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Sample records for years cohort study

  1. Counselling for burnout in Norwegian doctors: one year cohort study.

    Science.gov (United States)

    Rø, Karin E Isaksson; Gude, Tore; Tyssen, Reidar; Aasland, Olaf G

    2008-11-11

    To investigate levels and predictors of change in dimensions of burnout after an intervention for stressed doctors. Cohort study followed by self reported assessment at one year. Norwegian resource centre. 227 doctors participating in counselling intervention, 2003-5. Counselling (lasting one day (individual) or one week (group based)) aimed at motivating reflection on and acknowledgement of the doctors' situation and personal needs. Levels of burnout (Maslach burnout inventory) and predictors of reduction in emotional exhaustion investigated by linear regression. 185 doctors (81%, 88 men, 97 women) completed one year follow-up. The mean level of emotional exhaustion (scale 1-5) was significantly reduced from 3.00 (SD 0.94) to 2.53 (SD 0.76) (t=6.76, Ppsychotherapy, from 20% (36/182) to 53% (97/182). In the whole cohort, reduction in emotional exhaustion was independently associated with reduced number of work hours/week (beta=0.17, P=0.03), adjusted for sex, age, and personality dimensions. Among men "satisfaction with the intervention" (beta=0.25, P=0.04) independently predicted reduction in emotional exhaustion. A short term counselling intervention could contribute to reduction in emotional exhaustion in doctors. This was associated with reduced working hours for the whole cohort and, in men, was predicted by satisfaction with the intervention.

  2. Mandibular Overdentures Supported by 6-mm Dental Implants : A 1-Year Prospective Cohort Study

    NARCIS (Netherlands)

    Gulje, Felix; Raghoebar, Gerry M.; Ter Meulen, Jan-Willem P.; Vissink, Arjan; Meijer, Henny J. A.; Guljé, Felix

    Background: The extremely resorbed edentulous mandible, with a bone height of 8 mm or less, is still a challenge in implant dentistry. Recently, dental implants of 6 mm in length have been developed. Purpose: The purpose of this 1-year prospective cohort study was to evaluate treatment outcome of

  3. Food and nutrient consumption trends in older Australians: a 10-year cohort study.

    Science.gov (United States)

    Flood, V M; Burlutsky, G; Webb, K L; Wang, J J; Smith, W T; Mitchell, P

    2010-06-01

    Few longitudinal population-based cohort studies of older people have described dietary intakes over time. The objective of this study was to assess changes in the food and nutrient intake in a cohort of older Australians, using longitudinal data collected over 10 years. Population-based cohort of people aged 49 years and over at baseline (82% of those eligible) living in two postcode areas, west of Sydney. In 1992-1994, 3654 people were examined; 2334 were reexamined after 5 years and 1952 after 10 years (75% survivors at both examinations). A 145-item food frequency questionnaire was used to assess food and nutrient intake on each occasion, and 1166 participants provided usable dietary data at all three examinations. Energy and sugar intake significantly increased among women over the 10-year period (P-value for trend bread consumption decreased in both men and women (P-value for trend choices. This information could be used to inform nutrition policy and programs targeted to older persons. These data highlight the need to identify barriers to better food choices.

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

    Science.gov (United States)

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

    2016-01-01

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

  5. Irritable bowel syndrome and chronic fatigue 6 years after giardia infection: a controlled prospective cohort study.

    Science.gov (United States)

    Hanevik, Kurt; Wensaas, Knut-Arne; Rortveit, Guri; Eide, Geir Egil; Mørch, Kristine; Langeland, Nina

    2014-11-15

    Functional gastrointestinal disorders and fatigue may follow acute infections. This study aimed to estimate the persistence, prevalence, and risk of irritable bowel syndrome and chronic fatigue 6 years after Giardia infection. We performed a controlled prospective study of a cohort of 1252 individuals who had laboratory-confirmed Giardia infection during a waterborne outbreak in 2004. In total, 748 cohort cases (exposed) and 878 matched controls responded to a postal questionnaire 6 years later (in 2010). Responses were compared to data from the same cohort 3 years before (in 2007). The prevalences of irritable bowel syndrome (39.4%) by Rome III criteria and chronic fatigue (30.8%) in the exposed group 6 years after giardiasis were significantly elevated compared with controls, with adjusted relative risks (RRs) of 3.4 (95% confidence interval [CI], 2.9-3.9) and 2.9 (95% CI, 2.3-3.4), respectively. In the exposed group, the prevalence of irritable bowel syndrome decreased by 6.7% (RR, 0.85 [95% CI, .77-.93]), whereas the prevalence of chronic fatigue decreased by 15.3% from 3 to 6 years after Giardia infection (RR, 0.69 [95% CI, .62-.77]). Giardia exposure was a significant risk factor for persistence of both conditions, and increasing age was a risk factor for persisting chronic fatigue. Giardia infection in a nonendemic setting is associated with an increased risk for irritable bowel syndrome and chronic fatigue 6 years later. The prevalences of both conditions decrease over time, indicating that this intestinal protozoan parasite may elicit very long-term, but slowly self-limiting, complications. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

  6. Dietary pattern and 20 year mortality in elderly men in Finland, Italy and the Netherlands: Longitudinal cohort study.

    NARCIS (Netherlands)

    Huijbregts, P.; Feskens, E.J.M.; Résénen, L.; Fidanza, F.; Nissinen, A.; Menotti, A.; Kromhout, D.

    1997-01-01

    OBJECTIVE: To investigate the association of dietary pattern and mortality in international data. DESIGN: Cohort study with 20 years' follow up of mortality. SETTING: Five cohorts in Finland, the Netherlands, and Italy. SUBJECTS: Population based random sample of 3045 men aged 50-70 years in 1970.

  7. Blood pressure and 10-year mortality risk in the Milan Geriatrics 75+ Cohort Study

    DEFF Research Database (Denmark)

    Ogliari, Giulia; Westendorp, Rudi G J; Muller, Majon

    2015-01-01

    BACKGROUND: optimal blood pressure targets in older adults are controversial. OBJECTIVE: to investigate whether the relation of blood pressure with mortality in older adults varies by age, functional and cognitive status. DESIGN: longitudinal geriatric outpatient cohort. SETTING: Milan Geriatrics...... 75+ Cohort Study. SUBJECTS: one thousand five hundred and eighty-seven outpatients aged 75 years and over. METHODS: the relations of systolic (SBP) and diastolic blood pressure (DBP) with mortality risk were analysed using Cox proportional hazards models. Blood pressure, Mini-Mental State Examination......: the correlations of SBP and DBP with mortality were U-shaped. Higher SBP is related to lower mortality in subjects with impaired ADL and MMSE. ADL and MMSE may identify older subjects who benefit from higher blood pressure....

  8. Health costs in anthroposophic therapy users: a two-year prospective cohort study

    Directory of Open Access Journals (Sweden)

    Willich Stefan N

    2006-06-01

    Full Text Available Abstract Background Anthroposophic therapies (counselling, special medication, art, eurythmy movement, and rhythmical massage aim to stimulate long-term self-healing processes, which theoretically could lead to a reduction of healthcare use. In a prospective two-year cohort study, anthroposophic therapies were followed by a reduction of chronic disease symptoms and improvement of quality of life. The purpose of this analysis was to describe health costs in users of anthroposophic therapies. Methods 717 consecutive outpatients from 134 medical practices in Germany, starting anthroposophic therapies for chronic diseases, participated in a prospective cohort study. We analysed direct health costs (anthroposophic therapies, physician and dentist consultations, psychotherapy, medication, physiotherapy, ergotherapy, hospital treatment, rehabilitation and indirect costs (sick leave compensation in the pre-study year and the first two study years. Costs were calculated from resource utilisation, documented by patient self-reporting. Data were collected from January 1999 to April 2003. Results Total health costs in the first study year (bootstrap mean 3,297 Euro; 95% confidence interval 95%-CI 3,157 Euro to 3,923 Euro did not differ significantly from the pre-study year (3,186 Euro; 95%-CI 3,037 Euro to 3,711 Euro, whereas in the second year, costs (2,771 Euro; 95%-CI 2,647 Euro to 3,256 Euro were significantly reduced by 416 Euro (95%-CI 264 Euro to 960 Euro compared to the pre-study year. In each period hospitalisation and sick-leave together amounted to more than half of the total health costs. Anthroposophic therapies and medication amounted to 3%, 15%, and 8% of total health costs in the pre-study year, first year, and second study year, respectively. The cost reduction in the second year was largely accounted for by a decrease of inpatient hospitalisation, leading to a hospital cost reduction of 519 Euro (95%-CI 377 Euro to 904 Euro compared to the

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

    DEFF Research Database (Denmark)

    Laustrup, H; Voss, A; Green, A

    2009-01-01

    In 1995 all systemic lupus erythematosus (SLE) patients in the county of Funen were retrieved from four separate and independent sources as part of an 8-year prospective study to determine the pattern of disease activity and damage accumulation in a community based lupus cohort of predominantly...... Scandinavian ancestry. Incident cases were subsequently identified by surveillance of these sources. Established and new cases underwent annual, structured interviews, clinical examination and blood sampling. The Systemic Lupus Erythematosus Diseases Activity Index SLEDAI and Systemic Lupus International...

  10. Suicide in Scottish military veterans: a 30-year retrospective cohort study.

    Science.gov (United States)

    Bergman, B P; Mackay, D F; Smith, D J; Pell, J P

    2017-07-01

    Although reassuring data on suicide risk in UK veterans of the 1982 Falklands conflict and 1991 Gulf conflict have been published, there have been few studies on long-term overall suicide risk in UK veterans. To examine the risk of suicide in a broad population-based cohort of veterans in Scotland, irrespect ive of length of service or exposure to conflict, in comparison with people having no record of military service. A retrospective 30-year cohort study of 56205 veterans born 1945-85 and 172741 matched non-veterans, using Cox proportional hazard models to compare the risk of suicide and fatal self-harm overall, by sex, birth cohort, length of service and year of recruitment. There were 267 (0.48%) suicides in the veterans compared with 918 (0.53%) in non-veterans. The difference was not statistically significant overall [adjusted hazard ratio (HR) 0.99; 95% confidence interval (CI) 0.86-1.13]. The incidence was lower in younger veterans and higher in veterans aged over 40. Early service leavers were at non-significantly increased risk (adjusted HR 1.13; 95% CI 0.91-1.40) but only in the older age groups. Women veterans had a significantly higher risk of suicide than non-veteran women (adjusted HR 2.44; 95% CI 1.32-4.51, P suicide did not differ significantly between veterans and non-veterans, for either sex. The Scottish Veterans Health Study adds to the emerging body of evidence that there is no overall difference in long-term risk of suicide between veterans and non-veterans in the UK. However, female veterans merit further study. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  11. Assessment of dental caries predictors in 6-year-old school children - results from 5-year retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Masood Mohd

    2012-11-01

    Full Text Available Abstract Background This was a retrospective cohort study undertaken to assess the rate and pattern of dental caries development in 6-year-old school children followed-up for a period of 5 years, and to identify baseline risk factors that were associated with 5 years caries experience in Malaysian children. Methods This 5-years retrospective cohort study comprised primary school children initially aged 6 years in 2004. Caries experience of each child was recorded annually using World Health Organization criteria. The rates of dental caries were recorded in prevalence and incidence density of carious lesions from baseline to final examination. Risk assessment was done to assess relative risk for caries after 5 years in children with baseline caries status. Simple and multiple logistic regression analysis were performed to identify significant independent risk factors for caries. Results The sample consisted of 1830 school children. All components of DMFT showed significant differences between baseline and final examination. Filled teeth (FT component of the DMFT showed the greatest increases. Results revealed the initial baseline caries level in permanent dentition was a strong predictor for future caries after 5 years (RR=3.78, 95% CI=3.48-4.10, P0.001. Logistic regression analysis showed significant association between caries occurrence and residence (urban/rural (OR=1.80, Pp observed from baseline and after 5 years was 5.80 persons/100 person-year of observation. The rate of new caries-affected tooth (IDt in the period from baseline and after 5-years was 0.76 teeth/100 teeth-year of observation. Conclusion The majority of 12-year-old school children (70% were caries-free and most of the caries were concentrated in only a small proportion (30% of them. We found that the presence of caries in permanent teeth at the age of 6 years was a strong predictor of future caries development in this population. The strong evidence of early permanent teeth

  12. The impact of a healthy lifestyle on Disability-Adjusted Life Years: a prospective cohort study.

    Science.gov (United States)

    May, Anne M; Struijk, Ellen A; Fransen, Heidi P; Onland-Moret, N Charlotte; de Wit, G Ardine; Boer, Jolanda M A; van der Schouw, Yvonne T; Hoekstra, Jeljer; Bueno-de-Mesquita, H Bas; Peeters, Petra H M; Beulens, Joline W J

    2015-02-27

    The association between single health behaviours and incidence of and premature mortality from major chronic diseases, including myocardial infarction, stroke, diabetes mellitus, and cancer, has been demonstrated thoroughly. However, the association of several healthy behaviours with Disability-Adjusted Life Years (DALYs), which is a measure for total health combining Years Lost due to Disability and the Years of Life Lost due to premature mortality, has not been studied yet. A prospective cohort study was conducted among 33,066 healthy men and women aged 20 to 70 years recruited into the EPIC-NL study during 1993 to 1997. Participants' smoking status, BMI, physical activity, and adherence to a Mediterranean-style diet (excluding alcohol) were investigated separately and combined into a simple health behaviour score ranging from 0 to 4. Participants were followed until the end of 2007 for occurrence of and mortality from the most important chronic diseases. The association between lifestyle (separate lifestyle factors and a simple health behaviour score) and DALYs were adjusted for relevant confounders. After a median follow-up of 12.4 years, 6,647 disease incidences and 1,482 deaths were documented. Non-smoking, low BMI (BMI healthy lifestyle characteristics lived a minimum of 2 years longer in good health (DALYs: -2.13; 95% CI: -2.65 to -1.62) than persons with none. Due to our non-extinct cohort, the total number of DALYs, and consequently the estimates, is underestimated. Therefore, true lifetime health benefits of a healthy lifestyle will be even larger. Non-smoking, a low BMI, being physically active, and adherence to a Mediterranean diet were associated with a lower disease burden. Each additional healthy lifestyle factor contributed to a longer life in good health.

  13. Health status recovery at one year in children injured in a road accident: a cohort study.

    Science.gov (United States)

    Batailler, Pierre; Hours, Martine; Maza, Maud; Charnay, Pierrette; Tardy, Hélène; Tournier, Charlène; Javouhey, Etienne

    2014-10-01

    Despite the frequency of traumatic injuries due to road accidents and potential importance of identifying children at risk of impaired recovery one year after a road accident, there is a lack of data on long-term recovery of health status, except in children with severe traumatic brain injury. The aim of the present study was to evaluate predictive factors of recovery in children one year after road traffic injuries. The prospective cohort study was composed of children aged road accident. Recovery of health status one year after the accident and information concerning quality of life and the consequences of the accident for the child or family 1 year after the accident were collected by questionnaire, usually completed by the parents. Victims were in majority male (64.6%) and had mild or moderate injuries (81.9% with Maximum Abbreviated Injury Scale (M-AIS) accident, 75.0% of the mild-to-moderate and 34.8% of the severe cases estimated health status as fully recovered. After adjustment, severity score (M-AIS≥3) and lower limb injury (AIS>1) were associated with incomplete recovery of health status: weighted odds ratio (ORw), 4.3 [95% confidence interval (95% CI), 1.3-14.6] and ORw, 6.5 [95% CI, 1.9-21.7], respectively. Recovery status correlated significantly with quality of life physical scores (r=0.46), especially body pain (r=0.48) and role/social-physical (r=0.50) and, to a lesser extent, quality of life psychosocial scores (r=0.21). In a cohort of children injured in a road accident, those with high injury severity score and those with lower limb injuries are less likely to recover full health status by 1 year. Impaired health status was associated with a lower physical quality of life score at 1 year. Copyright © 2014. Published by Elsevier Ltd.

  14. Early risk factors for criminal offending in schizophrenia: a 35-year longitudinal cohort study.

    Science.gov (United States)

    Eriksson, Asa; Romelsjö, Anders; Stenbacka, Marlene; Tengström, Anders

    2011-09-01

    Recent evidence suggests that factors predicting offending among individuals with no mental disorder may also predict offending among individuals with schizophrenia. The aims of the study were (1) to explore the prevalence of risk factors for criminal offending reported at age 18 among males later diagnosed with schizophrenia, (2) to explore the associations between risk factors reported at age 18 and lifetime criminal offending, (3) to predict lifetime serious violent offending based on risk factors reported at age 18, and (4) to compare the findings with those in males with no later diagnosis of schizophrenia. The study was a prospective, longitudinal study of a birth cohort followed up through registers after 35 years. The cohort consisted of 49,398 males conscripted into the Swedish Army in 1969-1970, of whom 377 were later diagnosed with schizophrenia. Among the subjects later diagnosed with schizophrenia, strong associations were found between four of the items reported at age 18 and lifetime criminal offending: (1) low marks for conduct in school, (2) contact with the police or child care authorities, (3) crowded living conditions, and (4) arrest for public drinking. Three of these four risk factors were found to double the risk of offending among males with no later diagnosis of schizophrenia. Criminality in individuals with schizophrenia may at least partly be understood as a phenomenon similar to criminality in individuals in the general population.

  15. Effect of breastfeeding on common pediatric infections: a 5-year prospective cohort study.

    Science.gov (United States)

    Ardiç, Cüneyt; Yavuz, Erdinç

    2018-04-01

    The studies conducted revealed that breastfeeding duration has a reducing effect on common infectious diseases in the children during breastfeeding period. The aim of the present study was to address the association between breastfeeding duration and common infectious diseases in the children until 5 years of age to show long-term protective effects of the breast milk. The study included 411 infants who were born in Rize (Turkey) between January 2011 and December 2011. The present prospective-cohort study lasted for 5 years and 11 interviews were conducted with each mother of the infants during this period. The infants were divided into two groups as those who were breastfed more and less than 12 months and the association between breastfeeding and infections such as acute otitis media, acute gastroenteritis, acute respiratory tract infections and acute urinary system infections was investigated. Of 270 infants 193 (71.5%) were breastfed longer than 12 months and 77 (28.5%) were breastfed less than 12 months. Infants in the first group had less acute otitis media and acute gastroenteritis (n= 77, 28.52%) when compared with the infants breastfed less than 12 months during 5-year period (p <0.05). The present study detected that breastfeeding duration longer than 12 months significantly reduces the common childhood infections such as otitis media and gastroenteritis during the first 5 years of life. Sociedad Argentina de Pediatría.

  16. Jaundice in primary care: a cohort study of adults aged >45 years using electronic medical records.

    Science.gov (United States)

    Taylor, Anna; Stapley, Sally; Hamilton, William

    2012-08-01

    Jaundice is a rare but important symptom of malignant and benign conditions. When patients present in primary care, understanding the relative likelihood of different disease processes can help GPs to investigate and refer patients appropriately. To identify and quantify the various causes of jaundice in adults presenting in primary care. Historical cohort study using electronic primary care records. UK General Practice Research Database. Participants (186 814 men and women) aged >45 years with clinical events recorded in primary care records between 1 January 2005 and 31 December 2007. Data were searched for episodes of jaundice and explanatory diagnoses identified within the subsequent 12 months. If no diagnosis was found, the patient's preceding medical record was searched for relevant chronic diseases. From the full cohort, 277 patients had at least one record of jaundice between 1 January 2005 and 31 December 2006. Ninety-two (33%) were found to have bile duct stones; 74 (27%) had an explanatory cancer [pancreatic cancer 34 (12%), cholangiocarcinoma 13 (5%) and other diagnosed primary malignancy 27 (10%)]. Liver disease attributed to excess alcohol explained 26 (9%) and other diagnoses were identified in 24 (9%). Sixty-one (22%) had no diagnosis related to jaundice recorded. Although the most common cause of jaundice is bile duct stones, cancers are present in over a quarter of patients with jaundice in this study, demonstrating the importance of urgent investigation into the underlying cause.

  17. Study protocol: the JEU cohort study--transversal multiaxial evaluation and 5-year follow-up of a cohort of French gamblers.

    Science.gov (United States)

    Challet-Bouju, Gaëlle; Hardouin, Jean-Benoit; Vénisse, Jean-Luc; Romo, Lucia; Valleur, Marc; Magalon, David; Fatséas, Mélina; Chéreau-Boudet, Isabelle; Gorsane, Mohamed-Ali; Grall-Bronnec, Marie

    2014-08-20

    There is abundant literature on how to distinguish problem gambling (PG) from social gambling, but there are very few studies of the long-term evolution of gambling practice. As a consequence, the correlates of key state changes in the gambling trajectory are still unknown. The objective of the JEU cohort study is to identify the determinants of key state changes in the gambling practice, such as the emergence of a gambling problem, natural recovery from a gambling problem, resolution of a gambling problem with intermediate care intervention, relapses or care recourse. The present study was designed to overcome the limitations of previous cohort study on PG. Indeed, this longitudinal case-control cohort is the first which plans to recruit enough participants from different initial gambling severity levels to observe these rare changes. In particular, we plan to recruit three groups of gamblers: non-problem gamblers, problem gamblers without treatment and problem gamblers seeking treatment.Recruitment takes place in various gambling places, through the press and in care centers. Cohort participants are gamblers of both sexes who reported gambling on at least one occasion in the previous year and who were aged between 18 and 65. They were assessed through a structured clinical interview and self-assessment questionnaires at baseline and then once a year for five years. Data collection comprises sociodemographic characteristics, gambling habits (including gambling trajectory), the PG section of the DSM-IV, the South Oaks Gambling Screen, the Gambling Attitudes and Beliefs Survey - 23, the Mini International Neuropsychiatric Interview, the Wender-Utah Rating Scale-Child, the Adult ADHD Self-report Scale, somatic comorbidities (especially current treatment and Parkinson disease) and the Temperament and Character Inventory - 125. The JEU cohort study is the first study which proposes to identify the predictive factors of key state changes in gambling practice. This is

  18. Outcomes of Childhood Asthma and Wheezy Bronchitis. A 50-Year Cohort Study.

    Science.gov (United States)

    Tagiyeva, Nara; Devereux, Graham; Fielding, Shona; Turner, Stephen; Douglas, Graham

    2016-01-01

    Cohort studies suggest that airflow obstruction is established early in life, manifests as childhood asthma and wheezy bronchitis, and continues into early adulthood. Although an association between childhood asthma and chronic obstructive pulmonary disease (COPD) in later life has been demonstrated, it is unclear if childhood wheezy bronchitis is associated with COPD. To investigate whether childhood wheezy bronchitis increases the risk of COPD in the seventh decade. A cohort of children recruited in 1964 at age 10 to 15 years, which was followed up in 1989, 1995, and 2001, was followed up again in 2014 when at age 60 to 65 years. Discrete time-to-event and linear mixed effects models were used. FEV1 and FVC were measured. COPD was defined as post-bronchodilator FEV1/FVC Childhood wheezing phenotype was related to 1989, 1995, 2001, and 2014 spirometry data. Three hundred thirty subjects, mean age 61 years, were followed up: 38 with childhood asthma; 53 with childhood wheezy bronchitis; and 239 control subjects (of whom 57 developed adulthood-onset wheeze between ages 16 and 46 yr). In adjusted multivariate analyses, childhood asthma was associated with an increased risk of COPD (odds ratio, 6.37; 95% confidence interval, 3.73-10.94), as was childhood wheezy bronchitis (odd ratio 1.81; 95% confidence interval, 1.12-2.91). The COPD risk increased with childhood asthma, and wheezy bronchitis was associated with reduced FEV1 that was evident by the fifth decade and not an accelerated rate of FEV1 decline. In contrast, adulthood-onset wheeze was associated with accelerated FEV1 decline. Childhood wheezy bronchitis and asthma are associated with an increased risk of COPD and reduced ventilatory function.

  19. Multiple sclerosis risk sharing scheme: two year results of clinical cohort study with historical comparator.

    Science.gov (United States)

    Boggild, Mike; Palace, Jackie; Barton, Pelham; Ben-Shlomo, Yoav; Bregenzer, Thomas; Dobson, Charles; Gray, Richard

    2009-12-02

    To generate evidence on the longer term cost effectiveness of disease modifying treatments in patients with relapsing-remitting multiple sclerosis. Prospective cohort study with historical comparator. Specialist multiple sclerosis clinics in 70 centres in the United Kingdom. Patients with relapsing-remitting multiple sclerosis who started treatment from May 2002 to April 2005 under the UK risk sharing scheme. Treatment with interferon beta or glatiramer acetate in accordance with guidelines of the UK Association of British Neurologists. Observed utility weighted progression in disability at two years' follow-up assessed on the expanded disability status scale (EDSS) compared with that expected by applying the progression rates in a comparator dataset, modified for patients receiving treatment by multiplying by the hazard ratio derived separately for each disease modifying treatment from the randomised trials. In the primary per protocol analysis, progression in disability was worse than that predicted and worse than that in the untreated comparator dataset ("deviation score" of 113%; excess in mean disability status scale 0.28). In sensitivity analyses, however, the deviation score varied from -72% (using raw baseline disability status scale scores, rather than applying a "no improvement" algorithm) to 156% (imputing missing data for year two from progression rates for year one). It is too early to reach any conclusion about the cost effectiveness of disease modifying treatments from this first interim analysis. Important methodological issues, including the need for additional comparator datasets, the potential bias from missing data, and the impact of the "no improvement" rule, will need to be addressed and long term follow-up of all patients is essential to secure meaningful results. Future analyses of the cohort are likely to be more informative, not least because they will be less sensitive to short term fluctuations in disability.

  20. Maternal Hb during pregnancy and offspring's educational achievement: a prospective cohort study over 30 years.

    Science.gov (United States)

    Fararouei, Mohammad; Robertson, Claire; Whittaker, John; Sovio, Ulla; Ruokonen, Aimo; Pouta, Anneli; Hartikainen, Anna-Liisa; Jarvelin, Marjo-Riitta; Hyppönen, Elina

    2010-11-01

    The aim of the present study was to examine the association between maternal Hb levels during pregnancy and educational achievement of the offspring in later life. We analysed data obtained from the Northern Finnish Birth Cohort Study conducted in 1966, in which, data on mothers and offspring from pregnancy through to the age of 31 years were collected. The cohort comprised 11 656 individuals born from singleton births (51 % males and 49 % females). Maternal Hb levels were available from the third, seventh and ninth gestational months. Educational achievement was measured as school scores (range 4-10) taken at the ages of 14 (self-reported questionnaires) and 16 (school reports) years as well as the highest level of education at the age of 31 years. The present results showed a direct positive association between Hb levels and educational achievement in later life. After adjustment for sex, birth weight, birth month and a wide range of maternal factors (parity, smoking, mental status, whether pregnancy was wanted or not, education, social class and marital status), only maternal Hb levels that were measured at the ninth month were significantly associated with the offspring's school performance. If the levels were ≥ 110 g/l at all the three measurement points, offspring not only had better school scores at the ages of 14 and 16 years (β = 0·048, P = 0·04 and β = 0·68, P = 0·007, respectively), but also had an increased odds of having a higher level of education at the age of 31 years (OR = 1·14, P = 0·04). The present study suggests that low maternal Hb levels at the final stages of pregnancy are linked to the poorer educational achievement of the offspring. If our observation is confirmed, it would suggest that Fe prophylaxis even at fairly late stages of pregnancy may be beneficial for the subsequent health of the offspring. However, more studies are needed to fully establish the potential pathways and the clinical importance of the

  1. Association between diverticular disease and Ehlers-Danlos syndrome: a 13-year nationwide population-based cohort study.

    Science.gov (United States)

    Leganger, Julie; Søborg, Marie-Louise Kulas; Mortensen, Laura Quitzau; Gregersen, Rasmus; Rosenberg, Jacob; Burcharth, Jakob

    2016-12-01

    The aim of this study was to examine occurrence and consequences of diverticular disease in patients with Ehlers-Danlos syndrome (EDS) compared with a matched cohort. This nationwide population-based cohort study was conducted using data from medical registers in Denmark from year 2000 to 2012. The EDS cohort was identified using the specific diagnosis code for EDS and was randomly matched in a ratio of 1:20 by sex and date of birth (±1 year) with persons from the Danish general population. The occurrence of diverticular disease and the clinical characteristics of the initial diverticular event were compared between the EDS cohort and the comparison cohort. The first admission with diverticulitis was identified, and severity of diverticulitis, treatment, colonoscopies, length of stay, and 30-day mortality were investigated. We identified 1336 patients with EDS and matched a control cohort of 26,720 patients. The occurrence of diverticular disease in the EDS cohort (2.0 %) and the comparison cohort (0.68 %) differed significantly (p < 0.001). At the first diverticular event, the majority of patients were women (85 % for EDS and 87 % for the comparison cohort). Mean age, localization, and type of contact did not differ significantly. Admission with diverticulitis (1.0 % for EDS and 0.34 % for the comparison cohort) differed significantly (p < 0.001). We found no significant difference in severity of diverticulitis, treatment, length of stay, or 30-day mortality between the EDS and the comparison cohorts. Patients with EDS had an increased occurrence of overall diverticular events and admissions with diverticulitis compared with the general population.

  2. Depression and anxiety in women with early breast cancer: five year observational cohort study

    Science.gov (United States)

    Burgess, Caroline; Cornelius, Victoria; Love, Sharon; Graham, Jill; Richards, Michael; Ramirez, Amanda

    2005-01-01

    Objective To examine the prevalence of, and risk factors for, depression and anxiety in women with early breast cancer in the five years after diagnosis. Design Observational cohort study. Setting NHS breast clinic, London. Participants 222 women with early breast cancer: 170 (77%) provided complete interview data up to either five years after diagnosis or recurrence. Main outcome measures Prevalence of clinically important depression and anxiety (structured psychiatric interview with standardised diagnostic criteria) and clinical and patient risk factors, including stressful life experiences (Bedford College life events and difficulties schedule). Results Nearly 50% of the women with early breast cancer had depression, anxiety, or both in the year after diagnosis, 25% in the second, third, and fourth years, and 15% in the fifth year. Point prevalence was 33% at diagnosis, falling to 15% after one year. 45% of those with recurrence experienced depression, anxiety, or both within three months of the diagnosis. Previous psychological treatment predicted depression, anxiety, or both in the period around diagnosis (one month before diagnosis to four months after diagnosis). Longer term depression and anxiety, were associated with previous psychological treatment, lack of an intimate confiding relationship, younger age, and severely stressful non-cancer life experiences. Clinical factors were not associated with depression and anxiety, at any time. Lack of intimate confiding support also predicted more protracted episodes of depression and anxiety. Conclusion Increased levels of depression, anxiety, or both in the first year after a diagnosis of early breast cancer highlight the need for dedicated service provision during this time. Psychological interventions for women with breast cancer who remain disease free should take account of the broader social context in which the cancer occurs, with a focus on improving social support. PMID:15695497

  3. Consumption and direct costs of dental care for patients with head and neck cancer: A 16-year cohort study.

    Science.gov (United States)

    Lexomboon, Duangjai; Karlsson, Pär; Adolfsson, Jan; Ekbom, Anders; Naimi-Akbar, Aron; Bahmanyar, Shahram; Montgomery, Scott; Sandborgh-Englund, Gunilla

    2017-01-01

    Patients with head and neck (H&N) cancer are commonly treated with surgery and/or radiotherapy, which can increase the risk of oral infection, dental caries, and periodontal disease. The present study investigated dental care consumption and costs in patient with H&N cancer before and after the cancer diagnosis. Data from Swedish regional and national registers were used to follow up dental care utilization and dental procedure costs. The analysis included 2,754 patients who had been diagnosed with H&N cancer (exposed cohort) in Stockholm County, Sweden, during 2000-2012 and 13,036 matched persons without cancer (unexposed cohort). The exposed cohort was sub-grouped into irradiated and non-irradiated patients for analysis. The exposed cohort underwent a moderately higher number of dental procedures per year than the unexposed cohort in both the year of the cancer diagnosis and the year after cancer diagnosis; in addition, these numbers were higher in the irradiated than in the non-irradiated subgroup of the exposed cohort. Dental care consumption and costs in the exposed cohort declined over time but remained at a slightly higher level than in the unexposed cohort over the long term (more than two years). Examinations and preventive procedures accounted for most of the higher consumption in the short term (2 years) and at the longer term follow-up. Swedish national insurance subsidized costs for dental treatment, which were highest in the irradiated subgroup and lowest in the unexposed cohort. Direct costs to the patient, however, were similar among the groups. Swedish national health insurance protects patients with H&N cancer from high dental expenditures. Further studies on the cost-effectiveness of preventive dental care for patients are needed.

  4. Employment Outcome Ten Years after Moderate to Severe Traumatic Brain Injury: A Prospective Cohort Study.

    Science.gov (United States)

    Grauwmeijer, Erik; Heijenbrok-Kal, Majanka H; Haitsma, Ian K; Ribbers, Gerard M

    2017-09-01

    The objective of this prospective cohort study was to evaluate the probability of employment and predictors of employment in patients with moderate- to- severe traumatic brain injury (TBI) over 10-year follow-up. One hundred nine patients (18-67 years) were included with follow-up measurements 3, 6, 12, 18, 24, and 36 months and 10 years post-TBI. Potential predictors of employment probability included patient characteristics, injury severity factors, functional outcome measured at discharge from the hospital with the Glasgow Outcome Scale (GOS), Barthel Index (BI), Functional Independence Measure (FIM), and the Functional Assessment Measure (FAM). Forty-eight patients (42%) completed the 10-year follow-up. Three months post-TBI, 12% were employed, which gradually, but significantly, increased to 57% after 2-years follow-up (p employed persons had less-severe TBI, shorter length of hospital stay (LOS), and higher scores on the GOS, BI, FIM, and FAM at hospital discharge than unemployed persons. No significant differences in age, sex, educational level, living with partner/family or not, pre-injury employment, professional category, psychiatric symptoms, or discharge destination were found. Longitudinal multivariable analysis showed that time, pre-injury employment, FAM, and LOS were independent predictors of employment probability. We concluded that employment probability 10 years after moderate or severe TBI is related to injury severity and pre-injury employment. Future studies on vocational rehabilitation should focus on modifiable factors and take into consideration the effects of national legislation and national labor market forces.

  5. Cognitive Trajectory Changes Over 20 Years Before Dementia Diagnosis: A Large Cohort Study.

    Science.gov (United States)

    Li, Ge; Larson, Eric B; Shofer, Jane B; Crane, Paul K; Gibbons, Laura E; McCormick, Wayne; Bowen, James D; Thompson, Mary Lou

    2017-12-01

    Longitudinal studies have shown an increase in cognitive decline many years before clinical diagnosis of dementia. We sought to estimate changes, relative to "normal" aging, in the trajectory of scores on a global cognitive function test-the Cognitive Abilities Screening Instrument (CASI). A prospective cohort study. Community-dwelling members of a U.S. health maintenance organization. Individuals aged 65 and older who had no dementia diagnosis at baseline and had at least two visits with valid CASI test score (N = 4,315). Average longitudinal trajectories, including changes in trajectory before clinical diagnosis in those who would be diagnosed with dementia, were estimated for CASI item response theory (IRT) scores. The impact of sex, education level, and APOE genotype on cognitive trajectories was assessed. Increased cognitive decline relative to "normal" aging was evident in CASI IRT at least 10 years before clinical diagnosis. Male gender, lower education, and presence of ≥1 APOE ε4 alleles were associated with lower average IRT scores. In those who would be diagnosed with dementia, a trajectory change point was estimated at an average of 3.1 years (95% confidence interval 3.0-3.2) before clinical diagnosis, after which cognitive decline appeared to accelerate. The change point did not differ by sex, education level, or APOE ε4 genotype. There were subtle differences in trajectory slopes by sex and APOE ε4 genotype, but not by education. Decline in average global cognitive function was evident at least 10 years before clinical diagnosis of dementia. The decline accelerated about 3 years before clinical diagnosis. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  6. Raynaud phenomenon and mortality: 20+ years of follow-up of the Charleston Heart Study cohort

    Directory of Open Access Journals (Sweden)

    Nietert PJ

    2015-02-01

    Full Text Available Paul J Nietert,1 Stephanie R Shaftman,1 Richard M Silver,2 Bethany J Wolf,1 Brent M Egan,3 Kelly J Hunt,1 Edwin A Smith2 1Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA; 2Department of Medicine, Division of Rheumatology and Immunology, Medical University of South Carolina, Charleston, SC, USA; 3Greenville Health System, Care Coordination Institute, Greenville, SC, USA Background: Raynaud phenomenon (RP is a temporary vasoconstrictive condition that often manifests itself in the fingers in response to cold or stress. It often co-occurs with certain chronic diseases that impact mortality. Our objective was to determine whether RP has any independent association with survival. Methods: From 1987–1989, a total of 830 participants of the Charleston Heart Study cohort completed an in-person RP screening questionnaire. Two definitions of RP were used: a broad definition that included both blanching (pallor and cyanotic color changes and a narrow definition that included only blanching. All-cause and cardiovascular disease (CVD mortality were compared between subjects with and without RP using race-specific survival models that adjusted for age, sex, baseline CVD, and 10-year risk of coronary heart disease. Results: Using the narrow RP definition, we identified a significant interaction between older age and the presence of RP on all-cause mortality. In the broad RP definition model, the presence of RP was not associated with CVD mortality among blacks; however, among whites, the presence of RP was associated with a 1.6-fold increase in the hazard associated with CVD-related death (hazard ratio: 1.55, 95% confidence interval: 1.10–2.20, P=0.013. Conclusion: RP was independently associated with mortality among older adults in our cohort. Among whites, RP was associated with increased CVD-related death. It is possible that RP may be a sign of undiagnosed vascular disease. Keywords: Raynaud disease

  7. Cancer Incidence and Mortality in a Cohort of US Blood Donors: A 20-Year Study

    International Nuclear Information System (INIS)

    Vahidnia, F.; Busch, M. P.; Custer, B.; Hirschler, N. V.; Chinn, A.; Agapova, M.; Busch, M. P.; Custer, B.

    2013-01-01

    Blood donors are considered one of the healthiest populations. This study describes the epidemiology of cancer in a cohort of blood donors up to 20 years after blood donation. Records from donors who participated in the Retroviral Epidemiology Donor Study (REDS, 1991-2002) at Blood Centers of the Pacific (BCP), San Francisco, were linked to the California Cancer Registry (CCR, 1991-2010). Standardized incidence ratios (SIR) were estimated using standard US 2000 population, and survival analysis used to compare all-cause mortality among donors and a random sample of non donors with cancer from CCR. Of 55,158 eligible allogeneic blood donors followed-up for 863,902 person-years, 4,236 (7.7%) primary malignant cancers were diagnosed. SIR in donors was 1.59 (95% CI = 1.54,1.64). Donors had significantly lower mortality (adjusted HR = 0.70, 95% CI = 0.66-0.74) compared with non donor cancer patients, except for respiratory system cancers (adjusted HR = 0.93, 95% CI = 0.82-1.05). Elevated cancer incidence among blood donors may reflect higher diagnosis rates due to health seeking behavior and cancer screening in donors. A “healthy donor effect” on mortality following cancer diagnosis was demonstrated. This population-based database and sample repository of blood donors with long-term monitoring of cancer incidence provides the opportunity for future analyses of genetic and other bio markers of cancer

  8. Cancer Incidence and Mortality in a Cohort of US Blood Donors: A 20-Year Study

    Science.gov (United States)

    Hirschler, Nora V.; Chinn, Artina; Busch, Michael P.; Custer, Brian

    2013-01-01

    Blood donors are considered one of the healthiest populations. This study describes the epidemiology of cancer in a cohort of blood donors up to 20 years after blood donation. Records from donors who participated in the Retroviral Epidemiology Donor Study (REDS, 1991–2002) at Blood Centers of the Pacific (BCP), San Francisco, were linked to the California Cancer Registry (CCR, 1991–2010). Standardized incidence ratios (SIR) were estimated using standard US 2000 population, and survival analysis used to compare all-cause mortality among donors and a random sample of nondonors with cancer from CCR. Of 55,158 eligible allogeneic blood donors followed-up for 863,902 person-years, 4,236 (7.7%) primary malignant cancers were diagnosed. SIR in donors was 1.59 (95% CI = 1.54,1.64). Donors had significantly lower mortality (adjusted HR = 0.70, 95% CI = 0.66–0.74) compared with nondonor cancer patients, except for respiratory system cancers (adjusted HR = 0.93, 95% CI = 0.82–1.05). Elevated cancer incidence among blood donors may reflect higher diagnosis rates due to health seeking behavior and cancer screening in donors. A “healthy donor effect” on mortality following cancer diagnosis was demonstrated. This population-based database and sample repository of blood donors with long-term monitoring of cancer incidence provides the opportunity for future analyses of genetic and other biomarkers of cancer. PMID:24489545

  9. Cancer Incidence and Mortality in a Cohort of US Blood Donors: A 20-Year Study

    Directory of Open Access Journals (Sweden)

    Farnaz Vahidnia

    2013-01-01

    Full Text Available Blood donors are considered one of the healthiest populations. This study describes the epidemiology of cancer in a cohort of blood donors up to 20 years after blood donation. Records from donors who participated in the Retroviral Epidemiology Donor Study (REDS, 1991–2002 at Blood Centers of the Pacific (BCP, San Francisco, were linked to the California Cancer Registry (CCR, 1991–2010. Standardized incidence ratios (SIR were estimated using standard US 2000 population, and survival analysis used to compare all-cause mortality among donors and a random sample of nondonors with cancer from CCR. Of 55,158 eligible allogeneic blood donors followed-up for 863,902 person-years, 4,236 (7.7% primary malignant cancers were diagnosed. SIR in donors was 1.59 (95% CI = 1.54,1.64. Donors had significantly lower mortality (adjusted HR = 0.70, 95% CI = 0.66–0.74 compared with nondonor cancer patients, except for respiratory system cancers (adjusted HR = 0.93, 95% CI = 0.82–1.05. Elevated cancer incidence among blood donors may reflect higher diagnosis rates due to health seeking behavior and cancer screening in donors. A “healthy donor effect” on mortality following cancer diagnosis was demonstrated. This population-based database and sample repository of blood donors with long-term monitoring of cancer incidence provides the opportunity for future analyses of genetic and other biomarkers of cancer.

  10. Continuum of hepatitis C care in France: A 20-year cohort study.

    Directory of Open Access Journals (Sweden)

    Coralie Hermetet

    Full Text Available Hepatitis C virus (HCV-infected patients require a specific continuum of care (CoC from HCV screening to treatment. We assessed CoC of HCV-infected patients in a longitudinal study.We established a cohort of subjects undergoing HCV screening (high alanine aminotransferase levels or risk factors during preventive consultations at a French regional medical center from 1993 to 2013. Patients were considered to be HCV-infected if HCV RNA was detected in their serum. CoC was assessed as described by Viner et al. (Hepatology 2015: Stage 1, HCV screening; Stage 2, HCV RNA testing; Stage 3, continuing care; Stage 4, antiviral treatment. Cox multivariate analysis was performed to identify factors favoring CoC, defined as at least one course of antiviral treatment.In total, 12,993 HCV tests were performed and 478 outpatients were found to be HCV-seropositive. We included 417 seropositive patients, after excluding false positives and patients lost to follow-up. The baseline characteristics of the patients were: sex ratio (M/F 1.4; mean age 38.5 years; intravenous drug use (IDU in 55%; and 28% in unstable social situations, estimated by the EPICES deprivation score. Antiviral treatment was initiated for 179 (42.9% of the 379 (90.9% patients attending specialist consultations. CoC was associated with screening after 1997 (HR 2.0, 95%CI 1.4-2.9, age > 45 years (HR 1.5, 95%CI 1.02-2.3, patient acceptance of care (HR 9.3, 95%CI 5.4-16.10, specialist motivation for treatment (HR 10.9, 95%CI 7.4-16.0, and absence of cancer (HR 6.7, 95%CI 1.6-27.9. Other comorbid conditions, such as depression and IDU, were not associated with CoC.Our 20-year cohort study reveals the real-life continuum of care for HCV-infected patients in France. The number of patients involved in HCV care after positive testing was substantial due to the organization of healthcare in France. An improved CoC along with new direct-acting antivirals should help to decrease chronic HCV infection.

  11. Work Limitations 4 Years After Mild Traumatic Brain Injury: A Cohort Study.

    Science.gov (United States)

    Theadom, Alice; Barker-Collo, Suzanne; Jones, Kelly; Kahan, Michael; Te Ao, Braden; McPherson, Kathryn; Starkey, Nicola; Feigin, Valery

    2017-08-01

    To explore employment status, work limitations, and productivity loss after mild traumatic brain injury (TBI). Inception cohort study over 4 years. General community. Adults (N=245; >16y at the time of injury) who experienced a mild TBI and who were employed prior to their injury. Not applicable. Details of the injury, demographic information, and preinjury employment status were collected from medical records and self-report. Symptoms and mood were assessed 1 month postinjury using the Rivermead Post-Concussion Symptom Questionnaire and the Hospital Anxiety and Depression Scale. Postinjury employment status and work productivity were assessed 4 years postinjury using the Work Limitations Questionnaire. Four years after mild TBI, 17.3% of participants had exited the workforce (other than for reasons of retirement or to study) or had reduced their working hours compared with preinjury. A further 15.5% reported experiencing limitations at work because of their injury. Average work productivity loss was 3.6%. The symptom of taking longer to think 1 month postinjury significantly predicted work productivity loss 4 years later (β=.47, t=3.79, P≤.001). Although changes in employment status and difficulties at work are likely over time, the results indicate increased unemployment rates, work limitations, and productivity loss in the longer term after a mild TBI. Identification of cognitive difficulties 1 month after TBI in working aged adults and subsequent interventions to address these difficulties are required to facilitate work productivity. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  12. Involvement in Bullying and Suicide-Related Behavior at 11 Years: A Prospective Birth Cohort Study

    Science.gov (United States)

    Winsper, Catherine; Lereya, Tanya; Zanarini, Mary; Wolke, Dieter

    2012-01-01

    Objective: To study the prospective link between involvement in bullying (bully, victim, bully/victim), and subsequent suicide ideation and suicidal/self-injurious behavior, in preadolescent children in the United Kingdom. Method: A total of 6,043 children in the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort were assessed to…

  13. Trajectories of maternal depression and offspring psychopathology at 6 years: 2004 Pelotas cohort study

    Science.gov (United States)

    Matijasevich, Alicia; Murray, Joseph; Cooper, Peter J.; Anselmi, Luciana; Barros, Aluísio J.D.; Barros, Fernando C.; Santos, Iná S.

    2015-01-01

    Background Few studies have addressed the course and severity of maternal depression and its effects on child psychiatric disorders from a longitudinal perspective. This study aimed to identify longitudinal patterns of maternal depression and to evaluate whether distinct depression trajectories predict particular psychiatric disorders in offspring. Methods Cohort of 4231 births followed-up in the city of Pelotas, Brazil. Maternal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS) at 3, 12, 24 and 48 months and 6 years after delivery. Psychiatric disorders in 6-year-old children were evaluated through the development and well-being assessment (DAWBA) instrument. Trajectories of maternal depression were calculated using a group-based modelling approach. Results We identified five trajectories of maternal depressive symptoms: a “low” trajectory (34.8%), a “moderate low” (40.9%), a “increasing” (9.0%), a “decreasing” (9.9%), and a “high-chronic” trajectory (5.4%). The probability of children having any psychiatric disorder, as well as both internalizing and externalizing problems, increased as we moved from the “low” to the “high-chronic” trajectory. These differences were not explained by maternal and child characteristics examined in multivariate analyses. Limitations Data on maternal depression at 3-months was available on only a sub-sample. In addition, we had to rely on maternal report of child’s behavior alone. Conclusions The study revealed an additive effect on child outcome of maternal depression over time. We identified a group of mothers with chronic and severe symptoms of depression throughout the first six years of the child life and for this group child psychiatric outcome was particularly compromised. PMID:25553403

  14. Irritable bowel syndrome and chronic fatigue 3 years after acute giardiasis: historic cohort study.

    Science.gov (United States)

    Wensaas, Knut-Arne; Langeland, Nina; Hanevik, Kurt; Mørch, Kristine; Eide, Geir Egil; Rortveit, Guri

    2012-02-01

    Giardia lamblia is a common cause of gastroenteritis worldwide, but there is limited knowledge about the long-term complications. To estimate the relative risk of irritable bowel syndrome (IBS) and chronic fatigue 3 years after acute giardiasis. Controlled historic cohort study with 3 years' follow-up. Data collected by mailed questionnaire. Waterborne outbreak of giardiasis in the city of Bergen, Norway. 817 patients exposed to Giardia lamblia infection verified by detection of cysts in stool samples and 1128 matched controls. IBS and chronic fatigue. The prevalence of IBS in the exposed group was 46.1%, compared with 14.0% in the control group, and the adjusted RR=3.4 (95% CI 2.9 to 3.8). Chronic fatigue was reported by 46.1% of the exposed group and 12.0% of the controls, the adjusted RR was 4.0 (95% CI 3.5 to 4.5). IBS and chronic fatigue were associated and the RR for the exposed group of having a combination of the two outcomes was 6.8 (95% CI 5.3 to 8.5). The RR was also increased for having just one of the two syndromes, 1.8 for IBS (95% CI 1.4 to 2.3) and 2.2 for chronic fatigue (95% CI 1.7 to 2.8). Infection with Giardia lamblia in a non-endemic area was associated with a high prevalence of IBS and chronic fatigue 3 years after acute illness, and the risk was significantly higher than in the control group. This shows that the potential consequences of giardiasis are more serious than previously known. Further studies are needed, especially in areas where giardiasis is endemic.

  15. Childhood maltreatment preceding depressive disorder at age 18 years: A prospective Brazilian birth cohort study.

    Science.gov (United States)

    Gallo, Erika Alejandra Giraldo; De Mola, Christian Loret; Wehrmeister, Fernando; Gonçalves, Helen; Kieling, Christian; Murray, Joseph

    2017-08-01

    Childhood maltreatment is linked with increased risk for mental illness in adolescence and adulthood. However, little evidence is available on whether different forms of maltreatment have specific effects, and no prospective studies in low- or middle-income countries have addressed this issue. Participants in a population-based, birth cohort study in Pelotas, Brazil (N=3715) self-reported exposure to maltreatment (emotional abuse, physical neglect, physical abuse, sexual abuse, domestic violence) in confidential questionnaires at age 15 years, and were assessed for major depression in interviews at age 18 years, using the MINI. Confounding variables concerning family characteristics were measured in interviews with mothers in the perinatal period and at age 11 years. Females exposed to emotional abuse (OR=2.7; 95%CI=1.9, 3.8) and domestic violence (OR=1.9; 95%CI=1.2, 2.9) were at increased risk for depression after adjustment for confounders and other types of maltreatment. Females exposed to two or more forms of maltreatment were at particularly high risk for depression (OR=4.1; 95%Cl=2.8, 6.1) compared with females not exposed to maltreatment. In adjusted analyses, maltreatment was not associated with depression for males. Detailed information about maltreatment such as timing and frequency was not available, and 1534 individuals were not included in the analyses, who had poorer and less educated mothers. Emotional abuse and domestic violence are strong risk factors for major depression for females. Early intervention to prevent maltreatment and its consequences is critical, especially for girls exposed to poly-maltreatment. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  16. All-cause mortality and radar exposure among french navy personnel: a 30 years cohort study

    International Nuclear Information System (INIS)

    Dabouis, V.; Arvers, P.; Debouzy, J.C.; Perrin, A.; Hours, M.

    2006-01-01

    To improve operational performance in a modern navy force, radiofrequency (RF) and microwaves emitting devices are widely used. It has been suggested that exposure to electromagnetic fields could be associated with greater health hazards and higher mortality. The all-cause mortality of 39488 militaries of the French navy forces was studied over the period 1975-2001 with a cohort epidemiological study. They served from 1975 until 1995. In a first step, the mortality of radar exposed militaries was compared to a control group formed by militaries who served during the same period in the same environment but without radar exposure. Administrative procedures for identifying militaries and their vital status were equivalent in the radar and the control groups. The age standardized mortality ratio in the radar navy personnel was 0.70 (95% CI: 0.54-0.90). In professional militaries, no difference in mortality ratio was found according to duration of estimated exposure. During a 30 years period of observation, we found no increase in all-cause mortality in the French navy personnel who were close to radar equipments

  17. Psychosocial work conditions and registered sickness absence : a 3-year prospective cohort study among office employees

    NARCIS (Netherlands)

    Roelen, C. A. M.; Koopmans, P. C.; Bultmann, U.; Groothoff, J. W.; van der Klink, J. J. L.

    2009-01-01

    Purpose To investigate associations between a wide variety of psychosocial work conditions and sickness absence in a medium-sized company. Methods Prospective cohort study of 395 employees working in an insurance office. Self-reported psychosocial work conditions were measured by questionnaire in

  18. Marijuana use and risk of lung cancer: a 40-year cohort study.

    Science.gov (United States)

    Callaghan, Russell C; Allebeck, Peter; Sidorchuk, Anna

    2013-10-01

    Cannabis (marijuana) smoke and tobacco smoke contain many of the same potent carcinogens, but a critical-yet unresolved-medical and public-health issue is whether cannabis smoking might facilitate the development of lung cancer. The current study aimed to assess the risk of lung cancer among young marijuana users. A population-based cohort study examined men (n = 49,321) aged 18-20 years old assessed for cannabis use and other relevant variables during military conscription in Sweden in 1969-1970. Participants were tracked until 2009 for incident lung cancer outcomes in nationwide linked medical registries. Cox regression modeling assessed relationships between cannabis smoking, measured at conscription, and the hazard of subsequently receiving a lung cancer diagnosis. At the baseline conscription assessment, 10.5 % (n = 5,156) reported lifetime use of marijuana and 1.7 % (n = 831) indicated lifetime use of more than 50 times, designated as "heavy" use. Cox regression analyses (n = 44,284) found that such "heavy" cannabis smoking was significantly associated with more than a twofold risk (hazard ratio 2.12, 95 % CI 1.08-4.14) of developing lung cancer over the 40-year follow-up period, even after statistical adjustment for baseline tobacco use, alcohol use, respiratory conditions, and socioeconomic status. Our primary finding provides initial longitudinal evidence that cannabis use might elevate the risk of lung cancer. In light of the widespread use of marijuana, especially among adolescents and young adults, our study provides important data for informing the risk-benefit calculus of marijuana smoking in medical, public-health, and drug-policy settings.

  19. Seven years of teenage pregnancy in an inner London genitourinary medicine service - a retrospective cohort study.

    Science.gov (United States)

    Hegazi, Aseel; Daley, Natalie; Williams, Elizabeth; McLeod, Felicity; Rafiezadeh, Saba; Prime, Katia

    2014-12-01

    Young people attending genitourinary medicine services are at high risk of unplanned pregnancy. We performed a retrospective cohort study to identify characteristics of pregnant teenagers accessing an inner London genitourinary medicine service. There were 481 pregnancies in 458 teenagers with 54 previous pregnancies and 46 previous terminations of pregnancy. The under-18 and under-16 teenage pregnancy rates were 92.1 and 85.8 per 1000 age-matched clinic attendees, respectively. Median age was 17.1 years. 'Black Other' teenagers ('Black British', 'Mixed White-Black Caribbean' and 'Mixed White-Black African') were over-represented, compared to our clinic population, while those of White ethnicity were under-represented. Few pregnancies (1.5%) were planned with the majority (64%) intending terminations of pregnancy. Most teenagers did not use consistent contraception. Two-thirds of patients had attended genitourinary medicine services in the past and sexually transmitted infection prevalence at presentation was high. Effectively targeting the sexual and reproductive health needs of teenage genitourinary medicine clinic attendees may have a significant impact on reducing sexually transmitted infections, unplanned pregnancy and terminations of pregnancy in this group. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  20. Home Mechanical Ventilation: A 12-Year Population-Based Retrospective Cohort Study.

    Science.gov (United States)

    Povitz, Marcus; Rose, Louise; Shariff, Salimah Z; Leonard, Sean; Welk, Blayne; Jenkyn, Krista Bray; Leasa, David J; Gershon, Andrea S

    2018-04-01

    Increasing numbers of individuals are being initiated on home mechanical ventilation, including noninvasive (bi-level) and invasive mechanical ventilation delivered via tracheostomy due to chronic respiratory failure to enable symptom management and promote quality of life. Given the high care needs of these individuals, a better understanding of the indications for home mechanical ventilation, and health-care utilization is needed. We performed a retrospective cohort study using provincial health administrative data from Ontario, Canada (population ∼13,000,000). Home mechanical ventilation users were characterized using health administrative data to determine the indications for home mechanical ventilation, the need for acute care at the time of ventilation approval, and their health service use and mortality rates following approval. The annual incidence of home mechanical ventilation approval rose from 1.8/100,000 in 2000 to 5.0/100,000 in 2012, or an annual increase of approximately 0.3/100,000 persons/y. The leading indications were neuromuscular disease, thoracic restriction, and COPD. The indication for the remainder could not be determined due to limitations of the administrative databases. Of the 4,670 individuals, 23.0% commenced home mechanical ventilation following an acute care hospitalization. Among individuals who survived at least 1 y, fewer required hospitalization in the year that followed home mechanical ventilation approval (29.9% vs 39.8%) as compared with the year prior. Utilization of home mechanical ventilation is increasing in Ontario, Canada, and further study is needed to clarify the factors contributing to this and to further optimize utilization of health-care resources. Copyright © 2018 by Daedalus Enterprises.

  1. Social position, social ties and adult's oral health: 13 year cohort study.

    Science.gov (United States)

    Vettore, Mario Vianna; Faerstein, Eduardo; Baker, Sarah Ruth

    2016-01-01

    This study explored different pathways by which social position and social ties influence adult's oral health over a 13-year period. A cohort investigation (Pro-Saúde Study) was conducted of non-faculty civil servants at a university in Rio de Janeiro, Brazil (N=1613). Baseline data collected in 1999 included age, social position, social ties, and access to dental care. Psychological factors and smoking were assessed in 2001, whereas tooth loss and self-rated oral health (SROH) were collected in 2012. A hypothesised model exploring different direct and indirect pathways was developed and tested using structural equation modelling. The model was a good fit to the data and accounted for 40% and 27% of the variance in tooth loss and SROH, respectively. A greater social position was linked to more social ties (β=0.31), health insurance (β=0.48), low psychological distress (β=0.07), less smoking (β=-0.21), more regular dental visiting (β=0.30), less tooth loss (β=-0.44) and better SROH (β=-0.25) over time. Social position (β=0.0005) and social ties (β=-0.0015) were linked indirectly with psychological distress, smoking and tooth loss. Social position was linked indirectly with social ties, psychological distress and SROH (β=-0.0071). Poor social position and weak social ties were important predictors for tooth loss and poor SROH in adults over the 13-year period. Direct and indirect pathways via psychological factors and smoking on the aforementioned relationships were identified, suggesting different areas of intervention to promote adults' oral health. Adult's oral health is influenced by social conditions through direct and indirect pathways, including via psychological factors and smoking. Copyright © 2015. Published by Elsevier Ltd.

  2. Five year prognosis in patients with angina identified in primary care: incident cohort study.

    LENUS (Irish Health Repository)

    Buckley, Brian S

    2009-01-01

    OBJECTIVE: To ascertain the risk of acute myocardial infarction, invasive cardiac procedures, and mortality among patients with newly diagnosed angina over five years. DESIGN: Incident cohort study of patients with primary care data linked to secondary care and mortality data. SETTING: 40 primary care practices in Scotland. PARTICIPANTS: 1785 patients with a diagnosis of angina as their first manifestation of ischaemic heart disease, 1 January 1998 to 31 December 2001. MAIN OUTCOME MEASURES: Adjusted hazard ratios for acute myocardial infarction, coronary artery bypass grafting, percutaneous transluminal coronary angioplasty, death from ischaemic heart disease, and all cause mortality, adjusted for demographics, lifestyle risk factors, and comorbidity at cohort entry. RESULTS: Mean age was 62.3 (SD 11.3). Male sex was associated with an increased risk of acute myocardial infarction (hazard ratio 2.01, 95% confidence interval 1.35 to 2.97), death from ischaemic heart disease (2.80, 1.73 to 4.53), and all cause mortality (1.82, 1.33 to 2.49). Increasing age was associated with acute myocardial infarction (1.04, 1.02 to 1.06, per year of age increase), death from ischaemic heart disease (1.09, 1.06 to 1.11, per year of age increase), and all cause mortality (1.09, 1.07 to 1.11, per year of age increase). Smoking was associated with subsequent acute myocardial infarction (1.94, 1.31 to 2.89), death from ischaemic heart disease (2.12, 1.32 to 3.39), and all cause mortality (2.11, 1.52 to 2.95). Obesity was associated with death from ischaemic heart disease (2.01, 1.17 to 3.45) and all cause mortality (2.20, 1.52 to 3.19). Previous stroke was associated with all cause mortality (1.78, 1.13 to 2.80) and chronic kidney disease with death from ischaemic heart disease (5.72, 1.74 to 18.79). Men were more likely than women to have coronary artery bypass grafting or percutaneous transluminal coronary angioplasty after a diagnosis of angina; older people were less likely to

  3. Chronic Kidney Disease in Primary Care: Outcomes after Five Years in a Prospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Adam Shardlow

    2016-09-01

    Full Text Available Chronic kidney disease (CKD is commonly managed in primary care, but most guidelines have a secondary care perspective emphasizing the risk of end-stage kidney disease (ESKD and need for renal replacement therapy. In this prospective cohort study, we sought to study in detail the natural history of CKD in primary care to better inform the appropriate emphasis for future guidance.In this study, 1,741 people with CKD stage 3 were individually recruited from 32 primary care practices in Derbyshire, United Kingdom. Study visits were undertaken at baseline, year 1, and year 5. Binomial logistic regression and Cox proportional hazards models were used to model progression, CKD remission, and all-cause mortality. We used Kidney Disease: Improving Global Outcomes (KDIGO criteria to define CKD progression and defined CKD remission as the absence of diagnostic criteria (estimated glomerular filtration rate [eGFR] >60 ml/min/1.73 m2 and urine albumin-to-creatinine ratio [uACR] <3 mg/mmol at any study visit. Participants were predominantly elderly (mean ± standard deviation (SD age 72.9 ± 9.0 y, with relatively mild reduction in GFR (mean ± SD eGFR 53.5 ± 11.8 mL/min/1,73 m2 and a low prevalence of albuminuria (16.9%. After 5 y, 247 participants (14.2% had died, most of cardiovascular causes. Only 4 (0.2% developed ESKD, but 308 (17.7% evidenced CKD progression by KDIGO criteria. Stable CKD was observed in 593 participants (34.1%, and 336 (19.3% met the criteria for remission. Remission at baseline and year 1 was associated with a high likelihood of remission at year 5 (odds ratio [OR] = 23.6, 95% CI 16.5-33.9 relative to participants with no remission at baseline and year 1 study visits. Multivariable analyses confirmed eGFR and albuminuria as key risk factors for predicting adverse as well as positive outcomes. Limitations of this study include reliance on GFR estimated using the Modification of Diet in Renal Disease study (MDRD equation for

  4. Health Care Utilisation by Bullying Victims: A Cross-Sectional Study of A 9-Year-Old Cohort in Ireland

    OpenAIRE

    Catherine Hayes; Dervla Kelly; Cristina Taut; Elizabeth Nixon; Lina Zgaga; James Williams; Thomas O’Dowd; Udo Reulbach

    2018-01-01

    Children frequently refrain from disclosing being bullied. Early identification of bullying by healthcare professionals in children may prevent adverse health consequences. The aim of our study was to determine whether Health Care Utilisation (HCU) is higher in 9-year-olds who report being bullied and factors influencing type of HCU. The study consists of cross-sectional surveys of Child Cohort of Irish National Longitudinal Study of Children (Wave 1), 8,568 9-year-olds, and their carers. Bei...

  5. Ankle Sprain Injuries: A 2-Year Prospective Cohort Study in Female Greek Professional Basketball Players

    Science.gov (United States)

    Kofotolis, Nikolaos; Kellis, Eleftherios

    2007-01-01

    Context: Ankle sprains are a common basketball injury. Therefore, examination of risk factors for injury in female professional basketball players is worthwhile. Objective: To examine rates of ankle sprains, associated time missed from participation, and risk factors for injury during 2 consecutive seasons. Design: Prospective cohort study. Setting: Eighteen professional basketball facilities. Patients or Other Participants: We observed 204 players from 18 female professional basketball teams for 2 consecutive seasons during a 2-year period. Main Outcome Measure(s): Using questionnaires, we recorded the incidence of ankle sprains, participation time missed, and mechanisms of injury in games and practice sessions. Potential risk factors, such as age, body mass, height, training experience, and history of ankle sprain, were examined using multivariate logistic regression. Results: Fifty of the 204 participants sustained ankle injuries; injuries included 32 ankle sprains, which translated to an ankle sprain rate of 1.12 per 1000 hours of exposure to injury. The 32 players missed 224.4 training and game sessions and an average of 7.01 sessions per injury. Most injuries occurred in the key area of the basketball court and were the result of contact. Injury rates during games were higher than injury rates during practice sessions. Centers, followed by guards and forwards, had the highest rate of injury. Players who did not wear an external ankle support had an odds ratio of 2.481 for sustaining an ankle sprain. Conclusions: Female professional basketball athletes who did not wear an external ankle support, who played in the key area, or who functioned as centers had a higher risk for ankle sprain than did other players. PMID:18059995

  6. Trajectories of health-related quality of life after stroke : results from a one-year prospective cohort study

    NARCIS (Netherlands)

    van Mierlo, Maria; van Heugten, Caroline; Post, Marcel W M; Hoekstra, Trynke; Visser-Meily, Anne

    2018-01-01

    PURPOSE: To identify trajectories of physical and psychosocial health-related quality of life (HRQoL) from two months to one-year post stroke and to determine the factors that are associated with trajectory membership. METHOD: Multicenter prospective cohort study in which 351 stroke patients were

  7. Hopelessness as a Predictor of Attempted Suicide among First Admission Patients with Psychosis: A 10-Year Cohort Study

    Science.gov (United States)

    Klonsky, E. David; Kotov, Roman; Bakst, Shelly; Rabinowitz, Jonathan; Bromet, Evelyn J.

    2012-01-01

    Little is known about the longitudinal relationship of hopelessness to attempted suicide in psychotic disorders. This study addresses this gap by assessing hopelessness and attempted suicide at multiple time-points over 10 years in a first-admission cohort with psychosis (n = 414). Approximately one in five participants attempted suicide during…

  8. Depression, frailty, and all-cause mortality: a cohort study of men older than 75 years.

    Science.gov (United States)

    Almeida, Osvaldo P; Hankey, Graeme J; Yeap, Bu B; Golledge, Jonathan; Norman, Paul E; Flicker, Leon

    2015-04-01

    Depression is associated with increased mortality, but it is unclear if this relationship is truly causal. To determine the relative mortality associated with past and current depression, taking into account the effect of frailty. Prospective longitudinal cohort study of 2565 men aged 75 years or over living in metropolitan Perth, Western Australia, who completed the third wave of assessments of the Health In Men Study throughout 2008. All-cause mortality data were derived from Australian death records up to June 17, 2013. History of past depression and age of onset of symptoms were obtained from direct questioning and from electronic health record linkage. Diagnosis of current major depressive symptoms followed Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision guidelines. We considered that participants were frail if they showed evidence of impairment in 3 or more of the 5 domains on the fatigue, resistance, ambulation, illnesses, and loss of weight (FRAIL) scale. Other measured factors included age, education, living arrangements, smoking and alcohol history, and physical activity. 558 participants died during mean period of follow-up of 4.2 ± 1.1 years. The annual death rate per thousand was 50 for men without depression, 52 for men with past depression, and 201 for men with major depressive symptoms at baseline. The crude mortality hazard was 4.26 (95% confidence interval = 2.98, 6.09) for men with depression at baseline compared with never depressed men, and 1.79 (95% confidence interval = 1.21, 2.62) after adjustment for frailty. Further decline in mortality hazard was observed after adjustment for other measured factors. Current, but not past, depression is associated with increased mortality, and this excess mortality is strongly associated with frailty. Interventions designed to decrease depression-related mortality in later life may need to focus on ameliorating frailty in addition to treating depression. Copyright © 2015

  9. Estimated risk of radiation-induced cancer from paediatric chest CT: two-year cohort study

    Energy Technology Data Exchange (ETDEWEB)

    Niemann, Tilo [Cantonal Hospital Baden, Department of Radiology, Baden (Switzerland); University Lille Nord de France, Department of Thoracic Imaging, Hospital Calmette, Lille (France); Colas, Lucie; Santangelo, Teresa; Faivre, Jean Baptiste; Remy, Jacques; Remy-Jardin, Martine [University Lille Nord de France, Department of Thoracic Imaging, Hospital Calmette, Lille (France); Roser, Hans W.; Bremerich, Jens [University of Basel Hospital, Clinic of Radiology and Nuclear Medicine, Medical Physics, Basel (Switzerland)

    2015-03-01

    The increasing absolute number of paediatric CT scans raises concern about the safety and efficacy and the effects of consecutive diagnostic ionising radiation. To demonstrate a method to evaluate the lifetime attributable risk of cancer incidence/mortality due to a single low-dose helical chest CT in a two-year patient cohort. A two-year cohort of 522 paediatric helical chest CT scans acquired using a dedicated low-dose protocol were analysed retrospectively. Patient-specific estimations of radiation doses were modelled using three different mathematical phantoms. Per-organ attributable cancer risk was then estimated using epidemiological models. Additional comparison was provided for naturally occurring risks. Total lifetime attributable risk of cancer incidence remains low for all age and sex categories, being highest in female neonates (0.34%). Summation of all cancer sites analysed raised the relative lifetime attributable risk of organ cancer incidence up to 3.6% in female neonates and 2.1% in male neonates. Using dedicated scan protocols, total lifetime attributable risk of cancer incidence and mortality for chest CT is estimated low for paediatric chest CT, being highest for female neonates. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Willich Stefan N

    2007-04-01

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

  11. Ten-year blood pressure trajectories, cardiovascular mortality, and life years lost in 2 extinction cohorts: the Minnesota Business and Professional Men Study and the Zutphen Study.

    Science.gov (United States)

    Tielemans, Susanne M A J; Geleijnse, Johanna M; Menotti, Alessandro; Boshuizen, Hendriek C; Soedamah-Muthu, Sabita S; Jacobs, David R; Blackburn, Henry; Kromhout, Daan

    2015-03-09

    Blood pressure (BP) trajectories derived from measurements repeated over years have low measurement error and may improve cardiovascular disease prediction compared to single, average, and usual BP (single BP adjusted for regression dilution). We characterized 10-year BP trajectories and examined their association with cardiovascular mortality, all-cause mortality, and life years lost. Data from 2 prospective and nearly extinct cohorts of middle-aged men—the Minnesota Business and Professional Men Study (n=261) and the Zutphen Study (n=632)—were used. BP was measured annually during 1947-1957 in Minnesota and 1960-1970 in Zutphen. BP trajectories were identified by latent mixture modeling. Cox proportional hazards and linear regression models examined BP trajectories with cardiovascular mortality, all-cause mortality, and life years lost. Associations were adjusted for age, serum cholesterol, smoking, and diabetes mellitus. Mean initial age was about 50 years in both cohorts. After 10 years of BP measurements, men were followed until death on average 20 years later. All Minnesota men and 98% of Zutphen men died. Four BP trajectories were identified, in which mean systolic BP increased by 5 to 49 mm Hg in Minnesota and 5 to 20 mm Hg in Zutphen between age 50 and 60. The third systolic BP trajectories were associated with 2 to 4 times higher cardiovascular mortality risk, 2 times higher all-cause mortality risk, and 4 to 8 life years lost, compared to the first trajectory. Ten-year BP trajectories were the strongest predictors, among different BP measures, of cardiovascular mortality, all-cause mortality, and life years lost in Minnesota. However, average BP was the strongest predictor in Zutphen. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  12. German new onset diabetes in the young incident cohort study: DiMelli study design and first-year results.

    Science.gov (United States)

    Thümer, Leonore; Adler, Kerstin; Bonifacio, Ezio; Hofmann, Frank; Keller, Manfred; Milz, Christine; Munte, Axel; Ziegler, Anette-Gabriele

    2010-01-01

    Diabetes incidence in childhood and youth is increasing worldwide, including autoimmune and non-autoimmune cases. Recent findings suggest that there is a larger than expected proportion of type 2 diabetes in youth, and potential cases of intermediate diabetes phenotypes. Most pediatric diabetes registries focus on type 1 diabetes. Also, there is an absence of reliable data on type 2 diabetes incidence in youth. The DiMelli study aims to establish a diabetes incidence cohort registry of patients in Germany, diagnosed with diabetes mellitus before age 20 years. It will be used to characterize diabetes phenotypes by immunologic, metabolic, and genetic markers. DiMelli will assess the contribution of obesity and socio-demographic factors to the development of diabetes in childhood and youth. Recruitment of patients started in 2009, and is expected to continue at a rate of 250 patients per year. 84% of the 216 patients recruited within the first year were positive for multiple islet autoantibodies, 12% for one islet autoantibody, and 4% were islet autoantibody-negative. Patients with multiple islet autoantibodies were younger and had lower fasting C-peptide levels, compared to islet autoantibody-negative patients (median age 10.0 vs. 14.1 years, p < 0.01). Results from the first year of the study show that DiMelli will help to reveal new knowledge on the etiology of diabetes, and the contribution of genetic predisposition and environmental risk factors to the different types of diabetes.

  13. Impact of CAre-related Regret Upon Sleep (ICARUS) cohort study: protocol of a 3-year multicentre, international, prospective cohort study of novice healthcare professionals.

    Science.gov (United States)

    Cheval, Boris; Cullati, Stéphane; Pihl-Thingvad, Jesper; Mongin, Denis; Von Arx, Martina; Chopard, Pierre; Courvoisier, Delphine S

    2018-03-27

    Healthcare professionals are particularly at risk of developing numerous physical and psychological health problems. The experiences of emotional burden associated with providing healthcare, notably care-related regret, have been associated with these health problems, but only using cross-sectional data so far. Evidence of a causal impact of regret has not been assessed. The Impact of CAre-related Regret Upon Sleep (ICARUS) study is the first prospective and international cohort study established to examine how newly practising healthcare professionals adapt to their challenging job by assessing the impact of care-related regret on sleep and job quitting. The ICARUS cohort study will include newly practising healthcare professionals working in acute care hospitals and clinics recruited between May 2017 and November 2019. Data collection, which will begin as soon as the participant starts working with patients, will consist of a 1-year weekly assessment using a secure web survey. Follow-up data will be collected at 6, 12, 18 and 24 months after the end of the first year. We will collect detailed information on the experience of care-related regret (ie, highest regret intensity, accumulation of regrets and coping strategies related to regrets), sleep problems and job quitting. Moreover, quality of life, health status and burnout will be assessed during the follow-up. Several confounders factors, including sociodemographic characteristics, personality, night shifts and work environment characteristics, will be assessed. The study was approved by the Ethics Committee of Geneva Canton, Switzerland (CCER2016-02041), the Ethics Committee of London South Bank University (HSCSEP/17/06) and the University Research Ethics Committee of Bedfordshire (UREC106). Other study centres deemed local ethical approval unnecessary since the main ethics committee (Geneva) had already accepted the project. Results will be published in relevant scientific journals and be disseminated in

  14. Sickness Absence and Disability Pension After Breast Cancer Diagnosis: A 5-Year Nationwide Cohort Study.

    Science.gov (United States)

    Kvillemo, Pia; Mittendorfer-Rutz, Ellenor; Bränström, Richard; Nilsson, Kerstin; Alexanderson, Kristina

    2017-06-20

    Purpose To explore future diagnosis-specific sickness absence and disability pension among women with breast cancer compared with women without breast cancer. Also, to examine associations with disease-related and sociodemographic factors among those with breast cancer. Methods Longitudinal register data on 3,547 women living in Sweden (age 20 to 65 years) who were first diagnosed with breast cancer in 2005, and a matched comparison cohort (n = 14,188), were analyzed for the annual prevalence of diagnosis-specific sickness absence and disability pension over 5 years. Logistic regressions were used to explore associations of disease-related and sociodemographic factors with future sickness absence and disability pension among women with breast cancer. Results Immediately after being diagnosed with breast cancer, the proportion of women with sickness absence was high but decreased continuously from the 1st through 5th year after diagnosis (71%, 40%, 30%, 22%, and 19%, respectively). In comparison, the range for women without breast cancer was 17% to 11%, respectively. The higher prevalence of sickness absence after breast cancer was mainly a result of breast cancer diagnosis, not a mental diagnosis, or other somatic diagnoses. Advanced cancer at diagnosis, > 90 days sickness absence before diagnosis, low education, and being born outside Sweden were associated with higher odds ratios for sickness absence and disability pension (odds ratio range, 1.40 to 6.45). Conclusion The level of sickness absence increased substantially in women with breast cancer during the first year after diagnosis and approached the level of breast cancer-free women in the following years; however, even in the first year, most women were not on sickness absence for a substantial time, and even in high-risk groups, many were not on sickness absence or disability pension in the following years. Information about relatively low future sickness absence and disability pension levels can be used by

  15. Medical symptoms among pilots associated with work and home environments: a 3-year cohort study.

    Science.gov (United States)

    Fu, Xi; Lindgren, Torsten; Norbäck, Dan

    2015-05-01

    To study associations between the cockpit environment, psychosocial work environment, home environment, and medical symptoms in a cohort of commercial pilots followed over 3 yr. A standardized questionnaire was mailed in February-March 1997 to all Stockholm-based pilots on duty in a Scandinavian flight company (N = 622); 577 (93%) participated. During this time smoking was allowed on long haul flights, but not on shorter flights. Smoking was prohibited on all flights after September 1997. The same questionnaire was sent to the cohort of 577 pilots in February-March 2000; 436 participated (76%). The questionnaire contained questions on symptoms, the psychosocial work environment, and the home environment. Associations were investigated using multiple logistic and ordinal regression. Symptoms were common, especially eye symptoms (38.5%), nose symptoms (39.9%), and tiredness (29.9%). Pilots exposed to environmental tobacco smoke (ETS) on long haul flights had more eye symptoms (odds ratio = 1.91) and tiredness (odds ratio = 2.73). These symptoms were reduced when no longer exposed to ETS. Those who started working on long haul flights developed more nose symptoms. Pilots reporting increased work demands developed more nose and dermal symptoms and tiredness and those with decreased work control developed more eye symptoms. Pilots living in new houses, multifamily houses, and in recently painted homes reported more symptoms. Eliminating ETS exposure on board reduced medical symptoms. Further work to reduce ETS exposure globally is needed. Psychosocial aspects of the work environment for commercial pilots should be considered, as well as the home environment.

