WorldWideScience

Sample records for registry-based case-crossover study

  1. Use of a prescribed ephedrine/caffeine combination and the risk of serious cardiovascular events: a registry-based case-crossover study

    DEFF Research Database (Denmark)

    Hallas, Jesper; Bjerrum, Lars; Støvring, Henrik

    2008-01-01

    Ephedrine and herbal ephedra preparations have been shown to induce a small-to-moderate weight loss. Owing to reports on serious cardiovascular events, they were banned from the US market in 2004. There have been no large controlled studies on the possible association between prescribed ephedrine/caffeine...... and cardiovascular events in general. The authors linked data from four different sources within Statistics Denmark, using data on 257,364 users of prescribed ephedrine/caffeine for the period 1995-2002. The data were analyzed using a case-crossover technique with a composite endpoint: death outside of a hospital......, myocardial infarction, or stroke. To account for effects of chronic exposure and effects in naïve users, the authors performed a secondary case-control study nested within the cohort of ephedrine/caffeine ever users. Among 2,316 case subjects, 282 (12.2%) were current users of ephedrine/caffeine. The case...

  2. Persistent User Bias in Case-Crossover Studies in Pharmacoepidemiology

    DEFF Research Database (Denmark)

    Hallas, Jesper; Pottegård, Anton; Wang, Shirley

    2016-01-01

    Studying the effect of chronic medication exposure by means of a case-crossover design may result in an upward-biased odds ratio. In this study, our aim was to assess the occurrence of this bias and to evaluate whether it is remedied by including a control group (the case-time-control design...... for the retinal detachment controls were similar, leading to near-null case-time-control estimates for all 3 medication classes. For wrist fracture and stroke, the odds ratios were higher for cases than for controls, and case-time-control odds ratios were consistently above unity, thus implying significant...... residual bias. In case-crossover studies of medications, contamination by persistent users confers a moderate bias upward, which is partly remedied by using a control group. The optimal strategy for dealing with this problem is currently unknown....

  3. Triggers for Preeclampsia Onset: a Case-Crossover Study.

    Science.gov (United States)

    Ford, Jane B; Schemann, Kathrin; Patterson, Jillian A; Morris, Jonathan; Herbert, Robert D; Roberts, Christine L

    2016-11-01

    Risk factors for preeclampsia are well established, whereas, the triggers associated with timing of preeclampsia onset are not. The aim of this study was to establish whether recent infection or other triggers were associated with timing of preeclampsia onset. We used a case-crossover design with preeclampsia cases serving as their own controls. Women with singleton pregnancies of ≥20 weeks gestation presenting at three hospitals were eligible for inclusion. Exposures to potential triggers were identified via guided questionnaire. Infective episodes included symptoms lasting >24 h. Preeclampsia was defined as hypertension (BP ≥140 mmHg and/or ≥90 mmHg) and proteinuria (protein/creatinine ratio ≥30 mg/mmol). Conditional logistic regression was used to compare the odds of exposure to potential triggers in the case windows (1-7 days preceding diagnosis of preeclampsia) and control windows (8-14 days prior to diagnosis); unadjusted odds ratios (ORs) are reported. Among 286 recruited women, 25 (8.7%) reported a new infection in the 7 days prior to preeclampsia onset and 21 (7.3%) in the 8-14 days prior. There was no significant association between onset of infection in the 7 days prior and preeclampsia diagnosis (OR 1.24, 95% CI 0.65, 2.34). Consumption of caffeine (OR 0.51, 95% CI 0.33, 0.77), spicy food (OR 0.49, 95% CI 0.30, 0.81), and alcohol (OR 0.26, 95% CI 0.10, 0.71) were strongly inversely associated with preeclampsia onset. Recent infection does not appear to trigger preeclampsia. Decreased consumption of caffeine, spicy food, and alcohol may be prodromal markers. Such behaviours may be early markers of imminent preeclampsia. © 2016 John Wiley & Sons Ltd.

  4. A case-crossover study of transient risk factors influence on occupational injuries

    DEFF Research Database (Denmark)

    Oesterlund, Anna H; Lander, Flemming; Lauritsen, Jens

    2016-01-01

    questionnaire will be used to collect basic demographic data and information on eight transient risk factors. Based on previous studies and knowledge on occupational injuries the transient risk factors we chose to examine were: time pressure, performing a task with a different method/using unaccustomed......, but so far no relevant research has been conducted in Europe. METHOD: Case-crossover studies of occupational injuries were collected from PubMed and Embase and read through. Previous experiences concerning method, exposure and outcome, time-related measurements and construction of the questionnaire were...

  5. The effect of long working hours on cerebrovascular and cardiovascular disease; A case-crossover study.

    Science.gov (United States)

    Shin, Kyong-Sok; Chung, Yun Kyung; Kwon, Young-Jun; Son, Jun-Seok; Lee, Se-Hoon

    2017-09-01

    This study investigated the relationship between weekly working hours and the occurrence of cerebro-cardiovascular diseases using a case-crossover study design. We investigated average working hours during the 7 days before the onset of illness (hazard period) and average weekly working hours between 8 days and 3 months before the onset of cerebro-cardiovascular diseases (control period) for 1,042 cases from the workers' compensation database for 2009. Among all subjects, the odds ratio by conditional logistic regression for the risk of cerebro-cardiovascular diseases with a 10 hr increase in average weekly working hours was 1.45 (95% confidence interval [CI]: 1.22-1.72), a significant association. An increase in average weekly working hours may trigger the onset of cerebro-cardiovascular disease. Am. J. Ind. Med. 60:753-761, 2017. © 2017. Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  6. A case-crossover study on transient risk factors of work-related eye injuries.

    Science.gov (United States)

    Chen, S-Y; Fong, P-C; Lin, S-F; Chang, C-H; Chan, C-C

    2009-08-01

    To investigate modifiable risk and preventive factors of work-related eye injuries. A case-crossover study conducted to explore the associations between transient risk factors and work-related eye injuries. Patients seen at seven medical centres in Taiwan with work-related eye injuries over a 4-year period were enrolled in the study. Clinical information was collected from medical charts and detailed information on exposure to eight potentially modifiable factors during the 60 minutes prior to the occurrence of each injury, as well as during the same time interval on the last work day prior to the injury, were obtained using questionnaire surveys. Matched-pair interval analysis was adopted to assess the odds ratios (ORs) for work-related eye injuries given exposure to the eight modifiable factors. A total of 283 subjects were interviewed. Most of these injured workers were young, male, and self-employed or small enterprise workers. The most common injury type was photokeratitis (33.2%), mainly caused by welding (30.4%). The OR for a work-related eye injury was increased with the performance of an unfamiliar task (57.0), operation of a faulty tool or piece of equipment (48.5), distractions (24.0), being rushed (13.0), or fatigued (10.0), and a poor work environment (4.3). Wearing eye protection devices was found to have a significant protective effect on workers who might otherwise have been exposed to eye injuries (OR = 0.4; 95% CI 0.2 to 0.7). Potential modifiable risk and preventive factors for work-related eye injuries were identified using a case-crossover study. This information should be helpful in the development of preventive strategies.

  7. Case-crossover study of Burkholderia cepacia complex bloodstream infection associated with contaminated intravenous bromopride.

    Science.gov (United States)

    Martins, Ianick Souto; Pellegrino, Flávia Lúcia Piffano Costa; Freitas, Andrea d'Avila; Santos, Marisa da Silva; Ferraiuoli, Giovanna Ianini d'Alemeida; Vasques, Márcia Regina Guimarães; Amorim, Efigenia Lourdes Teixeira; Oliveira, Sandra; Nouér, Simone Aranha; Cardoso, Fernando Luiz Lopes; Mascarenhas, Luiz Affonso; Magalhães, Ana Cristina Gouveia; Cleinman, Isabella Barbosa; Figueiredo, Agnes Marie Sá; Moreira, Beatriz Meurer

    2010-05-01

    To investigate an outbreak of healthcare-associated Burkholderia cepacia complex (BCC) primary bloodstream infections (BCC-BSI). Case-crossover study in a public hospital, a university hospital and a private hospital in Rio de Janeiro, Brazil, from March 2006 to May 2006. Twenty-five patients with BCC-BSI. After determining the date BCC-BSI symptoms started for each patient, 3 time intervals of data collection were defined, each one with a duration of 3 days: the case period, starting just before BCC-BSI symptoms onset; the control period, starting 6 days before BCC-BSI symptoms onset; and the washout period, comprising the 3 days between the case period and the control period. Exposures evaluated were intravascular solutions and invasive devices and procedures. Potential risk factors were identified by using the McNemar chi(2) adjusted test. Cultures of samples of potentially contaminated solutions were performed. BCC strain typing was performed by pulsed-field gel electrophoresis using SpeI. The statistical analysis revealed that the use of bromopride and dipyrone was associated with BCC-BSI. A total of 21 clinical isolates from 17 (68%) of the 25 patients and an isolate obtained from the bromopride vial were available for strain typing. Six pulsotypes were detected. A predominant pulsotype (A) accounted for 11 isolates obtained from 11 patients (65%) in the 3 study hospitals. Our investigation, using a case-crossover design, of an outbreak of BCC-BSI infections concluded it was polyclonal but likely caused by infusion of contaminated bromopride. The epidemiological finding was validated by microbiological analysis. After recall of contaminated bromopride vials by the manufacturer, the outbreak was controlled.

  8. Acute Low Back Pain? Do Not Blame the Weather-A Case-Crossover Study.

    Science.gov (United States)

    Beilken, Keira; Hancock, Mark J; Maher, Chris G; Li, Qiang; Steffens, Daniel

    2017-06-01

    To investigate the influence of various weather parameters on the risk of developing a low back pain (LBP) episode. Case-crossover study. Primary care clinics in Sydney, Australia. 981 participants with a new episode of acute LBP. Weather parameters were obtained from the Australian Bureau of Meteorology. Odds ratios (OR) and 95% confidence intervals (95% CI) were derived comparing two exposure variables in the case window-(1) the average of the weather variable for the day prior to pain onset and (2) the change in the weather variable from 2 days prior to 1 day prior to pain onset-with exposures in two control windows (1 week and 1 month before the case window). The weather parameters of precipitation, humidity, wind speed, wind gust, wind direction, and air pressure were not associated with the onset of acute LBP. For one of the four analyses, higher temperature slightly increased the odds of pain onset. Common weather parameters that had been previously linked to musculoskeletal pain, such as precipitation, humidity, wind speed, wind gust, wind direction, and air pressure, do not increase the risk of onset for LBP. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  9. Psychological Factors and Pain Exacerbation in Knee Osteoarthritis : A Web Based Case-Crossover Study

    NARCIS (Netherlands)

    Erfani, Tahereh; Keefe, Francis; Bennell, Kim; Chen, J; Makovey, J; Metcalf, B; Williams, A.D.; Zhang, Y; Hunter, David

    2015-01-01

    OBJECTIVES: The pain experienced by osteoarthritis (OA) patients is neither constant nor unchanging and patients experience episodes of pain exacerbations. Using an innovative web based case-crossover design, we evaluated whether psychological factors are risk factors for pain exacerbations in

  10. Weather as a risk factor for epileptic seizures: A case-crossover study.

    Science.gov (United States)

    Rakers, Florian; Walther, Mario; Schiffner, Rene; Rupprecht, Sven; Rasche, Marius; Kockler, Michael; Witte, Otto W; Schlattmann, Peter; Schwab, Matthias

    2017-07-01

    Most epileptic seizures occur unexpectedly and independently of known risk factors. We aimed to evaluate the clinical significance of patients' perception that weather is a risk factor for epileptic seizures. Using a hospital-based, bidirectional case-crossover study, 604 adult patients admitted to a large university hospital in Central Germany for an unprovoked epileptic seizure between 2003 and 2010 were recruited. The effect of atmospheric pressure, relative air humidity, and ambient temperature on the onset of epileptic seizures under temperate climate conditions was estimated. We found a close-to-linear negative correlation between atmospheric pressure and seizure risk. For every 10.7 hPa lower atmospheric pressure, seizure risk increased in the entire study population by 14% (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.01-1.28). In patients with less severe epilepsy treated with one antiepileptic medication, seizure risk increased by 36% (1.36, 1.09-1.67). A high relative air humidity of >80% increased seizure risk in the entire study population by up to 48% (OR 1.48, 95% CI 1.11-1.96) 3 days after exposure in a J-shaped association. High ambient temperatures of >20°C decreased seizure risk by 46% in the overall study population (OR 0.54, 95% CI 0.32-0.90) and in subgroups, with the greatest effects observed in male patients (OR 0.33, 95% CI 0.14-0.74). Low atmospheric pressure and high relative air humidity are associated with an increased risk for epileptic seizures, whereas high ambient temperatures seem to decrease seizure risk. Weather-dependent seizure risk may be accentuated in patients with less severe epilepsy. Our results require further replication across different climate regions and cohorts before reliable clinical recommendations can be made. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  11. Antipsychotic medications and stroke in schizophrenia: A case-crossover study.

    Directory of Open Access Journals (Sweden)

    Wen-Yin Chen

    Full Text Available The association between antipsychotic use and the risk of stroke in schizophrenic patients is controversial. We sought to study the association in a nationwide cohort with schizophrenia.Using a retrospective cohort of patients with schizophrenia (N = 31,976 derived from the Taiwan National Health Insurance Research Database, 802 new-onset cases of stroke were identified within 10 years of follow-up (from 2000 through 2010. We designed a case-crossover study using 14-day windows to explore the risk factors of stroke and the association between antipsychotic drugs and the risk of stroke. We analyzed the risks of individual antipsychotics on various subgroups of stroke including ischemic, hemorrhagic, and other strokes, and the risks based on the antipsychotic receptor-binding profile of each drug.Use of any second-generation antipsychotic was associated with an increased risk of stroke (adjusted risk ratio = 1.45, P = .009 within 14 days while the use of any first-generation antipsychotic was not. Intriguingly, the use of any second-generation antipsychotic was associated with ischemic stroke but not hemorrhagic stroke. The antipsychotic receptor-binding profile analysis showed that the antihistamine 1 receptor was significantly associated with ischemic stroke (adjusted risk ratio = 1.72, P = .037, and the sensitivity analysis based on the 7-day window of exposure validated the association (adjusted risk ratio = 1.87, P = .015.Use of second-generation antipsychotic drugs appeared to be associated with an increased risk of ischemic stroke in the patients studied, possibly mediated by high affinity for histamine-1 receptor blockade. Further research regarding the underlying biological mechanism and drug safety is suggested.

  12. A Case-Crossover Study of Heat Exposure and Injury Risk in Outdoor Agricultural Workers.

    Science.gov (United States)

    Spector, June T; Bonauto, David K; Sheppard, Lianne; Busch-Isaksen, Tania; Calkins, Miriam; Adams, Darrin; Lieblich, Max; Fenske, Richard A

    2016-01-01

    Recent research suggests that heat exposure may increase the risk of traumatic injuries. Published heat-related epidemiological studies have relied upon exposure data from individual weather stations. To evaluate the association between heat exposure and traumatic injuries in outdoor agricultural workers exposed to ambient heat and internal heat generated by physical activity using modeled ambient exposure data. A case-crossover study using time-stratified referent selection among 12,213 outdoor agricultural workers with new Washington State Fund workers' compensation traumatic injury claims between 2000 and 2012 was conducted. Maximum daily Humidex exposures, derived from modeled meteorological data, were assigned to latitudes and longitudes of injury locations on injury and referent dates. Conditional logistic regression was used to estimate odds ratios of injury for a priori daily maximum Humidex categories. The mean of within-stratum (injury day and corresponding referent days) standard deviations of daily maximum Humidex was 4.8. The traumatic injury odds ratio was 1.14 (95% confidence interval 1.06, 1.22), 1.15 (95% confidence interval 1.06, 1.25), and 1.10 (95% confidence interval 1.01, 1.20) for daily maximum Humidex of 25-29, 30-33, and ≥34, respectively, compared to < 25, adjusted for self-reported duration of employment. Stronger associations were observed during cherry harvest duties in the June and July time period, compared to all duties over the entire study period. Agricultural workers laboring in warm conditions are at risk for heat-related traumatic injuries. Combined heat-related illness and injury prevention efforts should be considered in high-risk populations exposed to warm ambient conditions in the setting of physical exertion.

  13. A Case-Crossover Study of Heat Exposure and Injury Risk in Outdoor Agricultural Workers.

    Directory of Open Access Journals (Sweden)

    June T Spector

    Full Text Available Recent research suggests that heat exposure may increase the risk of traumatic injuries. Published heat-related epidemiological studies have relied upon exposure data from individual weather stations.To evaluate the association between heat exposure and traumatic injuries in outdoor agricultural workers exposed to ambient heat and internal heat generated by physical activity using modeled ambient exposure data.A case-crossover study using time-stratified referent selection among 12,213 outdoor agricultural workers with new Washington State Fund workers' compensation traumatic injury claims between 2000 and 2012 was conducted. Maximum daily Humidex exposures, derived from modeled meteorological data, were assigned to latitudes and longitudes of injury locations on injury and referent dates. Conditional logistic regression was used to estimate odds ratios of injury for a priori daily maximum Humidex categories.The mean of within-stratum (injury day and corresponding referent days standard deviations of daily maximum Humidex was 4.8. The traumatic injury odds ratio was 1.14 (95% confidence interval 1.06, 1.22, 1.15 (95% confidence interval 1.06, 1.25, and 1.10 (95% confidence interval 1.01, 1.20 for daily maximum Humidex of 25-29, 30-33, and ≥34, respectively, compared to < 25, adjusted for self-reported duration of employment. Stronger associations were observed during cherry harvest duties in the June and July time period, compared to all duties over the entire study period.Agricultural workers laboring in warm conditions are at risk for heat-related traumatic injuries. Combined heat-related illness and injury prevention efforts should be considered in high-risk populations exposed to warm ambient conditions in the setting of physical exertion.

  14. Air pollution and emergency department visits for respiratory diseases: A multi-city case crossover study.

    Science.gov (United States)

    Szyszkowicz, Mieczysław; Kousha, Termeh; Castner, Jessica; Dales, Robert

    2018-05-01

    Increasing evidence suggests that ambient air pollution is a major risk factor for both acute and chronic respiratory disease exacerbations and emergencies. The objective of this study was to determine the association between ambient air pollutants and emergency department (ED) visits for respiratory conditions in nine districts across the province of Ontario in Canada. Health, air pollutant (PM 2.5 , NO 2 , O 3 , and SO 2 ), and meteorological data were retrieved from April 2004 to December 2011. Respiratory diseases were categorized as: chronic obstructive pulmonary disease (COPD, including bronchiectasis) and acute upper respiratory diseases. A case-crossover design was used to test the associations between ED visits and ambient air pollutants, stratified by sex and season. For COPD among males, positive results were observed for NO 2 with lags of 3-6 days, for PM 2.5 with lags 1-8, and for SO 2 with lags of 4-8 days. For COPD among females, positive results were observed for O 3 with lags 2-4 days, and for SO 2 among lags of 3-6 days. For upper respiratory disease emergencies among males, positive results were observed for NO 2 (lags 5-8 days), for O 3 , (lags 0-6 days), PM 2.5 (all lags), and SO 2 (lag 8), and among females, positive results were observed for NO 2 for lag 8 days, for O 3 , PM 2.5 among all lags. Our study provides evidence of the associations between short-term exposure to air pollution and increased risk of ED visits for upper and lower respiratory diseases in an environment where air pollutant concentrations are relatively low. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

  15. How air pollution influences clinical management of respiratory diseases. A case-crossover study in Milan

    OpenAIRE

    Santus Pierachille; Russo Antonio; Madonini Enzo; Allegra Luigi; Blasi Francesco; Centanni Stefano; Miadonna Antonio; Schiraldi Gianfranco; Amaducci Sandro

    2012-01-01

    Abstract Background Environmental pollution is a known risk factor for multiple diseases and furthermore increases rate of hospitalisations. We investigated the correlation between emergency room admissions (ERAs) of the general population for respiratory diseases and the environmental pollutant levels in Milan, a metropolis in northern Italy. Methods We collected data from 45770 ERAs for respiratory diseases. A time-stratified case-crossover design was used to investigate the association bet...

  16. Flooding and emergency room visits for gastrointestinal illness in Massachusetts: a case-crossover study.

    Directory of Open Access Journals (Sweden)

    Timothy J Wade

    Full Text Available INTRODUCTION: Floods and other severe weather events are anticipated to increase as a result of global climate change. Floods can lead to outbreaks of gastroenteritis and other infectious diseases due to disruption of sewage and water infrastructure and impacts on sanitation and hygiene. Floods have also been indirectly associated with outbreaks through population displacement and crowding. METHODS: We conducted a case-crossover study to investigate the association between flooding and emergency room visits for gastrointestinal illness (ER-GI in Massachusetts for the years 2003 through 2007. We obtained ER-GI visits from the State of Massachusetts and records of floods from the National Oceanic and Atmospheric Association's Storm Events Database. ER-GI visits were considered exposed if a flood occurred in the town of residence within three hazard periods of the visit: 0-4 days; 5-9 days; and 10-14 days. A time-stratified bi-directional design was used for control selection, matching on day of the week with two weeks lead or lag time from the ER-GI visit. Fixed effect logistic regression models were used to estimate the risk of ER-GI visits following the flood. RESULTS AND CONCLUSIONS: A total of 270,457 ER-GI visits and 129 floods occurred in Massachusetts over the study period. Across all counties, flooding was associated with an increased risk for ER-GI in the 0-4 day period after flooding (Odds Ratio: 1.08; 95% Confidence Interval: 1.03-1.12; but not the 5-9 days (Odds Ratio: 0.995; 95% Confidence Interval: 0.955-1.04 or the 10-14 days after (Odds Ratio: 0.966, 95% Confidence Interval: 0.927-1.01. Similar results were observed for different definitions of ER-GI. The effect differed across counties, suggesting local differences in the risk and impact of flooding. Statewide, across the study period, an estimated 7% of ER-GI visits in the 0-4 days after a flood event were attributable to flooding.

  17. Air pollution and emergency department visits for conjunctivitis: A case-crossover study

    Directory of Open Access Journals (Sweden)

    Mieczysław Szyszkowicz

    2016-06-01

    Full Text Available Objectives: The purpose of this study was to examine the associations between emergency department (ED visits for conjunctivitis and ambient air pollution levels in urban regions across the province of Ontario, Canada. Material and Methods: Information from the National Ambulatory Care Reporting System was used to create time-series records, for the period of April 2004 to December 2011, on emergency department visits of patients suffering from conjunctivitis. A total of 77 439 emergency department visits for conjunctivitis were analyzed. A time-stratified case-crossover design was applied, completed with meta-analysis in order to pool inter-city results. Odds ratio (OR for an emergency department visit was calculated in different population strata per one-unit increase (one interquartile range – IQR increase in a pollutant’s daily level while controlling for the impacts of temperature and relative humidity. Results: Statistically significant positive results were observed in the female population sample, for nitrogen dioxide (NO2 exposure lagged 5–8 days, with the highest result for the 7-day lag (OR = 1.035, 95% CI: 1.018–1.052 and for fine particulate matter with a median aerodynamic diameter of less than 2.5 μm (PM2.5, for lags 6 and 7 days, with the highest result for lag 7 (OR = 1.017, 95% CI: 1.003–1.031. In the male population sample, statistically significant positive results were observed for NO2 at lag 5 days (OR = 1.024, 95% CI: 1.004–1.045 and for ozone (O3, at lags 0–3 and 7 days, with the highest result for lag 0 (OR = 1.038, 95% CI: 1.012–1.056. Also for males, statistically significant results were observed in the case of PM2.5 exposure lagged by 5 days (OR = 1.003, 95% CI: 1.000–1.038 and sulfur dioxide (SO2 exposure lagged by 1 and 2 days (OR = 1.016, 95% CI: 1.000–1.031 and OR = 1.018, 95% CI: 1.002–1.033. Conclusions: The findings of this study suggest that there are associations between levels of air

  18. How air pollution influences clinical management of respiratory diseases. A case-crossover study in Milan.

    Science.gov (United States)

    Santus, Pierachille; Russo, Antonio; Madonini, Enzo; Allegra, Luigi; Blasi, Francesco; Centanni, Stefano; Miadonna, Antonio; Schiraldi, Gianfranco; Amaducci, Sandro

    2012-10-18

    Environmental pollution is a known risk factor for multiple diseases and furthermore increases rate of hospitalisations. We investigated the correlation between emergency room admissions (ERAs) of the general population for respiratory diseases and the environmental pollutant levels in Milan, a metropolis in northern Italy. We collected data from 45770 ERAs for respiratory diseases. A time-stratified case-crossover design was used to investigate the association between air pollution levels and ERAs for acute respiratory conditions. The effects of air pollutants were investigated at lag 0 to lag 5, lag 0-2 and lag 3-5 in both single and multi-pollutant models, adjusted for daily weather variables. An increase in ozone (O(3)) levels at lag 3-5 was associated with a 78% increase in the number of ERAs for asthma, especially during the warm season. Exposure to carbon monoxide (CO) proved to be a risk factor for pneumonia at lag 0-2 and in the warm season increased the risk of ERA by 66%. A significant association was found between ERAs for COPD exacerbation and levels of sulphur dioxide (SO(2)), CO, nitrate dioxide (NO(2)), and particulate matter (PM(10) and PM(2.5)). The multipollutant model that includes all pollutants showed a significant association between CO (26%) and ERA for upper respiratory tract diseases at lag 0-2. For chronic obstructive pulmonary disease (COPD) exacerbations, only CO (OR 1.19) showed a significant association. Exposure to environmental pollution, even at typical low levels, can increase the risk of ERA for acute respiratory diseases and exacerbation of obstructive lung diseases in the general population.

  19. Atmospheric Pressure and Abdominal Aortic Aneurysm Rupture: Results From a Time Series Analysis and Case-Crossover Study.

    Science.gov (United States)

    Penning de Vries, Bas B L; Kolkert, Joé L P; Meerwaldt, Robbert; Groenwold, Rolf H H

    2017-10-01

    Associations between atmospheric pressure and abdominal aortic aneurysm (AAA) rupture risk have been reported, but empirical evidence is inconclusive and largely derived from studies that did not account for possible nonlinearity, seasonality, and confounding by temperature. Associations between atmospheric pressure and AAA rupture risk were investigated using local meteorological data and a case series of 358 patients admitted to hospital for ruptured AAA during the study period, January 2002 to December 2012. Two analyses were performed-a time series analysis and a case-crossover study. Results from the 2 analyses were similar; neither the time series analysis nor the case-crossover study showed a significant association between atmospheric pressure ( P = .627 and P = .625, respectively, for mean daily atmospheric pressure) or atmospheric pressure variation ( P = .464 and P = .816, respectively, for 24-hour change in mean daily atmospheric pressure) and AAA rupture risk. This study failed to support claims that atmospheric pressure causally affects AAA rupture risk. In interpreting our results, one should be aware that the range of atmospheric pressure observed in this study is not representative of the atmospheric pressure to which patients with AAA may be exposed, for example, during air travel or travel to high altitudes in the mountains. Making firm claims regarding these conditions in relation to AAA rupture risk is difficult at best. Furthermore, despite the fact that we used one of the largest case series to date to investigate the effect of atmospheric pressure on AAA rupture risk, it is possible that this study is simply too small to demonstrate a causal link.

  20. Changes in drinking as predictors of changes in sickness absence: a case-crossover study.

    Science.gov (United States)

    Ervasti, Jenni; Kivimäki, Mika; Pentti, Jaana; Halonen, Jaana I; Vahtera, Jussi; Virtanen, Marianna

    2018-01-01

    We investigated whether changes in alcohol use predict changes in the risk of sickness absence in a case-crossover design. Finnish public sector employees were surveyed in 2000, 2004 and 2008 on alcohol use and covariates. Heavy drinking was defined as either a weekly intake that exceeded recommendations (12 units for women; 23 for men) or having an extreme drinking session. The responses were linked to national sickness absence registers. We analysed the within-person relative risk of change in the risk of sickness absence in relation to change in drinking. Case period refers to being sickness absent within 1 year of the survey and control period refers to not being sickness absent within 1 year of the survey. Periods of heavy drinking were associated with increased odds of self-certified short-term (1-3 days) sickness absence (multivariable-adjusted OR 1.21, 95% CI 1.07 to 1.38 for all participants; 1.62, 95% CI 1.19 to 2.21 for men and 1.15, 95% CI 1.00 to 1.33 for women). A higher risk of short-term sickness absence was also observed after increase in drinking (OR=1.27, 95% CI 1.07 to 1.52) and a lower risk was observed after decrease in drinking (OR=0.83, 95% CI 0.69 to 1.00). Both increase (OR=1.38, 95% CI 1.21 to 1.57) and decrease (OR=1.27, 95% CI 1.19 to 1.43) in drinking were associated with increased risk of long-term (>9 days) medically certified all-cause sickness absence. Increase in drinking was related to increases in short-term and long-term sickness absences. Men and employees with a low socioeconomic position in particular seemed to be at risk. © 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.

  1. Risk of injury after alcohol consumption from case-crossover studies in five countries from the America’s

    Science.gov (United States)

    Borges, Guilherme; Orozco, Ricardo; Monteiro, Maristela; Cherpitel, Cheryl; Then, Eddy Pérez; López, Víctor A.; Bassier-Paltoo, Marcia; Weil A., Donald; de Bradshaw, Aldacira M

    2012-01-01

    Aims This study aimed to: 1) provide relative risk (RR) estimates between acute alcohol use and injuries from emergency departments in the Dominican Republic, Guatemala, Guyana, Nicaragua and Panama, and 2) test whether the RR differs if two control periods for the estimates were used. Design Case-crossover methodology was used to obtain estimates of the RR of having an injury within six hours after drinking alcohol, using a pair-matching design with control periods of the same time of day the day prior to injury, and the same time of day and day of week the week prior to injury. Setting Emergency departments(EDs). Participants 2,503 injured patients from EDs were interviewed between 2010–2011, with a response rate of 92.6%. Measurements Number of drinks consumed within six hours prior to the injury and in the two control periods. Findings The RR of injury after drinking alcohol was 4.38 (95% confidence interval CI= 3.29–5.84) using as the control period the prior week, and 5.35 (CI=3.50–8.17) using as a control period the prior day. The RR was 5.08 (CI=4.15–6.23) in multiple matching. Those drinking 1–2 drinks had a RR of 4.85 (CI=3.12–7.54); those drinking 3–5 a RR of 5.00 (CI =3.47–7.18); those drinking 6–15 a RR of 4.54 (CI=3.36–6.14); and those drinking 16 or more a RR of 10.42 (CI=4.38–24.79). Conclusions As in other countries, alcohol drinking is a trigger for an injury in all five countries. The use of more than one control period give further strength to these findings from case-crossover analysis. PMID:22775508

  2. Nordic registry-based cohort studies: Possibilities and pitfalls when combining Nordic registry data.

    Science.gov (United States)

    Maret-Ouda, John; Tao, Wenjing; Wahlin, Karl; Lagergren, Jesper

    2017-07-01

    All five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) have nationwide registries with similar data structure and validity, as well as personal identity numbers enabling linkage between registries. These resources provide opportunities for medical research that is based on large registry-based cohort studies with long and complete follow-up. This review describes practical aspects, opportunities and challenges encountered when setting up all-Nordic registry-based cohort studies. Relevant articles describing registries often used for medical research in the Nordic countries were retrieved. Further, our experiences of conducting this type of study, including planning, acquiring permissions, data retrieval and data cleaning and handling, and the possibilities and challenges we have encountered are described. Combining data from the Nordic countries makes it possible to create large and powerful cohorts. The main challenges include obtaining all permissions within each country, usually in the local language, and retrieving the data. These challenges emphasise the importance of having experienced collaborators within each country. Following the acquisition of data, data management requires the understanding of the differences between the variables to be used in the various countries. A concern is the long time required between initiation and completion. Nationwide Nordic registries can be combined into cohorts with high validity and statistical power, but the considerable expertise, workload and time required to complete such cohorts should not be underestimated.

  3. Cognition and sensation in very high static magnetic fields: a randomized case-crossover study with different field strengths.

    Science.gov (United States)

    Heinrich, Angela; Szostek, Anne; Meyer, Patric; Nees, Frauke; Rauschenberg, Jaane; Gröbner, Jens; Gilles, Maria; Paslakis, Georgios; Deuschle, Michael; Semmler, Wolfhard; Flor, Herta

    2013-01-01

    To establish the extent to which representative cognitive functions in subjects undergoing magnetic resonance (MR) imaging are acutely impaired by static magnetic fields of varying field strengths. This study was approved by the local ethics committee, and informed consent was obtained from all subjects. In this single-blind case-crossover study, 41 healthy subjects underwent an extensive neuropsychologic examination while in MR units of differing field strengths (1.5, 3.0, and 7.0 T), including a mock imager with no magnetic field as a control condition. Subjects were blinded to field strength. Tests were performed while subjects were lying still in the MR unit and while the examination table was moved. The tests covered a representative set of cognitive functions, such as memory, eye-hand coordination, attention, reaction time, and visual discrimination. Subjective sensory perceptions were also assessed. Effects were analyzed with a repeated-measures analysis of variance; the within-subject factors were field strength (0, 1.5, 3.0, and 7.0 T) and state (static, dynamic). Static magnetic fields were not found to have a significant effect on cognitive function at any field strength. However, sensory perceptions did vary according to field strength. Dizziness, nystagmus, phosphenes, and head ringing were related to the strength of the static magnetic field. Static magnetic fields as high as 7.0 T did not have a significant effect on cognition. RSNA, 2012

  4. Exposure to air pollutants and mortality in hypertensive patients according to demography: a 10 year case-crossover study.

    Science.gov (United States)

    Wong, Martin C S; Tam, Wilson W S; Wang, Harry H X; Lao, X Q; Zhang, Daisy Dexing; Chan, Sky W M; Kwan, Mandy W M; Fan, Carmen K M; Cheung, Clement S K; Tong, Ellen L H; Cheung, N T; Tse, L A; Yu, Ignatius T S

    2014-09-01

    This study evaluated whether short term exposures to NO2, O3, particulate matter <10 mm in diameter (PM10) were associated with higher risk of mortality. A total of 223,287 hypertensive patients attended public health-care services and newly prescribed at least 1 antihypertensive agent were followed-up for up to 5 years. A time-stratified, bi-directional case-crossover design was adopted. For all-cause mortality, significant positive associations were observed for NO2 and PM10 at lag 0-3 days per 10 μg/m(3) increase in concentration (excess risks 1.187%-2.501%). Significant positive associations were found for O3 at lag 1 and 2 days and the excess risks were 1.654% and 1.207%, respectively. We found similarly positive associations between these pollutants and respiratory disease mortality. These results were significant among those aged ≥65 years and in cold seasons only. Older hypertensive patients are susceptible to all-cause and respiratory disease-specific deaths from these air pollutants in cold weather. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Prescription medicine use by pedestrians and the risk of injurious road traffic crashes: A case-crossover study.

    Directory of Open Access Journals (Sweden)

    Mélanie Née

    2017-07-01

    Full Text Available While some medicinal drugs have been found to affect driving ability, no study has investigated whether a relationship exists between these medicines and crashes involving pedestrians. The aim of this study was to explore the association between the use of medicinal drugs and the risk of being involved in a road traffic crash as a pedestrian.Data from 3 French nationwide databases were matched. We used the case-crossover design to control for time-invariant factors by using each case as its own control. To perform multivariable analysis and limit false-positive results, we implemented a bootstrap version of Lasso. To avoid the effect of unmeasured time-varying factors, we varied the length of the washout period from 30 to 119 days before the crash. The matching procedure led to the inclusion of 16,458 pedestrians involved in an injurious road traffic crash from 1 July 2005 to 31 December 2011. We found 48 medicine classes with a positive association with the risk of crash, with median odds ratios ranging from 1.12 to 2.98. Among these, benzodiazepines and benzodiazepine-related drugs, antihistamines, and anti-inflammatory and antirheumatic drugs were among the 10 medicines most consumed by the 16,458 pedestrians. Study limitations included slight overrepresentation of pedestrians injured in more severe crashes, lack of information about self-medication and the use of over-the-counter drugs, and lack of data on amount of walking.Therapeutic classes already identified as impacting the ability to drive, such as benzodiazepines and antihistamines, are also associated with an increased risk of pedestrians being involved in a road traffic crash. This study on pedestrians highlights the necessity of improving awareness of the effect of these medicines on this category of road user.

  6. The Effects of Coarse Particles on Daily Mortality: A Case-Crossover Study in a Subtropical City, Taipei, Taiwan

    Directory of Open Access Journals (Sweden)

    Meng-Hsuan Cheng

    2016-03-01

    Full Text Available Many studies have examined the effects of air pollution on daily mortality over the past two decades. However, information on the relationship between levels of coarse particles (PM2.5–10 and daily mortality is relatively sparse due to the limited availability of monitoring data. Furthermore, the results are inconsistent. In the current study, the association between coarse particle levels and daily mortality in Taipei, Taiwan’s largest city, which has a subtropical climate, was undertaken for the period 2006–2008 using a time-stratified case-crossover analysis. For the single pollutant model (without adjustment for other pollutants, PM2.5–10 showed statistically significant association with total mortality both on warm and cool days, with an interquartile range increase associated with a 11% (95% CI = 6%–17% and 4% (95% CI = 1%–7% rise in number of total deaths, respectively. In two-pollutant models, PM2.5–10 remained significant effects on total mortality after the inclusion of SO2 and O3 both on warm and cool days. We observed no significant associations between PM2.5–10 and daily mortality from respiratory diseases both on warm and cool days. For daily mortality from circulatory diseases, the effect of PM2.5–10 remained significant when SO2 or O3 was added in the regression model both on warm and cool days. Future studies of this type in cities with varying climates and cultures are needed.

  7. Association between ambient air pollution and hospitalization for ischemic and hemorrhagic stroke in China: A multicity case-crossover study.

    Science.gov (United States)

    Liu, Hui; Tian, Yaohua; Xu, Yan; Huang, Zhe; Huang, Chao; Hu, Yonghua; Zhang, Jun

    2017-11-01

    There is growing interest in the association between ambient air pollution and stroke, but few studies have investigated the association in developing countries. The primary objective of this study was to examine the association between levels of ambient air pollutants and hospital admission for stroke in China. A time-stratified case-crossover analysis was conducted between 2014 and 2015 in 14 large Chinese cities among 200,958 ischemic stroke and 41,746 hemorrhagic stroke hospitalizations. We used conditional logistic regression to estimate the percentage changes in stroke admissions in relation to interquartile range increases in air pollutants. Air pollution was positively associated with ischemic stroke. A difference of an interquartile range of the 6-day average for particulate matter less than 10 μm in aerodynamic diameter, sulfur dioxide, nitrogen dioxide, carbon monoxide, and ozone corresponded to 0.7% (95% CI: 0%, 1.4%), 1.6% (95% CI: 1.0%, 2.3%), 2.6% (95% CI: 1.8%, 3.5%), 0.5% (95% CI: -0.2%, 1.1%), and 1.3% (95% CI: 0.3%, 2.3%) increases in ischemic stroke admissions, respectively. For hemorrhagic stroke, we observed the only significant association in relation to nitrogen dioxide on the current day (percentage change: 1.6%; 95% CI: 0.3%, 2.9%). Our findings contribute to the limited scientific literature concerning the effect of ambient air pollution on stroke in developing countries. Our findings may have significant public health implications for primary prevention of stroke in China. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Lack of adjustment latitude at work as a trigger of taking sick leave-a Swedish case-crossover study.

    Directory of Open Access Journals (Sweden)

    Hanna Hultin

    Full Text Available OBJECTIVES: Research has shown that individuals reporting a low level of adjustment latitude, defined as having few possibilities to temporarily adjust work demands to illness, have a higher risk of sick leave. To what extent lack of adjustment latitude influences the individual when making the decision to take sick leave is unknown. We hypothesize that ill individuals are more likely to take sick leave on days when they experience a lack of adjustment latitude at work than on days with access to adjustment latitude. METHODS: A case-crossover design was applied to 546 sick-leave spells, extracted from a cohort of 1 430 employees at six Swedish workplaces, with a 3-12 month follow-up of all new sick-leave spells. Exposure to lack of adjustment latitude on the first sick-leave day was compared with exposure during several types of control periods sampled from the previous two months for the same individual. RESULTS: Only 35% of the respondents reported variations in access to adjustment latitude, and 19% reported a constant lack of adjustment latitude during the two weeks prior to the sick-leave spell. Among those that did report variation, the risk of sick leave was lower on days with lack of adjustment latitude, than on days with access (Odds Ratio 0.36, 95% Confidence Interval 0.25-0.52. CONCLUSIONS: This is the first study to show the influence of adjustment latitude on the decision to take sick leave. Among those with variations in exposure, lack of adjustment latitude was a deterrent of sick leave, which is contrary to the à priori hypothesis. These results indicate that adjustment latitude may not only capture long-lasting effects of a flexible working environment, but also temporary possibilities to adjust work to being absent. Further studies are needed to disentangle the causal mechanisms of adjustment latitude on sick-leave.

  9. Gaseous air pollution and emergency hospital visits for hypertension in Beijing, China: a time-stratified case-crossover study

    Directory of Open Access Journals (Sweden)

    Zhang Yanshen

    2010-10-01

    Full Text Available Abstract Background A number of epidemiological studies have been conducted to research the adverse effects of air pollution on mortality and morbidity. Hypertension is the most important risk factor for cardiovascular mortality. However, few previous studies have examined the relationship between gaseous air pollution and morbidity for hypertension. Methods Daily data on emergency hospital visits (EHVs for hypertension were collected from the Peking University Third Hospital. Daily data on gaseous air pollutants (sulfur dioxide (SO2 and nitrogen dioxide (NO2 and particulate matter less than 10 μm in aerodynamic diameter (PM10 were collected from the Beijing Municipal Environmental Monitoring Center. A time-stratified case-crossover design was conducted to evaluate the relationship between urban gaseous air pollution and EHVs for hypertension. Temperature and relative humidity were controlled for. Results In the single air pollutant models, a 10 μg/m3 increase in SO2 and NO2 were significantly associated with EHVs for hypertension. The odds ratios (ORs were 1.037 (95% confidence interval (CI: 1.004-1.071 for SO2 at lag 0 day, and 1.101 (95% CI: 1.038-1.168 for NO2 at lag 3 day. After controlling for PM10, the ORs associated with SO2 and NO2 were 1.025 (95% CI: 0.987-1.065 and 1.114 (95% CI: 1.037-1.195, respectively. Conclusion Elevated urban gaseous air pollution was associated with increased EHVs for hypertension in Beijing, China.

  10. Association between mobile phone traffic volume and road crash fatalities: A population-based case-crossover study.

    Science.gov (United States)

    Gariazzo, Claudio; Stafoggia, Massimo; Bruzzone, Silvia; Pelliccioni, Armando; Forastiere, Francesco

    2018-06-01

    Use of mobile phones while driving is known to cause crashes with possible fatalities. Different habits of mobile phone use might be distracting forces and display differential impacts on accident risk; the assessment of the relative importance is relevant to implement prevention, mitigation, and control measures. This study aimed to assess the relationship between the use of mobile phones at population level and road crash fatalities in large urban areas. Data on road crashes with fatalities were collected from seven Italian metropolitan areas and matched in time and space with high resolution mobile phone traffic volume data about calls, texts, Internet connections and upload/download data. A case-crossover study design was applied to estimate the relative risks of road accident for increases in each type of mobile phone traffic volumes in underlying population present in the small areas where accidents occurred. Effect modification was evaluated by weekday/weekend, hour of the day, meteorological conditions, and street densities. Positive associations between road crashes rates and the number of calls, texts, and Internet connections were found, with incremental risks of 17.2% (95% Confidence Interval [CI] 7.7, 27.6), 8.4% (CI 0.7, 16.8), and 54.6% (CI 34.0, 78.5) per increases (at 15 min intervals) of 5 calls/100 people, 3 text/100 people, and 40 connections/100 people, respectively. Small differences across cities were detected. Working days, nighttime and morning hours were associated with greater phone use and more road accidents. The relationship between mobile phone use and road fatalities at population level is strong. Strict controls on cellular phone in the vehicle may results in a large health benefit. Copyright © 2018 Elsevier Ltd. All rights reserved.

  11. An association between initiation of selective serotonin reuptake inhibitors and suicide - a nationwide register-based case-crossover study.

    Directory of Open Access Journals (Sweden)

    Charlotte Björkenstam

    Full Text Available BACKGROUND: Treatment with selective serotonin reuptake inhibitors (SSRI is one of the most common treatments for depression. It is however not clear whether or not there is an increased short-term suicide risk during initiation with SSRI. METHODS: A register-based nationwide case-crossover study including 5,866 suicides, 1,698 women and 4,168 men, from the Death Register 2007-2010 in Sweden. SSRI initiation was defined as a dispensed prescription of SSRI within 28 days prior to the date of suicide with no previous dispensed prescription of SSRI within 4 months prior that prescription. The control period took place one year earlier. Odds ratio (OR was estimated using conditional logistic regression. RESULT: During the 28 day period prior to suicide 48 women and 138 men were exposed to SSRI initiation (while not being exposed in the control period and 22 women and 43 men were exposed in the control period (while not being exposed in the case period. The OR for suicide after initiation with SSRI was 2.7 (95% CI: 1.6-44 for women, and 4.3 (95% CI: 3.0-6.1 for men. The highest OR was found 8-11 days after initiation with SSRI 9.7 (95% CI: 3.0-31.7 for women and men combined. CONCLUSION: The main limitation in this study is confounding by indication, but the descriptive question is however not confounded by indication. Together with plausible biological mechanisms and previous clinical and epidemiological observations our findings, linking initiation of SSRI to increased short-term suicide risk, deserve further attention specifically in the clinical setting.

  12. The association between home care visits and same-day emergency department use: a case-crossover study.

    Science.gov (United States)

    Jones, Aaron; Schumacher, Connie; Bronskill, Susan E; Campitelli, Michael A; Poss, Jeffrey W; Seow, Hsien; Costa, Andrew P

    2018-04-30

    The extent to which home care visits contribute to the delay or avoidance of emergency department use is poorly characterized. We examined the association between home care visits and same-day emergency department use among patients receiving publicly funded home care. We conducted a population-based case-crossover study among patients receiving publicly funded home care in the Hamilton-Niagara-Haldimand-Brant region of Ontario between January and December 2015. Within individuals, all days with emergency department visits after 5 pm were selected as cases and matched with control days from the previous week. The cohort was stratified according to whether patients had ongoing home care needs ("long stay") or short-term home care needs ("short stay"). We used conditional logistical regression to estimate the association between receiving a home care visit during the day and visiting the emergency department after 5 pm on the same day. A total of 4429 long-stay patients contributed 5893 emergency department visits, and 2836 short-stay patients contributed 3476 visits. Receiving a home care nursing visit was associated with an increased likelihood of visiting the emergency department after 5 pm on the same day in both long-stay (odds ratio [OR] 1.32, 95% confidence interval [CI] 1.17-1.48) and short-stay patients (OR 1.22, 95% CI 1.07-1.39). Stronger associations were observed for less acute visits to the emergency department. No associations were observed for other types of home care visits. Patients receiving home care were more likely to visit the emergency department during the evening on days they received a nursing visit. The mechanism of the association between home care visits and same-day emergency department use and the extent to which same-day emergency department visits could be prevented or diverted require additional investigation. © 2018 Joule Inc. or its licensors.

  13. Ambient Ozone Concentrations and the Risk of Perforated and Nonperforated Appendicitis: A Multicity Case-Crossover Study

    Science.gov (United States)

    Tanyingoh, Divine; Dixon, Elijah; Johnson, Markey; Wheeler, Amanda J.; Myers, Robert P.; Bertazzon, Stefania; Saini, Vineet; Madsen, Karen; Ghosh, Subrata; Villeneuve, Paul J.

    2013-01-01

    Background: Environmental determinants of appendicitis are poorly understood. Past work suggests that air pollution may increase the risk of appendicitis. Objectives: We investigated whether ambient ground-level ozone (O3) concentrations were associated with appendicitis and whether these associations varied between perforated and nonperforated appendicitis. Methods: We based this time-stratified case-crossover study on 35,811 patients hospitalized with appendicitis from 2004 to 2008 in 12 Canadian cities. Data from a national network of fixed-site monitors were used to calculate daily maximum O3 concentrations for each city. Conditional logistic regression was used to estimate city-specific odds ratios (ORs) relative to an interquartile range (IQR) increase in O3 adjusted for temperature and relative humidity. A random-effects meta-analysis was used to derive a pooled risk estimate. Stratified analyses were used to estimate associations separately for perforated and nonperforated appendicitis. Results: Overall, a 16-ppb increase in the 7-day cumulative average daily maximum O3 concentration was associated with all appendicitis cases across the 12 cities (pooled OR = 1.07; 95% CI: 1.02, 1.13). The association was stronger among patients presenting with perforated appendicitis for the 7-day average (pooled OR = 1.22; 95% CI: 1.09, 1.36) when compared with the corresponding estimate for nonperforated appendicitis [7-day average (pooled OR = 1.02, 95% CI: 0.95, 1.09)]. Heterogeneity was not statistically significant across cities for either perforated or nonperforated appendicitis (p > 0.20). Conclusions: Higher levels of ambient O3 exposure may increase the risk of perforated appendicitis. PMID:23842601

  14. Prescription medicines and the risk of road traffic crashes: a French registry-based study.

    Directory of Open Access Journals (Sweden)

    Ludivine Orriols

    2010-11-01

    Full Text Available In recent decades, increased attention has been focused on the impact of disabilities and medicinal drug use on road safety. The aim of our study was to investigate the association between prescription medicines and the risk of road traffic crashes, and estimate the attributable fraction.We extracted and matched data from three French nationwide databases: the national health care insurance database, police reports, and the national police database of injurious crashes. Drivers identified by their national health care number involved in an injurious crash in France, between July 2005 and May 2008, were included in the study. Medicines were grouped according to the four risk levels of the French classification system (from 0 [no risk] to 3 [high risk]. We included 72,685 drivers involved in injurious crashes. Users of level 2 (odds ratio [OR]  = 1.31 [1.24-1.40] and level 3 (OR  = 1.25 [1.12-1.40] prescription medicines were at higher risk of being responsible for a crash. The association remained after adjustment for the presence of a long-term chronic disease. The fraction of road traffic crashes attributable to levels 2 and 3 medications was 3.3% [2.7%-3.9%]. A within-person case-crossover analysis showed that drivers were more likely to be exposed to level 3 medications on the crash day than on a control day, 30 days earlier (OR  = 1.15 [1.05-1.27].The use of prescription medicines is associated with a substantial number of road traffic crashes in France. In light of the results, warning messages appear to be relevant for level 2 and 3 medications and questionable for level 1 medications. A follow-up study is needed to evaluate the impact of the warning labeling system on road traffic crash prevention.

  15. The association between daily concentrations of air pollution and visits to a psychiatric emergency unit: a case-crossover study.

    Science.gov (United States)

    Oudin, Anna; Åström, Daniel Oudin; Asplund, Peter; Steingrimsson, Steinn; Szabo, Zoltan; Carlsen, Hanne Krage

    2018-01-10

    Air pollution is one of the leading causes of mortality and morbidity worldwide. Experimental studies, and a few epidemiological studies, suggest that air pollution may cause acute exacerbation of psychiatric disorders, and even increase the rate of suicide attempts, but epidemiological studies on air pollution in association with psychiatric disorders are still few. Our aim was to investigate associations between daily fluctuations in air pollution concentrations and the daily number of visits to a psychiatric emergency unit. Data from Sahlgrenska University Hospital, Gothenburg, Sweden, on the daily number of visits to the Psychiatric emergency unit were combined with daily data on monitored concentrations of respirable particulate matter(PM 10 ), ozone(O 3 ), nitrogen dioxides(NO 2 ) and temperature between 1st July 2012 and 31st December 2016. We used a case-crossover design to analyze data with conditional Poisson regression models allowing for over-dispersion. We stratified data on season. Visits increased with increasing PM 10 levels during the warmer season (April to September) in both single-pollutant and two-pollutant models. For example, an increase of 3.6% (95% Confidence Interval, CI, 0.4-7.0%) was observed with a 10 μg/m3 increase in PM 10 adjusted for NO 2 . In the three-pollutant models (adjusting for NO 2 and O 3 simultaneously) the increase was 3.3% (95% CI, -0.2-6.9). There were no clear associations between the outcome and NO 2 , O 3 , or PM 10 during the colder season (October to March). Ambient air particle concentrations were associated with the number of visits to the Psychiatric emergency unit in the warm season. The results were only borderline statistically significant in the fully adjusted (three-pollutant) models in this small study. The observation could be interpreted as indicative of air pollution as either exacerbating an underlying psychiatric disorder, or increasing mental distress, even in areas with comparatively low levels of

  16. Forest Fire Smoke Exposures and Out-of-Hospital Cardiac Arrests in Melbourne, Australia: A Case-Crossover Study.

    Science.gov (United States)

    Dennekamp, Martine; Straney, Lahn D; Erbas, Bircan; Abramson, Michael J; Keywood, Melita; Smith, Karen; Sim, Malcolm R; Glass, Deborah C; Del Monaco, Anthony; Haikerwal, Anjali; Tonkin, Andrew M

    2015-10-01

    Millions of people can potentially be exposed to smoke from forest fires, making this an important public health problem in many countries. In this study we aimed to measure the association between out-of-hospital cardiac arrest (OHCA) and forest fire smoke exposures in a large city during a severe forest fire season, and estimate the number of excess OHCAs due to the fire smoke. We investigated the association between particulate matter (PM) and other air pollutants and OHCA using a case-crossover study of adults (≥ 35 years of age) in Melbourne, Australia. Conditional logistic regression models were used to derive estimates of the percent change in the rate of OHCA associated with an interquartile range (IQR) increase in exposure. From July 2006 through June 2007, OHCA data were collected from the Victorian Ambulance Cardiac Arrest Registry. Hourly air pollution concentrations and meteorological data were obtained from a central monitoring site. There were 2,046 OHCAs with presumed cardiac etiology during our study period. Among men during the fire season, greater increases in OHCA were observed with IQR increases in the 48-hr lagged PM with diameter ≤ 2.5 μm (PM2.5) (8.05%; 95% CI: 2.30, 14.13%; IQR = 6.1 μg/m(3)) or ≤ 10 μm (PM10) (11.1%; 95% CI: 1.55, 21.48%; IQR = 13.7 μg/m(3)) and carbon monoxide (35.7%; 95% CI: 8.98, 68.92%; IQR = 0.3 ppm). There was no significant association between the rate of OHCA and air pollutants among women. One hundred seventy-four "fire-hours" (i.e., hours in which Melbourne's air quality was affected by forest fire smoke) were identified during 12 days of the 2006/2007 fire season, and 23.9 (95% CI: 3.1, 40.2) excess OHCAs were estimated to occur due to elevations in PM2.5 during these fire-hours. This study found an association between exposure to forest fire smoke and an increase in the rate of OHCA. These findings have implications for public health messages to raise community awareness and for planning of emergency

  17. Short-term nighttime wind turbine noise and cardiovascular events: A nationwide case-crossover study from Denmark.

    Science.gov (United States)

    Poulsen, Aslak Harbo; Raaschou-Nielsen, Ole; Peña, Alfredo; Hahmann, Andrea N; Nordsborg, Rikke Baastrup; Ketzel, Matthias; Brandt, Jørgen; Sørensen, Mette

    2018-05-01

    The number of people exposed to wind turbine noise (WTN) is increasing. WTN is reported as more annoying than traffic noise at similar levels. Long-term exposure to traffic noise has consistently been associated with cardiovascular disease, whereas effects of short-term exposure are much less investigated due to little day-to-day variation of e.g. road traffic noise. WTN varies considerably due to changing weather conditions allowing investigation of short-term effects of WTN on cardiovascular events. We identified all hospitalisations and deaths from stroke (16,913 cases) and myocardial infarction (MI) (17,559 cases) among Danes exposed to WTN between 1982 and 2013. We applied a time-stratified, case-crossover design. Using detailed data on wind turbine type and hourly wind data at each wind turbine, we simulated mean nighttime outdoor (10-10,000 Hz) and nighttime low frequency (LF) indoor WTN (10-160 Hz) over the 4 days preceding diagnosis and reference days. For indoor LF WTN between 10 and 15 dB(A) and above 15 dB(A), odds ratios (ORs) for MI were 1.27 (95% confidence interval (CI): 0.97-1.67; cases = 198) and 1.62 (95% CI: 0.76-3.45; cases = 21), respectively, when compared to indoor LF WTN below 5 dB(A). For stroke, corresponding ORs were 1.17 (95% CI: 0.95-1.69; cases = 166) and 2.30 (95% CI: 0.96-5.50; cases = 15). The elevated ORs above 15 dB(A) persisted across sensitivity analyses. When looking at specific lag times, noise exposure one day before MI events and three days before stroke events were associated with the highest ORs. For outdoor WTN at night, we observed both increased and decreased risk estimates. This study did not provide conclusive evidence of an association between WTN and MI or stroke. It does however suggest that indoor LF WTN at night may trigger cardiovascular events, whereas these events seemed largely unaffected by nighttime outdoor WTN. These findings need reproduction, as they were based on few cases

  18. Radiotherapy for bone metastases - Practice in Norway 1997 - 2007. A national registry-based study

    Energy Technology Data Exchange (ETDEWEB)

    Sande Laugsand, Tonje [European Palliative Care Research Centre (PRC), Faculty of Medicine, Norwegian Univ. of Technology and Science (NTNU), Trondheim (Norway)], e-mail: tonje.laugsand@ntnu.no; Kaasa, Stein; Lund, Jo-Aasmund [European Palliative Care Research Centre (PRC), Faculty of Medicine, Norwegian Univ. of Technology and Science (NTNU), Trondheim (Norway); Cancer Clinic, St. Olavs Hospital, Univ. Hospital of Trondheim, Trondheim (Norway); Romundstad, Paal [Dept. of Public Health, Faculty of Medicine, Norwegian Univ. of Technology and Science (NTNU), Trondheim (Norway); Johannesen, Tom Boerge [Cancer Registry of Norway, Oslo (Norway)

    2013-08-15

    Numerous randomised clinical trials have shown that the efficacy of single fraction radiotherapy for metastatic bone pain corresponds to that of multiple fractions of radiotherapy for the majority of patients. It is not clear to which extent single fraction radiotherapy has been implemented into clinical practice. Material and methods: A Norwegian national registry based study was conducted, including all radiotherapy schedules of 8 Gy x 1 and 3 Gy x 10 delivered to bone metastases in 1997 - 2007. Binomial regression analyses were used to study whether treatment centre, primary diagnosis, anatomical region irradiated, age, sex, and travel distance, were associated with the choice of fractionation. Results: A total of 14 380 radiotherapy episodes were identified. During the period 31% of the treatments were delivered as 8 Gy x 1. The proportion of single fraction treatments increased from 16% in 1997 to 41% in 2007. There were substantial differences in the proportion of single fraction treatments between the treatment centres (range 25 - 54%). These differences persisted after adjustment for sex, age, primary diagnosis, anatomical region, and travel distance. Conclusions: The study demonstrates an under utilisation of single fraction treatment for bone metastases in Norway during the study period.

  19. The effect of enteral tube feeding in cystic fibrosis: A registry based study.

    Science.gov (United States)

    Libeert, Denis; Declercq, Dimitri; Wanyama, Simeon; Thomas, Muriel; Van Daele, Sabine; De Baets, Frans; Van Biervliet, Stephanie

    2018-03-01

    Long-term effect of enteral tube feeding (ETF) in cystic fibrosis (CF) remains equivocal. A Belgian CF registry based, retrospective, longitudinal study, evaluated the pre- and post- ETF (n = 113) clinical evolution and compared each patient with 2 age, gender, pancreatic status and genotype class-matched controls. At baseline ETF had a worse BMI z-score (p ETF, had already a significant worse nutritional status and pulmonary function at first entry in the registry. Both parameters displayed a significant decline before ETF-introduction. ETF had more hospitalization and intravenous antibiotic (IVAB) treatment days (p ETF introduction hospitalizations and IVAB decreased significantly. After ETF-introduction BMI z-score recuperated towards the original curve before the decline, but remained below the controls. Starting ETF had no effect on rate of height gain in children. The pre-index FEV1 decline (-1.52%/year (p = 0.002)) stabilized to +0.39%/year afterwards. Controls displayed decline of -0.48%/year (p ETF introduction improved BMI z-score and stabilized FEV1, associated with less hospitalizations and IVAB treatments. Higher mortality and transplantation in the ETF cases, leading to drop-outs, made determination of the effect size difficult. Copyright © 2018 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

  20. Low Apgar score, neonatal encephalopathy and epidural analgesia during labour: a Swedish registry-based study.

    Science.gov (United States)

    Törnell, S; Ekéus, C; Hultin, M; Håkansson, S; Thunberg, J; Högberg, U

    2015-04-01

    Maternal intrapartum fever (MF) is associated with neonatal sequelae, and women in labour who receive epidural analgesia (EA) are more likely to develop hyperthermia. The aims of this study were to investigate if EA and/or a diagnosis of MF were associated to adverse neonatal outcomes at a population level. Population-based register study with data from the Swedish Birth Register and the Swedish National Patient Register, including all nulliparae (n=294,329) with singleton pregnancies who gave birth at term in Sweden 1999-2008. Neonatal outcomes analysed were Apgar score (AS)neonatal encephalopathy (e.g. convulsions or neonatal cerebral ischaemia). Multivariate logistic regression was used to calculate adjusted odds ratios (AOR) with 95% confidence intervals (CI). EA was used in 44% of the deliveries. Low AS or encephalopathy was found in 1.26% and 0.39% of the children in the EA group compared with 0.80% and 0.29% in the control group. In multivariate analysis, EA was associated with increased risk with low AS, AOR 1.27 (95% CI 1.16-1.39), but not with diagnosis of encephalopathy, 1.11 (0.96-1.29). A diagnosis of MF was associated with increased risk for both low AS, 2.27 (1.71-3.02), and of neonatal encephalopathy, 1.97 (1.19-3.26). Diagnosis of MF was associated with low AS and neonatal encephalopathy, whereas EA was only associated with low AS and not with neonatal encephalopathy. The found associations might be a result of confounding by indication, which is difficult to assess in a registry-based population study. © 2015 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  1. "Inclusive working life in Norway": a registry-based five-year follow-up study.

    Science.gov (United States)

    Foss, Line; Gravseth, Hans Magne; Kristensen, Petter; Claussen, Bjørgulf; Mehlum, Ingrid Sivesind; Skyberg, Knut

    2013-07-08

    In 2001, the Norwegian authorities and major labour market partners signed an agreement regarding 'inclusive working life' (IW), whereby companies that participate are committed to reducing sickness absence. Our main aim was to determine the effect of the IW program and work characteristics by gender on long-term (>8 weeks) sickness absence (LSA). Self-reported data on work characteristics from the Oslo Health Study were linked to registry-based data on IW status, education and LSA. From 2001-2005, 10,995 participants (5,706 women and 5,289 men) aged 30, 40, 45 and 60 years were followed. A Cox regression was used to compute hazard ratios (HR) for LSA risk. The cohort was divided into an IW group (2,733 women and 2,058 men) and non-IW group (2,973/3,231). 43.2% and 41.6% of women and 22.3%/24.3% of men (IW / non-IW, respectively) experienced at least one LSA. In a multivariate model, statistically significant risk factors for LSA were low education (stronger in men), shift work/night work or rotating hours (strongest in men in the non-IW group), and heavy physical work or work involving walking and lifting (men only and stronger in the non-IW group). Among men who engaged in shift work, the LSA risk was significantly lower in the IW group. Our results could suggest that IW companies that employ many men in shift work have implemented relevant efforts for reducing sickness absence. However, this study could not demonstrate a significant effect of the IW program on the overall LSA risk.

  2. Maternal Risk Factors for Preterm Birth in Murmansk County, Russia: A Registry-Based Study.

    Science.gov (United States)

    Usynina, Anna A; Postoev, Vitaly A; Grjibovski, Andrej M; Krettek, Alexandra; Nieboer, Evert; Odland, Jon Øyvind; Anda, Erik Eik

    2016-09-01

    Globally, about 11% of all liveborn infants are preterm. To date, data on prevalence and risk factors of preterm birth (PTB) in Russia are limited. The aims of this study were to estimate the prevalence of PTB in Murmansk County, Northwestern Russia and to investigate associations between PTB and selected maternal factors using the Murmansk County Birth Registry. We conducted a registry-based study of 52 806 births (2006-2011). In total, 51 156 births were included in the prevalence analysis, of which 3546 were PTBs. Odds ratios with 95% confidence intervals of moderate-to-late PTB, very PTB and extremely PTB for a range of maternal characteristics were estimated using multinomial logistic regression, adjusting for potential confounders. The overall prevalence of PTB in Murmansk County was 6.9%. Unmarried status, prior PTBs, spontaneous and induced abortions were strongly associated with PTB at any gestational age. Maternal low educational level increased the risk of extremely and moderate-to-late PTB. Young (<18 years) or older (≥35 years) mothers, graduates of vocational schools, underweight, overweight/obese mothers, and smokers were at higher risk of moderate-to-late PTB. Secondary education, alcohol abuse, diabetes mellitus, or gestational diabetes were strongly associated with moderate-to-late and very PTB. The observed prevalence of PTB (6.9%) in Murmansk County, Russia was comparable with data on live PTB from European countries. Adverse prior pregnancy outcomes, maternal low educational level, unmarried status, alcohol abuse, and diabetes mellitus or gestational diabetes were the most common risk factors for PTB. © 2016 John Wiley & Sons Ltd.

