence per 1000 person-years was higher among rural men (1.68) than urban men (0.85), and among rural women (1.28) than urban women (0.54). The strongest association with incidence was a HIV positive spouse in the baseline for both men (odds ratio 266, 95% CI 62-1137) and women (odds ratio 28, 95% CI 9-88). Among men the other significant associations with HIV incidence were frequent use of condom for sex over the past 6 months, non-circumcision, more than one lifetime woman sex partner or ever visited sex worker, and transport-related occupation; for women the other significant associations were having had HIV testing other than antenatal check-up, previously married but currently not, and tobacco use. These first population-based cohort incidence data from India suggest that rural areas of high HIV burden states would need more attention to prevent new HIV infections, and that spouses of HIV

  15. The Prevalence of Amblyopia and Its Determinants in a Population-based Study.

    Faghihi, Mohammad; Hashemi, Hassan; Nabovati, Payam; Saatchi, Mohammad; Yekta, Abbasali; Rafati, Shokoofeh; Ostadimoghaddam, Hadi; Khabazkhoob, Mehdi

    2017-12-01

    To determine the prevalence of amblyopia and its determinants in a population-based study in Mashhad County, Iran. This cross-sectional, population-based study was conducted on the population of Mashhad County aged >1 year using randomized stratified cluster sampling. Examinations were performed after selection of the participants and their free transportation to the sampling site. The examinations included the measurement of uncorrected and corrected visual acuity, cycloplegic and non-cycloplegic refraction, cover testing, slit-lamp biomicroscopy, and ophthalmoscopy. In this study, amblyopia was defined as best corrected visual acuity (BCVA) of 20/30 or less or 2-line interocular optotype acuity differences with no pathology. After considering the exclusion criteria, the data of 2739 individuals, 65.6% of whom were women, were analyzed. The mean age of the participants was 29.5±17.5 years. The prevalence of amblyopia was 4.6% (95% CI: 3.77%-5.43%) in the total population. The lowest prevalence was 2.24% in the age group 5-15 years (95% CI: 0.99%-3.48%) and the highest prevalence was 7.14% in the age group 55-65 years (95% CI: 2.64%-11.56%). Anisometropic amblyopia was observed in 45.24% of the amblyopic participants. Isometropic, mixed (strabismic/anisometropic), and strabismic amblyopia were other common causes of amblyopia, with a prevalence of 24.6%, 16.67%, and 13.49% in amblyopic patients, respectively. The odds ratio (OR) of having amblyopia for each 1-year increase in age was 1.02 (95% CI: 1.01-1.03). Amblyopia was less common in people with better socioeconomic status. This study showed the prevalence of amblyopia in all age groups in a population-based study for the first time. The findings of this study regarding the relatively high prevalence of amblyopia in the older population and its lower prevalence in young people indicate attention to amblyopia in recent years.

  16. Prevalence and correlates of diabetes mellitus in Malawi: population-based national NCD STEPS survey.

    Msyamboza, Kelias Phiri; Mvula, Chimwemwe J; Kathyola, Damson

    2014-05-12

    Previously considered as a disease of the affluent, west or urban people and not of public health importance, diabetes mellitus is increasingly becoming a significant cause of morbidity and mortality in sub-Saharan Africa. However, population-based data to inform prevention, treatment and control are lacking. Using the WHO STEPwise approach to chronic disease risk factor surveillance, a population-based, nationwide cross-sectional survey was conducted between July and September 2009 on participants aged 25-64 years. A multi-stage cluster sample design and weighting were used to produce a national representative data for that age range. Detailed findings on the magnitude of diabetes mellitus and impaired fasting blood glucose are presented in this paper. Fasting blood glucose measurement was conducted on 3056 participants (70.2% females, 87.9% from rural areas). The age- sex standardised population-based mean fasting blood glucose was 4.3 mmol/L (95% CI 4.1-4.4 mmol/L) with no significant differences by age, sex and location (urban/rural). The overall prevalence of impaired fasting blood glucose was 4.2% (95% CI 3.0%-5.4%). Prevalence of impaired blood glucose was higher in men than in women, 5.7% (95% CI 3.9%-7.5%) vs 2.7% (95% CI 1.6%- 3.8%), p prevalence of raised fasting blood glucose or currently on medication for diabetes was 5.6% (95% CI 2.6%- 8.5%). Although the prevalence of diabetes was higher in men than women, 6.5% (95% CI 2.6%-10.3%) vs 4.7% (95% CI 2.4%-7.0%), in rural than urban, 5.4% (95% CI 2.4%-8.4%) vs 4.4% (95% CI 2.8%-5.9%) and in males in rural than males in urban, 6.9% (95% CI 2.8%-11.0%) vs 3.2% (95% CI 0.1%-6.3%), the differences were not statistically significant, p > 0.05. Compared to previous estimates, prevalence of diabetes increased from prevalence of impaired fasting blood glucose and diabetes mellitus call for the implementation of primary healthcare approaches such as the WHO package for essential non-communicable diseases

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

    Menegaux, Florence; Lamy, Pierre-Jean; Rébillard, Xavier; Trétarre, Brigitte; Anger, Antoinette; Randrianasolo, Hasina; Mulot, Claire; Laurent-Puig, Pierre; Iborra, François; Bringer, Jean-Pierre; Leizour, Benoit; Thuret, Rodolphe

    2014-01-01

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

  18. Cardiovascular Disease Risk in a Large, Population-Based Cohort of Breast Cancer Survivors

    Boekel, Naomi B.; Schaapveld, Michael [Epidemiology, Netherlands Cancer Institute, Amsterdam (Netherlands); Gietema, Jourik A. [Medical Oncology, University Medical Center Groningen, Groningen (Netherlands); Russell, Nicola S. [Radiation Oncology, Netherlands Cancer Institute, Amsterdam (Netherlands); Poortmans, Philip [Radiation Oncology, Institute Verbeeten, Tilburg (Netherlands); Radiation Oncology, Radboud University Nijmegen Medical Center, Nijmegen (Netherlands); Theuws, Jacqueline C.M. [Radiotherapy, Catharina Hospital Eindhoven, Eindhoven (Netherlands); Schinagl, Dominic A.X. [Radiation Oncology, Radboud University Nijmegen Medical Center, Nijmegen (Netherlands); Rietveld, Derek H.F. [Radiation Oncology, VU University Medical Center Amsterdam, Amsterdam (Netherlands); Versteegh, Michel I.M. [Steering Committee Cardiac Interventions Netherlands, Leiden University Medical Center, Leiden (Netherlands); Visser, Otto [Registration and Research, Comprehensive Cancer Center The Netherlands, Utrecht (Netherlands); Rutgers, Emiel J.T. [Surgery, Netherlands Cancer Institute, Amsterdam (Netherlands); Aleman, Berthe M.P. [Radiation Oncology, Netherlands Cancer Institute, Amsterdam (Netherlands); Leeuwen, Flora E. van, E-mail: f.v.leeuwen@nki.nl [Epidemiology, Netherlands Cancer Institute, Amsterdam (Netherlands)

    2016-04-01

    Purpose: To conduct a large, population-based study on cardiovascular disease (CVD) in breast cancer (BC) survivors treated in 1989 or later. Methods and Materials: A large, population-based cohort comprising 70,230 surgically treated stage I to III BC patients diagnosed before age 75 years between 1989 and 2005 was linked with population-based registries for CVD. Cardiovascular disease risks were compared with the general population, and within the cohort using competing risk analyses. Results: Compared with the general Dutch population, BC patients had a slightly lower CVD mortality risk (standardized mortality ratio 0.92, 95% confidence interval [CI] 0.88-0.97). Only death due to valvular heart disease was more frequent (standardized mortality ratio 1.28, 95% CI 1.08-1.52). Left-sided radiation therapy after mastectomy increased the risk of any cardiovascular event compared with both surgery alone (subdistribution hazard ratio (sHR) 1.23, 95% CI 1.11-1.36) and right-sided radiation therapy (sHR 1.19, 95% CI 1.04-1.36). Radiation-associated risks were found for not only ischemic heart disease, but also for valvular heart disease and congestive heart failure (CHF). Risks were more pronounced in patients aged <50 years at BC diagnosis (sHR 1.48, 95% CI 1.07-2.04 for left- vs right-sided radiation therapy after mastectomy). Left- versus right-sided radiation therapy after wide local excision did not increase the risk of all CVD combined, yet an increased ischemic heart disease risk was found (sHR 1.14, 95% CI 1.01-1.28). Analyses including detailed radiation therapy information showed an increased CVD risk for left-sided chest wall irradiation alone, left-sided breast irradiation alone, and internal mammary chain field irradiation, all compared with right-sided breast irradiation alone. Compared with patients not treated with chemotherapy, chemotherapy used ≥1997 (ie, anthracyline-based chemotherapy) increased the risk of CHF (sHR 1.35, 95% CI 1

  19. Cardiovascular Disease Risk in a Large, Population-Based Cohort of Breast Cancer Survivors

    Boekel, Naomi B.; Schaapveld, Michael; Gietema, Jourik A.; Russell, Nicola S.; Poortmans, Philip; Theuws, Jacqueline C.M.; Schinagl, Dominic A.X.; Rietveld, Derek H.F.; Versteegh, Michel I.M.; Visser, Otto; Rutgers, Emiel J.T.; Aleman, Berthe M.P.; Leeuwen, Flora E. van

    2016-01-01

    Purpose: To conduct a large, population-based study on cardiovascular disease (CVD) in breast cancer (BC) survivors treated in 1989 or later. Methods and Materials: A large, population-based cohort comprising 70,230 surgically treated stage I to III BC patients diagnosed before age 75 years between 1989 and 2005 was linked with population-based registries for CVD. Cardiovascular disease risks were compared with the general population, and within the cohort using competing risk analyses. Results: Compared with the general Dutch population, BC patients had a slightly lower CVD mortality risk (standardized mortality ratio 0.92, 95% confidence interval [CI] 0.88-0.97). Only death due to valvular heart disease was more frequent (standardized mortality ratio 1.28, 95% CI 1.08-1.52). Left-sided radiation therapy after mastectomy increased the risk of any cardiovascular event compared with both surgery alone (subdistribution hazard ratio (sHR) 1.23, 95% CI 1.11-1.36) and right-sided radiation therapy (sHR 1.19, 95% CI 1.04-1.36). Radiation-associated risks were found for not only ischemic heart disease, but also for valvular heart disease and congestive heart failure (CHF). Risks were more pronounced in patients aged <50 years at BC diagnosis (sHR 1.48, 95% CI 1.07-2.04 for left- vs right-sided radiation therapy after mastectomy). Left- versus right-sided radiation therapy after wide local excision did not increase the risk of all CVD combined, yet an increased ischemic heart disease risk was found (sHR 1.14, 95% CI 1.01-1.28). Analyses including detailed radiation therapy information showed an increased CVD risk for left-sided chest wall irradiation alone, left-sided breast irradiation alone, and internal mammary chain field irradiation, all compared with right-sided breast irradiation alone. Compared with patients not treated with chemotherapy, chemotherapy used ≥1997 (ie, anthracyline-based chemotherapy) increased the risk of CHF (sHR 1.35, 95% CI 1

  20. Exposure to ambient air pollution and the incidence of dementia: A population-based cohort study.

    Chen, Hong; Kwong, Jeffrey C; Copes, Ray; Hystad, Perry; van Donkelaar, Aaron; Tu, Karen; Brook, Jeffrey R; Goldberg, Mark S; Martin, Randall V; Murray, Brian J; Wilton, Andrew S; Kopp, Alexander; Burnett, Richard T

    2017-11-01

    Emerging studies have implicated air pollution in the neurodegenerative processes. Less is known about the influence of air pollution, especially at the relatively low levels, on developing dementia. We conducted a population-based cohort study in Ontario, Canada, where the concentrations of pollutants are among the lowest in the world, to assess whether air pollution exposure is associated with incident dementia. The study population comprised all Ontario residents who, on 1 April 2001, were 55-85years old, Canadian-born, and free of physician-diagnosed dementia (~2.1 million individuals). Follow-up extended until 2013. We used population-based health administrative databases with a validated algorithm to ascertain incident diagnosis of dementia as well as prevalent cases. Using satellite observations, land-use regression model, and an optimal interpolation method, we derived long-term average exposure to fine particulate matter (≤2.5μm in diameter) (PM 2.5 ), nitrogen dioxide (NO 2 ), and ozone (O 3 ), respectively at the subjects' historical residences based on a population-based registry. We used multilevel spatial random-effects Cox proportional hazards models, adjusting for individual and contextual factors, such as diabetes, brain injury, and neighborhood income. We conducted various sensitivity analyses, such as lagging exposure up to 10years and considering a negative control outcome for which no (or weaker) association with air pollution is expected. We identified 257,816 incident cases of dementia in 2001-2013. We found a positive association between PM 2.5 and dementia incidence, with a hazard ratio (HR) of 1.04 (95% confidence interval (CI): 1.03-1.05) for every interquartile-range increase in exposure to PM 2.5 . Similarly, NO 2 was associated with increased incidence of dementia (HR=1.10; 95% CI: 1.08-1.12). No association was found for O 3 . These associations were robust to all sensitivity analyses examined. These estimates translate to 6.1% of

  1. Hypothyroidism and Risk of Mild Cognitive Impairment in Elderly Persons - A Population Based Study

    Parsaik, Ajay K; Singh, Balwinder; Roberts, Rosebud O; Pankratz, Shane; Edwards, Kelly K.; Geda, Yonas E; Gharib, H; Boeve, Bradley F; Knopman, David S; Petersen, Ronald C

    2014-01-01

    IMPORTANCE Association of clinical and subclinical hypothyroidism with mild cognitive impairment (MCI) is not established. OBJECTIVE To evaluate the association of clinical and subclinical hypothyroidism with MCI in a large population based cohort. DESIGN A cross-sectional, population-based study. SETTING Olmsted County, Minnesota. PARTICIPANTS Randomly selected participants were aged 70 to 89 years on October 1, 2004, and were without documented prevalent dementia. A total of 2,050 participants were evaluated and underwent in-person interview, neurological evaluation and neuropsychological testing to assess performance in memory, attention/executive function, visuospatial, and language domains. Subjects were diagnosed by consensus as cognitively normal, MCI or dementia according to published criteria. Clinical and subclinical hypothyroidism was ascertained from a medical records-linkage system. MAIN OUTCOME MEASURES Association of clinical and subclinical hypothyroidism with MCI. Results Among 1904 eligible participants, the frequency of MCI was 16% in 1450 subjects with normal thyroid function, 17% in 313 subjects with clinical hypothyroidism, and 18% in 141 subjects with subclinical hypothyroidism. After adjusting for covariates (age, gender, education, education years, sex, ApoE ε 4, depression, diabetes, hypertension, stroke, BMI and coronary artery disease) we found no significant association between clinical or subclinial hypothyroidism and MCI [OR 0.99 (95% CI 0.66–1.48) and OR 0.88 (95% CI 0.38–2.03) respectively]. No effect of gender interaction was seen on these effects. In stratified analysis, the odds of MCI with clinical and subclinical hypothyroidisn among males was 1.02 (95%CI, 0.57–1.82) and 1.29 (95%CI 0.68–2.44), among females was 1.04 (95% 0.66–1.66) and 0.86 (95% CI 0.37–2.02) respectively. Conclusion In this population based cohort of eldery, neither clinical nor subclinical hypothyrpodism was associated with MCI. Our findings

  2. Solid tumors after chemotherapy or surgery for testicular nonseminoma: a population-based study.

    Fung, Chunkit; Fossa, Sophie D; Milano, Michael T; Oldenburg, Jan; Travis, Lois B

    2013-10-20

    Increased risks of solid tumors after older radiotherapy strategies for testicular cancer (TC) are well established. Few population-based studies, however, focus on solid cancer risk among survivors of TC managed with nonradiotherapy approaches. We quantified the site-specific risk of solid cancers among testicular nonseminoma patients treated in the modern era of cisplatin-based chemotherapy, without radiotherapy. Standardized incidence ratios (SIRs) for solid tumors were calculated for 12,691 patients with testicular nonseminoma reported to the population-based Surveillance, Epidemiology, and End Results program (1980 to 2008) and treated initially with either chemotherapy (n = 6,013) or surgery (n = 6,678) without radiotherapy. Patients accrued 116,073 person-years of follow-up. Two hundred ten second solid cancers were observed. No increased risk followed surgery alone (SIR, 0.93; 95% CI, 0.76 to 1.14; n = 99 solid cancers), whereas significantly increased 40% excesses (SIR, 1.43; 95% CI, 1.18 to 1.73; n = 111 solid cancers) occurred after chemotherapy. Increased risks of solid cancers after chemotherapy were observed in most follow-up periods (median latency, 12.5 years), including more than 20 years after treatment (SIR, 1.54; 95% CI, 0.96 to 2.33); significantly increased three- to seven-fold risks occurred for cancers of the kidney (SIR, 3.37; 95% CI, 1.79 to 5.77), thyroid (SIR, 4.40; 95% CI, 2.19 to 7.88), and soft tissue (SIR, 7.49; 95% CI, 3.59 to 13.78). To our knowledge, this is the first large population-based series reporting significantly increased risks of solid cancers among patients with testicular nonseminoma treated in the modern era of cisplatin-based chemotherapy. Subsequent analytic studies should focus on the evaluation of dose-response relationships, types of solid cancers, latency patterns, and interactions with other possible factors, including genetic susceptibility.

  3. Population-based intervention for cardiovascular diseases related knowledge and behaviours in Asian Indian women.

    Pandey, Ravindra Mohan; Agrawal, Aachu; Misra, Anoop; Vikram, Naval Kishore; Misra, Puneet; Dey, Sanjit; Rao, Shobha; Vasantha Devi, K P; Usha Menon, V; Revathi, R; Sharma, Vinita; Gupta, Rajeev

    2013-01-01

    There is poor knowledge and behaviors regarding chronic diseases related nutritional and lifestyle factors among women in low income countries. To evaluate efficacy of a multilevel population-based intervention in improving knowledge and practices for related factors we performed a study in India. Population based study among women 35-70 years was performed in four urban and five rural locations. Stratified sampling was performed and we enrolled 4624 (rural 2616, urban 2008) of eligible 8000 women (58%). Demographic details, medical history, diet, physical activity and anthropometry were recorded and blood hemoglobin, glucose and total cholesterol determined. Knowledge and behaviors regarding diet in chronic diseases were inquired in a randomly selected 100 women at each site (n = 900). A systematic multilevel population based intervention (using posters, handouts, street plays, public lectures, group lectures and focused group discussions) was administered over 6 months at each site. The questionnaire was re-administered at the end in random 100 women (n = 900) and differences determined. Descriptive statistics are reported. Comparison of parameters before and after intervention was assessed using Mann Whitney test. Prevalence (%) of chronic disease related lifestyles and risk factors in rural/urban women, respectively, was illiteracy in 63.6/29.4, smoking/tobacco use 39.3/18.9, high fat intake 93.6/93.4, high salt intake 18.2/12.6, low physical activity 59.5/70.2, overweight/obesity 22.5/45.6, truncal obesity 13.0/44.3, hypertension 31.6/48.2, hypercholesterolemia 13.5/27.7, and diabetes in 4.3/15.1 percent. Composite chronic diseases knowledge at baseline vs after intervention increased significantly in overall (32.0 vs 62.0), rural (29.0 vs 63.5) and urban (39.5 vs 60.5) groups (p women in rural and urban locations in India increased chronic disease knowledge but failed to influence practices. Copyright © 2013. Published by Elsevier B.V.

  4. Childhood disability population-based surveillance: Assessment of the Ages and Stages Questionnaire Third Edition and Washington Group on Disability Statistics/UNICEF module on child functioning in a rural setting in South Africa

    Marieta Visser

    2016-09-01

    Conclusion: Since the WG/UNICEF module is quicker to administer, easier to understand and based on the ICF, it can be considered as an appropriate parent-reported measure for large-scale, population-based as well as smaller, community-specific contexts. It is, however, recommended that future research and development continues with the WG/UNICEF module to enhance its conceptual equivalence for larger-scale, population-based studies in South Africa and internationally.

  5. The impact of cancer incidence and stage on optimal utilization of radiotherapy. Methodology of a population based analysis by the ESTRO-HERO project

    Borras, Josep M; Barton, Michael; Grau, Cai

    2015-01-01

    -HERO project. MATERIALS AND METHODS: Data from Australian Collaboration for Cancer Outcomes Research and Evaluation (CCORE) were used. Population based stages at diagnosis from the cancer registries of Belgium, Slovenia, the Greater Poland region of Poland, and The Netherlands were used to assess the OUP...... in stage at diagnosis across countries. The most important impact on the OUP by country was due to changes in relative frequency of tumours rather than stage at diagnosis. CONCLUSIONS: This methodology can be adapted using European data, thus facilitating the planning of resources required to cope...

  6. Progression, incidence, and risk factors for intervertebral disc degeneration in a longitudinal population-based cohort: the Wakayama Spine Study.

    Teraguchi, M; Yoshimura, N; Hashizume, H; Yamada, H; Oka, H; Minamide, A; Nagata, K; Ishimoto, Y; Kagotani, R; Kawaguchi, H; Tanaka, S; Akune, T; Nakamura, K; Muraki, S; Yoshida, M

    2017-07-01

    The present study examined the progression, incidence, and risk factors for intervertebral disc degeneration (DD) throughout the lumbar spine using magnetic resonance imaging (MRI) in a large population-based cohort. We followed up 617 subjects for more than 4 years as part of the Wakayama Spine Study. 1) "Progression of DD" in each of the entire, upper (L1/2 to L3/4) and lower (L4/5 and L5/S1) lumbar spine was defined as Pfirrmann grade progression at follow-up in at least one disc in the affected region. 2) "Incidence of DD" in each of these regions was defined if all discs were grade 3 or lower (white disc) at baseline, and at least one disc had progressed to grade 4 or higher (black disc) at follow-up. Logistic regression analyses were used to determine the risk factors for progression and incidence of DD. DD progression and incidence in the entire lumbar spine were 52.0% and 31.6% in men, and 60.4% and 44.7% in women, respectively. Women was associated with DD progression in the upper lumbar spine (odds ratio [OR] = 1.68, 95% confidence interval [CI] = 1.18-2.42). Aging was associated with the incidence of DD in each region (entire: OR = 1.14, CI = 1.06-1.14; upper: OR = 1.10, CI = 1.05-1.15; lower: OR = 1.11, CI = 1.05-1.19). Diabetes mellitus (DM) was associated with the incidence of DD in the upper lumbar spine (OR = 6.83, CI = 1.07-133.7). This 4-year longitudinal study is the first to demonstrate DD progression and incidence in the lumbar spine and their risk factors in a large population-based cohort. Copyright © 2017 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  7. Risk perception among women receiving genetic counseling: a population-based follow-up study

    Mikkelsen, Ellen M; Sunde, Lone; Johansen, Christoffer

    2007-01-01

    -up study of 213 women who received genetic counseling for hereditary breast and ovarian cancer, 319 women who underwent mammography (Reference Group I), and a random sample of 1070 women from the general population (Reference Group II). RESULTS: Women who received genetic counseling decreased...... counseling, compared to a reduction of 5% (p=0.03) and 2% (p=0.01) in Reference Groups I and II, respectively. Risk communicated only in words, inaccurate risk perception at baseline, and presence of a familial mutation appeared to be predictors of inaccurate risk perception 12 months after counseling......BACKGROUND: We aimed to explore the impact of genetic counseling on perceived personal lifetime risk of breast cancer, the accuracy of risk perception, and possible predictors of inaccurate risk perception 1 year following counseling. METHODS: We conducted a population-based prospective follow...

  8. Determinants of successful implementation of population-based cancer screening programmes

    Lynge, Elsebeth; Törnberg, Sven; von Karsa, Lawrence

    2012-01-01

    consider when planning, implementing and running population based cancer screening programmes. The list is general and is applicable to breast, cervical and colorectal cancer screening. It is based on evidence presented in the three European Union guidelines on quality assurance in cancer screening...... and diagnosis, supplemented with other literature and expert experience presented at a European Science Advisory Network for Health workshop. The implementation of a cancer screening programme should be divided into the following seven phases: (1) before planning, (2) planning, (3) feasibility testing, (4......) piloting or trial implementation, (5) scaling up from pilot to service, (6) running of full-scale programme, and (7) sustainability. For each phase, a substantial number of specified conditions have to be met. Successful implementation of a cancer screening programme requires societal acceptance and local...

  9. A population-based, incidence cohort study of mid-back pain after traffic collisions

    Johansson, M S; Boyle, E; Hartvigsen, Jan

    2015-01-01

    BACKGROUND: Traffic collisions often result in a wide range of symptoms included in the umbrella term whiplash-associated disorders. Mid-back pain (MBP) is one of these symptoms. The incidence and prognosis of different traffic injuries and their related conditions (e.g. neck pain, low back pain...... data from a population-based inception cohort of all traffic injuries occurring in Saskatchewan, Canada, during a 2-year period were used. Annual overall and age-sex-specific incidence rates were calculated, the course of recovery was described using the Kaplan-Meier technique, and associations between...... recovery was 101 days (95% CI: 99-104) and about 23% were still not recovered after 1 year. Participant's expectation for recovery, general health, extent of severely affecting comorbidities and having experienced a previous traffic injury were some of the prognostic factors identified. CONCLUSIONS...

  10. Gender differences of cannabis smoking on serum leptin levels: population-based study

    Fernanda P. Moreira

    2018-02-01

    Full Text Available Objective: To evaluate the serum leptin levels in cannabis smokers. Methods: This was a cross-sectional population-based study of participants between the ages of 18 and 35 years. The data were collected through a self-administered questionnaire covering sociodemographic data and the use of psychoactive substances. Leptin levels were measured using a commercial ELISA kit. Results: Of the 911 participants, 6.7% were identified as cannabis smokers and had significantly lower leptin levels (p = 0.008. When stratified by gender, there was a significant decrease in leptin levels among male smokers (p = 0.039. Conclusion: Cannabis smoking was linked to leptin levels in men, suggesting that the response to biological signals may be different between men and women.

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

    Apesteguía Ciriza, Luis; Pina Insausti, Luis Javier

    2014-01-01

    Population-based breast cancer screening programs based on mammography must maintain a high level of quality, so the results must be constantly monitored. Although most authors consider that these programs have decreased the mortality due to breast cancer by about 30%, others claim that the mortality has decreased by only about 12% due to errors in the randomization of patients, because the rate of advanced tumors has hardly decreased and because adjuvant treatment also improves survival. Other criticisms focus on overdiagnosis and overtreatment. We believe that despite the unquestionable value of mammographic screening, we should be open to certain changes such as the stratification of patients by their level of risk and the introduction of complementary techniques like tomosynthesis, ultrasonography, and magnetic resonance imaging in selected cases. Copyright © 2012 SERAM. Published by Elsevier Espana. All rights reserved.