  16. Characterizing Adult Sleep Behavior Over 20 Years-The Population-Based Doetinchem Cohort Study

    NARCIS (Netherlands)

    Zomers, Margot L; Hulsegge, Gerben; van Oostrom, Sandra H; Proper, Karin I.; Verschuren, W M Monique; Picavet, H. Susan J

    2017-01-01

    Study Objectives: To describe sleep duration patterns of adults over a 20-year period; to compare sociodemographic, lifestyle, and health characteristics across these patterns; and to relate the patterns to sleep quality. Methods: The study population consisted of 3695 adults aged 20 to 59 years at

  17. Respiratory health of two cohorts of terminal grain elevator workers studied 30 years apart.

    Science.gov (United States)

    Dimich-Ward, Helen; Beking, Kris J; Dybuncio, Anne; Bartlett, Karen H; Karlen, Barbara J; Chow, Yat; Chan-Yeung, Moira

    2011-04-01

    We evaluated the respiratory health of two cohorts of grain terminal elevator workers who participated in one of either respiratory health surveys undertaken in 1978 and 2008. Questionnaire and spirometry data from 584 workers from the 1978 survey and 215 workers from the 2008 survey were compared using logistic regression and general linear modeling. The geometric means of area samples of grain dust averaged 8.28 mg/m(3) in 1978 and 2.06 mg/m(3) in 2008. Workers in the 1978 survey had a significantly higher prevalence of respiratory symptoms (with the largest adjusted odds ratio of 3.78, 95% CI 2.07-7.25, for shortness of breath), a lower prevalence of atopic conditions and lower mean lung function. Current grain workers had a lower risk of respiratory health consequences and a greater prevalence of atopic conditions than workers surveyed 30 years prior, most likely associated with reduced exposure to grain dust in the terminal elevator environment. Copyright © 2010 Wiley-Liss, Inc.

  18. A three-year prospective longitudinal cohort study of medical students' attitudes toward anatomy teaching and their career aspirations.

    Science.gov (United States)

    Bhangu, Aneel; Boutefnouchet, Tarek; Yong, Xu; Abrahams, Peter; Joplin, Ruth

    2010-01-01

    Today's medical students are faced with numerous learning needs. Continuously developing curricula have reduced time for basic science subjects such as anatomy. This study aimed to determine the students' views on the relevance of anatomy teaching, anatomical knowledge, and the effect these have on their career choices. A Likert scale questionnaire was distributed to second year medical students [response rate 91% (n = 292/320)]. The same questionnaire was subsequently distributed to the cohort three years later when they were final year students [response rate 37% (n = 146/392)]. Students in both the cohorts of study agreed strongly that clinically correlated anatomical teaching was relevant to clinical practice (92% and 86% of second and final year respondents, respectively) and helped them during their clinical placements (73% and 92%, respectively). Only 28% of the second year and 31% of the final year students agreed that their anatomy teaching prepared them to interpret clinical images (P = 0.269). Only 14% of the final year students felt confident in their knowledge of anatomy. Of the final year students, 30% felt that they had enough opportunity to scrub in the operating room. Nearly half of those students who would consider surgery as a career (19%) think that they will eventually become surgeons (11%). This data suggests that modern anatomy curriculum should focus on clinical correlations and clinical image interpretation. Students would value more opportunities to participate in surgeries. Vertical integration of anatomy teaching throughout the full medical course may be useful. Copyright 2010 American Association of Anatomists.

  19. Validation of a 5-year risk score of hip fracture in postmenopausal women. The Danish Nurse Cohort Study

    DEFF Research Database (Denmark)

    Hundrup, Y A; Jacobsen, R K; Andreasen, A H

    2010-01-01

    We evaluated the Women's Health Initiative (WHI) hip fracture risk score in 15,648 postmenopausal Danish nurses. The algorithm was well calibrated for Denmark. However, the sensitivity was poor at common decision making thresholds. Obtaining sensitivity better than 80% led to a low specificity...... was to test the clinical performance of the algorithm in a large Danish cohort of postmenopausal Caucasian women against hip fracture. METHODS: The Danish Nurse Cohort is a prospective risk factor and hormone therapy (HT) study established in 1993. Participants in the present analysis were 15......,648 postmenopausal nurses. The calibration and diagnostic performance of the WHI algorithm was evaluated using fracture events captured in the Danish National Hospital Registry. RESULTS: During 5 years of follow-up, 122 participants suffered a hip fracture (1.8/1,000 person years). The WHI algorithm predicted...

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

    NARCIS (Netherlands)

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

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

  1. Reflective ability and moral reasoning in final year medical students: a semi-qualitative cohort study.

    Science.gov (United States)

    Chalmers, Patricia; Dunngalvin, Audrey; Shorten, George

    2011-01-01

    Moral reasoning and reflective ability are important concepts in medical education. To date, the association between reflective ability and moral reasoning in medical students has not been measured. This study tested the hypotheses that, amongst final year medical students, (1) moral reasoning and reflective ability improve over time and (2) positive change in reflective ability favourably influences moral reasoning. With Institutional Ethical approval, 56 medical students (of a class of 110) participated fully both at the beginning and end of the final academic year. Reflective ability and moral reasoning were assessed at each time using Sobral's reflection-in-learning scale (RLS), Boenink's overall reflection score and by employing Kohlberg's schema for moral reasoning. The most important findings were that (1) Students' level of reflective ability scores related to medicine decreased significantly over the course of the year, (2) students demonstrated a predominantly conventional level of moral reasoning at both the beginning and end of the year, (3) moral reasoning scores tended to decrease over the course of the year and (4) RLS is a strong predictor of change in moral reasoning over time. This study confirms the usefulness of Sobral's RLS and BOR score for evaluating moral development in the context of medical education. This study further documents regression and levelling in the moral reasoning of final year medical students and a decrease in reflective ability applied in the medical context. Further studies are required to determine factors that would favourably influence reflective ability and moral reasoning among final year medical students.

  2. The HAPPY study (Holistic Approach to Pregnancy and the first Postpartum Year): design of a large prospective cohort study.

    Science.gov (United States)

    Truijens, Sophie E M; Meems, Margreet; Kuppens, Simone M I; Broeren, Maarten A C; Nabbe, Karin C A M; Wijnen, Hennie A; Oei, S Guid; van Son, Maarten J M; Pop, Victor J M

    2014-09-08

    The HAPPY study is a large prospective longitudinal cohort study in which pregnant women (N ≈ 2,500) are followed during the entire pregnancy and the whole first year postpartum. The study collects a substantial amount of psychological and physiological data investigating all kinds of determinants that might interfere with general well-being during pregnancy and postpartum, with special attention to the effect of maternal mood, pregnancy-related somatic symptoms (including nausea and vomiting (NVP) and carpal tunnel syndrome (CTS) symptoms), thyroid function, and human chorionic gonadotropin (HCG) on pregnancy outcome of mother and foetus. During pregnancy, participants receive questionnaires at 12, 22 and 32 weeks of gestation. Apart from a previous obstetric history, demographic features, distress symptoms, and pregnancy-related somatic symptoms are assessed. Furthermore, obstetrical data of the obstetric record form and ultrasound data are collected during pregnancy. At 12 and 30 weeks, thyroid function is assessed by blood analysis of thyroid stimulating hormone (TSH), free thyroxine (FT4) and thyroid peroxidase antibodies (TPO-Ab), as well as HCG. Also, depression is assessed with special focus on the two key symptoms: depressed mood and anhedonia. After childbirth, cord blood, neonatal heel screening results and all obstetrical data with regard to start of labour, mode of delivery and complications are collected. Moreover, mothers receive questionnaires at one week, six weeks, four, eight, and twelve months postpartum, to investigate recovery after pregnancy and delivery, including postpartum mood changes, emotional distress, feeding and development of the newborn. The key strength of this large prospective cohort study is the holistic (multifactorial) approach on perinatal well-being combined with a longitudinal design with measurements during all trimesters of pregnancy and the whole first year postpartum, taking into account two physiological possible

  3. Psychological resilience in U.S. military veterans: A 2-year, nationally representative prospective cohort study.

    Science.gov (United States)

    Isaacs, Kayla; Mota, Natalie P; Tsai, Jack; Harpaz-Rotem, Ilan; Cook, Joan M; Kirwin, Paul D; Krystal, John H; Southwick, Steven M; Pietrzak, Robert H

    2017-01-01

    Although many cross-sectional studies have examined the correlates of psychological resilience in U.S. military veterans, few longitudinal studies have identified long-term predictors of resilience in this population. The current prospective cohort study utilized data from a nationally representative sample of 2157 U.S. military veterans who completed web-based surveys in two waves (2011 and 2013) as part of the National Health and Resilience in Veterans Study (NHRVS). Cluster analysis of cumulative lifetime exposure to potentially traumatic events and Wave 2 measures of current symptoms of posttraumatic stress, major depressive, and generalized anxiety disorders was performed to characterize different profiles of current trauma-related psychological symptoms. Different profiles were compared with respect to sociodemographic, clinical, and psychosocial characteristics. A three-group cluster analysis revealed a Control group with low lifetime trauma exposure and low current psychological distress (59.5%), a Resilient group with high lifetime trauma and low current distress (27.4%), and a Distressed group with both high trauma exposure and current distress symptoms (13.1%). These results suggest that the majority of trauma-exposed veterans (67.7%) are psychologically resilient. Compared with the Distressed group, the Resilient group was younger, more likely to be Caucasian, and scored lower on measures of physical health difficulties, past psychiatric history, and substance abuse. Higher levels of emotional stability, extraversion, dispositional gratitude, purpose in life, and altruism, and lower levels of openness to experiences predicted resilient status. Prevention and treatment efforts designed to enhance modifiable factors such as gratitude, sense of purpose, and altruism may help promote resilience in highly trauma-exposed veterans. Published by Elsevier Ltd.

  4. Medial shoe-ground pressure and specific running injuries: A 1-year prospective cohort study.

    Science.gov (United States)

    Brund, René B K; Rasmussen, Sten; Nielsen, Rasmus O; Kersting, Uwe G; Laessoe, Uffe; Voigt, Michael

    2017-09-01

    Achilles tendinitis, plantar fasciopathy and medial tibial stress syndrome injuries (APM-injuries) account for approximately 25% of the total number of running injuries amongst recreational runners. Reports on the association between static foot pronation and APM-injuries are contradictory. Possibly, dynamic measures of pronation may display a stronger relationship with the risk of APM-injuries. Therefore, the purpose of the present study was to investigate if running distance until the first APM-injury was dependent on the foot balance during stance phase in recreational male runners. Prospective cohort study. Foot balance for both feet was measured during treadmill running at the fastest possible 5000-m running pace in 79 healthy recreational male runners. Foot balance was calculated by dividing the average of medial pressure with the average of lateral pressure. Foot balance was categorized into those which presented a higher lateral shod pressure (LP) than medial pressure, and those which presented a higher medial shod pressure (MP) than lateral pressure during the stance phase. A time-to-event model was used to compare differences in incidence between foot balance groups. Compared with the LP-group (n=59), the proportion of APM-injuries was greater in the MP-group (n=99) after 1500km of running, resulting in a cumulative risk difference of 16%-points (95% CI=3%-point; 28%-point, p=0.011). Runners displaying a more medial pressure during stance phase at baseline sustained a greater amount of APM-injuries compared to those displaying a lateral shod pressure during stance phase. Prospective studies including a greater amount of runners are needed to confirm this relationship. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  5. Quality of Life during the First Two Years Post Stroke : The Restore4Stroke Cohort Study

    NARCIS (Netherlands)

    van Mierlo, Maria L.; van Heugten, Caroline M.; Post, Marcel W. M.; Hajos, Tibor R. S.; Kappelle, L. Jaap; Visser-Meily, Johanna M. A.

    2016-01-01

    BACKGROUND: Little information is available about the course of quality of life (QoL) post stroke and how dependency on activities of daily living (ADL) influences this course. The aim of this study was therefore to describe the course of QoL from 2 months up to 2 years post stroke and to study the

  6. Midlife muscle strength and human longevity up to age 100 years: a 44-year prospective study among a decedent cohort.

    Science.gov (United States)

    Rantanen, Taina; Masaki, Kamal; He, Qimei; Ross, G Webster; Willcox, Bradley J; White, Lon

    2012-06-01

    We studied prospectively the midlife handgrip strength, living habits, and parents' longevity as predictors of length of life up to becoming a centenarian. The participants were 2,239 men from the Honolulu Heart Program/Honolulu-Asia Aging Study who were born before the end of June 1909 and who took part in baseline physical assessment in 1965-1968, when they were 56-68 years old. Deaths were followed until the end of June 2009 for 44 years with complete ascertainment. Longevity was categorized as centenarian (≥100 years, n = 47), nonagenarian (90-99 years, n = 545), octogenarian (80-89 years, n = 847), and ≤79 years (n = 801, reference). The average survival after baseline was 20.8 years (SD = 9.62). Compared with people who died at the age of ≤79 years, centenarians belonged 2.5 times (odds ratio (OR) = 2.52, 95% confidence interval (CI) = 1.23-5.10) more often to the highest third of grip strength in midlife, were never smokers (OR = 5.75 95% CI = 3.06-10.80), had participated in physical activity outside work (OR = 1.13 per daily hour, 95% CI = 1.02-1.25), and had a long-lived mother (≥80 vs. ≤60 years, OR = 2.3, 95% CI = 1.06-5.01). Associations for nonagenarians and octogenarians were parallel, but weaker. Multivariate modeling showed that mother's longevity and offspring's grip strength operated through the same or overlapping pathway to longevity. High midlife grip strength and long-lived mother may indicate resilience to aging, which, combined with healthy lifestyle, increases the probability of extreme longevity.

  7. Body composition at birth and height at 2 years: A prospective cohort study among children in Jimma, Ethiopia

    OpenAIRE

    Admassu, B.; Wells, J. C. K.; Girma, T.; Andersen, G. S.; Owino, V.; Belachew, T.; Michaelsen, K. F.; Abera, M.; Wibaek, R.; Friis, H.; Kaestel, P.

    2017-01-01

    BACKGROUND: Low birth weight is associated with childhood stunting, but equivalent associations for birth body composition (BC) remain unknown. The aim of this study was to assess associations between birth BC and height-for-age z-score (HAZ) at 2 years of age. / METHODS: In a prospective cohort study, fat mass (FM) and fat-free mass (FFM) were measured using air-displacement plethysmography within 48 h of birth. Linear regression models were applied to study the relationship between BC at bi...

  8. Incidence and remission of lower urinary tract symptoms during 12 years after the first delivery: A cohort study

    DEFF Research Database (Denmark)

    Viktrup, L.; Lose, G.

    2008-01-01

    Purpose: We estimated the incidence and remission of lower urinary tract symptoms during the 12 years following the first pregnancy and delivery. Materials and Methods: In a cohort study 242 primiparae were questioned about lower urinary tract symptoms 3 months, 5 years and 12 years after the first...... of stress urinary incontinence, urge urinary incontinence, urgency, diurnal frequency and nocturia during the same period occurred in 1 of 11 cases (9.1%), 2 of 5 (40%), 2 of 5 (40%), 4 of 7 (57.1%) and I of 1 (100%), respectively. From 5 to 12 years after the first delivery the incidence of stress urinary...... urge urinary incontinence and 15 (24.2%) had mixed urinary incontinence 12 years later. Of 13 women with pure urge urinary incontinence during the first pregnancy and puerperium 3 (23.1%) had pure urge urinary incontinence, 2 (15.4%) had pure stress urinary incontinence and 3 (23.1%) had mixed urinary...

  9. Serum Albumin and Cerebro-cardiovascular Mortality During a 15-year Study in a Community-based Cohort in Tanushimaru, a Cohort of the Seven Countries Study.

    Science.gov (United States)

    Umeki, Yoko; Adachi, Hisashi; Enomoto, Mika; Fukami, Ako; Nakamura, Sachiko; Nohara, Yume; Nakao, Erika; Sakaue, Akiko; Tsuru, Tomoko; Morikawa, Nagisa; Fukumoto, Yoshihiro

    Objective There is little long-term data on the association between the serum albumin levels and mortality in community-based populations. We aimed to determine whether the serum albumin level is an independent risk factor for all-cause and cause-specific death in a community-based cohort study in Japan. Methods In 1999, we performed a periodic epidemiological survey over a 15-year period in a population of 1,905 healthy subjects (783 males, 1,122 females) who were older than 40 years of age and who resided in Tanushimaru, a rural community, in Japan. Over the course of the study, we periodically examined the blood chemistry of the study subjects, including their serum albumin levels. Their baseline serum albumin levels were categorized into quartiles. Results The baseline albumin levels were significantly associated with age (inversely), body mass index (BMI), diastolic blood pressure, lipid profiles [high density lipoprotein-cholesterol (HDL-c), low-density lipoprotein-cholesterol (LDL-c) and triglycerides] and estimated glomerular filtration rate (eGFR). After adjusting for confounders, a Cox proportional hazards regression analysis demonstrated that a low serum albumin level was an independent predictor of all-cause death [hazard ratio (HR): 0.39, 95% confidence interval (CI): 0.24-0.65], cancer death (HR: 0.43, 95% CI: 0.18-0.99), death from infection (HR: 0.21, 95% CI: 0.06-0.73) and cerebro-cardiovascular death (HR: 0.19, 95% CI: 0.06-0.63). The HRs for all-cause and cerebro-cardiovascular death in the highest quartile vs. the lowest quartile of albumin after adjusting for confounders were 0.59 (95%CI:0.39-0.88) and 0.15 (95%CI: 0.03-0.66), respectively. Conclusion The serum albumin level was thus found to be a predictor of all-cause and cerebro-cardiovascular death in a general population.

  10. Management of breech presentation at term: a retrospective cohort study of 10 years of experience.

    Science.gov (United States)

    Burgos, J; Rodríguez, L; Cobos, P; Osuna, C; Del Mar Centeno, M; Larrieta, R; Martínez-Astorquiza, T; Fernández-Llebrez, L

    2015-10-01

    To evaluate the impact of management of childbirth (external cephalic version (ECV) plus planned vaginal delivery (PVD)) of breech presentation at term (⩾37 weeks of gestation). This retrospective cohort study was based on data collected of singleton breech presentations at term in the Obstetrics and Gynaecology Service, Cruces University Hospital (Biscay, Spain), from January 2003 to December 2012. We attended 2377 singleton breech pregnancies at term. We attended 1684 singleton breech term deliveries, attempting vaginal delivery after selection in 52.9% of cases and were successful in 57.5% of attempts. A total of 1360 ECV were attempted, with a success rate of 50.3% of those attempted. The use of ECV has decreased the rate of breech presentation at delivery by 39.0%, the rate of breech presentation as a caesarean section (CS) indication by 47.1% (CS due to breech presentation/total of CS) and the rate of CS for breech presentation out of the total of deliveries by 39.1% (CS due to breech presentation/total of deliveries). Early postnatal parameters (5-min Apgar score, umbilical cord arterial pH and acid-base analysis) were significantly lower following PVD compared with planned CS for breech presentation. However, we did not find any differences in the rates of admissions to the neonatal unit or neonatal mortality. Management of breech presentation with a protocol that includes ECV, careful selection criteria and active management of vaginal delivery achieve a great decrease in the rate of CS for breech presentation.

  11. Impact of team composition on student perceptions of interprofessional teamwork: A 6-year cohort study.

    Science.gov (United States)

    Lairamore, Chad; Morris, Duston; Schichtl, Rachel; George-Paschal, Lorrie; Martens, Heather; Maragakis, Alexandros; Garnica, Mary; Jones, Barbara; Grantham, Myra; Bruenger, Adam

    2018-03-01

    Interprofessional education (IPE) provides students with opportunities to learn about the roles and responsibilities of other professions and develop communication and teamwork skills. As different health professions have recognised the importance of IPE, the number of disciplines participating in IPE events is increasing. Consequently, it is important to examine the effect group structure has on the learning environment and student knowledge acquisition during IPE events. The purpose of this study was to determine the effect of group composition on student perceptions of interprofessional teamwork and collaboration when participating in a case-based IPE forum. To examine this construct, six cohorts of students were divided into two groups: Group-one (2010-2012) included students from five professions. Group-two (2013-2015) included students from 10 professions. The only other change for group-two was broadening the case scenarios to ensure a role for each profession. At the conclusion of the case-based IPE forums, both groups demonstrated a statistically significant increase in 'readiness for interprofessional learning' and 'interdisciplinary education perceptions'. However, participants in group-one (2010-2012) demonstrated a greater change in scores when compared to group-two (2013-2015). It was concluded a case-based IPE forum with students from numerous health professions participating in a discussion about broad case scenarios was moderately effective at introducing students to other health professions and increasing their knowledge of others' identities. However, a smaller grouping of professions with targeted cases was more effective at influencing student perceptions of the need for teamwork. When planning an IPE event, faculty should focus on intentional groupings of professions to reflect the social context of healthcare teams so all students can fully participate and experience shared learning.

  12. Quality of life and psychosocial outcomes after fixed orthodontic treatment: a 17-year observational cohort study.

    Science.gov (United States)

    Arrow, Peter; Brennan, David; Spencer, A John

    2011-12-01

    There is little evidence to suggest that orthodontic treatment can prevent or reduce the likelihood of dental caries or of periodontal disease or dental trauma and temporomandibular disorders, but there is a modest association between the presence of malocclusion/orthodontic treatment need and quality of life. However, little is known of the long-term outcomes of orthodontic treatment. This study reports on the longitudinal follow-up of quality of life and psychosocial outcomes of orthodontic treatment among a cohort of adults who were examined as adolescents in 1988/1989. Children who were examined in 1988/1989 were invited to a follow-up in 2005/2006. Respondents completed a questionnaire, which collected information on quality of life, receipt of orthodontic treatment and psychosocial factors, and were invited for a clinical examination. Oral health conditions including occlusal status using the Dental Aesthetic Index were recorded. Analysis of variance and multiple linear regression were used to examine the relationship between the measured factors. There was no statistically significant association between occlusal status at adolescence and quality of life at adulthood. Those individuals who had orthodontic treatment but did not need orthodontic treatment had higher self-esteem (23.1, SD 5.2) and were more satisfied with life (18.5, SD 3.7) than other treatment groups (self-esteem range, 20.0-22.7; life satisfaction range, 16.4-18.1), anovaP life, P life. Orthodontic treatment was negatively associated with psychosocial factors (life satisfaction; fixed orthodontic treatment (FOT) β = -0.91, P = 0.02 and self-esteem; FOT β = -1.39, P life and psychosocial factors. Receipt of fixed orthodontic treatment does not appear to be associated with oral health-related quality of life but appears to be negatively associated with self-esteem and satisfaction with life. © 2011 John Wiley & Sons A/S.

  13. Chronic disease prevalence in women and air pollution--A 30-year longitudinal cohort study.

    Science.gov (United States)

    To, Teresa; Zhu, Jingqin; Villeneuve, Paul J; Simatovic, Jacqueline; Feldman, Laura; Gao, Chenwei; Williams, Devon; Chen, Hong; Weichenthal, Scott; Wall, Claus; Miller, Anthony B

    2015-07-01

    Air pollution, such as fine particulate matter (PM2.5), can increase risk of adverse health events among people with heart disease, diabetes, asthma and chronic obstructive pulmonary disease (COPD) by aggravating these conditions. Identifying the influence of PM2.5 on prevalence of these conditions may help target interventions to reduce disease morbidity among high-risk populations. The objective of this study is to measure the association of exposure of PM2.5 with prevalence risk of various chronic diseases among a longitudinal cohort of women. Women from Ontario who enrolled in the Canadian National Breast Screening Study (CNBSS) from 1980 to 1985 (n = 29,549) were linked to provincial health administrative data from April 1, 1992 to March 31, 2013 to determine the prevalence of major chronic disease and conditions (heart disease, diabetes, asthma, COPD, acute myocardial infarction, angina, stroke and cancers). Exposure to PM2.5 was measured using satellite data collected from January 1, 1998 to December 31, 2006 and assigned to resident postal-code at time of entry into study. Poisson regression models were used to describe the relationship between exposure to ambient PM2.5 and chronic disease prevalence. Prevalence rate ratios (PRs) were estimated while adjusting for potential confounders: baseline age, smoking, BMI, marital status, education and occupation. Separate models were run for each chronic disease and condition. Congestive heart failure (PR = 1.31, 95% CI: 1.13, 1.51), diabetes (PR = 1.28, 95% CI: 1.16, 1.41), ischemic heart disease (PR = 1.22, 95% CI: 1.14, 1.30), and stroke (PR = 1.21, 95% CI: 1.09, 1.35) showed over a 20% increase in PRs per 10 μg/m(3) increase in PM2.5 after adjusting for risk factors. Risks were elevated in smokers and those with BMI greater than 30. This study estimated significant elevated prevalent rate ratios per unit increase in PM2.5 in nine of the ten chronic diseases studied. Copyright © 2015 Elsevier Ltd. All rights

  14. Stressful work, psychological job strain, and turnover: A 2-year prospective cohort study of truck drivers

    NARCIS (Netherlands)

    Croon, E.M.de; Sluiter, J.K.; Blonk, R.W.B.; Broersen, J.P.J.; Frings-Dresen, M.H.W.

    2004-01-01

    Based on a model that combines existing organizational stress theory and job transition theory, this 2-year longitudinal study examined antecedents and consequences of turnover among Dutch truck drivers. For this purpose, self-reported data on stressful work (job demands and control), psychological

  15. The incidence and prevalence of pterygium in South Korea: A 10-year population-based Korean cohort study.

    Directory of Open Access Journals (Sweden)

    Tyler Hyungtaek Rim

    Full Text Available Although numerous population-based studies have reported the prevalences and risk factors for pterygium, information regarding the incidence of pterygium is scarce. This population-based cohort study aimed to evaluate the South Korean incidence and prevalence of pterygium. We retrospectively obtained data from a nationally representative sample of 1,116,364 South Koreans in the Korea National Health Insurance Service National Sample Cohort (NHIS-NSC. The associated sociodemographic factors were evaluated using multivariable Cox regression analysis, and the hazard ratios and confidence intervals were calculated. Pterygium was defined based on the Korean Classification of Diseases code, and surgically removed pterygium was defined as cases that required surgical removal. We identified 21,465 pterygium cases and 8,338 surgically removed pterygium cases during the study period. The overall incidences were 2.1 per 1,000 person-years for pterygium and 0.8 per 1,000 person-years for surgically removed pterygium. Among subjects who were ≥40 years old, the incidences were 4.3 per 1,000 person-years for pterygium and 1.7 per 1,000 person-years for surgically removed pterygium. The overall prevalences were 1.9% for pterygium and 0.6% for surgically removed pterygium, and the prevalences increased to 3.8% for pterygium and 1.4% for surgically removed pterygium among subjects who were ≥40 years old. The incidences of pterygium decreased according to year. The incidence and prevalence of pterygium were highest among 60-79-year-old individuals. Increasing age, female sex, and living in a relatively rural area were associated with increased risks of pterygium and surgically removed pterygium in the multivariable Cox regression analysis. Our analyses of South Korean national insurance claims data revealed a decreasing trend in the incidence of pterygium during the study period.

  16. Does the African-American-white mortality gap persist after playing professional basketball? A 59-year historical cohort study.

    Science.gov (United States)

    Lawler, Tyler; Lawler, Frank; Gibson, Jack; Murray, Rachael

    2012-06-01

    The African-American-white mortality gap for males in the United States is 6 years in favor of whites. Participation in professional sport may moderate this ethnic disparity. The historical cohort of professional basketball players, with nearly equal numbers of African-American and white players, can provide a natural experiment that may control for the classic confounders of income, education, socioeconomic status (SES), and physical factors related to mortality. The objectives of this study are to assess mortality and calculate survival for the overall study population and within ethnicity. Data were combined from several publicly available sources. The cohort was analyzed to compare longevity among all players, and for players stratified by ethnicity, with the general U.S. population. The final dataset included 3366 individuals, of whom 56.0% were African American. Results suggest white players live 18 months longer than their African-American colleagues. African-American players gained 9 years on their respective referent and live longer than white men in the general public. After controlling for covariates, we found that African-American players have a 75% increased risk of death compared with white players, a statistically significant gap (p gap for males is largely ameliorated (1.5 years vs. 6.1 years) in professional basketball but still persists. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. Incidence of type 2 diabetes in Aboriginal Australians: an 11-year prospective cohort study.

    Science.gov (United States)

    Wang, Zhiqiang; Hoy, Wendy E; Si, Damin

    2010-08-17

    Diabetes is an important contributor to the health inequity between Aboriginal and non-Aboriginal Australians. This study aims to estimate incidence rates of diabetes and to assess its associations with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) among Aboriginal participants in a remote community. Six hundred and eighty six (686) Aboriginal Australians aged 20 to 74 years free from diabetes at baseline were followed for a median of 11 years. During the follow-up period, new diabetes cases were identified through hospital records. Cox proportional hazards models were used to assess relationships of the incidence rates of diabetes with IFG, IGT and body mass index (BMI). One hundred and twenty four (124) new diabetes cases were diagnosed during the follow up period. Incidence rates increased with increasing age, from 2.2 per 1000 person-years for those younger than 25 years to 39.9 per 1000 person-years for those 45-54 years. By age of 60 years, cumulative incidence rates were 49% for Aboriginal men and 70% for Aboriginal women. The rate ratio for developing diabetes in the presence of either IFG or IGT at baseline was 2.2 (95% CI: 1.5, 3.3), adjusting for age, sex and BMI. Rate ratios for developing diabetes were 2.2 (95% CI: 1.4, 3.5) for people who were overweight and 4.7 (95% CI: 3.0, 7.4) for people who were obese at baseline, with adjustment of age, sex and the presence of IFG/IGT. Diabetes incidence rates are high in Aboriginal people. The lifetime risk of developing diabetes among Aboriginal men is one in two, and among Aboriginal women is two in three. Baseline IFG, IGT and obesity are important predictors of diabetes.

  18. Incidence of type 2 diabetes in Aboriginal Australians: an 11-year prospective cohort study

    Directory of Open Access Journals (Sweden)

    Wang Zhiqiang

    2010-08-01

    Full Text Available Abstract Background Diabetes is an important contributor to the health inequity between Aboriginal and non-Aboriginal Australians. This study aims to estimate incidence rates of diabetes and to assess its associations with impaired fasting glucose (IFG and impaired glucose tolerance (IGT among Aboriginal participants in a remote community. Methods Six hundred and eighty six (686 Aboriginal Australians aged 20 to 74 years free from diabetes at baseline were followed for a median of 11 years. During the follow-up period, new diabetes cases were identified through hospital records. Cox proportional hazards models were used to assess relationships of the incidence rates of diabetes with IFG, IGT and body mass index (BMI. Results One hundred and twenty four (124 new diabetes cases were diagnosed during the follow up period. Incidence rates increased with increasing age, from 2.2 per 1000 person-years for those younger than 25 years to 39.9 per 1000 person-years for those 45-54 years. By age of 60 years, cumulative incidence rates were 49% for Aboriginal men and 70% for Aboriginal women. The rate ratio for developing diabetes in the presence of either IFG or IGT at baseline was 2.2 (95% CI: 1.5, 3.3, adjusting for age, sex and BMI. Rate ratios for developing diabetes were 2.2 (95% CI: 1.4, 3.5 for people who were overweight and 4.7 (95% CI: 3.0, 7.4 for people who were obese at baseline, with adjustment of age, sex and the presence of IFG/IGT. Conclusions Diabetes incidence rates are high in Aboriginal people. The lifetime risk of developing diabetes among Aboriginal men is one in two, and among Aboriginal women is two in three. Baseline IFG, IGT and obesity are important predictors of diabetes.

  19. Subsequent fracture rates in a nationwide population-based cohort study with a 10-year perspective

    DEFF Research Database (Denmark)

    Hansen, L; Petersen, K D; Eriksen, S A

    2014-01-01

    with an index fracture (ICD-10 codes: S22.x, S32.x, S42.x, S52.x, S62.x, S72.x, S82.x, S92.x, T02.x, T08.x, T10.x and T12.x) between January 1st, 2001 and December 31st, 2001 and if older than 50 years at time of fracture. The patients were investigated for future subsequent fractures from January 1st, 2002......Summary: Fractures after the age of 50 are frequently observed in Denmark, and many of these may be osteoporotic. This study examined the incidence of all and subsequent fractures in a 10-year period from 2001 to 2011. The incidence of subsequent fractures was high, especially following hip...... fracture. Introduction: The purpose of this study is to examine patterns of subsequent fractures and mortality rates over a 10-year period in patients already suffering from fracture. Methods: The study was designed as a nationwide, registerbased follow-up study. Patients were included if diagnosed...

  20. Does Extended Preoperative Rehabilitation Influence Outcomes 2 Years After ACL Reconstruction? A Comparative Effectiveness Study Between the MOON and Delaware-Oslo ACL Cohorts.

    Science.gov (United States)

    Failla, Mathew J; Logerstedt, David S; Grindem, Hege; Axe, Michael J; Risberg, May Arna; Engebretsen, Lars; Huston, Laura J; Spindler, Kurt P; Snyder-Mackler, Lynn

    2016-10-01

    Rehabilitation before anterior cruciate ligament (ACL) reconstruction (ACLR) is effective at improving postoperative outcomes at least in the short term. Less is known about the effects of preoperative rehabilitation on functional outcomes and return-to-sport (RTS) rates 2 years after reconstruction. The purpose of this study was to compare functional outcomes 2 years after ACLR in a cohort that underwent additional preoperative rehabilitation, including progressive strengthening and neuromuscular training after impairments were resolved, compared with a nonexperimental cohort. We hypothesized that the cohort treated with extended preoperative rehabilitation would have superior functional outcomes 2 years after ACLR. Cohort study; Level of evidence, 3. This study compared outcomes after an ACL rupture in an international cohort (Delaware-Oslo ACL Cohort [DOC]) treated with extended preoperative rehabilitation, including neuromuscular training, to data from the Multicenter Orthopaedic Outcomes Network (MOON) cohort, which did not undergo extended preoperative rehabilitation. Inclusion and exclusion criteria from the DOC were applied to the MOON database to extract a homogeneous sample for comparison. Patients achieved knee impairment resolution before ACLR, and postoperative rehabilitation followed each cohort's respective criterion-based protocol. Patients completed the International Knee Documentation Committee (IKDC) subjective knee form and Knee injury and Osteoarthritis Outcome Score (KOOS) at enrollment and again 2 years after ACLR. RTS rates were calculated for each cohort at 2 years. After adjusting for baseline IKDC and KOOS scores, the DOC patients showed significant and clinically meaningful differences in IKDC and KOOS scores 2 years after ACLR. There was a significantly higher (P < .001) percentage of DOC patients returning to preinjury sports (72%) compared with those in the MOON cohort (63%). The cohort treated with additional preoperative

  1. Sex Differences in Stroke Survival: 10-Year Follow-up of the Copenhagen Stroke Study Cohort

    DEFF Research Database (Denmark)

    Andersen, Morten Nonboe; Andersen, Klaus Kaae; Kammersgaard, Lars Peter

    2005-01-01

    BACKGROUND: Although diverging, most studies show that sex has no significant influence on stroke survival. METHODS: In a Copenhagen, Denmark, community all patients with stroke during March 1992 to November 1993 were registered on hospital admission. Stroke severity was measured using the Scandi......BACKGROUND: Although diverging, most studies show that sex has no significant influence on stroke survival. METHODS: In a Copenhagen, Denmark, community all patients with stroke during March 1992 to November 1993 were registered on hospital admission. Stroke severity was measured using......-up period. Predictors of death were identified using a Cox proportional hazards model. RESULTS: Of 999 patients, 559 (56%) were women and 440 (44%) were men. Women were older (77.0 v 70.9 years; P ... factors showed no difference between sexes for ischemic heart disease, hypertension, atrial fibrillation, diabetes mellitus, and previous stroke. Men more often were smokers and alcohol consumers. Unadjusted survival in men and women did not differ: 70.3% versus 66.7% (1-year), 40.0% versus 38.9% (5-year...

  2. Sex differences in stroke survival: 10-year follow-up of the Copenhagen stroke study cohort

    DEFF Research Database (Denmark)

    Andersen, Morten Nonboe; Andersen, Klaus Kaae; Kammersgaard, Lars Peter

    2005-01-01

    BACKGROUND: Although diverging, most studies show that sex has no significant influence on stroke survival. METHODS: In a Copenhagen, Denmark, community all patients with stroke during March 1992 to November 1993 were registered on hospital admission. Stroke severity was measured using the Scandi......BACKGROUND: Although diverging, most studies show that sex has no significant influence on stroke survival. METHODS: In a Copenhagen, Denmark, community all patients with stroke during March 1992 to November 1993 were registered on hospital admission. Stroke severity was measured using......-up period. Predictors of death were identified using a Cox proportional hazards model. RESULTS: Of 999 patients, 559 (56%) were women and 440 (44%) were men. Women were older (77.0 v 70.9 years; P ... factors showed no difference between sexes for ischemic heart disease, hypertension, atrial fibrillation, diabetes mellitus, and previous stroke. Men more often were smokers and alcohol consumers. Unadjusted survival in men and women did not differ: 70.3% versus 66.7% (1-year), 40.0% versus 38.9% (5-year...

  3. Infant eczema, infant sleeping problems, and mental health at 10 years of age: the prospective birth cohort study LISAplus.

    Science.gov (United States)

    Schmitt, J; Chen, C-M; Apfelbacher, C; Romanos, M; Lehmann, I; Herbarth, O; Schaaf, B; Kraemer, U; von Berg, A; Wichmann, H-E; Heinrich, J

    2011-03-01

    Cross-sectional studies suggest an association between eczema and mental health problems, possibly modified by sleeping problems, but prospective evidence is missing. We aimed to prospectively investigate the relationship between infant eczema (within first 2 years of age), infant sleeping problems (within first 2 years of age), and the risk of mental health problems at 10 years of age. Between 1997 and 1999, a population-based birth cohort was recruited in Munich, Leipzig, Wesel, and Bad Honnef, Germany, and followed until 10 years of age. Physician-diagnosed eczema, parent-reported sleeping problems, and known environmental risk factors for atopy were regularly assessed until 10 years of age. Mental health was measured using the Strengths and Difficulties Questionnaire (parent version) at 10 years of age. We applied logistic regression modeling adjusting for environmental and lifestyle factors, allergic comorbidity, and family history of eczema. From the original cohort of 3097 neonates, 1658 (54%) were followed until age 10, while 1578 (51%) were eligible for analysis. In the fully adjusted model, children with infant eczema were at increased risk of hyperactivity/inattention at 10 years of age [odds ratio (OR) 1.78; 95% confidence interval (95% CI) 1.02-3.09]. Infant eczema with concurrent sleeping problems predicted emotional problems [OR 2.63; 95% confidence interval (95% CI) 1.20-5.76] and conduct problems (OR 3.03; 95% CI 1.01-9.12) at 10 years of age. Infant eczema with concurrent sleeping problems appears to be a risk factor for the development of mental health problems. © 2010 John Wiley & Sons A/S.

  4. Control beliefs and risk for 4-year mortality in older adults: a prospective cohort study.

    Science.gov (United States)

    Duan-Porter, Wei; Hastings, Susan Nicole; Neelon, Brian; Van Houtven, Courtney Harold

    2017-01-11

    Control beliefs are important psychological factors that likely contribute to heterogeneity in health outcomes for older adults. We evaluated whether control beliefs are associated with risk for 4-year mortality, after accounting for established "classic" biomedical risk factors. We also determined if an enhanced risk model with control beliefs improved identification of individuals with low vs. high mortality risk. We used nationally representative data from the Health and Retirement Study (2006-2012) for adults 50 years or older in 2006 (n = 7313) or 2008 (n = 6301). We assessed baseline perceived global control (measured as 2 dimensions-"constraints" and "mastery"), and health-specific control. We also obtained baseline data for 12 established biomedical risk factors of 4-year mortality: age, sex, 4 medical conditions (diabetes mellitus, cancer, lung disease and heart failure), body mass index less than 25 kg/m 2 , smoking, and 4 functional difficulties (with bathing, managing finances, walking several blocks and pushing or pulling heavy objects). Deaths within 4 years of follow-up were determined through interviews with respondents' family and the National Death Index. After accounting for classic biomedical risk factors, perceived constraints were significantly associated with higher mortality risk (third quartile scores odds ratio [OR] 1.37, 95% CI 1.03-1.81; fourth quartile scores OR 1.45, 95% CI, 1.09-1.92), while health-specific control was significantly associated with lower risk (OR 0.69-0.78 for scores above first quartile). Higher perceived mastery scores were not consistently associated with decreased risk. The enhanced model with control beliefs found an additional 3.5% of participants (n = 222) with low predicted risk of 4-year mortality (i.e., 4% or less); observed mortality for these individuals was 1.8% during follow-up. Compared with participants predicted to have low mortality risk only by the classic biomedical model

  5. Characterizing Adult Sleep Behavior Over 20 Years-The Population-Based Doetinchem Cohort Study.

    Science.gov (United States)

    Zomers, Margot L; Hulsegge, Gerben; van Oostrom, Sandra H; Proper, Karin I; Verschuren, W M Monique; Picavet, H Susan J

    2017-07-01

    To describe sleep duration patterns of adults over a 20-year period; to compare sociodemographic, lifestyle, and health characteristics across these patterns; and to relate the patterns to sleep quality. The study population consisted of 3695 adults aged 20 to 59 years at baseline. Five measurements of self-reported sleep duration were used to compose seven patterns from 1987 to 2012: persistent short (≤6 hours), moderate (7-8 hours), or long (≥9 hours) sleep duration and several changing patterns (varying and became short, moderate, or long sleepers). Multinomial logistic regression analyses were used to compare characteristics across sleep duration patterns. About 56% of the adults had persistent moderate sleep duration over 20 years. This group had a better sleep quality than the other groups. Of the adults who changed in their sleep duration (40%), 43% became a short sleeper. Sleep duration patterns that deviate from persistent moderate sleep duration were associated with physical inactivity during leisure time (odds ratios [ORs] and 95% confidence intervals [95% CIs] varied between 1.26 [1.04-1.53] and 1.58 [1.06-2.37]) and with poor self-rated health (ORs [95% CIs] varied between 1.50 [1.20-1.87] and 2.15 [1.48-3.12]). Nearly half of the adults did not have persistent moderate sleep duration over a 20-year period and more than one-sixth became short sleeper. This is reason for concern considering the adverse health status associated with short and long sleep duration. Leisure-time physical activity is a potential important target to prevent unfavorable changes in sleep duration over the life course. © Sleep Research Society 2017. Published by Oxford University Press [on behalf of the Sleep Research Society].

  6. Association between pancreatic fat and incidence of metabolic syndrome: a 5-year Japanese cohort study.

    Science.gov (United States)

    Yamazaki, Hajime; Tauchi, Shinichi; Kimachi, Miho; Dohke, Mitsuru; Hanawa, Nagisa; Kodama, Yoshihisa; Katanuma, Akio; Yamamoto, Yosuke; Fukuma, Shingo; Fukuhara, Shunichi

    2018-04-26

    Previous cross-sectional studies showed that pancreatic fat was associated with metabolic syndrome. However, no longitudinal study has evaluated whether people with high pancreatic fat are likely to develop future metabolic syndrome. This study investigated the association between baseline pancreatic fat and metabolic syndrome incidence. In 2008-2009, 320 participants without metabolic syndrome underwent health checks, which included unenhanced computed tomography, and were followed up annually for 4-5 years. Baseline pancreatic fat amounts were evaluated using a histologically validated method that measured differences between pancreas and spleen attenuations on computed tomography. The participants were divided into low (reference), intermediate, and high pancreatic fat groups based on pancreas and spleen attenuation tertiles. Metabolic syndrome incidence was evaluated annually over a median follow-up period of 4.99 (interquartile range, 4.88-5.05) years, in accordance with the 2009 harmonized criteria. Risk ratios (RRs) for the association between baseline pancreatic fat amounts and metabolic syndrome incidence were estimated using Poisson regression models adjusted for age, sex, body mass index, liver fat, pre-metabolic syndrome, cigarette use, alcohol use, and physical activity. Metabolic syndrome incidence was 30.6% (98/320). Pancreatic fat was associated with an increased incidence of metabolic syndrome, based on a univariate analysis (RRs [95% confidence interval], 3.14 [1.74-5.67] and 3.96 [2.23-7.03] in the intermediate and high pancreatic fat groups, respectively). The association remained statistically significant in the multivariate analysis (RR [95% confidence interval], 2.04 [1.14-3.64] and 2.30 [1.28-4.14] for the same groups, respectively). Pancreatic fat predicts the future risk of metabolic syndrome. © 2018 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  7. Increase of mild disability in Japanese elders: A seven year follow-up cohort study

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    Okochi Jiro

    2005-05-01

    Full Text Available Abstract Background Japan has the highest life expectancy in the world. In a 2002 census government report, 18.5% of Japanese were 65 years old and over and 7.9% were over 75 years old. In this ageing population, the increase in the number of dependent older persons, especially those with mild levels of disability, has had a significant impact on the insurance budget. This study examines the increase of mild disability and its related factors. Methods All community-dwelling residents aged 65 and over and without functional decline (n = 1560, of Omishima town, Japan, were assessed in 1996 using a simple illustrative measure, "the Typology of the Aged with Illustrations" to establish a baseline level of function and were followed annually until 2002. The prevalence and incidence of low to severe disability, and their association with chronic conditions present at the commencement of the study, was analyzed. A polychotomous logistic regression model was constructed to estimate the association of each chronic condition with two levels of disability. Results An increase in mild functional decline was more prevalent than severe functional decline. The accumulation of mild disability was more prominent in women. The major chronic conditions associated with mild disability were chronic arthritis and diabetes in women, and cerebrovascular accident and malignancy in men. Conclusion This study showed a tendency for mild disability prevalence to increase in Japanese elders, and some risk factors were identified. As mild disability increasingly prevalent, these findings will help determine priorities for its prevention in Japanese elders.

  8. Factors associated with Clostridium difficile infection: A nested case-control study in a three year prospective cohort.

    Science.gov (United States)

    Khanafer, Nagham; Vanhems, Philippe; Barbut, Frédéric; Luxemburger, Christine

    2017-04-01

    Clostridium difficile infection (CDI) is a serious medical condition that is associated with substantial morbidity and mortality. Identification of risk factors associated with CDI and prompt recognition of patients at risk is key to successfully preventing CDI. A 3-year prospective, observational, cohort study was conducted in a French university hospital and a nested case-control study was performed to identify risk factors for CDI. Inpatients aged 18 years or older, suffering from diarrhea suspected to be related to CDI, were asked to participate. A total of 945 patients were included, of which 233 cases had a confirmed CDI. CDI infection was more common in men (58.4%) (P = 0.04) compared with patients with diarrhea not related to C. difficile. Previous hospitalization (P infection control issues. In future, these "high-risk" patients may benefit from novel agents being developed to prevent CDI. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Moderate glycemic control safe in critically ill adult burn patients: A 15 year cohort study.

    Science.gov (United States)

    Stoecklin, Patricia; Delodder, Frederik; Pantet, Olivier; Berger, Mette M

    2016-02-01

    Hyperglycemia is a metabolic alteration in major burn patients associated with complications. The study aimed at evaluating the safety of general ICU glucose control protocols applied in major burns receiving prolonged ICU treatment. 15 year retrospective analysis of consecutive, adult burn patients admitted to a single specialized centre. death or length of stay burned surface (TBSA), severity scores, infections, ICU stay, outcome. Metabolic variables: total energy, carbohydrate and insulin delivery/24h, arterial blood glucose and CRP values. Analysis of 4 periods: 1, before protocol; 2, tight doctor driven; 3, tight nurse driven; 4, moderate nurse driven. 229 patients, aged 45 ± 20 years (mean ± SD), burned 32 ± 20% TBSA were analyzed. SAPSII was 35 ± 13. TBSA, Ryan and ABSI remained stable. Inhalation injury increased. A total of 28,690 blood glucose samples were analyzed: the median value remained unchanged with a narrower distribution over time. After the protocol initiation, the normoglycemic values increased from 34.7% to 65.9%, with a reduction of hypoglycaemic events (no extreme hypoglycemia in period 4). Severe hyperglycemia persisted throughout with a decrease in period 4 (9.25% in period 4). Energy and glucose deliveries decreased in periods 3 and 4 (pprotocol improved the glycemic control in adult burn patients, reducing glucose variability. Moderate glycemic control in burns was safe specifically related to hypoglycemia, reducing the incidence of hypoglycaemic events compared to the period before. Hyperglycemia persisted at a lower level. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  10. Employment status and sick-leave following obesity surgery: a five-year prospective cohort study.

    Science.gov (United States)

    Andersen, John Roger; Hernæs, Ulrikke J V; Hufthammer, Karl Ove; Våge, Villy

    2015-01-01

    Background. Severe obesity is a risk factor for lower participation in paid work, but whether employment increases and sick leave decreases after obesity surgery is not well documented. Methods. We assessed 224 Norwegian patients with severe obesity (mean age: 40; mean BMI: 49; 61% female) regarding employment status (working versus not working) and the number of days of sick leave during the preceding 12 months, before and five years after obesity surgery (75% follow-up rate). Logistic regression analysis was used to study preoperative predictors of employment status after surgery. Results. There were no change in the employment rate over time (54% versus 58%), but the number of days of sick leave per year was significantly reduced, from a mean of 63 to a mean of 26, and from a median of 36 to a median of 4. Most of this change was attributable to patients with zero days of sick leave, which increased from 25% to 41%. Being female, older, having low education level, receiving disability pension and not being employed before obesity surgery were important risk factors for not being employed after obesity surgery. The type of obesity surgery, BMI and marital status were not useful predictors. Conclusions. Our findings suggest that undergoing obesity surgery is not associated with a higher rate of employment, although it may reduce the number of days of sick leave. Additional interventions are likely needed to influence the employment status of these patients. The significant preoperative predictors of not being employed in this study provide suggestions for further research.

  11. Employment status and sick-leave following obesity surgery: a five-year prospective cohort study

    Directory of Open Access Journals (Sweden)

    John Roger Andersen

    2015-09-01

    Full Text Available Background. Severe obesity is a risk factor for lower participation in paid work, but whether employment increases and sick leave decreases after obesity surgery is not well documented.Methods. We assessed 224 Norwegian patients with severe obesity (mean age: 40; mean BMI: 49; 61% female regarding employment status (working versus not working and the number of days of sick leave during the preceding 12 months, before and five years after obesity surgery (75% follow-up rate. Logistic regression analysis was used to study preoperative predictors of employment status after surgery.Results. There were no change in the employment rate over time (54% versus 58%, but the number of days of sick leave per year was significantly reduced, from a mean of 63 to a mean of 26, and from a median of 36 to a median of 4. Most of this change was attributable to patients with zero days of sick leave, which increased from 25% to 41%. Being female, older, having low education level, receiving disability pension and not being employed before obesity surgery were important risk factors for not being employed after obesity surgery. The type of obesity surgery, BMI and marital status were not useful predictors.Conclusions. Our findings suggest that undergoing obesity surgery is not associated with a higher rate of employment, although it may reduce the number of days of sick leave. Additional interventions are likely needed to influence the employment status of these patients. The significant preoperative predictors of not being employed in this study provide suggestions for further research.

  12. Knee osteoarthritis in traumatic knee symptoms in general practice: 6-year cohort study

    NARCIS (Netherlands)

    M. Kastelein (Marlous); P.A.J. Luijsterburg (Pim); I.M. Koster (Ingrid); J.A.N. Verhaar (Jan); D. Vroegindeweij (Dammis); S.M. Bierma-Zeinstra (Sita); E.H.G. Oei (Edwin)

    2016-01-01

    textabstractAim: To identify degenerative knee abnormalities using MRI and radiography 6 years after knee trauma, their relation with persistent knee symptoms and baseline prognostic factors. Methods: Adults (18–65 years) with incident traumatic knee symptoms visiting their

  13. A 2-Year Prospective Cohort Study of Overuse Running Injuries: The Runners and Injury Longitudinal Study (TRAILS).

    Science.gov (United States)

    Messier, Stephen P; Martin, David F; Mihalko, Shannon L; Ip, Edward; DeVita, Paul; Cannon, D Wayne; Love, Monica; Beringer, Danielle; Saldana, Santiago; Fellin, Rebecca E; Seay, Joseph F

    2018-05-01

    The National Center for Injury Prevention and Control, noting flaws in previous running injury research, called for more rigorous prospective designs and comprehensive analyses to define the origin of running injuries. To determine the risk factors that differentiate recreational runners who remain uninjured from those diagnosed with an overuse running injury during a 2-year observational period. Cohort study; Level of evidence, 2. Inclusion criteria were running a minimum of 5 miles per week and being injury free for at least the past 6 months. Data were collected at baseline on training, medical and injury histories, demographics, anthropometrics, strength, gait biomechanics, and psychosocial variables. Injuries occurring over the 2-year observation period were diagnosed by an orthopaedic surgeon on the basis of predetermined definitions. Of the 300 runners who entered the study, 199 (66%) sustained at least 1 injury, including 73% of women and 62% of men. Of the injured runners, 111 (56%) sustained injuries more than once. In bivariate analyses, significant ( P ≤ .05) factors at baseline that predicted injury were as follows: Short Form Health Survey-12 mental component score (lower mental health-related quality of life), Positive and Negative Affect Scale negative affect score (more negative emotions), sex (higher percentage of women were injured), and knee stiffness (greater stiffness was associated with injury); subsequently, knee stiffness was the lone significant predictor of injury (odds ratio = 1.18) in a multivariable analysis. Flexibility, quadriceps angle, arch height, rearfoot motion, strength, footwear, and previous injury were not significant risk factors for injury. The results of this study indicate the following: (1) among recreational runners, women sustain injuries at a higher rate than men; (2) greater knee stiffness, more common in runners with higher body weights (≥80 kg), significantly increases the odds of sustaining an overuse running

  14. Qidong hepatitis B virus infection cohort: a 25-year prospective study in high risk area of primary liver cancer.

    Science.gov (United States)

    Chen, Taoyang; Qian, Gengsun; Fan, Chunsun; Sun, Yan; Wang, Jinbing; Lu, Peixin; Xue, Xuefeng; Wu, Yan; Zhang, Qinan; Jin, Yan; Wu, Yiqian; Gan, Yu; Lu, Jianquan; Kensler, Thomas W; Groopman, John D; Tu, Hong

    2018-01-01

    Qidong hepatitis B virus (HBV) infection cohort (QBC) is a prospective community-based study designed to investigate causative factors of primary liver cancer (PLC) in Qidong, China, where both PLC and HBV infection are highly endemic. Residents aged 20-65 years, living in seven townships of Qidong, were surveyed using hepatitis B surface antigen (HBsAg) serum test and invited to participate in QBC from June 1991 to December 1991. A total of 852 and 786 participants were enrolled in HBsAg-positive and HBsAg-negative sub-cohorts in May 1992, respectively. All participants were actively followed up in person, received HBsAg, alanine aminotransferase (ALT), alpha-fetoprotein (AFP) tests and upper abdominal ultrasonic examination, and donated blood and urine samples once or twice a year. The total response rate was 99.6%, and the number of incident PLC was 201 till the end of February 2017. The ratio of incidence rates was 12.32 (95% confidence interval[CI]=7.16-21.21, P PLC was 13.25 (95% CI=6.67-26.33, P PLC-related mutations including A2159G, A2189C and G2203W at the C gene, A799G, A987G and T1055A at the P gene of HBV genome were identified by using samples from the cohort. The mutation in hepatitis B virus (HBV) basal core promoter region of HBV genome has an accumulative effect on the occurrence of PLC. In addition, the tripartite relationship of aflatoxin exposure, P53 mutation and PLC was also investigated. Dynamic prediction model for PLC risk by using its long-term follow-up information and serial blood samples for QBC was developed. This model is expected to improve the efficiency of PLC screening in HBV infection individuals.

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

    Directory of Open Access Journals (Sweden)

    Susan Shin-Jung Lee

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

  16. Prospective study of predictors of poor self-rated health in a 23-year cohort of earthquake survivors in Armenia

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    Anahit Demirchyan

    2015-09-01

    Full Text Available Long-term prospective studies exploring general health outcomes among disaster survivors are rare. Self-rated health (SRH – a proven correlate of morbidity and mortality prognosis – was used to investigate predictors of perceived health status among a 23-year cohort of survivors of 1988 Spitak earthquake in Armenia. A geographically-stratified subsample of 725 adults from a larger initial cohort was followed during the period of 1990–2012. A logistic regression model identified predictors of SRH. Adjusted relative risks for the long-term predictors of SRH were calculated. The rate of poor SRH among the survivors was 18.8%, fair 56.5%, and good/excellent 24.7%. In the fitted model, long-term risk factors of poor SRH included baseline body mass index, baseline multi-morbidity, number of experienced stressful life events, and perceived poor living standards during the post-earthquake decade, while participation in sports in the early 1990s was a protective factor. Short-term protective factors included socio-economic status score, social support, employment and dignity, while current household size was a risk factor for poor SRH. No association was found between earthquake exposure severity and SRH after 23 years. However, the identified predictors included a number of modifiable lifestyle, material and psychological factors. Thus, interventions targeting these factors could have a long-lasting impact on disaster victims’ health status.

  17. Insight, psychopathology, explanatory models and outcome of schizophrenia in India: a prospective 5-year cohort study

    Directory of Open Access Journals (Sweden)

    Johnson Shanthi

    2012-09-01

    Full Text Available Abstract Background The sole focus of models of insight on bio-medical perspectives to the complete exclusion of local, non-medical and cultural constructs mandates review. This study attempted to investigate the impact of insight, psychopathology, explanatory models of illness on outcome of first episode schizophrenia. Method Patients diagnosed to have DSM IV schizophrenia (n = 131 were assessed prospectively for insight, psychopathology, explanatory models of illness at baseline, 6, 12 and 60 months using standard instruments. Multiple linear and logistic regression and generalized estimating equations (GEE were employed to assess predictors of outcome. Results We could follow up 95 (72.5% patients. Sixty-five of these patients (68.4% achieved remission. There was a negative relationship between psychosis rating and insight scores. Urban residence, fluctuating course of the initial illness, and improvement in global functioning at 6 months and lower psychosis rating at 12 months were significantly related to remission at 5 years. Insight scores, number of non-medical explanatory models and individual explanatory models held during the later course of the illness were significantly associated with outcome. Analysis of longitudinal data using GEE showed that women, rural residence, insight scores and number of non-medical explanatory models of illness held were significantly associated with BPRS scores during the study period. Conclusions Insight, the disease model and the number of non-medical model positively correlated with improvement in psychosis arguing for a complex interaction between the culture, context and illness variables. These finding argue that insight and explanatory models are secondary to psychopathology, course and outcome of the illness. The awareness of mental illness is a narrative act in which people make personal sense of the many challenges they face. The course and outcome of the illness, cultural context

  18. First year growth in relation to prenatal exposure to endocrine disruptors - a Dutch prospective cohort study

    NARCIS (Netherlands)

    de Cock, M.; de Boer, M.R.; Lamoree, M.H.; Legler, J.; van de Bor, M.

    2014-01-01

    Growth in the first year of life may already be predictive of obesity later in childhood. The objective was to assess the association between prenatal exposure to various endocrine disrupting chemicals (EDCs) and child growth during the first year. Dichloro-diphenyldichloroethylene (DDE),

  19. Mortality in Children Aged 0-9 Years: A Nationwide Cohort Study from Three Nordic Countries

    DEFF Research Database (Denmark)

    Yu, Yongfu; Qin, Guoyou; Cnattingius, Sven

    2016-01-01

    boys and girls decreased from 1.25 to 1.21 with the most prominent reduction in children aged 5–9 years (from 1.59 to 1.19). Neoplasms, diseases of the nervous system and transport accidents were the most frequent cause of death after the first year of life. These three leading causes of death declined...... comparing cause-specific mortality, and half of deaths from diseases of the nervous system occurred in infancy. Mortality rate due to transport accidents increased with age and was highest in boys aged 5–9 years. Conclusions Mortality rate in children aged 0–9 years has been decreasing with diminished...... difference between genders over the past decades. Our results suggest the importance of further research on mortality by causes of neoplasms, and causes of transport accidents—especially in children aged 5–9 years...

  20. Urinary incontinence persisting after childbirth: extent, delivery history, and effects in a 12-year longitudinal cohort study.

    Science.gov (United States)

    MacArthur, C; Wilson, D; Herbison, P; Lancashire, R J; Hagen, S; Toozs-Hobson, P; Dean, N; Glazener, C

    2016-05-01

    To investigate the extent of persistent urinary incontinence (UI) 12 years after birth, and association with delivery-mode history and other factors. Twelve-year longitudinal cohort study. Maternity units in Aberdeen, Birmingham, and Dunedin. Women who returned questionnaires 3 months and 12 years after index birth. Data on all births over a period of 12 months were obtained from the units and then women were contacted by post. Persistent UI reported at 12 years, with one or more previous contact. Of 7879 women recruited at 3 months, 3763 (48%) responded at 12 years, with 2944 also having responded at 6 years; non-responders had similar obstetric characteristics. The prevalence of persistent UI was 37.9% (1429/3763). Among those who had reported UI at 3 months, 76.4% reported it at 12 years. Women with persistent UI had lower SF12 quality of life scores. Compared with having only spontaneous vaginal deliveries (SVDs), women who delivered exclusively by caesarean section were less likely to have persistent UI (odds ratio, OR 0.42, 95% CI 0.33-0.54). This was not the case in women who had a combination of caesarean section and SVD births (OR 1.01, 95% CI 0.78-1.30). Older age at first birth, greater parity, and overweight/obesity were associated with persistent UI. Of 54 index primiparae with UI before pregnancy, 46 (85.2%) had persistent UI. This study, demonstrating that UI persists to 12 years in about three-quarters of women, and that risk was only reduced with caesarean section if women had no other delivery mode, has practice implications. A longitudinal study of 3763 women showed a prevalence of persistent UI 12 years after birth of 37.9%. © 2015 Royal College of Obstetricians and Gynaecologists.

  1. Social withdrawal at 1 year is associated with emotional and behavioural problems at 3 and 5 years: the Eden mother-child cohort study.

    Science.gov (United States)

    Guedeney, Antoine; Pingault, Jean-Baptiste; Thorr, Antoine; Larroque, Beatrice

    2014-12-01

    The objective of the study was to examine how social withdrawal in infants aged 12 months predicted emotional and behavioural problems at ages 3 and 5 years. The sample included 1,586 infants from the French Eden Mother-Child Cohort Study who had a measure of social withdrawal with the Alarm Distress BaBy scale at age 1 year; among these children, emotional and behavioural difficulties were rated by mothers using the Strength and Difficulty Questionnaire (SDQ) at 3 years for 1,257 (79 %) children and at 5 years for 1,123 (72 %) children. Social withdrawal behaviour at age 1 year was significantly associated with the SDQ behavioural disorder scale at 3 years, independently of a host of familial and child temperament confounders. The association with the relational disorder, prosocial and total difficulty scales was close to significance at 3 years after taking into account familial and temperament confounders. Social withdrawal significantly predicted the three aforementioned scales when measured at 5 years. No significant predictivity of the emotional scale and hyperactivity scale was detected at any age. This study made with a large longitudinal sample confirms the negative effects on development of social withdrawal behaviour, shedding light on the unfolding of behavioural disorders and relational difficulties in children; this calls for early detection of sustained social withdrawal behaviour, as it seems to hamper emotional development.

  2. Lung protective mechanical ventilation and two year survival in patients with acute lung injury: prospective cohort study.

    Science.gov (United States)

    Needham, Dale M; Colantuoni, Elizabeth; Mendez-Tellez, Pedro A; Dinglas, Victor D; Sevransky, Jonathan E; Dennison Himmelfarb, Cheryl R; Desai, Sanjay V; Shanholtz, Carl; Brower, Roy G; Pronovost, Peter J

    2012-04-05

    To evaluate the association of volume limited and pressure limited (lung protective) mechanical ventilation with two year survival in patients with acute lung injury. Prospective cohort study. 13 intensive care units at four hospitals in Baltimore, Maryland, USA. 485 consecutive mechanically ventilated patients with acute lung injury. Two year survival after onset of acute lung injury. 485 patients contributed data for 6240 eligible ventilator settings, as measured twice daily (median of eight eligible ventilator settings per patient; 41% of which adhered to lung protective ventilation). Of these patients, 311 (64%) died within two years. After adjusting for the total duration of ventilation and other relevant covariates, each additional ventilator setting adherent to lung protective ventilation was associated with a 3% decrease in the risk of mortality over two years (hazard ratio 0.97, 95% confidence interval 0.95 to 0.99, P=0.002). Compared with no adherence, the estimated absolute risk reduction in two year mortality for a prototypical patient with 50% adherence to lung protective ventilation was 4.0% (0.8% to 7.2%, P=0.012) and with 100% adherence was 7.8% (1.6% to 14.0%, P=0.011). Lung protective mechanical ventilation was associated with a substantial long term survival benefit for patients with acute lung injury. Greater use of lung protective ventilation in routine clinical practice could reduce long term mortality in patients with acute lung injury. Clinicaltrials.gov NCT00300248.

  3. Satisfaction with dental care and life-course predictors: A 20-year prospective study of a Swedish 1942 birth cohort?

    Science.gov (United States)

    Ekbäck, Gunnar; Ordell, Sven; Ståhlnacke, Katri

    2016-01-01

    The aim was to assess the impact of care experience, health factors and socioeconomic factors on satisfaction with dental care across time and to assess the stability or change in levels of self-reported satisfaction with dental care in individuals as they progress from middle age to early old age. The present work is based on five separate data collections from a cohort study with 3585 individuals responding in all years of the survey. Data collection was conducted in 1992 when the subjects were 50 years of age and again 5, 10, 15 and 20 years later. Absolute stability in satisfaction with dental care was assessed by calculating the proportion of individuals who maintained their position in the same category from one survey period to another. Changes across time were tested using Cochran's Q test. Satisfaction with dental care across the 20-year survey period was modeled using the generalized estimating equation (GEE). The result showed that 85% of women and 83% of men remained satisfied with dental care. Binomial GEE revealed no statistical significant change in satisfaction with dental care between 1992-2012. In sum, this study has shown that this age group, born in 1942, was stably satisfied with dental care between age 50 and age 70, despite all changes during this time period. Females are more satisfied than men and the most important factors are the experience of attention during the last visit, satisfaction with dental appearance and good chewing capability.

  4. Prognostic impact of isolated right ventricular dysfunction in sepsis and septic shock: an 8-year historical cohort study.

    Science.gov (United States)

    Vallabhajosyula, Saraschandra; Kumar, Mukesh; Pandompatam, Govind; Sakhuja, Ankit; Kashyap, Rahul; Kashani, Kianoush; Gajic, Ognjen; Geske, Jeffrey B; Jentzer, Jacob C

    2017-09-07

    Echocardiographic myocardial dysfunction is reported commonly in sepsis and septic shock, but there are limited data on sepsis-related right ventricular dysfunction. This study sought to evaluate the association of right ventricular dysfunction with clinical outcomes in patients with severe sepsis and septic shock. Historical cohort study of adult patients admitted to all intensive care units at the Mayo Clinic from January 1, 2007 through December 31, 2014 for severe sepsis and septic shock, who had an echocardiogram performed within 72 h of admission. Patients with prior heart failure, cor-pulmonale, pulmonary hypertension and valvular disease were excluded. Right ventricular dysfunction was defined by the American Society of Echocardiography criteria. Outcomes included 1-year survival, in-hospital mortality and length of stay. Right ventricular dysfunction was present in 214 (55%) of 388 patients who met the inclusion criteria-isolated right ventricular dysfunction was seen in 100 (47%) and combined right and left ventricular dysfunction in 114 (53%). The baseline characteristics were similar between cohorts except for the higher mechanical ventilation use in patients with isolated right ventricular dysfunction. Echocardiographic findings demonstrated lower right ventricular and tricuspid valve velocities in patients with right ventricular dysfunction and lower left ventricular ejection fraction and increased mitral E/e' ratios in patients with combined right and left ventricular dysfunction. After adjustment for age, comorbidity, illness severity, septic shock and use of mechanical ventilation, isolated right ventricular dysfunction was independently associated with worse 1-year survival-hazard ratio 1.6 [95% confidence interval 1.2-2.1; p = 0.002) in patients with sepsis and septic shock. Isolated right ventricular dysfunction is seen commonly in sepsis and septic shock and is associated with worse long-term survival.

  5. Health locus of control in patients undergoing coronary artery surgery - changes and associated outcomes: a seven-year cohort study.

    Science.gov (United States)

    Rideout, Andrew; Tolmie, Elizabeth; Lindsay, Grace

    2017-01-01

    Health locus of control is a measure of an individual's beliefs in factors that are thought to determine health experiences. Scores are generated and form a graduated linear scale from external to internal control, with respect to their views on health causality. Health locus of control has been considered to be a relatively stable entity. However, it is not clear if this status changes in the advent of serious health challenges, such as coronary artery bypass graft surgery. The aim of this study is to explore the variability of health locus of control and its association with postoperative health in this context. In a longitudinal cohort study of patients undergoing coronary artery bypass graft surgery, a purposive sample ( n=215) were recruited from the waiting list and followed up postoperatively, at approximately one year and seven years later. Patients undergoing coronary artery bypass graft surgery demonstrated marked fluctuations in health locus of control in their peri-operative and rehabilitative phases. Mean health locus of control became more external (often associated with poorer outcomes) peri-operatively, and more internal (generally associated with better health outcomes) in the rehabilitative period. Health locus of control scores were shown to be changeable during a major health care intervention, with possible consequences for patient outcomes and care needs. The significant health belief upheaval demonstrated in this cohort should be considered in assessing patients preoperatively, and managed as part of the patients' clinical journey by both acute and rehabilitation staff. It is likely to have particular importance in individualised assessment and management of future prevention advice for patients.

  6. Risk Factors at Birth Predictive of Subsequent Injury Among Japanese Preschool Children: A Nationwide 5-Year Cohort Study.

    Science.gov (United States)

    Morioka, Hisayoshi; Itani, Osamu; Jike, Maki; Nakagome, Sachi; Otsuka, Yuichiro; Ohida, Takashi

    2018-03-19

    To identify risk factors at birth that are predictive of subsequent injury among preschool children. Retrospective analysis of population-based birth cohort data from the "Longitudinal Survey of Babies Born in the 21st Century" was performed from 2001 through 2007 in Japan (n = 47,015). The cumulative incidence and the total number of hospitalizations or examinations conducted at medical facilities for injury among children from birth up to the age of 5 years were calculated. To identify risk factors at birth that are predictive of injury, multivariate analysis of data for hospitalization or admission because of injury during a 5-year period (age, 0-5 years) was performed using the total number of hospital examinations as the dependent variable. The cumulative incidence (95% confidence interval) of hospital examinations for injury over the 5-year period was 34.8% (34.2%-35.4%) for boys and 27.6% (27.0%-28.2%) for girls. The predictive risk factors at birth we identified for injury among preschool children were sex (boys), heavy birth weight, late birth order, no cohabitation with the grandfather or grandmother, father's long working hours, mother's high education level, and strong intensity of parenting anxiety. Based on the results of this study, we identified a number of predictive factors for injury in children. To reduce the risk of injury in the juvenile population as a whole, it is important to pursue a high-risk or population approach by focusing on the predictive factors we have identified.

  7. Systolic Blood Pressure Trajectory, Frailty, and All-Cause Mortality >80 Years of Age: Cohort Study Using Electronic Health Records.

    Science.gov (United States)

    Ravindrarajah, Rathi; Hazra, Nisha C; Hamada, Shota; Charlton, Judith; Jackson, Stephen H D; Dregan, Alex; Gulliford, Martin C

    2017-06-13

    Clinical trials show benefit from lowering systolic blood pressure (SBP) in people ≥80 years of age, but nonrandomized epidemiological studies suggest lower SBP may be associated with higher mortality. This study aimed to evaluate associations of SBP with all-cause mortality by frailty category >80 years of age and to evaluate SBP trajectories before death. A population-based cohort study was conducted using electronic health records of 144 403 participants ≥80 years of age registered with family practices in the United Kingdom from 2001 to 2014. Participants were followed for ≤5 years. Clinical records of SBP were analyzed. Frailty status was classified using the e-Frailty Index into the categories of fit, mild, moderate, and severe. All-cause mortality was evaluated by frailty status and mean SBP in Cox proportional-hazards models. SBP trajectories were evaluated using person months as observations, with mean SBP and antihypertensive treatment status estimated for each person month. Fractional polynomial models were used to estimate SBP trajectories over 5 years before death. During follow-up, 51 808 deaths occurred. Mortality rates increased with frailty level and were greatest at SBP mortality was 7.7 per 100 person years at SBP 120 to 139 mm Hg, 15.2 at SBP 110 to 119 mm Hg, and 22.7 at SBP mortality may be accounted for by reverse causation if participants with lower blood pressure values are closer, on average, to the end of life. © 2017 The Authors.

  8. 1970 British Cohort Study

    Directory of Open Access Journals (Sweden)

    Matt Brown

    2014-10-01

    Full Text Available The 1970 British Cohort Study (BCS70 is one of Britain’s world famous national longitudinal birth cohort studies, three of which are run by the Centre for Longitudinal Studies at the Institute of Education, University of London.  BCS70 follows the lives of more than 17,000 people born in England, Scotland and Wales in a single week of 1970. Over the course of cohort members lives, the BCS70 has collected information on health, physical, educational and social development, and economic circumstances among other factors. Since the birth survey in 1970, there have been nine ‘sweeps’ of all cohort members at ages 5, 10, 16, 26, 30, 34, 38 and most recently at 42. Data has been collected from a number of different sources (the midwife present at birth, parents of the cohort members, head and class teachers, school health service personnel and the cohort members themselves. The data has been collected in a variety of ways including via paper and electronic questionnaires, clinical records, medical examinations, physical measurements, tests of ability, educational assessments and diaries. The majority of BCS70 survey data can be accessed by bona fide researchers through the UK Data Service at the University of Essex.

  9. Clinical profile and outcomes of acute cardiorenal syndrome type-5 in sepsis: An eight-year cohort study.

    Science.gov (United States)

    Vallabhajosyula, Saraschandra; Sakhuja, Ankit; Geske, Jeffrey B; Kumar, Mukesh; Kashyap, Rahul; Kashani, Kianoush; Jentzer, Jacob C

    2018-01-01

    To evaluate the clinical features and outcomes of acute cardiorenal syndrome type-5 in patients with severe sepsis and septic shock. Historical cohort study of all adult patients with severe sepsis and septic shock admitted to the intensive care units (ICU) at Mayo Clinic Rochester from January 1, 2007 through December 31, 2014. Patients with prior renal or cardiac dysfunction were excluded. Patients were divided into groups with and without cardiorenal syndrome type-5. Acute Kidney Injury (AKI) was defined by both serum creatinine and urine output criteria of the AKI Network and the cardiac injury was determined by troponin-T levels. Outcomes included in-hospital mortality, ICU and hospital length of stay, and one-year survival. Of 602 patients meeting the study inclusion criteria, 430 (71.4%) met criteria for acute cardiorenal syndrome type-5. Patients with cardiorenal syndrome type-5 had higher severity of illness, greater vasopressor and mechanical ventilation use. Cardiorenal syndrome type-5 was associated higher unadjusted in-hospital mortality, ICU and hospital lengths of stay, and lower one-year survival. When adjusted for age, gender, severity of illness and mechanical ventilation, cardiorenal syndrome type-5 was independently associated with 1.7-times greater odds of in-hospital mortality (p = .03), but did not predict one-year survival (p = .06) compared to patients without cardiorenal syndrome. In sepsis, acute cardiorenal syndrome type-5 is associated with worse in-hospital mortality compared to patients without cardiorenal syndrome.

  10. Effect of the National Stress Check Program on mental health among workers in Japan: A 1-year retrospective cohort study.