  3. The Association Between Urban Tree Cover and Gun Assault: A Case-Control and Case-Crossover Study.

    Science.gov (United States)

    Kondo, Michelle C; South, Eugenia C; Branas, Charles C; Richmond, Therese S; Wiebe, Douglas J

    2017-08-01

    Green space and vegetation may play a protective role against urban violence. We investigated whether being near urban tree cover during outdoor activities was related to being assaulted with a gun. We conducted geographic information systems-assisted interviews with boys and men aged 10-24 years in Philadelphia, Pennsylvania, including 135 patients who had been shot with a firearm and 274 community controls, during 2008-2011. Each subject reported a step-by-step mapped account of where and with whom they traveled over a full day from waking until being assaulted or going to bed. Geocoded path points were overlaid on mapped layers representing tree locations and place-specific characteristics. Conditional logistic regressions were used to compare case subjects versus controls (case-control) and case subjects at the time of injury versus times earlier that day (case-crossover). When comparing cases at the time of assault to controls matched at the same time of day, being under tree cover was inversely associated with gunshot assault (odds ratio (OR) = 0.70, 95% confidence interval (CI): 0.55, 0.88), especially in low-income areas (OR = 0.69, 95% CI: 0.54, 0.87). Case-crossover models confirmed this inverse association overall (OR = 0.55, 95% CI: 0.34, 0.89) and in low-income areas (OR = 0.54, 95% CI: 0.33, 0.88). Urban greening and tree cover may hold promise as proactive strategies to decrease urban violence. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  4. Immigrants’ use of emergency primary health care in Norway: a registry-based observational study

    Directory of Open Access Journals (Sweden)

    Sandvik Hogne

    2012-09-01

    Full Text Available Abstract Background Emigrants are often a selected sample and in good health, but migration can have deleterious effects on health. Many immigrant groups report poor health and increased use of health services, and it is often claimed that they tend to use emergency primary health care (EPHC services for non-urgent purposes. The aim of the present study was to analyse immigrants’ use of EPHC, and to analyse variations according to country of origin, reason for immigration, and length of stay in Norway. Methods We conducted a registry based study of all immigrants to Norway, and a subsample of immigrants from Poland, Germany, Iraq and Somalia, and compared them with native Norwegians. The material comprised all electronic compensation claims for EPHC in Norway during 2008. We calculated total contact rates, contact rates for selected diagnostic groups and for services given during consultations. Adjustments for a series of socio-demographic and socio-economic variables were done by multiple logistic regression analyses. Results Immigrants as a whole had a lower contact rate than native Norwegians (23.7% versus 27.4%. Total contact rates for Polish and German immigrants (mostly work immigrants were 11.9% and 7.0%, but for Somalis and Iraqis (mostly asylum seekers 31.8% and 33.6%. Half of all contacts for Somalis and Iraqis were for non-specific pain, and they had relatively more of their contacts during night than other groups. Immigrants’ rates of psychiatric diagnoses were low, but increased with length of stay in Norway. Work immigrants suffered less from respiratory and gastrointestinal infections, but had more injuries and higher need for sickness certification. All immigrant groups, except Germans, were more often given a sickness certificate than native Norwegians. Use of interpreter was reduced with increasing length of stay. All immigrant groups had an increased need for long consultations, while laboratory tests were most often used

  5. Immigrants’ use of emergency primary health care in Norway: a registry-based observational study

    Science.gov (United States)

    2012-01-01

    Background Emigrants are often a selected sample and in good health, but migration can have deleterious effects on health. Many immigrant groups report poor health and increased use of health services, and it is often claimed that they tend to use emergency primary health care (EPHC) services for non-urgent purposes. The aim of the present study was to analyse immigrants’ use of EPHC, and to analyse variations according to country of origin, reason for immigration, and length of stay in Norway. Methods We conducted a registry based study of all immigrants to Norway, and a subsample of immigrants from Poland, Germany, Iraq and Somalia, and compared them with native Norwegians. The material comprised all electronic compensation claims for EPHC in Norway during 2008. We calculated total contact rates, contact rates for selected diagnostic groups and for services given during consultations. Adjustments for a series of socio-demographic and socio-economic variables were done by multiple logistic regression analyses. Results Immigrants as a whole had a lower contact rate than native Norwegians (23.7% versus 27.4%). Total contact rates for Polish and German immigrants (mostly work immigrants) were 11.9% and 7.0%, but for Somalis and Iraqis (mostly asylum seekers) 31.8% and 33.6%. Half of all contacts for Somalis and Iraqis were for non-specific pain, and they had relatively more of their contacts during night than other groups. Immigrants’ rates of psychiatric diagnoses were low, but increased with length of stay in Norway. Work immigrants suffered less from respiratory and gastrointestinal infections, but had more injuries and higher need for sickness certification. All immigrant groups, except Germans, were more often given a sickness certificate than native Norwegians. Use of interpreter was reduced with increasing length of stay. All immigrant groups had an increased need for long consultations, while laboratory tests were most often used for Somalis and Iraqis

  6. Work-related psychosocial events as triggers of sick leave - results from a Swedish case-crossover study

    Directory of Open Access Journals (Sweden)

    Lindholm Christina

    2011-03-01

    Full Text Available Abstract Background Although illness is an important cause of sick leave, it has also been suggested that non-medical risk factors may influence this association. If such factors impact on the period of decision making, they should be considered as triggers. Yet, there is no empirical support available. The aim was to investigate whether recent exposure to work-related psychosocial events can trigger the decision to report sick when ill. Methods A case-crossover design was applied to 546 sick-leave spells, extracted from a Swedish cohort of 1 430 employees with a 3-12 month follow-up of new sick-leave spells. Exposure in a case period corresponding to an induction period of one or two days was compared with exposure during control periods sampled from workdays during a two-week period prior to sick leave for the same individual. This was done according to the matched-pair interval and the usual frequency approaches. Results are presented as odds ratios (OR with 95% confidence intervals (CI. Results Most sick-leave spells happened in relation to acute, minor illnesses that substantially reduced work ability. The risk of taking sick leave was increased when individuals had recently been exposed to problems in their relationship with a superior (OR 3.63; CI 1.44-9.14 or colleagues (OR 4.68; CI 1.43-15.29. Individuals were also more inclined to report sick on days when they expected a very stressful work situation than on a day when they were not under such stress (OR 2.27; CI 1.40-3.70. Conclusions Exposure to problems in workplace relationships or a stressful work situation seems to be able to trigger reporting sick. Psychosocial work-environmental factors appear to have a short-term effect on individuals when deciding to report sick.

  7. Academic performance in adolescents born after ART-a nationwide registry-based cohort study.

    Science.gov (United States)

    Spangmose, A L; Malchau, S S; Schmidt, L; Vassard, D; Rasmussen, S; Loft, A; Forman, J; Pinborg, A

    2017-02-01

    Is academic performance in adolescents aged 15-16 years and conceived after ART, measured as test scores in ninth grade, comparable to that for spontaneously conceived (SC) adolescents? ART singletons had a significantly lower mean test score in the adjusted analysis when compared with SC singletons, yet the differences were small and probably not of clinical relevance. Previous studies have shown similar intelligence quotient (IQ) levels in ART and SC children, but only a few have been on adolescents. Academic performance measured with standardized national tests has not previously been explored in a complete national cohort of adolescents conceived after ART. A Danish national registry-based cohort including all 4766 ART adolescents (n = 2836 singletons and n = 1930 twins) born in 1995-1998 were compared with two SC control cohorts: a randomly selected singleton population (n = 5660) and all twins (n = 7064) born from 1995 to 1998 in Denmark. Nine children who died during the follow-up period were excluded from the study. Mean test scores on a 7-point-marking scale from -3 to 12 were compared, and adjustments were made for relevant reproductive and socio-demographic covariates including occupational and educational level of the parents. The crude mean test score was higher in both ART singletons and ART twins compared with SC adolescents. The crude mean differences were +0.41 (95% CI 0.30-0.53) and +0.45 (95% CI 0.28-0.62) between ART and SC singletons and between ART and SC twins, respectively. However, the adjusted mean overall test score was significantly lower for ART singletons compared with SC singletons (adjusted mean difference -0.15 (95% CI -0.29-(-0.02))). For comparison, the adjusted mean difference was +2.05 (95% CI 1.82-2.28) between the highest and the lowest parental educational level, suggesting that the effect of ART is weak compared with the conventional predictors. The adjusted analyses showed significantly lower mean test scores in mathematics

  8. Preeclampsia complicated by advanced maternal age: a registry-based study on primiparous women in Finland 1997–2008

    Directory of Open Access Journals (Sweden)

    Lamminpää Reeta

    2012-06-01

    Full Text Available Abstract Background Preeclampsia is a frequent syndrome and its cause has been linked to multiple factors, making prevention of the syndrome a continuous challenge. One of the suggested risk factors for preeclampsia is advanced maternal age. In the Western countries, maternal age at first delivery has been steadily increasing, yet few studies have examined women of advanced maternal age with preeclampsia. The purpose of this registry-based study was to compare the obstetric outcomes in primiparous and preeclamptic women younger and older than 35 years. Methods The registry-based study used data from three Finnish health registries: Finnish Medical Birth Register, Finnish Hospital Discharge Register and Register of Congenital Malformations. The sample contained women under 35 years of age (N = 15,437 compared with those 35 and over (N = 2,387 who were diagnosed with preeclampsia and had their first singleton birth in Finland between 1997 and 2008. In multivariate modeling, the main outcome measures were Preterm delivery (before 34 and 37 weeks, low Apgar score (5 min., small-for-gestational-age, fetal death, asphyxia, Cesarean delivery, induction, blood transfusion and admission to a Neonatal Intensive Care Unit. Results Women of advanced maternal age (AMA exhibited more preeclampsia (9.4% than younger women (6.4%. They had more prior terminations (25 ( Conclusions Preeclampsia is more common in women with advanced maternal age. Advanced maternal age is an independent risk factor for adverse outcomes in first-time mothers with preeclampsia.

  9. Short-term effects of floods on Japanese encephalitis in Nanchong, China, 2007-2012: A time-stratified case-crossover study.

    Science.gov (United States)

    Zhang, Feifei; Liu, Zhidong; Zhang, Caixia; Jiang, Baofa

    2016-09-01

    This time-stratified case-crossover study aimed to quantify the impact of floods on daily Japanese encephalitis (JE) cases from 2007 to 2012 in Nanchong city of Sichuan Province, China. Using conditional logistic regression analysis, we calculated the odds ratios (ORs) and 95% confidence intervals (CIs) at different lagged days, adjusting for daily average temperature (AT) and daily average relative humidity (ARH). A total of 370 JE cases were notified during the study period, with the median patient age being 4.2years. The seasonal pattern of JE cases clustered in July and August during the study period. Floods were significantly associated with an increased number of JE cases from lag 23 to lag 24, with the strongest lag effect at lag 23 (OR=2.00, 95% CI: 1.14-3.52). Similarly, AT and ARH were positively associated with daily JE cases from lag 0 to lag 8 and from lag 0 to lag 9, respectively. Floods, with AT and ARH, can be used to forecast JE outbreaks in the study area. Based on the results of this study, recommendations include undertaking control measures before the number of cases increases, especially for regions with similar geographic, climatic, and socio-economic conditions as those in the study area. Copyright © 2016 Elsevier B.V. All rights reserved.

  10. Occupational risk factors for testicular cancer: a registry-based case-control study in Rhineland Palatinate – Germany

    Science.gov (United States)

    Yousif, Lamyaa; Hammer, Gaël P.; Emrich, Katharina; Blettner, Maria; Zeeb, Hajo

    2013-01-01

    Objectives: Testicular cancer affects mainly men below the age of 50. An association with occupation and social status has been suggested but risk factors are not well understood. A registry-based case-control study focusing on occupation was performed in Germany. Methods: All 348 testicular cancer cases with available gainful occupational information registered between 2000 and 2005; as well as 564 suitable controls (from a pool of other cancers) were drawn from the Cancer Registry of Rhineland-Palatinate. Unconditional logistic regression was used to compute odds ratios (OR) and associated 95% confidence intervals (CI). Results: Slightly elevated OR were observed for technicians and related professionals (OR 1.62, 95% CI 1.00–2.63) and for clerical support workers (OR 1.71, 95% CI 1.14–2.56). This increase was highest in the age group 20–50 for technicians (OR 2.02, 95% CI 1.23–3.33) and clerks (OR 2.00, 95% CI 1.30–3.09), respectively. An association with testicular cancer was observed for no other occupation. Conclusion: An increased risk of testicular cancer was observed for technicians and related professionals and clerical support workers. This could be related to socioeconomic status or sedentary life style, two factors that were identified in previous studies. While the feasibility of a purely registry-based study was shown, missing occupational data and the choice of cancer controls represent challenges to the validity of this approach. PMID:24265602

  11. The Effects of Fine Particulate Air Pollution on Daily Mortality: A Case-Crossover Study in a Subtropical City, Taipei, Taiwan

    Directory of Open Access Journals (Sweden)

    Shang-Shyue Tsai

    2014-05-01

    Full Text Available This study was undertaken to determine whether there was an association between PM2.5 levels and daily mortality in Taipei, Taiwan, the largest metropolitan city with a subtropical climate. Daily mortality, air pollution, and weather data for Taipei were obtained for the period from 2006–2008. The relative risk of daily mortality was estimated using a time-stratified case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. For the single pollutant model, PM2.5 showed association with total mortality both on warm (>23 °C and cool days (<23 °C. There is no indication of an association between PM2.5 and risk of death due to respiratory diseases both on warm and cool days. PM2.5 had effects on the risk of death from cardiovascular diseases only on cool days. In the two-pollutant models, PM2.5 remained effects on the risk of mortality for all cause and cardiovascular disease after the inclusion of SO2 and O3 both on warm and cool days. This study provides evidence that short-term exposure to PM2.5 increased the risk of death for all cause and cardiovascular disease.

  12. Outdoor air pollution and emergency department visits for asthma among children and adults: A case-crossover study in northern Alberta, Canada

    Directory of Open Access Journals (Sweden)

    Rowe Brian H

    2007-12-01

    Full Text Available Abstract Background Recent studies have observed positive associations between outdoor air pollution and emergency department (ED visits for asthma. However, few have examined the possible confounding influence of aeroallergens, or reported findings among very young children. Methods A time stratified case-crossover design was used to examine 57,912 ED asthma visits among individuals two years of age and older in the census metropolitan area of Edmonton, Canada between April 1, 1992 and March 31, 2002. Daily air pollution levels for the entire region were estimated from three fixed-site monitoring stations. Similarly, daily levels of aeroallergens were estimated using rotational impaction sampling methods for the period between 1996 and 2002. Odds ratios and their corresponding 95% confidence intervals were estimated using conditional logistic regression with adjustment for temperature, relative humidity and seasonal epidemics of viral related respiratory disease. Results Positive associations for asthma visits with outdoor air pollution levels were observed between April and September, but were absent during the remainder of the year. Effects were strongest among young children. Namely, an increase in the interquartile range of the 5-day average for NO2 and CO levels between April and September was associated with a 50% and 48% increase, respectively, in the number of ED visits among children 2 – 4 years of age (p Conclusion Our findings, taken together, suggest that exposure to ambient levels of air pollution is an important determinant of ED visits for asthma, particularly among young children and the elderly.

  13. Atmospheric Pressure and Abdominal Aortic Aneurysm Rupture : Results from a Time Series Analysis and Case-Crossover Study

    NARCIS (Netherlands)

    Penning De Vries, Bas B.L.; Kolkert, Joé L.P.; Meerwaldt, Robbert; Groenwold, Rolf H.H.

    2017-01-01

    Background: Associations between atmospheric pressure and abdominal aortic aneurysm (AAA) rupture risk have been reported, but empirical evidence is inconclusive and largely derived from studies that did not account for possible nonlinearity, seasonality, and confounding by temperature. Methods:

  14. Objective assessment of drowsiness and reaction time during intermittent Ramadan fasting in young men: a case-crossover study.

    Science.gov (United States)

    Bahammam, Ahmed S; Nashwan, Samar; Hammad, Omeima; Sharif, Munir M; Pandi-Perumal, Seithikurippu R

    2013-08-12

    Ramadan fasting and its attendant lifestyle changes induce changes in the circadian rhythm and in associated physiological and metabolic functions. Previous studies that have assessed psychomotor performance during Ramadan fasting have reported conflicting results. Therefore, we designed this study to objectively assess the effects of intermittent fasting during and outside Ramadan (to control for lifestyle changes) on drowsiness, blink total duration and mean reaction time (MRT) test while controlling for potential confounders. Eight healthy volunteers with a mean age of 25.3 ± 2.9 years and a mean body mass index (BMI) of 23.4 ± 3.2 kg/m2 reported to the sleep laboratory on four occasions for polysomnography (PSG) and drowsiness and psychomotor assessments as follows: 1) adaptation; 2) 4 weeks before Ramadan while performing the Islamic fasting for 1 week (baseline fasting) (BLF); 3) 1 week before Ramadan (non-fasting baseline) (BL); and 4) during the second week of Ramadan while fasting (Ramadan). OPTALERT™ was used to objectively assess daytime drowsiness using the Johns Drowsiness Scale (JDS), and blink total duration and a visual reaction time test were used to assess MRT. Rapid eye movement (REM) sleep percentage was significantly lower at BLF (17.7 ± 8.1%) and at Ramadan (18.6 ± 10.7%) compared with BL (25.6 ± 4.8%) (p intermittent fasting has no impact on drowsiness and vigilance as measured by the JDS, total blink duration and MRT.

  15. The impact of airborne particulate matter on pediatric hospital admissions for pneumonia among children in Jinan, China: A case-crossover study.

    Science.gov (United States)

    Lv, Chenguang; Wang, Xianfeng; Pang, Na; Wang, Lanzhong; Wang, Yuping; Xu, Tengfei; Zhang, Yu; Zhou, Tianran; Li, Wei

    2017-06-01

    This study aims to examine the effect of short-term changes in the concentration of particulate matter of diameter ≤2.5 µm (PM 2.5 ) and ≤10 µm (PM 10 ) on pediatric hospital admissions for pneumonia in Jinan, China. It explores confoundings factors of weather, season, and chemical pollutants. Information on pediatric hospital admissions for pneumonia in 2014 was extracted from the database of Jinan Qilu Hospital. The relative risk of pediatric hospital admissions for pneumonia was assessed using a case-crossover approach, controlling weather variables, day of the week, and seasonality. The single-pollutant model demonstrated that increased risk of pediatric hospital admissions for pneumonia was significantly associated with elevated PM 2.5 concentrations the day before hospital admission and elevated PM 10 concentrations 2 days before hospital admission. An increment of 10 μg/m 3 in PM 2.5 and PM 10 was correlated with a 6% (95% CI 1.02--1.10) and 4% (95% CI 1.00-1.08) rise in number of admissions for pneumonia, respectively. In two pollutant models, PM 2.5 and PM 10 remained significant after inclusion of sulfur dioxide or nitrogen dioxide but not carbon monoxide. This study demonstrated that short-term exposure to atmospheric particulate matter (PM 2.5 /PM 10 ) may be an important determinant of pediatric hospital admissions for pneumonia in Jinan, China. This study demonstrated that short-term exposure to atmospheric particulate matter (PM 2.5 /PM 10 ) may be an important determinant of pediatric hospital admissions for pneumonia in Jinan, China, and suggested the relevance of pollutant exposure levels and their effects. As a specific group, children are sensitive to airborne particulate matter. This study estimated the short-term effects attribute to other air pollutants to provide references for relevant studies.

  16. Hourly differences in air pollution and risk of respiratory disease in the elderly: a time-stratified case-crossover study.

    Science.gov (United States)

    Yorifuji, Takashi; Suzuki, Etsuji; Kashima, Saori

    2014-08-13

    Epidemiological studies have shown adverse effects of short-term exposure to air pollution on respiratory disease outcomes; however, few studies examined this association on an hourly time scale. We evaluated the associations between hourly changes in air pollution and the risk of respiratory disease in the elderly, using the time of the emergency call as the disease onset for each case. We used a time-stratified case-crossover design. Study participants were 6,925 residents of the city of Okayama, Japan, aged 65 or above who were taken to hospital emergency rooms between January 2006 and December 2010 for onset of respiratory disease. We calculated city-representative hourly average concentrations of air pollutants from several monitoring stations. By using conditional logistic regression models, we estimated odds ratios per interquartile-range increase in each pollutant by exposure period prior to emergency call, adjusting for hourly ambient temperature, hourly relative humidity, and weekly numbers of reported influenza cases aged ≥60. Suspended particulate matter (SPM) exposure 24 to respiratory disease. For example, following one interquartile-range increase, odds ratios were 1.05 (95% confidence interval: 1.01, 1.09) for SPM exposure 24 to respiratory disease of SPM or ozone. Overall, the effect estimates for chronic obstructive pulmonary disease and allied conditions were equivocal. This study provides further evidence that hourly changes in air pollution exposure increase the risks of respiratory disease, and that SO2 may be related with more immediate onset of the disease than other pollutants.

  17. Short-term effect of fine particulate air pollution on daily mortality: a case-crossover study in a tropical city, Kaohsiung, Taiwan.

    Science.gov (United States)

    Tsai, Shang-Shyue; Chen, Chih-Cheng; Yang, Chun-Yuh

    2014-01-01

    Many studies have examined the short-term effects of air pollution on frequency of daily mortality over the past two decades. However, information on the relationship between levels of fine particles (PM(2.5)) and daily mortality is relatively sparse due to limited availability of monitoring data. Further the results are inconsistent. This study was undertaken to determine whether there was an association between PM(2.5) levels and daily mortality rate in Kaohsiung, Taiwan, a large industrial city with a tropical climate. Daily mortality rate, air pollution parameters, and weather data for Kaohsiung were obtained for the period from 2006 through 2008. The relative risk of daily mortality occurrence was estimated using a time-stratified case-crossover approach, controlling for (1) weather variables, (2) day of the week, (3) seasonality, and (4) long-term time trends. For the single-pollutant model (without adjustment for other pollutants), no significant effects were found between PM(2.5) and frequency of daily mortality on warm days (≥25°C). On cool days, PM(2.5) showed significant correlation with increased risk of mortality rate for all causes and circulatory diseases in single-pollutant model. There was no indication of an association between PM(2.5) and deaths due to respiratory diseases. The relationship appeared to be stronger on cool days. This study provided evidence of associations between short-term exposure to PM(2.5) and elevated risk of death for all cause and circulatory diseases.

  18. Traffic-related air pollution and the onset of myocardial infarction: disclosing benzene as a trigger? A small-area case-crossover study.

    Directory of Open Access Journals (Sweden)

    Denis Bard

    Full Text Available Exposure to traffic is an established risk factor for the triggering of myocardial infarction (MI. Particulate matter, mainly emitted by diesel vehicles, appears to be the most important stressor. However, the possible influence of benzene from gasoline-fueled cars has not been explored so far.We conducted a case-crossover study from 2,134 MI cases recorded by the local Coronary Heart Disease Registry (2000-2007 in the Strasbourg Metropolitan Area (France. Available individual data were age, gender, previous history of ischemic heart disease and address of residence at the time of the event. Nitrogen dioxide, particles of median aerodynamic diameter <10 µm (PM10, ozone, carbon monoxide and benzene air concentrations were modeled on an hourly basis at the census block level over the study period using the deterministic ADMS-Urban air dispersion model. Model input data were emissions inventories, background pollution measurements, and meteorological data. We have found a positive, statistically significant association between concentrations of benzene and the onset of MI: per cent increase in risk for a 1 µg/m3 increase in benzene concentration in the previous 0, 0-1 and 1 day was 10.4 (95% confidence interval 3-18.2, 10.7 (2.7-19.2 and 7.2 (0.3-14.5, respectively. The associations between the other pollutants and outcome were much lower and in accordance with the literature.We have observed that benzene in ambient air is strongly associated with the triggering of MI. This novel finding needs confirmation. If so, this would mean that not only diesel vehicles, the main particulate matter emitters, but also gasoline-fueled cars--main benzene emitters-, should be taken into account for public health action.

  19. Socioenvironmental factors associated with heat and cold-related mortality in Vadu HDSS, western India: a population-based case-crossover study

    Science.gov (United States)

    Ingole, Vijendra; Kovats, Sari; Schumann, Barbara; Hajat, Shakoor; Rocklöv, Joacim; Juvekar, Sanjay; Armstrong, Ben

    2017-10-01

    Ambient temperatures (heat and cold) are associated with mortality, but limited research is available about groups most vulnerable to these effects in rural populations. We estimated the effects of heat and cold on daily mortality among different sociodemographic groups in the Vadu HDSS area, western India. We studied all deaths in the Vadu HDSS area during 2004-2013. A conditional logistic regression model in a case-crossover design was used. Separate analyses were carried out for summer and winter season. Odds ratios (OR) and 95% confidence intervals (CI) were estimated for total mortality and population subgroups. Temperature above a threshold of 31 °C was associated with total mortality (OR 1.48, CI = 1.05-2.09) per 1 °C increase in daily mean temperature. Odds ratios were higher among females (OR 1.93; CI = 1.07-3.47), those with low education (OR 1.65; CI = 1.00-2.75), those owing larger agricultural land (OR 2.18; CI = 0.99-4.79), and farmers (OR 1.70; CI = 1.02-2.81). In winter, per 1 °C decrease in mean temperature, OR for total mortality was 1.06 (CI = 1.00-1.12) in lag 0-13 days. High risk of cold-related mortality was observed among people occupied in housework (OR = 1.09; CI = 1.00-1.19). Our study suggests that both heat and cold have an impact on mortality particularly heat, but also, to a smaller degree, cold have an impact. The effects may differ partly by sex, education, and occupation. These findings might have important policy implications in preventing heat and cold effects on particularly vulnerable groups of the rural populations in low and middle-income countries with hot semi-arid climate.

  20. Short-term use of glucocorticoids and risk of peptic ulcer bleeding: a nationwide population-based case-crossover study.

    Science.gov (United States)

    Tseng, C-L; Chen, Y-T; Huang, C-J; Luo, J-C; Peng, Y-L; Huang, D-F; Hou, M-C; Lin, H-C; Lee, F-Y

    2015-09-01

    Controversy exists regarding glucocorticoids therapy and the risk of peptic ulcer bleeding (PUB). The present study was undertaken to determine whether short-term use of glucocorticoids is associated with the occurrence of peptic ulcer bleeding. The records of adult patients hospitalised for newly diagnosed peptic ulcer bleeding from 2000 to 2012 were retrieved from the Taiwan National Health Insurance Research Database, a nationwide population-based registry system. The association between systemic glucocorticoids usage and peptic ulcer bleeding was determined with a conditional logistic regression model comparing cases and controls during time windows of 7, 14 and 28 days using a case-crossover design. Of the 8894 enrolled patients, the adjusted self-matched odds ratios for peptic ulcer bleeding after exposure to the glucocorticoids were 1.37 (95% CI: 1.12-1.68, P = 0.003) for the 7-day window, 1.66 (95% CI: 1.38-2.00, P peptic ulcer bleeding. Concomitant use of a nonselective nonsteroidal anti-inflammatory drug (NSAID) or aspirin further elevated the risk. However, it does not eliminate the effect of underlying diseases flare-up that may have placed the patients at risk for peptic ulcer bleeding in this kind of study design. Short-term (7-28 days) exposure to glucocorticoids is significantly associated with peptic ulcer bleeding; this risk seems dose-dependent and is higher when nonselective NSAIDs or aspirin are used concurrently. © 2015 John Wiley & Sons Ltd.

  1. Death of a Close Relative and the Risk of Suicide in Sweden-A Large Scale Register-Based Case-Crossover Study.

    Directory of Open Access Journals (Sweden)

    Hanna Mogensen

    Full Text Available Bereavement is thought to be a risk factor for suicide but the association has not been thoroughly investigated according to specific sensitive time periods and risk groups using a self-matched design. We aimed to 1 determine the risk of suicide within the first year after death of a close relative, 2 investigate if and how the risk changes within this time window and 3 determine if sex, age, and type of relationship, affect this association.A self-matched, case-crossover study was performed by linking Swedish registers. In total, 31 059 individuals with suicide between 1990 and 2011 were included. Different periods within the year prior to the suicide were compared with corresponding periods one year earlier in the same individual's life. Conditional logistic regression was used to calculate odds ratios (OR and 95% confidence intervals (CI for suicide after death of a close relative.Increased ORs of suicide were seen during the first month, OR 1·77 (95% CI 1·35-2·34, and the first half-year, 1·27 (1·13-1·43. An even higher OR was found within the first week, 3·43 (1·89-6·22. Patterns were similar for women and men and across age groups. Death of a partner or child but not death of a sibling or parent was associated with a significantly increased suicide risk. The strongest association was seen after death of a partner in individuals aged 45 and older.These findings provide knowledge of sensitive time periods and at-risk groups in the early period of bereavement. Due to the use of a self-matched study design, methodological challenges of unmeasured residual confounding could be overcome.

  2. Traffic-Related Air Pollution and the Onset of Myocardial Infarction: Disclosing Benzene as a Trigger? A Small-Area Case-Crossover Study

    Science.gov (United States)

    Bard, Denis; Kihal, Wahida; Schillinger, Charles; Fermanian, Christophe; Ségala, Claire; Glorion, Sophie; Arveiler, Dominique; Weber, Christiane

    2014-01-01

    Background and Objectives Exposure to traffic is an established risk factor for the triggering of myocardial infarction (MI). Particulate matter, mainly emitted by diesel vehicles, appears to be the most important stressor. However, the possible influence of benzene from gasoline-fueled cars has not been explored so far. Methods and Results We conducted a case-crossover study from 2,134 MI cases recorded by the local Coronary Heart Disease Registry (2000–2007) in the Strasbourg Metropolitan Area (France). Available individual data were age, gender, previous history of ischemic heart disease and address of residence at the time of the event. Nitrogen dioxide, particles of median aerodynamic diameter pollution measurements, and meteorological data. We have found a positive, statistically significant association between concentrations of benzene and the onset of MI: per cent increase in risk for a 1 µg/m3 increase in benzene concentration in the previous 0, 0–1 and 1 day was 10.4 (95% confidence interval 3–18.2), 10.7 (2.7–19.2) and 7.2 (0.3–14.5), respectively. The associations between the other pollutants and outcome were much lower and in accordance with the literature. Conclusion We have observed that benzene in ambient air is strongly associated with the triggering of MI. This novel finding needs confirmation. If so, this would mean that not only diesel vehicles, the main particulate matter emitters, but also gasoline-fueled cars –main benzene emitters–, should be taken into account for public health action. PMID:24932584

  3. Socioeconomic Inequalities in the Kidney Transplantation Process: A Registry-Based Study in Sweden

    Directory of Open Access Journals (Sweden)

    Ye Zhang, MSc

    2018-02-01

    Conclusions. Socioeconomic status-related inequalities exist with regard to both access to the waitlist, and kidney transplantation conditional on listing. However, the former inequality is substantially larger and is therefore expected to contribute more to societal inequalities. Further studies are needed to explore the potential mechanisms and strategies to reduce these inequalities.

  4. Folic acid supplementation influences the distribution of neural tube defect subtypes : A registry-based study

    NARCIS (Netherlands)

    Bergman, J. E. H.; Otten, E.; Verheij, J. B. G. M.; de Walle, H. E. K.

    Periconceptional folic acid (FA) reduces neural tube defect (NTD) risk, but seems to have a varying effect per NTD subtype. We aimed to study the effect of FA supplementation on NTD subtype distribution using data from EUROCAT Northern Netherlands. We included all birth types with non-syndromal NTDs

  5. A nationwide registry-based cohort study of incidence of tonsillectomy in Denmark, 1991-2012

    DEFF Research Database (Denmark)

    Juul, Marie Louise; Rasmussen, Eva Rye; Rasmussen, Stig Hebbelstrup Rye

    2018-01-01

    OBJECTIVE: To update tonsillectomy incidence rates in Denmark and identify whether the incidence rates vary between geographical areas in the country during the period 1991-2012. DESIGN: This was a retrospective nationwide cohort study using data from the comprehensive Danish patient registries. ...

  6. Academic performance in adolescents born after ART—a nationwide registry-based cohort study

    DEFF Research Database (Denmark)

    Spangmose, Anne Lærke; Malchau, Sara; Schmidt, Lone

    2017-01-01

    singletons and ART twins. LIMITATIONS, REASONS FOR CAUTION Missing data on educational test scores occurred in 6.6% of adolescents aged 15–16 years for the birth cohorts 1995–1997, where all of the children according to their age should have passed the ninth grade exam at the time of data retrieval......STUDY QUESTION Is academic performance in adolescents aged 15–16 years and conceived after ART, measured as test scores in ninth grade, comparable to that for spontaneously conceived (SC) adolescents? SUMMARY ANSWER ART singletons had a significantly lower mean test score in the adjusted analysis...... are based on national data, our findings can be applied to other populations. The findings of this paper suggest that a possible small negative effect of parental subfertility or ART treatment is counterbalanced by the higher educational level in the ART parents. STUDY FUNDING/COMPETING INTEREST...

  7. Temporal Trends in Fertility Rates: A Nationwide Registry Based Study from 1901 to 2014

    OpenAIRE

    Blomberg Jensen, Martin; Priskorn, L?rke; Jensen, Tina Kold; Juul, Anders; Skakkebaek, Niels Erik

    2015-01-01

    Objective Increasing age at first childbirth has been suggested to increase the risk for infertility. Our objective is to determine whether women above thirty years of age historically have been able to sustain fertility rates above replacement level. Design A descriptive nationwide Danish study using birth registries from 1901?2014. Setting Information on women?s age at childbirth was obtained by using records from primary, secondary and tertiary institutions. Participants Mothers to 8,024,9...

  8. The Impact of Diagnosis on Job Retention: A Danish Registry-Based Cohort Study

    Directory of Open Access Journals (Sweden)

    Rasmus Espersen

    2015-01-01

    Full Text Available Background. In 1998, Denmark introduced the flex job scheme to ensure employment of people with a permanent reduced work capacity. This study investigated the association between select diagnoses and the risk of disability pension among persons eligible for the scheme. Methods. Using the national DREAM database we identified all persons eligible for the flex job scheme from 2001 to 2008. This information piece was linked to the hospital discharge registry. Selected participants were followed for 5 years. Results. From the 72,629 persons identified, our study included 329 patients with rheumatoid arthritis, 10,120 patients with spine disorders, 2179 patients with ischemic heart disease, and 1765 patients with functional disorders. A reduced risk of disability pension was found in the group with rheumatoid arthritis (hazard ratio = 0.69 (0.53–0.90 compared to the group with spine disorders. No differences were found when comparing ischemic heart disease and functional disorders. Employment during the first 3 months of the flex job scheme increased the degree of employment for all groups. Conclusion. Differences in the risk of disability pension were identified only in patients with rheumatoid arthritis. This study demonstrates the importance of obtaining employment immediately after allocation to the flex job scheme, regardless of diagnosis.

  9. Long-term sickness absence from work due to physical inactivity: A registry-based study.

    Science.gov (United States)

    Høgsbro, Cecilie; Davidsen, Michael; Sørensen, Jan

    2018-01-01

    The aim of this study was to explore the relationship between leisure-time physical inactivity and long-term sickness absence in a representative sample of individuals aged 16-54 years, within the labour market and in good health. It was hypothesised that physically inactive individuals have a higher risk of long-term sickness absence and longer duration of sickness absence. The study population was identified from the National Health and Morbidity Survey, 2010. Weekly data on long-term sickness absence were obtained from the National Register on Social Transfer Payments (the DREAM registry). The association of incidence and duration of long-term sickness absence with physical inactivity was explored using logistic and Poisson regression. Data were fitted to models with levels of physical activity, demographic, social and lifestyle characteristics as independent variables. A combined hurdle model was used to estimate the difference in mean number of absence weeks. Logistic regression showed that physically inactive individuals had a 27% higher incidence of long-term sickness absence compared with physically active individuals. The Poisson regression showed that long-term sickness absence was only slightly shorter (1 week less) for moderately active individuals compared with inactive individuals. The hurdle model estimated longer absence periods for inactive individuals (additional 2.5 weeks) in comparison with moderately and highly active individuals. The study showed that physically inactive individuals have a higher incidence of long-term absence and that physically inactive individuals have longer periods with sickness absence than moderately and highly active individuals. When adjustments for social and health behaviour were included, the estimated associations became statistically insignificant.

  10. A Nation-Wide Cancer Registry-Based Study of Adenosquamous Carcinoma in Taiwan.

    Directory of Open Access Journals (Sweden)

    Yuan-Tzu Lan

    Full Text Available Adenosquamous carcinoma (ASC is a rare disease involving various organs, yet there are no large-scale population-based comparative studies on ASC among different organs.The incidence and overall survival of ASC among various organs in cases diagnosed in Taiwan from January 1, 2003 to December 31, 2010 were calculated and compared using data from the Taiwan Cancer Registry (TCR. The various organs were classified and divided into three different systems: the female reproductive, respiratory, and alimentary systems. Survival analysis were also compared among 30,850 patients diagnosed as ASC, adenocarcinoma (AC or squamous cell carcinoma (SCC in organs with frequent ASC.During the study period, a total of 576 ASC cases were diagnosed in Taiwan. The most common primary system was respiratory (73.8%, followed by alimentary (16.2% and female reproductive (10%. The overall survival were significantly higher for cases involving the female reproductive system, followed by the respiratory and alimentary systems (P = 0.016. The median overall survival were worse in males than females for cases involving the respiratory system (22.4 vs. 31.8 months, P = 0.044. Multivariate analysis showed that age ≧ 65, more advanced T and N categories were independent unfavorable prognostic factors of overall survival in ASC. ASC histology is an independent unfavorable prognostic factor compared with AC and SCC.ASC at an old age and more advanced T and N categories were found to be associated with a poor prognosis.

  11. A Nation-Wide Cancer Registry-Based Study of Adenosquamous Carcinoma in Taiwan

    Science.gov (United States)

    Lan, Yuan-Tzu; Huang, Kuo-Hung; Liu, Chien-An; Tai, Ling-Chen; Chen, Ming-Huang; Chao, Yee; Li, Anna Fen-Yau; Chiou, Shih-Hwa; Shyr, Yi-Ming; Wu, Chew-Wun; Fang, Wen-Liang

    2015-01-01

    Background Adenosqamous carcinoma (ASC) is a rare disease involving various organs, yet there are no large-scale population-based comparative studies on ASC among different organs. Methods The incidence and overall survival of ASC among various organs in cases diagnosed in Taiwan from January 1, 2003 to December 31, 2010 were calculated and compared using data from the Taiwan Cancer Registry (TCR). The various organs were classified and divided into three different systems: the female reproductive, respiratory, and alimentary systems. Survival analysis were also compared among 30,850 patients diagnosed as ASC, adenocarcinoma (AC) or squamous cell carcinoma (SCC) in organs with frequent ASC. Results During the study period, a total of 576 ASC cases were diagnosed in Taiwan. The most common primary system was respiratory (73.8%), followed by alimentary (16.2%) and female reproductive (10%). The overall survival were significantly higher for cases involving the female reproductive system, followed by the respiratory and alimentary systems (P = 0.016). The median overall survival were worse in males than females for cases involving the respiratory system (22.4 vs. 31.8 months, P = 0.044). Multivariate analysis showed that age≧65, more advanced T and N categories were independent unfavorable prognostic factors of overall survival in ASC. ASC histology is an independent unfavorable prognostic factor compared with AC and SCC. Conclusions ASC at an old age and more advanced T and N categories were found to be associated with a poor prognosis. PMID:26445240

  12. Cancer in ANCA-Associated Glomerulonephritis: A Registry-Based Cohort Study

    Directory of Open Access Journals (Sweden)

    Sanjeevan Sriskandarajah

    2017-01-01

    Full Text Available Background. Immunosuppressive therapy for antineutrophil cytoplasmic antibody-associated vasculitis has been associated with increased malignancy risk. Objectives. To quantify the cancer risk associated with contemporary cyclophosphamide-sparing protocols. Methods. Patients from the Norwegian Kidney Biopsy Registry between 1988 and 2012 who had biopsy-verified pauci-immune glomerulonephritis and positive antineutrophil cytoplasmic antibody (ANCA serology were included. Standardised incidence ratios (SIRs were calculated to compare the study cohort with the general population. Results. The study cohort included 419 patients. During 3010 person-years, cancer developed in 41 patients (9.79%; the expected number of cancer cases was 37.5 (8.95%. The cohort had SIRs as follows: 1.09, all cancer types (95% CI, 0.81 to 1.49; 0.96, all types except nonmelanoma skin cancer (95% CI, 0.69 to 1.34; 3.40, nonmelanoma skin cancer (95% CI, 1.62 to 7.14; 3.52, hematologic cancer (95% CI, 1.32 to 9.37; 2.12, posttransplant cancer (95% CI, 1.01 to 4.44; and 1.53, during the 1–5-year follow-up after diagnosis (95% CI, 1.01 to 2.32. Conclusions. Cancer risk did not increase significantly in this cohort with ANCA-associated glomerulonephritis. However, increased risk of nonmelanoma skin cancer, posttransplant cancer, and hematologic cancer indicates an association between immunosuppression and malignancy.

  13. Temporal Trends in Fertility Rates: A Nationwide Registry Based Study from 1901 to 2014.

    Science.gov (United States)

    Blomberg Jensen, Martin; Priskorn, Lærke; Jensen, Tina Kold; Juul, Anders; Skakkebaek, Niels Erik

    2015-01-01

    Increasing age at first childbirth has been suggested to increase the risk for infertility. Our objective is to determine whether women above thirty years of age historically have been able to sustain fertility rates above replacement level. A descriptive nationwide Danish study using birth registries from 1901-2014. Information on women's age at childbirth was obtained by using records from primary, secondary and tertiary institutions. Mothers to 8,024,969 live births. Mothers were stratified according to age at childbirth to determine total and age specific fertility rates. Total fertility rate (TFR) decreased from 4.1 to 1.8 children per woman and age specific fertility also decreased from 1901 to 2014. Women aged 30-34, 35-39 or 40-44 years in the first decade of the 20th century had higher fertility rates than the corresponding five year younger age groups (25-29, 30-34 and 35-39, respectively) have had for the last 65 years. On average, women gave birth to two children after the age of 30 and one or more child after 35 years of age in the beginning of the 1900s. Furthermore, women more than 40 years of age accounted for 10% of TFR in 1901 compared with 4% in 2014 despite usage of assisted reproduction. This nationwide study shows that women above 30 years of age historically have been able to sustain fertility rates above replacement level. This implies that other factors besides age are strong determinants of fertility in women above 30 years of age.

  14. Transfer of newborns to neonatal care unit: a registry based study in Northern Tanzania

    Directory of Open Access Journals (Sweden)

    Kibiki Gibson S

    2011-10-01

    Full Text Available Abstract Background Reduction in neonatal mortality has been slower than anticipated in many low income countries including Tanzania. Adequate neonatal care may contribute to reduced mortality. We studied factors associated with transfer of babies to a neonatal care unit (NCU in data from a birth registry at Kilimanjaro Christian Medical Centre (KCMC in Tanzania. Methods A total of 21 206 singleton live births registered from 2000 to 2008 were included. Multivariable analysis was carried out to study neonatal transfer to NCU by socio-demographic factors, pregnancy complications and measures of the condition of the newborn. Results A total of 3190 (15% newborn singletons were transferred to the NCU. As expected, neonatal transfer was strongly associated with specific conditions of the baby including birth weight above 4000 g (relative risk (RR = 7.2; 95% confidence interval (CI 6.5-8.0 or below 1500 g (RR = 3.0; 95% CI: 2.3-4.0, five minutes Apgar score less than 7 (RR = 4.0; 95% CI: 3.4-4.6, and preterm birth before 34 weeks of gestation (RR = 1.8; 95% CI: 1.5-2.1. However, pregnancy- and delivery-related conditions like premature rupture of membrane (RR = 2.3; 95% CI: 1.9-2.7, preeclampsia (RR = 1.3; 95% CI: 1.1-1.5, other vaginal delivery (RR = 2.2; 95% CI: 1.7-2.9 and caesarean section (RR = 1.9; 95% CI: 1.8-2.1 were also significantly associated with transfer. Birth to a first born child was associated with increased likelihood of transfer (relative risk (RR 1.4; 95% CI: 1.2-1.5, while the likelihood was reduced (RR = 0.5; 95% CI: 0.3-0.9 when the father had no education. Conclusions In addition to strong associations between neonatal transfer and classical neonatal risk factors for morbidity and mortality, some pregnancy-related and demographic factors were predictors of neonatal transfer. Overall, transfer was more likely for babies with signs of poor health status or a complicated pregnancy. Except for a possibly reduced use of transfer

  15. Sarcoidosis in Denmark 1980-1994. A registry-based incidence study comprising 5536 patients

    DEFF Research Database (Denmark)

    Byg, Keld-Erik; Milman, Nils; Hansen, Stig

    2003-01-01

    BACKGROUND AND AIM: To evaluate the incidence of sarcoidosis in Denmark 1980-1994. METHODS: Patients with a diagnosis of sarcoidosis were identified from the Danish National Patient Registry. The file contained information about the year in which the diagnosis was reported, gender, age, and resid......BACKGROUND AND AIM: To evaluate the incidence of sarcoidosis in Denmark 1980-1994. METHODS: Patients with a diagnosis of sarcoidosis were identified from the Danish National Patient Registry. The file contained information about the year in which the diagnosis was reported, gender, age......, and residential county. RESULTS: 5536 persons (2816 men) with sarcoidosis were registered. Median age in men was 38 years, in women 45 years. The male/female incidence ratio was 1.06. The incidence (per 100,000 person years) declined gradually from 8.1 in 1980-1984 to 6.4 in 1990-1994. The overall incidence...... (11.0). CONCLUSION: Incidence rates in the present study are lower compared with previous mass-screening surveys showing an incidence rate of 13.8 (in persons examined). Peak incidences occurred at higher ages in both men and women. Previous surveys showed peak incidences at 20-25 years in men...

  16. The quest for a universal definition of polytrauma: a trauma registry-based validation study.

    Science.gov (United States)

    Butcher, Nerida E; D'Este, Catherine; Balogh, Zsolt J

    2014-10-01

    A pilot validation recommended defining polytrauma as patients with an Abbreviated Injury Scale (AIS) score greater than 2 in at least two Injury Severity Score (ISS) body regions (2 × AIS score > 2). This study aimed to validate this definition on larger data set. We hypothesized that patients defined by the 2 × AIS score > 2 cutoff have worse outcomes and use more resources than those without 2 × AIS score > 2 and that this would therefore be a better definition of polytrauma. Patients injured between 2009 and 2011, with complete documentation of AIS by New South Wales Trauma Registry and 16 years and older were selected. Age and sex were obtained in addition to outcomes of ISS, hospital length of stay (LOS), intensive care unit (ICU) admission, ICU LOS, and mortality. We compared demographic characteristics and outcomes between patients with ISS greater than 15 who did and did not meet the 2 × AIS score > 2 definition. We then undertook regression analyses (logistic regression for binary outcomes [ICU admission and death] and linear regression for hospital and ICU LOS) to compare outcomes for patients with and without 2 × AIS score > 2, adjusting for sex and age categories. In the adjusted analyses, patients with 2 × AIS score > 2 had twice the odds of being admitted to the ICU compared with those without 2 × AIS score > 2 (odds ratio, 2.5; 95% confidence interval [CI], 2.2-2.8) and 1.7 times the odds of dying (95% CI, 1.4-2.0; p 2 also had a mean difference of 1.5 days longer stay in the hospital compared with those without 2 × AIS score > 2 (95% CI, 1.4-1.7) and 1.6 days longer ICU stay (95% CI, 1.4-1.8; p 2 had higher mortality, more frequent ICU admissions, and longer hospital and ICU stay than those without 2 × AIS score > 2 and represents a superior definition to the definitions for polytrauma currently in use. Diagnostic test/ criteria, level III.

  17. New, Occasional, and Frequent Use of Zolpidem or Zopiclone (Alone and in Combination) and the Risk of Injurious Road Traffic Crashes in Older Adult Drivers: A Population-Based Case-Control and Case-Crossover Study.

    Science.gov (United States)

    Nevriana, Alicia; Möller, Jette; Laflamme, Lucie; Monárrez-Espino, Joel

    2017-08-01

    Previous studies on the effect of zolpidem or zopiclone use on the risk of road traffic crashes (RTCs) have shown mixed results. Our objective was to determine the association between zolpidem or zopiclone use (as separate drugs or combined) and the occurrence of injurious RTCs among older adult drivers. This was a population-based matched case-control and case-crossover study based on secondary data linked together from Swedish national registers. Cases were drivers aged 50-80 years involved in a vehicle crash resulting in injuries between January 2006 and December 2009 for the case-control study (n = 27,096) and from February 2006 to December 2009 for the case-crossover study (n = 26,586). For the first design, four controls were matched to each case by sex, age, and residential area, and exposure was categorized into new, occasional, and frequent use of zolpidem only, zopiclone only, and combined zolpidem and zopiclone. For the case-crossover study, newly dispensed zolpidem or zopiclone users were assessed during the 28 days prior to the crash and compared with an equally long control period using a 12-week washout period. Matched adjusted odds ratios (OR) were computed using conditional logistic regression. Increased ORs for all users were observed. In the case-control study, the highest odds were seen among newly initiated zolpidem-only users involved in single-vehicle crashes (adjusted OR 2.27; 95% confidence interval [CI] 1.21-4.24), followed by frequent combined zolpidem and zopiclone users [adjusted OR 2.20; CI 1.21-4.00]. In the case-crossover, newly initiated treatment with zolpidem or zopiclone showed an increased risk that was highest in the 2 weeks after the start of the treatment (OR 2.66; 95% CI 1.04-6.81). These results provide more compelling evidence for the role of zolpidem or zopiclone in the occurrence of RTCs among older adults, not only in frequent users, but also at the beginning of treatment.

  18. Brand name to generic substitution of antiepileptic drugs does not lead to seizure-related hospitalization: a population-based case-crossover study.

    Science.gov (United States)

    Polard, Elisabeth; Nowak, Emmanuel; Happe, André; Biraben, Arnaud; Oger, Emmanuel

    2015-11-01

    There is still controversy on brand-to-generic (B-G) antiepileptic drugs (AEDs) substitution. To assess association between B-G AED substitution and seizure-related hospitalization, we designed a case crossover using the French National Health Insurance Database. We identified a cohort of adult patients who filled a prescription in 2009-2011 for AEDs with at least one brand name and one generic form. The outcome date was defined as the date of hospitalization, coded G40.x or G41.x, with a G40/G41 hospitalization-free period of at least 1 year. Patients with a medical history of cancer and women who gave birth in 2009-2011 were excluded. We required individuals to have regular dispensations of AEDs within the year preceding the outcome date. Free patients were defined as patients who had only brand name dispensations before the control period. Eight thousand three hundred seventy nine patients (mean age ± standard deviation, 52.7 ± 18.8 years; sex ratio male/female, 1.27) were analyzed. Discordant pairs were 491 with B-G substitution in the control period only and 478 with B-G substitution in the case period only; odds ratio (95% confidence interval) 0.97 (0.86-1.10). No statistically significant interaction was detected among the four prespecified subgroup analyses (gender, age strata, free or non-free, and strict AED monotherapy or not). Controlling for non-seizure-related hospitalizations made no material difference. Sensitivity analyses yielded similar results. Brand-to-generic AED substitution was not associated with an elevated risk of seizure-related hospitalization. Copyright © 2015 John Wiley & Sons, Ltd.

  19. Pre-vaccination care-seeking in females reporting severe adverse reactions to HPV vaccine. A registry based case-control study

    DEFF Research Database (Denmark)

    Mølbak, Kåre; Hansen, Niels Dalum; Valentiner-Branth, Palle

    2016-01-01

    to the DMA of suspected severe adverse reactions.We selected controls without reports of adverse reactions from the Danish vaccination registry and matched by year of vaccination, age of vaccination, and municipality, and obtained from the Danish National Patient Registry and The National Health Insurance...... vaccination programme has declined. The aim of the present study was to determine health care-seeking prior to the first HPV vaccination among females who suspected adverse reactions to HPV vaccine. Methods In this registry-based case-control study, we included as cases vaccinated females with reports...... Service Register the history of health care usage two years prior to the first vaccine. We analysed the data by logistic regression while adjusting for the matching variables. Results The study included 316 cases who received first HPV vaccine between 2006 and 2014. Age range of cases was 11 to 52 years...

  20. Increasing trends in childlessness in recent birth cohorts - a registry-based study of the total Danish male population born from 1945 to 1980

    DEFF Research Database (Denmark)

    Priskorn, L; Holmboe, Sarah; Jacobsen, R

    2012-01-01

    The fertility rate has recently declined in many parts of the World, including Europe. To a large extent, this change can be explained by the socio-economic development. However, increasing fertility problems and widespread occurrence of poor semen quality could in part explain the few births....... The objective of this registry based study was to investigate birth cohort related trends in fertility and childlessness among Danish men. The study population comprised all 1 616 677 men in Denmark born from 1945 to 1980 of whom 1 359 975 (84.1%) were native Danes. Data were obtained from Statistics Denmark...... and contained information from The National Danish Birth Registry and The Danish In Vitro Fertilization (IVF) Registry. For consecutive birth cohorts of native Danish men cumulative fertility rates at age 45 declined from 1.91 children per man in the 1945 birth cohort to 1.71 for men born in 1960...

  1. Emotional stress as a trigger of falls leading to hip or pelvic fracture. Results from the ToFa study – a case-crossover study among elderly people in Stockholm, Sweden

    Science.gov (United States)

    Möller, Jette; Hallqvist, Johan; Laflamme, Lucie; Mattsson, Fredrik; Ponzer, Sari; Sadigh, Siv; Engström, Karin

    2009-01-01

    Background Sudden emotions may interfere with mechanisms for keeping balance among the elderly. The aim of this study is to analyse if emotional stress and specifically feelings of anger, sadness, worries, anxiety or stress, can trigger falls leading to hip or pelvic fracture among autonomous older people. Methods The study applied the case-crossover design and was based on data gathered by face to face interviews carried out in Stockholm between November 2004 and January 2006 at the emergency wards of two hospitals. Cases (n = 137) were defined as persons aged 65 and older admitted for at least one night due to a fall-related hip or pelvic fracture (ICD10: S72 or S32) and meeting a series of selection criteria. Results are presented as relative risks with 95% confidence intervals. Results There was an increased risk for fall and subsequent hip or pelvic fracture for up to one hour after emotional stress. For anger there was an increased relative risk of 12.2 (95% CI 2.7–54.7), for sadness of 5.7 (95% CI 1.1–28.7), and for stress 20.6 (95% CI 4.5–93.5) compared to periods with no such feelings. Conclusion Emotional stress seems to have the potential to trigger falls and subsequent hip or pelvic fracture among autonomous older people. Further studies are needed to clarify how robust the findings are – as the number of exposed cases is small – and the mechanisms behind them – presumably balance and vision impairment in stress situation. PMID:19203356

  2. Emotional stress as a trigger of falls leading to hip or pelvic fracture. Results from the ToFa study - a case-crossover study among elderly people in Stockholm, Sweden.

    Science.gov (United States)

    Möller, Jette; Hallqvist, Johan; Laflamme, Lucie; Mattsson, Fredrik; Ponzer, Sari; Sadigh, Siv; Engström, Karin

    2009-02-09

    Sudden emotions may interfere with mechanisms for keeping balance among the elderly. The aim of this study is to analyse if emotional stress and specifically feelings of anger, sadness, worries, anxiety or stress, can trigger falls leading to hip or pelvic fracture among autonomous older people. The study applied the case-crossover design and was based on data gathered by face to face interviews carried out in Stockholm between November 2004 and January 2006 at the emergency wards of two hospitals. Cases (n = 137) were defined as persons aged 65 and older admitted for at least one night due to a fall-related hip or pelvic fracture (ICD10: S72 or S32) and meeting a series of selection criteria. Results are presented as relative risks with 95% confidence intervals. There was an increased risk for fall and subsequent hip or pelvic fracture for up to one hour after emotional stress. For anger there was an increased relative risk of 12.2 (95% CI 2.7-54.7), for sadness of 5.7 (95% CI 1.1-28.7), and for stress 20.6 (95% CI 4.5-93.5) compared to periods with no such feelings. Emotional stress seems to have the potential to trigger falls and subsequent hip or pelvic fracture among autonomous older people. Further studies are needed to clarify how robust the findings are - as the number of exposed cases is small - and the mechanisms behind them - presumably balance and vision impairment in stress situation.

  3. Emotional stress as a trigger of falls leading to hip or pelvic fracture. Results from the ToFa study – a case-crossover study among elderly people in Stockholm, Sweden

    Directory of Open Access Journals (Sweden)

    Ponzer Sari

    2009-02-01

    Full Text Available Abstract Background Sudden emotions may interfere with mechanisms for keeping balance among the elderly. The aim of this study is to analyse if emotional stress and specifically feelings of anger, sadness, worries, anxiety or stress, can trigger falls leading to hip or pelvic fracture among autonomous older people. Methods The study applied the case-crossover design and was based on data gathered by face to face interviews carried out in Stockholm between November 2004 and January 2006 at the emergency wards of two hospitals. Cases (n = 137 were defined as persons aged 65 and older admitted for at least one night due to a fall-related hip or pelvic fracture (ICD10: S72 or S32 and meeting a series of selection criteria. Results are presented as relative risks with 95% confidence intervals. Results There was an increased risk for fall and subsequent hip or pelvic fracture for up to one hour after emotional stress. For anger there was an increased relative risk of 12.2 (95% CI 2.7–54.7, for sadness of 5.7 (95% CI 1.1–28.7, and for stress 20.6 (95% CI 4.5–93.5 compared to periods with no such feelings. Conclusion Emotional stress seems to have the potential to trigger falls and subsequent hip or pelvic fracture among autonomous older people. Further studies are needed to clarify how robust the findings are – as the number of exposed cases is small – and the mechanisms behind them – presumably balance and vision impairment in stress situation.

  4. A case-crossover study of sleep, fatigue, and other transient exposures at workplace and the risk of non-fatal occupational injuries among the employees of an Italian academic hospital

    Directory of Open Access Journals (Sweden)

    Francesca Valent

    2016-12-01

    Full Text Available Objectives: Transient exposure with acute effect has been shown to affect the risk of occupational injuries in various industrial settings and at the healthcare workplace. The objective of this study has been to identify transient exposures related to occupational injury risk in an Italian teaching hospital. Material and Methods: A case-crossover study was conducted among the employees of the University Hospital of Udine who reported an occupational injury, commuting accident, or incident involving biological risk in a 15-month period in the years 2013 and 2014. The matched-pair interval approach was used to assess the role of acute sleep deprivation whereas the usual frequency approach was used for other 13 transient exposures. Results: Sleep hours were not associated with the risk of injuries whereas a significant risk increase was associated with fatigue, rush, distraction, emergency situations, teaching to or being taught by someone, non-compliant patients, bloody operative/work field, excess noise, complex procedures, and anger. Conclusions: We identified transient exposures that increased the risk of occupational injuries in an Italian teaching hospital, providing indications for interventions to increase workers’ safety at the healthcare workplace. Int J Occup Med Environ Health 2016;29(6:1001–1009

  5. Migrant breast cancer patients and their participation in genetic counseling : results from a registry-based study

    NARCIS (Netherlands)

    Baars, J E; van Dulmen, A M; Velthuizen, M E; Theunissen, E B M; Vrouenraets, B C; Kimmings, A N; van Dalen, T; van Ooijen, B; Witkamp, A J; van der Aa, M A; Ausems, M G E M

    Certain ethnic groups seem to have less access to cancer genetic counseling. Our study was to investigate the participation in cancer genetic counseling among migrant breast cancer patients of Turkish and Moroccan origin. Hospital medical records of Turkish and Moroccan and of a comparative group of

  6. Migrant breast cancer patients and their participation in genetic counseling: results from a registry-based study.

    NARCIS (Netherlands)

    Baars, J.E.; Dulmen, A.M. van; Velthuizen, M.E.; Theunissen, E.B.M.; Vrouenraets, B.C.; Kimmings, A.N.; Dalen, T. van; Ooijen, B. van; Witkamp, A.J.; Aa, M.A. van der; Ausems, M.G.E.M.

    2016-01-01

    Certain ethnic groups seem to have less access to cancer genetic counseling. Our study was to investigate the participation in cancer genetic counseling among migrant breast cancer patients of Turkish and Moroccan origin. Hospital medical records of Turkish and Moroccan and of a comparative group of

  7. Migrant breast cancer patients and their participation in genetic counseling: results from a registry-based study

    NARCIS (Netherlands)

    Baars, J.E.; Dulmen, A.M. van; Velthuizen, M.E.; Theunissen, E.B.; Vrouenraets, B.C.; Kimmings, A.N.; Dalen, T. van; Ooijen, B. van; Witkamp, A.J.; Aa, M.A. van der; Ausems, M.G.

    2016-01-01

    Certain ethnic groups seem to have less access to cancer genetic counseling. Our study was to investigate the participation in cancer genetic counseling among migrant breast cancer patients of Turkish and Moroccan origin. Hospital medical records of Turkish and Moroccan and of a comparative group of

  8. Increasing Incidence of Hospitalization for Stroke and Transient Ischemic Attack in Young Adults: A Registry-Based Study.

    Science.gov (United States)

    Tibæk, Maiken; Dehlendorff, Christian; Jørgensen, Henrik S; Forchhammer, Hysse B; Johnsen, Søren P; Kammersgaard, Lars P

    2016-05-11

    Studies have reported increasing incidence of ischemic stroke in adults younger than 50 to 55 years. Information on temporal trends of other stroke subtypes and transient ischemic attack (TIA) is sparse. The aim of this study was to investigate temporal trends of the incidence of hospitalizations for TIA and stroke including sex- and subtype-specific trends in young adults aged 15 to 30 years. From the Danish National Patient Register, we identified all cases of first-ever stroke and TIA (age 15-30 years) in Denmark, who were hospitalized during the study period of 1994 to 2012. Incidence rates and estimated annual percentage changes (EAPCs) were estimated by using Poisson regression. During the study period, 4156 cases of first-ever hospitalization for stroke/TIA were identified. The age-standardized incidence rates of hospitalizations for stroke increased significantly (EAPC 1.83% [95% CI 1.11-2.55%]) from 11.97/100 000 person-years (PY) in 1994 to 16.77/100 000 PY in 2012. TIA hospitalizations increased from 1.93/100 000 PY in 1994 to 5.81/100 000 PY in 2012 and after 2006 more markedly in men than in women (EAPC 16.61% [95% CI 10.45-23.12%]). The incidence of hospitalizations for ischemic stroke was markedly lower among men, but increased significantly from 2006 (EAPC 14.60% [95% CI 6.22-23.63%]). The incidences of hospitalizations for intracerebral hemorrhage and subarachnoid hemorrhage remained stable during the study period. The incidence rates of first-time hospitalizations for ischemic stroke and TIA in young Danish adults have increased substantially since the mid 1990s. The increase was particularly prominent in the most recent years. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  9. Risk of breast cancer following fertility treatment--a registry based cohort study of parous women in Norway.

    Science.gov (United States)

    Reigstad, Marte Myhre; Larsen, Inger Kristin; Myklebust, Tor Åge; Robsahm, Trude Eid; Oldereid, Nan Birgitte; Omland, Anne Katerine; Vangen, Siri; Brinton, Louise Annette; Storeng, Ritsa

    2015-03-01

    Despite increasing numbers of women availing themselves of assisted reproductive technology (ART), effects on cancer risk remain unresolved. Given hormonal exposures, breast cancer risk is of particular concern. The aim of this study is to investigate breast cancer risk amongst women giving birth following ART as compared to that amongst women who gave birth without ART. Data on all women who gave birth in Norway with or without ART, between 1984 and 2010 were obtained from the Medical Birth Registry of Norway (MBRN). 808,834 women eligible for study were linked to the Cancer Registry of Norway. Cox proportional models computed hazard ratios (HR) and 95% confidence intervals (CI) of breast cancer between the two groups, adjusting for age, parity, age at first birth, calendar period and region of residence. In total, 8,037 women were diagnosed with breast cancer during the study period, 138 ART women and 7,899 unexposed. Total follow-up time was 12,401,121 person-years (median 16.0); median age at entry was 32.5 years (range 18.6-49.9) for ART women and 26.3 (range 10.5-54.6) for unexposed. Women exposed to ART had an elevated risk of breast cancer (adjusted HR 1.20, 95% CI 1.01-1.42). Subgroup analyses gave an HR of 1.30 (95% CI 1.07-1.57) for women treated with IVF and 1.35 (95 % CI 1.07-1.71) for women with follow-up >10 years, compared with controls. Our findings of increased risk in the study population warrant continued monitoring of women treated with ART as this population advances into more typical cancer age ranges. © 2014 UICC.

  10. Suicide death and hospital-treated suicidal behaviour in asylum seekers in the Netherlands: a national registry-based study

    Directory of Open Access Journals (Sweden)

    van Oostrum Irene EA

    2011-06-01

    Full Text Available Abstract Background Several suicide and suicidal behaviour risk factors are highly prevalent in asylum seekers, but there is little insight into the suicide death rate and the suicidal behaviour incidence in this population. The main objective of this study is to assess the burden of suicide and hospital-treated non-fatal suicidal behaviour in asylum seekers in the Netherlands and to identify factors that could guide prevention. Methods We obtained data on cases of suicide and suicidal behaviour from all asylum seeker reception centres in the Netherlands (period 2002-2007, age 15+. The suicide death rates in this population and in subgroups by sex, age and region of origin were compared with the rate in the Dutch population; the rates of hospital-treated suicidal behaviour were compared with that in the population of The Hague using indirect age group standardization. Results The study included 35 suicide deaths and 290 cases of hospital-treated suicidal behaviour. The suicide death rate and the incidence of hospital-treated suicidal behaviour differed between subgroups by sex and region of origin. For male asylum seekers, the suicide death rate was higher than that of the Dutch population (N = 32; RR = 2.0, 95%CI 1.37-2.83. No difference was found between suicide mortality in female asylum seekers and in the female general population of the Netherlands (N = 3; RR = 0.73; 95%CI 0.15-2.07. The incidence of hospital-treated suicidal behaviour was high in comparison with the population of The Hague for males and females from Europe and the Middle East/South West Asia, and low for males and females from Africa. Health professionals knew about mental health problems prior to the suicidal behaviour for 80% of the hospital-treated suicidal behaviour cases in asylum seekers. Conclusions In this study the suicide death rate was higher in male asylum seekers than in males in the reference population. The incidence of hospital-treated suicidal behaviour

  11. Educational attainment and differences in relative survival after acute myocardial infarction in Norway: a registry-based population study.