  12. Use of fertility drugs and risk of ovarian cancer: Danish Population Based Cohort Study

    Jensen, Allan; Sharif, Heidi; Frederiksen, Kirsten

    2009-01-01

    OBJECTIVE: To examine the effects of fertility drugs on overall risk of ovarian cancer using data from a large cohort of infertile women. DESIGN: Population based cohort study. SETTING: Danish hospitals and private fertility clinics. PARTICIPANTS: 54,362 women with infertility problems referred...... confounding factors. RESULTS: Analyses within cohort showed no overall increased risk of ovarian cancer after any use of gonadotrophins (rate ratio 0.83, 95% confidence interval 0.50 to 1.37), clomifene (1.14, 0.79 to 1.64), human chorionic gonadotrophin (0.89, 0.62 to 1.29), or gonadotrophin releasing...... hormone (0.80, 0.42 to 1.51). Furthermore, no associations were found between all four groups of fertility drugs and number of cycles of use, length of follow-up, or parity. CONCLUSION: No convincing association was found between use of fertility drugs and risk of ovarian cancer....

  13. Association between social capital and health in women of reproductive age: a population-based study.

    Baheiraei, Azam; Bakouei, Fatemeh; Mohammadi, Eesa; Majdzadeh, Reza; Hosseni, Mostafa

    2016-12-01

    Women's health is a public health priority. The origins of health inequalities are very complex. The present study was conducted to determine the association between social capital and health status in reproductive-age women in Tehran, Iran. In this population-based, cross-sectional study, the Social Capital Integrated Questionnaire, the SF-36 and socio-demographic questionnaires were used. Analysis of data by one-way ANOVA test and stepwise multiple linear regression showed that the manifestation dimensions of social capital (groups and networks, trust and solidarity, collective action and cooperation) can potentially lead to the outcome dimensions of social capital (social cohesion and inclusion, and empowerment and political action), which in turn affect health inequities after controlling for socio-demographic differences. © The Author(s) 2015.

  14. Population Based Analysis of Directional Information in Serial Deformation Tensor Morphometry

    Studholme, Colin; Cardenas, Valerie

    2012-01-01

    Deformation morphometry provides a sensitive approach to detecting and mapping subtle volume changes in the brain. Population based analyses of this data have been used successfully to detect characteristic changes in different neurodegenerative conditions. However, most studies have been limited to statistical mapping of the scalar volume change at each point in the brain, by evaluating the determinant of the Jacobian of the deformation field. In this paper we describe an approach to spatial normalisation and analysis of the full deformation tensor. The approach employs a spatial relocation and reorientation of tensors of each subject. Using the assumption of small changes, we use a linear modeling of effects of clinical variables on each deformation tensor component across a population. We illustrate the use of this approach by examining the pattern of significance and orientation of the volume change effects in recovery from alcohol abuse. Results show new local structure which was not apparent in the analysis of scalar volume changes. PMID:18044583

  15. Prevalence of chronic kidney disease in Nigeria: systematic review of population-based studies

    Chukwuonye II

    2018-05-01

    Full Text Available Innocent Ijezie Chukwuonye,1 Okechukwu Samuel Ogah,2 Ernest Ndukaife Anyabolu,3 Kenneth Arinze Ohagwu,1 Ogbonna Collins Nwabuko,4 Uwa Onwuchekwa,5 Miracle Erinma Chukwuonye,6 Emmanuel Chukwuebuka Obi,1 Efosa Oviasu7 1Division of Nephrology, Department of Internal Medicine, Federal Medical Centre, Umuahia, Abia State, 2Division of Cardiology, Department of Internal Medicine, University College Hospital Ibadan, Oyo State 3Division of Nephrology, Department of Internal Medicine, Chukwuemeka Odumegwu Ojukwu University Teaching Hospital Awka, Anambra State, 4Department of Haematology, Federal Medical Centre, Umuahia, 5Division of Nephrology, Department of Internal Medicine, Abia State University Teaching Hospital, Aba, 6Department of Family Medicine, Federal Medical Centre, Umuahia, 7Division of Nephrology, Department of Internal Medicine, University of Benin Teaching Hospital, Benin City, Nigeria Background: The aim of this study was to identify and discuss published population-based studies carried out in Nigeria that have information on the prevalence of chronic kidney disease (CKD and have also used the Kidney Disease Outcomes Quality Initiative (KDOQI practice guidelines in defining CKD, with emphasis on the performance of three estimating equations for glomerular filtration rate (GFR – Modification of Diet in Renal Disease (MDRD, Cockcroft–Gault, and CKD epidemiology collaboration (CKD-EPI creatinine equation. Materials and methods: A systematic literature search was carried out in Google, MEDLINE, PubMed, and AJOL database, with the aim of identifying relevant population-based studies with information on the prevalence of CKD in a location in Nigeria. Results: Seven cross-sectional population-based studies were identified. Two of the studies used the Cockcroft–Gault and observed a prevalence of 24.4% and 26%. Four of the studies used the MDRD and the prevalences observed were 12.3%, 14.2%, 2.5%, and 13.4%. One of the studies used the CKD

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

    Parmet, Wendy E

    2016-12-01

    This essay argues that it matters for the fate of health policies challenged in court whether courts consider health merely as a policy goal that must be subordinate to law, or as a legal norm warranting legal weight and consideration. Applying population-based legal analysis, this article demonstrates that courts have traditionally treated health as a legal norm. However, this norm appears to have weakened in recent years, a trend evident in the Supreme Court's first two decisions concerning the Affordable Care Act, NFIB v. Sebelius and Burwell v. Hobby Lobby However, in its more recent Affordable Care Act decision, King v. Burwell , the health legal norm is once again evident. Whether the Court will continue to treat health as a legal norm will prove critical to the deference and weight it grants health policies in the future. Copyright © 2016 by Duke University Press.

  17. Allogeneic blood transfusion and prognosis following total hip replacement: a population-based follow up study

    Pedersen, Alma B; Mehnert, Frank; Overgaard, Søren

    2009-01-01

    BACKGROUND: Allogeneic red blood cell transfusion is frequently used in total hip replacement surgery (THR). However, data on the prognosis of transfused patients are sparse. In this study we compared the risk of complications following THR in transfused and non-transfused patients. METHODS......: A population-based follow-up study was performed using data from medical databases in Denmark. We identified 28,087 primary THR procedures performed from 1999 to 2007, from which we computed a propensity score for red blood cell transfusion based on detailed data on patient-, procedure-, and hospital......-related characteristics. We were able to match 2,254 transfused with 2,254 non-transfused THR patients using the propensity score. RESULTS: Of the 28,087 THR patients, 9,063 (32.3%) received at least one red blood cell transfusion within 8 days of surgery. Transfused patients had higher 90-day mortality compared...

  18. Predicting sexual infidelity in a population-based sample of married individuals.

    Whisman, Mark A; Gordon, Kristina Coop; Chatav, Yael

    2007-06-01

    Predictors of 12-month prevalence of sexual infidelity were examined in a population-based sample of married individuals (N = 2,291). Predictor variables were organized in terms of involved-partner (e.g., personality, religiosity), marital (e.g., marital dissatisfaction, partner affair), and extradyadic (e.g., parenting) variables. Annual prevalence of infidelity was 2.3%. Controlling for marital dissatisfaction and demographic variables, infidelity was predicted by greater neuroticism and lower religiosity; wives' pregnancy also increased the risk of infidelity for husbands. In comparison, self-esteem and partners' suspected affair were predictive of infidelity when controlling for demographic variables but were not uniquely predictive of infidelity when also controlling for marital dissatisfaction. Religiosity and wives' pregnancy moderated the association between marital dissatisfaction and infidelity.

  19. Population based reference intervals for common blood haematological and biochemical parameters in the akuapem north district.

    Koram, Ka; Addae, Mm; Ocran, Jc; Adu-Amankwah, S; Rogers, Wo; Nkrumah, Fk

    2007-12-01

    To estimate the reference intervals for commonly used blood haematology and biochemical parameters in an adult (18-55yrs) population of residents of Mampong Akuapem. This was a population based cross sectional study of a randomly selected sample of the adult population of Mampong. The sample was selected from an updated census list of the Mampong area. Median values (95% range) for measured parameters were established as follows: Haemoglobin, (males) 14.2 g/dl (females) 12.0 g/dl Alanine aminotransferase (ALT), (female) 19.6 U/L (males) 26.1 U/L and Creatinine, (males) 108 mmol/L (females) 93 mmol/L. In comparison to reference values that are commonly used in Ghana, the haemoglobulin levels from this study were lower, and liver function parameters higher. This could be a result of genetic or environmental differences and calls for the need to establish site specific reference values applicable to our population.

  20. Effectiveness of a two-step population-based osteoporosis screening program using FRAX

    Rubin, K H; Rothmann, M J; Holmberg, T

    2018-01-01

    The Risk-stratified Osteoporosis Strategy Evaluation (ROSE) study investigated the effectiveness of a two-step screening program for osteoporosis in women. We found no overall reduction in fractures from systematic screening compared to the current case-finding strategy. The group of moderate......- to high-risk women, who accepted the invitation to DXA, seemed to benefit from the program. INTRODUCTION: The purpose of the ROSE study was to investigate the effectiveness of a two-step population-based osteoporosis screening program using the Fracture Risk Assessment Tool (FRAX) derived from a self......-administered questionnaire to select women for DXA scan. After the scanning, standard osteoporosis management according to Danish national guidelines was followed. METHODS: Participants were randomized to either screening or control group, and randomization was stratified according to age and area of residence. Inclusion...

  1. ASSOCIATON BETWEEN INTIMATE PARTNER VIOLENCE AND IRRITABLE BOWEL SYNDROME: A POPULATION-BASED STUDY IN NICARAGUA

    Becker-Dreps, Sylvia; Morgan, Douglas; Peña, Rodolfo; Cortes, Loreto; Martin, Christopher F.; Valladares, Eliette

    2010-01-01

    Irritable bowel syndrome (IBS) is a disabling functional gastrointestinal disorder, which serves as a model for abdominal pain syndromes. An association between intimate partner violence and IBS has been shown among Caucasian women in the industrialized world. To determine whether this relationship transcends cultural boundaries, we conducted a population-based, cross-sectional survey in Nicaragua, using the innovative Health and Demographic Surveillance System in the León province. Women who had experienced physical intimate partner violence had significantly increased risk of IBS (OR 2.08, 95% CI, 1.35, 3.21), as did those who had experienced sexual intimate partner violence (OR 2.85, 95% CI 1.45, 5.59). These findings argue for intimate partner violence screening among Latina women with IBS. PMID:20558772

  2. Association between intimate partner violence and irritable bowel syndrome: a population-based study in Nicaragua.

    Becker-Dreps, Sylvia; Morgan, Douglas; Peña, Rodolfo; Cortes, Loreto; Martin, Christopher F; Valladares, Eliette

    2010-07-01

    Irritable bowel syndrome (IBS) is a disabling functional gastrointestinal disorder, which serves as a model for abdominal pain syndromes. An association between intimate partner violence and IBS has been shown among White women in the industrialized world. To determine whether this relationship transcends cultural boundaries, we conducted a population-based, cross-sectional survey in Nicaragua using the innovative Health and Demographic Surveillance System in the León province. Women who had experienced physical intimate partner violence had significantly increased risk of IBS (odds ratio [OR] = 2.08; 95% confidence interval [CI] = 1.35, 3.21), as did those who had experienced sexual intimate partner violence (OR = 2.85; 95% CI = 1.45, 5.59). These findings argue for intimate partner violence screening among Latina women with IBS.

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

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

    2013-10-01

    Waiting times are key indicators of a health's system performance, but are not routinely available in France. We studied waiting times for diagnosis and treatment according to patients' characteristics, tumours' characteristics and medical management options in a sample of 1494 breast cancers recorded in population-based registries. The median waiting time from the first imaging detection to the treatment initiation was 34 days. Older age, co-morbidity, smaller size of tumour, detection by organised screening, biopsy, increasing number of specimens removed, multidisciplinary consulting meetings and surgery as initial treatment were related to increased waiting times in multivariate models. Many of these factors were related to good practices guidelines. However, the strong influence of organised screening programme and the disparity of waiting times according to geographical areas were of concern. Better scheduling of diagnostic tests and treatment propositions should improve waiting times in the management of breast cancer in France. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. HLA associations and risk of posttransplant lymphoproliferative disorder in Danish population-based cohort

    Vase, Maja Ølholm; Maksten, Eva Futtrup; Strandhave, Charlotte

    2015-01-01

    Background: Posttransplant lymphoproliferative disorder (PTLD) is a feared complication to organ transplantation, associated with substantial morbidity and inferior survival. Risk factors for PTLD include T cell–depleting induction therapy and primary infection or reactivation of Epstein-Barr virus....... Possible associations between certain HLA types and the risk of developing PTLD have been reported by other investigators; however, results are conflicting. Methods: We conducted a retrospective, population-based study on 4295 Danish solid organ transplant patients from the Scandiatransplant database...... can be clinically useful after transplantation in personalized monitoring schemes. Given the strong linkage disequilibrium in the HLA region, the associations must be interpreted carefully. The large size, virtually complete ascertainment of cases and no loss to follow-up remain important strengths...

  5. Genetic, epidemiological, and clinical aspects of hereditary pancreatitis: a population-based cohort study in Denmark

    Brusgaard, Klaus

    2010-01-01

    , respectively, and among tIP patients 9 and 12%, respectively. Pancreatic cancer was diagnosed in 5% of the HP families. CONCLUSIONS: The genotype of the Danish population with HP differs from that of previously described cohorts. The occurrence of exocrine and endocrine insufficiency is higher among patients......-degree relatives of the 18 initially identified HP patients, 38 HP patients in total were identified, and 28 patients had SPINK1-CFTR mutations. Among HP patients, no p.N29I mutations were found and the p.A16V mutation was more frequent than previously reported, 45 and 32% had exocrine and endocrine insufficiency......OBJECTIVES: In a population-based, well-defined group of patients first regarded as having pancreatitis of unknown origin (PUO), we identified, described, and compared the clinical and genetic aspects of patients with hereditary pancreatitis (HP) and with cystic fibrosis transmembrane conductance...

  6. Amygdala α-Synuclein Pathology in the Population-Based Vantaa 85+ Study.

    Raunio, Anna; Myllykangas, Liisa; Kero, Mia; Polvikoski, Tuomo; Paetau, Anders; Oinas, Minna

    2017-01-01

    We investigated the frequency of Lewy-related pathology (LRP) in the amygdala among the population-based Vantaa 85+ study. Data of amygdala samples (N = 304) immunostained with two α-synuclein antibodies (clone 42 and clone 5G4) was compared with the previously analyzed LRP and AD pathologies from other brain regions. The amygdala LRP was present in one third (33%) of subjects. Only 5% of pure AD subjects, but 85% of pure DLB subjects had LRP in the amygdala. The amygdala LRP was associated with dementia; however, the association was dependent on LRP on other brain regions, and thus was not an independent risk factor. The amygdala-predominant category was a rare (4%) and heterogeneous group.

  7. Lithium and renal and upper urinary tract tumors - results from a nationwide population-based study

    Kessing, Lars Vedel; Gerds, Thomas Alexander; Feldt-Rasmussen, Bo

    2015-01-01

    OBJECTIVES: A recent alarming finding suggested an increased risk of renal tumors among long-term lithium users. The objectives of the present study were to estimate rates of renal and upper urinary tract tumors (RUT), malignant and benign, among individuals exposed to successive prescriptions...... for lithium, anticonvulsants, and other psychotropic agents used for bipolar disorder, and among unexposed individuals. METHODS: This was a nationwide, population-based longitudinal study including time-specific data from all individuals exposed to lithium (n = 24,272) or anticonvulsants (n = 386,255), all...... individuals with a diagnosis of bipolar disorder (n = 9,651), and a randomly selected sample of 1,500,000 from the Danish population. The study period was from 1995 to 2012, inclusive. Outcomes were hazard rate ratios (HR) for RUT in three groups: (i) combined malignant and benign, (ii) malignant, and (iii...

  8. A Population-based survey of risk for cancer in individuals diagnosed with myotonic dystrophy

    Abbott, Diana; Johnson, Nicholas E; Cannon-Albright, Lisa A.

    2018-01-01

    Introduction The risk of cancer in patients diagnosed with myotonic dystrophy (DM) is reported for the homogeneous Utah population. Methods Clinical data accessed from the largest Utah healthcare providers have been record-linked to the Utah Population Database (UPDB), a population-based resource also linked to the Utah Cancer Registry. Relative risks were estimated for 36 cancers of different types in 281 DM patients. Results Testicular cancer (RR=10.74; 95% CI: 1.91, 38.79), endometrial cancer (6.98; 1.24, 25.22), and Non-Hodgkins lymphoma (4.25; 1.16, 12.43) were all observed at significant excess in DM patients. Discussion This study confirms an overall increased risk of cancer in DM. Individuals diagnosed with DM might benefit from risk counseling. PMID:27064430

  9. A population-based prescription study of asthma drugs during pregnancy

    Olesen, Charlotte; Thrane, Nana; Nielsen, G.L.

    2001-01-01

    Background: Among the goals of gestational asthma, therapy is optimisation of pulmonary function. According to the US Food and Drug Administration, no asthma drugs can be considered ‘safe’ during pregnancy. Fear of adverse fetal effects may thus lead to restrictive use of asthma drugs during...... pregnancy, and no population-based studies concerning gestational asthma therapy exist. Objectives: To examine whether asthma drugs or changing intensity of asthma therapy during pregnancy was associated with deviations from expected values of gestational age, birth weight, length at birth, or malformations....... Methods: The Birth Registry was used to identify all 15,756 primiparous women who gave birth in the County of North Jutland between 1991 and 1996. According to the North Jutland Prescription Database, 303 of these women received prescriptions for asthma drugs during pregnancy. Women who did not purchase...

  10. Risk of schizophrenia in second-generation immigrants: a Danish population-based cohort study

    Cantor-Graae, Elizabeth; Pedersen, Carsten Bøcker

    2007-01-01

    Background. Urban birth, a risk factor for schizophrenia, is more frequent among second-generation immigrants. The aim of the current study was to determine whether the increased risk for schizophrenia found in second-generation immigrants is explained by the degree of urbanization of birthplace...... for urbanization of birthplace and parental characteristics reduced these risks slightly. However, urbanization had a lesser effect in second-generation immigrants than in Danes. History of residence abroad was a risk factor for schizophrenia, regardless of whether parents were foreign-born or native Danes...... and/or factors related to parentage, such as geographic origin or history of residence abroad during upbringing.Method. Using data from the Danish Civil Registration System (CRS), we established a population-based cohort of 2.0 million Danes (persons born in Denmark). Schizophrenia in cohort members...

  11. Risk factors for common mental disorders in women. Population-based longitudinal study.

    Patel, Vikram; Kirkwood, Betty R; Pednekar, Sulochana; Weiss, Helen; Mabey, David

    2006-12-01

    The determinants of common mental disorders in women have not been described in longitudinal studies from a low-income country. Population-based cohort study of 2494 women aged 18 to 50 years, in India. The Revised Clinical Interview Schedule was used for the detection of common mental disorders. There were 39 incident cases of common mental disorder in 2166 participants eligible for analysis (12-month rate 1.8%, 95% CI 1.3-2.4%). The following baseline factors were independently associated with the risk for common mental disorder: poverty (low income and having difficulty making ends meet); being married as compared with being single; use of tobacco; experiencing abnormal vaginal discharge; reporting a chronic physical illness; and having higher psychological symptom scores at baseline. Programmes to reduce the burden of common mental disorder in women should target poorer women, women with chronic physical illness and who have gynaecological symptoms, and women who use tobacco.

  12. Safety from Crime and Physical Activity among Older Adults: A Population-Based Study in Brazil

    Corseuil, M.W.; Schneider, I.J.C.; Orsi, E.; Hallal, P.C.; Corseuil, H.X.

    2012-01-01

    Objective. To evaluate the association between safety from crime and physical activity among older adults. Methods. A population-based survey including 1,656 older adults (60+ years) took place in Florianopolis, Brazil, in 2009-2010. Commuting and leisure time physical activity were assessed through the long version of the International Physical Activity Questionnaire. Perception of safety from crime was assessed using the Neighbourhood Environment Walk ability Scale. Results. Perceiving the neighbourhood as safe during the day was related to a 25% increased likelihood of being active in leisure time (95% CI 1.02-1.53); general perception of safety was also associated with a 25% increase in the likelihood of being active in leisure time (95% CI 1.01-1.54). Street lighting was related to higher levels of commuting physical activity (prevalence ratio: 1.89; 95% CI 1.28-2.80). Conclusions. Safety investments are essential for promoting physical activity among older adults in Brazil

  13. Risk for schizophrenia and schizophrenia-like psychosis among patients with epilepsy: population based cohort study

    Qin, Ping; Xu, Huylan; Laursen, Thomas Munk

    2005-01-01

    .20) in people with a history of epilepsy. The effect of epilepsy was the same in men and in women and increased with age. Family history of psychosis and a family history of epilepsy were significant risk factors for schizophrenia and schizophrenia-like psychosis, and the effect of epilepsy, both in cases......OBJECTIVES: To investigate whether age at onset of epilepsy, type of epilepsy, family history of psychosis, or family history of epilepsy affect the risk of schizophrenia or schizophrenia-like psychosis among patients with epilepsy. DESIGN: Comparison of population based data. SETTING: Danish...... and families, was greater among people with no family history of psychosis. In addition, the increased risk for schizophrenia or schizophrenia-like psychosis did not differ by type of epilepsy but increased with increasing number of admissions to hospital and, particularly, was significantly greater for people...

  14. Suicide risk in relation to level of urbanicity - a population-based linkage study

    Qin, Ping

    2005-01-01

    from various Danish longitudinal registers. Data were analysed with conditional logistic regression. RESULTS: This study confirms that people living in more urbanized areas are at a higher risk of suicide than their counterparts in less urbanized areas. However, this excess risk is largely eliminated...... when adjusted for personal marital, income, and ethnic differences; it is even reversed when further adjusted for psychiatric status. Moreover, the impact of urbanicity on suicide risk differs significantly by sex and across age. Urban living reduces suicide risk significantly among men, especially......BACKGROUND: The extent to which the high suicide rate in urban areas is influenced by exposures to risk factors for suicide other than urbanicity remains unknown. This population-based study aims to investigate suicide risk in relation to the level of urbanicity in the context of other factors...

  15. Increased Risk of Venous Thromboembolism in Women with Uterine Leiomyoma: A Nationwide, Population-Based Case-Control Study

    Huang, Hung-Kai; Kor, Chew-Teng; Chen, Ching-Pei; Chen, Hung-Te; Yang, Po-Ta; Tsai, Chen-Dao; Huang, Ching-Hui

    2018-01-01

    Background Venous thromboembolism (VTE) is a sex-specific disease that has different presentations between men and women. Women with uterine leiomyoma can present with VTE without exhibiting the traditional risk factors. We investigated the relationship between a history of uterine leiomyoma and the risk of VTE using the National Health Insurance Research Database (NHIRD). Methods We conducted a retrospective, nationwide, population-based case-control study using the NHIRD. We identified 2,282 patients with diagnosed VTE and 392,635 subjects without VTE from 2000 to 2013. After development of an age and index diagnosis year frequency-matched model and propensity score-matched model, 2 models with a case-to-control ratio of 1 to 4 were established. Using the diagnosis of uterine leiomyoma as the exposure factor, conditional logistic regression was performed to examine the association between uterine leiomyoma and VTE. Multiple logistic regression analysis was used to investigate the joint effect of uterine leiomyoma and comorbid diseases on the risk of VTE. Results A strong association was observed between uterine leiomyoma and VTE in the overall patient model, frequency-matched model and propensity score-matched model [p leiomyoma who were ≥ 45 years old were less likely to experience VTE, but women with uterine leiomyoma and anemia, cancer, coronary artery disease or heart failure were more likely to experience VTE. Conclusions Women with uterine leiomyomas have an increased risk of developing VTE, especially during reproductive periods or in the presence of specific diseases. PMID:29375226

  16. Periodontitis and dental scaling associated with pyogenic liver abscess: A population-based case-control study.

    Yeh, Y-T; Wang, B-Y; Lin, C-W; Yang, S-F; Ho, S-W; Yeh, H-W; Huang, J-Y; Chang, Y-C; Yeh, C-B

    2018-05-18

    The purpose of this study was to investigate the relationship between periodontitis, dental scaling (DS) and pyogenic liver abscesses (PLAs). A nationwide population-based case-control study was applied using data from the National Health Insurance Research Database in Taiwan. We identified and enrolled 691 PLA patients, who were individually matched by age and sex to 2764 controls. Conditional logistic regression was applied to estimate adjusted odds ratios (aORs) in patients with exposure to periodontitis and DS before PLA. After adjusting for other confounding factors, periodontitis remained a risk factor for PLA among patients aged 20-40 years, with an aOR of 2.31 (95% confidence interval [CI] = 1.37-3.90, P = .0018). In addition, the average aOR for PLA was significantly lower among patients with one DS (aOR = 0.76, 95% CI = 0.59-0.96) and more than one DS (aOR = 0.61, 95% CI = 0.39-0.95) within 1 year before the index date. According to these results, we concluded that adult patients with periodontitis aged periodontal patients subjected to at least 2 DS per year are less at risk for PLA than controls. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Hospitalization resource use and costs before and after TIA and stroke: results from a population-based cohort study (OXVASC).

    Luengo-Fernandez, Ramon; Silver, Louise E; Gutnikov, Sergei A; Gray, Alastair M; Rothwell, Peter M

    2013-01-01

    High hospitalization rates, prolonged length of stay, and increased risks of subsequent events mean a steep increase in health care usage after stroke. No study, however, has examined to what extent increased costs after transient ischemic attack (TIA) or stroke are due to hospitalizations for the initial event, recurrent events, and/or nonvascular hospitalizations, and how costs compare with the year prior to the event. We studied patients in a population-based cohort study (Oxford Vascular Study) in the United Kingdom from 2003 to 2007. Hospitalization and cost details were obtained from patients' individualized Hospital Episode Statistics records. A total of 295 incident TIA and 439 incident stroke patients were included. For patients with stroke, average costs increased from £1437 in the year pre-event to £6629 in the year post-event (PTIA, costs increased from £876 1 year before the event to £2410 in the year post-event (PTIA incurred nonsignificantly higher costs due to hospitalizations linked to subsequent vascular events (£774) than for hospitalizations linked to the index TIA (£720). Hospital costs increased after TIA or stroke, primarily because of increased initial cerebrovascular hospitalizations. The finding that costs due to nonvascular diagnoses also increased after TIA or stroke appears, in part, to be explained by the miscoding of TIA/stroke-related hospitalizations in electronic information systems. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  18. The Utilization of Rehabilitation in Patients with Hemophilia A in Taiwan: A Nationwide Population-Based Study.

    Chien-Min Chen

    Full Text Available Rehabilitation plays an important role in the physical health of patients with hemophilia. However, comprehensive information regarding the utilization of rehabilitation for such patients remains scarce.This population-based study aimed to examine the characteristics, trends, and most important factors affecting rehabilitation usage in patients with hemophilia A using a nationwide database in Taiwan.Data from 777 patients with hemophilia A who were registered in the National Health Insurance Research Database between 1998 and 2008 were analyzed using SAS 9.0.Musculoskeletal or nervous system-related surgical procedures and clotting factor VIII concentrate costs were identified as factors affecting rehabilitation usage; musculoskeletal or nervous system-related surgical procedures (odds ratio = 3.788; P < 0.001 were the most important predictor of whether a patient with hemophilia A would use rehabilitation services. Joint disorders, arthropathies, bone and cartilage disorders, intracranial hemorrhage, and brain trauma were common diagnoses during rehabilitation use. The costs of physical therapy (physiotherapy comprised the majority (71.2% of rehabilitation therapy categories. Increasingly, rehabilitation therapy was performed at physician clinics. The total rehabilitation costs were <0.1% of the total annual medical costs.Musculoskeletal or nervous system-related surgical procedures and increased use of clotting factor VIII concentrate affect the rehabilitation utilization of patients with hemophilia A the most. The findings in this study could help clinicians comprehensively understand the rehabilitation utilization of patients with hemophilia A.