    Science.gov (United States)

    Imamura, Kotaro; Asai, Yumi; Watanabe, Kazuhiro; Tsutsumi, Akizumi; Shimazu, Akihito; Inoue, Akiomi; Hiro, Hisanori; Odagiri, Yuko; Yoshikawa, Toru; Yoshikawa, Etsuko; Kawakami, Norito

    2018-04-18

    This retrospective cohort study evaluated the impact of the Stress Check Program, a recently introduced national policy and program aimed at reducing psychological distress among Japanese workers. A baseline survey was conducted from November 2015 to February 2016, the period when Japan began enforcing the Stress Check Program. A one-year follow-up survey was conducted in December 2016. In the follow-up survey, two exposure variables were collected: having taken the annual stress survey, and experiencing an improvement in the psychosocial work environment. Psychological distress was assessed using the Brief Job Stress Questionnaire (BJSQ) at baseline and 1-year follow-up. The two exposure variables were used to define four groups: "Neither", "Stress survey (SS) only", "Psychosocial work environment improvement (WI) only", and "Both". BJSQ results were analyzed using repeated measures general linear modeling (GLM). The study included 2,492 participants: 1,342 in the "Neither" group, 1,009 in the "SS only" group, 76 in the "WI only" group, and 65 in the "Both" group. Overall time-group interaction effects were not significant. The "Both" group showed significantly greater improvements in psychological distress than the "Neither" group (p = 0.02) at the 1-year follow-up, although the effect size was small (d = -0.14). Combination of the annual stress survey and improvement in psychosocial work environment may have been effective in reducing psychological distress in workers, although the effect size was small.

  11. Uric Acid Is a Strong Risk Marker for Developing Hypertension From Prehypertension: A 5-Year Japanese Cohort Study.

    Science.gov (United States)

    Kuwabara, Masanari; Hisatome, Ichiro; Niwa, Koichiro; Hara, Shigeko; Roncal-Jimenez, Carlos A; Bjornstad, Petter; Nakagawa, Takahiko; Andres-Hernando, Ana; Sato, Yuka; Jensen, Thomas; Garcia, Gabriela; Rodriguez-Iturbe, Bernardo; Ohno, Minoru; Lanaspa, Miguel A; Johnson, Richard J

    2018-01-01

    Prehypertension frequently progresses to hypertension, a condition associated with high morbidity and mortality from cardiovascular diseases and stroke. However, the risk factors for developing hypertension from prehypertension remain poorly understood. We conducted a retrospective cohort study using the data from 3584 prehypertensive Japanese adults (52.1±11.0 years, 2081 men) found to be prehypertensive in 2004 and reexamined in 2009. We calculated the cumulative incidences of hypertension over 5 years, examined risk factors, and calculated odds ratios (ORs) for developing hypertension after adjustments for age, sex, body mass index, smoking and drinking habits, baseline systolic and diastolic blood pressure, pulse rate, diabetes mellitus, dyslipidemia, chronic kidney disease, and serum uric acid levels. The additional analysis evaluated whether serum uric acid (hyperuricemia) constituted an independent risk factor for developing hypertension. The cumulative incidence of hypertension from prehypertension over 5 years was 25.3%. There were no significant differences between women and men (24.4% versus 26.0%; P =0.28). The cumulative incidence of hypertension in subjects with hyperuricemia (n=726) was significantly higher than those without hyperuricemia (n=2858; 30.7% versus 24.0%; P hypertension from prehypertension were age (OR, 1.023; P hypertension from prehypertension. Further studies are needed to determine whether treatment of hyperuricemia in prehypertensive subjects could impede the onset of hypertension. © 2017 American Heart Association, Inc.

  12. Balance ability of 7 and 10 year old children in the population: results from a large UK birth cohort study.

    Science.gov (United States)

    Humphriss, Rachel; Hall, Amanda; May, Margaret; Macleod, John

    2011-01-01

    The literature contains many reports of balance function in children, but these are often on atypical samples taken from hospital-based clinics and may not be generalisable to the population as a whole. The purpose of the present study is to describe balance test results from a large UK-based birth cohort study. Data from the Avon Longitudinal Study of Parents and Children (ALSPAC) were analysed. A total of 5402 children completed the heel-to-toe walking test at age 7 years. At age 10 years, 6915 children underwent clinical tests of balance including beam-walking, standing heel-to-toe on a beam and standing on one leg. A proportion of the children returned to the clinic for retesting within 3 months allowing test-retest agreement to be measured. Frequency distributions for each of the balance tests are given. Correlations between measures of dynamic balance at ages 7 and 10 years were weak. The static balance of 10 year old children was found to be poorer with eyes closed than with eyes open, and poorer in boys than in girls for all measures. Balance on one leg was poorer than heel-to-toe balance on a beam. A significant learning effect was found when first and second attempts of the tests were compared. Measures of static and dynamic balance appeared independent. Consistent with previous reports in the literature, test-retest reliability was found to be low. This study provides information about the balance ability of children aged 7 and 10 years and provides clinicians with reference data for balance tests commonly used in the paediatric clinic. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  13. Sasang constitutional types for the risk prediction of metabolic syndrome: a 14-year longitudinal prospective cohort study.

    Science.gov (United States)

    Lee, Sunghee; Lee, Seung Ku; Kim, Jong Yeol; Cho, Namhan; Shin, Chol

    2017-09-02

    To examine whether the use of Sasang constitutional (SC) types, such as Tae-yang (TY), Tae-eum (TE), So-yang (SY), and So-eum (SE) types, increases the accuracy of risk prediction for metabolic syndrome. From 2001 to 2014, 3529 individuals aged 40 to 69 years participated in a longitudinal prospective cohort. The Cox proportional hazard model was utilized to predict the risk of developing metabolic syndrome. During the 14 year follow-up, 1591 incident events of metabolic syndrome were observed. Individuals with TE type had higher body mass indexes and waist circumferences than individuals with SY and SE types. The risk of developing metabolic syndrome was the highest among individuals with the TE type, followed by the SY type and the SE type. When the prediction risk models for incident metabolic syndrome were compared, the area under the curve for the model using SC types was significantly increased to 0.8173. Significant predictors for incident metabolic syndrome were different according to the SC types. For individuals with the TE type, the significant predictors were age, sex, body mass index (BMI), education, smoking, drinking, fasting glucose level, high-density lipoprotein (HDL) cholesterol level, systolic and diastolic blood pressure, and triglyceride level. For Individuals with the SE type, the predictors were sex, smoking, fasting glucose, HDL cholesterol level, systolic and diastolic blood pressure, and triglyceride level, while the predictors in individuals with the SY type were age, sex, BMI, smoking, drinking, total cholesterol level, fasting glucose level, HDL cholesterol level, systolic and diastolic blood pressure, and triglyceride level. In this prospective cohort study among 3529 individuals, we observed that utilizing the SC types significantly increased the accuracy of the risk prediction for the development of metabolic syndrome.

  14. Long-Term Effects of Otitis Media a Ten-Year Cohort Study of Alaskan Eskimo Children

    Science.gov (United States)

    Kaplan, Gary J.; And Others

    1973-01-01

    Histories of ear disease, otoscopic examinations, and audiologic, intelligence, and achievement tests were obtained from a cohort of 489 Alaskan Eskimo children, followed through the first 10 years of life, to determine whether otitis media (middle ear inflammation) deleteriously affected intellectual functioning and achievement in school.…

  15. Growth monitoring in children with low and normal birth weight up to two years: A retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Mina Danaei

    2016-09-01

    Full Text Available Objective: This study was conducted aimed to compare the growth indices in 2 years old children with a history of low birth weight with normal birth weight children.Methods: Current retrospective cohort study on all two-year children with low birth weight and three times the normal weight children covered by health centers of Kahnooj, was conducted in 2015. Cares at birth, 1, 2, 4, 6, 7, 9, 12, 15, 18 and 24 months of age were studied and, child growth indices (weight, height, head circumference, along with some demographic variables were studied. Information were entered SPSS version 20 and the analysis was performed.Results: There were significant differences in children's growth of both groups in all periods of care. Despite the same slope, growth pattern in children showed a significant difference. Young mother, girl sex of baby and preterm birth are predictor factors of low birth weight.Conclusion: Trends and growth patterns of weight, height and head circumference in underweight children have significant difference with normal children and, despite the same slope, these children can not compensate for the backwardness of its growth to the age of two. So you need to plot separate growth curves for these children and, possible preventive measures should be taken to prevent bearing underweight baby.

  16. Vitamin D insufficiency over 5 years is associated with increased fracture risk-an observational cohort study of elderly women.

    Science.gov (United States)

    Buchebner, D; McGuigan, F; Gerdhem, P; Malm, J; Ridderstråle, M; Akesson, K

    2014-12-01

    This study of elderly Swedish women investigated the association between chronic vitamin D insufficiency and osteoporotic fractures occurring between ages 80-90. The incidence and risk of hip and major osteoporotic fractures was significantly higher in elderly women with low vitamin D levels maintained over 5 years. Vitamin D insufficiency among the elderly is common; however, relatively little is known about the effects of long-term hypovitaminosis D on fracture. We investigated sequential assessment of serum 25(OH)D at age 75 and 80 to determine if continuously low 25(OH)D levels are associated with increased 10-year fracture incidence. One thousand forty-four Swedish women from the population-based OPRA cohort, all 75 years old, attended at baseline (BL); 715 attended at 5 years. S-25(OH)D was available in 987 and 640, respectively and categorized as: 75 nmol/L (High). Incident fracture data was collected with maximum follow-up to 90 years of age. Hip fracture incidence between age 80-85 was higher in women who had low 25(OH)D at both baseline and 5 years (22.2 % (Low) vs. 6.6 % (High); p = 0.003). Between age 80-90, hip fracture incidence was more than double that of women in the high category (27.9 vs. 12.3 %; p = 0.006). Within 5-years, 50 % of women in the continuously low group compared to 34 % in the continuously high 25(OH)D group had an osteoporotic fracture (p = 0.004) while 10-year incidence was higher compared to the intermediate (p = 0.020) but not the high category (p = 0.053). The 10-year relative risk of hip fracture was almost three times higher and osteoporotic fracture risk almost doubled for women in the lowest 25(OH)D category compared to the high category (HR 2.7 and 1.7; p = 0.003 and 0.023, respectively). In these elderly women, 25(OH)D insufficiency over 5-years was associated with increased 10-year risk of hip and major osteoporotic fractures.

  17. Cohort profile update: 2004 Pelotas (Brazil) Birth Cohort Study. Body composition, mental health and genetic assessment at the 6 years follow-up.

    Science.gov (United States)

    Santos, Iná S; Barros, Aluísio J D; Matijasevich, Alicia; Zanini, Roberta; Chrestani Cesar, Maria Aurora; Camargo-Figuera, Fabio Alberto; Oliveira, Isabel O; Barros, Fernando C; Victora, Cesar G

    2014-10-01

    This is an update of the 2004 Pelotas Birth Cohort profile, originally published in 2011. In view of the high prevalence of overweight and mental health problems among Brazilian children, together with the availability of state-of-the-art equipment to assess body composition and diagnostic tests for mental health in childhood, the main outcomes measured in the fifth follow-up (mean age 6.8 years) included child body composition, mental health and cognitive ability. A total of 3722 (90.2%) of the original mothers/carers were interviewed and their children examined in a clinic where they underwent whole-body dual X-ray absorptiometry (DXA), air displacement plethysmography and a 3D photonic scan. Saliva samples for DNA were obtained. Clinical psychologists applied the Development and Well-Being Assessment questionnaire and the Wechsler Intelligence Scale for Children to all children. Results are being compared with those of the two earlier cohorts to assess the health effects of economic growth and full implementation of public policies aimed at reducing social inequalities in the past 30 years. For further information visit the programme website at [http://www.epidemio-ufpel.org.br/site/content/coorte_2004/questionarios.php]. Applications to use the data should be made by contacting 2004 cohort researchers and filling in the application form available at [http://www.epidemio-ufpel.org.br/site/content/estudos/formularios.php]. © The Author 2014; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

  18. Cognitive development in children up to age 11 years born after ART-a longitudinal cohort study.

    Science.gov (United States)

    Barbuscia, Anna; Mills, Melinda C

    2017-07-01

    How does the cognitive development of children conceived after ART (IVF and ICSI) - measured as cognitive skills at age 3, 5, 7 and 11 years - differ over time from those born after natural conception (NC)? Improved measures of cognitive development up to age 5 years were recorded in children conceived with ART compared to NC, which attenuates by 11 years, with ART children still scoring slightly better than NC children. Results on the cognitive outcomes of children conceived after ART have been highly contradictory. Some have shown that ART children have an impaired behavioural, socio-emotional and cognitive development and higher risk of mental disorders. Others have reported no increased risk or difference. Cognitive development has not been previously examined using latent growth curve models from ages 3 to 11 years, also including appropriate attention to confounding parental characteristics. Longitudinal data for the first five waves (2000-2012) of the UK Millennium Cohort Study were used, which is a two-stage sample of all infants born in 2000-2001 and resident in the UK at 9 months of age, drawn from the Department of Social Security Child Benefit Registers. A final sample of N = 15 218 children (125 IVF and 61 ICSI), from 14 816 families was used. Information was available for all waves for 8298 children. Four additional follow-up surveys were conducted in 2003, 2005, 2007 and 2012. Our sample includes children born within a union (married or cohabiting parents) and where information on cognitive scores was available for at least two measurement points. Cognitive development was assessed with the British Ability Scales. At age 3 and 5 years (wave 2 and 3), children completed the naming vocabulary component, which measures expressive verbal ability. At age 7 years (wave 4), verbal cognitive abilities were assessed through the word reading test, and at age 11 years (wave 5) through a verbal similarity test. Two-tailed Student's t-tests examined differences

  19. Prehospital trauma care reduces mortality. Ten-year results from a time-cohort and trauma audit study in Iraq

    Directory of Open Access Journals (Sweden)

    Murad Mudhafar K

    2012-02-01

    Full Text Available Abstract Background Blunt implementation of Western trauma system models is not feasible in low-resource communities with long prehospital transit times. The aims of the study were to evaluate to which extent a low-cost prehospital trauma system reduces trauma deaths where prehospital transit times are long, and to identify specific life support interventions that contributed to survival. Methods In the study period from 1997 to 2006, 2,788 patients injured by land mines, war, and traffic accidents were managed by a chain-of-survival trauma system where non-graduate paramedics were the key care providers. The study was conducted with a time-period cohort design. Results 37% of the study patients had serious injuries with Injury Severity Score ≥ 9. The mean prehospital transport time was 2.5 hours (95% CI 1.9 - 3.2. During the ten-year study period trauma mortality was reduced from 17% (95% CI 15 -19 to 4% (95% CI 3.5 - 5, survival especially improving in major trauma victims. In most patients with airway problems, in chest injured, and in patients with external hemorrhage, simple life support measures were sufficient to improve physiological severity indicators. Conclusion In case of long prehospital transit times simple life support measures by paramedics and lay first responders reduce trauma mortality in major injuries. Delegating life-saving skills to paramedics and lay people is a key factor for efficient prehospital trauma systems in low-resource communities.

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

    DEFF Research Database (Denmark)

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

    2009-01-01

    occurred for 5.9% (48/817) of the women. Positive prognostic factors for delivery were male infertility, female age infertility and less than three previous treatment cycles. CONCLUSIONS A crude delivery rate of 69.4% in the total population 5 years after referral to tertiary......BACKGROUND The objective was to assess crude 5-year delivery rates after assisted reproductive technology (ART) treatment, intrauterine inseminations (IUI), spontaneous conceptions (SC) and adoptions in a large infertile cohort. METHODS A prospective longitudinal survey comprised 1338 infertile...... couples starting public infertility programmes offering IUIs and three free ART cycles during 2000-2001. The cohort was cross-linked with the National Medical Birth Register to obtain delivery rates for all 1338 couples. More detailed data were available from 817 women responding to a 5-year follow...

  1. Limitations in the Activity of Mobility at Age 6 Years After Difficult Birth at Term: Prospective Cohort Study.

    Science.gov (United States)

    van Iersel, Patricia A M; Algra, Annechien M; Bakker, Saskia C M; Jonker, Arnold J H; Hadders-Algra, Mijna

    2016-08-01

    A difficult birth at term (DBAT) may manifest as fetal acidosis and low Apgar scores and is often referred to as "perinatal asphyxia," especially when infants show signs of neonatal encephalopathy (NE). In contrast to DBAT resulting in moderate-to-severe NE, which is associated with neurodevelopmental disorders, little is known about the prognosis of less severe forms of DBAT, with or without NE. The purpose of this study was to evaluate the International Classification of Functioning, Disability and Health, Children & Youth Version activity "mobility" and other neurodevelopmental sequelae in infants with DBAT at age 6 years. The index cohort (n=62; 35 boys, 27 girls) consisted of consecutive term infants with DBAT based on clinical criteria in a Dutch nonacademic hospital from 1999 to 2005. Neonatal encephalopathy was assessed according to the Sarnat grading system and excluded infants with severe NE. The matched reference cohort (n=81; 49 boys, 32 girls) consisted of healthy term infants. The primary outcome at 6 years was limited mobility (Movement Assessment Battery for Children score ≤15th percentile). Secondary outcomes included learning and behavioral problems and the presence of minor neurological dysfunction. Three children developed cerebral palsy and were excluded from analyses. Children with DBAT more often had limited mobility than children without DBAT (risk ratio [RR]=2.44; 95% confidence interval [95% CI]=1.16, 5.14). The risk of limited mobility rose with increasing severity of NE (mild NE: RR=3.38; 95% CI=1.40, 8.16; moderate NE: RR=4.00; 95% CI=1.54, 10.40), and manual abilities especially were affected (RR=4.12; 95% CI=1.40, 12.14). Learning problems, need for physical therapy, and complex minor neurological dysfunction were more common in children with DBAT than in children without DBAT. Term infants who develop mild or moderate NE following DBAT are at increased risk for limited mobility at age 6 years. Routine monitoring of neuromotor

  2. Vitamin D supplementation during the first year of life and risk of schizophrenia: a Finnish birth cohort study.

    Science.gov (United States)

    McGrath, John; Saari, Kaisa; Hakko, Helinä; Jokelainen, Jari; Jones, Peter; Järvelin, Marjo-Riitta; Chant, David; Isohanni, Matti

    2004-04-01

    Based on clues from epidemiology and animal experiments, low vitamin D during early life has been proposed as a risk factor for schizophrenia. The aim of this study was to explore the association between the use of vitamin D supplements during the first year of life and risk of developing schizophrenia. Subjects were drawn from the Northern Finland 1966 Birth Cohort (n=9,114). During the first year of life, data were collected about the frequency and dose of vitamin D supplementation. Our primary outcome measures were schizophrenia, psychotic disorders other than schizophrenia, and nonpsychotic disorders as diagnosed by age 31 years. Males and females were examined separately. In males, the use of either irregular or regular vitamin D supplements was associated with a reduced risk of schizophrenia (Risk ratio (RR)=0.08, 95% CI 0.01-0.95; RR=0.12, 95% CI 0.02-0.90, respectively) compared with no supplementation. In males, the use of at least 2000 IU of vitamin D was associated with a reduced risk of schizophrenia (RR=0.23, 95% CI 0.06-0.95) compared to those on lower doses. There were no significant associations between either the frequency or dose of vitamin D supplements and (a) schizophrenia in females, nor with (b) nonpsychotic disorder or psychotic disorders other than schizophrenia in either males or females. Vitamin D supplementation during the first year of life is associated with a reduced risk of schizophrenia in males. Preventing hypovitaminosis D during early life may reduce the incidence of schizophrenia.

  3. Periodontitis and cancer mortality: Register-based cohort study of 68,273 adults in 10-year follow-up.

    Science.gov (United States)

    Heikkilä, Pia; But, Anna; Sorsa, Timo; Haukka, Jari

    2018-06-01

    Periodontitis, a multifactorial infection-induced low-grade chronic inflammation, can influence the process of carcinogenesis. We studied with 10 years follow-up of 68,273 adults-based cohort the involvement of periodontitis as a risk factor for cancer mortality. Periodontal status was defined based on procedure codes of periodontal treatment. Rate ratios and absolute differences of overall and cancer mortality rates were assessed with respect to periodontal status using multiplicative and additive Poisson regression models, respectively. We adjusted for effect of age, sex, calendar time, socio-economic status, oral health, dental treatments and diabetes. Data about smoking or alcohol consumption were not available. Altogether 797 cancer deaths occurred during 664,020 person-years accumulated over a mean 10.1-year follow-up. Crude cancer mortality rate per 10,000 person-years for participants without and with periodontitis was 11.36 (95% CI 10.47-12.31) and 14.45 (95% CI 12.51-16.61), respectively. Crude rate ratios for periodontitis indicated an increased risk of overall (RR 1.27, 95% CI 1.08-1.39) and pancreatic cancer (RR 1.69, 95% CI 1.04-2.76) mortality. After adjustment, the results showed even stronger associations of periodontitis with increased overall (RR 1.33, 95% CI 1.10-1.58) and pancreatic cancer (RR 2.32, 95% CI 1.31-3.98) mortality. A higher pancreatic cancer mortality among individuals with periodontitis contributed considerably to the difference in overall cancer mortality, but this difference was not due to pancreatic cancer deaths alone. © 2018 UICC.

  4. Association between Periodontal disease and Prostate cancer: Results of a 12-year Longitudinal Cohort Study in South Korea

    Science.gov (United States)

    Lee, Jae-Hong; Kweon, Helen Hye-In; Choi, Jung-Kyu; Kim, Young-Taek; Choi, Seong-Ho

    2017-01-01

    The incidence of prostate cancer (PC) accompanying periodontal disease (PD) is anticipated to increase due to population aging. The aim of this study was to determine the association between PD and PC using data in the National Health Insurance Service-Health Examinee Cohort (NHIS-HEC). A random stratified sample of 187,934 South Koreans was collected from the NHIS database from 2002 to 2013. We assessed the relationship between PD and PC while adjusting for potential confounding factors (sex, age, household income, insurance status, residence area, hypertension, diabetes mellitus, cerebral infarction, angina pectoris, myocardial infarction, smoking status, alcohol intake, and regular exercise). The overall incidence of PC with PD among those aged 40 years and older was 0.28% (n = 531). In the multivariate Cox proportional-hazard regression analysis with adjustment for confounding factors, PD was associated with a 14% higher risk of PC (HR = 1.14, 95% CI = 1.01-1.31, P = 0.042). The findings of this study suggest that PD is significantly and positively associated with PC. Further studies are required to identify the mechanisms underlying the links between PD and PC. PMID:28928887

  5. Age- and cohort-related variance of type-A behavior over 24 years: the Young Finns Study.

    Science.gov (United States)

    Hintsa, Taina; Jokela, Markus; Pulkki-Råback, Laura; Keltikangas-Järvinen, Liisa

    2014-12-01

    Over the recent decades, the incidence of cardiovascular and heart diseases has decreased while levels of type-A behavior, i.e., a potential risk factor, appear to have increased. However, the long-term developmental patterns of type-A behavior is poorly understood. Both age- and cohort-related changes may be involved in these developments. The purpose of this study was to examine an age- and cohort-related changes of Hunter-Wolf type-A behavior from adolescence to adulthood. Type-A behavior and its components (aggressiveness, leadership, hard driving, and eagerness energy) were assessed using the Hunter-Wolf A-B rating scale at five time points (1983, 1986, 1989, 2001, and 2007) in a population-based sample consisting of six birth cohorts born between 1962 and 1977 (n = 3,341, a total of 10,506 person observations). Development of type-A behavior and its components was examined with cohort-sequential multilevel modeling. Aggressiveness decreased with age, eagerness energy, hard driving, and global type-A behavior increased, and leadership exhibited no mean level changes. Younger cohorts had higher aggressiveness, lower hard driving, and global type-A behavior. The findings suggest that in order to understand the health consequences of type-A behavior, both life span and societal changes should be considered.

  6. Prospective cohort study showing persistent HSV-2 shedding in women with genital herpes 2 years after acquisition.

    Science.gov (United States)

    Ramchandani, Meena; Selke, Stacy; Magaret, Amalia; Barnum, Gail; Huang, Meei-Li Wu; Corey, Lawrence; Wald, Anna

    2017-11-25

    Herpes simplex virus type 2 (HSV-2) is a prevalent infection with great variability in clinical and virological manifestations among individuals. This prospective cohort study aims to evaluate the natural history of HSV-2 reactivation in the genital area in the same group of women over time. Eighteen immunocompetent HSV-2 seropositive women were evaluated for viral shedding for 70 consecutive days within a median of 8 months (range 1-24 months) of HSV-2 acquisition and again approximately 2.5 years later from the original study. Participants obtained daily swabs of genital secretions for HSV PCR and recorded genital symptoms. The viral shedding rate was 29% during the initial study and 19% in the follow-up study (32% reduction, P=0.019). Subclinical shedding rate also decreased from 24% to 13% (37% reduction, P=0.032), as did the rate of days with genital lesions from 22% to 15% (33% reduction, P=0.24). The mean copy number during viral shedding remained unchanged over time at 4.8 log 10 c/mL (SD=2.0 and 1.6 during each study, respectively, P=0.33). Women with high viral shedding rates in the past were likely to continue to have high shedding rates (r=0.63, P=0.005). Despite some reduction, high viral shedding rates persist in women with genital HSV-2 greater than 2 years after acquisition. © 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.

  7. Influence of body mass index (BMI on functional improvements at 3 years following total knee replacement: a retrospective cohort study.

    Directory of Open Access Journals (Sweden)

    Paul Baker

    Full Text Available BACKGROUND: The number of patients presenting for total knee replacement who are classified as obese is increasing. The functional benefits of performing TKR in these patients are unclear. AIM: To assess the influence pre-operative body mass index has upon knee specific function, general health status and patient satisfaction at 3 years following total knee replacement. DESIGN: Retrospective comparative cohort study using prospectively collected data from an institutional arthroplasty register. METHODS: 1367 patients were assessed using the Western Ontario and McMaster University Osteoarthritis Index (WOMAC and Medical Outcomes Trust Short Form-36 (SF-36 scores supplemented by a validated measure of satisfaction pre-operatively and subsequently at 1,2 and 3 year post-operatively. Comparisons were made by dividing the cohort into 4 groups based on body mass index (BMI 18.5-25.0 kg/m(2 (n = 253;>25.0-30.0 kg/m(2 (n = 559;>30.0-35.0 kg/m(2 (n = 373;>35.0 kg/m(2 (n = 182. RESULTS: Despite lower pre-operative, 1 and 3 year WOMAC and SF-36 scores patients with the highest BMIs >35.0 kg/m(2 experienced similar improvements to patients with a 'normal' BMI (18.5-25.0 kg/m(2 at 1 year (Difference in WOMAC improvement = 0.0 (95%CI -5.2 to 5.2, p = 1.00 and this improvement was sustained at up to 3 years (Difference in 1 year to 3 year improvement = 2.2 (95%CI: -2.1 to 6.5, p = 1.00. This effect was also observed for the SF-36 mental and physical component scores. Despite equivalent functional improvements levels of satisfaction in the >35.0 kg/m(2 group were lower than for any other BMI group (>35.0 kg/m(2 = 84.6% satisfied versus 18.5-5.0 kg/m(2 = 93.3% satisfied,p = 0.01 as was the proportion of patients who stated they would have the operation again (>35.0 kg/m(2 = 69.6% versus 18.5-25.0 kg/m(2 = 82.2%,p = 0.01. CONCLUSION: Obese and morbidly obese patients gain as much functional benefit from

  8. Gestational Age at Birth and 'Body-Mind' Health at 5 Years of Age: A Population Based Cohort Study.

    Directory of Open Access Journals (Sweden)

    Frances M Cronin

    Full Text Available Numerous studies have identified the effects of prematurity on the neonate's physical health, however few studies have explored the effects of prematurity on both the physical and mental health of the child as they develop. Secondary analysis of data from the Millennium Cohort Study, a longitudinal study of infants (n = 18 818, born 2000-2002 in the United Kingdom was performed. Effects of gestational age at birth on health outcomes at 5 years were measured using parental rating of their children's general health and severity of behavior problems. The association between parent's general health ratings and behavior problem ratings was low: 86% of those reporting serious behavior problems (5% of the sample, n = 764 rated their child as being in excellent, very good, or good health. Still, a gradient of increasing risk of poorer outcome with decreasing gestational age was observed for a composite health measure (poor/fair health and/or serious behavior problems, suggesting an association with prematurity for this composite assessment of health status. The greatest contribution to the childhood composite health measure at 5 years was for children born at 32-36 weeks gestation: population attributable fractions for having poor outcomes was 3.4% (Bonferroni-adjusted 95% confidence interval 1.1%-6.2%, compared to 1% (0.2-2.3 for birth at less than 32 weeks. Results suggest that preterm children, by school entry, are not only at high risk of physical health problems, but also of behavioral health problems. The recognition of, and response to comprehensive health and well-being outcomes related to prematurity are important in order to correctly plan and deliver adequate paediatric health services and policies.

  9. Gestational Age at Birth and 'Body-Mind' Health at 5 Years of Age: A Population Based Cohort Study.

    Science.gov (United States)

    Cronin, Frances M; Segurado, Ricardo; McAuliffe, Fionnuala M; Kelleher, Cecily C; Tremblay, Richard E

    2016-01-01

    Numerous studies have identified the effects of prematurity on the neonate's physical health, however few studies have explored the effects of prematurity on both the physical and mental health of the child as they develop. Secondary analysis of data from the Millennium Cohort Study, a longitudinal study of infants (n = 18 818, born 2000-2002 in the United Kingdom) was performed. Effects of gestational age at birth on health outcomes at 5 years were measured using parental rating of their children's general health and severity of behavior problems. The association between parent's general health ratings and behavior problem ratings was low: 86% of those reporting serious behavior problems (5% of the sample, n = 764) rated their child as being in excellent, very good, or good health. Still, a gradient of increasing risk of poorer outcome with decreasing gestational age was observed for a composite health measure (poor/fair health and/or serious behavior problems), suggesting an association with prematurity for this composite assessment of health status. The greatest contribution to the childhood composite health measure at 5 years was for children born at 32-36 weeks gestation: population attributable fractions for having poor outcomes was 3.4% (Bonferroni-adjusted 95% confidence interval 1.1%-6.2%), compared to 1% (0.2-2.3) for birth at less than 32 weeks. Results suggest that preterm children, by school entry, are not only at high risk of physical health problems, but also of behavioral health problems. The recognition of, and response to comprehensive health and well-being outcomes related to prematurity are important in order to correctly plan and deliver adequate paediatric health services and policies.

  10. Gestational Age at Birth and 'Body-Mind' Health at 5 Years of Age: A Population Based Cohort Study.

    LENUS (Irish Health Repository)

    Cronin, Frances M

    2016-01-01

    Numerous studies have identified the effects of prematurity on the neonate\\'s physical health, however few studies have explored the effects of prematurity on both the physical and mental health of the child as they develop. Secondary analysis of data from the Millennium Cohort Study, a longitudinal study of infants (n = 18 818, born 2000-2002 in the United Kingdom) was performed. Effects of gestational age at birth on health outcomes at 5 years were measured using parental rating of their children\\'s general health and severity of behavior problems. The association between parent\\'s general health ratings and behavior problem ratings was low: 86% of those reporting serious behavior problems (5% of the sample, n = 764) rated their child as being in excellent, very good, or good health. Still, a gradient of increasing risk of poorer outcome with decreasing gestational age was observed for a composite health measure (poor\\/fair health and\\/or serious behavior problems), suggesting an association with prematurity for this composite assessment of health status. The greatest contribution to the childhood composite health measure at 5 years was for children born at 32-36 weeks gestation: population attributable fractions for having poor outcomes was 3.4% (Bonferroni-adjusted 95% confidence interval 1.1%-6.2%), compared to 1% (0.2-2.3) for birth at less than 32 weeks. Results suggest that preterm children, by school entry, are not only at high risk of physical health problems, but also of behavioral health problems. The recognition of, and response to comprehensive health and well-being outcomes related to prematurity are important in order to correctly plan and deliver adequate paediatric health services and policies.

  11. Health Care Utilisation by Bullying Victims: A Cross-Sectional Study of A 9-Year-Old Cohort in Ireland.

    Science.gov (United States)

    Hayes, Catherine; Kelly, Dervla; Taut, Cristina; Nixon, Elizabeth; Zgaga, Lina; Williams, James; O'Dowd, Thomas; Reulbach, Udo

    2018-02-25

    Children frequently refrain from disclosing being bullied. Early identification of bullying by healthcare professionals in children may prevent adverse health consequences. The aim of our study was to determine whether Health Care Utilisation (HCU) is higher in 9-year-olds who report being bullied and factors influencing type of HCU. The study consists of cross-sectional surveys of Child Cohort of Irish National Longitudinal Study of Children (Wave 1), 8,568 9-year-olds, and their carers. Being bullied was assessed by a self-reported questionnaire completed by children at home. HCU outcomes consisted of the following: visits to GP, Mental Health Practitioner (MHP), Emergency Department (ED), and nights in hospital by parent interview. Bivariate logistic regression and gender-stratified Poisson models were used to determine association. Victimisation by bullying independently increased visits to GP (OR 1.13, 95% confidence interval (CI): 1.03 to 1.25; p = 0.02), MHP (OR 1.31, 95% CI: 1.05 to 1.63; p = 0.02), though not ED visits (OR 0.99, 95% CI: 0.87 to 1.13; p = 0.8) or nights in hospital (OR 1.07 95% CI: 0.97 to 1.18; p = 0.2), adjusting for underlying chronic condition(s) and socio-demographic confounders. Victimised girls made higher GP visits (RR 1.14, 95% CI: 1.06 to 1.23; p according to gender and gender differences in the presentation of victimisation. Our findings may lead to the development of clinical practice guidelines for early detection and appropriate management of bullied children.

  12. Risk of death among children of atomic bomb survivors after 62 years of follow-up: a cohort study.

    Science.gov (United States)

    Grant, Eric J; Furukawa, Kyoji; Sakata, Ritsu; Sugiyama, Hiromi; Sadakane, Atsuko; Takahashi, Ikuno; Utada, Mai; Shimizu, Yukiko; Ozasa, Kotaro

    2015-10-01

    No clear epidemiological hereditary effects of radiation exposure in human beings have been reported. However, no previous studies have investigated mortality into middle age in a population whose parents were exposed to substantial amounts of radiation before conception. We assessed mortality in children of the atomic bomb survivors after 62 years of follow-up. In this prospective cohort study, we assessed 75 327 singleton children of atomic bomb survivors in Hiroshima and Nagasaki and unexposed controls, born between 1946 and 1984, and followed up to Dec 31, 2009. Parental gonadal doses of radiation from the atomic bombings were the primary exposures. The primary endpoint was death due to cancer or non-cancer disease, based on death certificates. Median follow-up was 54·3 years (IQR 45·4-59·3). 5183 participants died from disease. The mean age of the 68 689 surviving children at the end of follow-up was 53·1 years (SD 7·9) with 15 623 (23%) older than age 60 years. For parents who were exposed to a non-zero gonadal dose of radiation, the mean dose was 264 mGy (SD 463). We detected no association between maternal gonadal radiation exposure and risk of death caused by cancer (hazard ratio [HR] for 1 Gy change in exposure 0·891 [95% CI 0·693-1·145]; p=0·36) or risk of death caused by non-cancer diseases (0·973 [0·849-1·115]; p=0·69). Likewise, paternal exposure had no effect on deaths caused by cancer (0·815 [0·614-1·083]; p=0·14) or deaths caused by non-cancer disease (1·103 [0·979-1·241]; p=0·12). Age or time between parental exposure and delivery had no effect on risk of death. Late effects of ionising radiation exposure include increased mortality risks, and models of the transgenerational effects of radiation exposure predict more genetic disease in the children of people exposed to radiation. However, children of people exposed to the atomic bombs in Hiroshima and Nagasaki had no indications of deleterious health effects after 62

  13. High dengue case capture rate in four years of a cohort study in Nicaragua compared to national surveillance data.

    Directory of Open Access Journals (Sweden)

    Katherine Standish

    Full Text Available Dengue is a major public health problem in tropical and subtropical regions; however, under-reporting of cases to national surveillance systems hinders accurate knowledge of disease burden and costs. Laboratory-confirmed dengue cases identified through the Nicaraguan Pediatric Dengue Cohort Study (PDCS were compared to those reported from other health facilities in Managua to the National Epidemiologic Surveillance (NES program of the Nicaraguan Ministry of Health. Compared to reporting among similar pediatric populations in Managua, the PDCS identified 14 to 28 (average 21.3 times more dengue cases each year per 100,000 persons than were reported to the NES. Applying these annual expansion factors to national-level data, we estimate that the incidence of confirmed pediatric dengue throughout Nicaragua ranged from 300 to 1000 cases per 100,000 persons. We have estimated a much higher incidence of dengue than reported by the Ministry of Health. A country-specific expansion factor for dengue that allows for a more accurate estimate of incidence may aid governments and other institutions calculating disease burden, costs, resource needs for prevention and treatment, and the economic benefits of drug and vaccine development.

  14. Cancer-Related Fatigue in Women With Breast Cancer: Outcomes of a 5-Year Prospective Cohort Study.

    LENUS (Irish Health Repository)

    Goldstein, David

    2012-04-16

    PURPOSEProlonged and disabling fatigue is prevalent after cancer treatment, but the early natural history of cancer-related fatigue (CRF) has not been systematically examined to document consistent presence of symptoms. Hence, relationships to cancer, surgery, and adjuvant therapy are unclear. PATIENTS AND METHODSA prospective cohort study of women receiving adjuvant treatment for early-stage breast cancer was conducted. Women (n = 218) were enrolled after surgery and observed at end treatment and at 1, 3, 6, 9, and 12 months as well as 5 years. Structured interviews and self-report questionnaires were used to record physical and psychologic health as well as disability and health care utilization. Patients with CRF persisting for 6 months were assessed to exclude alternative medical and psychiatric causes of fatigue. Predictors of persistent fatigue, mood disturbance, and health care utilization were sought by logistic regression.ResultsThe case rate for CRF was 24% (n = 51) postsurgery and 31% (n = 69) at end of treatment; it became persistent in 11% (n = 24) at 6 months and 6% (n = 12) at 12 months. At each time point, approximately one third of the patients had comorbid mood disturbance. Persistent CRF was predicted by tumor size but not demographic, psychologic, surgical, or hematologic parameters. CRF was associated with significant disability and health care utilization. CONCLUSIONCRF is common but generally runs a self-limiting course. Much of the previously reported high rates of persistent CRF may be attributable to factors unrelated to the cancer or its treatment.

  15. Anthroposophic therapy for children with chronic disease: a two-year prospective cohort study in routine outpatient settings

    Directory of Open Access Journals (Sweden)

    Willich Stefan N

    2009-06-01

    Full Text Available Abstract Background Many children with chronic disease use complementary therapies. Anthroposophic treatment for paediatric chronic disease is provided by physicians and differs from conventional treatment in the use of special therapies (art therapy, eurythmy movement exercises, rhythmical massage therapy and special medications. We studied clinical outcomes in children with chronic diseases under anthroposophic treatment in routine outpatient settings. Methods In conjunction with a health benefit program, consecutive outpatients starting anthroposophic treatment for any chronic disease participated in a prospective cohort study. Main outcome was disease severity (Disease and Symptom Scores, physicians' and caregivers' assessment on numerical rating scales 0–10. Disease Score was documented after 0, 6, and 12 months, Symptom Score after 0, 3, 6, 12, 18, and 24 months. Results A total of 435 patients were included. Mean age was 8.2 years (standard deviation 3.3, range 1.0–16.9 years. Most common indications were mental disorders (46.2% of patients; primarily hyperkinetic, emotional, and developmental disorders, respiratory disorders (14.0%, and neurological disorders (5.7%. Median disease duration at baseline was 3.0 years (interquartile range 1.0–5.0 years. The anthroposophic treatment modalities used were medications (69.2% of patients, eurythmy therapy (54.7%, art therapy (11.3%, and rhythmical massage therapy (6.7%. Median number of eurythmy/art/massage therapy sessions was 12 (interquartile range 10–20, median therapy duration was 118 days (interquartile range 78–189 days. From baseline to six-month follow-up, Disease Score improved by average 3.00 points (95% confidence interval 2.76–3.24 points, p Conclusion Children under anthroposophic treatment had long-term improvement of chronic disease symptoms. Although the pre-post design of the present study does not allow for conclusions about comparative effectiveness, study

  16. Quality of life impact of treatments for localized prostate cancer: Cohort study with a 5 year follow-up

    International Nuclear Information System (INIS)

    Ferrer, Montse; Guedea, Ferran; Suárez, José Francisco; Paula, Belén de; Macías, Víctor; Mariño, Alfonso; Hervás, Asunción; Herruzo, Ismael

    2013-01-01

    Purpose: To assess long-term quality of life (QoL) impact of treatments in localized prostate cancer patients treated with radical prostatectomy, external beam radiotherapy or brachytherapy. Material and methods: Observational, prospective cohort study with pre-treatment QoL evaluation and follow-up until five years after treatment. 704 patients with low or intermediate risk localized prostate cancer were consecutively recruited in 2003–2005. QoL was measured by the EPIC questionnaire, with urinary irritative–obstructive, incontinence, bowel, sexual, and hormonal scores (ranging 0–100). Results: Brachytherapy’s QoL impact was restricted to the urinary domain, Generalized Estimating Equation models showed score changes at five years of −12.0 (95% CI = −15.0, −9.0) in incontinence and −5.3 (95% CI = −7.5, −3.1) in irritative–obstructive scales. Compared to brachytherapy, radical prostatectomy fared +3.3 (95% CI = +0.0, +6.5) points better in irritative–obstructive but −17.1 (95% CI = −22.7, −11.5) worse in incontinence. Sexual deterioration was observed in radical prostatectomy (−19.1; 95% CI = −25.1, −13.1) and external radiotherapy groups (−7.5; 95% CI = −12.5, −2.5). Conclusions: Brachytherapy is the treatment causing the least impact on QoL except for moderate urinary irritative–obstructive symptoms. Our study provides novel long-term valuable information for clinical decision making, supporting brachytherapy as a possible alternative to radical prostatectomy for patients seeking an attempted curative treatment, while limiting the risk for urinary incontinence and sexual impact on QoL

  17. Health-related quality of life 3 years after moderate to severe traumatic brain injury: a prospective cohort study.

    Science.gov (United States)

    Grauwmeijer, Erik; Heijenbrok-Kal, Majanka H; Ribbers, Gerard M

    2014-07-01

    To evaluate the time course of health-related quality of life (HRQoL) after moderate to severe traumatic brain injury (TBI) and to identify its predictors. Prospective cohort study with follow-up measurements at 3, 6, 12, 18, 24, and 36 months after TBI. Patients with moderate to severe TBI discharged from 3 level-1 trauma centers. Patients (N=97, 72% men) with a mean age ± SD of 32.8±13.0 years (range, 18-65y), hospitalized with moderate (23%) or severe (77%) TBI. Not applicable. HRQoL was measured with the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), functional outcomes with the Glasgow Outcome Scale (GOS), Barthel Index, FIM, and Functional Assessment Measure, and mood with the Wimbledon Self-Report Scale. The SF-36 domains showed significant improvement over time for Physical Functioning (PPhysical (PPhysical Component Summary (PCS) score, whereas the Mental Component Summary (MCS) score remained stable. At 3-year follow-up, HRQoL of patients with TBI was the same as that in the Dutch normative population. Time after TBI, hospital length of stay (LOS), FIM, and GOS were independent predictors of the PCS, whereas LOS and mood were predictors of the MCS. After TBI, the physical component of HRQoL showed significant improvement over time, whereas the mental component remained stable. Problems of disease awareness seem to play a role in self-reported mental HRQoL. After TBI, mood status is a better predictor of the mental component of HRQoL than functional outcome, implying that mood should be closely monitored during and after rehabilitation. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  18. Workplace social capital and the onset of major depressive episode among workers in Japan: a 3-year prospective cohort study.

    Science.gov (United States)

    Sakuraya, Asuka; Imamura, Kotaro; Inoue, Akiomi; Tsutsumi, Akizumi; Shimazu, Akihito; Takahashi, Masaya; Totsuzaki, Takafumi; Kawakami, Norito

    2017-06-01

    This study examined the prospective association of workplace social capital (WSC) with major depressive episode (MDE) among Japanese employees. A 3-year prospective cohort study was conducted among 1058 employees from a private think-tank company who participated in a baseline survey; after excluding those with MDE in the past 12 months, 929 were followed up. WSC at baseline was measured using a 3-item scale. MDE was assessed at baseline and at follow-up every year, by using a web-based, self-administered version of the WHO Composite International Diagnostic Interview (WHO-CIDI) 3.0 depression section, based on the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition: Text Revision (DSM-IV-TR)/DSM-5 criteria. Cox discrete-time hazards analyses were used to estimate HRs and 95% CIs, adjusting for covariates. A group with middle-level WSC scores had the lowest risk of MDE after being fully adjusted (HR 0.34, 95% CI 0.14 to 0.84, p=0.02). The relationship between WSC and MDE was U-shaped, although a non-linear model fit better than a linear model, with only marginally statistical significance (p=0.06). Dichotomised and continuous variables of WSC scores were significantly and negatively associated with MDE (p=0.03 and pMDE in Japan. The slightly U-shaped relationship, that is, the group with high WSC having a small elevated risk of MDE, may reflect a dark side of WSC in a country with collectivity-oriented and hierarchy-oriented culture, such as Japan. 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/.

  19. Long-term persistence with injectable therapy in relapsing-remitting multiple sclerosis: an 18-year observational cohort study.

    Directory of Open Access Journals (Sweden)

    Simon Zhornitsky

    Full Text Available Disease modifying therapies (DMTs reduce the frequency of relapses and accumulation of disability in multiple sclerosis (MS. Long-term persistence with treatment is important to optimize treatment benefit. This long-term, cohort study was conducted at the Calgary MS Clinic. All consenting adults with relapsing-remitting MS who started either glatiramer acetate (GA or interferon-β 1a/1b (IFN-β between January 1st, 1996 and July 1st, 2011 were included. Follow-up continued to February 1st, 2014. Time-to-discontinuation of the initial and subsequently-prescribed DMTs (switches was analysed using Kaplan-Meier survival analyses. Group differences were compared using log-rank tests and multivariable Cox regression models. Analysis included 1471 participants; 906 were initially prescribed GA and 565 were initially prescribed IFN-β. Follow-up information was available for 87%; 29 (2% were lost to follow-up and 160 (11% moved from Southern Alberta while still using DMT. Median time-to-discontinuation of all injectable DMTs was 11.1 years. Participants with greater disability at treatment initiation, those who started treatment before age 30, and those who started between 2006 and 2011 were more likely to discontinue use of all injectable DMTs. Median time-to-discontinuation of the initial DMT was 8.6 years. Those initially prescribed GA remained on treatment longer. Of 610 participants who discontinued injectable DMT, 331 (54% started an oral DMT, or a second-line DMT, or resumed injectable DMT after 90 days. Persistence with injectable DMTs was high in this long-term population-based study. Most participants who discontinued injectable DMT did not remain untreated. Further research is required to understand treatment outcomes and outcomes after stopping DMT.

  20. Childhood correlates of adult TV viewing time: a 32-year follow-up of the 1970 British Cohort Study.

    Science.gov (United States)

    Smith, L; Gardner, B; Hamer, M

    2015-04-01

    To identify, using a longitudinal data set, parental and childhood correlates of adult television (TV) viewing time at 32-year follow-up. Data were derived from the 1970 British Cohort Study, a longitudinal observational study of 17 248 British people born in a single week of 1970. The present analyses incorporated data from the age 10 and 42-year surveys. When participants were aged 10 years, their mothers provided information on how often participants watched TV and played sports (never/sometimes/often), and parents' own occupation, as well as height and weight. A health visitor objectively assessed participants' height and weight at age 10. Thirty-two years later, when participants were aged 42 years, they reported their daily TV viewing hours (none/0≤1/1TV viewing time were investigated using logistic regression. Valid data at both time points were available for 6188 participants. Logistic regression models showed that those who reported 'often' watching TV at baseline were significantly more likely to watch >3 h/days of TV at follow-up (OR 1.42, 95% CI 1.21 to 1.65), as were those whose father was from a lower socio-occupational class (intermediate, routine/manual) compared with managerial (OR 1.55, 95% CI 1.14 to 2.11; OR 2.05, 95% CI 1.47 to 2.87). Body mass index (BMI) at age 10 was inversely associated with high TV in adulthood (per unit increase; OR 0.93, 95% CI 0.90 to 0.96) although fathers BMI when the child was aged 10 was positively associated with high TV in adulthood (per unit increase; OR 1.04, 95% CI 1.02 to 1.06). Findings suggest that childhood TV viewing time tracks into adulthood. Parents' health behaviours and social position appear to be associated with their children's viewing habits, which may have important implications for the direction of future policy and practice. Specifically, findings support the case for early life interventions, particularly on socioeconomic inequalities, as a way of preventing sedentary behaviour in

  1. The course of skull deformation from birth to 5 years of age: a prospective cohort study.

    Science.gov (United States)

    van Vlimmeren, Leo A; Engelbert, Raoul Hh; Pelsma, Maaike; Groenewoud, Hans Mm; Boere-Boonekamp, Magda M; der Sanden, Maria Wg Nijhuis-van

    2017-01-01

    In a continuation of a prospective longitudinal cohort study in a healthy population on the course of skull shape from birth to 24 months, at 5 years of age, 248 children participated in a follow-up assessment using plagiocephalometry (ODDI-oblique diameter difference index, CPI-cranio proportional index). Data from the original study sampled at birth, 7 weeks, 6, 12, and 24 months were used in two linear mixed models. (1) if deformational plagiocephaly (ODDI skull shape can be predicted at 5 years of age; (2) if positional preference occurs, ODDI is the highest at 7 weeks and decreases to a stable lowest value at 2 and 5 years of age; and (3) regarding brachycephaly, all children showed the highest CPI at 6 months of age with a gradual decrease over time. The course of skull deformation is favourable in most of the children in The Netherlands; at 5 years of age, brachycephaly is within the normal range for all children, whereas the severity of plagiocephaly is within the normal range in 80%, within the mild range in 19%, and within the moderate/severe range in 1%. Medical consumption may be reduced by providing early tailored counselling. What is Known: • Skull deformation prevalence increased after recommendations against Sudden Infant Death Syndrome, little is known about the longitudinal course. • Paediatric physical therapy intervention between 2 and 6 months of age reduces deformational plagiocephaly at 6 and 12 months of age. What is New: • The course of skull deformation is favourable in most of the children in The Netherlands; at 5 years of age, deformational brachycephaly is within the normal range for all children, whereas the severity of deformational plagiocephaly is within the normal range in 80%, within the mild range in 19%, and within the moderate to severe range in only 1%. • Paediatric physical therapy intervention does not influence the long-term outcome; it only influences the earlier decrease of the severity of

  2. Fertility treatment and child intelligence, attention, and executive functions in 5-year-old singletons: a cohort study.

    Science.gov (United States)

    Bay, B; Mortensen, E L; Kesmodel, U S

    2014-12-01

    To assess the association of fertility treatment and subfertility with offspring intelligence, attention, and executive functions in 5-year-old singletons. Follow-up study. Denmark 2003-2008. A cohort of 1782 children sampled from the Danish National Birth Cohort. The children were tested with a neuropsychological battery at age five. In addition to tests of intelligence, attention and executive functions, the follow up included extensive information on important covariates. The analyses were conducted using multiple linear regression and adjusted for parental educational level, maternal intelligence, age, parity, body mass index, smoking in pregnancy, alcohol consumption in pregnancy and child gender, child age, and examiner. Wechsler Preschool and Primary Scale of Intelligence-Revised, the Test of Everyday Attention for Children at Five, and the Behavior Rating Inventory of Executive Functions scores. A consistent pattern of nonsignificantly lower scores were only observed for intelligence and executive functions in children born after fertility treatment or by subfertile parents when the results were unadjusted for maternal intelligence and parental educational level. When adjusted for these and other covariates, there were no significant mean differences in intelligence (mean difference -2.8, 95% CI -7.8, 2.2), overall attention (-0.1, 95% CI -0.6, 0.3), or parent-rated executive functions (-0.1, 95% CI -3.0, 2.9) between children born after spontaneous conception and children born to parents conceiving after fertility treatment. Similarly, there were no significant mean differences in intelligence (mean difference 0.6, 95% CI -2.2, 3.4), overall attention (0.1, 95% CI -0.2, 0.4), or parent-rated executive functions (1.0, 95% CI -1.8, 3.7) between children born after spontaneous conception and children born to subfertile parents waiting more than 12 months before conceiving naturally. This study suggests that parental subfertility and fertility treatment are

  3. Predictors of successful outcomes after external cephalic version in singleton term breech pregnancies: a nine-year historical cohort study.

    Science.gov (United States)

    Cho, L Y; Lau, W L; Lo, T K; Tang, Helen H T; Leung, W C

    2012-02-01

    To study the success rate, predictors for success, and pregnancy outcomes after external cephalic version. Historical cohort study. Regional hospital, Hong Kong. All women who had singleton term breech pregnancies at term and opted for external cephalic version during 2001 and 2009. Their demographic data, clinical and ultrasound findings, procedure details, complications, and delivery outcomes were analysed. Predictive factors for successful external cephalic version. A total of 209 external cephalic versions were performed during the 9-year period. The success rate was 63% (75% for multiparous and 53% for nulliparous women). There was no significant complication. On univariate analysis, predictors of successful external cephalic version were: multiparity, unengaged presenting part, higher amniotic fluid index (≥ 10 cm), thin abdominal wall, low uterine tone, and easily palpable fetal head (subjective assessment by practitioners before external cephalic version). On multivariate analysis, only multiparity, non-engagement of the fetal buttock and thin maternal abdomen were associated with successful external cephalic version. In all, 69% of those who had successful external cephalic version succeeded in the first roll (Pexternal cephalic versions had vaginal deliveries (93% in multiparous and 69% in nulliparous women). Uptake rate of external cephalic version was studied in the latter part of the study period (2006-2009). Whilst 735 women were eligible for external cephalic version, 131 women chose to have the procedure resulting in an uptake rate of 18%. External cephalic version was effective in reducing breech presentations at term and corresponding caesarean section rates, but the uptake rate was low. Further work should address the barriers to the low acceptance of external cephalic version. The results of this study could encourage women to opt for external cephalic version.

  4. Health Care Utilisation by Bullying Victims: A Cross-Sectional Study of A 9-Year-Old Cohort in Ireland

    Directory of Open Access Journals (Sweden)

    Catherine Hayes

    2018-02-01

    Full Text Available Children frequently refrain from disclosing being bullied. Early identification of bullying by healthcare professionals in children may prevent adverse health consequences. The aim of our study was to determine whether Health Care Utilisation (HCU is higher in 9-year-olds who report being bullied and factors influencing type of HCU. The study consists of cross-sectional surveys of Child Cohort of Irish National Longitudinal Study of Children (Wave 1, 8,568 9-year-olds, and their carers. Being bullied was assessed by a self-reported questionnaire completed by children at home. HCU outcomes consisted of the following: visits to GP, Mental Health Practitioner (MHP, Emergency Department (ED, and nights in hospital by parent interview. Bivariate logistic regression and gender-stratified Poisson models were used to determine association. Victimisation by bullying independently increased visits to GP (OR 1.13, 95% confidence interval (CI: 1.03 to 1.25; p = 0.02, MHP (OR 1.31, 95% CI: 1.05 to 1.63; p = 0.02, though not ED visits (OR 0.99, 95% CI: 0.87 to 1.13; p = 0.8 or nights in hospital (OR 1.07 95% CI: 0.97 to 1.18; p = 0.2, adjusting for underlying chronic condition(s and socio-demographic confounders. Victimised girls made higher GP visits (RR 1.14, 95% CI: 1.06 to 1.23; p < 0.001 and spent more nights in hospital (RR 1.10, 95% CI: 1.04 to 1.15; p < 0.001. Victimised boys were more likely to contact MHPs (RR 1.21, 95% CI: 1.02 to 1.44; p = 0.03. 9-year-old bullied subjects were more likely to utilise primary care services than non-bullied 9-year-olds. Different HCU patterns were observed according to gender and gender differences in the presentation of victimisation. Our findings may lead to the development of clinical practice guidelines for early detection and appropriate management of bullied children.

  5. Maternal Caffeine Consumption during Pregnancy and Behavioral Disorders in 11-Year-Old Offspring: A Danish National Birth Cohort Study.

    Science.gov (United States)

    Hvolgaard Mikkelsen, Susanne; Obel, Carsten; Olsen, Jørn; Niclasen, Janni; Bech, Bodil Hammer

    2017-10-01

    To examine the association between maternal caffeine consumption from coffee and tea during pregnancy and offspring behavioral disorders. We studied 47 491 children enrolled in the Danish National Birth Cohort between 1996 and 2002. Data on maternal coffee and tea consumption was collected at 15 and 30 weeks of gestation. When the child was 11 years old, the Strength and Difficulties Questionnaire was filled in by children, parents, and teachers. We estimated risk ratios (RRs) for offspring behavioral disorders. At 15 weeks of gestation 3% and 4% of the pregnant women consumed ≥8 cups/d of coffee or tea, respectively. Maternal coffee consumption ≥8 cups/d at 15 weeks of gestation was associated with increased risk of hyperactivity-inattention disorder (RR 1.47; 95% CI 1.18-1.83), conduct-oppositional disorders (RR 1.22; 95% CI 1.01-1.48), and any psychiatric disorder (RR 1.23; 95% CI 1.08-1.40). Maternal tea consumption ≥8 cups/d at 15 weeks of gestation was associated with increased risk of anxiety-depressive disorders (RR 1.28; 95% CI 1.09-1.52) and any psychiatric disorder (RR 1.24; 95% CI 1.11-1.40). An increased risk of hyperactivity-inattention disorder was observed with increasing daily caffeine consumption at 15 weeks of gestation. High maternal caffeine consumption from coffee and tea at 15 weeks of gestation was associated with behavioral disorders in 11-year-old offspring. We hypothesize that caffeine exposure may affect the fetal brain and program for behavioral disorders later in life. The fetal brain seems to be more sensitive to caffeine exposure at 15 weeks of pregnancy compared with 30 weeks of gestation. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Changes in Pulmonary Function During the Early Years After Inpatient Rehabilitation in Persons With Spinal Cord Injury : A Prospective Cohort Study

    NARCIS (Netherlands)

    Haisma, Janneke A.; de Groot, Sonja; Hopman, Maria T.; Bergen, Michael. P.; Stam, Henk J.; Bussmann, Johannes B.; Postma, K.

    Objective: To describe changes in pulmonary function (PF) during the 5 years after inpatient rehabilitation in persons with spinal cord injury (SCI) and to study potential determinants of change. Design: Prospective cohort study. Setting: Eight rehabilitation centers with specialized SCI units.

  7. Energy restriction early in life and colon carcinoma risk: Results of The Netherlands Cohort Study after 7.3 years of follow-up

    NARCIS (Netherlands)

    Dirx, M.J.M.; Brandt, P.A. van den; Goldbohm, R.A.; Lumey, L.H.

    2003-01-01

    BACKGROUND. This study evaluated the effects of severe undernutrition during adolescence and subsequent colon carcinoma risk. METHODS. The authors evaluated The Netherlands Cohort Study on Diet and Cancer (NLCS) among 62,573 women and 58,279 men aged 55-69 years at baseline. Information on diet and

  8. Genetic variation in FADS genes and plasma cholesterol levels in 2-year-old infants: KOALA Birth Cohort Study.

    Directory of Open Access Journals (Sweden)

    Carolina Moltó-Puigmartí

    Full Text Available OBJECTIVE: Single nucleotide polymorphisms (SNPs in genes involved in fatty acid metabolism (FADS1 FADS2 gene cluster are associated with plasma lipid levels. We aimed to investigate whether these associations are already present early in life and compare the relative contribution of FADS SNPs vs traditional (non-genetic factors as determinants of plasma lipid levels. METHODS: Information on infants' plasma total cholesterol levels, genotypes of five FADS SNPs (rs174545, rs174546, rs174556, rs174561, and rs3834458, anthropometric data, maternal characteristics, and breastfeeding history was available for 521 2-year-old children from the KOALA Birth Cohort Study. For 295 of these 521 children, plasma HDLc and non-HDLc levels were also known. Multivariable linear regression analysis was used to study the associations of genetic and non-genetic determinants with cholesterol levels. RESULTS: All FADS SNPs were significantly associated with total cholesterol levels. Heterozygous and homozygous for the minor allele children had about 4% and 8% lower total cholesterol levels than major allele homozygotes. In addition, homozygous for the minor allele children had about 7% lower HDLc levels. This difference reached significance for the SNPs rs174546 and rs3834458. The associations went in the same direction for non-HDLc, but statistical significance was not reached. The percentage of total variance of total cholesterol levels explained by FADS SNPs was relatively low (lower than 3% but of the same order as that explained by gender and the non-genetic determinants together. CONCLUSIONS: FADS SNPs are associated with plasma total cholesterol and HDLc levels in preschool children. This brings a new piece of evidence to explain how blood lipid levels may track from childhood to adulthood. Moreover, the finding that these SNPs explain a similar amount of variance in total cholesterol levels as the non-genetic determinants studied reveals the potential

  9. Carriage of Staphylococcus aureus among Portuguese nursing students: A longitudinal cohort study over four years of education.

    Directory of Open Access Journals (Sweden)

    Teresa Conceição

    Full Text Available Staphylococcus aureus is a major human pathogen that can colonize healthy people mainly in the anterior nares. The aim of the present study was to evaluate S. aureus nasal colonization over time among Portuguese nursing students, including methicillin-resistant S. aureus (MRSA.In this longitudinal cohort study, we collected 280 nasal swabs from nursing students at 14 time points over four years of schooling (2012-2016. The isolates were characterized by pulsed-field gel electrophoresis (PFGE, spa typing, multilocus sequence typing (MLST, and SCCmec typing for MRSA. Among 47 students, 20 (43% carried methicillin-susceptible S. aureus (MSSA at admission, but none was colonized with MRSA. A total of 19 students (40% became colonized after exposure during the nursing training, out of which five carried MRSA. Overall, 39 students (83% had S. aureus detected at least once during the study period. Among the 97 MSSA isolates, most (65% belonged to four clones: PFGE A-ST30 (21%, B-ST72 (20%, C-ST508 (13%, and D-ST398 (11%. Three of the five MRSA carriers were colonized with the predominant clone circulating in Portuguese hospitals (ST22-IVh and two with ST3162-II. Colonization of nursing students was highly dynamic with continuous appearance of strains with distinct PFGE types in the same individual.A considerable proportion of students became colonized by S. aureus, including MRSA, during the nursing education, evidencing this population represents an important reservoir of S. aureus. Therefore, education on infection control measures in nursing schools is of major importance.

  10. [A prospective cohort study on the relationship between maternal prenatal depressive symptoms and children's behavioral problems at 2 years old].

    Science.gov (United States)

    Li, F; Tian, Y P; Liu, X M; Xia, R L; Jin, L M; Sun, X W; Song, X X; Yuan, W; Liang, H

    2018-04-10

    Objective: To explore the associations between maternal and prenatal depressive symptoms and children's behavioral problems at 2 years old. Methods: In the present study, a total of 491 mother-child pairs were selected from the Shanghai-Minhang Birth Cohort Study (S-MBCS) which was conducted in Maternal and Child Health Hospital of Minhang District in Shanghai between April and December, 2012. Data from the Center for Epidemiologic Studies on Depression was gathered to assess the maternal depressive symptoms in the second and third trimester of pregnancy, as well as at 6 months and 12 months postpartum. Neurodevelopment at 2 years was assessed, using the Child Behavior Checklist. We used generalized linear models with a log-link function and a Binomial distribution to estimate the risk ratios ( RR s) and 95% CI s, on children's behavioral problems at 2 years of age. Sensitivity analyses were performed among participants without postpartum depressive symptoms. Results: After adjustment on factors as maternal age, gestation week, average monthly income per person, parental education and children's gender etc ., maternal depression in second trimester of pregnancy was found associated with higher risk of both developing emotional ( RR =2.61, 95% CI : 1.36-4.99) and internalizing problems ( RR =1.94, 95% CI : 1.22-3.08). However, maternal depression in third trimester was found to be associated with higher risks of developing emotional ( RR =6.46, 95% CI : 3.09-13.53), withdrawn ( RR =2.42, 95% CI : 1.16-5.02), aggressive ( RR =2.93, 95% CI : 1.45-5.94), internalizing ( RR =1.79, 95% CI : 1.01-3.16) or externalizing problems ( RR =2.56, 95% CI :1.49-4.42). In sensitivity analysis, antenatal maternal depression was found positively associated with children's emotional, internalizing and externalizing problems and the differences all statistically significant. Conclusions: Maternal depression during pregnancy might increase the risks of children's behavioral problems. In

  11. Iron intakes and status of 2-year-old children in the Cork BASELINE Birth Cohort Study.

    Science.gov (United States)

    McCarthy, Elaine K; Ní Chaoimh, Carol; Hourihane, Jonathan O'B; Kenny, Louise C; Irvine, Alan D; Murray, Deirdre M; Kiely, Mairead

    2017-07-01

    Young children are at risk of iron deficiency and subsequent anaemia, resulting in long-term consequences for cognitive, motor and behavioural development. This study aimed to describe the iron intakes, status and determinants of status in 2-year-old children. Data were collected prospectively in the mother-child Cork BASELINE Birth Cohort Study from 15 weeks' gestation throughout early childhood. At the 24-month assessment, serum ferritin, haemoglobin and mean corpuscular volume were measured, and food/nutrient intake data were collected using a 2-day weighed food diary. Iron status was assessed in 729 children (median [IQR] age: 2.1 [2.1, 2.2] years) and 468 completed a food diary. From the food diary, mean (SD) iron intakes were 6.8 (2.6) mg/day and 30% had intakes < UK Estimated Average Requirement (5.3 mg/day). Using WHO definitions, iron deficiency was observed in 4.6% (n = 31) and iron deficiency anaemia in five children (1.0%). Following an iron series workup, five more children were diagnosed with iron deficiency anaemia. Twenty-one per cent had ferritin concentrations <15 µg/L. Inadequate iron intakes (OR [95% CI]: 1.94 [1.09, 3.48]) and unmodified cows' milk intakes ≥ 400 mL/day (1.95 [1.07, 3.56]) increased the risk of low iron status. Iron-fortified formula consumption was associated with decreased risk (0.21 [0.11, 0.41] P < 0.05). In this, the largest study in toddlers in Europe, a lower prevalence of low iron status was observed than in previous reports. Compliance with dietary recommendations to limit cows' milk intakes in young children and consumption of iron-fortified products appears to have contributed to improved iron status at two years. © 2016 John Wiley & Sons Ltd.

  12. Neonatal Vitamin D Levels in Relation to Risk of Overweight at 7 Years in the Danish D-Tect Case-Cohort Study

    DEFF Research Database (Denmark)

    Jensen, Camilla B.; Lundqvist, Marika; Sørensen, Thorkild I. A.

    2017-01-01

    Background: Vitamin D level in pregnancy may be associated with risk of overweight in the offspring later in life. Methods: In a case-cohort study based on Danish biobanks and registers we examined the association between 25-hydroxy-vitamin D (25(OH)D) level at birth and overweight at 7 years....... Cases of overweight (n = 871) were randomly selected among 7-year-old children from the Copenhagen School Health Records Register (CSHRR) with a BMI above the 90th percentile. The cohort (n = 1,311) was a random sample selected among all Danish children born during the same period. Neonatal 25(OH...

  13. A 13-year cohort study of musculoskeletal disorders treated in an autoplant, on-site physiotherapy clinic.

    Science.gov (United States)

    Sadi, Jackie; MacDermid, Joy C; Chesworth, Bert; Birmingham, Trevor

    2007-12-01

    The purpose of this study was to describe the rate and distribution of treatment visits provided in an on-site, automotive plant, physiotherapy clinic over a 13-year period. A retrospective cohort study was conducted using data collected at an on-site physiotherapy clinic (1990-2002, 65,977 visits; n = 2,636 workers). The average age of workers was 43 +/- 9 years; most remained at work (85%) when treated. Disorders most commonly affected the shoulder, lumbar, and cervical regions; the median number of visits for these was 7, 6, and 5, respectively. Elbow disorders occurred commonly only for work-related complaints and required a median of eight visits. Rate of utilization was higher for women, with 47% of the plant's female workers attending physiotherapy in 1 year. Women had higher rates of cervical spine (12 vs. 22%) and wrist (5 vs. 10%) disorders. The two most common causes of injury reported by workers with an industrial injury were "frank injury arising out of normal employment" (51%) and "gradual onset/no frank injury" (37%). The diagnosis most often reported by the physiotherapist after initial assessment was "strain" which was similar for both industrial (43%) and non-industrial (49%) injuries. The six main departments in this automotive plant account for 93% of all industrial injuries reported. Final Assembly accounted for the largest number and highest rate of injury, although shift variability was noted in utilization rates (13 vs. 26%), despite the same tasks, shift schedules, and demographics. Although there was no control group, the number of visits to discharge was lower than reported in the literature for off-site physical therapy; there was a large reduction in claims (441-275) following introduction of the clinic and reduced duration/costs of lost time were identified by the employer as a rationale to continue and enhance the service over time. On-site physiotherapy services can provide early, cost-effective management of WRMSD in the automotive

  14. Work engagement and high-sensitivity C-reactive protein levels among Japanese workers: a 1-year prospective cohort study.

    Science.gov (United States)

    Eguchi, Hisashi; Shimazu, Akihito; Kawakami, Norito; Inoue, Akiomi; Nakata, Akinori; Tsutsumi, Akizumi

    2015-08-01

    Evidence on the association between psychological well-being and high-sensitivity C-reactive protein (hs-CRP) levels is limited. We carried out a prospective study to investigate the association between work engagement and hs-CRP levels in a group of Japanese workers. Our cohort included 1,857 men and 657 women aged 65 and under, and free from major illness, working at two manufacturing worksites in Japan. Baseline examinations were conducted from April to June 2011 to determine the demographic and lifestyle characteristics and levels of work engagement. Blood samples were obtained from participants at baseline and after 1 year. Participants were classified into tertiles of low, moderate, and high work engagement at baseline. Hs-CRP levels were split into low (≤3.0 mg/L) and high (>3.0 mg/L). We used multiple logistic regression analyses to evaluate the association between work engagement at baseline and hs-CRP levels at follow-up, adjusting for hs-CRP at baseline and potential confounding factors. Participants reporting moderate and high levels of work engagement at baseline had significantly lower odds ratios (ORs) of having high hs-CRP levels at follow-up than those with low levels of work engagement at baseline [OR of moderate level 0.44, 95% confidence interval (CI) 0.24-0.81; OR of high level 0.57, 95% CI 0.33-0.99; p for trend work engagement has beneficial effects on workers' cardiovascular health.

  15. Insomnia symptoms as a cause of type 2 diabetes Incidence: a 20 year cohort study.

    Science.gov (United States)

    Green, Michael J; Espie, Colin A; Popham, Frank; Robertson, Tony; Benzeval, Michaela

    2017-03-16

    Insomnia symptoms are associated with type 2 diabetes incidence but are also associated with a range of potential time-varying covariates which may confound and/or mediate associations. We aimed to assess whether cumulative exposure to insomnia symptoms has a causal effect on type 2 diabetes incidence. A prospective cohort study in the West of Scotland, following respondents for 20 years from age 36. 996 respondents were free of diabetes at baseline and had valid data from up to four follow-up visits. Type 2 diabetes was assessed at the final visit by self-report, taking diabetic medication, or blood-test (HbA 1c  ≥ 6.5% or 48 mmol/mol). Effects of cumulative insomnia exposure on type 2 diabetes incidence were estimated with traditional regression and marginal structural models, adjusting for time-dependent confounding (smoking, diet, physical inactivity, obesity, heavy drinking, psychiatric distress) as well as for gender and baseline occupational class. Traditional regression yielded an odds ratio (OR) of 1.34 (95% CI: 1.06-1.70) for type 2 diabetes incidence for each additional survey wave in which insomnia was reported. Marginal structural models adjusted for prior covariates (assuming concurrently measured covariates were potential mediators), reduced this OR to 1.20 (95% CI: 0.98-1.46), and when concurrent covariates were also included (viewing them as potential confounders) this dropped further to 1.08 (95% CI: 0.85-1.37). The association between cumulative experience of insomnia and type 2 diabetes incidence appeared confounded. Evidence for a residual causal effect depended on assumptions as to whether concurrently measured covariates were confounders or mediators.

  16. Foot pronation is not associated with increased injury risk in novice runners wearing a neutral shoe : a 1-year prospective cohort study

    NARCIS (Netherlands)

    Nielsen, Rasmus Oestergaard; Buist, Ida; Parner, Erik Thorlund; Nohr, Ellen Aagaard; Sorensen, Henrik; Lind, Martin; Rasmussen, Sten

    Objective To investigate if running distance to first running-related injury varies between foot postures in novice runners wearing neutral shoes. Design A 1-year epidemiological observational prospective cohort study. Setting Denmark. Participants A total of 927 novice runners equivalent to 1854

  17. Neonatal Vitamin D Levels in Relation to Risk of Overweight at 7 Years in the Danish D-Tect Case-Cohort Study

    DEFF Research Database (Denmark)

    Jensen, Camilla B.; Lundqvist, Marika; Sørensen, Thorkild I.A.

    2017-01-01

    Background: Vitamin D level in pregnancy may be associated with risk of overweight in the offspring later in life.Methods: In a case-cohort study based on Danish biobanks and registers we examined the association between 25-hydroxy-vitamin D (25(OH)D) level at birth and overweight at 7 years. Cases...

  18. Prenatal methylmercury exposure and language delay at three years of age in the Norwegian Mother and Child Cohort Study.

    Science.gov (United States)

    Vejrup, Kristine; Schjølberg, Synnve; Knutsen, Helle Katrine; Kvalem, Helen Engelstad; Brantsæter, Anne Lise; Meltzer, Helle Margrete; Alexander, Jan; Magnus, Per; Haugen, Margaretha

    2016-01-01

    Prenatal methylmercury (MeHg) exposure and its possible neurodevelopmental effects in susceptible children are of concern. Studies of MeHg exposure and negative health outcomes have shown conflicting results and it has been suggested that co-exposure to other contaminants and/or nutrients in fish may confound the effect of MeHg. Our objective was to examine the association between prenatal exposure to MeHg and language and communication development at three years, adjusting for intake of fish, n-3 long chain polyunsaturated fatty acids (n-3 LCPUFAs) and co-exposure to dioxins and dioxin like polychlorinated biphenyls (dl-PCBs). We used data from the Norwegian Mother and Child Cohort Study (MoBa) collected between 2002 and 2008. The study sample consisted of 46,750 mother-child pairs. MeHg exposure was calculated from reported fish intake during pregnancy by a FFQ in mid-pregnancy. Children's language and communication skills were measured by maternal report on the Dale and Bishop grammar rating and the Ages and Stages communication scale (ASQ). We estimated odds ratios (OR) and 95% confidence intervals (CI) using logistic regressions. Median MeHg exposure was 1.3μg/day, corresponding to 0.14μg/kgbw/week. An exposure level above the 90th percentile (>2.6μg/day, >0.29μg/kgbw/week) was defined as the high MeHg exposure. Results indicated an association between high MeHg exposure and unintelligible speech with an adjusted OR 2.22 (1.31, 3.72). High MeHg exposure was also associated with weaker communication skills adjusted OR 1.33 (1.03, 1.70). Additional adjustment for fish intake strengthened the associations, while adjusting for PCBs and n-3 LCPUFA from diet or from supplements had minor impact. In conclusion, significant associations were found between prenatal MeHg exposure above the 90th percentile and delayed language and communication skills in a generally low exposed population. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Fear of falling predicts incidence of functional disability two years later: A perspective from an international cohort study.

    Science.gov (United States)

    Auais, Mohammad; French, Simon; Alvarado, Beatriz; Pirkle, Catherine; Belanger, Emmanuelle; Guralnik, Jack

    2017-12-06

    To study the extent to which fear of falling (FOF) is associated with the onset of functional disability over a 2-year period in older adults using self-reported and performance-based measures. In 2012, 1,601 participants (aged 65-74) were recruited from four sites: Kingston and Saint-Hyacinthe, Canada; Manizales, Colombia; and Natal, Brazil. They were re-assessed in 2014. We quantified FOF using the Fall Efficacy Scale-International (FES-I; range: 16-64). Functional disability measures were 1) self-reported incident mobility disability, defined as difficulty climbing a flight of stairs or walking 400 meters and 2) incident poor physical performance, defined as a score <9 on the Short Physical Performance Battery. In the Poisson regression analysis, we included only those participants without functional disability at baseline to calculate incident risk ratios in 2014. 1,355 participants completed the 2014 assessment, of which 917 and 1,078 had no mobility disability and poor physical performance at baseline, respectively. In 2014, 131 (14.3%), and 166 (15.4%) participants reported incident mobility disability and poor physical performance, respectively. After adjusting for age, sex, socioeconomic, and health covariates, a one-point increase in FES-I at baseline was associated with a 4% increase in the risk of reporting incident mobility disability (95% CI: 1.02-1.05) and a 3% increase in the risk of developing poor physical performance at follow up in the overall sample (95%CI: 1.01-1.05). FOF is associated with a higher risk of incident mobility disability and poor physical performance in a cohort of older adults. It is increasingly important to study FOF's effect on functional disability and to take necessary measures to prevent the transition to end-stage disability. © The Author(s) 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  20. Emergence and evolution of social self-management of Parkinson's disease: study protocol for a 3-year prospective cohort study.