    Science.gov (United States)

    Klitkou, Søren Toksvig; Wangen, Knut R

    2017-08-28

    Although there is a broad societal interest in socioeconomic differences in survival after an acute myocardial infarction, only a few studies have investigated how such differences relate to the survival in general population groups. We aimed to investigate education-specific survival after acute myocardial infarction and to compare this with the survival of corresponding groups in the general population. Our study included the entire population of Norwegian patients admitted to hospitals for acute myocardial infarction during 2008-2010, with a 6- year follow-up period. Patient survival was measured relative to the expected survival in the general population for three educational groups: primary, secondary and tertiary. Education, sex, age and calendar year-specific expected survival were obtained from population life tables and adjusted for the presence of infarction-related mortality. Six-year patient survivals were 56.3% (55.3-57.2) and 65.5% (65.6-69.3) for the primary and tertiary educational groups (95% CIs), respectively. Also 6-year relative survival was markedly lower for the primary educational group: 70.2% (68.6-71.8) versus 81.2% (77.4-84.4). Throughout the follow-up period, patient survival tended to remain lower than the survival in the general population with the same educational background. Both patient survival and relative survival after acute myocardial infarction are positively associated with educational level. Our findings may suggest that secondary prevention has been more effective for the highly educated. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. Survival after out-of-hospital cardiac arrest in relation to sex: a nationwide registry-based study.

    Science.gov (United States)

    Wissenberg, Mads; Hansen, Carolina Malta; Folke, Fredrik; Lippert, Freddy K; Weeke, Peter; Karlsson, Lena; Rajan, Shahzleen; Søndergaard, Kathrine Bach; Kragholm, Kristian; Christensen, Erika Frischknecht; Nielsen, Søren L; Køber, Lars; Gislason, Gunnar H; Torp-Pedersen, Christian

    2014-09-01

    Crude survival has increased following an out-of-hospital cardiac arrest (OHCA). We aimed to study sex-related differences in patient characteristics and survival during a 10-year study period. Patients≥12 years old with OHCA of a presumed cardiac cause, and in whom resuscitation was attempted, were identified through the Danish Cardiac Arrest Registry 2001-2010. A total of 19,372 patients were included. One-third were female, with a median age of 75 years (IQR 65-83). Compared to females, males were five years younger; and less likely to have severe comorbidities, e.g., chronic obstructive pulmonary disease (12.8% vs. 16.5%); but more likely to have arrest outside of the home (29.4% vs. 18.7%), receive bystander CPR (32.9% vs. 25.9%), and have a shockable rhythm (32.6% vs. 17.2%), all p<0.001. Thirty-day crude survival increased in males (3.0% in 2001 to 12.9% in 2010); and in females (4.8% in 2001 to 6.7% in 2010), p<0.001. Multivariable logistic regression analyses adjusted for patient characteristics including comorbidities, showed no survival difference between sexes in patients with a non-shockable rhythm (OR 1.00; CI 0.72-1.40), while female sex was positively associated with survival in patients with a shockable rhythm (OR 1.31; CI 1.07-1.59). Analyses were rhythm-stratified due to interaction between sex and heart rhythm; there was no interaction between sex and calendar-year. Temporal increase in crude survival was more marked in males due to poorer prognostic characteristics in females with a lower proportion of shockable rhythm. In an adjusted model, female sex was positively associated with survival in patients with a shockable rhythm. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  13. Causes of perinatal death at a tertiary care hospital in Northern Tanzania 2000–2010: a registry based study

    Directory of Open Access Journals (Sweden)

    Mmbaga Blandina T

    2012-12-01

    Full Text Available Abstract Background Perinatal mortality reflects maternal health as well as antenatal, intrapartum and newborn care, and is an important health indicator. This study aimed at classifying causes of perinatal death in order to identify categories of potentially preventable deaths. Methods We studied a total of 1958 stillbirths and early neonatal deaths above 500 g between July 2000 and October 2010 registered in the Medical Birth Registry and neonatal registry at Kilimanjaro Christian Medical Centre (KCMC in Northern Tanzania. The deaths were classified according to the Neonatal and Intrauterine deaths Classification according to Etiology (NICE. Results Overall perinatal mortality was 57.7/1000 (1958 out of 33 929, of which 1219 (35.9/1000 were stillbirths and 739 (21.8/1000 were early neonatal deaths. Major causes of perinatal mortality were unexplained asphyxia (n=425, 12.5/1000, obstetric complications (n=303, 8.9/1000, maternal disease (n=287, 8.5/1000, unexplained antepartum stillbirths after 37 weeks of gestation (n= 219, 6.5/1000, and unexplained antepartum stillbirths before 37 weeks of gestation (n=184, 5.4/1000. Obstructed/prolonged labour was the leading condition (251/303, 82.8% among the obstetric complications. Preeclampsia/eclampsia was the leading cause (253/287, 88.2% among the maternal conditions. When we excluded women who were referred for delivery at KCMC due to medical reasons (19.1% of all births and 36.0% of all deaths, perinatal mortality was reduced to 45.6/1000. This reduction was mainly due to fewer deaths from obstetric complications (from 8.9 to 2.1/1000 and maternal conditions (from 8.5 to 5.5/1000. Conclusion The distribution of causes of death in this population suggests a great potential for prevention. Early identification of mothers at risk of pregnancy complications through antenatal care screening, teaching pregnant women to recognize signs of pregnancy complications, timely access to obstetric care

  14. Prevalence, prenatal diagnosis and clinical features of oculo-auriculo-vertebral spectrum: a registry-based study in Europe.

    LENUS (Irish Health Repository)

    Barisic, Ingeborg

    2014-01-08

    Oculo-auriculo-vertebral spectrum is a complex developmental disorder characterised mainly by anomalies of the ear, hemifacial microsomia, epibulbar dermoids and vertebral anomalies. The aetiology is largely unknown, and the epidemiological data are limited and inconsistent. We present the largest population-based epidemiological study to date, using data provided by the large network of congenital anomalies registries in Europe. The study population included infants diagnosed with oculo-auriculo-vertebral spectrum during the 1990-2009 period from 34 registries active in 16 European countries. Of the 355 infants diagnosed with oculo-auriculo-vertebral spectrum, there were 95.8% (340\\/355) live born, 0.8% (3\\/355) fetal deaths, 3.4% (12\\/355) terminations of pregnancy for fetal anomaly and 1.5% (5\\/340) neonatal deaths. In 18.9%, there was prenatal detection of anomaly\\/anomalies associated with oculo-auriculo-vertebral spectrum, 69.7% were diagnosed at birth, 3.9% in the first week of life and 6.1% within 1 year of life. Microtia (88.8%), hemifacial microsomia (49.0%) and ear tags (44.4%) were the most frequent anomalies, followed by atresia\\/stenosis of external auditory canal (25.1%), diverse vertebral (24.3%) and eye (24.3%) anomalies. There was a high rate (69.5%) of associated anomalies of other organs\\/systems. The most common were congenital heart defects present in 27.8% of patients. The prevalence of oculo-auriculo-vertebral spectrum, defined as microtia\\/ear anomalies and at least one major characteristic anomaly, was 3.8 per 100 000 births. Twinning, assisted reproductive techniques and maternal pre-pregnancy diabetes were confirmed as risk factors. The high rate of different associated anomalies points to the need of performing an early ultrasound screening in all infants born with this disorder.European Journal of Human Genetics advance online publication, 8 January 2014; doi:10.1038\\/ejhg.2013.287.

  15. Divorce and subsequent increase in uptake of antidepressant medication: a Finnish registry-based study on couple versus individual effects.

    Science.gov (United States)

    Monden, Christiaan W S; Metsä-Simola, Niina; Saarioja, Saska; Martikainen, Pekka

    2015-02-19

    There is an average negative mental health effect for individuals who experience divorce. Little is known whether the pattern of such divorce effects varies within couples. We study whether the husband and wife experience similar harmful effects of divorce, whether they experience opposite effects, or whether divorce effects are purely individual. We use Finnish registry data to compare changes over a period of 5 years in antidepressant use of husbands and wives from 4,558 divorcing couples to 108,637 continuously married pairs aged 40-64, all of whom were healthy at baseline. In the period three years before and after divorce antidepressant use increases substantially. However, the likelihood of uptake of antidepressant medication during this process of divorce by one partner appears to be independent of medication uptake in the other partner. In contrast, among continuously married couples there is a clear pattern of convergence: If one partner starts to use antidepressants this increases the likelihood of uptake of antidepressant medication in the other partner. Our findings suggest that divorce effects on antidepressant use are individual and show no pattern of either convergence or divergence at the level of the couple. The increased incidence of antidepressant use associated with divorce occurs in individuals independent of what happens to their ex-partner.

  16. Predictors of nonfunctional arteriovenous access at hemodialysis initiation and timing of access creation: A registry-based study.

    Directory of Open Access Journals (Sweden)

    Natalia Alencar de Pinho

    Full Text Available Determinants of nonfunctional arteriovenous (AV access, including timing of AV access creation, have not been sufficiently described. We studied 29 945 patients who had predialysis AV access placement and were included in the French REIN registry from 2005 through 2013. AV access was considered nonfunctional when dialysis began with a catheter. We estimated crude and adjusted odds ratio (OR with 95% confidence intervals (CI of nonfunctional versus functional AV access associated with case-mix, facility characteristics, and timing of AV access creation. Analyses were stratified by dialysis start condition (planned or as an emergency and comorbidity profile. Overall, 18% patients had nonfunctional AV access at hemodialysis initiation. In the group with planned dialysis start, female gender (OR 1.43, 95% CI 1.32-1.56, diabetes (OR 1.28, 95% CI 1.15-1.44, and a higher number of cardiovascular comorbidities (OR 1.27, 95% CI 1.09-1.49, and 1.31, 1.05-1.64, for 3 and >3 cardiovascular comorbidities versus none, respectively were independent predictors of nonfunctional AV access. A higher percentage of AV access creation at the region level was associated with a lower rate of nonfunctional AV access (OR 0.98, 95% CI 0.98-0.99 per 1% increase. The odds of nonfunctional AV access decreased as time from creation to hemodialysis initiation increased up to 3 months in nondiabetic patients with fewer than 2 cardiovascular comorbidities and 6 months in patients with diabetes or 2 or more such comorbidities. In conclusion, both patient characteristics and clinical practices may play a role in successful AV access use at hemodialysis initiation. Adjusting the timing of AV access creation to patients' comorbidity profiles may improve functional AV access rates.

  17. Hand eczema, atopic dermatitis and filaggrin mutations in adult Danes: a registry-based study assessing risk of disability pension.

    Science.gov (United States)

    Heede, Nina G; Thuesen, Betina H; Thyssen, Jacob P; Linneberg, Allan; Szecsi, Pal B; Stender, Steen; Menné, Torkil; Johansen, Jeanne D

    2017-08-01

    Atopic dermatitis and hand eczema often impair the ability of people to work. Only a few studies have investigated whether individuals with loss-of-function filaggrin gene (FLG) mutations, who often have severe and early onset of dermatitis, experience occupational consequences. To investigate the personal consequences of having atopic dermatitis and/or hand eczema and FLG mutations. Adult Danes from the general population (n = 3247) and patients with atopic dermatitis and/or hand eczema (n = 496) were genotyped for common FLG mutations, and completed a questionnaire about skin symptoms and hand eczema. Socioeconomic variables, including disability pension, and information on work in risk occupations were retrieved from national registries. The reasons for granting disability pension were unknown. Disability pension was associated with hand eczema in the general population, especially among individuals with a history of atopic dermatitis. Moreover, self-reported hand eczema and atopic dermatitis were associated with particularly high risk of disability pension among FLG mutation carriers [odds ratio (OR) 4.02 and 95% confidence interval (CI): 1.15-14.11; and OR 6.01 and 95%CI: 2.37-15.34, respectively]. Furthermore, 60% of the FLG mutation carriers with atopic dermatitis who developed hand eczema had experienced symptoms before adulthood. In the general population, self-reported hand eczema and atopic dermatitis, particularly in individuals with a genetically impaired skin barrier, were associated with disability pension, suggesting that FLG mutations carriers with a history of atopic dermatitis and hand eczema could benefit from early attention with respect to choice of occupation. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Characterisation of antibiotic prescriptions for acute respiratory tract infections in Danish general practice: a retrospective registry based cohort study.

    Science.gov (United States)

    Aabenhus, Rune; Hansen, Malene Plejdrup; Saust, Laura Trolle; Bjerrum, Lars

    2017-05-19

    Inappropriate use of antibiotics is contributing to the increasing rates of antimicrobial resistance. Several Danish guidelines on antibiotic prescribing for acute respiratory tract infections in general practice have been issued to promote rational prescribing of antibiotics, however it is unclear if these recommendations are followed. We aimed to characterise the pattern of antibiotic prescriptions for patients diagnosed with acute respiratory tract infections, by means of electronic prescriptions, labeled with clinical indications, from Danish general practice. Acute respiratory tract infections accounted for 456,532 antibiotic prescriptions issued between July 2012 and June 2013. Pneumonia was the most common indication with 178,354 prescriptions (39%), followed by acute tonsillitis (21%) and acute otitis media (19%). In total, penicillin V accounted for 58% of all prescriptions, followed by macrolides (18%) and amoxicillin (15%). The use of second-line agents increased with age for all indications, and comprised more than 40% of the prescriptions in patients aged >75 years. Women were more often prescribed antibiotics regardless of clinical indication. This is the first Danish study to characterise antibiotic prescription patterns for acute respiratory tract infections by data linkage of clinical indications. The findings confirm that penicillin V is the most commonly prescribed antibiotic agent for treatment of patients with an acute respiratory tract infection in Danish general practice. However, second-line agents like macrolides and amoxicillin with or without clavulanic acid are overused. Strategies to improve the quality of antibiotic prescribing especially for pneumonia, acute otitis media and acute rhinosinusitis are warranted. TRACKING THE OVERUSE OF ANTIBIOTICS: Better adherence to guidelines for prescribing antibiotics for different respiratory tract infections are warranted in Danish general practice. The over-use of antibiotics, particularly so

  19. Use of acid-suppressive drugs in pregnancy and the risk of childhood asthma : Bidirectional case-crossover study using the general practice research database

    NARCIS (Netherlands)

    Hak, Eelko; Mulder, Bianca; Schuiling-Veninga, Nynke C. M.; De Vries, Tjalling W.; Jick, Susan S.

    2013-01-01

    Background: Recent studies have reported an association between maternal use of gastric acid-suppressive drugs during pregnancy and asthma in the offspring, but the association could have been confounded by unmeasured risk factors. Objectives: To assess the association between the use of

  20. Risk of new acute myocardial infarction hospitalization associated with use of oral and parenteral non-steroidal anti-inflammation drugs (NSAIDs: a case-crossover study of Taiwan's National Health Insurance claims database and review of current evidence

    Directory of Open Access Journals (Sweden)

    Shau Wen-Yi

    2012-02-01

    Full Text Available Abstract Background Previous studies have documented the increased cardiovascular risk associated with the use of some nonsteroidal anti-inflammatory drugs (NSAIDs. Despite this, many old NSAIDs are still prescribed worldwide. Most of the studies to date have been focused on specific oral drugs or limited by the number of cases examined. We studied the risk of new acute myocardial infarction (AMI hospitalization with current use of a variety of oral and parenteral NSAIDs in a nationwide population, and compared our results with existing evidence. Methods We conducted a case-crossover study using the Taiwan's National Health Insurance claim database, identifying patients with new AMI hospitalized in 2006. The 1-30 days and 91-120 days prior to the admission were defined as case and matched control period for each patient, respectively. Uses of NSAIDs during the respective periods were compared using conditional logistic regression and adjusted for use of co-medications. Results 8354 new AMI hospitalization patients fulfilled the study criteria. 14 oral and 3 parenteral NSAIDs were selected based on drug utilization profile among 13.7 million NSAID users. The adjusted odds ratio, aOR (95% confidence interval, for risk of AMI and use of oral and parenteral non-selective NSAIDs were 1.42 (1.29, 1.56 and 3.35 (2.50, 4.47, respectively, and significantly greater for parenteral than oral drugs (p for interaction Conclusions The collective evidence revealed the tendency of increased AMI risk with current use of some NSAIDs. A higher AMI risk associated with use of parenteral NSAIDs was observed in the present study. Ketorolac had the highest associated risk in both oral and parenteral NSAIDs studied. Though further investigation to confirm the association is warranted, prescribing physicians and the general public should be cautious about the potential risk of AMI when using NSAIDs.

  1. Short-term association between ambient air pollution and pneumonia in children: A systematic review and meta-analysis of time-series and case-crossover studies.

    Science.gov (United States)

    Nhung, Nguyen Thi Trang; Amini, Heresh; Schindler, Christian; Kutlar Joss, Meltem; Dien, Tran Minh; Probst-Hensch, Nicole; Perez, Laura; Künzli, Nino

    2017-11-01

    Ambient air pollution has been associated with respiratory diseases in children. However, its effects on pediatric pneumonia have not been meta-analyzed. We conducted a systematic review and meta-analysis of the short-term association between ambient air pollution and hospitalization of children due to pneumonia. We searched the Web of Science and PubMed for indexed publications up to January 2017. Pollutant-specific excess risk percentage (ER%) and confidence intervals (CI) were estimated using random effect models for particulate matter (PM) with diameter ≤ 10 (PM 10 ) and ≤2.5 μm (PM 2.5 ), sulfur dioxide (SO 2 ), ozone (O 3 ), nitrogen dioxide (NO 2 ), and carbon monoxide (CO). Results were further stratified by subgroups (children under five, emergency visits versus hospital admissions, income level of study location, and exposure period). Seventeen studies were included in the meta-analysis. The ER% per 10 μg/m 3 increase of pollutants was 1.5% (95% CI: 0.6%-2.4%) for PM 10 and 1.8% (95% CI: 0.5%-3.1%) for PM 2.5 . The corresponding values per 10 ppb increment of gaseous pollutants were 2.9% (95% CI: 0.4%-5.3%) for SO 2 , 1.7% (95% CI: 0.5%-2.8%) for O 3 , and 1.4% (95% CI: 0.4%-2.4%) for NO 2 . ER% per 1000 ppb increment of CO was 0.9% (95% CI: 0.0%-1.9%). Associations were not substantially different between subgroups. This meta-analysis shows a positive association between daily levels of ambient air pollution markers and hospitalization of children due to pneumonia. However, lack of studies from low-and middle-income countries limits the quantitative generalizability given that susceptibilities to the adverse effects of air pollution may be different in those populations. The meta-regression in our analysis further demonstrated a strong effect of country income level on heterogeneity. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Registry-based randomized controlled trials merged the strength of randomized controlled trails and observational studies and give rise to more pragmatic trials.

    Science.gov (United States)

    Mathes, Tim; Buehn, Stefanie; Prengel, Peggy; Pieper, Dawid

    2018-01-01

    The objective of this study was to analyze the features of registry-based randomized trials (rRCTs). We systematically searched PubMed for rRCTs. Study selection was performed independently by two reviewers. We extracted all data in standardized tables and prepared descriptive summary statistics. The search resulted in 1,202 hits. We included 71 rRCTs. Most rRCTs were from Denmark and Sweden. Chronic conditions were considered in 82.2%. A preventive intervention was examined in 45.1%. The median of included patients was 2,000 (range: 69-246,079). Definition of the study population was mostly broad. Study procedures were regularly little standardized. The number of included and analyzed patients was the same in 82.1%. In half of the rRCTs, more than one registry was utilized. Various linkage techniques were used. In median, two outcomes were collected from the registry/ies. The median follow-up of the rRCTs was 5.3 years (range: 6 weeks to 27 years). Information on quality of registry data was reported in 11.3%. rRCTs can provide valid (randomization, low lost-to-follow-up rates, generalizable) patient important long-term comparative-effectiveness data for relative little effort. Researchers planning an RCT should always check whether existing registries can be used for data collection. Reporting on data quality must be improved for use in evidence synthesis. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Timing of oral anticoagulant therapy in acute ischemic stroke with atrial fibrillation: study protocol for a registry-based randomised controlled trial.

    Science.gov (United States)

    Åsberg, Signild; Hijazi, Ziad; Norrving, Bo; Terént, Andreas; Öhagen, Patrik; Oldgren, Jonas

    2017-12-02

    Oral anticoagulation therapy is recommended for the prevention of recurrent ischemic stroke in patients with atrial fibrillation (AF). Current guidelines do not provide evidence-based recommendations on optimal time-point to start anticoagulation therapy after an acute ischemic stroke. Non-vitamin K antagonist oral anticoagulants (NOACs) may offer advantages compared to warfarin because of faster and more predictable onset of action and potentially a lower risk of intracerebral haemorrhage also in the acute phase after an ischemic stroke. The TIMING study aims to establish the efficacy and safety of early vs delayed initiation of NOACs in patients with acute ischemic stroke and AF. The TIMING study is a national, investigator-led, registry-based, multicentre, open-label, randomised controlled study. The Swedish Stroke Register is used for enrolment, randomisation and follow-up of 3000 patients, who are randomised (1:1) within 72 h from ischemic stroke onset to either early (≤ 4 days) or delayed (≥ 5-10 days) start of NOAC therapy. The primary outcome is the composite of recurrent ischemic stroke, symptomatic intracerebral haemorrhage, or all-cause mortality within 90 days after randomisation. Secondary outcomes include: individual components of the primary outcome at 90 and 365 days; major haemorrhagic events; functional outcome by the modified Rankin Scale at 90 days; and health economics. In an optional biomarker sub-study, blood samples will be collected after randomisation from approximately half of the patients for central analysis of cardiovascular biomarkers after study completion. The study is funded by the Swedish Medical Research Council. Enrolment of patients started in April 2017. The TIMING study addresses the ongoing clinical dilemma of when to start NOAC after an acute ischemic stroke in patients with AF. By the inclusion of a randomisation module within the Swedish Stroke Register, the advantages of a prospective randomised study design

  4. Pre-Vaccination Care-Seeking in Females Reporting Severe Adverse Reactions to HPV Vaccine. A Registry Based Case-Control Study.

    Directory of Open Access Journals (Sweden)

    Kåre Mølbak

    Full Text Available Since 2013 the number of suspected adverse reactions to the quadrivalent human papillomavirus (HPV vaccine reported to the Danish Medicines Agency (DMA has increased. Due to the resulting public concerns about vaccine safety, the coverage of HPV vaccinations in the childhood vaccination programme has declined. The aim of the present study was to determine health care-seeking prior to the first HPV vaccination among females who suspected adverse reactions to HPV vaccine.In this registry-based case-control study, we included as cases vaccinated females with reports to the DMA of suspected severe adverse reactions. We selected controls without reports of adverse reactions from the Danish vaccination registry and matched by year of vaccination, age of vaccination, and municipality, and obtained from the Danish National Patient Registry and The National Health Insurance Service Register the history of health care usage two years prior to the first vaccine. We analysed the data by logistic regression while adjusting for the matching variables.The study included 316 cases who received first HPV vaccine between 2006 and 2014. Age range of cases was 11 to 52 years, with a peak at 12 years, corresponding to the recommended age at vaccination, and another peak at 19 to 28 years, corresponding to a catch-up programme targeting young women. Compared with 163,910 controls, cases had increased care-seeking in the two years before receiving the first HPV vaccine. A multivariable model showed higher use of telephone/email consultations (OR 1.9; 95% CI 1.2-3.2, physiotherapy (OR 2.1; 95% CI 1.6-2.8 and psychologist/psychiatrist (OR 1.9; 95% CI 1.3-2.7. Cases were more likely to have a diagnosis in the ICD-10 chapters of diseases of the digestive system (OR 1.6; 95% CI 1.0-2.4, of the musculoskeletal system (OR 1.6; 95% CI 1.1-2.2, symptoms or signs not classified elsewhere (OR 1.8; 95% CI 1.3-2.5 as well as injuries (OR 1.5; 95% CI 1.2-1.9.Before receiving the

  5. Lithium is associated with decrease in all-cause and suicide mortality in high-risk bipolar patients: A nationwide registry-based prospective cohort study.

    Science.gov (United States)

    Toffol, Elena; Hätönen, Taina; Tanskanen, Antti; Lönnqvist, Jouko; Wahlbeck, Kristian; Joffe, Grigori; Tiihonen, Jari; Haukka, Jari; Partonen, Timo

    2015-09-01

    Mortality rates, in particular due to suicide, are especially high in bipolar patients. This nationwide, registry-based study analyses the associations of medication use with hospitalization due to attempted suicides, deaths from suicide, and overall mortality across different psychotropic agents in bipolar patients. Altogether 826 bipolar patients hospitalized in Finland between 1996-2003 because of a suicide attempt were followed-up for a mean of 3.5 years. The relative risk of suicide attempts leading to hospitalization, completed suicide, and overall mortality during lithium vs. no-lithium, antipsychotic vs. no-antipsychotic, valproic acid vs. no-valproic acid, antidepressant vs. no-antidepressant and benzodiazepine vs. no-benzodiazepine treatment was measured. The use of valproic acid (RR=1.53, 95% CI: 1.26-1.85, p<0.001), antidepressants (RR=1.49, 95% CI: 1.23-1.8, p<0.001) and benzodiazepines (RR=1.49, 95% CI: 1.23-1.80, p<0.001) was associated with increased risk of attempted suicide. Lithium was associated with a (non-significantly) lower risk of suicide attempts, and with significantly decreased suicide mortality in univariate (RR=0.39, 95% CI: 0.17-0.93, p=0.03), Cox (HR=0.37, 95% CI: 0.16-0.88, p=0.02) and marginal structural models (HR=0.31, 95% CI: 0.12-0.79, p=0.02). Moreover, lithium was related to decreased all-cause mortality by 49% (marginal structural models). Only high-risk bipolar patients hospitalized after a suicide attempt were studied. Diagnosis was not based on standardized diagnostic interviews; treatment regimens were uncontrolled. Maintenance therapy with lithium, but not with other medications, is linked to decreased suicide and all-cause mortality in high-risk bipolar patients. Lithium should be considered for suicide prevention in high-risk bipolar patients. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Associations between ozone, PM2.5, and four pollen types on emergency department pediatric asthma events during the warm season in New Jersey: a case-crossover study.

    Science.gov (United States)

    Gleason, Jessie A; Bielory, Leonard; Fagliano, Jerald A

    2014-07-01

    Asthma is one of the most common chronic diseases among school-aged children in the United States. Environmental respiratory irritants exacerbate asthma among children. Understanding the impact of a variety of known and biologically plausible environmental irritants and triggers among children in New Jersey - ozone, fine particulate matter (PM2.5), tree pollen, weed pollen, grass pollen and ragweed - would allow for informed public health interventions. Time-stratified case-crossover design was used to study the transient impact of ozone, PM2.5 and pollen on the acute onset of pediatric asthma. Daily emergency department visits were obtained for children aged 3-17 years with a primary diagnosis of asthma during the warm season (April through September), 2004-2007 (inclusive). Bi-directional control sampling was used to select two control periods for each case for a total of 65,562 inclusion days. Since the period of exposure prior to emergency department visit may be the most clinically relevant, lag exposures were investigated (same day (lag0), 1, 2, 3, 4, and 5 as well as 3-day and 5-day moving averages). Multivariable conditional logistic regression controlling for holiday, school-in-session indicator, and 3-day moving average for temperature and relative humidity was used to examine the associations. Odds ratios are based on interquartile range (IQR) increases or 10 unit increases when IQR ranges were narrow. Single-pollutant models as well as multipollutant models were examined. Stratification on gender, race, ethnicity and socioeconomic status was explored. The associations with ozone and PM2.5 were strongest on the same day (lag0) of the emergency department visit (RR IQR=1.05, 95% CI 1.04-1.06) and (RR IQR=1.03, 95% CI 1.02-1.04), respectively, with a decreasing lag effect. Tree and weed pollen were associated with pediatric ED visits; the largest magnitudes of association was with the 5-day average (RR IQR=1.23, 95% CI 1.21-1.25) and (RR 10=1.13, 95% CI 1

  7. A registry-based follow-up study, comparing the incidence of cardiovascular disease in native Danes and immigrants born in Turkey, Pakistan and the former Yugoslavia: do social inequalities play a role?

    DEFF Research Database (Denmark)

    Hempler, Nana F; Larsen, Finn; Nielsen, Signe S

    2011-01-01

    ), such as employment, income and housing conditions influenced potential differences. METHODS: In this registry-based follow-up study individuals were identified in a large database that included individuals from two major regions in Denmark, corresponding to about 60% of the Danish population. Incident cases of CVD......, differences in CVD and AMI were reduced after adjustment for SES, in particular, among Turks regarding CVD. In women, effects were particularly reduced among Yugoslavians in the case of CVD and in Turks in the case of CVD and AMI after adjustment for SES. CONCLUSIONS: In conclusion, country of birth...

  8. Occupational risk factors for testicular cancer: a registry-based case-control study in Rhineland Palatinate – Germany [Berufliche Risikofaktoren für Hodenkrebs: eine Register-basierte Fall-Kontroll-Studie in Rheinland-Pfalz – Deutschland

    Directory of Open Access Journals (Sweden)

    Yousif, Lamyaa

    2013-11-01

    Full Text Available [english] Objectives: Testicular cancer affects mainly men below the age of 50. An association with occupation and social status has been suggested but risk factors are not well understood. A registry-based case-control study focusing on occupation was performed in Germany.Methods: All 348 testicular cancer cases with available gainful occupational information registered between 2000 and 2005; as well as uitable controls (from a pool of other cancers were drawn from the Cancer Registry of Rhineland-Palatinate. Unconditional logistic regression was used to compute odds ratios (OR and associated onfidence intervals (CI.Results: Slightly elevated OR were observed for technicians and related professionals (OR 1.62, 95% CI 1.00–2.63 and for clerical support workers (OR 1.71, 95% CI 1.14–2.56. This increase was highest in the age group 20–50 for technicians (OR 2.02, 95% CI 1.23–3.33 and clerks (OR 2.00, 95% CI 1.30–3.09, respectively. An association with testicular cancer was observed for no other occupation.Conclusion: An increased risk of testicular cancer was observed for technicians and related professionals and clerical support workers. This could be related to socioeconomic status or sedentary life style, two factors that were identified in previous studies. While the feasibility of a purely registry-based study was shown, missing occupational data and the choice of cancer controls represent challenges to the validity of this approach.[german] Ziele: Hodenkrebs betrifft vor allem junge Männer im Alter von unter 50 Jahren. Ein Zusammenhang zwischen erhöhtem Auftreten von Hodenkrebs und Beruf bzw. sozialem Status wurde untersucht (in Betracht gezogen, aber die Risikofaktoren sind bislang noch nicht umfassend erforscht. Eine Register-basierte Fall-Kontroll-Studie zur Untersuchung eines Zusammenhangs von beruflicher Erwerbstätigkeit und Hodenkrebs wurde in Deutschland durchgeführt.Methoden: 348 Hodenkrebsfälle mit den verf

  9. The short-term effects of air pollutants on respiratory disease mortality in Wuhan, China: comparison of time-series and case-crossover analyses.

    Science.gov (United States)

    Ren, Meng; Li, Na; Wang, Zhan; Liu, Yisi; Chen, Xi; Chu, Yuanyuan; Li, Xiangyu; Zhu, Zhongmin; Tian, Liqiao; Xiang, Hao

    2017-01-13

    Few studies have compared different methods when exploring the short-term effects of air pollutants on respiratory disease mortality in Wuhan, China. This study assesses the association between air pollutants and respiratory disease mortality with both time-series and time-stratified-case-crossover designs. The generalized additive model (GAM) and the conditional logistic regression model were used to assess the short-term effects of air pollutants on respiratory disease mortality. Stratified analyses were performed by age, sex, and diseases. A 10 μg/m 3 increment in SO 2 level was associated with an increase in relative risk for all respiratory disease mortality of 2.4% and 1.9% in the case-crossover and time-series analyses in single pollutant models, respectively. Strong evidence of an association between NO 2 and daily respiratory disease mortality among men or people older than 65 years was found in the case-crossover study. There was a positive association between air pollutants and respiratory disease mortality in Wuhan, China. Both time-series and case-crossover analyses consistently reveal the association between three air pollutants and respiratory disease mortality. The estimates of association between air pollution and respiratory disease mortality from the case-crossover analysis displayed greater variation than that from the time-series analysis.

  10. Congenital Anomalies Associated with Trisomy 18 or Trisomy 13 : A Registry-Based Study in 16 European Countries, 2000-2011

    NARCIS (Netherlands)

    Springett, Anna; Wellesley, Diana; Greenlees, Ruth; Loane, Maria; Addor, Marie-Claude; Arriola, Larraitz; Bergman, Jorieke; Cavero-Carbonell, Clara; Csaky-Szunyogh, Melinda; Draper, Elizabeth S.; Garne, Ester; Gatt, Miriam; Haeusler, Martin; Khoshnood, Babak; Klungsoyr, Kari; Lynch, Catherine; Dias, Carlos Matias; McDonnell, Robert; Nelen, Vera; O'Mahony, Mary; Pierini, Anna; Queisser-Luft, Annette; Rankin, Judith; Rissmann, Anke; Rounding, Catherine; Stoianova, Sylvia; Tuckerz, David; Zymak-Zakutnia, Natalya; Morris, Joan K.

    2015-01-01

    The aim of this study was to examine the prevalence of trisomies 18 and 13 in Europe and the prevalence of associated anomalies. Twenty-five population-based registries in 16 European countries provided data from 2000-2011. Cases included live births, fetal deaths (20+ weeks' gestation), and

  11. 3-year follow-up of a long-term registry-based multicentre study on vitamin E diffused polyethylene in total hip replacement

    DEFF Research Database (Denmark)

    Sillesen, Nanna Hylleholt; Greene, Meridith E; Nebergall, Audrey K

    2016-01-01

    PURPOSE: Preclinical studies of vitamin E diffused highly cross-linked polyethylene (E-XLPE) has shown enhanced mechanical properties with less wear. The purpose of our study was to document the early clinical outcome of E-XLPE to ensure, for the safety of patients, that there are no unforeseen...... hip arthroplasty in functionality and quality of life across the centers. We have not observed any early in vivo adverse effects from diffusing the liners with vitamin E. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT00545285....... early adverse events from using this new biomaterial. METHODS: The enrolled patients (n = 977) have received either a porous titanium coated or porous plasma sprayed acetabular shell with either a E-XLPE liner or a medium cross-linked (AXL) liner. At each follow-up 5 patient-reported outcome measures...

  12. The impact of heat on mortality and morbidity in the Greater Metropolitan Sydney Region: a case crossover analysis

    OpenAIRE

    Wilson, Leigh Ann; Gerard Morgan, Geoffrey; Hanigan, Ivan Charles; Johnston, Fay H; Abu-Rayya, Hisham; Broome, Richard; Gaskin, Clive; Jalaludin, Bin

    2013-01-01

    Background This study examined the association between unusually high temperature and daily mortality (1997?2007) and hospital admissions (1997?2010) in the Sydney Greater Metropolitan Region (GMR) to assist in the development of targeted health programs designed to minimise the public health impact of extreme heat. Methods Sydney GMR was categorized into five climate zones. Heat-events were defined as severe or extreme. Using a time-stratified case-crossover design with a conditional logisti...

  13. Analyzing Seasonal Variations in Suicide With Fourier Poisson Time-Series Regression: A Registry-Based Study From Norway, 1969-2007.

    Science.gov (United States)

    Bramness, Jørgen G; Walby, Fredrik A; Morken, Gunnar; Røislien, Jo

    2015-08-01

    Seasonal variation in the number of suicides has long been acknowledged. It has been suggested that this seasonality has declined in recent years, but studies have generally used statistical methods incapable of confirming this. We examined all suicides occurring in Norway during 1969-2007 (more than 20,000 suicides in total) to establish whether seasonality decreased over time. Fitting of additive Fourier Poisson time-series regression models allowed for formal testing of a possible linear decrease in seasonality, or a reduction at a specific point in time, while adjusting for a possible smooth nonlinear long-term change without having to categorize time into discrete yearly units. The models were compared using Akaike's Information Criterion and analysis of variance. A model with a seasonal pattern was significantly superior to a model without one. There was a reduction in seasonality during the period. Both the model assuming a linear decrease in seasonality and the model assuming a change at a specific point in time were both superior to a model assuming constant seasonality, thus confirming by formal statistical testing that the magnitude of the seasonality in suicides has diminished. The additive Fourier Poisson time-series regression model would also be useful for studying other temporal phenomena with seasonal components. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. Gonorrhoea and Syphilis Epidemiology in Flemish General Practice 2009–2013: Results from a Registry-based Retrospective Cohort Study Compared with Mandatory Notification

    Directory of Open Access Journals (Sweden)

    Christoph Schweikardt

    2016-09-01

    Full Text Available Background: The number of newly diagnosed gonorrhoea and syphilis cases has increased in Flanders in recent years. Our aim was to investigate, to which extent these diagnoses were registered by general practitioners (GPs, and to examine opportunities and limits of the Intego database in this regard. Methods: Data from a retrospective cohort study based on the Flemish Intego general practice database was analyzed for the years 2009–2013. Case definitions were applied. Due to small case numbers obtained, cases were pooled and averaged over the observation period. Frequencies were compared with those calculated from figures of mandatory notification. Results: A total of 91 gonorrhoea and 23 syphilis cases were registered. The average Intego annual frequency of gonorrhoea cases obtained was 11.9 (95% Poisson confidence interval (CI 9.6; 14.7 per 100,000 population, and for syphilis 3.0 (CI 1.9; 4.5, respectively, while mandatory notification was calculated at 14.0 (CI: 13.6, 14.4 and 7.0 (CI: 6.7, 7.3, respectively. Conclusion: In spite of limitations such as small numbers and different case definitions, comparison with mandatory notification suggests that the GP was involved in the large majority of gonorrhoea cases, while the majority of new syphilis cases did not come to the knowledge of the GP.

  15. Diabetic nephropathy and its risk factors in a society with a type 2 diabetes epidemic: a Saudi National Diabetes Registry-based study.

    Directory of Open Access Journals (Sweden)

    Khalid Al-Rubeaan

    Full Text Available The prevalence of diabetic nephropathy and its risk factors have not been studied in a society known to have diabetes epidemic like Saudi Arabia. Using a large data base registry will provide a better understanding and accurate assessment of this chronic complication and its related risk factors.A total of 54,670 patients with type 2 diabetes aged ≥ 25 years were selected from the Saudi National Diabetes Registry (SNDR and analyzed for the presence of diabetic nephropathy. The American Diabetes Association (ADA criterion was used to identify cases with microalbuminuria, macroalbuminuria and end stage renal disease (ESRD for prevalence estimation and risk factor assessment.The overall prevalence of diabetic nephropathy was 10.8%, divided into 1.2% microalbuminuria, 8.1%macroalbuninuria and 1.5% ESRD. Age and diabetes duration as important risk factors have a strong impact on the prevalence of diabetic nephropathy, ranging from 3.7% in patients aged 25-44 years and a duration of >5 years, to 21.8% in patients ≥ 65 years with a diabetes duration of ≥ 15 years. Diabetes duration, retinopathy, neuropathy, hypertension, age >45 years, hyperlipidemia, male gender, smoking, and chronologically, poor glycemic control has a significantly high risk for diabetic nephropathy.The prevalence of diabetic nephropathy is underestimated as a result of a shortage of screening programs. Risk factors related to diabetic nephropathy in this society are similar to other societies. There is thus an urgent need for screening and prevention programs for diabetic nephropathy among the Saudi population.

  16. Biodegradable-Polymer Biolimus-Eluting Stents versus Durable-Polymer Everolimus-Eluting Stents at One-Year Follow-Up: A Registry-Based Cohort Study.

    Science.gov (United States)

    Parsa, Ehsan; Saroukhani, Sepideh; Majlessi, Fereshteh; Poorhosseini, Hamidreza; Lofti-Tokaldany, Masoumeh; Jalali, Arash; Salarifar, Mojtaba; Nematipour, Ebrahim; Alidoosti, Mohammad; Aghajani, Hassan; Amirzadegan, Alireza; Kassaian, Seyed Ebrahim

    2016-04-01

    We compared outcomes of percutaneous coronary intervention patients who received biodegradable-polymer biolimus-eluting stents with those who received durable-polymer everolimus-eluting stents. At Tehran Heart Center, we performed a retrospective analysis of the data from January 2007 through December 2011 on 3,270 consecutive patients with coronary artery disease who underwent percutaneous coronary intervention with the biodegradable-polymer biolimus-eluting stent or the durable-polymer everolimus-eluting stent. We excluded patients with histories of coronary artery bypass grafting or percutaneous coronary intervention, acute ST-segment-elevation myocardial infarction, or the implantation of 2 different stent types. Patients were monitored for 12 months. The primary endpoint was a major adverse cardiac event, defined as a composite of death, nonfatal myocardial infarction, and target-vessel and target-lesion revascularization. Durable-polymer everolimus-eluting stents were implanted in 2,648 (81%) and biodegradable-polymer biolimus-eluting stents in 622 (19%) of the study population. There was no significant difference between the 2 groups (2.7% vs 2.7%; P=0.984) in the incidence of major adverse cardiac events. The cumulative adjusted probability of major adverse cardiac events in the biodegradable-polymer biolimus-eluting stent group did not differ from that of such events in the durable-polymer everolimus-eluting stent group (hazard ratio=0.768; 95% confidence interval, 0.421-1.44; P=0.388). We conclude that in our patients the biodegradable-polymer biolimus-eluting stent was as effective and safe, during the 12-month follow-up period, as was the durable-polymer everolimus-eluting stent.

  17. Barriers to cervical cancer screening faced by immigrants: a registry-based study of 1.4 million women in Norway.

    Science.gov (United States)

    Leinonen, Maarit K; Campbell, Suzanne; Ursin, Giske; Tropé, Ameli; Nygård, Mari

    2017-10-01

    Immigrants from certain low- and middle-income countries are more prone to cancers attributed to viral infections in early life. Cervical cancer is caused by human papillomavirus but is highly preventable by regular screening. We assessed participation among immigrants in a population-based cervical screening programme and identified factors that predicted non-adherence within different immigrant groups. We used data from several nationwide registries. The study population consisted of 208 626 (15%) immigrants and 1 157 223 (85%) native Norwegians. Non-adherence was defined as no eligible screening test in 2008-12. We estimated prevalence ratios with 95% confidence intervals (CIs) for factors associated with non-adherence by modified Poisson regression. In total, 52% of immigrants were not screened. All immigrants showed 1.72 times higher non-adherence rates (95% CI 1.71-1.73) compared with native Norwegian women when adjusted for age and parity. The proportion of non-adherent immigrants varied substantially by region of origin and country of origin. Being unemployed or not in the workforce, being unmarried, having low income and having a male general practitioner was associated with non-adherence regardless of region of origin. Living immigrant groups. An increasing proportion of immigrants and low screening participation among them pose new public health challenges in Europe. Immigrants are diverse in terms of their sociodemographic attributes and screening participation. Tailored information and service delivery may be necessary to increase cancer screening among immigrants. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association.

  18. Diabetic Nephropathy and Its Risk Factors in a Society with a Type 2 Diabetes Epidemic: A Saudi National Diabetes Registry-Based Study

    Science.gov (United States)

    Al-Rubeaan, Khalid; Youssef, Amira M.; Subhani, Shazia N.; Ahmad, Najlaa A.; Al-Sharqawi, Ahmad H.; Al-Mutlaq, Hind M.; David, Satish K.; AlNaqeb, Dhekra

    2014-01-01

    Aims The prevalence of diabetic nephropathy and its risk factors have not been studied in a society known to have diabetes epidemic like Saudi Arabia. Using a large data base registry will provide a better understanding and accurate assessment of this chronic complication and its related risk factors. Methodology A total of 54,670 patients with type 2 diabetes aged ≥25 years were selected from the Saudi National Diabetes Registry (SNDR) and analyzed for the presence of diabetic nephropathy. The American Diabetes Association (ADA) criterion was used to identify cases with microalbuminuria, macroalbuminuria and end stage renal disease (ESRD) for prevalence estimation and risk factor assessment. Results The overall prevalence of diabetic nephropathy was 10.8%, divided into 1.2% microalbuminuria, 8.1%macroalbuninuria and 1.5% ESRD. Age and diabetes duration as important risk factors have a strong impact on the prevalence of diabetic nephropathy, ranging from 3.7% in patients aged 25–44 years and a duration of >5 years, to 21.8% in patients ≥65 years with a diabetes duration of ≥15 years. Diabetes duration, retinopathy, neuropathy, hypertension, age >45 years, hyperlipidemia, male gender, smoking, and chronologically, poor glycemic control has a significantly high risk for diabetic nephropathy. Conclusion The prevalence of diabetic nephropathy is underestimated as a result of a shortage of screening programs. Risk factors related to diabetic nephropathy in this society are similar to other societies. There is thus an urgent need for screening and prevention programs for diabetic nephropathy among the Saudi population. PMID:24586457

  19. Body Mass Index Class Is Independently Associated With Health-Related Quality of Life After Primary Total Hip Arthroplasty: An Institutional Registry-Based Study.

    Science.gov (United States)

    McLawhorn, Alexander S; Steinhaus, Michael E; Southren, Daniel L; Lee, Yuo-Yu; Dodwell, Emily R; Figgie, Mark P

    2017-01-01

    The purpose of this study was to compare the health-related quality of life (HRQoL) of patients across World Health Organization (WHO) body mass index (BMI) classes before and after total hip arthroplasty (THA). Patients with end-stage hip osteoarthritis who received elective primary unilateral THA were identified through an institutional registry and categorized based on the World Health Organization BMI classification. Age, sex, laterality, year of surgery, and Charlson-Deyo comorbidity index were recorded. The primary outcome was the EQ-5D-3L index and visual analog scale (EQ-VAS) scores at 2 years postoperatively. Inferential statistics and regression analyses were performed to determine associations between BMI classes and HRQoL. EQ-5D-3L scores at baseline and at 2 years were statistically different across BMI classes, with higher EQ-VAS and index scores in patients with lower BMI. There was no difference observed for the 2-year change in EQ-VAS scores, but there was a statistically greater increase in index scores for more obese patients. In the regression analyses, there were statistically significant negative effect estimates for EQ-VAS and index scores associated with increasing BMI class. BMI class is independently associated with lower HRQoL scores 2 years after primary THA. While absolute scores in obese patients were lower than in nonobese patients, obese patients enjoyed more positive changes in EQ-5D index scores after THA. These results may provide the most detailed information on how BMI influences HRQoL before and after THA, and they are relevant to future economic decision analyses on the topic. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Monitoring of timely and delayed vaccinations: a nation-wide registry-based study of Norwegian children aged < 2 years.

    Science.gov (United States)

    Riise, Øystein Rolandsen; Laake, Ida; Bergsaker, Marianne Adeleide Riise; Nøkleby, Hanne; Haugen, Inger Lise; Storsæter, Jann

    2015-11-13

    Delayed vaccinations increase the risk for vaccine preventable diseases (VPDs). Monitoring of delayed vaccinations by using a national immunisation registry has not been studied in countries recommending a two-dose (3 and 5 months of age) primary series of e.g., pertussis vaccine. Surveillance/monitoring of all vaccinations may improve vaccination programmes functioning. We obtained information from the Norwegian immunisation registry (SYSVAK) on all programme vaccinations received at age up to 730 days in children born in 2010 (n = 63,382). Timely vaccinations were received up to 7 days after the recommended age. Vaccinations were considered delayed if they were received more than one month after the recommended age in the schedule. In vaccinated children, timely administration of the subsequent three doses of pertussis and one dose of measles occurred in 73.8, 47.6, 53.6 and 43.5 % respectively. Delay for one or more programme vaccinations (diphtheria, tetanus, pertussis, polio, Haemophilus influenza type B, invasive pneumococcal disease, measles, mumps or rubella) was present in 28,336 (44.7 %) children. Among those who were delayed the mean duration was 139 days. The proportion of children that had vaccinations delayed differed among counties (range 37.4 %-57.8 %). Immigrant children were more frequently delayed 52.3 % vs. 43.1 %, RR 1.21 (95 % CI 1.19, 1.24). Children scheduled for vaccines in the summer holiday month (July) were more frequently delayed than others (1(st) dose pertussis vaccine 6.5 % vs. 3.9 % RR 1.65 (95 % CI 1.48, 1.85). Priming against pertussis (2(nd) dose), pneumococcal (2(nd) dose) and measles (1(st) dose) was delayed in 16.8, 18.6 and 29.3 % respectively. Vaccinations were frequently delayed. Delayed vaccinations differed among counties and occurred more frequently during the summer vacation (July) and in the immigrant population. Monitoring improves programme surveillance and may be used on an annual basis.

  1. Comorbidity and cervical cancer survival of Indigenous and non-Indigenous Australian women: A semi-national registry-based cohort study (2003-2012).

    Science.gov (United States)

    Diaz, Abbey; Baade, Peter D; Valery, Patricia C; Whop, Lisa J; Moore, Suzanne P; Cunningham, Joan; Garvey, Gail; Brotherton, Julia M L; O'Connell, Dianne L; Canfell, Karen; Sarfati, Diana; Roder, David; Buckley, Elizabeth; Condon, John R

    2018-01-01

    Little is known about the impact of comorbidity on cervical cancer survival in Australian women, including whether Indigenous women's higher prevalence of comorbidity contributes to their lower survival compared to non-Indigenous women. Data for cervical cancers diagnosed in 2003-2012 were extracted from six Australian state-based cancer registries and linked to hospital inpatient records to identify comorbidity diagnoses. Five-year cause-specific and all-cause survival probabilities were estimated using the Kaplan-Meier method. Flexible parametric models were used to estimate excess cause-specific mortality by Charlson comorbidity index score (0,1,2+), for Indigenous women compared to non-Indigenous women. Of 4,467 women, Indigenous women (4.4%) compared to non-Indigenous women had more comorbidity at diagnosis (score ≥1: 24.2% vs. 10.0%) and lower five-year cause-specific survival (60.2% vs. 76.6%). Comorbidity was associated with increased cervical cancer mortality for non-Indigenous women, but there was no evidence of such a relationship for Indigenous women. There was an 18% reduction in the Indigenous: non-Indigenous hazard ratio (excess mortality) when comorbidity was included in the model, yet this reduction was not statistically significant. The excess mortality for Indigenous women was only evident among those without comorbidity (Indigenous: non-Indigenous HR 2.5, 95%CI 1.9-3.4), indicating that factors other than those measured in this study are contributing to the differential. In a subgroup of New South Wales women, comorbidity was associated with advanced-stage cancer, which in turn was associated with elevated cervical cancer mortality. Survival was lowest for women with comorbidity. However, there wasn't a clear comorbidity-survival gradient for Indigenous women. Further investigation of potential drivers of the cervical cancer survival differentials is warranted. The results highlight the need for cancer care guidelines and multidisciplinary

  2. Burden of hospital admission and repeat angiography in angina pectoris patients with and without coronary artery disease: a registry-based cohort study.

    Science.gov (United States)

    Jespersen, Lasse; Abildstrom, Steen Z; Hvelplund, Anders; Madsen, Jan K; Galatius, Soren; Pedersen, Frants; Hojberg, Soren; Prescott, Eva

    2014-01-01

    To evaluate risk of hospitalization due to cardiovascular disease (CVD) and repeat coronary angiography (CAG) in stable angina pectoris (SAP) with no obstructive coronary artery disease (CAD) versus obstructive CAD, and asymptomatic reference individuals. We followed 11,223 patients with no prior CVD having a first-time CAG in 1998-2009 due to SAP symptoms and 5,695 asymptomatic reference individuals from the Copenhagen City Heart Study through registry linkage for 7.8 years (median). In recurrent event survival analysis, patients with SAP had 3-4-fold higher risk of hospitalization for CVD irrespective of CAG findings and cardiovascular comorbidity. Multivariable adjusted hazard ratios(95%CI) for patients with angiographically normal coronary arteries was 3.0(2.5-3.5), for angiographically diffuse non-obstructive CAD 3.9(3.3-4.6) and for 1-3-vessel disease 3.6-4.1(range)(all P<0.001). Mean accumulated hospitalization time was 3.5(3.0-4.0)(days/10 years follow-up) in reference individuals and 4.5(3.8-5.2)/7.0(5.4-8.6)/6.7(5.2-8.1)/6.1(5.2-7.4)/8.6(6.6-10.7) in patients with angiographically normal coronary arteries/angiographically diffuse non-obstructive CAD/1-, 2-, and 3-vessel disease, respectively (all P<0.05, age-adjusted). SAP symptoms predicted repeat CAG with multivariable adjusted hazard ratios for patients with angiographically normal coronary arteries being 2.3(1.9-2.9), for angiographically diffuse non-obstructive CAD 5.5(4.4-6.8) and for obstructive CAD 6.6-9.4(range)(all P<0.001). Patients with SAP symptoms and angiographically normal coronary arteries or angiographically diffuse non-obstructive CAD suffer from considerably greater CVD burdens in terms of hospitalization for CVD and repeat CAG compared with asymptomatic reference individuals even after adjustment for cardiac risk factors and exclusion of cardiovascular comorbidity as cause. Contrary to common perception, excluding obstructive CAD by CAG in such patients does not ensure a benign

  3. Comorbidity and cervical cancer survival of Indigenous and non-Indigenous Australian women: A semi-national registry-based cohort study (2003-2012.

    Directory of Open Access Journals (Sweden)

    Abbey Diaz

    Full Text Available Little is known about the impact of comorbidity on cervical cancer survival in Australian women, including whether Indigenous women's higher prevalence of comorbidity contributes to their lower survival compared to non-Indigenous women.Data for cervical cancers diagnosed in 2003-2012 were extracted from six Australian state-based cancer registries and linked to hospital inpatient records to identify comorbidity diagnoses. Five-year cause-specific and all-cause survival probabilities were estimated using the Kaplan-Meier method. Flexible parametric models were used to estimate excess cause-specific mortality by Charlson comorbidity index score (0,1,2+, for Indigenous women compared to non-Indigenous women.Of 4,467 women, Indigenous women (4.4% compared to non-Indigenous women had more comorbidity at diagnosis (score ≥1: 24.2% vs. 10.0% and lower five-year cause-specific survival (60.2% vs. 76.6%. Comorbidity was associated with increased cervical cancer mortality for non-Indigenous women, but there was no evidence of such a relationship for Indigenous women. There was an 18% reduction in the Indigenous: non-Indigenous hazard ratio (excess mortality when comorbidity was included in the model, yet this reduction was not statistically significant. The excess mortality for Indigenous women was only evident among those without comorbidity (Indigenous: non-Indigenous HR 2.5, 95%CI 1.9-3.4, indicating that factors other than those measured in this study are contributing to the differential. In a subgroup of New South Wales women, comorbidity was associated with advanced-stage cancer, which in turn was associated with elevated cervical cancer mortality.Survival was lowest for women with comorbidity. However, there wasn't a clear comorbidity-survival gradient for Indigenous women. Further investigation of potential drivers of the cervical cancer survival differentials is warranted.The results highlight the need for cancer care guidelines and

  4. Socioeconomic disparities in first stroke incidence, quality of care, and survival: a nationwide registry-based cohort study of 44 million adults in England

    Directory of Open Access Journals (Sweden)

    Benjamin D Bray, MD

    2018-04-01

    Full Text Available Summary: Background: We aimed to estimate socioeconomic disparities in the incidence of hospitalisation for first-ever stroke, quality of care, and post-stroke survival for the adult population of England. Methods: In this cohort study, we obtained data collected by a nationwide register on patients aged 18 years or older hospitalised for first-ever acute ischaemic stroke or primary intracerebral haemorrhage in England from July 1, 2013, to March 31, 2016. We classified socioeconomic status at the level of Lower Super Output Areas using the Index of Multiple Deprivation, a neighbourhood measure of deprivation. Multivariable models were fitted to estimate the incidence of hospitalisation for first stroke (negative binomial, quality of care using 12 quality metrics (multilevel logistic, and all-cause 1 year case fatality (Cox proportional hazards. Findings: Of the 43·8 million adults in England, 145 324 were admitted to hospital with their first-ever stroke: 126 640 (87% with ischaemic stroke, 17 233 (12% with intracerebral haemorrhage, and 1451 (1% with undetermined stroke type. We observed a socioeconomic gradient in the incidence of hospitalisation for ischaemic stroke (adjusted incidence rate ratio 2·0, 95% CI 1·7–2·3 for the most vs least deprived deciles and intracerebral haemorrhage (1·6, 1·3–1·9. Patients from the lowest socioeconomic groups had first stroke a median of 7 years earlier than those from the highest (p<0·0001, and had a higher prevalence of pre-stroke disability and diabetes. Patients from lower socioeconomic groups were less likely to receive five of 12 care processes but were more likely to receive early supported discharge (adjusted odds ratio 1·14, 95% CI 1·07–1·22. Low socioeconomic status was associated with a 26% higher adjusted risk of 1-year mortality (adjusted hazard ratio 1·26, 95% CI 1·20–1·33, for highest vs lowest deprivation decile, but this gradient was largely attenuated after

  5. Ethical aspects of registry-based research in the Nordic countries.

    Science.gov (United States)

    Ludvigsson, Jonas F; Håberg, Siri E; Knudsen, Gun Peggy; Lafolie, Pierre; Zoega, Helga; Sarkkola, Catharina; von Kraemer, Stephanie; Weiderpass, Elisabete; Nørgaard, Mette

    2015-01-01

    National health care registries in the Nordic countries share many attributes, but different legal and ethical frameworks represent a challenge to promoting effective joint research. Internationally, there is a lack of knowledge about how ethical matters are considered in Nordic registry-based research, and a lack of knowledge about how Nordic ethics committees operate and what is needed to obtain an approval. In this paper, we review ethical aspects of registry-based research, the legal framework, the role of ethics review boards in the Nordic countries, and the structure of the ethics application. We discuss the role of informed consent in registry-based research and how to safeguard the integrity of study participants, including vulnerable subjects and children. Our review also provides information on the different government agencies that contribute registry-based data, and a list of the major health registries in Denmark, Finland, Iceland, Norway, and Sweden. Both ethical values and conditions for registry-based research are similar in the Nordic countries. While Denmark, Finland, Iceland, Norway, and Sweden have chosen different legal frameworks, these differences can be resolved through mutual recognition of ethical applications and by harmonizing the different systems, likely leading to increased collaboration and enlarged studies.

  6. A registry-based follow-up study, comparing the incidence of cardiovascular disease in native Danes and immigrants born in Turkey, Pakistan and the former Yugoslavia: do social inequalities play a role?

    Directory of Open Access Journals (Sweden)

    Andreasen Anne H

    2011-08-01

    Full Text Available Abstract Background This study compared the incidence of cardiovascular disease (CVD and acute myocardial infarction (AMI between native Danes and immigrants born in Turkey, Pakistan and the former Yugoslavia. Furthermore, we examined whether different indicators of socioeconomic status (SES, such as employment, income and housing conditions influenced potential differences. Methods In this registry-based follow-up study individuals were identified in a large database that included individuals from two major regions in Denmark, corresponding to about 60% of the Danish population. Incident cases of CVD and AMI included fatal and non-fatal events and were taken from registries. Using Cox regression models, we estimated incidence rates at 5-year follow-up. Results Immigrant men and women from Turkey and Pakistan had an increased incidence of CVD, compared with native Danish men. In the case of AMI, a similar pattern was observed; however, differences were more pronounced. Pakistanis and Turks with a shorter duration of residence had a lower incidence, compared with those of a longer residence. Generally, no notable differences were observed between former Yugoslavians and native Danes. In men, differences in CVD and AMI were reduced after adjustment for SES, in particular, among Turks regarding CVD. In women, effects were particularly reduced among Yugoslavians in the case of CVD and in Turks in the case of CVD and AMI after adjustment for SES. Conclusions In conclusion, country of birth-related differences in the incidence of CVD and AMI were observed. At least some of the differences that we uncovered were results of a socioeconomic effect. Duration of residence also played a certain role. Future studies should collect and test different indicators of SES in studies of CVD among immigrants.

  7. Case-Crossover Analysis of Air Pollution Health Effects: A Systematic Review of Methodology and Application

    Science.gov (United States)

    Carracedo-Martínez, Eduardo; Taracido, Margarita; Tobias, Aurelio; Saez, Marc; Figueiras, Adolfo

    2010-01-01

    Background Case-crossover is one of the most used designs for analyzing the health-related effects of air pollution. Nevertheless, no one has reviewed its application and methodology in this context. Objective We conducted a systematic review of case-crossover (CCO) designs used to study the relationship between air pollution and morbidity and mortality, from the standpoint of methodology and application. Data sources and extraction A search was made of the MEDLINE and EMBASE databases. Reports were classified as methodologic or applied. From the latter, the following information was extracted: author, study location, year, type of population (general or patients), dependent variable(s), independent variable(s), type of CCO design, and whether effect modification was analyzed for variables at the individual level. Data synthesis The review covered 105 reports that fulfilled the inclusion criteria. Of these, 24 addressed methodological aspects, and the remainder involved the design’s application. In the methodological reports, the designs that yielded the best results in simulation were symmetric bidirectional CCO and time-stratified CCO. Furthermore, we observed an increase across time in the use of certain CCO designs, mainly symmetric bidirectional and time-stratified CCO. The dependent variables most frequently analyzed were those relating to hospital morbidity; the pollutants most often studied were those linked to particulate matter. Among the CCO-application reports, 13.6% studied effect modification for variables at the individual level. Conclusions The use of CCO designs has undergone considerable growth; the most widely used designs were those that yielded better results in simulation studies: symmetric bidirectional and time-stratified CCO. However, the advantages of CCO as a method of analysis of variables at the individual level are put to little use. PMID:20356818

  8. Fundamentos y aplicaciones del diseño de casos cruzados Case-crossover design: Basic essentials and applications

    Directory of Open Access Journals (Sweden)

    Eduardo Carracedo-Martínez

    2009-04-01

    short-term, acute event. The present article outlines the basics of case-crossover designs, as well as their applications and limitations. The case-crossover design is based on exclusively selecting case subjects. To calculate relative risk, exposure during the period of time prior to the event (case period is compared against the same subject's exposure during one or more control periods. This method is only appropriate when the exposures are transient in time and have acute short-term effects. For exposures in which there is no trend, a unidirectional approach is the most frequent and consists of selecting one or more control periods prior to the case period. When the exposure displays a time trend (e.g., air pollution, a unidirectional approach will yield biased estimates, and therefore bidirectional case-crossover designs are used, which select control time intervals preceding and subsequent to that of the event. The case-crossover design is being increasingly used across a wide range of fields, including factors triggering traffic, occupational and domestic accidents and acute myocardial infarction, and those involved in air pollution and health and pharmacoepidemiology, among others. Insofar as data-analysis is concerned, case-crossover designs can generally be regarded as matched case-control studies and consequently conditional logistic regression can be applied. Lastly, this study analyzes practical examples of distinct applications of the case-crossover design.

  9. Neurobehavioral effects among subjects exposed to high static and gradient magnetic fields from a 1.5 Tesla magnetic resonance imaging system--a case-crossover pilot study.

    Science.gov (United States)

    de Vocht, Frank; van-Wendel-de-Joode, Berna; Engels, Hans; Kromhout, Hans

    2003-10-01

    The interactive use of magnetic resonance imaging (MRI) techniques is increasing in operating theaters. A study was performed on 17 male company volunteers to assess the neurobehavioral effects of exposure to magnetic fields from a 1.5 Tesla MRI system. The subjects' neurobehavioral performances on a neurobehavioral test battery were compared in four 1-hr sessions with and without exposure to magnetic fields, and with and without additional movements. Adverse effects were found for hand coordination (-4%, P Tesla MRI system may lead to neurobehavioral effects. Further research is recommended, especially in members of operating teams using interactive MRI systems. Copyright 2003 Wiley-Liss, Inc.

  10. Functional principles of registry-based service discovery

    NARCIS (Netherlands)

    Sundramoorthy, V.; Tan, C.; Hartel, P.H.; Hartog, den J.I.; Scholten, J.

    2005-01-01

    As Service Discovery Protocols (SDP) are becoming increasingly important for ubiquitous computing, they must behave according to predefined principles. We present the functional Principles of Service Discovery for robust, registry-based service discovery. A methodology to guarantee adherence to

  11. A registry-based randomized trial comparing radial and femoral approaches in women undergoing percutaneous coronary intervention: the SAFE-PCI for Women (Study of Access Site for Enhancement of PCI for Women) trial.

    Science.gov (United States)

    Rao, Sunil V; Hess, Connie N; Barham, Britt; Aberle, Laura H; Anstrom, Kevin J; Patel, Tejan B; Jorgensen, Jesse P; Mazzaferri, Ernest L; Jolly, Sanjit S; Jacobs, Alice; Newby, L Kristin; Gibson, C Michael; Kong, David F; Mehran, Roxana; Waksman, Ron; Gilchrist, Ian C; McCourt, Brian J; Messenger, John C; Peterson, Eric D; Harrington, Robert A; Krucoff, Mitchell W

    2014-08-01

    This study sought to determine the effect of radial access on outcomes in women undergoing percutaneous coronary intervention (PCI) using a registry-based randomized trial. Women are at increased risk of bleeding and vascular complications after PCI. The role of radial access in women is unclear. Women undergoing cardiac catheterization or PCI were randomized to radial or femoral arterial access. Data from the CathPCI Registry and trial-specific data were merged into a final study database. The primary efficacy endpoint was Bleeding Academic Research Consortium type 2, 3, or 5 bleeding or vascular complications requiring intervention. The primary feasibility endpoint was access site crossover. The primary analysis cohort was the subgroup undergoing PCI; sensitivity analyses were conducted in the total randomized population. The trial was stopped early for a lower than expected event rate. A total of 1,787 women (691 undergoing PCI) were randomized at 60 sites. There was no significant difference in the primary efficacy endpoint between radial or femoral access among women undergoing PCI (radial 1.2% vs. 2.9% femoral, odds ratio [OR]: 0.39; 95% confidence interval [CI]: 0.12 to 1.27); among women undergoing cardiac catheterization or PCI, radial access significantly reduced bleeding and vascular complications (0.6% vs. 1.7%; OR: 0.32; 95% CI: 0.12 to 0.90). Access site crossover was significantly higher among women assigned to radial access (PCI cohort: 6.1% vs. 1.7%; OR: 3.65; 95% CI: 1.45 to 9.17); total randomized cohort: (6.7% vs. 1.9%; OR: 3.70; 95% CI: 2.14 to 6.40). More women preferred radial access. In this pragmatic trial, which was terminated early, the radial approach did not significantly reduce bleeding or vascular complications in women undergoing PCI. Access site crossover occurred more often in women assigned to radial access. (SAFE-PCI for Women; NCT01406236). Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc

  12. IT-CARES: an interactive tool for case-crossover analyses of electronic medical records for patient safety.

    Science.gov (United States)

    Caron, Alexandre; Chazard, Emmanuel; Muller, Joris; Perichon, Renaud; Ferret, Laurie; Koutkias, Vassilis; Beuscart, Régis; Beuscart, Jean-Baptiste; Ficheur, Grégoire

    2017-03-01

    The significant risk of adverse events following medical procedures supports a clinical epidemiological approach based on the analyses of collections of electronic medical records. Data analytical tools might help clinical epidemiologists develop more appropriate case-crossover designs for monitoring patient safety. To develop and assess the methodological quality of an interactive tool for use by clinical epidemiologists to systematically design case-crossover analyses of large electronic medical records databases. We developed IT-CARES, an analytical tool implementing case-crossover design, to explore the association between exposures and outcomes. The exposures and outcomes are defined by clinical epidemiologists via lists of codes entered via a user interface screen. We tested IT-CARES on data from the French national inpatient stay database, which documents diagnoses and medical procedures for 170 million inpatient stays between 2007 and 2013. We compared the results of our analysis with reference data from the literature on thromboembolic risk after delivery and bleeding risk after total hip replacement. IT-CARES provides a user interface with 3 columns: (i) the outcome criteria in the left-hand column, (ii) the exposure criteria in the right-hand column, and (iii) the estimated risk (odds ratios, presented in both graphical and tabular formats) in the middle column. The estimated odds ratios were consistent with the reference literature data. IT-CARES may enhance patient safety by facilitating clinical epidemiological studies of adverse events following medical procedures. The tool's usability must be evaluated and improved in further research. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association.