  19. Survival rate in nasopharyngeal carcinoma improved by high caseload volume: a nationwide population-based study in Taiwan

    Chou Pesus

    2011-08-01

    Full Text Available Abstract Background Positive correlation between caseload and outcome has previously been validated for several procedures and cancer treatments. However, there is no information linking caseload and outcome of nasopharyngeal carcinoma (NPC treatment. We used nationwide population-based data to examine the association between physician case volume and survival rates of patients with NPC. Methods Between 1998 and 2000, a total of 1225 patients were identified from the Taiwan National Health Insurance Research Database. Survival analysis, the Cox proportional hazards model, and propensity score were used to assess the relationship between 10-year survival rates and physician caseloads. Results As the caseload of individual physicians increased, unadjusted 10-year survival rates increased (p p = 0.001 after adjusting for comorbidities, hospital, and treatment modality. When analyzed by propensity score, the adjusted 10-year survival rate differed significantly between patients treated by high-volume physicians and patients treated by low/medium-volume physicians (75% vs. 61%; p Conclusions Our data confirm a positive volume-outcome relationship for NPC. After adjusting for differences in the case mix, our analysis found treatment of NPC by high-volume physicians improved 10-year survival rate.

  20. Survival rate in nasopharyngeal carcinoma improved by high caseload volume: a nationwide population-based study in Taiwan

    Lee, Ching-Chih; Hung, Shih-Kai; Huang, Tze-Ta; Lee, Moon-Sing; Su, Yu-Chieh; Chou, Pesus; Hsiao, Shih-Hsuan; Chiou, Wen-Yen; Lin, Hon-Yi; Chien, Sou-Hsin

    2011-01-01

    Positive correlation between caseload and outcome has previously been validated for several procedures and cancer treatments. However, there is no information linking caseload and outcome of nasopharyngeal carcinoma (NPC) treatment. We used nationwide population-based data to examine the association between physician case volume and survival rates of patients with NPC. Between 1998 and 2000, a total of 1225 patients were identified from the Taiwan National Health Insurance Research Database. Survival analysis, the Cox proportional hazards model, and propensity score were used to assess the relationship between 10-year survival rates and physician caseloads. As the caseload of individual physicians increased, unadjusted 10-year survival rates increased (p < 0.001). Using a Cox proportional hazard model, patients with NPC treated by high-volume physicians (caseload ≥ 35) had better survival rates (p = 0.001) after adjusting for comorbidities, hospital, and treatment modality. When analyzed by propensity score, the adjusted 10-year survival rate differed significantly between patients treated by high-volume physicians and patients treated by low/medium-volume physicians (75% vs. 61%; p < 0.001). Our data confirm a positive volume-outcome relationship for NPC. After adjusting for differences in the case mix, our analysis found treatment of NPC by high-volume physicians improved 10-year survival rate

  1. Spinal cord injury and Parkinson's disease: a population-based, propensity score-matched, longitudinal follow-up study.

    Yeh, T-S; Huang, Y-P; Wang, H-I; Pan, S-L

    2016-12-01

    To investigate whether patients with spinal cord injury (SCI) are at an increased risk of developing Parkinson's disease (PD). A population-based, propensity score-matched, longitudinal follow-up cohort study. The study was conducted using the National Health Insurance (NHI) Research Database. A total of 10 125 patients with at least 2 ambulatory visits with a diagnosis of SCI in 2001 were enrolled in the SCI group. The non-SCI group comprised 10 125 propensity score-matched patients without SCI. The propensity scores were computed using a logistic regression model that included age, sex, comorbidities and socioeconomic status. The PD-free survival rates of the two groups were estimated using the Kaplan-Meier method. Stratified Cox proportional hazard regression was used to estimate the effect of SCI on subsequent occurrence of PD. During the 3-year follow-up period, 99 subjects in the SCI group and 59 in the non-SCI group developed PD. The hazard ratio of PD for the SCI group compared with the non-SCI group was 1.65 (95% confidence interval 1.16-2.33, P=0.0049). The PD-free survival rate for the SCI group was lower than that for the non-SCI group (P=0.0017). This study shows that SCI is associated with a subsequent increased risk of PD. Further studies are needed to elucidate the mechanism underlying this association.

  2. Maternal veterinary occupation and adverse birth outcomes in Washington State, 1992-2014: a population-based retrospective cohort study.

    Meisner, Julianne; Vora, Manali V; Fuller, Mackenzie S; Phipps, Amanda I; Rabinowitz, Peter M

    2018-05-01

    Women in veterinary occupations are routinely exposed to potential reproductive hazards, yet research into their birth outcomes is limited. We conducted a population-based retrospective cohort study of the association between maternal veterinary occupation and adverse birth outcomes. Using Washington State birth certificate, fetal death certificate and hospital discharge data from 1992 to 2014, we compared birth outcomes of mothers in veterinary professions (n=2662) with those in mothers in dental professions (n=10 653) and other employed mothers (n=8082). Relative risks (RRs) and 95% CIs were estimated using log binomial regression. Outcomes studied were premature birth (veterinary support staff separately. While no statistically significant associations were found, we noted a trend for SGA births in all veterinary mothers compared with dental mothers (RR=1.16, 95% CI 0.99 to 1.36) and in veterinarians compared with other employed mothers (RR=1.37, 95% CI 0.96 to 1.96). Positive but non-significant association was found for malformations among children of veterinary support staff. These results support the need for further study of the association between veterinary occupation and adverse birth outcomes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  3. Temporal trends in obesity, osteoporosis treatment, bone mineral density, and fracture rates: a population-based historical cohort study.

    Leslie, William D; Lix, Lisa M; Yogendran, Marina S; Morin, Suzanne N; Metge, Colleen J; Majumdar, Sumit R

    2014-04-01

    Diverging international trends in fracture rates have been observed, with most reports showing that fracture rates have stabilized or decreased in North American and many European populations. We studied two complementary population-based historical cohorts from the Province of Manitoba, Canada (1996-2006) to determine whether declining osteoporotic fracture rates in Canada are attributable to trends in obesity, osteoporosis treatment, or bone mineral density (BMD). The Population Fracture Registry included women aged 50 years and older with major osteoporotic fractures, and was used to assess impact of changes in osteoporosis treatment. The BMD Registry included all women aged 50 years and older undergoing BMD tests, and was used to assess impact of changes in obesity and BMD. Model-based estimates of temporal changes in fracture rates (Fracture Registry) were calculated. Temporal changes in obesity and BMD and their association with fracture rates (BMD Registry) were estimated. In the Fracture Registry (n=27,341), fracture rates declined 1.6% per year (95% confidence interval [CI], 1.3% to 2.0%). Although osteoporosis treatment increased from 5.6% to 17.4%, the decline in fractures was independent of osteoporosis treatment. In the BMD Registry (n=36,587), obesity increased from 12.7% to 27.4%. Femoral neck BMD increased 0.52% per year and lumbar spine BMD increased 0.32% per year after covariate adjustment (pobesity or osteoporosis treatment. © 2014 American Society for Bone and Mineral Research.

  4. Risk of infective endocarditis in patients with systemic lupus erythematosus in Taiwan: a nationwide population-based study.

    Chang, Y S; Chang, C C; Chen, Y H; Chen, W S; Chen, J H

    2017-10-01

    Objectives Patients with systemic lupus erythematosus are considered vulnerable to infective endocarditis and prophylactic antibiotics are recommended before an invasive dental procedure. However, the evidence is insufficient. This nationwide population-based study evaluated the risk and related factors of infective endocarditis in systemic lupus erythematosus. Methods We identified 12,102 systemic lupus erythematosus patients from the National Health Insurance research-oriented database, and compared the incidence rate of infective endocarditis with that among 48,408 non-systemic lupus erythematosus controls. A Cox multivariable proportional hazards model was employed to evaluate the risk of infective endocarditis in the systemic lupus erythematosus cohort. Results After a mean follow-up of more than six years, the systemic lupus erythematosus cohort had a significantly higher incidence rate of infective endocarditis (42.58 vs 4.32 per 100,000 person-years, incidence rate ratio = 9.86, p endocarditis in systemic lupus erythematosus patients. Conclusions A higher risk of infective endocarditis was observed in systemic lupus erythematosus patients. Risk factors for infective endocarditis in the systemic lupus erythematosus cohort included heart disease, chronic kidney disease, steroid pulse therapy within 30 days, and a recent invasive dental procedure within 30 days.

  5. Workplace injuries in Fiji: a population-based study (TRIP 7).

    Reddy, R; Kafoa, B; Wainiqolo, I; Kool, B; Gentles, D; McCaig, E; Ameratunga, S

    2013-06-01

    Workplace injury rates in low and middle-income countries are known to be high. Contemporary data on this topic from Pacific Island countries and territories are scant. To describe the epidemiology of fatal and hospitalized workplace injuries in Fiji using a population-based trauma registry. An analysis of data from a prospective population-based surveillance registry investigated the characteristics associated with workplace injuries resulting in death or hospital admission among people aged 15 years and older in Viti Levu, the largest island in the Republic of Fiji, from October 2005 to September 2006. Incidence rates were calculated using denominator data from the 2004-05 Fiji Employment Survey. One hundred and eighty-nine individuals met the study eligibility criteria (including nine deaths). This corresponded to annual injury-related hospitalization and death rates of 73.4 and 3.7 per 100 000 workers, respectively. Males accounted for 95% of injuries, and hospitalization rates were highest among those aged 15-29 years (33 per 100 000 workers). Fijian and Indian workers had similar rates of admission to hospital (38.3 and 31.8 per 100 000 workers, respectively). Fractures (40%) and 'cuts/bites/open wounds' (32%) were the commonest types of injury while 'being hit by a person or object' (34%), falls (27%) and 'cutting or piercing' injuries (27%) were the commonest mechanisms. Overall, 7% of injuries were deemed intentional. Acknowledging the likely underestimation of the overall burden of workplace injuries, these findings support the need to identify context-specific risk factors and effective approaches to preventing workplace injuries in Fiji.

  6. Insurance problems among inflammatory bowel disease patients: results of a Dutch population based study.

    Russel, M G V M; Ryan, B M; Dagnelie, P C; de Rooij, M; Sijbrandij, J; Feleus, A; Hesselink, M; Muris, J W; Stockbrugger, R

    2003-03-01

    The majority of patients with inflammatory bowel disease (IBD) have a normal life expectancy and therefore should not be weighted when applying for life assurance. There is scant literature on this topic. In this study our aim was to document and compare the incidence of difficulties in application for life and medical insurance in a population based cohort of IBD patients and matched population controls. A population based case control study of 1126 IBD patients and 1723 controls. Based on a detailed questionnaire, the frequency and type of difficulties encountered when applying for life and medical insurance in matched IBD and control populations were appraised. In comparison with controls, IBD patients had an 87-fold increased risk of encountering difficulties when applying for life assurance (odds ratio (OR) 87 (95% confidence interval (CI) 31-246)), with a heavily weighted premium being the most common problem. Patients of high educational status, with continuous disease activity, and who smoked had the highest odds of encountering such problems. Medical insurance difficulties were fivefold more common in IBD patients compared with controls (OR 5.4 (95% CI 2.3-13)) although no specific disease or patient characteristics were identified as associated with such difficulties. This is the first detailed case control study that has investigated insurance difficulties among IBD patients. Acquiring life and medical insurance constituted a major problem for IBD patients in this study. These results are likely to be more widely representative given that most insurance companies use international guidelines for risk assessment. In view of the recent advances in therapy and promising survival data on IBD patients, evidence based guidelines for risk assessment of IBD patients by insurance companies should be drawn up to prevent possible discriminatory practices.

  7. Area-level poverty and preterm birth risk: A population-based multilevel analysis

    DeFranco, Emily A; Lian, Min; Muglia, Louis A; Schootman, Mario

    2008-01-01

    Background Preterm birth is a complex disease with etiologic influences from a variety of social, environmental, hormonal, genetic, and other factors. The purpose of this study was to utilize a large population-based birth registry to estimate the independent effect of county-level poverty on preterm birth risk. To accomplish this, we used a multilevel logistic regression approach to account for multiple co-existent individual-level variables and county-level poverty rate. Methods Population-based study utilizing Missouri's birth certificate database (1989–1997). We conducted a multilevel logistic regression analysis to estimate the effect of county-level poverty on PTB risk. Of 634,994 births nested within 115 counties in Missouri, two levels were considered. Individual-level variables included demographics factors, prenatal care, health-related behavioral risk factors, and medical risk factors. The area-level variable included the percentage of the population within each county living below the poverty line (US census data, 1990). Counties were divided into quartiles of poverty; the first quartile (lowest rate of poverty) was the reference group. Results PTB rate of PTB poverty and increased through the 4th quartile (4.9%), p poverty was significantly associated with PTB risk. PTB risk (poverty, adjusted odds ratio (adjOR) 1.18 (95% CI 1.03, 1.35), with a similar effect at earlier gestational ages (birth, above other underlying risk factors. Although the risk increase is modest, it affects a large number of pregnancies. PMID:18793437

  8. Design considerations for identifying breast cancer risk factors in a population-based study in Africa.

    Brinton, Louise A; Awuah, Baffour; Nat Clegg-Lamptey, Joe; Wiafe-Addai, Beatrice; Ansong, Daniel; Nyarko, Kofi M; Wiafe, Seth; Yarney, Joel; Biritwum, Richard; Brotzman, Michelle; Adjei, Andrew A; Adjei, Ernest; Aitpillah, Francis; Edusei, Lawrence; Dedey, Florence; Nyante, Sarah J; Oppong, Joseph; Osei-Bonsu, Ernest; Titiloye, Nicholas; Vanderpuye, Verna; Brew Abaidoo, Emma; Arhin, Bernard; Boakye, Isaac; Frempong, Margaret; Ohene Oti, Naomi; Okyne, Victoria; Figueroa, Jonine D

    2017-06-15

    Although breast cancer is becoming more prevalent in Africa, few epidemiologic studies have been undertaken and appropriate methodologic approaches remain uncertain. We therefore conducted a population-based case-control study in Accra and Kumasi, Ghana, enrolling 2,202 women with lesions suspicious for breast cancer and 2,161 population controls. Biopsy tissue for cases prior to neoadjuvant therapy (if given), blood, saliva and fecal samples were sought for study subjects. Response rates, risk factor prevalences and odds ratios for established breast cancer risk factors were calculated. A total of 54.5% of the recruited cases were diagnosed with malignancies, 36.0% with benign conditions and 9.5% with indeterminate diagnoses. Response rates to interviews were 99.2% in cases and 91.9% in controls, with the vast majority of interviewed subjects providing saliva (97.9% in cases vs. 98.8% in controls) and blood (91.8% vs. 82.5%) samples; lower proportions (58.1% vs. 46.1%) provided fecal samples. While risk factor prevalences were unique as compared to women in other countries (e.g., less education, higher parity), cancer risk factors resembled patterns identified elsewhere (elevated risks associated with higher levels of education, familial histories of breast cancer, low parity and larger body sizes). Subjects with benign conditions were younger and exhibited higher socioeconomic profiles (e.g., higher education and lower parity) than those with malignancies, suggesting selective referral influences. While further defining breast cancer risk factors in Africa, this study showed that successful population-based interdisciplinary studies of cancer in Africa are possible but require close attention to diagnostic referral biases and standardized and documented approaches for high-quality data collection, including biospecimens. © 2017 UICC.

  9. [Breast cancer incidence related with a population-based screening program].

    Natal, Carmen; Caicoya, Martín; Prieto, Miguel; Tardón, Adonina

    2015-02-20

    To compare breast cancer cumulative incidence, time evolution and stage at diagnosis between participants and non-participant women in a population-based screening program. Cohort study of breast cancer incidence in relation to participation in a population screening program. The study population included women from the target population of the screening program. The source of information for diagnostics and stages was the population-based cancer registry. The analysis period was 1999-2010. The Relative Risk for invasive, in situ, and total cancers diagnosed in participant women compared with non-participants were respectively 1.16 (0.94-1.43), 2.98 (1.16-7.62) and 1.22 (0.99-1.49). The Relative Risk for participants versus non-participants was 2.47 (1.55-3.96) for diagnosis at stagei, 2.58 (1.67-3.99) for T1 and 2.11 (1.38-3.23) for negative lymph node involvement. The cumulative incidence trend had two joint points in both arms, with an Annual Percent of Change of 92.3 (81.6-103.5) between 1999-2001, 18.2 (16.1-20.3) between 2001-2005 and 5.9 (4.0-7.8) for the last period in participants arm, and 72.6 (58.5-87.9) between 1999-2001, 12.6 (7.9-17.4) between 2001-2005, and 8.6 (6.5-10.6) in the last period in the non-participant arm. Participating in the breast cancer screening program analyzed increased the in situ cumulative cancer incidence, but not the invasive and total incidence. Diagnoses were earlier in the participant arm. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  10. Seroprevalence of Helicobacter pylori in Hispanics living in Puerto Rico: A population-based study.

    González-Pons, María; Soto-Salgado, Marievelisse; Sevilla, Javier; Márquez-Lespier, Juan M; Morgan, Douglas; Pérez, Cynthia M; Cruz-Correa, Marcia

    2018-02-01

    Helicobacter pylori is an important etiologic factor for peptic ulcers and gastric cancer, one of the top ten leading causes of cancer death in Puerto Rico. However, the prevalence of H. pylori infections in this population was previously unknown. The aim of this study was to examine the seroprevalence of H. pylori and its associated risk factors in Puerto Rico. A cross-sectional study was designed using an existing population-based biorepository. Seropositivity was determined using the Premier ™ H. pylori immunoassay. Helicobacter pylori seroprevalence was estimated with 95% confidence using marginal standardization following logistic regression. To assess the risk factors associated with H. pylori seropositivity, a multivariable log-binomial model was fitted to estimate the prevalence ratio (PR) and its 95% confidence interval (95% CI). A total of 528 population-based serum samples were analyzed. The mean age of the study population was 41 ± 12 years, of whom 55.3% were females. The overall seroprevalence of H. pylori was 33.0% (95% CI = 28.3%-38.1%). Increasing age and having Puerto Rico. The H. pylori seroprevalence observed in Puerto Rico is similar to the seroprevalence reported in the overall population of the United States. The association between H. pylori seroprevalence and the risk factors analyzed offers insight into the epidemiology of gastric cancer in Puerto Rico and warrants further investigation. © 2017 The Authors. Helicobacter Published by John Wiley & Sons Ltd.

  11. Medical illness, medication use and suicide in seniors: a population-based case-control study.

    Voaklander, D C; Rowe, B H; Dryden, D M; Pahal, J; Saar, P; Kelly, K D

    2008-02-01

    Suicide among seniors is a significant health problem in north America, particularly for men in whom the rates rise steadily after 50 years of age. The goal of this study was to examine elder suicides identified from a large population-based database using case-control methods to determine disease and medication factors related to suicide. A population-based 1 : 5 case-control study was conducted comparing seniors aged 66 years and older who had died by suicide with age and sex-matched controls. Case data were obtained through British Columbia (BC) Vital Statistics, whereas controls were randomly selected from the BC Health Insurance Registry. Cases and controls were linked to the provincial PharmaCare database to determine medication use and the provincial Physician Claims and Inpatient Hospitalization databases to determine co-morbidity. Between 1993 and 2002 a total of 602 seniors died by suicide in BC giving an annual rate of 13.2 per 100,000. Firearms were the most common mechanism (28%), followed by hanging/suffocation (25%), self-poisoning (21%), and jumping from height (7%). In the adjusted logistic model, variables related to suicide included: lower socioeconomic status, depression/psychosis, neurosis, stroke, cancer, liver disease, parasuicide, benzodiazepine use, narcotic pain killer use and diuretic use. There was an elevated risk for those prescribed inappropriate benzodiazepines and for those using strong narcotic pain killers. This study is consistent with previous studies that have identified a relationship between medical or psychiatric co-morbidity and suicide in seniors. In addition, new and potentially useful information confirms that certain types and dosages of benzodiazepines are harmful to seniors and their use should be avoided.

  12. Population-based metabolic syndrome risk score and its determinants: The Isfahan Healthy Heart Program

    Mohsen Hosseini

    2014-01-01

    Full Text Available Background: Metabolic syndrome (MetSy, an important predisposing factor for the most of noncommunicable diseases, has become a global pandemic. Given different definitions used for the MetSy, recently using a score termed "continuous MetSy risk score (CMetSyS" is recommended. The aim of this study was to provide a CMetSyS in a population-based sample of Iranian adults and to assess its determinants. Materials and Methods: We used the data of the baseline survey of a community trial entitled "the Isfahan health heart program." The MetSy was defined according to the Revised National Cholesterol Education Program Third Adult Treatment Panel. All probable predictive models and their predictive performance were provided using leave-one-out cross-validated logistic regression and the receiver operation characteristic curve methods. Multiple linear regression was performed to assess factors associated with the CMetSyS. Results: The study population consisted of 8313 persons (49.9% male, mean age 38.54 ± 15.86 years. The MetSy was documented in 1539 persons (21.86%. Triglycerides and waist circumference were the best predictive components, and fasting plasma glucose had the lowest area under curve (AUC. The AUC for our best model was 95.36 (94.83-95.83%. The best predictive cutoff for this risk score was −1.151 with 89% sensitivity and 87.93% specificity. Conclusion: We provided four population-based leave-one-out cross-validated risk score models, with moderate to perfect predictive performance to identify the MetSy in Iranian adults. The CMetSyS had significant associations with high sensitive C-reactive protein, body mass index, leisure time, and workplace physical activity as well as age and gender.

  13. The population-based Barcelona-Asymptomatic Intracranial Atherosclerosis Study (ASIA: rationale and design

    Pera Guillem

    2011-02-01

    Full Text Available Abstract Background Large-artery intracranial atherosclerosis may be the most frequent cause of ischemic stroke worldwide. Traditional approaches have attempted to target the disease when it is already symptomatic. However, early detection of intracranial atherosclerosis may allow therapeutic intervention while the disease is still asymptomatic. The prevalence and natural history of asymptomatic intracranial atherosclerosis in Caucasians remain unclear. The aims of the Barcelona-ASymptomatic Intracranial Atherosclerosis (ASIA study are (1 to determine the prevalence of ASIA in a moderate-high vascular risk population, (2 to study its prognostic impact on the risk of suffering future major ischemic events, and (3 to identify predictors of the development, progression and clinical expression of this condition. Methods/Design Cross-over and cohort, population-based study. A randomly selected representative sample of 1,503 subjects with a mild-moderate-high vascular risk (as defined by a REGICOR score ≥ 5% and with neither a history of cerebrovascular nor ischemic heart disease will be studied. At baseline, all individuals will undergo extracranial and transcranial Color-Coded Duplex (TCCD ultrasound examinations to detect presence and severity of extra and intracranial atherosclerosis. Intracranial stenoses will be assessed by magnetic resonance angiography (MRA. Clinical and demographic variables will be recorded and blood samples will be drawn to investigate clinical, biological and genetic factors associated with the presence of ASIA. A long-term clinical and sonographic follow-up will be conducted thereafter to identify predictors of disease progression and of incident vascular events. Discussion The Barcelona-ASIA is a population-based study aiming to evaluate the prevalence and clinical importance of asymptomatic intracranial large-artery atherosclerosis in Caucasians. The ASIA project may provide a unique scientific resource to better

  14. The population-based Barcelona-Asymptomatic Intracranial Atherosclerosis Study (ASIA): rationale and design.

    López-Cancio, Elena; Dorado, Laura; Millán, Mónica; Reverté, Silvia; Suñol, Anna; Massuet, Anna; Mataró, María; Galán, Amparo; Alzamora, Maite; Pera, Guillem; Torán, Pere; Dávalos, Antoni; Arenillas, Juan F

    2011-02-17

    Large-artery intracranial atherosclerosis may be the most frequent cause of ischemic stroke worldwide. Traditional approaches have attempted to target the disease when it is already symptomatic. However, early detection of intracranial atherosclerosis may allow therapeutic intervention while the disease is still asymptomatic. The prevalence and natural history of asymptomatic intracranial atherosclerosis in Caucasians remain unclear. The aims of the Barcelona-ASymptomatic Intracranial Atherosclerosis (ASIA) study are (1) to determine the prevalence of ASIA in a moderate-high vascular risk population, (2) to study its prognostic impact on the risk of suffering future major ischemic events, and (3) to identify predictors of the development, progression and clinical expression of this condition. Cross-over and cohort, population-based study. A randomly selected representative sample of 1,503 subjects with a mild-moderate-high vascular risk (as defined by a REGICOR score ≥ 5%) and with neither a history of cerebrovascular nor ischemic heart disease will be studied. At baseline, all individuals will undergo extracranial and transcranial Color-Coded Duplex (TCCD) ultrasound examinations to detect presence and severity of extra and intracranial atherosclerosis. Intracranial stenoses will be assessed by magnetic resonance angiography (MRA). Clinical and demographic variables will be recorded and blood samples will be drawn to investigate clinical, biological and genetic factors associated with the presence of ASIA. A long-term clinical and sonographic follow-up will be conducted thereafter to identify predictors of disease progression and of incident vascular events. The Barcelona-ASIA is a population-based study aiming to evaluate the prevalence and clinical importance of asymptomatic intracranial large-artery atherosclerosis in Caucasians. The ASIA project may provide a unique scientific resource to better understand the dynamics of intracranial atherosclerosis from

  15. Association of Sleep Disorders with Nonalcoholic Fatty Liver Disease (NAFLD): A Population-based Study.

    Mir, Heshaam M; Stepanova, Maria; Afendy, Hena; Cable, Rebecca; Younossi, Zobair M

    2013-09-01

    Nonalcoholic fatty liver disease (NAFLD) is a major cause of chronic liver disease. In smaller studies, sleep apnea has been previously associated with NAFLD. The aim of this study was to assess the prevalence and independent associations of sleep disorders in patients with NAFLD using recent population-based data. Three cycles of the National Health and Nutrition Examination Survey (NHANES) conducted between 2005 and 2010 were used. The diagnosis of NAFLD was established as elevated liver enzymes in the absence of all other causes of chronic liver disease. Sleep disorders were diagnosed using sleep disorder questionnaires completed by NHANES participants, and included self-reported history of sleep apnea, insomnia, and restless leg syndrome. The prevalence of sleep disorders was compared between those with and without NAFLD. A total of 10,541 adult NHANES participants with complete demographic, clinical, and laboratory data were included. Of those, 15.0% had NAFLD and 7.2% reported having sleep disorders. Of those with sleep disorders, 64.7% reported history of sleep apnea, 16.0% had history of insomnia, and 4.0% had restless leg syndrome. Individuals with NAFLD were more likely to be male (53.8% vs. 45.7%, P < 0.0001), obese (50.1% vs. 33.4%, P < 0.0001) and had higher prevalence of sleep disorders (9.1% vs. 6.9%, P = 0.0118). In multivariate analysis, having any sleep disorder, sleep apnea and insomnia were all independently associated with NAFLD [OR (95% CI) = 1.40 (1.11-1.76), OR = 1.39 (0.98-1.97), and OR = 2.17 (1.19-3.95); respectively)]. This large population-based data suggests that NAFLD is associated with sleep disorders. Although the exact mechanism is unknown, this association is most likely through metabolic conditions associated with NAFLD.