    Science.gov (United States)

    Tickle-Degnen, Linda; Saint-Hilaire, Marie; Thomas, Cathi A; Habermann, Barbara; Martinez, Linda S Sprague; Terrin, Norma; Noubary, Farzad; Naumova, Elena N

    2014-05-02

    Parkinson's disease affects facial, vocal and trunk muscles. As symptoms progress, facial expression becomes masked, limiting the person's ability to communicate emotions and intentions to others. As people with the disease live and reside in their homes longer, the burden of caregiving is unmitigated by social and emotional rewards provided by an expressive individual. Little is known about how adults living with Parkinson's disease manage their social lives and how an inability to be emotionally expressive can affect social connections and health. Because social networks have been shown to be crucial to the overall well-being of people living with chronic diseases, research is needed on how expressive capacity affects life trajectories and health. The overall objective is to understand the emergence and evolution of the trajectories of the self-management of the social lives of people living with Parkinson's disease. The central hypothesis is that expressive capacity predicts systematic change in the pattern of social self-management and quality of life outcomes. The specific aims of this 3-year longitudinal study of 120 people with the disease and a maximum of 120 care partners are: 1) characterize social self-management trajectories over a 3-year period; 2) estimate the degree to which expressive nonverbal capacity predicts the trajectory; and 3) determine the moderating effect of gender on the association between expressive capacity and change in social self-management. Each participant will be assessed 14 times to detect rapid and non-linear changes in social participation and management of social activities; social network; and social comfort, general health and well-being. This project will provide evidence to guide the development of interventions for supporting social integration of those living with Parkinson's disease, thus leading to improved overall health. It focuses on the novel construct of social self-management and known factors

  1. Association between maternal diet quality and offspring diet quality assessed at age 14 years: longitudinal study in a large contemporary cohort

    DEFF Research Database (Denmark)

    Bjerregaard, Anne Ahrendt; Halldorsson, Thorhallur I.; Tetens, Inge

    2017-01-01

    -pregnancy BMI, level of education, and maternal smoking. Interpretation  This is the first study, to our knowledge, to examine associations between maternal dietary habits during pregnancy and offspring dietary habits during adolescent years in a large contemporary cohort. Diet quality during pregnancy......Background  Emerging evidence suggests that exposures in fetal life may have an impact many years later on the individual's susceptibility to diseases. Study of diet–disease associations over long time-spans is a major methodological challenge. We examined whether overall diet quality during...... pregnancy was associated with adolescent diet quality 15 years later in a prospective cohort representing a typical high-income population. Methods  Dietary intake assessed with a 360-item food frequency questionnaire during mid-pregnancy (1996–2003) was matched with offspring dietary intake assessed...

  2. Age at death of major cardiovascular diseases in 13 cohorts. The seven countries study of cardiovascular diseases 45-year follow-up.

    Science.gov (United States)

    Menotti, Alessandro; Puddu, Paolo Emilio; Tolonen, Hanna; Adachi, Hisashi; Kafatos, Anthony; Kromhout, Daan

    2018-03-23

    To explore age at death (AD) for major cardiovascular diseases (CVD) and their risk factors in originally middle-aged men followed nearly to extinction in the Seven Countries Study. Thirteen cohorts of men aged 40-59 years (N = 10,628) in seven countries (USA, Finland, the Netherlands, Italy, Serbia, Greece, Japan) were enrolled in late 1950s and early 1960s and were followed 45 years for mortality. AD was computed for coronary heart disease (CHD), stroke (STR), heart disease of uncertain aetiology (HDUE) and for all-causes. AD was compared across CHD-HDUE-STR. Cox models were computed for each end-point using baseline age, cigarettes smoking, systolic blood pressure and serum cholesterol. After 45 years 92.9% of men had died. The most common CVD death was CHD in most cohorts except some Mediterranean and Japanese cohorts where STR or HDUE were most prevalent. In 13 cohorts mean AD was 74.5, 73.5, 75.7 and 79.1 years, respectively, for all-cause, CHD, STR and HDUE mortality (all possible differences were significant). The difference, across cohorts, between the highest and the lowest mean AD was 12.9, 9.0 and 4.7 years for CHD, HDUE and STR mortality, respectively. Risk factors explored were significant predictors of all three CVD end-points, except serum cholesterol, specific to CHD mortality. AD is a useful indicator of previous health and aging populations. STR and HDUE are diseases appearing later in life, thus being associated with a higher AD compared with CHD mortality.

  3. The Baux score is dead. Long live the Baux score: a 27-year retrospective cohort study of mortality at a regional burns service.

    Science.gov (United States)

    Roberts, Geoffrey; Lloyd, Mark; Parker, Mike; Martin, Rebecca; Philp, Bruce; Shelley, Odhran; Dziewulski, Peter

    2012-01-01

    To assess trends in mortality after burn injuries treated in a regional specialist burns service between 1982 and 2008. Patient and burn-specific information and mortality were collated from written admission ledgers and the hospital coding department for 11,109 patients. The data set was divided into age cohorts (0-14, 15-44, 45-64, and >65 years) and time cohorts (1982-1991, 1992-2000, and 2000-2008). Lethal area 50 (LA50) was calculated by logistic regression and probit analysis. Mortality was related to the Baux score (age + total % burned surface area) by logistic regression. In the time period 2000 to 2008, the LA50 values with approximate 95% confidence intervals (CIs) were 100% (CI, 85.5-100%) in the 0 to 14 cohort (LA10, 78.3%; CI, 64.1-92.5%), 76.4% (CI, 69.1-83.8%) in the 15 to 44 cohort, 58.6% (CI, 50.8-66.5%) in the 45 to 64 cohort, and 30.8% (CI, 24.7-36.9%) in the >65 cohort. The point of futility (the Baux Score at which predicted mortality is 100%) was 160 and the Baux50 (the Baux score at which predicted mortality is 50%) was 109.6 (CI, 105.9-113.4) in the 2000 to 2008 cohort. Mortality is markedly improved over earlier data from this study and other historical series and compares favorably with outcomes published from the US National Burn Repository. The Baux Score continues to provide an indication of the risk of mortality. Survival after major burn injury is increasingly common, and decisions by nonspecialist about initial triage, management, and futility of care should be made after consultation with a specialist burn service.

  4. Sick leave before and after the age of 65 years among those in paid work in Sweden in 2000 or 2005: a register-based cohort study.

    Science.gov (United States)

    Farrants, Kristin; Kjeldgård, Linnea; Marklund, Staffan; Head, Jenny; Alexanderson, Kristina

    2018-02-01

    Objective With pressure for older people to remain in work, research is needed on how people aged over 65 years fare in the labour market. However, few studies have focused on sick leave among older workers, especially those over the standard retirement age. This study investigated changes in sick-leave patterns among people aged over 65 years still in work. Methods All individuals in Sweden who turned 65 years old in 2000 or 2005 were followed from 1995 to 2010. The mean number of sick-leave days per year was measured for those who remained in paid work past the age of 65 years. Results Those over 65 years still working had fewer sick-leave days before the age of 65 years than those who retired. They also had fewer sick-leave days after 65 years than before. There were fewer socioeconomic differences after 65 years than before, but these differences were greater for workers over 65 years in the 2005 cohort. Conclusions Although there were more people over 65 years in paid work in 2005, sick-leave days and socioeconomic differences in sick leave were lower in this age group. Sick-leave days and socioeconomic differences in sick leave were greater in the 2005 cohort.

  5. Prenatal and childhood antecedents of suicide: 50-year follow-up of the 1958 British Birth Cohort study.

    Science.gov (United States)

    Geoffroy, M-C; Gunnell, D; Power, C

    2014-04-01

    We aimed to elucidate early antecedents of suicide including possible mediation by early child development. Using the 1958 birth cohort, based on British births in March 1958, individuals were followed up to adulthood. We used data collected at birth and at age 7 years from various informants. Suicides occurring up to 31 May 2009 were identified from linked national death certificates. Multivariable Cox proportional hazard models were used to investigate risk factors. Altogether 12399 participants (n = 44 suicides) had complete data. The strongest prenatal risk factors for suicide were: birth order, with risk increasing in later-born children [p trend = 0.063, adjusted hazard ratio (HR)], e.g. for fourth- or later-born children [HR = 2.27, 95% confidence interval (CI) 0.90-5.75]; young maternal age (HR = 1.18, 95% CI 0.34-4.13 for ⩽19 years and HR = 0.41, 95% CI 0.19-0.91 for >29 years, p trend = 0.034); and low (birth weight (HR = 2.48, 95% CI 1.03-5.95). The strongest risk factors at 7 years were externalizing problems in males (HR = 2.96, 95% CI 1.03-8.47, p trend = 0.050) and number of emotional adversities (i.e. parental death, neglected appearance, domestic tension, institutional care, contact with social services, parental divorce/separation and bullying) for which there was a graded association with risk of suicide (p trend = 0.033); the highest (HR = 3.12, 95% CI 1.01-9.62) was for persons with three or more adversities. Risk factors recorded at birth and at 7 years may influence an individual's long-term risk of suicide, suggesting that trajectories leading to suicide have roots in early life. Some factors are amenable to intervention, but for others a better understanding of causal mechanisms may provide new insights for intervention to reduce suicide risk.

  6. Maternal pre-pregnancy BMI and intelligence quotient (IQ) in 5-year-old children: a cohort based study.

    Science.gov (United States)

    Bliddal, Mette; Olsen, Jørn; Støvring, Henrik; Eriksen, Hanne-Lise F; Kesmodel, Ulrik S; Sørensen, Thorkild I A; Nøhr, Ellen A

    2014-01-01

    An association between maternal pre-pregnancy BMI and childhood intelligence quotient (IQ) has repeatedly been found but it is unknown if this association is causal or due to confounding caused by genetic or social factors. We used a cohort of 1,783 mothers and their 5-year-old children sampled from the Danish National Birth Cohort. The children participated between 2003 and 2008 in a neuropsychological assessment of cognitive ability including IQ tests taken by both the mother and the child. Linear regression analyses were used to estimate the associations between parental BMI and child IQ adjusted for a comprehensive set of potential confounders. Child IQ was assessed with the Wechsler Primary and Preschool Scales of Intelligence--Revised (WPPSI-R). The crude association between maternal BMI and child IQ showed that BMI was adversely associated with child IQ with a reduction in IQ of -0.40 point for each one unit increase in BMI. This association was attenuated after adjustment for social factors and maternal IQ to a value of -0.27 (-0.50 to -0.03). After mutual adjustment for the father's BMI and all other factors except maternal IQ, the association between paternal BMI and child IQ yielded a regression coefficient of -0.26 (-0.59 to 0.07), which was comparable to that seen for maternal BMI (-0.20 (-0.44 to 0.04)). Although maternal pre-pregnancy BMI was inversely associated with the IQ of her child, the similar association with paternal BMI suggests that it is not a specific pregnancy related adiposity effect.

  7. Sleep disruption, chronotype, shift work, and prostate cancer risk and mortality: a 30-year prospective cohort study of Finnish twins.

    Science.gov (United States)

    Dickerman, Barbra A; Markt, Sarah C; Koskenvuo, Markku; Hublin, Christer; Pukkala, Eero; Mucci, Lorelei A; Kaprio, Jaakko

    2016-11-01

    Sleep disruption and shift work have been associated with cancer risk, but epidemiologic evidence for prostate cancer remains limited. We aimed to prospectively investigate the association between midlife sleep- and circadian-related parameters and later prostate cancer risk and mortality in a population-based cohort of Finnish twins. Data were drawn from the Older Finnish Twin Cohort and included 11,370 twins followed from 1981 to 2012. Over the study period, 602 incident cases of prostate cancer and 110 deaths from prostate cancer occurred. Cox regression was used to evaluate associations between midlife sleep duration, sleep quality, chronotype, and shift work with prostate cancer risk and prostate cancer-specific mortality. Within-pair co-twin analyses were employed to account for potential familial confounding. Compared to "definite morning" types, "somewhat evening" types had a significantly increased risk of prostate cancer (HR 1.3; 95 % CI 1.1, 1.6). Chronotype significantly modified the relationship between shift work and prostate cancer risk (p-interaction shift work and prostate cancer risk in the overall analyses and no significant association between any sleep- or circadian-related parameter and risk in co-twin analyses. Neither sleep- nor circadian-related parameters were significantly associated with prostate cancer-specific mortality. The association between sleep disruption, chronotype, and shift work with prostate cancer risk and mortality has never before been studied in a prospective study of male twins. Our findings suggest that chronotype may be associated with prostate cancer risk and modify the association between shift work and prostate cancer risk. Future studies of circadian disruption and prostate cancer should account for this individual-level characteristic.

  8. Evaluating the Predictive Impact of an Emergent Literacy Model on Dyslexia in Italian Children: A Four-Year Prospective Cohort Study.

    Science.gov (United States)

    Bigozzi, Lucia; Tarchi, Christian; Pezzica, Sara; Pinto, Giuliana

    2016-01-01

    The strong differences in manifestation, prevalence, and incidence in dyslexia across languages invite studies in specific writing systems. In particular, the question of the role played by emergent literacy in opaque and transparent writing systems remains a fraught one. This research project tested, through a 4-year prospective cohort study, an emergent literacy model for the analysis of the characteristics of future dyslexic children and normally reading peers in Italian, a transparent writing system. A cohort of 450 children was followed from the last year of kindergarten to the third grade in their reading acquisition process. Dyslexic children were individuated (Grade 3), and their performances in kindergarten in textual competence, phonological awareness, and conceptual knowledge of the writing system were compared with a matched group of normally reading peers. Results showed the predictive relevance of the conceptual knowledge of the writing system. The study's implications are discussed. © Hammill Institute on Disabilities 2014.

  9. Pregnancy diet and offspring asthma risk over a 10-year period: the Lifeways Cross Generation Cohort Study, Ireland.

    Science.gov (United States)

    Viljoen, Karien; Segurado, Ricardo; O'Brien, John; Murrin, Celine; Mehegan, John; Kelleher, Cecily C

    2018-02-20

    The association of maternal pregnancy diet with offspring asthma risk have been reported. However, literature on longitudinal patterns of asthma risk relative to intrauterine nutrient exposure is limited. We aimed to establish whether vegetable, oily fish and vitamin D intake during pregnancy are associated with childhood asthma risk over a 10-year period in the Irish Republic. Mother-child pairs (n=897) from the Lifeways prospective birth cohort, with data on nutrient intake during pregnancy and asthma status, respectively, were eligible for inclusion in the analysis. Data on socioeconomic and morbidity indicators over 10 years of follow-up on mothers and the index child were collected through self-administered questionnaires. Asthma status as diagnosed by the general practitioner at any time point over 10 years was related to maternal vegetable, oily fish and vitamin D intake during pregnancy, while adjusting for gestational age, socioeconomic status, smoking at delivery, breast feeding, season of birth and supplement use. Data were modelled with a marginal model on correlated observations over time within individuals. In the fully adjusted model, asthma was inversely associated with higher daily average intake of oily fish (OR 0.23 per serving/day, 95% CI 0.04 to 1.41) and of vegetables (OR 0.96 per serving/day, 95% CI 0.88 to 1.05), but the confidence limits overlapped 1. A higher daily vitamin D intake was associated with reduced odds of asthma (OR 0.93 per μg/day, 95% CI 0.89 to 0.98). This analysis suggests higher daily average intake of vitamin D in pregnancy is associated with asthma risk in offspring over the first 10 years of life. © 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.

  10. Prevalence, incidence rates and persistence of contact allergy and allergic contact dermatitis in The Odense Adolescence Cohort Study: a 15-year follow-up

    DEFF Research Database (Denmark)

    Mortz, C. G.; Bindslev-Jensen, C.; Andersen, Klaus Ejner

    2013-01-01

    BACKGROUND: A cohort of 1501 unselected 8th grade schoolchildren was established 15 years ago with the aim to follow the course of contact allergy and allergic contact dermatitis (ACD) from school age into adult life. To date no studies have evaluated incidence rates and persistence of contact al...... the most common contact allergen, and new sensitizations occurred despite the European Union nickel regulation. Fragrance mix I was a poor marker for history of eczematous skin reaction to perfumed products....

  11. Hamstring and Quadriceps Isokinetic Strength Deficits Are Weak Risk Factors for Hamstring Strain Injuries: A 4-Year Cohort Study.

    Science.gov (United States)

    van Dyk, Nicol; Bahr, Roald; Whiteley, Rodney; Tol, Johannes L; Kumar, Bhavesh D; Hamilton, Bruce; Farooq, Abdulaziz; Witvrouw, Erik

    2016-07-01

    A hamstring strain injury (HSI) has become the most common noncontact injury in soccer. Isokinetic muscle strength deficits are considered a risk factor for HSIs. However, underpowered studies with small sample sizes unable to determine small associations have led to inconclusive results regarding the role of isokinetic strength and strength testing in HSIs. To examine whether differences in isokinetic strength measures of knee flexion and extension represent risk factors for hamstring injuries in a large cohort of professional soccer players in an adequately powered study design. Cohort study; Level of evidence, 2. A total of 614 professional soccer players from 14 teams underwent isokinetic strength testing during preseason screening. Testing consisted of concentric knee flexion and extension at 60 deg/s and 300 deg/s and eccentric knee extension at 60 deg/s. A clustered multiple logistic regression analysis was used to identify variables associated with the risk of HSIs. Receiver operating characteristic (ROC) curves were calculated to determine sensitivity and specificity. Of the 614 players, 190 suffered an HSI during the 4 seasons. Quadriceps concentric strength at 60 deg/s (odds ratio [OR], 1.41; 95% CI, 1.03-1.92; P = .03) and hamstring eccentric strength at 60 deg/s (OR, 1.37; 95% CI, 1.01-1.85; P = .04) adjusted for bodyweight were independently associated with the risk of injuries. The absolute differences between the injured and uninjured players were 6.9 N·m and 9.1 N·m, with small effect sizes (d hamstring eccentric strength, respectively, indicating a failed combined sensitivity and specificity of the 2 strength variables identified in the logistic regression models. This study identified small absolute strength differences and a wide overlap of the absolute strength measurements at the group level. The small associations between lower hamstring eccentric strength and lower quadriceps concentric strength with HSIs can only be considered as weak

  12. Rheumatic Heart Disease-Attributable Mortality at Ages 5-69 Years in Fiji: A Five-Year, National, Population-Based Record-Linkage Cohort Study.

    Science.gov (United States)

    Parks, Tom; Kado, Joseph; Miller, Anne E; Ward, Brenton; Heenan, Rachel; Colquhoun, Samantha M; Bärnighausen, Till W; Mirabel, Mariana; Bloom, David E; Bailey, Robin L; Tukana, Isimeli N; Steer, Andrew C

    2015-01-01

    Rheumatic heart disease (RHD) is considered a major public health problem in developing countries, although scarce data are available to substantiate this. Here we quantify mortality from RHD in Fiji during 2008-2012 in people aged 5-69 years. Using 1,773,999 records derived from multiple sources of routine clinical and administrative data, we used probabilistic record-linkage to define a cohort of 2,619 persons diagnosed with RHD, observed for all-cause mortality over 11,538 person-years. Using relative survival methods, we estimated there were 378 RHD-attributable deaths, almost half of which occurred before age 40 years. Using census data as the denominator, we calculated there were 9.9 deaths (95% CI 9.8-10.0) and 331 years of life-lost (YLL, 95% CI 330.4-331.5) due to RHD per 100,000 person-years, standardised to the portion of the WHO World Standard Population aged 0-69 years. Valuing life using Fiji's per-capita gross domestic product, we estimated these deaths cost United States Dollar $6,077,431 annually. Compared to vital registration data for 2011-2012, we calculated there were 1.6-times more RHD-attributable deaths than the number reported, and found our estimate of RHD mortality exceeded all but the five leading reported causes of premature death, based on collapsed underlying cause-of-death diagnoses. Rheumatic heart disease is a leading cause of premature death as well as an important economic burden in this setting. Age-standardised death rates are more than twice those reported in current global estimates. Linkage of routine data provides an efficient tool to better define the epidemiology of neglected diseases.

  13. Rheumatic Heart Disease-Attributable Mortality at Ages 5–69 Years in Fiji: A Five-Year, National, Population-Based Record-Linkage Cohort Study

    Science.gov (United States)

    Parks, Tom; Kado, Joseph; Miller, Anne E.; Ward, Brenton; Heenan, Rachel; Colquhoun, Samantha M.; Bärnighausen, Till W.; Mirabel, Mariana; Bloom, David E.; Bailey, Robin L.; Tukana, Isimeli N.; Steer, Andrew C.

    2015-01-01

    Background Rheumatic heart disease (RHD) is considered a major public health problem in developing countries, although scarce data are available to substantiate this. Here we quantify mortality from RHD in Fiji during 2008–2012 in people aged 5–69 years. Methods and Findings Using 1,773,999 records derived from multiple sources of routine clinical and administrative data, we used probabilistic record-linkage to define a cohort of 2,619 persons diagnosed with RHD, observed for all-cause mortality over 11,538 person-years. Using relative survival methods, we estimated there were 378 RHD-attributable deaths, almost half of which occurred before age 40 years. Using census data as the denominator, we calculated there were 9.9 deaths (95% CI 9.8–10.0) and 331 years of life-lost (YLL, 95% CI 330.4–331.5) due to RHD per 100,000 person-years, standardised to the portion of the WHO World Standard Population aged 0–69 years. Valuing life using Fiji’s per-capita gross domestic product, we estimated these deaths cost United States Dollar $6,077,431 annually. Compared to vital registration data for 2011–2012, we calculated there were 1.6-times more RHD-attributable deaths than the number reported, and found our estimate of RHD mortality exceeded all but the five leading reported causes of premature death, based on collapsed underlying cause-of-death diagnoses. Conclusions Rheumatic heart disease is a leading cause of premature death as well as an important economic burden in this setting. Age-standardised death rates are more than twice those reported in current global estimates. Linkage of routine data provides an efficient tool to better define the epidemiology of neglected diseases. PMID:26371755

  14. Rheumatic Heart Disease-Attributable Mortality at Ages 5-69 Years in Fiji: A Five-Year, National, Population-Based Record-Linkage Cohort Study.

    Directory of Open Access Journals (Sweden)

    Tom Parks

    Full Text Available Rheumatic heart disease (RHD is considered a major public health problem in developing countries, although scarce data are available to substantiate this. Here we quantify mortality from RHD in Fiji during 2008-2012 in people aged 5-69 years.Using 1,773,999 records derived from multiple sources of routine clinical and administrative data, we used probabilistic record-linkage to define a cohort of 2,619 persons diagnosed with RHD, observed for all-cause mortality over 11,538 person-years. Using relative survival methods, we estimated there were 378 RHD-attributable deaths, almost half of which occurred before age 40 years. Using census data as the denominator, we calculated there were 9.9 deaths (95% CI 9.8-10.0 and 331 years of life-lost (YLL, 95% CI 330.4-331.5 due to RHD per 100,000 person-years, standardised to the portion of the WHO World Standard Population aged 0-69 years. Valuing life using Fiji's per-capita gross domestic product, we estimated these deaths cost United States Dollar $6,077,431 annually. Compared to vital registration data for 2011-2012, we calculated there were 1.6-times more RHD-attributable deaths than the number reported, and found our estimate of RHD mortality exceeded all but the five leading reported causes of premature death, based on collapsed underlying cause-of-death diagnoses.Rheumatic heart disease is a leading cause of premature death as well as an important economic burden in this setting. Age-standardised death rates are more than twice those reported in current global estimates. Linkage of routine data provides an efficient tool to better define the epidemiology of neglected diseases.

  15. Increased risk of nonalcoholic fatty liver disease with occupational stress in Chinese policemen: A 4-year cohort study.

    Science.gov (United States)

    Li, Chen; Xing, Jing-Jing; Shan, An-Qi; Leng, Ling; Liu, Jin-Chuan; Yue, Song; Yu, Hao; Chen, Xi; Tian, Feng-Shi; Tang, Nai-Jun

    2016-11-01

    Nonalcoholic fatty liver disease (NAFLD) and occupational stress have been recognized as major public health concerns. We aimed to explore whether occupational stress was associated with NAFLD in a police population.A total of 6559 male police officers were recruited for this prospective study in April 2007. Among them, 2367 eligible subjects participated in follow-up from 2008 to 2011. NAFLD was diagnosed based on standard criteria. Occupational stress was evaluated by Occupational Stress Inventory-Revised scores.The incidence of NAFLD was 31.2% in the entire police. After adjusting for traditional risk factors, moderate occupational stress (MOS), high occupational stress (HOS), and high personal strain (HPS) were risk factors (MOS: hazard ratio [HR] = 1.237, 95% confidence interval [CI] = 1.049-1.460; HOS: HR = 1.727, 95% CI = 1.405-2.124; HPS: HR = 3.602, 95% CI = 1.912-6.787); and low occupational stress (LOS) and low personal strain (LPS) were protective factors (LOS: HR = 0.366, 95% CI = 0.173-0.776; LPS: HR = 0.490, 95% CI = 0.262-0.919) for NAFLD in the entire police cohort. HOS and HPS remained robust among traffic police.HOS and HPS were independent predictors for the development of NAFLD in a Chinese police population. Additional future prospective investigations are warranted to validate our findings.

  16. [Long-term infectious risks after splenectomy: A retrospective cohort study with up to 10 years follow-up].

    Science.gov (United States)

    Meriglier, E; Puyade, M; Carretier, M; Roblot, F; Roblot, P

    2017-07-01

    Although most infections occur within the first 2 years after splenectomy, the relatively short follow-up reported in many studies may underestimate the frequency of infections. The objective of the study was to determine the incidence of infective outcomes and factors associated with infection after splenectomy by studying a group of patients who underwent splenectomy over a 10-year period. A retrospective and monocentric study of patients who underwent splenectomy between January 1st, 1997 and December 31st, 2004 in a French university hospital. Age, sex, indication for splenectomy, infectious events, death, vaccination and antibiotic prophylaxis were collected in January 2015. One hundred and sixty-five patients were included. The most common reasons for splenectomy were therapeutic hematological indications (37.5%). Ninety-seven per cent received pneumococcal vaccine. Prophylactic antibiotics were prescribed in 78% of patients. Thirty-seven patients had 42 severe infections with a median incidence rate of 4 years after splenectomy (2 days-12 years). The rate of infection after splenectomy declined over time but 57% occurred after 2 years and 14.3% after 10 years. Respiratory infections were the most common sites of infections. The incidence of infection differed according to age was highest among the elderly (HR=6.2; 95%CI: 1.4-27.1; after 65 years old) and underlying reason for splenectomy (P=0.02). There is no difference with or without prophylactic antibiotics. After splenectomy, the incidence of severe infection declined over time but can occur after 10 years. The onset of infection is linked to age and reason for splenectomy. Copyright © 2017 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  17. Shift work and mental health sickness absence : A 10-year observational cohort study among male production workers

    NARCIS (Netherlands)

    Norder, Giny; Roelen, Corne A. M.; Bultmann, Ute; van der Klink, Jac J. L.

    Objectives Epidemiological studies investigating mental-health-related sickness absence (SA) among shift workers are lacking. This 10-year observational study investigated the risk of mental health SA among shift compared with day workers. Methods The data of 5826 male production workers were used

  18. Prevalence and Predictors of Persistent Speech Sound Disorder at Eight Years Old: Findings from a Population Cohort Study

    Science.gov (United States)

    Wren, Yvonne; Miller, Laura L.; Peters, Tim J.; Emond, Alan; Roulstone, Sue

    2016-01-01

    Purpose: The purpose of this study was to determine prevalence and predictors of persistent speech sound disorder (SSD) in children aged 8 years after disregarding children presenting solely with common clinical distortions (i.e., residual errors). Method: Data from the Avon Longitudinal Study of Parents and Children (Boyd et al., 2012) were used.…

  19. Prostate-specific antigen (PSA) testing of men in UK general practice: a 10-year longitudinal cohort study.

    Science.gov (United States)

    Young, Grace J; Harrison, Sean; Turner, Emma L; Walsh, Eleanor I; Oliver, Steven E; Ben-Shlomo, Yoav; Evans, Simon; Lane, J Athene; Neal, David E; Hamdy, Freddie C; Donovan, Jenny L; Martin, Richard M; Metcalfe, Chris

    2017-10-30

    Cross-sectional studies suggest that around 6% of men undergo prostate-specific antigen (PSA) testing each year in UK general practice (GP). This longitudinal study aims to determine the cumulative testing pattern of men over a 10-year period and whether this testing can be considered equivalent to screening for prostate cancer (PCa). Patient-level data on PSA tests, biopsies and PCa diagnoses were obtained from the UK Clinical Practice Research Datalink (CPRD) for the years 2002 to 2011. The cumulative risks of PSA testing and of being diagnosed with PCa were estimated for the 10-year study period. Associations of a man's age, region and index of multiple deprivation with the cumulative risk of PSA testing and PCa diagnosis were investigated. Rates of biopsy and diagnosis, following a high test result, were compared with those from the programme of PSA testing in the Prostate Testing for Cancer and Treatment (ProtecT) study. The 10-year risk of exposure to at least one PSA test in men aged 45 to 69 years in UK GP was 39.2% (95% CI 39.0 to 39.4%). The age-specific risks ranged from 25.2% for men aged 45-49 years to 53.0% for men aged 65-69 years (p for trend PSA level ≥3, a test in UK GP was less likely to result in a biopsy (6%) and/or diagnosis of PCa (15%) compared with ProtecT study participants (85% and 34%, respectively). A high proportion of men aged 45-69 years undergo PSA tests in UK GP: 39% over a 10-year period. A high proportion of these tests appear to be for the investigation of lower urinary tract symptoms and not screening for PCa. ISRCTN20141297,NCT02044172. © 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.

  20. Iron-Folic Acid Supplementation During Pregnancy Reduces the Risk of Stunting in Children Less Than 2 Years of Age: A Retrospective Cohort Study from Nepal

    Directory of Open Access Journals (Sweden)

    Yasir Bin Nisar

    2016-01-01

    Full Text Available The aim of the study was to investigate the effect of antenatal iron-folic acid (IFA supplementation on child stunting in Nepalese children age <2 years. A retrospective cohort study design was used, in which a pooled cohort of 5235 most recent live births 2 years prior to interview from three Nepal Demographic and Health Surveys (2001, 2006 and 2011 was analysed. The primary outcome was stunting in children age <2 years. The main exposure variable was antenatal IFA supplementation. Multivariate Poisson regression analysis was performed. In our sample, 31% and 10% of Nepalese children age <2 years were stunted and severely stunted, respectively. The adjusted relative risk of being stunted was 14% lower in children whose mothers used IFA supplements compared to those whose mothers did not use (aRR = 0.86, 95% CI = 0.77–0.97. Additionally, the adjusted relative risk of being stunted was significantly reduced by 23% when antenatal IFA supplementation was started ≤6 months with ≥90 IFA supplements used during pregnancy (aRR = 0.77, 95% CI = 0.64–0.92. Antenatal IFA supplementation significantly reduced the risk of stunting in Nepalese children age <2 years. The greatest impact on the risk reduction of child stunting was when IFA supplements were started ≤6 months with ≥90 supplements were used.

  1. Prognostic factors for work ability in women with chronic low back pain consulting primary health care: a 2-year prospective longitudinal cohort study.

    Science.gov (United States)

    Nordeman, Lena; Gunnarsson, Ronny; Mannerkorpi, Kaisa

    2014-05-01

    To investigate prognostic factors for future work ability in women with chronic low back pain (CLBP) consulting primary health care. A 2-year prospective longitudinal cohort study of female patients with CLBP within the primary health care was conducted. Patients were assessed at the first assessment and after 2 years. Prognostic factors for work ability (yes/no) were analyzed by multivariate regression. A total of 130 patients were included at first assessment. After 2 years, 123 patients (95%) were followed up. The 6-minute walk test, depression, and earlier work ability predicted work ability at the 2-year follow-up. A nomogram was constructed to assess the probability of future work ability. The 6-minute walk test, work ability, and depression predicted work ability for women with CLBP after 2 years.

  2. One-Year Effect of the Medicare Annual Wellness Visit on Detection of Cognitive Impairment: A Cohort Study.

    Science.gov (United States)

    Fowler, Nicole R; Campbell, Noll L; Pohl, Gerhardt M; Munsie, Leanne M; Kirson, Noam Y; Desai, Urvi; Trieschman, Erich J; Meiselbach, Mark K; Andrews, J Scott; Boustani, Malaz A

    2018-04-02

    To examine the effect of the Medicare Annual Wellness Visit (AWV) on the detection of cognitive impairment and on follow-up cognitive care for older adults. Retrospective matched-cohort study. United States. A 5% random sample of fee-for-service Medicare beneficiaries continuously enrolled for 12 months before and after an index ambulatory visit occurring from 2011 to 2013 with no claims evidence of cognitive impairment before index. Outcomes include 12-month post-index visit claims-based measurements of cognitive impairment, including new Alzheimer's disease and related dementia (ADRD) diagnoses; medications for ADRD; and cognitive care-related diagnostic examination such as neurobehavioral testing, brain imaging, and blood tests for thyroid-stimulating hormone (TSH), serum B12, folate, and syphilis. We also measured changes in burden of anticholinergic medication. There were no clinically relevant differences between the AWV and control groups in the rates of incident ADRD diagnoses (6.16% vs 6.86%, p<.001) and initiation of ADRD medications (1.00% vs 1.08%, p=.15), although there were differences favoring the AWV group in rates of TSH (39.80% vs 28.36%, p<.001), B12 (9.41% vs 6.97%, p<.001), folate (4.76% vs 3.72%, p<.001), and neurobehavioral (0.75% vs 0.55%, p<.001) testing. Although the AWV is correlated with an increase in some measures of cognitive care, such as laboratory testing for reversible causes of cognitive impairment, it does not appear to substantially increase recognition of undetected ADRD. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

  3. Light drinking versus abstinence in pregnancy - behavioural and cognitive outcomes in 7-year-old children: a longitudinal cohort study.

    Science.gov (United States)

    Kelly, Y; Iacovou, M; Quigley, M A; Gray, R; Wolke, D; Kelly, J; Sacker, A

    2013-10-01

    To assess whether light drinking in pregnancy is linked to unfavourable developmental outcomes in children. Prospective population-based cohort. UK. Ten thousand five hundred and thirty-four 7-year-olds. Quasi-experimental using propensity score matching (PSM) to compare children born to light (up to 2 units per week) and non-drinkers. Behavioural difficulties rated by parents and teachers; cognitive test scores for reading, maths and spatial skills. Ordinary least squares (OLS) regression and PSM analyses are presented. For behavioural difficulties, unadjusted estimates for percentage standard deviation (SD) score differences ranged from 2 to 14%. On adjustment for potential confounders, differences were attenuated, with a loss of statistical significance, except for teacher-rated boys' difficulties. For boys, parent-rated behavioural difficulties: unadjusted, -11.5; OLS, -4.3; PSM, -6.8; teacher-rated behavioural difficulties: unadjusted, -13.9; OLS, -9.6; PSM, -10.8. For girls, parent-rated behavioural difficulties: unadjusted, -9.6; OLS, -2.9; PSM, -4.5; teacher-rated behavioural difficulties: unadjusted, -2.4; OLS, 4.9; PSM, 3.9. For cognitive test scores, unadjusted estimates for differences ranged between 12 and 21% of an SD score for reading, maths and spatial skills. After adjustment for potential confounders, estimates were reduced, but remained statistically significantly different for reading and for spatial skills in boys. For boys, reading: unadjusted, 20.9; OLS, 8.3; PSM, 7.3; maths: unadjusted, 14.7; OLS, 5.0; PSM, 6.5; spatial skills: unadjusted, 16.2; OLS, 7.6; PSM, 8.1. For girls, reading: unadjusted, 11.6; OLS, -0.3; PSM, -0.5; maths: unadjusted, 12.9; OLS, 4.3; PSM, 3.9; spatial skills: unadjusted, 16.2; OLS, 7.7; PSM, 6.4. The findings suggest that light drinking during pregnancy is not linked to developmental problems in mid-childhood. These findings support current UK Department of Health guidelines on drinking during pregnancy. © 2013 The

  4. Acute respiratory symptoms and general illness during the first year of life: a population-based birth cohort study

    DEFF Research Database (Denmark)

    von Linstow, Marie-Louise; Holst, Klaus Kähler; Larsen, Karina

    2008-01-01

    . Determinants for respiratory symptoms were increasing age, winter season, household size, size of residence, day-care attendance, and having siblings aged 1-3 years attending a day nursery. In conclusion, the present study provides detailed data on the occurrence of disease symptoms during the first year......Respiratory symptoms are common in infancy. Most illnesses occurring among children are dealt with by parents and do not require medical attention. Nevertheless, few studies have prospectively and on a community-basis assessed the amount of respiratory symptoms and general illness in normal infants...... out by multiple logistic regression analysis. On average, children had general symptoms for 3.5 months during their first year of life, nasal discharge being most frequent followed by cough. Frequency of all symptoms increased steeply after 6 months of age. Each child had on average 6.3 episodes...

  5. Mediterranean diet adherence during pregnancy and risk of wheeze and eczema in the first year of life: INMA (Spain) and RHEA (Greece) mother-child cohort studies.

    Science.gov (United States)

    Chatzi, Leda; Garcia, Raquel; Roumeliotaki, Theano; Basterrechea, Mikel; Begiristain, Haizea; Iñiguez, Carmen; Vioque, Jesus; Kogevinas, Manolis; Sunyer, Jordi

    2013-12-14

    Maternal diet during pregnancy might influence the development of childhood allergic disorders. The aim of the present study was to evaluate the impact of Mediterranean diet (MD) adherence during pregnancy on wheeze and eczema in the first year of life in two population-based mother-child cohorts in Spain and Greece. We studied 1771 mother-newborn pairs from the Spanish multi-centre 'INMA' (INfancia y Medio Ambiente) study (Gipuzkoa, Sabadell and Valencia) and 745 pairs from the 'RHEA' study in Crete, Greece. The symptoms of wheeze and eczema were based on the criteria of the International Study of Asthma and Allergies in Childhood. Maternal diet during pregnancy was assessed by FFQ and MD adherence was evaluated through an a priori score. Multivariate log-binomial regression models were used to adjust for several confounders in each cohort and summary estimates were obtained by a meta-analysis. MD adherence was not associated with the risk of wheeze and eczema in any cohort, and similar results were identified in the meta-analysis approach. High meat intake (relative risk (RR) 1·22, 95 % CI 1·00, 1·49) and 'processed' meat intake (RR 1·18, 95 % CI 1·02, 1·37) during pregnancy were associated with an increased risk of wheeze in the first year of life, while a high intake of dairy products was significantly associated with a decreased risk of infantile wheeze (RR 0·83, 95 % CI 0·72, 0·96). The results of the present study show that high meat intake during pregnancy may increase the risk of wheeze in the first year of life, while a high intake of dairy products may decrease it.

  6. Back pain in children surveyed with weekly text messages - a 2.5 year prospective school cohort study

    DEFF Research Database (Denmark)

    Franz, Claudia; Wedderkopp, Niels; Jespersen, Eva

    2014-01-01

    BACKGROUND: Back pain is reported to occur already in childhood, but its development at that age is not well understood. The aims of this study were to describe BP in children aged 6-12 years, and to investigate any sex and age differences. METHODS: Data on back pain (defined as pain in the neck......, mid back and/or lower back) were collected once a week from parents replying to automated text-messages over 2.5 school years from 2008 till 2011. The prevalence estimates were presented as percentages and 95% confidence intervals. Differences between estimates were considered significant...

  7. Social Withdrawal Behaviour at One Year of Age Is Associated with Delays in Reaching Language Milestones in the EDEN Mother-Child Cohort Study.

    Directory of Open Access Journals (Sweden)

    Antoine Guedeney

    Full Text Available The aim of the study was to examine the relationship between social withdrawal behaviour at one year and motor and language milestones.One-year old children from the EDEN French population-based birth cohort study (Study on the pre- and postnatal determinants of the child's development and prospective health Birth Cohort Study were included. Social withdrawal at one year was assessed by trained midwives using the Alarm Distress BaBy (ADBB scale. Midwives concurrently examined infants' motor and language milestones. Parents reported on child's psychomotor and language milestones, during the interview with the midwife.After adjusting for potential confounding factors, social withdrawal behaviour was significantly associated with concurrent delays in motor and language milestones assessed by the midwife or the parents.Higher scores on social withdrawal behaviour as assessed with the ADBB were associated with delays in reaching language milestones, and to a lesser extent with lower motor ability scores. Taking the contribution of social withdrawal behaviour into account may help understand the unfolding of developmental difficulties in children.

  8. Social Withdrawal Behaviour at One Year of Age Is Associated with Delays in Reaching Language Milestones in the EDEN Mother-Child Cohort Study.

    Science.gov (United States)

    Guedeney, Antoine; Forhan, Anne; Larroque, Beatrice; de Agostini, Maria; Pingault, Jean-Baptiste; Heude, Barbara

    2016-01-01

    The aim of the study was to examine the relationship between social withdrawal behaviour at one year and motor and language milestones. One-year old children from the EDEN French population-based birth cohort study (Study on the pre- and postnatal determinants of the child's development and prospective health Birth Cohort Study) were included. Social withdrawal at one year was assessed by trained midwives using the Alarm Distress BaBy (ADBB) scale. Midwives concurrently examined infants' motor and language milestones. Parents reported on child's psychomotor and language milestones, during the interview with the midwife. After adjusting for potential confounding factors, social withdrawal behaviour was significantly associated with concurrent delays in motor and language milestones assessed by the midwife or the parents. Higher scores on social withdrawal behaviour as assessed with the ADBB were associated with delays in reaching language milestones, and to a lesser extent with lower motor ability scores. Taking the contribution of social withdrawal behaviour into account may help understand the unfolding of developmental difficulties in children.

  9. Prenatal exposure to airborne polycyclic aromatic hydrocarbons and children's intelligence at 5 years of age in a prospective cohort study in Poland.

    Science.gov (United States)

    Edwards, Susan Claire; Jedrychowski, Wieslaw; Butscher, Maria; Camann, David; Kieltyka, Agnieszka; Mroz, Elzbieta; Flak, Elzbieta; Li, Zhigang; Wang, Shuang; Rauh, Virginia; Perera, Frederica

    2010-09-01

    In this prospective cohort study of Caucasian mothers and children in Krakow, Poland, we evaluated the role of prenatal exposure to urban air pollutants in the pathogenesis of neurobehavioral disorders. The objective of this study was to investigate the relationship between prenatal polycyclic aromatic hydrocarbon (PAH) exposure and child intelligence at 5 years of age, controlling for potential confounders suspected to play a role in neurodevelopment. A cohort of pregnant, healthy, nonsmoking women was enrolled in Krakow, Poland, between 2001 and 2006. During pregnancy, participants were invited to complete a questionnaire and undergo 48-hr personal air monitoring to estimate their babies' exposure, and to provide a blood sample and/or a cord blood sample at the time of delivery. Two hundred fourteen children were followed through 5 years of age, when their nonverbal reasoning ability was assessed using the Raven Coloured Progressive Matrices (RCPM). We found that higher (above the median of 17.96 ng/m3) prenatal exposure to airborne PAHs (range, 1.8-272.2 ng/m3) was associated with decreased RCPM scores at 5 years of age, after adjusting for potential confounding variables (n = 214). Further adjusting for maternal intelligence, lead, or dietary PAHs did not alter this association. The reduction in RCPM score associated with high airborne PAH exposure corresponded to an estimated average decrease of 3.8 IQ points. These results suggest that prenatal exposure to airborne PAHs adversely affects children's cognitive development by 5 years of age, with potential implications for school performance. They are consistent with a recent finding in a parallel cohort in New York City.

  10. The prevalence of depressive symptoms among fathers and associated risk factors during the first seven years of their child’s life: findings from the Millennium Cohort Study

    Directory of Open Access Journals (Sweden)

    Selina Nath

    2016-06-01

    Full Text Available Abstract Background Increasing evidence suggests that postnatal paternal depression is associated with adverse emotional, behavioural and cognitive outcomes in children. Despite this, few studies have determined the prevalence of fathers’ depressive symptoms during the first few years of their children’s lives and explored what factors are related to these symptoms. We estimated the prevalence and examined associated risk factors of paternal depressive symptoms in a nationally representative sample of fathers with children aged between 9 months and 7 years old from the Millennium cohort study. The risk factors examined were maternal depressive symptoms, marital conflict, child temperament, child gender, paternal education, fathers’ ethnic background, fathers’ employment status, family housing, family income and paternal age. Methods Secondary data analysis was conducted using the UK Millennium cohort study, which consisted of data from England, Scotland, Wales and Northern Ireland of families with infants born in the year 2000/2001. Data from four sweeps were used from when children in the cohort were aged 9 months, 3, 5 and 7 years old (n = 5155–12,396. Results The prevalence of paternal depressive symptoms over time was 3.6 % at 9 months, 1.2 % at 3 years old, 1.8 % at 5 years and 2.0 % at 7 years (using Kessler cut-off points to categorise high depressive symptoms vs low depressive symptoms. Linear regression trends (using continuous measures of depressive symptoms indicated that both paternal and maternal depressive symptoms decreased over time, suggesting similar patterns of parents’ depressive symptoms after the birth of a child, but the decrease was more evident for mothers. Paternal depressive symptoms were consistently associated with fathers’ unemployment, maternal depressive symptoms and marital conflict. Socioeconomic factors such as rented housing when child was 9 months and low family income when

  11. Clinical and ultrasonographic features associated to response to intraarticular corticosteroid injection. A one year follow up prospective cohort study in knee osteoarthritis patient with joint effusion

    Science.gov (United States)

    Galisteo, Carlos; García-Manrique, María; Navarro, Noemí; Caixàs, Assumpta; Larrosa, Marta; Gratacós, Jordi

    2018-01-01

    Objectives Intraarticular injection is used for pain relief in knee osteoarthritis (OA), but there is not a well defined profile of patient who could get more benefit from it. The purpose of this study was to evaluate the frequency of pain relief at one year after corticosteroids intraarticular injection and to identify clinical factors associated to response in patients with knee osteoarthritis with joint effusion. Methods One-year prospective cohort study of patients with knee OA with joint effusion confirmed by ultrasound. An intraarticular injection was performed following a clinical protocol. Anthropometric measurements, laboratory parameters, clinical severity, ultrasound parameters and radiological severity were collected. Response regarding pain and presence of synovial fluid on ultrasound at one month and at one year were evaluated. Clinical responder were consider in subjects with enough improvement to carry out normal daily activities with pain VASeffusion. PMID:29351562

  12. Design and baseline characteristics of a coronary heart disease prospective cohort: two-year experience from the strategy of registry of acute coronary syndrome study (ERICO study

    Directory of Open Access Journals (Sweden)

    Alessandra C. Goulart

    2013-01-01

    Full Text Available OBJECTIVES: To describe the ERICO study (Strategy of Registry of Acute Coronary Syndrome, a prospective cohort to investigate the epidemiology of acute coronary syndrome. METHODS: The ERICO study, which is being performed at a secondary general hospital in São Paulo, Brazil, is enrolling consecutive acute coronary syndrome patients who are 35 years old or older. The sociodemographic information, medical assessments, treatment data and blood samples are collected at admission. After 30 days, the medical history is updated, and additional blood and urinary samples are collected. In addition, a retinography, carotid intima-media thickness, heart rate variability and pulse-wave velocity are performed. Questionnaires about food frequency, physical activity, sleep apnea and depression are also applied. At six months and annually after an acute event, information is collected by telephone. RESULTS: From February 2009 to September 2011, 738 patients with a diagnosis of an acute coronary syndrome were enrolled. Of these, 208 (28.2% had ST-elevation myocardial infarction (STEMI, 288 (39.0% had non-ST-elevation myocardial infarction (NSTEMI and 242 (32.8% had unstable angina (UA. The mean age was 62.7 years, 58.5% were men and 77.4% had 8 years or less of education. The most common cardiovascular risk factors were hypertension (76% and sedentarism (73.4%. Only 29.2% had a prior history of coronary heart disease. Compared with the ST-elevation myocardial infarction subgroup, the unstable angina and non-ST-elevation myocardial infarction patients had higher frequencies of hypertension, diabetes, prior coronary heart disease (p<0.001 and dyslipidemia (p = 0.03. Smoking was more frequent in the ST-elevation myocardial infarction patients (p = 0.006. CONCLUSIONS: Compared with other hospital registries, our findings revealed a higher burden of CV risk factors and less frequent prior CHD history.

  13. The natural course of eczema from birth to age 7 years and the association with asthma and allergic rhinitis: a population-based birth cohort study.

    Science.gov (United States)

    Shen, Chian-Yin; Lin, Ming-Chih; Lin, Heng-Kuei; Lin, Ching-Heng; Fu, Lin-Shien; Fu, Yun-Chin

    2013-01-01

    Although "atopic march" is a popular concept, the relationship between eczema and subsequent asthma is far from clear. However, some cohort studies have shown the possibility of two different allergic phenotypes in those who present with early eczema in terms of their persistency. We checked the cohort data from 308,849 children born in 2000 in Taiwan, to evaluate the different courses of eczema and their relationships to subsequent asthma and allergic rhinitis (AR) at age 7 years. We examined the age prevalence of eczema, asthma, and AR up to 7 years of age. We grouped all cases according to their course of eczema, as well as wheezing, and determined the rates of asthma and AR at age 7 years. We checked the adjusted risk factors by multiple logistic regression model. We also examined the distributions of wheezing types in different eczema groups. We found the "atopic march" pattern of allergic diseases based on their age prevalence. Early eczema was associated with asthma and AR at the age of 7 years. Those with eczema symptoms persisting after 36 months of age had a higher risk than those with transient eczema. Early wheeze also contributed to asthma and AR later in childhood. In addition, late-onset eczema had a completely different wheeze distribution compared with other groups and also had a higher risk for asthma and AR than transient eczema. In conclusion, different eczema phenotypes could be found in this population-based cohort. This article emphasizes the special attention to the persistency and late-onset eczema in clinical practice.

  14. Lower Incidence of End-Stage Renal Disease but Suboptimal Pre-Dialysis Renal Care in Schizophrenia: A 14-Year Nationwide Cohort Study.

    Directory of Open Access Journals (Sweden)

    Yueh-Han Hsu

    Full Text Available Schizophrenia is closely associated with cardiovascular risk factors which are consequently attributable to the development of chronic kidney disease and end-stage renal disease (ESRD. However, no study has been conducted to examine ESRD-related epidemiology and quality of care before starting dialysis for patients with schizophrenia. By using nationwide health insurance databases, we identified 54,361 ESRD-free patients with schizophrenia and their age-/gender-matched subjects without schizophrenia for this retrospective cohort study (the schizophrenia cohort. We also identified a cohort of 1,244 adult dialysis patients with and without schizophrenia (1:3 to compare quality of renal care before dialysis and outcomes (the dialysis cohort. Cox proportional hazard models were used to estimate the hazard ratio (HR for dialysis and death. Odds ratio (OR derived from logistic regression models were used to delineate quality of pre-dialysis renal care. Compared to general population, patients with schizophrenia were less likely to develop ESRD (HR = 0.6; 95% CI 0.4-0.8, but had a higher risk for death (HR = 1.2; 95% CI, 1.1-1.3. Patients with schizophrenia at the pre-ESRD stage received suboptimal pre-dialysis renal care; for example, they were less likely to visit nephrologists (OR = 0.6; 95% CI, 0.4-0.8 and received fewer erythropoietin prescriptions (OR = 0.7; 95% CI, 0.6-0.9. But they had a higher risk of hospitalization in the first year after starting dialysis (OR = 1.4; 95% CI, 1.0-1.8, P < .05. Patients with schizophrenia undertaking dialysis had higher risk for mortality than the general ESRD patients. A closer collaboration between psychiatrists and nephrologists or internists to minimize the gaps in quality of general care is recommended.

  15. Exposure to psychosocial job strain during pregnancy and odds of asthma and atopic dermatitis among 7-year old children – a prospective cohort study

    DEFF Research Database (Denmark)

    Larsen, Ann Dyreborg; Schlünssen, Vivi; Christensen, Berit Hvass

    2014-01-01

    OBJECTIVES: Few epidemiological studies have studied maternal stress exposure during pregnancy and odds of asthma and atopic dermatitis (AD) among offspring, and none have extended the focus to psychosocial job strain. The aim of this study was to assess the association between maternal job strain...... during pregnancy and asthma as well as AD among 7-year-old children. METHODS: The study is based on the Danish National Birth Cohort and includes prospective data from 32 104 pregnancies. Job strain was assessed early in pregnancy by use of two questions on demands and control. We categorized...... regression models were used to estimate odds ratios (OR) with 95% confidence intervals (95% CI) adjusted for several covariates. RESULTS: Maternal exposure to self-reported high strain during pregnancy was associated with 15% higher odds of atopic dermatitis among 7-year-old children (OR adj1.15, 95% CI 1...

  16. Cardiovascular and Metabolic Diseases Etiology Research Center (CMERC cohort: study protocol and results of the first 3 years of enrollment

    Directory of Open Access Journals (Sweden)

    Jee-Seon Shim

    2017-04-01

    Full Text Available Although the etiologies of cardiovascular disease (CVD are widely understood, the goal of finding a globally effective solution for preventing CVD is unrealistic. Therefore, we aimed to conduct a community-based prospective study on the prevention and management of CVD in Korean adults. This study was designed to recruit 8,000 healthy adults over the course of 5 years. The baseline assessment includes a wide range of established CVD risk factors, including demographic characteristics, medical history, health behaviors, psychological conditions, body size and composition, blood pressure, the augmentation index, carotid ultrasonography, an electrocardiogram, and biochemical indicators, as well as some novel factors, such as social network characteristics, exposure to environmental pollutants, inflammatory markers, hemostatic markers, and immunosenescence markers. Annual telephone interviews and follow-up health examinations at 5-year intervals after the baseline assessment are planned to collect information on changes in health status and its determinants. Additionally, indirect follow-up using secondary data sources will be conducted to obtain information on health services utilization and death. So far, more than 6,000 adults have been enrolled during the first three and a half years, and almost all participants have been tracked by annual telephone follow-up surveys. The data have been uploaded to iCReaT, the clinical research information management system of the Korea National Institute of Health.

  17. Antipsychotic adjunctive therapy to mood stabilizers and 1-year rehospitalization rates in bipolar disorder: A cohort study.

    Science.gov (United States)

    Hochman, Eldar; Krivoy, Amir; Schaffer, Ayal; Weizman, Abraham; Valevski, Avi

    2016-12-01

    Antipsychotic adjunctive therapy to mood stabilizers (MSs) may improve relapse prevention; however, only a few naturalistic studies, reflecting more generalizable bipolar disorder (BD) samples, support this notion. We compared the 1-year rehospitalization rates of manic patients with bipolar I disorder (BD-I) who were discharged with MS (lithium or valproate) monotherapy or with adjunctive atypical or typical antipsychotic therapy. A total of 201 patients with BD-I who were hospitalized with manic episodes between 2005 and 2013 were retrospectively followed for 1-year rehospitalization rates according to treatment at discharge: MS monotherapy, MS with atypical antipsychotics, and MS with typical antipsychotics. Additionally, time to rehospitalization during the 1-year period after discharge was compared between treatment groups. Multivariable survival analyses adjusted for covariates known to influence rehospitalization were conducted. Rehospitalization rates within 1 year were significantly lower in the MS with atypical antipsychotics group (6.3%) compared to the MS monotherapy group (24.3%, P=.008) and to the MS with typical antipsychotics group (20.6%, P=.02). Time to rehospitalization was significantly longer for the MS with atypical antipsychotics group (345.5 days) compared to the MS monotherapy group (315.1 days, P=.006) and to the MS with typical antipsychotics group (334.1 days, P=.02). The MS with atypical antipsychotics group had a significantly reduced adjusted risk of rehospitalization (hazard ratio=0.17, 95% confidence interval: 0.05-0.61, P=.007) compared to the MS monotherapy group. Atypical antipsychotic adjunctive therapy to MSs may be more effective than MS monotherapy in preventing rehospitalization during the 1-year period after a BD manic episode. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Social class and gender patterning of insomnia symptoms and psychiatric distress: a 20-year prospective cohort study.

    Science.gov (United States)

    Green, Michael J; Espie, Colin A; Benzeval, Michael

    2014-05-25

    Psychiatric distress and insomnia symptoms exhibit similar patterning by gender and socioeconomic position. Prospective evidence indicates a bi-directional relationship between psychiatric distress and insomnia symptoms so similarities in social patterning may not be coincidental. Treatment for insomnia can also improve distress outcomes. We investigate the extent to which the prospective patterning of distress over 20 years is associated with insomnia symptoms over that period. 999 respondents to the Twenty-07 Study had been followed for 20 years from approximately ages 36-57 (73.2% of the living baseline sample). Psychiatric distress was measured using the GHQ-12 at baseline and at 20-year follow-up. Gender and social class were ascertained at baseline. Insomnia symptoms were self-reported approximately every five years. Latent class analysis was used to classify patterns of insomnia symptoms over the 20 years. Structural Equation Models were used to assess how much of the social patterning of distress was associated with insomnia symptoms. Missing data was addressed with a combination of multiple-imputation and weighting. Patterns of insomnia symptoms over 20 years were classified as either healthy, episodic, developing or chronic. Respondents from a manual social class were more likely to experience episodic, developing or chronic patterns than those from non-manual occupations but this was mostly explained by baseline psychiatric distress. People in manual occupations experiencing psychiatric distress however were particularly likely to experience chronic patterns of insomnia symptoms. Women were more likely to experience a developing pattern than men, independent of baseline distress. Psychiatric distress was more persistent over the 20 years for those in manual social classes and this effect disappeared when adjusting for insomnia symptoms. Irrespective of baseline symptoms, women, and especially those in a manual social class, were more likely than men to

  19. Lung function decline over 25 years of follow-up among black and white adults in the ARIC study cohort.

    Science.gov (United States)

    Mirabelli, Maria C; Preisser, John S; Loehr, Laura R; Agarwal, Sunil K; Barr, R Graham; Couper, David J; Hankinson, John L; Hyun, Noorie; Folsom, Aaron R; London, Stephanie J

    2016-04-01

    Interpretation of longitudinal information about lung function decline from middle to older age has been limited by loss to follow-up that may be correlated with baseline lung function or the rate of decline. We conducted these analyses to estimate age-related decline in lung function across groups of race, sex, and smoking status while accounting for dropout from the Atherosclerosis Risk in Communities Study. We analyzed data from 13,896 black and white participants, aged 45-64 years at the 1987-1989 baseline clinical examination. Using spirometry data collected at baseline and two follow-up visits, we estimated annual population-averaged mean changes in forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) by race, sex, and smoking status using inverse-probability-weighted independence estimating equations conditioning-on-being-alive. Estimated rates of FEV1 decline estimated using inverse-probability-weighted independence estimating equations conditioning on being alive were higher among white than black participants at age 45 years (e.g., male never smokers: black: -29.5 ml/year; white: -51.9 ml/year), but higher among black than white participants by age 75 (black: -51.2 ml/year; white: -26). Observed differences by race were more pronounced among men than among women. By smoking status, FEV1 declines were larger among current than former or never smokers at age 45 across all categories of race and sex. By age 60, FEV1 decline was larger among former and never than current smokers. Estimated annual declines generated using unweighted generalized estimating equations were smaller for current smokers at younger ages in all four groups of race and sex compared with results from weighted analyses that accounted for attrition. Using methods accounting for dropout from an approximately 25-year health study, estimated rates of lung function decline varied by age, race, sex, and smoking status, with largest declines observed among current

  20. Factors associated with health-related quality of life after stroke: a 1-year prospective cohort study.

    Science.gov (United States)

    Algurén, Beatrix; Fridlund, Bengt; Cieza, Alarcos; Sunnerhagen, Katharina Stibrant; Christensson, Lennart

    2012-01-01

    In line with patient-centered health care, it is necessary to understand patients' perceptions of health. How stroke survivors perceive their health at different time points after stroke and which factors are associated with these feelings provide important information about relevant rehabilitation targets. This study aimed to identify the independent factors of health-related quality of life (HRQoL) from a biopsychosocial perspective using the methods of multivariate regression at 3 different time points poststroke. Included in the study were 99 patients from stroke units with diagnosed first-ever stroke. At admission and at 6 weeks, 3 months, and 1 year poststroke, HRQoL was assessed using the EuroQoL-5D Visual Analogue Scale (EQ-5D VAS). Consequences in Body Functions and Activities and Participation, and Environmental Factors were documented using 155 categories of the International Classification of Functioning, Disability and Health (ICF) Core Set for Stroke. For a period of 1 year, problems with recreation and leisure, personality functions, energy and drive functions, and gait pattern functions were repeatedly associated with worse HRQoL. Whereas Body Functions and Activities and Participation explained more than three-fourths of the variances of HRQoL at 6 weeks and 3 months (R² = 0.80-0.93), the variation at 1 year was best explained by either Body Functions or Environmental Factors (R² = 0.51). The results indicate the importance of Body Functions and Activities and Participation (mainly personality functions and recreation and leisure) on HRQoL within 3 months poststroke, but increased impact of Environmental Factors on HRQoL at 1 year.

  1. Risk factors for late-onset generalized anxiety disorder: results from a 12-year prospective cohort (the ESPRIT study).

    Science.gov (United States)

    Zhang, X; Norton, J; Carrière, I; Ritchie, K; Chaudieu, I; Ancelin, M-L

    2015-03-31

    Generalized anxiety disorder (GAD) is a chronic and highly prevalent disorder associated with increased disability and mortality in the elderly. Treatment is difficult with low rate of full remission, thus highlighting the need to identify early predictors for prevention in elderly people. The aim of this study is to identify and characterize incident GAD predictors in elderly people. A total of 1711 individuals aged 65 years and above and free of GAD at baseline were randomly recruited from electoral rolls between 1999 and 2001 (the prospective ESPRIT study). The participants were examined at baseline and five times over 12 years. GAD and psychiatric comorbidity were diagnosed with a standardized psychiatric examination, the Mini-International Neuropsychiatry Interview on the basis of DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, fourth edition) criteria and validated by a clinical panel. During the follow-up, 8.4% (95% confidence interval=7.1-9.7%) of the participants experienced incident GAD, 80% being first episodes; the incident rate being 10 per 1000 person-years. The principal predictors of late-onset incident GAD over 12 years derived from a multivariate Cox model were being female, recent adverse life events, having chronic physical (respiratory disorders, arrhythmia and heart failure, dyslipidemia, cognitive impairment) and mental (depression, phobia and past GAD) health disorders. Poverty, parental loss or separation and low affective support during childhood, as well as history of mental problems in parents were also significantly and independently associated with incident GAD. GAD appears as a multifactorial stress-related affective disorder resulting from both proximal and distal risk factors, some of them being potentially modifiable by health care intervention.

  2. Falls in advanced old age: recalled falls and prospective follow-up of over-90-year-olds in the Cambridge City over-75s Cohort study

    Directory of Open Access Journals (Sweden)

    Matthews Fiona E

    2008-03-01

    Full Text Available Abstract Background The "oldest old" are now the fastest growing section of most western populations, yet there are scarcely any data concerning even the common problem of falls amongst the very old. Prospective data collection is encouraged as the most reliable method for researching older people's falls, though in clinical practice guidelines advise taking a history of any recalled falls. This study set out to inform service planning by describing the epidemiology of falls in advanced old age using both retrospectively and prospectively collected falls data. Methods Design: Re-survey of over-90-year-olds in a longitudinal cohort study – cross-sectional interview and intensive 12-month follow-up. Participants and setting: 90 women and 20 men participating in a population-based cohort (aged 91–105 years, in care-homes and community-dwelling recruited from representative general practices in Cambridge, UK Measurements: Prospective falls data were collected using fall calendars and telephone follow-up for one year after cross-sectional survey including fall history. Results 58% were reported to have fallen at least once in the previous year and 60% in the 1-year follow-up. The proportion reported to have fallen more than once was lower using retrospective recall of the past year than prospective reports gathered the following year (34% versus 45%, as were fall rates (1.6 and 2.8 falls/person-year respectively. Repeated falls in the past year were more highly predictive of falls during the following year – IRR 4.7, 95% CI 2.6–8.7 – than just one – IRR 3.6, 95% CI 2.0–6.3, using negative binomial regression. Only 1/5 reportedly did not fall during either the year before or after interview. Conclusion Fall rates in this representative sample of over-90-year-olds are even higher than previous reports from octogenarians. Recalled falls last year, particularly repeated falls, strongly predicted falls during follow-up. Similar proportions

  3. Does the level of physical activity in university students influence development and progression of myopia? - A 2-year prospective cohort study

    DEFF Research Database (Denmark)

    Jacobsen, Niels; Jensen, Hanne; Goldschmidt, E.

    2008-01-01

    PURPOSE. To study whether physical activity has a protective effect on the development and progression of myopia in medical students. METHODS. In a 2-year longitudinal cohort study, 156 Caucasian first-year medical students from the University of Copenhagen were enrolled. The baseline examination...... with a refractive change toward myopia, whereas physical activity was inversely associated with a refractive change toward myopia (P = 0.015). Myopic eyes progressed significantly more than did emmetropic and hyperopic eyes (P = 0.002). CONCLUSIONS. An association between physical activity and myopia was observed......, suggesting a protective effect of physical activity on the development and progression of myopia in university students. The results confirm that intensive studying is a risk factor of myopia and that myopic progression or development is more likely in medical students in their early 20s than in their late...

  4. Childhood respiratory illness presentation and service utilisation in primary care: a six-year cohort study in Wellington, New Zealand, using natural language processing (NLP) software.

    Science.gov (United States)

    Dowell, Anthony; Darlow, Ben; Macrae, Jayden; Stubbe, Maria; Turner, Nikki; McBain, Lynn

    2017-08-01

    To identify childhood respiratory tract-related illness presentation rates and service utilisation in primary care by interrogating free text and coded data from electronic medical records. Retrospective cohort study. Data interrogation used a natural language processing software inference algorithm. 36 primary care practices in New Zealand. Data analysed from January 2008 to December 2013. The records from 77 582 children enrolled were reviewed over a 6-year period to estimate the presentation of childhood respiratory illness and service utilisation. This cohort represents 268 919 person-years of data and over 650 000 unique consultations. Childhood respiratory illness presentation rate to primary care practice, with description of seasonal and yearly variation. Respiratory conditions constituted 46% of all child-general practitioner consultations with a stable year-on-year pattern of seasonal peaks. Upper respiratory tract infection was the most common respiratory category accounting for 21.0% of all childhood consultations, followed by otitis media (12.2%), wheeze-related illness (9.7%), throat infection (7.4%) and lower respiratory tract infection (4.4%). Almost 70% of children presented to their general practitioner with at least one respiratory condition in their first year of life; this reduced to approximately 25% for children aged 10-17. This is the first study to assess the primary care incidence and service utilisation of childhood respiratory illness in a large primary care cohort by interrogating electronic medical record free text. The study identified the very high primary care workload related to childhood respiratory illness, especially during the first 2 years of life. These data can enable more effective planning of health service delivery. The findings and methodology have relevance to many countries, and the use of primary care 'big data' in this way can be applied to other health conditions. © Article author(s) (or their employer

  5. Occupational musculoskeletal and mental disorders as the most frequent associations to worker's sickness absence: a 10-year cohort study.

    Science.gov (United States)

    Zechinatti, Antonio Carlos; Belloti, João Carlos; de Moraes, Vinícius Ynoe; Albertoni, Walter Manna

    2012-05-11

    Sickness absence (SA) is a complex phenomenon influenced by the health of the worker and socio-economic factors. An epidemiological study of SA has never been conducted for Brazilian university workers. This study aimed to determine the main diseases that are associated with SA and find out the average length of SA duration, and its variation among different staff members and between sexes over the 10-year study period. We identified the main diseases responsible for SA in workers at a Brazilian federal university (UNIFESP) from January 1998 to August 2008 and grouped them according to the International Classification of Diseases (ICD10). Independent researchers assessed data collected from expert reports of the university Worker's Health Division. During the period of our study, 1176 workers experienced sickness absence. After evaluating 7579 consultations, ICD10 distribution showed that musculoskeletal and connective tissue disorders ("M" axis) and mental and behavioral diseases ("F" axis) were the most important causes of SA, occurring in 47.3% (IC 95%; 44.15-49.8) of workers aged 46.2 (SD 10.1) years. Female workers represented 78.1% (IC 95%; 76-80.7) of all workers with SA, but men had higher proportional rates (Chi-square; p = 0.044). Longer SA periods were observed for illnesses related to neoplasms and infectious diseases. Musculoskeletal and connective tissue disorders and mental and behavioral diseases were the most frequent cause of sickness absence. Men had an increased frequency of SA, and neoplasms and infectious disorders were associated with longer absences. Mostly, these are occupational disorders. A preventative research-focused agenda is desirable for a more accurate depiction of this population in the scope of policy-making. Our results for SA in Brazilian workers correspond with those of other studies worldwide.

  6. Use of health services in the last year of life and cause of death in people with intellectual disability: a retrospective matched cohort study.

    Science.gov (United States)

    Brameld, Kate; Spilsbury, Katrina; Rosenwax, Lorna; Leonard, Helen; Semmens, James

    2018-02-25

    To describe the cause of death together with emergency department presentations and hospital admissions in the last year of life of people with intellectual disability. A retrospective matched cohort study using de-identified linked data of people aged 20 years or over, with and without intellectual disability who died during 2009 to 2013 in Western Australia. Emergency department presentations and hospital admissions in the last year of life of people with intellectual disability are described along with cause of death. Of the 63 508 deaths in Western Australia from 2009 to 2013, there were 591 (0.93%) decedents with a history of intellectual disability. Decedents with intellectual disability tended to be younger, lived in areas of more social disadvantage, did not have a partner and were Australian born compared with all other decedents. A matched comparison cohort of decedents without intellectual disability (n=29 713) was identified from the general population to improve covariate balance.Decedents with intellectual disability attended emergency departments more frequently than the matched cohort (mean visits 3.2 vs 2.5) and on average were admitted to hospital less frequently (mean admissions 4.1 vs 6.1), but once admitted stayed longer (average length of stay 5.2 days vs 4.3 days). People with intellectual disability had increased odds of presentation, admission or death from conditions that have been defined as ambulatory care sensitive and are potentially preventable. These included vaccine-preventable respiratory disease, asthma, cellulitis and convulsions and epilepsy. People with intellectual disability were more likely to experience potentially preventable conditions at the end of their lives. This indicates a need for further improvements in access, quality and coordination of healthcare to provide optimal health for this group. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved

  7. Long-Term Survival after Stroke: 30 Years of Follow-Up in a Cohort, the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Boysen, G.; Marott, J.L.; Gronbaek, M.

    2009-01-01

    in the Copenhagen City Heart Study who experienced a first-ever stroke from 1978 to the end of 2001 were followed to the end of 2007. Stroke events were validated using the World Health Organization's definition of stroke. Linkage to the Danish Civil Registration System enabled identification of participants who...... died before the end of 2007. The National Register of Causes of Death provided cause of death. Survival in stroke patients was compared with survival in participants in the Copenhagen City Heart Study who did not suffer a stroke, and with survival in the general Danish population. Cox regression......-stroke controls. Long-term survival improved steadily over time. Life expectancy after stroke increased up to 4 years from 1978 to the end of 2001, exceeding the increase of life expectancy in the general population. Slightly longer survival was found in women than in men when adjusted for age at stroke onset...

  8. Spatiotemporal Determinants of Urban Leptospirosis Transmission: Four-Year Prospective Cohort Study of Slum Residents in Brazil.

    Directory of Open Access Journals (Sweden)

    José E Hagan

    2016-01-01

    Full Text Available Rat-borne leptospirosis is an emerging zoonotic disease in urban slum settlements for which there are no adequate control measures. The challenge in elucidating risk factors and informing approaches for prevention is the complex and heterogeneous environment within slums, which vary at fine spatial scales and influence transmission of the bacterial agent.We performed a prospective study of 2,003 slum residents in the city of Salvador, Brazil during a four-year period (2003-2007 and used a spatiotemporal modelling approach to delineate the dynamics of leptospiral transmission. Household interviews and Geographical Information System surveys were performed annually to evaluate risk exposures and environmental transmission sources. We completed annual serosurveys to ascertain leptospiral infection based on serological evidence. Among the 1,730 (86% individuals who completed at least one year of follow-up, the infection rate was 35.4 (95% CI, 30.7-40.6 per 1,000 annual follow-up events. Male gender, illiteracy, and age were independently associated with infection risk. Environmental risk factors included rat infestation (OR 1.46, 95% CI, 1.00-2.16, contact with mud (OR 1.57, 95% CI 1.17-2.17 and lower household elevation (OR 0.92 per 10m increase in elevation, 95% CI 0.82-1.04. The spatial distribution of infection risk was highly heterogeneous and varied across small scales. Fixed effects in the spatiotemporal model accounted for the majority of the spatial variation in risk, but there was a significant residual component that was best explained by the spatial random effect. Although infection risk varied between years, the spatial distribution of risk associated with fixed and random effects did not vary temporally. Specific "hot-spots" consistently had higher transmission risk during study years.The risk for leptospiral infection in urban slums is determined in large part by structural features, both social and environmental. Our findings

  9. Spatiotemporal Determinants of Urban Leptospirosis Transmission: Four-Year Prospective Cohort Study of Slum Residents in Brazil.

    Science.gov (United States)

    Hagan, José E; Moraga, Paula; Costa, Federico; Capian, Nicolas; Ribeiro, Guilherme S; Wunder, Elsio A; Felzemburgh, Ridalva D M; Reis, Renato B; Nery, Nivison; Santana, Francisco S; Fraga, Deborah; Dos Santos, Balbino L; Santos, Andréia C; Queiroz, Adriano; Tassinari, Wagner; Carvalho, Marilia S; Reis, Mitermayer G; Diggle, Peter J; Ko, Albert I

    2016-01-01

    Rat-borne leptospirosis is an emerging zoonotic disease in urban slum settlements for which there are no adequate control measures. The challenge in elucidating risk factors and informing approaches for prevention is the complex and heterogeneous environment within slums, which vary at fine spatial scales and influence transmission of the bacterial agent. We performed a prospective study of 2,003 slum residents in the city of Salvador, Brazil during a four-year period (2003-2007) and used a spatiotemporal modelling approach to delineate the dynamics of leptospiral transmission. Household interviews and Geographical Information System surveys were performed annually to evaluate risk exposures and environmental transmission sources. We completed annual serosurveys to ascertain leptospiral infection based on serological evidence. Among the 1,730 (86%) individuals who completed at least one year of follow-up, the infection rate was 35.4 (95% CI, 30.7-40.6) per 1,000 annual follow-up events. Male gender, illiteracy, and age were independently associated with infection risk. Environmental risk factors included rat infestation (OR 1.46, 95% CI, 1.00-2.16), contact with mud (OR 1.57, 95% CI 1.17-2.17) and lower household elevation (OR 0.92 per 10m increase in elevation, 95% CI 0.82-1.04). The spatial distribution of infection risk was highly heterogeneous and varied across small scales. Fixed effects in the spatiotemporal model accounted for the majority of the spatial variation in risk, but there was a significant residual component that was best explained by the spatial random effect. Although infection risk varied between years, the spatial distribution of risk associated with fixed and random effects did not vary temporally. Specific "hot-spots" consistently had higher transmission risk during study years. The risk for leptospiral infection in urban slums is determined in large part by structural features, both social and environmental. Our findings indicate that

  10. Prediction of five-year all-cause mortality in Chinese patients with type 2 diabetes mellitus - A population-based retrospective cohort study.

    Science.gov (United States)

    Wan, Eric Yuk Fai; Fong, Daniel Yee Tak; Fung, Colman Siu Cheung; Yu, Esther Yee Tak; Chin, Weng Yee; Chan, Anca Ka Chun; Lam, Cindy Lo Kuen

    2017-06-01

    This study aimed to develop and validate an all-cause mortality risk prediction model for Chinese primary care patients with type 2 diabetes mellitus(T2DM) in Hong Kong. A population-based retrospective cohort study was conducted on 132,462 Chinese patients who had received public primary care services during 2010. Each gender sample was randomly split on a 2:1 basis into derivation and validation cohorts and was followed-up for a median period of 5years. Gender-specific mortality risk prediction models showing the interaction effect between predictors and age were derived using Cox proportional hazards regression with forward stepwise approach. Developed models were compared with pre-existing models by Harrell's C-statistic and calibration plot using validation cohort. Common predictors of increased mortality risk in both genders included: age; smoking habit; diabetes duration; use of anti-hypertensive agents, insulin and lipid-lowering drugs; body mass index; hemoglobin A1c; systolic blood pressure(BP); total cholesterol to high-density lipoprotein-cholesterol ratio; urine albumin to creatinine ratio(urine ACR); and estimated glomerular filtration rate(eGFR). Prediction models showed better discrimination with Harrell"'s C-statistics of 0.768(males) and 0.782(females) and calibration power from the plots than previously established models. Our newly developed gender-specific models provide a more accurate predicted 5-year mortality risk for Chinese diabetic patients than other established models. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Natural disease course of Crohn's disease during the first 5 years after diagnosis in a European population-based inception cohort: an Epi-IBD study.