  13. Ethical aspects of registry-based research in the Nordic countries

    Directory of Open Access Journals (Sweden)

    Ludvigsson JF

    2015-11-01

    Full Text Available Jonas F Ludvigsson,1,2 Siri E Håberg,3 Gun Peggy Knudsen,3 Pierre Lafolie,4,5 Helga Zoega,6 Catharina Sarkkola,7 Stephanie von Kraemer,7 Elisabete Weiderpass,1,7–10 Mette Nørgaard11 1Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, 2Department of Pediatrics, Örebro University Hospital, Örebro, Sweden; 3Norwegian Institute of Public Health, Oslo, Norway; 4Department of Medicine, Clinical Pharmacology Unit, 5The Stockholm Regional Ethical Review Board, Karolinska Institutet, Stockholm, Sweden; 6Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland; 7Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland; 8Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, 9The Arctic University of Norway, Tromsø, 10Department of Research, Cancer Registry of Norway, Oslo, Norway; 11Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark Abstract: National health care registries in the Nordic countries share many attributes, but different legal and ethical frameworks represent a challenge to promoting effective joint research. Internationally, there is a lack of knowledge about how ethical matters are considered in Nordic registry-based research, and a lack of knowledge about how Nordic ethics committees operate and what is needed to obtain an approval. In this paper, we review ethical aspects of registry-based research, the legal framework, the role of ethics review boards in the Nordic countries, and the structure of the ethics application. We discuss the role of informed consent in registry-based research and how to safeguard the integrity of study participants, including vulnerable subjects and children. Our review also provides information on the different government agencies that contribute registry-based data, and a list of the major health registries in Denmark, Finland, Iceland, Norway, and

  14. The short-term effects of air pollutants on respiratory disease mortality in Wuhan, China: comparison of time-series and case-crossover analyses

    OpenAIRE

    Meng Ren; Na Li; Zhan Wang; Yisi Liu; Xi Chen; Yuanyuan Chu; Xiangyu Li; Zhongmin Zhu; Liqiao Tian; Hao Xiang

    2017-01-01

    Few studies have compared different methods when exploring the short-term effects of air pollutants on respiratory disease mortality in Wuhan, China. This study assesses the association between air pollutants and respiratory disease mortality with both time-series and time-stratified?case-crossover designs. The generalized additive model (GAM) and the conditional logistic regression model were used to assess the short-term effects of air pollutants on respiratory disease mortality. Stratified...

  15. Impaired alcohol metabolism after gastric bypass surgery: a case-crossover trial.

    Science.gov (United States)

    Woodard, Gavitt A; Downey, John; Hernandez-Boussard, Tina; Morton, John M

    2011-02-01

    Severe obesity remains the leading public health crisis of the industrialized world, with bariatric surgery the only effective and enduring treatment. Poor psychological adjustment has been occasionally reported postoperatively. In addition, evidence suggests that patients can metabolize alcohol differently after gastric bypass. Preoperatively and at 3 and 6 months postoperatively, 19 Roux-en-Y gastric bypass (RYGB) patients' breath alcohol content (BAC) was measured every 5 minutes after drinking 5 oz red wine to determine peak BAC and time until sober in a case-crossover design preoperatively and at 6 months postoperatively. Patients reported symptoms experienced when intoxicated and answered a questionnaire of drinking habits. The peak BAC in patients after RYGB was considerably higher at 3 months (0.059%) and 6 months (0.088%) postoperatively than matched preoperative levels (0.024%). Patients also took considerably more time to return to sober at 3 months (61 minutes) and 6 months (88 minutes) than preoperatively (49 minutes). Postoperative intoxication was associated with lower levels of diaphoresis, flushing, and hyperactivity and higher levels of dizziness, warmth, and double vision. Postoperative patients reported drinking considerably less alcohol, fewer preferred beer, and more preferred wine than before surgery. This is the first study to match preoperative and postoperative alcohol metabolism in gastric bypass patients. Post-RYGB patients have much higher peak BAC after ingesting alcohol and require more time to become sober. Patients who drink alcohol after gastric bypass surgery should exercise caution. Copyright © 2011 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  16. Sexual activity as a trigger of myocardial infarction. A case-crossover analysis in the Stockholm Heart Epidemiology Programme (SHEEP)

    DEFF Research Database (Denmark)

    Möller, J; Ahlbom, A; Hulting, J

    2001-01-01

    .9). CONCLUSIONS: The increased risk of myocardial infarction after sexual activity and the further increase in risk among the less physically fit support the hypothesis of causal triggering by sexual activity. However, the absolute risk per hour is very low, and exposure is relatively infrequent. Thus having sex......OBJECTIVE: To investigate sexual activity as a trigger of myocardial infarction and the potential effect modification of physical fitness. DESIGN: A case-crossover study nested in the Stockholm Heart Epidemiology Programme (SHEEP). SETTING: Stockholm County from April 1993 to December 1994...... once a week only increases the annual risk of myocardial infarction slightly. Counselling should focus on encouraging patients to live a physically active life and not on abstaining from sexual activity....

  17. A case-crossover analysis of forest fire haze events and mortality in Malaysia

    Science.gov (United States)

    Sahani, Mazrura; Zainon, Nurul Ashikin; Wan Mahiyuddin, Wan Rozita; Latif, Mohd Talib; Hod, Rozita; Khan, Md Firoz; Tahir, Norhayati Mohd; Chan, Chang-Chuan

    2014-10-01

    The Southeast Asian (SEA) haze events due to forest fires are recurrent and affect Malaysia, particularly the Klang Valley region. The aim of this study is to examine the risk of haze days due to biomass burning in Southeast Asia on daily mortality in the Klang Valley region between 2000 and 2007. We used a case-crossover study design to model the effect of haze based on PM10 concentration to the daily mortality. The time-stratified control sampling approach was used, adjusted for particulate matter (PM10) concentrations, time trends and meteorological influences. Based on time series analysis of PM10 and backward trajectory analysis, haze days were defined when daily PM10 concentration exceeded 100 μg/m3. The results showed a total of 88 haze days were identified in the Klang Valley region during the study period. A total of 126,822 cases of death were recorded for natural mortality where respiratory mortality represented 8.56% (N = 10,854). Haze events were found to be significantly associated with natural and respiratory mortality at various lags. For natural mortality, haze events at lagged 2 showed significant association with children less than 14 years old (Odd Ratio (OR) = 1.41; 95% Confidence Interval (CI) = 1.01-1.99). Respiratory mortality was significantly associated with haze events for all ages at lagged 0 (OR = 1.19; 95% CI = 1.02-1.40). Age-and-gender-specific analysis showed an incremental risk of respiratory mortality among all males and elderly males above 60 years old at lagged 0 (OR = 1.34; 95% CI = 1.09-1.64 and OR = 1.41; 95% CI = 1.09-1.84 respectively). Adult females aged 15-59 years old were found to be at highest risk of respiratory mortality at lagged 5 (OR = 1.66; 95% CI = 1.03-1.99). This study clearly indicates that exposure to haze events showed immediate and delayed effects on mortality.

  18. Does air pollution trigger suicide? A case-crossover analysis of suicide deaths over the life span.

    Science.gov (United States)

    Casas, Lidia; Cox, Bianca; Bauwelinck, Mariska; Nemery, Benoit; Deboosere, Patrick; Nawrot, Tim Steve

    2017-11-01

    In addition to underlying health disorders and socio-economic or community factors, air pollution may trigger suicide mortality. This study evaluates the association between short-term variation in air pollution and 10 years of suicide mortality in Belgium. In a bidirectional time-stratified case-crossover design, 20,533 suicide deaths registered between January 1st 2002 and December 31st 2011 were matched by temperature with control days from the same month and year. We used municipality-level air pollution [particulate matter (PM 10 ) and O 3 concentrations] data and meteorology data. We applied conditional logistic regression models adjusted for duration of sunshine and day of the week to obtain odds ratios (OR) and their 95% CI for an increase of 10 µg/m 3 in pollutant concentrations over different lag periods (lag 0, 0-1, 0-2, 0-3, 0-4, 0-5, and 0-6 days). Effect modification by season and age was investigated by including interaction terms. We observed significant associations of PM 10 and O 3 with suicide during summer (OR ranging from 1.02 to 1.07, p-values suicide, particularly during warm periods, even at concentrations below the European thresholds. Furthermore, PM 10 may have strong trigger effects among children and elderly population.

  19. Risks of neurological and immune-related diseases, including narcolepsy, after vaccination with Pandemrix: a population- and registry-based cohort study with over 2 years of follow-up.

    Science.gov (United States)

    Persson, I; Granath, F; Askling, J; Ludvigsson, J F; Olsson, T; Feltelius, N

    2014-02-01

    To investigate the association between vaccination with Pandemrix and risk of selected neurological and immune-related diseases including narcolepsy. Population-based prospective cohort study using data from regional vaccination registries and national health registries. Seven healthcare regions in Sweden comprising 61% of the Swedish population. Study population of 3,347,467 vaccinated and 2,497,572 nonvaccinated individuals (vaccination coverage ≈ 60%) followed between 2009 and 2011 for 6.9 million person-years after exposure and 6.0 million person-years without exposure. First recorded diagnosis of neurological and immune-related diseases. Relative risks [hazard ratios (HRs) with 95% confidence intervals (CIs)] assessed using Cox regression, adjusted for covariates. For all selected neurological and immune-related outcomes under study, other than allergic vaccine reactions (for which we verified an expected increase in risk) and narcolepsy, HRs were close to 1.0 and always below 1.3. We observed a three-fold increased risk of a diagnosis of narcolepsy (HR: 2.92, 95% CI: 1.78-4.79; that is, four additional cases per 100,000 person-years) in individuals ≤ 20 years of age at vaccination and a two-fold increase (HR: 2.18, 95% CI: 1.00-4.75) amongst young adults between 21 and 30 years of age. The excess risk declined successively with increasing age at vaccination; no increase in risk was seen after 40 years of age. For a large number of selected neurological and immune-related diseases, we could neither confirm any causal association with Pandemrix nor refute entirely a small excess risk. We confirmed an increased risk for a diagnosis of narcolepsy in individuals ≤ 20 years of age and observed a trend towards an increased risk also amongst young adults between 21 and 30 years. © 2013 The Association for the Publication of the Journal of Internal Medicine.

  20. Comprehensive Analysis of the Incidence and Survival Patterns of Lung Cancer by Histologies, Including Rare Subtypes, in the Era of Molecular Medicine and Targeted Therapy: A Nation-Wide Cancer Registry-Based Study From Taiwan.

    Science.gov (United States)

    Chang, Jeffrey S; Chen, Li-Tzong; Shan, Yan-Shen; Lin, Sheng-Fung; Hsiao, Sheng-Yen; Tsai, Chia-Rung; Yu, Shu-Jung; Tsai, Hui-Jen

    2015-06-01

    Lung cancer is the third most common cancer in the world and has the highest cancer mortality rate. A worldwide increasing trend of lung adenocarcinoma has been noted. In addition, the identification of epidermal growth factor receptor (EGFR) mutations and the introduction of EGFR inhibitors to successfully treat EGFR mutated non-small cell lung cancers are breakthroughs for lung cancer treatment. The current study evaluated the incidence and survival of lung cancer using data collected by the Taiwan Cancer Registry between 1996 and 2008. The results showed that the most common histologic subtype of lung cancer was adenocarcinoma, followed by squamous cell carcinoma, small cell carcinoma, large cell carcinoma, neuroendocrine tumors, lymphoma, and sarcoma. Overall, the incidence of lung cancer in Taiwan increased significantly from 1996 to 2008. An increased incidence was observed for adenocarcinoma, particularly for women, with an annual percentage change of 5.9, whereas the incidence of squamous cell carcinoma decreased. Among the subtypes of lung cancer, the most rapid increase occurred in neuroendocrine tumors with an annual percentage change of 15.5. From 1996-1999 to 2005-2008, the 1-year survival of adenocarcinoma increased by 10% for men, whereas the 1-, 3-, and 5-year survivals of adenocarcinoma for women increased by 18%, 11%, and 5%, respectively. Overall, the incidence of lung cancer has been increasing in Taiwan, although the trends were variable by subtype. The introduction of targeted therapies was associated with a significantly improved survival for lung adenocarcinoma in Taiwan; however, more studies are needed to explain the rising incidence of lung adenocarcinoma. In addition, it is important to investigate the molecular pathogenesis of the various subtypes of lung cancer to develop novel therapeutic agents.

  1. Determination of the Oswestry Disability Index score equivalent to a "satisfactory symptom state" in patients undergoing surgery for degenerative disorders of the lumbar spine-a Spine Tango registry-based study.

    Science.gov (United States)

    van Hooff, Miranda L; Mannion, Anne F; Staub, Lukas P; Ostelo, Raymond W J G; Fairbank, Jeremy C T

    2016-10-01

    The achievement of a given change score on a valid outcome instrument is commonly used to indicate whether a clinically relevant change has occurred after spine surgery. However, the achievement of such a change score can be dependent on baseline values and does not necessarily indicate whether the patient is satisfied with the current state. The achievement of an absolute score equivalent to a patient acceptable symptom state (PASS) may be a more stringent measure to indicate treatment success. This study aimed to estimate the score on the Oswestry Disability Index (ODI, version 2.1a; 0-100) corresponding to a PASS in patients who had undergone surgery for degenerative disorders of the lumbar spine. This is a cross-sectional study of diagnostic accuracy using follow-up data from an international spine surgery registry. The sample includes 1,288 patients with degenerative lumbar spine disorders who had undergone elective spine surgery, registered in the EUROSPINE Spine Tango Spine Surgery Registry. The main outcome measure was the ODI (version 2.1a). Surgical data and data from the ODI and Core Outcome Measures Index (COMI) were included to determine the ODI threshold equivalent to PASS at 1 year (±1.5 months; n=780) and 2 years (±2 months; n=508) postoperatively. The symptom-specific well-being item of the COMI was used as the external criterion in the receiver operating characteristic (ROC) analysis to determine the ODI threshold equivalent to PASS. Separate sensitivity analyses were performed based on the different definitions of an "acceptable state" and for subgroups of patients. JF is a copyright holder of the ODI. The ODI threshold for PASS was 22, irrespective of the time of follow-up (area under the curve [AUC]: 0.89 [sensitivity {Se}: 78.3%, specificity {Sp}: 82.1%] and AUC: 0.91 [Se: 80.7%, Sp: 85.6] for the 1- and 2-year follow-ups, respectively). Sensitivity analyses showed that the absolute ODI-22 threshold for the two follow-up time-points were

  2. Use of a geographic information system to identify differences in automated external defibrillator installation in urban areas with similar incidence of public out-of-hospital cardiac arrest: a retrospective registry-based study.

    Science.gov (United States)

    Fredman, David; Haas, Jan; Ban, Yifang; Jonsson, Martin; Svensson, Leif; Djarv, Therese; Hollenberg, Jacob; Nordberg, Per; Ringh, Mattias; Claesson, Andreas

    2017-06-02

    Early defibrillation in out-of-hospital cardiac arrest (OHCA) is of importance to improve survival. In many countries the number of automated external defibrillators (AEDs) is increasing, but the use is low. Guidelines suggest that AEDs should be installed in densely populated areas and in locations with many visitors. Attempts have been made to identify optimal AED locations based on the incidence of OHCA using geographical information systems (GIS), but often on small datasets and the studies are seldom reproduced. The aim of this paper is to investigate if the distribution of public AEDs follows the incident locations of public OHCAs in urban areas of Stockholm County, Sweden. OHCA data were obtained from the Swedish Register for Cardiopulmonary Resuscitation and AED data were obtained from the Swedish AED Register. Urban areas in Stockholm County were objectively classified according to the pan-European digital mapping tool, Urban Atlas (UA). Furthermore, we reclassified and divided the UA land cover data into three classes (residential, non-residential and other areas). GIS software was used to spatially join and relate public AED and OHCA data and perform computations on relations and distance. Between 1 January 2012 and 31 December 2014 a total of 804 OHCAs occurred in public locations in Stockholm County and by December 2013 there were 1828 AEDs available. The incidence of public OHCAs was similar in residential (47.3%) and non-residential areas (43.4%). Fewer AEDs were present in residential areas than in non-residential areas (29.4% vs 68.8%). In residential areas the median distance between OHCAs and AEDs was significantly greater than in non-residential areas (288 m vs 188 m, p<0.001). The majority of public OHCAs occurred in areas classified in UA as 'residential areas' with limited AED accessibility. These areas need to be targeted for AED installation and international guidelines need to take geographical location into account when suggesting

  3. Heredity In Sarcoidosis - A Registry-Based Twin Study

    DEFF Research Database (Denmark)

    Sverrild, Asger; Backer, Vibeke; Kyvik, Kirsten Ohm

    2008-01-01

    BACKGROUND: Sarcoidosis is a multiorgan, granulomatous, inflammatory disease with unknown aetiology. Familial clustering of cases and ethnic variation in the epidemiology suggests a genetic influence on the disease susceptibility. AIM: This paper reports twin concordance and heritability estimates...... of sarcoidosis in order to assess the overall contribution of genetic factors to the disease susceptibility. METHODS: Monozygotic and dizygotic twins enrolled in either the Danish or the Finnish population-based, national Twin Cohorts (61,662 pairs in total) were linked to diagnostic information on sarcoidosis.......012. Compared to the general population we found an 80-fold increased risk of developing sarcoidosis in co-twins of affected monozygotic brothers or sisters. The increased risk in dizygotic twins was on the other hand only 7-fold. Aetiological model fitting gave a heritability of sarcoidosis of 0.66 (95% CI 0...

  4. Holt Oram syndrome : a registry-based study in Europe

    NARCIS (Netherlands)

    Barisic, Ingeborg; Boban, Ljubica; Greenlees, Ruth; Garne, Ester; Wellesley, Diana; Calzolari, Elisa; Addor, Marie-Claude; Arriola, Larraitz; Bergman, Jorieke E. H.; Braz, Paula; Budd, Judith L. S.; Gatt, Miriam; Haeusler, Martin; Khoshnood, Babak; Klungsoyr, Kari; McDonnell, Bob; Nelen, Vera; Pierini, Anna; Queisser-Wahrendorf, Annette; Rankin, Judith; Rissmann, Anke; Rounding, Catherine; Tucker, David; Verellen-Dumoulin, Christine; Dolk, Helen

    2014-01-01

    Background: Holt-Oram syndrome (HOS) is an autosomal dominant disorder characterised by upper limb anomalies and congenital heart defects. We present epidemiological and clinical aspects of HOS patients using data from EUROCAT (European Surveillance of Congenital Anomalies) registries. Methods: The

  5. Holt Oram syndrome: a registry-based study in Europe

    DEFF Research Database (Denmark)

    Barisic, Ingeborg; Boban, Ljubica; Greenlees, Ruth

    2014-01-01

    were reported in all cases. Agenesis/hypoplasia of radius was present in 49.2% (30/61), ulnar aplasia/hypoplasia in 24.6% (15/61) and humerus hypoplasia/phocomelia in 42.6% (26/61) of patients. Congenital heart defects (CHD) were recorded in 78.7% (48/61) of patients. Isolated septal defects were...

  6. Intracerebral haemorrhage associated with hourly concentration of ambient particulate matter: case-crossover analysis.

    Science.gov (United States)

    Yamazaki, S; Nitta, H; Ono, M; Green, J; Fukuhara, S

    2007-01-01

    To examine the association of hourly time lagged concentration of ambient particulate matter and death due to stroke. Mortality data for five years (January 1990 to December 1994) were obtained from the Ministry of Health, Labour, and Welfare of Japan. Data were used only if the deceased was 65 years old or older at the time of death, if death was attributed to intracerebral haemorrhage or ischaemic stroke, and if the deceased lived in one of 13 major urban areas. Hourly mean concentrations of PM7, NO2, and photochemical oxidants were measured at monitoring stations in the 13 areas. Time stratified case-crossover analysis was used to examine the data for evidence of triggering stroke mortality. The 1-hour mean concentration of PM7 measured about 2 hours before death was associated with the risk of death due to intracerebral haemorrhage from April to September (odds ratio = 2.40, 95% CI 1.48 to 3.89, for exposure to PM7 of more than 200 microg/m3 (threshold)). The higher risk was independent of the 24-hour mean concentration of PM7. PM7 was not associated with death due to ischaemic stroke. Transiently high concentrations of PM7 are associated with death due to intracerebral haemorrhage. Air quality standards or guidelines for particulate matter should be based not only on 24-hour mean concentrations, but also on hourly data.

  7. The effect of ambient temperature on type-2-diabetes: case-crossover analysis of 4+ million GP consultations across England.

    Science.gov (United States)

    Hajat, S; Haines, A; Sarran, C; Sharma, A; Bates, C; Fleming, L E

    2017-07-12

    Given the double jeopardy of global increases in rates of obesity and climate change, it is increasingly important to recognise the dangers posed to diabetic patients during periods of extreme weather. We aimed to characterise the associations between ambient temperature and general medical practitioner consultations made by a cohort of type-2 diabetic patients. Evidence on the effects of temperature variation in the primary care setting is currently limited. Case-crossover analysis of 4,474,943 consultations in England during 2012-2014, linked to localised temperature at place of residence for each patient. Conditional logistic regression was used to assess associations between each temperature-related consultation and control days matched on day-of-week. There was an increased odds of seeking medical consultation associated with high temperatures: Odds ratio (OR) = 1.097 (95% confidence interval = 1.041, 1.156) per 1 °C increase above 22 °C. Odds during low temperatures below 0 °C were also significantly raised: OR = 1.024 (1.019, 1.030). Heat-related consultations were particularly high among diabetics with cardiovascular comorbidities: OR = 1.171 (1.031, 1.331), but there was no heightened risk with renal failure or neuropathy comorbidities. Surprisingly, lower odds of heat-related consultation were associated with the use of diuretics, anticholinergics, antipsychotics or antidepressants compared to non-use, especially among those with cardiovascular comorbidities, although differences were not statistically significant. Type-2 diabetic patients are at increased odds of medical consultation during days of temperature extremes, especially during hot weather. The common assumption that certain medication use heightens the risk of heat illness was not borne-out by our study on diabetics in a primary care setting and such advice may need to be reconsidered in heat protection plans.

  8. Air Pollution and Suicide in 10 Cities in Northeast Asia: A Time-Stratified Case-Crossover Analysis.

    Science.gov (United States)

    Kim, Yoonhee; Ng, Chris Fook Sheng; Chung, Yeonseung; Kim, Ho; Honda, Yasushi; Guo, Yue Leon; Lim, Youn-Hee; Chen, Bing-Yu; Page, Lisa A; Hashizume, Masahiro

    2018-03-06

    There is growing evidence suggesting an association between air pollution and suicide. However, previous findings varied depending on the type of air pollutant and study location. We examined the association between air pollutants and suicide in 10 large cities in South Korea, Japan, and Taiwan. We used a two-stage meta-analysis. First, we conducted a time-stratified case-crossover analysis to estimate the short-term association between nitrogen dioxide (NO 2 ), sulfur dioxide (SO 2 ), and particulate matter [aerodynamic diameter ≤10μm (PM 10 ), aerodynamic diameter ≤2.5μm (PM 2.5 ), and PM 10–2.5 ] and suicide, adjusted for weather factors, day-of-week, long-term time trends, and season. Then, we conducted a meta-analysis to combine the city-specific effect estimates for NO 2 , SO 2 , and PM 10 across 10 cities and for PM 2.5 and PM 10–2.5 across 3 cities. We first fitted single-pollutant models, followed by two-pollutant models to examine the robustness of the associations. Higher risk of suicide was associated with higher levels of NO 2 , SO 2 , PM 10 , and PM 10–2.5 over multiple days. The combined relative risks (RRs) were 1.019 for NO 2 (95% confidence interval [CI]: 0.999, 1.039), 1.020 for SO 2 (95% CI: 1.005, 1.036), 1.016 for PM 10 (95% CI: 1.004, 1.029), and 1.019 for PM 10–2.5 (95% CI: 1.005, 1.033) per interquartile range (IQR) increase in the 0-1 d average level of each pollutant. We found no evidence of an association for PM 2.5 . Some of the associations, particularly for SO 2 and NO 2 , were attenuated after adjusting for a second pollutant. Our findings suggest that higher levels of air pollution may be associated with suicide, and further research is merited to understand the underlying mechanisms. https://doi.org/10.1289/EHP2223.

  9. The impact of heat on mortality and morbidity in the Greater Metropolitan Sydney Region: a case crossover analysis.

    Science.gov (United States)

    Wilson, Leigh Ann; Morgan, Geoffrey Gerard; Hanigan, Ivan Charles; Johnston, Fay H; Abu-Rayya, Hisham; Broome, Richard; Gaskin, Clive; Jalaludin, Bin

    2013-11-15

    This study examined the association between unusually high temperature and daily mortality (1997-2007) and hospital admissions (1997-2010) in the Sydney Greater Metropolitan Region (GMR) to assist in the development of targeted health programs designed to minimise the public health impact of extreme heat. Sydney GMR was categorized into five climate zones. Heat-events were defined as severe or extreme. Using a time-stratified case-crossover design with a conditional logistic regression model we adjusted for influenza epidemics, public holidays, and climate zone. Odds ratios (OR) and 95% confidence intervals were estimated for associations between daily mortality and hospital admissions with heat-event days compared to non-heat event days for single and three day heat-events. All-cause mortality overall had similar magnitude associations with single day and three day extreme and severe events as did all cardiovascular mortality. Respiratory mortality was associated with single day and three day severe events (95th percentile, lag0: OR = 1.14; 95%CI: 1.04 to 1.24). Diabetes mortality had similar magnitude associations with single day and three day severe events (95th percentile, lag0: OR = 1.22; 95%CI: 1.03 to 1.46) but was not associated with extreme events. Hospital admissions for heat related injuries, dehydration, and other fluid disorders were associated with single day and three day extreme and severe events. Contrary to our findings for mortality, we found inconsistent and sometimes inverse associations for extreme and severe events with cardiovascular disease and respiratory disease hospital admissions. Controlling for air pollutants did not influence the mortality associations but reduced the magnitude of the associations with hospital admissions particularly for ozone and respiratory disease. Single and three day events of unusually high temperatures in Sydney are associated with similar magnitude increases in mortality and hospital admissions. The trend

  10. Potentially disruptive life events: what are the immediate impacts on chronic disease management? A case-crossover analysis.

    Science.gov (United States)

    Lauffenburger, Julie C; Gagne, Joshua J; Song, Zirui; Brill, Gregory; Choudhry, Niteesh K

    2016-08-04

    To explore the association between unexpected potentially disruptive life events in a patient or family member that may challenge an individual's ability to take medications as prescribed and the discontinuation of evidence-based medications for common, chronic conditions. Understanding the relationship between medication adherence and life stressors, especially those that can be identified using administrative data, may help identify patients at risk of non-adherence. Observational self-controlled case-crossover design. Individuals in a nationally representative US commercial health insurance database. Adult individuals who initiated an oral hypoglycaemic, antihypertensive and/or statin and subsequently stopped the medication for ≥90 days. Potentially disruptive life events among patients and their family members measured in the 30 days just before the medication was discontinued ('hazard period') compared with the 30 days before this period ('control period'). These events included personal injury, hospitalisation, emergency room visits, changes in insurance coverage, acute stress or acute anxiety. Among the 326 519 patients meeting study criteria who discontinued their chronic disease medications, 88 896 (27.2%) experienced at least one potentially disruptive life event. Newly experiencing an injury (OR: 1.26, 95% CI 1.12 to 1.42), an emergency room visit (OR: 1.19, 95% CI 1.13 to 1.26) and acute stress (OR: 1.19, 95% CI 1.08 to 1.31) were associated with discontinuation. Life events among patients' family members did not appear to be associated with medication discontinuation or occurred less frequently just prior to discontinuation. Potentially disruptive life events among individuals identified using routinely collected claims data are associated with discontinuation of chronic disease medications. Awareness of these events may help providers or payers identify patients at risk of non-adherence to maximise patient outcomes. Published by the BMJ

  11. Flooding and emergency room visits for gastrointestinal illness in Massachusetts: A case-crossover study.

    Science.gov (United States)

    Introduction: Floods and other severe weather events are anticipated to increase as a result of global climate change. Floods can lead to outbreaks of gastroenteritis and other infectious diseases due to disruption of sewage and water infrastructure and impacts on san...

  12. Road traffic noise and registry based use of sleep medication.

    NARCIS (Netherlands)

    Evandt, Jorunn; Oftedal, Bente; Krog, Norun Hjertager; Skurtveit, Svetlana; Nafstad, Per; Schwarze, Per E; Skovlund, Eva; Houthuijs, Danny; Aasvang, Gunn Marit

    2017-01-01

    Road traffic noise has been associated with adverse health effects including sleep disturbances. Use of sleep medication as an indicator of sleeping problems has rarely been explored in studies of the effects of traffic noise. Furthermore, using registry data on sleep medications provides an

  13. Air pollution and asthma attacks in children: A case-crossover analysis in the city of Chongqing, China.

    Science.gov (United States)

    Ding, Ling; Zhu, Daojuan; Peng, Donghong; Zhao, Yao

    2017-01-01

    Data on particulate matter of diameter <2.5 μm (PM 2.5 ) in the city of Chongqing were first announced in 2013. We wished to assess the effects of pollutants on asthmatic children in Chongqing, China. Daily numbers of hospital visits because of asthma attacks in children aged 0-18 years in 2013 were collected from the Children's Hospital of Chongqing Medical University. Data on pollutants were accessed from the nine air quality-monitoring stations in Chongqing. A time-stratified case-crossover design was applied and conditional logistic regression was undertaken to analyze the data. We found that short-term exposure to PM 10 , PM 2.5 , sodium dioxide, nitrogen and carbon monoxide could trigger hospital visits for asthma in children. Nitrogen dioxide had an important role, whereas ozone had no effect. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Modifiers of short-term effects of ozone on mortality in eastern Massachusetts - A case-crossover analysis at individual level

    Directory of Open Access Journals (Sweden)

    Schwartz Joel

    2010-01-01

    Full Text Available Abstract Background Substantial epidemiological studies demonstrate associations between exposure to ambient ozone and mortality. A few studies simply examine the modification of this ozone effect by individual characteristics and socioeconomic status, but socioeconomic status was usually coded at the city level. Methods This study used a case-crossover design to examine whether impacts of ozone on mortality were modified by socioeconomic status coded at the tract or characteristics at an individual level in eastern Massachusetts, US for a period May-September, 1995-2002, with a total of 157,197 non-accident deaths aging 35 years or older. We used moving averages of maximal 8-hour concentrations of ozone monitored at 8 stationary stations as personal exposure. Results A 10 ppb increase in the four-day moving average of maximal 8-hour ozone was associated with 1.68% (95% confidence interval (CI: 0.51%, 2.87%, 1.96% (95% CI: -1.83%, 5.90%, 8.28% (95% CI: 0.66%, 16.48%, 0.44% (95% CI: -1.45%, 2.37%, -0.83% (95% CI: -2.94%, 1.32%, -1.09% (95% CI: -4.27%, 2.19% and 6.5% (95% CI: 1.74%, 11.49% changes in all natural deaths, respiratory disorders, diabetes, cardiovascular diseases, heart diseases, acute myocardial infarction and stroke, respectively. We did not find any evidence that the associations were significantly modified by socioeconomic status or individual characteristics although small differences of estimates across subpopulations were demonstrated. Conclusions Exposure to ozone was associated with specific cause mortality in Eastern Massachusetts during May-September, 1995-2002. There was no evidence that effects of ozone on mortality were significantly modified by socioeconomic status and individual characteristics.

  15. Apparent temperature and cause-specific mortality in copenhagen, denmark: a case-crossover analysis

    DEFF Research Database (Denmark)

    Wichmann, Janine; Andersen, Zorana Jovanovic; Ketzel, Matthias

    2011-01-01

    Temperature, a key climate change indicator, is expected to increase substantially in the Northern Hemisphere, with potentially grave implications for human health. This study is the first to investigate the association between the daily 3-hour maximum apparent temperature (Tapp...

  16. Associations between ambient air pollution and daily mortality in a cohort of congestive heart failure: Case-crossover and nested case-control analyses using a distributed lag nonlinear model.

    Science.gov (United States)

    Buteau, Stephane; Goldberg, Mark S; Burnett, Richard T; Gasparrini, Antonio; Valois, Marie-France; Brophy, James M; Crouse, Dan L; Hatzopoulou, Marianne

    2018-04-01

    Persons with congestive heart failure may be at higher risk of the acute effects related to daily fluctuations in ambient air pollution. To meet some of the limitations of previous studies using grouped-analysis, we developed a cohort study of persons with congestive heart failure to estimate whether daily non-accidental mortality were associated with spatially-resolved, daily exposures to ambient nitrogen dioxide (NO 2 ) and ozone (O 3 ), and whether these associations were modified according to a series of indicators potentially reflecting complications or worsening of health. We constructed the cohort from the linkage of administrative health databases. Daily exposure was assigned from different methods we developed previously to predict spatially-resolved, time-dependent concentrations of ambient NO 2 (all year) and O 3 (warm season) at participants' residences. We performed two distinct types of analyses: a case-crossover that contrasts the same person at different times, and a nested case-control that contrasts different persons at similar times. We modelled the effects of air pollution and weather (case-crossover only) on mortality using distributed lag nonlinear models over lags 0 to 3 days. We developed from administrative health data a series of indicators that may reflect the underlying construct of "declining health", and used interactions between these indicators and the cross-basis function for air pollutant to assess potential effect modification. The magnitude of the cumulative as well as the lag-specific estimates of association differed in many instances according to the metric of exposure. Using the back-extrapolation method, which is our preferred exposure model, we found for the case-crossover design a cumulative mean percentage changes (MPC) in daily mortality per interquartile increment in NO 2 (8.8 ppb) of 3.0% (95% CI: -0.9, 6.9%) and for O 3 (16.5 ppb) 3.5% (95% CI: -4.5, 12.1). For O 3 there was strong confounding by weather

  17. Exposure to air pollution and meteorological factors associated with children's primary care visits at night due to asthma attack: case-crossover design for 3-year pooled patients.

    Science.gov (United States)

    Yamazaki, Shin; Shima, Masayuki; Yoda, Yoshiko; Oka, Katsumi; Kurosaka, Fumitake; Shimizu, Shigeta; Takahashi, Hironobu; Nakatani, Yuji; Nishikawa, Jittoku; Fujiwara, Katsuhiko; Mizumori, Yasuyuki; Mogami, Akira; Yamada, Taku; Yamamoto, Nobuharu

    2015-05-03

    We examined the association of outdoor air pollution and meteorological parameters with primary care visits (PCVs) at night due to asthma attack. A case-crossover study was conducted in a primary care clinic in Himeji City, Japan. Participants were 1447 children aged 0-14 years who visited the clinic with an asthma attack from April 2010 until March 2013. Daily concentrations of air pollutants and meteorological parameters were measured. PCVs at night due to asthma attack. A conditional logistic regression model was used to estimate ORs of PCVs per unit increment of air pollutants or meteorological parameters (the per-unit increments of particulate matter with an aerodynamic diameter ≤2.5 µm (PM₂.₅) and ozone were 10 μg/m(3) and 10 ppb, respectively). Analyses took into consideration the effects of seasonality. We noted an association between PCVs and daily ozone levels on the day before a PCV (OR=1.17; 95% CI 1.01 to 1.35; p=0.04), as well as between PCVs and 3-day mean ozone levels before a PCV (OR=1.29; 95% CI 1.00 to 1.46; p=0.04), from April until June. We also observed an association between PCVs and daily PM₂.₅ levels on the day before a PCV from December until March (OR=1.16; 95% CI 1.01 to 1.33; p=0.05). Meteorological parameters, such as hours of sunshine from September until November, atmospheric pressure from April until June, and temperature from April until August, were also found to be associated with PCVs. The findings in the present study supported an association between ozone and PCVs and suggest that certain meteorological items may be associated with PCVs. 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.

  18. Air pollution events from forest fires and emergency department attendances in Sydney, Australia 1996-2007: a case-crossover analysis.

    Science.gov (United States)

    Johnston, Fay H; Purdie, Stuart; Jalaludin, Bin; Martin, Kara L; Henderson, Sarah B; Morgan, Geoffrey G

    2014-12-10

    Severe air pollution generated by forest fires is becoming an increasingly frequent public health management problem. We measured the association between forest fire smoke events and hospital emergency department (ED) attendances in Sydney from 1996-2007. A smoke event occurred when forest fires caused the daily citywide average concentration of particulate matter (PM10 or PM2.5) to exceed the 99th percentile of the entire study period. We used a time-stratified case-crossover design and conditional logistic regression models adjusted for meteorology, influenza epidemics, and holidays to estimate odds ratios (OR) and 95% confidence intervals (CI) for ED attendances on event days compared with non-event days for all non-trauma ED attendances and selected cardiorespiratory conditions. The 46 validated fire smoke event days during the study period were associated with same day increases in ED attendances for all non-trauma conditions (1.03, 95% CI 1.02, 1.04), respiratory conditions (OR 1.07, 95% CI 1.04, 1.10), asthma (OR 1.23, 95% CI 1.15, 1.30), and chronic obstructive pulmonary disease (OR 1.12, 95% CI 1.02, 1.24). Positive associations persisted for one to three days after the event. Ischaemic heart disease ED attendances were increased at a lag of two days (OR 1.07, 95% CI 1.01, 1.15) while arrhythmias had an inverse association at a lag of two days (OR 0.91, 95% CI 0.83, 0.99). In age-specific analyses, no associations present in children less than 15 years of age for any outcome, although a non-significant trend towards a positive association was seen with childhood asthma. A further association between smoke event and heart failure attendances was present for the 15-65 year age group, but not older adults at a lag of two days (OR 1.37 95% CI 1.05, 1.78). Smoke events were associated with an immediate increase in presentations for respiratory conditions and a lagged increase in attendances for ischaemic heart disease and heart failure. Respiratory impacts were

  19. Association between emergency admission for peptic ulcer bleeding and air pollution: a case-crossover analysis in Hong Kong's elderly population.

    Science.gov (United States)

    Tian, Linwei; Qiu, Hong; Sun, Shengzhi; Tsang, Hilda; Chan, King-Pan; Leung, Wai K

    2017-05-01

    Air pollution increases intestinal permeability, alters the gut microbiome, and promotes inflammation, which might contribute towards gastrointestinal bleeding. In the present study, we aim to examine whether short-term elevations in air pollution are associated with increased numbers of emergency hospital admissions for peptic ulcer bleeding in Hong Kong. Daily air pollution (particulate matter with aerodynamic diameter less than 2·5 μm [PM 2·5 ], nitric oxide [NO 2 ], sulpher dioxide [SO 2 ], and ozone [O 3 ]) data during 2005-10 were collected from the Environmental Protection Department and emergency admission data for peptic ulcer bleeding in elderly people (aged 65 years or older) from the Hospital Authority of Hong Kong. A time stratified case-crossover analysis with conditional logistic regression was used to estimate the excess risk of peptic ulcer bleeding associated with each air pollutant, in single-pollutant and multi-pollutant models. Cardiorespiratory diseases were used as positive controls. 8566 emergency admissions for peptic ulcer bleeding were recorded among Hong Kong's elderly population during 2005-10; the daily number of admissions ranged from 0 to 13. An IQR increment of 5-day moving average (lag 04 ) of NO 2 concentration (25·8 μg/m 3 ) was associated with a 7·6% (95% CI 2·2-13·2) increase in emergency admissions for peptic ulcer bleeding. Multi-pollutant models confirmed the robustness of the risk estimates for NO 2 . Other pollutants (PM 2·5 , SO 2 , and O 3 ) were not associated with peptic ulcer bleeding admissions. Short-term elevation in ambient NO 2 might trigger peptic ulcer bleeding events and increase the risk of emergency admissions for peptic ulcer bleeding in Hong Kong's elderly population. These findings strengthen the hypothesis that air pollution affects not just cardiopulmonary diseases, but also certain diseases of the digestive system. None. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an

  20. The NordiNet® International Outcome Study and NovoNet® ANSWER Program®: rationale, design, and methodology of two international pharmacoepidemiological registry-based studies monitoring long-term clinical and safety outcomes of growth hormone therapy (Norditropin®).

    Science.gov (United States)

    Höybye, Charlotte; Sävendahl, Lars; Christesen, Henrik Thybo; Lee, Peter; Pedersen, Birgitte Tønnes; Schlumpf, Michael; Germak, John; Ross, Judith

    2013-01-01

    Randomized controlled trials have shown that growth hormone (GH) therapy has effects on growth, metabolism, and body composition. GH therapy is prescribed for children with growth failure and adults with GH deficiency. Carefully conducted observational study of GH treatment affords the opportunity to assess long-term treatment outcomes and the clinical factors and variables affecting those outcomes, in patients receiving GH therapy in routine clinical practice. The NordiNet® International Outcome Study (IOS) and the American Norditropin® Web Enabled Research (ANSWER Program®) are two complementary, non-interventional, observational studies that adhere to current guidelines for pharmacoepidemiological data. The studies include pediatric and adult patients receiving Norditropin®, as prescribed by their physicians. The studies gather long-term data on the safety and effectiveness of reallife treatment with the recombinant human GH, Norditropin®. We describe the origins, aims, objectives, and design methodology of the studies, as well as their governance and validity, strengths, and limitations. The NordiNet® IOS and ANSWER Program® studies will provide valid insights into the effectiveness and safety of GH treatment across a diverse and large patient population treated in accordance with real-world clinical practice and following the Good Pharmacoepidemiological Practice and STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) guidelines.

  1. Methadone treatments in a Swiss Region, 2001–2008: a registry-based analysis

    Directory of Open Access Journals (Sweden)

    Huissoud Thérèse

    2012-12-01

    Full Text Available Abstract Background To determine, in a region of Switzerland, the duration of retention in opioid substitution treatments with methadone (OSTM, duration of treatment interruptions, probability of re-entry to treatment after a treatment interruption, and associated factors. Methods A secondary analysis of registry-based data was performed with patients (n = 2880 registered in the methadone treatment register database of the Public Health Service of the canton of Vaud between January 1, 2001 and June 30, 2008. Survival analysis and multivariate analysis was conducted. Results The probability of remaining on treatment was 69% at 1 year and 45% at 3 years (n =1666. One-third of patients remained on treatment beyond 5 years. The estimated hazard of leaving treatment was increased by a ratio of 1.31 in the case of a first treatment (P = 0.001, 1.83 for those without a fixed home (P P n = 1581. Factors at the interruption of treatment associated with a higher probability of re-entering were: interruption not due to methadone withdrawal, bad physical health, and higher methadone dose. Conclusions OSTM are long-term (maintenance treatments in Switzerland. Younger age, bad living conditions at entry, and first treatment are predictors of lower retention. Approximately one-half of patients who interrupt treatment will re-enter treatment within 5 years.

  2. The association between urban tree cover and gun assault: A case-control and case-crossover study

    Science.gov (United States)

    Michelle C. Kondo; Eugenia C. South; Charles C. Branas; Therese S. Richmond; Douglas J. Wiebe

    2017-01-01

    Green space and vegetation may play a protective role against urban violence. We investigated whether being near urban tree cover during outdoor activities was related to being assaulted with a gun. We conducted geographic information systems–assisted interviews with boys andmen aged 10–24 years in Philadelphia, Pennsylvania, including 135 patients who had been shot...

  3. Application of a Time-Stratified Case-Crossover Design to Explore the Effects of Air Pollution and Season on Childhood Asthma Hospitalization in Cities of Differing Urban Patterns: Big Data Analytics of Government Open Data.

    Science.gov (United States)

    Kuo, Ching-Yen; Pan, Ren-Hao; Chan, Chin-Kan; Wu, Chiung-Yi; Phan, Dinh-Van; Chan, Chien-Lung

    2018-03-31

    Few studies have assessed the lagged effects of levels of different urban city air pollutants and seasons on asthma hospitalization in children. This study used big data analysis to explore the effects of daily changes in air pollution and season on childhood asthma hospitalization from 2001 to 2010 in Taipei and Kaohsiung City, Taiwan. A time-stratified case-crossover study and conditional logistic regression analysis were employed to identify associations between the risk of hospitalization due to asthma in children and the levels of air pollutants (PM 2.5 , PM 10 , O₃, SO₂, and NO₂) in the days preceding hospitalization. During the study period, 2900 children in Taipei and 1337 in Kaohsiung aged ≤15 years were hospitalized due to asthma for the first time. The results indicated that the levels of air pollutants were significantly associated with the risk of asthma hospitalization in children, and seasonal effects were observed. High levels of air pollution in Kaohsiung had greater effects than in Taipei after adjusting for seasonal variation. The most important factor was O₃ in spring in Taipei. In children aged 0-6 years, asthma was associated with O₃ in Taipei and SO₂ in Kaohsiung, after controlling for the daily mean temperature and relative humidity.

  4. Application of a Time-Stratified Case-Crossover Design to Explore the Effects of Air Pollution and Season on Childhood Asthma Hospitalization in Cities of Differing Urban Patterns: Big Data Analytics of Government Open Data

    Directory of Open Access Journals (Sweden)

    Ching-Yen Kuo

    2018-03-01

    Full Text Available Few studies have assessed the lagged effects of levels of different urban city air pollutants and seasons on asthma hospitalization in children. This study used big data analysis to explore the effects of daily changes in air pollution and season on childhood asthma hospitalization from 2001 to 2010 in Taipei and Kaohsiung City, Taiwan. A time-stratified case-crossover study and conditional logistic regression analysis were employed to identify associations between the risk of hospitalization due to asthma in children and the levels of air pollutants (PM2.5, PM10, O3, SO2, and NO2 in the days preceding hospitalization. During the study period, 2900 children in Taipei and 1337 in Kaohsiung aged ≤15 years were hospitalized due to asthma for the first time. The results indicated that the levels of air pollutants were significantly associated with the risk of asthma hospitalization in children, and seasonal effects were observed. High levels of air pollution in Kaohsiung had greater effects than in Taipei after adjusting for seasonal variation. The most important factor was O3 in spring in Taipei. In children aged 0–6 years, asthma was associated with O3 in Taipei and SO2 in Kaohsiung, after controlling for the daily mean temperature and relative humidity.

  5. Better survival after breast-conserving therapy compared to mastectomy when axillary node status is positive in early-stage breast cancer: a registry-based follow-up study of 6387 Norwegian women participating in screening, primarily operated between 1998 and 2009.

    Science.gov (United States)

    Hartmann-Johnsen, Olaf Johan; Kåresen, Rolf; Schlichting, Ellen; Nygård, Jan F

    2017-07-03

    Recent registry studies on early-stage breast cancer have shown better survival rates when women underwent breast-conserving therapy (BCT) compared with mastectomy (MTX). The aim of this study is to investigate women participating in screening, in all four stages of early breast cancer (T1N0M0, T2N0M0, T1N1M0, and T2N1M0), as to whether there is a survival benefit when women undergo BCT compared to MTX. A cohort of 6387 women aged 50-69, with primary-operated breast cancer from January 1998 to December 2009, participating in screening and followed-up until the end of 2010. Life tables were calculated by stages (pT1N0M0, pT2N0M0, pT1N1M0, and pT2N1M0), surgery groups (BCT and MTX), and screening detection (first screening, later screening, or interval cancer). Cox regression was used to calculate hazard ratios (HR) between BCT and MTX in crude and adjusted analyses. In stage T1N1M0, women who underwent MTX had an HR of 2.91 (95% CI 1.30-6.48) for breast cancer death compared to women who underwent BCT, after adjusting for screening detection, years of diagnosis, age at diagnosis, histology, grade, and hormone receptor status. For all other TNM categories of early breast cancer, there was no difference in survival. 10-year breast cancer-specific survival (BCSS) in T1N0M0 was 98% for women undergoing BCT and 96% for women undergoing MTX. 10-year BCSS in T1N1M0 was 97% for women undergoing BCT and 89% for women undergoing MTX. For women participating in screening, there is a benefit of BCT over MTX in stage T1N1M0. No such effects were observed in the other early stages of breast cancer.

  6. Instantaneous Wave-Free Ratio versus Fractional Flow Reserve guided intervention (iFR-SWEDEHEART): Rationale and design of a multicenter, prospective, registry-based randomized clinical trial.

    Science.gov (United States)

    Götberg, Matthias; Christiansen, Evald H; Gudmundsdottir, Ingibjörg; Sandhall, Lennart; Omerovic, Elmir; James, Stefan K; Erlinge, David; Fröbert, Ole

    2015-11-01

    Instantaneous wave-free ratio (iFR) is a new hemodynamic resting index for assessment of coronary artery stenosis severity. iFR uses high frequency sampling to calculate a gradient across a coronary lesion during a period of diastole. The index has been tested against fractional flow reserve (FFR) and found to have an overall classification agreement of 80% to 85%. Whether the level of disagreement is clinically relevant is unknown. Clinical outcome data on iFR are scarce. This study is a registry-based randomized clinical trial, which is a novel strategy using health quality registries as on-line platforms for randomization, case record forms, and follow-up. iFR-SWEDEHEART is a multicenter, prospective, randomized, controlled, clinical open-label clinical trial. Two thousand patients with stable angina or acute coronary syndrome and an indication for physiology-guided assessment of one or more coronary stenoses will be randomized 1:1 to either iFR- or FFR-guided intervention. The randomization will be conducted online in the Swedish web-based system for enhancement and development of evidence-based care in heart disease evaluated according to recommended therapies (SWEDEHEART) registry. The trial has a non-inferiority design, with a primary combined end point of all-cause death, non-fatal myocardial infarction, and unplanned revascularization at 12 months. End points will be identified through national registries and undergo central blind adjudication to ensure data quality. The iFR-SWEDEHEART trial is an registry-based randomized clinical trial evaluating the safety and efficacy of the diagnostic method iFR compared to FFR. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Ethnic Heterogeneity of Cancer in Europe : Lessons from registry-based studies in migrants

    NARCIS (Netherlands)

    M. Arnold (Melina)

    2013-01-01

    textabstractEurope has long since laid off its image as a primarily emigration-dominated continent and has transformed into a coveted destination of immigrants from all over the world. Immigration has substantially characterized the European society and has ensured a positive migration balance as

  8. Leukaemia and occupation: a New Zealand Cancer Registry-based case-control Study.

    Science.gov (United States)

    McLean, David; Mannetje, Andrea 't; Dryson, Evan; Walls, Chris; McKenzie, Fiona; Maule, Milena; Cheng, Soo; Cunningham, Chris; Kromhout, Hans; Boffetta, Paolo; Blair, Aaron; Pearce, Neil

    2009-04-01

    To examine the association between occupation and leukaemia. We interviewed 225 cases (aged 20-75 years) notified to the New Zealand Cancer Registry during 2003-04, and 471 controls randomly selected from the Electoral Roll collecting demographic details, information on potential confounders and a comprehensive employment history. Associations between occupation and leukaemia were analysed using logistic regression adjusted for gender, age, ethnicity and smoking. Elevated odds ratios (ORs) were observed in agricultural sectors including horticulture/fruit growing (OR: 2.62, 95% confidence interval (CI): 1.51, 4.55), plant nurseries (OR: 7.51, 95% CI: 1.85, 30.38) and vegetable growing (OR: 3.14, 95% CI: 1.18, 8.40); and appeared greater in women (ORs: 4.71, 7.75 and 7.98, respectively). Elevated ORs were also observed in market farmers/crop growers (OR: 1.84, 95% CI: 1.12, 3.02), field crop/vegetable growers (OR: 3.98, 95% CI: 1.46, 10.85), market gardeners (OR: 5.50, 95% CI: 1.59, 19.02), and nursery growers/workers (OR: 4.23, 95% CI: 1.34, 13.35); also greater in women (ORs: 3.48, 7.62, 15.74 and 11.70, respectively). These elevated ORs were predominantly for chronic lymphocytic leukaemia (CLL). Several associations persisted after semi-Bayes adjustment. Elevated ORs were observed in rubber/plastics products machine operators (OR: 3.76, 95% CI: 1.08, 13.08), predominantly in plastic product manufacturing. CLL was also elevated in tailors and dressmakers (OR: 7.01, 95% CI: 1.78, 27.68), cleaners (OR: 2.04, 95% CI: 1.00, 4.14) and builder's labourers (OR: 4.03, 95% CI: 1.30, 12.53). These findings suggest increased leukaemia risks associated with certain agricultural, manufacturing, construction and service occupations in New Zealand.

  9. Safety of vaccinations in patients with cryopyrin-associated periodic syndromes: a prospective registry based study

    NARCIS (Netherlands)

    Jaeger, Veronika K.; Hoffman, Hal M.; van der Poll, Tom; Tilson, Hugh; Seibert, Julia; Speziale, Antonio; Junge, Guido; Franke, Kristina; Vritzali, Eleni; Hawkins, Philip N.; Kuemmerle-Deschner, Jasmin; Walker, Ulrich A.

    2017-01-01

    Pneumococcal, tetanus and influenza vaccinations are recommended for patients with cryopyrin-associated periodic syndromes (CAPS) when treated with immunosuppressive medication. The aim of this publication is to report the safety of pneumococcal and other vaccinations in CAPS patients. All CAPS

  10. Leukaemia and occupation: a New Zealand Cancer Registry-based case-control Study.

    NARCIS (Netherlands)

    McLean, D.; 't Mannetje, A.; Dryson, E.; Walls, C.; McKenzie, F.; Maule, M.; Cheng, S.; Cunningham, C.; Kromhout, H.; Boffetta, P.; Blair, A.; Pearce, N.

    2009-01-01

    BACKGROUND: To examine the association between occupation and leukaemia. METHODS: We interviewed 225 cases (aged 20-75 years) notified to the New Zealand Cancer Registry during 2003-04, and 471 controls randomly selected from the Electoral Roll collecting demographic details, information on

  11. Upfront haploidentical transplant for acquired severe aplastic anemia: registry-based comparison with matched related transplant.

    Science.gov (United States)

    Xu, Lan-Ping; Jin, Song; Wang, Shun-Qing; Xia, Ling-Hui; Bai, Hai; Gao, Su-Jun; Liu, Qi-Fa; Wang, Jian-Min; Wang, Xin; Jiang, Ming; Zhang, Xi; Wu, De-Pei; Huang, Xiao-Jun

    2017-01-21

    Haploidentical donor (HID) hematopoietic stem cell transplantation (HSCT) is an alternative treatment method for severe aplastic anemia (SAA) patients lacking suitable identical donors and those who are refractory to immunosuppressive therapy (IST). The current study evaluated the feasibility of upfront haploidentical HSCT in SAA patients. We conducted a multicenter study based on a registry database. One hundred fifty-eight SAA patients who underwent upfront transplantation between June 2012 and September 2015 were enrolled. Eighty-nine patients had haploidentical donors (HIDs), and 69 had matched related donors (MRDs) for HSCT. The median times for myeloid engraftment in the HID and MRD cohorts were 12 (range, 9-20) and 11 (range, 8-19) days, with a cumulative incidence of 97.8 and 97.1% (P = 0.528), respectively. HID recipients had an increased cumulative incidence of grades II-IV acute graft-versus-host disease (aGVHD) (30.3 vs. 1.5%, P < 0.001), grades III-IV aGVHD (10.1 vs. 1.5%, P = 0.026), and chronic GVHD (cGVHD) (30.6 vs. 4.4%, P < 0.001) at 1 year but similar extensive cGVHD (3.4 vs. 0%, P = 0.426). The three-year estimated overall survival (OS) rates were 86.1 and 91.3% (P = 0.358), while the three-year estimated failure-free survival (FFS) rates were 85.0 and 89.8% (P = 0.413) in the HID and MRD cohorts, respectively. In multivariate analysis, survival outcome for the entire population was significantly adversely associated with increased transfusions and poor performance status pre-SCT. We did not observe differences in primary engraftment and survival outcomes by donor type. Haploidentical SCT as upfront therapy was an effective and safe option for SAA patients, with favorable outcomes in experienced centers.

  12. Short-term effects of air pollution on a range of cardiovascular events in England and Wales: case-crossover analysis of the MINAP database, hospital admissions and mortality.

    Science.gov (United States)

    Milojevic, Ai; Wilkinson, Paul; Armstrong, Ben; Bhaskaran, Krishnan; Smeeth, Liam; Hajat, Shakoor

    2014-07-01

    To inform potential pathophysiological mechanisms of air pollution effects on cardiovascular disease (CVD), we investigated short-term associations between ambient air pollution and a range of cardiovascular events from three national databases in England and Wales. Using a time-stratified case-crossover design, over 400,000 myocardial infarction (MI) events from the Myocardial Ischaemia National Audit Project (MINAP) database, over 2 million CVD emergency hospital admissions and over 600,000 CVD deaths were linked with daily mean concentrations of carbon monoxide (CO), nitrogen dioxide (NO2), particulate matter less than 10 μm in aerodynamic diameter (PM10), particulate matter less than 2.5 μm in aerodynamic diameter (PM2.5) and sulfur dioxide (SO2), and daily maximum of 8-hourly running mean of O3 measured at the nearest air pollution monitoring site to the place of residence. Pollutant effects were modelled using lags up to 4 days and adjusted for ambient temperature and day of week. For mortality, no CVD outcome analysed was clearly associated with any pollutant, except for PM2.5 with arrhythmias, atrial fibrillation and pulmonary embolism. With hospital admissions, only NO2 was associated with a raised risk: CVD 1.7% (95% CI 0.9 to 2.6), non-MI CVD 2.0% (1.1 to 2.9), arrhythmias 2.9% (0.6 to 5.2), atrial fibrillation 2.8% (0.3 to 5.4) and heart failure 4.4% (2.0 to 6.8) for a 10th-90th centile increase. With MINAP, only NO2 was associated with an increased risk of MI, which was specific to non-ST-elevation myocardial infarction (non-STEMIs): 3.6% (95% CI 0.4 to 6.9). This study found no clear evidence for pollution effects on STEMIs and stroke, which ultimately represent thrombogenic processes, though it did for pulmonary embolism. The strongest associations with air pollution were observed with selected non-MI outcomes. 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.

  13. Exploring The Association Between Severe Respiratory Syncytial Virus Infection and Asthma: a Registry-Based Twin Study

    DEFF Research Database (Denmark)

    Thomsen, Simon Francis; Sluis, Sophie V D; Stensballe, Lone G

    2009-01-01

    ) and linked to information on asthma obtained from hospital discharge registries and parent-completed questionnaires. Genetic variance components models and direction of causation models were fitted to the observed data. RESULTS: RSV hospitalization and asthma were positively associated (r=0.43) and genetic...

  14. Impact of varying control moment selection in a case-crossover (CCO) study on antidepressant drug (AD) use and hip/femur fracture (HFF) in protect

    NARCIS (Netherlands)

    De Groot, Mark C.H.; Belitser, Svetlana V.; Souverein, Patrick C.; Groenwold, Rolf H.H.; Candore, Gianmario; Alvarez, Yolanda; Schlienger, Raymond G.; Reynolds, Robert; Klungel, Olaf H.; Gardarsdottir, Helga

    2014-01-01

    Background: The CCO design is appealing because it eliminates time-invariant person related confounding. A prerequisite is that exposure in real life drug use is sufficiently transient to allow for independence of exposure states. The impact of variation in time of control moment selection is

  15. The survival of patients with Stage III Colon Cancer is improved in HNPCC compared with sporadic cases. A Danish registry based study

    DEFF Research Database (Denmark)

    Brixen, Line Merrild; Bernstein, Inge Thomsen; Bülow, Steffen

    2013-01-01

    AIM: Patients with hereditary non-polyposis colorectal cancer (HNPCC) seem to have a better prognosis than those with sporadic colon cancer (CC)s. The aim was to compare survival after stage III CC in patients with HNPCC with those having sporadic CC. METHOD: 230 patients with hereditary cancer...... from The Danish HNPCC-Register and 3557 patients with sporadic CC from The Danish Colorectal Cancer Database, diagnosed during May 2001-December 2008 were included. HNPCC patients were classified according to Mismatch Repair mutation status and family pedigree. Sporadic cases had no known family...... history of cancer. Patient characteristics, geographic differences and survival data were analyzed. RESULTS: The overall survival (OS) was better in HNPCC patients compared to sporadic CC after stratification for sex and age (p=0.02; CI 1.04-1.7). The 5-year survival was 70% in HNPCC patients compared...

  16. Factors associated with dropout among patients in opioid maintenance treatment (OMT) and predictors of re-entry. A national registry-based study.

    Science.gov (United States)

    Bukten, Anne; Skurtveit, Svetlana; Waal, Helge; Clausen, Thomas

    2014-10-01

    Retention in treatment is often highlighted as one of the key indicators of success in opioid maintenance treatment (OMT). To identify factors associated with long-term retention in opioid maintenance treatment and to analyse predictors of subsequent treatment episodes. Treatment retention and re-entry were examined for a national cohort of patients admitted to OMT in Norway in the period 1997-2003. Multivariate Cox regression models were used to investigate factors associated with treatment dropout 18months after treatment entry. The 18month retention rate among patients admitted to OMT in Norway (n=2431) was 65.8% (n=1599). Dropout from OMT within 18months was associated with younger age (HR 0.97 [0.96-0.98]), high levels of general pre-treatment criminal offences (HR 1.66 [1.32-2.09]) and having drug-related offences during the 30days prior to dropout (HR 1.80 [1.36-2.38]). Of the patients who dropped out (n=832), 42.7% (n=355) were re-engaged in subsequent treatment episodes. Pre-treatment criminal offences were associated with increased odds for treatment re-entry, whereas being younger and having drug-related offences during the first OMT episode were associated with lower odds for re-engagement in OMT. Gender was not associated with treatment dropout and re-entry. High levels of pre-treatment criminal offences and drug offences during the 30days prior to dropout were associated with treatment dropout. Efforts to increase support services to these patients may contribute to higher rates of retention in OMT. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Adult Height after Growth Hormone Treatment at Pubertal Onset in Short Adolescents Born Small for Gestational Age: Results from a Belgian Registry-Based Study

    Directory of Open Access Journals (Sweden)

    M. Thomas

    2018-01-01

    Full Text Available Objectives. Information on the efficacy of GH treatment in short SGA children starting their treatment in adolescence is limited. Therefore, adult height (AH, total height gain, and pubertal height gain were evaluated in short SGA children who started GH treatment at pubertal onset. Patient and Methods. Growth data of 47 short SGA adolescents (22 boys who started GH treatment at pubertal onset (PUB group were compared with results from 27 short SGA patients (11 boys who started GH therapy at least 1 year before pubertal onset (PrePUB group. Results. The PUB group achieved a mean (±SD total height gain of 0.8 ± 0.7 SDS and an AH of −2.5 ± 0.7 SDS after 4.1 ± 1.1 years of GH treatment with a dosage of 41.8 ± 8.4 μg/kg/day. These results were comparable with those in the PrePUB group, which was treated for a longer duration (5.8 ± 2.1 years, resulting in a total height gain of 1.1 ± 0.7 SDS and an AH of −2.1 ± 1.0 SDS. Multiple regression analysis showed a significantly lower height gain in pubertal patients, females, and patients weighing less at start of GH treatment. An AH above −2 SDS and above the parent-specific lower limit of height was, respectively, reached in 28% and 70% of PUB and 44% and 67% of PrePUB patients (NS. AH SDS was positively correlated with the height SDS at start of GH. Conclusions. Short SGA adolescents starting GH therapy at an early pubertal stage have a modest and variable height gain. A normal AH can be expected in one third of the patients, especially in those with a smaller height deficit at onset of GH treatment.

  18. Evaluating the use and limitations of the Danish National Hospital Register in registry-based research using an example of multiple sclerosis

    DEFF Research Database (Denmark)

    Mason, K; Thygesen, Lau Caspar; Stenager, Egon

    2012-01-01

    in epidemiological MS research, in particular incidence studies. The study also found that the completeness of the LPR could be increased to 92.8% by including LPR records from other departments in addition, but this reduced the validity of the LPR to 95.1%. However, these results cannot uncritically be applied......BACKGROUND: The Danish National Patient Register, Landspatientregistret (LPR), is a register of all hospital discharges and outpatient treatments in Denmark. AIMS: It is increasingly used in research so it is important to understand to what extent this can be used as an accurate source...