  16. Population-Based Incidence Rates of Cervical Intraepithelial Neoplasia in the Human Papillomavirus Vaccine Era.

    Benard, Vicki B; Castle, Philip E; Jenison, Steven A; Hunt, William C; Kim, Jane J; Cuzick, Jack; Lee, Ji-Hyun; Du, Ruofei; Robertson, Michael; Norville, Scott; Wheeler, Cosette M

    2017-06-01

    A substantial effect of human papillomavirus (HPV) vaccines on reducing HPV-related cervical disease is essential before modifying clinical practice guidelines in partially vaccinated populations. To determine the population-based cervical intraepithelial neoplasia (CIN) trends when adjusting for changes in cervical screening practices that overlapped with HPV vaccination implementation. The New Mexico HPV Pap Registry, which captures population-based estimates of both cervical screening prevalence and CIN, was used to compute CIN trends from January 1, 2007, to December 31, 2014. Under New Mexico Administrative Code, the New Mexico HPV Pap Registry, a statewide public health surveillance program, receives mandatory reporting of all cervical screening (cytologic and HPV testing) and any cervical, vulvar, and vaginal histopathological findings for all women residing in New Mexico irrespective of outcome. Prespecified outcome measures included low-grade CIN (grade 1 [CIN1]) and high-grade CIN (grade 2 [CIN2] and grade 3 [CIN3]). From 2007 to 2014, a total of 13 520 CIN1, 4296 CIN2, and 2823 CIN3 lesions were diagnosed among female individuals 15 to 29 years old. After adjustment for changes in cervical screening across the period, reductions in the CIN incidence per 100 000 women screened were significant for all grades of CIN among female individuals 15 to 19 years old, dropping from 3468.3 to 1590.6 for CIN1 (annual percentage change [APC], -9.0; 95% CI, -12.0 to -5.8; P women 20 to 24 years old, dropping from 1027.7 to 627.1 (APC, -6.3; 95% CI, -10.9 to -1.4; P = .02). Population-level decreases in CIN among cohorts partially vaccinated for HPV may be considered when clinical practice guidelines for cervical cancer screening are reassessed. Evidence is rapidly growing to suggest that further increases in raising the age to start screening are imminent, one step toward integrating screening and vaccination.

  17. Incidence of anogenital warts in Germany: a population-based cohort study

    Mikolajczyk Rafael T

    2010-12-01

    Full Text Available Abstract Background Human papilloma virus (HPV types 6 and 11 account for 90 percent of anogenital warts (AGW. Assessment of a potential reduction of the incidence of AGW following introduction of HPV vaccines requires population-based incidence rates. The aim of this study was to estimate incidence rates of AGW in Germany, stratified by age, sex, and region. Additionally, the medical practitioner (gynaecologist, dermatologist, urologist etc. who made the initial diagnosis of AGW was assessed. Methods Retrospective cohort study in a population aged 10 to 79 years in a population-based healthcare insurance database. The database included more than 14 million insurance members from all over Germany during the years 2004-2006. A case of AGW was considered incident if a disease-free period of twelve months preceded the diagnosis. To assess regional variation, analyses were performed by federal state. Results The estimated incidence rate was 169.5/100,000 person-years for the German population aged 10 to 79 years. Most cases occurred in the 15 to 40 years age group. The incidence rate was higher and showed a peak at younger ages in females than in males. The highest incidence rates for both sexes were observed in the city-states Berlin, Hamburg and Bremen. In females, initial diagnosis of AGW was most frequently made by a gynaecologist (71.7%, whereas in males, AGW were most frequently diagnosed by a dermatologist (44.8% or urologist (25.1%. Conclusions Incidence of AGW in Germany is comparable with findings for other countries. As expected, most cases occurred in the younger age groups. The frequency of diagnoses of AGW differs between sexes and women and men receive treatment by doctors of different specialties.

  18. Lower urinary tract symptoms and urinary incontinence in a geriatric cohort - a population-based analysis.

    Wehrberger, Clemens; Madersbacher, Stephan; Jungwirth, Susanne; Fischer, Peter; Tragl, Karl-Heinz

    2012-11-01

    To assess prevalence and severity of lower urinary tract function in 85-year-old men and women. Little is known on the prevalence of lower urinary tract dysfunction in this geriatric age group, which is now the fastest growing sector of the population worldwide. The Vienna Trans-Danube Aging study (VITA) is a longitudinal, population-based study initiated in 2000 that included men/women aged 75 years living in a well-defined area in Vienna. The main purpose of the VITA study was to identify risk factors for incident Alzheimer's disease. All study participants alive in 2010 were contacted by mail to complete a detailed questionnaire on various aspects of lower urinary tract symptoms (LUTS) and urinary incontinence (UI). The response rate was 68%, resulting in a total of 262 questionnaires available for analysis (men n= 96; women n= 166). All study participants were 85 years of age. Urinary incontinence defined as any involuntary loss during the past 4 weeks was reported by 24% of men and 35% of women (P= 0.04). Stress UI was more frequent in women (39%) than in men (14%, P 0.05). Nocturia more often than twice was more prevalent in men (69%) than in women (49%) (P= 0.02). Overactive bladder, according to International Continence Society criteria, was present in 55% of women and 50% of men. No difference regarding quality of life impairment as the result of LUTS and UI was noticed between sexes. A few co-morbidities were identified to correlate with UI and storage symptoms. These data provide insights into the prevalence and severity of LUTS and UI in individuals in their eighties, to our knowledge the largest population-based study in this age group. Demographic changes in upcoming decades underline the importance of a thorough understanding of lower urinary tract dysfunction in a geriatric population. © 2012 BJU INTERNATIONAL.

  19. A simplified questionnaire for self-assessment of hirsutism in population-based studies.

    Gabrielli, Ligia; Aquino, Estela M L

    2015-04-01

    The measurement of excess body hair is not straightforward. As the modified Ferriman-Gallwey (mFG) score is unsuitable for self-assessment and requires specialist training, a short, self-administered questionnaire to identify hirsutism was constructed and validated for large-scale application, particularly targeting population-based studies. A validation study was conducted to assess a new hirsutism questionnaire. A total of 90 women aged 35-72 years who were enrolled in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) were evaluated. A self-administered instrument containing four questions was designed to evaluate five body areas: upper lip, chin, chest, lower abdomen, and thighs with respect to the current distribution of body hair and that before 35 years of age. A score of 0-4 was attributed to each region based on drawings provided in the instrument. Test-retest reliability was evaluated by reformulating the initial questions. An independent medical examination was conducted to apply the gold standard, the mFG score. The area under the receiver operating characteristic curve was 0.93 (95% CI: 0.87-0.99). A cut-off score of 5 showed the best balance between sensitivity (85%) and specificity (90%), with 88.9% accuracy. Spearman's correlation between current and past body hair score was calculated at 0.82 (P=0.000), and showed a test-retest reliability of 0.49, with a trend toward similar answers regarding changes in the quantity of body hair over time, irrespective of how the questions were asked (P=0.000). The accuracy and internal consistency of this self-administered questionnaire for the identification of hirsutism were good. Therefore, this questionnaire represents a useful tool for self-assessment of hirsutism in population-based studies. © 2015 European Society of Endocrinology.

  20. The Epidemiology of Functional Gastrointestinal Disorders in Mexico: A Population-Based Study

    Aurelio López-Colombo

    2012-01-01

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

  1. Area-level poverty and preterm birth risk: A population-based multilevel analysis

    Muglia Louis A

    2008-09-01

    Full Text Available Abstract Background Preterm birth is a complex disease with etiologic influences from a variety of social, environmental, hormonal, genetic, and other factors. The purpose of this study was to utilize a large population-based birth registry to estimate the independent effect of county-level poverty on preterm birth risk. To accomplish this, we used a multilevel logistic regression approach to account for multiple co-existent individual-level variables and county-level poverty rate. Methods Population-based study utilizing Missouri's birth certificate database (1989–1997. We conducted a multilevel logistic regression analysis to estimate the effect of county-level poverty on PTB risk. Of 634,994 births nested within 115 counties in Missouri, two levels were considered. Individual-level variables included demographics factors, prenatal care, health-related behavioral risk factors, and medical risk factors. The area-level variable included the percentage of the population within each county living below the poverty line (US census data, 1990. Counties were divided into quartiles of poverty; the first quartile (lowest rate of poverty was the reference group. Results PTB th quartile (4.9%, p adjOR 1.18 (95% CI 1.03, 1.35, with a similar effect at earlier gestational ages (adjOR 1.27 (95% CI 1.06, 1.52. Conclusion Women residing in socioeconomically deprived areas are at increased risk of preterm birth, above other underlying risk factors. Although the risk increase is modest, it affects a large number of pregnancies.

  2. Patterns of cannabis use in patients with Inflammatory Bowel Disease: A population based analysis.

    Weiss, Alexandra; Friedenberg, Frank

    2015-11-01

    Tobacco use patterns and effects in patients with Inflammatory Bowel Disease have been extensively studied, however the role and patterns of cannabis use remains poorly defined. Our aim was to evaluate patterns of marijuana use in a large population based survey. Cases were identified from the NHANES database from the National Center for Health Statistics for the time period from January, 2009 through December, 2010 as having ulcerative colitis or Crohn's disease, and exact matched with controls using the Propensity Score Module of SPSS, based on age, gender, and sample weighted using the nearest neighbor method. After weighting, 2084,895 subjects with IBD and 2013,901 control subjects were identified with no significant differences in demographic characteristics. Subjects with IBD had a higher incidence of ever having used marijuana/hashish (M/H) (67.3% vs. 60.0%) and an earlier age of onset of M/H use (15.7 years vs. 19.6 years). Patients with IBD were less likely to have used M/H every month for a year, but more likely to use a heavier amount per day (64.9% subjects with IBD used three or more joints per day vs. 80.5% of subjects without IBD used two or fewer joints per day). In multivariable logistic regression, presence of IBD, male gender, and age over 40 years predicted M/H use. Our study is the first to evaluate marijuana patterns in a large-scale population based survey. Older, male IBD patients have the highest odds of marijuana use. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Migraine and Mental Health in a Population-Based Sample of Adolescents.

    Orr, Serena L; Potter, Beth K; Ma, Jinhui; Colman, Ian

    2017-01-01

    To explore the relationship between migraine and anxiety disorders, mood disorders and perceived mental health in a population-based sample of adolescents. The Canadian Community Health Survey (CCHS) is a cross-sectional health survey sampling a nationally representative group of Canadians. In this observational study, data on all 61,375 participants aged 12-19 years from six survey cycles were analyzed. The relationships between self-reported migraine, perceived mental health, and mood/anxiety disorders were modeled using univariate and multivariate logistic regression. The migraine-depression association was also explored in a subset of participants using the Composite International Diagnostic Interview-Short Form (CIDI-SF) depression scale. The odds of migraine were higher among those with mood disorders, with the strongest association in 2011-2 (adjusted odds ratio [aOR]=4.59; 95% confidence interval [CI 95%]=3.44-6.12), and the weakest in 2009-10 (aOR=3.06, CI 95%=2.06-4.55). The migraine-mood disorders association was also significant throughout all cycles, other than 2011-2, when the CIDI-SF depression scale was employed. The odds of migraine were higher among those with anxiety disorders, with the strongest association in 2011-2 (aOR=4.21, CI 95%=3.31-5.35) and the weakest in 2010 (aOR=1.87, CI 95%=1.10-3.37). The inverse association between high perceived mental health and the odds of migraine was observed in all CCHS cycles, with the strongest association in 2011-2 (aOR=0.58, CI 95%=0.48-0.69) and the weakest in 2003-4 (aOR=0.75, CI 95%=0.62-0.91). This study provides evidence, derived from a large population-based sample of adolescents, for a link between migraine and mood/anxiety disorders.

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

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

    2016-03-01

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

  5. The Global Incidence of Appendicitis: A Systematic Review of Population-based Studies.

    Ferris, Mollie; Quan, Samuel; Kaplan, Belle S; Molodecky, Natalie; Ball, Chad G; Chernoff, Greg W; Bhala, Nij; Ghosh, Subrata; Dixon, Elijah; Ng, Siew; Kaplan, Gilaad G

    2017-08-01

    We compared the incidence of appendicitis or appendectomy across the world and evaluated temporal trends. Population-based studies reported the incidence of appendicitis. We searched MEDLINE and EMBASE databases for population-based studies reporting the incidence of appendicitis or appendectomy. Time trends were explored using Poisson regression and reported as annual percent change (APC) with 95% confidence intervals (CI). APC were stratified by time periods and pooled using random effects models. Incidence since 2000 was pooled for regions in the Western world. The search retrieved 10,247 citations with 120 studies reporting on the incidence of appendicitis or appendectomy. During the 21st century the pooled incidence of appendicitis or appendectomy (in per 100,000 person-years) was 100 (95% CI: 91, 110) in Northern America, and the estimated number of cases in 2015 was 378,614. The pooled incidence ranged from 105 in Eastern Europe to 151 in Western Europe. In Western countries, the incidence of appendectomy steadily decreased since 1990 (APC after 1989=-1.54; 95% CI: -2.22, -0.86), whereas the incidence of appendicitis stabilized (APC=-0.36; 95% CI: -0.97, 0.26) for both perforated (APC=0.95; 95% CI: -0.25, 2.17) and nonperforated appendicitis (APC=0.44; 95% CI: -0.84, 1.73). In the 21st century, the incidence of appendicitis or appendectomy is high in newly industrialized countries in Asia (South Korea pooled: 206), the Middle East (Turkey pooled: 160), and Southern America (Chile: 202). Appendicitis is a global disease. The incidence of appendicitis is stable in most Western countries. Data from newly industrialized countries is sparse, but suggests that appendicitis is rising rapidly.

  6. Two-Year Outcomes of a Population-Based Intervention for Preschool Language Delay: An RCT.

    Wake, Melissa; Levickis, Penny; Tobin, Sherryn; Gold, Lisa; Ukoumunne, Obioha C; Goldfeld, Sharon; Zens, Naomi; Le, Ha N D; Law, James; Reilly, Sheena

    2015-10-01

    We have previously shown short-term benefits to phonology, letter knowledge, and possibly expressive language from systematically ascertaining language delay at age 4 years followed by the Language for Learning intervention. Here, we report the trial's definitive 6-year outcomes. Randomized trial nested in a population-based ascertainment. Children with language scores >1.25 SD below the mean at age 4 were randomized, with intervention children receiving 18 1-hour home-based therapy sessions. Primary outcome was receptive/expressive language. Secondary outcomes were phonological, receptive vocabulary, literacy, and narrative skills; parent-reported pragmatic language, behavior, and health-related quality of life; costs of intervention; and health service use. For intention-to-treat analyses, trial arms were compared using linear regression models. Of 1464 children assessed at age 4, 266 were eligible and 200 randomized; 90% and 82% of intervention and control children were retained respectively. By age 6, mean language scores had normalized, but there was little evidence of a treatment effect for receptive (adjusted mean difference 2.3; 95% confidence interval [CI] -1.2 to 5.7; P = .20) or expressive (0.8; 95% CI -1.6 to 3.2; P = .49) language. Of the secondary outcomes, only phonological awareness skills (effect size 0.36; 95% CI 0.08-0.65; P = .01) showed benefit. Costs were higher for intervention families (mean difference AU$4276; 95% CI: $3424 to $5128). Population-based intervention targeting 4-year-old language delay was feasible but did not have lasting impacts on language, possibly reflecting resolution in both groups. Long-term literacy benefits remain possible but must be weighed against its cost. Copyright © 2015 by the American Academy of Pediatrics.

  7. Survival in pediatric medulloblastoma: a population-based observational study to improve prognostication.

    Weil, Alexander G; Wang, Anthony C; Westwick, Harrison J; Ibrahim, George M; Ariani, Rojine T; Crevier, Louis; Perreault, Sebastien; Davidson, Tom; Tseng, Chi-Hong; Fallah, Aria

    2017-03-01

    Medulloblastoma is the most common form of brain malignancy of childhood. The mainstay of epidemiological data regarding childhood medulloblastoma is derived from case series, hence population-based studies are warranted to improve the accuracy of survival estimates. To utilize a big-data approach to update survival estimates in a contemporary cohort of children with medulloblastoma. We performed a population-based retrospective observational cohort study utilizing the Surveillance, Epidemiology, and End Results Program database that captures all children, less than 20 years of age, between 1973 and 2012 in 18 geographical regions representing 28% of the US population. We included all participants with a presumed or histologically diagnosis of medulloblastoma. The main outcome of interest is survivors at 1, 5 and 10 years following diagnosis. A cohort of 1735 children with a median (interquartile range) age at diagnosis of 7 (4-11) years, with a diagnosis of medulloblastoma were identified. The incidence and prevalence of pediatric medulloblastoma has remained stable over the past 4 decades. There is a critical time point at 1990 when the overall survival has drastically improved. In the contemporary cohort (1990 onwards), the percentage of participants alive was 86, 70 and 63% at 1, 5 and 10 years, respectively. Multivariate Cox-Regression model demonstrated Radiation (HR 0.37; 95% CI 0.30-0.46, p < 0.001) and Surgery (HR 0.42; 95% CI 0.30-0.58, p < 0.001) independently predict survival. The probability of mortality from a neurological cause is <5% in patients who are alive 8 years following diagnosis. The SEER cohort analysis demonstrates significant improvements in pediatric medulloblastoma survival. In contrast to previous reports, the majority of patients survive in the modern era, and those alive 8 years following initial diagnosis are likely a long-term survivor. The importance of minimizing treatment-related toxicity is increasingly apparent given

  8. Effects of population based screening for Chlamydia infections in the Netherlands limited by declining participation rates.

    Boris V Schmid

    Full Text Available BACKGROUND: A large trial to investigate the effectiveness of population based screening for chlamydia infections was conducted in the Netherlands in 2008-2012. The trial was register based and consisted of four rounds of screening of women and men in the age groups 16-29 years in three regions in the Netherlands. Data were collected on participation rates and positivity rates per round. A modeling study was conducted to project screening effects for various screening strategies into the future. METHODS AND FINDINGS: We used a stochastic network simulation model incorporating partnership formation and dissolution, aging and a sexual life course perspective. Trends in baseline rates of chlamydia testing and treatment were used to describe the epidemiological situation before the start of the screening program. Data on participation rates was used to describe screening uptake in rural and urban areas. Simulations were used to project the effectiveness of screening on chlamydia prevalence for a time period of 10 years. In addition, we tested alternative screening strategies, such as including only women, targeting different age groups, and biennial screening. Screening reduced prevalence by about 1% in the first two screening rounds and leveled off after that. Extrapolating observed participation rates into the future indicated very low participation in the long run. Alternative strategies only marginally changed the effectiveness of screening. Higher participation rates as originally foreseen in the program would have succeeded in reducing chlamydia prevalence to very low levels in the long run. CONCLUSIONS: Decreasing participation rates over time profoundly impact the effectiveness of population based screening for chlamydia infections. Using data from several consecutive rounds of screening in a simulation model enabled us to assess the future effectiveness of screening on prevalence. If participation rates cannot be kept at a sufficient level

  9. Comparing administrative and survey data for ascertaining cases of irritable bowel syndrome: a population-based investigation

    Targownick Laura E

    2010-02-01

    Full Text Available Abstract Background Administrative and survey data are two key data sources for population-based research about chronic disease. The objectives of this methodological paper are to: (1 estimate agreement between the two data sources for irritable bowel syndrome (IBS and compare the results to those for inflammatory bowel disease (IBD; (2 compare the frequency of IBS-related diagnoses in administrative data for survey respondents with and without self-reported IBS, and (3 estimate IBS prevalence from both sources. Methods This retrospective cohort study used linked administrative and health survey data for 5,134 adults from the province of Manitoba, Canada. Diagnoses in hospital and physician administrative data were investigated for respondents with self-reported IBS, IBD, and no bowel disorder. Agreement between survey and administrative data was estimated using the κ statistic. The χ2 statistic tested the association between the frequency of IBS-related diagnoses and self-reported IBS. Crude, sex-specific, and age-specific IBS prevalence estimates were calculated from both sources. Results Overall, 3.0% of the cohort had self-reported IBS, 0.8% had self-reported IBD, and 95.3% reported no bowel disorder. Agreement was poor to fair for IBS and substantially higher for IBD. The most frequent IBS-related diagnoses among the cohort were anxiety disorders (34.4%, symptoms of the abdomen and pelvis (26.9%, and diverticulitis of the intestine (10.6%. Crude IBS prevalence estimates from both sources were lower than those reported previously. Conclusions Poor agreement between administrative and survey data for IBS may account for differences in the results of health services and outcomes research using these sources. Further research is needed to identify the optimal method(s to ascertain IBS cases in both data sources.

  10. A population-based survey in Australia of men's and women's perceptions of genetic risk and predictive genetic testing and implications for primary care.

    Taylor, S

    2011-01-01

    Community attitudes research regarding genetic issues is important when contemplating the potential value and utilisation of predictive testing for common diseases in mainstream health services. This article aims to report population-based attitudes and discuss their relevance to integrating genetic services in primary health contexts. Men's and women's attitudes were investigated via population-based omnibus telephone survey in Queensland, Australia. Randomly selected adults (n = 1,230) with a mean age of 48.8 years were interviewed regarding perceptions of genetic determinants of health; benefits of genetic testing that predict 'certain' versus 'probable' future illness; and concern, if any, regarding potential misuse of genetic test information. Most (75%) respondents believed genetic factors significantly influenced health status; 85% regarded genetic testing positively although attitudes varied with age. Risk-based information was less valued than certainty-based information, but women valued risk information significantly more highly than men. Respondents reported 'concern' (44%) and 'no concern' (47%) regarding potential misuse of genetic information. This study contributes important population-based data as most research has involved selected individuals closely impacted by genetic disorders. While community attitudes were positive regarding genetic testing, genetic literacy is important to establish. The nature of gender differences regarding risk perception merits further study and has policy and service implications. Community concern about potential genetic discrimination must be addressed if health benefits of testing are to be maximised. Larger questions remain in scientific, policy, service delivery, and professional practice domains before predictive testing for common disorders is efficacious in mainstream health care. Copyright © 2011 S. Karger AG, Basel.

  11. Research

    ebutamanya

    2015-03-02

    Mar 2, 2015 ... Joseph Daniels1,&, Ruth Nduati1,2, James Kiarie1,3, Carey Farquhar1,4,5 .... or basic science research career (Socio-Behavioral Research, .... a research environment that supports knowledge sharing to develop research ...

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

    Pridemore, William Alex

    2014-06-01

    There is a growing body of research on the effects of incarceration on health, though there are few studies in the sociological literature of the association between incarceration and premature mortality. This study examined the risk of male premature mortality associated with incarceration. Data came from the Izhevsk (Russia) Family Study, a large-scale population-based case-control design. Cases (n = 1,750) were male deaths aged 25 to 54 in Izhevsk between October 2003 and October 2005. Controls (n = 1,750) were selected at random from a city population register. The key independent variable was lifetime prevalence of incarceration. I used logistic regression to estimate mortality odds ratios, controlling for age, hazardous drinking, smoking status, marital status, and education. Seventeen percent of cases and 5 percent of controls had been incarcerated. Men who had been incarcerated were more than twice as likely as those who had not to experience premature mortality (odds ratio = 2.2, 95 percent confidence interval: 1.6-3.0). Relative to cases with no prior incarceration, cases who had been incarcerated were more likely to die from infectious diseases, respiratory diseases, non-alcohol-related accidental poisonings, and homicide. Taken together with other recent research, these results from a rigorous case-control design reveal not only that incarceration has durable effects on illness, but that its consequences extend to a greater risk of early death. I draw on the sociology of health literature on exposure, stress, and social integration to speculate about the reasons for this mortality penalty of incarceration. © American Sociological Association 2014.

  13. Increased Risk of Acute Cholecystitis in Patients with Spinal cord injury: A Nationwide Population-Based Cohort Study.

    Hsu, Cherng-Lan; Wang, Mei-Ting; Ho, Yu-Chun; Pan, Shin-Liang

    2017-10-31

    Retrospective cohort study. To evaluate the risk of acute cholecystitis (AC) in patients with spinal cord injury (SCI) based on a nationwide sample. Prior research evaluating the risk of AC in patients with SCI is limited. Moreover, since most previous studies on the association between AC and SCI used case-series designs, little is known about the relative risk of SCI patients developing AC from a longitudinal follow-up, compared with individuals without SCI. We used the data from Taiwan's National Health Insurance Research Database. The SCI group consisted of 11523 patients with SCI aged between 20 to 90 years. Propensity score matching procedure was employed to minimize potential confounding effects arising from the imbalance in the baseline characteristics. A total of 23046 propensity score-matched patients without SCI were enrolled in the non-SCI group. We compared the incidence of AC between these two groups, and assessed the impact of SCI on the risk of developing AC. In the SCI and non-SCI groups, the respective incidence rates of AC were 36.9 (95% confidence interval [CI], 30.0 to 44.8) and 25.2 (95% CI, 21.2 to 29.8) per 10000 person-years. As compared to the non-SCI group, the hazard ratio for the SCI group of AC was 1.71 (95% CI, 1.22 to 2.41, P = 0.0018); and the cumulative incidence of AC of the SCI group was higher than that of the non-SCI group (P = 0.0036). This population-based cohort study showed that there was an increased risk of AC in patients with SCI. 3.

  14. Clinical evaluation of a novel population-based regression analysis for detecting glaucomatous visual field progression.