    Science.gov (United States)

    Burisch, Johan; Kiudelis, Gediminas; Kupcinskas, Limas; Kievit, Hendrika Adriana Linda; Andersen, Karina Winther; Andersen, Vibeke; Salupere, Riina; Pedersen, Natalia; Kjeldsen, Jens; D'Incà, Renata; Valpiani, Daniela; Schwartz, Doron; Odes, Selwyn; Olsen, Jóngerð; Nielsen, Kári Rubek; Vegh, Zsuzsanna; Lakatos, Peter Laszlo; Toca, Alina; Turcan, Svetlana; Katsanos, Konstantinos H; Christodoulou, Dimitrios K; Fumery, Mathurin; Gower-Rousseau, Corinne; Zammit, Stefania Chetcuti; Ellul, Pierre; Eriksson, Carl; Halfvarson, Jonas; Magro, Fernando Jose; Duricova, Dana; Bortlik, Martin; Fernandez, Alberto; Hernández, Vicent; Myers, Sally; Sebastian, Shaji; Oksanen, Pia; Collin, Pekka; Goldis, Adrian; Misra, Ravi; Arebi, Naila; Kaimakliotis, Ioannis P; Nikuina, Inna; Belousova, Elena; Brinar, Marko; Cukovic-Cavka, Silvija; Langholz, Ebbe; Munkholm, Pia

    2018-01-23

    The Epi-IBD cohort is a prospective population-based inception cohort of unselected patients with inflammatory bowel disease from 29 European centres covering a background population of almost 10 million people. The aim of this study was to assess the 5-year outcome and disease course of patients with Crohn's disease (CD). Patients were followed up prospectively from the time of diagnosis, including collection of their clinical data, demographics, disease activity, medical therapy, surgery, cancers and deaths. Associations between outcomes and multiple covariates were analysed by Cox regression analysis. In total, 488 patients were included in the study. During follow-up, 107 (22%) patients received surgery, while 176 (36%) patients were hospitalised because of CD. A total of 49 (14%) patients diagnosed with non-stricturing, non-penetrating disease progressed to either stricturing and/or penetrating disease. These rates did not differ between patients from Western and Eastern Europe. However, significant geographic differences were noted regarding treatment: more patients in Western Europe received biological therapy (33%) and immunomodulators (66%) than did those in Eastern Europe (14% and 54%, respectively, P<0.01), while more Eastern European patients received 5-aminosalicylates (90% vs 56%, P<0.05). Treatment with immunomodulators reduced the risk of surgery (HR: 0.4, 95% CI 0.2 to 0.6) and hospitalisation (HR: 0.3, 95% CI 0.2 to 0.5). Despite patients being treated early and frequently with immunomodulators and biological therapy in Western Europe, 5-year outcomes including surgery and phenotype progression in this cohort were comparable across Western and Eastern Europe. Differences in treatment strategies between Western and Eastern European centres did not affect the disease course. Treatment with immunomodulators reduced the risk of surgery and hospitalisation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the

  12. Soft tissues stability of cad-cam and stock abutments in anterior regions: 2-year prospective multicentric cohort study.

    Science.gov (United States)

    Lops, Diego; Bressan, Eriberto; Parpaiola, Andrea; Sbricoli, Luca; Cecchinato, Denis; Romeo, Eugenio

    2015-12-01

    Aim of this study was to verify if the type of implant abutment manufacturing, stock or cad-cam, could influence the maintenance of stable gingival margins around single restorations in anterior areas. After 16 weeks of healing, implants (Osseospeed, Astra Tech Dental Implant) were positioned. Depending on the different fixture inclination and the thickness of buccal peri-implant soft tissue, abutment selection resulted in four groups: Group 1 (patients with zirconia ZirDesign(®) stock abutments), Group 2 (titanium stock TiDesign(®) abutments), Group 3 (zirconia cad-cam abutments), and Group 4 (titanium cad-cam abutments). The following parameters were assessed: buccal gingival margin modification (BGM). The modification of the implant gingival margin was followed at 1 and 2 years of follow-up. A computerized analysis was performed for measurements. Differences between soft tissue margin at baseline and after 2 years measured the gingival margin recession. A general linear model was used to evaluate each group in relation to gingival recession after two years. Tukey's post hoc test was used to compare the mean REC indexes of each group of abutments. Seventy-two healthy patients (39 males and 33 females; mean age of 46 years) scheduled for single gap rehabilitation in anterior areas were enrolled. A 100% of implant survival rate was observed after 24 months of function. One failure occurred due to fracture of a Zirconia cad-cam abutment. Moreover, two abutment screw unscrewing were observed. Both for zirconia and titanium stock abutments (Group 1 and 2), the mean recession of implant buccal soft tissue was of 0.3 mm (SD of 0.3 and 0.4 mm, respectively). Soft tissue mean recession of zirconia and titanium cad-cam abutments (Group 3 and 4) was of 0.1 and -0.3 mm, respectively (SD of 0.3 and 0.4 mm, respectively). REC values of cad-cam titanium abutments (Group 4) were significantly lower than that of Group 1 (-0.57 mm), Group 2 (-0.61 mm), and Group 3 (-0.40 mm

  13. Patient Characteristics and Comorbidities Influence Walking Distances in Symptomatic Peripheral Arterial Disease: A Large One-Year Physiotherapy Cohort Study.

    Science.gov (United States)

    Dörenkamp, Sarah; Mesters, Ilse; de Bie, Rob; Teijink, Joep; van Breukelen, Gerard

    2016-01-01

    The aim of this study is to investigate the association between age, gender, body-mass index, smoking behavior, orthopedic comorbidity, neurologic comorbidity, cardiac comorbidity, vascular comorbidity, pulmonic comorbidity, internal comorbidity and Initial Claudication Distance during and after Supervised Exercise Therapy at 1, 3, 6 and 12 months in a large sample of patients with Intermittent Claudication. Data was prospectively collected in standard physiotherapy care. Patients received Supervised Exercise Therapy according to the guideline Intermittent Claudication of the Royal Dutch Society for Physiotherapy. Three-level mixed linear regression analysis was carried out to analyze the association between patient characteristics, comorbidities and Initial Claudication Distance at 1, 3, 6 and 12 months. Data from 2995 patients was analyzed. Results showed that being female, advanced age and a high body-mass index were associated with lower Initial Claudication Distance at all-time points (p = 0.000). Besides, a negative association between cardiac comorbidity and Initial Claudication Distance was revealed (p = 0.011). The interaction time by age, time by body-mass index and time by vascular comorbidity were significantly associated with Initial Claudication Distance (p≤ 0.05). Per year increase in age (range: 33-93 years), the reduction in Initial Claudication Distance was 8m after 12 months of Supervised Exercise Therapy. One unit increase in body-mass index (range: 16-44 kg/m2) led to 10 m less improvement in Initial Claudication Distance after 12 months and for vascular comorbidity the reduction in improvement was 85 m after 12 months. This study reveals that females, patients at advanced age, patients with a high body-mass index and cardiac comorbidity are more likely to show less improvement in Initial Claudication Distances (ICD) after 1, 3, 6 and 12 months of Supervised Exercise Therapy. Further research should elucidate treatment adaptations that

  14. The course of untreated anxiety and depression, and determinants of poor one-year outcome: a one-year cohort study

    NARCIS (Netherlands)

    van Beljouw, I.M.J.; Verhaak, P.; Cuijpers, P.; van Marwijk, H.W.J.; Penninx, B.W.J.H.

    2010-01-01

    Background: Little is known about the course and outcome of untreated anxiety and depression in patients with and without a self-perceived need for care. The aim of the present study was to examine the one-year course of untreated anxiety and depression, and to determine predictors of a poor

  15. The course of untreated anxiety and depression, and determinants of poor one-year outcome: a one-year cohort study.

    NARCIS (Netherlands)

    Beljouw, I.M.J. van; Verhaak, P.F.M.; Cuijpers, P.; Marwijk, H.W.J. van; Penninx, B.W.J.H.

    2010-01-01

    Background: Little is known about the course and outcome of untreated anxiety and depression in patients with and without a self-perceived need for care. The aim of the present study was to examine the one-year course of untreated anxiety and depression, and to determine predictors of a poor

  16. The course of untreated anxiety and depression, and determinants of poor one-year outcome : a one-year cohort study

    NARCIS (Netherlands)

    van Beljouw, Ilse M. J.; Verhaak, Peter F. M.; Cuijpers, Pim; van Marwijk, Harm W. J.; Penninx, Brenda W. J. H.

    2010-01-01

    Background: Little is known about the course and outcome of untreated anxiety and depression in patients with and without a self-perceived need for care. The aim of the present study was to examine the one-year course of untreated anxiety and depression, and to determine predictors of a poor

  17. Sick Leave within 5 Years of Whiplash Trauma Predicts Recovery: A Prospective Cohort and Register-Based Study.

    Science.gov (United States)

    Carstensen, Tina Birgitte Wisbech; Fink, Per; Oernboel, Eva; Kasch, Helge; Jensen, Troels Staehelin; Frostholm, Lisbeth

    2015-01-01

    10-22% of individuals sustaining whiplash trauma develop persistent symptoms resulting in reduced working ability and decreased quality of life, but it is poorly understood why some people do not recover. Various collision and post-collision risk factors have been studied, but little is known about pre-collision risk factors. In particular, the impact of sickness and socioeconomic factors before the collision on recovery is sparsely explored. The aim of this study was to examine if welfare payments received within five years pre-collision predict neck pain and negative change in provisional situation one year post-collision. 719 individuals with acute whiplash trauma consecutively recruited from emergency departments or primary care after car accidents in Denmark completed questionnaires on socio-demographic and health factors immediately after the collision. After 12 months, a visual analogue scale on neck pain intensity was completed. 3595 matched controls in the general population were sampled, and national public register data on social benefits and any other welfare payments were obtained for participants with acute whiplash trauma and controls from five years pre-collision to 15 months after. Participants with acute whiplash trauma who had received sickness benefit for more than 12 weeks pre-collision had increased odds for negative change in future provisional situation (Odds Ratio (OR) (95% Confidence Interval (CI) = 3.8 (2.1;7.1)) and future neck pain (OR (95%CI) = 3.3 (1.8;6.3)), controlling for other known risk factors. Participants with acute whiplash trauma had weaker attachment to labour market (more weeks of sick leave (χ2(2) = 36.7, p whiplash trauma raised the odds for future negative change in provisional situation (OR (95%CI) = 3.1 (2.3;4.4)) compared with controls. Sick leave before the collision strongly predicted prolonged recovery following whiplash trauma. Participants with acute whiplash trauma had weaker attachment to labour market pre

  18. Sick Leave within 5 Years of Whiplash Trauma Predicts Recovery: A Prospective Cohort and Register-Based Study

    Science.gov (United States)

    Carstensen, Tina Birgitte Wisbech; Fink, Per; Oernboel, Eva; Kasch, Helge; Jensen, Troels Staehelin; Frostholm, Lisbeth

    2015-01-01

    Background 10–22% of individuals sustaining whiplash trauma develop persistent symptoms resulting in reduced working ability and decreased quality of life, but it is poorly understood why some people do not recover. Various collision and post-collision risk factors have been studied, but little is known about pre-collision risk factors. In particular, the impact of sickness and socioeconomic factors before the collision on recovery is sparsely explored. The aim of this study was to examine if welfare payments received within five years pre-collision predict neck pain and negative change in provisional situation one year post-collision. Methods and Findings 719 individuals with acute whiplash trauma consecutively recruited from emergency departments or primary care after car accidents in Denmark completed questionnaires on socio-demographic and health factors immediately after the collision. After 12 months, a visual analogue scale on neck pain intensity was completed. 3595 matched controls in the general population were sampled, and national public register data on social benefits and any other welfare payments were obtained for participants with acute whiplash trauma and controls from five years pre-collision to 15 months after. Participants with acute whiplash trauma who had received sickness benefit for more than 12 weeks pre-collision had increased odds for negative change in future provisional situation (Odds Ratio (OR) (95% Confidence Interval (CI) = 3.8 (2.1;7.1)) and future neck pain (OR (95%CI) = 3.3 (1.8;6.3)), controlling for other known risk factors. Participants with acute whiplash trauma had weaker attachment to labour market (more weeks of sick leave (χ2(2) = 36.7, p whiplash trauma raised the odds for future negative change in provisional situation (OR (95%CI) = 3.1 (2.3;4.4)) compared with controls. Conclusions Sick leave before the collision strongly predicted prolonged recovery following whiplash trauma. Participants with acute whiplash trauma

  19. Sick Leave within 5 Years of Whiplash Trauma Predicts Recovery: A Prospective Cohort and Register-Based Study.

    Directory of Open Access Journals (Sweden)

    Tina Birgitte Wisbech Carstensen

    Full Text Available 10-22% of individuals sustaining whiplash trauma develop persistent symptoms resulting in reduced working ability and decreased quality of life, but it is poorly understood why some people do not recover. Various collision and post-collision risk factors have been studied, but little is known about pre-collision risk factors. In particular, the impact of sickness and socioeconomic factors before the collision on recovery is sparsely explored. The aim of this study was to examine if welfare payments received within five years pre-collision predict neck pain and negative change in provisional situation one year post-collision.719 individuals with acute whiplash trauma consecutively recruited from emergency departments or primary care after car accidents in Denmark completed questionnaires on socio-demographic and health factors immediately after the collision. After 12 months, a visual analogue scale on neck pain intensity was completed. 3595 matched controls in the general population were sampled, and national public register data on social benefits and any other welfare payments were obtained for participants with acute whiplash trauma and controls from five years pre-collision to 15 months after. Participants with acute whiplash trauma who had received sickness benefit for more than 12 weeks pre-collision had increased odds for negative change in future provisional situation (Odds Ratio (OR (95% Confidence Interval (CI = 3.8 (2.1;7.1 and future neck pain (OR (95%CI = 3.3 (1.8;6.3, controlling for other known risk factors. Participants with acute whiplash trauma had weaker attachment to labour market (more weeks of sick leave (χ2(2 = 36.7, p < 0.001 and unemployment (χ2(2 = 12.5, p = 0.002 pre-collision compared with controls. Experiencing a whiplash trauma raised the odds for future negative change in provisional situation (OR (95%CI = 3.1 (2.3;4.4 compared with controls.Sick leave before the collision strongly predicted prolonged recovery

  20. Risk of future trauma based on alcohol screening scores: A two-year prospective cohort study among US veterans

    Science.gov (United States)

    2012-01-01

    Background Severe alcohol misuse as measured by the Alcohol Use Disorders Identification Test–Consumption (AUDIT-C) is associated with increased risk of future fractures and trauma-related hospitalizations. This study examined the association between AUDIT-C scores and two-year risk of any type of trauma among US Veterans Health Administration (VHA) patients and assessed whether risk varied by age or gender. Methods Outpatients (215, 924 male and 9168 female) who returned mailed AUDIT-C questionnaires were followed for 24 months in the medical record for any International Statistical Classification of Diseases and Related Health Problems (ICD-9) code related to trauma. The two-year prevalence of trauma was examined as a function of AUDIT-C scores, with low-level drinking (AUDIT-C 1–4) as the reference group. Men and women were examined separately, and age-stratified analyses were performed. Results Having an AUDIT-C score of 9–12 (indicating severe alcohol misuse) was associated with increased risk for trauma. Mean (SD) ages for men and women were 68.2 (11.5) and 57.2 (15.8), respectively. Age-stratified analyses showed that, for men ≤50 years, those with AUDIT-C scores ≥9 had an increased risk for trauma compared with those with AUDIT-C scores in the 1–4 range (adjusted prevalence, 25.7% versus 20.8%, respectively; OR = 1.24; 95% confidence interval [CI], 1.03–1.50). For men ≥65 years with average comorbidity and education, those with AUDIT-C scores of 5–8 (adjusted prevalence, 7.9% versus 7.4%; OR = 1.16; 95% CI, 1.02–1.31) and 9–12 (adjusted prevalence 11.1% versus 7.4%; OR = 1.68; 95% CI, 1.30–2.17) were at significantly increased risk for trauma compared with men ≥65 years in the reference group. Higher AUDIT-C scores were not associated with increased risk of trauma among women. Conclusions Men with severe alcohol misuse (AUDIT-C 9–12) demonstrate an increased risk of trauma. Men ≥65 showed an increased risk

  1. Convergent and discriminant validity of psychiatric symptoms reported in The Norwegian Mother and Child Cohort Study at age 3 years with independent clinical assessment in the Longitudinal ADHD Cohort Study

    Directory of Open Access Journals (Sweden)

    Guido Biele

    2014-12-01

    Full Text Available Epidemiological studies often use parent questionnaires to assess children's development and mental health. To date, few studies have investigated the validity of parent questionnaires with standardized clinical assessments as criterion. The current study examines discriminant and convergent validity of parent questionnaires for symptoms of Attention Deficit Hyperactivity Disorder (ADHD, Oppositional Defiance Disorder (ODD, and Conduct Disorder (CD as well as symptoms of Separation Anxiety employed in the Norwegian Mother and Child Cohort Study by using structured clinical interviews performed 5 months later in the Longitudinal ADHD Cohort Study as a criterion. The comparison of confirmatory factor analysis models and examination of factor correlations indicate convergent and discriminant validity of MoBa parent questionnaires for preschool children, especially for the assessment of ADHD and ODD/CD. Future research should attempt to further improve parent questionnaires, examine their validity in representative samples, and explicitly test their utility for screening.

  2. Relapse insomnia increases greater risk of anxiety and depression: evidence from a population-based 4-year cohort study.

    Science.gov (United States)

    Chen, Ping-Jen; Huang, Charles Lung-Cheng; Weng, Shih-Feng; Wu, Ming-Ping; Ho, Chung-Han; Wang, Jhi-Joung; Tsai, Wan-Chi; Hsu, Ya-Wen

    2017-10-01

    We investigated the longitudinal impacts of insomnia on the subsequent developments of anxiety and depression during a four-year follow-up. We further categorized individuals with insomnia into different insomnia subgroups to examine whether the risk of anxiety and depression varies by subtype. Participants were identified from National Health Insurance enrollees in Taiwan during 2002-2009. The study included 19,273 subjects with insomnia and 38,546 matched subjects without insomnia. All subjects did not have previous diagnosis of insomnia, sleep apnea, anxiety, or depression. Compared with non-insomniacs, insomniacs had a higher risk of developing anxiety only [adjusted hazard ratio (HR) = 8.83, 95% CI = 7.59-10.27], depression only (adjusted HR = 8.48, 95% CI = 6.92-10.39), and both anxiety and depression (adjusted HR = 17.98, 95% CI = 12.65-25.56). When breaking down the insomnia subgroups, individuals with a relapse of insomnia (adjusted HR = 10.42-26.80) had the highest risk of anxiety only, depression only, and both anxiety and depression, followed by persistent insomnia (adjusted HR = 9.82-18.98), then remitted insomnia (adjusted HR = 4.50-8.27). All three insomnia subgroups had a greater four-year cumulative incidence rate than the non-insomnia group for anxiety only, depression only, and both anxiety and depression (p anxiety or/and depression. Awareness of insomnia and treatment of insomnia should be recommended at clinics, and patterns of insomnia should be monitored to help treatment and control of subsequent psychiatric disorders. Future research with comprehensive data collection is needed to identify factors that contribute to different insomnia subtypes. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Non-alcoholic fatty liver disease predicts type 2 diabetes mellitus, but not prediabetes, in Xi'an, China: a five-year cohort study.

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    Ming, Jie; Xu, Shaoyong; Gao, Bin; Liu, Guocai; Ji, Yufei; Yang, Fan; Jia, Yunan; Fang, Yujie; Ji, Qiuhe

    2015-11-01

    Emerging studies have focused the association between non-alcoholic fatty liver disease (NAFLD) and the risk of type 2 diabetes mellitus (T2DM) but the results were inconsistent. In addition, few studies have put focus on the association between NAFLD and the risk of prediabetes. We aimed to investigate whether NAFLD diagnosed by ultrasonography could predict the risk of future T2DM and prediabetes in Chinese population. The population-based cohort study held in Xi'an, Northwestern China, was based on China National Diabetes and Metabolic Disorders Survey. During a follow-up of 5 years, 508 healthy subjects were included as study sample. NAFLD was determined by abdominal ultrasonography. T2DM and prediabetes were diagnosed based on oral glucose tolerance test. Of 508 subjects, 97 (19.1%) were diagnosed as NAFLD and 411 (80.9%) were as non-NAFLD; 20 (3.9%) developed diabetes and 85 (16.7%) developed prediabetes during follow-up. The incidence of diabetes and prediabetes in the NAFLD group was 20.6 and 51.6 per 1000 person-years, respectively, whereas that in non-NAFLD group was 4.9 and 29.2 per 1000 person-years respectively. Cox proportional hazard regression showed that the multivariable-adjusted relative risk (RR) of T2DM and prediabetes in the NAFLD group was 4.462 [95% confidence interval (CI): 1.855-10.734, P liver disease was a significant predictor for future diabetes, but not for prediabetes, in Xi'an, China. More cohort studies are needed to confirm our findings. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Risk factors for the onset and persistence of neck pain in undergraduate students: 1-year prospective cohort study

    Science.gov (United States)

    2011-01-01

    Background Although neck pain is common in young adulthood, studies on predictive factors for its onset and persistence are scarce. It is therefore important to identify possible risk factors among young adults so as to prevent the development of neck pain later in life. Methods A prospective study was carried out in healthy undergraduate students. At baseline, a self-administered questionnaire and standardized physical examination were used to collect data on biopsychosocial factors. At 3, 6, 9, and 12 months thereafter, follow-up data were collected on the incidence of neck pain. Those who reported neck pain on ≥ 2 consecutive follow-ups were categorized as having persistent neck pain. Two regression models were built to analyze risk factors for the onset and persistence of neck pain. Results Among the recruited sample of 684 students, 46% reported the onset of neck pain between baseline and 1-year follow-up, of whom 33% reported persistent neck pain. The onset of neck pain was associated with computer screen position not being level with the eyes and mouse position being self-rated as suitable. Factors that predicted persistence of neck pain were position of the keyboard being too high, use of computer for entertainment Neck pain is quite common among undergraduate students. This study found very few proposed risk factors that predicted onset and persistence of neck pain. The future health of undergraduate students deserves consideration. However, there is still much uncertainty about factors leading to neck pain and more research is needed on this topic. PMID:21756362

  5. Infant-onset eczema in relation to mental health problems at age 10 years: results from a prospective birth cohort study (German Infant Nutrition Intervention plus).

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    Schmitt, Jochen; Apfelbacher, Christian; Chen, Chih-Mei; Romanos, Marcel; Sausenthaler, Stefanie; Koletzko, Sibylle; Bauer, Carl-Peter; Hoffmann, Ute; Krämer, Ursula; Berdel, Dietrich; von Berg, Andrea; Wichmann, H-Erich; Heinrich, Joachim

    2010-02-01

    Cross-sectional studies suggest an association between eczema and mental health problems, but the temporal relationship is unclear. To assess the association between infant-onset eczema and mental health problems in a prospective study. Between 1995 and 1998, a birth cohort study was recruited and followed until age 10 years. Physician-diagnosed eczema, comorbidities, and a broad set of environmental exposures were assessed at age 1, 2, 3, 4, 6, and 10 years. First, we investigated the association between infant-onset eczema (age 1-2 years) and mental health problems at age 10 years according to the Strengths and Difficulties Questionnaire. Second, we analyzed the likelihood of mental health problems at age 10 years in relation to the course of eczema. A total of 2916 infants were eligible for analysis. Compared with participants never diagnosed as having eczema, children with infant-onset eczema had a significantly increased risk for possible/probable mental health problems (Strengths and Difficulties Questionnaire total score) at age 10 years (odds ratio, 1.49; 95% CI, 1.13-1.96) and for emotional symptoms (odds ratio, 1.62; 95% CI, 1.25-2.09). Eczema limited to infancy predicted a significantly higher risk for conduct problems at age 10 years. The strength of the association between eczema and emotional problems at age 10 years increased with increasing eczema persistence. Infants with eczema are at increased risk for mental health problems at age 10 years. Even if cleared afterward, eczema at age 1 to 2 years may cause persistent emotional and behavioral difficulties. Copyright 2010 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  6. Secular changes in the relation between social factors and depression: a study of two birth cohorts of Swedish septuagenarians followed for 5 years.

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    Sjöberg, Linnea; Östling, Svante; Falk, Hanna; Sundh, Valter; Waern, Margda; Skoog, Ingmar

    2013-09-05

    Rapid societal changes occurred in the Western world during the 20(th) century. It is not clear whether this has changed the relation between social factors and depression in older people. Representative samples of 70-year-olds from Gothenburg, Sweden, were examined with identical psychiatric examinations in 1971-72 (N=392; 226 women and 166 men) and 2000-01 (N=499; 270 women and 229 men). Follow-up studies were conducted after five years. Social factors were obtained by self-report and depression was diagnosed according to DSM-IV-TR. Feelings of loneliness were related to both concurrent depression at baseline and new depression at follow-up in both birth cohorts. Visits with others than children and neighbours once per month or less, compared to having more visits, and the perception of having too little contact with others, were related to both concurrent and new depression in 70-year-olds examined 1971-72, but not in those examined 30 years later. The response rate declined from 85.2% in 1971-72 to 65.8% in 2000-01. Participation bias may have resulted in an underestimation of depression in the later-born cohort. Social contacts with others were related to depression in 70-year-olds examined in the 1970s, but not in those examined in the 2000s. This may reflect period changes in the ways of socialising, communicating and entertaining, e.g. due to technological development and expansion of mass media. Findings may be useful when developing modern and effective programs for the prevention of mental ill-health in older people. Copyright © 2013 Elsevier B.V. All rights reserved.

  7. β-thymosins and interstitial lung disease: study of a scleroderma cohort with a one-year follow-up

    Directory of Open Access Journals (Sweden)

    Messana Irene

    2011-02-01

    Full Text Available Abstract Background β-thymosins play roles in cytoskeleton rearrangement, angiogenesis, fibrosis and reparative process, thus suggesting a possible involvement in the pathogenesis of systemic sclerosis. The aim of the study was to investigate the presence of thymosins β4, β4 sulfoxide, and β10 in bronchoalveolar lavage fluid of scleroderma patients with interstitial lung disease and the relation of these factors with pulmonary functional and radiological parameters. Methods β-thymosins concentrations were determined by Reverse Phase-High Performance Liquid Chromatography-Electrospray-Mass Spectrometry in the bronchoalveolar lavage fluid of 46 scleroderma patients with lung involvement and of 15 controls. Results Thymosin β4, β4 sulfoxide, and β10 were detectable in bronchoalveolar lavage fluid of patients and controls. Thymosin β4 levels were significantly higher in scleroderma patients than in controls. In addition, analyzing the progression of scleroderma lung disease at one-year follow-up, we have found that higher thymosin β4 levels seem to have a protective role against lung tissue damage. Thymosin β4 sulfoxide levels were higher in the smokers and in the scleroderma patients with alveolitis. Conclusions We describe for the first time β-thymosins in bronchoalveolar lavage fluid and their possible involvement in the pathogenesis of scleroderma lung disease. Thymosin β4 seems to have a protective role against lung tissue damage, while its oxidation product mirrors an alveolar inflammatory status.

  8. The outcomes and controversies of transplant tourism—Lessons of an 11-year retrospective cohort study from Taiwan

    Science.gov (United States)

    Holm, Soren; Lin, Yi-Ping; Chang, Yu-Kang

    2017-01-01

    Background Transplant tourism has increased rapidly in the past two decades, accounting for about 10% of world organ transplants. However it is ethically controversial and discouraged by professional guidelines. We conducted this study to investigate the outcomes and trends of overseas kidney and liver transplantation in Taiwan to provide a sound basis for ethical reflection. Methods and findings The Taiwanese National Health Insurance Research Database was used to identify 2381 domestic and 2518 overseas kidney transplant (KT) recipients from 1998 to 2009 and 1758 domestic and 540 overseas liver transplantation (LT) recipients from 1999 to 2009. Cox proportional hazards models were used to assess the risks of mortality and graft failure. The numbers of overseas transplantation increased after 2000, reached a peak in 2005 and decreased after 2007. Compared to their domestic counterparts, the overseas KT recipients were older, male predominant, with shorter pre-op dialysis period and more comorbidities. Similarly, the overseas LT recipients were older, male predominant and had more hepatocellular carcinoma cases. The 1-, 5-, and 10-year patient survival rates were 96.9%, 91.7% and 83.0% respectively for domestic KT and 95.8%, 87.8% and 73.1% for overseas KT (ptourism decreased but the practice still persisted surreptitiously. Compulsory registration policies for overseas transplantation with international conventions to sanction organ trafficking and transplant tourism should be considered to stop these controversial practices. PMID:28575014

  9. The outcomes and controversies of transplant tourism-Lessons of an 11-year retrospective cohort study from Taiwan.

    Science.gov (United States)

    Tsai, Daniel Fu-Chang; Huang, Shi-Wei; Holm, Soren; Lin, Yi-Ping; Chang, Yu-Kang; Hsu, Chih-Cheng

    2017-01-01

    Transplant tourism has increased rapidly in the past two decades, accounting for about 10% of world organ transplants. However it is ethically controversial and discouraged by professional guidelines. We conducted this study to investigate the outcomes and trends of overseas kidney and liver transplantation in Taiwan to provide a sound basis for ethical reflection. The Taiwanese National Health Insurance Research Database was used to identify 2381 domestic and 2518 overseas kidney transplant (KT) recipients from 1998 to 2009 and 1758 domestic and 540 overseas liver transplantation (LT) recipients from 1999 to 2009. Cox proportional hazards models were used to assess the risks of mortality and graft failure. The numbers of overseas transplantation increased after 2000, reached a peak in 2005 and decreased after 2007. Compared to their domestic counterparts, the overseas KT recipients were older, male predominant, with shorter pre-op dialysis period and more comorbidities. Similarly, the overseas LT recipients were older, male predominant and had more hepatocellular carcinoma cases. The 1-, 5-, and 10-year patient survival rates were 96.9%, 91.7% and 83.0% respectively for domestic KT and 95.8%, 87.8% and 73.1% for overseas KT (ptourism decreased but the practice still persisted surreptitiously. Compulsory registration policies for overseas transplantation with international conventions to sanction organ trafficking and transplant tourism should be considered to stop these controversial practices.

  10. Work-unit measures of organisational justice and risk of depression--a 2-year cohort study.

    Science.gov (United States)

    Grynderup, Matias Brødsgaard; Mors, Ole; Hansen, Åse Marie; Andersen, Johan Hviid; Bonde, Jens Peter; Kærgaard, Anette; Kærlev, Linda; Mikkelsen, Sigurd; Rugulies, Reiner; Thomsen, Jane Frølund; Kolstad, Henrik Albert

    2013-06-01

    The aim of this study is to analyse if low justice at work, analysed as aggregated workplace means, increases the risk of depression. A total of 4237 non-depressed Danish public employees within 378 different work units were enrolled in 2007. Mean levels of procedural and relational justice were computed for each work unit to obtain exposure measures that were robust to reporting bias related to depression. Two years later in 2009, 3047 (72%) participated at follow-up. Those reporting high levels of depressive, burn-out or stress symptoms were assigned to a psychiatric diagnostic interview. In the interview 58 cases of new onset depression were identified. Depression ORs by work unit level of procedural and relational justice were estimated by multivariable logistic regression accounting for established risk factors for depression. Working in a work unit with low procedural justice (adjusted ORs of 2.50, 95% CI 1.06 to 5.88) and low relational justice (3.14, 95% CI 1.37 to 7.19) predicted onset of depression. Our results indicate that a work environment characterised by low levels of justice is a risk factor for depression.

  11. Neighborhood socioeconomic status at the age of 40 years and ischemic stroke before the age of 50 years: A nationwide cohort study from Sweden.

    Science.gov (United States)

    Carlsson, Axel C; Li, Xinjun; Holzmann, Martin J; Ärnlöv, Johan; Wändell, Per; Gasevic, Danijela; Sundquist, Jan; Sundquist, Kristina

    2017-10-01

    Objective We aimed to study the association between neighborhood socioeconomic status at the age of 40 years and risk of ischemic stroke before the age of 50 years. Methods All individuals in Sweden were included if their 40th birthday occurred between 1998 and 2010. National registers were used to categorize neighborhood socioeconomic status into high, middle, and low and to retrieve information on incident ischemic strokes. Hazard ratios and their 95% confidence intervals were estimated. Results A total of 1,153,451 adults (women 48.9%) were followed for a mean of 5.5 years (SD 3.5 years), during which 1777 (0.30%) strokes among men and 1374 (0.24%) strokes among women were recorded. After adjustment for sex, marital status, education level, immigrant status, region of residence, and neighborhood services, there was a lower risk of stroke in residents from high-socioeconomic status neighborhoods (hazard ratio 0.87, 95% confidence interval 0.78-0.96), and an increased risk of stroke in adults from low-socioeconomic status neighborhoods (hazard ratio 1.16, 95% confidence interval 1.06-1.27), compared to their counterparts living in middle-socioeconomic status neighborhoods. After further adjustment for hospital diagnoses of hypertension, diabetes, heart failure, and atrial fibrillation prior to the age of 40, the higher risk in neighborhoods with low socioeconomic status was attenuated, but remained significant (hazard ratio 1.12, 95% confidence interval 1.02-1.23). Conclusions In a nationwide study of individuals between 40 and 50 years, we found that the risk of ischemic stroke differed depending on neighborhood socioeconomic status, which calls for increased efforts to prevent cardiovascular diseases in low socioeconomic status neighborhoods.

  12. Hypertension prevalence, awareness, treatment and its correlates among people 35 years and older: Result from pilot phase of the Azar cohort study.

    Science.gov (United States)

    Ghorbani, Zohreh; Shamshirgaran, Seyed Morteza; Ghaffari, Samad; Sarbakhsh, Parvin; Najafipour, Farzad; Aminisani, Nayyereh

    2018-01-01

    There is remarkable alteration in hypertension prevalence and awareness, and their correlates among various geographic locations and ethnic groups. The aim of this study was to report hypertension prevalence, awareness, and its correlates as well as hypertension treatment, and control among Azari people aged 35 years and older. The pilot phase of the Azar Cohort Study; a state level of a nationwide PERSIAN cohort study was conducted in Khameneh city between October 2014 and January 2015. All people 35 years of age and above were invited to take part in this study. A comprehensive range of different biomarkers, lifestyle, socioeconomic factors, and health-related factors was collected. Blood pressure was measured by a trained nurse/midwife. Descriptive statistical methods were used to present general characteristics of the study population as frequency tables. Separate multiple logistic regression models were built to assess the predictors of hypertension prevalence. A total of 1038 people were included in this study. The overall prevalence of hypertension was 22.9%. Awareness of hypertension was 60.5% and in those with known hypertension, 84% were using the antihypertensive medications, of those 68.5% had controlled hypertension. After adjustment; age (odds ratios [OR] adj = 1.12 95% confidence interval [CI]: 1.09-1.15), gender (OR adj = 1.65 95% CI: 1.08-2.51), obesity OR adj = 2.51 (1.40-4.88), waist-to-hip ratio (WHR) (OR adj = 1.70 (1.05-2.75), and comorbidities (OR adj = 2.51 (1.72-3.66) were independent predictors of hypertension. Age, sex, body mass index, WHR, and comorbidities were known as predictors of hypertension in this study, health promotion strategies including lifestyle modification to reduce overweight/obesity and secondary prevention programs for early detection of hypertension in high-risk groups according to age, gender, and disease profile are recommended.

  13. Relationship between anticholinergic drug use and one-year outcome among elderly people hospitalised in medical wards via emergency department: the SAFES cohort study.

    Science.gov (United States)

    Narbey, D; Jolly, D; Mahmoudi, R; Trenque, T; Blanchard, F; Novella, J-L; Dramé, M

    2013-09-01

    To investigate the relationship between anticholinergic drug use and one-year outcome of elderly patients hospitalised via the emergency department. Prospective, multicentre, cohort study of patients aged 75 years and older. Comprehensive geriatric evaluation was performed. We included in this analysis all patients for whom data on drug use was available. Anticholinergic drugs were coded using the online database "Thesorimed". One-year mortality and nursing home admission were analysed using a Cox model, with matching on the propensity to use anticholinergic drugs. In total, 1176 subjects were included in this analysis, average age 85±6 years, 65% women. Overall, 144 (12%) were taking at least one anticholinergic drug. Mortality and nursing home admission at one year were respectively 29% and 30% in the anticholinergic group, and 34% and 33% respectively in subjects not taking anticholinergic drugs. No significant relationship was observed between anticholinergic drug use and the main endpoints. Although we did not observed any statistically significant relationship between use of anticholinergic drugs and one-year outcome in elderly patients, the long-term use of anticholinergic drugs can have deleterious effects on memory and functional capacity, and therefore requires prescriptions to be reviewed regularly.

  14. Laparoscopic Roux-En-Y Gastric Bypass Improves Lipid Profile and Decreases Cardiovascular Risk: a 5-Year Longitudinal Cohort Study of 1048 Patients.

    Science.gov (United States)

    Gero, Daniel; Favre, Lucie; Allemann, Pierre; Fournier, Pierre; Demartines, Nicolas; Suter, Michel

    2018-03-01

    Dyslipidemia is a known risk factor for cardiovascular (CV) events. The aim of the study was to assess lipid profiles and their impact on CV risk changes in a large patient cohortyears after Roux-en-Y gastric bypass (RYGB). All patients who underwent primary RYGB for severe obesity in our two hospitals between January 1999 and December 2009 were included. The Framingham risk score was used. One thousand and forty-eight patients were included, 791 women and 257 men. Five-year complete lipid profile was available for 77% of patients. At 5 years, mean body mass index (BMI) decreased from 45.7 ± 6 to 31 ± 5.8 kg/m 2 (p profile improved more in patients with greater weight loss (%EBMIL ≥ 50 or %TWL ≥ 25%). Assuming that all patients were non-smokers and other baseline risk factors (hypertension, diabetes) remained unchanged at 5 years, the amelioration of the lipid profile itself yielded to a 27% reduction of CV risk (p profile from the first to fifth postoperative year. This improvement translates into significantly lower CV risk from the first year after surgery.

  15. Manganese in Drinking Water and Cognitive Abilities and Behavior at 10 Years of Age: A Prospective Cohort Study.

    Science.gov (United States)

    Rahman, Syed Moshfiqur; Kippler, Maria; Tofail, Fahmida; Bölte, Sven; Hamadani, Jena Derakhshani; Vahter, Marie

    2017-05-26

    Cross-sectional studies have indicated impaired neurodevelopment with elevated drinking water manganese concentrations (W-Mn), but potential susceptible exposure windows are unknown. We prospectively evaluated the effects of W-Mn, from fetal life to school age, on children's cognitive abilities and behavior. We assessed cognitive abilities and behavior in 1,265 ten-year-old children in rural Bangladesh using the Wechsler Intelligence Scale for Children (WISC-IV) and the Strengths and Difficulties Questionnaire (SDQ), respectively. Manganese in drinking water used during pregnancy and by the children at 5 y and 10 y was measured using inductively coupled plasma mass spectrometry. The median W-Mn was 0.20 mg/L (range 0.001–6.6) during pregnancy and 0.34mg/L (cognitive abilities. Stratifying by gender (p for interaction in general cognitive ability measures in girls but not in boys. W-Mn at all time points was associated with an increased risk of conduct problems, particularly in boys (range 24–43% per mg/L). At the same time, the prenatal W-Mn was associated with a decreased risk of emotional problems [odds ratio (OR)=0.39 (95% CI: 0.19, 0.82)] in boys. In girls, W-Mn was mainly associated with low prosocial scores [prenatal W-Mn: OR=1.48 (95% CI: 1.06, 1.88)]. Elevated prenatal W-Mn exposure was positively associated with cognitive function in girls, whereas boys appeared to be unaffected. Early life W-Mn exposure appeared to adversely affect children's behavior. https://doi.org/10.1289/EHP631.

  16. Metabolic syndrome and fatal outcomes in the post-stroke event: a 5-year cohort study in Cameroon.

    Directory of Open Access Journals (Sweden)

    Eric Vounsia Balti

    Full Text Available BACKGROUND AND PURPOSE: Determinants of post-acute stroke outcomes in Africa have been less investigated. We assessed the association of metabolic syndrome (MetS and insulin resistance with post-stroke mortality in patients with first-ever-in-lifetime stroke in the capital city of Cameroon (sub-Saharan Africa. METHODS: Patients with an acute first-stroke event (n = 57 were recruited between May and October 2006, and followed for 5 years for mortality outcome. MetS definition was based on the Joint Interim Statement 2009, insulin sensitivity/resistance assessed via glucose-to-insulin ratio, quantitative insulin sensitivity check index and homeostatic model assessment. RESULTS: Overall, 24 (42% patients deceased during follow-up. The prevalence of MetS was higher in patients who died after 28 days, 1 year and 5 years from any cause or cardiovascular-related causes (all p≤0.040. MetS was associated with an increased overall mortality both after 1 year (39% vs. 9% and 5 years of follow-up (55% vs. 26%, p = 0.022. Similarly, fatal events due to cardiovascular-related conditions were more frequent in the presence of MetS both 1 year (37% vs. 9% and 5 years after the first-ever-in-lifetime stroke (43% vs. 13%, p = 0.017. Unlike biochemical measures of insulin sensitivity and resistance (non-significant, in age- and sex-adjusted Cox models, MetS was associated with hazard ratio (95% CI of 2.63 (1.03-6.73 and 3.54 (1.00-12.56 respectively for all-cause and cardiovascular mortality 5 years after stroke onset. CONCLUSION: The Joint Interim Statement 2009 definition of MetS may aid the identification of a subgroup of black African stroke patients who may benefit from intensification of risk factor management.

  17. The epidemiology of irritable bowel syndrome: Symptom development over a 3-year period in Denmark. A prospective, population-based cohort study.

    Science.gov (United States)

    Krogsgaard, L R; Engsbro, A L; Jones, M P; Bytzer, P

    2017-04-01

    We aimed to explore the natural history of irritable bowel syndrome (IBS) in Denmark over 3 years by studying development of IBS symptoms and associated factors. A cohort study was carried out using a web panel representative of the Danish general population 18-50 years. The survey, including a questionnaire based on the Rome III criteria for IBS, was conducted in January 2010, January 2011, and March 2013. The prevalence of IBS was 15.4% (920/5986). The incidence was 10.3%, and was three times higher for persons with unspecific gastrointestinal (GI) symptoms compared to asymptomatic persons. Of respondents with IBS symptoms in both 2010 and 2011, 69% (131/191) also reported symptoms of IBS in 2013, which was significantly more compared to respondents with IBS symptoms in 2010 reporting to be asymptomatic or having unspecific GI symptoms in 2011 (20% and 39%, respectively, P<.001). Being diagnosed with IBS predicted fulfilling the criteria for IBS 3 years later (OR: 2.59, 95% CI: 1.11-6.10). Fulfilling criteria for IBS after 1 year also led to a high risk of IBS symptoms 3 years later in asymptomatic persons and persons with unspecific symptoms at baseline. The vast majority of persons fulfilling criteria for IBS report GI symptoms after one and 3 years. Fulfilling IBS criteria after 1 year led to a high risk of reporting IBS symptoms after 3 years. In the general population having an IBS diagnosis predicts persistently fulfilling the Rome III criteria for IBS 3 years later. © 2016 John Wiley & Sons Ltd.

  18. Food choices and coronary heart disease: a population based cohort study of rural Swedish men with 12 years of follow-up.

    Science.gov (United States)

    Holmberg, Sara; Thelin, Anders; Stiernström, Eva-Lena

    2009-10-01

    Coronary heart disease is associated with diet. Nutritional recommendations are frequently provided, but few long term studies on the effect of food choices on heart disease are available. We followed coronary heart disease morbidity and mortality in a cohort of rural men (N = 1,752) participating in a prospective observational study. Dietary choices were assessed at baseline with a 15-item food questionnaire. 138 men were hospitalized or deceased owing to coronary heart disease during the 12 year follow-up. Daily intake of fruit and vegetables was associated with a lower risk of coronary heart disease when combined with a high dairy fat consumption (odds ratio 0.39, 95% CI 0.21-0.73), but not when combined with a low dairy fat consumption (odds ratio 1.70, 95% CI 0.97-2.98). Choosing wholemeal bread or eating fish at least twice a week showed no association with the outcome.

  19. Food Choices and Coronary Heart Disease: A Population Based Cohort Study of Rural Swedish Men with 12 Years of Follow-up

    Directory of Open Access Journals (Sweden)

    Sara Holmberg

    2009-10-01

    Full Text Available Coronary heart disease is associated with diet. Nutritional recommendations are frequently provided, but few long term studies on the effect of food choices on heart disease are available. We followed coronary heart disease morbidity and mortality in a cohort of rural men (N = 1,752 participating in a prospective observational study. Dietary choices were assessed at baseline with a 15-item food questionnaire. 138 men were hospitalized or deceased owing to coronary heart disease during the 12 year follow-up. Daily intake of fruit and vegetables was associated with a lower risk of coronary heart disease when combined with a high dairy fat consumption (odds ratio 0.39, 95% CI 0.21-0.73, but not when combined with a low dairy fat consumption (odds ratio 1.70, 95% CI 0.97-2.98. Choosing wholemeal bread or eating fish at least twice a week showed no association with the outcome.

  20. Clinical and ultrasonographic features associated to response to intraarticular corticosteroid injection. A one year follow up prospective cohort study in knee osteoarthritis patient with joint effusion.

    Science.gov (United States)

    Calvet, Joan; Orellana, Cristóbal; Galisteo, Carlos; García-Manrique, María; Navarro, Noemí; Caixàs, Assumpta; Larrosa, Marta; Gratacós, Jordi

    2018-01-01

    Intraarticular injection is used for pain relief in knee osteoarthritis (OA), but there is not a well defined profile of patient who could get more benefit from it. The purpose of this study was to evaluate the frequency of pain relief at one year after corticosteroids intraarticular injection and to identify clinical factors associated to response in patients with knee osteoarthritis with joint effusion. One-year prospective cohort study of patients with knee OA with joint effusion confirmed by ultrasound. An intraarticular injection was performed following a clinical protocol. Anthropometric measurements, laboratory parameters, clinical severity, ultrasound parameters and radiological severity were collected. Response regarding pain and presence of synovial fluid on ultrasound at one month and at one year were evaluated. Clinical responder were consider in subjects with enough improvement to carry out normal daily activities with pain VAS<40mm. One hundred and thirty-two patients were included.A significant number of patients (61.4%) improved pain at one year following the protocol established in this study. Pain and ultrasound synovial fluid at one month appeared to predict the response at one year. The Lequesne index and the percentage of body fat were independently associated to pain at one year while the Lequesne index and ultrasound synovial hypertrophy were independently related to the presence of synovial fluid at one year. The status regarding pain or ultrasound synovial fluid at one month after an intraarticular joint injection appeared to predict the status at one year in patients with knee osteoarthritis and synovial effusion.

  1. Use of certainty-based marking in a second-year medical student cohort: a pilot study.

    Science.gov (United States)

    Schoendorfer, Niikee; Emmett, David

    2012-01-01

    Assessments which consider both competence and confidence attempt to provide insight into actual performance in order to optimize physician capabilities, providing motivation and direction for future learning. The aim of this project was to assess medical students' thoughts and opinions of the utility of a certainty-based marking (CBM) protocol with respect to improving their learning experiences. Second-year medical students at the University of Queensland were provided with a series of optional online formative assessment tools, in the form of 10 sample questions, to support their current module learning outcomes. During four consecutive weeks, CBM was offered on weeks 1, 2, and 4, with week 3 being provided in the usual question-answer format. A mixed-method survey was distributed at the conclusion of the trial period to obtain feedback on the students' impressions of learning via this technique. Of the 400 students, 15%, 11%, 9%, and 8% used the resource over the four-week period, respectively. During the four-week module directly prior to the test module, 46%, 44%, 44%, and 40% of the students accessed the sample questions which were delivered in the usual multiple choice format. A majority of the students either agreed or strongly agreed that CBM was easy to understand (52%) and useful (57%), but took more time (67%) because they needed to consider their certainty level for every question (76%). A number of students (43%) also stated that CBM affected their attitudes toward decision-making, while 86% thought it would be most useful for revision as opposed to an examination format. Despite the inherent benefits of gaining experience in higher order thinking processes, students were less likely to participate in the CBM tasks than standard multiple choice, even though these did not count toward their final grades. Utilizing such practices at the beginning of an educational program may minimize apparent resistance and alter learning practices to become conducive

  2. Low volumetric BMD is linked to upper-limb fracture in pubertal girls and persists into adulthood: a seven-year cohort study.

    Science.gov (United States)

    Cheng, Sulin; Xu, Leiting; Nicholson, Patrick H F; Tylavsky, Frances; Lyytikäinen, Arja; Wang, Qingju; Suominen, Harri; Kujala, Urho M; Kröger, Heikki; Alen, Markku

    2009-09-01

    The aetiology of increased incidence of fracture during puberty is unclear. This study aimed to determine whether low volumetric bone mineral density (vBMD) in the distal radius is associated with upper-limb fractures in growing girls, and whether any such vBMD deficit persists into adulthood. Fracture history from birth to 20 years was obtained and verified by medical records in 1034 Finnish girls aged 10-13 years. Bone density and geometry at distal radius, biomarkers and lifestyle/behavioural factors were assessed in a subset of 396 girls with a 7.5-year follow-up. We found that fracture incidence peaked during puberty (relative risk 3.1 at age of 8-14 years compared to outside this age window), and 38% of fractures were in the upper-limb. Compared to the non-fracture cohort, girls who sustained upper-limb fracture at ages 8-14 years had lower distal radial vBMD at baseline (258.9+/-37.5 vs. 287.5+/-34.1 mg/cm(3), p=0.001), 1-year (252.0+/-29.3 vs. 282.6+/-33.5 mg/cm(3), p=0.001), 2-year (258.9+/-32.2 vs. 289.9+/-40.1 mg/cm(3), p=0.003), and 7-year follow-ups (early adulthood, 307.6+/-35.9 vs. 343.6+/-40.9 mg/cm(3), p=0.002). There was a consistent trend towards larger bone cross-sectional area in the fracture cohort compared to non-fracture. In a logistic regression model, lower vBMD (p=0.001) was the only significant predictor of upper-limb fracture during the period of 8-14 years. Our results indicate that low BMD is an important factor underlying elevated upper-limb fracture risk during puberty, and that low BMD in pubertal girls with fracture persists into adulthood. Hence low vBMD during childhood is not a transient deficit. Methods to monitor vBMD and to maximise bone mineral accrual and reduce risks of falling in childhood should be developed.

  3. Course of bereavement over 8-10 years in first degree relatives and spouses of people who committed suicide : longitudinal community based cohort study

    NARCIS (Netherlands)

    de Groot, Marieke; Kollen, Boudewijn J.

    2013-01-01

    Objective To identify factors predicting the long term course of complicated grief, depression, and suicide ideation in a community based sample of relatives bereaved through suicide. Design Longitudinal cohort study. Included in the multilevel regression models were sociodemographic and personality

  4. Course of bereavement over 8-10 years in first degree relatives and spouses of people who committed suicide: longitudinal community based cohort study

    NARCIS (Netherlands)

    de Groot, M.; Kollen, B.J.

    2013-01-01

    Objective To identify factors predicting the long term course of complicated grief, depression, and suicide ideation in a community based sample of relatives bereaved through suicide. Design Longitudinal cohort study. Included in the multilevel regression models were sociodemographic and personality

  5. Waist circumference, BMI, and lung function in 8-year-old children : The PIAMA birth cohort study

    NARCIS (Netherlands)

    Bekkers, Marga B. M.; Wijga, Alet H.; de Jongste, Johan C.; Kerkhof, Marjan; Postma, Dirkje; Gehring, Ulrike; Smit, Henriette A.; Brunekreef, Bert

    Background Body mass index (BMI) and waist circumference (WC) may be associated with lung function in children, as observed in adults. Methods Height, weight, waist circumference, and lung function (FVC and FEV1) were measured during a medical examination in 1,058 eight-year-old children

  6. Predictive Factors for Subjective Improvement in Lumbar Spinal Stenosis Patients with Nonsurgical Treatment: A 3-Year Prospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Ko Matsudaira

    Full Text Available To assess the predictive factors for subjective improvement with nonsurgical treatment in consecutive patients with lumbar spinal stenosis (LSS.Patients with LSS were enrolled from 17 medical centres in Japan. We followed up 274 patients (151 men; mean age, 71 ± 7.4 years for 3 years. A multivariable logistic regression model was used to assess the predictive factors for subjective symptom improvement with nonsurgical treatment.In 30% of patients, conservative treatment led to a subjective improvement in the symptoms; in 70% of patients, the symptoms remained unchanged, worsened, or required surgical treatment. The multivariable analysis of predictive factors for subjective improvement with nonsurgical treatment showed that the absence of cauda equina symptoms (only radicular symptoms had an odds ratio (OR of 3.31 (95% confidence interval [CI]: 1.50-7.31; absence of degenerative spondylolisthesis/scoliosis had an OR of 2.53 (95% CI: 1.13-5.65; <1-year duration of illness had an OR of 3.81 (95% CI: 1.46-9.98; and hypertension had an OR of 2.09 (95% CI: 0.92-4.78.The predictive factors for subjective symptom improvement with nonsurgical treatment in LSS patients were the presence of only radicular symptoms, absence of degenerative spondylolisthesis/scoliosis, and an illness duration of <1 year.

  7. Fibrosis progression in interferon treatment-naive Chinese plasma donors with chronic hepatitis C for 20 years: a cohort study

    Directory of Open Access Journals (Sweden)

    Jun-Feng Li

    2014-10-01

    Conclusions: Based on histopathology results, the progression of fibrosis in patients with CHC infected by repeated plasma donation is slow after HCV infection of approximately 20 years. Liver inflammation is closely related to the development of moderate to severe liver fibrosis.

  8. A 4-Year Follow-up Cohort Study of the Respiratory Functions in Toner-handling Workers

    Directory of Open Access Journals (Sweden)

    Nobuaki Yanagi

    2014-12-01

    Conclusion: Our study does not suggest any toner exposure effects on respiratory function. However, the number of subjects was small in our study; studies of larger populations will be desired in the future.

  9. Cancer risk in patients aged 30 years and above with type 2 diabetes receiving antidiabetic monotherapy: a cohort study using metformin as the comparator

    Directory of Open Access Journals (Sweden)

    Chen YC

    2015-08-01

    Full Text Available Yu-Ching Chen,1 Victor C Kok,1,2 Ching-Hsuan Chien,1 Jorng-Tzong Horng,1,3 Jeffrey J P Tsai11Department of Biomedical Informatics, Asia University, Taichung, 2Department of Internal Medicine, Kuang Tien General Hospital, Taichung, 3Department of Computer Science and Information Engineering, National Central University, Jhongli, TaiwanIntroduction: Accumulating evidence suggests that metformin reduces incident cancer development. Few cohort studies have evaluated the risk of subsequent cancer development in diabetic cohorts receiving antidiabetic monotherapy. We conducted a population-based study in patients with new-onset type 2 diabetes treated with antidiabetic monotherapy.Methods: We identified a cohort of patients with type 2 diabetics aged ≥30 years receiving hypoglycemic monotherapy (n=7,325 from the 1998–2007 Longitudinal Health Insurance Dataset. Patients were grouped according to the antidiabetic therapy they received into metformin (n=2,223, sulfonylurea (n=3,965, glitazone (n=53, meglitinide (n=128, acarbose (n=150, and insulin (n=806 groups. Patients with preexisting cancer were excluded. All patients were followed up until cancer development, dropout, death, or until December 31, 2008. Cox’s model was used to estimate multivariable hazard ratios (HRs adjusted for age, sex, Charlson comorbidity index, smoking-related comorbidities, alcohol use disorders, morbid obesity, pancreatitis, hypertension, monthly income, and urbanization level. The log-rank test was used to compare cumulative cancer incidence. Two-sided P-values <0.05 were required to reject the null hypothesis.Results: The overall median follow-up duration was 2.5 years (interquartile range, 3.6 years. Totally, 367 and 124 cancers developed in the sulfonylurea and metformin groups, respectively, representing an adjusted HR of 1.36 (95% confidence interval [CI], 1.11–1.67; P<0.005. No significant differences were observed between other groups. Increased adjusted HRs

  10. Outcome of older persons admitted to intensive care unit, mortality, prognosis factors, dependency scores and ability trajectory within 1 year: a prospective cohort study.

    Science.gov (United States)

    Level, Claude; Tellier, Eric; Dezou, Patrick; Chaoui, Karim; Kherchache, Aissa; Sejourné, Philippe; Rullion-Pac Soo, Anne Marie

    2017-12-06

    The outcome and functional trajectory of older persons admitted to intensive care (ICU) unit remain a true question for critical care physicians and geriatricians, due to the heterogeneity of geriatric population, heterogeneity of practices and absence of guidelines. To describe the 1-year outcome, prognosis factors and functional trajectory for older people admitted to ICU. In a prospective 1-year cohort study, all patients aged 75 years and over admitted to our ICU were included according to a global comprehensive geriatric assessment. Follow-up was conducted for 1 year survivors, in particular, ability scores and living conditions. Of 188 patients included [aged 82.3 ± 4.7 years, 46% of admissions, median SAPS II 53.5 (43-74), ADL of Katz's score 4.2 ± 1.6, median Barthel's index 71 (55-90), AGGIR scale 4.5 ± 1.5], the ICU, hospital and 1-year mortality were, respectively, 34, 42.5 and 65.5%. Prognosis factors were: SAPS 2, mechanical ventilation, comorbidity (Lee's and Mc Cabe's scores), disability scores (ADL of Katz's score, Barthel's index and AGGIR scale), admission creatinin, hypoalbuminemia, malignant haemopathy, cognitive impairment. One-year survivors lived in their own home for 83%, with a preserved physical ability, without significant variation of the three ability assessed scores compared to prior ICU admission. The mortality of older people admitted to ICU is high, with a significant impact of disabilty scores, and preserved 1-year survivor independency. Other studies, including a better comprehensive geriatric assessment, seem necessary to determine a predictive "phenotype" of survival with a "satisfactory" level of autonomy.

  11. Health risk factor modification predicts incidence of diabetes in an employee population: results of an 8-year longitudinal cohort study.

    Science.gov (United States)

    Rolando, Lori; Byrne, Daniel W; McGown, Paula W; Goetzel, Ron Z; Elasy, Tom A; Yarbrough, Mary I

    2013-04-01

    To understand risk factor modification effect on Type 2 diabetes incidence in a workforce population. Annual health risk assessment data (N = 3125) in years 1 through 4 were used to predict diabetes development in years 5 through 8. Employees who reduced their body mass index from 30 or more to less than 30 decreased their chances of developing diabetes (odds ratio = 0.22, 95% confidence interval: 0.05 to 0.93), while those who became obese increased their diabetes risk (odds ratio = 8.85, 95% confidence interval: 2.53 to 31.0). Weight reduction observed over a long period can result in clinically important reductions in diabetes incidence. Workplace health promotion programs may prevent diabetes among workers by encouraging weight loss and adoption of healthy lifestyle habits.

  12. Association of childhood adiposity measures with adulthood knee cartilage defects and bone marrow lesions: a 25-year cohort study.

    Science.gov (United States)

    Meng, Tao; Thayer, Shaun; Venn, Alison; Wu, Feitong; Cicuttini, Flavia; March, Lyn; Dwyer, Terence; Halliday, Andrew; Cross, Marita; Laslett, Laura L; Jones, Graeme; Ding, Changhai; Antony, Benny

    2018-05-15

    To describe the associations between childhood adiposity measures and adulthood knee cartilage defects and bone marrow lesions (BMLs) measured 25 years later. 327 participants from the Australian Schools Health and Fitness Survey of 1985 (aged 7-15 years) were followed up 25 years later (aged 31-41 years). Childhood measures (weight, height and skinfolds) were collected in 1985. Body mass index (BMI), overweight status and fat mass were calculated. Participants underwent 1.5T knee magnetic resonance imaging (MRI) during 2008-2010, and cartilage defects and BMLs were scored from knee MRI scans. Log binomial regressions were used to examine the associations. Among 327 participants (47.1% females), 21 (6.4%) were overweight in childhood. Childhood adiposity measures were associated with the increased risk of adulthood patellar cartilage defects (Weight relative risk (RR) 1.05/kg, 95% confidence interval (CI) 1.01 to 1.09; BMI 1.10/kg/m 2 , 1.01 to 1.19; Overweight 2.22/yes, 1.21 to 4.08; fat mass 1.11/kg, 1.01 to 1.22), but not tibiofemoral cartilage defects. Childhood adiposity measures were not significantly associated with adulthood knee BMLs except for the association between childhood overweight status and adulthood patellar BMLs (RR 2.87/yes, 95% CI 1.10 to 7.53). These significant associations persisted after adjustment for corresponding adulthood adiposity measure. Childhood adiposity measures were associated with the increased risk of adulthood patellar cartilage defects and, to a lesser extent, BMLs, independent of adulthood adiposity measures. These results suggest that adiposity in childhood has long-term effects on patellar structural abnormalities in young adults. Copyright © 2018. Published by Elsevier Ltd.

  13. Evaluation of mammographic surveillance services in women aged 40-49 years with a moderate family history of breast cancer: a single-arm cohort study.

    Science.gov (United States)

    Duffy, S W; Mackay, J; Thomas, S; Anderson, E; Chen, T H H; Ellis, I; Evans, G; Fielder, H; Fox, R; Gui, G; Macmillan, D; Moss, S; Rogers, C; Sibbering, M; Wallis, M; Warren, R; Watson, E; Whynes, D; Allgood, P; Caunt, J

    2013-03-01

    Women with a significant family history of breast cancer are often offered more intensive and earlier surveillance than is offered to the general population in the National Breast Screening Programme. Up to now, this strategy has not been fully evaluated. To evaluate the benefit of mammographic surveillance for women aged 40-49 years at moderate risk of breast cancer due to family history. The study is referred to as FH01. This was a single-arm cohort study with recruitment taking place between January 2003 and February 2007. Recruits were women aged women were offered annual mammography for at least 5 years and observed for the occurrence of breast cancer during the surveillance period. The age group 40-44 years was targeted so that they would still be aged women, 94% of whom were aged women aged 40-49 years with a significant family history of breast or ovarian cancer is both clinically effective in reducing breast cancer mortality and cost-effective. There is a need to further standardise familial risk assessment, to research the impact of digital mammography and to clarify the role of breast density in this population. National Research Register N0484114809. This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 17, No. 11. See the HTA programme website for further project information.

  14. Physical activity patterns and risk of depression in young adulthood: a 20-year cohort study since childhood.

    Science.gov (United States)

    McKercher, Charlotte; Sanderson, Kristy; Schmidt, Michael D; Otahal, Petr; Patton, George C; Dwyer, Terence; Venn, Alison J

    2014-11-01

    Little is known about how physical activity patterns during childhood and adolescence are associated with risk of subsequent depression. We examined prospective and retrospective associations between leisure physical activity patterns from childhood to adulthood and risk of clinical depression in young adulthood. Participants (759 males, 871 females) in a national survey, aged 9-15 years, were re-interviewed approximately 20 years later. Leisure physical activity was self-reported at baseline (1985) and follow-up (2004-2006). To bridge the interval between the two time-points, historical leisure activity from age 15 years to adulthood was self-reported retrospectively at follow-up. Physical activity was categorized into groups that, from a public health perspective, compared patterns that were least beneficial (persistently inactive) with those increasingly beneficial (decreasing, increasing and persistently active). Depression (major depressive or dysthymic disorder) was assessed using the Composite International Diagnostic Interview. Compared with those persistently inactive, males who were increasingly and persistently active had a 69 and 65 % reduced risk of depression in adulthood, respectively (all p active had a 51 % reduced risk of depression in adulthood (p = 0.01). Similar but non-significant trends were observed for leisure physical activity in females and historical leisure activity in males. Results excluded those with childhood onset of depression and were adjusted for various sociodemographic and health covariates. Findings from both prospective and retrospective analyses indicate a beneficial effect of habitual discretionary physical activity since childhood on risk of depression in young adulthood.

  15. Risk of cancer incidence before the age of 15 years after exposure to ionising radiation from computed tomography: results from a German cohort study

    Energy Technology Data Exchange (ETDEWEB)

    Krille, L. [University Medical Center Mainz, Institute of Medical Biostatistics, Epidemiology and Informatics, Mainz (Germany); International Agency for Research on Cancer, Lyon (France); Dreger, S.; Zeeb, H. [University of Bremen, Leibniz - Institute for Prevention Research and Epidemiology - BIPS, Research Focus Health Sciences Bremen, Bremen (Germany); Schindel, R.; Blettner, M. [University Medical Center Mainz, Institute of Medical Biostatistics, Epidemiology and Informatics, Mainz (Germany); Albrecht, T. [Vivantes, Klinikum Neukoelln, Institut fuer Radiologie und Interventionelle Therapie, Berlin (Germany); Asmussen, M. [Zentralinstitut fuer Bildgebende Diagnostik, Staedtisches Klinikum Karlsruhe, Karlsruhe (Germany); Barkhausen, J. [Universitaetsklinikum Schleswig Holstein, Klinik fuer Radiologie und Nuklearmedizin, Campus Luebeck, Luebeck (Germany); Berthold, J.D. [Medizinische Hochschule Hannover, Institut fuer Diagnostische und Interventionelle Radiologie, Hannover (Germany); Chavan, A. [Klinikum Oldenburg GmbH, Institut fuer Diagnostische and Interventionelle Radiologie, Oldenburg (Germany); Claussen, C. [Universitaetsklinikum Tuebingen, Abt. fuer Diagnostische und Interventionelle Radiologie, Tuebingen (Germany); Forsting, M. [Universitaetsklinikum Essen, Institut fuer Diagnostische und Interventionelle Radiologie und Neuroradiologie, Essen (Germany); Gianicolo, E.A.L. [University Medical Center Mainz, Institute of Medical Biostatistics, Epidemiology and Informatics, Mainz (Germany); National Research Council, Institute of Clinical Physiology, Lecce (Italy); Jablonka, K. [Klinikum Bremen-Mitte, Klinik fuer Radiologische Diagnostik und Nuklearmedizin, Bremen (Germany); Jahnen, A. [Centre de Recherche Public Henri Tudor, Luxembourg (Luxembourg); Langer, M. [Universitaetsklinikum Freiburg, Klinik fuer Radiologie, Freiburg (Germany); Laniado, M. [Universitaetsklinikum Carl Gustav Carus Dresden, Institut und Poliklinik fuer Radiologische Diagnostik, Dresden (Germany); Lotz, J. [Universitaetsmedizin Goettingen, Institut fuer Diagnostische und Interventionelle Radiologie, Goettingen (Germany); Mentzel, H.J. [Universitaetsklinikum Jena, Institut fuer Diagnostische und Interventionelle Radiologie, Sektion Kinderradiologie, Jena (Germany); Queisser-Wahrendorf, A. [Universitaetsmedizin Mainz, Zentrum fuer Kinder- und Jugendmedizin, Mainz (Germany); Rompel, O. [Universitaetsklinikum Erlangen, Radiologisches Institut, Erlangen (Germany); Schlick, I. [Klinikum Nuernberg Sued, Institut fuer Radiologie und Neuroradiologie, Nuremberg (Germany); Schneider, K.; Seidenbusch, M. [Institut fuer Klinische Radiologie, Klinikum der Universitaet Muenchen, Dr. von Haunersches Kinderspital, Munich (Germany); Schumacher, M. [Universitaetsklinik Freiburg, Klinik fuer Neuroradiologie, Neurozentrum, Freiburg (Germany); Spix, C. [University Medical Center Mainz, German Childhood Cancer Registry, Mainz (Germany); Spors, B. [Charite - Universitaetsmedizin Berlin, Kinderradiologie, Standort Campus Virchow Klinikum, Berlin (Germany); Staatz, G. [Universitaetsmedizin Mainz, Klinik und Poliklinik fuer diagnostische und interventionelle Radiologie, Sektion Kinderradiologie, Mainz (Germany); Vogl, T. [Klinikum der Johann Wolfgang Goethe-Universitaet Frankfurt/Main, Institut fuer Diagnostische und Interventionelle Radiologie, Frankfurt (Germany); Wagner, J. [Vivantes, Klinikum im Friedrichshain, Institut fuer Radiologie und Interventionelle Therapie, Berlin (Germany); Weisser, G. [Universitaetsklinikum Mannheim, Institut fuer Klinische Radiologie und Nuklearmedizin, Mannheim (Germany)

    2015-03-15

    The aim of this cohort study was to assess the risk of developing cancer, specifically leukaemia, tumours of the central nervous system and lymphoma, before the age of 15 years in children previously exposed to computed tomography (CT) in Germany. Data for children with at least one CT between 1980 and 2010 were abstracted from 20 hospitals. Cancer cases occurring between 1980 and 2010 were identified by stochastic linkage with the German Childhood Cancer Registry (GCCR). For all cases and a sample of non-cases, radiology reports were reviewed to assess the underlying medical conditions at time of the CT. Cases were only included if diagnosis occurred at least 2 years after the first CT and no signs of cancer were recorded in the radiology reports. Standardised incidence ratios (SIR) using incidence rates from the general population were estimated. The cohort included information on 71,073 CT examinations in 44,584 children contributing 161,407 person-years at risk with 46 cases initially identified through linkage with the GCCR. Seven cases had to be excluded due to signs possibly suggestive of cancer at the time of first CT. Overall, more cancer cases were observed (O) than expected (E), but this was mainly driven by unexpected and possibly biased results for lymphomas. For leukaemia, the SIR (SIR = O/E) was 1.72 (95 % CI 0.89-3.01, O = 12), and for CNS tumours, the SIR was 1.35 (95 % CI 0.54-2.78, O = 7). Despite careful examination of the medical information, confounding by indication or reverse causation cannot be ruled out completely and may explain parts of the excess. Furthermore, the CT exposure may have been underestimated as only data from the participating clinics were available. This should be taken into account when interpreting risk estimates. (orig.)

  16. Risk of cancer incidence before the age of 15 years after exposure to ionising radiation from computed tomography: results from a German cohort study.

    Science.gov (United States)

    Krille, L; Dreger, S; Schindel, R; Albrecht, T; Asmussen, M; Barkhausen, J; Berthold, J D; Chavan, A; Claussen, C; Forsting, M; Gianicolo, E A L; Jablonka, K; Jahnen, A; Langer, M; Laniado, M; Lotz, J; Mentzel, H J; Queißer-Wahrendorf, A; Rompel, O; Schlick, I; Schneider, K; Schumacher, M; Seidenbusch, M; Spix, C; Spors, B; Staatz, G; Vogl, T; Wagner, J; Weisser, G; Zeeb, H; Blettner, M

    2015-03-01

    The aim of this cohort study was to assess the risk of developing cancer, specifically leukaemia, tumours of the central nervous system and lymphoma, before the age of 15 years in children previously exposed to computed tomography (CT) in Germany. Data for children with at least one CT between 1980 and 2010 were abstracted from 20 hospitals. Cancer cases occurring between 1980 and 2010 were identified by stochastic linkage with the German Childhood Cancer Registry (GCCR). For all cases and a sample of non-cases, radiology reports were reviewed to assess the underlying medical conditions at time of the CT. Cases were only included if diagnosis occurred at least 2 years after the first CT and no signs of cancer were recorded in the radiology reports. Standardised incidence ratios (SIR) using incidence rates from the general population were estimated. The cohort included information on 71,073 CT examinations in 44,584 children contributing 161,407 person-years at risk with 46 cases initially identified through linkage with the GCCR. Seven cases had to be excluded due to signs possibly suggestive of cancer at the time of first CT. Overall, more cancer cases were observed (O) than expected (E), but this was mainly driven by unexpected and possibly biased results for lymphomas. For leukaemia, the SIR (SIR = O/E) was 1.72 (95 % CI 0.89-3.01, O = 12), and for CNS tumours, the SIR was 1.35 (95 % CI 0.54-2.78, O = 7). Despite careful examination of the medical information, confounding by indication or reverse causation cannot be ruled out completely and may explain parts of the excess. Furthermore, the CT exposure may have been underestimated as only data from the participating clinics were available. This should be taken into account when interpreting risk estimates.

  17. Cohort profile: The Limache, Chile, birth cohort study.

    Science.gov (United States)

    Amigo, Hugo; Bustos, Patricia; Zumelzú, Elinor; Rona, Roberto J

    2014-08-01

    The Limache cohort was set up to assess the programming and life course events hypotheses in relation to cardiovascular risk factors and chronic respiratory conditions, especially asthma, in the context of an unprecedented economic growth in Chile. The cohort was a representative sample of 1232 participants born between 1974 and 1978 in the hospital of Limache. The study includes data collected at birth, during the 1st year of life, at 22 to 28 years (collected between 2000 and 2002) and at 32 to 38 years (collected between 2010 and 2012). The data collected include anthropometric measurements at birth, 1st year of life and in adulthood, socio-economic and demographic data, lifestyle information including smoking, alcohol consumption and food intake, respiratory symptoms, lung function, broncho-reactivity to methacholine and skin prick reaction to eight allergens, measurement of cardiovascular risk factors and information on common mental health, mainly in the most recent study. The principal researchers welcome collaborative projects, especially those that will compare similar data sets in other settings. Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2013; all rights reserved.

  18. Multi-disciplinary management for patients with oligometastases to the brain: results of a 5 year cohort study

    International Nuclear Information System (INIS)

    Maclean, Jillian; Fersht, Naomi; Singhera, Mausam; Mulholland, Paul; McKee, Orla; Kitchen, Neil; Short, Susan C

    2013-01-01

    The incidence of oligometastases to the brain in good performance status patients is increasing due to improvements in systemic therapy and MRI screening, but specific management pathways are often lacking. We established a multi-disciplinary brain metastases clinic with specific referral guidelines and standard follow-up for good prognosis patients with the view that improving the process of care may improve outcomes. We evaluated patient demographic and outcome data for patients first seen between February 2007 and November 2011. The clinic was feasible to run and referrals were appropriate. 87% of patients referred received a localised therapy during their treatment course. 114 patients were seen and patient numbers increased during the 5 years that the clinic has been running as relationships between clinicians were developed. Median follow-up for those still alive was 23.1 months (6.1-79.1 months). Primary treatments were: surgery alone 52%, surgery plus whole brain radiotherapy (WBRT) 9%, radiosurgery 14%, WBRT alone 23%, supportive care 2%. 43% received subsequent treatment for brain metastases. 25%, 11% and 15% respectively developed local neurological progression only, new brain metastases only or both. Median overall survival following brain metastases diagnosis was 16.0 months (range 1–79.1 months). Breast (32%) and NSCLC (26%) were the most common primary tumours with median survivals of 26 and 16.9 months respectively (HR 0.6, p=0.07). Overall one year survival was 55% and two year survival 31.5%. 85 patients died of whom 37 (44%) had a neurological death. Careful patient selection and multi-disciplinary management identifies a subset of patients with oligometastatic brain disease who benefit from aggressive local treatment. A dedicated joint neurosurgical/ neuro-oncology clinic for such patients is feasible and effective. It also offers the opportunity to better define management strategies and further research in this field. Consideration should be

  19. Early term and late preterm birth are associated with poorer school performance at age 5 years: a cohort study.

    Science.gov (United States)

    Quigley, Maria A; Poulsen, Gry; Boyle, Elaine; Wolke, Dieter; Field, David; Alfirevic, Zarko; Kurinczuk, Jennifer J

    2012-05-01

    To compare school performance at age 5 years in children born at full term (39-41 weeks gestation) with those born at early term (37-38 weeks gestation), late preterm (34-36 weeks gestation), moderately preterm (32-33 weeks gestation) and very preterm (2000-2001 and attending school in England in 2006. School performance was measured using the foundation stage profile (FSP), a statutory assessment by teachers at the end of the child's first school year. The FSP comprises 13 assessment scales (scored from 1 to 9). Children who achieve an average of 6 points per scale and at least 6 in certain scales are classified as 'reaching a good level of overall achievement'. Fifty-one per cent of full term children had not reached a good level of overall achievement; this proportion increased with prematurity (55% in early term, 59% in late preterm, 63% in moderately preterm and 66% in very preterm children). Compared with full term children, an elevated risk remained after adjustment, even in early term (adjusted RR 1.05, 95% 1.00 to 1.11) and late preterm children (adjusted RR 1.12, 95% CI 1.04 to 1.22). Similar effects were noted for 'not working securely' in mathematical development, physical development and creative development. The effects of late preterm and early term birth were small in comparison with other risk factors. Late preterm and early term birth are associated with an increased risk of poorer educational achievement at age 5 years.

  20. Retrospective cohort study of all deaths among infants born between 22 and 27 completed weeks of gestation in Switzerland over a 3-year period.