  19. Chronic granulomatous disease: a 25-year patient registry based on a multistep diagnostic procedure, from the referral center for primary immunodeficiencies in Greece

    NARCIS (Netherlands)

    Raptaki, Maria; Varela, Ioanna; Spanou, Kleopatra; Tzanoudaki, Marianna; Tantou, Sofia; Liatsis, Manolis; Constantinidou, Nikki; Bakoula, Chryssa; Roos, Dirk; Kanariou, Maria

    2013-01-01

    Chronic Granulomatous Disease (CGD) is an uncommon primary immunodeficiency caused by the absence or dysfunction of one of NADPH oxidase subunits, with heterogeneous genetic aetiologies. The aim of this study was the CGD patient registry in Greece, the identification of the responsible genotype and

  20. Ischemic Stroke and Its Risk Factors in a Registry-Based Large Cross-Sectional Diabetic Cohort in a Country Facing a Diabetes Epidemic

    Directory of Open Access Journals (Sweden)

    Khalid Al-Rubeaan

    2016-01-01

    Full Text Available The main aim of this study is to determine the prevalence and risk factors of ischemic stroke among diabetic patients registered in the Saudi National Diabetes Registry (SNDR database. A cross-sectional sample of 62,681 diabetic patients aged ≥25 years was used to calculate ischemic stroke prevalence and its risk factors. Univariate and multivariate logistic regression analyses were used to assess the roles of different risk factors. The prevalence of ischemic stroke was 4.42% and was higher in the older age group with longer diabetes duration. Poor glycemic control and the presence of chronic diabetes complications were associated with a high risk of ischemic stroke. History of smoking and type 2 diabetes were more frequent among stroke patients. Obesity significantly decreased the risk for ischemic stroke. Regression analysis for ischemic stroke risk factors proved that age ≥45 years, male gender, hypertension, coronary artery disease (CAD, diabetes duration ≥10 years, insulin use, and hyperlipidemia were significant independent risk factors for ischemic stroke. We conclude that ischemic stroke is prevalent among diabetic individuals, particularly among those with type 2 diabetes. Good glycemic, hypertension, and hyperlipidemia control, in addition to smoking cessation, are the cornerstones to achieve a significant reduction in ischemic stroke risk.

  1. Impact of maternal obesity on inhaled corticosteroid use in childhood: a registry based analysis of first born children and a sibling pair analysis.

    Directory of Open Access Journals (Sweden)

    Adrian J Lowe

    Full Text Available BACKGROUND: It has been proposed that maternal obesity during pregnancy may increase the risk that the child develops allergic disease and asthma, although the mechanisms underpinning this relationship are currently unclear. We sought to assess if this association may be due to confounding by genetic or environmental risk factors that are common to maternal obesity and childhood asthma, using a sibling pair analysis. METHODS: The study population comprised a Swedish national cohort of term children born between 1992 and 2008 to native Swedish parents. Maternal body mass index (BMI was measured at 8-10 weeks gestation. Unconditional logistic regression models were used to determine if maternal obesity was associated with increased risk of inhaled corticosteroid (ICS in 431,718 first-born children, while adjusting for potential confounders. An age-matched discordant sib-pair analysis was performed, taking into account shared genetic and environmental risk factors. RESULTS: Maternal over-weight and obesity were associated with increased risk that the child would require ICS (for BMI≥35 kg/m(2, aOR = 1.30, 95%CI = 1.10-1.52 compared with normal weight mothers in children aged 6-12 years. Similar effects were seen in younger children, but in children aged 13-16 years, maternal obesity (BMI≥30 was related to increased risk of ICS use in girls (aOR = 1.28, 95%CI = 1.07-1.53 but not boys (OR = 1.05, 95%CI = 0.87-1.26. The sib-pair analysis, which included 2,034 sib-pairs older than six years who were discordant for both ICS use and maternal BMI category, failed to find any evidence that increasing maternal weight was related to increased risk of ICS use. CONCLUSION: Maternal obesity is associated with increased risk of childhood ICS use up to approximately 12 years of age, but only in girls after this age. These effects could not be confirmed in a sib pair analysis, suggesting either limited statistical power, or the effects

  2. Flooding and Clostridium difficile infection: a case-crossover analysis

    Science.gov (United States)

    Clostridium difficile is a bacterium that can spread by water. It often causes acute gastrointestinal illness in older adults who are hospttalized and/or receiving antibiotics; however, community­ associated infections affecting otherwise healthy individuals have become more comm...

  3. Association between perception of fault for the crash and function, return to work and health status 1 year after road traffic injury: a registry-based cohort study.

    Science.gov (United States)

    Gabbe, Belinda J; Simpson, Pamela M; Cameron, Peter A; Ekegren, Christina L; Edwards, Elton R; Page, Richard; Liew, Susan; Bucknill, Andrew; de Steiger, Richard

    2015-11-26

    To establish the association between the patient's perception of fault for the crash and 12-month outcomes after non-fatal road traffic injury. Two adult major trauma centres, one regional trauma centre and one metropolitan trauma centre in Victoria, Australia. 2605 adult, orthopaedic trauma patients covered by the state's no-fault third party insurer for road traffic injury, injured between September 2010 and February 2014. EQ-5D-3L, return to work and functional recovery (Glasgow Outcome Scale-Extended score of upper good recovery) at 12 months postinjury. After adjusting for key confounders, the adjusted relative risk (ARR) of a functional recovery (0.57, 95% CI 0.46 to 0.69) and return to work (0.92, 95% CI 0.86 to 0.99) were lower for the not at fault compared to the at fault group. The ARR of reporting problems on EQ-5D items was 1.20-1.35 times higher in the not at fault group. Patients who were not at fault, or denied being at fault despite a police report of fault, experienced poorer outcomes than the at fault group. Attributing fault to others was associated with poorer outcomes. Interventions to improve coping, or to resolve negative feelings from the crash, could facilitate better outcomes in the future. 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/

  4. 10 year survival after breast-conserving surgery plus radiotherapy compared with mastectomy in early breast cancer in the Netherlands : a population-based study

    NARCIS (Netherlands)

    van Maaren, Marissa C.; de Munck, Linda; de Bock, Geertruida H.; Jobsen, Jan J.; van Dalen, Thijs; Linn, Sabine C.; Poortmans, Philip; Strobbe, Luc J. A.; Siesling, Sabine

    BACKGROUND: Investigators of registry-based studies report improved survival for breast-conserving surgery plus radiotherapy compared with mastectomy in early breast cancer. As these studies did not present long-term overall and breast cancer-specific survival, the effect of breast-conserving

  5. 10 year survival after breast-conserving surgery plus radiotherapy compared with mastectomy in early breast cancer in the Netherlands: a population-based study

    NARCIS (Netherlands)

    Maaren, M.C. van; Munck, L.; Bock, G.H. de; Jobsen, J.J.; Dalen, T. van; Linn, S.C.; Poortmans, P.; Strobbe, L.J.A.; Siesling, S.

    2016-01-01

    BACKGROUND: Investigators of registry-based studies report improved survival for breast-conserving surgery plus radiotherapy compared with mastectomy in early breast cancer. As these studies did not present long-term overall and breast cancer-specific survival, the effect of breast-conserving

  6. 10 year survival after breast-conserving surgery plus radiotherapy compared with mastectomy in early breast cancer in the Netherlands : a population-based study

    NARCIS (Netherlands)

    van Maaren, Marissa C.; de Munck, Linda; de Bock, Geertruida H.; Jobsen, Jan J.; van Dalen, Thijs; Linn, Sabine C.; Poortmans, Philip; Strobbe, Luc J A; Siesling, Sabine

    Background Investigators of registry-based studies report improved survival for breast-conserving surgery plus radiotherapy compared with mastectomy in early breast cancer. As these studies did not present long-term overall and breast cancer-specific survival, the effect of breast-conserving surgery

  7. Risk of Infective Endocarditis After Invasive Dental Treatments: A Case-Only Study.

    Science.gov (United States)

    Chen, Tzu-Ting; Yeh, Yi-Chun; Chien, Kuo-Liong; Lai, Mei-Shu; Tu, Yu-Kang

    2018-04-19

    Background -Invasive dental treatments (IDTs) can yield temporary bacteremia and has therefore been considered a potential risk factor of infective endocarditis (IE). It is hypothesized that, through the trauma caused by IDTs, bacteria gain entry to the bloodstream and may attach to abnormal heart valves or damaged heart tissue, giving rise to IE. However, the association between IDTs and IE remains controversial. The aim of this study is to estimate the association between IDTs and IE. Methods -The data in this study were obtained from the Health Insurance Database in Taiwan. We selected two case-only study designs, case-crossover and self-controlled case series, to analyze the data. The advantage of these methods is that confounding factors which do not vary with time are adjusted for implicitly. In the case-crossover design, conditional logistic regression model with exposure to IDTs was used to estimate the risks of IE following an IDT with 4, 8, 12, and 16 weeks delay, respectively. In the self-controlled case series design, conditional Poisson regression model was used to estimate the risk of IE for the risk periods of 1-4, 5-8, 9-12, and 13-16 weeks following an IDT. Results -In total, 9120 and 8181 IE patients were included in case-crossover design and self-controlled case series design, respectively. In case-crossover design, 277 cases and 249 controls received IDTs during the exposure period, and the odds ratio was 1.12 (95% Confidence Interval (CI): 0.94-1.34) for 4 weeks. In self-controlled case series design, we observed that 407 IE occurred during the first four weeks after IDTs, and the age-adjusted incidence rate ratio was 1.14 (95% CI: 1.02-1.26) for 1-4 weeks after IDTs. Conclusions -In both study designs, we did not observe a clinically larger risk for IE in the short periods after IDTs. We also found no association between IDTs and IE among high-risk patients. Therefore, antibiotic prophylaxis for prevention of IE is not required for the

  8. [Pilot testing of an internet based pregnancy planning study "Snart-gravid.dk"].

    Science.gov (United States)

    Mikkelsen, Ellen M; Maindal, Helle Terkildsen

    2011-01-01

    Before launching a new study pilot testing is often recommended, however, it is seldom described in depth. Here, we report extensively on a pilot study using the internet as a new method for recruitment and data collection in a prospective cohort study of women planning a pregnancy.We aimed to enroll 2500 participants in six months and attained more than 75 % after 12 months follow up. To test data completeness and validity we randomized participants to fill either a long or a short version of the baseline questionnaire and compared self reported data with registry based data.We succeeded in enrolling 2288 participants, and participation rate was 82 % after 12 months. We found high correlations (0.96) for self-reported vs. registry based data and no difference in participation rate or data completeness according to questionnaire length. Overall, the internet based methods seem promising and we plan to launch the full study.

  9. Flooding and Health Care Visits for Clostridium Difficile Infection: A Case-Crossover Analysis

    Science.gov (United States)

    Floods can contaminate potable water and other resources, thus increasing the potential for fecal-oral transmission of pathogens. Clostridium difficile is a bacterium that can spread by water and cause acute gastrointestinal illness. It often affects older adults who are hospital...

  10. Extreme Precipitation and Emergency Room Visits for Influenza in Massachusetts: A Case-Crossover Analysis

    Science.gov (United States)

    BACKGROUND: Influenza peaks during the wintertime in temperate regions and during the annual rainy season in tropical regions – however reasons for the observed differences in disease ecology are poorly understood. We hypothesize that episodes of extreme precipitation also result...

  11. Case-crossover analysis of heat-coded deaths and vulnerable subpopulations: Oklahoma, 1990-2011

    Science.gov (United States)

    Moore, Brianna F.; Brooke Anderson, G.; Johnson, Matthew G.; Brown, Sheryll; Bradley, Kristy K.; Magzamen, Sheryl

    2017-11-01

    The extent of the association between temperature and heat-coded deaths, for which heat is the primary cause of death, remains largely unknown. We explored the association between temperature and heat-coded deaths and potential interactions with various demographic and environmental factors. A total of 335 heat-coded deaths that occurred in Oklahoma from 1990 through 2011 were identified using heat-related International Classification of Diseases codes, cause-of-death nomenclature, and narrative descriptions. Conditional logistic regression models examined the association between temperature and heat index on heat-coded deaths. Interaction by demographic factors (age, sex, marital status, living alone, outdoor/heavy labor occupations) and environmental factors (ozone, PM10, PM2.5) was also explored. Temperatures ≥99 °F (the median value) were associated with approximately five times higher odds of a heat-coded death as compared to temperatures effect estimates were attenuated when exposure to heat was characterized by heat index. The interaction results suggest that effect of temperature on heat-coded deaths may depend on sex and occupation. For example, the odds of a heat-coded death among outdoor/heavy labor workers exposed to temperatures ≥99 °F was greater than expected based on the sum of the individual effects (observed OR = 14.0, 95% CI 2.7, 72.0; expected OR = 4.1 [2.8 + 2.3-1.0]). Our results highlight the extent of the association between temperature and heat-coded deaths and emphasize the need for a comprehensive, multisource definition of heat-coded deaths. Furthermore, based on the interaction results, we recommend that states implement or expand heat safety programs to protect vulnerable subpopulations, such as outdoor workers.

  12. Procedures for assessing psychological predictors of injuries in circus artists: a pilot prospective study.

    Science.gov (United States)

    Shrier, Ian; Raglin, John S; Levitan, Emily B; Mittleman, Murray A; Steele, Russell J; Powell, Janette

    2014-06-11

    Research on psychological risk factors for injury has focused on stable traits. Our objective was to test the feasibility of a prospective longitudinal study designed to examine labile psychological states as risk factors of injury. We measured psychological traits at baseline (mood, ways of coping and anxiety), and psychological states every day (1-item questions on anxiety, sleep, fatigue, soreness, self-confidence) before performances in Cirque du Soleil artists of the show "O". Additional questions were added once per week to better assess anxiety (20-item) and mood. Questionnaires were provided in English, French, Russian and Japanese. Injury and exposure data were extracted from electronic records that are kept as part of routine business practices. The 43.9% (36/82) recruitment rate was more than expected. Most artists completed the baseline questionnaires in 15 min, a weekly questionnaire in <2 min and a daily questionnaire in <1 min. We improved the formatting of some questions during the study, and adapted the wording of other questions to improve clarity. There were no dropouts during the entire study, suggesting the questionnaires were appropriate in content and length. Results for sample size calculations depend on the number of artists followed and the minimal important difference in injury rates, but in general, preclude a purely prospective study with daily data collection because of the long follow-up required. However, a prospective nested case-crossover design with data collection bi-weekly and at the time of injury appears feasible. A prospective study collecting psychological state data from subjects who train and work regularly together is feasible, but sample size calculations suggest that the optimal study design would use prospective nested case-crossover methodology.

  13. Correcting for catchment area nonresidency in studies based on tumor-registry data

    International Nuclear Information System (INIS)

    Sposto, R.; Preston, D.L.

    1993-05-01

    We discuss the effect of catchment area nonresidency on estimates of cancer incidence from a tumor-registry-based cohort study and demonstrate that a relatively simple correction is possible in the context of Poisson regression analysis if individual residency histories or the probabilities of residency are known. A comparison of a complete data maximum likelihood analysis with several Poisson regression analyses demonstrates the adequacy of the simple correction in a large simulated data set. We compare analyses of stomach-cancer incidence from the Radiation Effects Research Foundation tumor registry with and without the correction. We also discuss some implications of including cases identified only on the basis of death certificates. (author)

  14. Flooding and intestinal illness due to Clostridium difficile infection: a case-crossover analysis of Massachusetts data, 2003-2007

    Science.gov (United States)

    Background. Climate change has contributed to a rise in extreme weather events, including heavier rainfalls. Floods can cause water bodies to overflow, damage water treatment and drinking water infrastructure, overwhelm sewage treatment facilities, and result in discharges of un...

  15. A case-crossover analyses of fine particulate matter and out-of-hospital sudden unexpected death

    Science.gov (United States)

    Out-of-hospital sudden unexpected deaths (OHSUD) are natural deaths that occur without obvious underlying causes and account for nearly 1 in 6 deaths in the United States. Ambient air pollution is known to be causally related to overall mortality, therefore, we hypothesized that ...

  16. Death by suicide and other externally caused injuries after stroke in Japan (1990-2010): the Japan Public Health Center-based prospective study.

    Science.gov (United States)

    Yamauchi, Takashi; Inagaki, Masatoshi; Yonemoto, Naohiro; Iwasaki, Motoki; Inoue, Manami; Akechi, Tatsuo; Iso, Hiroyasu; Tsugane, Shoichiro

    2014-01-01

    No large population-based prospective study has investigated the risks of suicide and death by other externally caused injuries (ECIs) among stroke patients. The purpose of this study was to examine whether stroke increases the risks of suicide and ECI deaths. We analyzed data from the Japan Public Health Center-based Prospective Study between 1990 and 2010. Poisson regression models were used to calculate adjusted risk ratios (RR) for suicide and ECI deaths. To adjust for unmeasured confounders, case-crossover analyses of all stroke patients who died by suicide and ECIs were also performed. A population-based cohort of 93,027 Japanese residents was established. During the follow-up period, 4793 residents had been diagnosed as having stroke. During this period, there were 22 suicides and 53 ECI deaths among stroke patients and 490 suicides and 675 ECI deaths among those who were stroke-free. Stroke patients were at increased risk for death by suicide and ECIs within the first 5 years after a stroke (suicide: RR = 10.2, 95% confidence interval [CI] = 6.3-16.6; ECI: RR = 12.8, 95% confidence interval = 9.0-18.2). Furthermore, case-crossover analyses confirmed the results of the Poisson regression models. The RRs of suicide and ECI deaths within the first 5 years after a stroke were noticeably high. These findings underscore the need for clinicians and health care professionals to be aware of causes of death after a stroke and closely monitor patients during the first few poststroke years.

  17. Death by suicide and other externally caused injuries following a cancer diagnosis: the Japan Public Health Center-based Prospective Study.

    Science.gov (United States)

    Yamauchi, Takashi; Inagaki, Masatoshi; Yonemoto, Naohiro; Iwasaki, Motoki; Inoue, Manami; Akechi, Tatsuo; Iso, Hiroyasu; Tsugane, Shoichiro

    2014-09-01

    There have been very few population-based prospective studies that have investigated the risks of deaths by suicide and other externally caused injuries (ECIs) among cancer patients in an Asian population. This study investigated whether the risk of death by both suicide and ECIs increases during the first year following the initial diagnosis of cancer. Data were analyzed from a population-based cohort of Japanese residents between 1990 and 2010, collected during the Japan Public Health Center-based Prospective Study. Poisson regression models were used to calculate adjusted risk ratios (RRs) for both suicide and ECI deaths. To adjust for unmeasured confounding factors, case-crossover analyses were conducted for all patients with cancer who died by suicide and ECIs. A population-based cohort of 102,843 Japanese residents was established. During the follow-up period, there were 34 suicides and 48 ECI deaths among patients with cancer, as compared with 527 suicides and 707 ECI deaths among those who did not have cancer. Analyses revealed that those who were newly diagnosed with cancer were at a greatly increased risk of death by suicide and ECIs within the first year after their diagnosis (suicide RR = 23.9, 95% CI: 13.8-41.6; ECI RR = 18.8, 95% CI: 11.4-31.0). Furthermore, the case-crossover analyses generally confirmed the results of the Poisson regressions. The risks of suicide and ECI deaths within the first year after a cancer diagnosis were higher than those among cancer-free populations. A diagnosis of cancer is a critical experience that may increase the risk of fatal outcomes. Copyright © 2014 John Wiley & Sons, Ltd.

  18. Informed consent and registry-based research - the case of the Danish circumcision registry

    DEFF Research Database (Denmark)

    Ploug, Thomas; Holm, Søren

    2017-01-01

    Background: Research into personal health data holds great potential not only for improved treatment but also for economic growth. In these years many countries are developing policies aimed at facilitating such research often under the banner of 'big data'. A central point of debate is whether...... the secondary use of health data requires informed consent if the data is anonymised. In 2013 the Danish Minister of Health established a new register collecting data about all ritual male childhood circumcisions in Denmark. The main purpose of the register was to enable future research into the consequences......) polarised research, and that a person may therefore have a strong and legitimate interest in deciding whether or not such data should be collected and/or used in research. This casts doubt on the claim that the requirement of informed consent could and should be waived for all types of secondary research...

  19. Different effects of bariatric surgical procedures on dyslipidemia: a registry-based analysis.

    Science.gov (United States)

    Spivak, Hadar; Sakran, Nasser; Dicker, Dror; Rubin, Moshe; Raz, Itamar; Shohat, Tamy; Blumenfeld, Orit

    2017-07-01

    The scale and variables linked to bariatric surgery's effect on dyslipidemia have not been conclusive. To compare the effect of Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and adjustable gastric banding (LAGB) on dyslipidemia SETTING: National bariatric surgery registry. Plasma lipids and associated variables were compared at baseline and 1 year (12±4 mo) after surgery for registry patients with dyslipidemia enrolled from June 2013 to August 2014. The greatest mean total-cholesterol (TC) reduction was observed post-RYGB, 226.7±26.4 to 181.3±30.9 mg/dL (19.9%, n = 208), followed by post-SG, 227.9±24.4 to 206.7±34.2 mg/dL (8.9%, n = 1515; Pdyslipidemia, independent of weight loss. Overall, the RYGB achieved the biggest reduction in plasma lipids (TC and LDL), although SG did affect HDL. Our results could aid in the decision-making process regarding the most appropriate procedure for patients with dyslipidemia. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  20. Population based case–control study of serious non-fatal motorcycle crashes

    Science.gov (United States)

    2013-01-01

    Background Motorcycle sales, registration and use are increasing in many countries. The epidemiological literature on risk factors for motorcycle injury is becoming outdated, due to changes in rider demography, licensing regulations, traffic mix and density, road environments, and motorcycle designs and technologies. Further, the potential contribution of road infrastructure and travel speed has not yet been examined. Methods/design A population based case–control study together with a nested case-crossover study is planned. Cases will be motorcycle riders who are injured but not killed in a motorcycle crash on a public road within 150 km radius of Melbourne, Australia, and admitted to one of the study hospitals. Controls will be motorcycle riders who ride through the crash site on the same type of day (weekday or weekend) within an hour of the crash time. Data on rider, bike, and trip characteristics will be collected from the participants by questionnaire. Data on crash site characteristics will be collected in a structured site inspection, and travel speed for the cases will be estimated from these data. Travel speed for the controls will be measured prior to recruitment with a radar traffic detection device as they ride through the crash site. Control sites for the case-crossover study will be selected 1 km upstream from the crash site and matched on either intersection status or road curvature (either straight or cornered). If the initial site selected does not match the case site on these characteristics, then the closest matching site on the case route will be selected. Conditional multivariate logistic regression models will be used to compare risk between the matched case and control riders and to examine associations between road infrastructure and road environment characteristics and crash occurrence. Interactions between type of site and speed will be tested to determine if site type is an effect modifier of the relationship between speed and crash

  1. Assessment of a head support system to prevent pediatric out-of-position: an observational study.

    Science.gov (United States)

    Lopez-Valdes, Francisco J; Forman, Jason L; Ash, Joseph H; Kent, Richard; Alba, Juan J; Segui-Gomez, Maria

    Head injuries are the most common severe injuries sustained by pediatric occupants in road traffic crashes. Preventing children from adopting positions that can result in an increased injury risk due to unfavorable interactions with the restraints is fundamental. The objective of this paper was to assess the effect of a head support system (SS) on the lateral position of the head, the vertical position of the sternum and the shoulder belt fit. Thirty pediatric rear-seat passengers were exposed to two 75-minute trials. Volunteers were restrained by a three-point belt and, if needed, used the appropriate child restraint system for their anthropometry (high-back booster, low-back booster, no booster). A case crossover study was designed in which the volunteers used the head support system (SS) during one of the trials, acting as their own controls (No SS) in the other. Compared to the control group, the head support reduced significantly the 90(th) percentile value of the absolute value of the relative lateral motion of the head, regardless of the restraint used. The system also reduced the maximum downward position of the sternal notch within the low-back booster group. As for the belt fit, the use of the head support improved significantly the position of the shoulder belt on the occupant in the low-back booster and in the no booster groups.

  2. ACE-Inhibitors and the Risk of Urinary Tract Infections : Comparison of a Case-Crossover and Prescription Sequence Symmetry Design

    NARCIS (Netherlands)

    Pouwels, Koen B.; Bos, Jens H.J.; Hak, Eelko

    2014-01-01

    Background: In a post-hoc analysis of a randomized controlled trial (RCT) (HR 1.82, 95%CI, 1.16-2.88) and a prescription sequence symmetry analysis (PSSA) (SR 1.56, 95%CI 1.11-2.20), we observed that angiotensin-converting enzyme inhibitor (ACEi) use was associated with an increased risk of urinary

  3. Birth characteristics and Wilms tumors in children in the Nordic countries: a register-based case-control study.

    Science.gov (United States)

    Schüz, Joachim; Schmidt, Lisbeth Samsø; Kogner, Per; Lähteenmäki, Päivi M; Pal, Niklas; Stokland, Tore; Schmiegelow, Kjeld

    2011-05-01

    Little is known about causes of Wilms tumor. Because of the young age at diagnosis, several studies have looked at various birth characteristics. We conducted a registry-based case-control study involving 690 cases of Wilms tumor aged 0-14 years, occurring in Denmark, Finland, Norway or Sweden during 1985-2006, individually matched to five controls drawn randomly from the Nordic childhood population. Information on birth characteristics was obtained from the population-based medical birth registries. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) using conditional logistic regression analysis. We observed a distinct association between Wilms tumor and high birth weight (≥4 kg) for girls (OR 1.97, CI 1.50-2.59) but not for boys (1.04, 0.78-1.38); overall, the OR was 1.43 (1.17-1.74). Among girls, risk increased by 28% (15-42%) per 500 g increase in birth weight. Large-for-gestational age girls also had a higher risk (2.48, 1.51-4.05), whereas no effect was seen for boys (1.12, 0.60-2.07). An association was seen with Apgar score at 5 min birth order. In our large-scale, registry-based study, we confirmed earlier observations of an association between high birth weight and risk of Wilms tumor, but we found an effect only in girls. The higher risk of infants with low Apgar score might reflect hypoxia causing cell damage, adverse side effects of neonatal treatment or reverse causation as low Apgar score might indicate the presence of a tumor. Copyright © 2010 UICC.

  4. Acute and Subacute Effects of Urban Air Pollution on Cardiopulmonary Emergencies and Mortality: Time Series Studies in Austrian Cities

    Directory of Open Access Journals (Sweden)

    Daniel Rabczenko

    2013-10-01

    Full Text Available Daily pollution data (collected in Graz over 16 years and in the Linz over 18 years were used for time series studies (GAM and case-crossover on the relationship with daily mortality (overall and specific causes of death. Diagnoses of patients who had been transported to hospitals in Linz were also available on a daily basis from eight years for time series analyses of cardiopulmonary emergencies. Increases in air pollutant levels over several days were followed by increases in mortality and the observed effects increased with the length of the exposure window considered, up to a maximum of 15 days. These mortality changes in Graz and Linz showed similar patterns like the ones found before in Vienna. A significant association of mortality could be demonstrated with NO2, PM2.5 and PM10 even in summer, when concentrations are lower and mainly related to motor traffic. Cardiorespiratory ambulance transports increased with NO2/PM2.5/PM10 by 2.0/6.1/1.7% per 10 µg/m³ on the same day. Monitoring of NO2 (related to motor traffic and fine particulates at urban background stations predicts acute effects on cardiopulmonary emergencies and extended effects on cardiopulmonary mortality. Both components of urban air pollution are indicators of acute cardiopulmonary health risks, which need to be monitored and reduced, even below current standards.

  5. Recruiting former melanoma patients via hospitals in comparison to office-based dermatologists in a register-based cohort study that required indirect contact

    Directory of Open Access Journals (Sweden)

    S. R. Zeissig

    2017-11-01

    Full Text Available Abstract Background There are detailed reviews about different recruitment strategies, but not with regard to differences between recruitment of hospital-based versus office-based physicians. Within this study, the two different recruitment schemes are compared. Advantages and disadvantages of different ways of recruitment in registry-based studies are discussed. Methods In a cross-sectional cancer-registry-based study, long-term melanoma patients were contacted by dermatologists rather than directly by the registry on the basis of the legal situation. Logistic regression models and generalized estimating equations were used to assess effects of various patient and physician characteristics on participation and data quality. Especially differences between hospital-based versus office-based dermatologists are evaluated. Results Seventy two out of 112 contacted dermatologists took part in the study (64.3%. The cooperation proportion was 52.2% (689 participants/1320 contacted patients. Participants and non-participants differed regarding age and sex, but not regarding other social demographic factors and cancer stage. We did not observe a difference in patient participation between hospital-based versus office-based dermatologists (OR 1.08 [CI 0.84–1.39]; p = 0.57. However, medical data provided by the cancer registry were better for participants registered and recruited by hospitals. Conclusions In cohort studies with epidemiological cancer registries, recruitment via physicians has potential disadvantages and is more complex. If this indirect way of contact is mandatory, we recommend recruitment procedures including hospital-based rather than office-based physicians. However, physician characteristics were not associated with outcome.

  6. Title: Studies on drug switchability showed heterogeneity in methodological approaches: a scoping review.

    Science.gov (United States)

    Belleudi, Valeria; Trotta, Francesco; Vecchi, Simona; Amato, Laura; Addis, Antonio; Davoli, Marina

    2018-05-16

    Several drugs share the same therapeutic indication, including those undergoing patent expiration. Concerns on the interchangeability are frequent in clinical practice, challenging the evaluation of switchability through observational research. To conduct a scoping review of observational studies on drug switchability to identify methodological strategies adopted to deal with bias and confounding. We searched PubMed, EMBASE, and Web of Science (updated 1/31/2017) to identify studies evaluating switchability in terms of effectiveness/safety outcomes or compliance. Three reviewers independently screened studies extracting all characteristics. Strategies to address confounding, particularly, previous drug use and switching reasons were considered. All findings were summarized in descriptive analyses. Thirty-two studies, published in the last 10 years, met the inclusion criteria. Epilepsy, cardiovascular and rheumatology were the most frequently represented clinical areas. 75% of the studies reported data on effectiveness/safety outcomes. The most frequent study design was cohort (65.6%) followed by case-control (21.9%) and self-controlled (12.5%). Case-control and case-crossover studies showed homogeneous methodological strategies to deal with bias and confounding. Among cohort studies, the confounding associated with previous drug use was addressed introducing variables in multivariate model (47.3%) or selecting only adherent patients (14.3%). Around 30% of cohort studies did not report reasons for switching. In the remaining 70%, clinical parameters or previous occurrence of outcomes were measured to identify switching connected with lack of effectiveness or adverse events. This study represents a starting point for researchers and administrators who are approaching the investigation and assessment of issues related to interchangeability of drugs. Copyright © 2018. Published by Elsevier Inc.

  7. Air pollution and cardiovascular and respiratory disease: Rationale and methodology of CAPACITY study

    Science.gov (United States)

    Rabiei, Katayoun; Hosseini, Sayed Mohsen; Sadeghi, Erfan; Jafari-Koshki, Tohid; Rahimi, Mojtaba; Shishehforoush, Mansour; Lahijanzadeh, Ahmadreza; Sadeghian, Babak; Moazam, Elham; Mohebi, Mohammad Bagher; Ezatian, Victoria; Sarrafzadegan, Nizal

    2017-01-01

    BACKGROUND Considering the high level of air pollution and its impact on health, we aimed to study the correlation of air pollution with hospitalization and mortality of cardiovascular (CVD) and respiratory diseases (ResD) (CAPACITY) to determine the effects of air pollutants on CVD and ResD hospitalizations and deaths in Isfahan, Iran. METHODS Hourly levels of air pollutants including particulate matter (PM), carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), and ozone (O3), information of CVD and ResD admissions and death certificate were obtained respectively from Department of Environment (DOE), Iran, hospitals and cemetery. Time series and case-crossover model were used to find the impact of air pollutants. This paper only summarizes the descriptive findings of the CAPACITY study. RESULTS The total number of hospitalized patients were 23781 in 2010 and 22485 in 2011. The most frequent cause of hospitalization and death was ischemic heart diseases in both years. While the mean annual levels of O3, CO, and PM10 were lower in 2011 than in 2010, NO2 and SO2 levels higher in 2011. In both years, PM10 was similarly increased during last month of fall, late spring and early summer. In 2011, the PM2.5 and PM10 monthly trend of change were similar. CONCLUSION The CAPACITY study is one of the few large-scale studies that evaluated the effects of air pollutants on a variety of CVD and ResD in a large city of Iran. This study can provide many findings that could clarify the effects of these pollutants on the incidence and burden of both disease groups. PMID:29643921

  8. Air pollution and cardiovascular and respiratory disease: Rationale and methodology of CAPACITY study.

    Science.gov (United States)

    Rabiei, Katayoun; Hosseini, Sayed Mohsen; Sadeghi, Erfan; Jafari-Koshki, Tohid; Rahimi, Mojtaba; Shishehforoush, Mansour; Lahijanzadeh, Ahmadreza; Sadeghian, Babak; Moazam, Elham; Mohebi, Mohammad Bagher; Ezatian, Victoria; Sarrafzadegan, Nizal

    2017-11-01

    Considering the high level of air pollution and its impact on health, we aimed to study the correlation of air pollution with hospitalization and mortality of cardiovascular (CVD) and respiratory diseases (ResD) (CAPACITY) to determine the effects of air pollutants on CVD and ResD hospitalizations and deaths in Isfahan, Iran. Hourly levels of air pollutants including particulate matter (PM), carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), and ozone (O3), information of CVD and ResD admissions and death certificate were obtained respectively from Department of Environment (DOE), Iran, hospitals and cemetery. Time series and case-crossover model were used to find the impact of air pollutants. This paper only summarizes the descriptive findings of the CAPACITY study. The total number of hospitalized patients were 23781 in 2010 and 22485 in 2011. The most frequent cause of hospitalization and death was ischemic heart diseases in both years. While the mean annual levels of O3, CO, and PM10 were lower in 2011 than in 2010, NO2 and SO2 levels higher in 2011. In both years, PM10 was similarly increased during last month of fall, late spring and early summer. In 2011, the PM2.5 and PM10 monthly trend of change were similar. The CAPACITY study is one of the few large-scale studies that evaluated the effects of air pollutants on a variety of CVD and ResD in a large city of Iran. This study can provide many findings that could clarify the effects of these pollutants on the incidence and burden of both disease groups.

  9. Air pollution and cardiovascular and respiratory disease: Rationale and methodology of CAPACITY study

    Directory of Open Access Journals (Sweden)

    Katayoun Rabiei

    2017-11-01

    Full Text Available BACKGROUND: Considering the high level of air pollution and its impact on health, we aimed to study the correlation of air pollution with hospitalization and mortality of cardiovascular (CVD and respiratory diseases (ResD (CAPACITY to determine the effects of air pollutants on CVD and ResD hospitalizations and deaths in Isfahan, Iran.METHODS: Hourly levels of air pollutants including particulate matter (PM, carbon monoxide (CO, nitrogen dioxide (NO2, sulfur dioxide (SO2, and ozone (O3, information of CVD and ResD admissions and death certificate were obtained respectively from Department of Environment (DOE, Iran, hospitals and cemetery. Time series and case-crossover model were used to find the impact of air pollutants. This paper only summarizes the descriptive findings of the CAPACITY study.RESULTS: The total number of hospitalized patients were 23781 in 2010 and 22485 in 2011. The most frequent cause of hospitalization and death was ischemic heart diseases in both years. While the mean annual levels of O3, CO, and PM10 were lower in 2011 than in 2010, NO2 and SO2 levels higher in 2011. In both years, PM10 was similarly increased during last month of fall, late spring and early summer. In 2011, the PM2.5 and PM10 monthly trend of change were similar.CONCLUSION: The CAPACITY study is one of the few large-scale studies that evaluated the effects of air pollutants on a variety of CVD and ResD in a large city of Iran. This study can provide many findings that could clarify the effects of these pollutants on the incidence and burden of both disease groups. 

  10. A mixed method to evaluate burden of malaria due to flooding and waterlogging in Mengcheng County, China: a case study.

    Science.gov (United States)

    Ding, Guoyong; Gao, Lu; Li, Xuewen; Zhou, Maigeng; Liu, Qiyong; Ren, Hongyan; Jiang, Baofa

    2014-01-01

    Malaria is a highly climate-sensitive vector-borne infectious disease that still represents a significant public health problem in Huaihe River Basin. However, little comprehensive information about the burden of malaria caused by flooding and waterlogging is available from this region. This study aims to quantitatively assess the impact of flooding and waterlogging on the burden of malaria in a county of Anhui Province, China. A mixed method evaluation was conducted. A case-crossover study was firstly performed to evaluate the relationship between daily number of cases of malaria and flooding and waterlogging from May to October 2007 in Mengcheng County, China. Stratified Cox models were used to examine the lagged time and hazard ratios (HRs) of the risk of flooding and waterlogging on malaria. Years lived with disability (YLDs) of malaria attributable to flooding and waterlogging were then estimated based on the WHO framework of calculating potential impact fraction in the Global Burden of Disease study. A total of 3683 malaria were notified during the study period. The strongest effect was shown with a 25-day lag for flooding and a 7-day lag for waterlogging. Multivariable analysis showed that an increased risk of malaria was significantly associated with flooding alone [adjusted hazard ratio (AHR)  = 1.467, 95% CI = 1.257, 1.713], waterlogging alone (AHR = 1.879, 95% CI = 1.696, 2.121), and flooding and waterlogging together (AHR = 2.926, 95% CI = 2.576, 3.325). YLDs per 1000 of malaria attributable to flooding alone, waterlogging alone and flooding and waterlogging together were 0.009 per day, 0.019 per day and 0.022 per day, respectively. Flooding and waterlogging can lead to higher burden of malaria in the study area. Public health action should be taken to avoid and control a potential risk of malaria epidemics after these two weather disasters.

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

    Science.gov (United States)

    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.

  12. Associations of PM2.5 and Black Carbon with Hospital Emergency Room Visits during Heavy Haze Events: A Case Study in Beijing, China.

    Science.gov (United States)

    Liang, Fengchao; Tian, Lin; Guo, Qun; Westerdahl, Dane; Liu, Yang; Jin, Xiaobin; Li, Guoxing; Pan, Xiaochuan

    2017-07-05

    In January 2013, severe haze events over northeastern China sparked substantial health concerns. This study explores the associations of fine particulate matter less than 2.5 μm (PM 2.5 ) and black carbon (BC) with hospital emergency room visits (ERVs) during a haze season in Beijing. During that period, daily counts of ERVs for respiratory, cardiovascular and ocular diseases were obtained from a Level-3A hospital in Beijing from 1 December 2012 to 28 February 2013, and associations of which with PM 2.5 and BC were estimated by time-stratified case-crossover analysis in single- and two-pollutant models. We found a 27.5% (95% confidence interval (CI): 13.0, 43.9%) increase in respiratory ERV (lag02), a 19.4% (95% CI: 2.5, 39.0%) increase in cardiovascular ERV (lag0), and a 12.6% (95% CI: 0.0, 26.7%) increase in ocular ERV (lag0) along with an interquartile range (IQR) increase in the PM 2.5 . An IQR increase of BC was associated with 27.6% (95% CI: 9.6, 48.6%) (lag02), 18.8% (95% CI: 1.4, 39.2%) (lag0) and 11.8% (95% CI: -1.4, 26.8%) (lag0) increases for changes in these same health outcomes respectively. Estimated associations were consistent after adjusting SO₂ or NO₂ in two-pollutant models. This study provides evidence that improving air quality and reducing haze days would greatly benefit the population health.

  13. Markers of DNA/RNA damage from oxidation as predictors of a registry-based diagnosis of psychiatric illness in type 2 diabetic patients

    DEFF Research Database (Denmark)

    Jorgensen, Anders; Siersma, Volkert; Davidsen, Annette S.

    2018-01-01

    Oxidative stress is a potential biological mediator of the higher rates of psychiatric illness (PI) observed after the onset of type 2 diabetes (T2DM). We investigated validated urinary markers of systemic DNA/RNA damage from oxidation (8-oxodG/8-oxoGuo respectively) as predictors of incident PI......, this association was most predominant in minor PIs (unipolar depression and anxiety) compared to major PIs such as schizophrenia and bipolar disorder. These observations indicate that higher levels of systemic oxidative stress are not associated with a higher risk of PI after T2DM onset. Only PI patients treated...... in a cohort of 1381 newly diagnosed T2DM patients, who were followed prospectively for a total of 19 years after diagnosis. Psychiatric diagnoses were from Danish national registries. Patients were examined at the time of diagnosis and at a 6-year follow-up. At baseline, 8-oxodG was slightly lower in PI vs...

  14. The International Collaboration for Autism Registry Epidemiology (iCARE): Multinational Registry-Based Investigations of Autism Risk Factors and Trends

    Science.gov (United States)

    Schendel, Diana E.; Bresnahan, Michaeline; Carter, Kim W.; Francis, Richard W.; Gissler, Mika; Grønborg, Therese K.; Gross, Raz; Gunnes, Nina; Hornig, Mady; Hultman, Christina M.; Langridge, Amanda; Lauritsen, Marlene B.; Leonard, Helen; Parner, Erik T.; Reichenberg, Abraham; Sandin, Sven; Sourander, Andre; Stoltenberg, Camilla; Suominen, Auli; Surén, Pål; Susser, Ezra

    2013-01-01

    The International Collaboration for Autism Registry Epidemiology (iCARE) is the first multinational research consortium (Australia, Denmark, Finland, Israel, Norway, Sweden, USA) to promote research in autism geographical and temporal heterogeneity, phenotype, family and life course patterns, and etiology. iCARE devised solutions to challenges in…

  15. Application for disability pension and change in use of prescribed drugs. A regional Danish cohort study.

    Science.gov (United States)

    Petersen, Thomas T; Fonager, Kirsten; Bøggild, Henrik; Pedersen, Lars; Mortensen, Jens T

    2009-06-01

    To investigate if a pending application for disability pension had an influence on the applicant's purchase of medical drugs, with a particular focus on musculoskeletal disorders and the use of painkillers. We performed a registry-based follow-up study including 12,020 applicants for disability pension in a Danish county from 1995 to 2000 and linked this information to a database of drug prescriptions. Purchase of drug was calculated for the 6-month period just before the decision and for the 6-month period 2 years later. Changes in a 2-year time period were estimated by differences in purchase rates. Furthermore, the proportion of applicants with an increased purchase of drugs and the proportion of applicants who ceased buying drugs were estimated. The results were stratified by diagnosis and result of application (awarded/rejected). The analyses were furthermore restricted to musculoskeletal disorders and the use of painkillers. At baseline 81% had a purchase and after the 2-year time period 11% ceased buying prescribed drugs. Half of all applicants increased the purchase of drugs. For musculoskeletal disorders one third had an increased purchase rate of painkillers while one fourth ceased purchase of drugs with variations in different diagnostic subgroups. The major changes of drug purchase after a pending application for disability pension are probably ascribed to characteristics of the diseases underlying the disability.

  16. Celiac Disease Is Associated with Childhood Psychiatric Disorders: A Population-Based Study.

    Science.gov (United States)

    Butwicka, Agnieszka; Lichtenstein, Paul; Frisén, Louise; Almqvist, Catarina; Larsson, Henrik; Ludvigsson, Jonas F

    2017-05-01

    To determine the risk of future childhood psychiatric disorders in celiac disease, assess the association between previous psychiatric disorders and celiac disease in children, and investigate the risk of childhood psychiatric disorders in siblings of celiac disease probands. This was a nationwide registry-based matched cohort study in Sweden with 10 903 children (aged celiac disease and 12 710 of their siblings. We assessed the risk of childhood psychiatric disorders (any psychiatric disorder, psychotic disorder, mood disorder, anxiety disorder, eating disorder, psychoactive substance misuse, behavioral disorder, attention-deficit hyperactivity disorder [ADHD], autism spectrum disorder [ASD], and intellectual disability). HRs of future psychiatric disorders in children with celiac disease and their siblings was estimated by Cox regression. The association between previous diagnosis of a psychiatric disorder and current celiac disease was assessed using logistic regression. Compared with the general population, children with celiac disease had a 1.4-fold greater risk of future psychiatric disorders. Childhood celiac disease was identified as a risk factor for mood disorders, anxiety disorders, eating disorders, behavioral disorders, ADHD, ASD, and intellectual disability. In addition, a previous diagnosis of a mood, eating, or behavioral disorder was more common before the diagnosis of celiac disease. In contrast, siblings of celiac disease probands were at no increased risk of any of the investigated psychiatric disorders. Children with celiac disease are at increased risk for most psychiatric disorders, apparently owing to the biological and/or psychological effects of celiac disease. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Study

    Directory of Open Access Journals (Sweden)

    Erum Zahir

    2017-05-01

    Full Text Available Physicochemical properties like density, viscosity, boiling point, saponification value (SV, iodine value (IV,and peroxide value (PV of Corn and Mustard oils were studied to evaluate the compositional quality of oils and also to investigate the effect on the use of same oil for repeated frying as it ultimately changes the physicochemical, nutritional and sensory properties of the oil. FT-IR spectroscopy was used to evaluate the degree of oxidation after heating and frying processes. Results revealed that due to the temperature change in the oil there is a notable difference in the spectral band which showed that the proportions of the fatty acids were changed. The spectra of Corn oil at the boiling point and at multiple frying times with a piece of potato showed frequencies in range of 2852.7–2926.0 cm−1 while in Mustard oil an additional peak was observed at 3633.8 cm−1 which exhibits the secondary oxidized product formation.

  18. Antiepileptic drugs and risk of suicide: a nationwide study

    DEFF Research Database (Denmark)

    Olesen, Jonas Bjerring; Hansen, Peter Riis; Erdal, Jesper

    2010-01-01

    . The case-crossover analysis estimated AED treatment initiation to increase the risk of suicide (odds ratio (OR): 1.84, 95% confidence interval (CI): 1.36-2.49). Clonazepam (OR: 2.01, CI: 1.25-3.25), valproate (OR: 2.08, CI: 1.01-4.16), lamotrigine (OR: 3.15, CI: 1.35-7.34) and phenobarbital (OR: 1.96, CI...... that clonazepam, valproate, lamotrigine and phenobarbital relatively shortly after treatment initiation may increase the risk of suicide. The increased risk of suicide associated with these AEDs appears to be a consistent finding. Copyright (C) 2010 John Wiley & Sons, Ltd...

  19. Initiation and persistence with dual antiplatelet therapy after acute myocardial infarction

    DEFF Research Database (Denmark)

    Green, Anders; Pottegård, Anton; Broe, Anne

    2016-01-01

    OBJECTIVES: The study investigated dual antiplatelet therapy (DAPT) patterns over time and patient characteristics associated with the various treatments in a myocardial infarction (MI) population. DESIGN: A registry-based observational cohort study was performed using antecedent data. SETTING: T...

  20. Challenges in translating end points from trials to observational cohort studies in oncology

    Directory of Open Access Journals (Sweden)

    Ording AG

    2016-06-01

    Full Text Available Anne Gulbech Ording,1 Deirdre Cronin-Fenton,1 Vera Ehrenstein,1 Timothy L Lash,1,2 John Acquavella,1 Mikael Rørth,1 Henrik Toft Sørensen1 1Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 2Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA Abstract: Clinical trials are considered the gold standard for examining drug efficacy and for approval of new drugs. Medical databases and population surveillance registries are valuable resources for post-approval observational research, which are increasingly used in studies of benefits and risk of new cancer drugs. Here, we address the challenges in translating endpoints from oncology trials to observational studies. Registry-based cohort studies can investigate real-world safety issues – including previously unrecognized concerns – by examining rare endpoints or multiple endpoints at once. In contrast to clinical trials, observational cohort studies typically do not exclude real-world patients from clinical practice, such as old and frail patients with comorbidity. The observational cohort study complements the clinical trial by examining the effectiveness of interventions applied in clinical practice and by providing evidence on long-term clinical outcomes, which are often not feasible to study in a clinical trial. Various endpoints can be included in clinical trials, such as hard endpoints, soft endpoints, surrogate endpoints, and patient-reported endpoints. Each endpoint has it strengths and limitations for use in research studies. Endpoints used in oncology trials are often not applicable in observational cohort studies which are limited by the setting of standard clinical practice and by non-standardized endpoint determination. Observational studies can be more helpful moving research forward if they restrict focus to appropriate and valid endpoints. Keywords: endpoint determination, medical oncology

  1. Does heavy physical exertion trigger myocardial infarction?

    DEFF Research Database (Denmark)

    Hallqvist, J; Möller, J; Ahlbom, A

    2000-01-01

    To study possible triggering of first events of acute myocardial infarction by heavy physical exertion, the authors conducted a case-crossover analysis (1993-1994) within a population-based case-referent study in Stockholm County, Sweden (the Stockholm Heart Epidemiology Program). Interviews were...

  2. A benchmarking study of two trauma centres highlighting limitations when standardising mortality for comorbidity

    Directory of Open Access Journals (Sweden)

    McKenzie Gilbert

    2008-01-01

    Full Text Available Abstract Introduction A continuous process of trauma centre evaluation is essential to ensure the development and progression of trauma care at regional, national and international levels. Evaluation may be by comparison between pooled datasets or by direct benchmarking between centres. This study attempts to benchmark mortality at two trauma centres standardising this for multiple case-mix factors, which includes the prevalence of individual background pre-existing diseases within the study population. Methods Trauma patients with an Injury Severity Score (ISS >15 admitted to the two centres in 2001 and 2002 were included in the study with the exception of those who died in the emergency department. Patient characteristics were analysed in terms of 18 case-mix factors including Glasgow Coma Scale on arrival, Injury Severity Score and the presence or absence of 9 co-morbidity types, and patient outcome was compared based on in-hospital mortality before and after standardisation. Results Crude mortality was greater at UHNS (18.2 vs 14.5% with a non-significant odds ratio of 1.31 prior to adjusting for case-mix (P = 0.171. Adjustment for case mix using logistic regression analysis altered the odds ratio to 1.64, which was not significant (P = 0.069. Discussion This study did not demonstrate any significant difference in the outcome of patients treated at either hospital during the study period. More importantly it has raised several important methodological issues pertinent to researchers undertaking registry based benchmarking studies. Data at the two registries was collected by personnel with differing backgrounds, in formats that were not completely compatible and was collected for patients that met different admissions criteria. The inclusion of a meaningful analysis of pre-existing disease was limited by the availability of robust data and sample size. We suggest greater communication between trauma research coordinators to ensure equivalent

  3. External Validation of the European Hernia Society Classification for Postoperative Complications after Incisional Hernia Repair: A Cohort Study of 2,191 Patients.

    Science.gov (United States)

    Kroese, Leonard F; Kleinrensink, Gert-Jan; Lange, Johan F; Gillion, Jean-Francois

    2018-03-01

    Incisional hernia is a frequent complication after midline laparotomy. Surgical hernia repair is associated with complications, but no clear predictive risk factors have been identified. The European Hernia Society (EHS) classification offers a structured framework to describe hernias and to analyze postoperative complications. Because of its structured nature, it might prove to be useful for preoperative patient or treatment classification. The objective of this study was to investigate the EHS classification as a predictor for postoperative complications after incisional hernia surgery. An analysis was performed using a registry-based, large-scale, prospective cohort study, including all patients undergoing incisional hernia surgery between September 1, 2011 and February 29, 2016. Univariate analyses and multivariable logistic regression analysis were performed to identify risk factors for postoperative complications. A total of 2,191 patients were included, of whom 323 (15%) had 1 or more complications. Factors associated with complications in univariate analyses (p < 0.20) and clinically relevant factors were included in the multivariable analysis. In the multivariable analysis, EHS width class, incarceration, open surgery, duration of surgery, Altemeier wound class, and therapeutic antibiotic treatment were independent risk factors for postoperative complications. Third recurrence and emergency surgery were associated with fewer complications. Incisional hernia repair is associated with a 15% complication rate. The EHS width classification is associated with postoperative complications. To identify patients at risk for complications, the EHS classification is useful. Copyright © 2017. Published by Elsevier Inc.

  4. Does childhood cancer affect parental divorce rates? A population-based study.

    Science.gov (United States)

    Syse, Astri; Loge, Jon H; Lyngstad, Torkild H

    2010-02-10

    PURPOSE Cancer in children may profoundly affect parents' personal relationships in terms of psychological stress and an increased care burden. This could hypothetically elevate divorce rates. Few studies on divorce occurrence exist, so the effect of childhood cancers on parental divorce rates was explored. PATIENTS AND METHODS Data on the entire Norwegian married population, age 17 to 69 years, with children age 0 to 20 years in 1974 to 2001 (N = 977,928 couples) were retrieved from the Cancer Registry, the Central Population Register, the Directorate of Taxes, and population censuses. Divorce rates for 4,590 couples who were parenting a child with cancer were compared with those of otherwise similar couples by discrete-time hazard regression models. Results Cancer in a child was not associated with an increased risk of parental divorce overall. An increased divorce rate was observed with Wilms tumor (odds ratio [OR], 1.52) but not with any of the other common childhood cancers. The child's age at diagnosis, time elapsed from diagnosis, and death from cancer did not influence divorce rates significantly. Increased divorce rates were observed for couples in whom the mothers had an education greater than high school level (OR, 1.16); the risk was particularly high shortly after diagnosis, for CNS cancers and Wilms tumors, for couples with children 0 to 9 years of age at diagnosis, and after a child's death. CONCLUSION This large, registry-based study shows that cancer in children is not associated with an increased parental divorce rate, except with Wilms tumors. Couples in whom the wife is highly educated appear to face increased divorce rates after a child's cancer, and this may warrant additional study.

  5. Using NASA Satellite Aerosol Optical Depth to Enhance PM2.5 Concentration Datasets for Use in Human Health and Epidemiology Studies

    Science.gov (United States)

    Huff, A. K.; Weber, S.; Braggio, J.; Talbot, T.; Hall, E.

    2012-12-01

    are being correlated with data on inpatient hospitalizations and emergency room visits for seven respiratory and cardiovascular diseases using statistical case-crossover analyses. Preliminary results will be discussed regarding the potential for the addition of AOD data to increase the correlation between PM2.5 concentrations and health outcomes. Environmental public health tracking programs associated with the Maryland Department of Health and Mental Hygiene, the New York State Department of Health, the CDC, and the U.S. EPA have expressed interest in using the results of this study to enhance their existing environmental health surveillance activities.

  6. Benzodiazepine and Z-drug use and risk of pneumonia in patients with chronic kidney disease: A population-based nested case-control study.

    Science.gov (United States)

    Wang, Meng-Ting; Wang, Yun-Han; Chang, Hsin-An; Tsai, Chen-Liang; Yang, Ya-Sung; Lin, Chen Wei; Kuo, Cheng-Chin; Hsu, Yu-Juei

    2017-01-01

    Concerns were raised about pneumonia development from benzodiazepines (BZDs) and Z-drugs, but direct evidence is limited, conflicting and without examining the highly susceptible patients with chronic kidney disease (CKD) nor specifying the risk for different drug utilizations. This study aimed to investigate whether use of BZDs and Z-drugs was each associated with an increased risk of pneumonia in a CKD population. We performed a nested case-control study of 36,880 CKD patients analyzing the Taiwan National Health Insurance Database between 01/1/2000 and 12/31/2011. Among the study cohort, we identified 4,533 cases of pneumonia based on validated disease codes, chest x-ray examination, and prescriptions of respiratory antibiotics, and randomly selected 16,388 controls from risk sets, matched by sex, age, and number of CKD-related hospitalizations. All prescription filling records of BZDs and Z-drugs in the year before the event/index date were analyzed for cases and controls. Conditional logistic regressions were performed to estimate the odds ratios (ORs). Current use of BZDs was associated with a 1.31-fold (95% CI, 1.18-1.26) increased risk of pneumonia compared to nonuse, but not for recent and past use. The risk from current BZD use was confined to new initiation (adjusted OR, 2.47; 95% CI, 2.02-3.03) or use for ≤ 30 days, and elevated to 2.88-fold (95% CI, 1.87-4.42) with parenteral administration. New initiation and current short-term use of Z-drugs was associated with a 2.94-fold (95% CI, 1.65-5.26) and 1.75-fold (95% CI, 1.13-2.72) increased risk of pneumonia, respectively. The findings were robust to adoption of a case-crossover study that analyzed cases only. Use of BZRAs is associated with an increased risk of pneumonia in CKD patients, especially for patients newly initiating BZDs or Z-drugs or those injected with BZDs. Physicians should exercise cautions for signs of pneumonia when prescribing BZDs or Z-drugs to CKD patients.

  7. Chronic pain patients can be classified into four groups: Clustering-based discriminant analysis of psychometric data from 4665 patients referred to a multidisciplinary pain centre (a SQRP study.

    Directory of Open Access Journals (Sweden)

    Emmanuel Bäckryd

    Full Text Available To subgroup chronic pain patients using psychometric data and regress the variables most responsible for subgroup discrimination.Cross-sectional, registry-based study.Chronic pain patients assessed at a multidisciplinary pain centre between 2008 and 2015.Data from the Swedish quality registry for pain rehabilitation (SQRP were retrieved and analysed by principal component analysis, hierarchical clustering analysis, and partial least squares-discriminant analysis.Four subgroups were identified. Group 1 was characterized by low "psychological strain", the best relative situation concerning pain characteristics (intensity and spreading, the lowest frequency of fibromyalgia, as well as by a slightly older age. Group 2 was characterized by high "psychological strain" and by the most negative situation with respect to pain characteristics (intensity and spreading. Group 3 was characterized by high "social distress", the longest pain durations, and a statistically higher frequency of females. The frequency of three neuropathic pain conditions was generally lower in this group. Group 4 was characterized by high psychological strain, low "social distress", and high pain intensity.The identification of these four clusters of chronic pain patients could be useful for the development of personalized rehabilitation programs. For example, the identification of a subgroup characterized mainly by high perceived "social distress" raises the question of how to best design interventions for such patients. Differentiating between clinically important subgroups and comparing how these subgroups respond to interventions is arguably an important area for further research.

  8. Use of Sleep Medications and Mortality: The Hordaland Health Study.

    Science.gov (United States)

    Sivertsen, Børge; Madsen, Ida E H; Salo, Paula; Tell, Grethe S; Øverland, Simon

    2015-06-01

    Previous research suggests a possible link between the use of sleep medications and mortality, but findings are mixed and well-controlled community-based studies are lacking. The aim of the current study was to examine the prospective association between sleep medications and all-cause mortality. Using a cohort design with 13-15 years of follow-up, we linked self-reported medication use and data on possible confounders from the Hordaland Health Study (HUSK N = 21,826) obtained over the period 1997-1999 to mortality data from the Norwegian Cause of Death Registry. Users of sleep medications (n = 159) were defined as those reporting intake of any prescribed sleep medication (coded according to the Anatomical Therapeutic Chemical [ATC] classification system) on the day before participation in HUSK. Users of sleep medications were also asked if their intake was on a daily or a non-daily basis. Analyses presented are adjusted for sociodemographic and lifestyle factors, mental and physical health, and other medication use. We found that both type and frequency of sleep medication use were associated with increased general mortality risk. Compared with participants not using sleep medications, those who reported any use had a twofold risk for mortality (95 % confidence interval [CI] 1.1-3.7); the hazard ratio (HR) was 2.9 (95 % CI 1.4-5.9) for daily and 1.1 (95 % CI 0.3-3.4) for non-daily users. Mortality risk was higher for benzodiazepines (HR 3.1; 95 % CI 1.3-7.6), but not significant for short-acting benzodiazepine agonists (HR 1.5; 95 % CI 0.7-3.5). Community dwellers who use sleep medications, particularly benzodiazepines, had a significantly increased risk of dying during the 13-15 years of follow-up. The low numbers of individuals reporting chronic usage indicate that the data should be interpreted with great caution, and more well-controlled studies with registry-based information on sleep medication use are needed to further examine the potential

  9. Parental Occupational Exposure to Organic Solvents and Testicular Germ Cell Tumors in their Offspring: NORD-TEST Study.

    Science.gov (United States)

    Le Cornet, Charlotte; Fervers, Béatrice; Pukkala, Eero; Tynes, Tore; Feychting, Maria; Hansen, Johnni; Togawa, Kayo; Nordby, Karl-Christian; Oksbjerg Dalton, Susanne; Uuksulainen, Sanni; Wiebert, Pernilla; Woldbæk, Torill; Skakkebæk, Niels E; Olsson, Ann; Schüz, Joachim

    2017-06-30

    Testicular germ cell tumors (TGCT) were suggested to have a prenatal environmentally related origin. The potential endocrine disrupting properties of certain solvents may interfere with the male genital development in utero . We aimed to assess the association between maternal and paternal occupational exposures to organic solvents during the prenatal period and TGCT risk in their offspring. This registry-based case control study included TGCT cases aged 14–49 y ( n =8,112) diagnosed from 1978 to 2012 in Finland, Norway, and Sweden. Controls ( n =26,264) were randomly selected from the central population registries and were individually matched to cases on year and country of birth. Occupational histories of parents prior to the child’s birth were extracted from the national censuses. Job codes were converted into solvent exposure using the Nordic job-Nordic Occupational Cancer Study Job-Exposure Matrix. Conditional logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI). Overall, no association was found between prenatal maternal exposure to solvents and TGCT risk. In subset analyses using only mothers for whom occupational information was available in the year of or in the year prior to the child’s birth, there was an association with maternal exposure to aromatic hydrocarbon solvents (ARHC) (OR=1.53; CI: 1.08, 2.17), driven by exposure to toluene (OR=1.67; CI: 1.02, 2.73). No association was seen for any paternal occupational exposure to solvents with the exception of exposure to perchloroethylene in Finland (OR=2.42; CI: 1.32, 4.41). This study suggests a modest increase in TGCT risk associated with maternal prenatal exposure to ARHC. https://doi.org/10.1289/EHP864.

  10. Is mortality after childhood cancer dependent on social or economic resources of parents? A population-based study.

    Science.gov (United States)

    Syse, Astri; Lyngstad, Torkild Hovde; Kravdal, Oystein

    2012-04-15

    Diagnostic and treatment protocols for childhood cancer are generally standardized, and therefore, survival ought to be fairly equal across social strata in societies with free public health care readily available. Nevertheless, our study explores whether there are disparities in mortality after childhood cancer in Norway depending on socioeconomic status of parents. Limited knowledge on differentials exists from earlier analyses. Discrete-time hazard regression models for all-cause mortality for the first 10 years after diagnosis were estimated for all Norwegian children (younger than 20 years), who were diagnosed with cancer during 1974-2007 (N = 6,280), using data from five national registers. Mortality was reduced by about 15% for children with highly educated mothers and children without siblings. These effects were most pronounced for cancers predicted to encompass intense, long-lasting treatments resulting in chronic health problems. Neither earnings nor the marital status of parents affected children's survival. This large, registry-based study suggests that time constraints and various noneconomic rewards of parents from their education appears to have an impact on childhood cancer survival. It may be that children with resourceful parents are healthier at the outset and/or are more likely to avoid later health problems. It may also be that children of well-informed and strongly involved parents are offered better treatment or are able to make better use of what is offered, for instance, by adhering more closely to recommendations for follow-up treatment. The possibility of such differentials in offered and actual treatment should be addressed in future research. Copyright © 2011 UICC.

  11. Validation of risk stratification schemes for predicting stroke and thromboembolism in patients with atrial fibrillation: nationwide cohort study.

    Science.gov (United States)

    Olesen, Jonas Bjerring; Lip, Gregory Y H; Hansen, Morten Lock; Hansen, Peter Riis; Tolstrup, Janne Schurmann; Lindhardsen, Jesper; Selmer, Christian; Ahlehoff, Ole; Olsen, Anne-Marie Schjerning; Gislason, Gunnar Hilmar; Torp-Pedersen, Christian

    2011-01-31

    To evaluate the individual risk factors composing the CHADS(2) (Congestive heart failure, Hypertension, Age ≥ 75 years, Diabetes, previous Stroke) score and the CHA(2)DS(2)-VASc (CHA(2)DS(2)-Vascular disease, Age 65-74 years, Sex category) score and to calculate the capability of the schemes to predict thromboembolism. Registry based cohort study. Nationwide data on patients admitted to hospital with atrial fibrillation. Population All patients with atrial fibrillation not treated with vitamin K antagonists in Denmark in the period 1997-2006. Stroke and thromboembolism. Of 121,280 patients with non-valvular atrial fibrillation, 73,538 (60.6%) fulfilled the study inclusion criteria. In patients at "low risk" (score = 0), the rate of thromboembolism per 100 person years was 1.67 (95% confidence interval 1.47 to 1.89) with CHADS(2) and 0.78 (0.58 to 1.04) with CHA(2)DS(2)-VASc at one year's follow-up. In patients at "intermediate risk" (score = 1), this rate was 4.75 (4.45 to 5.07) with CHADS(2) and 2.01 (1.70 to 2.36) with CHA(2)DS(2)-VASc. The rate of thromboembolism depended on the individual risk factors composing the scores, and both schemes underestimated the risk associated with previous thromboembolic events. When patients were categorised into low, intermediate, and high risk groups, C statistics at 10 years' follow-up were 0.812 (0.796 to 0.827) with CHADS(2) and 0.888 (0.875 to 0.900) with CHA(2)DS(2)-VASc. The risk associated with a specific risk stratification score depended on the risk factors composing the score. CHA(2)DS(2)-VASc performed better than CHADS(2) in predicting patients at high risk, and those categorised as low risk by CHA(2)DS(2)-VASc were truly at low risk for thromboembolism.

  12. Prevalence of smoking before and during pregnancy and changes in this habit during pregnancy in Northwest Russia: a Murmansk county birth registry study.

    Science.gov (United States)

    Kharkova, Olga A; Krettek, Alexandra; Grjibovski, Andrej M; Nieboer, Evert; Odland, Jon Øyvind

    2016-03-08

    Smoking during pregnancy leads to adverse maternal and birth outcomes. However, the prevalence of smoking among women in Russia has increased from  20% in the 2000s. We conducted a registry-based study in Murmansk County, Northwest Russia. Our aims were twofold: (i) assess the prevalence of smoking before and during pregnancy; and (ii) examine the socio-demographic factors associated with giving up smoking or reducing the number of cigarettes smoked once pregnancy was established. This study employs data from the population-based Murmansk County Birth Registry (MCBR) collected during 2006-2011. We used logistic regression to investigate associations between women's socio-demographic characteristics and changes in smoking habit during pregnancy. To avoid departure from uniform risk within specific delivery departments, we employed clustered robust standard errors. Of all births registered in the MCBR, 25.2% of the mothers were smokers before pregnancy and 18.9% continued smoking during pregnancy. Cessation of smoking during pregnancy was associated with education, marital status and parity but not with maternal age, place of residence, and ethnicity. Women aged ≤ 20-24 years had higher odds of reducing the absolute numbers of cigarettes smoked per day during pregnancy than those aged ≥ 30-34 years. Moreover, smoking nulliparae and pregnant women who had one child were more likely to reduce the absolute numbers of cigarettes smoked per day compared to women having ≥ 2 children. About 25.0% of smoking women in the Murmansk County in Northwest Russia quit smoking after awareness of the pregnancy, and one-third of them reduced the number cigarettes smoked during pregnancy. Our study demonstrates that women who have a higher education, husband, and are primiparous are more likely to quit smoking during pregnancy. Maternal age and number of children are indicators that influence reduction in smoking during pregnancy. Our findings are useful in

  13. The relationship between a less gender-stereotypical parenthood and alcohol-related care and death: A registry study of Swedish mothers and fathers

    Directory of Open Access Journals (Sweden)

    Backhans Mona

    2008-09-01

    Full Text Available Abstract Background In general men tend to drink more alcohol and experience more alcohol-related sickness, injuries and mortality than women. In this paper, the overall hypothesis was that increased gender similarity in the division of parental duties would lead to convergence in alcohol-related harm. The aim was to analyse whether the risk of alcohol harm differs between parents who fit a gender-stereotypical versus those with a less gender-stereotypical division of childcare and paid work. Methods The study sample was a retrospective registry-based cohort study of all Swedish couples who had their first child together in 1978 (N = 49,120. A less gender-stereotypical parenthood was indicated by paternity leave for fathers (1978–1979 and full-time work for mothers (1980. The outcome was inpatient care and/or death caused by alcohol psychosis, alcoholism, liver disease, or alcohol intoxication in the two decades following (1981–2001. Our main statistical method was multivariate logistic regression with odds ratios used to estimate relative risks. Results The main results show that fathers who took paternity leave had 18% lower risk of alcohol-related care and/or death than other fathers. Mothers who worked full-time about two years after having a child had 71% higher risk than mothers who were unemployed or worked part-time. Conclusion A less gender-stereotypical division of duties between parents in early parenthood may contribute to a long-term decreased gender disparity regarding risky alcohol consumption and alcohol-related harm. In order to know more about the causal direction however, future research has to consider subjects' drinking patterns in the years prior to parenthood.