    Kovalska, M P; Bürki, E; Schoetzau, A; Orguel, S F; Orguel, S; Grieshaber, M C

    2011-04-01

    The distinction of real progression from test variability in visual field (VF) series may be based on clinical judgment, on trend analysis based on follow-up of test parameters over time, or on identification of a significant change related to the mean of baseline exams (event analysis). The aim of this study was to compare a new population-based method (Octopus field analysis, OFA) with classic regression analyses and clinical judgment for detecting glaucomatous VF changes. 240 VF series of 240 patients with at least 9 consecutive examinations available were included into this study. They were independently classified by two experienced investigators. The results of such a classification served as a reference for comparison for the following statistical tests: (a) t-test global, (b) r-test global, (c) regression analysis of 10 VF clusters and (d) point-wise linear regression analysis. 32.5 % of the VF series were classified as progressive by the investigators. The sensitivity and specificity were 89.7 % and 92.0 % for r-test, and 73.1 % and 93.8 % for the t-test, respectively. In the point-wise linear regression analysis, the specificity was comparable (89.5 % versus 92 %), but the sensitivity was clearly lower than in the r-test (22.4 % versus 89.7 %) at a significance level of p = 0.01. A regression analysis for the 10 VF clusters showed a markedly higher sensitivity for the r-test (37.7 %) than the t-test (14.1 %) at a similar specificity (88.3 % versus 93.8 %) for a significant trend (p = 0.005). In regard to the cluster distribution, the paracentral clusters and the superior nasal hemifield progressed most frequently. The population-based regression analysis seems to be superior to the trend analysis in detecting VF progression in glaucoma, and may eliminate the drawbacks of the event analysis. Further, it may assist the clinician in the evaluation of VF series and may allow better visualization of the correlation between function and structure owing to VF

  15. A population-based study on alcohol and high-risk sexual behaviors in Botswana.

    Sheri D Weiser

    2006-10-01

    Full Text Available In Botswana, an estimated 24% of adults ages 15-49 years are infected with HIV. While alcohol use is strongly associated with HIV infection in Africa, few population-based studies have characterized the association of alcohol use with specific high-risk sexual behaviors.We conducted a cross-sectional, population-based study of 1,268 adults from five districts in Botswana using a stratified two-stage probability sample design. Multivariate logistic regression was used to assess correlates of heavy alcohol consumption (>14 drinks/week for women, and >21 drinks/week for men as a dependent variable. We also assessed gender-specific associations between alcohol use as a primary independent variable (categorized as none, moderate, problem and heavy drinking and several risky sex outcomes including: (a having unprotected sex with a nonmonogamous partner; (b having multiple sexual partners; and (c paying for or selling sex in exchange for money or other resources. Criteria for heavy drinking were met by 31% of men and 17% of women. Adjusted correlates of heavy alcohol use included male gender, intergenerational relationships (age gap > or =10 y, higher education, and living with a sexual partner. Among men, heavy alcohol use was associated with higher odds of all risky sex outcomes examined, including unprotected sex (AOR = 3.48; 95% confidence interval [CI], 1.65 to 7.32, multiple partners (AOR = 3.08; 95% CI, 1.95 to 4.87, and paying for sex (AOR = 3.65; 95% CI, 2.58 to 12.37. Similarly, among women, heavy alcohol consumption was associated with higher odds of unprotected sex (AOR = 3.28; 95% CI, 1.71 to 6.28, multiple partners (AOR = 3.05; 95% CI, 1.83 to 5.07, and selling sex (AOR = 8.50; 95% CI, 3.41 to 21.18. A dose-response relationship was seen between alcohol use and risky sexual behaviors, with moderate drinkers at lower risk than both problem and heavy drinkers.Alcohol use is associated with multiple risks for HIV transmission among both men

  16. The prevalence of amblyopia in Germany: data from the prospective, population-based Gutenberg Health Study.

    Elflein, Heike M; Fresenius, Susanne; Lamparter, Julia; Pitz, Susanne; Pfeiffer, Norbert; Binder, Harald; Wild, Philipp; Mirshahi, Alireza

    2015-05-08

    Amblyopia is due to insufficient development of the visual system in early childhood and is a major source of lifelong impairment of visual acuity. Too little is known about the prevalence of amblyopia in Germany and the frequency of its various causes. The Gutenberg Health Study of the University of Mainz Faculty of Medicine is an ongoing population-based, prospective, monocentric cohort study with 15 010 participants aged 35 to 74. All participants are examined for the presence of ocular, cardiovascular, neoplastic, metabolic, immunologic, and mental diseases. 3227 participants aged 35 to 44 underwent ophthalmological examination from 2007 to 2012. Amblyopia was defined as impaired visual acuity in the absence of any organic pathology capable of explaining the condition, and in the presence of a known risk factor for amblyopia. Amblyopia, when defined as a visual acuity less than or equal to 0.63, was present in 182 participants (5.6%, 95% confidence interval [CI] 4.9-6.5%), 120 of whom had a visual acuity less than or equal to 0.5 (3.7%, 95% CI 3.3-5.2%). A narrower definition of amblyopia requiring, in addition, an interocular difference in acuity of at least two lines yielded slightly lower prevalence figures: 5.0% (95% CI 4.2-5.8%) and 3.7% (95% CI 3.1-4.4%), respectively. The causes of amblyopia (visual acuity ≤ 0.63) were anisometropia (different refractive strengths of the two eyes) in 49% of participants, strabismus (a squint) in 23%, both of these factors in 17%, and visual deprivation in 2%. 3 patients (2%) had relative amblyopia due to a traumatic cataract sustained in early childhood. 7% of the participants with amblyopia had binocular amblyopia. This study yielded a prevalence figure of 5.6% for amblyopia in Germany-a higher figure than in other, comparable population-based studies, which have generally yielded figures of ca. 3% for visual acuity ≤ 0.63. The distribution of the causes of amblyopia is similar across studies.

  17. Perceived weight discrimination in England: a population-based study of adults aged ⩾50 years.

    Jackson, S E; Steptoe, A; Beeken, R J; Croker, H; Wardle, J

    2015-05-01

    Despite a wealth of experimental studies on weight bias, little is known about weight discrimination at the population level. This study examined the prevalence and socio-demographic correlates of perceived weight discrimination in a large population-based sample of older adults. Data were from 5307 adults in the English Longitudinal Study of Ageing; a population-based cohort of men and women aged ⩾50 years. Weight discrimination was reported for five domains (less respect/courtesy; treated as less clever; poorer treatment in medical settings; poorer service in restaurants/stores; threatened/harassed) at wave 5 (2010-2011). Height and weight were measured at wave 4 (2008-2009). We used logistic regression to test the odds of weight discrimination in relation to weight status, age, sex, wealth, education and marital status. Perceived weight discrimination in any domain was reported by 4.6% of participants, ranging from 0.8% in the normal-weight participants through 0.9, 6.7, 24.2 and 35.1% in individuals who were overweight or met criteria for class I, II and III obesity. Overall, and in each situation, odds of perceived weight discrimination were higher in younger and less wealthy individuals. There was no interaction between weight status and any socio-demographic variable. Relative to normal-weight participants, odds ratios for any perceived weight discrimination were 1.13 (95% confidence interval 0.53-2.40) in those who were overweight, 8.86 (4.65-16.88) in those with class I obesity, 35.06 (18.30-67.16) in class II obese and 56.43 (27.72-114.87) in class III obese. Our results indicate that rates of perceived weight discrimination are comparatively low in individuals who are overweight or have class I obesity, but for those with class II/III obesity, >10% had experienced discrimination in each domain, and >20% had been treated with less respect or courtesy. These findings have implications for public policy and highlight the need for effective interventions

  18. Cancer survival in Cixian of China, 2003-2013: a population-based study.

    Li, Dongfang; Li, Daojuan; Song, Guohui; Liang, Di; Chen, Chao; Zhang, Yachen; Gao, Zhaoyu; He, Yutong

    2018-04-01

    Cixian is one of the high-risk areas for upper gastrointestinal cancer in China and the world. From 2005, comprehensive population-based screening for upper gastrointestinal cancers has been conducted in Cixian. The aim of this study was to investigate population-based cancer survival from 2003 to 2013 and to explore the effect of screening on upper gastrointestinal cancer survival in Cixian. Observed survival was estimated using the life table method. The expected survival from the general population was calculated using all-cause mortality data from the population of Cixian with the EdererII method. Cixian cancer registry, with a total coverage of 6.88 million person years, recorded 19,628 cancer patients diagnosed during 2003-2013. In Cixian, from 2003 to 2013, there were 19,628 newly cancer cases and 13,984 cancer deaths, with an incidence rate of 285.37/100,000 and mortality rate of 203.31/100,000. The overall five-year relative cancer survival for patients diagnosed in Cixian in 2003-2013 was 22.53%. The relative survival for all cancers combined in Cixian had an overall upward trend from 2003 to 2013. Among upper gastrointestinal cancer in Cixian, the five-year relative survival for cardia gastric cancer was highest at 30.42%, followed by oesophageal cancer at 25.37% and noncardia gastric cancer at 18.93%. In 2013, the five-year relative survival for oesophageal cancer, cardia gastric cancer, and noncardia gastric cancer patients aged 45-69 years was 39.97% (95% CI: 34.52-45.43%), 51.74% (95% CI: 42.09-60.86%), and 37.43% (95% CI: 26.93-48.17%), respectively, the absolute values increasing 14.11%, 16.71%, and 14.92% compared with that in 2003. There is an increasing trend in overall survival for upper gastrointestinal cancer with early screening and treatment of cancer in Cixian. © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  19. Necrotizing Fasciitis Associated with Pregnancy: a Population-Based Cohort Study.

    Oud, Lavi; Watkins, Phillip

    2014-12-01

    Necrotizing fasciitis (NF) is a rare complication in pregnant women. There have been no population-level data reported to date on its epidemiology, clinical features, resource utilization, and outcomes. This was a retrospective, population-based cohort study, using the Texas Inpatient Public Use Data File to identify pregnancy-associated hospitalizations for the years 2001-2010. Hospitalizations with a diagnosis of NF were then identified using the International Classification of Diseases, Ninth Revision, Clinical Modification code 728.86. Denominator data for incidence estimates were derived from the Texas Center for Health Statistics reports of live births, abortions and fetal deaths, and previously reported population-based, age-specific linkage data on miscarriage, and were used to estimate the annual total number of pregnancies (TEP). The incidence of pregnancy-associated NF (PANF), hospitalization type, clinical features, resource utilization and outcomes were examined. There were 4,060,201 pregnancy-associated hospitalizations and 148 PANF hospitalizations during study period. Postpartum hospitalizations accounted for 82.4% of all PANF events, and intensive care unit care was required in 61.5%. The key trends noted between 2001-2002 and 2009-2010 included rising incidence of PANF from 1.1 vs. 3.8 per 100,000 TEP-years (P = 0.0001), chronic comorbidities 0% vs. 31.7% (P = 0.0777), and development of organ failure in 9.1% vs. 31.7% (P = 0.0302). There was no significant change in total hospital charges or hospital length of stay. Three patients (2%) died in the hospital and 55% of survivors had routine home discharge. The present cohort of PANF is the largest reported to date. The incidence of PANF rose nearly 3.5-fold over the past decade, with most events developing following delivery hospitalization. Chronic illness has been increasingly present, along with rising severity of illness. The majority of patients required ICU care. Hospital mortality was

  20. Bone metastasis pattern in initial metastatic breast cancer: a population-based study

    Xiong Z

    2018-02-01

    Full Text Available Zhenchong Xiong,1–3,* Guangzheng Deng,1–3,* Xinjian Huang,1–3,* Xing Li,1–3 Xinhua Xie,1–3 Jin Wang,1–3 Zeyu Shuang,1–3 Xi Wang1–3 1Department of Breast Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China; 2State Key Laboratory of Oncology in Southern China, Guangzhou, China; 3Collaborative Innovation Center for Cancer Medicine, Guangzhou, China *These authors contributed equally to this work Purpose: Bone is one of the most common sites of breast cancer metastasis, and population-based studies of patients with bone metastasis in initial metastatic breast cancer (MBC are lacking. Materials and methods: From 2010 to 2013, 245,707 breast cancer patients and 8901 patients diagnosed with initial bone metastasis were identified by Surveillance, Epidemiology, and End Results database of the National Cancer Institute. Multivariate logistic and Cox regression were used to identify predictive factors for the presence of bone metastasis and prognosis factors. Kaplan–Meier method and log-rank test were used for survival analysis. Results: Eight thousand nine hundred one patients with initial MBC had bone involvement, accounting for 3.6% of the entire cohort and 62.5% of the patients with initial MBC. Also, 70.5% of patients with bone metastasis were hormone receptor (HR positive (HR+/human epidermal growth factor receptor 2 [HER2]−: 57.6%; HR+/HER2+: 12.9%. Patients with initial bone metastasis had a better 5-year survival rate compared to those with initial brain, liver, or lung metastasis. HR+/HER2− and HR+/HER2+ breast cancer had a propensity of bone metastasis in the entire cohort and were correlated with better prognosis in patients with initial bone metastasis. Local surgery had significantly improved overall survival in initial MBC patients with bone metastasis. Conclusion: Our study has provided population-based estimates of epidemiologic characteristics and prognosis in patients with bone metastasis at the time of

  1. Falls among the elderly: risk factors in a population-based study.

    Rodrigues, Iara Guimarães; Fraga, Gustavo Pereira; Barros, Marilisa Berti de Azevedo

    2014-01-01

    The aim of the present study was to identify factors associated with the occurrence of falls among elderly adults in a population-based study (ISACamp 2008). A population-based cross-sectional study was carried out with two-stage cluster sampling. The sample was composed of 1,520 elderly adults living in the urban area of the city of Campinas, São Paulo, Brazil. The occurrence of falls was analyzed based on reports of the main accident occurred in the previous 12 months. Data on socioeconomic/demographic factors and adverse health conditions were tested for possible associations with the outcome. Prevalence ratios (PR) were estimated and adjusted for gender and age using the Poisson multiple regression analysis. Falls were more frequent, after adjustment for gender and age, among female elderly participants (PR = 2.39; 95% confidence interval (95% CI) 1.47 - 3.87), elderly adults (80 years old and older) (PR = 2.50; 95% CI 1.61 - 3.88), widowed (PR = 1.74; 95% CI 1.04 - 2.89) and among elderly adults who had rheumatism/arthritis/arthrosis (PR = 1.58; 95% CI 1.00 - 2.48), osteoporosis (PR = 1.71; 95% CI 1.18 - 2.49), asthma/bronchitis/emphysema (PR = 1,73; 95% CI 1.09 - 2.74), headache (PR = 1.59; 95% CI 1.07 - 2.38), mental common disorder (PR = 1.72; 95% CI 1.12 - 2.64), dizziness (PR = 2.82; 95% CI 1.98 - 4.02), insomnia (PR = 1.75; 95% CI 1.16 - 2.65), use of multiple medications (five or more) (PR = 2.50; 95% CI 1.12 - 5.56) and use of cane/walker (PR = 2.16; 95% CI 1.19 - 3,93). The present study shows segments of the elderly population who are more prone to falls through the identification of factors associated with this outcome. The findings can contribute to the planning of public health policies and programs addressed to the prevention of falls.

  2. Falls among the elderly: risk factors in a population-based study

    Iara Guimarães Rodrigues

    2014-09-01

    Full Text Available Purpose: The aim of the present study was to identify factors associated with the occurrence of falls among elderly adults in a population-based study (ISACamp 2008. Methods: A population-based cross-sectional study was carried out with two-stage cluster sampling. The sample was composed of 1,520 elderly adults living in the urban area of the city of Campinas, São Paulo, Brazil. The occurrence of falls was analyzed based on reports of the main accident occurred in the previous 12 months. Data on socioeconomic/demographic factors and adverse health conditions were tested for possible associations with the outcome. Prevalence ratios (PR were estimated and adjusted for gender and age using the Poisson multiple regression analysis. Results: Falls were more frequent, after adjustment for gender and age, among female elderly participants (PR = 2.39; 95% confidence interval (95%CI 1.47 - 3.87, elderly adults (80 years old and older (PR = 2.50; 95%CI 1.61 - 3.88, widowed (PR = 1.74; 95%CI 1.04 - 2.89 and among elderly adults who had rheumatism/arthritis/arthrosis (PR = 1.58; 95%CI 1.00 - 2.48, osteoporosis (PR = 1.71; 95%CI 1.18 - 2.49, asthma/bronchitis/emphysema (PR = 1,73; 95%CI 1.09 - 2.74, headache (PR = 1.59; 95%CI 1.07 - 2.38, mental common disorder (PR = 1.72; 95%CI 1.12 - 2.64, dizziness (PR = 2.82; 95%CI 1.98 - 4.02, insomnia (PR = 1.75; 95%CI 1.16 - 2.65, use of multiple medications (five or more (PR = 2.50; 95%CI 1.12 - 5.56 and use of cane/walker (PR = 2.16; 95%CI 1.19 - 3,93. Conclusion: The present study shows segments of the elderly population who are more prone to falls through the identification of factors associated with this outcome. The findings can contribute to the planning of public health policies and programs addressed to the prevention of falls.

  3. Emergency Department Length of Stay for Critical Care Admissions. A Population-based Study.

    Rose, Louise; Scales, Damon C; Atzema, Clare; Burns, Karen E A; Gray, Sara; Doing, Christina; Kiss, Alex; Rubenfeld, Gordon; Lee, Jacques S

    2016-08-01

    Hospital emergency department (ED) strain is common in North America. Excessive strain may result in prolonged ED length of stay and may lead to worse outcomes for patients admitted to intensive care units (ICUs). To describe patient, ED, and hospital characteristics associated with prolonged ED length of stay for adult patients admitted from EDs to ICUs. We conducted a population-based cohort study in the Province of Ontario, Canada, including patients admitted to an adult ICU from an ED and excluding only interhospital transfers and scheduled visits. Using regression modeling, we examined associations between patient- and hospital-level characteristics and two ED performance measures: length of stay in the ED of more than 6 hours and 90-day mortality. From April 2007 to March 2012, 261,274 adults presented to 118 EDs in Ontario, generating 314,836 ICU admissions. This activity represented 4.1% of all adult ED visits (incidence, 1,374 ICU admissions/100,000 ED visits). Median (interquartile range) ED length of stay was 7 (4-13) hours. Less than half (41.4%; 95% confidence interval [CI], 41.2-41.5) of these patients had an ED length of stay of 6 hours or less, whereas 10.5% (95% CI, 10.4-10.6) stayed 24 hours or longer. Hospital characteristics associated with ED length of stay more than 6 hours included shift-level ED crowding (mean length of stay of patients of similar acuity registering during same 8 h epoch) (odds ratio [OR], 1.19/h; 95% CI, 1.19-1.19), ED annual visit volume (OR, 1.01/1,000 patients; 95% CI, 1.01-1.01), time of ED presentation (00:00-07:59) (OR, 1.41; 95% CI, 1.38-1.45), and ICU functioning at greater than 20% above the average annual census (OR, 1.10; 95% CI, 1.08-1.12). ED length of stay more than 6 hours was not associated with 90-day mortality after adjustment for selected confounders (OR, 0.99; 95% CI, 0.97-1.02). In this population-based study, less than half of adult ED patients were admitted to an ICU 6 hours or less after arrival to

  4. Monthly Fluctuations of Insomnia Symptoms in a Population-Based Sample

    Morin, Charles M.; LeBlanc, M.; Ivers, H.; Bélanger, L.; Mérette, Chantal; Savard, Josée; Jarrin, Denise C.

    2014-01-01

    Study Objectives: To document the monthly changes in sleep/insomnia status over a 12-month period; to determine the optimal time intervals to reliably capture new incident cases and recurrent episodes of insomnia and the likelihood of its persistence over time. Design: Participants were 100 adults (mean age = 49.9 years; 66% women) randomly selected from a larger population-based sample enrolled in a longitudinal study of the natural history of insomnia. They completed 12 monthly telephone interviews assessing insomnia, use of sleep aids, stressful life events, and physical and mental health problems in the previous month. A total of 1,125 interviews of a potential 1,200 were completed. Based on data collected at each assessment, participants were classified into one of three subgroups: good sleepers, insomnia symptoms, and insomnia syndrome. Results: At baseline, 42 participants were classified as good sleepers, 34 met criteria for insomnia symptoms, and 24 for an insomnia syndrome. There were significant fluctuations of insomnia over time, with 66% of the participants changing sleep status at least once over the 12 monthly assessments (51.5% for good sleepers, 59.5% for insomnia syndrome, and 93.4% for insomnia symptoms). Changes of status were more frequent among individuals with insomnia symptoms at baseline (mean = 3.46, SD = 2.36) than among those initially classified as good sleepers (mean = 2.12, SD = 2.70). Among the subgroup with insomnia symptoms at baseline, 88.3% reported improved sleep (i.e., became good sleepers) at least once over the 12 monthly assessments compared to 27.7% whose sleep worsened (i.e., met criteria for an insomnia syndrome) during the same period. Among individuals classified as good sleepers at baseline, risks of developing insomnia symptoms and syndrome over the subsequent months were, respectively, 48.6% and 14.5%. Monthly assessment over an interval of 6 months was found most reliable to estimate incidence rates, while an

  5. Association between osteoporosis and urinary calculus: evidence from a population-based study.

    Keller, J J; Lin, C-C; Kang, J-H; Lin, H-C

    2013-02-01

    This population-based case-control analysis investigated the association between osteoporosis and prior urinary calculus (UC) in Taiwan. We succeeded in detecting an association between osteoporosis and prior UC (adjusted odds ratio = 1.66). This association was consistent and significant regardless of stone location. UC has been demonstrated to be a risk factor for osteoporotic fractures, but no studies to date have directly investigated the association between UC and osteoporosis. This case-control analysis aimed to investigate the association of osteoporosis with prior UC using a population-based dataset in Taiwan. We first identified 39,840 cases ≥40 years who received their first-time diagnosis of osteoporosis between 2002 and 2009 and then randomly selected 79,680 controls. We used conditional logistic regression analyses to compute the odds ratio (OR) and the corresponding 95 % confidence interval (CI) for having been previously diagnosed with UC between cases and controls. The OR of having been previously diagnosed with UC for patients with osteoporosis was 1.66 (95 % CI = 1.59-1.73) when compared to controls after adjusting for geographic location, urbanization level, type I diabetes mellitus, coronary heart disease, hyperlipidemia, rheumatoid arthritis, stroke, renal disease, Parkinson's disease, hyperthyroidism, chronic hepatopathy, Cushing's syndrome, malabsorption, gastrectomy, obesity, and alcohol abuse/alcohol dependence syndrome. The results consistently showed that osteoporosis was significantly associated with a previous diagnosis of UC regardless of stone location; the adjusted ORs of prior kidney calculus, ureter calculus, bladder calculus, and unspecified calculus when compared to controls were 1.71 (95 % CI = 1.61-1.81), 1.60 (95 % CI = 1.47-1.74), 1.59 (95 % CI = 1.23-2.04), and 1.69 (95 % CI = 1.59-1.80), respectively. This study succeeded in detecting an association between osteoporosis and prior UC. In addition

  6. Excessive daytime sleepiness and body composition: a population-based study of adults.

    Amie C Hayley

    Full Text Available BACKGROUND: Excessive daytime sleepiness (EDS is often associated with increased adiposity, particularly when assessed in the context of samples of sleep-disordered patients; however, it is unclear if this relationship is sustained among non-clinical, population-based cohorts. This study aimed to investigate the relationship between EDS and a number of body composition markers among a population-based sample of men and women. METHODS: This study assessed 1066 women aged 21-94 yr (median = 51 yr, IQR 35-66, and 911 men aged 24-92 yr (median = 60 yr, IQR 46-73 who participated in the Geelong Osteoporosis Study (GOS between the years 2001 and 2008. Total body fat mass was determined from whole body dual-energy X-ray absorptiometry scans, and anthropometric parameters (weight, height, and waist circumference were measured. Lifestyle and health information was collected via self-report. Sleepiness was assessed using the Epworth Sleepiness Scale (ESS. Scores of ≥ 10 were considered indicative of EDS. RESULTS: Women: After adjusting for age, alcohol intake, antidepressant medication use and physical activity, EDS was associated with greater waist circumference and body mass index (BMI. EDS was also associated with 1.5-1.6-fold increased odds of being overweight or obese. Men: After adjusting for age, alcohol use, physical activity and smoking status, EDS was associated with greater BMI. These findings were not explained by the use of sedative or antidepressant medication. EDS was also associated with 1.5-fold increased likelihood of being obese, independent of these factors. No differences in lean mass, %body fat, or %lean mass were detected between those with and without EDS for men or women. CONCLUSIONS: These data suggest that EDS is associated with several anthropometric adiposity profiles, independent of associated lifestyle and health factors. Among women, symptoms of EDS are pervasive at both overweight and obese BMI classifications

  7. Familial aggregation of Parkinson’s disease and coaggregation with neuropsychiatric diseases: a population-based cohort study

    Liu FC

    2018-05-01

    Full Text Available Fu-Chao Liu,1,2,* Huan-Tang Lin,1,2,* Chang-Fu Kuo,2–4 Mei-Yun Hsieh,4 Lai-Chu See,3,5,6 Huang-Ping Yu1,2,7 1Department of Anesthesiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; 2College of Medicine, Chang Gung University, Taoyuan, Taiwan; 3Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; 4Office for Big Data Research, Chang Gung Memorial Hospital, Taoyuan, Taiwan; 5Department of Public Health, College of Medicine, Chang Gung University, Taoyuan, Taiwan; 6Biostatistics Core Laboratory, Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan; 7Department of Anesthesiology, Xiamen Changgung Hospital, Xiamen, China *These authors contributed equally to this work Background: Individuals with a family history of Parkinson’s disease (PD appear to have a higher risk of developing PD and other neuropsychiatric diseases. However, estimates of the relative risks (RRs of PD and the roles of genetic and environmental factors in PD susceptibility are unclear. The aim of this study was to examine familial aggregation and genetic contributions to PD and the RRs of other neuropsychiatric diseases in relatives of PD patients. Methods: In this population-based family cohort study, the records of all individuals actively registered in the Taiwan National Health Insurance Research Database in 2015 were queried (N=24,349,599. In total, 149,187 individuals with a PD-affected parent, 3,698 with an affected offspring, 3,495 with an affected sibling, and 15 with an affected twin were identified. Diagnoses of PD were ascertained between January 1, 1999, and December 31, 2015. The prevalence and RRs of PD and other neuropsychiatric diseases in individuals with first-degree relatives with PD, as well as the contributions of heritability and environmental factors to PD susceptibility were investigated. Results: The prevalence of PD was 0.46% in the general population and 0.52% in individuals with

  8. Research

    A descriptive qualitative research design was used to determine whether participants ... simulation as a teaching method; a manikin offering effective learning; confidence ..... Tesch R. Qualitative Research: Analysis Types and Software Tools.

  9. Association between benzodiazepines and recurrent falls: a cross-sectional elderly population-based study.

    Rossat, A; Fantino, B; Bongue, B; Colvez, A; Nitenberg, C; Annweiler, C; Beauchet, O

    2011-01-01

    While the association between benzodiazepines (BZD) and single fall is long-known, the association between BZD and recurrent falls has been few studied. The aims of this study were 1) to examine whether BZD were associated with recurrent falls while taking into account the effect of potential confounders, and 2) to determine whether there was an interaction in terms of risk of falls between BZD and balance impairment in a community-dwelling population-based adults aged 65 and older. Cross-sectional. Three health centers in North-East of France. 7643 community-dwelling volunteers aged 65 and older. The use of BZD, the Mini Mental State Examination (MMSE) score, the Clock Drawing Test (CDT), the One Leg Balance (OLB) test, the Five Times Sit-To-Stand test (FTSS), and a history of falls were recorded. Subjects were separated into 4 groups based on the number of falls: 0, 1, 2 and ≥ 3 falls. Among the 1456 (19.2%) fallers, 994 (13.0%) were single fallers and 462 (6.1%) were recurrent fallers (i.e., > 2 falls). The number of falls increased significantly with age (Incident Rate Ratio (IRR)=1.04, P falls. After adjustment only the advance in age (IRR=1.02, P falls. The current study shows that the age, the female gender, the use of clobazam or prazepam and a low score at OLB are related to the recurrence of falls.