    Science.gov (United States)

    Berger, T M; Steurer, M A; Bucher, H U; Fauchère, J C; Adams, M; Pfister, R E; Baumann-Hölzle, R; Bassler, D

    2017-06-15

    The aim of this research is to assess causes and circumstances of deaths in extremely low gestational age neonates (ELGANs) born in Switzerland over a 3-year period. Population-based, retrospective cohort study. All nine level III perinatal centres (neonatal intensive care units (NICUs) and affiliated obstetrical services) in Switzerland. ELGANs with a gestational age (GA) Switzerland, most deaths among infants born at less than 24 weeks of gestation occurred in the delivery room. In contrast, most deaths of ELGANs with a GA ≥24 weeks were observed following unrestricted provisional intensive care, end-of-life decision-making and redirection of care in the NICU regardless of the degree of immaturity. © 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.

  1. A 2-year cohort study on the impact of an Employee Assistance Programme (EAP) on depression and suicidal thoughts in male Japanese workers.

    Science.gov (United States)

    Nakao, Mutsuhiro; Nishikitani, Mariko; Shima, Satoru; Yano, Eiji

    2007-11-01

    Depression and suicide-related behaviours are important issues for workers, and the number of Japanese companies contracting with the Employee Assistance Programme (EAP) to promote employees' mental health has recently increased. However, no longitudinal studies have reported that the EAP maintains or improves the overall level of depression among employees qualitatively. Thus, we attempted to assess the impact of the EAP on depression and suicide-related behaviours in the workplace. A cohort study was conducted on 283 male Japanese employees aged 22-38 years at a Japanese information-technology company introducing the EAP. Because the privacy policy of the EAP service made it difficult to perform a randomised design in the workplace, 22 men working at an affiliated company without the EAP were used as a reference group. All the subjects completed the 17-item Hamilton Depression Scale (HAM-D) and Job Content Questionnaire (JCQ) consisting of job demands, control, and social support before the EAP was introduced to establish a baseline and after 2 years. In the EAP group, the total HAM-D scores significantly decreased after the 2-year study period (P=0.0011); the changes in the scores of the five HAM-D items (i.e., suicidal thoughts, agitation, psychomotor retardation, guilt, and depressed mood) were significant. Specifically, 19 (86%) of the 22 workers with a positive response to the suicidal thoughts item (i.e., score >or= 1) at baseline reported that they no longer had suicidal thoughts (i.e., score=0) after the 2 year study period. No significant changes were observed in the reference group. The three JCQ scores were not significantly different between the baseline and after the 2 year study period in both groups. Although further studies are needed, EAPs may be a promising strategy for maintaining the good mental health of workers.

  2. Characterizing Durations of Heroin Abstinence in the California Civil Addict Program: Results From a 33-Year Observational Cohort Study

    Science.gov (United States)

    Nosyk, Bohdan; Anglin, M. Douglas; Brecht, Mary-Lynn; Lima, Viviane Dias; Hser, Yih-Ing

    2013-01-01

    In accordance with the chronic disease model of opioid dependence, cessation is often observed as a longitudinal process rather than a discrete endpoint. We aimed to characterize and identify predictors of periods of heroin abstinence in the natural history of recovery from opioid dependence. Data were collected on participants from California who were enrolled in the Civil Addict Program from 1962 onward by use of a natural history interview. Multivariate regression using proportional hazards frailty models was applied to identify independent predictors and correlates of repeated abstinence episode durations. Among 471 heroin-dependent males, 387 (82.2%) reported 932 abstinence episodes, 60.3% of which lasted at least 1 year. Multivariate analysis revealed several important findings. First, demographic factors such as age and ethnicity did not explain variation in durations of abstinence episodes. However, employment and lower drug use severity predicted longer episodes. Second, abstinence durations were longer following sustained treatment versus incarceration. Third, individuals with multiple abstinence episodes remained abstinent for longer durations in successive episodes. Finally, abstinence episodes initiated >10 and ≤20 years after first use lasted longer than others. Public policy facilitating engagement of opioid-dependent individuals in maintenance-oriented drug treatment and employment is recommended to achieve and sustain opioid abstinence. PMID:23445901

  3. Weight change after 20 years of age and the incidence of dyslipidemia: a cohort study of Japanese male workers.

    Science.gov (United States)

    Sogabe, N; Sawada, S S; Lee, I-M; Kawakami, R; Ishikawa-Takata, K; Nakata, Y; Mitomi, M; Noguchi, J; Tsukamoto, K; Miyachi, M; Blair, S N

    2016-06-01

    While heavier weight is known to increase the incidence of dyslipidemia, limited data are available on the relationship between weight gain and its development. A total of 2647 males were categorized into the following four groups according to the difference between their self-reported weight at 20 years of age and their measured weight in 1994-95: a loss of ≥5% (decrease), loss of dyslipidemia were determined using logistic regression models. A total of 1342 participants developed dyslipidemia during the follow-up period. The 'increase' and 'sizable increase' groups had odds ratios for the incidence of dyslipidemia of 1.97 (95% CI, 1.59-2.45) and 2.68 (2.15-3.34), respectively, demonstrating that there was a significant dose-response association between weight gain since 20 years of age and the incidence of dyslipidemia (P dyslipidemia could be prevented by avoiding weight gain in adulthood. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. The course of untreated anxiety and depression, and determinants of poor one-year outcome: a one-year cohort study

    Directory of Open Access Journals (Sweden)

    van Marwijk Harm WJ

    2010-10-01

    Full Text Available Abstract Background Little is known about the course and outcome of untreated anxiety and depression in patients with and without a self-perceived need for care. The aim of the present study was to examine the one-year course of untreated anxiety and depression, and to determine predictors of a poor outcome. Method Baseline and one-year follow-up data were used of 594 primary care patients with current anxiety or depressive disorders at baseline (established by the Composite Interview Diagnostic Instrument (CIDI, from the Netherlands Study of Depression and Anxiety (NESDA. Receipt of and need for care were assessed by the Perceived Need for Care Questionnaire (PNCQ. Results In depression, treated and untreated patients with a perceived treatment need showed more rapid symptom decline but greater symptom severity at follow-up than untreated patients without a self-perceived mental problem or treatment need. A lower education level, lower income, unemployment, loneliness, less social support, perceived need for care, number of somatic disorders, a comorbid anxiety and depressive disorder and symptom severity at baseline predicted a poorer outcome in both anxiety and depression. When all variables were considered at the same time, only baseline symptom severity appeared to predict a poorer outcome in anxiety. In depression, a poorer outcome was also predicted by more loneliness and a comorbid anxiety and depressive disorder. Conclusion In clinical practice, special attention should be paid to exploring the need for care among possible risk groups (e.g. low social economic status, low social support, and support them in making an informed decision on whether or not to seek treatment.

  5. Early Father Involvement and Subsequent Child Behaviour at Ages 3, 5 and 7 Years: Prospective Analysis of the UK Millennium Cohort Study.

    Science.gov (United States)

    Kroll, Mary E; Carson, Claire; Redshaw, Maggie; Quigley, Maria A

    Fathers are increasingly involved in care of their babies and young children. We assessed the association of resident fathers' involvement with subsequent behaviour of their children, examining boys and girls separately. We used longitudinal data from the UK Millennium Cohort Study for children born in 2000-2001, divided into three separate analysis periods: ages 9 months to 3 years, 3 to 5 years, and 5 to 7 years. By exploratory factor analysis of self-reported attitudes and engagement in caring activities, we derived composite measures of various types of father involvement at 9 months, 3 and 5 years. Where possible we created equivalent measures of mother involvement. Child behaviour was assessed by the Strengths and Difficulties Questionnaire (SDQ), which was completed by the mother when the child was aged 3, 5 and 7 years. We estimated gender-specific odds ratios for behaviour problems per quintile of father involvement, using separate logistic regression models for boys and girls in each analysis period. We controlled for a wide range of potential confounders: characteristics of the child (temperament and development at 9 months, and illness and exact age at outcome), equivalent mother involvement where appropriate, and factors related to socioeconomic status, household change, and parental well-being, where statistically significant. Paternal positive parenting beliefs at age 9 months and increased frequency of creative play at age 5 years were significantly associated with lower risk of subsequent behaviour problems (SDQ total difficulties) in both boys and girls (pinvolvement. No associations were observed for other composite measures of caring activity by the father at 9 months, 3 years or 5 years. Quality of parenting, rather than the division of routine care between parents, was associated with child behavioural outcomes.

  6. Long term cause specific mortality among 34 489 five year survivors of childhood cancer in Great Britain: population based cohort study

    Science.gov (United States)

    Fidler, Miranda M; Reulen, Raoul C; Winter, David L; Kelly, Julie; Jenkinson, Helen C; Skinner, Rod; Frobisher, Clare

    2016-01-01

    Objective To determine whether modern treatments for cancer are associated with a net increased or decreased risk of death from neoplastic and non-neoplastic causes among survivors of childhood cancer. Design Population based cohort study. Setting British Childhood Cancer Survivor Study. Participants Nationwide population based cohort of 34 489 five year survivors of childhood cancer with a diagnosis from 1940 to 2006 and followed up until 28 February 2014. Main outcome measures Cause specific standardised mortality ratios and absolute excess risks are reported. Multivariable Poisson regression models were utilised to evaluate the simultaneous effect of risk factors. Likelihood ratio tests were used to test for heterogeneity or trend. Results Overall, 4475 deaths were observed, which was 9.1 (95% confidence interval 8.9 to 9.4) times that expected in the general population, corresponding to 64.2 (95% confidence interval 62.1 to 66.3) excess deaths per 10 000 person years. The number of excess deaths from all causes declined among those treated more recently; those treated during 1990-2006 experienced 30% of the excess number of deaths experienced by those treated before 1970. The corresponding percentages for the decline in excess deaths from recurrence or progression and non-neoplastic causes were 30% and 60%, respectively. Among survivors aged 50-59 years, 41% and 22% of excess deaths were attributable to subsequent primary neoplasms and circulatory conditions, respectively, whereas the corresponding percentages among those aged 60 years or more were 31% and 37%. Conclusions The net effects of changes in cancer treatments, and surveillance and management for late effects, over the period 1940 to 2006 was to reduce the excess number of deaths from both recurrence or progression and non-neoplastic causes among those treated more recently. Among survivors aged 60 years or more, the excess number of deaths from circulatory causes exceeds the excess number

  7. Fasting Plasma Insulin at 5 Years of Age Predicted Subsequent Weight Increase in Early Childhood over a 5-Year Period—The Da Qing Children Cohort Study

    Science.gov (United States)

    Chen, Yan Yan; Wang, Jin Ping; Jiang, Ya Yun; Li, Hui; Hu, Ying Hua; Lee, Kok Onn; Li, Guang Wei

    2015-01-01

    Background The association between hyperinsulinemia and obesity is well known. However, it is uncertain especially in childhood obesity, if initial fasting hyperinsulinemia predicts obesity, or obesity leads to hyperinsulinemia through insulin resistance. Objective To investigate the predictive effect of fasting plasma insulin on subsequent weight change after a 5-year interval in childhood. Methods 424 Children from Da Qing city, China, were recruited at 5 years of age and followed up for 5 years. Blood pressure, anthropometric measurements, fasting plasma insulin, glucose and triglycerides were measured at baseline and 5 years later. Results Fasting plasma insulin at 5 years of age was significantly correlated with change of weight from 5 to 10 years (ΔWeight). Children in the lowest insulin quartile had ΔWeight of 13.08±0.73 kg compare to 18.39±0.86 in the highest insulin quartile (P<0.0001) in boys, and similarly 12.03±0.71 vs 15.80±0.60 kg (P<0.0001) in girls. Multivariate analysis showed that the predictive effect of insulin at 5 years of age on subsequent weight gain over 5 years remained statistically significant even after the adjustment for age, sex, birth weight, TV-viewing time and weight (or body mass index) at baseline. By contrast, the initial weight at 5 years of age did not predict subsequent changes in insulin level 5 years later. Children who had both higher fasting insulin and weight at 5 years of age showed much higher levels of systolic blood pressures, fasting plasma glucose, the homeostasis model assessment for insulin resistance (HOMA-IR) and triglycerides at 10 years of age. Conclusions Fasting plasma insulin at 5 years of age predicts weight gain and cardiovascular risk factors 5 year later in Chinese children of early childhood, but the absolute weight at 5 years of age did not predict subsequent change in fasting insulin. PMID:26047327

  8. Fasting Plasma Insulin at 5 Years of Age Predicted Subsequent Weight Increase in Early Childhood over a 5-Year Period-The Da Qing Children Cohort Study.

    Directory of Open Access Journals (Sweden)

    Yan Yan Chen

    Full Text Available The association between hyperinsulinemia and obesity is well known. However, it is uncertain especially in childhood obesity, if initial fasting hyperinsulinemia predicts obesity, or obesity leads to hyperinsulinemia through insulin resistance.To investigate the predictive effect of fasting plasma insulin on subsequent weight change after a 5-year interval in childhood.424 Children from Da Qing city, China, were recruited at 5 years of age and followed up for 5 years. Blood pressure, anthropometric measurements, fasting plasma insulin, glucose and triglycerides were measured at baseline and 5 years later.Fasting plasma insulin at 5 years of age was significantly correlated with change of weight from 5 to 10 years (ΔWeight. Children in the lowest insulin quartile had ΔWeight of 13.08±0.73 kg compare to 18.39±0.86 in the highest insulin quartile (P<0.0001 in boys, and similarly 12.03±0.71 vs 15.80±0.60 kg (P<0.0001 in girls. Multivariate analysis showed that the predictive effect of insulin at 5 years of age on subsequent weight gain over 5 years remained statistically significant even after the adjustment for age, sex, birth weight, TV-viewing time and weight (or body mass index at baseline. By contrast, the initial weight at 5 years of age did not predict subsequent changes in insulin level 5 years later. Children who had both higher fasting insulin and weight at 5 years of age showed much higher levels of systolic blood pressures, fasting plasma glucose, the homeostasis model assessment for insulin resistance (HOMA-IR and triglycerides at 10 years of age.Fasting plasma insulin at 5 years of age predicts weight gain and cardiovascular risk factors 5 year later in Chinese children of early childhood, but the absolute weight at 5 years of age did not predict subsequent change in fasting insulin.

  9. Predictive factors for 1-year outcome of a cohort of patients with severe traumatic brain injury (TBI): results from the PariS-TBI study.

    Science.gov (United States)

    Jourdan, C; Bosserelle, V; Azerad, S; Ghout, I; Bayen, E; Aegerter, P; Weiss, J J; Mateo, J; Lescot, T; Vigué, B; Tazarourte, K; Pradat-Diehl, P; Azouvi, P

    2013-01-01

    To assess outcome and predicting factors 1 year after a severe traumatic brain injury (TBI). Multi-centre prospective inception cohort study of patients aged 15 or older with a severe TBI in the Parisian area, France. Data were collected prospectively starting the day of injury. One-year evaluation included the relatives-rating of the Dysexecutive Questionnaire (DEX-R), the Glasgow Outcome Scale-Extended (GOSE) and employment. Univariate and multivariate tests were computed. Among 257 survivors, 134 were included (mean age 36 years, 84% men). Good recovery concerned 19%, moderate disability 43% and severe disability 38%. Among patients employed pre-injury, 42% were working, 28% with no job change. DEX-R score was significantly associated with length of education only. Among initial severity measures, only the IMPACT prognostic score was significantly related to GOSE in univariate analyses, while measures relating to early evolution were more significant predictors. In multivariate analyses, independent predictors of GOSE were length of stay in intensive care (LOS), age and education. Independent predictors of employment were LOS and age. Age, education and injury severity are independent predictors of global disability and return to work 1 year after a severe TBI.

  10. A prospective observational cohort study to assess the incidence of acute otitis media among children 0-5 years of age in Southern Brazil.

    Science.gov (United States)

    Lanzieri, Tatiana M; Cunha, Clóvis Arns da; Cunha, Rejane B; Arguello, D Fermin; Devadiga, Raghavendra; Sanchez, Nervo; Barria, Eduardo Ortega

    To estimate acute otitis media incidence among young children and impact on quality of life of parents/caregivers in a southern Brazilian city. Prospective cohort study including children 0-5 years of age registered at a private pediatric practice. Acute otitis media episodes diagnosed by a pediatrician and impact on quality of life of parents/caregivers were assessed during a 12-month follow-up. During September 2008-March 2010, of 1,136 children enrolled in the study, 1074 (95%) were followed: 55.0% were ≤2 years of age, 52.3% males, 94.7% white, and 69.2% had previously received pneumococcal vaccine in private clinics. Acute otitis media incidence per 1000 person-years was 95.7 (95% confidence interval: 77.2-117.4) overall, 105.5 (95% confidence interval: 78.3-139.0) in children ≤2 years of age and 63.6 (95% confidence interval: 43.2-90.3) in children 3-5 years of age. Acute otitis media incidence per 1000 person-years was 86.3 (95% confidence interval: 65.5-111.5) and 117.1 (95% confidence interval: 80.1-165.3) among vaccinated and unvaccinated children, respectively. Nearly 68.9% of parents reported worsening of their overall quality of life. Acute otitis media incidence among unvaccinated children in our study may be useful as baseline data to assess impact of pneumococcal vaccine introduction in the Brazilian National Immunization Program in April 2010. Copyright © 2017 Sociedade Brasileira de Infectologia. Published by Elsevier Editora Ltda. All rights reserved.

  11. The First Six Years of Building and Implementing a Return-to-Work Service for Patients with Acquired Brain Injury. The Rapid-Return-to-Work-Cohort-Study.

    Science.gov (United States)

    Haveraaen, L; Brouwers, E P M; Sveen, U; Skarpaas, L S; Sagvaag, H; Aas, R W

    2017-12-01

    Background and objective Despite large activity worldwide in building and implementing new return-to-work (RTW) services, few studies have focused on how such implementation processes develop. The aim of this study was to examine the development in patient and service characteristics the first six years of implementing a RTW service for persons with acquired brain injury (ABI). Methods The study was designed as a cohort study (n=189). Data were collected by questionnaires, filled out by the service providers. The material was divided into, and analyzed with, two implementation phases. Non-parametrical statistical methods and hierarchical regression analyses were applied on the material. Results The number of patients increased significantly, and the patient group became more homogeneous. Both the duration of the service, and the number of consultations and group session days were significantly reduced. Conclusion The patient group became more homogenous, but also significantly larger during the first six years of building the RTW service. At the same time, the duration of the service decreased. This study therefore questions if there is a lack of consensus on the intensity of work rehabilitation for this group.

  12. All-cause mortality and risk factors in a cohort of retired military male veterans, Xi'an, China: an 18-year follow up study

    Directory of Open Access Journals (Sweden)

    Li Liang S

    2007-10-01

    Full Text Available Abstract Background Risk factors of all-cause mortality have not been reported in Chinese retired military veterans. The objective of the study was to examine the risk factors and proportional mortality in a Chinese retired military male cohort. Methods A total of 1268 retired military men aged 55 or older were examined physically and interviewed using a standard questionnaire in 1987. The cohort was followed up every two years and the study censored date was June30, 2005 with a follow-up of up to 18 years. Death certificates were obtained from hospitals and verified by two senior doctors. Data were entered (double entry by Foxbase, and analysis was carried out by SAS for Windows 8.2. Multivariate Cox proportional hazard regression model was used to compute hazard ratio (HR and 95% confidence interval (CI. Results The total person-years of follow-up was 18766.28. Of the initial cohort of 1268 men, 491 had died, 748 were alive and 29 were lost to follow up. Adjusted mortality (adjusted for age, blood pressure, body mass index, cholesterol, triglycerides, alcohol, exercise, and existing disease was 2,616 per 100,000 person years. The proportional mortality of cancer, vascular disease and Chronic Obstructive Pulmonary Disease (COPD were 39.71%, 28.10% and 16.90% respectively. Multivariate analysis showed that age, cigarettes per day, systolic blood pressure, triglyceride, family history of diseases (hypertension, stroke and cancer, existing diseases (stroke, diabetes and cancer, body mass index, and age of starting smoking were associated with all-cause mortality, HR (95%CI was1.083(1.062–1.104, 1.026(1.013–1.039, 1.009(1.003–1.015, 1.002(1.001–1.003, 1.330(1.005–1.759, 1.330(1.005–1.759, 1.444(1.103–1.890, 2.237(1.244–4.022, 1.462(1.042–2.051, 2.079(1.051–4.115, 0.963(0.931–0.996and 0.988(0.978–0.999respectively. Compared with never-smokers, current smokers had increased risks of total mortality [HR 1.369(1.083–1

  13. Socio economic achievements of individuals born very preterm at the age of 27 to 29 years: A nationwide cohort study

    DEFF Research Database (Denmark)

    Mathiasen, René; Hansen, Bo M; Andersen, Anne-Marie Nybo

    2009-01-01

    Aim To describe the socio economic achievement of individuals born very preterm (VPT) at the age of 27 to 29 years. Method Demographic and social data were extracted from national registers for all individuals born between 1974 and 1976 in Denmark (n=208 656). Of these, 203 283 individuals were...... results in the two groups were similar, but significant differences appeared. The VPT group had a lower educational level than the term group: 23.9% versus 16.3% had a basic education (corresponding to attendance at basic school for 9y or less; odds ratio [OR] =1.61, 95% confidence interval [CI] 1.......42-1.82). Similarly, 31.9% versus 37.6% had a tertiary education (corresponding to different levels of professional education; OR=0.77, CI 0.69-0.86). Net income was 11% lower in the VPT group and 10.8% versus 5.3% were receiving welfare support (OR=2.14, CI 1.81-2.55). In the VPT group 59% versus 52% did not have...

  14. Association of diabetes in pregnancy with child weight at birth, age 12 months and 5 years--a population-based electronic cohort study.

    Directory of Open Access Journals (Sweden)

    Kelly Morgan

    Full Text Available This study examines the effect of diabetes in pregnancy on offspring weight at birth and ages 1 and 5 years.A population-based electronic cohort study using routinely collected linked healthcare data. Electronic medical records provided maternal diabetes status and offspring weight at birth and ages 1 and 5 years (n = 147,773 mother child pairs. Logistic regression models were used to obtain odds ratios to describe the association between maternal diabetes status and offspring size, adjusted for maternal pre-pregnancy weight, age and smoking status.We identified 1,250 (0.9% pregnancies with existing diabetes (27.8% with type 1 diabetes, 1,358 with gestational diabetes (0.9% and 635 (0.4% who developed diabetes post-pregnancy. Children whose mothers had existing diabetes were less likely to be large at 12 months (OR: 0.7 (95%CI: 0.6, 0.8 than those without diabetes. Maternal diabetes was associated with high weight at age 5 years in children whose mothers had a high pre-pregnancy weight tertile (gestational diabetes, (OR:2.1 (95%CI:1.25-3.6, existing diabetes (OR:1.3 (95%CI:1.0 to 1.6.The prevention of childhood obesity should focus on mothers with diabetes with a high maternal pre-pregnancy weight. We found little evidence that diabetes in pregnancy leads to long term obesity 'programming'.

  15. Yogurt consumption in infancy is inversely associated with atopic dermatitis and food sensitization at 5 years of age: A hospital-based birth cohort study.

    Science.gov (United States)

    Shoda, Tetsuo; Futamura, Masaki; Yang, Limin; Narita, Masami; Saito, Hirohisa; Ohya, Yukihiro

    2017-05-01

    Several studies have suggested that habitual yogurt consumption is associated with favorable outcomes for health issues in children. However, the effects of yogurt consumption on allergic diseases and sensitization in children remain poorly understood. This prospective birth cohort study aimed to investigate for associations between habitual yogurt consumption in infancy and development of allergic diseases/sensitization at 5 years of age. Data were obtained from the Tokyo Children's Health, Illness and Development (T-CHILD) study. A total of 1550 children were born to the recruited women. Consumption of yogurt by children during infancy was determined by using questionnaires completed at 12 months of age. Outcome data for children were collected from the questionnaires and medical check-ups completed at 5 years of age. Possible associations between habitual yogurt consumption in infancy and allergic diseases/sensitization were analyzed by multiple logistic regression analyses. We analyzed the data for 1166 children whose parents responded at 5 years of age. Habitual yogurt consumption in infancy and atopic dermatitis at 5 years of age were significantly associated (UKWP criteria: aOR, 0.70; 95% CI, 0.51-0.97; P=0.03). Children with habitual yogurt consumption in infancy were less likely to be sensitized to food allergens (aOR, 0.53; 95% CI, 0.31-0.93; P=0.03), but no associations were seen in regard to any other allergens. Our study demonstrated that habitual consumption of yogurt in infancy has the potential to prevent development of atopic dermatitis and food sensitization, but not other allergic diseases, at 5 years of age. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  16. Hamstring and Quadriceps Isokinetic Strength Deficits Are Weak Risk Factors for Hamstring Strain Injuries: A 4-Year Cohort Study

    NARCIS (Netherlands)

    van Dyk, Nicol; Bahr, Roald; Whiteley, Rodney; Tol, Johannes L.; Kumar, Bhavesh D.; Hamilton, Bruce; Farooq, Abdulaziz; Witvrouw, Erik

    2016-01-01

    A hamstring strain injury (HSI) has become the most common noncontact injury in soccer. Isokinetic muscle strength deficits are considered a risk factor for HSIs. However, underpowered studies with small sample sizes unable to determine small associations have led to inconclusive results regarding

  17. Mothers' Own Recollections Of Being Parented And Risk Of Offspring Depression 18 Years Later: A Prospective Cohort Study

    Science.gov (United States)

    Mahedy, Liam; Heron, Jon; Stapinski, Lexine A; Pearson, Rebecca M; Evans, Jonathan; Joinson, Carol; Bowes, Lucy; Lewis, Glyn

    2014-01-01

    Background Although the relationship between maternal bonding and risk of offspring depression has been demonstrated, it is unclear whether this risk exists for subsequent generations. This study examines the association between maternal reports of her own mother's parenting and later risk of depression in offspring at age 18. Method This study is based on data from the Avon Longitudinal Study of Parents and Children. Mothers enrolled in the study, completed the Parental Bonding Instrument to provide an assessment of how they were parented by their own mothers up to the age of 16. Offspring depression was assessed at age of 18 using the Clinical Interview Schedule-Revised. The sample comprised 10,405 respondents who had completed the Parental Bonding Instrument during the antenatal period. Results were adjusted for grandmother's history of depression, maternal depression, and a range of socioeconomic variables. Results A one standard deviation increase in mothers’ perceived lack of care in their own childhood was associated with a 16% increase in the odds of offspring depression at age 18 (odds ratios = 1.16, 95% confidence intervals = [1.04, 1.30]). This effect remained following adjustment for potential confounders (odds ratios = 1.14, 95% confidence intervals = [1.02, 1.27]). There was no evidence for an association between overprotection and offspring depression. Conclusions This study is consistent with the hypothesis that sensitive caregiving is important to future risk of depression across generations. Preventative interventions could be aimed at promoting positive parenting practices, which may help to reduce the risk of depression in subsequent generations. PMID:24105778

  18. Mothers' own recollections of being parented and risk of offspring depression 18 years later: a prospective cohort study.

    Science.gov (United States)

    Mahedy, Liam; Heron, Jon; Stapinski, Lexine A; Pearson, Rebecca M; Evans, Jonathan; Joinson, Carol; Bowes, Lucy; Lewis, Glyn

    2014-01-01

    Although the relationship between maternal bonding and risk of offspring depression has been demonstrated, it is unclear whether this risk exists for subsequent generations. This study examines the association between maternal reports of her own mother's parenting and later risk of depression in offspring at age 18. This study is based on data from the Avon Longitudinal Study of Parents and Children. Mothers enrolled in the study, completed the Parental Bonding Instrument to provide an assessment of how they were parented by their own mothers up to the age of 16. Offspring depression was assessed at age of 18 using the Clinical Interview Schedule-Revised. The sample comprised 10,405 respondents who had completed the Parental Bonding Instrument during the antenatal period. Results were adjusted for grandmother's history of depression, maternal depression, and a range of socioeconomic variables. A one standard deviation increase in mothers' perceived lack of care in their own childhood was associated with a 16% increase in the odds of offspring depression at age 18 (odds ratios = 1.16, 95% confidence intervals = [1.04, 1.30]). This effect remained following adjustment for potential confounders (odds ratios = 1.14, 95% confidence intervals = [1.02, 1.27]). There was no evidence for an association between overprotection and offspring depression. This study is consistent with the hypothesis that sensitive caregiving is important to future risk of depression across generations. Preventative interventions could be aimed at promoting positive parenting practices, which may help to reduce the risk of depression in subsequent generations. © 2013 The Authors. Depression and Anxiety published by Wiley Periodicals, Inc.

  19. Patients with sciatica still experience pain and disability 5 years after surgery: A systematic review with meta-analysis of cohort studies.

    Science.gov (United States)

    Machado, G C; Witzleb, A J; Fritsch, C; Maher, C G; Ferreira, P H; Ferreira, M L

    2016-11-01

    The clinical course of patients with sciatica is believed to be favourable, but there is conflicting evidence on the postoperative course of this condition. We aimed to investigate the clinical course of sciatica following surgery. An electronic search was conducted on MEDLINE, EMBASE and CINAHL from inception to April 2015. We screened for prospective cohort studies investigating pain or disability outcomes for patients with sciatica treated surgically. Fractional polynomial regression analysis was used to generate pooled means and 95% confidence intervals (CI) of pain and disability up to 5 years after surgery. Estimates of pain and disability (converted to a 0-100 scale) were plotted over time, from inception to last available follow-up time. Forty records (39 cohort studies) were included with a total of 13,883 patients with sciatica. Before surgery, the pooled mean leg pain score was 75.2 (95% CI 68.1-82.4) which reduced to 15.3 (95% CI 8.5-22.1) at 3 months. Patients were never fully recovered in the long-term and pain increased to 21.0 (95% CI 12.5-29.5) at 5 years. The pooled mean disability score before surgery was 55.1 (95% CI 52.3-58.0) and this decreased to 15.5 (95% CI 13.3-17.6) at 3 months, and further reduced to 13.1 (95% CI 10.6-15.5) at 5 years. Although surgery is followed by a rapid decrease in pain and disability by 3 months, patients still experience mild to moderate pain and disability 5 years after surgery. WHAT DOES THIS REVIEW ADD?: This review provides a quantitative summary of the postoperative course of patients with sciatica. Patients with sciatica experienced a rapid reduction in pain and disability in the first 3 months, but still had mild to moderate symptoms 5 years after surgery. Although no significant differences were found, microdiscectomy showed larger improvements compared to other surgical techniques. © 2016 European Pain Federation - EFIC®.

  20. Relation between body composition at birth and child development at 2 years of age: a prospective cohort study among Ethiopian children.

    Science.gov (United States)

    Abera, M; Tesfaye, M; Girma, T; Hanlon, C; Andersen, G S; Wells, J C; Admassu, B; Wibaek, R; Friis, H; Kæstel, P

    2017-12-01

    Birth weight (BW), independent of socioeconomic status, has been identified as a predictor for childhood cognitive development. However, it is not known whether this relation is related to low BW per se or particularly related to a deficit in fat mass (FM) or fat-free mass (FFM) at birth. This study therefore aimed at investigating the relation between body composition at birth and child development at 2 years of age. An Ethiopian birth cohort was followed up at 2 years. Body composition was measured within 48 h of birth using infant air-displacement plethysmography. Child development was assessed at 2 years of age using Denver developmental screening test. Associations between body composition at birth and development at 2 years of age were tested using linear regression analysis. FFM but not FM at birth was positively associated with higher global developmental score at 2 years of age (β=2.48, 95% confidence interval (CI) 0.17; 4.79) adjusted for neonatal, postnatal and parental characteristics. This association was attributable to the association with the language developmental domain (β=1.61, 95 CI 0.33; 2.90). Among Ethiopian children, FFM at birth but not FM predicted better global and language development at 2 years of age. Higher FFM at birth might have exerted a positive effect on the growth and differentiation of the brain and neuronal circuits for better development. This study therefore highlights the need to improve mother's nutritional status during pregnancy in ways that stimulate fetal FFM growth.

  1. The outcomes and controversies of transplant tourism-Lessons of an 11-year retrospective cohort study from Taiwan

    OpenAIRE

    Tsai, Daniel Fu-Chang; Huang, Shi-Wei; Holm, Soren; Lin, Yi-Ping; Chang, Yu-Kang; Hsu, Chih-Cheng

    2017-01-01

    BACKGROUND: Transplant tourism has increased rapidly in the past two decades, accounting for about 10% of world organ transplants. However it is ethically controversial and discouraged by professional guidelines. We conducted this study to investigate the outcomes and trends of overseas kidney and liver transplantation in Taiwan to provide a sound basis for ethical reflection.METHODS AND FINDINGS: The Taiwanese National Health Insurance Research Database was used to identify 2381 domestic and...

  2. Increase in relative skeletal muscle mass over time and its inverse association with metabolic syndrome development: a 7-year retrospective cohort study.

    Science.gov (United States)

    Kim, Gyuri; Lee, Seung-Eun; Jun, Ji Eun; Lee, You-Bin; Ahn, Jiyeon; Bae, Ji Cheol; Jin, Sang-Man; Hur, Kyu Yeon; Jee, Jae Hwan; Lee, Moon-Kyu; Kim, Jae Hyeon

    2018-02-05

    Skeletal muscle mass was negatively associated with metabolic syndrome prevalence in previous cross-sectional studies. The aim of this study was to investigate the impact of baseline skeletal muscle mass and changes in skeletal muscle mass over time on the development of metabolic syndrome in a large population-based 7-year cohort study. A total of 14,830 and 11,639 individuals who underwent health examinations at the Health Promotion Center at Samsung Medical Center, Seoul, Korea were included in the analyses of baseline skeletal muscle mass and those changes from baseline over 1 year, respectively. Skeletal muscle mass was estimated by bioelectrical impedance analysis and was presented as a skeletal muscle mass index (SMI), a body weight-adjusted appendicular skeletal muscle mass value. Using Cox regression models, hazard ratio for developing metabolic syndrome associated with SMI values at baseline or changes of SMI over a year was analyzed. During 7 years of follow-up, 20.1% of subjects developed metabolic syndrome. Compared to the lowest sex-specific SMI tertile at baseline, the highest sex-specific SMI tertile showed a significant inverse association with metabolic syndrome risk (adjusted hazard ratio [AHR] = 0.61, 95% confidence interval [CI] 0.54-0.68). Furthermore, compared with SMI changes metabolic syndrome development were 0.87 (95% CI 0.78-0.97) for 0-1% changes and 0.67 (0.56-0.79) for > 1% changes in SMI over 1 year after additionally adjusting for baseline SMI and glycometabolic parameters. An increase in relative skeletal muscle mass over time has a potential preventive effect on developing metabolic syndrome, independently of baseline skeletal muscle mass and glycometabolic parameters.

  3. Job strain and loss of healthy life years between ages 50 and 75 by sex and occupational position: analyses of 64 934 individuals from four prospective cohort studies.

    Science.gov (United States)

    Magnusson Hanson, Linda L; Westerlund, Hugo; Chungkham, Holendro S; Vahtera, Jussi; Rod, Naja H; Alexanderson, Kristina; Goldberg, Marcel; Kivimäki, Mika; Stenholm, Sari; Platts, Loretta G; Zins, Marie; Head, Jenny

    2018-05-07

    Poor psychosocial working conditions increase the likelihood of various types of morbidity and may substantially limit quality of life and possibilities to remain in paid work. To date, however, no studies to our knowledge have quantified the extent to which poor psychosocial working conditions reduce healthy or chronic disease-free life expectancy, which was the focus of this study. Data were derived from four cohorts with repeat data: the Finnish Public Sector Study (Finland), GAZEL (France), the Swedish Longitudinal Occupational Survey of Health (Sweden) and Whitehall II (UK). Healthy (in good self-rated health) life expectancy (HLE) and chronic disease-free (free from cardiovascular disease, cancer, respiratory disease and diabetes) life expectancy (CDFLE) was calculated from age 50 to 75 based on 64 394 individuals with data on job strain (high demands in combination with low control) at baseline and health at baseline and follow-up. Multistate life table models showed that job strain was consistently related to shorter HLE (overall 1.7 years difference). The difference in HLE was more pronounced among men (2.0 years compared with 1.5 years for women) and participants in lower occupational positions (2.5 years among low-grade men compared with 1.7 years among high-grade men). Similar differences in HLE, although smaller, were observed among those in intermediate or high occupational positions. Job strain was additionally associated with shorter CDFLE, although this association was weaker and somewhat inconsistent. These findings suggest that individuals with job strain have a shorter health expectancy compared with those without job strain. © 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.

  4. Vitamin D Deficiency in Adult Patients with Schizophreniform and Autism Spectrum Syndromes: A One-Year Cohort Study at a German Tertiary Care Hospital.

    Science.gov (United States)

    Endres, Dominique; Dersch, Rick; Stich, Oliver; Buchwald, Armin; Perlov, Evgeniy; Feige, Bernd; Maier, Simon; Riedel, Andreas; van Elst, Ludger Tebartz

    2016-01-01

    Vitamin D has many immunomodulatory, anti-inflammatory, and neuroprotective functions, and previous studies have demonstrated an association between vitamin D deficiency and neuropsychiatric disease. The aim of our study was to analyze the prevalence of vitamin D deficiency in a 1-year cohort of adult inpatients with schizophreniform and autism spectrum syndromes in a naturalistic inpatient setting in Germany. Our study was comprised of 60 adult schizophreniform and 23 adult high-functioning autism spectrum patients who were hospitalized between January and December of 2015. We compared our findings with a historical German reference cohort of 3,917 adults using Pearson's two-sided chi-squared test. The laboratory measurements of 25-hydroxyvitamin D2/3 [25(OH)vitamin D] were obtained using a chemiluminescence immunoassay. In the schizophreniform group, we found decreased (vitamin D levels in 48/60 (80.0%) of the patients. In the autism spectrum group, decreased levels were detected in 18/23 (78.3%) of the patients. 25(OH)vitamin D deficiencies were found in 57.3% of the historical control group. Particularly, severe deficiencies (vitamin D values of >30 ng/ml were observed in only 5% of the schizophreniform patients, 8.7% of the autism spectrum patients, and 21.9% of the healthy controls. We found very high rates of 25(OH)vitamin D deficiencies in both patient groups and have discussed whether our findings might be related to alterations in the immunological mechanisms. Irrespective of the possible pathophysiological links between vitamin D deficiency and schizophrenia or autism spectrum disorders, a more frequent measurement of vitamin D levels seems to be justified in these patient groups. Further prospective, controlled, blinded, and randomized research should be conducted to analyze the effectiveness of vitamin D supplementation on the improvement of psychiatric symptoms.

  5. Vitamin D Deficiency in Adult Patients with Schizophreniform and Autism Spectrum Syndromes: A One-Year Cohort Study at a German Tertiary Care Hospital

    Directory of Open Access Journals (Sweden)

    Dominique Endres

    2016-10-01

    Full Text Available Introduction: Vitamin D has many immunomodulatory, anti-inflammatory, and neuroprotective functions, and previous studies have demonstrated an association between vitamin D deficiency and neuropsychiatric disease. The aim of our study was to analyze the prevalence of vitamin D deficiency in a one-year cohort of adult inpatients with schizophreniform and autism-spectrum syndromes in a naturalistic in-patient setting in Germany. Participants and methods: Our study was comprised of 60 adult schizophreniform and 23 adult high-functioning autism spectrum patients who were hospitalized Page: 2between January and December of 2015. We compared our findings with a historical German reference cohort of 3,917 adults using Pearson’s two-sided chi-squared test. The laboratory measurements of 25-hydroxyvitamin D2/3 (25(OHvitamin D were obtained using a chemiluminescence immunoassay. Results: In the schizophreniform group, we found decreased ( 30 ng/ml were observed in only 5% of the schizophreniform patients, 8.7% of the autism spectrum patients, and 21.9% of the healthy controls. Discussion: We found very high rates of 25(OHvitamin D deficiency in both patient groups, and have discussed whether our findings might be related to alterations in the immunological mechanisms. Irrespective of the possible pathophysiological links between vitamin D deficiency and schizophrenia or autism spectrum disorders, a more frequent measurement of vitamin D levels seems to be justified in these patient groups. Further prospective, controlled, blinded, and randomized research should be conducted to analyze the effectiveness of vitamin D supplementation on the improvement of psychiatric symptoms.

  6. Work-unit measures of organisational justice and risk of depression--a 2-year cohort study

    DEFF Research Database (Denmark)

    Grynderup, Matias Brødsgaard; Mors, Ole; Andersen, Johan Hviid

    2013-01-01

    diagnostic interview. In the interview 58 cases of new onset depression were identified. Depression ORs by work unit level of procedural and relational justice were estimated by multivariable logistic regression accounting for established risk factors for depression. RESULTS: Working in a work unit with low...... procedural justice (adjusted ORs of 2.50, 95% CI 1.06 to 5.88) and low relational justice (3.14, 95% CI 1.37 to 7.19) predicted onset of depression. CONCLUSIONS: Our results indicate that a work environment characterised by low levels of justice is a risk factor for depression.......OBJECTIVES: The aim of this study is to analyse if low justice at work, analysed as aggregated workplace means, increases the risk of depression. METHODS: A total of 4237 non-depressed Danish public employees within 378 different work units were enrolled in 2007. Mean levels of procedural...

  7. [Application of cohort study in cancer prevention and control].

    Science.gov (United States)

    Dai, Min; Bai, Yana; Pu, Hongquan; Cheng, Ning; Li, Haiyan; He, Jie

    2016-03-01

    Cancer control is a long-term work. Cancer research and intervention really need the support of cohort study. In the recent years, more and more cohort studies on cancer control were conducted in China along with the increased ability of scientific research in China. Since 2010, Cancer Hospital, Chinese Academy of Medical Sciences, collaborated with Lanzhou University and the Worker' s Hospital of Jinchuan Group Company Limited, have carried out a large-scale cohort study on cancer, which covered a population of more than 50 000 called " Jinchang cohort". Since 2012, a National Key Public Health Project, "cancer screening in urban China" , has been conducted in Jinchang, which strengthened the Jinchang cohort study. Based on the Jinchang cohort study, historical cohort study, cross-sectional study and prospective cohort study have been conducted, which would provide a lot of evidence for the cancer control in China.

  8. Epidemiology of frequent attenders: a 3-year historic cohort study comparing attendance, morbidity and prescriptions of one-year and persistent frequent attenders

    Directory of Open Access Journals (Sweden)

    ter Riet Gerben

    2009-01-01

    Full Text Available Abstract Background General Practitioners spend a disproportionate amount of time on frequent attenders. So far, trials on the effect of interventions on frequent attenders have shown negative results. However, these trials were conducted in short-term frequent attenders. It would be more reasonable to target intervention at persistent frequent attenders. Typical characteristics of persistent frequent attenders, as opposed to 1-year frequent attenders and non-frequent attenders, may generate hypotheses regarding modifiable factors on which new randomized trials may be designed. Methods We used the data of all 28,860 adult patients from 5 primary healthcare centers. Frequent attenders were patients whose attendance rate ranked in the (age and sex adjusted top 10 percent during 1 year (1-year frequent attenders or 3 years (persistent frequent attenders. All other patients on the register over the 3-year period were referred to as non-frequent attenders. The lists of medical problems coded by the GP using the International Classification of Primary Care (ICPC were used to assess morbidity. First, we determined which proportion of 1-year frequent attenders was still a frequent attender during the next two consecutive years and calculated the GPs' workload for these patients. Second, we compared morbidity and number of prescriptions for non-frequent attenders, 1-year frequent attenders and persistent frequent attenders. Results Of all 1-year frequent attenders, 15.4% became a persistent frequent attender equal to 1.6% of all patients. The 1-year frequent attenders (3,045; 10.6% were responsible for 39% of the face-to-face consultations; the 470 patients who would become persistent frequent attenders (1.6% were responsible for 8% of all consultations in 2003. Persistent frequent attenders presented more social problems, more psychiatric problems and medically unexplained physical symptoms, but also more chronic somatic diseases (especially diabetes

  9. Knee pain and future self-reliance in older adults: evidence from a community-based 3-year cohort study in Japan.

    Science.gov (United States)

    Nishiwaki, Yuji; Michikawa, Takehiro; Yamada, Mutsuko; Eto, Norihito; Takebayashi, Toru

    2011-01-01

    Although knee pain is common in older persons and can cause ambulatory limitation, its impact on self-reliance has rarely been examined in Japan, particularly in a community setting. The aim of this 3-year cohort study was to investigate the association of knee pain with dependence in activities of daily living (ADL) and mortality in community-dwelling older Japanese adults. In 2005, presence of knee pain was assessed by a home visit survey of 1391 older adults aged 65 years or older (participation proportion = 97.3%). A total of 1265 participants who were ADL-independent at baseline were followed for 3 years, and information on outcomes, namely death and dependence in ADL, was collected. Participants who always had knee pain were more likely to become dependent in ADL than those who reported no knee pain (multivariate-adjusted OR, 1.98; 95% CI, 1.03-3.83); however, always having knee pain was not associated with mortality or a composite outcome of ADL dependence and death. Further analyses of each component of ADL dependence revealed that knee pain was associated with a need for assistance at home (long-term care eligibility, bathing, dressing, and transferring), but not with institutionalization. The participants were highly representative of the target population and the rate of follow-up was almost perfect (99.4%). The results suggest that knee pain is associated with future dependence in ADL, particularly a need for assistance at home.

  10. Delirium symptoms are associated with decline in cognitive function between ages 53 and 69 years: Findings from a British birth cohort study.

    Science.gov (United States)

    Tsui, Alex; Kuh, Diana; Richards, Marcus; Davis, Daniel

    2017-11-21

    Few population studies have investigated whether longitudinal decline after delirium in mid-to-late life might affect specific cognitive domains. Participants from a birth cohort completing assessments of search speed, verbal memory, and the Addenbrooke's Cognitive Examination at age 69 were asked about delirium symptoms between ages 60 and 69 years. Linear regression models estimated associations between delirium symptoms and cognitive outcomes. Period prevalence of delirium between 60 and 69 years was 4% (95% confidence interval 3.2%-4.9%). Self-reported symptoms of delirium over the seventh decade were associated with worse scores in the Addenbrooke's Cognitive Examination (-1.7 points; 95% confidence interval -3.2, -0.1; P = .04). In association with delirium symptoms, verbal memory scores were initially lower, with subsequent decline in search speed by the age of 69 years. These effects were independent of other Alzheimer's risk factors. Delirium symptoms may be common even at relatively younger ages, and their presence may herald cognitive decline, particularly in search speed, over this time period. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  11. Daily-Life Gait Quality as Predictor of Falls in Older People: A 1-Year Prospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Kimberley S van Schooten

    Full Text Available Falls can have devastating consequences for older people. We determined the relationship between the likelihood of fall incidents and daily-life behavior. We used wearable sensors to assess habitual physical activity and daily-life gait quality (in terms of e.g. stability, variability, smoothness and symmetry, and determined their predictive ability for time-to-first-and-second-falls. 319 older people wore a trunk accelerometer (Dynaport MoveMonitor, McRoberts during one week. Participants further completed questionnaires and performed grip strength and trail making tests to identify risk factors for falls. Their prospective fall incidence was followed up for six to twelve months. We determined interrelations between commonly used gait characteristics to gain insight in their interpretation and determined their association with time-to-falls. For all data -including questionnaires and tests- we determined the corresponding principal components and studied their predictive ability for falls. We showed that gait characteristics of walking speed, stride length, stride frequency, intensity, variability, smoothness, symmetry and complexity were often moderately to highly correlated (r > 0.4. We further showed that these characteristics were predictive of falls. Principal components dominated by history of falls, alcohol consumption, gait quality and muscle strength proved predictive for time-to-fall. The cross-validated prediction models had adequate to high accuracy (time dependent AUC of 0.66-0.72 for time-to-first-fall and 0.69-0.76 for -second-fall. Daily-life gait quality obtained from a single accelerometer on the trunk is predictive for falls. These findings confirm that ambulant measurements of daily behavior contribute substantially to the identification of elderly at (high risk of falling.

  12. The stability of baseline-defined categories of alcohol consumption during the adult life-course: a 28-year prospective cohort study.

    Science.gov (United States)

    Knott, Craig S; Bell, Steven; Britton, Annie

    2018-01-01

    Studies that report the relationship between alcohol consumption and disease risk have predominantly operationalized drinking according to a single baseline measure. The resulting assumption of longitudinal stability may be simplistic and complicate interpretation of risk estimates. This study aims to describe changes to the volume of consumption during the adult life-course according to baseline categories of drinking. A prospective observational study. United Kingdom. A cohort of British civil servants totalling 6838 men and 3372 women aged 34-55 years at baseline, followed for a mean 19.1 (standard deviation = 9.5) years. The volume of weekly alcohol consumption was estimated from data concerning the frequency and number of drinks consumed. Baseline categories were defined: non-current drinkers, infrequent drinkers, 0.1-50.0 g/week, 50.1-100.0 g/week, 100.1-150.0 g/week, 150.1-250.0 g/week and >250.0 g/week. For women, the highest category was defined as > 100.0 g/week. Baseline frequency was derived as 'daily or almost daily' and 'not daily or almost daily'. Trajectories were estimated within baseline categories using growth curve models. Trajectories differed between men and women, but were relatively stable within light-to-moderate categories of baseline consumption. Drinking was least stable within the highest categories of baseline consumption (men: > 250.0 g/week; women: > 100.0 g/week), declining by 47.0 [95% confidence interval (CI) = 40.7, 53.2] and 16.8 g/week (95% CI = 12.6, 21.0), respectively, per 10-year increase in age. These declines were not a consequence of sudden transitions to complete abstention. Rates of decline appear greatest in older age, with trajectories converging toward moderate volumes. Among UK civil servants, consumption within baseline drinking categories is generally stable during the life-course, except among heavier baseline drinkers, for whom intakes decline with increasing age. This shift does not appear

  13. Risk Compensation Following Medical Male Circumcision: Results from a 1-Year Prospective Cohort Study of Young School-Going Men in KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Govender, K; George, G; Beckett, S; Montague, C; Frohlich, J

    2018-02-01

    This study sought to assess risk compensation following voluntary medical male circumcision of young school-going men. Risk compensation is defined as an inadvertent increase in sexual risk behaviors and a corresponding decrease in self-perceived risk for contracting HIV following the application of a risk reduction technology. This study documented the sexual practices of circumcised (n = 485) and uncircumcised (n = 496) young men in 42 secondary schools at three time points (baseline and 6 and 12 months) in a sub-district of KwaZulu-Natal, South Africa. Study participants were aged from 16 to 24 years old. At the end of the study period, there was no significant difference between the two cohorts concerning learners' perceptions of being at risk of contracting HIV (interaction effect: b = -0.12, p = 0.40). There was also no significant difference in the number of sexual partners in the previous month (interaction effect: b = -0.23, p = 0.15). The proportion of learners who have never used a condom decreased significantly over time (time effect: b = -0.27, p = 0.01), and there was no difference between the circumcised and uncircumcised learners (interaction effect: b = -0.09, p = 0.91). Risk compensation, as evidenced in this study over a 1-year period, was not associated with undergoing voluntary medical male circumcision (VMMC) in our sample of young school-going men. However, it is of concern that at the end of this study, less than half of the sexually active sample in a high-HIV-prevalence community used condoms consistently in the previous month (39% for both study cohorts). The latter underscores the need to view VMMC as a potential entry point for planned HIV and sexuality education interventions targeting young men in this community.

  14. Cohort studies in health sciences librarianship.

    Science.gov (United States)

    Eldredge, Jonathan

    2002-10-01

    What are the key characteristics of the cohort study design and its varied applications, and how can this research design be utilized in health sciences librarianship? The health, social, behavioral, biological, library, earth, and management sciences literatures were used as sources. All fields except for health sciences librarianship were scanned topically for either well-known or diverse applications of the cohort design. The health sciences library literature available to the author principally for the years 1990 to 2000, supplemented by papers or posters presented at annual meetings of the Medical Library Association. A narrative review for the health, social, behavioral, biological, earth, and management sciences literatures and a systematic review for health sciences librarianship literature for the years 1990 to 2000, with three exceptions, were conducted. The author conducted principally a manual search of the health sciences librarianship literature for the years 1990 to 2000 as part of this systematic review. The cohort design has been applied to answer a wide array of theoretical or practical research questions in the health, social, behavioral, biological, and management sciences. Health sciences librarianship also offers several major applications of the cohort design. The cohort design has great potential for answering research questions in the field of health sciences librarianship, particularly evidence-based librarianship (EBL), although that potential has not been fully explored.

  15. Measures of frequency used in cohorts studies to evaluate the suicidal behaviour in young people (12-26 years): A systematic review.

    Science.gov (United States)

    Lagares-Franco, Carolina; Almenara-Barrios, José; O'Ferrall-González, Cristina; Castellvi-Obiols, Pere; Gabilondo, Andrea; Blasco-Cubedo, María Jesús; Miranda-Mendizábal, Andrea; Parés-Badell, Oleguer; Piqueras, José Antonio; Roca, Miquel; Rodríguez-Jiménez, Tíscar; Rodríguez-Marín, Jesús; Soto-Sanz, Victoria; Vilagut-Saiz, Gemma; Alonso, Jordi

    2017-12-12

    A priority for the WHO by 2020 is to have reduced the rates of suicide; they indicate difficulties in giving precise estimations due to a wide variety of factors, which include aspects related to the statistical measurements themselves of suicidal behaviour. The proportion of deaths from suicide is 8.5% among young people between 15-29 years of age. To review the methodology used to express the frequency of suicidal behaviour in young people and to describe the methodological characteristics of the studies reviewed. A systematic review of longitudinal studies registered on PROSPERO. The extracted information included the following: year of publication, journal, population size, sample, country, design, age, percentage of men, follow-up time and losses, suicidal behaviour, risk factors, ethical aspects, fundamentally, evaluating the measures of frequency used. Eighty-two articles were selected from 37,793 documents. None of the studies define the measure of frequency used for suicidal behaviour, there are currently up to 9 different ways of measuring it. The populations are students or the general population (66%), birth cohorts (16%) and specific groups. Follow-up was from 24 weeks to 30 years. Only 24.1% of the studies took ethical aspects into consideration. Researchers must make an effort to reach an agreement on the measures of frequency used in suicidal behaviour studies, as the methodological and terminological variability currently used impedes making any comparisons between different studies or understanding the real dimension of the problem. Copyright © 2017 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Prenatal and postnatal exposure to phthalate esters and asthma: a 9-year follow-up study of a taiwanese birth cohort.

    Directory of Open Access Journals (Sweden)

    Hsiu Ying Ku

    Full Text Available Previous studies have shown that phthalate exposure in childhood is associated with the development of respiratory problems. However, few studies have assessed the relative impact of prenatal and postnatal exposure to phthalates on the development of asthma later in childhood. Therefore, we assessed the impact of prenatal and postnatal phthalate exposure on the development of asthma and wheezing using a Taiwanese birth cohort. A total of 430 pregnant women were recruited, and 171 (39.8% of them had their children followed when they were aged 2, 5, and 8 years. The International Study of Asthma and Allergies in Childhood questionnaire was used to assess asthma and wheezing symptoms and serum total immunoglobulin E levels were measured at 8 years of age. Urine samples were obtained from 136 women during their third trimester of pregnancy, 99 children at 2 years of age, and 110 children at 5 years. Four common phthalate monoester metabolites in maternal and children's urine were measured using liquid chromatography-electrospray ionization-tandem mass spectrometry. Maternal urinary mono-benzyl phthalate [MBzP] concentrations were associated with an increased occurrence of wheezing in boys at 8 years of age (odds ratio [OR] = 4.95 (95% CI 1.08-22.63, for upper quintile compared to the others after controlling for parental allergies and family members' smoking status. Urinary mono-2-ethylhexyl phthalate [MEHP] levels over the quintile at 2-year-old were associated with increased asthma occurrence (adjusted OR = 6.14 (1.17-32.13 in boys. Similarly, the sum of di-2-ethyl-hexyl phthalate [DEHP] metabolites at 5 years was associated with asthma in boys (adjusted OR = 4.36 (1.01-18.86. Urinary MEHP in maternal and 5-year-old children urine were significantly associated with increased IgE in allergic children at 8 years. Prenatal and postnatal exposure to phthalate was associated with the occurrence of asthma in children, particularly for boys.

  17. Frailty Change and Major Osteoporotic Fracture in the Elderly: Data from the Global Longitudinal Study of Osteoporosis in Women 3-Year Hamilton Cohort.

    Science.gov (United States)

    Li, Guowei; Papaioannou, Alexandra; Thabane, Lehana; Cheng, Ji; Adachi, Jonathan D

    2016-04-01

    Investigating the cumulative rate of deficits and the change of a frailty index (FI) chronologically is helpful in clinical and research settings in the elderly. However, limited evidence for the change of frailty before and after some nonfatal adverse health event such as a major osteoporotic fracture (MOF) is available. Data from the Global Longitudinal Study of Osteoporosis in Women 3-Year Hamilton cohort were used in this study. The changes of FI before and after onset of MOF were compared between the women with and without incident MOF. We also evaluated the relationship between risk of MOF, falls, and death and the change of FI and the absolute FI measures. There were 3985 women included in this study (mean age 69.4 years). The change of FI was significantly larger in the women with MOF than those without MOF at year 1 (0.085 versus 0.067, p = 0.036) and year 2 (0.080 versus 0.052, p = 0.042) post-baseline. The FI change was not significantly related with risk of MOF independently of age. However, the absolute FI measures were significantly associated with increased risk of MOF, falls, and death independently of age. In summary, the increase of the FI is significantly larger in the elderly women experiencing a MOF than their peer controls, indicating their worsening frailty and greater deficit accumulation after a MOF. Measures of the FI change may aid in the understanding of cumulative aging nature in the elderly and serve as an instrument for intervention planning and assessment. © 2015 American Society for Bone and Mineral Research.

  18. Protein-energy malnutrition during early childhood and periodontal disease in the permanent dentition of Haitian adolescents aged 12-19 years: a retrospective cohort study.

    Science.gov (United States)

    Russell, Stefanie L; Psoter, Walter J; Jean-Charles, Germain; Prophte, Samuel; Gebrian, Bette

    2010-05-01

    The aim of this retrospective cohort study was to examine whether exposure to early childhood protein-energy malnutrition (ECPEM) is related to worsened periodontal status in the permanent dentition during adolescence. A trained clinician/researcher examined the periodontal status of 96 persons aged 12-19 living in rural Haiti using WHO diagnostic criteria (Community Periodontal Index, WHO 1997). Malnutrition data of the study participants had been collected during the years 1988-1993 by a nongovernmental organization. We compared those who had been malnourished in early childhood, based on z-scores for anthropomorphic data collected during the first 5 years of life, with those who had not been malnourished, regarding mean Community Periodontal Index (CPI) score, controlling for age, sex, socioeconomic status, and smoking. Overall, 57.3% of the participants demonstrated a CPI score of 3 or greater in at least one sextant. ECPEM was independently and positively related to mean CPI score, when controlling for sex and smoking. More than half of these young Haitians demonstrated CPI scores of 3 or greater, and ECPEM was related to poorer periodontal status, as measured by CPI, in the permanent dentition.

  19. Source-specific workplace social support and high-sensitivity C-reactive protein levels among Japanese workers: A 1-year prospective cohort study.

    Science.gov (United States)

    Eguchi, Hisashi; Shimazu, Akihito; Kawakami, Norito; Inoue, Akiomi; Tsutsumi, Akizumi

    2016-08-01

    This study investigated the prospective association between source-specific workplace social support and high-sensitivity C-reactive protein (hs-CRP) levels in workers in Japan. We conducted a 1-year prospective cohort study with 1,487 men and 533 women aged 18-65 years. Participants worked at two manufacturing worksites in Japan and were free of major illness. We used multivariable linear regression analyses to evaluate the prospective association between supervisor and coworker support at baseline, and hs-CRP levels at follow-up. We conducted the analyses separately for men and women. For women, high supervisor support at baseline was significantly associated with lower hs-CRP levels at follow-up (β = -0.109, P support at baseline was not significantly associated with hs-CRP levels at follow-up. Associations between supervisor and coworker support and hs-CRP levels were not significant for men. Supervisor support may have beneficial effects on inflammatory markers in working women. Am. J. Ind. Med. 59:676-684, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  20. Decline in HIV incidence and injecting, but not in sexual risk behaviour, seen in drug users in Amsterdam: a 19-year prospective cohort study

    NARCIS (Netherlands)

    Lindenburg, Catharina E. A.; Krol, Anneke; Smit, Colette; Buster, Marcel C. A.; Coutinho, Roel A.; Prins, Maria

    2006-01-01

    OBJECTIVE: To study temporal changes in HIV incidence, HIV transmission routes, and both injecting and sexual risk behaviour in the open Amsterdam Cohort Study (ACS) among drug users. Initiated in 1985, the ACS enables us to study changes in trends since HAART became widespread in 1996. METHODS:

  1. BMI, waist circumference at 8 and 12 years of age and FVC and FEV1 at 12 years of age; the PIAMA birth cohort study

    NARCIS (Netherlands)

    Bekkers, Marga B; Wijga, Alet H; Gehring, Ulrike; Koppelman, Gerard H; de Jongste, Johan C; Smit, Henriette A; Brunekreef, Bert

    2015-01-01

    BACKGROUND: In adults, overweight is associated with reduced lung function, in children evidence on this association is conflicting. We examined the association of body mass index (BMI) and waist circumference (WC) at age 12, and of persistently (at ages 8 and 12 years) high BMI and large WC, with

  2. High Prevalence and Incidence of Diabetic Peripheral Neuropathy in Children and Adolescents With Type 1 Diabetes Mellitus: Results From a Five-Year Prospective Cohort Study.

    Science.gov (United States)

    Walter-Höliner, Isabella; Barbarini, Daniela Seick; Lütschg, Jürg; Blassnig-Ezeh, Anya; Zanier, Ulrike; Saely, Christoph H; Simma, Burkhard

    2018-03-01

    In this prospective cohort study, we investigated the prevalence of diabetic peripheral neuropathy at baseline and after five years of follow-up in children and adolescents with type 1 diabetes mellitus using both measurements of nerve conduction velocity and clinical neurological examination. A total of 38 patients who underwent insulin pump or intensive insulin therapy were included. The subjects averaged 12.6 ± 2.4 years of age and their diabetes duration averaged 5.6 ± 3.2 years. All patients underwent a detailed physical, neurological, and electrophysiological examination, as well as laboratory testing at their annual checkup. At baseline, the prevalence of diabetic peripheral neuropathy diagnosed using neurological examination was 13.2%, whereas nerve conduction velocity testing revealed diabetic peripheral neuropathy in 31.6%, highlighting a high prevalence of subclinical diabetic peripheral neuropathy. During follow-up, there was a strong increase in the prevalence of clinically diagnosed diabetic peripheral neuropathy, which reached 34.2% (P = 0.039) after five years; the proportion of patients with subclinical diabetic peripheral neuropathy even reached 63.2% (P = 0.002). The most significant changes in electrophysiological parameters were observed in the tibial sensory nerve (P = 0.001). The prevalence of diabetic peripheral neuropathy in children and adolescents with type 1 diabetes mellitus was high, and there was a rapid increase in the prevalence of diabetic peripheral neuropathy during a five-year follow-up interval. Importantly, our data show that a mere clinical evaluation is not sensitive enough to diagnose diabetic peripheral neuropathy in these patients. Nerve conduction velocity measurement, which is regarded as the gold standard for the assessment of diabetic peripheral neuropathy, should be applied more broadly. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Vulnerability to intimate partner violence and poor mental health in the first 4-year postpartum among mothers reporting childhood abuse: an Australian pregnancy cohort study.

    Science.gov (United States)

    Gartland, D; Woolhouse, H; Giallo, R; McDonald, E; Hegarty, K; Mensah, F; Herrman, H; Brown, S J

    2016-12-01

    The purpose of this study was to investigate intergenerational patterns of abuse and trauma and the health consequences for women in the early childbearing years. A prospective pregnancy cohort of 1507 nulliparous women (≦24 weeks gestation) were recruited in Melbourne, Australia, 2003-2005. Follow-up was scheduled in late pregnancy, 3-, 6- and 12-month and 4-year postpartum. Childhood abuse was retrospectively reported at 4-year postpartum using the Child Maltreatment History Self Report. Intimate partner violence (IPV) was assessed at 1- and 4-year postpartum with the Composite Abuse Scale. Maternal depressive symptoms were assessed in all follow-ups using the Edinburgh Postnatal Depression Scale. Multivariable logistic regression was used to examine associations between childhood abuse, maternal mental health and IPV. Childhood abuse was reported by 41.1 % of women. In the 4 years after having their first child, 28.2 % of women reported IPV, 25.2 % depression and 31.6 % anxiety. Childhood abuse was associated with odds of depression or anxiety 1.5-2.6 times greater and 1.8-3.2 times greater for IPV. Childhood physical abuse remained significantly associated with depression and anxiety in pregnancy and postpartum after adjusting for IPV and stressful life events, while sexual abuse remained significantly associated only with anxiety. Women who begin childbearing with a history of childhood abuse are more vulnerable to IPV and poor mental health. All health care services and agencies in contact with children, young people and families should have adequate training to identify trauma associated with abuse and IPV and provide first line supportive care and referral.

  4. Calcium supplementation and inflammation increase mortality in rheumatoid arthritis: A 15-year cohort study in 609 patients from the Oslo Rheumatoid Arthritis Register.

    Science.gov (United States)

    Provan, Sella A; Olsen, Inge C; Austad, Cathrine; Haugeberg, Glenn; Kvien, Tore K; Uhlig, Till

    2017-02-01

    To investigate whether osteoporosis or use of calcium supplementations predict all-cause mortality, or death from CVD, in a longitudinal cohort of patients with rheumatoid arthritis (RA). Patients in the Oslo RA register (ORAR) were examined, and bone mineral density was measured in 1996. The cohort was linked to the Norwegian Cause of Death registry on December 31, 2010. Death from CVD was defined in 3 following different outcomes: (1) primary atherosclerotic death, (2) atherosclerotic death as one of the 5 listed causes of death, and (3) CVD according to World Health Organization (WHO) definition as primary cause of death. Baseline predictors of all-cause mortality and death from CVD were identified in separate Cox regression models, using backwards selection. Sensitivity analyses were performed including analyses of interactions and competing risk. A total of 609 patients were examined in 1996/1997. By December 31, 2010, 162 patients (27%) had died, resulting in 7439 observed patient-years. Of the deceased, 40 (24.7%) had primary atherosclerotic death. In the final model of all-cause mortality increased baseline ESR [hazard ratio (HR) 1.02 per mm/h, 95% CI: 1.01-1.03], calcium supplementation (1.74, 1.07-2.84), and osteoporosis, defined as a T score ≤2.5 SD at any location, (1.58, 1.07-2.32) predicted higher mortality rates, in models adjusted for age, gender, and a propensity score. In the final model of primary atherosclerotic death, increased ESR (1.03 per mm/h, 1.01-1.05) and calcium supplementation (3.39, 1.41-8.08), predicted higher mortality. Increased baseline ESR and use of calcium supplementation were predictors of increased all-cause mortality and risk of death from CVD in this longitudinal study of patients with RA. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Refractive outcome of premature infants with or without retinopathy of prematurity at 2 years of age: A prospective controlled cohort study

    Directory of Open Access Journals (Sweden)

    Ching-ju Hsieh

    2012-04-01

    Full Text Available This study evaluated the extent to which refractive morbidity is correlated to preterm birth or retinopathy of prematurity (ROP itself, or both, and examined the risk factors associated with refractive errors in a cohort of preterm infants with and without ROP compared with full-term infants. This longitudinal, prospective, controlled cohort study enrolled 109 infants, including 74 preterm and 35 full-term infants. Infants were divided into the following groups: no ROP, regressed ROP, laser-treated threshold ROP, and full-term. Cycloplegic refraction was determined at 6 and 24 months’ corrected age. Multiple regression models, analysis of variance (ANOVA with post hoc comparisons, paired t test, and the χ2 test were used for data analysis. ROP status was highly predictive of significant refractive errors in preterm infants. Eyes with laser-treated threshold ROP had significant myopia at both ages (mean spherical equivalent [MSE] in right eye at both refractions −0.72, −1.21 diopters [D], astigmatism (MSE −1.62, −1.80 D, and anisometropia (MSE 0.82, 1.02 D; ANOVA p  0.05. Thus, the persistent hyperopic status across ages in patients with regressed ROP and in patients without ROP differed significantly (paired t test p > 0.05 from that in the full-term infants, with a reduction in hypermetropia noted for the first 2 years of life (paired t test p < 0.05. The incidence and magnitude of significant refractive errors increased with severe ROP and with age. Although the emmetropization process of preterm birth, including regressed ROP and no ROP, differed from full-term birth in early infancy, we found no differences in the refractive status after 1 year in patients with regressed ROP and in patients without ROP, who were at risk of developing ametropia similar to that of full-term patients. Therefore, apart from laser-treated ROP, children with regressed ROP and without ROP can likely be observed with a verbal vision screening at 3

  6. HbA1c monitoring interval in patients on treatment for stable type 2 diabetes. A ten-year retrospective, open cohort study.

    Science.gov (United States)

    Ohde, Sachiko; Deshpande, Gautam A; Yokomichi, Hiroshi; Takahashi, Osamu; Fukui, Tsuguya; Yamagata, Zentaro

    2018-01-01

    [Aims] This study aims to suggest an informative interval for HbA1c in DM patients with stable glycemic control, based on test characteristics of the HbA1C assay using the signal-to-noise ratio method. [Methods] This was a retrospective, open cohort study. Data were collected between January 2005 to December 2014 at a tertiary-level community hospital in Japan. All adult patients aged under 75 years, with stable glycemic control on a first pharmaceutical regimen for Type II diabetes, and at least two HbA1c measurements after they achieved glycemic stability, were included in the analysis. We defined stable glycemic control as HbA1c HbA1c. The screening interval for HbA1c was defined as informative when the signal-to-noise ratio exceeded 1. [Results] Among 1066 adults with diabetes, 639 patients (18.5%) were identified as achieving stable glycemic control (511 male (67.3%)), with a mean HbA1c (SD) of 6.4 (0.4)% (46 mmol/mol). Patients with stable glycemic control increase their HbA1c 0.27% (3 mmol/mol) every year while HbA1c has 0.32% (3.5 mmol/mol) noise, as testing characteristics. Signal exceeds noise after 1.2 years (95%CI: 0.9-1.6). [Conclusion] Once patients achieve stable glycemic control at their HbA1c goal, an informative interval for HbA1c monitoring is once every year. Current guidelines, which suggest testing every six months, may contribute to substantial over-testing. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  7. Characteristics of individuals receiving disability benefits in the Netherlands and predictors of leaving the disability benefit scheme: a retrospective cohort study with five-year follow-up.

    Science.gov (United States)

    Louwerse, Ilse; Huysmans, Maaike A; van Rijssen, H Jolanda; van der Beek, Allard J; Anema, Johannes R

    2018-01-18

    Today, work disability is one of the greatest social and labour market challenges for policy makers in most OECD countries, where on average, about 6% of the working-age population relies on disability benefits. Understanding of factors associated with long-term work disability may be helpful to identify groups of individuals at risk for disability benefit entitlement or continuing eligibility, and to develop effective interventions for these groups. The purpose of this study is to provide insight into the main diagnoses of workers who qualify for disability benefits and how these diagnoses differ in age, gender and education. Using a five-year follow-up, we examined the duration of disability benefits and how durations differ among individuals with various characteristics. We performed a cohort study of 31,733 individuals receiving disability benefits from the Dutch Social Security Institute (SSI) with a five-year follow-up. Data were collected from SSI databases. Information about disorders was assessed by an insurance physician upon benefit application. These data were used to test for significant relationships among socio-demographics, main diagnoses and comorbidity, and disability benefit entitlement and continuing eligibility. Mental disorders were the most frequent diagnosis for individuals claiming work disability. Diagnoses differed among age groups and education categories. Mental disorders were the main diagnosis for work disability for younger and more highly educated individuals, and physical disorders (generally musculoskeletal, cardiovascular and cancer) were the main diagnosis for older and less educated individuals. In 82% of the claims, the duration of disability benefit was five years or more after approval. Outflow was lowest for individuals with (multiple) mental disorders and those with comorbidity of mental and physical disorders, and highest for individuals with (multiple) physical disorders. The main diagnosis for persons entitled to

  8. PFA-100-measured aspirin resistance is the predominant risk factor for hospitalized cardiovascular events in aspirin-treated patients: A 5-year cohort study.

    Science.gov (United States)

    Chen, H Y; Chou, P

    2018-04-01

    Aspirin therapy is the clinical gold standard for the prevention of cardiovascular events. However, cardiovascular events still develop in some patients undergoing aspirin therapy. Many laboratory methods exist for measuring aspirin resistance. Using the platelet Function Analyzer (PFA)-100 system, we aimed to determine the effect of aspirin resistance on hospitalized cardiovascular events (hCVE) in a 5-year follow-up cohort. We also sought to determine the impact of aspirin resistance on the relationship between common cardiovascular risk factors and cardiovascular hospitalization. Aspirin resistance was evaluated in aspirin-treated patients from the outpatient department. A total of 465 patients during a 5-year follow-up period were included in this study. The primary endpoint of the study was hospitalization for any acute cardiovascular event. The prevalence and associated risk factors of acute cardiovascular events were evaluated. Aspirin resistance was prevalent in 91 (20.0%) of 465 patients. Prior hospitalization history of cardiovascular events was highly associated with aspirin resistance (P = .001). At the 5-year follow-up, cardiovascular events were found to have developed in 11 patients (8 stroke and 3 myocardial infarction) who exhibited aspirin resistance (12.1%) and in 9 (4 stroke and 5 myocardial infarction) patients who did not exhibit aspirin resistance (2.4%) (P resistance and cardiovascular events (adjusted odds ratio 4.28; 95% CI: 1.64-11.20; P = .03). PFA-100 measurements of aspirin resistance correlate with hCVE, as evidenced by both the past medical history and the 5-year follow-up. The logistic regression analysis results showed that aspirin resistance plays a larger role in hospitalized cardiovascular disease than do other cardiovascular risk factors. © 2017 John Wiley & Sons Ltd.

  9. Influence of adiposity on health-related quality of life in the Gateshead Millennium Study cohort: longitudinal study at 12 years.

    Science.gov (United States)

    Parkinson, Kathryn N; Adamson, Ashley J; Basterfield, Laura; Reilly, Jessica K; Le Couteur, Ann; Reilly, John J

    2015-08-01

    To examine whether adiposity is associated with an impaired quality of life (an individual's perception of their life) in general population samples in early adolescence. Relationships between a direct measure of adiposity (fat mass index from bioimpedance) and a proxy measure (waist circumference), and a generic (KIDSCREEN-27) and a weight-specific measure of health-related quality of life (HRQoL, Impact of Weight on Quality of Life-Kids (IWQOL-Kids)) were examined in a longitudinal population-based cohort of young adolescents aged 12 years (n=519). The effects of change in adiposity over time (from 7 years and 9 years) were also examined (n=331-445 in longitudinal analyses). Impairment in HRQoL was associated with current adiposity but it was not predicted by earlier adiposity. At 12 years, higher adiposity was associated with lower Physical Well-Being on KIDSCREEN-27, and with lower Total Scores on the weight-specific IWQOL-Kids instrument, the latter particularly in girls. Health and education professionals need to be aware in their clinical practice that higher adiposity impairs HRQoL in general populations of young adolescents. Further research would be useful to determine whether or not children of primary school age self-reporting lower HRQoL are more likely to develop higher adiposity later in adolescence or early adulthood. 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.

  10. The Fate of Meniscus Tears Left in situ at the time of Anterior Cruciate Ligament Reconstruction: A 6-year Follow-up Study from the MOON Cohort

    Science.gov (United States)

    Duchman, Kyle R.; Westermann, Robert W.; Spindler, Kurt P.; Reinke, Emily K.; Huston, Laura J.; Amendola, Annunziato; Wolf, Brian R.