  14. The relationship between a less gender-stereotypical parenthood and alcohol-related care and death: A registry study of Swedish mothers and fathers

    Science.gov (United States)

    Månsdotter, Anna; Backhans, Mona; Hallqvist, Johan

    2008-01-01

    Background In general men tend to drink more alcohol and experience more alcohol-related sickness, injuries and mortality than women. In this paper, the overall hypothesis was that increased gender similarity in the division of parental duties would lead to convergence in alcohol-related harm. The aim was to analyse whether the risk of alcohol harm differs between parents who fit a gender-stereotypical versus those with a less gender-stereotypical division of childcare and paid work. Methods The study sample was a retrospective registry-based cohort study of all Swedish couples who had their first child together in 1978 (N = 49,120). A less gender-stereotypical parenthood was indicated by paternity leave for fathers (1978–1979) and full-time work for mothers (1980). The outcome was inpatient care and/or death caused by alcohol psychosis, alcoholism, liver disease, or alcohol intoxication in the two decades following (1981–2001). Our main statistical method was multivariate logistic regression with odds ratios used to estimate relative risks. Results The main results show that fathers who took paternity leave had 18% lower risk of alcohol-related care and/or death than other fathers. Mothers who worked full-time about two years after having a child had 71% higher risk than mothers who were unemployed or worked part-time. Conclusion A less gender-stereotypical division of duties between parents in early parenthood may contribute to a long-term decreased gender disparity regarding risky alcohol consumption and alcohol-related harm. In order to know more about the causal direction however, future research has to consider subjects' drinking patterns in the years prior to parenthood. PMID:18793385

  15. The relationship between a less gender-stereotypical parenthood and alcohol-related care and death: a registry study of Swedish mothers and fathers.

    Science.gov (United States)

    Månsdotter, Anna; Backhans, Mona; Hallqvist, Johan

    2008-09-15

    In general men tend to drink more alcohol and experience more alcohol-related sickness, injuries and mortality than women. In this paper, the overall hypothesis was that increased gender similarity in the division of parental duties would lead to convergence in alcohol-related harm. The aim was to analyse whether the risk of alcohol harm differs between parents who fit a gender-stereotypical versus those with a less gender-stereotypical division of childcare and paid work. The study sample was a retrospective registry-based cohort study of all Swedish couples who had their first child together in 1978 (N = 49,120). A less gender-stereotypical parenthood was indicated by paternity leave for fathers (1978-1979) and full-time work for mothers (1980). The outcome was inpatient care and/or death caused by alcohol psychosis, alcoholism, liver disease, or alcohol intoxication in the two decades following (1981-2001). Our main statistical method was multivariate logistic regression with odds ratios used to estimate relative risks. The main results show that fathers who took paternity leave had 18% lower risk of alcohol-related care and/or death than other fathers. Mothers who worked full-time about two years after having a child had 71% higher risk than mothers who were unemployed or worked part-time. A less gender-stereotypical division of duties between parents in early parenthood may contribute to a long-term decreased gender disparity regarding risky alcohol consumption and alcohol-related harm. In order to know more about the causal direction however, future research has to consider subjects' drinking patterns in the years prior to parenthood.

  16. The effect of foetal growth restriction on the development of migraine and tension-type headache in adulthood. The HUNT Study.

    Directory of Open Access Journals (Sweden)

    Sigrid Børte

    Full Text Available There is little knowledge about how factors early in life affect the development of migraine and tension-type headache. We aimed to examine whether growth restriction in utero is associated with development of migraine and frequent tension-type headache in adults.The population-based Nord-Trøndelag Health Study (HUNT 3 contained a validated headache questionnaire, which differentiated between migraine and tension-type headache. These data were linked to information on weight and gestational age at birth from the Norwegian Medical Birth Registry. In total 4557 females and 2789 males, aged 19-41 years, were included in this registry-based study. Participants were categorized as appropriate for gestational age (AGA, 10th-90th percentile, small for gestational age (SGA, 3rd-10th percentile or very small for gestational age (VSGA, < 3rd percentile. Logistic regression was used to calculate odds ratios (OR with 95% confidence intervals (CI for migraine and tension-type headache, with exposure being growth restriction at birth.The effect of growth restriction on migraine was modified by sex, with a significant association in males (p<0.001, but not in females (p = 0.20. In particular, males born VSGA were at increased risk of developing migraine (OR 2.73, 95% CI 1.63-4.58, p<0.001, with an intermediate risk among those born SGA (OR 1.50, 95% CI 0.96-2.35, p = 0.08 compared to those born AGA. There was no significant association between growth restriction and frequent TTH (p = 0.051.Growth restriction was associated with increased risk of migraine in adulthood among males, but not among females. This suggests that migraine might, in part, be influenced by early life events, and that males seem to be particularly vulnerable.

  17. A survival analysis of the liver-first reversed management of advanced simultaneous colorectal liver metastases: a LiverMetSurvey-based study.

    Science.gov (United States)

    Andres, Axel; Toso, Christian; Adam, Rene; Barroso, Eduardo; Hubert, Catherine; Capussotti, Lorenzo; Gerstel, Eric; Roth, Arnaud; Majno, Pietro E; Mentha, Gilles

    2012-11-01

    Liver-first reversed management (RM) for the treatment of patients with simultaneous colorectal liver metastases (CRLM) includes liver-directed chemotherapy, the resection of the CRLM, and the subsequent resection of the primary cancer. Retrospective data have shown that up to 80% of patients can successfully undergo a complete RM, whereas less than 30% of those undergoing classical management (CM) do so. This registry-based study compared the 2 approaches. The study was based on the LiverMetSurvey (January 1, 2000 to December 31, 2010) and included patients with 2 or more metastases. All patients had irinotecan and/or oxaliplatin-based chemotherapy before liver surgery. Patients undergoing simultaneous liver and colorectal surgery were excluded. A total of 787 patients were included: 729 in the CM group and 58 in the RM group. Patients in the 2 groups had similar numbers of metastases (4.20 vs 4.80 for RM and CM, P = 0.231) and Fong scores of 3 or more (79% vs 87%, P = 0.164). Rectal cancer, neoadjuvant rectal radiotherapy, and the use of combined irinotecan/oxaliplatin chemotherapy were more frequent in the RM group (P < 0.001), whereas colorectal lymph node involvement was more frequent in the CM group (P < 0.001). Overall survival and disease-free survival were similar in the RM and CM groups (48% vs 46% at 5 years, P = 0.965 and 30% vs 26%, P = 0.992). Classical and reversed managements of metastatic liver disease in colorectal cancer are associated with similar survival when successfully completed.

  18. Identifying specific non-attending groups in breast cancer screening - population-based registry study of participation and socio-demography

    Directory of Open Access Journals (Sweden)

    Jensen Line

    2012-11-01

    Full Text Available Abstract Background A population-based breast cancer screening programme was implemented in the Central Denmark Region in 2008–09. The objective of this registry-based study was to examine the association between socio-demographic characteristics and screening participation and to examine whether the group of non-participants can be regarded as a homogeneous group of women. Method Participation status was obtained from a regional database for all women invited to the first screening round in the Central Denmark Region in 2008–2009 (n=149,234. Participation data was linked to registries containing socio-demographic information. Distance to screening site was calculated using ArcGIS. Participation was divided into ‘participants’ and ‘non-participants’, and non-participants were further stratified into ‘active non-participants’ and ‘passive non-participants’ based on whether the woman called and cancelled her participation or was a ‘no-show’. Results The screening participation rate was 78.9%. In multivariate analyses, non-participation was associated with older age, immigrant status, low OECD-adjusted household income, high and low level education compared with middle level education, unemployment, being unmarried, distance to screening site >20 km, being a tenant and no access to a vehicle. Active and passive non-participants comprised two distinct groups with different socio-demographic characteristics, with passive non-participants being more socially deprived compared with active non-participants. Conclusion Non-participation was associated with low social status e.g. low income, unemployment, no access to vehicle and status as tenant. Non-participants were also more likely than participants to be older, single, and of non-Danish origin. Compared to active non-participants, passive non-participants were characterized by e.g. lower income and lower educational level. Different interventions might be warranted to increase

  19. Retrospective cohort study of cancer incidence and mortality by HIV status in a Georgia, USA, prisoner cohort during the HAART era.

    Science.gov (United States)

    Zlotorzynska, Maria; Spaulding, Anne C; Messina, Lauren C; Coker, Daniella; Ward, Kevin; Easley, Kirk; Baillargeon, Jacques; Mink, Pamela J; Simard, Edgar P

    2016-04-11

    Non-AIDS-defining cancers (NADCs) have emerged as significant contributors to cancer mortality and morbidity among persons living with HIV (PLWH). Because NADCs are also associated with many social and behavioural risk factors that underlie HIV, determining the extent to which each of these factors contributes to NADC risk is difficult. We examined cancer incidence and mortality among persons with a history of incarceration, because distributions of other cancer risk factors are likely similar between prisoners living with HIV and non-infected prisoners. Registry-based retrospective cohort study. Cohort of 22,422 persons incarcerated in Georgia, USA, prisons on 30 June 1991, and still alive in 1998. Cancer incidence and mortality were assessed between 1998 and 2009, using cancer and death registry data matched to prison administrative records. Age, race and sex-adjusted standardised mortality and incidence ratios, relative to the general population, were calculated for AIDS-defining cancers, viral-associated NADCs and non-infection-associated NADCs, stratified by HIV status. There were no significant differences in cancer mortality relative to the general population in the cohort, regardless of HIV status. In contrast, cancer incidence was elevated among the PLWH. Furthermore, incidence of viral-associated NADCs was significantly higher among PLWH versus those without HIV infection (standardised incidence ratio=6.1, 95% CI 3.0 to 11.7, pcancer incidence was elevated relative to the general population, likely related to increased prevalence of oncogenic viral co-infections. Cancer prevention and screening programmes within prisons may help to reduce the cancer burden in this high-risk population. 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/

  20. Fish oil intake compared with olive oil intake in late pregnancy and asthma in the offspring: 16 y of registry-based follow-up from a randomized controlled trial

    DEFF Research Database (Denmark)

    Olsen, Sjurdur F; Østerdal, Marie Louise; Salvig, Jannie Dalby

    2008-01-01

    BACKGROUND: Evidence suggests that asthma is rooted in the intrauterine environment and that intake of marine n-3 polyunsaturated fatty acids (n-3 PUFAs) in pregnancy may have immunomodulatory effects on the child. OBJECTIVE: Our aim was to examine whether increasing maternal intake of n-3 PUFAs...... in pregnancy may affect offspring risk of asthma. DESIGN: In 1990, a population-based sample of 533 women with normal pregnancies were randomly assigned 2:1:1 to receive four 1-g gelatin capsules/d with fish oil providing 2.7 g n-3 PUFAs (n = 266); four 1-g, similar-looking capsules/d with olive oil (n = 136...... results support that increasing n-3 PUFAs in late pregnancy may carry an important prophylactic potential in relation to offspring asthma....

  1. Transient risk factors of acute occupational injuries

    DEFF Research Database (Denmark)

    Østerlund, Anna H; Lander, Flemming; Nielsen, Kent

    2017-01-01

    Objectives The objectives of this study were to (i) identify transient risk factors of occupational injuries and (ii) determine if the risk varies with age, injury severity, job task, and industry risk level. Method A case-crossover design was used to examine the effect of seven specific transient...... risk factors (time pressure, disagreement with someone, feeling sick, being distracted by someone, non-routine task, altered surroundings, and broken machinery and materials) for occupational injuries. In the study, 1693 patients with occupational injuries were recruited from a total of 4002...... in relation to sex, age, job task, industry risk level, or injury severity. Conclusion Use of a case-crossover design identified several worker-related transient risk factors (time pressure, feeling sick, being distracted by someone) that led to significantly increased risks for occupational injuries...

  2. The Perinatal Adverse events and Special Trends in Cognitive Trajectory (PLASTICITY - pre-protocol for a prospective longitudinal follow-up cohort study [v1; ref status: indexed, http://f1000r.es/qe

    Directory of Open Access Journals (Sweden)

    Laura Hokkanen

    2013-02-01

    Full Text Available Prospective follow-up studies on long term effects of pre- and perinatal adverse conditions in adulthood are rare. We will continue to follow the prospective cohort of initially 1196 subjects with predefined at-delivery risk factors out of 22,359 consecutive deliveries during 1971-74 at a single maternity hospital. The risk cohort and 93 controls have been followed up with a comprehensive clinical program at 5, 9, and 16 years of age and by questionnaire at the age of 30 years. Major medical events known to affect the development and growth of the brain, or cognitive functions and personality have been documented. Here we present a pre-protocol for the project, which we will call PLASTICITY, whose aim is to follow consenting subjects and controls into mid-adulthood and beyond, and to explore how the neonatal risk factors modulate neurodevelopmental and neurodegenerative processes such as learning disabilities, ADHD, aging, early onset mild cognitive impairment and even dementia. Our first focus is on the neurological and cognitive outcomes at age 40 years, using detailed neurological, neuropsychological, neuroimaging, genetic, blood chemistry and registry based methods. Results will be expected to offer information on the risk of neurological, psychiatric, metabolic and other medical consequences as well as the need for health and social services at the brink of middle age, when new degenerative phenomena are known to emerge. The evaluation at age 40 years will serve as a baseline for later aging studies. We welcome all comments and suggestions, which we will apply in finalizing details and inviting collaboration.

  3. Feasibility of Using a Multilingual Web Survey in Studying the Health of Ethnic Minority Youth

    Science.gov (United States)

    Malin, Maili; Raisamo, Susanna Ulrika; Lindfors, Pirjo Liisa; Pere, Lasse Antero; Rimpelä, Arja Hannele

    2015-01-01

    Background Monolingual Web survey is a common tool for studying adolescent health. However, national languages may cause difficulties for some immigrant-origin youths, which lower their participation rate. In national surveys, the number of ethnic minority groups is often too small to assess their well-being. Objective We studied the feasibility of a multilingual Web survey targeted at immigrant-origin youths by selection of response language, and compared participation in different language groups with a monolingual survey. Methods The Adolescent Health and Lifestyle Survey (AHLS), Finland, with national languages (Finnish/Swedish) was modified into a multilingual Web survey targeted at a representative sample of 14- and 16-year olds (N=639) whose registry-based mother tongue was other than the national languages. The survey was conducted in 2010 (16-year olds) and 2011 (14-year olds). The response rate of the multilingual survey in 2011 is compared with the AHLS of 2011. We also describe the translation process and the e-form modification. Results Of the respondents, 57.6% answered in Finnish, whereas the remaining 42.4% used their mother tongue (P=.002). A majority of youth speaking Somali, Middle Eastern, Albanian, and Southeast Asian languages chose Finnish. The overall response rate was 48.7% with some nonsignificant variation between the language groups. The response rate in the multilingual Web survey was higher (51.6%, 163/316) than the survey with national languages (46.5%, 40/86) in the same age group; however, the difference was not significant (P=.47). The adolescents who had lived in Finland for 5 years or less (58.0%, 102/176) had a higher response rate than those having lived in Finland for more than 5 years (45.1%, 209/463; P=.005). Respondents and nonrespondents did not differ according to place of birth (Finland/other) or residential area (capital city area/other). The difference in the response rates of girls and boys was nearly significant (P

  4. Long-Term Efficacy and Safety of Cyclosporine in a Cohort of Steroid-Refractory Acute Severe Ulcerative Colitis Patients from the ENEIDA Registry (1989-2013): A Nationwide Multicenter Study.

    Science.gov (United States)

    Ordás, I; Domènech, E; Mañosa, M; García-Sánchez, V; Iglesias-Flores, E; Peñalva, M; Cañas-Ventura, A; Merino, O; Fernández-Bañares, F; Gomollón, F; Vera, M; Gutiérrez, A; Garcia-Planella, E; Chaparro, M; Aguas, M; Gento, E; Muñoz, F; Aguirresarobe, M; Muñoz, C; Fernández, L; Calvet, X; Jiménez, C E; Montoro, M A; Mir, A; De Castro, M L; García-Sepulcre, M F; Bermejo, F; Panés, J; Esteve, M

    2017-11-01

    To determine the efficacy and safety of cyclosporine (CyA) in a large national registry-based population of patients with steroid-refractory (SR) acute severe ulcerative colitis (ASUC) and to establish predictors of efficacy and adverse events. Multicenter study of SR-ASUC treated with CyA, based on data from the ENEIDA registry. SR-ASUC patients treated with infliximab (IFX) or sequential rescue therapy (CyA-IFX or IFX-CyA) were used as comparators. Of 740 SR-ASUC patients, 377 received CyA, 131 IFX and 63 sequential rescue therapy. The cumulative colectomy rate was higher in the CyA (24.1%) and sequential therapy (32.7%) than in the IFX group (14.5%; P=0.01) at 3 months and 5 years. There were no differences in early and late colectomy between CyA and IFX in patients treated after 2005. 62% of patients receiving CyA remained colectomy-free in the long term (median 71 months). There were no differences in mortality between CyA (2.4%), IFX (1.5%) and sequential therapy (0%; P=0.771). The proportion of patients with serious adverse events (SAEs) was lower in CyA (15.4%) than in IFX treated patients (26.5%) or sequential therapy (33.4%; P<0.001). This difference in favor of CyA was maintained when only patients treated after 2005 were analyzed. Treatment with CyA showed a lower rate of SAE and a similar efficacy to that of IFX thereby supporting the use of either CyA or IFX in SR-ASUC. In addition, the risk-benefit of sequential CyA-IFX for CyA non-responders is acceptable.

  5. Differences in primary health care use among sub-Saharan African immigrants in Norway: a register-based study.

    Science.gov (United States)

    Diaz, Esperanza; Mbanya, Vivian N; Gele, Abdi A; Kumar, Bernadette

    2017-07-28

    Immigrants' utilization of primary health care (PHC) services differs from that of the host populations. However, immigrants are often classified in broad groups by continent of origin, and the heterogeneity within the same continent may hide variation in use among immigrant groups at a national level. Differences in utilization of PHC between sub-Saharan African immigrants have not received much attention. Registry-based study using merged data from the National Population Register and the Norwegian Health Economics Administration. African immigrants and their descendants registered in Norway in 2008 (36,366 persons) where included in this study. Using χ 2 test and logistic regression models, we assessed the differences in the use of PHC, including general practitioner (GP) and emergency room (ER) services, and the distribution of morbidity burden for immigrants from Somalia, Ethiopia, Eritrea, and Gambia. For the analyses, we used the number of visits and medical diagnoses from each consultation registered by the physician. Among the total studied population, 66.1% visited PHC within 1 year. The diagnoses registered were similar for all four immigrants groups, regardless of country of origin. Compared to immigrants from Somalia, the age and sex adjusted odds ratios (OR) for use of GP were significantly lower for Ethiopians (OR 0.91; 0.86-0.97), Eritreans (OR 0.85; 0.79-0.91), and Gambians (OR 0.88; 0.80-0.97). Similarly, we also observed lower use of ER among Ethiopians (OR 0.88; 0.81-0.95), Eritreans (OR 0.56; 0.51-0.62) and Gambians (OR 0.81; 0.71-0.92). However, immigrants from Somalia reduced their use of PHC with longer duration of stay in Norway. Differences between groups persisted after further adjustment for employment status. Despite the similarities in diagnoses among the sub-Saharan African immigrant groups in Norway, their use of PHC services differs by country of origin and length of stay. It is important to assess the reasons for the differences

  6. Differential utilization of primary health care services among older immigrants and Norwegians: a register-based comparative study in Norway.

    Science.gov (United States)

    Diaz, Esperanza; Kumar, Bernadette N

    2014-11-26

    Aging in an unfamiliar landscape can pose health challenges for the growing numbers of immigrants and their health care providers. Therefore, better understanding of how different immigrant groups use Primary Health Care (PHC), and the underlying factors that explain utilization is needed to provide adequate and appropriate public health responses. Our aim is to describe and compare the use of PHC between elderly immigrants and Norwegians. Registry-based study using merged data from the National Population Register and the Norwegian Health Economics Administration database. All 50 year old or older Norwegians with both parents from Norway (1,516,012) and immigrants with both parents from abroad (89,861) registered in Norway in 2008 were included. Descriptive analyses were carried out. Immigrants were categorised according to country of origin, reason for migration and length of stay in Norway. Binary logistic regression analyses were conducted to study the utilization of PHC comparing Norwegians and immigrants, and to assess associations between utilization and both length of stay and reason for immigration, adjusting for other socioeconomic variables. A higher proportion of Norwegians used PHC services compared to immigrants. While immigrants from high-income countries used PHC less than Norwegians disregarding age (OR from 0.65 to 0.92 depending on age group), they had similar number of diagnoses when in contact with PHC. Among immigrants from other countries, however, those 50 to 65 years old used PHC services more often (OR 1.22) than Norwegians and had higher comorbidity levels, but this pattern was reversed for older adults (OR 0.56 to 0.47 for 66-80 and 80+ years respectively). For all immigrants, utilization of PHC increased with longer stay in Norway and was higher for refugees (1.67 to 1.90) but lower for labour immigrants (0.33 to 0.45) compared to immigrants for family reunification. However, adjustment for education and income levels reduced most

  7. Recurrent Stroke: The Value of the CHA2DS2VASc Score and the Essen Stroke Risk Score in a Nationwide Stroke Cohort

    DEFF Research Database (Denmark)

    Andersen, Søren Due; Gorst-Rasmussen, Anders; Lip, Gregory Y H

    2015-01-01

    , and cardiovascular events (stroke, transient ischemic attack, myocardial infarction, or arterial thromboembolism) in a nationwide Danish cohort study, among patients with incident ischemic stroke and no atrial fibrillation. Methods—We conducted a registry-based study in patients with incident ischemic stroke...

  8. First-trimester smoking cessation in pregnancy did not increase the risk of preeclampsia/eclampsia: A Murmansk County Birth Registry study.

    Directory of Open Access Journals (Sweden)

    Olga A Kharkova

    Full Text Available Although prior studies have shown that smoking reduces preeclampsia/eclampsia risk, the consequence of giving up this habit during pregnancy should be assessed. The aims of the current study were threefold: (i describe maternal characteristics of women with preeclampsia/eclampsia; (ii examine a possible association between the number of cigarettes smoked daily during pregnancy and the development of this affliction; and (iii determine if first-trimester discontinuation of smoking during pregnancy influences the risk.A registry-based study was conducted using data from the Murmansk County Birth Registry (MCBR. It included women without pre-existing hypertension, who delivered a singleton infant during 2006-2011 and had attended the first antenatal visit before 12 week of gestation. We adjusted for potential confounders using logistic regression.The prevalence of preeclampsia/eclampsia was 8.3% (95%CI: 8.0-8.6. Preeclampsia/eclampsia associated with maternal age, education, marital status, parity, excessive weight gain and body mass index at the first antenatal visit. There was a dose-response relationship between the number of smoked cigarettes per day during pregnancy and the risk of preeclampsia/eclampsia (adjusted OR1-5 cig/day = 0.69 with 95%CI: 0.56-0.87; OR6-10 cig/day = 0.65 with 95%CI: 0.51-0.82; and OR≥11 cig/day = 0.49 with 95%CI: 0.30-0.81. There was no difference in this risk among women who smoked before and during pregnancy and those who did so before but not during pregnancy (adjusted OR = 1.10 with 95%CI: 0.91-1.32.Preeclampsia/eclampsia was associated with maternal age, education, marital status, parity, excessive weight gain, and body mass index at the first antenatal visit. There was a negative dose-response relationship between the number of smoked cigarettes per day during pregnancy and the odds of preeclampsia/eclampsia. However, women who gave up smoking during the first trimester of gestation had the same risk of

  9. Avoiding delayed diagnosis of significant blunt bowel and mesenteric injuries: Can a scoring tool make the difference? A 7-year retrospective cohort study.

    Science.gov (United States)

    Zingg, Tobias; Agri, Fabio; Bourgeat, Mylène; Yersin, Bertrand; Romain, Benoît; Schmidt, Sabine; Keller, Nathalie; Demartines, Nicolas

    2018-01-01

    Significant blunt bowel and mesenteric injuries (sBBMI) are frequently missed despite the widespread use of computed tomography (CT). Early treatment improves the outcome related to these injuries. The aim of this study was to assess the prevalence of sBBMI, the incidence of delayed diagnosis and to test the performance of the Bowel Injury Prediction Score (BIPS), determined by the white blood cell (WBC) count, presence or absence of abdominal tenderness and CT grade of mesenteric injury. Single-centre, registry-based retrospective cohort study, screening all consecutive trauma patients admitted to Lausanne University Hospital Trauma Centre from 2008 to 2015 after a road traffic accident. All patients with reliable information about the presence or absence of sBBMI who underwent abdominal CT and for whom calculation of the BIPS was possible were included for analysis. The incidence of delayed (>24h after admission) diagnosis in the patient group with sBBMI was determined and the diagnostic performance of the BIPS for sBBMI was assessed. For analysis, 766 patients with reliable information about the presence or absence of sBBMI were included. The prevalence of sBBMI was 3.1% (24/766). In 24% (5/21) of stable trauma patients undergoing CT, a diagnostic delay of more than 24h occurred. Abdominal tenderness (p<0.0001) and CT grade ≥4 (p<0.0001) were associated with sBBMI, whereas CT grade 4 alone (p=0.93) and WBC count ≥17G/l (p=0.30) were not. A BIPS ≥2 had a sensitivity of 89% (95% CI, 67-99), specificity of 89% (95% CI, 86-91), positive likelihood ratio of 8 (95% CI, 6.1-10), negative likelihood ratio of 0.12 (95% CI, 0.03-0.44), positive predictive value (PPV) of 19% (95% CI, 15-24) and negative predictive value (NPV) of 99.7% (95% CI, 98.7-99.9). CT alone identified 79% (15/19) and the BIPS 89% (17/19) of patients with sBBMI (p=0.66). Diagnostic delays in patients with sBBMI are common (24%), despite the routine use of abdominal CT. Application of the BIPS

  10. The role of general practice in routes to diagnosis of lung cancer in Denmark: a population-based study of general practice involvement, diagnostic activity and diagnostic intervals.

    Science.gov (United States)

    Guldbrandt, Louise Mahncke; Fenger-Grøn, Morten; Rasmussen, Torben Riis; Jensen, Henry; Vedsted, Peter

    2015-01-22

    Lung cancer stage at diagnosis predicts possible curative treatment. In Denmark and the UK, lung cancer patients have lower survival rates than citizens in most other European countries, which may partly be explained by a comparatively longer diagnostic interval in these two countries. In Denmark, a pathway was introduced in 2008 allowing general practitioners (GPs) to refer patients suspected of having lung cancer directly to fast-track diagnostics. However, symptom presentation of lung cancer in general practice is known to be diverse and complex, and systematic knowledge of the routes to diagnosis is needed to enable earlier lung cancer diagnosis in Denmark. This study aims to describe the routes to diagnosis, the diagnostic activity preceding diagnosis and the diagnostic intervals for lung cancer in the Danish setting. We conducted a national registry-based cohort study on 971 consecutive incident lung cancer patients in 2010 using data from national registries and GP questionnaires. GPs were involved in 68.3% of cancer patients' diagnostic pathways, and 27.4% of lung cancer patients were referred from the GP to fast-track diagnostic work-up. A minimum of one X-ray was performed in 85.6% of all cases before diagnosis. Patients referred through a fast-track route more often had diagnostic X-rays (66.0%) than patients who did not go through fast-track (49.4%). Overall, 33.6% of all patients had two or more X-rays performed during the 90 days before diagnosis. Patients whose symptoms were interpreted as non-alarm symptoms or who were not referred to fast-track were more likely to experience a long diagnostic interval than patients whose symptoms were interpreted as alarm symptoms or who were referred to fast-track. Lung cancer patients followed several diagnostic pathways. The existing fast-track pathway must be supplemented to ensure earlier detection of lung cancer. The high incidence of multiple X-rays warrants a continued effort to develop more accurate lung

  11. Eligibility of sacubitril-valsartan in a real-world heart failure population: a community-based single-centre study.

    Science.gov (United States)

    Norberg, Helena; Bergdahl, Ellinor; Lindmark, Krister

    2018-04-01

    This study aims to investigate the eligibility of the Prospective Comparison of Angiotensin Receptor-Neprilysin Inhibitor (ARNI) with ACE inhibitor to Determine Impact on Global Mortality and Morbidity in Heart Failure (PARADIGM-HF) study to a real-world heart failure population. Medical records of all heart failure patients living within the catchment area of Umeå University Hospital were reviewed. This district consists of around 150 000 people. Out of 2029 patients with a diagnosis of heart failure, 1924 (95%) had at least one echocardiography performed, and 401 patients had an ejection fraction of ≤35% at their latest examination. The major PARADIGM-HF criteria were applied, and 95 patients fulfilled all enrolment criteria and thus were eligible for sacubitril-valsartan. This corresponds to 5% of the overall heart failure population and 24% of the population with ejection fraction ≤ 35%. The eligible patients were significantly older (73.2 ± 10.3 vs. 63.8 ± 11.5 years), had higher blood pressure (128 ± 17 vs. 122 ± 15 mmHg), had higher heart rate (77 ± 17 vs. 72 ± 12 b.p.m.), and had more atrial fibrillation (51.6% vs. 36.2%) than did the PARADIGM-HF population. Only 24% of our real-world heart failure and reduced ejection fraction population was eligible for sacubitril-valsartan, and the real-world heart failure and reduced ejection fraction patients were significantly older than the PARADIGM-HF population. The lack of data on a majority of the patients that we see in clinical practice is a real problem, and we are limited to extrapolation of results on a slightly different population. This is difficult to address, but perhaps registry-based randomized clinical trials will help to solve this issue. © 2018 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

  12. Nosocomial transmission of sporadic Creutzfeldt-Jakob disease: results from a risk-based assessment of surgical interventions

    DEFF Research Database (Denmark)

    de Pedro-Cuesta, Jesús; Mahillo-Fernández, Ignacio; Rábano, Alberto

    2011-01-01

    Evidence of surgical transmission of sporadic Creutzfeldt-Jakob disease (sCJD) remains debatable in part due to misclassification of exposure levels. In a registry-based case-control study, the authors applied a risk-based classification of surgical interventions to determine the association...

  13. Early retirement among Danish female cleaners and shop assistants according to work environment characteristics and upper extremity complaints

    DEFF Research Database (Denmark)

    Jensen, Lone Donbæk; Bonde, Jens Peter Ellekilde; Christensen, Michael Victor

    2016-01-01

    -year cohort study with registry-based follow-up of 1430 female cleaners and 579 shop assistants. In subsequent analyses of female cleaners, disability pension and voluntary early retirement were modeled according to work characteristics and upper extremity complaints. RESULTS: The adjusted hazard rate...

  14. Collaborative effects of bystander-initiated cardiopulmonary resuscitation and prehospital advanced cardiac life support by physicians on survival of out-of-hospital cardiac arrest: a nationwide population-based observational study.

    Science.gov (United States)

    Yasunaga, Hideo; Horiguchi, Hiromasa; Tanabe, Seizan; Akahane, Manabu; Ogawa, Toshio; Koike, Soichi; Imamura, Tomoaki

    2010-01-01

    There are inconsistent data about the effectiveness of prehospital physician-staffed advanced cardiac life support (ACLS) on the outcomes of out-of-hospital cardiac arrest (OHCA). Furthermore, the relative importance of bystander-initiated cardiopulmonary resuscitation (BCPR) and ACLS and the effectiveness of their combination have not been clearly demonstrated. Using a prospective, nationwide, population-based registry of all OHCA patients in Japan, we enrolled 95,072 patients whose arrests were witnessed by bystanders and 23,127 patients witnessed by emergency medical service providers between 2005 and 2007. We divided the bystander-witnessed arrest patients into Group A (ACLS by emergency life-saving technicians without BCPR), Group B (ACLS by emergency life-saving technicians with BCPR), Group C (ACLS by physicians without BCPR) and Group D (ACLS by physicians with BCPR). The outcome data included 1-month survival and neurological outcomes determined by the cerebral performance category. Among the 95,072 bystander-witnessed arrest patients, 7,722 (8.1%) were alive at 1 month, including 2,754 (2.9%) with good performance and 3,171 (3.3%) with vegetative status or worse. BCPR occurred in 42% of bystander-witnessed arrests. In comparison with Group A, the rates of good-performance survival were significantly higher in Group B (odds ratio (OR), 2.23; 95% confidence interval, 2.05 to 2.42; P < 0.01) and Group D (OR, 2.80; 95% confidence interval, 2.28 to 3.43; P < 0.01), while no significant difference was seen for Group C (OR, 1.18; 95% confidence interval, 0.86 to 1.61; P = 0.32). The occurrence of vegetative status or worse at 1 month was highest in Group C (OR, 1.92; 95% confidence interval, 1.55 to 2.37; P < 0.01). In this registry-based study, BCPR significantly improved the survival of OHCA with good cerebral outcome. The groups with BCPR and ACLS by physicians had the best outcomes. However, receiving ACLS by physicians without preceding BCPR significantly

  15. Modifying effect of age on the association between ambient ozone and nighttime primary care visits due to asthma attack.

    Science.gov (United States)

    Yamazaki, Shin; Shima, Masayuki; Ando, Michiko; Nitta, Hiroshi

    2009-01-01

    We examined the association between short-term exposure to outdoor air pollution and nighttime primary care visits due to asthma attack. We also investigated the modifying effects of age on this association. A case-crossover study was conducted at a primary care clinic in metropolitan Tokyo. The subjects were 308 children aged 0-14 years and 95 adolescents and adults aged 15-64 years. All subjects made visits to the clinic for an asthma attack at between 7 PM and 12 AM. Data on hourly concentrations of particulate matter with a 50% cut-off aerodynamic diameter asthma attack in warmer months; the association was greater among preschool children.

  16. Use of self-controlled designs in pharmacoepidemiology

    DEFF Research Database (Denmark)

    Hallas, J.; Pottegård, Anton

    2014-01-01

    Self-controlled observational study designs, such as the case-crossover design and the self-controlled case series, are reviewed, and their respective rationale, strengths and limitations are compared. Although no single design is generally superior to the others, they share the trait of being...... robust towards confounders that are stable over time. The self-controlled designs can be particularly useful when using secondary healthcare data for pharmacoepidemiological research and might be useful in screening for adverse drug effects. The main limitations of self-controlled designs...

  17. Low Ambient Temperature and Intracerebral Hemorrhage: The INTERACT2 Study.

    Directory of Open Access Journals (Sweden)

    Danni Zheng

    Full Text Available Rates of acute intracerebral hemorrhage (ICH increase in winter months but the magnitude of risk is unknown. We aimed to quantify the association of ambient temperature with the risk of ICH in the Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT2 participants on an hourly timescale.INTERACT2 was an international, open, blinded endpoint, randomized controlled trial of patients with spontaneous ICH (<6h of onset and elevated systolic blood pressure (SBP, 150-220 mmHg assigned to intensive (target SBP <140 mmHg or guideline-recommended (SBP <180 mmHg BP treatment. We linked individual level hourly temperature to baseline data of 1997 participants, and performed case-crossover analyses using a distributed lag non-linear model with 24h lag period to assess the association of ambient temperature and risk of ICH. Results were presented as overall cumulative odds ratios (ORs and 95% CI.Low ambient temperature (≤10°C was associated with increased risks of ICH: overall cumulative OR was 1.37 (0.99-1.91 for 10°C, 1.92 (1.31-2.81 for 0°C, 3.13 (1.89-5.19 for -10°C, and 5.76 (2.30-14.42 for -20°C, as compared with a reference temperature of 20°C.There was no clear relation of low temperature beyond three hours after exposure. Results were consistent in sensitivity analyses.Exposure to low ambient temperature within several hours increases the risk of ICH.ClinicalTrials.gov NCT00716079.

  18. Low Ambient Temperature and Intracerebral Hemorrhage: The INTERACT2 Study

    Science.gov (United States)

    Zheng, Danni; Arima, Hisatomi; Sato, Shoichiro; Gasparrini, Antonio; Heeley, Emma; Delcourt, Candice; Lo, Serigne; Huang, Yining; Wang, Jiguang; Stapf, Christian; Robinson, Thompson; Lavados, Pablo; Chalmers, John; Anderson, Craig S.

    2016-01-01

    Background Rates of acute intracerebral hemorrhage (ICH) increase in winter months but the magnitude of risk is unknown. We aimed to quantify the association of ambient temperature with the risk of ICH in the Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT2) participants on an hourly timescale. Methods INTERACT2 was an international, open, blinded endpoint, randomized controlled trial of patients with spontaneous ICH (<6h of onset) and elevated systolic blood pressure (SBP, 150–220 mmHg) assigned to intensive (target SBP <140 mmHg) or guideline-recommended (SBP <180 mmHg) BP treatment. We linked individual level hourly temperature to baseline data of 1997 participants, and performed case-crossover analyses using a distributed lag non-linear model with 24h lag period to assess the association of ambient temperature and risk of ICH. Results were presented as overall cumulative odds ratios (ORs) and 95% CI. Results Low ambient temperature (≤10°C) was associated with increased risks of ICH: overall cumulative OR was 1.37 (0.99–1.91) for 10°C, 1.92 (1.31–2.81) for 0°C, 3.13 (1.89–5.19) for -10°C, and 5.76 (2.30–14.42) for -20°C, as compared with a reference temperature of 20°C.There was no clear relation of low temperature beyond three hours after exposure. Results were consistent in sensitivity analyses. Conclusions Exposure to low ambient temperature within several hours increases the risk of ICH. Trial Registration ClinicalTrials.gov NCT00716079 PMID:26859491

  19. Winter air pollution and infant bronchiolitis in Paris.

    Science.gov (United States)

    Ségala, Claire; Poizeau, David; Mesbah, Mounir; Willems, Sylvie; Maidenberg, Manuel

    2008-01-01

    Respiratory syncytial virus (RSV) is one of the most common respiratory pathogens in infants and young children. It is not known why some previously healthy infants, when in contact with RSV, develop bronchiolitis whereas others have only mild symptoms. Our study aimed to evaluate the possible association between emergency hospital visits for bronchiolitis and air pollution in the Paris region during four winter seasons. We included children under the age of 3 years who attended emergency room services for bronchiolitis (following standardized definition) during the period 1997-2001. Two series of data from 34 hospitals, the daily number of emergency hospital consultations (n=50857) and the daily number of hospitalizations (n=16588) for bronchiolitis, were analyzed using alternative statistical methods; these were the generalized additive model (GAM) and case-crossover models. After adjustments for public holidays, holidays and meteorological variables the case-crossover model showed that PM10, BS, SO2 and NO2 were positively associated with both consultations and hospitalizations. GAM models, adjusting for long-term trend, seasonality, holiday, public holiday, weekday and meteorological variables, gave similar results for SO2 and PM10. This study shows that air pollution may act as a trigger for the occurrence of acute severe bronchiolitis cases.

  20. Study Proposal

    African Journals Online (AJOL)

    MATHEMATICS DEPARTMENT

    This cross sectional study design on mathematical syllabi at preparatory levels of the high schools was to ... Technology, Computer Science and Applied Sciences. It is studied of ..... For example, Jimma University Medical faculty students ...

  1. Initial Study

    DEFF Research Database (Denmark)

    Torp, Kristian

    2009-01-01

    increased. In the initial study presented here, the time it takes to pass an intersection is studied in details. Two major signal-controlled four-way intersections in the center of the city Aalborg are studied in details to estimate the congestion levels in these intersections, based on the time it takes...

  2. Game Studies

    NARCIS (Netherlands)

    Raessens, J.F.F.

    2016-01-01

    This entry describes game studies as a dynamic interdisciplinary field of academic study and research that focuses on digital games and play in a wide variety of social and cultural contexts. It examines the history of game studies from its prehistory, when games were looked at as part of other

  3. Does macrolide use confer risk of out-of-hospital cardiac arrest compared with penicillin V?

    DEFF Research Database (Denmark)

    Hertz, Frederik Boetius; Jensen, Aksel; Knudsen, Jenny D

    2018-01-01

    were examined by conditional logistic regression analyses in case-crossover and case-time-control models, using penicillin-V treatment as the comparative reference. From nationwide registries, we identified all OHCAs in Denmark from 2001 to 2010 and use of antibiotics. ETHICS: The present study...... was approved by the Danish Data Protection Agency (Danish Data Protection Agency (ref.no. 2007-58-0015, local ref.no. GEH-2014-017, (I-Suite.nr. 02 735)). PARTICIPANTS: We identified 29 111 patients with an OHCA. Of these, 514 were in macrolide treatment ≤7 days before OHCA and 1237 in penicillin-V treatment....... RESULTS: In the case-crossover analyses, overall macrolide use was not associated with OHCA with penicillin V as negative comparative reference (OR=0.90; 95% CI 0.73 to 1.10). Compared with penicillin-V treatment, specific macrolides were not associated with increased risk of OHCA: roxithromycin (OR=0...

  4. HTS Teologiese Studies / Theological Studies

    African Journals Online (AJOL)

    HTS Teologiese Studies/Theological Studies is an acclaimed Open Access journal with broad coverage that promotes multidisciplinary, religious, and biblical aspects of studies in the international theological arena. The journal's publication criteria are based on high ethical standards and the rigor of the methodology and ...

  5. Study protocol

    DEFF Research Database (Denmark)

    Thorsteinsson, Troels; Helms, Anne Sofie; Adamsen, Lis

    2013-01-01

    , and problems related to interaction with peers. Methods/design The RESPECT study is a nationwide population-based prospective, controlled, mixed-methods intervention study looking at children aged 6-18 years newly diagnosed with cancer in eastern Denmark (n = 120) and a matched control group in western Denmark......, and one year after the cessation of treatment. The study is powered to quantify the impact of the combined educational, physical, and social intervention programs. Discussion RESPECT is the first population-based study to examine the effect of early rehabilitation for children with cancer, and to use...

  6. Absorption studies

    International Nuclear Information System (INIS)

    Ganatra, R.D.

    1992-01-01

    Absorption studies were once quite popular but hardly anyone does them these days. It is easier to estimate the blood level of the nutrient directly by radioimmunoassay (RIA). However, the information obtained by estimating the blood levels of the nutrients is not the same that can be obtained from the absorption studies. Absorption studies are primarily done to find out whether some of the essential nutrients are absorbed from the gut or not and if they are absorbed, to determine how much is being absorbed. In the advanced countries, these tests were mostly done to detect pernicious anaemia where vitamin B 12 is not absorbed because of the lack of the intrinsic factor in the stomach. In the tropical countries, ''malabsorption syndrome'' is quire common. In this condition, several nutrients like fat, folic acid and vitamin B 12 are not absorbed. It is possible to study absorption of these nutrients by radioisotopic absorption studies

  7. Clinical Studies

    DEFF Research Database (Denmark)

    Pallesen, Ulla

    universities and practicing dentists restore millions of teeth throughout the World with composite resin materials. Do we know enough about the clinical performance of these restorations over time? Numerous in vitro studies are being published on resin materials and adhesion, some of them attempting to imitate...... in vivo conditions. But real life is different and in vitro studies cannot include all variables. Only clinical studies can provide valid information on the clinical performance of restorations over time. What do we know about longevity of posterior resin restorations? What are the reasons for replacement...... and results from own up to 30-year prospective clinical university studies and practice based studies from Public Dental Health Service on the clinical performance of posterior composite resin restorations....

  8. Hydrogeological study

    International Nuclear Information System (INIS)

    Massa, E.; Carrion, R.

    1987-01-01

    This work refers to the hydrogeological study about underground water to domestic uses. It was required by Artigas intendence of Uruguay, in the rural school 10, located belongs to the Chiflero zone around the capital of the Artigas Province.

  9. Feasibility study

    International Nuclear Information System (INIS)

    Gibbs, P.; Kalas, P.

    1975-01-01

    The feasibility study itself examines the technical, economic and financial implications of a nuclear power station in depth so as to make sure that nuclear power is the right course to take. This means that it is quite an expensive operation and it is to avoid wasting this money that a pre-feasibility study is carried out. This preliminary study should eliminate cases where the electrical system cannot absorb the capacity of a nuclear station of commercial size, where other sources of power such as hydro-electricity, gas or cheap coal would make nuclear obviously uneconomic or where no suitable sites exist. If this first rather simple survey shows that nuclear power is a credible solution to a utilities need for electricity or heat production plant, then the next stage is a full feasibility study. (orig./TK) [de

  10. INTERHEART STUDY

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. INTERHEART STUDY. About 90% of CHD Risk (“PAR”) can be explained by 9 Risk Factors: Smoking. Dyslipidemia. High BP. Diabetes. Abdominal Obesity. Psychosocial Factors. Fruits & Vegetables. Exercise. Alcohol.

  11. Study Drugs

    Science.gov (United States)

    ... to quit, they may have withdrawal symptoms like depression, thoughts of suicide, intense drug cravings, sleep problems, and fatigue. The health risks aren't the only downside to study drugs. Students caught with illegal prescription drugs may get suspended ...

  12. Environmental studies

    International Nuclear Information System (INIS)

    Mohd Tadza Abd Rahman

    2003-01-01

    Nuclear Technology offers unique method, yet effective for environmental research. Nuclear techniques are invented to carry out research activities on environmental pollutions, erosion and slope stability, landslide ground water studies and water pollution

  13. Floodplain Study

    Data.gov (United States)

    Montgomery County of Maryland — The purpose of a floodplain study is to establish the 100-year floodplain limits within or near a development in order to preserve the natural resources within the...

  14. Creole Studies

    DEFF Research Database (Denmark)

    This book launches a new approach to creole studies founded on phylogenetic network analysis. Phylogenetic approaches offer new visualisation techniques and insights into the relationships between creoles and non-creoles, creoles and other contact varieties, and between creoles and lexifier...... languages. With evidence from creole languages in Africa, Asia, the Americas, and the Pacific, the book provides new perspectives on creole typology, cross-creole comparisons, and creole semantics. The book offers an introduction for newcomers to the fields of creole studies and phylogenetic analysis. Using...... these methods to analyse a variety of linguistic features, both structural and semantic, the book then turns to explore old and new questions and problems in creole studies. Original case studies explore the differences and similarities between creoles, and propose solutions to the problems of how to classify...

  15. Actuarial Studies

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Office of the Actuary in the Centers for Medicare and Medicaid Services (CMS) from time to time conducts studies on various aspects of the Medicare and Medicaid...

  16. ARHCO studies

    International Nuclear Information System (INIS)

    Rogers, L.E.

    1977-01-01

    Ecological studies at the Hanford Reservation are designed to clarify ecosystem structure and function in and near the radioactive waste management areas. To date, emphasis has been placed on characterizing the abiotic and biotic components of these areas. During the current year, deer, raptors, coots, and mice have been under active study with respect to their potential for dissemination of radioactivity from pond or burial locations via feeding

  17. European Studies

    Directory of Open Access Journals (Sweden)

    V. O. Pechatnov

    2014-01-01

    Full Text Available The study of Western countries and teaching courses on the related subjects have longstanding and established tradition at MGIMO-University. The basis of this brilliant research and teaching tradition was laid down by such academicians as E.V. Tarle and V.G. Trukhanovsky, Professor L.I. Clove, Y. Borisov, F.I. Notovitch, G.L. Rozanov. Their work in 1940-1960's at the Department of World History at MGIMO-University progressed in following directions: France studies, German studies, American studies. The work resulted in a number of monographs and textbooks on modern history and foreign policy of the studied countries and regions. The aim of the publications was dictated by the goal of the Institute - to prepare the specialists in international affairs primarily for practical work. A close relationship with the Foreign Ministry was "binding advantage" sometimes limiting researchers in choosing periods and subjects for the study. At the same time the undisputed advantage and quality of regional studies at MGIMO were strengthened by the practical relevance of research, making it a vital and interesting not only for specialists but also for students and researchers from other research centers. Another characteristic of the tradition is the analysis of foreign policy and diplomacy in a close relationship with the socio-economic and political processes. Such an integrated approach to regional geography also formed largely under the influence of institutional profile designed to train highly skilled and versatile specialists in specific countries and regions with a good knowledge of their languages, history, economics, politics, law and culture. Therefore, scientific and educational-methodical work at MGIMO-University has always relied on a wealth of empirical data and has been focused on the analysis of real-world phenomena and processes, acute problems of foreign countries. Scientific research at MGIMO-University traditionally intertwined with

  18. Club studies

    DEFF Research Database (Denmark)

    Demant, Jakob Johan; Ravn, Signe; Harder, Sidsel Kirstine

    2010-01-01

    Club studies are sociological investigations of youth drug use in the social situation of the club. By being present at the club the researcher tries to gain access to a somehow hidden population of drug users who only to a lesser extent perceive their drug use as problematic. In spite of impress......Club studies are sociological investigations of youth drug use in the social situation of the club. By being present at the club the researcher tries to gain access to a somehow hidden population of drug users who only to a lesser extent perceive their drug use as problematic. In spite...... of impressive club studies conducted in both Great Britain and in the United States, it seems that, broadly speaking, previous efforts can be characterized as either very broad and/or quantitative or very particular, sub-cultural and exclusively qualitative. Through a review of these studies, this article...... suggests a mixed-methods approach to club studies that combine quantitative data, qualitative interviews and ethnography conducted in the club space. By introducing the concept of ‘socionautics', this review suggests that the researcher travels into the social landscape of youth, clubs and drugs...

  19. Studying Sideways

    DEFF Research Database (Denmark)

    Plesner, Ursula

    2011-01-01

    inequalities in relation to the people we study. This article argues that not all types of social scientific research interviews benefit from an à priori problematization of power and control, ethics and equality, or emancipation. From a constructivist perspective, the article seeks to displace......, we must cultivate interview methods which cause confrontation and disagreement—not to acknowledge asymmetry but to enhance the quality of research.......One strand of the qualitative interview literature has been concerned with the normative or otherwise problematic implications of studying down or studying up (i.e., interviewing “disadvantaged” people or elites). This interview literature is part of a tradition of taking up the problem of power...

  20. Invisibility Studies

    DEFF Research Database (Denmark)

    Invisibility Studies explores current changes in the relationship between what we consider visible and what invisible in different areas of contemporary culture. Contributions trace how these changes make their marks on various cultural fields and investigate the cultural significance of these de......Invisibility Studies explores current changes in the relationship between what we consider visible and what invisible in different areas of contemporary culture. Contributions trace how these changes make their marks on various cultural fields and investigate the cultural significance...... conditioned by physical and social settings that create certain possibilities for visibility and visuality, yet exclude others. The richness and complexity of this cultural framework means that no single discipline or interdisciplinary approach could capture it single-handedly. Invisibility Studies begins...

  1. Project studies

    DEFF Research Database (Denmark)

    Geraldi, Joana; Söderlund, Jonas

    2018-01-01

    Project organising is a growing field of scholarly inquiry and management practice. In recent years, two important developments have influenced this field: (1) the study and practice of projects have extended their level of analysis from mainly focussing on individual projects to focussing on micro......, and of the explanations of project practices they could offer. To discuss avenues for future research on projects and project practice, this paper suggests the notion of project studies to better grasp the status of our field. We combine these two sets of ideas to analyse the status and future options for advancing...... project research: (1) levels of analysis; and (2) type of research. Analysing recent developments within project studies, we observe the emergence of what we refer to as type 3 research, which reconciles the need for theoretical development and engagement with practice. Type 3 research suggests pragmatic...

  2. Study protocol

    DEFF Research Database (Denmark)

    Smith, Benjamin E; Hendrick, Paul; Bateman, Marcus

    2017-01-01

    avoidance behaviours, catastrophising, self-efficacy, sport and leisure activity participation, and general quality of life. Follow-up will be 3 and 6 months. The analysis will focus on descriptive statistics and confidence intervals. The qualitative components will follow a thematic analysis approach....... DISCUSSION: This study will evaluate the feasibility of running a definitive large-scale trial on patients with patellofemoral pain, within the NHS in the UK. We will identify strengths and weaknesses of the proposed protocol and the utility and characteristics of the outcome measures. The results from...... this study will inform the design of a multicentre trial. TRIAL REGISTRATION: ISRCTN35272486....

  3. Study Drugs

    OpenAIRE

    Lam, Stephanie Phuong; Roosta, Natalie; Nielsen, Mikkel Fuhr; Meyer, Maria Holmgaard; Friis, Katrine Birk

    2016-01-01

    In recent years, students around the world, started to use preparations as Ritalin and Modafinil,also known as study drugs, to improve their cognitive abilities1. It is a common use among thestudents in United States of America, but it is a new tendency in Denmark. Our main focus is tolocate whether study drugs needs to be legalized in Denmark or not. To investigate this ourstarting point is to understand central ethical arguments in the debate. We have chosen twoarguments from Nick Bostrom a...

  4. Security studies

    International Nuclear Information System (INIS)

    Venot, R.

    2001-01-01

    Full text: Security studies constitute one of the major tools for evaluating the provisions implemented at facilities to protect and control Nuclear Material against unauthorized removal. Operators use security studies to demonstrate that they are complying with objectives set by the Competent Authority to counter internal or external acts aimed at unauthorized removal of NM. The paper presents the context of security studies carried out in France. The philosophy of these studies is based on a postulated unauthorized removal of NM and the study of the behavior of the systems implemented to control and protect NM in a facility. The potential unauthorized removal of NM usually may take place in two stages. The first stage involves the sequence leading to handling of the NM. It occurs inside the physical barriers of a facility and may include action involving the documents corresponding to Material Control and Accounting systems. At this stage it is possible to limit the risk of unauthorized removal of NM by means of detection capabilities of the MC and A systems. The second stage is more specific to theft and involves removing the NM out of the physical barriers of a facility in which they are being held, notably by affecting the Physical Protection System. Operators have to study, from a quantity and time lapse point of view, the ability of the installed systems to detect unauthorized removal, as well as the possibility of tampering with the systems to mask unlawful operations. Operators have also to analyze the sequences during which NM are accessed, removed from their containment and further removed from the facility in which they are stored. At each stage in the process, the probability of detection and the time taken to carry out the above actions have to be estimated. Of course, these two types of studies complement each other. Security studies have begun, in France, for more than fifteen years. Up to now more than fifty security studies are available in the

  5. Polarization study

    International Nuclear Information System (INIS)

    Nurushev, S.B.

    1989-01-01

    Brief review is presented of the high energy polarization study including experimental data and the theoretical descriptions. The mostimportant proposals at the biggest accelerators and the crucial technical developments are also listed which may become a main-line of spin physics. 35 refs.; 10 figs.; 4 tabs

  6. Hydrogeological study

    International Nuclear Information System (INIS)

    Massa, E.; Heinzen, W.; Santana, J.

    1987-01-01

    This work shows the hydrogeological study and well drilling carried out in the Teaching Formation Institute San Jose de Mayo Province Uruguay. It was developed a geological review in the National Directorate of Geology and Mining data base as well as field working, geology and hydrogeology recognition and area well drilling inventory.

  7. Immunology studies

    International Nuclear Information System (INIS)

    Smith, D.M.; Baron, P.A.; Drake, G.A.; LaBauve, P.M.; London, J.E.; Wilson, J.S.

    1977-01-01

    The following studies were conducted in the field of immunology; a model system to determine toxic effects on the immune system using 3 H-uridine uptake by Feells of rats; and survival in lethally irradiatd mice receiving allogenic fetal liver and thymus

  8. CASE STUDY

    African Journals Online (AJOL)

    2011-06-02

    Jun 2, 2011 ... immunosuppression associated with HIV/AIDS puts them at a higher risk of developing oesophageal cancer. 47. CASE STUDY. A 49-year-old man was diagnosed as HIV infected, with a CD4 count of 60 cells/µl. He was started on an antiretroviral treatment regimen comprising zidovudine, lamivudine and ...

  9. Pilot study

    International Nuclear Information System (INIS)

    Hofmeester, G.H.; Swart, A.; Dijk, E. van

    1984-01-01

    In May 1980 it was decided to organize an intercomparison of personal dosimeters for photon radiations. The Commission of the European Communities initiated the intercomparison by starting a pilot study in which three laboratories NPL (United Kingdom), PTB (Germany) and RIV (The Netherlands) were asked to irradiate a series of personal dosemeters from institutes, GSF (Muenchen), CEA (Fontenay-aux-Roses), CNEN (Bologna) and CEGB (Berkeley). The latter institutes are secondary standard laboratories and have a radiation protection service as well. A new aspect of this pilot study is the fact that the irradiations also take place in front of a phantom. Irradiations took place in July and August 1980. The results of 4 institutes show that the personal dosemeters are quite capable of measuring the backscattered photon components

  10. Study Strategies

    DEFF Research Database (Denmark)

    Nielsen, Camilla Kirketerp; Noer, Vibeke Røn

    and theory forms the basis of the research. Veterinary students have been followed through alternating learning contexts referring to both the scholastic academic classrooms and workplaces in commercial pig herds as well as to group work and game-based situations in a mandatory master course - ”the pig...... as a student´ and the process of professionalization. By maintaining the position of focusing upon the education as a situated and formative trajectory, the comparative analysis shows how students in profession-oriented educational settings manage the challenges of education and use study strategies......ID: 1277 / 22 SES 06 B: 2 22. Research in Higher Education Format of Presentation: Paper Alternative EERA Network: 19. Ethnography Topics: NW 22: Teaching, learning and assessment in higher education Keywords: Profession-oriented learning, study strategies, professionalisation processes...

  11. Economic Studies

    Directory of Open Access Journals (Sweden)

    A. V. Kholopov

    2014-01-01

    Full Text Available The establishment of the School of Economic Science at MGIMO was due to the necessity of the world economy research, and the need to prepare highly skilled specialists in international economics. The school is developing a number of areas, which reflect the Faculty structure. - Economic theory is one of the most important research areas, a kind of foundation of the School of Economic Science at MGIMO. Economic theory studies are carried out at the chair of Economic theory. "The course of economic theory" textbook was published in 1991, and later it was reprinted seven times. Over the past few years other textbooks and manuals have been published, including "Economics for Managers" by Professor S.N. Ivashkovskaya, which survived through five editions; "International Economics" - four editions and "History of Economic Thought" - three editions. - International Economic Relations are carried out by the Department of International Economic Relations and Foreign Economic Activity. Its establishment is associated with the prominent economist N.N. Lyubimov. In 1957 he with his colleagues published the first textbook on the subject which went through multiple republications. The editorial team of the textbook subsequently formed the pride of Soviet economic science - S.M. Menshikov, E.P. Pletnev, V.D. Schetinin. Since 2007, the chair of Foreign Economic Activities led by Doctor of Economics, Professor I. Platonova has been investigating the problems of improving the architecture of foreign economic network and the international competitiveness of Russia; - The history of the study of problems of the world economy at MGIMO begins in 1958 at the chair baring the same name. Since 1998, the department has been headed by Professor A. Bulatov; - The study of international monetary relations is based on the chair of International Finance, and is focused on addressing the fundamental scientific and practical problems; - The chair "Banks, monetary circulation

  12. Studying Emerge

    DEFF Research Database (Denmark)

    Davies, Sarah Rachael; Selin, Cynthia; Rodegher, Sandra

    2015-01-01

    The Emerge event, held in Tempe, AZ in March 2012, brought together a range of scientists, artists, futurists, engineers and students in order to experiment with innovative methods for thinking about the future. These methodological techniques were tested through nine workshops, each of which made...... use of a different format; Emerge as a whole, then, offered an opportunity to study a diverse set of future-oriented engagement practices. We conducted an event ethnography, in which a team of 11 researchers collaboratively developed accounts of the practices at play within Emerge and its workshops...

  13. Law Studies

    Directory of Open Access Journals (Sweden)

    G. P. Tolstopiatenko

    2014-01-01

    Full Text Available At the origin of the International Law Department were such eminent scientists, diplomats and teachers as V.N. Durdenevsky, S.B. Krylov and F.I. Kozhevnikov. International law studies in USSR and Russia during the second half of the XX century was largely shaped by the lawyers of MGIMO. They had a large influence on the education in the international law in the whole USSR, and since 1990s in Russia and other CIS countries. The prominence of the research of MGIMO international lawyers was due to the close connections with the international practice, involving international negotiations in the United Nations and other international fora, diplomatic conferences and international scientific conferences. This experience is represented in the MGIMO handbooks on international law, which are still in demand. The Faculty of International Law at MGIMO consists of seven departments: Department of International Law, Department of Private International and Comparative Law; Department of European Law; Department of Comparative Constitutional Law; Department of Administrative and Financial Law; Department of Criminal Law, Department Criminal Procedure and Criminalistics. Many Russian lawyers famous at home and abroad work at the Faculty, contributing to domestic and international law studies. In 1947 the Academy of Sciences of the USSR published "International Law" textbook which was the first textbook on the subject in USSR. S.B. Krylov and V.N. Durdenevsky were the authors and editors of the textbook. First generations of MGIMO students studied international law according to this textbook. All subsequent books on international law, published in the USSR, were based on the approach to the teaching of international law, developed in the textbook by S.B. Krylov and V.N. Durdenevsky. The first textbook of international law with the stamp of MGIMO, edited by F.I. Kozhevnikov, was published in 1964. This textbook later went through five editions in 1966, 1972

  14. Immunology studies

    International Nuclear Information System (INIS)

    Anon.

    1979-01-01

    Three efforts dealing with the role of the immune state have continued to show promise over the last year. The first deals with the development of animal models for testing the part played by immune dysfunction in carcinogenesis. The second and related program is a clinical study of high-risk uranium miners whose status in relation to neoplastic manifestations is rather well-defined. The third program is one in which fetal tissue is used to attempt the rescue of lethally irradiated hosts

  15. Geologic studies

    International Nuclear Information System (INIS)

    Wayland, T.E.; Rood, A.

    1983-01-01

    The modern Great Divide Basin is the end product of natural forces influenced by the Green River lake system, Laramide tectonism, and intermittent volcanic events. It ranks as one of the most complex structural and stratigtaphic features within the Tertiary basins of Wyoming. Portions of the Great Divide Basin and adjoining areas in Wyoming have been investigated by applying detailed and region exploration methods to known uranium deposits located within the Red Desert portions of the basin. Geologic field investigations conducted by Bendix Field Engineering Corporaton (Bendix) were restricted to reconnaissance observations made during infrequent visits to the project area by various Bendix personnel. Locations of the most comprehensive field activities are shown in Figure II-1. The principal source fo data for geologic studies of the Red Desert project area has been information and materials furnished by industry. Several hundred holes have been drilled by various groups to delineate the uranium deposits. Results from Bendix-drilled holes at selected locations within the project area are summarized in Table II-1. Additional details and gross subsurface characteristics are illustrated in cross sections; pertinent geologic features are illustrated in plan maps. Related details of continental sedimentation that pertain to the Wyoming Basins generally, and the project area specificially, are discussed in subsections of this Geologic Studies section

  16. Improving Clinical Risk Stratification at Diagnosis in Primary Prostate Cancer: A Prognostic Modelling Study.

    Directory of Open Access Journals (Sweden)

    Vincent J Gnanapragasam

    2016-08-01

    new five-stratum risk stratification system was produced, and its prognostic power was compared against the current system, with PCSM as the outcome. The results were analysed using a Cox hazards model, the log-rank test, Kaplan-Meier curves, competing-risks regression, and concordance indices. In the training set, the new risk stratification system identified distinct subgroups with different risks of PCSM in pair-wise comparison (p < 0.0001. Specifically, the new classification identified a very low-risk group (Group 1, a subgroup of intermediate-risk cancers with a low PCSM risk (Group 2, hazard ratio [HR] 1.62 [95% CI 0.96-2.75], and a subgroup of intermediate-risk cancers with an increased PCSM risk (Group 3, HR 3.35 [95% CI 2.04-5.49] (p < 0.0001. High-risk cancers were also sub-classified by the new system into subgroups with lower and higher PCSM risk: Group 4 (HR 5.03 [95% CI 3.25-7.80] and Group 5 (HR 17.28 [95% CI 11.2-26.67] (p < 0.0001, respectively. These results were recapitulated in the testing set and remained robust after inclusion of competing risks. In comparison to the current risk stratification system, the new system demonstrated improved prognostic performance, with a concordance index of 0.75 (95% CI 0.72-0.77 versus 0.69 (95% CI 0.66-0.71 (p < 0.0001. In an external cohort, the new system achieved a concordance index of 0.79 (95% CI 0.75-0.84 for predicting PCSM versus 0.66 (95% CI 0.63-0.69 (p < 0.0001 for the current NICE risk stratification system. The main limitations of the study were that it was registry based and that follow-up was relatively short.A novel and simple five-stratum risk stratification system outperforms the standard three-stratum risk stratification system in predicting the risk of PCSM at diagnosis in men with primary non-metastatic prostate cancer, even when accounting for competing risks. This model also allows delineation of new clinically relevant subgroups of men who might potentially receive more appropriate

  17. Aerosol studies

    International Nuclear Information System (INIS)

    Cristy, G.A.; Fish, M.E.