  10. Is the age at menopause a cause of sexual dysfunction? A Brazilian population-based study.

    Lett, Caio; Valadares, Ana L R; Baccaro, Luiz F; Pedro, Adriana O; Filho, Jeffrey L; Lima, Marcelo; Costa-Paiva, Lucia

    2018-01-01

    The aim of the study was to evaluate the association between age at menopause and sexual dysfunction and the components of sexual function in postmenopausal women. In this cross-sectional population-based study, data of 540 women aged 45 to 60 years regarding the age they were when they achieved menopause and its association with sexual dysfunction (evaluated using the Short Personal Experiences Questionnaire) were obtained through interviews. We assessed the data for associations between age at menopause and sexual dysfunction and demographic, behavioral, and clinical characteristics. Age at menopause was not associated with sexual dysfunction. Arousal (dysfunction) was the only component of sexual function that was associated with premature ovarian insufficiency (POI) and early menopause (P = 0.01). It was reported by 64.2% of women with POI (women 45 years, respectively (P = 0.04). In women with POI or early menopause, Poisson regression analysis showed that having a partner with sexual problems (prevalence ratio [PR] = 6.6; 95% CI: 3.3-13,2; P POI. The major factors affecting this association were having a partner with sexual problems, dyspareunia, and no satisfaction with the partner as a lover. These findings highlight the importance of evaluating partner problems and improving lubrication in these groups of women.

  11. Association of dietary and supplemental iron and colorectal cancer in a population-based study.

    Ashmore, Joseph H; Lesko, Samuel M; Miller, Paige E; Cross, Amanda J; Muscat, Joshua E; Zhu, Junjia; Liao, Jason; Harper, Gregory; Lazarus, Philip; Hartman, Terryl J

    2013-11-01

    We evaluated the role of dietary iron, heme iron, and supplemental iron on colorectal cancer (CRC) risk in a population-based case-control study in Pennsylvania, including 1005 incident cases and 1062 controls. Diet was assessed through a modified food frequency questionnaire that included supplement use and a meat-specific module. Cases reported intakes for the year before diagnosis, whereas controls reported intakes for the year before interview. Heme iron intake was calculated using a new heme database developed by the US National Cancer Institute. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression. After multivariate adjustment, there were no significant associations between heme iron or total iron intake and CRC incidence. Dietary iron intake was inversely associated with CRC among women (OR Q5 vs. Q1=0.45; 95% CI=0.22-0.92), but not among men. Supplemental iron intake of more than 18 mg/day versus none was positively associated with CRC incidence (OR=2.31; 95% CI=1.48-3.59; P-trendconsumption of more than 18 mg/day of supplemental iron may increase risk for CRC.

  12. Risk of Monozygotic Twins After Assisted Reproduction: A Population-Based Approach.

    Parazzini, Fabio; Cipriani, Sonia; Bianchi, Stefano; Bulfoni, Camilla; Bortolus, Renata; Somigliana, Edgardo

    2016-02-01

    Recent studies have suggested that ovarian stimulation and assisted reproductive techniques (ART) may increase the frequency of monozygotic twins. In this article, we present the analysis of the estimated frequency of twin deliveries following in vitro fertilization (IVF) in Lombardy during the period 2010-2014 for a total of 450,949 pregnancies. This is a population-based study using data from the regional data base of Lombardy, a northern Italian region with a population of about 10 million inhabitants. During the considered period, a total of 461,424 single or multiple births were registered in Lombardy. After exclusion of triplets or more pregnancies, the total number of twin deliveries, in separate strata of like and unlike sex pregnancies twin deliveries, were obtained and the rate of twin deliveries was computed according to spontaneous and non-spontaneous conception and type of ART. Further, estimates of dizygotic or monozygotic twin births were calculated using Weinberg's methods. The frequency of twins deliveries was 1.24/100 deliveries after natural conception and 20.05 after assisted conception. The estimated rates of monozygotic twins was 0.45 and 0.72/100 (95% CI: 0.58-0.91) deliveries after natural and assisted conception, respectively. This difference was statistically significant (p assisted than after natural conception.

  13. Wealth Inequality and Mental Disability Among the Chinese Population: A Population Based Study

    Wang, Zhenjie; Du, Wei; Pang, Lihua; Zhang, Lei; Chen, Gong; Zheng, Xiaoying

    2015-01-01

    In the study described herein, we investigated and explored the association between wealth inequality and the risk of mental disability in the Chinese population. We used nationally represented, population-based data from the second China National Sample Survey on Disability, conducted in 2006. A total of 1,724,398 study subjects between the ages of 15 and 64, including 10,095 subjects with mental disability only, were used for the analysis. Wealth status was estimated by a wealth index that was derived from a principal component analysis of 10 household assets and four other variables related to wealth. Logistic regression analysis was used to estimate the odds ratio (OR) and 95% confidence interval (CI) for mental disability for each category, with the lowest quintile category as the referent. Confounding variables under consideration were age, gender, residence area, marital status, ethnicity, education, current employment status, household size, house type, homeownership and living arrangement. The distribution of various types and severities of mental disability differed significantly by wealth index category in the present population. Wealth index category had a positive association with mild mental disability (p for trend wealth index category had a significant, inverse association with mental disability when all severities of mental disability were taken into consideration. This study’s results suggest that wealth is a significant factor in the distribution of mental disability and it might have different influences on various types and severities of mental disability. PMID:26492258

  14. Sexual violence, mood disorders and suicide risk: a population-based study

    Thaíse Campos Mondin

    2016-03-01

    Full Text Available Abstract This article seeks to analyze the association between sexual violence, manic and depressive episodes, and suicide risk among young adults. This is a cross-sectional population-based study carried out with young people between 18 and 24 years of age in a town in southern Brazil. The sample was selected through clusters. The prevalence of sexual violence, manic, depressive and mixed episodes and suicide risk were evaluated, as well as the association between them. The chi-square test and Poisson regression were used for statistical analysis. The study sample comprised 1,560 subjects. Among these, 3.1% had suffered sexual violence at some point in their life. The prevalence of depressive, mixed episodes, and (hypomanic episodes were 10%, 2.4% and 2.3%, respectively. Suicide risk had a prevalence of 8.6% in the total sample. Young people who have suffered sexual violence are more likely to be subject to mood changes or suicide risk than those who have not (p < 0.05, except for the occurrence of (hypomanic episodes. These results revealed a strong association between sexual violence and depressive and mixed episodes and suicide risk.

  15. Predicting Successful Aging in a Population-Based Sample of Georgia Centenarians

    Arnold, Jonathan; Dai, Jianliang; Nahapetyan, Lusine; Arte, Ankit; Johnson, Mary Ann; Hausman, Dorothy; Rodgers, Willard L.; Hensley, Robert; Martin, Peter; MacDonald, Maurice; Davey, Adam; Siegler, Ilene C.; Jazwinski, S. Michal; Poon, Leonard W.

    2010-01-01

    Used a population-based sample (Georgia Centenarian Study, GCS), to determine proportions of centenarians reaching 100 years as (1) survivors (43%) of chronic diseases first experienced between 0–80 years of age, (2) delayers (36%) with chronic diseases first experienced between 80–98 years of age, or (3) escapers (17%) with chronic diseases only at 98 years of age or older. Diseases fall into two morbidity profiles of 11 chronic diseases; one including cardiovascular disease, cancer, anemia, and osteoporosis, and another including dementia. Centenarians at risk for cancer in their lifetime tended to be escapers (73%), while those at risk for cardiovascular disease tended to be survivors (24%), delayers (39%), or escapers (32%). Approximately half (43%) of the centenarians did not experience dementia. Psychiatric disorders were positively associated with dementia, but prevalence of depression, anxiety, and psychoses did not differ significantly between centenarians and an octogenarian control group. However, centenarians were higher on the Geriatric Depression Scale (GDS) than octogenarians. Consistent with our model of developmental adaptation in aging, distal life events contribute to predicting survivorship outcome in which health status as survivor, delayer, or escaper appears as adaptation variables late in life. PMID:20885919

  16. The full moon and motorcycle related mortality: population based double control study.

    Redelmeier, Donald A; Shafir, Eldar

    2017-12-11

    To test whether a full moon contributes to motorcycle related deaths. Population based, individual level, double control, cross sectional analysis. Nighttime (4 pm to 8 am), United States. 13 029 motorcycle fatalities throughout the United States, 1975 to 2014 (40 years). Motorcycle fatalities during a full moon. 13 029 motorcyclists were in fatal crashes during 1482 relevant nights. The typical motorcyclist was a middle aged man (mean age 32 years) riding a street motorcycle with a large engine in a rural location who experienced a head-on frontal impact and was not wearing a helmet. 4494 fatal crashes occurred on the 494 nights with a full moon (9.10/night) and 8535 on the 988 control nights without a full moon (8.64/night). Comparisons yielded a relative risk of 1.05 associated with the full moon (95% confidence interval 1.02 to 1.09, P=0.005), a conditional odds ratio of 1.26 (95% confidence interval 1.17 to 1.37, Pmotorcycle crashes, although potential confounders cannot be excluded. An awareness of the risk might encourage motorcyclists to ride with extra care during a full moon and, more generally, to appreciate the power of seemingly minor distractions at all times. 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.

  17. Population-based worksite obesity management interventions: a qualitative case study.

    Romney, Martha C; Thomson, Erin; Kash, Kathryn

    2011-06-01

    Due to the increased prevalence of obesity and associated direct and indirect costs to employers, weight management programs have become an integral component of employer and insurer benefits plans. The programs vary in foci, scope, breadth, and implementation. The aim of this study was to explore promising employer-sponsored population-based obesity management programs. A case study that utilized a telephonic semi-structured questionnaire was conducted with small and large organizations located in different regions of the United States that had been recruited to participate. Eight employers and 1 health care advocacy coalition who met the inclusion criteria were interviewed about features of their weight management programs. The case study revealed a number of themes consistent with reports in the literature and reflecting cited best practices. Key findings include confirmation that weight management is a significant component of the wellness strategy in all participating organizations because employers are invested in population health programs and cost savings. Based upon their experience and knowledge, occupational health specialists are responsible for designing, implementing, managing, and evaluating employee health programs. Almost all employers utilize electronic media as a prominent component of wellness and disease management initiatives. Experience has shown that incentives-both financial and nonmonetary-are effective motivators for employee engagement and outcomes. However, while employers report success, favorable outcomes have been difficult to quantify.

  18. Noise Annoyance in Urban Children: A Cross-Sectional Population-Based Study

    Grelat, Natacha; Houot, Hélène; Pujol, Sophie; Levain, Jean-Pierre; Defrance, Jérôme; Mariet, Anne-Sophie; Mauny, Frédéric

    2016-01-01

    Acoustical and non-acoustical factors influencing noise annoyance in adults have been well-documented in recent years; however, similar knowledge is lacking in children. The aim of this study was to quantify the annoyance caused by chronic ambient noise at home in children and to assess the relationship between these children′s noise annoyance level and individual and contextual factors in the surrounding urban area. A cross sectional population-based study was conducted including 517 children attending primary school in a European city. Noise annoyance was measured using a self-report questionnaire adapted for children. Six noise exposure level indicators were built at different locations at increasing distances from the child′s bedroom window using a validated strategic noise map. Multilevel logistic models were constructed to investigate factors associated with noise annoyance in children. Noise indicators in front of the child′s bedroom (p ≤ 0.01), family residential satisfaction (p ≤ 0.03) and socioeconomic characteristics of the individuals and their neighbourhood (p ≤ 0.05) remained associated with child annoyance. These findings illustrate the complex relationships between our environment, how we may perceive it, social factors and health. Better understanding of these relationships will undoubtedly allow us to more effectively quantify the actual effect of noise on human health. PMID:27801858

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

    Eva M Kingma

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

  20. Shoulder pain in people with a stroke: a population-based study.

    Ratnasabapathy, Yogini; Broad, Joanna; Baskett, Jonathan; Pledger, Megan; Marshall, Jane; Bonita, Ruth

    2003-05-01

    To measure the occurrence of shoulder pain after stroke. To identify the factors that predict risk of shoulder pain after stroke. Auckland Stroke Study, population-based case-cohort study. All cases of stroke, including those managed outside hospital, over a 12-month period ending February 1992 were considered in Auckland. Self-reported shoulder pain at one week, one month and six months after the onset of stroke for each person. A total of 1,761 stroke events were identified. Self-reported shoulder pain among survivors increased from 256/1474 (17%) at one week, to 261/1,336 (20%) at one month and 284/1,201 (23%) at six months. Shoulder pain was positively associated with motor deficit, side of deficit and severity of deficit. In those surviving to six months after stroke, the risk of shoulder pain was higher in those with severe upper limb motor deficit (odds ratio (OR) 4.94; 95% confidence interval (CI) 3.06-7.98) and in diabetics (OR 1.57, 95% CI 1.15-2.14). Risk of shoulder pain increased with time and was lower for those in institutional care. Shoulder pain after stroke is common, especially in patients with severe sensorimotor deficits, diabetics and those living at home. Appropriate management may reduce the rate of occurrence.

  1. Mitochondrial dysfunction in autism spectrum disorders: a population-based study.

    Oliveira, G; Diogo, L; Grazina, M; Garcia, P; Ataíde, A; Marques, C; Miguel, T; Borges, L; Vicente, A M; Oliveira, C R

    2005-03-01

    A minority of cases of autism has been associated with several different organic conditions, including bioenergetic metabolism deficiency. In a population-based study, we screened associated medical conditions in a group of 120 children with autism (current age range 11y 5mo to 14y 4mo, mean age 12y 11mo [SD 9.6mo], male:female ratio 2.9:1). Children were diagnosed using Diagnostic and Statistical Manual of Mental Disorders criteria, the Autism Diagnostic Interview--Revised, and the Childhood Autism Rating Scale; 76% were diagnosed with typical autism and 24% with atypical autism. Cognitive functional level was assessed with the Griffiths scale and the Wechsler Intelligence Scale for Children and was in the normal range in 17%. Epilepsy was present in 19 patients. Plasma lactate levels were measured in 69 patients, and in 14 we found hyperlactacidemia. Five of 11 patients studied were classified with definite mitochondrial respiratory chain disorder, suggesting that this might be one of the most common disorders associated with autism (5 of 69; 7.2%) and warranting further investigation.

  2. Population-based estimates of whiplash injury using nass cds data - biomed 2009.

    Storvik, Steven G; Stemper, Brian D; Yoganandan, Narayan; Pintar, Frank A

    2009-01-01

    Clinical investigations identified occupant-related factors that may predispose specific populations to increased whiplash injury susceptibility. However, clinical studies represent a specific patient population and are not representative of the population at large. The present objective was to analyze nationally-representative data to assess the association between gender and whiplash in motor vehicle rear-end impacts. A cohort of front-seat occupants in rear impacts (5-7 o'clock) from 1998-2007 were acquired using the National Automotive Sampling System (NASS) Crashworthiness Data System database. Outcome measure was "cervical spine strain" without fracture or dislocation, coded as 640278.1. Differences between injured population proportions were analyzed using Chi-Square test of independence. 1,973 rear impacts were selected, representing 936,439 weighted crashes from across the United States. Females accounted for 69% of the weighted whiplash injuries, and the proportion of females sustaining whiplash was 10% higher than males. Furthermore, gender was associated with acquiring whiplash in rear impacts (odds ratio for females: 2.16; 95% confidence interval: 1.5-3.1). Although NASS data is inherently weighted toward more severe impacts (i.e., tow-away collisions), this population-based study has demonstrated increased female susceptibility to whiplash injury. The importance of gender suggests that specific safety measures for female front-seat occupants should be addressed separately from males.

  3. Ethnicity, social disadvantage and psychotic-like experiences in a healthy population based sample.

    Morgan, C; Fisher, H; Hutchinson, G; Kirkbride, J; Craig, T K; Morgan, K; Dazzan, P; Boydell, J; Doody, G A; Jones, P B; Murray, R M; Leff, J; Fearon, P

    2009-03-01

    We sought to investigate the prevalence and social correlates of psychotic-like experiences in a general population sample of Black and White British subjects. Data were collected from randomly selected community control subjects, recruited as part of the AESOP study, a three-centre population based study of first-episode psychosis. The proportion of subjects reporting one or more psychotic-like experience was 19% (n = 72/372). These were more common in Black Caribbean (OR 2.08) and Black African subjects (OR 4.59), compared with White British. In addition, a number of indicators of childhood and adult disadvantage were associated with psychotic-like experiences. When these variables were simultaneously entered into a regression model, Black African ethnicity, concentrated adult disadvantage, and separation from parents retained a significant effect. The higher prevalence of psychotic-like experiences in the Black Caribbean, but not Black African, group was explained by high levels of social disadvantage over the life course.

  4. Maternal obesity and congenital heart defects: a population-based study123

    Mills, James L; Troendle, James; Conley, Mary R; Carter, Tonia; Druschel, Charlotte M

    2010-01-01

    Background: Obesity affects almost one-third of pregnant women and causes many complications, including neural tube defects. It is not clear whether the risk of congenital heart defects, the most common malformations, is also increased. Objective: This study was conducted to determine whether obesity is associated with an increased risk of congenital heart defects. Design: A population-based, nested, case-control study was conducted in infants born with congenital heart defects and unaffected controls from the cohort of all births (n = 1,536,828) between 1993 and 2003 in New York State, excluding New York City. The type of congenital heart defect, maternal body mass index (BMI; in kg/m2), and other risk factors were obtained from the Congenital Malformations Registry and vital records. Mothers of 7392 congenital heart defect cases and 56,304 unaffected controls were studied. Results: All obese women (BMI ≥ 30) were significantly more likely than normal-weight women (BMI: 19–24.9) to have children with a congenital heart defect [odds ratio (OR): 1.15; 95% CI: 1.07, 1.23; P heart defects with increasing maternal obesity (P heart syndrome, aortic stenosis, pulmonic stenosis, and tetralogy of Fallot. Conclusions: Obese, but not overweight, women are at significantly increased risk of bearing children with a range of congenital heart defects, and the risk increases with increasing BMI. Weight reduction as a way to reduce risk should be investigated. PMID:20375192

  5. Oral cancer in Cali, Colombia: a population-based analysis of incidence and mortality trends.

    Dora Ordóñez

    2014-09-01

    Full Text Available Objective. To describe the time trends of the incidence and mortality rates of oral cancer (OC in Cali, Colombia between 1962-2007. Materials and methods. Age-standardized (Segi’s world population incidence (ASIR and mortality (ASMR rates for oral cancer were estimated using data from the Population-based Cancer Registry of Cali, Colombia and from the database of the Municipal Secretary of Public Health (MSPH respectively. Annual percentage change (APC was used to measure the changes in rates over time. Results. 1 637 new cases of oral cancer were registered in the CPCR and the mean age upon diagnosis was 60 years. The ASIR decreased from 1962-2007 in men APC= 1.3 (IC95%:-2.0; -0.6 and women APC= -1.0 (IC95%: -1.7; -0.4.The ASMR decreased from 1984-2001 only in men, APC=2.8 (IC95%: -4.1; -1.5. Conclusions. There was a significant decrease in the incidence and mortality rates for OC in Cali, Colombia. The type of tumor associated to these changes was the squamous cell carcinoma

  6. [Oral cancer in Cali, Colombia: a population-based analysis of incidence and mortality trends].

    Ordóñez, Dora; Aragón, Natalia; García, Luz Stella; Collazos, Paola; Bravo, Luis Eduardo

    2014-01-01

    To describe the time trends of the incidence and mortality rates of oral cancer (OC) in Cali, Colombia between 1962-2007. Age-standardized (Segi's world population) incidence (ASIR) and mortality (ASMR) rates for oral cancer were estimated using data from the Population-based Cancer Registry of Cali, Colombia and from the database of the Municipal Secretary of Public Health (MSPH) respectively. Annual percentage change (APC) was used to measure the changes in rates over time. 1637 new cases of oral cancer were registered in the CPCR and the mean age upon diagnosis was 60 years. The ASIR decreased from 1962-2007 in men APC= 1.3 (IC95%:-2.0; -0.6) and women APC= -1.0 (IC95%: -1.7; -0.4).The ASMR decreased from 1984-2001 only in men, APC=2.8 (IC95%: -4.1; -1.5). There was a significant decrease in the incidence and mortality rates for OC in Cali, Colombia. The type of tumor associated to these changes was the squamous cell carcinoma.

  7. Distinguishing pathological from constitutional small for gestational age births in population-based studies.

    Ananth, Cande V; Vintzileos, Anthony M

    2009-10-01

    Small for gestational age (SGA) can occur following a pathological process or may represent constitutionally small fetuses. However, distinguishing these processes is often difficult, especially in large studies, where the term SGA is often used as a proxy for restricted fetal growth. Since biologic variation in fetal size is largely a third trimester phenomenon, we hypothesized that the definition of SGA at term may include a sizeable proportion of constitutionally small fetuses. In contrast, since biologic variation in fetal size is not fully expressed in (early) preterm gestations, it is plausible that SGA in early preterm gestations would comprise a large proportion of growth restricted fetuses. We compared mortality and morbidity rates between SGA and appropriate for gestational age (AGA) babies. A population-based study of over 19million non-malformed, singleton births (1995-04) in the United States was performed. Gestational age (24-44weeks) was based on a clinical estimate. SGA and AGA were defined as sex-specific birthweight constitutionally small.

  8. General health influences episodes of xerostomia: a prospective population-based study.

    da Silva, Luciana; Kupek, Emil; Peres, Karen G

    2017-04-01

    The aim of this study was to investigate the associated factors of changes in symptoms of xerostomia (SOX) in adults aged 20-59. A prospective population-based study was conducted in 2009 (n = 1720) and 2012 (n = 1222) in the urban area of Florianópolis, SC, Brazil. Information on SOX was collected in both years together with age, family income, years of schooling, smoking habit, alcohol consumption, changes in the body mass index (BMI; kg/m²), medicine use, self-reported diagnosis of chronic diseases, change in hypertension status and in the use and need for dentures, and number of remaining teeth. Associated factors with changes in SOX were investigated using multinomial logistic regression, considering those who had never reported this symptom as the reference. Prevalence of regular SOX was equal to 3.8% (95% CI: 2.9-5.1) and irregular (one period only) equal to 12.2% (95% CI: 10.2-14.5). Age, smoking habit, medicine use, self-reported diagnosis of depression, and weight gain increased the probability of regular SOX, whereas highest schooling level was associated with lower probability of this symptom. General and psychosocial health influenced the number of episodes of xerostomia symptoms, calling for multidisciplinary actions to prevent common risk behaviors for oral and general diseases. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Prevalence and risk factors associated with dry eye symptoms: a population based study in Indonesia

    Lee, A J; Lee, J; Saw, S-M; Gazzard, G; Koh, D; Widjaja, D; Tan, D T H

    2002-01-01

    Aim: To determine the prevalence and identify associated risk factors for dry eye syndrome in a population in Sumatra, Indonesia. Methods: A one stage cluster sampling procedure was conducted to randomly select 100 households in each of the five rural villages and one provincial town of the Riau province, Indonesia, from April to June 2001. Interviewers collected demographic, lifestyle, and medical data from 1058 participants aged 21 years or over. Symptoms of dry eye were assessed using a six item validated questionnaire. Presence of one or more of the six dry eye symptoms often or all the time was analysed. Presence of pterygium was documented. Results: Prevalence of one or more of the six dry eye symptoms often or all the time adjusted for age was 27.5% (95% confidence interval (CI) 24.8 to 30.2). After adjusting for all significant variables, independent risk factors for dry eye were pterygium (p<0.001, multivariate odds ratio (OR) 1.8; 95% CI 1.4 to 2.5) and a history of current cigarette smoking (p=0.05, multivariate OR 1.5; 95% CI 1.0 to 2.2). Conclusions: This population based study provides prevalence rates of dry eye symptoms in a tropical developing nation. From our findings, pterygium is a possible independent risk factor for dry eye symptoms. PMID:12446361

  10. Prevalence of premenstrual syndrome and premenstrual dysphoric disorder in a population-based sample in China.

    Qiao, Mingqi; Zhang, Huiyun; Liu, Huimin; Luo, Songping; Wang, Tianfang; Zhang, Junlong; Ji, Lijin

    2012-05-01

    To investigate the prevalence of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD), and the frequency and severity of the symptoms in a population-based sample of Chinese women of reproductive age. Women aged 18-45 years were screened for suspected PMS and PMDD based on the ACOG recommendations for a diagnosis of PMS and diagnostic and statistical manual of mental disorders, fourth edition (DSM-IV). For those who were consistent with PMS diagnostic criteria, the daily record of severity of problems (DRSP) questionnaire was used to assess the symptoms prospectively over 2 months. Participants were then categorized as having no perceived symptoms, mild PMS, moderate PMS, and PMDD, based on a validated algorithm. Among the study group, the incidence of PMDD was 2.1% and PMS was 21.1%. The most common symptoms were irritability (91.21%), breast tenderness (77.62%), depression (68.31%), abdominal bloating (63.70%) and angry outbursts (59.62%). The prevalence of PMS/PMDD and the frequency and severity of the symptoms have their own characteristics in Chinese women. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  11. Measuring limitations in activities of daily living: a population-based validation of a short questionnaire.

    Elfering, Achim; Cronenberg, Sonja; Grebner, Simone; Tamcan, Oezguer; Müller, Urs

    2017-12-01

    A newly developed questionnaire assessing limitations in activity of daily living (LADL-Q) that should improve assessment of LADL is tested in a large population-based validation study. This survey was paper-based. Overall, 16,634 individuals who were representative of the working population in the German-speaking part of Switzerland participated in the study. Item analysis was used the final version of the LADL-Q to four items per subscale that correspond to potential problems in three body regions (back and neck, upper extremities, lower extremities). Analysis included tests for reliability, internal consistency, dimensionality and convergent validity. Test-retest reliability coefficients after 2 weeks ranged from 0.82 to 0.99 (Mdn = 0.87), with no item having a coefficient below 0.60. The median item-total coefficients ranged between moderate and good. Correlation coefficients between LADL-Q subscales and three validated clinical instruments (Western Ontario and McMaster Universities osteoarthritis index, shoulder pain disability index, Oswestry) ranged from 0.63 to 0.81. In structural equation modeling the three subscales were significantly related with two important outcomes in occupational rehabilitation: self-reported general health and daily task performance. The new LADL-Q is a brief, reliable and valid tool for assessment of LADL in studies on musculoskeletal health.

  12. Population-based estimate of urinary stones from Ballabgarh, northern India.

    Lohiya, Ayush; Kant, Shashi; Kapil, Arti; Gupta, Sanjeev Kumar; Misra, Puneet; Rai, Sanjay K

    2017-01-01

    Stones in the urinary tract are a common condition but there is paucity of data on their population-based estimates in India. We describe our findings of the burden of urinary stones during a cross-sectional study with another primary goal. We conducted the study at Ballabgarh Health and Demographic Surveillance System, Haryana, among residents aged 18 years or above. We used simple random sampling to enrol participants. Self-reported history of urinary stones was elicited through an interview schedule. Results of the descriptive analysis were described as proportions with 95% confidence intervals (CI) or as mean wherever applicable. Bivariate analysis was done using t-test and chi-square test as applicable. The response rate for our study was 86.6%; lifetime prevalence (95% CI) of urinary stones was 7.9% (5.7, 10.8). In a majority of participants, urinary stones were diagnosed at an age of 20-40 years (55.9%), mostly by an ultrasonography examination (94.1%). A high burden of urinary stones is indicated in the working-age population in northern India at the community level. Untreated urinary stones can lead to an acute emergency (colic) or may have long-term adverse consequences, e.g. hydronephrosis, which have implications for the healthcare delivery system.