    2016-01-01

    Background The management of meniscus tears identified at the time of primary ACL reconstruction is highly variable and includes repair, meniscectomy, and non-treatment. Hypothesis/Purpose The purpose of this study is to determine the reoperation rate for meniscus tears left untreated at the time of ACL reconstruction with minimum follow-up of 6 years. We hypothesize that small, peripheral tears identified at the time of ACL reconstruction managed with “no treatment” will have successful clinical outcomes. Study Design Retrospective study of a prospective cohort; Level of Evidence, 3 Methods Patients with meniscus tears left untreated at the time of primary ACL reconstruction were identified from a multicenter study group with minimum 6-year follow-up. Patient, tear, and reoperation data were obtained for analysis. Need for reoperation was used as the primary endpoint, with analysis performed to determine patient and tear characteristics associated with reoperation. Results There were 194 patients with 208 meniscus tears (71 medial; 137 lateral) left in situ without treatment with complete follow-up for analysis. Of these, 97.8% of lateral and 94.4% of medial untreated tears required no reoperation. Sixteen tears (7.7%) left in situ without treatment underwent subsequent reoperation: 9 tears (4.3%) underwent reoperation in the setting of revision ACL reconstruction and 7 tears (3.4%) underwent reoperation for isolated meniscus pathology. Patient age was significantly lower in patients requiring reoperation, while tears measuring ≥ 10 mm more frequently required reoperation. Conclusions Lateral and medial meniscus tears left in situ at the time of ACL reconstruction did not require reoperation at minimum 6-year follow-up for 97.8% and 94.4% of tears, respectively. These findings reemphasize the low reoperation rate following non-treatment of small, peripheral lateral meniscus tears while noting less predictable results for medial meniscus tears left without

  11. Serum Uric Acid and the Risk of Mortality During 23 Years Follow-up in the Scottish Heart Health Extended Cohort Study

    Science.gov (United States)

    Juraschek, Stephen P.; Tunstall-Pedoe, Hugh; Woodward, Mark

    2017-01-01

    Background Elevated uric acid is a prevalent condition with controversial health consequences. Observational studies disagree with regard to the relationship of uric acid with mortality, and with factors modifying this relationship. Objective We examined the association of serum uric acid with mortality in 15,083 participants in the Scottish Heart Health Extended Cohort (SHHEC) Study. Methods Serum uric acid measured at study enrollment. Death was ascertained using both the Scottish death register and record linkage. Results During a median follow-up of 23 years, there were 3,980 deaths. In Cox proportional hazards models with sexes combined, those in the highest fifth of uric acid had significantly greater mortality (HR 1.18, 95% CI: 1.06, 1.31) compared with the second fifth, after adjustment for traditional cardiovascular risk factors. This relationship was modified by sex (P-interaction = 0.002) with adjusted HRs of 1.69 (95% CI: 1.40, 2.04) and 0.99 (95% CI: 0.86, 1.14) in women and men, respectively. Compared with the second fifth, the highest fifth of uric acid was most associated with kidney-related death (HR: 2.08, 95% CI: 1.31, 3.32). Conclusion Elevated uric acid is associated with earlier mortality, especially in women. Future studies should evaluate mechanisms for these interactions and explore the strong association with renal-related mortality. PMID:24534458

  12. Serum uric acid and the risk of mortality during 23 years follow-up in the Scottish Heart Health Extended Cohort Study.

    Science.gov (United States)

    Juraschek, Stephen P; Tunstall-Pedoe, Hugh; Woodward, Mark

    2014-04-01

    Elevated uric acid is a prevalent condition with controversial health consequences. Observational studies disagree with regard to the relationship of uric acid with mortality, and with factors modifying this relationship. We examined the association of serum uric acid with mortality in 15,083 participants in the Scottish Heart Health Extended Cohort (SHHEC) Study. Serum uric acid was measured at study enrollment. Death was ascertained using both the Scottish death register and record linkage. During a median follow-up of 23 years, there were 3980 deaths. In Cox proportional hazards models with sexes combined, those in the highest fifth of uric acid had significantly greater mortality (HR 1.18, 95% CI: 1.06, 1.31) compared with the second fifth, after adjustment for traditional cardiovascular risk factors. This relationship was modified by sex (P-interaction=0.002) with adjusted HRs of 1.69 (95% CI: 1.40, 2.04) and 0.99 (95% CI: 0.86, 1.14) in women and men, respectively. Compared with the second fifth, the highest fifth of uric acid was most associated with kidney-related death (HR: 2.08, 95% CI: 1.31, 3.32). Elevated uric acid is associated with earlier mortality, especially in women. Future studies should evaluate mechanisms for these interactions and explore the strong association with renal-related mortality. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  13. Predictors of emergency department attendance by people with dementia in their last year of life: Retrospective cohort study using linked clinical and administrative data.

    Science.gov (United States)

    Sleeman, Katherine E; Perera, Gayan; Stewart, Robert; Higginson, Irene J

    2018-01-01

    A fall in hospital deaths in dementia has been interpreted as indicating an improvement in end-of-life care. Whether other indicators of quality of end-of-life care, such as emergency department (ED) attendance, show a similar trend is unclear. Retrospective cohort study using electronic medical records from a large mental health care provider, linked to national mortality and hospital use data (2008-2013). Of 4867 patients, 78.6% (3824) had at least one ED attendance during their last year of life (mean 2.13, standard deviation 2.34, range 0-54). ED attendance increased over the time period (incidence rate ratio 1.62, 95% confidence interval 1.46-1.80 for 2012-2013 compared with 2008-2009). ED attendance in the last year of life for people with dementia is common and is increasing. Policy makers must pay attention to a broader range of indicators of poor end-of-life care alongside the place of death. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  14. Dose-Response Relationship between Cumulative Occupational Lead Exposure and the Associated Health Damages: A 20-Year Cohort Study of a Smelter in China.

    Science.gov (United States)

    Wu, Yue; Gu, Jun-Ming; Huang, Yun; Duan, Yan-Ying; Huang, Rui-Xue; Hu, Jian-An

    2016-03-16

    Long-term airborne lead exposure, even below official occupational limits, has been found to cause lead poisoning at higher frequencies than expected, which suggests that China's existing occupational exposure limits should be reexamined. A retrospective cohort study was conducted on 1832 smelting workers from 1988 to 2008 in China. These were individuals who entered the plant and came into continuous contact with lead at work for longer than 3 months. The dose-response relationship between occupational cumulative lead exposure and lead poisoning, abnormal blood lead, urinary lead and erythrocyte zinc protoporphyrin (ZPP) were analyzed and the benchmark dose lower bound confidence limits (BMDLs) were calculated. Statistically significant positive correlations were found between cumulative lead dust and lead fumes exposures and workplace seniority, blood lead, urinary lead and ZPP values. A dose-response relationship was observed between cumulative lead dust or lead fumes exposure and lead poisoning (p lead dust and fumes doses were 0.68 mg-year/m³ and 0.30 mg-year/m³ for lead poisoning, respectively. The BMDLs of workplace airborne lead concentrations associated with lead poisoning were 0.02 mg/m³ and 0.01 mg/m³ for occupational exposure lead dust and lead fume, respectively. In conclusion, BMDLs for airborne lead were lower than occupational exposure limits, suggesting that the occupational lead exposure limits need re-examination and adjustment. Occupational cumulative exposure limits (OCELs) should be established to better prevent occupational lead poisoning.

  15. Five-year incidence of chronic kidney disease (stage 3-5 and associated risk factors in a Spanish cohort: the MADIABETES Study.

    Directory of Open Access Journals (Sweden)

    Miguel A Salinero-Fort

    Full Text Available To evaluate the incidence rate of Chronic Kidney Disease (CKD stage 3-5 (persistent decreased kidney function under 60 mL/min per 1.73 m2 among patients with type 2 diabetes over five years, to identify the risk factors associated with CKD, and develop a risk table to predict five-year CKD stage 3-5 risk stratification for clinical use.The MADIABETES Study is a prospective cohort study of 3,443 outpatients with type 2 diabetes mellitus, sampled from 56 primary health care centers (131 general practitioners in Madrid (Spain.The cumulative incidence of CKD stage 3-5 at five-years was 10.23% (95% CI = 9.12-11.44 and the incidence density was 2.07 (95% CI = 1.83-2.33 cases per 1,000 patient-months or 2.48 (95% CI = 2.19-2.79 cases per 100 patient-years. The highest hazard ratio (HR for developing CKD stage 3-5 was albuminuria ≥ 300 mg/g (HR = 4.57; 95% CI= 2.46-8.48. Furthermore, other variables with a high HR were age over 74 years (HR = 3.20; 95% CI = 2.13-4.81, a history of Hypertension (HR = 2.02; 95% CI = 1.42-2.89, Myocardial Infarction (HR= 1.72; 95% IC= 1.25-2.37, Dyslipidemia (HR = 1.68; 95% CI 1.30-2.17, duration of diabetes mellitus ≥ 10 years (HR = 1.46; 95% CI = 1.14-1.88 and Systolic Blood Pressure >149 mmHg (HR = 1.52; 95% CI = 1.02-2.24.After a five-year follow-up, the cumulative incidence of CKD is concordant with rates described in Spain and other countries. Albuminuria ≥ 300 mg/g and age over 74 years were the risk factors more strongly associated with developing CKD (Stage 3-5. Blood Pressure, lipid and albuminuria control could reduce CKD incidence of CKD in patients with T2DM.

  16. Five-Year Incidence of Chronic Kidney Disease (Stage 3-5) and Associated Risk Factors in a Spanish Cohort: The MADIABETES Study

    Science.gov (United States)

    Salinero-Fort, Miguel A.; San Andrés-Rebollo, Francisco J.; de Burgos-Lunar, Carmen; Gómez-Campelo, Paloma; Chico-Moraleja, Rosa M.; López de Andrés, Ana; Jiménez-García, Rodrigo

    2015-01-01

    Objective To evaluate the incidence rate of Chronic Kidney Disease (CKD) stage 3-5 (persistent decreased kidney function under 60 mL/min per 1.73 m2) among patients with type 2 diabetes over five years, to identify the risk factors associated with CKD, and develop a risk table to predict five-year CKD stage 3-5 risk stratification for clinical use. Design The MADIABETES Study is a prospective cohort study of 3,443 outpatients with type 2 diabetes mellitus, sampled from 56 primary health care centers (131 general practitioners) in Madrid (Spain). Results The cumulative incidence of CKD stage 3-5 at five-years was 10.23% (95% CI = 9.12–11.44) and the incidence density was 2.07 (95% CI = 1.83–2.33) cases per 1,000 patient-months or 2.48 (95% CI = 2.19–2.79) cases per 100 patient-years. The highest hazard ratio (HR) for developing CKD stage 3-5 was albuminuria ≥300 mg/g (HR = 4.57; 95% CI= 2.46-8.48). Furthermore, other variables with a high HR were age over 74 years (HR = 3.20; 95% CI = 2.13–4.81), a history of Hypertension (HR = 2.02; 95% CI = 1.42–2.89), Myocardial Infarction (HR= 1.72; 95% IC= 1.25–2.37), Dyslipidemia (HR = 1.68; 95% CI 1.30–2.17), duration of diabetes mellitus ≥ 10 years (HR = 1.46; 95% CI = 1.14-1.88) and Systolic Blood Pressure >149 mmHg (HR = 1.52; 95% CI = 1.02–2.24). Conclusions After a five-year follow-up, the cumulative incidence of CKD is concordant with rates described in Spain and other countries. Albuminuria ≥ 300 mg/g and age over 74 years were the risk factors more strongly associated with developing CKD (Stage 3-5). Blood Pressure, lipid and albuminuria control could reduce CKD incidence of CKD in patients with T2DM. PMID:25856231

  17. Incident chronic kidney disease and newly developed complications related to renal dysfunction in an elderly population during 5 years: a community-based elderly population cohort study.

    Directory of Open Access Journals (Sweden)

    Shin Young Ahn

    Full Text Available BACKGROUND: Few studies have evaluated the association between incident chronic kidney disease (CKD and related complications, especially in elderly population. We attempted to verify the association between GFR and concurrent CKD complications and elucidate the temporal relationship between incident CKD and new CKD complications in a community-based prospective elderly cohort. METHOD: We analyzed the available data from 984 participants in the Korean Longitudinal Study on Health and Aging. Participants were categorized into 6 groups according to eGFR at baseline examination (≥90, 75-89, 60-74, 45-59, 30-44, and <30 ml/min/1.73 m(2. RESULT: The mean age of study population was 76 ± 9.1 years and mean eGFR was 72.3 ± 17.0 ml/min/1.73 m(2. Compared to eGFR group 1, the odds ratio (OR for hypertension was 2.363 (95% CI, 1.299-4.298 in group 4, 5.191 (2.074-12.995 in group 5, and 13.675 (1.611-115.806 in group 6; for anemia, 7.842 (2.265-27.153 in group 5 and 13.019 (2.920-58.047 in group 6; for acidosis, 69.580 (6.770-715.147 in group 6; and for hyperkalemia, 19.177 (1.798-204.474 in group 6. Over a 5-year observational period, CKD developed in 34 (9.6% among 354 participants with GFR ≥ 60 ml/min/1.73 m(2 at basal examination. The estimated mean number of new complications according to analysis of co-variance was 0.52 (95% CI, 0.35-0.68 in subjects with incident CKD and 0.24 (0.19-0.29 in subjects without CKD (p = 0.002. Subjects with incident CKD had a 2.792-fold higher risk of developing new CKD complications. A GFR level of 52.4 ml/min/1.73 m(2 (p = 0.032 predicted the development of a new CKD complication with a 90% sensitivity. CONCLUSION: In an elderly prospective cohort, CKD diagnosed by current criteria is related to an increase in the number of concurrent CKD complications and the development of new CKD complications.

  18. Alcohol consumption and risk of gastric cancer: a cohort study of men in Kaunas, Lithuania, with up to 30 years follow-up

    Directory of Open Access Journals (Sweden)

    Everatt Ruta

    2012-10-01

    Full Text Available Abstract Background Gastric cancer is the second most common cause of death from cancer in the world. Epidemiological findings on alcohol use in relation to gastric cancer remain controversial. The aim of this study was to examine the effect of alcohol consumption on the risk of gastric cancer. Methods The association between alcohol intake and the risk of gastric cancer was examined in a population-based cohort of 7,150 men in Kaunas, Lithuania, who were enrolled during 1972–1974 or 1976–1980. After up to 30 years of follow-up, 185 gastric cancer cases were identified. Multivariate Cox proportional hazards models were used to estimate hazard ratios (HR and corresponding 95% confidence intervals (95% CI. The attained age was used as a time-scale. Results After adjustment for smoking, education level and body mass index, the HR of gastric cancer was 2.00 (95% CI: 1.04–3.82 for the highest alcohol consumption frequency (2–7 times per week compared with occasional drinking (a few times per year and 1.90 (95% CI: 1.13–3.18 for ≥100.0 g ethanol/week versus 0.1–9.9 g ethanol/week. A stronger effect of alcohol consumption on gastric cancer risk was observed during the second half of the study (1993–2008. In the analysis of gastric cancer risk by alcoholic beverage type, all beverages were included simultaneously in the model. The multivariate HR for men who consumed ≥0.5 litre of wine per occasion (compared with those who consumed Conclusions This study supports a link between alcohol consumption (primarily from ethanol and the development of gastric cancer in the Lithuanian population. Although an association with heavy wine consumption was observed, the effect of exposure to acetaldehyde on the development of gastric cancer in this cohort was not confirmed. Further research is needed to provide a more detailed evaluation of alcohol drinking and gastric cancer risk.

  19. Riyadh Mother and Baby Multicenter Cohort Study: The Cohort Profile.

    Directory of Open Access Journals (Sweden)

    Hayfaa Wahabi

    Full Text Available To assess the effects of non-communicable diseases, such as diabetes, hypertension and obesity, on the mother and the infant.A multicentre cohort study was conducted in three hospitals in the city of Riyadh in Saudi Arabia. All Saudi women and their babies who delivered in participating hospitals were eligible for recruitment. Data on socio-demographic characteristics in addition to the maternal and neonatal outcomes of pregnancy were collected. The cohort demographic profile was recorded and the prevalence of maternal conditions including gestational diabetes, pre-gestational diabetes, hypertensive disorders in pregnancy and obesity were estimated.The total number of women who delivered in participating hospitals during the study period was 16,012 of which 14,568 women participated in the study. The mean age of the participants was 29 ± 5.9 years and over 40% were university graduates. Most of the participants were housewives, 70% were high or middle income and 22% were exposed to secondhand smoke. Of the total cohort, 24% were married to a first cousin. More than 68% of the participants were either overweight or obese. The preterm delivery rate was 9%, while 1.5% of the deliveries were postdate. The stillbirth rate was 13/1000 live birth. The prevalence of gestational diabetes was 24% and that of pre-gestational diabetes was 4.3%. The preeclampsia prevalence was 1.1%. The labour induction rate was 15.5% and the cesarean section rate was 25%.Pregnant women in Saudi Arabia have a unique demographic profile. The prevalence of obesity and diabetes in pregnancy are among the highest in the world.

  20. Motor trajectories from birth to 5 years of children born at less than 30 weeks' gestation: early predictors and functional implications. Protocol for a prospective cohort study.

    Science.gov (United States)

    Spittle, Alicia J; McGinley, Jennifer L; Thompson, Deanne; Clark, Ross; FitzGerald, Tara L; Mentiplay, Benjamin F; Lee, Katherine J; Olsen, Joy E; Burnett, Alice; Treyvaud, Karli; Josev, Elisha; Alexander, Bonnie; Kelly, Claire E; Doyle, Lex W; Anderson, Peter J; Cheong, Jeanie Ly

    2016-10-01

    Motor impairments are one of the most frequently reported adverse neurodevelopmental consequences in children born motor impairment at school age. The first 5 years of life are critical for the development of fundamental motor skills. These skills form the basis for more complex skills that are required to competently and confidently participate in schooling, sporting and recreational activities. In children born at motor development from birth to 5 years is not fully understood. The neural alterations that underpin motor impairments in these children are also unclear. It is essential to determine if early clinical evaluations and neuroimaging biomarkers can predict later motor impairment and associated functional problems at 5 years of age. This will help to identify children who will benefit the most from early intervention and improve functional outcomes at school age. The primary aim of this study is to compare the prevalence of motor impairment from birth to 5 years of age between children born at motor assessments in the newborn period in those born at motor functioning at 5 years of age. Secondary aims for children born at motor impairments at 5 years are detectable in the neonatal period; 2) to investigate the association between motor impairments and concurrent deficits in body structure and function at 5 years of age; and 3) to explore how motor impairments at 5 years (including abnormalities of gait, postural control and strength) are associated with concurrent functional outcomes, including physical activity, cognitive ability, learning ability, and behavioural and emotional problems. Prospective longitudinal cohort study. 150 preterm children (born at 36 completed weeks' gestation and weighing > 2499g) admitted to the Royal Women's Hospital, Melbourne, were recruited at birth and will be invited to participate in a 5-year follow-up study. This study will examine previously collected data (from birth to 2 years) that comprise detailed motor assessments

  1. Physical activity and inflammatory markers over 10 years: follow-up in men and women from the Whitehall II cohort study.

    Science.gov (United States)

    Hamer, Mark; Sabia, Severine; Batty, G David; Shipley, Martin J; Tabák, Adam G; Singh-Manoux, Archana; Kivimaki, Mika

    2012-08-21

    Inflammatory processes are putative mechanisms underlying the cardioprotective effects of physical activity. An inverse association between physical activity and inflammation has been demonstrated, but no long-term prospective data are available. We therefore examined the association between physical activity and inflammatory markers over a 10-year follow-up period. Participants were 4289 men and women (mean age, 49.2 years) from the Whitehall II cohort study. Self-reported physical activity and inflammatory markers (serum high-sensitivity C-reactive protein and interleukin-6) were measured at baseline (1991) and follow-up (2002). Forty-nine percent of the participants adhered to standard physical activity recommendations for cardiovascular health (2.5 h/wk moderate to vigorous physical activity) across all assessments. Physically active participants at baseline had lower C-reactive protein and interleukin-6 levels, and this difference remained stable over time. Compared with participants who rarely adhered to physical activity guidelines over the 10-year follow-up, the high-adherence group displayed lower log(e) C-reactive protein (β=-0.07; 95% confidence interval, -0.12 to -0.02) and log(e) interleukin-6 (β=-0.07; 95% confidence interval, -0.10 to -0.03) at follow-up after adjustment for a range of covariates. Compared with participants who remained stable, those who reported an increase in physical activity of at least 2.5 h/wk displayed lower log(e) C-reactive protein (β coefficient=-0.05; 95% confidence interval, -0.10 to -0.001) and log(e) interleukin-6 (β coefficient=-0.06; 95% confidence interval, -0.09 to -0.03) at follow-up. Regular physical activity is associated with lower markers of inflammation over 10 years of follow-up and thus may be important in preventing the proinflammatory state seen with aging.

  2. Immediately loaded mini dental implants as overdenture retainers: 1-Year cohort study of implant stability and peri-implant marginal bone level.

    Science.gov (United States)

    Šćepanović, Miodrag; Todorović, Aleksandar; Marković, Aleksa; Patrnogić, Vesna; Miličić, Biljana; Moufti, Adel M; Mišić, Tijana

    2015-05-01

    This 1-year cohort study investigated stability and peri-implant marginal bone level of immediately loaded mini dental implants used to retain overdentures. Each of 30 edentulous patients received 4 mini dental implants (1.8 mm × 13 mm) in the interforaminal mandibular region. The implants were immediately loaded with pre-made overdentures. Outcome measures included implant stability and bone resorption. Implant stability was measured using the Periotest Classic(®) device immediately after placement and on the 3rd and 6th weeks and the 4th, 6th and 12th months postoperatively. The peri-implant marginal bone level (PIBL) was evaluated at the implant's mesial and distal sides from the polished platform to the marginal crest. Radiographs were taken using a tailored film holder to reproducibly position the X-ray tube at the 6th week, 4th and 12th months postoperatively. The primary stability (Periotest value, PTV) measured -0.27 ± 3.41 on a scale of -8 to + 50 (lower PTV reflects higher stability). The secondary stability decreased significantly until week 6 (mean PTV = 7.61 ± 7.05) then increased significantly reaching (PTV = 6.17 ± 6.15) at 12 months. The mean PIBL measured -0.40 mm after 1 year of functional loading, with no statistically significant differences at the various follow-ups (p = 0.218). Mini dental implants placed into the interforaminal region could achieve a favorable primary stability for immediate loading. The follow-up Periotest values fluctuated, apparently reflecting the dynamics of bone remodeling, with the implants remaining clinically stable (98.3%) after 1 year of function. The 1-year bone resorption around immediately loaded MDIs is within the clinically acceptable range for standard implants. Copyright © 2014 Elsevier GmbH. All rights reserved.

  3. Maternal depression and personality traits in association with child neuropsychological and behavioral development in preschool years: Mother-child cohort (Rhea Study) in Crete, Greece.

    Science.gov (United States)

    Koutra, Katerina; Roumeliotaki, Theano; Kyriklaki, Andriani; Kampouri, Mariza; Sarri, Katerina; Vassilaki, Maria; Bitsios, Panos; Kogevinas, Manolis; Chatzi, Leda

    2017-08-01

    Poor perinatal maternal mental health has been linked with negative outcomes on early child development; however, the importance of maternal personality has been neglected thus far. We aimed to examine the effects of antenatal and postnatal maternal mental health, including assessment of maternal personality characteristics, on child neuropsychological and behavioral development at preschool years in a population based mother-child cohort (Rhea Study) in Crete, Greece. Self-reported measures of maternal depression (EPDS), trait anxiety (STAI-Trait) and personality traits (EPQ-R) were assessed in a sample of 288 women at 28-32 weeks of gestation. A larger sample of 642 mothers completed the EPDS scale at 8 weeks postpartum. Children's neuropsychological (MSCA) and behavioral (ADHDT and SDQ) development were assessed at 4 years of age. Linear regression analyses were used to estimate the associations between the exposures and outcomes of interest after adjustment for potential confounders. Regarding child neuropsychological development, increased postnatal depressive symptoms were associated with child's perceptual performance, whereas increased maternal psychoticism was linked with child's motor ability at 4 years of age. Furthermore, elevated levels of maternal depression during pregnancy and postpartum, and the predisposing personality characteristics of trait anxiety and neuroticism, were associated with children's behavioral difficulties. A clinical diagnostic instrument for maternal mental health was not used and assessment of children's behavior was based on maternal report. These findings suggest that poor perinatal maternal mental health and an adverse personality profile may be associated with impaired child neuropsychological and behavioral development at preschool years. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Effects of low-level prenatal lead exposure on child IQ at 4 and 8 years in a UK birth cohort study.

    Science.gov (United States)

    Taylor, Caroline M; Kordas, Katarzyna; Golding, Jean; Emond, Alan M

    2017-09-01

    The association between childhood exposure to lead (Pb) and deficits in cognitive function is well established. The association with prenatal exposure, however, is not well understood, even though the potential adverse effects are equally important. To evaluate the association between low prenatal exposure to lead and IQ in children, to determine whether there were sex differences in the associations, and to evaluate the moderation effect of prenatal Pb exposure on child IQ. Whole blood samples from pregnant women enrolled in ALSPAC (n=4285) and from offspring at age 30 months (n=235) were analysed for Pb. Associations between prenatal blood lead concentrations (B-Pb) and child IQ at age 4 and 8 years (WPPSI and WISC-III, respectively) were examined in adjusted regression models. There was no association of prenatal lead exposure with child IQ at 4 or 8 years old in adjusted regression models, and no moderation of the association between child B-Pb and IQ. However, there was a positive association for IQ at age 8 years in girls with a predicted increase in IQ (points) per 1μg/dl of: verbal 0.71, performance 0.57, total 0.73. In boys, the coefficients tended to be negative (-0.15, -0.42 and -0.29 points, respectively). Prenatal lead exposure was not associated with adverse effects on child IQ at age 4 or 8 years in this study. There was, however, some evidence to suggest that boys are more susceptible than girls to prenatal exposure to lead. Further investigation in other cohorts is required. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  5. Longitudinal course and outcome of chronic insomnia in Hong Kong Chinese children: a 5-year follow-up study of a community-based cohort.

    Science.gov (United States)

    Zhang, Jihui; Lam, Siu Ping; Li, Shirley Xin; Li, Albert Martin; Lai, Kelly Y C; Wing, Yun-Kwok

    2011-10-01

    There are limited data on the long-term outcome of childhood insomnia. We explored the longitudinal course, predictors, and impact of childhood insomnia in a community-based cohort. 5-year prospective follow-up. Community-based. 611 children (49% boys) aged 9.0 ± 1.8 years at baseline; 13.7 ± 1.8 years at follow-up. NA. Chronic insomnia was defined as difficulty initiating sleep, difficulty maintaining sleep and/or early morning awakening ≥ 3 times/week in the past 12 months. General health, upper airway inflammatory diseases, and behavioral problems in recent one year were assessed at both time points, while mental health and lifestyle practice were assessed at follow-up study. The questionnaires at baseline and follow-up were reported by parents/caretakers and adolescents themselves, respectively. The prevalence of chronic insomnia was 4.2% and 6.6% for baseline and follow-up, respectively. The incidence and persistence rates of chronic insomnia were 6.2% and 14.9%, respectively. New incidence of insomnia was associated with lower paternal education level, baseline factors of frequent temper outbursts and daytime fatigue as well as alcohol use and poor mental health at follow-up. Baseline chronic medical disorders, frequent temper outbursts, and poor mental health at follow-up were associated with the persistence of insomnia in adolescents. Baseline insomnia was associated with frequent episodes of laryngopharyngitis and lifestyle practice (coffee and smoking) at follow-up. Chronic insomnia is a common problem with moderate persistent rate in children. The associations of adverse physical and mental health consequences with maladaptive lifestyle coping (smoking and alcohol) argue for rigorous intervention of childhood insomnia.

  6. Baseline data from a multicenter, 5-year, prospective cohort study of Japanese age-related macular degeneration: an AMD2000 report.

    Science.gov (United States)

    Tsujikawa, Akitaka; Akagi-Kurashige, Yumiko; Yuzawa, Mitsuko; Ishibashi, Tatsuro; Nakanishi, Hideo; Nakatani, Eiji; Teramukai, Satoshi; Fukushima, Masanori; Yoshimura, Nagahisa

    2018-03-01

    To report research participants' baseline characteristics in the AMD2000 study, a prospective, multicenter, 5-year, observational cohort study of Japanese age-related macular degeneration (AMD). The characteristics were determined using multimodal imaging. Patients with AMD were recruited at 18 clinical sites in Japan between April 2006 and March 2009. Each patient underwent a complete ophthalmic examination, including measurement of best-corrected visual acuity (Landolt chart), indirect ophthalmoscopy, slit-lamp biomicroscopy with a contact lens, optical coherence tomography imaging, fundus photography, and fluorescein and indocyanine green angiography. Four hundred sixty participants (326 men [70.9%]) were included in the study. At enrollment, 131 eyes (28.5%) had hard drusen and 125 eyes (27.2%) had soft drusen in the macular area. A total of 455 eyes (98.9%) were diagnosed as having wet AMD, and 5 eyes (1.1%), as having dry AMD. Of the 455 eyes with wet AMD, 209 eyes (45.4%) had typical AMD, 228 eyes (49.6%) had polypoidal choroidal vasculopathy (PCV), and 18 eyes (3.9%) had retinal angiomatous proliferation. The size of choroidal neovascularization (CNV) was significantly smaller with indocyanine green angiography than with fluorescein angiography (P macular edema, older age, scar, extrafoveal macular edema, subfoveal CNV, large branching vascular network, and hard exudates. Japanese patients with AMD are predominantly male, lack drusen, and have a high rate of PCV.

  7. Urine cytology screening of French workers exposed to occupational urinary tract carcinogens: a prospective cohort study over a 20-year period

    Science.gov (United States)

    Rouanet, Lucile; Mulliez, Aurélien; Naughton, Geraldine; Fontana, Luc; Druet-Cabanac, Michel; Moustafa, Farès; Chamoux, Alain

    2017-01-01

    Objectives To demonstrate that urine cytology screening can provide relevant epidemiological data for earlier detection of urothelial cancer caused by occupational exposure. Design Prospective cohort study. Setting Industries using urothelial carcinogens in France. Urine samples were collected on site, after a work week and were analysed at the University Hospital of Clermont-Ferrand, France. Participants Participants were workers exposed to urothelial carcinogens. Women and current smokers at time of study recruitment were exclusion criteria. Outcomes Urine cells atypia were ranged into three classes: negative/normal, atypical/suspicious/dysplasia or positive/malignant. Results We included 2020 workers over a period of 20 years from 1993 to 2013: 606 worked in rubber manufacturing, 692 from metal processing, 245 in chemical industry and 477 in roadwork and building industry. Workers had a mean exposure of 15.2±10.4 years before their first urine cytology screening. There was a mean of 3.4±4.3 urine cytology screenings per worker between 1993 and 2013. 6478 cytology were normal, 462 suspicious and 13 malignant. Suspicious and malignant cytology occurred in 4.8% of workers exposed for 1–10 years, 6.2% for 11–20 years of exposure, 7.6% for 21–30 years and 8.6% for >30 years (p30 years of exposure. Using metal processing as reference, the risk of pathological urine cytology results increased for rubber manufacturing (OR=1.32, 95% CI 1.05 to 1.65, p=0.02), with a trend for roadwork and building industry (OR=1.39, 95% CI 0.98 to 1.97, p=0.07) and for chemical industry (OR=1.34, 95% CI 0.94 to 1.93, p=0.11). Conclusions Urine cytology is a useful tool in occupational medicine. We promote new guidelines with an early screening of urothelial cancer by cytology, starting with beginning of exposure. PMID:28939575

  8. Low Risk of Unemployment, Sick Leave, and Work Disability Among Patients with Inflammatory Bowel Disease: A 7-year Follow-up Study of a Danish Inception Cohort.

    Science.gov (United States)

    Vester-Andersen, Marianne K; Prosberg, Michelle V; Vind, Ida; Andersson, Mikael; Jess, Tine; Bendtsen, Flemming

    2015-10-01

    To assess the occurrence and risk of unemployment (UE), sick leave (SL), and work disability (WD) in incident patients with inflammatory bowel disease (IBD) after 7 years of follow-up compared with the background population and to determine outcome predictors. The study population consisted of patients aged 18 to 67 years (N = 379) from an IBD inception cohort registered January 1, 2003 to December 31, 2004 in the Copenhagen area. Clinical data were retrospectively collected from medical records. Data on UE, SL, and WD were retrieved from national registries. A random subset of the general population (n = 1435) were matched with IBD cases based on sex, age, and residency. The cumulative probabilities of UE, SL, and WD were calculated. A Cox proportional hazard regression was performed to identify possible outcome predictors. There was no difference in UE rates between patients with IBD and controls (P = 0.23). The risk of SL was significantly increased in patients with IBD (hazard ratio 2.0; 95% confidence interval 1.7-2.4). Patients with IBD showed a higher risk of WD (hazard ratio 2.1; 95% confidence interval 1.2-3.8), particularly male patients older than 55 years. The rate of WD in CD (5.8%) was markedly lowered compared with previous studies. Within the IBD population, sex, educational level, disease behavior, smoking status, and surgery were predictors of UE, SL, and WD. The observed increased risk of SL and WD in patients with IBD underscores the need for the early identification of risk factors. A multidisciplinary approach to secure IBD patients' participation in the labor market is recommended.

  9. Occurrence of Anaemia in the First Year of Inflammatory Bowel Disease in a European Population-based Inception Cohort-An ECCO-EpiCom Study.

    Science.gov (United States)

    Burisch, Johan; Vegh, Zsuzsanna; Katsanos, Konstantinnos H; Christodoulou, Dimitrios K; Lazar, Daniela; Goldis, Adrian; O'Morain, Colm; Fernandez, Alberto; Pereira, Santos; Myers, Sally; Sebastian, Shaji; Pedersen, Natalia; Olse, Jóngerð; Rubek Nielsen, Kári; Schwartz, Doron; Odes, Selwyn; Almer, Sven; Halfvarson, Jonas; Turk, Niksa; Cukovic-Cavka, Silvja; Nikulina, Inna; Belousova, Elena; Duricova, Dana; Bortlik, Martin; Shonová, Olga; Salupere, Riina; Barros, Louisa; Magro, Fernando; Jonaitis, Laimas; Kupcinskas, Limas; Turcan, Svetlana; Kaimakliotis, Ioannis; Ladefoged, Karin; Kudsk, Karen; Andersen, Vibeke; Vind, Ida; Thorsgaard, Niels; Oksanen, Pia; Collin, Pekka; Dal Piaz, Giulia; Santini, Alessia; Niewiadomski, Ola; Bell, Sally; Moum, Bjørn; Arebi, Naila; Kjeldsen, Jens; Carlsen, Katrine; Langholz, Ebbe; Lakatos, Peter Laszlo; Munkholm, Pia; Gerdes, Lars Ulrik; Dahlerup, Jens Frederik

    2017-10-01

    Anaemia is an important complication of inflammatory bowel disease [IBD]. The aim of this study was to determine the prevalence of anaemia and the practice of anaemia screening during the first year following diagnosis, in a European prospective population-based inception cohort. Newly diagnosed IBD patients were included and followed prospectively for 1 year in 29 European and one Australian centre. Clinical data including demographics, medical therapy, surgery and blood samples were collected. Anaemia was defined according to the World Health Organization criteria. A total of 1871 patients (Crohn's disease [CD]: 686, 88%; ulcerative colitis [UC]: 1,021, 87%; IBD unclassified [IBDU] 164. 81%) were included in the study. The prevalence of anaemia was higher in CD than in UC patients and, overall, 49% of CD and 39% of UC patients experienced at least one instance of anaemia during the first 12 months after diagnosis. UC patients with more extensive disease and those from Eastern European countries, and CD patients with penetrating disease or colonic disease location, had higher risks of anaemia. CD and UC patients in need of none or only mild anti-inflammatory treatment had a lower risk of anaemia. In a significant proportion of patients, anaemia was not assessed until several months after diagnosis, and in almost half of all cases of anaemia a thorough work-up was not performed. Overall, 42% of patients had at least one instance of anaemia during the first year following diagnosis. Most patients were assessed for anaemia regularly; however, a full anaemia work-up was frequently neglected in this community setting. Copyright © 2017 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com

  10. Nutritional Status of Breast Cancer Survivors 1 Year after Diagnosis: A Preliminary Analysis from the Malaysian Breast Cancer Survivorship Cohort Study.

    Science.gov (United States)

    Majid, Hazreen Abd; Keow, Low Phei; Islam, Tania; Su, Tin Tin; Cantwell, Marie; Taib, Nur Aishah

    2018-04-01

    Lifestyle factors, such as diet, body weight, and physical activity, are linked to better survival after breast cancer (BC) diagnosis. A high percentage of the Malaysian population is overweight or obese. In addition, studies have shown a disparity in survival among Malaysian women compared with other higher-income countries. The Malaysian Breast Cancer Survivorship Cohort (MyBCC) study aims to study lifestyle factors that affect survival in BC survivors. These are the preliminary findings on the nutritional status of Malaysian BC survivors. Our aim was to evaluate the nutritional status of BC survivors at 1 year after diagnosis. This was a cross-sectional study of 194 participants from the MyBCC study, recruited within 1 year of their diagnosis. Participants completed a 3-day food diary. Malaysian women (aged 18 years and older) who were newly diagnosed with primary BC, managed at the University Malaya Medical Center, and able to converse either in Malay, English, or Mandarin were included. Dietary intake and prevalence of overweight or obesity among participants 1 year after diagnosis were measured. Student's t test and analysis of variance or its equivalent nonparametric test were used for association in continuous variables. About 66% (n=129) of participants were overweight or obese and >45% (n=86) had high body fat percentage 1 year after diagnosis. The participants' diets were low in fiber (median=8.7 g/day; interquartile range=7.2 g/day) and calcium (median=458 mg/day; interquartile range=252 mg/day). Ethnicity and educational attainment contributed to the differences in dietary intake among participants. Higher saturated fat and lower fiber intake were observed among Malay participants compared with other ethnic groups. Overweight and obesity were highly prevalent among BC survivors and suboptimal dietary intake was observed. Provision of an individualized medical nutrition therapy by a qualified dietitian is crucial as part of comprehensive BC survivorship

  11. Prognostic value of myocardial perfusion and ventricular function in a Japanese multicenter cohort study (J-ACCESS). The first-year total events and hard events

    International Nuclear Information System (INIS)

    Nakajima, Kenichi; Kusuoka, Hideo; Nishimura, Shigeyuki; Yamashina, Akira; Nishimura, Tsunehiko

    2009-01-01

    The objective of this study was to determine the prognostic value of myocardial ischemia, function and coronary risk factors on total and hard cardiac events using myocardial perfusion imaging in a Japanese population. A prospective cohort study was performed in 117 Japanese hospitals, each with a nuclear cardiology facility. A total of 4,031 patients with suspected or confirmed ischemic heart disease were registered. The patients were followed up for a year to investigate total and hard events, and those who had any events were followed up for 3 years to evaluate subsequent hard events. A stress-rest gated myocardial perfusion study was performed with 99m Tc-tetrofosmin using gated single-photon emission computed tomography (SPECT) and analyzed by semi-quantitative scores. During the 1-year follow-up period, 263 (6.5%) patients had total events comprising all-cause death, non-fatal myocardial infarction (MI), heart failure, unstable angina, angina pectoris and coronary revascularization. Cardiac death occurred in 23 patients (0.6%) and non-fatal MI in 11 (0.3%). Among patients with ejection fraction (EF) of <45% and a summed difference score (SDS) of ≥2, 18.7% (2.4% for cardiac death and 0.6% for non-fatal MI) experienced total events compared with 3.9% (0.3% for cardiac death and 0.2% for non-fatal MI; P<0.0001) of those with EF≥45% and SDS<2. Multivariate analysis identified EF, SDS, age, history of revascularization and diabetes as significant predictors of all events, while the significant predictors were age and EF for hard events. When the patients who had heart failure in the first year were followed up, 9 of 41 (22.0%) experienced cardiac death in the subsequent 3-year follow-up period. Myocardial ischemia defined by SDS and ventricular function were the main predictors of total events despite the relatively low incidence of hard events in this Japanese population. In patients with cardiac events in a year, closer attention should be paid to subsequent

  12. Trajectories of disposable income among people of working ages diagnosed with multiple sclerosis: a nationwide register-based cohort study in Sweden 7 years before to 4 years after diagnosis with a population-based reference group.

    Science.gov (United States)

    Murley, Chantelle; Mogard, Olof; Wiberg, Michael; Alexanderson, Kristina; Karampampa, Korinna; Friberg, Emilie; Tinghög, Petter

    2018-05-09

    To describe how disposable income (DI) and three main components changed, and analyse whether DI development differed from working-aged people with multiple sclerosis (MS) to a reference group from 7 years before to 4 years after diagnosis in Sweden. Population-based cohort study, 12-year follow-up (7 years before to 4 years after diagnosis). Swedish working-age population with microdata linked from two nationwide registers. Residents diagnosed with MS in 2009 aged 25-59 years (n=785), and references without MS (n=7847) randomly selected with stratified matching (sex, age, education and country of birth). DI was defined as the annual after tax sum of incomes (earnings and benefits) to measure individual economic welfare. Three main components of DI were analysed as annual sums: earnings, sickness absence benefits and disability pension benefits. We found no differences in mean annual DI between people with and without MS by independent t-tests (p values between 0.15 and 0.96). Differences were found for all studied components of DI from diagnosis year by independent t-tests, for example, in the final study year (2013): earnings (-64 867 Swedish Krona (SEK); 95% CI-79 203 to -50 528); sickness absence benefits (13 330 SEK; 95% CI 10 042 to 16 500); and disability pension benefits (21 360 SEK; 95% CI 17 380 to 25 350). A generalised estimating equation evaluated DI trajectory development between people with and without MS to find both trajectories developed in parallel, both before (-4039 SEK; 95% CI -10 536 to 2458) and after (-781 SEK; 95% CI -6988 to 5360) diagnosis. The key finding of parallel DI trajectory development between working-aged MS and references suggests minimal economic impact within the first 4 years of diagnosis. The Swedish welfare system was responsive to the observed reductions in earnings around MS diagnosis through balancing DI with morbidity-related benefits. Future decreases in economic welfare may be experienced as the

  13. Methodology Series Module 1: Cohort Studies.

    Science.gov (United States)

    Setia, Maninder Singh

    2016-01-01

    Cohort design is a type of nonexperimental or observational study design. In a cohort study, the participants do not have the outcome of interest to begin with. They are selected based on the exposure status of the individual. They are then followed over time to evaluate for the occurrence of the outcome of interest. Some examples of cohort studies are (1) Framingham Cohort study, (2) Swiss HIV Cohort study, and (3) The Danish Cohort study of psoriasis and depression. These studies may be prospective, retrospective, or a combination of both of these types. Since at the time of entry into the cohort study, the individuals do not have outcome, the temporality between exposure and outcome is well defined in a cohort design. If the exposure is rare, then a cohort design is an efficient method to study the relation between exposure and outcomes. A retrospective cohort study can be completed fast and is relatively inexpensive compared with a prospective cohort study. Follow-up of the study participants is very important in a cohort study, and losses are an important source of bias in these types of studies. These studies are used to estimate the cumulative incidence and incidence rate. One of the main strengths of a cohort study is the longitudinal nature of the data. Some of the variables in the data will be time-varying and some may be time independent. Thus, advanced modeling techniques (such as fixed and random effects models) are useful in analysis of these studies.

  14. Methodology series module 1: Cohort studies

    Directory of Open Access Journals (Sweden)

    Maninder Singh Setia

    2016-01-01

    Full Text Available Cohort design is a type of nonexperimental or observational study design. In a cohort study, the participants do not have the outcome of interest to begin with. They are selected based on the exposure status of the individual. They are then followed over time to evaluate for the occurrence of the outcome of interest. Some examples of cohort studies are (1 Framingham Cohort study, (2 Swiss HIV Cohort study, and (3 The Danish Cohort study of psoriasis and depression. These studies may be prospective, retrospective, or a combination of both of these types. Since at the time of entry into the cohort study, the individuals do not have outcome, the temporality between exposure and outcome is well defined in a cohort design. If the exposure is rare, then a cohort design is an efficient method to study the relation between exposure and outcomes. A retrospective cohort study can be completed fast and is relatively inexpensive compared with a prospective cohort study. Follow-up of the study participants is very important in a cohort study, and losses are an important source of bias in these types of studies. These studies are used to estimate the cumulative incidence and incidence rate. One of the main strengths of a cohort study is the longitudinal nature of the data. Some of the variables in the data will be time-varying and some may be time independent. Thus, advanced modeling techniques (such as fixed and random effects models are useful in analysis of these studies.

  15. Clinical characteristics and consequences of hand eczema - an 8-year follow-up study of a population-based twin cohort

    DEFF Research Database (Denmark)

    Lerbaek, Anne; Kyvik, Kirsten Ohm; Ravn, Henrik

    2008-01-01

    affected. Mean hand eczema severity index score in individuals with clinical symptoms was 12.0. Sick leave was reported by 12.4%; job change by 8.5%. Being in the lowest socio-economic group and atopic dermatitis were risk factors for sick leave [odds ratio (OR) = 5.6; 95% confidence interval (95% CI) 1......BACKGROUND: Few population-based clinical follow-up studies on hand eczema are reported. Objectives: The aim of this study was to characterize clinical symptoms and to examine occupational and medical consequences as well as persistence of hand eczema in a population-based twin cohort. PATIENTS.......5-22.9 and OR = 2.9; 95% CI 1.0-8.1]. The majority (63.4%) had seen a doctor at least once, and atopic dermatitis was a risk factor for more than 1 visit (OR = 3.0; 95% CI 1.4-6.4). Duration of >10 years was a risk factor for persistence of symptoms, which was reported by 67.7%. CONCLUSIONS: The clinical picture...

  16. Maternal smoking during pregnancy and the risk of pediatric cardiovascular diseases of the offspring: A population-based cohort study with up to 18-years of follow up.

    Science.gov (United States)

    Leybovitz-Haleluya, Noa; Wainstock, Tamar; Landau, Daniella; Sheiner, Eyal

    2018-06-01

    Cigarette smoke is a well-known reproductive toxicant. We aimed to study the long-term effect of cigarette smoking during pregnancy on the risk for childhood cardiovascular morbidity of the offspring. A population-based cohort analysis was performed comparing total and subtypes of cardiovascular related pediatric hospitalizations among offspring of smoking mothers versus offspring of non-smoking mothers. The analysis included all singletons born between the years 1999-2014.A Kaplan-Meier survival curve was used to compare the cumulative cardiovascular morbidity, and a Cox proportional hazards model was constructed to adjust for confounders. The study population included 242,342 newborns which met inclusion criteria; among them 2861 were born to smoking mothers. Offspring of smoking mothers had higher rates of cardiovascular-related hospitalizations (1.3% vs. 0.6%, OR 2.1, 95% CI 1.5-2.9; p < 0.001; Kaplan-Meier log-rank test p < 0.001). Smoking exposure during pregnancy is associated with an increased risk for long-term pediatric cardiovascular morbidity of the offspring. Copyright © 2018 Elsevier Inc. All rights reserved.

  17. Long-term follow-up on health-related quality of life in major depressive disorder: a 2-year European cohort study.

    Science.gov (United States)

    Saragoussi, Delphine; Christensen, Michael Cronquist; Hammer-Helmich, Lene; Rive, Benoît; Touya, Maëlys; Haro, Josep Maria

    2018-01-01

    Major depressive disorder (MDD) is associated with significant impairments in health-related quality of life (HRQoL) and everyday functioning. This cohort study investigated the long-term development of HRQoL in patients with MDD and its association with patient characteristics, including depressive symptom severity and cognitive symptoms. The Prospective Epidemiological Research on Functioning Outcomes Related to Major depressive disorder (PERFORM) study was a longitudinal cohort study conducted in 1,159 outpatients aged 18-65 years with MDD in France, Germany, Spain, Sweden, and the UK. The patients were either initiating antidepressant monotherapy or undergoing their first switch of antidepressant. HRQoL was assessed using the Medical Outcomes Study Short-Form 12-item Health Survey (SF-12) up to month 12 and the EuroQol Five Dimensions questionnaire up to month 24 (UK only). Depressive symptom severity was assessed up to month 24 by the patient-reported Patient Health Questionnaire and cognitive symptoms by the Perceived Deficit Questionnaire. Multivariate analyses were performed to identify patient characteristics associated with HRQoL. Mental HRQoL was severely impaired at baseline versus normative data (mean [SD] SF-12 mental component summary [MCS], 26.5 [9.2]); mean (SD) physical component summary (PCS) total score was 45.2 (12.1). SF-12 MCS improved over 12 months of follow-up (38.7 [11.6] at month 12), while SF-12 PCS remained stable (45.3 [11.1]). At each assessment time point, there was a clear pattern of lower SF-12 MCS and PCS total score in patients experiencing greater cognitive problems. The mean EuroQol Five Dimensions questionnaire utility index score generally decreased (i.e., worsened) with increasing severity of cognitive and depressive symptoms at all time points up to 24 months. Multivariate analyses identified both depression severity and cognitive symptoms as strongly and significantly associated with poor HRQoL. These findings highlight

  18. Late-career unemployment and all-cause mortality, functional disability and depression among the older adults in Taiwan: A 12-year population-based cohort study.

    Science.gov (United States)

    Chu, Wei-Min; Liao, Wen-Chun; Li, Chi-Rong; Lee, Shu-Hsin; Tang, Yih-Jing; Ho, Hsin-En; Lee, Meng-Chih

    2016-01-01

    To evaluate whether late-career unemployment is associated with increased all-cause mortality, functional disability, and depression among older adults in Taiwan. In this long-term prospective cohort study, data were retrieved from the Taiwan Longitudinal Study on Aging. This study was conducted from 1996 to 2007. The complete data from 716 men and 327 women aged 50-64 years were retrieved. Participants were categorized as normally employed or unemployed depending on their employment status in 1996. The cumulative number of unemployment after age 50 was also calculated. Logistic regression analysis was used to examine the effect of the association between late-career unemployment and cumulative number of late-career unemployment on all-cause mortality, functional disability, and depression in 2007. The average age of the participants in 1996 was 56.3 years [interquartile range (IQR)=7.0]. A total of 871 participants were in the normally employed group, and 172 participants were in the unemployed group. After adjustment of gender, age, level of education, income, self-rated health and major comorbidities, late-career unemployment was associated with increased all-cause mortality [Odds ratio (OR)=2.79; 95% confidence interval (CI)=1.74-4.47] and functional disability [OR=2.33; 95% CI=1.54-3.55]. The cumulative number of late-career unemployment was also associated with increased all-cause mortality [OR=1.91; 95% CI=1.35-2.70] and functional disability [OR=2.35; 95% CI=1.55-3.55]. Late-career unemployment and cumulative number of late-career unemployment are associated with increased all-cause mortality and functional disability. Older adults should be encouraged to maintain normal employment during the later stage of their career before retirement. Employers should routinely examine the fitness for work of older employees to prevent future unemployment. Copyright © 2016. Published by Elsevier Ireland Ltd.

  19. Evolution of blood pressure from adolescents to youth in salt sensitivies: a 18-year follow-up study in Hanzhong children cohort

    Directory of Open Access Journals (Sweden)

    Mu Jianjun

    2012-09-01

    Full Text Available Abstract Background Essential hypertension mostly originates from children. Salt Sensitivity (SS is regarded as the intermediate phenotype of essential hypertension. The present study investigated the effects of salt-sensitivity on evolution of blood pressure (BP and development to hypertension from adolescents to youth. Methods A baseline survey was carried out in 4,623 adolescents aged 6-15 years old in Hanzhong rural areas in 1987, 310 of whom(mean 9.2 years were randomly recruited for determination of salt sensitivity using the tests of oral saline load and furosemide sodium-volume depletion. SS was diagnosed in 101 subjects while 209 were determined as non-salt-sensitive (NSS. We made a 18-year followed-up of the cohort in 2005. Results The response rate for surviving baseline adolescents was 71.9%. At follow up, BP in youth with baseline SS was higher than that in NSS (SBP:122.9 ± 13.1 VS 117.3 ± 12.4, P  DBP: 78.2 ± 10.4 VS 74.7 ± 10.8, P P VS 6.3%, RR = 2.34, P  Conclusion Our findings indicate that adolescents with higher BP salt-sensitivity have a higher rate of incident hypertension in youth. Salt sensitivity could be at high risk predisposing to development of hypertension from adolescents to youth.

  20. Perceived food intolerance and irritable bowel syndrome in a population 3 years after a giardiasis-outbreak: a historical cohort study.

    Science.gov (United States)

    Litleskare, Sverre; Wensaas, Knut-Arne; Eide, Geir Egil; Hanevik, Kurt; Kahrs, Gudrun Elise; Langeland, Nina; Rortveit, Guri

    2015-11-19

    Studies have shown an increased prevalence of irritable bowel syndrome (IBS) after acute gastroenteritis. Food as a precipitating and perpetuating factor in IBS has gained recent interest, but food intolerance following gastroenteritis is less investigated. The aims of this study were firstly, to compare perceived food intolerance in a group previously exposed to Giardia lamblia with a control group; secondly, to explore the relation with IBS status; and thirdly, to investigate associations with content of fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) in foods reported. This is a historical cohort study with mailed questionnaire to 1252 Giardia exposed and a control cohort matched by gender and age. Differences between groups were investigated using bivariate and multivariate analyses. The questionnaire response rate in the exposed group was 65.3 % (817/1252) and in the control group 31.4 % (1128/3598). The adjusted odds ratio (OR) for perceived food intolerance for the exposed group was 2.00 with 95 % confidence interval (CI): 1.65 to 2.42, as compared with the control group. Perceived intolerance for dairy products was the most frequently reported intolerance, with an adjusted OR for the exposed of 1.95 (95 % CI: 1.51 to 2.51). Perceived intolerance for fatty foods, vegetables, fruit, cereals and alcohol was also significantly higher in the exposed group. The groups did not differ in perceived intolerance to spicy foods, coffee or soda. The association between exposure to Giardia infection and perceived food intolerance differed between the IBS group and the no-IBS group, but IBS was not a significant effect modifier for the association. Perceived intolerance for high FODMAP foods (adjusted OR 1.91) and low FODMAP foods (adjusted OR 1.55) was significantly associated with exposure status. Exposure to Giardia infection was associated with perceived food intolerance 3 years after giardiasis. IBS status did not alter the

  1. Does perceived physical attractiveness in adolescence predict better socioeconomic position in adulthood? Evidence from 20 years of follow up in a population cohort study.

    Science.gov (United States)

    Benzeval, Michaela; Green, Michael J; Macintyre, Sally

    2013-01-01

    There is believed to be a 'beauty premium' in key life outcomes: it is thought that people perceived to be more physically attractive have better educational outcomes, higher-status jobs, higher wages, and are more likely to marry. Evidence for these beliefs, however, is generally based on photographs in hypothetical experiments or studies of very specific population subgroups (such as college students). The extent to which physical attractiveness might have a lasting effect on such outcomes in 'real life' situations across the whole population is less well known. Using longitudinal data from a general population cohort of people in the West of Scotland, this paper investigated the association between physical attractiveness at age 15 and key socioeconomic outcomes approximately 20 years later. People assessed as more physically attractive at age 15 had higher socioeconomic positions at age 36- in terms of their employment status, housing tenure and income - and they were more likely to be married; even after adjusting for parental socioeconomic background, their own intelligence, health and self esteem, education and other adult socioeconomic outcomes. For education the association was significant for women but not for men. Understanding why attractiveness is strongly associated with long-term socioeconomic outcomes, after such extensive confounders have been considered, is important.

  2. Does perceived physical attractiveness in adolescence predict better socioeconomic position in adulthood? Evidence from 20 years of follow up in a population cohort study.

    Directory of Open Access Journals (Sweden)

    Michaela Benzeval

    Full Text Available There is believed to be a 'beauty premium' in key life outcomes: it is thought that people perceived to be more physically attractive have better educational outcomes, higher-status jobs, higher wages, and are more likely to marry. Evidence for these beliefs, however, is generally based on photographs in hypothetical experiments or studies of very specific population subgroups (such as college students. The extent to which physical attractiveness might have a lasting effect on such outcomes in 'real life' situations across the whole population is less well known. Using longitudinal data from a general population cohort of people in the West of Scotland, this paper investigated the association between physical attractiveness at age 15 and key socioeconomic outcomes approximately 20 years later. People assessed as more physically attractive at age 15 had higher socioeconomic positions at age 36- in terms of their employment status, housing tenure and income - and they were more likely to be married; even after adjusting for parental socioeconomic background, their own intelligence, health and self esteem, education and other adult socioeconomic outcomes. For education the association was significant for women but not for men. Understanding why attractiveness is strongly associated with long-term socioeconomic outcomes, after such extensive confounders have been considered, is important.

  3. The risk of cancer in patients with connective tissue diseases but without dermatomyositis or polymyositis: A multicenter cohort study conducted over 15 years in China.

    Science.gov (United States)

    Xu, Wei; Guo, Huan; Liu, Zhi; Chen, Chen; Lei, Cong-Cong

    2016-09-01

    To investigate the relative risk of cancer in Chinese patients with connective tissue diseases (CTD) associated with and without dermatomyositis or polymyositis. A retrospective, multicenter cohort study investigated 32,380 CTD patients (2334 diagnosed with dermatomyositis or polymyositis) without a history of malignancies treated from January 1, 1997, to December 31, 2011. Standardized incidence ratios (SIR) of cancers determined the incidence of malignancies during follow-up. The data was compared with the cancer morbidity of the general population from the Chinese Cancer Registry Annual Report of National Central Cancer Registry. A total of 113 patients (348.98 per 100,000) developed cancer during follow-up, 75 (249.62 per 100,000) were patients with CTD without dermatomyositis or polymyositis. The risk of cancer among patients with CTD was increased (SIR=1.45, 95% confidence interval [CI] 1.22-1.71), and this risk increased with age (60 years SIR=2.34 (95%CI 0.93-2.77]) and the time of follow-up (cancer risk among CTD patients without dermatomyositis or polymyositis was not affected (SIR=0.93, 95%CI 0.75-1.16), regardless of gender, age, or follow-up. The cancer risk for patients with CTD without dermatomyositis or polymyositis was not increased or decreased, but it was increased when patients with dermatomyositis or polymyositis were included. Copyright © 2016 European Federation of Immunological Societies. Published by Elsevier B.V. All rights reserved.

  4. Costs of medically assisted reproduction treatment at specialized fertility clinics in the Danish public health care system: results from a 5-year follow-up cohort study.

    Science.gov (United States)

    Christiansen, Terkel; Erb, Karin; Rizvanovic, Amra; Ziebe, Søren; Mikkelsen Englund, Anne L; Hald, Finn; Boivin, Jacky; Schmidt, Lone

    2014-01-01

    To examine the costs to the public health care system of couples in medically assisted reproduction. Longitudinal cohort study of infertile couples initiating medically assisted reproduction treatment. Specialized public fertility clinics in Denmark. Seven hundred and thirty-nine couples having no child at study entry and with data on kind of treatment and live birth (yes/no) for each treatment attempt at the specialized public fertility clinic. Treatment data for medically assisted reproduction attempts conducted at the public fertility clinics were abstracted from medical records. Flow diagrams were drawn for different standard treatment cycles and direct costs at each stage in the flow charts were measured and valued by a bottom-up procedure. Indirect costs were distributed to each treatment cycle on the basis of number of visits as basis. Costs were adjusted to 2012 prices using a constructed medical price index. Live birth, costs. Total costs per live birth in 2012 prices were estimated to 10,755€. Costs per treated couple - irrespective of whether the treatment was terminated by a live birth or not - were estimated at 6607€. Costs per live birth of women <35 years at treatment initiation were 9338€ and 15,040€ for women ≥35 years. The public costs for live births after conception with medically assisted reproduction treatment are relatively modest. The results can be generalized to public fertility treatment in Denmark and to other public treatment settings with similar limitations in numbers of public treatment cycles offered. © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

  5. Long-term exposure to ambient air pollution and respiratory disease mortality in Shenyang, China: a 12-year population-based retrospective cohort study.

    Science.gov (United States)

    Dong, Guang-Hui; Zhang, Pengfei; Sun, Baijun; Zhang, Liwen; Chen, Xi; Ma, Nannan; Yu, Fei; Guo, Huimin; Huang, Hui; Lee, Yungling Leo; Tang, Naijun; Chen, Jie

    2012-01-01

    In China, both the levels and patterns of outdoor air pollution have altered dramatically with the rapid economic development and urbanization over the past two decades. However, few studies have investigated the association of outdoor air pollution with respiratory mortality, especially in the high pollution range. We conducted a retrospective cohort study of 9,941 residents aged ≥35 years old in Shenyang, China, to examine the association between outdoor air pollutants [particulate matter mortality using 12 years of data. We applied extended Cox proportional hazards modeling with time-dependent covariates to respiratory mortality. Analyses were also stratified by age, sex, educational level, smoking status, personal income, occupational exposure and body mass index (BMI) to examine the association of air pollution with mortality. We found significant associations between PM(10) and NO(2) levels and respiratory disease mortality. Our analysis found a relative risk of 1.67 [95% confidence interval (CI) 1.60-1.74] and 2.97 (95% CI 2.69-3.27) for respiratory mortality per 10 µg/m(3) increase in PM(10) and NO(2), respectively. The effects of air pollution were more apparent in women than in men. Age, sex, educational level, smoking status, personal income, occupational exposure, BMI and exercise frequency influenced the relationship between outdoor PM(10) and NO(2) and mortality. For SO(2), only smoking, little regular exercise and BMI above 18.5 influenced the relationship with mortality. These data contribute to the scientific literature on the long-term effects of air pollution for the high-exposure settings typical in developing countries. Copyright © 2011 S. Karger AG, Basel.

  6. Recurrent skin and soft tissue infections in HIV-infected patients during a 5-year period: incidence and risk factors in a retrospective cohort study.

    Science.gov (United States)

    Hemmige, Vagish; McNulty, Moira; Silverman, Ethan; David, Michael Z

    2015-10-26

    Skin and soft tissue infections (SSTIs) are common in the era of community-associated methicillin resistant Staphylococcus aureus among HIV-infected patients. Recurrent infections are frequent. Risk factors for recurrence after an initial SSTI have not been well-studied. Retrospective cohort study, single center, 2005-2009. Paper and electronic medical records were reviewed by one of several physicians. Subjects with initial SSTI were followed until the time of SSTI recurrence. Standard descriptive statistics were calculated to describe the characteristics of subjects who did and did not develop a recurrent SSTI. Kaplan-Meier methods were used to estimate the risk of recurrent SSTI. A Cox regression model was developed to identify predictors of SSTI recurrence. 133 SSTIs occurred in 87 individuals. 85 subjects were followed after their initial SSTI, of whom 30 (35.3 %) had a recurrent SSTI in 118.3 person-years of follow-up, for an incidence of second SSTI of 253.6 SSTIs/1000 person-years (95 % CI 166.8-385.7). The 1-year Kaplan-Meier estimated risk of a second SSTI was 29.2 % (95 % CI 20.3-41.0 %), while the 3-year risk was 47.0 % (95 % CI 34.4-61.6 %). Risk factors for recurrent SSTI in a multivariable Cox regression model were non-hepatitis liver disease (HR 3.44; 95 % CI 1.02-11.5; p = 0.05), the presence of an intravenous catheter (HR 6.50; 95 % CI 1.47-28.7; p = 0.01), and a history of intravenous drug use (IVDU) (HR 2.80; 95 % CI 1.02-7.65; p = 0.05); African-American race was associated with decreased risk of recurrent SSTI (HR 0.12; 95 % CI 0.04-0.41; p < 0.01). Some evidence was present for HIV viral load ≥ 1000 copies/mL as an independent risk factor for recurrent SSTI (HR 2.21; 95 % CI 0.99-4.94; p = 0.05). Hemodialysis, currently taking HAART, CD4+ count, trimethoprim-sulfamethoxazole or azithromycin use, initial SSTI type, diabetes mellitus, incision and drainage of the original SSTI, or self-report of being a man who has sex with men were not

  7. Work Engagement as a Predictor of Onset of Major Depressive Episode (MDE) among Workers, Independent of Psychological Distress: A 3-Year Prospective Cohort Study

    OpenAIRE

    Imamura, Kotaro; Kawakami, Norito; Inoue, Akiomi; Shimazu, Akihito; Tsutsumi, Akizumi; Takahashi, Masaya; Totsuzaki, Takafumi

    2016-01-01

    Objective This study investigated work engagement as a baseline predictor of onset of major depressive episode (MDE). Methods The study used a prospective cohort design, conforming to the STROBE checklist. Participants were recruited from the employee population of a private think tank company (N = 4,270), and 1,058 (24.8%) of them completed a baseline survey, of whom 929 were included in this study. Work engagement and psychological distress at baseline were assessed as predictor variables. ...

  8. Survival and predictors of mortality among human immunodeficiency virus patients on anti-retroviral treatment at Jinka Hospital, South Omo, Ethiopia: a six years retrospective cohort study

    Science.gov (United States)

    Ameni, Gobena

    2016-01-01

    OBJECTIVES The survival rate of human immunodeficiency virus (HIV)-infected patients receiving treatment in Ethiopia is poorly understood. This study aimed to determine the survival rate and predictors of mortality among HIV-infected adults on antiretroviral therapy (ART) at Jinka Hospital, South Omo, Ethiopia. METHODS A 6-year retrospective cohort study was conducted using 350 patient records drawn from 1,899 patients on ART at Jinka Hospital from September 2010 to August 2015. The data were analyzed using Kaplan-Meier statistics and Cox regression models. RESULTS Of the 350 study participants, 315 (90.0%) were censored and 35 (10.0%) died. Twenty-two (62.9%) of the deaths occurred during the first year of treatment. The total follow-up encompassed 1,995 person-years, with an incidence rate of 1.75 deaths per 100 person-years. The mean survival time of patients on highly active antiretroviral therapy (HAART) was 30.84±19.57 months. The overall survival of patients on HAART was 64.00% (95% confidence interval [CI], 61.85 to 66.21%) at 72 months of follow-up. The significant predictors of mortality included non-disclosure of HIV status (adjusted hazard ratio [aHR], 5.82; 95% CI, 1.91 to 17.72), a history of tuberculosis (aHR, 1.82; 95% CI, 1.41 to 3.51), and ambulatory (aHR, 2.97; 95% CI, 1.20 to 8.86) or bedridden (aHR, 4.67; 95% CI, 1.30 to 17.27) functional status, World Health Organization (WHO) clinical stage IV illness (aHR, 24.97; 95% CI, 2.75 to 26.45), and substance abusers (aHR, 3.72; 95% CI, 1.39 to 9.97). CONCLUSIONS Patients with a history of tuberculosis treatment, ambulatory or bedridden functional status, or advanced WHO clinical stage disease, as well substance abusers, should be carefully monitored, particularly in the first few months after initiating antiretroviral therapy. Patients should also be encouraged to disclose their status to their relatives. PMID:27820957

  9. Survival and predictors of mortality among human immunodeficiency virus patients on anti-retroviral treatment at Jinka Hospital, South Omo, Ethiopia: a six years retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Erdaw Tachbele

    2016-11-01

    Full Text Available OBJECTIVES The survival rate of human immunodeficiency virus (HIV-infected patients receiving treatment in Ethiopia is poorly understood. This study aimed to determine the survival rate and predictors of mortality among HIV-infected adults on antiretroviral therapy (ART at Jinka Hospital, South Omo, Ethiopia. METHODS A 6-year retrospective cohort study was conducted using 350 patient records drawn from 1,899 patients on ART at Jinka Hospital from September 2010 to August 2015. The data were analyzed using Kaplan-Meier statistics and Cox regression models. RESULTS Of the 350 study participants, 315 (90.0% were censored and 35 (10.0% died. Twenty-two (62.9% of the deaths occurred during the first year of treatment. The total follow-up encompassed 1,995 person-years, with an incidence rate of 1.75 deaths per 100 person-years. The mean survival time of patients on highly active antiretroviral therapy (HAART was 30.84±19.57 months. The overall survival of patients on HAART was 64.00% (95% confidence interval [CI], 61.85 to 66.21% at 72 months of follow-up. The significant predictors of mortality included non-disclosure of HIV status (adjusted hazard ratio [aHR], 5.82; 95% CI, 1.91 to 17.72, a history of tuberculosis (aHR, 1.82; 95% CI, 1.41 to 3.51, and ambulatory (aHR, 2.97; 95% CI, 1.20 to 8.86 or bedridden (aHR, 4.67; 95% CI, 1.30 to 17.27 functional status, World Health Organization (WHO clinical stage IV illness (aHR, 24.97; 95% CI, 2.75 to 26.45, and substance abusers (aHR, 3.72; 95% CI, 1.39 to 9.97. CONCLUSIONS Patients with a history of tuberculosis treatment, ambulatory or bedridden functional status, or advanced WHO clinical stage disease, as well substance abusers, should be carefully monitored, particularly in the first few months after initiating antiretroviral therapy. Patients should also be encouraged to disclose their status to their relatives.

  10. Work Engagement as a Predictor of Onset of Major Depressive Episode (MDE) among Workers, Independent of Psychological Distress: A 3-Year Prospective Cohort Study

    Science.gov (United States)

    Imamura, Kotaro; Kawakami, Norito; Inoue, Akiomi; Shimazu, Akihito; Tsutsumi, Akizumi; Takahashi, Masaya; Totsuzaki, Takafumi

    2016-01-01

    Objective This study investigated work engagement as a baseline predictor of onset of major depressive episode (MDE). Methods The study used a prospective cohort design, conforming to the STROBE checklist. Participants were recruited from the employee population of a private think tank company (N = 4,270), and 1,058 (24.8%) of them completed a baseline survey, of whom 929 were included in this study. Work engagement and psychological distress at baseline were assessed as predictor variables. MDE was measured at baseline and at each of the follow-ups as the outcome, using the web-based, self-administered version of the Japanese WHO-CIDI 3.0 depression section based upon DSM-IV-TR/DSM-5 criteria. Cox discrete-time hazards analyses were conducted to estimate hazard ratios (95% confidence intervals CIs). Results Follow-up rates of participants (N = 929) were 78.4%, 67.2%, and 51.6% at 1-, 2-, and 3-year follow-ups, respectively. The association between work engagement at baseline and the onset of MDE was U-shaped. Compared with a group with low work engagement scores, groups with the middle and high scores showed significantly (HR = 0.19, 95% CI = 0.05 to 0.64; p = 0.007) and marginally significantly (HR = 0.48, 95% CI = 0.20 to 1.15, p = 0.099) lower risks of MDE, respectively, over the follow-ups, after adjusting for covariates. The pattern remained the same after additionally adjusting for psychological distress. Conclusions The present study first demonstrated work engagement as an important predictor of the onset of MDE diagnosed according to an internationally standard diagnostic criteria of mental disorders. PMID:26841020

  11. Effect of Helicobacter pylori eradication and antisecretory maintenance therapy on peptic ulcer recurrence in cirrhotic patients: a prospective, cohort 2-year follow-up study.

    Science.gov (United States)

    Tzathas, Charalambos; Triantafyllou, Konstantinos; Mallas, Elias; Triantafyllou, George; Ladas, Spiros D

    2008-07-01

    The role of Helicobacter pylori eradication to cure peptic ulcer disease in patients with cirrhosis is not clear. To investigate the course of peptic ulcer disease in cirrhotics, first after healing with either H. pylori eradication or omeprazole therapy and second while on omeprazole maintenance therapy after recurrence. Prospective cohort study in a tertiary-care hospital in Greece. Out of 365 consecutive cirrhotic patients who underwent endoscopy, 67 had peptic ulcer and 30 were enrolled. H. pylori positive patients received eradication therapy and H. pylori negative patients received omeprazole treatment. Follow-up endoscopies were performed at 12 and 24 months or when symptoms recurred. Patients with ulcer recurrence were treated with omeprazole maintenance therapy. The main outcome measurement of the study was peptic ulcer relapse rate during follow-up. Twenty-eight patients with healed ulcers were followed for up to 2 years. During follow-up, ulcer relapsed in 17 patients (8/18 H. pylori positive and 9/10 H. pylori negative at study entry, P=0.041), including 2 patients who died from ulcer bleeding. No further ulcer relapse was observed in the remaining 15 patients who received omeprazole maintenance therapy for the rest of follow-up. H. pylori negative status (P=0.002) and severity of cirrhosis (P=0.015) at study entry were independently related to shorter peptic ulcer relapse-free time. H. pylori eradication does not protect all cirrhotics from ulcer recurrence and the majority of ulcers recur in H. pylori negative patients. Therefore, omeprazole maintenance treatment is mandatory, irrespectively of H. pylori status.

  12. Work Engagement as a Predictor of Onset of Major Depressive Episode (MDE among Workers, Independent of Psychological Distress: A 3-Year Prospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Kotaro Imamura

    Full Text Available This study investigated work engagement as a baseline predictor of onset of major depressive episode (MDE.The study used a prospective cohort design, conforming to the STROBE checklist. Participants were recruited from the employee population of a private think tank company (N = 4,270, and 1,058 (24.8% of them completed a baseline survey, of whom 929 were included in this study. Work engagement and psychological distress at baseline were assessed as predictor variables. MDE was measured at baseline and at each of the follow-ups as the outcome, using the web-based, self-administered version of the Japanese WHO-CIDI 3.0 depression section based upon DSM-IV-TR/DSM-5 criteria. Cox discrete-time hazards analyses were conducted to estimate hazard ratios (95% confidence intervals CIs.Follow-up rates of participants (N = 929 were 78.4%, 67.2%, and 51.6% at 1-, 2-, and 3-year follow-ups, respectively. The association between work engagement at baseline and the onset of MDE was U-shaped. Compared with a group with low work engagement scores, groups with the middle and high scores showed significantly (HR = 0.19, 95% CI = 0.05 to 0.64; p = 0.007 and marginally significantly (HR = 0.48, 95% CI = 0.20 to 1.15, p = 0.099 lower risks of MDE, respectively, over the follow-ups, after adjusting for covariates. The pattern remained the same after additionally adjusting for psychological distress.The present study first demonstrated work engagement as an important predictor of the onset of MDE diagnosed according to an internationally standard diagnostic criteria of mental disorders.

  13. Work Engagement as a Predictor of Onset of Major Depressive Episode (MDE) among Workers, Independent of Psychological Distress: A 3-Year Prospective Cohort Study.

    Science.gov (United States)

    Imamura, Kotaro; Kawakami, Norito; Inoue, Akiomi; Shimazu, Akihito; Tsutsumi, Akizumi; Takahashi, Masaya; Totsuzaki, Takafumi

    2016-01-01

    This study investigated work engagement as a baseline predictor of onset of major depressive episode (MDE). The study used a prospective cohort design, conforming to the STROBE checklist. Participants were recruited from the employee population of a private think tank company (N = 4,270), and 1,058 (24.8%) of them completed a baseline survey, of whom 929 were included in this study. Work engagement and psychological distress at baseline were assessed as predictor variables. MDE was measured at baseline and at each of the follow-ups as the outcome, using the web-based, self-administered version of the Japanese WHO-CIDI 3.0 depression section based upon DSM-IV-TR/DSM-5 criteria. Cox discrete-time hazards analyses were conducted to estimate hazard ratios (95% confidence intervals CIs). Follow-up rates of participants (N = 929) were 78.4%, 67.2%, and 51.6% at 1-, 2-, and 3-year follow-ups, respectively. The association between work engagement at baseline and the onset of MDE was U-shaped. Compared with a group with low work engagement scores, groups with the middle and high scores showed significantly (HR = 0.19, 95% CI = 0.05 to 0.64; p = 0.007) and marginally significantly (HR = 0.48, 95% CI = 0.20 to 1.15, p = 0.099) lower risks of MDE, respectively, over the follow-ups, after adjusting for covariates. The pattern remained the same after additionally adjusting for psychological distress. The present study first demonstrated work engagement as an important predictor of the onset of MDE diagnosed according to an internationally standard diagnostic criteria of mental disorders.

  14. Five-year outcome of a retrospective cohort study on the rehabilitation of completely edentulous atrophic maxillae with immediately loaded zygomatic implants placed extra-maxillary.

    Science.gov (United States)

    Maló, Paulo; Nobre, Miguel de Araújo; Lopes, Armando; Ferro, Ana; Moss, Steven

    2014-01-01

    To report retrospectively on the 5-year follow-up results of the rehabilitation of complete edentulous atrophied maxillae, using extra-maxillary zygomatic implants alone or in combination with conventional implants. This retrospective report includes an initial cohort of 39 patients (30 women and 9 men), with a mean age of 53 years, followed for 5 years. The patients were rehabilitated with 39 fixed prostheses and 169 implants (92 zygomatic implants inserted extra-maxillary and 77 conventional dental implants). A provisional prosthesis was manufactured and attached via multiunit abutments secured to the implants on the same day as implant placement. According to patient desires and each clinical situation, either an acrylic resin, a metal-acrylic or metal-ceramic final prosthesis was inserted approximately 6 months after implant placement. Outcome measures were: prosthesis success; implant success; complications; probing pocket depths; marginal bleeding; and marginal bone levels (only for conventional implants). Data were analysed with descriptive statistics. Two patients died after 8 and 30 months of follow-up due to causes unrelated to their oral rehabilitations, and 5 patients dropped out of the study. No prosthesis was lost; one zygomatic implant was removed after 46 months of follow-up, giving cumulative success rates of 97% and 98.8% (patient and implant related, respectively). Twelve complications occurred in 12 patients: 5 sinus infections in 5 patients, all with a previous history of sinusitis and whose sinus membrane was disrupted during surgery; one oroantral communication (leading to removal of the implant), 2 all acrylic resin prostheses fractures, 1 ceramic crown fracture (on a metal-ceramic prosthesis); and 3 screw loosenings. Bleeding on probing was recorded in 6 patients (13 implants). Probing pocket depths >4 mm were present in 13 patients (23 implants) at 5 years of follow-up. The average (standard deviation) marginal bone loss on conventional

  15. Prestroke Mobility and Dementia as Predictors of Stroke Outcomes in Patients Over 65 Years of Age: A Cohort Study From The Swedish Dementia and Stroke Registries.