    1978-01-01

    As part of the continuing studies of the effects of very severe reactor accidents, an effort was made to develop, test, and improve simple, effective, and inexpensive methods by which the average citizen, using only materials readily available, could protect his residence, himself, and his family from injury by toxic aerosols. The methods for protection against radioactive aerosols should be equally effective against a clandestine biological attack by terrorists. The results of the tests to date are limited to showing that spores of the harmless bacterium, bacillus globegii (BG), can be used as a simulant for the radioactive aerosols. An aerosol generator of Lauterbach type was developed which will produce an essentially monodisperse aerosol at the rate of 10 9 spores/min. Analytical techniques have been established which give reproducible results. Preliminary field tests have been conducted to check out the components of the system. Preliminary tests of protective devices, such as ordinary vacuum sweepers, have given protection factors of over 1000

  18. Conceptual study

    Energy Technology Data Exchange (ETDEWEB)

    Harty, H.

    1978-09-01

    This appendix is a compendium of topical reports prepared for the Hanford Nuclear Energy Center: Status Report: Conceptual Fuel Cycle Studies for the Hanford Nuclear Energy Center; Selection of Heat Disposal Methods for a Hanford Nuclear Energy Center; Station Service Power Supply for a Hanford Nuclear Energy Center (HNEC); Impact of a Hanford Nuclear Energy Center on Ground Level Fog and Humidity; A Review of Potential Technology for the Seismic Characterization of Nuclear Energy Centers; Reliability of Generation at a Hanford Nuclear Energy Center (HNEC); Meteorological Evaluation of Multiple Reactor Contamination Probabilities for a Hanford Nuclear Energy Center; Electric Power Transmission for a Hanford Nuclear Energy Center (HNEC); The Impact of a Hanford Nuclear Energy Center on Cloudiness and Insolation; and A Licensing Review for an HNEC.

  19. Terrestrial studies

    International Nuclear Information System (INIS)

    Anon.

    1980-01-01

    Tritium in the organic fraction of soil, separated as water by high temperature combustion, was 5 to 50 times higher in activity than water that was freeze-dried from the same samples. The 50-year dose commitment from ingestion of crops is not influenced significantly by the plutonium in the SRP environment. This plutonium is a result of more than 20 years of operating chemical separations facilities. Techniques were developed to detect as little as 0.02 pCi/m 2 of iodine-129 and 0.2 pg of technetium-99 in soil to evaluate environmental effects. A sensitive three-stage mass spectrometer was completed for use in environmental studies of transuranium elements. Results of monitoring particle size distribution of entrapped particles containing Pu-238, and Pu-239,240 are reported

  20. Conceptual study

    International Nuclear Information System (INIS)

    Harty, H.

    1978-09-01

    This appendix is a compendium of topical reports prepared for the Hanford Nuclear Energy Center: Status Report: Conceptual Fuel Cycle Studies for the Hanford Nuclear Energy Center; Selection of Heat Disposal Methods for a Hanford Nuclear Energy Center; Station Service Power Supply for a Hanford Nuclear Energy Center (HNEC); Impact of a Hanford Nuclear Energy Center on Ground Level Fog and Humidity; A Review of Potential Technology for the Seismic Characterization of Nuclear Energy Centers; Reliability of Generation at a Hanford Nuclear Energy Center (HNEC); Meteorological Evaluation of Multiple Reactor Contamination Probabilities for a Hanford Nuclear Energy Center; Electric Power Transmission for a Hanford Nuclear Energy Center (HNEC); The Impact of a Hanford Nuclear Energy Center on Cloudiness and Insolation; and A Licensing Review for an HNEC

  1. Studying antimatter

    CERN Multimedia

    CERN. Geneva

    2006-01-01

    Antiparticles are a crucial ingredient of particle physics and cosmology. Almost 80 years after Dirac’s bold prediction and the subsequent discovery of the positron in 1932, antiparticles are still in the spotlight of modern physics. This lecture for non-specialists will start with a theoretical and historical introduction. Why are antiparticles needed? When and how were they discovered? Why is the (CPT) symmetry between particles and antiparticles so fundamental? What is their role in cosmology? The second part will give an overview about the many aspects of antiparticles in experimental physics: their production, their use in colliders; as a probe inside atoms or nuclei; or as an object to study fundamental symmetries. In the third part, the lecture will focus on results and challenges of the “antimatter” programme at the Antiproton Decelerator (AD), with special emphasis on antihydrogen production, trapping and precision measurements.

  2. Spectroscopic study

    International Nuclear Information System (INIS)

    Flores, M.; Rodriguez, R.; Arroyo, R.

    1999-01-01

    This work is focused about the spectroscopic properties of a polymer material which consists of Polyacrylic acid (Paa) doped at different concentrations of Europium ions (Eu 3+ ). They show that to stay chemically joined with the polymer by a study of Nuclear Magnetic Resonance (NMR) of 1 H, 13 C and Fourier Transform Infrared Spectroscopy (Ft-IR) they present changes in the intensity of signals, just as too when this material is irradiated at λ = 394 nm. In according with the results obtained experimentally in this type of materials it can say that is possible to unify chemically the polymer with this type of cations, as well as, varying the concentration of them, since that these are distributed homogeneously inside the matrix maintaining its optical properties. These materials can be obtained more quickly and easy in solid or liquid phase and they have the best conditions for to make a quantitative analysis. (Author)

  3. American Studies

    Directory of Open Access Journals (Sweden)

    V. O. Pechatnov

    2014-01-01

    Full Text Available The "Founding fathers" of American Studies at MGIMO are considered to be A.V. Efimov and L.I. Clove. Alexey Efimov - Corresponding Member of the USSR Academy of Sciences since 1938, Head of the Department of Modern and Contemporary History and Dean of the Historical School at the Moscow State University - one of the first professors of the Faculty of International Relations MGIMO. Efimov distinguished himself by a broad vision and scope of scientific interests. Back in 1934 he published a monograph "On the history of capitalism in the United States," which initiated a series of research culminating in the fundamental work "The United States. The path of capitalist development (pre-imperialist era". Alexey was not only a great scientist but also a great teacher, whose lectures was popular throughout Moscow. His lecture courses, given at the end of the 1940s at MGIMO, became the basis for the first post-war history textbooks USA - "Essays on the history of the United States." At least as colorful a figure was Professor Leo Izrailevich Zubok - a man of unusual destiny. As a teenager he emigrated to the United States with his parents, where he soon joined the American revolutionary movement in the 1920s and was forced to leave the country. He came to MGIMO being already an experienced scientists. His research interests were very wide: from the study of American foreign policy expansion to the history of the labor movement in the United States. Zubok's fundamental works still have not lost its scientific significance. He has successfully combined scientific work with teaching. Tutorials that are based on his lectures were very popular not only among students of MGIMO.

  4. Aquatic studies

    International Nuclear Information System (INIS)

    Anon.

    1980-01-01

    Thermal stress to microorganisms was measured by the production of dissolved organic matter by algal communities and the mineralization of glucose by heterotrophic populations. Mutagenic activity as measured by the Ames/Salmonella/microsome assay indicate that such activity does not occur in Par Pond, although limited mutagenic activity does occur in a nearby canal system due to chlorination of cooling water. Sodium hypochlorite, used as an algicide in the reactor fuel storage basins, caused increased pitting corrosion to reactor fuel targets. Five other compounds selected for testing proved to be superior to sodium hypochlorite. Legionella pneumophila, the pathogen which causes Legionnaire's disease, was found to be a natural part of aquatic ecosystems. It occurs over a wide range of environments and is able to utilize nutrients provided by primary producers. Phytoplankton size classes of less than 3 μm (less than 5% of the total phytoplankton biomass) accounted for 15 to 40% of the total primary productivity in Par Pond, Pond C, and Clark Hill Reservoir. Three major biological data sets were compiled and are available in the SRL computer system for analysis: the SRP deer herd data; 20 years of Par Pond data; and 25 years of biological data on the Savannah River. Results of marine studies indicated that nearly all plutonium in the Savannah River and its estuary resulted from nuclear weapons fallout. The plutonium concentration in the Savannah River is about one fourth the concentration in the Newport River which has no nuclear operations associated with it

  5. Catalysis studies

    International Nuclear Information System (INIS)

    Taylor, T.N.; Ellis, W.P.

    1977-11-01

    The New Research Initiatives Program (NRIP) project on catalysis in Los Alamos Scientific Laboratory (LASL) Group CMB-8 has made significant progress towards performing the first basic in situ experimental studies of heterogeneous catalysis on solid compound surfaces in a LEED-Auger system. To further understand the surface crystallography of a possible catalyst compound, LEED-Auger measurements were made on UO 2 (approximately 100) vicinal surfaces. These (approximately 100) vicinal surfaces were shown to decompose irreversibly into lower index facets, including prominent (100) facets, at temperatures below those needed for creation of lowest index faceting on (approximately 111) vicinal surfaces. LEED examination of fully faceted surfaces from both types of UO 2 vicinal cuts did not show evidence of cyclopropane or propene chemisorption. The existing LEED-Auger system was modified to allow catalytic reactions at approximately less than 10 -3 torr. A sample holder, specifically designed for catalysis measurements in the modified system, was tested while examining single crystals of CoO and Cr 2 O 3 . Extensive LEED-Auger measurements were made on CoO in vacuo and in the presence of light hydrocarbons and alcohols plus H 2 O, NO, and NH 3 . No chemisorptive behavior was observed except with H 2 O in the presence of the electron beam. Although only examined briefly, the Cr 2 O 3 was remarkable for the sharp LEED features obtained prior to any surface treatment in the vacuum system

  6. An Association Between Selective Serotonin Reuptake Inhibitor Use and Serious Upper Gastrointestinal Bleeding

    DEFF Research Database (Denmark)

    Dall, Michael; Schaffalitzky de Muckadell, Ove B; Lassen, Annmarie Touborg

    2009-01-01

    BACKGROUND & AIMS: In vitro studies have shown that selective serotonin reuptake inhibitors (SSRIs) inhibit platelet aggregation. It is controversial whether use of SSRIs is a cause of clinically important bleeding; results from observational studies have been equivocal. METHODS: A population......-based case-control study was conducted in the county of Funen, Denmark. The 3652 cases all had a first discharge diagnosis of serious upper gastrointestinal bleeding (UGB) from 1995 to 2006. All cases were manually validated. Controls (n = 36,502), matched for age and sex, were selected by risk-set sampling....... Data on drug exposure and medical history were retrieved from a prescription database and the county's patient register. Confounders were controlled for by conditional logistic regression and the case-crossover design. RESULTS: The adjusted odds ratio (OR) of UGB among current, recent, and past users...

  7. Tramadol use and the risk of hospitalization for hypoglycemia in patients with noncancer pain.

    Science.gov (United States)

    Fournier, Jean-Pascal; Azoulay, Laurent; Yin, Hui; Montastruc, Jean-Louis; Suissa, Samy

    2015-02-01

    Tramadol is a weak opioid analgesic whose use has increased rapidly, and it has been associated with adverse events of hypoglycemia. To assess whether tramadol use, when compared with codeine use, is associated with an increased risk of hospitalization for hypoglycemia. A nested case-control analysis was conducted within the United Kingdom Clinical Practice Research Datalink linked to the Hospital Episodes Statistics database of all patients newly treated with tramadol or codeine for noncancer pain between 1998 and 2012. Cohort and case-crossover analyses were also conducted to assess consistency of the results. Cases of hospitalization for hypoglycemia were matched with up to 10 controls on age, sex, and duration of follow-up. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated comparing use of tramadol with codeine. A cohort analysis, with high-dimensional propensity score-adjusted hazard ratios (HRs) and 95% CIs, was performed comparing tramadol with codeine in the first 30 days after treatment initiation. Finally, a case-crossover analysis was also performed, in which exposure to tramadol in a 30-day risk period immediately before the hospitalization for hypoglycemia was compared with 11 consecutive 30-day control periods. Odds ratios and 95% CIs were estimated using conditional logistic regression analysis. The cohort included 334,034 patients, of whom 1105 were hospitalized for hypoglycemia during follow-up (incidence, 0.7 per 1000 per year) and matched to 11,019 controls. Compared with codeine, tramadol use was associated with an increased risk of hospitalization for hypoglycemia (OR, 1.52 [95% CI, 1.09-2.10]), particularly elevated in the first 30 days of use (OR, 2.61 [95% CI, 1.61-4.23]). This 30-day increased risk was confirmed in the cohort (HR, 3.60 [95% CI, 1.56-8.34]) and case-crossover analyses (OR, 3.80 [95% CI, 2.64-5.47]). The initiation of tramadol therapy is associated with an increased risk of hypoglycemia requiring

  8. Air Pollution Exposure—A Trigger for Myocardial Infarction?

    Directory of Open Access Journals (Sweden)

    Niklas Berglind

    2010-03-01

    Full Text Available The association between ambient air pollution exposure and hospitalization for cardiovascular events has been reported in several studies with conflicting results. A case-crossover design was used to investigate the effects of air pollution in 660 first-time myocardial infarction cases in Stockholm in 1993–1994, interviewed shortly after diagnosis using a standard protocol. Air pollution data came from central urban background monitors. No associations were observed between the risk for onset of myocardial infarction and two-hour or 24-hour air pollution exposure. No evidence of susceptible subgroups was found. This study provides no support that moderately elevated air pollution levels trigger first-time myocardial infarction.

  9. Weather conditions may worsen symptoms in rheumatoid arthritis patients: the possible effect of temperature.

    Science.gov (United States)

    Abasolo, Lydia; Tobías, Aurelio; Leon, Leticia; Carmona, Loreto; Fernandez-Rueda, Jose Luis; Rodriguez, Ana Belen; Fernandez-Gutierrez, Benjamin; Jover, Juan Angel

    2013-01-01

    Patients with rheumatoid arthritis (RA) complain that weather conditions aggravate their symptoms. We investigated the short-term effects of weather conditions on worsening of RA and determined possible seasonal fluctuations. We conducted a case-crossover study in Madrid, Spain. Daily cases of RA flares were collected from the emergency room of a tertiary level hospital between 2004 and 2007. 245 RA patients who visited the emergency room 306 times due to RA related complaints as the main diagnostic reason were included in the study. Patients from 50 to 65 years old were 16% more likely to present a flare with lower mean temperatures. Our results support the belief that weather influences rheumatic pain in middle aged patients. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  10. Seasonal Patterns of Japanese Encephalitis and Associated Meteorological Factors in Taiwan.

    Science.gov (United States)

    Lin, Che-Liang; Chang, Hsiao-Ling; Lin, Chuan-Yao; Chen, Kow-Tong

    2017-10-29

    The persistent transmission of Japanese encephalitis virus (JEV) in Taiwan necessitates exploring the risk factors of occurrence of Japanese encephalitis (JE). The purpose of this study was to assess the relationship between meteorological factors and the incidence of JE in Taiwan. We collected data for cases of JE reported to the Taiwan Centers for Disease Control (Taiwan CDC) from 2000 to 2014. Meteorological data were obtained from the Taiwan Central Weather Bureau. The relationships between weather variability and the incidence of JE in Taiwan were determined via Poisson regression analysis and a case-crossover methodology. During the 15-year study period, a total of 379 cases of JE were reported. The incidence of JE showed significant seasonality, with the majority of cases occurring in summertime (for oscillation, p Taiwan. Therefore, these factors could be regarded as warning signals indicating the need to implement preventive measures.

  11. Fostering Effective Studying and Study Planning with Study Questions

    Science.gov (United States)

    Wilhelm, Pascal; Pieters, Jules M.

    2007-01-01

    In a course on biological psychology and neuropsychology, study questions were provided that also appeared as test questions in the course exam. This method was introduced to support students in active processing and reproduction of the study texts, and study planning. Data were gathered to test the hypothesis that study question use would be…

  12. Acute effects of urban and industrial pollution in a government-designated "Environmental risk area": the case of Brindisi, Italy.

    Science.gov (United States)

    Gianicolo, Emilio Antonio Luca; Bruni, Antonella; Mangia, Cristina; Cervino, Marco; Vigotti, Maria Angela

    2013-01-01

    Exposure to air pollutants has been associated with increased hospital admissions (HAs) for respiratory and cardiovascular diseases. This work describes a short-term epidemiological study in Brindisi, a highly industrialized town in Southern Italy. The effects of daily exposure to PM10 and NO2 on daily HAs for cardiac, respiratory, and cerebrovascular diseases were investigated by means of a case-crossover design in the period 2001-2007. Results showed positive associations between PM10 and HAs for cardiac and respiratory diseases and between NO2 and HAs for all the categories of diseases considered, particularly among females. Although not statistically significant, increased risk was observed for wind blowing from the port and the industrial area. Findings confirm the health risks associated with ambient air pollution exposure, even though NO2 and PM10 concentrations were below the legal limits. This may be due to the complex scenario of emissions in the area, which should be better investigated.

  13. Air Pollution and Ischemic Stroke Among Young Adults.

    Science.gov (United States)

    Yitshak Sade, Maayan; Novack, Victor; Ifergane, Gal; Horev, Anat; Kloog, Itai

    2015-12-01

    Studies have demonstrated consistent associations between cardiovascular illness and particulate matter (PM) stroke received less attention. We hypothesized that air pollution, an inflammation progenitor, can be associated with stroke incidence in young patients in whom the usual risk factors for stroke are less prevalent. We aimed to evaluate the association between stroke incidence and exposure to PM stroke between 2005 and 2012. Exposure assessment was based on a hybrid model incorporating daily satellite remote sensing data at 1-km spatial resolution. We performed case-crossover analysis, stratified by personal characteristics and distance from main roads. We identified 4837 stroke cases (89.4% ischemic stroke). Interquartile range of PM ischemic stroke and increases of interquartile range average concentrations of particulate matter ischemic stroke associated with PM among young adults. This finding can be explained by the inflammatory mechanism, linking air pollution and stroke. © 2015 American Heart Association, Inc.

  14. Association between outdoor ozone and compensated acute respiratory diseases among workers in Quebec (Canada).

    Science.gov (United States)

    Adam-Poupart, Ariane; Labrèche, France; Busque, Marc-Antoine; Brand, Allan; Duguay, Patrice; Fournier, Michel; Zayed, Joseph; Smargiassi, Audrey

    2015-01-01

    Respiratory effects of ozone in the workplace have not been extensively studied. Our aim was to explore the relationship between daily average ozone levels and compensated acute respiratory problems among workers in Quebec between 2003 and 2010 using a time-stratified case-crossover design. Health data came from the Workers' Compensation Board. Daily concentrations of ozone were estimated using a spatiotemporal model. Conditional logistic regressions, with and without adjustment for temperature, were used to estimate odds ratios (ORs, per 1 ppb increase of ozone), and lag effects were assessed. Relationships with respiratory compensations in all industrial sectors were essentially null. Positive non-statistically significant associations were observed for outdoor sectors, and decreased after controlling for temperature (ORs of 0.98; 1.01 and 1.05 at Lags 0, 1 and 2 respectively). Considering the predicted increase of air pollutant concentrations in the context of climate change, closer investigation should be carried out on outdoor workers.

  15. Risk of Carotid Stroke after Chiropractic Care

    DEFF Research Database (Denmark)

    Cassidy, J. David; Boyle, Eleanor; Côté, Pierre

    2017-01-01

    Background Chiropractic manipulation is a popular treatment for neck pain and headache, but may increase the risk of cervical artery dissection and stroke. Patients with carotid artery dissection can present with neck pain and/or headache before experiencing a stroke. These are common symptoms seen...... by both chiropractors and primary care physicians (PCPs). We aimed to assess the risk of carotid artery stroke after chiropractic care by comparing association between chiropractic and PCP visits and subsequent stroke. Methods A population-based, case-crossover study was undertaken in Ontario, Canada. All...... incident cases of carotid artery stroke admitted to hospitals over a 9-year period were identified. Cases served as their own controls. Exposures to chiropractic and PCP services were determined from health billing records. Results We compared 15,523 cases to 62,092 control periods using exposure windows...

  16. Case Study: Testing with Case Studies

    Science.gov (United States)

    Herreid, Clyde Freeman

    2015-01-01

    This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue discusses using case studies to test for knowledge or lessons learned.

  17. Association of Ambient Fine Particles With Out-of-Hospital Cardiac Arrests in New York City

    Science.gov (United States)

    Silverman, Robert A.; Ito, Kazuhiko; Freese, John; Kaufman, Brad J.; De Claro, Danilynn; Braun, James; Prezant, David J.

    2010-01-01

    Cardiovascular morbidity has been associated with particulate matter (PM) air pollution, although the relation between pollutants and sudden death from cardiac arrest has not been established. This study examined associations between out-of-hospital cardiac arrests and fine PM (of aerodynamic diameter ≤2.5 μm, or PM2.5), ozone, nitrogen dioxide, sulfur dioxide, and carbon monoxide in New York City. The authors analyzed 8,216 out-of-hospital cardiac arrests of primary cardiac etiology during the years 2002–2006. Time-series and case-crossover analyses were conducted, controlling for season, day-of-week, same-day, and delayed/apparent temperature. An increased risk of cardiac arrest in time-series (relative risk (RR) = 1.06, 95% confidence interval (CI): 1.02, 1.10) and case-crossover (RR = 1.04, 95% CI: 0.99, 1.08) analysis for a PM2.5 increase of 10 μg/m3 in the average of 0- and 1-day lags was found. The association was significant in the warm season (RR = 1.09, 95% CI: 1.03, 1.15) but not the cold season (RR = 1.01, 95% CI: 0.95, 1.07). Associations of cardiac arrest with other pollutants were weaker. These findings, consistent with studies implicating acute cardiovascular effects of PM, support a link between PM2.5 and out-of-hospital cardiac arrests. Since few individuals survive an arrest, air pollution control may help prevent future cardiovascular mortality. PMID:20729350

  18. Fostering effective studying and study planning with study questions

    NARCIS (Netherlands)

    Wilhelm, P.; Pieters, J.M.

    2007-01-01

    In a course on biological psychology and neuropsychology, study questions were provided that also appeared as test questions in the course exam. This method was introduced to support students in active processing and reproduction of the study texts, and study planning. Data were gathered to test the

  19. Archives: HTS Teologiese Studies / Theological Studies

    African Journals Online (AJOL)

    Items 1 - 50 of 120 ... Archives: HTS Teologiese Studies / Theological Studies. Journal Home > Archives: HTS Teologiese Studies / Theological Studies. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Journal Home · ABOUT THIS JOURNAL · Advanced Search ...

  20. Childhood vaccines and Kawasaki disease, Vaccine Safety Datalink, 1996-2006.

    Science.gov (United States)

    Abrams, Joseph Y; Weintraub, Eric S; Baggs, James M; McCarthy, Natalie L; Schonberger, Lawrence B; Lee, Grace M; Klein, Nicola P; Belongia, Edward A; Jackson, Michael L; Naleway, Allison L; Nordin, James D; Hambidge, Simon J; Belay, Ermias D

    2015-01-03

    Kawasaki disease is a childhood vascular disorder of unknown etiology. Concerns have been raised about vaccinations being a potential risk factor for Kawasaki disease. Data from the Vaccine Safety Datalink were collected on children aged 0-6 years at seven managed care organizations across the United States. Defining exposure as one of several time periods up to 42 days after vaccination, we conducted Poisson regressions controlling for age, sex, season, and managed care organization to determine if rates of physician-diagnosed and verified Kawasaki disease were elevated following vaccination compared to rates during all unexposed periods. We also performed case-crossover analyses to control for unmeasured confounding. A total of 1,721,186 children aged 0-6 years from seven managed care organizations were followed for a combined 4,417,766 person-years. The rate of verified Kawasaki disease was significantly lower during the 1-42 days after vaccination (rate ratio=0.50, 95% CL=0.27-0.92) and 8-42 days after vaccination (rate ratio=0.45, 95% CL=0.22-0.90) compared to rates during unexposed periods. Breaking down the analysis by vaccination category did not identify a subset of vaccines which was solely responsible for this association. The case-crossover analyses revealed that children with Kawasaki disease had lower rates of vaccination in the 42 days prior to symptom onset for both physician-diagnosed Kawasaki disease (rate ratio=0.79, 95% CL=0.64-0.97) and verified Kawasaki disease (rate ratio=0.38, 95% CL=0.20-0.75). Childhood vaccinations' studied did not increase the risk of Kawasaki disease; conversely, vaccination was associated with a transient decrease in Kawasaki disease incidence. Verifying and understanding this potential protective effect could yield clues to the underlying etiology of Kawasaki disease. Copyright © 2014. Published by Elsevier Ltd.

  1. Inequalities in Access to Treatment and Care for Patients with Dementia and Immigrant Background

    DEFF Research Database (Denmark)

    Stevnsborg, Lea; Jensen-Dahm, Christina; Nielsen, Thomas R

    2016-01-01

    BACKGROUND: Previous studies demonstrated lower quality diagnostic assessment of dementia in immigrant populations, but knowledge about the quality of treatment and care for dementia is still lacking. OBJECTIVE: To conduct a nationwide registry-based study to determine whether inequality exists...... in a nursing home were compared among Danish-born and Western and non-Western immigrants with dementia. Logistic regression analysis was done with adjustment for age, sex, comorbidity, marital status, basis of inclusion, and time since dementia diagnosis. RESULTS: Immigrant background was associated...

  2. Vitamin D status and incident cardiovascular disease and all-cause mortality

    DEFF Research Database (Denmark)

    Skaaby, Tea; Husemoen, Lise Lotte Nystrup; Pisinger, Charlotta

    2013-01-01

    Low vitamin D status has been associated with cardiovascular disease (CVD) and mortality primarily in selected groups, smaller studies, or with self-reported vitamin D intake. We investigated the association of serum vitamin D status with the incidence of a registry-based diagnosis of ischemic...... heart disease (IHD), stroke, and all-cause mortality in a large sample of the general population. A total of 9,146 individuals from the two population-based studies, Monica10 and Inter99, were included. Measurements of serum 25-hydroxyvitamin D at baseline were carried out using the IDS ISYS immunoassay...

  3. CASE STUDY CRITIQUE; UPPER CLINCH CASE STUDY

    Science.gov (United States)

    Case study critique: Upper Clinch case study (from Research on Methods for Integrating Ecological Economics and Ecological Risk Assessment: A Trade-off Weighted Index Approach to Integrating Economics and Ecological Risk Assessment). This critique answers the questions: 1) does ...

  4. Self-esteem across the second half of life: The role of socioeconomic status, physical health, social relationships, and personality factors.

    Science.gov (United States)

    von Soest, Tilmann; Wagner, Jenny; Hansen, Thomas; Gerstorf, Denis

    2018-06-01

    Self-esteem development across adulthood has been in the center of interest for some time now. However, not much is known about factors that shape self-esteem and its development in the second half of life and whether the factors differ with age and gender. To examine these questions, this study uses 2-wave data from the population-based NorLAG study in Norway (N = 5,555; M age = 58 years; 51% women) and combines self-report data on self-esteem and personality with registry-based information on socioeconomic status (education, income, unemployment), health problems (sick leave, lifetime history of disability), and social relationships (cohabiting partner, lifetime history of divorce and widowhood). Results from latent change score models revealed that self-esteem peaked at around age 50 and declined thereafter. More importantly, lower socioeconomic status, not having a cohabiting partner, unemployment, and disability were each uniquely associated with lower levels of self-esteem and/or steeper declines in self-esteem over the 5-year study period. Over and above registry-based information, personality characteristics were relevant, with a more mature personality being associated with higher self-esteem level. Emotionally stable participants also showed less pronounced declines in self-esteem. Moreover, associations of disability and of emotional stability with self-esteem level were weaker with advancing age. Among women, self-esteem level was more strongly associated with emotional stability and less strongly with openness, compared to men. Our findings demonstrate the utility of registry-based information and suggest that physical health, social relationships, and personality factors are in manifold ways uniquely associated with self-esteem and its development later in life. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  5. Building Transdisciplinary Environmental Studies

    DEFF Research Database (Denmark)

    Holm, Jesper

    2006-01-01

    Conceptual analytical-methodological conceptualization of crossdisciplinary sustainability studies......Conceptual analytical-methodological conceptualization of crossdisciplinary sustainability studies...

  6. Danish Hip Arthroscopy Registry (DHAR)

    DEFF Research Database (Denmark)

    Lund, Bent; Mygind-Klavsen, Bjarne; Grønbech Nielsen, Torsten

    2017-01-01

    The Danish Hip Arthroscopy Registry (DHAR) was initiated in January 2012 as a web-based prospective registry. The purpose of this study was to evaluate and report the first registry based outcome data of a national population with radiological and clinical femoroacetabular impingement (FAI......) data from DHAR between January 2012 and November 2015 were extracted. Radiological pincer-type FAI was defined as LCE > 35° and cam FAI as alpha-angle > 55°. These data were combined with FAI surgical data such as osteochondroplasty and labral repair or resection. PROMs consisting of HAGOS, EQ-5 D...

  7. The Long-term financial consequences of breast cancer

    DEFF Research Database (Denmark)

    Jensen, L.; Overgaard, C.; Bøggild, H.

    2017-01-01

    This registry-based cohort study was based on information retrieved from linked Danish nationwide registries. We compared the incomes of 13,101 women (aged 30-59 years) diagnosed with breast cancer (exposed) to those of 60,819 women without breast cancer (unexposed). Changes in income were examined....... For exposed and unexposed groups, the observed income changes were dichotomized to those above and those below the expected change in income in the Danish female population. We examined the impact of breast cancer on income each year with logistic regression models. Analyses were stratified according...

  8. WWC Study Review Guide: Group Design Studies

    Science.gov (United States)

    What Works Clearinghouse, 2018

    2018-01-01

    Underlying all What Works Clearinghouse (WWC) products are WWC Study Review Guides, which are intended for use by WWC certified reviewers to assess studies against the WWC evidence standards. As part of an ongoing effort to increase transparency, promote collaboration, and encourage widespread use of the WWC standards, the Institute of Education…

  9. German Studies in America. German Studies Notes.

    Science.gov (United States)

    Sander, Volkmar; Osterle, Heinz D.

    This volume contains two papers, "German Studies in America," by Volkmar Sander, and "Historicism, Marxism, Structuralism: Ideas for German Culture Courses," by Heinz D. Osterle. The first paper discusses the position of German studies in the United States today. The greatest challenge comes from low enrollments; therefore,…

  10. Study of lip prints: A forensic study

    Directory of Open Access Journals (Sweden)

    Vikash Ranjan

    2014-01-01

    Full Text Available Background: Although several studies have been done on lip prints for human identification in forensic science, there is a doubt about their use in gender determination. Aims: The present study was designed to study the lip groove patterns in all the quadrants of both male and female subjects to identify the sex, based on the patterns of the grooves of the lip prints. Study Design: 300 lip prints were collected from volunteers of D. J. College of Dental Sciences and Research, Modinagar (UP. Materials and Methods: Lip prints were recorded with lip stick and transferred on to a glass slide. Statistical Analysis: Pearson chi-square test was adopted for statistical analysis and probability value (P value was calculated. Conclusion: In our study, none of the lip prints were identical, thus confirming the role of lip prints in individual identification. According to Suzuki′s classification, Type I, II, III and IV patterns were significant in gender determination.

  11. Repository design sensitivity study: Engineering study report

    International Nuclear Information System (INIS)

    1987-01-01

    A preliminary sensitivity study of the salt repository design has been performed to identify critical site and design parameters to help guide future site characterization and design optimization activities. The study considered the SCP-conceptual design at the Deaf Smith County site in Texas with the horizontal waste package emplacement mode as the base case. Relative to this base case, parameter variations were compared. Limited studies were performed which considered the vertical emplacement mode geometry. The report presents the reference data base and design parameters on which the study was based (including the range of parameters that might be expected). Detailed descriptions of the numerical modeling methods and assumptions are included for the thermal, thermomechanical and hydrogeological analyses. The impacts of parameter variations on the sensitivity of the rock mass response are discussed. Recommendations are provided to help guide site characterization activities and advanced conceptual design optimization activities. 47 refs., 119 refs., 22 tabs

  12. Civilian End Strength Study. Study Sponsor ODCSLOG.

    Science.gov (United States)

    1985-12-30

    Chief of Staff deferred action on the recommendations and requested a subsequent briefing with the following guidance. (1) Need to do more to take...Term Actions ... ..................... 38-39 ix CIVILIAN END STRENGTH STUDY Abstract This study examined the methodology by which the Army determines...DAPE-MBC) and COA ( DACA -OMP) has facilitated this process; an updated LOI, in draft, will clear up some of the problems identified in the test

  13. Drinking Game Studies

    DEFF Research Database (Denmark)

    Debus, Michael S.

    2016-01-01

    The paper examines research on drinking game participation from a game studies ontological perspective, covering definition, classification and problems with the, in the studies implied, underlying ontology of drinking games.......The paper examines research on drinking game participation from a game studies ontological perspective, covering definition, classification and problems with the, in the studies implied, underlying ontology of drinking games....

  14. Southeastern Cancer Study Group: breast cancer studies

    International Nuclear Information System (INIS)

    Smalley, R.V.; Bartolucci, A.A.; Moore, M.

    1983-01-01

    During the past 10 years, the Southeastern Cancer Study Group (SECSG) has been engaged in one major adjuvant study and three major advanced disease studies for patients with adenocarcinoma of the breast. The adjuvant study is demonstrating that six months of adjuvant CMF is the therapeutic equivalent of 12 months and that post-operative irradiation is of no added therapeutic benefit. In patients with advanced disease, a low dose 5 drug combination of CMFVP induces more objective responses than single agent 5FU, but improves survival only for those patients with liver metastases when compared to the sequential use of the same 5 single agents. The three drug combination, CAF, utilizing doxorubicin, induces more objective responses than low dose CMFVP, but it does not improve overall survival. The addition of a phase active combination, CAMELEON, (i.e., sequentially alternating therapy) of CAF has not improved the duration of disease control and survival for patients with liver metastases, lymphangitic and nodular lung metastases compared to CAF. Aggressive combination chemotherapeutic approaches to patients with advanced disease provide better and longer disease and tumor control but only marginal improvements in overall survival. Adding additional agents to a maximally tolerable regimen has not improved the therapeutic outcome

  15. Physics studies in Europe; a comparative study

    NARCIS (Netherlands)

    Steenstrup, S; dalle Rose, LFD; Jones, WG; Tugulea, L; van Steenwijk, FJ

    What are the differences and similarities between physics studies at different universities across Europe (here the definition of Europe is broad)? How much does a student have to work to obtain a degree in physics? Questions like those prompted EUPEN (European Physics Education Network) to make a

  16. Case Study Research Methodology

    Directory of Open Access Journals (Sweden)

    Mark Widdowson

    2011-01-01

    Full Text Available Commenting on the lack of case studies published in modern psychotherapy publications, the author reviews the strengths of case study methodology and responds to common criticisms, before providing a summary of types of case studies including clinical, experimental and naturalistic. Suggestions are included for developing systematic case studies and brief descriptions are given of a range of research resources relating to outcome and process measures. Examples of a pragmatic case study design and a hermeneutic single-case efficacy design are given and the paper concludes with some ethical considerations and an exhortation to the TA community to engage more widely in case study research.

  17. The Study of Algae

    Science.gov (United States)

    Rushforth, Samuel R.

    1977-01-01

    Included in this introduction to the study of algae are drawings of commonly encountered freshwater algae, a summary of the importance of algae, descriptions of the seven major groups of algae, and techniques for collection and study of algae. (CS)

  18. Current Research Studies

    Science.gov (United States)

    ... Success Home > Explore Research > Current Research Studies Current Research Studies Email Print + Share The Crohn’s & Colitis Foundation ... conducted online. Learn more about IBD Partners. Clinical Research Alliance The Clinical Research Alliance is a network ...

  19. FEMA DFIRM Study Info

    Data.gov (United States)

    Minnesota Department of Natural Resources — This table contains details about the study such as the study name, datum, projection, etc. There is normally only one record in this table for each Flood Insurance...

  20. Neutron beam studies

    International Nuclear Information System (INIS)

    Willis, B.T.M.; Apps, M.E.

    1979-01-01

    The report is in sections, entitled: metallurgy; reactor fuels; defect solid state and interatomic forces; surface studies; colloid, polymer and biological studies; glasses; energy-related materials; solid state physics and crystallography; instrumentation and experimental technique. (U.K.)

  1. Study of strange nuclei

    International Nuclear Information System (INIS)

    Chrien, R.E.

    1982-01-01

    A brief history of the discovery of hypernuclei is given and some recent hypernuclei studies are described. Topics include the study of p-shell hypernuclei, 12 C (K - , π - ) experiment, and hypernuclear gamma rays. 13 references

  2. Chemical Industry Bandwidth Study

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2006-12-01

    The Chemical Bandwidth Study provides a snapshot of potentially recoverable energy losses during chemical manufacturing. The advantage of this study is the use of "exergy" analysis as a tool for pinpointing inefficiencies.

  3. Critical Kinship Studies

    DEFF Research Database (Denmark)

    In recent decades the concept of kinship has been challenged and reinvigorated by the so-called “repatriation of anthropology” and by the influence of feminist studies, queer studies, adoption studies, and science and technology studies. These interdisciplinary approaches have been further...... developed by increases in infertility, reproductive travel, and the emergence of critical movements among transnational adoptees, all of which have served to question how kinship is now practiced. Critical Kinship Studies brings together theoretical and disciplinary perspectives and analytically sensitive...... in the Humanities and Social Sciences today. Critical Kinship Studies should be of particular interest to students and scholars in Anthropology, Sociology, Cultural Studies, Medical Humanities, Politics, Gender and Queer Studies and Globalization....

  4. 522 Postmarket Surveillance Studies

    Data.gov (United States)

    U.S. Department of Health & Human Services — The 522 Postmarket Surveillance Studies Program encompasses design, tracking, oversight, and review responsibilities for studies mandated under section 522 of the...

  5. Descriptive studies of Purepecha: Introductory study

    Directory of Open Access Journals (Sweden)

    Violeta Vázquez Rojas Maldonado

    2013-12-01

    Full Text Available Seven papers in this volume are the result of a collective project of linguistic description. This introduction offers a general background for such enterprise. It provides information about some sociolinguistic and grammatical aspects of the Purepecha language, a list of some recent studies on the language, it describes the orthographic conventions employed. We also provide details about the elicitation methodology and the demographic information of the language consultants.

  6. Study deep geothermal energy; Studie dypgeotermisk energi

    Energy Technology Data Exchange (ETDEWEB)

    Havellen, Vidar; Eri, Lars Sigurd; Andersen, Andreas; Tuttle, Kevin J.; Ruden, Dorottya Bartucz; Ruden, Fridtjof; Rigler, Balazs; Pascal, Christophe; Larsen, Bjoern Tore

    2012-07-01

    The study aims to analyze the potential energy with current technology, challenges, issues and opportunities for deep geothermal energy using quantitative analysis. It should especially be made to identify and investigate critical connections between geothermal potential, the size of the heating requirements and technical solutions. Examples of critical relationships may be acceptable cost of technology in relation to heating, local geothermal gradient / drilling depth / temperature levels and profitability. (eb)

  7. INTRODUCTION/ BACKGROUND OF STUDY

    African Journals Online (AJOL)

    user

    The study was carried out in Abia State. Five out ... study area and the farmers were more of women. ... Cassava utilization, as livestock feed, is very popular in the whole world, ... In order to relieve farmers from this problem of poor yield during harvesting, the .... Also majority (54.7 percent) of the cassava farmers in the study.

  8. Low frequency noise study.

    Science.gov (United States)

    2007-04-01

    This report documents a study to investigate human response to the low-frequency : content of aviation noise, or low-frequency noise (LFN). The study comprised field : measurements and laboratory studies. The major findings were: : 1. Start-of-takeof...

  9. STUDYING ON THE INTERNET

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    正Nowadays the Internet is more and more popular.I think it is a good way of learning. First,the Intemet enables people to study whenever and wherever it is convenient. They can also choose to study whatever they are interested in.However,a traditional school doesn't provide such great freedom.Students have to study given sub-

  10. Selling the Social Studies.

    Science.gov (United States)

    Girod, Gerald R.; Harmon, Gerald R.

    1987-01-01

    Maintains school-aged children would prefer not to study social studies. Presents several strategies to help encourage positive attitudes. Strategies include persuasion, reinforcement, enthusiasm, personalized contact. Stresses that negative attitudes must be changed in order for social studies to achieve its fundamental citizenship goals. (BR)

  11. Studying Engineering Practice

    DEFF Research Database (Denmark)

    Buch, Anders

    2015-01-01

    The study of engineering practices has been the focus of Engineering Studies over the last three decades. Theses studies have used ethnographic and grounded methods in order to investigate engineering practices as they unfold in natural settings - in workplaces and engineering education. However......, engineering studies have not given much attention to conceptually clarifying what should be understood by 'engineering practices' and more precisely account for the composition and organization of the entities and phenomena that make up the practices. This chapter investigates and discusses how a 'practice...... will draw out some methodological consequences and discuss the ramifications of a practice theoretical approach for Engineering Studies....

  12. Mysore study: A study of suicide notes.

    Science.gov (United States)

    Namratha, P; Kishor, M; Sathyanarayana Rao, T S; Raman, Rajesh

    2015-01-01

    Suicide is one of the leading causes of preventable deaths. Recent data suggest South India as one of the regions with highest suicide rates in the world. In 2013, 134,799 people committed suicide in India according to the statistics released by the National Crime Records Bureau. Suicide note is one of the most important sources to understand suicide, which may be beneficial in suicide prevention. Studies on suicidal notes from this part of the world are sparse. The aim was to study the themes in suicide notes that might be useful in prevention strategies. A descriptive study of all suicide notes of those individuals who committed suicide between 2010 and 2013 available with Police Department, Mysore district was obtained and analyzed. A total of 22 suicide note were available. A majority of suicide note was in age group of 16-40 years (86%) and most were men (59%). All suicide notes were handwritten, the majority (70%) in regional language Kannada. Length of notes varied from just few words to few pages. Contents of suicide notes included apology/shame/guilt (80%), love for those left behind (55%) and instruction regarding practical affairs (23%). Most have blamed none for the act (50%). 23% mentioned that they are committing suicide to prove their innocence. 32% mentioned a last wish. The majority of suicidal note contained "guilt" which is a strong indicator of possible depression in deceased. Creating awareness about suicide among public and ensuring access to professionals trained in suicide prevention is need of the hour in this part of the world.

  13. The CAIRO4 study

    DEFF Research Database (Denmark)

    't Lam-Boer, Jorine; Mol, Linda; Verhoef, Cornelis

    2015-01-01

    stages of the disease. We here propose a randomized trial in order to demonstrate that resection of the primary tumour improves overall survival. METHODS/DESIGN: The CAIRO4 study is a multicentre, randomized, phase III study of the Dutch Colorectal Cancer Group (DCCG). Patients with synchronous...... objective of this study is to determine the clinical benefit in terms of overall survival of initial resection of the primary tumour. Secondary endpoints include progression free survival, surgical morbidity, quality of life and the number of patients requiring resection of the primary tumour in the control...... arm. DISCUSSION: The CAIRO4 study is a multicentre, randomized, phase III study that will assess the benefit of resection of the primary tumour in patients with synchronous metastatic CRC. TRIAL REGISTRATION: The CAIRO4 study is registered at clinicaltrials.gov (NCT01606098)....

  14. The modal study

    International Nuclear Information System (INIS)

    Cook, J.R.

    1988-01-01

    The term ''Modal Study'' refers to a research program conducted for the Nuclear Regulatory Commission (NRC) on the level of protection provided by NRC-certified packages during the shipment of spent nuclear fuel form U.S. power reactors. The objective of the study was to examine the response of the packages to actual highway and railway accident conditions. The Modal Study results show that NRC-certified spent fuel casks would perform their safety functions under severe, actual accident conditions. The study also explains how NRC's cask design conditions, which are expressed in engineering terms, relate to actual accident conditions, with which the public is more familiar. The Modal Study, along with other transportation studies, physical testing of casks, and the spent fuel shipment safety record confirm the view that casks provide a high level of public safety during spent fuel transport

  15. Nuclear Industry Family Study

    International Nuclear Information System (INIS)

    1993-01-01

    This is a copy of the U.K.A.E.A. Question and Answer brief concerning an epidemiological study entitled the Nuclear Industry Family Study, to investigate the health of children of AEA, AWE, and BNFL Workers. The study is being carried out by an independent team of medical research workers from the London School of Hygiene and Tropical Medicine, and the Imperial Cancer Research Fund. (UK)

  16. Doing Cultural Studies

    DEFF Research Database (Denmark)

    du Gay, Paul; Hall, Stuart; Janes, Linda

    What does the Walkman have to do with the 21st century? The long-awaited second edition of this classic textbook takes students on a journey between past and present, giving them the skills do to cultural analysis along the way. Through the notion of the 'circuit of culture', this book teaches st......' for cultural studies. It is an essential classic, reworked for today's students in cultural studies, media studies and sociology....

  17. Phase controlled rectifier study

    International Nuclear Information System (INIS)

    Bronner, G.; Murray, J.G.

    1976-03-01

    This report introduces the results of an engineering study incorporating a computer program to determine the transient and steady-state voltage and current wave shapes for a 12-pulse rectifier system. Generally, rectifier engineering studies are completed by making simplified assumptions and neglecting many circuit parameters. The studies incorporate the 3-phase AC parameters including nonlinear source or generator, 3-winding transformer impedances, and shunt and series capacitors. It includes firing angle control, and DC filter circuits with inductive loads

  18. Innovation and Entrepreneurship Studies

    DEFF Research Database (Denmark)

    Landström, Hans; Åström, Fredrik; Harirchi, Gouya

    2015-01-01

    -of-the-art” books in entrepreneurship studies and eleven books in innovation studies. The chapters in these “state-of-the-art” books are written by experts within the field, and it can be assumed that the most frequently cited references in these chapters represent “core knowledge” in entrepreneurship...... innovation and entrepreneurship studies can be considered as two fields or parts of a single broader scientific field, sharing and contributing to the same knowledge base? The studies by Fagerberg et al. and Landström et al. are based on two unique databases consisting of all references in twelve “state...

  19. Project management case studies

    CERN Document Server

    Kerzner, Harold R

    2013-01-01

    A new edition of the most popular book of project management case studies, expanded to include more than 100 cases plus a ""super case"" on the Iridium Project Case studies are an important part of project management education and training. This Fourth Edition of Harold Kerzner''s Project Management Case Studies features a number of new cases covering value measurement in project management. Also included is the well-received ""super case,"" which covers all aspects of project management and may be used as a capstone for a course. This new edition:Contains 100-plus case studies drawn from re

  20. Information society studies

    CERN Document Server

    Duff, Alistair S

    2013-01-01

    We are often told that we are ""living in an information society"" or that we are ""information workers."" But what exactly do these claims mean, and how might they be verified? In this important methodological study, Alistair S. Duff cuts through the rhetoric to get to the bottom of the ""information society thesis."" Wide-ranging in coverage, this study will be of interest to scholars in information science, communication and media studies and social theory. It is a key text for the newly-unified specialism of information society studies, and an indispensable guide to the future of this disc

  1. Human exploration mission studies

    Science.gov (United States)

    Cataldo, Robert L.

    1989-01-01

    The Office of Exploration has established a process whereby all NASA field centers and other NASA Headquarters offices participate in the formulation and analysis of a wide range of mission strategies. These strategies were manifested into specific scenarios or candidate case studies. The case studies provided a systematic approach into analyzing each mission element. First, each case study must address several major themes and rationale including: national pride and international prestige, advancement of scientific knowledge, a catalyst for technology, economic benefits, space enterprise, international cooperation, and education and excellence. Second, the set of candidate case studies are formulated to encompass the technology requirement limits in the life sciences, launch capabilities, space transfer, automation, and robotics in space operations, power, and propulsion. The first set of reference case studies identify three major strategies: human expeditions, science outposts, and evolutionary expansion. During the past year, four case studies were examined to explore these strategies. The expeditionary missions include the Human Expedition to Phobos and Human Expedition to Mars case studies. The Lunar Observatory and Lunar Outpost to Early Mars Evolution case studies examined the later two strategies. This set of case studies established the framework to perform detailed mission analysis and system engineering to define a host of concepts and requirements for various space systems and advanced technologies. The details of each mission are described and, specifically, the results affecting the advanced technologies required to accomplish each mission scenario are presented.

  2. Study Groups in Denmark

    DEFF Research Database (Denmark)

    Hjorth, Poul G.

    2007-01-01

    Since 1998 European Study Groups have been held in Denmark, and Danish companies from LEGO and NOVO to very small high-tech firms have participated. I briefly describe the history, the organisation and the format of the Danish Study Groups, and highlight a few problem solutions.......Since 1998 European Study Groups have been held in Denmark, and Danish companies from LEGO and NOVO to very small high-tech firms have participated. I briefly describe the history, the organisation and the format of the Danish Study Groups, and highlight a few problem solutions....

  3. Film studies the basics

    CERN Document Server

    Villarejo, Amy

    2013-01-01

    Film Studies: The Basics is a compelling guide to the study of cinema in all its forms. This second edition has been thoroughly revised and updated to take account of recent scholarship, the latest developments in the industry and the explosive impact of new technologies. Core topics covered include:   The history, technology and art of cinema Theories of stardom, genre and film-making The movie industry from Hollywood to Bollywood Who does what on a film set   Complete with film stills, end-of-chapter summaries and a substantial glossary, Film Studies: The Basics is the ideal introduction to those new to the study of cinema.

  4. Towards Marxian Internet Studies

    Directory of Open Access Journals (Sweden)

    Christian Fuchs

    2012-05-01

    Full Text Available This article gives an overview of example approaches of Critical Internet Studies and points out key concepts of this field. Critical Cyberculture Studies and Critical Political Economy/Critical Theory of the Internet are identified as two approaches in Critical Internet Studies. The paper also discusses the role of 11 Marxian concepts for Critical Internet Studies. Marxian concepts that have been reflected in Critical Internet Studies include: dialectics, capitalism, commodification, surplus value/exploitation/alienation/class, globalization, ideology, class struggle, commons, public sphere, communism, and aesthetics. The paper points out the importance of explicitly acknowledging the importance of Karl Marx’s thinking in Critical Internet Studies. Marx’s concepts are today frequently used implicitly, without acknowledging and engaging with their roots. A critique of the approach of “Critical” Cyberculture Studies is advanced. This approach is compared to the approaches of Critical Theory and Critical Political Economy of the Internet. The difference between these two approaches reflects the debate about class exploitation and non-class domination between Cultural Studies and Critical Political Economy in Media and Communication Studies.

  5. Studies in chemical dynamics

    International Nuclear Information System (INIS)

    Kuppermann, A.

    1978-01-01

    Progress made in the following studies is reported: low-energy electron scattering; variable-angle photoelectron spectroscopy; laser photochemistry and spectroscopy; and collisions in crossed molecular beams

  6. Parental Occupational Exposure to Heavy Metals and Welding Fumes and Risk of Testicular Germ Cell Tumors in Offspring

    DEFF Research Database (Denmark)

    Togawa, Kayo; Le Cornet, Charlotte; Feychting, Maria

    2016-01-01

    BACKGROUND: Data are scarce on the association between prenatal/preconception environmental exposure and testicular germ cell tumor (TGCT) in offspring. We examined parental occupational exposures to heavy metals and welding fumes in relation to TGCT in offspring in a registry-based case-control ......BACKGROUND: Data are scarce on the association between prenatal/preconception environmental exposure and testicular germ cell tumor (TGCT) in offspring. We examined parental occupational exposures to heavy metals and welding fumes in relation to TGCT in offspring in a registry-based case......-control study (NORD-TEST Study). METHODS: We identified TGCT cases diagnosed at ages 14-49 years in Finland (1988-2012), Norway (1978-2010), and Sweden (1979-2011) through nationwide cancer registries. These cases were individually matched by country and year of birth to controls selected from population...... registries. Information on parental occupations was retrieved from censuses. From this, we estimated prenatal/preconception exposures of chromium, iron, nickel, lead, and welding fumes (all three countries), and cadmium (Finland only) for each parent using job-exposure matrices specifying prevalence (P...

  7. Simulation in International Studies

    Science.gov (United States)

    Boyer, Mark A.

    2011-01-01

    Social scientists have long worked to replicate real-world phenomena in their research and teaching environments. Unlike our biophysical science colleagues, we are faced with an area of study that is not governed by the laws of physics and other more predictable relationships. As a result, social scientists, and international studies scholars more…

  8. Ca-48 metabolism studies

    International Nuclear Information System (INIS)

    Van der Merwe, D.G.

    1987-03-01

    Calcium metabolism has been studied in depth physiologically and is a relatively well-understood element in biochemistry and medicine. There is still only restricted knowledge of the metabolic fate of calcium in normal and abnormal paediatric subjects. The latter is partially owing to inadequate techniques for tracing and modelling calcium pathways in children. The advent of radioactive tracers has unquestionably enhanced medical research and improved the quality of many metabolic studies. The present study was aimed at the development, promotion and justification of a new tracer technique using the stable isotope, calcium-48. The obvious advantages of such a technique are its harmlessness tothe subject, its applicability to both short- and long-term studies as well as its usefulness to the study for which it was originally motivated, viz research defining the actual relationship between a calcium-deficient diet and the occurrence of rickets in rural Black children in South Africa. Exploratory instrumental analyses were performed specifically with serum samples. This proved successful enough to develop a less specific pre-concentration technique which improved the sensitivity and reduces the cost of doing calcium-48 metabolism studies. The results of a simple metabolic study are presented whereby the scope of the technique is demonstrated in a real situation. The possibilities and limitations of double-isotope metabolic studies are discussed, particularly with regard to strontium as the second tracer

  9. Journal of Cultural Studies

    African Journals Online (AJOL)

    The Journal of Cultural Studies was established in 1999 as an independent tool for research development in Africa. It is published by the Nigerian Group for the Study of African ... Sexual Harassment in the Workplace: A Case for Linguistic and Sexual Politics? EMAIL FULL TEXT EMAIL FULL TEXT DOWNLOAD FULL TEXT ...

  10. Designing a Language Study.

    Science.gov (United States)

    Brown, James Dean

    Some issues in the design of classroom research on second language teaching are discussed, with the intention of helping the researcher avoid conceptual pitfalls that may cripple the study later in the process. This begins with an examination of concerns in sampling, including definition of a population to be studied, alternative sampling…

  11. Jabiluka environmental studies

    Energy Technology Data Exchange (ETDEWEB)

    Morley, A.W.; Koontz, D.V.; Sanderson, N.T. (Pancontinental Mining Ltd., Sydney (Australia))

    1984-02-01

    Environmental baseline studies associated with development of the Jabiluka uranium deposits are described. Some basic characteristics of the area local to the deposits are reported and a brief explanation is provided of the nature of, and philosophy behind the environmental studies. The major findings from this program are discussed.

  12. Jabiluka environmental studies

    International Nuclear Information System (INIS)

    Morley, A.W.; Koontz, D.V.; Sanderson, N.T.

    1984-01-01

    Environmental baseline studies associated with development of the Jabiluka uranium deposits are described. Some basic characteristics of the area local to the deposits are reported and a brief explanation is provided of the nature of, and philosophy behind the environmental studies. The major findings from this program are discussed. (author)

  13. Aquatic biology studies

    International Nuclear Information System (INIS)

    Anon.

    1976-01-01

    Aquatic biology studies focused on studying the hydrothermal effects of Par Pond reservoir on periphyton, plankton, zooplankton, macrophytes, human pathogens, and microbial activity; the variability between the artificial streams of the Flowing Streams Laboratory and Upper Three Runs Creek; and the bacterial production of methane in Savannah River Plant aquatic systems

  14. Mirror hybrid reactor studies

    International Nuclear Information System (INIS)

    Bender, D.J.

    1978-01-01

    The hybrid reactor studies are reviewed. The optimization of the point design and work on a reference design are described. The status of the nuclear analysis of fast spectrum blankets, systems studies for fissile fuel producing hybrid reactor, and the mechanical design of the machine are reviewed

  15. Pacific Studies: Quo Vadis?

    Directory of Open Access Journals (Sweden)

    Anne Holden Rønning

    2014-02-01

    Full Text Available Looking back to the past this paper discusses why Pacific studies and in particular Australasian studies became an area of interest in tertiary education in Europe. What subject areas initiated these studies, and how do past legacies shape the present? With cutbacks in higher education over the past two decades the future of interdisciplinary studies and the humanities looks bleak. At the same time due to global business and increased political communication across borders there is a vibrant interest in and need for such studies among businesses and students. For most Europeans the literature of settler countries, with their European legacy, makes access to ways of thought and culture easier than studies of countries with other mythological backgrounds. In today’s multicultural environment such studies can provide knowledge for an understanding of other cultures and increase tolerance of the ‘other’. Area studies have relevance to our situation in Europe with increased migrancy, not least as a result of Schengen and EU regulations.

  16. Missouri airport investment study

    Science.gov (United States)

    The studys purpose is to provide MoDOT with insight to the potential ROI for airport : investments in terms of economic development. To do so, this study addresses two central : objectives: first, an approach to evaluate airport investments; and s...

  17. Energy conversion alternatives study

    Science.gov (United States)

    Shure, L. T.

    1979-01-01

    Comparison of coal based energy systems is given. Study identifies and compares various advanced energy conversion systems using coal or coal derived fuels for baselaoad electric power generation. Energy Conversion Alternatives Study (ECAS) reports provede government, industry, and general public with technically consistent basis for comparison of system's options of interest for fossilfired electric-utility application.

  18. The Study of Butterflies

    Indian Academy of Sciences (India)

    The Study of Butterflies. 3. Intra-specific ... study of chitinous parts of the genitalia, especially of males proved a .... not known to affect mating habits in any way. We now .... such random interactions as well as modifications caused by external ...

  19. Theorizing Iberian Studies

    Science.gov (United States)

    Newcomb, Robert Patrick

    2015-01-01

    A growing number of scholars invested in Iberian Studies are asking how peninsular literary and cultural studies might be reimagined, and reinvigorated, by placing the Spanish and Portuguese canons into critical dialogue with each other, and with Galician, Catalan, Basque/Euskadi, and Latin American and North African immigrant writers, cultural…

  20. Prolactinomas : clinical studies

    NARCIS (Netherlands)

    Kars, Marleen

    2008-01-01

    Prolactinoma are treated with dopamine agonists, which are effective in reducing prolactin and tumor size. Studies reporting clinical and radiological outcome are scarce. The study described in chapter 2, assesses long-term outcome in patients treated with dopamine agonists for macroprolactinoma. An

  1. Fusion energy studies

    International Nuclear Information System (INIS)

    Anon.

    1977-01-01

    Current experimental efforts are aimed toward developing cryosorption vacuum pumps for removing unburned fuel and impurities from the plasma, studying deep-bed sorption pumps for roughing and transfer operations, investigating methods for recovery of tritium bred in blankets of lithium or lithium alloys, and studying containment of tritium that permeates metal walls

  2. Designing satisfaction studies

    DEFF Research Database (Denmark)

    Kristensen, Kai; Eskildsen, Jacob Kjær

    2007-01-01

    In the effect sampling method, presentation of researcher, the intro text, the order of questions in the questionnaire along with the number of categories in the rating scale is tested in relation to the design of satisfaction studies. Based on the analyses specific recommendations for designing...... satisfaction studies are given....

  3. American Studies in Transition

    DEFF Research Database (Denmark)

    Nye, David

    Papers first given at a conference the previous year in Fåborg, Denmark, with a dual focus on 20th century America and new methods in American Studies.......Papers first given at a conference the previous year in Fåborg, Denmark, with a dual focus on 20th century America and new methods in American Studies....

  4. Studies of Personality Disorders

    DEFF Research Database (Denmark)

    Ronningstam, Elsa; Simonsen, Erik; Oldham, John M

    2014-01-01

    The past 25 years have shown major advances in the studies of personality disorders. This collaborative article by the presidents, past and present, of ISSPD reflects on the progress within several significant areas of studies, i.e., assessment, neuroscience, treatment, prevention, advocacy...

  5. Geothermal studies in China

    International Nuclear Information System (INIS)

    Wang Ji-Yang; Chen Mo-Xiang; Wang Ji-An; Deng Xiao; Wang Jun; Shen Hsien-Chieh; Hsiung Liang-Ping; Yan Shu-Zhen; Fan Zhi-Cheng; Liu Xiu-Wen

    1981-01-01

    Geothermal studies have been conducted in China continuosly since the end of the 1950's with renewed activity since 1970. Three areas of research are defined: (1) fundamental theoretical research of geothermics, including subsurface temperatures, terrestrial heat flow and geothermal modeling; (2) exploration for geothermal resources and exploitation of geothermal energy; (3) geothermal studies in mines. (orig./ME)

  6. Lesson study i Danmark?

    DEFF Research Database (Denmark)

    Mogensen, Arne

    2009-01-01

    Der beskrives et japansk lesson study forløb, og det diskuteres i hvilket omfang, de gode japanske erfaringer kan overføres til dansk matematikundervisning.......Der beskrives et japansk lesson study forløb, og det diskuteres i hvilket omfang, de gode japanske erfaringer kan overføres til dansk matematikundervisning....

  7. Radiopharmaceuticals for renal studies

    International Nuclear Information System (INIS)

    Verdera, Silvia

    1994-01-01

    Between the diagnostic techniques using radiopharmaceuticals in nuclear medicine it find renal studies.A brief description about renal glomerular filtration(GFR) and reliability renal plasma flux (ERPF),renal blood flux measurement agents (RBF),renal scintillation agents and radiation dose estimates by organ physiology was given in this study.tabs

  8. Memetics and Translation Studies

    OpenAIRE

    Andrew, Chesterman

    2000-01-01

    Translation Studies is a branch of memetics. This is a claim, a hypothesis. More specifically, it is an interpretive hypothesis: I claim that Translation Studies can be thus interpreted, and that this is a useful thing to do because it offers a new and beneficial way of understanding translation.

  9. Managerial Accounting. Study Guide.

    Science.gov (United States)

    Plachta, Leonard E.

    This self-instructional study guide is part of the materials for a college-level programmed course in managerial accounting. The study guide is intended for use by students in conjuction with a separate textbook, Horngren's "Accounting for Management Control: An Introduction," and a workbook, Curry's "Student Guide to Accounting for Management…

  10. Studies Highlight Biodiesel's Benefits

    Science.gov (United States)

    , Colo., July 6, 1998 — Two new studies highlight the benefits of biodiesel in reducing overall air Energy's National Renewable Energy Laboratory (NREL) conducted both studies: An Overview of Biodiesel and Petroleum Diesel Life Cycles and Biodiesel Research Progress, 1992-1997. Biodiesel is a renewable diesel

  11. Multimodality in organization studies

    DEFF Research Database (Denmark)

    Van Leeuwen, Theo

    2017-01-01

    This afterword reviews the chapters in this volume and reflects on the synergies between organization and management studies and multimodality studies that emerge from the volume. These include the combination of strong sociological theorizing and detailed multimodal analysis, a focus on material...

  12. Luminescence study of spodumene

    International Nuclear Information System (INIS)

    Isotani, S.; Fujii, A.T.; Antonini, R.; Pontuschka, W.M.; Rabani, S.R.; Furtado, W.W.

    1990-02-01

    A comparative study is made of the luminescence of five kinds of spodumene from Minas Gerais, Brazil, studied previously by optical absorption spectroscopy. Natural gemstones are used which, in the course of the experiments, were irradiated with X-rays. (L.C.) [pt

  13. Methods of Studying Persons.

    Science.gov (United States)

    Heinemann, Allen W.; Shontz, Franklin C.

    Conventional research strategies typically emphasize behavior-determining tendencies so strongly that the person as a whole is ignored. Research strategies for studying whole persons focus on symbolic structures, formulate specific questions in advance, study persons one at a time, use individualized measures, and regard participants as expert…

  14. Explaining Kansei design studies

    NARCIS (Netherlands)

    Levy, P.D.; Vakamori, S.; Yamanaka, T.

    2008-01-01

    Within the last thirty years, Kansei studies have become an important field of research in Japan. More recently, foreign researchers have become more and more interested in understating the approach, despite the difficulties related to the cultural dimension of Kansei and Kansei studies. The aim of

  15. Censorship in Social Studies.

    Science.gov (United States)

    Seiferth, Berniece B.

    In order to determine how much censorship was taking place in Illinois social studies classes, 200 principals were asked to respond to a questionnaire regarding censorship of teaching methods and social studies textbooks. The principals were asked to respond to the following topics concerning the degree of censorship encountered for each item:…

  16. Archives: African Studies Monographs

    African Journals Online (AJOL)

    Archives: African Studies Monographs. Journal Home > Archives: African Studies Monographs. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives. 1 - 5 of 5 Items. 2007. Vol 8 (2007) ...

  17. Critical Digital Tourism Studies

    DEFF Research Database (Denmark)

    Gyimóthy, Szilvia; Munar, Ana María

    2013-01-01

    This paper advocates the need for a critical and cross-disciplinary research agenda on the field of digital technologies and tourism. The changing virtual landscape of tourism has received increased attention by tourism scholars. However, contemporary studies on information technologies (IT......) are approached mostly from a business administration perspective and informed by conceptual frameworks developed in management and marketing. IT studies in tourism are still at a stage similar to the first advocacy phase of tourism research in general (Jafari, 1990) and are seldom inspired by relevant...... to studying digital socio-technical systems and virtual mediation in tourism. Critical Digital Tourism Studies opens a new cross-disciplinary field where the sociality of virtual tourism interactions is examined (entailing the study of structures, social rules, ideologies, power relations, sustainability...

  18. Hanford groundwater scenario studies

    International Nuclear Information System (INIS)

    Arnett, R.C.; Gephart, R.E.; Deju, R.A.; Cole, C.R.; Ahlstrom, S.W.

    1977-05-01

    This report documents the results of two Hanford groundwater scenario studies. The first study examines the hydrologic impact of increased groundwater recharge resulting from agricultural development in the Cold Creek Valley located west of the Hanford Reservation. The second study involves recovering liquid radioactive waste which has leaked into the groundwater flow system from a hypothetical buried tank containing high-level radioactive waste. The predictive and control capacity of the onsite Hanford modeling technology is used to evaluate both scenarios. The results of the first study indicate that Cold Creek Valley irrigationis unlikely to cause significant changes in the water table underlying the high-level waste areas or in the movement of radionuclides already in the groundwater. The hypothetical tank leak study showed that an active response (in this case waste recovery) can be modeled and is a possible alternative to passive monitoring of radionuclide movement in the unlikely event that high-level waste is introduced into the groundwater

  19. The bismuth miners study

    International Nuclear Information System (INIS)

    Grosche, B.; Kreuzer, M.; Kreisheimer, M.; Schnelzer, M.; Tschense, A.; Gottschalk, K.