  13. Fertility rates and perinatal outcomes of adolescent pregnancies: a retrospective population-based study

    Maria de Lourdes de Souza

    Full Text Available ABSTRACT Objective: analyze trends in fertility rates and associations with perinatal outcomes for adolescents in Santa Catarina, Brazil. Methods: a population-based study covering 2006 to 2013 was carried out to evaluate associations between perinatal outcomes and age groups, using odds ratios, and Chi-squared tests. Results: differences in the fertility rate among female adolescents across regions and time period were observed, ranging from 40.9 to 72.0 per 1,000 in mothers aged 15-19 years. Adolescents had fewer prenatal care appointments than mothers ≥20 years, and a higher proportion had no partner. Mothers aged 15-19 years were more likely to experience preterm birth (OR:1.1; CI:1.08-1.13; p<0.001, have an infant with low birthweight (OR:1.1; CI:1.10-1.15; p<0.001 and low Apgar score at 5 minutes (OR:1.4; CI:1.34-1.45; p<0.001 than mothers ≥20 years, with the odds for adverse outcomes greater for those aged 10-14 years. Conclusion: this study provides evidence of fertility rates among adolescents remaining higher in regions of social and economic deprivation. Adolescent mothers and their infants more likely to experience adverse perinatal outcomes. Nurses, public health practitioners, health and social care professionals and educators need to work collaboratively to better target strategies for adolescents at greater risk; to help reduce fertility rates and improve outcomes.

  14. Predictors of Recurrence and Complications After Chronic Subdural Hematoma Surgery: A Population-Based Study.

    Bartek, Jiri; Sjåvik, Kristin; Kristiansson, Helena; Ståhl, Fredrik; Fornebo, Ida; Förander, Petter; Jakola, Asgeir S

    2017-10-01

    To investigate predictors of recurrence and moderate to severe complications after burr-hole surgery for chronic subdural hematoma (cSDH). A retrospective review was conducted in a Scandinavian single-center population-based cohort of 759 adult patients with cSDH operated with burr-hole surgery between January 1, 2005 and December 31, 2010. Possible predictors of recurrence and complications, assessed using a standardized reporting system of adverse events, were identified and analyzed in univariable analyses. Variables with a P value hematoma (odds ratio [OR], 2.05; 95% confidence interval [CI], 1.25-3.35; P hematoma diameter in millimeters (OR, 1.05; 95% CI, 1.01-1.09; P 1 (OR, 2.28; 95% CI, 1.10-4.75; P = 0.03) were independent predictors of moderate to severe complications. Recurrence after cSDH surgery is more often encountered in patients with radiologically more extensive disease reflected by bilateral hematoma and large hematoma diameter. On the other hand, moderate to severe complications are more often seen in patients in a worse clinical condition, reflected by decreased level of consciousness and more comorbidities. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Unhealthy behaviours and risk of visual impairment: The CONSTANCES population-based cohort.

    Merle, Bénédicte M J; Moreau, Gwendoline; Ozguler, Anna; Srour, Bernard; Cougnard-Grégoire, Audrey; Goldberg, Marcel; Zins, Marie; Delcourt, Cécile

    2018-04-26

    Unhealthy behaviours are linked to a higher risk of eye diseases, but their combined effect on visual function is unknown. We aimed to examine the individual and combined associations of diet, physical activity, smoking and alcohol consumption with visual impairment among French adults. 38 903 participants aged 18-73 years from the CONSTANCES nationwide cohort (2012-2016) with visual acuity measured and who completed, lifestyle, medical and food frequency questionnaires were included. Visual impairment was defined as a presenting visual acuity visual impairment increased with decreasing diet quality (p for trend = 0.04), decreasing physical activity (p for trend = 0.02) and increasing smoking pack-years (p for trend = 0.03), whereas no statistically significant association with alcohol consumption was found. Combination of several unhealthy behaviours was associated with increasing odds for visual impairment (p for trend = 0.0002), with a fully-adjusted odds ratio of 1.81 (95% CI 1.18 to 2.79) for participants reporting 2 unhealthy behaviours and 2.92 (95% CI 1.60 to 5.32) for those reporting 3 unhealthy behaviours. An unhealthy lifestyle including low/intermediate diet quality, low physical activity and heavy smoking was associated with visual impairment in this large population-based study.

  16. Wealth Inequality and Mental Disability Among the Chinese Population: A Population Based Study.

    Wang, Zhenjie; Du, Wei; Pang, Lihua; Zhang, Lei; Chen, Gong; Zheng, Xiaoying

    2015-10-19

    In the study described herein, we investigated and explored the association between wealth inequality and the risk of mental disability in the Chinese population. We used nationally represented, population-based data from the second China National Sample Survey on Disability, conducted in 2006. A total of 1,724,398 study subjects between the ages of 15 and 64, including 10,095 subjects with mental disability only, were used for the analysis. Wealth status was estimated by a wealth index that was derived from a principal component analysis of 10 household assets and four other variables related to wealth. Logistic regression analysis was used to estimate the odds ratio (OR) and 95% confidence interval (CI) for mental disability for each category, with the lowest quintile category as the referent. Confounding variables under consideration were age, gender, residence area, marital status, ethnicity, education, current employment status, household size, house type, homeownership and living arrangement. The distribution of various types and severities of mental disability differed significantly by wealth index category in the present population. Wealth index category had a positive association with mild mental disability (p for trend disability (p for trend disability when all severities of mental disability were taken into consideration. This study's results suggest that wealth is a significant factor in the distribution of mental disability and it might have different influences on various types and severities of mental disability.

  17. Patterns in place of cancer death in the State of Qatar: a population-based study.

    Mohsen, Hassan; Haddad, Pascale; Allam, Ayman; Hassan, Azza

    2014-01-01

    International studies show that most people prefer to die at home; however, hospitals remain the most common place of death (PoD). This study aims to investigate the patterns in PoD and the associated factors, which are crucial for end-of-life cancer care enhancement. This retrospective, population-based study analyzed all registered cancer deaths in Qatar between January 1, 2006 and December 31, 2012 (n = 1,224). The main outcome measures were patient characteristics: age, gender, nationality, cancer diagnosis, year of death, and PoD. Time trends for age-standardized proportions of death in individual PoDs were evaluated using chi-square analysis. Odds ratio (OR) were determined for variables associated with the most preferred (acute palliative care unit [APCU] and hematology/oncology ward) versus least preferred (ICU and general medicine ward) PoDs in Qatar, stratified by nationality. The hematology/oncology ward was the most common PoD (32.4%; 95% CI 26.7-35.3%) followed by ICU (31.4%; 95% CI 28.7-34.3%), APCU (26.9%; 95% CI 24.3-29.6%), and general medicine ward (9.2%; 95% CI 7.6-11.1%). APCU trended upward (+0.057/year; pQatar occur in hospital. As home was the preferred PoD for most people, effective home care and hospice programs are needed to improve end-of-life cancer care.

  18. Allergic rhinitis and arterial blood pressure: a population-based study.

    Sakallioglu, O; Polat, C; Akyigit, A; Cetiner, H; Duzer, S

    2018-05-01

    To investigate the likelihood of allergic rhinitis and potential co-morbidities, and to assess whether allergic rhinitis is associated with arterial blood pressure and hypertension. In this population-based study, 369 adults with allergic rhinitis and asthma were assessed via a questionnaire and immunoglobulin E levels. There were four groups: control (n = 90), allergic rhinitis (n = 99), asthma (n = 87) and hypertension (n = 93). Arterial blood pressure was measured in all groups. There were no significant differences in systolic or diastolic blood pressure between males and females in any group. Pairwise comparisons revealed no significant differences between: the control and allergic rhinitis groups, the control and asthma groups, or the allergic rhinitis and asthma groups. The systolic and diastolic blood pressure values of males and females were significantly higher in the hypertension group than the allergic rhinitis group. There were no significant differences in systolic blood pressure or diastolic blood pressure for seasonal and perennial allergic rhinitis patients. Rhinitis was not associated with increased blood pressure. Allergic rhinitis can coincide with asthma and hypertension. The findings do not support the need for blood pressure follow up in allergic rhinitis patients.

  19. Incidence of Stroke and Transient Ischemic Attack in Croatia: A Population Based Study.

    Kadojić, Dragutin; Demarin, Vida; Dikanović, Marinko; Lusić, Ivo; Tuskan-Mohar, Lidija; Trkanjec, Zlatko; Mihaljević, Ivan; Kadojić, Mira; Bitunjac, Milan; Vranjes, Zeljko

    2015-09-01

    The aim of this population based neuroepidemiological study was to establish the real incidence rates of acute cerebrovascular disease (CVD): stroke and transient ischemic attack (TIA) in the Republic of Croatia. Multicentric study included 89 501 persons of all ages in four regional centres in Croatia: Zagreb, Osijek + Slavonski Brod, Rijeka and Split. The following incidence rates of stroke, expressed at population of 100 000, have been established: Zagreb 290.52, Osijek + Slavonski Brod 302.14, Rijeka 219.65, Split 195.82. Incidence rate of stroke for the Republic of Croatia is 251.39. The following incidence rates of TIA, expressed at population of 100,000, have been established: Zagreb 87.15, Osijek + Slavonski Brod 156.53, Rijeka 90.11, Split 59.10. Incidence rate of TIA for the Republic of Croatia is 100.55. In the continental part of Croatia (Zagreb, Osijek + Slavonski Brod) incidence rate of stroke is higher by 45%, while incidence rate of TIA is higher by 82% than in the coastal part of Croatia, probably due to different lifestyle and environmental factors. The study has shown relatively high incidence rates of acute CVD (stroke and TIA) in the Republic of Croatia, which proves that CVD are a great public health problem.

  20. Risk and protective factors for chronic diseases in adults: a population-based study

    Danielle Cristina Guimarães da Silva

    Full Text Available Abstract The article describes the relative frequency ok of risk and protective behaviors for chronic non-communicable diseases (NCDs in adults residing in Viçosa, Brazil. A cross-section-al population-based study including 1,226 adults living in the municipality. We used a structured questionnaire containing questions sociodemographic and behavioral The risk and protection factors evaluated were: smoking, physical activity, excessive consumption of alcohol and food consumption. The proportion of risk and protection factors was calculated in the total population, according to gender, education and socioeconomic status. The studied population has a high frequency of risk factors for NCDs, such as excessive consumption of alcoholic beverages, habit of consuming whole milk, habit of eating meat with visible fat, regular consumption of soft drinks and 78.5% did not achieve the minimum recommendation for physical activity in leisure time. With regard to protective factors, 86.2% of the population reported regular consumption of fruits and vegetables, and 73%, of beans. It was found the highest frequency of risk factors in among males, in younger people and middle socioeconomic status. This population has an urgent need for public policy of municipal planning to change this current scenario.

  1. Prevalence and risk factors of urinary incontinence in Chinese women: a population-based study.

    Ge, Jing; Yang, Peng; Zhang, Yi; Li, Xinyu; Wang, Quanyi; Lu, Yongxian

    2015-03-01

    To estimate the current prevalence rate of urinary incontinence (UI) and to identify risk factors in Chinese women, we conducted a population-based survey in 3058 women in Beijing, China, in 2009. The prevalence rate of UI was estimated to be 22.1%, with stress UI (12.9%) being more prevalent than urgency UI (1.7%) and mixed UI (7.5%). The prevalence rates of UI, urgency UI, and mixed UI increased with age, with the highest recorded in participants aged ≥70 years. However, stress UI was most commonly seen in participants aged 50 to 69 years. Risk factors for UI included aging, lower education background, older age of menarche, menstrual disorder, pregnancy history, episiotomy, chronic pelvic pain, gynecological disease, other chronic diseases, constipation, fecal incontinence, lower daily water intake, and frequency of high protein intake. UI is a common disorder in Chinese women, and many risk factors are able to affect the development of UI. © 2011 APJPH.

  2. Use of fertility drugs and risk of ovarian cancer: Danish Population Based Cohort Study.

    Jensen, Allan; Sharif, Heidi; Frederiksen, Kirsten; Kjaer, Susanne Krüger

    2009-02-05

    To examine the effects of fertility drugs on overall risk of ovarian cancer using data from a large cohort of infertile women. Population based cohort study. Danish hospitals and private fertility clinics. 54,362 women with infertility problems referred to all Danish fertility clinics during 1963-98. The median age at first evaluation of infertility was 30 years (range 16-55 years), and the median age at the end of follow-up was 47 (range 18-81) years. Included in the analysis were 156 women with invasive epithelial ovarian cancer (cases) and 1241 subcohort members identified in the cohort during follow-up in 2006. Effect of four groups of fertility drugs (gonadotrophins, clomifene citrate, human chorionic gonadotrophin, and gonadotrophin releasing hormone) on overall risk of ovarian cancer after adjustment for potential confounding factors. Analyses within cohort showed no overall increased risk of ovarian cancer after any use of gonadotrophins (rate ratio 0.83, 95% confidence interval 0.50 to 1.37), clomifene (1.14, 0.79 to 1.64), human chorionic gonadotrophin (0.89, 0.62 to 1.29), or gonadotrophin releasing hormone (0.80, 0.42 to 1.51). Furthermore, no associations were found between all four groups of fertility drugs and number of cycles of use, length of follow-up, or parity. No convincing association was found between use of fertility drugs and risk of ovarian cancer.

  3. Possible Prevention of Neonatal Death: A Regional Population-Based Study in Japan.

    Koshida, Shigeki; Yanagi, Takahide; Ono, Tetsuo; Tsuji, Shunichiro; Takahashi, Kentaro

    2016-03-01

    The neonatal mortality rate in Japan has currently been at the lowest level in the world. However, it is unclear whether there are still some potentially preventable neonatal deaths. We, therefore, aimed to examine the backgrounds of neonatal death and the possibilities of prevention in a region of Japan. This is a population-based study of neonatal death in Shiga Prefecture of Japan. The 103 neonatal deaths in our prefecture between 2007 and 2011 were included. After reviewing by a peer-review team, we classified the backgrounds of these neonatal deaths and analyzed end-of-life care approaches associated with prenatal diagnosis. Furthermore, we evaluated the possibilities of preventable neonatal death, suggesting specific recommendations for its prevention. We analyzed 102 (99%) of the neonatal deaths. Congenital malformations and extreme prematurity were the first and the second most common causes of death, respectively. More than half of the congenital abnormalities (59%) including malformations and chromosome abnormality had been diagnosed before births. We had 22 neonates with non-intensive care including eighteen cases with congenital abnormality and four with extreme prematurity. Twenty three cases were judged to have had some possibility of prevention with one having had a strong possibility of prevention. Among specific recommendations of preventable neonatal death, more than half of them were for obstetricians. There is room to reduce neonatal deaths in Japan. Prevention of neonatal death requires grater prenatal care by obstetricians before birth rather than improved neonatal care by neonatologists after birth.

  4. Childhood trauma and increased peripheral cytokines in young adults with major depressive: Population-based study.

    Pedrotti Moreira, Fernanda; Wiener, Carolina David; Jansen, Karen; Portela, Luis Valmor; Lara, Diogo R; Souza, Luciano Dias de Mattos; da Silva, Ricardo Azevedo; Oses, Jean Pierre

    2018-06-15

    The aim of this study was to evaluate the effect of childhood trauma in cytokine serum levels of individuals with MDD. This was a cross-sectional study population-based, with people aged 18 to 35. The Mini International Neuropsychiatric Interview (M.I.N.I) measured to current major depressive disorder (MDD). To evaluate traumatic experiences during childhood, the Childhood Trauma Questionnaire (CTQ) was applied. Serum TNF- α, IL-6 and IL-10 levels were measured by ELISA using a commercial kit. The total sample comprised 166 young adults, of these: 40.4% were subjects with MDD and childhood trauma and 59.6% were diagnosed with MDD without childhood trauma. In relation to serum interleukin levels, subjects with childhood trauma showed a significantly higher serum IL-6 (p = 0.013) and IL-10 levels (p = 0.022) to compare no childhood trauma. Subjects with childhood trauma was observed positive correlation between serum IL-6 and physical abuse (r = 0.232, p = 0.035) and emotional abuse (r = 0.460, p ≤ 0.001). Moreover, IL-10 were positive correlation with physical abuse (r = 0.258, p = 0.013). TNF- α was not associated with childhood trauma. Childhood maltreatment may result higher inflammation dysregulation in individuals with depression than individuals that no has childhood maltreatment. Copyright © 2018 Elsevier B.V. All rights reserved.

  5. Peripartum cardiomyopathy is associated with increased uric acid concentrations: A population based study.

    Sagy, Iftach; Salman, Amjad Abu; Kezerle, Louise; Erez, Offer; Yoel, Idan; Barski, Leonid

    Peri-partum cardiomyopathy (PPCM) is a clinical heart failure that usually develops during the final stage of pregnancy or the first months following delivery. High maternal serum uric acid concentrations have been previous associated with heart failure and preeclampsia. 1) To explored the clinical characteristics of PPCM patients; and 2) to determine the association between maternal serum uric acid concentrations and PPCM. This is a retrospective population based case control study. Cases and controls were matched 1:4 (for gestational age, medical history of cardiac conditions and creatinine); conditional logistic regression was used to identify clinical parameters that were associated with PPCM. The prevalence of peripartum cardiomyopathy at our institution was 1-3832 deliveries (42/160,964). In a matched multivariate analysis high maternal serum uric acid concentrations were associated with PPCM (O.R 1.336, 95% C.I 1.003-1.778). Uric acid concentrations were higher within the Non-Jewish patients and mothers of male infant with PPCM in compare to those without PPCM (p value 0.003 and 0.01 respectively). PPCM patients had increased maternal serum uric acid concentrations. This observation aligns with previous report regarding the increased uric acid concentration in women with preeclampsia and congestive heart failure, suggestive of a common underlying mechanism that mediates the myocardial damage. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Falls in very old people: the population-based Umeå 85+ study in Sweden.

    von Heideken Wågert, Petra; Gustafson, Yngve; Kallin, Kristina; Jensen, Jane; Lundin-Olsson, Lillemor

    2009-01-01

    The aim of this study was to describe incidences of falls and fall-related injuries, and to identify predisposing factors for falls in very old people in a prospective population-based follow-up study for falls. The study is part of the Umeå 85+ Study which includes half of the population aged 85, and the total population aged 90 and > or =95 (-103), in Umeå, Sweden. Of the 253 people interviewed, 220 (87%) were followed up for falls for 6 months, of whom 109 lived in ordinary and 111 in institutional housing. A comprehensive geriatric baseline assessment was made through interviews and testing during home visits. Forty percent of the participants did fall a total 304 times, corresponding to 2.17 falls per Person Year (PY). It occurred 0.83 injuries per PY, including 0.14 fractures per PY. In a Cox regression analysis, the independent explanatory risk factors for time to first fall were dependency in activities of daily living (ADL), thyroid disorders, treatment with selective serotonin reuptake inhibitors (SSRIs) and occurrence of falls in the preceding year. It could be predicted that every seventh participant and every third of the people who did fall would suffer a fracture within 1 year. ADL, thyroid disorders and treatment with SSRIs should be considered in fall prevention programmes.

  7. The Prevalence of Burning Mouth Syndrome: A Population-Based Study

    Kohorst, John J.; Bruce, Alison J.; Torgerson, Rochelle R.; Schenck, Louis A.; Davis, Mark D. P.

    2015-01-01

    Background Burning mouth syndrome (BMS) is defined as symptoms of persistent burning in the mouth without objective findings accounting for the symptoms. Objectives To calculate the point prevalence of BMS in Olmsted County, Minnesota, on December 31, 2010. Methods The Rochester Epidemiology Project (REP) medical records linkage system was used to identify BMS cases diagnosed or potentially diagnosed before December 31, 2009. Inclusion criteria were subjective oral discomfort, normal oral examination, and documented BMS diagnosis by a REP physician. Results In total, 149 BMS cases were confirmed, representing age- and sex-adjusted point prevalence of BMS in Olmsted County of 0.11%, or 105.6 (95% CI, 88.6–122.6) per 100,000 persons. Age-adjusted prevalence in women was significantly higher than men: 168.6 (95% CI, 139.0–198.2) vs 35.9 (95% CI, 21.4–50.3) per 100,000 persons (P<.001). The highest prevalence was in women aged 70 through 79 years (527.9 per 100,000 persons). Mean (SD) age at BMS diagnosis was 59.4 (15.1) years (range, 25–90 years). Conclusions To our knowledge, we provide the first report of population-based BMS prevalence. The data show that BMS most commonly affects women older than 50 years, and when defined through diagnostic criteria, it is less prevalent than described previously. PMID:25495557

  8. Disease management programs for patients with asthma in Germany: a longitudinal population-based study.

    Mehring, Michael; Donnachie, Ewan; Mutschler, Robert; Hofmann, Frank; Keller, Manfred; Schneider, Antonius

    2013-07-01

    The primary aim of the disease management program (DMP) for patients with asthma is to improve health outcomes and to reduce costs. Five years after its introduction in Germany, no consensus has yet been reached as to whether DMP has been effective in reaching these goals. To evaluate the DMP for asthma in Bavaria using routinely collected subject medical records. A longitudinal population-based study encompassing over 100,000 DMP participants between 2006 (when the program began) and 2010. The prescription rate of oral corticosteroids dropped from 15.7% in 2006 to 13.6% in 2007, and again from 7.5% in 2008 to 5.9% in 2010 (P management education increased from 4.4% to 23.4% (P management. The proportion of subjects requiring hospitalization decreased. Our results suggest that the German DMP for asthma has been effective in enhancing the quality of care in regard to an improved symptom frequency, adherence to guidelines, pharmacotherapy, and hospitalization.

  9. Fertility rates and perinatal outcomes of adolescent pregnancies: a retrospective population-based study.

    Souza, Maria de Lourdes de; Lynn, Fiona Ann; Johnston, Linda; Tavares, Eduardo Cardoso Teixeira; Brüggemann, Odaléa Maria; Botelho, Lúcio José

    2017-04-06

    analyze trends in fertility rates and associations with perinatal outcomes for adolescents in Santa Catarina, Brazil. a population-based study covering 2006 to 2013 was carried out to evaluate associations between perinatal outcomes and age groups, using odds ratios, and Chi-squared tests. differences in the fertility rate among female adolescents across regions and time period were observed, ranging from 40.9 to 72.0 per 1,000 in mothers aged 15-19 years. Adolescents had fewer prenatal care appointments than mothers ≥20 years, and a higher proportion had no partner. Mothers aged 15-19 years were more likely to experience preterm birth (OR:1.1; CI:1.08-1.13; ppobreza social y económica. Madres adolescentes y sus bebés tienen mayor probabilidad de efectos perinatales adversos. Enfermeros, trabajadores de salud pública, profesionales de salud y asistencia social y educadores deben colaborar para mejor dirigir estrategias a adolescentes con riesgo superior; para fines de ayudar a reducir las tasas de fertilidad y mejorar los resultados.

  10. Hyperhomocysteinemia is independently associated with albuminuria in the population-based CoLaus study

    Paccaud Fred

    2011-09-01

    Full Text Available Abstract Background Increased serum levels of homocysteine and uric acid have each been associated with cardiovascular risk. We analyzed whether homocysteine and uric acid were associated with glomerular filtration rate (GFR and albuminuria independently of each other. We also investigated the association of MTHFR polymorphisms related to homocysteine with albuminuria to get further insight into causality. Methods This was a cross-sectional population-based study in Caucasians (n = 5913. Hyperhomocysteinemia was defined as total serum homocysteine ≥ 15 μmol/L. Albuminuria was defined as urinary albumin-to-creatinine ratio > 30 mg/g. Results Uric acid was associated positively with homocysteine (r = 0.246 in men and r = 0.287 in women, P P for trend P P = 0.004 were significantly associated with albuminuria, independently of hypertension and type 2 diabetes. The 2-fold higher risk of albuminuria associated with hyperhomocysteinemia was similar to the risk associated with hypertension or diabetes. MTHFR alleles related to higher homocysteine were associated with increased risk of albuminuria. Conclusions In the general adult population, elevated serum homocysteine and uric acid were associated with albuminuria independently of each other and of renal function.

  11. Conditional net survival: Relevant prognostic information for colorectal cancer survivors. A French population-based study.

    Drouillard, Antoine; Bouvier, Anne-Marie; Rollot, Fabien; Faivre, Jean; Jooste, Valérie; Lepage, Côme

    2015-07-01

    Traditionally, survival estimates have been reported as survival from the time of diagnosis. A patient's probability of survival changes according to time elapsed since the diagnosis and this is known as conditional survival. The aim was to estimate 5-year net conditional survival in patients with colorectal cancer in a well-defined French population at yearly intervals up to 5 years. Our study included 18,300 colorectal cancers diagnosed between 1976 and 2008 and registered in the population-based digestive cancer registry of Burgundy (France). We calculated conditional 5-year net survival, using the Pohar Perme estimator, for every additional year survived after diagnosis from 1 to 5 years. The initial 5-year net survival estimates varied between 89% for stage I and 9% for advanced stage cancer. The corresponding 5-year net survival for patients alive after 5 years was 95% and 75%. Stage II and III patients who survived 5 years had a similar probability of surviving 5 more years, respectively 87% and 84%. For survivors after the first year following diagnosis, five-year conditional net survival was similar regardless of age class and period of diagnosis. For colorectal cancer survivors, conditional net survival provides relevant and complementary prognostic information for patients and clinicians. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  12. Social contacts and Ecstasy offers: findings of a population-based study.

    Smirnov, Andrew; Najman, Jake M; Legosz, Margot; Wells, Helene; Kemp, Robert

    2013-01-01

    Ecstasy (MDMA) use is relatively common among young adults in many developed countries. However, little is known about how young non-users are first introduced to Ecstasy, including the relative contribution of peer networks and individual risk factors. We assess the role of social contact with Ecstasy-using peers in regard to young adults' exposure to offers of Ecstasy, using data from the Natural History Study, a population-based study conducted in Australia. Population screening of young adults (19- to 23-year-olds) identified a sample of young Ecstasy users (N = 315) and a comparison group of Ecstasy-naïve participants (N = 199). Two outcomes are considered: being exposed to any Ecstasy offers and being exposed to > 3 offers. Extensive social contact with Ecstasy users was defined as knowing > 10 Ecstasy users. Of the Ecstasy-naïve young adults, > 40% had ever received Ecstasy offers. Extensive social contact with Ecstasy users independently predicted exposure to multiple (> 3) Ecstasy offers for Ecstasy-naïve young adults. These findings indicate that Ecstasy offers are widespread among users and non-users of Ecstasy. For non-users, exposure to Ecstasy offers occurs through social contact with drug-using peers independently of individual risk factors. The pervasiveness of Ecstasy offers suggests that universal education concerning Ecstasy use is required.

  13. The Brady Bunch? New evidence for nominative determinism in patients' health: retrospective, population based cohort study.

    Keaney, John J; Groarke, John D; Galvin, Zita; McGorrian, Catherine; McCann, Hugh A; Sugrue, Declan; Keelan, Edward; Galvin, Joseph; Blake, Gavin; Mahon, Niall G; O'Neill, James

    2013-12-12

    To ascertain whether a name can influence a person's health, by assessing whether people with the surname "Brady" have an increased prevalence of bradycardia. Retrospective, population based cohort study. One university teaching hospital in Dublin, Ireland. People with the surname "Brady" in Dublin, determined through use of an online telephone directory. Prevalence of participants who had pacemakers inserted for bradycardia between 1 January 2007 and 28 February 2013. 579 (0.36%) of 161,967 people who were listed on the Dublin telephone listings had the surname "Brady." The proportion of pacemaker recipients was significantly higher among Bradys (n=8, 1.38%) than among non-Bradys (n=991, 0.61%; P=0.03). The unadjusted odds ratio (95% confidence interval) for pacemaker implantation among individuals with the surname Brady compared with individuals with other surnames was 2.27 (1.13 to 4.57). Patients named Brady are at increased risk of needing pacemaker implantation compared with the general population. This finding shows a potential role for nominative determinism in health.