    Science.gov (United States)

    Garcia-Ptacek, Sara; Contreras Escamez, Beatriz; Zupanic, Eva; Religa, Dorota; von Koch, Lena; Johnell, Kristina; von Euler, Mia; Kåreholt, Ingemar; Eriksdotter, Maria

    2018-02-01

    To explore the association between prestroke mobility dependency and dementia on functioning and mortality outcomes after stroke in patients>65 years of age. Longitudinal cohort study based on SveDem, the Swedish Dementia Registry and Riksstroke, the Swedish Stroke Registry. A total of 1689 patients with dementia >65 years of age registered in SveDem and suffering a first stroke between 2007 and 2014 were matched with 7973 controls without dementia with stroke. Odds ratios (ORs) and 95% confidence intervals (CIs) for intrahospital mortality, and functioning and mortality outcomes at 3 months were calculated. Functioning included level of residential assistance (living at home without help, at home with help, or nursing home) and mobility dependency (independent, needing help to move outdoors, or needing help indoors and outdoors). Prestroke dependency in activities of daily living and mobility were worse in patients with dementia than controls without dementia. In unadjusted analyses, patients with dementia were more often discharged to nursing homes (51% vs 20%; P mobility (OR 2.57; 2.20-3.02). Patients with dementia who were independent for mobility prestroke were more likely to be discharged to a nursing home compared with patients without dementia with the same prestroke mobility (37% vs 16%; P mobility limitations were associated with higher odds for poorer mobility, needing more residential assistance, and death. Patients with mobility impairments and/or dementia present a high burden of disability after a stroke. There is a need for research on stroke interventions among these populations. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  16. The health care cost of dying: a population-based retrospective cohort study of the last year of life in Ontario, Canada.

    Directory of Open Access Journals (Sweden)

    Peter Tanuseputro

    Full Text Available Coordinated and appropriate health care across sectors is an ongoing challenge, especially at the end-of-life. Population-level data on end-of-life health care use and cost, however, are seldom reported across a comprehensive array of sectors. Such data will identify the level of care being provided and areas where care can be optimized.This retrospective cohort study identified all deaths in Ontario from April 1, 2010 to March 31, 2013. Using population-based health administrative databases, we examined health care use and cost in the last year of life.Among 264,755 decedents, the average health care cost in the last year of life was $53,661 (Quartile 1-Quartile 3: $19,568-$66,875. The total captured annual cost of $4.7 billion represents approximately 10% of all government-funded health care. Inpatient care, incurred by 75% of decedents, contributed 42.9% of total costs ($30,872 per user. Physician services, medications/devices, laboratories, and emergency rooms combined to less than 20% of total cost. About one-quarter used long-term-care and 60% used home care ($34,381 and $7,347 per user, respectively. Total cost did not vary by sex or neighborhood income quintile, but were less among rural residents. Costs rose sharply in the last 120 days prior to death, predominantly for inpatient care.This analysis adds new information about the breadth of end-of-life health care, which consumes a large proportion of Ontario's health care budget. The cost of inpatient care and long-term care are substantial. Introducing interventions that reduce or delay institutional care will likely reduce costs incurred at the end of life.

  17. Is there an occupational status gradient in the development of periodontal disease in Japanese workers? A 5-year prospective cohort study

    Directory of Open Access Journals (Sweden)

    Koichiro Irie

    2017-02-01

    Full Text Available Background: Development of periodontal disease (PD may be affected by socioeconomic status. This study examined the relationship between occupational status and PD in a 5-year prospective cohort of Japanese workers. Methods: In total, 19,633 participants had initial examinations at the Aichi Health Promotion Foundation, of whom 8210 participants aged 20 years or older did not have PD. Follow-up examinations were conducted for 3757 participants, accounting for 45.8% of baseline participants. Ultimately, 3390 participants were analyzed according to the criterion of job classification at baseline, which was based on the International Standard Classification of Occupations, 1987. Oral examinations were performed using the Community Periodontal Index (CPI. The CPI scores were coded as follows: healthy (score of 0; bleeding after probing (1; dental calculus (2; shallow pockets (3; and deep pockets (4. Participants with one or more sextants with a score >2 were diagnosed with PD. Poisson regression analysis was performed to adjust for age and other potential confounders. Results: Overall, 31.6% of men and 23.8% of women had developed PD (CPI scores of 3 or 4. The adjusted relative risk (RR for PD (CPI scores of 3 or 4 in men was not significant. On the other hand, the adjusted RRs for PD (CPI score of 4 in men were 2.52-, 2.39-, and 2.74-fold higher for skilled workers, sales persons, and drivers, respectively, than for professionals. In contrast, we found no gradient in women. Conclusions: We found a gradient related to the risk of developing PD according to occupational status among men in a Japanese worker population.

  18. Is there an occupational status gradient in the development of periodontal disease in Japanese workers? A 5-year prospective cohort study.

    Science.gov (United States)

    Irie, Koichiro; Yamazaki, Toru; Yoshii, Saori; Takeyama, Hideo; Shimazaki, Yoshihiro

    2017-02-01

    Development of periodontal disease (PD) may be affected by socioeconomic status. This study examined the relationship between occupational status and PD in a 5-year prospective cohort of Japanese workers. In total, 19,633 participants had initial examinations at the Aichi Health Promotion Foundation, of whom 8210 participants aged 20 years or older did not have PD. Follow-up examinations were conducted for 3757 participants, accounting for 45.8% of baseline participants. Ultimately, 3390 participants were analyzed according to the criterion of job classification at baseline, which was based on the International Standard Classification of Occupations, 1987. Oral examinations were performed using the Community Periodontal Index (CPI). The CPI scores were coded as follows: healthy (score of 0); bleeding after probing (1); dental calculus (2); shallow pockets (3); and deep pockets (4). Participants with one or more sextants with a score >2 were diagnosed with PD. Poisson regression analysis was performed to adjust for age and other potential confounders. Overall, 31.6% of men and 23.8% of women had developed PD (CPI scores of 3 or 4). The adjusted relative risk (RR) for PD (CPI scores of 3 or 4) in men was not significant. On the other hand, the adjusted RRs for PD (CPI score of 4) in men were 2.52-, 2.39-, and 2.74-fold higher for skilled workers, sales persons, and drivers, respectively, than for professionals. In contrast, we found no gradient in women. We found a gradient related to the risk of developing PD according to occupational status among men in a Japanese worker population. Copyright © 2016 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

  19. The incidence of diabetes mellitus and diabetic retinopathy in a population-based cohort study of people age 50 years and over in Nakuru, Kenya.

    Science.gov (United States)

    Bastawrous, Andrew; Mathenge, Wanjiku; Wing, Kevin; Bastawrous, Madeleine; Rono, Hillary; Weiss, Helen A; Macleod, David; Foster, Allen; Peto, Tunde; Blows, Peter; Burton, Matthew; Kuper, Hannah

    2017-03-23

    The epidemic rise of diabetes carries major negative public health and economic consequences particularly for low and middle-income countries. The highest predicted percentage growth in diabetes is in the sub-Saharan Africa (SSA) region where to date there has been no data on the incidence of diabetic retinopathy from population-based cohort studies and minimal data on incident diabetes. The primary aims of this study were to estimate the cumulative six-year incidence of Diabetes Mellitus (DM) and DR (Diabetic Retinopathy), respectively, among people aged ≥50 years in Kenya. Random cluster sampling with probability proportionate to size were used to select a representative cross-sectional sample of adults aged ≥50 years in 2007-8 in Nakuru District, Kenya. A six-year follow-up was undertaken in 2013-14. On both occasions a comprehensive ophthalmic examination was performed including LogMAR visual acuity, digital retinal photography and independent grading of images. Data were collected on general health and risk factors. The primary outcomes were the incidence of diabetes mellitus and the incidence of diabetic retinopathy, which were calculated by dividing the number of events identified at 6-year follow-up by the number of people at risk at the beginning of follow-up. Age-adjusted risk ratios of the outcomes (DM and DR respectively) were estimated for each covariate using a Poisson regression model with robust error variance to allow for the clustered design and including inverse-probability weighting. At baseline, 4414 participants aged ≥50 years underwent complete examination. Of the 4104 non-diabetic participants, 2059 were followed-up at six-years (50 · 2%). The cumulative incidence of DM was estimated at 61 · 0 per 1000 (95% CI: 50 · 3-73 · 7) in people aged ≥50 years. The cumulative incidence of DR in the sample population was estimated at 15 · 8 per 1000 (95% CI: 9 · 5-26 · 3) among those without DM at baseline

  20. Food Choices and Coronary Heart Disease: A Population Based Cohort Study of Rural Swedish Men with 12 Years of Follow-up

    OpenAIRE

    Holmberg, Sara; Thelin, Anders; Stiernstr?m, Eva-Lena

    2009-01-01

    Coronary heart disease is associated with diet. Nutritional recommendations are frequently provided, but few long term studies on the effect of food choices on heart disease are available. We followed coronary heart disease morbidity and mortality in a cohort of rural men (N = 1,752) participating in a prospective observational study. Dietary choices were assessed at baseline with a 15-item food questionnaire. 138 men were hospitalized or deceased owing to coronary heart disease during the 12...

  1. Predictors of mortality and short-term physical and cognitive dependence in critically ill persons 75 years and older: a prospective cohort study.

    Science.gov (United States)

    Daubin, Cédric; Chevalier, Stéphanie; Séguin, Amélie; Gaillard, Cathy; Valette, Xavier; Prévost, Fabrice; Terzi, Nicolas; Ramakers, Michel; Parienti, Jean-Jacques; du Cheyron, Damien; Charbonneau, Pierre

    2011-05-16

    The purpose of this study was to identify predictors of 3-month mortality in critically ill older persons under medical care and to assess the clinical impact of an ICU stay on physical and cognitive dependence and subjective health status in survivors. We conducted a prospective observational cohort study including all older persons 75 years and older consecutively admitted into ICU during a one-year period, except those admitted after cardiac arrest, All patients were followed for 3 months or until death. Comorbidities were assessed using the Charlson index and physical dependence was evaluated using the Katz index of Activity of Daily Living (ADL). Cognitive dependence was determined by a score based on the individual components of the Lawton index of Daily Living and subjective health status was evaluated using the Nottingham Health Profile (NHP) score. One hundred patients were included in the analysis. The mean age was 79.3 ± 3.4 years. The median Charlson index was 6 [IQR, 4 to 7] and the mean ADL and cognitive scores were 5.4 ± 1.1 and 1.2 ± 1.4, respectively, corresponding to a population with a high level of comorbidities but low physical and cognitive dependence. Mortality was 61/100 (61%) at 3 months. In multivariate analysis only comorbidities assessed by the Charlson index [Adjusted Odds Ratio, 1.6; 95% CI, 1.2-2.2; p physical (p = 0.04), and cognitive (p = 0.62) dependence in survivors had changed very little at 3 months. In addition, the mean NHP score was 213.1 ± 132.8 at 3 months, suggesting an acceptable perception of their quality of life. In a selected population of non surgical patients 75 years and older, admission into the ICU is associated with a 3-month survival rate of 38% with little impact on physical and cognitive dependence and subjective health status. Nevertheless, a high comorbidity level (ie, Charlson index), multi-organ failure, and the need for extra-renal support at the early phase of intensive care could be considered as

  2. Change in lifestyle behaviors and diabetes risk: evidence from a population-based cohort study with 10 year follow-up.

    Science.gov (United States)

    Feldman, Adina L; Long, Gráinne H; Johansson, Ingegerd; Weinehall, Lars; Fhärm, Eva; Wennberg, Patrik; Norberg, Margareta; Griffin, Simon J; Rolandsson, Olov

    2017-03-29

    Promoting positive changes in lifestyle behavior in the whole population may be a feasible and effective approach to reducing type 2 diabetes burden, but the impact of population shifts of modifiable risk factors remains unclear. Currently most of the evidence on modifiable lifestyle behavior and type 2 diabetes risk on a population level comes from studies of between-individual differences. The objective of the study was to investigate the association and potential impact on disease burden for within-individual change in lifestyle behavior and diabetes risk. Population-based prospective cohort study of 35,680 participants aged 30-50 at baseline in 1990-2003 in Västerbotten County, Sweden (follow-up until 2013). Five self-reported modifiable lifestyle behaviors (tobacco use, physical activity, alcohol intake, dietary fiber intake and dietary fat intake) were measured at baseline and 10 year follow-up. Lifestyle behaviors were studied separately, and combined in a score. Incident diabetes was detected by oral glucose tolerance tests. Multivariate logistic regression models and population attributable fractions (PAF) were used to analyze the association between change in lifestyle behavior between baseline and 10 year follow-up, and risk of incident diabetes. Incident diabetes was detected in 1,184 (3.3%) participants at 10 year follow-up. There was a reduced diabetes risk associated with increase in dietary fiber intake, odds ratio (OR) 0.79 (95% confidence interval (CI) 0.66, 0.96) for increase of at least one unit standard deviation (3.0 g/1,000 kcal) of the baseline distribution, PAF 16.0% (95% CI 4.2, 26.4%). Increase in the lifestyle behavior score was associated with reduced diabetes risk, OR 0.92 (95% CI 0.85, 0.99) per unit increase of the score. These results support a causal link between lifestyle behavior and type 2 diabetes incidence. A small shift in lifestyle behaviors, in particular intake of dietary fiber, has the potential to reduce diabetes

  3. Does the impact of subsequent incontinence risk factors depend on continence status during the first pregnancy or the postpartum period 12 years before? A cohort study in 232 primiparous women

    DEFF Research Database (Denmark)

    Viktrup, L.; Rortveit, G.; Lose, G.

    2008-01-01

    OBJECTIVE: Assess the impact of subsequent urinary incontinence risk factors in women with different urinary incontinence history. STUDY DESIGN: In a cohort study 232 women answered validated questions about urinary incontinence after the first delivery and 12 years later. Women who were continent...

  4. Vitamin C Status Correlates with Markers of Metabolic and Cognitive Health in 50-Year-Olds: Findings of the CHALICE Cohort Study

    Directory of Open Access Journals (Sweden)

    John F. Pearson

    2017-08-01

    Full Text Available A cohort of 50-year-olds from Canterbury, New Zealand (N = 404, representative of midlife adults, undertook comprehensive health and dietary assessments. Fasting plasma vitamin C concentrations (N = 369 and dietary vitamin C intake (N = 250 were determined. The mean plasma vitamin C concentration was 44.2 µmol/L (95% CI 42.4, 46.0; 62% of the cohort had inadequate plasma vitamin C concentrations (i.e., <50 µmol/L, 13% of the cohort had hypovitaminosis C (i.e., <23 µmol/L, and 2.4% had plasma vitamin C concentrations indicating deficiency (i.e., <11 µmol/L. Men had a lower mean plasma vitamin C concentration than women, and a higher percentage of vitamin C inadequacy and deficiency. A higher prevalence of hypovitaminosis C and deficiency was observed in those of lower socio-economic status and in current smokers. Adults with higher vitamin C levels exhibited lower weight, BMI and waist circumference, and better measures of metabolic health, including HbA1c, insulin and triglycerides, all risk factors for type 2 diabetes. Lower levels of mild cognitive impairment were observed in those with the highest plasma vitamin C concentrations. Plasma vitamin C showed a stronger correlation with markers of metabolic health and cognitive impairment than dietary vitamin C.

  5. The personal and health service impact of falls in 85 year olds: cross-sectional findings from the Newcastle 85+ cohort study.

    Directory of Open Access Journals (Sweden)

    Joanna Collerton

    Full Text Available Falls are common in older people and increase in prevalence with advancing old age. There is limited knowledge about their impact in those aged 85 years and older, the fastest growing age group of the population. We investigated the prevalence and impact of falls, and the overlap between falls, dizziness and blackouts, in a population-based sample of 85 year olds.Cross-sectional analysis of baseline data from Newcastle 85+ Cohort Study.Primary care, North-East England.816 men and women aged 85 years.Structured interview with research nurse. Cost-consequence analysis of fall-related healthcare costs.Over 38% (313/816 of participants had fallen at least once in the previous 12 months and of these: 10.6% (33/312 sustained a fracture, 30.1% (94/312 attended an emergency department, and 12.8% (40/312 were admitted to hospital. Only 37.2% (115/309 of fallers had specifically discussed their falls problem with their general practitioner and only 12.7% (39/308 had seen a falls specialist. The average annual healthcare cost per faller was estimated at £202 (inter-quartile range £174-£231 or US$329 ($284-$377. 'Worry about falling' was experienced by 42.0% (128/305 of fallers, 'loss of confidence' by 40.0% (122/305, and 'going out less often' by 25.9% (79/305; each was significantly more common in women, odds ratios (95% confidence interval for women: men of 2.63 (1.45-4.55, 4.00 (2.27-7.14, and 2.86 (1.54-5.56 respectively. Dizziness and blackouts were reported by 40.0% (318/796 and 6.4% (52/808 of participants respectively. There was marked overlap in the report of falls, dizziness and blackouts.Falls in 85 year olds are very common, associated with considerable psychological and physical morbidity, and have high impact on healthcare services. Wider use of fall prevention services is needed. Significant expansion in acute and preventative services is required in view of the rapid growth in this age group.

  6. Fish consumption and prenatal methylmercury exposure: cognitive and behavioral outcomes in the main cohort at 17 years from the Seychelles child development study.

    Science.gov (United States)

    Davidson, Philip W; Cory-Slechta, Deborah A; Thurston, Sally W; Huang, Li-Shan; Shamlaye, Conrad F; Gunzler, Douglas; Watson, Gene; van Wijngaarden, Edwin; Zareba, Grazyna; Klein, Jonathan D; Clarkson, Thomas W; Strain, J J; Myers, Gary J

    2011-12-01

    People worldwide depend upon daily fish consumption as a major source of protein and other nutrients. Fish are high in nutrients essential for normal brain development, but they also contain methylmercury (MeHg), a neurotoxicant. Our studies in a population consuming fish daily have indicated no consistent pattern of adverse associations between prenatal MeHg and children's development. For some endpoints we found performance improved with increasing prenatal exposure to MeHg. Follow up studies indicate this association is related to the beneficial nutrients present in fish. To determine if the absence of adverse outcomes and the presence of beneficial associations between prenatal MeHg and developmental outcomes previously reported persists into adolescence. This study was conducted on the Main Cohort of the Seychelles Child Development Study (SCDS). We examined the association between prenatal MeHg exposure and subjects' performance at 17 years of age on 27 endpoints. The test battery included the Wisconsin Card Sorting Test (WCST), the California Verbal Learning Test (CVLT), the Woodcock-Johnson (W-J-II) Achievement Test, subtests of the Cambridge Neuropsychological Test Automated Battery (CANTAB), and measures of problematic behaviors. Analyses for all endpoints were adjusted for postnatal MeHg, sex, socioeconomic status, maternal IQ, and child's age at testing and the child's IQ was added for problematic behavioral endpoints. Mean prenatal MeHg exposure was 6.9 ppm. There was no association between prenatal MeHg and 21 endpoints. Increasing prenatal MeHg was associated with better scores on four endpoints (higher W-J-II math calculation scores, reduced numbers of trials on the Intra-Extradimensional Shift Set of the CANTAB), fewer reports of substance use and incidents of and referrals for problematic behaviors in school. Increasing prenatal MeHg was adversely associated with one level of referrals to a school counselor. At age 17 years there was no consistent

  7. Comparison of Clinical Characteristic and Prognosis between Ovarian Clear Cell Carcinoma and Serous Carcinoma: A 10-Year Cohort Study of Chinese Patients.

    Science.gov (United States)

    Ye, Shuang; Yang, Jiaxin; You, Yan; Cao, Dongyan; Huang, Huifang; Wu, Ming; Chen, Jie; Lang, Jinghe; Shen, Keng

    2015-01-01

    To compare the clinicopathologic features and prognosis of Chinese patients with ovarian clear cell carcinoma (CCC) and serous carcinoma (SC). A retrospective cohort study was designed to investigate the clinicopathologic characteristic and prognosis of patients with CCC and SC who were diagnosed and treated in in a tertiary referral center (Peking Union Medical College Hospital) between 1999 and 2009. The Kaplan-Meier method and Cox regression were employed in the survival analysis. A total of 504 cases were included in the study, comprising 197 cases of CCC and 307 cases of SC. The mean age of the patients with SC was greater than of CCC patients (3.6±0.94, PPatients with CCC were more likely to be early-stage and optimally debulked (Ppatients with CCC had normal values, and the level was significantly lower than in patients with SC (Ppatients had platinum-resistant tumors compared with platinum-sensitive disease (45.7% in CCC vs. 61.0% in SC [P=0.008]). The 5-year survival rate was 51.2% in the CCC group vs. 49.8% in the SC group (P=0.428). Patients with advanced CCC had a statistically significant poorer overall survival (OS) compared with their SC counterparts (38.0 vs. 52.0 months; hazard ratio 1.584, 95% confidence interval [CI] 1.167-2.150, P=0.003). However, the advantage of improved progression-free survival (PFS) existed across all stages. Women with ovarian CCC presented at a younger age and early stage. Patients with ovarian CCC also had improved PFS, but they had similar OS compared to patients with SC. However, patients with advanced CCC had decreased survival.

  8. Dose-Response Relationship between Cumulative Occupational Lead Exposure and the Associated Health Damages: A 20-Year Cohort Study of a Smelter in China

    OpenAIRE

    Yue Wu; Jun-Ming Gu; Yun Huang; Yan-Ying Duan; Rui-Xue Huang; Jian-An Hu

    2016-01-01

    Long-term airborne lead exposure, even below official occupational limits, has been found to cause lead poisoning at higher frequencies than expected, which suggests that China’s existing occupational exposure limits should be reexamined. A retrospective cohort study was conducted on 1832 smelting workers from 1988 to 2008 in China. These were individuals who entered the plant and came into continuous contact with lead at work for longer than 3 months. The dose-response relationship between o...

  9. Effect of miscarriage history on maternal-infant bonding during the first year postpartum in the first baby study: a longitudinal cohort study.

    Science.gov (United States)

    Bicking Kinsey, Cara; Baptiste-Roberts, Kesha; Zhu, Junjia; Kjerulff, Kristen H

    2014-07-15

    Miscarriage, the unexpected loss of pregnancy before 20 weeks gestation, may have a negative effect on a mother's perception of herself as a capable woman and on her emotional health when she is pregnant again subsequent to the miscarriage. As such, a mother with a history of miscarriage may be at greater risk for difficulties navigating the process of becoming a mother and achieving positive maternal-infant bonding with an infant born subsequent to the loss. The aim of this study was to examine the effect of miscarriage history on maternal-infant bonding after the birth of a healthy infant to test the hypothesis that women with a history of miscarriage have decreased maternal-infant bonding compared to women without a history of miscarriage. We completed secondary analysis of the First Baby Study, a longitudinal cohort study, to examine the effect of a history of miscarriage on maternal-infant bonding at 1 month, 6 months, and 12 months after women experienced the birth of their first live-born baby. In a sample of 2798 women living in Pennsylvania, USA, we tested our hypothesis using linear regression analysis of Shortened Postpartum Bonding Questionnaire (S-PBQ) scores, followed by longitudinal analysis using a generalized estimating equations model with repeated measures. We found that women with a history of miscarriage had similar S-PBQ scores as women without a history of miscarriage at each of the three postpartum time points. Likewise, longitudinal analysis revealed no difference in the pattern of maternal-infant bonding scores between women with and without a history of miscarriage. Women in the First Baby Study with a history of miscarriage did not differ from women without a history of miscarriage in their reported level of bonding with their subsequently born infants. It is important for clinicians to recognize that even though some women may experience impaired bonding related to a history of miscarriage, the majority of women form a healthy bond

  10. The role of poverty in explaining health variations in 7-year-old children from different family structures: findings from the UK Millennium Cohort Study.

    Science.gov (United States)

    Pearce, Anna; Lewis, Hannah; Law, Catherine

    2013-02-01

    Despite rises in reconstituted and lone-parent families, relatively little is known about how the health of children in different family types varies, and the extent to which any differences might be explained by poverty. The authors examined this using cross-sectional data on 13 681 seven-year-olds from the Millennium Cohort Study. The authors estimated RRs and 95% CIs for having poor physical (general health, long-standing illness, injury, overweight, asthma, fits) and mental health (using strengths and difficulties scores) according to family structure using Poisson regression. The authors adjusted for confounders (aRR) and then investigated the role of poverty as a mediator by entering a poverty score (based on income, receipt of benefits, subjective poverty and material deprivation) into the main model. Children living in reconstituted and lone-parent families were at a slight increased risk of poor health compared with those living with two natural parents. Adjusting for poverty tended to remove the elevated risk of poor physical health in children living in lone-parent and reconstituted families. However, for the mental health outcomes, poverty tended to remove the elevated risk for lone parents but not for reconstituted families. For example, the aRR for borderline-abnormal total difficulties fell from 1.45 (1.22 to 1.72) to 1.34 (1.13 to 1.59) in children living in reconstituted families and from 1.29 (1.14 to 1.45) to 1.05 (0.92 to 1.19) in those living with lone parents. Poor physical and mental health was slightly more prevalent in children living in lone-parent or reconstituted families. Poverty reduction may help to reduce these differences, especially for children living with lone parents; however, alternative mechanisms should be also explored, particularly for children living in reconstituted families.

  11. Are babies conceived during Ramadan born smaller and sooner than babies conceived at other times of the year? A Born in Bradford Cohort Study.

    Science.gov (United States)

    Daley, Amanda; Pallan, Miranda; Clifford, Sue; Jolly, Kate; Bryant, Maria; Adab, Peymane; Cheng, K K; Roalfe, Andrea

    2017-07-01

    It is not known whether infants exposed to intermittent maternal fasting at conception are born smaller or have a higher risk of premature birth than those who are not. Doctors are therefore unsure about what advice to give women about the safety of Ramadan fasting. This cohort study aimed to investigate these questions in Muslim mother-infant pairs to inform prenatal care. Routinely collected data accessed from maternity records were the source for information. Mothers were considered exposed if they were Muslim and Ramadan overlapped with their infant conception date, estimated to be 14 days after the last menstrual period. Infants were included as exposed if their estimated conception date was in the first 21 days of Ramadan or 7 days prior to Ramadan. After adjusting for gestational age, maternal age, infant gender, maternal body mass index at booking, smoking status, gestational diabetes, parity and year of birth, there was no significant difference in birth weight between infants born to Muslim mothers who were conceived during Ramadan (n=479) and those who were not (n=4677) (adjusted mean difference =24.3 g, 95% CI -16.4 to 64.9). There was no difference in rates of premature births in exposed and unexposed women (5.2% vs 4.9%; OR=1.08, 95% CI 0.71 to 1.65). Healthy Muslim women considering becoming pregnant prior to, or during Ramadan, can be advised that fasting does not seem to have a detrimental effect on the size (weight) of their baby and it appears not to increase the likelihood of giving birth prematurely. 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/.

  12. Predictors of Persistent Anaemia in the First Year of Antiretroviral Therapy: A Retrospective Cohort Study from Goma, the Democratic Republic of Congo.

    Directory of Open Access Journals (Sweden)

    Pierre Zalagile Akilimali

    Full Text Available Anaemia is associated with adverse outcomes including early death in the first year of antiretroviral therapy (ART. This study reports on the factors associated with persistent anaemia among HIV-infected patients initiating ART in the Democratic Republic of Congo (DR Congo.We conducted a retrospective cohort study and analyzed data from patients receiving HIV care between January 2004 and December 2012 at two major hospitals in Goma, DR Congo. Haemoglobin concentrations of all patients on ART regimen were obtained prior to and within one year of ART initiation. A logistic regression model was used to identify the predictors of persistent anaemia after 12 months of ART.Of 756 patients, 69% of patients were anaemic (IC95%: 65.7-72.3 at baseline. After 12 months of follow up, there was a 1.2 g/dl average increase of haemoglobin concentration (P < 0.001 with differences depending on the therapeutic regimen. Patients who received zidovudine (AZT gained less than those who did not receive AZT (0.99 g/dl vs 1.33 g/dl; p< 0.001. Among 445 patient who had anaemia at the beginning, 33% (147/445 had the condition resolved. Among patients with anaemia at ART initiation, those who did not receive cotrimoxazole prophylaxis before starting ART(AOR 3.89; 95% CI 2.09-7.25; P < 0.001 and a AZT initial regimen (AOR 2.19; 95% CI 1.36-3.52; P < 0.001 were significantly at risk of persistent anaemia.More than two thirds of patients had anaemia at baseline. The AZT-containing regimen and absence of cotrimoxazole prophylaxis before starting ART were associated with persistent anaemia 12 months, after initiation of treatment. Considering the large proportion of patients with persistence of anaemia at 12 months, we suggest that it is necessary to conduct a large study to assess anaemia among HIV-infected patients in Goma.

  13. Do open youth unemployment and youth programs leave the same mental health scars?--Evidence from a Swedish 27-year cohort study.

    Science.gov (United States)

    Strandh, Mattias; Nilsson, Karina; Nordlund, Madelene; Hammarström, Anne

    2015-11-20

    Recent findings suggest that the mental health costs of unemployment are related to both short- and long-term mental health scars. The main policy tools for dealing with young people at risk of labor market exclusion are Active Labor Market Policy programs for youths (youth programs). There has been little research on the potential effects of participation in youth programs on mental health and even less on whether participation in such programs alleviates the long-term mental health scarring caused by unemployment. This study compares exposure to open youth unemployment and exposure to youth program participation between ages 18 and 21 in relation to adult internalized mental health immediately after the end of the exposure period at age 21 and two decades later at age 43. The study uses a five wave Swedish 27-year prospective cohort study consisting of all graduates from compulsory school in an industrial town in Sweden initiated in 1981. Of the original 1083 participants 94.3% of those alive were still participating at the 27-year follow up. Exposure to open unemployment and youth programs were measured between ages 18-21. Mental health, indicated through an ordinal level three item composite index of internalized mental health symptoms (IMHS), was measured pre-exposure at age 16 and post exposure at ages 21 and 42. Ordinal regressions of internalized mental health at ages 21 and 43 were performed using the Polytomous Universal Model (PLUM). Models were controlled for pre-exposure internalized mental health as well as other available confounders. Results show strong and significant relationships between exposure to open youth unemployment and IMHS at age 21 (OR = 2.48, CI = 1.57-3.60) as well as at age 43 (OR = 1.71, CI = 1.20-2.43). No such significant relationship is observed for exposure to youth programs at age 21 (OR = 0.95, CI = 0.72-1.26) or at age 43 (OR = 1.23, CI = 0.93-1.63). A considered and consistent active labor

  14. A protocol for resuscitation of severe burn patients guided by transpulmonary thermodilution and lactate levels: a 3-year prospective cohort study.

    Science.gov (United States)

    Sánchez, Manuel; García-de-Lorenzo, Abelardo; Herrero, Eva; Lopez, Teresa; Galvan, Beatriz; Asensio, María; Cachafeiro, Lucia; Casado, Cesar

    2013-08-15

    The use of urinary output and vital signs to guide initial burn resuscitation may lead to suboptimal resuscitation. Invasive hemodynamic monitoring may result in over-resuscitation. This study aimed to evaluate the results of a goal-directed burn resuscitation protocol that used standard measures of mean arterial pressure (MAP) and urine output, plus transpulmonary thermodilution (TPTD) and lactate levels to adjust fluid therapy to achieve a minimum level of preload to allow for sufficient vital organ perfusion. We conducted a three-year prospective cohort study of 132 consecutive critically burned patients. These patients underwent resuscitation guided by MAP (>65 mmHg), urinary output (0.5 to 1 ml/kg), TPTD and lactate levels. Fluid therapy was adjusted to achieve a cardiac index (CI) >2.5 L/minute/m² and an intrathoracic blood volume index (ITBVI) >600 ml/m2, and to optimize lactate levels. Statistical analysis was performed using mixed models. We also used Pearson or Spearman methods and the Mann-Whitney U-test. A total of 98 men and 34 women (mean age, 48 ± 18 years) was studied. The mean total body surface area (TBSA) burned was 35% ± 22%. During the early resuscitation phase, lactate levels were elevated (2.58 ± 2.05 mmol/L) and TPTD showed initial hypovolemia by the CI (2.68 ± 1.06 L/minute/m²) and the ITBVI (709 ± 254 mL/m²). At 24 to 32 hours, the CI and lactic levels were normalized, although the ITBVI remained below the normal range (744 ± 276 ml/m²). The mean fluid rate required to achieve protocol targets in the first 8 hours was 4.05 ml/kg/TBSA burned, which slightly increased in the next 16 hours. Patients with a urine output greater than or less than 0.5 ml/kg/hour did not show differences in heart rate, mean arterial pressure, CI, ITBVI or lactate levels. Initial hypovolemia may be detected by TPTD monitoring during the early resuscitation phase. This hypovolemia might not be reflected by blood pressure and hourly urine output. An

  15. Escalating Health Care Expenditures in Cancer Decedents' Last Year of Life: A Decade of Evidence from a Retrospective Population‐Based Cohort Study in Taiwan

    Science.gov (United States)

    Hung, Yen‐Ni; Liu, Tsang‐Wu; Wen, Fur‐Hsing; Chou, Wen‐Chi

    2017-01-01

    Abstract Background. No population‐based longitudinal studies on end‐of‐life (EOL) expenditures were found for cancer decedents. Methods. This population‐based, retrospective cohort study examined health care expenditures from 2001 to 2010 among 339,546 Taiwanese cancer decedents' last year of life. Individual patient‐level data were linked from administrative datasets. Health care expenditures were converted from Taiwan dollars to U.S. dollars by health‐specific purchasing power parity conversions to account for different health‐purchasing powers. Associations of patient, physician, hospital, and regional factors with EOL care expenditures were evaluated by multilevel linear regression model by generalized estimating equation method. Results. Mean annual EOL care expenditures for Taiwanese cancer decedents increased from 2000 to 2010 from U.S. $49,591 to U.S. $68,773, respectively, with one third of spending occurring in the patients' last month. Increased EOL care expenditures were associated with male gender, younger age, being married, diagnosed with hematological malignancies and cancers other than lung, gastric, and hepatic‐pancreatic cancers, and dying within 7–24 months of diagnosis. Patients spent less at EOL when they had higher comorbidities and metastatic disease, died within 6 months of diagnosis, were under care of oncologists, gastroenterologists, and intensivists, and received care at a teaching hospital with more terminally ill cancer patients. Higher EOL care expenditures were associated with greater EOL care intensity at the primary hospital and regional levels. Conclusion. Taiwanese cancer decedents consumed considerable National Health Insurance disbursements at EOL, totaling more than was consumed in six developed non‐U.S. countries surveyed in 2010. To slow increasing cost and improve EOL cancer care quality, interventions to ensure appropriate EOL care provision should target hospitals and clinicians less experienced in

  16. 10-year survival rate and the incidence of peri-implant disease of 374 titanium dental implants with a SLA surface: a prospective cohort study in 177 fully and partially edentulous patients

    NARCIS (Netherlands)

    van Velzen, F.J.J.; Ofec, R.; Schulten, E.A.J.M.; ten Bruggenkate, C.M.

    2015-01-01

    Purpose This prospective cohort study evaluates the 10-year survival and incidence of peri-implant disease at implant and patient level of sandblasted, large grid, and acid-etched titanium dental implants (Straumann, soft tissue level, SLA surface) in fully and partially edentulous patients.

  17. Change in HbA1c Levels between the Age of 8 Years and the Age of 12 Years in Dutch Children without Diabetes: The PIAMA Birth Cohort Study

    Science.gov (United States)

    Jansen, Hanneke; Wijga, Alet H.; Scholtens, Salome; Koppelman, Gerard H.; Postma, Dirkje S.; Brunekreef, Bert; de Jongste, Johan C.; Smit, Henriëtte A.; Stolk, Ronald P.

    2015-01-01

    Objective HbA1c is associated with cardiovascular risk in persons without diabetes and cardiovascular risk accumulates over the life course. Therefore, insight in factors determining HbA1c from childhood onwards is important. We investigated (lifestyle) determinants of HbA1c at age 12 years and the effects of growth on change in HbA1c and the tracking of HbA1c between the age of 8 and 12 years. Study Design and Methods Anthropometric measurements were taken and HbA1c levels were assessed in 955 children without diabetes aged around 12 years participating in the PIAMA birth cohort study. In 363 of these children HbA1c was also measured at age 8 years. Data on parents and children were collected prospectively by questionnaires. Results We found no significant association between known risk factors for diabetes and HbA1c at age 12 years. Mean(SD) change in HbA1c between ages 8 and 12 years was 0.6(0.7) mmol/mol per year (or 0.1(0.1) %/yr). Anthropometric measures at age 8 and their change between age 8 and 12 years were not associated with the change in HbA1c. 68.9% of the children remained in the same quintile or had an HbA1c one quintile higher or lower at age 8 years compared to age 12 years. Conclusion The lack of association between known risk factors for diabetes and HbA1c suggest that HbA1c in children without diabetes is relatively unaffected by factors associated with glycaemia. HbA1c at age 8 years is by far the most important predictor of HbA1c at age 12. Therefore, the ranking of HbA1c levels appear to be fairly stable over time. PMID:25875773

  18. A meta-analysis of four genome-wide association studies of survival to age 90 years or older: the Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium.

    Science.gov (United States)

    Newman, Anne B; Walter, Stefan; Lunetta, Kathryn L; Garcia, Melissa E; Slagboom, P Eline; Christensen, Kaare; Arnold, Alice M; Aspelund, Thor; Aulchenko, Yurii S; Benjamin, Emelia J; Christiansen, Lene; D'Agostino, Ralph B; Fitzpatrick, Annette L; Franceschini, Nora; Glazer, Nicole L; Gudnason, Vilmundur; Hofman, Albert; Kaplan, Robert; Karasik, David; Kelly-Hayes, Margaret; Kiel, Douglas P; Launer, Lenore J; Marciante, Kristin D; Massaro, Joseph M; Miljkovic, Iva; Nalls, Michael A; Hernandez, Dena; Psaty, Bruce M; Rivadeneira, Fernando; Rotter, Jerome; Seshadri, Sudha; Smith, Albert V; Taylor, Kent D; Tiemeier, Henning; Uh, Hae-Won; Uitterlinden, André G; Vaupel, James W; Walston, Jeremy; Westendorp, Rudi G J; Harris, Tamara B; Lumley, Thomas; van Duijn, Cornelia M; Murabito, Joanne M

    2010-05-01

    Genome-wide association studies (GWAS) may yield insights into longevity. We performed a meta-analysis of GWAS in Caucasians from four prospective cohort studies: the Age, Gene/Environment Susceptibility-Reykjavik Study, the Cardiovascular Health Study, the Framingham Heart Study, and the Rotterdam Study participating in the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium. Longevity was defined as survival to age 90 years or older (n = 1,836); the comparison group comprised cohort members who died between the ages of 55 and 80 years (n = 1,955). In a second discovery stage, additional genotyping was conducted in the Leiden Longevity Study cohort and the Danish 1905 cohort. There were 273 single-nucleotide polymorphism (SNP) associations with p < .0001, but none reached the prespecified significance level of 5 x 10(-8). Of the most significant SNPs, 24 were independent signals, and 16 of these SNPs were successfully genotyped in the second discovery stage, with one association for rs9664222, reaching 6.77 x 10(-7) for the combined meta-analysis of CHARGE and the stage 2 cohorts. The SNP lies in a region near MINPP1 (chromosome 10), a well-conserved gene involved in regulation of cellular proliferation. The minor allele was associated with lower odds of survival past age 90 (odds ratio = 0.82). Associations of interest in a homologue of the longevity assurance gene (LASS3) and PAPPA2 were not strengthened in the second stage. Survival studies of larger size or more extreme or specific phenotypes may support or refine these initial findings.

  19. Impact of Caregiver Type for 3-Year-Old Children on Subsequent Between-Meal Eating Habits and Being Overweight From Childhood to Adulthood: A 20-Year Follow-up of the Ibaraki Children’s Cohort (IBACHIL Study

    Directory of Open Access Journals (Sweden)

    Mizuki Sata

    2015-09-01

    Full Text Available Background: Because of the increasing number of mothers who continue to work after childbirth, participation in childcare has diversified. However, the impact of the main caregiver on children’s habits has not been determined. We sought to examine the effect of caregiver differences on childhood habituation of between-meal eating and body mass index (BMI. Methods: The Ibaraki Children’s Cohort Study involved 4592 Japanese children whose parents answered health questionnaires at age 3. Follow-up questionnaires were distributed to parents when children were 6 and 12 years old and to study subjects directly when they were 22 years old. We compared prevalence of between-meal eating and overweight as well as mean BMI at ages 6, 12, and 22 years, by their main daytime caregiver at age 3. Results: Compared to children cared for by mothers, those cared for by grandparents had a higher prevalence of between-meal eating before dinner for boys and girls at ages 6 and 12 years. At age 22 years, boys cared for by grandparents had a higher prevalence of overweight than those cared for by mothers (18.5% versus 11.2%, P = 0.037, but no such difference was noted in girls. However, both boys and girls cared for by grandparents had higher mean BMI over time than those cared for by mothers (coefficient = 0.47 kg/m2 for boys and coefficient = 0.35 kg/m2 for girls. Conclusions: Being cared for by grandparents at age 3 was associated with subsequent between-meal eating habits, being overweight, and increased mean BMI from childhood to adulthood.

  20. Population based absolute and relative survival to 1 year of people with diabetes following a myocardial infarction: A cohort study using hospital admissions data

    Directory of Open Access Journals (Sweden)

    Macey Steven M

    2010-06-01

    Full Text Available Abstract Background People with diabetes who experience an acute myocardial infarction (AMI have a higher risk of death and recurrence of AMI. This study was commissioned by the Department for Transport to develop survival tables for people with diabetes following an AMI in order to inform vehicle licensing. Methods A cohort study using data obtained from national hospital admission datasets for England and Wales was carried out selecting all patients attending hospital with an MI for 2003-2006 (inclusion criteria: aged 30+ years, hospital admission for MI (defined using ICD 10 code I21-I22. STATA was used to create survival tables and factors associated with survival were examined using Cox regression. Results Of 157,142 people with an MI in England and Wales between 2003-2006, the relative risk of death or recurrence of MI for those with diabetes (n = 30,407 in the first 90 days was 1.3 (95%CI: 1.26-1.33 crude rates and 1.16 (95%CI: 1.1-1.2 when controlling for age, gender, heart failure and surgery for MI compared with those without diabetes (n = 129,960. At 91-365 days post AMI the risk was 1.7 (95% CI 1.6-1.8 crude and 1.50 (95%CI: 1.4-1.6 adjusted. The relative risk of death or re-infarction was higher at younger ages for those with diabetes and directly after the AMI (Relative risk; RR: 62.1 for those with diabetes and 28.2 for those without diabetes aged 40-49 [compared with population risk]. Conclusions This is the first study to provide population based tables of age stratified risk of re-infarction or death for people with diabetes compared with those without diabetes. These tables can be used for giving advice to patients, developing a baseline to compare intervention studies or developing license or health insurance guidelines.

  1. Social class differences in secular trends in established coronary risk factors over 20 years: a cohort study of British men from 1978-80 to 1998-2000.

    Directory of Open Access Journals (Sweden)

    Sheena E Ramsay

    Full Text Available BACKGROUND: Coronary heart disease (CHD mortality in the UK since the late 1970s has declined more markedly among higher socioeconomic groups. However, little is known about changes in coronary risk factors in different socioeconomic groups. This study examined whether changes in established coronary risk factors in Britain over 20 years between 1978-80 and 1998-2000 differed between socioeconomic groups. METHODS AND FINDINGS: A socioeconomically representative cohort of 7735 British men aged 40-59 years was followed-up from 1978-80 to 1998-2000; data on blood pressure (BP, cholesterol, body mass index (BMI and cigarette smoking were collected at both points in 4252 survivors. Social class was based on longest-held occupation in middle-age. Compared with men in non-manual occupations, men in manual occupations experienced a greater increase in BMI (mean difference = 0.33 kg/m(2; 95%CI 0.14-0.53; p for interaction = 0.001, a smaller decline in non-HDL cholesterol (difference in mean change = 0.18 mmol/l; 95%CI 0.11-0.25, p for interaction≤0.0001 and a smaller increase in HDL cholesterol (difference in mean change = 0.04 mmol/l; 95%CI 0.02-0.06, p for interaction≤0.0001. However, mean systolic BP declined more in manual than non-manual groups (difference in mean change = 3.6; 95%CI 2.1-5.1, p for interaction≤0.0001. The odds of being a current smoker in 1978-80 and 1998-2000 did not differ between non-manual and manual social classes (p for interaction = 0.51. CONCLUSION: Several key risk factors for CHD and type 2 diabetes showed less favourable changes in men in manual occupations. Continuing priority is needed to improve adverse cardiovascular risk profiles in socially disadvantaged groups in the UK.

  2. Is underage abortion associated with adverse outcomes in early adulthood? A longitudinal birth cohort study up to 25 years of age.

    Science.gov (United States)

    Leppälahti, Suvi; Heikinheimo, Oskari; Kalliala, Ilkka; Santalahti, Päivi; Gissler, Mika

    2016-09-01

    Is underage abortion associated with adverse socioeconomic and health outcomes in early adulthood when compared with underage delivery? Underage abortion was not found to be associated with mental health problems in early adulthood, and socioeconomic outcomes were better among those who experienced abortion compared with those who gave birth. Teenage motherhood has been linked with numerous adverse outcomes in later life, including low educational levels and poor physical and mental health. Whether abortion at a young age predisposes to similar consequences is not clear. This nationwide, retrospective cohort study from Finland, included all women born in 1987 (n = 29 041) and followed until 2012. We analysed socioeconomic, psychiatric and risk-taking-related health outcomes up to 25 years of age after underage (abortion (n = 1041, 3.6%) and after childbirth (n = 394, 1.4%). Before and after conception analyses within the study groups were performed to further examine the association between abortion and adverse health outcomes. A group with no pregnancies up to 20 years of age (n = 25 312, 88.0%) served as an external reference group. We found no significant differences between the underage abortion and the childbirth group regarding risks of psychiatric disorders (adjusted odds ratio 0.96 [0.67-1.40]) or suffering from intentional or unintentional poisoning by medications or drugs (1.06 [0.57-1.98]). Compared with those who gave birth, girls who underwent abortion were less likely to achieve only a low educational level (0.41 [95% confidence interval 0.31-0.54]) or to be welfare-dependent (0.31 [0.22-0.45]), but more likely to suffer from injuries (1.51 [1.09-2.10]). Compared with the external control group, both pregnancy groups were disadvantaged already prior to the pregnancy. Psychiatric disorders and risk-taking-related health outcomes, including injury, were increased in the abortion group and in the childbirth group similarly on both sides of the pregnancy

  3. Implant Optimisation for Primary Hip Replacement in Patients over 60 Years with Osteoarthritis: A Cohort Study of Clinical Outcomes and Implant Costs Using Data from England and Wales.

    Directory of Open Access Journals (Sweden)

    Simon S Jameson

    Full Text Available Hip replacement is one of the most commonly performed surgical procedures worldwide; hundreds of implant configurations provide options for femoral head size, joint surface material and fixation method with dramatically varying costs. Robust comparative evidence to inform the choice of implant is needed. This retrospective cohort study uses linked national databases from England and Wales to determine the optimal type of replacement for patients over 60 years undergoing hip replacement for osteoarthritis.Implants included were the commonest brand from each of the four types of replacement (cemented, cementless, hybrid and resurfacing; the reference prosthesis was the cemented hip procedure. Patient reported outcome scores (PROMs, costs and risk of repeat (revision surgery were examined. Multivariable analyses included analysis of covariance to assess improvement in PROMs (Oxford hip score, OHS, and EQ5D index (9159 linked episodes and competing risks modelling of implant survival (79,775 procedures. Cost of implants and ancillary equipment were obtained from National Health Service procurement data.EQ5D score improvements (at 6 months were similar for all hip replacement types. In females, revision risk was significantly higher in cementless hip prostheses (hazard ratio, HR = 2.22, p<0.001, when compared to the reference hip. Although improvement in OHS was statistically higher (22.1 versus 20.5, p<0.001 for cementless implants, this small difference is unlikely to be clinically important. In males, revision risk was significantly higher in cementless (HR = 1.95, p = 0.003 and resurfacing implants, HR = 3.46, p<0.001, with no differences in OHS. Material costs were lowest with the reference implant (cemented, range £1103 to £1524 and highest with cementless implants (£1928 to £4285. Limitations include the design of the study, which is intrinsically vulnerable to omitted variables, a paucity of long-term implant survival data (reflecting the

  4. Relationships Among Changes in Health Behaviors in a Six-Year U.S. Navy Cohort

    National Research Council Canada - National Science Library

    Hurtado, Suzzanne

    1997-01-01

    ... to practice healthy behaviors in general. This study utilized longitudinal data to examine the relationships among changes in five key lifestyle behaviors among a 6-year cohort of U.S. Navy personnel...

  5. Historic cohort study in Montreal's fur industry.

    Science.gov (United States)

    Guay, D; Siemiatycki, J

    1987-01-01

    A historic cohort mortality study was carried out among two groups of male workers in the Montreal fur industry: 263 dressers and dyers and 599 fur garment manufacturers. The first group is exposed to a very wide variety of chemicals used in tanning, cleaning, and dyeing fur, including substances considered to be carcinogenic and/or mutagenic. The second group is exposed to residue from the dressing and dyeing stage and to respirable fur dust. The cohorts consisted of all active members of two unions as of January 1, 1966. The mean age of the workers was 43.2 and the mean number of years since first employment 14.1. The follow-up period was from January 1, 1966, to December 31, 1981; 95% of the workers were successfully traced. Observed deaths were compared with those expected based on mortality rates of the population of metropolitan Montreal. Standardized mortality ratios (SMRs) for the manufacturers were significantly low, probably because of the ethnic composition of the cohort and a healthy worker effect. SMRs for the dressers and dyers were also low, but not as low as for the manufacturers. When attention was restricted to the French Canadians in the cohort, the observed deaths were close to the expected; there was a noteworthy excess of colorectal cancer (four observed, 0.8 expected) for dressers and dyers. Apart from this weak suggestive evidence, the results did not indicate any excess mortality risks in the fur industry. However, because of the relatively small number of expected and observed deaths in the cohort and especially among the heavily exposed dressers and dyers, the confidence intervals around SMR estimates were wide and excess risks cannot be ruled out.

  6. [Revival after Ebola: multidisciplinary assessment at 1 year, prospect and follow-up study of surviving patients from Ebola in Guinea (PostEboGui cohort)].

    Science.gov (United States)

    Msellati, P; Touré, A; Sow, M S; Cécé, K; Taverne, B; Desclaux, A; Barry, M; Etard, J-F; Delaporte, E

    2016-10-01

    Ebola virus disease (EVD) epidemic that spread in West Africa from the end of 2013 to early 2016 has reached more people than all past epidemics. Beyond care management of acute phase ill patients and measures for the control of the epidemic, the outcome of Ebola survivors became an important question as their number increased and raised new issues. A multidisciplinary prospective cohort of survivors in Guinea has been launched by IRD UMI 233 and Donka National Hospital, Conakry, Guinea, to assess the long-term clinical, psychological, sociological, immunological, and viral outcomes potentially related to EVD. This paper describes PostEboGui Programme, constraints and changes to the initial proposal, participants, first results, and new issues, 1 year after its start, in a descriptive and critical view. We started also to work on ethical aspects in the context of epidemics and of mass interventions with a risk of overinvestigation of patients.

  7. Changes in white matter as determinant of global functional decline in older independent outpatients: three year follow-up of LADIS (leukoaraiosis and disability) study cohort

    DEFF Research Database (Denmark)

    Inzitari, Domenico; Pracucci, Giovanni; Poggesi, Anna

    2009-01-01

    OBJECTIVE: To assess the impairment in daily living activities in older people with age related changes in white matter according to the severity of these changes. DESIGN: Observational data collection and follow-up of a cohort of older people undergoing brain magnetic resonance imaging after non-disabling...... complaints. SETTING: 11 European centres. PARTICIPANTS: 639 non-disabled older patients (mean age 74.1 (SD 5.0), 45.1% men) in whom brain magnetic resonance imaging showed mild, moderate, or severe age related changes in white matter (Fazekas scale). Magnetic resonance imaging assessment also included...... cerebral infarcts and atrophy. MAIN OUTCOME MEASURE: Transition from no disability (defined as a score of 0 or 1 on the instrumental activities of daily living scale) to disability (score >/=2) or death over three year follow-up. Secondary outcomes were incident dementia and stroke. RESULTS: Over a mean...

  8. Prevalence and impact of diffuse axonal injury in patients with moderate and severe head injury: a cohort study of early magnetic resonance imaging findings and 1-year outcome.

    Science.gov (United States)

    Skandsen, Toril; Kvistad, Kjell Arne; Solheim, Ole; Strand, Ingrid Haavde; Folvik, Mari; Vik, Anne

    2010-09-01

    In this prospective cohort study the authors examined patients with moderate to severe head injuries using MR imaging in the early phase. The objective was to explore the occurrence of diffuse axonal injury (DAI) and determine whether DAI was related to level of consciousness and patient outcome. One hundred and fifty-nine patients (age range 5-65 years) with traumatic brain injury, who survived the acute phase, and who had a Glasgow Coma Scale (GCS) score of 3-13 were admitted between October 2004 and August 2008. Of these 159 patients, 106 were examined using MR imaging within 4 weeks postinjury. Patients were classified into 1 of 3 stages of DAI: Stage 1, in which lesions were confined to the lobar white matter; Stage 2, in which there were callosal lesions; and Stage 3, in which lesions occurred in the dorsolateral brainstem. The outcome measure used 12 months postinjury was the Glasgow Outcome Scale-Extended (GOSE). Diffuse axonal injury was detected in 72% of the patients and a combination of DAI and contusions or hematomas was found in 50%. The GCS score was significantly lower in patients with "pure DAI" (median GCS Score 9) than in patients without DAI (median GCS Score 12; p GOSE score of 7, and patients without DAI had a median GOSE score of 8 (p = 0.10). Outcome was better in patients with DAI Stage 1 (median GOSE Score 8) and DAI Stage 2 (median GOSE Score 7.5) than in patients with DAI Stage 3 (median GOSE Score 4; p < 0.001). Thus, in patients without any brainstem injury, there was no difference in good recovery between patients with DAI (67%) and patients without DAI (66%). Diffuse axonal injury was found in almost three-quarters of the patients with moderate and severe head injury who survived the acute phase. Diffuse axonal injury influenced the level of consciousness, and only in patients with DAI was GCS score related to outcome. Finally, DAI was a negative prognostic sign only when located in the brainstem.

  9. Ten-Year Mortality after a Breast Cancer Diagnosis in Women with Severe Mental Illness: A Danish Population-Based Cohort Study.

    Directory of Open Access Journals (Sweden)

    Anette Riisgaard Ribe

    Full Text Available Breast cancer is the leading cause of cancer death in women worldwide. Nevertheless, it is unknown whether higher mortality after breast cancer contributes to the life-expectancy gap of 15 years in women with severe mental illness (SMI.We estimated all-cause mortality rate ratios (MRRs of women with SMI, women with breast cancer and women with both disorders compared to women with neither disorder using data from nationwide registers in Denmark for 1980-2012.The cohort included 2.7 million women, hereof 31,421 women with SMI (12,852 deaths, 104,342 with breast cancer (52,732 deaths, and 1,106 with SMI and breast cancer (656 deaths. Compared to women with neither disorder, the mortality was 118% higher for women with SMI (MRR: 2.18, 95% confidence interval (CI: 2.14-2.22, 144% higher for women with breast cancer (MRR: 2.44, 95% CI: 2.42-2.47 and 327% higher for women with SMI and breast cancer (MRR: 4.27, 95% CI: 3.98-4.57. Among women with both disorders, 15% of deaths could be attributed to interaction. In a sub-cohort of women with breast cancer, the ten-year all-cause-mortality was 59% higher after taking tumor stage into account (MRR: 1.59, 95% CI: 1.47-1.72 for women with versus without SMI.The mortality among women with SMI and breast cancer was markedly increased. More information is needed to determine which factors might explain this excess mortality, such as differences between women with and without SMI in access to diagnostics, provision of care for breast cancer or physical comorbidity, health-seeking-behavior, and adherence to treatment.

  10. Escalating Health Care Expenditures in Cancer Decedents' Last Year of Life: A Decade of Evidence from a Retrospective Population-Based Cohort Study in Taiwan.

    Science.gov (United States)

    Hung, Yen-Ni; Liu, Tsang-Wu; Wen, Fur-Hsing; Chou, Wen-Chi; Tang, Siew Tzuh

    2017-04-01

    No population-based longitudinal studies on end-of-life (EOL) expenditures were found for cancer decedents. This population-based, retrospective cohort study examined health care expenditures from 2001 to 2010 among 339,546 Taiwanese cancer decedents' last year of life. Individual patient-level data were linked from administrative datasets. Health care expenditures were converted from Taiwan dollars to U.S. dollars by health-specific purchasing power parity conversions to account for different health-purchasing powers. Associations of patient, physician, hospital, and regional factors with EOL care expenditures were evaluated by multilevel linear regression model by generalized estimating equation method. Mean annual EOL care expenditures for Taiwanese cancer decedents increased from 2000 to 2010 from U.S. $49,591 to U.S. $68,773, respectively, with one third of spending occurring in the patients' last month. Increased EOL care expenditures were associated with male gender, younger age, being married, diagnosed with hematological malignancies and cancers other than lung, gastric, and hepatic-pancreatic cancers, and dying within 7-24 months of diagnosis. Patients spent less at EOL when they had higher comorbidities and metastatic disease, died within 6 months of diagnosis, were under care of oncologists, gastroenterologists, and intensivists, and received care at a teaching hospital with more terminally ill cancer patients. Higher EOL care expenditures were associated with greater EOL care intensity at the primary hospital and regional levels. Taiwanese cancer decedents consumed considerable National Health Insurance disbursements at EOL, totaling more than was consumed in six developed non-U.S. countries surveyed in 2010. To slow increasing cost and improve EOL cancer care quality, interventions to ensure appropriate EOL care provision should target hospitals and clinicians less experienced in providing EOL care and those who tend to provide aggressive EOL care to

  11. Pre-test probability risk scores and their use in contemporary management of patients with chest pain: One year stress echo cohort study

    Science.gov (United States)

    Demarco, Daniela Cassar; Papachristidis, Alexandros; Roper, Damian; Tsironis, Ioannis; Byrne, Jonathan; Monaghan, Mark

    2015-01-01

    Objectives To compare how patients with chest pain would be investigated, based on the two guidelines available for UK cardiologists, on the management of patients with stable chest pain. The UK National Institute of Clinical Excellence (NICE) guideline which was published in 2010 and the European society of cardiology (ESC) guideline published in 2013. Both guidelines utilise pre-test probability risk scores, to guide the choice of investigation. Design We undertook a large retrospective study to investigate the outcomes of stress echocardiography. Setting A large tertiary centre in the UK in a contemporary clinical practice. Participants Two thirds of the patients in the cohort were referred from our rapid access chest pain clinics. Results We found that the NICE risk score overestimates risk by 20% compared to the ESC Risk score. We also found that based on the NICE guidelines, 44% of the patients presenting with chest pain, in this cohort, would have been investigated invasively, with diagnostic coronary angiography. Using the ESC guidelines, only 0.3% of the patients would be investigated invasively. Conclusion The large discrepancy between the two guidelines can be easily reduced if NICE adopted the ESC risk score. PMID:26673458

  12. Cohort profile: the lidA Cohort Study-a German Cohort Study on Work, Age, Health and Work Participation.

    Science.gov (United States)

    Hasselhorn, Hans Martin; Peter, Richard; Rauch, Angela; Schröder, Helmut; Swart, Enno; Bender, Stefan; du Prel, Jean-Baptist; Ebener, Melanie; March, Stefanie; Trappmann, Mark; Steinwede, Jacob; Müller, Bernd Hans

    2014-12-01

    The lidA Cohort Study (German Cohort Study on Work, Age, Health and Work Participation) was set up to investigate and follow the effects of work and work context on the physical and psychological health of the ageing workforce in Germany and subsequently on work participation. Cohort participants are initially employed people subject to social security contributions and born in either 1959 (n = 2909) or 1965 (n = 3676). They were personally interviewed in their homes in 2011 and will be visited every 3 years. Data collection comprises socio-demographic data, work and private exposures, work ability, work and work participation attitudes, health, health-related behaviour, personality and attitudinal indicators. Employment biographies are assessed using register data. Subjective health reports and physical strength measures are complemented by health insurance claims data, where permission was given. A conceptual framework has been developed for the lidA Cohort Study within which three confirmatory sub-models assess the interdependencies of work and health considering age, gender and socioeconomic status. The first set of the data will be available to the scientific community by 2015. Access will be given by the Research Data Centre of the German Federal Employment Agency at the Institute for Employment Research (http://fdz.iab.de/en.aspx). © The Author 2014. Published by Oxford University Press on behalf of the International Epidemiological Association.

  13. Breastfeeding, weight gain in infancy, and overweight at seven years of age - The prevention and incidence of asthma and mite allergy birth cohort study

    NARCIS (Netherlands)

    Scholtens, Salome; Gehring, Ulrike; Brunekreef, Bert; Smit, Henriette A.; de Jongste, Johan C.; Kerkhof, Marjan; Gerritsen, Jorrit; Wijga, Alet H.

    2007-01-01

    Compared with nonbreastfed children, breastfed children tend to have a lower body mass index (BMI) at about 1 year of age. How the BMI of breastfed children develops after the first year when this difference in BMI at 1 year of age is considered is not clear. The authors studied the association

  14. Ten years after acquiring an HIV-1 infection: a study in a cohort of eleven neonates infected by aliquots from a single plasma donation

    NARCIS (Netherlands)

    van den Berg, H.; Gerritsen, E. J.; van Tol, M. J.; Dooren, L. J.; Vossen, J. M.

    1994-01-01

    We present data from a 10-year follow-up study of 11 children who had been infected in the neonatal period by small aliquots of plasma from a single donation. Three of the children died within the first 2.5 years of life, 5 other children died between 6.2 and 11 years after infection and 3 are alive

  15. Cohort study of atypical pressure ulcers development.

    Science.gov (United States)

    Jaul, Efraim

    2014-12-01

    Atypical pressure ulcers (APU) are distinguished from common pressure ulcers (PU) with both unusual location and different aetiology. The occurrence and attempts to characterise APU remain unrecognised. The purpose of this cohort study was to analyse the occurrence of atypical location and the circumstances of the causation, and draw attention to the prevention and treatment by a multidisciplinary team. The cohort study spanned three and a half years totalling 174 patients. The unit incorporates two weekly combined staff meetings. One concentrates on wound assessment with treatment decisions made by the physician and nurse, and the other, a multidisciplinary team reviewing all patients and coordinating treatment. The main finding of this study identified APU occurrence rate of 21% within acquired PU over a three and a half year period. Severe spasticity constituted the largest group in this study and the most difficult to cure wounds, located in medial aspects of knees, elbows and palms. Medical devices caused the second largest occurrence of atypical wounds, located in the nape of the neck, penis and nostrils. Bony deformities were the third recognisable atypical wound group located in shoulder blades and upper spine. These three categories are definable and time observable. APU are important to be recognisable, and can be healed as well as being prevented. The prominent role of the multidisciplinary team is primary in identification, prevention and treatment. © 2013 The Authors. International Wound Journal © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  16. Long-term risks after splenectomy among 8,149 cancer-free American veterans: a cohort study with up to 27 years follow-up

    Science.gov (United States)

    Kristinsson, Sigurdur Y.; Gridley, Gloria; Hoover, Robert N; Check, David; Landgren, Ola

    2014-01-01

    Although preservation of the spleen following abdominal trauma and spleen-preserving surgical procedures have become gold standards, about 22,000 splenectomies are still conducted annually in the USA. Infections, mostly by encapsulated organisms, are the most well-known complications following splenectomy. Recently, thrombosis and cancer have become recognized as potential adverse outcomes post-splenectomy. Among more than 4 million hospitalized USA veterans, we assessed incidence and mortality due to infections, thromboembolism, and cancer including 8,149 cancer-free veterans who underwent splenectomy with a follow-up of up to 27 years. Relative risk estimates and 95% confidence intervals were calculated using time-dependent Poisson regression methods for cohort data. Splenectomized patients had an increased risk of being hospitalized for pneumonia, meningitis, and septicemia (rate ratios=1.9–3.4); deep venous thrombosis and pulmonary embolism (rate ratios=2.2); certain solid tumors: buccal, esophagus, liver, colon, pancreas, lung, and prostate (rate ratios =1.3–1.9); and hematologic malignancies: non-Hodgkin lymphoma, Hodgkin lymphoma, multiple myeloma, acute myeloid leukemia, chronic lymphocytic leukemia, chronic myeloid leukemia, and any leukemia (rate ratios =1.8–6.0). They also had an increased risk of death due to pneumonia and septicemia (rate ratios =1.6–3.0); pulmonary embolism and coronary artery disease (rate ratios =1.4–4.5); any cancer: liver, pancreas, and lung cancer, non-Hodgkin lymphoma, Hodgkin lymphoma, and any leukemia (rate ratios =1.3–4.7). Many of the observed risks were increased more than 10 years after splenectomy. Our results underscore the importance of vaccination, surveillance, and thromboprophylaxis after splenectomy. PMID:24056815

  17. Comparison of the Outcomes of Individuals With Medically Attended Influenza A and B Virus Infections Enrolled in 2 International Cohort Studies Over a 6-Year Period

    DEFF Research Database (Denmark)

    Dwyer, Dominic E; Lynfield, Ruth; Losso, Marcelo H

    2017-01-01

    Background: Outcome data from prospective follow-up studies comparing infections with different influenza virus types/subtypes are limited. Methods: Demographic, clinical characteristics and follow-up outcomes for adults with laboratory-confirmed influenza A(H1N1)pdm09, A(H3N2), or B virus infect...... to be hospitalized than those with A(H3N2). Hospitalized patients infected with A(H1N1)pdm09 were younger and more likely to have severe disease at study entry (measured by ICU enrollment), but did not have worse 60-day outcomes.......Background: Outcome data from prospective follow-up studies comparing infections with different influenza virus types/subtypes are limited. Methods: Demographic, clinical characteristics and follow-up outcomes for adults with laboratory-confirmed influenza A(H1N1)pdm09, A(H3N2), or B virus...... infections were compared in 2 prospective cohorts enrolled globally from 2009 through 2015. Logistic regression was used to compare outcomes among influenza virus type/subtypes. Results: Of 3952 outpatients, 1290 (32.6%) had A(H1N1)pdm09 virus infection, 1857 (47.0%) had A(H3N2), and 805 (20.4%) had...

  18. Prevalence of SCN1A-related dravet syndrome among children reported with seizures following vaccination: a population-based ten-year cohort study.

    Directory of Open Access Journals (Sweden)

    Nienke E Verbeek

    Full Text Available OBJECTIVES: To determine the prevalence of Dravet syndrome, an epileptic encephalopathy caused by SCN1A-mutations, often with seizure onset after vaccination, among infants reported with seizures following vaccination. To determine differences in characteristics of reported seizures after vaccination in children with and without SCN1A-related Dravet syndrome. METHODS: Data were reviewed of 1,269 children with seizures following immunization in the first two years of life, reported to the safety surveillance system of the Dutch national immunization program between 1 January 1997 and 31 December 2006. Selective, prospective follow-up was performed of children with clinical characteristics compatible with a diagnosis of Dravet syndrome. RESULTS: In 21.9% (n = 279 of children, a diagnosis of Dravet syndrome could not be excluded based on available clinical data (median age at follow-up 16 months. Additional follow-up data were obtained in 83.9% (n = 234 of these children (median age 8.5 years. 15 (1.2% of 1,269; 95%CI:0.6 to 1.8% children were diagnosed with SCN1A-related Dravet syndrome. Of all reported seizures following vaccinations in the first year of life, 2.5% (95%CI:1.3 to 3.6% were due to SCN1A-related Dravet syndrome, as were 5.9% of reported seizures (95%CI:3.1 to 8.7% after 2(nd or 3(rd DTP-IPV-Hib vaccination. Seizures in children with SCN1A-related Dravet syndrome occurred more often with a body temperature below 38.5°C (57.9% vs. 32.6%, p = 0.020 and reoccurred more often after following vaccinations (26.7% vs. 4.0%, p = 0.003, than in children without a diagnosis of SCN1A-related Dravet Syndrome. CONCLUSIONS: Although Dravet syndrome is a rare genetic epilepsy syndrome, 2.5% of reported seizures following vaccinations in the first year of life in our cohort occurred in children with this disorder. Knowledge on the specific characteristics of vaccination-related seizures in this syndrome might promote early diagnosis

  19. 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

  20. A 5-year cohort study of the effects of high protein intake on lean mass and BMC in elderly postmenopausal women.

    Science.gov (United States)

    Meng, Xingqiong; Zhu, Kun; Devine, Amanda; Kerr, Deborah A; Binns, Colin W; Prince, Richard L

    2009-11-01

    Long-term effects of high dietary protein intake on muscle and bone structure in the elderly are not clear. The aim of this study was to investigate the relationship between baseline protein intake and lean mass and BMC 5 yr later in a cohort of elderly postmenopausal women. A total of 862 community-dwelling women 75 +/- 3 yr of age provided baseline data including nutrient intake assessed by a food frequency questionnaire. At 5 yr, upper arm muscle area (UAMA) and body composition using DXA were measured. Baseline protein intake was 81 +/- 28 g/d (1.2 +/- 0.4 g/kg/d), contributing 19 +/- 3% of total energy intake. There were positive correlations between baseline protein intake and whole body and appendicular bone-free lean mass and BMC (r = 0.14-0.18, p 87 g/d) had 5.4-6.0% higher whole body and appendicular lean mass and UAMA and 5.3-6.0% higher whole body and appendicular BMC. These effects remained after adjusting for potential confounders. However, the effect on BMC disappeared after further adjustment for lean mass. This study shows that high protein intake is associated with long-term beneficial effects on muscle mass and size and bone mass in elderly women. The protein effect on bone may be partly mediated by its effects on muscle.

  1. Maternal prenatal blood mercury is not adversely associated with offspring IQ at 8 years provided the mother eats fish: A British prebirth cohort study.

    Science.gov (United States)

    Golding, Jean; Hibbeln, Joseph R; Gregory, Steven M; Iles-Caven, Yasmin; Emond, Alan; Taylor, Caroline M

    2017-10-01

    Conflicting evidence concerning possible harm from mercury (Hg) in regard to offspring cognition if the woman eats fish has prompted this study to examine evidence from a British pre-birth cohort to investigate the relationship between the two. Pregnant women (median prenatal blood mercury 1.86μg/L) resident in the study area with delivery between April 1991 and December 1992 were followed up and verbal, performance and total intelligence quotient (IQ) of 2062 offspring were measured at age 8. Analysis treated IQ as (a) continuous and (b) the lowest 25% of the distribution. Multiple and logistic regression analyses took account of social and demographic variables. Stratification considered children of fish eaters separately. Before adjustment, mean full-scale IQ increased with increasing Hg (change with 1SD of Hg=+2.02; 95%CI+1.40,+2.64 IQ points; P mercury and offspring IQ appears to be benign provided the mother consumes fish. Copyright © 2017 The Authors. Published by Elsevier GmbH.. All rights reserved.

  2. A 5-year multicenter prospective cohort study on the long-term visual prognosis and predictive factors for visual outcome in Japanese patients with age-related macular degeneration: the AMD2000 study.

    Science.gov (United States)

    Akagi-Kurashige, Yumiko; Tsujikawa, Akitaka; Yuzawa, Mitsuko; Ishibashi, Tatsuro; Nakanishi, Hideo; Nakatani, Eiji; Teramukai, Satoshi; Fukushima, Masanori; Yoshimura, Nagahisa

    2018-03-01

    In this study (AMD2000), we aimed to determine the visual prognosis of Japanese patients with age-related macular degeneration (AMD). This was a multicenter prospective observational cohort study. In total, 460 patients with AMD were recruited from April 2006 to March 2009 from 18 clinical trial sites in Japan. They were followed up for 5 years, as they continued to receive medical treatment. Of the 409 study eyes followed up for at least 1 year, 243 eyes (59.4%) were treated with photodynamic therapy (PDT) using verteporfin, and 58 eyes (14.2%) were treated with intravitreal injections of antivascular endothelial growth factor agents as the initial treatment. The mean best-corrected visual acuities (BCVA) for typical AMD (tAMD; 0.688 ± 0.498) and polypoidal choroidal vasculopathy (PCV; 0.451 ± 0.395) were significantly less at 2 years (tAMD, 0.779 ± 0.632, P macular edema as well as the lesion size was associated with 5-year maintenance of the baseline BCVA. In some patients, the diagnosis changed: of the 192 eyes initially diagnosed with typical AMD, 19 were newly diagnosed with PCV during follow-up. Maintaining the baseline BCVA over the long term is difficult in Japanese eyes with wet AMD.

  3. Associations between skeletal growth in childhood and cognitive function in mid-life in a 53-year prospective birth cohort study.

    Directory of Open Access Journals (Sweden)

    Robert Stewart

    Full Text Available Several studies have found that shorter stature (height and limb length in late life is associated with dementia and cognitive impairment. The extent to which childhood environment and early life cognitive function accounts for these associations is not clear.We investigated associations of adult trunk height and leg length with cognitive function in middle age, analysing data from the MRC National Survey of Health and Development: a cohort followed from birth to age 53, 1677 of whom had data on all covariates. The four cognitive tests measured verbal ability, word list memory, verbal fluency and speed/concentration. Early life environmental measures included parental education, poverty, parental divorce, physical health, cognitive ability at age 15, own education and own adult social class.After adjusting for gender, shorter trunk length was associated with lower cognitive function on all four tests and shorter leg length with lower verbal intelligence and word list memory. These associations were only partially attenuated following adjustment for childhood adversity/health but were substantially accounted for by cognitive ability at age 15.Shorter stature was associated with lower cognitive function at age 53, the majority of this association being accounted for by cognitive function at age 15. Reduced cognitive reserve may well account for later associations between anthropometric measures and dementia.

  4. Associations between skeletal growth in childhood and cognitive function in mid-life in a 53-year prospective birth cohort study.

    Science.gov (United States)

    Stewart, Robert; Hardy, Rebecca; Richards, Marcus

    2015-01-01

    Several studies have found that shorter stature (height and limb length) in late life is associated with dementia and cognitive impairment. The extent to which childhood environment and early life cognitive function accounts for these associations is not clear. We investigated associations of adult trunk height and leg length with cognitive function in middle age, analysing data from the MRC National Survey of Health and Development: a cohort followed from birth to age 53, 1677 of whom had data on all covariates. The four cognitive tests measured verbal ability, word list memory, verbal fluency and speed/concentration. Early life environmental measures included parental education, poverty, parental divorce, physical health, cognitive ability at age 15, own education and own adult social class. After adjusting for gender, shorter trunk length was associated with lower cognitive function on all four tests and shorter leg length with lower verbal intelligence and word list memory. These associations were only partially attenuated following adjustment for childhood adversity/health but were substantially accounted for by cognitive ability at age 15. Shorter stature was associated with lower cognitive function at age 53, the majority of this association being accounted for by cognitive function at age 15. Reduced cognitive reserve may well account for later associations between anthropometric measures and dementia.

  5. Paternal smoking and spontaneous abortion: a population-based retrospective cohort study among non-smoking women aged 20-49 years in rural China.

    Science.gov (United States)

    Wang, Long; Yang, Ying; Liu, Fangchao; Yang, Aimin; Xu, Qin; Wang, Qiaomei; Shen, Haiping; Zhang, Yiping; Yan, Donghai; Peng, Zuoqi; He, Yuan; Wang, Yuanyuan; Xu, Jihong; Zhao, Jun; Zhang, Hongguang; Zhang, Ya; Dai, Qiaoyun; Ma, Xu

    2018-06-11

    To comprehensively evaluate the association of paternal smoking and spontaneous abortion. We conducted a population-based retrospective cohort study among 5 770 691 non-smoking rural Chinese women, along with their husbands, participating in the National Free Pre-Pregnancy Checkups Project, regarding outcome events that occurred in 2010-2016. The main outcome was spontaneous abortion (SA). Multivariable logistic regression was used to estimate OR and 95% CI, and restricted cubic spline was used to estimate the non-linear relationship. The multivariable-adjusted OR of exposure to paternal smoking for SA was 1.17 (95% CI 1.16 to 1.19), compared with women without exposure to paternal smoking; and corresponding OR of exposure to preconception paternal smoking for SA was 1.11 (95% CI 1.08 to 1.14), compared with women without exposure to preconception paternal smoking. The ORs of preconception paternal smoking also increased with increases in paternal smoking (p nonlinear 0.05). In addition, periconception paternal smoking cessation was associated with an 18% (15%-22%) lower risk of SA. Paternal smoking was associated with SA. The importance of tobacco control, specifically pertaining to paternal smoking, should be emphasised during preconception and pregnancy counselling. © 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.

  6. Maternal caffeine consumption from coffee and tea during pregnancy and behavioural disorders in 11-year-old offspring; a Danish national birth cohort study

    DEFF Research Database (Denmark)

    Mikkelsen, Susanne Hvolgaard; Obel, Carsten; Olsen, Jørn

    2017-01-01

    Objective: To examine the association between maternal caffeine consumption from coffee and tea during pregnancy and offspring behavioural disorders. Methods: We studied 47491 children enrolled in the Danish National Birth Cohort between 1996-2002. Data on maternal coffee and tea consumption...... consumed ≥8 cups/day of coffee or tea, respectively. Maternal coffee consumption ≥8 cups/day at 15 weeks of gestation was associated with increased risk of hyperactivity-inattention disorder (RR: 1.47 (1.18; 1.83)), conduct-oppositional disorders (RR: 1.22 (1.01; 1.48)) and any psychiatric disorder (RR: 1.......23 (1.08; 1