    2005-01-01

    The Federal Radiation Protection Office carried out a retrospective cohort study on some 60,000 former employees of the SAG/SDAG Wismut. The purpose of the study was to validate the radon-related risk of acquiring lung cancer previously calculated from 11 jointly evaluated studies among miners on the basis of an independent, homogeneous data record of comparable size. A further goal was to study the risk of acquiring extrapulmonal tumours. This paper only briefly describes the sampling, design and methods used in the study, as these were already presented during the Radon Status Talks. The first follow-up on the cohort was completed in 2003. Around this time a job exposure matrix (JEM) suitable for scientific inquiries was made available by the professional miners' association and the roof organisation of professional trade associations (HVBG). This paper is the first to report on the outcome of the risk analysis in direct comparison with the results found by BEIR

  20. Single Policy Study

    DEFF Research Database (Denmark)

    Kronsell, Annica; Manners, Ian James

    2015-01-01

    Single policy studies are the most common form of European Union (EU) research. Single policy studies are widely used to understand the role of the EU in a wide variety of sectors, together with their development over time, and often offer public policy prescriptions. This chapter discusses...... the relevance of single policy studies in EU research and give examples of how such research can be designed and carried out. The chapter reviews three examples of single policy studies using different methods based on EU environmental policy, the EU biofuels directive, and the EU Common Security and Defence...... Policy (CSDP). The examples are illustrative of how single policy studies can be designed to use different approaches in the analysis: multiple streams approach to policy-making; a comparative hypothesis testing; and feminist institutional theory....

  1. International user studies

    DEFF Research Database (Denmark)

    Nielsen, Lene; Madsen, Sabine; Jensen, Iben

    In this report, we present the results of a research project about international user studies. The project has been carried out by researchers from the Center for Persona Research and –Application, The IT University in Copenhagen and the Department of Learning and Philosophy, Aalborg University...... in Sydhavnen, and it is funded by InfinIT. Based on a qualitative interview study with 15 user researchers from 11 different companies, we have investigated how companies collect and present data about users on international markets. Key findings are: Companies do not collect data about end users in all...... the countries/regions they operate in. Instead, they focus on a few strategic markets. International user studies tend to be large-scale studies that involve the effort of many both internal and external/local human resources. The studies typically cover 2-4 countries/regions and many end users in each country...

  2. Effective Physics Study Habits

    Science.gov (United States)

    Zettili, Nouredine

    2011-04-01

    We discuss the methods of efficient study habits and how they can be used by students to help them improve learning physics. In particular, we deal with ideas pertaining to the most effective techniques needed to help students improve their physics study skills. These ideas were developed as part of Project IMPACTSEED (IMproving Physics And Chemistry Teaching in SEcondary Education), an outreach grant funded by the Alabama Commission on Higher Education. This project is motivated by a major pressing local need: A large number of high school physics teachers teach out of field. In the presentation, focus on topics such as the skills of how to develop long term memory, how to improve concentration power, how to take class notes, how to prepare for and take exams, how to study scientific subjects such as physics. We argue that the student who conscientiously uses the methods of efficient study habits will be able to achieve higher results than the student who does not; moreover, a student equipped with the proper study skills will spend much less time to learn a subject than a student who has no good study habits. The underlying issue here is not the quantity of time allocated to the study efforts by the student, but the efficiency and quality of actions. This work is supported by the Alabama Commission on Higher Education as part of IMPACTSEED grant.

  3. Metabolomic Studies in Drosophila.

    Science.gov (United States)

    Cox, James E; Thummel, Carl S; Tennessen, Jason M

    2017-07-01

    Metabolomic analysis provides a powerful new tool for studies of Drosophila physiology. This approach allows investigators to detect thousands of chemical compounds in a single sample, representing the combined contributions of gene expression, enzyme activity, and environmental context. Metabolomics has been used for a wide range of studies in Drosophila , often providing new insights into gene function and metabolic state that could not be obtained using any other approach. In this review, we survey the uses of metabolomic analysis since its entry into the field. We also cover the major methods used for metabolomic studies in Drosophila and highlight new directions for future research. Copyright © 2017 by the Genetics Society of America.

  4. Decontamination solution development studies

    International Nuclear Information System (INIS)

    Allen, R.P.; Fetrow, L.K.; Kjarmo, H.E.; Pool, K.H.

    1993-09-01

    This study was conducted for the Westinghouse Hanford Company (WHC) by Pacific Northwest Laboratory (PNL) as part of the Hanford Grout Technology Program (HGTP). The objective of this study was to identify decontamination solutions capable of removing radioactive contaminants and grout from the Grout Treatment Facility (GTF) process equipment and to determine the impact of these solutions on equipment components and disposal options. The reference grout used in this study was prepared with simulated double-shell slurry feed (DSSF) and a dry blend consisting of 40 wt % limestone flour, 28 wt % blast furnace slag, 28 wt % fly ash, and 4 wt % type I/II Portland cement

  5. Teaching Secondary Social Studies

    Directory of Open Access Journals (Sweden)

    Colin Everett

    2018-03-01

    Full Text Available Review of the book, instructional strategies for middle and high school social studies: Methods, assessment, and classroom management, by Bruce E. Larson. The book has two goals: It situates the learning of social studies within the broader developmental context of learning and also focuses on “Instructional Strategies.” “Instructional Strategies for Middle and High School Social Studies: Methods, Assessment, and Classroom Management.” 2nd Edition. By Bruce E. Larson. New York: Routledge, 2017. ISBN: 978-1-138-84678-4

  6. Motivations of parametric studies

    International Nuclear Information System (INIS)

    Birac, C.

    1988-01-01

    The paper concerns the motivations of parametric studies in connection with the Programme for the Inspection of Steel Components PISC II. The objective of the PISC II exercise is to evaluate the effectiveness of current and advanced NDT techniques for inspection of reactor pressure vessel components. The parametric studies were initiated to determine the influence of some parameters on defect detection and dimensioning, and to increase the technical bases of the Round Robin Tests. A description is given of the content of the parametric studies including:- the effect of the defects' characteristics, the effect of equipment characteristics, the effect of cladding, and possible use of electromagnetic techniques. (U.K.)

  7. Tokamak reactor studies

    International Nuclear Information System (INIS)

    Baker, C.C.

    1981-01-01

    This paper presents an overview of tokamak reactor studies with particular attention to commercial reactor concepts developed within the last three years. Emphasis is placed on DT fueled reactors for electricity production. A brief history of tokamak reactor studies is presented. The STARFIRE, NUWMAK, and HFCTR studies are highlighted. Recent developments that have increased the commercial attractiveness of tokamak reactor designs are discussed. These developments include smaller plant sizes, higher first wall loadings, improved maintenance concepts, steady-state operation, non-divertor particle control, and improved reactor safety features

  8. [Case and studies].

    Science.gov (United States)

    Schubert, András

    2015-11-15

    Case studies and case reports form an important and ever growing part of scientific and scholarly literature. The paper deals with the share and citation rate of these publication types on different fields of research. In general, evidence seems to support the opinion that an excessive number of such publications may negatively influence the impact factor of the journal. In the literature of scientometrics, case studies (at least the presence of the term "case study" in the titles of the papers) have a moderate share, but their citation rate is practically equal to that of other publication types.

  9. Nuclear material shipment study

    International Nuclear Information System (INIS)

    Shepherd, E.W.

    1980-01-01

    The Radioactive Material Transport Assessment Study is expected to provide a flexible set of capabilities and useful information to the public, industry and government users by using a system design to assure obtaining high quality data from selected industry sources at acceptable cost. It is expected that the shipping record approach coupled with an efficient sampling strategy will accomplish this. The study is also designed to yield analytical capabilities and statistical output to serve public, industry and government users. The information provided by the study will make a valuable contribution to environmental and accident risk assessment, policy development and operational planning and management activities

  10. Border region studies

    DEFF Research Database (Denmark)

    Makkonen, Teemu; Williams, Allan

    2016-01-01

    The contemporary conditions of academic capitalism exert pressures on researchers to avoid ‘peripheral’ journals and ‘unfashionable’ topics. Here an attempt is made to shed light onto the structure of one such ‘offbeat’ field, namely ‘border region studies’, by discussing its geographical...... distribution, key themes, significance and impact. The review suggests that border region studies can be considered a significant and important ‘branch’ of regional studies, which accounts for a small but increasing proportion of regional studies research particularly in Europe and North America. Four main...

  11. Building Transdisciplinary Environmental Studies

    DEFF Research Database (Denmark)

    Holm, Jesper

    We will in this paper approach the challenge of building integrated environmental studies by presenting a crude frame of analysis which take into account both the physical aspects and the social-discursive articulations of environmental problems. This framework partly mirrors the approach of our...... department (Dept. of Environment, Technology and Social Studies, Roskilde University), and has originally in another version been presented in the book “Miljøregulering - tværvidenskabelige studier (Environmental Regulation. Interdisciplinary Studies)” (Holm, Kjærgård & Pedersen eds. 1997, in Danish) written...

  12. Plutonium storage study

    International Nuclear Information System (INIS)

    1979-01-01

    This Spanish study gives a more detailed analysis of a possible store for plutonium oxide. The capacity of the store is assumed to be 30 t Pu and the minimum storage time 2 years. The study includes a general description of the store and its design philosophy; comments on the quality and properties of the material stored; a detailed criticality study and comments on gas and heat generation and shielding requirements; and a brief cost evaluation. Costs are estimated to be about $110/kg PuO 2 /year

  13. American Studies in Romania

    Directory of Open Access Journals (Sweden)

    Ioana Luca

    2006-01-01

    Full Text Available American Studies at the University of BucharestThe idea of teaching American Studies and founding a program in American Studies was first voiced in the long meetings of faculty and students held at the University of Bucharest soon after the collapse of the communist regime. The proposal was one of many that reflected the spirit of reform and hope for radical changes at the outset of Romania’s transition to democracy. The absence of institutional structures other than English departments and t...

  14. Study of copper fluorination

    International Nuclear Information System (INIS)

    Gillardeau, J.

    1967-02-01

    This report deals with the action of fluorine on copper. Comprehensive descriptions are given of the particular technological methods and of the preparation of the reactants. This fluorination reaction has been studied at medium and low fluorine pressures. A nucleation and growth phenomenon is described. The influence of a pollution of the gas phase on the fluorination process is described. The solid-state reaction between cupric fluoride and cooper has also been studied. A special study has been made of the growth of copper deposits by thermal decomposition of gaseous fluorides. (author) [fr

  15. Pavement Subgrade Performance Study

    DEFF Research Database (Denmark)

    Zhang, Wei; Ullidtz, Per; Macdonald, Robin

    1998-01-01

    The report describes the second test in the Danish Road Testing Machine (RTM) under the International Pavement Subgrade Performance Study. Pavement response was measured in different layers, and compared to different theroretical values. Performance in terms of plastic strains, rutting...

  16. Optimum study designs.

    Science.gov (United States)

    Gu, C; Rao, D C

    2001-01-01

    Because simplistic designs will lead to prohibitively large sample sizes, the optimization of genetic study designs is critical for successfully mapping genes for complex diseases. Creative designs are necessary for detecting and amplifying the usually weak signals for complex traits. Two important outcomes of a study design--power and resolution--are implicitly tied together by the principle of uncertainty. Overemphasis on either one may lead to suboptimal designs. To achieve optimality for a particular study, therefore, practical measures such as cost-effectiveness must be used to strike a balance between power and resolution. In this light, the myriad of factors involved in study design can be checked for their effects on the ultimate outcomes, and the popular existing designs can be sorted into building blocks that may be useful for particular situations. It is hoped that imaginative construction of novel designs using such building blocks will lead to enhanced efficiency in finding genes for complex human traits.

  17. Accelerator research studies

    International Nuclear Information System (INIS)

    1993-01-01

    The Accelerator Research Studies program at the University of Maryland, sponsored by the Department of Energy under grant number DE-FG05-91ER40642, is currently in the second year of a three-year funding cycle. The program consists of the following three tasks: TASK A, ''Study of Transport and Longitudinal Compression of Intense, High-Brightness Beams,'' (P.I., M. Reiser); TASK B, ''Study of Collective Ion Acceleration by Intense Electron Beams and Pseudospark Produced High Brightness Electron Beams,'' (Co-P.I.'s, W.W. Destler, M. Reiser, M.J. Rhee, and C.D. Striffler); TASK C, ''Study of a Gyroklystron High-Power Microwave Source for Linear Colliders,'' (Co-P.I.'s, V.L. Granatstein, W. Lawson, M. Reiser, and C.D. Striffler). In this report we document the progress that has been made during the past year for each of the three tasks

  18. Exploratory studies, 1988

    International Nuclear Information System (INIS)

    1989-05-01

    This report discusses the following topics: accelerator physics for the ALS; SSC support; machine investigations; mathematical techniques in particle dynamics; APIARY: B-factory studies; and two-beam accelerators and bright electron sources

  19. Accelerator research studies

    International Nuclear Information System (INIS)

    1990-01-01

    This progress report for the Accelerator Research Studies program at the University of Maryland covers the second year (June 1, 1989 to May 31, 1990) of the current three-year contract period from June 1, 1988 to May 31, 1991, funded by the Department of Energy under Contract No. AC05-85ER40216. The research program is divided into three separate tasks, as follows: the study of Transport and Longitudinal Compression of Intense, High-Brightness Beams; the study of Collective Ion Acceleration by Intense Electron Beams and Pulse-Powered Plasma Focus; the study of Microwave Sources and Parameter Scaling for High-Frequency Linacs. This report consists of three sections in which the progress for each task is documented separately. An introduction and synopsis is presented at the beginning of the progress report for each task

  20. Geomembrane special study

    International Nuclear Information System (INIS)

    1988-07-01

    The objective of the Geomembrane Special Study was to asses the suitability of geomembranes in Uranium Mill Tailings Remedial Action (UMTRA) Project pile designs. Geomembranes, also called flexible membrane liners, are made of polymer resins and are thermoplastic materials. Part of the special study was to evaluate regulatory compliance and acceptability issues. This study was proposed because of the extensive use of geomembranes in hazardous waste site remedial actions and their accepted use in Resource Conservation and Recovery Act (RCRA) cells as both covers and liners to limit infiltration, or as part of leachate collection systems. This study has reviewed the recent geomembrane literature focusing on: (1) longevity; (2) performance; (3) constructibility; and (4) quality control/quality assurance considerations. In addition to these technical considerations, regulatory compliance and acceptability concerns were also evaluated. This report describes the results of the literature review, including correspondence with manufacturers, resin producers, experts in the field, and long-term major users. 12 refs., 2 tabs

  1. STUDYING BUSINESS CYCLES SYNCHRONIZATION

    Directory of Open Access Journals (Sweden)

    N. Servetnyk

    2014-06-01

    Full Text Available The paper researches business cycles synchronization. The fluctuations in post-Soviet countries are considered. The study examines different measures of synchronization in groups of countries according to some criteria.

  2. The Black Studies Boondoggle

    Science.gov (United States)

    Long, Richard A.

    1970-01-01

    Indicates tendencies dangerous to the basic purpose of Black Studies, and identifies four external challeges--imperialism, paternalism, nihilism, and materialism. An internal challenge is considered to be the use of European and Establishment constructs to analyze black reality. (DM)

  3. Septic Systems Case Studies

    Science.gov (United States)

    A collection of septic systems case studies to help community planners, elected officials, health department staff, state officials, and interested citizens explore alternatives for managing their decentralized wastewater treatment systems.

  4. Mobile OS Comparative Study

    OpenAIRE

    Joseph, Jyothy; K, Shinto Kurian

    2013-01-01

    In the fast growing mobile revolutionary era, many operating systems are playing vital role in present market. This study is intending to identify the apt and secure mobile based on mobile operating systems capability and user requirements.

  5. Color transparency study group

    International Nuclear Information System (INIS)

    Appel, J.A.; Pordes, S.; Botts, J.; Bunce, G.; Farrar, G.

    1990-01-01

    The group studied the relatively new notion of color transparency, discussed present experimental evidence for the effect, and explored several ideas for future experiments. This write-up summarizes these discussions. 11 refs., 1 fig

  6. Earth study from space

    Science.gov (United States)

    Sidorenko, A. V.

    1981-01-01

    The significance that space studies are making to all Earth sciences in the areas of geography, geodesy, cartography, geology, meteorology, oceanology, agronomy, and ecology is discussed. It is predicted that cosmonautics will result in a revolution in science and technology.

  7. Tailored Barium Swallow Study

    Science.gov (United States)

    ... Impulse Oscillimetry (IOS) Hypoxic and Hypercapnic Drive Response Lung Diffusion Capacity Testing (DLCO) Maximum Inspiratory/Expiratory Pressures Nitrogen Washout Performing Pressure Volume Study Performing Routine Pulmonary Test Performing Spirometry Test ...

  8. Esophagram (Barium Swallow Study)

    Science.gov (United States)

    ... Impulse Oscillimetry (IOS) Hypoxic and Hypercapnic Drive Response Lung Diffusion Capacity Testing (DLCO) Maximum Inspiratory/Expiratory Pressures Nitrogen Washout Performing Pressure Volume Study Performing Routine Pulmonary Test Performing Spirometry Test ...

  9. Evidence: Study Guide. Revision

    National Research Council Canada - National Science Library

    1997-01-01

    ...) correct application of principles of military rules of evidence. This study guide is also intended to be a convenient reference for use by Navy and Marine Corps judge advocates and Coast Guard law...

  10. Reconnaissance Geochemical Study

    African Journals Online (AJOL)

    distribution patterns. The geochemical distribution maps of the elements reveal that Cu, Pb, Zn, Co, Sc, Ni, Cr, .... After filtration, the leached solutions were diluted with ultra ...... some other rare earth elements in the study area. The occurrence ...

  11. Study the Problem.

    Science.gov (United States)

    Choate, Joyce S.

    1990-01-01

    The initial step of a strategic process for solving mathematical problems, "studying the question," is discussed. A lesson plan for teaching students to identify and revise arithmetic problems is presented, involving directed instruction and supervised practice. (JDD)

  12. The Faroese IBD Study

    DEFF Research Database (Denmark)

    Hammer, Turid; Nielsen, Kari R.; Munkholm, Pia

    2016-01-01

    Background and Aims: Inflammatory bowel diseases [IBDs] include Crohn’s disease [CD], ulcerative colitis [UC], and IBD unclassified [IBDU]. In 2010 and 2011, the ECCO-EpiCom study found the worldwide highest incidence of inflammatory bowel disease [IBD] in the Faroe Islands: 83 per 100 000...... [European Standard Population, ESP]. The present study assessed the long-term time trends in IBD incidence in the Faroese population. Methods: In this population-based study, data were retrieved from the National Hospital of the Faroe Islands and included all incident cases of CD, UC, and IBDU diagnosed...... from 4 to 44, and for IBDU from 2 to 21 per 100 000 [ESP]. Conclusions: The high IBD incidence was found to be a relatively new phenomenon. The observed increase is unlikely to be an artefact resulting from, for instance, better registration. Our study indicated a real and increasing disease burden...

  13. South African Music Studies

    African Journals Online (AJOL)

    SAMUS: South African Music Studies is the official organ for the South African ... Shifty Records in Apartheid South Africa: Innovations in Independent Record ... Experiences of Belonging and Exclusion in the Production and Reception of ...

  14. Kuwait oil spill studied

    Science.gov (United States)

    Bush, Susan

    1992-02-01

    More than a year after the Persian Gulf War, scientists are still trying to assess the environmental impact of the estimated 6-8 million barrels of oil that were dumped into the gulf and to understand the environmental processes that take place in such a disturbance. Many atmospheric studies were done in the months immediately following the war, but oceanographic studies have been slower in getting started.The National Oceanic and Atmospheric Administration is currently spearheading a major oceanographic study being undertaken in the Persian Gulf by the research vessel Mt. Mitchell. The ship left its home port of Norfolk, Va., in mid-January and arrived in Muscat, Oman, on February 16 to begin a 100-day oceanographic and environmental survey. The six-leg cruise will feature physical oceanography, near-shore, and marine life studies.

  15. A qualitative study

    African Journals Online (AJOL)

    ismail - [2010

    Methods: A descriptive qualitative study was carried out in Adami Tulu District of East Shoa Zone – the ... to enhance teaching learning at CBE sites and facilitate ..... on good nutrition”. ... not observing any misbehavior: “The behavior of the.

  16. HYDROGEOLOGIC CASE STUDIES

    Science.gov (United States)

    Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

  17. Digital signature feasibility study

    Science.gov (United States)

    2008-06-01

    The purpose of this study was to assess the advantages and disadvantages of using digital signatures to assist the Arizona Department of Transportation in conducting business. The Department is evaluating the potential of performing more electronic t...

  18. Accelerator research studies

    International Nuclear Information System (INIS)

    1992-01-01

    The Accelerator Research Studies program at the University of Maryland, sponsored by the Department of Energy under grant number DE-FG05-91ER40642, is currently in the first year of a three-year funding cycle. The program consists of the following three tasks: TASK A, Study of Transport and Longitudinal Compression of Intense, High-Brightness Beams, TASK B, Study of Collective Ion Acceleration by Intense Electron Beams and Pseudospark Produced High Brightness Electron Beams; TASK C, Study of a Gyroklystron High-power Microwave Source for Linear Colliders. In this report we document the progress that has been made during the past year for each of the three tasks

  19. Study of biological compartments

    International Nuclear Information System (INIS)

    Rocha, A.F.G. da

    1976-01-01

    The several types of biological compartments are studied such as monocompartmental system, one-compartment balanced system irreversible fluxes, two closed compartment system, three compartment systems, catenary systems and mammilary systems [pt

  20. IRD dropout study

    Science.gov (United States)

    Yalowitz, Jeffrey S.; Schroer, Michael A.; Dickson, John E., Jr.

    1992-01-01

    This final report describes work performed by SRS Technologies for the NASA Marshall Space Flight Center under Contract NAS8-39077, entitled 'Integrated Receiver-Decoder Dropout Study'. The purpose of the study was to determine causes of signal fading effects on ultra-high-frequency (UHF) range safety transmissions to the Space Shuttle during flyout. Of particular interest were deep fades observed at the External Tank (ET) Integrated Receiver-Decoder (IRD) during the flyout interval between solid rocket booster separation and ET separation. Analytical and simulation methods were employed in this study to assess observations captured in flight telemetry data records. Conclusions based on the study are presented in this report, and recommendations are given for future experimental validation of the results.

  1. A Psychobiographical Case Study

    African Journals Online (AJOL)

    man, and cancer fighter. This psychobiographical case study entailed a psychosocial-historical ... does not draw more attention as a research method, as this approach has .... of the applied Levinsonian theory to the life of Jobs against the ...

  2. Applied Research Study

    Science.gov (United States)

    Leach, Ronald J.

    1997-01-01

    The purpose of this project was to study the feasibility of reusing major components of a software system that had been used to control the operations of a spacecraft launched in the 1980s. The study was done in the context of a ground data processing system that was to be rehosted from a large mainframe to an inexpensive workstation. The study concluded that a systematic approach using inexpensive tools could aid in the reengineering process by identifying a set of certified reusable components. The study also developed procedures for determining duplicate versions of software, which were created because of inadequate naming conventions. Such procedures reduced reengineering costs by approximately 19.4 percent.

  3. Thyroid function study

    International Nuclear Information System (INIS)

    Rocha, A.F.G. da

    1976-01-01

    A short revision of thyroid physiology is done. The radioisotopes of common use in thyroid investigation and the choice of the most appropriated ones are discussed. A table showing radioisotopes frequently used in this study, with their main characteristics is presented. Among several isotopic assays in thyroid propaedeutics, those that refer to the function study, topographic studies and tests 'in vitro' are pointed out. Exploration methods 'in vivo' are treated, such as: thyroid uptake; urinary excretion; thyroid scintigraphy, with scintigraphic imagings; stimulation test by TSH; suppression test; pbi; clearance test with perchlorate; iodine deficiency test and thyroid study with technetium. 'In vitro' proofs like triiodothyronine (T 3 ) and thyroxine (T 4 ) assays, as well as free thyroxine index, are treated. At last, the therapeutics by Iodine 131 is commented and emphasis is given to its application on the treatment of hyperthyroidism and thyroid carcinoma [pt

  4. PPB | Study Team

    Science.gov (United States)

    The Pleuropulmonary Blastoma (PPB) DICER1 Syndrome Study team is made up of researchers from the National Cancer Institute, Children¹s National Medical Center, the International Pleuropulmonary Blastoma Registry, and Washington University in St. Louis.

  5. 451 Case studies Cardiac

    African Journals Online (AJOL)

    Marinda

    Case Studies. 29 ... A case of a 26-year-old ASA I physical status male undergoing septoplasty had an abrupt ... myocardial infarction, severe hypertensive crisis, cerebral .... or no formal management is required in an ASA I patient.8 One.

  6. Chamberino Floodplain Management Study

    Data.gov (United States)

    Earth Data Analysis Center, University of New Mexico — The Dona Ana County Flood Commission requested the United States Department of Agriculture's Natural Resources Conservation Service to conduct a study of the...

  7. Epidemiological studies on syncope

    DEFF Research Database (Denmark)

    Ruwald, Martin Huth

    2013-01-01

    of the patients play an essential role. In epidemiology these factors have major impact on the outcome of the patients. Until recently, even the definition of syncope differed from one study to another which has made literature reviews difficult. Traditionally the data on epidemiology of syncope has been taken...... from smaller studies from different clinical settings with wide differences in patient morbidity. Through the extensive Danish registries we examined the characteristics and prognosis of the patients hospitalized due to syncope in a nationwide study. The aims of the present thesis were to investigate......, prevalence and cardiovascular factors associated with the risk of syncope, 4) the prognosis in healthy individuals discharged after syncope, and 5) the prognosis of patients after syncope and evaluation of the CHADS2 score as a tool for short- and long-term risk prediction. The first studies of the present...

  8. Nature Study Tips. Spiders.

    Science.gov (United States)

    Mulaik, Stanley B.

    1990-01-01

    Different types of spiders, their ranges and habits are discussed. Activities associated with the study of spiders are suggested. Four references are listed which may be of interest to beginners. (CW)

  9. Advanced Propulsion Study

    National Research Council Canada - National Science Library

    Davis, Eric

    2004-01-01

    ... that show promise of leading to a major advance in Earth-to-orbit (ETO) propulsion. The study also reviewed and evaluated a select number of credible far-term breakthrough propulsion physics concepts pertaining...

  10. Public Key Infrastructure Study

    National Research Council Canada - National Science Library

    Berkovits, Shimshon

    1994-01-01

    The National Institute of Standards and Technology (NIST) has tasked The MITRE Corporation to study the alternatives for automated management of public keys and of the associated public key certificates for the Federal Government...

  11. African Studies Monographs

    African Journals Online (AJOL)

    The African Studies Monographs is a serial that promotes research and scholarship on the African perspective worldwide. This includes matters of philosophy, history, literature, arts and culture, environment, gender, politics, administration crisis management, etc.

  12. Thermoluminescence studies in geology

    International Nuclear Information System (INIS)

    Sankaran, A.V.; Sunta, C.M.; Nambi, K.S.V.; Bapat, V.N.

    1980-01-01

    Even though the phenomenon of thermoluminescence is well studied, particularly over last 3 decades, its potentialities in the field of geology have not been adequately evaluated. In this report several useful applications of TL in mineralogy, petrogenesis, stratigraphy, tectonics, ore-prospecting and other branches have been identified with particular emphasis to the Indian scene. Important areas in the country that may provide the basic material for such studies are indicated at the end along with brief geological or mineralogical accounts. (auth.)

  13. Qualitative Case Study Guidelines

    Science.gov (United States)

    2013-11-01

    Introduction to Sociological Methods. 2nd ed. New York, McGraw-Hill 14. Denzin , N. K. and Lincoln , Y. S. (2011) The SAGE Handbook of Qualitative...The Art of Science. In: Denzin , N. K. and Lincoln , Y. S. (eds.) Handbook of Qualitative Research. Thousand Oaks, Sage 19. GAO (1990) Case Study...Rinehart & Winston 39. Stake, R. E. (1994) Case Studies. In: Denzin , N. K. and Lincoln , Y. S. (eds.) Handbook of Qualitative Research. Thousand Oaks, Sage

  14. DOE's Yucca Mountain studies

    International Nuclear Information System (INIS)

    1992-12-01

    This booklet is about the disposal of high-level nuclear waste in the United States. It is for readers who have a general rather than a technical background. It discusses why scientists and engineers thinkhigh-level nuclear waste may be disposed of safely underground. It also describes why Yucca Mountain, Nevada, is being studied as a potential repository site and provides basic information about those studies

  15. University related studies

    International Nuclear Information System (INIS)

    Anon.

    1976-01-01

    Over the years, opportunities for terrestrial ecology studies have attracted student researchers associated with Pacific Northwest colleges and universities. During the past year, four students have been involved with undergraduate or graduate thesis projects. Brief descriptions of these studies are included in this section. It is expected that university participation will be enhanced by designating parts of the Hanford Reservation as a National Environmental Research Park (NERP)

  16. Workshop I: Gender Studies

    Science.gov (United States)

    Hennessey, Eden; Kurup, Anitha; Meza-Montes, Lilia; Shastri, Prajval; Ghose, Shohini

    2015-12-01

    Participants in the Gender Studies workshop of the 5th IUPAP International Conference on Women in Physics discussed the gender question in science practice from a policy perspective, informed by investigations from the social science disciplines. The workshop's three sessions—"Equity and Education: Examining Gender Stigma in Science," "A Comparative Study of Women Scientists and Engineers: Experiences in India and the US," and "Toward Gender Equity Through Policy: Characterizing the Social Impact of Interventions—are summarized, and the resulting recommendations presented.

  17. Vitrification melter study

    International Nuclear Information System (INIS)

    Jones, J.A.

    1995-04-01

    This report presents the results of a study performed to identify the most promising vitrification melter technologies that the Department of Energy (EM-50) might pursue with available funding. The primary focus was on plasma arc systems and graphite arc melters. The study was also intended to assist EM-50 in evaluating competing technologies, formulating effective technology strategy, developing focused technology development projects, and directing the work of contractors involved in vitrification melter development

  18. Tanzania country study

    Energy Technology Data Exchange (ETDEWEB)

    Meena, H E [Centre for Energy, Environment, Science and Technology, Dar es Salaam (Tanzania, United Republic of)

    1998-10-01

    An objective of this study is to analyse the role of the land use sectors of Tanzania (especially forestry) on mitigation of greenhouse gases. Specific emphasis is placed on the relationship between forestry and energy supply from biomass. This is a follow up study on an earlier effort which worked on mitigation options in the country without an in-depth analysis of the forestry and land use sectors. (au)

  19. Cerebral perfution studies

    International Nuclear Information System (INIS)

    Mut, Fernando

    1994-01-01

    For detecting in precocious form a coronary disease is necessary to aply a diagnostic techniques. The main considerations to be indicated in the present work are: physiological considerations, myocardial perfusion studies with radiotracers such as Talio 201, 99mTc, MIBI, 99mTc-Teboroxima, 99mTc-Fosfinas, instrumentation for obtain good images, proceedings protocols, studies interpretation, standards, SPECT, anomalies standards, coronary diseases

  20. Artificial Intelligence Study (AIS).

    Science.gov (United States)

    1987-02-01

    ARTIFICIAL INTELLIGNECE HARDWARE ....... 2-50 AI Architecture ................................... 2-49 AI Hardware ....................................... 2...ftf1 829 ARTIFICIAL INTELLIGENCE STUDY (RIS)(U) MAY CONCEPTS 1/3 A~NLYSIS AGENCY BETHESA RD R B NOJESKI FED 6? CM-RP-97-1 NCASIFIED /01/6 M |K 1.0...p/ - - ., e -- CAA- RP- 87-1 SAOFŔ)11 I ARTIFICIAL INTELLIGENCE STUDY (AIS) tNo DTICFEBRUARY 1987 LECT 00 I PREPARED BY RESEARCH AND ANALYSIS

  1. Radiation Studies, Vol.10

    International Nuclear Information System (INIS)

    Nadareishvili, K.; Tsitskishvili, M.; Chankseliani, Z.; Gelashvili, K.; Mtskhoetadze, A.; Oniani, T.; Todua, F.; Vepkhoadze, N.; Zaalishvili, T.

    2002-01-01

    'Radiation studies' - is a periodical edition of Scientific Research Center of Radiobiology and Radiation Ecology of Georgian Academy of Sciences, Problem Council of Radiobiology of Georgian Academy of Sciences and Georgian Academy of Ecological Sciences. The 10th volume of 'Radiation studies' reflects activities of above-mentioned institutions during previous two years and contains 26 articles, from which 17 are within the scope of INIS

  2. Evaluation of epidemiological studies

    International Nuclear Information System (INIS)

    Breckow, J.

    1995-01-01

    The publication is intended for readers with a professional background in radiation protection who are not experts in the field of epidemiology. The potentials and the limits of epidemiology are shown and concepts and terminology of radioepidemilogic studies as well as epidemiology in general are explained, in order to provide the necessary basis for understanding or performing evaluations of epidemiologic studies. (orig./VHE) [de

  3. Zambia country study

    Energy Technology Data Exchange (ETDEWEB)

    1999-09-01

    The Zambia Country Study, which was part of the Danida-funded project Climate Change Mitigation in Southern Africa: Phase 2, aimed at methodological development, national mitigation analysis and institutional capacity building in Zambia. The study comprised the following five elements: Comprehensive evaluation of national social and economic development framework for climate change; Baseline scenario(s) projection(s); Mitigation scenario(s) projection(s); Macro-economic assessment; Implementation Issues. (au) 17 refs.

  4. Tanzania country study

    International Nuclear Information System (INIS)

    Meena, H.E.

    1998-01-01

    An objective of this study is to analyse the role of the land use sectors of Tanzania (especially forestry) on mitigation of greenhouse gases. Specific emphasis is placed on the relationship between forestry and energy supply from biomass. This is a follow up study on an earlier effort which worked on mitigation options in the country without an in-depth analysis of the forestry and land use sectors. (au)

  5. Future ATLAS Higgs Studies

    CERN Document Server

    Smart, Ben; The ATLAS collaboration

    2017-01-01

    The High-Luminosity LHC will prove a challenging environment to work in, with for example $=200$ expected. It will however also provide great opportunities for advancing studies of the Higgs boson. The ATLAS detector will be upgraded, and Higgs prospects analyses have been performed to assess the reach of ATLAS Higgs studies in the HL-LHC era. These analyses are presented, as are Run-2 ATLAS di-Higgs analyses for comparison.

  6. clinical and experimental study

    OpenAIRE

    Tornow, Christoph

    2011-01-01

    Posterior capsule opacity (PCO) is a frequent complication in extracapsular cataract extraction in conjunction with an intraocular lens implant. Different studies have shown that a reduction in PCO frequency can be achieved via a number of factors. Lens design is a significant criterion in this process. In this study, two multifocal intraocular lenses (MIOLs) were compared. The design of these lenses differed due to their varying optical principles. They are the refractive MIOL A...

  7. Networked Microgrids Scoping Study

    Energy Technology Data Exchange (ETDEWEB)

    Backhaus, Scott N. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Dobriansky, Larisa [General MicroGrids, San Diego, CA (United States); Glover, Steve [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Liu, Chen-Ching [Washington State Univ., Pullman, WA (United States); Looney, Patrick [Brookhaven National Lab. (BNL), Upton, NY (United States); Mashayekh, Salman [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Pratt, Annabelle [National Renewable Energy Lab. (NREL), Golden, CO (United States); Schneider, Kevin [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Stadler, Michael [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Starke, Michael [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Wang, Jianhui [Argonne National Lab. (ANL), Argonne, IL (United States); Yue, Meng [Brookhaven National Lab. (BNL), Upton, NY (United States)

    2016-12-05

    Much like individual microgrids, the range of opportunities and potential architectures of networked microgrids is very diverse. The goals of this scoping study are to provide an early assessment of research and development needs by examining the benefits of, risks created by, and risks to networked microgrids. At this time there are very few, if any, examples of deployed microgrid networks. In addition, there are very few tools to simulate or otherwise analyze the behavior of networked microgrids. In this setting, it is very difficult to evaluate networked microgrids systematically or quantitatively. At this early stage, this study is relying on inputs, estimations, and literature reviews by subject matter experts who are engaged in individual microgrid research and development projects, i.e., the authors of this study The initial step of the study gathered input about the potential opportunities provided by networked microgrids from these subject matter experts. These opportunities were divided between the subject matter experts for further review. Part 2 of this study is comprised of these reviews. Part 1 of this study is a summary of the benefits and risks identified in the reviews in Part 2 and synthesis of the research needs required to enable networked microgrids.

  8. Study of wilms' tumor

    International Nuclear Information System (INIS)

    Khan, M.H.; Yaqub, N.

    2001-01-01

    This study is an effort to bring into light data related to children with Wilms' tumor managed at Islamabad as local literature on this topic is lacking. It was retrospective study. The study was conducted at Children Hospital, Pakistan Institute of Medical Science, Islamabad between January, 1987 and December 1995. All patients managed during the study period were included in the study. In all the patients complete blood count (CBC), urine analysis (D/R),X-ray abdomen and chest, ultrasound abdomen and in selected cases CT scan were performed. National Wilms' Tumor Study Group (NWTS 3) protocol was followed for further management. Fifty patients including 28 males and 22 females with the age range from 9 months to 8 years were managed in 9 years period. Left kidney was involved in 31 patients. Most of the tumors were solid on ultrasound, 76% patients were in stage III and IV. In one case bilateral involvement of kidney was found. Forty patients underwent primary surgery. Only 14 patients received complete course of chemotherapy while 31 radiotherapy. Nineteen patients died and 15 lost to follow-up. The survival and mortality rates are comparable to NWTS-3 results, although, most of the patients were presented in advance stage of Wilms tumor. The survival of these patients can be improved by increasing awareness of society through electronic and print media. (author)

  9. Studying Organizations on Instagram

    Directory of Open Access Journals (Sweden)

    Uta Russmann

    2016-10-01

    Full Text Available With the rise of social media platforms based on the sharing of pictures and videos, the question of how such platforms should be studied arises. Previous research on social media (content has mainly focused on text (written words and the rather text-based social media platforms Twitter and Facebook. Drawing on research in the fields of visual, political, and business communication, we introduce a methodological framework to study the fast-growing image-sharing service Instagram. This methodological framework was developed to study political parties’ Instagram accounts and tested by means of a study of Swedish political parties during the 2014 election campaign. In this article, we adapt the framework to also study other types of organizations active on Instagram by focusing on the following main questions: Do organizations only use Instagram to share one-way information, focusing on disseminating information and self-presentation? Or is Instagram used for two-way communication to establish and cultivate organization-public relationships? We introduce and discuss the coding of variables with respect to four clusters: the perception of the posting, image management, integration, and interactivity.

  10. Impact studies at Winfrith

    International Nuclear Information System (INIS)

    Cooper, C.A.; Wicks, S.J.

    1987-02-01

    Analytical and experimental studies of subsonic impacts on nuclear reactor plant structures have been in progress at Winfrith since 1977. These studies have examined the behaviour of concrete and metal structures under the impact of missiles typifying those derived either from the plant itself or from external sources, such as crashing aircraft. During 1986 the Winfrith programme was expanded to include studies of the behaviour of radioactive materials transport containers under impact conditions. This report initially describes the experimental facilities available for impact studies at Winfrith. These include both compressed air guns, capable of delivering payloads of up to 65 kg at sonic velocity or payloads up to 2 tonnes at speeds up to 45 ms -1 , and drop test facilities for impact testing of models, up to full-scale radioactive materials transport flasks, at relatively low speeds. Supporting facilities include a small concrete manufacturing laboratory to produce concrete targets. Assessments of the resistance of concrete or metal structures to impact damage are performed using empirical or semi-empirical correlations, derived from data obtained in well-characterised experiments, or using structural dynamics finite element codes. The codes used by the analysts and the computing facilities available for impact analysis work are described. Finally the current programme of impact studies is reviewed, recent progress is summarised and future plans outlined. (author)

  11. Cosmos-1989 immunology studies

    Science.gov (United States)

    Sonnenfeld, Gerald

    1991-01-01

    Evidence from both human and rodent studies has indicated that alterations in immunological parameters occur after space flight. The number of flight experiments has been small, and the full breadth of immunological alterations occurring after space flight remains to be established. Among the major effects on immune responses after space flight that have been reported are: alterations in lymphocyte blastogenesis and natural killer cell activity, alterations in production of cytokines, changes in leukocyte sub-population distribution, and decreases in the ability in the ability of bone marrow cells to respond to colony stimulating factors. Changes have been reported in immunological parameters of both humans and rodents. The significance of these alterations in relation to resistance to infection remains to be established. The current study involved a determination of the effects of flight on Cosmos mission 2044 on leukocyte subset distribution and the sensitivity of bone marrow cells to colony stimulating factor-GM. A parallel study with antiorthostatic suspension was also carried out. The study involved repetition and expansion of studies carried out on Cosmos 1887.

  12. Laboratory microfusion capability study

    International Nuclear Information System (INIS)

    1993-05-01

    The purpose of this study is to elucidate the issues involved in developing a Laboratory Microfusion Capability (LMC) which is the major objective of the Inertial Confinement Fusion (ICF) program within the purview of the Department of Energy's Defense Programs. The study was initiated to support a number of DOE management needs: to provide insight for the evolution of the ICF program; to afford guidance to the ICF laboratories in planning their research and development programs; to inform Congress and others of the details and implications of the LMC; to identify criteria for selection of a concept for the Laboratory Microfusion Facility and to develop a coordinated plan for the realization of an LMC. As originally proposed, the LMC study was divided into two phases. The first phase identifies the purpose and potential utility of the LMC, the regime of its performance parameters, driver independent design issues and requirements, its development goals and requirements, and associated technical, management, staffing, environmental, and other developmental and operational issues. The second phase addresses driver-dependent issues such as specific design, range of performance capabilities, and cost. The study includes four driver options; the neodymium-glass solid state laser, the krypton fluoride excimer gas laser, the light-ion accelerator, and the heavy-ion induction linear accelerator. The results of the Phase II study are described in the present report

  13. Indoor radon epidemiological study

    Energy Technology Data Exchange (ETDEWEB)

    Kunz, E; Tomasek, L; Mueller, T [National Radiation Protection Institute, Prague (Czech Republic); Placek, V [Inst. for Expertises and Emergencies, Pribram-Kamenna (Czech Republic); Matzner, J; Heribanova, A [State Office for Nuclear Safety, Prague (Czech Republic)

    1996-12-31

    The study is a long-term prospective cohort study of lung cancer and possibility other causes of death. The study population includes inhabitants of the area, who had resided there for at three years and at least one of these between 1.1.1960 and 21.12.1989. A total of 11865 inhabitants satisfied these criteria. The cumulative exposure of each respondent is being assessed on the basis of measurements in dwellings, time spent there and estimation of previous exposure levels by a model accounting for constructional changes in buildings. One year lasting measurements of radon daughter products by integral dosimeters (Kodak film LR 115) were performed in practically all dwellings of the specified area. Radon measurements in houses in term of equilibrium concentration are compared with the results of a pilot study in Petrovice in 1990-91 which gave the stimulus for the epidemiological study. The distribution of death causes and ratio of observed (O) to expected (E) cases among collected death cases in the cohort, generally, somewhat lower ratios than one reflect the non-industrial character of the region, with the exception of lung cancer in man. The differences in the O/E ratios for lung cancer among the separate communities indicate that even in the situation of generally lower mortality, the dependence of lung cancer mortality on radon.

  14. Photovoltaics information user study

    Energy Technology Data Exchange (ETDEWEB)

    Belew, W.W.; Wood, B.L.; Marie, T.L.; Reinhardt, C.L.

    1980-10-01

    The results of a series of telephone interviews with groups of users of information on photovoltaics (PV) are described. These results, part of a larger study on many different solar technologies, identify types of information each group needed and the best ways to get information to each group. The report is 1 of 10 discussing study results. The overall study provides baseline data about information needs in the solar community. It covers these technological areas: photovoltaics, passive solar heating and cooling, active solar heating and cooling, biomass energy, solar thermal electric power, solar industrial and agricultural process heat, wind energy, ocean energy, and advanced energy storage. An earlier study identified the information user groups in the solar community and the priority (to accelerate solar energy commercialization) of getting information to each group. In the current study only high-priority groups were examined. Results from seven PV groups respondents are analyzed in this report: DOE-Funded Researchers, Non-DOE-Funded Researchers, Researchers Working for Manufacturers, Representatives of Other Manufacturers, Representatives of Utilities, Electric Power Engineers, and Educators.

  15. Environmental health studies

    International Nuclear Information System (INIS)

    Easterly, C.E.; Shank, K.E.

    1978-01-01

    The two major thrusts of the environmental health studies have been in the areas of health physics aspects of fusion power and methodology for assessing health effects related to nuclear facilities. Researchers were unable to discern a dose-response relationship or to find adverse health effects in the local population around nuclear facilities which might be related to radiation exposure. A second study analyzed the trends in incidence of cancer, congenital malformation, and fetal and infant mortality for Oak Ridge, Anderson County, and Roane County relative to Tennessee. Finally, a more in-depth study on congenital malformations and fetal mortality trends for nine East Tennessee counties surrounding Oak Ridge was completed. The objective of the Health Physics Aspects of Fusion Power Program is to provide, on a timely basis, scientific information and technical evaluations on the potential impacts of fusion power to occupational workers and to members of the public. The primary areas of study in this program during the past year have been (1) factors affecting calculations of dose resulting from a release of tritium, (2) an assessment of the potential for reducing occupational risk from exposures to tritium, and (3) experimental studies of tritium conversion from molecular hydrogen to tritiated water

  16. Functional studies using NMR

    International Nuclear Information System (INIS)

    McCready, V.R.; Leach, M.O.; Sutton; Ell, P.

    1986-01-01

    The object of this book is to discuss and evaluate an area of Nuclear Magnetic Resonance which to date has been less emphasized than it might be, namely the use of NMR for functional studies. The book commences with a discussion of the areas in which the NMR techniques might be needed due to deficiencies in other techniques. The physics of NMR especially relating to functional measurement are then explained. Technical factors in producing functional images are discussed and the use of paramagnetic substances for carrying out flow studies are detailed. Particular attention is paid to specific studies in the various organs. The book ends with a survey of imaging in each organ and the relation of NMR images to other techniques such as ultrasound, nuclear medicine and X-rays

  17. Florida statewide radiation study

    International Nuclear Information System (INIS)

    Nagda, N.L.; Koontz, M.D.; Fortmann, R.C.; Schoenborn, W.A.; Mehegan, L.L.

    1987-01-01

    Florida phosphate deposits contain higher levels of uranium than most other soils and rocks, thus exposing the population to higher-than-desirable levels of radon and its short-lived daughters. The Florida Legislature ordered a survey of significant land areas where an environmental radiation standard should be applied. Among other things, the study assessed indoor radon in 6,000 homes, soil radon at 3,000 residences, and all data existing prior to the study. The report explains the purpose of the study, how it was designed and conducted, and its results. It concludes with a discussion of radon/radon decay product equilibrium factor, correlation between indoor and soil radon, and preliminary attempts to develop a safe threshold for soil radon below which few elevated indoor levels would be anticipated

  18. Oxidizer Scoping Studies

    Energy Technology Data Exchange (ETDEWEB)

    Chancellor, Christopher John [Los Alamos National Laboratory

    2016-11-07

    The purpose of this report is to present the results of the acceptable knowledge (AK) review of oxidizers present in active waste streams, provide a technical analysis of the oxidizers, and report the results of the scoping study testing. This report will determine the fastest burning oxidizer to be used in the development of a Test Plan for Preparation and Testing of Sorbents Mixed with Oxidizer found in Transuranic Waste (DWT-TP-001). The companion report, DWT-RPT-002, Sorbent Scoping Studies, contains similar information for sorbents identified during the AK review of TRU waste streams. The results of the oxidizer and sorbent scoping studies will be used to inform the QL1 test plan. The QL1 test results will support the development of a basis of knowledge document that will evaluate oxidizing chemicals and sorbents in TRU waste and provide guidance for treatment.

  19. Seal design alternatives study

    International Nuclear Information System (INIS)

    Van Sambeek, L.L.; Luo, D.D.; Lin, M.S.; Ostrowski, W.; Oyenuga, D.

    1993-06-01

    This report presents the results from a study of various sealing alternatives for the WIPP sealing system. Overall, the sealing system has the purpose of reducing to the extent possible the potential for fluids (either gas or liquid) from entering or leaving the repository. The sealing system is divided into three subsystems: drift and panel seals within the repository horizon, shaft seals in each of the four shafts, and borehole seals. Alternatives to the baseline configuration for the WIPP seal system design included evaluating different geometries and schedules for seal component installations and the use of different materials for seal components. Order-of-magnitude costs for the various alternatives were prepared as part of the study. Firm recommendations are not presented, but the advantages and disadvantages of the alternatives are discussed. Technical information deficiencies are identified and studies are outlined which can provide required information

  20. Parylene C Aging Studies.

    Energy Technology Data Exchange (ETDEWEB)

    Achyuthan, Komandoor; Sawyer, Patricia Sue.; Mata, Guillermo Adrian; White II, Gregory Von; Bernstein, Robert

    2014-09-01

    Parylene C is used in a device because of its conformable deposition and other advantages. Techniques to study Parylene C aging were developed, and "lessons learned" that could be utilized for future studies are the result of this initial study. Differential Scanning Calorimetry yielded temperature ranges for Parylene C aging as well as post-deposition treatment. Post-deposition techniques are suggested to improve Parylene C performance. Sample preparation was critical to aging regimen. Short-term (%7E40 days) aging experiments with free standing and ceramic-supported Parylene C films highlighted "lessons learned" which stressed further investigations in order to refine sample preparation (film thickness, single sided uniform coating, machine versus laser cutting, annealing time, temperature) and testing issues ("necking") for robust accelerated aging of Parylene C.

  1. The Hi Five study

    DEFF Research Database (Denmark)

    Johansen, Anette; Denbæk, Anne Maj; Bonnesen, Camilla Thørring

    2015-01-01

    of school toilets during the school day. Baseline data was collected from December 2011 to April 2012. The intervention period was August 2012 to June 2013. The follow-up data was collected from December 2012 to April 2013. DISCUSSION: The Hi Five study fills a gap in international research. This large......BACKGROUND: Infectious illnesses such as influenza and diarrhea are leading causes of absenteeism among Danish school children. Interventions in school settings addressing hand hygiene have shown to reduce the number of infectious illnesses. However, most of these studies include small populations...... and almost none of them are conducted as randomized controlled trials. The overall aim of the Hi Five study was to develop, implement and evaluate a multi-component school-based intervention to improve hand hygiene and well-being and to reduce the prevalence of infections among school children...

  2. Underground layout tradeoff study

    International Nuclear Information System (INIS)

    1988-01-01

    This report presents the results of a technical and economic comparative study of four alternative underground layouts for a nuclear waste geologic repository in salt. The four alternatives considered in this study are (1) separate areas for spent fuel (SF) and commercial high-level waste (CHLW); (2) panel alternation, in which SF and CHLW are emplaced in adjacent panels of rooms; (3) room alternation, in which SF and CHLW are emplaced in adjacent rooms within each panel; and (4) intimate mixture, in which SF and CHLW are emplaced in random order within each storage room. The study concludes that (1) cost is not an important factor; (2) the separate-areas and intimate-mixture alternatives appear, technically, to be more desirable than the other alternatives; and (3) the selection between the separate-areas and intimate mixture alternatives depends upon future resolution of site-specific and reprocessing questions. 5 refs., 6 figs., 12 tabs

  3. Waarom Jesus-studies?

    Directory of Open Access Journals (Sweden)

    P. A. Geyser

    2000-12-01

    Full Text Available Why Jesus studies? Present-day historical Jesus studies are the epistemological product of what has become known as the New Historicism. The aim of the article is to emphasize two aspects of the New Historicism as epistemological approach. The one aspect focuses on the profitability of this endeavour and the other on the historical nature of the New Historicism. As far as profitability is concerned, the social standing and identity of the researcher are emphasized. Among otherthings, the social interests of the researcher are taken into account. Concerning the historical nature of this kind of research, a distinction is drawn between the Jesus of history and the Jesus of faith. The aim of the article is to gain clarity on the relationship between the Jesus of history (pre-Easter and the Jesus of faith (post-Easter. J D Crossan's exposition of the reasons for Jesus studies is followed. He distinguishes three reasons: historical, ethical and theological.

  4. Operation and machine studies

    International Nuclear Information System (INIS)

    1992-01-01

    This annual report describes the GANIL (Grand accelerateur national d'ions lourds, Caen, France) operation and the machine studies realized in 1992. Metallic ions have been accelerated during 36 pc of the time; some were produced for the first time at GANIL: 125 Te, 52 Cr with ECR3, 181 Ta with ECR4. The various machine studies are: comparison of lifetimes of carbon sheets, charge exchange of very heavy ions in carbon foils and in the residual gas of the Ganil cyclotrons, commissioning of the new high intensity axial injection system for Ganil, tantalum acceleration with the new injector, a cyclotron as a mass spectrometer; other studies concerned: implementing the new control system, gettering flux measurement, energy deposited by neutrons and gamma rays in the cryogenic system of SISSI; latest developments on multicharged ECR ion sources, and an on-line isotopic separator test bench at Ganil

  5. STUDY ON VIRTUAL COLONOSCOPY

    Directory of Open Access Journals (Sweden)

    Aithagani Rama Chandraiah

    2016-10-01

    Full Text Available BACKGROUND Current options available in the investigations of colorectal carcinoma include screening using digital rectal examination, sigmoidoscopy, barium enema and fiberoptic colonoscopy, virtual colonoscopy. The aim of the study was to prospectively evaluate patient acceptance of virtual colonoscopy compared with that of conventional colonoscopy when performed in patients with or suspected of having colorectal disease. MATERIALS AND METHODS The study had been conducted on patients attending Department of Radiology for a period of 1 year. Patients with primary or secondary complaints of pain abdomen, lump in abdomen, bleeding per rectum, loose motions/constipation, altered bowel habits, loss of appetite and weight and anaemia, so total number of cases were 51. RESULTS In our study, the patients were in age groups of 21-70 years. Both sexes were represented in our study. Male preponderance was noted in 51 patients. Cases of adenoma were more commonly found 37 (72.78%. The sensitivity of the CT colonography for the polyps more than 10 mm is 100%, polyps 6-9 mm is 90%, less than 6 mm is 80%. Our study consists of 51 patients; among them, 30 patients showed acceptance for CT colonography, 10 patients for optical colonoscopy. Our study consists of 51 patients, the polyps (more than 10 mm detected in 2D viewing were 24, 2D and 3D viewing of 24, the polyps (less than 10 mm detected in 2D viewing were 15, 2D and 3D viewing were 17. 3D viewing resulted in increased sensitivity for identification of patients with larger polyps more than 1 cm, (70-85% sensitivity and patients with smaller polyps less than 1 cm (increased sensitivity 75-88%. CONCLUSIONS Multislice CT (64 colonography is a good alternative to other colorectal screening tests because it has high sensitivity for polyps 10 mm or more in diameter is relatively safe, clinical effective, minimally invasive, cost effective and filter for therapeutic optical colonoscopy.

  6. Making Media Studies

    Directory of Open Access Journals (Sweden)

    David Gauntlett

    2015-12-01

    Full Text Available This podcast is a recording of a research seminar that took place on December 3, 2015, at the University of Westminster's Communication and Media Research Institute (CAMRI. In this contribution, David Gauntlett discusses his new book, Making Media Studies, and other new work. In Making Media Studies (Peter Lang, 2015, Gauntlett proposes a vision of media studies based around doing and making – not about the acquisition of skills, as such, but an experience of building knowledge and understanding through creative hands-on engagement with all kinds of media. Gauntlett suggests that media studies scholars have failed to recognise the significance of everyday creativity – the vital drive of people to make, exchange, and learn together, supported by online networks. He argues that we should think about media in terms of conversations, inspirations, and making things happen. Media studies can be about genuine social change, he suggests, if we recognise the significance of everyday creativity, work to transform our tools, and learn to use them wisely. David Gauntlett is a Professor in the School of Media, Arts and Design at the University of Westminster, where he is also the School's Co-Director of Research. He is the author of several books, including: Creative Explorations (2007, Media, Gender and Identity: An Introduction (2nd edition 2008, Making is Connecting (2011, and Making Media Studies (2015. He has made a number of popular online resources, videos and playthings, and has pioneered creative research and workshop methods. He is external examiner for Information Experience Design at the Royal College of Art, London.

  7. Application Actuation Trade Study

    Science.gov (United States)

    1982-01-01

    32 RCA PRICE-L Podel Calculated 0 & S Values 138 33 RCA PRICE LCC Summery - Typical LRU 139 34 Airplane Actuation Trade Study LCC Summary 140 35...results achieved can be duplicated by a user. The RCA PRICE Podel calculates the RDTSE. Production cost, and creates the YiDF file for use in the PCA...PR ICE L). Some of the basic program ground rules for this study were as follows: RCA - PRICE Cost Podel RCA - PRICE L Model Prototype Hardware 10

  8. Study of estuarine dynamics

    International Nuclear Information System (INIS)

    Genders, S.

    1979-01-01

    A case study of a shallow, well mixed fjord illustrates the use of radioactive and an activable tracer. An instantaneous injection of the rare earth lanthanum was used as an activable tracer to determine residence-time and internal recirculation in the fjord system. An instantaneous injection of bromine-82 was used to investigate tae bypass of water from a harbour area through a power plant cooling water system to a partly enclosed basin of the fjord. Instantaneous releases of bromine-82 were further used for short time studies of the primary spread and transport of river water discharged to the inner section of the fjord system. (Author) [pt

  9. Regional Studies Program

    International Nuclear Information System (INIS)

    Parzyck, D.C.

    1978-01-01

    Progress is reported on methodology studies with regard to hydrologic analysis; atmospheric transport; forest growth models; distribution of sensitive species; agricultural analysis; and environmental objectives in energy facility siting. National coal utilization assessment studies are reported with regard to technology characterization; air quality impacts; water resources; regional characterization; forest impacts; coal extraction impacts on sensitive animal species; and health impacts. The following special projects were carried out: water resource aspects of inexhaustible technology deployment; ecological constraints on the rapidly expanded use of coal; and U.S. coal and the global carbon problem

  10. Studies in Rheoencephalography (REG

    Directory of Open Access Journals (Sweden)

    Michael Bodo

    2010-01-01

    Full Text Available This article presents an overview of rheoencephalography (REG – electrical impedance measurements of the brain – and summarizes past and ongoing research to develop medical applications of REG for neuro-critical care and for primary prevention of stroke and cardiovascular disease. The availability of advanced electronics and computation has opened up the potential for use of REG technology as a noninvasive, continuous and inexpensive brain monitor for military and civilian applications. The clinical background information presented here introduces physiological and clinical environments where REG has potential for use in research and clinical settings. REG studies over the past three decades have involved in vitro and in vivo groups (animal and human, including more than 1500 measurements and related electronic and computational results and practical applications. In vitro studies helped researchers understand the flow/volume relationship between Doppler ultrasound and electrical impedance signals and supported development of REG data processing methods. In animal studies, REG was used to monitor the lower limit of cerebral blood flow (CBF autoregulation (AR using a newly developed algorithm. These animal studies also confirmed correlations between REG and measurements of carotid flow (CF and intracranial pressure (ICP. Human studies confirmed the applicability of REG for detecting cerebrovascular alteration, demonstrating the usefulness of REG in the field of stroke/cardio-vascular disease prevention. In these studies, REG was compared to known stroke risk factors and to results obtained using carotid ultrasound measurements. An intelligent REG system (Cerberus has been developed for primary stroke prevention. In these studies, the biologically relevant variables of the REG signal were pulse amplitude (minimum – maximum distance and duration of the anacrotic (rising portion of the REG pulse wave. The principal limitation of REG for

  11. Reporting of teratology studies.

    Science.gov (United States)

    Barrow, Paul C; Reynaud, Lucie

    2013-01-01

    The regulatory toxicology report is an unusual document that requires a particular skill to write. The report must be clear, accurate, concise, and focused. A clear and direct writing style is required. The end-users of the report will hope to find the information they seek with as little effort as possible. Few, or none, will read the entire document. The author should aim to appease the user by obliging him to read as little text and turn as few pages as possible. This chapter gives tips and guidance on how to present the experimental data and write the narrative text in the final study report for a teratology study.

  12. Biological study in schizophrenia

    International Nuclear Information System (INIS)

    Kasai, Kiyoto; Yoshikawa, Akane; Natsubori, Takanobu; Koike, Shinsuke; Nagai, Tatsuya; Araki, Tsuyoshi; Nishimura, Yukika; Iwamoto, Kazuya

    2012-01-01

    Schizophrenia is associated with enormous morbidity, mortality, personal disability, and social cost. Although considerable research on schizophrenia has been performed, the etiology of this disease has not been fully elucidated. In recent years, imaging and genetic technologies have been developed dramatically. Disturbances in glutamate and gamma-aminobutyric acid (GABA)ergic neurotransmission may underlie the pathophysiology of schizophrenia. We attempted an integrative review, of studies pertaining to recent advances of schizophrenia research with a focus on neuroimaging and genetic studies. Additionally, we present the preliminary findings of the clinical research in our outpatient unit, specialized for early intervention, at the University of Tokyo Hospital. (author)

  13. CTR plasma engineering studies

    International Nuclear Information System (INIS)

    Miley, G.H.

    1990-01-01

    The main focus of the work by the Fusion Plasma Engineering Group at the University during the prior contract year involved a study of fusion ash (helium) effects on burn efficiency and on potential ways to control ash buildup. This work has wide application to a variety of fusion reactor concepts, but the immediate application for the present work is in the ARIES tokamak reactor design study now being undertaken by a national design team headed by the UCLA. The examples presented here largely deal with the ARIES-I design which is a D-T device operating in the first instability regime

  14. Throughput rate study

    International Nuclear Information System (INIS)

    Ford, L.; Bailey, W.; Gottlieb, P.; Emami, F.; Fleming, M.; Robertson, D.

    1993-01-01

    The Civilian Radioactive Waste Management System (CRWMS) Management and Operating (M ampersand O) Contractor, has completed a study to analyze system wide impacts of operating the CRWMS at varying throughput rates, including the 3000 MTU/year rate which has been assumed in the past. Impacts of throughput rate on all phases of the CRWMS operations (acceptance, transportation, storage and disposal) were evaluated. The results of the study indicate that a range from 3000 to 5000 MTU/year is preferred, based on system cost per MTU of SNF emplaced and logistics constraints

  15. Methodology of site studies

    International Nuclear Information System (INIS)

    Caries, J.C.; Hugon, J.; Grauby, A.

    1980-01-01

    This methodology consists in an essentially dynamic, estimated and follow-up analysis of the impact of discharges on all the environment compartments, whether natural or not, that play a part in the protection of man and his environment. It applies at two levels, to wit: the choice of site, or the detailed study of the site selected. Two examples of its application will be developed, namely: at the choice of site level in the case of marine sites, and of the detailed study level of the chosen site in that of a riverside site [fr

  16. ARIES tokamak reactor study

    International Nuclear Information System (INIS)

    Steiner, D.; Embrechts, M.

    1990-07-01

    This is a status report on technical progress relative to the tasks identified for the fifth year of Grant No. FG02-85-ER52118. The ARIES tokamak reactor study is a multi-institutional effort to develop several visions of the tokamak as an attractive fusion reactor with enhanced economic, safety, and environmental features. The ARIES study is being coordinated by UCLA and involves a number of institutions, including RPI. The RPI group has been pursuing the following areas of research in the context of the ARIES-I design effort: MHD equilibrium and stability analyses; plasma-edge modeling and blanket materials issues. Progress in these areas is summarized herein

  17. Camp Marmal Flood Study

    Science.gov (United States)

    2012-03-01

    was simulated by means of a broad - crested weir built into the topography of the mesh. There is 0.5 m of freeboard and the width of the weir is 30 m...ER D C/ CH L TR -1 2- 5 Camp Marmal Flood Study Co as ta l a nd H yd ra ul ic s La bo ra to ry Jeremy A. Sharp , Steve H. Scott...Camp Marmal Flood Study Jeremy A. Sharp , Steve H. Scott, Mark R. Jourdan, and Gaurav Savant Coastal and Hydraulics Laboratory U.S. Army Engineer

  18. Alecto 2 - interaction studies

    International Nuclear Information System (INIS)

    Brunet, J.P.; Clouet d'Orval, Ch.; Mougniot, J.C.; Penet, F.

    1965-01-01

    Weak interactions were experimentally studies with the tank of the critical assembly Alecto II and one, two or three bottles containing solutions of various concentrations. In particular, was studied the validity of certain classical assumptions, shielding effects, screening and semi-reflexion effects, importance of thermal coupling. The method of the 'k eff , solid angle' is shown to apply to such a system. The determination by divergence and pulsed neutron technique of the reactivity related to a millimeter of solution level affords the obtention of critical heights in terms of reactivity. (authors) [fr

  19. Rockwell support studies

    International Nuclear Information System (INIS)

    Rogers, L.E.

    1978-01-01

    The Rockwell Hanford Operations (RHO) supported ecological studies are designed to clarify ecosystem structure and functioning as pertaining to the management of radioactive waste control areas. To date, emphasis has been placed on characterizing the abiotic and biotic components of these areas, resulting in publication of over 20 PNL documents and several scientific articles pertinent to the 200 Area Waste Management Program. Results are reported from studies on the food habits of ground-dwelling beetles, mule deer, and American Coots inhabiting the areas, and the radiation dose received by rodents inhabiting waste management areas

  20. CCNA Wireless Study Guide

    CERN Document Server

    Lammle, Todd

    2010-01-01

    A complete guide to the CCNA Wireless exam by leading networking authority Todd Lammle. The CCNA Wireless certification is the most respected entry-level certification in this rapidly growing field. Todd Lammle is the undisputed authority on networking, and this book focuses exclusively on the skills covered in this Cisco certification exam. The CCNA Wireless Study Guide joins the popular Sybex study guide family and helps network administrators advance their careers with a highly desirable certification.: The CCNA Wireless certification is the most respected entry-level wireless certification