  14. The Brady Bunch? New evidence for nominative determinism in patients’ health: retrospective, population based cohort study

    Groarke, John D; Galvin, Zita; McGorrian, Catherine; McCann, Hugh A; Sugrue, Declan; Keelan, Edward; Galvin, Joseph; Blake, Gavin; Mahon, Niall G; O’Neill, James

    2013-01-01

    Objective To ascertain whether a name can influence a person’s health, by assessing whether people with the surname “Brady” have an increased prevalence of bradycardia. Design Retrospective, population based cohort study. Setting One university teaching hospital in Dublin, Ireland. Participants People with the surname “Brady” in Dublin, determined through use of an online telephone directory. Main outcome measure Prevalence of participants who had pacemakers inserted for bradycardia between 1 January 2007 and 28 February 2013. Results 579 (0.36%) of 161 967 people who were listed on the Dublin telephone listings had the surname “Brady.” The proportion of pacemaker recipients was significantly higher among Bradys (n=8, 1.38%) than among non-Bradys (n=991, 0.61%; P=0.03). The unadjusted odds ratio (95% confidence interval) for pacemaker implantation among individuals with the surname Brady compared with individuals with other surnames was 2.27 (1.13 to 4.57). Conclusions Patients named Brady are at increased risk of needing pacemaker implantation compared with the general population. This finding shows a potential role for nominative determinism in health. PMID:24336304

  15. Associations among binge eating behavior patterns and gastrointestinal symptoms: a population-based study

    Cremonini, F; Camilleri, M; Clark, MM; Beebe, TJ; Locke, GR; Zinsmeister, AR; Herrick, LM; Talley, NJ

    2009-01-01

    Background The psychological symptoms associated with binge eating disorder (BED) have been well documented. However, the physical symptoms associated with BED have not been explored. Gastrointestinal (GI) symptoms such as heartburn and diarrhea are more prevalent in obese adults, but the associations remain unexplained. Patients with bulimia have increased gastric capacity. The objective of the study was to examine if the severity of binge eating episodes would be associated with upper and lower GI symptoms. Methods Population-based survey of community residents through a mailed questionnaire measuring GI symptoms, frequency of binge eating episodes and physical activity level. The association of GI symptoms with frequency of binge eating episodes was assessed using logistic regression models adjusting for age, gender, body mass index (BMI) and physical activity level. Results In 4096 subjects, BED was present in 6.1%. After adjusting for BMI, age, gender, race, diabetes mellitus, socioeconomic status and physical activity level, BED was independently associated with the following upper GI symptoms: acid regurgitation (P symptoms: diarrhea (P symptoms in the general population, independent of the level of obesity. The relationship between increased GI symptoms and physiological responses to increased volume and calorie loads, nutritional selections and rapidity of food ingestion in individuals with BED deserves further study. PMID:19139750

  16. Predicting Successful Aging in a Population-Based Sample of Georgia Centenarians

    Jonathan Arnold

    2010-01-01

    Full Text Available Used a population-based sample (Georgia Centenarian Study, GCS, to determine proportions of centenarians reaching 100 years as (1 survivors (43% of chronic diseases first experienced between 0–80 years of age, (2 delayers (36% with chronic diseases first experienced between 80–98 years of age, or (3 escapers (17% with chronic diseases only at 98 years of age or older. Diseases fall into two morbidity profiles of 11 chronic diseases; one including cardiovascular disease, cancer, anemia, and osteoporosis, and another including dementia. Centenarians at risk for cancer in their lifetime tended to be escapers (73%, while those at risk for cardiovascular disease tended to be survivors (24%, delayers (39%, or escapers (32%. Approximately half (43% of the centenarians did not experience dementia. Psychiatric disorders were positively associated with dementia, but prevalence of depression, anxiety, and psychoses did not differ significantly between centenarians and an octogenarian control group. However, centenarians were higher on the Geriatric Depression Scale (GDS than octogenarians. Consistent with our model of developmental adaptation in aging, distal life events contribute to predicting survivorship outcome in which health status as survivor, delayer, or escaper appears as adaptation variables late in life.

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

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

    2015-08-01

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

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

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

    2001-07-01

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

  19. Respiratory diseases and allergic sensitization in swine breeders: a population-based cross-sectional study.

    Galli, Luigina; Facchetti, Susanna; Raffetti, Elena; Donato, Francesco; D'Anna, Mauro

    2015-11-01

    The daily occupation as a swine breeder involves exposure to several bacterial components and organic dusts and inhalation of a large amount of allergens. To investigate the risk of respiratory diseases and atopy in swine breeders compared with the general population living in the same area. A population-based cross-sectional study was conducted in an agricultural area of northern Italy that enrolled a random sample of resident male breeders and non-breeders. Demographic features, comorbidities, and presence of allergic respiratory disease were retrieved through interview. Prick tests for common allergens were performed. An evaluation of pollen and mold in air samples taken inside and outside some swine confinement buildings also was performed. One hundred one male breeders (78 native-born, mean age ± SD 43.0 ± 11.1 years) and 82 non-breeders (43.0 ± 11.1 years) were enrolled. When restricting the analysis to native-born subjects, breeders vs non-breeders showed a lower prevalence of respiratory allergy (12.8% vs 31.1%, respectively, P = .002), asthma (6.4% vs 15.8%, P = .059), rhinitis (16.7% vs 51.2%, P increase, and might decrease, the risk of pollen sensitization and allergic disease. Copyright © 2015 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  20. Epidemiology of leisure-time physical activity: a population-based study in southern Brazil

    Juvenal Soares Dias-da-Costa

    Full Text Available We aimed to measure the prevalence of physical inactivity (PI during leisure time and to identify variables associated with it in a southern Brazilian adult population. A population-based cross-sectional study was carried out, covering a multiple-stage sample of 1,968 subjects aged 20-69 years. Weekly participation in leisure-time physical activity was addressed. For each activity, energy expenditure was calculated using data on duration, metabolic equivalent, and body weight. Energy expenditures of individual activities were summed to give a weekly total. PI was defined as fewer than 1,000 kilocalories per week. The prevalence of PI was 80.7% (95%CI: 78.9-82.4. After adjusted analyses, the following variables were positively associated with the outcome: female gender, age, living with a partner, and smoking. Schooling and economic status were inversely associated with PI. Chronically undernourished individuals were significantly more likely to be inactive. We found no differences according to skin color or alcohol consumption. In conclusion, the prevalence of PI in this adult population was higher than in populations from developed countries, but the associated variables were similar.

  1. Measuring HPV vaccination coverage in Australia: comparing two alternative population-based denominators.

    Barbaro, Bianca; Brotherton, Julia M L

    2015-08-01

    To compare the use of two alternative population-based denominators in calculating HPV vaccine coverage in Australia by age groups, jurisdiction and remoteness areas. Data from the National HPV Vaccination Program Register (NHVPR) were analysed at Local Government Area (LGA) level, by state/territory and by the Australian Standard Geographical Classification Remoteness Structure. The proportion of females vaccinated was calculated using both the ABS ERP and Medicare enrolments as the denominator. HPV vaccine coverage estimates were slightly higher using Medicare enrolments than using the ABS estimated resident population nationally (70.8% compared with 70.4% for 12 to 17-year-old females, and 33.3% compared with 31.9% for 18 to 26-year-old females, respectively.) The greatest differences in coverage were found in the remote areas of Australia. There is minimal difference between coverage estimates made using the two denominators except in Remote and Very Remote areas where small residential populations make interpretation more difficult. Adoption of Medicare enrolments for the denominator in the ongoing program would make minimal, if any, difference to routine coverage estimates. © 2015 Public Health Association of Australia.

  2. Natural history of heartburn: a 10-year population-based study.

    Olafsdottir, Linda Bjork; Gudjonsson, Hallgrimur; Jonsdottir, Heidur Hrund; Thjodleifsson, Bjarni

    2011-02-07

    To study the natural history and prevalence of heartburn at a 10-year interval, and to study the effect of heartburn on various symptoms and activities. A population-based postal study was carried out. Questionnaires were mailed to the same age- and gender-stratified random sample of the Icelandic population (aged 18-75 years) in 1996 and again in 2006. Subjects were classified with heartburn if they reported heartburn in the preceding year and/or week, based on the definition of heartburn. Heartburn in the preceding year was reported in 42.8% (1996) and 44.2% (2006) of subjects, with a strong relationship between those who experienced heartburn in both years. Heartburn in the preceding week was diagnosed in 20.8%. There was a significant relationship between heartburn, dyspepsia and irritable bowel syndrome. Individuals with a body mass index (BMI) below or higher than normal weight were more likely to have heartburn. Heartburn caused by food or beverages was reported very often by 20.0% of subjects. Heartburn is a common and chronic condition. Subjects with a BMI below or higher than normal weight are more likely to experience heartburn. Heartburn has a great impact on daily activities, sleep and quality of life.

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

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

    2014-02-01

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

  4. Constipation and Lower Urinary Tract Dysfunction in Children and Adolescents: A Population-Based Study.

    Sampaio, Clara; Sousa, Ariane Sampaio; Fraga, Luis Gustavo A; Veiga, Maria Luiza; Bastos Netto, José Murillo; Barroso, Ubirajara

    2016-01-01

    To evaluate the correlation between constipation and lower urinary tract dysfunction (LUTD) and nocturnal enuresis in a population-based study. This is a cross-sectional study. The criteria for inclusion were children and adolescents of between 5 and 17 years and who agreed to sign the informed consent form. The study excluded students with neurological problems or who had documented abnormalities of the urinary tract. To identify the presence and severity of LUTD, we used the Voiding Dysfunction Symptom Score (DVSS). To evaluate the presence of constipation, Rome III questionnaire was used. We interviewed 829 children and adolescents, of which 416 (50.18%) were male. The mean (SD) age was 9.1 (±2.9) years. The overall prevalence of LUTD was 9.1%, predominantly in girls (15 versus 3.1%, p  urinary symptoms that are independent predictors of the presence of constipation. The presence of infrequent urination ( p  = 0.004) and holding maneuvers ( p  urinary symptoms, infrequent voiding and holding maneuvers are independent factors of urinary expressions in constipated children. Children with more severe constipation have more prominent urinary symptoms. The presence of enuresis was not associated with constipation.

  5. Personality Profiles Identify Depressive Symptoms over Ten Years? A Population-Based Study

    Kim Josefsson

    2011-01-01

    Full Text Available Little is known about the relationship between temperament and character inventory (TCI profiles and depressive symptoms. Personality profiles are useful, because personality traits may have different effects on depressive symptoms when combined with different combinations of other traits. Participants were from the population-based Young Finns study with repeated measurements in 1997, 2001, and 2007 (=1402 to 1902. TCI was administered in 1997 and mild depressive symptoms (modified Beck’s depression inventory, BDI were reported in 1997, 2001, and 2007. BDI-II was also administered in 2007. We found that high harm avoidance and low self-directedness related strongly to depressive symptoms. In addition, sensitive (NHR and fanatical people (ScT were especially vulnerable to depressive symptoms. high novelty seeking and reward dependence increased depressive symptoms when harm avoidance was high. These associations were very similar in cross-sectional and longitudinal analysis. Personality profiles help in understanding the complex associations between depressive symptoms and personality.

  6. Psoriatic Arthritis and Diabetes: A Population-Based Cross-Sectional Study

    Dreiher, Jacob; Freud, Tamar; Cohen, Arnon D.

    2013-01-01

    Background. Diabetes has been associated with psoriasis, but little is known about the association between psoriatic arthritis and diabetes. Methods. Patients diagnosed with psoriatic arthritis by a rheumatologist were compared to age- and sex-matched patients without psoriatic arthritis regarding the prevalence of diabetes in a population-based cross-sectional study using logistic multivariate models. The study was performed utilizing the medical database of Clalit, the largest healthcare provider organization in Israel. Results. The study included 549 patients with psoriatic arthritis ≥21 years and 1,098 patients without psoriatic arthritis. The prevalence of diabetes in patients with psoriatic arthritis was increased as compared to the prevalence in patients without psoriatic arthritis (15.3% versus 10.7%, P value = 0.008). The difference was prominent among females (18.7% versus 10.3%, P < 0.001) but not among males (11.2% in patients with and without psoriatic arthritis, P = 1.000). In a multivariate analysis, psoriatic arthritis was associated with diabetes among females (OR = 1.60, 95% CI: 1.02–2.52, P = 0.040) but not among males (OR = 0.71, 95% CI: 0.42–1.22, P = 0.213). Conclusion. Our study suggests a possible association between psoriatic arthritis and diabetes in women. Women with psoriatic arthritis might be candidates for diabetes screening. PMID:23843781

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

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

    2016-01-01

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

  8. Dietary pattern and risk of hodgkin lymphoma in a population-based case-control study.

    Epstein, Mara M; Chang, Ellen T; Zhang, Yawei; Fung, Teresa T; Batista, Julie L; Ambinder, Richard F; Zheng, Tongzhang; Mueller, Nancy E; Birmann, Brenda M

    2015-09-01

    Classic Hodgkin lymphoma (cHL) has few known modifiable risk factors, and the relationship between diet and cHL risk is unclear. We performed the first investigation of an association between dietary pattern and cHL risk in 435 cHL cases and 563 population-based controls from Massachusetts and Connecticut (1997-2000) who completed baseline diet questionnaires. We identified 4 major dietary patterns ("vegetable," "high meat," "fruit/low-fat dairy," "desserts/sweets") using principal components analysis. We computed multivariable odds ratios and 95% confidence intervals for associations of dietary pattern score (quartiles) with younger-adult (age dietary patterns were not clearly associated with cHL. We report the first evidence for a role of dietary pattern in cHL etiology. Diets featuring high intake of meat or desserts and sweets may increase cHL risk. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  9. Medication Responsiveness of Motor Symptoms in a Population-Based Study of Parkinson Disease

    Yvette M. Bordelon

    2011-01-01

    Full Text Available We assessed degree of Parkinson disease motor symptom improvement with medication among subjects enrolled in an ongoing, population-based study in Central California. The motor section of the unified Parkinson disease rating scale (UPDRS was performed on subjects in both OFF and ON medication states, and difference between these scores was used as an indicator of symptomatic benefit. Higher OFF minus ON scores correlated with more severe baseline symptoms. There was equivalent improvement on the motor UPDRS scale for subjects divided according to medication classes used: levodopa alone 7.3 points, levodopa plus other medications 8.5 points, and dopamine agonists but not levodopa 6.1 points. In addition, there was no difference in the magnitude of improvement when subjects were divided according to Parkinson disease subtype, defined as tremor dominant, akinetic-rigid, or mixed. In this community-based sample, these values are within the range of a clinically important difference as defined by previous studies.

  10. Occupation and breast cancer risk in Polish women: a population-based case-control study.

    Peplonska, Beata; Stewart, Patricia; Szeszenia-Dabrowska, Neonila; Rusiecki, Jennifer; Garcia-Closas, Montserrat; Lissowska, Jolanta; Bardin-Mikolajczak, Alicja; Zatonski, Witold; Gromiec, Jan; Brzeznicki, Slawomir; Brinton, Louise A; Blair, Aaron

    2007-02-01

    The etiology of breast cancer is not well understood and the role of occupational exposures in breast carcinogenesis is still uncertain. The population-based case-control study included 2,386 incident breast cancer cases diagnosed in 2000-2003, and 2,502 controls. Lifetime occupational histories and information on other potential breast cancer risk factors were obtained through personal interviews. Conditional logistic regression analyses calculated odds ratios (ORs) associated with various occupations and industries after control for potential confounders. We found statistically significant excesses of breast cancer among engineers (OR=2.0; 95% CI: 1.0-3.8), economists (2.1; 1.1-3.8), sales occupations-retail (1.2; 1.0-1.5), and other sales occupations (1.2; 1.0-1.5). Industries showing significantly elevated risks included special trade contractors (2.2; 1.2-4.3), electronic and electric equipment manufacturers (1.7; 1.1-2.7); and public administration/general government n.e.c. (2.7; 1.3-5.7). Each of these findings was supported by a statistically significant positive trend for duration of employment (Pelectronic and electric equipment manufacturing industry and for the occupations with potential exposure to magnetic fields deserve further evaluation.

  11. Bipolar disorder and the risk of fracture: A nationwide population-based cohort study.

    Su, Jian-An; Cheng, Bi-Hua; Huang, Yin-Cheng; Lee, Chuan-Pin; Yang, Yao-Hsu; Lu, Mong-Liang; Hsu, Chung-Yao; Lee, Yena; McIntyre, Roger S; Chin Lin, Tzu; Chin-Hung Chen, Vincent

    2017-08-15

    The co-primary aims are: 1) to compare the risk of fracture between adults with bipolar disorder and those without bipolar disorder; and 2) to assess whether lithium, anticonvulsants and antipsychotics reduce risk of fracture among individuals with bipolar disorder. The analysis herein is a population-based retrospective cohort study, utilizing the National Health Insurance (NHI) medical claims data collected between 1997 and 2013 in Taiwan. We identified 3705 cases with incident diagnoses of bipolar disorder during study period and 37,050 matched controls without bipolar diagnoses. Incident diagnosis of fracture was operationalized as any bone fracture after the diagnosis of bipolar disorder or after the matched index date for controls. Bipolar patients had significantly higher risk of facture when compared to matched controls (17.6% versus 11.7%, respectively pbipolar disorder and a prior history of psychiatric hospitalization were had higher risk for bone fracture than those without prior history of psychiatric hospitalization when compared to match controls. Higher cumulative dose of antipsychotics or mood stabilizers did not increase the risk of fracture. The diagnoses of bipolar disorder were not confirmed with structured clinical interview. Drug adherence, exact exposure dosage, smoking, lifestyle, nutrition and exercise habits were unable to be assessed in our dataset. Bipolar disorder is associated with increased risk of fracture, and higher cumulative dose of mood stabilizers and antipsychotics did not further increase the risk of fracture. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Population-based study of ischemic stroke risk after trauma in children and young adults.

    Fox, Christine K; Hills, Nancy K; Vinson, David R; Numis, Adam L; Dicker, Rochelle A; Sidney, Stephen; Fullerton, Heather J

    2017-12-05

    To quantify the incidence, timing, and risk of ischemic stroke after trauma in a population-based young cohort. We electronically identified trauma patients (trauma and 3 controls per case. A physician panel reviewed medical records, confirmed cases, and adjudicated whether the stroke was related to trauma. We calculated the 4-week stroke incidence and estimated stroke odds ratios (OR) by injury location using logistic regression. From 1,308,009 trauma encounters, we confirmed 52 trauma-related ischemic strokes. The 4-week stroke incidence was 4.0 per 100,000 encounters (95% confidence interval [CI] 3.0-5.2). Trauma was multisystem in 26 (50%). In 19 (37%), the stroke occurred on the day of trauma, and all occurred within 15 days. In 7/28 cases with cerebrovascular angiography at the time of trauma, no abnormalities were detected. In unadjusted analyses, head, neck, chest, back, and abdominal injuries increased stroke risk. Only head (OR 4.1, CI 1.1-14.9) and neck (OR 5.6, CI 1.03-30.9) injuries remained associated with stroke after adjusting for demographics and trauma severity markers (multisystem trauma, motor vehicle collision, arrival by ambulance, intubation). Stroke risk is elevated for 2 weeks after trauma. Onset is frequently delayed, providing an opportunity for stroke prevention during this period. However, in one-quarter of stroke cases with cerebrovascular angiography at the time of trauma, no vascular abnormality was detected. © 2017 American Academy of Neurology.

  13. Medication use and kidney cancer risk: A population-based study.

    Nayan, Madhur; Juurlink, David N; Austin, Peter C; Macdonald, Erin M; Finelli, Antonio; Kulkarni, Girish S; Hamilton, Robert J

    2017-09-01

    Exposure to commonly prescribed medications may be associated with cancer risk. However, there is limited data in kidney cancer. Furthermore, methods of classifying cumulative medication exposure in previous studies may be prone to bias. We conducted a population-based case-control study of 10,377 incident kidney cancer cases aged ≥66 years matched with 35,939 controls on age, sex, history of hypertension, comorbidity score, and geographic location. Cumulative exposure to commonly prescribed medications hypothesised to modulate cancer risk was obtained using prescription claims data. We modelled exposure in four different fashions: (1) as continuous exposures using (a) fractional polynomials (which allow for a non-linear relationship between an exposure and outcome) or (b) assuming linear relationships; and 2) as dichotomous exposures denoting (a) ≥3 years versus kidney cancer. The directions of association were relatively consistent across analyses; however, the magnitudes were sensitive to the method of analysis. When utilising fractional polynomials, increasing cumulative exposure to acetylsalicylic acid, selective serotonin reuptake inhibitors, and proton-pump inhibitors was associated with significantly reduced risk of kidney cancer, while increasing exposure to antihypertensive drugs was associated with significantly increased risk. Our study provides impetus to further explore the effect of commonly prescribed medications on carcinogenesis to identify modifiable pharmacological interventions to reduce the risk of kidney cancer. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. A Population-based Study of Age Inequalities in Access to Palliative Care Among Cancer Patients

    Burge, Frederick I.; Lawson, Beverley J.; Johnston, Grace M.; Grunfeld, Eva

    2013-01-01

    Background Inequalities in access to palliative care programs (PCP) by age have been shown to exist in Canada and elsewhere. Few studies have been able to provide greater insight by simultaneously adjusting for multiple demographic, health service, and socio-cultural indicators. Objective To re-examine the relationship between age and registration to specialized community-based PCP programs among cancer patients and identify the multiple indicators contributing to these inequalities. Methods This retrospective, population-based study was a secondary data analysis of linked individual level information extracted from 6 administrative health databases and contextual (neighborhood level) data from provincial and census information. Subjects included all adults who died due to cancer between 1998 and 2003 living within 2 District Health Authorities in the province of Nova Scotia, Canada. The relationship between registration in a PCP and age was examined using hierarchical nonlinear regression modeling techniques. Identification of potential patient and ecologic contributing indicators was guided by Andersen’s conceptual model of health service utilization. Results Overall, 66% of 7511 subjects were registered with a PCP. Older subjects were significantly less likely than those center had a major impact on registration. Conclusions Age continues to be a significant predictor of PCP registration in Nova Scotia even after controlling for the confounding effects of many new demographic, health service, and ecologic indicators. PMID:19300309

  15. Association between habitual daytime napping and metabolic syndrome: a population-based study.

    Lin, Diaozhu; Sun, Kan; Li, Feng; Qi, Yiqin; Ren, Meng; Huang, Chulin; Tang, Juying; Xue, Shengneng; Li, Yan; Yan, Li

    2014-12-01

    Our objective was to evaluate the association between habitual daytime napping and the prevalence of metabolic syndrome. We conducted a population-based study of 8,547 subjects aged 40 years or older. Metabolic syndrome was defined according to a harmonized definition from a joint statement and the recommended thresholds for the Chinese population. Information about sleep duration was self-reported. The prevalence of metabolic syndrome in the no daytime napping group, the 0 to 1 hour daytime napping group and the more than 1 hour daytime napping group were 35.0%, 36.0% and 44.5% among the females (Pnapping hours were positively associated with parameters of metabolic syndrome in the female subjects, including waist circumference, systolic blood pressure, triglycerides and fasting plasma glucose (Pnapping females, napping for more than 1 hour was independently associated with an increased prevalence of metabolic syndrome (odds ratio 1.39, 95% confidence interval, 1.13-1.72). Compared to the female subjects in the no daytime napping group, those habitually napped for more than 1 hour exhibited 46% and 26% increases in the prevalence of central obesity and hypertriglyceridemia (all Pnapping hours and metabolic syndrome among the male subjects. Daytime napping is associated with an increased prevalence of metabolic syndrome in middle-aged non-obese Chinese women. Copyright © 2014. Published by Elsevier Inc.

  16. A population-based study of anxiety as a precursor for depression in childhood and adolescence

    van den Bree Marianne BM

    2004-12-01

    Full Text Available Background Anxiety and depression co-occur in children and adolescents with anxiety commonly preceding depression. Although there is some evidence to suggest that the association between early anxiety and later depression is explained by a shared genetic aetiology, the contribution of environmental factors is less well examined and it is unknown whether anxiety itself is a phenotypic risk factor for later depression. These explanations of the association between early anxiety and later depression were evaluated. Methods Anxiety and depressive symptoms were assessed longitudinally in a U.K. population-based sample of 676 twins aged 5–17 at baseline. At baseline, anxiety and depression were assessed by parental questionnaire. Depression was assessed three years later by parental and adolescent questionnaire. Results Shared genetic effects between early anxiety and later depression were found. A model of a phenotypic risk effect from early anxiety on later depression provided a poor fit to the data. However, there were significant genetic effects specific to later depression, showing that early anxiety and later depression do not index entirely the same genetic risk. Conclusions Anxiety and depression are associated over time because they share a partly common genetic aetiology rather than because the anxiety phenotype leads to later depression.

  17. Breast cancer screening among shift workers: a nationwide population-based survey in Korea.

    Son, Heesook; Kang, Youngmi

    2017-04-01

    We aimed to examine the association between shift work types and participation in breast cancer screening (BCS) programs by comparing rates of participation for BCS among regular daytime workers and alternative shift workers using data from a nationally representative, population-based survey conducted in Korea. In addition, the results were analyzed according to sociodemographic factors, including occupation, education, income, private health insurance, age, and number of working hours a week. This secondary cross-sectional analysis used data from the 2012 Korean National Health and Nutritional Examination Survey. The target population included women aged ≥ 40 years who responded as to whether they had undergone BCS in the previous year. Accordingly, we analyzed survey data for a total of 1,193 women and used a multivariate logistic regression analysis to evaluate the differences in factors affecting BCS between regular daytime and alternative shift workers. A logistic regression analysis was performed considering private health insurance as a significant sociodemographic factor for BCS among regular daytime shift workers. In contrast, none of the tested variables could significantly predict adherence to BCS among alternative shift workers. The results of this study suggest the need for the development of comprehensive workplace breast cancer prevention programs by considering shift work types. More attention should be given to female workers with low education levels, those who are uninsured, and young workers to improve the participation rate for BCS at the workplace.

  18. Recurrent pain is associated with decreased selective attention in a population-based sample.

    Gijsen, C P; Dijkstra, J B; van Boxtel, M P J

    2011-01-01

    Studies which have examined the impact of pain on cognitive functioning in the general population are scarce. In the present study we assessed the predictive value of recurrent pain on cognitive functioning in a population-based study (N=1400). Furthermore, we investigated the effect of pain on cognitive functioning in individuals with specific pain complaints (i.e. back pain, gastric pain, muscle pain and headache). Cognitive functioning was assessed using the Stroop Color-Word Interference test (Stroop interference), the Letter-Digit-Substitution test (LDST) and the Visual Verbal learning Task (VVLT). Pain was measured with the COOP/WONCA pain scale (Dartmouth Primary Care Cooperative Information Project/World Organization of National Colleges, Academies, and Academic Associations of General Prac